Wendy Anne Makhdum Prosser's Blog

Posted by Wendy Anne Makhdum Prosser

Did you know that over 36,000 hearts are beating today because of life-saving medicines? Or that eight out of 10 children can now conquer their cancer, compared with only two out of 10 in 1960? These victories are due to advances in medicine made possible by clinical research.

Quintiles have announced the launch of ClinicalResearch.com, a resource providing information for patients and caregivers who may have little or no understanding of clinical research and its role in health care. How drugs are developed and the ethics and safety of clinical trials are covered in detail, and patients can even learn how to enrol in a clinical trial themselves. With a few clicks, ongoing or future clinical trials concerning particular diseases or conditions can be identified and narrowed down by geographical area.

The clinical trial became the standard approach to developing drugs in 1962, since when the US Food and Drug Administration has approved more than 1,000 new therapies. Almost all medicines used today were developed through clinical research, including drugs for cancer, heart disease, depression, HIV, Alzheimer's disease and asthma. Clinical trials are arguably the greatest medical innovation of the 20th century, and in the 21st continue to offer hope to patients in need of effective medicines.

Posted by Wendy Anne Makhdum Prosser

The winners of the 2009 Nobel Prize in Physiology or Medicine were announced today in Stockholm; they are Elizabeth H. Blackburn from the University of California San Francisco, Carol W. Greider from the Johns Hopkins University School of Medicine and Jack W. Szostak from Harvard Medical School. The prize was awarded jointly for their work on "how chromosomes are protected by telomeres and the enzyme telomerase".

'Telomere' is the name given to the region at the ends of each of our chromosomes – the tightly bound packages of DNA that carry our genes. The telomeres do not contain any genes themselves, but guard the chromosomes from damage when the cell that contains them divides. Dr Blackburn has compared telomeres to the tips on the ends of shoelaces that stop them unravelling. Telomerase is an enzyme involved in the building of these protective caps.

Understanding the functions of telomeres and telomerase is important in medicine because it may help solve problems such why we age, and the causes of cancer cell growth (Gu J et al. Carcinogenesis 2005; 26(10): 1741–7). It has been suggested that repeated shortening of the telomeres every time a cell divides places a limit on the total number of divisions the cell can undergo, and thereby on its lifespan. Conversely, cancer cells can divide indefinitely, and have been shown to contain high levels of telomerase.

Findings such as these have prompted a search for ways to block the action of telomerase in malignant cells, and perhaps provide a new treatment for cancer.

Posted by Wendy Anne Makhdum Prosser

As summer draws to a close in the Northern Hemisphere, yet more research highlights the risks of reckless exposure to the Sun.

In this month's Archives of Dermatology, a team from the University of Colorado Denver reports that 6–8-year-olds with very pale skin who develop a tan when exposed to the Sun have significantly more moles than those who do not tan. Darker-skinned children, in contrast, showed no such difference. Since the number of moles that a person has is a risk factor for malignant melanoma, the authors suggest that parents of pale-skinned children who tan easily should take extra care to protect them from the Sun’s rays. Sensible precautions include covering up with loose clothing and hats, and avoiding the Sun when it is at its strongest, in the hours around noon.

Shielding young children from harm might be straightforward enough, but protecting older kids is another matter. In a second study in the same journal, data collectors posing as 15-year-old, fair-skinned girls telephoned over 3500 tanning bed studios throughout the USA to ask about the establishments' age restrictions and parental consent policies.

Although a large majority of the studios required parental consent, only 5% would not allow the 'teenager' to tan because of her age. Yet previous research has shown that a woman who uses a tanning bed for the first time before the age of 35 years increases her risk of melanoma by as much as 75% (El Ghissassi F et al. Lancet Oncol 2009; 10(8): 751–2).

Several states plan to introduce regulations regarding teens and tanning studios, including bans on tanning bed use by under-18s. However, for Joni A. Mayer, principal investigator on this study and Professor of Public Health at San Diego University, this does not go far enough. "Our data and other data indicate that those under age 17 need to be banned from tanning beds," she says.

Posted by Wendy Anne Makhdum Prosser

Any reader who has ever bemoaned her chunky thighs can take heart. A study from Denmark published in the British Medical Journal has found that thin thighs may be associated with an increased risk of cardiovascular disease, regardless of other factors such as obesity, blood pressure, smoking and exercise levels.

Doctors already use ‘anthropometric’ features such as body mass index (BMI), hip circumference and waist-to-hip ratio to identify patients who might be at risk of cardiovascular problems. The authors of this new study suggest that thigh circumference might become a useful addition to these tools.

Interestingly, the BMJ has been criticized for its press release on this study. The title of the document, transmitted to news agencies worldwide, was ‘Large thighs protect against heart disease and early death’. This could be considered misleading, since the Danish study shows nothing of the sort. An ‘association’ is not the same as a ‘cause’ – a point that all writers and readers of health-related media would do well to remember!