Indiana University School of Medicine researchers have developed a new breast cancer diagnostic marker that could enable physicians to more easily determine which patients have a less aggressive form of the disease that may not require chemotherapy treatment.
The marker has been licensed by Clarient Inc., a California-based cancer diagnostics company that plans to develop a commercial test based on the research by Harikrishna Nakshatri, B.V.Sc., Ph.D., Marian J. Morrison Professor of Breast Cancer Research, and Sunil Badve, M.D., associate professor of pathology and laboratory medicine.
In two studies involving nearly 675 patients, Nakshatri and Badve found that patients who tested positive for the presence of the biomarker - a protein called FOXA1 - were patients whose cancer is generally considered less aggressive.
About 70 percent of breast cancer patients have tumors that are "estrogen receptor positive," meaning that the hormone estrogen stimulates the tumors to grow. However, nearly two-thirds of the estrogen receptor positive patients have a subtype that is less aggressive and is associated with a better prognosis - most of whom also tested positive for the FOXA1 biomarker.
A commercial test based on the biomarker - for which IU and the IU School of Medicine researchers are seeking a patent - could be a significantly less expensive alternative to existing methods to test for breast cancer subtypes that require sophisticated genomic analyses.
"This is something that 80 percent of surgical pathology labs up and down the country could do," said Dr. Badve.
"Even in a developing country, a third-world country, these things can be easily done," said Dr. Nakshatri.
Those patients who test positive for the biomarker are more likely to respond to anti-estrogen hormone therapies, such as tamoxifen, the researchers said. For other patients the standard of care would be chemotherapy.
The IU researchers, working with scientists in North Carolina, Canada, Britain and Italy, tested the diagnostic capabilities of the FOX1A biomarker in two retrospective studies - meaning that tests were conducted on tissue samples from patients who had been treated for breast cancer. The first study, published in the Aug. 1, 2007, edition of Clinical Cancer Research, studied samples from 438 patients with a median of more than 15.4 years of followup.
A second study, of 245 cases with a median followup of more than 5 years, was published in the Nov. 15, 2007, edition of the Journal of Clinical Pathology. Data from a third study, with 4,000 cases, was recently completed in collaboration with researchers at the University of British Columbia and data from the research are being analyzed.
Financial support for the research was provided by the National Institutes of Health, including the National Cancer Institute, Sanofi-Aventis and Breakthrough Breast Cancer.
Source
Indiana University School of Medicine
Jun 25, 2009
What Is Hemophilia? What Causes Hemophilia?
Hemophilia (from the Greek haima meaning blood and philia meaning friend) is an inherited medical condition where the blood does not clot properly. Essentially, hemophiliacs - people with hemophilia - lack a protein called a clotting factor that works with platelets to stop bleeding at the site of an injury. People with hemophilia tend to bleed for longer periods of time after an injury and they are more susceptible to internal bleeding.
There are two major types of hemophilia, labeled type A and type B. Hemophilia A is characterized by a lack of clotting factor VIII (8) and accounts for about 90% of hemophilia cases. Seventy percent of hemophilia A cases are severe. Hemophilia B is characterized by a lack of clotting factor IX (9).
As very rare disorders, hemophilia A occurs about once in every 10,000 births and hemophilia B occurs once in every 50,000 births.
What causes hemophilia?
Most cases of hemophilia arise as an inherited disorder, which means that a person is born with hemophilia as determined by his genetic makeup. The condition is caused by a defect in one of the clotting factor genes that lies on the X chromosome. Hemophilia almost always occurs in males since the gene can be passed from mother to son, and a son lacks a second X chromosome to make up for the defective gene. Girls, on the other hand, are likely to be carriers of hemophilia but unlikely to actually have the disorder. In order to have hemophilia, girls must have the abnormal gene on both X chromosomes - a very rare occurrence.
Though most hemophiliac cases are inherited, it is possible for someone to acquire the condition through a spontaneous genetic mutation. It can also develop if the body forms antibodies to clotting factors in the blood that prohibit the clotting factors from working.
What are the symptoms of hemophilia
Hemophilia symptoms are characterized by excessive bleeding and easy bruising. There may be variation in the severity of these symptoms depending on the deficiency level of the clotting factors. Hemophilia may be suspected in a baby boy if excessive bleeding occurs after circumcision.
Excessive bleeding can occur both externally and internally. Signs of excessive external bleeding include bleeding in the mouth from a cut, bite, or tooth loss, spontaneous nosebleeds, heavy bleeding from a minor cut, and prolonged or continued bleeding after bleeding previously ceased. Signs of excessive internal bleeding include blood in the urine or stool and large, deep bruises. Tightness in joints may be the result of bleeding in the knees, elbows, or other joints, and the joints may become swollen, hot to touch, and painful to move.
Hemophiliacs may develop internal bleeding in the brain from a bump on the head or a more serious injury. Symptoms of brain bleeding include headaches, vomiting, lethargy, behavioral changes, clumsiness, vision problems, and seizures.
How is hemophilia diagnosed?
If bleeding problems are observed or hemophilia is suspected, a physician will first look at family and personal medical histories. A doctor may be able to use this information to identify the genetic origins of hemophilia. A physical examination and blood tests are often ordered as well. Blood tests will provide information on how long it takes for blood to clot, levels of clotting factors, and which clotting factors, if any, are missing. Blood test results can identify the type of hemophilia and its severity.
For pregnant women who are carriers of hemophilia, doctors are able to test the fetus for the condition as early as 10 weeks into pregnancy.
How is hemophilia treated?
Hemophilia is treated with replacement therapy, which is the giving or replacing of clotting factors that are too low or missing in a hemophilia patient. Patients receive clotting factors by injection or intravenously.
Clotting factor treatments for replacement therapy can be derived from human blood or synthetically produced in a laboratory (called recombinant clotting factors). Some patients will require replacement therapy regularly in order to prevent bleeding, while others may receive treatment only after bleeding begins and remains uncontrollable. The former is called prophylactic therapy and the latter is called demand therapy. Replacement therapies carry risks such as the possibility of developing antibodies, viral infections from human clotting factors, and damage to joints, muscles, and other body parts if treatment is delayed.
Additional hemophilia treatments include desmopressin (a man-made hormone that stimulates the release of stored factor VIII) for moderate forms of hemophilia A, antifibrinolytic medicines that prevent clots from breaking down, and - in the future - gene therapies. A study revealed how Hemophilia A mice benefited from gene therapy.
How can I cope with hemophilia?
Though there is no way to prevent hemophilia, there are ways to avoid excessive bleeding and to protect joints. These include regular exercise, avoiding certain medications (such as aspirin, nonsteroidal anti-inflammatory drugs, and blood thinners such as heparin), practicing good dental hygiene, and protecting against injuries that can cause bleeding by wearing proper padding and practicing proper safety when engaging in physical or dangerous activities.
Written by Peter Crosta M.A.
There are two major types of hemophilia, labeled type A and type B. Hemophilia A is characterized by a lack of clotting factor VIII (8) and accounts for about 90% of hemophilia cases. Seventy percent of hemophilia A cases are severe. Hemophilia B is characterized by a lack of clotting factor IX (9).
As very rare disorders, hemophilia A occurs about once in every 10,000 births and hemophilia B occurs once in every 50,000 births.
What causes hemophilia?
Most cases of hemophilia arise as an inherited disorder, which means that a person is born with hemophilia as determined by his genetic makeup. The condition is caused by a defect in one of the clotting factor genes that lies on the X chromosome. Hemophilia almost always occurs in males since the gene can be passed from mother to son, and a son lacks a second X chromosome to make up for the defective gene. Girls, on the other hand, are likely to be carriers of hemophilia but unlikely to actually have the disorder. In order to have hemophilia, girls must have the abnormal gene on both X chromosomes - a very rare occurrence.
Though most hemophiliac cases are inherited, it is possible for someone to acquire the condition through a spontaneous genetic mutation. It can also develop if the body forms antibodies to clotting factors in the blood that prohibit the clotting factors from working.
What are the symptoms of hemophilia
Hemophilia symptoms are characterized by excessive bleeding and easy bruising. There may be variation in the severity of these symptoms depending on the deficiency level of the clotting factors. Hemophilia may be suspected in a baby boy if excessive bleeding occurs after circumcision.
Excessive bleeding can occur both externally and internally. Signs of excessive external bleeding include bleeding in the mouth from a cut, bite, or tooth loss, spontaneous nosebleeds, heavy bleeding from a minor cut, and prolonged or continued bleeding after bleeding previously ceased. Signs of excessive internal bleeding include blood in the urine or stool and large, deep bruises. Tightness in joints may be the result of bleeding in the knees, elbows, or other joints, and the joints may become swollen, hot to touch, and painful to move.
Hemophiliacs may develop internal bleeding in the brain from a bump on the head or a more serious injury. Symptoms of brain bleeding include headaches, vomiting, lethargy, behavioral changes, clumsiness, vision problems, and seizures.
How is hemophilia diagnosed?
If bleeding problems are observed or hemophilia is suspected, a physician will first look at family and personal medical histories. A doctor may be able to use this information to identify the genetic origins of hemophilia. A physical examination and blood tests are often ordered as well. Blood tests will provide information on how long it takes for blood to clot, levels of clotting factors, and which clotting factors, if any, are missing. Blood test results can identify the type of hemophilia and its severity.
For pregnant women who are carriers of hemophilia, doctors are able to test the fetus for the condition as early as 10 weeks into pregnancy.
How is hemophilia treated?
Hemophilia is treated with replacement therapy, which is the giving or replacing of clotting factors that are too low or missing in a hemophilia patient. Patients receive clotting factors by injection or intravenously.
Clotting factor treatments for replacement therapy can be derived from human blood or synthetically produced in a laboratory (called recombinant clotting factors). Some patients will require replacement therapy regularly in order to prevent bleeding, while others may receive treatment only after bleeding begins and remains uncontrollable. The former is called prophylactic therapy and the latter is called demand therapy. Replacement therapies carry risks such as the possibility of developing antibodies, viral infections from human clotting factors, and damage to joints, muscles, and other body parts if treatment is delayed.
Additional hemophilia treatments include desmopressin (a man-made hormone that stimulates the release of stored factor VIII) for moderate forms of hemophilia A, antifibrinolytic medicines that prevent clots from breaking down, and - in the future - gene therapies. A study revealed how Hemophilia A mice benefited from gene therapy.
How can I cope with hemophilia?
Though there is no way to prevent hemophilia, there are ways to avoid excessive bleeding and to protect joints. These include regular exercise, avoiding certain medications (such as aspirin, nonsteroidal anti-inflammatory drugs, and blood thinners such as heparin), practicing good dental hygiene, and protecting against injuries that can cause bleeding by wearing proper padding and practicing proper safety when engaging in physical or dangerous activities.
Written by Peter Crosta M.A.
Jun 22, 2009
What is Cancer? What Causes Cancer?
Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.
Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumors can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function. Tumors that stay in one spot and demonstrate limited growth are generally considered to be benign.
More dangerous, or malignant, tumors form when two things occur:
1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.
When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.
In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialize in the study, diagnosis, treatment, and prevention of cancer are called oncologists.
What causes cancer?
Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.
Genes - the DNA type
Cells can experience uncontrolled growth if there are damages or mutations to DNA, and therefore, damage to the genes involved in cell division. Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.
Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene function, leading to uncontrollable cell growth.
Carcinogens
Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.
Genes - the family type
Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.
Other medical factors
As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) - and anything else that suppresses or weakens the immune system - inhibits the body's ability to fight infections and increases the chance of developing cancer.
What are the symptoms of cancer?
Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Some cancers can be felt or seen through the skin - a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.
Other cancers have symptoms that are less physically apparent. Some brain tumors tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumor grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.
As cancer cells use the body's energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.
When cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.
How is cancer classified?
There are five broad groups that are used to classify cancer.
1. Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.
2. Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.
3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
4. Leukemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.
5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.
Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:
* Adeno- = gland
* Chondro- = cartilage
* Erythro- = red blood cell
* Hemangio- = blood vessels
* Hepato- = liver
* Lipo- = fat
* Lympho- = white blood cell
* Melano- = pigment cell
* Myelo- = bone marrow
* Myo- = muscle
* Osteo- = bone
* Uro- = bladder
* Retino- = eye
* Neuro- = brain
How is cancer diagnosed and staged?
Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.
Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body's sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.
After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.
TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable.
How is cancer treated?
Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.
Surgery
Surgery is the oldest known treatment for cancer. If a cancer has not metastasized, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.
Radiation
Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumor or destroy cancer cells (including those associated with leukemia and lymphoma), and it is also used in combination with other cancer treatments.
Chemotherapy
Chemotherapy utilizes chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasized because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.
Immunotherapy
Immunotherapy aims to get the body's immune system to fight the tumor. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumor to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumors. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoetic stem cell transplantation) can also be considered immunotherapy because the donor's immune cells will often attack the tumor or cancer cells that are present in the host.
Hormone therapy
Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing estrogen levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukemia and lymphoma cases can be treated with the hormone cortisone.
Gene therapy
The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.
How can cancer be prevented?
Cancers that are closely linked to certain behaviors are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer - most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.
Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.
Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus's relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.
Some cancer prevention is based on systematic screening in order to detect small irregularities or tumors as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.
Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumors can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function. Tumors that stay in one spot and demonstrate limited growth are generally considered to be benign.
More dangerous, or malignant, tumors form when two things occur:
1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.
When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.
In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialize in the study, diagnosis, treatment, and prevention of cancer are called oncologists.
What causes cancer?
Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.
Genes - the DNA type
Cells can experience uncontrolled growth if there are damages or mutations to DNA, and therefore, damage to the genes involved in cell division. Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.
Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene function, leading to uncontrollable cell growth.
Carcinogens
Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.
Genes - the family type
Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.
Other medical factors
As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) - and anything else that suppresses or weakens the immune system - inhibits the body's ability to fight infections and increases the chance of developing cancer.
What are the symptoms of cancer?
Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Some cancers can be felt or seen through the skin - a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.
Other cancers have symptoms that are less physically apparent. Some brain tumors tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumor grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.
As cancer cells use the body's energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.
When cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.
How is cancer classified?
There are five broad groups that are used to classify cancer.
1. Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.
2. Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.
3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
4. Leukemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.
5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.
Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:
* Adeno- = gland
* Chondro- = cartilage
* Erythro- = red blood cell
* Hemangio- = blood vessels
* Hepato- = liver
* Lipo- = fat
* Lympho- = white blood cell
* Melano- = pigment cell
* Myelo- = bone marrow
* Myo- = muscle
* Osteo- = bone
* Uro- = bladder
* Retino- = eye
* Neuro- = brain
How is cancer diagnosed and staged?
Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.
Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body's sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.
After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.
TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable.
How is cancer treated?
Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.
Surgery
Surgery is the oldest known treatment for cancer. If a cancer has not metastasized, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.
Radiation
Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumor or destroy cancer cells (including those associated with leukemia and lymphoma), and it is also used in combination with other cancer treatments.
Chemotherapy
Chemotherapy utilizes chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasized because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.
Immunotherapy
Immunotherapy aims to get the body's immune system to fight the tumor. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumor to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumors. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoetic stem cell transplantation) can also be considered immunotherapy because the donor's immune cells will often attack the tumor or cancer cells that are present in the host.
Hormone therapy
Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing estrogen levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukemia and lymphoma cases can be treated with the hormone cortisone.
Gene therapy
The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.
How can cancer be prevented?
Cancers that are closely linked to certain behaviors are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer - most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.
Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.
Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus's relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.
Some cancer prevention is based on systematic screening in order to detect small irregularities or tumors as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.
Jun 18, 2009
United To Fight Child Hunger Across The World
Tens of thousands of people yesterday took to the streets in cities around the world to show their support for the work of the United Nations World Food Programme (WFP) in the fight against global hunger.
The annual 'End Hunger: Walk the World' initiative mobilised an estimated 300,000 people to raise awareness and funds for WFP's school feeding programmes. At least 200 walks took place in 70 countries across all 24 time zones.
Now in its seventh year, the Walk the World event is sponsored by three of WFP's global private sector partners: express delivery company TNT, consumer goods company Unilever, and nutrition and life-science specialists DSM.
"Walk the World - both in its global scope and in its diversity - showed that the problem of hunger and undernutrition resonates with people from all walks of life," said Nancy Roman, WFP's Director of Public Policy, Communications and Private Partnerships. "Hunger is a problem that touches one out of every seven people on this planet, and it is our responsibility to take action collectively to fight hunger."
The worldwide series of walks kicked off in Australia with a climb up Sydney Harbour Bridge. In the Philippines, monsoon rains gave way to a bright sunny day for 6,000 people to walk together in the streets of Manila, while in Indonesia an early-morning walk followed by a concert attracted 12,000 supporters.
The largest walks took place on the African continent, with 64,000 people walking in 53 locations in Malawi and 50,000 people gathering in Tanzania under the enthusiastic leadership of Prime Minister Mizengo Kayanza Peter Pinda, who walked in Arusha. In Burkina Faso, Walk the World became a flagship event for the women of the country. Under the patronage of the first lady Chantal Kompaoré and many other eminent women, the walk and concert attracted 15,000 people. In Kenya, WFP Ambassador Against Hunger Paul Tergat - a champion marathon runner and former school feeding beneficiary - joined walkers in Nairobi.
In Europe, the largest walk took place in Portugal with about 4,000 participants, while the CEOs of the three global sponsors of the event walked in The Hague in The Netherlands. In Denmark, participants braved blustery weather to walk together and to taste a rice-and-beans dish prepared by a celebrity chef inspired by the meals WFP distributes to schoolchildren in Tanzania.
Supporters of the fight against hunger in Egypt walked through the old citadel of Cairo. In the Americas, walks began in New York City with a walk in Battery Park. WFP's Filipina Ambassador Against Hunger KC Concepcion, on tour in Canada, joined walkers in Toronto. In Latin America, walks ranged from a massive 30,000 participants in the Honduran capital of Tegucigalpa to just a few hundred determined walkers on the island of Trinidad.
Hundreds of supporters also joined a virtual online walk, where donations were counted as miles walked with the objective of 'walking' 25,000 miles around the world. At the time of writing more than US$17,600 had been donated. The online walk will remain open at http://www.wfp.org/walktheweb until the end of June.
Source
United Nations World Food Programme
The annual 'End Hunger: Walk the World' initiative mobilised an estimated 300,000 people to raise awareness and funds for WFP's school feeding programmes. At least 200 walks took place in 70 countries across all 24 time zones.
Now in its seventh year, the Walk the World event is sponsored by three of WFP's global private sector partners: express delivery company TNT, consumer goods company Unilever, and nutrition and life-science specialists DSM.
"Walk the World - both in its global scope and in its diversity - showed that the problem of hunger and undernutrition resonates with people from all walks of life," said Nancy Roman, WFP's Director of Public Policy, Communications and Private Partnerships. "Hunger is a problem that touches one out of every seven people on this planet, and it is our responsibility to take action collectively to fight hunger."
The worldwide series of walks kicked off in Australia with a climb up Sydney Harbour Bridge. In the Philippines, monsoon rains gave way to a bright sunny day for 6,000 people to walk together in the streets of Manila, while in Indonesia an early-morning walk followed by a concert attracted 12,000 supporters.
The largest walks took place on the African continent, with 64,000 people walking in 53 locations in Malawi and 50,000 people gathering in Tanzania under the enthusiastic leadership of Prime Minister Mizengo Kayanza Peter Pinda, who walked in Arusha. In Burkina Faso, Walk the World became a flagship event for the women of the country. Under the patronage of the first lady Chantal Kompaoré and many other eminent women, the walk and concert attracted 15,000 people. In Kenya, WFP Ambassador Against Hunger Paul Tergat - a champion marathon runner and former school feeding beneficiary - joined walkers in Nairobi.
In Europe, the largest walk took place in Portugal with about 4,000 participants, while the CEOs of the three global sponsors of the event walked in The Hague in The Netherlands. In Denmark, participants braved blustery weather to walk together and to taste a rice-and-beans dish prepared by a celebrity chef inspired by the meals WFP distributes to schoolchildren in Tanzania.
Supporters of the fight against hunger in Egypt walked through the old citadel of Cairo. In the Americas, walks began in New York City with a walk in Battery Park. WFP's Filipina Ambassador Against Hunger KC Concepcion, on tour in Canada, joined walkers in Toronto. In Latin America, walks ranged from a massive 30,000 participants in the Honduran capital of Tegucigalpa to just a few hundred determined walkers on the island of Trinidad.
Hundreds of supporters also joined a virtual online walk, where donations were counted as miles walked with the objective of 'walking' 25,000 miles around the world. At the time of writing more than US$17,600 had been donated. The online walk will remain open at http://www.wfp.org/walktheweb until the end of June.
Source
United Nations World Food Programme
Zimbabwean Nightmare Of Neglect Continues In South Africa
Zimbabwean Nightmare Of Neglect Continues In South Africa
Violence, sexual abuse, harassment, appalling living conditions, and a serious lack of access to essential healthcare define the desperate lives of thousands of Zimbabweans in South Africa, warned the international medical humanitarian aid organization, Doctors Without Borders/Médecins Sans Frontières (MSF).
Recent developments in Zimbabwe and South Africa have done little to alter the fact that scores of Zimbabweans continue to flee to South Africa as a matter of survival. Once they cross the border, their living conditions hardly improve. MSF is calling on the government of South Africa and United Nations (UN) agencies to urgently address the specific humanitarian needs of vulnerable Zimbabweans falling through the cracks of South African society.
Click here to read a new MSF report: "No Refuge, Access Denied: Medical and Humanitarian Needs of Zimbabweans in South Africa."
"Every day, despite claims that Zimbabwe is 'normalizing', thousands of Zimbabweans continue to cross the border into South Africa, fleeing economic meltdown, food insecurity, political turmoil, and the total collapse of their health system," said Rachel Cohen, head of mission for MSF in South Africa. "Instead of finding the refuge they so desperately need, they endure intolerable suffering on their journey to and within South Africa."
Since 2007, MSF has been providing basic primary health care, referral to secondary and specialized care services, emergency medical treatment for victims of violence and epidemic outbreaks, and specific services for survivors of sexual violence, as well as unaccompanied minors. Each month, MSF medical teams perform between 4,000-5,000 consultations for Zimbabweans in the South African border town of Musina and at a clinic at the Central Methodist Church in inner-city Johannesburg, a 'safe haven' for thousands of Zimbabweans.
"We see thousands of sick, wounded, psychologically scarred and marginalized Zimbabweans in both Johannesburg and Musina every month," said Dr Eric Goemaere, medical coordinator for MSF in South Africa. "They come to us because they have nowhere else to turn. Many of those who reach us have chronic diseases, such as HIV and TB, and severe violence-related injuries, most often from rape and sexual assault experienced while crossing the border from Zimbabwe, but also in South Africa itself. Consultations in our Johannesburg clinic have almost tripled in the last year, a telling sign of the extent to which Zimbabweans are consistently denied access to even the most basic health services necessary for their survival."
South Africa's constitution guarantees access to health care and other essential services to all who live in the country-including refugees, asylum-seekers, and migrants-regardless of legal status. But in reality Zimbabwean patients are rejected outright, or are often charged exorbitant fees and subjected to long delays, inappropriate treatment, or premature discharge, thus placing health care out of reach for many.
"The stories of our patients are truly shocking," said Bianca Tolboom, MSF nurse and project coordinator in Johannesburg. "I'm talking about pregnant women, unconscious or critically ill patients, even a six-year-old girl who had been raped, who were all refused the medical care they urgently required. It's deplorable, it's a breach of medical ethics and it's a violation of their rights under the South African Constitution. This nightmare of neglect must end."
MSF has been treating an increasing number of victims of sexual violence in Musina. In April, more than half of those treated had survived gang rape and 70 percent had been raped under threat of a gun, knife, or other weapon. Another worrying trend is the number of unaccompanied children crossing the border alone. They make their way to the Central Methodist Church, a journey of more than 500 kilometers, where as many as 4,000 Zimbabweans seek shelter each night - either dangerously packed into all available space inside the building, or sleeping on the pavement outside the church. Currently, there are more than 150 unaccompanied children between the ages of seven and 18 years crammed into the church. These children are extremely vulnerable and exposed to many forms of abuse in South Africa, yet no viable solution has been found to ensure they are properly assisted or protected.
"Each day, MSF teams witness the failure of the South African government primarily, but also of UN agencies, to meet the basic medical and humanitarian needs of vulnerable Zimbabweans," said Rachel Cohen. "The recent announcement by the South African Department of Home Affairs that a new system will be put in place to regularize the legal status of Zimbabweans in South Africa, and to stop their systematic deportation, is a welcome departure from the government's previous policy of aggressive harassment, arrest, and deportation. However, these measures have yet to translate into tangible improvements in the lives of most Zimbabweans. Their only places of safety are under attack and they remain relegated to the shadows of society, forced to live in squalor and denied access to adequate assistance and protection."
Source
Doctors Without Borders/Médecins Sans Frontières
Violence, sexual abuse, harassment, appalling living conditions, and a serious lack of access to essential healthcare define the desperate lives of thousands of Zimbabweans in South Africa, warned the international medical humanitarian aid organization, Doctors Without Borders/Médecins Sans Frontières (MSF).
Recent developments in Zimbabwe and South Africa have done little to alter the fact that scores of Zimbabweans continue to flee to South Africa as a matter of survival. Once they cross the border, their living conditions hardly improve. MSF is calling on the government of South Africa and United Nations (UN) agencies to urgently address the specific humanitarian needs of vulnerable Zimbabweans falling through the cracks of South African society.
Click here to read a new MSF report: "No Refuge, Access Denied: Medical and Humanitarian Needs of Zimbabweans in South Africa."
"Every day, despite claims that Zimbabwe is 'normalizing', thousands of Zimbabweans continue to cross the border into South Africa, fleeing economic meltdown, food insecurity, political turmoil, and the total collapse of their health system," said Rachel Cohen, head of mission for MSF in South Africa. "Instead of finding the refuge they so desperately need, they endure intolerable suffering on their journey to and within South Africa."
Since 2007, MSF has been providing basic primary health care, referral to secondary and specialized care services, emergency medical treatment for victims of violence and epidemic outbreaks, and specific services for survivors of sexual violence, as well as unaccompanied minors. Each month, MSF medical teams perform between 4,000-5,000 consultations for Zimbabweans in the South African border town of Musina and at a clinic at the Central Methodist Church in inner-city Johannesburg, a 'safe haven' for thousands of Zimbabweans.
"We see thousands of sick, wounded, psychologically scarred and marginalized Zimbabweans in both Johannesburg and Musina every month," said Dr Eric Goemaere, medical coordinator for MSF in South Africa. "They come to us because they have nowhere else to turn. Many of those who reach us have chronic diseases, such as HIV and TB, and severe violence-related injuries, most often from rape and sexual assault experienced while crossing the border from Zimbabwe, but also in South Africa itself. Consultations in our Johannesburg clinic have almost tripled in the last year, a telling sign of the extent to which Zimbabweans are consistently denied access to even the most basic health services necessary for their survival."
South Africa's constitution guarantees access to health care and other essential services to all who live in the country-including refugees, asylum-seekers, and migrants-regardless of legal status. But in reality Zimbabwean patients are rejected outright, or are often charged exorbitant fees and subjected to long delays, inappropriate treatment, or premature discharge, thus placing health care out of reach for many.
"The stories of our patients are truly shocking," said Bianca Tolboom, MSF nurse and project coordinator in Johannesburg. "I'm talking about pregnant women, unconscious or critically ill patients, even a six-year-old girl who had been raped, who were all refused the medical care they urgently required. It's deplorable, it's a breach of medical ethics and it's a violation of their rights under the South African Constitution. This nightmare of neglect must end."
MSF has been treating an increasing number of victims of sexual violence in Musina. In April, more than half of those treated had survived gang rape and 70 percent had been raped under threat of a gun, knife, or other weapon. Another worrying trend is the number of unaccompanied children crossing the border alone. They make their way to the Central Methodist Church, a journey of more than 500 kilometers, where as many as 4,000 Zimbabweans seek shelter each night - either dangerously packed into all available space inside the building, or sleeping on the pavement outside the church. Currently, there are more than 150 unaccompanied children between the ages of seven and 18 years crammed into the church. These children are extremely vulnerable and exposed to many forms of abuse in South Africa, yet no viable solution has been found to ensure they are properly assisted or protected.
"Each day, MSF teams witness the failure of the South African government primarily, but also of UN agencies, to meet the basic medical and humanitarian needs of vulnerable Zimbabweans," said Rachel Cohen. "The recent announcement by the South African Department of Home Affairs that a new system will be put in place to regularize the legal status of Zimbabweans in South Africa, and to stop their systematic deportation, is a welcome departure from the government's previous policy of aggressive harassment, arrest, and deportation. However, these measures have yet to translate into tangible improvements in the lives of most Zimbabweans. Their only places of safety are under attack and they remain relegated to the shadows of society, forced to live in squalor and denied access to adequate assistance and protection."
Source
Doctors Without Borders/Médecins Sans Frontières
The US National Heart, Lung, And Blood Institute Battles Chronic Disease In Developing Countries
The US National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, which is a founding member of the Global Alliance for Chronic Disease, has decided to go forward strongly and improve its plan to target chronic diseases in developing countries by collaborating with a leading health and wellbeing corporation. Together, they plan to build numerous centers of excellence (COEs) across the world. The details of this partnership have been published in a comment Online First and in this week's edition of The Lancet.
The article in the comment is written by Dr Elizabeth G Nabel, director of NHLBI, Bethesda, MD, USA; Simon Stevens, executive vice president of UnitedHealth Group; and Dr Richard Smith, director of the UnitedHealth Chronic Disease Initiative. It mentions that cancer, type 2 diabetes, cardiovascular and chronic respiratory diseases are the major problems that face the developing nations with an astonishing 80 percent of chronic disease related deaths occuring in these poorer nations. These diseases are also responsible of causing more than half of all the deaths worldwide. The authors continue by saying: "If present trends continue unabated, annual deaths from chronic diseases will reach 41 million by 2015, and almost half of these will be in people younger than 70 years. Since the major causes of chronic diseases are known, half of these deaths are preventable."
NHLBI has developed a partnership with UnitedHealth group, producing an association of COEs worldwide, including in Bangladesh, China, Guatemala, India, Kenya, Peru, South Africa-Tanzania, Tunisia, and the US-Mexico border. The authors say: "Each COE includes a research institution in a developing country paired with at least one partner academic institution in a developed country. The research goals span a range of activities tailored to regional needs and disease effect...Clearly, not only do chronic diseases know no boundaries, they also travel together. Thus, the consortium aims to broaden study beyond individual diseases, in keeping with WHO's recommendation to address chronic diseases as they group in a real-world setting."
The first COEs in the South Africa-Tanzania and China sites developed portable tools that can be used in the field to determine risk of chronic disease. The South African site is near completion putting emphasis on straightforward and comprehensive chronic disease management guidelines that can be used by nurses and community health workers. Some COEs, such as those in India-Bangalore, Guatemala, Tunisia, and along the US/Mexico border, are working with whole small communities; helping in redesigning entirely, including schools and workplaces so that choices are simple and practical. In general, the early results of the first COEs are very promising.
In conclusion, the authors mention: "The NHLBI and the UnitedHealth Group will work in partnership with...other entities to enhance synergy and to avoid duplication. To that end, the NHLBI is a founding member of the Global Alliance for Chronic Disease, a new alliance of six initial national biomedical research funders to address research needs in the chronic non-communicable diseases.
"Now is the time for sustained and coordinated scientific leadership to focus global efforts on combating the social, economic, and political toll of chronic disease. The NHLBI and UnitedHealth Group collaboration is an important piece of this public health initiative that is so vital for our global citizenry."
"Combating chronic disease in developing countries"
Elizabeth G Nabel, Simon Stevens, Richard Smith
The article in the comment is written by Dr Elizabeth G Nabel, director of NHLBI, Bethesda, MD, USA; Simon Stevens, executive vice president of UnitedHealth Group; and Dr Richard Smith, director of the UnitedHealth Chronic Disease Initiative. It mentions that cancer, type 2 diabetes, cardiovascular and chronic respiratory diseases are the major problems that face the developing nations with an astonishing 80 percent of chronic disease related deaths occuring in these poorer nations. These diseases are also responsible of causing more than half of all the deaths worldwide. The authors continue by saying: "If present trends continue unabated, annual deaths from chronic diseases will reach 41 million by 2015, and almost half of these will be in people younger than 70 years. Since the major causes of chronic diseases are known, half of these deaths are preventable."
NHLBI has developed a partnership with UnitedHealth group, producing an association of COEs worldwide, including in Bangladesh, China, Guatemala, India, Kenya, Peru, South Africa-Tanzania, Tunisia, and the US-Mexico border. The authors say: "Each COE includes a research institution in a developing country paired with at least one partner academic institution in a developed country. The research goals span a range of activities tailored to regional needs and disease effect...Clearly, not only do chronic diseases know no boundaries, they also travel together. Thus, the consortium aims to broaden study beyond individual diseases, in keeping with WHO's recommendation to address chronic diseases as they group in a real-world setting."
The first COEs in the South Africa-Tanzania and China sites developed portable tools that can be used in the field to determine risk of chronic disease. The South African site is near completion putting emphasis on straightforward and comprehensive chronic disease management guidelines that can be used by nurses and community health workers. Some COEs, such as those in India-Bangalore, Guatemala, Tunisia, and along the US/Mexico border, are working with whole small communities; helping in redesigning entirely, including schools and workplaces so that choices are simple and practical. In general, the early results of the first COEs are very promising.
In conclusion, the authors mention: "The NHLBI and the UnitedHealth Group will work in partnership with...other entities to enhance synergy and to avoid duplication. To that end, the NHLBI is a founding member of the Global Alliance for Chronic Disease, a new alliance of six initial national biomedical research funders to address research needs in the chronic non-communicable diseases.
"Now is the time for sustained and coordinated scientific leadership to focus global efforts on combating the social, economic, and political toll of chronic disease. The NHLBI and UnitedHealth Group collaboration is an important piece of this public health initiative that is so vital for our global citizenry."
"Combating chronic disease in developing countries"
Elizabeth G Nabel, Simon Stevens, Richard Smith
Jun 12, 2009
The Key Causes For Bowel Cancer Are Alcohol And Smoking
A new global study has found that lifestyle risk factors such as alcohol consumption and cigarette smoking are important risk factors for bowel cancer. Researchers have shown that people who consume the largest quantities of alcohol (equivalent to > 7 drinks per week) have 60% greater risk of developing the cancer, compared with non-drinkers.
Smoking, obesity and diabetes were also associated with a 20% greater risk of developing bowel cancer - the same risk linked with consuming high intakes of red and processed meat.
Approximately one million new cases of bowel (colorectal) cancer are diagnosed worldwide each year, and more than half a million people die from this type of cancer. In Australia alone, it is the most commonly occurring cancer with more than 12,000 new cases diagnosed each year.
According to lead researcher Associate Professor Rachel Huxley at The George Institute, the most startling finding of this study was, "The strong, and largely, unknown association between high intakes of alcoholic beverages with risk of colorectal cancer. Most people probably know that being overweight and having poor dietary habits are risk factors for the disease, but most are probably unaware that other lifestyle risk factors such as alcohol consumption, cigarette smoking and diabetes are also important culprits."
Australia's National Health and Medical Research Council recommend individuals shouldn't be drinking more than two standard drinks per day.
On a positive note, researchers also demonstrated that physical activity lowered an individual's risk of the disease but surprisingly, there was little evidence to indicate that high intakes of fruit and vegetables were protective against bowel cancer.
"These findings strongly suggest that a large proportion of colorectal cancer cases could potentially be avoided by making relatively modest lifestyle adjustments such as drinking less, quitting smoking, eating healthily and being a little more active", said Associate Professor Huxley. "Such changes would also have huge benefits in terms of reducing an individuals' risk of developing other major forms of illness including cardiovascular disease."
The study reviewed more than 100 published studies that had reported on the association between major and modifiable risk factors for colorectal cancer including alcohol, smoking, diabetes, physical activity and various dietary components.
Reference: Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
This study received support from a National Health and Medical Research Council of Australia program grant, and an unrestricted educational grant from Meat and Livestock Australia.
Source:
Emma Orpilla
Research Australia
Smoking, obesity and diabetes were also associated with a 20% greater risk of developing bowel cancer - the same risk linked with consuming high intakes of red and processed meat.
Approximately one million new cases of bowel (colorectal) cancer are diagnosed worldwide each year, and more than half a million people die from this type of cancer. In Australia alone, it is the most commonly occurring cancer with more than 12,000 new cases diagnosed each year.
According to lead researcher Associate Professor Rachel Huxley at The George Institute, the most startling finding of this study was, "The strong, and largely, unknown association between high intakes of alcoholic beverages with risk of colorectal cancer. Most people probably know that being overweight and having poor dietary habits are risk factors for the disease, but most are probably unaware that other lifestyle risk factors such as alcohol consumption, cigarette smoking and diabetes are also important culprits."
Australia's National Health and Medical Research Council recommend individuals shouldn't be drinking more than two standard drinks per day.
On a positive note, researchers also demonstrated that physical activity lowered an individual's risk of the disease but surprisingly, there was little evidence to indicate that high intakes of fruit and vegetables were protective against bowel cancer.
"These findings strongly suggest that a large proportion of colorectal cancer cases could potentially be avoided by making relatively modest lifestyle adjustments such as drinking less, quitting smoking, eating healthily and being a little more active", said Associate Professor Huxley. "Such changes would also have huge benefits in terms of reducing an individuals' risk of developing other major forms of illness including cardiovascular disease."
The study reviewed more than 100 published studies that had reported on the association between major and modifiable risk factors for colorectal cancer including alcohol, smoking, diabetes, physical activity and various dietary components.
Reference: Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
This study received support from a National Health and Medical Research Council of Australia program grant, and an unrestricted educational grant from Meat and Livestock Australia.
Source:
Emma Orpilla
Research Australia
Swine Flu (H1N1) Reaches Level 6 Pandemic
The international outbreak of swine flu has now hit the highest level set by World Health Organization (WHO) standards. As reported yesterday, the H1N1 has evolved over the last few days, causing officials to consider elevating the alert status. This morning, WHO Director-General Dr. Margaret Chan officially announced the change in status from level 5 to level 6, saying, “On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.”
Dr. Margaret Chan warned that, "This means the world is moving into the early days of its first influenza pandemic in the 21st century.” While the alert has been raised to level 6 (of 6), she is optimistic and explained that the pandemic is considered moderate at this time. This is due, in part, to the pandemic preparedness that has been put in place over the last five years. She seemed confident that “we have a head start…and…are in a strong position.”
Level 6 means that the “spread of the virus continues and activity has become established in at least two regions in the world,” according to Dr. Keiji Fukuda, acting WHO assistant director-general. At present, 74 countries have officially reported 28,774 cases of influenza H1N1infection, including 144 deaths. Addressing the increase in cases and deaths, Dr. Chan said, “Worldwide, the number of deaths is small. Each and every one of these deaths is tragic, and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.”
Currently, the countries with the most cases are:
* United States 13,217
* Mexico 6,241
* Canada 2,446
* Chile 1,694
* Australia 1,307
The highest number of deaths has occurred in Mexico, with 108. The United States is a distant second with 27 deaths. No other country has reported more than 4 deaths. For more details, WHO has published a map of influenza outbreak, which you can access here.
source:
By: Susan Brady
Dr. Margaret Chan warned that, "This means the world is moving into the early days of its first influenza pandemic in the 21st century.” While the alert has been raised to level 6 (of 6), she is optimistic and explained that the pandemic is considered moderate at this time. This is due, in part, to the pandemic preparedness that has been put in place over the last five years. She seemed confident that “we have a head start…and…are in a strong position.”
Level 6 means that the “spread of the virus continues and activity has become established in at least two regions in the world,” according to Dr. Keiji Fukuda, acting WHO assistant director-general. At present, 74 countries have officially reported 28,774 cases of influenza H1N1infection, including 144 deaths. Addressing the increase in cases and deaths, Dr. Chan said, “Worldwide, the number of deaths is small. Each and every one of these deaths is tragic, and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.”
Currently, the countries with the most cases are:
* United States 13,217
* Mexico 6,241
* Canada 2,446
* Chile 1,694
* Australia 1,307
The highest number of deaths has occurred in Mexico, with 108. The United States is a distant second with 27 deaths. No other country has reported more than 4 deaths. For more details, WHO has published a map of influenza outbreak, which you can access here.
source:
By: Susan Brady
Jun 9, 2009
Keeping Crohn’s Disease in Check
Crohn’s disease is a chronic inflammatory disease of the digestive system. The cause is unknown, and there is no medical cure. The disorder primarily is responsible for ulcerations in the small and large intestines, but can affect the digestive system from the mouth to the anus. Crohn’s disease is closely related to ulcerative colitis, another chronic condition, and both are frequently called IBD (inflammatory bowel disease). It is estimated that there are between 500,000 to 2 million people suffering from the disorders in the United States. Unlike many diseases that affect one sex more than the other, IBD affects the genders equally. IBD generally begins in adolescence or early adulthood, but it can begin earlier or later in life. Individuals who have a close blood relative with Crohn’s disease are more likely to have the disease.
Those affected with Crohn’s disease suffer from abdominal pain and diarrhea. They may also have rectal bleeding, weight loss, fever, and skin problems. Children with Crohn’s disease may suffer from slow growth and development.
Corticosteroids such as prednisone and hydrocortisone have been used in the treatment of Crohn’s disease for many years. Steroids are non-specific treatments, meaning they affect the entire body and not just the disease they are being used for. Cortisteroid treatments have the possibility of side effects, including changes in bone structure and thinning of the skin. These side effects normally do not reverse if the medication is discontinued.
Researchers recently released the results of an international study involving the treatment of Crohn's patients who received a combination of infliximab (Remicade) and azathioprine (Azasan). Patients being treated with both drugs had a higher rate of steroid-free remission than those receiving only one drug.
Researchers divided 508 patients, with moderate to severe Crohn’s disease who had not previously been treated with the drugs involved in the study, into three groups. One group received both infliximab and azathioprine, group two received infliximab and a placebo, and group three received azathioprine and a placebo for 30 weeks, with the option to continue in a blinded study through 50 weeks.
After 50 weeks, 72.2 percent of patients in the drug combination group were in steroid-free remission, as compared to 60.8 percent in the infliximab group, and 54.7 who had taken azathioprine only. The results were released in a Digestive Disease Week news release.
Colonoscopies and a Crohn’s Disease Activity Index were used to measure clinical symptoms. The patients who did not enroll in the study extension to 50 weeks were assumed to have continued symptoms, the remaining patients in steroid-free remission at the end of the study was 46.2 percent of the infliximab plus azathioprine group, 34.9 percent with infliximab therapy, and 24.1 percent with azathioprine treatment.
Patients who developed serious infections were similar in all groups and in the study extension there were no new infections or deaths.
“This study will provide practitioners and their patients with more clinical data on how to use these drugs most appropriately to most effectively treat Crohn’s disease,” study author Dr. William J Sanborn, vice chair of the division of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minnesota said in a news release. “For the first time, we have longer-term outcome data on the advantages of combination therapy that will help guide our treatment of patients with Crohn’s disease.” In this study patients were started on the drugs earlier than occurs in typical treatment, Sanborn noted.
Infliximab is a monocional antibody, increasingly used to treat several types of gastroenterological disorders. Monocional antibodies are specific antibodies which are identical because they are produced as a clone of a single parent cell to treat a specific disorder.
Dr. Nicholas J. Shaheen, of the University of North Carolina School of Medicine said that the use of monoclonal antibodies is rising for a number of gastroenterological disorders, such as inflammatory bowel disease and new indications for the treatments are continuing to be developed. The safety profile is better understood, making good treatment options for patients with recurrent or chronic gastrointestinal diseases.
Humira, another monoclonal antibody, was approved by the FDA for the treatment of Crohn's disease in 2007. New study results of this drug demonstrate its long-term efficacy in patients with moderately to severely active Crohn's disease.
Crohn’s disease cannot be cured but it may be easier in the future to relieve the symptoms without the side effects associated with older treatments.
Those affected with Crohn’s disease suffer from abdominal pain and diarrhea. They may also have rectal bleeding, weight loss, fever, and skin problems. Children with Crohn’s disease may suffer from slow growth and development.
Corticosteroids such as prednisone and hydrocortisone have been used in the treatment of Crohn’s disease for many years. Steroids are non-specific treatments, meaning they affect the entire body and not just the disease they are being used for. Cortisteroid treatments have the possibility of side effects, including changes in bone structure and thinning of the skin. These side effects normally do not reverse if the medication is discontinued.
Researchers recently released the results of an international study involving the treatment of Crohn's patients who received a combination of infliximab (Remicade) and azathioprine (Azasan). Patients being treated with both drugs had a higher rate of steroid-free remission than those receiving only one drug.
Researchers divided 508 patients, with moderate to severe Crohn’s disease who had not previously been treated with the drugs involved in the study, into three groups. One group received both infliximab and azathioprine, group two received infliximab and a placebo, and group three received azathioprine and a placebo for 30 weeks, with the option to continue in a blinded study through 50 weeks.
After 50 weeks, 72.2 percent of patients in the drug combination group were in steroid-free remission, as compared to 60.8 percent in the infliximab group, and 54.7 who had taken azathioprine only. The results were released in a Digestive Disease Week news release.
Colonoscopies and a Crohn’s Disease Activity Index were used to measure clinical symptoms. The patients who did not enroll in the study extension to 50 weeks were assumed to have continued symptoms, the remaining patients in steroid-free remission at the end of the study was 46.2 percent of the infliximab plus azathioprine group, 34.9 percent with infliximab therapy, and 24.1 percent with azathioprine treatment.
Patients who developed serious infections were similar in all groups and in the study extension there were no new infections or deaths.
“This study will provide practitioners and their patients with more clinical data on how to use these drugs most appropriately to most effectively treat Crohn’s disease,” study author Dr. William J Sanborn, vice chair of the division of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minnesota said in a news release. “For the first time, we have longer-term outcome data on the advantages of combination therapy that will help guide our treatment of patients with Crohn’s disease.” In this study patients were started on the drugs earlier than occurs in typical treatment, Sanborn noted.
Infliximab is a monocional antibody, increasingly used to treat several types of gastroenterological disorders. Monocional antibodies are specific antibodies which are identical because they are produced as a clone of a single parent cell to treat a specific disorder.
Dr. Nicholas J. Shaheen, of the University of North Carolina School of Medicine said that the use of monoclonal antibodies is rising for a number of gastroenterological disorders, such as inflammatory bowel disease and new indications for the treatments are continuing to be developed. The safety profile is better understood, making good treatment options for patients with recurrent or chronic gastrointestinal diseases.
Humira, another monoclonal antibody, was approved by the FDA for the treatment of Crohn's disease in 2007. New study results of this drug demonstrate its long-term efficacy in patients with moderately to severely active Crohn's disease.
Crohn’s disease cannot be cured but it may be easier in the future to relieve the symptoms without the side effects associated with older treatments.
Jun 2, 2009
Unvaccinated Children at Much Greater Risk for Whooping Cough
Whooping cough, known medically as pertussis, is a highly contagious infection of the respiratory system that is marked by severe coughing spells that end in a “whooping” sound when the person breathes in. Before a vaccine was available, whooping cough was a major cause of childhood illness and death in the U.S., but 
with the introduction of a vaccine in the 1940s, the number of cases fell from approximately 200,000 a year to an all-time low of 1,010 in 1976. Since then, however, the number of whooping cough cases has been steadily increasing, reaching 25,827 in 2004; the highest since 1959. Experts believe this trend could be due in part to the rising number of parents who refuse some or all of the recommended immunizations for their children—a theory confirmed by a recent study.
To get a better idea of the impact immunization refusal has had on whooping cough, Dr. Jason Glanz and colleagues analyzed the records of children 2 months to 18 years enrolled in the Kaiser Permanente Colorado health plan from 1996 to 2007. They looked for children who had laboratory-confirmed cases of whooping cough, and for those whose parents had refused at least one of the initial series of DPT—diphtheria, pertussis, and tetanus—immunizations for nonmedical reasons. The researchers found that unvaccinated children were 23 times more likely to get the infection than those who received the full course of immunizations.
Additionally, a second analysis of 27,748 children from 2 to 20 months of age who were continuously enrolled at Kaiser Permanente, there was a similarly high risk of infection among the children of parents who refused the vaccine. “This study helps dispel one of the commonly held beliefs among vaccine-refusing parents: that their children are not at risk for vaccine-preventable diseases,” Dr. Glanz said. “It also shows that the decision to refuse immunizations could have important ramifications for the health of the entire community. Based on our analysis, we found that 1 in 10 additional whooping cough infections could have been prevented by immunization.”
While the study did not examine the reasons why parents refused to have their children vaccinated, the researchers say it could be because as many vaccine-preventable diseases, such as whooping cough, polio and smallpox, become rarer, parents are shifting their focus from disease prevention to issues of vaccine safety. Though numerous studies have found no link between vaccines and autism, the fear is still prompting some parents to refuse vaccinations. Other parents believe their children are at low risk for infection and that many diseases aren’t a severe enough threat to their children’s health. “These findings stress the need to further understand why parents refuse immunizations and to develop strategies for conveying the risks and benefits of immunizations to parents more effectively,” the researchers write.
Dr. Gregory Poland, director of Mayo Clinic Vaccine Research Group in Rochester, Minnesota says the findings are consistent with other studies and agrees that “parents need to know they place their children at a documented and real risk, as well as others, when they refuse vaccines based on inaccurate information.” He added that “there is plenty of pertussis out there and it is highly contagious.”
The bacteria spread from person to person through tiny drops of fluid from an infected person’s nose or mouth. These may become airborne when the person coughs, sneezes, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. Experts believe that up to 80 percent of non-immunized family members will develop whooping cough if they live in the same house with someone who has the infection.
Dr. Glanz and his colleagues say they are concerned that the decreased immunization rates could also lead to other disease outbreaks across the country. For instance, in 2008 there were 131 cases of measles, the most in 12 years.
The study will appear in the June 2009 issue of the journal Pediatrics.
with the introduction of a vaccine in the 1940s, the number of cases fell from approximately 200,000 a year to an all-time low of 1,010 in 1976. Since then, however, the number of whooping cough cases has been steadily increasing, reaching 25,827 in 2004; the highest since 1959. Experts believe this trend could be due in part to the rising number of parents who refuse some or all of the recommended immunizations for their children—a theory confirmed by a recent study.
To get a better idea of the impact immunization refusal has had on whooping cough, Dr. Jason Glanz and colleagues analyzed the records of children 2 months to 18 years enrolled in the Kaiser Permanente Colorado health plan from 1996 to 2007. They looked for children who had laboratory-confirmed cases of whooping cough, and for those whose parents had refused at least one of the initial series of DPT—diphtheria, pertussis, and tetanus—immunizations for nonmedical reasons. The researchers found that unvaccinated children were 23 times more likely to get the infection than those who received the full course of immunizations.
Additionally, a second analysis of 27,748 children from 2 to 20 months of age who were continuously enrolled at Kaiser Permanente, there was a similarly high risk of infection among the children of parents who refused the vaccine. “This study helps dispel one of the commonly held beliefs among vaccine-refusing parents: that their children are not at risk for vaccine-preventable diseases,” Dr. Glanz said. “It also shows that the decision to refuse immunizations could have important ramifications for the health of the entire community. Based on our analysis, we found that 1 in 10 additional whooping cough infections could have been prevented by immunization.”
While the study did not examine the reasons why parents refused to have their children vaccinated, the researchers say it could be because as many vaccine-preventable diseases, such as whooping cough, polio and smallpox, become rarer, parents are shifting their focus from disease prevention to issues of vaccine safety. Though numerous studies have found no link between vaccines and autism, the fear is still prompting some parents to refuse vaccinations. Other parents believe their children are at low risk for infection and that many diseases aren’t a severe enough threat to their children’s health. “These findings stress the need to further understand why parents refuse immunizations and to develop strategies for conveying the risks and benefits of immunizations to parents more effectively,” the researchers write.
Dr. Gregory Poland, director of Mayo Clinic Vaccine Research Group in Rochester, Minnesota says the findings are consistent with other studies and agrees that “parents need to know they place their children at a documented and real risk, as well as others, when they refuse vaccines based on inaccurate information.” He added that “there is plenty of pertussis out there and it is highly contagious.”
The bacteria spread from person to person through tiny drops of fluid from an infected person’s nose or mouth. These may become airborne when the person coughs, sneezes, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. Experts believe that up to 80 percent of non-immunized family members will develop whooping cough if they live in the same house with someone who has the infection.
Dr. Glanz and his colleagues say they are concerned that the decreased immunization rates could also lead to other disease outbreaks across the country. For instance, in 2008 there were 131 cases of measles, the most in 12 years.
The study will appear in the June 2009 issue of the journal Pediatrics.
Can Children Recover from Autism?
Autism is a disease that affects many Americans but little is known about it. Today there is more and more research being done to find ways to cope with the illness and to bring more awareness into American homes. The most recent research has shown that approximately 10 percent of children that suffer from the autism could actually recover.
One of the people who proved this is possible is Leo Lytel. He was diagnosed with autism as a small child, but by the age of 9 he had overcome the disorder. Lytel’s progress is part of a growing study that suggests at least 10 percent of children with autism can “recover” from it; however, most of the recoveries occur after years of undergoing intensive behavioral therapy.
Many of the skeptics question this phenomenon, but Deborah Fein, who is a psychology professor at the University of Connecticut, is among the group that is convinced that the facts are real. This week she presented research at an autism conference that was held in Chicago that included 20 children who, according to very rigorous analysis, received a correct diagnosis but years later were no longer still considered to be autistic. This study was funded by the National Institute of Mental Health and involved children between the ages of 9 to 18.
Among these children was Leo, a boy from Washington, D.C., who once never made eye contact, who echoed most words spoken to him and often spun around in circles, all classic symptoms of autism. Today, he is an articulate and social third grade student, and his teacher calls him a leader.
Geraldine Dawson, who is an autism researcher and chief science officer of the advocacy group Autism Speaks, said that Fein’s research was a breakthrough. “Even though a number of us out in the clinical field have seen kids who appear to recover,” it has never been thoroughly documented like Fein’s work, Dawson stated. She also said that they were still at a very early stage in terms of actually understanding this phenomenon.
Previous studies have suggested that anywhere from 3 percent to 25 percent of children with autism recover. Fein says that her studies have shown that the range is between 10 and 20 percent. However, even after numerous amounts of therapy, carefully designed social activities, and education with rewards, most of the autistic children remain autistic.
Fein stated that recovery is not really a realistic expectation for the majority of the children, but the parents should know that it can happen. Doubters usually say that “either they really weren’t autistic to begin with…” or “they’re still socially odd and obsessive, but they don’t exactly meet criteria” for the illness. Fein said that the children that were in her study “really were” autistic and no the children are “really not.”
Catherine Lord, an autism expert from the University of Michigan, said that she has also seen autistic patients recover. Most of them had parents who spent long hard hours working with them on the improvement of their behavior. However, Lord also said that it is not likely that we will be able to predict whom this will happen for or whether it is possible to make it happen.
An autism specialist diagnosed the children from Fein’s ongoing study before the age of 5 but who in later years no longer meet the diagnostic criteria to be considered autistic. Early medical records confirmed the initial diagnoses for the children. Because this phenomenon is considered rare, Fein is still looking for more children to help bolster evidence on which traits the formerly autistic children may have in common. Her research team is also comparing these children with other children who were both autistic and non-autistic. So far, the kids that are considered to be “recovered” are turning out to be very normal on neuropsychological exams and verbal and nonverbal tests.
The researchers are also performing imaging tests to see if the recovered children’s brains resemble the brains of the autistic or non-autistic children. The brains of the children that suffer from autism tend to be slightly larger than normal. The imaging scans are also being performed to examine the brain function in formerly autistic children. The researchers want to know if their “normal” behavior is a result of “normal” brain activity, or if it is the way their brains process information in a non-typical way to compensate for any deficits. The results from these tests are still being analyzed.
Most of the children who were formerly autistic got long-term behavior treatment very soon after their diagnosis, in some cases for 30 to 40 hours a week. Many of the children also have above-average IQs and had been diagnosed with cases of autism that were relatively mild. By the age of 2, many were within the normal range for motor development, they were able to walk, climb, and also hold a pencil. The most significant improvement that suggested recovery was evident around the age of 7 in most cases, Fein stated.
None of these children have shown any sign of relapse, but nearly three-fourths of the kids that were formerly autistic have had other disorders which include tics, phobias, and attention-deficit problems. Also, eight of the children are still affected.
One of the people who proved this is possible is Leo Lytel. He was diagnosed with autism as a small child, but by the age of 9 he had overcome the disorder. Lytel’s progress is part of a growing study that suggests at least 10 percent of children with autism can “recover” from it; however, most of the recoveries occur after years of undergoing intensive behavioral therapy.
Many of the skeptics question this phenomenon, but Deborah Fein, who is a psychology professor at the University of Connecticut, is among the group that is convinced that the facts are real. This week she presented research at an autism conference that was held in Chicago that included 20 children who, according to very rigorous analysis, received a correct diagnosis but years later were no longer still considered to be autistic. This study was funded by the National Institute of Mental Health and involved children between the ages of 9 to 18.
Among these children was Leo, a boy from Washington, D.C., who once never made eye contact, who echoed most words spoken to him and often spun around in circles, all classic symptoms of autism. Today, he is an articulate and social third grade student, and his teacher calls him a leader.
Geraldine Dawson, who is an autism researcher and chief science officer of the advocacy group Autism Speaks, said that Fein’s research was a breakthrough. “Even though a number of us out in the clinical field have seen kids who appear to recover,” it has never been thoroughly documented like Fein’s work, Dawson stated. She also said that they were still at a very early stage in terms of actually understanding this phenomenon.
Previous studies have suggested that anywhere from 3 percent to 25 percent of children with autism recover. Fein says that her studies have shown that the range is between 10 and 20 percent. However, even after numerous amounts of therapy, carefully designed social activities, and education with rewards, most of the autistic children remain autistic.
Fein stated that recovery is not really a realistic expectation for the majority of the children, but the parents should know that it can happen. Doubters usually say that “either they really weren’t autistic to begin with…” or “they’re still socially odd and obsessive, but they don’t exactly meet criteria” for the illness. Fein said that the children that were in her study “really were” autistic and no the children are “really not.”
Catherine Lord, an autism expert from the University of Michigan, said that she has also seen autistic patients recover. Most of them had parents who spent long hard hours working with them on the improvement of their behavior. However, Lord also said that it is not likely that we will be able to predict whom this will happen for or whether it is possible to make it happen.
An autism specialist diagnosed the children from Fein’s ongoing study before the age of 5 but who in later years no longer meet the diagnostic criteria to be considered autistic. Early medical records confirmed the initial diagnoses for the children. Because this phenomenon is considered rare, Fein is still looking for more children to help bolster evidence on which traits the formerly autistic children may have in common. Her research team is also comparing these children with other children who were both autistic and non-autistic. So far, the kids that are considered to be “recovered” are turning out to be very normal on neuropsychological exams and verbal and nonverbal tests.
The researchers are also performing imaging tests to see if the recovered children’s brains resemble the brains of the autistic or non-autistic children. The brains of the children that suffer from autism tend to be slightly larger than normal. The imaging scans are also being performed to examine the brain function in formerly autistic children. The researchers want to know if their “normal” behavior is a result of “normal” brain activity, or if it is the way their brains process information in a non-typical way to compensate for any deficits. The results from these tests are still being analyzed.
Most of the children who were formerly autistic got long-term behavior treatment very soon after their diagnosis, in some cases for 30 to 40 hours a week. Many of the children also have above-average IQs and had been diagnosed with cases of autism that were relatively mild. By the age of 2, many were within the normal range for motor development, they were able to walk, climb, and also hold a pencil. The most significant improvement that suggested recovery was evident around the age of 7 in most cases, Fein stated.
None of these children have shown any sign of relapse, but nearly three-fourths of the kids that were formerly autistic have had other disorders which include tics, phobias, and attention-deficit problems. Also, eight of the children are still affected.
Type 1 Diabetes Among Young Children Predicted to Rise Dramatically
An estimated 13,000 children are diagnosed with type 1 diabetes each year in the United States, and more than 1 million American children and adults live with the disease every day. Previously known as juvenile diabetes, type 1 diabetes is usually diagnosed among children and young adults. With this disease, the body does not produce insulin, a hormone that is necessary for the body to convert sugar (glucose) and starches as well as other food into the energy essential for daily life. In addition, having type 1 diabetes increases the risk for serious complications such as heart disease, blindness, nerve damage, and kidney damage.
A recent study has indicated that over the next decade, the incidence of type 1 diabetes among very young children will double in comparison to the number of cases recorded in 2005 if current trends continue. Although these indicators are based on the course of the disease in Europe, it is believed that the rate of increase will be similar in the U.S. Environmental factors are thought to be the driving force behind this increase, yet it remains unclear as to what these environmental vulnerabilities are. Researchers are looking at many possible factors including changes in lifestyles among nations with increasing wealth such as more births by caesarian section, greater height and weight, and fewer infections experienced early in life.
Christopher C. Patterson, Ph.D., an epidemiologist at Ireland's Queen's University in Belfast, and colleagues, have concluded that type 1 diabetes is increasing at a much faster rate among young children and teens than previously predicted. The study results can be found in the journal The Lancet. According to Patterson, “We are likely to see more children with severe diabetes complications presenting at earlier ages if we fail to recognize and adequately treat disease in very young patients.”
During their study, the researchers analyzed data gathered from the registries of 20 centers in 17 European countries. Information was included on 29,311 children having type 1 diabetes, who were registered between the years 1989 and 2003. Findings of the analysis revealed an overall increase in type 1 diabetes incidence of 3.9 percent annually.
The largest increase of 5.4 percent was seen in childen under the age of 5 years compared to an annual increase of 4.3 percent among children ages 5 through 9 years, and a rate of 2.9 percent among children ages 10 through 14 years. If this general course of increase continues, the total number of cases of type 1 diabetes is projected to jump by 70 percent by the year 2020, and rates are expected to double for children under the age of 5.
An estimated 15,000 cases of type 1 diabetes were diagnosed in Europe in 2005. Of those cases, children ages 4 and younger accounted for 24 percent, while those ages 5 through 9 accounted for 37 percent, and children 10 to 14 years of age accounted for 34 percent. The researchers predict that number could reach 24,400 new cases in 2020. With the continuation of current trends, the total number of new and existing cases in European children under the age of 15 could jump from 94,000 in 2005 to 160,000 in 2020.
To prepare for the future case growth, Patterson wrote, “In the absence of any effective means to prevent Type 1 diabetes, European countries need to ensure appropriate planning of services and that resources are in place to provide high- quality care for the increased numbers of children who will be diagnosed with diabetes in future years.”
source from http://www.healthnews.com
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