By Kate Kelland
Reuters

Scientists from a British cancer charity are teaming up with technology gurus from the likes of Amazon, Facebook and Google to design and develop a mobile game aimed at speeding the search for new cancer drugs. 

The project, led by the charity Cancer Research UK, should mean that anyone with a smart phone and five minutes to spare will be able to investigate vital scientific data at the same time as playing a mobile game.

The first step is for 40 computer programmers, gamers, graphic designers and other specialists to take part in a weekend "GameJam" to turn the charity's raw genetic data into a game format for future so-called "citizen scientists".

"We're making great progress in understanding the genetic reasons cancer develops. But the clues to why some drugs will work and some won't are held in data which need to be analyzed by the human eye - and this could take years," said Carlos Caldas at Cancer Research UK's Cambridge Institute.

"By harnessing the collective power of citizen scientists we'll accelerate the discovery of new ways to diagnose and treat cancer much more precisely."

After the GameJam, which runs in London from March 1-3, an agency will build the game concept into reality and the team plans to launch it in mid 2013.

Cancer already kills more than 7.5 million people a year and the number of people with the disease worldwide is expected to surge by more than 75 percent by 2030, according to the World Health Organization's cancer agency IARC.

CRUK's scientists are working hard to identify the genetic faults that drive cancer to try to find new ways of diagnosing and treating patients in a more targeted way based on their genetic profile and that of their tumors.

In a major international study on breast cancer genetics published last year, CRUK researchers said they are now able to classify the disease into 10 subtypes - a finding that could lead to more accurate and tailored treatment in future.

That study also found several completely new genes that drive breast cancer, offering potential targets for new types of drugs.

Yet this type of research generates colossal amounts of data that need to be analyzed, CRUK said as it announced the gaming project. And while advances in technology mean scientists can process data faster than ever, much of it still needs to be analyzed by people rather than machines.

"The human eye can detect subtle changes that machines are not programmed to look for - leading to serendipitous discoveries providing clues to the causes and drivers of the disease," the charity said.

"With the collective power of hundreds of thousands of people across the globe helping our scientists to analyze this data we could drastically speed up research."

Philip Su, engineering site director of Facebook London said his company believes the best way to solve a problem "is to bring smart people together to 'hack' a solution." 

"That approach is just as valid in the field of life sciences as it is in software engineering," he said.

By Andrew M. Seaman
Reuters
People who take a certain type of diabetes drug to lower blood sugar levels may be at an increased risk of developing an inflamed pancreas, according to a new study. 

Glucagonlike peptide 1(GLP-1) therapies that include exenatide - marketed as Byetta by an alliance between Bristol-Myers Squibb and AstraZeneca - and sitagliptin - marketed as Januvia by Merck - have been linked to pancreatitis before in studies on animals and small groups of patients, said the study's lead author.

"New therapies and risks are only evaluated when studies are done. We need to know (the drugs) are effective in lowering blood sugar, but we also need to know about risks," said Dr. Sonal Singh, from the Johns Hopkins University School of Medicine in Baltimore.

Pancreatitis, which can cause life-threatening complications, is rare but more common in people with type 2 diabetes. Singh said pancreatitis occurs in about three of every 1,000 diabetes patients.

The U.S. Centers for Disease Control and Prevention estimates that there are about 19 million Americans diagnosed with diabetes, and another 7 million who have the disease but don't know it yet.

In people with type 2 diabetes, the body doesn't produce enough insulin or is resistant to what it does produce.

For the new study, published in JAMA Internal Medicine, the researchers used data on 1,269 diabetes patients between the ages of 18 and 64 years old, who were admitted to U.S. hospitals with pancreatitis in 2005 through 2008.

They compared those to 1,269 other diabetes patients who were similar, but were not hospitalized with pancreatitis.

Overall, they found 87 of the diabetes patients with pancreatitis were taking GLP-1 therapies, compared to 58 of the diabetes patients without pancreatitis.

Singh told Reuters Health that the findings show the drugs are linked to a doubling of the risk of pancreatitis - about six cases per 1,000 diabetics.

"I won't say you should be alarmed about the findings, but it's something you should consider," he said.

‘Changing treatment'

Dr. Aaron Cypess, a staff endocrinologist in the clinic of the Joslin Diabetes Center in Boston, said the new study will not change how he treats patients, but it may influence him to go over his patients' risk factors for pancreatitis.

"For me personally it's not going to change my practice pattern in terms of stopping the drugs, but we may revisit whether you're showing any of the risk factors," said Cypess, who was not involved with the new study.

In a joint statement, the American Diabetes Association and the American Association of Clinical Endocrinologists also said the new findings should not change how doctors treat diabetes patients.

"The analysis is a retrospective study using data from an administrative database. This type of analysis is not considered as robust as a prospective randomized controlled clinical trial, the gold standard for evaluating treatments," the organizations wrote in the statement.

They continue that there are nine of those "gold standard" trials in the works that should provide answers soon. 

The current study also had limitations, including that the diabetes patients hospitalized with pancreatitis tended to lead a less healthy lifestyle than those who did not have the condition.

In a commentary, Belinda Gier and Dr. Peter Butler from the University of California, Los Angeles, write supporters say the drugs are safe and offer some advantages over older medications. 

Currently, the labels for Januvia and Byetta carry warnings that there have been reports of pancreatitis in people taking the drugs.

Other side effects of Byetta include nausea and other stomach issues. For Januvia side effects also include respiratory infections and headaches. Cypess told Reuters Health both drugs are still protected by patents and can be expensive. 

Representatives from Merck and Bristol-Myers Squibb said they - along with drug regulators - actively monitor reports of adverse events in users of their drugs, and have not found evidence showing the drugs cause pancreatitis.

Zachary Confections Inc. has recalled certain lots of its Chocolate Covered Marshmallow Eggs and suspended further production because the treats may be contaminated with salmonella. 

The Frankfort, Ind., firm announced the voluntary recall of their popular Easter treat after a test of one lot detected salmonella. The firm said in a press release that it's recalling four lots of the product out of an abundance of caution. No illnesses have been reported in connection with the recall, firm officials said.

The recall includes chocolate-coated marshmallow eggs packaged in white egg crates with purple, green and yellow lettering. The products include the cases with a UPC code of 1 00 75186 31797 3 and the individual unit UPC code 075186 15797 8. The treats have a Best Buy date of Feb. 14, 2014. The recall included the following code dates: D3245D, D3145E, F3145E and D3245E. For more information, click here. 

The recalled product was manufactured on Feb. 20 and 21 and shipped to retail stores in Iowa, Minnesota, North Dakota, South Dakota and Wisconsin. No other Zachary Confections products are included in the recall, the company said. 

Production of the product has been suspended while federal Food and Drug Administration inspectors and company officials investigate the possible source of the contamination.

Consumers should destroy the products or return them to the purchase place for a refund. For more information, call (765) 654-8356 between the hours of 8 a.m. ET and 4:30 p.m. ET. 

Salmonella infections can cause fever, diarrhea, vomiting and abdominal cramping in affected people. Infections usually resolve within several days, but in some people, particularly children, the elderly and those with weakened immune systems, salmonella can cause severe illness requiring hospitalization. 

Related: 

• 4 charged in salmonella outbreak plead not guilty
• Salmonella by mail? Hatchery sparks 8-year outbreak

Four people charged in connection with a 2009 salmonella outbreak in peanuts that killed nine and sickened hundreds pleaded not guilty Thursday to all charges.

Peanut Corporation of America owner Stewart Parnell, his food broker brother Michael Parnell, Georgia plant manager Samuel Lightsey and Georgia plant quality assurance manager Mary Wilkerson entered their pleas in a south Georgia federal court.

A 76-count indictment charges the four defendants in a scheme to manufacture and ship salmonella-tainted peanuts.

The outbreak caused one of the largest recalls in history and prompted the government to file criminal charges, rarely pursued in food poisoning cases because intentional contamination is difficult to prove.

U.S. Magistrate Judge Thomas Langstaff set bond at $100,000 each for the Parnell brothers, $50,000 for Lightsey and $25,000 for Wilkerson. The defendants and their family members, who attended Thursday's hearing, did not speak to reporters.

The case next goes to U.S. District Judge W. Louis Sands. A trial date has yet to be set.

Among the various charges are conspiracy, mail fraud, wire fraud and the introduction of adulterated and misbranded food into interstate commerce with the intent to defraud or mislead.

Assistant U.S. Attorney Kenneth Dasher told the court that Stewart Parnell faces a maximum 754 years in prison and $17 million in fines if convicted. His brother Michael faces a maximum 437 years and $10 million.

The indictment said the company misled consumers about salmonella being in its product, even when laboratory tests indicated its presence. It said certificates accompanying some of the peanut shipments were altered to say the peanuts were safe when tests said otherwise.

The indictment also says Stewart Parnell, Lightsey and Wilkerson gave false or misleading statements to federal food investigators who visited the plant as the outbreak was unfolding, resulting in obstruction of justice charges.

The company later went bankrupt.

Investigations are pending into two other large outbreaks in recent years — an outbreak of salmonella in eggs in 2010 and an outbreak of listeria in cantaloupe in 2011 that was linked to more than 30 deaths.

The AP's Kate Brumback contributed to this report.

Getty Images / Frederick M. Brown

Debi Austin, shown here in 2004, became an influential anti-tobacco advocate in a series of TV ads that showed the dangers of smoking.

The California woman who appeared in the dramatic 1996 anti-smoking television commercial “Voicebox,” has died after a 20-year battle with cancer. Debi Austin was 62.

Austin, who was known as California's most well-known anti-smoking advocate, died on Feb. 22, public health director Dr. Ron Chapman announced on the state's website this week.

“We are saddened by Debi’s death,” Chapman said on the site. “She exemplified the real toll tobacco takes on a person’s body.”

In “Voicebox,” Austin, who had her larynx removed, inhales a cigarette through the surgical hole in her throat. She recalls smoking her first cigarette at age 13.

“When I found out how bad it was, I tried to quit,” she says. “But I couldn’t. They say nicotine isn’t addictive. How can they say that?”

“Voicebox,” Austin’s first ad for the California tobacco control program, also aired in New York and Hawaii. Austin, the woman the state calls its most well-known anti-smoking advocate, later appeared in other commercials in which she warned of the dangers of smoking.

“Gradually tobacco took not just my health but my dreams,” she says though gasps in “Candle.” “Think about what tobacco is taking from you. Quit not before it’s too late.”

“Debi was a pioneer in the fight against tobacco and showed tremendous courage by sharing her story to educate Californians on the dangers of smoking,” Chapman said. “She was an inspiration for Californians to quit smoking and also influenced countless others not to start. We trust she will continue to touch those that hear her story, particularly teens and young adults.”

In a family statement, loved ones mourned “our beloved sister, aunt and dear friend,” and noted her 20-year struggle against cancer.

“True to Debi’s spirit, she was a fighter to the end and leaves a big hole in our hearts and lives,” the statement said. “Debi will be remembered fondly by those who love her to be caring, courageous, very funny and always there to offer advice or lend a hand. She was passionate and outspoken about what she believed in and deeply touched all who knew her or heard her story.”

Though they can be hard to watch, commercials like Austin’s are effective in spreading the anti-smoking message, said Andrew Strasser, an associate professor of psychiatry at the University of Pennsylvania who studies the effectiveness of anti-smoking public service announcements.

“Even on just a simple level, it opens the dialog because you see how this can turn out for someone who chooses to smoke,” he said. “For youth, it might be a good method of prevention, so you don’t end up this way, and for current smokers, it’s a good reminder that it’s better to quit not and not end up here.

“Her message resonated for a lot of people, both at risk and current smokers,” Strasser said.

Strasser has used Austin’s ads in his research, in which asks people what they remember a week after seeing a public service announcement.

“Her message always scored very well,” he said. “Her story really stuck with people. It had good staying power so I think they were very effective.”

Related:

• Smokers' lungs safe for transplant, study finds
• Why young smokers should quit before turning 44

More Americans know about and smoke electronic cigarettes in the U.S., the Centers for Disease Control and Prevention reported on Thursday -- something that highlights the need for government regulation and evaluation, the head of CDC's office on smoking and health said.

The CDC found the number of smokers who have tried them doubled in just a year amid heavy marketing -- from 10 percent in 2010 to about 21 percent in 2011. The numbers grew from 2.5 percent to 7.4 percent for former smokers, the report,  published in the journal Nicotine & Tobacco Research, finds.

Nearly six in 10 adults in the U.S. are aware of the battery-powered devices that heat a liquid nicotine solution and create vapor that users inhale, according the first study to assess the change in awareness and use of electronic cigarettes on a national level.

"These finding sort of tantalizingly underscore the need for more rigorous study of patterns of use of e-cigarettes and impacts," the CDC's Dr. Tim McAfee said in an interview with The Associated Press. "Until there's regulatory authority and oversight, it's going to be more difficult to be certainly reassuring around things like toxic effects."

Some of the nation's largest tobacco companies have gotten into the e-cig market as part of the industrywide push to diversify beyond the traditional cigarette business. Reynolds American Inc., the second-biggest U.S. cigarette maker, has begun limited distribution of its first electronic cigarette under the Vuse brand. Lorillard Inc., the nation's third-biggest tobacco company, acquired e-cigarette maker Blu Ecigs in April. Some e-cigarettes are made to look like a cigarette with a tiny light on the tip that glows like the real thing.

The Food and Drug Administration says e-cigarettes have not been fully studied. The federal agency is expected to assert regulatory authority over e-cigarettes later this year to treat them the same as traditional cigarettes and other tobacco products.

The FDA has said its tests found that the liquid in some electronic cigarettes contained toxins besides nicotine as well as cancer-causing substances that occur naturally in tobacco. But some public health experts say the level of carcinogens was comparable to those found in nicotine replacement therapy, because the nicotine in all of the products is extracted from tobacco.

According to the results of a series of online surveys, the CDC reported, awareness of electronic cigarettes increased from 40 percent in 2010 to nearly 60 percent in 2011, and use among adults doubled to 6 percent during that time. 

McAfee said the motivations behind e-cigarette use remain unclear. For example, a former smoker could be experimenting with them as a new nicotine delivery system, or could have used an electronic cigarette to quit smoking regular cigarettes. Current smokers might be using e-cigs in places where tobacco smoking isn't allowed.

More than 45 million Americans smoke cigarettes, and about half of smokers try to quit each year.

First marketed overseas in 2002, e-cigarettes didn't become easily available in the U.S. until late 2006. Now, the industry has grown from the thousands of users in 2006 to several million worldwide. Analysts estimate sales could double to $1 billion in 2013. Some companies have even started running TV commercials.

Devotees tout e-cigs as a way to break addiction to real cigarettes. They say the devices address both the nicotine addiction and the behavioral aspects of smoking — the holding of the cigarette, the puffing and exhaling something that looks like smoke — without the more than 4,000 chemicals found in cigarettes.

"The bottom line is ... the impact of e-cigarettes on public health remains uncertain," McAfee said.

The biggest study yet into genetics and mental health has come up with a stunning result: The five most common mental illnesses -- autism, attention deficit disorder, bipolar disease, schizophrenia and major depression -- all have a common genetic root.

The finding, published in the journal Lancet on Wednesday, may eventually lead to a complete rewrite of the medical understanding of the causes of mental illness.

“We have been able to discover specific genetic variants that seem to overlap among disorders that we think of as very clinically different,” Dr. Jordan Smoller of Massachusetts General Hospital in Boston, who led the study, said in a telephone interview.

The study does not explain every case of psychiatric disease, the researchers stress.

“We think this is one tiny fraction of the genetic component of these disorders. They involve hundreds and possibly thousands of genes,” Smoller said.

And it didn’t show every case was related. But it demonstrated on a genetic level that the five diseases are more like a continuum of dysfunction than five separate and discrete conditions.

Smoller’s international team included dozens of researchers who looked at the genetics of more than 33,000 psychiatric patients and compared them to nearly 28,000 people without mental illness. They did what is called a genome-wide association study -- a scan of all the DNA.

“We aimed to identify specific variants underlying genetic effects shared between the five disorders in the Psychiatric Genomics Consortium: autism spectrum disorder, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder, and schizophrenia,” they wrote in their report.

They linked a considerable number to four places in the genome: a big stretch of chromosome 3; another part of chromsome 10, and two very specific genetic areas known to be involved in controlling cell function called calcium channels.

It wasn’t a complete surprise, Smoller says. Doctors have noted some overlap of symptoms and knew that in families prone to one psychiatric disease, another could also occur. “Autism was once known as childhood schizophrenia and the two disorders were not clearly differentiated until the 1970s,” the team wrote.

This finding could suggest that a genetic weakness upstream in the development of the brain could lead to a variety of psychiatric symptoms, perhaps influenced by other genes, or by the environment as well.

“We didn’t know going in that we would be able to find commonality with such a broad array of disorders,” Smoller said. “The fact that a particular pathway emerged as being relevant was also surprising. We didn’t know about that one before.”

Dr. Ken Duckworth, medical director of the National Alliance on Mental Illness, hopes the findings may help dispel some of the stigma that still surrounds psychiatric diseases.

“Ultimately this kind of research will give us a return in terms of social attitudes toward brain-based illness,” Duckworth said in a telephone interview. “If you can understand an illness process, it doesn’t seem so mysterious and terrifying.”

Duckworth said every psychiatrist knows of patients whose symptoms don’t clearly meet the definition of any one disease, and he noted that Sigmund Freud defined schizophrenia as a group of diseases. “This is a corner piece of the jigsaw puzzle,” he said.

And it might lead to better treatments, said Dr. Bruce Cuthbert, who is director of the National Institute of Mental Health’s division of Adult Translational Research. “We are finally starting to make inroads where we have actual physiological mechanisms that we can target,” he said. “We can really start to understand the biology instead of having to guess at it.”

Related:

• Flu, fever linked with autism
• Gene blips account for schizophrenia
• Flu in pregnancy linked to schizophrenia

Dr. William Begg wiped away tears as he pleaded with Congress on Wednesday to help rescind laws that limit medical research into gun deaths and that restrict doctors from asking patients about guns in their homes.

Begg’s testimony highlighted a growing battle between some doctors and some gun advocates over whether federal health dollars should be spent on research into gun violence, and on whether doctors should counsel their patients about gun safety.

Medical groups have been complaining for years about restrictions on the research. And now 101 doctors from Newtown, Conn., have started their own group to try to influence both legislation and, perhaps, the U.S. culture itself.

“We are being intimidated not to discuss gun violence as a public health issue,” Begg, emergency medical services director at Danbury Hospital, 10 miles from Newtown, said in testimony to a Senate Judiciary Committee hearing on gun violence.

Begg was working in his hospital’s emergency department on Dec. 14 when Adam Lanza shot and killed 20 small children at Sandy Hook Elementary School using his mother’s assault rifle and other weapons. He has begun speaking out, with other doctors, against what they see as efforts to keep them from doing their utmost to prevent gun violence.

“Allow me as a medical doctor, when I see a patient and I talk to them about the risks of excess alcohol, or tobacco use, or safe sex, morbid obesity, seat belts, texting and driving, can I talk to them about the risk of gun violence, please?” Begg asked.

Begg asked Congress to ban assault weapons, high capacity ammunition magazines and semi-automatic rifles. “People say the overall number of assault weapons deaths is small. Please don’t say that to the people of Tucson or Columbine or Aurora or Virginia Tech and don’t tell that to the people of Newtown,” he said to applause from the audience in the hearing room.

Alex Wong/Getty Images

Dr. William Begg (R), and Neil Heslin (L), the father of 6-year-old Sandy Hook Elementary School shooting victim Jesse Lewis, testify during a hearing before the Senate Judiciary Committee on "The Assault Weapons Ban of 2013."

“This is a tipping point. And this is a public health issue.”

Begg referred to legislation in Florida – rescinded after a judge ruled against it — that would have pulled the medical licenses of doctors who tried to discuss gun safety with patients and then fined $10,000. The American Medical Association, the American Academy of Pediatrics and other medical groups all oppose such legislation – and they had been calling even before the Connecticut shootings for more research on gun violence.

In 1996, after a particularly critical report on gun deaths in the United States, Ark. Rep. Jay Dickey sponsored an amendment that removed $2.6 million from the Centers for Disease Control and Prevention’s budget, which was the precise amount the agency had spent on firearms studies. It hasn’t published a gun study since.

President Barack Obama earlier this year issued a memorandum directly ordering the CDC and other federal agencies to do gun research. But groups like the Union of Concerned Scientists say more needs to be done to ensure that medical professionals can have a hand in compiling statistics on gun deaths, can talk to patients about the dangers of firearms, and can speak out about their findings publicly.

Pediatrician Dr. Greg Dworkin agrees. He and about 100 other doctors from the Newtown area, Begg among them, have started a group called United Physicians for Newtown.

“We, the physicians, felt that we needed to do something and we needed to do it in a way that was consistent with our own profession,” Dworkin said in a telephone interview.

“We got together as physicians to see if there was something we could agree on, knowing the whole issue of how to prevent violence like this is not so simple.”

As in any community, the doctors in Newtown – who had begun calling one another and moving into place to help within minutes of learning about the shootings – have a range of political views.

“Newtown is a rural area,” Dworkin said. It’s full of hunters and sports shooting enthusiasts. Some people even have backyard gun ranges. The doctors were sensitive to fears that peoples’ guns might be taken away from them.

But there was plenty they did agree on.

“We felt that as a first principle, we want to speak up as physicians (and say) that research on violence, gun violence, violence against children should be done,” he said.

“We agreed mental health should be part of this. We agreed there is a culture of violence,” he added.

“We agreed we had to take a stand about gun safety.”

Universal background checks, assault weapons bans and bans on high capacity-ammunition magazines all won wide support from the doctors, he said.

And they wanted to keep party politics out of it. “But it is reasonable for physicians and professional health workers to be allowed to discuss this,” Dworkin said.

“We are talking about a registry of injuries,” he added. After the Sept. 11 attacks, public health officials started a registry of illnesses among people exposed to toxic dust as the World Trade Centers collapsed. There needs to be something similar for firearms injuries, the group agreed. “It’s a public health issue,” Dworkin says.

Dworkin, himself a blogger for the Daily Kos, says members of the group want to speak publicly – at hearings before the Senate Judiciary Committee, for instance.

Begg reeled off the statistics.”If you actually own a gun in your home because you think it is going to make you safer, let me give you some facts,” he told the committee hearing.

“Women are five times more likely be killed by a spouse if there’s a gun in the house. That’s a real study. If you have a gun in the house you are five times as likely to die of suicide, 20 times as likely to die of unintentional gun death.”

Research like this can only inform the argument, Begg, Dworkin and the other doctors of Newtown argue.

Related: 

Tearful testimony in Senate hearing on guns

Biden calls for courage on gun violence

A long weekend of gun violence

Would you eat horsemeat?  A lot of people would not. Should you have the right to know if the meat you are eating contains horsemeat?  The answer to that question is a resounding yes – and that’s why the current scandal in Europe over horsemeat reveals a lot about the push to get better labels on the food we eat.

If you don’t want to eat horse – why? What is the problem?  If you eat meat, then why not horse? After all, many people around the world do eat it. Horse is on the menu or in the kitchen in many nations including Kazakhstan, Indonesia, Japan, South Korea, Mongolia, Tonga, Iceland, Germany, Sweden and Holland. So whatever you think about eating horse, it isn’t safety that makes you disgusted at the very idea. 

Still, Europe is in the midst of a huge scandal involving horsemeat showing up in a lot of the wrong places. Testing has revealed that much of what has been sold as beef or pork in restaurants, schools and hospitals as well as in frozen meat products in grocery stores such as lasagna contains horsemeat.  Even the furniture giant Ikea had traces of horsemeat found in the meatballs they were selling in their restaurant stores in some parts of Europe.

Why is the discovery of horse meat in food such a big deal?  What is so troubling to Europeans that there have been protests and outrage against food companies in many nations where mislabeled meat has been found?  To understand the furor generated by consumers finding out there is horse in there you need to look elsewhere.  The South Philadelphia restaurant Monsu provides a clue.

The head chef of BYOB Monsu announced last week that the restaurant's menu would soon include some selections of the equine variety. But the day after announcing horse was going on the menu, the restaurant received a serious threat. “They called into the restaurant and said, ‘You guys start cooking horses, I am going to blow up your restaurant,’” Andrews said to NBC10.com.  Clearly, some folks feel very strongly that horses belong in a paddock, not a plate.

Food is much more than safety, and it is much more than nutrition – we see this  when we get into fights about labeling genetically modified food, or requiring that meat from cloned animals be clearly marked or that organic food really be organic to merit the description the European scandal over horse meat.  Food is culture.  Food is family.  Food, in short, is values.

Those who get into fights about labeling food thinking it is just an issue of safety never tried to put horse on the menu in South Philadelphia or deal with an outraged customer in England whose beef stew was more than that.  The ethical and policy lesson for regulators, industry and farmers of putting horse meat where it is not supposed to be is very simple--when it comes to food we should be able to find out anything and everything we want to know about what we eat.  To do otherwise is to deny informed choice about a subject -- food -- that is too complicated to permit any other standard.

Related: 

Horse meat found in Ikea meatballs, Czech officials say

If all the coughing and sneezing associated with this year’s severe flu season have you worried you’ll catch the bug, consider boosting the humidity in the rooms around you.

Moderate to high humidity can actually reduce the ability of the flu virus to infect folks, according to a new study published in the journal PLOS One. Maintaining relative indoor humidity at 43 percent or higher could cut the bug’s threat to about 15 percent, researchers found.

The flu is often spread through the air, said John D. Noti, team leader of the infectious disease transmission program at the National Institute for Occupational Safety and Health. When we cough or sneeze, bits of virus hitch a ride on droplets of mucous or water, explained Noti, the report’s lead author.

While the large droplets hit the floor and other surfaces fairly quickly, the smallest ones can remain in the air for hours -- just waiting for you to breathe them in.

“Typically they stay in the air for an hour or so, but we have caught them as long as five hours out,” Noti says. “If you’re a health care worker in a room full of coughing patients there could be a lot of them.”

Earlier studies had suggested that the flu virus might be sensitive to humidity. So Noti and his colleagues set up an ingenious experiment, one that simulated a real-life situation, but exposed no humans to the nasty virus.

The researchers put two manikins about six feet apart in a closed-off room. One of the manikins was designed to “cough” flu particles into the air, while the one on the other side of the room “breathed” them in.

Noti and his colleagues collected samples from the inhaling manikin every few minutes and then deposited them in a cell culture to see if the virus particles would be able to infect the tissue cells.

The researchers ran their experiment at varying levels of humidity.

They found that when the humidity was less than 23 percent, the virus retained between about 71 percent of its ability to infect. When the humidity was boosted to 43 percent or higher, the infectivity dropped to about 15 percent.

And that drop-off in infectivity happened fast -- within 15 minutes of the initial cough.

The experiment may explain why we see so much more flu in the fall and winter months, Noti says. “In the winter months when the heat is on, the air is really dry,” he says. “It’s often down around 10 percent or less. So that may be what is driving all that February activity.”

The new study might offer interesting insight into the biology of the virus itself, says E. John Wherry, director of the Institute for Immunology at the University of Pennsylvania School of Medicine.

“There are lots of theories as to why the flu seasonally cycles: More people are inside, the weather is colder, mucous membranes might be more sensitive because of the dry conditions inside,” says Wherry. “But this suggests that humidity influences the virus itself rather than making our mucous membranes more susceptible.”

The researchers don’t address what happens to the virus, Wherry says. “But this virus is not very hardy. Changes in humidity, concentrations of salt or protein could have a major impact on it. The next step might be to look at what features of the virus change when the humidity is high. Those might offer targets for intervention. If you can show the weak point of the virus, that might be more broadly useful.”

In the meantime, it might make sense for folks to invest in a humidifier for their homes.

“Given that there’s very little downside to humidifying houses in the winter -- that looks like a good idea based on their data.”

Related stories: 

• CDC says flu vaccine barely worked in over-65s this year
• Nasty flu season sparks spotty vaccine shortages

By Marilynn Marchione
Associated Press

There's reassuring news for pregnant women miserable with morning sickness: A very large study in Denmark finds no evidence that using a popular anti-nausea drug will harm their babies. 

One in 10 pregnant women has nausea and vomiting bad enough to need medicine but many forgo it out of fear of side effects. No drugs are currently approved for morning sickness in the United States although doctors are free to prescribe whatever they believe is best.

Zofran, sold by GlaxoSmithKline and in generic form for treating nausea from cancer treatments and other causes, has been the top choice. Yet women and doctors have been leery of it because a small study previously suggested it might raise the risk of a birth defect — cleft palate.

The new study of more than 600,000 pregnancies in Denmark found no evidence of major birth-related problems, so women should not be afraid to use Zofran if they need it, said Dr. Iffath Hoskins, a high-risk pregnancy specialist at NYU Langone Medical Center and a spokeswoman for the American College of Obstetricians and Gynecologists.

"It's effective and it's safe," she said. "Nobody is giving you a gold star for suffering through this."

Poor nutrition because of excessive vomiting can harm the woman and the fetus, she said.

Hoskins had no role in the study, which was led by Dr. Bjorn Pasternak of the State Serum Institute in Copenhagen. Results appear in Thursday's New England Journal of Medicine.

Researchers used nationwide health registries to compare rates of miscarriage, stillbirth, birth defects, preterm delivery and having a baby that weighed too little among women who used Zofran during pregnancy and others who did not. They also looked separately at use during the first trimester of pregnancy, when risks to the developing fetus are highest.

No harms were seen from Zofran use, which occurred in 1,970 of the 608,385 pregnancies. The study looked at birth defects collectively, and cannot rule out a higher risk of specific ones, although the incidence of those is very small, researchers noted. The Danish Medical Research Council paid for the study.

As a first step, women should try treating morning sickness with crackers, ginger ale and certain B vitamins and use Zofran or one of the other prescription anti-nausea medicines as a last resort, Hoskins said. 

"Whenever possible, nothing or simple is better" than a drug, especially in the first three months of pregnancy, she said.

By KEVIN FREKING, AP staff

WASHINGTON - A veterans' health clinic in Brick, N.J. is in such disrepair that when the snow gets heavy, patients have to go elsewhere for fear the roof might collapse. Another in San Antonio has extensive mildew and mold problems that could prove a health hazard for employees and patients in the coming years. 

In Lake Charles, La., it's not the condition of a clinic but the lack of one. It's estimated that 6,000 veterans would enroll in VA health care if the community were to get a new clinic. 

The Department of Veterans Affairs has cited these examples as it sought approval from Congress last year for a dozen new or expanded health clinics around the country. 

Lawmakers anticipated that the cost for the current fiscal year would probably run into the tens of millions of dollars, but the estimate from the Congressional Budget Office came in at $1.2 billion. The nonpartisan CBO said that sound accounting principles require the full cost of the 20-year leases for the clinics be accounted for up front. 

The huge jump in the clinics' price tag left lawmakers scrambling, and in the face of the budget-cutting climate on Capitol Hill, the VA request stalled. Now the agency is warning that unless lawmakers act, some currently operating clinics may have to close after their old leases expire and other long-planned expansions will not go forward. 

Since the mid-1990s, the VA has turned to outpatient clinics as a way to bring health care closer to where veterans live. The department has opened 821 clinics to supplement the care provided at 152 medical centers. The clinics vary in size and services offered but virtually all provide primary care and mental health counseling. In most cases, the VA enters into a lease with private building owners, which gives the department flexibility to meet changes in demand down the road. 

"I know the VA itself had plans to go beyond these 12 in the next several years. It's going to be difficult for that to happen at a time when we see veterans' needs rising," said Rep. Charles Boustany Jr., R-La., whose congressional district includes Lake Charles and Lafayette, where the expansion of another VA outpatient clinic was delayed. "This has thrown a wrench into the entire way we do things." 

Any lease costing more than $1 million a year requires congressional approval. That's where the 12 proposed clinics come in. Lawmakers submitted the legislation to the Congressional Budget Office, which keeps score of how legislation fits with congressional spending targets. 

When CBO took a closer look at the clinics, analysts determined that the leases generally involved the construction of new buildings that the VA would essentially finance through a 20-year lease. The CBO told lawmakers that the entire cost of the leases needed to be accounted for up front to show taxpayers the true cost associated with a 20-year obligation. 

The Congressional Budget Office declined to discuss publicly the rational for its new treatment of VA leases. Instead, it forwarded a brief about financing arrangements akin to those being used by the VA. The brief said that treating long-term investments as annual operating expenses understates the size of the federal government and its obligations. Sound budgeting requires agencies to acknowledge the full cost of their investment up front, the brief said. 

That left lawmakers with two options — find $1.2 billion in savings from other government programs or waive rules that require offsets to new spending. They decided to regroup and try again this year. 

"Most Democrats and Republicans agree that these projects should move ahead, so the task at hand is simply finding a way forward in light of CBO's new method of scoring lease authorizations," said Rep. Jeff Miller, the Republican chairman of the House Committee on Veterans Affairs. "I'm confident we'll find a solution that doesn't involve cuts to veterans' benefits to pay for these leases, an option that is not on the table and one that I would not support." 

The VA leases the buildings used for nearly two-thirds of its outpatient clinics. Most of the leases that Congress declined to take up last year involved expansions. 

For example, in New Port Richey, Fla., the VA proposed to consolidate leases covering five different buildings into one lease that would more than double the amount of square footage now in use. The change would result in shorter wait times and more effective care, the VA said in its proposal. The proposal added that contracting out care was not a good alternative because "there are not sufficient, qualified, private-sector providers in the New Port Richey area to accommodate increasing veteran workload." It said that constructing a new, VA-owned building would delay the expansion and "limits the ability to relocate services in the future to adapt to changes in veterans demographics." 

For veterans in Lake Charles, talk about building a new VA clinic has been going on for a decade now. Local veteran Jim Jackson said the project has been fraught with delays. A mobile RV is stationed there now, but Jackson said local vets want a more permanent solution. He said patients concerned about privacy, particularly female veterans or those seeking mental health care, are reluctant to seek care out of the RV. 

"When you go to war, you come back different," Jackson said. "We have to take care of our veterans." 

The Department of Veterans Affairs said in a statement that failure to move ahead with the leases would hurt access to health care with increased travel and wait times for veterans. 

Veterans groups are starting to voice alarm as well. The group Disabled American Veterans sent an alert to its members in recent days saying that leases for nearly two dozen additional clinics could be in jeopardy over the next five years. 

"Unless a change is made, VA will be forced to buy land and construct government-owned clinics, or more likely will require veterans who need VA care to travel longer distances to receive it," the alert stated.

For the past six years Carmen Blandin Tarleton, a 44-year-old registered nurse and mother of two from Thetford, Vt., has been living with a face horribly disfigured by industrial strength lye that was squirted on her by her estranged husband. The attack in June of 2007 left burns on more than 80 percent of Tarleton’s body.

Carmen Blandin Tarleton before the attack and in July 2011, prior to face transplant surgery.

Earlier this month Tarleton became the fifth person to receive a full face transplant at Boston’s Brigham and Women’s Hospital. During the 15-hour operation that involved more than 30 physicians, nurses, anesthesiologists and technicians, surgeons transplanted a donor’s neck, nose, lips, facial muscles, arteries and nerves.

“They were among the worst injuries I’ve seen in my entire career,” Dr. Bohdan Pomahac, director of Plastic Surgery Transplantation, Brigham and Women's Hospital, said at a Wednesday news conference at the Boston hospital. “She was unrecognizable to anyone who knew her. But she was a fighter, and fight she did.”

The surgery was more extensive than the hospital's previous procedures -- including the face transplant operation for chimp attack victim Charla Nash -- because not only was the donor’s face attached, but also her neck, doctors explained.

Tarleton is still recovering and did not attend the hospital event. But in a blog post published Wednesday, she wrote: “I could never have imagined the overwhelming feelings I encountered after my surgery. I could freely move my head from side to side without the usual scar discomfort I have felt for almost six years now. I cried with such a deep appreciation for the persons truly responsible for giving me this gift: this new physical freedom.”

Tarleton was in the process of being divorced from her husband, Herbert Rodgers, when he broke into her home, fractured her skull and broke an arm, according to the Associated Press. He then poured a squeeze bottle filled with lye over her entire body. After being airlifted to the hospital, doctors weren’t sure she would survive her injuries.

Tarleton was in a medically induced coma for three months, during which she received 38 surgeries to try to repair the damage from the lye. Since then there have been another 17.

But even after those surgeries, Tarleton was still unable to control the muscles in her mouth and lips which led to a constant stream of drool. The scarring on her neck blocked her from turning her head. She was left blind in one eye, but can see well enough through the other to read, Pomahac said.

Because of all the prior surgeries and skin grafts, Tarleton’s case presented more complications than other recent transplants. There have been 26 face transplant surgeries worldwide, with seven performed in the United States, said Dr. Daniel Alam, section head for plastic and reconstructive surgery at the Cleveland Clinic. Alam also participated in Charla Nash's procedure.

Tarleton is almost past the point where doctors worry that the face might be rejected by her body, Pomahac said. In the coming weeks, the nerves will start to reconnect and she may regain some sensation.

Tarleton’s sister Kesstan Blandin read a statement from Tarleton at the news conference Wednesday: “I feel great appreciation and gratitude for the tremendous gift that had been given to me that will greatly improve my quality of life. My spirits are high and I have tremendous optimism I want to convey to the donor family what a great gift has been given to me.”

Although the donor’s identity has not been revealed, the family responded: “While we are heartbroken at the loss of a mother, sister and friend, we are comforted that she chose to give the gift of life,” according to a statement read by Richard Luskin, CEO of the New England Organ Bank. “We believe her spirit will live on by the human connections she made in life, including the four she never met. Now their lives are intertwined.”

In 2009, her ex-husband Rodgers was convicted in Vermont for the attack and sentenced to a 30-70 year prison term.

Related:

Lye victim fights to live, family struggles to cope

Va. man gets extensive face transplant after gun accident

CDC

In the U.S. today, the most common type of highly drug-resistant germs known as CREs are the Klebsiella pneumonia bacteria like those shown here. Nearly untreatable, they're being detected in a growing number of health care settings.

A sharp jump in the number of rare but potentially deadly types of a superbug resistant to nearly all last-resort antibiotics has prompted government health officials to renew warnings for U.S. hospitals, nursing homes and other health care settings.

The move comes just as researchers in Israel are reporting that people who carry dangerous CRE -- Carbapenem-resistant enterobacteriaceae -- can take more than a year before they test negative for the bacteria, making it more difficult to control and raising the risk of wider spread.

Reports of unusual forms of CRE have nearly doubled in the U.S., the Centers for Disease Control and Prevention reported this month. Of 37 cases of rare forms of CRE, including the alarming NDM  -- New Delhi metallo-beta-lactamase -- 15 have been reported since last July.

“This increase highlights the need for U.S. health care providers to act aggressively to prevent the emergence and spread of these unusual CRE organisms,” the CDC said in a health advisory.

CREs are part of a family of drug-resistant germs that have shown up in growing numbers of U.S. health care settings. They’re named for their ability to elude carbapenem antibiotics, the big guns in the medical arsenal. They usually strike people who are already ill and require devices such as ventilators or catheters or who have been taking antibiotics for a long time. But they can infect any patient.

Twenty-nine of the unusual CRE cases have been NDM, up from the first case detected in the U.S. in 2010, said the CDC's Dr. Alex Kallen, a medical epidemiologist and outbreak response coordinator in the agency’s Healthcare Quality Promotion division. It's especially worrying because it confers resistance to multiple drugs and is easily transmitted to other types of bacteria.

The others were even rarer types of CRE, including VIMs, IMPs and OXA-48s, all of which produce enzymes that render most antibiotics virtually useless.

The agency called for stricter isolation and hygiene precautions, increased screening of patients potentially colonized with CRE and better communication within and between hospitals and other health care settings where the bugs can become intractable -- and deadly. CRE infections have a mortality rate of up to 40 percent, much higher than other health care infections, such as those caused by MRSA or C. difficile.

“Our main objective is to slow or stop the spread in places where we can identify them,” said Kallen. “Right now, the therapeutic options are very limited.”

Health officials have been worried about them for more than a decade, particularly the KPCs, or carbapenemase-producing Klebsiella pneumonia, which have now been reported in 42 U.S. states and Puerto Rico, the CDC reports.

Nine states have reported NDMs and at least two have reported other rare forms that also block antibiotic effectiveness, including those known as VIMs, or Verona integron-encoded metallo-beta-lactamase, and IMPs.  So far, they’ve been associated mostly with people who’ve been hospitalized in countries outside the U.S.

The bugs were in the news last summer after reports of a CRE strain of Klebsiella pneumoniae roared through the National Institutes of Health Clinical Center near Washington, D.C., killing seven people, including a 16-year-old boy.

In Colorado last summer, NDM-producing CRE was detected in eight patients, the largest outbreak in the U.S. to date, according to a CDC report this month. It was found largely because the University of Colorado Hospital already has stringent surveillance protocols in place, said Dr. Michelle Barron, director of infection control and prevention. Since then, the hospital has probably tested 500 or 600 patients with unusual resistance patterns, she told NBC News.  

None of the eight patients in the original outbreak died. The evidence showed that patients who were colonized with the germs, but not actually sick, contributed to the spread.

That’s a point underscored by the study by Israeli doctors published Wednesday in the American Journal of Infection Control. They studied medical records of adult patients hospitalized between January 2009 and December 2010 at Shaare Zedek Medical Center, a 700-bed, university-affiliated hospital in Jerusalem.

In 97 patients with positive CRE cultures, it took a mean time of 387 days to log a negative test -- and nearly 40 percent remained positive after a year, according to Dr. Amon Yinnon, one of the study authors.

“The major concern is that an undiagnosed carrier may be admitted to hospital for totally unrelated reasons, and subsequently and unwittingly pass his CRE to other patients,” Yinnon said in an email to NBC News.

Patients who were hospitalized repeatedly were at higher risk of remaining colonized with CRE, the study found.

CDC officials hope to increase awareness of the growing problem among the general public as well as the health care providers before it gets out of control.

“I can’t predict the future, of course, but there is a concern that we can see more of these as they spread,” Kallen said. “This can become a community bug.”

Related stories: 

• Superbug kills 7th patient at hospital in Maryland
• Untreatable gonorrhea threat rises in the U.S., Canada

By Kate Kelland
Reuters

GlaxoSmithKline's Pandemrix swine flu vaccine has been linked to cases of the rare sleep disorder narcolepsy in children in a scientific study in England that confirms similar findings elsewhere in Europe.

The vaccine, more than 30 million doses of which were given during the H1N1 flu pandemic in 2009-2010, contains a booster, or adjuvant, and may have triggered an adverse immune reaction in some children at higher genetic risk of narcolepsy, scientists said in new research published on Wednesday.

Researchers at Britain's Health Protection Agency (HPA) who published the study in the British Medical Journal said the at least 14-fold increased risk they found had "implications for the future licensing and use of adjuvanted pandemic vaccines".

Narcolepsy is a life-long disorder and thought to be an autoimmune disease in which patient's immune system attacks the body's own cells. Its symptoms include frequent bouts of daytime sleepiness and in its severe forms it also causes night terrors, hallucinations and cataplexies - when strong emotions trigger a sudden loss of muscle strength.

Studies in Finland, Sweden and Ireland have also found a Pandemrix link to narcolepsy, and GSK says more than 800 cases linked to the shot have been reported in Europe.

A spokesman for the British drugmaker told Reuters on Wednesday: "We really want to get to the bottom of this and understand more about the potential role of Pandemrix in the development of narcolepsy."

He added, however, that GSK believes "the available data are insufficient to assess the likelihood of a causal association between Pandemrix and narcolepsy."

As Reuters reported earlier this month, scientists investigating the link further are homing in on the vaccine's adjuvant, a booster called AS03, and analysing whether its super-charging effect may have played a role.

According to the UK results, vaccination with Pandemrix at any time was associated with a 14-fold increased risk of narcolepsy, whereas vaccination within six months before onset of the disease was associated with a 16-fold increased risk.

"The increased risk of narcolepsy indicates a causal association," said the research team led by Liz Miller, a consultant epidemiologist with the HPA. They added, however, that because of variable delay in diagnosis, the risk may be overestimated because vaccinated children may have been referred to specialist sleep clinics more rapidly.

Scientists said the risk translated into around one in 50,000, lower than studies have found in other countries such as Finland and Sweden where Pandemrix was used more widely and the risk was around one in 16,000 to 17,000 children vaccinated.

In total, more than 30 million doses of the GSK shot were given in 47 mainly European countries during the H1N1 flu pandemic. It was not used in the United States.

The UK study looked at 75 children aged between four and 18 who were diagnosed with narcolepsy from January 2008 and who attended sleep centres across England. Eleven of the children had been vaccinated with Pandemrix before their symptoms began. 

Finn stressed that Pandemrix is the only vaccine linked to this problem: "There is nothing to suggest that it occurs after other flu vaccines or vaccines against other diseases." 

Narcolepsy is thought to be due to loss of function in cells called hypocretin cells in one of the brain's sleep centres.

John Shneerson, a consultant physician from the Respiratory Support and Sleep Centre at Papworth Hospital in Cambridge who co-led the UK study, said Pandemrix may have triggered an immune reaction against those cells, causing narcolepsy in some children who were genetically vulnerable.

Experts say around 25 percent of Europeans have a genetic profile making them more susceptible. Narcolepsy has no known cure, but specialist doctors say symptoms can be treated with drug combinations aimed at re-regulating the sleep-wake cycle. 

By Michelle Andrews
Kaiser Health News

Starting next year, the Affordable Care Act will largely prohibit insurers who sell individual and small-group health policies from charging women higher premiums than men for the same coverage.

Long-term-care insurance, however, isn't bound by that law, and the country's largest provider of such coverage has announced it will begin setting its prices based on sex this spring.

"Gender pricing is good for insurance companies," said Bonnie Burns, a policy specialist at California Health Advocates, a Medicare advocacy and education organization, "but it’s bad public policy and it's bad for women."

Genworth Financial says the new pricing reflects the fact that women receive two of every three claims dollars. The change will affect only women who buy new individual policies, or about 10 percent of all purchasers, according to the company. The new rates won't be applied to existing policyholders or those who apply as a couple with their husbands.

"This change is being made now to reflect our actual claims experience and help stabilize pricing," Genworth Financial spokeman Thomas Topinka said in an e-mail.

Women's premiums may increase by 20 to 40 percent under the new pricing policy, said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The average annual premium for a 55-year-old who qualified for preferred health discounts and bought between $165,000 and $200,000 of coverage was $1,720 last year, according to the association.

Experts say they expect other long-term-care insurers will soon follow suit.

Long-term-care insurance provides protection for people who need help with basic daily tasks such as bathing and dressing. It typically pays a set amount for a certain number of years -- say, $150 daily for three years -- for care provided in a nursing home, assisted living facility or at home. Never a very popular product with consumers, many of whom found it unaffordable, in recent years the industry has struggled and many carriers have raised premiums by double digits or left the market.

Consumer health advocates say they aren't surprised that women's claims for long-term-care insurance are higher than men's.

Because women typically live longer than men, they frequently act as caregivers when their husbands need long-term care, advocates say, thus reducing the need for nursing help that insurance might otherwise pay for. Once a woman needs care, however, there may be no one left to provide it.

"Women live longer alone than men," Burns said. "If you don't have a live-in caregiver when you start needing this kind of care, you’re in big trouble."

LuMarie Polivka-West knows the potential problems all too well. Polivka-West, 64, is the senior director of policy and program development for the Florida Health Care Association, a trade organization for nursing homes and assisted living facilities. (I first spoke with Polivka-West two years ago, when she discussed the financial challenges she and her two brothers faced caring for their aging parents.)

About 15 years ago, she bought a long-term-care policy. The company went out of business after five years, and she let her policy lapse rather than switch to another plan with higher premiums and less comprehensive coverage. But she's reconsidering that decision. Polivka-West's husband is four years older than she is. Her mother died of Alzheimer's disease at age 89 after struggling with it for eight years. What if a similar fate awaits her?

Polivka-West thinks insurers shouldn't be allowed to charge her more just because she's a woman.

"The Affordable Care Act recognized the gender bias in health insurance," she said. "The same [rules] should apply to long-term-care insurance."

The federal health overhaul sought to eliminate the coverage and price discrepancies in the larger health insurance market. A 2012 study by the National Women's Law Center found that 92 percent of top-selling health plans in the individual market practiced sex-based pricing in states where the practice was allowed. (Fourteen states banned or limited the practice, according to the report.) Nearly a third of plans charged women at least 30 percent more than men for the same coverage, even plans that did not include maternity benefits, the study found.

Insurers that sell individual and small-group health policies on the state-based health insurance exchanges or outside them on the private market in 2014 will be able to vary premiums based only on geography, family size, age and tobacco use. (Plans that have grandfathered status under the law are exempt from these requirements.)

Under federal laws against sex discrimination in the workplace, employers are generally prohibited from charging women more than men for the same health insurance coverage.

Meanwhile, Genworth Financial says it won't switch to gender-based pricing for long-term care in two states—Colorado and Montana--that prohibit varying premiums based on gender in all health insurance products.

As states move to bring their laws into conformance with the gender rating requirements under the Affordable Care Act, some advocates see an opportunity.

"Any state with a strong advocacy group could be advocating for a very broad-based prohibition against gender rating" in all insurance products, says Donna Wagner, the associate dean for academic affairs at the College of Health and Social Services at New Mexico State University who also chairs the policy committee for the Older Women’s League, an advocacy group.

As weight-loss surgery has become more common over the last several years, doctors have had tantalizing clues that certain procedures bring dramatic reduction in type 2 diabetes -- beyond getting their ability to reduce the patient’s weight.

The surgery appears to have stopped damage to the pancreas, reversing the cause of diabetes as well as alleviating the symptoms, the researchers reported Tuesday in the journal Diabetes Care.

A year ago researchers at the Cleveland Clinic carried out a careful trial of 150 patients with diabetes that was not being adequately controlled. One-third got gastric bypass, one-third were given a device similar to a lap band that reduces stomach volume, and the rest received the best drug therapies. The goal was to reduce the participants’ blood sugar to below normal levels.

In the patients who got the bypass surgery the results were dramatic.

"It's pretty amazing," bariatric surgeon Dr. Philip Schauer of the Cleveland Clinic said at the time. “Many of our patients, even within hours of the operation, their blood sugar becomes normal … even before they've lost any weight at all.”

The big question was, would the results last? In a one-year follow-up study, published in the journal Diabetes Care on Tuesday, the answer is yes. "Gastric bypass surgery seems to uniquely restore pancreatic beta-cell function, presumably by targeting belly fat and modifying the hormones in the gastrointestinal tract," Dr. Sangeeta Kashyap, an endocrinologist with the Cleveland Clinic, said in a statement. "Gastric bypass remarkably targets belly fat where hormones that are toxic to the body develop."

The pancreas makes insulin, which in turn control blood sugar. People with diabetes can't control their blood sugar as well, and the excess sugar damages organs such as the eyes and kidneys. The pancreas worked again in patients who had the surgery, Kashyap says. "This is something that is very novel and something we don’t see with medications or with insulin," she said.

A gastric bypass procedure makes the stomach smaller by dividing it into two sections and connects a portion of the small intestine to one of the stomach pouches, reducing the amount of calories absorbed by the body. Curiously, another surgical procedure called sleeve gastrectomy, which also reduced stomach volume, caused the patients to lose just as much weight, but it did not bring the same dramatic reduction in diabetes.

The doctors are not sure how the bypass surgery changes the hormone balance in the body to cure the diabetes. And they hope someday they might achieve the same effect without the surgery.

The Cleveland Clinic doctors want to treat more patients before they are confident they have a cure. An estimated 26 million Americans have type 2 diabetes and it has been called one of the fastest-spreading epidemic ever.

If it continues to be successful, the main issue will be whether major surgery costing $25,000 -- and often not covered by insurance -- is too drastic a treatment. In response any doctors point out that uncontrolled diabetes often leads to kidney problems, heart attacks, strokes, amputations and death. For many diabetic patients medical costs far exceed $25,000. So, if the diabetes cannot be controlled in other ways, the surgery may become far more common.

Related:

Diabetes patients benefit from weight-loss surgery

High-glycemic foods tied to diabetes risk

Big rise in diabetes, especially down South

Courtesy of Stephanie Carson

Stephanie Carson, 38, was diagnosed with breast cancer at 29. She's part of a growing trend of very young women who are diagnosed with breast cancer that has spread.

More young women are being diagnosed with advanced breast cancer, doctors reported on Tuesday. It is a very small increase in a group of people who only rarely develop cancer, but it’s significant enough to have experts asking why.

The biggest increase was seen in women aged 25 to 34. It’s bad news because when women are diagnosed this young, usually the cancer is more aggressive, there’s no good way to screen for it and because there is no cure, even if the women can control it they face decades of life as breast cancer patients.

Stephanie Carson is one of them. Diagnosed at age 29, she’s now 38 and on disability from her job as a software engineer. Breast cancer robbed her and her husband of all hope of having a family.

“At the time it was definitely a shock. The cancer tumor was literally growing before my eyes,” Carson told NBC News. “Every day it was getting bigger, so it was very aggressive.” She had a double mastectomy, but the cancer had already spread to both her lungs.

This is what doctors believe is typical of breast cancer in younger women: It grows faster, spreads more quickly, and is harder to treat. While the five-year survival rate for breast cancer that has not spread is 93 percent, for women 39 and under whose cancer has spread, it’s only 31 percent.

Dr. Rebecca Johnson of Seattle Children's Hospital and University of Washington in Seattle was working with a cancer nonprofit, Critical Mass: The Young Adult Cancer Alliance and wanted to see if there were any differences in rates of cancer for young adults.

Johnson, a pediatric oncologist and breast cancer survivor herself, looked at National Cancer Institute data from 1973 to 2009. She and colleagues broke it down by age, ethinic group, diagnosis and other factors.

They found a steady increase starting in 1976 of breast cancer that had spread out of the breast among 25- to 39-year-old women. The rate went from 1.53 per 100,000 women in 1976 to 2.9 per 100,000 women in 2009, Johnson and colleagues wrote in their report in the Journal of the American Medical Association. That represents an average increase of just 2.07 percent per year, a relatively small rise, but it shows no signs of abating, the authors noted.

“This change translates into a tripling of the incidence of metastatic breast cancer over the 34-year period,” Johnson told NBC News. “In 1975, our projections show there were about 250 cases per year of metastatic breast cancer in young adult women. In 2009, it was about 800.”

The study looks only at data, and Johnson isn’t sure of why the cases might be increasing. It’s not more or better screening --women this young are not routinely screened for breast cancer. She also doesn’t believe doctors are finding more cases because they are trying harder to see if the cancer has spread in these young women.

“If that was the case, then it would be like a pie, with a larger piece of the pie being distal disease,” Johnson said. “But there’s been no decrease in any other stage of breast cancer.’

Obesity is a risk factor for breast cancer in middle-aged women and that’s worth more study, Johnson says. But she notes that obesity actually lowers the risk of breast cancer among the youngest women. Some studies have suggested a combination of obesity, a lack of exercise and overeating may raise the risk and that’s worth looking at, she says.

It is possible chemicals could somehow be a cause. There are also theories that viruses may be involved -- a virus causes cervical cancer and head and neck cancer, for instance.

Dr. Sandra Swain, a breast cancer specialist at Washington Hospital Center in Washington D.C. and president of the American Society of Clinical Oncology, says women are putting off pregnancy longer and that could have an effect.  “Having kids younger decreases the risk of breast cancer by half,” she says.

Swain also believes higher rates of obesity may be a factor. She stresses that the results should be confirmed in larger studies, and says even if they are confirmed, the findings are not a cause for panic.

“There’s actually a decrease in mortality, especially in younger women, probably because our treatments are better,” Swain says.

Carson’s a living example of this. She’s had surgery, radiotherapy, several types of chemotherapy and treatment with new “smart bomb” drugs. She’s about to start a new round of treatment with a drug the Food and Drug Administration approved just last week – Kadcyla -- which combines a strong chemotherapy drug with Herceptin, a genetically engineered immune system protein that homes in on tumor cells.

“Hopefully it will knock things out again,” Carson says cheerfully. She’s covered by her husband’s health insurance -- he’s a software engineer, too.

All the therapy has taken a toll.

“The side-effect that hurt me the most recently -- I was in a clinical trial in Seattle three years ago, an immune therapy trial, and it gave me headaches,” Carson says. “I have had a headache every day since since then. I have had a headache for three years. That is one reason I had to stop working.”

Carson uses some alternative approaches to cope, like qigong, a meditative version of a Chinese martial art. And she works with other young women with breast cancer through the Young Survival Coalition.

“I can help them deal with some of the feelings of isolation,” Carson says. “It is strange to be this age and on disability. You feel kind of retired, but your peers are all raising families and working full time,” she adds. “I can relate to the feeling of not being able to have children.”

Young cancer patients also have higher rates of other cancers, such as leukemia, that are caused by the chemotherapy and radiation. They also risk heart disease, for the same reasons.

Breast cancer is the biggest cancer killer of U.S. women, after lung cancer. It will be diagnosed in about 235,000 U.S. men and women this year and will kill 40,000, according to the American Cancer Society.

The risk goes up with age. About one in eight cases of invasive breast cancer are found in women under 45. Less than 1 percent -- 0.43 percent -- of women aged 30 will develop breast cancer within the next 10 years, and only 4 percent will get it by age 70. About 35 out of every 1,000 women now aged 60 will develop breast cancer over the next 10 years, according to the Centers for Disease Control and Prevention.

Johnson, the researcher, is now 44. She was one of the luckier young survivors of breast cancer. She was diagnosed at 27 and her tumor had not spread beyond the breast. She found a lump by chance and waited several months before she had it checked. “I was super-busy,” she said. So her advice to young women? "If there’s a general take-home message it would just be for awareness. If you find a breast lump, you need to know that breast cancer can happen,” she said.

Related:

• New breast cancer drug helps advanced cases
• Eight things to ask if you have breast cancer
• Breast-saving therapy may save lives, too

By Kathryn Doyle, Reuters

NEW YORK - For heavy drinkers in treatment for domestic violence problems, an extra therapy session targeting alcohol abuse may help to speed overall improvement in violent behavior, according to a new study. 

Alcohol can lower inhibitions and impair judgment, according to lead author Gregory Stuart of the University of Tennessee in Knoxville. "One theory is that alcohol can narrow focus to negative aspects of the environment, and is linked to impulsivity," he told Reuters Health. 

Men who are arrested for domestic violence are usually referred by the court to group educational sessions called batterer programs, which don't always address alcohol - even though drinking is involved in a high percentage of domestic disputes, experts said. 

Because previous research has found these programs especially ineffective for batterers who also have drinking problems, Stuart's team set out to test whether adding a therapy session devoted to alcohol would affect both drinking and violent behaviors over the course of a year. 

For the trial, the researchers recruited 252 men who had been arrested in Rhode Island for violence against an intimate partner and who reported binge drinking (having five or more drinks per occasion) at least once a month. 

All attended the court-mandated standard battery program, consisting of 40 hours of group educational programs split into 20 sessions, and half of the men attended an additional 90-minute one-on-one substance abuse session with a therapist. 

The men were then asked to complete a survey about their behavior at 3, 6 and 12 months following the treatment program. The researchers also gathered any police reports relevant to the study participants, and analyzed only data for men who had intimate partners at the beginning of the study period. 

On average, all of the men participating in the study reported lowered overall violence levels after one year, Stuart's team reports in the journal Addiction. 

But participants who received the extra alcohol counseling session had greater short-term improvement in both violence and alcohol consumption compared to men in the standard batterer program. 

When the researchers looked at specific aspects of partner violence, for example, men who received the alcohol intervention were less physically aggressive toward their partners at the three-month mark, and less psychologically aggressive at the six-month mark.

The alcohol-intervention group also drank less per day at the three-month mark and drank less often at the six-month mark. 

But at every checkpoint in the study, there was little difference in overall frequency of partner violence in both groups, and after a year, the levels of physical and psychological aggression among men in the comparison group caught up to those of the men in the alcohol therapy group. 

"I would have preferred to see these results maintained over time, but for the first six months the rate of improvement was greater for the folks who got the alcohol intervention," Stuart said. 

The improvements associated with the extra alcohol-focused session didn't fade over time, Stuart pointed out, but the extra therapy seemed to give those men a "jump start" over the other group during the early months. 

"These 90-minute motivational enhancements have been shown to be effective with a variety of different (people)," but usually for those who seek out treatment of their own accord, according to Kenneth Leonard, director of the Research Institute on Addictions at the University at Buffalo in New York who was not involved in the study. 

For that reason, seeing any positive result, even a small one, in a group of men in a court-ordered program who had not sought treatment on their own was promising, Leonard said. 

In Rhode Island, the 40-hour standard batterer program includes a short section on alcohol, but the duration and content of such programs can vary widely by state, according to Stuart. 

Other studies have questioned the effectiveness of existing batterer programs, which Stuart says were "created with the best of intentions" but sometimes include methods that aren't supported by evidence and have a lot of room for improvement. 

"All of the participants on average had substantially less substance use and violence relative to where they started, however, there was still too much violence and substance use," Stuart said. 

He and his colleagues suggest that the jump-start might have lasted longer if there had been multiple follow up "booster" sessions with a therapist over the course of the year. 

"When you start getting into these more severe samples, my sense is that something more than 90 minutes would be required, or additional sessions," Leonard agreed. 

Although the gains were small and temporary, Stuart thinks the results of this study are a promising start toward improving batterer programs. 

"The goal is to gently lead them to the conclusion that potentially stopping the use of alcohol and drugs is a good idea," he said.