Scientists crack gene code of common cancers

Two common forms of cancer have been genetically mapped for the first time, British scientists announced, in a major breakthrough in understanding the diseases.

The maps have exposed the DNA mutations that lead to skin and lung cancers, in a discovery scientists said could transform the way these diseases are diagnosed and treated in coming years.

All cancers are caused by damage to genes -- mutations in DNA -- that can be triggered by environmental factors such as tobacco smoke, harmful chemicals or ultraviolet radiation, and causes cells to grow out of control.

Scientists from Britain's Wellcome Trust Sanger Institute and their collaborators have mapped this genetic damage from the tumours of two patients suffering from lung cancer and malignant melanoma, a deadly skin cancer.

"This is a fundamental moment in cancer research. From here on in we will think about cancers in a very different way," said Professor Mike Stratton who led the institute's cancer genome project.

"Today for the first time, in two individual cancers, a melanoma and a lung cancer, we have provided the complete list of abnormalities in DNA in each of those two cancers," he told the BBC.

"We now see uncovered all the forces that have generated that cancer and we now see all the genes that are responsible for driving those two cancers."

The scientists' research, published in the journal Nature, also gained deeper insights into the way the body tries to repair the damage caused by the cancers and stop the disease spreading.

Stratton said the research could in future change the way cancers are treated -- by using genetic maps to find the defects that caused them.

"Now that we have these comprehensive complete catalogues of mutations on individual cancers, we will be able to see how each cancer developed, what were the exposures, what were the environmental factors and that's going to be key for our understanding generally of how cancers develop," he said.

"And for our individual patients, we will see all the genes that are abnormal and are driving each cancer and that's really critical, because that will tell us which drugs are likely to have an effect on that particular cancer and which are not."

Peter Campbell, a cancer-genomics expert involved in the research, said the number of mutations discovered -- 33,345 for melanoma -- and 22,910 for lung cancer -- was remarkable.

"It is amazing what you can see in these genomes," he said on the website of the journal Nature.

The research shows most mutations could be traced to the effects of chemicals in tobacco smoke (in the lung tumour) or ultraviolet light (in the melanoma tumour), supporting the idea that they are largely preventable.

"Every pack of cigarettes is like a game of Russian roulette," he said.

"Most of those mutations will land where nothing happens in the genome and won't do major damage, but every once in a while they'll hit a cancer gene."

Fake sugar may alter how the body handles real sugar

Combining artificial sweeteners with the real thing boosts the stomach's secretion of a hormone that makes people feel full and helps control blood sugar, new research shows.

It's unknown whether this means anything for people's health, but "in light of the large number of individuals using artificial sweeteners on a daily basis, it appears essential to carefully investigate the associated effects on metabolism and weight," conclude Dr. Rebecca J. Brown and colleagues from the National Institute of Diabetes and Digestive and Kidney Diseases.

Because artificial sweeteners are virtually carbohydrate-free, they have been thought not to have any effect on how the body handles glucose (sugar), the researchers explain.

But there's some evidence that artificial sweeteners may trigger secretion of glucagon-like peptide-1 (GLP-1). GLP-1 is released from the digestive tract when a person eats as a "fullness" signal to the brain, curbing appetite and calorie intake.

To investigate further, Brown's team had 22 healthy normal-weight young people take two glucose challenge tests. These tests, which measure how well the body metabolizes glucose, require a person to drink a sugar-filled beverage after fasting for several hours.

Ten minutes before consuming the "glucose load," study participants drank either roughly two-thirds of a diet soda containing an artificial sweetener or the same amount of carbonated water.

In both cases, the increase in a person's blood glucose was the same. But the researchers did find that people secreted significantly more GLP-1 when they drank diet soda before the glucose challenge compared to when they drank carbonated water.

Studies in humans and animals have shown that when artificial sweeteners are consumed without carbohydrates they do not trigger GLP-1 secretion. "However, our data demonstrate that artificial sweeteners synergize with glucose to enhance GLP-1 release in healthy volunteers," Brown and colleagues report.

What this all means to the average diet soda drinker is not known, but the fact that the effect occurred with less than a single can of diet soda suggests it "may be relevant in daily life," the researchers say.

Future research is needed to understand the significance of enhanced GLP-1 secretion for health, they conclude, and studies should be conducted in people with type 2 diabetes and other abnormalities in metabolism.

SOURCE: Diabetes Care, December 2009.

NHS maternity services in meltdown: A former midwife reveals how understaffed wards are sinking into chaos

Clutching her husband's hand and with agony and exhaustion etched on her face, a young woman struggled into a room in the maternity unit where I worked.

She was in the early stages of labour with her first baby, she was terrified, in excruciating pain and desperate for any crumb of support.

Helpless beside her, her overnight bag in his hand, her poor husband looked equally traumatised.

My heart went out to them. But I knew there was little I could do. With five other pregnant women to care for at the same time, all with hugely different and complex problems, I was rushed off my feet and didn't have the time to look after her properly, to allay her fears or to hear about how she wanted the birth to unfold.

I longed to sit with this poor young woman, calm her and remind her gently to breathe deeply through each contraction.

Just half an hour of my time could have made all the difference. Instead, I put on my cheeriest smile and followed hospital procedure. 'Would you like a painkiller?' I asked.

Ten hours later, after she had been drugged to the eyeballs to dull the pain, I heard she'd given birth.

Her baby was healthy, but I knew I'd let her down.

As I watched her being wheeled into the ward, I felt eaten up with guilt. She'd effectively been ignored from the moment she turned up until the moment she gave birth.

Plonked on an antenatal ward until her time came, with no one to reassure her during what was most likely the most terrifying moment of her life.

No woman should have to give birth in these conditions - let alone in a modern hospital with professional staff at hand.

Welcome to the modern NHS maternity ward. A world of shoddy practice, poor hygiene standards and a shocking disregard for patients' individual needs.

When I read about newly qualified midwife Theresa Naish, who hanged herself in January after a premature baby died on her shift, I couldn't help wondering if she, too, was a victim of the over-worked and under-resourced labour wards I have experienced.

Her father Thomas told the inquest into her death: 'Like all NHS staff, she was over-worked, doing too many hours in a department that was understaffed.'

Although the child had little chance of survival, poor Theresa spent weeks torturing herself that she was to blame, before killing herself.

I don't want to alarm people for, of course, the vast majority of babies are born healthy and safe, but I think it's time we admit what is happening in our hospitals.

Driven by targets and mired in red tape, our NHS maternity wards are becoming baby-producing factories where mothers' needs come very low on the agenda.

The quicker midwives turn out babies, the more successful everyone tells us that we are. We might as well be producing sausages. It's utter madness.

I started working as a midwife in Basildon in 1995. I left to work as an independent midwife in January last year because I simply could not bear to let any more women down.

Midwife and baby

Special job: Midwives play a vital role throughout the birth

During a typical 12-hour shift, I could be the sole midwife in charge of six women in the antenatal ward - some in early labour - or one of two qualified midwives running a postnatal ward with up to 32 women.

If I was in the delivery unit, I would assist in the births of up to three babies a shift.

Obviously, if there was a crisis during a woman's labour - such as a sudden need for an emergency Caesarean - there was always a surgical team on call, and there would be an anaesthetist available to administer epidurals and so on.

But in terms of the normal care through labour, that was all down to the midwives.

Although we were under huge stress even back in 1995, current cutbacks mean fewer and fewer midwives are caring for more and more women.

No wonder new mothers are encouraged to leave hospital just hours after giving birth.

When I started in the mid-Nineties, there were 35,000 midwives working in Britain. A year or two ago, that number had fallen to 25,000, more than half of whom were part-time.

So, how bad did it get? Take one typical day I remember a few years ago. I found myself with up to six patients to look after at once and no back-up.

From the moment I stepped into the admissions ward, the area was crammed with women clamouring for attention.

Two women were in early labour. I longed to reassure them. But my stress levels rocketed when I saw the dramas that lay ahead.

One young woman, expecting her second baby in three months, had arrived in an ambulance with high blood pressure.

She had been sent by her GP, who feared that her life and her baby's were in danger.

High blood pressure is often a symptom of pre-eclampsia - one of the most serious risks facing a pregnant woman and one of the most difficult to detect.

Terrified she was going to lose her baby, or die, or both, she was frightened. I tried to reassure her.

All the while, half my brain was on the screams of the two women in early labour a few doors away.

Did they need more pain relief? When would they need to go into the delivery suite?

I had to check my new patient's blood pressure every 15 minutes as well as taking blood samples to be sent for analysis to see exactly what the problem was.

It was a race against time because if her blood pressure carried on rising I'd have to ensure she was whisked off for emergency surgery.

As I ran between her bed and the two women in early labour, I barely had time to greet another patient.

Midwife and baby

Bonding: But staff need to teach mothers how to feed their infants and are rarely given the time

She was in floods of tears. Her baby was due in a month. He had stopped moving and she was convinced he was dead.

Strapping her up to a monitor to check the baby's heartbeat, I tried to calm her. But I didn't even have time to offer her a cup of tea before rushing to another new arrival.

She'd arrived in an ambulance after her waters broke while she was out shopping. The baby wasn't due for another week. Again, her unborn baby had to be urgently monitored.

I was frantically checking my watch to ensure I remembered my patient with high blood pressure when a young woman, hair matted with sweat and eyes wild with fear, staggered towards me.

'I can't take any more,' she said, gripping my hand. 'You've got to help me.' She'd been in labour for five hours and the pain was excruciating. I knew she'd be happier in a delivery room - which is more comfortable and has better specialist equipment - rather than a bed on the ward, but my heart sank. There was no room.

I felt sick with guilt as I led her back to her bed. She was in agony, but she'd have to wait.

It was an hour before she was wheeled into the labour room. And in between nursing, I had to write up notes on each patient.

There were days when I barely had time to go to the toilet.

In the 13 years since I joined the NHS, conditions have deteriorated. Starting from the moment they arrive through the hospital doors, birth plans tucked neatly in their overnight bags, women are being betrayed.

There is reams of evidence to prove that a woman's labour is likely to be shorter and she runs less chance of needing medical intervention if she feels calm and relaxed in the early stages. It's not rocket science.

Yet because midwives don't have time to sit with women in early labour for more than a few minutes at most, we are encouraged to do the next best thing.

We offer them strong painkilling drugs such as pethidine or diamorphine - which is a form of heroin.

Drugs keep the mother nice and quiet which, of course, suits staff.

But they also likely to make her and her unborn baby terribly sleepy.

Although these drugs can sometimes increase contractions, they all too often slow them down.

The end result at the woman will need more drugs, not fewer, and labour will take longer.

But, of course, we don't explain of that as we dole out our pain killers. Besides, on a busy ward, what's the alternative?

Once a woman is in full labour, you'd thought we'd put her needs first. But I'm embarrassed to admit that, all too often, we were not allowed to.

Most hospitals rigidly enforce the rule that, once in labour, a woman's canal must dilate at the rate of 1cm an hour.

If that isn't happening, midwives are encouraged to tell the her that her baby may be getting in distress - even if that isn't the case.

Terrified and exhausted by a haze of drugs, the woman agrees to anything which is offered.

In practice, this means we give her extra drugs to intensify the contractions and so speed the arrival of the child.

Her pain levels increase and she'll need an epidural injection in her spine to numb the pain around her groin.

It's a vicious circle. I felt terribly mean persuading women to go along with it. I knew I wasn't always acting in their best interests. But what could I do?

It's a joke to say women have choices over how they give birth. The truth is - thanks to the drive to cut costs and improve efficiency - births are turning into conveyer-belt productions.

Women dream of having a natural birth and there is often no medical reason why they can't.

Instead, they leave the delivery room with a healthy baby, but feeling like a failure because they have used drugs.

Some are on such heavy drugs they don't remember giving birth at all. It's heartbreaking.

I also get very angry when I hear NHS authorities extolling the virtues of breastfeeding.

According to the NHS website, it's the 'best start in life'. I couldn't agree more.

But the truth is that breastfeeding rates are plummeting in the hospitals I've worked in.

The reason is simple. Midwives don't have the time to spend helping mothers to feed properly.

And without that vital support in the early days, women give up. With three women arriving on a ward at any one time, and three ready to leave, how could I possibly sit for an hour and help a new mother?

It's physically impossible, particularly as we are encouraged to rush women home as soon as they are on their feet.

It's to save money, but it does at least reduce the risk of the new mums and their babies picking up an infection.

It's no news that hospitals are often dirty. By the time I left, I was almost inured to the filth around me.

With so many women and too little time, it was impossible to keep the wards spotless.

I regularly found myself wiping off blood which had been missed by the cleaners in their rush.

It's a huge relief to have left the NHS. As an independent midwife in Northwich, Cheshire, I am finally able to help women the way they deserve.

Calm, supported and not rushed, my mothers give birth in six to seven hours. In the units where I worked, the average labour was ten to 14 hours.

I feel guilty about the women I let down as an NHS midwife. Weak and in pain, they don't have the knowledge or strength to stand up for themselves.

Instead, they end up being patronised by doctors and bullied by midwives into taking drugs they don't want.

But what makes me most sad and angry is that those hospital staff - everyone from managers down - are taking advantage of women when they are at their most vulnerable.

Interview: TESSA CUNNINGHAM


Read more: http://www.dailymail.co.uk/health/article-1235921/Midwives-meltdown-A-NHS-worker-reveals-understaffed-maternity-wards-sinking-chaos.html#ixzz0Zor9tYSl

CT Scans Could Cause Thousands of Cancer Cases

(Dec. 15) -- Common CT scans deliver much more radiation than scientists believed, and could be blamed for as many as 29,000 new cancers -- and 14,500 deaths -- annually, according to two studies reported in USA Today and the Los Angeles Times.

The research, published this week in the Archives of Internal Medicine, shows that the same CT scans at different hospitals could expose patients to highly varied, and sometimes dangerous, doses of radiation. MORE>>>>>>>>>>>>>>>>>>>>>

Plastic Bottle Chemical Inflames Intestines

The chemical Bisphenol A used in plastic containers and drinks cans has been shown for the first time to affect the functioning of the intestines, according to a French study published Monday.

National Institute of Agronomic Research researchers in Toulouse found the digestive tract of rats react negatively to even low doses of the chemical also called BPA, the Proceedings of the National Academy Sciences journal reported.

Their research, also conducted on human intestine cells, found that the chemical lowered the permeability of the intestines and the immune system's response to digestive inflammation, it said.

BPA is used in the production of polycarbonated plastics and epoxy resins found in baby bottles, plastic containers, the lining of cans used for food and beverages, and in dental sealants.

More than 130 studies over the past decade have linked even low levels of BPA, which can leach from plastics, to serious health problems, breast cancer, obesity and the early onset of puberty, among other disorders.

The French study focuses on the first organ to come in contact with the substance, the intestine.

The researchers orally administered doses of BPA to the rats that were equivalent to about 10 times less than the daily amount considered safe for humans, a statement from the Toulouse institute said.

They saw that BPA reduced the permeability of the intestinal lining through which water and essential minerals enter the body, it said.

They also found that newborn rats exposed to BPA in the uterus and during feeding have a higher risk of developing severe intestinal inflammation in adulthood.

The study "shows the very high sensitivity on the intestine of Bisphenol A and opens news avenues for research" including to define new acceptable thresholds of the substance for humans, the institute said.

In May this year, the six major baby bottle makers in the United States agreed to stop using the chemical.

STDs Continue to Spread in U.S.

American squeamishness about talking about sex has helped keep common sexually transmitted infections far too common, especially among vulnerable teens, U.S. researchers reported Monday.

Latest statistics on chlamydia, gonorrhea, and syphilis show the three highly treatable infections continue to spread in the United States.

"Chlamydia and gonorrhea are stable at unacceptably high levels, and syphilis is resurgent after almost being eliminated," said John Douglas, director of the division of sexually transmitted diseases at the U.S. Centers for Disease Control and Prevention.

"We have among the highest rates of STDs of any developed country in the world," Douglas added in a telephone interview.

The administration of President Barack Obama has signaled a willingness to move away from so-called abstinence-only sex education approaches that his predecessor, George W. Bush, and conservative state and local governments have promoted.

Several studies have shown such approaches do not work well and that it is better to encourage abstinence while also offering children and teens information about how to protect themselves from diseases as well as pregnancy.

"We haven't been promoting the full battery of messages," Douglas said. "We have been sending people out with one seatbelt in the whole car."

The CDC's latest study on STDs found:


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Extraordinary Benefits of Exercise

The results of two new German studies emphasize that exercise is one of the most effective methods of preventing disease. The first study found that exercise has an extraordinary potential to prevent stroke. Rapid walking or cycling lowered the risk of cerebral hemorrhage (bleeding in the brain) by 40 percent in men and cerebral infarction (blood supply blocked by a clot) by 27 percent.

The second study found that regular walking lowers the risk of colorectal cancer by 40 percent. It also found that patients with colorectal carcinoma can improve their chances of survival by exercising.

Professor Dieter Leyk of the German Sport University in Cologne raises the question of why the tremendous benefits of exercise, both preventive and therapeutic, are not fully utilized by medical professionals.

Food Poisoning Can Cause Lifelong Problems

More than just a bad bout of stomach flu, some food-borne illnesses can cause long-term consequences, especially for young people, a report released on Thursday has found.


Researchers at the Center for Foodborne Illness Research & Prevention in Pennsylvania studied the five most common food-borne diseases and found they can cause life-long complications including kidney failure, paralysis, seizures, hearing or visual impairments and mental retardation.


"It's not just a tummy ache," the center's Tanya Roberts told a news briefing.
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Acetaminophen Increases Asthma Risk

An analysis of 19 studies provides additional evidence of increased asthma risk in children and adults given acetaminophen.


The study's lead author told Reuters Health, while this type of study isn't the best way to prove that the medication actually causes the illness, it does show that the relationship should be investigated further.


"We know acetaminophen affects inflammatory cells in the airway," said Dr. J. Mark FitzGerald of the Vancouver Coastal Health Research Institute in British Columbia. But even if the medication does boost asthma risk, he added, it's likely only one factor in the rise in asthma prevalence seen in recent years.


Asthma has become increasingly common worldwide, and some investigators have suggested that more widespread acetaminophen use could be one contributing factor, given that the drug lowers levels of an antioxidant called glutathione found in lung tissue, FitzGerald and his team note in the journal CHEST.


Also, the researcher pointed out in an interview, a study of about 200,000 patients published in 2008 suggested an increased risk of asthma and wheezing in those who took acetaminophen.


To investigate further, FitzGerald and his associates searched the medical literature for studies that looked at acetaminophen and risk of asthma and wheezing.


When the researchers did a combined analysis of the 19 studies they identified, which included 425,140 patients in all, they found acetaminophen use was associated with a 1.6-fold increased risk of asthma. Children exposed to the drug in the womb were at 1.3-fold greater risk of asthma and 1.5-fold increased risk of wheezing.


The one study that looked at high-dose acetaminophen in children found it more than tripled asthma risk.


At this point, FitzGerald said, parents shouldn't purge their medicine chests of acetaminophen.


When a pediatrician recommends acetaminophen to treat fever in a child, according to the researcher, parents should follow this advice. The drug "works very well to do what it is supposed to do," he noted, adding "there's always a risk benefit in terms of medication."


SOURCE: CHEST, November 2009.