Sixteen percent of eighth-graders reported using an illicit drug in the past year, an increase of 1.5% over the previous year, a recent national survey has found. The rise has been stoked by steady increases in marijuana use, which also increased among tenth and twelfth graders.

According to results from the 2010 Monitoring the Future Survey (MTF), the percent of eighth, tenth and twelfth graders who reported smoking the herb daily last year were 1.2%, 3.3% and 6.1%, respectively. That represented an across-the-board increase from 2009 figures, which were 1.0%, 2.8% and 5.2%, respectively.

The increases were associated with declining perceptions that smoking marijuana regularly is harmful. Among 10th graders surveyed in 2010 for example, 57.2% felt this practice was harmful. In 2009, 59.5% of 10th graders felt this way. In a related trend, the percentage of eighth graders that disapproved of smoking marijuana dropped significantly in 2010.

“These high rates of marijuana use during the teen and pre-teen years, when the brain continues to develop, place our young people at particular risk,” said Nora Volkow, the Director of the National Institute on Drug Abuse in a press release. “Not only does marijuana affect learning, judgment, and motor skills, but research tells us that about 1 in 6 people who start using it as adolescents become addicted.”

Remarkably, more 12th-graders now smoke pot than cigarettes, the survey showed. Last year, 21.4% of high school seniors had used marijuana in the last month, compared with 19.2% that had smoked cigarettes. (more…)

Millions of parents sign-up their kids to play in organized sports leagues, happy in the belief that their little ones will, among other things, get their recommended daily amount of exercise. Remarkably, a new study suggests these parents are mistaken.

Federal guidelines call for kids to get a minimum of one hour per day’s worth of moderate-to-vigorous exercise. But scientists at San Diego State and the UCSD found that on average, only 24% of youth participants on organized soccer, softball and baseball teams met this minimum standard.

To reach these conclusions, Desiree Leek and colleagues recruited 200 kids between the ages of 7 and 14 that belonged to 29 teams from community sports leagues in San Diego County. The scientists asked the kids to wear accelerometers during practices and games.

Most kids practiced twice per week and participated in 1-2 games per week. Team practice times ranged from 40-130 minutes for soccer and 35-217 minutes for softball and baseball. Despite these lengthy practice times, the kids averaged 45.1 minutes of moderate to vigorous physical activity (MVPA) per work-out.

Participants on soccer teams (+13.7 minutes), boys (+10.7 minutes), and those aged 7 to 10 years (+7.0 minutes) got significantly more MVPA than their counterparts. Incredibly, less than 10% of kids in the 11-to 14-age bracket, and only 2% of girl softball players met the 60-minute guideline.

“Though participation in organized sports contributes to overall physical activity…sports participation is not sufficient to ensure youth meet recommendations on practice days,” the authors concluded.

In part, this turns out to be because kids are inactive for long stretches of these “organized” practices while they receive instructions from coaches or wait in line to take batting practice or run a drill.

“The health effects of youth sports could be improved by adopting policies and practices that ensure youth obtain sufficient physical activity during practices,” wrote the authors, who suggested among other things, “emphasizing participation over competition, sponsoring teams for all skill levels across all ages…increasing practice frequency, extending short seasons, using pedometers or accelerometers to monitor physical activity periodically during practices, providing coaches strategies to increase physical activity, and supporting youth and parents in obtaining adequate physical activity on nonpractice days.”

And remember, these practices and games occur only 3-4 days per week. Parents need to assure their kids get enough exercise every day.

The write-up appears in the Archives of Pediatrics & Adolescent Medicine.

Cancer of the ovary is a particularly nasty disease. It often remains asymptomatic until it has reached an advanced, incurable stage, and scientists have been unable to develop an effective screening test for the disease like the ones in widespread use for cancers of the breast and cervix.

The dismal status of ovarian cancer screening was underscored a year ago when an NIH-sponsored study showed that over 70% of cancers detected by transvaginal ultrasound and CA 125 biomarker testing—the two best ovarian screening tests we’ve got—had reached stage III or IV at the time the patients screened positive. That’s about what happens when women aren’t screened at all.

That wasn’t the worst of it, however. In just the first year of that screening program, positive test results obligated 566 surgical procedures which uncovered only 18 cancers. That’s an awful lot of unnecessary surgery and associated morbidity right there. Things were no better on the false-negative side of things. Overall, 89 cases of ovarian cancer were diagnosed during the NIH study, and a third of them had been missed by both screening modalities.

What’s New?     The NIH study didn’t evaluate the impact of screening on ovarian cancer mortality, but a recent study by Laura Havrilesky and colleagues at Duke did indeed address the point. Sadly, the results were abysmal.

Havrilesky’s team developed a modified a Markov model to characterize the natural history of ovarian cancer, and used it to show that mortality would fall by a paltry 11% if a widespread screening program (in this case, CA 125 biomarker testing followed by pelvic ultrasound imaging for women with abnormal results) was put into place. 

The scientists emphasized that the protean nature of ovarian cancer—not just its tendency to remain asymptomatic until an advanced stage—was a huge challenge in developing an effective screening tool. According to their analysis, some ovarian cancers tend to grow slowly, taking nearly 3 years before progressing to an advanced stage. Other ovarian cancers are more aggressive, reaching an advanced stage after only 13 months.

“If we assume ovarian cancers grow and spread at different rates, the best screening strategy available will only reduce the number of women dying from the cancer by 11%,” Havrilesky said in a press release. “This is partially because the slower growing cancers are more likely to be caught by a screening test.”

The authors didn’t exactly throw up their hands in disgust at the poor prospects for ovarian screening, but they did suggest that policy makers consider directing funds towards prevention and treatment of the disease, and away from screening.

That said, most experts do recommend routine screening for ovarian cancer in women that have a family history of the disease and in those who carry genes known to increase the risk of developing it. As always, women with questions about these issues should consult their doctors.

Havrilesky’s write-up appears in Cancer.

The FDA has been tough on diet drugs of late. Three years ago, it scuttled an attempt to get the European diet drug rimonabant approved for use in the US. More recently it rejected, at least temporarily, applications for Qnexa and Lorcaserin.

But that trend may have been reversed last week, when an advisory committee set the stage for possible FDA approval of Orexigen’s investigational diet drug, Contrave. By a 13-7 vote, the committee said in essence that the somewhat modest beneficial effects of the drug outweighed its tendency to increase blood pressure.

The FDA will make final decision on the matter by the end of January. It is not required to follow the advice of its advisory committees, but as was the case for the 3 diet drugs mentioned above,  it usually does.

Orexigen has petitioned the FDA to approve Contrave for the treatment of obesity and weight management in people who have a body mass index of at least 30, or at least 27 if they have at least one cardiovascular disease risk factor like diabetes, high cholesterol or high blood pressure.

Contrave is a combination of 2 drugs that were approved long-ago by the FDA and are widely used today. Naltrexone, the first of these, is used to treat opioid addiction and alcohol dependence. The second, bupropion, is used to treat depression and as a quit-smoking aide.

Before reaching its verdict, the FDA’s Endocrine and Metabolic Drugs Advisory Committee reviewed the results of 4 randomized trials that were sponsored by Orexigen. Together, the studies enrolled more than 4,500 overweight and obese subjects. The Committee noted that in pooled results from the 4 trials, the weight-loss difference between those receiving Contrave and those receiving a placebo was about 4.2%, which it deemed to be “of nominal statistical significance.” However, more than a third of subjects in the Contrave group did lose least 5% of their body weight during a 1-year follow-up period.

“As far as efficacy goes, I think they made it by the hair of their chinny chin chin,” Melanie Coffin, a patient representative on the Committee told ABC News.

The Committee did raise concerns about several side effects of Contrave, including seizures and suicidal ideation, although it was clearly most concerned about the drug’s tendency to increase blood pressure, a phenomenon that seemed to be most apparent in the first few weeks after the drug was started. Ultimately though, the Committee decided there wasn’t enough data to draw clear conclusions about the cardiovascular risks of Contrave. It did recommend that Orexigen should submit post-market data on the matter, if and when it receives full FDA approval.

Currently, the only anti-obesity drug on the market is Orlistat (also known as Xenical and Alli). Recently, Abbott pulled another one, sibutramine (Meridia) after mounting evidence suggested it was associated with strokes and heart attacks.

Last month, a Medicare advisory committee provided metza metz support for sipuleucel-T, Dendreon’s prostate cancer vaccine that is  better known as Provenge. The lukewarm recommendation by the Medicare Evidence Development & Coverage Advisory Committee means that that Medicare will probably end-up paying for the treatment, but only for FDA-approved uses.

Provenge is the first cancer-fighting vaccine to be approved by the FDA. The regulatory agency green-lighted the vaccine after a key Phase III trial showed the jab increased life-expectancy in patients with asymptomatic or minimally symptomatic, metastatic, castrate-resistant prostate cancer by a median of 4.1 months and increased 3-year survival by 38%.

Those improvements come at the exceptionally steep price of $93,000 per course of therapy. By law, Medicare cannot factor-in treatment costs when deciding whether to cover a particular treatment.

The final ruling by Medicare won’t be made until next spring. It will be crucial for Dendreon, since prostate cancer strikes elderly men almost exclusively, and many of them use Medicare to insure themselves against catastrophic illness.

The committee’s decision comes at a time when governments around the world are struggling to control spiraling health costs.

In reaching its decision, the committee voted on 5 separate issues concerning the vaccine. On a 5-point scale (with 5 being high), the committee came out with an overall score of 3.6 when asked to rate their confidence in the evidence showing the vaccine improved survival.

Most casual readers would view this as lukewarm support, but Daniel Petrylak, a Provenge investigator and the co-director of the Prostate Cancer Program at Columbia concluded otherwise. “It’s clear that they believe from their voting that there is a survival benefit,” Petrylak told MedScape.

The committee was unequivocallly against the idea that Provenge should be used for non-FDA-approved (that is, off-label) indications. The committee’s average vote regarding the use of Provenge in 3 such categories ranged between 1.1 and 1.4. One of these groups was patients in whom the disease had not metastasized. That’ll cap things, at least a little.

In a common version of the “Ultimatum Game,” Player A is asked to dole out $40 to himself and Player B. He can distribute the loot in either a $35-$5 split, or in a $25-$15 split. If Player B accepts the payout, both parties keep their cash, but if Player B says no, both players go home empty.

Theoretically, Player B should accept either offer: five dollars is, after all, better than nothing. It turns out though, that fairly often Player B will reject the lowball offer, presumably because he finds it insulting.

In a fascinating riff on this observation back in 2007, Harvard University professor Terry Burnham measured testosterone levels in a cohort of men that had volunteered to play the Ultimatum Game. Burnham observed that only 7% of Player B’s with below-average testosterone rejected the $5 offer, whereas 45% of Player B’s with above average testosterone rejected the offer.

Recently, a team of scientists led by Maurice Levi of the University of British Columbia wondered whether the notorious male sex hormone might similarly affect business outcomes from corporate take-over attempts. Merger-and acquisition deals are indeed similar to the Ultimatum Game with one important exception: companies that receive a takeover bid can negotiate a better price. And of course, stock price shifts, regulatory matters and a host of other variables often complicate matters.

Still, what the heck?

The researchers studied 357 takeover bids that took place between 1997 and 2007. Not being able to measure testosterone levels of the involved CEOs retrospectively, they used the age of the CEO as a proxy, since it is a known fact that testosterone levels decline with age.

Lo and behold they found that young (high-testosterone) CEOs who launched takeover bids were 20% more likely to withdraw their bids later after initially being rebuffed by the target company. They postulated that withdrawing the bid altogether rather than negotiating a higher price was a way for the young, high-testosterone bidder CEO to demonstrate “dominance.”

Maybe the Securities and Exchange commission should require publicly traded companies to disclose their CEOs’ testosterone levels in their quarterly reports…

A single small dose of psilocybin, the hallucinogenic ingredient in “magic mushrooms,” has been shown to reduce anxiety and depression for up to 6 months in terminal cancer patients, according a report by Los Angeles-based scientists.

To reach these conclusions, Charles Grob and colleagues at UCLA Medical Center performed a small study involving 12 subjects with Stage IV cancer and anxiety that was attributed to their underlying condition. Each subject had 2 therapeutic sessions, one involving psilocybin and the other involving niacin, a drug that provokes flushing and nausea but has no psychological effects.

The drugs were administered in an inpatient clinical research unit. During the 6 hours after drug administration, subjects were asked to relax in bed, wear sunglasses and listen to music. They were monitored closely throughout.

Subjects received a low dose of psilocybin, 0.2 mg/kg. Every single one of them reported that their mood improved for at least 2 weeks after administration of the hallucinogen. In some cases, objective tests of mood and anxiety revealed significant improvements 6 full months after treatment. Most also said they needed to take fewer narcotic pain medications after receiving the drug. There were no adverse reactions.

“This is a landmark study in many ways,” Stephen Ross, clinical director of the Center of Excellence on Addiction at New York University‘s Langone Medical Center told the LA Times. “This is the first time a paper like this has come out in a prestigious psychiatric journal in 40 years.”

However, Grob, Ross and others involved in psilocybin research strongly advised cancer patients against experimenting with psilocybin on their own. The drugs “are dangerous…people can have fearful reactions, panic reactions, engage in dangerous behavior and do great harm to themselves,” they explained.

The write-up appears in the Archives of General Psychiatry.

Surgeons at UC San Diego have removed a woman’s gallbladder through her mouth. The procedure, known as natural orifice translumenal endoscopic surgery (NOTES), was performed as part of a prospective multicenter clinical trial designed to compare it with laparoscopy.

Soon after laparoscopy was introduced in the 1980s, it became the technique of choice for gallbladder removal (cholecystectomy), because it was associated with reduced costs and morbidity.

Typically, laparoscopic cholecystectomy requires creating 3-5 incisions in the abdominal wall. In contrast, NOTES involves accessing the gallbladder through the mouth and a subsequent a hole created in the stomach (the so-called transgastric approach). An alternative NOTES procedure accesses the gallbladder through the vagina (the transvaginal approach).

“What is unique about this trial is that we will not only evaluate the safety and efficacy of NOTES compared to laparoscopy but will also assess and compare pain levels, cosmetic outcomes, operative costs and logistical outcomes,” said Santiago Horgan a principal investigator in the study and chief of minimally invasive surgery at UCSD Health System. Horgan has performed more than 70 NOTES surgeries.

Horgan said that traditional laparoscopy is highly effective, but suggested the newer approach might reduce post-operative infection, hernia, scarring and pain.

“We hypothesize that NOTES procedures may reduce pain and infection by eliminating abdominal wall incisions altogether,” Horgan explained. “Post-operatively, many patients experience pain while walking or coughing due to contraction of the abdominal muscles. This discomfort is absent following the natural orifice approach.”

The trial is designed to perform 70 NOTES cases (35 transgastric and 35 transvaginal) and 70 laparoscopic cases. The UCSD site plans to enroll 20 patients.

Cholecystectomy is one of the most common surgeries in the US. Nearly 750,000 patients undergo the procedure each year.

The dream of an effective vaccine against the AIDS virus may have moved one step closer to reality, according to federal scientists.

The scientists identified 2 naturally occurring antibodies that destroy nearly 90% of all strains of HIV, the virus that causes AIDS. They say their finding could hasten development of new HIV treatments as well as a vaccine.

HIV is deviously mutable. Frequent mutations in its DNA change the composition of surface proteins on the virus, allowing it to escape an immune response. This enables the virus to continue infecting cells even after antibodies targeting it have appeared — it has thus been able to avoid vaccines developed against it so far.

There are hundreds of variants of the HIV virus around the world. Finding so-called broadly neutralizing antibodies that can kill the majority of these strains has been the goal of HIV researchers for 2 decades.

To date, the best researchers have been able to do is find antibodies that block about 40% of the known HIV strains. Key to a breakthrough in this regard is to isolate antibodies that attack relatively unchanging parts on the surface of the HIV virus. And that’s what may just have been accomplished.

“I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years,” Gary Nabel of the National Institute of Allergy and Infectious Diseases told the LA Times. Nabel headed the project reporting the breakthrough. The write-up appears in Science.

Nabel’s team isolated antibodies from a 60-year-old African American man that had been infected with HIV. Using new imaging and analytical techniques, the team isolated 2 antibodies, known as VRC01 and VRC02, which are directed against a protuberance on the surface of the HIV virus. The spike facilitates binding to something called the CD4 binding site on white blood cells of humans. When an antibody binds to to the spike, it prevents the virus from entering the cell.

The HIV virus relies exclusively on this receptor to enter human white blood cells, so it can’t infect them when antibodies are attached to the spike.

Nabel’s team is currently testing a synthetic version of the spike as a possible vaccine in animals. They hope to begin human testing fairly soon.

Most of us know we can expect to feel a burning sensation when we consume jalapenos or other hot peppers. But few peope know that such spicy fare might also increase body temperature via a mechanism that burns calories just as effectively as exercise.

At least that’s what scientists at the UCLA Center for Human Nutrition seem to have discovered during a recent trial involving 34 volunteers who were trying to peel off some pounds.

The tongue-scorching effects of spicy peppers comes from capsaicin, a chemical produced by plants to discourage animals from turning them into dinner. These same plants also produce a milder tasting analogue known as dihydrocapsiate (DCT).

The UCLA scientists randomized the study subjects to receive either DCT or a placebo with their meals. They subsequently measured the subjects’ energy expenditure and found it to be highest among the cohort that had received DCT. In fact, it was nearly twice as high as in those receiving the dummy pill, and the phenomenon was associated with increased fat burning as well.

The scientists warn however that their findings are preliminary, since their subjects were placed on a low-calorie liquid diet, and it’s not clear the same results would be seen among people on a normal diet. The researchers also said the energy-burning effects of DCT might not be seen in folks who are of normal weight to begin with.

The findings were presented during an April meeting of a conference known as the Experimental Biology 2010 meeting, which was held in  in Anaheim.