A new study published in Archives of Disease in Childhood suggested that two thirds of severely obese children have at least one cardiovascular risk factor.
The findings were based on data from the Dutch Paediatric Surveillance Unit on children aged 2-18 between 2005 an d 2007. Paediatricians were asked to report information on children's cardiovascular risk factors - high blood pressure, fasting blood glucose levels and blood fats.
The study found that 307 out of 363 children were correctly classified severely obese, 52% were boys and they tended to be more severely obese at younger age but girls were obese at older age. Nearly 1 in 3 severely obese children came from single parent family. 67% had at least 1 cardiovascular risk factor, 56% had hypertension and 54% had high levels of bad cholesterol, 14% had high fasting blood glucose, and 1% already had type 2 diabetes. The authors said "high prevalence of hypertension and abnormal lipids may lead to cardiovascular disease in young adulthood.”
Critics noted some limitatons to the study, eg, a lack of internationally agreed criteria for diagnosing severe obesity in children, the difficulty of generalising the study results to other populations due to the small size of the study, the ethnicities of the children might also have an effect on the results.
Source: Van Emmerik NMA, Renders CM, van de Veer M, et al. High cardiovascular risk in severely obese young children and adolescents. Archives of Disease in Childhood. Published online July 23, 2012
(full text via Athens)
Tuesday, July 31, 2012
Wednesday, July 25, 2012
Increasing dietary antioxidant intake could cut pancreatic cancer risk
According to a new study published in Gut, more than 250,000 people die from pancreatic cancer each year around the world and only 3% - 5% of the patients survive beyond 5 years. It is difficult to detect and often not diagnosed until it is advanced. Smoking and type 2 diabetes are major risk factors, the researchers thought diet may have an impact in the incidence of the cancer.
The researchers examined data from the Norfolk arm of the European Prospective Investiagtion of Cancer (EPIC) study investigating the lifestyle and dietary factors associated with pancreatic cancer, including more than 23,600 participants aged 40 - 74 between 1993 and 1997. All participants had completed a comprehensive food diary tracking the type of food and amount they ate during a 7 day period, as welll as the methods they used to prepare the food, the nutrient value of each person is calculated. The nutrient intakes of the pancreatic cancer patients were comapred with 4000 healthy individuals to see if there were any difference.
The researchers found that within 10 years entering thte study, 49 developed pancreatic cancer, increased to 86 by 2010. They survived 6 months after diagnosis on average. Those eating a combination of the highest three quartiles of all of vitamins C and E and selenium had a decreased risk of pancreatic cancer. Researchers said the finding is not a chance finding, if the association is causal, 1 in 12 cancers might be prevented by avoiding the lowest intakes, but they point out that the study cannot show it is causal link therefore the need for studies in other populations.
Critics say it is important to note that the study only found a correlation with pancreatic cancer risk in people taking very low levels of these antioxidants. High levels of intake was not better than moderate levels of consumption. Too high levels of intake of these supplements and other vitamins and minerals are associated with different types of danger, people should seek advice before making changes to food or dietary supplement intake.
Source: Dietary antioxidants and the aetiology of pancreatic cancer: a cohort study using data from food diaries and biomarkers. Gut 2012, doi:10.1136/gutjnl-2011-301908 Full text via Athens.
The researchers examined data from the Norfolk arm of the European Prospective Investiagtion of Cancer (EPIC) study investigating the lifestyle and dietary factors associated with pancreatic cancer, including more than 23,600 participants aged 40 - 74 between 1993 and 1997. All participants had completed a comprehensive food diary tracking the type of food and amount they ate during a 7 day period, as welll as the methods they used to prepare the food, the nutrient value of each person is calculated. The nutrient intakes of the pancreatic cancer patients were comapred with 4000 healthy individuals to see if there were any difference.
The researchers found that within 10 years entering thte study, 49 developed pancreatic cancer, increased to 86 by 2010. They survived 6 months after diagnosis on average. Those eating a combination of the highest three quartiles of all of vitamins C and E and selenium had a decreased risk of pancreatic cancer. Researchers said the finding is not a chance finding, if the association is causal, 1 in 12 cancers might be prevented by avoiding the lowest intakes, but they point out that the study cannot show it is causal link therefore the need for studies in other populations.
Critics say it is important to note that the study only found a correlation with pancreatic cancer risk in people taking very low levels of these antioxidants. High levels of intake was not better than moderate levels of consumption. Too high levels of intake of these supplements and other vitamins and minerals are associated with different types of danger, people should seek advice before making changes to food or dietary supplement intake.
Source: Dietary antioxidants and the aetiology of pancreatic cancer: a cohort study using data from food diaries and biomarkers. Gut 2012, doi:10.1136/gutjnl-2011-301908 Full text via Athens.
Tuesday, July 24, 2012
Surgery may not be the best for prostate cancer
According to a 15-year study., most patient diagnosed with prostate cancer at a very early stage will choose surgery or radiation treatments with the adverse effects of impotence or incontinence. About 10% choose no treatment at all, this is called watchful waiting or active surveillance or expectant management, normally not recommended by their doctors. The study, published in New England Journal of Medicine, found that patients with early stage prostate cancer survived the disease whether they opt for surgery or not.
731 men diagnosed with prostate cancer after having high PSA levels were randomly assigned to radical prostatectomy or observation and followed through January 2010. They found that radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation. More than 1 in 5 in the surgery group had adverse effects from their operation.
The study suggests that most prostate cancers are not life-threatening, but most patients are given radical prostatectomy and they believe that treatment will eliminate the risk. Many men report pressurised by their doctors and families to seek aggressive treatment. The lead author of the study said the study shows that observation can be a wise and preferred option for most men diagnosed with prostate cancer detected with PSA.
However not all experts agree with the study's conclusion, but all feel that more research is needed to identify which cancer would be harmless and slow-growing. Some said that education and teaching is needed to understand the concept that not all cancers are the same.
Source : Radical Prostatectomy versus Observation for Localized Prostate Cancer. New England Journal of Medicine 2012; 367:203-213 (July 19, 2012), Abstract only, full text via Athens 90 days after publication.
731 men diagnosed with prostate cancer after having high PSA levels were randomly assigned to radical prostatectomy or observation and followed through January 2010. They found that radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation. More than 1 in 5 in the surgery group had adverse effects from their operation.
The study suggests that most prostate cancers are not life-threatening, but most patients are given radical prostatectomy and they believe that treatment will eliminate the risk. Many men report pressurised by their doctors and families to seek aggressive treatment. The lead author of the study said the study shows that observation can be a wise and preferred option for most men diagnosed with prostate cancer detected with PSA.
However not all experts agree with the study's conclusion, but all feel that more research is needed to identify which cancer would be harmless and slow-growing. Some said that education and teaching is needed to understand the concept that not all cancers are the same.
Source : Radical Prostatectomy versus Observation for Localized Prostate Cancer. New England Journal of Medicine 2012; 367:203-213 (July 19, 2012), Abstract only, full text via Athens 90 days after publication.
The cost of knowledge
The British Government announced on Tuesday 16 July 2012 that scientific research funded by British taxpayers' money will be free to access online by 2014, The Guardian reported. The announcement was made in response to the Finch Report that was commissioned by the Wellcome Trust in April 2012 to find a solution for open access to scientific research following the "academic spring" where thousands of researchers protested to boycot journals that publishers charged academic institutions high subscription fees for access.
The "academic spring" was sparked by a blog article posted in January this year by Tim Gowers, a distinguished mathematician at Cambridge University and winner of Fields Medal, unhappy with the high charges imposed by publishers on UK universities for access to research work produced by his peers and largely funded by taxpayers, therefore decided to decline to submit or review papers for any academic journals published by Elsevier.
Hundreds of supporting comments were posted to him, one of his readers set up a website for academics to register their protest against Elsevier. More than 12,000 signatories have now been collected of which more than 800 are medical researchers, committed to refuse to peer review , submit or undertake editorial work for Elsevier journals. Elsevier publsihes more than 2000 journals, eg Science Direct journals.
In April this year, Harvard University informed its teaching and research staff that it could no longer afford the high prices imposed by many large journal publishers and encouraged its staff to submit their research to open access journals and resign from editorial boards that keep articles behind paywalls. The Univeristy said that the current system of journal pricing and access policies is unsustainable and universities will need to work together to take control of the scholarly publishing.
In the current publishing model, researchers submit articles to journal editors, the manuscript is sent for peer review, usually unpaid. If the work is accepted, it is published and then sold back to university libraries and other subscribers.
Advocates of open access argue that public-funded scientific research should be made freely available to the wider public and for economic benefits. However, one of the barriers of adopting the open access model is that, apart from the publishers and prices, research grants in the UK are distrbuted to universiities on their publication records, the more articles the academics get published in prestigious journals, the higher the chance of funding opportunities for their universities or departments, so some may be relunctant to move to open access publishing.
It is estimated that UK universities spend about £200m a year for purchasing access to the scientific journals, unfortunately many are restricted by the licence agreement with publishers to extend the journal access to their affiliated NHS organisations, NHS hospitals will have to pay for their journal access. In 2008, the British Government officially formed 5 academic health science centres (AHSC), these are partnerships between a university and NHS Trust with the aim to improve the quality of health services by bringing research, educaton and patient care closer together. The AHSCs should use the collective bargaining power with publishers to strike a deal to address the issue of HE/NHS inequality of access to electronic library resources.
If you are NHS doctors, authors and users of journal articles, would you consider following Harvard's action?
The "academic spring" was sparked by a blog article posted in January this year by Tim Gowers, a distinguished mathematician at Cambridge University and winner of Fields Medal, unhappy with the high charges imposed by publishers on UK universities for access to research work produced by his peers and largely funded by taxpayers, therefore decided to decline to submit or review papers for any academic journals published by Elsevier.
Hundreds of supporting comments were posted to him, one of his readers set up a website for academics to register their protest against Elsevier. More than 12,000 signatories have now been collected of which more than 800 are medical researchers, committed to refuse to peer review , submit or undertake editorial work for Elsevier journals. Elsevier publsihes more than 2000 journals, eg Science Direct journals.
In April this year, Harvard University informed its teaching and research staff that it could no longer afford the high prices imposed by many large journal publishers and encouraged its staff to submit their research to open access journals and resign from editorial boards that keep articles behind paywalls. The Univeristy said that the current system of journal pricing and access policies is unsustainable and universities will need to work together to take control of the scholarly publishing.
In the current publishing model, researchers submit articles to journal editors, the manuscript is sent for peer review, usually unpaid. If the work is accepted, it is published and then sold back to university libraries and other subscribers.
Advocates of open access argue that public-funded scientific research should be made freely available to the wider public and for economic benefits. However, one of the barriers of adopting the open access model is that, apart from the publishers and prices, research grants in the UK are distrbuted to universiities on their publication records, the more articles the academics get published in prestigious journals, the higher the chance of funding opportunities for their universities or departments, so some may be relunctant to move to open access publishing.
It is estimated that UK universities spend about £200m a year for purchasing access to the scientific journals, unfortunately many are restricted by the licence agreement with publishers to extend the journal access to their affiliated NHS organisations, NHS hospitals will have to pay for their journal access. In 2008, the British Government officially formed 5 academic health science centres (AHSC), these are partnerships between a university and NHS Trust with the aim to improve the quality of health services by bringing research, educaton and patient care closer together. The AHSCs should use the collective bargaining power with publishers to strike a deal to address the issue of HE/NHS inequality of access to electronic library resources.
If you are NHS doctors, authors and users of journal articles, would you consider following Harvard's action?
Thursday, July 12, 2012
BNF free app for NHS Athens users
An official BNF app has been launched by NICE and is now available as a free download for anyone with an NHS Athens account who uses Android and iPhone smartphones or iPod touch. Users will need to enter their NHS Athens details to activate the content.
The BNF app offers access to the latest prescribing information from the BNF at the touch of a button and allows for browsing, searching BNF content, and receiving updates. Once downloaded, the app can be run without an internet connection meaning that professionals can access the BNF wherever they are.
Eligible health and care professionals in England who do not yet have an NHS Athens password can register directly from their Smartphone by following the instruction displayed in Apple App store and
To use the NICE BNF app for the first time, you will need to:
3. Enter your NHS Athens username and password
For help or further details, ask the librarian at your NHS Trust.
The BNF app offers access to the latest prescribing information from the BNF at the touch of a button and allows for browsing, searching BNF content, and receiving updates. Once downloaded, the app can be run without an internet connection meaning that professionals can access the BNF wherever they are.
Eligible health and care professionals in England who do not yet have an NHS Athens password can register directly from their Smartphone by following the instruction displayed in Apple App store and
To download the app on Android, users will require the minimum operating system: 2.3.3 and up. Iphone and Ipod touch users will require the minimum operating system: iOS 4.3 or later.
To use the NICE BNF app for the first time, you will need to:
1. Click on 'Sign in'
2. You will be asked to sign in with your NHS Athens account. 3. Enter your NHS Athens username and password
4. If you do not have an Athens account, click Register.
5. Click Sign in again.
6. Downloading to device may take up to 10 minutes
For help or further details, ask the librarian at your NHS Trust.
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