HIV cure dealt a setback

LOS ANGELES — The search-and-destroy mission against the HIV virus just got much more complicated.

New research suggests that HIV's genetic program is far more abundant in dormant T-cells of infected patients and is potentially more capable of unleashing its deadly instructions than previously thought.

The reservoir of human immune cells hosting that code, or provirus, could be 50 times greater than previously thought, according to the study, published Thursday in the journal Cell. And a bigger proportion of those proviruses appears to be fully functional, awaiting the throw of a switch.

"It's a little bit scary," acknowledged microbiologist Janet D. Siliciano of Johns Hopkins University School of Medicine, one of the lead authors of the paper. "We've known about the latent reservoir for many years now. What we didn't realize until this study is it might be larger than previously estimated."

The discovery, by a team that also included the Howard Hughes Medical Institute, Harvard University and the medical schools of Yale and Louisiana State universities, recalibrates the magnitude of the quest to conquer, and not just control, HIV.

Dr. Warner C. Greene, an AIDS researcher and director of the Gladstone Institutes at the University of California, San Francisco, who was not involved in the study, called the results "a rather sobering new perspective for HIV cure research."

Multidrug therapies have been able to thwart the HIV virus in its quest to enter T-cells, and patients following the regime can live a long time, essentially virus-free. There also have been promising advances, including a Mississippi infant who recently was found to be functionally cured of the HIV virus after treatment with antiretroviral drugs.

For adults on the multidrug therapy, however, "virus free" has long been something of a misnomer. Researchers have known that the virus' genome manages to copy and insert itself into the genome of the host cell's nucleus. As long as the T-cells are inactive, these viral genes remain "transcriptionally silent," or turned off. In the short run, that is good news for the human host. But in the long run, it's a big bonus for the virus.

"It's the perfect mechanism for virus persistence because it allows for the virus' genetic information to persist, unaffected by the host immune response and unaffected by the antiretroviral drugs," Siliciano said. "The immune system doesn't see that cell, and the drugs don't affect it because it's not making virus."

Researchers had assumed that genetic silence was a sign of defect. But the study revealed that about 12 percent of these provirus sequences were intact and could be used to synthesize the virus in the lab, where it replicated just like the native stock.

That result essentially multiplies the target of researchers, who have turned to a "shock and kill" strategy to eradicate the last vestiges of the virus. The strategy is something like lighting a fire to kill a wildfire. Activating the T-cells lights the match that kindles the fire of virus production. But the antiretroviral drugs fight those flames, keeping the virus from invading a new host. The old host, meanwhile, essentially burns out. Gone with it is the provirus genome.

The research team has been very successful in waking up the T cells but found that not all of them produced viruses. Repeated attempts kicked more of the laggard genes into gear, but the hit-and-miss nature of the process baffled researchers.

Researchers still must figure out the fickle behavior of the proviruses and try to find ways to activate them without doing harm to patients, for whom an overactive T-cell system can be deadly. And they are faced with far more targets than expected.

"I don't think it's discouraging," Saliciano said. "Our approach has always been to try to understand the latent reservoir. Everything that we're doing just gives us more information about the reservoir, and about the mechanisms of latency. I think the more we learn about what works and doesn't work helps us go forward."

Source : http://onlineathens.com/health/2013-10-27/hiv-cure-dealt-setback

HIV cure dealt a setback

LOS ANGELES — The search-and-destroy mission against the HIV virus just got much more complicated.

New research suggests that HIV's genetic program is far more abundant in dormant T-cells of infected patients and is potentially more capable of unleashing its deadly instructions than previously thought.

The reservoir of human immune cells hosting that code, or provirus, could be 50 times greater than previously thought, according to the study, published Thursday in the journal Cell. And a bigger proportion of those proviruses appears to be fully functional, awaiting the throw of a switch.

"It's a little bit scary," acknowledged microbiologist Janet D. Siliciano of Johns Hopkins University School of Medicine, one of the lead authors of the paper. "We've known about the latent reservoir for many years now. What we didn't realize until this study is it might be larger than previously estimated."

The discovery, by a team that also included the Howard Hughes Medical Institute, Harvard University and the medical schools of Yale and Louisiana State universities, recalibrates the magnitude of the quest to conquer, and not just control, HIV.

Dr. Warner C. Greene, an AIDS researcher and director of the Gladstone Institutes at the University of California, San Francisco, who was not involved in the study, called the results "a rather sobering new perspective for HIV cure research."

Multidrug therapies have been able to thwart the HIV virus in its quest to enter T-cells, and patients following the regime can live a long time, essentially virus-free. There also have been promising advances, including a Mississippi infant who recently was found to be functionally cured of the HIV virus after treatment with antiretroviral drugs.

For adults on the multidrug therapy, however, "virus free" has long been something of a misnomer. Researchers have known that the virus' genome manages to copy and insert itself into the genome of the host cell's nucleus. As long as the T-cells are inactive, these viral genes remain "transcriptionally silent," or turned off. In the short run, that is good news for the human host. But in the long run, it's a big bonus for the virus.

"It's the perfect mechanism for virus persistence because it allows for the virus' genetic information to persist, unaffected by the host immune response and unaffected by the antiretroviral drugs," Siliciano said. "The immune system doesn't see that cell, and the drugs don't affect it because it's not making virus."

Researchers had assumed that genetic silence was a sign of defect. But the study revealed that about 12 percent of these provirus sequences were intact and could be used to synthesize the virus in the lab, where it replicated just like the native stock.

That result essentially multiplies the target of researchers, who have turned to a "shock and kill" strategy to eradicate the last vestiges of the virus. The strategy is something like lighting a fire to kill a wildfire. Activating the T-cells lights the match that kindles the fire of virus production. But the antiretroviral drugs fight those flames, keeping the virus from invading a new host. The old host, meanwhile, essentially burns out. Gone with it is the provirus genome.

The research team has been very successful in waking up the T cells but found that not all of them produced viruses. Repeated attempts kicked more of the laggard genes into gear, but the hit-and-miss nature of the process baffled researchers.

Researchers still must figure out the fickle behavior of the proviruses and try to find ways to activate them without doing harm to patients, for whom an overactive T-cell system can be deadly. And they are faced with far more targets than expected.

"I don't think it's discouraging," Saliciano said. "Our approach has always been to try to understand the latent reservoir. Everything that we're doing just gives us more information about the reservoir, and about the mechanisms of latency. I think the more we learn about what works and doesn't work helps us go forward."

Source : http://onlineathens.com/health/2013-10-27/hiv-cure-dealt-setback

What You Haven't Heard About the HIV Baby's 'Cure'

A Mississippi baby's so-called HIV "cure" looks promising so far, according to a new study, but the study doesn't mention that doctors began aggressive and potentially toxic treatment for the virus days before they could confirm she had it.

The doctors behind a Mississippi baby's so-called HIV "cure" announced eight months ago with great fanfare have published a study about the case, but they're no longer calling it a "functional cure" as they did in March. Instead, they've opted for the more conservative term "remission," presumably because the virus could still return to cause an infection.

But in three years, it hasn't, according to the study published in the New England Journal of Medicine.

"I'm glad they're not still calling it a functional cure," said Dr. Mark Kline, a pediatric HIV and AIDS specialist at Baylor College of Medicine in Houston, who said many of his patients have approached him since last March with the false hope that they, too, could stop taking their HIV medication. "On the basis of one case, it's hard to say whether there are broader treatment implications. For right now, I'd say probably not."

Dr. Hannah Gay, a University of Mississippi Medical Center pediatrician, treated the baby girl with aggressive doses of potentially toxic antiretroviral drugs 30 hours after her birth.

Gay ran virologic tests shortly before she started the baby on HIV treatment, but she did not wait the several days it would take for the test results to confirm whether the baby was actually infected with the virus, ABCNews.com reported last March.

Since there was a 75 percent to 80 percent chance that the baby would not have contracted HIV from her mother, Gay's treatment has often been called "gutsy."

Gay and two of her fellow researchers were named one of Time magazine's most influential people of 2013.

"We're thrilled that the child remains off medication and has no detectable virus replicating," Gay said in a statement Oct. 23. "We've continued to follow the child, obviously, and she continues to do very well. There is no sign of the return of HIV, and we will continue to follow her for the long term."

The decision to stop calling this case a "functional cure" came because people outside the medical community misunderstood its meaning, homing in on the word "cure," Gay said in a statement to ABCNews.com.

"We felt that for the [New England Journal of Medicine] article the word 'remission' might better communicate to all audiences the concept we were trying to convey," she said. "From the beginning, we have urged caution against labeling this single case as a complete 'cure,' stressing the need to observe the child for a longer period of time to be certain there is no rebound."

Read about 14 French patients who went into HIV remission.

Did the Baby Really Have HIV?

The story started three years ago in rural Mississippi, where a mother learned she was HIV positive during labor. (Her identity has been kept under wraps for privacy reasons.)

Once the baby was born, doctors wanted to administer the standard dose of antiretroviral medications to prevent the virus from taking hold, but they did not have the liquid version of the drug intended for infants, according to The Associated Press. The baby was transferred to the University of Mississippi Medical Center, where Gay is a pediatric HIV specialist.

The baby girl had a higher risk of being infected with the virus because her mother, not knowing her HIV status, had not taken transmission-reducing drugs, which have been found to reduce the rate of HIV transmission to 1 percent, during her pregnancy, Kline said. Without these prenatal preventive measures, babies have a 20 to 25 percent chance of becoming infected with their mother's HIV, said Kline.

Source : http://abcnews.go.com/Health/doctors-longer-hiv-baby-cured/story?id=20671079

HIV cure dealt a setback

LOS ANGELES — The search-and-destroy mission against the HIV virus just got much more complicated.

New research suggests that HIV's genetic program is far more abundant in dormant T-cells of infected patients and is potentially more capable of unleashing its deadly instructions than previously thought.

The reservoir of human immune cells hosting that code, or provirus, could be 50 times greater than previously thought, according to the study, published Thursday in the journal Cell. And a bigger proportion of those proviruses appears to be fully functional, awaiting the throw of a switch.

"It's a little bit scary," acknowledged microbiologist Janet D. Siliciano of Johns Hopkins University School of Medicine, one of the lead authors of the paper. "We've known about the latent reservoir for many years now. What we didn't realize until this study is it might be larger than previously estimated."

The discovery, by a team that also included the Howard Hughes Medical Institute, Harvard University and the medical schools of Yale and Louisiana State universities, recalibrates the magnitude of the quest to conquer, and not just control, HIV.

Dr. Warner C. Greene, an AIDS researcher and director of the Gladstone Institutes at the University of California, San Francisco, who was not involved in the study, called the results "a rather sobering new perspective for HIV cure research."

Multidrug therapies have been able to thwart the HIV virus in its quest to enter T-cells, and patients following the regime can live a long time, essentially virus-free. There also have been promising advances, including a Mississippi infant who recently was found to be functionally cured of the HIV virus after treatment with antiretroviral drugs.

For adults on the multidrug therapy, however, "virus free" has long been something of a misnomer. Researchers have known that the virus' genome manages to copy and insert itself into the genome of the host cell's nucleus. As long as the T-cells are inactive, these viral genes remain "transcriptionally silent," or turned off. In the short run, that is good news for the human host. But in the long run, it's a big bonus for the virus.

"It's the perfect mechanism for virus persistence because it allows for the virus' genetic information to persist, unaffected by the host immune response and unaffected by the antiretroviral drugs," Siliciano said. "The immune system doesn't see that cell, and the drugs don't affect it because it's not making virus."

Researchers had assumed that genetic silence was a sign of defect. But the study revealed that about 12 percent of these provirus sequences were intact and could be used to synthesize the virus in the lab, where it replicated just like the native stock.

That result essentially multiplies the target of researchers, who have turned to a "shock and kill" strategy to eradicate the last vestiges of the virus. The strategy is something like lighting a fire to kill a wildfire. Activating the T-cells lights the match that kindles the fire of virus production. But the antiretroviral drugs fight those flames, keeping the virus from invading a new host. The old host, meanwhile, essentially burns out. Gone with it is the provirus genome.

The research team has been very successful in waking up the T cells but found that not all of them produced viruses. Repeated attempts kicked more of the laggard genes into gear, but the hit-and-miss nature of the process baffled researchers.

Researchers still must figure out the fickle behavior of the proviruses and try to find ways to activate them without doing harm to patients, for whom an overactive T-cell system can be deadly. And they are faced with far more targets than expected.

"I don't think it's discouraging," Saliciano said. "Our approach has always been to try to understand the latent reservoir. Everything that we're doing just gives us more information about the reservoir, and about the mechanisms of latency. I think the more we learn about what works and doesn't work helps us go forward."

Source : http://onlineathens.com/health/2013-10-27/hiv-cure-dealt-setback

HIV cure dealt a setback

LOS ANGELES — The search-and-destroy mission against the HIV virus just got much more complicated.

New research suggests that HIV's genetic program is far more abundant in dormant T-cells of infected patients and is potentially more capable of unleashing its deadly instructions than previously thought.

The reservoir of human immune cells hosting that code, or provirus, could be 50 times greater than previously thought, according to the study, published Thursday in the journal Cell. And a bigger proportion of those proviruses appears to be fully functional, awaiting the throw of a switch.

"It's a little bit scary," acknowledged microbiologist Janet D. Siliciano of Johns Hopkins University School of Medicine, one of the lead authors of the paper. "We've known about the latent reservoir for many years now. What we didn't realize until this study is it might be larger than previously estimated."

The discovery, by a team that also included the Howard Hughes Medical Institute, Harvard University and the medical schools of Yale and Louisiana State universities, recalibrates the magnitude of the quest to conquer, and not just control, HIV.

Dr. Warner C. Greene, an AIDS researcher and director of the Gladstone Institutes at the University of California, San Francisco, who was not involved in the study, called the results "a rather sobering new perspective for HIV cure research."

Multidrug therapies have been able to thwart the HIV virus in its quest to enter T-cells, and patients following the regime can live a long time, essentially virus-free. There also have been promising advances, including a Mississippi infant who recently was found to be functionally cured of the HIV virus after treatment with antiretroviral drugs.

For adults on the multidrug therapy, however, "virus free" has long been something of a misnomer. Researchers have known that the virus' genome manages to copy and insert itself into the genome of the host cell's nucleus. As long as the T-cells are inactive, these viral genes remain "transcriptionally silent," or turned off. In the short run, that is good news for the human host. But in the long run, it's a big bonus for the virus.

"It's the perfect mechanism for virus persistence because it allows for the virus' genetic information to persist, unaffected by the host immune response and unaffected by the antiretroviral drugs," Siliciano said. "The immune system doesn't see that cell, and the drugs don't affect it because it's not making virus."

Researchers had assumed that genetic silence was a sign of defect. But the study revealed that about 12 percent of these provirus sequences were intact and could be used to synthesize the virus in the lab, where it replicated just like the native stock.

That result essentially multiplies the target of researchers, who have turned to a "shock and kill" strategy to eradicate the last vestiges of the virus. The strategy is something like lighting a fire to kill a wildfire. Activating the T-cells lights the match that kindles the fire of virus production. But the antiretroviral drugs fight those flames, keeping the virus from invading a new host. The old host, meanwhile, essentially burns out. Gone with it is the provirus genome.

The research team has been very successful in waking up the T cells but found that not all of them produced viruses. Repeated attempts kicked more of the laggard genes into gear, but the hit-and-miss nature of the process baffled researchers.

Researchers still must figure out the fickle behavior of the proviruses and try to find ways to activate them without doing harm to patients, for whom an overactive T-cell system can be deadly. And they are faced with far more targets than expected.

"I don't think it's discouraging," Saliciano said. "Our approach has always been to try to understand the latent reservoir. Everything that we're doing just gives us more information about the reservoir, and about the mechanisms of latency. I think the more we learn about what works and doesn't work helps us go forward."

Source : http://onlineathens.com/health/2013-10-27/hiv-cure-dealt-setback

What You Haven't Heard About the HIV Baby's 'Cure'

A Mississippi baby's so-called HIV "cure" looks promising so far, according to a new study, but the study doesn't mention that doctors began aggressive and potentially toxic treatment for the virus days before they could confirm she had it.

The doctors behind a Mississippi baby's so-called HIV "cure" announced eight months ago with great fanfare have published a study about the case, but they're no longer calling it a "functional cure" as they did in March. Instead, they've opted for the more conservative term "remission," presumably because the virus could still return to cause an infection.

But in three years, it hasn't, according to the study published in the New England Journal of Medicine.

"I'm glad they're not still calling it a functional cure," said Dr. Mark Kline, a pediatric HIV and AIDS specialist at Baylor College of Medicine in Houston, who said many of his patients have approached him since last March with the false hope that they, too, could stop taking their HIV medication. "On the basis of one case, it's hard to say whether there are broader treatment implications. For right now, I'd say probably not."

Dr. Hannah Gay, a University of Mississippi Medical Center pediatrician, treated the baby girl with aggressive doses of potentially toxic antiretroviral drugs 30 hours after her birth.

Gay ran virologic tests shortly before she started the baby on HIV treatment, but she did not wait the several days it would take for the test results to confirm whether the baby was actually infected with the virus, ABCNews.com reported last March.

Since there was a 75 percent to 80 percent chance that the baby would not have contracted HIV from her mother, Gay's treatment has often been called "gutsy."

Gay and two of her fellow researchers were named one of Time magazine's most influential people of 2013.

"We're thrilled that the child remains off medication and has no detectable virus replicating," Gay said in a statement Oct. 23. "We've continued to follow the child, obviously, and she continues to do very well. There is no sign of the return of HIV, and we will continue to follow her for the long term."

The decision to stop calling this case a "functional cure" came because people outside the medical community misunderstood its meaning, homing in on the word "cure," Gay said in a statement to ABCNews.com.

"We felt that for the [New England Journal of Medicine] article the word 'remission' might better communicate to all audiences the concept we were trying to convey," she said. "From the beginning, we have urged caution against labeling this single case as a complete 'cure,' stressing the need to observe the child for a longer period of time to be certain there is no rebound."

Read about 14 French patients who went into HIV remission.

Did the Baby Really Have HIV?

The story started three years ago in rural Mississippi, where a mother learned she was HIV positive during labor. (Her identity has been kept under wraps for privacy reasons.)

Once the baby was born, doctors wanted to administer the standard dose of antiretroviral medications to prevent the virus from taking hold, but they did not have the liquid version of the drug intended for infants, according to The Associated Press. The baby was transferred to the University of Mississippi Medical Center, where Gay is a pediatric HIV specialist.

The baby girl had a higher risk of being infected with the virus because her mother, not knowing her HIV status, had not taken transmission-reducing drugs, which have been found to reduce the rate of HIV transmission to 1 percent, during her pregnancy, Kline said. Without these prenatal preventive measures, babies have a 20 to 25 percent chance of becoming infected with their mother's HIV, said Kline.

Source : http://abcnews.go.com/Health/doctors-longer-hiv-baby-cured/story?id=20671079

The art of the vintage party

Catch a tube in London on any Friday night, and you'll see a curious thing. There'll be all the usual characters headed out for a night on the town – women in miniskirts destined for nightclubs, or men in shiny new suits travelling to bars. But what you'll also, increasingly, spot are people who look like they've stepped out of a previous time – girls in 1950s dresses with bright red lipstick, or men sporting 1920s braces and fedora hats.

Throwing such parties certainly isn't easy – they require the host to source everything from scene-setting props to authentic period food – so what advantages do they offer?

"If you love parties, like any good host, you want your party to be remembered," she says. "Vintage themes allow people to break the ice more easily – it helps with conversation, whether you are complimenting someone's beautifu beaded flapper dress or having a conversation about the food."

You don't, she says, need a large budget to throw such an event – the devil is in small details. Themed invitations set the tone right from the start, and should offer some advice for costumes. Music is one of the most important ingredients: "Get this right, and your party will swing when it's meant to, and keep your guests from leaving early".

Food should be evocative of the period, planned in advance, and can take the form of canapés if you don't have the money or time to organise a meal. It's important, she says, to offer themed drinks - like punch for a 1950s street party, or cocktails popular in the Jazz Age for a 1920s event - and to make sure that they are chilled in plenty of time for the party. As for props, many can be easily handmade.

"Just pay attention to getting the ingredients right," she says. "So your guests really feel they have had a little taste of the past, in the world they live in today."

How to throw a 1920s cocktail party: guide

Setting the scene

Bresaola and parmesan crostini recipe

Queen of Sheba cocktail recipe

Chocolate and hazelnut strawberries recipe

'Style Me Vintage: Tea Parties' is available from Pavilion, £9.99

Source : http://telegraph.feedsportal.com/c/32726/f/564649/s/330d080f/sc/38/l/0L0Stelegraph0O0Cfoodanddrink0C10A40A46160CThe0Eart0Eof0Ethe0Evintage0Eparty0Bhtml/story01.htm

Mystery swirls around Obamacare covergirl - and her vanishing

• Share this
• Email
• Print
• Reprints

By Barbara Goldberg

Tue Oct 29, 2013 2:08pm EDT

(Reuters) - Hers was the face that launched 20 million snipes.

The smiling wholesome beauty was a symbol of Healthcare.gov but she has vanished amid a sea of frustrated users, her image taken down from the trouble-plagued Obamacare website by early Monday morning.

Nicknamed "Glitch Girl," the unnamed model stirred curiosity among media who scrambled to try to identify her after the site, which went live on October 1, was immediately slowed by technical problems and visitors found themselves endlessly staring at her on their frozen computer screens.

So far, 20 million unique users have clicked on the federal site, but only 700,000 applications have been submitted through a combination of the site and state-run Obamacare exchanges, according to testimony prepared for U.S. Secretary of Health and Human Services, Kathleen Sebelius, to deliver to a Congressional panel on Wednesday.

Frustrated users unleashed their ire on the mystery woman, venting on Twitter and other social media.

"The #obamacare girl got the worst photo shoot gig since Joey did the STD poster on Friends," tweeted @RONCOULTER, referring to the sitcom character's shock when he discovered that his modeling picture had been used in a campaign about venereal disease.

After the Obamacare girl disappeared from the site, social media users rallied to support the mystery woman, whose image file on the site is named "Adriana."

"It's not the obamacare cover girl they need to fire," tweeted @joepatton.

Others said they planned to dress up as her character on Halloween.

The Centers for Medicare and Medicaid Services, which runs the website, was not immediately available for comment.

The government has replaced "Adriana" with four chunky icons that represent ways to sign up for the new mandatory health insurance. Creative critics have suggested other stand-ins, including the ghoulish Freddy Krueger character from the film series "A Nightmare on Elm Street" or Norwegian artist Edvard Munch's "The Scream."

The mystery surrounding the Obamacare girl may only deepen as new theories about her disappearance are tested online.

"Wasn't Manti T'eo dating #ObamacareGirl?" tweeted @MonteBlachford, referring to the Notre Dame football star who admitted he lied to keep up a hoax involving a nonexistent dying girlfriend.

(Additional reporting by Elizabeth Dilts; editing by Gunna Dickson)

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/lifestyle/~3/WhpuZTaFAvo/story01.htm

How to throw a 1920s cocktail party

The entrance to the party should be very humble to the point of being hard to find. The speakeasies of New York legend were hidden behind toy stores, or entered through fake phone booths. Guests should have to search hard to find the party – the less glamorous, the better. There should be no obvious sign that there are hinky things goings on. If you have a back door or side entrance use it. To identify your joint, use a building number or a green flag or one broken bulb. This one detail will need to be included in the invitation. You could have a bouncer on the door. An absolute must is a special knock, a password from popular 1920's slang, or an object to be handed in at the door (a popular item was a library book – if a raid occurred they claimed to be reading clubs). Again, this must be mentioned on the invitation.

Decor

To create the intimate, secretive vibe of a speakeasy, decorate your room with dark, rich fabrics, faux furs and velvet, for a lavish touch. Provide small, round tables with chairs and cover the tables in heavy tablecloths. The lighting should be subdued – pop a few low-level lamps or small candle holders on the tables – empty liquor bottles fashioned into candelabras are another fun touch.

If you have bartenders, they should be in some sort of uniform. Provide drinks in crystal glasses or use innocent little teacups and saucers for your cocktails – this was the traditional way to serve alcohol at a speakeasy back in the Roaring Twenties. Serve your canapés from silver platters and glass plates, with shiny red or black tableware.

Create a background with props, including violin cases (notoriously used to hide Tommy guns), dusty antiquebooks, art deco paintings, flapper prints or vintage-style alcohol adverts, photographs of Al Capone, Bonnie and Clyde, or any other famous gangster of that time period. Print out tabloid newspapers and leave them around the place. Promote the retro bar ambience by purchasing old-looking bottles from secondhand stores and online.

If you are having the party at your house or somewhere that has a bath, fill the tub with water and ice to keep your drinks cold – you can call it "bathtub gin".

Use your television to play old silent films in the background. Play music, but hide your modern system with antique linen or a tablecloth.

Music

The 1920s saw the height of New Orleans and Chicago styles of jazz, sandwiched between the Dixieland soundof the 1900s and the Swing era of the 1930s. Fill your playlist with authentic 1920's sounds: pianist and bandleader Jelly Roll Morton, Louis Armstrong and his Hot Five, cornetist Bix Beiderbecke, pianist Earl Hines, pianist James P. Johnson, and saxophonist-clarinetist Sidney Bechet.

If you have the budget, the sound of a live upbeat jazz band will add a wonderful energy to your evening! A pianist, with a singing Sheba, is also rather swanky.

Invitations

Send out Art Deco-style black and white invitations. These days you have the choice of sending online or mailed invitations, but using the old-fashioned postal way will add to the intrigue. Whichever way you choose, make sure that you grab your guest's attention and be sure to mention what attire you would like them to wear.

"...Come drink & dance the night away at our Roaring '20s Speakeasy Party...."

"...Dress as a gangster or silent screen star...

"...Come as a flapper or come as you are..."

What to wear

Ladies

In the 1920s, a new woman was born: she smoked, drank, danced, and voted; she cut her hair, wore heavy make-up; she was giddy and took risks. She was a Flapper. The typical flapper look comprised a short, finger-waved bob with a feathered headband, a drop-waisted, fringed or heavily beaded cocktail dress, over-the-knee stockings and a sexy pair of round-toed heels. Accessorise this look with a long cigarette holder, a long string of pearls, and a feather boa. Flappers often finished the ensemble with a felt, bell-shaped hat called a cloche. Also, as a speakeasy was the only place to get a decent drink, so no respectable flapper would be seen without her personal hipflask neatly tied to her leg.

Chaps

Some speakeasies were used as homes and offices by gangsters, who adopted an extravagant lifestyle. Successful gangsters could be identified by their fashionable silk suits, expensive jewellery, and guns. Men – you can't put on any old rags. Emulate the style of Al Capone – think pin-striped suits with fedora hats. Black or white ties on a black shirt, spats (white canvas or vinyl shoe covers). Don't be a "gooseberry lay" – check out the internet's supply of men's gangster costumes, you can find a great deal! If you want to do something a little different, wear a Henley shirt with long baggy trousers and braces. Top it off with a hat and you will have a genuine twenties look.

Learn to dance the Charleston together!

The Charleston was a popular dance that originated inthe 1920s during the flapper period. Flappers would dance it at the speakeasies, alone or together, as a way of mocking the "drys," or those who supported Prohibition, as the dance was considered quite immoral and provocative. In fact,it was banned in dancehalls of the day for being too wild.

There are variations and extra steps, but the basic dance is easy to learn. For tips and videos, or tutorials visit Charleston Dance

Why not have a Charleston contest for your guests andaward a prize to the winner.

Food and drink

Any cocktail you choose will probably be fitting as the majority of today's cocktails were created in the 1920s to mask the strength and bad taste of bathtub liquors and moonshines. Recipes for drinks popular in the Roaring Twenties include some full of innuendo, like Between the Sheets, or favorites like the Mint Julep or the Old Fashioned. Champagne cocktails were also a big hit. I recommend serving canapés and drinks only. You will most likely want this party to occur in the evening, so people will probably already have had dinner. You can always serve filled bagels as the night wears on, as people need something to soak up the moonshine.

1920s recipes

Bresaola and parmesan crostini recipe

Queen of Sheba cocktail recipe

Chocolate and hazelnut strawberries recipe

'Style Me Vintage: Tea Parties' is available from Pavilion, £9.99

Source : http://telegraph.feedsportal.com/c/32726/f/564649/s/330bde8c/sc/26/l/0L0Stelegraph0O0Cfoodanddrink0C10A40A44830CHow0Eto0Ethrow0Ea0E1920As0Ecocktail0Eparty0Bhtml/story01.htm

Vitamin D supplements may not increase bone density

• Share this
• Email
• Print
• Reprints

By Shereen Jegtvig

NEW YORK | Tue Oct 29, 2013 2:11pm EDT

NEW YORK (Reuters Health) - People over the age of 50 often take vitamin D supplements thinking they're making their bones stronger and preventing osteoporosis.

But a new review of past studies finds the supplements don't usually increase bone density. And researchers said they aren't necessary for most healthy adults.

Among people with osteoporosis, bones become weak and fragile due to the loss of bone density that often comes with aging. Fragile bones are more likely to break. A common prevention strategy is to take calcium and vitamin D supplements.

Vitamin D is needed for the body to absorb calcium. But it's not commonly found in foods, unless they're fortified, like most milk. The body makes vitamin D after skin is exposed to sunlight.

Although calcium is necessary for strong bones, there has been some concern about the safety of taking calcium supplements.

"Recent evidence has indicated that calcium, with or without vitamin D, probably increases the risk of heart attacks," Dr. Ian Reid told Reuters Health in an email.

"Therefore, there is a renewed interest in the value of using vitamin D alone for optimizing bone health," Reid added. He is a professor of medicine at the University of Auckland in New Zealand and the lead author of the new study

Reid and his colleagues collected 23 past studies on vitamin D and bone density and re-analyzed their findings.

The studies included a total of 4,082 participants. The participants were in their late 50s, on average, and 92 percent of them were women.

The researchers found vitamin D supplements at any dose didn't make much of a difference for bone density.

"We were surprised at the large number of carefully conducted studies which did not disclose any benefit to bone density from vitamin D supplements, even when the baseline levels of vitamin D in the study subjects were quite low," Reid said.

The results were published in The Lancet.

Each of the studies measured bone density at between one and five sites on the body, like the spine, hip and forearm.

Across the studies, there were 70 separate measurements of bone density at a particular site before and after participants took vitamin D supplements. Of those, six showed some benefit tied to supplement use, two showed bone loss and the rest found no effect of vitamin D.

There was no difference comparing vitamin D2 and D3, the two forms normally sold as supplements.

Reid said he finds the current evidence that calcium supplements increase the risk of heart attacks to be persuasive. So he doesn't recommend people take calcium, unless it's advised by a doctor.

"Individuals interested in lifestyle modifications to optimize bone health should aim to achieve an adequate calcium intake from their diet, without recourse to supplements, and to have regular exercise and sunshine exposure without risking sunburn," Reid advised.

"In practice this means sunlight exposure at the beginning or end of the day in summer."

Some people do need to consider vitamin D supplements, he said.

"Individuals who are permanently indoors, usually as a result of advanced age and frailty, require supplements. Supplements are also required by individuals with very dark skin living at a distance from the equator, and those who are habitually veiled," explained Reid.

Paul Coates, director of the National Institutes of Health Office of Dietary Supplements, confirmed many people in the U.S. take vitamin D supplements, although they trail behind multivitamins and calcium in popularity.

It's possible vitamin D supplements might have other benefits, but Coates told Reuters Health there isn't enough evidence to make recommendations for anything other than bone health. Studies are currently being done to examine vitamin D's relationship to cancer and type 2 diabetes prevention.

Opinions and recommendations on dietary supplements seem to change frequently, making it difficult for consumers to keep up with the science.

Coates suggested the Office of Dietary Supplements website (ods.od.nih.gov) and the National Library of Medicine's MedlinePlus (medlineplus.gov) as two resources.

SOURCE: bit.ly/1c6S3OZ The Lancet, online October 11, 2013.

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/healthNews/~3/7kUx769XmuM/story01.htm

Lullabies reduce pain in children, say academics

The scientists then compared this with two other groups, one in which the children had been read to and the other where they had been left alone, and found only those who had been sung to showed a reduction in pain or heart rate.

"It shows that children can be affected physiologically by music," he said.

He underlined that the research was still in the early stages, but added: "The practical applications are fairly obvious. Music therapists are going to be a lot cheaper than drugs to numb pain."

Professor Tim Griffiths, a consultant neurologist with the Wellcome Trust, told BBC Radio 4's Today programme: "There's an ancient part of the brain in the limbic system which is responsible for the emotional responses to music.

"What I think is happening here is that the emotional part of the brain is being stimulated by music, more so than the reading stimulus," he said of the study at the London children's hospital.

"This is decreasing the arousal level, and that in turn is affecting their pain response levels."

The songs researchers used to reduce pain:

- Hush Little Baby

- Hushabye Baby

- See Saw Margery Daw

- Donkey Riding

- Little Fish

- Twinkle Twinkle

- Five Little Ducks

Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/330add3c/sc/14/l/0L0Stelegraph0O0Chealth0Cchildren0Ishealth0C10A410A9460CLullabies0Ereduce0Epain0Ein0Echildren0Esay0Eacademics0Bhtml/story01.htm

High-tech helps tradition to make Hungary's Tokaj wine

• Share this
• Email
• Print
• Reprints

By Krisztina Than

TOKAJ, Hungary | Tue Oct 29, 2013 1:50pm EDT

TOKAJ, Hungary (Reuters) - The Hungarian tradition of plucking shriveled grapes, sometimes one-by-one, to make pricey, sweet white wine dates back centuries, but growers hope new technology will help them harvest the fruit at its rotten best.

Tokaji Aszu wine, which retails in Britain for at least 20 pounds ($32) a bottle, is one of a handful of wines around the world made with fruit affected by "noble rot", induced by the "Botrytis" fungus that shrivels the grapes and concentrates their sugar.

One of the big Tokaj estates already uses sensors to measure humidity, precipitation and moisture on the vine leaves, data that, along with weather forecasts, can help predict common grape diseases, calculating the best time to spray the vines.

The same technology may soon be used to determine whether the grapes could reach the right stage of "noble rot" that is vital to making the Tokaji Aszu that was favored by the French royal court.

"The Botrytis fungus is an infection as well, one which we can turn to our advantage here thanks to the microclimatic conditions," said Gergely Makai, winemaker at the Hetszolo winery, owned by France's Michel Reybier vineyards.

The "SmartVineyard" system, developed in Hungary, allows users to access the data on smartphones or laptops.

"We have not tried yet, but we'd like this equipment and algorithm to help us predict sometime ahead how much chance there is for aszu grapes, for the Botrytis infection first of all, and then for it to induce a noble rot."

THE MARKS OF AGE

Although technology is slowly intruding, the Tokaj region in the northeast of Hungary is a UNESCO World Heritage site and, like the wine made there, is strongly attached to its traditions.

"Those who try the aszu (shriveled grapes) once, will always feel that taste in their mouth," says Ilona Takacs, who will soon turn 70 and has worked in the vineyards for decades.

This year, when a hot summer was followed by a rainy period and then by warm, sunny days, promises a good harvest. Aszu grapes are picked by hand and, traditionally, pressed into the consistency of aszu paste, then fermented with white wine and aged in oak barrels for several years.

Legend has it that the first time Aszu was made was during Hungary's Turkish occupation in the 17th century when the harvest was delayed until the grapes had shriveled, and the infection set in.

While climatic conditions above the ground are critical, they are equally important below the ground in the deep vaulted cellars where bottles are kept, some for more than 100 years.

In the village of Tolcsva, government-owned cellars still hold some 280,000 bottles, the oldest of which are from 1895. The special climate of the cellar - a steady temperature of 10-11 degrees C (50-52 F) and over 90 percent humidity - has helped preserve them.

Laszlo Gardosi, in charge of the museum wines, says the oldest Tokaji Aszu he had tasted was from 1906.

"It was perhaps like an old man whose face bears the marks of age but still carries the elusive beauty that defined him in his youth," he said of the experience. ($1 = 0.6199 British pounds)

(Reporting by Krisztina Than and Krisztina Fenyo; Editing by Michael Roddy and Robin Pomeroy)

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/lifestyle/~3/W_MQfsPMjHc/story01.htm

Cancer survival rates revealed

One year net survival for men diagnosed between 2007 and 2011 and followed up to 2012

Testis – 98.1 per cent

Melanoma of skin – 96 per cent

Prostate – 93.1 per cent

Hodgkin lymphoma – 90.3 per cent

Larynx – 85 per cent

Rectum – 79.9 per cent

Bladder – 78 per cent

Non-Hodgkin lymphoma – 77.4 per cent

Colorectum – 75.9 per cent

Myeloma – 73.9 per cent

Colon – 73.8 per cent

Kidney – 72.9 per cent

Leukaemia – 67.1 per cent

Stomach – 43.7 per cent

Brain – 43.5 per cent

Oesophagus – 42.3 per cent

Lung – 31 per cent

Pancreas – 18.8 per cent

One year net survival for women diagnosed between 2007 and 2011 and followed up to 2012

Melanoma of skin – 97.9 per cent

Breast – 95.8 per cent

Hodgkin lymphoma – 93 per cent

Uterus – 89.9 per cent

Cervix – 83.7 per cent

Non-Hodgkin lymphoma – 80.1 per cent

Rectum – 79.4 per cent

Colorectum – 74.7 per cent

Myeloma – 74.7 per cent

Ovary – 73.7 per cent

Kidney – 73.2 per cent

Colon – 73 per cent

Bladder – 67.2 per cent

Leukaemia – 65 per cent

Brain – 44.1 per cent

Stomach – 42.2 per cent

Oesaphagus – 42.2 per cent

Lung – 35.4 per cent

Pancreas – 20.7 per cent

Five-year net survival for men diagnosed between 2007 and 2011 and followed up to 2012

Testis – 97.1 per cent

Melanoma of skin – 85.5 per cent

Hodgkin lymphoma – 82.4 per cent

Prostate – 81.7 per cent

Larynx – 66.1 per cent

Non-Hodgkin lymphoma – 62.4 per cent

Bladder – 58.6 per cent

Rectum – 57.1 per cent

Colon – 56.6 per cent

Colorectum – 56.5 per cent

Kidney – 54.7 per cent

Leukaemia – 47 per cent

Myeloma – 42.8 per cent

Stomach – 18.4 per cent

Brain – 17.8 per cent

Oesophagus – 13.5 per cent

Lung – 9.7 per cent

Pancreas – 4.7 per cent

Five-year net survival for women diagnosed between 2007 and 2011 and followed up to 2012

Melanoma of skin – 92.1 per cent

Hodgkin lymphoma – 86 per cent

Breast – 85 per cent

Uterus – 77.4 per cent

Non-Hodgkin lymphoma – 68.5 per cent

Cervix – 67.3 per cent

Rectum – 59.9 per cent

Colorectum – 57.8 per cent

Colon – 57.3 per cent

Kidney – 56.9 per cent

Bladder – 49.1 per cent

Leukaemia – 46.8 per cent

Ovary – 46.3 per cent

Myeloma – 41.6 per cent

Brain – 20.4 per cent

Stomach – 19.6 per cent

Oesaphagus – 15.6 per cent

Lung – 12.5 per cent

Pancreas – 5.4 per cent

Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/330ef3a4/sc/25/l/0L0Stelegraph0O0Chealth0Chealthnews0C10A4120A780CCancer0Esurvival0Erates0Erevealed0Bhtml/story01.htm

Kids need help returning to school after concussions

• Share this
• Email
• Print
• Reprints

By Kathryn Doyle

NEW YORK | Tue Oct 29, 2013 2:10pm EDT

NEW YORK (Reuters Health) - After a concussion, it can be difficult for children to learn new things or remember old things. Parents, pediatricians and school staff need to be able to make adjustments to suit the child for a few weeks or sometimes longer, a new statement from the American Academy of Pediatrics (AAP) says.

Concussions are a relatively new concern. Most regulations and guidelines have focused on athletes returning to play, since that has been the most high-profile issue, Dr. Cynthia Devore said. Fewer have addressed kids returning to learning.

Devore is one of the lead authors of the new clinical report, which offers guidance for pediatricians on getting kids back to school after a concussion but is not an absolute mandate. It is published in Pediatrics.

"Pediatricians can help families and kids understand their symptoms following concussion and guide them in limiting activities," said Devore, a pediatrician from Rochester, New York.

School nurses, psychologists and counselors can also help children make a gradual return to academics, she told Reuters Health.

Physical, mental and emotional rest are key for concussion recovery, Devore said.

After a concussion, kids should avoid bright lights, computer screens and noisy environments, according to the report.

If they are having trouble concentrating for 30 minutes straight, they should stay home from school and limit computer and videogame time and text messaging. Parents should coordinate with schools to make sure learning adjustments are made when the child returns.

Concussions can make learning tough, and trying to learn with a concussed brain can make recovery time longer, the statement says.

The AAP councils involved in the report recommend a team-based strategy for adults who manage the child.

Pediatricians should be in charge of managing the child's recovery and return to school as part of a medical team. That team should work with the family team and two school teams, one that is in charge of academics and one for physical activity, the report says.

For that to work, team members like teachers, sports coaches and school nurses will need to be aware that the child may have special learning needs post-injury.

"Many schools already have teams in place that can address the concussed student's needs," Devore said.

But one specialist not involved in the report said pediatricians aren't necessarily trained and ready to manage a student's return to school after a concussion.

"The article seems to communicate to pediatricians that they should be able to create and orchestrate academic accommodations for students," Rosemarie Scolaro Moser told Reuters Health.

"I believe this is too much to ask pediatricians in all that they do and this is not their area of expertise, so it is important that they refer to and consult with the cognitive specialists, like the neuropsychologist, whose role unfortunately seems to be underplayed in this article."

Moser is a neuropsychologist herself and director of the Sports Concussion Center of New Jersey in Lawrenceville.

The statement recommends having neuropsychologists on the medical team. But they should have a more central role, especially if children continue to struggle with learning more than three weeks after hitting their heads, Moser said.

Joanna Boyd, public education coordinator at the Brain Injury Alliance of New Jersey in North Brunswick, agreed.

"Neuropsychologists specialize in understanding which parts of the brain are functioning best, weeding through cognitive symptoms to provide a much better guide for school accommodations," Boyd told Reuters Health. She also wasn't involved in writing the new report.

There hasn't been much research on a large scale of what happens to the brain after a sports injury, and every injury and every child is unique, she said. That makes it tough to offer blanket rules for when kids should return to school and which kind of learning works best.

That's why specialists often play an important role in concussion recovery, Boyd said.

SOURCE: bit.ly/16Glx1X Pediatrics, online October 28, 2013.

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/healthNews/~3/n2UFlaow9PM/story01.htm

HIV cure dealt a setback

LOS ANGELES — The search-and-destroy mission against the HIV virus just got much more complicated.

New research suggests that HIV's genetic program is far more abundant in dormant T-cells of infected patients and is potentially more capable of unleashing its deadly instructions than previously thought.

The reservoir of human immune cells hosting that code, or provirus, could be 50 times greater than previously thought, according to the study, published Thursday in the journal Cell. And a bigger proportion of those proviruses appears to be fully functional, awaiting the throw of a switch.

"It's a little bit scary," acknowledged microbiologist Janet D. Siliciano of Johns Hopkins University School of Medicine, one of the lead authors of the paper. "We've known about the latent reservoir for many years now. What we didn't realize until this study is it might be larger than previously estimated."

The discovery, by a team that also included the Howard Hughes Medical Institute, Harvard University and the medical schools of Yale and Louisiana State universities, recalibrates the magnitude of the quest to conquer, and not just control, HIV.

Dr. Warner C. Greene, an AIDS researcher and director of the Gladstone Institutes at the University of California, San Francisco, who was not involved in the study, called the results "a rather sobering new perspective for HIV cure research."

Multidrug therapies have been able to thwart the HIV virus in its quest to enter T-cells, and patients following the regime can live a long time, essentially virus-free. There also have been promising advances, including a Mississippi infant who recently was found to be functionally cured of the HIV virus after treatment with antiretroviral drugs.

For adults on the multidrug therapy, however, "virus free" has long been something of a misnomer. Researchers have known that the virus' genome manages to copy and insert itself into the genome of the host cell's nucleus. As long as the T-cells are inactive, these viral genes remain "transcriptionally silent," or turned off. In the short run, that is good news for the human host. But in the long run, it's a big bonus for the virus.

"It's the perfect mechanism for virus persistence because it allows for the virus' genetic information to persist, unaffected by the host immune response and unaffected by the antiretroviral drugs," Siliciano said. "The immune system doesn't see that cell, and the drugs don't affect it because it's not making virus."

Researchers had assumed that genetic silence was a sign of defect. But the study revealed that about 12 percent of these provirus sequences were intact and could be used to synthesize the virus in the lab, where it replicated just like the native stock.

That result essentially multiplies the target of researchers, who have turned to a "shock and kill" strategy to eradicate the last vestiges of the virus. The strategy is something like lighting a fire to kill a wildfire. Activating the T-cells lights the match that kindles the fire of virus production. But the antiretroviral drugs fight those flames, keeping the virus from invading a new host. The old host, meanwhile, essentially burns out. Gone with it is the provirus genome.

The research team has been very successful in waking up the T cells but found that not all of them produced viruses. Repeated attempts kicked more of the laggard genes into gear, but the hit-and-miss nature of the process baffled researchers.

Researchers still must figure out the fickle behavior of the proviruses and try to find ways to activate them without doing harm to patients, for whom an overactive T-cell system can be deadly. And they are faced with far more targets than expected.

"I don't think it's discouraging," Saliciano said. "Our approach has always been to try to understand the latent reservoir. Everything that we're doing just gives us more information about the reservoir, and about the mechanisms of latency. I think the more we learn about what works and doesn't work helps us go forward."

Source : http://onlineathens.com/health/2013-10-27/hiv-cure-dealt-setback

What You Haven't Heard About the HIV Baby's 'Cure'

A Mississippi baby's so-called HIV "cure" looks promising so far, according to a new study, but the study doesn't mention that doctors began aggressive and potentially toxic treatment for the virus days before they could confirm she had it.

The doctors behind a Mississippi baby's so-called HIV "cure" announced eight months ago with great fanfare have published a study about the case, but they're no longer calling it a "functional cure" as they did in March. Instead, they've opted for the more conservative term "remission," presumably because the virus could still return to cause an infection.

But in three years, it hasn't, according to the study published in the New England Journal of Medicine.

"I'm glad they're not still calling it a functional cure," said Dr. Mark Kline, a pediatric HIV and AIDS specialist at Baylor College of Medicine in Houston, who said many of his patients have approached him since last March with the false hope that they, too, could stop taking their HIV medication. "On the basis of one case, it's hard to say whether there are broader treatment implications. For right now, I'd say probably not."

Dr. Hannah Gay, a University of Mississippi Medical Center pediatrician, treated the baby girl with aggressive doses of potentially toxic antiretroviral drugs 30 hours after her birth.

Gay ran virologic tests shortly before she started the baby on HIV treatment, but she did not wait the several days it would take for the test results to confirm whether the baby was actually infected with the virus, ABCNews.com reported last March.

Since there was a 75 percent to 80 percent chance that the baby would not have contracted HIV from her mother, Gay's treatment has often been called "gutsy."

Gay and two of her fellow researchers were named one of Time magazine's most influential people of 2013.

"We're thrilled that the child remains off medication and has no detectable virus replicating," Gay said in a statement Oct. 23. "We've continued to follow the child, obviously, and she continues to do very well. There is no sign of the return of HIV, and we will continue to follow her for the long term."

The decision to stop calling this case a "functional cure" came because people outside the medical community misunderstood its meaning, homing in on the word "cure," Gay said in a statement to ABCNews.com.

"We felt that for the [New England Journal of Medicine] article the word 'remission' might better communicate to all audiences the concept we were trying to convey," she said. "From the beginning, we have urged caution against labeling this single case as a complete 'cure,' stressing the need to observe the child for a longer period of time to be certain there is no rebound."

Read about 14 French patients who went into HIV remission.

Did the Baby Really Have HIV?

The story started three years ago in rural Mississippi, where a mother learned she was HIV positive during labor. (Her identity has been kept under wraps for privacy reasons.)

Once the baby was born, doctors wanted to administer the standard dose of antiretroviral medications to prevent the virus from taking hold, but they did not have the liquid version of the drug intended for infants, according to The Associated Press. The baby was transferred to the University of Mississippi Medical Center, where Gay is a pediatric HIV specialist.

The baby girl had a higher risk of being infected with the virus because her mother, not knowing her HIV status, had not taken transmission-reducing drugs, which have been found to reduce the rate of HIV transmission to 1 percent, during her pregnancy, Kline said. Without these prenatal preventive measures, babies have a 20 to 25 percent chance of becoming infected with their mother's HIV, said Kline.

Source : http://abcnews.go.com/Health/doctors-longer-hiv-baby-cured/story?id=20671079

Study questions FDA's shorter drug approval times

• Share this
• Email
• Print
• Reprints

By Toni Clarke

WASHINGTON | Tue Oct 29, 2013 12:54am EDT

WASHINGTON (Reuters) - New drugs that receive expedited review by the Food and Drug Administration are being tested on fewer patients, leaving many safety questions unanswered even after they are approved, a study released on Monday in the Journal of the American Medical Association found.

Study authors Thomas Moore of the Institute for Safe Medication Practices and Dr Curt Furberg, a professor at Wake Forest School of Medicine, examined the development times, clinical testing and risks associated with 20 new drugs approved in 2008. Eight were given expedited review and 12 standard review.

It found that expedited drugs underwent a median of 5.1 years of clinical testing before being approved, compared with 7.5 years for those that underwent a standard review. But in many cases safety monitoring trials that were supposed to be conducted after the products were approved were either not conducted, not completed, or not submitted to the FDA.

"The testing of new drugs has shifted from a situation in which most testing was conducted prior to initial approval to a situation in which many innovative drugs are more rapidly approved after a small trial in a narrower patient population with extensive additional testing conducted after approval," the authors said.

At the urging of patient groups, Congress and the drug industry, the FDA over the past decade has introduced multiple mechanisms for speeding new products to the market. While patient groups and drug companies applaud these measures, saying they get much-needed medication into the hands of patients more quickly, critics say the agency is approving products before they have been fully vetted.

Of the drugs studied by Moore and Furberg in 2008, the FDA required 85 follow-up trials to monitor for safety. By 2013, only 40 percent of those studies had been completed.

The FDA said in a statement that it will review the article in more detail but that on the surface "it shows that the expedited development programs are working as intended by getting promising new drugs to patients more quickly."

RELAXED EVIDENCE

The FDA has traditionally required two controlled clinical trials to prove that a drug is safe and effective. Over time the agency has relaxed the evidence it is willing to accept for certain products.

In some cases the FDA will accept data from a single trial and success may be judged on the basis of a surrogate measure - such as tumor shrinkage - that may or may not translate into a concrete measure such as increased survival.

"In situations of serious and life-threatening diseases with unmet medical need, patients and physicians who treat them have told us repeatedly that they are willing to accept greater uncertainty about risk in order to have access to the hope of improved treatment today," the FDA said in its statement.

The FDA is discussing additional measures to speed the drug development process, including the use of "enriched" trials that would select patients based on certain demographic or genetic characteristics in order to increase the chance of a trial's success.

The idea is to direct treatment to patients for whom it will be most effective or who are most likely to respond.

But in a commentary published alongside the study, Daniel Carpenter, a professor of government at Harvard University, said the FDA has put few measures in place to ensure that drugs that are approved based on limited populations are only marketed to those limited groups.

"The current system of accelerating drug approval in the United States can be described as a growing hodgepodge of exceptions to the rule of rigorous premarket review," he said.

The FDA said it has a "robust program for postmarketing surveillance and ensuring the completion of required post-approval trials."

"We believe that we have set the bar for the balance between pre-approval testing and early availability of promising new drugs to treat serious and life-threatening diseases in the right place."

(Reporting by Toni Clarke in Washington; editing by Matthew Lewis)

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/healthNews/~3/fK8y_NiwUOo/story01.htm

Men - welcome to a woman's world

Perhaps you are tempted by some red healing crystals, or Ayurvedic medicine, or even the prospect of "Snowballs" cooling underwear (still in development, and based on the theory that the testes need to be kept cool to produce healthy sperm). Or maybe you just want to stock up on one of the vitamin supplements packed full of amino acids and herbs known to thin the blood, in the hope of improving erectile quality.

Of course, the reality for men – as for women – is far less frivolous than my shopping lists suggest.

Male fertility is in decline, as research published last December showed. Between 1989 and 2005, average sperm counts fell by a third in a study of 26,000 men, increasing their risk of infertility, according to researchers from the Institut de Veille Sanitaire in St Maurice. The quantity of healthy sperm produced was also reduced, by a similar proportion.

The findings, published in the journal Human Reproduction, confirmed findings over the past 20 years that shows sperm counts declining across the world. Many reasons, ranging from tight underwear to toxins in the environment, have been advanced to explain the fall, but no definitive cause has been found. The European Commission has even set up a working group, Reprotrain, to tackle the increasing crisis around "Male Reproductive Biology and Andrology".

Some men won't need the new test. They already know, or suspect, they have a problem (it is estimated that problems with sperm account for about a third of known fertility problems) but are probably suffering in silence. Far less attention, after all, is paid to the psychological effect failure to conceive can have on men.

Jo Hemmings, a behavioural psychologist and relationship coach, says: "Perhaps because women are deemed to have a stronger maternal instinct than men's paternal instinct, and gestate, give birth and breast feed, they have received more attention than men. And so men are often seen as having an almost interdependent role – more of a support role to their partner's emotions, than a need to express emotions in their own right."

Men do not have quite the same sort of societal "permission" to express feelings around infertility, she notes. "Yet for many men, there are feelings of inadequacy, low self-esteem, guilt, shame and anger. This can often lead to a withdrawal from communication – and indeed sexual dysfunction – making the problem that much more difficult." Old stereotypes have not done much to help. Men with fertility problems may find it grimly ironic that, until recently, all males were considered fertile until proven otherwise, even in old age. And there were only two realistic ways of altering that: a vasectomy or condoms.

For, just as attention has focused on women's experiences of infertility, so has the medical establishment concentrated on women's control of fertility.

Scientists have been talking about a male contraceptive pill since the early 1980s (with many women sceptical as to whether they would trust a man to take it), but we are still not there.

According to the NHS, research is focusing on combinations of hormones – synthetic testosterone and progestogens – with some in phase III trials, the last stage of clinical trial before a medicine is given a marketing licence. Scientists in Israel are looking into how blood-pressure drugs called calcium channel blockers (such as nifedipine) may alter the metabolism of sperm so that they are not able to fertilise an egg – such a pill could be on offer as early as 2015, researchers suggest. We won't hold our breath.

In the meantime, rising levels of anxiety seem to be doing a better job on suppressing fertility than hormones. Researchers note that the increase in the number of men diagnosed with infertility seems to correlate with increasing anxiety in general. In July, psychiatrists at the University of Cambridge and the University of Hertfordshire reported that more than 8 million people in Britain suffer from anxiety disorders – up from 2.3 million people in a 2007 study.

Of course, infertility makes people anxious, raising the possibility of a vicious cycle. The impact of male infertility is an area "where the man's psychological and physiological reactions should be considered far more seriously than current research would suggest", argues Hemmings.

And yet, silence still surrounds the issue in many quarters. Visitors to the female-dominated Mumsnet website forum discussing conception quickly learn that there is no such thing as TMI (too much information) among women desperately seeking reassurance as they attempt to get a BFP (Big Fat Positive) line on their pregnancy test. But hop over to the Men's Health site forum on "becoming a dad" and users seem more worried about whether their wives will still be attractive after giving birth.

Look, too, to the Hollywood stars who – refreshingly – are admitting to fertility problems more openly than before; they are overwhelmingly female. You won't find many men risking their He-Man reputations. A rare exception is Tom Arnold, the hero of True Lies and ex-husband of Roseanne Barr, who said earlier this year: "I have a very low sperm count. I didn't think fatherhood was in the cards for me, I'll be honest."

Given this backdrop, perhaps SpermCheck will help to get men talking about infertility as openly as women do. Certainly, men and women need to accept when there is a legitimate problem – and not be afraid to ask for support. At the time of the contraceptive pill being introduced, Germaine Greer said: "The management of fertility is one of the most important functions of adulthood." Fifty years on, how we handle infertility is at least as vital.

Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/33058bb6/sc/8/l/0L0Stelegraph0O0Chealth0Cmen0Ishealth0C10A40A93740CMen0Ewelcome0Eto0Ea0Ewomans0Eworld0Bhtml/story01.htm

Swaddling babies 'causes hip problems'

Demand for swaddling clothes, however, rose by 61 per cent in Britain between 2010 and 2011, and in North America nine in ten infants are now swaddled in their first six months after birth.

When the Duke and Duchess of Cambridge presented a swaddled Prince George to the world in August, his Aden + Anais cloth was reported to have sold out within four hours.

The popularity of the technique is thought to be down to its supposed calming effects, with some evidence suggesting it helps induce sleep and prevent excessive crying and colic.

However, some studies suggest that forcing the baby's hips to straighten and shift forward can lead them to them becoming misaligned.

A study in rats found that those which were swaddled from birth were more likely to develop hip dislocation, with the risk increasing the longer they were swaddled for.

Rates of hip dislocation in Japan halved following an educational programme encouraging grandmothers not to swaddle their grandchildren.

In a leading article in the Archives of Disease in Childhood journal Prof Clarke wrote: "'Safe swaddling' with appropriate devices should be promoted because it is recognised that traditional swaddling is a risk factor for DDH.

"In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints. The babies' legs should not be tightly wrapped in extension and pressed together."

DDH is one of the most common congenital disorders and often resolves itself naturally, but swaddling can delay this process, Prof Clarke wrote.

Dr Alastair Sutcliffe, a paediatrician at University College London, said hip dislocation is much more common in far eastern countries where swaddling is commonly used, compared with places where babies are commonly carried with their legs wrapped around the mother's waist, such as Nigeria.

"I would advise that if a baby needs to be wrapped up to get off to sleep that parents do this in a sympathetic and loose manner, and not tight especially around the babies' hips," he said.

Andreas Roposch, a consultant orthopaedic surgeon at Great Ormond Street Hospital, added: "Swaddling should not be employed in my view as there is no health benefit but a risk for adverse consequences of the growing and often immature hips."

Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/33066ea1/sc/14/l/0L0Stelegraph0O0Chealth0Cchildren0Ishealth0C10A40A94790CSwaddling0Ebabies0Ecauses0Ehip0Eproblems0Bhtml/story01.htm

Hawaii begins debate over whether to legalize gay marriage

• Share this
• Email
• Print
• Reprints

Hawaii Governor Neil Abercrombie reads a quote from the Dalai Lama as he gives testimony in support of same sex marriage during a Senate hearing at the Hawaii State Capital in Honolulu October 28, 2013.

Credit: Reuters/Hugh Gentry

By Treena Shapiro

HONOLULU | Mon Oct 28, 2013 10:05pm EDT

HONOLULU (Reuters) - Hawaii started debating on Monday a proposal that would make the popular wedding and honeymoon destination the 15th U.S. state to legalize same-sex marriage, repealing a voter-approved constitutional amendment that banned gay matrimony.

Democratic Governor Neil Abercrombie appeared as the first witness in support of the measure with more than 1,800 people signed up to address the state Senate Judiciary Committee during a special session called by the governor.

The debate this week in Hawaii, which allows civil unions, comes at a time of increasing momentum for gay marriage in the courts, at the ballot box and statehouses across the country.

The governor stressed that the proposal was crafted to address opponents' concerns that legalizing gay marriage would infringe on religious freedom. The proposal exempts clergy and churches from having to perform same-sex marriages.

"Our whole focus has been on trying to accommodate the First Amendment here with respect to people's religious rights, and that's been done in good faith," Abercrombie said.

Hearings in the state House of Representatives are scheduled to open on Thursday.

Democrats hold an overwhelming majority over Republicans in both chambers - 24-1 in the Senate and 44-7 in the House - virtually assuring passage of a gay marriage bill.

GAY RIGHTS GAINING MOMENTUM

The special session was originally expected to last five days, but there is already talk of the legislature taking two weeks to complete its work.

Abercrombie, who served more than two decades in the U.S. House of Representatives before running for governor in 2010, signed a same-sex civil unions bill into law two years ago and has since been a vocal proponent of gay marriage.

His immediate predecessor, Republican Linda Lingle, vetoed a civil unions bill in 2010.

Just one year ago, only six states and the District of Columbia recognized same-sex marriage. That number has more than doubled since then, due in most cases to litigation over the issue.

Maine, Maryland and Washington state became the first three states to extend marriage rights to same-sex couples by popular vote with passage of ballot initiatives last November.

In June, the U.S. Supreme Court forced the federal government to recognize same-sex marriages performed in states where such unions are legal and upheld a lower-court decision throwing out a state ban on gay matrimony in California.

And last week New Jersey Governor Chris Christie dropped his legal opposition to gay marriage, making his state the 14th to legalize same-sex weddings.

The New Mexico Supreme Court is expected to decide by year's end whether same-sex marriage should be recognized statewide rather than county by county, and the Illinois legislature is also considering the issue.

(Reporting by Treena Shapiro; Writing by Steve Gorman; Editing by Dan Whitcomb and Lisa Shumaker)

• Link this
• Share this
• Digg this
• Email
• Reprints

Source : http://feeds.reuters.com/~r/reuters/lifestyle/~3/nklhpVLMvo0/story01.htm