Health & Fitness (208)
STOCKHOLM (AP) -- Nine women in Sweden have successfully received transplanted wombs donated from relatives in an experimental procedure that has raised some ethical concerns. The women will soon try to become pregnant with their new wombs, the doctor in charge of the pioneering project has revealed.
The women were born without a uterus or had it removed because of cervical cancer. Most are in their 30s and are part of the first major experiment to test whether it's possible to transplant wombs into women so they can give birth to their own children.
Life-saving transplants of organs such as hearts, livers and kidneys have been done for decades and doctors are increasingly transplanting hands, faces and other body parts to improve patients' quality of life. Womb transplants - the first ones intended to be temporary, just to allow childbearing - push that frontier even farther and raise some new concerns.
There have been two previous attempts to transplant a womb - in Turkey and Saudi Arabia - but both failed to produce babies. Scientists in Britain, Hungary and elsewhere are also planning similar operations but the efforts in Sweden are the most advanced.
"This is a new kind of surgery," Dr. Mats Brannstrom told The Associated Press in an interview from Goteborg. "We have no textbook to look at."
Brannstrom, chair of the obstetrics and gynecology department at the University of Gothenburg, is leading the initiative. Next month, he and colleagues will run the first-ever workshop on how to perform womb transplants and they plan to publish a scientific report on their efforts soon.
Some experts have raised concerns about whether it's ethical to use live donors for an experimental procedure that doesn't save lives. But John Harris, a bioethics expert at the University of Manchester, didn't see a problem with that as long as donors are fully informed. He said donating kidneys isn't necessarily life-saving, yet is widely promoted.
"Dialysis is available, but we have come to accept and to even encourage people to take risks to donate a kidney," he said.
Brannstrom said the nine womb recipients are doing well. Many already had their periods six weeks after the transplants, an early sign that the wombs are healthy and functioning. One woman had an infection in her newly received uterus and others had some minor rejection episodes, but none of the recipients or donors needed intensive care after the surgery, Brannstrom said. All left the hospital within days.
None of the women who donated or received wombs has been identified. The transplants began in September 2012 and the donors include mothers and other relatives of the recipients. The team had initially planned to do 10 transplants, but one woman couldn't proceed due to medical reasons, university spokesman Krister Svahn said.
The transplant operations did not connect the women's uteruses to their fallopian tubes, so they are unable to get pregnant naturally. But all who received a womb have their own ovaries and can make eggs. Before the operation, they had some removed to create embryos through in-vitro fertilization. The embryos were then frozen and doctors plan to transfer them into the new wombs, allowing the women to carry their own biological children.
The transplants have ignited hope among women unable to have children because they lost a uterus to cancer or were born without one. About one in girl in 4,500 is born with a syndrome, known as MRKH, where she doesn't have a womb.
Lise Gimre, 35, who was born without a womb, said she thought many women with MRKH would be interested if the operation proves to be safe and effective. Gimre runs an organization for women with the syndrome in Norway.
"If this had been possible when I was younger, no doubt I would have been interested," she said. Gimre, who has two foster children, said the only option for women like her to have biological children is via surrogacy, which is illegal in many European countries, including Norway and Sweden.
Fertility experts have hailed the project as significant but stress it's unknown whether the transplants will result in healthy babies.
The technique used in Sweden, using live donors, is somewhat controversial. In Britain, doctors are also planning to perform uterus transplants, but will only use wombs from dying or dead people. That was also the case in Turkey. Last year, Turkish doctors announced their patient got pregnant but the pregnancy failed after two months.
"Mats has done something amazing and we understand completely why he has taken this route, but we are wary of that approach," said Dr. Richard Smith, head of the U.K. charity Womb Transplant UK, which is trying to raise 500,000 pounds ($823,000) to carry out five operations in Britain.
He said removing a womb for donation is like a radical hysterectomy but it requires taking a bigger chunk of the surrounding blood vessels to ensure adequate blood flow, raising the risk of complications for the donor. Smith said British officials don't consider it ethical to let donors take such chances for an operation that isn't considered life-saving.
Smith said the biggest question is how any pregnancies will proceed.
"The principal concern for me is if the baby will get enough nourishment from the placenta and if the blood flow is good enough," he said.
All of the women who received womb transplants will need to take anti-rejection medicines, but Smith said data from women who have received kidney transplants doesn't suggest their babies are at any increased risk from the drugs.
Brannstrom said using live donors allowed them to ensure the donated wombs were functional and didn't have any problems like an HPV infection.
Doctors in Saudi Arabia performed the first womb transplant in 2000, using a live donor, but it had to be removed after three months because of a blood clot.
Brannstrom said he and his colleagues hope to start transferring embryos into some of their patients soon, possibly within months. The Swedish researchers and others have previously reported successful uterus transplants in animals including mice, sheep and baboons, but no offspring from the primates were produced.
After a maximum of two pregnancies, the wombs will be removed so the women can stop taking the anti-rejection drugs, which can cause high blood pressure, swelling and diabetes and may also raise the risk of some types of cancer.
Other experts said if the operations are successful, womb transplants could be an alternative for women who have few choices.
"What remains to be seen is whether this is a viable option or if this is going to be confined to research and limited experimentation," said Dr. Yacoub Khalaf, director of the Assisted Conception unit at Guy's and St. Thomas' hospital in London, who was unconnected to any of the womb transplant projects.
Brannstrom warned the transplants might not result in children but remained optimistic.
"This is a research study," he said. "It could lead to (the women) having children, but there are no guarantees ... what is certain is that they are making a contribution to science."
Cheng reported from London.
NEW DELHI (AP) -- India marked three years Monday since its last reported polio case, putting the country on course to being formally declared free of the disease later this year.
India has made great strides against polio in recent years through a rigorous vaccination campaign. But for many in India, where polio victims with withered, twisted limbs are a common sight on the streets, these advances have come too late.
"My parents were very poor and couldn't afford medical treatment for me," said Sonu Kumar, 24, who contracted the disease when he was 10. Paralyzed from the waist down, he begs outside a temple in central Delhi and uses a wheelchair to move around.
Polio is a vaccine-preventable disease that has been eradicated in most countries. But it still causes paralysis or death in some parts of the world, including Nigeria, Pakistan and Afghanistan.
Polio usually infects children under age 5 when they drink contaminated water. The virus attacks the central nervous system, causing paralysis, muscular atrophy, deformation and, in some cases, death.
"India was once thought to be the most difficult country in which to achieve polio eradication," Global Polio Eradication Initiative said in a statement.
Monday's milestone was significant, but the World Health Organization stills need to confirm there are no undetected cases before making the official declaration that India is polio-free in March.
Still, Junior Home Minister R.P.N. Singh sent a triumphant message on Twitter: "Proud day for all of us as Indians ... India is polio free for three years."
Widespread poverty, dense population, poor sanitation, high levels of migration and a weak public health system made the task of reaching out to every child under age 5 that much more difficult.
An army of nearly 2.5 million volunteers, doctors and medical workers carried out a campaign across the country to vaccinate children over three years to wipe out the scourge. The number of polio cases came down from 741 in 2009 to 42 in 2010.
The last case of polio was reported in eastern India in 2011.
In 2012, WHO removed India from a list of countries with active endemic wild polio transmission after it passed one year without registering any new cases.
Health officials remained concerned about the possibility of the virus entering the country from neighboring Pakistan. Indian health authorities have set up polio immunization booths at the two border crossings with Pakistan and all children who enter by road and train are being given vaccines.
Mithlesh Devi, 27, who contracted the disease when she was 1 year old, said she has never known a normal life in India but has hopes for her family's future.
"I have ensured that my daughters do not meet the same fate," said Devi, who begs for money outside Hindu temples in New Delhi. "I got them polio drops at the right age. I am not happy with my tough life. But I have no choice."
Associated Press writer Ashok Sharma contributed to this story.
WASHINGTON (AP) -- Some of the nation's largest food companies have cut calories in their products by more than 6.4 trillion, according to a new study.
The study sponsored by the Robert Wood Johnson Foundation found between 2007 and 2012 the companies reduced their products' calories by the equivalent of around 78 calories per person per day. The total is more than four times the amount those companies had pledged to cut by next year.
Seventy-eight calories would be about the same as an average cookie or a medium apple, and the federal government estimates an average daily diet at around 2,000 calories. The study said the calories cut averaged out to 78 calories per day for the entire U.S. population.
The 2010 pledge taken by 16 companies - including General Mills Inc., Campbell Soup Co., ConAgra Foods Inc., Kraft Foods Inc., Kellogg Co., Coca-Cola Co., PepsiCo Inc. and Hershey Co. - was to cut 1 trillion calories by 2012 and 1.5 trillion calories by 2015.
The Robert Wood Johnson Foundation signed on to hold the companies accountable, and that group hired researchers at the University of North Carolina at Chapel Hill to painstakingly count the calories in almost every single packaged item in the grocery store. To do that, the UNC researchers used the store-based scanner data of hundreds of thousands of foods, commercial databases and nutrition facts panels to calculate exactly how many calories the companies were selling.
The researchers aren't yet releasing the entire study, but they said Thursday that the companies have exceeded their own goals by a wide margin.
Dr. James Marks, director of the Health Group at the Robert Wood Johnson Foundation, said the group is pleased with the results but the companies "must sustain that reduction, as they've pledged to do, and other food companies should follow their lead."
The Robert Wood Johnson Foundation is a nonpartisan philanthropic and research organization that works to improve the nation's health.
Even though the companies that made the commitment represent most of the nation's most well-known food companies, they sold only around a third of all packaged foods and beverages at the beginning of the study. Missing are many off-label brands sold under the names of retailers, and it's unknown whether those products have changed.
It is also unclear how the reduction in calories translates into consumers' diets. When the companies made the pledge in 2010, they said one way they would try and reduce calories would be to change portion sizes in an attempt to persuade consumers to eat less. The companies also said that they would develop new lower-calorie options and change existing products so they have fewer calories.
Evidence of those efforts are visible on any grocery store shelf. Many products now come in lower calorie versions, are baked instead of fried, or sold in miniature as well as larger versions.
Marks says he believes that companies' efforts to package smaller servings - 100 calorie packs of popular snacks, for example - and smaller cans of sugary drinks may have contributed to the reduction in calories. He says the main contributors most likely were the public's increasing willingness to buy healthier foods and companies responding to those consumers.
The companies involved are all part of an industry coalition of food businesses called the Healthy Weight Commitment Foundation that has organized to help reduce obesity. The foundation pledged to reduce the calories as part of an agreement with a group of nonprofit organizations and made the 2010 announcement as part of first lady Michelle Obama's Let's Move campaign to combat childhood obesity.
Lisa Gable of the Healthy Weight Commitment Foundation says the study's findings "exceeded our expectations."
She said the companies achieved the goal by coming together and also competing to make new lower-calorie foods. Market studies have shown that many of the healthier foods have outperformed other products, she said.
"This is a very significant shift in the marketplace," Gable said.
Follow Mary Clare Jalonick on Twitter: HTTP://TWITTER.COM/MCJALONICK
CHICAGO (AP) -- Young teens aren't exactly embracing the government's Let's Move mantra, the latest fitness data suggest.
Only 1 in 4 U.S. kids aged 12 to 15 meet the recommendations - an hour or more of moderate to vigorous activity every day.
The results are based on about 800 kids who self-reported their activity levels and had physical exams as part of the 2012 National Youth Fitness Survey.
Government researchers won't call the results disappointing, but lead author Tala Fakhouri of the Centers for Disease Control and Prevention said, "There's always room for improvement."
The CDC released partial results Wednesday from the fitness survey, which involved kids aged 3 to 15. Other results from the same survey are pending and include fitness data based on more objective measures including treadmill tests.
Fakhouri said the nationally representative results provide useful information for initiatives that aim to increase kids' fitness, including the Let's Move anti-obesity campaign launched by first lady Michelle Obama in 2010.
Kids in the survey reported on which physical activities they did most frequently outside of school gym class - basketball for boys and running for girls.
While few met guidelines established in 2008 for activity that raises the heart rate and makes you breathe harder, most said they did at least an hour of exercise at that level during the previous week. Overall, about 25 percent said they got an hour of that kind of exercise every day
Obese kids were less active than normal-weight girls and boys. Overweight girls were slightly less active than normal-weight girls, but levels were similar among overweight and normal-weight boys.
"It's definitely very concerning to see that our kids are engaging in such a limited amount of physical activity each day when we are still battling" an obesity epidemic, said Dr. Stephen Pont, an Austin, Texas, pediatrician and chairman of the American Academy of Pediatrics' section on obesity.
Data suggest obesity may have decreased slightly among some kids but the overall rate for children aged 2 to 19 is 17 percent, or about 12.5 million obese kids.
Pont said schools can do more to help by not cutting recess and giving kids more time for physical activity. He said research suggests kids who get physical education at school may do better academically.
Recent national data on kids' fitness levels is limited. A 2009-10 CDC survey involving kids ages 6 to 11 found about 70 percent met the physical activity guidelines, although levels dropped off among older kids in that age group. The results came from parents, who may be inclined to over-report how active their kids are because of "social desirability," the researchers said.
AP Medical Writer Lindsey Tanner can be reached atHTTP://WWW.TWITTER.COM/LINDSEYTANNER
CHICAGO (AP) -- Anti-smoking measures have saved roughly 8 million U.S. lives since a landmark 1964 report linking smoking and disease, a study estimates, yet the nation's top disease detective says dozens of other countries do a better job on several efforts to cut tobacco use.
The study and comments were published online Tuesday in the Journal of the American Medical Association. This week's issue commemorates the 50th anniversary of the surgeon general report credited with raising alarms about the dangers of smoking.
In one study, researchers used national health surveys and death rates to calculate how many deaths might have occurred since 1964 if Americans' smoking habits and related deaths had continued at a pace in place before the report.
More than 42 percent of U.S. adults smoked in years preceding the report; that rate has dropped to about 18 percent.
The researchers say their calculation - 8 million deaths - equals lives saved thanks to anti-smoking efforts.
Their report also says tobacco controls have contributed substantially to increases in U.S. life expectancy. For example, life expectancy for 40-year-olds has increased by more than five years since 1964; tobacco control accounts for about 30 percent of that gain, the report says.
The conclusions are just estimates, not hard evidence, but lead author Theodore Holford, a biostatistics professor at Yale University's school of public health, said the numbers "are pretty striking."
Yet smoking remains a stubborn problem and heart disease, cancer, lung ailments and stroke - all often linked with smoking - are the nation's top four leading causes of death.
The U.S. Centers for Disease Control says about 443,000 Americans still die prematurely each year from smoking-related causes.
"Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people," Dr. Thomas Frieden, the CDC's director, wrote in a JAMA commentary.
Frieden said the United States lags behind many other countries in adopting measures proven to reduce tobacco use, including graphic health warning labels on cigarettes, high tobacco taxes and widespread bans on tobacco advertising.
"Images of smoking in movies, television and on the Internet remain common; and cigarettes continue to be far too affordable in nearly all parts of the country," Frieden wrote.
Frieden cited data showing 32 countries have done better at raising tobacco taxes, and at least 30 have adopted stronger cigarette warning labels. These include Australia, Brazil, Canada and Uruguay, and research has suggested that gruesome labels can help persuade smokers to quit.
Tobacco companies have fought U.S. efforts to adopt similar labeling and an appeals court last year blocked a Food and Drug Administration mandate for stronger labels.
Other articles and studies in the journal show:
-Smoking declined an average 25 percent among men in 187 countries from 1980-2012, and by 42 percent among women. Because of population growth, the number of smokers worldwide has increased and rates remain high in many countries. More than half of men smoke in Russia, Indonesia and Armenia, and more than 1 in 4 women smoke in Chile, France and Greece.
-Smoking rates among U.S. registered nurses dropped to 7 percent in 2010-11, from 11 percent in 2003, and remained low among doctors, at just below 2 percent. The rate was 25 percent among licensed practical nurses, who have less advanced education than registered nurses.
-Drugs including nicotine patches, Chantix and Zyban, work better than dummy treatments at helping smokers quit at least temporarily but many often resume after a year.
-Electronic cigarettes may help some smokers quit but conclusive research is needed and their long-term safety is unknown. Users inhale nicotine vapor from the battery-operated devices and they could lead to nicotine addiction among nonsmokers, according to a review article.
AP Medical Writer Lindsey Tanner can be reached atHTTP://WWW.TWITTER.COM/LINDSEYTANNER
WASHINGTON (AP) -- The Supreme Court has refused a group of doctors' request to block implementation of the nation's new health care law.
Chief Justice John Roberts turned away without comment Monday an emergency stay request from the Association of American Physicians & Surgeons, Inc. and the Alliance for Natural Health USA.
They asked the chief justice Friday to temporarily block the law, saying Congress had passed it incorrectly by starting it in the Senate instead of the House. Revenue-raising bills are supposed to originate in the lower chamber. They also wanted blocked doctor registration requirements they say will make it harder for independent non-Medicare physicians to treat Medicare-eligible patients.
Still pending is a decision on a temporary block on the law's contraceptive coverage requirements, which was challenged by a group of nuns.