Britain to decide on stem cell research
Tue, 04 Sep 2007 20:10:17 GMTBy DANICA KIRKA, Associated Press Writer
LONDON - Britain is considering whether to permit research using animal eggs to create human stem cells — a process that tests the ethical boundaries of cutting-edge scientific research.
The Human Fertilization and Embryology Authority will rule Wednesday on whether to accept such research, which involves placing human DNA into cow or rabbit eggs that have had their genetic material removed. If the authority allows such research, each project will be decided on a case-by-case basis.
Experts have warned that such research is critical to unlocking treatments for Alzheimer's and other genetic diseases. Scientists want to use animal eggs because the supply of human eggs is limited.
However, such research has raised ethical worries. The use of material from animals has caused some public concern, while right-to-life advocates fear that such research will lead ultimately to genetically modified babies — even though the research under consideration will allow the eggs to develop for only a few days.
Britain's government had earlier proposed outlawing the production of human stem cells from animal eggs, though former Prime Minister Tony Blair had said he was not necessarily flatly opposed to such research.
The authority is set to meet Wednesday to review a report filed earlier this week and make a decision.
"No good reasons for banning this research have been identified by the HFEA," said Evan Harris, a Liberal Democrat lawmaker in favor of the research. Without such opposition, the authority must now clear the way to grant permission to scientists to conduct research, he said.
Several scientists have submitted applications for a license to create human stem cells using animal eggs.
The research involves taking a cow or rabbit egg which no longer has its own DNA and injecting human genetic material. The egg is induced to divide, becoming a very early embryo from which stem cells could be extracted.
Scientists insist it would be a human embryo made in the shell of an animal egg, though a minute amount of animal genes remain. The resulting egg contains 13 animal genes compared with some 20,000-25,000 human genes.
Dr. David King, the director of the independent watchdog group Human Genetics Alert, said allowing such research to go forward would be the first step toward producing genetically modified babies.
"These experiments are scientifically useless and morally very problematic," he said. "The HFEA's report deliberately obscures the far more important problem caused by genetically modified human embryos."
International study shows stent risks
Tue, 04 Sep 2007 18:10:08 GMTBy MARIA CHENG, AP Medical Writer
VIENNA, Austria - Even some heart attack patients would be better off if their doctors avoided using drug-coated stents to open their clogged arteries, an international study found, raising new concerns about the devices.
The study, presented Tuesday, showed that heart attack patients who received drug-coated stents in an emergency situation were five times more likely to die after two years than those who received bare metal stents.
Previous studies have spotted risks from the drug-coated versions mainly when used to treat non-emergency heart cases — not people suffering acute heart attacks.
The tiny, metal-mesh tubes that ooze drugs are used in one of the world's most common procedures, an angioplasty, which uses a balloon to prop open clogged heart vessels. The stents are used to keep the vessels open.
Drug-lined stents are used in up to 30 percent of Americans having heart attacks, said Dr. Valentin Fuster, director of the Cardiovascular Institute at Mount Sinai School of Medicine in New York. Fuster said the stents are less commonly used in Europe, implanted in only about 15 percent of patients there.
The new research was presented by Dr. Gabriel Steg, of the Hospital Bichat-Claude Bernard in Paris, at a meeting of the European Society of Cardiology in Vienna. It was based on data from 94 hospitals in 14 countries, and followed 2,298 patients for two years after they had received either a drug-eluting or a bare metal stent.
Seventy-five percent of the patients had bare metal stents, and 27 of those died. Just 25 percent of the patients had drug-coated stents, but 49 in that group died.
Experts emphasized that there were differences among the patients in the study that could have affected the outcome, and that these findings are not the final word on the safety of drug-coated stents for heart attack patients.
However, Steg said, "With this increased mortality, we perhaps need to take a step back from our use of drug-eluting stents."
The study was funded by Sanofi-Aventis, and Steg has received grants from Sanofi-Aventis, and consults for Bristol-Myers Squibb. The two companies make anti-clotting drugs, which are also used to treat these heart problems.
Given the controversy surrounding drug-coated stents — which have been linked to fatal blood clots in other patient groups — doctors said the new research would likely affect doctors' treatment choices.
Last year, the U.S. Food and Drug Administration concluded that the stents should only be used in certain conditions. The health advisory body in the United Kingdom recently suggested that it would stop paying for them.
On Sunday at the European cardiology meeting, another study suggested the drug-coated stents did not raise the risk of blood clots among stable patients — appearing to contradict some earlier studies. Some experts said that more cautious use of the stents might help explain the new results.
"Drug-eluting stents are not for everyone," said Dr. Eckhart Fleck, director of cardiology at the German Heart Institute in Berlin and a spokesman for the European Society of Cardiology.
Drug-lined stents typically cost about $2,300 compared to about $700 for a bare metal version.
In emergency situations where heart attack patients already have a blood clot after an artery has burst, Fleck said that a drug-eluting stent could make the situation worse by causing even more clotting and blocking blood flow.
"This study will make doctors less enthusiastic about using drug-eluting stents," said Dr. Spencer King, a cardiologist at Fuqua Arts Center in Atlanta and spokesman for the American College of Cardiology. "The concerns about safety may make doctors shy away."
When drug stents were first introduced in 2003, they became the fastest-selling medical device in recent history.
But when worries arose that they could lead to fatal clots in some patients, sales plummeted. In the U.S., use has dropped from about more than 90 percent of eligible heart patients to about 70 percent.
Doctors think the initial response to stents may have been an overreaction.
While experts called for more long-term data on drug-lined stents, they said the devices should not be avoided altogether. "There is absolutely a place for drug-eluting stents," Steg said.
Fat toddlers at risk for iron deficiency
Tue, 04 Sep 2007 12:37:56 GMTBy CARLA K. JOHNSON, Associated Press Writer
CHICAGO - Pudgy toddlers have an alarmingly high rate of iron deficiency, and Hispanic youngsters are more affected than other groups, a new study finds.
The study is the first to discover a link between obesity and low iron levels in preschoolers. Iron deficiency can cause mental and behavioral delays, so the findings underscore the importance of healthy eating habits in children ages 1 to 3.
The researchers found that 20 percent of obese toddlers have iron deficiency, compared to 7 percent of normal-weight toddlers. Lack of iron reduces the amount of oxygen carried through the body by the blood and can cause anemia.
Experts blamed parents who let toddlers drink cow's milk and juice from a bottle, instead of weaning them and introducing iron-rich foods such as meat, beans, eggs, spinach and fortified breads.
Toddlers still fed from bottles tend to drink too much milk and juice, which are low in iron, and don't get enough solid food, said Dr. Jane Brotanek of the University of Texas Southwestern Medical Center in Dallas, a study co-author.
"What you put in your baby's bottle can affect your child's future," she said.
The researchers also found that children who attend day care centers are about 50 percent less likely to have iron deficiency than children who aren't in day care. Day care providers may pay more attention to nutrition, Brotanek speculated.
Hispanic toddlers were more likely than white and black toddlers to be obese and not in day care, possibly explaining their increased risk of iron deficiency, Brotanek said. Twelve percent of Hispanic toddlers were iron deficient, compared to 6 percent of white children and 6 percent of black children.
The study appears in the September issue of the journal Pediatrics.
Dr. Geoffrey Allen, a specialist in blood diseases at Chicago's Children Memorial Hospital, said the findings are a reminder of the importance of childhood tests for iron deficiency.
"It's amazing how anemic children can be and still run around and play," Allen said. "It can be hard to detect mild and moderate anemia."
The researchers analyzed data from 960 U.S. toddlers who had three blood tests for iron deficiency. The information came from 1999-2002 data in the National Health and Nutrition Examination Survey conducted by a branch of the U.S. Centers for Disease Control and Prevention.
The survey has stopped collecting the iron status information, a change some experts are lamenting.
"NHANES is a great way to keep a finger on the pulse of the entire population," Allen said. "Now we're taking away an extremely valuable tool for measuring iron deficiency."
CDC spokesman Bill Crews said the decision to drop the iron tests stemmed from the fact that iron deficiency hasn't been rising or falling in recent years. Since only a small amount of blood is drawn on very young children participating in the survey, he said, a limited number of blood tests can be done.
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On the Net:
Pediatrics: http://www.aap.org
Poorer nations asked to aid mentally ill
Tue, 04 Sep 2007 09:19:11 GMTBy MARIA CHENG, AP Medical Writer
LONDON - War, poverty and diseases such as AIDS are adding to mental health problems in poorer countries, which are generally ill-equipped to respond to depression, schizophrenia and other such ailments, according to health officials.
Experts say that has to change.
On Tuesday, health officials called for new strategies and more money to treat the mentally ill in the developing world in a special issue of the British medical journal, The Lancet. Unless mental health treatment becomes widely available, the futures of poor countries will be handicapped, the writers argue.
Among the simple solutions offered: training lay people to spot mental illness in their community. The ill people and their families can then be referred for treatment. India has already introduced such a program for schizophrenia in certain provinces.
"We're thinking outside the box. We're not thinking of more mental health specialists," said Dr. Vikram Patel, a professor of international mental health at London's School of Hygiene and Tropical Medicine and co-author of several of the papers in The Lancet.
Nirmala Srinivasan, head of Action For Mental Illness, a lobby group based in Bangalore, India, said only a small percentage of Indians who suffer from some form of mental illness — schizophrenia, depression, obsessive compulsive disorder, anxiety — get proper treatment.
"The main reason is that people can't access treatment," Srinivasan told The Associated Press, adding that "there is no treatment available" in rural areas.
Dr. N. Vijaya, head of the Institute of Mental Health, a 1,600-bed facility with programs for 400-500 more outpatients in the southern Indian city of Chennai, said awareness of mental health was increasing in India — leading more people to seek treatment.
She said nearly a third of her facility's patients have been "wandering mentally ill" rescued from the streets by police and private aid groups.
"Social workers help us in contacting their families later," she said.
In Brazil, mental health care rivaling that in developed nations is available for those who can afford it. The Lancet said Brazil's mental health care system has improved in the past several decades, but gaps remain.
Mentally ill adults in the teeming cities of Brazil, Latin America's largest nation, are frequently seen begging on street corners and sleeping under highway overpasses. In destitute rural communities, families living in poverty cope the best they can with mentally ill relatives, but often can't afford medication or special care.
In some poorer countries, people turn to chains or cages to restrain those with mental illness.
In African countries, doctors and nurses are often too overwhelmed with illnesses such as AIDS and malaria to care for those with mental health problems.
But mental health advocates argue that because psychiatric problems such as depression and psychoses often lead to physical problems, investing in treating mental illness could prevent other diseases. That can in turn aid the overall economy.
Treating mental illness can't be solved simply by sending in foreign doctors, experts said. Counseling for mental health problems must come from someone who speaks the language and understands the local culture.
In countries such as Zambia, where mental illness is believed to be a sign of witchcraft or being possessed by the devil, people who are sick are reluctant to seek help. When they do, or when others alert the authorities, they are often locked up in institutions.
"You can't just parachute into a system and expect to solve their complex mental health problems," said Cornelius Williams, who helps treat emotionally scarred former child soldiers in Uganda for UNICEF.
Dr. Richard Horton, The Lancet's editor, wrote in an accompanying commentary that the World Health Organization has not done enough to support nations' mental health needs. Although the agency pledged in 2001 to bring "new hope" to treating the mentally ill, "WHO has not backed its words with resources," Horton said.
WHO officials declined to comment.
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Associated Press writers Ashok Sharma in New Delhi and Alan Clendenning in Sao Paulo, Brazil, contributed to this report.
Skinny gene keeps mice lean study finds
Tue, 04 Sep 2007 20:35:27 GMTBy Maggie Fox, Health and Science Editor
WASHINGTON - A gene that keeps mice and fruit flies lean might offer a way to prevent obesity and diabetes in people, U.S. researchers said on Tuesday.
The gene, discovered more than 50 years ago in fruit flies, makes mice fat when tweaked one way and thin when manipulated another way, the researchers reported.
That suggests it would work this way in humans, because mice and people are both mammals, the team at the University of Texas Southwestern Medical Center reported.
&;If you turn up its function, you get skinny, and if you turn down its function, you get fat,&; Dr. Jonathan Graff, who directed the research, said in a telephone interview.
&;This is a skinny gene. It's an anti-thrifty gene.&;
For years, researchers seeking to explain why people are prone to get fat have used the &;thrifty gene&; hypothesis. Early humans who survived famine after famine were those who could easily store a layer of fat for the lean times.
While obesity is likely to be caused by a variety of genes and their interactions with behavior and the environment, this one is a good candidate for study, Graff and colleagues report in the journal Cell Metabolism.
The gene, called adp for adipose, was discovered by Winifred Doane, while she was studying infertility in fruit flies as a graduate student at Yale University.
Doane, now a professor emeritus of zoology at Arizona State University, stressed the flies by starving them and putting them in a desiccator to simulate extreme conditions. Those that lacked a working copy of the adp gene survived, despite starvation and dry conditions.
Jae Myoung Suh, a graduate student working on his PhD in Graff's lab, used Doane's work as the basis of an experiment in mice.
DO THESE GENES MAKE YOU LOOK FAT?
Finding that it works in the same way in mice and fruit flies is important because it means the gene is conserved, or has evolved from &;lower&; to &;higher&; animals.
&;It was always my dream that the drosophila adipose gene would turn out to be a model for controlling obesity and type 2 diabetes. It looks like it is starting in that direction now,&; Doane said in a telephone interview.
Doane said the gene appears to be a regulatory gene, meaning it controls the activity of other genes.
Graff and other experts say one place to start looking for humans who have mutant versions of the gene would be Pima Indians from the southwestern United States and Australian aborigines, both of whom have high rates of type-2 diabetes and obesity when they begin living Western lifestyles.
&;Even if people don't have abnormalities in this gene, if you had a drug that could work on this, you could treat people,&; Graff said.
In humans, adp is in a region of the genome that is already linked to obesity and diabetes, Graff said.
And it is not an all-or-nothing gene, at least not in mice tested in the lab. &;This is a volume control -- not on and off. As you get less and less function of protein, you get fatter and fatter, and as you get more and more, you get skinnier and skinner,&; Graff said.
&;People who want to fit in their jeans might someday be able to overcome their genes.&;
