Egypt officials ban female circumcision

The death of a 12-year-old Egyptian girl at the hands of a doctor performing female circumcision has sparked a public outcry and prompted health and religious authorities to ban the practice.

The girl, Badour Shaker, died this month while undergoing the procedure in an illegal clinic in the southern town of Maghagh. Her mother, Zeniab Abdel Ghani, told the Al-Masry Al-Youm newspaper that she paid about $9 to a female physician to perform the procedure.

The mother also told the paper the doctor tried to bribe her to withdraw a lawsuit accusing the physician of murdering her daughter, in return for $3,000, but she refused.

A forensic inquiry into the case showed the girl's death was caused by an anesthesia overdose.

The case sparked widespread condemnation of female circumcision, or genital mutilation, and was closely followed in Egyptian newspapers, which also reported the girl had passed out sweets to pupils in her class earlier on the day of her death, to celebrate her good grades.

It also evoked memories of a 1995 CNN television documentary depicting a barber circumcising a 10-year-old girl in a Cairo slum.

On Thursday, the Egyptian Health Ministry issued a decree stating that it is "prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system, either in government hospitals, nongovernment hospitals or any other places."

It warned that violators would be punished, but did not specify the penalty. The ban is not as enforceable as a law, which requires passage in the national legislature.

Female genital mutilation usually involves the removal of the clitoris and other parts of female genitalia. Those who practice it say it tames a girl's sexual desire and maintains her honor.

It is practiced by Muslims and Christians alike, deeply rooted in the Nile Valley region and parts of sub-Saharan African, and is also done in Yemen and Oman.

The ban by the Health Ministry marks a return to a 1950s government order prohibiting hospitals and doctors from carrying out the procedure.

After that order, the practice continued in Egypt, mostly carried out by barbers, midwives and other amateurs. The order was reversed in 1995, shortly after the CNN documentary, with only medical staff permitted to perform the procedure.

Although the documentary embarrassed Cairo internationally, it failed to propel the parliament to pass legislation penalizing female circumcision.

A 2003 survey by UNICEF said that 97 percent of married women in Egypt have undergone genital mutilation.

A recent study by Egypt's Ministry of Health and Population found that 50.3 percent of girls between the age of 10-18 years have been circumcised.

After the girl's death, the country's supreme religious authorities stressed that Islam is against female circumcision.

"Its prohibited, prohibited, prohibited," Grand Mufti Ali Gomaa said on the privately owned al-Mahwar network.

While top clerics insist the practice has nothing to do with Islam, parents, especially in villages and Cairo slums, believe they are helping their daughters. They think circumcision is necessary for cleanliness and to protect a girl's virginity before marriage.

Opponents say girls can bleed to death, suffer chronic urinary infections and have life-threatening complications in childbirth as a result of the procedure.

The Al-Masry Al-Youm daily reported the doctor in Shaker's case denied allegations of malpractice and said the girl was in a "bad condition" to start with, and was immediately transferred to a regular hospital where she died. The doctor was not identified.

Egypt's renowned feminist activist, Nawal el-Saadawi, 76, who has published a biography on her own experience with circumcision, wrote: "Badour, did you have to die for some light to shine in the dark minds? Did you have to pay with your dear life a price ... for doctors and clerics to learn that the right religion doesn't cut children's organs."

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Antidepressants not big risk for defects

Newborns face little risk of birth defects from antidepressants taken by many women early in pregnancy, say the reassuring findings of the two biggest studies of this controversial link.

The research focuses on the class of drugs chosen most often for depression and anxiety, including the brands Prozac, Paxil and Zoloft.

Paxil carries a warning of possible heart defects in newborns, and experts don't expect the new research to change that. However, they find the new studies comforting for women struggling with depression.

The possibility of birth defects from antidepressants has put doctors and patients in a tricky quandary. Birth defects obviously hurt newborns, but depressed mothers who can't give proper care also endanger their babies.

Confusing matters, researchers have wondered if the concern about birth defects should extend beyond Paxil to this entire class of drugs, known as selective serotonin-reuptake inhibitors, or SSRIs. The two latest studies, appearing Thursday in The New England Journal of Medicine, relieve some of that worry, say birth specialists.

"Yeah, there's a risk, but the risk overall is probably pretty small," said Dr. Susan Ramin, obstetrics chairman at the University of Texas Medical School in Houston, who was familiar with the findings.

The two studies — one from the federal Centers for Disease Control and the other from Boston University — use more cases of birth defects than previous research to consider links between the abnormalities and SSRIs. The Boston University study was funded partly by the National Institutes of Health and Paxil maker GlaxoSmithKline PLC.

Together, the two studies looked at 19,471 newborns with birth defects and 9,952 without them. Then they considered what SSRIs the mothers in both groups took during the first three months of pregnancy and mapped the patterns of birth defects.

Neither study was able to tie SSRIs as a group to either heart defects or most other defects. That reassurance is especially welcome because depressed women fret even more than other mothers about the health of their newborns, said Dr. Stephan Quentzel, a psychiatrist who treats pregnant women at Beth Israel Medical Center in New York City.

Also, a mother's untreated depression can lead to poor care or turmoil at home, a weaker maternal bond, and other problems for a newborn. "The fetus and the newborn are almost always worse off if the mom is depressed than if ... exposed to the vast majority of antidepressants," Quentzel said.

However, doctors and mothers have been very wary about medications and birth defects since Europe's thalidomide scandal of deformed babies in the 1960s. Defects from all causes are expected in about 3 percent of births, enough to make many mothers nervous.

The concern about SSRIs grew out of GlaxoSmithKline's own alert in 2005 about possible heart defects in newborns whose mothers took Paxil early in pregnancy. The U.S. Food and Drug Administration added its own warning. Last year, a separate study linked SSRIs taken late in pregnancy to a lung disorder in newborns.

The latest studies do not consider that disorder, known as persistent pulmonary hypertension. But they suggest that the risk of other defects from an SSRI — even if confirmed — would add only a fraction of 1 percent to the overall danger, researchers said.

Paxil did appear to triple the risk of a defect in blood flow from the heart, both studies found. But that additional danger would still be modest, experts said.

The studies further hinted at possible ties between other SSRIs and a handful of other defects, but researchers said the numbers of newborns with specific defects were too small to draw strong conclusions.

"Based on these studies, it's correct to say: no major risk," said Carol Louik, a public health expert who led the Boston study. "I wouldn't say, 'No risk.'"

Researchers said women should talk over the potential risks and benefits with their doctors, preferably before pregnancy.

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Norway cracks down on female circumcision abroad

Norway took steps on Friday to crack down on circumcision of girls by barring families from traveling abroad if officials suspect they plan to have the procedure done outside the country.

The intervention followed reports in Norwegian media that at least 185 girls from Norway -- daughters of immigrants -- had their genitals cut in just one village in Somalia.

The government said it would refuse passports to families suspected of sending girls abroad to have the procedure carried out. Authorities can also forbid a family from traveling if they suspect the purpose is female circumcision, officials said.

"Today's decision is about how to prevent children from being subject to genital mutilation," Astri Aas-Hansen, a senior official at the Ministry of Justice and Police, told Reuters.

"This is violence," she said.

Justice Minister Knut Storgberget told Norwegian NTB newswire that officials would not block people from traveling based only on their skin color or destination. "The authorities must have concrete suspicions that circumcision is planned to be able to deny a passport," he said.

Genital cutting, sometimes referred to as female genital mutilation or circumcision, is banned in Norway and arouses widespread horror in the West but is a rite of passage for young women in many countries, predominantly in Africa.

It also occurs in some Middle Eastern countries, such as Saudi Arabia, in some immigrant communities in Europe and North America and in parts of Asia, including Indonesia.

The practice usually involves removing part or all of the clitoris and other parts of the female genitalia. Many of the practitioners are untrained and use crude instruments, making the practice life-threatening.

The Norwegian government is also considering mandatory check-ups for girls to weed out the practice.

In the last three years, Oslo's university hospital has treated 260 children and women for health problems tied to genital mutilation, some as young as 10 or 11 years old.

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FDA recalls Veggie Booty snacks

Veggie Booty, a snack particularly popular among small children, may carry Salmonella food poisoning and should be thrown out, the U.S. Food and Drug Administration said.

The FDA said on Thursday at least 52 people in 17 states had become sick after eating the green-colored snack food marketed by Robert's American Gourmet. The New Jersey-based company said it had temporarily stopped making and selling the snack, which contains spinach, kale and other vegetables.

"Almost all the illnesses have occurred in children under 10 years old, with the most cases in toddlers. Most persons had reported bloody diarrhea; four were hospitalized," the FDA said in a statement.

"Veggie Booty is often consumed by children, so parents are encouraged to watch their children, and seek medical care if they observe signs of illness," the FDA added.

It said people who have recently eaten the snack and experienced symptoms should contact a doctor.

Salmonella infection usually causes diarrhea, often bloody, with abdominal cramps and fever. It can be life-threatening in infants, persons with poor underlying health and those with weakened immune systems.

The U.S. Centers for Disease control estimates that about 300,000 Americans each year are hospitalized with food-borne illnesses and 5,000 people die.

Robert's American Gourmet is recalling all potentially contaminated product, which is sold in all 50 states and Canada. The Canadian Food Inspection Agency issued a similar warning.

The company said its other products were safe. It posted a Web site about the recall at http://www.robscape.com/files/veggie-booty-recall.php.

"Due to the serious nature of the health risk, Robert's has decided to temporarily stop the manufacture and sale of Veggie Booty only until test results can positively identify the source," the company said on the Web site.

"We stand by our snacks and hope to resume making Veggie Booty shortly," it said.

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Hong Kong drug addicts head to China to pop pills

The ease of travel to the China mainland since Hong Kong's handover in 1997 has drawn the city's young people to a cheap and convenient playground just across the border in Shenzhen city.

Every weekend, young people pour into Shenzhen in China's southern Guangdong province to devour cheap food, entertainment -- and illicit party drugs.

Street drugs of all types -- cocaine, ecstasy, heroin, ketamine and methamphetamine -- are more easily available and cheaper in discotheques in southern China than in Hong Kong.

"At first I didn't like Shenzhen because it seemed foreign and dangerous, but after a while it was very nice, a new place with new faces and we didn't get raided there," said Siu Bak, a former addict of nine years who kicked the habit in 2005.

"It's far easier to get drugs in China. Any staff can get it for you. The security guards will just turn a blind eye or they will tell you to take them in the toilet," said Siu Bak, 24.

Ketamine is one of the most popular party drugs now in Hong Kong and it is proving to be a disastrous health hazard.

In a report published last week, a group of Hong Kong doctors detailed cases of bladder and kidney dysfunction in 10 ketamine addicts. Their mean age was 25, with the youngest only 18.

Among the symptoms, the addicts' bladders were able to hold the equivalent of only two tablespoons of urine and they needed to urinate every 15 minutes.

Ketamine, an anesthetic for animals, has never been linked to such disorders. But street ketamine -- in the form of a white powder -- is diluted with cheap substances to fatten suppliers' profits.

Street ketamine can include washing powder, paint flakes, talcum powder, flour, painkillers and barbiturates, said scientists who have examined the drug.

"Some suppliers put in glass powder to give it a shine, which is a mark of high grade ketamine. They give you a nosebleed, but all ketamine does that after a while because all that snorting damages your nasal membranes," said Siu Bak, who used to use more than 30 packets of ketamine a day at the height of her addiction.

A packet of ketamine, containing about half a teaspoon of powder, cost HK$100 (US$12.80) a few years ago but can be obtained for as little as HK$20 now.

"These people are consuming all sorts of street ketamine, from different suppliers and we don't know what kind of contaminants they have been snorting," said Lau Fei-lung, director of the Hong Kong Poisons Information Centre, .

"We don't know if these disorders are due to ketamine or the cutting agents," he said. "Ketamine is normally not consumed this way. It's an anesthetic agent and there have been no studies on its effect if it is taken daily, or twice a day, for years. The effect will be different, it will be totally unpredictable."

OBLIVIOUS

But these concerns hardly figure in Shenzhen's packed discos where revelers vigorously toss heads to the beat of fast music.

Many people can go on for hours -- expending a store of energy so huge that party-goers readily admit it can only come with help from illicit drugs.

A powerful hallucinogen containing LSD has even been named after this jerky head dance - "fing tau yun" in Cantonese, or "vigorous head-tossing pill."

"These people from Hong Kong come to our massage parlor ... after tossing their heads all night," said a masseur in Shenzhen. "Their necks are so stiff we need to use all our strength for them to feel even a little effect. Some interrupt the massage session and snort drugs right in front of us."

Peggy Chu, a urologist and member of the team of doctors who revealed the disorders linked to ketamine, said there were now 30 young addicts being treated for bladder damage from the drug.

"We used traditional drugs to relax their bladders but they are not working and we are trying new drugs. But treating them is very difficult and complicated because none of them have given up ketamine. They say they have stopped but when I check their urine, I still detect ketamine," Chu said.

"One of them who had an operation to enlarge the bladder has even shifted to cocaine. In the worst case, they may end up with renal failure and require dialysis and even a kidney transplant."

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U.S. tracks serious form of syphilis in gay men

A particularly serious form of the sexually transmitted bacterial disease syphilis has been detected in gay and bisexual U.S. men infected with the AIDS virus, federal health officials reported on Thursday.

The U.S. Centers for Disease Control and Prevention tracked 49 HIV-infected gay and bisexual men who had "symptomatic early neurosyphilis" from January 2002 to June 2004 in four cities -- Los Angeles, San Diego, Chicago, New York.

The CDC cited the report as further evidence that gay and bisexual men, many also infected with HIV, are the driving force behind increases in U.S. syphilis cases this decade.

The findings also indicate that these men are engaging in the same risky, unprotected sex that can spread the human immunodeficiency virus, which causes AIDS.

"These are primarily infections that people are probably getting because they're not using condoms," Dr. Thomas Peterman of the CDC's Division of STD Prevention, an author of the report.

In some instances, the men involved have the attitude that they do not need safe-sex practices because they already are infected with HIV, Peterman said.

Since dropping to the lowest level on record in 2000, the U.S. rate of syphilis has risen steadily. Gay and bisexual men accounted for 7 percent of syphilis cases in 2000, but more than 60 percent in 2005, CDC officials have said.

Symptomatic early neurosyphilis is a rare manifestation of syphilis usually occurring within the first year of infection.

Ordinary syphilis is readily curable with antibiotics in its early stages. Neurosyphilis can lead to blindness or stroke, Peterman said.

"There are a number of studies that continue to show that there are some HIV-infected and some uninfected men who have sex with men who continue to have large numbers of (sexual) partners and anonymous sex. This is one of the consequences of that," Peterman said.

Of the 49 HIV-positive gay and bisexual men with symptomatic early neurosyphilis, 63 percent were non-Hispanic whites, 18 were non-Hispanic blacks and 14 percent were Hispanic. Their average age was 38.

"I think the bigger message is that we need to get control of syphilis. And control of syphilis would require safe-sex behavior, reducing the number of partners, and using condoms with those partners," Peterman said.

"And for men who have sex with men, it means getting tested for HIV and other STDs at least once a year," Peterman added.

Syphilis, like many other sexually transmitted diseases, raises the likelihood of infection by or transmission of HIV.

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Being breastfed may not cut kids' obesity risk

Breastfeeding has many benefits for babies, but protection from obesity may not be one of them, a UK research team reports.

Instead, the researchers say, the protective effect of breastfeeding some studies have found is likely due to the fact that women who breastfeed their infants also tend to have qualities that make them less likely to raise obese children.

"There are several reasons for why mothers should breastfeed their children, independent of obesity," Dr. Andre M. Toschke of Kings College London, the study's lead author, told Reuters Health. "(Our) study questions a little bit the argument of breastfeeding for protection against obesity."

To better understand the breastfeeding-obesity link, Toschke and his team used a technique called dual-energy X-ray absorptiometry (DXA) to measure fat mass in a group of 4,325, 9- to 10-year-olds. Most studies to date have used body mass index (BMI) to measure overweight, which is less precise, the researchers note in the June issue of the American Journal of Clinical Nutrition.

Children who were breastfed, who represented 82 percent of the total, had lower fat mass percentages. But once the researchers used statistical techniques to control for factors linked to both breastfeeding and obesity risk, including mother's education and socioeconomic class, maternal BMI, time the mother spent watching television daily, and time spent in a car for each weekday, the effect of breastfeeding was weakened.

The association did remain strong, however, for children who had been breastfed for six months or longer. They were 55 percent less likely than their non-breastfed peers to fall into the top tenth of the group based on body fat percentage.

To get a definitive answer on whether breastfeeding truly protects children from becoming overweight later on, it would be necessary to randomly assign mother-infant pairs to breast or bottle-feeding, which would be unethical, Toschke said.

But studies of breastfeeding promotion interventions with adequate follow-up could also help answer this question, he added, and would be free of the confounding factors at play in other research.

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Sanofi withdraws anti-obesity drug in US

French pharmaceutical group Sanofi-Aventis said Friday it had withdrawn an application for regulatory approval for its anti-obesity drug Acomplia in the United States.

A panel of experts from the US Food and Drug Administration concluded earlier this month that the dieting treatment, referred to as rimonabant by the company, was unsafe and should not be sold in the United States.

"Sanofi-Aventis will work towards submitting the rimonabant file to the FDA at a future date," the company said, adding that it will "undertake the necessary discussions with the FDA to determine the required modifications to its file."

The FDA's expert panel concluded that suicidal thoughts appeared to be a side-effect of taking Acomplia, which has been authorised in the European Union.

The FDA was expected to heed the opinion of the panel of experts and block the sale of the drug.

Sanofi had previously forecast annual sales of 3.0 billion euros (4.0 billion dollars) for the drug.

In a separate development, European regulators said they were reviewing data on the psychiatric effects of Acomplia.

The European Medicines Agency (EMEA) said it expected to announce its conclusions at the end of a July 16-19 meeting.

The agency "is currently reviewing the available data on psychiatric events (in particular suicidal ideation and depression-related events)," it said.

Acomplia has been authorised in 37 countries and is currently sold in 18.

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Sanofi pulls obesity drug application in U.S.

Sanofi-Aventis SA is withdrawing its application to sell obesity drug rimonabant -- its biggest new drug hope -- in the United States, the French drugmaker said on Friday.

The move comes two weeks after a U.S. advisory panel said the medicine should not be approved in the world's largest drugs market because it may increase suicidal thinking and depression.

Sanofi said it would work towards resubmitting the medicine, known by the brand names Acomplia and Zimulti, at a future date and would undertake necessary discussions with the Food and Drug Administration (FDA) on required modifications to its file.

Industry analysts said the decision was a fresh setback for the hoped-for blockbuster, which is also facing an extended safety review in Europe, where it has been on the market since last year.

Paul Diggle of Nomura Code Securities said the drug might yet have a future in the United States as a niche treatment for diabetes but as a weight-loss treatment it appeared "fatally wounded."

Others said the world's third-biggest drugmaker was acting proactively to save face and avoid outright rejection from the

FDA.

Shaojing Tong, an analyst with Mehta Partners in New York, said the medicine could still be approved if it fares well in a large trial underway that may provide a better picture of its risks and benefits -- but this would delay approval until 2011.

"This trial is longer than earlier studies and metabolic benefits from raising HDL (good) cholesterol and lowering triglycerides could be reflected" in terms of patient health benefits, Tong said.

The drug is the first in a new class of drugs that switch off the same brain circuits that make people hungry when they smoke cannabis.

EU DECISION IN JULY

European regulators said they were still reviewing the latest safety data on the medicine and would only come to a final decision on the product next month.

"The review is expected to be finalized at the July CHMP (Committee for Medicinal Products for Human Use) meeting," a spokeswoman for the European Medicines Agency said.

The EU watchdog had initially said it was likely to give a view this month. Sanofi said it was submitting an update of safety data on the medicine to the CHMP.

Shares in Sanofi, which plunged on the U.S. panel decision earlier in June, gave up earlier gains to end 0.6 percent down on the day at 60.10 euros in Paris.

Acomplia is currently not recommended for European patients with major depression, due to its potential psychiatric side effects, and industry analysts believe further restrictions on its use are now very possible.

"I don't think it will be withdrawn in Europe but I think the label is going to get tougher," Nomura's Diggle said. "There is no way that people's forecasts are not going to come down even further."

Paris-based Sanofi has in the past trumpeted Acomplia as potential mega blockbuster, with sales of $3 billion a year or more. But actual take-up of the medicine in those markets where it is available has been slow, partly because of lack of reimbursement.

Worldwide sales of Acomplia in the first quarter of 2007 totaled just 15 million euros ($20.17 million), down from 20 million in the fourth quarter of 2006.

It is currently approved in 42 countries and marketed in 20 to treat obesity and overweight patients with associated cardiovascular risk factors.

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Overweight elderly don't have higher death rates

After the age of 80, carrying a few extra pounds may not subtract years from your lifespan, a new study from Japan shows.

Among a group of 80-year-olds followed for four years, the researchers found that underweight individuals were more likely to die from cancer, heart disease or pneumonia than normal-weight or overweight people. "Overweight status was associated with longevity and underweight with short life," Dr. Yutaka Takata and colleagues from Kyushu Dental College in Kitakyushu City conclude.

While being overweight has been tied to a greater risk of heart disease, studies have also found that being underweight with heart disease may carry an increased risk of morbidity and mortality, Takata and his team note.

To better understand the controversial relationship between body mass index (BMI) and mortality from heart disease, as well as all-cause mortality, the researchers looked at men and women who were 80-years-old.

Fifty-two were underweight, with an average BMI of 17.2; another 468 were normal-weight, with BMIs averaging 21.8; and 155 were overweight, with an average BMI of 27.3. Just five people in the study were obese (with a BMI of 30 or greater), so they were included in the overweight group. People with BMIs between 18.5 and 25 are considered normal weight, while individuals with BMIs of 25 or greater are classified as overweight.

Mortality rates from heart disease, pneumonia and cancer for normal-weight and overweight individuals weren't significantly different, the researchers found. But underweight men and women were nearly four times as likely to die from any cause compared with as overweight individuals, and nearly 18 times more likely to die from cancer. Heart disease mortality in the underweight group was almost four times greater than among normal-weight individuals.

Other studies have found a protective effect of extra pounds among older individuals, Takata and his colleagues note; for example, among elderly US men, the lowest mortality is seen among men with BMIs of 26 and among women with BMIs of 29.6. While Takata and his colleagues attempted to control for the effects of illness, it is still possible that existing disease accounted for some of the increased mortality risk seen among the underweight individuals, they note.

"It is likely that only mild obesity (but not severe obesity) or overweight status in older people and in patients with heart disease may be associated with a lower mortality rate from any disease, as well as with lower mortality from cardiovascular disease," the researchers conclude.

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With calcium, food trumps pills

Most women know that calcium is critical in preventing osteoporosis, the disease of progressive bone loss and fractures that affects millions of Americans.

But which source is better — calcium-rich foods or supplements? A preliminary study by researchers at Washington University School of Medicine suggests dietary calcium may be better at protecting bone health.

Though not definitive, the study found that women who get most of their daily calcium from food have healthier bones and higher bone density than women whose calcium comes mainly from supplemental tablets.

That was true even though the supplement-takers had higher average levels of calcium.

Calcium from dietary sources is generally better absorbed than that from supplements, which could help explain the difference, said the study's lead author, Dr. Reina Armamento-Villareal.

Those getting calcium from foods also had more estrogen in their bodies; the hormone is needed to maintain bone mineral density. Researchers can't yet explain the food-estrogen connection.

The research is preliminary and offers "a springboard to do something more, a hypothesis to test," said Armamento-Villareal, a bone specialist and assistant professor in the School of Medicine's division of bone and mineral diseases. It was published in the May issue of the American Journal of Clinical Nutrition.

Researchers asked 183 postmenopausal women to meticulously document their diet and their calcium supplement intake for seven days. They tested their bone mineral density and their urine for levels of estrogen.

The women then were divided into three groups: those who got at least 70 percent of their daily calcium from supplements, those who got the same amount from dairy products and other food, and those whose calcium-source percentages fell somewhere in between.

The "diet group" took in the least calcium, an average of 830 milligrams per day. Yet, the group had higher bone density in their spines and hip bones than women in the "supplement group," who consumed 1,030 milligrams per day.

Women in the "diet plus supplement group" tended to have the highest bone mineral density as well as the highest calcium intake at 1,620 milligrams per day.

An analysis showed that women in the "diet group" and the "diet plus supplement group" had higher levels of estrogen, needed for bone mineral density.

Dr. Robert Recker, who heads osteoporosis research at the Creighton University School of Medicine in Omaha, noted weaknesses in the study, which he said "is certainly not definitive."

Those who got calcium from their diet might have also taken in more vitamin D from milk, which would aid in calcium absorption. As for the estrogen connection, they might have eaten plant sources containing more of the hormone, he said.

"Nevertheless it's not to be ignored," Recker said. "Observation studies are very good for generating a hypothesis to be tested later in an outright experiment."

Dairy foods and calcium-fortified orange juice are excellent sources of calcium. Dark green, leafy vegetables also contain it, though it is not as readily absorbed as calcium from dairy, researchers said.

Armamento said she'd like to do a long-term study of teenagers whose bones are still developing to see what, if any, differences might emerge among young women taking calcium from diet versus supplements.

"It's a lifestyle issue," she said, noting that some teenagers avoid dairy products.

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"Permanent makeup" can disfigure long term

"Permanent makeup" -- a kind of tattoo of the lips, eyelids and eyebrows undergone by more than 8 million U.S. women -- can for years disfigure patients who suffer allergic reactions, federal researchers said on Wednesday.

Doctors have long known that allergic reactions can occur with such ink injections, the researchers report in this week's issue of the New England Journal of Medicine.

In 2004, American Institute of Intradermal Cosmetics in Arlington, Texas, recalled and replaced inks in its Premier Pigments brand after they were implicated in many of the problems reported to the U.S. Food and Drug Administration.

To assess how long the disfigurement lasted, Masja Straetemans of the Centers for Disease Control and Prevention and her colleagues interviewed 92 women who had problems after the procedure.

More than 9 out of 10 had swelling and tenderness, nearly that many complained of itching, and more than 4 out of 5 had bumps.

They found that the allergic reaction lasted anywhere from five months to more than three years.

"In 68 percent the reactions had not healed at the time of the telephone interview," said Straetemans.

According to the FDA's Office of Cosmetics and Colors, "reports of allergic reactions to tattoo pigments have been rare. However, when they happen they may be particularly troublesome because the pigments can be hard to remove. Occasionally, people may develop an allergic reaction to tattoos they have had for years."

"Consumers and medical professionals should report adverse reactions to permanent-makeup procedures to the FDA," the researchers wrote.

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Scientists eye an enzyme as target in fighting autism

US researchers have reversed the symptoms of mental retardation and autism in mice by inhibiting an enzyme that affects the connections between brain cells, researchers said Wednesday.

In a series of experiments on mice, the MIT investigators showed that they could undo the brain damage seen in a condition called Fragile X syndrome by inhibiting a key brain chemical called PAK.

In humans, Fragile X syndrome (FXS) is the leading cause of mental retardation and the most common genetic cause of autism -- the complex and devastating developmental disorder that is now being diagnosed in increasing numbers of children.

The study raises the intriguing possibility that the brain damage seen in children with the condition can be rolled back and identifies a specific target for potential drug therapies.

"It opens up a new avenue for drug research to treat this condition," said Susumu Tonegawa, a neuroscientist at the Massachusetts Institute of Technology in Cambridge, Massachusetts, and lead author of the paper.

MIT researchers began by creating a batch of mice that had been genetically modified to have Fragile X, a condition in which the neurons of the brain are structurally abnormal and functionally impaired compared to regular nerve cells.

These transgenic mice had many of the behavioral problems seen in kids with the condition: hyperactivity, attention deficits, repetitive behaviors and poor social skills.

The investigators then cross-bred these mice with another batch of mice that had been genetically modified to inhibit the activity of the PAK (p21-activated kinase) enzyme which is instrumental in shaping the formation of neuronal connections in the brain.

The researchers knew that when PAK was inactivated, the mice developed neurons that had short, fat dendritic spines, with a higher-than-usual capacity for relaying the electrical impulses that pass between brain cells.

In other words, the shape and function of the dendritic spines in the PAK mice was just the reverse of those seen in the brain cells of the mice with Fragile X syndrome.

The researchers gambled that the two abnormalities would cancel each other out, and that's exactly what the experiment showed.

The cross-bred mice had been genetically engineered so that the inactivation of the PAK enzyme began two weeks into the mouse's life cycle, which in human terms would be several years after birth.

Tests and autopsies showed that the PAK-blocking action restored electrical communication between neurons in the brains of the double mutant mice, correcting their behavioral abnormalities in the process.

"This is very exciting because it suggests that PAK inhibitors could be used for therapeutic purposes to reverse already established mental impairments in fragile X children," said Eric Klann, a professor at New York University's Center for Neural Science.

The study was conducted by Tonegawa and a postdoctoral student at MIT's Picower Institute for Learning and Memory and appears in this week's edition of the Proceedings of the National Academy of Sciences.

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World Bank loans Kenya 80 million dollars to boost war on AIDS

The World Bank has approved a loan of 80 million dollars (60 million euros) to boost Kenya's efforts to fight HIV/AIDS, which poses a major challenge in the country, an official statement said Wednesday.

The funds will be used to strengthen the National AIDS Control Council (NACC), the country's frontline agency in fighting the deadly disease that has killed at least 1.5 million people since 1984.

"We are determined that the support should reach the five million people in Kenya - especially orphans and young women - who are directly and indirectly affected and made very vulnerable by the disease," said Colin Bruce, the bank's representative in Kenya, in the statement.

Britain's Department for International Development (DfID) is also expected to provide 33 million dollars (25 million euros) in additional funding towards the country's war against the scourge, the statement added.

The NACC said Tuesday the rate of HIV/AIDS infections in the country of nearly 35 million fell from 6.1 percent in 2004 to 5.9 percent in 2005.

A shift in sexual habits and the more widespread use of condoms had played a large part in curbing infections, whose prevalence Kenya aims to slash to a rate of 5.5 percent by 2010, said the agency.

At least 1.3 million people are currently living with HIV/AIDS in Kenya, 65 percent of whom are women between the ages of 19 and 45, according to NACC statistics.

Last year, Kibaki announced that public hospitals would no longer charge HIV/AIDS patients for life-prolonging anti-retroviral drugs, in a new bid to fight the disease.

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Mom's Antidepressant Use Poses Little Danger to Baby

Pregnant women who use antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are not increasing the risk of most birth defects for their newborns, new research suggests.

Drugs within this class -- which include Celexa, Paxil, Prozac and Zoloft -- may increase the risk for certain defects, but, even then, the absolute risk is extremely small, concluded two studies published in the June 28 issue of the New England Journal of Medicine.

"It's a fairly reassuring message for women who need antidepressants and are pregnant or who plan on becoming pregnant," said Carol Louik, lead author of the first paper and an assistant professor of epidemiology at Boston University's Slone Epidemiology Center. "We saw no large risks, and the fewer elevated risks that we did see would only lead to very small absolute risks."

"This is a valuable contribution," added Dr. Jon Shaw, director of child and adolescent psychiatry at the University of Miami's Miller School of Medicine. "It substantiates the need to always be prudent in prescribing antidepressants."

The issue of maternal use of antidepressants, particularly those known as selective serotonin reuptake inhibitors (SSRIs) is a charged one.

Last November, the American College of Obstetricians and Gynecologists recommended that women avoid the SSRI Paxil if they are pregnant or planning on becoming pregnant, due to a potential heightened risk of birth defects.

The guidelines come a year after the U.S. Food and Drug Administration (FDA) issued a warning about possible birth defects associated with Paxil when the drug is taken during the first trimester of pregnancy.

The initial FDA warning came in September of 2005. In December of the same year, the FDA instructed Paxil's maker, GlaxoSmithKline, to reclassify the drug from a Category C to D (a stronger warning) for pregnant women. Category D means studies in pregnant women have demonstrated a risk to the fetus.

Other reports had indicated that SSRIs may cause newborns to have withdrawal symptoms.

To complicate matters further, yet another study found that pregnant women who discontinued their antidepressant medication were five times more likely to relapse into depression than women who continued with the medication.

Women of reproductive age have the highest prevalence of major depressive disorders, with experts estimating that about one in 10 will experience a bout of major or minor depression sometime during pregnancy or the postpartum period.

The first study, conducted by Louik's team of Boston researchers, looked at almost 10,000 infants with birth defects and close to 6,000 infants without birth defects. The researchers wanted to see if there was an association between defects that had been previously linked to SSRIs and the use of these drugs by mothers during their first trimester of pregnancy.

Overall, SSRI use was not associated with significantly increased risks of craniosynostosis (when connections between skull bones close prematurely), omphalocele (when intestines or other abdominal organs protrude from the navel) or heart defects.

There were, however, associations between maternal use of Zoloft (sertraline) and omphalocele and septal defects (defects in the walls that separate the chambers of the heart) and between Paxil and defects that interfere with blood flow to the lungs.

But even if a certain drug increased rates by a factor of four, the risk of having a child affected by the problem would still be less than 1 percent, the researchers said.

The study was funded by grants from the U.S. National Institute of Child Health and Human Development and the U.S. National Heart, Lung, and Blood Institute, as well as drug companies Aventis, Sanofi Pasteur and GlaxoSmithKline (maker of Paxil).

A second study, this time conducted by scientists at the U.S. Centers for Disease Control and Prevention (CDC), Atlanta, found that the use of SSRIs during the first trimester of pregnancy was not associated with any increased risks of most categories of birth defects, including congenital heart defects.

The researchers looked at four SSRIs: fluoxetine (Prozac), sertraline (Zoloft), Paxil and citalopram (Celexa).

There were some associations between maternal SSRI use and anencephaly (a brain defect), craniosynostosis and omphalocele, but, again, the absolute risk was very small. These defects had not previously been associated with SSRI use during pregnancy, the study authors noted.

Louik said she did not anticipate any labeling changes based on these studies, but that she did anticipate more research.

"These studies make a large contribution to the field, but they're not the final word by any means," she said.

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Antidepressants not big risk for defects

Newborns face little risk of birth defects from antidepressants taken by many women early in pregnancy, say the reassuring findings of the two biggest studies of this controversial link.

The research focuses on the class of drugs chosen most often for depression and anxiety, including the brands Prozac, Paxil and Zoloft.

Paxil carries a warning of possible heart defects in newborns, and experts don't expect the new research to change that. However, they find the new studies comforting for women struggling with depression.

The possibility of birth defects from antidepressants has put doctors and patients in a tricky quandary. Birth defects obviously hurt newborns, but depressed mothers who can't give proper care also endanger their babies.

Confusing matters, researchers have wondered if the concern about birth defects should extend beyond Paxil to this entire class of drugs, known as selective serotonin-reuptake inhibitors, or SSRIs. The two latest studies, appearing Thursday in The New England Journal of Medicine, relieve some of that worry, say birth specialists.

"Yeah, there's a risk, but the risk overall is probably pretty small," said Dr. Susan Ramin, obstetrics chairman at the University of Texas Medical School in Houston, who was familiar with the findings.

The two studies — one from the federal Centers for Disease Control and the other from Boston University — use more cases of birth defects than previous research to consider links between the abnormalities and SSRIs. The Boston University study was funded partly by the National Institutes of Health and Paxil maker GlaxoSmithKline PLC.

Together, the two studies looked at 19,471 newborns with birth defects and 9,952 without them. Then they considered what SSRIs the mothers in both groups took during the first three months of pregnancy and mapped the patterns of birth defects.

Neither study was able to tie SSRIs as a group to either heart defects or most other defects. That reassurance is especially welcome because depressed women fret even more than other mothers about the health of their newborns, said Dr. Stephan Quentzel, a psychiatrist who treats pregnant women at Beth Israel Medical Center in New York City.

Also, a mother's untreated depression can lead to poor care or turmoil at home, a weaker maternal bond, and other problems for a newborn. "The fetus and the newborn are almost always worse off if the mom is depressed than if ... exposed to the vast majority of antidepressants," Quentzel said.

However, doctors and mothers have been very wary about medications and birth defects since Europe's thalidomide scandal of deformed babies in the 1960s. Defects from all causes are expected in about 3 percent of births, enough to make many mothers nervous.

The concern about SSRIs grew out of GlaxoSmithKline's own alert in 2005 about possible heart defects in newborns whose mothers took Paxil early in pregnancy. The U.S. Food and Drug Administration added its own warning. Last year, a separate study linked SSRIs taken late in pregnancy to a lung disorder in newborns.

The latest studies do not consider that disorder, known as persistent pulmonary hypertension. But they suggest that the risk of other defects from an SSRI — even if confirmed — would add only a fraction of 1 percent to the overall danger, researchers said.

Paxil did appear to triple the risk of a defect in blood flow from the heart, both studies found. But that additional danger would still be modest, experts said.

The studies further hinted at possible ties between other SSRIs and a handful of other defects, but researchers said the numbers of newborns with specific defects were too small to draw strong conclusions.

"Based on these studies, it's correct to say: no major risk," said Carol Louik, a public health expert who led the Boston study. "I wouldn't say, 'No risk.'"

Researchers said women should talk over the potential risks and benefits with their doctors, preferably before pregnancy.

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Biggest study yet backs Glaxo cervical cancer shot

GlaxoSmithKline Plc's experimental vaccine Cervarix has proved more than 90 percent effective in preventing precancerous lesions due to two types of a virus responsible for most cases of cervical cancer.

Interim results from the biggest cervical cancer vaccine trial to date, published on Thursday in the Lancet medical journal, confirm previous promising data. Cervarix is a rival to Merck & Co. Inc.'s similar product Gardasil.

Analysts expect both vaccines will be multibillion-dollar sellers. Gardasil, however, may have the edge, since it is already established in international markets.

So far, the only major market where Cervarix has a green light is Australia. Glaxo expects to launch it in Europe in the second half of this year but in the United States -- the world's top market -- it will not go on sale before 2008.

Cervarix is designed to prevent types 16 and 18 of the sexually transmitted human papillomavirus (HPV), which are responsible for 70 percent of all cervical cancers. Gardasil targets two additional virus strains that cause genital warts, a less serious condition.

Results of the Phase III study involving 18,644 women aged 15 to 25 years showed Cervarix was 90.4 percent effective against types 16 and 18, based on pre-specified analyses that only required detection of virus in the lesion.

In practice, however, researchers found most lesions contained multiple cancer-causing HPV types and when this was taken into account, Glaxo said the data showed Cervarix was actually 100 percent effective against strains 16 and 18.

CROSS-PROTECTION

Cervarix also provided significant cross-protection against infection caused by virus types 45, 31 and 52, which together account for another 12 percent of cervical cancer cases.

"To have up to 100 percent protection against two viruses that are responsible for more than 70 percent of cervical cancers and to confirm some preliminary findings on cross-protection, as well as the safety profile, is extremely exciting news for us," Philippe Monteyne, Glaxo's head of vaccine development, told reporters in a conference call.

In an accompanying comment in the Lancet, Jessica Kahn of the University of Cincinnati College of Medicine and Robert Burk of the Albert Einstein College of Medicine in New York, said the results were encouraging but it was still early days to assess efficacy, since cervical cancer can evolve over several decades.

They also highlighted some increases in adverse reactions among vaccinated women, including injection site symptoms and some general symptoms, although there were no clinically meaningful differences in safety outcomes.

Many governments around the world have endorsed the idea of vaccinating young girls around the age of puberty, on the basis that it will save lives and healthcare costs in the years ahead.

The enthusiastic reception for HPV vaccination has helped fuel strong Gardasil sales, which totaled $365 million for Merck in the first quarter of 2007.

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Vaccine ninety percent effective against cervical cancer

A new vaccine protects nine out of ten women against cervical cancer linked to two strains of the deadly human papillomavirus (HPV), according to a study published Thursday.

HPV types 16 and 18 account for 70 percent of cervical cancer cases worldwide, which number about 500,000 per year, according to the UN Population Fund (UNFPA).

If left untreated, invasive cervical cancer is almost always fatal.

In a clinical trial, more than 9,000 women were vaccinated with the experimental drug, with a control group receiving a vaccine for hepatitis A.

Over a 15-month follow up period, the drug showed a 90.4 percent efficacy against the kind of pre-cancerous lesions that are a precursor to full-blown cervical cancer.

"The vaccine is effective, well-tolerated and immunogenic" -- meaning it produces an immune response -- "in a broad population of young adult women," said University of Helsinki professor Jorma Paavonen, who led the study.

Side-effects were minimal, the study found.

The drug being tested, which has yet to go to market, would be sold under the brand name Cervarix, and is manufactured by British firm GlaxoSmithKline, which funded the study.

A similar drug produced by US firm Merck, Gardasil, also vaccinates against HPV types 16 and 18, and has already been approved for sale in many countries.

More than half of the women vaccinated in the phase III trials were from Finland, with the rest coming from 13 other countries, including many in the developing world, where 90 percent of new cases occur.

"The vaccine is not therapeutic but prophylactic," Paavonen said by telephone, explaining that it would not benefit women who already test positive for both of the targeting virus strains.

But those who were exposed to only one of the strains would be protected from the other, and even those who had been exposed to both "received some cross-protection from other strains," he said.

Cervical cancer is the second most common type of cancer among women, with deaths projected to rise by almost 25 percent over the next 10 years, according to the UNFPA.

Earlier this month the British government took steps towards vaccinating girls as young as 12 against the sexually-transmitted virus, a measure that could be implemented by late next year.

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Sharpening Your Wits Could Outwit Alzheimer's

Doing plenty of mentally-stimulating activities -- such as playing chess, reading a newspaper, or attending a play -- in old age helps reduce the risk of Alzheimer's disease, according to a study of more than 700 elderly Americans.

The Chicago residents, who averaged 80 years of age at the start of the study, underwent annual cognitive testing for up to five years. During the study, 90 people developed Alzheimer's disease, and 102 died.

However, the Rush University Medical Center researchers found that those who were "cognitively active" were 2.6 times less likely than those who got minimal mental stimulation to develop Alzheimer's disease.

The study, published June 27 in the journal Neurology, also found that frequent mental stimulation was associated with a reduced risk of mild cognitive impairment -- a transitional stage between normal aging and dementia -- and less rapid decline in cognitive function.

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Antidepressants not big risk for defects

Newborns face little risk of birth defects from antidepressants taken by many women early in pregnancy, say the reassuring findings of the two biggest studies of this controversial link.

The research focuses on the class of drugs chosen most often for depression and anxiety, including the brands Prozac, Paxil and Zoloft.

Paxil carries a warning of possible heart defects in newborns, and experts don't expect the new research to change that. However, they find the new studies comforting for women struggling with depression.

The possibility of birth defects from antidepressants has put doctors and patients in a tricky quandary. Birth defects obviously hurt newborns, but depressed mothers who can't give proper care also endanger their babies.

Confusing matters, researchers have wondered if the concern about birth defects should extend beyond Paxil to this entire class of drugs, known as selective serotonin-reuptake inhibitors, or SSRIs. The two latest studies, appearing Thursday in The New England Journal of Medicine, relieve some of that worry, say birth specialists.

"Yeah, there's a risk, but the risk overall is probably pretty small," said Dr. Susan Ramin, obstetrics chairman at the University of Texas Medical School in Houston, who was familiar with the findings.

The two studies — one from the federal Centers for Disease Control and the other from Boston University — use more cases of birth defects than previous research to consider links between the abnormalities and SSRIs. The Boston University study was funded partly by the National Institutes of Health and Paxil maker GlaxoSmithKline PLC.

Together, the two studies looked at 19,471 newborns with birth defects and 9,952 without them. Then they considered what SSRIs the mothers in both groups took during the first three months of pregnancy and mapped the patterns of birth defects.

Neither study was able to tie SSRIs as a group to either heart defects or most other defects. That reassurance is especially welcome because depressed women fret even more than other mothers about the health of their newborns, said Dr. Stephan Quentzel, a psychiatrist who treats pregnant women at Beth Israel Medical Center in New York City.

Also, a mother's untreated depression can lead to poor care or turmoil at home, a weaker maternal bond, and other problems for a newborn. "The fetus and the newborn are almost always worse off if the mom is depressed than if ... exposed to the vast majority of antidepressants," Quentzel said.

However, doctors and mothers have been very wary about medications and birth defects since Europe's thalidomide scandal of deformed babies in the 1960s. Defects from all causes are expected in about 3 percent of births, enough to make many mothers nervous.

The concern about SSRIs grew out of GlaxoSmithKline's own alert in 2005 about possible heart defects in newborns whose mothers took Paxil early in pregnancy. The U.S. Food and Drug Administration added its own warning. Last year, a separate study linked SSRIs taken late in pregnancy to a lung disorder in newborns.

The latest studies do not consider that disorder, known as persistent pulmonary hypertension. But they suggest that the risk of other defects from an SSRI — even if confirmed — would add only a fraction of 1 percent to the overall danger, researchers said.

Paxil did appear to triple the risk of a defect in blood flow from the heart, both studies found. But that additional danger would still be modest, experts said.

The studies further hinted at possible ties between other SSRIs and a handful of other defects, but researchers said the numbers of newborns with specific defects were too small to draw strong conclusions.

"Based on these studies, it's correct to say: no major risk," said Carol Louik, a public health expert who led the Boston study. "I wouldn't say, 'No risk.'"

Researchers said women should talk over the potential risks and benefits with their doctors, preferably before pregnancy.

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Meningitis shot advised for ages 11-18

Now that a hard-to-get meningitis vaccine is more plentiful, health experts recommended Wednesday that the shots be given to all children ages 11-18.

Their advice expands on earlier guidance set when the vaccine was in short supply. Priority was given to college freshmen and teens entering high school, and later to 11- to 12-year-olds.

Wednesday's new recommendations by a vaccine committee that advises the government is not a call for immediate mass vaccinations. But doctors should make a point of offering the shot to youngsters in the 11-18 age range when they come in for checkups, said Dr. Jon Abramson, the committee's chairman.

The recommendations by the Advisory Committee on Immunization Practices usually are accepted by federal health officials, and they influence insurance companies' decisions on vaccination coverage.

At issue is Menactra, an $89-a-dose vaccine made by Sanofi Pasteur, the vaccines subsidiary of Sanofi-Aventis Group. The government approved it in 2005.

The vaccine is designed to prevent bacterial meningitis and an associated bloodstream infection. The disease is not common in the United States, but in those who get it, symptoms develop quickly and can lead to death in only a couple of days.

The bacteria is spread by coughing, sneezing and kissing, and most cases occur in previously healthy children and young adults. It can be easily spread in college dorms.

Demand for the shot exceeded supply. "There was a very enthusiastic response," more than anticipated, said Phil Hosbach, Sanofi's vice president of immunization policy and government relations.

Now supply is comfortably ahead of demand — about 9 million doses should be available this year.

"Supply is good and we're not expecting any problems," said spokeswoman Donna Cary, adding that the company should be able to handle the 7-million-dose demand expected from the new recommendation.

The committee voted 11-1 in favor. The dissenter was Dr. Susan Lett of the Massachusetts Department of Public Health, who felt the supply had only recently stabilized and that this step — a reversal of last year's limitations — might leave doctors confused.

Menactra is one of a half-dozen childhood and adolescent vaccines added to federal recommendations in recent years, which has driven the per-child cost of vaccination from $155 in 1995 to $900 for boys and $1,200 for girls.

More than 1 million children aren't able to get the meningitis shots paid for by private or public insurance, said Dr. Grace Lee, a Harvard researcher who presented results of a study she did on gaps in vaccine financing.

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Birth defect risk from antidepressants low

Newer antidepressant drugs may increase the risk of birth defects but the risk remains very remote, according to two new studies published on Thursday.

The drugs, known as selective serotonin reuptake inhibitors or SSRIs, may cause a very small increase in the number of heart defects, but even this is unclear, researchers report in this week's issue of the New England Journal of Medicine.

"Researchers, did, however, find associations between SSRI use and three specific birth defects: a defect of the brain, one type of abnormal skull development and a gastrointestinal abnormality," the U.S. Centers for Disease Control and Prevention said in a statement.

"CDC plans to continue to study the association to clarify whether a true risk exists," it added.

"Any increased risks of these malformations in association with the use of SSRIs are likely to be small in terms of absolute risks," Dr. Michael Greene of Massachusetts General Hospital wrote in a commentary.

About 10 percent of pregnant women suffer from depression, according to the March of Dimes. The CDC says every pregnancy has a 3 percent risk of a major birth defect, regardless of exposures.

Concern over SSRIs surfaced nearly two years ago when a survey of 527 fetuses whose mothers took GlaxoSmithKline's Paxil during their first three months of pregnancy found that 4.4 percent were born with major malformations, usually of the heart.

The rate was 2.2 percent among women taking other antidepressants.

The finding prompted a change in labeling and new studies.

In November, a committee of the American College of Obstetricians and Gynecologists recommended that such drugs be discontinued if possible when a patient becomes pregnant. Prozac, made by Eli Lilly and Co.; Lexapro, made by Forest Laboratories Inc. and Zoloft, made by Pfizer, are all SSRIs.

OVERBLOWN CONCERNS

The New England Journal studies suggest that such concerns may be overblown. One found small increases in some uncommon defects and the other found no links in most cases.

"It should be recognized that the specific defects implicated are rare and the absolute risks are small," wrote one team, led by Carol Louik of Boston University, which looked at the cases of 15,709 babies.

Her group found, for example, no overall increase in the risk of heart defects, an original cause for concern.

In the second study, a group led by Sura Alwan of the University of British Columbia in Vancouver assessed data from 13,714 births to conclude that when a link between the drugs and a problem was discovered, the number of cases was too small to be definitive.

For example, they found that the risk of a child being born without a brain was 2.4 times higher if the fetus was exposed to an SSRI during the first three months of development. But that number was based on only nine affected babies who had been exposed to a drug, out of the 214 born with the defect.

They said letting a mother suffer from depression during pregnancy or discontinue her medicine if she suffers from serious depression can be dangerous to both herself and the child.

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New findings back smoking-stillbirth link

A large study that followed women through their first and second consecutive pregnancy provides additional evidence of a direct link between smoking and increased risk of stillbirth.

Compared with women who didn't smoking during either pregnancy, the investigators found that those who smoked during their first but not their second pregnancy did not have an increased risk of stillbirth. However, women who smoked during both consecutive pregnancies had a 35 percent higher risk of stillbirth than nonsmokers.

Because the study found a reduction in stillbirth risk among women who quit smoking, it suggests that smoking can cause infants to not survive delivery, Drs. L. Hogberg and S. Cnattingius of the Karolinska Institutet in Stockholm, Sweden conclude.

There is a well-established association between smoking during pregnancy and stillbirth, but evidence supporting a causal link has been mixed, Hogberg and Cnattingius note in BJOG: An International Journal of Obstetrics and Gynecology.

To investigate how changes in smoking habits might affect stillbirth risk, the researchers looked at data from a nationwide birth registry of 526,691 women who had delivered their first and second children between 1983 and 2001.

Women who smoked during their first pregnancy but quit during their second pregnancy were no more likely to have a stillborn infant than those who never smoked at all.

As mentioned, overall, women who smoked during both their first and second pregnancies were at a 35 percent greater risk of delivering their second child stillborn. In addition, heavy smokers, defined as 10 or more cigarettes per day, had a 45-percent increased risk of having a stillborn infant in their second pregnancy, while smoking one to nine cigarettes per day during the second pregnancy did not increase stillbirth risk.

While 31 percent of the women smoked every day in early pregnancy in 1983, that number fell to 10 percent by 2003, the researchers note. Nevertheless, they conclude, "As smoking is a preventable risk factor for stillbirth and other adverse pregnancy outcomes, smoking interventions should continue to have a high priority in the work of antenatal care centers."

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Dads, moms equally likely to pass MS risk to kids

Mothers and fathers with multiple sclerosis are equally likely to pass genetic risk for it on to their children, according to a study countering a previous finding that fathers were twice as likely to do so.

Writing on Wednesday in the journal Neurology, researchers said they looked at 3,088 Canadian families with one parent with the disease.

They found that 9.41 percent of children of fathers with MS got the disease, compared to the nearly identical figure of 9.76 percent of children of mothers with MS.

"We found that it's absolutely bang-on random," Dr. George Ebers of Britain's University of Oxford said in a telephone interview.

"That is to say that the offspring risk from the female side is no different than the offspring risk from the male side," when a parent has MS.

MS is an incurable and sometimes disabling disease of the central nervous system in which communication between the brain and other parts of the body is disrupted. It is thought to be an autoimmune disease in which the body mistakenly attacks its own tissues.

The exact cause of MS is unknown, but experts believe genetic and environmental factors are at play. Ebers said the new findings do not support the notion that a whole bunch of genes determine MS susceptibility.

Of the 8,401 children in these families, 798 had MS. The study also found that genetic risk was no more likely to be transmitted to daughters or sons from a parent with MS.

PATERNAL TRANSMISSION

The findings run counter to a smaller study published in July 2006 in the same journal led by Mayo Clinic researchers. That study, which looked at 444 U.S. children of a parent with MS, concluded that fathers with the disease transmitted it to their children 2.2 times more often than mothers.

MS is far more common in women than men. These researchers hypothesized that because men are more resistant to MS, they need stronger or a larger number of genes in order to develop it, and then pass those genes to their children.

Mayo Clinic neurologist Dr. Orhun Kantarci, who led last year's study, said of the new findings: "This is a very important study involving a much larger sample of patients than previous studies and, therefore, the results are valid."

But Kantarci added that he did not think the new study necessarily negated the earlier finding that fathers were more likely to pass on MS to children than mothers, saying the differing results may be because the two studies examined different populations.

"This is just one of those studies, as is the case with our study, that adds to the pool of interesting results in this field," Kantarci said, adding that more research was needed to clarify parental genetic transmission of MS risk.

Multiple sclerosis can be mild in some people while causing permanent disability in others. Symptoms may include numbness or weakness in the limbs, partial or complete loss of vision, tingling or pain, electric-shock sensations with certain head movements, tremors and an unsteady gait.

About 2.5 million people worldwide, including about 400,000 Americans, have MS, according to the National Multiple Sclerosis Society.

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Brazil offers morning-after pill to poor

Brazil's government has added "morning after" pills to its newly expanded birth control program in hopes of helping poor people reduce unwanted pregnancies and dangerous illegal abortions.

Health Minister Jose Gomes Temporao announced the addition a month after President Luiz Inacio Lula da Silva said the government would provide cheap birth control pills at 10,000 drug stores across Latin America's biggest country.

Speaking at a round-table discussion Monday sponsored by the Folha de S. Paulo newspaper, Temporao called the morning-after pill "an important tool for the prevention of unwanted pregnancies that will definitely be part of our strategy" to help Brazil's poor have the same access to birth control as its rich elite.

The Health Ministry said he attended, but would not immediately confirm his remarks.

Brazil already distributes 254 million free condoms a year, many as part of an anti-AIDS program that makes a special effort just before each year's Carnival celebrations. Brazil also has handed out the morning-after pill and regular contraceptives at government pharmacies for years.

The newly expanded program offers regular contraceptives at commercial drug stores for sale at just $2.40 for a year's supply. Temporao didn't say whether the morning-after pills would be subsidized or entirely free. Previously, the government said it would distribute 50 million packages of regular birth control pills, each with a month's supply, by year's end.

Morning-after pills have high doses of the same drugs found in many regular birth-control pills, and can lower the risk of pregnancy by up to 89 percent if taken within 72 hours of unprotected sex.

Ana Lucia Cavalcanti, who heads women's programs for Sao Paulo, knew of no other Latin American nations that supply free or subsidized morning-after pills. She called on the government to launch education programs so poor women understand how to use them.

Brazil is the world's largest Roman Catholic nation, and the church has vehemently opposed any expansion of birth control. Brazilian Archbishop Orlando Brandes, who represents the church on this issue, was unavailable for comment Tuesday, his office said.

Temporao also has lobbied for a national referendum to legalize abortion up to the 12th week of pregnancy. Brazil now allows abortions only when women have been raped or their lives are in danger, and polls show Brazilians overwhelmingly oppose changes.

Women's rights groups estimate 800,000 illegal abortions happen in Brazil each year, and about 4,000 women die from the back-office procedures annually. Abortions are the fourth leading cause of maternal death in Brazil after hypertension, hemorrhages and infections.

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FDA says unmoved by aspartame/ cancer report

A U.S. consumer group called for an urgent Food and Drug Administration review of the safety of aspartame on Monday, but the FDA said there was no immediate need to do so despite a new study showing the sweetener may cause cancer.

Italian researchers published a new study last week that showed aspartame -- widely used in soft drinks -- might cause leukemia, lymphoma and breast cancer in rats.

"This is the second study by the same lab showing that aspartame causes cancer in rats," Center for Science in the Public Interest executive director Michael Jacobson said in a telephone interview.

Aspartame is used mostly in soft drinks but is also sold in packets to use in coffee, tea or on food. "People can easily avoid products using Nutrasweet or Equal and keep these products away from kids," Jacobson added.

Morando Soffritti of the Ramazzini Foundation in Bologna, Italy and colleagues tested aspartame in rats, which they allowed to live until they died naturally.

Their study of more than 4,000 rats showed a lifetime of eating high doses of the sweetener raised the likelihood of several types of cancer.

"On the basis of the present findings, we believe that a review of the current regulations governing the use of aspartame cannot be delayed," Soffritti's team wrote in the journal Environmental Health Perspectives, which is published by the U.S. National Institute of Environmental Health Sciences.

"This review is particularly urgent with regard to aspartame-containing beverages, heavily consumed by children."

FDA spokesman Michael Herndon said the agency had not yet reviewed the study.

"However, the conclusions from this second European Ramazzini Foundation are not consistent with those from the large number of studies on aspartame that have been evaluated by FDA, including five previously conducted negative chronic carcinogenicity studies," Herndon said in an e-mail.

"Therefore, at this time, FDA finds no reason to alter its previous conclusion that aspartame is safe as a general purpose sweetener in food."

LETTING RATS LIVE

Jacobson said researchers in previous studies all killed rats at the age of two years. Allowing the rats to live longer may have been a better way to assess the natural risk of cancer, he said.

The CSPI said the Acceptable Daily Intake of aspartame in the United States is 50 mg per kilogram of body weight, equivalent to a 50-pound (20 kg) child drinking 2.5 cans of diet soda a day, or a 150-pound (68 kilogram) adult drinking about 7.5 cans a day.

The Italian researchers found a cancer risk at the very highest doses -- double the U.S. Acceptable Daily Intake.

A spokesman for Coca-Cola was not immediately available for comment.

Merisant, which makes Equal, has this statement on its Web site: "The safety of aspartame has been confirmed by regulatory authorities in more than 100 countries, including the U.S. Food and Drug Administration, Health Canada, and the European Commission's Scientific Committee on Food, as well as by experts with the United Nations' Food and Agricultural Organization and World Health Organization."

Jacobson said people should avoid the product for now.

"People shouldn't panic, but they should stop buying beverages and foods containing aspartame," he advised.

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More vitamin D can put more pep in seniors' steps

Declining physical performance among some Dutch seniors may not be a simple consequence of aging, it may actually be due to a vitamin D deficiency, results of a new study suggest.

"Physicians and the general public should be made more aware of the high prevalence of vitamin D deficiency and insufficiency, and more effort should be concentrated on the early detection and treatment of people with suboptimal levels of vitamin D," study co-author Dr. Paul Lips, of VU University Medical Center in Amsterdam, and his colleagues write.

Previous research has shown that low vitamin D status is not uncommon among seniors, which may be explained by their decreased exposure to sunshine, reduced dietary consumption of vitamin D, and reduced capacity to naturally synthesize the vitamin. This deficiency is known to result in bone loss and fractures, among other bone and muscle-related problems.

The extent to which an individual's vitamin D status can affect his or her physical performance, however, has not been as well explored.

To investigate, Lips and his colleagues analyzed data on 979 seniors, 65 years or older, who were involved in the ongoing Longitudinal Aging Study Amsterdam.

They found that the study participants' vitamin D status was indeed associated with their physical performance, even after the seniors' age, the presence of chronic diseases, extent of alcohol consumption and various other factors were taken into account, they report in the Journal of Clinical Endocrinology & Metabolism.

For example, nearly half (47 percent) of the seniors had low vitamin D levels at the start of the study, and their deficiency was associated with poorer physical performance than their peers. Over the 3-year study, these vitamin D-deficient adults were also twice as likely as their peers to exhibit a decline in physical performance, such as taking longer to rise from a sitting position.

In light of these findings, "public health strategies should be aimed at this group," the researchers conclude.

The findings can also be generalized to other groups of older Dutch Caucasians, as well as to younger people, who may simply be better able to compensate for their vitamin D deficiency and subsequent decline in physical performance.

Vitamin D deficiency is not unique to the Dutch population, however. Dr. Nancy S. Wellman, a spokesperson for the American Society for Nutrition, told Reuters Health that "vitamin D is one of the most common shortfall nutrients in diets of older Americans."

"It is not found naturally in many foods," she explained.

To address this problem, Wellman, a professor and director of the National Resource Center on Nutrition, Physical Activity & Aging, at Florida International University, advises seniors to drink milk or orange juice that is fortified with vitamin D and calcium, since "both are needed for bone health."

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Health Tip: Stop Your Child From Biting

Young children often bite out of frustration, anger and emotions that they don't otherwise know how to express.

Here are suggestions on how to break a child's biting habit, courtesy of the Center for Effective Parenting:

• Watch what prompts the child to bite -- such as large playgroups or playing with certain toys -- and try to change or avoid those situations.
• Place the child promptly in time out after he has bitten, and explain that he is not allowed to return to fun activities until he has calmed down.
• Explain to the child what she can do instead of biting -- asking an adult for help, for example.
• Direct your attention to the child who was bitten, and away from the biter. If the child bites for attention, he will learn that there are more effective ways to get it

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Rise in Child Chronic Illness Could Swamp Health Care

As more American children eat poorly and exercise less, rates of chronic illness such as asthma and diabetes are continuing to rise, researchers are reporting.

And because childhood illness often sets the stage for adult health woes, the U.S. health-care system could be headed toward a crisis in coming decades, experts warn in a number of reports in the June 27 issue of the Journal of the American Medical Association.

"A chronic condition in a child will become a chronic condition in an adult -- we just know that. And what you're talking about for an adult is maybe 10, 20 years of suffering. But with a child, you're talking about maybe 50, 60 years of suffering," said the journal's editor-in-chief, pediatrician Dr. Catherine DeAngelis, during a Tuesday teleconference.

A surge in childhood illness will also have a big impact on the U.S. health-care system, another expert said.

"Given these high rates of [ill children] in the next decade, there are going to be tremendously higher rates of expenditures for health care and social welfare, because a lot of these people will have health disabilities, and they won't be employable," Dr. James Perrin, director of the Center for Child and Adolescent Health Policy at MassGeneral Hospital for Children, in Boston, told HealthDay. Perrin is also co-author of a journal analysis of the prevalence and causes of childhood chronic illness.

The special themed issue of JAMA is devoted to chronic childhood illness, defined as any debilitating illness that lasts a year or more past diagnosis. A number of new studies suggest that, in many ways, the health of America's children is getting worse, not better.

Some findings:

* According to the analysis by Perrin and colleagues, more than 7 percent of U.S. children and youth were hampered in their daily activities by an illness that lasted three months or longer in 2004, compared to just 1.8 percent of children in 1960.
* Chronic conditions now affect 15 percent to 18 percent of children and teens, and even those estimates may not fully account for obesity and mental health woes, the Harvard team said.
* The "big three" chronic health conditions for kids are obesity, which affected 5 percent of American children in the early 1970s but 18 percent of children today; asthma (9 percent prevalence, nearly double from the 1980s), and attention deficit hyperactivity disorder (a dramatic rise, mostly linked to better diagnosis).

Childhood diabetes is one of the prime results of rising obesity rates, which in turn result from more sedentary behaviors and poor diets.

"Children's environments have really changed a lot in the last 30 to 40 years," said Perrin. "By that, we mean a big change in their diets -- much more fast-food, high-calorie foods -- and major changes in their use of electronic media, especially television. They are spending much more time in the home watching television and eating high-calorie foods while they do so."

However, new research finds that the rise in childhood diabetes is still largely attributed to an increase in type 1 disease -- usually thought of as an inherited illness -- rather than an increase in obesity-linked type 2 disease, the form that typically strikes obese adults.

Experts aren't sure why type 1 diabetes numbers might be rising. Some experts believe that obesity might help spur certain immune-cell changes that are seen in type 1 disease, changes that eventually lead to the destruction of insulin-producing cells in the pancreas. Or, as Dr. Rebecca Lipton of the University of Chicago noted in an editorial, many of these type 1 cases may be type 2 cases misdiagnosed by physicians.

Diabetes does seem to be affecting different groups of American children in different ways, however.

"We have seen an increase in type 1 diabetes over a 27-year period of about 60 percent. This translates into 2.7 percent higher annual rates for non-Hispanic white children and about 1.6 percent higher annual rates for Hispanics," said Dr. Dana Dabelea, of the University of Colorado Health Sciences Center, and lead author of the country-wide SEARCH for Diabetes in Youth study group.

"Based on these data, we estimate that 15,000 youth are diagnosed annually with type 1 diabetes in the United States," she said.

As for type 2 diabetes, Dabelea said that form of the disease "accounts for 1 to 2 percent of cases in Caucasian children [in Europe], whereas here in the United States, this figure is 15 percent. That figure speaks for itself... It's a deleterious consequence of obesity in this country."

In their journal study, the researchers at University of Colorado Health Sciences Center found that non-Hispanic white children are more likely to develop type 1 diabetes than minority children. On the other hand, type 2 disease is much more likely to appear in black or Hispanic 15- to 19-year-olds than in white teens.

Asthma, too, is affecting more and more children, and childhoods spent largely indoors may be to blame here, as well, said Perrin, who is also a professor of pediatrics at Harvard Medical School.

While allergies to cockroaches and dust mites have long been linked to soaring asthma rates among America's urban poor, studies have shown no concurrent rise in the rate of household infestations over the past decades, he pointed out.

"However, we do know that kids now spend much more time indoors [than they used to] in intimate contact with cockroaches and dust mites," Perrin said.

Even the good news on childhood illness comes mixed with a little bad news. Dutch researchers note that more and more children are claiming victory over a wide variety of cancers. However, the study also suggests that battling cancer in childhood boosts risks for adult illnesses.

The study of almost 1,400 five-year survivors of childhood cancer tracked these young people to an average of just over 24 years of age. Three-quarters of these survivors experienced some form of adverse medical event in young adulthood, and one-quarter suffered five or more such events, the researchers found. More than one-third (36.8 percent) developed a life-threatening or disabling disorder years after beating their cancer, the researchers found.

Study author Dr. Huib Caron, of Emma Children's Hospital/Academic Medical Center, in Amsterdam, strongly supports the creation of specialized follow-up clinics that could monitor childhood cancer survivors into adulthood.

These clinics are essential because "the majority of adult medicine physicians haven't got the faintest clue about the health risks that this population is running -- they haven't got the expertise," Caron said. And many problems, such as cardiac troubles, are asymptomatic and would only show up on doctor-ordered ultrasounds or other tests, he said.

Getting doctors to keep closer tabs on childhood cancer survivors might not be so difficult. However, changing the poor eating habits and lax exercise patterns of America's children -- and their parents -- will be a lot tougher, Perrin said.

Recent public policy moves -- such as bans on sugary or greasy snacks and soft drinks in schools -- are steps in the right direction. But parents, especially, "are critical to this effort," Perrin said.

By modeling good behaviors and closely monitoring their children's behaviors, "parents can do a really good job, and it's important for them to realize that," he said. "We think that improving how parents parent is a critical way of stemming this epidemic."

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Childhood cancer can lead to chronic health problems later in life

Most children who undergo cancer treatment will develop one or more chronic health problems later in life due to the illness and complications from its treatment, a study released Tuesday suggested.

Dutch researchers who conducted a long-term study of more than 1,300 childhood cancer survivors found that 75 percent went on to develop one or more chronic health conditions by the time they reached their mid 20s, or early 30s at the latest.

Close to 25 percent had multiple health problems by that point, and some 40 percent had suffered at least one severe, life-threatening, or disabling event or condition.

The most serious repercussions of their early struggles with cancer and its treatment with chemicals, radiation and surgery included secondary cancers, obesity, infertility, neurological problems, and learning, behavioural and hormonal disorders.

The investigators found that children who had been treated for bone tumours had the most health problems to contend with down the road - far more than kids who beat leukemia or Wilms tumour (a tumor of the kidney).

Their analysis also showed that radiotherapy, as a stand-alone treatment, was associated with a much higher disease burden later in life than either stand-alone chemo or drug therapy or stand-alone surgery.

More than half the children in the study who underwent radiation treatment had a high or severe burden of illness by the time they were young adults, compared to 25 percent of patients who had surgery, and 15 percent of kids who got medication only.

That finding may reflect that fact that radiation damages healthy tissue in addition to zapping cancer cells, which increases the risk for secondary cancers, according to the lead author of the paper, Huib Caron, a professor of pediatric oncology at Emma Children's Hospital in Amsterdam in the Netherlands.

Ultimately, the findings show that early, life-saving interventions come at a price - one that can take a heavy toll on the survivors' quality of life, and reduce their life expectancy.

The results emphasise the need for ongoing monitoring of young cancer patients so subsequent problems can be diagnosed and treated early, the authors said.

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White U.S. children have highest rates of diabetes

Non-Hispanic white children have the highest rates of diabetes in the United States, U.S. researchers said on Tuesday, and the disease appears to be more common than expected.

They said type 1 diabetes is the most common form of diabetes in children and teens, but they also noted increases in cases of type 2 diabetes, the kind linked with obesity and lack of exercise.

The research, published in the Journal of the American Medical Association, found about 15,000 youths are diagnosed with type 1 diabetes each year.

"We found more type 1 diabetes than we expected in whites, blacks and Hispanics," said Dr. Dana Dabelea of the University of Colorado in Denver, who led the study.

"Although the rates of type 2 diabetes are relatively low, we did find type 2 in all racial and ethnic groups, including non-Hispanic whites," she said in a telephone interview.

Type 1 diabetes occurs when the immune system goes haywire and starts attacking itself, destroying insulin-producing cells in the pancreas needed to control blood sugar. People with type 1 diabetes must take daily insulin injections.

Type 1 diabetes is sometimes called juvenile diabetes. Type 2 formerly was called adult onset diabetes.

Dabelea said the study, which included 2,435 youths with newly diagnosed diabetes in 2002 and 2003, is the largest to measure the rate at which diabetes develops in people under 20.

"What we found is that type 1 diabetes is highest in non-Hispanic white children. The age group at which this disease peaks is around puberty," Dabelea said.

She found about one in 3,000 non-Hispanic white children in this age group develop type 1 diabetes each year, compared with one in about 5,000 African-American and Hispanic youths.

The rates are much lower, about 1 in 10,000, for Asian Pacific Islanders and American Indian children, she said.

"For type 2 diabetes, the picture is a little different," she said. "The age group with the highest incidence is adolescents -- 15- to 19-year-olds."

In this age group, American Indian children are hit hardest, with about one in 2,000 developing type 2 diabetes each year.

The study was designed to specifically look at type 2 diabetes in children in light of rising rates of obesity. The disease, which typically strikes overweight, inactive adults, develops when the body loses the ability to use insulin properly.

"We found overall the rates of type 2 diabetes in kids are relatively low," she said. "But 15 years ago, there was no type 2 diabetes in kids."

So while the number is not very high, it is becoming a problem. "In ethnic groups such as American Indians, it is a huge problem," she said.

Nearly 21 million Americans have diabetes, which causes 5 percent of all deaths globally each year. Most have type 2, which can damage blood vessels, leading to loss of toes and limbs, blindness, heart disease and death.

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Intercytex artificial skin heals wounds in tests

A British biotechnology company has developed a long-lasting artificial skin that has produced promising results in healing wounds in early clinical trials.

Scientists said the advance could mark a breakthrough in regenerative medicine.

Intercytex Group Plc, which specializes in cell therapy, said on Tuesday its laboratory-made living skin was fully and consistently integrated into the human body. The group's shares rose 12 percent to 66-1/2 pence in early trade.

The new skin appears to work better than other substitutes tried in the past, which biodegrade in situ after a few weeks.

Results of the tests were published in the journal Regenerative Medicine and showed that Intercytex's artificial skin, ICX-SKN, was fully integrated after 28 days, producing a closed and healed wound site.

Intercytex now plans to test ICX-SKN on larger wounds and move on to pivotal clinical trials that would generate sufficient data to seek a marketing license.

Current best practice for serious wounds is to use a skin graft taken from a different part of the patient's own body -- but this is a painful process and creates a new wound.

ICX-SKN is made up of a matrix produced by the same skin cells -- fibroblasts -- that are responsible for laying down the collagen in natural skin. The fibroblasts weave a structure which mimics that found in skin.

Stephen Minger, an expert in cell biology at King's College London, said the results marked "a real breakthrough" in wound healing and regenerative medicine in general.

"To have an off-the-shelf skin replacement product that can be used in large numbers of patients will revolutionize the treatment of burned and skin damaged patients," he said.

Intercytex founder Paul Kemp hopes to develop a range of cell-based implants that can regenerate lost tissue.

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Portion-Control Dishware Helps Obese Diabetics Lose Weight

Using a plate and cereal bowl that indicate proper portion sizes helped obese patients with diabetes lose weight and decrease their use of glucose-controlling medications, says a Canadian study.

The plates -- divided into painted-line sections for carbohydrates, proteins, vegetables, cheese and sauce -- held enough for an 800-calorie meal for men and a 650-calorie meal for women. The bowl allowed for a 200-calorie serving of cereal and milk.

Over six months, about half of 122 patients (average age 56) used the portion-control plates and bowls, while the rest of the patients received usual care consisting of dietary assessments and teaching by dietitians.

The patients who used the portion-control plates and bowls lost an average of 1.8 percent of their body weight, compared to an average of 0.1 percent among those who received usual care.

The University of Calgary researchers also found that 16.9 percent of the patients who used the portion-control plates and bowls, which were donated by a U.K. company called The Diet Plate, lost at least 5 percent of their body weight, compared with 4.6 percent of patients who received usual care.

"This is important, as a 5 percent weight loss has been shown to be clinically significant in terms of decreasing morbidity and mortality associated with obesity-linked disorders such as cancer and (heart attack)," the study authors wrote.

The use of diabetes medications decreased by 26.2 percent among patients using the plates and bowls, compared with 10.8 percent among those who received usual care.

The portion-control plates and bowls offer a simple, inexpensive method of weight control that shows promise in helping obese people with diabetes, the study authors concluded.

The findings were published in the June 25 issue of the journal Archives of Internal Medicine.

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