It may be possible to use "stem cell shielding" to protect the body from the damaging effects of chemotherapy, early results from a US trial suggest.

Chemotherapy drugs try to kill rapidly dividing cancer cells, but they can also affect other healthy tissues such as bone marrow.

A study, in Science Translational Medicine, used genetically modified stem cells to protect the bone marrow.

Cancer Research UK said it was a "completely new approach".

The body constantly churns out new blood cells in the hollow spaces inside bone. However, bone marrow is incredibly susceptible to chemotherapy.

The treatment results in fewer white blood cells being produced, which increases the risk of infection, and fewer red blood cells, which leads to shortness of breath and tiredness.

Researchers at the Fred Hutchinson Cancer Research Center, in Seattle, said these effects were "a major barrier" to using chemotherapy and often meant the treatment had to be stopped, delayed or reduced.

They have tried to protect the bone marrow in three patients with a type of brain cancer, glioblastoma.

One of the researchers, Dr Jennifer Adair, said: "This therapy is analogous to firing at both tumour cells and bone marrow cells, but giving the bone marrow cells protective shields while the tumour cells are unshielded."

Bone marrow was taken from the patients and stem cells, which produce blood, were isolated. A virus was then used to infect the cells with a gene which protected the cells against a chemotherapy drug. The cells were then put back into the patient.

The lead author of the report, Prof Hans-Peter Kiem, said: "We found that patients were able to tolerate the chemotherapy better, and without negative side effects, after transplantation of the gene-modified stem cells than patients in previous studies who received the same type of chemotherapy without a transplant of gene-modified stem cells."

The researchers said the three patients had all lived longer than the average survival time of 12 months for the cancer. They said one patient was still alive 34 months after treatment.

Cancer Research UK scientist Prof Susan Short said: "This is a very interesting study and a completely new approach to protecting normal cells during cancer treatment.

"It needs to be tested in more patients but it may mean that we can use temozolomide [a chemotherapy drug] for more brain tumour patients than we previously thought.

"This approach could also be a model for other situations where the bone marrow is affected by cancer treatment."

Story By: by Rob Stein

Connor and family.

“The choking game is a strangulation activity that some kids participate in, using either their hands or something like a rope or a belt or something like that,” she says.

Why? Thomas A. Andrew, New Hampshire’s chief medical examiner, who has studied the trend, explains: “As the brain is deprived of oxygen, there’s this sensation of lightheadedness, which is interpreted as a high. And then once the pressure is released and blood flow is restored in a fashion, they see stars and the feeling is described as a rush,” he said.

According to a study Hedberg’s colleagues published today in the journal Pediatrics, around 6 percent of more than 5,000 middle-schoolers surveyed in Portland, Ore., have tried the choking game. And about a quarter of them have tried it at least five times, the researchers reported.

“With each of those episodes, obviously, just a little bit of the brain is being damaged,” Andrew said. “So who knows what the long-term effects may be on children who do this repeatedly?”

And no one really knows how often the game is being played or how many kids may have died. Back in 2008, a national estimate put the death toll from the choking game at about 82 between 1995 and 2007. But the study relied on media reports that couldn’t be verified independently. And many deaths that weren’t reported in the news could have been missed.

Cleveland pediatrician Nancy Bass, who has also studied the game, hopes the new research will help parents, doctors and teachers spot kids at risk. The survey found that despite the game’s reputation as being a “good kid’s high,” those participating in the game also engaged in other high-risk activities, such as drug and alcohol use.

“The thing that haunts me is that every parent that I’ve taken care of their child that has done this did say to me, ‘If I just knew. I mean, I saw hickeys or red marks on my child’s neck. I saw scarfs tied around the bedpost or the closet rod being bowed,’ ” Bass said. “And, ‘If I would have just known what that meant, I could have talked to my child and gotten them some help.’ “

In hindsight, Galloway remembers telltale signs about Connor. Since he died, she has gotten involved with a group of other parents who lost children to the game, hoping her story will at least help prevent more deaths. Galloway and her husband are both teachers.

Even so, she said, “Neither one of us had never, ever heard about it before.”

Story By: by Michelle Andrews

Traditional Medicare doesn’t pay for hearing aids, so some in Congress would like to give purchasers a tax break.

Hearing loss is all too common.

Some 35 million people have trouble hearing. After high blood pressure and arthritis, it’s third on the list of chronic health issues for seniors.

Yet traditional Medicare coverage doesn’t include the cost of hearing aids, and most private health plans follow suit. That leaves it to many people to scrape up the money on their own.

That’s no small task, since hearing aids can cost a few thousand dollars and generally have to be replaced every four to six years.

Legislators in both houses of Congress over the past decade have repeatedly proposed a tax credit that could provide at least a modicum of financial help.

Bipartisan bills are pending again in both the House and Senate, but they’re not moving ahead anytime soon. “We continue to gain support of the bill, but there has been no legislative activity,” says Ingrida Lusis, director of federal and political advocacy at the American Speech-Language-Hearing Association. Both bills have been referred to committee, but no action has been taken.

The House bill would provide a tax credit of up to $500 per hearing aid every five years to people age 55 or older or to families who bought one for a dependent. People with incomes over $200,000 would be ineligible for the tax credit. It has been estimated to cost about $300 million.

The Senate bill provides for a similar tax credit but with no restriction on age or income.

One hearing aid user, Kathy Borzell, 62, of Sapphire, N.C., estimates she’s spent $25,000 out of pocket over the past 20 years buying hearing aids for both ears.

Although $500 may only be a fraction of the cost most people spend on hearing aids, advocates say it would let policymakers send a message to those needing hearing aids that “We hear you.”

Story By: by Nancy Shute

Christopher Astacio reads with his daughter Cristina, 2, recently diagnosed with a mild form of autism, in her New York bedroom on Wednesday.

The number of children diagnosed with autism jumped 23 percent between 2006 and 2008, according to the latest federal estimate.

Now, 1 in 88 children has been diagnosed with autism, according to figures from the Centers for Disease Control and Prevention.

The rapid rise prompted calls to declare the developmental disorder an epidemic. “This is a national emergency in need of a national plan,” Mark Roithmayr, president of the advocacy group Autism Speaks, said at a CDC media briefing Thursday.

But CDC scientists weren’t about to go that far. Instead, they said that most if not all of that startling increase could be due to better recognition of the disorder by parents, doctors and teachers.

“There is the possibility that the increase in cases is entirely the result of better detection,” Dr. Thomas Frieden, head of the CDC, said at the briefing.

From 2002 to 2008, the number of children diagnosed with an autism spectrum disorder has risen 78 percent, according to this ongoing study, which tracks diagnoses among 8-year-olds in 14 states. It was published in the CDC’s Morbidity and Mortality Weekly Report.

The survey counted not just children who had been given an official diagnosis of autism, but those whose school or medical records included descriptions of behavior typical of the disorder. Those methods have been consistent throughout the study.

Because there is no known cause for autism, the question of what’s fueled the swift rise in diagnoses over the past 20 years has been a major point of contention between advocates and scientists.

“In very much respect to Dr. Frieden, only part of the increase is better diagnoses,” Roithmayr said at the CDC today. “There is a great unknown. Something is going on here that we don’t know.”

Autism Speaks and other advocacy groups have long pressed the federal government to do more research on environmental causes of autism, including the unproven theory that childhood vaccines caused autism. Scientists have tended to focus on genetic causes of autism, and factors such as advanced parental age and premature birth, both of which increase a child’s risk of autism.

Twenty-one percent of adults think autism is linked to vaccines, according to an NPR-Thomson Reuters poll conducted last August. That was at the same time that a review from the Institute of Medicine said vaccines don’t cause autism.

The advocates and scientists do agree on one fact: Too many children miss out on an early diagnosis, which could lead help them get behavioral therapies early on, when they do the most good.

In this study, most of the children had been diagnosed by age 4. But 20 percent of the 8-year-olds identified hadn’t been diagnosed before.

“At 4 years old, it’s too late,” Frieden said today. “We need to get this down to 18 months of age.” The American Academy of Pediatrics recommends that pediatricians screen all children for autism at 18 months and 24 months.

“It’s really important for parents who have concerns to bring them up,” said pediatrician Susan Hyman, who spoke representing the AAP. “And it’s important for them to be persistent. Any concern a parent has has to be taken seriously. Don’t defer.”

The soaring numbers of children being diagnosed also means soaring costs for school districts and insurers. Parents and advocacy groups have been pushing in Congress and state legislatures for better coverage of special education and health care for children with an autism diagnosis.

A survey released yesterday by Autism Speaks estimates that direct and indirect costs of caring for children with autism costs $126 billion a year. But that number is based on the 2006 estimate of prevalence, which is 1 in 110. Bump that up to 1 in 88, and the cost wouldl be $137 billion a year, Roithmayr said.

The disorder can be mild or severe, but it interferes with a person’s ability to communicate and understand social cues. More seriously affected people are unable to speak.

Editor’s note: Dr. Peter Szatmari has worked in the field of autism spectrum disorders for more than 30 years. He is a professor and the head of the Division of Child and Adolescent Psychiatry in the Department of Psychiatry and Behavioral Neurosciences at McMaster University in Hamilton, Ontario.

The disorder usually shows up in infancy, starting with noticeable problems in social communication, with a preference for engaging in repetitive, sensory-oriented behaviors. The severity of these deficits varies greatly among individuals diagnosed with ASD. Recovery is rare, though it is true that some individuals may make substantial progress over time.

The disorder is associated with a high burden of suffering in terms of the limitations it imposes on those affected. There has also been a lot of attention paid to the extra burden and loss of income it represents for parents and the cost to the social, educational and health care systems.

CNNMoney: Autism’s financial toll

But one aspect of autism that doesn’t get a lot of attention is the way the condition manifests differently in girls and boys.

We have known for many years that autism is more common in boys than girls. The disorder appears different in the sexes, and these differences may have important implications for both diagnosis and treatment.

A striking finding of the recent Centers for Disease Control and Prevention report, showing a 78% increase in cases over the past decade, is that the ratio of boys to girls in ASD is about 5-to-1. That is higher than what is usually reported in other studies, where a ratio of 2-, 3- or 4-to-1 is more common.

There is no adequate explanation for this imbalance in the sex ratio, though it must be recognized it is also true for other developmental disorders of early childhood such as learning disabilities and attention deficit disorder. In contrast, girls appear to be overrepresented in disorders that begin after puberty such as depression and anxiety.

Something seems to protect girls from developing ASD and other developmental disorders. That “something” could be hormone levels in utero, epigenetic factors that turn autism susceptibility genes “on” and “off” during development, or the fact that young girls have in general better social skills than boys and so need a bigger “dose” of what causes ASD to cross that threshold to being impaired. It is also possible that a proportion of girls with mild autistic traits lose those traits early on and so escape detection by 8 years of age (the age of the children in the CDC study).

With autism, he’s no longer ‘invisible’

Whatever the reason, the sex ratio in ASD is perhaps the most consistent finding in the field but perhaps the least understood. Yet it is possible that those “protective” factors, once identified and understood, could play an important role in pointing toward new treatments and interventions that capitalize on those protective factors and so make a real difference to long-term outcomes.

The clinical expression of autism is also different in boys. Generally speaking, girls with autism have greater learning disabilities and more problems academically than boys. The sex ratio in ASD approaches 1-to-1 as the degree of cognitive impairment increases. Conversely, the sex ratio has sometimes been reported to be even greater than 5-to-1 among so-called “higher-functioning” individuals with ASD, though not all studies agree on this point.

An intriguing finding is that perhaps higher-functioning girls with ASD are missed by clinicians who are not experts in diagnosis. There is some evidence that among this subgroup, girls have better social skills than higher-functioning boys with ASD and so are not diagnosed as readily.

Often, the symptoms of ASD appear as extreme shyness or anxiety in girls, masking that they may not be responsive to the social cues of others. And while fixated interests are common in both sexes on the autism spectrum, girls tend to focus on topics such as on ponies, princesses, dolls or drawings — common passions for non-autistic girls, too. Boys, on the other hand, may become stuck on less typical activities, such as lining up blocks or running sand through their fingers. As a result, doctors may miss that some of their female patients show signs of autism.

Life with autism: Your stories

Girls on the autism spectrum also engage in fewer repetitive behaviors such as rocking and spinning and less sensory irritability than boys with ASD. Since these signs are subtle, doctors may not recognize the disorder. Diagnosis at a later age reduces the chances of early treatment, which is thought to produce a better outcome.

Girls may be different than boys with ASD in their lived experience of the disability as well. There’s increasing concern about peers bullying children with ASD at school and in the community. Some evidence suggests that girls with ASD are bullied less often than boys. They appear to “blend in” more readily with their peer group and are less often the victim of bullying by other girls.

Sex differences in ASD is an important topic, but one that has only recently become the focus of attention. Understanding those sex differences both biologically and experientially holds the promise of improving the long-term outcome of all children with ASD.

Most important, clinicians need to be sensitive to how the disorder shows up in girls so that those affected can receive early intervention as soon as possible.

The opinions expressed in this commentary are solely those of Peter Szatmari.

A children's charity is calling for more clarification about the terms of an external review into children's congenital heart services in Northern Ireland.

But on Friday, Sarah Quinlan of the Children's Heartbeat Trust said: "On behalf of parents, we will seek immediate clarification from the DHSSPS on the terms of reference and timescale of the department's external review of paediatric congenital cardiac services in Belfast.

"Most importantly, we will also seek assurances that the views of families of children with congenital heart disease play a central role in the consultation.

"We welcome the decision by the Belfast Trust to invite the Royal College of Surgeons to conduct a review and await its findings.

"Children's Heartbeat Trust has absolute confidence in the medical staff and services which support the treatment of children with congenital heart disease at the Royal Belfast Hospital for Sick Children. "

A majority of children's heart operations are now carried out in England as the Belfast Health Trust has yet to replace a heart surgeon who retired in 2010.

Dr Frank Casey, a children's heart consultant at the Royal Victoria Hospital, said he welcomed the review, but tougher safety measures were already in place.

"We have the most robust monitoring arrangements of any centre in the UK," he said.

"We audit our results on a weekly basis and we know that since we started that monitoring in the last 18 months, of all the children who have gone through our unit for cardiac surgery, there have been no deaths."

A spokesman for the Department of Health said: "The minister has been informed of the decision by the Health and Social Care Board to carry out an external review of paediatric congenital cardiac services in Northern Ireland.

"He has made a statement to the Assembly to inform members that this review will provide assurance on the quality of services for patients in Northern Ireland."

The Belfast Trust has a free advice line for any parent who is concerned. It is 0800 9178226.

Story By: by Ted Burnham

U.S. Surgeon General Regina Benjamin totes a copy of a report on the need to reduce children’s use of tobacco.

Update 5:25 p.m.: Altria, the parent company of Phillip Morris, released a statement responding to the Surgeon General’s report. “We agree with the Surgeon General and others that kids should not use tobacco products, and we share the common goal of keeping tobacco products out of the hands of kids,” the statement reads, emphasizing that tobacco companies do not market directly to children. It says Phillip Morris has given states more than $55 billion in settlements over the last 15 years, but says states have not used the money to its full potential.

The U.S. Surgeon General today issued the first report on youth smoking since 1994. And the findings aren’t encouraging.

Surgeon General Regina Benjamin calls tobacco use a “pediatric epidemic.” The nation’s war on smoking hinges on preventing young people from taking up the habit in the first place, she says.

For starters, 1 in 4 American high school seniors smokes cigarettes. Most of them will become adult smokers, and half of them will die prematurely as a result, the report says.

To stop that from happening, Benjamin says the nation has to “reinvigorate” its battle against tobacco.

Anti-smoking campaigns need to focus on teenagers and young adults. That means doing a lot more to counter the billions of dollars the tobacco industry still spends on advertising and marketing.

The Surgeon General says strategies might include public service ads, higher taxes on cigarettes and more smoking bans.

Smoking rates for teens dipped in the early part of the last decade, after a wave of public concern in the late ’90s. But by 2007, rates were at a standstill.

The new report comes as many states, hit hard by the recession, have cut funding for anti-smoking campaigns. Although states won a $246 billion settlement from the tobacco industry in 1998, much of the money earmarked specifically for anti-smoking programs has been shifted to other uses, as USA Today reported recently,

Story By: by Robert Krulwich

The question was simple enough. Richard Feynman, one of the greatest science teachers of our age, physicist, scholar, Nobel Laureate, bongo player, a man who could explain pretty much anything, is sitting, a little uncomfortably, in an easy chair and the reporter interviewing him asks: Why do magnets work?

Feynman shifts a little. “You’re asking…” and he gives the reporter a look that almost says “This is what you want to ask me…come on…”

“I think that’s a perfectly reasonable question,” the reporter says.

“Of course it’s a reasonab — it’s an excellent question,” says Feynman. “But how does a person answer ‘Why something happens..?’ “

Then Feynman does what he does. He lets loose and ponders the word “Why?”

Just sit back and watch him fly.

For those of you in the New York area, I will be talking to Radiolab regular Jonah Lehrer about his new book, Imagine, on Monday, March 19. The book investigates how people come up with new ideas, all kinds of different ideas: how to surf backwards on a wave, how to create a martini infused with bacon, how to perform brilliantly on a cello, how to create a dust mop, how write poetry, rock ballads, how the mind generates new ideas. It’s not really a “How To,” it’s more a “How Do?” as in How do brains do that?

Jonah and I will be at Barnes & Noble, 33 East 17th Street at 7 p.m. Everybody’s welcome.

Story By: by Nancy Shute

Chocolate chip cookies don’t seem to be a great vehicle for chickpeas, according to kids.

Will kids eat their veggies if they’re inside desserts? Parents and nutritionists have been debating this question for years.

Now, it seems there’s an answer: Yes, if it’s broccoli in the cake. No, if it’s chickpeas in the chocolate-chip cookies.

Nutritionists generally hate the idea of “stealth veggies,” arguing that children should learn to eat their vegetables and like them, darn it. They got really bent out of shape after reading The Sneaky Chef by Missy Chase Lapine, and Deceptively Delicious by Jessica Seinfeld, both of which argued for sneaking veggies into kid-friendly foods.

To figure out who’s right, scientists at the Teachers College, Columbia University cooked up three treats: zucchini chocolate chip bread, broccoli gingerbread spice cake, and chickpea chocolate chip cookies.

Chickpea chocolate chip cookies?

That sure got me dialing the phone. Lizzy Pope, the lead author of the study, says the cookies did indeed contain actual chickpeas. “You just pour a can of chickpeas into your cookie dough.

“I thought they were pretty good, actually,” says Pope, a registered dietitian who is now a PhD student at the University of Vermont. She says the cookies are a bit moister than usual, but that the chickpeas tend to blend in with the dough.

Pope served her creations to 68 children, ages 8 through 14. The trick was that all the desserts contained stealth items, but only half were labeled that way. The other half were falsely labeled chocolate chip bread, gingerbread spice cake, and chocolate chip cookies.

Kind of a reverse deceptively sneaky.

The children surprised the researchers by being just as happy with the bread and cake, whether or not they were labeled as having vegetables. The cookies were another matter.

The kids voted overwhelmingly for the cookies they thought had no chickpeas, and rejected the overtly leguminous ones.

Pope thinks the problem wasn’t chickpeas per se. It’s that most of the kids weren’t familiar with them. That wasn’t the case with broccoli and zucchini. “It was a neophobia thing going on.”

The take-home message, at least from this study: “You don’t have to hide vegetables in food to get kids to eat them,” Pope says. The research was published in the current Journal of Nutrition Education and Behavior.

Instead, she says, telling children there’s a vegetable in what they’re eating might not be a bad idea at all.

Especially if it’s a broccoli gingerbread spice cake.

For more on adventures in upping the vegetable content in food, check out Allison Aubrey’s report on school lunches. Or check out Lizzy’s Pope’s blog on her study.

Story By: by NPR Staff

Jennifer Coursey with her son, 12-year-old Grant Coursey, at StoryCorps in Ukiah, Calif.

When Grant Coursey was a toddler, he was diagnosed with neuroblastoma, a cancer often found in young children. A tumor had wrapped itself around Grant’s spinal cord and had grown so that it pushed against his lungs.

Now 12, Grant is cancer-free; he received his first “clean” scan 10 years ago in March 2002. He had to undergo several procedures to rid his body of the cancer.

Recently, Grant and his mother, Jennifer, sat down to talk about his young life and how cancer has affected it.

“So, Mom, when I was diagnosed with cancer, how old was I?” Grant asks.

“You were 16 months old,” Jennifer says.

That diagnosis was made after Grant’s doctor started looking into what seemed to be a case of asthma. A chest X-ray was scheduled to find the cause of Grant’s wheezing. When the Courseys came in to have the X-ray images taken, Grant’s grandfather, a doctor, walked over from his office to be with them.

“As a professional courtesy, the radiologist asked if we’d like to see the images right there and then,” Jennifer says. “So, when they put the images up, things got real quiet in the room.”

The X-rays showed a tumor the size of a grapefruit. As Jennifer remembers, Grant’s grandfather looked at the images then gave his family a hug.

“And you know how Papa walks really straight?” Jennifer asks Grant, referring to his grandfather. “He kinda looked like somebody’d kicked him in the gut as he was walking back to his office, and that scared me.”

The boy was quickly scheduled for a biopsy. Over the next 12 months, more surgeries followed.

“The first time they put you under anesthesia and they put the mask on your face, you really struggled,” Jennifer says. “That’s pretty awful for …”

“A parent,” Grant says.

“A parent and a kid,” Jennifer says.

“But I remember as I got older I used to like it, actually,” Grant says.

Before he was three years old, Grant Coursey underwent several surgeries for a cancerous tumor.

“Yeah. So, you being super into firefighters, I said, ‘This is just like the firefighters, you know? They put the clean air on so they can go in there and save people.’”

“I practically put it on myself the minute I walked in there!” Grant says.

“You did! You loved it,” Jennifer says. “So, what else do you remember?”

“I remember being scared, a lot,” Grant says. “I remember waiting in the waiting room made me … what’s the word? Apprehensive, kind of. That was brutal, always.”

After the biopsy, Grant underwent a 10-hour operation, as surgeons removed the bulk of the tumor from his chest. Eventually, he required one more surgery to remove the remnants of the tumor, which had begun to grow anew.

“I always kind of hoped that you didn’t really remember much,” Jennifer says, “but the scary stuff really stuck with you.”

“Yeah. You know, I’ve got big scars all over my back from getting cut open,” Grant says. “Whenever that kind of starts to twinge a little bit, like if I touch it wrong or something like that, it just kind of reminds me I’m lucky.”

“Yeah,” Jennifer says.

“You know, life is really good,” Grant says. “And there’s this saying that says if you’ve been close to death, you understand life more. And sometimes I think of that, and I think, you know, if this had never happened to me, I never would have understood how much life means, kinda. You know? What if I had died? I’d never have this amazing life.”

“That’s right,” his mother says.

“That’s crazy to think about,” Grant says.

“It is crazy to think about,” Jennifer says. “Well, Grant, I’m sure glad you got well.”

“Yeah.”

“I sure love you. And I hope you’re picking up that I’m so proud of you,” Jennifer says. “I’m so proud of you.”

“I pick that up a lot, honestly,” Grant says.

“Good.”

Audio produced for Morning Edition by Michael Garofalo.