Genes give clue to early puberty

21 November 2010 Last updated at 13:18 ET

At least 30 genes appear to play a role in the age at which girls reach puberty, according to an international group of scientists.

The team scanned the genetic code of more than 100,000 women, reporting their findings in the journal Nature Genetics.

In the UK, girls as young as 10 are now showing the first signs of puberty.

A specialist said early puberty was linked to an increased risk of female cancers later in life.

The reasons why girls are going through puberty several years earlier than a century ago are not well understood by scientists.

Some have suggested a relationship between early puberty and obesity, and the latest research, carried out by the Reprogen consortium of scientists from the US, Europe and Australia, supports this idea.

Among the 30 genes highlighted by their genome research were some already linked to fat metabolism and weight regulation.

However, it is still not clear whether being obese or overweight in childhood is itself the cause of early puberty, or just another consequence of a different mechanism.

In addition, the study does not show how much of the risk is due to genes, and how much other environmental factors such as diet and upbringing are responsible.

Fat stores

One author, Dr Ken Ong, from the Medical Research Council Epidemiology Unit in Cambridge, said: "We know that girls who are overweight are more likely to go through puberty at young ages.

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"Start Quote

You need to be aware that you may be laying down your future risk from childhood"

End Quote Professor Anthony Swerdlow, Institute of Cancer Research

"If rates of childhood obesity continue to rise we will see many more girls with puberty at young ages."

Dr Anna Murray, another of the researchers from Exeter University, suggested that holding larger stores of fat might signal to the brain that it had the resources to start a woman's reproductive life.

She said: "We found that the timing of puberty is related to fatty acid metabolic pathways - there is evidence that the brain can sense these types of body fats."

Aside from the confusion experienced by young children entering puberty, it carries other health risks in the longer term.

Professor Anthony Swerdlow, from the Institute of Cancer Research, said that early puberty meant a higher risk of female cancers, particularly breast cancer.

This was possibly due to a higher lifetime exposure to sex hormones such as oestrogen.

He said that good diet and exercise, or the lack of it, in early childhood might be crucial to health many decades later.

He said: "What we increasingly believe is that, at least for breast cancer, the risk starts very, very young, even before puberty.

"If you are to prevent it, you need to be aware that you may be laying down your future risk from childhood."

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Plain cigarette packets proposed

20 November 2010 Last updated at 19:14 ET

Cigarette packets should have plain packaging to make smoking less attractive, ministers have suggested.

The government is currently planning to ask retailers to cover up their displays of cigarettes from next year to protect children.

But now cigarette packets could also be made a standard colour like grey, rather than the existing bright colours.

Campaign group ASH says this is "an enormous leap forward".

The Department of Health is considering the idea of asking tobacco firms to put only basic information and health or picture warnings on their packets.

Making the cigarette packets a plain colour would protect children from taking up smoking in the first place, it suggests.

It would also help support people who are trying to give up smoking, the department said.

'Costs too high'

Health Secretary Andrew Lansley, said it was time to try a new approach.

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"Start Quote

The industry use packaging to seduce our kids and mislead smokers"

End Quote Martin Dockrell ASH

"The evidence is clear that packaging helps to recruit smokers, so it makes sense to consider having less attractive packaging. It's wrong that children are being attracted to smoke by glitzy designs on packets.

"We would prefer it if people did not smoke and adults will still be able to buy cigarettes, but children should be protected from the start.

"The levels of poor health and deaths from smoking are still far too high, and the cost to the NHS and the economy is vast. That money could be used to educate our children and treat cancer," Mr Lansley said.

"We will shortly set out a radical new approach to public health in a White Paper."

Martin Dockrell, director of policy and research at ASH, (Action on Smoking and Health), said the industry calls packaging "the silent salesman".

"They use it to seduce our kids and mislead smokers into the false belief that a cigarette in a blue pack is somehow less deadly than a cigarette in a red one.

"By helping smokers who want to quit and protecting our children from the tobacco ad men this will be an enormous leap forward for public health, perhaps even bigger than the smoking ban," he said.

"The government accepts that packaging and tobacco displays influence young people, so there is no time to waste. It may take years to pass a new law on plain packs but the law on tobacco displays is already on the statute books and comes into force next year."

Recent research published in Tobacco Control showed that putting tobacco out of sight in shops not only changes young people's attitude to smoking, it also doesn't result in retailers losing money.

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Pope's condom comments welcomed

20 November 2010 Last updated at 20:58 ET

Catholic reformers and groups working to combat HIV have welcomed remarks by Pope Benedict that the use of condoms might not always be wrong.

The Pope said their use might be justified on a case by case basis to prevent the spread of HIV/Aids.

The remarks, due to be published in a book next week, mark a softening of his previously hard line against condoms in the battle against HIV, analysts say.

The Vatican has long opposed condoms as an artificial form of contraception.

This has drawn heavy criticism, particularly from Aids campaigners,who say condoms are one of the few methods proven to stop the spread of HIV.

'Significant shift'

Pope Benedict said during a visit to Cameroon last year that handing out condoms might actually make HIV infection worse, drawing criticism from several EU states.

In his latest comments, however, he said the use of condoms might be justified in exceptional circumstances.

He gave the example of male prostitutes where, he said, using condoms to prevent the spread of AIDS could be seen as an act of moral responsibility, even though condoms were "not really the way to deal with the evil of HIV infection".

This marks a significant shift in his previously implacable opposition to the use of condoms, says the BBC's religious affairs correspondent, Robert Pigott.

UNAIDS, the United Nations programme on HIV/Aids, welcomed the comments as a "significant and positive step forward".

"This move recognizes that responsible sexual behaviour and the use of condoms have important roles in HIV prevention," said UNAIDS Executive Director Michel Sidibe.

The Kenya Treatment Access Movement (KETAM), which works to combat the spread of HIV, welcomed what it said was the Pope's acceptance of reality that abstinence did not always work.

"It's accepting the reality on the ground," said David Kamau, head of the KETAM. "If the Church has failed to get people to follow its moral values and practice abstinence, they should take the next best step and encourage condom use."

The Catholic reform group We Are Church said the comments showed the Pope was able to learn from experience.

The British gay rights campaigner, Peter Tatchell, told the BBC the Pope's comments were significant but needed "clarification".

'Not a moral solution'

The new book - Light of the World: The Pope, the Church and the Signs of the Times - is based on a series of interview the Pope gave the German Catholic journalist, Peter Seewald, earlier this year.

When asked whether the Catholic Church was not opposed in principle to the use of condoms, the Pope replied: "She of course does not regard it as a real or moral solution, but, in this or that case, there can be nonetheless, in the intention of reducing the risk of infection, a first step in a movement toward a different way, a more human way, of living sexuality."

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Pope Benedict said the "sheer fixation on the condom implies a banalisation of sexuality" where sexuality was no longer an expression of love, "but only a sort of drug that people administer to themselves".

Although Pope Benedict reiterated the Church's fundamental opposition to contraception, and repeated his view that condoms were not the answer to curbing HIV, he added that there was much in the area of sexual ethics that needed to be pondered and expressed in new ways.

Austen Ivereigh, coordinator of the Catholic Voices group, said that while this was the first time the Pope had voiced such an opinion on condoms, it was in line with what Catholic moral theologians have been saying for many years.

"The Church's teaching on contraception predates the discovery of Aids," Mr Ivereigh told the BBC news website.

"The prevalence of HIV raised the question of whether condoms could be used to prevent the transmission of the virus.

"If the intention is to prevent transmission of the virus, rather than prevent contraception, moral theologians would say that was of a different moral order."

But Clifford Longley, who writes for The Tablet, a British Catholic newspaper, said the development was far more significant than a nuanced change in attitude.

He said the "small concession... could easily become a collapse in the whole edifice of Catholic teaching on contraception".

"The implication seems to me to be much vaster than even the Pope anticipates," said Mr Longley.

The Vatican newspaper, L'Osservatore Romano, published excerpts of the book in its Saturday edition.

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GP leader warns over NHS reform

20 November 2010 Last updated at 08:34 ET

Doctors could be faced with angry patients questioning spending decisions if NHS reforms go ahead, the new leader of the Royal College of GPs has warned.

Clare Gerada criticised plans to put �80bn of annual funding into the hands of GPs as part of widespread reform.

Patients could end up begging doctors for life-saving drugs while drug companies lobby GPs, she warned.

The NHS has been told by Health Secretary Andrew Lansley to make up to �20bn of savings by 2014.

Mr Lansley believes GPs know what works best and wants to tap into their entrepreneurial spirit to drive improvement.

'Begging letters'

The plans move the responsibility of deciding who gets treatment from the National Institute for Health and Clinical Excellence and primary care trusts in England to GPs, from 2013.

"At worst, the negative impact for GPs could be patients lobbying outside their front door, saying 'You've got a nice BMW car but you will not allow me to have this cytotoxic drug that will give me three more months of life'," she told the Guardian newspaper.

"I'm concerned that my profession, GPs, will be exposed to lobbying by patients, patient groups and the pharma industry to fund or commission their bit of the service. There could be letters from MPs and patient groups, and begging letters from patients."

She added: "Patients might think that the decision made about their healthcare will be based on self-interest - GPs saving money for themselves rather than spending it on patients."

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"Start Quote

I think it is the end of the NHS as we currently know it"

End Quote Clare Gerada Royal College of GPs

Currently about 80% of the budget is held by local managers working for the 151 primary care trusts in England.

Ministers want to transfer much of that responsibility to GPs working in consortiums across the country, phasing out primary care trusts and regional bodies known as strategic health authorities over the next few years.

NHS break-up

But Dr Gerada predicted the demise of the NHS through such reform.

"I think it is the end of the NHS as we currently know it, which is a national, unified health service, with central policies and central planning, in the way that (Aneurin) Bevan imagined," she said.

A Department of Health spokeswoman said the reform was "a necessity", not an option.

"We share a common goal with the RCGP that we all want patients to get the best health and care services," she added.

Shadow health secretary John Healey said the plans were "signalling a break-up of the NHS that will see it move away from a consistency of service that can be accessed whatever people's means."

He accused Mr Lansley of not listening to warnings from doctors, nurses and health experts "to slow down on his high-cost, high-risk plans."

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E. coli O157 linked to heart risk

18 November 2010 Last updated at 22:57 ET

Catching the most dangerous strain of E. coli could increase the risk of high blood pressure and heart problems years later, say researchers.

A Canadian study of almost 2,000 who fell ill during an outbreak of E. coli O157 found heart attack risk doubled.

Writing in the British Medical Journal, the researchers recommended annual health checks, even for patients who had apparently fully recovered.

A microbiologist said basic food hygiene could prevent many cases.

There are an estimated 1m cases of food poisoning in the UK each year, but the O157 strain of E. coli is regarded as one of the most dangerous.

Low numbers

It can cause severe gastroenteritis and contact with small numbers of the bacteria, carried in animal faeces, is enough to make you ill.

There are approximately 1,000 confirmed cases each year in the UK, and while it is known to cause kidney problems in a small number of people, there has been little investigation into other possible longer-term complications.

The research team, based in Victoria Hospital, London Ontario, followed up people affected when the municipal water system in Walkerton became contaminated in May 2000.

Seven people died, and thousands fell ill, and while some were only mildly affected, many had significant symptoms, including severe diarrhoea.

Checking their medical history in the intervening years revealed that the rate of kidney problems tripled among those with gastroenteritis compared with those who were relatively unaffected.

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"Start Quote

It is a rare strain, but the key thing is to stop yourself falling ill in the first place"

End Quote Bob Martin Food Standards Agency

The severely-hit patients were also slightly more likely to develop high blood pressure, and more than twice as likely to have a heart attack during this period.

The researchers suggested that the powerful toxin released by E. coli O157 could trigger inflammation that could affect blood vessel linings, and making heart and blood pressure problems more likely.

They recommended annual blood pressure checks for people who had been seriously affected by the strain.

The number of E. coli O157 cases in the UK has remained stable in recent years, ranging from approximately 800 to 1,200 annually.

However, despite the low numbers, Bob Martin, a microbiologist at the Food Standards Agency, said that people still needed to follow basic hygiene rules when buying and cooking meat products, or after handling animals.

He said: "It is a rare strain, but the key thing is to stop yourself falling ill in the first place.

"You can reduce the risk by keeping things clean in the domestic setting, and cooking food thoroughly, as this will kill off bugs, particularly things like sausages and burgers which are made from minced meat.

"Keeping food properly refrigerated is also important, as is preventing cross-contamination between raw meat and cooked food."

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Call to extend breast screening

18 November 2010 Last updated at 00:32 ET By Helen Briggs Health reporter, BBC News

Annual screening for women in their 40s with a family history of breast cancer may save lives, research suggests.

The NHS breast screening programme currently offers mammograms to women aged between 50 and 70.

But UK researchers say a pilot study suggests regular mammograms should be given to younger women who have relatives with breast cancer.

A cancer charity said more data was needed to weigh up risks and benefits.

The study, published in the journal Lancet Oncology, looked at women deemed at moderate risk of breast cancer because they have relatives with the disease.

Screening is considered unjustified in women with no family history of breast cancer because of the risk of a false-alarm.

Women at high-risk - because they are thought to have a gene mutation associated with the disease - are already closely assessed, with many given MRI scans or offered early surgery.

False alarms

The study recruited 6,710 moderate risk women across the UK who were given mammograms to check for signs of breast cancer every year for four years.

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It will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group"

End Quote Hazel Nunn Cancer Research UK

These women are not currently included in the main NHS breast screening programme, which offers mammograms to women aged 50-70 every three years.

The researchers, led by Professor Stephen Duffy of Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, compared cancer rates and deaths in this group with women from other trials who were not given annual screening.

They say the women given screening were significantly more likely to be alive 10 years after a diagnosis of cancer than women in the two control groups.

Professor Duffy told the BBC: "It means that annual mammography does reduce the risk of dying of breast cancer in this group of moderate risk women.

"It means they can go and seek medical help knowing that there is something that can be done."

Rough figures suggest that it would probably save an extra 50 lives a year, he added.

"It doesn't sound like much but it means alot to the people who are in that group because they have relatives who have had breast cancer," he explained. "It's not a huge expense to the NHS."

Surveillance

But Hazel Nunn, senior health information manager at Cancer Research UK, said the full picture was not yet clear.

"Since it seems 5,000 women would need to be screened to save one life, it will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group," she said.

"We await the results of further research measuring the risks."

The NHS Breast Screening Programme said plans were in place to extend screening to women with a family history of breast cancer in the future.

Assistant Director, Sarah Sellars, said current guidelines for women at risk of breast cancer because of their family history recommend that certain women should be offered surveillance.

She said these services were currently commissioned locally but in the future would be run by them.

"In the future, the NHS Breast Screening Programmes will be taking on responsibility for routinely screening higher risk women under 50," she said.

"Several breast screening sites are currently testing the software to be able to manage these women effectively.

"This service will sit alongside our current breast screening programme for women aged 50 years old and over."

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