Diabetes warning over soft drinks

Drinking one or more cans of sugary soft drinks a day is linked to an increased risk of diabetes in later life, a study suggests.

A can a day raises the relative risk of Type-2 diabetes by about a fifth, compared with one can a month or under, say European scientists.

The report in the journal Diabetologia mirrors previous US findings.

A diabetes charity recommends limiting sugary foods and drinks as they are calorific and can cause weight gain.

The latest research was carried out in the UK, Germany, Denmark, Italy, Spain, Sweden, France and the Netherlands.

Some 350,000 individuals were questioned about their diet, as part of a large European study looking at links between diet and cancer.

"The consumption of sugar sweetened soft drinks increases your risk of diabetes - so for every can of soft drinks that you drink per day, the risk is higher," lead researcher Dora Romaguera from Imperial College London told BBC News.

She called for clearer public health information on the effects of sugary soft drinks.

"Given the increase in sweet beverage consumption in Europe, clear messages on its deleterious effect on health should be given to the population," Dr Romaguera and colleagues conclude in their research paper.

'Not definitive evidence'

An increased risk of diabetes was also linked to drinking artificially sweetened soft drinks, but this disappeared when body mass index was taken into account.

Fruit juice consumption was not associated with diabetes incidence, however.

Commenting on the results, Dr Matthew Hobbs, head of research at Diabetes UK, said the link between sugar-sweetened soft drinks and Type-2 diabetes persisted even when body mass index was taken into account.

This suggests the increased risk is not solely due to extra calories, he said.

"Even so, it is not definitive evidence that sugar-sweetened soft drinks increase the risk of Type 2 diabetes, other than through their effect on body weight," he added.

"We do, though, already recommend limiting consumption of sugary foods and drinks as these are usually high in calories and so can lead to weight gain if you have too many of them.

"This is important for Type 2 diabetes because we know that maintaining a healthy weight is the single most important thing you can do to prevent it."

Statistics expert Professor Patrick Wolfe, from University College London, said the absolute risk of Type-2 diabetes is low at about 4% of the adult UK population.

"In and of themselves, sugary soft drinks are only part of the picture - they're just one of the potential risk factors for Type-2 diabetes," he said.

"But since they are one we can easily eliminate - by switching to diet soft drinks or, even better, cutting them out of our diets altogether - it makes good sense to do so."

Gavin Partington, director general of the drinks industry body the British Soft Drinks Association said: "Soft drinks are safe to consume but, like all other food and drink, should be consumed in moderation as part of a balanced diet."

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Cutting cord early 'risk to babies'

Cutting the umbilical cord immediately after birth - currently standard practice - puts the baby at risk of iron deficiency, experts say.

Official guidelines are currently being examined - and professionals and campaigners say they should change.

Leaving the cord attached for a few minutes allows the blood in the cord to transfer to the baby,

The National Institute for Health and Care Excellence (NICE) says it will publish new guidelines next year.

Developmental concerns

The existing guidance on cord-clamping was published in 2007, when the consensus was that cutting the cord immediately was the best option - something which had been the case for decades.

But since then, researchers have questioned whether that is still the case.

A paper from the Royal College of Obstetricians and Gynaecologists (RCOG) published in 2009, stated that babies whose umbilical cords are clamped immediately have lower iron stores for up to six months.

Low iron levels have been linked to brain development problems.

The suggestion is that the cord should not be cut until it has stopped pulsating naturally - anywhere between two and five minutes after birth.

Some hospitals have already changed their practice.

'No good evidence'

Commenting on the current re-evaluation of the guidance, an RCOG spokeswoman said: "The college recommends that the umbilical cord should not be clamped earlier than necessary and should always be based on clinical assessment of the situation.

"Research has shown that delayed cord clamping of more than 30 seconds may benefit the newborn in reducing anaemia.

"It also allows time for the transfusion of placental blood to the newborn, especially in cases of premature birth."

But she said there could be some cases where complications meant it was better to clamp the cord immediately.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT) said: "When a baby is born about a third for the baby's blood is still in his/her cord and placenta.

"With no good evidence to support it, accepted practice is to accelerate the arrival of the placenta with an injection and clamp and cut the cord immediately, depriving the baby of this blood.

"The NCT would like to see the default position become leaving the cord for a few minutes until it stops pulsating, unless the mother chooses to have an injection to speed the arrival of her placenta or unless the blood loss from the mother means her uterus must be encouraged, with drugs, to contract and expel the placenta quickly."

Prof Mark Baker, director of the centre for clinical practice at NICE, said all its guidelines were regularly updated to take into account developments in research.

He added: "All available evidence on the right time to clamp a newborn baby's cord is being considered.

"Our recommendation will represent what we believe is best possible practice and will put mother and baby's safety first."

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Study suggests new approach to dengue fever

Dengue fever may be more than three times more prevalent than current estimates, according to a new report. 

The study, led by researchers at the University of Oxford in England, estimates there are 390 million dengue infections around the world each year. Currently, the World Health Organization puts the number between 50 and 100 million infections each year. Researchers hope their findings will help pinpoint parts of the world most vulnerable to dengue fever and develop strategies to treat it.

Dengue fever is passed from person to person by mosquitos. Unlike malaria, there are no drugs you can take to avoid getting it. It also is difficult to treat and thus far, attempts to develop a vaccine have been unsuccessful. 

Map: Areas in red indicate high risk for dengue occurrence, while green areas indicate low risk.

It is most common in Asia and India, but more cases have been popping up in the Caribbean and Latin America in recent years. In mild cases, dengue fever causes a high fever, rash and joint and muscle pain. In extreme cases, it can cause death. According to the World Health Organization, about 12,000 people die of dengue fever each year. Many of them are children.

For this research,  a team of international experts developed a statistical model based on things like temperature, humidity and even newspaper reports, to figure out where dengue was most likely to show up. Then, they combined that information to develop a map, down to precise 5-by-5 kilometer regions where outbreaks were most likely to occur.

"This helps us make a decision on where we prioritize efforts to reduce the burden of disease," says Tom Scott, a researcher at the University of California, Davis, and one of the authors of the report. By 2015, the WHO wants to reduce deaths from dengue fever by 50%. 

"It's really doable," says Scott.  "These maps could help direct that."

But some experts take issue with the study's numbers and say the estimate is too high. 

"Dengue is extremely complicated," says Dr. Scott Halstead, who has been studying the disease for over 50 years and is the senior scientific advisor to the Dengue Vaccine initiative at the Bill & Melinda Gates Foundation. 

He points out the numbers for Africa.  "A disease resistance gene in Africa has been well established, which suggests the disease burden in Africa  is overestimated," says Halstead.

The study is published in the current edition of the journal Nature.

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Merger of drugmakers Valeant, Actavis on hold: source

(Reuters) - A proposed merger of Valeant Pharmaceuticals International Inc and Actavis Inc was put on hold after the two drugmakers failed to agree on terms of a deal that would have created a healthcare giant with a combined market value of $35 billion, a person familiar with the situation told Reuters on Saturday.

Actavis spokesman David Belian and Valeant spokeswoman Laurie Little both declined to comment.

Canada's Valeant was seeking to buy smaller U.S. rival Actavis for more than $13 billion before the discussions started to unravel late this week because of disagreements on the proposed terms, the source said. It was not clear on Saturday if the merger could be revived.

Valeant, which has a market capitalization of about $22.2 billion, said in February it was in talks to make more acquisitions, and it remains open to discuss a potential "merger of equals," even as it aims to lower its $10.8 billion debt.

The Montreal-based company has aggressively built up its dermatology and aesthetics portfolio in the United States in the past year, acquiring about a dozen assets or smaller companies, most recently winning a short bidding war for Obagi Medical Products.

Actavis, the third-largest global generic drugmaker, is itself the product of a merger. The company changed its name in January from Watson after buying Actavis as part of its strategy to expand in international markets and offer more specialty drugs.

Valeant, which was formerly known as Biovail before it acquired Valeant and assumed its name, is scheduled to report first-quarter results on Thursday.

(Reporting by Soyoung Kim and Jessica Toonkel in New York; Additional reporting and writing by Rod Nickel in Winnipeg, Manitoba; Editing by Peter Cooney)

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Complications of chronic empyema

Complications due to chronic toxaemia.—The most common complications are those which arise as the result of a chronic toxaemia ; they include pulmonary osteoarthropathy, amyloid disease and nephritis. The symptoms and joint effusions associated with pulmonary osteoarthropathy usually clear up quickly as soon as the chronic suppuration in the chest has been controlled. It is important to realize that amyloid disease is also reversible, provided that it has not been present over a long period. In many cases the

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Treatment (Empyema)

A chronic empyema can be cured permanently only by obliteration of the cavity. This may occur either as the result of re-expansion of the lung or in consequence of operative mobilization of the chest wall ; in the latter case, the parietal pleura falls inwards to meet and fuse with the visceral layer where it covers the partially collapsed lung. It is obvious that the functional and cosmetic result is much better when the cavity is obliterated by re-expansion of the lung ; plastic operations on the chest wall should therefore be reserved for cases in which complete re-expansion of the lung proves to be impossible.

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