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MUSIC: "Our World" theme
Straight ahead on "Our World," ... Melting glaciers and rising sea levels ... calcium supplements to prevent broken bones: maybe ... and treating parasites to reduce the risk of AIDS.
HOTEZ: "For 40 cents an individual, we can make a very profound impact indirectly on HIV/AIDS and malaria just by treating the underlying worms."
Those stories, new insights from a long-ago war, plus much more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."
Avian, or bird flu continued its relentless advance this week. The virus has moved west into the heart of Western Europe, with infected birds now identified in Germany, Austria and Italy.
European Union veterinary experts held an emergency meeting in Brussels and adopted several measures, including the establishment of a 10-kilometer quarantine and surveillance zone around suspected or confirmed outbreaks. So far, the early detection and control measures have been effective in Europe, says Samuel Jutzi, an official of the U.N.'s Food and Agriculture Organization.
JUTZI: "There is no reason to panic in Europe. Europe has vigorous veterinary services, who are monitoring the situation carefully. Poultry in Europe, poultry products are safe to eat."
Meanwhile, officials are monitoring the status of bird flu cases in Nigeria. The World Health Organization's Africa director, Dr. Luis Sambo, said this week that it is crucial to contain the outbreak in Nigeria to avoid what he called a "public health nightmare."
A new study released this week says the more rapid melting of glaciers in Greenland may be causing global sea levels to rise faster than predicted. VOA's David McAlary reports.
McALARY: U.S. researchers say the movement of glaciers in the southern half of the Greenland ice sheet is accelerating, causing them to lose mass to the sea. Eric Rignot of the California Institute of Technology told a scientific meeting in St. Louis that the amount of ice being lost annually has more than doubled since 1996. The loss last year was 150 cubic kilometers.
RIGNOT: "The mass loss resulting from this glacier acceleration in Greenland is very significant. These are very active glaciers. They all end up in the ocean, discharge icebergs and are very dynamic. One you push them a little bit out of equilibrium, they start retreating very fast."
McALARY: His calculations are based on satellite observations of the moving glaciers taken in 1996, 2000, and last year. He and a colleague combined the movement data with ice thickness estimates to calculate Greenland's annual ice loss over the last decade. Their new paper in the journal "Science" is the first to include glacier velocity as a factor in the loss.
They say that rising air temperatures appear to be triggering the glacier speedup. They believe the base of the glaciers are lubricated by melting caused by the warming.
Rignot says the glacier movement is responsible for two-thirds of the ice loss, and is therefore a much more important factor than once thought. What this means, he says, is that Greenland is contributing more to sea level rise, about half a millimeter per year, than current estimates show.
RIGNOT: "You should view predictions of what it is going to do in the future as conservative because they did not include some of the processes that we are seeing. If I had to say something about the next 10 years, I would say it could be two to three times more than what has been predicted."
McALARY: Observations of South American glaciers show the same trend, according to Gino Casassa of the Center for Scientific Studies in Valdivia, Chile. He told the science meeting in St. Louis that the volume lost is smaller than in Greenland, but the melt still diminishes the amount of fresh water available while increasing glacier flooding and ice and rock falls.
CASASSA: "In Venezuela, for instance, there are practically no glaciers left. There is less than one square kilometer of glaciers. In the rest of South America, there is a similar situation. There are very few glaciers that are advancing in Patagonia and Tierra del Fuego basically, but the vast majority are retreating and thinning."
McALARY: concerning Greenland, Eric Rignot says that if warming continues, the recent trend of faster moving glaciers in southern Greenland may reach those in the northwestern part. David McAlary, VOA News, Washington.
Like all tissue in the body, bone tissue is constantly being broken down and replaced with new bone. The trouble is, as we age, the body doesn't replace all the bone, and the result is a gradual loss in bone density.
Women are affected more than men, and doctors often tell women — especially post-menopausal women — to take calcium supplements with vitamin D to help prevent broken bones.
This week, scientists published the results of a seven-year study of more than 36,000 women in their 50s, 60s and 70s on the usefulness of those supplements. Half the women were supposed to take a daily calcium supplement, and the other half got a placebo, a dummy pill. At the end of seven years, there was little difference between the two groups.
But the results were different when the researchers looked at two subgroups — women who actually took the supplements they were supposed to take, and those over 60.
Dr. Elizabeth Nabel of the National Heart, Lung and Blood Institute said in these subgroups, those taking daily calcium and vitamin D supplements did show a small but significant benefit in preserving bone mass.
NABEL: "The results also showed that supplements prevent hip fractures in certain groups, including older women. Women who consistently took the full supplemental dose did have a significant 29 percent decrease in hip fracture, and those older than 60 had a 21 percent reduction."
Reducing the risk of hip fractures is important because of the extreme impact such injuries can have on an older woman's life, says lead author Rebecca Jackson of Ohio State University.
JACKSON: "I think that one of the important things when looking at the hip fractures, is that hip fracture's the most debilitating fracture, and certainly that fracture which has the greatest impact on loss of independence and potentially loss of life. And so interventions that can decrease the risk of hip fractures may have a significant benefit in improving the quality as well as the length of life for post-menopausal women."
While the calcium-plus-vitamin-D supplements may offer some protection against hip fractures, there was no evidence they helped prevent other kinds of broken bones, nor did they protect against colorectal cancer. There was a small increase in the risk of kidney stones for women in the calcium-taking group.
The study was part of the Women's Health Initiative, a government program to investigate health issues facing older women. Jacques Rossuw of the Initiative summarized the take-home message of the study.
ROSSUW: "I think our findings say that all older women would be OK with getting adequate calcium and vitamin D, and if they don't meet it with dietary means and sunlight, they can take the supplements. But the benefit appears to be particularly pronounced in women older than 60, and these are the women who get most of the fractures.
But an editorial published with the study this week in the New England Journal of Medicine stresses the lack of a clear result from the overall study, not just from the subgroup of women who consistently took their calcium supplement. While the study did show a benefit for women in certain groups — such as those over age 60 — the editorial stressed that women should not believe that just because they take calcium supplements that they are protected against a debilitating hip fracture.
That calcium study is pretty complicated. And unless you are a specialist, if you tried to read the original paper, you would probably find it fairly difficult to understand. And as with many research papers, unless you have access to a university library, you probably have to pay for it — even if you access it online.
Our Website of the Week seeks to address both these issues, providing free access to papers published in some medical journals and adding material that helps explain the latest research in a way that ordinary folks can understand. It's called PatientInform.org. Brian Crawford, now with the American Chemical Society and a veteran of the scientific publishing industry, says the idea was hatched several years ago.
CRAWFORD: "The principle was rather simple: that we wanted to join with voluntary health organizations to provide an interpretive layer that would link the primary research content that many of us offer and provide that to patients in a way that could make a difference in their understanding of their medical conditions."
Partners in PatientInform.org include the American Cancer Society and similar groups focusing on heart disease, diabetes and other conditions.
Dr. Kenneth Moritsugu, U.S. Deputy Surgeon General, said the new website is similar what they do in his office — issuing what he called the "comic book" versions of important research reports, written so ordinary people can understand.
MORITSUGU: "Because information comes at you from all different directions and in all different manners, and it's important to be able to communicate that information to the individual in such a fashion that the individual can hear it, can understand it, can embrace it, and then put it into action."
When you visit the Patient Inform website, you can link to the latest research about cancer, heart disease, diabetes and some other conditions, with more expected to be added as new partners sign on. And the actual research articles are accompanied by other articles that help patients interpret the findings in language they can understand.
There's also important background information about medical studies in general and how they are conducted and published. All online at PatientInform.org, or get the link from our site, voanews.com/ourworld.
MUSIC: "Medicine Man" by Sam the Sham and the Pharaohs
It's VOA's science and technology magazine, Our World, I'm Art Chimes in Washington.
There's an interesting article in the New England Journal of Medicine this week about the future of telemedicine.
Many American hospitals are already practicing telemedicine on a limited basis. For example, a patient who has been in a car wreck here in Washington is brought in at two in the morning and gets an MRI. There's no trained radiologist at the hospital to interpret the results at that hour, so instead of calling someone in, the digitized images are sent electronically to India, where it's mid-day and where a qualified specialist evaluates the pictures and reports back the results.
Dr. Robert Wachter, author of the article, predicts that technology and pressures to keep costs down — especially in the United States — are going to drive increased out-sourcing of medical work.
WACHTER: "As we digitize more and more things you're going to have doctors performing laparoscopic surgery, robotic surgery, reading colonoscopies, reading echocardiograms, reading pathology specimens, who are not in the same building as the patient."
In fact there are already specialists known as "intensivists," who monitor critically ill hospital patients using closed circuit TV and remote monitoring equipment.
Although some analysts see value in medical outsourcing by stretching scarce health care resources, Dr. Wachter notes that patients could suffer if the focus is on saving money, rather than providing the best quality care.
At times of war or natural disaster, we often hear about post-traumatic stress disorder, or PTSD. It's a medical term that describes symptoms suffered by some people who have been exposed to horrible situations — your army buddy being killed as the two of you ride in a truck, or members of your family swept away in a flood before your very eyes.
Now a new study has, apparently for the first time, looked at the mental and physical effects of traumatic experience for decades afterwards.
SILVER: "With increasing traumatic exposure, one sees increasing and mental and physical health difficulties over the lifespan."
Professor Roxane Cohen Silver of the University of California — Irvine used data created from the records of tens of thousands of soldiers who served in the American Civil War in the 1860s.
SILVER: "The National Archives houses the original medical and military records from the Civil War. And a group of historians and economists spent about 15 years and millions of dollars to translate them and put them in a database that could be accessible to other researchers."
Although there is no one measure of traumatic experience in war, the researchers used the number of soldiers killed in a particular unit as measure, or "proxy," for the level of traumatic experiences a surviving member of that unit was exposed to. They reasoned that the more deaths in a unit, the more its soldiers would have had to handle bodies, seen friends being killed, or have similar experiences.
After the war, government doctors kept medical records on the veterans as part of the pension system. A century or more ago, of course, medical terminology was quite different, so modern day physicians reviewed the old records —
SILVER: "And they re-coded the medical diagnoses into current medical terminology."
So there were data both about the soldiers' wartime experiences and their medical experiences afterwards. Although this study was based on an enormous quantity of objective data, obviously, there were limitations.
SILVER: "For example, not all signs and symptoms of post-traumatic stress disorder were assessed during the Civil War because the diagnosis didn't exist at that time."
As a result, says Silver, they couldn't label veterans as having what we would now label post-traumatic stress disorder, because not all the symptoms of PTSD were noted at the time.
SILVER: "But back in the Civil War, symptoms that are very similar to PTSD were called 'irritable heart syndrome' or 'soldiers heart'."
Earlier studies have shown a link between traumatic experiences and mental illnesses afterwards. Silver says her study confirmed that, plus more
SILVER: "What we're seeing as new and unique in this study is demonstrating [that] not only are there mental health consequences, but we see physical health consequences and in fact, in some cases, early mortality as a result of increased traumatic exposure."
Professor Roxane Cohen Silver's study was published this month in the "Archives of General Psychiatry."
HIV/AIDS, tuberculosis and malaria — often referred to as the Big Three of the world's diseases — account for 5.6 million deaths each year, largely in the developing world. In recent years, more global resources have been committed to fight these diseases, but some health experts argue that greater attention to so-called 'neglected' tropical diseases could be a powerful aid in the fight against the Big Three. Rosanne Skirble explains:
SKIRBLE: In a United Nations meeting last month in Stockholm, Sweden, researchers warned that thirteen tropical diseases, when taken together, rank a close second for deadliness behind HIV/AIDS, TB and malaria.
These relatively neglected tropical diseases kill 530,000 people each year and disable many millions more, says Dr. Peter Hotez, professor and chair of the Department of Microbiology and Tropical Diseases at George Washington University.
HOTEZ: "Most of these 13 tropical diseases are parasitic infections. They include worm infections — diseases caused by parasitic worms, such as guinea worm, river blindness, elephantiasis, hookworm infections, schistosomiasis... and they include bacterial infections such as trachoma, Buruli ulcer, as well as leprosy."
SKIRBLE: Hotez says these infectious diseases retard childhood development and education and carry disfiguring stigmas. They also largely afflict the poor in the same rural communities of Sub-Saharan Africa and impoverished regions of the Americas, Southeast Asia and parts of India that are infected with AIDS, TB and malaria.
HOTEZ: "What this is saying is that when an individual gets AIDS or malaria in the developing world, they more often than not are simultaneously afflicted with hookworm and schistosomiasis or river blindness. And this profoundly affects the natural history of malaria or HIV/AIDS."
SKIRBLE: Hotez says multiple parasitic diseases promote the severity and increased number of cases of malaria and a more rapid decline among people with HIV/AIDS.
HOTEZ: "So for instance, treating a mother with underlying parasitic worms, just by treating the worms alone seems to have a huge impact on reducing the risk that she will transmit HIV/AIDS to her baby. So that in some cases, treating the underlying worms could have just as big an effect as anti-malarial bed nets."
SKIRBLE: Dr. Hotez says a cheap and effective treatment for neglected diseases already exists.
HOTEZ: "The estimates are that for 40 [U.S.] cents an individual, we can make a very profound impact indirectly on HIV/AIDS and malaria just by treating the underlying worms."
SKIRBLE: Hotez says $200 million would cover drugs that could control or eliminate seven of the tropical diseases in 500 million Africans.
HOTEZ: "This is actually an instance where it is not really the money. It is a little bit the money, but it is more the political will. It is educating the organizations that are controlling the Big Three on the importance of poly parasites."
SKIRBLE: Hotez says vaccines for certain diseases like hookworm look promising and could have a huge impact on the Big Three. It is surprising, he says that those aiming to control HIV/AIDS, TB and malaria have largely ignored these opportunities. I'm Rosanne Skirble.
Finally, today, a new study from Mexico on a disease you may have never heard of and its impact on poor, rural women in developing countries.
Tobacco smokers are known to be at risk for chronic obstructive pulmonary disease, or COPD, in which the air passages of the lungs become blocked. Patients have persistent cough, shortness of breath and other symptoms. This new study indicates that breathing smoke from wood-burning cook stoves can cause the disease, with medical costs and risks of death similar to those associated with COPD caused by smoking.
Dr. Alejandra Ramirez and her colleagues at Mexico's National Institute of Respiratory Diseases found similarities between people who smoke tobacco and those who spend hours a day, year after year, in smoky, poorly-ventilated kitchens.
RAMIREZ: "This is very common in rural areas, that women spend a lot of time in [the] kitchen. And the problem is that the kitchens are with poor ventilation, very badly ventilated."
In the study, she compared tobacco smokers to those exposed to wood, or biomass smoke. The tobacco smokers were mainly men.
RAMIREZ: "Women were mainly affected in biomass group. So it's a problem of gender. Whereas smokers were mainly men."
Ramirez says that in comparison to cigarette smokers, the women are exposed to smoke from wood stove starting as little girls, learning domestic skills from their mothers.
RAMIREZ: "These young girls are more susceptible to present the problem because in our country these girls used to help mothers in the kitchen since they are little girls, spending around six to eight hours a day in poorly ventilated rooms. These girls, as women, may be more susceptible to pulmonary infection and the problem is a very long time of exposure."
Although Dr. Ramirez's study was done in Mexico, cooking over stoves fueled by wood is common throughout developing countries, especially in rural areas. It is cheap fuel, and it's the traditional way of cooking. Environmentalists worry that the gathering of wood contributes to deforestation. Now this report [published in the American Journal of Respiratory and Critical Care Medicine] raises a more immediate health threat to women who are working hard to feed their families.
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Our show was edited by Rob Sivak. Eva Nenicka is our technical director. And this is Art Chimes, inviting you to join us online at voanews.com/ourworld or on your radio next Saturday and Sunday as we check out the latest in science and technology...in Our World.