Thursday, October 28, 2010

Pop it in: Low-dose aspirin slashes colon cancer risk

I wanted to delay the posting of this article, but I think that it will be good to have it up in the web now...

I've been wondering, they never run out of tests and researches in Paris, don't they?

PARIS: Low doses of aspirin, taken daily and over the long term, cut cases of colorectal cancer by a quarter and the death toll from this disease by a third, according to a study published online on Friday by The Lancet.

Aspirin is already recommended in low, daily doses by many doctors for patients at risk of a heart attack or a stroke.

High doses of this cheap, over-the-counter medication have similarly been found to help prevent cancer of the rectum and colon.

But, studies have also found, the benefits may well be outweighed by the risks, such as increased bleeding from high aspirin use.

Eager to verify whether low doses can also be protective, researchers followed up four trials in Britain and Sweden, conducted in the 1980s or early 1990s, on the cardiovascular impacts of aspirin.

The study entailed looking over centralised data banks to see whether volunteers in these trials had since died or been diagnosed with colorectal cancer.

On average, the trials lasted six years, entailing volunteers who took either aspirin or a dummy lookalike pill called a placebo. The doses ranged up to 1,200 mg.

Out of 14,033 patients whose health could be traced 18 years or so since the trial, 391 had colorectal cancer, the investigators found.

Taking aspirin reduced the risk of cancer by 24 percent and the risk of dying from it by 35 percent.

The results were consistent across all four trials - and there was no increase in benefits beyond a dose of 75 mg.

Where the reduction was most remarkable was in cases of proximal colon cancer.

These occur in the upper colon and are thus liable to be missed in lower-intestine scans for polyps, the precursor of tumours.

The authors say their study had limits, as the original trials were not designed to look at aspects of colorectal cancer, nor was data available for any deaths from aspirin's side effects.

Also, aspirin's benefit may have been somewhat over-estimated, they said.

This was because the original trials took place before colon screening for polyps became a routine practice in those countries.

Even so, the evidence has now swung the scales in favour of low-dosage aspirin for a disease that claims 600,000 deaths worldwide each year, they said.

"Our findings suggest that long-term low-dose aspirin treatment and sigmoidoscopy screening would combine to substantially reduce cancer incidence in all parts of the colon and rectum," said the lead author, Peter Rothwell, a professor at the Department of Clinical Neurology at Oxford University.

In a commentary, doctors Robert Benamouzig and Bernard Uzzan of the Avicenne Hospital in Bobigny, on the outskirts of Paris, said the study should unleash "the next logical step," of formulating guidelines for people at risk.

Colorectal cancer is the second commonest cancer in developed countries, with a lifetime risk of five percent, according to figures cited in the city.

Aspirin is believed to have a preventive effect because it inhibits an enzyme called COX-2, which promotes cell proliferation in colorectal tumours.

- AFP/de

From; source article is below:
Low-dose aspirin slashes colon cancer risk

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US research shows gene therapy could treat depression

When getting old brings in all the troubles, too...

An exhibition at Tan Tock Seng hospital to raise awareness on depression in the elderly.
WASHINGTON: Gene therapy could become a powerful new weapon in the fight against severe depression that does not respond to traditional drug treatments, US researchers said Wednesday.

Restoring a key gene that activates a specific protein in the tiny part of the brain known as the nucleus accumbens reversed depression-like behaviour in mice, the researchers said in the latest issue of Science Translational Medicine.

"Given our findings, we potentially have a novel therapy to target what we now believe is one root cause of human depression," said lead researcher Michael Kaplitt, a neurosurgeon at New York Presbyterian Hospital.

"Current therapies for depression treat symptoms but not underlying causes, and while that works for many patients, those with advanced depression, or depression that does not respond to medication, could hopefully benefit from our new approach," he added.

The research found that a particular protein known as p11 in the nucleus accumbens was associated with experiencing pleasure and a sense of satisfaction that is often absent in severe depression.

Postmortem analysis on human subjects revealed that people with severe depression had low levels of the p11 protein compared to more normal subjects.

In their studies, mice without p11 all exhibited depression-like behaviours,
researchers said, leading the team to suggest that restoring this function and the availability of p11 was critical to alleviating depressive symptoms.

"In the absence of p11, a neuron can produce all the serotonin receptors it needs, but they will not be transported to the cell surface," said Kaplitt.

Serotonin is needed to transmit impulses, or informative data, between neurons and between neurons and other parts of the brain.

The therapy would insert a manufactured virus into the brain cells to deposit "a genetic payload" into the genome of neurons that would produce the protein, according to the research.

"Together, these studies provide strong evidence that maintaining adequate levels of this particular protein, p11, in this pleasure-reward area of the brain may be central to preventing or treating depression," Kaplitt said. - AFP/fa

From; source article is below:
US research shows gene therapy could treat depression

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Giving birth: Postnatal depression can hit any woman

Having kids has its downside, and toll - on the mother.

Theatre Actress Karen Tan's and her two daughters Rachel (Left) and Olivia (Right), posing for photo at KK Women's and Children's Hospital on October 14. Photo: KOH MUI FONG
SINGAPORE - By all accounts, Karen Tan had appeared to be a picture of marital bliss. No one would have suspected she was depressed. She had a doting husband, her new baby was, in her own words, well and "thriving", and her home was "very clean".

After their marriage, the theatre actress and her gynaecologist husband moved to London where they lived for seven years. Their first daughter, Rachel, was born in the United Kingdom in 1996.

Beneath her well-kept household, however, Karen was an emotional wreck.

Speaking to TODAY, the 43-year-old recounted her spiralling moods after the birth of her first child, made worse by the lack of family support during her time overseas.

"My husband and I didn't realise it was depression until months later because in the mornings, I would still get up and do things, but something inside me was wrong. I would cry at night. I couldn’t sleep and I found it difficult to be happy."

However, Karen did not want to take any medication that would cause her to be too "zoned out" to care for the baby.

By sheer will, she bounced back. In 2005, after the birth of her second daughter, Karen lapsed into depression again. "I felt the same feelings of inadequacy all over again, even though this time, I had a maid and my family with me. I felt I wasn’t good enough to be a mother."

I am a lousy mother

Other than her persistent low moods and insomnia, Karen's feelings of excessive self-blame and guilt are not uncommon among women suffering from postnatal depression, said Dr Helen Chen, senior consultant and head of Mental Wellness Service at KK Women's and Children's Hospital (KKH).

"Afflicted mothers often report difficulty in bonding with their child, in part because of their depressed mood and lack of interest or energy, and in part because they view themselves as bad mothers," said Dr Chen, who has been treating Karen for three years.

Baby blues are considered normal for up to 70 per cent of women in the first one to two weeks after childbirth.

During this period, a new mother may become more emotional at times, explained Dr Chen. In most cases, it is usually mild - they may feel weepy, irritable and anxious - and the condition will eventually go away.

Not typical baby blues

Depression, however, works differently. "The woman’s low mood persists for longer than two weeks and symptoms are severe, such that her ability to function is affected," said Dr Chen.

Women undergoing severe postnatal depression may also hear voices, have suicidal thoughts or an impulse to hurt her baby.

In her practice, Dr Chen has encountered many such cases.

"The ones I worry most about are those who suffer from postpartum psychotic depression. In this condition, suffering women hear voices or have delusional beliefs that make them lose touch with reality. They are most at risk of harming themselves or their infants," she said.

For instance, one of Dr Chen's patients had, in that psychotic state, left home as she was terrified that her violent impulses might harm her baby. Fortunately, her family arranged for prompt treatment when she returned.

It is estimated that maternal depression - a term which includes depression during pregnancy and after delivery - affects one in 10 women.

A recent National University Hospital survey found that about 12 and seven per cent of women here suffer from depression during their pregnancy and after childbirth, respectively.

Another study conducted at KKH found that as high as 20 per cent of the pregnant and recently delivered women surveyed had significant depressive symptoms, although they were not necessarily having clinical depression.

Dr Chen stressed that this form of depression is not solely due to hormonal changes that occur during pregnancy and after childbirth. "Otherwise every woman would be afflicted!" she said.

Research has shown that hormonal changes only causes a new mother to be more vulnerable to depression, so that in the face of other stressors, the balance tips her over to clinical depression, explained Dr Chen.

Women at risk include first-time mothers, those with ill infants, those with a family history of mental illness, and young mothers, particularly those under 21.

Other risk factors include marital problems, family conflicts or financial issues.

Not all in the mind

Like hypertension or diabetes, maternal depression is a medical condition that requires clinical attention, said Dr Chen.

Yet, too often, the sufferer's condition is dismissed by people around her. Karen said, "If you have cancer or other illnesses, people will sympathise with you; here, no one will say the same thing if you're depressed. It's really, really sad for women struggling with this condition."

According to Dr Chen, it is common for family or spouses to say to the suffering mother, 'It's all in your mind' or 'Snap out of it'.

"I think it stems from the stigma of mental illness which often leads to the mother keeping the suffering to herself because everyone around her expects her to be happy and excited about her baby," she said.

That is why KKH Mental Wellness Service is organising a play aptly named "When The Bough Breaks", which will run next month.

Produced by The Necessary Stage, the play is about a woman's struggles with postnatal depression and her recovery process.

Karen appears as a doctor, counselor as well as support group worker in the play, which also stars Ong Shu An, Rodney Oliveiro and Catherine Sng.

Through the play, Karen hopes to create greater awareness of maternal depression and encourage sufferers to seek medical help.

Ever candid about her experience with postnatal depression, Karen said: "I know people are going to read this and say, 'Oh, what is Karen Tan complaining about? She has a maid and a family and a comfortable life.'"

"But regardless of your educational level or background, it can still hit you."

- TODAY/rl

From; source article is below:
Postnatal depression can hit any woman

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Aging on: Pain, pain, go away

Sufferers from chronic pain should see a doctor instead of buying over-the-counter medications.
SINGAPORE - Your joints are acting up again. To relieve the pain, you pop some pain relief medication bought from the pharmacy.

This scenario is not uncommon among chronic pain sufferers. Rather than seek medical attention, most people cope with pain by self-medicating with over-the-counter (OTC) drugs.

Findings from a survey, sponsored by biopharmaceutical company Pfizer, on 1,220 chronic pain patients in China, Taiwan and Thailand found that about 60 per cent of the respondents practise some form of self-medication to ease their persistent aches and pains.

Dr Alex Yeo, director of the pain specialist clinic at Mt Elizabeth Hospital, and president of the Pain Association Of Singapore, presented the survey findings at the Asian Pacific Digestive Week held in Malaysia last month.

Although Singapore patients did not take part in the survey, Dr Yeo said the findings are also applicable here. From experience, he has seen countless patients who often self-medicate because they hope to achieve some control over the pain.

Chronic pain, defined as pain associated with medical conditions and which persists for more than six months, is a significant problem in Singapore. In a local survey initiated by the Pain Association Of Singapore last year, it was found that approximately 8.7 per cent of the population suffer from the problem.

Women - about 10.9 per cent of the respondents - were also more likely to get it.

The survey findings are worrying. Without a doctor’s supervision, prolonged use of certain pain relief medication can be detrimental to health, said Dr Yeo.

- TODAY/rl

From; source article is below:
Pain, pain, go away

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New breakthrough: New research offers hope for preventing kidney stones

WASHINGTON: A new technique to curb the growth of crystals in one type of kidney stone offers hope for preventing development of the hard deposits which can cause extreme pain, researchers reported on Thursday.

Scientists at New York University's Department of Chemistry and its Molecular Design Institute, NYU School of Medicine, and the Medical College of Wisconsin sought to attack kidney stones at the molecular level by examining the crystals that form them.

The researchers used atomic force microscopy, which allows for the observation of objects as small as a nanometer, to observe the growth of the L-cystine crystals that make up one type of kidney stone.

Knowing how these crystals grew, the researchers could then select a chemical agent to inhibit this process.

"This may lead to a new approach to preventing cystine stones simply by stopping crystallisation," said Michael Ward, one of the authors of the research and chair of NYU's Department of Chemistry.

"Moreover, these findings are an example of the significant advances that can be achieved through collaborations between researchers in physical sciences and in medicine."

Kidney stones comprised of L-cystine affect an estimated 20,000 individuals in the United States.

This number is smaller than the number of Americans afflicted by calcium oxalate monohydrate (COM) stones, but L-cystine stones are larger, recur more frequently, and are more likely to cause chronic kidney disease.

Although they often cause no permanent damage, kidney stones can be extremely painful and sometimes are removed by surgery or sound waves.

Current medications for L-cystine stone prevention can cause adverse side effects such as nausea, fever, fatigue, skin allergies, and hypersensitivity.

The findings of the latest research appear in the October 15 issue of the journal Science.

- AFP/de

From; source article is below:
New research offers hope for preventing kidney stones

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Wednesday, October 27, 2010

'You can have my liver, Mum'

I was vacillating between having this article posted or not; I thought that this story was too personal. But then again, health issues, while in many cases are outstandingly medical and intellectual, are in many ways also become real and personal when we hear stories of how heroic people become - to their own hurt - to be able to augment a loved one's life.

They share a part of themself, literally and figuratively - their body parts - and love.

Read on...


By Eveline Gan, TODAY | Posted: 12 October 2010 0931 hrs
Johnson Tan and his mother, Theresa Yee.

SINGAPORE - Johnson Tan has lost track of the Mother's Day gifts - handbags, earrings and shoes, among other things - he has given his mother, Mdm Theresa Yee, over the years.

On Mother's Day last year, however, the 28-year-old presented his mother with a gift both of them will never forget. He gave her half of his liver.

Mdm Yee was diagnosed with autoimmune liver disease in 2007. Last year, she was told that she needed a liver transplant and was subsequently placed on the waiting list for a liver from a cadaveric or deceased donor. By April, her illness took a turn for the worse.

"One night, I suddenly started vomiting blood. I remembered vomiting all the way from home to the hospital until I lost consciousness," said the 55-year-old homemaker, recounting the awful experience.

Her condition was critical and there was still no cadaveric donor in sight. There and then, her husband and son both volunteered to be her donor. Although both of them were eligible to become Mdm Yee's donor, Johnson was eventually chosen as his liver was in a "better" condition.

Living organ donation

Just three decades ago, this gift of life between two living people was unheard of in Singapore.

As of June 30 this year, there are 472 people on the National Organ Transplant Waiting List, according to a spokesperson from the Ministry Of Health (MOH). The Human Organ Transplant Act (Hota) allows for the organs (kidney, liver, heart and cornea) of Singapore citizens and permanent residents to be donated for transplantation in the event of death.

Currently, the liver and kidney are the only organs that can be donated by living donors here. The number of living organ transplants have increased over the years. Last year, 123 living organ transplants were performed here, an 8.8-per-cent increase from 2007, according to MOH.

Singapore's first living kidney transplant was performed in 1976, six years following its first cadaveric kidney transplant.

Singapore's first cadaveric liver transplant was performed at the National University Hospital in 1990. It wasn't until 1996 that the first live liver transplant occurred.

A gift of life

An organ transplant is often required to treat those battling end-stage organ disease. This is especially so for those suffering from liver failure.

"Unlike kidney transplants, we currently don't have any effective options to artificially maintain liver function, so a liver transplant really is a gift of life," explained Associate Professor Tan Chee Kiat, director of the Liver Transplant Service at Singapore General Hospital (SGH), which carried out 12 liver transplants last year.

While waiting for a suitable organ, it is possible for a person with kidney failure to survive on dialysis. When the liver fails, there is often no hope.

"If a person's liver is failing, it can no longer break down food, repair cells and clear the body of toxins. This can lead to swelling of the abdomen and legs, drowsiness, blood infections and even coma," said Assoc Prof Tan, who is also a senior consultant at SGH's gastroenterology and hepatology department.

Assoc Prof Tan estimated that each year, some 20 to 30 liver disease patients progress to a stage where they would need a liver transplant.

A lifeline from a living donor

For these urgent cases, a living donor becomes, quite literally, the patient's lifeline.

"Finding a living donor reduces waiting time and eliminates uncertainty and possible detriment caused by waiting for a deceased donor liver," said Assoc Prof Tan.

There are also other reasons why living organ transplants are preferred over deceased organ transplants.

With a living donor, the graft is also "healthier" as the surgery can be coordinated so that the organ can be quickly transplanted into the recipient, added Assoc Prof Tan.

According to Assoc Prof Tan, anyone can become a living donor. However, he stressed that the donation is an "entirely voluntary act" and the donor can change his mind right up until the point when he goes for the transplant surgery.

What are the risks?

Given today's medical advancements, doctors said live organ donation procedures are relatively safe. However, many people still have misconceptions about it (see box).

In the case of liver transplants, Assoc Prof Tan said donors do not face significant long-term health risks of organ failure. "In fact, the donor's remaining liver rapidly regenerates within the first two weeks and is back to its normal size by about two months post-transplant," he said.

"However, as with other types of major surgery, there are risks of pain, infection and blood clots. There is a low risk of mortality related to the surgery."

A year and a half on, life is back to normal for both Johnson and Mdm Yee.

For Johnson, who now sports a six-inch vertical scar on his belly, giving up half of his liver for his mother had not been a tough decision to make.

"There wasn't much time (to hesitate). My mum's condition was serious," he said.

On the contrary, it was Mdm Yee who, despite being in critical condition, had worried about Johnson's health.

"I felt that it was a dangerous thing to do, and since I was already so old, it didn't matter if I recovered or not.

"But thank God for giving me such a good son," she said.

- TODAY/rl

From; source article is below:
'You can have my liver, Mum'

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Tuesday, October 19, 2010

US begins first trial with human embryonic stem cells

A researcher manipulates drops of stem cells in a laboratory.
WASHINGTON - US doctors have begun the first tests of human embryonic stem cells in patients, treating a man with spinal cord injuries in a landmark trial of the controversial process, the Geron Corporation said on Monday.

The patient began the pioneering treatment on Friday with an injection of the biotech company's human embryonic stem cells, as part of a clinical trial that aims to test safety and efficacy towards regaining sensation and movement.

The treatment took place at the Shepherd Center in Atlanta, Georgia, a spokeswoman for the hospital told AFP, declining to give further details due to patient privacy concerns.

The Phase I trial is expected to involve around 10 patients. Participants in the human trials must be severely injured and start treatment with Geron's product, GRNOPC1, seven to 14 days after sustaining their injury.

Patients will be given a single injection of two million of Geron's GRNOPC1 cells in the trial.

Those taking part will be followed up for one year to monitor safety and also to see if they have regained any sensory function or movement in their lower extremities.

If the initial group of subjects shows no negative side-effects, Geron plans to seek FDA approval to extend the study to increase the dose of GRNOPC1 and to include patients with "as broad a range of severe spinal cord-injured patients as medically appropriate."

The ultimate goal for GRNOPC1 is to inject it directly into the spinal cord lesions of injured humans where it would, Geron hopes, prompt damaged nerve cells to regrow, enabling patients to eventually recover feeling and movement.

Geron began working with human embryonic stem cells in 1999.

Back then, "many predicted that it would be a number of decades before a cell therapy would be approved for human clinical trials," Geron's president and chief executive Thomas Okarma said in a statement.

Okarma described Monday's start of the clinical trial as "a milestone for the field of human embryonic stem cell-based therapies."

GRNOPC1 is made up of cells containing precursors to oligodendrocytes - multi-tasking cells that occur in the nervous system.

Oligodendrocytes are lost in spinal cord injury, resulting in myelin and neuronal loss which cause paralysis in many patients.

Preclinical studies of GRNOPC1 found that when it was injected into the injury site of animals with spinal cord injuries, it migrated throughout the lesion site and matured into oligodendrocytes.

Those oligodendrocytes then re-lined axons with myelin, the insulating layers of cell membrane that wrap around the axons of neurons to enable them to conduct electrical impulses.

The process produced biologicals that enhance the survival and function of neurons, resulting in significantly improved locomotion in the treated animals.

In the animal trials, GRNOPC1 was injected seven days after the injury was sustained.

Every year, some 12,000 people in the United States sustain spinal cord injuries, usually in automobile accidents or from falls, gunshot wounds and sports.

Geron got clearance in January 2009 from the Food and Drug Administration to conduct human trials of GRNOPC1.

Around six weeks later, President Barack Obama reversed a ban on federal funding for research on human embryonic stem cells, which had been imposed by his predecessor at the White House, George W. Bush.

But the clinical trials of GRNOPC1 remained on hold for more than a year while the US courts wrangled about whether lifting the ban on embryonic stem cell research was legal.

Backers of the research believe the field holds huge potential for treating serious diseases including cancer and Alzheimer's, and even for reversing paralysis.

Opponents argue that living embryos are destroyed in order to obtain the potentially life-saving embryonic stem cells.

Legislation passed by Congress in 1996 bans federal funding for research in which human embryos are either destroyed or discarded.

In lifting the ban on embryonic stem cell research, the Obama administration argued the research does not require disposal or destruction of the embryos, which were created for in-vitro fertilization treatments but never used.

Last month, a US appeals court ruled that the federal funding can continue, dissolving a lower court's ban.

- AFP/al

From; source article is below:
US begins first trial with human embryonic stem cells

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Sleeping with light on may lead to weight gain, says study

What if I am afraid of the dark? Maybe a bit of weight gain won't be bad somehow...
A night view of the Hong Kong skyline.

WASHINGTON: Too much light at night appears to lead to weight gain, according to a report released Monday, based on studies of mice that provide fresh clues on obesity.

The researchers found that mice exposed to a dim light at night over eight weeks had a weight gain that was about 50 percent more than other mice that lived in a standard light-dark cycle.

"Although there were no differences in activity levels or daily consumption of food, the mice that lived with light at night were getting fatter than the others," said Laura Fonken, lead author of the study and a researcher at Ohio State University.

The study, which appears in the Proceedings of the National Academy of Sciences journal, said the weight gain could be a sign that light has an effect on the metabolism.

"Something about light at night was making the mice in our study want to eat at the wrong times to properly metabolise their food," said Randy Nelson, co-author of the study and professor of neuroscience and psychology at Ohio State.

If these results are confirmed in humans, it would suggest that late-night eating might be a particular risk factor for obesity, Nelson said.

In one study, mice were housed in one of three conditions: 24 hours of constant light, a standard light-dark cycle that included 16 hours of light and eight hours of dark, or 16 hours of daylight and eight hours of dim light.

Results showed that, compared to mice in the standard light-dark cycle, those in dim light at night had significantly higher increases in body mass, beginning in the first week of the study and continuing throughout.

By the end of the experiment, dim-light-at-night mice had gained about 12 grams of body mass, compared to eight grams for those in the standard light-dark cycle.

Mice in constant bright light also gained more than those in the standard light-dark cycle, but Nelson said the mice exposed to dim light was a more important comparison for humans.

Although the mice exposed to dim light did not eat more than others, they did change when they ate, consuming more food at night.

Since the timing of eating seemed significant, the researchers did a second study, with a change: instead of having food freely available at all times, food was restricted to either the times when mice would normally be active or when they would normally be at rest.

In this experiment, mice exposed to the dim light at night did not have a greater gain in body mass than did the others when their food was restricted to times when they normally would be active.

"When we restricted their food intake to times when they would normally eat, we didn't see the weight gain," Fonken said. "This further adds to the evidence that the timing of eating is critical to weight gain."

The researchers said the findings offer clues for causes of the obesity epidemic in Western countries.

"Light at night is an environmental factor that may be contributing to the obesity epidemic in ways that people don't expect," Nelson said. "Societal obesity is correlated with a number of factors including the extent of light exposure at night."

He said prolonged computer use and television have previously been linked to obesity but because they are associated with a lack of physical activity.

"It may be that people who use the computer and watch the TV a lot at night may be eating at the wrong times, disrupting their metabolism," Nelson said.

"Clearly, maintaining body weight requires keeping caloric intake low and physical activity high, but this environmental factor may explain why some people who maintain good energy balance still gain weight."

- AFP/de

From; source article is below:
Sleeping with light on may lead to weight gain, says study

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Fewer heart attacks, more strokes with carotid stents

Surgeons perform heart surgery.
WASHINGTON: Stents to keep blocked carotid arteries open are not as effective as surgery in preventing strokes, but nevertheless are associated with a lower rate of heart attacks, researchers said on Monday.

A study from the Journal of the American Medical Association's Archives of Neurology concluded that stenting lead to some increased risks but has some advantages over surgery in preventing heart attacks.

The researchers at the New York University School of Medicine and the Harvard Clinical Research Institute published the results of what they called the "largest and most comprehensive meta-analysis" comparing the use of stents as a non-surgical alternative to carotid endarterectomy.

Stenting has emerged as a popular alternative to surgery to treat blockages in the carotid artery that supplies blood to the brain, but its safety and effectiveness remain controversial.

The researchers said some patients may benefit from one treatment or the other but that "strategies are urgently needed to identify patients who are best served by carotid artery stenting versus carotid endarterectomy."

The study found that in the first 30 days, carotid artery stenting was associated with a 65 percent increased risk of death or stroke and a 67 percent increased risk of any stroke.

However, the stent procedure was associated with a 55 percent lower risk of heart attack and 85 percent reduction in cranial nerve injury in the same time-frame.

Over the longer term, carotid artery stenting as compared with carotid endarterectomy was associated with a 19 percent increase in the risk of stroke as well as a 180 percent increase in the risk of restenosis, or a renewed narrowing of the carotid artery.

"Both therapeutic procedures are effective. Both procedures showed a relatively low rate of serious complications. Surgery is superior concerning some outcomes; stenting seems to have advantages in others," said Louis Caplan of Beth Israel Deaconess Medical Centre and Thomas Brott of the Mayo Clinic in an accompanying editorial.

In addition, they said that "aggressive medical treatment of blood lipids, blood pressure and anti-platelets, along with lifestyle changes may be as good as or better than either surgery or stenting at stroke and myocardial infarcts prevention."

- AFP/de

From; source article is below:
Fewer heart attacks, more strokes with carotid stents

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Jaundiced newborns more prone to autism: study

A boy with autism is seen at a treatment center.
WASHINGTON: Infants born with jaundice are at much greater risk of developing autism, a study published Monday showed.

The study published in the US journal Pediatrics found full-term infants born in Denmark between 1994 and 2004 who had jaundice were 67 percent more likely to develop autism.

Neonatal jaundice is usually caused by elevated production of bilirubin, a substance found in bile that results from the normal breakdown of red blood cells.

Jaundice is seen in 60 percent of term infants and usually resolves within the first week of life, but prolonged exposure to high bilirubin levels is neurotoxic and can cause lifelong developmental problems, the study says.

In this study researchers found the risk of autism was higher if the mother had had previous children, or, somewhat oddly, if the child was born between October and March.

The risk for autism disappeared if the child was a firstborn child or was born between April and September. Authors suggest the seasonal difference may be due to different levels of exposure to daylight, which has an effect on jaundice, or due to infections.

The difference in risk in firstborn versus subsequent children could be due to different levels of antibodies in women who have had multiple pregnancies, or it could reflect different levels of access to health care in the first days after delivery.

In Denmark, women with healthy term newborns who have already had children are discharged soon after delivery. Women having their first child remain in the hospital for three to four days, and so jaundice may be diagnosed while the infant is still in the hospital.


From; source article is below:
Jaundiced newborns more prone to autism: study

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Dengue fever spreading in Asia

NEW DELHI - Dengue fever, a mosquito-borne disease with no known treatment, is spreading in Asia, with cases in India at a 20-year high as the country hosts the Commonwealth Games.

The World Health Organisation (WHO) has warned that 2.5 billion people are at risk from one of the world's fastest-emerging infections, which has "grown dramatically in recent decades."

Officials at the WHO say Asia, home to 70 per cent of the at-risk population, has seen a rise in dengue mainly because of higher temperatures due to climate change, rising populations and greater international travel.

The organisation says "a rapid rise in urban mosquito populations" is also bringing ever greater numbers of people into contact with the virus.

According to data collected by the UN body, the highest number of reported cases in Asia this year to August are in Indonesia (80,065) followed by Thailand (57,948) and Sri Lanka (27,142).

Dengue, transmitted to humans by the female Aedes mosquitoes, causes a severe flu-like illness for most victims that lasts about a week. There are four strains, one of which is a potentially lethal haemorrhagic type.

"The disease has spread fast. Dengue is appearing in new areas," said Yogesh Choudhri, an expert at the WHO on the Asia region, who said the disease had crossed new international borders and spread within countries.

It was found in the Himalayan countries of Bhutan and Nepal for the first time in 2004, and is endemic in most of Southeast and South Asia as well as Indonesia and East Timor.

In India, government hospitals in New Delhi are overflowing with dengue victims as the city hosts 7,000 foreign athletes and officials for the Commonwealth Games, which finish next Thursday.

A.C. Dhariwal, director of India's National Vector-Borne Disease Control Programme, told AFP that cases in India were at a 20-year high, with 50 people dead and 12,000 reported infections. The number of actual infections is likely to be far higher.

He blamed the delayed construction work for the Commonwealth Games for part of the problem in New Delhi, where monsoon rains have been at their strongest in years.

"Delays in Games construction and urban improvement projects are to blame for the severe dengue outbreak since mounds of rubble and puddles are strewn across the city," he said.

Last week an official with the Indian lawn bowls squad contracted dengue, the first person associated with the Games to to do so.

There is no known treatment for dengue, but several preventative steps can be taken. The most important is to ensure there is no standing water near residential areas where mosquitoes breed.

Spraying insecticide, an approach taken by many city authorities, can also help, as does applying mosquito repellent and wearing long sleeves and trousers.

In Thailand, the government is worried about a South Korean-inspired fashion craze for black leggings which could be putting teenagers at risk.

"I'm worried about how people dress, especially teenagers," said Deputy Public Health Minister Phansiri Kulanartsiri, noting that the mosquitoes which transmit the disease are attracted by dark colours.

"The mosquitoes can bite through the leggings' thin fabric, so those who wear them are at greater risk of being infected with dengue."

In Sri Lanka, authorities have introduced heavy fines for people with standing water in their homes, and troops have been deployed to clean up public places.

Malaysia has reported a 53-per cent rise in dengue-related deaths this year, but backed away from a controversial trial of releasing genetically modified mosquitoes to wipe out the disease.

In the first experiment of its kind in Asia, 2,000-3,000 modified male Aedes aegypti mosquitoes were to have been released in two Malaysian states in October or November.

The offspring of the mosquitoes would have died quickly, curbing the growth of the population in a technique researchers hope could eventually eradicate the dengue mosquito altogether. But the government scrapped the idea after complaints from environmentalists.

Health authorities in Bangladesh said dengue prevalence was on the rise but fatalities were down.

Surveys conducted by the health ministry indicate that the dengue prevalence rate was 3.4 per cent in 2006, rising to 5.25 per cent in 2007, and by 2009 to 9.1 per cent.

The number of dengue fever patients in South Korea and Japan remains small but is rising as more travel overseas, especially to Southeast Asia and Latin America.

- CNA/al

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Dengue fever spreading in Asia

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World health agency challenges mental health neglect

Margaret Chan
GENEVA - World Health Organisation chief Margaret Chan on Thursday vowed to "change the landscape" for mental health, saying neglect is leaving millions of poor people without care.

About 75 per cent of sufferers in poor and middle income countries are thought to be left untreated, a problem fuelled by a lack of knowledge among ordinary doctors and nurses, health experts said.

Adding to the problem is social stigma, neglect, lack of funding, and an increasingly challenged rich country focus on psychiatric institutions.

"One in four people are affected by mental, neurological disorders or substance abuse in their lifetime," said WHO Assistant Director General Ala Alwan.

The WHO estimates that 150 million people suffer from depression - 95 million of them in developing nations - 40 million from epilepsy, 20 million from dementia or Alzheimer's disease among a host of mental or neurological disorders.

"Efforts to close the mental health gap have been impeded by a widespead assumption that improvements in mental health require sophisticated and expensive technologies, delivered in highly specialised settings by highly specialised staff," said WHO Director General Chan.

"We face a misplaced perception that mental health intervention is a luxury," she added pledging to challenge that attitude.

While high profile diseases grab attention, mental and neurological disorders are "swept under the carpet and brushed aside" even though they form 14 per cent of the global disease burden, said Chan.

A cornerstone of the drive is a new guide for ordinary doctors and nurses in developing and emerging countries to ease diagnosis and proper treatment of mental and neurological disorders, as well as drug and alcohol abuse.

Chan said it could "change the landscape for mental health."

Drawn up by 200 specialists from around the world, the guide places the emphasis on primary care, leading general doctors methodically through each stage from identifying symptoms of disorders such as depression and epilepsy to treatment or care.

But the experts discovered that 99 per cent of the knowledge came from rich nations, and faced substantial work in adapting it to developing countries, said one of the authors, Graham Thornicroft of the Institute of Psychiatry in London.

The guide covers depression, psychosis, bipolar disorders, seizures, behavioural and developmental disorders, dementia, alcohol problems, drug addiction and suicide.

Its guidance take into account the needs of different genders as well as age - for example by avoiding drug treatment for children suffering from symptoms of depression.

"The programme will lead to nurses in Ethiopia recognising people suffering with depression in their day to day work and providing psychosocial assistance," said WHO mental health director Shekhar Saxena.

"Similarly, doctors in Jordan and medical assistants in Nigeria will be able to treat children with epilepsy."

"Both these conditions are commonly encountered in primary care, but neither identified nor treated due to lack of knowledge and skills of the health care providers," he explained.

Saxena insisted that the experts had steered clear of any commercial influence on their guidance.

"It's very easy to fall into the trap of recommending medicines," he added.

- AFP/al

From; source article is below:
World health agency challenges mental health neglect

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