Senior government doctors, who were supposed to go on a one-day token strike on Monday, called off their agitation after state
government set up a committee to look into the pay hike demands put forward by Tamil Nadu Government Doctors' Association. (TNGDA). Meanwhile, house surgeons and postgraduate medical students of government colleges continued their strike.

Senior doctors had given a strike call after talks with state government failed on Sunday morning.

However, the government panicked that strike by doctors will paralyse the government hospitals where services have already been hit by the ongoing students' strike.

Hence, health department held talks with representatives of TNGDA on Monday evening and promised them that a committee headed by special secretary law department Praveen Kumar will be constituted.

"Director of medical education, director of public health and director of medical service and two representatives of TNGDA will be members of the committee which will submit its report recommending the government about the demands of the doctors," said health minister M R K Paneerselvam.

However, "the government would clear all backlog in promotions of doctors," he added.

Though the government managed to thwart the doctors' attempt to go on strike, continuing strike by students are expected to further affect the hospitals.

With the working force of the government hospitals striking work, the services at most hospitals were severely hit. While some hospitals cancelled elective surgeries, others grappled with long queues of patients at the out-patient units.

An irked minister even ordered the directorate of medical education to bar all striking house surgeons from appearing for the postgraduate entrance in 2010. "We will also mention their participation in the strike in their conduct certificates," director of medical education Dr S Vinayagam said.

How molecules of the oldest branch of the human immune system have interconnected has remained a mystery. Now, two new structures, both involving a central component of an enzyme important to the complement system of the immune response, reveal how this system fights invading microbes while avoiding problems of the body attacking itself.

The structures may pave the way to more efficient therapeutics for such complement-mediated diseases as age-related macular degeneration, rheumatoid arthritis, or systemic lupus erythematosus, as well as give insight into the pathogenesis of other immune and inflammatory diseases.

The complement system, an evolutionarily old arm of the immune system, comprises a network of proteins that "complement" the work of antibodies in destroying foreign invaders. They serve as a rapid defense mechanism in most species, from primitive sponges to humans. When complement proteins are triggered into action by a microbe, the proteins ultimately form a complex enzyme called C3 convertase, initiating a cascade of immune and inflammatory reactions. In order to avoid self-attack, regulatory proteins such as factor H bind with C3b, a central component of C3, to help the immune system recognize the body's own tissue and keep complement in check.

Researchers at the University of Pennsylvania School of Medicine, in collaboration with colleagues at Utrecht University in the Netherlands, have determined the structure of C3 convertase and of the C3b fragment in complex with factor H. The work appears this month in two companion papers in Nature Immunology.

"Research on the complement system has waited more than 30 years for these structures," says senior author John Lambris, PhD, the Dr. Ralph and Sallie Weaver Professor of Research Medicine at Penn.

In the case of the C3 convertase structure, the researchers were able to make crystals by stabilizing the convertase complex with an inhibitor from the Staphylococcus aureus bacteria, called SCIN. SCIN freezes C3 convertase in an inactive state, preventing complement proteins from working further, and in turn, protecting the bacteria from attacking immune cells.

As a central component of C3 convertase, C3b forms an enzyme complex that cleaves its parent molecule C3, which leads to the generation and deposition of more C3b on the bacterial surface. The structure of C3 convertase provides important details about the molecular mechanisms behind these activation and amplification processes. When SCIN is bound to C3 convertase, the enzyme can no longer generate C3b and amplify the complement response, which likely renders the immune system less effective against staphylococcal infections.

"We plan to look for potential drugs that mimic the interaction of SCIN and C3 convertase and inhibit complement without triggering an adverse immune response," says Lambris. The crystals were therefore examined for critical interaction points between the SCIN inhibitor and C3 convertase.

The second study, describing the structure formed between C3b and factor H, a key regulator of the complement system, is important because of its suspected involvement in a number of immune-related diseases. "It was a surprise to see that the factor H fragment is spread across the entire C3b complex," notes Lambris.

Factor H binding inhibits C3 convertase activity and prevents the complement response from attacking the host's own cells. "This gives us a structural model for designing new therapies for several immune-mediated diseases," said Lambris.

Mutations in factor H are associated with age-related macular degeneration, the major cause of blindness in elderly people in the U.S; atypical hemolytic uremic syndrome, a rare but severe kidney disease that causes acute renal failure and high blood pressure; and membranoproliferative glomerulonephritis type II, another rare, progressive renal disorder also known as dense deposit disease.

"We observed that mutations in factor H could weaken its binding activity to C3b, and thus may lead to a loss of regulatory activity in the disease states," explains Lambris. Correlating disease-related mutations with functional consequences is likely to give insight into the pathogenesis of these and other diseases with immune or inflammatory components.

Current work is focused on designing drugs to counter the effect of SCIN or use it as a template for complement system-targeting therapeutics that target complement-mediated diseases: understanding the implications of the various factor H mutations on diseases, and developing an updated and more dynamic model of complement regulation.

Professor Bo Malmberg and Professor Gerdt Sundström at the School of Health Sciences in Jönköping, Sweden have studied loneliness among older people.

A common stereotype about older people is that loneliness is typical for older women, rather than for older men. One problem with this stereotype is that feelings of loneliness are not particularly common among either men or women in the Nordic countries.

"Some studies show a lower prevalence among women and some a lower among men. We use several national and local surveys to analyze gender differences in perceived loneliness. Longitudinal surveys, which enable us to analyze changes during ageing,", says Bo Malmberg and Gerdt Sundström

Older people who still live at home in communities in Scandinavian welfare states are either married or living alone, with the latter group reporting more of a sense of loneliness. Two mar­riages out of three end in the death of the husband, and if marital status is excluded from the equation, most of the differences in loneliness between the genders disappear.

Yet, in the 80+ age group, (the few) men who live alone report a higher frequency of loneliness than women in the same category. At that age, most men are still married, but most women are living alone. These patterns are even more pronounced in the 90+ age group.

"We interpret the results as the outcome of selection mechanisms and that they may reflect male-female differences in marital adaptation. Those men who survive and live alone are more often from a working-class background and in poor health, while women who live alone are socially and health-wise a more heterogeneous group", says Bo Malmberg and Gerdt Sundström.

There may also be a difference in marital back­ground, colouring the way men and women see their situation: men more often have had their wives as their only confidant, whereas women have a wider social network and may even see their new solitary life as a relief.

Dartmouth researchers have determined that movie characters who smoke, regardless of whether they are "good guys" or "bad guys," influence teens to try smoking. The study, published in the July 2009 issue of the journal Pediatrics, is titled "Adolescent Smoking: Who Matters More, Good Guys or Bad Guys?"

"Previous studies have confirmed a link between smoking in movies and the initiation of smoking by adolescents, and we wanted to dig deeper into the data to see if the type of character who is smoking matters. Is it 'good guys' or 'bad guys' that have more of an influence?" said Susanne Tanski, the lead author on the study, and an assistant professor of pediatrics at Dartmouth Medical School. "It's true that 'bad guys' are more often smokers in the movies, but there really are not that many 'bad guys' compared to 'good guys'. Episode for episode, youth who saw negative character smoking were more likely to start smoking, but since overall there is so much more exposure to 'good guy' smoking, the net effect is similar."

The survey also revealed that low-risk teens, based on sensation-seeking behavior, are more strongly influenced by "bad guy" movie smoking. "This suggests that it's alluring for 'good' kids to emulate the 'bad' characters on the movie screen," said Tanksi.

Tanski is part of a team of researchers at Dartmouth College and Dartmouth Medical School (DMS) who have been studying the connections between popular culture and risky behavior in adolescents. They have published numerous journal articles that document the link between exposure to smoking and drinking alcohol in movies and teens using tobacco and alcohol.

Tanski acknowledges that, although there is a downward trend, smoking still occurs in many movies that teens watch, particularly given the popularity of movie channels and video rentals providing access to older films. "Parents should limit movie viewing and specifically restrict access to R-rated movies, which tend to contain more smoking," she said. "When teens do see movies or TV shows that contain smoking, parents should talk with them in an effort to discourage initiation of smoking."

Women with breast cancer who receive chemotherapy appear more likely than those treated with radiation therapy to experience a major change in work status, according to a study published in the journal Cancer, Reuters reports. For the study, Dana-Farber Cancer Institute researcher Michael Hassett and colleagues used a large health insurance claims database to identify 3,233 women who were first diagnosed with breast cancer between 1998 and 2002. All of the women were younger than age 64, insured, and working full time or part time as of diagnosis. About 54% of the women received chemotherapy, and 58% received radiation therapy.

Hassett said that most of the women did "not experience a significant change in their employment after cancer diagnosis and treatment." However, of the 6.6% who experienced such a change, those who received chemotherapy had a 1.8-fold greater risk of leaving work, retiring or going on long-term disability leave in the subsequent year. Sixty-seven percent of women who experienced a change went from full-time employment to early retirement, while the rest went from full-time employment to long-term disability or retirement, or their status was unknown. Although the study looked at many factors, only chemotherapy and older age were associated with an increased likelihood of a change in employment. Hassett said that most of the participants in the study worked for large employers that offered health insurance. He added that further research is needed to evaluate the effect of cancer diagnosis and treatment on work status for women who are self-employed or work for smaller companies.