Four-in-one AIDS drug gets the OK in clinical trial

AP Photo

An experimental once-daily pill that combines four drugs to fight HIV is as safe and effective as commonly-prescribed treatments against the AIDS virus, researchers reported in The Lancet today.

Doctors tested the new drug, called Quad, for the third and final phase in which new pharmaceutical products are vetted for safety and effectiveness.

Publication in the British journal follows a recommendation in May by a US Food and Drug Administration (FDA) advisory panel to approve Quad for previously untreated adults infected with HIV-1. A final decision is expected by August.

The first trial entailed testing Quad against a three-in-one pill, Atripla, which since 2006 has been a standard treatment for the human immunodeficiency virus (HIV).

Researchers enrolled 700 patients in centres in North America and assigned them randomly to either Quad or Atripla.

After 48 weeks of treatment, 88 percent of Quad patients had suppressed viral loads to below detectable levels, against 84 percent in the Atripla group.

Side effects were infrequent but similar in both groups. Among Quad patients, mild nausea was the more common adverse event, whereas with Atripla, symptoms were likelier to be dizziness, abnormal dreams or insomnia and skin rashes.

In the second trial, 708 patients were enrolled in Australia, Europe, North America and Europe.

Patients were either given Quad or a widely recommended therapy comprising the molecules atazanavir (ATV), boosted by ritonavir (RTV), together with emtricitabine (FTC) and tenofovir disoproxil fumarate, or TDF.

After 48 weeks, 90 percent of the Quad group had viral levels below detectable levels compared to 87 percent in the other drug group.

Only 3.7 percent of patients in the Quad group stopped treatment because of side effects, compared with 5.1 percent in the other group. On the other hand, the number who reported kidney complications in the Quad group was relatively higher.

Quad comprises FTC and TDF, along with a drug called elvitegravir (ETV), which is designed to inhibit HIV replication. The fourth ingredient is a "pharmacoenhancer" called cobicistat to boost the effectiveness of ETV.

The movement towards a single once-daily pill to suppress HIV has a huge benefit for patients, say AIDS researchers.

When the first antiretroviral drugs emerged in the 1990s, patients had to take a dozen tablets a day or more, a "pill burden" that meant many forgot to follow the entire treatment.

"Patient adherence to medication is vital, especially for patients with HIV, where missed doses can quickly lead to the virus becoming resistant," said Paul Sax of Harvard Medical School, who led the first study in Friday's Lancet.

"Our results provide an additional highly potent, well-tolerated treatment option, and highlight the simplicity of treatment resulting from combining several antiretrovirals in single pill." Quad is made by the US pharmaceutical giant Gilead Sciences, which also funded the trials, a practice that is relatively common in drug development.

Clinical tests for new drugs have to go through a three-phase process that is scrutinised by independent assessors and government regulators for safety and objectivity. Publication of the research in a peer-reviewed journal is a final step in the procedure. (PARIS - Agence France-Presse)

Dark chocolate may protect heart

A scientific study likely to stir the souls of chocoholics has suggested that eating dark chocolate every day for 10 years could reduce the likelihood of heart attacks and strokes in some high-risk patients.

Tesearchers from Australia used a mathematical model to predict the long-term health impact of daily dark chocolate consumption in 2,013 people with a condition known as metabolic syndrome, which puts them at high risk of heart disease.

The team found that in the best case scenario, with no patient missing any daily portions, the treatment could potentially avert 70 non-fatal and 15 fatal heart attacks or strokes per 10,000 people over 10 years.

The model also suggested that mounting effective “dark chocolate prevention strategies” might cost an individual just 25 pounds a year.

The researchers, whose work was published in the British Medical Journal on June 1, said the protective effects had only been shown for dark chocolate containing at least 60 to 70 percent cocoa - not for milk or white chocolate. This is probably due to higher levels of flavonoids in dark chocolate.

But experts urged caution. “Recommendations for daily consumption of dark chocolate will certainly get people with metabolic syndrome excited, but at this point these findings are more hypothetical than proven, and the results need real-life data to confirm,” said Kenneth Ong at the Brooklyn Hospital Center in the U.S. (LONDON - Reuters)

Rate of smokers decline in Turkey, ministry says

The number of cigarettes consumed in Turkey was 107 billion in 2008 and it has dropped under 100 billion in the last two years. according toHealth Ministry’s data.

Ministry of Health announces that the number of smokers are in decline and Turkey is among the top four countries in the world in the fight against smoking

On “World No Tobacco Day” the Turkish Ministry of Health announced that some 2.2 million people in Turkey had quit smoking since 2008, and that the number of those subjected to smoke in closed areas had dropped by 60 percent.

The Ministry of Health said Turkey was among the top four countries in the world in the fight against smoking, quoting World Health Organization.

Other countries in the list are reported as Hungary, Sweden and England “The number of smokers is 1.2 billion in the world and in Turkey is 16 million,” the Ministry’s statement read.

“As a result of the campaigns against smoking, the rate of smoking has dropped from 33.4 percent to 27.1 percent in the last six years.”

Although Turkey started legal means to fight against smoking in 1996, a smoking ban took full effect in 2009 in Turkey, and outlawed smoking in all enclosed public places, including bars, cafes, restaurants, taxis, trains and outdoor stadiums. The ban included premises that serve nargile, or hookah, and excluded private residences.

Smoking ban
The ministry’s report said some 2.9 million businesses had been inspected after the ban took effect and that those who did not apply the ban had been fined a total of 24 million Turkish Liras.

The volume of cigarette sales in Turkey has also seen a significant decline in recent years, according to figures provided by the Tobacco and Alcohol Market Regulatory Agency (TAPDK).

Accordingly, the number of cigarettes smoked in Turkey has dropped to under 100 billion in the last two years.

While in 2008 the number of cigarettes consumed was 107 billion, that number decreased to 91 billion last year, the figures show.

The ministry also reported that some 3.4 million people had called Turkey’s “ALO 171,” a call center that aims to help people quit smoking.

Turkish Prime Minister Recep Tayyip Erdoğan himself is also a devout fighter against smoking.

“This is a reality. Consequently, the fight against tobacco has gained as much importance as the fight against terrorism,” Erdoğan said at a meeting marking the second anniversary of the legislation banning smoking in public places.

Tobacco ban in Dubai for a day

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DUBAI- Agence France Presse

Nearly 300 stores in the Gulf emirate of Dubai will ban the sale of cigarettes for 24 hours on Thursday to mark the World No Tobacco Day, local media reported.“In Dubai, nearly 300 outlets including petrol stations and supermarkets will stop selling tobacco for 24 hours,” reported English daily, The National.

“One in four deaths is linked to smoking-related diseases” in the United Arab Emirates, another local daily, Gulf News, quoted a hospital official as saying.

The sale of cigarettes in Dubai is prohibited to anyone below 20 years of age and public smoking is banned in the emirate.

(Ankara-Anatolia News Agency)

Research gives idea of cancer genome

Breast cancer kills 450,000 women a year. Hürriyet photo

Scientists have mapped the complete genetic codes of 21 breast cancers and created a catalogue of the mutations that accumulate in breast cells, raising hopes that the disease may be able to be spotted earlier and treated more effectively in future.

The research, the first of its kind, untangles the genetic history of how cancer evolves, allowing scientists to identify mutational patterns that fuel the growth of breast tumors, and start to work out the processes behind them.

“These findings have implications for our understanding of how breast cancers develop over the decades before diagnosis in adults and might help to find possible targets for improved diagnosis or therapeutic intervention in the future,” said Mike Stratton, who led the research team.

Most common cancer

Breast cancer kills more than 450,000 women a year worldwide and is the most common cancer among women, according to the World Health Organization (WHO).

“This is the first time we’ve been able to delve fully into breast cancer genomes in such a thorough way,” said Peter Campbell, head of cancer genetics and genomics at the Wellcome Trust Sanger Institute in Cambridge, where the studies were led.

The work had given scientists “a full panoramic view of the cancer genome” and helped them identify “mutational patterns rather than individual mutations in specific genes”, he added. “We’ve known for many years now that all cancers are due to abnormalities of DNA...that occur in every single cell of the body over the course of a lifetime,” said Stratton.

“But although we’ve known that, it’s remarkable how rudimentary our knowledge is about what the processes are that cause these abnormalities, these mutations in our DNA.” (LONDON - Reuters)

Medical marijuana supporter wins Oregon AG primary

REUTERS photo

A retired state judge supported by marijuana advocates has defeated a former federal prosecutor in a Democratic primary race for attorney general that focused on Oregon's medical marijuana law.

Former Oregon Court of Appeals judge Ellen Rosenblum's victory Tuesday came with the help of marijuana activists who flexed their political muscles in a state with 55,000 registered pot users. She defeated former interim U.S. Attorney Dwight Holton, who has criticized Oregon's medical marijuana law and had overseen raids on medical marijuana growers.

Rosenblum's pro-pot groups attacked Holton and steered large campaign contributions to Rosenblum, who promised to make marijuana enforcement a low priority in office.

Rosenblum fended off Holton's criticism that she was taking money from medical marijuana supporters while promising to downplay the laws that regulate them.
(PORTLAND, Oregon - The Associated Press)

Botox given go-ahead for migraine sufferers

Botox could make a huge difference to some migraine sufferers, according to headache specialists. Photograph: Alamy

Nice has reversed its previous opposition and is recommending the injections as a treatment for adults who are badly affected

Botox, best-known for smoothing wrinkles, is to become available on the NHS to thousands of people whose lives are blighted by chronic migraines after a rethink by the drugs rationing body.

The National Institute for Health and Clinical Excellence (Nice) is to recommend the injections as a treatment to stop headaches from developing in adults who are badly affected by migraines.

In final draft guidance issued on Friday, Nice reversed its previous opposition to Botox being used for such patients. In February it said there was too little evidence to justify approving it.

But it is now backing the use of botulinum toxin type A in adults with chronic migraine whose condition has not been alleviated by taking at least three previous preventative medications and who are not overusing medication.

Botox could make a huge difference to some migraine sufferers, headache specialists predicted. "The headache experts with first-hand experience in treating chronic migraine know how debilitating the condition can be for some patients and Botox can be a life-changing treatment," said Dr Fayyaz Ahmed, chair of the British Association for the Study of Headache (Bash).

"The medical evidence shows that Botox can provide significant benefit to patients with chronic migraine, helping to reduce the number of days disrupted by migraine or headache and improving their quality of life," Ahmed added.

Sufferers who have used Botox say it helps them to undertake everyday tasks such as doing the school run, attending meetings or visiting a relative, he said.

Chronic migraine affects an estimated one in 50 people, according to the Migraine Trust. Sufferers endure a headache for at least 15 days a month, and have a migraine on at least eight of them. The Medicines and Healthcare products Regulatory Agency (MHRA) licensed Botox for that purpose in 2010.

"Although Botox may not be effective or appropriate for all patients with chronic migraine, the Migraine Trust and Bash believe that it should be available on the NHS for those patients who have been unable to manage their condition with preventative medication and who are most likely to respond to the treatment," the organisations said in a joint statement.

Nice will issue its final guidance in June, but is not expected to change its mind after its independent appraisal committee reviewed the available evidence after the watchdog's initial rejection. After that, the NHS in England and Wales will have 90 days to make Botox available when specialists recommend it. It will cost £349.40 for a 12-week cycle, and sufferers will receive injections in their head and neck.

"Chronic migraine is a disabling condition and in many cases ruins people's lives," said Wendy Thomas, chief executive of the Migraine Trust. "For patients who suffer with this condition Botox may offer a safe and effective preventative treatment option to help them manage and improve their quality of life."

Meanwhile, in a separate decision, Nice has come under fire for refusing to approve a drug, which, in some instances, can help men with advanced prostate cancer live up to three months longer.

Sir Andrew Dillon, Nice's chief executive, said at £22,000 per patient, the drug cabazitaxel, which is marketed as Jevtana, did not represent value for money for the NHS. There are also concerns about its side-effects, he added.

But prostate cancer charities criticised Nice for denying men with the disease one of the few treatments that can potentially help them live longer.

"This decision seeks to limit what we as clinicians can do for our patients and their families," said Professor Jonathan Waxman, an NHS oncologist and the clinical chair in prostate cancer at Imperial College London.

"The cost argument on which Nice bases their decision is false, giving a much higher estimate of true cost than applies in reality. As a result yet another successful and effective cancer treatment is denied our patients, a mortifying blow to cancer care in England." (guardian)

FDA panel backs first pill to block HIV infection

Federal drug regulators on Tuesday affirmed landmark study results showing that a popular HIV-fighting pill can also help healthy people avoid contracting the virus that causes AIDS in the first place. AP Photo

The first drug shown to prevent HIV infection won the endorsement of a panel of U.S. federal advisers, clearing the way for a landmark approval in the 30-year fight against the virus that causes AIDS.

In a series of votes on Thursday, a Food and Drug Administration advisory panel recommended approval of the daily pill Truvada for healthy people who are at high risk of contracting HIV, including gay and bisexual men and heterosexual couples with one HIV-positive partner.

The FDA is not required to follow the panel's advice, though it usually does. A final decision is expected by June 15.

Gilead Sciences Inc., based in Foster City, California, has marketed Truvada since 2004 as a treatment for people who are infected with the virus. The medication is a combination of two older HIV drugs, Emtriva and Viread. Doctors usually prescribe it as part of a drug cocktail to repress the virus.

While panelists ultimately backed Truvada for prevention, Thursday's 12-hour meeting highlighted a number of concerns created by the first drug to prevent HIV. In particular, the panel debated whether Truvada might lead to reduced use of condoms, the most reliable defense against HIV. The experts also questioned the drug's effectiveness in women, who have shown much lower rates of protection in studies.

Panelists struggled to outline steps that would ensure patients take the pill every day. In clinical trials, patients who didn't take their medication diligently were not protected, and patients in the real world are even more likely to forget than those in studies.

"The trouble is adherence, but I don't think it's our charge to judge whether people will take the medicine," said Dr. Tom Giordano of Baylor College of Medicine, who voted in favor of the drug. "I think our charge is to judge whether it works when it's taken and whether the risks outweigh the benefits." Panelists stressed that people should be tested to make sure they don't have HIV before starting therapy with Truvada. Patients who already have the virus and begin taking Truvada could develop a resistance to the drug, making their disease even more difficult to treat. The experts grappled with how to protect patients while avoiding hurdles that could discourage them from seeking treatment.

"If we put up too many hoops to jump through, there will be people who don't make it through those hoops," said Daniel Raymond, the panel's patient representative.

Truvada first made headlines in 2010, when government researchers showed it could prevent people from contracting HIV. A three-year study found that daily doses cut the risk of infection in healthy gay and bisexual men by 42 percent, when accompanied by condoms and counseling. Last year another study found that Truvada reduced infection by 75 percent in heterosexual couples in which one partner was infected with HIV and the other was not.

Because Truvada is on the market to manage HIV, some doctors already prescribe it as a preventive measure. FDA approval would allow Gilead Sciences to formally market its drug for that use.

But Truvada's groundbreaking preventive ability has exposed stark disagreements on prevention among those in the HIV community. While Truvada's supporters say the drug is an important new option, critics worry that the drug could give users a false sense of security, and encourage risky behavior.

During the meeting's public comment period, FDA panelists heard from more than two dozen doctors, nurses and patients who said patients would not take the drug as recommended, every day, in addition to using condoms.

"Truvada needs to be taken every day, 100 percent of the time, and my experience as a registered nurse tells me that won't happen," Karen Haughey told the panel. "In my eight years, not one patient that I've cared for has been 100 percent adherent." Other speakers worried that wide scale use of Truvada would divert limited funding from more cost-effective options. Truvada sells for about $900 a month, or just under $11,000 per year. The AIDS Healthcare Foundation, which opposes approval of Truvada, estimates that 20 HIV-positive patients could be treated for the cost of treating one patient with preventive Truvada.

"Truvada for prevention will squeeze already-constrained health care resources that can be better spent on cheaper and more effective prevention therapies," the group states in a petition to the FDA.

The FDA is legally barred from considering cost when reviewing drugs. Medicare and Medicaid, the nation's largest health insurance plans, generally cover all drugs approved by the FDA and many large insurers take their cues for coverage from the government plans.

An estimated 1.2 million Americans have HIV, which develops into AIDS unless treated with antiviral drugs. AIDS causes the body's immune system to breakdown, leading to infections which are eventually fatal. Gay and bisexual men account for the majority of cases — nearly two-thirds.

The number of new HIV infections in the U.S. has held steady for 15 years at about 50,000 per year.

But with no vaccine in sight and an estimated 240,000 HIV carriers unaware of their status, doctors and patients say new methods are needed to fight the spread of the virus.
Nick Literski, a federal worker in Seattle, has been taking Truvada for HIV prevention for more than a year. His partner is HIV-infected and his doctor prescribes the drug as a precautionary measure, even though it is not yet FDA-approved for that use. Literski pays a $40 monthly co-pay for the once-daily pill.

FDA approval of the drug for prevention would be "a huge step forward" in the fight against AIDS, he said in an interview Thursday. But he said rejection would be devastating, threatening gay relationships like his that involve one partner who is HIV infected and one who isn't.

"Many HIV-positive men end up ending their relationships with HIV-negative men out of fear of infecting their partner," Literski said, and he worried about that happening to him before he started using Truvada. (ILVER SPRING, Maryland - The Associated Press)

Karatay Diet: Fact or fantasy?

Various media reports have quoted doctors supporting Karatay.

Professor Karatay raised eyebrows among her colleagues when she claimed the chief cause of high cholesterol levels was insulin-resistance as opposed to the medical consensus on fat consumption.

Turkish Cardiology Association vowed to take it to the court when Karatay took it far enough to claim the patients should give up their cholesterol regulatory medication. However, as a person of science, she is not alone in her claim. Various media reports have quoted doctors supporting Karatay who elaborately explains several uses of cholesterol in an organism.

Daily Habertürk quoted Karatay saying that cholesterol was produced by our body as a protective agent against stresses like a hypothermic disease caused by viruses and bacteria. “Cholesterol is a bactericide and a virucide as well as being the basic structural unit of brain cells and nervous system. Breast milk is composed of cholesterol and Omega 3 fatty acids at around 90 percent. Cholesterol is innocent and its level rises in blood only to fix something going wrong.”

She added that it was not the cholesterol that clogged the arteries but the platelets, which are chiefly formed by the insulin hormone. High insulin in blood triggers coagulation, according to her account. (ISTANBUL - Hürriyet Daily News)

Turkish limb transplant patient under critical condition

Atilla Kavdır held hands with his wife, Ayşe Kavdır, for the first time on April 3. ‘Hopefully, I will see the day when my husband wears a wedding ring,’ said Ayşe Kavdır. DHA photo

Turkey’s first triple-limb transplant patient Atilla Kavdır was taken under intensive-care unit yesterday due to heart and kidney failure at 4 p.m., some 100 days after he underwent the landmark surgery at Akdeniz University in the Mediterranean province of Antalya.

A team of doctors at Akdeniz University Hospital in the southern province of Antalya performed Kavdır’s operation on Jan. 21. Atilla Kavdır was Turkey’s first triple-limb transplant patient, yet his body rejected the leg a day after the surgery.

Kavdır lost his arms and right leg when he was 11 years old after he electrocuted himself by hitting a power line outside his home with an iron rod he was using to scare away pigeons.

“I have been living without arms for 23 years; I want to hold my wife’s and children’s hands and drive a motorbike or a car perhaps,” Kavdır had said at an earlier press meeting.

Atilla Kavdır held hands with his wife, Ayşe Kavdır, for the first time on April 3.

“We had always dreamed of this day. Hopefully, I will also see the day when my husband wears a wedding ring on his finger and puts on a watch on his wrist,” said Ayşe Kavdır, who has been married to Atilla Kavdır for 17 years. (ANTALYA - Doğan News Agency)

Women have too much faith in pills

According to a new study, women have too much faith in hormonal birth control.

Many women may think birth control pills and condoms are better at pregnancy prevention than they actually are, a new study suggests.

Researchers found that of more than 4,100 women who were seeking birth control, about 45 percent overestimated the effectiveness of the Pill and condoms.

They also had too much faith in hormonal birth control patches, vaginal rings and injections, according to findings reported in the American Journal of Obstetrics and Gynecology.

The findings point to a need for better education on how well different birth control methods work with “typical use” in the real world, study leader Dr. David L. Eisenberg told Reuters Health.

In the U.S., the Pill and condoms are the most popular reversible forms of birth control. But they are not the most effective.

That designation goes to intrauterine devices (IUDs) and contraceptive implants.

IUDs are implanted in the uterus, where they release small amounts of either copper or the hormone progestin to prevent pregnancy. The contraceptive implant, about the size of a matchstick, is inserted under the skin of the arm, where it releases controlled amounts of progestin.

The hormonal IUD, sold under the brand-name Mirena, can prevent pregnancy for five years, while the copper version, sold as ParaGard, is effective for about 10 years. The contraceptive implant (Implanon) works for three years.

It’s estimated that between 0.2 percent and 0.8 percent of women who use an IUD will have an unplanned pregnancy within a year. The rate is just 0.05 percent with a contraceptive implant.

The advantage is that unlike birth control pills and condoms, the IUD does not rely on perfect use.

With the Pill, the pregnancy rate with “typical use” is about nine percent per year. With condoms, it’s between 18 and 21 percent. (NEW YORK - Reuters)

Swiss woman starves to death after trying to live on sunlight

REUTERS photo

Swiss newspaper Tages-Anzeiger reports that a woman starved to death after embarking on a spiritual diet that required her to stop eating or drinking and live off sunlight alone.

The Zurich newspaper reported Wednesday that the unnamed Swiss woman in her fifties decided to follow the radical fast in 2010 after viewing an Austrian documentary about an Indian guru who claims to have lived this way for 70 years.

Tages-Anzeiger says there have been similar cases of self-starvation in Germany, Britain and Australia.

The prosecutors' office in the Swiss canton (state) of Aargau confirmed Wednesday that the woman died in January 2011 in the town of Wolfhalden in eastern Switzerland.

Spokeswoman Jennifer Rissi says prosecutors haven't opened a criminal investigation over the woman's death. (GENEVA - The Associated Press)

Turkish town bans alcohol for ‘public good’

Hürriyet photo

The inner Aegean province of Afyonkarahisar has banned the sale and consumption of alcohol in public places, citing the interests of the “public good,” daily Hürriyet reported this morning.

The ban, the first of its kind in Turkey, followed a statement by Health Minister Recep Akdağ on fighting against alcohol as well as smoking.

The ban forbids the sale and consumption alcohol in public places, including parks, picnic areas, gardens, bus stations, streets, gravesites, bridges, places of worship, cultural and historical sites and abandoned buildings.

Drinking alcohol in all kinds of vehicles, including public transportation, is also banned.

Explaining the reason for the decision, the Afyonkarahisar Governor’s Office said the ban was designed to "ensure peace and security within the city's borders and prevent crimes."

"Alcohol consumers frequently occupy a number of places in the city, causing unrest in these areas and traffic accidents," the governor’s office said. "This regulation was formed to keep the public order intact within the city and to prevent traffic accidents from occurring."

Those who violate the ordinance can be assessed a fine of 82 Turkish Liras. (Hürriyet)

Mobile phones: 'Still no evidence of harm to health'

There are 80 million mobile phones in the UK

There is still no evidence mobile phones harm human health, says a major safety review for the UK's Health Protection Agency (HPA).

Scientists looked at hundreds of studies of mobile exposure and found no conclusive links to cancer risk, brain function or infertility.

However, they said monitoring should continue because little was known about long-term effects.

The HPA said children should still avoid excessive use of mobiles.

It is the biggest ever review of the evidence surrounding the safety of mobile phones.

There are now an estimated 80 million mobiles in the UK, and because of TV and radio broadcasting, Wi-Fi, and other technological developments, the study said exposure to low-level radio frequency fields was almost universal and continuous.

A group of experts working for the HPA looked at all significant research into the effects of low-level radio frequency.

'Relatively reassuring'
They concluded that people who were not exposed above UK guideline levels did not experience any detectable symptoms.

That included people who reported being sensitive to radio frequency.

They also said there was no evidence that exposure caused brain tumours, other types of cancer, or harm to fertility or cardiovascular health.

But they said very little was known about risks beyond 15 years, because most people did not use mobile phones until the late 1990s.

Prof Anthony Swerdlow, who chaired the review group, said it was important to continue monitoring research.

"Even though it's relatively reassuring, I also think it's important that we keep an eye on the rates of brain tumours and other cancers," he said.

"One can't know what the long-term consequences are of something that has been around for only a short period."

There has been speculation about the health effects of using mobile phones for years.

The HPA conducted a previous review in 2003, which also concluded that there was no evidence of harm. But there is now far more research into the subject.

Advice on children

The experts said more work was needed on the effect of radio frequency fields on brain activity, and on the possible association with behavioural problems in children.

They also called for more investigation into the effects of new technology which emits radio frequency, such as smart meters in homes and airport security scanners.

The HPA said it was not changing its advice about mobile phone use by children.

"As this is a relatively new technology, the HPA will continue to advise a precautionary approach," said Dr John Cooper, director of the HPA's centre for radiation, chemical and environmental hazards.

"The HPA recommends that excessive use of mobile phones by children should be discouraged." (Source: bbc.co.uk)

Discovery of US mad cow case due to random testing

A nondescript building in the heart of California's dairy country has become the focus of intense scrutiny after mad cow disease was discovered in a dead dairy cow.

The finding, announced Tuesday, is the first new case of the disease in the U.S. since 2006 and the fourth ever discovered in the country. Two major South Korean retailers suspended sales of U.S. beef in response. Reaction elsewhere in Asia was muted, with Japan saying there's no reason to restrict imports.

Tests are performed on only a small portion of dead animals brought to the transfer facility in central California.

The cow had died at one of the region's hundreds of dairies, but hadn't exhibited outward symptoms of the disease: unsteadiness, incoordination, a drastic change in behavior or low milk production, officials said. But when the animal arrived at the facility with a truckload of other dead cows on April 18, its 30-month-plus age and fresh corpse made her eligible for USDA testing.

"We randomly pick a number of samples throughout the year, and this just happened to be one that we randomly sampled," Baker Commodities executive vice president Dennis Luckey said. "It showed no signs" of disease.

The samples went to the food safety lab at the University of California, Davis on April 18. By April 19, markers indicated the cow could have bovine spongiform encephalopathy (BSE), a disease that is fatal to cows and can cause a deadly human brain disease in people who eat tainted meat. It was sent to the USDA lab in Iowa for further testing.

On Tuesday, federal agriculture officials announced the findings: the animal had atypical BSE. That means it didn't get the disease from eating infected cattle feed, said John Clifford, the Agriculture Department's chief veterinary officer.

It was "just a random mutation that can happen every once in a great while in an animal," said Bruce Akey, director of the New York State Veterinary Diagnostic Laboratory at Cornell University. "Random mutations go on in nature all the time." South Korea's No. 2 and No. 3 supermarket chains, Home Plus and Lotte Mart, said they have "temporarily" halted sales of U.S. beef to calm worries among South Koreans. South Korea is the world's fourth-largest importer of U.S. beef, buying 107,000 tons of the meat worth $563 million in 2011.

In humans, experts say the disease can occur in one in 1 million people, causing sponge-like holes in the brain. But they say not enough is known about how and how often the disease strikes cattle.
The disease cannot be transmitted by contact among cows, and experts say it's unclear whether this rare type of BSE ever has been transmitted from a cow to a human by eating meat.

The California Department of Public Health and the state Department of Food and Agriculture quickly worked to assure consumers that the food supply is safe and that the cow hadn't been destined for human consumption. The building where the cow was selected to be tested sends animals to a rendering plants, which process animal parts for products not going into the human food chain, such as animal food, soap, chemicals or other household products.

Among the unknowns about the current case is whether the animal died of the disease and whether other cattle in its herd are similarly infected. The name of the dairy where the cow died hasn't been released, and officials haven't said where the cow was born.

"It's appropriate to be cautious, it's appropriate to pay attention and it's appropriate to ask questions, but now let's watch and see what the researchers find out in the next couple of days," said James Culler, director of the UC Davis dairy food safety laboratory and an authority on BSE.

Culler said that in this case the food safety testing program worked and that this form of BSE so rarely occurs that consumers shouldn't be alarmed.

"Are you worried about all of the meteors that passed the earth last night while you were sleeping? Of course not," Culler said. "Would you pay 90 percent of your salaries to set up all of the observatories on earth to watch for them? Of course not. It's the same thing." The National Cattlemen's Beef Association said in a statement that "U.S. regulatory controls are effective, and that U.S fresh beef and beef products from cattle of all ages are safe and can be safely traded due to our interlocking safeguards." The infected cow was identified through an Agriculture Department surveillance program that tests about 40,000 cows a year for the fatal brain disease.

There have been three confirmed cases of BSE in cows in the United States in a Canadian-born cow in 2003 in Washington state, in 2005 in Texas and in 2006 in Alabama.

Both the 2005 and 2006 cases were also atypical varieties of the disease, USDA officials said.
The mad cow cases that plagued England in the early 1990s were caused when livestock routinely were fed protein supplements that included ground cow spinal columns and brain tissue, which can harbor the disease.

The Agriculture Department is sharing its lab results with international animal health officials in Canada and England who will review the test results, Clifford said. Federal and California officials will further investigate the case. He said he did not expect the latest discovery to affect beef exports.

State and federal agriculture officials plan to test other cows that lived in the same feeding herd as the infected bovine, said Michael Marsh, chief executive of Western United Dairymen, who was briefed on the plan. They also plan to test cows born at around the same time the diseased cow was.

"Our members have meticulous records on their animals, so they can tell when the animal was born, the parents, and they can trace other animals to the same facility," Marsh said.

For now, all of the other cows that arrived on the truck with the diseased one are still in cold storage at Baker's transfer station, which sits in the middle of a wheat field. (The Associated Press)

Aspirin may lower risk of lung cancer

Women who take aspirin at least a couple of times a week have a much lower risk of developing lung cancer, whether or not they smoke, according to a study of more than a thousand Asian women.

The findings, published in the journal Lung Cancer, linked regularly taking aspirin to a risk reduction of 50 percent or more, although researchers cautioned that they did not prove aspirin directly protects against lung cancer.

The study included 398 Chinese women diagnosed with lung cancer and 814 cancer-free women, and Lim’s team found that women who had used aspirin regularly, at least twice a week for a month or longer, were less likely to have lung cancer.

Among women who had never smoked, the odds were 50 percent lower for aspirin users versus non-users. Among smokers, aspirin use was tied to a 62 percent lower risk of lung cancer. There was a fairly large relative difference in cancer risk between aspirin users and non-users in the study, but the absolute reduction in any one person’s risk, if there is one, might be small.

There are biological reasons that aspirin might offer protection against cancer. It blocks an enzyme called cyclooxygenase-2, or COX-2, which promotes inflammation and cell division, and is found in high levels in tumors. But Andrew Chan at Harvard Medical School, who was not involved in the study, said that the evidence on aspirin and lung cancer has been “mixed.”

“The number one thing a person can do to minimize the risk of lung cancer is to not smoke,” he said.
There is stronger evidence that aspirin may be protective against colon cancer, according to Chan, a gastroenterologist. (Reuters)

Turkish man released after three attacks on health officials

A Turkish man has been released from custody after attacking health officials in İzmir, daily Hürriyet reported today, a week after medical personnel staged strikes around the country following the murder of a Gaziantep doctor by a patient’s relative.

An ambulance team in the Aegean province lodged a complaint with police about a group of people who were drinking alcohol and disturbing other people around 20 days ago. A man from the group, E.K., was enraged by the paramedics, who reported him to the police. E.K. allegedly went to the ambulance station a day later and attacked 15 personnel with a big knife but was restrained by three staff members who called police.

Police captured and questioned the attacker, but he was subsequently released by prosecutors.

Following his release, the man allegedly made a fake call to emergency services from a café, but paramedics realized upon arrival that the individual calling for help was their previous attacker. They immediately left the premises and lodged another complaint with police about the individual, saying he had been trying to lure them with fake emergency calls and that they were worried for their safety. Police subsequently launched an operation to locate the man.

While still being sought by police, the attacker was taken to a hospital by friends who said he was suffering from a mental breakdown.

The man, however, allegedly attacked a doctor and another medical official after being injected with anodyne. Two staff members consequently lodged a complaint about the individual to police.

E.K. was taken to the police station and questioned again, but prosecutors chose to release him.

Health officials will make a press statement in front of their hospital on the matter, Hürriyet reported.

Gaziantep physician Ersin Arslan, 26, was stabbed to death April 17 by the 17-year-old grandson of a deceased patient that had reportedly been treated by the doctor. (hurriyetdailynews)

Tobacco display ban 'to curb young smokers'

A ban on tobacco displays is coming into force in England - with ministers promising it will help curb the number of young people taking up smoking.

The ban will apply only to large shops and supermarkets, with smaller outlets given an exemption until 2015.

It means cigarettes and other products will have to be kept below the counter.

Other parts of the UK are also planning to take similar action as part of a concerted effort to drive down smoking rates.

A fifth of adults smoke - a figure which has remained steady in recent years after decades of rapid falls.

A plan to force manufacturers to put cigarettes into plain packets is also expected to be put out to consultation later this year.

The display ban will apply to shops of over 280 sq m (3,014 sq ft).

Public health minister Anne Milton cited evidence from Ireland which suggested the measure could play an important role in discouraging young people in particular from smoking.

"We cannot ignore the fact that young people are recruited into smoking by colourful, eye-catching, cigarette displays.

"Most adult smokers started smoking as teenagers and we need to stop this trend."

Jo Butcher, of the National Children's Bureau, agreed: "It's essential that we create a culture that promotes and protects public health and tobacco legislation is a significant factor in making this happen."

'No sound evidence'
However, the move has upset the tobacco industry.

Moves by Scotland to introduce such a ban have been delayed by legal action taken by Imperial Tobacco.

Meanwhile, a spokesman for British American Tobacco said: "We do not believe that hiding products under the counter or behind curtains or screens will discourage people, including the young, from taking up smoking.

"There's no sound evidence to prove display bans are justified."

He added if anything it could encourage the illicit trade of tobacco products.

The display ban was announced by the government last year as part of its tobacco control strategy.

Although the legislation allowing it to happen was actually put in place by the Labour government before it lost power in 2010.

A number of countries, including Canada, Ireland, Iceland and Finland, have already introduced similar bans.
(Source: bb.co.uk)

NHS reforms: GPs losing faith, BBC poll suggests

The number of GPs who believe that the government's health reforms in England will improve patient care is falling, a BBC poll suggests.

Just 12% agreed that putting GP-led groups in charge of the budget would mean patients saw a "noticeable" improvement.

That figure was 23% when a similar poll was carried out in September 2010.

A majority of the 814 GPs polled also believed there would be more rationing of care because of financial pressures.

In total, 83% said there would be an increase in rationing in their area.

Ministers have cited the financial challenges facing the health service as one of the reasons they have pushed ahead with the changes in the face of mounting opposition.

While 12% of family doctors agreed that GP-led commissioning - the buying and planning of services on a local level - would improve care, some 55% said they disagreed and 33% said they did not know whether or not it would.

The polling also asked about another controversial aspect of the reforms - the role of the private sector.

Asked about the role of private companies in the NHS, 87% agreed the changes set out in the health bill would lead to them having a bigger role.

The King's Fund, a health think tank, said the poll highlighted once again the challenge facing the government in carrying the NHS with it as it implemented the health reforms.

"GPs will be in the vanguard of this - their commitment is essential for implementing clinical commissioning, the government's big idea for ensuring that care meets the needs of patients," said chief executive Chris Ham.

"The public will judge the government's stewardship of the NHS on the basis of whether patient care improves, so ministers should be concerned that many GPs fear that care will get worse rather than better in the years ahead."

Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said the findings came as no surprise and reflected what doctors had been telling them directly.

"Increasingly, GPs are worrying that they will be blamed for making the hard decisions that may need to be made in order to meet the £20bn savings target set by the government. The government needs to be much more upfront with the public about the scale of savings that need to be made and why.

"If those who will have to deliver the latest health reforms are unconvinced and reluctant, the government should take notice of what they say."

April changes
In April next year the control of about £60bn of the NHS budget in England is due to pass to GP-led groups that will plan and buy most routine healthcare for their local community.

They will be taking over at a time of unprecedented financial pressure. The latest government statistics suggest the NHS is currently managing to meet all waiting targets and has found the savings needed in the last financial year. The polling for the BBC suggests considerable anxiety about what lies ahead.

Almost half of the GPs, 49%, thought the NHS would not be able to go on meeting the 18-week target for routine treatments. Just 22% thought that it would be possible. A similar picture emerged for A&E departments, with 42% agreeing the NHS would need to close or downgrade some in the next five years.

The health secretary Andrew Lansley said the Health and Social Care Act would hand power to GPs, put patients at the heart of the NHS, and reduce needless bureaucracy.

"Of course, every important reform to the NHS, under whatever government, has had its critics from within the system. But putting GPs in leadership positions in the NHS will mean they can improve services for their entire local population. Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver."

Andy Burnham, Labour's shadow health secretary, said the findings were significant.

"Most GPs are clear that the NHS is going in the wrong direction and that the government's changes will make it worse not better. These results echo the concerns Labour has consistently raised and flatly contradict the reassurances given by the prime minister to get his Bill through."

The poll interviews were carried out by ComRes for the BBC between 21 and 30 March.
(Source: bbc.co.uk)

Shisha pipes: 'Is smoking them really harmless?'

The sweet smelling tobacco is gaining in popularity, but most people who smoke it in cafes are unaware of the potential risks.

You might call it shisha in Egypt and Sudan, nargile in Turkey and Syria or hookah in India. Some are made from clay, others from ornately carved metals or plastics. But the principle is same – these water-pipes allow you to smoke flavoured tobacco as it is bubbled through water. Maybe you know it simply as hubble-bubble.

Sharing a water-pipe is thought to be harmless, relaxing fun. They are now enjoying something of a resurgence in popularity in India and the Middle East, where they are said to have originated. In the Middle East the trend has extended to teenagers and women, many of whom do not smoke cigarettes.

This shisha cafe culture has also extended to Europe, Brazil and the United States. If I run home from my office in London, I pass a street filled with cafes where groups of people sit outside engulfed in clouds of honey-scented smoke. In the United States many hookah cafes have opened in college towns and a recent study found that as many as a fifth of American students have tried it. In many countries these pipes are seen as safe enough to be exempt from legislation on smoking in public places.

But the idea that these pipes are harmless is a myth.

Smoke on the water

One of the main misconceptions is that the risks of tobacco are minimised because it is purified as it passes through the water. But this ignores the complete source of the smoke that enters your mouth.

The tobacco burns in a small dish on top of the main body of the water-pipe. You inhale through a mouthpiece connected by a pipe to a reservoir of water at the bottom. As you breathe in smoke is drawn from the burning tobacco and bubbles through the water and up into your mouth. The tobacco is sweetened with glycerine, which can make it damp, so charcoal is added to keep the tobacco burning. This means the smoke inhaled derives from charcoal too, and charcoal contains several toxic substances, including nicotine, carbon monoxide, heavy metals and tar.

Some water-pipes are sold with mouthpieces containing cotton filters or a plastic mesh. This does result in smaller bubbles, but a report by the World Health Organisation says there is no evidence that these mouthpieces reduce the harm.

Unknown risk

But surely the water cools the smoke, making it less dangerous than a cigarette? It is true that this might make an individual puff less harmful, but this does not factor in the quantity of puffs. A typical water-pipe session lasts for at least 20 minutes, often for an hour. So instead of taking 8-12 puffs of a single cigarette a person is inhaling 50-200 puffs in a session. This, in effect, makes it more like chain smoking. In an hour-long session a person can inhale the equivalent of 100 to 200 times the smoke from a single cigarette, which may come as a surprise to most people. A survey carried out this year by the British Heart Foundation found that 84% of respondents thought the amount of smoke inhaled was equivalent to 10 cigarettes or fewer.

In a study in Florida, USA, customers’ carbon monoxide levels were tested as they left bars that allowed the smoking either of cigarettes or hookah pipes. The people leaving the bars that had water-pipes had triple the levels of carbon monoxide in their bodies. Some reported feeling high, which the authors say could have been the early stages of carbon monoxide poisoning.

But what do we know about any long-term consequences? Here, the science is incomplete, as long-term studies of the kind conducted on cigarette tobacco have not been carried out. Researchers admit the evidence is scant, but suggest that smokers of water-pipes could be at long-term risk for nicotine dependence, cardiovascular disease and even cancer. Professor Hani Najm, Head of Cardiac Surgery at National Guard Health Affairs in Saudi Arabia told me in an interview that he fears that water-pipe smoking could result in an escalation in heart disease in the Gulf States.

So bear in mind one thing. Whether you call it shisha, nargile or hubble bubble, it might smell nice, but it is not as harmless as you might think.

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All content within this column is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health. (source: bbc.com)