The Buddy System

Today, the wonderful Scarleteen website published an article on ‘The Buddy System’, explaining the benefits behind using two forms of contraception at a time. 

After a lot of statistical scribbles, the women behind this website have found that no combination leaves you with less than a 95 percent protection rate. The most effective form of contraception is the implant with condoms. 

They are careful to admit that adding a third contraceptive method makes such a slight statistical difference that it is not worth dealing with and some pairings are not suitable, for example two hormonal forms of contraception or the nuva ring and spermacide. 

In a time when the focus of contraceptive choice is being questioned, with more and more doctors recommending long term forms of contraception and the public appearing resistant to the suggestion, then ‘The Buddy System’ seems like a sensible half-way house. 

You can find the article and Scarleteen’s calculations of the rates of protection for various combinations here.

Endurance training could cause heart problems

Endurance training could exacerbate heart problems, particularly among middle-aged individuals according to scientists this month. They are adding to the ongoing debate on whether endurance training can cause heart attacks, by claiming cycling and marathon running can increase the frequency of cardiac arrhythmias in certain participants.

The researchers from Spain however, stress any risk is very low and may only occur in people with pre-existing heart problems. Sports scientist Dr Luis Mont, who led the research team said pre-training screening is crucial, but more research needs to be done. He said, “It is certainly of great interest to define which recommendations for sport should be implemented in an individual patient, and how best to manage arrhythmias in participants.” at the European Society of Cardiologists conference last month.

The paper he presented is the latest in a long line of papers which have debated the problems endurance training can cause.

Ellen Mason, a senior cardiac nurse at the British Heart Foundation says any risk to triathletes is very low explaining, “There is a term called athlete’s heart syndrome that is sometimes used for this condition.

“The general feeling is that having an athletic heart is a good thing overall, and does not pose significant risk. Although the ventricles can become thickened and the heart larger, the risk of dangerous heart rhythm disturbances is low.This is compared to people who have heart muscle dysfunction caused hypertrophic cardiomyopathy (HCM), where the heart is enlarged and the muscle thicker. The risk of dangerous ventricular rhythms in people with HCM is often quite high, requiring treatment including anti-arrhythmic drugs and/or an implantable cardioverter defibrillator (ICD). Basically one condition is considered generally benign and HCM is pathologically abnormal. 

“The reason for testing young athletes at the start of their careers, with an ECG and echocardiogram is to identify any with underlying cardiomyopathies”

Not all is lost though, the study suggests that the drug losartan could be used to counteract the most common causes of heart arrhythmias in endurance

Controversy over effectiveness of HPV screening with cervical smears

Controversy over the effectiveness of HPV screening in addition to basic cervical smear testing has been reported by Pulse magazine today.

Currently, cervical screening involves liquid-based cytography to detect abnormalities on the cervix. This, according to Professor Henry Kitchener’s lab at The University of Manchester is adequate for effective screening which currently prevents 70 percent of cervical cancer cases in this country alone.

He claims HPV screening alongside cervical smears is no more effective than liquid-based cytography tests alone. HPV is a virus which can cause cervical cancer.

However, Professor Jack Cuzick claims in Pulse magazine that, “‘I think this study has some major issues. About another dozen studies show HPV results are better, and all other literature contradicts the results of this study.’

The University of Manchester study will continue for another three years in order to investigate if HPV testing could results in a need for fewer cervical smear tests for women in this country.

Who’s job is it anyway?

“What is crystal clear is that he didn’t spot how the growing size and increasing connectedness of financial institutions was making the Bank of England’s sterling work in controlling inflation the equivalent of re-arranging deckchairs on the Titanic.” said Robert Peston on Mervyn King’s attempts to stabilise inflation last year.

The BBC Business Editor may have had a point about King’s feeble attempts to nudge and poke the economy into shape, but following last week’s explosive Mansion House events, we have to ask if the Governor of the Bank of England had enough power to do any thing else? Last week King said it was not clear how the Bank could complete its legal duties “if we can do no more than issue sermons or organise burials.” hammering a final nail in the coffin for the tripartite system of bank regulation.

The legal duty to the Bank of England to analyse financial threats was only handed over last year, some could argue it was a token gesture when the depths the recession could take the economy became clear. Then, this month, while reform plans were being unveiled in both the UK and the USA, King made it clear he desired more authority to be able to tell the banks what to do. This is a significant departure from the current regulatory system, introduced by Gordon Brown in 1997, which has up until now been defended by the Labour party. The Liberal Democrats are behind King, but the Conservatives have failed to deliver any detailed proposals…yet.

This is an interesting and brave response by King, as he has said exactly what the Labour Party and the banks did not want to hear. If the Bank of England can not tell the banks what to do, then who can?

Darling has responded to the financial crisis by tinkering with Brown’s holy trinity of the Financial Services Authority (FSA), the Bank of England and the Treasury: the tripartite system which King claims does not stand up to the power of the banks. Darling has also refused to blame the current regulatory system for being responsible for the financial crisis, instead insisting the bank boardroom is the first line of defence against risky decision making.

The speech by Darling at Mansion House resonated strongly in the wake of sweeping reforms by the US Treasury which many claim are being made far too late. However, perhaps now is the time Darling should heed the admission by the US Treasury that: “the government could have done more to prevent many of the problems from growing out of control and threatening the stability of the financial system”, as we await the effects of the UK reforms over the next couple of months.

Women should have babies before 35

The Daily Mail has been the first to report the recent findings of a report by the Royal College of Obstetricians and Gynaecologists which has highlighted the difficulty many women face reproducing after the age of 35.

The study claims the optimum age to have children is between the ages of 20 and 35. One of the most likely reasons for this is the risk of preeclampsia which increases in frequency in pregnancy women under the age of 20 and over the age of 40.

Since the story was published earlier today on the Mail’s website, comments have been predictably split. Though, it is Jillie in London who almost hits the nail on the head:

“Outrageous advise ( if you can call it that) responsible people might want to be financially secure, or have a partner/husband on the scene when they start a family, to scare and badger women into having children before 35 is unforgivable, or is this a ploy by the government to ensure that there are enough young bloods to provide pensions in the years to come?”

The issue of social responsibility to reproduce or not reproduce has become increasingly antagonistic, particularly since the Optimum Population Trust launched their Stop at Two Pledge. However, this has never been an issue in Scandinavia.

Norway in particular, is responsible for launching social policy which enables women to reproduce during the optimum time period without loss of finances and therefor loss of taxes paid. Many of the Nordic countries, unlike many other developed Western countries have an increasing birth rate. It is believed that this is due to the implementation of policy including extended parental leave, subsidises child care and economic support packages for families.

Interestingly a study published in Demographic Research in 2004, showed longer maternity leave with better pay had a positive impact on the number of women reproducing in their twenties and thirties, suggesting policy can have a significant effect on when women chose to have children.

Mooncup sales on the rise

Many advocates cite the environmental benefits. (Distributed under the Creative Common's license)

Sales of menstrual cups have increased dramatically over the last year in the UK, mainly due to their increasing presence on the high street.

High street chemist Boots stocked the menstrual product in only 300 of its stores last year, but you can now buy them in 1,300. Sales have grown by 37 per cent since April 2008.

Kath Clements, a spokesperson for Mooncup UK  said, “It is now a normal thing to do rather than a fringe product. I think it has become popular during this financial crisis because it saves a lot of money and some women like the fact that it is an environmentally friendly product.”

Their product has received a lot of attention recently with a recent positive Which? review. Expert Alison Eastwood said, “four out of seven testers [became] enthusiastic converts, won over by the cost, how well it works and the convenience of not having to carry tampons about and dispose of them” 
 

In the same year, Mooncup has been awarded ‘Best Buy’ status by the Ethical Consumer Magazine.   The Mooncup is also the top rated sanitary product in The Good Shopping Guide (New Edition).

So what is the Mooncup?

Basically, it is a small silicon cup which you use in place of a tampon. It is reusable so you only need to buy one. They currently retail for around £19, but the company and coverts claim the savings quickly add up. It is registered with the Vegan Society.

Many women use it for the environmental benefits, but more use it because of heavy periods or conversely light periods. The Mooncup holds on average three times as much as a tampon or pad, but because it isn’t absorbent it can be used by people with light flows without being uncomfortable.

Mooncup UK are based near Bristol and are an ethical company which employs only eight people. (Distributed under the Creative Commons license.)

So, what’s wrong with it. Firstly it could cause problems if you are prone to urinary tract infections as it can press on the urethra in a similar way to the diaphragm. Originally, supporters of The Mooncup cited it did not carry the risk  of toxic shock syndrome which tampons did, but current medical advice suggests you do not leave anything in your vagina for longer than eight hours. The manufacturers of The Mooncup also admit their product requires a “hands on approach” which women who are used to modern products may find hard to become accustomed too.

Now the big one. Carrying it around in public is a bit of a bore. The only thing which is provided to hold it is a pretty cotton drawstring bag. It is attractive but: white, absorbent and porous. Plus, there is the issue of rinsing it out in public. The company suggest carrying a bottle of water with you to use in the cubicle, but that could end up seeming more cumbersome than what you are currently using.

Have you used the Mooncup or are you thinking about doing so? If so drop me a line on what you think of this innovative product.

Changes to cervical cancer surgery

Changes to the surgical methods used to treat early stage cervical cancer could increase survival rates by up to 20 percent, according to new research published in The Lancet.

German researchers have found a more targeted approach which involves only removing tissue in the areas where tumor is most likely to spread, is more effective at treating cervical cancer than radical hysterectomy, which is the traditional tttreatment.

By removing a more defined, section which includes the fallopian tubes, uterus, and certain parts of the vagina, radiotherapy can also be avoided.

The technique is called mesometrial resection (TMMR), and the study practised the method on 212 patients. In high risk patients the recurrence rate was only 5 percent compared to 28 percent for patients who had received traditional surgery.

The surgery also avoids a lot of potential nerve damage which is a problem experienced by a large number of women who undergo hysterectomy.

Cancer UK agree the technique shows potential and are hoping larger trials will start so the treatment can be offered to more patients.

The news comes not long after results showing the removal of ovaries during hysterectomy had no positive effect on survival rates in women(1).

1.Parker WH, Broder MS, Chang E et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study. Obstetrics and Gynecology. 2009;113:1027-37.

Trauma during birth results in lower desire

There is little significant difference in the sexual activity of women after birth who have experienced major trauma during labour compared with women who have experienced minor trauma.

Researchers asked women to complete a twelve point questionnaire know as the Intimate Relationship Scale in the study reported in this month’s Journal of Midwifery and Women’s Health.

The study found 85 percent of women had resumed sexual relations three months after birth and total IRS scores did not differ between trauma groups nor did complaints of pain on intercourse.

However, women who had required perineal suturing had lower IRS scores, and women who had experienced major trauma during birth had less desire to be touched and held by their partners.

The study excluded women who had experienced episiotomy.

Growing our medicines

Dr Julian Ma believes the silence on the plant biotechnology front over the past couple of years has been intentional. “Every time we do raise our heads above the parapet you do get shot down” he claims. As the head of Pharma-Planta, a Europe wide consortium of plant scientists devoted to developing plant-produced treatments and vaccines, he feels this was partly to do with the media coverage of the subject, “it was very antagonistic, so a lot of people kept their heads low.”

Back in 2004 when Pharma-Planta was launched the possibility of growing pharmaceuticals in genetically engineered crops was greeted with a lukewarm reception from the public. €12 million was pumped into a consortium of labs across Europe to produce plant crops which could be used for ‘pharming’. Clinical trials were due to start this year, in 2009.

However, progress has been rapid during these past four years with a number of new technologies about to enter clinical trials. Ma also thinks the silence has given the group some time for a shake up. “Plant scientists have little commercial nouse with no idea what it takes to get these technologies onto a commercial platform.” he says. “It’s taken a couple of years to get rid of that mindset.”

After years of low expression levels, rows about patents and mixed opinion on the commercial viability of genetically engineering novel plants crops, pharmaceutical crops appear to be overtaking food crops on most counts. Notable food crops engineered to improve nutritional value of the plants like golden rice, failed to produce high enough levels of these substances to be of any use. This has not been a great concern for pharmaceutical crops. The levels of expression required to be financially profitable are lower than is needed for genetically modified food crops.  

Cheaper and quicker

Last year researchers Charles Arntzen and Richard Levy released results for the first commercial plant-derived vaccine. They had produced a vaccine for non-Hodgekins lymphoma which had successfully completed phase one of its clinical trial. Their success came from a new approach. After isolating antigens from a lymphoma patient, tobacco mosaic virus was used to infect tobacco plants. A week later the plants were harvested, the antigen was purified and a vaccine was produced. The study started after Levy became frustrated with the time it was taking to produce vaccines through conventional animal cell cultures. Then he found the total time taken to produce a vaccine from biopsy to treatment was three or four months: half the time it takes to produce a vaccine from animal cell cultures (Proceedings of the National Academy of Sciences, vol 105 p 10131).  

Ma agrees the use of viral expression systems like tobacco mosaic virus offers hope, “Currently the most promising systems are transient expression systems, driving expression from a virally derived plasmid.” He explains, “This infects the plant cell [where] it divides like a virus inside the cell, so we get multiple copies.”

The plant species used are also important, though currently a diverse number of plants are being used. This is due to the growing number of patents on plant technologies. Around the time of the launch of Pharma-Planta, Ma and his lab looked at which plants were best for their technologies, “We ignored freedom to operate – we took the patent situation out of it. We found tobacco and maize were the best plants to use as they offered the highest expression of the products we were trying to produce.

“But a number of plants are currently being used. Carrot cells are being used by a company in Israel. That’s about to complete its final phase three trial. Human insulin grown in safflower is also close to a commercial lease right now.”

Sembiosys the biotechnology company behind the insulin producing safflower crop highlight the fact that growing human insulin in a safflower crop will reduce manufacturing costs by up to 70 percent, and product cost by 40 percent. This also means just one acre of safflower is needed to produce enough insulin to treat 2,500 patients for a year. A figure not to be sniffed at considering insulin use has tripled in Europe in the last 12 years.

Opposition

Though it is more than four years on, opposition hasn’t changed much. GeneWatch and other environmental groups including Greenpeace are still opposed to any GM technology on the grounds using food crops for non-food products is high risk. Ma does not agree with their conclusions saying that the tiny scale on which pharmaceutical crops are grown compared with genetically engineered food crops means a lot of their risk assessment is outdated. He notes, “Pharmaceuticals are high value, they are for a very tiny niche market that will use specialist growers on a low acreage. The value of these crops is so high we need to protect against pest and failure, so we would have to grow in greenhouses rather than in open fields. It’s not a worry about the pharmaceutical crops getting out, the problem is stopping the food crops getting in.”

Claire Oxborrow, senior food campaigner for Friends of the Earth claims the risks involved in human error are high, but appreciates these can be reduced.  She says, “If things are being contained and they do prevent it happening we still wouldn’t say we were in favour of them, but we would be less opposed. There is always going to be human error and where this involves food crops this is unacceptable. However, if you are talking about tobacco and you are going to grow them in containment then it is going to be further down the risk scale for us.”

The choice of disease targets is also an area which is ripe for controversy. It has been shown costs of drug production can be dramatically reduced, but diabetes and cancer are diseases of Europe and not of the third world. Ma notes that encephalitis is an important disease but as it is not present in the UK there is little research surrounding it. “You have to be careful with your targets. We have always done diseases which affect the developing world like HIV and tuberculosis, but those are pretty important in the UK and Europe as well.”  

Staunch opposition may still be the case from some areas of society but in these stretched times, cheap pharmaceuticals should be welcomed. As other strains of biologically engineered plants, currently being developed, start to enter clinical trials we will be able to see their possible impact and the effect this may have on any public opposition.

(NB this is the box out from the copy)

Improving Nature

Plants have been used since the dawn of civilisation to create medicines, so the ideas behind growing our own drugs isn’t anything new. One of the most notable modern plant derived drugs is Tamoxifen, a drug derived from the Pacific Yew which is used to treat breast cancer and increasingly to prevent it in high risk women as well.

Extraction of taxol which is used to produce Tamoxifen from the plant is often expensive and time consuming as it exists in such low quantities. In the Pacific Yew, taxol is only produced in the bark of the tree and the tree grows extremely slowly. There is also the added problem of the numerous similar compounds which are present and need to be separated from the taxol: a long and expensive process.

Bioengineering of taxol is a possibility, but is hindered by the complicated genetic pathway which controls the production of taxol. There are fifteen genes which control this pathway and have so far been successfully transformed into yeast, but there is still a long way to go.

Previously genetically modified crops have failed to produce the substances they were engineered to provide, because the host plant they were being grown in was too unlike the original organism. The hunt is on to find a fast growing tree which can be engineered to produce taxol in its bark.

Air brushed lad’s mags images

A colleague of mine tweeted these images yesterday, 1 and 2. They are marked up images for a men’s magazine.

I realise they are slightly blurry so here is what I can make out the first one says, moving clockwise from the head: remove shadow, remove eye bags, remove (points at arm pit ‘fat’), smooth line, remove (outer part of arm), smooth veins and lines, smooth (outer leg), blend (on both thighs), remove (pointing to a spot on hand) and smooth (on the arms).

The other one all I can work out is ’smooth skin’.

However, obviously the most striking part of these pictures is the sheer area of the pictures which is marked for touching up. Also the fact that these are already high quality pictures of slender women with, to my eyes, no ‘flaws’.  If I hadn’t known better I would have assumed these pictures were ready to go.  That is obviously the difference between myself and a picture editor.

Can anyone else decipher what is written on the girls?

Any thoughts on this process?

UPDATE

I have received confirmation from the person who took the photographs that on the first photgraph there is an instruction to “reduce make up” and the second photograph has an instruction to “clean neck”.

More to the point I have heard from a graphic designer that these changes are standard, not just in men’s magazines but accross the board. He also made the point that these photographs are of professional models, much  more needs to be done when ‘normal’ women are in the magazine.