WHO urges smoking ban in public places
Tue, 29 May 2007 19:27:41 GMTBy BRADLEY S. KLAPPER, Associated Press Writer
GENEVA - The U.N. health agency on Tuesday issued its strongest policy recommendations yet for controlling tobacco use, urging all countries to ban smoking at indoor workplaces and in public buildings.
"The evidence is clear. There is no safe level of exposure to secondhand tobacco smoke," said Dr. Margaret Chan, director-general of the World Health Organization.
Tobacco use is the world's leading cause of preventable death, accounting for 10 percent of adult fatalities, according to WHO. It is responsible for 5.4 million deaths each year, a figure that is expected to rise to 8.3 million by 2030, the agency says.
Increasing numbers of nonsmokers will also die unless governments take action, WHO said in its 50-page report. It said governments of both rich and poor countries should declare all public indoor places smoke-free, by passing laws and actively enforcing measures to ensure that "everyone has a right to breathe clean air, free from tobacco smoke."
At least 200,000 workers die each year because of exposure to smoke at their offices and factories, according to the U.N. labor agency. The U.S. Environmental Protection Agency estimates that about 3,000 deaths from lung cancer each year occur among nonsmoking Americans.
"This is not about shaming the smoker. This is not even about banning smoking," said Dr. Armando Peruga, who heads WHO's anti-tobacco campaign. "This is about society taking decisions about where to smoke and where not to smoke."
He cited Ireland and Uruguay as governments that have successfully tackled smoking by creating and enforcing smoke-free environments. Legislation of the kind has proved popular among both smokers and nonsmokers, according to WHO, whose policy recommendations set broad goals for its 193 member states but are not legally binding.
Almost half the world's children — some 700 million — are exposed to air polluted by tobacco smoke, particularly at home, WHO says. The agency made its recommendations on the basis of new reports by the International Agency for Research on Cancer, the U.S. surgeon general and the California Environmental Protection Agency.
WHO said in 2005 that it had stopped hiring smokers, as part of what it termed its "public lead" in the fight against tobacco.
Dutch show has kidney donation contest
Tue, 29 May 2007 14:31:13 GMTBy TOBY STERLING, Associated Press Writer
AMSTERDAM, Netherlands - A Dutch reality show that claims to be trying to draw attention to a shortage of organ donors said Tuesday it would go ahead with a program in which a terminally ill woman will choose a contestant to receive one of her kidneys.
The program, "Big Donor Show," has been attacked as unethical and tasteless. One member of the Dutch parliament suggested the government should block Friday's broadcast.
"We know that this program is super controversial and some people will think it's tasteless, but we think the reality is even more shocking and tasteless: waiting for an organ is just like playing the lottery," Laurens Drillich, chairman of the BNN network, said in a statement.
He said waiting lists in the Netherlands are more than four years long and 200 patients die annually for lack of a donor.
The network identified the donor as "Lisa," a 37-year-old woman with an inoperable brain tumor. During the show, she will hear interviews with the three candidates, their families and friends before choosing who will get her kidney.
The show is being produced by Endemol NV, the creator of the "Big Brother" series.
A spokeswoman for BNN said that there could be no guarantees the donation would actually be made, "but the intention is" Lisa's donation would be carried out before she died.
That is because her wish to donate to a particular candidate "wouldn't be valid anymore after her death" under Dutch donation rules, Marieke Saly said. If Lisa does donate one kidney while living, the other kidney may still be awarded to someone else on a national donation waiting list under the country's organ allotment system.
Viewers will be able to vote for the candidate they feel is most deserving via SMS text message, but "Lisa will determine who the happy one is," BNN said in a statement.
Saly could not say how much it will cost to send an SMS, but most TV programs charge around $1.35.
Joop Atsma, a lawmaker of the ruling Christian Democrats, raised the issue in parliament, asking the government whether the program violated any law.
"Is it desirable that public broadcasting would go down this path, and is there no way to send a strong signal that we reject this?" he said.
Education Minister Ronald Plasterk, addressing parliament on behalf of the government because the health minister was ill, replied that there were serious questions about whether the transplant would actually go through as BNN has advertised it — but that there was no way to stop the program from airing.
"The information I have right now tells me that the program is unfitting and unethical, especially due to the competitive element, but it's up to program makers to make their choices," he said.
"The constitution forbids me from interfering in the content of programs: let there be no mistake about that, that would be censorship."
He said that there were practical barriers.
"In every transplant the tissue of the donor and the patient must match as much as possible," Plasterk said. "The doctors in this program can't make any concessions on that front."
There also was doubt whether Lisa's organs could be donated at all because it might spread her cancer, he said.
"So it's very possible that in practical terms we're not talking about anything here, because it's possible this transplant can't take place," he said.
Noting the shortage of donors, he said it was a good time for a debate on the question of what incentives to donate are ethical.
He cited the example of a Dutch funeral home that is offering discounts to the families of people who were registered as donors, and an idea presented by the country's Kidney Institute to give registered donors preference on organ waiting lists.
Conjoined twin boys separated in India
Tue, 29 May 2007 16:46:09 GMTNEW DELHI - Doctors separated 10-month-old conjoined twin boys in five hours of surgery in central India on Tuesday.
The babies, who had been joined at the abdomen, were doing well, Press Trust of India ed the head surgeon at Raipur Medical College, Ashok Sharma, as saying. "We see a good chance of their survival," he said.
Sharma said the boys' liver, pancreas and sternum were separated during the surgery at a hospital in Raipur, capital of the central state of Chhattisgarh.
The boys, Ram and Lakshman, are the sons of poor farm laborers who live in a village in Chhattisgarh state.
Antibodies point to new bird flu therapy
Tue, 29 May 2007 02:48:44 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Blood donated by four survivors of bird flu seems to harbor a potent protection against the deadly virus. Scientists have long suspected that culling immune-system molecules from survivors could provide a new therapy for the hard-to-treat H5N1 flu strain. Monday, an international team of researchers reported the first evidence, albeit from tests in mice, that it really may work.
If the research pans out, it could be possible to stockpile these antibodies, the immune system's search-and-destroy force, as an additional way to treat or even prevent H5N1 in case the worrisome flu strain ever mutates to spark a worldwide epidemic.
"Obviously we're interested and excited about this potential," said Dr. Anthony Fauci, infectious disease chief at the National Institutes of Health.
The research started when four Vietnamese adults who survived bouts of H5N1 in 2004 agreed to donate blood to the Hospital for Tropical Diseases in Ho Chi Minh City.
At Switzerland's Institute for Research in Biomedicine, Dr. Antonio Lanzavecchia created a way to cull antibody-producing cells from the blood and keep them churning out the molecules in laboratory dishes.
In the U.S., the NIH's Dr. Kanta Subbarao tested thousands of those antibodies to tease out the handful able to kill H5N1. They were purified to better target the virus.
Then came the real tests: Subbarao's lab infected mice with H5N1. Some were given the antibodies before they were exposed, others after they already were infected; still others were given antibodies that target different diseases, not influenza.
Mice given the non-H5N1 antibodies died. The H5N1-targeting antibodies protected mice, both when they were administered as a vaccine-like preventive or after infection. Importantly, they worked against both the same 2004 strain that the people had survived and against a different H5N1 strain that circulated in 2005.
The work is reported Monday in the online journal PLoS-Medicine.
This approach is called "passive immunotherapy," and more crude forms of the approach have long been used to protect against certain viruses. Before hepatitis A vaccines, for example, antibody-containing shots were common for tourists heading to developing countries.
And during the 1918 flu pandemic, the worst in history, doctors sometimes transfused blood directly from survivors to the newly sick, sometimes with good results.
The mouse study is "a very lovely, elegant proof of principle," said Dr. William Schaffner, a flu expert at Vanderbilt University.
More work is needed before trying these purified antibodies in people. It's standard to test flu vaccines and treatments in ferrets, who respond to influenza more like people do. Then the antibodies would need testing in healthy people, to see if they're safe.
If so, they might be tried as a treatment for people still falling ill with H5N1 in parts of Asia. The only treatment now is the drug Tamiflu, which doesn't always save them.
But Schaffner points to a more immediate use: If antibodies can help the notorious bird flu, why not cull some specific to the regular, but still too often deadly, influenza that spreads every winter?
"This has the dual potential of being useful potentially in a pandemic, but perhaps more so on an annual basis," Schaffner said. "That's where I think the real excitement is."
Heavy infants run high risk of being obese later on
Tue, 29 May 2007 11:58:33 GMTBy Tan Ee Lyn
HONG KONG - Babies who are born heavy and grow fast have a 150 percent chance of being overweight or obese by the time they are seven years old, a survey of more than 8,000 children in Hong Kong has shown.
Obesity has long been associated with a person's lifestyle and dietary habits, but the study shows it might just as well be dependent on &;epigenetics&; -- factors such as genes, and the eating habits and lifestyle of parents and grandparents, said researchers at the University of Hong Kong.
&;You tend to assume it's just your lifestyle, but what people are realizing is it's not just what you are doing now, but what people have done in your family in the past,&; said Mary Schooling, assistant professor at the university's School of Public Health.
New born infants would be considered heavy if they weigh 3.65 kg and over.
Excess weight and obesity pose major risks for chronic diseases such as diabetes, heart disease, hypertension, stroke and some forms of cancer.
Globally, more than 1 billion adults are overweight, of which 300 million are obese, said the World Health Organisation.
And the problem is not confined to advanced nations in the west. In China, Japan, certain African nations, Thailand, Malaysia, Singapore and Hong Kong, childhood obesity is on the rise. In China, 10 million children aged between 7 and 18 were overweight in 2000, up 28 times from 1985.
Some experts explain this using the &;thrifty gene&; theory. Assuming a frugal environment from as recent as the 1950s and 1960s, the Asian constitution is programmed to store fat. But faced with sudden affluence, it is less able to cope and the person ends up obese and assailed with health problems.
The west, however, adapted to an environment of plenty over a far longer period, starting with the industrial revolution from the mid 18th century.
TRACKING A GENERATION OF CHILDREN
More than 8,300 children born in April and May 1997 in Hong Kong are involved in the long-term study and researchers plan to monitor them for the rest of their lives.
The scientists tracked their development at birth, 3 months, 9 months, 36 months and 7 years.
About 800 children in the study are now overweight or obese.
Boys at 7 years with a body mass index of more than 17.9 are considered overweight, while a BMI of over 20.6 would be obese. For girls, a BMI of over 17.53 would be overweight and more than 20.5 obese.
&;What we have shown here is that babies who are born big and who have grown fast have a higher risk of being overweight or obese at age 7,&; Schooling said.
&;The key point is to make sure that babies grow at a reasonable rate. That can be achieved most effectively by ensuring they are breastfed.&;
Experts say breastfeeding helps prevent overfeeding. Schooling and colleague Gabriel Leung said a child's body size may well be dependent on a host of other factors. &;It has to do with the mother's diet, her lifestyle, even the grandmother's living environment ... it has to do with the life course of your parents, grandparents,&; Leung said.
&;Perhaps our grandparents lived in scarcity, they may have the biological imprint for the baby to prepare for scarcity. But there is excess now, and the human body has no time to prepare for this change ... that's why our diabetes rate is so high.&;
The researchers plan to interview parents and grandparents of the group children to see if their body sizes are linked to dietary and lifestyle habits of the older generations.
Further ahead, these children would be monitored for health problems that tend to appear later in life, such as high blood pressure and diabetes.
