Children and young people show elevated leukaemia rates near nuclear facilities

Review covers 136 countries in US, Canada, UK, France, Germany, Japan and Spain

Leukaemia rates in children and young people are elevated near nuclear facilities, but no clear explanation exists to explain the rise, according to a research review published in the July issue of European Journal of Cancer Care.

Researchers at the Medical University of South Carolina carried out a sophisticated meta-analysis of 17 research papers covering 136 nuclear sites in the UK, Canada, France, the USA, Germany, Japan and Spain.

They found that death rates for children up to the age of nine were elevated by between five and 24 per cent, depending on their proximity to nuclear facilities, and by two to 18 per cent in children and young people up to the age of 25.

Incidence rates were increased by 14 to 21 per cent in zero to nine year olds and seven to ten percent in zero to 25 year-olds.

“Childhood leukaemia is a rare disease and nuclear sites are commonly found in rural areas, which means that sample sizes tend to be small” says lead author Dr Peter J Baker.

“The advantage of carrying out a meta-analysis is that it enables us to draw together a number of studies that have employed common methods and draw wider conclusions.”

Eight separate analyses were performed – including unadjusted, random and fixed effect models – and the figures they produced showed considerable consistency.

But the authors point out that dose-response studies they looked at – which describe how an organism is affected by different levels of exposure – did not show excess rates near nuclear facilities.

“Several difficulties arise when conducting dose-response studies in an epidemiological setting as they rely on a wide range of factors that are often hard to quantify” explains Dr Baker. “It is also possible that there are environmental issues involved that we don’t yet understand.

“If the amount of exposure were too low to cause the excess risk, we would expect leukaemia rates to remain consistent before and after the start-up of a nuclear facility. However, our meta-analysis, consistently showed elevated illness and death rates for children and young people living near nuclear facilities.”

The research review looked at studies carried out between 1984 and 1999, focusing on research that provided statistics for individual sites on children and young people aged from zero to 25.

Four studies covered the UK, with a further three covering just Scotland. Three covered France, two looked at Canada and there was one study each from the USA, Japan, Spain, the former East Germany and the former West Germany.

“Although our meta-analysis found consistently elevated rates of leukaemia near nuclear facilities, it is important to note that there are still many questions to be answered, not least about why these rates increase” concludes Dr Baker.

“Several hypotheses have been proposed to explain the excess of childhood leukaemia in the vicinity of nuclear facilities, including environmental exposure and parental exposure. Professor Kinlen from Oxford University has also put forward a hypothesis that viral transmission, caused by mixing populations in a new rural location, could be responsible.

“It is clear that further research is needed into this important subject.”

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Notes to editors

Meta-analysis of standardized incidence and mortality rates of childhood leukaemia in proximity to nuclear facilities. Baker PJ and Hoel D. European Journal of Cancer Care. 16, pages 355-363. July 2007.

The European Journal of Cancer Care provides a medium for communicating multi-professional cancer care across Europe and internationally. The Journal publishes peer-reviewed papers, reviews, reports, features and news, and provides a means of recording lively debate and an exchange of ideas. It is published six times a year by Blackwell Publishing.
Blackwell Publishing is the world’s leading society publisher, partnering with 665 medical, academic, and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. The company employs over 1,000 staff members in offices in the US, UK, Australia, China, Singapore, Denmark, Germany and Japan and officially merged with John Wiley & Sons, Inc’s Scientific, Technical and Medical business in February 2007. Blackwell’s mission as an expert publisher is to create long-term partnerships with our clients that enhance learning, disseminate research, and improve the quality of professional practice. For more information on Blackwell Publishing, please visit http://www.blackwellpublishing.com or http://www.blackwell-synergy.com

Contact: Annette Whibley
wizard.media@virgin.net
Blackwell Publishing Ltd.

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CMAJ – Press Release

Embargo: Monday, July 16th, 2007 at 5 pm

Poor ventilation and crowding in Nunavut homes associated with lung infections in Inuit children

Inadequate ventilation and overcrowding may contribute to the high incidence of lower respiratory tract lung infections in young Inuit children. Dr. Tom Kovesi and colleagues collected data on respiratory health and indoor air quality for 49 Inuit children under 5 years of age in the Baffin Region of Nunavut. They found that lower respiratory tract infection was significantly associated with indoor carbon dioxide levels and occupancy. On average, there were 6.1 occupants per house (as compared with 3.3–4.4 in southern Canada). Ventilation rates were below the recommended Canadian standard in 80% of the houses, with carbon dioxide levels often exceeding recommended concentrations. Elevated carbon dioxide is an indication of crowding and reduced ventilation. Smokers were present in 93% of the homes.

In a related commentary, Dr. Pamela Orr notes that the results of this research come as no surprise to those who live, work and study in the Canadian North. However, it is not clear whether crowded housing and inadequate ventilation are risk markers (reflecting an association with other risks, for example poverty) or risk factors (reflecting causation, for example exposure to infection) for lung infections in children. She notes that Kovesi’s study raises several questions, including the appropriateness of current housing designs in the North, which reflect Euro-Canadian designs for single nuclear family life rather than the extended communal family life of Inuit.

Inuit infants in the Baffin Region of Nunavut have the highest reported rate of hospital admission because of severe respiratory syncytial virus lung infection in the world, with annualized rates of up to 306 per 1000 infants. The infections are unusually severe in these infants: 12% of those admitted to hospital in Iqaluit require intubation and intensive care, necessitating costly and difficult air transport to tertiary care hospitals in southern Canada. Inuit infants also have disproportionately high rates of permanent chronic lung disease following a lower respiratory tract infection.

Contact for research: Dr. Tom Kovesi, Pediatric Respirologist, Children’s Hospital of Eastern Ontario. To arrange an interview, contact Julie Leblanc, CHEO Sr. Communications Advisor; 613 737-7600, ext. 3586, JLeblanc@cheo.on.ca

Contact for commentary: Pamela Orr, professor, Departments of Medicine, Medical Microbiology and Community Health Sciences, and consultant, J.A. Hildes Northern Medical Unit, University of Manitoba, Winnipeg, Man., is available on July 16 only; 204 787-3391 or 204 787-7772

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One man’s junk may be a genomic treasure

Scientists have only recently begun to speculate that what’s referred to as “junk” DNA – the 96 percent of the human genome that doesn’t encode for proteins and previously seemed to have no useful purpose – is present in the genome for an important reason. But it wasn’t clear what the reason was. Now, researchers at the University of California, San Diego (UCSD) School of Medicine have discovered one important function of so-called junk DNA.

Genes, which make up about four percent of the genome, encode for proteins, “the building blocks of life.” An international collaboration of scientists led by Michael G. Rosenfeld, M.D., Howard Hughes Medical Investigator and UCSD professor of medicine, found that some of the remaining 96 percent of genomic material might be important in the formation of boundaries that help properly organize these building blocks. Their work will be published in the July 13 issue of the journal Science.

“Some of the ‘junk’ DNA might be considered ‘punctuation marks’ – commas and periods that help make sense of the coding portion of the genome,” said first author Victoria Lunyak, Ph.D., assistant research scientist at UCSD.

In mice, as in humans, only about 4 percent of the genome encodes for protein function; the remainder, or “junk” DNA, represents repetitive and non-coding sequences. The research team studied a repeated genomic sequence called SINE B2, which is located on the growth hormone gene locus, the gene related to the aging process and longevity. The scientists were surprised to find that SINE B2 sequence is critical to formation of the functional domain boundaries for this locus.

Functional domains are stretches of DNA within the genome that contain all the regulatory signals and other information necessary to activate or repress a particular gene. Each domain is an entity unto itself that is defined, or bracketed, by a boundary, much as words in a sentence are bracketed by punctuation marks. The researchers’ data suggest that repeated genomic sequences might be a widely used strategy used in mammals to organize functional domains.

“Without boundary elements, the coding portion of the genome is like a long, run-on sequence of words without punctuation,” said Rosenfeld.

Decoding the information written in “junk” DNA could open new areas of medical research, particularly in the area of gene therapy. Scientists may find that transferring encoding genes into a patient, without also transferring the surrounding genomic sequences which give structure or meaning to these genes, would render gene therapy ineffective.

Contributors to the paper include Lluis Montoliu, Rosa Roy and Angel Garcia-Díaz of the Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología in Madrid, Spain; Christopher K. Glass, M.D., Ph.D., UCSD Department of Cellular and Molecular Medicine; Esperanza Núñez, Gratien G. Prefontaine, Bong-Gun Ju, Kenneth A. Ohgi, Kasey Hutt, Xiaoyan Zhu and Yun Yung, Howard Hughes Medical Institute, Department of Molecular Medicine, UCSD School of Medicine; and Thorsten Cramer, Division of Endocrinology, UCSD Department of Medicine.

The research was funded in part by the Howard Hughes Medical Institute and the National Institutes of Health.

Contact: Debra Kain
ddkain@ucsd.edu
619-543-6163
University of California – San Diego

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Adding folic acid to flour significantly reduces congenital malformations

This release is also available in French.

Quebec City, July 12, 2007 – Dr. Philippe De Wals of Université Laval’s Department of Social and Preventive Medicine today publishes a study clearly indicating that the addition of folic acid to flours has led to a 46% drop in the incidence of congenital neural tube deformation (mainly anencephaly and spina bifida) in Canada. Such deformations either result in the child’s death or in major health problems, including physical and learning disabilities. Dr. De Wals’s work as head of a team of a dozen Canadian researchers appears today in the New England Journal of Medicine.

The neural tube is the basis of the embryo’s nervous system. Poor development of the neural tube, which is sometimes due to a lack of folic acid, can result in major health problems. Folic acid is found in green vegetables, fruit, whole grains, and meat. However, even a balanced diet won’t supply enough folic acid for a pregnant mother and the child she is carrying. Before1998, Canadian medical authorities were already recommending that women in their child-bearing years consume vitamin supplements containing folic acid. “Canada decided to add folic acid to all flour produced in the country because formation of the neural tube in embryos is particularly intense during the first four weeks of pregnancy, which is before a lot of women even know they’re pregnant. Since half of Canadian pregnancies are unplanned and the human body can’t store folic acid, it is better to integrate folic acid into the food chain than to focus exclusively on taking vitamin supplements,” stated Dr. De Wals. Health Canada still recommends taking folic acid supplements to women in their child-bearing years.

Researchers Dr. Philippe De Wals and Fassiatou Tairou of Université Laval’s Faculty of Medicine compared the incidence of neural tube deformations before and after the introduction of folic acid–enriched flours for over 2 million births in Canada. Between 1993 and 1997, the incidence was 1.58 per 1,000 births. Between 2000 and 2002, the rate dropped 46% to 0.86. The biggest improvement occurred in the parts of Canada that had the highest rates of neural tube deformation before 1998—Newfoundland, Prince Edward Island, and Nova Scotia. In Québec, the drop was also pronounced, but closer to the Canadian average.

Currently, only Canada, the United States, and Chile require that folic acid be added to flour. The effectiveness of this practice, as demonstrated by Dr. De Wals’s team, could encourage other countries to follow suit. Every year, approximately 200,000 cases of spina bifida and anencephaly occur worldwide. Adding folic acid to food could reduce that number by half.

Contact: Martin Guay
martin.guay@dap.ulaval.ca
418-656-3952
Université Laval

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Study shows an electronic medical records system can pay for itself within 16 months

CHICAGO (July 12, 2007) — A new study to be published in the July issue of the Journal of the American College of Surgeons shows that one academic medical center recouped its investment in electronic health records within 16 months. The new analysis counters concerns of health care providers reluctant to invest in electronic medical records systems.

The widespread loss of paper medical records in New Orleans after Hurricane Katrina is one of several factors behind the recent push to get surgeons and other health care providers to go electronic, according to David A. Krusch, MD, FACS, of the University of Rochester Department of Surgery and co-author of the study.

“Health care providers most frequently cite cost as primary obstacle to adopting an electronic medical records system. And, until this point, evidence supporting a positive return on investment for electronic health records technologies has been largely anecdotal,” said Dr. Krusch.

The study measured the return on investment of installing electronic health records at five ambulatory offices representing 28 providers within the University of Rochester (NY) Medical Center. Starting in November 2003, the offices implemented a Touchworks EHR system from Chicago-based Allscripts over the next five months. The study compared the cost of activities such as pulling charts, creating new charts, filing time, support staff salary, and transcription when done electronically in the third quarter of 2005, versus the cost of those same activities performed manually in the third quarter of 2003.

The University of Rochester Medical Center estimated that the new electronic medical records system reduced costs by $393,662 per year, nearly two-thirds of that coming from a sharp reduction in the time required to manually pull charts. Given that its electronic system cost $484,577 to install and operate, it took the University of Rochester Medical Center 16 months to recoup its investment. After the first year, it cost about $114,016 annually to operate the new system, which translates to a savings of $279,546 a year for the medical center, or $9,983 per provider.

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The complete study, “A Pilot Study to Document the Return on Investment for Implementing an Ambulatory Electronic Health Record at an Academic Medical Center”, will appear in the July issue of the Journal of the American College of Surgeons. In addition to Krusch, Dara L. Grieger, MD, of the University of Rochester Department of Surgery and Stephen H. Cohen, MN, CPE, also co-authored the article.

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 71,000 members and it is the largest organization of surgeons in the world. For more information, visit http://www.facs.org.

Contact: Sally Garneski
pressinquiry@facs.org
Weber Shandwick Worldwide

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Tobacco industry efforts to derail effective anti-smoking campaigns

Anti-smoking ads that reveal the tobacco industry’s deceptive practices have been aggressively quashed through various methods found Temple University Assistant Professor Jennifer K. Ibrahim, co-author of an analysis in the August issue of the American Journal of Public Health.

In the article, Ibrahim tracks the rise and fall of state and national efforts to curb smoking for the past 40 years. She chronicles industry strategies to prevent a campaign’s creation, steer messages to smaller audiences, limit the content of the message, limit or eliminate the campaign’s funding, and pursue litigation against the campaign. Ibrahim looks at campaigns in Minnesota, California, Arizona, Oregon, Florida, and a national campaign from the American Legacy Foundation.

This billboard was part of a weak media campaign in Michigan after Gov. John Engler’s political staff took control of the campaign, excluding the state health department’s staff from any…

“It tells the story behind the smoke. People often judge these ads and now you know what the tobacco industry was doing trying to undermine them,” Ibrahim said.

Research has found ads that reveal the deceptive practices of the tobacco industry are the most effective media campaigns that reduce smoking rates, she said.

This billboard ad from California in 2001 is considered a more effective message to reduce smoking rates.

For example, one billboard in California read “Tobacco is legal, profitable, and kills people” featuring an alligator labeled big tobacco with a smirk saying “Two out of three’s not bad.”

However, these messages aren’t always getting out there because of the money spent by the tobacco industry to eliminate them, said Ibrahim, an assistant professor of public health.

State health departments face an uphill battle when dealing with the political clout of the industry with its lobbying, campaign contributions and specials events, Ibrahim said.

One tactic also involves the industry producing its own ineffective campaigns in order to portray state programs as duplicative and a waste of public dollars. Campaigns designed by the tobacco companies patronize youth in their early teen years, with messages like “Think, Don’t smoke”, Ibrahim said.

In contrast, Florida’s “truth” anti-smoking campaign empowered them by giving them information about how the tobacco industry tried to manipulate by marketing.

The tobacco industry has spent more money in advertising in light of successful media campaigns that target large audiences.

From 1975 to 2003, tobacco industry expenditures in advertising and promotion grew from $491 million to $15.5 billion. During this period, the percentage of smokers in the United States fell from about 37 percent to 22 percent, according to the Behavioral Risk Factor Surveillance System.

Attitudes are changing as the public is becoming more aware about the dangers of smoking, secondhand smoke, and the deceptive practices of the industry, Ibrahim said.

While the numbers offer some promise, more initiatives are needed to keep anti-smoking efforts alive.

“It’s naïve to think the industry is still not following these practices and preparing tactics to respond,” Ibrahim said.

The Master Settlement Agreement in 1998 marked an important step when seven tobacco companies agreed to change the way tobacco products are marketed, release previously secret industry documents, dispand trade groups, and pay the states an estimated $206 billion. The tobacco companies also agreed to finance a $1.5 billion public anti-smoking campaign.

States’ attorney generals continue to enforce the provisions of the agreement, Ibrahim said.

A recent product that has created uproar is Camel’s No. 9s pink cigarettes that public health advocates say target teenage girls not women. In June, congress sent a letter to the editors of 11 major magazines, from Glamour to Cosmopolitan, requesting them to stop running the ads for the cigarettes.

Aggressive efforts to battle current marketing efforts and litigation from the tobacco industry are vital to keep the best media campaigns from disappearing, Ibrahim said.

“The efforts put forth by California and the American Legacy Foundation as they pursued legal battles with tobacco companies provide a good example of the tenacity needed to successfully defend and promote tobacco control campaigns,” said Ibrahim. “Persistence can pay off. We need to go with campaigns that work,”

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The research was funded by the National Cancer Institute. For the article, Ibrahim collected the data, conducted the analysis, and drafted the article. Co-author Stanton A. Glantz from the Center for Tobacco Control Research and Education at the University of California, San Francisco, supervised the data collection, edited and revised the article.

Contact: Anna Nguyen
anna.nguyen@temple.edu
215-707-1731
Temple University

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Organic farming can feed the world, U-M study shows

July 10, 2007

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ANN ARBOR, Mich.—Organic farming can yield up to three times as much food as conventional farming on the same amount of land—according to new findings which refute the long-standing assumption that organic farming methods cannot produce enough food to feed the global population.

Researchers from the University of Michigan found that in developed countries, yields were almost equal on organic and conventional farms. In developing countries, food production could double or triple using organic methods, said Ivette Perfecto, professor at U-M’s School of Natural Resources and Environment, and one the study’s principal investigators. Catherine Badgley, research scientist in the Museum of Paleontology, is a co-author of the paper along with several current and former graduate and undergraduate students from U-M.

“My hope is that we can finally put a nail in the coffin of the idea that you can’t produce enough food through organic agriculture,” Perfecto said.

In addition to equal or greater yields, the authors found that those yields could be accomplished using existing quantities of organic fertilizers, and without putting more farmland into production.

The idea to undertake an exhaustive review of existing data about yields and nitrogen availability was fueled in a roundabout way, when Perfecto and Badgley were teaching a class about the global food system and visiting farms in Southern Michigan.

“We were struck by how much food the organic farmers would produce,” Perfecto said. The researchers set about compiling data from published literature to investigate the two chief objections to organic farming: low yields and lack of organically acceptable nitrogen sources.

Their findings refute those key arguments, Perfecto said, and confirm that organic farming is less environmentally harmful yet can potentially produce more than enough food. This is especially good news for developing countries, where it’s sometimes impossible to deliver food from outside, so farmers must supply their own. Yields in developing countries could increase dramatically by switching to organic farming, Perfecto said.

While that seems counterintuitive, it makes sense because in developing countries, many farmers still do not have the access to the expensive fertilizers and pesticides that farmers use in developed countries to produce those high yields, she said.

After comparing yields of organic and convention farms, the researchers looked at nitrogen availability. To do so, they multiplied the current farm land area by the average amount of nitrogen available for production crops if so-called “green manures” were planted between growing seasons. Green manures are cover crops which are plowed into the soil to provide natural soil amendments instead of synthetic fertilizers. They found that planting green manures between growing seasons provided enough nitrogen to farm organically without synthetic fertilizers.

Organic farming is important because conventional agriculture—which involves high-yielding plants, mechanized tillage, synthetic fertilizers and biocides—is so detrimental to the environment, Perfecto said. For instance, fertilizer runoff from conventional agriculture is the chief culprit in creating dead zones—low oxygen areas where marine life cannot survive. Proponents of organic farming argue that conventional farming also causes soil erosion, greenhouse gas emission, increased pest resistance and loss of biodiversity.

For their analysis, researchers defined the term organic as: practices referred to as sustainable or ecological; that utilize non-synthetic nutrient cycling processes; that exclude or rarely use synthetic pesticides; and sustain or regenerate the soil quality.

Perfecto said the idea that people would go hungry if farming went organic is “ridiculous.”

“Corporate interest in agriculture and the way agriculture research has been conducted in land grant institutions, with a lot of influence by the chemical companies and pesticide companies as well as fertilizer companies—all have been playing an important role in convincing the public that you need to have these inputs to produce food,” she said.

Contact: Laura Bailey
Phone: (734) 647-1848

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New gene mutation identified in common type of dementia

ST. PAUL, MN — Researchers have identified a new gene mutation linked to frontotemporal dementia, according to a study published in the July 10, 2007 issue of Neurology®, the medical journal of the American Academy of Neurology.

Frontotemporal dementia, one form of which is known as Pick’s disease, involves progressive shrinking of the areas of the brain that control behavior and language. Symptoms include language problems and personality changes, often with inappropriate social behavior. Unlike Alzheimer’s disease dementia, the disease does not affect memory in the early stages. The genetic form of the disease is rare; most cases occur randomly.

“We are hopeful that this finding will help us better understand how this disease works and eventually help us develop new therapies for the disease,” said study author Amalia Bruni, MD, of the Regional Neurogenetic Centre in Lamezia Terme, Italy.

The researchers discovered a new mutation in the gene named progranulin in an extended family in southern Italy. The genealogy of this family has been reconstructed for 15 generations, going back to the 16th century; 36 family members have had frontotemporal dementia. For this study, DNA tests were conducted on 70 family members, including 13 people with the disease. “This is an important result that we pursued for more than 10 years,” said study co-author Ekaterina Rogaeva, PhD, with the Centre for Research in Neurodegenerative Diseases at the University of Toronto.

The mutation identified in this study is in a gene on chromosome 17. The mutation leads to a loss of progranulin, a protein growth factor that helps brain cells survive. The mutation causes only half of the protein to be produced, because only one copy of the gene is active. Production of too much progranulin has been associated with cancer.

The new gene mutation was found in nine of those family members with the disease and 10 people who are currently too young to have the symptoms of the disease. But four people with the disease did not have the gene mutation. Bruni noted that these four people belong to a branch of the family with the disease in at least three generations. “These results are intriguing, since the family has two genetically distinct diseases that appear almost identical,” said Bruni.

The Italian family had no cases with two copies of the mutated gene. “We would have expected to see cases with two copies of the mutated gene, especially since this family shares much of the same genetic material, as there have been at least five marriages between first cousins over the years,” Bruni said. “It’s possible that loss of both copies of the progranulin gene leads to the death of embryos, and that’s why there were no cases with two copies of the mutated gene.”

“Another intriguing aspect in this Italian family is the variable age at onset, which ranged from 35 to 87 years in the family members who inherited the same mutation. Our future research will try to identify the modifying factors responsible for the severity of the disorder,” said Rogaeva.

Rogaeva says their studies will also try to identify the second gene responsible for dementia in this family.

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The study was supported by grants from the Canadian Institutes of Health Research, Howard Hughes Medical Institute, Canada Foundation for Innovation, Japan-Canada and Canadian Institutes of Health Research Joint Health Research Program, Parkinson Society of Canada, W. Garfield Weston Fellows, Japanese Society for the Promotion of Science, National Institute on Aging Intramural Program, Italian Ministry of Health, and the Calabria Regional Health Department.

The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

For more information about the American Academy of Neurology, visit http://www.aan.com.

Contacts:

Angela Babb
ababb@aan.com
651-695-2789

Robin Stinnett
rstinnett@aan.com
651-695-2763

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Low vitamin D levels may be common in otherwise healthy children

Many otherwise healthy children and adolescents have low vitamin D levels, which may put them at risk for bone diseases such as rickets. African American children, children above age nine and with low dietary vitamin D intake were the most likely to have low levels of vitamin D in their blood, according to researchers from The Children’s Hospital of Philadelphia.

A study in the current issue of the American Journal of Clinical Nutrition measured blood levels of vitamin D in 382 healthy children between six years and 21 years of age living in the northeastern U.S. Researchers assessed dietary and supplemental vitamin D intake, as well as body mass, and found that more than half of the children had low blood levels of vitamin D. Of the subjects, 55 percent of the children had inadequate vitamin D blood levels and 68 percent overall had low blood levels of the vitamin in the wintertime.

“The best indicator of a person’s vitamin D status is the blood level of a vitamin D compound called 25-hydroxyvitamin D,” said Babette Zemel, Ph.D., a nutritional anthropologist at Children’s Hospital and primary investigator of this study. “Vitamin D deficiency remains an under-recognized problem overall, and is not well studied in children.”

Vitamin D is crucial for musculoskeletal health. The primary dietary source of the vitamin is fortified milk, but the best way to increase vitamin D levels is from exposure to sunshine. Severe deficits in vitamin D may lead to muscle weakness, defective bone mineralization and rickets. In addition to musculoskeletal effects, vitamin D is important for immune function, and low blood levels of the vitamin may contribute to diseases such as hypertension, cancer, multiple sclerosis and type 1 diabetes. Decreased blood levels of vitamin D have also been linked to obesity.

Further study is needed to determine the appropriate blood levels of vitamin D in children, said Dr. Zemel, who added that a review of the current recommendations for vitamin D intake is needed.

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Grants from the National Institutes of Health and several private sources supported this study.

Dr. Zemel’s co-authors were Mary B. Leonard, M.D. and Virginia A. Stallings, M.D., of The Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine, as well as Francis L. Weng and Justine Shults, also of the University of Pennsylvania School of Medicine.

About The Children’s Hospital of Philadelphia: The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

Contact: Joey Marie McCool
McCool@email.chop.edu
267-426-6070
Children’s Hospital of Philadelphia

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Cancer-fighting virus shows promise in early clinical trial

A virus that has been specifically designed by scientists to be safe to normal tissue but deadly to cancer is showing early promise in a preliminary study, researchers said today at the ESMO Conference Lugano (ECLU), Switzerland.

The virus, called NV1020, is a type of herpes simplex virus modified so that it selectively replicates in virus cells, killing them in the process.

“It doesn’t replicate in normal, healthy cells, so our hope is that it will help fight cancers without causing side-effects in the rest of the body,” said Dr. Axel Mescheder, VP Clinical Research & Development, from the Munich-based biotech company MediGene. The study is conducted in seven leading US-cancer centers, with Dr. Tony Reid from the University of California in San Diego, CA as Principal Investigator. Dr. Mescheder presented preliminary safety and efficacy results and a case report from this ongoing clinical trial in patients with colorectal cancer metastatic to the liver at the meeting.

Dr. Mescheder’s poster presentation described the case of a patient whose cancer had spread to 10 different places around the liver and four in the lungs. He was given the virus treatment in four weekly infusions direct into blood stream, followed by two cycles of approved chemotherapy.

Six months after treatment, scans showed the liver masses had nearly disappeared. “The reduction in the tumor masses was really impressive in this patient,” Dr. Mescheder said. “The hepatic masses almost disappeared.”

The patient survived for 12 months after treatment.

“In the current study, the scientists are testing the treatment in patients with colorectal cancer that have not responded to chemotherapy and where the cancer has spread to the liver,” Dr. Mescheder said. “We are hoping to extend overall survival.”

So far, the findings are looking positive. The treatment seems very tolerable for patients and safe. “The results are really quite encouraging at this early stage,” he said.

Almost 40% of patients with colorectal cancer ultimately die from metastatic disease, where the cancer spreads to other parts of the body. Most of the spreading occurs to the liver and 15% of patients have liver metastases at the time of diagnosis.

The latest human results reported today follow testing in the lab and in animals where the virus was shown to be effective at killing colorectal cancer cells and liver cancers.

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About ESMO Conference Lugano (ECLU)

ECLU 2007 represents the new direction ESMO has given to the scientific and educational meeting previously known as the ESMO Summer Educational Conference (ESEC). It will be held every July under the auspices of the City of Lugano, hometown to the European Society for Medical Oncology (ESMO). Around 1000 young oncologists, senior oncologists and cancer healthcare professionals will attend sessions on the latest developments in multidisciplinary oncology which will cover progress in cancer research and promising new technologies. International cancer specialists will highlight progress on important topics such as pharmacogenomics, molecular diagnostics, molecular-targeted therapies, new frontiers in response evaluation, cancer prevention and state-of-the-art oncology at its finest. Each Conference will also include a session on a specific topic, which in 2007 is the important issue of cancer prevention.

The 6th ESMO Patient Seminar, 7 July 2007, will also take place during ECLU. The Patient Seminar provides patients, their families and caregivers the opportunity to interact with international and local oncologists and learn more about the most recent developments and options in cancer treatment. More information about ECLU is available at http://www.esmo.org/activities/ecluconference/.

Contact: Vanessa Pavinato
media@esmo.org
European Society for Medical Oncology

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