HEALTH and MEDICINE

BREAKTHROUGH IN EXPERIMENTAL HIV VACCINE

[Agence France-Presse, September 24, 2009]

An experimental HIV vaccine has for the first time cut the risk of infection, researchers said today, hailing it as a medical "breakthrough" in the quarter-century battle against the disease. The vaccine reduced the risk of being infected by almost a third, they said after the world's largest vaccine trial of more than 16,000 volunteers carried out by the US Army and the Thailand Ministry of Public Health.

"It is the first demonstration that a vaccine against HIV can protect against infection," Colonel Jerome Kim of the US military HIV research program said. "This is a very important scientific advance and gives us hope that a globally effective vaccine may be possible in the future," he said.

The vaccine was effectively a combination of two older vaccines that had not reduced infection on their own. It was tested on volunteers at average risk of HIV infection in two Thai provinces near Bangkok starting in October 2003. The two older vaccines combined for the trial were ALVAC manufactured by Sanofi-Aventis and AIDSVAX made by VaxGen Inc. "The outcome represents a breakthrough in HIV vaccine development because for the first time ever there is evidence that HIV vaccine has preventative efficacy," said a statement released by the researchers. "The vaccine has a 31.2 per cent efficacy in reducing the risk of HIV infection."

Thai Public Health Minister Witthaya Kaewparadai said the "outcome of this study is a scientific breakthrough."

AIDS first came to public notice in 1981 and has since killed at least 25 million people, and 33 million others are living with AIDS or the HIV virus. Swift progress in identifying the virus that caused it unleashed early optimism that a vaccine would quickly emerge. HIV destroys immune cells and exposes the body to opportunistic disease. Out of the 50 candidates that have been evaluated among humans, only two vaccines have made it through all three phases of trials, and both were flops. About 30 vaccines remain in the pipeline.

US ambassador to Thailand Eric John said the vaccine trial had "incredible conclusions and brought us one step closer to an HIV vaccine." He said more research was needed but the results had "important implications" for a future vaccine.

Earlier this month in a study published in the journal Science, US researchers said they had discovered two powerful new antibodies which could hold the key to achieving a viable AIDS vaccine. The antibodies are produced naturally by a minority of people infected with HIV and are able to neutralise a high percentage of the many types of the virus in circulation worldwide.

MISCARRIAGE CAN NOW BE PREDICTED SIX WEEKS INTO PREGNANCY

[Herald Sun, September 24, 2009]

Pregnant women can be told as early as six weeks into a pregnancy whether they are likely to suffer a miscarriage, through new predictive tests developed in Australia. The tests are 80 per cent accurate and based on information such as bleeding, previous caesareans, miscarriages and the first ultrasound scan. Researchers from Sydney's Omni Gynaecological Care Centre and Sydney University are developing the test, using a mathematical process.

Melbourne's Royal Women's Hospital already offers a similar test in its Early Pregnancy Assessment Service (EPAS), but it is offered only to women with known risk factors. Dr Ricardo Palma Dias, head of the RWH's fetal management unit, said offering a test to the general public could have benefits for some women, but it would be a cost-driven decision as to whether it went ahead.

"It is a highly accurate prediction," he said. "It is a cost-effectiveness issue and they would screen and spend a lot of money on normal people, because we shouldn't forget most pregnancies will be normal," Dr Palma Dias said.

Associate Professor George Condous, director of Omni Gynecological Care Centre, said the top question pregnant women always asked him was their chances of miscarriage. "At the moment I can't tell them," he said.

In the first stage of trials, he used the information gathered on more than 400 women visiting the early pregnancy unit at Nepean Hospital. "If a woman was deemed to be a risk of a miscarriage, we could then see them more regularly for scanning and monitor their progress, rather than leave it six weeks for another scan," he said.

The second stage of clinical trials is about to begin at the Nepean, where he will compare data on another 400. By the new year, Dr Condous hopes he can use the test on women who present themselves for an ultrasound for the first time. One in four pregnancies results in a miscarriage.

HIGH COST OF OBESITY IN AUSTRALIA

[AAP, May 12, 2008]

Australia’s obesity "timebomb" has already gone off, with more than half the population overweight, a health expert says. "There is no obesity timebomb. The bomb has already gone off," Associate Professor Katherine Samaras told a federal parliamentary health committee inquiry today. An obesity expert from St Vincent's Hospital in Sydney, Prof Samaras said 60 per cent of Australians were overweight or obese. Obesity was the "underlying cause" of many individual health complaints treated by public hospitals, including "a majority of non-genetic breast cancers," heart conditions, diabetes and birth complications.

But hospitals treated patients for the symptom, not the underlying cause, so the cost of obesity was largely hidden. Prof Samaras said 75 per cent of hip replacement patients at the hospital were obese or overweight, as were 80 per cent of her diabetes patients - including a 30-year-old who weighed 197kg. "He costs $12,000 a year in insulin alone," she said.

Other examples of hidden costs included obese or overweight women spending five days longer in hospital on average after giving birth, higher caesarian rates amongst overweight women, and longer hospitalisation for overweight cardiac patients. Royal North Shore Hospital senior dietician Vanessa Brenninger said hospitals needed more money to treat obese patients. "Obesity is putting a big strain on the system," she said.

Her hospital spent $57,000 in February this year in intensive care costs for just one obese patient -- a 54-year-old weighing 254kg. "He was unable to sit, stand or walk, and needed oxygen," Ms Brenninger said. "He needed eight hospital staff to move him."

Prof Samaras said obesity was not restricted to particular socio-economic or ethnic groups, with judges and chief executive officers among her patients. "Not everyone can become obese," she said. "Some are genetically susceptible. It's very predictable. We don't need specialised genetic tests. We only need to look at the parents and grandparents."

With obesity rates in Australia already high and growing, the parliamentary inquiry will investigate what the long-term health ramifications are of Australians' growing waistlines.

BRAZILIAN WANDERING SPIDER GIVES "HARD" BITE

Spider-Man may want to check out the erection-stimulating venom of one of his Latin cousins in his next adventure: The poisonous bite of the Brazilian wandering spider gives men an erection that lasts for hours! Doctors in Brazil's emergency rooms easily diagnose male victims of Phoneutria nigriventer by their high levels of pain, their increase in blood pressure, and their uncomfortable erections. Now, Brazilian scientists at Medical College Georgia say they have isolated the chemical that causes the erections.

"The erection is a side effect that everybody who gets stung by this spider will experience along with the pain and discomfort," said Romulo Leite, a member of the Medical College Georgia study team. "We're hoping eventually this will end up in the development of real drugs for the treatment of erectile dysfunction."

The chemical, named Tx2-6, is a compound made up of a relatively short string of amino acids. Tests on rats showed it caused a significant increase in penis pressure. The chemical triggers the production of nitric oxide, which sends a message telling the body to begin making an erection.

It works in a different manner from Viagra, influencing an earlier stage in the erection process. Studies show that about one in three men with erectile dysfunction don't respond well to Viagra, and have low success rates with either Levitra or Cialis. The study team believes a synthetic version of the venom combined with a drug such as Viagra could result in an amplified effect. Leite said, "The combination of the two drugs could be even more efficient in patients that don't respond well to Viagra."

Recent research by Johns Hopkins University found that in the United States approximately 18 million men suffer from erectile dysfunction.

PARACETAMOL -- MOST COMMON CAUSE OF LIVER FAILURE IN AUSTRALIA

[The Sunday Telegraph, April 8, 2007]

Paracetamol, the drug commonly found in headache tablets, has surpassed hepatitis and alcohol to become the most common cause of liver failure in Australia.

Doctors are being urged to exercise caution when prescribing paracetamol following cases of patients suffering accidental poisoning after taking only the recommended dose of the pain killer, often sold under the brand Panadol.

A report published in The Medical Journal of Australia found people who didn't eat enough, drank a lot of alcohol or took certain medications were vulnerable to toxic effects from paracetamol. Elderly people with kidney or heart and lung problems may also be at increased risk.

"Accidental paracetamol poisoning should be suspected in any patient with acute liver failure," the report said. "Clinicians should be cautious about prescribing regular doses of paracetamol for pain control in malnourished or fasting patients, and need to counsel patients who are regular users of the drug."

Healthy people are usually able to metabolise paracetamol, most of which is excreted from the body in urine. But the drug can accumulate in people with risk factors, rendering even a normal dose toxic.

The Accidental Paracetamol Poisoning report, compiled by experts from Austin Health in Victoria, describes the case of a 45-year-old Australian woman who died from liver failure. She was taking paracetamol for abdominal pain after having a hysterectomy and suffering complications. Her eating had been poor because of pain, vomiting and treatment.

"The patient ... was noted to be displaying odd behaviour," the record states. "The following morning she became increasingly confused and drowsy. She was admitted to the intensive-care unit, where her conscious state deteriorated rapidly and she required intubation."

The woman was transferred to a liver transplant unit but died before a donor organ became available. A post-mortem examination found a toxic level of paracetamol in her body.

Hepatitis and alcoholism are other major causes of acute liver failure. Parents are warned not to give children pain killers unless they have high fever or severe pain. Dr David Thomas, pediatric spokesman for the Australian Medical Association, said: "Paracetamol and ibuprofen are drugs -- they aren't without risks or side-effects.”

JUNK FOOD ADS DURING KIDS' TV HOURS

[AAP, April 19, 2007]

Two thirds of food ads during popular children's television programs promote junk food, and a new study says they could be making children fat.

The University of Sydney researchers say their findings are further evidence that laws governing acceptable viewing for children should be tightened to reduce their exposure to junk food marketing. The study measured the number of advertisements for high-fat and high-sugar foods during programs popular with children aged five to 12 and teenagers aged 13 to 17, and compared it to adult viewing hours.

The team found the number of junk food commercials was much higher during times when children were watching. Junk food ads made up 66.8 per cent of food ads when teenagers were watching and 65.9 when children were watching, compared with just 39 per cent during adult viewing hours, the team found. Overall, about a quarter of commercial television advertisements were for food.

Children were exposed to an average nine junk food ads an hour, which at a "very conservative" estimate based on one hour's viewing a day amounted to 63 a week. But research dietician Bridget Kelly said Australian children were estimated to watch an average 2.1 hours of television a week, so the actual exposure could be a lot higher.

"Considering past research about the relationship between advertising exposure and patterns of food consumption, it is likely that the levels of advertising of high-fat/high-sugar foods, and the targeting of these during high-ratings periods, are contributing to excess energy consumption and overweight and obesity among Australian children," the report found.

The research team made the findings after monitoring Sydney's three commercial channels from 6am until 11pm for a week in May last year. Ms Kelly, from the Australian Centre for Health Promotion, said children were found to be watching up to 10pm and during traditional "adult" viewing hours, including Big Brother, The Simpsons and Neighbours. Children's television standards do not apply after 8.30pm.

"The current regulations aren't covering the times when children are actually watching television," Ms Kelly said.

Federal Health Minister Tony Abbott has so far resisted calls to ban junk food ads, but the Government has announced a review of the children's television standards. The researchers want junk food commercials limited to 14 per cent of food ads, in line with the maximum recommended intake of junk food compared to total food energy intake each day.

BIGGER BOOBS THE "NATURAL" WAY

[The Australian, AAP, The Times, February 12, 2007]

Women may be able to undergo a "natural" form of breast enlargement using their own stem cells and fat. The technique, pioneered in Japan, results in breasts that look and feel smoother than conventional cosmetic surgery using implants.

Stem cells, which have the potential to change into any cells in the body, are found in embryos, but the most plentiful supply in adults is from body fat. When body fat is transferred to the breasts, the stem cells enable the fat to grow its own blood supply, thus becoming an integral part of the breast rather than a foreign object.

Dozens of women in Japan have received the enlargements during trials. This month, German authorities gave approval to the process. Under EU rules, this means that the procedure is now legal throughout Europe, including Britain. But Australian women may have to wait for the procedure to become widely available because of litigation concerns.

Michael Zacharia, president of the Australasian College of Cosmetic Surgery, said the technique could make the detection of subsequent breast cancer more difficult. While the procedure "gives a very nice natural result", he said it could be hard to determine whether changes occurring in a breast were as a result of cancer or the fat transfer.

"Medical insurance companies just refuse to cover it," he said.

In a separate development, scientists have unearthed a genetic mutation that gives one in four women a small shield against breast cancer. This is the first concrete discovery of a common gene linked to the disease, and is the biggest breast cancer find since two rare and high-risk genes were identified a decade ago. Australian researchers contributed to the international study which found a genetic variation that gives some women a 10 per cent reduced risk of breast cancer.

Everyone has the gene, called Caspase 8, but 25 per cent of women of European descent have a mutated variation which gives them a little protection. And 2 per cent have two variations, giving them twice the defence. Leader of the Australian research arm, Georgia Chenevix-Trench from the Queensland Institute of Medical Research, said confirmation of a low-risk gene for breast cancer was significant.

It has no immediate implications for women already diagnosed with breast cancer, but Dr Chenevix-Trench said researchers expected to unearth similar genes which women could eventually be screened for. "After that we can start to think about testing protocols to see whether it's worth identifying women who have multiple variants," Dr Chenevix-Trench said.

The results are published in the journal Nature Genetics.