Medical Articles 2012: Anatomy and Diseases in Human
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Aspirin taken daily 'cuts bowel cancer death risk'


Aspirin taken daily cuts bowel cancer death risk  Bowel cancer patients who take daily aspirin could cut their chance of dying from the disease by about a third, experts believe.

 A study in the British Journal of Cancer looked at 4,500 bowel cancer patients living in The Netherlands.

 All of the patients on aspirin were taking a low dose - 80mg or less a day - something already recommended for people with heart disease.

 But experts say it is too soon to start routinely offering it for bowel cancer.

 A wealth of evidence already suggests aspirin might prevent certain cancers from developing in the first place. And more recent work suggests it might also work as a cancer therapy - slowing down or preventing a cancer's spread.

 But the drug can also have unpleasant and dangerous side effects, causing irritation of the stomach lining and internal bleeds in a very small minority of patients.

 The findings

 In the study, which spanned nearly a decade, a quarter of the patients did not use aspirin, a quarter only took aspirin after being diagnosed with bowel cancer, and the remaining half took aspirin both before and after their diagnosis.

 Most of the patients on aspirin had been taking it to prevent cardiovascular disease-related problems like stroke or heart attack.

 Taking aspirin for any length of time after diagnosis cut the chance of dying from bowel cancer by 23%.

 The patients who took a daily dose of aspirin for at least nine months after their diagnosis cut their chance of dying from the disease by 30%.

 Taking aspirin only after bowel cancer had been detected had a bigger impact on reducing mortality compared with when aspirin was taken before and after diagnosis - reducing death risk by 12%.

 Lead researcher Dr Gerrit-Jan Liefers, of the Leiden University Medical Centre, said: "Our work adds to growing evidence that aspirin not only can prevent cancer from occurring but if it is there it can help prevent it spreading."

 He said aspirin should not be seen as an alternative to other treatments, such as chemotherapy, but could be a useful additional treatment.

 "It's possible that some older people may have other health problems which mean that they are not well enough to have chemotherapy. Bowel cancer is more common in older people so these results could be a big advance in treatment of the disease, particularly in this group. But we need further research to confirm this."

 He said they now planned to hold a randomised controlled trial - the "gold standard" in medical research - to look at how well aspirin fared against a dummy drug in people aged over 70 with bowel cancer.

 Sarah Lyness of Cancer Research UK said: "This latest study adds to the growing evidence about the benefits of aspirin.

 "But we are not yet at the point where we would recommend people start taking aspirin to reduce their chances of developing cancer.

 "There are still questions we need to answer about the side effects, such as internal bleeding, who might benefit most from taking aspirin, who might be harmed, what dose and how long people some people might want to take it for.

 "Anyone thinking of taking aspirin to cut their risk of cancer should talk to their GP first. People with cancer should be aware that aspirin can increase the chances of complications before surgery or other cancer treatments such as chemotherapy, and should discuss this with their specialist.

 "In the meantime, there are many ways we can take to lower our risk of developing cancer - not smoking, cutting back on alcohol and keeping a healthy weight can help stack the odds in our favour."

 This may be because those who took aspirin and still got bowel cancer had a particularly aggressive form of tumour that did not respond as well to aspirin, say the researchers.

London Olympics 2012: Blood donor appeal ahead of Games


 The health service is appealing for extra blood donations before the Olympics start in July.

 NHS Blood and Transplant (NHSBT) says stocks need to be 30% higher than normal by the start of the Games.

 The extra supplies are part of the contingency plans to cope with the extra visitors coming to the UK.

 There are also concerns that donations may drop off during large national celebrations like the Diamond Jubilee and other major sporting events.

 'Perfect storm'

 The situation has been described as a potential "perfect storm" of increased demand at the same time as falling supplies.

 The Olympics and Paralympics are expected to bring an extra 1.2m visitors to the UK. That will include 15,000 athletes from every part of the world.

 During major sporting events or national holidays, blood stocks sometimes dip as regular donors forget to make appointments.

 Jon Latham, from NHSBT, told the BBC: "Every unit of blood saves or improves the life of three people. We obviously want to make sure everyone enjoys the Games, and want to make sure that if there are any accidents we have the blood supplies to help them recover quickly."

 This summer presents a particular challenge for the blood service because of the unusual combination of events. There is an additional bank holiday for the Diamond Jubilee, as well as Wimbledon and football's European Championships.

 During big sporting events, the number of donations drops as people miss sessions to watch their favourite sports. That is why NHSBT is hoping to increase the supply of blood just before the Olympics.

 By starting with a high level of stock, they can allow it to taper back to normal reserves during the summer.

 Each year 230,000 new donors are needed, so the appeal is partly aimed at getting people to think about signing up now rather than later in the year.

 A lifesaving donation

 Relatively little donated blood is used for treating people injured in accidents on the road or at work.

 Blood is needed for a wide range of medical situations, from women giving birth who lose blood to helping those undergoing surgery.

 Lucia Sarsby, who is 11 years old, is a patient at Bristol Royal Infirmary, where she has received regular transfusions of red blood cells since she was a toddler.

 Lucia has a condition called beta thalassemia major, and is matter of fact about its consequences: "I can't make red blood and without it I would die."

 Maintaining supplies to regular patients and also having enough reserves to cope with any contingency will present the blood service with a challenge.

Men can inherit a form of heart disease from father via Y chromosome


Men can inherit a form of heart disease from father via Y chromosome  Men can inherit heart disease from their father say scientists who have tracked the condition to the Y chromosome that dads pass to sons.

 By studying the DNA of over 3,000 men they found a particular version of the sex chromosome increases the risk of coronary artery disease by 50%.

 As many as one in five British men carry this version of Y.

 And the risk it confers is in addition to other heart risk factors like cholesterol, The Lancet reports.

 Experts already know that men develop heart disease a decade earlier than women, on average. By the age of 40, the lifetime risk of heart disease is one in two for men and one in three for women.

 Lifestyle factors like smoking and blood pressure are important contributors. This latest work suggests the male Y chromosome can also play a role in coronary artery disease - a common form of heart disease that kills thousands each year in the UK.

 Passed down

 Dr Maciej Tomaszewski, from the University of Leicester, and colleagues studied 3,233 biologically unrelated British men who were already enrolled in other medical studies investigating heart disease risk.

 When they carried out genetic tests on the men they found that 90% possessed one of two common versions of Y chromosome - named haplogroup I and haplogroup R1b1b2.

 And the risk of coronary artery disease among the men carrying the haplogroup I version was 50% higher than in other men.

 The scientists say they now need to pinpoint precisely which genes on the Y chromosome are responsible.

 But they believe they already know how they exert their effect - by upsetting a man's immune system.

 Dr Maciej Tomaszewski, a clinical senior lecturer at the University's Department of Cardiovascular Sciences, said: "We are very excited about these findings as they put the Y chromosome on the map of genetic susceptibility to coronary artery disease.

 "Doctors usually associated the Y chromosome with maleness and fertility but this shows it is also implicated in heart disease."

 He said, ultimately, the discovery could lead to new ways to treat and prevent heart disease in men, as well as a genetic test to spot those greatest risk.

 In the meantime, he said men should focus on risk factors that they already have the power to modify themselves, such as getting enough exercise and eating a healthy diet to keep their blood pressure and cholesterol down.

 Dr Hélene Wilson of the British Heart Foundation, which part-funded the work, said: "Coronary heart disease is the cause of heart attacks, which claim the lives of around 50,000 UK men every year.

 "Lifestyle choices such as poor diet and smoking are major causes, but inherited factors carried in DNA are also part of the picture. The next step is to identify specifically which genes are responsible and how they might increase heart attack risk."

Boehner calls for law to stop US contraception rule


Boehner calls for law to stop US contraception rule  The top US Republican in Congress has called for action against a White House contraception rule that has angered Catholic leaders.

 Speaker John Boehner said legislation was needed against the rule, which means Church-linked institutions must buy health insurance that covers birth control costs.

 Catholic leaders say that would force them to violate religious beliefs.

 White House officials say they want to find ways to allay Church concerns.

 But one report in the New York Times on Wednesday said the administration would not back down from the rule.

 Under President Barack Obama's healthcare reform law, employers must offer insurance that includes contraceptives.

 Churches and other houses of worship were given a waiver under the new law, but institutions including Catholic universities and hospitals are not exempt.

 'Must not stand'

  Mr Boehner, a Republican from Ohio, took to the floor of the House of Representatives on Wednesday to call for legislation against the rule.

 "This attack by the federal government on religious freedom must not stand and will not stand," he said.

 The speaker said the House Energy and Commerce Committee was working on legislation related to the rule.

 The mandate has also provoked strong condemnation from the Republican presidential candidates on the campaign trail.

 In Colorado on Tuesday, Mitt Romney described the policy as a "violation of conscience".

 But the White House and other Republican candidates have hit back at his criticism.

 During Mr Romney's tenure as governor of Massachusetts, the state implemented legislation that required hospitals - including Catholic ones - to provide emergency contraception to rape victims.

 Democratic congresswomen have defended the White House measure, arguing that the policy would control health costs, stop unwanted pregnancies and that overturning the rule would adversely affect staff who may not be Catholic.

 Jan Schakowsky, a Democratic Representative from Illinois, said: "Women's healthcare should not depend on who the boss is."

 Wisconsin Representative Gwen Moore said the church "can't impose its religious views on people and whether they can have healthcare".

 The uproar began over the weekend, after US Health Secretary Kathleen Sebelius defended the policy in an editorial for USA Today.

 Catholic bishops called for the rule to be dropped, including Archbishop Timothy Dolan of New York, who wrote in an editorial for the Wall Street Journal that the mandate was "an unprecedented incursion into freedom of conscience".

 The Obama administration has sought to portray the issue as a balance between religious freedoms and preventing discrimination under the new healthcare law.

 "You are going to have folks of all faiths who work for those large institutions," White House spokesman Jay Carney said in a Tuesday press briefing.

 "Those women ought to be able to have access to the same contraceptive services that other women will have access to."

Gene therapy 'gave me sight back'


Gene therapy gave me sight back  Three US citizens who lost their sight in childhood have reported a dramatic improvement in vision after having gene therapy in both eyes.

 There was some improvement after the genetic fault in one eye was corrected four years ago.

 Now, one woman has described her joy at seeing her children's faces, after her second eye was treated.

 The research increases hopes that gene therapy can be used in a range of eye conditions, said a UK expert.

 The three have Leber's Congenital Amaurosis (LCA), a rare inherited disease caused by defects in a gene encoding a protein needed for vision.

 It appears at birth or in the first months of life, leading to severely impaired vision, involuntary eye movements and poor night vision.

 The disorder, which can be caused by 'mistakes' in more than 10 different genes, prevents normal function of the retina; the light-sensitive layer of cells at the back of the eye.

 Several teams around the world are carrying out early trials of gene therapy in blindness, including experts at the Philadelphia Children's Hospital and the University of Philadelphia, US.

 Only a handful of patients worldwide have received the treatment to boost a faulty gene underlying an inherited form of blindness.

 The US researchers revealed in 2008 that 12 people with LCA had recovered some vision after being injected in one eye with an engineered virus carrying the gene RPE65.

 In a follow-up study they treated the other eye of three of them, and found it improved their sight even more.

 The subjects could see better in dim light and two were able to find their way around obstacles.

 The results were revealed in the latest edition of the journal Science Translational Medicine.

 The principal investigator of the study, Dr Jean Bennett, said the patients could now do things they could never do before, such as walking around at night, going shopping for groceries and recognising people's faces.

 She told the BBC: "We've shown that it is possible to safely treat both eyes of people with this particular form of retinal deficiency using a gene-based treatment and further we've demonstrated that the brain understands what the retina is seeing."

 MRI scans showed the brain could "see" the newly-treated eye.

 Dr Manzar Ashtari, from The Children's Hospital of Philadelphia, who carried out the brain scans, told the BBC: "We saw the brain gets activated - the brain after treatment responded to the visual stimuli."

 'Incredibly valuable'

 One of the three patients who took part in the clinical trial, Tami Morehouse, told the BBC how her vision gradually returned, opening up a whole new world for her.

 Even though she can't see well enough to read or drive a car, she can now make-out her children's faces, watch them play baseball and see the light change over Lake Erie, where she lives.

 She said: "Life is so much easier at a level that most people take for granted. Any amount of vision that you can get when you have almost nothing is incredibly valuable."

 The researchers now hope to treat the second eye of the remaining nine patients, and extend the clinical trial.

 Dr Bennett said: "I think it will be a stepping stone to treating more common forms of blindness in both eyes."

 Commenting on the study, Clara Eaglen, policy and campaigns manager at the Royal National Institute of Blind People (RNIB), UK, said: "The early results of this small scale trial are encouraging, but clearly, a lot more research is needed to maximise the benefits of gene therapy techniques and understand how they can then be turned into effective treatments for a variety of more common degenerative eye conditions."

 Professor Robin Ali of the Institute of Ophthalmology at University College London leads a UK team carrying out a similar trial of gene therapy.

 He said: "This is confirmation that it is possible to administer gene therapy safely to the second eye of patients.

 'This is reassuring and increases the prospect of this type of therapy for treatment of a wide range of eye conditions.'

Pseudomonas found in more hospital taps


Pseudomonas found in more hospital taps  Pseudomonas has been detected in water outlets in the neonatal units at three more hospitals in Northern Ireland.

 Water tests from Daisy Hill in Newry, Craigavon Area Hospital and the Erne Hospital in Enniskillen were positive.

 As in all neonatal units, steps had already been taken to ensure that babies did not come into contact with the water supply.

 No babies in these hospitals are infected with Pseudomonas, although two at Craigavon are colonised.

 That means they have Pseudomonas on their skin but are not infected, and it is not having any effect on those babies.

 No babies in the Erne Hospital or Daisy Hill Hospital's neonatal units are colonised.

 The Public Health Agency said that of Tuesday, the total number of confirmed pseudomonas infections associated with the Royal Jubilee Maternity Hospital (RJM) outbreak was seven.

 The number of babies currently in neonatal units who have confirmed pseudomonas colonisations and are associated with the RJM outbreak is six.

 Five other babies have confirmed pseudomonas colonisations. They are being cared for in Altnagelvin, Craigavon and Antrim hospitals.

 In December, a baby died from a Pseudomonas infection at Altnagelvin Hospital in Londonderry.

 In December and January, three more died from a different strain of the infection at the Royal Jubilee Maternity in Belfast.

 Taps in neo-natal unit across Northern Ireland have been changed and only sterile water is being used for the direct care of patients.

Gene switch 'key to heart health'


Gene switch 'key to heart health'  Scientists may be closer to understanding how genes can influence serious heart conditions, says a Nature Genetics report.

 The failure to turn off a specific gene at the right time in an embryo's development could mean illness later in life.

 Mice in which the gene was left active were born apparently healthy, but suffered heart muscle problems later.

 A heart charity said it might one day be possible to fix the genetic switch.

 The science of "epigenetics", which places importance not just on the genes you carry, but also how well they are working, is a relatively new area.

 There is increasing evidence that suggests that while you carry the same set of genes for life, environmental factors, such as diet or even your mother's health while you are in the womb, could affect their activity, and your chances of certain illnesses later in life.

 The scientists from the Gladstone Institute in San Francisco focused on two genes, and their role in cardiomyopathy, a enlarging and weakening of the heart muscle which is a feature in life-threatening heart defects in children and adults.

 Developing signs

 One of the genes, called Six1, appears to play an important role in embryonic heart development, while the other, Ezh2, seems to have the job of switching off genes, including Six1, when they are no longer needed.

 The researchers tested the precise relationship by stopping Ezh2 from working in the embryo and foetus at various points during pregnancy, thereby allowing Six1 to go on working for longer than usual.

 They found that while the mice were born apparently normal and healthy, they then started to develop the signs of cardiomyopathy.

 This suggested that although leaving Six1 switched on in humans might produce a seemingly healthy baby, it could be storing up heart problems for later in life.

 Analysis of the results revealed that, in a healthy pregnancy, Six1 should only normally be switched on briefly during heart development.

 'Crucial step'

 Dr Paul Delgado-Olguin, one of the team, said: "When Six1 remains active for too long in Ezh2-deficient mice, it boosts the activity of other genes that shouldn't be activated in heart muscle cells - such as genes that make skeletal muscle.

 "The enlargement and thickening of the mice's hearts over time eventually led to heart failure."

 They are hopeful that further work will reveal more about the roots of congenital heart problems in early life.

 Professor Peter Weissberg, from the British Heart Foundation, said the research was "important".

 "What this shows is that a really crucial step in normal heart development is the switching off of genes.

 "If this doesn't happen, and they continue to be expressed, this can cause trouble later in life."

 He said that there was the possibility that faulty gene expression could be corrected, although it would be some years before such techniques could be used in humans.

 The possible reasons for the faulty "switch" - whether dietary, medical or something else - could also be investigated, he added.



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