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Thursday, 3 July 2014

Decline in trials for Alzheimer's disease

Decline in trials for Alzheimer's disease

Dementia

More than 99% of drug trials for Alzheimer's disease during the past decade have failed, according to a study.
There is an urgent need to increase the number of potential therapies being investigated, say US scientists.
Only one new medicine has been approved since 2004, they report in the journal Alzheimer's Research & Therapy.
The drug failure rate is troubling and higher than for other diseases such as cancer, says Alzheimer's Research UK.
Dr Jeffrey Cummings, of the Cleveland Clinic Lou Ruvo Center for Brain Health, in Las Vegas, and colleagues, examined a public website that records clinical trials.

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The authors of the study highlight a worrying decline in the number of clinical trials for Alzheimer's treatments in more recent years”
Dr Simon Ridley Alzheimer's Research UK
Between 2002 and 2012, they found 99.6% of trials of drugs aimed at preventing, curing or improving the symptoms of Alzheimer's had failed or been discontinued.
This compares with a failure rate of 81% for cancer drugs.
The failure rate was "especially troubling" given the rising numbers of people with dementia, said Dr Simon Ridley, of Alzheimer's Research UK.
"The authors of the study highlight a worrying decline in the number of clinical trials for Alzheimer's treatments in more recent years," he said.
"There is a danger that the high failure rates of trials in the past will discourage pharmaceutical companies from investing in dementia research. 
"The only way we will successfully defeat dementia is to continue with high quality, innovative research, improve links with industry and increase investment in clinical trials."
Experimental models
Dr Eric Hill, of the School of Life and Health Sciences at Aston University, said more research was needed to understand the complex mechanisms behind the disease.
"The development of better experimental models that could be incorporated into a battery of tests, will not only help us to understand the changes that occur in the brains of Alzheimer's disease patients, but also provide tools for the development of new drug treatments that could slow or stop the onset of disease," he told BBC News.
Alzheimer's disease is the most common form of dementia.
It affects more than 820,000 people in the UK and costs the economy £23bn a year. 

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Ebola 'out of control' in West Africa as health workers rush to trace 1,500 possible victims

Ebola 'out of control' in West Africa as health workers rush to trace 1,500 possible victims

Fear, mistrust of Western medicine and difficulties reaching remote areas mean hundreds of potentially infected people have not yet been found.

Health workers carry the body of an Ebola virus victim in Kenema, Sierra Leone

Hundreds of West Africans could be carrying the deadly Ebola virus and not know it, potentially infecting hundreds more, as cash-strapped governments and overwhelmed aid agencies struggle to contain the virus's spread.
At least 1,500 people have not yet been traced who are known to have come into contact with others confirmed or suspected to be infected with the haemorrhagic fever, Medecins Sans Frontieres (MSF) told The Telegraph.
Many more could be moving freely in the three countries battling the virus, Guinea, Liberia and Sierra Leone, but fear of the illness and mistrust of Western medicine means they refuse to come forward to speak to doctors.
The current outbreak is the worst ever. So far 467 people have died and health staff have identified at least 292 other suspected or confirmed cases.
Ebola is transmitted by coming into contact with bodily fluids of an infected person. It has no cure and as many as 90 per cent of its victims die, often from uncontrollable internal and external bleeding.

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Gene linked to higher stroke and heart attack risk

Gene linked to higher stroke and heart attack risk.

Strokes are most commonly caused by clots blocking crucial blood supply to the brain

A blood clot in a vessel supplying the brain can starve the brain of oxygen

Researchers have identified a gene that may put people at greater risk of strokes and heart attacks.
Writing in PLOS ONE they say the gene fault may encourage the formation of blood clots - the ultimate cause of most heart attacks and strokes.
Scientists hope gene tests may help doctors one day to pinpoint individuals more likely to suffer these conditions.
But experts say lifestyle factors such as smoking and exercise have the greatest influence on risk.
Around one in 10 people in the Caucasian population carries this variation of the gene, named PIA2.
And researchers from King's College London reviewed more than 80 studies involving about 50,000 people - the largest analysis of this genetic fault to date.
 Threat to under-45s
They found individuals with PIA2 were more likely to have a stroke - caused by a blood clot blocking blood supply to the brain - than those without the gene.
Scientists calculate the gene increases a person's risk of having a stroke by 10-15%.
But how significant this increase is depends on an individual's baseline risk - influenced by factors such as smoking, diet, weight and exercise, the scientists say.
 Heart attacks are caused by a blockage to the blood vessels that carry oxygen to the heart.  
More than 100,000 heart attacks are recorded in the UK each year
And for people with two copies of the gene the risk rises by up to 70% from this baseline.
In a second study published in the same journal, the scientists show PIA2 is also linked to an increased risk of heart attacks in people under 45.
More research is needed to see whether this holds true for the whole population, they say.
About 150,000 people have a stroke in the UK each year and more than 100,000 heart attacks are recorded annually.
Both thrombotic strokes (the most common kind) and heart attacks are caused by blockage of blood vessels in the heart and brain - ultimately through the formation of clots.
'Devastating condition'
The faulty gene appears to affect a protein called glycoprotein IIIa - present on platelets, natural clotting cells in the blood.
Platelets help trigger the formation of clots to stop bleeding after injury. But scientists say carrying the gene may render them overactive.
They caution that overall the genes play a smaller role in risk than more established factors, such as high blood pressure and obesity.
But developing a genetic test could help predict people at highest risk, allowing doctors to suggest more potent medication or lifestyle changes, they say.
Prof Albert Ferro, of King's College London, who led the research, told the BBC: "We would now need to validate this test and see how useful it is in the clinical world."
Dr Shamim Quadir, of the Stroke Association, said: "These latest results are an important step forward in stroke research.
"We hope the findings from this study could lead to many more people who are most at risk of this devastating condition being identified.
'High cholesterol'
"However, if you have a family history of stroke or have any other risk factors, this does not mean the condition is inevitable. Regular exercise, eating a balanced diet and stopping smoking can be important steps to significantly reduce your stroke risk."
Prof Jeremy Pearson, of the British Heart Foundation, said: "It is as yet uncertain whether a genetic test to detect a variation in this protein would be beneficial for patients in everyday practice.
"All patients who are at risk should be monitored to see whether or not lifestyle changes or medication have a positive impact on the more standard major risk factors such as high blood pressure and high cholesterol."

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Tuesday, 1 July 2014

Malaria parasite 'can manipulate body odour of mice'

Malaria parasite 'can manipulate body odour of mice'.

Illustration of mosquito biting skin

Malaria parasites may manipulate the body odour of the host to ensure reproduction.

Malaria parasites can manipulate the body odour of mice, research in the journal Proceedings of the National Academy of Sciences suggests.

Researchers believe parasites may change odours in order to help them with a key stage in their reproduction.
And scientists found the altered scent persists at a critical time when mice have no symptoms but remain infectious.
They are working on further trials to determine whether parasites can affect human smell too.
Scientists from the Swiss Federal Institute of Technology and Pennsylvania State University in the US studied the odour of mice with and without malaria for 45 days.
They found the scent of infected mice was markedly different to non-infected ones.
'Complex life-cycle'
The parasite did not completely alter the smell of the individual - instead it changed the level of compounds already present in mouse odour.

And this was particularly noticeable in mice which were still infectious but no longer showed any symptoms of the disease - corresponding to a crucial time in the life cycle of the parasite.
Prof Consuelo De Moraes of Pennsylvania State University and one of the lead authors of the research said: "There appears to be an overall elevation of several compounds that are attractive to mosquitoes."
The study showed mosquitoes were most attracted to mice when the parasites in their bodies were at a key point in their development - a stage when they needed to be passed back to a mosquito in order to reproduce.
Malaria parasites have a complex life-cycle with several stages. They need to develop and mature in both humans and mosquitoes.
Scientists believe parasites may manipulate the host's smell in order to ensure continued survival.
'Attractive to mosquitoes'
Researchers are now working on trials to see if this pattern of odour change can be traced in humans too.
Professor Mark Mescher of Pennsylvania State University who was also involved in the research told the BBC: "One of the major potential values of this research is if it can help us identify people who do not show symptoms of the disease. 
 Without symptoms people carry the disease without treatment and still transmit it.
"But there is still a long way to go. In mice we have a very controlled environment. In humans there are so many different factors at play - from diverse environments to diverse genes."
Dr James Logan of the London School of Hygiene and Tropical Medicine who was not involved in the research said:
"This is one of the first convincing studies that demonstrates a significant change in odour compounds from malaria-infected mammals can affect mosquito behaviour.
"The strength of this paper is in the experimental approaches used, combining analytical chemistry, statistical analyses and mosquito behaviour.
"However, this demonstration is in an animal model which may or may not relate to human beings infected with malaria."

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Saturday, 28 June 2014

Call to halve target for added sugar

Call to halve target for added sugar.

Sugar cubes

Sugar: There are growing concerns about sugar and healt

People need to more than halve their intake of added sugar to tackle the obesity crisis, according to scientific advice for the government in England.
A draft report by the Scientific Advisory Committee on Nutrition (SACN) says sugar added to food or naturally present in fruit juice and honey should account for 5% of energy intake.
Many fail to meet the old 10% target.
The sugar industry said "demonising one ingredient" would not "solve the obesity epidemic".
The body reviewed 600 scientific studies on the evidence of carbohydrates - including sugar - on health to develop the new recommendations.
One 330ml can of fizzy pop would take a typical adult up to the proposed 5% daily allowance, without factoring in sugar from any other source. 

Coca Cola Europe boss James Quincey confronted by Newsnight's Jeremy Paxman in November 2013
Prof Ian MacDonald, chairman of the SACN working group on carbohydrates, said: "The evidence that we have analysed shows quite clearly that high free sugars intake in adults is associated with increased energy intake and obesity.
"There is also an association between sugar-sweetened beverages and type-2 diabetes.
"In children there is clear demonstration that sugar-sweetened beverages are associated with obesity.
"By reducing it to 5% you would reduce the risk of all of those things, the challenge will be to get there."
The target of 5% of energy intake from free sugars amounts to 25g for women (five to six teaspoons) and 35g (seven to eight teaspoons) for men, based on the average diet. 
 Daily added sugar intake by age group'Silver bullet'
Public Health England will now reconsider its recommendations on fruit juice and smoothies in its five-a-day campaign.
The current advice from the NHS is that juice counts as a maximum of one portion a day, while a smoothie may count as more than one portion, depending on how it is made.
It will also investigate measures to protect children from food advertising while online and whether a sugar tax would have any merit.
Dr Alison Tedstone, the chief nutritionist at Public Health England, said: "We are very concerned around sugar intakes in England.
"It doesn't mean having a completely different diet from today, it is thinking about swapping high sugar foods for a lower sugar alternative.
"Instead of fizzy drink, have water or low-fat milk, instead of a chocolate bar, have a piece of fruit."
 Analysis
By James Gallagher, Health editor, BBC news online
 Orange juice
There's something noticeably missing from a call to halve added sugar - how would you go about doing it?
This group was set up to assess the science and determine what we should be eating. Its role was not to come up with policies.
The target of 5% is a huge challenge when teenagers are currently getting 15% of their calories from added sugar.
One option that doctors have called for is a tax on sugary drinks. The measure is being tried in Mexico, although there is still little evidence on its impact.
The tough decisions are all still to come - what measures will the public accept and how can we be encouraged to eat less sugar without driving us back into the arms of saturated fat and salt?
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The SACN advice echoes an announcement by the World Health Organization in March.
Its draft guidelines reiterated that sugars should constitute no more than 10% of energy intake and that people and governments should be aiming for 5%.
The limits would apply to all sugars added to food, as well as sugar naturally present in honey, syrups, fruit juices and fruit concentrates.

The Food and Drink Federation, which represents manufacturers, said: "SACN's comprehensive analysis of the evidence on carbohydrates has looked at the role of carbohydrates, including sugars and fibre in the diet. We will look at the content of the report and its recommendations over the next few weeks with the intention of engaging in the consultation process and related discussions."
Dr Julian Cooper, head of food science at AB Sugar, said targeting sugar was not a "silver bullet" and people should balance their calorie intake against how much they exercise.
'Fantastic'
The campaign group, Action on Sugar, said the development was "fantastic" news.
The group's chairman Prof Graham MacGregor argued: "Health Secretary Jeremy Hunt must start by setting targets for reducing sugar in soft drinks this summer and move responsibility for nutrition to an independent body such as the Food Standards Agency so that the soft drinks and food industry are given a level playing field, with the threat of regulation to ensure the whole of the food industry comply.
"Before another million British kids become obese."
Public Health Minister for England, Jane Ellison, said: "We know eating too much sugar can have a significant impact on health, and this draft advice confirms that.
"We want to help people make healthier choices and get the nation into healthy habits for life. This report will inform the important debate taking place about sugar."

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Big jump in Mers cases reported

Big jump in Mers cases reported.

Coronavirus 

More than 100 more cases and 34 deaths from the new respiratory disease Mers-coronavirus have been reported by officials in Saudi Arabia.

The cases date back to February and came to light after an analysis of hospital records.
The World Health Organization says there have now been 820 cases of Mers and 286 deaths.
The exact source of the novel infection is still uncertain, but camels are a prime suspect.
The virus is from the same family as the common cold, but can lead to kidney failure and pneumonia.
It was first detected in June 2012.
The update from the Saudi authorities said there were 113 additional cases - 76 of the patients recovered, three are still in hospital and 34 have died. 

Cases have also been confirmed in Jordan, Qatar, the United Arab Emirates, France, Germany, Italy, Tunisia, Egypt, the UK and the US - usually after travel to Saudi Arabia.
Source?
 Camel 
Researchers believe the coronavirus that causes the infection crossed over from animals.
Earlier this month, a report in the New England Journal of Medicine found "identical" Mers viruses in camels and their owner.
However, the link had not been conclusively proven and some researchers argue there may be another source.
The figures do show that nearly half of the cases were spread between people. It seems to have spread after close contact with family member or medical staff.
The World Health Organization does not recommend restrictions on trade or travel, but does warn people to avoid raw camel milk, camel urine and to ensure meat is properly cooked. 
 What is Mers?
Mers virus
  • Acronym for Middle East Respiratory Syndrome
  • A type of coronavirus which causes respiratory infections
  • First death recorded in 2012 in Saudi Arabia
  • Camels are suspected to be the primary source of infection for humans
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Sunday, 22 June 2014

Antidepressant suicide warnings 'may have backfired'

Antidepressant suicide warnings 'may have backfired'

Woman taking antidepressant medication

US warnings about the risk of suicide in young people prescribed antidepressant medication may have backfired, research suggests.
A study, in the British Medical Journal, showed a sudden fall in antidepressant prescriptions and a rise in suicide attempts after media reports of the connection.
The team at Harvard Medical School said the unintended effect was "disturbing".
Experts said similar changes had been seen in other countries.
In 2003, there were concerns about an increased suicide risk from some antidepressants. It led to the US Food and Drug Administration changing the medicine warnings and widespread media reports.
However, there was concern that the reports were exaggerated and missed out the benefits of antidepressants.
Big fall
The study, which followed 2.5 million teenagers and young adults between 2000 and 2010, showed an immediate impact of the warnings.
Prescriptions fell by a third in teenagers and by a quarter in young adults. 
 The number of suicide attempts increased by 22% in teenagers and 34% in young adults. Overall it led to an additional 77 attempts, the researchers estimated. 
 Antidepressant
The report concluded: "It is disturbing that after the health advisories, warnings and media reports about the relation between antidepressant use and suicidality in young people, we found substantial reductions in antidepressant treatment and simultaneous, small but meaningful increases in suicide attempts."
One of the researchers, Prof Stephen Soumerai, said: "This is an extraordinarily difficult public health problem, and if we don't get it right, it can backfire in serious ways.
"These drugs can save lives. The media concentrated more on the relatively small risk than on the significant upside."
'Powerful impact'
Prof Keith Hawton, the director of the centre for suicide research at the University of Oxford in the UK, said: "The results of this study are important.
"Such findings illustrate the powerful impact that such announcements can have on clinician behaviour.
"Until now there has not been convincing evidence that such changes in practice have affected suicidal behaviour.
"The US study suggests that this may have happened, although fortunately without evidence of an increase in actual suicides."
Dr Christine Lu, of Harvard, told the BBC: "There are several lessons for us to consider. Drug risk communication is a big field and we need to be better next time. Any communication can have intended and unintended consequences. 

"And I think a key message is to remind ourselves not to consider only the new evidence on any drugs, but also consider its risk and the benefits, and undertreating the original condition itself."

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