Health

Psychiatrist is among five chosen for medical award

The psychiatrist who upset Freudian dogma in the 1960's by developing cognitive therapy is one of five winners of this year's Lasker Awards, widely considered the nation's most prestigious medical prizes.

The awards, announced yesterday by the Albert and Mary Lasker Foundation, are also going to four scientists who made important discoveries about aging and cancer.

Mary Lasker created the awards in 1946 as a birthday gift to her husband, Albert, in hopes of curing cancer in 10 years. Each award carries a $100,000 prize.

The psychiatrist, Dr. Aaron T. Beck, 85, of the University of Pennsylvania, won the Lasker clinical research award. Dr. Beck's technique, cognitive therapy, transformed the treatment of depression and many other mental health conditions.

Cognitive therapy "is one of the most important advances - if not the most important advance - in the treatment of mental diseases in the last 50 years," said Dr. Joseph L. Goldstein, the chairman of the Lasker jury.

The therapy is a counseling technique in which patients learn to head off or defuse self-defeating thoughts before acting on them. Dr. Beck and his students showed that cognitive therapy can reverse serious mental illnesses in weekly sessions over two or three months.

In making those advances, Dr. Beck set a new standard for determining the effectiveness of any type of psychotherapy, the Lasker jury said, by testing his radical new methods in clinical studies with a degree of rigor not previously applied to any form of talk therapy, including Freudian psychoanalysis.

Dr. Beck published much of his work in his own journal, Cognitive Therapy and Research, in part because other psychiatrists resisted, if not rejected, his findings.

Dr. Beck understood the reluctance. In a letter in The New York Times on March 6, 1983, he wrote that he empathized with his critics. He said that in the late 1950's his research had "set out to prove that anger turned against the self played a central role in depression," but to his surprise it "ultimately refuted this hypothesis."

The four other Lasker winners are Dr. Elizabeth H. Blackburn, 57, of the University of California San Francisco; Dr. Joseph Gall, 78, of the Department of Embryology at the Carnegie Institution, Baltimore; Dr. Carol W. Greider, 45, of Johns Hopkins University of Medicine; and Dr. Jack W. Szostak, 53, of Harvard Medical School.

The awards to those four were made in two categories. Three of the recipients were cited for discoveries involving the structure and function of chromosomes, which are the strands of genes in cells that pass on hereditary information.

Dr. Blackburn, Dr. Greider and Dr. Szostak are sharing the Lasker basic medical research award for predicting the existence of telomerase, and then discovering it. Telomerase is an enzyme that replenishes the tips of chromosomes.

Discovery of the enzyme emerged after Dr. Gall and Dr. Blackburn studied two organisms, a pond-dwelling parasite and baker's yeast.

The scientists were driven by curiosity, not because they thought their research was related to human disease, said Dr. Goldstein, who works at the University of Texas Southwestern Medical Center in Dallas.

After further research, carried out independently and in collaborations with each other, the scientists identified and purified telomerase in human cells, setting the stage for discoveries about the enzyme's role in cancer and aging.

Strong evidence suggests that the enzyme allows cells to proliferate by continually refreshing their telomeres.

For example, adding the enzyme to certain human cells grown in culture dishes renders the cells immortal.

Conversely, blocking its action in lab-grown cancer cells can inhibit their growth or kill them.

The work of the four scientists and that of others showed that each time a cell divides, its chromosomes become shorter. As cells age, their telomeres shorten, leading to loss of telomere function and changes in chromosome that can lead to cancer.

In animal experiments, researchers are testing chemicals that thwart telomerase as a potential strategy for fighting cancer in humans.

Dr. Gall won a special achievement award for a 57-year career in which he became a founder of modern cell biology and the field of chromosome structure and function.

He "ranks among the most distinguished cell biologists in history," the Lasker Foundation said. In his youth, Dr. Gall collected amphibians, insects and tiny pond creatures. That experience provided him with a knack for choosing the appropriate organism for studying a particular research problem.

Dr. Gall went on to become a "bold experimentalist" who invented what "quickly became one of the most important and widely used techniques in cell biology," the foundation said.

The technique, known as in situ hybridization, allows researchers to pinpoint the location of a specific sequence of RNA or DNA within the nucleus of cells. The technique remains the standard way scientists map genes in cells and chromosomes.

Using fluorescent molecules in modifications of the technique, scientists can produce exquisitely detailed pictures of genes and their activity.

The Lasker Foundation said it was further honoring Dr. Gall for being an early champion of women in science by welcoming them "into his lab before anyone was talking about excellence through diversity."

The awards represent a lineage of three generations in science. Dr. Gall trained Dr. Blackburn when they worked at Yale.

She, in turn, trained Dr. Greider when they worked at the University of California, Berkeley.

Dr. Gall still works in the laboratory.

A current interest is deciphering the function of a structure in the cell nucleus that the Spanish scientist Santiago Ramon y Cajal described in 1903.

(NEWYORK TIMES)

New drug shown to lower risk of diabetes

A drug that improves the body's ability to turn sugars into fuel can substantially reduce the chances of people at risk of developing a type of diabetes, according to new research.

The study, published in the British journal *The Lancet*, tested 5000 people with "pre-diabetes", recruited from 21 countries, for three years. Chosen at random, just under half were given the Type 2 diabetes drug rosiglitazone, sold under the brand name Avandia.

The rest were given a placebo. All participants were given advice on exercise and diet. Those who were given the drug had to take an eight-milligram dose daily.

The results were clear: 26 per cent of those taking the placebo went on to develop diabetes; only 11 per cent taking Avandia did. And 51 per cent of those taking the drug returned to normal blood sugar levels. Just 30 per cent of those taking the placebo did.

Type 2 diabetes is normally acquired in adulthood, although with the blow-out in obesity rates, even adolescents and children are now getting the disease. It is caused by high blood sugar levels, which in turn is caused by reduced insulin sensitivity in the body.

The Australian principal investigator for the study, Paul Zimmet, said it was a "very important" result. "We knew that people actually start to get complications from diabetes even before the diabetes is diagnosed," he said.

"There has been a move to see whether you should start treating people in this earlier phase of pre-diabetes, so you don't start getting the devastating complications."

However, Professor Zimmet - foundation director of the International Diabetes Institute, and professor of diabetes at Monash University - said the medication was not without problems. "This particular tablet does have some side effects: people do put on weight and there's some cases of heart failure," he said.

According to the study, 14 participants who took Avandia developed heart trouble, whereas only two in the placebo group did.

Professor Zimmet said "governments aren't going to be very keen" to support the drug, as it was expensive, and exercise and weight loss were cheaper.

"It's unlikely for a few years that governments will approve the use of tablets like this for pre-diabetes. It's a new ball game. They want to know whether it is cost-effective or not, and will want to know whether it is safe."

(BBC News)

To find the bacteria, follow the water

The outbreak of illness last week due to bacterial contamination of bagged spinach is one of the larger episodes of its kind, with at least 94 victims, including one death, in 20 states.

But the outbreak, which health authorities linked to spinach sold by a company in the Salinas Valley in California, is not an isolated one. In the past decade there have been eight others tied to E. coli contamination of fresh greens from the valley, where most of the nation's lettuce and spinach is grown.

Why do these outbreaks keep happening?

Dean Cliver, a professor of food safety at the University of California at Davis, said that no one, including the federal Food and Drug Administration had been able to pinpoint sources of bacterial contamination. "Food and Drug is flailing about on this issue," Dr. Cliver said. "If they had an answer it wouldn't still be happening."

The most likely source, he said, is irrigation and processing water that has been contaminated by animal waste. But poor sanitation for field workers and use of compost containing manure are other possibilities.

Dr. Cliver said greens are a quick crop, and fields are turned and replanted long before an outbreak occurs. Even if the contamination could be traced to a particular field, determining the source of the water can be difficult.

"Tracing groundwater is an art form," he said.

WHO clears DDT spraying for malaria

DDT, the long-banned insecticide blamed for killing birds and other wildlife, is now approved for use indoors to fight malaria, the World Health Organization announced on Friday.

"One of the best tools we have against malaria is indoor residual house spraying," said Dr. Arata Kochi, director of the World Health Organization (WHO) malaria department. "Of the dozen pesticides WHO has approved as safe for house spraying, the most effective is DDT."

For about $5 per house, indoor spraying with DDT is a cost-effective response to malaria, which kills about a million people annually, most of them children under five.

In parts of Africa and Asia where malaria-carrying mosquitoes spread the disease, 85 percent of home dwellers approached by health workers allow their houses to be sprayed, global health officials said at a news conference.

DDT came into common use in the 1930s as an agricultural insecticide.

It became notorious after biologist and ecologist Rachel Carson's 1962 book "Silent Spring" exposed how DDT entered the food chain, killing wildlife and threatening humans.

In 1969, the National Cancer Institute announced findings that DDT could cause cancer, and a U.S. federal ban was imposed in 1972.

Richard Tren, director of the group Africa Fighting Malaria, stressed the difference between agricultural DDT sprayed outdoors and the residual spraying meant to act like a giant mosquito net over individual houses.

"The environmental impact associated with spraying insecticides whether it's DDT or other insecticides indoors is minimal, it's negligible ... This is as unrelated to 'Silent Spring' as anything," Tren said.

"The science is very clear that there are no harmful human effects." Tren said environmental groups in Africa support its use.

In Washington, the director of the Sierra Club's environmental quality program gave muted backing to the plan.

"Reluctantly, we do support it," said the group's Ed Hopkins. "Malaria kills millions of people and when there are no other alternatives to indoor use of DDT, and where that use will be well-monitored and controlled, we support it." Hopkins stressed the need for safer alternatives to DDT, "because DDT is not a silver bullet to solve this problem."

(Chinaview.com)

Toxic chemical spills in space station

An oxygen generator on the international space station overheated and spilled a toxic irritant Monday, forcing the three-man crew to don masks and gloves in the first emergency ever declared aboard the 8-year-old orbiting outpost.

NASA said the crew members' lives were never in any danger. They cleaned up the spill with towels. A charcoal filter scrubbed the irritant out of the air. And within a couple of hours, life aboard the station 220 miles above Earth was nearly back to normal.

But it was the biggest scare this smooth-running space station has had.

Although it paled in comparison to two fires and a collision on two previous Russian space stations and the nearly fatal explosion on Apollo 13, the incident served as a reminder of how life-and-death emergencies can come out of nowhere. It is why an emergency space capsule is always parked at the outpost in case of a sudden order to abandon ship.

NASA never came close to ordering the crew to leave the station, space station program manager Mike Suffredini said. But astronauts did reveal they were worried.

About three hours after the emergency, station commander Pavel Vinogradov tried to explain what happened to Moscow Mission Control, saying "different thoughts came to my mind."

Russian flight controllers interrupted, telling him: "We were kind of nervous here, too." NASA and the Russian space agency were investigating what caused the problem.

"We don't exactly know the nature of the spill ... but the crew is doing well," Suffredini. "It's not a life-threatening material." The astronauts sounded an alarm after the equipment began smoking and turned off the ventilation system to avoid spreading any fumes from leaking drops of potassium hydroxide, which is used to power batteries.

Monitors showed that the cabin air was safe. "It was just an irritant issue," NASA spokesman James Hartsfield said. "The crew did exactly the right things they were trained to do." It was the type of problem that is always in the back of crew members' minds, said former astronaut Jerry Linenger, who was aboard the Russian space station Mir during a 1997 fire and frequent antifreeze leaks that gave that old station a gas-station-like smell.

"Fumes is one of those low-level risks that sort of wears on you," Linenger said. "You realize you are in a closed ecosystem and you're breathing it. It's kind of in the back of your mind and it's hard to get out of the back of your mind. ... You're thinking this is not good." The problem originated in a Russian oxygen generating machine, called an Elektron, that had been shut off for nine days while the space shuttle Atlantis was docked to the station.

At about 4 a.m. EDT Monday, Russian flight controllers asked that the device be turned back on. It shut itself down and would not restart.

(AP)

Two trillion USD cost on bird flu threat

The outbreak of a severe avian influenza pandemic could cost the world economy up to 2 trillion U.S. dollars, the World Bank warned last week.

"We estimate this could cost, in fact, certainly over 1 trillion dollars and perhaps as high as 2 trillion dollars, in the worst case scenario, so I think the threat, the economic threat, remains real and remains substantial," said Jim Adams, vice president for East Asia and the Pacific and head of the bank's avian flu task force.

Earlier estimates last year of about 800 billion dollars in economic costs were basically written on the back of an envelope, he said at a press conference during the International Monetary Fund and World Bank annual meetings in Singapore.

"But more recent financial modelling had revealed a sharper threat should the virus mutate and pass easily among people," he also said, adding a severe pandemic could cost more than 3 percent of the global economy's gross national product.

The World Bank has provided advice and financing totaling 150 million dollars to projects to tackle bird flu in Albania, Armenia, Azerbaijan, Georgia, the Kyrgyz Republic, Laos, Moldavia, Nigeria, Tajikistan, Turkey and Vietnam.

The international community has pledged to donate 2 billion dollars to developing countries, and of this, 1.2 billion dollars has been committed so far.

Asia has been hardest hit, with 127 out the 144 human deaths arising from bird flu since 2003 occurring in East Asian countries, other officials of the bank said.