Health Highlights: Oct. 27, 2011

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Food Industry Decides on Safety of Thousands of Ingredients

At least 3,000 food ingredients have been classified as safe by the food industry in recent decades without any U.S. government oversight, a new report says.

The food ingredients determined to be safe by industry trade associations and private companies since the early 1960s range from grape seed extract used in cheese and instant coffee to artificially synthesized chemicals used in chewing gum, the Associated Press reported.

The report, published in the Comprehensive Reviews in Food Science and Food Safety journal, uses research funded by the Pew Health Group, the health and consumer safety division of the nonprofit Pew Charitable Trusts.

"We don't know the names of a lot of these chemicals because the companies have never told FDA or the public about them," Erik Olson, a study author and Pew Health Group's director of food and consumer safety programs, told the AP. "Often there is not publicly available data on the potential health impacts because FDA has never evaluated them."

Food ingredients are classified as safe only after they undergo rigorous testing, according to the Grocery Manufacturers Association. But the group agrees that more transparency in the approval process would help reassure consumers.

The report raises important questions about the public's access to information about ingredient safety, FDA Deputy Commissioner Michael Taylor said.

"Transparency in decision-making is a high priority for FDA, and FDA considers it timely to explore whether the statutory and regulatory framework for food additives adequately addresses today's need for transparency," he told the AP.

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Turkish Pine Nuts Linked to Salmonella Outbreak: CDC

Turkish pine nuts from bulk bins at Wegmans grocery stores have been linked to a salmonella outbreak that's sickened 42 people in six states, the U.S. Centers for Disease Control and Prevention announced Thursday.

The illnesses began on or after August 20 and include 26 people in New York state, 8 in Pennsylvania, 4 in Virginia, 2 in New Jersey, and 1 each in Arizona and Maryland. The patients range in age from less than a year old to 94 years old.

Two people have been hospitalized. No deaths have been reported, the CDC said.

There may be more illnesses that occurred after Sept. 28 and have not yet been reported because it can take 2 to 3 weeks between the time a person becomes ill and when the illness is reported to health officials.

Wegmans Food Markets Inc. is recalling about 5,000 lbs. of Turkish pine nuts sold from bulk bins of most Wegmans stores in New York, Pennsylvania, New Jersey, Virginia and Maryland between July 1 and Oct. 18, 2011.

Consumers should not eat the nuts or any products -- such as baked goods, pesto and salads -- that contain the nuts. Anyone who purchased the nuts should place them in a closed plastic bag and put the bag in a sealed trash can, the CDC advised.

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Birth Control Pills and Having Babies Reduce Ovarian Cancer Risk: Study

Women can significantly reduce their risk of ovarian cancer by using birth control pills and having babies, according to a new study.

Researchers followed about 300,000 European women for an average of nine years and found that women who took the pill for 10 years reduced their risk of ovarian cancer by 45%, ABC News reported.

Women who had used birth control pills at some point in their lives had a 15% reduced risk, according to the study published this week in the British Journal of Cancer.

The researchers also found that having one child reduced ovarian cancer risk by 29% and having more children reduced the risk by an additional 8%, ABC News reported.

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Researchers Examine Gene Makeup of Very Elderly

Researchers conducting whole-genome sequencing of very old, healthy people to learn why they've lived so long say the findings may lead to new medicines that could help others live longer, healthier lives.

Whole-genome sequencing involves deciphering a person's complete collection of DNA, the Associated Press reported.

One effort is the Wellderly Study, which will include thousands of Americans 80 and older with no history of chronic disease.

"Why are these people Teflon-coated? Why don't they get disease?" asked Dr. Eric Topol, head of the Scripps Health of San Diego study, the AP reported.

Another project is called the Archon Genomics X Prize competition, which is offering $10 million in prize money to scientists who complete DNA code from 100 people older than 100.

The competition is just a first step in discovering the genetic secrets of a long and healthy life, according to genome pioneer and contest co-chair J. Craig Venter.

"We need 10,000 genomes, not 100, to start to understand the link between genetics, disease and wellness," he said.

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Copyright � 2011 HealthDay. All rights reserved.

Source: http://www.medicinenet.com/guide.asp?s=rss&a=150981&k=Womens_Health_General

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What We're Reading This Week

health:�blog�

NEWS OCTOBER 17

Katherine Perry and Lindsay Roseman

DIY Pumpkin Puree
Can't get enough pumpkin this fall? Why not make your own puree! Sure, you can buy it in a can, but DIY to cut down on preservatives, salt, and sugar. Via Munchin With Munchkin

Sweets For A Sweetie
Halloween is two short weeks away. Is your sweet tooth already getting warmed up? A new study found that people with a taste for sugary treats have sweeter dispositions and are more likely to lend a helping hand. Via Medical News Today

Barley On Top
Barley just got a lot more exciting. Try a spin on a Italian risotto by swapping the grain for the traditional rice. Add some goat cheese and spinach? Voila...dinner is served.Via Shop.Cook.Make.

Good Partner vs. Hot Sex
If you're wondering why you can't just have it all, your birth control could be the answer. Since the pill smooths out normal hormonal variations, women are more attracted to the nice-guy-with-a-stable-job type, research says. Via MSNBC

It's "Chili" Outside
Ok, so we have a bit of a pumpkin addiction this days. But with this chili how could you not? It's the perfect hearty soup for a crisp fall day. Via Skinnytaste

Marathon Mommy
For some of us, running 26.2 miles sounds plenty daunting ? try doing it while pregnant. This woman went into labor with her second child shortly after crossing the Chicago finish line. Find out what the experts have to say about that. Via Healthland

Tags: headlines

Last Updated: October 18, 2011 - 12:49pm

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Source: http://www.womenshealthmag.com/health/news-october-17

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The Benefits of Meditation

Be beautiful from the inside out! Get advice from eco-experts, discover natural beauty products, organic recipes, and responsibly sourced fashion. Plus, you'll find tons of simple ways to live a little greener.

About Green Goddess Ren�e Loux

Ren�e Loux is infatuated with intersections ? form and function, ecology and economy, entrepreneurship and philanthropy, style and substance. She's secretly a science geek, an admitted natural product junkie, obsessed with food and cooking, and smitten with the smell of static electricity.

A trendsetter in the sustainable food and green-living movement and a maven of natural beauty for more than a dozen years, it's no wonder why she's the green staple of the WH Advisory Board. She?s consulted for some of the leading brands in the natural beauty and eco-fashion sector and sits on the board of Exhale Spas.

As an author, television personality, chef, culinary teacher, restaurateur, and consultant, Ren�e has published four books, including Easy Green Living, The Whole Green Catalog, The Balanced Plate, and Living Cuisine. She is the host of It's Easy Being Green on the Scripps Network, and frequently appears as a green expert on the Today Show, Good Morning America, the Early Show, Extra, Insider Edition, and Fox News.

Visit her at reneeloux.com

Source: http://www.womenshealthmag.com/health/why-to-meditate

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Childbirth finally leaves the Stone Age

Indulge me in a thought experiment. Imagine an experience that affects only men and involves hours of mind-altering pain, blood, gore and brutality. It leaves some of them so shaken that they slip into debilitating depression; it leaves others sitting uncomfortably, prone to haemorrhoids or incontinence ? and even allergic to sex.

Now picture a procedure that does away with all that pain and horror, but comes at an extra �800 cost to the NHS. Do you think that men would pause for a nanosecond before pushing and shoving the Government into making that procedure available to all, on demand, with no ifs or buts? Sit-ins, protest marches, and the threat of strikes would bring the medical authorities to their knees, and the NHS's experts to their senses. Citing everything from their fragile mental health to their vital contribution to the economy, men would get their way.

But childbirth is a woman's matter. The government of the day has to launch consultations, specialists have to conduct studies, and the sands of time must trickle down painfully s-l-o-w-l-y before anyone sees fit to release females from the greatest suffering that most of them will ever endure. NICE (the National Institute for Health and Clinical Excellence) has finally proposed that caesarean births should be available to any woman who wants one on the NHS ? but it's taken them more than 60 years to get around to it.

I don't just blame the NICE men. Natural birth fanatics, midwives, and NHS bean counters have long opposed caesarean sections, deriding those who want it as wimps and scroungers.

Step into an NHS surgery when pregnant and you'll come face to face with placenta-munching Gaia-worshipping thugs determined to make you have a baby "Nature's way". They wax lyrical about contractions that "ebb and flow like the sea" and birthing pools that simulate the womb. I still wince at the memory of being an "elderly primigravida", the flattering term for an expectant mother over 40.

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/19afc9d4/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C88591320CChildbirth0Efinally0Eleaves0Ethe0EStone0EAge0Bhtml/story01.htm

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Obama tackles drug shortages, prices

By Alan Silverleib, CNN

updated 2:33 PM EST, Mon October 31, 2011

STORY HIGHLIGHTS

• Obama order aimed at prescription drug shortages, rising costs
• The FDA will report more possible shortages, speed up regulatory reviews
• The Justice Department will examine possible price gouging
• Obama endorses more comprehensive legislation to deal with the problem

Washington (CNN) -- President Barack Obama signed an executive order Monday designed to help reduce a growing number of prescription drug shortages while protecting patients from possible pharmaceutical industry price gouging.

Among other things, the order requires the Food and Drug Administration to increase its reporting of possible shortages of certain prescription drugs, while also speeding up regulatory reviews of new drug manufacturing sites, drug suppliers and manufacturing changes.

The Justice Department will be tasked with examining whether specific drug shortages are tied to an intentional stockpiling of medications designed to raise prices.

Administration officials are also calling on Congress to pass more comprehensive legislation to boost the FDA's power to address prescription drug shortages. The new steps are part of a highly publicized White House initiative to bolster the economy and help consumers without assistance from a sharply divided Congress.

"The shortage of prescription drugs drives up costs, leaves consumers vulnerable to price gouging and threatens our health and safety," Obama said in a written statement. "This is a problem we can't wait to fix."

Obama administration officials have also sent a letter to drug manufacturers "reminding them of their responsibility to report the discontinuation of certain drugs to the FDA," the statement noted. Drug manufacturers are being encouraged to voluntarily disclose possible prescription drug shortages in instances not currently required by law.

Under current law, pharmaceutical companies are only required to announce a decision to stop the manufacture of certain critical drugs if those drugs are available through a single manufacturer, according to the administration.

The White House is also directing the FDA to increase the total number of staffers dealing with drug shortage issues.

The new executive actions are being taken in response to a growing drug shortfall in the United States. The total number of prescription drug shortages almost tripled from 2005 to 2010, the White House noted.

As the number of shortages has grown, prices have skyrocketed in certain instances.

The White House cited an August Premier health care alliance report estimating that the "typical gray market vendor" jacks up prices by 650% on average.

"At the extreme," the White House statement noted, "a drug used to treat high blood pressure that was normally priced at $25.90 was being sold at $1,200 due to a drug shortage."

Later, White House Press Secretary Jay Carney told reporters the administration will continue to use its executive branch authority to act on a number of fronts without congressional assistance. Democrats have been frustrated by GOP opposition to the president's $447 billion jobs plan, as well as a series of other administration-backed measures.

"One of the reasons why we can't wait is because Congress won't act," Carney said. "As we have said throughout this initiative and in general, the president looks to ways he can use his executive authority to, broadly speaking, help Americans who can be helped through actions that this administration can take."

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/8wXKdtxt31E/index.html

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Do statins cut breast cancer recurrence?

?A daily dose of drugs designed to lower cholesterol could also slash the risk of breast cancer recurring,? the Daily Mail reported today.

The news is based on the findings of a large Danish study that looked for an association between the use of statins and the recurrence of breast cancer. Researchers followed 18,769 women, for an average of 6.8 years, who had previously been diagnosed with invasive breast cancer. Of these, 17% had ever been prescribed statins. Compared to non-users, women who took simvastatin and other ?lipophilic? (fat-soluble) statins were less likely to have breast cancer that reoccurred. Those who took ?hydrophilic? (water-soluble) statins did not have a reduced risk. However, this type of statin was used by only 6% of the statin users, which limits the strength of this finding.

This type of study can only find associations, and further studies would need to confirm that the lower risk of recurrent breast cancer is caused by lipophilic statins. The findings do not mean that taking a statin provides any protection against developing breast cancer in the first place. Without further study, women who have had breast cancer but who have no medical reason to use statins should not be encouraged to take the medication to try to prevent their cancer from coming back.

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Where did the story come from?

The study was carried out by researchers from Brigham and Women?s Hospital, Harvard Medical School and Boston University School of Medicine in the US, and Aarhus University Hospital and Aalborg Hospital, Denmark. It was funded by Klinisk Institute of Aarhus University Hospital, the United States National Cancer Institute at the National Institutes of Health, the Danish Cancer Society, the Karen Elise Jensen Foundation, and the Congressionally Directed Medical Research Programs. The study was published in the peer-reviewed Journal of the National Cancer Institute.

The Daily Mail?s report was mainly accurate.

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What kind of research was this?

This cohort study examined the association between statin use and breast cancer recurrence in a cohort of Danish women diagnosed with invasive breast cancer. Statins are a class of drug that lower cholesterol levels, and are usually prescribed to prevent cardiovascular disease.

The study?s design is appropriate for finding associations between factors. However, it cannot show that one things causes another. The potential use of statins as an additional treatment to help prevent recurrent breast cancer would need to be assessed in a randomised controlled trial.

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What did the research involve?

The researchers enrolled all female residents of Denmark diagnosed with stage I-III invasive breast cancer between 1996 and 2003 (18,769 women). Data on tumour, treatment and patient characteristics were collected. Women were followed for an average (median) of 6.8 years (maximum 10 years) after initial diagnosis, and follow-up examinations were performed every 3-6 months for the first five years after diagnosis and then annually.

Statin use was determined from the national electronic pharmacy database, which recorded filled statin prescriptions. The researchers analysed statin usage on a yearly basis. Women were defined as statin users if they had been prescribed statins at least once that year, and non-users if they had not.

The use of a lipophilic (fat-soluble) statin was defined as exclusive use of simvastatin, lovastatin, fluvastatin or cerivastatin. Lipophilic statins were used by 2,524 women, 92% of whom were prescribed simvastatin. The use of a hydrophilic (water-soluble) statin was defined as exclusive use of atorvastatin, pravastatin or rosuvastatin. Hydrophilic statins were used by 206 women.

The researchers then looked at the association between statin use and recurrent breast cancer, after they had adjusted the data to account for the women?s age and menopausal status at diagnosis, the type of tumour, treatment, hormonal therapy before diagnosis and other medications that the women were taking.

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What were the basic results?

Over the median 6.8 years of follow-up, there were 3,419 breast cancer recurrences in this cohort of 18,769 women.

Of the cohort, 3,282 women were prescribed a statin at some point during the follow-up. The median length of time that the statin was prescribed for was four years.

Over the follow-up period:

• The adjusted recurrence risk of breast cancer among women who did not use statins was 0.302 (3,170 recurrences).
• The adjusted recurrence risk of breast cancer among statin users was 0.207 (249 recurrences).
• The adjusted recurrence risk of breast cancer among women who were exclusively prescribed a lipophilic statin was 0.194 (182 recurrences).
• The adjusted recurrence risk of breast cancer among women who were exclusively prescribed a hydrophilic statin was 0.350 (39 recurrences).
• Lipophilic statin users had a reduced rate of recurrence compared with non-users (10-year adjusted hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.60 to 0.89).
• Users of hydrophilic statins had approximately the same risk of breast cancer recurrence as non-users.
• Compared with non-users of any statin, users of simvastatin (the most commonly prescribed lipophilic statin) had a further reduced risk of recurrence (10-year adjusted HR 0.70, 95% CI 0.57 to 0.86).
• The adjusted 10-year risk difference between women prescribed simvastatin compared with non-users was -0.10 (95% CI -0.11 to -0.08). This means that exclusive simvastatin users had approximately 10 fewer breast cancer recurrences per 100 women after 10 years of follow-up.

To confirm that the association observed was due to simvastatin and was not affected by the medical condition that led to the women taking statins, the researchers compared the risk of recurrence in exclusive simvastatin users and people who received a different class of statins (hydrophilic statins). Again, they found that simvastatin was associated with a reduced risk of breast cancer recurrence (10-year adjusted HR 0.55, 95% CI 0.35 to 0.85).

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How did the researchers interpret the results?

The researchers concluded that ?simvastatin, a highly lipophilic statin, was associated with a reduced risk of breast cancer recurrence among Danish women diagnosed with stage I-III breast carcinoma, whereas no association between hydrophilic statin use and breast cancer recurrence was observed.?

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Conclusion

In this cohort study, use of a lipophilic statin (including simvastatin, the most commonly prescribed of the statins) was associated with a reduced risk of recurrent breast cancer in women with invasive breast cancer.

The researchers also investigated the association between the exclusive use of simvastatin and the risk of recurrent breast cancer, and found that that use of simvastatin reduced the risk of recurrent breast cancer compared to no statin treatment or treatment with a hydrophilic statin. Use of a hydrophilic (water-soluble) statin, including atorvastatin, pravastatin or rosuvastatin, was not found to be associated with reduced risk, though the strength of this association is limited by the small proportion of statin users (only 6%) who used this type of statin. There trial also has numerous limitations, including the fact that it is not known whether the women who were prescribed statins actually took the drugs. Also, the study was not able to adjust for certain potential confounders that may have affected the risk of breast cancer recurrence, such as the women?s body mass index.

This finding is worthy of further study to investigate whether it is the use of lipophilic statins that� directly reduces the risk of recurrent breast cancer. Further investigation into why these types of statins have this effect is also warranted.

On its own, this study can only demonstrate an association and does not provide conclusive evidence that statins reduce the risk of breast cancer recurrence. A randomised controlled trial would be needed to more accurately determine whether taking a statin reduces the risk of recurrence in women previously diagnosed with breast cancer. However, the ethics of using statins in women with no cardiovascular reason for taking them would need to be considered in such a trial.

The current study does not provide any evidence that taking a statin protects against developing breast cancer in the first place. Without further study, women previously diagnosed with breast cancer and who have no cardiovascular risk factors should not be encouraged to start taking statins to try to prevent cancer recurrence.

Links To The Headlines

Daily dose of statins could cut risk of breast cancer by 30%. Daily Mail, October 31 2011

Links To Science

Ahern TP, Pedersen L, Tarp M et al. Statin Prescriptions and Breast Cancer Recurrence Risk: A Danish Nationwide Prospective Cohort Study. Journal of the National Cancer Institute (2011) 103 (19): 1461-1468.

Source: http://www.nhs.uk/news/2011/10October/Pages/statins-lower-breast-cancer-risk.aspx

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Call for action on 'legal high' drugs

Government drug advisers have today called for tighter regulation of ?legal highs? - recreational drugs sold legally due to loopholes in the law. In a new report the Advisory Council on the Misuse of Drugs (ACMD) has published details of how drugs such as ?meow meow? (mephedrone), which was banned last year, have been openly sold over the internet under the guise of being ?plant food? or ?research chemicals?.

The report also highlighted the false perception that just because a drug is technically legal it must be safe, pointing out that there have been at least 42 deaths associated with the use of mephedrone, and dozens more where its use has been suspected.

While the mephedrone family of drugs has now been banned, the ACMD said those manufacturing legal highs are increasingly tweaking the chemical formulas of banned legal highs to bypass bans on specific substances. In response, it suggested that legislation should be used to make it illegal to produce substances with similar effects to banned drugs, rather than just banning specific chemicals as they emerge.

In its report, the ACMD made further recommendations aimed at trying to reduce sales, demand and harms.

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What are legal highs?

Legal highs are drugs that are intended to mimic the effects of illegal drugs but can technically be sold or possessed legally. However, the lack of legal control does not imply that they are safe, and a number of substances sold as legal highs in the past have since been associated with health problems and even death. For example, until it was banned in 2010, the substance mephedrone (also known as meow meow) was legally allowed to be sold when labelled as a research chemical or as a plant food. However, recent data has shown that despite perceptions that it was safe, the drug has contributed to at least 42 recorded deaths. Its use has also been suspected in dozens of further deaths.

While many substances that were once sold as legal highs have since been banned, the ACMD says that chemists are constantly using their knowledge to develop new ?legal highs? that fall outside existing drug legislation. These are often chemically similar to banned substances and produce similar effects, but due to them having different chemical compositions they may not technically be governed by existing laws. Given the new, or novel, nature of legal highs, the ACMD refers to them as Novel Psychoactive Substances (NPS).

The ACMD says legal highs generally fall into four broad categories:

• products with names that give no indication of what they contain
• substances that are designed to be similar to specific controlled drugs
• substances related to medicines
• herbal or fungal materials or their extracts

NPS products cannot be marketed, sold or labelled as being intended for human consumption, which would make them subject to strict pharmaceutical legislation. To circumvent these laws they are often labelled as something else; for example, plant food, bath salts, research chemical or boat cleaner, with disclaimers saying they are ?not for human consumption?.

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What issues did the report consider?

The report considered a number of different factors relating to NPS, their use and measures to tackle them. Among the specific issues examined were:

• legal highs? place in the UK drug scene
• personal harm
• societal impact
• measures to reduce demand
• measures to reduce supply
• current and future legislation
• ways to future-proof drug laws

The ACMD was keen to point out that the report does not provide a solution to the current problem or guidance on specific NPS products, but rather options that may help reduce the harmful impact of legal highs. However, in considering the issue in general, the report described cases studies for mephedrone, which was banned in 2010, and Ivory Wave (also known as Desoxypipradrol or 2-DPMP), an NPS that has not yet been classified as a controlled substance.

In the case of mephedrone the report highlighted how quickly the novel drug rose in popularity, but also that there has been a growing number of adverse incidents reported, and at least 42 deaths where the drug played a significant role. The report also stated that a few months after mephedrone was banned, those manufacturing legal highs started producing a similar (and technically legal) substance called naphyrone, highlighting how quickly existing laws can be circumvented.

Desoxypipradrol, the main active ingredient in Ivory Wave, is not yet a ?controlled substance? (illegal to supply or possess), although its import into this country has been banned. However, testing of Ivory Wave products has shown its chemical contents can vary, and at times it may contain controlled substances. This means that a person who had bought an Ivory Wave product thinking it was legal could still subject to prosecution if they were stopped by the police and found to carrying a controlled substance.

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What are the dangers from using legal highs?

Generally, there is a lack of safety data on the legal highs, which mostly appear to be untested and unregulated compounds. Aside from these obvious risks, the contents of products are often variable and not specified on packaging, meaning people can never be sure exactly what they are taking, even if they have used a product before.

Even though there is limited data available on these substances, there appears to have been an increase in hospital admissions and medical appointments due to the toxicity of legal highs. In addition, health services are starting to see health problems caused by regular use of legal highs, including, dependence that requires detoxification treatment.

Testing has also shown that many NPS are synthetic amphetamine-like stimulants, meaning they are likely to share many of the well-documented adverse effects of amphetamines, such as dependence. It also means that it is possible that the more potent NPS are likely to carry an overdose risk at just a few milligrams, which is likely to be associated with acute toxic effects.

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How popular are legal highs?

The ACMD says that NPS use is such a new phenomenon that it is hard to gauge how popular and readily available these substances are. However, while the council says that robust data on the issue is often unavailable, sources such as the British Crime Survey have recently started collecting data on their use. The council highlights some of the survey?s data on mephedrone for 2010/11, which suggested that:

• 4.4% of people aged 16-24 had used mephedrone in the past 12 months, the same proportion that had used cocaine. (This data related to both the period when mephedrone was considered to be legal high and when it became a controlled substance and was banned).
• Across all adults surveyed (ages 16-59), 1.4% had used mephedrone in the past 12 months, a similar level of usage to ecstasy.

The report also cited a 2011 survey run by the dance music magazine Mixmag, which asked clubbers several question on their use of drugs. Although the survey was aimed specifically at clubbers, 75% of them said it was easy or very easy to obtain mephedrone prior to the ban. Post-ban 38% of respondents said it was easy or very easy to obtain. The same survey, however, said that 42% of respondents had tried the drug pre-ban, but that 61% had tried it post-ban.

The ACMD report noted that British Crime Survey figures suggested that overall drug use is coming down in the UK.

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What recommendations does the council make?

The report made extensive recommendations relating to policy, the law, public health messages and how to close loopholes that mean that drugs are legal until they are specifically deemed controlled substances. Some suggested measures recommend that:

• The UK should develop EU and international networks to address the issue of legal highs.
• Countries involved in the manufacture of the legal highs should be encouraged to stop.
• The UK government should put in place processes that would allow the Misuse of Drugs Act 1971 to be updated quickly and easily when minor changes are required.
• Chemical detection and testing methods need to be developed so that illegal compounds present in legal highs can be easily detected.
• That new legislation should be considered, possibly similar to the Analogue Act 1986 used in the US. This would mean that chemical substances similar to controlled chemicals would automatically be banned, that is, it would be automatically be illegal to create a chemical with similar properties to a banned substance.
• The burden of proof should be placed upon the supplier to establish beyond reasonable doubt that the product being sold is not for human consumption and is safe for its intended use -�in other words,�to prevent it being marketed as bath salts or plant food.
• Specific legislation, namely the Consumer Protection from Unfair Trading Regulation and General Product Safety Regulations (2005), should be applied to the sale of legal highs, and the Advertising Standards Agency should investigate claims made by the websites selling legal highs.
• Research into the chemistry, pharmacology, toxicity and social harm of legal highs should be increased.
• Moves to increase public awareness should be implemented.

Links To The Headlines

Mephedrone users told they are playing Russian roulette. The Independent, October 26 2011

Legal high linked to up to 100 deaths. The Daily Telegraph, October 26 2011

98 deaths fuel calls for legal highs ban. The Sun, October 26 2011

Government advisers call on ministers to launch a war on ?legal highs?. Daily Mirror, October 26 2011

Party drug meow meow kills one young Briton a week. Daily Mail, October 26 2011

'Legal highs' should be automatically banned, says government drugs adviser. The Guardian,� October 26 2011

Legal highs need more controls, say drug council. BBC News, October 26 2011

Links To Science

Advisory Council on the Misuse of Drugs: Consideration of the Novel Psychoactive Substances (?Legal Highs?). October 2011

Source: http://www.nhs.uk/news/2011/10October/Pages/call-to-tackle-legal-highs-like-mephedrone.aspx

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Do fizzy drinks make teens violent?

?Teens who down more than five cans of soft fizzy drinks a week are more likely to be violent or carry a weapon,? reported the Daily Mirror. It said that researchers believe the ?sugar or caffeine content in carbonated, non-diet drinks could be to blame ? although they admit there may also be other factors involved.?

Many newspapers covered this study of 1,878 US�high school students. Researchers surveyed the teenagers on how many non-diet soft drinks they drank and their violent behaviour. Those who drank five or more cans of non-diet soft drinks a week were about 9 to 15% more likely to say they had been violent towards others in the past 30 days, or to have carried a weapon in the past year.

Despite the level of news coverage this study received, the results do not show that fizzy drinks cause violent behaviour. This is because the findings are from a single survey that assessed soft drink consumption and violence at the same time. As such, we cannot be sure which came first and therefore whether one could have contributed to causing the other.

It is important that we put these results into context. The participants may not represent all teenagers. The study was based in schools and so may have not included the manifestly most violent teenagers who may have been excluded from school, or those who had been incarcerated. It also excluded children at private schools.

The violence in this study also ranged from pushing someone to threatening them with a weapon, and no indication is given of how severe the average level of violence was.

The causes of violence are complex and unlikely to be simply due to the consumption of fizzy drinks.

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Where did the story come from?

The study was carried out by researchers from the University of Vermont and Harvard School of Public Health in the US. It was funded by the US Centers for Disease Control and Prevention. The study was published in the peer-reviewed medical journal Injury Prevention.

This story is covered in several newspapers. Though the reports included quotes from experts highlighting some of the limitations to this study, it could have been made clearer that the findings cannot tell us whether soft drinks cause violent behaviour.

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What kind of research was this?

This was a cross-sectional study assessing whether there is a link between soft drink consumption and violence among adolescents in the US. The researchers say some people think that diet, including level of sugar consumption, may be linked to antisocial behaviour. They say� one theory that might explain such an association is that people who consume a lot of sugary drinks may do so because they have low blood sugar levels, which have been linked to irritability and violent behaviour.

This type of study assesses two factors at the same time, and does not tell us which came first. This means that it cannot prove that one factor caused the other.

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What did the research involve?

The researchers surveyed a sample of 1,878 public high school students from Boston in the US. They asked them how often they drank non-diet soft drinks in the past week, and whether they had carried a weapon or engaged in physical violence with a peer group member. They then analysed the results to see if those who drank more sugary drinks were more likely to have engaged in violence.

The survey included students in grades 9-12, who would be aged about 14 to 18 years. Religious and private schools were not included in the survey, nor were schools where students were transitioning back to school following incarceration, or schools for disabled children. Of the eligible schools, 71% participated and about four classrooms were selected at random from each school, with one class sampled for each grade. Of the 2,725 eligible students, 69% participated and filled in the study questionnaire.

Students were asked how many non-diet soft drink cans (12oz or 355ml) they had drunk in the past week (a 20oz [591ml]�bottle was counted as two cans). Based on their answers they were grouped into those who drank up to four cans in the past week and those who drank five or more. The students also answered questions about whether they had been violent towards other adolescents, another child in their family or someone they were dating in the past 30 days. Violence was defined as:

• physical fight
• pushing
• shoving
• slapping
• hitting
• punching
• kicking or choking a person
• attacking or threatening a person with a weapon

They were also asked if they had carried a gun or knife anywhere in the past year.

In their analyses, the researchers compared violent behaviours between those who drank soft drinks more often and those who drank them less often. These analyses took into account factors that were also assessed in the questionnaire and could influence their results, including age, sex, race, body mass index (BMI), typical sleep patterns, tobacco use, alcohol use and having family dinners.

�

What were the basic results?

The researchers found that 29.8% of the participating adolescents reported drinking more than five cans of non-diet soft drinks each week, and 70.2% drank less than this. Adolescents who drank more than five cans a week were more likely to have used tobacco or alcohol in the past 30 days.

Overall, 30.8% reported carrying a gun or knife in the past year. In the last 30 days, 44.4% reported being violent to a peer, 19.5% being violent in a dating relationship, and 31.6% being violent to a child in their family.

Adolescents who drank more than ?ve cans of soft drinks in a week were signi?cantly more likely to:

• have carried a weapon: 40.3% compared with 26.8% who drank four cans or less a week
• have been violent with peers: 56.7% compared with 39.1% who drank four cans or less a week
• have been violent with children in their family: 42.0% compared with 27.2% who drank four cans or less a week
• have been violent with dates: 26.2% compared with 16.2% who drank four cans or less a week.

The link between soft drink consumption and these measures remained even after taking into account factors such as age, sex and race, which could influence results.

The researchers found consumption of high quantities of soft drinks was associated with a 9 to 15% higher likelihood of engaging in violent behaviour or carrying a weapon. The link between high soft drink consumption and violence was similar to the links between violence and tobacco or alcohol use, which were associated with a 6 to 20% higher likelihood of engaging in violent behaviour. The link between high soft drink consumption and carrying a weapon (9% increase) was weaker than the link between tobacco or alcohol use and carrying a weapon (15 to 26% increase).

�

How did the researchers interpret the results?

The researchers conclude that there was a strong link between soft drinks and violence. They say that this 'may be a direct cause-and-effect relationship, perhaps due to the sugar or caffeine content of soft drinks, or there may be other factors, unaccounted for in our analyses, that cause both high soft drink consumption and aggression'.

�

Conclusion

This study has found a link between soft drink consumption and violent behaviour. However, there are a number of limitations to this study that need to be considered when interpreting its findings:

• The main limitation is that it was cross sectional. This means that it cannot establish which factor came first: soft drink consumption or violence, and therefore cannot say whether one might have contributed to the other.
• The study took into account some factors that could be contributing to an association between violence and soft drink consumption, but there may be other factors having an effect. For example, it did not take into account the adolescents? socioeconomic status, which seems likely to be contributing to this relationship.
• The study had to rely on the teenagers? reports of their own soft drink consumption and violent behaviour, and there may be some inaccuracies, particularly with regard to violent behaviour.
• The violence assessed in the study ranged from pushing someone to threatening them with a weapon. This is a wide range and the study does not split this into different levels of violence, meaning that we do not know how severe this violence was.
• The study included adolescents who were attending public school in the US and willing to complete a questionnaire. These teenagers may not be representative of all teenagers. In particular, the most violent teenagers are likely to have been excluded from school or to have been in correctional facilities. The study also excluded children attending private school who are likely to have different socioeconomic profile.

Explanations for links found in research might not always be causal. The researchers mention that low blood sugar may plausibly be linked to both aggressive behaviour and consumption of sugary drinks. This study raises questions about such unmeasured variables rather than providing answers.

The causes of violence are complex, and unlikely to be simply due to the consumption of fizzy drinks.

Links To The Headlines

Fizzy drinks make kids violent claims study.�Daily Mirror, October 25 2011

Fizzy drinks may lead to teenage violence.�The Independent, October 25 2011

Two fizzy drinks a week can turn teens into thugs.�Daily Express, October 25 2011

Just one can of fizzy drink a day will make teenagers behave more aggressively.�Daily Mail, October 25 2011

Fizzy drinks make teenagers violent.�The Daily Telegraph, October 25 2011

�

Links To Science

Solnick SJ, Hemenway D.�The ?Twinkie Defense?: the relationship between carbonated non-diet soft drinks and violence perpetration among Boston high school students. Injury Prevention 2011, Published online first, October 24

Source: http://www.nhs.uk/news/2011/10October/Pages/fizzy-drinks-teenage-violence.aspx

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5,000 pounds of pine nuts recalled

By the CNN Wire Staff

updated 5:28 PM EST, Sun October 30, 2011

The pine nuts were ingredients in several prepared foods sold at Wegmans.

STORY HIGHLIGHTS

• The pine nuts may be contaminated with Salmonella Enteritidis
• 43 cases of salmonellosis have been reported in six states
• The bacteria can cause fever, diarrhea and abdominal cramps

(CNN) -- The Wegmans supermarket chain is recalling 5,000 pounds of Turkish pine nuts because of possible salmonella contamination, the U.S. Food and Drug Administration said.

At least 43 cases of salmonellosis in California, Maryland, New York, Pennsylvania, New Jersey and Virginia are linked to the pine nuts, the FDA said Friday, citing the Centers for Disease Control. The agency warned consumers not to eat the nuts, offered for sale in unlabeled plastic bulk containers at Wegmans stories, or any food items, such as pesto or salads, that have been made using them.

The pine nuts were ingredients in several prepared foods sold at Wegmans, including Caprese salad and asparagus with pine nuts, the agency said.

The pine nuts may be contaminated with Salmonella Enteritidis, which may cause illness. They were sold in New York, Pennsylvania, New Jersey, Virginia and Maryland, the FDA said.

The salmonella bacteria can cause diarrhea, fever and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, the FDA said. While most people recover without treatment, infection may lead to hospitalization and can be fatal. The bacteria is most dangerous to older adults, infants and those with compromised immune systems, the FDA said.

Consumers are urged to check their homes for the nuts purchased at Wegmans stores between July 1 and October 18, and either throw them away or return them to Wegmans for a refund, the FDA said.

Wegmans said the pine nuts were imported from Turkey and distributed by Sunrise Commodities.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/JcUl2OIeGIc/index.html

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Viewing TV Coverage Of Terrorism Has More Negative Effect On Women

Main Category: Anxiety / Stress
Also Included In: Bio-terrorism / Terrorism;��Women's Health / Gynecology;��Psychology / Psychiatry
Article Date: 31 Oct 2011 - 0:00 PDT email to a friend � printer friendly � opinions �

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Exposure to television coverage of terrorism causes women to lose psychological resources much more than men, which leads to negative feelings and moodiness. This has been shown in a new study, conducted at the University of Haifa and soon to be published in Anxiety, Stress & Coping, that examined the differences between men and women in a controlled experiment environment.

An earlier study conducted by Prof. Moshe Zeidner of the Department of Counseling and Human Development at the University of Haifa and Prof. Hasida Ben-Zur of the University of Haifa's School of Social Work, has shown that viewing television coverage of terrorism causes viewers to lose psychological resources, such the sense of significance or success, and causes a feeling of being threatened. The current study set out to examine whether there are differences between men and women in the levels of psychological resource loss.

According to the authors of the new study, earlier research dealing with gender differences in the effects of traumatic events examined data based on questionnaires relating to past experiences. The present study is now taking a new step as it is examining these differences in a controlled experiment environment in which all of the participants are exposed to the same events and report on their feelings immediately following the events.

In order to create such a controlled environment, men and women were shown news video clips reporting on terrorist attacks that took place over the past few years and which resulted in serious casualties. In parallel, two other groups of men and women were shown news coverage of "regular", everyday news events.

The results of this study show that the women who viewed terrorism coverage testified to higher levels of feeling threatened and lower levels of psychological resources compared to the men who viewed the same news reports. These gender differences were not found amongst the control groups. The study has also found that the feeling of being threatened and loss of resources has an effect on the senses and lead to a higher level of negativity, such as hostility and moodiness.

"It is possible that the differences between men and women are founded in gender socialization, 'teaching' women to respond to terrorism with more anxiety than men," said Prof. Moshe Zeidner.

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Source: http://www.medicalnewstoday.com/releases/236745.php

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Culinary experts explain how they keep fit

How do foodies ? the chefs, restaurateurs and cookery writers of today ? stay in shape? It?s hard enough for most of us to resist an extra chocolate biscuit or slice of cake on a cold winter?s day, so surely it can?t be possible to hold back when indulgence is all around you?

Thankfully, eating well and healthily does not mean abandoning our favourite foods. Our top British epicureans reveal their healthy habits and guilty pleasures.

HENRY DIMBLEBY FOUNDER OF THE LEON RESTAURANT CHAIN

?For me, keeping in shape is all about clarity of mind rather than firmness of body. I cycle everywhere. You?re forced not to answer your phone and to take in everything around you. It?s a stress reliever as well as being good exercise.

Source: http://telegraph.feedsportal.com/c/32726/f/569020/s/199187ba/l/0L0Stelegraph0O0Cfoodanddrink0C88484270CCulinary0Eexperts0Eexplain0Ehow0Ethey0Ekeep0Efit0Bhtml/story01.htm

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Labour induction methods compared

According to the Daily Mail, a method of inducing labour that dates back to the 1930s ?has been found to work as well as modern treatments but with fewer side effects?.

The news is based on a large Dutch trial that examined�inducing labour using of a simple mechanical device, called a Foley catheter. Researchers tested the device against the use of hormone gels designed to trigger contractions. The study, which featured 824 women, found that both techniques led to similar rates of spontaneous vaginal deliveries, instrumental deliveries (such as using forceps) and women requiring a caesarean section.

The Foley catheter also seemed to lead to fewer side effects in the women and their babies, although using the method of induction in the first 24 hours led to longer labours. It is unclear which method women would prefer to be offered, as patient satisfaction was not assessed in this study.

Current guidelines from the National Institute for Health and Clinical Excellence (NICE) recommend the use of hormone gels for induction of labour, but not the routine use of mechanical devices for induction. This is because there was limited evidence for their use when the guidelines were written. This new, relatively large trial has shown no important differences between the two methods used in these women. It is possible that the mechanical technique might find a place for women where there may be risks from using hormone gel. The safety and effectiveness of the technique could be reassessed in the light of this new evidence to see whether the guidelines should be amended.

�

Where did the story come from?

The study was carried out by researchers from various hospitals in the Netherlands and received no external funding. The study was published in the�peer-reviewed medical journal The Lancet.

The Daily Mail covered this research well.

�

What kind of research was this?

The researchers say that a high proportion of induced labours are performed because a woman?s cervix is not ready for the birth and does not open appropriately.

This�randomised controlled trial compared two methods for inducing birth in women who had single babies and a reason to be induced. The women were either induced using mechanical means (a Foley catheter) or with application of a hormone gel into the vagina. A Foley catheter is a mechanical device that helps open the cervix. A fluid-filled balloon is inflated in the cervix, which stretches it until it is at an appropriate size to allow birth. The prostaglandin hormone gel mimics the natural mechanism by which a woman?s hormones cause the cervix to open.

The researchers say that hormonal induction has become the method of choice in several countries, but that use of the Foley catheter may result in similar numbers of successful inductions without the need for a caesarean section. They also say that the Foley catheter induction may have several advantages over hormone methods, such as not causing ?over-stimulation? of the birthing processes (when hormones cause contractions to be too frequent or too long).

The researchers compared the two methods. They were particularly interested in the rates of caesarean section, but also looked at foetal distress during induction and bleeding after birth.

�

What did the research involve?

The trial was carried out in twelve hospitals in the Netherlands. The study included 824 women who were over 37 weeks pregnant without twins, who had an ?unfavourable cervix?, whose baby was positioned head down and whose waters had not broken. The study did not include women who had already had a caesarean section or who had a condition called placenta praevia, where the placenta is positioned so that it grows over the cervix. Women whose baby had a developmental abnormality or a known hypersensitivity to either method were also excluded.

The women were randomly allocated to either the Foley catheter or the hormone gel groups. They were induced using these methods and, when the cervix was open sufficiently, their waters were broken. In both groups, if the cervix was still unfavourable after 48 hours, the women were assigned a day of rest followed by another 48 hours of induction. If after these five days the cervix was still unfavourable, induction was defined as having failed. Further management was decided on by the obstetrician looking after the women.

The main outcome that the researchers looked at was the rate of caesarean sections. Other outcomes included resorting to instrumental vaginal delivery (for example using forceps), reasons for operative delivery, and time from induction to delivery. The researchers also assessed whether the uterus had been overstimulated, defined as when the women experienced more than 6 contractions within 10 minutes for more than two 10-minute periods, or when they had a contraction lasting more than 3 minutes where the baby?s heart rate changed. Researchers also looked at rates of damage to the uterus, the use of painkillers and antibiotics, infection and whether the women had a haemorrhage in the 24 hours after delivery. Finally, they assessed the health of the baby and recorded any cases where the baby had picked up an infection.

�

What were the basic results?

The researchers found that the caesarean section rates were much the same between the two groups: 23% of women who had been induced using a Foley catheter required a caesarean section compared to 20% of the women induced using the hormone gel (relative risk [RR] 1.13, 95%�confidence interval [CI] 0.87 to 1.47). Likewise, a similar number of women in each group needed extra mechanical help with the birth, such as the use of forceps (11% in the Foley catheter group and 13% in the hormone gel group).

A greater number of women induced with the Foley catheter required a caesarean because they failed to progress in the first stage of birth (12%) than the hormone gel group (8%) (RR 1.63, 95% CI 1.07 to 2.50). The first stage of labour is when contractions cause the neck of the uterus to open. Similar proportions of each group had a caesarean section because their baby was becoming distressed (7% in the Foley catheter group compared to 9% in the hormone gel group).

A similar number of women in each group had assisted deliveries because their babies were distressed. Fewer women in the prostaglandin hormone group (59%) needed an additional hormone called oxytocin to stimulate uterus contractions than in the Foley catheter group (86%). The time from the start of induction to birth was on average 29 hours (range 15-35 hours) in the Foley catheter group and 18 hours (range 12-33 hours) in the hormone gel group.

The groups did not differ in terms of painkillers taken, haemorrhage, overstimulation or health status of the baby. Fewer babies delivered with the Foley catheter (12%) needed to be admitted to the general ward (not an intensive care ward) than those induced using hormones (20%). More women treated with the hormone gel (3%) had suspected infections during birth compared to those induced with Foley catheter (1%).

Overall, there was no difference in the number of adverse events in each group.

�

How did the researchers interpret the results?

The researchers said similar rates of vaginal delivery and caesarean section occurred when using the Foley catheter and the hormone gel for induction of labour in women who needed it. However, use of the Foley catheter led to fewer maternal and newborn side effects. They say that health professionals should consider a Foley catheter for induction of labour in women with an unfavourable cervix at full term of pregnancy.

�

Conclusion

This large randomised controlled trial showed no difference in caesarean or vaginal delivery rates after women were induced with either a Foley catheter or hormone gel. The Foley catheter seemed to be associated with fewer maternal and newborn side effects, although not all these associations were statistically significant. The researchers point out that one benefit of the method is that it reduces the need to monitor contractions as closely as with hormonal induction, which carries the risk of overstimulation. They also say that because of the low cost and easy storage of the Foley catheter, its use could be suitable in developing countries.

However, labour lasted longer after induction with the Foley catheter and it is unclear whether this would affect women?s preference for either induction method. The researchers said that a limitation of the study was that they did not assess their patients? satisfaction with the treatments.� Another limitation is that the study did not assess whether this longer birth period would be more costly or use up more staff time. These unexplored factors could be important in deciding which method is more appropriate for a particular birth. Since the treatments appear equally effective, further research into these important areas�might help clinicians choose between the two methods.

In the UK, NICE recommends that women with uncomplicated pregnancies should usually be offered induction of labour between 41 and 42 weeks of pregnancy to avoid the risks of prolonged pregnancy. There are other reasons to induce labour and the exact timing should take into account the woman?s preferences and local circumstances. NICE recommends the use of vaginal hormone gels and a pessary, but not the routine use of mechanical procedures. When the NICE guidelines were written (2008), they suggested that there should be further research into the use of mechanical methods in situations where hormone methods carried risks. The guidelines state that there had been a large number of studies, but that these were small and had used different methods, so they did not provide suitable evidence to support the recommendation of mechanical procedures.

This relatively large trial contributes to the available evidence, and is likely to be considered when labour induction guidelines are reviewed in the future.

Links To The Headlines

Bringing on birth the 30s way 'is safer': Trial finds fewer side effects than with modern practices. Daily Mail, October 25 2011

Links To Science

Jozwiak M, Oude Rengerink K, Benthem M et al. Foley catheter versus vaginal prostaglandin E2 gel for induction of labour at term (PROBAAT trial): an open-label, randomised controlled trial. The Lancet, 25 October 2011 (early online publication)

Source: http://www.nhs.uk/news/2011/10October/Pages/foley-catheter-vs-prostaglandin-induced-labour.aspx

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Do real men do yoga?

Are you one of the tens of thousands in the UK who have discovered the wonders of yoga? No, me neither. I don?t know my asana from my elbow ? but lately it seems as though everybody else does. Even footballers: Ryan Giggs was so pleased that downward dogging helped him become one of the oldest players in the Premiership, he released a ?yoga for men? DVD.

Leading sportsmen, from Andy Murray and Evander Holyfield to the entire New Zealand All Blacks, rave about how yoga tones muscle, improves flexibility and increases endurance. According to the current issue of Men?s Health, one pose in particular ? vipareeta karani, or the legs-up-a-wall shoulder stand to those who don?t speak Sanskrit ? can even halt hair loss. And yet despite all the chatter, it still seems irredeemably? girlie.

Not any more. James Muthana, founder of YogaAt.com, which offers tailored sessions in the workplace, says that the gender balance of his classes has recently reversed. Men now regularly outnumber the women.

?Yoga is no longer the preserve of the hippy-dippy stereotype. The men we teach fit a common profile: they?re between 30 and 40, work in the City, and do two or three sessions a week to maintain peak condition for their main sport, be it rugby, football, running or triathlons.

?They?ve realised that yoga is great for keeping trim, sculpting the abs, as well as providing that calm but focused mental attitude that?s useful at work and play. They see yoga as part of their general conditioning.?

Source: http://telegraph.feedsportal.com/c/32726/f/569020/s/19985db6/l/0L0Stelegraph0O0Chealth0Cdietandfitness0C88486830CDo0Ereal0Emen0Edo0Eyoga0Bhtml/story01.htm

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When the tests get it wrong

Kathleen Maxian says her cancer could have been prevented, and now she's angry.

STORY HIGHLIGHTS

• Myriad Genetics owns the patent on breast cancer genes
• Myriad offers one test that catches most abnormalities, then charges $700 for second
• Company defends BART test, based on separate technology

(CNN) -- Imagine going in for a cancer screening, and the technician turns to you and says, "We're finished, but if I push this button over here, the machine can detect even smaller cancers. But here's the hitch: You have to pay $700 if you want me to push this button."

"You'd be enraged," says Ellen Matloff, director of cancer genetic counseling at Yale University Cancer Center. "You'd want to know why you have to pay extra to push that button. Why didn't they just do it right the first time?"

Doctors and genetic counselors interviewed by CNN say that Myriad Genetics in Utah is doing something very similar with tests that determine if a woman has a potentially dangerous genetic abnormality linked to breast cancers.

Most breast cancers do not seem to be genetic. Instead, they're the result of cells gone wild for no apparent reason. However, some women get breast cancer because a bad gene runs in their families. When testing shows that a woman carries such a gene, she has a much higher chance of getting breast cancer. These women usually then get more frequent MRIs, ultrasounds and mammograms to detect a cancer, and sometimes even choose to remove their breasts to prevent a cancer from growing in the first place.

Myriad owns the patent on breast cancer genes and so is the only company that can test for them. It offers one test that catches most, but not all, abnormalities, and then charges nearly all patients $700 for a second test that catches the rest.

If a woman can't afford the $700 fee, she may miss an abnormality, which could mean the difference between life and death.

"What Myriad's doing -- charging extra for this test -- is really sleazy," Matloff says. "They're collecting blood money off my patients."

Myriad defends the $700 charge for its second test, called BART, even though many patients can't afford it and insurance won't pay for it.

"The BART test is based on different and separate technology," Rebecca Chambers, a Myriad spokeswoman, wrote in an e-mail to CNN. "[It's] based on a sophisticated new technology developed exclusively by Myriad."

She added that Myriad is trying to persuade insurance companies to pay for the test and that it offers financial assistance to patients who meet certain criteria, and monthly interest-free payments to those why do owe the $700 fee.

"Myriad's mission is to improve the patient's quality of life and to save lives," she added in the e-mail.

Understanding the furor

To understand the anger and bitterness that patients, doctors and genetic counselors harbor toward Myriad, it's important to know the basics of genetic testing.

In 1996, Myriad offered its first test for breast cancer genetic abnormalities. Known as the BRCA test, it's been revolutionary and has saved countless lives: If the test reveals that a woman has a genetic abnormality, it means she has a very high chance of getting breast cancer in the future, and some women then opt to remove their breasts as a pre-emptive strike against cancer.

Women who test positive for BRCA also sometimes opt to have their ovaries removed, since having a breast cancer gene abnormality gives them a higher-than-normal chance of getting ovarian cancer as well.

"Genetic testing has been a godsend for so many women," Matloff says.

Myriad calls its test the Comprehensive BRACAnalysis, but it soon became clear that it wasn't truly comprehensive. It did not catch all genetic abnormalities linked to cancer, and so in 2006, the company began selling BART, the newer test that catches genetic defects that the original test misses. Doctors and counselors expected Myriad to offer BART as part of its original test, but instead the company offers it separately and charges nearly everyone $700 to take it.

"This is so irresponsible of Myriad," says Molly Klein, director of genetic counseling at Piedmont Hospital in Atlanta.

She and other genetic counselors have been fighting to get Myriad to stop the $700 charge. They say they worry that women who tested negative under the first test feel assured that they don't have a bad gene when in fact they might, and wouldn't know they're at increased risk for getting breast cancer.

Klein and other genetic counselors say that when Myriad came up with an improvement in its colon cancer test, it wrapped it into its original screening at one price. The counselors say they think Myriad handled the breast cancer test differently, charging a separate fee, because it has no competition.

"From a business perspective, I guess I understand why Myriad is doing what they're doing, because this is a good chunk of money for them," says Kristen Shannon, the senior genetic counselor at the Massachusetts General Hospital Cancer Center. "But I feel really strongly that Myriad is doing the wrong thing."

"That accusation is incorrect," Chambers wrote in an e-mail to CNN.

"I'm so angry"

For Eileen Kelly and Kathleen Maxian, money wasn't the issue.

The two sisters were stunned three years ago when Kelly was diagnosed with breast cancer at age 40. They breathed a sigh of relief when Kelly tested negative for the BRCA gene using Myriad's original test. This meant Kelly's cancer was a fluke, and not something her sister or other relatives needed to worry about.

Then two years later, at the age of 47, Maxian found out she had ovarian cancer. Surgeons removed her ovaries and found the cancer had spread to her abdomen. After chemotherapy, the cancer came back a year later.

"I told my surgeon my sister had genetic testing, but it came back negative," Maxian says. "My surgeon just hung her head down and shook it back and forth. I was like, 'What? How weird is that?' "

The surgeon told Maxian that her sister's test might have been incomplete. She instructed Maxian to ask her sister, who lives in Atlanta, to find out if she'd received the second test, BART, in addition to the original breast cancer genetic test.

Kelly found out she had not had not received BART. She went back to Piedmont Hospital to have it done, and the test was positive. Maxian and her father then had BART, and it turns out that they, too, carry a genetic abnormality.

Women who have genetic abnormalities like Maxian's have a 50% to 85% chance of getting breast cancer, and a 10% to 40% chance of getting ovarian cancer. She says that if her sister had had BART from the beginning, she also would have taken the test, and the positive result would have made her remove her breasts and ovaries "in a minute."

"If BART had been done from the beginning, it could have saved Kathleen from getting ovarian cancer," says Dr. Nefertiti duPont, Maxian's surgeon at the Roswell Park Cancer Institute in Buffalo, New York.

"It could have prevented my cancer, or at least caught it early," Maxian adds. "Now my cancer is so advanced, I have only a 20% chance of being alive five years from now. I'm so angry."

Klein, the genetic counselor at Piedmont Hospital, says she never mentioned BART to Kelly, nor to most of the women who came in for testing at that time. She says information from Myriad led her to believe that BART mutations were extremely rare among women like Kelly without an extremely strong family history of breast or ovarian cancer. When some women do have a very strong family history, Myriad will do a BART analysis for free as part of its original test, and has spent $20 million on these tests.

"We were left with the impression that BART wasn't necessary for families like Eileen's," Klein says. "It just didn't seem urgent."

But over time, it's become clear that Myriad might have been wrong about who needs BART testing, counselors say. Several studies, such as one done by Shannon at the Massachusetts General Hospital Cancer Center, show that a substantial number of women had BART mutations even without a very strong family history. Now, Klein and others offer BART to all their patients, but many can't do it because of the cost.

"This is all really frustrating," Klein says. "We know we're missing women out there with BART mutations because they can't afford to pay. If you miss just one BART mutation, that woman could be in danger, and so could her mother, her sisters and her other relatives."

"It's heartbreaking," says Mollie Hutton, Maxian's genetic counselor at the Roswell Park Cancer Institute. "It's so sad that now Kathleen is fighting for her life when something could have been done to avoid it. It's just crappy."

Chambers, the Myriad spokeswoman, says studies show "less than one percent of all women tested" have a BART mutation.

What to do when you get breast cancer genetic testing

If you're about to get breast cancer genetic testing, specifically ask if you'll receive BART testing.

If you've had breast cancer genetic testing, don't assume you received the BART test.

Also, don't assume that the place where you had the testing will get back in touch with you to let you know about BART. CNN contacted four genetic testing centers, each of which did something different: One center quickly contacted all patients to tell them about BART; another contacted only patients they considered high risk; the third contacted patients three years after BART became available; and the fourth still hasn't contacted patients to tell them about BART.

Genetic counselors recommend that you call the place where you had testing every year or so to see if there have been any improvements in the test.

Most women will have to decide whether they want to spend $700 to get BART testing.

Eileen Kelly wishes she'd had the opportunity to spend that money.

"I'm so mad at Myriad. It's even hard just to talk about it," Kelly says, starting to cry. "A test could have put the information in our hands that could have prevented my sister's cancer. It's frustrating and really hard to comprehend."

Aaron Cooper contributed to this report.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/H_D8jfsBF54/index.html

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Breast screening programme to be reviewed

Many news sources have reported that a ?major review? of the NHS breast screening programme is to take place. BBC News said ?the evidence for breast cancer screening in the UK is being reviewed amid controversy about the measure's effectiveness?.

The news of the review comes from Professor Sir Mike Richards, national cancer director at the Department of Health, who discusses it in an open letter in the British Medical Journal. It follows criticism of the current screening programme by some doctors who believe that by throwing up some false results, screening may be doing more harm than good.

The majority of specialists in the field are thought to support the current breast screening programme. However, Richards said: "Should the independent review conclude that the balance of harms outweighs the benefits of breast screening, I will have no hesitation in referring the findings to the UK National Screening Committee and then ministers.?

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What has prompted this review?

Professor Richards announced the review in response to debate among scientists over the effectiveness of breast screening. For example, a recent Cochrane Collaboration review of breast screening concluded that ?it was not clear whether screening does more good than harm?.

The three highest-quality studies covered by the review showed that screening did not significantly reduce death from breast cancer after 13 years in comparison to women who weren?t screened. However, lower-quality studies showed a significant reduction in breast cancer death in those who were screened.

When the high- and lower-quality studies were combined, the overall effect showed screening did reduce the relative risk of breast cancer death by 13-26%. The authors highlighted that the lower-quality studies may be biased to favour screening, and estimated the true relative reduction in death from breast cancer due to screening to be in the region of 15%.

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What are the pros and cons of breast screening?

There has always been debate about the pros and cons of screening, revolving around the complex balance of its benefits and harms.

The benefit of screening is in finding breast cancer at an early stage when there is a good chance of successful treatment and full recovery. The drawback, however, is that screening will also result in some women being over-diagnosed ? receiving a diagnosis of cancer that would not have led to death or sickness. Currently, it is not possible to tell who these women are, and they are therefore likely to have breasts or lumps removed and to receive unnecessary radiotherapy. The investigations, such as a biopsy, needed to reach a firm diagnosis can also cause harm.

Different research studies and reviews have produced different figures for the relative number of women who benefit from screening versus those potentially harmed by it. Hence, it is difficult to establish exactly how accurate the current screening programme is.

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What is the breast screening programme?

The NHS Breast Screening Programme screens around 1.6million women a year. Women aged 50 to 70 years of age, who are registered with a GP, are automatically invited for screening every three years. In 2012, an extension to the programme is being introduced by conducting a large trial where women aged 47-73 will be invited to take part in the study.

Screening takes place at a special clinic or mobile breast screening unit where a mammogram (X-ray of the breast) is taken by a female health professional. This is then studied to look for any abnormalities. The aim is to find breast cancer at an early stage, when any changes in the breast would be too small to feel and when there is a good chance of successful treatment and full recovery.

The main treatments for breast cancer are surgery (removing a lump or the entire breast), radiotherapy, chemotherapy, hormone therapy and biological therapy. Patients may have one of these treatments or a combination.

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How will the review be carried out?

The independent review will be led by Professor Richards and Harpal Kumar, chief executive at Cancer Research UK. Professor Richards says they are seeking independent advisers for the review who have never previously published on the topic of breast cancer screening. The letter did not give any indication of how long the review might take.

Links To The Headlines

Breast cancer screening under review.�BBC News, October 27 2011

Fears that breast screening 'does more harm than good' prompts major NHS review.�Daily Mail, October 27 2011

Breast screening is no longer a no-brainer.�The Guardian, October 27 2011

Breast screening review will give women 'more accurate information'.�The Daily Telegraph, October 27 2011

Links To Science

Bewley S. The NHS breast screening programme needs independent review. BMJ 2011; 343:d6894

Richards M. An independent review is under way. BMJ 2011; 343:d6843

Source: http://www.nhs.uk/news/2011/10October/Pages/breast-screening-programme-review.aspx

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