Heart disease warning for women

Fears are being raised that rising levels of obesity and diabetes may be affecting the fall in heart disease death rates in women aged under 50. Researchers from Oxford and Liverpool universities believe death rates among that age group may be plateauing after continuous falls since the 1970s. They studied all deaths in England and Wales from 1931 to 2005 and found the pace of the drop had started to slow. The team said the findings, in the BMC Public Health journal, were disturbing.

Heart disease death rates for all age groups increased until the 1970s, but have been falling continuously since. This has been put down to better treatment and a fall in the number of people smoking. However, the rate of the fall among women under 50 has started showing signs of slowing in contrast to the continuing increase in decline seen in older people. For example, the death rate in the 45-49 age group nearly halved from the rate it was between 1976 and 1985 to 15 deaths per 100,000 between 1986 and 1995. But in the 10-year period starting in 1996, it fell only to 12.5 deaths per 100,000.

Report author Peter Scarborough said: "What we may be seeing with the figures for women is a plateauing and in the future it may even rise. "It seems to me that the increased rates of obesity and diabetes are playing a role in this and if this pattern is emerging in women then it is quite likely we will see the same in men in the future." The report pointed out that obesity and diabetes levels have been rising in younger age groups over the last 10 years, while physical activity levels have fallen. However, Mr Scarborough also admitted that as the number of deaths in the younger age groups was relatively small, it was hard to draw accurate conclusions.

Professor Peter Weissberg, medical director for the British Heart Foundation, which helped to fund the study, said the findings were "worrying". "It's a common misconception that heart disease is a male problem, yet cardiovascular disease is the biggest cause of premature death in women. "Heart disease should be a very real issue for all women, and younger generations must take action now to cut down their risk."

Copyright BBC Health News Thursday 1st May 2008 00:04

Source: http://news.bbc.co.uk/1/hi/health/7375941.stm

'Bionic' eye gives blind people some sight

Surgeons have fitted "bionic eyes" to two men in their 50s to partially restore their eyesight. They are the first in Britain to have the artificial retinas fitted, in three-hour operations at Moorfields Eye hospital in London, it was confirmed yesterday. Both were completely blind, but will now be able to walk around unaided and identify simple objects. If the trial is successful, the £15,000 retinas could be approved for general use within three years. The men have an inherited disease, retinitis pigmentosa, which progressively destroys the eye's light-sensitive cells, and affects around 25,000 people in Britain.

The operation implanted a tiny metal plate studded with electrodes into the retina at the back of the eye. A little video camera mounted on a pair of glasses beams images to the electrodes, which connect via the optic nerve to the brain. Patients wear a small unit at their waist to power the camera and process the images. While not reproducing natural vision, the system enables the viewing of basic images on a 10 x 6 grid. The two Britons are among 15 patients given the artificial retinas as part of a three-year trial in the US, Mexico and Europe.

"These people are truly blind and are dependent on a stick, a dog or another person to find their way around. We want to see if we can give them some level of rudimentary vision which they find useful, predominantly to navigate, so they get some independence," said Lyndon da Cruz, a consultant surgeon who did the operations last week. Moorfields expects to treat three more patients soon, and a further five if there are no complications. The device is designed by a US company, Second Sight, and is an upgrade of a prototype first implanted in 2002 with 16 electrodes arranged in a 4 x 4 grid, enabling patients to walk about independently and distinguish basic objects such a cup or plate on a table. The latest version has 60 electrodes, giving much more detail. Doctors expect it will take the men a few months to learn to use the system.

Greg Cosendai, Second Sight's director for Europe, said: "They should receive enough information to be able to read. That doesn't mean it [definitely] will work for them, but it's certainly a milestone, along with recognising faces."

Linda Morfoot, 64, living in Long Beach, California, was diagnosed with retinitis pigmentosa at the age of 21 and was almost completely blind by the time she was 50, with only a small amount of light reception in her left eye. She had a 16-electrode implant in 2004. "When they gave me the glasses it was just amazing," she said. "I can shoot baskets with my grandson, I can stay in the middle of the sidewalk. I can find the door to get out of a room, and I can see my granddaughter dancing across the stage. "When we went to New York I could see the Statue of Liberty, how big it was. In Paris we went to the top of the Eiffel Tower at night, and I could see all the city lights. I feel more connected to what's around me."

Copyright The Guardian, Sample, I and R. Williams, 'Bionic' Eye gives blind people some sight, Tuesday April 22nd 2008, p.5 UK News.

Source: http://www.guardian.co.uk/science/2008/apr/22/medicalresearch.news

Bacterial Infection Treatment Hope

Bacteria which lie dormant and impervious to antibiotics could be activated briefly before being killed off, say scientists. Dormant E. coli bathed in nutrients in the lab were transformed for a few hours into a vulnerable, active state. Israeli researchers, reporting in Proceedings of the National Academy of Sciences, say this might be the best time for treatment. However, a British expert said the approach was "fraught with risks". Some bacteria are hard to treat because even large doses of antibiotics cannot clear the infection, with large numbers in an inactive state inside or outside cells.

When conditions are right, these dormant bacteria have the ability to reawaken and start to divide and spread once more. The best known of these is tuberculosis, and infected patients are given courses of drugs which last for many months to try to eradicate it, raising the risk both of the bacterium gaining resistance to the drugs, and of the patient failing to observe the drug regime. The researchers from The Hebrew University in Jerusalem believe that there may be a way to boost the effectiveness of antimicrobial drugs against dormant bacteria, by introducing a precisely-timed dose.

By measuring, in real-time, the chemicals produced, they proved that dormant E. coli bacteria bathed in a nutrient-rich broth sprung back to life, but only for a single hour. Shortly afterwards, they returned to their dormant state, and could survive a five-hour dose of antibiotics. While this was observed in the laboratory, so far the researchers have not created the same conditions in a human being to test their theory, or tested to see if the same effect could be produced in the laboratory using other bacteria, including TB.

Professor Michael Brown, a microbiologist from the University of Wolverhampton, said there were practical difficulties in aiming for a similar effect in humans. If the large numbers of dormant bacteria in a patient could be sparked to life at once, he said, this might well be counterproductive. "It could be a bit like awakening a sleeping giant," he said. "Even if you could bring all these bacteria out of dormancy, I don't believe that antibiotics or the patient's own immune system would be capable of eradicating them all." 

Copyright BBC Health News Tuesday 22nd April 2008 12:20

Source: http://news.bbc.co.uk/1/hi/health/7358453.stm

Therapy 'may slow tumour growth'

Scientists believe they have identified a gene that may be able to limit the growth of breast cancer tumours. The US National Cancer Institute found in tests on mice that tumours containing the Brd4 gene ended up 10 times smaller than ones that did not. And an analysis of studies involving human breast cancer patients revealed the presence of the gene may be useful as a predictor of survival chances. Cancer experts said more research was needed into the findings.

Researchers chose to study the effect of the Brd4 gene as it is known to influence the growth of cells. They believe the findings may not be limited solely to breast cancer, although they have yet to test that fully. In this study, published in the Proceedings of the National Academy of Sciences, researchers inserted copies of the gene into some of the mice breast cancer tumours. They found after 28 days the size of the tumours had been limited to a tenth of the size of those without the gene, while the spread of the disease to the lungs was much more limited. The team then carried out research into 1,240 patients, split between five separate groups. They found those with the Brd4 gene had much better survival rates - in some of the groups it was nearly double the rate than those without the gene. Researchers said as well as being able to predict the consequences of the disease, a treatment could even be developed to stimulate or introduce the gene.

Report author Kent Hunter said: "Potentially, this treatment could help manage and control a cancer. "That is still a long way off, but in the more immediate future we could at least predict the course of the disease."

But Dr Julie Sharp, of Cancer Research UK, said it was too early to tell if a treatment could be developed because the tests had only been done on mice. She added: "Identifying better tools to predict which cancers will spread is an important goal of many cancer researchers. "This work suggests that measuring Brd4 gene activity could have a role to play, although more work is needed before scientists will know whether it can reliably predict aggressive behaviour in breast or any other type of cancer."

Copyright BBC Health News Tuesday 22nd April 2008 12:16

Source: http://news.bbc.co.uk/1/hi/health/7359204.stm

'Bad habits' link to Alzheimer's

Heavy drinkers and smokers develop Alzheimer's disease six to seven years earlier than those who do not smoke or drink, US researchers claim. A study of 900 people aged over 60 found early onset was most likely in those who also had a high-risk gene. A second US study found people with high cholesterol in their early 40s are one and a half times more likely to develop Alzheimer's. The research was presented at an American Academy of Neurology meeting. It has been estimated that a delay in the onset of Alzheimer's disease by five years would lead to a 50% drop in the number of cases.

The researchers said their findings showed heavy drinking and smoking were two of the most important preventable risk factors for the condition. Those taking part in the study had been diagnosed with possible or probable Alzheimer's disease and smoking and drinking history was obtained from family members. Heavy drinking, defined as more than two drinks a day was found to lead to an almost five-year earlier onset of Alzheimer's. And those who smoked more than 20 cigarettes a day developed the disease two years sooner. People with a specific gene - APOE variant 4 - developed Alzheimer's disease three years earlier than those without the gene variant. All three risk factors together were associated with onset of the disease 8.5 years earlier than those with none of the risk factors.

Study leader, Dr Ranjan Duara, from Mount Sinai Medical Center in Florida said: "It's possible that if we can reduce or eliminate heavy smoking and drinking, we could substantially delay the onset of Alzheimer's disease for people and reduce the number of people who have Alzheimer's at any point in time." In the second study, 9,700 men and women were followed from the age of 40. Those with cholesterol levels higher than around six millimols per litre (mmol/L) had a one and a half times higher risk of developing Alzheimer's than those with low cholesterol.

"High mid-life cholesterol increased the risk of Alzheimer's disease regardless of diabetes, high blood pressure, obesity, smoking and late-life stroke," said researcher Alina Solomon.

Dr Susanne Sorensen, head of research at the Alzheimer's Society said the research added to the weight of evidence on drinking and smoking habits and the risk of developing dementia. "The best way to reduce your risk is to eat a balanced diet rich in antioxidants and vitamins and to exercise regularly. "Not smoking, drinking only in moderation and getting your blood pressure and cholesterol checked regularly throughout life are also important ways people can reduce their risk of dementia."
Copyright BBC Health News 17th April 2008

Source: http://news.bbc.co.uk/1/hi/health/7351986.stm

Early childhood growth linked to obesity

A spurt in growth early in childhood could lead to obesity later in life, research suggests. Scientists have found a link between rapid growth as a baby and the long-term rise in a person's metabolism.

Neil Metcalfe of Glasgow University, who led the research, compared the resting metabolic rates of zebra finches fed on a regular protein diet as they grew with birds switched from a low- to a high-protein diet halfway through their growth period. Zebra finches in the latter group experienced a spurt in growth because their diet had improved. Medcalfe also found that the resting metabolic rate as adults was 20% higher than if they had grown more steadily.

The results were published in the Proceedings of the Royal Society B journal. Metcalfe said a higher resting metabolic rate could lead to a rise in overall appetite levels. "In wild animals that might not be a problem," he said. "But in a western culture if you have a high appetite plus access to lots of high-fat foods then you could end up being obese." He said growth spurts that had these effects were due to changes in diet as a baby, rather than hormonal growth spurts children experience at puberty.

The work adds to a growing body of evidence that the risk of developing diseases, including obesity, depends on nutrition in childhood. Of particular concern is a pattern in early childhood, called catch-up growth by scientists. Catch-up growth, which might happen if a baby is born small and then given a diet to make it bigger or stronger, is known to store up problems for later life including greater blood pressure and a higher risk of coronary heart disease and diabetes.

Metcalfe said the effects of catch-up growth could be due to the fact that a person's basic body parts are being fixed in their first years.

Copyright Jha, A. Wednesday 9th April 2008 Researchers link growth spurt in early childhood to obesity The Guardian, p14

Source: http://www.guardian.co.uk/science/2008/apr/09/medicalresearch.children

New drug can protect healthy cells during radiotherapy

Scientists have found a drug which can protect healthy cells from radiation. The discovery could improve the effectiveness of radiation therapy in treating cancer and help prevent radiation sickness after exposure to a nuclear accident or attack.

Radiotherapy is an important tool in the fight against cancer but it has unpleasant side-effects, killing healthy cells in the bone marrow, gut and spleen. The radiation causes damage to the DNA of healthy cells, prompting them to kill themselves through a process known as apoptosis. The body uses this method to stop damaged cells from multiplying; tumour cells survive by switching off the apoptosis mechanism.

Lyudmila Burdelya, of the Roswell Park Cancer Institute in Buffalo, New York, led a team that investigated whether radiation-damaged healthy cells could be rescued by mimicking cancer cells. The new drug, CBLB502, works by activating the same mechanism used by cancer cells to switch off apoptosis. A single dose given to mice and monkeys just before a big dose of radiotherapy significantly reduced damage to gastrointestinal cells and prolonged the animals' lives.

"The treatment rescued more than 87% of mice from radiation-induced death. At this radiation dose, the most powerful previously described radioprotectants provided about 54% protection or had no protective effect at all," the researchers write today in the journal Science. In rhesus monkeys, injecting the drug up to 24 hours before a dose of radiation which would normally kill 70% of the animals "delayed the onset of radiation-induced mortality by 10 days and increased the 40-day survival rate from 25 to 64%".

The drug was also effective in mice when administered an hour after the radiation exposure, and the researchers reported no obvious side-effects. In a separate experiment, the scientists also showed that the treatment of tumour cells by radiation was unaffected by the drug. The researchers said that the drug was mainly a way for doctors to make radiotherapy work better but thought it could be stockpiled as a preventive medicine in case members of the public or armed forces are exposed to radiation during a nuclear accident or as a result of a "dirty bomb" using radioactive material.

Richard Kolesnick, of the Memorial Sloan-Kettering Cancer Centre in New York City, told Science that the work was "a breakthrough in an issue that has challenged the scientific community". It was a good example, he said, of "how understanding mechanisms of tissue damage can result in [the discovery of] valuable pharmacologic agents".

Copyright: Jha, A. New drug can protect healthy cells during radiotherapy, The Guardian, 11th April 2008, p. 10

Source: http://www.guardian.co.uk/science/2008/apr/11/cancer.medicalresearch 

Stem cell hope for osteoarthritis

Stem cells offer a potential way to repair cartilage damaged by osteoarthritis, say scientists. They have identified a type of stem cell which can be transformed into cartilage cells known as chondrocytes. In theory, it should be possible to create new chondrocytes in sufficient numbers to achieve a real therapeutic effect for osteoarthritis patients. The Cardiff University work was presented to the UK National Stem Cell Network Annual Science Meeting.

Osteoarthritis, which affects more than two million people in the UK, occurs when changes in the make-up of the body's cartilage causes joints to fail to work properly. At its worse it can bring about the break-up of cartilage, causing the ends of the bones in the joint to rub against each other. This results in severe pain and deformation of the joint. One current treatment for younger patients is to harvest cartilage cells from neighbouring healthy cartilage and transplant them into the damaged area. Unfortunately, only a limited number of cells can be generated. Immature stem cells have the ability to become any tissue in the body. However, the cell identified by the Cardiff team is at a more advanced stage, where it has lost some of its plasticity but not its ability to become a chondrocyte if cultured in the lab in the right way.

Lead researcher Professor Charlie Archer said: "We have identified a cell which, when grown in the lab, can produce enough of a person's own cartilage that it could be effectively transplanted. "There are limitations in trying to transplant a patient's existing cartilage cells but, by culturing it from a resident stem cell, we believe we can overcome this limitation. "This research could have real benefits for arthritis sufferers and especially younger active patients with cartilage lesions that can progress to whole scale osteoarthritis." The Cardiff team have now started animal tests, and hope to launch a clinical trial next year.

Professor Alan Silman, medical director of the Arthritis Research Campaign, which part-funded the study, said: "How to stop or even reverse the wearing away of cartilage that is the hallmark of osteoarthritis has been a treatment goal which up to now has not proved possible. "If we can translate these successes from the laboratory into treating patients the possibility opens up of making a remarkable impact on this common painful and disabling condition."
Copyright BBC Health News Monday 14th April 2008 00:08

Source: news.bbc.co.uk/1/hi/health/7339245.stm

Pneumococcal bug poses new threat

A strain of bacteria which can cause pneumonia and meningitis in children is on the rise in England and Wales, figures suggest. The introduction of a vaccine against pneumococcal disease in 2006 has dramatically cut the number of infections in children. But cases caused by a pneumococcal type not covered by the vaccine seem to be increasing, say researchers. Similar patterns have been seen in the US and new vaccines are in development.

The pneumococcal vaccine given to infants at two and four months with a booster dose at 13 months of age protects against seven types of Streptococcus pneumoniae. After the introduction of Hib and meningitis C vaccines, pneumococcal infection became the of the most common causes of invasive bacterial infection in children and it can be fatal. Figures from the Health Protection Agency show there has been a huge fall in the number of children suffering serious illness as a result of pneumococcal infection since immunisation began. At the end of 2007, government officials predicted 300 children had avoided invasive pneumococcal disease, which includes pneumonia, septicaemia and meningitis. But surveillance data presented at the Royal College of Paediatrics and Child Health annual scientific conference also shows serotype 1 pneumococcal may be coming in to "fill the gap".

Dr David Spencer, consultant respiratory paediatrician in Newcastle, has been monitoring cases of empyema in children - a complication of pneumonia which involves the cavity around the lungs. He found that in most cases the disease is caused by serotype 1. And he predicts there are probably about 1,000 cases a year in the UK now compared with a handful in the early 1990s. "Serotype one is continuing to increase and the likely factors are better recording but also that there has been a genuine increase because it's not covered by the vaccine. "Overall there have been very dramatic benefits from vaccination but we're dealing with constantly shifting sands and surveillance will help us plan for the future." There are two vaccines in the pipeline which protect against serotype 1 as well as others and it is hoped they will be available within a couple of years.

A spokesperson for the HPA said experience from countries such as the US showed you would expect to see some non-vaccine strains of pneumococcal becoming more common. "Currently there are more than 90 known pneumococcal types and vaccination protects against the seven most common types which circulate in the UK. "Serotype 1 was increasing prior to introduction of a pneumococcal conjugate vaccine so it is too early to tell if this trend has been exacerbated by the introduction of the vaccine."

Professor Adam Finn, head of the Bristol Children's Vaccine Centre said the increase in serotype 1 may be a coincidence and not related to the introduction of the vaccine. "In the US they're definitely seeing higher rates of invasive disease caused by non-vaccine types. "So everyone's been expecting that to happen. "You can pretty much guarantee that once one of the new broader vaccines becomes available we will switch to it."

Copyright BBC Health News Monday 14th April 2008

Source: http://news.bbc.co.uk/1/hi/health/7342240.stm

Caution on cancer exercise link

Prostate cancer patients have been told to carry on exercising despite research in mice which appears to suggest it speeds the growth of tumours. The US study found tumours expanded twice as fast in mice given exercise wheels compared to those without. The researchers said improved blood flow to the tumour was a possible cause, but encouraged patients to remain active. Sedentary lifestyles raised the risk of other serious diseases, they said.

The results of the mouse experiment, presented at a US cancer conference, could actually help reveal ways to improve prostate cancer treatments, said researchers from Duke University Medical Center. The research team implanted 50 human prostate tumours into mice and then placed half of them in cages where exercise was impossible. The remainder were allowed to run for an average of half a mile a day.

Dr Lee Jones, one of the researchers, said: "Our study showed that exercise led to a significantly greater tumour growth than a more sedentary lifestyle. "Among the mice that had the opportunity to voluntarily exercise, tumours grew approximately twice as fast as they did among the mice that did not have the opportunity to exercise." However, he said that exercise could be a way to improve treatment by delivering drugs more effectively to prostate tumours, which can generally have a poor blood supply.

Dr Stephen Freedland, another Duke researcher, said the circumstances were very different to human prostate cancer, and said that the results should be interpreted with caution. "These mice were not receiving treatment and we were allowing aggressive tumours to grow unchecked for the sake of the experiment. Patients would not find themselves in the same situation." He said that the benefits of exercise in improving cardiovascular health, and reducing the risk of diabetes, obesity, and other chronic conditions meant that it was still advisable for prostate patients, and older men in general, to take regular exercise.

A spokesman for the Prostate Cancer Charity agreed that men should not avoid exercise for fear of the disease. A spokesman for the charity said: "It is important to remember that a balanced healthy diet together with regular exercise will benefit your overall health and reduce your risk of all cancers as well as other common conditions such as heart disease and diabetes."
Copyright BBC Health News Monday April 14th 09:06

Source: http://news.bbc.co.uk/1/hi/health/7343146.stm