High levels of oestrogen in the womb linked to autism

The discovery adds further evidence to support the prenatal sex steroid theory of autism first proposed 20 years ago.

 

The sex ratio in autism diagnoses shows that males are three times more likely to develop autism. The male-biased prevalence, together with the finding that autistic girls have a higher mutational load than autistic boys, suggests mechanisms of sexual differentiation in the development of this condition. Several recent findings support this hypothesis.

 

A team of scientists at the University of Cambridge and the State Serum Institute in Denmark tested the amniotic fluid of boys with and without autism (n = 98 and n = 177 respectively) from the Danish Historic Birth Cohort.

 

Levels of prenatal oestriol, oestradiol, oestrone and oestrone sulphate were significantly elevated, on average, in the 98 foetuses who later developed autism, compared to the 177 foetuses who did not. Interestingly, high levels of prenatal oestrogens were more predictive of autism development than were high levels of prenatal androgens (such as testosterone). Contrary to popular belief that associates oestrogens with feminisation, prenatal oestrogens have effects on brain growth and masculinise the brain in many mammals.

 

Genetics is a well-established primary cause for autism development, however the authors conclude that prenatal oestrogenic excess may interact with genetic predisposition to affect neurodevelopment.

 

It is not known whether these elevated hormones come from the mother, the baby or the placenta. The next step should be to study all these possible sources and how they interact during pregnancy.

 

Of note, the team cautioned that these findings cannot and should not be used to screen for autism. ‘We are interested in understanding autism, not preventing it’, added Professor Baron-Cohen, the lead author of the study.

 

In summary, scientists demonstrated that prenatal oestrogens are elevated in boys who later developed autism. This supports their previous finding of elevated prenatal steroidogenesis in the same cohort, together adding weight to the prenatal steroid theory of autism. Further, high levels of prenatal oestradiol contribute to a greater degree to autism likelihood than other prenatal sex steroids, including testosterone.

 

As I ended my previous article on the cause of autism, whether it be genetics or environment, the aetiological basis is likely to be during foetal development. Thus, a person with autism is born with autism.

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Red meat intake linked with higher risk of death in study of 81,469 adults

Increased red meat intake — especially processed red meat — is tied to increased risk of death over 8 years, according to results today in the British Medical Journal.

Results also suggested that substituting red meat with healthier alternatives, such as whole grains or vegetables, may lower the risk for death.

 

Making sense of the beef with red meat

This long-term study provides further evidence that reducing red meat intake while eating other protein foods or more whole grains and vegetables may reduce risk of premature death.

Red meat, especially processed meat, contains saturated fat, high levels of sodium, preservatives, and potential carcinogens that can contribute to health problems.

Eating red meat has been tied to increased risk for chronic diseases, such as cardiovascular disease, type 2 diabetes, and cancer. Processed red meat, like hot dogs and bacon, has been linked to an even larger number of health problems, as well as increased risk for death.

 

Study details

The authors of the study analysed data from two prospective US cohort studies: the Nurses’ Health Study (53,553 women) and the Health Professionals Follow-up Study (27,916 men). Participants were free from cardiovascular disease or cancer at baseline.

An important factor in the study is that the researchers looked at the change in consumption over time, rather than actual intake of red meat.

After adjusting for age, race, smoking, alcohol consumption, and several other factors, including baseline red meat consumption, the researchers found that increasing total red meat consumption by up to 3.5 servings per week over 8 years was linked to 10% higher risk for death compared with no change in red meat consumption.

When they distinguished between processed and unprocessed red meat, they found a similar trend, with the risk associated with processed meat higher than that for unprocessed meat. Specifically, increased consumption of processed red meat by up to 3.5 servings per week was tied to 13% increased risk for death, whereas the same increase in unprocessed red meat consumption was tied to 9% increased risk for death.

Results were similar regardless of age, physical activity level, diet quality, smoking, and alcohol consumption. Results were also similar with 4- and 12-year changes in consumption.

Risk for death decreased when one serving per day of red meat was replaced with one serving per day of nuts, whole grains, vegetables without legumes, dairy, eggs, and legumes.

 

Consistent with previous data

During the past decade, much has been written on diet and the association with cancer risk. A number of studies have found varying associations between the consumption of red meat and cancer.

In a recent study, published this year in the International Journal of Epidemiology, authors found that consuming a moderate amount of red or processed meat is associated with an increased risk of developing colorectal cancer.

According to their findings, an average of 76 grams of red meat or processed meat a day, which is in line with current government recommendations from the United Kingdom, was associated with a 20% higher chance of developing colorectal cancer as compared to consuming only about 21 grams a day.

The primary dataset used in this study is the UK Biobank cohort, comprised of almost 500,000 participants.

The American Institute for Cancer Research and the World Cancer Research Fund published several reports during the past 10 years or so on the effect of diet, nutrition, and/or physical activity on risk for several cancer types.

Their most recent study, published in 2017, found that consuming red meat and processed meat may increase the risk for colorectal cancer, as may drinking two or more alcoholic beverages per day. On the flip side, eating whole grains daily and ramping up activity levels can reduce the risk.

 

Conclusion

It is becoming increasingly clear that replacing meat with healthy plant based foods, such as vegetables or whole grains, can improve longevity.

But the health benefits of keeping meat of the menu is only one side of the issue. For conscience-stricken individuals, it is the colossal death and destruction caused by animal agriculture that makes meat unpalatable.

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Danish study shows MMR vaccine does not cause autism

A new large-scale Danish study concluded that the measles, mumps and rubella (MMR) vaccine does not increase the risk of autism, even in susceptible children. Once again, no links are found.

 

The study that sparked the storm

Andrew Wakefield’s famous study, published in 1998, first described a link between autism and the MMR vaccine. A flurry of fear among the public has since found no rest.

However, the evidence of that study is poor and circumstantial at best. There is no attempt made to show a proven mechanism of how the vaccination process could or did lead to the degeneration of behaviour observed. While there is undoubtedly a trend in their data, the authors are vastly overstating the likelihood that this could be a true causal association.

Importantly, this study does not include controls, such as patients with autism that were not vaccinated, neither does it suggest that this type of even-handed study should be done. It appears that the authors have ‘chosen’ a set of patients with autism to reach a presupposed conclusion. This is clear bias and should be accounted for.

Further, the paper was soon retracted as Wakefield was found guilty of fabricating data and violating ethical protocols. The confidence of the authors in their conclusions is thus unjustified.

Despite there being no convincing evidence that the MMR vaccine causes autism, there is an underground faction of concerned parents who believe that it does. One reason for this may be that ∼50,000 children per month, in Britain alone, receive the MMR vaccine between ages 1 and 2 years. This is at a time when autism typically presents. Thus, coincidental associations are inevitable.

 

The data are in, again

A new large study yet again found no association between the MMR vaccine and autism.

The researchers followed 657,461 Danish children born between 1999 and 2010 and compared autism rates in those who had received the MMR vaccine against those who did not.

In emphatic language they write, ‘The study strongly supports that MMR vaccination does not increase the risk for autism, [and] does not trigger autism in susceptible children’.

In further analyses, they also looked for links between vaccinations other than MMR and autism; again, they found none.

One of the study’s main strengths is the large number of individuals included in the analysis. As the authors write, the study’s size allowed them to conclude that ‘even minute increases in autism risk after MMR vaccination are unlikely’.

 

So, what causes autism? 

The aetiological basis of autism is predominantly genetic, and the apparent rise in diagnosis has more to do with increased awareness of the condition and changes in the diagnostic criteria. Nevertheless, while mutations in some genes are strongly implicated in autism, most associated variants confer modest increases in risk.

These genetic variants of small effect sizes can have a significant impact when present in certain combinations, or even lower the threshold of one acquiring the condition with exposure to environmental risk factors.

The answer to what causes autism is unlikely to reside solely in genetics. Recent studies suggest that environmental factors can cause autism, but this is most likely to occur in utero (during pregnancy). This is important because some parents are concerned that things such as high pollution or vaccines cause autism postpartum.

Regardless, the heritability of autism is estimated to be more than 90%. This means that more than 90% of the cause of autism is due to genetics.

 

Conclusion

With the continued generation of high-quality empirical evidence, the fears surrounding vaccines might, one day, be eradicated once and for all.

The bottom line is that whatever the cause of autism may be – genetic or environmental – it is likely to take effect during foetal development. Thus, a person with autism is born with autism.

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Teenagers are at risk using cannabis, experts warn

Researchers from UK and Canada carried out a systematic review and meta-analysis that measured cannabis use during adolescence, and evaluated the risk of depression, anxiety, and suicidality during young adulthood.

Among a cohort of 23,317 individuals, adolescent cannabis consumption was associated with a 37% increased risk of developing depression later in life.

The authors note that these findings should act as a warning to families and inform public health policy and governments to apply preventive strategies to cannabis use among youth.

 

The risks of cannabis

This study, published in the journal JAMA Psychiatry, is the first to quantify the actual risk in this way.

Among the increased risks of depression, the authors also investigated whether there was an association with anxiety and suicide attempts.

There was an increased risk of anxiety developing in young adulthood, but this was not considered statistically significant.

However, teenagers who used cannabis were three times more likely to try to kill themselves. The association between cannabis and suicidal behaviour has also been reported in previous studies.

Short term side effects of cannabis use range from anxiety and paranoia to problems with attention, memory and coordination. This explains why stoned drivers are twice as likely to crash their cars as nonusers.

Mental health problems are one of the greatest long-term effect concerns. Daily users have a doubled risk of developing schizophrenia in their lives compared to the general population, though the risk of other less serious mental health issues is even greater. Other issues include adverse birth outcomes during use in pregnancy and increased prevalence of respiratory diseases such as chronic bronchitis.

 

Cause and correlation

This study does not definitively prove that cannabis use causes depression and suicidal ideation. At best, one can only conclude that there is a strong correlation.

This is because of the impact cannabis has on the developing brain.

The adolescent brain is still under development and psychotropic drugs used during this time may disturb neurodevelopment, especially of the frontal cortex and limbic system.

To definitively confirm causation, studies would have to be conducted on young people, which of course is deemed unethical.

However, it doesn’t require a stretch of the imagination to postulate a causative link between a powerful mind-altering drug and mental health issues.

 

Conclusion

The cannabis leaf has become the symbol of the supposed sovereignty over the self, and propaganda runs rampant on social media to portray it as an astonishing wonder drug. There is thus an urgent need to implement better drug use prevention programs and interventions aimed at educating adolescents to resist peer pressure on drug consumption.

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Eating more fibre and whole grains lowers risk of death and disease, major study finds

Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g or more of dietary fibre a day, according to research commissioned by the World Health Organization.

 

People who had higher intakes of dietary fibre and whole grains had lower rates of chronic diseases, such as heart disease, cancer and diabetes, compared to those with diets low in fibre and whole grains.

 

Main findings

Current UK guidelines recommend that people eat 30g a day, yet only 9 per cent of British adults meet the target. Fibre consumption is even worse in the US, with the average adult eating just 15g of fibre a day.

 

Higher fibre diets were associated with a 15 to 31 percent reduction in the risk of death and disease. That meant 13 fewer deaths and six fewer cases of coronary heart disease, per 1,000 participants in the studies.

 

People with diets high in whole grains saw similar benefits, with up to 33 percent reduction in risk, translating to 26 fewer deaths and seven fewer cases of coronary heart disease.

 

The study, published in The Lancet, one of the most prestigious and oldest medical journals, suggests eating at least 25 to 29 grams of dietary fibre per day to achieve these health benefits. Higher intakes could produce more benefits; however, the authors note that consuming copious amounts of it could have ill-effects for people with low iron or mineral levels.

 

The research consisted of analysing 185 observational studies and 58 clinical trials that were conducted over nearly 40 years.

 

The importance

This landmark study is important and timely because the Internet is a wasteland of deranged dietary advice. Quack ‘doctors’, self-proclaimed nutritionists, and – excuse my French – broscience baloney have infiltrated forums, social media and YouTube. In particular, there is a growing trend advocating the carnivore diet. This consists of consuming only animal foods. No fruits. No vegetables. But all the burgers, steaks and pork chops you want, which are often eaten raw by enthusiasts.

 

This dangerous and stupid dietary advice is gaining popularity, despite it being diametrically opposed to the robust, high quality empirical evidence that continues to emerge in the scientific literature.

 

Supporting evidence

For instance, another recent study, also published in The Lancet, showed that Tsimane people (forager-horticulturalist population of the Bolivian Amazon) have the lowest reported levels of vascular ageing of all populations yet studied. It turns out that their diet is largely carbohydrate-based (72%) and includes high fibre foods such as rice, plantain, corn, nuts and fruits. Protein constitutes only 14% of their diet, and they consume very low levels of fat. So much for the carnivore diet.

 

Conclusion

In summary, recent studies confirm that fibre and whole grain intakes are vitally important for longer term health. If your current diet is low in fibre, increase it gradually to help avoid bowel upset.

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apple-watch-ecg

How Accurate Is The ECG Function In The Apple Watch 4?

The new Apple Watch 4 comes with several features, but the one that’s received the most attention is the ability to perform an electrocardiogram (ECG). An ECG is typically performed by attaching sensors to the skin which detect the electrical signals produced by the heart each time it beats.

But is Apple’s new feature sufficiently accurate to do more good than harm?

 

Portable ECG devices are nothing new

‘We’ve added electrodes into the back-sapphire crystal and the digital crown, allowing you to take an electrocardiogram’, said COO Jeff Williams, eliciting one of the day’s biggest rounds of applause. ‘This is the first ECG product offered over the counter, directly to consumers’.

It turns out that Apple’s new watch is not the first direct-to-consumer ECG. There are several different monitoring devices on the market that allow you to conduct your own ECG. One example is the monitor from AliveCor. It costs £100 and connects to your smartphone via Bluetooth. The company even offers a KardiaBand, also £100, which works with the original Apple Watch to add the same ECG functionality.

But let’s not concern ourselves with the novelty claim. The bigger question is whether it’s a good idea in the first place. Healthcare providers usually use ECGs in hospitals to measure the heart’s electrical activity and detect abnormalities in its rhythm. But with the latest iteration of its smartwatch, Apple wants to put an ECG on your wrist that you can use ‘anytime, anywhere’.

It sounds like a great idea, in theory.

ecg-iphone-apple

Conducting an ECG

Not only are ECG readings notoriously difficult to grasp even among medical professionals, it usually involves a more complex setup. The standard test is known as a 12-lead ECG, which simultaneously records electrical activity from multiple locations in the body giving you 12 different views of the heart.

 

Contrary to this, the Apple Watch 4 is equivalent to a single-lead ECG. On the back of the watch, there are electrodes built into the digital crown. Touching the digital crown with your finger for 30 seconds will create a closed loop that will then generate an ECG waveform.

Although it gives only one view of the heart it can still be useful. Indeed, some monitors that outpatients wear over an extended duration also offer one view.

 

‘It will save lives!’

‘Do you wind up catching a few undiagnosed cases? Sure. But for the vast majority of people it will have either no impact or possibly a negative impact by causing anxiety or unnecessary treatment’, says cardiologist Theodore Abraham, director of the UCSF Echocardiography Laboratory. The more democratised you make something like ECG, he says, the more you increase the rate of false positives – especially among the hypochondriac set. ‘In the case of people who are very type-A, obsessed with their health, and fitness compulsive, you could see a lot of them over using Apple’s tech to self-diagnose and have themselves checked out unnecessarily’.

A false positive result is when the monitoring device identifies an individual as being at risk of having a heart condition and is subsequently diagnosed as not being so. Direct-to-consumer screening devices, in general, will naturally aim to give an excess of false positives for fear of possible legal action. This would result in hordes of frantic, yet otherwise healthy, individuals rushing to see a doctor, thus placing excess pressure on the health service.

Screening for diseases is only a sieve – it will not pick up all cases, and some will be missed or develop soon after. The concern is whether home screening devices, such as Apple’s new watch, can prevent enough people from developing a serious disease to justify the burden of false positives.

The American Heart Association (AHA) does not endorse the watch, or any other products – and had no role in Apple’s ECG app. Yet this did not prevent Ivor Benjamin, president of the AHA, to give his support during Apple’s official unveiling of the watch: ‘Products that seek to provide deeper health insights, like the Apple Watch Series 4, offer great potential in getting us there’.

It’s also worth noting that the FDA has approved the ECG feature on the Apple watch, albeit with caveats. As expected, the FDA report injected a bit more modesty into the product, stating, ‘The ECG data displayed by the ECG app is intended for informational use only. The user is not intended to interpret or take clinical action’.

 

Conclusion

The Apple Watch 4 starts at £399 for the GPS-only model and increases to £499 if you upgrade to the cellular model. It offers several useful applications besides ECG monitoring and heart rate measurement. It can track falls and call emergency services if it doesn’t detect movement after a minute, alert users to low heart rates, and offers a host of fitness tracking features.

Although the Apple Watch 4 may not be as accurate as some other ECG devices, it could still prove useful for flagging up an undiagnosed heart condition and prompting further investigation. The question is whether Apple’s new feature can prevent enough people from developing a serious heart condition to justify the expense. It’s doubtful. But with all the data collected it could, with your permission, make you a research subject.

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childhood-boy-child-Childhood Cancer Awareness Month

Go Gold Through Childhood Cancer Awareness Month

The internationally recognised symbol for childhood cancer is the gold ribbon. During Childhood Cancer Awareness Month (CCAM) each September, people ‘Go Gold’ and raise awareness of the need for more research that leads to safer treatments and cures. The following are some facts and figures for childhood cancers and some suggestions on what you can do to help raise awareness.

child-cancer

Incidence

4,000 children and young people are diagnosed with cancer every year in the UK. That’s ten every day. In children under 14, the incidence is rare – around 1,600 new cases are diagnosed every year in the UK. This means that around one child in 500 will develop some form of cancer by the age of 14 years.

 

Different types

Tumours that affect children are in two major groups. The first is the leukaemia, which are cancers of the blood and bone marrow. The second is the ‘solid’ tumours; the most commonly affected area is the child’s central nervous system (brain and spinal cord).

The most common type of childhood cancer is a type of leukaemia, known as acute lymphoblastic leukaemia (ALL). Normally the bone marrow makes stem cells that mature into blood cells over time. In ALL, too many stem cells turn into immature white blood cells (lymphoblasts) that don’t mature into the normal blood cells (lymphocytes) that fight infection by attacking germs and other harmful bacteria.

The most common solid tumours of childhood affect the brain and spinal cord, and they have the highest mortality rate of the childhood cancers. Types include medulloblastoma, PNET, germ cell tumours, low-grade and high-grade gliomas, ependymoma, and astrocytoma.

 

Survival

Choosing optimal chemotherapy is no longer done by the oncologist alone, but by a large team of oncologists, pharmacists, cell biologists, and trial coordinators, who analyse the results from previous attempts to treat cancers and alter regimens accordingly. New developments are tested in large-scale multicentre trials, which most oncology patients are enrolled into. In this way, there has been a dramatic improvement in the outcome for most childhood and adult cancers over the last 20 years.

Fifty years ago, 75% of children diagnosed with cancer died; today the average five-year survival rate across all childhood cancer types is 82%. However, survival rates vary considerably between different types of childhood cancer and by age and gender. For e.g., the survival rate for retinoblastoma (eye cancer) has now reached 100%. For ALL it is 92%. Brain and spinal cord tumours have an overall survival rate of 75%. However, because brain tumours are one of the most common types of cancer, it accounts for more than a third of all childhood cancer deaths.

 

Causes

The causes of most childhood cancers are not known. About 5% of all cancers in children are caused by an inherited genetic mutation (a mutation that can be passed from parents to their children). For e.g., around 30% of cases of retinoblastoma are caused by an inherited mutation in a gene called RB1. But this explains little about the overall aetiology as retinoblastoma accounts for only about 4% of all cancers in children.

Most cancers are thought to develop because of mutations in genes that lead to uncontrolled cell growth. If the mutations are not inherited, they can arise spontaneously in an individual (de novo). These gene mutations can be the result of exposure to environmental factors. But in children, these environmental risk factors have been proven difficult to identify. Several studies have shown that exposure to ionizing radiation can damage DNA, which can lead to cancer. Genetic mutations that initiate cancer development can also arise during the development of a fetus in the womb. Parental exposure to cancer-causing chemicals or x-rays could be a catalyst for this.

Mutations in DNA repair pathways have been implicated in the production of chromosomal translocations. The Philadelphia chromosome is a specific genetic abnormality found in approximately 30% of adult ALL cases and 10% of paediatric ALL cases. It is a mutated form of chromosome 22 resulting from a translocation with chromosome 9. The mix of genetic material causes the ABL1 gene of chromosome 9 to combine with the BCR gene of chromosome 22, resulting in the fusion gene BCR-ABL1. The resulting BCR-ABL1 protein is a tyrosine kinase signalling protein that is constitutively active (i.e. always switched on) and rapidly drives cell proliferation.

Clearly, more work needs to be done to identify the causes of childhood cancers, which would help to develop novel therapeutic modalities.

 

Be bold and go gold

This article will have hopefully familiarised you with some facts and figures about childhood cancer. There are plenty of resources online if you feel inclined to delve deeper.

One way to show kids with cancer that they are not alone is to do something brave and bold. Shave Your Lid for a Kid and join the growing movement of everyday heroes standing in solidarity with the kids who need it the most.

More modestly, you can help raise awareness by wearing a gold ribbon, which is the official symbol for CCAM. And of course, to help drive research forward you can fundraise. From bike-a-thons to golf tournaments and everything in between, hosting a fundraiser is a great way to raise awareness.

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Honey-cold

A Spoonful Of Honey For That Cold

 

sick-cold-honeyHave you got a cough or cold?

Maybe you should think about treating it with good ol’ fashioned honey…that’s according to recent guidance by Public Health England (PHE) and the National Institute of Health and Care Excellence (NICE)

 

 

 

 

 

 

 

GPs like myself are being urged to encourage patients to use self care products to tackle those nasty bugs!

Self care products such as honey and over the counter cough mixtures including Beechams and Lemsip can be the key to tackle those nasty colds. They can help treat coughs and colds but also reduce the need for antibiotics.

Dr Tessa Lewis, a GP and chairwoman of the antimicrobial prescribing guidelines group, sums up the general management well.

 

“If someone has a runny nose, sore throat and cough, we would expect the cough to settle over two to three weeks and antibiotics are not needed.” 

“If the cough is getting worse rather than better, or the person feels very unwell or breathless, then they would need to contact their GP.”

 

So why is reducing the prescriptions of antibiotics a good thing, well its simple.

Taking antibiotics when you dont need them puts you and your family at risk of developing infections which are difficult to treat. It can have all sorts of nasty side effects including diarrhoea and nausea to name but a few.

You can also increase the likelihood of developing an antibiotic resistance. Which basically means when your older and genuinely in need of antibiotics to treat an infection, the antibiotics may not be as effective in treating the infection, if at all.

 

So that old saying you’ve heard over and over was right. Take a spoonful of honey for that cold.

 

 

 

 

 

 

 

 

 

 

By Dr Ashish Srivastava

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vape

Yes Or No? Vaping From A Doctor’s Perspective

 

 

vapingThe debate continues to rage on over Vaping. Is it safe? Does it help reduce or even stop people smoking cigarettes??

Having not been a smoker myself, but with more of my patients asking me about vaping vs smoking, I decided to look into it a little more.

There is no definitive answer to the above, as NICE (our clinical regulator) has informed us: ‘it’s too soon to tell’. E-cigarettes and Vaping are fairly young in their lives at the moment have only been around for the last decade. This has meant that there is little in the way of testing or evidence to look back at to make any firm conclusions. Basically, people have not been Vaping for long enough for us to know the long-term effects.

 

  1. Vaping is the inhalation of a water vapour.

A battery operating coil heats a liquid which contains nicotine that has been extracted from tobacco. It also includes flavourings and ‘other chemicals’ which together form the vapour that is inhaled.

It is thought that there are less ‘toxic chemicals’ in the vapour produced compared to the approximately 7,000 chemicals in tobacco cigarettes, most of which are toxic.

   

     2. There is still Nicotine in the Vape: the addiction continues:

Nicotine is still present in the vapour which means that users are still at risk of these harmful effects. These can include: addiction, withdrawal symptoms, rise in heart rate and blood pressure.

     

     3. Does it help you stop smoking?

The evidence is patchy here, but it is thought that because you can control the strength of the nicotine you can gradually wean yourself off it. The school of thought is that generally speaking those that vape are more likely to stop smoking than those who go cold turkey.

     

     4. Will it ‘explode’?

There have been several stories about vapes exploding in pockets and bags. This has been put down to misuse of the equipment. There is a standard regulated battery and coil length that is used. People who modify this e.g elongate the coil (allows for more vape), cause the battery to be overworked and can cause it to explode.

 

So – is it safe?  This would depend on the person asking it:

Ask me: a non-smoker, no addiction to nicotine, I would say – no it’s not safe.

Ask a smoker trying to quit – ‘yes, it is SAFER, than smoking a tobacco cigarette.’

 

 

 

 

 

By Dr Vibhu Kaushal

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espresso-regulate-blood-glucose-levels

Can An Espresso Regulate Blood Glucose Levels?

Coffee and healthA cup of coffee after a meal may soon be a way to adjust glucose levels in a person with diabetes.

 

 

 

 

 

 

 

 

 

 

 

What is diabetes?

There are two types of diabetes mellitus: type 1 and type 2. Both types are characterised by having higher than normal blood sugar levels, but the cause and development of the conditions are different.

Type 1 diabetes is an autoimmune disease, which means that the immune system mistakenly attacks insulin-producing beta cells in the pancreas. Patients with this condition need to inject themselves with insulin to compensate for the loss of their beta cells, rendering them insulin-dependent.

In contrast, type 2 diabetes is characterised by the body losing its ability to respond to insulin, which is known as insulin resistance. Diabetes affects more than 400 million people worldwide, and associated health costs amount to about 630 billion GBP per year.

Some people manage diabetes by taking frequent pin prick samples to measure their blood sugar levels. Type 1 diabetes is managed with insulin injections as well as lifestyle changes. Type 2 diabetes may be managed with non-insulin medications, insulin injections, or lifestyle changes.

However, scientists in Switzerland are developing a pioneering method that may render insulin injections unnecessary. Headed by Professor Martin Fussenegger, a biotechnologist at ETH Zurich, the researchers created genetically modified cells that are introduced into the body and release insulin as soon as they detect the presence of caffeine.

(Read more about the research)

 

Synthetic biology and gene circuits

The team took human kidney cells and engineered them to produce insulin. They did this by creating synthetic receptors on the kidney cells that sense caffeine. Once caffeine is detected, the cells produce synthetic human glucagon-like peptide 1 (shGLP-1), which stimulates the pancreas to produce insulin, thus lowering blood glucose levels.

Scientists introduced an implant with hundreds of thousands of modified cells under the skin of ten diabetic mice. After giving them caffeine with their food, they found that the experimental animals were now able to control their blood sugar levels, just as well as those mice that did not have diabetes.

Further, the automated bio-system seemed to safely keep the mice from accidentally overdosing on insulin. The risk of accidentally triggering insulin secretion is very low, as the only source of caffeine in our diet is coffee, tea or some energy drink. And if the insulin dose needs to be increased, it would be sufficient to increase the amount of caffeine, e.g. with a larger cup of coffee.

The cellular implant that responds directly to caffeine is estimated to last for six months to one year, before a replacement is needed. But it should be tested further on animals and humans before it is ready for use, which may take even a decade until it is safe and effective.

If, however, it works for humans just as well, then it is a candidate to replace insulin injections. Something particularly promising for the more than 400 million people around the world who have diabetes. Fortunately, as many people already drink some sort of caffeinated beverage, this therapy can be integrated with lifestyle, thus minimising the issue of non-compliance.

 

Conclusion

This work demonstrates a promising potential in the field of synthetic biology, which can improve healthcare with minimal disruptions to lifestyle. Drinking a cup of coffee after breakfast, lunch or dinner, depending on how much insulin is required, could be enough to bring blood glucose levels back within the normal range.

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