Health News Review

Genetic embryo screening: Questions grow with number of procedures

admin — Wed, 01 Apr 2009 04:40:06 +0000

But figuring out the ethical and regulatory guidelines for such screening is proving difficult. Testing that at first focused on eliminating genetic defects certain to cause early suffering and death has been expanded to include defects such as genetically linked breast and ovarian cancer, which are not always fatal, hit somewhat later in life and affect 50 percent to 85 percent of those who carry the gene rather than 100 percent.

In the United States — though not in Britain—families also can use genetic testing to ensure they have children of a particular sex. Still, doctors say, expanded embryo screening probably is not a slippery slope toward designer babies, not only because the process is costly and difficult but because the number of embryos is limited and finding one that includes a number of desired traits would be very difficult.

“The things you might want to select for in a child—intelligence, athletic prowess, body stature—involve not single genes but many, many genes,” said Mark Hughes, director of the Detroit-based Genesis Genetics Institute, the world’s largest embryo testing lab. “No one in their right mind, or even out of it, would go through the psychological and financial hoops for something trivial.”

Testing embryos in an effort to weed out genetic defects—or to produce a younger sibling child who could be a stem cell donor for an older, sick sibling—is not cheap. The procedure, used in conjunction with in-vitro fertilization, costs about $3,500 in the United States and twice that in Britain.

But it is significantly easier in the United States, where clinics are licensed but the individual procedures are not. In Britain each instance of “pre-implantation genetic diagnosis” has to be registered with the British Human Fertilization and Embryology Authority.

That government agency has approved testing for just over slightly more than 70 genetic defects after intensive public consultation about what is a serious enough problem to justify trying to eliminate it.

In the United States, by comparison, Genesis Genetics already has tested for 171 genetic defects, Hughes said. In the U.S. “there is no approval mechanism. No one is saying you can do this to save a sibling but you can’t do this for BRCA1,” the breast cancer gene prevalent in Cohn’s family, Hughes said.

He sees no problem in that approach, but others argue there may be good reason to limit the type of genetic defects families are allowed to screen out.

In public hearings in Britain, “quite a lot of people felt there could well be treatment [for some conditions] by the time these children grow up, and then [their condition] won’t be an issue,” said Clare Williams, a bioethics specialist at King’s College London.

A new study by Johns Hopkins University researchers also shows that, as of 2006, 65 percent of about 200 U.S. clinics carrying out screening on embryos allowed parents to select the sex of the embryo implanted, even if the child was their first or they were not trying to create a family with a balanced numbers of girls and boys.

That—and a recent scandal in which a California-based genetics lab advertised its ability (since disproved) to select a baby’s eye and hair color—have raised concerns among many Americans about the genetic selection of embryos.

Nearly 40 percent, according to the Johns Hopkins study, believe the process should be more closely regulated for ethical reasons; an additional 19 percent think it should be banned altogether, on grounds ranging from a belief that discarding any embryo is immoral to worries that selecting against certain diseases devalues the lives of those now living with them.

Families like the Cohns, however, say genetic testing of embryos is crucial to help bring an end to long family histories of suffering.

Cohn, after seeing her mother and sister stricken with cancer, has undergone a double mastectomy and, more recently, removal of her ovaries to try to ensure she lives long enough to see her daughter, now 7, grow up. Doctors told her that without the surgery she had a 90 percent risk of developing cancer.

Unless less invasive cancer therapies arise, she would “absolutely” advise her daughter to use genetic testing to ensure her own children are free from the defective gene.

Whether such coverage could eventually lead to pressure on families with deadly genes to undergo the embryo screening or face loss of benefits remains a worry.

“I have high hopes this field will be obsolete in 15 or 20 years and we’ll have stem cells and cures for these [conditions],” Hughes said. But for now, “people are looking for alternatives to throwing the genetic dice.”

lgoering@tribune.com

Teddy Cancer Plea: Keep Your Eye On The Ball

admin — Tue, 31 Mar 2009 22:20:08 +0000

10:15am UK, Monday March 30, 2009

Teddy Sheringham has told men to “keep their eye on the ball” in a campaign to raise awareness of testicular cancer.

Teddy Sheringham in an advert to raise awareness of testicular cancer

The former England footballer is appearing in a new advert urging men to check their testicles.

The advert will be played in Premier League stadiums over the next two weeks.

The campaign, titled Keep Your Eye On The Ball, is aimed at those in the sporting community.

It coincides with new research showing that testicular cancer survival rates are increasing, as more men get diagnosed early.

In England and Wales survival is up 2% since 1990 and now 99% of men survive if the cancer is treated in its early stages.

In 1960 the survival rate for testicular cancer was less than 50%.

Teddy Sheringham in advert

The research, published in the British Journal of Cancer also showed 77% of men are being diagnosed in the early stages compared with 57% in the early 1980s.

Sheringham said: “This research shows it’s important for blokes to take notice of their prized balls and if they notice something wrong to seek medical help immediately.”

From the Everyman Male Cancer Research Centre, Dr Robert Huddart said: “Most of the recent improvement in survival is likely due to men knowing the symptoms of testicular cancer, leading to early diagnosis.

“We are finding that the average size of tumours at diagnosis has halved to just 2.5 centimetres making it much easier to treat.”

Testicular cancer survivor and Hull City keeper Matt Duke said: “The improvement in survival would bring great comfort to the men currently battling testicular cancer.

“This highlights the importance of raising awareness of this disease through campaigns such as Everyman and Keep Your Eye on the Ball and also the need to fund vital research into the causes and treatment.”

Other awareness campaigns include The Bobby Moore Fund which was set up after the footballer died of bowel cancer in 1993.

Polypill ‘could become a reality’

admin — Tue, 31 Mar 2009 17:11:10 +0000

A cheap five-in-one pill can guard against heart attacks and stroke, research suggests.

Study: Cholesterol drug lowers blood clot risk (AP)

admin — Mon, 30 Mar 2009 16:20:05 +0000

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By MARILYNN MARCHIONE, AP Medical Writer Marilynn Marchione, Ap Medical Writer

–
Sun Mar 29, 2:47 pm ET

ORLANDO, Fla. – Statin drugs, taken by millions of Americans to lower cholesterol and prevent heart disease, also can cut the risk of developing dangerous blood clots that can lodge in the legs or lungs, a major study suggests.

The results provide a new reason for many people with normal cholesterol to consider taking these medicines, sold as Crestor, Lipitor, Zocor and in generic form, doctors say.

In the study, Crestor cut nearly in half the risk of blood clots in people with low cholesterol but high scores on a test for inflammation, which plays a role in many diseases. This same big study last fall showed that Crestor dramatically lowered rates of heart attacks, death and stroke in these people, who are not usually given statins now.

“It might make some people who are on the fence decide to go on statins,” although blood-clot prevention is not the drugs’ main purpose, said Dr. Mark Hlatky, a Stanford University cardiologist who had no role in the study.

Results were reported Sunday at the American College of Cardiology conference and published online by the New England Journal of Medicine.

The study was led by statistician Robert Glynn and Dr. Paul Ridker of Harvard-affiliated Brigham and Women’s Hospital in Boston. Ridker is a co-inventor on a patent of the test for high-sensitivity C-reactive protein, or CRP. It is a measure of inflammation, which can mean clogged arteries or less serious problems, such as an infection or injury.

It costs about $80 to have the blood test done. The government does not recommend it be given routinely, but federal officials are reconsidering that.

For the study, researchers in the U.S. and two dozen other countries randomly assigned 17,802 people with high CRP and low levels of LDL, or bad cholesterol (below 130), to take dummy pills or Crestor, a statin made by British-based AstraZeneca PLC.

With an average of two years of follow-up, 34 of those on Crestor and 60 of the others developed venous thromboembolism a blood clot in the leg that can travel to the lungs. Several hundred thousand Americans develop such clots each year, leading to about 100,000 deaths.

However, this is uncommon compared to the larger number who suffer heart attacks. Many doctors have been uncomfortable with expanding statin use to people with normal cholesterol because so many would have to be treated to prevent a single additional case.

“I don’t know that it changes the big picture very much” to say that a statin can prevent blood clots, Hlatky said. “Where do you draw the line? Are we giving it to 10-year-old kids that are fat?”

AstraZeneca paid for the study, and Ridker and other authors have consulted for the company and other statin makers. Many doctors believe that other statins would give similar benefits, though Crestor is the strongest such drug. It also has the highest rate of a rare but serious muscle problem, and the consumer group Public Citizen has campaigned against it, saying there are safer alternatives.

Crestor costs $3.45 a day versus less than a dollar for generic drugs. Its sales have been rising even though two statins Zocor and Pravachol are now available in generic form.

Researchers do not know whether the benefits seen in the study were due to reducing CRP or cholesterol, since Crestor did both. Another new analysis reported Sunday and published in the British journal the Lancet found that the patients who did the best in the study were those who saw both numbers drop.

Many doctors remain reluctant to expand CRP testing or use of statins. A survey by the New England journal found them evenly divided on the questions. Others questioned why so few people in the study were getting other treatments to prevent heart problems.

“If more of them were on aspirin, you would have less benefit from the statin,” said Dr. Thomas Pearson of the University of Rochester School of Medicine and Dentistry.

Dr. James Stein of the University of Wisconsin-Madison said that doctors examining treatment guidelines should pay close attention to the new results.

He said the CRP test had helped him convince patients that they need to be on a statin drug.

“There are very few times you can say to a patient, ‘this medicine is going to keep you alive.’ We should try not to pick apart studies that save lives,” Stein said.

___

On the Net:

Heart meeting: http://www.acc.org

Medical journal: http://www.nejm.org

Debate Over Drugs For ADHD Reignites

admin — Mon, 30 Mar 2009 08:00:07 +0000

New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months.

Pregnancy hormone shows promise in heart failure

admin — Sun, 29 Mar 2009 23:40:07 +0000

CHICAGO (Reuters) - A pregnancy hormone that relaxes blood vessels appeared to reduce symptoms of acute heart failure and improve survival, according to a preliminary study released by U.S. researchers on Sunday.

Health Tip: Depression Among Seniors (HealthDay)

admin — Sun, 29 Mar 2009 16:20:05 +0000

(HealthDay News) — Depression affects more than 6 million people
aged 65 or older in the United States, but only about 10 percent of them
are treated, the Cleveland Clinic says.

Newly Pregnant Smokers Have a 15-Week Window to Quit (HealthDay)

admin — Sun, 29 Mar 2009 07:10:13 +0000

THURSDAY, March 26 (HealthDay News) — Pregnant women who quit smoking
before the 15th week of pregnancy reduce their risk of premature birth and
having small babies to that of nonsmoking women, a new study finds.

Clinical Trials Update: March 27, 2009 (HealthDay)

admin — Sat, 28 Mar 2009 23:30:05 +0000

(HealthDay News) — Here are the latest clinical trials, courtesy
of CenterWatch:

Woman accused of illegally importing bear bile (AP)

admin — Sat, 28 Mar 2009 16:10:07 +0000

LOS ANGELES – Federal prosecutors in California have charged a South Korean national with illegally importing almost a kilogram of bear bile to sell as an aphrodisiac.