Tuesday, November 30, 2010

Acupuncture's effect 'isn't just psychological' (?)

This is very poor logic. It would be surprising if sticking needles into people DIDN'T produce brain responses. The question is whether it reduces pain

Acupuncture works directly on the brain to reduce the amount of pain we feel, MRI scans indicate. It limits activity in parts of the brain tasked with gauging pain, an experiment on 18 volunteers found.

Crucially, researchers believe the study shows that acupuncture does not only work on a psychological level - as a 'placebo' - but that is also has a direct 'dampening' effect on the brain's pain processing centres. Many critics believe acupuncture only works as a placebo.

The experiment, conducted by researchers at the Department of Complementary and Integrative Medicine at University of Duisburg-Essen in Germany, looked at brain scans of volunteers who were given mild electric shocks.

Firstly they were given the shocks without acupuncture, and then they were given the same shocks while acupuncture needles were placed between the toes, below the knee and near the thumb.

Researchers then compared MRI scan images - which can measure the small metabolic changes that take place in active parts of the brain - to see whether the responses differed.

Dr Nina Theysohn, who will present the research in Chicago on Tuesday at the annual meeting of the Radiological Society of North America, said: "Activation of brain areas involved in pain perception was significantly reduced or modulated under acupuncture."

These areas included the contralateral supplementary motor area, somatosensory cortex, precuneus bilateral insula and ipsilateral somatomotor cortex. All are involved in pain perception.

The scans also showed that acupuncture worked as a placebo, said the researchers, affecting activity in areas that govern expectation and comprehension of pain such as the anterior insula.

Dr Theysohn said: "Acupuncture is supposed to act through at least two mechanisms—nonspecific expectancy-based effects and specific modulation of the incoming pain signal. "Our findings support that both these nonspecific and specific mechanisms exist, suggesting that acupuncture can help relieve pain."

But Edzard Ernst, professor of complementary medicine at the Peninsula Medical School in Exeter, urged caution. He said: "Studies like this might go some way to explaining how acupuncture works. "We should remember, however, that we are currently not sure whether acupuncture does,in fact,reduce clinical pain.

"In my view, this is the more important question. If acupuncture does not have meaningfull clinical effects, its mechanism is hardly a relevant issue."

Last year the National Institute for Clinical Excellence (Nice) appeared to endorse the traditional Chinese medicine, by announcing that doctors should "consider offering a course of up to 10 sessions of acupuncture over a period of up to 12 weeks" for cases of "non-specific" lower back pain.


A partial cure for hand eczema

When Denise Hyland, an English teacher in Greenwich, south east London, took to wearing a black silk glove in the classroom, the pupils were impressed: after all, Michael Jackson had worn something similar. But when she took the glove off, the reaction changed.

“When they saw my hand they called it 'the lurgy,’” she said.

Denise, who is 58, had chronic hand eczema, a condition which suddenly appeared nearly eight years ago and went on to blight her life. “I was washing up when I felt a searing pain in my right palm. At first I thought it was caused by the washing-up liquid,” she recalls.

Over the next few months, her right hand became painfully inflamed, with red-raw cracks appearing over her entire palm and the front of her thumb. It was the beginning of a pattern. “Over a month my hand would become dry and itchy,” she says. “Then it peeled and turned scaly. This was followed by yellow blisters, cracks, bleeding and weeping. The cells would try to repair my hand by producing thick, rhino-like skin. That would then peel off, leaving soft skin for a short time before the whole thing started again.”

Six million people in the UK are estimated to suffer from this debilitating skin condition. As with other types of eczema, the skin becomes inflamed and broken, causing symptoms such as flaking, itchiness and blisters. Until recently, one in five cases of hand eczema was untreatable. Now a drug called alitretinoin, the first to be developed for hand eczema, is available. Research shows it can help almost 50 per cent of patients who have not responded to other treatments.

Hand eczema can be triggered by a combination of factors, including genetic make-up and, in particular, contact with irritant or allergenic substances at work: high-risk jobs include hairdressing, catering and dentistry. According to Ian Coulson, a consultant dermatologist at Burnley General Hospital, it is the third most common cause of people taking time off work in the UK (just behind backache and stress): an “enormous economic problem” he says.

In Denise’s case the cause of the eczema and why it affected only her right hand was a mystery.

“I had slight eczema in my ears when I was 11. I also have type 2 diabetes and there may be a link to that. One consultant said it was caused by menopause.” She is naturally right-handed, so not being able to use the hand fully made life miserable. “When the rhino skin starts you lose all flexibility,” she continues. “I couldn’t open jars, lift things into the oven or stir pans. It felt as if my hand was on fire and I couldn’t sleep at night.”

Depression is common in sufferers. “My social life died,” says Denise. “I avoided shaking hands with anyone new and wore a glove in the classroom because I was so embarrassed. I also felt embarrassed for my children [Luke, 13 and Giny, 15] when they invited friends home for dinner. I had an open wound which I had to tend day and night.”

Denise began a frantic hunt for help from skin specialists. As well as moisturisers and steroid creams – standard treatments for eczema – her doctor tried her on PUVA. This ultraviolet light treatment reduces the exaggerated immune response that can trigger certain types of eczema. He also tried two powerful drugs. Nothing worked. In desperation she visited an alternative practitioner, living in Spain. “He gave me a list of at least 50 foods to avoid,” she says. “I couldn’t keep it up.”

Denise’s story has a happy ending. She was finally prescribed alitretinoin (brand name Toctino®,) which has been approved by the National Institute for Health and Clinical excellence (Nice) as the first treatment for chronic severe hand eczema, where topical treatments have not worked. Denise took the once-a-day tablets for four months, by which time the eczema had disappeared. Whether it will return is uncertain.

Alitretinoin can have side effects, although Denise’s only problem was a slight sensitivity under her left breast, where her bra fits. The drug is not suitable for everyone. According to Nice, its use should be monitored by a dermatologist or a doctor experienced in treating severe hand eczema and in using this type of drug.

Margaret Cox, chief executive at the Eczema Society, says many people’s lives are made impossible by hand eczema. “They often can’t work, can’t dress themselves, can’t hand over money in shops, and this drug has transformed their lives,” she says.

Denise’s main feeling is relief. “I’ve finally got my life back,” she says.


Monday, November 29, 2010

Paracetamol (Tylenol) use in children under 15 months doubles their chance of getting asthma, study finds

Although it is for some inexplicable reason rather fashionable these days, paracetamol is a very dangerous drug. It causes three times as many cases of liver failure as all other drugs combined, and is the most common cause of acute liver failure in the United States, accounting for 39% of cases. While it occurs through overdosing, even recommended doses especially combined with even small amounts of alcohol, have caused irreversible liver failure. [Summary from Wikipedia]. So I am rather appalled that it is given to children at all. All drugs have side effects but aspirin use is much less likely to be catastrophic

The study below, however, proves nothing. It fails to ask WHY some kids were taking a lot of painkillers. Presumably they were in poor health anyway and thus more likely to develop other ailments

YOUNG children who take paracetamol are twice as likely to develop asthma, New Zealand researchers say. A study of more 1400 children found that those that took paracetamol before the age of 15 months were twice as likely to develop asthma and three times as likely to develop allergies by age six.

Researchers at University of Otago Wellington were not sure why and said they needed clinical trials to further look at any associations.

The study also found that by age six, 95 per cent of children were using paracetamol, significantly increasing the risk of asthma and wheeze. It found a dose-response affect, so the more regularly a child was using paracetamol the greater the risk appeared to be.

The study's author, Professor Julian Crane, said he was unable to determine how much paracetamol a child would have to take before becoming more suspectable to asthma or allergies.

"It's difficult to say, it's over a period rather than any absolute (amount). But we did find a sort of dose-response affect, so the more regularly a child was using it the greater the risk appeared to be," he said.

However, it was not a case of taking the medication once and immediately become more suspectable, he said. "It's clearly more subtle, you don't take it and suddenly get wheezy. "(But) the results at this stage are supportive of a role for paracetamol in asthma and allergic disease."


Aspirin: is it really a wonder drug?

Last week, researchers claimed everyone over 45 should take an aspirin a day to prevent cancer and heart disease. I pointed out how weak the evidence for that is on 25th. Now we see below a much more extensive coverage of the issue -- JR

Should aspirin be added to the water supply? This was the vision which sprang to mind last week when academics advised that the benefits of taking a small daily dose of aspirin far outweigh any side-effects for most healthy people aged 45 and over.

The pronouncement by a panel of experts speaking at the Royal Society of Medicine, comes a month after research from Oxford University, published in The Lancet, showed that taking 75mg of aspirin - a quarter of the standard over-the-counter pill - daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third. Research is expected to be published shortly showing similar effects for other cancers.

This simple painkiller has many well established benefits. It thins the blood, which is why it is routinely prescribed for people who already have heart disease or who have had a stroke. It is also often prescribed for people who may be at high risk of these illnesses – because of high blood pressure or diabetes, for example. And it’s used widely for blood-clotting disorders and to help prevent recurrent miscarriage, migraines, cataracts, gum disease and pre-eclampsia (a serious complication of pregnancy).

But should low-dose aspirin now be taken daily by healthy people who want to stay that way? Is this a watershed in the history of public health medicine – a 'put it in the water’ moment?

No is the simple answer, since it cannot be taken by certain people (including most children under 16). But Professor Gordon McVie, senior consultant at the European Institute of Oncology, Milan, is evangelical about the benefits of aspirin. 'For me this is clear cut,’ he says. 'Aspirin is cheap and effective, and there is huge potential to cut the cases of illness particularly colon cancer.’

In agreement is Peter Elwood, Professor of Epidemiology at the University of Wales in Cardiff, who led the first randomised trial into the benefits of aspirin for heart disease patients in 1984 (and who has himself taken aspirin daily for the past ten years). 'Breakthrough is an overused word but in this case it is justified,’ he says.’ There is disagreement around the peripheral issues – how much to give, should there be an age range – but overall it seems clear to me that the latest work proves taking aspirin every day will increase your chance of survival against important diseases.’

The study which seems to have tipped the scales is principally the work of Oxford neurologist Professor Peter Rothwell (who has also started taking low-dose aspirin daily). He believes that aspirin’s effect on bowel cancer is unlikely to be an isolated phenomenon, given the similarities in how cancers of different types develop. Last week he also advised that with the risk of cancer rising between 40 and 55, 45 would be an optimal age to start taking it.

But despite the excitement, not every doctor is reaching for the prescribing pad just yet.

For one thing, aspirin’s usefulness in warding off heart attacks and strokes in healthy people is in doubt. The latest research, published in the Journal of the American Medical Association in March and involving almost 30,000 men and women, found it had no significant effect on heart attacks and strokes in low-risk populations.

And last year, the influential Drug and Therapeutics Bulletin (DTB), warned aspirin should not be used to prevent future heart attacks and strokes in people with no obvious sign of cardiovascular disease, as the risks outweigh any potential benefits.

The biggest drawback of taking aspirin is that it can irritate the lining of the stomach. Although for most people this side effect is mild, it can occasionally cause ulcers and in a small number of cases, serious bleeding, particularly in elderly people.

But what of the recent study on bowel cancer, the third most common cancer in Britain and which kills 600,000 people worldwide annually? Some doctors point out that while the study shows thousands of lives might indeed be saved by aspirin, the reduction in absolute risk of bowel cancer is about 1.5% (from 4% to 2.5%) .

Dr Ike Iheanacho, the DTB’s editor, says that the reduction in risk is a 'sizeable benefit’ from society’s point of view. 'But one problem with this kind of data is that it’s often reported as if the benefit to the individual is huge,’ he says.

'In effect, around 60 people would have to take the aspirin continuously for around 5 years to prevent one death from bowel cancer during a 20-year period,’ he says. 'While that remains a considerable benefit, it could clearly put a very different perspective on things for an individual deciding whether to take aspirin for this purpose.

'And this particular research didn’t report adverse events related to aspirin. Let’s not forget that the drug can cause major internal bleeding and this can kill. If you’re going to advise people to take aspirin, you have to factor in potential harms to give them a balanced view of the potential effects of treatment.’

The blanket prescribing of any drug is also at odds with the 'stratified’ response that most oncologists predict will be the future of cancer treatment – in other words, medical interventions will be tailored to our genetic makeup and our individual risk.

One way forward might be to give aspirin only to those at high risk of bowel cancer, an idea Professor McVie has said he supports; he believes that in a few years a blood test to detect those at higher risk will become available.

Overall, with medical opinion divided, the feeling is that the public will need to make up their own minds about whether to take low dose aspirin. Professor Peter Whorwell, a gastro-enterologist at Manchester University, advises that anyone considering taking it on a daily basis should discuss with their GP whether they also need to take drugs to protect the stomach.

Back to Professor McVie who with a family history of heart disease, confirms that he too has been taking aspirin daily for more than 20 years. 'I saw some data long before it was verified and published, and I was convinced,’ he says. 'After this month’s data, I’m pretty chuffed with myself now.’

Who shouldn’t take aspirin?

• Aspirin should not be given to anyone under 16 unless under specialist advice. It can cause Reye’s syndrome, a potentially fatal disease, in this age group [This is a very rare and poorly understood ailment and there is some evidence that paracetamol also causes Reye's syndrome -- and the syndrome can occur in the absence of aspirin]

• Aspirin should be avoided if you have a stomach (peptic) ulcer, haemophilia or other bleeding disorder, or an allergy to aspirin or to other non-steroidal anti-inflammatory drugs (NSAID). These include ibuprofen and diclofenac

• Low-dose aspirin should only be taken with caution by certain groups, including those with asthma, allergies, liver, kidney or digestive problems.

• Pregnant and breastfeeding women should only take aspirin on the advice of a GP.

• Aspirin can interact with certain other medicines. Ask your doctor or pharmacist or read the patient information leaflet


Sunday, November 28, 2010

Australia: The "obesity" war gets more and more vicious

Overweight mothers now turned away from hospitals

PREGNANT women are being turned away from several NSW hospitals for being too fat, causing outrage among women's groups. An investigation by The Sunday Telegraph has found a number of public hospitals across the state are not allowing women with a body mass index (BMI) of 35 or above to give birth there, deeming them too "high risk".

BMI is a measurement of a person's health based on their height and weight, so a woman who stands 155cm and weighs 83kg would have a BMI of 35 and be considered too overweight to give birth safely in many hospitals.

In Sydney, Sutherland Hospital and Ryde Hospital refer women with a BMI of 35 or higher to hospitals with more specialised models of care. At Hornsby, Ku-ring-gai, Mona Vale and Manly hospitals, women with a BMI of more than 40 will be told to book in to another facility.

In regional areas, Shellharbour, Milton Ulladulla, Bowral and District, Wyong, Lithgow and the Blue Mountains hospitals all refer women with a BMI of 35 or more to another hospital.

NSW Australian College of Midwives president Hannah Dahlen said that rejecting women with a BMI of 35 was "extreme" and would push more people into dangerous birthing alternatives. "It is very insensitive - one woman with a BMI of 35 is not the same as another woman with a BMI of 35," she said. "They forget about the individual. Women are making decisions like free birth at home with no assistance and that is a much worse option. "We have to be more flexible in our health system about labelling women and look at things like lifestyle, diet and exercise."

Ms Dahlen said a BMI of 35 was now "very, very common", particularly among certain cultures. [Polynesians]

Publicly-funded birthing centres run by midwives also have a policy to turn away women with a BMI of more than 35, she said.

While there is no statewide policy, all area health services in NSW consider a BMI of 35 as the benchmark. Pregnant women who are overweight run a greater risk of diseases such as gestational diabetes, high blood pressure and pre-eclampsia. There are also higher rates of neonatal intensive care admissions, birth defects, prematurity, still birth and perinatal death among obese women.

The president of the Maternity Coalition, a national organisation advocating best-practice maternity care for women, Lisa Metcalfe, said BMI restrictions further reduced women's options. "It is another nail in the coffin for women's choice. Next, they'll be telling you, 'She has blue eyes, she'll need a specialist'," she said.

A spokeswoman for Sydney West Area Health Service said BMI was not the only risk indicator and was used as a guide for clinicians, with other factors including the mother's age, medical history and previous birth experiences.


Some very encouraging news about pancreatic cancer

Last December, Kevin Jones, a 43-year-old businessman from Dorset was diagnosed with pancreatic cancer. It was advanced and inoperable. Today, as he prepares to celebrate Christmas with his son, Mr Jones is free from any detectable trace of the disease; the human face of a medical breakthrough so exciting that the scientists involved struggle to contain their excitement.

Cancer of the pancreas is one of the most deadly cancers of all. Symptoms are hard to detect, meaning the disease is usually advanced, and tumours cannot be safely removed by the time it is diagnosed. Of almost 8,000 people diagnosed with pancreatic cancer in the UK each year, just 4 per cent survive five years or more. Among the small number of cases caught early enough for patients to undergo surgery, just one quarter will survive more than five years.

By the time Mr Jones was diagnosed, he already knew those grim statistics. When he first started suffering from sharp pains in the summer of 2009 – usually when he was having a pint with friends after work, or after a round of golf – he assumed it was heartburn. Antacids made no difference. His GP thought it might be an ulcer; tablets did not help. Blood tests found diabetes, for which he was treated, yet still the pains continued. Mr Jones began to worry.

"I started to do some research on the internet, and I wondered if it might be pancreatitis, an inflammation that could explain the diabetes, because the pancreas produces insulin. I went back to my GP and asked to be referred to a specialist in pancreatic disease."

Scans detected some kind of mass in the organ. It could be scar tissue, or a benign lump, the businessman was told. Two weeks before Christmas he received the results of a biopsy. It was cancer, it was advanced, and it was inoperable. The expected prognosis was 12 to 14 months.

"I was only 43, my son was then not yet 15, and he has special needs," says Mr Jones. "The idea that I could be gone in a year, that I would leave him was just not something I could accept. Everyone in my family was crying, but I felt totally numb."

In fact, he says, he never accepted the prognosis. "I never thought this might be my last Christmas. I couldn't let myself think that. I thought, well that's the average, I might get more. I decided whatever they said, I would settle for three years. That would mean my boy had finished school; it was enough time to sort out my business and my will. Three years would do."

Searching online, he read about experimental trials for patients with pancreatic cancer. "When you've got nothing to get hold of, when you have nowhere to go, you grab at anything," says Mr Jones. He asked his specialist at Poole Hospital if there were any such trials in which he could take part. Within weeks, he had signed up for one of the most ground-breaking pieces of medical research of recent decades.

Five years ago, a group of scientists embarked on a radical trial. In recent years, most of the advances in treatment of pancreatic cancer had involved improved targeting of radiation, to deliver the burning rays most precisely to the cancer, and to limit damage to the tissue around it. But at the same time, scientists were increasingly aware of the role of genes in making some cancers more resistant to radiation than others.

The question was, could anything be done to switch off some of the molecular reactions that occur with cancer, and to make tumours more sensitive to radiation, so that they shrunk sufficiently that they could be removed. The group of scientists, now based at the Gray Institute for Radiation Oncology and Biology, in Oxford, decided to see whether a drug called Nelfinavir, used for the treatment of HIV, could change the way tumours responded to radiation.

Twelve patients with inoperable tumours were enrolled on a phase I trial, used to establish the safety and toxicity of a drug. They were given daily doses of the drug before radiation therapy. At the end of the trial, led by Dr Thomas Brunner, the patients were scanned again.

The research team was stunned by the results. Of 10 patients who completed the course, six were able to have previously inoperable tumours removed. Across the group, overall average survival time more than doubled. More remarkably still, in one case the combination of drug treatment and radiotherapy had eradicated every living cancer cell, with no trace of disease found by surgeons. "There was a complete pathological response. No sign of the cancer at all. It had completely disappeared."

The excitement from Professor Gillies McKenna, the head of the Gray Institute, is palpable. He quickly checks himself. Forty years pioneering advances in cancer treatment make him all too aware of the desperation of those diagnosed with advanced disease, and the rush to pin "miracle" labels on significant, but faltering, steps.

Yet four years since the trial started, the man remains free of cancer. A female patient, who had 90 per cent of cancer cells destroyed, also remains healthy, more than three years on.

"We are really excited about this," says Prof McKenna. "We are still several years away from proving that this is a major breakthrough, because this was a small trial. But to get these kinds of results for pancreatic cancer – well, we just couldn't help but prick up our ears."

Early this year, the team embarked on a larger phase II trial. Kevin Jones is among 80 patients being recruited to try the experimental technique. He began treatment in March.

"They never gave any false promises," says Mr Jones. "It had taken years of research to get to this point, and the results they had were on a small group. Why would there be a major breakthrough now? Well, the way I saw it, why not?"

For two weeks, he took a daily dose of the HIV drug. For six more weeks, he underwent daily radiation treatment at Oxford's Churchill Hospital. Regular measurements of tumour markers, which reflect the extent of disease, showed dramatic improvements. But by the end of the treatment, he felt terrible.

"I felt really sick, I couldn't eat and I didn't have much strength. I decided to take a holiday with my son in case it was the last one we had," says Mr Jones. He took his son Brett, who has Asperger's syndrome, to Canada, where they had been building a holiday home. "It was a special time, bonding, building this home together. Whatever else happened, I was grateful for that time."

He returned to England to undergo further scans. In June, the research team asked him to come for a consultation with one of the hospital's surgeons. "They showed me the scan. Where there had previously been a solid mass of two-and-a-half inches, there was now a faint outline, with a hole in the middle."

The research team and surgeons were cautious, warning him it was impossible to say from seeing the scans whether any of the tissues were cancerous. Nevertheless, says Mr Jones: "I walked out of that room feeling 10ft tall."

In July, he underwent surgery to remove the mass. It was then that surgeons told him that not a single cancer cell had been found; every deadly tissue had been destroyed. He was now the second such case to emerge from the Oxford trials. "They couldn't believe it. The surgeon who operated said he had never seen anything like it," says Mr Jones.

In such unchartered territory, no one can predict whether his cancer will return. He says: "The surgeons said to me, 'Don't think in terms of three years, or five years, you might have two decades – you might have more.' This time last year I'd have settled for three years. Now I might be cured."

The centre is still recruiting patients for the current trial, which will run for two years. Scientists like Prof McKenna, who returned to Britain to set up the institute, after 40 years leading radiation therapy programmes across the US, believe the evidence emerging may be "the tip of an iceberg" – giving scientists valuable lessons about ways to both block the progress of many aggressive cancers, and to enable different types of tumours to respond better to treatment.

But medical breakthroughs are expensive. The institute, set up just two years ago, receives most of its funding from Cancer Research UK, which is funded by donations from the public. Prof McKenna has had to fight hard to ensure funding for research into treatments, such as radiation therapy, which can be neglected.

"People dismiss radiotherapy as somehow being old-fashioned, as something that would die out when new treatments were being invented," he says. "Actually, that prediction was almost 100 per cent wrong; some of the most dramatic improvements in cancer over the past decade have come from this field.

"Our teams are here and we are ready to go to work, but we are totally dependent on the generosity of the public to make the breakthroughs we need."


Saturday, November 27, 2010

Sulloway is still banging the birth order drum

Though rather more cautiously these days. See below. His claims are all just selective use of data. Facts that don't suit him he ignores or misrepresents. Sulloway exposed himself as the charlatan he is by doing something almost unknown in academe: bringing a lawsuit in an attempt to prevent publication of an article disproving his claims. Not even the Warmists have done that.

The whole extraordinary story is here. I myself have previously put up a brief summary comment on the matter here. My comment should explain why I am not surprised that it is NPR that is preaching the Sulloway story below

There are lots of expectations and assumptions about how birth order may shape our adult lives, and many of them go back ages. Centuries ago, the oldest son had huge incentives to stay on track and live up to family expectations — that's because, by tradition, he was set to inherit almost everything.

"Historically the practice of primogeniture was very common in Europe," says Frank Sulloway, a visiting scholar at the Institute of Personality and Social Research at the University of California, Berkeley. "So firstborns had every reason to preserve the status quo and be on good terms with their parents."

Now you may think any "first born" effect would have completely disappeared in modern times. But not so, say experts who study birth order. Researchers first examined the status of firstborns among Washington power brokers in 1972.

"I expected that there would be a disproportionately high number of firstborns among members of Congress" says psychologist Richard Zweigenhaft of Guilford College. "And that's exactly what I found."

Out of 121 representatives and senators included in his sample, Zweigenhaft found that 51 were firstborns, 39 were middle children, and 31 were youngest children. It wasn't a huge overrepresentation of firstborns, but the difference, he says, is too significant to ignore.

Several surveys and studies conducted throughout the years have found that firstborns do edge out later-borns in lots of high-achieving professions, from corporate CEOs to college professors to U.S. presidents and Supreme Court justices. There's even evidence that firstborn children are about 3 IQ points smarter than their second-born siblings.

Unintended Overparenting

So what nudges oldest children to be conscientious, striving achievers? One factor is that firstborns tend to get undivided parental resources, explains Sulloway. "When the second [child] comes along, the oldest still gets half of all that [attention], so younger siblings never have a chance to catch up," he says.

It's not that mothers and fathers intend to parent differently — oftentimes it just works out that way. Partly it's the inexperience that makes some first-time parents go overboard: signing children up for every lesson and activity imaginable, for example.

Monica Hanson says this was the strategy she took with her oldest daughter. "Oh, gosh, she did everything," recalls Hanson. "I put her in tennis lessons, dance lessons, art classes, music, swimming." She says her son, who is seven years younger than her daughter, didn't do nearly as many activities.

Hanson says birth order played a role in her own childhood, as well. As the eldest of four siblings, she did get the ballet lessons and a lot of attention early on, but she also sensed that her parents had high expectations. She was expected to do well in school and to help out with her younger siblings. She also recalls that her parents held her to stricter rules, like an earlier curfew.

"I don't think they did it on purpose — but I was expected to do a lot of things, to be unselfish, to get it done," she says. Hanson says she never pushed back — she fell into the firstborn role naturally. To this day, Hanson is still seen by family and friends as the doer — the boss, the person who can hold everybody together. And she's never outgrown many of the firstborn influences.

"Let's say, for example, if I'm going to run a banquet for my daughter's school," says Hanson. "I'll do the best I can." She's known as a person who will bring 100 percent every time.

Experts say it's never entirely predictable how birth order may influence our personalities, behaviors or family dynamics — there are plenty of firstborns who don't fit the mold. "The one thing you can say about birth order is that it's not absolutely deterministic of how people's lives turn out," says Sulloway.

Experts say it's just one small piece of the puzzle. "I'm not sure I would say that birth order plays a strong role in who we become," Zweigenhaft says. "Birth order contributes to who we become." After all, we're all amalgams of many childhood influences, from teachers and peers to random life events, including turns of good luck and bad.

Hanson says one of the traits she sees in herself and all of her sisters — a love of life — can't possibly be the work of birth order. She chalks it up to the spirit and values they learned from their father. "He said you can do anything you want in this world, but whatever you do, make sure it's what you want," Hanson recalls. "Don't compare yourself to anyone."

Hanson says her father preached that same message to all of his children, from the firstborn to the baby.


Federal government subsidizes obesity and wealthy yuppies

In the Washington Examiner, David Freddoso explains how the federal Department of Health and Human Services spent $766,000 of your tax dollars to help open an International House of Pancakes in a prosperous section of Washington, D.C. That’s ironic, given that government food nannies depict IHOP’s sugary entrees as a cause of obesity (and even though IHOP serves two of Men’s Health Magazine’s 20 most unhealthy restaurant dishes). The IHOP is opening in a wealthy yuppie area where even a tiny one-bedroom apartment rents for at least $1800 per month.

While HHS is busy subsidizing IHOP, another branch of HHS, the FDA, is trying to restrict the salt content of food, which could lead to increased obesity rates, more heart attacks, and “higher death rates among some individuals,” and make it harder to market low-fat foods. Ironically, if salt levels are curbed, people will compensate by eating fattier food, since there seems to be a trade-off between salt and fat.

A recent study funded by NIH (another branch of HHS) encouraged parents to stock their fridges with apple sauce (even though apple sauce has basically no nutrition unless vitamins are artificially added to it, since the natural vitamin C in an apple is largely destroyed when it is processed into apple sauce), while disparaging potatoes, which are rich in vitamin C, potassium, and various minerals. (Disclosure: I participated in that study for $100). (Baked potatoes are healthy, although some of potatoes’ vitamin C is lost when you process them into french fries. Potatoes have much more vitamin C than bananas or apples. And they have more potassium than supposedly potassium-rich bananas).

The federal government is now banning the use of WIC money by low-income mothers to buy white potatoes, while allowing the money to be used for a host of less nutritious foods.


Friday, November 26, 2010

Passive smoking kills 600,000 a year?

This is utter rubbish: The usual epidemiological speculation combined with assuming what you have to prove.

As far as I can tell, all that these do-gooder Swedish epidemiologists did was look at areas where a lot of people smoked and then looked at illness in those places. And, Hey Presto! Places where a lot of people smoked had more illness! But saying that inhaling other peoples smoke CAUSED the illness is totally unproven. It is just assumed.

A much more likely explanation for the relationship they report comes from the fact that it is mostly the poor who smoke these days and poor people have worse health in general.

But be that as it may, what the study completely ignores is much more direct evidence on the question concerned -- such as the fact that non-smoking wives of smokers have no worse health outcomes than average

Passive smoking claims more than 600,000 lives each year around the world - an estimated one per cent of all deaths, a global study has found.

Children are the group most heavily exposed to second-hand tobacco smoke, and about 165,000 of them die as a result, said researchers.

The World Health Organisation (WHO) study is the first to assess the global impact of inhaling other people's smoke.

Based on 2004 data from 192 countries, the figures show smoking in that year killed almost six million people, either actively or passively by claiming the lives of non-smokers.

Second-hand smoke was believed to have caused 379,000 deaths from heart disease, 165,000 from respiratory infections, 36,900 from asthma and 21,400 from lung cancer. In addition 10.9 million years of disability-free life were lost globally because of passive smoking.

The findings are published on Friday in an early online edition of The Lancet medical journal.

Dr Annette Pruss-Ustun, from the WHO in Geneva, Switzerland, and her fellow authors wrote: "Exposure to second-hand smoke is still one of the most common indoor pollutants worldwide. "On the basis of the proportions of second-hand smoke exposure, as many as 40 per cent of children, 35 per cent of women and 33 per cent of men are regularly exposed to second-hand smoke indoors. "We have estimated that second-hand smoke caused 603,000 deaths.. worldwide in 2004, corresponding to one per cent of all deaths..

The figures were obtained by analysing data from disease incidence studies and smoking surveys.

More bulldust here.

The academic journal article is here, under the title "Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries"

The Food Police Take Aim

Providing nutritional information is one thing. Trying to outlaw the occasional splurge is quite another.

As people all across this nation prepare to loosen their belts and load their dinner plates high with delicious holiday fare, public-interest groups are busy trying to send us all on a collective guilt trip for unhealthy eating habits.

True, the food-police killjoys at the Center for Science in the Public Interest haven’t yet taken aim at Mom’s stuffed turkey and candied yams. But they do target restaurant meals they think should be off limits. This year’s edition of the CSPI’s annual finger-wag, Xtreme Eating 2010, cites such familiar villains as The Cheesecake Factory, P. F. Chang’s, the D.C. burger mecca (and Obama favorite) Five Guys, and other chain restaurants for offering high-calorie menu items.

Thank God for the CSPI! I mean, without this helpful list, how would Americans know that making a habit of consuming a Five Guys burger with fries and a non-diet drink might be bad for them? How would simple-minded Americans begin to understand that something called the “Chocolate Tower Truffle Cake” might be a little heavy on calories and fat? I mean, without the CSPI, people might mistake The Cheesecake Factory’s cream-and-bacon-laden Pasta Carbonara for health food. As my eleven-year-old niece would put it: Duh!

Of course, some of the information on the list is indeed jarring. Who doesn’t cringe when seeing the 2,000-plus calorie totals for some of these meals? But what the food police at the CSPI don’t seem to understand is that people don’t eat this rich food every day. For most people, treating themselves to a high-calorie restaurant meal is an occasional indulgence.

And while the CSPI implies that these restaurant meals are responsible for America’s obesity problem (and in truth, obesity rates have stayed level for ten years), a recent study released by the Cato Institute found that eating in restaurants has a negligible effect on obesity. The authors found that the calorie difference among those who eat out regularly and those who do not is “too small to account for more than a trivial fraction of the increase in [Body Mass Index] observed over the past several decades.”

If the CSPI were releasing its lists simply to help inform consumers that some restaurant food is high in calories and saturated fat, it would be providing a helpful service to the dining consumer. But the CSPI’s goals go way beyond informing the public; the CSPI wants to browbeat these restaurants into serving only healthy foods.

The CSPI has a long history of beating up on the restaurant industry. It has promoted policies requiring restaurants to provide calorie counts and other nutrition information on menus and poster boards. More recently, the CSPI heralded provisions in the health-care bill requiring chain restaurants with 20 or more locations to display the calorie count and other nutritional information for each menu item. While many restaurants already provide this information voluntarily, the health-care bill will mandate it for all.

The White House cheers these mandates and suggests, wrongly, that such displays help reduce obesity. In a recently released report to the president, the White House Task Force on Childhood Obesity included the results of one study that showed that calorie information can help people make more healthy food decisions. But that study was laughably unscientific: It was conducted in one Subway sandwich shop and had only 292 participants, the vast majority of whom were adult white males.

A much larger study conducted by researchers from New York University and Yale University, and published in the journal Health Affairs, considered 1,100 customers at four fast-food restaurants — McDonald’s, Wendy’s, Burger King, and Kentucky Fried Chicken — located in poor neighborhoods of New York City where obesity rates are high. They found that only half the customers noticed the calorie counts, which were prominently posted on the menu boards. Of those, only 28 percent said the information influenced their ordering, but nearly all of this group (nine out of ten) said they had made healthier choices as a result.

When researchers inspected their receipts, however, they found that these same customers who said they had made healthier choices actually ordered more calories than the average customer had ordered before New York City’s labeling law went into effect.
Increasingly, government is trying to find ways to control the eating habits of Americans, using tactics that range from restrictions on the use of particular ingredients — such as salt, sugar, and certain types of oil — to dictates on how food manufacturers and retailers can market their products to consumers. These efforts are unlikely to succeed, but if they do, they will represent a disturbing increase in government’s interference in our lives.

It’s a fine thing for the CSPI to try to inform the public of the health consequences of a consistently unhealthy diet. But its efforts should stop there: It’s none of the CSPI’s — or the government’s — business if someone wants 2,000 calories’ worth of cake for his birthday.

This Thanksgiving, enjoy the quintessential American freedom to choose to put extra gravy on your potatoes. Go nuts; skip the white meat and have that extra slice of pumpkin pie. Just be sure not to invite anyone who works at the CSPI to your family’s Thanksgiving feast.


Thursday, November 25, 2010

The wonders of dark chocolate again

A sample of only 10 people?? Are they kidding?

Chocolate may ease the symptoms of chronic fatigue syndrome, British researchers have suggested. Dark chocolate is rich in chemicals known to increase signals carried around the brain but this is thought to be the first time the confection has been found to help symptoms of chronic fatigue syndrome.

Researchers from the University of Hull and the Hull York Medical School tested ten patients with a severe form of the disease. They ate dark chocolate for eight weeks, followed by a break and then another variety with little cocoa but which tasted the same. They were asked to eat 15g three times a day and not make any other changes to their diet.

The results were published in Nutrition Journal. They reported significant improvement in their wellbeing.

Professor Steve Atkin who led the study says: “The significance of the results is particularly surprising because of the small number of subjects in the study. A further study is needed to see what the effects would be on a larger group of people, but this is potentially very encouraging news for those who suffer from Chronic Fatigue Syndrome.”

Chronic fatigue syndrome is characterised by extreme, persistent fatigue for six months or more with other problems with as muscle pain, headaches and poor memory.

There is debate in the medical community about whether it is a distinct condition from myalgic encephalomyelitis or ME and the terms are sometimes used interchangeably.


The wonders of aspirin again

An unsystematic meta-analysis recently published in Lancet claims that taking regular doses of aspirin slightly reduces the risk of getting bowel cancer. The effects reported are however too small to enable causative inferences and other problems with the study are mentioned below.

The findings are much more dubious than the media hysteria over them would suggest. Sadly, as usual, it is scientists getting over-excited about their own work that is driving the immoderate publicity

In The Lancet today, Peter Rothwell and colleagues1 present the 20-year follow-up of five pooled randomised trials,2-6 which assessed the effect of aspirin on colorectal cancer incidence and mortality, and focused on dose, scheduled duration of treatment, and site of tumour. The study of 14 033 patients used data from death certificates in the UK and Sweden, and from cancer registries in the UK.

During the 20-year follow-up, aspirin reduced long-term risk of colon cancer (incidence hazard ratio [HR] 0·76, 95% CI 0·60-0·96, p=0·02; mortality HR 0·65, 0·48-0·88, p=0·005) with a latent period of 7-8 years between aspirin intake and its preventive effect. Aspirin doses that were higher than 75 mg per day showed no additional benefit, but doses of 30 mg per day seemed to be less effective. The investigators previously showed a similar effect of aspirin in randomised trials and in case-control or cohort studies, but after only 10 years of use.7 In today's study, aspirin reduced cancer risk in the proximal colon by 55%, but not in the distal colon. 5-year therapy with aspirin reduced subsequent risk of proximal colon cancer by about 70%.

Rothwell and colleagues' study provides original information. First, it provides an extremely long follow-up (20 years) of patients treated with aspirin for about 5 years in randomised, double-blind, placebo-controlled trials, except for the British Doctors Aspirin Trial5 (open-control group) or the Dutch TIA Aspirin Trial6 (283 mg vs 30 mg of aspirin, both daily, with no untreated group). Aspirin reduced colorectal cancer incidence and mortality.

Data from randomised trials for this issue are scarce. The US Physicians' Health Study8 randomised 22 071 men to aspirin 325 mg or placebo every other day for 5 years; the risk of colorectal cancer was similar in both groups.

In a larger trial, aspirin 100 mg on alternate days did not prevent colorectal cancer in women.9 Second, the 27% overall decrease in long-term incidence of colorectal cancer by lower-dose aspirin was greater than the 17% reduction in adenomas noted in short-term trials, but consistent with the 28% decrease in advanced adenomas in these trials.10

Third, by contrast with several case-control and cohort studies, Rothwell and colleagues' study found a similar reduction in colorectal cancer incidence with lower (75 mg per day) and higher (300-1200 mg per day) doses of aspirin. Fourth, the preventive effect of aspirin predominated on proximal cancers, but this subgroup analysis relied on small numbers. Only one randomised preventive study, which was restricted to serrated polyps, showed similarly that the effect of aspirin predominated on proximal lesions (40-50% reduction) with no effect on distal lesions.11 If confirmed, this original finding might present a strong argument for the addition of aspirin chemoprevention to screening sigmoidoscopy.

Today's study has several limitations. First, colorectal cancer was not the primary outcome in any of the trials included. Additionally, the choice of studies seemingly relied more on practical than scientific reasons.

Second, the investigators reported specific mortality and not overall mortality, and did not assess mortality related to aspirin side-effects.

In a systematic review, aspirin reduced colorectal cancer incidence, especially when used for more than 10 years, but with a dose-related increase in gastrointestinal complications.12 Whether the digestive-tract complications of aspirin are dose-related, especially from 75 mg to 300-500 mg per day, is still controversial.

Third, these side-effects, especially digestive-tract bleeding, might have allowed earlier diagnosis of cancer in aspirin users via additional colonoscopies (the distribution of which was unknown between aspirin and control groups), although such an effect was not observed in Rothwell and colleagues' study.

Fourth, there were important proportions of withdrawals in the original studies. Such withdrawals seem unavoidable in long-term clinical trials. Fifth, patients in the trials were mostly men with cardiovascular risk (men only in two trials), thus, no conclusions can be made about women and patients with no cardiovascular risk.

The mechanisms of colon carcinogenesis might differ between cardiovascular and other patients-eg, because of increased tobacco consumption. Finally, after completion of the randomised periods of the trials, all patients were exposed to aspirin, which would have underestimated its benefits.

No randomised trial is currently exploring the effect of aspirin on colorectal cancer. In a prospective cohort study of 1279 men and women, regular aspirin use after colorectal cancer diagnosis was associated with a reduced risk of cancer-specific and overall mortality, specifically in patients whose initial tumour overexpressed COX-2.13

This interesting study could incite clinicians to turn to primary prevention of colorectal cancer by aspirin, at least in high risk-populations. Specific guidelines for aspirin chemoprevention would be the next logical step.

We declare that we have no conflicts of interest.


1 Rothwell PM, Wilson M, Elwin C-E, et al. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 201010.1016/S0140-6736(10)61543-7. published online Oct 22.

2 Meade TW, Wilkes HC, Stirling Y, Brennan PJ, Kelleher C, Browne W. Randomized controlled trial of low dose warfarin in the primary prevention of ischaemic heart disease in men at high risk: design and pilot study. Eur Heart J 1988; 9: 836-843.

3 The SALT Collaborative Group. Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet 1991; 338: 1345-1349.

4 Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54: 1044-1054.

5 Peto R, Gray R, Collins R, et al. Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313-316.

6 The Dutch TIA Trial Study Group. A comparison of two doses of aspirin (30 mg vs 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. N Engl J Med 1991; 325: 1261-1266.

7 Flossmann E, Rothwell PMfor the British Doctors Aspirin Trial and the UK-TIA Aspirin Trial. Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies. Lancet 2007; 369: 1603-1613.

8 Gann PH, Manson JE, Glyn RJ, Buring JE, Hennekens CH. Low-dose aspirin and incidence of colorectal tumor in a randomized trial. J Natl Cancer Inst 1993; 85: 1220-1224.

9 Cook NR, Lee IM, Gaziano JM, et al. Low-dose aspirin in the primary prevention of cancer: the Women's Health Study: a randomized controlled trial. JAMA 2005; 294: 47-55.

10 Cole BF, Logan RF, Halabi S, et al. Aspirin for the chemoprevention of colorectal adenomas: meta-analysis of the randomized trials. J Natl Cancer Inst 2009; 101: 256-266.

11 Wallace K, Grau MV, Ahnen D, et al. The association of lifestyle and dietary factors with the risk for serrated polyps of the colorectum. Cancer Epidemiol Biomarkers Prev 2009; 18: 2310-2317.

12 Dube C, Rostom A, Lewin G, et al. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the US Preventive Services Task Force. Ann Intern Med 2007; 146: 365-375.

13 Chan AT, Ogino S, Fuchs CS. Aspirin use and survival after diagnosis of colorectal cancer. JAMA 2009; 302: 649-658.


Wednesday, November 24, 2010


First read the article from the popular press below then read details of the research on which it is based. The research findings bear virtually no resemblance to the advice given. And the advice is dangerous. There are many ailments that can be acquired through contact with dirt -- the terrifying necrotizing fasciitis for a start

The popular article fails to mention: 1). That the research concerns mice -- and the large differences between the mouse and human brains render the generalizability of the findings to humans unknown;

2). The effect is temporary; the mice actually had to be FED the live bacterium to get the results;

3). The effect on mood, making the mice less cautious, could have its own dangers;

4). It may only be the effect on mood rather than any increase in ability that got the mice through the maze more quickly. Mice are naturally very hesitant and cautious

Sadly, the willingness of the researchers to speculate seems to be largely at fault for the dangerous advice. Two articles below:

Playing in the dirt makes kids smart

PARENTS, step away from the baby wipes and put that hand sanitiser away - eating dirt could actually make your child smarter.

Research published in the current issue of Kidsafe NSW's playgrounds newsletter shows the positive side of a soil-borne bacteria that is likely to be inhaled when children are playing outside.

Academics discovered that mice that were fed the dirt bacteria Mycobacterium vaccae navigated complex mazes twice as fast as those which were not.

The research, presented in the US earlier this year, was welcomed by Kidsafe NSW Playground Advisory Unit program manager Kate Fraser as another reason kids should be encouraged to get outside and get dirty.

"Over the past few years terms like 'cotton wool kids' and 'helicopter parents' are becoming really common," Ms Fraser said. "So we thought it was time to air the laundry on what's happening with our play spaces and make sure we are offering kids challenges. "We need to make playgrounds safe, but also offer a certain amount of risk and controlled risk. It's a real balancing act."

It is believed the bacteria increases levels of serotonin, reduces anxiety and may also stimulate growth in certain neurons in the brain.

Ms Fraser said that while playing in the dirt was great, parents should take care around potting mix, which can contain harmful bacteria. "But as long as safety directions are followed, that can be a great learning experience, too," she said.

The research will be a relief to the parents who know it's almost impossible to stop children getting dirty. Nicole Livisianos, of Zetland, said her one-year-old Sebastian loves to get messy. "We come to the park almost every afternoon and he is always into something dirty," she said. "There's no point trying to stop him."

Providing natural play environments is a topic at the Kidsafe NSW Playground Conference next week. "Many pre-schools and schools are planting sustainable garden beds and are teaching kids how plants grow," Ms Fraser said. "They learn about the environment and where their food comes from. The benefits are endless. The trend is definitely to make the most of the natural environment."


A soil bacterium fed to mice appears to make them temporarily smarter

Exposure to specific bacteria in the environment, already believed to have antidepressant qualities, could increase learning behavior, according to research presented at the 110th General Meeting of the American Society for Microbiology in San Diego.

"Mycobacterium vaccae is a natural soil bacterium which people likely ingest or breath in when they spend time in nature," says Dorothy Matthews of The Sage Colleges in Troy, New York, who conducted the research with her colleague Susan Jenks.

Previous research studies on M. vaccae showed that heat-killed bacteria injected into mice stimulated growth of some neurons in the brain that resulted in increased levels of serotonin and decreased anxiety.

"Since serotonin plays a role in learning we wondered if live M. vaccae could improve learning in mice," says Matthews. Matthews and Jenks fed live bacteria to mice and assessed their ability to navigate a maze compared to control mice that were not fed the bacteria. "We found that mice that were fed live M. vaccae navigated the maze twice as fast and with less demonstrated anxiety behaviors as control mice," says Matthews.

In a second experiment the bacteria were removed from the diet of the experimental mice and they were retested. While the mice ran the maze slower than they did when they were ingesting the bacteria, on average they were still faster than the controls.

A final test was given to the mice after three weeks' rest. While the experimental mice continued to navigate the maze faster than the controls, the results were no longer statistically significant, suggesting the effect is temporary.

"This research suggests that M. vaccae may play a role in anxiety and learning in mammals," says Matthews. "It is interesting to speculate that creating learning environments in schools that include time in the outdoors where M. vaccae is present may decrease anxiety and improve the ability to learn new tasks."



There was for a time a view that early exposure to dirt protected children from developing autoimmune diseases such as asthma and diabetes. That theory has however by now been largely discredited. For instance: Tribal Australian Aborigines normally live in very squalid and dirty conditions by Western standards yet have HIGH rates of autoimmune diseases such as asthma and diabetes. Asthma in particular seems to be highly hereditary, though the "triggers" do vary from person to person

Australia's arrogant medical regulators take another big tumble

The arrogant bitches (e.g. Rita Maclachlan and Fiona Cumming) at the TGA thought they knew it all -- and to hell with evidence and to hell with people's jobs. No word so far about any of them being penalized for their grossly improper behaviour -- even though one of them even shredded notes in an attempt to hide their deliberations. The taxpayer is just left with a $100m bill for their high-handed actions -- $50m in 2008 and another $50m now

A SETTLEMENT, believed to be more than $50 million, has been reached in the Pan Pharmaceuticals class action against the federal government. The settlement, announced yesterday, brings to a close a string of legal suits since 2003, and is belated vindication for the company's founder, Jim Selim, who died earlier this year after a stroke and battle with leukaemia.

Mr Selim had been giving evidence in the Federal Court in the months before his death. Terms of settlement are confidential.

In 2003, Pan boasted "the largest product offering of its kind in the world", with 4500 formulations of tablets, gels, liquids, creams and powders on offer, when it became the subject of a huge product recall.

In April that year the Therapeutic Goods Administration suspended Pan's manufacturing licence and recalled everything it had manufactured in the past year. Its investigation into Pan was sparked by reports the company's Travacalm product was causing hallucinations in some people. The company collapsed within months.

In 2008 Mr Selim received a $50 million settlement from the federal government.

About 165 of Pan's customers, creditors and sponsors joined a class action, led by PharmaCare, seeking their own payments from the government and the TGA, saying they were left $120 million out of pocket by the action taken by authorities. Three other companies ran their own cases alongside it.

The litigation funder, IMF, said if the settlement was approved by the court they would receive $24 million which would generate a profit after overheads but before tax of $17 million.

Litigation funders generally receive about one-third of proceeds of settlement, making the settlement in favour of the class action more than $50 million. "Any settlement is a compromise from all parties concerned," said the executive director of IMF, John Walker. "[In] this particular dispute, I think everybody involved ought to be happy with the outcome."

Pan's associates had accused the authorities of negligence and misfeasance of public office and some are claiming for a loss of share value, which lawyers for the TGA said there was no legal authority for.

Mr Walker hoped an application for approval would be before the court before year's end.


Tuesday, November 23, 2010

Cocktail of cheap drugs 'can prevent Alzheimer's' and keep the brain healthy into old age -- if you are a mouse

Journal article here. The experiments were in vitro and in vivo only. People not involved

A cheap diabetes drug taken with a red wine ‘miracle pill’ could prevent millions from suffering the agony of Alzheimer’s. Costing only pennies a day, the two-in-one cocktail could keep the brain healthy into old age, stopping dementia developing in some cases and halting it in others, British doctors believe.

With the pills already credited with a host of health-boosting qualities, including potentially extending life, the Dundee University breakthrough brings hope of a brighter future for millions.

The latest breakthrough centres on drugs called metformin and resveratrol. Metformin has been safely used for more than 50 years to control blood sugar levels in age and obesity-related diabetes. Recent research suggests it has other benefits, including the ability to extend life.

Resveratrol, the ‘miracle ingredient’ behind many of red wine’s health-boosting qualities, has also been hailed as an elixir of life, with experiments crediting it with warding off a host of ills, from old age to cancer.

The Dundee researchers showed that metformin interferes with the formation of toxic ‘tangles’ of a protein called tau that clog the brain in Alzheimer’s, leading to the destruction of memory cells, the journal Proceedings of the National Academy of Sciences reports. Resveratrol has a similar protective effect and taken together, the two could have the power to hold Alzheimer’s at bay, researchers believe. Professor Susann Schweiger said: ‘The best hope is that it would stop it.’


Gardening really is good for your health

Keeping an allotment [a small plot of land devoted to gardening] really is good for your health, the first study to examine the issue directly has found. Dutch researchers have found that allotment keepers in their 60s tend to be significantly healthier than their more sedentary neighbours.

While plenty of anecdotal evidence exists to suggest growing one's own fruit and vegetables protects against ill-health, no one had carried out such a direct comparison before.

Agnes van den Berg, from Wageningen University and Research Centre, the Netherlands, said: "Taken together, our findings provide the first direct empirical evidence for health benefits of allotment gardens. Having an allotment garden may promote an active life-style and contribute to healthy ageing."

She and her fellow researchers polled 121 gardeners in the Netherlands, plus 63 neighbours who did not keep allotments as the control group. They were asked a range of questions such as how many times they had contacted their GP in the last two months, how stressed they felt, and how they rated their health and well being.

Van der Berg concluded: "Around the world, allotment gardens are increasingly under pressure from building and infrastructure developments. "Considering that allotments may play a vital role in developing active and healthy lifestyles, governments and local authorities might do well to protect and enhance them."

However, she and her colleagues, writing in the journal Environmental Health, cautioned that those who keep allotments may simply be more active individuals.

Previous research has found that spending half an hour in an allotment leads to twice the drop in the stress hormone cortisol as does reading a book (22 per cent drop compared to 11 per cent).

Other studies have found that the health benefits of exercising in green spaces are greater than exercising in the gym.


Monday, November 22, 2010

Moles are good for you

THE secret of supermodel Cindy Crawford's ageless allure may be out as British scientists have discovered that people with lots of moles are genetically protected from many of the ravages of time. New research suggests they may not only develop fewer wrinkles in old age, but also have stronger bones and tauter muscles.

Moles or beauty spots - for which Crawford is famous - are formed by rapidly dividing cells that start producing dots of dark pigment on children as young as four, but which usually vanish from about the age of 40. In some people, however, they continue to spread as they grow older, producing a smooth and wrinkle-free complexion that can make a woman look at least seven years younger than her real age.

A study of 1200 identical and non-identical female twins, aged 18-79, showed that those with more than 100 moles on their bodies also have tougher bones and are therefore 50 percent less likely to develop osteoporosis than women with fewer than 25 moles.

The findings by a team at King’s College London, were presented at a meeting of the Royal Society of Medicine last week. Researchers are now examining whether people with many moles are also protected against other symptoms of aging, including failing eyesight, and even heart disease.

The new evidence contrasts with previous warnings about moles being linked to an increased risk of skin cancer.

People with lots of moles have been found to carry white blood cells with extra long "telomeres" - the spare ends of chromosomes in each cell that carry the genetic material allowing it to replicate. The more spare DNA, the greater the potential number of replications before the cell dies.

While the average person has 30-40 tiny moles dotted over their bodies, some have as many as 400. Those with at least 100 moles make up 10-15 per cent of the white population.


Glass of red wine a day 'treats diabetes by helping body regulate blood sugar levels'

This is a highly speculative conclusion based on observations in laboratory glassware only

A small glass of red wine every day could keep adult diabetes under control, scientists claimed last night. A new study found that the drink contains high concentrations of chemicals that help the body regulate levels of sugar in the blood. Just a small glass of red contained as many of these active ingredients as a daily dose of an anti-diabetic drug, the researchers found.

Although the study didn't look at the effects of wine on people, its authors believe moderate drinking as part of a calorie controlled diet could protect against type 2 diabetes. However, their conclusions angered Diabetes UK who accused the researchers of making 'astonishingly bold suggestions' based on 'limited research'. The charity warned that wine was so high in calories it could lead to weight gain - outweighing any benefit.

Around 2.6million people suffer from type 2 diabetes in Britain. The disease occurs when the pancreas is unable to produce enough insulin - the hormone that regulates blood sugar - or when its insulin does not work properly. High levels of sugar in the blood can cause tiredness, heart disease, strokes, blindness, nerve damage and kidney disease.

Past studies have shown that natural chemicals found grape skin and wine called polyphenols can help the body control glucose levels, and prevent potentially dangerous spikes or dips in blood sugar. The new study compared the polyphenol content of 12 different wine varieties. The team, from the University of Natural Resources and Applied Life Sciences, Vienna, found that levels were higher in red wines.

The scientists then studied how these polyphenols interact with cells in the human body, focussing on a particular 'receptor - or molecule that sits on the surface of cells - called PPAR-gamma - involved in the development of fat cells, energy storage and the regulation of blood sugar.

The authors showed that polyphenols in wine bind to the receptor and that a small glass of wine contains enough to rival the activity of the potent diabetes drug Avandia.

The researchers who report the findings in the Royal Society of Chemistry journal Food and Function believe moderate red wine consumption could have benefits for diabetics. 'You could derive a natural extract from grape skins for the treatment of diabetes,' Professor Alois Jungbauer said. 'Also, this is further scientific evidence that a small amount of wine really is beneficial for health.'

Previous research involving thousands of people has shown that moderate drinking of alcohol can reduce the risk of diabetes type 2, he said. 'Moderate is the equivalent of a small glass each day for women, and two for men,' he added. 'Our big problem is to convey the message of a healthy lifestyle because too much wine will cause diabetes and obesity. 'If you have wine then you must reduce your intake of calories from food by the same amount.'

But Dr Iain Frame, director of research at Diabetes UK was critical of Prof Jungbauer's conclusions. 'It is very difficult to see how this limited research will have any benefit to people with Type 2 diabetes. It is a basic study into the chemistry of red wine and has no clinical relevance at this stage,' he said.

'The researchers have made an astonishingly bold suggestion based on the results of their research suggesting that a very small glass of red wine may be beneficial to people with Type 2 diabetes. This assumption is fundamentally wrong based on the evidence presented from this research.

'Previous studies have demonstrated potential health benefits from chemicals isolated from red wine. However the alcohol in wine is high in calories and can lead to weight gain, which can outweigh the benefits of these chemicals.'


Sunday, November 21, 2010

Backlash against genetic explanation for longevity

The criticisms seem to be of the nitpicking variety -- and likely to be insubstantial in view of the fact that the authors in the original study took care to cross-validate their conclusions. They showed that the set of characteristics that they found in their first group had predictive power on a totally different second body of people.

I think that the criticisms are principally motivated by the usual Leftist hatred of genetic explanations generally. They would like you to think that avoiding so-called "junk" foods was the path to longevity -- despite there being no double-blind evidence of that

I can't resist pointing out again that we Australians have exceptionally long life spans -- with lots of nonagenarians tottering around the place who grew up on a traditional diet of fried steak and onions -- fried in dripping (animal fat) and with plenty of salt for flavouring. I think that falsifies food-freak assertions pretty convincingly. It certainly was not a low fat or low salt diet that got so many of our oldies into their 90s. Most families I know here in Australia have or have had a nonagenarian somewhere among their relatives -- my own family included, even a centenarian in my case

Researchers had claimed by studying genomes it was possible to predict a person’s lifespan with an accuracy of 77 per cent. They said people carrying certain longevity genes would be likely to live beyond 100, regardless of their lifestyle.

The study opened up the possibility of screening people for life threatening diseases who were deemed to be at risk of early death.

Scientists at Boston University found the “genetic signatures of exceptional longevity” by studying more than 1,000 people who had lived beyond 100.

But now other scientists have expressed technical doubts about the way the researchers arrived at their main conclusions. Researchers involved in similar studies where entire genomes are scanned by sophisticated “gene chips” said one of the chips could produce “skewed data” under certain conditions.

The Journal Science, which published the study earlier this year, has issued an unprecedented “editorial expression of concern”.

It is unlikely that the study will be retracted but some of the results may be revised following fresh analysis of the data.

When the initial study was published, one of the authors, Doctor Thomas Perls, said: "These genetic signatures are a new advance towards personalised genomics and predictive medicine, where this analytic method may prove to be generally useful in prevention and screening of numerous diseases, as well as the tailored uses of medications."

His co-author Professor Paola Sebastiani said the preliminary data suggest that exceptional longevity may be the result of a "defensive genes" that counter the effect of disease-associated damage to the body and contribute to the compression of morbidity and disability towards the end of these very long lives.

But Prof Sebastiani added: "This prediction is not perfect, however, and although it may improve with better knowledge of the variations in the human genome, its limitations confirm that environmental factors – for example, lifestyle – also contribute in important ways to the ability of humans to survive to very old ages."


Night lights 'could cause depression'

If you are a Siberian hamster. Primitive people must have been depressed a lot -- with that pesky moon shining down on them such a lot. Anybody want to guess that human beings are fully adapted to that?

Sleeping in anything other than a completely dark room could lead to depression, research suggests. Neuroscientists believe that even having a dim light on - such as a night light often used in a child's room - adversely affects the chemical balance and structure of the brain. Such a light appears to interfere with secretion of the hormone melatonin, which helps let the body know it is night time.

A team at Ohio State University in the US came to their conclusions after comparing two sets of Siberian hamsters, one group which was exposed to a dim light at night, the other which enjoyed complete darkness.

Tracy Bedrosian, a doctoral student who co-authored the study, said: "Even dim light at night is sufficient to provoke depressive-like behaviours in hamsters, which may be explained by the changes we saw in their brains after eight weeks of exposure." For example, she said they drank less sugar water.

When they examined the hamsters' brains they found those exposed to dim night light had less dense networks of dendritic spines in a part of the brain called the hippocampus. Dendritic spines are the hairlike growths on brain cells that transmit chemical messages from one cell to another.

Bedrosian, who presented the research on Wednesday at the annual meeting of the American Society for Neuroscience in San Diego, added: "The hippocampus plays a key role in depressive disorders, so finding changes there is significant."

Earlier studies in mice have found that those exposed to bright light at night tend to become depressed and put on weight.


Saturday, November 20, 2010

Natural Isn't Always Better

John Stossel

It's not what we don't know that causes us trouble. It's what we know that isn't so. Whichever famous writer said that (it's been attributed to many), what he said carries truth.

What are some of the things we know that aren't so? Here's one: Grass-fed "free-range" beef cattle are better for the environment -- and for you -- than factory-farmed corn-fed cattle. It does seem to make sense that the steer raised in the more "natural" environment would be better for the world.

Michael Pollan, the prolific food author and activist, wrote in The New York Times that "what was once a solar-powered ruminant (grass-fed steer) (has been turned) into the very last thing we need: another fossil-fuel machine" (http://tinyurl.com/2fnr6xx). How so? Farmers burn fossil fuels to ship corn to feed cows instead of letting them eat what's naturally under their feet.

Restaurants serving burgers supposedly made from grass-fed beef self-servingly claim their foods are healthier for the planet. The American Grassfed Association -- surprise, surprise -- says its cattle are better for the environment because harmony is created between the land and the animals.

People believe. Nobody likes the idea of cattle jammed into feedlots. When we asked people, in preparing this week's Fox Business show, which kind of cattle were better, we got the expected answers:

"Free roaming."

"Cows should be outside."

"Free-roaming grass-fed cows, because you've got happy cows. They've lived a happy life out in sunshine."

It's logical to think that grass-fed steers might be better for the environment, but so often what sounds logical is just wrong.

Don't believe me? Dr. Jude Capper, an assistant professor of dairy sciences at Washington State University, has studied the data (http://tinyurl.com/36492d8). Capper said: "There's a perception out there that grass-fed animals are frolicking in the sunshine, kicking their heels up full of joy and pleasure. What we actually found was from the land-use basis, from the energy, from water and, particularly, based on the carbon footprints, grass-fed is far worse than corn-fed."

How can that be? "Simply because they have a far lower efficiency, far lower productivity. The animals take 23 months to grow. (Corn-fed cattle need only 15.) That's eight extra months of feed, of water, land use, obviously, and also an awful lot of waste. If we have a grass-fed animal, compared to a corn-fed animal, that's like adding almost one car to the road for every single animal. That's a huge increase in carbon footprints."

Once again, modern technology saves money and is better for the earth. By stuffing the feedlot animals with corn, farmers get them to grow faster. Therefore they can slaughter them sooner, which is better for the earth than letting them live longer and do all the environmentally damaging things natural cows do while they are alive. "Absolutely right," Capper said. "Every single day, they need feed, they need water, and they give off methane nitrous oxide -- very potent greenhouse gases that do damage."

But what about damage to people? Some advocates of grass-fed beef claim that the more naturally raised animals are healthier to eat. "There is absolutely no scientific evidence based on that. Absolutely none," she replied. "There is some very slight difference in fatty acids, for example, but they are so minor that they don't make any significant human health impact."

But what about those hormones the cows are given? Surely that cannot be good for us. "What we have to remember is every food we eat -- whether it's tofu, whether it's beef, whether it's apples -- they all contain hormones. There's nothing, apart from salts, that doesn't have some kind of hormone in them."

So the next time you reach for that package of beef in the grocery store tagged with all the latest grass-fed, free-range lingo, remember: Not only does it often cost twice as much, but there's no evidence it's better for the environment or better for you. It's just another food myth.


Food Fight Breaks Out in Senate

It’s worse than your kids at the dinner table: the battle over food safety has gotten worse after the Senate voted to move forward on the bill Wednesday.

With a 74-25 vote on the motion to begin debate, passage has all but cleared for the bill, which would impose significant regulations on big and small businesses in the food production industry. A complicated reconciliation process would have to take place in order for the bill to be sent to the President’s desk, but those will be addressed by the end of the week.

One of the major hurdles – even if the bill is passed – includes the Tester Amendment, which would exempt small farms from some of the regulations. This amendment has been touted as a way to save small, local producers from going out of business as soon as the bill is passed.

Townhall.com spoke to several players in the debate over this Amendment and the bill at large, which is numbered S. 510. Answers are from Patty Lovera, the assistant director for Food & Water Watch, Mark Dopp, senior vice president at the American Meat Institute, and Ferd Hoefner, the policy director for the National Sustainable Agriculture Coalition. Their answers provide a general picture of the debate going on in the Senate right now.

Q: There are clearly safety issues with food products that need to be addressed. However, if certain regulation adversely affects a large segment of an industry – especially a segment with an excellent track record of food safety, as with small / organic farms – how is that regulation defensible?

Lovera, Food & Water Watch: The process for developing this legislation has taken a long time and has included a lot of discussion about how to address the real problems we have in food safety and in how FDA does its job, without wiping out small farms and small businesses. We don't want to make life harder for small operations, but we've been trying for a long time to get FDA's food safety program to be directed towards preventing problems, rather than just responding to them. So we think the Tester amendment (and several other provisions of the bill that establish some flexibility and training assistance for small operations) is an appropriate way to handle this tension.

Dopp, American Meat Institute: Regarding your question, it’s not defensible. If a large segment of an industry is meeting existing standards and in doing so is producing a safe product, the solution is not to provide the government with another regulation. The solution is for the problem company (i.e.) to abide by the necessary good practices and rules so that they too comply and produce safe product. An important element of that solution also is for the government to be more focused, targeted, and effective in its enforcement of regulations that work -- as evidenced by the assertion that a large segment of the industry has an excellent track record of food safety. By analogy, if 95% of the population is paying its taxes on time and properly, does the government need a new rule that will hurt that 95% in order to allow the government to find and collect from the delinquent 5% of taxpayers?

Hoefner, National Sustainable Agriculture Coalition: Perhaps the biggest underlying issue in the S. 510 debate is how, with what will likely be fairly static resources for the foreseeable future, will FDA move to ensure improved food safety outcomes. S. 510 does not provide any additional resources to FDA, nor is it likely that the next several appropriations bills will help much either. Therefore, getting better outcomes will require focusing on the areas of biggest known risk, while staying attuned to possible future changes in relative risk. It is clear from recent outbreaks the big risk related to the farm level is from large scale national and global distribution of primarily co-mingled product, especially those with using processing and packaging techniques that increase risk. This is where the focus needs to be.

Q: Please address the concern that the big players in the food industry are simply manipulating legislation in order to gain an economic advantage (this doesn’t preclude the fact that these big players might also advance legislation for the public good).

Lovera, F&WW: My response is that the issues of how regulations impact different types of farmers and food businesses is important and we can't pass good legislation without dealing with that. That's why we have supported the Tester amendment – it recognizes that there are a lot of small players in the food system and that we need to focus FDA's efforts on the largest players who are producing more food and putting more people at risk. There are lessons to be learned from the meat industry, when new food safety programs implemented by the USDA in the 1990s proved to be very hard to implement for small plants.

Dopp, AMI: Without specifics regarding a particular provision and the alleged “manipulation” that question is a bit difficult to answer. That said, a couple points. First, do the critics…think shouldn’t have the right to participate in the legislative process? There is nothing wrong with, and in fact it is incumbent upon affected entities, companies and people, to participate in the legislative process and to let Congress know how proposed legislation will affect those entities and the public at large. Second, when it comes to food safety, there cannot and should not be different standards for companies or facilities of different sizes. Safe is safe. Listeria monocytogenes on a product processed in a facility or operation with 1 employee is just as deadly as a produced coming from a company with 1000 employees.

AMI has been consistent in that regard. For example, AMI petitioned for mandatory HACCP for all meat and poultry companies in the early 90’s and all such plants now operate under HACCP, regardless of size. The benefits of that program speak for themselves through the reduced incidence of pathogens in meat and poultry products. Allowing smaller entities, arguably with fewer resources, additional time to meet the standard may make sense but it doesn’t preclude the need to meet the standard. Similarly, the 2008 Farm Bill included language that allows state inspected meat and poultry establishments, most of which are small, to ship products in interstate commerce. But those plants may only do so if they satisfy the same food safety requirements that federally inspected establishments must meet. Thus, executive branch and the legislative branch have both concluded that there should not be different food safety standards based on size. Moreover, experience has taught us that food recalls and food borne illness outbreaks adversely affect the entire industry -- large and small companies alike.

Hoefner, NSAC: There is clearly an anti-competitive thrust to calls by mega farms and agribusiness for one-size-fits-all regulation. Layering on high financial and human resource cost regulations designed for large firms and applying them to small family farms can be an effective way to drive people from business and further consolidate production into fewer hands. If we want improved food safety outcomes, not only do we need to focus limited federal resources on where the biggest problems are, but we also need appropriate mechanisms for different sectors of farming. The numerous provisions included in the Manager's amendment to S. 510 as well as the Tester-Hagan amendment move the bill away from one-size-fits-all. These are very positive steps forward, helped to ensure improved food safety without increasing anti-competitive pressure.

Q: If this legislation is passed, what will be your next legislative priority?

Lovera: If the legislation passes, there will be a lot of work to do to get the FDA to define and implement the provisions spelled out in the legislation and that will be a critically important process. As for Congress, FDA's funding is a major issue that will determine whether the agency is able to do the activities it needs to do to implement the law. Beyond the FDA, we are always focused on making sure that USDA has adequate funding and resources for meat and poultry inspection.

Dopp, AMI: There are a number of important legislative issues out there, involving immigration, ethanol, etc. If the question is specific to food safety that will depend on what is introduced and its impact on the industry.

Hoefner: The most important legislative next step, should this bill pass both houses and become law, is to fund the farmer and small processor training program championed by Senator Debbie Stabenow (D-MI) and incorporated into the pending Manager's amendment to the bill. This will be an important issue in the next agricultural appropriations bill and perhaps in the 2012 Farm Bill as well.


Friday, November 19, 2010

Video gaming BOOSTS your ability to concentrate in a crisis

Action packed video games are often criticised for being distracting and encouraging violent behaviour. However, a review published today has found that people who play 'shoot 'em ups' such as Halo and Call of Duty have far better visual attention than their non-gaming peers.

This mental skill allows people to focus on relevant visual information while suppressing irrelevant data. It helps us to pick out a friend's face from a crowd or drive a car along a busy street without getting sensory overload.

The review, led by Dr Daphne Bavelier from the University of Rochester looked at how gaming can affect our ability to cope with the almost overwhelming amount of visual data that we must process every day. The study, published in WIREs Cognitive Science, found gamers consistently outstripped non-gamers in visual attention tests.

The authors referred to a number of training studies that found non-gamers could improve their visual attention by playing video games, establishing that the games themselves were causing the benefits. However, only fast-paced, action based games provided this benefit. These games emphasised rapid responses to visual information and required divided attention.

Study co-author Bjorn Hubert-Wallander, said: 'Just as drivers have to focus on the road, other cars, and potential obstacles while ignoring other information, modern action games place heavy attentional demands on players. 'These games require players to aim and shoot accurately in the center of the screen while continuously tracking other enemies and fast moving objects.'

The findings could have implications for military training as well as clinical rehabilitation programs for conditions such as amblyopia or 'lazy eye.'

Co-author Shawn Green said: 'At the core of these action video game-induced improvements appears to be a remarkable enhancement in the ability to flexibly and precisely control attention, a finding that could have a variety of real-world applications.

'For example, those in professions that demand "super-normal" visual attention, such as fighter pilots, would benefit enormously from enhanced visual attention, as their performance and lives depend on their ability to react quickly and accurately to primarily visual information.'


'Spare tyre' could save lives: Study finds belly fat helped heart attack patients

This is a tiny study reporting tiny improvements in heart function so the results will most likely wash out in a larger trial

Stem cells taken from waistline fat could be used as a treatment for heart attacks. Scientists injected stem cells derived from waistline fat tissue into the hearts of coronary patients and found the cells reduced levels of damage, increased blood flow and improved the organs' pumping ability.

Eleven men and three women who had suffered recent heart attacks took part in the pioneering pilot study, given the name Apollo. Ten patients were treated with stem cells while four received a dummy 'placebo' infusion.

Liposuction - a cosmetic procedure commonly used to reduce people's waistlines - was used to remove up to 250 cubic centimetres of fat from the patients' bellies. From each sample, the researchers isolated and extracted 20 million adult stem cells - regenerative cells with the potential to become more than one kind of tissue.

It took nine to ten minutes to infuse the stem cells into a patient's heart.

Six months later members of the treated group showed a 3.5 per cent improvement in heart perfusion, the heart's ability to receive oxygenated blood. Compared with the placebo patients, they also experienced a 5.7 per cent increase in the amount of blood pumped out by the heart's left ventricle chamber.

On average, the amount of damaged heart muscle in the treated patients was halved from 31.6 per cent to 15.4 per cent. In the non-treated group, levels of heart damage remained the same.

The stem cells did not interfere with blood flow and were not associated with any potentially dangerous changes in heart rhythm, the study found.

Lead researcher Dr Eric Duckers, from Erasmus University Medical Centre in Rotterdam, the Netherlands, said: 'The study suggests that these cells can be safely obtained and infused inside the hearts of patients following an acute heart attack.'

The findings were presented today at the American Heart Association's Scientific Sessions meeting in Chicago.

Dr Duckers has now started work on a bigger follow-up trial, called Advance, that will recruit up to 375 patients from 35 European centres. It will focus on heart attack patients with a left ventricle ejection fraction - a measure of the heart's pumping performance - of less than 45 per cent .

Forty per cent of patients will receive 20 million stem cells while another 40 per cent will get a larger dose of 30 million cells. The remaining 20 per cent will make up the placebo group.

The condition of the patients' hearts will be checked after six months.