German parliament OKs genetic embryo tests (AP)

BERLIN � After an emotional debate, German lawmakers voted Thursday to allow a procedure that looks for genetic disorders in embryos before they are implanted in the womb.

Lawmakers voted 326-260 to permit the procedure known as pre-implantation genetic diagnosis under strict conditions after a debate that cut across party lines. Eight abstained.

The procedure is sometimes used after in-vitro fertilization, when parents whose families have a history of genetic disorders want to avoid having a child with a lethal or severely debilitating birth defect.

Elsewhere in Europe and in the U.S., the test is often used in infertile couples who have failed in previous attempts to have children while using IVF in hopes that the test will boost their chances of implanting the best embryo.

The procedure's legality had been a gray area in Germany. Parliament took up the issue after a federal court last year ruled that a doctor who had performed the procedure hadn't committed any offense.

Under the law approved Thursday, an ethics commission will have to decide on a case-by-case basis whether couples can use the procedure. An expert would have to certify that a couple's child faced a high risk of a serious genetic disorder or that a miscarriage or stillbirth was likely.

A large minority of lawmakers favored a total ban, with some saying that even limited permission for genetic selection set a bad precedent.

"This is about variety: Do we want to allow it in our society?" asked Katrin Goering-Eckardt of the opposition Greens, one of those advocating a ban.

But lawmakers who backed allowing the practice said it would be an option only in a few cases, and argued that parents who worry about possible genetic defects should be trusted to decide.

"I am firmly convinced that we should not choose to close our eyes to how we can use modern medicine appropriately to support and help these long-suffering families," said Labor Minister Ursula von der Leyen.

Opposition lawmaker Soeren Bartol said he wanted to give couples at risk of passing on genetic disorders the option of deciding to have a child.

"I would also like these parents to be spared, as far as possible, the terrible experience of a miscarriage or a still birth," he added.

Debates on procedures that involve genetic selection tend to be tinged in Germany by memories of the country's Nazi past including experiments on humans, but lawmakers didn't refer to that explicitly on Thursday.

Church leaders, however, criticized the decision. The country's top Roman Catholic bishop, Archbishop Robert Zoellitsch, said that "the selection of human embryos violates the precept of respect for human dignity" and Lutheran church leader Nikolaus Schneider said he would have liked greater restrictions.

Thursday's debate centered squarely on the morality of the procedure, a test done to pick the best embryos, rather than its medical merits � which researchers say have largely been a disappointment.

Doctors had assumed the test would improve pregnancy rates, but studies showed that women who had their embryos tested were actually less likely to become pregnant, probably because scientists still can't accurately predict which embryos will succeed.

A study in its early stages presented this week at a European fertility conference in Stockholm suggested that embryos which look problematic three days after fertilization can fix themselves by day five. Many embryos created by IVF are implanted after three days, although doctors are increasingly waiting until day five if possible.

The German motion refers to tests removing one to two cells out of an embryo about three days after its fertilization � when it typically has about eight cells � to see whether it looks abnormal. Some experts say that is too early and jeopardizes the embryo's future development.

___

AP medical writer Maria Cheng contributed to this report from London.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Obesity rates still rising in many states (AP)

WASHINGTON � In 1995, no state had an obesity rate above 20 percent. Now, all but one does.

An annual obesity report by two public health groups looked for the first time at state-by-state statistics over the last two decades. The state that has the lowest obesity rate now � Colorado, with 19.8 percent of adults considered obese � would have had the highest rate in 1995.

"When you look at it year by year, the changes are incremental," says Jeffrey Levi, executive director of the Trust for America's Health, which writes the annual report with the Robert Wood Johnson Foundation. "When you look at it by a generation you see how we got into this problem."

The study, based on 2010 data, says a dozen states top 30 percent obesity, most of them in the South. Mississippi topped the list for the seventh year in a row, with Alabama, West Virginia, Tennessee and Louisiana close behind. Just five years ago, in 2006, Mississippi was the only state above 30 percent.

No state decreased its level of obesity, which is defined as a body mass index of 30 or more. The body mass index is a measurement based on weight and height.

There was a bit of good news in the report: Sixteen states reported increases in their obesity rates, down from 28 states that reported increases last year. Levi says those increases have been gradually slowing, most likely due to greater public awareness of health issues and government attempts to give schools and shoppers better access to healthier foods.

"We're leveling off to some degree at an unacceptably high level," Levi said.

First lady Michelle Obama has tackled the issue with her "Let's Move" campaign, pushing for healthier school lunches, more access to fruits and vegetables and more physical activity. Republicans in Congress have pushed back somewhat against some of those programs, however, saying a rewrite of school lunch rules is too costly and questioning an Obama administration effort to curb junk food marketing aimed at children.

As in previous years, the study showed that racial and ethnic minorities, along with those who have less education and make less money, have the highest obesity rates. Adult obesity rates for African-Americans topped 40 percent in 15 states, while whites topped 30 percent in only four states. About a third of adults who did not graduate from high school are obese; about a fifth of those who graduated from college are considered obese.

Dr. Mary Currier, Mississippi's state health officer, says her state has struggled to drop its No. 1 status and it has been challenging because much of the state is poor and rural.

"We live in an area of the country where eating is one of the things we do, and we eat a lot of fried foods," she said. "Trying to change that culture is pretty difficult."

She says the state has had some success by making school lunches healthier, taking high-calorie foods and drinks out of school vending machines and trying to find more low-cost exercise facilities for residents of rural areas.

"It is frustrating, but we've had some progress," Currier said. "We just have to continue to work at this. It's not something that's going to change overnight."

___

Online:

Calculate your body mass index: http://www.nhlbisupport.com/bmi

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Colon cancer deaths down except in Mississippi (AP)

ATLANTA � Health officials say colon cancer deaths continue to drop across America � except in the state of Mississippi.

The Centers for Disease Control and Prevention issued a report Tuesday that echoes earlier findings of a national decline in colon cancer deaths. Death rates fell by as much as 5 and 6 percent in some New England states. Mississippi was the only state that saw no real decline.

Screening exams can catch colon cancer before it grows deadly. Mississippi has one of the nation's lowest screening rates. Also, blacks die of colon cancer at higher rates, and more than a third of Mississippi's residents are black.

The report is based on information for the years 2003 through 2007.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Seeds blamed for Europe E. coli still on sale (AP)

LONDON � Egyptian sprout seeds blamed for a massive and deadly E. coli outbreak are still on the market and were shipped to more European countries than was previously believed, officials said Tuesday, as the EU announced a ban on further imports.

The European Food Safety Authority confirmed in a report that one lot of contaminated fenugreek seeds from Egypt was probably the source of the recent food poisoning outbreaks in Germany and France. But the number of European countries that received parts of the suspected lot is "much larger than previously known," and includes Austria, Britain and Spain, it said.

The European Union said in a statement it was banning the import of Egyptian fenugreek seeds until Oct. 31, adding that its members must destroy all seeds from "one Egyptian exporter" received between 2009 and 2011. Officials have not released the name of the exporter.

The move, however, may be largely symbolic, since tainted seeds have already been widely distributed in Europe and it's unclear officials will be able to identify them because the amount of bacteria may be too small to detect.

Fenugreek seeds from the suspect Egyptian lot � about 15,000 kilograms � were imported to one large German distributor, the agency said. Those seeds were then sold to 70 different companies, 54 of them in Germany, the center of the outbreak, and to 16 companies in 11 other European countries.

Fenugreek is a clover-shaped plant whose leaves are commonly used as an herb and also in Indian curries. The seeds are often sold dried, and if they are contaminated with E. coli, the bacteria can survive for years.

Tracing exactly where the seeds from the suspected lot were sold could take weeks, food safety officials said. In Germany, the fenugreek seeds were sold in mixed spice packages with lentil seeds.

European food safety officials could not rule out that other lots of seeds from the same exporter weren't also tainted. Last year, Europe imported about 49,000 tons of fenugreek seeds from Egypt, worth more than euro56 million ($81 million)

Officials previously believed that sales had centered primarily on Germany and France but until now had little detailed information on where the seeds were shipped.

So far, the strain has killed 51 people, including 49 deaths in Germany and one each in Sweden and the U.S.

More than 4,000 people in Germany have fallen sick since the outbreak was detected in May, including 851 who have developed a serious complication that can lead to kidney failure. The same bacteria was also responsible for a much smaller outbreak in France last month.

Scientists said it was possible only a small part of the lot were infected, which might explain why there weren't more cases given how widely they were sold. "You could have some seeds contaminated but not necessarily the whole batch," said Ian Henderson, a professor of microbial biology at the University of Birmingham.

He said it would be difficult to find the culprit bacteria on the seeds since large quantities only appear once the sprouts begin to grow. "It could be like searching for a needle in a haystack," he said.

Experts said many of the infected seeds may already have been used but that some were still in the food chain.

Some suspect there have been numerous undetected E. coli cases across Europe. "Most people who get this won't get that ill and it won't be diagnosed," said Paul Hunter, a professor of health protection at the University of East Anglia.

He said that the outbreaks were caught because there were large numbers of people getting sick at the same time, in unusual circumstances. But if people bought and ate infected sprouts on their own � like from a 50-gram (1.76-ounce) packet from a garden center, as was the case in the French outbreak � their illness would probably be missed.

Health officials warn there could be further outbreaks of the lethal E. coli strain since the tainted fenugreek seeds are still for sale. Experts say people should not grow or eat their own sprouts and that all sprouts should be thoroughly cooked before being eaten.

"If people do not eat raw sprouts, we might not see many new infections," Hunter said. "But people are very good at ignoring public health advice," he said. "I wouldn't bet against more outbreaks."

_______

Associated Press writers David Rising in Berlin and Gabriele Steinhauser in Brussels contributed to this report.

(This version corrects amount of fenugreek seeds imported into EU to 49,000 tons instead of 3,000.)

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Fraternal twins with autism: Is risk in the womb? (AP)

CHICAGO � Most of the risk of autism has been blamed by experts on inherited genes. Now one of the largest studies of twins and autism shifts the focus to the womb, suggesting that the mother's age and health may play a larger role than thought.

The new research doesn't solve the mystery of what causes autism. Most scientists think faulty genes and outside factors are both at work. And since autism spectrum disorders include a wide range of conditions, from mild to severe, it's unlikely there's a single cause for all of them.

Conditions during pregnancy may trigger autism where there's a genetic vulnerability, said Dr. Gary Goldstein of the Kennedy Krieger Institute in Baltimore, who was not involved in the new research.

"We've identified lots of vulnerability genes, but not everybody who has them gets autism," Goldstein said.

The new twins study, published Monday by Archives of General Psychiatry, used rigorous methods to diagnose autism spectrum disorders, including direct observation of the children.

Using California health records, it's the largest study to do that and the first to consider a large sample of twins drawn from a general population, said lead author Dr. Joachim Hallmayer of Stanford University in Palo Alto, Calif.

Children with autism can have trouble communicating and interacting socially. They may have poor eye contact and engage in repetitive behavior such as rocking or hand-flapping. One in 100 children have autism disorders, according to U.S. government estimates.

The new study included 192 sets of twins where at least one of the twins was affected with autism.

Some of the twins were identical and some were non-identical, or fraternal, twins.

The researchers used DNA testing to determine which twins were identical and which were fraternal. That was important because identical twins come from one fertilized egg and have identical genetic makeups. Fraternal twins, from two fertilized eggs, share no more genetic material than any other siblings.

The new study found, as expected, high rates of shared autism disorders for identical twins: 77 percent of male twin pairs and 50 percent for female pairs had autism in both twins.

Surprisingly, it also found fairly high rates of fraternal twins both having autism spectrum disorders: 31 percent rate for male fraternal twins and 36 percent for female fraternal twins.

Other studies have found 10 to 20 percent of younger siblings of children with autism are likely to be diagnosed themselves with the disorder.

Fraternal twins share the same womb, even though they don't share identical genes. That could be important, said Dr. John Constantino of Washington University School of Medicine in St. Louis, who wasn't involved in the new research.

"Finding so many fraternal twin pairs in whom both twins have autism spectrum disorders is a key finding that puts a spotlight on pregnancy as a time when environmental factors might exert their effects," Constantino said.

Those factors could include stress, diet, infections, a mother's age and medications, experts said. The new study didn't try to determine what factors increase risk.

The study was funded by grants from the National Institute of Mental Health and Autism Speaks, an advocacy group.

In another study published Monday in the same journal, researchers found a higher risk of autism among children born to mothers who took antidepressants during the year before birth, particularly in the first three months of pregnancy.

It's too early to advise pregnant women against antidepressants, however. Untreated depression also can be harmful to mother and baby, said lead author Lisa Croen of the Autism Research Program at Kaiser Permanente, a large health maintenance organization in California.

___

Online:

Journal: http://archpsyc.ama-assn.org/

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials

Heart disease, No. 1 killer, can sneak up on women (AP)

WASHINGTON � Heart disease can sneak up on women in ways that standard cardiac tests can miss.

It's part of a puzzling gender gap: Women tend to have different heart attack symptoms than men. They're more likely to die in the year after a first heart attack.

In fact, more than 40 percent of women still don't realize that heart disease is the No. 1 female killer. One in 30 women's deaths in 2007 was from breast cancer, compared to about 1 in 3 from cardiovascular disease, according to the American Heart Association.

A new report says there's been too little progress in tackling the sex differences in heart disease. It outlines the top questions scientists must answer to find the best ways to treat women's hearts � and protect them in the first place.

"A woman's heart is her major health threat, and everyone who takes care of a woman has to realize that," says Emory University cardiologist Dr. Nanette Wenger, who co-authored the report.

Make no mistake: Heart disease is the leading killer of men, too. The illness is more prevalent in men, and tends to hit them about a decade earlier than is usual for women.

But while overall deaths have been dropping in recent years, that improvement has been slower for women who face some unique issues, says the report from the nonprofit Society for Women's Health Research and WomenHeart: The National Coalition for Women with Heart Disease.

Sure, being a couch potato and eating a lot of junk food is bad for a woman's heart just like a man's. High cholesterol will clog arteries. High blood pressure can cause a stroke.

But here's one problem: Even if a test of major heart arteries finds no blockages, at-risk women still can have a serious problem � something called coronary microvascular disease that's less common in men. Small blood vessels that feed the heart become damaged so that they spasm or squeeze shut, Wenger explains.

Specialists who suspect microvascular disease prescribe medications designed to make blood vessels relax and blood flow a bit better, while also intensively treating the woman's other cardiac risk factors. But Wenger says it's not clear what the best treatments are.

The report says part of the lack of understanding about such gender issues is because heart-related studies still don't focus enough on women, especially minority women. Only a third of cardiovascular treatment studies include information on how each gender responds even though federal policy says they should. The report urged direct comparisons of which treatments work best in women, and improved diagnostic tests.

Another issue: Even young women sometimes have a heart attack, and there are troubling hints that their risks are rising. There's been a small uptick in deaths among women younger than 45. Plus, high blood pressure, diabetes or related complications during pregnancy � a growing worry as more women start their pregnancies already overweight � aren't just a temporary problem but increase those mothers' risk of heart disease once they reach middle age. The report says too few doctors are aware they should consider that.

Then there are the questions of how best to tell which women are at high risk. Nearly two-thirds of women who die suddenly of heart disease report no previous symptoms, for example, compared with half of men. As for heart attacks, chest pain is the most common symptom but women are more likely than men to experience other symptoms such as shortness of breath, nausea and pain in the back or jaw.

Legislation pending in Congress would require better study of gender differences, and would expand a government program that currently screens poor women in 20 states for high cholesterol and other heart risks, offering smoking cessation and nutrition education to help lower those risks. Wenger's groups, which receive some funding from drug companies, and the heart association support the bill.

One young patient says women need to know more about heart disease � and to get pushy about any symptoms.

Essence Harris of New Orleans was just 30 and seemingly healthy when she started getting short of breath and feeling a flutter in her chest during her daily workouts. Her primary care doctor thought it was panic attacks. A cardiologist found no obvious risk either � her cholesterol and blood pressure were normal � but ordered a stress test that signaled her heart fears were right. A further exam found severe blockages in two arteries that required stents to prop open.

Now 37, Harris says doctors' best guess is that a stressful lifestyle � a single mother, a full-time job, a part-time personal trainer, and studying for an advanced degree all at the same time � left her vulnerable even without obvious risk factors. Had she not been so fit, they said, her heart might not have held out as long before symptoms appeared. She's learned to be more laid-back, along with a healthier diet and keeping up that exercise.

"Listen to your body," she advises other women. "Nobody knows you better than you."

___

EDITOR'S NOTE � Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Online:

Women and heart disease info: http://www.womenheart.org

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Settlement Statement | WordPress Tutorials