Wednesday, October 31, 2007

Stupid Brits to jump on the folic acid bandwagon. Who cares if it gives people bowel cancer?

Because America does it, it must be OK, seems to be their reasoning. The article below says that the experts have found no evidence of harm from folates. They were not looking very hard. I can find plenty and I am only a desultory reader of the relevant literature. Note this recent expert comment about folates and bowel cancer:

"Other reasonable hypotheses about one-carbon metabolism and colorectal carcinogenesis, based on our current understanding of the biochemistry and underlying mechanisms, have also not been proven correct. In a recently published placebo-controlled randomized clinical trial among 1021 men and women with a recent history of colorectal adenoma, supplemental folic acid at 1 mg/d for up to 6 years did not reduce the incidence of subsequent colorectal adenomas and might have increased it."

WHOA! The folate that Americans get compulsorily added to their bread did no good and seems to have done harm?? And do we see a double blind controlled study contradicting epidemiological inferences?? Who would have believed it! They go on to admit that two animal studies have shown that folate INCREASES cancer. Aren't you glad that your government is dosing you up with the stuff and giving you no say in the matter?

The addition of folate to our bread is more and more looking like an iatrogenic disaster to come. I think I should note once again that a folate expert has reported that the addition of folate to bread seems to have caused an upsurge in bowel cancer among Americans.

Bread should be fortified with folic acid by law to cut the risk of birth defects, the Food Standards Agency decided yesterday. The FSA board, which was split on the issue when it was last discussed in 2002, decided unanimously to back a recommendation from its scientific advisers for mandatory fortification of flour or bread, whichever is the more practicable.

In the US, Canada and several other countries, mandatory fortification has already cut sharply birth defects such as spina bifida. But Britain has hung back because of doubts about possible side-effects, and fear that "compulsory medication" would cause a public outcry.

The recommendation will now go to ministers, who will decide whether to implement it. If they do they could face opposition in the House of Commons but will be able to cite a mass of evidence gathered by the FSA.

The mandatory fortification of bread would include regular white and brown bread, but not wholemeal, enabling objectors to opt out. It would also be accompanied by controls on food that are already fortified voluntarily by manufacturers, such as some breakfast cereals, to avoid any possibility of an overdose.

The FSA board was given a range of options to consider, including the present policy of advising women planning pregnancies to take folic acid supplements. But half of pregnancies are unplanned, and the advice does not reach women in lower social classes whose diets are the most likely to be deficient. It has had relatively little effect.

The levels of fortification recommended by the FSA are 300 micrograms per 100 grams of flour, which it estimates will increase the average intake of the UK population by 78 micrograms a day. That should cut the incidence of neural tube defects by between 11 and 18 per cent, or between 77 and 162 cases a year. Greater reductions than this have been achieved abroad, and range from 27 to 50 per cent. But direct comparisons are difficult because they depend on the level of folic acid in the diet of each country before fortification began, and on eating patterns. The US achieved much greater increases in folic acid intake, probably because the amounts added to food exceeded the recommendations.

Dame Deirdre Hutton, chair of the FSA, told the board meeting in Nottingham that she supported the measure. "I don't believe it is the ultimate solution. I believe it is the best pragmatic solution we can get," she said.

The FSA board wants further advice on how folic acid can be added to bread without affecting cakes or biscuits. It called for more debate on how products fortified with folic acid should be labelled. Andrew Russell, the chief executive of the Association for Spina Bifida and Hydrocephalus, said: "We are delighted that the FSA board has taken the decision to recommend mandatory flour fortification to ministers. "It is a rare opportunity to benefit from a vitamin, and significantly improve public health. Now that the science has been listened to, we look to health ministers to speedily implement this life-saving measure." Between 700 and 900 pregnancies per year in the UK are affected by neural tube defects (NTDs) such as spina bifida. The majority are terminated when the defects are detected in antenatal checks.

The FSA estimated that the cost of NTDs was 136 million pounds a year, of which the greatest cost was in treating babies who died soon after birth. Of the 800 affected pregnancies each year, 110 end in stillbirths or deaths early in life; 79 in births of children who require treatment but have good life expectancy, and 611 in terminations.

The FSA's decision is in stark contrast to that of 2002, when the measure was rejected. The fear then was that fortifying flour with folic acid would conceal vitamin B12 deficiencies in older people, leading them to medical problems. The unknown effect of excessive folic acid consumption on cancer risk also caused concern. Since then, the US has found no evidence of harm.


'Magic bullet' devised to beat cancer

Sounds interesting

A new targeted therapy against cancer has shown impressive results in animal experiments. By using a beam of ultraviolet light to activate antibodies inside the tumour, a team at Newcastle University has created "magic bullets" that can use the body's immune system to destroy tumours while leaving healthy tissue unharmed.

They use antibodies - the body's own natural defences - that are injected into the tumour. But before injection, the antibodies are "cloaked" by attaching them to an organic oil that renders them ineffective. Once in place, a beam of ultraviolet light breaks up the cloaking chemical, bringing the antibody back to life. The antibody then binds to T-cells, the body's defence system, and triggers them to target the surrounding tissue.

Antibodies are the big growth area in cancer therapy. Drugs such as Avastin and Herceptin have shown good results in shrinking tumours, and 20 antibody drugs have so far been licensed, with many more in the pipeline. But targeting them precisely and avoiding damage to surrounding healthy tissue have proved stumbling blocks. The team, led by Colin Self, believes that its technique could reduce or eliminate these problems.

Two papers published today in the journal ChemMedChem report that in a small animal trial, the technique elimated ovarian cancers in five out of six mice, and greatly reduced the tumour's size in the sixth mouse.

The body is not very effective at using its own defences to fight cancer, possibly because it fails to recognise the tumours as a threat. The aim of the technique is to activate the killer T-cells to attack cancer cells and destroy them.

There are risks in activating T-cells, as the failed human trial last year at Northwick Park Hospital in Harrow proved. In that trial, an experimental antibody treatment called TGN1412 caused such a huge response that six healthy human volunteers suffered serious injuries as their activated T-cells attacked almost every organ in their bodies.

The trial showed just how powerful boosting the T-cell response can be. The Newcastle technique ought to avoid these dangers because the T-cell response will be local - inside the cancer - and not general.

However, the process will require extensive testing in animals and human trials before it has any chance of reaching a cancer clinic. David Glover, an expert in antibody technology and in drug trials, estimated yesterday that even if all went well it would be a decade before such a product could reach the market.

Light-activated therapies have achieved some success against cancers, particularly skin cancers, but have been used previously to activate chemotherapy drugs, not T-cells. There are some limitations, as light cannot always reach internal tumours very easily. But Professsor Self suggested yesterday that in an operation to cut out a prostate tumour, for example, the method could be used at the end of the operation to destroy any remaining tumour cells that the surgeon had been unable to remove, and hence prevent recurrence.

The method offers a further refinement, in which the cloaked antibody is linked to a second antibody directed against the tumour in a "double whammy". When uncloaked, it recruits T-cells to attack the tumour at the same time as the antitumour antibody also attacks it.

Professor Self said yesterday that his team had "very exciting" new results that confirmed the findings and that he was raising money for a human trial. This will be aimed at treating secondary skin cancers in patients who are already suffering cancers of the internal organs. The aim will not be to cure them, but simply to see if the skin cancers can be controlled, as a proof that the technique works in human beings.

Professor Self said: "I would describe this development as the equivalent of ultra-specific magic bullets. This could mean that a patient coming in for treatment of bladder cancer would receive an injection of the cloaked antibodies. She would sit in the waiting room for an hour and then come back in for treatment by light. Just a few minutes of the light therapy directed at the region of the tumour would activate the T-cells causing her body's own immune system to attack the tumour.
"While our work indicates that sunlight doesn't activate these antibodies, patients may have to be advised to avoid direct sunlight for a short time."

BioTransformations Ltd, the company set up by Professor Self to develop the technology, hopes to begin clinical trials on patients with secondary skin cancers early next year.


British Conservatives to cut immigration

Tory leader David Cameron pledged to cut net immigration into the UK, to ward off "unsustainable" pressure on the country's public services and infrastructure. In his first major speech on immigration, Mr Cameron set out his "modern Conservative population strategy" to slow the rate of growth in the numbers of people living in the UK. A Tory administration would set annual limits on economic migration from outside the EU "substantially lower" than the current rate, set up a Border Police Force with powers to track down and remove illegal migrants, and impose transitional controls on the right of nationals of new EU states to work in the UK.

And Mr Cameron said he would raise the minimum age for spouses coming to Britain to 21 and demand that they are able to speak English. A failure to reduce net immigration would "make it more difficult for a Conservative government to deliver its vision of opportunity, responsibility and security", he warned.

The Conservative leader also cautioned: "The promises that Gordon Brown makes - whether on improving the NHS, the education system or housing provision - will quite simply be overwhelmed by his failure to deal with the root causes of our demographic challenge."

Latest figures from the Office for National Statistics suggest, on current trends, the UK's population will rise from 60.6 million to more than 71 million by 2031, increasing pressure on housing, healthcare, schools, the transport system, energy and water supplies. Some of the increased pressure comes from Britain's ageing population, as well as the "atomisation" of society through divorce, family break-up and later marriage, which means more single-person households, said Mr Cameron. But with 190,000 more people coming to the UK from abroad than leave the country each year, the bulk of the population rise - around 70% - is driven by immigration.

"Of course we should recognise that in an advanced, open economy there will be high levels of both emigration and immigration," said Mr Cameron in his speech in central London. "But what matters is the net figure, which I believe is currently too high... It is time for change. We need policy to reduce the level of net immigration. And we need policy to strengthen society and combat atomisation."

Immigration minister Liam Byrne accused Mr Cameron of "rehashing platitudes". "He talks of a limit on immigration numbers but nowhere does he say what this would be," he said.


Reducing emissions could speed global warming (??)

There's no such thing as a happy Greenie and Prof. Lovelock is unhappy about EVERYTHING

A rapid cutback in greenhouse gas emissions could speed up global warming, the veteran environmental maverick James Lovelock will warn in a lecture today. Prof Lovelock, inventor of the Gaia theory that the planet behaves like a single organism, says this is because current global warming is offset by global dimming - the 2-3§C of cooling cause by industrial pollution, known to scientists as aerosol particles, in the atmosphere.

His lecture will be delivered as Hilary Benn, the Environment Secretary, launches the results of a public consultation on the Government's proposed Climate Change Bill which is intended to cut Britain's greenhouse gas emissions by 60 per cent by 2050. Prof Lovelock will say in a lecture to the Royal Society: "Any economic downturn or planned cutback in fossil fuel use, which lessened aerosol density, would intensify the heating. "If there were a 100 per cent cut in fossil fuel combustion it might get hotter not cooler. We live in a fool's climate. We are damned if we continue to burn fuel and damned if we stop too suddenly."

Prof Lovelock believes that even the gloomiest predictions of the Intergovernmental Panel on Climate Change are underestimating the current severity of climate change because they do not go into the consequences of the current burden pollution in the atmosphere which will last for centuries. He argues that though the scientific language of the IPCC, which reported earlier this year, is "properly cautious" it gives the impression that the worst consequences of climate change are avoidable if we take action now....

According to Professor Lovelock's gloomy analysis, the IPCC's climate models fail to take account of the Earth as a living system where life in the oceans and land takes an active part in regulating the climate. He will argue that when a model includes the whole Earth system it shows that: "When the carbon dioxide in the air exceeds 500 parts per million the global temperature suddenly rises 6§C and becomes stable again despite further increases or decreases of atmospheric carbon dioxide. "This contrasts with the IPCC models that predict that temperature rises and falls smoothly with increasing or decreasing carbon dioxide."

He argues that we should cut greenhouse gas emissions, nonetheless, because it might help slow the pace of global heating. We also have to do our best to lessen our destruction of natural forests but this is unlikely to be enough and we will have to learn to adapt to the inevitable changes we will soon experience.

The pro-nuclear Prof Lovelock will say that we should think of the Earth as a live self-regulating system and devise ways to harness the natural processes that regulate the climate in the fight against global warming. This could involve paying indigenous peoples to protect their forests and develop ways to make the ocean absorb and store carbon from the atmosphere more efficiently.

Prof Lovelock intends to add: "We are not merely a disease; we are through our intelligence and communication the planetary equivalent of a nervous system. We should be the heart and mind of the Earth not its malady." ...


Out-of-hours NHS care 'failing'

The NHS is failing to offer sufficient out-of-hours GP care for severely ill patients, experts have said. Existing services are "inadequate and inflexible" and there is a need for better diagnostic facilities, the Royal College of Physicians taskforce said. The group also said hospital care needed to be redesigned for those with non-life threatening life conditions that none-the-less require treatment. The government said care was improving after record investment.

The taskforce, which included a range of health professionals, looked at acute medical care. This includes the care of patients with respiratory problems or chest pains or complications linked to epilepsy or diabetes, which are not yet emergencies but could become so. The taskforce said poor standards of weekend and evening GP cover, which is now done by co-operatives of health professionals and private firms after family doctors were allowed to opt out in 2004, was forcing some patients to turn up at hospital for "reassurance".

The report recommended that local navigational hubs be set up to sign-post patients to the right services. And it called for specialist outreach clinics to be set up in the community to bring expert care out of hospitals. It said out-of-hours cover needed better access to diagnostic facilities, which includes scans and blood tests, to create a "see and treat" culture rather than the "see and greet" one that currently exists.

The experts also said hospital services needed to be redesigned to ensure "rapid streaming of patients". The experts said that all too often even patients already in hospital can find themselves moving slowly through the system seeing nurses, junior doctors and then consultants when they really need urgent help. They said acute medical units, rapid assessment, diagnosis and treatment centres which are becoming increasingly common in hospitals, need to be located near other key services such as the emergency department and critical care.

RCP president Professor Ian Gilmore said NHS professionals were facing a challenge - "to change what we do, when we do it and how we do it". He added: "For doctors, nurses, managers and all those involved with the care of acutely ill patients, this task will not be easy, but the status quo is not an option if we are to give these patients a consistently high standard of care."

Health Minister Ben Bradshaw said the government welcomed the report but was already making sure that people have access to care around the clock. "Primary Care Trusts must deliver high quality out-of-hours care, and in addition, patients have access to a range of other services that can provide urgent care out-of-hours including NHS Direct and NHS walk-in centres," he said. "We have invested record amounts in out of hours services and patients are seeing the benefits - eight our of ten patients say that they are satisfied with the service, and six out of ten rated the service as excellent or good."


As a great fan of Ayckbourn, I am delighted by this news: "An early play by Sir Alan Ayckbourn has been found more than 40 years after it was presumed destroyed, completing the 70-volume canon of his manuscripts. The satires about middle-class manners by Ayckbourn have established him as one of the most highly regarded playwrights in the world, but he was an actor in Scarborough when he wrote Love after All, his second play, in 1959. It was another nine years before he made his name with Relatively Speaking, which became a hit in the West End. The manuscript was discovered by staff from the Stephen Joseph Theatre in Scarborough, where Ayckbourn’s archive is based and his plays are still premiered. Working with curators from the Department of Manuscripts at the British Library, they found it in the archives of the Lord Chamberlain who, until 1968, vetted every play before it could be performed".

Britain now closing libraries: "Proposals to close library buildings across England are being explored by a government advisory body even though more than 100 buildings are estimated to have been lost in the past two years, The Times has learnt. Two years ago a damning report by the Commons Select Committee for Culture condemned the shabby and neglected public library services, with their backlog of building repairs and refurbishments. MPs had urged the Government to give libraries access to lottery money, calculating that up to two thirds of a billion pounds would be needed to wipe out the backlog of repairs. Campaigners, who are already outraged that libraries are being turned into centres for fitness classes and Pilates, were shocked to discover yesterday that the Museums, Libraries and Archives Council (MLA), the government agency in charge of the sector, is addressing the problem by examining whether there are too many library buildings."

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