Birth control pills affect sexiness of man

Birth control pills may affect how appealing a woman finds a man's scent -- potentially steering her toward a mate who is genetically similar to her, according to British researchers.

The sense of smell is thought to be important to mate-seeking animals and humans. Genes of the major histocompatability complex (MHC) play a role in a person's odor, and people tend to be attracted to those with an MHC makeup that is dissimilar to their own.

This could have evolutionary significance, since genetic diversity in a couple increases the chances of having healthy children.

But in the new study, researchers found that after women began using birth control pills, their smell preferences tended to shift -- making them more likely to find the scent of a genetically similar man "sexy."

The findings appear in the journal Proceedings of the Royal Society B: Biological Sciences.

For the study, researchers led by Dr. S. Craig Roberts, of the University of Liverpool, recruited 110 women between the ages of 18 and 35. They had each volunteer rate the odors of six men, using t-shirts that the men had worn overnight.

The women were asked to rate odor "pleasantness" -- considered a correlate of "sexiness" -- and odor intensity. Odor "desirability" was tested with the question, "Based on this smell, how much would you like this man as a long-term partner?"

For each woman, the investigators pre-selected three MHC-similar and three MHC-dissimilar men.

At the time of the first sniffing session, none of the women was using oral contraception. A second session took place three months later, after 40 women had started using birth control pills.

The researchers found that, in general, the more pleasant a woman found a man's odor, the more desirable he was to her. But among women who began using birth control pills, the definition of a sexy odor changed over time.

"The results showed that the preferences of women who began using the contraceptive pill shifted towards men with genetically similar odors," Roberts said in a written statement.

If the sense of smell is in fact a strong player in humans' mate choices, the researchers write, birth control pills just might nudge a woman toward a less-than-ideal man.

"Not only could MHC-similarity in couples lead to fertility problems," Roberts said, "but it could ultimately lead to the breakdown of relationships when women stop using the contraceptive pill, as odor perception plays a significant role in maintaining attraction to partners."

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Asthma risk increased with childhood eczema

Children with the allergic skin condition eczema are at increased risk of developing asthma well into adulthood, according to a decades-long study.

Australian researchers found that among nearly 8,600 study participants followed from the age of 7, those who'd had childhood eczema were roughly twice as likely to develop asthma by middle-age.

It's not clear whether the eczema directly contributed to asthma development in these cases. However, the findings do suggest a cause-and-effect relationship between the two conditions, according to the researchers, led by Dr. John A. Burgess of the University of Melbourne.

They report the results in the Journal of Allergy and Clinical Immunology.

The findings come from a study that began in 1968, when parents of 8,583 7-year-old children in Tasmania were surveyed about their children's health. The children also had a medical exam. At that time, 769 were found to have eczema.

The researchers found that children with eczema were twice as likely as their peers to develop asthma as teenagers, and 63 percent more likely to develop the lung condition as adults.

Other researchers have noted a phenomenon dubbed the "atopic march," which refers to the sequential development of eczema, followed by nasal allergies and finally asthma. The current findings, Burgess and his colleagues write, suggest that this march continues on well past childhood.

It's also possible that eczema directly contributes to asthma development, the researchers say. One theory is that certain immune system cells, primed for an allergic response, might migrate from an eczema patient's skin to tissue of the airways. That could make their airways more likely to inflame in response to an inhaled allergen, leading to asthma symptoms.

"Our data suggest that a causal link is possible," Burgess told Reuters Health.
"If in fact the link was causal," he added, "then aggressive treatment of childhood eczema aimed at really tight control of that disease might have an impact on the development of asthma in adolescence and in adult life."


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Sextuplets birth in Iraq

A woman has given birth to rare sextuplets in southern Iraq, but two of them died because the hospital lacked the proper equipment to keep them alive, her doctor said on Saturday.

Some Iraqi media described it as the first birth of sextuplets -- six children born at once -- in the country, although this could not be verified.

Sextuplet births are extremely rare although fertility treatments have increased the frequency of multiple births.

"Two of the children died because of problems breathing," said Dr Ali al-Jabiri, in charge of premature infants at Al-Habboubi Hospital in the southern Iraqi city of Nassiriya.

"If we had suitable medical equipment then we could have saved them," he added.

The babies all weighed between 700 and 1,200 grams (24-44 ounces). Two boys and two girls survived. Their mother had used fertility drugs.

"The problem is, how can I take care of them? How to feed them?" said their mother, Ibtisam Najim Abid, at the hospital.

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Eye cells may improve sleeping pills

Sleepiness can be controlled by a set of nerve cells in the eye, tests on mice suggest, offering a new target for drug developers that may lead to better sleeping pills, British scientists said on Sunday.

Light levels have long been known to affect alertness, which is why dimly lit rooms lead people to feel drowsy. But the biological mechanism for this has been unclear.

Now University of Oxford researchers have discovered that so-called retinal ganglion cells play a key role. In mice where these cells are turned off genetically, the effects of light on sleep and alertness is completely abolished.

"We have discovered a new pathway that modulates sleep and arousal," lead researcher Russell Foster, of the Nuffield Laboratory of Ophthalmology, said.

"If we can mimic the effect of light pharmacologically, we could turn sleep on and off."

Many drugs have been developed to modify sleep-wake cycles, creating a multibillion-a-year sleeping pill market. But the action of current medicines is relatively crude and the drugs have side-effects.

By targeting the specific mechanism controlling the action of retinal ganglion cells, it may be possible in the future to develop much more sophisticated treatments.

The researchers were able to track the sleep pathway to the brain, showing that two sleep-inducing centers there were directly activated by the cells.

The research, however, is still at an early stage and scientists have yet to establish if the same processes affecting the back-to-front world of the mouse will work in humans.

Because mice are nocturnal, the affects seen in the animal tests were opposite to those that would be expected in humans.

Mice normally sleep when it is light and wake up in the dark -- but those mice in which the light-sensitive cells were turned off stayed wide awake when the lights were on.

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Bipolar disorder linked to genetic traits

Two genes that influence the activity of nerve cells in the brain may play a key role in a person's risk for bipolar disorder, marked by dramatic swings from depression to manic behavior, researchers said on Sunday.

The findings are not expected to lead to a genetic test for the risk of the condition but could help unravel the mystery of how it arises and lead to better treatments, they reported in the journal Nature Genetics.

An international team of scientists examined the genomes of 10,596 people mainly from Britain and the United States, including 4,387 with bipolar disorder, also sometimes known as manic-depression.

The researchers found those with bipolar disorder more likely to have certain variants of the ANK3 and CACNA1C genes. Proteins made by the two genes help govern the flow of sodium and calcium ions into and out of neurons in the brain, influencing the activity of these nerve cells.

"The key importance of this is that it gives us a clear idea of the sorts of chemicals and mechanisms in the brain that are involved in bipolar disorder," Nick Craddock of Britain's Cardiff University, who helped lead the study, said in a telephone interview.

"Over a number of years, that will help researchers to develop better approaches to diagnosis and treatment."

Because it tends to run in families, scientists have been trying to pinpoint genes involved in bipolar disorder. This was the largest genetic analysis of its kind on the disease, which affects an estimated 1 percent to 3 percent of adults worldwide, Craddock said.

The brain disorder causes extreme shifts in mood, energy and ability to function. It is marked by high periods of elation or irritability and low periods of sadness and hopelessness that can last months.

EQUILIBRIUM

The proper function of brain neurons depends on a delicate equilibrium between sodium and calcium, the researchers said.

"The brain operates according to how quickly calcium and sodium are going in and out of cells and how much of it goes in and out," Craddock said.

The findings suggest that bipolar disorder may stem at least in part from malfunctions in the flow of these ions, which are electrically charged versions of the chemicals.

There is a need for better treatment, Craddock said. Lithium, the most common, helps only about two-thirds of those with the disorder and can cause drowsiness, weight gain and mild shakiness.

The U.S. government's National Institutes of Health helped fund the research. Dr. Thomas Insel, director of the NIH's National Institute of Mental Health, said the findings may help solve the puzzle that is bipolar disorder.

"It's not going to tell us the whole story -- it doesn't give you the whole puzzle -- but it's something to build on," Insel said in a telephone interview.

Craddock said identifying the two gene variants probably will not be helpful in determining an individual's risk for the disorder because many who do not have the disease will have the genes.

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1918 flu survivors protected by antibodies

Antibodies from survivors of the 1918 flu pandemic, the worst in human memory, still protect against the highly deadly virus, researchers reported on Sunday.

The findings by a team of influenza and immune system experts suggest new and better ways to fight viruses -- especially new pandemic strains that emerge and spread before a vaccine can be formulated.

These survivors, now aged 91 to 101, all lived through the pandemic as children.

Their immune systems still carry a memory of that virus and can produce proteins called antibodies that kill the 1918 flu strain with surprising efficiency, the researchers report in the journal Nature.

"It was very surprising that these subjects would still have cells floating in their blood so long afterward," said Dr. James Crowe of Vanderbilt University in Tennessee, who helped lead the study.

The antibodies also protected mice from the 1918 virus, which swept around the world at the end of World War One killing between 50 million and 100 million people, Crowe's team reports in the journal Nature.

"The antibodies that we isolated are remarkable antibodies. They grab onto the virus very tightly and they virtually never fall off," Crowe said in a telephone interview.

"That allows them to kill the 1918 virus with extreme potency, meaning it takes a very small amount of antibody."

The human body has two systems for fighting off bacterial and viral invaders. One system uses so-called T-cells while the other employs B-cells, made in the bone marrow, which in turn make antibodies to both flag and directly attack the targets.

RESURRECTED VIRUS

Dr. Christopher Basler and colleagues at the Mount Sinai School of Medicine in New York tested the 1918 survivors and found that in most of them, the B-cells made antibodies highly attuned to the 1918 flu strain.

Dr. Terrence Tumpey at the U.S. Centers for Disease Control and Prevention had worked on a team that resurrected the 1918 virus taken from buried victims of the epidemic and tested this virus in mice. Mice given the antibodies from the elderly survivors lived, while those given placebos died.

Crowe said it will now be important to test other people who have had influenza to see if their immune responses are as strong. "The thought is the first influenza that you see during life is the one that you have the best immunity to," he said.

"If we can learn the rules about how these antibodies work we may be able to design antibodies to lots of other viruses."

The 1918 flu was an H1N1 strain that apparently came straight from birds. "This study tells us that human beings can make long lasting immune responses to bird influenza," Crowe said.

Crowe said his team is working to get antibodies from people vaccinated with experimental shots for the H5N1 avian influenza now circulating in Asia, Europe, the Middle East and Africa. H5N1 mostly affects birds but it has infected 385 people since 2003, killing 243.

Experts fear that, like the H1N1 virus did in 1918, H5N1 will mutate into a form that passes easily among people and spark another pandemic. No one knows if the vaccines being made now would protect against whatever form of H5N1 might emerge.
Crowe said antibodies from survivors might make a good interim treatment while a vaccine is formulated, manufactured and distributed -- a process that would take months.


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Obese men with prostate cancer have poor prognosis

Prostate cancer diagnosis tends to be delayed and surgical treatment more difficult in obese men than in lean men, according to two studies published Friday.

The primary reason for the later diagnosis, and consequently poorer prognosis, seems to be that the PSA test used to screen for prostate cancer is "biased" against obese men, according to researchers.

The problem, they explain, may stem from obese men's larger blood volume, which dilutes their PSA levels. High blood levels of PSA -- or prostate specific antigen - can signal the presence of a prostate tumor.

"We know that obese men tend to have lower PSA values than their normal-weight counterparts, possibly caused by larger blood volumes which dilute their readings," Dr. Stephen J. Freedland, who led the studies, said in a written statement.

"Now we know some of the real implications of this -- that these men are at a disadvantage in terms of prognosis compared to normal-weight men."

Freedland, of Duke University Medical Center in Durham, North Carolina, and his colleagues report their findings online in the journal BJU International.

In one study, the researchers looked at the outcomes of nearly 3,400 prostate cancer patients who had undergone surgical removal of the prostate between 1988 and 2007. Some had had their cancer detected by PSA, while the rest had had it discovered during a digital rectal exam.

Overall, Freedland's team found, obese men were more likely to have more-aggressive tumors and to suffer a cancer recurrence after surgery.

However, the link between weight and disease progression was limited to men treated since 2000, when PSA screening had become the norm.

By contrast, obesity had no effect on the risk of progression for cancers detected by digital rectal exam. The findings support the notion that PSA testing, in particular, confers a bias against obese men, according to Freedland.

In the second study, the researchers found that obese prostate cancer patients tend to have a higher rate of "positive surgical margins" after prostate removal -- which means the odds are higher that some tumor cells were left behind.

"The aggressiveness of obese men's tumors, coupled with the fact that they may be more difficult to remove, is like a double whammy for being obese," Dr. Jayakrishnan Jayachandran, another researcher on the studies, said in a statement.

The findings of both studies, according to Freedland, build up the case for developing alternative prostate cancer screening methods for obese men -- or for lowering the PSA threshold for these patients.

"The least we can do is find a way to level the playing field when it comes to diagnostic tools," Freedland said.

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Physical barriers affect India's fight against HIV

Vast distances are a major hurdle to India's efforts to curb its soaring HIV rate.

India, which has the world's third largest HIV-positive caseload, gives drugs for free to HIV/AIDS patients. But doctors say this is not enough to stop the spread of HIV which is making inroads in rural India, especially among women infected by itinerant husbands, and also children.

For three days a month, Sambit squeezes into a crowded and often filthy train for a three hour journey to Delhi to receive HIV treatment.

"There's no seat and I am very weak," said the 30-year-old former tailor, who asked that his full name not be revealed. He can't afford lodging in Delhi and can barely afford the train tickets.

"I need to borrow money from my family for all these trips," he said.

Many patients in the same position simply give up treatment, an anathema in HIV therapy as it gives rise to drug resistance. These patients may then need more powerful second line treatment, which is not freely available in India.

"Travel can affect drug compliance. Patients who don't get family support, women who may not like to travel alone will just give up," said a doctor at a New Delhi hospital, who spoke on condition of anonymity because he did not have permission to speak to reporters.

There are 147 "antiretroviral therapy" or ART centers in the country, part of a government drive that has been encouraged by the World Health Organization in a bid to prevent HIV from becoming a major health problem.

Delhi has nine such centers and is far better served than many other states. Up to 6,000 patients receive treatment in Delhi, nearly half of these live outside the capital.

The government now plans to build "link centers", small facilities that are closer to where patients live so people like Sambit can obtain their medications more easily.

"They just come to pick up the drugs if they have no side effects and they go home ... that saves transport and other costs," Rao said, adding that the plan was to have as many as 500 such centers all over India.

INFECTION FIGURES AREN'T GOING DOWN

India has 2.47 million HIV cases, according to the latest figures, but health workers say the number is rising rapidly and spreading to new population groups.

"Our numbers are going up," said Loon Gangte, South Asia coordinator of the Collaborative Fund for HIV Treatment Preparedness.

"It's not confined to high risk groups, it's going into the general population. It's not a problem of sex workers, drug users or truck drivers. These people have wives and children at home and the disease is making its way into the general population."

Sujatha Rao, director-general of the government's National AIDS Control Organization, says doctors are increasingly seeing women infected by their husbands.

In some clinics, 1 out of 100 women who come for ante-natal care checkups are HIV positive, she said.

"It is a generalized epidemic," she said. "We have pockets where the prevalence is more than 1 percent among ante-natal care mothers, so we need to intensify our work."

Out of India's 611 districts, HIV prevalence is more than 1 percent of the population in 156 districts.

"The epidemic is getting deeper into (certain) rural, general areas of the country ... it is migrant-related. They go to work and then they take back the infection to their homes," she said.

Even though HIV drugs are free, only about 155,000 people have access to retroviral drugs, up from 20,000 just two years ago.

Health expert say there are many people who do not know they are infected or who do not know that treatment is available.

Some health professionals believe India's HIV problem is closely intertwined with poverty and that the government must tackle poverty if it seeks to curb the spread of HIV.

"Many of these people are very poor, they worry about food, shelter. So they may not think their HIV status is a problem because they don't even know where their next meal is coming from," said Errol Arnette of the help group Sahara.

"A lot of AIDS patients die of TB because it's hard for hospitals to keep them (in hospital). HIV patients are just thrown in a corner because of heavy stigma."

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Doctors fall short on heart disease prevention

Some doctors are not making the grade when it comes to helping their patients ward off heart disease, a new survey suggests.

The survey, of nearly 900 U.S. primary care doctors, found that many do not follow practice guidelines on managing patients who are at elevated risk of heart and blood vessel disease.

"Despite the benefits demonstrated for managing cardiovascular risks, gaps remain in primary care practitioners' management of risks according to guideline recommendations," conclude researchers in a report in the journal BMC Family Practice.

"Patients should talk to their physicians about setting goals together for reducing blood pressure and cholesterol and making a plan to achieve the goals," lead researcher Dr. Hamidreza Doroodchi, from Birmingham, Alabama-based Outcomes, Inc., noted in comments to Reuters Health.

Doroodchi and colleagues sent a survey on cardiovascular disease management to a random sample of 12,000 U.S. family physicians and general internists. A total of 888 completed the survey, which contained "case vignettes" for managing adults deemed to be at low or high risk of heart disease.

The study found that in the hypothetical case of a low-risk 45-year-old woman, only 28 percent of family doctors and 37 percent of internists made the "guideline-based preventive choice" of prescribing no aspirin or other antiplatelet therapy -- drugs that help prevent blood clots by keeping platelet blood cells from clumping together. The majority indicated that they would prescribe a daily aspirin for such a patient to reduce the risk of heart attack.

When asked whether they would start drug therapy to combat abnormal cholesterol levels, 51 percent of doctors said they would not do so in this low-risk patient -- which is in accordance with guidelines. On the other hand, 41 percent said they would prescribe a statin.

When it came to basic lifestyle advice, which is appropriate for low- and high-risk patients alike, doctors often fell short.

For example, while experts recommend that all adults limit their intake of artery-clogging trans fats, over one-third of doctors in the survey failed to recommend this measure for the low-risk 45-year-old woman.

For a 50-year-old man at high risk for heart disease, only 59 percent of family doctors and 56 percent of internists correctly identified the guideline-based goal of keeping "bad" LDL cholesterol below 100 milligrams per deciliter.

Similarly, for a 78-year-old woman at high risk for heart disease but no obvious symptoms, only about half of family doctors and internists were in accordance with guidelines to order a stress test should she develop chest pain or shortness of breath.

Doctors in practice for 10 years or less were much more likely than doctors in practice for more than 10 years to make appropriate guideline-based choices for the prevention of heart disease. Younger doctors were also more apt to adhere to guidelines than were more experienced doctors.

Doroodchi and colleagues found it "especially concerning" that doctors who see a greater percentage of patients with high blood pressure and cholesterol abnormalities were significantly less likely to offer guideline-based care.

"Innovative educational approaches," they conclude, "are needed to address barriers, and target specific groups of physicians to facilitate implementation of guideline-based recommendations for cardiovascular management."

The findings should not, however, be taken as a sign that doctors lack concern for their patients, according to Doroodchi.

"Most primary care physicians are concerned about cardiovascular risk in their patients and set goals for their patients to reduce this risk," the researcher said. "Physicians are concerned that their patients do not follow their advice about changes in exercise and diet, and (that) they do not always take the medicine that is prescribed."

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Study shows few HIV patients tested for tuberculosis

A new report suggests that only 1 percent of HIV-positive patients worldwide have been screened for tuberculosis, a curable infection that frequently kills those living with the AIDS virus.

The low TB screening rate is "unacceptable," researchers from the Advocacy to Control TB Internationally (ACTION) coalition said during a press conference at the International AIDS Conference underway here.

"A mere one percent of people living with HIV/AIDS are reported to have been screened for TB," said Dr. Jim Yong Kim, chief of the division of social medicine and health inequalities at Harvard Medical School. "One of the great tragedies of this epidemic is that people who are living with HIV, after hard-fought battles for access to antiretroviral treatment, go on to die needlessly from TB."

Quoting WHO statistics, the report says that of the 33 million HIV-positive people worldwide, only 314,394 individuals had been tested for tuberculosis. Of those who had been screened, over one in four were found to have active tuberculosis, according to a press release issued by ACTION.

"Persons living with HIV/AIDS are 50 times more likely to develop tuberculosis, than those who are HIV negative," the release cautions. "Without treatment, approximately 90% of persons living with HIV/AIDS die within a few months of developing TB."

"We are facing a preventable plague inside a devastating epidemic," said Michel Sidibe, assistant secretary general and deputy executive director of UNAIDS.

Screening for tuberculosis is not mandatory in the programs being funded by the three major international donors -- Global Fund, PREPFAR and the World Bank, the release states.

The ACTION group recommends universal TB screening of all people living with HIV/AIDS and access to the 3 "I"s -- Intensified case finding, Infection control, and Isoniazid preventive therapy.

Screening tests for tuberculosis are inexpensive compared to the cost of the drug cocktails used to treat HIV/AIDS, Kim said in response to a question at the press conference.

An integrated HIV/TB approach is needed, Kim told Reuters Health.

"TB is a curable disease," he said. "It is a crime not to test for tuberculosis."

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