Monday, March 31, 2008

Nature at its best?

Having made linked to so many of their programs and news items, it seems only fair that we give the BBC a plug.


Wired Magazine’s
(16.04) April Play List recommending the BBC Natural History Collection asks

Love nature but hate the outdoors? BBC has a solution: a set of DVDs — 45 hours of nature docs. With Planet Earth (Best. Nature show. Ever.), The Blue Planet: Seas of Life, The Life of Mammals, and The Life of Birds, you can watch the daily struggles of nearly every animal on Earth.


Link to BBC America’s on line shop


Link to Wired’s Play List



DSM More?

The New Scientist (March 29 – April 4, 2008) in

Internet addiction is a psychiatric disorder

If you regularly fall into bed bleary-eyed after a night of online gaming, you may be suffering from a psychiatric disorder.

In the American Journal of Psychiatry, psychiatrist Jerald Block of Portland, Oregon, argues that internet addiction should be included in the next version of DSM, the US handbook of recognized psychiatric conditions, which is currently being drawn up. The condition is characterized by excessive use of the internet, anger or depression if computer access is lost, poor achievement and social isolation.

In South Korea, where the average high-schooler spends over 20 hours a week gaming, the government is well aware of the problem and has trained 1000 counselors to help the 200,000 children believed to be affected.

reference

Editorial: Issues for DSM-V: Internet Addiction
Jerald J. Block, MD
American Journal of Psychiatry 165:306-307, March 2008
doi: 10.1176/appi.ajp.2007.07101556

Link to Am. J. Psych. editorial

Link to New Scientist report

You thought of what? Where?

Wired Magazine:( April Issue 16.04) includes a Photo Essay by Mathew Honan

Unlikely Places Where
Wired
Pioneers Had Their

Eureka
!
Moments


Link to Wired Magazine Photo Essay

Sunday, March 30, 2008

Spitting Image




More Images


Recognizing that we live in a visual age
– an age of images – iconic, instant and influential,
John Barrow in his new book
Cosmic Imagery: Key Images in the History of Science

traces their history and influence
to tell the story of modern science.





Copernicus's diagram of the solar system


Sketch of the double helix early 1953.

The Möbius strip

The New Scientist reviewed the book (March 22-28, 2008 issue) with links to some of the images covered.

Link to New Scientist review

Cosmic Imagery: Key images in the history of science

John D. Barrow

Bodley Head

ISBN 9780224075237

[Not yet readily available in US outlets]

John David Barrow FRS (born London November 29, 1952,) is an English cosmologist, theoretical physicist, and mathematician. He is currently Research Professor of Mathematical Sciences at the University of Cambridge. Barrow is also a writer of popular science and an amateur playwright.

Link to Prof. Barrow’s Cambridge site

Images

Whoever controls images has great social influence.
Did the camera damage the church's popularity?

David Hockney explored this in The Guardian (March 27, 2008) in

Pictures and power

Michael Curtis, one of the founders of Hollywood and director of Casablanca and many swashbuckling Erroll Flynn movies, tells a story about seeing his first bit of cinema in about 1908, in the Cafe New York in Budapest. He recalls what fascinated him: it wasn't the film itself but the fact that everybody watched it. He realised not everyone goes to the theatre, not everyone goes to the opera, but the cinema will attract the masses. By 1920 he was in Hollywood - which was the Budapest - but California had the money, the light, and the technology. He was right.

Now let's go back 350 years, to Neopolitan scholar Giambattista Della Porta, who published a book, Natural Magick, about optical projections of nature. He was a renaissance man: scientist, playwright and showman. He put on shows using optical projections (simple to do) and was hauled before the Inquisition by the church.

The church at that time was the sole purveyor of pictures. It knew the power of images, and Della Porta would have noticed, like Michael Curtis, how people were attracted to that optical projection. They still are.

The church had social control. Whoever controlled the images had power. And they still do. Social control followed the lens and mirror for most of the 20th century. What's now known as the media exert social control, not the church, but we are moving into a new era, because the making and distribution of images is changing. Anyone can make and distribute images on a mobile phone. The equipment is everywhere

We do not have debates about images. The world of art is separate from the world of images, but the power is with images, not art. An obvious problem is seen. The world of images claims a relationship to visual reality - television and cinema - but this claim cannot now be sustained. We will get more confused if we don't think about them

For instance, the NHS published an image of a boy (it could have been a girl) with a fish hook in his mouth. "Don't get hooked," it said, for the anti-smoking campaign. There were protests at the disturbing image, which had been seen on television and bus stops. It had to be withdrawn

The image looked like a photograph, and by that I mean the idea that an event took place in front of a camera at a particular time and place. If this had been true, the photographer should have been prosecuted - depicting cruelty to another human being is against the law in Britain under the Obscene Publications Act, obviously meaning there is a difference between painting and photography because paintings of the crucifixion are "allowed"

No one was prosecuted. Why? Because no one believed the event actually happened. It was made with an application such as Photoshop. People are now prosecuted for owning images. How do we know they have anything to do with reality?

Parliament will discuss depiction, but not art. We are in a confusing time. The decline of religion in Europe is seen as part of the "scientific" revolution. I have begun to doubt this now; it is quite likely that it's to do with images. The decline of the church parallels the mass manufacture of cameras. They are deeply connected. I noticed on a recent tour of Italy that not many Italians went in the churches to see pictures. They see them at home, not made by Botticelli but by Berlusconi. Think about it.


David Hockney this week donated his largest work,
Bigger Trees Near Water,
to the Tate; it will hang at Tate Britain.

Link to hockneypictures.com

Link to The Guardian article

Saturday, March 29, 2008

Lights Out

On Saturday, March 29, 2008, Earth Hour invites people around the world to turn off their lights for one hour – from 8:00pm to 9:00pm in their local time zone. On this day, cities around the world, including Copenhagen, Chicago, Melbourne, Dubai, and Tel Aviv, will hold events to acknowledge their commitment to energy conservation.

Zimbabwe Votes




Ghost Voters?





Peter Brookes - The Times

Friday, March 28, 2008

Worst Person in the World

And the band plays on . . . .

The AIDS Clock – 3-28-2008

For the latest numbers:
Link to the AIDS Clock


365Gay.com Newscenter (March 28, 2008 )

Report Shows 48% Hike In US HIV Cases

Reported new HIV infections in the United States increased by 48 percent in 2006 according to new data from the Centers for Disease Control and Prevention.

The stunning figures, in the CDC Surveillance Report, comes in advance of a long anticipated in depth review of HIV infections that was to have been released early this year but is believed to be months away.

The CDC said last December at the HIV Prevention Conference that it was working on new estimation methods but the federal agency has delayed release of the document.

In its Surveillance Report the CDC this week said there were 52,878 new HIV infections in 45 states and the District of Columbia for 2006. In 2005, CDC reported only 35,537 new infections in 38 states and the District of Columbia.

HIV/AIDS groups say that the increase is alarming, despite an increase in the number of state reporting.

The seven new states for which CDC is reporting HIV data for the first time in 2006 are: California, Delaware, Illinois, Maine, Oregon, Rhode Island, and Washington.

"New CDC data showing a 48% higher incidence of new HIV/AIDS diagnoses in 2006 compared with 2005 are just the latest piece of bad news about the sexual health of the American people," said Marjorie J. Hill, PhD, Chief Executive Officer of Gay Men’s Health Crisis (GMHC).

"While there are seven additional states reporting in 2006, this does not account for the 48% jump in new diagnoses. These devastating numbers reinforce what we have known for quite some time: that HIV prevention is under-funded and hamstrung by ideological restrictions that force us to fight this epidemic with one hand tied behind our back."

In recent months, government data have shown increases in HIV infections among young men who have sex with men and young women in New York City, especially young people of color.

Nationally, HIV is up for MSM and dramatically up among Black MSM. Teen pregnancy rates have also increased for the first time since the early 1990s. Earlier this month, the CDC reported that one quarter of teenage females have a sexually transmitted infection, with nearly half of Black teenage females in the study infected.

Michael Weinstein, President of AIDS Healthcare Foundation, called the new statistics a "catastrophe".
"There is no other word to describe these CDC numbers which underscore the wholesale failure of US HIV prevention efforts." Weinstein said.

"We now face $36 billion in costs associated with lifetime care and treatment of all these infected individuals," said Whitney Engeran, III, Director, Public Health Division, and AIDS Healthcare Foundation.

GMHC said that under the Bush-Cheney administration, funding for prevention at CDC has dropped 19 percent in real dollar terms.


Link to 65gay.com News report

Link to CDC Surveillance Report [pdf]


Meanwhile BBC News on line reports (March 28, 20098) on the UK situation

Gay men risk of HIV 'still high'

Gay men are being urged to get HIV tests more regularly and practise safe sex in a bid to halt the high numbers of new cases in the UK.

The Health Protection Agency made the warning after new diagnoses among gay men topped 2,600 for the third year.

Overall, the number of new cases hit an estimated 6,840 in 2007 - a fall of 1,400 from the previous year.

The HPA said this was mostly due to a decline in cases among those infected heterosexually in Africa.

But experts said the new cases among gay men were still at worrying levels.

There were 2,630 diagnoses - a slight fall on previous years, but much higher than the annual figures in the 1990s which tended to hover around 1,500.

HPA head of HIV surveillance Dr Valerie Delpech said: "Gay men continue to be the group most at risk of acquiring HIV within the UK.

"We need to reinforce the safe sex message for gay men that the best way to protect yourself from contracting HIV is practicing safe sex by using a condom with all new and casual partners."

She also urged more regular testing so treatment could be started earlier and to reduce the risk of transmission to partners.

Link to HPA press release

Link to BBC News report


cost-effectiveness of STI management

Kelly Morris writing for Aidsmap (March 26, 2008)

Study confirms cost-effectiveness of STI management in HIV control

In sub-Saharan Africa, the management of sexually transmitted infections (STIs) remains a cost-effective strategy for controlling HIV in a number of different scenarios, according to an international team of researchers. Even in mature epidemics with substantial condom use, their study found that more than half of new HIV infections may be attributable to STIs.

Previous research conducted in Mwanza, Tanzania, of syndromic management of STIs - treatment of presenting symptoms according to guidelines - showed that STI treatment was cost-effective in reducing HIV incidence. However, later African trials failed to find a reduction in HIV incidence with such management.

Investigators from the London School of Hygiene and Tropical Medicine suggested that “this may be because behavior change and the later stage of the HIV epidemic reduce the role of curable STIs in HIV transmission”. These findings have led some policy makers to question the role of STI treatment in tackling generalized epidemics of HIV in Africa.

In this latest study investigators used a known statistical model to simulate the natural history and transmission of HIV and STIs between individuals. The simulation has previously been used and found to agree with data from large, randomized trials. Data from the Tanzanian trial were used as a basis to simulate the effect and costs of STI treatment.

The study notes “the absolute impact of syndromic management remains high in generalized epidemics, and it remained cost-saving in three of the four populations in which the cost per HIV infection averted ranged between US $321 and $1665”.

These figures are lower than the estimated lifetime cost of treating HIV infection in these areas, at around $3500. In the fourth city, STI treatment might not be cost-effective due to the relatively low prevalences of curable STIs and the low incidence of HIV.

The authors further suggest that in cities with low rates of male circumcision and relatively high-risk sexual behaviors, STI treatment may be cost-effective even with condom usage as high as 30-37.5% of casual contacts and 45% of sex worker contacts or higher. STI treatment is virtually always cost-effective if HIV prevalence was above 5.5%, they report.

In other scenarios, STI management has “important collateral public health benefits, which effectively protects patients with STIs from the enhanced risk of HIV acquisition and transmission,” the team concludes.

Reference


Treating curable sexually transmitted infections to prevent HIV in Africa: still an effective control strategy?
White, Richard G PhD et al
Journal of Acquired Immune Deficiency Syndromes. 47(3):346-353, March 1, 2008.

Link to JAIDS abstract

Link to Aidsmap article

'silenced' RNA

BBC News on line (March 27, 2008)

Cells' disease machinery silenced

A team of Danish scientists say they have taken a major step towards a new generation of drugs for many conditions, including cancer, because they "silenced" key genetic material in cells called RNA.

Working on monkeys, they cut the animal’s cholesterol levels by silencing strands of micro-RNA in liver cells controlling its metabolism. Previous tests had only been carried out in a test-tube, or on rodents.

The study holds out hope for the treatment of liver diseases.

The team from the Copenhagen-based drug firm Santaris Pharma are aiming to use their findings to develop a treatment for Hepatitis C rather than high cholesterol, for which there are already a number of effective treatments. But they say the technique could ultimately be employed to treat a range of conditions, including certain types of cancer, cardiac diseases and metabolic problems like diabetes.

The treatment is based on the idea of silencing certain types of RNA, which scientists have increasingly come to understand as the main regulator of what goes on in a cell.

There is evidence to suggest that levels of one form of RNA are extremely elevated in lymphomas, and that they are not just a symptom but a driver of the disease.

Silencing them could therefore prove an effective treatment, if not a cure.

reference

LNA-mediated microRNA silencing in non-human primates
Joacim Elmén et al

Nature advance online publication 26 March 2008 | doi:10.1038/nature06783

Link to Nature abstract


Link to BBC news report

Stressed parents = sick kids

New Scientist (March 22 – 28, 2008)

Chill out or the kids get a fever

Stressed parents aren't just damaging their own health - they may also be making their children more vulnerable to illness.

Stress is well known to affect a person's own physical health, but the effect on their children's health was unclear. To investigate, Mary Caserta and her colleagues at the University of Rochester in New York asked the parents of 169 children aged between 5 and 10 to monitor their child's health over three years, recording symptoms of illnesses and taking their temperatures.

Every six months, the parents took a test designed to assess their own psychiatric health, noting markers of stress such as anxiety or depression.

Caserta's team found that the total number of illnesses, both with and without fever, was significantly higher in the children of parents who reported high levels of emotional stress. The team also measured the levels of immune cells in the children, and found those with highly stressed parents were much more likely to have heightened immune activity - a sign that they were working hard to fend off infection .

Reference:

The associations between psychosocial stress and the frequency of illness, and innate and adaptive immune function in children
Mary T. Caserta et al
Brain, Behavior, and Immunity
doi:10.1016/j.bbi.2008.01.007

Link to Brain, Behavior and Immunity abstract

Link to New Scientist report

Thursday, March 27, 2008

World's Worst

MMR vaccine

BBC News on line (March 27, 2008)

MMR doctor defends his research

Dr Andrew Wakefield who first linked the MMR vaccine to autism has defended the way he carried out his research and his motivation for doing so. He said he adhered to official guidelines in his research, which led to the publication of the 1998 Lancet paper.

Dr Wakefield, and two colleagues, who deny charges of professional misconduct, aid he had wanted to help treat and prevent autism after being approached by worried parents.

The 51-year-old, who is now working in the US, is accused of violating ethical guidelines, and of acting against the clinical interests of the children who took part in his trial.

He is also accused of acting dishonestly in failing to disclose to the Lancet that he was advising solicitors acting for parents who had alleged their children had been damaged by MMR.

The British General Medical Council case is not examining the safety of MMR, designed to protect against measles, mumps and rubella.

Dr Wakefield said he was approached by a mother in 1995 who believed her child had regressed into autism after having the MMR jab and felt it was his duty as a "human being" to help her. The mother said her child also had terrible bowel problems, which she believed was linked to the autism. At the time Dr Wakefield had been looking at links between measles and bowel disorders, but thought the woman's concerns were worth exploring as it was well-known that there was a link between gut and brain problems. This woman then put him in touch with other parents in a similar position, he said.

The GMC hearing was told that Dr Wakefield, along with colleagues, developed a hypothesis linking MMR and autism and decided to conduct clinical studies to establish the "validity" of it. He said he wanted to do this "so we could help in treatment and prevention". He said at this time he was unaware that some parents were seeking to take legal action over the issue.
"The parents contacting me was nothing to do with litigation, and litigation was not my primary concern."

And when asked by his own QC, Kieran Coonan, whether he had followed Royal College of Physicians guidance on research practices, he replied: "We complied entirely consistently with this document."

He added that decisions to carry out procedures such as magnetic resonance imaging (MRI) scans and invasive tests such as lumbar punctures and colonoscopies - which form a central part of the GMC case - were made by one of his colleagues.

If found guilty of serious professional misconduct, Dr Wakefield faces being struck off the medical register in the UK. Also facing professional misconduct charges are Professor John Walker-Smith, and Professor Simon Murch.

Link to BBC News report


As the BBC notes, the impact of the MMR research has already extended beyond this the circumstances of the Wakefield Case.

Despite the scientific community repeatedly stressing that the vaccine is safe, there has still been a crisis in public confidence.

Jennifer Steinhauer explored this issue for the New York Times Health Section (March 21, 2008)

Public Health Risk Seen as Parents Reject Vaccines

In a highly unusual outbreak of measles in San Diego, CA last month, 12 children fell ill; nine of them had not been inoculated against the virus because their parents objected, and the other three were too young to receive vaccines.

The parents who objected to their children being inoculated are among a small but growing number of vaccine skeptics in California and other states who take advantage of exemptions to laws requiring vaccinations for school-age children.

The exemptions have been growing since the early 1990s at a rate that many epidemiologists, public health officials and physicians find disturbing.

Children who are not vaccinated are unnecessarily susceptible to serious illnesses, they say, but also present a danger to children who have had their shots — the measles vaccine, for instance, is only 95 percent effective — and to those children too young to receive certain vaccines.

Measles, almost wholly eradicated in the United States through vaccines, can cause pneumonia and brain swelling, which in rare cases can lead to death. The measles outbreak here alarmed public health officials, sickened babies and sent one child to the hospital.

Every state allows medical exemptions, and most permit exemptions based on religious practices. But an increasing number of the vaccine skeptics belong to a different group — those who object to the inoculations because of their personal beliefs, often related to an unproven notion that vaccines are linked to autism and other disorders.

Twenty states, including California, Ohio and Texas, allow some kind of personal exemption, according to a tally by the Johns Hopkins University.

There is substantial evidence that communities with pools of unvaccinated clusters risk infecting a broad community that includes people who have been inoculated.

For instance, in a 2006 mumps outbreak in Iowa that infected 219 people, the majority of those sickened had been vaccinated. In a 2005 measles outbreak in Indiana, there were 34 cases, including six people who had been vaccinated.

In California, six pertussis outbreaks infected 24 people in 2007; only 2 of 24 were documented as having been appropriately immunized.

Link to New York Times article

Sarkozy's State Visit

Steve Bell - The Guardian


Peter Brookes - The Times

Pacemakers can be hijacked by radio

New Scientist (March 22 – 28, 2008)

Not even your heartbeat is safe

It gives new meaning to the term "heart attack". Last week researchers led by William Maisel at Harvard University used a commercially available radio transmitter to hijack the software on a device that acts as both a heart pacemaker and defibrillator.

The device was not implanted in anyone, but the experiment raises the prospect of hackers being able to disrupt a person's heartbeat or stealthily administer damaging shocks.

Is the threat of a hacker-instigated heart attack imminent? "The chances of someone being harmed by malicious reprogramming of their device is remote," says Maisel. However, implanted drug pumps and neurostimulators, which deliver electrical pulses to the brain, could be more vulnerable to such attacks in future as they increasingly have wireless capabilities built in.


Link to New Scientist report

breast cancer scares

BBC News on line (March 26, 2008)

Breast MRI scans 'overly scare'


Lumps detected in women at a high risk of breast cancer using hi-tech MRI scans overwhelmingly turn out to be false alarms, a Dutch study suggests.

But while researchers found five out of six scans which suggested a problem were wrong, they were nonetheless very effective at spotting invasive cancers. And while false-positives caused anxiety, the study did not find women were rashly opting for mastectomies.

MRI scans - which use magnetic resonance imaging - are more sensitive than standard mammograms, and as such are seen as particularly effective in picking up early breast cancers in younger women with denser breast tissue. But this very sensitivity is what makes them more likely to spot abnormalities which may turn out to be completely benign.

Researchers at the Hereditary Cancer Clinic at Nijmegen Medical Centre in the Netherlands followed 196 women with the BRCA1 or BRCA2 gene mutation which has been linked to breast cancer.

On their first visit, they were asked whether they had a preference for ongoing surveillance in the form of scans, or whether they would rather have their breasts removed as a precaution.

About 30% said they wanted a protective mastectomy, three expressed no preference and the others wanted regular check-ups. All also went on to receive a scan. About 83% of the MRI scans which appeared to detect a tumor were later found to be so-called "false positives".

However, the positive scan appeared to do little to sway decisions on breast removal.

Some 90% of the group who had wanted a mastectomy went on to have one, while fewer than a third of those who received a positive result and had originally opted for surveillance opted for breast removal.

"The final decision to actually undergo prophylactic mastectomy appeared to be determined more frequently by a woman's prior preference than by a positive scan," said Dr Nicoline Hoogerbrugge, who led the research. There was little information available about how women made the choice, she added. "Both genetic counseling and breast cancer surveillance are events in the entire decision-making process, but appear to have a limited impact."

But the researchers did confirm that the MRI scan was more effective in picking up genuine tumors and pre-cancerous developments.

Reference:

European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition—summary document
N. Perry et al
Annals of Oncology 2008 19(4):614-622; doi:10.1093/annonc/mdm481

Link to Annals of Oncology abstract

Link to BBC News report

AIDS: losing teachers

Charles Mangwiro reports from Maputo, Mozambique for Reuters (March 25, 2008)

Over 1,300 Mozambique teachers die yearly of AIDS

More than one-sixth of Mozambique's 9,000 teachers are dying of HIV/AIDS each year, lowering the quality of education and jeopardizing future development, a government official told Reuters on Tuesday.

Education and Culture Minister Aires Aly said in an interview that the pandemic had become a national emergency, eroding a critical human resource that is key to the poor southern African nation's economic development.
"We are losing 17 percent of our 9,000 teachers each year, which means we are talking of 1,360 workers lost to HIV/AIDS, and the disease is spreading very fast at national level".

Health officials say more than 16 percent of the 20 million Mozambicans between the ages of 14 and 49 -- generally the most economically productive -- are infected with HIV, and an estimated 500 new infections occur each day.

"This is a crucial issue for us and we are trying to train more teachers for them to be able to deal with it (the pandemic) in the communities. Teachers play a major role in the economic development of this country", he said.

Despite its limited skilled labor force, Mozambique's economy has boomed in recent years, spurred by a rise in foreign investment and development aid, and GDP growth is projected to hit 8 percent this year after reaching 7.5 percent in 2007.

Aly said the devastating effect of HIV/AIDS on the country's human resources threatened to damage its economic prospects.

Mozambique, still one of the world's poorest nations, is struggling to raise the $150 million a year it needs to rebuild its dilapidated education infrastructure, neglected during the 17-year post-independence civil war that ended in 1992.

Very few of those needing anti-retroviral drugs in the former Portuguese colony have access to the life-saving treatment, though there are plans to set up a factory to produce the drugs in Mozambique.


Link to Reuters article

“The History of Medicine.”



A few years ago
the World Health Organization
published this anonymous bit of doggerel titled
The History of Medicine.”




  • 2000 B.C. – Here, eat this root.
  • A.D. 1000 – That root is heathen. Here, say this prayer.
  • A.D. 1850 – That prayer is superstition. Here, drink this potion.
  • A.D. 1920 – That potion is snake oil. Here, swallow this pill.
  • A.D. 1945 – That pill is ineffective. Here, take this penicillin.
  • A.D. 1955 – Oops . . . bugs mutated. Here, take this tetracycline.
  • 1960-1999 – 39 more “oops.” Here, take this more powerful antibiotic.
  • A.D. 2000 – The bugs have won! Here, eat this root.

It is quoted in a serious piece by Marlene Zuk, a professor of biology at the University of California at Riverside, in her contribution to Well blog by Tara Parker Pope for the New York Times (March 27, 2008)

Drug Resistance, Explained

Link to NY Times blogs : Well – Drug Resistance Explained

Wednesday, March 26, 2008

The Devine Comedy


i've been to a marvellous party


something for the weekend

AIDS Vaccine

Lawrence K. Altman writing for the New York Times (March 26, 2008)

Rethinking Is Urged on a Vaccine for AIDS

Researchers must go back to the drawing board before they can develop an effective vaccine against HIV-AIDS experts said at a scientific meeting on Tuesday.

And Dr. Anthony S. Fauci, the top federal official responsible for AIDS research, agreed that more fundamental knowledge is needed about HIV and the way the body and experimental vaccines respond to it before the goal of a licensed HIV vaccine can be reached. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, pledged to re-evaluate the use of all $1.5 billion his agency spends on AIDS research to come up with the necessary money.

The reassessment comes after last September’s widely publicized failure of what had been the most promising candidate for an HIV vaccine. Many health officials believe that an effective vaccine would be the most crucial weapon in stopping the HIV pandemic.

Scientists do not have a full understanding of why the vaccine failed, or why it was possibly harmful, in two large trials in the United States and South Africa. Dr. Fauci’s institute helped pay for the trials of the vaccine, which was made by Merck. Such failures have led a number of scientists to challenge the direction of federal HIV research.

On Tuesday, the AIDS Health Care Foundation called for the suspension of money for HIV vaccine research and reallocating resources into effective HIV/AIDS prevention, testing and treatment strategies.

But Dr. Fauci strongly rejected the proposal. “Under no circumstances will we stop AIDS vaccine research,” Dr. Fauci said at the conclusion of the meeting.

A crucial issue is supporting younger researchers to replace the cadre of veteran AIDS scientists, many of whom are working beyond traditional retirement age. Dr. Fauci said a first step would be to pare existing projects to immediately provide $10 million to $15 million for about 30 grants to be awarded to scientists who propose novel ideas. Some of the grants would be used to support young researchers.


Link to New York Times article

Salmonella & HIV


Adam Legge writing for Aidsmap (March 25, 2008)

Researchers discover why salmonella is so dangerous for people with HIV

Researchers believe they have discovered why people with HIV are far more likely to die of Salmonella food poisoning, compared to those without HIV who tend to suffer a bout of diarrhoea.

Their study, published online in Nature Medicine, suggests the virus disrupts the normal gastrointestinal lining, allowing the Salmonella bacteria to cross into the bloodstream causing death.

The rise in numbers of people with AIDS in sub-Saharan Africa has been associated with a big increase in cases of what is termed nontyphoidal Salmonella serotype (NTS) infections.

NTS are a common cause of food-borne diseases across the world but tend to be confined to the intestine, usually causing a week-long bout of diarrhea. But up to half of HIV-infected African people die after contracting NTS infection.

Now, US and UK researchers have looked at NTS infection in rhesus macaque monkeys infected with simian immunodeficiency virus (SIV), which is similar to HIV.

They have found that SIV infection leads to a depletion in the numbers of a type of lymphocyte called T helper type 17 (TH17) in the walls of the ileum – the final section of the small intestine. CD4+ cells are another type of T helper lymphocyte.

TH17 cells produce a cytokine – or chemical messenger – called interleukin 17 (IL-17) which plays a pivotal role in the gut’s response to infection.

It is this reduction in IL-17 which is thought to allow the gut wall to become ‘leaky’, allowing the NTS bacteria to cross into and infect the bloodstream.

One of the researchers, Professor Satya Dandekar, chair of the department of medical microbiology and immunology at the University of California at Davis said: “We found that animals that had no SIV infection were able to generate immediate responses to bacterial exposure, producing TH17 cells in large amounts.”

But the SIV-infected animals had either a significantly lower response or failed to produce measurable amounts of the cytokine, he said. “This muted TH17 response led to dissemination of Salmonella from the gut to the peripheral blood.”

The data suggest TH17 may be a useful biomarker for monitoring HIV infection and testing the efficacy of vaccines and other therapies. The authors also suggest that efforts to enhance TH17 function could improve existing antiretroviral treatments.

But the research also has wider implications, with this interruption in the gut’s immune response possibly explaining how HIV can maintain reservoirs of infection that evade drug treatment.

Reference

Simian immunodeficiency virus–induced mucosal interleukin-17 deficiency promotes Salmonella dissemination from the gut.
Manuela Raffatellu et al

Nature Medicine, published online, 23rd March 2008. | doi:10.1038/nm1743

Link to Nature Medicine abstract

Link to Aidsmap report

Nanny always said, “Remember your Cod Liver Oil”

BBC News on line (March 25, 2008)

Cod oil 'cuts arthritis drug use'

A daily dose of cod liver oil can cut painkiller use in patients with rheumatoid arthritis, a Dundee University study suggests. Taking 10g of cod liver oil a day reduced the need for non-steroidal anti-inflammatory drugs (NSAIDs) by 30%, researchers say. Concerns about side-effects of NSAIDs has prompted research into alternative.

Rheumatologists said the study, in Rheumatology Journal, funded by Seven Seas, was small but showed fish oil could benefit some patients.

Patients in the trial were either given cod liver oil or placebo and after 12 weeks asked to gradually reduce their use of NSAIDs, such as ibuprofen.

The reduction in drug use was not associated with any worsening of pain or the disease, the researchers reported.

The research team at the University of Dundee, aided by colleagues at the University of Edinburgh, have now completed three studies which have all shown patients are able to cut down their NSAID use when taking cod liver oil. It is thought fatty acids in the fish oil have anti-inflammatory properties.

Some side-effects of NSAIDs, such as an increased risk of stomach bleeding have been known for a long time. But more recently, concerns have been raised about an apparent increased risk of heart attacks and strokes in those taking the drugs.


Reference:

Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis
B. Galarraga et al
Rheumatology Advance Access published online on
March 24, 2008
Rheumatology, doi:10.1093/rheumatology/ken024

Link to Rheumatology abstract


Link to BBC News report

Tuesday, March 25, 2008

Distorting science?

New Scientist (March 22-28, 2008)

White House ignored air quality advice

For many researchers, the Bush administration will be best remembered for the way it has manipulated scientific advice for political ends. The latest evidence of this tactic is a controversial proposal to change the way US air-quality standards are set, according to the Union of Concerned Scientists (UCS) in Washington DC.

When the Environmental Protection Agency said last week that it would beef up air-quality controls by cutting ground-level ozone limits from 80 parts per billion to 75 ppb, it seemed like good news. Ozone can trigger respiratory problems and heart attacks. The new rules should save lives and, by cutting pressure on hospitals, might create financial benefits that outweigh the cost of implementing the changes.

However, around a year ago the EPA's own scientific advisers told the agency that there was "overwhelming" evidence that an even tighter limit of 70 ppb would save thousands more lives. The decision to ignore that advice has angered public-health groups.

Now worse may be to come. The administration wants to reform the process for setting air-quality standards and may allow political appointees to help draft the advisory reports, a job that is currently in the hands of researchers. The UCS fears this will allow the White House to suppress this kind of independent scientific advice in future.

"The interference in science has been a consistent theme of this administration for many years now," says Tim Donaghy of the UCS. "The administration has changed the rules along the way so that, when the next administration gets into office, the role science plays in setting regulations will be greatly diminished."

Link to New Scientist report


Link to UCS : Scientific Freedom and the Public Good

hidden dangers?

Alex Berenson writing for the Business Section of the New York Times (March 25, 2008)

One Drug, Two Faces

Explores from Anchorage, Alaska

Two courtrooms, two floors of the Nesbett Courthouse, two views of Zyprexa.

In Courtroom 403, lawyers read corporate memorandums to a jury that must decide a lawsuit brought by the state of Alaska, which claims that the drug maker Eli Lilly hid the dangers of Zyprexa, Lilly’s best-selling schizophrenia medicine.

At the same time, in Courtroom 301, William Bigley had his own opinions on Zyprexa, and all the other drugs he has taken since 1980 to battle demons that only he can see. On this day, March 14, a state court judge would decide whether Mr. Bigley should be held for 30 days in a psychiatric hospital.

Mr. Bigley’s hearing — which had an unexpected outcome — offered a textbook illustration of the agonizing choices faced by mentally ill patients as they consider taking Zyprexa and similar medicines, called antipsychotics.

By calming the hallucinations and delusions that plague people with schizophrenia, drugs like Zyprexa allow many patients to live outside psychiatric institutions.

But the documents being discussed in Room 403 offered plenty of evidence that Mr. Bigley, whatever his delusions, has good reason to dislike the medicines.

All antipsychotics have side effects, and Zyprexa’s are among the worst, according to the American Diabetes Association and independent scientists. In many patients, Zyprexa causes severe weight gain that can lead to diabetes, as well as sharply higher cholesterol and triglyceride levels in the blood. Those are all risk factors for heart disease, the leading killer in the United States.

Further, the documents introduced in Courtroom 403 show that for much of the last decade, Lilly executives played down those risks. Among themselves, in internal e-mail messages and memorandums, they shared worries that Zyprexa’s sales would fall if the drug was linked to weight gain or diabetes.

In 2002, for example, the Japanese government ordered Lilly to warn Japanese doctors against giving Zyprexa to people at high risk for diabetes. But Lilly did not add a similar warning to Zyprexa’s label in the United States. Internally, Lilly executives acknowledged that the warning had hurt Zyprexa sales in Japan.

“The impact of the label change in Japan has been very profound,” two senior Lilly executives wrote in a memorandum on July 1, 2002. “There has been a 75% drop in new patients who are being put on the drug.”

Indeed, as American doctors have learned on their own about the connection between Zyprexa and diabetes, prescriptions for Zyprexa have plunged. Since 2003, they have slid 50 percent.

Yet Zyprexa, which sometimes works better than other antipsychotics on severely ill patients, remains widely used. In the United States, it is still prescribed almost four million times a year. It had sales worldwide of $4.8 billion in 2007, half in the United States.

Mr. Bigley’s case illustrates why psychiatrists and patients feel they have no choice but to use Zyprexa, whatever its side effects. Mr. Bigley, a thin man with greasy black hair, cloudy eyes and a salt-and-pepper beard, has been hospitalized more than 70 times since his first breakdown in 1980.

Psychiatrists say he has paranoid schizophrenia with symptoms of mania. Over the years, he has been medicated with Zyprexa, Risperdal, Haldol, Thorazine and many other psychiatric drugs, despite his objections.

Read the rest of the article to see Judge Smith’s reasoning for his release of Mr. Bigley

Link to New York Times article

New treatment?

Adam Legge writing for Aidsmap (March 25, 2008)

New way of attacking HIV looks promising in early trial

A new monoclonal antibody treatment that blocks HIV’s ability to infect human cells is safe and effective, according to a preliminary trial in patients the results of which are published in the March 1st edition of the Journal of Infectious Diseases.

HGS004 is a human monoclonal antibody that binds to and inhibits the activity of the CCR5 receptor on the cell surface. HIV uses both the CCR5 and the CD4 receptors to gain entry to the cell but CCR5 is the primary receptor enabling HIV transmission and replication from the early stages of infection through to progression to AIDS. Small-molecule CCR5 inhibitors like maraviroc and vicriviroc have already been shown to be effective HIV treatments, leading to maraviroc gaining a license last year.

But monoclonal antibody drugs have advantages compared to traditional small-molecule drugs. They can be dosed less frequently - biweekly or even monthly- and usually do not interfere with other drugs allowing a greater freedom of combination. They also should theoretically work against resistant strains. However, they have to be injected, rather than taken orally.


Reference


Safety, pharmacokinetics, and antiviral activity of HGS004, a novel fully human IgG4 monoclonal antibody against CCR5, in HIV-1 infected patients.
Jacob Lalezari et al

The Journal of Infectious Diseases 197: 721-727, 2008. DOI: 10.1086/527327

Link to J. Infectious Diseases abstract

Link to Aidsmap report

Monday, March 24, 2008

Gertrude Lawrence - The Physician

Morland - The Times

Leafy greens = tossed salad

New Scientist (March 22-28, 2008)

Mystery food poisoning traced to salads

The rate of food poisoning from salad greens in the US is hugely outstripping increases in their consumption.

Three large outbreaks in 2006 that between them made 300 Americans sick were traced to bulk-prepared greens. "For most outbreaks, investigators are unable to pinpoint where contamination occurred," says Michael Lynch of the US Centers for Disease Control in Atlanta, Georgia.

Whatever the cause, increased consumption is not it. Between 1986 and 1995, Americans ate 17 per cent more leafy greens than in the previous decade, yet poisonings rose 60 per cent. In the decade between 1996 and 2005, poisonings rose 39 per cent, against a consumption hike of just 9 per cent.

Lynch, who presented his team's results at the 2008 International Conference on Emerging Infectious Diseases in Atlanta, Georgia , says more research is needed to explain the discrepancy.


Link to New Scientist report

Link to Conference Report