New malaria method could boost drug production

BERLIN (AP) — German scientists have developed a new way to make a key malaria drug that they say could easily quadruple production and drop the price significantly, increasing the availability of treatment for a disease that kills hundreds of thousands every year.

Chemists at the Max Planck Institute take the waste product from the creation of the drug artemisinin — artemisinic acid — and convert it into the drug itself.

The entire apparatus is compact, about the size of a carry-on suitcase, and inexpensive. That means it can be easily added to production sites anywhere around the world.

"Four hundred of these would be enough to make a world supply of artemisinin," said unit director Peter Seeberger, pointing to the machine on a table in his lab in Berlin's Dahlem neighborhood. "The beauty of these things is they're very small and very mobile."

A paper on the new technique was published this month in chemistry journal Angewandte Chemie.

Artemisinin is extracted from sweet wormwood, a plant that primarily grows in China and Vietnam and varies in its availability according to the season. In the extraction process, for every part artemisinin produced, there is 10 times the amount of artemisinic acid discarded as waste.

Past attempts to convert the acid using ultraviolet light to trigger the conversion have been unsuccessful because the process took several steps in a large tank of acid, making production inefficient and far too expensive.

So the Max Planck chemists thought small — creating a machine that pumps all of the required ingredients through a thin tube wrapped around a UV lamp in a continuous process that takes 4 1/2 minutes from start-to-finish to produce the artemisinin.

The technique can convert about 40 percent of the waste acid into artemisinin — producing four times more of the drug from what had in the past been discarded, Seeberger said.

Colin Sutherland, a malaria expert at the London School of Hygiene and Tropical Medicine who was not involved in the Max Planck research, said the development could be significant in boosting production of the key malaria drug. He noted that currently very little artemisinin can be made from a large amount of the sweet wormwood, which is also difficult to grow.

"If it's a simple process, given a certain amount of plant material, you can generate more drugs, that will make things cheaper and faster," he said.

Since the end product is the same molecule, there should be no decrease in effectiveness of the synthetic product, Sutherland said.

Seeberger said a commercial prototype of the Max Planck machine could be ready in about six months and that it could go into production in about a year. He said current price estimates are around euro100,000 (US$132,000).

When it's in production, the idea is to make it available for a minimal fee to cover costs, he said.

"The goal is to make sure that the drug is produced and made available to as many people as possible," said Seeberger, a former Massachusetts Institute of Technology professor who now teaches at Berlin's Free University.

Sabine Haubenreisser, a spokeswoman at the European Medicines Agency, said that if the new drug is close enough to the original, its producers could apply for it to be considered as a generic product or use older data proving artemesinin's effectiveness — which could speed the approval process.

Malaria cases and deaths have been dropping since 2004, due largely to campaigns to distribute bednets, spray homes with insecticide and make better drugs available. The World Health Organization estimates that at least 655,000 people die of malaria every year, mostly children under 5 in Africa.

At the moment, artemisinin-based therapies are considered the best treatment, but cost about $10 per dose — far too much for impoverished communities.

Former U.S. President Bill Clinton's Clinton Foundation currently has a program to purchase the treatments, then sell them at a deeply discounted 50 cents to communities where they're most needed.

Cutting the price further while increasing production could "make a big difference," said Sutherland.

"Many times more children will have access to the right drug early in their disease and that's likely to have an impact on mortality."

___

AP Medical Writer Maria Cheng contributed to this report from London.

View the original article here

As Police Strike in Brazil, Carnival Could Be a Danger

The strike by police officers in Brazil’s northeast state of Bahia seemed to lose its momentum on Thursday with the arrests of several of the movement’s leaders. But a vote on Thursday night by police officers here in Rio to strike immediately, and the threat of other work stoppages by police unions in several Brazilian states, have kept regions of the country on edge.

More than a thousand police officers and firefighters gathered in downtown Rio on Thursday night to pressure lawmakers to vote for a measure that would raise their salaries. Sérgio Simões, a state defense official, told reporters here that the federal authorities had agreed to make 14,000 soldiers and national police officers available to maintain order in the state of Rio de Janeiro in case a strike took place.

In the northeast, the authorities registered at least 142 homicides during the strike in the metropolitan area of Salvador, Bahia’s capital, more than double the number in the same period last year. The strike has also been marked by clashes between rebellious police officers and federal security forces sent by the authorities in Brasília, the national capital, to reassert order on Salvador’s streets.

A strike could be even more tumultuous in Rio, especially during Carnival later this month, when throngs of visitors flood the streets and violent crime is a concern even when the regular police force is working.

The strike in Bahia revolved around demands by the military police, who do most of the street policing in Brazil, for wage and benefit increases, focusing new attention on Brazil’s income disparities. An array of social welfare programs have lifted millions of Brazilians from dire poverty over the last decade, but salaries for many public employees, including police officers and schoolteachers, remain relatively low.

While Brazil’s cost of living rivals that of the United States and surpasses it in some places, police officers in Bahia earn about $1,250 a month. Salaries for police officers in Rio de Janeiro are lower, roughly $1,170 a month when some benefits are included. About one-third of Bahia’s 31,000-member military police force adhered to the strike, which began when Bahia’s governor, Jaques Wagner, was away in Cuba.

“This strike should be a wake-up call for the entire country,” said Romeu Karnikowski, a sociologist who specializes in Brazil’s public security policies. “Brazil now has the world’s sixth-largest economy, but our policing model is an embarrassing failure.”

The strike opened a window into the disorder and disparity that characterize some of Brazil’s police forces. Other states, like Ceará in Brazil’s northeast and Pará in the Amazon, have recently suffered similar strikes. Elsewhere, corrupt police officers, like the militias and extermination squads of Rio de Janeiro, have been implicated in carrying out hideous crimes.

Scholars who study the police attribute some of the corruption to low salaries and a lack of prestige. Policing on the street level is often left to large contingents of low-paid, relatively untrained recruits in the military police, a force that is considered an auxiliary of the Brazilian Army and that is subordinated to state governments.

Meanwhile, administrative duties like investigating crimes are often the responsibility of each state’s civil police, who enjoy somewhat higher status and better salaries. Here in Rio, both the military and the civil police voted to go on strike, as did the state’s firefighters.

Brazil also has a well-paid federal police force, which investigates crimes like drug trafficking and ranks among Latin America’s most respected law enforcement entities.

In Bahia, intercepted cellphone conversations among leaders of the police strike, recorded by intelligence officials and broadcast on the Globo television network, suggested that rebellious police officers were plotting acts of vandalism and were trying to extend the strike to Brazil’s two most powerful states, São Paulo and Rio de Janeiro.

Brazil’s president, Dilma Rousseff, speaking on Thursday from the northeast state of Pernambuco, said she was “terrified” after hearing the intercepted calls. “I do not consider the increase of murders in the street, burning buses, to be the correct way of leading a movement,” she said.

Still, the arrest of the leaders of Bahia’s police strike failed to put a definitive end to it, with officers there opting Thursday to continue the stoppage. Veja, a leading newsmagazine, said that police officers in as many as eight states were considering going on strike, timing their decisions ahead of Carnival.

The Bahia strike has divided Brazil’s judges and legal scholars as to whether it is legal, since the military police are subordinated to the army. One federal judge, Marcus Orione Gonçalves of São Paulo, argued that the police had the right to strike. But João Oreste Dalazen, the president of Brazil’s Superior Labor Tribunal, described the events in Bahia as a “rebellion” instead of a strike, telling reporters that the police there were carrying out an “aggression” against the democratic rule of law.

At the same time that Bahia’s police strike stunned the country, Brazil’s judges have been defending generous benefits of their own, adding to a debate over the country’s broad discrepancy in public-sector pay.

In the state of Rio de Janeiro, for instance, the so-called super-salaries for some judges are $23,000 to $87,000 a month, according to a report in the newspaper Estado de São Paulo.

View the original article here

Aspirin could beat cancer spread: Australian study

Aspirin and other household drugs may inhibit the spread of cancer because they help shut down the chemical "highways" which feed tumours, Australian researchers said Tuesday.

Scientists at Melbourne's Peter MacCallum Cancer Centre said they have made a biological breakthrough helping explain how lymphatic vessels -- key to the transmission of tumours throughout the body -- respond to cancer.

"We've shown that molecules like the aspirin... could effectively work by reducing the dilation of these major vessels and thereby reducing the capacity of tumours to spread to distant sites," researcher Steven Stacker said.

Doctors have long suspected that non-steroidal anti-inflammatory drugs such as aspirin may help inhibit the spread of cancer but they have been unable to pinpoint exactly how this is done.

By studying cells in lymphatic vessels, the researchers found that a particular gene changed its expression in cancers which spread, but not when the cancer did not spread.

The results published in Cancer Cell journal reveal that the gene is a link between a tumour's growth and the cellular pathway which can cause inflammation and dilation of vessels throughout the body.

Once these lymphatic vessels widen, the capacity for them to act as "supply lines" to tumours and become more effective conduits for the cancer to spread is increased.

But aspirin acts to shut down the dilation of the vessels.

"So it seems like we have found a pivotal junction point in a biochemical sense between all these different contributors," Stacker said.

The discovery could lead to new and improved drugs which could help contain many solid tumours, including breast and prostate cancer, as well as potentially provide an "early warning system" before a tumour begins to spread.

Last year, a study published in medical journal The Lancet found that rates of cancer of the colon, prostate, lung, brain and throat were all reduced by daily aspirin use.

Many doctors recommend regular use of aspirin to lower the risk of heart attack, clot-related strokes and other blood flow problems. A downside of extended daily use is the risk of stomach problems.

mfc/mp/jms

View the original article here

Recent Pot Use Could Double Risk of Car Crash, Research Shows

THURSDAY, Feb. 9 (HealthDay News) -- Getting behind the wheel within three hours after using marijuana nearly doubles a driver's risk of having an accident, a large new research review finds.

The risk is especially high for fatal crashes, and the risk is only a little less than that of people who drive drunk, Canadian researchers say.

"On the whole, alcohol increases the risk of a crash at a higher level than cannabis [marijuana]," said lead researcher Mark Asbridge, an associate professor in the community health and epidemiology department at Dalhousie University, in Halifax.

But marijuana makes it harder to judge distance and drivers often tailgate and swerve from lane to lane, which cuts down their reaction time and leads to crashes, he explained.

Although the extent of the problem isn't known, some studies have found that 5 percent of people report driving after using marijuana; and for those under age 25, as many as 20 percent, Asbridge said.

Studies on the effect of driving under the influence of marijuana have had mixed results, he said.

"There were some studies finding that cannabis actually had a negative association with crash risk, so people were actually safer using cannabis driving than when they weren't, but these were poorly designed studies," Asbridge said.

"So our study gives some clarity to the issue in showing a doubling of the risk in the very best studies that are out there and adds some level of justification to existing policies that restrict drug-impaired driving," he said.

The report was published in the Feb. 10 online edition of the BMJ.

To see how marijuana affected driving, Asbridge's team reviewed nine studies that included more than 49,000 people. This process -- called a meta-analysis -- looks for patterns across studies.

The researchers found that those driving under the influence of marijuana were nearly twice as likely to have a car crash as those who were not under the influence.

Studies outside the review have shown that drivers aged 35 and younger are more likely to have car accidents after using marijuana, the authors noted.

"These findings reaffirm many of our accepted understandings regarding acute cannabis intoxication and psychomotor performance," said Paul Armentano, deputy director of NORML (the National Organization for the Reform of Marijuana Laws). "That is why operating a motor vehicle while acutely impaired by cannabis is presently a criminal offense in all 50 states."

This risk appears to be greatest in less-experienced cannabis users, younger drivers, and among those who combine the use of cannabis and alcohol, Armentano pointed out.

"That said, it should further be noted that cannabis-induced changes in performance are typically subtle, short-lived and less dramatic in more experienced cannabis consumers, who appear to develop tolerance to some of the drug's behavioral effects," he added.

"Further, this overall elevated risk is far less than the elevated risk of accidents associated with the consumption of alcohol, including its use in legal quantities," Armentano said.

While some suggest that drivers should be tested for marijuana, so far, no effective test exists that can be done at a traffic stop to accurately pinpoint when a driver used the drug.

"This evidence makes a case for introducing policies to reduce cannabis-impaired driving," said Wayne Hall, from the University of Queensland Centre for Clinical Research in Brisbane, Australia. He wrote an accompanying editorial for the journal.

He said that roadside drug testing, such as that used for alcohol, may be a useful approach.

But there are no handy devices, such as a breathalyzer, to tell if someone has recently used marijuana, Asbridge noted.

"The challenge is defining a level that equates with impairment. A number of countries have already introduced roadside testing by deciding that any detectable evidence of recent use constitutes impaired driving. However, we do not know how effective testing has been because the policy has not been evaluated," Hall said.

Another expert outlined the problems with such tests.

"Because THC, the active ingredient in marijuana, can be detected several weeks after use of marijuana, it is hard to determine with certainty if a driver testing positive for marijuana is indeed impaired by the substance at the time of testing," said Dr. Guohua Li, a professor of epidemiology at Columbia University in New York City.

So more research is needed. "This issue is especially urgent and important in light of the ongoing epidemic of drugged driving and increased permissibility and availability of marijuana worldwide," Li said.

While recognition that driving under the influence of marijuana is a problem is a first step in finding ways to curb it, Jan Withers, national president of Mothers Against Drunk Driving (MADD), stated that "drunk driving remains the primary threat to our families on the road."

However, she added, "this study underscores the importance of the work that MADD is doing to support people who have been victimized by drugged driving and recognize law-enforcement's efforts to pioneer effective strategies to stop drugged driving. Notably, it shows the increased danger posed by those drivers using both alcohol and drugs."

More information

For more about drugged driving, visit the U.S. National Institute on Drug Abuse.

View the original article here

Pot Use Could Double Risk of Car Crash, Research Shows

THURSDAY, Feb. 9 (HealthDay News) -- Getting behind the wheel within three hours after using marijuana nearly doubles a driver's risk of having an accident, a large new research review finds.

The risk is especially high for fatal crashes, and the risk is only a little less than that of people who drive drunk, Canadian researchers say.

"On the whole, alcohol increases the risk of a crash at a higher level than cannabis [marijuana]," said lead researcher Mark Asbridge, an associate professor in the community health and epidemiology department at Dalhousie University, in Halifax.

But marijuana makes it harder to judge distance and drivers often tailgate and swerve from lane to lane, which cuts down their reaction time and leads to crashes, he explained.

Although the extent of the problem isn't known, some studies have found that 5 percent of people report driving after using marijuana; and for those under age 25, as many as 20 percent, Asbridge said.

Studies on the effect of driving under the influence of marijuana have had mixed results, he said.

"There were some studies finding that cannabis actually had a negative association with crash risk, so people were actually safer using cannabis driving than when they weren't, but these were poorly designed studies," Asbridge said.

"So our study gives some clarity to the issue in showing a doubling of the risk in the very best studies that are out there and adds some level of justification to existing policies that restrict drug-impaired driving," he said.

The report was published in the Feb. 10 online edition of the BMJ.

To see how marijuana affected driving, Asbridge's team reviewed nine studies that included more than 49,000 people. This process -- called a meta-analysis -- looks for patterns across studies.

The researchers found that those driving under the influence of marijuana were nearly twice as likely to have a car crash as those who were not under the influence.

Studies outside the review have shown that drivers aged 35 and younger are more likely to have car accidents after using marijuana, the authors noted.

"These findings reaffirm many of our accepted understandings regarding acute cannabis intoxication and psychomotor performance," said Paul Armentano, deputy director of NORML (the National Organization for the Reform of Marijuana Laws). "That is why operating a motor vehicle while acutely impaired by cannabis is presently a criminal offense in all 50 states."

This risk appears to be greatest in less-experienced cannabis users, younger drivers, and among those who combine the use of cannabis and alcohol, Armentano pointed out.

"That said, it should further be noted that cannabis-induced changes in performance are typically subtle, short-lived and less dramatic in more experienced cannabis consumers, who appear to develop tolerance to some of the drug's behavioral effects," he added.

"Further, this overall elevated risk is far less than the elevated risk of accidents associated with the consumption of alcohol, including its use in legal quantities," Armentano said.

While some suggest that drivers should be tested for marijuana, so far, no effective test exists that can be done at a traffic stop to accurately pinpoint when a driver used the drug.

"This evidence makes a case for introducing policies to reduce cannabis-impaired driving," said Wayne Hall, from the University of Queensland Centre for Clinical Research in Brisbane, Australia. He wrote an accompanying editorial for the journal.

He said that roadside drug testing, such as that used for alcohol, may be a useful approach.

But there are no handy devices, such as a breathalyzer, to tell if someone has recently used marijuana, Asbridge noted.

"The challenge is defining a level that equates with impairment. A number of countries have already introduced roadside testing by deciding that any detectable evidence of recent use constitutes impaired driving. However, we do not know how effective testing has been because the policy has not been evaluated," Hall said.

Another expert outlined the problems with such tests.

"Because THC, the active ingredient in marijuana, can be detected several weeks after use of marijuana, it is hard to determine with certainty if a driver testing positive for marijuana is indeed impaired by the substance at the time of testing," said Dr. Guohua Li, a professor of epidemiology at Columbia University in New York City.

So more research is needed. "This issue is especially urgent and important in light of the ongoing epidemic of drugged driving and increased permissibility and availability of marijuana worldwide," Li said.

While recognition that driving under the influence of marijuana is a problem is a first step in finding ways to curb it, Jan Withers, national president of Mothers Against Drunk Driving (MADD), stated that "drunk driving remains the primary threat to our families on the road."

However, she added, "this study underscores the importance of the work that MADD is doing to support people who have been victimized by drugged driving and recognize law-enforcement's efforts to pioneer effective strategies to stop drugged driving. Notably, it shows the increased danger posed by those drivers using both alcohol and drugs."

More information

For more about drugged driving, visit the U.S. National Institute on Drug Abuse.

View the original article here

'Hunger hormone' could help chemo patients: study

NEW YORK (Reuters Health) - A synthetic version of the "hunger hormone" ghrelin might help limit the loss of appetite that can come with cancer chemotherapy, a small study from Japan suggests.

Ghrelin is a hormone secreted by the gut to boost appetite. Because of that, scientists have been studying it as a target in the obesity war, which has included work on an anti-obesity "vaccine" that inhibits ghrelin. But the research has met with little success so far.

Since the hormone spurs hunger, in theory, infusions of synthetic ghrelin could help prevent the sometimes severe appetite loss caused by cancer drugs.

In particular, a commonly used cancer drug called cisplatin often causes nausea, vomiting and appetite loss -- and cuts the body's natural ghrelin levels.

For the new study, Japanese researchers tested the effects of ghrelin infusions in 41 patients undergoing cisplatin treatment for advanced cancer of the esophagus.

Half of the patients were randomly assigned to have ghrelin infusions twice a day, before their meals, over one week of chemotherapy. The rest were given infusions of saline.

In the end, the ghrelin patients maintained better appetites and were able to take in almost 50 percent more calories per day than patients given saline.

Overall, more than half of the saline group had nausea, versus one in five ghrelin patients. And while half of the saline group had anorexia -- significant appetite loss -- during chemo, only one in six ghrelin patients did.

Dr. Yuichiro Hiura and colleagues at Osaka University report their findings in the journal Cancer. The study was funded by a grant from the Japanese government.

It appears to be the first to show that ghrelin may help cancer patients being treated with cisplatin, so further studies are needed, the researchers say.

There is already a medication -- one that decreases the activity of the hormone serotonin -- that eases nausea and vomiting in the first 24 hours of cisplatin treatment, Hiura's team notes.

But, they add, lingering nausea and appetite loss in the following days are still a challenge to control. So ghrelin could offer a way to help with those longer-term effects.

Intensive chemotherapy with multiple drugs, including cisplatin, is commonly used for advanced-stage cancer, Hiura's team writes. But side effects may keep many patients from completing their treatment.

Ultimately, the researchers say, the goal is to make chemotherapy easier for patients to get through -- and, it's hoped, improve the treatment's effectiveness.

SOURCE: http://bit.ly/wB771x Cancer, online January 26, 2012.

View the original article here

'Hunger hormone' could help chemo patients: study

NEW YORK (Reuters Health) - A synthetic version of the "hunger hormone" ghrelin might help limit the loss of appetite that can come with cancer chemotherapy, a small study from Japan suggests.

Ghrelin is a hormone secreted by the gut to boost appetite. Because of that, scientists have been studying it as a target in the obesity war, which has included work on an anti-obesity "vaccine" that inhibits ghrelin. But the research has met with little success so far.

Since the hormone spurs hunger, in theory, infusions of synthetic ghrelin could help prevent the sometimes severe appetite loss caused by cancer drugs.

In particular, a commonly used cancer drug called cisplatin often causes nausea, vomiting and appetite loss -- and cuts the body's natural ghrelin levels.

For the new study, Japanese researchers tested the effects of ghrelin infusions in 41 patients undergoing cisplatin treatment for advanced cancer of the esophagus.

Half of the patients were randomly assigned to have ghrelin infusions twice a day, before their meals, over one week of chemotherapy. The rest were given infusions of saline.

In the end, the ghrelin patients maintained better appetites and were able to take in almost 50 percent more calories per day than patients given saline.

Overall, more than half of the saline group had nausea, versus one in five ghrelin patients. And while half of the saline group had anorexia -- significant appetite loss -- during chemo, only one in six ghrelin patients did.

Dr. Yuichiro Hiura and colleagues at Osaka University report their findings in the journal Cancer. The study was funded by a grant from the Japanese government.

It appears to be the first to show that ghrelin may help cancer patients being treated with cisplatin, so further studies are needed, the researchers say.

There is already a medication -- one that decreases the activity of the hormone serotonin -- that eases nausea and vomiting in the first 24 hours of cisplatin treatment, Hiura's team notes.

But, they add, lingering nausea and appetite loss in the following days are still a challenge to control. So ghrelin could offer a way to help with those longer-term effects.

Intensive chemotherapy with multiple drugs, including cisplatin, is commonly used for advanced-stage cancer, Hiura's team writes. But side effects may keep many patients from completing their treatment.

Ultimately, the researchers say, the goal is to make chemotherapy easier for patients to get through -- and, it's hoped, improve the treatment's effectiveness.

SOURCE: http://bit.ly/wB771x Cancer, online January 26, 2012.

View the original article here

Recent Pot Use Could Double Risk of Car Crash, Research Shows

THURSDAY, Feb. 9 (HealthDay News) -- Getting behind the wheel within three hours after using marijuana nearly doubles a driver's risk of having an accident, a large new research review finds.

The risk is especially high for fatal crashes, and the risk is only a little less than that of people who drive drunk, Canadian researchers say.

"On the whole, alcohol increases the risk of a crash at a higher level than cannabis [marijuana]," said lead researcher Mark Asbridge, an associate professor in the community health and epidemiology department at Dalhousie University, in Halifax.

But marijuana makes it harder to judge distance and drivers often tailgate and swerve from lane to lane, which cuts down their reaction time and leads to crashes, he explained.

Although the extent of the problem isn't known, some studies have found that 5 percent of people report driving after using marijuana; and for those under age 25, as many as 20 percent, Asbridge said.

Studies on the effect of driving under the influence of marijuana have had mixed results, he said.

"There were some studies finding that cannabis actually had a negative association with crash risk, so people were actually safer using cannabis driving than when they weren't, but these were poorly designed studies," Asbridge said.

"So our study gives some clarity to the issue in showing a doubling of the risk in the very best studies that are out there and adds some level of justification to existing policies that restrict drug-impaired driving," he said.

The report was published in the Feb. 10 online edition of the BMJ.

To see how marijuana affected driving, Asbridge's team reviewed nine studies that included more than 49,000 people. This process -- called a meta-analysis -- looks for patterns across studies.

The researchers found that those driving under the influence of marijuana were nearly twice as likely to have a car crash as those who were not under the influence.

Studies outside the review have shown that drivers aged 35 and younger are more likely to have car accidents after using marijuana, the authors noted.

"These findings reaffirm many of our accepted understandings regarding acute cannabis intoxication and psychomotor performance," said Paul Armentano, deputy director of NORML (the National Organization for the Reform of Marijuana Laws). "That is why operating a motor vehicle while acutely impaired by cannabis is presently a criminal offense in all 50 states."

This risk appears to be greatest in less-experienced cannabis users, younger drivers, and among those who combine the use of cannabis and alcohol, Armentano pointed out.

"That said, it should further be noted that cannabis-induced changes in performance are typically subtle, short-lived and less dramatic in more experienced cannabis consumers, who appear to develop tolerance to some of the drug's behavioral effects," he added.

"Further, this overall elevated risk is far less than the elevated risk of accidents associated with the consumption of alcohol, including its use in legal quantities," Armentano said.

While some suggest that drivers should be tested for marijuana, so far, no effective test exists that can be done at a traffic stop to accurately pinpoint when a driver used the drug.

"This evidence makes a case for introducing policies to reduce cannabis-impaired driving," said Wayne Hall, from the University of Queensland Centre for Clinical Research in Brisbane, Australia. He wrote an accompanying editorial for the journal.

He said that roadside drug testing, such as that used for alcohol, may be a useful approach.

But there are no handy devices, such as a breathalyzer, to tell if someone has recently used marijuana, Asbridge noted.

"The challenge is defining a level that equates with impairment. A number of countries have already introduced roadside testing by deciding that any detectable evidence of recent use constitutes impaired driving. However, we do not know how effective testing has been because the policy has not been evaluated," Hall said.

Another expert outlined the problems with such tests.

"Because THC, the active ingredient in marijuana, can be detected several weeks after use of marijuana, it is hard to determine with certainty if a driver testing positive for marijuana is indeed impaired by the substance at the time of testing," said Dr. Guohua Li, a professor of epidemiology at Columbia University in New York City.

So more research is needed. "This issue is especially urgent and important in light of the ongoing epidemic of drugged driving and increased permissibility and availability of marijuana worldwide," Li said.

While recognition that driving under the influence of marijuana is a problem is a first step in finding ways to curb it, Jan Withers, national president of Mothers Against Drunk Driving (MADD), stated that "drunk driving remains the primary threat to our families on the road."

However, she added, "this study underscores the importance of the work that MADD is doing to support people who have been victimized by drugged driving and recognize law-enforcement's efforts to pioneer effective strategies to stop drugged driving. Notably, it shows the increased danger posed by those drivers using both alcohol and drugs."

More information

For more about drugged driving, visit the U.S. National Institute on Drug Abuse.

View the original article here

Pot Use Could Double Risk of Car Crash, Research Shows

THURSDAY, Feb. 9 (HealthDay News) -- Getting behind the wheel within three hours after using marijuana nearly doubles a driver's risk of having an accident, a large new research review finds.

The risk is especially high for fatal crashes, and the risk is only a little less than that of people who drive drunk, Canadian researchers say.

"On the whole, alcohol increases the risk of a crash at a higher level than cannabis [marijuana]," said lead researcher Mark Asbridge, an associate professor in the community health and epidemiology department at Dalhousie University, in Halifax.

But marijuana makes it harder to judge distance and drivers often tailgate and swerve from lane to lane, which cuts down their reaction time and leads to crashes, he explained.

Although the extent of the problem isn't known, some studies have found that 5 percent of people report driving after using marijuana; and for those under age 25, as many as 20 percent, Asbridge said.

Studies on the effect of driving under the influence of marijuana have had mixed results, he said.

"There were some studies finding that cannabis actually had a negative association with crash risk, so people were actually safer using cannabis driving than when they weren't, but these were poorly designed studies," Asbridge said.

"So our study gives some clarity to the issue in showing a doubling of the risk in the very best studies that are out there and adds some level of justification to existing policies that restrict drug-impaired driving," he said.

The report was published in the Feb. 10 online edition of the BMJ.

To see how marijuana affected driving, Asbridge's team reviewed nine studies that included more than 49,000 people. This process -- called a meta-analysis -- looks for patterns across studies.

The researchers found that those driving under the influence of marijuana were nearly twice as likely to have a car crash as those who were not under the influence.

Studies outside the review have shown that drivers aged 35 and younger are more likely to have car accidents after using marijuana, the authors noted.

"These findings reaffirm many of our accepted understandings regarding acute cannabis intoxication and psychomotor performance," said Paul Armentano, deputy director of NORML (the National Organization for the Reform of Marijuana Laws). "That is why operating a motor vehicle while acutely impaired by cannabis is presently a criminal offense in all 50 states."

This risk appears to be greatest in less-experienced cannabis users, younger drivers, and among those who combine the use of cannabis and alcohol, Armentano pointed out.

"That said, it should further be noted that cannabis-induced changes in performance are typically subtle, short-lived and less dramatic in more experienced cannabis consumers, who appear to develop tolerance to some of the drug's behavioral effects," he added.

"Further, this overall elevated risk is far less than the elevated risk of accidents associated with the consumption of alcohol, including its use in legal quantities," Armentano said.

While some suggest that drivers should be tested for marijuana, so far, no effective test exists that can be done at a traffic stop to accurately pinpoint when a driver used the drug.

"This evidence makes a case for introducing policies to reduce cannabis-impaired driving," said Wayne Hall, from the University of Queensland Centre for Clinical Research in Brisbane, Australia. He wrote an accompanying editorial for the journal.

He said that roadside drug testing, such as that used for alcohol, may be a useful approach.

But there are no handy devices, such as a breathalyzer, to tell if someone has recently used marijuana, Asbridge noted.

"The challenge is defining a level that equates with impairment. A number of countries have already introduced roadside testing by deciding that any detectable evidence of recent use constitutes impaired driving. However, we do not know how effective testing has been because the policy has not been evaluated," Hall said.

Another expert outlined the problems with such tests.

"Because THC, the active ingredient in marijuana, can be detected several weeks after use of marijuana, it is hard to determine with certainty if a driver testing positive for marijuana is indeed impaired by the substance at the time of testing," said Dr. Guohua Li, a professor of epidemiology at Columbia University in New York City.

So more research is needed. "This issue is especially urgent and important in light of the ongoing epidemic of drugged driving and increased permissibility and availability of marijuana worldwide," Li said.

While recognition that driving under the influence of marijuana is a problem is a first step in finding ways to curb it, Jan Withers, national president of Mothers Against Drunk Driving (MADD), stated that "drunk driving remains the primary threat to our families on the road."

However, she added, "this study underscores the importance of the work that MADD is doing to support people who have been victimized by drugged driving and recognize law-enforcement's efforts to pioneer effective strategies to stop drugged driving. Notably, it shows the increased danger posed by those drivers using both alcohol and drugs."

More information

For more about drugged driving, visit the U.S. National Institute on Drug Abuse.

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Gonorrhea Could Join Growing List of Untreatable Diseases

cdc-gonorrhea5529_lores Gonorrhea under a microscope. Image: courtesy of CDC/Susan Lindsley

The arms race between humanity and disease-causing bacteria is drawing to a close and the bacteria are winning. The latest evidence: gonorrhea is becoming resistant to all standard antibiotic treatment.

Gonorrhea is one of the most common sexually transmitted diseases in the world with about 600,000 cases diagnosed in the U.S. each year. A few years ago, investigators started seeing cases of infection that did not easily respond to treatment with a group of drugs called cephalosporins, which are currently the last line of defense against this particular infection. Now, the number of drug-resistant cases has grown so much in the U.S. and elsewhere that gonorrheal infection may soon become untreatable, according to doctors writing in the February 9 issue of the New England Journal of Medicine.

If it seems to you that the drumbeat of bad news with respect to antibiotic resistance has become louder and more insistent in the past few years, you would be right:

Researchers reported in January that they had for the first time collected samples of E. coli bacteria from the Antarctic with particularly dangerous drug-resistance genes. The dispersal of drug resistance genes via E. coli is particularly worrisome because that bacterium lives normally in the human intestine along with thousands of other species of bacteria. From that fertile ground, there s practically no stopping the widespread dissemination of bacterial resistance genes.

Meanwhile reports surfaced in India of several cases of totally untreatable tuberculosis although further investigation suggested that they may have merely been extensively drug-resistant TB.

Hospitals in New York City are now struggling with how to deal with a deadly pneumonia that resists treatment with powerful, last-resort antibiotics called carbapenems, as reported by Maryn McKenna in a feature for Scientific American, entitled The Enemy Within: A New Pattern of Antibiotic Resistance (preview version here). Indeed, figuring out how to deal with the problem is the subject of an upcoming seminar on carbapenem resistance, at the New York Academy of Science on February 17.

Scientific American has actually written a fair amount on the problem of antibiotic resistance in all its guises. Check out our in-depth report on the Crisis of Antibiotic Resistance, which I just pulled together, for more detail.

Follow Scientific American on Twitter @SciAm and @SciamBlogs. Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.

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Hard Drug Use in Middle Age Could Prove Fatal, Study Finds

FRIDAY, Feb. 3 (HealthDay News) -- People who start using hard drugs -- such as cocaine, opiates and amphetamines -- as young adults and continue to use them into their 50s have a fivefold increased risk of early death, researchers report.

The finding is from an analysis of hard drug use among 4,300 U.S. adults who took part in a long-term study of cardiovascular disease and risk factors. The participants, including blacks, whites, men and women, were recruited when they were 18 to 30 years of age and followed from 1985 to 2006.

The University of Alabama at Birmingham researchers compared those who stopped drug use early in life to those who continued, and calculated their risk of premature death.

"Fourteen percent of the people in the study reported recent hard-drug use at least once, and of these, half continued using well into middle age," lead author Dr. Stefan Kertesz, an associate professor in the preventive medicine division, said in a university news release.

Kertesz characterized most drug users as "dabblers" who used a few days a month, but not daily.

The researchers found that older drug users were more likely to have been raised in economically challenging circumstances in a family that was unsupportive, abusive or neglectful.

Those who were heavy drug users when they were young adults and continued into middle age were about five times more likely to die prematurely than people who didn't use drugs, according to the report published online Jan. 27 in the Journal of General Internal Medicine.

But, while the study uncovered an association between continued heavy drug use and premature death, it did not prove a cause-and-effect relationship, the study authors noted.

"We can't assume that drugs caused death, as in an overdose," Kertesz said. "Rather what we found is that middle-age adults who continue to dabble in hard drugs represent a group that is at risk of bad outcomes -- which could include death from trauma, heart disease or other causes that are not a direct result of their drug use -- at a higher rate than people who stopped using drugs."

About 9.4 percent of Americans aged 50 to 59 and 7 percent of those aged 35 to 49 reported use of a drug other than marijuana sometime in the past year, according to the U.S. National Survey on Drug Use and Health.

More information

The U.S. Substance Abuse and Mental Health Services Administration has more about illicit drug use among older adults.

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