'Jellyfish' smoothies offer solar solutions, By Barry Neild, for CNN

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'Jellyfish' smoothies offer solar solutions, By Barry Neild, for CNN

Glowing jellyfish are one source of the raw ingredients for a new solar cell.

(CNN) -- Putting thousands of jellyfish in a blender to make a smoothie sounds like the start of bad joke. In fact, it's one way to source ingredients for a new generation of solar power solutions that could aid medical science and offer cheap energy.
Scientists say by liquidizing the humble Aequorea victoria -- a glow-in-the-dark jellyfish commonly found off the western coast of North America -- they can use the green fluorescent protein (GFP) it contains to create miniature fuel cells.
These, say their creators, could be used to power microscopic "nanodevices" that could operate independently inside the human body, helping reverse blindness or fight tumors.
Nanotechnology -- the manipulation of matter at an atomic scale (one nanometer is equivalent to one billionth of a meter) -- is seen by many as the future of medicine, but the science of powering nano-machinery is still in its infancy.
Which is where the jellyfish come in.
Zackary Chiragwandi at Chalmers University of Technology in Gothenburg, Sweden told CNN he has developed a method of generating power at a nano-level by administration a droplet of jellyfish-type GFP onto aluminum electrodes and exposing it to ultraviolet light.

The technique, he says, is more foolproof than existing light-powered cells, doing away with the need for expensive and tricky titanium elements found in "Gratzel cells" -- acclaimed solar-power fuel cells that mimic plant photosynthesis.
Chiragwandi says his cell can even utilize enzymes from fireflies and Renilla reniformis sea pansies to create its own light source, making it completely self-contained.
In Chiragwandi's "biophotovoltaic nanodevice," electrons flow through a circuit when light hits the green fluorescent protein. He says this generates a current measuring "tens of nano amperes."
The amount may seem negligible, but if scaled up would appear to offer a more efficient power supply than existing solar cells.
"The output characteristics of the biophotovoltaic nanodevice are comparable with those of earlier reported high efficiency solar cells," says Chiragwandi, adding that the power cells could be deployed within one or two years.
"The biological fuels may be a means to independently power nanotechnology embedded in a living organism, such as diagnostic, medical or even communication devices residing within a living organism without need for an external electrical power source," he says.
Meanwhile at the UK's University of Cambridge, scientists say they have worked out a way to turn living algae into what is effectively a floating biological solar cell that could be used to generate power from almost any non-freezing body of fresh or salt water.
Paolo Bombelli, who is part of the team developing the method, says it is possible to hack into the energy released by photosynthesizing organisms using specially-designed transparent electrodes.
By tapping into this process -- which sees water broken into oxygen, protons and electrons -- they have so far managed to generate enough electricity to run a digital clock.
"As we stand, we are not talking about a large amount of electricity," he told CNN, adding that the team were "quite far from a real application; definitely a long-term plan."
Although they have demonstrated that they could operate the technique on seawater in a broad temperature range -- thus opening up most of the world's oceans to potential use -- Bombelli says they have yet to exceed sunlight-to-electricity efficiency levels of 0.1 percent.
A major problem, he says, is working out "how we can push the system further without killing the organisms."
Although the algae might currently be at risk, for the jellyfish there is good news. Thanks to modern breakthroughs allowing scientists to grow their own green fluorescent protein using bacteria -- the unsuspecting sea creatures are no longer on the milkshake menu.

Australian scientists make breast cancer breakthrough with protein discovery

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Australian scientists make breast cancer breakthrough with protein discovery

Making a huge breakthrough in potential breast cancer treatment, Australia's Brisbane-based researchers have found that the concentration of a protein that moves calcium into a specific area of the cell was higher in many breast cancers.

Published on Saturday, scientists at the have discovered the presence of a protein

"When people hear about calcium, they think milk, teeth and bones, but calcium is also an important signal that is tightly controlled by specific transporters," said Associate Professor Greg Monteith of University of Queensland in a statement.

"We now realize that these transporters can be altered in some cancer types.

"Hopefully these results and our current work will help us exploit these changes and target breast cancer more effectively,” he added.

Characterising the new drug target was a six-year process involving collaboration with international researchers, while Associate Professor Sarah Roberts-Thomson said future treatments that target the protein could be used in conjunction with chemotherapy and radiotherapy to treat breast cancer and prevent its spread.

"If you diminish the level of this transporter it stops the cancer cell from replicating or proliferating which is something that is a hallmark of cancer," Professor Roberts-Thomson said in a statement.

"We can show that if you decrease the level of this protein you can stop tumour growth,” she added.

Roberts-Thomson said in a drug form that this could used with chemotherapy and radiotherapy, reports englishnews.cn.

"You could actually use this protein and use a drug that actually targets that protein and use it to treat some breast cancers," she said.

The study has been published in the prestigious scientific journal Cell.

Ten tips to steer clear of breast cancer

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Ten tips to steer clear of breast cancer

National Breast Cancer Awareness Month, experts from Fred Hutchinson Cancer Research Center and its clinical care partner, the Seattle Cancer Care Alliance, are offering research-based tip sheets related to breast cancer, including breast cancer prevention, screening and early detection, treatment, and survivorship.

The series launches today with '10 Tips for Breast Cancer Prevention' provided by Anne McTiernan, director of the Hutchinson Center's Prevention Center, a member of the Center's Public Health Sciences Division, and author of "Breast Fitness" (St. Martin's Press).

10 tips for breast cancer prevention

1. Avoid becoming overweight. Obesity raises the risk of breast cancer after menopause, the time of life when breast cancer most often occurs. Try to maintain a body-mass index under 25.

2. Eat healthy to avoid tipping the scale. Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Eat lean protein such as fish or chicken breast and eat red meat in moderation, if at all. Eat whole grains. Choose vegetable oils over animal fats.

3. Keep physically active, even when begun later in life. It reduces overall breast-cancer risk by about 10% to 30%. All it takes is moderate exercise like a 30-minute walk five days a week.

4. Drink little or no alcohol. Alcohol use is associated with an increased risk of breast cancer.

5. Avoid hormone replacement therapy. Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to manage menopausal symptoms, avoid those that contain progesterone and limit their use to less than three years. "Bioidentical hormones" and hormonal creams and gels are no safer than prescription hormones and should also be avoided.

6. Consider taking an oestrogen-blocking drug. Women with a family history of breast cancer or who are over age 60 should talk to their doctor about the pros and cons of oestrogen-blocking drugs such as tamoxifen and raloxifene.

7. Don't smoke. Research suggests that long-term smoking is associated with increased risk of breast cancer in some women.

8. Breast-feed your babies for as long as possible. Women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later.

9. Participate in a research study. The Hutchinson Center is home to several studies that are looking at ways to reduce the risk for breast cancer.

10. Get fit and support breast cancer research at the same time. Regular physical activity is associated with a reduced risk of breast cancer. Ascend some of the world's most breathtaking peaks while raising vital funds for and awareness of breast cancer research by participating in the Hutchinson Center's annual Climb to Fight Breast Cancer.

Energy drinks are just a waste of money

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Energy drinks are just a waste of money

All those who are spending money on energy sports drinks are just wasting their money — as they just end up consuming lots of extra calories, warned an expert.

"While the drinks might be suitable for people training for events such as the marathon, those doing workouts of less than two hours do not really benefit from the drinks," Nick Hudson, national fitness manager for Virgin Active, said.

"They are certainly useful for people who compete in very long-distance events," The Scotsman quoted him as saying.

"Your body is generally thought to be able to store enough glycogen (a form of glucose) to last roughly for two hours and marathon runners swear by them [energy drinks].

"But those doing shorter, more intense workouts do not really benefit physiologically," he said.

Hudson said people aiming to lose weight should avoid the drinks altogether, or opt for a low-calorie version.

Half of women don’t check their breasts for cancer

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Half of women don’t check their breasts for cancer

Breast cancer is the most commonly diagnosed cancer among women in Scotland with around 4,000 women diagnosed each year.

Despite this, nearly half (42%) of women in Scotland do not check their breasts simply because they forget to do so, according to a survey by Breakthrough Breast Cancer.

More than half of women (53%) did not know that drinking alcohol could increase their risk; almost the same number (50%) did not realise that putting on weight or being obese could make them vulnerable too.

Furthermore, 41% did not know that getting older increases the risk, despite increasing age being the biggest risk factor.

A similar proportion (39%) did not know that regular exercise could help to reduce their risk.

"These results showed that more work is needed to make sure that women are breast aware," the Daily Express quoted Dr Sarah Rawlings, the charity's head of policy, as saying.

H.I.V.: National Institutes of Health Licenses Its Patent on a New Drug for AIDS, By DONALD G. McNEIL Jr.

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H.I.V.: National Institutes of Health Licenses Its Patent on a New Drug for AIDS, By DONALD G. McNEIL Jr.

In a move that gave official American backing to the controversial idea of a “patent pool,” the National Institutes of Health last week became the first entity to license its patent on a new AIDS drug to an entity loosely affiliated with the World Health Organization.

The rights to the N.I.H. patent on the drug, darunavir, do not mean that generic-drug makers will instantly be able to make it cheaply for poor countries, since other darunavir patents are held by private companies, including Tibotec, a Johnson & Johnson subsidiary.

But it increases pressure on drug makers to follow suit. They have been reluctant because they fear losing the profits they could make as once-poor countries become richer, as India and Brazil have. Also, they fear losing control over quality, since a bad batch of a generic could hurt the reputations of their patented drugs. Instead, they have tended to cut private deals with generic makers.

The pool is run by Unitaid, an independent agency founded at the United Nations in 2006. Its original mission was to accept the receipts from several taxes dedicated to global health — mostly from a fee on European airline tickets. The money has been spent on AIDS drugs for children and second-line drugs.

“We ask that companies step up and collaborate so we can quickly see more affordable, easy-to-use pills getting into people’s mouths,” said Nelson Otwoma, head of Kenya’s Network of People Living with H.I.V./AIDS and a Unitaid board member.

Child protective services has 'outlived its usefulness,' pediatrician says, Los Angeles Times

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Child protective services has 'outlived its usefulness,' pediatrician says, Los Angeles Times

Much attention has been focused on the inadequacy of child protective services agencies in the United States. That attention includes a Los Angeles Times' 2009 series on flaws in local CPS operations titled "Innocents Betrayed." A new study confirms the difficulty of child protective services agencies nationwide in altering the fate of abused or neglected children.

Researchers used a national database to examine the outcomes of 595 children ages 4 to 8 who were considered at high risk for abuse or neglect. About one-quarter of the children had been the subject of a child protective services investigation for suspected child maltreatment. But when researchers examined the children at age 8, they found that children who were subjects of investigations fared no better than noninvestigated children in the study on such measures as social support, family functioning, poverty, maternal education and child behavior problems. In other words, being the subject of a CPS investigation did nothing to improve the lives of the children.

In fairness, the focus of a child protective services investigation is not larger issues such as poverty or lack of parental education. Instead, CPS targets immediate threats to safety. But, the authors wrote: "The lack of change in household characteristics known to be associated with repeat abuse suggests that CPS intervention represents a missed opportunity to improve outcomes for children at high risk for future maltreatment, medical problems and behavioral problems." Moreover, they said, it's not clear that the actions taken by child protective services to reduce an immediate threat do anything to reduce future threats of abuse and neglect.

Gov. Arnold Schwarzenegger recently signed a bill targeted at the Los Angeles County database that will provide social workers with information about a family's history during a child-abuse investigation. Improvements to the child protective services system are desperately needed, but piecemeal measures may not be enough. According to an editorial, titled "Child Protective Services Has Outlived Its Usefulness," that accompanied the study, the system, which was launched by the federal Child Abuse Prevention and Treatment Act of 1974, needs an overhaul. Although physical and sexual abuse of children has declined nationwide, many abuses today are related to neglect, a category that CPS has not done a satisfactory job of responding to, according to Dr. Abraham B. Bergman of Harborview Medical Center in Seattle. He suggests that allegations of physical or sexual abuse be investigated by law enforcement personnel while public health nurses should be the first responders to cases of child neglect. Professionally trained social workers, he writes, can do assessments and counseling and secure resources and services for families.

The study and commentary were published Monday in the Archives of Pediatrics & Adolescent Medicine.



-- Shari Roan / Los Angeles Times

Some common diet mistakes, Times Of India

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Some common diet mistakes, Times Of India

You know it's diet time when your favourite jeans becomes 'difficult-to-breathe-in' tight.

Some do make it and are able to wriggle into those delicious figure-skimming dresses they've been eyeing for quite some time. Some try and change their lifestyle and eating habits, but their weight refuses to budge. Here's why. People tend to think they change their food habits way more than they actually do. Here are three of the most common diet mistakes most people make:

Sneaking in food (and not keeping track!)

Okay, so you are all resolute and don't order dessert. But what about the 'not just a couple of' bites you sneak in from your friend's rich chocolate gateaux? Doesn't that count? What about the tea and cookies you have when you drop in for a friendly chat at your neighbour's? How many cups of coffee do you guzzle while brainstorming at a business meeting? How many glasses of water do you drink in a day? Dietician and sports nutritionist Deepshikha Agarwal says, "Drinking less water is the mistake people make the most. It's a misconception that drinking a lot of water causes water-retention. Most of us live in denial, or are merely not aware, of the amount of food we eat."

Skipping a meal

Nutritionist Dr Pooja Makhija says, "Without a doubt, the biggest blunder you can make when it comes to dieting is to starve yourself. Just because you're dieting, it isn't acceptable to skip a meal. When you skip a meal, your blood sugar level drops, increasing your craving for saturated sugary foods, which are a lot fattening than a simple, home-cooked meal." Skipping breakfast is bad and you're likely to eat more calories during the day. Deepshikha says, "People on a diet tend to eat twice, once or not at all. In fact, one must eat small meals six times a day. It increases your metabolic rate, which in lay man's language is your calorie burning capacity," she says.

Looking at the short-term

You goal should be to reach to a healthy size and maintain it, instead of drastic weight loss. Sustained weight-loss requires systematic lifestyle changes. Eat a balanced nutritious diet that contains food from different groups and supplement it with exercise and an active lifestyle.

Maintain a food diary
 

The simple act of recording what you eat daily can strengthen your tenacity to see a diet to target. Psychiatrist Dr Harish Shetty says, "A food diary not only gives you a sense of regulation, but also keeps you alert, to psyche you into eating right. It is great for the dietician as well to keep track since it is a written testimony by the client himself."

— Record every morsel of food. It will give you a clear picture of how the extra calories come in your diet. You can also track emotional eating through this.

— You're less likely to binge or overeat (reaching out for a second helping of pudding) when you're fully aware that you're recording your actions. You will start listening to your real hunger pangs, and not your moody ones.

— Buy a pretty-looking journal that you anticipate writing in every night, and also carry around with you.

— Besides writing about what you eat, also jot down why you eat that particular food.
Keep it for a month and see how it works out for you. Most likely, you won't really need it after that.

You will be more aware of your eating patterns and avoid or manage confrontations that generate over-eating reactions from you.

You also know situations better. Do you eat the same amount while you order a la-carte and while in a buffet? You could make your food diary tech savvy and use an electronic log or a spreadsheet. In fact, if you're one of those techno freaks, you could tweet about your food if it helps you, for all anyone would care.

So forget the diets that promise weight loss, just opt for this self-controlling weight loss method. Needless to say, it is also the thriftiest diet aid ever!

2.6L HIV patients have no access to treatment, Times Of India

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2.6L HIV patients have no access to treatment, Times Of India

NEW DELHI: Around 3.2 lakh HIV patients in India were on life-saving anti-retroviral therapy (ART) in December 2009 — more than 85,000 patients from the previous year. Be that as it may, 2.6 lakh people are still in dire need of ART.

According to the World Health Organisation's (WHO) latest report, "Towards Universal Access", which tracks progress in achieving the 2010 target for HIV prevention, treatment and care; around 5.8 lakh HIV patients required ART in end-2009.

Globally, the HIV epidemic continued to be a real public health challenge as around 33.4 million people are suffering from the lethal disease. In 2008 alone, 2.7 million people were newly infected with the virus.

According to the report, only one-third of HIV patients have been put on ART, and coverage of prevention interventions is largely inadequate.

This year, WHO's revised guidelines on ART for adults and adolescents, including would-be mothers, said ART would be initiated when CD4 cell counts reach or drop below 350 cells/mm3, irrespective of whether the patients have clinical symptoms. As per this count, though an estimated 11 -14 lakh HIV patients in India need ART, only 23% are receiving the treatment.

The number of pregnant women, who require ART, is pegged at 43,000. But only 21% are covered. Another 30,000-76,000 HIV positive children, too, require ART.

However, there has been a spurt in the number of HIV tests across the world. For instance, 100 countries had tested 67 million people last year.

In 82 countries — for which comparable data was available for 2008 and 2009 — the median number of tests performed per 1,000 people had increased from 41 to 50, respectively. ART coverage, among young adults less than 15 years, has gone up from 22% in 2008 to 28% in 2009.

Even the percentage of HIV positive pregnant women receiving ART to prevent mother-to-child transmission has increased from 45% in 2008 to 53% in 2009. In end-2009, 5.25 million people were receiving ART in low and middle-income countries, including India, which translates to an increase of over 1.2 million people from the previous year.

The report maintains that HIV-related TB remains a cause for concern. In 2008, of the 9.4 million TB cases reported worldwide, an estimated 1.4 million were diagnosed among HIV patients. Though the rate of HIV test and counselling for TB patients is rising, the initiative is insufficient.

Inescapable stress, Dr S. Sivaramakrishnan, Deccan Chronicle

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Inescapable stress, Dr S. Sivaramakrishnan, Deccan Chronicle

Stress is a natural component of the human condition and at times, some level of stress is almost essential in order to survive. After all, at some point in our lives, we have all felt that we work best under pressure. However, over the past few decades, the degree of stress that people perform under has increased owing to urbanisation, globalisation and the rise of the corporate world. Very often, an individual works under “emergency” circumstances on a daily basis and this leads to excess stress, which in turn, leads to mental and physiological illnesses.
Therefore, the need of the hour, especially for people in the corporate world, is to understand what causes stress and learn stress management.
Stress and anatomy
Our anatomy has not changed for over a billions years but the thing that has changed, is our lifestyle. In fact, what makes urban stress detrimental is the fact that it is mental stress, as most jobs require no physical activity but tremendous mental activity. However, the body can only release stress through physical exertion. Therefore, besides a modified life style, indulging in any kind of physical activity is recommended.
Signs and symptoms
The following are the most common distress symptoms: Physical: Hypertension, coronary artery disease, backache, arthritis, osteoporosis, headache, allergies, peptic ulcer, diabetes mellitus, irritable bowel syndrome, skin disease, liver cirrhosis, respiratory diseases, impotence, insomnia and metabolic syndrome.
Psychological: Depression, alienation, anger, suspiciousness, irritability, mood swings, lack of self-confidence, neuroticism.
Behavioural: Increased substance abuse, unsafe behaviour pattern, suicidal tendencies, aggression, restlessness and speech disturbance.
Lifestyle and stress
We can easily combat the ill effects of stress by modifying our lifestyle. The first thing you can do is to give yourself a “stress audit.” The audit will help identify the symptoms of excess stress so that you can then find ways to combat it.
In order to ascertain what kind of changes one needs to make one needs to know what triggers stress.
* Improper diet pattern.
* Lack of sleep.
* Lack of aerobic activity.
* Imbalance between work and personal life.
* Excess smoking or alcohol consumption.
The cure
Proactive lifestyle modifications can help in preventing premature onset of stress related illnesses. Once we have detected what triggers excess stress in our life, we must then work to remove or minimise these factors. The best ways to do this are:
* Exercise.
* Change your diet.
* Reprioritise.
Lifestyle modifications help in regressing the progress of any stress related disorder and can serve to be both a complementary and supplementary treatment.
The writer is a health physician at the
Hinduja Hospital in Mumbai.

Vaccine against four dengue strains to go on trial, Deccan Cronicle.

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Vaccine against four dengue strains to go on trial, Deccan Cronicle.

Sydney: Researchers are about to try out a new vaccine to protect against all four strains of the potentially devastating dengue fever.
The study is being conducted by the Vaccine Trials Group at the Telethon Institute for Child Health Research with Princess Margaret Hospital for Children and University of Western Australia School of Paediatrics and Child Health.
The dengue virus can cause fever, often with a severe headache, vomiting, muscle and joint pains and skin rash. It can cause more severe symptoms and can be fatal, mainly in children, according to a statement said.
The study leader, associate professor, Mr Peter Richmond, of the University of Western Australia, said a vaccine against the mosquito-borne virus would be of great value to travellers.
Dengue fever is an increasing scourge in South East Asia..., Mr Richmond said. A safe and effective vaccine would be of great benefit to our region, and provide protection for Australians heading to these popular tourist destinations.
At the moment there is no licensed vaccine available to prevent dengue disease and no specific treatment exists, Richmond said. Controlling mosquito numbers is the only effective method of prevention at this time.

Drugs 'could target asthma genes, BBC News.

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Drugs 'could target asthma genes, BBC News.

A large international study has revealed several genetic variants which are linked to people with asthma.

In all, more than 500,000 tests were performed on the genes of 10,000 children and adults with the condition, and 16,000 non-asthmatics.

The Imperial College-led research, published in the New England Journal of Medicine, could point to new targets for drugs.

Experts said gene testing could not predict who would get the condition.

One in seven children in the UK suffers from asthma, which causes the airways to become irritated and narrow, making it harder for them to breathe.

The reasons why people develop the disease are not yet fully clear, although scientists suspect a roughly equal mixture of genetic susceptibility and environmental factors.

The latest genetic variants discovered by the international research appeared in more than a third of children with asthma.

However, the gene with the strongest impact on children did not affect people who developed asthma in adulthood, suggesting that the two versions of asthma may differ biologically.

Some of the genes identified are involved in the body's system for telling the immune system about damage to the lining of the airways, while others appear to control how quickly the airways heal.

Professor William Cookson, from Imperial College London, who co-ordinated the research, said: "Asthma is a complex disease in which many different parts of the immune system can become activated.

"Our study now highlights targets for effective asthma therapies and suggests that therapies against these targets will be of use to large numbers of asthmatics in the population."

However, parents have been warned that although genes make a contribution to asthma development, there is no way to use a genetic test to predict the condition.

Leanne Metcalf, from Asthma UK, said: "This unique study helps us to understand in much more detail how the genetic side of things works.

"Importantly, it has also shown that genetic testing does not help to predict who is susceptible to developing asthma, meaning that early diagnosis and intervention, and effective treatment for everyone who is affected by asthma, are even more vital.

"However the most exciting part is that these results will now help to ensure that scientists are able to focus their research on the most influential targets for asthma, with the important long-term aim of preventing a condition which is responsible for the deaths of three people every day."

Call to 'suspend' diabetes drug By Nick Triggle, BBC News.

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Call to 'suspend' diabetes drug By Nick Triggle, BBC News.

A widely-used diabetes drug should be pulled from the market, European regulators say.

Avandia is used to control blood sugar levels in type 2 diabetes patients.

It was licensed 10 years ago and more than 100,000 patients in the UK use it despite on-going concerns linking it to heart problems.

After reviewing safety data, the European Medicines Agency said the benefits no longer outweighed the risks and it should be suspended.

The drug - generic name rosiglitazone - is also used in combination with other drugs under the names Avandamet and Avaglim.

Contrast
A spokeswoman for the regulator said: "Patients who are currently taking these medicines should make an appointment with their doctor to discuss suitable alternative treatments.

"Patients are advised not to stop their treatment without speaking to their doctor."

Continue reading the main story
“
Start Quote

It should not take this long to come to a decision when there is evidence that people's lives may be at risk”

Peter Walsh
Action Against Medical Accidents
But the recommendation in Europe contrasts with the US where regulators have decided only to introduce tougher restrictions over its use - a verdict which they confirmed at the same time as the EMA announcement.

Avandia was originally licensed with warnings about the risks for patients with heart failure.

These were later expanded to include other heart problems after further research into its use.

The advice by an expert panel of advisers, who looked at the issue amid mounting concerns, will now be passed to the European Commission.

It may be several months before they make a final ruling, although it is unusual for them to ignore advice from the regulator.

Dr Ellen Strahlman, chief medical officer at GlaxoSmithKline, the manufacturer, said: "Our primary concern continues to be patients with type 2 diabetes and we are making every effort to ensure that physicians in Europe and the US have all the information they need to help them understand how these regulatory decisions affect them and their patients."

GSK said it still believes the drug was an "important treatment" for diabetes patients.

Peter Walsh, head of the patient group Action Against Medical Accidents, said: "Medical experts have been warning for months about the dangers of this drug, which have been well documented.

"It should not take this long to come to a decision when there is evidence that people's lives may be at risk.

"We need a review of how medicines are regulated in the UK and Europe as a whole. We fear that pharmaceutical companies have far more influence than they should have."

Simon O'Neill, of Diabetes UK, agreed action in such cases should be taken more quickly.

But he added: "Patient safety is paramount, so we welcome that a decision has been made about Avandia."

Mammograms’ Value in Cancer Fight at Issue, New York Times By GINA KOLATA

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Mammograms’ Value in Cancer Fight at Issue, New York Times By GINA KOLATA

A radiologist reviewing mammogram images at the Elizabeth Center for Cancer Detection in Los Angeles. Most health officials recommend the screenings, but experts disagree over their value

A new study suggests that increased awareness and improved treatments rather than mammograms are the main force in reducing the breast cancer death rate.

Starting in their 40s or 50s, most women in this country faithfully get a mammogram every year, as recommended by health officials. But the study suggests that the decision about whether to have the screening test may now be a close call.

The study, medical experts say, is the first to assess the benefit of mammography in the context of the modern era of breast cancer treatment. While it is unlikely to settle the debate over mammograms — and experts continue to disagree about the value of the test — it indicates that improved treatments with hormonal therapy and other targeted drugs may have, in a way, washed out most of mammography’s benefits by making it less important to find cancers when they are too small to feel.

Previous studies of mammograms, done decades ago, found they reduced the breast cancer death rate by 15 to 25 percent, a meaningful amount. But that was when treatment was much less effective.

In the new study, mammograms, combined with modern treatment, reduced the death rate by 10 percent, but the study data indicated that the effect of mammograms alone could be as low as 2 percent or even zero. A 10 percent reduction would mean that if 1,000 50-year-old women were screened over a decade, 996 women rather than 995.6 would not die from the cancer — an effect so tiny it may have occurred by chance.

The study, published Thursday in The New England Journal of Medicine, looked at what happened in Norway before and after 1996, when the country began rolling out mammograms for women ages 50 to 69 along with special breast cancer teams to treat all women with breast cancer.

The study is not perfect. The ideal study would randomly assign women to have mammograms or not. But, cancer experts said, no one would do such a study today when mammograms are generally agreed to prevent breast cancer deaths. In the study, which is continuing, women were followed for a maximum of 8.9 years. It is possible that benefits may emerge later.

Nonetheless, the new study is “very credible,” said Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health.

“This is the first time researchers used real populations to compare the effects of treatment and mammography in the modern era of treatment,” Dr. Kramer said. “It shows the relative impacts of screening versus therapy in an era in which therapy has been improving.”

Dr. Otis Brawley of the American Cancer Society said in a statement that the investigators used “careful methodology.” The society, Dr. Brawley said, “believes that the total body of the science supports the fact that regular mammography is an important part of a woman’s preventive health care.”

Dr. Carol Lee, a radiologist at Memorial Sloan-Kettering Cancer Center and chairwoman of the breast imaging commission of the American College of Radiology, said the new study affirmed that mammography saves lives.

“Mortality from breast cancer is decreasing, and I have to believe that screening mammography has played a part,” Dr. Lee said.

In their study, the investigators analyzed data from all 40,075 Norwegian women who had received a diagnosis of breast cancer from 1986 to 2005, a time when treatment was changing markedly.

In that period, 4,791 women died. And, starting in 1996, Norway began offering mammograms to women ages 50 to 69 and assigning multidisciplinary treatment teams to all women with breast cancer, similar to the teams at many major medical centers in the United States. The question was, Did the program of mammograms and optimal new treatment with coordinated teams of surgeons, pathologists, oncologists, radiologists and nurses lower the breast cancer death rate?

The investigators found that women 50 to 69 who had mammograms and were treated by the special teams had a 10 percent lower breast cancer death rate than similar women who had had neither.

They also found, though, that the death rate fell by 8 percent in women over 70 who had the new treatment teams but had not been invited to have mammograms. And Dr. Kramer said he knew of no evidence that breast cancer was more easily treated in women over 70 than in women ages 50 to 69.

That means, Dr. H. Gilbert Welch of Dartmouth wrote in an additional analysis in an accompanying editorial, that mammography could have reduced the breast cancer death rate by as little as 2 percent, an amount so small that it is not really different from zero.

Two percent is an estimate, Dr. Welch said. But, he said, whatever the effect of mammograms is, “all the signals here are that it is much smaller than we believed.”

Dr. Laura Esserman, a professor of surgery and radiology at the University of California in San Francisco, said it tells her that “if you get the same treatment and the outcome is the same if you find it earlier or later, then you don’t make a difference when you find it early.”

And screening has a cost, Dr. Welch said. Screening 2,500 50-year-olds for a decade would identify 1,000 women with at least one suspicious mammogram resulting in follow-up tests. Five hundred would have biopsies. And 5 to 15 of those women would be treated for cancers that, if left alone, would have grown so slowly they would never have been noticed.

When the study was planned, the scientists expected that screening would be even more effective than it was in studies from decades ago. After all, mammography had improved and, in Norway, each mammogram was independently read by two radiologists, which should make it less likely that cancers would be missed. The researchers expected mammograms to reduce the breast cancer death rate by a third.

“We were surprised,” said Dr. Mette Kalager, the lead author of the paper who is a breast surgeon at Oslo University and a visiting scientist at the Harvard School of Public Health.

Marvin Zelen, a statistician at the Harvard School of Public Health and the Dana-Farber Cancer Institute, who was a member of the research team said even though the mammography benefit is small, if he were a woman he would get screened.

“It all depends on how you approach risk,” Dr. Zelen said. His approach, he says, is “minimax” — he wants to minimize the maximum risk — which, in this case, is dying of a cancer.

Dr. Kalager came to the opposite conclusion. She worries about the small chance of benefit in light of the larger chance of finding and treating a cancer that did not need to be treated.

“Since I’m a breast cancer surgeon, I know what being treated is like,” she says. The decision to be screened, she says, “is a matter of personal preference. Is it worth it to risk becoming a patient without it being necessary?”

Many women may still want mammograms, she says, and that is fine.

“I think we have to respect what women want to do.”