Thursday, April 18, 2013

Bacterial Vaginosis Could Put Pregnancy At Risk If Left Untreated

Women in the UK are more likely to know about intimate beauty treatments than they are about serious health issues that could make them six times more likely to miscarry or give birth prematurely.

Research published this week by Balance Activ reveals women are more aware of bikini waxing (67%) and vajazzles (48%) than they are about intimate health, with nearly two thirds of women questioned (61%) unaware or unsure of health problems that could lead to fertility problems, miscarriage and increased risk of STI's.

BV (Bacterial Vaginosis) affects one in three women* and because very few know about it the symptoms are often confused with other infections. It is twice as prevalent as thrush and if left untreated during pregnancy the condition can lead to serious implications:
  • Pregnant women with BV are six times more likely to miscarry and twice as likely to give birth prematurely than other women
  • It's thought BV is responsible for one in three of all premature births in the UK
  • BV can put women at risk of contracting STIs such as Gonorrhoea and Chlamydia
It seems intimate women's health is the last taboo as over a third of women questioned (38%) admit they would only feel comfortable getting health advice from online forums while nearly a fifth (19%) are too embarrassed to speak with a GP.

The research, carried out to coincide with National BV Day (Tuesday 16th April), reveals 63% of women feel angry that more information on intimate health conditions is not made available. Health experts are now calling for more awareness of intimate health and the serious side effects that can be the result of untreated conditions.

As part of National BV Day women can access videos featuring Dr Dawn Harper explaining the key symptoms of BV, and how to treat them quickly and easily at home using lactic acid pessaries or gel. The videos advise that BV is not a sexually transmitted disease nor linked to poor hygiene, but is in fact a condition caused by changes in the vagina's pH balance. Triggers can include the use of scented soaps and bubble bath.
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Nearly Half Of All Deaths From Prostate Cancer Can Be Predicted Before Age 50

A new design of screening could improve ratio between benefit and harms of screening

Focusing prostate cancer testing on men at highest risk of developing the disease is likely to improve the ratio between benefits and the harms of screening, suggests a paper published this week on

Prostate specific antigen (PSA) screening is widely used for the early detection of prostate cancer, but remains highly controversial, as it became widespread long before evidence to prove its value. There is now evidence that PSA screening can reduce prostate cancer mortality in men who would not otherwise be screened. However, this can come at considerable harm.

As there is little evidence to support many aspects of screening guidelines, researchers from Sweden and the USA carried out a case-control study taking data from the Malmo Preventative Project (MPP) cohort, in an attempt to develop an evidence-based scheme for prostate cancer testing. A previous study from the MPP, published in the BMJ in 2010, demonstrated that PSA level at age 60 is strongly predictive of the risk of death from prostate cancer by age 85.

The Malmo cohort included 21,277 men aged 27 to 52 who participated in the MPP between 1974 and 1984. All these men gave a blood sample. A smaller group of these men were then invited to provide a second blood sample about six years later: 4922 (72%) of those re-invited complied.

The researchers focused their studies on men close to age 40, mid-to-late forties (45-49) and early-to-mid fifties (51-55).

Within 25 to 30 years, 44% of deaths from prostate cancer occurred in those with the top 10% of PSA levels at age 45-49, a PSA of about 1.5 ng / ml or more. The risk of prostate cancer death was more than 10 times greater in this group compared to men with the lowest 25% of PSA levels.

The researchers questioned whether PSA screening should start at age 40, mid-to-late 40s or early 50s: they found that even for men with PSA in the top decile at age 40, the risk of metastatic prostate cancer was very low at 0.6%, after 15 years of follow-up. The researchers say that due to this, it would be difficult to justify initiating PSA testing at age 40 for men with no other significant risk factor.

In contrast, the risk of developing metastatic prostate cancer within 15 years is close to three-fold higher for men in the top level PSA at age 45-49 (1.7%) and close to ten-fold higher at age 51-55 (5.2%). This suggests that initiating PSA screening after age 50 would leave a significant proportion of men at elevated risk of later being diagnosed with an incurable cancer.

The researchers also looked at screening intervals: results showed that the absolute risk of metastatic cancer remains very low within 15 years follow-up for men with PSA in the low deciles and as such, a screening interval less than five years for these men is unnecessary.

The researchers conclude that PSA levels are informative of the current risk of cancer as well as being "predictive of the future risk of prostate cancer" and any cancer-specific death. They say that screening programmes can be designed so as to "reduce the risk of over-diagnosis whilst still enabling early cancer detection for men at highest risk of death from prostate cancer". As it turns out, the best way to determine risk is a single PSA before the age of 50.
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What Really Makes Us Fat?

Article questions our understanding of the cause of obesity

If we are to make any progress in tackling the obesity crisis, we have to look again at what really makes us fat, claims an article published in this week's BMJ.
Gary Taubes, co-founder of the Nutrition Science Initiative, argues that our understanding of the cause of obesity may be incorrect, and that rectifying this misconception is "absolutely critical" to future progress.

"What we want to know," he says, "is what causes us to gain weight, not whether weight loss can be induced under different conditions of semi-starvation."

The history of obesity research is a history of two competing hypotheses of energy balance and endocrinology, writes Taubes. Since the 1950s, conventional wisdom on obesity has been that it is caused by a positive energy balance - in other words we get fat because we overeat. The alternative hypothesis - that obesity is a hormonal or regulatory disorder - was dismissed after the second world war as being unworthy of serious attention.

But Taubes believes that the wrong hypothesis - energy balance - won out and that it is this hypothesis, along with substandard science, that has fuelled the obesity crisis and the related chronic diseases.

He argues that attempts to blame the obesity epidemics worldwide on increased availability of calories "typically ignore the fact that these increases are largely carbohydrates" and, as such, these observations "shed no light on whether it's total calories to blame or the carbohydrate calories."

Nor do they shed light on the more fundamental question of whether people or populations get fat "because they're eating more, or eat more because the macronutrient composition of their diets is promoting fat accumulation ... in effect, driving an increase in appetite."

Taubes also points to "substandard" research that is "incapable of answering the question of what causes obesity."

As a result, he has co-founded the Nutrition Science Initiative, a not-for-profit organisation to "fund and facilitate rigorously well controlled experimental trials, carried out by independent, sceptical researchers." Our hope, he says, is that these experiments will answer definitively the question of what causes obesity, and help us finally make meaningful progress against it.

If we are to make progress in the struggle against obesity and its related chronic diseases, he believes we must accept the existence of alternative hypotheses of obesity, refuse to accept substandard science, and find the willingness and the resources to do better.

"With the burden of obesity now estimated at greater than $150bn (£100bn; €118bn) a year in the US alone, virtually any amount of money spent on getting nutrition research right can be defended on the basis that the long term savings to the healthcare system and to the health of individuals will offset the costs of the research by orders of magnitude," he concludes.
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Antibody Treatment For HIV

Data on SEEK's Novel Immunotherapy for HIV Published in Virology Journal

SEEK, a privately-owned UK drug discovery group, announces that pre-clinical results on its HIV immunotherapy have been published in the peer-reviewed journal Virology Journal.

SEEK's HIV immunotherapy triggers the immune system's cellular and antibody responses to selectively identify and kill HIV infected cells. The most exciting aspect of this therapy is that it directs the immune system towards short highly conserved regions of proteins produced by most circulating HIV strains. The triggered immune responses are highly effective both independently and in combination.

This opens up developing the antibody response into a monoclonal based therapy for treating HIV.

Monoclonal antibodies have revolutionised the treatment of cancer by improving outcomes and survival. In HIV/AIDS there is new interest in these products, as shown by the recent work of Duke University (USA) in developing a monoclonal antibody that prevents the virus from infecting cells. A monoclonal antibody capable of killing HIV-infected cells (potentially curative effect) would represent a radical new development in HIV therapy, which to this day relies on slowing down the virus rate of growth rather than in killing the cells that harbour it.

By targeting a HIV component that is found only in infected cells and never in healthy cells, such monoclonal antibody therapy offers the potential of high specificity, reduced frequency of administration and minimal side-effects. This would represent a significant improvement over current anti-HIV drugs which require daily treatment and are associated with significant side effects.

Commenting on today's announcement, Gregory Stoloff, CEO of SEEK Group, said: "It is very exciting to be at the forefront of this new approach which opens up HIV therapy to established and available antibody technology."

In July 2011, SEEK announced the results of a Phase Ib/II study in humans which demonstrated that HIV immunotherapy showed a one log(approx 90 percent) difference in viral count in HIV-infected people compared with the placebo group, after just a single administration.
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