Wednesday, April 30, 2008
The virus has killed 20 children since it was discovered in Fuyang, a city in
State media said the number of cases had now increased to nearly 1,900.
The outbreak began in early March, but was only reported this week - leading to accusations by Chinese press of a cover-up by local authorities.
The number of infected children has steadily increased since hospitals in Fuyang began admitting patients with fever, ulcers in the mouth, or a rash on their hands and feet, according to the
An official investigation into the cause of the outbreak has been launched, and a prevention and control team has been set up to contain infected areas in the province, the bureau said.
EV71 - mainly affects children under the age of 10.
The World Health Organization said it was concerned about the number of deaths in the current outbreak, although EV71 has been reported in
The question of reporting infectious diseases is especially sensitive in
Attempts to cover up the scale of that outbreak led to the sacking of
Dr Kate Nambiar from Brighton and Sussex University Hospital told the conference that a study tested residual blood samples left over from patients who had presented to local GP practices and emergency departments between January 2006 and June 2007 and who had been tested for Full Blood Count or for glandular fever.
This was an anonymous unlinked survey: although details such as the sex and (known) HIV status of the patient were kept, samples were anonymized and ones that tested positive could not be traced back to individuals.
In order for samples to be tested, patients had to have presented with flu-like symptoms, muscle and joint aches, fever, night sweats, rash or mouth ulcers or a combination of other symptoms suggestive of primary HIV infection.
Samples were tested for HIV antibodies and the HIV p24 protein (which appears earlier than HIV antibodies in infected people). Pooled samples were also tested for HIV RNA (i.e. given a viral load test) in order to identify people in primary infection before seroconversion.
Samples positive for HIV were then sent on to the Health Protection Agency’s laboratory for confirmation with a Western Blot HIV test and to be tested with the STARHS assay, which can detect infections less than six months to a year old.
A total of 686 samples were tested and of these 7% tested HIV positive. Eliminating patients known to have HIV, this left 1% of patients (seven samples) who tested positive for HIV and were undiagnosed. One of these samples tested positive for primary HIV infection. It was recorded that 33 of the 686 patients had taken a same-day HIV test, but all were negative.
Seventy-one per cent of samples were collected from GPs and 29% from A&E departments; however only two of the positive samples were from GPs and the other five were from A&E. This meant that the proportion of undiagnosed patients attending GPs was only 0.4% (one in 250) but the proportion attending A&Es was 2.4% (one in 40).
Dr Nambiar commented that the study had found HIV in a considerably lower than expected proportion of patients presenting with symptoms suggestive of primary HIV infection (PHI) than had some previous US surveys; these had found PHI levels in undiagnosed symptomatic patients of up to 0.8%.
Dr. Nambiar commented that the suspected reason was that patients presenting with flu-like symptoms, particularly at GPs, were not undergoing any blood tests at all: “They may just be told ‘it’s only a virus’, and sent home with a prescription for paracetamol,” she said.
The study therefore did not support the use of pooled RNA testing as a means of picking up on primary HIV infection in the community.
However, she added, given that HIV screening is probably cost-effective if done in populations where the background undiagnosed HIV prevalence is 0.05% (one in 2,000) or more, the relatively high prevalence of undiagnosed infection in symptomatic individuals presenting to A&E suggested that, even if their symptoms were not caused by HIV, in Brighton at least, “there is a case for routine HIV testing in accident and emergency”.
Diagnosing the undiagnosed: identifying symptomatic primary HIV infection (PHI) presenting to primary and emergency healthcare physicians.
Kate Nambiar et al
Fourteenth BHIVA Conference,
Link to BHIVA site
The site links to Conference abstracts
Inactivating the ITK protein which is involved in the immune response blocks many steps of HIV replication, studies in the laboratory show.
Most current HIV drugs attack the virus itself which is liable to mutate and become resistant to treatment.
ITK is involved in activating a type of immune cell -- a T cell -- in the presence of infection.
HIV works by infecting T cells, taking them over so they can replicate and create large quantities of the virus, compromising the whole immune system.
The National Institutes of Health team realized that many of the pathways regulated by ITK were also needed for HIV to take hold in the body.
Tests in human cells in the laboratory showed that removing or inactivating ITK could, as predicted, block many different steps in the ability of HIV to enter a cell, spread and replicate.
What remains to be seen is how effective targeting ITK would be compared to existing drugs she said.
But due to other research looking at the role of ITK in immune responses in asthma, there are already potential drugs in development.
"Currently we have multiple options for treating HIV and we use multi-drug regimens but most of these therapies are directed against viral proteins which are subject to rapid changes allowing mutations to develop.
"Our own cellular machinery is less prone to making mistakes."
"ITK had an effect on HIV replication at several stages which if you add them up seems to be a profound effect."
Selective targeting of ITK blocks multiple steps of HIV replication
Julie A. Readinger et al
Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0709659105 Published on line
Tuesday, April 29, 2008
A Great Pox’s Greatest Feat:
which explores the evolving of syphilis . This includes the research which suggested that syphilis originated as a skin ailment in
She suggests the origin of syphilis has always held an implied accusation: if Europeans brought it to the
But we may not have as much say as we might like to think. Infectious diseases are caused by living beings that spread from one host to another, and natural selection will favor anything that increases that spread — say, a higher probability of becoming airborne, or a better means of attaching to the gut wall.
The syphilis bacterium, Treponema pallidum, has no nervous system or brain, no consciousness with which to plot an attack. But it has an ability that is even better: it can reproduce at a rate that leaves us in the evolutionary dust. For any STD., making the host more likely to have sex will benefit the pathogen that causes it. And syphilis may be a case in point.
Detailed records of syphilis infection start appearing in
Two points are noteworthy about this vivid account. First, it contrasts markedly with modern experiences with the disease. Although serious in its overall effects — which can include heart problems, brain damage and infertility — the rash and other overt symptoms of syphilis are now much more muted, and the disease may go undetected for some time, which helps explain why it is so hard to control. Second, it is reasonable to suppose that a sufferer of the symptoms von Hutten describes would be unlikely to get a lot of dates.
These two observations led Rob Knell, a scientist at Queen Mary University in
And while these changes were too rapid to be attributed to humans’ evolving resistance to the disease, he continued, for the syphilis bacteria, even a few years represents many thousands of generations. So we have syphilis itself to thank for the lessening of its symptoms. The disease is still serious, of course. But the rapid evolutionary change is striking.
Conventional wisdom used to hold that all diseases eventually evolved toward a more benign state, a “don’t bite the hand that feeds you” rationale. The muting of syphilis notwithstanding, we now realize that is not the case.
Diseases can evolve to become more virulent, more benign or neither — it all depends on what’s in it for them. For some diseases — cholera, for instance — killing the host is immaterial if the pathogen can spread via contaminated water sources. But sexually transmitted diseases must get around via sex. From the pathogen’s perspective, simply sitting around in the intestinal tract waiting for a too cursory bout of hand washing is unsatisfactory.
The disease organism from which syphilis arose is spread through simple skin contact. In chilly
So you might blame
Syphilis in Renaissance
Robert J. Knell
Proceedings of the Royal Society B, Volume 271,
Biology Letters Supplement 4 /
Link to PlusNews Report
In less than two months, government officials and AIDS activists from around the world will convene in New York to review the global HIV/AIDS response.
National progress reports, submitted earlier this year, will be compared to targets adopted by the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) in 2001.
Based on a review of the reports from Eastern and Southern Africa, the regions worst affected by the HIV/AIDS crisis, experts from UNAIDS have already concluded that despite significant progress in areas such as treatment, many of the UNGASS goals are still far from being reached.
In the area of prevention, described in the 2001 document as the "mainstay of the response", progress has been particularly disappointing, with some countries even documenting a backward slide since the last round of reporting in 2006.
Children still accounted for one in six of new HIV infections globally in 2007, according to UNAIDS. Although some countries in the region saw a decrease in HIV prevalence among people aged 15 to 24 - the age group that provides the best indication of new adult infections - others saw no change or slight increases.
In 11 countries with high HIV prevalence that recently conducted surveys, only about 15 percent of orphans were living in households that received some form of medical, financial or psychosocial assistance - an increase of just 5 percent from 2005.
Expectations around this year's UNGASS meeting in
Amanda H. Beck, the Peace Corps press director, said Tschetter plans to respond to the ACLU, which posted the letter on its Web site and sent out a news release about Johnson's case.
"The Peace Corps does not have a policy of automatically excluding people with HIV," Beck said. "The Peace Corps conducts individualized medical examinations of volunteers and applicants who are HIV-positive."
She said she cannot comment on Johnson's case because of privacy rules, noting that Johnson "has not given us permission to speak about his individual situation."
In its letter, the ACLU pointed out that the State Department in February changed rules that disqualified HIV-positive Americans from becoming diplomats. The department said it revised medical clearance guidelines based on advances in HIV care and treatment and will take a case-by-case approach in deciding on applicants for Foreign Service assignments.
State's policy change came just weeks before a trial was scheduled to start in a lawsuit brought in 2003 by Lorenzo Taylor, who had been rejected for employment when he told the department about his HIV status. He was represented by Lambda Legal, a
On the notice, the Peace Corps said that it had determined "the resolution of your condition(s) will take longer than the maximum-allowable 45 days" and that "you would be medically unable to perform your volunteer assignment."
The reason for the medical separation written on the form is: "HIV -- lab work positive."Link to The Washington Post article
Records of trials at the Old Bailey throughout the 1800s and early 1900s have been placed online, from infamous murders to bungled bicycle frauds, all catalogued into a searchable archive.
Yesterday the site was creaking under the strain as people logged on, punched in their family name and waited for news of how and when it had been blackened by an unscrupulous ancestor.
Accounts of The Proceedings of the Old Bailey were originally collated and circulated from 1674 in what became a popular
By the early 20th century the readership had declined and the authorities were no longer willing to bear the expense. The last edition rolled off the presses in April 1913; thereafter the complete record was contained in a handful of rare leather-bound collections.
Efforts to make this rich seam of
The new records include the indictment for “acts of gross indecency” of Oscar Wilde and Alfred Taylor in May 1895. There is the case of Dr Hawley Crippen, who murdered his wife, a
— The latest records are from trials conducted between 1834 and 1913
— About 100,000 trials have been transcribed and digitalized in a searchable online database
— The website contains more than 100 million words
— The first mention of the bicycle appears in the fraud case of 1875
— The motor car makes its debut in 1899 in another case of fraud
Monday, April 28, 2008
Mitja Back and colleagues at the
The panels' guesses agreed most with a personality survey the teenagers had completed when it came to qualities like openness, conscientiousness and narcissism, and diverged most on the trait of extroversion. Addresses that gave away personality often contained periods, numbers or a name that was obviously not genuine
How extraverted is firstname.lastname@example.org? Inferring personality from e-mail addresses
Mitja D. Back et al
Journal of Research in Personality doi:10.1016/j.jrp.2008.02.001
They say their findings confirm a long-held theory. Carbon spewed out by volcanoes is removed from the air by rock weathering and transported to the ocean floor.
Using evidence from an Antarctic ice core, the team calculated that over a period of 610,000 years the long-term change in atmospheric CO2 concentration was just 22 parts per million (ppm), although there were larger fluctuations associated with the transitions between glacial and interglacial conditions. By comparison, two centuries of human industry have raised levels by about 100 ppm - a speed of rise about 14,000 times faster.
"These long term cycles are way too slow to protect us from the effect of (anthropogenic) greenhouse gases," said Richard Zeebe from the
"They will not help us with our current CO2 problem. Right now, we have put the system entirely out of equilibrium."
Scientists have long believed that the Earth’s climate was stabilized by a natural carbon thermostat. In their model, carbon released into the atmosphere, primarily by volcanoes, is slowly removed through the weathering of mountains, washed downhill into oceans, and finally buried in deep sea sediments.
"A lot of people had tried to refute this hypothesis, but our study provides the first direct evidence (that it is correct)," said Dr Zeebe.
He studied levels of CO2 recorded in air bubbles trapped in a 3km ice core drilled from an Antarctic region called Dome Concordia (Dome C).
Data from the ice core, drilled by the European Project for Ice Coring in
"It is remarkable how exact the balance is between the carbon input from volcanoes and the output from rock weathering," said Dr Zeebe.
"This suggests a natural thermostat which helps maintain climate stability."
The delicately balanced carbon thermostat has been a key factor in allowing liquid water, and life, to remain on Earth, he said.
"If it weren’t for these feedbacks, the Earth would look very different today."
Close mass balance of long-term carbon fluxes from ice-core CO2 and ocean chemistry records
Richard E. Zeebe & Ken Caldeira
Nature Geoscience published online:
Sunday, April 27, 2008
has always been cool. It has something to do with all that rain and bad weather that comes in off the Wales Irish sea.
Laverbread - Bara Lawr – “delicious with bacon”
The Big Pit “Best interactive museum in the UK”
Portmeirion “Has to be seen to be believed”
The Language “Alive and kicking”
Saturday, April 26, 2008
Most scientists involved in Aids research believe that a vaccine against HIV is further away than ever and some have admitted that effective immunization against the virus may never be possible, according to an unprecedented poll conducted by The Independent.
A mood of deep pessimism has spread among the international community of Aids scientists after the failure of a trial of a promising vaccine at the end of last year. It just was the latest in a series of setbacks in the 25-year struggle to develop an HIV vaccine.
The article also links to The Independent's Survey and to a Comment
The Wall Street Journal (
HIV treatment guidelines have recently been changed in the UK, Europe and US recommending that anti-HIV therapy should be started when a patient’s CD4 cell count is in the region of 350 cells/mm3, mainly because the SMART treatment interruption study showed that a higher CD4 cell count was associated with a lower risk of not only AIDS-defining illnesses, but also some serious diseases not traditionally associated with HIV.
The findings of the current study potentially add to our understanding of the importance of CD4 cell count in reducing the risk of serious illnesses not normally associated with HIV.
On the basis of their findings, the investigators comment, “if the potential reduction in non-AIDS risk as well as AIDS risk could be realized through earlier initiation of antiretroviral therapy (at CD4 cell counts greater than 350 cells/mm3), thereby maximizing CD4 cell recovery and minimizing time spent at lower CD4 levels, the public health benefit would be substantial.”
Potent antiretroviral therapy lowers HIV viral load, allowing the CD4 cell count to increase, thereby reducing the risk of HIV-related opportunistic infections and cancers. Thanks to the success of antiretroviral therapy, the main causes of illness and death in people with HIV are no longer HIV-related.
The investigators comment that their findings show that “rates of non-AIDS diseases decrease with increasing CD4 counts”. They call for a randomized controlled trial “to determine the risk-benefit balance of starting antiretroviral therapy at higher CD4 counts.”
CD4+ count and risk of non-AIDS diseases following initial treatment for HIV infection.
Jason V Baker et al
Friday, April 25, 2008
BBC News on line (
Mr Ban wants all of
He called for bed nets for an extra 500 million people, more malaria clinics, more training for community health workers, and encouragement of research into the disease.
"We have the resources and the know-how but we have less than 1,000 days before the end of 2010," he said of the goal.
Each year more than half a billion people are infected with malaria ---, which is and treatable and preventable
He described the 2010 deadline as a "bold but achievable vision", saying that several African countries had "made dramatic strides in malaria control".
But he added: "The most affected nations remain off track to reach the goal of halting and reversing the incidence of the disease."
Previous efforts to control malaria have proved less than successful. Link to WHO
In 1998 the Roll Back Malaria initiative aimed to halve malaria deaths by 2010 - but halfway through the program deaths had actually risen.
Reversing the trend of increase in malaria and other diseases is one of the UN's Millennium Development Goals, aimed at reducing poverty and improving the quality of life by 2015.
Link to WHO
Thursday, April 24, 2008
The three-year study, commissioned by insurance conglomerate the California Earthquake Authority, combined empirical evidence on prior earthquakes with the physical data from various fault lines in the region and precise satellite information about movements of the Earth's surface.
According to the study, there is a 99.7 per cent chance of a quake of magnitude 6.7 or greater hitting
Disturbingly for southern Californians, it seems they are more vulnerable to a catastrophic quake than those living in the north - with a 37 per cent chance of a quake greater than magnitude 7.5 before 2037, which is more than twice the probability for the north.
Doctors Who Kill Themselves
reports every year, between 300 and 400 doctors take their own lives—roughly one a day. No other profession has a higher suicide rate. And, in sharp contrast to the general population, where male suicides outnumber female suicides four to one, the suicide rate among male and female doctors is the same.
He focuses on a new documentary, Struggling in Silence (airing next month on public-television stations), which explores the dark side of the profession—the little-known and rarely discussed problem of depression and suicide among physicians
"Undiagnosed and untreated depression is the culprit here," says Dr. Charles Reynolds, professor of psychiatry at the University of Pittsburgh School of Medicine, who appears in the film and was co-author of a 2003 paper (one of the few) on physician suicide, published in The Journal of the American Medical Association. While the rate of depression over a lifetime is basically the same for male physicians and the general population of men—about 12 percent—the doctors' suicide rate is 1.4 times higher. Female docs have double the rate of depression and 2.3 times the rate of suicide compared with the general population of women. (Some studies report equal rates of depression for women doctors; others report even higher suicide rates for physicians.)
So why aren't depressed docs seeking treatment for a common illness that millions of Americans have learned to manage with therapy and readily available medications? Because they worry—not without reason—that if they admit to a mental-health problem they could lose respect, referrals, income and even their licenses. Because, despite the steady increase in the number of women in the field, medicine is still very much a macho profession; physicians are supposed to be the strong ones who care for the sick, not the sick ones who need to be cared for. "I did not want it to go on my medical record that I had been treated for depression," says Dr. Robert Lehmberg, 60, whose moving account of his struggle with the condition—and the stigma it carries—is featured in the film. "Once I got treated, I realized how foolish all that was."
The goal of Struggling in Silence, and of the new Web site doctorswithdepression.org (both the work of the American Foundation for Suicide Prevention), is to raise awareness, prevent suffering and even save some lives. There could be a bonus as well. "If we teach doctors to recognize depression in themselves," says Dr. Paula Clayton, the foundation's medical director, "they will recognize it in their patients." And then everybody will feel better.
Confronting Depression and Suicide in Physicians
A Consensus Statement
Claudia Center, JD et al
Journal of the American Medical Association 2003; 289:3161-3166.
Wednesday, April 23, 2008
Adam Liptak writing for the New York Times (
gives an in depth appraisal of the US penal system. The United States has less than 5 percent of the world’s population. But it has almost a quarter of the world’s prisoners.
The United States leads the world in producing prisoners, a reflection, he says, of a relatively recent and now entirely distinctive American approach to crime and punishment. Americans are locked up for crimes — from writing bad checks to using drugs — that would rarely produce prison sentences in other countries. And in particular they are kept incarcerated far longer than prisoners in other nations.
Criminologists and legal scholars in other industrialized nations say they are mystified and appalled by the number and length of American prison sentences.
The United States has, for instance, 2.3 million criminals behind bars, more than any other nation, according to data maintained by the International Center for Prison Studies at King’s College London.
Maybe there is a hint as to the under pinnings of US crime and punishment in another piece in the same edition
Gilbert King, the author of The Execution of Willie Francis: Race, Murder and the Search for Justice in the American South writes an opinion article for the New York Times (
King explains - with gruesome details - why the court was wrong in the 19th century and how that
error that has infected its jurisprudence for more than 100 years.
And 60 years after two drunken executioners disregarded the tortured screams of a teenage boy named Willie Francis, the Supreme Court continues to do so.
The bill would have provided for jail sentences up to seven years for anyone convicted of using threatening language on the basis of sexual orientation.
The legislation had already passed the House of Commons.
The Lords voted 81 to 57 to strip prison sentences from the bill, leaving it toothless.
The vote leaves the Labor government with two choices: either let the bill die, or use a procedural vote in the Lower House to override the Lords.
Even some gay rights advocates, including Peter Tatchell, opposed the bill, saying it would hamper free speech.
Church leaders also fought the legislation claiming it could be used to silence any criticism of homosexuality from the pulpit.
Comedic actor Rowan Atkinson said that if the bill were enacted it would bar humorists and comedians from characterizing gays.
The bill was put together with the help of LGBT rights group Stonewall.
Stonewall director Ben Summerskill dismissed the criticism of the legislation saying people could still criticize homosexuality as long as they were "temperate and polite".
Attempts to charge people with homophobic speech under existing law has been met with failure.
Similar hate speech laws in Europe and Canada have been met with mixed results as judges attempt to balance hate crime laws with free speech and religious freedom protections.
The American Civil Liberties Union has sent a letter to the Peace Corps demanding that it change its policy of barring people with HIV from serving as volunteers.
The letter was sent on behalf of a Denver, Colorado volunteer who was sent home from his post in the Ukraine and terminated after he tested positive.
"I joined the Peace Corps because I wanted to learn more about the world and help people," said Jeremiah Johnson.
"It was hard enough to learn that I had contracted HIV, but to then be shipped home and told I was unworthy of finishing my service was incredibly humiliating."
Johnson, now 25, began his tour as a Peace Corps volunteer in December 2006. He tested negative for HIV prior to beginning his service.
For nearly thirteen months, he was the sole volunteer in Rozdilna, Ukraine, where he taught English to middle and high school students.
In January 2008, Johnson, who was in Kiev to attend a Russian language program with other volunteers, received a midservice medical examination and opted to take an HIV test.
After the results confirmed that he was positive for the disease, he was immediately told that he could no longer work in the country because of a Ukrainian law barring people with HIV from working in the country. He was also told he would not be able to finish his service elsewhere.
Although he had no health problems, he was only allowed to return to Rozdilna for two days to pack his bags and say goodbye to the people he had met during his tour, the ACLU said in a statement.
He was forced to abandon projects that he had been developing to help the community. Johnson was then sent to Washington, D.C., for an end-of-service medical exam.
The ACLU said that while in DC, he again asked Peace Corps officials to explain why he was being terminated and asked if he could continue his service elsewhere, but these requests were denied. Instead, he was given an automatic medical termination, stating HIV as the reason for his termination.
The ACLU’s demand letter charges that it is illegal under the Rehabilitation Act for the Peace Corps to discriminate against Johnson because he has HIV.
The letter cites a recent federal appeals court decision finding that it is illegal for the Foreign Service to bar people with HIV from serving. In that case, the Foreign Service, which also sends workers around the globe, had argued that it was justified in barring people with HIV from service in order to protect the health of people with HIV who would be stationed in areas with limited access to medical treatment. The court rejected that rationale.
"There is not a single justifiable reason for the Peace Corp to bar people with HIV from serving as volunteers," said Rebecca Shore, an attorney with the ACLU’s AIDS Project.
"Jeremiah was, and continues to be, in good health, fully capable of performing his responsibilities. It is especially disappointing that an agent of our government would have an illegal and discriminatory policy barring people with HIV from trying to make the world better."
The ACLU’s letter demands that the Peace Corps change its policy or confirm that it does not have a policy of automatically excluding all people with HIV. According to the ACLU, the Peace Corps must consider on an individualized basis whether an applicant with HIV can volunteer, including making every effort to place those who are able to serve in a country that doesn’t bar people with HIV from working in the country.
A number of Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco starts with "Shh!" and claims 12,000 veterans a year attempt suicide while under department treatment.
"Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" the e-mail asks.
A VA spokesman declined to comment Tuesday.
Another e-mail said an average of 18 war veterans kill themselves each day _ and five of them are under VA care when they commit suicide.
Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation Tuesday calling on the VA to track how many veterans commit suicide each year. Currently, VA facilities record the number of suicides and attempted suicides in VA facilities but do not record how many veterans overall take their own lives. The agency is reluctant to disclose specific numbers, veterans advocates complain.
The new bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since
Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer on Monday urged a judge to dismiss the lawsuit, saying the agency runs a "world class" medical care system.
Tuesday, April 22, 2008
An analysis of 50,000 cases of melanoma found people with these cancers were nearly twice as likely to die as those with the disease on arms or legs.
Scalp and neck cancers were often found later but there seemed to be something inherently virulent about them, the Archives of Dermatology study found.
Survival rates from skin cancer are nonetheless relatively high.
The five-year survival rate for patients with scalp or neck cancer was 83%, compared with 92% for those with melanomas on the face and ears and on the extremities - the arms, legs, hands and feet.
Cancers on the scalp and neck appeared to be thicker and were more likely to be ulcerated than cancers at other sites. The lymph nodes were also more often affected in patients with scalp and neck cancers than in the other skin cancer groups.
The researchers acknowledged that people with cancers in areas likely to be hidden by hair were more likely to spot skin abnormalities later. But even after this was factored into the analysis, there was a poorer survival rate overall - leading the researchers to conclude that there were biological differences between the cancers
"Only 6% of melanomas present with the disease on the scalp or neck, but those patients account for 10% of melanoma deaths," said Nancy Thomas, a professor of dermatology who led the research.
Survival Differences Between Patients With Scalp or Neck Melanoma and Those With Melanoma of Other Sites in the Surveillance, Epidemiology, and End Results (SEER) Program
Anne M. Lachiewicz et al
Archives of Dermatology Apr 2008; 144 (4): 515 - 521.
Researchers chose to study the effect of the Brd4 gene as it is known to influence the growth of cells. They believe the findings may not be limited solely to breast cancer, although they have yet to test that fully.
The researchers inserted copies of the gene into some of the mice breast cancer tumors. They found after 28 days the size of the tumors had been limited to a tenth of the size of those without the gene, while the spread of the disease to the lungs was much more limited.
The team then carried out research into 1,240 patients, split between five separate groups. They found those with the Brd4 gene had much better survival rates - in some of the groups it was nearly double the rate than those without the gene.
Researchers said as well as being able to predict the consequences of the disease, a treatment could even be developed to stimulate or introduce the gene.
Report author Kent Hunter said: "Potentially, this treatment could help manage and control a cancer.
"That is still a long way off, but in the more immediate future we could at least predict the course of the disease."
Bromodomain 4 activation predicts breast cancer survival
Nigel P. S. Crawford et al
Proc. Natl. Acad. Sci. USA, published