COVID-19 Powerful Disinfectants, Simple and Studied WHO Formulations

COVID-19 Powerful Disinfectants, Simple and Studied WHO Formulations

“We showed that both WHO-recommended formulations sufficiently inactivate the virus after 30 seconds,” as Stephanie Pfänder sums up the results. Plus, this does not merely apply to the WHO solutions; rather, their main components, the alcohols ethanol and isopropanol, also showed adequate inactivation of the virus.

#COVID19 #SARSCOV2 #Disinfectant

Disinfectant I

80 volume percent ethanol,

1.45 volume percent glycerine

0.125 volume percent hydrogen peroxide.

Disinfectant II

75 volume percent isopropanol,

1.45 volume percent glycerine

0.125 volume percent hydrogen peroxide

Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 by WHO-Recommended Hand Rub Formulations and Alcohols dx.doi.org/10.3201/eid2607.200915

https://wwwnc.cdc.gov/eid/article/26/7/20-0915_article

(non verified) Department of Homeland Security COVID-19 Science and Technology Report.

Scribd link : https://www.scribd.com/document/456897616/DHSST#download

Disinfectants, covid-19, ethanol, isopropanol, sars-cov-2, destroy, eradicate, clean, sterilize, virus, rna, formula, WHO, CDC, world health organization, tested, simple, inactivation, eliminate, solutions, hand , hydrogen peroxide

Confidence in government linked to willingness to vaccinate

Public Release: 2-Feb-2015

Study looked at 2009 swine flu vaccine use in United States

COLUMBUS, Ohio – A new study suggests that confidence in government may play a key role in the public’s willingness to get at least some vaccines.

The study re-analyzed national survey data from 2009 that examined Americans’ views on a then-new vaccine for the H1N1 virus – commonly known as swine flu.

Results showed that Republicans and independents were significantly less likely than Democrats to say they would get the vaccine. But it wasn’t their political affiliation itself that was driving Republican and independent views, said Kent Schwirian, professor of sociology at The Ohio State University.

“It’s not that Republicans reject vaccination because of their conservative views or exposure to certain media,” Schwirian said.

“It was their lack of confidence in the government to deal with the swine flu crisis that was driving their anti-vaccination views.”

The study found that people trusting the government’s ability to deal with the epidemic were almost three times more likely to take the vaccine than were others. Continue reading “Confidence in government linked to willingness to vaccinate”

Misuse of pesticides may be causing large scale kidney failure among farmers worldwide

RAJANGANAYA, Sri Lanka (AP) — It’s midmorning and hundreds of people are squeezed under a banyan tree’s shady canopy to have blood drawn by just three nurses, working assembly-line fast. Others wait outside this dusty rural health center to get their vitals taken and give urine samples.

Most of the 1,000 villagers have come here on foot and have stood for hours under the hot sun — not because they feel sick, but out of fear. They want to know if they will be the next victims of a mysterious kidney disease that has killed thousands of farmers in Sri Lanka’s rice basket.

Many have watched neighbors and loved ones — some only in their 30s — quickly succumb to deaths after their kidneys gave out. In the worst-hit villages, it kills as many as 10 people every month. No one knows why.

“In some cases, you only know if a certain person died of kidney disease after the autopsy,” says Kalyani Samarasinghe, 47, standing outside the health center with a handful of medical papers and a cotton ball taped to her arm. “If you get a pain in the stomach or something, then you think: Is it the kidney?”

The disease has killed up to 20,000 people over the past 20 years and sickened another 70,000 to 400,000. It has expanded from two districts to seven in the North Central province’s dry zone, where farming was transformed after the introduction of modern techniques in the 1960s and ’70s. No cases have been detected elsewhere in the country, and research has failed to determine the cause.

Some blame the water, heavy use of pesticides and fertilizer. Others wonder if it’s something in the food, or whether heavy metals or toxic algae could be the source. Villagers have been told to give up lake fish, aluminum cooking utensils and illicit home-brewed alcohol, but no one’s sure if any of it helps.
Dr. Rajeeva Dassanayake, a kidney specialist at the area’s largest hospital in Anuradhapura, has come to the screening to try to calm the crowd. Continue reading “Misuse of pesticides may be causing large scale kidney failure among farmers worldwide”

Up to 100 children die from tainted measles vaccine – Syrian ambassador to UN ” the immunisation of children continues “

18 September 2014

UNITED NATIONS. KAZINFORM Some 100 children have died in the Syrian opposition-controlled areas of the north-western Idlib province where the UN measles vaccination campaign was held, Syrian Ambassador to the UN Bashar Jaafari said on Wednesday.

Earlier media reports suggested 40 children died following measles vaccination.

The diplomat told Itar-Tass that he had information about the death of 100 children. Jaafari said the tainted vaccine was made in Turkey. He said Syria urged the World Health Organisation (WHO) to investigate the incident, ITAR-TASS reports.

The Syrian ambassador to the UN put the blame for the children’s death on UN Under-Secretary-General for Humanitarian Affairs Valerie Amos. He said the tragedy occurred through Amos’ fault because she insisted on co-operating with the terrorists in that region.

United Nations World Health Organisation logo
United Nations World Health Organisation logo (Photo credit: Wikipedia)

Continue reading “Up to 100 children die from tainted measles vaccine – Syrian ambassador to UN ” the immunisation of children continues “”

Dozens of children die in Syria after tainted vaccines

Despite rumors of sabotage, health experts believe that it was a bad batch of vaccines.
By Aileen Graef | Sept. 17, 2014 at 9:48 AM

ALEPPO, Syria, Sept. 17 (UPI) — At least 36 children are dead after receiving tainted measles vaccines at U.N. clinics Monday night in the rebel-held region of Syria.The children were injected with the vaccines before quickly falling ill and dying in what was described as an “excruciating” manner. The program has been shut down since rumors of sabotage spread throughout the country to prevent the worsening of the civil war’s death toll from the outbreak of measles.

“It’s very bad. The figures of dead we are getting go into the 30s. Children are dying very quickly,” Daher Zidan, the coordinator of the medical charity Uossm, told The Telegraph. “We think it will get worse.”

Health experts say it was likely a contaminated batch of vaccines and a major setback to an effort praised by the World Health Organization (WHO) to vaccinate 1.6 million children.

Local governments are investigating the incident to find out how the two batches were tainted.

Continue reading “Dozens of children die in Syria after tainted vaccines”

15 Syrian Children Die of UN Measles Vaccines

Thursday, 18 September 2014

The UN has halted a measles vaccination campaign in northern Syria after at least 15 children died after receiving shots, the UN Children’s Fund (UNICEF) and World Health Organization (WHO) confirmed in a joint statement.

“UNICEF and WHO have been shocked and saddened to learn of the deaths of at least 15 young children in Idlib, Syria,” the statement said. “The deaths of the children occurred in areas where a measles immunization campaign had been under way.”

The children were all under the age of two, Reuters reported, citing aid workers.

Around one hour after being given a second round of the measles vaccine in Idlib on Tuesday, the children demonstrated signs of “severe allergic shock,” said Abdullah Ajaj, a physician administering the vaccinations at a medical center in Jarjanaz, according to AP. The second round of vaccinations began in Idlib and Deir Ezzour on Monday.

Following the vaccine, some of the children’s bodies swelled and they suffocated to death. Continue reading “15 Syrian Children Die of UN Measles Vaccines”

Live virus used in polio vaccine can evolve and infect, warns TAU researcher

” Can act like wild poliovirus and continue the threat of contagion ”  November 7, 2011 _ Requested Re-Post from our HRR Site

Health professionals and researchers across the globe believe they are on the verge of eradicating polio, a devastating virus which can lead to paralysis and death. Despite successful eradication in most countries, there are still four countries where the virus is considered endemic — and many more in which the virus still lurks.

Dr. Lester Shulman of Tel Aviv University’s Sackler Faculty of Medicine and the Israeli Ministry of Health has spent years tracking isolated cases of live poliovirus infections, often discovered in countries that are supposedly polio-free. When the live-virus version of the vaccine, called Oral Polio Vaccine (OPV) evolves, he says, it can act like wild poliovirus and continue the threat of contagion.

None - This image is in the public domain and ...

Continue reading “Live virus used in polio vaccine can evolve and infect, warns TAU researcher”

WHO and the pandemic flu “conspiracies” – The BMJ and the Bureau of Investigative Journalism report that was covered up

Conflicts of Interest

A joint investigation by the BMJ and the Bureau of Investigative Journalism has uncovered evidence that raises troubling questions about how WHO managed conflicts of interest among the scientists who advised its pandemic planning

The secrecy of the committee is also fuelling conspiracy theories, particularly around the activation of dormant pandemic vaccine contracts. A key question will be whether the pharmaceutical companies, which had invested around $4bn (£2.8bn, 3.3bn) in developing the swine flu vaccine, had supporters inside the emergency committee

The original advisory opinion was requested by...

– Was it appropriate for WHO to take advice from experts who had declarable financial and research ties with pharmaceutical companies producing antivirals and influenza vaccines?

– Why was key WHO guidance authored by an influenza expert who had received payment for other work from Roche, manufacturers of oseltamivir, and GlaxoSmithKline, manufacturers of zanamivir?

– Why does the composition of the emergency committee from which Chan sought guidance remain a secret known only to those within WHO?

–  Our investigation has identified key scientists involved in WHO pandemic planning who had declarable interests, some of whom are or have been funded by pharmaceutical firms that stood to gain from the guidance they were drafting

– FDA’s advisory committee voted by 13 to 4 not to approve zanamivir on the grounds that it was no more effective than placebo when the patients were on other drugs such as paracetamol. He said that it didn’t reduce symptoms even by a day.

– conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.”

– the advisory committee decided not to recommend zanamivir, the FDA’s management reassigned the oseltamivir review to someone else. Dr Elashoff believes that the approval of zanamivir paved the way for oseltamivir, which was approved by the FDA later that year.

– “WHO never publishes individual DOIs [declaration of interest], except after consultation with the Office of the Director-General.

Deborah Cohen, features editor, BMJ, Philip Carter, journalist, The Bureau of Investigative Journalism, London

dcohen@bmj.com

Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.” Deborah Cohen and Philip Carter investigate

Next week marks the first anniversary of the official declaration of the influenza A/H1N1 pandemic. On 11 June 2009 Dr Margaret Chan, the director general of the World Health Organization, announced to the world’s media: “I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose. On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met…The world is now at the start of the 2009 influenza pandemic.” Continue reading “WHO and the pandemic flu “conspiracies” – The BMJ and the Bureau of Investigative Journalism report that was covered up”

WHO apologises for claiming half of Greek HIV infections are self-inflicted

WHO blames ‘gross editing error’ for report claiming half of new cases are acquired deliberately by people trying to claim benefits
Associated Press

theguardian.com, Tuesday 26 November 2013 09.53 EST

A drug user gives blood sample for a HIV test

A drug user gives a blood sample for a HIV test inside a clinic in Athens: in a correction issued on Tuesday, the WHO said its report should have read that ‘few’ new cases of HIV were deliberate. Photograph: Yorgos Karahalis/Reuters

The World Health Organisation has apologised and blamed an “editing error” for claiming in a September report that half of the new HIV cases in Greece were acquired deliberately by people trying to claim government benefits.

In a correction issued on Tuesday, the WHO said the report should have read that “few” new cases of HIV are deliberate.

“This was just a gross editing error for which the WHO apologises,” said a WHO spokesman, Gregory Härtl.

In the report published by the WHO’s European office, the agency wrote that “about half of new HIV infections are being self-inflicted”.

WHO said it only became aware of the mistake on Tuesday after journalists asked about the claim.

Since the financial crisis first hit Greece several years ago, rates of HIV infection have soared.

http://www.theguardian.com/world/2013/nov/26/who-apologises-hiv-infections-greece-self-inflicted

Report: Half of new HIV cases in Greece from 2009-2011 self-inflicted to get benefits

Posted By Caroline May On 1:30 PM  11/25/2013 In  |

A case study contained within a lengthy World Health Organization report reviewing the health inequities among European countries says Greeks may be contracting HIV intentionally in order to go on public assistance.

According to the “case study” contained in the report “Review of social determinants and the health divide in the WHO European Region: final report,” while suicides, homicide, and thefts increased during the Greek economic crisis, so too did the rate of HIV infection — about half of which the report says were likely self-inflicted to obtain benefits.

“Suicides rose by 17% between 2007 and 2009 and to 25% in 2010, according to unofficial 2010 data (398),” the case study reads. “The Minister of Health reported a further 40% rise in the first half of 2011 compared with the same period in 2010. Suicide attempts have also increased, particularly among people reporting economic distress (610). Homicide and theft rates have doubled.

Continue reading “Report: Half of new HIV cases in Greece from 2009-2011 self-inflicted to get benefits”

AIDS guidelines for children may not improve death rates but may improve treatment access ( Yes, you read that right )

Contact: Fiona Godwin medicinepress@plos.org Public Library of Science

Recent changes to World Health Organization guidelines for starting anti-AIDS drugs (antiretroviral therapy—ART)  in young children are unlikely to improve death rates but may increase the numbers of children receiving ART by simplifying access to treatment,  according to a study by international researchers published in this week’s PLOS Medicine.

Continue reading “AIDS guidelines for children may not improve death rates but may improve treatment access ( Yes, you read that right )”

Depression: ‘Now the Second biggest cause of disability’ in world

By Helen Briggs BBC News

Depression
Depression is common across the world

 

Depression is the second most common cause of disability worldwide after back pain, according to a review of research.

The disease must be treated as a global public health priority, experts report in the journal PLOS Medicine.

The study compared clinical depression with more than 200 other diseases and injuries as a cause of disability.

Globally, only a small proportion of patients have access to treatment, the World Health Organization says.

“Depression is a big problem and we definitely need to pay more attention to it than we are now”

End Quote Dr Alize Ferrari University of Queensland

Depression was ranked at number two as a global cause of disability, but its impact varied in different countries and regions. For example, rates of major depression were highest in Afghanistan and lowest in Japan. In the UK, depression was ranked at number three in terms of years lived with a disability.

Dr Alize Ferrari from the University of Queensland’s School of Population Health led the study.

“Depression is a big problem and we definitely need to pay more attention to it than we are now,” she told BBC News.

“There’s still more work to be done in terms of awareness of the disease and also in coming up with successful ways of treating it.

“The burden is different between countries, so it tends to be higher in low and middle income countries and lower in high income countries.”

Policy-makers had made an effort to bring depression to the forefront, but there was a lot more work to be done, she added.

“There’s lots of stigma we know associated with mental health,” she explained.

“What one person recognises as disabling might be different to another person and might be different across countries as well, there are lots of cultural implications and interpretations that come in place, which makes it all the more important to raise awareness of the size of the problem and also signs and how to detect it.”

The data – for the year 2010 – follows similar studies in 1990 and 2000 looking at the global burden of depression.

Commenting on the study, Dr Daniel Chisholm, a health economist at the department for mental health and substance abuse at the World Health Organization said depression was a very disabling condition.

“It’s a big public health challenge and a big problem to be reckoned with but not enough is being done.

“Around the world only a tiny proportion of people get any sort of treatment or diagnosis.”

The WHO recently launched a global mental health action plan to raise awareness among policy-makers.

http://www.bbc.co.uk/news/health-24818048

 

WSU researchers link DDT and obesity / Effects seen across generations

Contact: Michael Skinner skinner@wsu.edu 509-335-1524 Washington State University

PULLMAN, Wash.—Washington State University researchers say ancestral exposures to environmental compounds like the insecticide DDT may be a factor in high rates of obesity. The finding comes as DDT is getting a second look as a tool against malaria.

“What your great-grandmother was exposed to during pregnancy, like DDT, may promote a dramatic increase in your susceptibility to obesity, and you will pass this on to your grandchildren in the absence of any continued exposures,” says Michael Skinner, WSU professor and founder of its Center for Reproductive Biology. He and his colleagues document their finding in the current issue of the journal BMC Medicine.

When Skinner and his colleagues exposed gestating rats to DDT, they saw no altered rates of obesity in the parent or first generation of offspring. But the disease developed in more than half the third-generation males and females. The researchers say the insecticide may be affecting how genes are turned on and off in the offspring of an exposed animal, even though its DNA sequences remain unchanged.

This is called transgenerational epigenetic inheritance. In recent years, the Skinner lab has documented epigenetic effects from a host of environmental toxicants, including plastics, pesticides, fungicides, dioxins, hydrocarbons and the plasticizer bisphenol-A or BPA.

However, says Skinner, the frequency of DDT effects on obesity are far greater than other toxicants his lab has reviewed.

He notes that more than 50 years have passed since Rachel Carson’s book “Silent Spring” documented many of DDT’s effects on the environment. Its use has since been banned in the U.S. However, says Skinner, “the third generation of people exposed in the 1950s is now of adult age and has a dramatic increase in diseases such as obesity.”

Meanwhile, he says, groups like the U.S. Agency for International Development and the World Health Organization are backing the use of DDT to control malaria in developing countries.

“The potential transgenerational actions of DDT need to be considered in the risk-benefit analysis of its use,” says Skinner.

###

Mentally ill tied to trees and left to die in Somalia

Source: Thomson Reuters Foundation – Mon, 7 Oct 2013 01:28 PM

Men walk on a beach in front of a building destroyed during a war in Mogadishu June 27, 2012. REUTERS/Goran Tomasevic

    

 

In Somalia there’s a belief that a mentally ill person can be cured by shutting them in a room with a hyena.

Mentally ill people in the war-ravaged country are often chained or locked up. Others are tied to trees and abandoned when their families are forced to flee fighting.

In one of the most moving radio interviews I’ve heard in a long time, psychiatric nurse Abdirahman Ali Awale, who is commonly known as Dr Habeeb, told how he was reduced to tears every day by what he sees.

“I have saved many, many patients who have been left to die. They have been tied to a tree and abandoned simply because they are mentally ill,” he told the BBC World Service.

Somalia has one of the world’s highest rates of mental illness with one in three people affected, according to the World Health Organisation (WHO).

But there has traditionally been almost no help. Somalia’s health sector was destroyed over two decades ago as the country descended into civil war.

The relentless shelling, fighting, killing and maiming, along with the repeated displacement of communities, has taken such a toll that Habeeb is on record as saying he doesn’t believe anyone in the whole of southern and central Somalia has good mental health.

The psychiatric nurse was spurred to set up the first of his six clinics in 2005 when he saw five mentally ill women being chased down the road by small boys.

He says his centres have since treated more than 15,000 patients. The most prevalent condition is post-traumatic stress disorder.

“This is usually what we see with many of our younger patients who come in,” says Habeeb. “We also see depression. A lot of our patients are very sad. They exclude themselves from society and they are very quiet and sad and stay in a corner.”

After the war, he believes the second biggest contributor to mental health issues is the widely used stimulant khat. The plant, which is chewed for its euphoric effects, has been linked to psychosis and depression.

HYENA “CURE”

But Habeeb doesn’t just treat people. He is on a mission to dispel the myths and stigma surrounding mental illness and end harmful practices.

This is done through radio broadcasts, lectures and classes.

“We tell them … that mental health illness is just like any other illness,” he told the World Service’s Outlook programme.

Many Somalis attribute behavioural problems to bad spirits and seek help from religious leaders or traditional healers. One of the most extreme treatments involves locking a person up with a hyena.

“In Somalia, there’s this belief that hyenas can see everything including the thing that causes mental illnesses,” says Habeeb.

“Two hyenas were brought from the bushes and brought to Mogadishu. Patients were locked in a room with the hyena with the belief that when the thing that caused the mental problem sees the hyena it would leave the body of the patient and the patient would be fine after that.”

This treatment is not cheap – the cost can be around $560, according to Habeeb. It’s also highly dangerous. Patients are left with long lasting trauma, physical injuries and even die, according to a WHO report on mental health in Somalia.

 “I CRY EVERY DAY”

WHO says most mentally ill people in Somalia are chained up or imprisoned.

Habeeb told the BBC more than 170,000 people have been “locked and … left to die”.  And no one in authority is talking about it.

You don’t have to look hard to find numerous images on the internet showing people chained to trees, rocks and beds. Many are chained for years on end, leading to long-lasting trauma and physical harm. Some commit suicide.

But the use of chains is often an act of desperation by families rather than cruelty, according to WHO. Families may believe they are preventing the person harming themselves or others, and that this is their only option.

Habeeb’s organisation, together with WHO, is pushing for an end to chaining.

But addressing mental illness is a very low priority in a country so devastated by fighting and hunger. It has also been ignored by international agencies.

Habeeb believes this is because treating mental health illness is expensive and does not bring quick results.

Not surprisingly, the work is exhausting.

“I’ve seen countless patients locked and left to die and that takes a toll mentally,” Habeeb says.

“I am alone. I am one person and I’m dealing with big, big, big problems that no one is ready to admit. Personally, I cry seven to eight times a day. I’m a big man, I’m a grown-up man, and in this society it is not common to see a grown man cry.

“I’ve cried on TV, I’ve cried in public places, I’ve even cried in front of presidents for them to speak about this problem, even for one day.”

 

http://www.trust.org/item/20131007132825-oupwe/?source=hpblogs

Study adds lung damage to harmful effects of arsenic / lung damage comparable to decades of smoking

Contact: John Easton john.easton@uchospitals.edu 773-795-5225 University of Chicago Medical Center

A new study confirms that exposure to low to moderate amounts of arsenic in drinking water can impair lung function. Doses of about 120 parts per billion of arsenic in well water—about 12 times the dose generally considered safe—produced lung damage comparable to decades of smoking tobacco. Smoking, especially by males, made arsenic-related damage even worse.

This is the first population-based study to clearly demonstrate significant impairment of lung function, in some cases extensive lung damage, associated with low to moderate arsenic exposure.

“Restrictive lung defects, such as we saw in those exposed to well-water arsenic, are usually progressive and irreversible,” said the study’s senior author, Habibul Ahsan, MD, MMedSc, Director of the Center for Cancer Epidemiology and Prevention at the University of Chicago Medicine. “They can lead over time to serious lung disease.”

The study, conducted in Bangladesh and published early online in the American Journal of Respiratory and Critical Care Medicine, adds to a growing list of arsenic-related health problems that includes skin, bladder and lung cancers, cardiovascular disease, cognitive deficits and premature death. An estimated 77 million people—nearly half of the residents of Bangladesh, the world’s eighth most populous country—live in areas where groundwater wells contain harmful amounts of arsenic.

Less is known about exposure to elevated arsenic levels from well water or foods in other parts of the world, including regions in Mexico and the United States. Researchers have recently begun to re-examine foods, such as rice syrup and apple juice, that contain more arsenic than the 10 parts per billion that is allowed in U.S. drinking water.

“It is challenging to conduct rigorous biomedical research in a place like Bangladesh that lacks the infrastructure for such projects,” Ahsan said, “but over the last 12 to15 years we have learned how to meet those challenges. We now have a large series of related findings that map out exposures and illustrate the severity of the problem.”

“Our findings reinforce the growing interest in looking more carefully at arsenic-exposure issues in the United States,” he added.

The study, coordinated by Ahsan and co-author Faruque Parvez, DrPH, of Columbia University, was the next step in the Health Effects of Arsenic Longitudinal Study (HEALS), a long-term Bangladesh-based project, begun in 2000 and expanded in 2006.

A nation of major rivers and low-lying plains, Bangladesh is prone to frequent floods, which, along with sanitation shortcomings, have historically contaminated the nation’s drinking water. This led to high rates of infectious disease and child mortality. In the 1960s, more than 250,000 Bangladeshi children died each year from waterborne diseases.

To protect those children, international charity organizations launched a massive humanitarian effort to provide clean drinking water. They installed roughly 10 million hand-pumped wells to bring up water from deep underground.

Nearly 20 years later, by the early 1990s, scientists realized that this well-intentioned plan had gone astray. Though the underground water was free from the bacterial contamination of surface sources, it was tainted with inorganic arsenic, a toxic element. This was “the largest mass poisoning of a population in history,” according to the World Health Organization.

The HEALS team follows about 20,000 people in Araihazar, a region of central Bangladesh, about 20 miles east of the capital, Dhaka, with a wide range of arsenic levels in drinking-water wells. Between 2005 and 2010, the researchers evaluated 950 individuals who reported respiratory symptoms such as cough and shortness of breath to HEALS clinic doctors. The researchers tested each patient’s lung function and documented his or her arsenic levels.

They divided the patients into three groups according to arsenic exposure, using two related measures: how much arsenic was in their drinking water and how much was in their urine.

Then, local physicians trained by pulmonologist Christopher Olopade, MD, of the University of Chicago, rigorously measured each patient’s lung function using a spirometer with a focus on two standard lung-function tests: forced expiratory flow (FEV1, the amount of air a person can expel in one second) and forced vital capacity (FVC, the total volume of air exhaled after fully filling the lungs).

Both measures showed that arsenic’s effects were dose-dependent. After they corrected for possible confounders, the researchers found that:

  • One-third of the participants had been exposed to the lowest arsenic levels, less than 19 parts per billion in water. They had no detectable arsenic-related loss of lung function.
  • One-third had been exposed to drinking water with a relatively low arsenic dose, 19 to 97 parts per billion. Their lung function, as measured by FEV1 and FVC, decreased slightly but was not significantly different from the group with the lowest arsenic level in water.
  • One-third were exposed to a moderate dose, more than 97 parts per billion. For this group, both spirometric variables were significantly decreased. Their FEV1 decreased by about three times as much as those exposed to 19 to 97 parts per billion and their FVC fell by about six times as much.
  • Smoking amplified the damage. About 90 percent of the men tested smoked.

“These results clearly demonstrate significant impairment of lung function associated with lower concentrations than previously reported,” Ahsan said. “Those most affected were older, thinner, less educated and more likely to use tobacco. Many of these people have limited excess lung capacity. It made a significant difference in their lives.”

“This suggests that a large proportion of the country’s population are at increased risk of developing serious respiratory disease, including COPD, bronchitis and interstitial lung disease in the future,” the authors conclude.

“This is not just a problem for South Asia,” Ahsan said. “About 13 million people in the United States get water from a private well that contains more arsenic than the legal limit. And we are becoming more and more aware that exposure through certain foods might be a bigger issue than drinking water. No comparable, large, prospective study has been done in this country.”

###

The National Institutes of Health funded this study. Additional authors include Maria Argos from the University of Chicago; Mahbub Yunus, Rabiul Hasan, Alauddin Ahmed and Tariqul Islam from the University of Chicago and the Columbia University Arsenic Project Office in Dhaka; Vesna Slavkovich and Joseph H. Graziano from Columbia University; Yu Chen and Stephanie Segers from New York University; and Mahmud Akter from the National Asthma Center, Dhaka.

The Hidden Threat That Could Prevent Polio’s Global Eradication – Vaccinated Children that Become “chronic excreters”

 

Polio could soon be wiped out—but only if scientists can track down the last carriers

By Helen Branswell

 


Image: GETTY IMAGES

Global eradication of polio has been the ultimate game of Whack-a-Mole for the past decade; when it seems the virus has been beaten into submission in a final refuge, up it pops in a new region. Now, as vanquishing polio worldwide appears again within reach, another insidious threat may be in store from infection sources hidden in plain view.

Polio’s latest redoubts are “chronic excreters,” people with compromised immune systems who, having swallowed weakened polioviruses in an oral vaccine as children, generate and shed live viruses from their intestines and upper respiratory tracts for years. Healthy children react to the vaccine by developing antibodies that shut down viral replication, thus gaining immunity to infection. But chronic excreters cannot quite complete that process and instead churn out a steady supply of viruses. The oral vaccine’s weakened viruses can mutate and regain wild polio’s hallmark ability to paralyze the people it infects. After coming into wider awareness in the mid-1990s, the condition shocked researchers.

Philip Minor, deputy director of the U.K.’s National Institute for Biological Standards and Control, describes the biomedical nightmare: Wild polioviruses stop circulating. Countries cut back on vaccination efforts. A chronic excreter kisses an unvaccinated baby, and the baby goes to day care. “And zappo,” he adds, “it’s all over the place, with babies drooling all over each other. So you could see a scenario where polio would come back from a developed country.” It could happen in the developing world as well. Although it was once thought that immunocompromised individuals could not survive for long in lower-income countries, circumstances are changing as those countries improve their health care systems. In 2009 an immunodeficient 11-year-old Indian boy was paralyzed by polio, five years after swallowing a dose of oral vaccine. It was only then that researchers recognized him as a chronic excreter.

Chronic excreters are generally only discovered when they develop polio after years of surreptitiously spreading the virus. Thankfully, such cases are rare. According to Roland W. Sutter, the World Health Organization scientist who heads research policy for the Global Polio Eradication Initiative, the initiative is pushing for the development of drugs that could turn off vaccine virus shedding. A few promising options are in the pipeline.

Drugs can only solve the problem if chronic excreters are identified, and that’s no easy task. For years scientists in Finland, Estonia and Israel monitored city sewers, watching for signs of shedders’ presence. In many samples, they have found the telltale viruses from chronic excreters, but they have failed to locate any of the individuals. These stealthy shedders may not be classic immunodeficient patients traceable through visits to immunologists. Instead they may be people who do not know they have an immunity problem at all and are under no specialized medical care. “We know that there’s really a Damocles sword hanging over them,” Sutter says. It hangs over the rest of us as well.

This article was originally published with the title Hidden and Dangerous.

 

http://www.scientificamerican.com/article.cfm?id=hidden-threat-that-could-prevent-polio-global-eradication

Scientists to make mutant forms of new bird flu to assess risk

Source: Reuters – Wed, 7 Aug 2013 05:00 PM

Author: Reuters

 

* Controversial research sparked previous security fears

* Flu experts say it is critical to prepare for threat

* New H7N9 bird flu strain has killed 43 people so far

* Outbreak currently controlled, may return in autumn

By Kate Kelland, Health and Science Correspondent

LONDON, Aug 7 (Reuters) – Scientists are to create mutant forms of the H7N9 bird flu virus that has emerged in China so they can gauge the risk of it becoming a lethal human pandemic.

The genetic modification work will to result in highly transmissible and deadly forms of H7N9 being made in several high security laboratories around the world, but it is vital to prepare for the threat, the scientists say.

The new bird flu virus, which was unknown in humans until February, has already infected at least 133 people in China and Taiwan, killing 43 of them, according to the latest World Health Organization (WHO) data.

Announcing plans to start the controversial experiments, leading virologists Ron Fouchier and Yoshihiro Kawaoka said H7N9’s pandemic risk would rise “exponentially” if it gained the ability to spread easily among people.

And the only way to find out how likely that is, and how many genetic changes would need to take place before it could happen, is to engineer those mutations in laboratory conditions  and test the virus’s potential using animal models, they said.

“It’s clear this H7N9 virus has some hallmarks of pandemic viruses, and it’s also clear it is still missing at least one or two of the hallmarks we’ve seen in the pandemic viruses of the last century,” Fouchier told Reuters in a telephone interview.

“So the most logical step forward is to put in those (missing) mutations first.”

Writing in the journals Nature and Science on behalf of 22 scientists who will carry out various aspects of the H7N9 work, Fouchier said because the risk of a pandemic caused by a bird flu virus exists in nature, it was critical for risk-mitigation plans to study the likely mutations that could make that happen.

This kind of science is known as “gain of function” (GOF) research. It aims to identify combinations of genetic mutations that allow an animal virus to jump to humans and spread easily.

By finding the mutations needed, researchers and health authorities can better assess how likely it is that a new virus could become dangerous and if so, how soon they should begin developing drugs, vaccines and other scientific defences.

Yet such work is highly controversial. It has fuelled an international row in the past two years after it was carried out on another threatening bird flu virus called H5N1.

BIOTERRORISM FEARS

When Fouchier, of the Erasmus Medical Centre in Rotterdam, The Netherlands, and Kawaoka, at the University of Wisconsin in the United States, announced in late 2011 they had found how to make H5N1 into a form that could spread between mammals, the U.S. National Science Advisory Board for Biosecurity (NSABB) was so alarmed that it took the unprecedented step of trying to censor publication of the studies.

The NSABB said it feared details of the work could fall into the wrong hands and be used for bioterrorism. A year-long moratorium on such research followed while the World Health Organisation, U.S. security advisers and international flu researchers sought ways to ensure the highest safety controls.

The laboratory Fouchier will be working in is known as a  BSL3 Enhanced lab (Bio-Safety Level 3), the highest level of biosecurity that can be achieved in academic research.

“Nature is the biggest threat to us, not what we do in the lab. What we do in the lab is under very intense biosecurity measures,” he said. “There are layers upon layers of layers of biosafety measures such that if one layer might break there are additional layers to prevent this virus ever coming out.”

Fouchier conceded that GOF research has been “under fire” recently. “One of the accusations against the flu community was that we were not transparent enough about what experiments were being done, and why and how they were being done,” he said. “We’re trying to pre-empt such accusations this time.”

The H7N9 bird flu outbreak currently appears under control with only 3 new human cases in May after 87 in April and 30 in March. Experts say this is largely thanks to the closure of many live poultry markets and because of warmer weather.

Yet as winter approaches in China, many experts believe H7N9 could re-emerge, meaning the threat of a pandemic looms if it mutates to become easily transmissible between people.

The first scientific analysis of probable human-to-human transmission of H7N9 raised concern about its pandemic potential and prompted scientists James Rudge and Richard Coker of the London School of Hygiene and Tropical Medicine to warn: “The threat posed by H7N9 has by no means passed.”

Fouchier and colleagues said they hope to unravel the molecular processes behind H7N9 by manipulating its genetic material to increase virulence or induce drug resistance.

Wendy Barclay, an Imperial College London flu expert, said it would be ludicrous to shy away from such studies. “This type of work is like fitting glasses for someone who can’t see well,” she said. “Without the glasses the vision is blurred and uncertain, with them you can focus on the world and deal with it a lot more easily.”   (Reporting by Kate Kelland; editing by David Evans)

http://www.trust.org/item/20130807165536-m5jun/?source=hpbreaking

 

In search of fair babies, Indians chase Caucasian donors for IVF

Shobita Dhar,  TNN Jul 21, 2013, 04.06AM IST

 

(Dr Manish Banker, director…)

Mayuri Singhal, 36, married into a fair-skinned family. She herself is what is often described in matrimonial columns as ‘wheatish’. When she couldn’t conceive, she walked into an IVF clinic with her demand: a ‘white’ baby. “I had read on the internet that one could access a donor who is fair. I decided to opt for one so that the child blends in with the family.”

According to the World Health Organization, there are close to 19 million infertile couples in India and their numbers are growing. “Couples who come for in-vitro fertilization (IVF) list out specifications — the egg or sperm donor should be educated, fair, have blue eyes,” says Dr Rita Bakshi, an IVF expert. Dr Bakshi says roughly 70% clients ask for fair donors.

Infertility experts warn that getting a ‘designer’ baby is difficult and expensive. “You need a lot of paperwork and approvals,” cautions Dr Anjali Malpani, a Mumbai-based fertility specialist. European donors may charge between $1,000 to $5,000 (Rs 6,000 to Rs 30,000 approximately) depending on factors such as physical health and educational background.

Dr Manish Banker, director of a fertility clinic, says: “Seeking fair-skinned donors is a rising trend. Couples usually ask for donors with blue or brown eyes.”

IVF clinics can obtain permission to import frozen human embryo after getting certain documents in order. Caucasian eggs are usually sourced from donors in Spain and countries in Eastern Europe. Dr Bakshi of Delhi explains: “You need to get a legal agreement signed by the intended parents, and the clinic, which should be registered with the ICMR. The clinic should issue a No Objection Certificate to import frozen human embryo and it should be signed by the intended parents while they are physically present in India.” Various courier services and cryopreservation companies ship such biological material to India.

Laws vary according to the country. For example, Canada forbids its donors from demanding any financial compensation. On the other hand, the US does not regulate the amount of money that can be paid to a donor. In 2012, fertility watchdog Human Fertility and Embryology Authority raised the limit for UK donors from £250 per cycle to £750 (Rs 22,600 to Rs 67,800 approx.).

But there are issues of logistics and laws. Dr Malpani of Mumbai cites a 2010 incident where a container carrying frozen human embryos from the US was seized by customs officials at Mumbai airport and returned to the US. While the ART Bill 2010 clearly states that import of human embryos is allowed, the customs department has yet to update its import tariff manual to include it.

None of this deters couples like Suresh and Supriya Shetty from Hyderabad who scouted for a donor fairer than them. “We are so grateful that our daughter Vani is as white as milk. There is no denying that it is easier to get fair girls married,” says Suresh who came to Ahmedabad to get IVF treatment done.

 

http://articles.timesofindia.indiatimes.com/2013-07-21/india/40708297_1_ivf-donors-dr-manish-banker

American Samoa’s battle against obesity as 95 per cent of the nation are declared overweight

  • WHO figures reveal extent of the obesity  crisis in the small Pacific island
  • One airline charging passengers tickets  based on their weight to save costs
  • Island-wide health push to encourage  healthier eating and more activity

By  Helen Collis

PUBLISHED: 11:58 EST, 8 July  2013 |  UPDATED: 11:59  EST, 8 July 2013

 

It has been officially ranked the fattest  population in the world – with estimates as high as 94 per cent  obesity.

The sheer scale of the problem has prompted  both public and private sector organisations to take action.

One airline has has become unpopular with the  locals by making every passenger stand on a set of scales with their luggage and  making them pay according to their individual weight.

Officially fattest: Islanders living on the beautiful American Samoa archipelago are officially the fattest in the world, according to WHO figures 

Officially fattest: Islanders living on the beautiful  American Samoa archipelago are officially the fattest in the world, according to  WHO figures

 

An American Samoan manAmerican Samoan local women performing a cultural show

Local American Samoans performing a cultural show; the  island’s inhabitants have been ranked the fattest in the world

While the healthcare sector is actively  encouraging the island’s inhabitants to pursue healthier lifestyles in a bid to  prevent the ticking time-bomb of health complications later in life, associated  with obesity.

The American-owned island, which forms part  of the Samoan archipelago chain in the Pacific Ocean, only has a population of  700,000, according to a 2013 census.

 

But, according to World Health Organization  records, 94 per cent, or 658,000 of them are overweight.

The dire statistic is blamed on an unhealthy  fast-food culture, influenced by its mainland powerhouse, and a penchant for a  sedentary lifestyle.

Almost all of the food in American Samoa is  imported and therefore expensive, but fast-food chains offer a cheap and  convenient alternative.

WHERE  ARE THE WORLD’S FATTEST PLACES…

1. American Samoa – 94 per cent

2. Kiribati, Central Pacific – 82 per  cent

3. French Polynesia – 74 per cent

4. Saudi Arabia – 73 per cent

5. Panama – 67.4 per cent

6. The U.S. – 66.9 per cent

7. Germany – 66.5 per cent

8. Egypt – 66 per cent

9. Kuwait – 64 per cent

10. Bosnia and Herzegovina – 63 per  cent

11. New Zealand – 62.7 per cent

12. Malta – 62.3 per cent

13. Israel – 61.9 per cent

14. Croatia – 61.4 per cent

15. Bahrain – 61 per cent

16. Macedonia – 60.4 per cent

17. Barbados  – 60.4 per cent

18. Seychelles – 60.1 per cent

19. Canada – 59.1 per cent

20. Chile – 59.7 per  cent

Samoa Air’s new ‘pay-by-weight’ system may be  having an effect on its passengers, however, so perhaps this is the way forward  for fat countries?

The island’s obesity epidemic is at crisis  point, since its population is now giving birth to overweight babies, starting  life with a plethora of health complications.

One study found that at just 15 months old,  40 per cent of boys and 30 per cent of girl babies were classed as overweight.

Being overweight is associated with a  catalogue of awful chronic diseases and health complications, including  hypertension and heart disease, diabetes and subsequent renal failure and liver  disease. It is also linked the asthma, cancer, depression, stroke and problems  associated with digestion.

The implications and burdens of such  crippling chronic diseases, not just to the individual and their relatives, but  also for the the country’s healthcare system, are immense.

But at last, it appears the island’s health  push is apparently sinking in.

An early morning exercise class at the  island’s only sports stadium is attracting more members.

Olivia Reid-Gillet attends twice a week  because she became aware of how serious her weight issues were.

Quoted by CBS News, she said: ‘I needed to  get healthier. I had high blood pressure, type 2 diabetes, high  cholesterol.’

Clinics including dietary advice, wellness  programmes, and childhood obesity tracking are also being offered to educate  people so they can take more control of their disease.

Local doctor, John Tuitele, told the news  service: ‘The people are being aware of the problem. People are realising the  importance of what we’re trying to get across.’

 

Read more: http://www.dailymail.co.uk/news/article-2358371/American-Samoas-battle-obesity-95-cent-nation-declared-overweight.html#ixzz2YWaiIbc3 Follow us: @MailOnline on Twitter | DailyMail on Facebook

Vitamin D deficiency may help spread of hepatitis B throughout liver

Contact: Dawn Peters sciencenewsroom@wiley.com 781-388-8408 Wiley

Researchers from Germany have found that low levels of vitamin D are associated with high levels of hepatitis B virus (HBV) replication. Findings published online in Hepatology, a journal of the American Association for the Study of Liver Diseases, suggest seasonal fluctuations in vitamin D and HBV levels point to a link in these variables among patients with chronic HBV.

While highly effective vaccines are available, HBV still remains one of the most significant infectious diseases worldwide. In fact, the World Health Organization (WHO) states that HBV is 50 to 100 times more infectious than human immunodeficiency virus (HIV). Furthermore WHO reports that two billion individuals have been infected with HBV, which is responsible for nearly 600,000 deaths each year. In the U.S. the Centers for Disease Control and Prevention (CDC) estimates that up to 1.4 million Americans are living with chronic HBV.

“Vitamin D helps maintain a healthy immune system and there is evidence of its role in inflammatory and metabolic liver disease, including infection with hepatitis C virus (HCV),” explains lead investigator Dr. Christian Lange from Johann Wolfgang Goethe University Hospital in Frankfurt. “However, the relationship between vitamin D metabolism and chronic HBV infection remains unknown and is the focus of our present study.”

Between January 2009 and December 2010, the team recruited 203 patients with chronic HBV who had not previously received treatment for their infection. Levels of 25-hydroxyvitamin D were measured from each participant. Patients co-infected with HCV, HIV, or hepatitis D; those with excessive alcohol use; and those with liver cancer or other malignancies were excluded.

Results show that 34% of participants had severe vitamin D deficiency (less than 10 ng/mL), 47% with vitamin D insufficiency (between 10-20 ng/mL) and 19% had normal levels of vitamin D (greater than 20 ng/mL). Further analyses indicate that the concentration of HBV in the blood, known as viral load, was a strong indicator of low vitamin D levels. In patients with HBV DNA less than 2000 IU/mL versus 2000 IU/mL or more, the levels of vitamin D were 17 and 11 ng/mL, respectively.

Researchers also determined that patients with the hepatitis B antigen (HBeAg) had lower levels of vitamin D than HBeAg negative participants. Inverse seasonal fluctuations between vitamin D and HBV levels were noted, which further suggests a relationship between the two variables.

“Our data confirm an association between low levels of vitamin D and high concentrations of HBV in the blood,” concludes Dr. Lange. “These findings differ from previous research of patients with chronic hepatitis C, which found no connection between vitamin D levels and concentration of HCV in the blood.” The authors propose further investigation of vitamin D as a therapeutic intervention for controlling HBV.

###

This study is published in Hepatology. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.

Full citation: “Low Vitamin D Serum Concentration is Associated with High Levels of Hepatitis B Virus (HBV) Replication in Chronically Infected Patients.” Harald Farnik, Jorg Bojunga, Annemarie Berger, Regina Allwinn, Oliver Waidmann, Bernd Kronenberger, Oliver T. Keppler, Stefan Zeuzem, Christoph Sarrazin and Christian M. Lange. Hepatology; (DOI: 10.1002/hep.26488) Published Online: May 22, 2013.

URL: http://doi.wiley.com/10.1002/hep.26488

About the Journal

Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://wileyonlinelibrary.com/journal/hep.

About Wiley

Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s website can be accessed at http://www.wiley.com.

Study finds vitamin C can kill drug-resistant TB

Contact: Kim Newman sciencenews@einstein.yu.edu 718-430-3101 Albert Einstein College of Medicine

May 21, 2013 — (Bronx, NY) — In a striking, unexpected discovery, researchers at Albert Einstein College of Medicine of Yeshiva University have determined that vitamin C kills drug-resistant tuberculosis (TB) bacteria in laboratory culture. The finding suggests that vitamin C added to existing TB drugs could shorten TB therapy, and it highlights a new area for drug design. The study was published today in the online journal Nature Communications.

TB is caused by infection with the bacterium M. tuberculosis. In 2011, TB sickened some 8.7 million people and took some 1.4 million lives, according to the World Health Organization. Infections that fail to respond to TB drugs are a growing problem: About 650,000 people worldwide now have multi-drug-resistant TB (MDR-TB), 9 percent of whom have extensively drug-resistant TB (XDR-TB).TB is especially acute in low and middle income countries, which account for more than 95 percent of TB-related deaths, according to the World Health Organization.

The Einstein discovery arose during research into how TB bacteria become resistant to isoniazid, a potent first-line TB drug. The lead investigator and senior author of the study was William Jacobs, Jr. Ph.D., professor of microbiology & immunology  and of genetics at Einstein. Dr. Jacobs is a Howard Hughes Medical Institute investigator and a recently elected member of the National Academy of Sciences.

Dr. Jacobs and his colleagues observed that isoniazid-resistant TB bacteria were deficient in a molecule called mycothiol. “We hypothesized that TB bacteria that can’t make mycothiol might contain more cysteine, an amino acid,” said Dr. Jacobs. “So, we predicted that if we added isoniazid and cysteine to isoniazid-sensitive M. tuberculosis in culture, the bacteria would develop resistance. Instead, we ended up killing off the culture— something totally unexpected.”

The Einstein team suspected that cysteine was helping to kill TB bacteria by acting as a “reducing agent” that triggers the production of reactive oxygen species (sometimes called free radicals), which can damage DNA.

“To test this hypothesis, we repeated the experiment using isoniazid and a different reducing agent— vitamin C,” said Dr. Jacobs. “The combination of isoniazid and vitamin C sterilized the M. tuberculosis culture. We were then amazed to discover that vitamin C by itself not only sterilized the drug-susceptible TB, but also sterilized MDR-TB and XDR-TB strains.”

To justify testing vitamin C in a clinical trial, Dr. Jacobs needed to find the molecular mechanism by which vitamin C exerted its lethal effect. More research produced the answer: Vitamin C induced what is known as a Fenton reaction, causing iron to react with other molecules to create reactive oxygen species that kill the TB bacteria.

“We don’t know whether vitamin C will work in humans, but we now have a rational basis for doing a clinical trial,” said Dr. Jacobs. “It also helps that we know vitamin C is inexpensive, widely available and very safe to use. At the very least, this work shows us a new mechanism that we can exploit to attack TB.”

###

 

The paper is titled, “Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction.” The other contributors are Catherine Vilcheze, Ph.D., Travis Hartman and Brian Weinrick, Ph.D., all at Einstein.

The study was supported by a grant (AI26170) from National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

The authors declare no conflict of interest.

About Drug-Resistant TB

Multi-drug-resistant TB (MDR-TB): TB that does not respond to isoniazid and rifampicin, the two most potent anti-TB drugs.  Extensively drug-resistant TB (XDR-TB): TB that is resistant to rifampicin and isoniazid, as well as to any member of the quinolone family of antibiotics and at least one of four second-line injectable anti-TB drugs.

About Albert Einstein College of Medicine of Yeshiva University

Albert Einstein College of Medicine of Yeshiva University is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2012-2013 academic year, Einstein is home to 742 M.D. students, 245 Ph.D. students, 116 students in the combined M.D./Ph.D. program, and 360 postdoctoral research fellows. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2012, Einstein received over $160 million in awards from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore Medical Center, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Through its extensive affiliation network involving Montefiore, Jacobi Medical Center –Einstein’s founding hospital, and five other hospital systems in the Bronx, Manhattan, Long Island and Brooklyn, Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States. For more information, please visit http://www.einstein.yu.edu and follow us on Twitter @EinsteinMed.

US company selling lead paint in Africa 5,000 times the allowable limit and is refusing to remove it !!!t

Contact: Melody Harris melody.harris@taylorandfrancis.com Taylor & Francis

US company identified as manufacture of lead paint in Africa

SAN FRANCISCO, CA (March 19, 2013) – House paint containing dangerous concentrations of lead is being sold in Cameroon by an American company – and the company is refusing to remove the paint from store shelves.

“There is an immediate need for regulations to restrict the lead content of paint in Cameroon to protect public health,” said Perry Gottesfeld, Executive Director of Occupational Knowledge International (OK International) and co-author of a new research study about this lead hazard.

“The levels of lead are extraordinarily high, and these products have been banned in the U.S. for more than 30 years,” Gottesfeld said.

The study, in the May issue of the Journal of Occupational and Environmental Hygiene revealed lead concentrations are as high as 50 percent by weight in household paint being sold by Cameroon’s largest paint company, Seignerurie – a subsidiary of the U.S. Company PPG. This concentration is more than 5,000 times the allowable limit in the U.S.

Lead is added to paint because it is inexpensive way to add color, resist corrosion, or to improve the drying.

The research was jointly conducted by OK International and the Research and Education Centre for Development (CREPD) and involved samples from dozens of stores. Results showed that two-thirds (66%) of new paints in Cameroon made by more than ten companies had hazardous lead levels in excess of 90 parts per million (ppm). The researchers also found that none of the lead paints surveyed in stores had any hazard warnings while only 8% of the paints had labels identifying any of the ingredients. The new study is the first one which provides the names of paint companies and the lead concentrations for all 61 paints tested.

“This is the ultimate case of a company operating with double standards as they sell hazardous products in developing countries that have been banned in the U.S. since the 1970s,” Gottesfeld added.

As a result of this research, consumers in Cameroon are being warned to avoid purchasing paints unless the cans are labeled with as having no added lead. Most of the paint available in the market contains hazardous levels of lead that causes birth defects, brain damage, high blood pressure, and other health effects in both children and adults.

CREPD is issuing a warning following the results of a recent survey showing that most of the new paints being sold in stores still contain lead at excessive levels despite pledges by some paint companies to reformulate.

“The problem we are seeing is that the older paint is still in stores because none of the companies have recalled products with hazardous levels of lead,” said Gilbert KUEPOUO, Coordinator of CREPD. “As a result, we are asking consumers to look for labels that indicate that lead levels are less than 90 parts per million (PPM) as required in the U.S., China, and other countries.”

PPG sent a letter to some of the distributors offering to exchange some products, but few responded.

CREPD recently interviewed the managers of the 11 stores that sell Seigneurie paints and identified only three that had returned products based on the companies offer. There are no regulations regarding the lead content of new paints in Cameroon.

The World Health Organization estimates that 240 million people around the world are overexposed to lead contamination and 99 percent of those most severely exposed reside in developing countries. Lead paint in housing contributes significantly to children’s exposure resulting in brain damage, mental retardation, lower educational performance, and a range of other health effects.

###

 

For additional information, contact: Mr. Perry Gottesfeld Executive Director OK International 4444 Geary Boulevard, Suite 300 San Francisco, CA 94118 USA 1+415-221-8900 info@okinternational.org

The complete article in the Journal of Occupational and Environmental Hygiene has been made available for a free download here: http://www.tandfonline.com/doi/abs/10.1080/15459624.2013.768934

About Occupation Knowledge International

OK International is a nonprofit organization based in San Francisco that works to build capacity in developing countries to identify, monitor, and mitigate environmental and occupational exposures to hazardous materials in order to protect public health and the environment. The organization seeks to address inequities in environmental standards between developed and developing countries by working in partnership with industry, government and non-governmental organizations (NGOs). For more information, visit http://www.okinternational.org.

More HIV ‘cured’: first a baby, now 14 adults

 

A drug-free life beckons for some people with HIV <i>(Image: Bruce Forster/Getty)</i>A drug-free life beckons for some people with HIV (Image: Bruce Forster/Getty)

Two weeks after the revelation that a baby has been “cured” of HIV, reports suggest that a similar treatment can cure some adults too. Early treatment seems crucial, but does not guarantee success.

Asier Sáez-Cirión of the Pasteur Institute’s unit for regulation of retroviral infections in Paris analysed 70 people with HIV who had been treated with antiretroviral drugs (ARVs) between 35 days and 10 weeks after infection – much sooner than people are normally treated.

All of the participants’ drug regimes had been interrupted for one reason or another. For example, some people had made a personal choice to stop taking the drugs, others had been part of a trial of different drug protocols.

Most of the 70 people relapsed when their treatment was interrupted, with the virus rebounding rapidly to pre-treatment levels. But 14 of them – four women and 10 men – were able to stay off of ARVs without relapsing, having taken the drugs for an average of three years.

The 14 adults still have traces of HIV in their blood, but at such low levels that their body can naturally keep it in check without drugs.

Drugless years

On average, the 14 adults have been off medication for seven years. One has gone 10-and-a-half years without drugs. “It’s not eradication, but they can clearly live without pills for a very long period of time,” says Sáez-Cirión.

Last week, a baby was reported to have been “functionally cured” of HIV after receiving a three-drug regime of ARVs almost immediately after birth. Sáez-Cirión warns that rapid treatment doesn’t work for everyone, but the new study reinforces the conclusion that early intervention is important.

“There are three benefits to early treatment,” says Sáez-Cirión. “It limits the reservoir of HIV that can persist, limits the diversity of the virus and preserves the immune response to the virus that keeps it in check.”

Further analysis confirmed that the 14 adults were not “super-controllers” – the 1 per cent of the population that are naturally resistant to HIV – since they lack the necessary protective genes. Also, natural controllers rapidly suppress their infections, whereas these 14 mostly had severe symptoms which led to their early treatment. “Paradoxically, doing badly helped them do better later,” says Sáez-Cirión.

Rapid response

The researchers are trying to identify additional factors that could explain why early intervention only works on some people, hopefully extending the scope for more functional cures.

“This whole area is fascinating, and we’ve been looking very closely at issues of early initiation of treatment, and the potential for functional cures,” says Andrew Ball, senior adviser on HIV/AIDS strategy at the World Health Organization in Geneva.

“The big challenge is identifying people very early in their infection,” says Ball, adding that many people resist testing because of the stigma and potential discrimination. “There’s a good rationale for being tested early, and the latest results may give some encouragement to do that,” he says.

Journal reference: PLoS Pathogens, DOI: 10.1371/journal.ppat.1003211

http://www.newscientist.com/article/dn23276-more-hiv-cured-first-a-baby-now-14-adults.html

 

Herbal defluoridation of drinking water

Contact: Albert Ang press@inderscience.com Inderscience Publishers

Researchers in India have developed a filter system based on a medicinal herb, which they say can quickly and easily remove “fluoride” from drinking water. The technology described in the March issue of the International Journal of Environmental Engineering uses parts of the plant Tridax procumbens as a biocarbon filter for the ion.

Drinking water can contain natural fluoride or fluoride might be added as a protective agent for teeth by water companies. However, its presence is not without controversy while in some natural drinking water levels may be above those considered safe by the World Health Organisation. Chemist Malairajan Singanan of the Presidency College (Autonomous), in Chennai, points out that the WHO guidelines suggest that a safe level of fluoride is 1.5 milligrams per liter. He adds that various techniques to reduce fluoride content have been tried including coagulation, adsorption, precipitation, ion exchange, reverse osmosis, and electrodialysis. However, metal ions with an affinity for fluoride in a biocarbon matrix represent a promising new approach.

Singanan has investigated Tridax procumbens, which is commonly used as a medicinal herb in India, as a biocarbon absorbent for fluoride. Previously, the plant has been tested in the extraction of toxic heavy metals from water. He explains that by loading up plant tissue with aluminum ions it is possible create a safe biocarbon filter that will readily absorb fluoride ions from water warmed to around 27 Celsius passing through the filter. His trials show that it takes just three hours to remove 98% of fluoride with just 2 grams of the biocarbon filter.

The biocarbon filter might provide an inexpensive way to defluoridate water in regions where the natural level of this mineral is high in ground water, including India, China, Sri Lanka, West Indies, Spain, Holland, Italy, Mexico, North and South America. It might also be adapted for those consumers who wish to reduce their exposure to fluoride, despite its dental health benefits, in parts of the world where it is added to the water supply for public health reasons.

###

“Defluoridation of drinking water using metal embedded biocarbon technology” in Int. J. Environmental Engineering, 2013, 5, 150-160

Commonly used painkiller ‘should be banned over heart risk’

A painkiller used by at least a million people in Britain a year should be banned because it raises the risk of heart attack and stroke by almost half, say British academics.

Common painkillers can raise heart risk

Daily doses of painkillers can increase the risk of heart attacks and stroke Photo: ALAMY

<!– remove the whitespace added by escenic before end of tag –>

Stephen Adams

By , Medical Correspondent

10:00PM GMT 12 Feb 2013

Safer alternatives exist to diclofenac, say researchers at the Barts and the London School of Medicine and Dentistry, who want it banned worldwide.

Diclofenac, like ibuprofen, is a non-steroidal anti-inflammatory drug or ‘NSAID’. It is often prescribed after surgery and to combat arthritic pain, when ibuprofen is not strong enough.

It can also be purchased over the counter at a pharmacy without a prescription, for example in the branded form of Voltarol Pain-eze tablets.

But two years ago the Barts researchers found that it was linked with a 40 per cent increased risk of heart attack and stroke.

That analysis crystallised the fears of many doctors, who have raised concerns about the drug for years.

Another study, also published in 2011, indicated diclofenac raised the risk of dying from heart attack or stroke four-fold.

Writing in the journal PLoS Medicine Dr Patricia McGettigan, who led the 2011 study, said drugs regulators needed to take action now.

She said: “The regulators need to look at medicine like this on the basis that the evidence that it causes harm has been known for years but its sale and prescription patterns in England are only slowly drifting down.

“If it is not going to change appropriately then the regulators need to act, particularly when there is a safer alternative available.”

About five million prescriptions are made for diclofenac every year, according to official data. Although many take it regularly, lots of people take it as a ‘one off’, meaning it is likely that well over a million take it every year. The risks are highest in those who take it regularly.

Dr McGettigan, who has trained as both a pharmacist and doctor, noted the increased risk from diclofenac was not much less that from another drug, which was withdrawn in 2004. Vioxx, an arthritis drug, was found to raise the chance of heart attack and stroke by 45 per cent.

Diclofenac still appears on the World Health Organisation’s list of “essential medicines” in 74 countries, according to Dr McGettigan and her colleague David Henry, chief executive of the Institute for Clinical Evaluative Sciences at the University of Toronto, who contributed to the study.

Professor Henry said: “Given the availability of safer alternatives, diclofenac should be de-listed from national essential medicines lists.”

Dr McGettigan added: “Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage,” she said.

“Because it’s been around for so long people have become familiar with it and almost don’t believe it could have a side effect like this.

“There are strong arguments to revoke its marketing authorisations globally.”

A spokesman for the UK drugs regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA), said diclofenac was “an extremely important NSAID”.

He said: “For most patients the risks of side-effects are outweighed by the benefits these drugs bring in managing pain.”

He continued: “The MHRA has carefully reviewed the safety profile of diclofenac as new data becomes available. This has resulted in updates to information for healthcare professionals and patients, and numerous communications to ensure that any risk to patients is minimised.

“Our advice remains that these medicines should be used for the shortest time necessary and at the lowest dose possible to control symptoms.”

A European review, instigated by the MHRA, was currently taking place, he added.

Maureen Talbot, senior cardiac nurse at the British Heart Foundation, urged caution when prescribing NSAIDs but did not say diclofenac should be banned.

She said: “The risks associated with non-steroidal anti-inflammatory painkillers, which include diclofenac, have been known for some years and they should always be prescribed with caution.

“Anyone taking these painkillers should be made aware of both their risks, especially of cardiovascular disease and internal bleeding, and benefits in treating debilitating pain such as that caused by arthritis.

“If you are taking these powerful drugs and are worried, discuss your concerns with your GP or pharmacist who will be able to help you decide whether the benefits outweigh the risks.”

http://www.telegraph.co.uk/health/healthnews/9866239/Commonly-used-painkiller-should-be-banned-over-heart-risk.html

 

CIA Vaccine Hoax Condemned By Public Health Deans

 

Posted: 01/10/2013  5:41 pm EST  |  Updated: 01/10/2013  6:32 pm EST

University public health schools’ deans say health workers should be off limits.

Public health school deans from prominent colleges and universities across the country have signed a letter condemning a hoax the Central Intelligence Agency reportedly used to obtain DNA samples from Osama bin Laden’s former compound before the raid that killed him, the New York Times reports.

Signed by representatives from Columbia, Harvard and Johns Hopkins universities, as well as other public health programs, the letter claims forces hostile to the United States have now targeted vaccinators fighting to eliminate polio in the region because a CIA operation destroyed the trust established between vaccinators and Pakistanis.

The Guardian reported in July 2011 that the CIA admitted to hiring a Pakistani doctor and sending him to Abbottabad in March 2011. He was instructed to tell officials he had procured funds to give free vaccinations for hepatitis B and to sidestep local health services by paying off low-ranking government workers. Health-related professionals typically “were among the few people who had gained access to the bin Laden compound in the past, administering polio drops to some of the children,” according to The Guardian.

The operation, which the CIA has acknowledged, used an existing international framework to eliminate polio; the doctor started his task in poorer districts to avoid suspicion and more closely align himself with existing operations.

After the hoax came to light following the U.S military raid resulting in the death of bin Laden in May 2011, angry villagers have run legitimate vaccinators out of town, and the Taliban has banned health workers from two districts in Pakistan until the United States agrees to end drone attacks — a relatively ineffective ultimatum, according to World Health Organization officials who spoke with the Times.

Nine polio vaccinators were killed in December. In their letter, the public health deans urge the U.S. government to stop using health officials as undercover agents.

The full text of the letter is provided below.

Dear President Obama,In the first years of the Peace Corps, its director, Sargent Shriver, discovered that the Central Intelligence Agency (CIA) was infiltrating his efforts and programs for covert purposes. Mr. Shriver forcefully expressed the unacceptability of this to the President. His action, and the repeated vigilance and actions of future directors, has preserved the Peace Corps as a vehicle of service for our country’s most idealistic citizens. It also protects our Peace Corps volunteers from unwarranted suspicion, and provides opportunities for the Peace Corps to operate in areas of great need that otherwise would be closed off to them.

In September Save the Children was forced by the Government of Pakistan (GoP) to withdraw all foreign national staff. This action was apparently the result of CIA having used the cover of a fictional vaccination campaign to gather information about the whereabouts of Osama Bin Laden. In fact, Save the Children never employed the Pakistani physician serving the CIA, yet in the eyes of the GoP he was associated with the organization. This past month, eight or more United Nations health workers who were vaccinating Pakistani children against polio were gunned down in unforgivable acts of terrorism. While political and security agendas may by necessity induce collateral damage, we as an open society set boundaries on these damages, and we believe this sham vaccination campaign exceeded those boundaries.

As an example of the gravity of the situation, today we are on the verge of completely eradicating polio. With your leadership, the U.S. is the largest bilateral donor to the Global Polio Eradication Initiative and has provided strong direction and technical assistance as well. Polio particularly threatens young children in the most disadvantaged communities and today has been isolated to just three countries: Afghanistan, Nigeria and Pakistan. Now, because of these assassinations of vaccination workers, the UN has been forced to suspend polio eradication efforts in Pakistan. This is only one example, and illustrates why, as a general principle, public health programs should not be used as cover for covert operations.

Independent of the Geneva Conventions of 1949, contaminating humanitarian and public health programs with covert activities threatens the present participants and future potential of much of what we undertake internationally to improve health and provide humanitarian assistance. As public health academic leaders, we hereby urge you to assure the public that this type of practice will not be repeated.

International public health work builds peace and is one of the most constructive means by which our past, present, and future public health students can pursue a life of fulfillment and service. Please do not allow that outlet of common good to be closed to them because of political and/or security interests that ignore the type of unintended negative public health impacts we are witnessing in Pakistan.

Sincerely, Pierre M. Buekens, M.D., M.P.H., Ph.D. Dean, Tulane University School of Public Health and Tropical Medicine*

James W. Curran, M.D., M.P.H. Dean, Rollins School of Public Health, Emory University*

John R. Finnegan Jr., Ph.D. Professor and Dean, University of Minnesota School of Public Health* Chair of the Board, Association of Schools of Public Health*

Julio Frenk, M.D., M.P.H., Ph.D. Dean and T&G Angelopoulos Professor of Public Health and International Development Harvard School of Public Health*

Linda P. Fried, M.D., M.P.H. Dean, Mailman School of Public Health, Columbia University*

Howard Frumkin, M.D., Dr.P.H. Dean, School of Public Health, University of Washington* Lynn R. Goldman, M.D., M.P.H. Professor and Dean, School of Public Health and Health Services, George Washington University* Jody Heymann, M.D., M.P.P., Ph.D. Dean, UCLA Fielding School of Public Health*

Michael J. Klag, M.D., M.P.H. Dean, Johns Hopkins Bloomberg School of Public Health* Martin Philbert, Ph.D. Dean, School of Public Health, University of Michigan* Barbara K. Rimer, Dr.P.H. Dean and Alumni Distinguished Professor UNC Gillings School of Global Public Health* Stephen M. Shortell, Ph.D. Dean, School of Public Health, University of California Berkeley*

http://www.huffingtonpost.com/2013/01/10/cia-polio-vaccine-hoax_n_2450726.html

146th Health Research Report 11 JAN 2013

 

 

In this issue:

1. Foodborne Illness Could Have Sinister Causes : Medications being intentionally added

2. Cholesterol medicine affects energy production in muscles

3. Sublingual immunotherapy shows promise as treatment for peanut allergy

4. Hold the diet soda? Sweetened drinks linked to depression, coffee tied to lower risk

5. Disappearing bacterium may protect against stroke

6. High fiber diet prevents prostate cancer progression

7. High Fructose Corn Syrup Direct Correlation with Autism in the U.S. – Clin Epigenetics. 2012 (Excerpt)

 

 

 

Foodborne Illness Could Have Sinister Causes : Medications being intentionally added

Observation Article: Foodborne Illness Could Have Sinister Causes

Doctors should consider the intentional addition of medicine to food as a potential cause of foodborne disease outbreaks. The World Health Organization suggests possible sources of foodborne disease outbreaks are pathogenic bacteria, viruses, protozoa, parasitic worms, natural toxins, and chemicals, but not medicines. A 2010 foodborne disease outbreak in Beijing, China was a result of clonidine, a medication used to treat hypertension and ADHD, being intentionally added to lunch ingredients. Eighty travelers who had just finished lunch in a Beijing restaurant began to feel faint. Within a few hours they developed dizziness, weakness, lethargy, dry mouth, and nausea, among other troublesome symptoms. At a nearby hospital, the travelers were treated for low blood pressure and low heart rate. With no response to treatment, the patients were referred for a screening for common toxins and drugs. The screening found clonidine in the patients’ systems. The patients were treated for clonidine poisoning and symptoms resolved in all patients within 48 hours. After six days, all patients had been discharged from the hospital and at one year no patients had residual symptoms. An investigation found that two persons put clonidine into the starch used to make certain dishes (the kitchen staff would not notice the addition because starch and clonidine are both white, odorless powders) to gain a competitive advantage for a nearby restaurant.

Cholesterol medicine affects energy production in muscles

Painful side effects

Up to 75 per cent of patients who take statins to treat elevated cholesterol levels may suffer from muscle pain. Scientists at the Center for Healthy Aging at the University of Copenhagen have now identified a possible mechanism underlying this unfortunate side effect. The results have just been published in the well-reputed Journal of American College of Cardiology.

Statin is a class of drugs which are used to treat high levels of blood cholesterol by way of inhibiting the liver’s ability to produce cholesterol. Statins are the most potent drugs on the market for lowering low-density cholesterol (LDL). At present 600,000 Danes with elevated cholesterol levels take statins daily. 30-40 per cent of the older Danish population (ages 65+) are currently undergoing treatment.

From 30-40% of the older Danish population (ages 65+) are currently undergoing treatment with statins.

“A well-known side effect of statin therapy is muscle pain. Up to 75 per cent of the physically active patients undergoing treatment for high cholesterol experience pain. This may keep people away from either taking their medicine or from taking exercise – both of which are bad choices,” says Professor Flemming Dela from the Center for Healthy Aging at the University of Copenhagen. He continues:

“We have now shown that statin treatment affects the energy production in muscles. We are working on the assumption that this can be the direct cause of muscle weakness and pain in thepatients.”

Scientists also showed that the patients examined who were being treated with statins had low levels of the key protein Q10. Q10 depletion and ensuing lower energy production in the muscles could be the biological cause of the muscle pain that is a problem for many patients.

Side effects of statin therapy

About 40 per cent of the patients being treated with statins in Denmark are in so-called ’mono therapy’ and thus are prescribed only this one drug. Presumably these are people who ‘only’ have high cholesterol and no other risk factors that could influence heart health:

“The effect of statins is marginal for these patients – in a previous published Cochrane analysis only 0.5% reduction in all-cause mortality was detected, indicating that for every 200 patients taking statins daily for five years, one death would be prevented. This patient group is obviously interesting in light of the side effects of statin therapy,” comments Professor Flemming Dela.

The media influence patients

“The new study is the basis for a large planned research project, where we will focus broadly on patients undergoing statin treatment. We will look at statin consumption from a medical point of view, and will also investigate the media’s influence on patients’ acceptance or rejection of statins as a treatment option. Many contradictory views find their way into the public forum, and it can be difficult for patients to distinguish between fact and fiction,” continues Professor Flemming Dela.

Scientists will also be looking at how home-monitoring of cholesterol levels influences patients – for example, does it make patients feel more or less secure when they take responsibility for their own health in this manner? The Center for Healthy Aging is currently seeking funding for the research project.

See scientific article Simvastatin Effects on Skeletal Muscle in Journal of American College of Cardiology.

Contact:

Professor Flemming Dela Phone: +45 35 32 74 25

Sublingual immunotherapy shows promise as treatment for peanut allergy

CHAPEL HILL, N.C. – Peanuts are one of the most common triggers of severe food-induced allergic reactions, which can be fatal, and the prevalence of peanut allergy is increasing. However, there is currently no clinical treatment available for peanut allergy other than strict dietary elimination and, in cases of accidental ingestion, injections of epinephrine.

But a new multicenter clinical trial shows promise for sublingual immunotherapy (SLIT), a treatment in which patients are given daily doses, in gradually increasing amounts, of a liquid containing peanut powder. The patients first hold the liquid under the tongue for 2 minutes and then swallow it.

The two lead authors of the study, published in the January 2013 issue of the Journal of Allergy and Clinical Immunology, are David M. Fleischer, MD, of National Jewish Health in Denver, Colo., and Wesley Burks, MD, Curnen Distinguished Professor and Chair of the Department of Pediatrics in the University of North Carolina School of Medicine.

“These results are encouraging,” Burks said. “The immune response was stronger than we thought it might be, and the side effects of this treatment were relatively small. However, the magnitude of the therapeutic effect was somewhat less than we had anticipated. That’s an issue we plan to address in future studies.”

In the study, 40 people with peanut allergy, ages 12 to 37 years, were randomized to receive daily peanut or placebo SLIT. All were given a baseline oral food challenge of up to 2 grams of peanut powder to test how much peanut powder they could consume without symptoms.

After 44 weeks, all were given a second oral food challenge. Those who were able to consume either 5 grams, or at least 10-fold more peanut powder than their baseline amount, were considered to be responders (i.e., desensitized to peanut). At 44 weeks, 70 percent of those who received peanut SLIT were responders, compared to 15 percent of those receiving placebo. Among the peanut-SLIT responders, the median amount of peanut powder they could successfully consume increased from 3.5 to 496 milligrams. After 68 weeks, that amount increased significantly, to 996 milligrams.

Of 10,855 peanut doses given through week 44 of the study, 63.1 percent were symptom-free. When oral/pharyngeal symptoms were excluded from the analysis, 95.2 percent of doses were symptom-free.

The study concluded that peanut SLIT safely induced desensitization in a majority of participants compared to placebo, and that longer duration of therapy led to significant increases in the amount of peanut powder people could safely consume.

However, Burks cautions, this is not a treatment that people should try on their own. For now it’s a treatment that should only be given by medical professionals in a carefully monitored clinical trial, he said.

###

Study participants were recruited from five U.S. sites: New York, N.Y.; Baltimore, Md.; Little Rock, Ark.; Denver, Colo.; and Durham, N.C. Study co-authors include researchers from the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Johns Hopkins University School of Medicine, Mount Sinai School of Medicine, the EMMES Corp. in Rockville, Md., and the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH).

The study was funded by grants from the NIAID and the NIH’s National Center for Research Resources.

Hold the diet soda? Sweetened drinks linked to depression, coffee tied to lower risk

SAN DIEGO – New research suggests that drinking sweetened beverages, especially diet drinks, is associated with an increased risk of depression in adults while drinking coffee was tied to a slightly lower risk. The study was released today and will be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, March 16 to 23, 2013.

“Sweetened beverages, coffee and tea are commonly consumed worldwide and have important physical—and may have important mental—health consequences,” said study author Honglei Chen, MD, PhD, with the National Institutes of Health in Research Triangle Park in North Carolina and a member of the American Academy of Neurology.

The study involved 263,925 people between the ages of 50 and 71 at enrollment. From 1995 to 1996, consumption of drinks such as soda, tea, fruit punch and coffee was evaluated. About 10 years later, researchers asked the participants whether they had been diagnosed with depression since the year 2000. A total of 11,311 depression diagnoses were made.

People who drank more than four cans or cups per day of soda were 30 percent more likely to develop depression than those who drank no soda. Those who drank four cans of fruit punch per day were about 38 percent more likely to develop depression than those who did not drink sweetened drinks. People who drank four cups of coffee per day were about 10 percent less likely to develop depression than those who drank no coffee. The risk appeared to be greater for people who drank diet than regular soda, diet than regular fruit punches and for diet than regular iced tea.

“Our research suggests that cutting out or down on sweetened diet drinks or replacing them with unsweetened coffee may naturally help lower your depression risk,” said Chen. “More research is needed to confirm these findings, and people with depression should continue to take depression medications prescribed by their doctors.”

###

The study was supported by the National Institutes of Health, the National Institute of Environmental Health Sciences and the National Cancer Institute.

Learn more about depression, which commonly affects people with brain diseases, at http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Media Contacts:

Rachel Seroka, rseroka@aan.com, (612) 928-6129

Angela Babb, APR, ababb@aan.com, (612) 928-6102

Disappearing bacterium may protect against stroke

H. pylori isn’t a major cause of death and may protect against stroke and some cancers

New York (January 9, 2013) — A new study by NYU School of Medicine researchers reveals that an especially virulent strain of the gut bacterium Helicobacter pylori (H. pylori) isn’t implicated in the overall death rate of the U.S. population, and may even protect against stroke and some cancers. The findings, based a nationwide health survey of nearly 10,000 individuals over a period of some 12 years, are published online, January 9, in the journal Gut.

Those individuals carrying the most virulent strain of H. pylori, the study found, had a 55 percent reduced risk of deaths from stroke compared with their counterparts who were not infected with H. pylori. Participants with the most virulent strain also had a 45 percent reduced risk of death from lung cancer.

These surprising findings emerged from an analysis by Yu Chen, PhD, MPH, associate professor of population health and environmental medicine, and Martin J. Blaser, MD, professor of internal medicine and professor of microbiology, of individuals who participated in a national survey designed to assess the health and nutritional status of adults and children in the United States. Previous studies by Dr. Blaser have confirmed the bacterium’s link to gastric diseases ranging from gastritis to stomach cancer. He and Dr. Chen have more recently shown that H. pylori may protect against childhood asthma. The most virulent H. pylori strains have a gene called cagA.

“The significance of this study is that this is a prospective cohort of participants representative of the U.S. population with a long follow-up,” says Dr. Chen. “We studied both the overall H. pylori as well as cagA strain of H. pylori, which is more interactive with the human body. We found that H. pylori is not related to the risk of death from all causes, despite it being related to increased risk of death from gastric cancer.”

“This finding confirms earlier work, however, that gastric cancers are now uncommon in the United States,” says Dr. Chen. “We also found that H. pylori was related to a reduced risk of stroke and lung cancer, and these effects were stronger for the cagA strain, suggesting its mixed role in human health,” she says.

H. pylori, an ancient bacterium, lives in the mucous layer lining the stomach where, until recently, it survived for decades. More than half of the world’s population harbor H. pylori in their upper gastrointestinal tract. Mainly transmitted in families, the bacterium is usually acquired before age 10. In developing countries H. pylori is still prevalent, but is vanishing in the developed world thanks to better sanitation and widespread use of antibiotics.

To better understand the relationship between H. pylori and the overall death rate, or all-cause mortality, the researchers analyzed data from 9,895 participants in the National Health and Nutrition Surveys (NHANES III), enrolled from 1988 to 1994. Test results for H. pylori and cagA were available on 7,384 subjects at the time of enrollment, and participants were followed until 2000.

There was no association of either H. pylori-positivity or cagA-positivity with all-cause mortality in the population, the researchers found. Participants with and without H. pylori experienced a similar risk of death from all causes. Consistent with past reports, a strong association was observed between H. pylori and gastric cancer mortality, according to the study. Individuals who were H. pylori positive were 40 times more likely to die from gastric cancer. The study also found that participants with cagA-positivity had a 55 percent reduced risk of deaths from stroke compared with their counterparts who were H. pylori negative/ cagA-negative. Participants with cagA-positivity also had a 45 percent reduced risk of deaths from lung cancer.

“The most interesting finding was that there is a strong inverse association with stroke which could be protective,” says Dr. Blaser. “There is some precedent for this and it is possible that the same cells (T reg cells) that H. pylori induces that protect against childhood asthma could be the protective agents, however, the findings need to be confirmed.”

###

Authors: Yu Chen. PhD, MPH, associate professor, Departments of Population Health and Environmental Medicine; Stephanie Segers, MPH, statistician, Department of Population Health; Martin J. Blaser, MD, professor, Departments of Medicine and Microbiology.

Competing Interests: None reported.

Funding/Support: This work was supported in part by grants R01DK090989, R01GM63270, ES000260, and P30CA16087 from the National Institutes of Health, and by the Diane Belfer Program for Human Microbial Ecology.

About NYU School of Medicine:

NYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one on the nation’s premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of three hospitals – Tisch Hospital, its flagship acute care facility; the Rusk Institute of Rehabilitation Medicine, the world’s first university-affiliated facility devoted entirely to rehabilitation medicine; and the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center’s tri-fold mission to serve, teach and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research.

High fiber diet prevents prostate cancer progression

By Garth Sundem in In the Lab · January 9, 2013 · No comments

Komal Raina, PhD, shows that prostate cancers in mice fed a high-fiber diet fail to progress.

A high-fiber diet may have the clinical potential to control the progression of prostate cancer in patients diagnosed in early stages of the disease.

The rate of prostate cancer occurrence in Asian cultures is similar to the rate in Western cultures, but in the West, prostate cancer tends to progress, whereas in Asian cultures it does not. Why? A University of Colorado Cancer Center study published in the January 2013 issue of the journal Cancer Prevention Research shows that the answer may be a high-fiber diet.

The study compared mice fed with of inositol hexaphosphate (IP6), a major component of high-fiber diets, to control mice that were not. Then the study used MRI to monitor the progression of prostate cancer in these models.

“The study’s results were really rather profound. We saw dramatically reduced tumor volumes, primarily due to the anti-angiogenic effects of IP6,” says Komal Raina, PhD, research instructor at the Skaggs School of Pharmacy and Pharmaceutical Sciences, working in the lab of CU Cancer Center investigator and School of Pharmacy faculty member, Rajesh Agarwal, PhD.

Basically, feeding with the active ingredient of a high-fiber diet kept prostate tumors from making the new blood vessels they needed to supply themselves with energy. Without this energy, prostate cancer couldn’t grow. Likewise, treatment with IP6 slowed the rate at which prostate cancers metabolized glucose.

Possible mechanisms for the effect of IP6 against metabolism include a reduction in a protein called GLUT-4, which is instrumental in transporting glucose.

“Researchers have long been looking for genetic variations between Asian and Western peoples that could explain the difference in prostate cancer progression rates, but now it seems as if the difference may not be genetic but dietary. Asian cultures get IP6 whereas Western cultures generally do not,” Raina says.

The research provides the cover image of this month’s issue of the journal.

Support provided in part by NCI RO1grant CA116636, the NCI Cancer Center P30 CA046934, and the NCRR CTSA UL1 RR025780

Herbal treatments for postmenopausal symptoms can be recommended as an alternative to HRT

Herbal and complementary medicines could be recommended as an alternative to hormone replacement therapy (HRT) for treating postmenopausal symptoms says a new review published today in The Obstetrician and Gynaecologist (TOG).

The review outlines the advantages and limitations of both pharmacological and herbal and complementary treatments for women with postmenopausal symptoms.

The menopause is defined as the time after a woman’s menstrual periods have ceased (12 months after a woman’s final menstrual period). It is associated with an estrogen deficiency and can cause an increase in vasomotor symptoms (hot flushes), genitourinary symptoms (vaginal dryness, sexual dysfunction, frequent urinary tract infections, urinary incontinence), and musculoskeletal symptoms (joint pain) as well as sleep and mood disturbance.

One of the most common menopausal symptoms is hot flushes; approximately two-thirds of postmenopausal women will experience them, and 20% of women can experience them for up to 15 years, states the review.

Estrogen deficiency can also lead to longer-term health issues such as cardiovascular disease and osteoporosis. While pharmacological agents are available to treat postmenopausal symptoms, many non-pharmacological treatment options are also available.

HRT is the most effective treatment of hot flushes, improving symptoms in 80 – 90% of women, says the review. However, the author notes that there are possible health risks associated with HRT, such as links to breast cancer, blood clots, stroke, and cardiovascular problems.

Due to these possible risks, other treatment options may be equally effective, such as behaviour modification and herbal and complimentary medicines, says the author.

The review states that as many as 50 – 75% of postmenopausal women use herbal options to treat hot flushes, and of the complimentary therapies, soy, red clover and black cohosh have been the most investigated.

Soy is the most common plant containing estrogen, found naturally in food and supplements. Previous research has shown a reduction in hot flush symptoms with soy ranging from 20 – 55%. Red clover, a legume also containing estrogen, and black cohosh, a plant originating from the eastern United States and Canada, have also been reported to ease postmenopausal symptoms.

The author of the review recommends these herbal treatments as there are no significant adverse side effects associated with them, as long as they are used in women who do not have a personal history of breast cancer, are not at high risk for breast cancer, and are not taking tamoxifen. However, the review notes that herbal medicines are not regulated in many countries, and therefore the contents of a given product may vary from sample to sample.

Iris Tong, Director of Women’s Primary Care at the Women’s Medicine Collaborative, The Warren Alpert Medical School of Brown University, Rhode Island, and author of the review said:

“Up to 75% of women use herbal and complimentary medicines to treat their postmenopausal symptoms. Therefore, it is vitally important for healthcare providers to be aware of and informed about the non-pharmacological therapies available for women who are experiencing postmenopausal symptoms and who are looking for an alternative to HRT.”

TOG‘s Editor –in-Chief, Jason Waugh said:

“Postmenopausal symptoms can be very distressing and it is important to review the advantages and limitations of the non-pharmacological treatments available as well as the pharmacological ones. Even simple behaviour modification can make a difference to postmenopausal symptoms, including keeping the room temperature cool, wearing layered clothing, relaxation techniques and smoking cessation.”

High Fructose Corn Syrup Direct Correlation with Autism in the U.S. – Clin Epigenetics. 2012 (Excerpt)

EEV: Highlights Although there are many potential causes. We chose to highlight HFCS, due to its toxin amplification.

1) Ca, Mg and Zn, or losses or displacement of any of these minerals from the consumption of HFCS

2) mercury (Hg) and fructose may both modulate PON1 activity

3) mercury (Hg) that may occur from the low Hg concentrations sometimes found in HFCS as a result of the manufacturing process

4) HFCS, may further enhance the toxic effects of lead (Pb) on cognitive and behavioral development in children

2nd Source http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378453/

Initial Study date: 10 APR 2012

A macroepigenetic approach to identify factors responsible for the autism epidemic in the United States

Abstract

The number of children ages 6 to 21 in the United States receiving special education services under the autism disability category increased 91% between 2005 to 2010 while the number of children receiving special education services overall declined by 5%. The demand for special education services continues to rise in disability categories associated with pervasive developmental disorders. Neurodevelopment can be adversely impacted when gene expression is altered by dietary transcription factors, such as zinc insufficiency or deficiency, or by exposure to toxic substances found in our environment, such as mercury or organophosphate pesticides. Gene expression patterns differ geographically between populations and within populations. Gene variants of paraoxonase-1 are associated with autism in North America, but not in Italy, indicating regional specificity in gene-environment interactions. In the current review, we utilize a novel macroepigenetic approach to compare variations in diet and toxic substance exposure between these two geographical populations to determine the likely factors responsible for the autism epidemic in the United States.

A macroepigenetic model to explain gene-environment interactions in autism

In public health, epidemiology arguably has led the way in researching gene-environment interactions by studying how genotypes, environmental exposures and disorder outcomes occur in the human population [5]. However, this epidemiological approach has often resulted in contradictory scientific conclusions when its practitioners do not consider the dietary factors that interact and modulate the molecular and genetic mechanisms underlying human metabolism and brain function [14]. This has been the case despite the existence of literature from the field of “nutrigenomics”, which has specifically studied the effects of food and food ingredients on gene expression. In identifying the public health and the social and/or environmental determinants of disease, it seems invalid to study epidemiology without nutrigenomics, or vice versa. In other words, a more macro-level approach to unraveling the full range of environmental and genetic factors contributing to these kinds of neurological disorders ought to include nutrition factors as a component of the environment. By combining information derived from both nutrigenomic and epidemiology studies, a macroepigenetic model has already been developed to explain some of the gene-environment interactions with dietary factors that lead to the development of autism and ADHD [4].

Figure 1 shows the Mercury Toxicity model that provides a macroepigenetic explanation of how human neurodevelopment can be adversely impacted when gene expression is altered by dietary transcription factors such as zinc insufficiency or deficiency, or by exposure to toxic substances found in our environment, such as the heavy metals mercury and copper [4]. Elimination of heavy metals requires the expression of the metallothionein (MT) gene, which synthesizes the Zn-dependent metal binding protein metallothionein [15]. With dietary zinc (Zn) loss and copper (Cu) gain from the consumption of high fructose corn syrup (HFCS) [16], metabolic processes required to eliminate heavy metals are impaired in children with autism [4]. Mercury has been found in samples of high fructose corn syrup and is allowable in trace amounts in certain food colors so long as the concentration does not exceed one part per million [17,18]. Mercury (Hg) and specific other heavy metals, including lead (Pb), copper (Cu), cadmium (Cd), silver (Ag) and bismuth (Bi), are capable of displacing the Zn atom in the MT protein molecule [15]. This ‘pathogenic’ displacement of Zn impairs the MT molecule and its ability to pick up the heavy metal and carry it out of the body. If the diet is deficient in Zn or the absorption of Zn is impaired, then the body may not produce enough MT protein to carry and excrete the heavy metal load [19,20]. Children with autism may be Zn deficient and often have MT dysfunction [2123]. Because of their diminished capacity to excrete toxic heavy metals, the severity of their condition is associated with their toxic metal burden [24]. This macroepigenetic model proposes that autism prevalence is related to the consumption of HFCS and the overall exposure to Hg in the U.S. [4]. However, other dietary factors associated with the consumption of HFCS may further contribute to the development of autism in the U.S.

                        Figure 1. The original Mercury Toxicity Model. The original Mercury Toxicity Model was published in 2009 by Dufault et al. in the Behavioral and Brain Functions journal. The model is a flow chart of what can happen in the body when there is exposure to mercury (Hg) from ingestion of foods (via HFCS, food colors and fish) or inhalation of air. Human neurodevelopment can be adversely impacted when MT gene expression is altered or suppressed by dietary transcription factors such as zinc (Zn) insufficiency or deficiency. Without proper MT expression and function, mercury excretion may not be possible and oxidative stress in the brain from mercury insult leads to reduced neuronal plasticity and impaired learning. Hg in fish is a problem when there is not enough selenium (Se) in the fish to counteract the Hg and the glutathione (GSH) system is disrupted leading to further oxidative stress.

Additional dietary factors associated with consumption of HFCS

U.S. per capita consumption of HFCS in 2009 was 35.7 pounds per year [25]. The peak years for annual consumption of HFCS coincided with the peak growth rates of ASD in California, the only state that reports number of cases of ASD dating back to the mid-1980s [4]. The Mercury Toxicity Model shows the HFCS characteristics most likely contributing to autism include the zinc-depleting effect that comes from consuming HFCS and certain food colors found in processed foods, and the additional Hg exposure that may occur from the low Hg concentrations sometimes found in HFCS as a result of the manufacturing process [4,17]. This model can be expanded to include additional adverse effects associated with the consumption of HFCS that likely contribute to the development of autism through PON1 gene modulation and lead intoxication.

U.S. Department of Agriculture (USDA) scientists warn that when dietary intake of magnesium (Mg) is low, consumption of HFCS leads to lower calcium (Ca) and phosphorus (P) balances adversely affecting macromineral homeostasis in humans [26]. This is an unfortunate finding because there is evidence to suggest that dietary intake of Mg is low among Americans, most of whom consume a high fructose diet. In 2003, CDC scientists reported that substantial numbers of U.S. adults fail to consume adequate Mg in their diets [27]. Children with autism were found to have significantly lower plasma Mg concentrations than normal subjects [28]. Adams et al. found significant reductions in red blood cell (RBC) Ca, serum and white blood cell (WBC) Mg and an increase in RBC copper in autistic children as compared to controls [29]. Recently, USDA scientists reported that the National Health and Nutrition Examination Survey (NHANES) data for 2005 to 2006 indicate that overall, nearly one half of all individuals one year and over had inadequate intakes of dietary Mg [30]. With a substantial number of Americans consuming inadequate amounts of dietary Mg along with HFCS diets, one may predict that substantial numbers of Americans are likely experiencing a calcium (Ca) deficit as well.

Insufficient intake of dietary Ca, Mg and Zn, or losses or displacement of any of these minerals from the consumption of HFCS, may further enhance the toxic effects of lead (Pb) on cognitive and behavioral development in children [31]. A significant and independent inverse relationship between dietary Ca intake and blood Pb concentrations was found in 3,000 American children examined as part of NHANES II [32]. Elevated blood Pb levels are indicative of Pb intoxication, which is found in some children diagnosed with autism and associated with the development of ADHD [33,34]. It may be that inadequate intake of Ca or Mg combined with a HFCS zinc-depleting diet increases the risk of developing autism and ADHD from Pb intoxication.

Inadequate intake of Ca or Mg may further contribute to these developmental disorders by impacting human serum paraoxonase-1 (PON1) gene expression. PON1 is a calcium dependent enzyme responsible for OP pesticide detoxification as well as hydrolysis of the thiolactone form of homocysteine [35,36]. PON1 is synthesized in the liver and secreted in blood where it is incorporated into high density lipoproteins (HDL). The availability and catalytic activity of PON1 are impaired in many children with ASD making them more susceptible to the toxic effects of OP pesticide residues which are most frequently found in grain [37,38]. Figure 2 shows the expanded Mercury Toxicity Model that includes changes both in Pb toxicity and PON1 activity when dietary intake of Mg is low and consumption of HFCS leads to greater loss of calcium (Ca) and phosphorus (P), thereby adversely affecting macromineral homeostasis.

Figure 2. The expanded Mercury Toxicity Model. Figure 2 shows the expanding Mercury Toxicity Model that includes changes both in lead (Pb) toxicity and human serum paraoxonase (PON1) activity when dietary intake of Mg is low and consumption of high fructose corn syrup (HFCS) leads to lower calcium (Ca) and phosphorus (P) balances, adversely affecting macromineral homeostasis. With insufficient dietary intake of Ca and/or Mg, children become more susceptible to Pb intoxication and OP exposures with decreasing PON1 activity. Pb intoxication and OP exposures can both lead to oxidative stress in the brain reducing neuronal plasticity.

PON1 activity and organophosphate exposure in U.S

One can assert that with the consumption of a HFCS intensive diet and inadequate Mg intakes, PON1 activity may decrease, along with resulting Ca losses in genetically predisposed individuals. Although there are no human data yet to support this assertion, PON1 activity in rats decreased when fed a HFCS diet to mimic the human metabolic syndrome [39]. PON1 activity has been extensively studied in humans and there are a number of factors known to modulate or alter PON1 expression including, but not limited to, Hg exposure, sex and age [40,41]. Age plays the most relevant role, as PON1 activity is very low before birth and gradually increases during the first few years of life in humans [41]. In one study, scientists at UC Berkeley found the PON1 levels in many children may remain lower than those of their mothers for several years, especially those with genotypes associated with decreased PON1 activities [42]. The scientists concluded that these children may be more susceptible to OP pesticides throughout their childhood and more vulnerable to conditions associated with oxidative stress such as autism [42]. In a different study, scientists at UC Berkeley found that two-year-old children were less likely to display symptoms of PDD when their mothers had higher paraoxonase levels during their pregnancy [43]. Proper function and adequate expression of the PON1 gene is essential both for prenatal development and child health because exposure to OP pesticides is a common occurrence in the U.S.

The CDC tracks exposure to OP pesticides or their metabolites through the National Biomonitoring Program (NBP). Exposure data are reported for the population as a whole and for subgroups. While most American groups are exposed to OP pesticides, children ages 6 to 11 have significantly higher exposures than adults and are at greatest risk from OP neurotoxicity [44]. Harvard University researchers recently reported finding OP pesticide residues in a number of foods frequently consumed by children [45]. The researchers expressed concern that the children were at times being exposed to multiple pesticide residues in single food commodities. OP pesticide exposures occur primarily from the consumption of foods containing pesticide residues.

It is well known that pesticide exposure can impair neurodevelopment in children, but recent studies have found that pesticide exposure during pregnancy can also cause delayed mental development in children [46]. A review of epidemiological studies in 2008 found that prenatal and childhood exposure to OPs impairs neurobehavioral development [47]. Higher concentrations of urinary dialkyl phosphate (DAP) measured during pregnancy was significantly associated with lower cognitive scores in children at seven years of age. Those children in the highest quintile of maternal DAP concentrations had an IQ score seven points lower than those children in the lowest quintile [48]. In a group of newborns with the highest levels of the organophosphate chlorpyrifos measurable in their umbilical cord blood, birth weight averaged 150 grams less than the group with the lowest exposure [49]. Prenatal pesticide exposure showed deficits consistent with developmental delays of 1.5 to 2 years [49].

Diet is the main source of OP exposure in children. Under the 1996 Food Quality Protection Act, the U.S. Secretary of Agriculture is directed to collect pesticide residue data on commodities frequently consumed by infants and children. USDA Pesticide Data Program (PDP) provides the residue data to comply with this law [50]. We reviewed the PDP data from 2004 to 2008 and identified the foods most frequently found to contain organophosphate insecticide residues. In addition, we obtained the per capita availability data from the USDA to determine the amount of each food commodity the average American consumes [25]. The results of our review indicate that wheat and corn are the commodities most likely contributing to OP exposure in U. S. children. Estimated per capita wheat consumption was approximately 95 pounds per year while estimated per capita corn consumption was approximately 23 pounds per year. The primary use of corn is for the production of corn sweeteners, such as HFCS; however, pesticide residue data were not gathered for this commodity by the PDP. Table 2 provides a complete breakdown of the results of this data review.

Table 2. PDP residue detections by year sampled wi th U.S. per capita consumption data

From Table 2 it is clear consumers are at risk of exposure to multiple OP pesticide residues from consuming the very same commodity. Cumulative exposures will continue to occur in the U.S. where OP pesticide use is widespread by the agricultural industry. Although OP pesticide use is equally widespread in other countries, there is genetic variation across populations that determine degree of susceptibility to OP exposure. The PON1 gene variants associated with autism in subgroups of the U.S. population but not in Italy could be attributed to the fact that HFCS consumption rarely occurs in Italy, thereby lessening the conditions for PON1 modulation.

HFCS consumption and PON1 modulation in autism in the U.S

In the 27-member European Union (EU), of which Italy is an original participant, HFCS is known as “isoglucose” and currently it is rarely consumed by Italians. Americans on the other hand consume on average 35.7 pounds per year, which may increase their overall Hg exposure [17,25]. Figure 3 shows U.S. per capita food consumption in pounds per year for HFCS beginning in the early 1970s and increasing throughout the 1980s to reach a peak between 1999 and 2002. In our previous publication, we reported the peak years for annual consumption of HFCS in the U.S. occurred within the same period as when the annual growth rates of autism peaked in California [4].

Figure 3. U.S. per capita consumption of high fructose corn syrup 1966-2004. Figure 3 shows the United States (US) per capita consumption of high fructose corn syrup (HFCS) in pounds per year as calculated by the United States Department of Agriculture (USDA)/Economic Research Service.

American per capita consumption of HFCS has exceeded 20 pounds per year since 1980 while Italians consume negligible amounts of the same ingredient. As was previously mentioned, mercury (Hg) and fructose may both modulate PON1 activity [3941]. While excessive fructose exposure in the U.S. may primarily occur through the consumption of foods containing HFCS, mercury exposure may occur in a number of ways. A comparison of common sources of mercury exposure in the U.S. and Italy may offer a further explanation of the PON1 gene variation associated with autism in the U.S. but not in Italy.

In addition to HFCS, primary sources of inorganic and elemental Hg exposure may occur from consumption of food colors and preservatives made with mercury-cell chlorine or chlor-alkali products, seafood consumption, Hg in dental amalgam, thimerosal in vaccines, and depending on geographic location, inhalation of Hg contaminated air [4,5154]. Children living near coal-fired power plants are often exposed to higher levels of Hg in their breathing air and have a higher prevalence of autism [55]. Because Hg emissions from coal-fired power plants are not yet regulated in either the U.S. or Italy, this particular source of Hg exposure is unlikely to explain the overall difference in autism prevalence between these two countries. With respect to the consumption of seafood, use of Hg dental amalgam, thimerosal in vaccines or Hg-containing food colors and preservatives, there is also no appreciable difference between Italy and the U.S. [5658]. The only remaining variable in our model is the excessive consumption of HFCS by Americans, which results in greater chronic exposures to both inorganic Hg and, by definition, fructose [4].

Inorganic Hg may interact with cysteine residues on PON1 preventing its activation in the liver and impairing the body’s ability to protect itself against OP pesticides and oxidative stressors involved in autism [41]. As noted above, PON1 is responsible for hydrolysis of homocysteine thiolactone, and plasma PON1 activity is negatively correlated with homocysteine levels [36,59]. Homocysteine is a metabolic biomarker for oxidative stress and impaired methylation capacity. A recent study of the Inuit population found a significant inverse correlation between PON1 activity and Hg levels, as well as a direct correlation with selenium levels [60]. With increasing Hg and fructose exposure and reductions in dietary Ca, one can expect to see reduced PON1 activity and increasing homocysteine levels in children with ASD.

Indeed, Pasca et al. recently reported finding that both PON1 arylesterase and PON1 paraoxonase activities were decreased in children with autism [61,62]. James et al. found that children with autism had higher plasma homocysteine levels than controls but demonstrated significant improvements in transmethylation metabolites and glutathione (GSH) after receiving folate and vitamin B12 [63]. Patel and Curtis found that in addition to glutathione and B12 injections one to three times per week, children with autism and ADHD showed significant improvement in many areas of social interaction, concentration, writing, language and behavior when fed an organic diet low in fructose and free of food additives and food colors [64].

Mothers of autistic children in the U.S. were also found to have significant increases in mean plasma homocysteine levels compared to controls [65]. Schmidt et al. found that women who took vitamin supplements during the periconceptional period reduced the risk of autism in their children [66]. Those women who did not take vitamins during this period were more likely to have a child with autism and were at even greater risk when they had specific genetic variants within one-carbon metabolism pathways. This suggests that folate and other dietary methyl donors may alter epigenetic regulation of gene expression in their children, thereby reducing the risk of autism [66].

Methionine synthase links oxidation to epigenetics

Epigenetic regulation of gene expression is highly dependent upon methylation of both DNA and histones, and methylation capacity is in turn dependent upon activity of the folate and vitamin B12-dependent enzyme methionine synthase, which converts homocysteine to methionine. Lower methionine synthase activity decreases the level of the methyl donor S-adenosylmethionine (SAM) while simultaneously increasing the level of the methylation inhibitor S-adenosylhomocysteine (SAH) [67]. The combined effect of changes in the SAM to SAH ratio, therefore, exerts a powerful influence over more than 200 methylation reactions, including DNA and histone methylation [68].

Methionine synthase activity is inhibited by oxidative stress, and its inhibition results in the diversion of homocysteine to produce the antioxidant glutathione (GSH), providing an important adaptive response [69]. However, oxidative inhibition of methionine synthase leads to epigenetic effects via the resultant decrease in the SAM to SAH ratio and decreased DNA and histone methylation. Epigenetic changes in gene expression can recruit further adaptive responses to oxidative stress. Figure 4 illustrates how these changes may occur when the body is under oxidative stress from exposure to OP pesticides, heavy metals, and calcium depleting substances, such as HFCS. Decreased methionine synthase activity during oxidative stress also increases homocysteine thiolactone formation [70], raising the importance of PON1. As was previously mentioned, PON1 is essential for reducing homocysteine levels, which are thought to be harmful. Elevated plasma homocysteine (tHcy) levels are associated with genome-wide DNA hypomethylation that may carry over from one generation to the next, increasing the risk of autism [71]. Epigenetic changes affecting germline cells can give rise to these transgenerational effects [72]. James et al. found that parents share similar metabolic deficits in methylation capacity and glutathione-dependent antioxidant/detoxification capacity with their children with autism [71].

Figure 4. Methionine synthase links oxidative stress to epigenetic regulation. Figure 4 shows how exposure to toxic substances, such as OP pesticides, HFCS, or heavy metals, inhibits methionine synthase through effects of oxidative stress. As a result, decrease of SAM to SAH ratio will lead to a decrease in DNA methylation and consequently to altered PON1 gene expression.

Synergistic effect of multiple neurotoxins

Based upon the discussion above, it is clear that methionine synthase activity is crucial for translating changes in oxidative status into epigenetic effects, and this role is confirmed by the improved metabolic profile in autistic subjects given folate and vitamin B12 [63]. This relationship has given rise to the “Redox/Methylation Hypothesis of Autism”, which proposed that oxidative insults arising from environmental exposures, such as Hg and pesticides, can cause neurodevelopmental disorders by disrupting epigenetic regulation [73]. The macroepigenetic Mercury Toxicity Model expanded in this paper provides additional support for the “Redox/Methylation Hypothesis of Autism” while contributing important insight into the oxidative stress feedback mechanisms that may occur as a result of malnutrition resulting from dietary exposures to toxins. The delivery of children exhibiting autistic behaviors might be associated with the prenatal diet of their mothers. The severity of these behaviors can be further exacerbated by toxic dietary exposures of the children, which can improve with dietary changes aimed at eliminating these exposures. Children with autism could well be exhibiting an epigenetic response to several neurotoxic substances at once, including, but not limited to, inorganic Hg, Pb, OP pesticides and/or HFCS. The combined effect of these substances acting together is likely greater than the sum of the effects of the substances acting by themselves. This effect likely reduces neuronal plasticity and impairs learning capacity in autistic children.

Conclusion

The number of children ages 6 to 21 in the U.S. receiving special education services under the autism disability category increased 91% between 2005 to 2010 despite fewer children receiving special education services overall during the same time period. A comparison of autism prevalence between the U.S. and Italy using the Mercury Toxicity Model suggests the increase in autism in the U.S. is not related to mercury exposure from fish, coal-fired power plants, thimerosal, or dental amalgam but instead to the consumption of HFCS. Consumption of HFCS may lead to mineral imbalances, including Zn, Ca and P loss and Cu gain and is a potential source of inorganic mercury exposure. These mineral imbalances create multiple pathways for oxidative stress in the brain from exposure to OP pesticides and heavy metals, such as Pb or Hg. Inorganic mercury and fructose exposure from HFCS consumption may both modulate PON1 gene expression. With a reduction in PON1 activity, there is a potential for increasing homocysteine levels which are associated with genome-wide DNA hypomethylation that may carry over from one generation to the next, affecting both neurodevelopment and autism prevalence.

v

These reports are done with the appreciation of all the Doctors, Scientist, and other Medical Researchers who sacrificed their time and effort. In order to give people the ability to empower themselves. Without base aspirations of fame, or fortune. Just honorable people, doing honorable things.

store logo

Health Research Report

146th Issue Date 11 JAN 2013

Compiled By Ralph Turchiano

www.vit.bz

www.youtube.com/vhfilm www.facebook.com/engineeringevil

www.engineeringevil.com  www.healthresearchreport.me 

120922_0002

Foodborne Illness Could Have Sinister Causes : Medications being intentionally added

Contact: Angela Collom
acollom@acponline.org
215-351-2653
American College of Physicians

 

Observation Article: Foodborne Illness Could Have Sinister Causes

Doctors should consider the intentional addition of medicine to food as a potential cause of foodborne disease outbreaks. The World Health Organization suggests possible sources of foodborne disease outbreaks are pathogenic bacteria, viruses, protozoa, parasitic worms, natural toxins, and chemicals, but not medicines. A 2010 foodborne disease outbreak in Beijing, China was a result of clonidine, a medication used to treat hypertension and ADHD, being intentionally added to lunch ingredients. Eighty travelers who had just finished lunch in a Beijing restaurant began to feel faint. Within a few hours they developed dizziness, weakness, lethargy, dry mouth, and nausea, among other troublesome symptoms. At a nearby hospital, the travelers were treated for low blood pressure and low heart rate. With no response to treatment, the patients were referred for a screening for common toxins and drugs. The screening found clonidine in the patients’ systems. The patients were treated for clonidine poisoning and symptoms resolved in all patients within 48 hours. After six days, all patients had been discharged from the hospital and at one year no patients had residual symptoms. An investigation found that two persons put clonidine into the starch used to make certain dishes (the kitchen staff would not notice the addition because starch and clonidine are both white, odorless powders) to gain a competitive advantage for a nearby restaurant.

Note: For an embargoed PDF, please contact Megan Hanks or Angela Collom

WHO downplayed health effects of nuclear crisis on Fukushima residents : German physician

Jiji

BERLIN — A German doctor and member of a Nobel Peace Prize-winning physicians’ group has criticized a World Health Organization report on the Fukushima nuclear catastrophe for underestimating its impact on human health.

In a research paper, Alex Rosen said the WHO report, published in May this year on estimated radiation doses received by residents near the crippled Fukushima No. 1 nuclear plant, was compiled mainly by officials related to the International Atomic Energy Agency, which promotes the use of atomic energy for peaceful purposes.

Rosen, a member of International Physicians for the Prevention of Nuclear War, called for an independent assessment based on solid scientific methodology that would examine the health impacts from radioactive fallout released after the Fukushima No. 1 complex suffered three core meltdowns in March 2011.

The WHO report put the maximum whole-body radiation dose per person in the first four months of the crisis at 50 millisieverts, even in two municipalities very close to the plant, the town of Namie and the village of Iitate. It also estimated that no area experienced doses in excess of 100 millisieverts.

The risk of developing cancer is believed to substantially increase if the annual dose exceeds 100 millisieverts.

Rosen noted that the WHO’s estimate on the amount of radioactive fallout emitted from the plant’s destroyed reactors was significantly lower than projections provided by research institutes in many other countries.

The WHO report also failed to take into account the radiation exposure of people living within 20 km of the No. 1 plant and who were evacuated in the first few days of the calamity, after the area was designated a no-go zone, Rosen said, pointing to the possibility that these residents may have received high doses before or during their evacuation.

The report “seems to suggest a certain safety while omitting the important information that the risk of developing cancer and other radiation-induced diseases increases proportionally to the amount of radioactive exposure,” Rosen, a pediatrician, said.

The most flawed aspect of the WHO report is “its apparent lack of neutrality,” he said.

Rosen further asserted that the report reflects an effort to downplay the effects of the disaster, as it was compiled chiefly by IAEA staff and members of nuclear regulatory bodies that were closely colluding with Japan’s nuclear power industry.

“It is unclear why a report written mainly by the IAEA and collaborating nuclear institutions would need to be published in the name of the WHO, if not to provide an unsuspicious cover” for the true radiation levels Fukushima residents were exposed to, Rosen argued.

Last month, the German branch of the international physicians’ group sent a letter to WHO Director General Margaret Chan, calling for a substantial expansion of medical research on the health effects of the Fukushima disaster. The branch also sought the early establishment of a comprehensive registry of residents in Fukushima who are estimated to have been exposed to radiation of more than 1 millisievert following the triple meltdowns.

A WHO official said the organization is as yet unable to respond to Rosen’s research paper or the German branch’s letter because it is still examining the documents.

International Physicians for the Prevention of Nuclear War, established in December 1980 and headquartered in Somerville, Massachusetts, won the Nobel Peace Prize in 1985. The group has branches in 62 countries and regions worldwide, including Japan.

http://www.japantimes.co.jp/text/nn20121216a4.html

 

Brain and nervous system damaged by low-level exposure to organophosphate pesticides

Contact: Dave Weston d.weston@ucl.ac.uk 44-020-310-83844 University College London

Scientists have found that low-level exposure to organophosphates (OPs) produces lasting decrements in neurological and cognitive function. Memory and information processing speed are affected to a greater degree than other cognitive functions such as language.

The systematic review of the literature was carried out by researchers at UCL and the Open University. It is the first to attempt a quantitative evaluation of the data assimilated from 14 studies and more than 1,600 participants. The researchers used meta-analysis to obtain an overview of the literature and their findings are published in the journal Critical Reviews in Toxicology.

“Meta-analysis combines the results of several studies and moves the discussion away from individual pieces of research, towards an overview of a body of literature,” says lead author Dr Sarah Mackenzie Ross (UCL Clinical, Educational & Health Psychology).

“This is considered to be the method of choice in situations where research findings may be used to inform public policy,” explains Professor Chris McManus (UCL Clinical, Educational & Health Psychology), co-author of the study.

Dr Mackenzie Ross continues: “This is the first time anyone has analysed the literature concerning the neurotoxicity of organophosphate pesticides, using the statistical technique of meta-analysis.

“The analysis reveals that the majority of well-designed studies undertaken over the last 20 years find a significant association between low-level exposure to organophosphates and impaired cognitive function.”

Pesticides prevent millions of people from starving to death and from contracting disease, but they are also harmful to humans under certain circumstances. Derived from World War II nerve gas agents, organophosphate pesticides are the most widely used insecticides in the world. They are used extensively in agriculture, by the military and also for domestic purposes.

According to the World Health Organisation (WHO) organophosphate pesticides are one of the most hazardous pesticides to vertebrate animals, responsible for many cases of poisoning worldwide.

The toxic effects of high level poisoning are well established but the possibility that long-term low-level exposure to OPs in doses below that causing acute toxicity causes ill health is controversial.

“In the UK a number of occupational groups have expressed concern that their health has been affected by exposure to organophosphates,” explains Dr Virginia Harrison (Open University), co-author of the study. This includes sheep farmers, who between 1988 and 1991 were required to dip sheep yearly in pesticide formulations containing OPs. Between 1985 and 1998 more than 600 reports of ill health following exposure to sheep dip were received by a government adverse reaction surveillance scheme.

Other groups affected include:

(1) Gulf War Veterans, who were exposed to pesticides on a daily basis during their tour of duty to protect them from pests such as sand flies, mosquitoes and fleas which carry infectious diseases

(2) airline pilots and cabin crew, who can be exposed to organophosphates in engine oil.

The researchers hope their findings will be of interest to Government advisory committees and departments who are currently reviewing the neurotoxicity of low level exposure to OPs; as well as farmers, Gulf War veterans and aviation workers who believe their health has been affected by exposure to OPs.

###

Notes for Editors

1. For more information or to speak to Dr Sarah Mackenzie Ross please contact Dave Weston in the UCL Media Relations Office on tel: +44 (0)20 3108 3844, out of hours +44 (0)7917 271 364, e-mail: d.weston@ucl.ac.uk

2. ‘Neurobehavioral problems following low-level exposure to organophosphate pesticides: a systematic and meta-analytic review’ is published online in the Critical Reviews in Toxicology. Copies of the paper are available from UCL Media Relations.

About UCL (University College London)

Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. We are among the world’s top universities, as reflected by performance in a range of international rankings and tables. UCL currently has 24,000 students from almost 140 countries, and more than 9,500 employees. Our annual income is over £800 million.

www.ucl.ac.uk | Follow us on Twitter @uclnews

Scientists warn of sperm count crisis : “serious public health warning”

Biggest-ever study confirms drastic decline in male reproductive health

Jeremy Laurance

Wednesday, 5 December 2012

The reproductive health of the average male is in sharp decline, the world’s largest study of the quality and concentration of sperm has found.

Between 1989 and 2005, average sperm counts fell by a third in the study of 26,000 men, increasing their risk of infertility. The amount of healthy sperm was also reduced, by a similar proportion.

The findings confirm research over the past 20 years that has shown sperm counts declining in many countries across the world. Reasons ranging from tight underwear to toxins in the environment have been advanced to explain the fall, but still no definitive cause has been found.

The decline occurred progressively throughout the 17-year period, suggesting that it could be continuing.

The latest research was conducted in France but British experts say it has global implications. The scientists said the results constituted a “serious public health warning” and that the link with the environment “particularly needs to be determined”.

The worldwide fall in sperm counts has been accompanied by a rise in testicular cancer – rates have doubled in the last 30 years – and in other male sexual disorders such as undescended testes, which are indicative of a “worrying pattern”, scientists say.

There is an urgent need to establish the causes so measures can be taken to prevent further damage, they add.

Richard Sharpe, professor of reproductive health at the University of Edinburgh and an international expert on toxins in the environment, said the study was “hugely impressive” and answered sceptics who doubted whether the global decline was real.

“Now, there can be little doubt that it is real, so it is a time for action. Something in our modern lifestyle, diet or environment is causing this and it is getting progressively worse. We still do not know which are the most important factors but the most likely are … a high-fat diet and environmental chemical exposures.”

Researchers from the Institut de Veille Sanitaire, St Maurice, used data from 126 fertility clinics in France which had collected semen samples from the male partners of women with blocked or missing fallopian tubes. The men, whose average age was 35, did not have fertility problems of their own and were therefore considered representative of the general male population.

The results, reported in the journal Human Reproduction, showed the concentration of sperm per millilitre of semen declined progressively by 1.9 per cent a year throughout the 17 years – from 73.6 million sperm per millilitre in 1989 to 49.9 million/ml in 2005. The proportion of normally formed sperm also decreased by 33.4 per cent over the same period.

Although the average sperm count of the men was well above the threshold definition of male infertility – which is 15 million/ml – it was below the World Health Organisation threshold of 55 million/ml which is thought to lengthen the time to conceive. Other European studies have shown that one in five young men has a sperm count low enough to cause problems conceiving.

Combined with other social trends, such as delayed childbearing which reduces female fertility, the decline in sperm counts could signal a crisis for couples hoping for a family.

Sperm count: How to boost it

1. Wear loose underwear – to make healthy sperm the testicles need to be below body temperature.

2. Eat food low in saturated fat.

3. Avoid smoking, drinking, using drugs and becoming obese.

4. Reduce exposure to industrial chemicals such as those used in making plastics – they can mimic the female hormone oestrogen countering male hormones.

5. Protect women in pregnancy – there is growing evidence that falling sperm counts may stem from effects in the womb.

6. Avoid anti-depressants – in rare cases they can cut sperm counts.

 

http://www.independent.co.uk/news/science/scientists-warn-of-sperm-count-crisis-8382449.html?printService=print

A vaccine-derived strain of poliovirus that has spread in recent years is serious but it can be tackled with an existing vaccine

2010 study posted for filing

Contact: Laura Gallagher l.gallagher@imperial.ac.uk 44-020-759-48432 Imperial College London

Polio research gives new insight into tackling vaccine-derived poliovirus

A vaccine-derived strain of poliovirus that has spread in recent years is serious but it can be tackled with an existing vaccine, according to a new study published today in the New England Journal of Medicine.

Vaccine-derived polioviruses can emerge on rare occasions in under-immunised populations, when the attenuated virus contained in a vaccine mutates and recombines with other viruses, to create a circulating vaccine-derived strain.

The researchers behind today’s study say their findings highlight the importance of completing polio eradication. They also say that should wild-type poliovirus be eradicated, routine vaccination with oral polio vaccines will need to cease, in order to prevent further vaccine-derived strains of the virus from emerging.

The study was carried out by researchers from the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial College London, working with the Government of Nigeria and the World Health Organization (WHO) research teams.

Poliovirus is highly infectious and primarily affects children under five years of age. Around one in 200 of the people infected with polio develop permanent paralysis, which can be fatal.

Polio was virtually wiped out by the early 2000s following a major vaccination drive by the Global Polio Eradication Initiative, but since then the number of cases of paralysis reported has plateaued, remaining roughly constant at between one and two thousand each year from 2003 to 2009, dropping only recently in 2010.

The first reported polio outbreak resulting from a circulating vaccine-derived poliovirus, known as a cVDPV, occurred in Hispaniola in 2000.  Prior to today’s study, there was little evidence available about the severity and potential impact of this kind of poliovirus.

Although billions of doses of oral vaccine have been distributed in the last decade, just 14 cVDPV outbreaks have been reported, affecting 15 countries. These outbreaks have usually been limited in size.

For the new study, researchers looked at the largest recorded outbreak of a cVDPV to date, which began to circulate in Nigeria in 2005. The authors examined data from 278 children paralysed by this cVDPV, and compared them with children paralysed by wild-type poliovirus in the country. Their analysis showed that this serotype 2 cVDPV is as easily transmitted and likely to cause severe disease as wild-type poliovirus of the same serotype.

The study also shows that vaccination with trivalent OPV, one of the main types of vaccine currently used to combat polio, is highly effective in preventing paralysis by this serotype 2 cVDPV.

The research shows that it is even more effective against cVDPV than against the wild-type polioviruses that are currently circulating, which can also be targeted with a different vaccine.

The new findings mean that it is particularly vital that efforts to vaccinate children with trivalent OPV continue in Nigeria and neighbouring countries, to protect children against all strains of polio. The scientists hope their findings will help countries to devise the right vaccine strategies to eradicate polio.

Helen Jenkins, the lead author of the study from the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial College London, said: “Our research shows that vaccine-derived polioviruses must be taken seriously and that we have the right tools to tackle them. We’ve had a lot of success against polio in the past and we’re optimistic that ultimately we should be able to eradicate it completely.

“However, our study shows that we can’t be complacent about the virus. It’s still vital for us to protect children from this dangerous and debilitating disease and we have to make sure we continue to vaccinate as many children as possible in affected countries for as long as wild-type poliovirus continues to circulate,” added Ms Jenkins.

Senior study author Dr Nicholas Grassly, also from the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial College London, added: “There has been some debate about the significance of circulating vaccine-derived polioviruses for the eradication initiative. Our research shows these viruses can be as pathogenic and transmissible as wild-type polioviruses and outbreaks must be responded to with just as much vigour.”

Dr Bruce Aylward, Director of the Global Polio Eradication Initiative at WHO, added:  “These new findings suggest that if cVDPVs are allowed to circulate for a long enough time, eventually they can regain a similar capacity to spread and paralyse as wild polioviruses.  This means that they should be subject to the same outbreak response measures as wild polioviruses.  These results also underscore the need to eventually stop all OPV use in routine immunization programmes after wild polioviruses have been eradicated, to ensure that all children are protected from all possible risks of polio in future.”

###

This study was funded by the Medical Research Council and the Royal Society.

For further information please contact:

Laura Gallagher Research Media Relations Manager Imperial College London email: l.gallagher@imperial.ac.uk Tel: +44(0)20 7594 8432 Out of hours duty press officer: +44(0)7803 886 248

Notes to editors:

1. “Implications of a circulating vaccine-derived poliovirus (cVDPV) in Nigeria for polio eradication” New England Journal of Medicine, Wednesday 23 June 2010

Lead author: Helen Jenkins, Imperial College London (for full list of authors please see paper) Download a proof copy of the study (strictly embargoed) using this link:  https://fileexchange.imperial.ac.uk/files/3eba66aa7b6/Nigeria%20cVDPV%20paper%20R2%20clean.doc

2. About the Global Polio Eradication Initiative (GPEI)

The GPEI is spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. Since 1988 (the year the GPEI was launched), the incidence of polio has been reduced by more than 99%. In 1988, more than 350,000 children were paralyzed each year in more than 125 endemic countries. In 2010, 349 cases have been reported and four countries remain endemic: Nigeria, India, Pakistan and Afghanistan.

Further information can be found at www.polioeradication.org. A list of countries in which there have been cases of polio reported since 2009 can be found at http://www.polioeradication.org/casecount.asp

3. About Imperial College London

Consistently rated amongst the world’s best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment – underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial’s contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.

In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK’s first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.

Website: www.imperial.ac.uk

4. For almost 100 years the Medical Research Council has improved the health of people in the UK and around the world by supporting the highest quality science. The MRC invests in world-class scientists. It has produced 29 Nobel Prize winners and sustains a flourishing environment for internationally recognised research. The MRC focuses on making an impact and provides the financial muscle and scientific expertise behind medical breakthroughs, including one of the first antibiotics penicillin, the structure of DNA and the lethal link between smoking and cancer. Today MRC funded scientists tackle research into the major health challenges of the 21st century. www.mrc.ac.uk

Peaches, plums induce deliciously promising death of breast cancer cells

2010 study posted for filing

 

Contact: Kathleen Phillips ka-phillips@tamu.edu 979-845-2872 Texas A&M AgriLife Communications

      AUDIO:   Breast cancer cells — even the most aggressive type — died after treatments with peach and plum extracts in lab tests at Texas AgriLife Research recently, and scientists say the…Click here for more information.

 

COLLEGE STATION — Breast cancer cells – even the most aggressive type – died after treatments with peach and plum extracts in lab tests at Texas AgriLife Research recently, and scientists say the results are deliciously promising. Not only did the cancerous cells keel over, but the normal cells were not harmed in the process.

AgriLife Research scientists say two phenolic compounds are responsible for the cancer cell deaths in the study, which was published in the Journal of Agriculture and Food Chemistry. The phenols are organic compounds that occur in fruits. They are slightly acidic and may be associated with traits such as aroma, taste or color.

“It was a differential effect which is what you’re looking for because in current cancer treatment with chemotherapy, the substance kills all cells, so it is really tough on the body,” said Dr. David Byrne, AgriLife Research plant breeder who studies stone fruit. “Here, there is a five-fold difference in the toxic intensity. You can put it at a level where it will kill the cancer cells – the very aggressive ones – and not the normal ones.”

Byrne and Dr. Luis Cisneros-Zevallos originally studied the antioxidants and phytonutrients in plums and found them to match or exceed the blueberry which had been considered superior to other fruits in those categories.

“The following step was to choose some of these high antioxidant commercial varieties and study their anticancer properties,” Cisneros-Zevallos said. “And we chose breast cancer as the target because it’s one of the cancers with highest incidence among women. So it is of big concern.”

According to the National Cancer Institute, there were 192,370 new cases of breast cancer in females and 1,910 cases in males in 2009. That year, 40,170 women and 440 men died from breast cancer. The World Health Organization reports that breast cancer accounts for 16 percent of the cancer deaths of women globally.

      IMAGE:   Breast cancer cells — even the most aggressive type — died after treatments with peach and plum extracts in lab tests at Texas AgriLife Research.Click here for more information.

 

Cisneros-Zevallos, an AgriLife Research food scientist, said the team compared normal cells to two types of breast cancer, including the most aggressive type. The cells were treated with an extract from two commercial varieties, the “Rich Lady” peach and the “Black Splendor” plum.

“These extracts killed the cancer cells but not the normal cells,” Cisneros-Zevallos said.

A closer look at the extracts determined that two specific phenolic acid components – chlorogenic and neochlorogenic – were responsible for killing the cancer cells while not affecting the normal cells, Cisneros-Zevallos said.

The two compounds are very common in fruits, the researchers said, but the stone fruits such as plums and peaches have especially high levels.

“So this is very, very attractive from the point of view of being an alternative to typical chemotherapy which kills normal cells along with cancerous ones,” Byrne added.

The team said laboratory tests also confirmed that the compounds prevented cancer from growing in animals given the compounds.

Byrne plans to examine more fully the lines of the varieties that were tested to see how these compounds might be incorporated into his research of breeding plums and peaches. Cisneros-Zevallos will continue testing these extracts and compounds in different types of cancer and conduct further studies of the molecular mechanisms involved.

###

The work documenting the health benefits of stone fruit has been supported by the Vegetable and Fruit Improvement Center at Texas A&M University, the U.S. Department of Agriculture and the California Tree Fruit Agreement.

WHO and the pandemic flu “conspiracies” – FULL report from the BMJ and The Bureau of Investigative Journalism 2010

2010 report posted for filing

Conflicts of Interest

WHO and the pandemic flu “conspiracies”

Deborah Cohen, features editor, BMJ, Philip Carter, journalist, The Bureau of Investigative Journalism, London

dcohen@bmj.com

Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as “conspiracy theories.” Deborah Cohen and Philip Carter investigate

Next week marks the first anniversary of the official declaration of the influenza A/H1N1 pandemic. On 11 June 2009 Dr Margaret Chan, the director general of the World Health Organization, announced to the world’s media: “I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose. On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met…The world is now at the start of the 2009 influenza pandemic.”

It was the culmination of 10 years of pandemic preparedness planning for WHO—years of committee meetings with experts flown in from around the world and reams of draft documents offering guidance to governments. But one year on, governments that took advice from WHO are unwinding their vaccine contracts, and billions of dollars’ worth of stockpiled oseltamivir (Tamiflu) and zanamivir (Relenza)—bought from health budgets already under tight constraints—lie unused in warehouses around the world.

 

A joint investigation by the BMJ and the Bureau of Investigative Journalism has uncovered evidence that raises troubling questions about how WHO managed conflicts of interest among the scientists who advised its pandemic planning, and about the transparency of the science underlying its advice to governments. Was it appropriate for WHO to take advice from experts who had declarable financial and research ties with pharmaceutical companies producing antivirals and influenza vaccines? Why was key WHO guidance authored by an influenza expert who had received payment for other work from Roche, manufacturers of oseltamivir, and GlaxoSmithKline, manufacturers of zanamivir? And why does the composition of the emergency committee from which Chan sought guidance remain a secret known only to those within WHO? We are left wondering whether major public health organisations are able to effectively manage the conflicts of interest that are inherent in medical science.

Already WHO’s handling of the pandemic has led to an unprecedented number of reviews and inquiries by organisations including the Council of Europe, European Parliament, and WHO itself, following allegations of industry influence. Dr Chan has dismissed these as “conspiracies,” and earlier this year, during a speech at the Centers for Disease Control and Prevention in Atlanta, she said: “WHO anticipated close scrutiny of its decisions, but we did not anticipate that we would be accused, by some European politicians, of having declared a fake pandemic on the advice of experts with ties to the pharmaceutical industry and something personal to gain from increased industry profits.”

The inquiry by British MP Paul Flynn for the Council of Europe Parliamentary Assembly—due to be published today—will be critical. It will say that decision making around the A/H1N1 crisis has been lacking in transparency. “Some of the outcomes of the pandemic, as illustrated in this report, have been dramatic: distortion of priorities of public health services all over Europe, waste of huge sums of public money, provocation of unjustified fear amongst Europeans, creation of health risks through vaccines and medications which might not have been sufficiently tested before being authorised in fast-track procedures, are all examples of these outcomes. These results need to be critically examined by public health authorities at all levels with a view to rebuilding public confidence in their decisions.”

The investigation by the BMJ/The Bureau reveals a system struggling to manage the inherent conflict between the pharmaceutical industry, WHO, and the global public health system, which all draw on the same pool of scientific experts. Our investigation has identified key scientists involved in WHO pandemic planning who had declarable interests, some of whom are or have been funded by pharmaceutical firms that stood to gain from the guidance they were drafting. Yet these interests have never been publicly disclosed by WHO and, despite repeated requests from the BMJ/The Bureau, WHO has failed to provide any details about whether such conflicts were declared by the relevant experts and what, if anything, was done about them.

It is this lack of transparency over conflicts of interests—coupled with a documented changing of the definition of a pandemic and unanswered questions over the evidence base for therapeutic interventions1—that has led to the emergence of these conspiracies.

WHO says: “Potential conflicts of interest are inherent in any relationship between a normative and health development agency, like WHO, and a profit-driven industry. Similar considerations apply when experts advising the Organization have professional links with pharmaceutical companies. Numerous safeguards are in place to manage possible conflicts of interest or their perception.”

Another factor that has fuelled the conspiracy theories is the manner in which risk has been communicated. No one disputes the difficulty of communicating an uncertain situation or the concept of risk in a pandemic situation. But one world expert in risk communication, Gerd Gigerenzer, director of the Centre for Adaptive Behaviour and Cognition at the Max Planck Institute in Germany, told the BMJ/The Bureau: “The problem is not so much that communicating uncertainty is difficult, but that uncertainty was not communicated. There was no scientific basis for the WHO’s estimate of 2 billion for likely H1N1 cases, and we knew little about the benefits and harms of the vaccination. The WHO maintained this 2 billion estimate even after the winter season in Australia and New Zealand showed that only about one to two out of 1000 people were infected. Last but not least, it changed the very definition of a pandemic.”

WHO for years had defined pandemics as outbreaks causing “enormous numbers of deaths and illness” but in early May 2009 it removed this phrase—describing a measure of severity—from the definition.2

 

The beginnings

The routes to the Council of Europe’s criticisms can be traced back to 1999, a pivotal year in the influenza world. In April that year WHO—spurred on by the 1997 chicken flu outbreak in Hong Kong—began to organise itself for a feared pandemic. It drew up a key document, Influenza Pandemic Plan: The Role of WHO and Guidelines for National and Regional Planning.

WHO’s first influenza pandemic preparedness plan was stark in the scale of the risk the world faced in 1999: “It is impossible to anticipate when a pandemic might occur. Should a true influenza pandemic virus again appear that behaved as in 1918, even taking into account the advances in medicine since then, unparalleled tolls of illness and death would be expected.”

In the small print of that document it states: “R Snacken, J Wood, L R Haaheim, A P Kendal, G J Ligthart, and D Lavanchy prepared this document for the World Health Organization (WHO), in collaboration with the European Scientific Working Group on Influenza (ESWI).” What this document does not disclose is that ESWI is funded entirely by Roche and other influenza drug manufacturers. Nor does it disclose that René Snacken and Daniel Lavanchy were participating in Roche sponsored events the previous year, according to marketing material seen by the BMJ/The Bureau.

Dr Snacken was working for the Belgian ministry of public health when he wrote about studies involving neuraminidase inhibitors for a Roche promotional booklet. And Dr Lavanchy, meanwhile, was a WHO employee when he appeared at a Roche sponsored symposium in 1998. His role at that time was in the WHO Division of Viral Diseases. Dr Lavanchy has declined to comment.

In 1999 other members of the European Scientific Working Group on Influenza included Professor Karl Nicholson of Leicester University, UK, and Professor Abe Osterhaus of Erasmus University in the Netherlands. These two scientists are also identified in Roche marketing material seen by this investigation which was produced between 1998 and 2000. Professor Osterhaus told the BMJ that he had always been transparent about any work he has done with industry. Professor Nicholson similarly has consistently declared his connections with pharmaceutical companies, for example, in papers published in journals such as the BMJ and Lancet.

Both experts were also at that time engaged in a randomised controlled trial on oseltamivir supported by Roche. The trial was subsequently published in the Lancet in 2000.3 It remains one of the main studies supporting oseltamivir’s effectiveness—and one that was subsequently shown to have employed undeclared industry funded ghostwriters.1

The influence of the European Scientific Working Group on Influenza would continue as the decade wore on and the calls for pandemic planning became more strident. Founded in 1992, this “multidisciplinary group of key opinion leaders in influenza aims to combat the impact of epidemic and pandemic influenza” and claims links to WHO, the Robert Koch Institute, and the European Centre for Disease Prevention and Control, among others.4 Despite the group’s claims of scientific independence its 100% industry funding does present a potential conflict of interest. One if its roles is to lobby politicians, as highlighted in a 2009 policy document.5

At a pre-pandemic preparation workshop of the European Scientific Working Group on Influenza in January last year, Professor Osterhaus said: “I can tell you that ESWI is working on that idea [that is, convincing politicians] quite intensively. We have contact with MEPs [members of the European Parliament] and with national politicians. But it is they who have to decide at the end of the day, and they will only act at the request of their constituencies. If the latter are not prompted, nothing will happen.”

The group’s policy plan for 2006-10 specifically stated that government representatives needed to “take measures to encourage the pharmaceutical industry to plan its vaccine/antivirals production capacity in advance” and also to “encourage and support research and development of pandemic vaccine” and to “develop a policy for antiviral stockpiling.” It also added that government representatives needed to know that “influenza vaccination and use of antivirals is beneficial and safe.” It said that the group provided “evidence based, palatable information”; and also “networking/exchange with other stakeholders (eg, with industry in order to establish pandemic vaccine and antivirals contracts).” In the meantime, in Roche’s own marketing plan, one goal was to “align Roche with credible third party advocates”. They “leveraged these relationships by enlisting our third-party partners to serve as spokespeople and increase awareness of Tamiflu and its benefits.”6

Barbara Mintzes, assistant professor in the Department of Pharmacology and Therapeutics at the University of British Columbia, is currently part of a group working with Health Action International and WHO developing model curricula for medical and pharmaceutical students on drug promotion and interactions with the industry, including conflicts of interest. She thinks that caution is advised when working with medical bodies of this sort.

“It is legitimate for WHO to work with industry at times. But I would have concerns about involvement with a group that looks like it is for independent academics that is actually mainly industry funded,” she told the BMJ/The Bureau, adding: “The Institute of Medicine has raised concerns about the need to have a firewall with medical groups. To me this does not sound like an independent group, as it is mainly funded by manufacturers.”

She also thinks that there is a difference between the conflict of interest in having a clinical trial funded by a company and the conflict of interest in being involved in marketing a drug—for example, on a paid speaker’s bureau or in marketing material. “Some academic medical departments, for example Stanford University, have banned staff from being involved in marketing or being on a paid speakers bureau,” she said.

The presence of leading influenza scientists at promotional events for oseltamivir reflected not just the concern of an impending pandemic, but the excitement over the potential of a new class of drugs—neuraminidase inhibitors—to offer treatment and protection against seasonal influenza.

In 1999 two new drugs first came to market: oseltamivir, from Roche; and zanamivir, manufactured by what is now GlaxoSmithKline. The two drugs would battle it out over the coming years, with oseltamivir—aided by its oral administration—trumping its rival in global sales as the decade wore on.

The potential was quickly grasped. Indeed, that year Professor Osterhaus published an article proposing the use of neuraminidase inhibitors in pandemics: “Finally, during a possible future influenza pandemic, in view of their broad reactivity against influenza virus neuraminidase subtypes and the expected lack of sufficient quantities of vaccine, the new antivirals will undoubtedly have an essential role to play in reducing the number of victims.”7

However, he also warned that antivirals should not be seen as a replacement for vaccinations. “Close collaboration and consultation between, on the one hand, companies marketing influenza vaccines and, on the other, those marketing antivirals will therefore be absolutely essential. It is important that a clear and uniform message indicating the complementary roles of vaccines and antivirals is delivered.”

That article appeared in the European Scientific Working Group on Influenza’s bulletin of April 1999; Professor Osterhaus signs off with the affiliation of WHO National Influenza Centre Rotterdam, The Netherlands.

Other experts soon followed suit—recommending the role neuraminidase inhibitors could play in any future pandemic—in both the academic literature and in the general media.

Food and Drug Administration

While the excitement over these drugs fuelled scientific symposiums, the US Food and Drug Administration (FDA) was less than convinced. The BMJ/The Bureau has since spoken to people from within the American and European drug regulators, the FDA and the European Medicines Agency (EMEA), who said that both regulators struggled with the paucity of the data presented to them for zanamivir and oseltamivir, respectively, during the licensing process. At the end of last year, the BMJ called for access to raw data for key public health drugs after the Cochrane Collaboration found the effectiveness of the drugs impossible to evaluate.8 The group are continuing to negotiate access to what they say they need to fully assess the effectiveness of antivirals.

In the US, the FDA first approved zanamivir in 1999.9 Michael Elashoff, a former employee of the FDA, was the statistician working on the zanamivir account. He told the BMJ how the FDA advisory committee initially rejected zanamivir because the drug lacked efficacy.

After Dr Elashoff’s review (he had access to individual patient data and summary study reports) the FDA’s advisory committee voted by 13 to 4 not to approve zanamivir on the grounds that it was no more effective than placebo when the patients were on other drugs such as paracetamol. He said that it didn’t reduce symptoms even by a day.

 

“When I was reviewing the data, I tried to replicate the analyses in their summary study reports. The issue was not of data quality, but sensitivity analyses showed even less efficacy,” he said. “The safety analysis showed there were safety concerns, but the focus was on if Glaxo had demonstrated efficacy.” Dr Elashoff’s view was that zanamivir was no better than placebo—and it had side effects. And when the FDA medical reviewer made a presentation, her conclusion was that it could either be approved or not approved. It was a fairly borderline drug.

There were influenza experts on the FDA’s advisory committee and much of the discussion hinged on why a drug that looked so promising in earlier studies wasn’t working in the largest trials in the US. One hypothesis was that people in the US were taking other drugs for symptomatic relief that masked any effect of zanamivir. So zanamivir might have no impact on symptoms over and above the baseline medications that people take when they have influenza.

Two other trials—one in Europe and one in Australia— showed a bit more promise. But there was a very low rate of people taking other medications. “So in the context of not being allowed to take anything for symptomatic relief, there might be some effect of Relenza. But in the context of a typical flu, where you have to take other things to manage your symptoms, you wouldn’t notice any effect of Relenza over and above those other things,” Dr Elashoff said. The advisory committee recommended that the drug should not be approved.

Nevertheless, FDA management decided to overturn the committee’s recommendation.

 

“They would feel better if there was something on the market in case of a pandemic. It wasn’t a scientific decision,” Dr Elashoff said.

While Dr Elashoff was working on the zanamivir review, he was assigned the oseltamivir application. But when the review and the advisory committee decided not to recommend zanamivir, the FDA’s management reassigned the oseltamivir review to someone else. Dr Elashoff believes that the approval of zanamivir paved the way for oseltamivir, which was approved by the FDA later that year.

 

European Medicines Agency

In Europe the EMEA was similarly troubled by the evidence for oseltamivir. By early 2002 Roche had sought a European Union-wide licence from the EMEA. It was a lengthy process, taking three meetings of the Committee for Medicinal Products for Human Use as well as expert panels, according to one of the two rapporteurs, Pekka Kurki of the Finnish Medicines Agency. Echoing the Cochrane Collaborations’s 2009 findings6 Kurki told us: “We discussed the same issues that are still discussed today: does it show clinically significant benefits in treatment and prophylaxis of flu and what was the magnitude of the benefits presented in the RCTs? Our assessment and Cochrane’s in 2009 are very similar with regard to the effect size in RCTs. The data show that the effects of Tamiflu were clear but not very impressive.

“What was unclear and is still unclear is what is the impact of Tamiflu on serious complications. Circulating influenza was very mild when Tamiflu was developed and therefore it is very difficult to say anything about serious complications. The data did not clearly show an effect on serious complications—it was not demonstrated by the RCTs.”

In documents obtained under the freedom of information legislation, two of the experts who provided opinions during the EMEA licensing process have also featured in Roche marketing material: Annike Linde and Rene Snacken. In Dr Snacken’s EMEA presentation dated 18 February 2002, he discussed the need for chemoprophylaxis and called for the use of oseltamivir during a pandemic. He made his presentation as a representative of the Belgian Ministry of Public Health. At the time Dr Snacken was also “liaison officer” for the European Scientific Working Group on Influenza. He also played a key role in the Belgian government during its pandemic planning, and he later became a senior expert at the Preparedness and Response Unit, European Centre for Disease Prevention and Control. We do not know what, if anything, he declared to the EMEA about his relationship with Roche.

Annike Linde has confirmed in an email that she has had connections with Roche over a number of years. She made a presentation to the EMEA on “influenza surveillance” in her capacity as a representative of the Swedish Institute for Infectious Disease. Again, it is not clear what, if anything, she declared to the EMEA concerning her previous relationship with Roche.

Dr Linde, now the Swedish state epidemiologist, has told the BMJ/The Bureau that she received payments from Roche International in respect of various pieces of work she did for the company until 2002. She has subsequently given occasional lectures for Roche Sweden. All money she has received from Roche was given, Dr Linde says, to the Swedish Institute for Infectious Disease Control.

We asked the scientists whether they declared their relationship with Roche at the time to the EMEA. Neither has answered that question entirely satisfactorily. Dr Snacken has not replied to repeated emails posing this question. Dr Linde responded by telling the BMJ/The Bureau: “We contribute with our expertise to the regulatory agencies when asked. When we do so, a declaration of interest, where e.g. participation at advisory meetings at Roche, is given and evaluated by the regulatory agency.” The BMJ/The Bureau requested Linde and Snacken’s declaration of interest statements for the 2002 meeting from the EMEA under the freedom of information act. The EMEA was unable to provide statements for those particular people at that time.

Developing the guidelines

In October 2002 WHO convened a meeting of influenza experts at its Geneva headquarters. Their purpose was to develop WHO’s guidelines for the use of vaccines and antivirals during an influenza pandemic.

Included at this meeting were representatives from Roche and Aventis Pasteur and three experts who had lent their name to oseltamivir’s marketing material (Professors Karl Nicholson, Ab Osterhaus, and Fred Hayden).

Two years later the WHO published a key report from that meeting, WHO Guidelines on the Use of Vaccines and Antivirals during Influenza Pandemics 2004. The specific guidance on antivirals, Considerations for the Use of Antivirals During an Influenza Pandemic, was written by Fred Hayden. Professor Hayden has confirmed to the BMJ/The Bureau in an email that he was being paid by Roche for lectures and consultancy work for the company at the time the guidance was produced and published. He also told us in an email that he had received payments from GlaxoSmithKline for consultancy and lecturing until 2002. According to Prof Hayden: “DOI [declaration of interest] forms were filled out for the 2002 consultation.”

The WHO guidance concluded that: “Based on their pandemic response goals and resources, countries should consider developing plans for ensuring the availability of antivirals. Countries that are considering the use of antivirals as part of their pandemic response will need to stockpile in advance, given that current supplies are very limited.” Many countries around the world would adopt this guidance.

The previous year Professor Hayden was also one of the main authors of a Roche sponsored study that claimed what was to become one of oseltamivir’s main selling points—a claimed 60% reduction in hospitalisations from flu, which the Cochrane Collaboration was later unable to verify.8

Our investigation has also identified relevant and declarable interests relating to the two other named authors of annexes to WHO’s 2004 guidelines. Arnold Monto was the author of the annexe dealing with vaccine usage in pandemics. Between 2000 and 2004—and at the time of writing the annexe—Dr Monto has consistently and openly declared honorariums, consultancy fees, and research support from Roche, 10 11 12 consultancy fees and research support from GlaxoSmithKline 10 12 13 14; and also research funding from ViroPharma.15

No conflict of interest statement was included in the annex he wrote for WHO. When asked if he had signed a declaration of interest form for WHO, Dr Monto told the BMJ/The Bureau: “Conflict of Interest forms are requested before participation in any WHO meeting”.

Professor Karl Nicholson is the author of the third annex, Pandemic Influenza. According to declarations made by Professor Nicholson in the BMJ16and Lancet in 2003,17 he had received travel sponsorship and honorariums from GlaxoSmithKline and Roche for consultancy work and speaking at international respiratory and infectious diseases symposiums. Before writing the annexe, he had also been paid and declared ad hoc consultancy fees by Wyeth, Chiron, and Berna Biotech.

Even though the previous year these declarations had been openly made in the Lancet and the BMJ, no conflict of interest statement was included in the annex he wrote for WHO. Professor Nicholson told the BMJ/The Bureau that he last had “financial relations” with Roche in 2001. When asked if he had signed a declaration of interest form for WHO, Prof Nicholson replied: “The WHO does require attendees of meetings, such as those held in 2002 and 2004, to complete declarations of interest.”

Leaving aside the question of what declarations experts made to WHO, one simple fact remains: WHO itself did not publicly disclose any of these conflicts of interest when it published the 2004 guidance. It is not known whether information about these conflicts of interest was relayed privately to governments around the world when they were considering the advice contained in the guidelines.

The year before WHO issued the 2004 guidance, it published a set of rules on how WHO guidelines should be developed and how any conflicts of interest should be handled. This guidance included recommendations that people who had a conflict of interest should not take part in the discussion or the piece of work affected by that interest or, in certain circumstances, that the person with the conflict should not participate in the relevant discussion or work at all. The WHO rules make provision for the director general’s office to allow declarations of interest to be seen if the objectivity of a meeting has been called into question.18

The BMJ/The Bureau has asked WHO for the conflict of interest declarations for the Geneva 2002 meeting and those related to the guidance document itself. WHO told us that the query went directly up to Margaret Chan’s office. “WHO never publishes individual DOIs [declaration of interest], except after consultation with the Office of the Director-General. In this case, we put in a request on your behalf but it was not granted. In more recent years, many WHO committees have published summaries of relevant interests with their meeting reports.”

In a BMJ interview (see film on bmj.com), WHO spokesperson Gregory Hartl reiterated the fact that Dr Margaret Chan, “is very committed personally to transparency.” Yet her office has turned down repeated requests for declaration of interest statements and declines to comment on the allegations that authors of the guidelines had declarable interests.

Nevertheless, Prof Hayden told the BMJ/The Bureau: “I strongly support transparency in declarations of interest, in part because this allows those reading documents, particularly ones authored by specific individuals (eg, Annex 5) [the part he wrote], to make their own judgments about the possible relevance of any potential conflicts.”

While experts need to work with industry to develop the best possible drugs for illnesses, questions remain about what level of involvement experts with industry ties should have in the formulation of public health policy decisions and guidelines. Professor Nicholson told the BMJ/The Bureau: “The WHO and decision makers must be informed of ongoing developments and research findings to ensure that they are as up to date as possible. Some of the most relevant expertise and information are held by companies or individuals with conflicts of interest. I understand the view that experts with conflicts of interest should not advise governments or organisations such as the WHO. But to exclude such people from discussions could deprive WHO and decision makers of important new information.”

But not everyone agrees. Barbara Mintzes is unequivocal about what role they should play. “No one should be on a committee developing guidelines if they have links to companies that either produce a product—vaccine or drug—or a medical device or test for a disease. It would be preferable that there are no financial ties when it comes to making big decisions on public health—for example, stockpiling a drug—and that includes if they have a currently funded clinical trial,” she said.

“Ideally, what you want are independent experts who are in the public sector to provide expertise on drugs and vaccines. But they can be hard to find. One solution is consult with the experts who are involved in industry, but not put them on any decision making committee. You need a firewall,” she added.

Indeed, Professor Harvey Fineberg, president of the Institute of Medicine and chairman of the panel reviewing WHO’s management of the pandemic, takes a similarly hard line. His own institution went through a detailed review of how they interact with industry and experts with conflicts of interests last year.19 “Sometimes publication of conflict of interests is enough—for example with a journal. But if you are giving expert judgment to influence policy, revealing is not enough,” he told the BMJ, referring to the Institute of Medicine’s policy.

WHO also says that it takes conflicts of interests seriously and has the mechanisms in place to deal with them. But what action does it take when a scientist declares a conflict of interest, and when does it judge a scientist to be too conflicted to play a leading role in the formulation of global health policy? Since WHO has not provided us with an answer to this question, we are left to guess.

As it stands, this situation is the worst possible outcome for WHO, according to Professor Chris Del Mar, a Cochrane Review author and expert on WHO’s Strategic Advisory Group of Experts on Immunization group. “If it proves to be the case that authors of WHO guidance which promoted the use of certain drugs were being paid at the same time by the makers of those drugs for other work they were doing for these companies that is reprehensible and should be condemned in the strongest possible terms.”

WHO’s endorsement of oseltamivir was not lost on Roche. In an advert placed by the company for the drug in the main conference programme of the European Scientific Working Group on Influenza’s 2005 conference in Malta, it says: “Antivirals will initially be the principal medical intervention in a pandemic situation and Roche is working as a responsible partner with governments to assist in their pandemic planning.” The source reference for this is the WHO Global Influenza Preparedness Plan.

Throughout the following years, WHO would appear to have been inconsistent in how it treated conflicts of interest. Updated pandemic plans would continue to be prepared by experts who openly had work funded and acted as consultants to manufacturers of vaccines and antivirals. WHO produced its global influenza preparedness plan in 2005, and in 2006 it constituted an interim Influenza Pandemic Task Force. No public declarations of interest have been made and to date no details have been provided by WHO in response to our requests.

WHO’s stance that it does not publish declarations of interest from its experts is far from consistent. It is undermined, for example, by the position WHO adopts in relation to the Strategic Advisory Group of Experts on Immunization, its standing vaccine advisory body. Here, contrary to its approach to pandemic planning advisers, WHO does publish summaries of declarations of interest.

Emergency Committee

These seeming inconsistencies in WHO’s approach to transparency and its handling of conflicts of interest extend into the workings of the Emergency Committee formed last year to advise the director general on the pandemic. The identities of its 16 members are unknown outside WHO. This secret committee has guided WHO pandemic policy since then—including deciding when to judge that the pandemic is over.

WHO says it has to keep the identities secret to protect the scientists from being influenced or targeted by industry. In a phone call to the BMJ/The Bureau in March, WHO spokesperson Gregory Hartl explained: “Our general principle is we want to protect the committee from outside influences.”

The committee advised the WHO director general on phase changes as well as temporary recommendations. According to WHO, When the Emergency Committee met to discuss a possible move to a declaration of a pandemic, the meeting additionally included members who represented Australia, Canada, Chile, Japan, Mexico, Spain, the UK, and the US, eight countries that experienced widespread outbreaks at the time. These national representatives were present to ensure full consideration of the views and possible reservations of the countries expected to bear the initial brunt of economic and social repercussions.

WHO says all members of the Emergency Committee sign a confidentiality agreement, provide a declaration of interests, and agree to give their consultative time freely, without compensation. However, only one member of the committee has been publicly named: Professor John MacKenzie, who chairs it.

This is a troubling stance: it suggests that WHO considers other advisory groups whose members are not anonymous —such as the Strategic Advisory Group of Experts on Immunization—to be potentially subject to outside influences, and it allows no scrutiny of the scientists selected to advise WHO and global governments on a major public health emergency.

Under the International Health Regulations framework, the membership of the Emergency Committee is drawn from a roster of about 160 experts covering a range of public health areas. This framework provides guidelines about how WHO deals with acute public health risks. The BMJ/The Bureau has identified approximately 15 scientists from the International Health Regulations roster with influenza expertise and has emailed them to ask if they were on the Emergency Committee. Under the framework at least some of these scientists are members of the Emergency Committee. Yet because of the confidentiality agreements they have signed, these scientists cannot acknowledge their membership of the committee, putting them in an invidious position.

David Salisbury, chair of WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) committee at the time of the pandemic and a member of the International Health Regulations, says the secrecy has caused problems for his group. “It certainly caused problems for SAGE. Since all of the details of SAGE are in the public domain, there was a perception that it had been SAGE that had given advice about the changing of definitions or the pandemic levels—when we had not done so. SAGE members came in for unfair personal abuse by journalists,” he told the BMJ/The Bureau.

“Given the importance of the advice, the transparency of the source of the advice was important. I believe it is necessary to keep confidential the source of advice if revealing details might put individuals at risk, for example when bioterrorism is being discussed. This does not seem to be the case for pandemic flu,” he added.

The secrecy of the committee is also fuelling conspiracy theories, particularly around the activation of dormant pandemic vaccine contracts. A key question will be whether the pharmaceutical companies, which had invested around $4bn (£2.8bn, 3.3bn) in developing the swine flu vaccine, had supporters inside the emergency committee, who then put pressure on WHO to declare a pandemic. It was the declaring of the pandemic that triggered the contracts.

The BMJ/The Bureau can confirm that Dr Monto, Dr John Wood, and Dr Masato Tashiro are members of the Emergency Committee.

Although Dr Monto did not answer the question directly, his Infectious Disease Society of America biography states that he is a member.20

Last year, according to figures made public in the US by GlaxoSmithKline, Professor Monto received $3000 speakers fees from the company in the period between the second quarter and the last quarter of 2009. As a national official of the Japanese government, Dr Tashiro says that he must “have nothing concerning conflict of interest with private companies”. Dr John Wood works for the UK National Institute for Biological Standards and Control (NIBSC). Dr Wood, like Dr Tashiro, has no personal conflict of interests but he told the BMJ/The Bureau that as part of its statutory role in developing standards for measurement of biological medicines to ensure accurate dosing and carrying out independent control testing to assure their safety and efficacy, the institute must work closely with the pharmaceutical industry. This is made clear on their website.

“The International Federation of Pharmaceutical Manufacturers and Associations has also made publicly available the nature of their close interaction with NIBSC and similar organisations in order to develop influenza vaccines,” he said.21

Those who said that they were not on the committee include David Salisbury, Alan Hampson, Albert Osterhaus, Donato Greco, and Howard Njoo. Maria Zambon, from the UK’s Health Protection Agency told the BMJ: “I undertake various advisory roles to WHO. Declaration of interest statements are prepared before undertaking such roles.

“The HPA Centre for Infection, as part of its role in national infectious disease surveillance, provision of specialist and reference microbiology and vaccine efficacy monitoring, works closely with vaccine manufacturers and biotechnology companies.”

International Health Regulations review

WHO’s own review into the operation of the International Health Regulations and WHO’s handling of the pandemic is now being conducted by Harvey Feinberg, president of the US Institute of Medicine, and will report its findings next year. Dr Chan and Professor Feinberg have both made clear the need for a thorough investigation. But questions are already arising about how independent the review will turn out to be. According to the International Health Regulations list in our possession, some 13 of the 29 members of the review panel are members of the International Health Regulations itself and one is the chair of the Emergency Committee. To critics that might suggest a somewhat incestuous approach.

Professor Mintzes does not agree with WHO’s explanation that secrecy was needed to protect against the influence of outside interest on decision making. “I can’t understand why the WHO kept this secret. It should be public in terms of accountability like the expert advisory committees. If the rationale of secret membership is not to be unduly influenced, there are other ways of dealing with this through strong conflict of interest provisions,” she said.

She also believes that the very nature of allowing a trigger point for vaccine contracts opens the system up unnecessarily to exploitation. “It seems a problem that this declaration might trigger contracts to be realised. There should be safeguards in place to make sure those with an interest in vaccine manufacturers can’t exploit the situation. The WHO will have to look long and hard at this in future,” she said.

The number of victims of H1N1 fell far short of even the more conservative predictions by the WHO. It could, of course, have been far worse.. Planning for the worst while hoping for the best remains a sensible approach. But our investigation has revealed damaging issues. If these are not addressed, H1N1 may yet claim its biggest victim—the credibility of the WHO and the trust in the global public health system.

Cite this as: BMJ 2010;340:c2912

——————————————————————————–

Competing interests: PC declares no competing interests. DC has been paid expenses by WHO for giving talks at two conferences.

Common antidepressant drugs linked to lactation difficulties in moms

2010 study posted for filing

Contact: Aaron Lohr alohr@endo-society.org 240-482-1380 The Endocrine Society

According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), women taking commonly used forms of antidepressant drugs may experience delayed lactation after giving birth and may need additional support to achieve their breastfeeding goals.

Breastfeeding benefits both infants and mothers in many ways as breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections. The World Health Organization recommends that infants should be exclusively breastfed for the first six months of life. This new study shows that certain common antidepressant drugs may be linked to a common difficulty experienced by new mothers known as delayed secretory activation, defined as a delay in the initiation of full milk secretion.

“The breasts are serotonin-regulated glands, meaning the breasts’ ability to secrete milk at the right time is closely related to the body’s production and regulation of the hormone serotonin,” said Nelson Horseman, PhD, of the University of Cincinnati and co-author of the study. “Common antidepressant drugs like fluoxetine, sertraline and paroxetine are known as selective serotonin reuptake inhibitor (SSRI) drugs and while they can affect mood, emotion and sleep they may also impact serotonin regulation in the breast, placing new mothers at greater risk of a delay in the establishment of a full milk supply.”

In this study, researchers examined the effects of SSRI drugs on lactation using laboratory studies of human and animal cell lines and genetically modified mice. Furthermore, an observational study evaluated the impact of SSRI drugs on the onset of milk production in postpartum women. In this study of 431 postpartum women, median onset of lactation was 85.8 hours postpartum for the SSRI-treated mothers and 69.1 hours for mothers not treated with SSRI drugs. Researchers commonly define delayed secretory activation as occurring later than 72 hours postpartum.

“SSRI drugs are very helpful medications for many moms, so understanding and ameliorating difficulties moms experience can help them achieve their goals for breastfeeding their babies,” said Horseman. “More human research is needed before we can make specific recommendations regarding SSRI use during breastfeeding.”

###

Other researchers working on the study include: Aaron Marshall, Laura Hernandez and Karen Gregerson of the University of Cincinnati in Ohio; Laurie Nommsen-Rivers of Cincinnati Children’s Hospital Medical Center in Ohio; Kathryn Dewey of the University of California at Davis; and Caroline Chantry of the University of California Davis Medical Center in Sacramento.

The article, “Serotonin transport and metabolism in the mammary gland modulates secretory activation and involution,” will appear in the February 2010 issue of JCEM.

Founded in 1916, The Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endo-society.org.

Activating the ‘mind’s eye’ — sounds, instead of eyesight can be alternative vision ( can actually “see” and describe objects and even identify letters and words )

Contact: Jerry Barach
jerryb@savion.huji.ac.il
972-258-82904
The Hebrew University of Jerusalem

Jerusalem, Nov. 7, 2012 — Common wisdom has it that if the visual cortex in the brain is deprived of visual information in early infanthood, it may never develop properly its functional specialization, making sight restoration later in life almost impossible.

Scientists at the Hebrew University of Jerusalem and in France have now shown that blind people – using specialized photographic and sound equipment – can actually “see” and describe objects and even identify letters and words.

The new study by a team of researchers, led by Prof. Amir Amedi of the Edmond and Lily Safra Center for Brain Sciences and the Institute for Medical Research Israel-Canada at the Hebrew University and Ph.D. candidate Ella Striem-Amit, has demonstrated how this achievement is possible through the use of a unique training paradigm, using sensory substitution devices (SSDs).

SSDs are non-invasive sensory aids that provide visual information to the blind via their existing senses. For example, using a visual-to-auditory SSD in a clinical or everyday setting, users wear a miniature camera connected to a small computer (or smart phone) and stereo headphones.

The images are converted into “soundscapes,” using a predictable algorithm, allowing the user to listen to and then interpret the visual information coming from the camera. The blind participants using this device reach a level of visual acuity technically surpassing the world-agreed criterion of the World Health Organization (WHO) for blindness, as published in a previous study by the same group.

The resulting sight, though not conventional in that it does not involve activation of the ophthalmological system of the body, is no less visual in the sense that it actually activates the visual identification network in the brain.

The study shows that following a dedicated (but relatively brief) 70 hours of unique training paradigm developed in the Amedi lab, the blind people could easily use SSDs to characterize images into object categories, such as images of faces, houses, body shapes, everyday objects and textures. They could also identify even more complex everyday objects — locating people’s positions, identifying facial expressions, and even reading letters and words (for demos, movies and further information: http://brain.huji.ac.il/).

These unprecedented behavioral results are reported in the current issue of the prestigious neuroscience journal, Neuron.

The Hebrew University study went on further to actually test what happens in the brain when the blind learn to see with sounds. Specifically, the group tested the ability of this high-acuity vision to activate the supposedly dormant visual cortex of the blind, even though it was taught to process the visual images through sounds only in adulthood.

Prof. Amedi, and Ella Striem-Amit used functional magnetic resonance imaging (fMRI) to measure the neural activity of people blind from birth as they “saw” — using the SSD — high-resolution images of letters, faces, houses, everyday objects and body-shapes. Surprisingly, not only was their visual cortex activated by the sounds, their brain showed selectivity for visual categories which characterize the normally developing, sighted brain.

A specific part of the brain, known as the Visual Word Form Area, or VWFA — that was first discovered in sighted people by Profs. Laurent Cohen and Stanislas Dehaene of Pitie-Salpétriere Hospital-INSERM-CEA, of France, co-authors of the current article — is normally very selective.

In sighted people, it has a role in reading, and is activated by seeing and reading letters more than by any other visual object category. Astonishingly, the same was found in this area in people deprived of sight. Their VWFA, after only tens of hours of training in SSD use, showed more activation for letters than for any of the other visual categories tested.

In fact, the VWFA was so plastic to change, that it showed increased activation for SSD letters after less than two hours of training by one of the study participants.

“The adult brain is more flexible that we thought,” says Prof. Amedi. In fact, this and other recent research from various groups have demonstrated that multiple brain areas are not specific to their input sense (vision, audition or touch), but rather to the task, or computation they perform, which may be computed with various modalities. (This information was summarized in a recent review by the Amedi research group published in the journal Current Directions in Neurology.)

All of this suggests that in the blind, brain areas might potentially be “awakened” to processing visual properties and tasks even after years or maybe even lifelong blindness, if the proper technologies and training approaches are used, says Amedi.

The findings also give hope that reintroduced input into the visual centers of the blind brain could potentially restore vision, and that SSDs might be useful for visual rehabilitation.

“SSDs might help blind or visually-impaired individuals learn to process complex images, as done in this study, or they might be used as sensory interpreters that provide high-resolution, supportive, synchronous input to a visual signal arriving from an external device such as bionic eyes” says Prof. Amedi.

Common food preservative may slow, even stop tumor growth: ( nisin )

Contact: Laura Bailey
baileylm@umich.edu
734-647-1848
University of Michigan

ANN ARBOR—Nisin, a common food preservative, may slow or stop squamous cell head and neck cancers, a University of Michigan study found.

What makes this particularly good news is that the Food and Drug Administration and the World Health Organization approved nisin as safe for human consumption decades ago, says Yvonne Kapila, the study’s principal investigator and professor at the University of Michigan School of Dentistry.

This means that obtaining FDA approval to test nisin’s suggested cancer-fighting properties on patients in a clinical setting won’t take as long as a new therapy that hasn’t been tried yet on people, she says.

Antibacterial agents like nisin alter cell properties in bacteria to render it harmless. However, it’s only recently that scientists began looking to antibacterial agents like nisin to see if they altered properties in other types of cells, such as cancer cells or cells in tumors.

Oral cancer is a leading cause of death worldwide, and oral squamous cell carcinoma accounts for more than 90 percent of oral cancers. However, survival rates for oral cancer haven’t improved in decades, according to the study.

“The poor five-year survival rates for oral cancer underscore the need to find new therapies for oral cancer,” Kapila said. “The use of small antibacterial agents, like nisin, to treat cancer is a new approach that holds great promise. Nisin is a perfect example of this potential because it has been used safely in humans for many years, and now the laboratory studies support its anti-tumor potential.”

The U-M study, which looked at the use of antimicrobials to fight cancerous tumors, suggests nisin, in part, slows cell proliferation or causes cell death through the activation of a protein called CHAC1 in cancer cells, a protein known to influence cell death.

The study is the first to show CHAC1’s new role in promoting cancer cell death under nisin treatment. The findings also suggest that nisin may work by creating pores in the cancer cell membranes that allow an influx of calcium. It’s unclear what role calcium plays in nisin-triggered cell death, but it’s well known that calcium is a key regulator in cell death and survival.

Additionally, the findings suggest that nisin slows or stops tumor growth by interrupting the cell cycle in “bad” cells but not the good cells; thus nisin stops cancer cell proliferation but doesn’t hurt good cells.

 

###

The paper, “Nisin, an apoptogenic bacteriocin and food preservative, attenuates HNSCC tumorigenesis via CHAC,” appears this month in the journal Cancer Medicine.

Yvonne Kapila: www.dent.umich.edu/pom/faculty/links/ykbio

U-M School Dentistry: http://dent.umich.edu

Drinking coffee slows progression of liver disease in chronic hepatitis C sufferers

2009 study posted for filing

Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell

Patients with chronic hepatitis C and advanced liver disease who drink three or more cups of coffee per day have a 53% lower risk of liver disease progression than non-coffee drinkers according to a new study led by Neal Freedman, Ph.D., MPH, from the National Cancer Institute (NCI). The study found that patients with hepatitis C-related bridging fibrosis or cirrhosis who did not respond to standard disease treatment benefited from increased coffee intake. An effect on liver disease was not observed in patients who drank black or green tea. Findings of the study appear in the November issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases.

Hepatitis C virus (HCV) infects approximately 2.2% of the world’s population with more than 3 million Americans infected. The Centers for Disease Control and Prevention (CDC) cites HCV as the leading cause of liver transplantation in the U.S. and accounts for 8,000 to 10,000 deaths in the country annually. Globally, the World Health Organization (WHO) estimates 3 to 4 million persons contract HCV each year with 70% becoming chronic cases that can lead to cirrhosis of the liver and liver cancer.

This study included 766 participants enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had hepatitis C-related bridging fibrosis or cirrhosis and failed to respond to standard treatment of the anti-viral drugs peginterferon and ribavirin. At the onset of the study, HALT-C patients were asked to report their typical frequency of coffee intake and portion size over the past year, using 9 frequency categories ranging from ‘never’ to ‘every day’ and 4 categories of portion size (1 cup, 2 cups, 3-4 cups, and 5+ cups). A similar question was asked for black and green tea intake. “This study is the first to address the association between liver disease progression related to hepatitis C and coffee intake,” stated Dr. Freedman.

Participants were seen every 3 months during the 3.8-year study period to assess clinical outcomes which included: ascites (abnormal accumulation of fluid in the abdomen), prognosis of chronic liver disease, death related to liver disease, hepatic encephalopathy (brain and nervous system damage), hepatocellular carcinoma (liver cancer), spontaneous bacterial peritonitis, variceal hemorrhage, or increase in fibrosis. Liver biopsies were also taken at 1.5 and 3.5 five years to determine the progression of liver disease.

Results showed that participants who drank 3 or more cups of coffee per day had a relative risk of .47 for reaching one of the clinical outcomes. Researchers did not observe any association between tea intake and liver disease progression, though tea consumption was low in the study. “Given the large number of people affected by HCV it is important to identify modifiable risk factors associated with the progression of liver disease,” said Dr. Freedman. “Although we cannot rule out a possible role for other factors that go along with drinking coffee, results from our study suggest that patients with high coffee intake had a lower risk of disease progression.” Results from this study should not be generalized to healthier populations cautioned the authors.

 

###

 

For the preceding study you may also contact:
NCI Office of Media Relations
301-496-6641
ncipressofficers@mail.nih.gov

Article: “Coffee Intake Is Associated with Lower Rates of Liver Disease Progression in Chronic Hepatitis C,” Neal D. Freedman, James E. Everhart, Karen L. Lindsay , Marc G. Ghany, Teresa M. Curto, Mitchell L. Shiffman, William M. Lee, Anna S. Lok, Adrian M. Di Bisceglie, Herbert L. Bonkovsky, John C. Hoefs, Jules L. Dienstag, Chihiro Morishima, Christian C. Abnet, Rashmi Sinha1, and the HALT-C Trial Group. Hepatology; Published Online: July 13, 2009 (DOI: 10.1002/hep.23162); Print Issue Date: November 2009. http://www3.interscience.wiley.com/journal/122511224/abstract

Media Advisory

What: The 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD)

Founded in 1950, AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD has grown into an international society responsible for all aspects of hepatology, and the annual meeting attracts 7,500 physicians, surgeons, researchers, and allied health professionals from around the world.

The Liver Meeting® is the premier meeting in the science and practice of hepatology, including the latest findings on new drugs, novel treatments, and the results from pilot and multicenter studies.

When: October 31 – November 3, 2009

Where : Hynes Convention Center
900 Boylston Street
Boston, Massachusetts

Contact: Please contact Ann Tracy at 703-299-9766 or atracy@aasld.org to obtain a press pass for this event

CDC Wants Safety Threat Information on Goose Flu

WASHINGTON (CN) – The Centers for Disease Control and Prevention request information and comments to questions on a highly contagious “goose” variant of avian influenza H5N1 viruses.

The viruses contain a hemagglutinin from the Goose/Guangdong/1/96 lineage. The CDC, among other questions, asks about “their potential to pose a severe threat to public health and safety.”

The CDC notes on its website that ferrets can transmit this variant, and it has been associated with infections in humans.

Comments will be accepted until Dec. 17.

For more information, click the document icon for this regulation and others.

http://www.courthousenews.com/2012/10/23/51581.htm

Bird flu virus remains infectious up to 600 days in municipal landfills H5N1

2009 study posted for filing

 

Environmental Science & Technology

 

Amid concerns about a pandemic of swine flu, researchers from Nebraska report for the first time that poultry carcasses infected with another threat — the “bird flu” virus — can remain infectious in municipal landfills for almost 2 years. Their report is scheduled for the June 15 issue of ACS’ semi-monthly journal Environmental Science & Technology.

 

Shannon L. Bartelt-Hunt and colleagues note that avian influenza, specifically the H5N1 strain, is an ongoing public health concern. Hundreds of millions of chickens and ducks infected with the virus have died or been culled from flocks worldwide in efforts to control the disease. More than 4 million poultry died or were culled in a 2002 outbreak in Virginia, and the carcasses were disposed of in municipal landfills. Until now, few studies have directly assessed the safety of landfill disposal.

 

“The objectives of this study were to assess the survival of avian influenza in landfill leachate and the influence of environmental factors,” says the report. The data showed that the virus survived in landfill leachate — liquid that drains or “leaches” from a landfill — for at least 30 days and up to 600 days. The two factors that most reduced influenza survival times were elevated temperature and acidic or alkaline pH. “Data obtained from this study indicate that landfilling is an appropriate method for disposal of carcasses infected with avian influenza,” says the study, noting that landfills are designed to hold material for much longer periods of time.

Plant-Based Diets Can Remedy Chronic Diseases

According to the World Health Organization (WHO), 63 percent of the deaths that occurred in 2008 were attributed to non-communicable chronic diseases such as cardiovascular disease, certain cancers, Type 2 diabetes and obesity—for which poor diets are contributing factors. Yet people that live in societies that eat healthy, plant-based diets rarely fall victim to these ailments. Research studies have long indicated that a high consumption of plant foods is associated with lower incidents of chronic disease. In the October issue of Food Technology magazine, Senior Writer/Editor Toni Tarver discusses recent discoveries in nutritional genomics that explain how plant-based diets are effective at warding off disease.

October 17, 2012

CHICAGO—According to the World Health Organization (WHO), 63 percent of the deaths that occurred in 2008 were attributed to non-communicable chronic diseases such as cardiovascular disease, certain cancers, Type 2 diabetes and obesity—for which poor diets are contributing factors. Yet people that live in societies that eat healthy, plant-based diets rarely fall victim to these ailments. Research studies have long indicated that a high consumption of plant foods is associated with lower incidents of chronic disease. In the October issue of Food Technology magazine, Senior Writer/Editor Toni Tarver discusses recent discoveries in nutritional genomics that explain how plant-based diets are effective at warding off disease.
The article indicates that bioactive compounds in plant foods play a role in controlling genetic and other biological factors that lead to chronic disease. For example, antioxidants in plant foods counter free radicals that can cause chronic inflammation and damage cells. And other plant compounds help control a gene linked to cardiovascular disease and plaque buildup in arteries and the genes and other cellular components responsible for forming and sustaining tumors.
William W. Li, M.D., President and Medical Director of the Angiogenesis Foundation in Cambridge, Mass., says that all consumers should look at their diets as if food is the medicine necessary to maintain healthy, disease-free lives. “Prevention is always better than a cure,” said Li. Foods that may help prevent cancer and other chronic diseases include artichokes, black pepper, cinnamon, garlic, lentils, olives, pumpkin, rosemary, thyme, watercress, and more.  For a more comprehensive list of medicinal foods, read “The Chronic Disease Food Remedy” in the October 2012 issue of Food Technology.

###

About IFT For more than 70 years, IFT has existed to advance the science of food. Our nonprofit scientific society—more than 18,000 members from more than 100 countries—brings together food scientists, technologists and related professions from academia, government, and industry. For more information, please visit ift.org.

Ebola antibody treatment, produced in plants, protects monkeys from lethal disease: Even 48 hours after exposure

Contact: Caree Vander Linden
caree.vanderlinden@us.army.mil
US Army Medical Research Institute of Infectious Diseases

 

A new Ebola virus study resulting from a widespread scientific collaboration has shown promising preliminary results, preventing disease in infected nonhuman primates using monoclonal antibodies.

In this week’s online edition of the Proceedings of the National Academy of Sciences (PNAS), the research team describes a proof-of-concept for using a “cocktail” of monoclonal antibodies, or mAbs, to prevent lethal disease in rhesus macaques. When administered one hour after infection, all animals survived. Two-thirds of the animals were protected even when the treatment, known as MB-003, was administered 48 hours after infection.

Ebola virus, which causes hemorrhagic fever with human case fatality rates as high as 90 percent, has been responsible for numerous deaths in central Africa over the past several months. In addition to being a global health concern, the virus also is considered a potential biological threat agent. Currently there are no available vaccines or treatments approved for use in humans.

The work is the culmination of more than a decade of effort between government and industry partners. According to lead investigator Gene Olinger, Ph.D., a virologist at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), this consortium of investigators has taken very distinct technologies and combined them to develop a cutting-edge medical countermeasure against a lethal viral disease.

“It is rare that an antiviral compound prevents Ebola virus infection with limited to no morbidity in treated animals at any point of treatment following infection by this lethal virus,” said Olinger. “Until recently, attempts to utilize antibodies to provide protection against Ebola virus have been met with failure. The level of protection against disease that we saw with MB-003 was impressive.”

In addition, the production method used in this study offers the potential to make an economical and effective medical countermeasure, according to the authors. Initially developed as a monoclonal antibody cocktail in the mouse model, MB-003 was successfully humanized and then produced in the tobacco plant-based production system.

“We were pleased to see how well the humanized mAbs of MB-003 performed,” said Larry Zeitlin, Ph.D., president of Mapp Biopharmaceutical and senior author on the study. “We also were pleasantly surprised by the superiority of the plant-derived mAbs compared to the same mAbs produced in traditional mammalian cell culture.”

Further improvement in antibody efficacy was developed at Kentucky BioProcessing (KBP). Using a fully automated production system that operates in accordance with good manufacturing practices (GMP), antibody is produced in a tobacco plant system. This new development process significantly decreases the amount of time required for production, increases the quantity of antibody produced, and slashes the cost of manufacturing, according to Barry Bratcher, chief operating officer of KBP and co-author on the PNAS study.

“Our GMP facility can generate a new antibody lot in two weeks to rapidly address new threats and new outbreaks,” said Bratcher.

Olinger said efforts are underway to advance MB-003 to clinical safety testing as his team at USAMRIID continues to determine the true therapeutic capability of the cocktail.

 

###

Multiple agencies contributed funding for this and related studies, including the National Institutes of Health, the Defense Advanced Research Projects Agency, the Transformational Medical Technologies Initiative, and the Defense Threat Reduction Agency.

USAMRIID’s mission is to protect the warfighter from biological threats and to be prepared to investigate disease outbreaks or threats to public health. Research conducted at USAMRIID leads to medical solutions—vaccines, drugs, diagnostics, and information—that benefit both military personnel and civilians. The Institute plays a key role as the lead military medical research laboratory for the Defense Threat Reduction Agency’s Joint Science and Technology Office for Chemical and Biological Defense. USAMRIID is a subordinate laboratory of the U.S. Army Medical Research and Materiel Command

Questions of ethics and quality cloud globalization of clinical trials: Same drug in different populations could produce markedly different results

2009 study posted for filing

Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-724-5343
Duke University Medical Center

DURHAM, N.C. – Top-tier U.S.-based pharmaceutical companies are moving their clinical trials overseas at warp speed, raising questions about ethics, quality control, and even the scientific value of their findings for people back in the U.S.

Many of the trials are taking place in developing countries in Eastern Europe and Asia where study participants are often poorer and less educated than are study participants in the U.S., according to researchers at Duke Clinical Research Institute (DCRI).

“The FDA is supposed to provide oversight for such trials, but it simply wasn’t designed to handle this kind of situation,” says Kevin Schulman, M.D., the senior author of the report appearing in the New England Journal of Medicine. Schulman says the number of Food and Drug Administration investigators based outside the U.S. has grown by 15 percent every year since 2002, while the number of U.S.-based investigators has fallen just over 5 percent during the same period.

Schulman and a research team led by Seth Glickman, M.D., a senior scholar at Duke’s Fuqua School of Business, used the clinicaltrials.gov registry to examine recruitment patterns in industry-sponsored Phase 3 trials in 2007. Phase 3 trials are typically the largest and most meaningful trials, often involving thousands of patients. They found that about a third of the trials (157 of 509) were being solely conducted outside the U.S. They also discovered that over half the study sites (13,521 of 24,206) lay outside U.S. borders.

Researchers also reviewed 300 articles reporting clinical trial results appearing in the New England Journal of Medicine, the Journal of the American Medical Association and the Lancet in 1995 and 2005 and found that over that decade, the number of clinical trial sites abroad doubled, while the number in the U.S and Western Europe declined.

“There are powerful forces luring clinical trials overseas, including the lower cost of doing business and access to larger study populations,” says Glickman. “The cost per participant in a clinical trial in India, for example, can be only one-tenth of what it is in the U.S.”

“But there are equally powerful forces pushing,” says Schulman, who adds that a mix of well-intentioned policy efforts is actually creating barriers to conducting research in a timely fashion in the U.S.

The authors say some of the clinical trials abroad are raising concern about aligning research to the health needs of the population under study. “It’s pretty clear that companies are testing drugs in countries where they will not be marketed or sold,” says Glickman. “This is a major ethical concern.” The researchers found plenty of examples where companies were testing drugs for conditions such as allergic rhinitis, fibromyalgia and overactive bladders in emerging markets – rather than treatments for diseases like malaria or tuberculosis that might be more prevalent there.

Glickman says social ecology and genetics may also play a role in trial outcomes, and may limit their applicability to patients who do not share such characteristics. For example, healthcare-rich economies produce patients with one set of characteristics, while participants with little access to healthcare may have quite different profiles. “It is conceivable that use of the same drug in both populations would produce markedly different results.” Likewise, genetic polymorphisms, or “signatures” in some populations can affect response to certain drugs, making it inappropriate to apply results from studies in these populations to patients who do not share those characteristics.

“Clearly, there is some benefit for everyone involved in clinical trials overseas,” says Glickman. “Generally, such trials increase local prosperity, education and access to better healthcare. And it is critical that new drugs and devices be tested in diverse populations. In order to for that to properly continue, however, we need a robust research framework that will protect trial participants and ensure that sponsors adhere to the highest ethical standards.”

The authors say a body such as the Institute of Medicine or the World Health Organization could create an international commission that would bring industry, academia, regulatory agencies and patient advocacy groups to the same table. “The future of the pharmaceutical and device industries is predicated on addressing these issues,” they write.

 

###

 

DCRI colleagues who contributed to the study include Drs. John McHutchison, Eric Peterson, Charles Cairns, Robert Harrington and Rob Califf

World Health Organisation says has found new SARS-like virus

6:13pm EDT

By Kate Kelland

LONDON (Reuters) – A new virus belonging to the same family as the SARS virus that killed 800 people in 2002 has been identified in Britain in a man who had recently been in Saudi Arabia, the World Health Organisation (WHO) said on Sunday.

The United Nations health body, which issued a statement through its “global alert and response” system, said tests on the patient, a 49-year-old Qatari man, confirmed the presence of a new, or novel, coronavirus.

Coronaviruses are a large family of viruses which includes the common cold and SARS.

“Given that this is a novel coronavirus, WHO is currently in the process of obtaining further information to determine the public health implications,” the statement said.

SARS, or Severe Acute Respiratory Syndrome, appeared in China in 2002 and killed some 800 people globally before being brought under control.

Peter Openshaw, director of the Centre for Respiratory Infection at Imperial College London, said at this stage the novel virus looked unlikely to prove a concern, and may well only have been identified due to sophisticated testing techniques.

“For now, I would be watchful but not immediately concerned,” he told Reuters.

The WHO said the Qatari patient had first presented to doctors on September 3, 2012 with symptoms of an acute respiratory infection.

On September 7, he was admitted to an intensive care unit in Doha, Qatar, and on September 11, he was transferred to Britain by air ambulance from Qatar.

“The Health Protection Agency of the UK conducted laboratory testing and has confirmed the presence of a novel coronavirus,” the WHO said.

It said scientists at the HPA compared gene sequences of the virus from the Qatari patient with samples of virus sequenced by Dutch scientists from lung tissue of a fatal case earlier this year in a 60-year-old Saudi national.

The two were almost identical, it said.

Openshaw said the fact the two cases found so far are apparently unrelated suggests “that what has been picked up is just some rare event that in past times might have been undiagnosed”.

But he added: “Any evidence of sustained human-to-human transmission or of contact would be more worrying, raising the worry that another SARS-like agent could be emerging.”

The WHO said it was not recommending any travel restrictions but would be seeking further information on the virus.

(Reporting by Kate Kelland; Editing by Sophie Hares)

http://www.reuters.com/article/2012/09/23/us-virus-who-idUSBRE88M0FV20120923

The pandemic potential of H9N2 avian influenza viruses

Re-Post for Filing 2008

Contact: Beth Cavanaugh
bcavana@umd.edu
Public Library of Science

Since their introduction into land-based birds in 1988, H9N2 avian influenza A viruses have caused multiple human infections and become endemic in domestic poultry in Eurasia. This particular influenza subtype has been evolving and acquiring characteristics that raise concerns that it may become more transmissible among humans. Mechanisms that allow infection and subsequent human-to-human transmission of avian influenza viruses are not well understood.

In a new study published August 13 in the journal PLoS ONE, Daniel Perez (of the University of Maryland) and colleagues used ferrets to characterize the mechanism of replication and transmission of recent avian H9N2 viruses. The researchers show that some currently circulating avian H9N2 viruses can transmit to naïve ferrets placed in direct contact with infected ferrets. However, aerosol transmission was not observed, a key factor in potentially pandemic strains.

More importantly, Perez and colleagues show that a single amino acid residue (Leu226) at the receptor-binding site (RBS) of the hemagglutinin (HA) surface protein plays a major role in the ability of these viruses to transmit. They also found that an avian-human H9N2 reassortant virus increases virulence, pathology and replication in ferrets. These results suggest that the establishment and prevalence of H9N2 viruses in poultry could pose a significant threat for humans.

 

###

Contact:

Beth Cavanaugh
University of Maryland Press Office
Email: bcavana@umd.edu

Daniel Perez
University of Maryland
Email: dperez1@umd.edu

Citation: Wan H, Sorrell EM, Song H, Hossain MJ, Ramirez-Nieto G, et al. (2008) Replication and Transmission of H9N2 Influenza Viruses in Ferrets: Evaluation of Pandemic Potential. PLoS ONE 3(8): e2923. doi:10.1371/journal.pone.0002923

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT (URL live from Aug 13): http://dx.plos.org/10.1371/journal.pone.0002923

PRESS-ONLY PREVIEW: http://www.plos.org/press/pone-03-08-perez.pdf

Pacifiers may have emotional consequences for boys

Contact: Paula Niedenthal niedenthal@wisc.edu 608-890-4379 University of Wisconsin-Madison

MADISON — Pacifiers may stunt the emotional development of baby boys by robbing them of the opportunity to try on facial expressions during infancy.

Three experiments by a team of researchers led by psychologists from the University of Wisconsin–Madison tie heavy pacifier use as a young child to poor results on various measures of emotional maturity.

The study, published today by the journal Basic and Applied Social Psychology, is the first to associate pacifiers with psychological consequences. The World Health Organization and American Academy of Pediatrics already call for limiting pacifier use to promote breast-feeding and because of connections to ear infections or dental abnormalities.

Humans of all ages often mimic — unwittingly or otherwise — the expressions and body language of the people around them.

“By reflecting what another person is doing, you create some part of the feeling yourself,” says Paula Niedenthal, UW–Madison psychology professor and lead author of the study. “That’s one of the ways we understand what someone is feeling — especially if they seem angry, but they’re saying they’re not; or they’re smiling, but the context isn’t right for happiness.”

Mimicry can be an important learning tool for babies.

“We can talk to infants, but at least initially they aren’t going to understand what the words mean,” Niedenthal says. “So the way we communicate with infants at first is by using the tone of our voice and our facial expressions.”

With a pacifier in their mouth, a baby is less able to mirror those expressions and the emotions they represent.

The effect is similar to that seen in studies of patients receiving injections of Botox to paralyze facial muscles and reduce wrinkles. Botox users experience a narrower range of emotions and often have trouble identifying the emotions behind expressions on other faces.

“That work got us thinking about critical periods of emotional development, like infancy,” says Niedenthal, whose work is supported by the French Agence Nationale de la Recherche. “What if you always had something in your mouth that prevented you from mimicking and resonating with the facial expression of somebody?”

The researchers found six- and seven-year-old boys who spent more time with pacifiers in their mouths as young children were less likely to mimic the emotional expressions of faces peering out from a video.

College-aged men who reported (by their own recollections or their parents’) more pacifier use as kids scored lower than their peers on common tests of perspective-taking, a component of empathy.

A group of college students took a standard test of emotional intelligence measuring the way they make decisions based on assessing the moods of other people. Among the men in the group, heavier pacifier use went hand-in-hand with lower scores.

“What’s impressive about this is the incredible consistency across those three studies in the pattern of data,” Niedenthal says. “There’s no effect of pacifier use on these outcomes for girls, and there’s a detriment for boys with length of pacifier use even outside of any anxiety or attachment issues that may affect emotional development.”

Girls develop earlier in many ways, according to Niedenthal, and it is possible that they make sufficient progress in emotional development before or despite pacifier use. It may be that boys are simply more vulnerable than girls, and disrupting their use of facial mimicry is just more detrimental for them.

“It could be that parents are inadvertently compensating for girls using the pacifier, because they want their girls to be emotionally sophisticated. Because that’s a girly thing,” Niedenthal says. “Since girls are not expected to be unemotional, they’re stimulated in other ways. But because boys are desired to be unemotional, when you plug them up with a pacifier, you don’t do anything to compensate and help them learn about emotions.”

Suggesting such a simple and common act has lasting and serious consequences is far from popular.

“Parents hate to have this discussion,” Niedenthal says. “They take the results very personally. Now, these are suggestive results, and they should be taken seriously. But more work needs to be done.”

Sussing out just why girls seem to be immune (or how they may compensate) is an important next step, as is an investigation of what Niedenthal calls “dose response.”

“Probably not all pacifier use is bad at all times, so how much is bad and when?” she asks. “We already know from this work that nighttime pacifier use doesn’t make a difference, presumably because that isn’t a time when babies are observing and mimicking our facial expressions anyway. It’s not learning time.”

But even with more research planned to further explain the new results, Niedenthal is comfortable telling parents to consider occasionally pocketing the pacifier.

“I’d just be aware of inhibiting any of the body’s emotional representational systems,” Niedenthal says. “Since a baby is not yet verbal — and so much is regulated by facial expression — at least you want parents to be aware of that using something like a pacifier limits their baby’s ability to understand and explore emotions. And boys appear to suffer from that limitation.”

###

 

— Chris Barncard, 608-890-0465, barncard@wisc.edu

Scores at risk as new breed of mosquito foils malaria prevention methods: There is NO KNOWN DNA match

Published: 16 September, 2012, 21:14

Annual deaths could jump by the hundreds of thousands because of a new species of mosquito, which bites people in the early evening rather than at night, making bed nets useless in the battle against malaria.

The new strain of mosquito, which was discovered in the highlands of western Kenya by scientists from the London School of Hygiene and Tropical Medicine, feeds while people are outside in the early evening, according to a Sunday report by the Independent.

Malaria is already one of the world’s top killers, with nearly one million people a year dying from the disease.

And if not for mosquito nets that number would be much higher, as nets prevent the insects from biting at night, when the female anopheles mosquito sucks blood as part of its egg-production cycle. As many as one million people are thought to have dodged death by sleeping under mosquito nets covered with insecticide over the last 12 years.

Even more distressing is that scientists have as yet been unable to match the DNA of the new species to that of any existing variety.

Jennifer Stevenson, a scientist in the London School research group, told the Independent, “We observed that many mosquitos we caught – including those infected with malaria – did not physically resemble other known malaria mosquitoes.”

Stevenson, whose team set up outdoor and indoor traps to catch the species, added, “the main difference that came through from this study is that we caught 70 per cent of these species A – which is what we named them because we don’t know exactly what they are – outdoors before 10:30pm, which is the time when people in the village usually go indoors.”

Jo Lines, a colleague of Stevenson and a former co-coordinator for the World Health Organization’s global malaria program, also said, “we do not yet know what these unidentified specimens are, or whether they are acting as vectors [transmitters] on a wider scale, but in the study area they are clearly playing a major and previously unsuspected role.”

Scientists are now calling for wider controls to deal with the outdoor transmission of the disease.

Andrew Griffiths, from the children’s charity World Vision, said the findings are a setback in the fight against the disease. “It’s concerning because bed nets are one of the important tools in combating malaria and we’ve seen deaths go down dramatically. It would mean that one of the important parts in the response to malaria would be taken away. We have to be talking about protecting yourself at different times of the day and put even more focus on the community and other systems,” he said.

In a separate development, scientists in the UK and the US are developing genetically-modified mosquitos, which could prove effective in the battle against mosquito borne-diseases like malaria

http://rt.com/news/health-malaria-mosquito-africa-270/

Newborn vitamin A reduces infant mortality by 15%

Contact: Tim Parsons
tmparson@jhsph.edu
410-955-7619
Johns Hopkins University Bloomberg School of Public Health

A single, oral dose of vitamin A, given to infants shortly after birth in the developing world can reduce their risk of death by 15 percent, according to a study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health. The study is published in the July 2008 edition of the journal Pediatrics.

“It has long been known that vitamin A supplementation can reduce mortality in children over 6 months of age. Our study showed that vitamin A given at birth can also improve infant survival within the first 6 months of life,” said Rolf D.W. Klemm, DrPH, MPH, the study’s lead author and a researcher with the Bloomberg School’s Center for Human Nutrition.

The study enrolled 15,937 newborns from rural communities in northwest Bangladesh, where over 90 percent of babies are born at home. Half were randomly selected to receive a 50,000 IU dose of vitamin A, while the other half received a placebo. A 200,000 IU dose of vitamin A is recommended semi-annually for older children. The vitamin A was given orally to the infants within a few days of birth, usually by 7 hours after delivery. The mortality rate for the vitamin A group was 38.5 deaths per 1,000 births compared to 45.1 deaths per 1,000 births for the non-vitamin A group.

Although vitamin A reduced infant deaths from all causes, lives were likely saved by reducing the severity of potentially fatal infections which are responsible for most deaths in early infancy in South Asia.

“This study supports the findings of previous vitamin A studies in Southern Asia where the evidence is now strong that vitamin A given to newborns can dramatically reduce mortality,” said study co-author Keith West, DrPH, MPH, RD, the George G. Graham Professor in Infant and Child Nutrition at the Bloomberg School of Public Health. “More studies are urgently needed to determine if newborn vitamin A supplementation would reduce mortality among infants in other regions, especially Africa.”

“We are excited by the results of this study, that build on two previous studies in South Asia, confirming this low cost intervention can significantly contribute to reducing mortality in the first 6 months of life,” said Kent R. Hill, assistant administrator for Global Health at the U.S. Agency for International Development (USAID). He added, “A key next step is to consider the operational issues for using this intervention.” In conjunction with other partners, USAID is conducting operations research in Nepal and Bangladesh to determine possible approaches for delivering vitamin A to newborn infants.

In the 1980s, Alfred Sommer, MD, MHS, demonstrated that vitamin A deficiency dramatically increased the risk of child mortality. Sommer, along with West and colleagues from Hopkins further demonstrated that a single dose of vitamin A could reduce child mortality by 34 percent. The control of vitamin A deficiency is a global goal of the World Health Organization and is considered one of the most cost-effective of all health interventions for saving young lives.

“Because childhood mortality is greatest during the first few months of life, a single dose of vitamin A administered by mouth to a newborn child can save the lives of an additional 300,000 children in Asia every year,” said Alfred Sommer, MD, MHS, professor and dean emeritus of the Bloomberg School of Public Health. “That is on top of the one million lives a year that would be saved by dosing all vitamin A deficient children twice a year from six months through 5 years of age.”

 

###

The research was supported by grants from the U.S. Agency for International Development and the Bill & Melinda Gates Foundation. Additional support was provided by the Sight and Life Research Institute, Nutrilite Health Institute, the Canadian International Development Agency and the National Integrated Population and Health Program of the Ministry of Health and Family Welfare of the government of the People’s Republic of Bangladesh.

 

“Newborn Vitamin A Supplementation Reduced Infant Mortality in Rural Bangladesh” was written by Rolf D.W. Klemm, DrPH, MPH; Alain B. Labrique, MSc, MHS, PhD; Parul Christian, MPH, DrPH; Mahbubur Rashid, MBBS, MHS; Abu Ahmed Shamin, MSc; Joanne Katz, MS, ScD; Alfred Sommer, MD, MHS; and Keith West, DrPH, MPH, RD.

For public health news throughout the day, visit www.jhsph.edu/publichealthnews.

Gestational exposure to urban air pollution linked to vitamin D deficiency in newborns

Contact: Aaron Lohr alohr@endo-society.org 240-482-1380 The Endocrine Society

New study highlights potential importance of vitamin D supplementation in pregnant women

Chevy Chase, MD—Gestational exposure to ambient urban air pollution, especially during late pregnancy, may contribute to lower vitamin D levels in offspring, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology and Metabolism (JCEM). According to study authors, this could affect the child’s risk of developing diseases later in life.

Recent data have demonstrated that maternal vitamin D deficiency during pregnancy may have an influence on the development of asthma and allergic diseases in offspring. A number of factors may influence vitamin D supply in women. Exposure to high levels of air pollution has been suggested as a contributor to vitamin D deficiency in adults and children.

“We investigated the associations between gestational exposure to urban air pollutants and vitamin D cord blood serum level,” said Nour Baïz, MASc, of Intitut National de la Santé et de la Recherche Médicale (INSERM) in Paris, France who led the study. “Our findings show for the first time, that exposure to ambient air pollution comparable to current World Health Organization standards might contribute to vitamin D deficiency in newborns.”

In this study, researchers investigated the associations between gestational exposure to urban air pollutants and 25-hydroxyvitamin D cord blood serum level in 375 mother-child pairs. Maternal exposure to urban levels of nitrogen dioxide and particulate matter less than 10 micro meters during the whole pregnancy was a strong predictor of low vitamin D status in newborns. The association between gestational exposure to air pollutants and vitamin D deficiency in newborns was strongest for third-trimester exposures.

###

Other researchers participating in the study included: Isabella Annesi-Maesano of INSERM; Patricia Dargent-Molina of University Pierre and Marie Curie in Paris, France; John Wark of The Royal Melbourne Hospital in Victoria, Australia; Jean-Claude Souberbielle of Université Paris-Descartes in Paris, France; and Rémy Slama of Institut Albert Bonniot in Grenoble, France.

The article “Gestational Exposure to Urban Air Pollution Related to a Decrease in Cord Blood Vitamin D Levels” is slated to appear in the November 2012 issue of JCEM.

Founded in 1916, The Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 15,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endo-society.org. Follow us on Twitter at https://twitter.com/#!/EndoMedia.