Health Newsletter:May 2007
Related Links:From WebHealth
Contents |
[edit] Birth Defect Risk Higher With Older Dads
Increased maternal age has long been associated with birth defect, one of them being Down’s syndrome, and fertility work ups are frequently involving women after the age of 30. So far it seemed that the biological clock has only been ticking for women, and it was assumed that there was not such a thing for older men who fathered children. Mounting evidence questions this assumption, suggesting that as men get older they face a higher risk of fathering children with abnormalities as well. Newer studies have been alarming, as they found higher rates of common conditions, including schizophrenia and autism in offspring of fathers who were in their middle and late forties. Obviously there is a difference between males and females, as women simply cannot have children after a certain age. But males cannot assume that a biological clock is non-existent for them. Dr. Harry Fish, director of the Male Reproductive Center at New York Presbyterian Hospital/Columbia University Medical Center cautions that not every man can be guaranteed that everything is going to be without problems. Aside from the higher risk for some genetic abnormalities a drop in fertility may also be present in a higher age group. There is a decline in the number of sperm being produced and there may be a decline in the amount of testosterone. Analyses of sperm samples from healthy men have found changes as men age including increased fragmentation of DNA. Some studies outside the U.S. have noted increased rates of some cancers in children of older fathers. Geneticists have been aware that the risk of some rare birth defects increases with the father’s age. The list includes a form of dwarfism (achondroplasia), neurofibromatosis, the connective tissue disorder Marfan syndrome, skull and facial abnormalities like Apert syndrome and some other diseases and abnormalities. Studies suggest that the risk of sporadic single-gene mutations may be four to five times higher for fathers who are 45 and older, compared to fathers in their 20’s. In an Israeli research project Avi Reichenberg studied a data base to determine whether there was a correlation between paternal age and the incidence of autism and related disorders. It found that children of men who became father at 40 or older were 5.75 times as likely to have an autism disorder as those whose fathers were younger than 30. A study on schizophrenia found that the risk of illness was doubled among children of fathers in their late 40s when compared to fathers in their 20s. The risk jumped to almost threefold in children where the father was fifty or older. Higher age in the father also is a contributing factor in 50% of Down’s syndrome cases in babies born to women over forty. Dr.Fish advises that healthy habits, regular exercise and a balanced diet may help preserve fertility. He warns against smoking, the use of anabolic steroids and hot tubs, all of which can damage sperm. He suggests that if a couple wants children “have them sooner rather than later. No matter what happens, the biological clock ticks.”
National Review of Medicine, March 30, 2007, pg. 17-19
[edit] Test for Early Ovarian Cancer
Ovarian cancer is the number one killer for gynecological malignancies. Diagnosis usually occurs, when the patient presents at the doctor’s office with abdominal pain or bloating, pelvic discomfort or vaginal bleeding. Unfortunately the cancer will be at an advanced stage at this point, and a five-year survival is devastatingly low at 20%. So far there has been no reliable test which can screen for early ovarian cancer. Researchers at Yale-New Haven Hospital in New Haven, Conn. have developed a test model that uses six biomarkers to identify ovarian cancer: leptin, prolactin, osteopontin, insulin-like growth factor II, macrophage inhibitory factor (MIF) and CA 125. Dr.Aliza Leiser who is heading the research project states that the power of the test is in the combination of the six markers. Each marker by itself is not able to distinguish cancer with a high specificity, but the combination of the six biomarkers results in a test with high sensitivity of 97.5 % and also a high specificity of 99.7%. A prospective study is underway, and Dr. Leiser is confident that the test could have the potential to become a general screening test for women not unlike a mammogram or Pap test. She stated that the applicability of the test to a high risk population is not yet known. Also, the test would not be a single-step test for ovarian cancer screening. Like many tests it would be a two-step model: those patients with an abnormal blood test would undergo trans-vaginal ultrasound to determine if surgery was indicated. The most compelling aspect about the blood test is its sensitivity and specificity which makes it possible to detect ovarian cancer early. This in turn will translate into a five-year survival of 90 % for the patient.
The Medical Post, March 20, 2007, page 1 and 59.
[edit] Dioxin Fears and Healthy Living
Toxic environmental contaminants can be a hazard to our health, and their appearance in our foods has made plenty of headlines. Substances like PCB’s and dioxins have long come under scrutiny, and as a result consumers can be concerned and confused. What foods are safe? Will the pesticide in vegetables make us sick, or will the consumption of fish poison us? As a result, organic food sales have drastically increased. Taking a closer look at dioxins shows that while they are toxic substances, there are things the consumer can do. Dioxins are formed through various means, combustion processes like the burning of fuels such as wood, coal, or oil; through municipal waste incineration, bleaching of pulp and paper and burning of household trash. Dioxins also appear in nature through volcanic activity and forest fires. The number one quantifiable source of dioxins comes from the burning of household materials, paper, plastic, cardboard and yard trimmings. Once dioxin release into the air they can travel long distances and can be found all over the world. When they are airborne they can get deposited on plants. If they get released into water they can get transported or eaten by fish. As a result of this, they make their way into the food chain. Due to widespread industrialization dioxin levels have been shooting upwards since 1920. Only in the 1970’s dioxins were identified as highly toxic chemicals, and environmental protection agencies began to aggressively control dioxin production and release. These efforts have paid off: dioxin levels in the U.S. have been decreased by more than 90% compared with 1987 levels. Dioxin remains a poison, and various studies suggest that high-risk workers also have a higher risk for cancer. People exposed to high levels of dioxins in industrial settings may develop “chloracne”, an acne-like skin condition on the face and upper body. For consumers there is a piece of reassuring news. The dietary exposure does not cause significant dioxin levels in the body. The FDA has been monitoring dioxin in our foods and removed any sources that contain increased dioxin levels since 1999. As a result of these precautions our dietary intake of dioxins is now 90% lower than in the 1970’s. The individual still can take some preventive actions. Dioxins accumulate in animal fats. In order to keep dioxins as low as possible, it makes sense to limit the intake of butter and lard. It is sensible (also for other health reasons) to remove the skin from chicken before cooking it, and the choice of low-fat meat cuts is a sensible one. Following what we know to be a healthy diet along with the above mentioned guidelines will serve us well.
The Medical Post, March 27, 2007, page 30
[edit] Experimental Drug Stabilizes Alzheimer
Cognitive functional impairment, the loss of memory, reasoning, and judgement, which can be an indicator for the progressively worsening condition of Alzheimer’s disease, remains a difficult condition to treat. It presents not only challenges to the medical community to effectively care for the patients, but it remains a troubling disease for the aging population. Dr. Suzanne Hendrix (PhD), a researcher with Myriad Pharmaceuticals Inc. of Salt Lake City reports about a study, which shows new and promising possibilities for effective treatment. Current medications have not been able to stabilize patients with Alzheimer’s. Drugs have been able to “buy time” to the extent that patients were able to cope in their usual home environment for a few months longer before they had to be admitted to special care homes. New treatment agents have emerged, and one of them is a drug which aims at reducing brain amyloid pathology. The agent under the name of tarenflurbil (Flurizan) is effective to lower a substance which is called amyloid-beta 42 protein, which is thought to be the key initiator of Alzheimer’s. It is this protein which forms senile plaques in the brain that are damaging brain function and associated cognitive processes. Flurizan has been used in a phase II trial, and the researchers presented 24 month follow-up data. The study evaluated 207 patients from Canada and the United Kingdom. Of a group that received 800 mg Flurizan twice a day 60% responded by either improving or having zero decline in cognition after 12 months. It is of essence to diagnose and treat cognitive impairment and Alzheimer’s early. In patients with mild disease there was an almost flattening of the disease curve after 12 months, meaning that the medication almost halts the decline. Tarenflurbil was also well tolerated, and no dose-limiting adverse effects were observed.
The Medical Post, April 10, 2007, page 63
[edit] Robotics Open New Surgical Territory
Modern medicine has become an intriguing mix between the traditional art of medicine and high tech diagnostic methods to explore the function of the human body. In surgery of the past the skill and experience of the surgeon has had limits, but with the advent of microsurgery in the 1960’s new frontiers have been discovered and procedures that border to the miraculous have been introduced to the benefit of patients. It also placed enormous demands on the dexterity, skill, accuracy and endurance of the surgeons and the most demanding field in this respect can be neurosurgery. The human hand also has its limits: top surgeons can operate accurately within one-eighth of an inch. Where fractions of an inch count, the new development of robotics will move boundaries in neurosurgery to the astonishing and previously thought impossible. The world’s first surgical robot called NeuroArm has been developed by neurosurgeon Dr. Garnette Sutherland and his team. Dr.Sutherland and a team of Canadian scientists have spent the last six years in cooperation with MacDonald, Dettwiler and Associates Ltd. (MDA) to come up with a machine that will revolutionize neurosurgery and other fields of surgical medicine. The development of NeuroArm represents a milestone in medical technology, as it liberates the surgeon from the constraints of the human hand. The machine is designed to be controlled by a surgeon from a computer station in conjunction with real-time MR imaging. So far surgery has been performed on an organ level, but with the new arrival of this type of technological advance surgery can be shifted to a cell level, as surgeons will be able to manipulate tools at a microscopic scale. Whereas the surgeon of the past could operate accurately within a fraction of an inch, accuracy is now the width of a hair or a fraction of a millimeter. NeuroArm was designed and built in collaboration with MDA, which has become known for Canadarm and Canadarm 2, and it has required cooperation and partnering between medicine, engineering, physics and education, involving some of Calgary’s most visionary philanthropists, the high tech sector and numerous government agencies and funding organizations. A lot of this technology has been used in space programs of NASA. It will now become a tool to help patients get back to healing and normal daily living. The task has not only been to develop an advanced device to push the boundaries of microsurgery and neurosurgery but a robotics program that will have a significant impact on the region and beyond. Advanced surgical testing of NeuroArm is currently underway. This new technique is anticipated to be used on patients from the summer of 2007 onwards.
References:
1. worlds-first-surgical-robot-to-enhance-accuracy-and-safety-of-brain-surgery
2. http://www.newelectronics.co.uk/article/9147/Under-the-robotic-knife---COVER-STORY.aspx (23/3/2007)
Sponsored Results for Health Web
