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Sep 30
Your Eyes May Be A Window To Heart Disease
For centuries eyes have been seen as windows to the soul. But medical researchers now believe the eyes may also offer vital clues to your risk of heart disease and stroke.

Importantly, this research could lead to optometrists and ophthalmologists playing a key diagnostic role in identifying signs of life threatening health problems.

Researchers at the Centre for Eye Research Australia (CERA) are seeking to confirm that blood vessels in the retina at the back of the eye reflect changes in blood vessels in other parts of the body, especially the brain, kidneys and heart.

A project funded by the MBF Foundation is showing that blood vessels in the retina can be photographed and the images analysed by a computer to accurately determine a person's risk of heart attack or stroke - cardiovascular diseases that change the appearance of blood vessels in the eye.

Lead CERA researcher, Professor Tien Wong, said they aim to show that combining this non-invasive retinal scan with the results from current risk assessment methods will improve precision and reliability in predicting cardiovascular disease.

Professor Wong's team has taken thousands of eye images and created a program that recognises common features of conditions that cause damage to be seen on the retina.

Once a person has symptoms of cardiovascular disease, damage has already been done to the body. So finding and treating high risk people early, even before they have symptoms, could minimise blood vessel damage and potentially avoid heart attack or stroke.

Currently, doctors estimate a person's statistical chance of developing cardiovascular disease by looking at individual factors such as whether they smoke, their family history, weight, blood cholesterol and blood pressure. Once you get symptoms, more extensive and sometimes invasive tests, such as angiogram are needed to confirm the result and assess severity of damage to the arteries of the heart or elsewhere.

Professor Wong said, "Results from the retinal scan would be delivered to GPs for a better picture of their patient's health.

"The test is simple, has no side effects or risks, which are present for invasive tests like angiograms, and will result in more targeted preventive measures."

Dr Christine Bennett, chair of the MBF Foundation Steering Committee and Bupa Chief Medical Officer*, went on to say, "This early assessment of the likelihood that a person will develop diseases like heart disease, stroke or even type 2 diabetes has the potential to significantly improve quality of life, reduce hospitalisations and the 50,000 deaths each year caused by cardiovascular disease."

Once a person knows their risk they may be able to delay the onset of developing cardiovascular disease by modifying their lifestyle accordingly.

"We know that smoking, too much alcohol, inactivity and poor nutrition are bad for our health but seeing the evidence not with, but in, your own eyes could be the wake-up call that triggers change," Dr Bennett said.

"A range of locations, such as optometrists, ophthalmologists, pathologists and GPs will be assessed to find the best way to make this test accessible to as many at-risk Australians as possible."

Sep 29
After pilots, 4000 doctors quit jobs over pay
In Karnataka, four thousand government doctors resigned en masse on Monday, despite a government plea to to defer the decision till they meet the Chief Minister on October 4.

The doctors are demanding a hike in payment and regularisation of their contracts.

"We also want time bound promotions and incentive for doctors who are working in rural and academic organisations," said H K Shyla Kumar, Treasurer of the Doctors' Association.

Patients will not be affected immediately, as the protesting doctors have agreed to serve a notice period till October 14. "From October 15, we will start practicing in private," one of the doctors said.

Meanwhile Principal Health
Secretary N Perumal maintained his plea, saying. "The Chief Minister wants them not to precipitate the matter, and wait until October 4."

Sep 29
Researchers examine use of Toad Venom in Cancer Treatment
A Chinese medicine made from dried venom secreted by the skin glands of toads has shown promise in slowing down cancer progression in patients, say researchers.

Huachansu, the Chinese medicine, is widely used to treat patients with liver, lung, colon and pancreatic cancer at oncology clinics in China.

"Studying traditional Chinese medicine such as huachansu is new to American research institutions, which have been skeptical and slow to adopt these complementary treatments," said Dr Lorenzo Cohen, one of the paper's authors and director of the Integrative Medicine Program at M. D. Anderson.

"However, it is important to understand its potential role in treating cancer.

"We wanted to apply a Western medicine-based approach to explore the role of the toad venom compound in cancer patients and test if it is possible to deliver a more potent dose without raising toxicities or side effects," Cohen added.

In the study, 15 patients with stage III or IV hepatocellular (liver) carcinoma, nonsmall cell lung cancer or pancreatic cancer received one of five dose levels ranging from 10 mL/ m2 up to 90 mL/m2 from January 2005 through July 2006. The treatment was repeated daily for 14 days followed by seven days off (one cycle). After two cycles, most patients received other treatments.

While the dose was up to eight times higher than conventional doses used in China, researchers observed only low toxicities or side effects.

Of the 15 patients who completed the treatment, six hepatocellular carcinoma patients had stable disease for a median of six months.

One patient had a 20 percent reduction in tumour mass that lasted for more than 11 months.

"Even though we saw no complete or partial response (reduction of disease by 30 percent or more) it is encouraging that the cancer did not progress in a large set of the hepatocellular carcinoma patients," said Zhiqiang Meng, principal investigator on the trial and an associate professor and deputy chair of the Department of Integrative Oncology at Fudan University Cancer Hospital.

"Previous observations from studies conducted in China have shown that huachansu can inhibit tumour cell growth and improve immunologic function. These findings, coupled with that knowledge, demonstrate the need for further clinical trials of this promising agent," Meng added.

Sep 29
Babies With Position-Related Head Flattening May Have Higher Rate Of Ear Infections
The recommendation to lay babies on their backs to sleep has reduced sudden infant death syndrome (SIDS), but has led to an increased number of infants with a skull deformity called deformational (or positional) plagiocephaly. Now new research suggests that infants with more severe plagiocephaly may have a higher rate of middle ear abnormalities associated with ear infections (otitis media), reports the September issue of The Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Given the potential impact on hearing and other aspects of child development, more research will be needed to clarify the risk of otitis media in infants with deformational plagiocephaly, according to researcher Adam Purzycki, BS, and colleagues of Wake Forest University Medical Center, Winston-Salem, NC.

Results Suggest Possible Increase in Otitis Media with Severe Plagiocephaly

Children with deformational plagiocephaly have flattening of the back of the head, ranging from mild to severe. In recent years, the number of infants with this form of plagiocephaly has increased exponentially as a result of the "Back to Sleep" campaign to prevent SIDS. The growing skull becomes deformed as a result of pressure from lying in the same position. For most affected infants, treatment consists of a helmet or band to gently mold the growing skull into a more normal shape.

The researchers asked the parents of 1,259 children with deformational plagiocephaly about their child's history of ear infections. Almost exactly half of the children had at least one ear infection before one year old-similar to the rate in the normal population. The rate was slightly higher for children with more severe plagiocephaly: 54 percent, compared to 49 percent in those with milder deformity.

In 124 children, the researchers performed a test called a tympanogram, done to measure pressures within the middle ear. Certain patterns of tympanogram results suggest the presence of otitis media.

The results showed "a marked trend" toward a relationship between otitis media-related abnormalities and the severity of plagiocephaly. "The more severe cases (types IV-V) of plagiocephaly had a higher percentage of otitis media than the less severe cases (types I-III)," the researchers write.

Hearing Loss Could Contribute to Developmental Problems

In more severe plagiocephaly, the skull deformity may cause the ear to move forward. Resulting abnormalities of the eustachian tube may cause problems with fluid drainage from the middle ear, promoting infections and otitis media. "The significantly high percentage of tympanogram readings that pointed to otitis media…suggests an overall malfunction of the middle ear drainage function of the eustachian tube in these children," according to Purzycki and colleagues.

There is growing attention to the possibility of long-term complications related to plagiocephaly, with some studies reporting developmental problems such as language disorders and learning disabilities. The new findings raise the possibility that at least some of these problems could be related to hearing loss-a known complication of persistent otitis media in children.

If so, then recognition and appropriate management of otitis media in children with deformational plagiocephaly might help to reduce these long-term developmental concerns. However, the researchers emphasize the need for more research to clarify the link between plagiocephaly and otitis media-including the clinical significance of the abnormal tympanograms.

Sep 29
Diabetes can delay bone fracture healing
An inflammatory molecule called TNF-a may contribute to delayed bone fracture healing in diabetics, according to a study.

A research article on the study, published in the American Journal of Pathology, describes diabetes as a condition where the body either does not produce enough, or respond to, insulin.

The report says that long-term complications of diabetes include cardiovascular disease, chronic renal failure, retinal damage that may lead to blindness, nerve damage, and blood vessel damage, which may cause erectile dysfunction and poor wound healing.

It further points out that diabetic patients often experience low bone density, which is associated with increased risk of bone fractures and delayed fracture repair.

With a view to determining how diabetes affects bone, Dr. Dana Graves and colleagues of the University of Medicine and Dentistry of New Jersey and the Boston University School of Medicine explored bone repair in a mouse model of diabetes.

The researchers observed increased levels of inflammatory molecules, including TNF-a during fracture healing.

They revealed that the diabetic animals had rapid loss of cartilage in the healing bones, which was due to increased numbers of osteoclasts, cells that remove bone and cartilage.

They further said that factors that stimulate osteoclast formation were regulated by both TNF-a and a downstream mediator, FOXO1.

According to the researchers, these results suggest that diabetes-mediated increases in TNF-a and FOXO1 may underlie the impaired healing of diabetic fractures.

The researchers say: "TNF-a dysregulation plays a prominent role in the recently identified catabolic events associated with diabetic fracture healing." In future studies, Dr. Graves and colleagues plan to "examine the effect of FOXO1 on mineralized tissue to examine how it may regulate factors that control bone resorption and osteoclastogenesis, in addition to effects it may have on osteoblastic cells."

Sep 29
Fat caused 124,000 cancer cases in Europe: Experts
More than 124,000 people in Europe developed cancer last year because they are overweight, and rising body fat levels threaten to add tens of thousands more to their ranks, experts said on Thursday.

A study of cancer among overweight people in Europe showed the proportion of new cases of the disease caused by people being fat was highest in women and in central European countries like the Czech Republic, Latvia, Slovenia and Bulgaria.

The most common cancers linked to excess body weight were endometrial, breast and colorectal cancers.

"It is possible that obesity may become the biggest attributable cause of cancer in women within the next decade," lead researcher Andrew Renehan, of Cardiff University in Britain, told the ECCO-ESMO European cancer congress in Berlin.

Renehan used data from the World Health Organization (WHO) and the International Agency for Research on Cancer to estimate that in 2002 some 70,0000 new cases of cancer in 30 European countries were caused by people being overweight or obese.

The study used WHO definitions, classing overweight as having a body mass index (BMI) between 25 and 30, and obese as having a BMI of 30 or more.

They then projected the figures forward to 2008, taking into account the steep decline in women's use of hormone replacement therapy from 2002 after it was linked to increased risk of breast cancer, and the wider use of prostate cancer screening.

They found that the number of cancers that could be attributed to excess body weight increased to 124,050 in 2008.

In men, 3.2 percent of new cancers were attributed to being overweight or obese and in women it was 8.6 percent, and at a country level, obesity-related cancer is a greater problem for central European countries like the Czech Republic, but less of a problem in France and Denmark.

The largest number of obesity-related new cancers was for endometrial cancer (33,421), post-menopausal breast cancer (27,770) and colorectal cancer (23,730). Together, they accounted for 65 percent of all cancers attributable to fat.

Renehan stressed that his numbers were "very conservative estimates" and urged health authorities to take note.

"In the face of an unabating obesity epidemic, and apparent failure of public health policies to control weight gain, there is a need to look at alternative strategies, including pharmacological approaches," he said.

Obesity has long been known to raise the risk of cancer, and the evidence continues to mount. Swedish researchers said in June that women who had weight-loss surgery were 42 percent less likely to develop cancer during a 10-year study.

Although European countries are taking some steps to tackle the obesity epidemic, the study emphasized the "urgency of the task and the scale of the problems" caused by fat, Renehan said.

Sep 26
World's First Successful AIDS Vaccine Brings Hope
AIDS Society of India (ASI) has welcomed the outcome of the Thai AIDS Vaccine trial (RV 144) and said it is a time for celebration for the clinicians and researchers engaged in the field of HIV/AIDS as also those prone to contract HIV infection.

Describing it as the first successful trial after 95 failures globally, ASI said it is definitely a stepping stone for vaccine-based HIV prevention strategy.

However, ASI said it would like to caution people, both HIV infected and uninfected, as such events, while being news-worthy, have little practical benefits in the immediate future.

People are used to risk-taking behaviour under the false sense of security of the impending HIV vaccine, Dr I S Gilada, general secretary of ASI said.

ASI cautioned the public that unscrupulous quacks may take advantage (of reports on AIDS vaccine trial) and dupe gullible people as it happens after such media reports.

The RV 144 employed a two-pronged approach. It sought to create antibodies to attack HIV and also boosted the body's response to alert white blood cells.

Half of 16,395 study participants in the trials were given six doses of the vaccines in 2006 and half received placebos. All received condoms, counselling, regular HIV testing and treatment for any sexually transmitted diseases. Of the 8,197 volunteers who received vaccine, new infections occurred in 51 people.

Of the 8,198 participants who received placebo (dummy) shot, new infections occurred in 74.

Surprisingly, RV144 is combination of the two failed vaccines (Alvac-HIV and AIDSVAX )and has shown 31 per cent success rate at the end of three years.

ASI feels this is in consonance with other strategies in HIV prevention and treatment (as well as Tuberculosis treatment) where a combination works rather than an individual strategy/drug.

Conventionally there are two types of vaccines- preventive that helps prevent a particular infection in healthy persons on repeated exposures to virus or bacteria; other for Immunotherapy (treatment) for an infected person to prevent further harm.

Globally, about 95 AIDS vaccines have been tried for prevention and treatment ever since HIV that causes AIDS was isolated in 1984. It cost millions of dollars and were not successful.

"We have reasons to be optimistic about the vaccine though we need to continue our research pursuits, especially towards the India-specific vaccine, as like Africa, we mainly have HIV subtype C," Gilada said.

RV 144 is designed for HIV subtypes B/E (USA and Thailand). Earlier a Phase-I vaccine trial in India failed in 2008, when mysteriously, the already failed recombinant adeno-associated viral vector, rAAV, was tried in some 30 volunteers in Pune.

ASI will have a session on AIDS Vaccine at its 3rd National Conference on March 19-21, 2010 in Hyderabad where the scientists involved with the Thai Vaccine trial including Dr. Anthony Fauci will be attending.

Sep 26
'Spectacular' treatment for skin cancer developed
merican scientists have developed, what is being hailed as a "simply spectacular" treatment for skin cancer that could shrink the tumors at a
Skin Infection
''Spectacular'' treatment for skin cancer developed (Getty Images)
"rapid and dramatic" rate in patients whose disease had spread.

The results of the drug trial are significant because skin cancer, though curable when caught early, usually become fatal when it spreads to other parts of the body.

Experts described the results as "simply spectacular" and said the drug, known at the moment only as PLX4032, could improve and extend the lives of those fighting the disease. It is already known that around half of all malignant melanomas are fuelled by a mutation in a gene, known as Braf.

And now, for the first time, scientists have developed a drug that can interfere with this gene’s protein, cutting off the fuel supply to the tumors.

The small study, conducted on 31 patients showed that patients treated with the twice-a-day pill saw their tumors shrink rapidly and a larger trial is now needed to confirm the findings.
But the results showed that in two thirds of the 22 patients evaluated, the tumors shrank by 30 per cent in only a month.

A further six patients also saw their tumors shrink, but not by as much.

Cancer experts are excited by the findings because it means that PLX4032 could also work in other cancers triggered by the Braf mutation, which includes around five per cent of bowel cancers, accounting for 1,500 new cases a year.

In addition the drug also offers hope to the thousands of skin cancer patients who have very few treatment options once their tumours have spread. However, experts admit the drug will not cure metastatic melanoma.

"We are very excited. So far 70 per cent of patients have responded," The Daily Express quoted Dr Paul Chapman, from the Memorial Sloan-Kettering Cancer Centre in New York, which carried out the trial, as saying.

Sep 26
Pioneering surgery saves dying man with damaged heart
In a surgery believed to be the world’s first, a dying heart patient has been saved by a British surgeon who used a combination of an artificial heart and stem cells to rebuild his heart’s damaged muscles.

Greek patient Ioannis Manolopoulos’s heart was fitted with the mechanical pump in Thessaloloniki, Greece, by a team of surgeons led by Professor Stephen Westaby, based at Oxford's John Radcliffe Hospital.

The surgeons injected his heart with six million of his own stem cells extracted from his bone marrow to repair the damaged heart muscles.

Mechanical pump takes the pressure off the damaged part of the heart
The mechanical pump works by diverting the blood away from the damaged pumping chamber of the heart. This procedure allows the damaged part to repair itself.

Professor Westaby said, "The idea of combining a pump is to take the pressure off the wall of the heart and try and give the stem cells a better environment to grow and develop.

"I think it's very promising for the future as the patient is going well and is up and about and making good progress," he added.

Surgeons consider heart pumps could save many lives
Professor Westaby believes that with the aid of these mechanical pumps, many ailing lives could be saved.

Professor Christos Papakonstantinou, heart surgeon at the Ahepa University Hospital in Thessaloniki, also said, "We hope the combination of stem cells and pumps will enable patients to enjoy life for many years."

The surgeons, however, noted that funding could be a problem towards making this procedure a success.

Manolopoulos hopes for a normal life
Manolopoulos, who is recovering after the operation, said, "If things go well, I must go to church and pray because I feel very lucky to get this device and have the chance of a normal life."

He had two heart attacks and none of the treatments had succeeded to improve his condition prior to this surgery.

Sep 24
Restricting Salt Intake Should Be A Major Public Health Priority
Reducing sodium intake is a major public health priority that must be acted upon by governments and nongovernmental organizations to improve population health, states an article in CMAJ (Canadian Medical Association Journal).

Higher blood pressure is a risk factor for cardiovascular disease and a diet high in sodium has been linked to high blood pressure, vascular and cardiac damage, stomach cancer, osteoporosis and other diseases. Almost 1 billion adults worldwide have hypertension, and 17-30% of these cases can be attributed to excessive sodium consumption.

In developed countries, almost 80% of sodium intake is from processed food. Regulation of the food industry by government will bring about the most effective change, although immediate voluntary action is desired.

The recommended intake in Canada ranges from 1,000 mg/day sodium for people aged 1-3 years to 1,500 mg/day for those aged 9-50. Average daily sodium intake in Canada is more than double the highest recommended level.

"A population-wide reduction in sodium intake could prevent a large proportion of cardiovascular events in both normotensive and hypertensive populations," write Dr. Kevin Willis, Canadian Stroke Network and coauthors. "For example, a population-wide decrease of 2 mm Hg diastolic blood pressure would be estimated to lower the prevalence of hypertension by 17%, coronary artery disease by 6% and the risk of stroke by 15%, with many of the benefits occurring among patients with normal blood pressure."

National public health policy should be focused on reformulating processed food, educating consumers, labelling food clearly and setting timelines to meet these targets. Nongovernmental groups should lobby the food industry to change practice and partner with governments to mount public education campaigns.

As well, health care professionals should to counsel patients about healthy choices in reducing sodium consumption. Training to do this should be incorporated into curricula.

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