Air pollution could increase breast cancer risk: study

Traffic-related air pollution may put women at risk for breast cancer, according to a new study from Quebec.

The study, published in the journal Environmental Health Perspectives, looks at links between the risk of breast cancer, a leading cause of death from cancer in women, and traffic pollution.

Researchers from McGill University and the Université de Montréal charted incidences of breast cancer and compared them with pollution maps.

“We’ve been watching breast cancer rates go up for some time,” study co-author Mark Goldberg, a researcher at McGill University Health Centre, said in a release on Wednesday.

“Nobody really knows why, and only about one-third of cases are attributable to known risk factors. Since no one had studied the connection between air pollution and breast cancer using detailed air pollution maps, we decided to investigate it.”

Dr. Goldberg and his colleagues combined data from several studies. They created two air pollution maps which showed levels of nitrogen dioxide, a byproduct of vehicle traffic, in different parts of Montreal in 1996 and 10 years earlier in 1986.

Then, the research team looked at the home addresses of women diagnosed with breast cancer in a 1996-97 study and charted that onto the air pollution maps.

The team says its results were “startling,” and showed the incidence of breast cancer was increased in areas with higher levels of air pollution.

“We found a link between post-menopausal breast cancer and exposure to nitrogen dioxide (NOsub2/sub), which is a marker for traffic-related air pollution,” Dr. Goldberg said in the release.

“Across Montreal, levels of NOsub2/sub varied between five parts per billion to over 30 parts per billion. We found that risk increased by about 25% with every increase of NOsub2/sub of five parts per billion.

“Another way of saying this is that women living in the areas with the highest levels of pollution were almost twice as likely to develop breast cancer as those living in the least polluted areas.”

Dr. Goldberg warns, however, that the study must be interpreted with caution.

“First of all, this doesn’t mean NOsub2/sub causes breast cancer,” he said. “This gas is not the only pollutant created by cars and trucks, but where it is present, so are the other gases, particles and compounds we associate with traffic — some of which are known carcinogens.”

Dr. Goldberg said the study can be subject to unknown variables and that some areas of uncertainty remain.

“For example, we don’t know how much the women in the study were exposed to pollution while at home or at work, because that would depend on their daily patterns of activity, how much time they spend outdoors and so on,” Dr. Goldberg said.

“At the moment, we are not in a position to say with assurance that air pollution causes breast cancer. However, we can say that the possible link merits serious investigation,” the team said in its release.

Studies published in the U.S, have also shown possible links between cancer and air pollution.

The study was funded by a research grant from the Canadian Cancer Society and another one from the Canadian Institutes of Health Research.

Doctors give teenager artificial heart

Doctors in Italy have implanted an artificial heart into a 15-year-old boy, the first time the procedure has been performed on a child.

Heart surgeons at Rome's Bambino Gesu Children's Hospital carried out the 10-hour breakthrough operation on Thursday, and the hospital said it was "cautious" over the boy's condition.

"A permanent artificial heart in the inside of the chest was implanted for the first time on an (adolescent) patient. So far this type of implant has only taken place on adults," the hospital in a statement on Saturday.

Artificial hearts are usually used on a temporary basis for patients awaiting a suitable human transplant, but the boy suffered from an illness that made a long wait impossible.

The artificial heart is four centimetres wide and weighs 400 grams, and special measures were taken to reduce the risk of infection.

"The risk of infection represents the primary cause of failure of alternative solutions attempted to date worldwide," said the hospital.

The procedure "opened new therapeutic perspectives and hope for life for all patients with cardiac illnesses for whom a transplant is needed, especially for those like Thursday's patient who cannot receive a donated heart for clinical reasons," the statement said.

Two women seriously ill after drinking aloe vera juice they bought at school fair which was laced with horse tranquilliser

Medical chiefs issued a warning today after two women who bought a health drink contaminated with a horse tranquilliser were left seriously ill in hospital.

The women, one aged 60 and the other in her 40s, suffered a severe reaction when they drank the aloe vera juice that they purchased at a school fair.

One of the victims collapsed into a 'vegetative state' according to her daughter and had to be revived by paramedics.

Both women, who have not been named, were said to be in a 'satisfactory' condition in the Leicester Royal Infirmary.

It has now been confirmed the drink was contaminated with Ketamine, an anaesthetic agent which slows the breathing. It is used by vets treating horses, but is also popular with recreational drug users.

Dr Philip Monk, a public health consultant with the Health Protection Agency, said: 'The Ketamine was probably neat.  

'In the small doses such as these, it is unlikely to prove fatal but could cause serious damage.'

The women, who are suffering from respiratory problems, are believed to have bought it at the Abbey Mela in Leicester last Saturday, an Asian carnival put on by the city's Abbey Primary School.

The 60-year-old victim collapsed 'within seconds' of drinking a small amount of the juice and complaining of a burning sensation in her throat.

Her daughter said: 'It happened about 9.30pm last Wednesday. I received a panicked phone call from my father and arrived about five minutes later.

'When I got there, I thought she was going to die. My dad was crying as the paramedics were trying to revive her. It was awful.

'She was basically in a vegetative state. They thought she might have bleeding on the brain. I thought "that's it".'

Aloe vera juice is used for consumption and relief of digestive issues such as heartburn and irritable bowel syndrome.

Leicester City Councillor Rashmi Joshi, who is a friend of one of the woman, said: 'Her family are extremely worried about her.

'Her husband thought she had gone. But he worked on her until the paramedics arrived and they treated her for 20 minutes before she was taken to hospital.

Health officials have said that anyone who has recently bought the drink, made by Indian-based company Gayatri Herbals, should avoid consuming it and hand it over to police.

Dr Tim Davis, from the Leicester City Primary Care Trust, speaking on behalf of the Health Protection Agency, said: 'We are unaware how many bottles were sold. It was in a white plastic bottle, and is normally sold like a health product.'

A spokeswoman for Leicestershire Police said: 'We are working with the Health Protection Agency to look into how the drinks consumed came to be potentially contaminated.

'We are keeping an open mind as to the circumstances.'

Adrian Russell, the city council's director of environmental services, said he did not think the product was widely sold. However, one shop has already been completely cleared of it's stock.

Experimental diet pill shows promise, little risk

An experimental diet pill helped about half the people who tried it lose some weight and keep it off a year later, without the heart problems that some earlier drugs caused, a study found.

Arena Pharmaceuticals' lorcaserin is one of three drugs that are boosting hope for a new generation of more effective weight-loss medicines. One gets a Food and Drug Administration review on Thursday and the others, later this year.

In the study, lorcaserin (lore-KASS-ah-rin) caused more people to lose at least 5 percent of their body weight over one year, more than twice the rate achieved by those on dummy pills.

Most people don't stick to diets. And diet pills have had bad side effects or can't be taken long-term. A low point came in 1997 when the popular "fen-phen" was pulled from the market after it was tied to heart valve problems.

But now comes lorcaserin, a round blue tablet that would be the first truly novel weight-loss pill in a dozen years if it wins approval. The drug targets the same appetite pathway fen-phen did but in a more selective, and perhaps safer, manner.

Results of a large company-funded study of it are in Thursday's New England Journal of Medicine.

The study involved more that 3,100 obese or overweight people given either the drug or dummy pills.

After a year, nearly 48 percent of the lorcaserin group had lost at least 5 percent of their body weight - about 13 pounds on average. Just 20 percent of the placebo group lost that much weight.

Only about half of those in the study stuck with it a year. That's not unusual; diet studies typically have lots of dropouts. But more of the people on lorcaserin stayed in than those on placebo, suggesting that side effects were not a problem.

A second phase of the study began after one year with the original participants who remained. Those on dummy pills kept taking them, while the people on lorcaserin were assigned either to keep getting it or to switch to dummy pills. Neither they nor their doctors knew which treatment they were receiving.

Of those in the lorcaserin group who had lost at least 5 percent of their body weight in the first year of the study, about 68 percent who kept taking the drug kept the weight off, versus 50 percent of those switched to dummy pills.

Except for headaches and dizziness, side effects were essentially no worse with the drug than placebo. There was no higher rate of heart valve problems - a key concern. However, larger studies are needed to conclusively rule out this risk.

Unlike some other obesity drugs, lorcaserin did not raise heart rates or blood pressure. In fact, cholesterol levels and other risk factors for heart disease improved in those on the drug.

"It looks very safe at this point," said study leader, Dr. Steven Smith of the Sanford-Burnham Medical Research Institute in Orlando.

Some experts described the drug's effectiveness as moderately good, and its safety as apparently very good. The findings are probably sufficient to meet FDA benchmarks and win approval, they predicted.

Current diet pills include the appetite suppressant phentermine; sibutramine, an appetite suppressant sold as Meridia; and orlistat, a drug that blocks fat absorption and is sold as the prescription drug Xenical or the over-the-counter Alli.

They are all problematic. Phentermine has been linked to heart palpitations and higher blood pressure. Sibutramine has been tied to heart risks and has been removed from the market in Europe; the FDA will review its risks and benefits later this year. And orlistat can cause stomach pains, gas, and bowel leakage.

San Diego-based Arena hasn't put a price on lorcaserin. But it could be especially useful for obese patients with heart problems.

"There's a whole group of individuals we cannot use these current medications on," said Dr. Robert Kushner, a weight-loss expert at Chicago's Northwestern University who advises a company that makes another experimental diet drug.

The two other drugs before the FDA are combinations of medicines already on the market.

Vivus Inc.'s Qnexa is up for review Thursday. It combines phentermine and topiramate, a drug used for migraines and epilepsy that has raised safety concerns. Topiramate carries warnings about possible suicidal tendencies.

Contrave, made by Orexigen Therapeutics Inc., combines bupropion and naltrexone. The first is used to help people quit smoking and deal with depression. The second is used to decrease cravings for alcohol and illegal drugs.

Good news for fast food addicts

Washington (IANS)- Here's some good news for fast food addicts. Five major US food chains, including McDonald's and Burger King, have cut down on trans fats in their food.

Trans fats can elevate the risk of heart disease by increasing "bad" cholesterol and decreasing "good" cholesterol levels.

The latest findings from University of Minnesota School of Public Health suggest that major fast food chains may have been responsive to public health concerns.

Researchers relied on the School of Public Health proprietary database, comprising nutritional values of more than 18,000 foods, to look at levels of trans fat and saturated fat in french fries from chains like McDonald's, Burger King, Wendy's, Jack in the Box and Dairy Queen.

They found that three of the restaurants - McDonald's, Burger King, and Wendy's - significantly decreased the trans and saturated fatty acid composition of French fries between 1997 and 2008, says a university release.

"While it took time for major fast food chains to decrease trans fats in their foods, I'm pleased to see that they have done it," said Lisa Harnack, associate professor of epidemiology at the school, who led the research.

"I'm also pleased to see that they haven't raised levels of saturated fats to replace trans fats," Harnack added.

The findings were presented at the National Nutrient Database Conference in Grand Forks, North Dakota.

Many doctors don't blow whistle on colleagues

Your doctor could be drunk, addicted to drugs or outright incompetent, but other physicians may not blow the whistle.

A new survey finds that many American physicians fail to report troubled colleagues to authorities, believing that someone else will take care of it, that nothing will happen if they act or that they could be targeted for retribution.

A surprising 17% of the doctors surveyed had direct, personal knowledge of an impaired or incompetent physician in their workplaces, said the study's lead author, Catherine DesRoches of Harvard Medical School.

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One-third of those doctors had not reported the matter to authorities such as hospital officials or state medical boards. The findings, appearing in Wednesday's Journal of the American Medical Association, are based on a 2009 survey of 1,891 practicing U.S. doctors.

Reporting a problem doctor can trigger important changes. Twenty-one years ago, a colleague smelled alcohol on a young physician's breath and anonymously reported him to the head of the residency program. A now-sober Dr. A. Clark Gaither is grateful.

"I wish I knew who reported me," Gaither said. "I'd like to give them a big ol' hug and thank them for saving my life."

Programs exist for retraining doctors with weak skills and getting addicted ones into treatment. But the survey results suggest doctors are not confident in the system, DesRoches said.

The American Medical Association and other professional groups say doctors have an ethical obligation to make such reports. And many states require doctors to tell authorities about colleagues who endanger patients because of alcoholism, drug abuse or mental illness.

Despite that, many doctors do not know what to do or where to start, DesRoches said.

In an accompanying editorial, one ethics expert called the findings "jarring."

"I don't think there's any excuse for less than 100% of physicians holding true to these ideals," said Dr. Matthew Wynia, director of the AMA Institute for Ethics.

He called for better protections for whistle-blowers and more education for doctors on how to report a colleague.

The survey did not specify the type or severity of the impairment or incompetence, asking: "In the last three years, have you had direct, personal knowledge of a physician who was impaired or incompetent to practice medicine in your hospital, group, or practice?"

Most states have programs that not only get doctors into treatment but also advise their colleagues how to intervene. Most will keep reports anonymous. Some use the threat of medical board sanction to persuade doctors to go to rehab.

For Gaither, the first confrontation with concerned colleagues was in medical school. He reassured his fellow students he was fine. Even the second confrontation, from the program head who had heard the report of Gaither's alcohol-scented breath, did not take. Gaither signed a contract promising to stay sober, go to Alcoholics Anonymous meetings and submit to testing.

"I went home and drank that night," he said. "I was thinking with an addicted brain, and I was an alcoholic."

Finally, a third confrontation and the temporary loss of his training license forced Gaither into what he calls "a state of surrender." With help from the North Carolina Physicians Health Program, he got into a residential rehab program.

His last drink was Jan. 21, 1990. Gaither, now 55, finished his residency and became a family doctor. He practices in Goldsboro, N.C., where he started a free mobile clinic for the uninsured.

In 2002, the North Carolina Academy of Family Physicians named him Physician of the Year. He thanked AA and all the colleagues who confronted him and supported him in his acceptance speech.

He now urges others to report what they know. "It is our duty," he said.

Dr. Warren Pendergast runs the North Carolina program, which cooperates with the state medical society and state disciplinary board. About 200 doctors a year are referred for alcoholism, drug addiction, anger-management problems and depression.

Ninety% of addicted doctors who've been through the program remain clean and sober five years after treatment, Pendergast said.

"They're motivated. They have a lot to lose," he said. Their reputations and careers depend on their participation in treatment. Colleagues of troubled doctors "can feel comfortable getting peers help rather than sticking their head in the sand," he said.

Gaither, who speaks publicly about the program, said doctors worry that their troubled colleagues will lose their licenses and livelihoods if reported.

"I ask them, 'Would it be better if they lost their money, their marriage, their home, their cars, their license and then their life?'" he said. "Does that sound better than getting them the help that they need?"

Plastic antibodies, the new black, Audubon bird report

Plastic antibodies (New Scientist, Science Daily)

Natural antibodies are made of protein. Now, scientists at the University of California have made plastic antibodies for bee venom. Their process forms polymers around bee venom molecules, then dissolves the venom, leaving polymers customized to fit venom, just like natural antibodies.

The new black (New Scientist)

Materials scientists have created a "metamaterial" made of nano-wires of silver embedded in aluminum oxide, which can absorb virtually all the radiation that falls on it, in a range of frequencies depending on the details of construction. This means it could be a much more perfect black than ordinary black objects. More practically, it can be made to absorb radar.

(Cf. "fulligin," the color darker than black, in The Book of the New Sun, by Gene Wolfe.)

Audubon bird report

The NH Audubon Society has issued its statewide bird report here. A third of the species in the state are declining, a third are stable or increasing, and for a third there is insufficient data.