How Coconut Oil Could Help Reduce The Symptoms Of Type 2 Diabetes

A new study in animals demonstrates that a diet rich in coconut oil protects against 'insulin resistance' (an impaired ability of cells to respond to insulin) in muscle and fat. The diet also avoids the accumulation of body fat caused by other high fat diets of similar calorie content. Together these findings are important because obesity and insulin resistance are major factors leading to the development of Type 2 diabetes.

The study is also interesting because it helps explain human studies showing that people who incorporate medium chain 'fatty acids', such as those found in coconut oil, into their diets can lose body fat.

Dr Nigel Turner and Associate Professor Jiming Ye, from Sydney's Garvan Institute of Medical Research, compared fat metabolism and insulin resistance in mice fed coconut oil and lard based diets. Their findings are now published online in the international journal Diabetes.

"The medium chain fatty acids, like those found in coconut oil, are interesting to us because they behave very differently to the fats normally found in our diets," said study leader Nigel Turner.

"Unlike the long chain fatty acids contained in animal fats, medium chain fatty acids are small enough to enter mitochondria - the cells' energy burning powerhouses - directly, where they can then be converted to energy."

"Unfortunately the downside to eating medium chain fatty acids is that they can lead to fat build up in the liver, an important fact to be taken into consideration by anyone considering using them as a weight loss therapy."

Fat storage is determined by the balance between how much fat is taken in by cells and how much of this fat is burned for energy. When people eat a high fat diet, their bodies attempt to compensate by increasing their capacity to oxidise fat. The medium chain fatty acid (coconut oil) diet was more effective at increasing the oxidative capacity of muscle than the long chain fatty acid (lard) diet leading to less fat storage in muscle and better insulin action.

According to Turner, the lard-based diet used in this research is similar to the diet eaten by people in the Western world. "Its fatty acid composition is about 40% saturated fats, 40% monounsaturated fats and 20% polyunsaturated fats, of which the vast proportion is omega-6, rather than omega-3," he said.

"Obese humans usually eat 40-50% of their calories as fat. Our mice were fed 45% of their calories as fat."

"No high fat diet is good, and the normal dietary combination of long chain fats leads to an overload that our bodies can't cope with. Therefore high consumption of common dietary fats is contributing directly towards the global escalation of obesity and Type 2 diabetes."

"If someone is trying to prevent weight gain, we can see they may benefit from substituting oils containing medium chain fatty acids for other oils in their diet, as long as consideration is given to the potential problem of excess fat in the liver. Other natural dietary alternatives, such as fish oil, might be helpful because the fatty acids in fish oil are thought to exert a lot of their beneficial effects through improving fat oxidation in the liver."

Source
Garvan Institute of Medical Research

UAB's Dr. Whitley Chosen To Serve On President's H1N1 Swine Flu Working Group

University of Alabama at Birmingham (UAB) Director of Pediatric Infectious Diseases Richard Whitley, M.D., has been tapped to serve on the 2009-H1N1 influenza working group of the President's Council of Advisors on Science and Technology (PCAST).

The group is providing recommendations to U.S. President Barack Obama, through PCAST, on federal activities needed to respond to H1N1, or swine flu. Issues examined by the group include infection data collection, vaccine production, drug stockpile, preparedness plans and other public-health concerns, Whitley said.

Whitley is co-director of UAB's Center for Emerging Infections and Emergency Preparedness and a renowned researcher on the antiviral therapies designed to fight infections in children and adults. A UAB professor of pediatrics, microbiology, medicine and neurosurgery, he also serves as vice-chair of the Department of Pediatrics.

Whitley is president elect of the Infectious Diseases Society of America (IDSA) and serves on the Advisory Council for the National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health.

PCAST, which is administered by the Office of Science and Technology Policy, and its working groups include the nation's leading scientists, doctors and engineers who directly advise the president and the Executive Office of the President on prevention, planning, best practices, resource allocation and other responsibilities.

Source: University of Alabama at Birmingham

Second Wave Of Swine Flu Could Overwhelm Resources In Europe And North America Say Canadian Expert

A panel of experts in Canada has written an article in a leading medical journal suggesting that if the H1N1 pandemic swine flu follows the same disease pattern in the northern hemisphere this fall as it has in the southern hemisphere, then resources in North America and Europe could be overwhelmed. The experts say strong leadership will be needed to mobilize effective immunization and other campaigns and they also call for the appointment of national and local leaders and champions.

The editorial article was written by Dr Paul Hébert, Editor-in-Chief of the Canadian Medical Association Journal (CMAJ), and colleagues, and appears in the 17 August issue of the journal.

Hébert and colleagues wrote that vaccination must be the top priority against H1N1 flu this fall if the anticipated second wave of the pandemic virus follows the same pattern of spread in the northern hemisphere as it has in the southern hemisphere.

Canada and much of the Western world does not have much experience in implemeting time-sensitive mass vaccination campaigns, wrote the panel. We already struggle to get vulnerable groups vaccinated for seasonal flu, they added.

For example, in some years, only 15 per cent of people living in Nunavut (a major portion of northern Canada) are vaccinated, and last year, during the most recent outbreak of mumps in Nova Scotia's young adult population, only 15 per cent of targeted individuals were vaccinated (note this is the population segment most likely to be severely affected by the 2009 H1N1 swine flu).

"We need to act now to overcome these access and delivery problems," wrote Hébert and colleagues.

"No immunization program is 100 per cent effective. If a sufficient number of cases are not prevented, we can expect a large number of young critically ill patients filling all tertiary level intensive care beds," they warned, adding that although most infections have been mild so far, unlike most seasonal flu strains, in more serious cases the new 2009 pandemic H1N1 virus seems to invade the lower respiratory system more aggressively, causing more severe illness.

"The world's experience so far tells us that serious illness associated with this virus often manifests as acute lung injury resulting in overwhelming hypoxemia," they wrote.

Hébert and colleagues suggest Canada needs national leadership to make sure vaccines, expertise and equipment reaches everyone that needs them. New laws may be needed to give people power to act quickly.

Each country should have a "visible independent health care czar, with executive powers across all jurisdictions and who is ultimately accountable to the highest office," they added.

After that, the priority is local leadership, including "champions" to coordinate rapid response.

"In countries such as Canada that have shared responsibilities between many levels of government, collaboration and clear communication are essential as a first line of defence," they wrote.

"To see that this happens, governments need to have or enact laws to provide the necessary power to ensure rapid action on complex issues."

They also pointed out that a second wave is likely to hit the northern hemisphere this fall if the H1N1 virus follows the same pattern as it has in the southern hemisphere. This would overwhelm our resources; for example in most areas there are still no plans on how to get the correctly trained health professionals in place to "deliver technologies to help patients survive".

Hébert and colleagues wrote "this is not a time for complacency", and urged that health czars and other national leaders call an immediate summit and bring together officials from public health, critical care, first response, and other health care areas, as well as decision makers, community planners and members of the public to:

"Communicate next steps and to ensure that actions taken by leaders will work at the ground level".

One of the ideas that health czars need to get across to the public is that everyone has a responsibility in tackling the pandemic, it is not just a top down approach, but also a bottom up approach that is needed.

An example of the bottom up approach that Hébert and colleagues referred was one being promoted in the UK called the "flu buddy" system, where individuals partner with one another and take responsibility to check each other's health status regularly.

Improved Colorectal Cancer Survival Linked To Postdiagnosis Use Of Aspirin

US researchers found that patients who regularly took aspirin after being diagnosed with colorectal cancer had a reduced risk of dying from the disease, and the benefit was greater for patients with a type of colon cancer where the tumors overexpress the COX-2 enzyme, which happens in around two thirds of cases. However, more work needs to be done to confirm the result before applying it to patient care, said the researchers.

The study was the work of investigators from Massachusetts General Hospital (MGH), Dana-Farber Cancer Institute and Brigham and Women's Hospital and is published online in the 12 August issue of the Journal of the American Medical Association (JAMA).

Lead author Dr Andrew Chan, of the MGH Gastrointestinal Unit told the press that:

"While previous studies by our group and others showed that aspirin and other non-steroidal anti-inflammatory drugs reduce the risk of developing colorectal cancer, this study is the among the first to show that aspirin can also improve survival in patients who have already been diagnosed with colorectal cancers."

"Moreover, the benefit appeared to be especially strong among patients with cancers that express COX-2," he added, stating that:

"This is an important first step toward developing targeted approaches to improving patient outcomes."

Chan and colleagues brought together data from two ongoing prospective studies, the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS), which capture detailed health information on their participants every two years. Researchers use the comprehensive data from these studies to look for links between various factors such as use of drugs and incidence of several diseases.

For this study, Chan and colleagues focused on the data from 1,279 study participants who were diagnosed with stage 1, 2 or 3 colorectal cancer during the period of the studies and for whom data on their use of aspirin before and diagnosis was available.

The results showed that:

* After a median follow up of 11.8 years, 193 (35 per cent) of the 549 participants who regularly used aspirin after being diagnosed with colorectal cancer had died, and of these deaths 81 (15 per cent) were from colorectal cancer.

* This compared with 287 total deaths (39 per cent) and 141 colorectal cancer-specific deaths (19 per cent) among 730 participants who did not use aspirin.

* Compared with those who did not use aspirin, participants who regularly used aspirin after diagnosis had a 29 per cent lower risk of dying from the disease and a 21 per cent lower risk of dying from any cause.

* Among 719 participants who did not use aspirin before diagnosis, those that started using aspirin after diagnosis had a 47 per cent lower rate of death from colorectal cancer compared with those who did not.

* Tumor samples from 459 participants were tested for COX-2 expression.

* Among these, regular aspirin use after diagnosis was linked to a 71 per cent lower risk of dying from colorectal cancer for those participants whose tumors overexpressed COX-2, whereas aspirin use was not linked to lower risk among those whose primary tumors had weak or no expression of COX-2.

The authors concluded that:

"Regular aspirin use after the diagnosis of colorectal cancer is associated with lower risk of colorectal cancer-specific and overall mortality, especially among individuals with tumors that overexpress COX-2."

Senior author Dr Charles Fuchs of of Dana-Farber said:

"We believe our results could lead to improvements in the therapy of patients with colon cancer."

"We're now following up this observational study with a randomized trial to evaluate adding the COX-2 inhibitor celecoxib -- which is less likely to have the gastrointestinal side effects of aspirin -- to standard chemotherapy."

Antivirals Unlikely To Prevent Swine Flu Complications In Children, Study

Research published this week in a leading medical journal says that based on current evidence, which is limited and not easily generalized to children in the current swine flu epidemic, the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza) are unlikely to prevent complications in children infected with swine flu.

The study was led by Dr Matthew Thompson, senior clinical scientist at the University of Oxford, UK, and appears online in the 10 August issue of the BMJ.

Children are a high risk group during seasonal flu epidemics, which typically affect 40 per cent of pre-schoolers and 30 per cent of school age children, who are also the main route of transmission into households, said the researchers.

They went on to explain that the current control strategy for treating patients who get the flu and preventing its spread includes use of antivirals because vaccination coverage is often low and there is not enough time to make vaccine and get it to everyone who needs it because it's a continual race against emerging strains.

The last time this strategy was examined was in 2005 which is why they decided to do a new review and re-assess the benefits and harms of antivirals.

For this review Thompson and colleagues pooled and re-analyzed data from randomized controlled trials of the neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza) in treatment of children with seasonal influenza who were treated at home (ie not hospitalized).

They found that the antivirals provided a small benefit by shortening the duration of illness by a day and a half, and they reduced transmission in households, but they had little effect on asthma flare ups, increased ear infections and the likelihood of children needing antibiotics. Tamiflu also carries an increased risk of vomiting.

The effects of these drugs on the incidence of serious complication and the current A/H1N1 swine flu strain remain undetermined, they wrote.

For their analysis they reviewed data from published and unpublished controlled trials. They searched well known registeries, consulted with manufacturers and authors to make a comprehensive list of the trials.

They then selected only those trials that were randomized and controlled, assessed neuraminidase inhibitors in children aged 12 and under who were treated in the community (that is, not in hospital), with confirmed or clinically suspected influenza and did a systematic meta-analysis where they re-analyzed the pooled data.

The main measures of effectiveness that they looked for were how long it took for the illness to resolve and how many children in the households involved caught the flu.

After applying the eligibility criteria, the researchers found a total of four trials testing the antivirals in children treated at home for the flu. Two used Tamiflu (oseltamivir ) and two used Relenza (zanamivir). Between them the four trials covered 1,766 children (1,243 with confirmed influenza, of whom 55 to 69 per cent had influenza A).

They also found another three randomized trials (one with Tamiflu and two with Relenza) that tested the antivirals for postexposure prophylaxis (ability to prevent flu). These covered a total of 863 children.

The researchers emphasized that none of these trials tested the effectiveness of the two drugs against the current pandemic strain of swine flu.

After reviewing the results of these trials, Thompson and colleagues found that:

* The treatment trials showed a reduction in median times to resolution of symptoms, or return to normal activities, or both, of between 0.5 and 1.5 days, but this was significant in only two trials.

* Treatment was not linked with a reduced use of antibiotics.

* In the three postexposure prophylaxis trials, a 10 day course of oseltamivir (Tamiflu) and zanamivir (Relenza) resulted in an 8 per cent decrease in the incidence of symptomatic influenza (the 95 per cent confidence interval ranged from 5 to 12 per cent).

* Based on only one trial, oseltamivir (Tamiflu) "did not reduce asthma exacerbations or improve peak flow in children with asthma".

* While zanamivir (Relenza) was well tolerated, oseltamivir (Tamiflu) was linked with an increased risk of vomiting.

The authors concluded that:

"Neuraminidase inhibitors provide a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission. They have little effect on asthma exacerbations or the use of antibiotics."

"Their effects on the incidence of serious complications, and on the current A/H1N1 influenza strain remain to be determined," they added.

In the meantime, several new antiviral drugs are undergoing trials which may change this result in the future. One such drug showed promise in final stage trials, where according to this week's announcement from its manufacturer, the Japanese global pharma company Daiichi Sankyo, it outperformed Tamiflu in tests on children.

Effect Of Gastric Bypass Surgery On Kidney Stone Disease

UroToday.com - "Those who cannot remember the past are condemned to repeat it." (George Santayana in The Life of Reason 1905). One of the first unintentional human models created for calcium oxalate stone formation was in the obese patient who underwent a jejunal ileal bypass.

In this patient population, the risk of stone disease at 5 years after surgery rose to approximately 20%. In some patients, renal failure resulted. Given this situation, in 1979, the Food and Drug Administration declared a moratorium on jejunal ileal bypass.

Fast-forward 30 years. Enter the Roux-en-Y gastric bypass surgery for obesity. In this comparison of 4,639 patients undergoing this procedure vs. 4,639 nonoperated obese patients, the incidence of urolithiasis (stones in kidney, bladder and/or urethra) was 7.65% vs. 4.63% (p < 0.001) with all patients having a minimum of 3 years of follow-up over the period from 2002-2006. Of note, Asplin and Coe had previously noted in patients undergoing the Roux-en-Y gastric bypass, that oxalate levels averaged 78.4 mg., more than double normal oxalate levels. Indeed, the calcium oxalate super saturation among these patients was similar to what was seen in the jejunal ileal bypass patients 30 years ago.

To be sure, these patients are at an increased risk of stone formation after their procedures. Appropriate dietary measures were recommended by the authors (increased fluid intake, low protein diet, low salt diet, normal calcium diet); however, recommending a diet to someone who has undergone an operative procedure for obesity seems futile at best. Are we rediscovering what we already knew and have we now sewn seeds that over time will lead to worsening urolithiasis and new cases of renal failure?

WHO Seeks To Reassure Public About Swine Flu Vaccine Safety

Following media reports raising concern about the safety of vaccines for the swine flu pandemic, the World Health Organization (WHO) issued a statement yesterday reassuring the public about the regulatory procedures for the licensing and approval of pandemic vaccines, which they said are rigorous and do not threaten safety or quality.

Dated 6 August, and issued from Geneva, where the WHO has its headquarters, the world agency said that vaccines are one of the most important medical devices for minimizing illness and deaths during a pandemic, but to be effective they have to be available quickly and in very large quantities.

If all goes to plan this swine flu pandemic will be the first where vaccines are available in time to anticipate a large surge in infections.

The 1918 pandemic killed an estimated 50 million people worldwide (according to WHO figures); there was no vaccine at all in those days.

And the most severe phases of the 1957 and 1968 pandemics were over by the time the vaccines were ready.

In 2007 the WHO got together with manufacturers, health officials and regulators worldwide to look at what would be needed to ensure the world was ready if another pandemic virus should emerge, and how to shorten the time between the arrival of a new pandemic virus and the production and availabiity of effective vaccines. A key step in that process is vaccine regulation and approval.

When they looked at the whole process and zoomed in on certain parts, they could see how to shorten some of the steps without reducing vaccine effectiveness and safety.

For example, in some cases pandemic vaccines are not entirely "new" because manufacturers can build on existing technology used to make seasonal flu vaccine, and much of the infrastructure for testing and regulatory control, including a vast reservoir of safety data, is already in place.

In this respect, approving a pandemic vaccine is similar to the steps taken to approve a new strain of seasonal flu vaccine, a routine occurrence every year when vaccines change to match the viruses circulating in the Northern and Southern Hemispheres, said the WHO.

Another example of where the timescale can be shortened without compromising vaccine quality and effectiveness is to require less data from those manufacturers who already have a vaccine licence and have said they will use the same process to make pandemic vaccine. Those procedures already exist.

The European Medicines Agency, the regulatory body for the European Union, uses a rolling review procedure. This allows manufacturers to submit data required for a single approval application as it becomes available, as opposed to waiting until the end of all the trials cited in the application.

The WHO said given the safety record of season vaccines, they expect adverse events to be rare, and like seasonal vaccines, many that occur will probably be coincidental with time of vaccination and not necessarily caused by vaccination.

However, they did say, that in order to meet the timescale, full clinical testing of the vaccines will not have completed by the time the first batches are being administered and the test results will most likely roll out in parallel with vaccination programmes.

For these reasons, the WHO advises:

"All countries administering pandemic vaccines to conduct intensive monitoring for safety and efficacy."

They said that many countries already have plans in place to do this, and on a more positive note remind the public that mass vaccination programs can generate a lot of safety data in a short space of time, a matter of weeks, they said.

Another important factor in helping things move fast will be how data is collected and shared. The WHO said that the post-marketing surveillance data will be collected in line with protocols that follow a standard developed by the WHO so that it can be reported as it happens, in real time, and relayed worldwide via the WHO website.

According to the Los Angeles Times, the WHO also announced yesterday that manufacturers will be delivering the first doses of vaccine for pandemic H1N1 flu in September.

The first batches will be limited, but more are expected in October, said the LA Times report.

One of the media reports that questioned the safety of the new swine flu vaccine was a BBC Radio 4 documentary that alleged little or no data exists on the safety of flu vaccines in young children and pregnant women, two of the groups that will be targeted in the swine flu vaccination campaign.

There have been no trials of swine flu vaccies on pregnant women, said the BBC, which also noted that in 1976 the US government vaccinated 45 million for a swine flu outbreak that never happened.

However, following that campaign, 500 people were in a coma with a rare neurological condition called Guillame Barre syndrome and 25 of them died.

Peter Smith, Professor of tropical epidemiology at the London School of Hygiene and Tropical Medicine, who also happens to chair the WHO's global advisory committee on vaccine safety, is one of the experts that remain mystified by the reaction.

Smith told the BBC that reaction has "not really been observed with subsequent influenza vaccines".

He said the experience influences the way in which the US treats all new vaccines.

Health experts think it is highly unlikely that such a reaction will happen again.

Gut Hormone Has 'Remote Control' On Blood Sugar

A gut hormone first described in 1928 plays an unanticipated and important role in the remote control of blood sugar production in the liver, according to a report in the August 6th Cell Metabolism, a Cell Press publication. What's more, the researchers show that rats fed a high-fat diet for a few days become resistant to the glucose-lowering hormone known as cholecystokinin (CCK).

"We show for the first time that CCK from the gut activates receptors to regulate glucose levels," said Tony Lam of the University of Toronto. "It does so via a gut-brain-liver neuronal axis."

Researchers already knew that CCK levels rise in the upper intestine in response to nutrients such as lipids to lower food intake, Lam explained. Now, his team shows that the CCK hormone binds local receptors on nerves of the small intestine, sending a powerful signal to the brain. The brain in turn tells the liver to stop producing glucose.

Lam said his group described the gut-brain-liver circuitry in a paper published last year. The new study shows that it is CCK that acts as the trigger.

A primary increase of CCK-8, the biologically active form of CCK, in the upper intestine lowers glucose production independently of any change to circulating insulin levels, they found. CCK-8's effects depend on activation of CCK-A receptors and the signals they send to the brain and on to the liver, where glucose production slows. Those effects of the hormone begin to fail early in the onset of high-fat diet-induced insulin resistance, they report.

The findings suggest that CCK resistance, like insulin resistance, might be a key contributor to the high blood sugar that often comes with a high-fat diet. It also suggests that drugs targeting the CCK receptors in the gut may hold promise for therapy. That's key, Lam said, because such gut-targeted drugs might be expected to have fewer side effects than currently available diabetes drugs that work directly on the liver.

"This raises the possibility that we might be able to tap into the circuitry [to lower blood sugar]," Lam said. "At least now we know where to start."

Drug combinations that could increase sensitivity to both insulin and CCK might better combat diabetes than either could alone, he added. While the magnitude of CCK's influence over glucose levels relative to the effects of insulin aren't yet known, Lam said it's now clear both are important and neither works properly in the case of diabetes or obesity.

The researchers further suggest that CCK's role in the gut might somehow explain why people often show improvements in their blood sugar levels following gastric bypass surgeries, even before they lose any weight.

"Since we described that duodenal CCK normally triggers a gut-brain-liver axis to lower glucose production but fails to do so in high-fat fed rodents, we propose that duodenal bypass surgeries improve glucose tolerance in diabetes and obesity partly because the surgery bypasses an acquired defect involving duodenal CCK resistance in response to high-fat feeding," they wrote. Further studies are needed to explore that notion.

The researchers include Grace W.C. Cheung, University Health Network, Toronto, Canada, University of Toronto, Toronto, Canada; Andrea Kokorovic, University Health Network, Toronto, Canada, University of Toronto, Toronto, Canada; Carol K.L. Lam, University Health Network, Toronto, Canada, University of Toronto, Toronto, Canada; Madhu Chari, University Health Network, Toronto, Canada, University of Toronto, Toronto, Canada; and Tony K.T. Lam, University Health Network, Toronto, Canada, University of Toronto, Toronto, Canada.

Pneumonic Plague Kills Third Human In Chinese Town

Authorities in China confirmed that a third man has died of pneumonic plague in Ziketan, Qinghai Province, China. The town has been sealed off. The 64-year-old man lived near the other two men who died, officials said.

Checkpoints have been set up around Ziketan, a town of 10,000 people, while medics disinfect the area. Teams of workers have been sent in to exterminate rats and insects.

Pneumonic plague is caused by Yersina pestis, a bacterial agent that infects the lungs. It is a disease of rodents and their fleas and humans. It can spread from animals to people and from person-to-person. Initial symptoms of pneumonic plague are fever, headache, weakness and a cough which produces bloody or watery sputum. Within two to four days it can cause septic shock. Without early treatment the disease is fatal.

It is caused by the same bacterium as the one that caused the Black Death which killed about 25 million people in Europe during the Middle Ages.

Human-to-human infection occurs through respiratory droplets. To become infected a human needs to have face-to-face contact with a sick person.

If treated early the following antibiotics are effective - streptomycin, tetracycline, and chloramphenicol. Although there is no vaccine, antibiotic treatment for seven days can protect people who have had face-to-face contact with infected people.

In the USA the Centers for Disease Control and Prevention (CDC) classify Yersina pestis as a Category A (high priority) bioterrorism agent.

The World Health Organization (WHO) has praised Chinese authorities for their swift response and for getting the situation under control. According to the British Broadcasting Corporation (BBC) Chinese authorities are being open about this outbreak.

Local media report that so far approximately ten people have become infected. Authorities are urging anyone showing symptoms who has been to the town since the middle of July to seek medical attention immediately.

Gene Variant That Increases Ovarian Cancer Risk Discovered

By searching millions of DNA variations in the genomes of thousands of women with and without ovarian cancer, scientists have discovered a previously undetected region of DNA which when altered, can increase a woman's risk of developing ovarian cancer by 40 per cent. The hope is that this will one day lead to a reliable screening test for a disease that currently has a high mortality rate because it is difficult to detect early.

The study was conducted by an international research team that included UK scientists from University College London (UCL), the Cancer Research UK Genetic Epidemiology Unit, and the University of Cambridge, and is published in the 2 August online issue of Nature Genetics.

Ovarian cancer is the fifth most common cancer in women in the UK, where around 6,800 new cases are diagnosed every year, which is a rate of about 130 women a week finding out they have the disease.

However, ovarian cancer is the most common cause of cancer death in women in the UK, where it kills around 4,300 women every year.

The human genome, the DNA-coded blueprint of how to make a human being, has more than 10 million genetic variants, of which just a small number will increase a woman's chance of getting ovarian cancer.

Scientists already know that variants in the BRCA1 and BRCA2 breast cancer genes significantly increase a woman's chances of getting ovarian cancer, but these are rare and account for less than 5 per cent of ovarian cancers.

Senior author Dr Simon Gayther of UCL said this study identified a significant new variant and there is real hope that as more are found:

"We can start to identify the women at greatest risk and this could help doctors to diagnose the disease earlier when treatment has a better chance of being successful."

Gayther and his gynaecological cancer research team's work is supported by funds from Cancer Research UK and The Eve Appeal charity.

For the study the scientists analysed 2.5 million variations in DNA base pairs from the genomes of 1,810 women with, and 2,535 women without ovarian cancer in the UK.

DNA base pairs are like letters of the words that spell out the genetic code. Strips of DNA base pairs (the "words" if you like) are called single nucleotide polymorphisms (SNPs). Small alterations in the coding of particular SNPs, akin to "spelling errors" in words, link to ovarian cancer risk.

After eight years of searching, Gayther and colleagues found an SNP on chromosome 9 that was uniquely linked to ovarian cancer. Each of us has 23 pairs of chromosomes, each "copy" in the pair comes from one biological parent.

In collaboration with the international Ovarian Cancer Association Consortium (OCAC) they confirmed the finding in another group of 7,000 women with ovarian cancer and 10,000 women without the disease. The samples came from women all over the world.

The scientists estimated that:

* Women carrying that particular version of the SNP on both copies of chromosome 9 have a 40 per cent higher lifetime risk of developing ovarian cancer than women who do not carry it on either copy of chromosome 9.

* The risk for women carrying both copies is 14 in 1,000 compared to 10 in 1,000.

* About 15 per cent of women in the UK have both copies of the variant.

* Women with only one copy of the variant have a 20 per cent higher lifetime risk of developing ovarian cancer than women who have none.

* The risk for women carrying only one copy is 12 in 1,000 compared to 10 in 1,000.

* About 40 per cent of women in the UK have one copy.

David Lammy, the Member of Parliament for Tottenham and Minister for Higher Education and Intellectual Property, had particular reason to be interested in this research because it included a DNA sample from his mother, Rose Lammy, who died of ovarian cancer last year. She carried both copies of the DNA variant that Gayther and colleagues identified.

Lammy said the study brings us a step closer toward earlier diagnosis of ovarian cancer, when treatment is more likely to succeed. He told the media:

"I am pleased that Mum's sample was included in this study."

"We now know the fact that she had this altered DNA meant that her lifetime risk had risen from 10 in 1,000 to 14 in 1,000, an increase of 40 per cent compared to those women who don't carry this DNA variation," he added.

Is Organic Food Really No Better Than Other Foods?

Some facts about the study:

* It did not include papers that were not written in English - estimated to be about half of all good quality studies.

* It did not include research from the European Union published in April, 2009.

* It ignored a study by scientists at Rhode Island Hospital which found a substantial link between increased levels of nitrates in our environment and food, with increased deaths from diseases, including Alzheimer's, diabetes mellitus and Parkinson's. The study was published in the peer-reviewed Journal of Alzheimer's Disease (Volume 17:3 July 2009). Fair enough, this was published after the FSA had concluded their research. However, everyone knew this study was ongoing. Why not wait a little bit longer until it was completed?

* It did not use the top British centers of excellence in this field to carry out the study. Scientists at the Nafferton Ecological Farming Group at Newcastle University, in one of many studies, found that grazing cows on organic farms in the UK produce milk which contains significantly higher beneficial fatty acids, antioxidants and vitamins than their conventional 'high input' counterparts. A nationwide British daily newspaper, The Daily Mail, could not understand why the FSA used the London School of Hygiene and Tropical Medicine to carry out the study - a center of excellence, but not renowned as a leading center in this field - instead of, for example Newcastle University.

Why do people choose organic?
Putting the health issue to one side, there are many other reasons people wish to buy organic - two of them are listed below:

* The environment

o The effect on life forms within the soil - if you look at video footage of tractors ploughing fields forty years ago you will notice there used to be a sizeable number of birds gobbling up worms and bugs. Today there are very few of them, and sometimes none at all.

o There are significantly more birds, butterflies, beetles, bats and wild flowers on organic farms than conventional farms.

o Protection of endangered species - intensive farming is known to have a negative impact on the future of many endangered species. "A staggering 5 million skylarks are estimated to have vanished in the past 30 years as a result of agricultural intensification," (Speech given by Sir John Krebs, Chair of the Food Standards Agency at Queen's University, Belfast, on 5 November 2003).

o Coastal waters - there is much less run-off of nutrients from organic farms, compared to other farms, which cause algae blooms in coastal waters.

o Organic farming encourages practices which are more in line with measures to combat climate change. An example is the use of solar powered fertility through crops like red clover that fix nitrogen into the soil for subsequent crops.

* Animal welfare (farm animals)

As organically farmed animals are encouraged to pursue natural behavior, which usually includes plenty of space, more natural feeding habits, as well as receiving fewer drugs and antibiotics, their quality of life is generally of better quality compared to animals in other farms. In the vast majority of cases, organic farms with livestock have free-range animals. In every organic poultry farm in the UK, birds are kept in smaller flocks and spend much more of their time roaming outside on fresh grass - they also have considerably more indoor space, compared to non-organic poultry farms.

What about unknown long-term complications?
Can we really say organic is not better for health if we do not have enough long term evidence?

Scientists at Emory University, the University of Washington, and the Centers for Disease Control and Prevention (CDC), found that by substituting elementary school-age children's foods with just organic products, the concentration of the organophosphorus pesticides found in their bodies decreased substantially to non-detectable levels until the conventional diets were re-introduced.

The researchers were specifically measuring the exposure of two organophosphorus pesticides - malathion and chlorpyrifos. Research team leader, Dr. Lu said "During the days when children consumed organic diets, most of their urine samples contained zero concentration for the malathion metabolite. However, once the children returned to their conventional diets, the average malathion metabolite concentration increased to 1.6 parts per billion with a concentration range from 5 to 263 parts per billion."

An elementary school child will most likely live another 70, 80 or even 90 years. We cannot and should not ignore potential long-term complications.

Swine Flu Might Infect 40% Of The US Population In The Next 24 Months

Health authorities in the United States have voiced concern that 40% of the country's whole population could be infected with the swine flu (H1N1) virus over the next 24 months. The estimates are based on data gleaned from the 1957 flu pandemic which killed nearly 70,000 people in the country. That pandemic was not as severe as the 1918-1919 Spanish flu one. If one hundred and twenty million people caught swine flu this time round, and vaccine campaigns were not successful, the eventual death toll could be in the hundreds of thousands.

Such a level of infection would be double the expected number during a normal flu season, say experts. However, if an effective vaccine were to come out in time many immunized people would show no symptoms - that is, if the vaccine worked and authorities managed to get enough of them out there.

The Centers for Disease Control and Prevention (CDC) informs that approximately 160 million doses of swine flu vaccines should be available in October, as long as they pass testing. Testing has not started yet but will soon, officials say. Researchers at the University of Maryland School of Medicine's Center for Vaccine Development say testing will start in August, involving 1,000 volunteers in 8 centers around the country.

The American Medical Association estimates that approximately 36,000 Americans die each year from flu and complications from flu.

About 2 billion people are expected to become infected with swine flu worldwide over the next 24 months, the World Health Organization (WHO) estimates. WHO added that we are in the initial phase of the current pandemic.

WHO has asked countries to seriously consider closing schools as a measure to slow down the spread of infection.

It is now virtually impossible to know accurately how many people have been infected so far. A significant proportion of infected individuals never go and see their doctor and recover completely by staying at home and self-medicating with OTC drugs. Others may go to see their doctor with some mild flu like symptoms and be sent home and told to drink plenty of fluids and rest.

Officials at the CDC say that it is likely that over one million Americans have so far been infected since the virus first started infecting people in April this year.

American and Japanese researchers have discovered that the Swine Flu virus reaches deeper into the lungs than normal seasonal flu. This may well indicate that it is more virulent than first thought.
Swine flu infection numbers jump in the UK
The Department of Health, UK, reported that about 100,000 people became infected last week - double the total during the week before. Help lines and a new website have been set up. The National Flu Service was set up whereby patients can access flu drugs on the phone and via the internet without having to see their doctor. The website received over 9 million hits per hour initially.

UK's Chief Medical Officer, Sir Liam Donaldson said that while the numbers rose from 55,000 to 100,000, the number of people being hospitalized for flu rose from 652 to 840 - a much lower percentage increase, which is encouraging. "There is no evidence to suggest it is becoming more virulent. Most people with no underlying conditions will get over the flu perfectly well," he said in a BBC interview. UK authorities said Tamiflu stocks are very high and there is absolutely no danger of running out.

Developing countries worry that when vaccines are ready they will be bought up by rich countries, leaving very little for the rest of the world.

Children Capable Of Lifesaving CPR

Nine-year-olds can and should learn CPR. A study of 147 schoolchildren, published in BioMed Central's open access journal Critical Care, has shown that, although the smallest may lack the requisite strength, the knowledge of how to perform basic life support is well retained by young children.

Fritz Sterz, from the Medical University of Vienna, Austria, led a team of researchers who studied children who had received six hours of life support training. Upon examination four months after the training, 86% performed CPR correctly. Sterz said, "The usefulness of CPR training in schools has been questioned since young students may not have the physical and cognitive skills needed to perform such complex tasks correctly. We found that, in fact, students as young as 9 years are able to successfully and effectively learn basic life support skills. As in adults, physical strength may limit depth of chest compressions and ventilation volumes, but skill retention is good."

The skills taught to the children included automatic defibrillator deployment, providing CPR, usage of the recovery position and calling for the emergency services. For the critical skills of CPR and mouth-to-mouth resuscitation, BMI was the factor that had the biggest influence on depth of compressions and amount of air inhaled. Age did not play a role, indicating that a well-built nine-year-old can be just as capable as an older child.

The researchers conclude, "Given the excellent performance by the students evaluated in this study, the data support the concept that CPR training can be taught and learnt by school children and that CPR education can be implemented effectively in primary schools at all levels. Even if physical strength may limit CPR effectiveness, cognitive skills are not dependent on age, and with periodic retraining, children's performance would likely improve over time."

Doctors Call For Better Sex Education In Schools, Scotland

[NEWS]Commenting on figures released on Tuesday on Sexually Transmitted Infections (STIs) in Scotland, Dr Charles Saunders, chairman of the BMA's Scottish Consultants Committee, said:

"Today's figures show that in Scotland the number of STIs diagnosed continues to rise, with almost a quarter of all acute STI diagnoses being in those aged less than 20. This demonstrates the need for improving the education of young people to help prevent the further spread of these infections.

"It is clear from government statistics that children are becoming sexually active at a younger age so it is imperative that we do more to inform young people of the risks of contracting STIs and educate them on how to prevent them. The BMA firmly believes that children should start sex and relationship education at primary school so that they gain the confidence to delay becoming sexually active and when they do decide to have sex, that they do it for the right reasons and take the necessary precautions."

BMA Scotland believes that in order to meet increasing patient need much more must be done to improve sexual health services, particularly for young people. Dr Saunders added:

"The increased incidence of STIs flags up the importance of education and prevention but also brings with it challenges for the NHS in treating these patients. Sexual health services need adequate and sustained funding to enable them to plan and deliver comprehensive services as locally as possible.

"Improving sexual health services is an essential part of disease prevention. Failure to treat infections promptly means that untreated patients who remain sexually active can continue to spread STIs. Ensuring that people have access to the right help at the right time is crucial." Thank you for reading :)

Blood Pressure Can Be Lowered By Reducing Salt Intake

Adults who use less salt in their diet can experience a slight reduction in their blood pressure in the medium term. However, whether in the long term this can also reduce the risk of late complications in people with sustained high blood pressure, otherwise known as essential hypertension, and whether in the long term their anti-hypertensive medication can be reduced remains unresolved. This is the conclusion of the Institute for Quality and Efficiency in Health Care (IQWiG) in its final report published in the form of a rapid report on 20 July 2009.

This rapid report is part of a package commissioned by the Federal Joint Committee (G-BA), in which the benefit of various non-drug treatment strategies for high blood pressure are to be assessed. Stress management and more physical activity are also included, as well as giving up smoking and cutting down alcohol consumption. IQWiG has already completed a report on the effect of weight reduction on blood pressure.

Assessment was based on secondary literature

IQWiG's benefit assessments are generally based on systematic searches and analysis of clinical trials, in other words, primary literature. However, this rapid report was prepared on the basis of secondary literature. In principle, this can be done - and is included in IQWiG's General Methods - if current, high quality systematic reviews are already available on a given topic. This was the case with reducing salt intake in hypertension, as IQWiG's preliminary search revealed.

IQWiG searched for systematic reviews (these basically provide an analysis of studies in summary) that compared the following patients with hypertension: an intervention group, which was to follow a low-salt diet over a long period, versus a control group, which either did not have this target or whose salt reduction was not so great as in the intervention group. The minimum duration of the studies had to be 4 weeks. In order not to overlook any current and potentially relevant studies, IQWiG also conducted an update search of recently published primary studies.

IQWiG was able to include in its assessment 7 reviews, in which the results of between 520 and 3391 participants from a total of 62 randomized controlled trials were analysed together.

No conclusions on cardiovascular disease or mortality possible

IQWiG found that no conclusions on late complications could be drawn from the available data. The reason for this is that none of the studies had the primary goal of investigating the effects of a low-salt diet on cardiovascular disease or all-cause mortality. Moreover, most of the studies were only of a few months' duration and had low numbers of participants, which meant that possible differences in late complications might not have been detected with certainty.

Uncertainty whether the reduction in blood pressure is sustainable

However, the investigations consistently show that a reduction in salt intake can assist in lowering blood pressure: over a period of up to one year, there was a mean drop of 3.6 to 8 mmHg in systolic values and a mean drop of approximately 2 to 3 mmHg in diastolic values. This applied primarily to patients who did not take any additional anti-hypertensive drugs.

The sustainability of this effect, however, remains unclear. The authors of at least one review report that the observed advantage disappears when the analysis is restricted to studies of a longer duration (at least 6 months).

None of the reviews solely considered patients who were simultaneously taking anti-hypertensive drugs or separately analysed data for participants on concomitant medication. The additional blood pressure-lowering effect of a low-salt diet in these patients is therefore uncertain.

Basically, it is still not known whether people with essential hypertension can reduce their drug dosage through less salt intake.

Report preparation procedure

Rapid reports are intended to offer timely information on a current topic. They are not designed for G-BA guideline decisions. In order to guarantee a shorter delivery time, the report preparation procedure differs primarily in two ways from that of the other reports: working documents, report plans or preliminary reports are not published, nor is there a submission of comments procedure. Furthermore, the assessment is generally based on information already published, i.e. IQWiG is not concerned with obtaining unpublished study data from drug manufacturers, for example.

The report was produced in collaboration with external experts. A preliminary version was reviewed by a further independent research group and the final version was despatched to the G-BA on 22 June 2009. Thank you for reading :)

Simian Virus 40 (SV40)

SV40 (simian virus) is the 40th virus identified by scientists studying monkeys. It has recently been identified in human mesothelioma cells. SV40 may work together (synergistically) with asbestos to cause mesothelioma. Polio vaccines administered to more than 90 million Americans during 1955 - 1961 were contaminated with SV40. During this time period polio vaccines were developed using monkeys to create the antibodies to protect people from polio. Both the Salk vaccine (administered by inoculation) and Sabin vaccine (administered orally) were contaminated with SV40 until at least the early 1960s. Researchers and vaccine manufacturers were aware of the SV40 contamination but did not take steps to remove the virus from the vaccines. However the implications of these facts are not totally understood and further research will be needed to clarify the link between malignant mesothelioma and a viral etiology.

Who Is At Risk of Asbestos Exposure?

Nearly everyone is exposed to asbestos fibers at some time during his or her life. Anyone who has been exposed to airborne asbestos fibers is at risk to develop asbestos related diseases. Although it is known that the risk to workers increases with heavier exposure and longer exposure time, investigators have found asbestos-related diseases in individuals who had only brief exposures.

Most cases of mesothelioma are found in males. This is associated with the fact that mostly males have worked in the occupations that deal with asbestos containing products.

Persons working in shipbuilding trades, asbestos mining and milling, manufacturing of asbestos textiles and other asbestos products, insulation work in the construction and building trades, brake repair, and a variety of other trades are likely to have exposed to asbestos. Demolition workers, drywall removers, and firefighters also may have been exposed to asbestos dust.

Workers' families may inhale asbestos fibers brought into the home on the shoes, clothing, skin, and hair of workers. People who live or work near asbestos-related operations might inhale asbestos fibers that have been released into the air by the operations.

The amount of asbestos to which someone is exposed will vary, according to:

• the concentration of fibers in the air;
• the duration of exposure;
• the person's breathing rate; and,
• weather conditions

Today's workers are less likely to be at risk than workers in the past because of improved work practices, increased awareness of the potential harm of asbestos, and government regulations.

Types of Mesothelioma

There are three types of malignant mesothelioma, differentiated by their cell types and appearance under the microscope (their histology). These are:

* epithelial type
* sarcomatous type
* mixed epithelial and sarcomatous type

Cell types are determined by taking a biopsy specimen from the tumor. The most common kind of malignant mesothelioma appears to be the epithelial type (half the cases in one series), then mixed (in about one-third of cases) and sarcomatous. Within the tumor, there may be great variation in cell types, however. Some experts say that the more biopsy specimens taken, the greater the likelihood of calling the tumor "mixed type".
The epithelial type of malignant mesothelioma may be hard to distinguish from a type of lung cancer, and the sarcomatous form may resemble other sarcomatous-type cancers. However, special laboratory techniques can be used to confirm the diagnosis of malignant mesothelioma, which may be important for litigation purposes.

There is some evidence that the epithelial type of malignant mesothelioma is associated with a better outcome.

Few Mesothelioma Facts & FAQs

What is mesothelioma?
Mesothelioma is a cancer of the cells that make up the lining around the outside of the lungs and inside of the ribs (pleura), or around the abdominal organs (peritoneum).

What does asbestos have to do with mesothelioma?
The only known cause of mesothelioma in the U.S. is previous exposure to asbestos fibers. Asbestos manufacturers knew about the hazards of asbestos seventy years ago - but they kept this knowledge to themselves. The first warnings to workers exposed to asbestos were given in the mid-1960s, and they were terribly inadequate. Even today, workers are not always told they are working around asbestos and are at risk for asbestos disease.

What can someone with mesothelioma do?

• Seek out the best and most up-to-date information.
• Seek out the best medical care.
• Early screening for mesothelioma diagnosis.
• Stay in close contact with your doctor.
• Consider whether or not you want to bring a lawsuit because of this asbestos-related injury.
• Remember that resources are available to you through community and medical support groups, asbestos victims' organizations, your place of worship, as well as your family and friends.

First Swine Flu Deaths Announced In Israel And Saudi Arabia

[NEWS] On Monday, the Health Ministries of Israel and Saudi Arabia reported their countries' first deaths from H1N1 swine influenza.

The Israeli Health Ministry confirmed that a 35-year old man, Shimon Azran, was infected with the novel H1N1 virus when he died, but did not confirm whether the virus had caused his death, reported Israel's daily newspaper Haaretz. Azran was admitted to hospital in Eilat after experiencing symptoms of pneumonia. Tests performed after his death confirmed the presence of H1N1 in his body.

The Saudi Arabian Health Ministry said that a 30-year old male Saudi citizen died of swine flu on Saturday, according to Arab media group Al Bawaba. The man was admitted to hospital with symptoms that included coughing, high fever, and difficulty breathing. He was given Tamiflu but his condition got worse.

These two deaths bring the total of deaths to swine flu in the Middle East to three. The first reported death in the region was of a 25-year old woman who died in Egypt after returning from a pilgrimage to Umrah in Saudi Arabia. She died in hospital on 18 July after testing positive for the H1N1 swine flu virus, said the Egyptian Health Ministry. Her symptoms on admission were "rheumatic fever, lack of oxygen in the blood and a stroke" said a MENA news agency report.

According to Israel's health ministry, there have now been more than 1,300 confirmed cases of H1N1 swine flu in Israel.

A two-year old from Bnei Brak who died on Sunday after being hospitalized with symptoms of pneumonia has since been confirmed as not being infected with H1N1. This followed news of two new cases of swine flu in Israel last Wednesday, a 50-year old man and a 13-year old girl, both of whom are in hospital.

Meanwhile four other swine flu patients in hospital in Israel, including a female tourist from Sweden, and a mother who has recently given birth, are said to be improving.

Saudi Arabia has reported 294 confirmed cases of swine flu, more than any other Arab country.

Health ministers are planning to ban children, the elderly and people with chronic illnesses from this year's annual Haj pilgrimage. At least 2 million people attended the last event, which this year falls in November.

On 16 July, the World Health Organization (WHO) announced that it would stop issuing updates on pandemic H1N1 cases and deaths around the world because the virus was so widespread, and in fact had spread in 6 weeks as widely as previous pandemics had spread in 6 months.

The global agency also said on the 24th of July that many countries where the virus has spread widely have moved to testing only samples of people who are ill, and have moved from counting individual cases to watching trends.

But the WHO said it would still report on swine flu cases and deaths in newly affected countries.

-- WHO