Thursday 6 June 2013

Nutrition 'must be a global priority', say researchers


Malnutrition is responsible for 45% of the global deaths of children under the age of five, research published in the Lancet medical journal suggests.
Poor nutrition leads to the deaths of about 3.1 million under-fives annually, it says.
An international team reviewed different causes of malnutrition in pregnancy and childhood.
They say the first 1,000 days of life - from conception to two years - have lasting consequences for health.
Malnutrition - which includes being overweight or obese as well as under-nourished - also has an economic impact.
According to a recent United Nations report, malnutrition is estimated to cost the world $3.5tn (£2.3tn) - or $500 for every person - in healthcare and lost productivity.

Start Quote

If maternal and child nutrition can be optimised, the benefits will accrue and extend over generations, which is why we must work together now to seize this opportunity.”
Dr Richard HortonThe Lancer
A team led by Prof Robert Black, of Johns Hopkins Bloomberg School of Public Health, Baltimore, US, reviewed evidence on maternal and child under-nutrition and obesity in low-income and middle-income countries since 2008.
The team also assessed national and international progress on nutrition programmes.
Prof Black and colleagues say while some progress has been made in recent years, they estimate that more than 165 million children were affected by stunting (low height for age) and 50 million by wasting (low weight for height) in 2011.
An estimated 900,000 lives could be saved in 34 countries if 10 proven nutritional interventions were scaled-up to 90% of the world, they say.
"The nutritional consequences of the months during pregnancy and the conditions during the first two years of life have very important consequences for mortality and for adult chronic disease," Prof Black told BBC News.
"The early nutritional deficit results in developmental consequences for the individual and that has implications for their ability to succeed in school and ultimately in society to have the most productive jobs."
The researchers warn that countries will not break out of poverty unless nutrition becomes a global priority.
Dr Richard Horton, editor-in-chief of the Lancet, said: "If maternal and child nutrition can be optimised, the benefits will accrue and extend over generations, which is why we must work together now to seize this opportunity."
Experts working in development are gathering in London this weekend for a summit on nutrition hosted by the UK and Brazilian governments.
This will be followed by the annual summit of leaders from the G8 countries.
The Enough Food for Everyone IF campaign is calling for $1bn per year in additional aid money to be spend on malnutrition by 2015.
Enough Food for Everyone IF spokesperson Anita Tiessen said:
"These new figures confirm our worst fears - that hundreds of thousands more children are dying from malnutrition than we previously thought.
"We have made incredible progress in tackling child deaths around the world, but malnutrition remains the Achilles' heel in our efforts to prevent millions of needless deaths each year. We must urgently prioritise tackling hunger if we are to continue the progress we have made."

Thursday 30 May 2013

HIV inner shell structure revealed

Researchers have for the first time unravelled the complex structure of the inner protein shell of HIV.
The US team, reporting in Nature, also worked out exactly how all the components of the shell or 'capsid' fit together at the atomic level.
Until now the exact structure had proved elusive because of the capsid's large size and irregular shape.
The finding opens the way for new types of drugs, the researchers from the University of Pittsburgh said.
It was already known that the capsid, which sits inside the outer membrane of the virus, was a cone-shaped shell made up of protein sub-units in a lattice formation.
But because it is huge, asymmetrical and non-uniform, standard techniques for working out the structure had proved ineffective.
HIVComputer model of HIV capsid structure
The team used advanced imaging techniques and a supercomputer to calculate how the 1,300 proteins which make up the cone-shaped capsid fit together.
Critical interactions
The process revealed critical interactions between molecules in areas that are necessary for the shell's assembly and stability.
These potential vulnerabilities in the protective coat of the viral genome could be exploited by scientists designing new drugs to tackle the problem of HIV resistance, the researchers explained.
Study leader Dr Peijun Zhang, associate professor in structural biology at the University of Pittsburgh School of Medicine said: "The capsid is critically important for HIV replication, so knowing its structure in detail could lead us to new drugs that can treat or prevent the infection.
"The capsid has to remain intact to protect the HIV genome and get it into the human cell, but once inside, it has to come apart to release its content so that the virus can replicate.
"Developing drugs that cause capsid dysfunction by preventing its assembly or disassembly might stop the virus from reproducing."
She added that the fast mutation rate of HIV made drug resistance a big problem.
"This approach has the potential to be a powerful alternative to our current HIV therapies, which work by targeting certain enzymes."
Prof Simon Lovell, a structural biologist at the University of Manchester, said not only had the researchers managed to achieve something that was very difficult, they had also found some really interesting results.
"The big problem with HIV is that it evolves so quickly that any drug you use you get drug resistance which is why we use a multi-drug cocktail.
"This is another target, another thing we can go after to develop a new class of drugs to work alongside the existing class.

Common painkillers 'pose heart risk

Two common painkillers, ibuprofen and diclofenac, can slightly increase the risk of heart problems if taken in high doses for a long time, data suggests.
People with severe arthritis often take the drugs, which also calm inflammation, to go about daily life.
The researchers said some patients would deem the risk acceptable, but they should be given the choice.
A study, published in the Lancet, showed the drugs posed even greater risks for smokers and the overweight.
The risks have been reported before, but a team of researchers at the University of Oxford analysed the issue in unprecedented detail in order to help patients make an informed choice.
The group investigated more than 353,000 patient records from 639 separate clinical trials to assess the impact of non-steroidal anti-inflammatory drugs.
They looked at high-dose prescriptions levels, rather than over-the-counter pain relief, of 150mg diclofenac or 2,400mg ibuprofen each day.
They showed that for every 1,000 people taking the drugs there would be three additional heart attacks, four more cases of heart failure and one death as well cases of stomach bleeding - every year as a result of taking the drugs.
So the number of heart attacks would increase from eight per 1,000 people per year normally, to 11 per 1,000 people per year with the drugs.
"Three per thousand per year sounds like it is quite a low risk, but the judgement has to be made by patients," said lead researcher Prof Colin Baigent.
He added: "So if you're a patient and you go and sit in front of your doctor and discuss it, you are the one who should be making the judgement about whether three per thousand per year is worth it to allow you, potentially, to go about your daily life."
He said this should not concern people taking a short course of these drugs, for example for headaches.
However, he did warn that those already at risk of heart problems would be at even greater risk as a result of the high-dose drugs.
High blood pressure, cholesterol and smoking all increase the risk of heart problems.
Prof Baigent said: "The higher your risk of heart disease, the higher your risk of a complication. Roughly speaking, if you've got double the risk of heart disease, then the risk of having a heart attack is roughly doubled."
He said patients should consider ways to reduce their risk, which could include statins for some patients.
Alternative
A similar drug called rofecoxib (known as Vioxx), was voluntarily taken off the market by its manufacturer in 2004 after similar concerns were raised.
There are more than 17 million prescriptions of non-steroidal anti-inflammatory drugs in the UK each year. Two thirds are either ibuprofen or diclofenac.
A third drug, naproxen, had lower risks of heart complications in the study and some doctors are prescribing this to higher-risk patients.
The drug does a similar job to aspirin by stopping the blood from clotting although this also increases the odds of a stomach bleed.
Prof Alan Silman, medical director of Arthritis Research UK, said the drugs were a "lifeline" for millions of people with arthritis and were "extremely effective in relieving pain".
He added: "However, because of their potential side-effects, in particular the increased risk of cardiovascular complications which has been known for a number of years, there is an urgent need to find alternatives that are as effective, but safer."
Prof Donald Singer, member of the British Pharmacological Society and from the University of Warwick, said: "The findings underscore a key point for patients and prescribers - powerful drugs may have serious harmful effects.
"It is therefore important for prescribers to take into account these risks and ensure patients are fully informed about the medicines they are taking."

Thursday 16 May 2013

Gene clues for testicular cancer, heart defect


PARIS: Separate studies of the human genome have found tantalising clues to the inherited causes of testicular cancer and non-inherited causes of congenital heart disease, journals reported on Sunday.

University of Pennsylvania researchers looked at the DNA of more than 13,000 men, comparing the DNA code of those with testicular cancer -- the commonest form of cancer diagnosed among young men today -- against men who were otherwise healthy.

They found four new variants that increase the risk of this disease, bringing the tally of known mutations to 17, according to research reported in Nature Genetics.

Meanwhile, investigators at the Yale School of Medicine found a clutch of gene mutations, absent in parents but found in their offspring, which account for at least 10 percent of cases of severe congenital heart disease, a birth defect that afflicts nearly one percent of babies.

"Most interestingly, the set of genes mutated in congenital heart disease unexpectedly overlapped with genes and pathways mutated in autism," said Richard Lifton, a professor of genetics.

"These findings suggest there may be common pathways that underlie a wide range of common congenital diseases."

The study appears in the journal Nature.

Genomics is one of the fastest-moving areas of medical research.

Identifying genetic signatures associated with disease opens up the prospect of DNA tests to identify people most at risk. They also throw open avenues of research to block or reverse the disease. (AFP)