Wednesday, June 20, 2012

India Polio-Free For One Year

India, which was once a major polio hotspot, has reported no new cases of the disease in just over 12 months, ever since a two-year old female case on 13th January, 2011, in the state of West Bengal. According to WHO (World Health Organization), India used to be known as the planet's "epicenter" of polio.

WHO scientists say that as soon as all remaining lab investigations come back negative, India will be officially recognized as a nation that has stopped indigenous transmission of wild poliovirus, leaving just three countries with existing indigenous transmissions - Pakistan, Nigeria and Afghanistan.

Despite this major achievement, scientists say India must not become complacent. Childhood immunity against wild poliovirus must be religiously maintained, as should nationwide surveillance.

Unfortunately, and also rather worryingly, Pakistan and Afghanistan have had rising numbers of reported poliovirus infections over the last 12 months. Poliovirus found its way from Pakistan into China, re-infecting the country after it had been polio-free for over a decade.

Nigeria, DR Congo, and Chad continue having active polio transmission. There have also been sporadic outbreaks in Central and West Africa over the past year. Polio will remain a global threat as long as it exists somewhere in the world, says WHO.

Health experts and leaders throughout the world praised India for its dedication and commitment to the eradication of polio, as well as the millions of health workers, including vaccinators, community mobilizers, Rotarians, caregivers and parents who have been behind this drive over the last decade.

Over 170 million kids under 5 are vaccinated annually in India - this includes 70 million in very high-risk areas. A total of almost 1 billion polio vaccine doses per year have been administered in the country to people of all ages.

Hundreds of thousands saved - India's polio campaign means that hundreds of thousands of children throughout the country will be spared a lifetime of paralysis and/or premature death. The poliovirus can easily spread from affected to polio-free areas. Eradicating polio in India will make sure recurrences and outbreaks do not occur in other parts of the world.


WHO Director-General Margaret Chan, said:

"India's success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio. The Global Polio Eradication Initiative is in full emergency mode and focused on using this momentum to close this crippling disease down. Stopping polio in India required creativity, perseverance and professionalism - many of the innovations in polio eradication were sparked by the challenges in India. The lessons from India must now be adapted and implemented through emergency actions to finish polio everywhere."


UNICEF Executive Director, Anthony Lake, said:

"India's achievement is proof positive that we can eradicate polio even in the most challenging environments - in fact, it is only by targeting these areas that we can defeat this evil disease. We have the ability to protect every last person, especially children, from this entirely preventable disease - and because we can, we must finish the job of eradicating polio globally, once and for all."


Rotary International, President Kalyan Banerjee said:

"India is undoubtedly the biggest domino to fall in the polio eradication effort. India's success is a great credit to the Indian government and to Indian Rotary members - as well as those from around the world - who have worked with local leaders to conduct these immunization efforts to reach every child with the polio vaccine."


In order to maintain the progress made so far, it is crucial that India continues protecting its children through supplementary and routine vaccinations.

Dr. Thomas Frieden, Director of the U.S. Centers for Disease Control and Prevention, said:

"Polio's history contains many cautionary tales. Polio anywhere in the world is a risk everywhere in the world, and to protect itself from a setback, India is appropriately planning to continue meticulous monitoring and intensive childhood vaccination against polio."


Bill Gates, co-chair of the Bill & Melinda Gates Foundation, said:

"Polio can be stopped when countries combine the right elements - political will, quality immunization campaigns, and an entire nation's determination. World leaders must continue to raise the funds needed to run the global campaign and help to ensure that no child suffers from this crippling disease ever again."


WHO says focus must be maintained in improving anti-polio efforts in Pakistan, Nigeria and Chad.

By the end of next year, India will have donated over $2 billion towards polio eradication, according to WHO.

WHO informs that:

"When all pending specimens are processed (stools from children with acute flaccid paralysis and samples from sewage sampling), if no wild poliovirus is detected, India will no longer be considered polio-endemic. The laboratory system is expected to clear all samples within 4-6 weeks of collection."


GPEI (Global Polio Eradication Initiative) is a joint venture that includes Rotary International, the CDC, UNICEF, the CDC (USA), and national governments.
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The Upside Of "Gossip": Maintaining Social Order

Gossip is often considered an undesirable, unattractive feature of society, amounting to idle chatter that undermines trust and damages reputations, but now a new study suggests it has an upside, it helps maintain social order by keeping bad behavior in check, and preventing exploitation. And it also lowers stress.

Co-author and social psychologist Robb Willer said they had found evidence that gossip plays a vital role in maintaining social order:

"Spreading information about the person whom they had seen behave badly tended to make people feel better, quieting the frustration that drove their gossip."

Willer and colleagues found gossip has a therapeutic effect: volunteer's heart rates rose when they observed someone behaving badly, but then the heart rates lessened somewhat when they warned others about what they had witnessed.

For the study, the researchers focused on "prosocial" gossip, which is intended to warn others about untrustworthy or dishonest people. This is in contrast to other forms of gossip, such as voyeuristic rumor-mongering about a celebrity's latest exploits.

To study prosocial gossip, the researchers carried out four experiments where they monitored volunteers as they watched people playing an "economic trust game" against each other and where players' generosity was measured according to how many dollars or points they shared.

In the first experiment, 51 volunteers agreed to have their heart rate monitored as they watched two people play the game and observed their scores. After two rounds it was obvious from the score that one of the players was not playing fair and was hoarding all the points.

As they witnessed the cheating, the volunteer observers' heart rates rose, and in fact, when a new player came in to play against the cheat, many of the observers took the opportunity to slip them a "gossip note" to warn them about their opponent. When they did this, their heart rate went down somewhat.

Willer said being able to warn the new player made the observers "feel better":

"Passing on the gossip note ameliorated their negative feelings and tempered their frustration," he said.

In the second experiment, the researchers invited 111 participants to complete questionnaires about their level of altruism and cooperativeness, and then asked them to watch a screen that showed the scores from three rounds of the economic trust game. They could see from the scores that one of the players was cheating.

Again, they were given the chance to pass a gossip note to warn the next player. The observers also answered questions about how they felt about what they saw and their actions.

The results showed that the observers who scored the highest on the prosocial scales were the ones who reported feeling frustrated by the cheat's behavior, but then very relieved to be able to warn the vulnerable person, the next player, via the gossip note.

In the third experiment the researchers raised the stakes for the observers: they were asked to sacrifice the fee they were paid for taking part in the study if they wanted to pass the gossip note to the next player. And they were told their sacrifice would not affect the cheat's score. Even with the stakes set higher, the majority of the observers chose to forfeit their fee and send the warning gossip note.

And in the final experiment, the researchers recruited 300 game players from around the country to play several rounds of the same economic trust game online (they recruited them via Craiglist, the free online network for classified and other advertisements). The currency of the game was raffle tickets: winning tickets would be entered in a draw for a $50 cash prize, so there was an incentive to hold on to as many of these as possible.

However, the difference with this game was that some of the players were told at the start that the volunteers observing the game would have a chance during a break to pass a gossip note to the players of the next round to warn them about the behavior of cheats. The threat of being the subject of "negative" gossip spurred nearly all of these players to play fairly, even the ones who had scored low on altruism in questionnaires they had completed at the outset.

The researchers conclude that the results of experiments 1, 2 and 3 show that:
  • People who witness a negative act feel bad (experience negative affect), and are compelled to pass on their information to a potentially vulnerable person.

  • Sharing this information reduces the negative affect that arose from seeing the antisocial behaviour.

  • People who are more prosocial are the ones most motivated to engage in such "gossip", even at personal cost, and are the ones most likely to experience the greatest reduction in negative affect.
They conclude that experiment 4 shows that "prosocial gossip can effectively deter selfishness and promote cooperation".

Willer said taken together, the results of all four experiments demonstrate that we become frustrated when see people behave immorally.

"But being able to communicate this information to others who could be helped makes us feel better," he added.
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Roux-en-Y Gastric Bypass Better Than Gastric Banding For Rapid And Safe Weight Loss

Roux-en-Y gastric bypass (RYGBP) and gastric banding (GB). The researchers found that for more sustainable and rapid weight loss, RYGBP is the better form of treatment.

Sebastien Romy, M.D., of Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, and colleagues, comment that although early morbidity is higher among patients receiving RYGBP, there were significantly fewer long-term complications and re-operations, compared to those receiving GB.

They noted:

"At the present time, RYGBP seems clearly superior to GB when treating morbidly obese patients, who should be informed accordingly."


The percentage of people who are morbidly obese has shot up over the past two decades. A recent survey shows that the number of bariatric procedures has increased drastically, more than doubling between 2003 and 2008. Of these procedures, in the U.S there was a much greater increase for GB than RYGBP. This is likely due to marketing campaigns and the thought that GB is a "simple and safer" procedure.

The study observed 442 patients, half of whom received GB treatment, whilst the other half received RYGBP treatment. The two groups were balanced in accordance to age, sex, and body mass index (BMI). The study period was six years long and had a follow-up rate of 92.3 percent.

Results taken after the six years showed that the percentage of failures (BMI above 35 or reversal of the procedure/conversion) in the GB group was 48.3 percent, compared to only 12.3 percent in the RYGBP group. Those in the GB group were also more likely to face reoperations (26.7 percent compared to 12.7 percent) and long-term complications (41.6 percent compared to 19 percent).

In relation to the treatment of other comorbidities - other existing illnesses among the patients - RYBGP was also found to be more successful. Cholesterol levels in those who received GB remained unchanged, but those who received RYBGP saw a notable decrease. The lipid profile for those after RYGBP was "significantly better" after five years than for those in the GB group, as well as a lower mean fasting glucose level.

The researchers note:

"On the basis of our results and the analysis of the literature, we conclude that RYGBP provides better, more rapid, and more sustained weight loss, resulting in better correction of comorbidities than GB,"
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Chemotherapy During Pregnancy Does Not Risk The Child's General Health

A recent study published by the The Lancet Oncology indicates that children of women who received chemotherapy during their pregnancy suffer no adverse effects, developing as well as children in the general population. The study was led by Dr Frédéric Amant, Multidisciplinary Breast Cancer Center, Leuven Cancer Institute, Katholieke Universiteit Leuven, Belgium.

The researchers assessed 68 pregnancies of mothers who received an average of three to four cycles of chemotherapy - a total of 236 cycles. The average age of cancer diagnosis for the mothers was 18 weeks into pregnancy. The median gestation age of birth was at 36 weeks, with two thirds (47) of the women giving birth before 37 weeks. A total of 70 children were assessed, ranging from ages 1.5 to 18 years.

They carried out a series of tests on the children to examine their overall health and development, including: Bayley or intelligence quotient tests, electrocardiography and echocardiography, and a questionnaire on general health and development. Children above the age of 5 were given more tests such as the Auditory Verbal Learning Test, audiometry, the Test of Everyday Attention for Children, and their parents were to complete a 'Child Behavior Checklist'.

Neurocognitive outcomes were within normal ranges for children born at full term, children born preterm, however, had lower results, but the authors stress that this difference is found among the general population as well. The results of the tests indicated that the children's behavior, general health, heart dimensions/function, hearing, and growth were all equal to the average results of children in the general population.

  The authors said:


"We show that children who were prenatally exposed to chemotherapy do as well as other children... Our findings do not support a strategy of delay in chemotherapy administration or iatrogenic (ie physician induced) preterm delivery with post-partum chemotherapy administration to avoid harm to the fetus."


They also add:

"The decision to administer chemotherapy should follow the same guidelines as in non-pregnant patients. In practice, it is possible to administer chemotherapy from 14 weeks gestational age onwards with specific attention to prenatal care."


 They stress the need for a follow-up with more children over a longer period to provide more certainty on whether or not chemotherapy in pregnancy has any detrimental health effects on children.

  Dr Elyce Cardonick, Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, NJ, USA, comments:

"The study by Amant and colleagues has the potential to affect clinical practice: if we can present this reassuring data to pregnant women with cancer, women might be more likely to accept treatment during pregnancy when indicated. This report might encourage oncologists and obstetricians to recognise the advantages of collaboration when the subject under study such as cancer in pregnancy is rare."
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National Alzheimer's Plan, USA - HHS Sets 2025 Deadline

US Health Authorities have set 2025 as the deadline for coming up with an effective Alzheimer's disease treatment. Some would say this is over-ambitious, because there is no current cure for the disease; and none in the pipeline either. The Alzheimer's Association informs that during the second meeting of the Advisory Council on Alzheimer's Research, Care and Services, ". . . in-depth discussions took place about goals and strategies to change the trajectory of Alzheimer's disease."

Harry Johns, president and CEO of the Alzheimer's Association and member of the Advisory Council, said:

"Alzheimer's can't wait and families won't forget. For the first time ever, families grappling with this progressive, degenerative and ultimately fatal disease can have real hope that a national strategy addressing the escalating Alzheimer's crisis is coming."


The Alzheimer's Association says that approximately 5.4 million people in the USA live with Alzheimer's, while a further 15 million family members and friends provide round-the-clock care. This year, the Alzheimer's disease economic toll will reach about $183 billion in the USA, and is expected to exceed $1 trillion by the middle of this century.

Of the ten leading causes of death today, Alzheimer's is the only one with no treatment to prevent or cure it, or even slow down its progression.

According to Alzheimer's Disease International, there are about 37 million people globally living with Alzheimer's - numbers are expected to rise to 66 million in 2030 and 115 million in 2050.

The national Alzheimer's plan is a result of the new law signed in by President Obama - The National Alzheimer's Project Act (NAPA). The law authorized the current process to devise a national plan for the disease. The (Alzheimer's) Advisory Council was also created as a result of the new law - it consists of stakeholders from the whole spectrum of the Alzheimer's community, as well as representatives from several relevant federal agencies. The Council has been told to provide the HHS Secretary with recommendations for a national plan.

John's added:

"This process is about changing the course of Alzheimer's disease. It is about setting the path for that change right away with an aggressive timeline. Developing an urgent, achievable and accountable strategy for Alzheimer's is about hope for millions of people today and tomorrow. What we need now is a meaningful plan with appropriate resources that, when fully implemented, will bring us from possibility to reality."


Among its several recommendations, the Advisory Council says an extra $2 billion should be spent annually on Alzheimer's research. A Council Subcommittee is looking into electing a person who is responsible and accountable for putting the National Plan into action.

Several countries, such as South Korea, France and Australia, have thorough Alzheimer's plans already in place. Experts have been commenting for a while now that the USA needs one too.

Dr. Howard Koh, HHS Assistant Secretary for Health, said in an interview with Reuters:

"We want to demonstrate that as a country we are committed to addressing this issue.

We know the projected number of patients is expected to rise in the future. We know there are far too many patients who are suffering from this devastating condition and it is affecting them and their caregivers."


Several experts comment that similar drives on cancer and HIV/AIDS have no deadlines. They add that perhaps the focus should simply be on continuing the fight and making progress. There is concern that by placing a deadline, the whole project is setting itself up for failure if no cure is found for Alzheimer's by 2025.

Secretary of State, Hillary Clinton set a goal for eliminating the disease last year, thirty years into the fight against AIDS. AIDS has received enormous amounts of funding, Alzheimer's, in contrast, has not.

Many experts say that without public funding, most pharmaceutical companies will not pursue medical breakthroughs in Alzheimer's. Earlier this week Pfizer Inc and Medivation Inc announced the end of their collaboration with Dimbebon, an experimental drug that many had hoped might improve cognitive ability in late-state Alzheimer's - the drug failed to improve signs and symptoms.
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Sign Of Autism Can Be Seen In Infants

A recent study that took place at the Centre for Brain and Cognitive Development, Birkbeck, University of London, and was published in the January edition of Current Biology, states that detecting autism symptoms in babies as young as 6 months old can help to determine how the autism will develop later in the child's life. The researches found that babies show signs of autism in their first year of life. When the babies are looked at, or when someone looks away from them, their brain responds differently compared to other babies.

Professor Mark Johnson, MRC scientist and head of the Centre for Brain and Cognitive Development at Birkbeck, lead the study. He said:

The study is only a first step toward earlier diagnosis, but our findings demonstrate for the first time that direct measures of the brain functioning during their first year of life associate with a later diagnosis of autism - well before the emergence of behavioral symptoms.


At present, most children are diagnosed with autism after the age of 2. These diagnoses are made after carefully evaluating the child for the first 2 years. Johnson and team analyzed children ages 6 to 10 months old who had either a brother or sister with autism, because these children had a greater chance of developing the condition themselves.

To determine their findings, the researches put passive sensors on the children's heads to determine their brain activity when observing someone looking at them and then looking away, and the other way around. The reason this is important is because face-to-face socializing is a very important factor in human interactions and behavior. Children who have been diagnosed with autism tend to inhibit out of the ordinary eye contact and brain response patterns.

Johnson states:

At this age, no behavioral markers of autism are yet evident, and so measurements of brain function may be a more sensitive indicator of risk.


His study shows that infant brains that will eventually show autism already process information differently as tiny babies. The study did, however, determine that not all babies showed irregular brain patterns and were later diagnosed with autism. Also, some infants who did show the irregular patterns did not end up having autism later on in life.

Professor Christopher Kennard, Chair of the MRC's Neuroscience and Mental Health funding board stated:

This is a very interesting study which suggests that early signs of brain responses to eye contact can contribute to an earlier diagnosis for children at high risk of autism; crucial for ensuring that they receive appropriate care. An investment like this can improve our understanding of the basis of autism, which hopefully will lead to new ways of treating those affected in the future and so dramatically affect the quality of life for patients and their families.


Professor Tony Charman of the Centre for Research in Autism and Education at the Institute of Education co-led this study. It was funded by the UK Medical Research Council and the BASIS funding consortium led by Autistica.
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A Broken Heart Breaks Your Heart, Literally !

Heart attack risk after bereavement is much higher for several weeks after the loss. The day the loved one dies, the risk of a heart attack is a stunning twenty one times higher.

The article also warns friends and family to look for signs of heart failure in the bereaved person, ensuring they relax and maintain any medication regime they may be on.

The study was conducted with nearly 2000 adult heart attack survivors and while the risk of a heart problem declined over the first month, it still remained at six times the normal risk during the first week after a loved one died.

Murray Mittleman, M.D., Dr.P.H., a preventive cardiologist and epidemiologist at Harvard Medical School's Beth Israel Deaconess Medical Center and School of Public Health's epidemiology department in Boston, Mass. said:

"Caretakers, healthcare providers, and the bereaved themselves need to recognize they are in a period of heightened risk in the days and weeks after hearing of someone close dying."


This is the first study of its kind to focus on the effects of emotional events in our lives, on the heart.

Broken heart syndrome is a well documented effect, but it is not thought to produce any lasting health problems, and while it may be true that those suffering from symptoms of a broken heart generally recover with no ill effect, it certainly appears that others, while not suffering from the "pseudo" heart attack of broken heart syndrome, jump straight into full blown symptoms and physical heart issues.

Researchers say that figures show that 1 in 320 people who are at high risk for heart failure and 1 in nearly 1,400 people who are at low risk, will suffer increased heart problems due to a bereavement. Additionally, the grieving spouses are more likely to die in the future, with heart attacks and strokes accounting for 53 percent of their deaths.

As part of the multicenter study, the scientists analyzed charts and talked with patients while in the hospital, after a confirmed heart attack between 1989 and 1994. Patients answered questions about circumstances surrounding their heart attack, as well as whether they recently lost someone significant in their lives over the past year, when the death happened, and the importance of their relationship.

Researchers used a case crossover design to compare patients over the past six months. The approach eliminated the possible confounding factors of comparing different people. The authors also estimated the relative risk of a heart attack by comparing the number of patients who had someone close to them die in the week before their heart attack, to the number of deaths of significant people in their lives from one to six months before their heart attack. Psychological stress, such as that caused by intense grief, can increase heart rate, blood pressure, and blood clotting, which can raise the chances of a heart attack.

The information should be particularly useful for healthcare professionals and family members alike. The grieving process can cause a person to get less sleep, have a lower appetite and higher cortisol levels, all of which are associated with heart attacks. It's also easy for a person who is in a state of emotional shock from a sudden loss, to neglect medications, fail to eat correctly, or eat more harmful foods, drink and smoke more, and so forth.

Elizabeth Mostofsky, lead author of the research said:

"Friends and family of bereaved people should provide close support to help prevent such incidents, especially near the beginning of the grieving process."


Her colleague Dr. Mittleman said:

"During situations of extreme grief and psychological distress, you still need to take care of yourself and seek medical attention for symptoms associated with a heart attack."


Heart attack signs include chest discomfort, upper body or stomach pain, shortness of breath, breaking into a cold sweat, nausea, or lightheadedness.

Co-authors Elizabeth Mostofsky, M.P.H, Sc.D.; Malcolm Maclure, Sc.D.; Jane Sherwood, R.N.; Geoffrey Tofler, M.D.; and James Muller, M.D. recommend a more in depth study of the issues.

The report doesn't make any mention of the age of the participants, you'd have to assume that it would be more likely to affect the elderly. They say that a divorce is worse than a death, since you have to reconcile not only the loss, but deal with a living person also, and whilst most heated divorces take place at a younger age, it would still be interesting to assess the effect of other emotional events such as this, on the bodies health, as well as the factor of age of a person.
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More Black Tea Lowers Blood Pressure

Tea, the second most consumed drink after water, may help lower blood pressure. Scientists at The University Of Western Australia and Unilever, state in Archives of Internal Medicine, that drinking black tea three times a day may drastically lower a person's systolic and diastolic blood pressure.

Leading the research, Jonathan Hodgson, professor at UWA's School Of Medicine and Pharmacology says:


There is already mounting evidence that tea is good for your heart health, but this is an important discovery, because it demonstrates a link between tea and a major risk factor for heart disease.


During their study, the researchers examined 95 Australians, ages 35 to 75. A portion of the participants were asked to drink black tea, three times daily, while the others were given a placebo that tasted identical and contained the same caffeine content, but did not originate from tea.


Black tea
Black tea appears to have cardiovascular benefits


Six months later, the researchers examined the findings. They concluded that the people who drank the black tea were found to have lower 24-hour systolic and diastolic blood pressure; between 2 and 3 mmHg lower.

Professor Hodgson states

Blood pressure measurement consists of two numbers. The First is the systolic and measures blood pressure when the heart beats, or contracts to push blood through the body. The second number is the diastolic and measures the amount of pressure in between beats when the person is at rest.


Hodgson also says:

More research is required to better understand how tea may reduce blood pressure, although earlier studies reported a link between tea drinking and the improved health of people's blood vessels.
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Junk Food Linked To Weight Gain In Schools? Apparently Not

Despite a tripling of obesity rates in US schools over the last forty years, and an increase in junk foods, candy and sugary drinks availability in schools, a new study claims to demonstrate that the two are not linked - put simply, the study researchers say that junk food at school does not appear to be associated with higher obesity and overweight rates. The study has been published in Sociology in Education, and was authored by Jennifer Van Hook, a Professor of Sociology and Demography, and doctoral student Claire Altman.

Prof. Hook said:

"We were really surprised by that result and, in fact, we held back from publishing our study for roughly two years because we kept looking for a connection that just wasn't there."


Prof. Hook and Claire E. Altman gathered data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999. The large study tracked the children all the way up to eighth grade. The researchers focused on a sample of 19,450 kids during the years 2003-2004 (fifth graders) and 2006-2007 (eighth graders).

Junk food was available in 86.3% of the eighth graders' schools and 59.2% of the fifth graders'.

Even though the percentage rise in junk food availability and accessibility from fifth to eighth grade was significant, the obesity/overweight rates in the two age groups remained pretty much the same. In fact, (obesity/overweight) rates dropped as the children got older - from 39.1% in fifth graders to 35.4% in eighth graders.

Van Hook said:

"There has been a great deal of focus in the media on how schools make a lot of money from the sale of junk food to students, and on how schools have the ability to help reduce childhood obesity. In that light, we expected to find a definitive connection between the sale of junk food in middle schools and weight gain among children between fifth and eighth grades.

But, our study suggests that - when it comes to weight issues - we need to be looking far beyond schools and, more specifically, junk food sales in schools, to make a difference."


The authors believe that authorities need to focus on the home and family environments, plus other broader non-school environments, if they want to tackle childhood obesity effectively.

Van Hook explained:

"Schools only represent a small portion of children's food environment. They can get food at home, they can get food in their neighborhoods, and they can go across the street from the school to buy food. Additionally, kids are actually very busy at school.

When they're not in class, they have to get from one class to another and they have certain fixed times when they can eat. So, there really isn't a lot of opportunity for children to eat while they're in school, or at least eat endlessly, compared to when they're at home. As a result, whether or not junk food is available to them at school may not have much bearing on how much junk food they eat."


According to the findings in this study, combating childhood obesity/overweight is most effective when younger children are targeted.

The authors wrote:

"There has been a lot of research showing that many children develop eating habits and tastes for certain types of foods when they are of preschool age, and that those habits and tastes may stay with them for their whole lives," Van Hook said. "So, their middle school environments might not matter a lot."
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Dutasteride Slows Down Early Stage Prostate Cancer Progression

A study published Online First in The Lancet has found that a common medication (dutasteride) used to treat enlargement of the prostate, may also reduce the need for treatments that pose risks of incontinence and impotence and delay growth of early-stage prostate cancer.

Neil Fleshner, lead researcher of the investigation from Princess Margaret Hospital, Toronto, Canada, said:

"Our trial is the first study to show the benefits of use of a 5α-reductase inhibitor to reduce the need for aggressive treatment in men undergoing active surveillance for low-risk prostate cancer...delaying their time to pathological progression and initiation of primary therapy."


In the United States about 20% of males will be diagnosed with the disease, although the majority will have low-risk (low-grade, low-volume) prostate cancer. For them, it can be appropriate to stay under conservatively managed active surveillance, meaning they do not have to undergo immediate therapy in favor of regular assessment and biopsies to monitor the disease.

Dutasteride is a 5α-reductase inhibitor that works by preventing testosterone from converting to dihydrotestosterone (the male sex hormone involved in the development of prostate cancer). The drug has been approved for treating benign prostatic hyperplasia, a non-cancerous enlargement of the prostate, and has shown to decrease the volume of some prostate cancers.

302 men aged between 48 to 82 years old undergoing active surveillance for low-risk localized prostate cancer were enrolled to participate in the Reduction by Dutasteride of Clinical Progression Events in Expectant Management (REDEEM). The researchers randomly assigned the participants to two groups; one group received 0.5 mg dutasteride once daily for 3 years, while the other group received placebo for the same duration.

In order to measure time to disease progression, participants received biopsies at 18 months and 3 years. In addition, the researchers gave participants a questionnaire in order to examine anxiety associated to the disease.

The researchers found that dutasteride considerably delayed disease progression in comparison with placebo - 48% of men given placebo experienced disease progression compared with 38% of participants receiving dutasteride.

Furthermore, cancer was less likely to be detected at final biopsy for participants in the dutasteride group (36% [50 men]) compared with 23% (31) men in the placebo group. Throughout the duration of the study, those who received dutasteride also reported considerably lower cancer-related anxiety compared with men in the placebo group.

Similar side effects were observed between both groups. Drug-related adverse effects, consisting mainly of adverse sexual events or breast enlargement or tenderness, were experienced by more participants in the dutasteride group (24%) than those given placebo (15%). There were no cases of disease spread or deaths related to prostate cancer during the duration of the study.

In an associated comment, Chris Parker from the Royal Marsden National Health Service Foundation Trust, Sutton, UK warns:

"These data are consistent with the hypothesis that dutasteride reduces the volume of low-grade prostate cancers but has no effect, or even an adverse effect, on the progression of high-grade disease. Thus, although reducing overall prostate cancer detection, dutasteride could plausibly have no effect (or possibly a deleterious one) on prostate cancer mortality."


The researchers conclude:

"The benefit of dutasteride is to reduce the amount of low-grade cancer, not to reduce the risk of being diagnosed with higher-grade cancer. This reduction leads to fewer men with biopsy-detectable prostate cancer, and therefore fewer treatment interventions. Dutasteride...provides a treatment option for men with low-risk, localized disease."
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Older Women On Statins Have Higher Risk Of Diabetes

According to a study published Online First in the Archives of Internal Medicine, one of the JAMA/Archives journals, using statins in postmenopausal women, is linked to an increased risk of diabetes.

However, researchers point out that statins address the cardiovascular consequences of diabetes, and that the latest American Diabetes Association guidelines for primary and secondary prevention should not change. The authors advise not changing guidelines for statin use in nondiabetic populations.

Annie L. Culver, B. Pharm, Rochester Methodist Hospital, Mayo Clinic, Rochester, Minn., and her team evaluated data from the national, multiyear Women's Health Initiative until 2005, which included 153,840 women without diabetes, aged on average 63.2 years. The researchers examined statin use at enrollment, and in year three. 7.04% of women reported to receive statin medication at baseline.

According to the findings, 10,242 new cases of diabetes and statin use at baseline was linked to an increased risk of diabetes. The results remained unchanged following adjustment for other potential variables, such as age, race/ethnicity and body mass index, and did not differ between all types of statins.

The researchers comment:

"The results of this study imply that statin use conveys an increased risk of new-onset DM in postmenopausal woman. In keeping with the findings of other studies, our results suggest that statin-induced DM is a medication class effect and not related to potency or to individual statin.

However, the consequences of statin-induced DM (diabetes mellitus) have not been specifically defined and deserve more attention. Given the wide use of statins in the aging population, further studies among women, men, and diverse ethnicities will clarify DM risk and risk management to optimize therapy."
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What Are Warts? What Causes Warts?

Warts are skin growths which are caused by the human papillomavirus (HPV) - they are non-cancerous. The virus causes keratin, a hard protein in the epidermis (the top layer of the skin) to grow too fast. Warts are different from moles. While moles are dark and can be quite large, warts tend to be small, skin-colored rough lumps. Warts most commonly appear on a person's hands and feet.

The appearance of a wart can vary depending on what part of the body it is, as well as how thick the skin is. A wart that is located on the sole of the foot is known as a verruca.

What are the different types of warts?

Experts say there are several different kinds of warts. According to the National Health Service (NHS), UK, a survey of 1,000 children with warts found that:
  • 74 per cent of them had common warts
  • 24 per cent of them had verrucas
  • 3.5 per cent of them had plane warts
  • 2 per cent of them had filiform warts

  • Common warts (verruca vulgaris) - these have a rough surface. They are firm and raised and may have a cauliflower surface type look. They are thickened bumps called papules or plaques. Common warts may appear in any part of the body, but are more common on the knuckles, fingers, elbows and knees. Often they have tiny dark spots which are from blood vessels that have clotted. 
  • Verrucas (plantar warts) - these appear on the soles of the feet, sometimes the heel and toes. They usually grow back into the skin because the weight of the person pushes onto the sole of the foot. They can be painful. It is common for verrucas to have a black dot in the middle, with a surrounding hard, white area. The dark dot is the wart's blood supply.

  • Plane warts (verruca plana) - plane (plana) means flat. Plane warts are round, flat and smooth. They are generally yellowish, brownish or skin color. They are also known as flat warts and are more common among young children. They are usually found on the hands, legs and face. Adults can have plane warts, but this is unusual.

  • Filiform warts (verruca filiformis) - these are long and can usually be found on the eyelids, neck and armpits.

  • Mosaic warts - these grow in clusters. Palmar warts are mosaic warts that grow on the palm of the hands and feet.

When should you see your doctor?

If you are sure it is a wart tell your doctor next time you see him/her. Most warts do not need to be treated medically. Most warts disappear on their own. If you are not sure and wonder whether it may be something else, go and see your doctor to have it checked.

You should definitely see a doctor if the wart causes pain, bleeds easily, changes appearance, spreads easily to other parts of your body, or comes back. If you want the wart removed for cosmetic reasons see your doctor. Podiatrists (foot specialists) can give people advice about verrucas.

What are the causes of warts?

Different HPV (human papilloma virus) strains cause warts. The wart-causing virus can be passed on by close skin-to-skin contact, as well as through contact with towels or shoes.

The wart-causing virus can be spread to other parts of the body in the following ways:
  • If somebody scratches or bites a wart
  • Sucking fingers
  • Biting fingernails can cause warts to spread on the fingertips and around nails
  • Shaving (face or legs)
A person whose skin is damaged, wet, or comes into contact with rough surfaces is more likely to catch the infection. For example, a person with scratches or cuts on the soles of his/her feet is more likely to catch verrucas in and around public swimming pools.

As we all have different immune systems some of us may develop warts when we come into contact with HPV, while others don't. The risk of catching warts from another person is fairly small, but it exists. Genital warts are much more contagious.

How are warts and verrucas diagnosed?

Warts and verrucas are generally easy for doctors to identify just by looking at them. The doctor may ask whether any other family members have warts. Occasionally, he/she may take some tissue from a wart and examine it under a microscope.

What is the treatment for warts?

The majority of warts clear up without any treatment. How long it takes for them to clear up varies considerably from person to person. They tend to clear up faster among young children. Some warts may take several years to clear up. Less commonly, warts may clear up without treatment within weeks.

Some treatments may cause the skin around the wart to become irritated, others may cause pain, and even blistering. The type of treatment depends on where the wart is located and how many of them there are:
  • Salicylic acid - most creams, gels, paints and medicated plasters that you can get at a pharmacy without a prescription contain salicylic acid. Studies indicate that salicylic acid treatment usually gets rid of most warts within three months. It is important to protect the skin before applying treatment. This is because salicylic acid may destroy healthy skin. Petroleum jelly or a corn plaster may be used to protect the skin around the wart.

    Before applying the medication soak the wart in water for about five minutes. Rub dead tissue off the surface of the wart each week using a pumice stone or emery board. Make sure you do not share it with anybody else. In most cases treatment is applied daily for about three months. If the skin becomes sore, stop the treatment.

    Medications containing salicylic acid should not be used on the face. Patients with poor circulation should not use medications that have salicylic acid without checking with their doctor.

  • Duct tape - some people use duct tape in order to get rid of warts. They should never be used for warts on the face. Duct tape is placed over the wart and left there for about six days, and then removed. The wart is then soaked in warm water for about five minutes after which the dead tissue is gently rubbed off using an emery board or pumice stone. It is important that the emery board or pumice stone is not used by anybody else. The wart is then left uncovered overnight and a new piece of duct tape is placed the next day.

  • Cryotherapy - very cold liquid, possibly nitrogen, is sprayed on to the wart, freezing it and destroying the cells. A blister develops, which eventually turns into a scab and falls off a week or so later. This treatment has to be done by a healthcare professional and may require a local anesthetic. If the wart is large several treatments may be required over a number of weeks. Cryotherapy has a lower risk of skin irritation compared to medications containing salicylic acid or the use of duct tape. Pharmacies sell dimethyl-ether/propane spray which the patient can use himself/herself - this should not be used on the face.

  • Surgery - this is less common for warts. Warts treated with surgery often come back. Surgery has a higher risk of scarring. However, sometimes a doctor may recommend surgery, which will generally be performed under local or general anesthetic. Surgery may be recommended if other treatments have not worked. If the wart is very big it will be cut out. Smaller warts may be scraped off using a curette.

  • Laser treatment - a precise laser beam is used to destroy the wart. Laser treatment is usually recommended for warts that are hard to treat.

  • Electrocautery - an electric current is used to burn off the wart.

  • Photodynamic therapy - the wart cells absorb a chemical. This chemical is activated by light - usually laser light - and destroys the wart cells.

  • Chemical treatments - these are available on prescription. They may include formaldehyde, glutaraldehyde and podophyllin. They must be applied only on the wart, and not on the surrounding skin.

  • Cantharidin - this is a substance which is extracted from the blister beetle. The doctor will apply it onto the warts. Usually this extract is mixed with other chemicals, applied onto the skin and covered with a bandage. It is painless; however the resulting blister may be uncomfortable. The blister lifts the wart off the skin so that the doctor can them remove the dead part of the wart.
Doctors may sometimes treat pregnant patients, or they may decide to wait until after the pregnancy is over.

If warts have not responded to standard treatments a GP (general practitioner, primary care physician) may refer the patient to a dermatologist (skin specialist). The dermatologist may use some of the treatments below:
  • Immunotherapy - the aim here is to get the patient's immune system to destroy the warts.

  • Bleomycin (Blenoxane) - this is injected into the wart and kills the virus. Bleomycin is also used for treating some types of cancer.

  • Retinoids - these disrupt the wart's skin cell growth. Retinoids are derived from vitamin A.

  • Antibiotics are not effective for treating warts. Antibiotics are used for bacterial infection, not viral infections. Warts are caused by a virus.
  • A common flower that helps wipe out garden insects has also shown promise in eradicating stubborn warts, a study found.
Common warts may be difficult to eliminate completely or permanently, especially those located around and under the fingernails and toenails. Many people who are susceptible to warts will regularly have them, even after successful treatment. Experts say that sometimes more than one treatment approach is needed for better management of warts.

Complications

  • Some people who have many warts, especially on their face, may find their self-confidence is affected.

  • Some treatments may cause pain and irritate the skin around the wart.

  • Although scarring is possible, it is unusual.

  • It is harder to successfully treat warts if the patient has a weakened immune system.

  • People with weakened immune systems are at a higher risk of their warts becoming malignant. Even so, this is rare.

Prevention

  • Do not touch other people's warts.

  • Do not use towels, flannels or other personal items of people who have warts.

  • Do not share shoes and socks with a person who has verrucas.

  • Do not scratch your warts or verrucas. If you do they will most likely spread.

  • Wear sandals when going into and out of communal showers.

  • Wear sandals when walking around communal pools.

  • Cover your wart/verruca with a waterproof plaster (band aid) when you go swimming.

  • There are special socks you can buy to cover verrucas.

  • Wear gloves in the gym if you have warts on your hands.

  • Do not brush, comb, shave, clip areas that have warts.

  • When filing or cutting your nails do not use the same utensil on the infected nail and then on the healthy nails.

  • Do not bite your fingernails if you have warts near them.

  • Keep your hands as dry as possible.

  • Wash your hands thoroughly after touching a wart.
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What Are Skin Tags? What Causes Skin Tags?

A skin tag, also known as an acrochordon, cutaneous papilloma, cutaneous tag, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, papilloma colli, soft fibroma, and Templeton skin tag, is a small tag of skin which may have a peduncle (stalk) - they look like a small piece of soft, hanging skin.

They can appear on any part of the surface of the body (skin), but most typically exist in areas where skin may rub against skin, such as the:
  • Eyelids
  • Axillae (armpits)
  • Under the breasts
  • Groin
  • Upper chest
  • Neck
Skin tags are invariably benign - non cancerous - tumors of the skin which cause no symptoms, unless it is repeatedly rubbed or scratched, as may happen with clothing, jewelry, or when shaving. Very large skin tags may burst under pressure.

Skin tags are composed of a core of fibers and ducts, nerve cells, fat cells, and a covering or epidermis.

Some people are more susceptible to tags, either because of their overweight, partly due to heredity, and often for unknown reasons. People with diabetes and pregnant women tend to be more prone to skin tags. Dermatologists say that skin tags affect males and females equally.

Some people may have had skin tags and never noticed them - they would have rubbed or fallen off painlessly. In most cases, however, they do not fall off.

According to Medilexicon's medical dictionary:

A skin tag is

1. a polypoid outgrowth of both epidermis and dermal fibrovascular tissue

2. embryology a skin-covered projection that may or may not contain cartilage; typically located in a line between the tragus of the ear and the corner of the mouth and associated with external ear anomalies.


The surface of skin tags may be smooth or irregular in appearance, they are often raised from the surface of the skin on fleshy peduncles (stalks). They are usually flesh-colored or slightly brownish.

Initially they are quite small, flattened like a pinhead bump. Skin tags can range in diameter from 2mm to 1cm; some may even reach 5cm.

As skin tags more commonly occur in skin creases or fold, it is believed they are mainly caused by skin rubbing against skin.

What causes skin tags?

Skin tags are very common and generally occur after midlife. They are said to be caused by bunches of collagen and blood vessels which are trapped inside thicker bits of skin.

They are believed to be the result of skin rubbing against skin. That is why they are generally found in skin creases and folds.

Risk factors - a risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2. Skin tags are more common in:
  • People who are overweight and obese, probably because they have more skin folds and creases.
  • Pregnant women - most likely because of the hormones secreted.
  • Individuals with diabetes.
  • People with the human papilloma virus (low-risk HPV 6 and 11).
  • Illegal steroid use - they interfere with the body and muscles, causing the collagen fibers in the skin to bond, allowing skin tags to be formed.
According to the NIH (National Institutes of Health), USA, approximately 46% of people have skin tags.

A causal genetic component is thought to exist, i.e. susceptibility may be genetic. People with close family members who have skin tags are more likely to develop them themselves.

Skin tags are rarely associated with:
  • Birt-Hogg-Dubé syndrome
  • Polycystic ovary syndrome
A skin tag is also known as acrochordon, cutaneous papilloma, cutaneous tag, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, papilloma colli, soft fibroma, and Templeton skin tag.
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Red Wine Reduces Breast Cancer Risk

The authors explained that the chemicals in the seeds and skins of red grapes slightly reduce estrogen levels and raise testosterone among premenopausal females - thus reducing their breast cancer risk.

The authors stress that it is the red grape that has the beneficial compounds, and not just red wine. They suggest that women should consider red wine when choosing an alcoholic beverage to consume, rather than encouraging wine over grapes.

This study contradicts in part a widespread belief that the consumption of all types of alcoholic drinks raises a woman's chances of developing breast cancer, because alcohol raises estrogen levels, which in turn encourages the growth of cancer cells.

However, the researchers found that premenopausal women who consumed eight ounces of red wine every evening for approximately a month, had lower estrogen and higher testosterone levels. They tried out the same with another group of women, but they had to consume white wine - it did not have the same effect.

Moderate female alcohol drinkers should perhaps reassess their choices, the authors suggested.

Study co-author, Chrisandra Shufelt, MD, wrote:

"If you were to have a glass of wine with dinner, you may want to consider a glass of red. Switching may shift your risk."


There are over 230,000 new diagnoses of breast cancer each year in the USA - it is the leading type of female cancer in the country, the authors wrote. Approximately 39,000 adult females died from breast cancer in 2011, says the American Cancer Society.

The study involved 36 premenopausal females. They were randomly selected into two groups:
  • The red wine group (Cabernet Sauvignon)
  • The white wine group (Chardonnay)
For one month, they drank eight ounces of their designated wine every evening. During the second month they swapped groups, i.e. the women on white wine during the first one switched to red wine during the second month. Blood was collected from each participant four times, twice each month, to check for levels of hormones.

The scientists wanted to find out the ingredients of red wine might imitate what aromatase inhibitors do. Aromatase inhibitors are drugs that inhibit aromatase, an enzyme which is involved in estrogen levels. Aromatase inhibitors are used in breast cancer therapy.

They found that red wine lowers estrogen levels, which in turn should stem cancer cell growth. They added that test tube studies had indicated the same thing.

Co-author Glenn D. Braunstein, MD, explained that even though white wine (grapes) appears to lack the protective elements found in red wine (grapes), this does not necessarily mean that white wine raises breast cancer risk.

Braunstein, said:

"There are chemicals in red grape skin and red grape seeds that are not found in white grapes that may decrease breast cancer risk."


Braunstein added that a larger study is needed to determine how safe and effective red wine might be in reducing breast cancer risk.
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What are Blackheads? How to Get Rid of Blackheads

A blackhead, or open comedo is a wide opening on the skin with a blackened mass of skin debris covering the opening. Despite their name, some blackheads can be yellowish in color. A comedo is a widened hair follicle which is filled with skin debris (keratin squamae), bacteria and oil (sebum).

A closed comedo is a whitehead, while an open comedo is a blackhead. the plural of "comedo" is comedomes".

Blackheads are said to be the first stage of acne. They form before bacteria invade the pores of the patient's skin. A blackhead can develop into a pimple, which is also known as a papule or pustule.

Blackheads, and acne in general, usually develop after puberty, when hormone levels surge and reach the skin. The presence of higher levels of hormones in the skin triggers the stimulation of the sebaceous glands, which produce oily substances. The sebaceous glands produce too much oil in the pores, which accumulates and gets stuck. When the occluded oil is exposed to air it becomes black.

Several conditions and circumstances can cause blackheads, or make them worse, such as the use of topical oils and make up. Blackheads can affect people with any type of skin, but are generally more common in those with oily skin.


Blackheads
Blackheads on a man's nose

What are the causes of blackheads

The overproduction of oil is the main cause of the emergence of blackheads. This is likely to occur in a high proportion of humans during puberty. Spikes in hormone production can result in the high levels of DHT (dihydrotestosterone), a hormone which triggers overactivity in the oil glands, resulting in clogged pores.

Clean skin - if the skin is not cleaned properly, more blackheads can appear, especially during those milestones in life when they are more prevalent, such as puberty. Improperly cleaned skin makes it more likely that dead skin cells build up within the pores. The pore openings can become clogged, which accelerates the build up of oil inside - thus causing blackheads to form. However, many experts warn that dirt does not cause blackheads to form - which frequently confuses and frustrates patients. Blackheads are caused by oxidized oil, not dirt, experts add. Over-cleaning the skin can lead to irritation.

In some cases, blackheads can emerge if moisturizers, sun screens, make up, or foundations are overused.

In the majority of cases, blackhead susceptibility is not heredity, with the exception of some severe acnes.

Food does not cause acne - although parents and grandparents commonly tell their teenage offspring not to eat chocolates and greasy foods, because they think they encourage the formation of acne - they do not cause blackheads or make them worse. Some studies have pointed towards a link between some dairy products and acne, but the evidence is not compelling.

Stress - stress does not directly affect blackhead occurrence. However, stress and anxiety can cause people to pick at their blackheads and acne, which may make them worse. Put simply, the behaviors resulting from stress and anxiety may worsen acne symptoms, but not the stress/anxiety itself.

What are the treatment options for blackheads

Hormonal treatments - contraceptives have often been used for the treatment of blackheads and acne, often with good results.

Cleaning the skin - clean your face with a good cleanser, ideally, one for oily skin, such as a salicylic acid cleanser.

Medications - adapalene is a third-generation topical retinoid, used mainly in the treatment of mild to moderate acne. Many patients with blackheads have had good results. In the USA adapalene is available under brand name Differin, in three preparations - 0.1% cream, 0.1% gel, and 0.3% gel. Since 2010, it has also been available in the USA under the generic name Teva, (0.1% gel). Only the 0.1% cream and 0.1% gel forms are available in Europe.

UV exposure - exposing the skin to sunlight or ultra-violet light encourages it to peel, which helps unblock pores. Sunbathing or using sunbeds may help. However, it is important to discuss this with your doctor. Exposing skin to sunlight, if overdone, also raises the risk of burning and developing skin cancer.

Hair - greasy hair touching the face of your skin can spread infection and in some cases encourage the spread of blackheads and acne. Keeping your hair away from your face may help keep blackheads to a minimum.
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