One billion suffer from hidden tropical disease

The World Health Organization estimated Thursday that 1 billion of the world's poorest people suffer from neglected tropical diseases such as dengue, rabies and leprosy that remain concentrated in remote rural areas and urban slums despite being mostly eradicated from large areas of the world.
WHO said it can substantially reduce those numbers with the help of drug donations from the pharmeceutical industry, which announced fresh pledges.
WHO identified 17 diseases and disease groups present in 149 countries one-third of the 2.7 billion people living on less than $2 a day. Thirty countries have six or more of the diseases. In all, more than one-third of the 2.7 billion people living on less than $2 a day are affected.
"They cause massive but hidden and silent suffering, and frequently kill, but not in the numbers comparable to the deaths caused by HIV/AIDs, tuberculosis or malaria," said WHO director general Margaret Chan.
Still, Chan said that the diseases take a serious toll that serves to "anchor large populations in poverty."
Two of the diseases, onchocerciasis, known as river blindness, and trachoma, a bacterial eye infection, cause blindness. Leprosy and lymphatic filariasis, or elephantiasis, leave victims deformed, hamper productivity and normal social interaction, Chan said. Sleeping sickness, or human African trypanosomiasis, debilitates before it kills. Left untreated, rabies is fatal.
Novartis has renewed a commitment to donate drugs to treat leprosy, while GlaxoSmithKline said it would expand donations of a drug to treat worm infections and Sanofi-Aventis will continue its support to help eliminate sleeping sickness and other illness.
Also active in the fight are Bayer, Eisai and Johnson&Johnson, WHO said.
The stigma was especially hard on girls and women. "Many neglected tropical diseases cause disfigurement and disability, leading to stigma and social discrimination," diminishing marriage prospects and raising the likelihood of abandonment for women and girls, the report said.
Diseases like dengue don't garner the same sort of international response because the victims lack a political voice, and the diseases don't tend to spread to distant countries and only rarely affect travelers, the report said.

Among the strategies to control the neglected tropical diseases are expanding preventative chemotherapy, which means treating whole populations where such diseases are identified with drugs that may knock out several of the diseases at once.

The report also recommends doing a better job of identifying the diseases, improving sanitation and controlling insects and animals, which can spread the diseases into human populations.
Chan said the campaign is aimed at making a "deliberate effort" to eradicate the diseases as a means to alleviate poverty, rather than waiting for them to "gradually disappear as countries develop."

Protein urine test may signal prostate cancer

A protein in urine could be a strong indicator of prostate cancer risk, according to British scientists who say their findings could one day be developed into a quick and simple test for the disease.
Scientists from the Cancer Research UK Cambridge Research Institute and the Institute of Cancer Research (ICR) said the protein, called microseminoprotein-beta or MSMB, is found at reduced levels in men diagnosed with the disease and are also lower in men with more aggressive forms of the cancer.
"The protein is easy to detect because it is found in urine and would potentially be a very simple test to carry out on men to identify those most at risk of developing the disease," said Hayley Whitaker of the Cambridge institute, who led the study.
Whitaker said that while it could be around five years before the results of this study are translated into a test for doctors to use in clinics, she hoped it would then also help them to determine which patients have aggressive tumors.
Prostate cancer killed an estimated 258,000 men around the world in 2008 and is the second most common cause of cancer death in men in the United States. In Britain, around 35,000 men are diagnosed with it and some 10,000 die from the disease.
The most effective screening tests currently available are based on a single biomarker called prostate specific antigen (PSA). But PSA testing is problematic because it has low specificity, which generates high false positive rates and leads to unnecessary surgical and radiotherapy treatment.
A U.S. study published last year found that routine PSA prostate screening has resulted in more than one million American men being diagnosed with tumors who might otherwise have suffered no ill effects from them.
"At the moment, PSA testing is the best method we have to detect prostate cancer but it has significant limitations, so there is an urgent need to find new biomarkers such as MSMB that could be used in screening and diagnosis," said Rosalind Eeles of the ICR and The Royal Marsden Hospital, who also worked on the study.
The protein -- which regulates prostate cell death -- is produced by normal prostate cells.
The scientists took tissue and urine samples from around 350 men both with and without prostate cancer to test MSMB levels.

The results, published in the Public Library of Science (PLoS) ONE journal, showed that MSMB is found at significantly lower levels in the urine of men diagnosed with prostate cancer than those without the disease. They also showed men with aggressive tumors were also likely to have lower levels of the protein in their urine.

Commenting on the study, Kate Holmes of the UK's Prostate Cancer Charity, said they could prove very valuable in future.
"Given the known limitations of the PSA blood test, finding a technique to accurately diagnose prostate cancer is the Holy Grail of research into the disease," she said in a statement.
"An accurate, reliable urine test for prostate cancer would be an invaluable tool if it is proven to be successful on a large scale."

When It Comes to Math, Females Are as Smart as Males

Males and females have equal math skills, a new report confirms.

Researchers reviewed 242 studies published between 1990 and 2007 that assessed the math skills of nearly 1.3 million people from grade school to college and beyond. They also examined the findings of several large, long-term scientific studies.

Both analyses showed a "meaningless" difference in math skills between males and females. The findings were published in the Oct. 11 online edition of the journal Psychological Bulletin.

While social scientists agree that both genders have equal math abilities, many parents and teachers still believe boys are better at math than girls. This can lead them to guide girls away from careers in math-heavy sciences or engineering, said the study's chief author Janet Hyde, a professor of psychology and women's studies at the University of Wisconsin-Madison.

"Parents and teachers continue to hold stereotypes that boys are better in math, and that can have a tremendous impact on individual girls who are told to stay away from engineering or the physical sciences because 'girls can't do math,'" Hyde said in a university news release.

It's known that stereotypes affect academic performance, she added.

"There is lots of evidence that what we call 'stereotype threat' can hold women back in math. If, before a test, you imply that the women should expect to do a little worse than the men, that hurts performance. It's a self-fulfilling prophecy," Hyde said.

"Parents and teachers give little implicit messages about how good they expect kids to be at different subjects and that powerfully affects their self-concept or ability. When you are deciding about a major in physics, this can become a huge factor," she added.

The study findings reinforce a recent study that ranked gender last among nine factors -- including parental education, family income and school effectiveness -- in influencing the math performance of 10-year-old students.

Hyde noted that women have made big advances in technical fields, and half of medical school students are female, as are 48 percent of math majors in college. "If women can't do math, how are they getting these majors?" she asked.

Is living under a flight path bad for the heart?

 Living with airplanes regularly thundering over your head could risk the healthy pumping of your heart, suggests a new Swiss study. Based on 4.6 million adults across Switzerland, researchers found that dying from a heart attack was more common with increased exposure to aircraft noise.

"The effect was especially evident for people who were exposed to really high levels of noise, and was dependent on how long those people had lived in the noisy place," researcher Matthias Egger of the University of Bern, told Reuters Health.

This isn't the first time that noise has been linked to negative health effects, including cardiovascular risks. But it could be novel progress in determining whether the sound is really exerting the effect, or if it is something else tagging along with the noise, such as air pollution.
"It's been a problem that when you look at road traffic noise there are both high levels of noise and high levels of air pollution," said Egger. "By looking at airports we were in a position to disentangle these effects."
Egger and his colleagues identified 15,532 heart attack deaths among 4.6 million Swiss residents between late 2000 and the end of 2005 using detailed information from an ongoing mortality study called the Swiss National Cohort. Government records and environmental data helped the team determine the distance of individuals' residences from airports and major roads, as well as relative levels of particulate matter in the vicinity. These allowed the researchers to pinpoint both aircraft noise and air pollution exposures for each individual over a period of 15 years or longer.
After accounting for air pollution and other factors including education and income levels, the group found that both the level and duration of aircraft noise drove up the risk of lethal heart attack.
People exposed to a daily average of at least 60 decibels of noise had a 30 percent greater risk of dying from a heart attack compared with those exposed to less than 45 decibels, the researchers report in the journal Epidemiology. Among those exposed to the higher decibel levels for 15 or more years, the risk was actually 50 percent higher.
Measuring exposure is complicated by the fact that aircraft noise is intermittent and can temporarily soar above 100 decibels if you're close to one taking off or landing, explained Egger, but the average of 60 decibels is about what you'd expect in a crowded, noisy bar.
Living within 100 meters of a major road also increased the risk of heart attack. However, the researchers found no impact of particulate-matter air pollution on the heart.
"This adds to growing evidence that there is a causal association between noise exposure and chronic disease, particularly coronary disease," said Hugh Davies of the University of British Columbia School of Environmental Health, in Canada, who was not involved in the study.
Davies pointed to two possible pathways by which noise could harm the body. The first is the well-known fight-or-flight response. "You hear a really loud noise and the first thing you do is jump into the air, literally startled," he told Reuters Health. "We're hard-wired for this response, and it's not something you can easily turn off."
The other path is more indirect: annoyance. Even if something isn't that loud or disturbing, such as a neighbor's radio, it can become really bothersome if they don't turn it off, he said.
At the end of both routes is the classic stress response, Davies added, which includes a rise in heart rate and blood pressure. Although usually not a problem when it's experienced in short, infrequent bursts, this kind of response can lead to significant wear and tear if it continues daily -- as it might if you live on a busy road or under a flight path.
Of course, road and air traffic produce different noise patterns that might not be easily comparable. Road traffic noise is much more constant and arguably easier to get used to than the startling roar of a plane taking off or landing, suggested Egger.
"Noise probably does have effects on health and it is important that we gain a better understanding of these," he said. "Our study can't prove a causal relationship, or be directly generalized. We need further studies."
An earlier study looking at noise exposure during sleep revealed a significant increase in blood pressure from aircraft noise, road traffic and other indoor sources such as snoring.
"This implies that it is the noise itself regardless of the sources that affects the blood pressure," Jenny Selander of the Karolinska Institute in Stockholm, Sweden, and who was not involved in the study, told Reuters Health in an e-mail. "I believe that applying these findings to other traffic-related noise sources would be fine."
As the evidence builds, the researchers suggest that further measures should be added to protect people. Sound barriers, controlling the speed and volume of traffic, and better home insulation can all help to reduce exposures, said Egger.
Davies suggested that adjustments to flight paths, cutting back on night flights and improved technology to reduce engine noise could aid in lowering risks as well.
But other than popping in earplugs at night, what is an individual to do? "If this affects you, you could think about moving somewhere quieter. But you'd probably find equal heart benefit if you stopped smoking, ate a healthier diet or exercised more," noted Davies. "There are probably only a few people that noise outright kills."
"In the 1890s, horses and carts on cobble roads in New York City was the big environmental problem," added Davies, noting that a published story at the time expressed excitement over the promise of far quieter horseless carriages. "How far we've come."

Women's "Body shape' DNA revealed

The parts of our DNA which may influence body shape, including the classic "apple" or "pear" shape in women, have been revealed.

A study in Nature Genetics found the locations of 13 genes which may play a role, with a stronger effect in women.

Where body fat lies may affect diabetes and heart disease risk, so the results could shed light on those diseases.

A British Heart Foundation spokesman said the findings could lead to new dietary advice or medicines.

It is known that men and women who carry more fat around their waists compared with their bottoms and thighs are more prone to diabetes and heart disease - but the reason why fat accumulates in different places is far less clear.

The scientists, led by researchers at Oxford University and the Medical Research Council, looked at the genetic code of more than 77,000 people, looking for genetic regions which could be linked to differences in body fat distribution.
Although the 13 locations highlighted probably only account for a tiny fraction of the variation in the ratio between waist and hip, they are more likely to point towards the underlying body mechanisms which control fat storage.
Genes known to be involved in controlling cholesterol, insulin, and insulin resistance - linked to the development of diabetes - fall within the 13 regions.

'Stepping stone'

The fact that the effect of genes in these locations may be stronger for women than for men also intrigues the researchers.

Dr Cecilia Lindgren, of the Wellcome Trust Centre for Human Genetics at Oxford, said: "By finding genes that have an important role in influencing whether we are apple-shaped or pear-shaped, and the ways in which that differs between men and women, we hope to home in on the crucial underlying biological processes.

Understanding biology through finding genes is just a first step in a long journey towards treatment, but it is a vital one."

A second, even bigger study looked for genetic variations connected to differences in "body mass index", the standard measure of weight vs height used as a guide to whether a person is a healthy weight.

They found 18 new genetic variants involved in people with higher BMI - in fact, people who inherited many of them weighed as much as 9kg (1st 5lbs) more than those who had only inherited a few.

Dr Ruth Loos, who led this study, said that the two studies combined may eventually lead to better ways to prevent obesity and even the development of new drugs.

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: "We've known for some time that while fat anywhere in your body is not good for you, fat around the tummy increases your risk of heart disease and other illnesses more than fat around the bum.

"We've also known that the pattern for where our body stores fat is partly controlled by our genes, but only one of the genes responsible had been discovered.

"It's likely that several of these new genes will control the behaviour of fat cells. This will need to be confirmed with further research, but these findings are a good stepping stone towards how we might be able to offer new dietary advice or medicines to control the pattern of fat distribution in future."

Who's better at sweating: Men or women?

The idea that women's "glow" is somehow different from men's "sweat" has new support: A Japanese study finds that women have to work harder than men while exercising in order to start sweating.

Moreover, men are more efficient at sweating, say scientists at Osaka International University and Kobe University in Japan.

The study, published in the journal Experimental Physiology, looked at 37 people, which included 20 females and 17 males. Of them, 10 of the females and eight of the males were trained. "Training" meant that these subjects had participated in endurance sports for more than six years, whereas "untrained" people in the study had not done any regular physical activity in the previous three years, with the exception of gymnastics lessons. None of the females had taken oral contraceptives, which might have altered the sweating results.

Participants cycled at 35, 50 and 65 percent of their maximal uptake of oxygen for an hour, with relative humidity of 45 percent.

Researchers found that trained participants had a greater average local sweating rate on their foreheads, chests, backs, forearms and thighs than untrained participants. But there was a striking gender difference also: Men benefited more from their training experience in their sweat production than women.

Untrained females had to work harder or have a higher body temperature in order to achieve a maximal activated sweat gland response, the scientists found.

The scientists suggest that increases in the sweat gland's response to physical training was smaller among trained females than trained males. This could be because men have higher testosterone levels than women, and testosterone may enhance the sweating response.

An important limitation is that this study did not measure testosterone levels. Also, it only included 37 people.

The findings suggest that women especially should take care when a heat wave is about to hit. But everyone can benefit from regular exercise in terms of the way their bodies respond to heat.

Sweat may be smelly sometimes, but there are good reasons to want to perspire.

Perspiration is mostly water and salt, with trace amount of electrolytes, which help regulate the fluid balance in the body, according to the Mayo Clinic. This fluid comes from the eccrine glands, which get stimulated by the automatic nervous system when your body temperature goes up. This kind of sweat cools the body as it evaporates on the surface of the skin.

But there is also another kind of sweat, which comes from the apocrine glands. This is the type of sweat is associated with emotional stress, and the accompanying odor comes from bacteria breaking it down.

Future research would look at the effectiveness of different kinds of sweat, and also examine how the sweating response relates to reproductive hormones, study authors said.

Findings of NSSHB on sexual and sexual-health behavior

Condom Use by US Individuals Ages 14 to 94

Findings from the largest nationally representative study of sexual and sexual-health behaviors ever fielded, conducted by Indiana University sexual health researchers, provides an updated and much needed snapshot of contemporary Americans' sexual behaviors, including a description of more than 40 combinations of sexual acts that people perform during sexual events, patterns of condom use by adolescents and adults, and the percentage of Americans participating in same-sex encounters.

The National Survey of Sexual Health and Behavior (NSSHB) was conducted by researchers from the Center for Sexual Health Promotion (CSHP) in Indiana University's School of Health, Physical Education, and Recreation (HPER).
The NSSHB is one of the most comprehensive studies on these topics in almost two decades and documents the sexual experiences and condom-use behaviors of 5,865 adolescents and adults ages 14 to 94.
Initial findings from the survey, presented in nine separate research articles, were published on Oct. 1 in a special issue of The Journal of Sexual Medicine, a peer-reviewed journal in the area of urology and sexual health. The issue also includes commentaries offering perspectives on the study from leading U.S. sexual health authorities, including former U.S. Surgeon General Dr. Joycelyn Elders, Dr. Kevin Fenton, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the national Centers for Disease Control and Prevention (CDC), and Lynn Barclay, President and CEO of the American Social Health Association.
"This survey is one of the most expansive nationally representative studies of sexual behavior and condom use ever conducted, given the 80-year span of ages," said Michael Reece, director of the Center for Sexual Health Promotion. "These data about sexual behaviors and condom use in contemporary America are critically needed by medical and public health professionals who are on the front lines addressing issues such as HIV, sexually transmissible infections and unintended pregnancy."
According to the study's findings, one of four acts of vaginal intercourse are condom protected in the U.S. (one in three among singles).
"These data, when compared to other studies in the recent past, suggest that although condom use has increased among some groups, efforts to promote the use of condoms to sexually active individuals should remain a public health priority," Reece said.
Researchers believe the findings will be of interest to the general public, as well as to health professionals.
"People are often curious about others' sex lives," said Debby Herbenick, associate director of the CSHP. "They want to know how often men and women in different age groups have sex, the types of sex they engage in, and whether they are enjoying it or experiencing sexual difficulties. Our data provide answers to these common sex questions and demonstrate how sex has changed in the nearly 20 years since the last study of its kind."
Herbenick said the study helps both the public and professionals to understand how condom use patterns vary across these different stages in people's relationships and across ages, adding that "findings show that condoms are used twice as often with casual sexual partners as with relationship partners, a trend that is consistent for both men and women across age groups that span 50 years."
The survey indicates that there is enormous variability in the sexual repertoires of U.S. adults now, and adult men and women rarely engage in just one sex act when they have sex. While vaginal intercourse is still the most common sexual behavior reported by adults, many sexual events do not involve intercourse and include only partnered masturbation or oral sex. When it comes to responsible sexual behaviors, condom use is higher among black and Hispanic Americans than among white Americans and those from other racial groups.
A unique feature of the study was the inclusion of adolescent men and women. Dennis Fortenberry, M.D., professor of pediatrics in the IU School of Medicine, led the adolescent aspects of the study.
"Many surveys of adolescent sexual behavior create an impression that adolescents are becoming sexually active at younger ages, and that most teens are sexually active," Fortenberry said. "Our data show that partnered sexual behaviors are important but by no means pervasive aspects of adolescents' lives. In fact, many contemporary adolescents are being responsible by abstaining or by using condoms when having sex."
Additional key findings highlighted in the collection of papers include:

• There is enormous variability in the sexual repertoires of U.S. adults, with more than 40 combinations of sexual activity described at adults' most recent sexual event.
• Many older adults continue to have active pleasurable sex lives, reporting a range of different behaviors and partner types, however adults over the age of 40 have the lowest rates of condom use. Although these individuals may not be as concerned about pregnancy, this suggests the need to enhance education efforts for older individuals regarding STI risks and prevention.
• About 85 percent of men report that their partner had an orgasm at the most recent sexual event; this compares to the 64 percent of women who report having had an orgasm at their most recent sexual event. (A difference that is too large to be accounted for by some of the men having had male partners at their most recent event.)
• Men are more likely to orgasm when sex includes vaginal intercourse; women are more likely to orgasm when they engage in a variety of sex acts and when oral sex or vaginal intercourse is included.
• While about 7 percent of adult women and 8 percent of men identify as gay, lesbian or bisexual, the proportion of individuals in the U.S. who have had same-gender sexual interactions at some point in their lives is higher.
• At any given point in time, most U.S. adolescents are not engaging in partnered sexual behavior. While 40 percent of 17 year-old males reported vaginal intercourse in the past year, only 27 percent reported the same in the past 90 days.
• Adults using a condom for intercourse were just as likely to rate the sexual extent positively in terms of arousal, pleasure and orgasm than when having intercourse without one.

In addition to Reece, Herbenick and Fortenberry, co-authors include Stephanie Sanders of The Kinsey Institute for Research in Sex, Gender, and Reproduction and the Department of Gender Studies at IU; and Vanessa Schick, Brian Dodge, and Susan Middlestadt of the Center for Sexual Health Promotion at IU. The study was funded by Church & Dwight Co. Inc., maker of Trojan® brand sexual health products.

Possible Method for Boosting the Immune System to Protect Infants Against HIV

Researchers at Oregon Health &Science University may have uncovered a new weapon for combating HIV as it is passed from mother to newborn child. The research, which was led by researchers at OHSU's Oregon National Primate Research Center, will be published in the October 3rd online edition of the journal Nature Medicine.
"Mother-to-infant transmission of HIV is a tremendous worldwide problem, especially in several African nations," said Nancy Haigwood, Ph.D., researcher and director of the Oregon National Primate Research Center at OHSU.
According to the latest data from the World Health Organization, 33.4 million people were infected by the virus in 2008. About 67 percent of the world's infections are in African countries. In addition, 91 percent of the world's childhood infections are in Africa.
Haigwood, her colleagues at OHSU, along with researchers at the University of Washington are investigating strategies for preventing or countering HIV infections in babies born to women with HIV. Their strategy: to educate part of the baby's immune system within the first few hours of birth to better fight of the disease.
"HIV attacks and kills T-cells, the white blood cells that play an important role in the immune system because they have the ability to identify and destroy disease invaders. By attacking the body's natural defenses, the disease progresses, causes AIDS and eventually death," explained Haigwood. "Therefore, many therapies focus on protecting T-cells."
However, Haigwood and her colleagues took a different approach. They focused on another component of the immune system, which was initially thought to play a lesser role in the body's defense against HIV. Babies born to HIV-infected mothers have HIV-specific neutralizing antibodies at the time of birth that are "passively" acquired across the placenta. They wanted to determine whether boosted neutralizing antibody levels would weaken the disease's ability to overtake the body's defenses.
To investigate this possible treatment, the researchers studied three small groups of infant monkeys. The first group was given additional antibodies derived from healthy mothers. The second group was given antibodies matched to simian/human immunodeficiency virus (SHIV). SHIV is a hybrid virus used in research to ensure that results translate between species. The third group of animals was provided with HIV antibodies similar to, but not exactly matching, the strain of infection they would receive. The three groups were then exposed to SHIV and their immune systems were subsequently monitored.
Unlike the other two groups, the "HIV-matched" animals were better protected from the virus. They developed higher levels of neutralizing antibodies and, had lower levels of SHIV in their blood plasma than the comparison groups six months post-infection. In addition they maintained their CD4+ T cells -- another component of the immune system.
The study also provided insights into the level of antibodies needed to impact disease progression. For this study, the antibody levels were relatively low dosed. Previously, antibodies were shown to block infection in animal models. This study demonstrated, for the first time, that very low levels of antibodies  too low to block infection  can influence disease progression in this setting and stimulate an immune response that contributes to viral control in the absence of drug treatment.
In future studies, the researchers hope to learn whether higher doses of antibodies translate into greater protection for the infants.
"This research demonstrates that boosting the body's HIV antibodies by a time-honored method of passive transfer that would use new HIV-specific human monoclonal antibodies  may be a strategy for reducing infection levels and protecting CD4+ T cells in newborn children," said Haigwood. "While the treatment would not likely prevent infection, it could limit the levels of infection in children which would greatly reduce suffering and extend lives."
The National Institutes of Health and the Elizabeth Glaser Pediatric AIDS Foundation funded this research.

Molecule structure offers clue to HIV and cancer treatments

Scientists have created an image of an important molecule linked to HIV infection and cancer which may help treat the diseases.

Researchers from California used an X-ray technique to find out the structure of the CXCR4 molecule and how it works.
The findings could open up new areas for drug discovery, says the study published in Science.
But experts say we still need to understand more about the activity of CXCR4.
The molecule is part of a large family of proteins called G-protein coupled receptors (GPCRs).
These molecules span the cell's membrane and transmit signals from the external environment to its interior.
They help control practically every bodily process, including cell growth, hormone secretion and light perception. Normally CXCR4 helps activate the immune system and stimulate cell movement.

Mixed signals
But when the signals that activate the receptor are not properly regulated, CXCR4 can spur the growth and spread of cancer.
To get a picture of this important molecule, scientists used a method called X-ray crystallography.
But this method proved difficult because membrane proteins are tricky to coax into the crystal form required for the X-ray technique, the study says.
In the end it took three years to produce the right conditions to get a clear picture of the CXCR4 molecule's structure.
Scientists then managed to generate five distinct structures of CXCR4.
The structures showed that CXCR4 molecules form closely linked pairs, confirming data from other experiments.
'Wine glass' structure
Professor Raymond Stevens, lead researcher from Scripps Research Institute in California, said: "The structures open up entire new areas for understanding fundamental principles in chemokine GPCR signalling," he said.
The images also showed that CXCR4 is shaped like two wine glasses touching in a toast.
Researchers said the pictures suggest how to design compounds that regulate CXCR4 activity or block HIV entry into cells.
If developed into drugs, the study says, such compounds could offer new ways to treat HIV infection or cancer.
Keith Alcorn is senior editor at NAM, a charity that supports people living and working with HIV.
"HIV uses a number of receptors to gain entry to cells. Most people with HIV start out with a virus that uses a receptor called CCR5.
"Over time their virus population may switch to using CXCR4, for reasons we still don't fully understand. Several companies have already developed drugs which block the CCR5 receptor.
"A combination of drugs that block both CCR5 and CXCR4 might prove to be a very successful form of HIV treatment, but we need to understand more about the consequences of blocking the activity of CXCR4, because this receptor is also involved in some of the normal immune system functions," he said.
Josephine Querido, senior science information officer at Cancer Research UK, welcomed the research findings.
"This is exciting research as CXCR4 has been linked to the growth and spread of a variety of different cancers. Unravelling the structure of this molecule is a vital step towards designing new drugs to help treat cancer."

3 or More X-Rays May Raise Leukemia Risk Among Kids

Researchers report that exposure to three or more X-rays in childhood may double the odds that a child will develop a form of leukemia, although the overall risk remains small.

The study authors aren't calling for an end to childhood X-rays, which can be crucial to the treatment of conditions such as pneumonia and broken bones. And the study doesn't definitively prove that the X-rays directly boost the risk of leukemia.

However, the researchers are recommending that doctors not order X-rays when they aren't necessary and that they take special precautions regarding CT scans, which deliver much more potentially dangerous radiation to the body.

Study co-author and epidemiologist Patricia Buffler called the findings a "very serious alert."

"Eliminating or reducing any unnecessary exposure [to radiation] is important," said Buffler, a professor at the University of California, Berkeley's School of Public Health, although she acknowledged that "some exposures are very important for making accurate diagnoses."

Leukemia, a form of cancer that strikes the bone marrow and blood, sickens about 3,317 children from birth to age 14 in the United States each year, according to the Leukemia & Lymphoma Society. One type, acute lymphoid leukemia, is the most common type of cancer among kids aged 1 to 7 years.

Doctors can usually treat this leukemia successfully, but it has the potential to be deadly.

In the new study, the researchers looked at the medical records of 711 children up to the age of 14 who were diagnosed with acute lymphoid leukemia in California from 1995-2008. Researchers compared them to similar kids who didn't have leukemia.

The findings were published in the Oct. 1 online edition of the International Journal of Epidemiology.
The researchers excluded the X-rays in the year prior to diagnosis and before birth. They found that kids were 1.85 times more likely to develop that type of leukemia if they had had three or more X-rays. In a separate part of the study, the researchers looked at kids with acute myeloid leukemia, but found no link between that type of leukemia and exposure to X-rays.
In the big picture, the increased risk doesn't greatly increase the risk of leukemia in children overall. In general, about four out of every 100,000 kids develop the specific kind of leukemia in question, study co-author Buffler said, and if the risk doubled the number would go to eight.
The results are surprising in light of previous assumptions about the safety of X-rays. "We're talking about fairly routine diagnostic X-rays," Buffler said.

Why might X-rays be so risky? Research suggests that the kind of radiation found in X-rays can cause cells in the body to mutate and create cancer, Buffler explained. And CT scans, which have grown in popularity in recent years, create more radiation than traditional X-rays, she noted. Future studies will look into the effects of CT scans on leukemia rates, she added.

The findings make sense to Dr. Anna Meadows, an oncologist at Children's Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania.

"The bottom line is that any kind of radiation X-ray can increase the risk of cancer. There is a risk here, but the risk is small," she said.

"Doctors should not be ordering X-rays without a good reason," Meadows added. "But if there is a good reason, they shouldn't hesitate."

More information
Learn more about leukemia from the U.S. National Library of Medicine.

Kids With Allergies Shouldn't Skip Flu Shots

The flu vaccine is safe for children with food allergies, experts say, as long as precautions are taken.
That assessment is being offered by a team of researchers at the Johns Hopkins Children's Center in Baltimore, who noted that up to 3 percent of American kids harbor an allergy to eggs, raising concerns among parents who worry that the egg-based flu vaccine may spell trouble.
"Some parents are understandably concerned about allergic reactions to the flu vaccine and in the past may have opted against it, but the risk of catching the flu far outweighs the risk for an allergic reaction to the vaccine, and even children with egg allergies can be immunized safely," Dr. Robert Wood, director of Allergy & Immunology at Hopkins Children's, said in a news release from the center.
The issue of allergy risk is perhaps more front and center this year than in the past, given that this flu season U.S. health officials for the first time have decided to call for the vaccination of all children 6 months of age and up.
Previously, only children with high-risk medical conditions -- such as asthma, diabetes, heart disease or neurological disorders and/or suppressed immune systems -- were advised to get a flu shot.
The dilemma is further aggravated by the fact that while some vaccines do come in an allergen-free form, the flu vaccine is not among them.
Nevertheless, Wood said that most children with egg allergies can be vaccinated, as long as they undergo a skin-prick allergy test first to assess the severity of their allergy and to look for signs of antibodies against either the gelatin or egg proteins that are often found in vaccines.
Anti-allergy drugs, such as antihistamines and corticosteroids, are available and can be given pre-vaccination to minimize the risk of a reaction, he added.
Wood first teamed up with Hopkins pediatrician Dr. Neal Halsey to outline a safe approach towards the flu shot/allergy issue two years ago. At that time, the team advocated vaccination for almost all allergic kids as long as they undergo allergy testing, as well as close post-inoculation monitoring for a few hours by a physician.
The researchers noted that serious allergic reactions, which typically manifest very shortly (within minutes to a couple of hours) after vaccination, are actually extremely rare, occurring in just one or two patients per million.
That said, parents and physicians need to know that children with a prior history of allergic reactions are more prone to suffer future ones, and Wood stressed that those children already known to have a severe egg allergy should always be seen by a pediatric allergist before being immunized.
Immediate allergic reactions typically have a wide range of symptoms, including hives, swelling, wheezing, coughing, low blood pressure, vomiting and diarrhea. At times, full-blown anaphylaxis -- a life-threatening allergic reaction -- can occur, according to background information in the news release.
Delayed reactions manifesting days or weeks after the fact are usually not serious or life-threatening if they are diagnosed and treated promptly.
In that context, Wood said that those children with mild or unconfirmed allergies are usually good to go for a pediatrician-applied flu shot.
And now is a good time to book that appointment because Friday marks the unofficial start of the 2010-2011 flu season.
More information
For more on the flu vaccine and children, visit the U.S. Centers for Disease Control and Prevention.

Health Tip: Keeping Diabetes Under Control

-- Whether you need to lose weight, gain weight or stay where you are, if you're diabetic, eating the right food can help you manage the disease.
People with diabetes must take extra care to make sure that their diet is balanced with insulin and oral medications, and to exercise to help manage their blood glucose levels, says the American Diabetes Association. Sticking to a meal plan can help you improve your blood glucose, blood pressure and cholesterol numbers, and also help keep your weight on track.
This might sound like a lot of work, but your doctor or dietitian can help you create a meal plan that is best for you, one that fits into your schedule and lifestyle. When you make healthy food choices, you will improve your overall health, and you can even help prevent complications such as heart disease, some cancers, and hypertension.

'Father of test tube baby' wins Nobel

KARL RITTER, MALIN RISING /Associated Press

Robert Edwards of Britain won the 2010 Nobel Prize in medicine on Monday for developing in-vitro fertilization, a controversial breakthrough that ignited sharp criticism from religious leaders but helped millions of infertile couples in the last three decades have children.
Edwards, an 85-year-old professor emeritus at the University of Cambridge, started working on IVF as early as the 1950s. He developed the technique — in which egg cells are removed from a woman, fertilized outside her body and then implanted into the womb — together with British gynecologist surgeon Patrick Steptoe, who died in 1988.
On July 25, 1978, Louise Brown in Britain became the first baby born through the groundbreaking procedure, marking a revolution in fertility treatment.
"(Edwards') achievements have made it possible to treat infertility, a medical condition afflicting a large proportion of humanity, including more than 10 percent of all couples worldwide," the medicine prize committee in Stockholm said in its citation.
"Approximately 4 million individuals have been born thanks to IVF," the citation said. "Today, Robert Edwards' vision is a reality and brings joy to infertile people all over the world."
Steptoe and Edwards developed IVF from the early beginning experiments into a practical course of medicine and founded the first IVF clinic at Bourn Hall in Cambridge in 1980.
Today, the probability that an infertile couple will take home a baby after a cycle of IVF is 1 in 5, about the same odds that healthy couples have of conceiving naturally.
Prize committee secretary Goran Hansson said Edwards was not in good health Monday when the committee tried to reach him. Bourn Hall said Edwards was too ill to give interviews.
"I spoke to his wife and she was delighted and she was sure he would be delighted too," Hansson told reporters in Stockholm after announcing the 10 million kronor ($1.5 million) award.
"Louise's birth signified so much," Edwards said at Brown's 25th birthday celebration in 2003. "We had to fight a lot of opposition but we had concepts that we thought would work and they worked."
Brown, now 32, reportedly is a postal worker in the English coastal city of Bristol. In 2007 she gave birth to her first child — a boy named Cameron. She said the child was conceived naturally.
"Its fantastic news, me and mum are so glad that one of the pioneers of IVF has been given the recognition he deserves. We hold Bob in great affection and are delighted to send our personal congratulations," Brown said in a statement released by Bourn Hall.
The work by Edwards and Steptoe stirred a "lively ethical debate," the Nobel citation said, with the Vatican, other religious leaders and some scientists demanding the project be stopped. When the British Medical Research Council declined funding for Steptoe and Edwards, a private donation allowed them to continue their research.
The Vatican is opposed to IVF because it involves separating conception from the "conjugal act" — sexual intercourse between a husband and wife — and often results in the destruction of human embryos that are taken from a woman but not used.
There was no immediate comment from the Vatican's top bioethics officials Monday to word of the Nobel.
In a statement, Bourn Hall said one of Edwards' proudest moments was discovering that 1,000 IVF babies had been born at the clinic since Brown, and relaying that information to a seriously ill Steptoe shortly before his death in 1988.
"I'll never forget the look of joy in his eyes," Edwards said.
William Ledger, head of reproductive and developmental medicine at Sheffield University, called the award "an appropriate recognition" for Edwards.
"The only sadness is that Patrick Steptoe has not lived to see this day because it was always a joint team effort between the two of them," Ledger said.
Steptoe was not honored with a prize because Nobel rules were amended in 1974 to prohibit posthumous prizes.
Other experts criticized Britain for not honoring Edwards earlier with a knighthood.
"It's a shame Britain hasn't recognized him in a more explicit fashion," said Francoise Shenfield, infertility expert with the European Society of Human Reproduction and lecturer in medical ethics at University College London.
In an interview with The Times of London in 2003, Edwards said he was "not terribly bothered" about not getting a knighthood.
"I'm a very left-wing socialist and I won't shed a tear. But if you can organize a Nobel, please go ahead," he joked.
Aleksander Giwercman, head of reproduction research at the University of Lund in Sweden, said Edwards' achievements also provided tools for other areas of research, including cancer and stem cells.
"Many of the illnesses that develop when we are adults have their origin early on in life, during conception," Giwercman said.
The controversy over in-vitro technology has not dimmed despite its popularity. In the last few years, the increasing use of IVF has also raised discussions about what age it's appropriate to become a mother. In 2006, a 67-year-old Spanish woman became a mother after she used IVF technology to conceive twins, only to die herself two years later.
The medicine award was the first of the 2010 Nobel Prizes to be announced. It will be followed by physics on Tuesday, chemistry on Wednesday, literature on Thursday, the Nobel Peace Prize on Friday and economics on Monday Oct. 11.
The prestigious awards were created by Swedish industrialist Alfred Nobel, and first handed out in 1901, five years after his death.
Famous Nobel winners include President Barack Obama, who received last year's peace prize; Albert Einstein, Martin Luther King Jr., Nelson Mandela and Winston Churchill. But most winners are relatively anonymous outside their disciplines until they suddenly are catapulted into the global spotlight by the prize announcement.

'Father of test tube baby'

"As early as the 1950s, Edwards had the vision that IVF could be useful as a treatment for infertility," which affects about 10 percent of all couples worldwide, the commitee said.
"He worked systematically to realize his goal, discovered important principles for human fertilization, and succeeded in accomplishing fertilization of human egg cells in test tubes (or more precisely, cell culture dishes). His efforts were finally crowned by success on 25 July, 1978, when the world's first 'test tube baby' was born," the committee said.
His work has led to the birth of about four million babies, the committee said in praising his work.
The prize is worth 10 million Swedish kronor (about $1.5 million).
Born in Manchester, England, in 1925, Edwards is based at Cambridge University in England.
The announcement marks the beginning of a week of prizes, with physics, chemistry, literature and peace coming in the next four days. The prize in economics will be announced next Monday.
Last year's prize for medicine went jointly to three United States researchers for solving "a major problem in biology," the Nobel Committee said.
Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak shared the $1.4 million prize "for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase."

Understanding how chromosomes are protected against degradation could shed light on human aging and diseases, including cancer.

Robert Edwards - the IVF pioneer who fulfilled a mission

When he first began mixing eggs and sperm in a petri dish in a Cambridge laboratory in the 1960s, Professor Robert Edwards knew that he would face criticism from fellow scientists, the media and the church.

At a Washington conference on biomedical ethics in 1971, the Nobel laureate James Watson, who with Francis Crick had discovered DNA, said in vitro fertilization (IVF) research would necessitate infanticide.

But Edwards stood up and forcefully defended his work, receiving a standing ovation in the process. On Monday, he won the Nobel Prize in Medicine for his work.

Edwards, 85, still believes that clergy who condemn IVF are 'totally mistaken.' He also holds the opinion that IVF should be funded by the state.

'Catholics are told not to do it and yet Catholics go and do it. All the popes have done for themselves is teach their people to disobey them,' Edwards has said.

Edwards, who has five daughters and 11 grandchildren, said he was 'proud' two years ago to celebrate the 30th birthday of Louise Brown, whose birth by Caesarean section in 1978 he vividly remembered.

'I think the birth of a child is the greatest thing that can happen, and anybody that gets in the way should be pushed to one side. It is the No 1 thing,' he has said.

Edwards was educated at Manchester Central High School and served in the British army in Palestine, Jordan, Egypt and Iraq from 1944 to 1948.

He did undergraduate studies at the University of Bangor in Wales and gained a postgraduate degree at the Institute of Animal Genetics in Edinburgh University, before becoming a Population Council Research Fellow at the Institute of Technology in California in the late 1950s.

Edwards began his long association with Cambridge University in 1963 and was scientific director at Bourn Hall, the clinic he co- founded with his colleague and fellow scientist, Patrick Steptoe, from 1980 to 1990.

He was appointed an emeritus professor at Cambridge University in 1989. His many honours, national and international, include being made a Fellow of the Royal Society, Britain's foremost science institution, in 1984.

Edwards, who was awarded a CBE (Commander of the British Empire) by Queen Elizabeth II in 1988.

His outside interests include politics, farming, conservation, rugby and cricket.

Male infertility gene discovered

A faulty gene could help explain some cases of unexplained male infertility, according to research.

Mutations of the NR5A1 gene were found in a small percentage of infertile men, reports the American Journal of Human Genetics.
Scientists from the Pasteur Institute in France and University College London said it could help doctors investigating men with the condition.
A UK expert said he hoped that further gene defects could be found.

In the majority of cases, doctors can find no cause for male infertility, despite it accounting for up to half of cases in which couples have difficulty conceiving.

Male infertility appears to be more common within certain families, and this leads scientists to believe that there may be a genetic root for some cases, but only a handful of gene mutations which might be responsible have actually been found.
The latest research looks at a gene already known to be involved in sexual development in both men and women - defects in NR5A1 have been linked to physical defects in the development of the testicles or ovaries.
Their findings suggest that, even where there is no physical evidence of a problem, defects in the gene may be hampering the ability to make sperm.

They looked at the gene in 315 apparently healthy men who had an unexplained inability to produce sperm.

From this group, they found mutations in the gene in just seven, and closer examination revealed the men had altered levels of sex hormones and, in one case, mild abnormalities in the cellular structure of the testicles.
The research authors, from the UCL Institute of Child Health in London and the Institut Pasteur in Paris, said: "We conclude that approximately 4% of men with otherwise unexplained failure to produce sperm carry mutations in the NR5A1 gene."
Although the find would affect only a small proportion of infertile men, other specialists believe that other similar discoveries could help build up a clearer picture of the origins of the condition.
Dr Allan Pacey, a senior lecturer in andrology at the University of Sheffield, said that there was still "embarrassingly little" known about the genetics behind male infertility.
"Given the complexity of the sperm production process it is likely that many genes are involved and therefore that may gene defects linked to infertility may be found.
"Although this gene defect affects only a small number of men, we need more studies like this so that we can fill in the gaps in our knowledge and possibly one day build a robust diagnostic test for male fertility based on genetics."

Contraceptive coil raises hope of delaying womb cancer

 Michelle Roberts/BBC News

European experts are hopeful that the coil contraceptive device could be used to delay womb cancer.

Promising early trial findings show an intrauterine device (IUD) can deliver hormones to the womb lining to halt and even reverse cancer growth.
This can buy young women with the disease time to have children before undergoing a curative hysterectomy.
It has already enabled nine such women to conceive, Annals of Oncology journal reports.

The usual treatment for endometrial cancer is a total hysterectomy with the removal of the womb and ovaries, but this results in the end of the woman's fertility.

Preserving fertility
Sometimes it is possible for patients to be given oral hormone therapy to slow down the growth of the cancer, but this can cause unpleasant side effects, including skin rashes, nausea and vomiting.
Delivering the hormones direct to the problem area with a coil can avoid some of these side effects.
In this first prospective clinical trial of the treatment, 39 women aged between 20 and 40 and with very early womb cancer were studied.
Each of the woman was fitted with an IUD that released a steady stream of a progesterone-like hormone aimed at halting the cancer growth.

The women also received a monthly injection of gonadotropin-releasing hormone for six months to stop them producing oestrogen - the hormone that promotes the development of endometrial cancer.

The IUD was left in place for a year, and then, if the cancer had not continued to grow or returned, it was removed, enabling the women to plan for pregnancies.
Once the women had completed their desired number of pregnancies, they had hysterectomies.
All of the women are alive and well and so far nine have succeeded in having a baby.
Dr Lucas Minig, one of the authors of the study conducted at the European Institute of Oncology in Milan, said the findings gave encouragement for starting a larger international trial of the treatment.
Henry Scowcroft of Cancer Research UK said there were more hurdles to overcome before it could be recommended as a treatment for women with womb cancer.
"We look forward to seeing the results of larger more robust trials," he said.
The charity has been funding its own studies into this type of treatment.
Meanwhile, its latest research in the British Journal of Cancer suggests women who exercise and keep active can cut their risk of womb cancer by almost a third.

Staying active on workdays good for the heart

Commuting to work on your own two feet, or while spinning two wheels, could help stave off heart failure, suggests a new Finnish study.

And if your job keeps you active during the day too, even better.

Not only is leisure-time physical activity an important component of a healthy lifestyle, but so is occupational activity and daily walking or cycling to and from work, senior researcher Dr. Gang Hu of Pennington Biomedical Research Center in Baton Rouge, Louisiana, told Reuters Health in an e-mail.

Previous studies had found protective effects of regular physical activity on both coronary heart disease and stroke. However, researchers had not yet explored the impact of exercise on the risk of heart failure, or the unique roles of leisure and non-leisure activities on the condition.

Heart failure is characterized by a heart unable to pump sufficient blood to meet the body's needs, and currently affects more than 5 million Americans.

In an effort to tease apart the effects of occupational, commuting and leisure-time physical activity on the risk of heart failure, Hu and his colleagues studied nearly 60,000 Finnish men and women who participated in a series of surveys conducted between 1972 and 2002.

During an average follow-up of 18 years, about 3,500 (6 percent) of the men and women developed heart failure.

Not surprisingly, leisure-time physical activity significantly lowered the risk among both men and women, with men who vigorously exercised at least three times a week enjoying the most benefit: a 47 percent lower risk of heart failure than inactive men.

After accounting for age and the year in which each participant started the study, the team found that men who participated in moderate or high occupational activity -- from a fair amount of standing and walking to heavy manual labor -- had about a quarter lower risk of heart failure, compared to those who sat around an office all day. For women, drops in risk were 33 and 13 percent for moderate and high activity, respectively.

Women who commuted to work by walking or cycling also had a reduced risk of heart failure compared to those who did not, even after adjusting for leisure-time and occupational physical activity.

The more types of physical activities someone participated in, the greater the risk reduction, report the researchers in the Journal of the American College of Cardiology.

Dr. Luc Djousse of Brigham and Women's Hospital, in Boston, noted that the findings are consistent with those from the Physician's Health Study, in which he and his colleagues also showed that leisure-time physical activity was associated with a lower risk of heart failure in men.

The new study goes further by identifying the benefits of exercise beyond just our few hours of leisure, he noted in an e-mail to Reuters Health.

"Increases in computerization and mechanization that have resulted in ever-increasing numbers of people being sedentary for most of their time," said Hu, advising that people try to incorporate short spurts of exercise during work breaks, active commuting, and physical activity during leisure time.

"At the community level, effort should be devoted to infrastructure that favors commuting as well as leisure-time physical activity," added Djousse, highlighting the benefits of pedestrian and cycling paths, as well as parks.

He further suggested that employers focus on workplace design and policies that encourage various types of exercise, including the use of stairs instead of elevators or escalators, and adequate space for bicycle parking.

Besides physical activity, said Djousse, other lifestyle factors that can lower the risk of heart failure include not smoking and eating a diet high in fruits and vegetables, legumes, and whole grains, while also low in salt and red meat.

Treatment for heart failure can include drugs or implanted devices that stimulate the heart to beat properly, or surgery to correct mechanical defects.