The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
February 5, 2005

Important Medical Disclaimer: The content displayed in Personal Health is designed to educate and inform. Under no circumstances is it meant to replace the expert care and advice of a qualified physician. Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Personal Health assumes no responsibility for how information presented is used.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL HEALTH for the week of January 1-7

 

  1. Allergies Up Healthcare Use by Asthmatic Children
  2. Health Tip: The Highs and Lows of Cholesterol
  3. Lyrica Relieves Diabetes Pain
  4. Musks in Fragrances May Weaken Immune System, Study Says
  5. Electrical Therapy Improves Walking After Stroke
  6. Wrist Splints at Night Ease Carpal Tunnel Symptoms
  7. Red Wine May Reduce Prostate Cancer Risk
  8. Chamomile Tea May Have Medicinal Value
  9. Magnesium Infusion Helps Kids with Asthma Attacks
  10. Dog Epilepsy Gene Discovery Could Aid People: Study
  11. Health Tip: Profile of a Weight Loser
  12. Gene Helps People Resist AIDS Infection- Study
  13. New Clues to Restless Legs Syndrome in Kids
  14. Nip from Hamster Fells Young Boy
  15. Cord Blood Stems Heart Attack Damage
  16. People with Diabetes Need to Take Care of Teeth
  17. No Link Found Between Vaccines and Autism
  18. Errors Endanger Hospitalized Children
  19. U.S. Gets Failing Grades on Tobacco Control
  20. Drug Industry Agrees to Disclose More Trial Data
  21. Herbal Extract Reduces Migraines
  22. Health Tip: Symptoms of Appendicitis
  23. Secondhand Smoke Lowers Kids' Math, Reading Scores
  24. Obese Blacks Incur Lower Health-Care Costs
  25. Fruits, Veggies Lower Kids' Blood Pressure
  26. Some Cases of Sudden Cardiac Death May Start in Brain
  27. Lifestyle Changes Cut Heart Risk Without Drugs
  28. Elderly Women With Cervical Cancer Face Tough Battle
  29. Cigarette Smoke Worsens RSV Infection in Infants
  30. Mammography's Early Catches Have Silver Lining
  31. Mental Deficits Common After Very Preterm Birth
  32. Childhood Obesity Weighs Heavily on Kids
  33. U.S. Studies Point to Protein Role in Heart Attacks
  34. Role Seen for Vitamin A to Prevent Breast Cancer
  35. Antibiotic Shown to Protect Nerves in Animal Study
  36. Tanners Have Higher Vitamin D Levels, Bone Mass
  37. Pick a Diet and Stick to It, Study Says
  38. Protein May Protect Against Lung Disease Damage
  39. Statin Use May Slightly Impair Brain Function
  40. Health Tip: Passing Kidney Stones
  41. Eye Disease Predicts Heart Failure
  42. Health Tip: Be Smart When Applying Makeup
  43. Air Pollution Tied to Lower Birth Weight
  44. Checking Cancer's Growth
  45. Curry Spice May Fight Alzheimer's
  46. Passive Smoke Lowers Kids' Test Scores
  47. Study: Test Detects Pregnancy Complication
  48. Study Unlikely to Change Use of Hypertension Drugs
  49. Study Shows No One Knows Which Diets Work Best
  50. Health Tip: Mullin' Melons
  51. Painkillers Damage Intestine, U.S. Expert Says
  52. Aspirin Use Lags Among Diabetic Women
  53. Dual Pacemakers Worth the Cost, U.S. Study Finds
  54. Saliva Holds Clues to Oral Cancer
  55. Italian Study: Shy Children Don't Read Emotions Well
  56. Artificial Hip a Story of Setbacks, Triumph
  57. High Body Weight Linked to Kidney Cancer Risk
  58. Only Moderate Drinking Wards Off Stroke
  59. More Awareness Needed of Toddlers' Risk for Scalds
  60. Protein Plays Key Role in Alcohol Abuse
  61. With Diabetes, Women Do Worse After Stenting
  62. These Drugs Pull Double Duty
  63. Brain Surface Stimulation May Ease Parkinson's
  64. Teen Obesity Is a Ticking Time Bomb
  65. Fibromyalgia: New Insights Into a Misunderstood Ailment

 

 

 

Friday, January 7, 2005

 

Allergies Up Healthcare Use by Asthmatic Children

 

Reuters Health

Friday, January 7, 2005

NEW YORK (Reuters Health) - Children with both asthma and hay fever (allergic rhinitis) incur greater asthma drug costs and are hospitalized more often than similar children who have just asthma, according to a new report.

Dr. Vasilisa Sazonov Kocevar, from Merck and Co., Inc. in Whitehouse Station, New Jersey, and colleagues analyzed data from 9522 asthmatic children in the UK to assess healthcare resource use. Of these subjects, 1879 had allergic rhinitis.

During the 12-month study period, the group with rhinitis had an average of 4.4 general practitioner (GP) visits and a hospitalization rate of 1.4 percent, the investigators report in the medical journal Pediatrics. The asthma-only group averaged 3.4 doctor visits with a 0.5 percent hospitalization rate.

In addition, rhinitis was linked to an increase in asthma drug costs, regardless of asthma severity.

"These results are consistent with those of two US studies," Kocevar's team notes.

The researchers conclude that the "coexistence of asthma and allergic rhinitis identifies a high-risk group of children that should be targeted for care."

Source: Pediatrics, January 2005.

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Health Tip: The Highs and Lows of Cholesterol

 

HealthDayNews

Friday, January 7, 2005

(HealthDayNews) -- Most health-conscious people know that too much "bad" cholesterol can raise your risk of a heart attack, but lots of people may not realize what cholesterol is or what it does, the American Heart Association (news - web sites) says.

Cholesterol is a waxy substance that stems from two sources: the liver and the animal-based foods we eat. While the body needs cholesterol to insulate nerves, make cell membranes, and produce hormones, the body makes enough on its own without dietary help.

When there is too much "bad" cholesterol in your blood, it combines with other substances to build up on the walls of your arteries. This buildup is called plaque, and it causes arteries to become narrow, slowing blood and oxygen flow to the heart.

If the blood supply to a portion of the heart is mostly or entirely cut off by a blockage, conditions are ripe for a heart attack.

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Lyrica Relieves Diabetes Pain

 

Reuters Health

Friday, January 7, 2005

NEW YORK (Reuters Health) - A new drug, Lyrica (pregabalin) is a well-tolerated, effective treatment for pain in the extremities often experienced by people with diabetes, according to a recent report. In addition to reducing the pain, the drug seems to improve sleep.

The findings, which appear in the medical journal Neurology, are based on a study sponsored by Pfizer, which markets Lyrica. Just last week, the FDA (news - web sites) approved the drug specifically for painful diabetic neuropathy.

The study involved 338 patients with diabetes-related pain who were randomly given Lyrica, at one of three doses, or inactive "placebo" for five weeks.

The intermediate and highest doses of Lyrica, but not the lowest dose, were better than placebo at improving pain, Dr. Harold Lesser, from the University of Rochester School of Medicine & Dentistry in New York, and colleagues note. These doses were also tied to significant improvements in sleep and quality of life.

People who were given Lyrica were also more likely to have a treatment response, meaning that they had a 50 percent or greater improvement in their pain. The two higher doses of Lyrica had responder rates of around 47 percent, whereas the rate with placebo was just 18 percent.

The improvements in pain and sleep were noted within 1 week of treatment with Lyrica and continued throughout the study, the investigators point out.

Treatment with Lyrica was well tolerated and side effects were generally mild, most commonly dizziness and sleepiness, the report indicates.

The results suggest that Lyrica has the potential to become a first-line treatment for diabetes pain, Lesser's team notes.

Source: Neurology, December 15, 2004.

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Musks in Fragrances May Weaken Immune System, Study Says

HealthDayNews

Friday, January 7, 2005

FRIDAY, Jan. 7 (HealthDayNews) -- Synthetic musks that are widely used as fragrances in products such as soaps, cosmetics and detergents may reduce the body's ability to defend against toxic compounds, says a study in the January issue of Environmental Health Perspectives.

About 8,000 metric tons of synthetic musks are produced worldwide each year.

In laboratory research using human tissue, researchers at Stanford University's Hopkins Marine Station found that exposure to synthetic musks inhibited the tissue's natural defenses against toxic compounds from California mussels. This effect persisted long after the end of the tissue's exposure to the synthetic musks.

The synthetic musk levels used in this study were several times higher than those found in the environment, the study authors noted. However, these musks concentrate in fats, including breast milk, and remain in human tissue long after exposure. This means that long-term exposure to these synthetic musks could result in tissue concentrations high enough to impair natural cellular defenses in humans, the authors suggested.

"While other studies have shown that humans are constantly exposed to musk compounds, routine toxicology screens have always shown these compounds to be nontoxic. This study's suggestion that they could harm the body's ability to fight other toxicants certainly merits further examination," Dr. Jim Burkhart, science editor for Environmental Health Perspectives, said in a prepared statement.

The fragrance industry, in a prepared statement, disputed the findings.

"Fragrances and fragrance ingredients are safe. The ingredients used to make fragrances have been extensively researched, and fragrances have a long history of safe use dating back hundreds of years," Glenn Roberts, executive director of the Fragrance Materials Association, said.

"Nitromusks and polycyclic musks (PCMs) are among the most thoroughly researched and tested fragrance ingredients. Their safety for human health has been extensively tested and affirmed by numerous regulatory agencies and academic scientists around the world. The results in this paper do not impact the safe use of nitromusks or PCMs, nor alter their environmental risk assessment," Roberts added.

More information

The U.S. Environmental Protection Agency (news - web sites) outlines exposure pathways of hazardous substances.

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Electrical Therapy Improves Walking After Stroke

Reuters Health

Friday, January 7, 2005

NEW YORK (Reuters Health) - Adding functional electrical stimulation (FES) to standard rehabilitation improves lower extremity function and walking ability in patients with a first acute stroke, new research shows.

FES, which has been in use since the 1960s, involves the use of mild electric currents designed to stimulate the muscles.

Previous reports have suggested an advantage for electric stimulation therapy over standard rehabilitation, but most studies investigating the issue have not been properly designed, Dr. Christina W. Y. Hui-Chan, from The Hong Kong Polytechnic University, and colleagues note.

To address this issue, the researchers assessed the outcomes of 46 patients who were randomly treated with standard rehabilitation alone or in combination with either FES or fake "placebo" stimulation. Stimulation began a few days after the stroke and was given five days per week for three weeks.

The researchers' findings appear in the American Heart Association (news - web sites)'s journal Stroke.

Compared with the other two interventions, FES plus standard rehabilitation improved several measures of lower limb function.

As noted, treatment with FES also improved walking ability. After treatment, all patients in the FES group were able to walk and 85 percent returned home. In contrast, the percentage of patients returning home in the other groups hovered around just 50 percent.

While the results are encouraging, it is not clear that they can be generalized to all stroke patients because the study did not include all stroke categories or patients outside the 45- to 85-year-old age range, the researchers note.

Source: Stroke, January 2005.

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Wrist Splints at Night Ease Carpal Tunnel Symptoms

By Serena Gordon
HealthDay Reporter

HealthDayNews

Friday, January 7, 2005

FRIDAY, Jan. 7 (HealthDayNews) -- A simple treatment -- splinting your wrists at night -- may be all that's needed to improve the numbness and tingling of early carpal tunnel syndrome.

That's the conclusion of a new study from the January issue of the Archives of Physical Medicine and Rehabilitation, which found that wearing a custom-made wrist splint for six weeks could bring long-lasting relief.

"This fairly innocuous, low-cost intervention dramatically improves the level of discomfort, not only in the short-term, but the relief lasts up to a year out," said study author Dr. Robert Werner, the chief of physical medicine and rehabilitation at the Ann Arbor VA Medical Center in Michigan.

Carpal tunnel syndrome is a repetitive stress injury that occurs when the median nerve in the wrist is compressed for long periods of time. This compression can cause permanent nerve damage if left untreated. According to the National Institutes of Health (news - web sites), carpal tunnel syndrome is five times more common in women than in men and most often occurs in people between the ages of 30 and 60.

Conservative treatment options include wrist splints, rest, non-steroidal anti-inflammatory medications (NSAIDs), diuretics, cold laser, vitamin B6 and steroid injections, according to the study.

"Simple treatments like nighttime splits can be useful when you get at it early, but many people don't seek treatment right away, and light carpal tunnel can go for long periods of time, causing permanent nerve injury," said Peter Stevens, a physician's assistant in the orthopedics department at Ochsner Clinic Foundation Hospital in New Orleans.

If simple treatments fail, surgery becomes an option. Werner said that about half the people with carpal tunnel syndrome end up having surgery, which is successful for most. But, he added, surgery is expensive and means a month or so of lost work and discomfort.

One hundred and twelve people working at a Midwestern automotive plant were recruited for the study. The repetitive nature of their work puts auto workers at an increased risk of carpal tunnel syndrome, the researchers said. All of the study participants had early symptoms of the syndrome, including burning, tingling, numbness, and pain in the hand that lasted longer than a week and happened more than three times in the six months before the study.

All of the participants watched a short video about carpal tunnel syndrome that contained tips on reducing the risk of the disorder.

Then, 63 people were fitted with custom-made wrist splints that held their wrist in a neutral position, which meant the median nerve wasn't compressed at all. They were told to wear the splints every night for six weeks. The other 49 received no additional instruction.

After 30 days, the group wearing the splints had almost a 50 percent reduction in symptom severity; the control group had a 15 percent reduction.

The researchers followed up with the study participants again after a year, and many who had used the splints still had improvement in their symptoms.

"This study clearly indicates that if you do nighttime splinting that the discomfort levels are improved," said Werner, who suggested that people can try this at home. He said the splints are available at drugstores and they're a "simple home remedy."

But, he added, if you don't start feeling relief after six weeks, or your symptoms are getting worse, you should seek medical attention.

Werner said that wearing the splints kept the study participants from compressing the median nerve at night because people often sleep with their wrists in strange positions. The splints also allowed the median nerve to rest and begin to repair overnight, he said.

"Early intervention is key," said Heather Turkopp, an occupational therapist and certified hand therapist at William Beaumont Hospital in Royal Oak, Mich. "The longer that nerve is compressed, the more permanent damage you're doing."

She said symptoms to be on the watch for include numbness and tingling in the median nerve area, which includes the thumb, index and middle finger, and sometimes part of the ring finger.  

Stevens pointed out the symptoms are often worse at night, and when the wrist is bent, such as holding a book or the telephone.

If you buy splints on your own, Turkopp pointed out that you should make sure the wrist isn't flexed at all. Sometimes, she said, you have to bend the metal support to ensure that the wrist is in a neutral position.

The study was funded by the United Auto Workers (news - web sites)-General Motors National Joint Committee on Health and Safety.

More information

To learn more about carpal tunnel syndrome and treatments for the disorder, go to the National Institute for Neurological Disorders and Stroke.

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Red Wine May Reduce Prostate Cancer Risk

Reuters Health

Friday, January 7, 2005

NEW YORK (Reuters Health) - The results of a new study add to accumulating evidence that consumption of red wine may reduce the risk of prostate cancer in middle-aged men.

Dr. Janet L. Stanford, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues studied data from 753 newly diagnosed prostate cancer patients between 40 and 64 years of age, and from a comparison group of 703 matched "controls" to assess the association between alcohol consumption and prostate cancer.

The men with and without prostate cancer completed in-person interviews about lifetime alcohol consumption and other risk factors for prostate cancer.

No clear associations were observed between the risk of prostate cancer and overall alcohol consumption, the team reports in published in the International Journal of Cancer.

However, "each additional glass of red wine consumed per week showed a statistically significant 6% decrease in relative risk" of prostate cancer, they report.

Alcohol alters the balance of hormones, Stanford's group notes, and it "contains chemical substances such as flavonoids (red wine), which may alter tumor cell growth."

They say the findings "highlight the need for further research on the biological effects of polyphenol rich foods and beverages," which includes red wine.

Source: International Journal of Cancer January 1, 2005.

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Chamomile Tea May Have Medicinal Value

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Friday, January 7, 2005

FRIDAY, Jan. 7 (HealthDayNews) -- Chamomile tea, long touted as a cure-all for the sick or the stressed, may relieve a wide range of health problems, including colds and menstrual cramps.

Elaine Holmes, a chemist with the Imperial College London, and her team used German chamomile, also called manzanilla, whose flowers and leaves are brewed as a flavorful tea. Fourteen volunteers each drank five cups of the tea daily for two weeks.

"There have been many studies on the effects of individual ingredients of chamomile in animal models, but there have been very few studies on the effect of chamomile on human metabolism so far," Holmes said.

Daily urine samples were collected and tested before, during and after the study. A significant increase was found in urinary levels of hippurate, a breakdown product of plant-based compounds known as phenolics. Some of those have been associated with increased antibacterial activity, and this might explain why the tea seems to fight infections associated with colds, the researchers said.

Drinking the tea was also linked with an increase in urinary levels of glycine, an amino acid that has been shown to relieve muscle spasms. That might be why the tea seems to ease menstrual cramps, the researchers said. Glycine also can act as a nerve relaxant, perhaps explaining the tea's sedative value, they added.

Holmes' group found that the levels of both hippurate and glycine remained elevated for up to two weeks after the subjects stopped drinking the tea, so the compounds might work their magic for some time. Oxford Natural Products, a pharmaceutical, nutraceutical and technology company, funded the study.

The report appears in the Jan. 26 issue of the Journal of Agricultural and Food Chemistry.

In other research, scientists have found that tea may have anticancer properties and may help lower cholesterol, among other health benefits.

"Other types of tea may work as well," Holmes said. "We don't know as yet." The chamomile appears to be altering the gut microflora, which leads to an increase in urinary hippurate and glycine, she explained.

"One of the most interesting findings was that the effect of the chamomile tea lasted at least two weeks after the volunteers had stopped drinking the tea," she noted.

The findings are probably a true reflection of the science, said Hasan Mukhtar, a researcher at the University of Wisconsin who has studied green tea and its role in stemming the spread of prostate cancer.

More information

To learn more about tea, visit the Tea Association of Canada.

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Magnesium Infusion Helps Kids with Asthma Attacks

Reuters Health

Friday, January 7, 2005

NEW YORK (Reuters Health) - For children who need to go to the ER because of a severe asthma attack, giving them an intravenous infusion of magnesium sulphate along with conventional medications provides an additional benefit, Hong Kong doctors report.

Dr. D. K. L. Cheuk, at the University of Hong Kong, and colleagues analyzed clinical trials involving a total of 182 children. The studies evaluated the effects of intravenous magnesium sulphate with or without inhaled beta-2-agonist bronchodilators and oral steroid drugs in subjects suffering acute asthma who were seen in the emergency department.

The main point was to see if the treatment kept the children from being hospitalized for treatment.

"After pooling the results together, intravenous magnesium sulphate was effective in avoiding hospitalization," Cheuk's team reports in the Archives of Disease in Childhood.

A significant improvement was also seen with magnesium treatment in short-term lung function tests and symptom scores.

Given these results, the investigators conclude, "Intravenous magnesium sulphate is likely to be effective in avoiding hospitalization and improving bronchoconstriction and clinical symptoms of moderate to severe acute asthma in children, when added to standard therapies of inhaled bronchodilators and systemic steroids."

Source: Archives of Disease in Childhood, January 2005.

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Thursday, January 6, 2005

 

Dog Epilepsy Gene Discovery Could Aid People: Study

 

Reuters

Thursday, January 6, 2005

WASHINGTON (Reuters) - A gene that causes a rare but severe form of epilepsy in people is also found in highly bred dogs, which could lead to new ways to treat the condition, an international team of researchers said on Thursday.

Dr. Berge Minassian of the Hospital for Sick Children in Toronto, Canada and colleagues in the United States, France and Britain found the gene in purebred dachshunds, and were able to breed it out of them.

Writing in the journal Science, they said they hoped their findings could lead to treatments for epilepsy in people.

"Epilepsy afflicts 1 percent of humans and 5 percent of dogs," they wrote.

"More than 5 percent of purebred miniature wire-haired dachshunds in the United Kingdom suffer an autosomal recessive progressive myoclonic epilepsy, which we show to be Lafora disease, the severest form of teenage-onset epilepsy in humans."

In dogs, the disease was much less severe than in humans.

The dachshunds with Lafora disease had a mutation in the EPM2B gene that prevents the gene from functioning. It takes two faulty copies of the gene, one from each parent, to cause epilepsy.

The mutation was found across dogs but not in close dog relatives such as bears, raccoons or skunks, the researchers said. Cats also lack the mutation.

They said their study at the very least showed that dogs can be used to study the epilepsy and to look for better treatments.

In 2003 Minassian's team found the EPM2B gene was associated with Lafora disease. A closely related gene called EPM2A can also cause the epilepsy, which causes seizures and progressive brain damage and kills within about 10 years.

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Health Tip: Profile of a Weight Loser

 

HealthDayNews

Thursday, January 6, 2005

(HealthDayNews) -- It that time of year, when people decide they have to lose weight.

And although many people who lose weight eventually gain it back, it's a myth that this happens to everyone, says Rena Wing, Ph.D., co-developer of a research study known as the National Weight Control Registry. Wing's findings are reported on the U.S. Food and Drug Administration (news - web sites)'s Web site.

Tucked away in the registry's database is information about the weight-control behaviors of more than 3,000 American adults, who have lost an average of 60 pounds and have kept it off for an average of six years. How do they do it?

Successful weight losers report four common behaviors, Wing says. They eat a low-calorie, low-fat diet; they weigh themselves often; they are very physically active; and they eat breakfast.

Eating breakfast every day is contrary to the typical pattern for the average overweight person who is trying to diet, Wing said. "They get up in the morning and say 'I'm going to start my diet today,' and they eat little or no breakfast and a light lunch. Then they get hungry and consume most of their calories late in the day. Successful weight losers have managed to change this pattern."

Most of the registry's successful losers report eating a low-calorie, low-fat diet. They also exercise for about an hour or more a day, expending about 2,800 calories per week.

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Gene Helps People Resist AIDS Infection- Study

 

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, January 6, 2005

WASHINGTON (Reuters) - A gene that may help block the AIDS (news - web sites) virus from getting into cells seems to protect some people from the deadly and incurable infection, researchers said on Thursday.

They found that people who carry extra copies of the gene are less likely to become infected with the virus, which affects 40 million people worldwide.

The findings may eventually lead to better ways to prevent and treat HIV (news - web sites), which has killed more than 25 million people since it was first identified in the early 1980s, said the National Institute of Allergy and Infectious Diseases (news - web sites), which funded the study.

It also may help explain overall human immunity against infectious diseases, the researchers write in an advance report in the journal Science.

The gene, called CCL3L1, controls production of an immune system signaling chemical, or chemokine.

Normally, genetic variation means people have slight mutations or variations in a gene, or working and non-working copies -- one copy inherited from the mother and one from the father. In this case, people actually have multiple copies of the entire gene, said Dr. Sunil Ahuja of the University of Texas Health Science Center in San Antonio, who led the study.

"About five percent of the human genome has got large chunks of sequence that are duplicated," Ahuja said in a telephone interview.

For CCL3L1, some people have no copies of the gene at all and some people have four, five and more. This chemokine is associated with a receptor -- a cellular entryway -- known as CCR5.

CCR5 is known to affect susceptibility to HIV infection and to how quickly an infected person progresses to AIDS.

Studying Different Ethnic Groups

For their study Ahuja and colleagues in the United States, Britain and Argentina analyzed blood samples from more than 4,300 HIV-infected and non-infected people of different ancestral origins.

They counted how many copies of the CCL3L1 gene each person had, and found big variations.

For example, HIV-negative black adults had an average of four copies of CCL3L1, while HIV-negative European-Americans averaged two copies each and uninfected Hispanic-Americans had an average of three copies.

The more copies a person had, the less likely he or she was to be infected with HIV.

And it was not the absolute number of extra copies of the gene that mattered, Ahuja's team found. Instead, it was whether a person had more copies than average for his or her ethnic group.

In general, each extra copy of the CCL3L1 offered 4 percent to 10 percent protection from the virus, Ahuja said.

About 1 percent of people of Caucasian descent have a mutation in the CCR5 gene that makes them very unlikely to acquire HIV, or to come down with AIDS once infected. That led Ahuja's team to look at chemokines that interact with CCR5.

He described infection as a battle between the virus and the body's immune system chemokines, all trying to get into immune cells called T-cells. "The virus is trying to compete with sites for chemokines," he said.

The outcome depends on how much virus is in the blood, how many CCR5 receptors a cell has and how much chemokine is around.

Dr. Matthew Dolan, an Air Force colonel at Brooks City-Base in San Antonio who worked on the study, said the finding could help doctors decide when and how to treat HIV-infected patients with cocktails of anti-viral drugs. It could also help in designing new vaccines and testing current HIV vaccines, Dolan said.

He said it was unclear if the CCL3L1 chemokine itself could be made into a treatment of vaccine.

"You don't know if varying what nature has wrought here could improve this disease or worsen some other disease," Dolan said.

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New Clues to Restless Legs Syndrome in Kids

 

HealthDayNews

Thursday, January 6, 2005

THURSDAY, Jan. 6 (HealthDayNews) -- Iron deficiency and a family history of the disease are the most common risk factors for restless legs syndrome in children, says a Mayo Clinic study.

It also found that nearly 6 percent of children who come to Mayo's sleep clinic have restless legs syndrome.

"Restless legs syndrome is underdiagnosed in kids," Dr. Suresh Kotagal, sleep specialist and chairman of Mayo Clinic pediatric neurology, said in a prepared statement.

"If you look at children with difficulty falling asleep, you'll see a fair number have restless legs. Thus far, there have been sporadic case reports, but nobody has studied a larger group of children, looking at children with insomnia complaints as a whole to see how many had restless legs syndrome," Kotagal said.

He added that growing pains in children may in fact be restless legs syndrome.

"Occasional growing pains are nothing to worry about, but growing pains every night may be restless legs syndrome," Kotagal said.

He and a colleague studied the medical records of 538 children seen by Mayo Clinic's pediatric sleep disorders program. A low level of iron in the blood was found in 83 percent of children identified as having restless legs syndrome. It wasn't apparent whether this iron deficiency was linked to diet or a genetic predisposition to low iron levels.

A family history of restless legs syndrome was identified in 72 percent of children with the condition.

"There seems to be a strong genetic component in restless legs syndrome," Kotagal said.

The study appears in the December issue of the Annals of Neurology.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about restless legs syndrome.

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Nip from Hamster Fells Young Boy

 

Reuters Health

Thursday, January 6, 2005

NEW YORK (Reuters Health) - Pet hamsters are a potential source of serious infection, U.S. health officials warned on Thursday.

Researchers from the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC) describe the case of a 3-year-old boy from Colorado who came down with tularemia after being bitten by a pet hamster.

Tularemia is caused by the bug Francisella tularensis, which is one of the most infectious germs known and for that reason is considered a potential biologic terrorism agent.

As outlined in the CDC's Morbidity and Mortality Weekly Report, the boy's family purchased six hamsters from a pet store in the Denver metropolitan area. Within a week, all of the hamsters died of diarrhea, but not before one of them bit the child on the finger.

Seven days after the bite, the child developed fever, malaise, painful swelling of lymph nodes in his left armpit, "and skin sloughing at the bite site."

Treatment with the antibiotic amoxicillin-clavulanate failed to clear up the condition, and lymph node biopsy was performed. This revealed the cause to be Francisella tularensis.

Employees at the pet store reported that an unusual number of hamsters had died around the time the boy's family purchased the hamsters.

Officials with the CDC and the Colorado Department of Public Health (news - web sites) and Environment investigated, and they think that infected rodents infested the pet store and spread the bacterium to hamsters by urinating and defecating through metal screens covering their cages.

One of two pet cats in the store was also found to be infected with the tularensis bug, perhaps from catching or eating an infected rodent.

"Although tularemia has been associated with hamster hunting in Russia, it has not been associated previously with pet hamsters in the United States," the CDC's Dr. Dayna Ferguson and colleagues note in the article.

Symptoms of tularemia include sudden fever, chills, headache, diarrhea, muscle aches, joint pain, dry cough and progressive weakness.

Source: Morbidity and Mortality Weekly Report, January 7, 2005.

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Cord Blood Stems Heart Attack Damage

HealthDayNews

Thursday, January 6, 2005

THURSDAY, Jan. 6 (HealthDayNews) -- Stem cells taken from human umbilical cord blood reduced heart attack damage in rats, says a University of South Florida study published online this week in Cell Transplantation.

The stem cells were injected into the rats' hearts just after they suffered induced heart attacks. The stem cells greatly reduced the amount of heart damage and restored heart pumping function to near normal. Drugs were not needed to prevent the rats' immune systems from rejecting the human stem cells.

If further animal and human research proves this method is safe and effective, umbilical cord blood stem cells could offer a new way to limit or repair heart attack damage in people, the study said.

"Patients with heart failure due to heart attacks and other causes spend much of their day at home in a chair or bed. These are the patients whose lives we hope to greatly improve with stem cell therapy to restore heart function," study author and cardiologist Dr. Robert J. Henning said in a prepared statement.

"Our initial results are extremely promising, but raise questions about how these umbilical cord blood cells work. Are they transforming into new heart muscle cells or secreting growth factors that trigger the heart to repair itself? We need more research to ensure such therapy will ultimately benefit patients with little or no side effects," Henning said.

More information

The Cleveland Clinic Foundation has more about heart attack.

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People with Diabetes Need to Take Care of Teeth

Reuters Health

Thursday, January 6, 2005

NEW YORK (Reuters Health) - Dental health is particularly important for people with diabetes, new findings indicate.

Among Pima Indians with type 2 diabetes, periodontal disease strongly predicts mortality from heart disease and kidney disease, according to a study published in the January issue of Diabetes Care.

Dr. Robert G. Nelson, of the National Institute of Diabetes and Digestive and Kidney Disease in Phoenix, Arizona, and colleagues studied 628 Pima Indians 35 years of age or older with type 2 diabetes.

The team used dental x-rays and examinations to see if the participants had periodontal disease, and classified it as none, mild, moderate, or severe. Overall, nearly 60 percent of the subjects had severe periodontal disease. Of these, 263 (70 percent) had lost all their teeth.

A total of 204 participants died during an average follow-up of 11 years. The death rates for all natural causes "expressed as the number of deaths per 1000 person-years of follow-up were 3.7 for no or mild periodontal disease, 19.6 for moderate disease, and 28.4 for severe periodontal disease," the investigators report.

The causes of death associated with periodontal disease were specifically heart disease and diabetes-related kidney disease.

"Periodontal disease is a major public health burden in Pima Indians, and it is a strong predictor of death from cardiorenal disease in those with type 2 diabetes," the researchers conclude.

Source: Diabetes Care, January 2005.

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No Link Found Between Vaccines and Autism

HealthDayNews

Thursday, January 6, 2005

THURSDAY, Jan. 6 (HealthDayNews) -- There is no link between autism and immunizations, says a Mayo Clinic study in the January issue of the Archives of Pediatrics & Adolescent Medicine.

Over the past two decades there have been suggestions about a possible connection between increasing rates of autism and immunization.

However, this study found no such link and suggests that the increase in autism may be due to a number of factors. These include improved awareness about autism, changes in diagnostic criteria and availability of services for children with autism.

The Mayo Clinic team did not find a link between environmental factors and autism.

"This study is the first to measure the incidence -- the occurrence of new cases -- of autism by applying consistent, contemporary criteria for autism to a specific population over a long period of time," study co-author Dr. William Barbaresi, a developmental pediatrician, said in a prepared statement.

"In doing so, the study accounts for improvements in the diagnostic criteria for autism, the medical community's improved understanding of this disease and changes in federal special education laws," Barbaresi said.

For this study, he and his colleagues reviewed data from the Rochester Epidemiology Project, a database of all inpatient and outpatient records in Olmsted County, Minn.

More information

The Nemours Foundation has more about autism.

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Errors Endanger Hospitalized Children

Reuters Health

Thursday, January 6, 2005

NEW YORK (Reuters Health) - A substantial number of "adverse events" -- many of which could have been prevented -- affect children in hospitals each year, according to a new study.

Dr. Donna Woods, of Northwestern University, Chicago, and colleagues used data from the Colorado and Utah Medical Practice Study to analyze the incidence and types of adverse events in children. The analysis included some 3700 hospital patients up to 20 years of age and, for comparison purposes, about 7500 adult patients between the ages of 21 and 65 years.

The team defined an adverse event as an injury caused by medical management rather than disease that led to prolonged hospitalization or disability that persisted at the time the patient left the hospital. They defined a preventable adverse event as an injury that was avoidable using currently accepted practices.

Overall, 1 of every 100 patients in the study suffered an adverse event, and 60 percent of these were preventable, the investigators report in the medical journal Pediatrics.

Preventable adverse event rates were 0.53 percent among infants, compared with 0.22 percent in children 1 to 12 years of age and 0.95 percent among adolescents 13 to 20 years of age. The figure was 1.50 percent for adults.

"Most preventable adverse events were...birth related (32.2 percent), followed by diagnostic-related (30.4 percent) and system-related preventable adverse events (27.3 percent)," Woods and colleagues write.

"To reduce the adverse events that occur in hospitalized children, research should focus on adolescent hospitalized patients, birth-related medical care, and diagnostics in pediatric medicine," the researchers conclude.

Source: Pediatrics, January 2005.

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U.S. Gets Failing Grades on Tobacco Control

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, January 6, 2005  

THURSDAY, Jan. 6 (HealthDayNews) -- The American Lung Association has graded states' efforts to curb tobacco use for years, but this year it moved on to the U.S. government -- and promptly flunked it.

The ALA's annual report card, released Thursday, includes the first-ever ratings for Congress and the White House on their tobacco control actions in 2004.

"There's been progress in tax increases and clean indoor air laws state-by-state gradually over the last couple of years," said John L. Kirkwood, president and CEO of the ALA. "There's been no progress at the federal level."

The most miserable failing, Kirkwood said, was the U.S. House of Representatives' blockage of legislation that would have given the Food and Drug Administration (news - web sites) (FDA (news - web sites)) authority to regulate tobacco products, including marketing of such products as Camel Kauai Kolada and Kool Mix Mocha Taboo to youth.

"If you did have FDA legislation, then cigarette products would be subject to the same rules and regulations that we have with drugs," Kirkwood said. "You couldn't make claims, for example, that lighter cigarettes were less hazardous."

The federal government also received a failing or nearly failing grade in three other areas:

"Nationally, we have not stepped up to the plate," Kirkwood said. "Where the hell is the government on this? They should be taking a leadership role."

 

"The tragedy of the failure of the federal government to act is that we have the tools to dramatically reduce the number of Americans who die from tobacco each year," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. "We know that increased tobacco taxes, public education, and regulation of the tobacco industry could save literally hundreds of thousands of live each year."

 

And Rep. Henry Waxman (news, bio, voting record) (D-Calif.), who has fought for harsher measures against tobacco companies, added, in a prepared statement, "Today's report by the American Lung Association provides a stark reminder of the federal government's failure to reduce youth smoking, regulate tobacco products, or generate funds for tobacco cessation programs. The federal government deserves this failing grade."

 

The report did find that state and local governments have done a better job, although that record remains mixed.

 

Six states (California, Connecticut, Delaware, Maine, Massachusetts and New York) now ban smoking in all workplaces, including bars and restaurants. Thirty-three states, the District of Columbia, and Puerto Rico, however, received an F for smoke-free air.

In 2004, several cities, including Lawrence, Kan., Columbus, Ohio, Lincoln, Neb., and Minneapolis banned smoking in workplaces. A study published last year found that the number of heart attacks reported in Helena, Mont., fell by 40 percent while a six-month comprehensive smoke-free air law was in effect.

 

Three states (Michigan, New Jersey and Rhode Island) now have cigarette taxes at or above $2 per pack. Seventeen states plus the District of Columbia and Puerto Rico now have taxes at or above $1 per pack.

 

Kentucky replaced Virginia as having the lowest cigarette tax in the country (3 cents per pack). Virginia's tax is now 20 cents due to its first increase since the cigarette tax was established in 1960. Eleven states raised their cigarette taxes in 2004, increasing the average state cigarette tax by 12 cents, to 84 cents per pack. Twelve states failed in this category.

 

One troubling trend is the cuts in tobacco prevention programs, including model programs in Florida, Indiana, Maryland, Massachusetts and Minnesota. In all, 36 states plus the District of Columbia received an F here.

 

Seven states received an A for limiting youth access to tobacco; 23 states received an F.

 

"The federal government and the states should be working in concert," Kirkwood said.

 

"At the time the Surgeon General's report came out in 1964, about 46 percent of the public smoked. Now we're down to around 22 percent. That's cut in half. That's indicative of where the trend is going on this."

 

More information

 

Read more about tobacco control from the Campaign for Tobacco-Free Kids.


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Drug Industry Agrees to Disclose More Trial Data

By Ben Hirschler, European Pharmaceuticals Correspondent

Reuters

Thursday, January 6, 2005

LONDON (Reuters) - The global pharmaceutical industry unveiled plans on Thursday to publish more data about trials of medicines in a bid to reassure patients following recent alarms over drug safety.

Trade groups in the United States, Europe and Japan, in collaboration with major drugmakers, agreed an industry-wide code to publish detailed information about all clinical trials, other than exploratory Phase I studies, on the Internet.

The code will be voluntary, but companies are expected to be keen to take part, hoping to head off potentially more onerous legislation from governments in the wake of scandals over pain drug Vioxx and the use of antidepressants in adolescents.

"By publishing not just the results of the trials that have taken place -- whether positive or negative -- but also those that are just starting, the industry has made a major step toward achieving greater transparency," Richard Barker, Director General of the Association of the British Pharmaceutical Industry (ABPI), told reporters.

The scheme has the backing of major pharmaceutical groups such as GlaxoSmithKline Plc, Pfizer Inc., AstraZeneca Plc, Merck & Co. Inc., Novartis AG and Sanofi-Aventis SA, the ABPI said.

Under the plan, companies must register trials within 21 days of their start and give each one a unique identifier to ensure easy tracking through multiple databases.

Results should be published within one year of a medicine's approval or, for trials on drugs that have already been approved, within one year of the trial being completed.

The scheme applies to new trials initiated after July 1, while trials already underway should be included from Sept. 13.

Commercial Secrets

The move does not represent full disclosure, however.

Early stage Phase I studies on healthy volunteers -- often the first sign a company has a good hunch about a new drug approach -- are exempt and there is no obligation to reveal results of studies before a drug is approved.

"There are issues around commercial sensitivities at the very early stage," ABPI medical director Richard Tiner said.

Companies will also not give details on precise clinical trial design, although this might be included in a secure non-public third-party database for later disclosure.

Controversy about drug firms concealing research, either to prevent rivals learning too much or because negative results would hit product sales, has been simmering for years.

New York Attorney General Eliot Spitzer brought the issue to a head last June by accusing GlaxoSmithKline of fraudulently suppressing important information about the use of its antidepressant Paxil, or Seroxat, in children.

GSK settled the case for $2.5 million, a trifling sum for a company with 2003 sales of 21.4 billion pounds ($40.15 billion). But it also agreed to publish results of its drug trials in a registry, setting a precedent for greater disclosure.

Safety Concerns

Concerns about drug safety have also come to the fore in recent months, with the worldwide withdrawal of Merck's Vioxx pill in September after it was linked to heart attacks.

And a senior official at the U.S. Food and Drug Administration (news - web sites) raised concerns about AstraZeneca Plc's cholesterol-lowering medicine Crestor in November.

Safety concerns have led to hearings over medicines in the U.S. Senate, and British parliamentarians are investigating the influence of the pharmaceutical industry.

Drugmakers, already struggling to find enough new medicines to sustain historic growth rates, need to tread a fine line when deciding how much information to disclose about their trials.

While seeking to satisfy legislators, they are anxious to hold back anything that could give them a competitive advantage in an increasingly cut-throat industry.

The ABPI's Barker said the new voluntary code should satisfy the industry's critics, including a group of 11 medical-journal editors who last September demanded much more openness.

"We hope this issue will now be rather in the past than the future," he said.

(Additional reporting by Mark Potter) ($1=.5330 Pound)

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Wednesday, January 5, 2005

Herbal Extract Reduces Migraines

 

By Karla Gale

Reuters Health

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - An extract of the root of a plant called butterbur (Petasites hybridus) significantly reduces the frequency of migraine headaches, new research findings suggest.

"I've long held the view that the distinction shouldn't be between complementary medicine and pharmaceuticals, but between treatments that have scientific support and those that don't," lead investigator Dr. Richard B. Lipton told Reuters Health.

His group's trial that compared butterbur with an inactive placebo "was a promising opportunity to figure out if an extract of butterbur really works for migraine."

Lipton, a neurologist at Albert Einstein College of Medicine in Bronx, New York, and his associates compared the efficacy of two different doses of butterbur extract to that of a placebo in about 230 migraine patients. They had experienced two to six attacks per month for the 3 months prior to the study.

The number of attacks per month was reduced by 45 percent in the group that took 75 milligrams of butterbur twice daily, compared with a reduction of 28 percent in the placebo group during the 16-week trial, according to the investigators' report in the journal Neurology.

A group that took 50 milligrams of butterbur twice daily experienced a 32 percent decrease, not significantly different from placebo.

"The size of the treatment effect is quite comparable to what is seen with prescription drugs," such as beta-blockers and antidepressants, Lipton said.

The butterbur extract was well tolerated, the team reports, with burping as the only adverse event occurring more frequently in the active treatment groups. There were no changes in blood pressure, heart rate, or routine laboratory tests.

"People who need a preventive medication -- those who are having three or more days of headaches that interfere with their lives per month -- should consider taking a preventive medication," Lipton advised.

"Many of those people don't like the idea of taking a prescription medication every day, and for them, (butterbur) is an excellent alternative that now has a firm base of scientific support," he said.

He cautioned that, because raw butterbur root contains toxins that are removed during the manufacturing process, patients should only use commercially available products rather than "home-brewed" butterbur extract.

Source: Neurology, December 28, 2004.

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Health Tip: Symptoms of Appendicitis

HealthDayNews

Wednesday, January 5, 2005

(HealthDayNews) -- The appendix is a tubelike structure attached to the first part of the large intestine in the lower-right portion of the abdomen. It has no known function, and removal appears to cause no change in digestive function, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Appendicitis is an inflammation of the appendix. Once it starts, there is no medical therapy short of removal. When treated for this medical emergency promptly, most patients recover. But if treatment is delayed, the appendix can burst, causing infection and even death.

Symptoms of appendicitis may include pain in the abdomen, first around the belly button, then moving to the lower-right area; loss of appetite; nausea; constipation; diarrhea; low fever that begins after other symptoms; and abdominal swelling. Pain worsens when the patient moves, sneezes, coughs or takes deep breaths.

Not everyone with appendicitis has all of these symptoms. If you or a member of your family think you may have an inflamed appendix, seek medical attention immediately.

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Secondhand Smoke Lowers Kids' Math, Reading Scores

By Alison McCook
Reuters Health
Wednesday, January 5, 2005

NEW YORK (Reuters Health) - Kids and teenagers exposed to even trace amounts of secondhand smoke score lower on tests of reading and reasoning, according to new research.

Overall, up to 33 million children and teenagers in the U.S. may be exposed to enough secondhand tobacco smoke to affect their reading ability, making this a huge public health issue, study author Dr. Kimberly Yolton of the Cincinnati Children's Hospital Medical Center in Ohio told Reuters Health.

"That's an enormous amount of children," she said in an interview. "We really need to do a better job of making sure they have clean air to breathe, so they can reach their fullest potential."

During the study, Yolton and her colleagues asked 4,399 kids between the ages of 6 and 16 to complete reading, math and reasoning tests. The researchers also checked their blood for cotinine, a substance created when the body breaks down nicotine, thereby serving as a marker for exposure to tobacco smoke.

Cotinine scores were typically higher in African-American kids, and in those who shared a home with at least one smoker.

The researchers found that children with more cotinine in their blood tended to score lower on the reading, math and reasoning tests. And the higher the cotinine levels, the lower were their scores, the authors note in the journal Environmental Health Perspectives.

Moreover, even trace amounts of cotinine in blood appeared to lower kids' test scores in reading and reasoning.

Yolton explained that the amount of secondhand smoke kids inhale depends on many variables, including ventilation and how close they are to smokers, making it difficult to equate cotinine levels with a specific number of cigarettes smoked.

However, she said that she and her colleagues saw decreases in reading scores from cotinine levels associated with living in a house with a smoker who consumes less than one pack per day.

Just why tobacco smoke may influence kids' test scores is also unclear, she added. Research in animals suggests that smoke can alter the structure of the nervous system, Yolton said. It also makes sense that breathing tobacco smoke may deprive kids of oxygen, she noted.

"When we breathe (cigarette smoke) in, it takes the place of oxygen that we need to let our brains function well," Yolton said.

Although kids are mostly exposed to cigarette smoke at home, older kids spend more time outside of the home, and parents who want to limit kids' exposure to secondhand smoke should find out if their friends smoke, or if they hang out in smoky places, the researcher noted.

"When they leave the house, we have to think about ways to protect them," she said.

Source: Environmental Health Perspectives, January 2005.

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Obese Blacks Incur Lower Health-Care Costs

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- Health-care costs for obese blacks are less than for obese whites, says a study that also concludes the costs of obesity-related health problems grow progressively greater as adults age.

The study, led by researchers at Beth Israel Deaconess Medical Center, appears in the January issue of the American Journal of Public Health.

"From the perspective of the health-care system, obesity may be less costly among African-Americans than among whites. In white Americans, health-care spending was dramatically higher for those who were obese than for those in the recommended weight range, but in African-Americans higher body weight was not significantly associated with higher overall health-care spending," researcher Dr. Christina Wee, of Beth Israel's division of general medicine and primary care and an assistant professor of medicine at Harvard Medical School (news - web sites), said in a prepared statement.

The lower health costs among obese black Americans may be due to a number of factors, including health-care disparities that primarily affect blacks, biological differences, or the fact that black Americans already have a higher death rate due to other health risks, Wee said.

The study also found that obesity-related health costs become more pronounced as people get older, especially after age 55.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about the health risks of obesity.

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Fruits, Veggies Lower Kids' Blood Pressure

By Charnicia E. Huggins

Reuters Health

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - Preschoolers who eat the recommended four servings of fruits and vegetables -- along with two servings of dairy products -- each day may have lower blood pressures in early adolescence, new study findings suggest.

"The roots of high blood pressure and other diseases that we acquire as adults can be found in childhood," study author Dr. Lynn L. Moore of Boston University School of Medicine told Reuters Health.

"Those who develop high blood pressure earlier in life, say as a young adult, rather than during middle age or later will be at much higher risk for heart attack, stroke, and other disabling conditions at a younger age," she added.

A diet rich in fruits, vegetables and low-fat dairy products has been shown to reduce blood pressure among adults with borderline high blood pressure. Studies have also shown that vegetarians tend to have lower blood pressures than non-vegetarians. Whether such findings extend to children, however, has been unknown until now.

To investigate, Moore and her team followed 95 children, from preschool -- ages 3 to 6 -- to early adolescence at age 12.

Preschoolers who ate at least four servings of fruits and vegetables each day and at least two servings of dairy products had the lowest blood pressures at 12 years old, the researchers report in the journal Epidemiology.

By the end of the 8-year study period, blood pressure among those in the high intake group for both fruits and vegetables and dairy products was 7 points lower, on average, than among those with a lower than recommended intake of fruits, vegetables and dairy products.

The children who ate less than four servings of fruits and vegetables and less than two dairy servings per day "will be at higher risk for developing high blood pressure as young adults," Moore said.

In general, children who ate more fruits, vegetables, and dairy products at younger ages tended to continue these healthy eating habits in early adolescence.

It is unclear how a higher consumption of fruits, vegetables, and dairy products lowers blood pressure. People with such diets may have healthier dietary patterns in general, the authors speculate. For example, children who ate more fruits and vegetables also tended to consume more whole grains and less fat than their peers.

"Since adolescent blood pressure predicts adult blood pressure levels, these results suggest that a diet rich in fruits, vegetables, and dairy products in very early childhood may prevent or delay the development of adult hypertension," Moore said.

"Children who learn to eat a healthy diet in earlier childhood will reap the benefits for years and years to come," she added. "It's the parent's responsibility to start children off on the right track."

The study was funded by grants from the National Heart, Lung, and Blood Institute and Dairy Management, Inc., which manages the American Dairy Association/National Dairy Council.

Source: Epidemiology, January 2005.

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Some Cases of Sudden Cardiac Death May Start in Brain

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- Disrupted signals from the brain to the heart may be responsible for sudden cardiac death caused by emotional stress, says a University College London study.

It found that some people have problems with a system that coordinates signals sent from the brain stem to different parts of the heart to control heart rhythm. These people may have a greater risk of potentially fatal heart rhythms when they're doing stressful mental tasks or during emotional events.

The researchers monitored the brain activity of people with heart disease while they performed stressful mental tasks. Stress-induced changes in heart electrical currents were accompanied by uneven activity within the brain stem, the study found.

"Some people are at risk of sudden cardiac death from stress, mainly people who already have heart disease. In these cases, the combination of heart and brain irregularities means heart failure could occur during a stressful or emotional event like a family gathering or even a boisterous New Year party," researcher Dr. Peter Taggart, of the university's Centre for Cardiology, said in a prepared statement.

"Efforts to prevent the development of potentially dangerous heart rhythms in response to stress have focused on drugs which act directly on the heart, but results have so far been rather disappointing. Our research focuses on what is happening upstream, in the brain, when stress causes these heart rhythm problems. The results so far are very encouraging," Taggart said.

"It may soon be possible to identify which people are particularly at risk and even to treat a heart problem with a drug that works on the brain," he added.

The findings appear in the January issue of Brain.

More information

The Heart Rhythm Society has more about sudden cardiac death.

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Lifestyle Changes Cut Heart Risk Without Drugs

Reuters Health

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - In a new study, a 12-week program designed to change unhealthy lifestyles helped adults with high blood pressure, high cholesterol, and high blood sugar reach their goal risk-factor levels without using drug therapy.

These results "refute the notion that intensive lifestyle intervention is not worth the effort," lead author Dr. Neil F. Gordon, from St. Joseph's/Candler Health System in Savannah, Georgia, and colleagues note in the American Journal of Cardiology.

The results are based on a study of 2390 adults who participated in the lifestyle program, which involved an initial health assessment followed by the setting of goals and lifestyle changes designed to reduce their risk factors.

Participation in the program was associated with a significant improvement in blood pressure, cholesterol levels, sugar levels, and body weight. Moreover, in a subset of 700 patients, the intervention was linked to a significant reduction in standard risk scores for heart disease.

"Therapeutic lifestyle changes can generally be implemented less expensively than most medications and, unlike single-drug therapy, favorably affect multiple risk factors," the investigators point out.

Thus, the current findings could have important implications for healthcare payers, which often do not reimburse for such lifestyle interventions, they add.

Source: American Journal of Cardiology, December 15, 2004.

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Elderly Women With Cervical Cancer Face Tough Battle

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- Elderly women with cervical cancer face an especially difficult struggle, says a study by researchers at Washington University School of Medicine in St. Louis.

The study found that women 70 and older with cervical cancer are more likely to die from the disease than those younger than 70, and they're also less likely to receive the most aggressive treatments for their cancer.

Researchers analyzed medical records of more than 1,500 women treated for invasive cervical cancer between 1986 and 2003. The women were divided into two groups, those 70 and older and those younger than 70.

Surgery was used to treat 16 percent of women in the older group, compared with 54 percent of those in the younger group. The remainder of patients were treated with radiation without surgery.

Overall, women treated with radiation alone had survival odds five times lower than those who received surgery. The study found that elderly women treated with radiation received lower doses on average and were nine times more likely to not have any treatment.

Cervical cancer patients over age 70 had 1.6 times greater risk of death as women under age 70 with the same tumor stage, type of treatment and additional medical diseases, the study found.

"It may be that physicians are influenced by the presence of other medical conditions when choosing treatments for elderly patients," study author Dr. Jason Wright said in a prepared statement.

"But, other studies have shown that elderly patients tolerate radiation therapy and aggressive surgical therapy well, so in light of the age-related risk from cancer, physicians should give greater thought to recommending aggressive treatment," Wright said.

The study appears in the Jan. 1 issue of Cancer.

A recent U.S. National Cancer Institute (news - web sites) report said that women aged 65 and older with cervical cancer have a death rate of 7.6 per 100,000, compared with 2.1 per 100,000 for women younger than 65.

More information

The U.S. National Women's Health Information Center has more about cervical cancer.

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Cigarette Smoke Worsens RSV Infection in Infants

By Will Boggs, MD

Reuters Health

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - Babies and young children are prone to infection with respiratory syncytial virus (RSV), and new research shows that the condition is worsened if they're exposed to cigarette smoke.

A family history of allergies or asthma also has an impact, but for the good, according to a report in the medical journal Pediatrics.

"Physicians should encourage parents/caregivers not to expose their children to secondhand smoke, especially during a respiratory tract illness," Dr. Mario Castro from Washington University School of Medicine, St. Louis, told Reuters Health.

Castro studied 206 hospitalized children enrolled in the RSV Bronchiolitis in Early Life (RBEL) study. Bronchiolitis is an inflammation of the small airways in the lungs, which can result from respiratory infections.

The infants in the study who were exposed to cigarette smoke had significantly lower oxygen concentrations in their blood during hospitalization for RSV than did unexposed infants, the team reports.

Infants with a family history of allergies or asthma, on the other hand, had higher oxygen levels during hospitalization, the study found.

Other factors linked to RSV bronchiolitis severity were younger age, white race, and maternal smoking.

"All children with respiratory tract illness during the RSV season (December through March in most areas) suggestive of bronchiolitis should be screened for RSV," Castro said. "Prompt diagnosis of RSV infection in children is helpful in making sure that the child is stable and in provision of bronchodilators to clear and open the airways."

The RBEL study, sponsored by the National Institutes of Health (news - web sites), is "currently in its sixth year of follow-up," Castro added. The investigators are hoping to see if other factors such as breastfeeding, childcare, or genetics, "have an impact on modifying this risk in children exposed to a serious illness with RSV."

Source: Pediatrics, January 2005.

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Mammography's Early Catches Have Silver Lining

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- Women whose breast cancer is detected by physical examination are about three times more likely to receive chemotherapy than women whose breast cancer is detected by mammography, a Dartmouth-Hitchcock Medical Center study finds.

The reason: Screening mammography detects breast cancer at an earlier stage, the study said.

Researchers reviewed data on 992 women with invasive breast cancer. Of those, 532 had their cancer detected by physical examination and 460 had their cancer detected by mammography.

The study found that, overall, women whose breast cancer was found by physical examination were three times more likely to have chemotherapy than women whose breast cancer was detected by mammography.

Women aged 40 to 49 were about twice as likely to have chemotherapy if their cancer was detected by physical examination. Women 70 and older were about five times more likely to receive chemotherapy.

Overall, women whose breast cancer was detected by physical examination were more than twice as likely to have a mastectomy rather than breast conservation surgery. Women aged 70 and older were five times more likely to have a mastectomy if their breast cancer was detected by physical examination rather than mammography.

The study authors noted that chemotherapy is commonly recommended for women with breast tumors larger than 1 centimeter in diameter or if the cancer has spread to the lymph nodes. Cancers detected by mammography were only half as large as those detected by physical examination, the study found.

It also found that breast cancer had spread to the lymph nodes in 16 percent of the women whose tumors were detected by mammography, compared with 42 percent of the women whose breast cancer was detected by physical examination.

The study findings indicate that screening mammography detects breast cancer at an earlier stage and increases the likelihood that it can be treated with less toxic therapy, the authors concluded.

The findings appear in the January issue of the American Journal of Roentgenology.

More information

The U.S. National Cancer Institute (news - web sites) has more about breast cancer screening.

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Mental Deficits Common After Very Preterm Birth

By Karla Gale

Reuters Health

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - More than three-quarters of children who were born before the 26th week of pregnancy are affected by cognitive and neurologic impairments by the time they reach school age, British researchers report.

"There are a number of follow-up studies of preterm babies," Dr. Dieter Wolke told Reuters Health. "However, there is no real population study of babies born at the limits of viability," at 22 to 25 weeks into a pregnancy.

Wolke, at the University of Bristol, and his colleagues tested 241 extremely premature children at an average age of 6 and compared the results with those of a "control" group made up of 160 classmates born at full term.

Compared with the controls, 41 percent of those born extremely premature had significantly lower mental functioning, the team reports in this week's New England Journal of Medicine (news - web sites). Serious impairments were more than twice as likely in boys than in girls.

Severe disability -- such as incapacitating cerebral palsy, low IQ, profound hearing loss, or blindness -- was diagnosed in 22 percent, while 24 percent had moderate disabilities that included less-severe cerebral palsy, somewhat below-par IQ, correctible hearing loss or impaired vision without blindness.

Only 20 percent of those born between 22 and 25 weeks had no disability.

"There is an immense amount of money invested in the neonatal care of these extremely preterm babies," Wolke pointed out. "Our findings show they certainly have an immense need of care after they've been discharged from the neonatal unit."

He believes that "if the decision is made for full treatment neonatally, then similar resources should be available to help these families afterwards to see if we can prevent learning disabilities or help them achieve a higher quality of life."

Source: New England Journal of Medicine, January 6, 2005.

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Childhood Obesity Weighs Heavily on Kids

By Serena Gordon
HealthDay Reporter

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- It may not come as a surprise to anyone who's ever heard an overweight child getting teased in the schoolyard, but a new study reports that kids who are overweight or obese have a lower quality of life than their normal-weight peers.

"The impact of childhood overweight is not restricted to severely obese children," said study author Joanne Williams, a senior research fellow at Royal Children's Hospital and Murdoch Children's Research Institute in Parkville, Australia.

According to the study, children and their parents reported that physical, emotional and social well-being decreased as soon as a child's weight began to rise above average.

"Elementary school children who are either overweight or obese experience significant psychosocial effects which are likely to impact on their self-image and self-esteem. The psychological impact of this may remain with them for the rest of their lives, regardless of whether or not they are overweight later in life," she added.

Dr. Rebecca Unger, a pediatrician at the Nutrition Evaluation Clinic at Children's Memorial Hospital in Chicago, said this study highlights the importance of preventing excess weight gain by youngsters.

"We wouldn't only be preventing medical issues like high blood pressure and high cholesterol, but also quality-of-life issues," she said.

These quality-of-life issues are affecting an ever-increasing part of the population. The study reports that in many countries about one in four people are either overweight or obese. In the United States, the American Obesity Association reports that as many as one in six children can be classified as obese.

Results of the study appear in the Jan. 5 issue of the Journal of the American Medical Association (news - web sites).

For the study, Williams and her colleagues recruited 1,456 children from 24 schools in Australia. They were between the ages of 9 and 12, with an average age of 10. The researchers measured each child's height and weight.

Every child and one parent also completed a survey assessing the child's quality of life. The survey, called the Pediatric Quality of Life Inventory, asked questions about a child's physical, emotional, social and school issues.

The survey included statements such as "It is hard for me to run," or "Other kids tease me," and were answered using a scale of zero through four, with zero meaning never and four meaning almost always.

Twenty percent of the children surveyed were overweight and slightly more than 4 percent were obese.

As a child's weight increased, his or her survey score decreased, indicating a lower quality of life. The average score in parent surveys was 83.1 for children who were not overweight, 80 for overweight children and 75 for obese youngsters. The average score for children's surveys was 80.5 for non-overweight kids, 79.3 for overweight youngsters and 74 for obese children.

"In addition to the physical health consequences of childhood obesity, there are important psychosocial consequences and these are not restricted to severely obese children," said Williams.

Dr. Jeffrey Zitsman, co-director of the Adolescent Obesity Program at The Children's Hospital at New York-Presbyterian/Columbia University Medical Center, said the new study shows "even being overweight has its own diminishing effect on a child's quality of life."

"Controlling a child's weight is paramount, both from a health standpoint and because of the psychological problems that arise from being overweight," Zitsman said.

Both Zitsman and Unger recommended intervening as quickly as possible if a child is getting too heavy. They suggested limiting high caloric foods and sugary beverages, and emphasized the importance of getting children to exercise.

Unger said children should be active every day, and engage in vigorous exercise at least three times a week. She said parents should look for opportunities to increase their child's activity level, such as walking to school or walking to do errands. She also suggested getting your child a pedometer to see how many steps he or she takes a day, and try to increase that to 10,000 per day.

She said lifestyle changes need to be a family affair and that parents need to demonstrate healthy behavior.

"Show children that you put a priority on being active and eating healthy," Unger said.

More information

To learn more about childhood obesity, visit the American Obesity Association.

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U.S. Studies Point to Protein Role in Heart Attacks

By Gene Emery

Reuters

Wednesday, January 5, 2005

BOSTON (Reuters) - It's not enough to reduce "bad" cholesterol to prevent heart attacks because a substance called CRP also must be kept low, doctors said on Wednesday in a finding that could save tens of thousands of lives.

Fortunately, it appears that statins -- the same types of drugs that have been shown to reduce low-density lipoprotein or "bad" cholesterol -- also bring down CRP, or C-reactive protein.

Evidence has been growing that a special type of inflammation, different from the form treated with aspirin and other related drugs, contributes to heart disease. CRP measures that inflammation.

A study led by Paul Ridker of Brigham and Women's Hospital in Boston showed that the people with the lowest risk of suffering a second heart attack also had the lowest levels of CRP.

A second study, led by Steven Nissen of the Cleveland Clinic, found that among 502 patients who lowered their CRP levels the most, there was ultrasound evidence that their clogged arteries had opened up a bit.

Both studies appeared in this week's issue of The New England Journal of Medicine (news - web sites).

Ridker said the findings have "the potential to save thousands of lives" and should radically change the way the public thinks about heart disease prevention.

"It's no longer enough to monitor cholesterol levels if we want to do enough for our patients," Ridker told Reuters.

The Ridker group discovered that among 3,745 heart attack victims treated with statins, the risk of having a second heart attack after 2-1/2 years was nearly 10 percent among those with high levels of CRP and LDL cholesterol. Bringing down either the CRP or the LDL cholesterol shaved that risk to about 7 percent.

But when both levels were cut, the risk dropped to 4.9 percent.

CRP levels of less than 1 milligram per liter of blood brought the risk down to 4 percent.

One blood test isn't enough, the researchers found, because cholesterol and CRP levels are independent of each other.

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Role Seen for Vitamin A to Prevent Breast Cancer


By Amanda Gardner
HealthDay Reporter

HealthDayNews

Wednesday, January 5, 2005

WEDNESDAY, Jan. 5 (HealthDayNews) -- A glitch in the way the body processes vitamin A may contribute to the development of breast cancer, a new study says.

Although the findings, published in the Jan. 5 issue of the Journal of the National Cancer Institute (news - web sites), are extremely preliminary, researchers hope they may one day translate into a new target for drugs to prevent breast cancer and other malignancies.

Because the findings are so preliminary, they should not be regarded as an invitation to ingest large amounts of vitamin A, experts warn.

"This is very interesting scientific work, but in terms of actual import, people should not be taking extra doses of vitamin A," stressed Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in New Orleans.

"It's a distance from taking it from the test tube. . . to humans," added Dr. Julia Smith, director of the Lynne Cohen Breast Cancer (news - web sites) Prevention Care Program at New York University Medical Center in New York City. "But I do think that this adds another important piece of information to our knowledge."

Scientists have long suspected that vitamin A may be linked to cancer prevention, but the mechanisms by which this may be happening have not been well understood.

Vitamin A (also known as retinol) is found in various food products, including milk, eggs, and fruits and vegetables, notably carrots. Once taken into the body, vitamin A is stored in the liver and other tissues, including the breast. When needed, it is converted into retinoic acid, which activates the retinoic acid receptor in the cells. This receptor, in turn, regulates the expression of various genes, most of them associated with cell differentiation. When cells differentiate, they turn into cells with specific roles to play. Cells that don't differentiate can turn into tumors.

Previous research had revealed that stores of retinol were low in breast cancer tissue. "The consequence is that even in an individual who has normal vitamin A in the diet, there may be local deficiency in those cells that are premalignant or malignant," said Reuben Lotan, author of an accompanying editorial and deputy division head for research in the division of cancer medicine at the University of Texas M. D. Anderson Cancer Center.

If the cells don't have enough vitamin A stored, the receptor doesn't get activated, the cells don't differentiate, and they can turn cancerous, said study author Eduardo F. Farias, a postdoctoral fellow in medical oncology at Mount Sinai School of Medicine.

Farias and his colleagues set out to discover when cells lost the ability to store vitamin A.

Working with human and mouse breast cells, the researchers discovered the problem was with cellular retinol-binding protein I (CRBP-I), which is involved in the storage process.

"We found that, in the early stages of tumor formation, if you don't have CRBP or LRAT [another protein] to store the retinol, it's likely the receptors will not work in the normal way," Farias said. This means that cells can't differentiate, and therefore start to proliferate into tumors.

The researchers also found that if they put CRBP back into human cells, the tumors didn't progress.

"Cellular storage of retinol is very important to keep the cells under control," Farias explained.

The findings may help in the development of a prognostic marker to help physicians decide which kind of therapy is best. Even further in the future, the findings may hold the key to new drugs.

Gene therapy may also help correct the defect, Lotan said, as may certain drugs already in development that might restore CRBP.

Despite the promise, experts urge caution.

"We have seen so often extremely exciting discoveries that are logical and make sense and that we were hoping to translate into clinical outcomes," said Dr. Stefan Gluck, clinical associate director of the Braman Family Breast Cancer Institute and professor of medicine at the University of Miami School of Medicine. "More often than not we were disappointed, but we were not disappointed all the time. Yes, it's exciting. Yes, we need to take it forward, but don't start taking high levels of vitamin A in the wrong belief that you are doing something good for your body."

Farias added that too much vitamin A is toxic to the body.

More information

For more on vitamin A, visit the Office of Dietary Supplements at the National Institutes of Health (news - web sites).

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Antibiotic Shown to Protect Nerves in Animal Study

Reuters

Wednesday, January 5, 2005

LONDON (Reuters) - Antibiotics could one day be used for more than killing bacteria and may help patients suffering from neurological diseases, scientists said on Wednesday.

If a family of antibiotics, which include penicillin, produces the same effect in humans as they did in mice, researchers from Johns Hopkins University in Maryland believe the drugs could help to prevent nerve damage and death in illnesses such dementia, stroke and epilepsy.

"We're very excited by these drugs' abilities," Jeffrey Rothstein, a professor of neurology and neuroscience at the university, said in a statement.

In studies of mice genetically engineered to develop amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease (news - web sites), Rothstein and his team discovered that daily injections of the drug ceftriaxone improved survival and reduced symptoms of the progressive disease that attacks nerve cells in the brain and spinal cord causing paralysis and death.

Ceftriaxone is produced by Roche Holding AG under the brand name Rocephin.

They found that the drug turned on a gene that increased the number of transporters that remove the brain chemical glutamate from nerves. Glutamate usually helps electrical signals travel from one nerve to another but too much of the chemical can kill nerves.

"Because we study ALS, we tested the drugs in a mouse model of that disease, but this is much bigger than ALS. This approach has potential applications in numerous neurological and psychiatric conditions that arise from abnormal control of glutamate," Rothstein, who reported the findings in the science journal Nature, explained.

Although it is early research and clinical trials in humans are needed to prove if the drugs can help patients, the scientists said the results are encouraging despite the fact that the mice treated with the antibiotic were eventually paralyzed.

"If we can find drugs that protect against other causes of nerve death in ALS, the combination might offer a real therapy, much like using drug combinations to treat cancer," said Rothstein.

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Tanners Have Higher Vitamin D Levels, Bone Mass

By Amy Norton

Reuters Health

HealthDayNews

Wednesday, January 5, 2005

NEW YORK (Reuters Health) - People who try to stay bronze with the help of a tanning bed tend to have higher blood levels of vitamin D than those shun the salon, according to a new study.

The findings, say the study authors, suggest that a regular appointment at the tanning salon may have health benefits -- though they and other experts don't recommend that people start tanning in order to boost their vitamin D levels.

The study of 156 adults found those who regularly soaked up the artificial rays of a tanning bed had a 90 percent higher average vitamin D concentration in their blood. The tanners, who frequented the salon at least once a week for 6 or more months, also had greater bone density in the hips.

The study, published in the American Journal of Clinical Nutrition (news - web sites), was partially financed by the UV Foundation, which is funded by the Indoor Tanning Association, an industry group.

A precursor to vitamin D exists naturally in the skin, and exposure to the sun's ultraviolet (UV) rays touches off a chemical process that creates the usable form of the vitamin. Because vitamin D is needed for proper calcium absorption, the nutrient is vital to bone health. There is also a body of research suggesting vitamin D helps protect against certain cancers and some autoimmune diseases, such as type 1 diabetes and multiple sclerosis.

But the fact that UV radiation is the major cause of skin cancer, as well as the major source of vitamin D, has made for a controversy over how much sun -- or artificial sun -- people should get.

The senior author on the new study, Dr. Michael F. Holick of Boston University School of Medicine, has for some time advocated that people spend a short amount of time outside, without sunscreen, several days a week -- with the amount of time depending on factors such as latitude and a person's skin sensitivity.

For a white person in Boston, that might mean 10 minutes in the sun, while a darker-skinned person would need longer exposure.

"I'm not an advocate of tanning," Holick told Reuters Health in an interview, noting that some people -- those with particularly sun-sensitive skin that never tans -- should avoid tanning salons.

However, Holick said, the new findings indicate that there is a "health benefit above and beyond feeling good" from tanning beds that emit UVB light, the form of UV radiation that triggers vitamin D production.

Moreover, Holick said, the results add to research showing that many Americans may be low in vitamin D. A number of studies have found fairly high rates of vitamin D deficiency in the U.S., particularly among African Americans, who need more UV exposure to produce the vitamin.

Among the 50 tanning-salon patrons in Holick's study, 8 percent were deemed deficient in vitamin D, compared with 41.5 percent of non-tanners.

But dermatologists, concerned about skin cancer, balk at the idea that many Americans need to increase their UV exposure for the sake of vitamin D.

The American Academy of Dermatology advises people to avoid outdoor activities when the sun's rays are strongest -- between 10 a.m. and 4 p.m. -- and to wear sunscreen with SPF 15 or higher whenever they're outside. The group has also urged a ban on the use of tanning equipment for non-medical purposes.

"You get plenty of UV light in your normal daily activities," said Dr. Darrell S. Rigel, a clinical professor of dermatology at New York University in New York City.

Even when protected with sunscreen, he noted in an interview, the skin still absorbs UV rays and churns out vitamin D.

Anyone concerned about getting enough of the nutrient, Rigel said, can get more by taking vitamin supplements and from vitamin D-fortified milk or other dietary sources of the vitamin. Some cereals and juices are also D-fortified, and fatty fish such as salmon and tuna are natural sources.

With UV radiation known to be a carcinogen, Rigel said, "there's no reason to go to a tanning bed."

Holick said that people who do not wish to get more sun should take supplements to increase their vitamin D levels, as it may be tough to consume enough milk and fatty fish.

Source: American Journal of Clinical Nutrition, December 2004.

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Tuesday, January 4, 2005

 

Pick a Diet and Stick to It, Study Says

 

Reuters

Tuesday, January 4, 2005

CHICAGO (Reuters) - Only one in four people can stick to a diet for a full year, a study comparing adherence to weight-loss programs said on Tuesday.

In the study, four groups of 40 overweight or obese adults each were assigned to one of four weight-loss programs: the Atkins low-carbohydrate diet, the Ornish vegetarian, the Weight Watchers plan or the Zone. Participants were enrolled in two-month classes to help them, and then were on their own.

"We found that all four diets worked well for weight loss (and) heart disease risk factor reduction, but only in the people who could follow their diet closely for a year," said study author Dr. Michael Dansinger of Tufts-New England Medical Center in Boston.

Three in four participants quit their diets before the year was out. The highest dropout rates were among enrollees in the Atkins and Ornish diets, he said.

Overall, successful dieters lost an average of 5 percent of their body weight or roughly 10 to 20 pounds after one year, and one in 10 dieters lost more than 10 percent of their weight or more than 25 pounds.

Dansinger, writing in the Journal of the American Medical Association (news - web sites), said no single diet worked for everyone -- especially low-carbohydrate diets like Atkins that are in vogue.

"To find the one that's best for you, try 'dating the diets' as if looking for a life-long partner. You may kiss a few frogs along the way, but once you find the one you can live with forever, stand by your plan," Dansinger said.

The report came on the heels of another diet study published on Monday in the Annals of Internal Medicine that concluded no one really knows which diets work and which are a waste of time, with the possible exception of Weight Watchers, which had scientific research to back its approach.

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Protein May Protect Against Lung Disease Damage

 

HealthDayNews

Tuesday, January 4, 2005

TUESDAY, Jan. 4 (HealthDayNews) -- A protein believed to cause lung problems may actually help protect the lungs against damage caused by asthma and other chronic respiratory diseases, says a University of Texas Medical School at Houston study.

In research with mice bred to mimic human chronic lung disease, the scientists found that knocking out the A1 adenosine receptor resulted in higher levels of inflammation, mucus and tissue damage in the lungs of the mice. The mice who lacked this protein also died sooner.

"Some believe this receptor protein plays a detrimental role and if you block it, you could improve asthma. This study shows that if you remove this protein from a diseased lung, you'll make lung inflammation and damage worse," study senior author Michael R. Blackburn, an associate professor of biochemistry and molecular biology, said in a prepared statement.

"It will be important to examine the interplay of adenosine receptor signaling in other model systems as well in the lungs of people suffering chronic lung disease to determine how these pathways might be manipulated to treat the progression of asthma and COPD [chronic obstructive pulmonary disease]," Blackburn said.

The study appears in the Jan. 4 issue of the Journal of Clinical Investigation.

More information

The U.S. National Heart, Lung, and Blood Institute has more about asthma.

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Statin Use May Slightly Impair Brain Function

 

By Megan Rauscher

Reuters Health

Tuesday, January 4, 2005  

NEW YORK (Reuters Health) - The results of a new study suggest that treatment with a cholesterol-lowering statin called simvastatin (Zocor) may have small negative effects on brain function.

The effects on cognitive function were "too small" to have any immediate implications for the way the statin is prescribed, but they do suggest the possibility that the drug may harm the brain, lead researcher Dr. Matthew F. Muldoon, from the University of Pittsburgh, told Reuters Health.

Muldoon and his colleagues published their findings in the American Journal of Medicine.

This is the second trial the group has conducted in which a statin has been found to have subtle, adverse effects on cognitive function. The first study involved a drug called lovastatin (Mevacor).

In the current trial, 308 adults with high cholesterol were assigned to daily treatment with a placebo ("sugar pill"), 10 milligrams (mg) simvastatin, or 40 mg simvastatin. The subjects underwent a number of cognitive function tests before the six-month treatment period started and after it ended.

Altogether, 283 subjects completed the trial -- 94 in the placebo group, 96 in the 10-mg simvastatin group, and 93 in the 40-mg simvastatin group.

Compared with placebo, simvastatin was associated with minor negative changes in performance on several tests assessing attention, memory, and overall mental efficiency. In the team's earlier trial, 20 mg of lovastatin given every day for six months produced similar changes on these same tests.

The researchers emphasize that, as with the earlier trial, the effects of simvastatin on cognitive function were small and did not appear to affect overall performance.

It is not clear why statins may harm brain function, but Muldoon noted that statins have "potent effects on fat metabolism, and fat molecules play numerous important roles in our bodies' chemistry."

Source: American Journal of Medicine, December 1, 2004.

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Health Tip: Passing Kidney Stones

 

HealthDayNews

Tuesday, January 4, 2005  

(HealthDayNews) -- If you've had a kidney stone, you know how painful it can be. Most kidney stones pass from the body without medical help. But sometimes a stone will not just go away. It may even get larger.

A kidney stone is a solid piece of material that forms in the kidney from substances in the urine. It can stay in the kidney or break loose and travel down the urinary tract, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

If you have a stone that will not pass by itself, your doctor may need to help you get rid of it. In the past, the only way to remove problem stones was through surgery. Now, doctors have new ways to remove them, including shock waves that break a large stone into smaller pieces that will pass through your urinary system.

Another option is tunnel surgery, in which the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it.

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Eye Disease Predicts Heart Failure

 

Reuters Health

Tuesday, January 4, 2005

NEW YORK (Reuters Health) - A common type of disease that involves the back of the eye, known as retinopathy, is a risk factor for heart failure, even in the absence of preexisting heart disease, high blood pressure or diabetes, according to a new report.

Retinopathy is a known marker for blood vessel disease throughout the body, which is thought to play a role in the development of heart failure. Still, it was unclear if retinopathy was a predictor of heart failure.

To investigate, Dr. Tien Y. Wong, from the University of Melbourne in Australia, and colleagues analyzed data from 11,612 subjects who participated in the Atherosclerosis Risk in Communities (ARIC) study, a population-based study lasting 7 years.

Photographs of the retina were taken between 1993 and 1995 and evaluated for retinopathy. Heart failure was determined through hospital and death records.

The researchers' findings appear in the Journal of the American Medical Association (news - web sites).

The rate of heart failure during follow-up was 5.4 percent, the authors note. The rate of heart failure among subjects with retinopathy was much higher than that seen among subjects without retinopathy, at 15.1 and 4.8 percent, respectively.

After adjusting for various factors that may have influenced the association, retinopathy remained a strong predictor of heart failure, nearly doubling the risk. Moreover, in subjects without preexisting heart disease, high blood pressure, or diabetes, the presence of retinopathy almost tripled the risk of heart failure

The results suggest that it may be worthwhile to screen for heart failure in people with retinopathy, even if they don't have symptoms of heart trouble, Wong's team concludes.

Source: Journal of the American Medical Association, January 5, 2005.

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Health Tip: Be Smart When Applying Makeup

HealthDayNews

Tuesday, January 4, 2005

(HealthDayNews) -- The most common injury from applying cosmetics is scratching the eye with a mascara wand, according to the U.S. Food and Drug Administration (news - web sites).

Eye infections can result if eye scratches go untreated. Such infections can lead to ulcers on the cornea, loss of lashes, or even blindness.

Be smart -- never try to apply mascara while in motion, including as a passenger in a car, bus, train or plane.

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Air Pollution Tied to Lower Birth Weight

By Amy Norton

Reuters Health

Tuesday, January 4, 2005

NEW YORK (Reuters Health) - Pregnant women who live in areas with high levels of air pollution may give birth to slightly smaller babies, according to U.S. government researchers.

A new study of more than 18,000 full-term infants born in California in 2000 found that a mother's exposure to fine-particle air pollution seemed to make a difference in her baby's birth weight and the infant's risk of being below average in size.

Fine particulate matter, called PM2.5 by scientists, is composed of microscopic substances such as acids, metals and organic chemicals, and can be seen in the form of a hazy sky. It is given off by the burning of fuels from sources such as cars, power plants and some industrial processes.

In the study, babies born to women who lived in areas with the highest levels of PM2.5 were 26 percent more likely to be small for their gestational age compared with infants born to women from low-pollution areas.

The absolute difference between these groups of infants was modest. Among women with the least exposure to fine-particle pollution, 8.5 percent had a baby who was small for gestational age. That compares with 9.2 percent of women with the highest pollution exposure.

Similarly, the difference between the groups as far as average birth weight was slight, noted the study's lead author, Dr. Jennifer D. Parker of the National Center for Health Statistics in Hyattsville, Maryland.

"But the results are consistent with other research," she said in an interview with Reuters Health. Therefore, the "body of evidence" points to an effect of air pollution on birth weight, according to Parker.

She and her colleagues report their study findings in the January issue of the journal Pediatrics.

According to Parker and her colleagues, PM2.5 levels may influence birth weight either indirectly through effects on the mother's health or by directly affecting fetal development.

The exact reason for the link between fine-particle pollution and birth weight is not yet clear, however, Parker said.

For their study, she and her colleagues analyzed data from air pollution monitoring stations in California and looked at birth records for 18,247 full-term infants whose mothers lived within five miles of a monitoring station during pregnancy.

The women were split into four groups based on their exposure to fine particulate matter and to carbon monoxide. Average birth weight was lowest in the group with the highest exposure to particulate matter, though the difference between this group and the group with the highest average birth weight amounted to 42 grams, or less than two ounces.

A limitation of breaking exposures into four broad groups like this is that it cannot determine anything about "extreme" exposures, Parker noted. It's unclear, she said, whether air pollution might have a greater impact on birth weight when a woman works amid car exhaust at a highway toll plaza, for example.

The U.S. Environmental Protection Agency (news - web sites) recently released data on the nation's first "fine particle standard." The agency said portions of 20 states, as well as the District of Columbia, do not meet new PM2.5 air-quality standards. Information on the affected areas is available on the EPA's Web site at www.epa.gov. 

Source: Pediatrics, January 2005.

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Checking Cancer's Growth

HealthDayNews

Tuesday, January 4, 2005

TUESDAY, Jan. 4 (HealthDayNews) -- Specific molecular events that cause a cell to switch from active growth to a permanent halt of growth -- a state called senescence -- have been identified by scientists at the Fox Chase Cancer Center in Philadelphia.

This research may help scientists better understand and fight cancer. Senescence is a normal stage of a cell's life cycle. Continued uncontrolled cell growth is a hallmark of cancer.

The findings appear in the January 2005 issue of Developmental Cell.

More information

The National Cancer Institute (news - web sites) has more about cancer.

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Curry Spice May Fight Alzheimer's

By Amy Norton

Reuters Health

Tuesday, January 4, 2005

NEW YORK (Reuters Health) - The pigment that gives curry spice its yellow hue may also be able to break up the "plaques" that mark the brains of Alzheimer's disease (news - web sites) patients, early research suggests.

Scientists found that curcumin, a component of the yellow curry spice turmeric, was able to reduce deposits of beta-amyloid proteins in the brains of elderly lab mice that ate curcumin as part of their diets.

In addition, when the researchers added low doses of curcumin to human beta-amyloid proteins in a test tube, the compound kept the proteins from aggregating and blocked the formation of the amyloid fibers that make up Alzheimer's plaques.

Accumulation of beta-amyloid proteins in the brain is one of the hallmarks of Alzheimer's disease.

The new findings suggest that curcumin could be capable of both treating Alzheimer's and lowering a person's risk of developing the disease, said study co-author Dr. Gregory M. Cole of the University of California Los Angeles and the Greater Los Angeles Veterans Affairs Healthcare System.

Cole and his colleagues have gotten funding to begin a small trial in humans suffering from Alzheimer's disease.

"The big question is how high are the doses we need to fight Alzheimer's and are they really safe in elderly patients?" he told Reuters Health.

The current findings, published online recently by the Journal of Biological Chemistry, add to the body of research pointing to curcumin's medicinal value. Long used as part of traditional Indian medicine, curcumin is now under study as a potential cancer therapy, and animal research has suggested the compound might serve as a treatment for multiple sclerosis and cystic fibrosis.

Interest in curcumin as an Alzheimer's therapy grew after studies found low rates of the disease among elderly adults in India, where curry spice is a dietary staple.

Curcumin is structurally similar to a stain known as Congo red, which is used by pathologists to identify amyloid protein in autopsied brain tissue in order to confirm a diagnosis of Alzheimer's disease after a patient's death.

Curcumin can also stain amyloid deposits, Cole said, but it has the additional ability, when eaten or injected, to cross into a living animal's brain and bind to amyloid deposits.

What's more, he explained, curcumin is an antioxidant and anti-inflammatory agent, and it appears to counter the oxidative damage and inflammation that arises in response to amyloid accumulation.

"It attacks both the amyloid and the response to amyloid," Cole said.

Because oxidative damage and inflammation mark a number of diseases of aging - such as arthritis and the buildup of plaques in the heart's arteries - Cole said he and his colleagues hope that curcumin eventually proves useful for a range of age-related conditions.

Source: Journal of Biological Chemistry, online Dec. 7, 2004.

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Passive Smoke Lowers Kids' Test Scores

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Tuesday, January 4, 2005

TUESDAY, Jan. 4 (HealthDayNews) -- Even small amounts of secondhand smoke can sabotage a child's performance on reading, math, reasoning and logic tests, a new study finds.

Scores on standardized exams to measure cognitive function decrease in what is called a dose-response relationship found that, the more tobacco smoke a child is exposed to, the worse he or she does on the test, according to the report in the January issue of Environmental Health Perspectives.

"We were looking for links between environmental tobacco smoke and performance on cognitive testing," said study author Kimberly Yolton, an assistant professor of pediatrics at the Children's Environmental Health Center at Cincinnati Children's Hospital Medical Center.

Yolton and her colleagues collected data on 4,399 children, aged 6 to 16, who were part of the third National Health and Nutrition Examination Survey (NHANES-III). The study was conducted from 1988 to 1994 by the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention (news - web sites).

To determine the amount of exposure to tobacco smoke, Yolton's team measured levels of cotinine in the children's bodies. Cotinine is a substance produced when nicotine is metabolized. Cognitive and academic ability were measured using parts of standardized intelligence and achievement tests.

"We found that there was a clear, strong association between exposure to tobacco smoke and declining scores in reading, math and problem-solving. Children who had more exposure had a greater detriment in their scores," Yolton said.

"This effect remained significant even at very low levels of exposure," Yolton added. In general, there was about a three-point drop in reading scores and about a two-point drop in math scores among those exposed to the highest levels of secondhand smoke, she noted.

"A lot of people would say, 'What's three points on a reading test that has a mean of 100?' For the individual child, it may not seem like it's a big effect that we need to be concerned about," Yolton said. "But if you think about it, we estimated that somewhere around 33 million children are exposed to tobacco smoke. So if you think about 33 million children across the country losing three points, then it has a greater societal impact."

Whether these effects of secondhand smoke on cognitive skills remain throughout the child's lifetime is not clear. Yolton is not sure if passive smoke causes permanent changes in mental function by altering brain development, or if the changes are temporary.

"Children are getting exposed to tobacco smoke in places other than in their homes," Yolton said. "Parents need to pay attention to where their children are, and what they are surrounded by." While only 43 percent of the children reported being exposed to smoking at home, 84 percent had some level of exposure, she noted.

"The study does suffer from one serious limitation: There was no measure of parental intelligence," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

It is well-established that, other things being equal, more intelligent parents tend to have more intelligent children, and vice versa, Katz said.

"It may just be that somewhat less intelligent parents are the ones who expose their children to tobacco smoke; after all, based on evidence available long before this study, doing so simply isn't very bright. If that is the case, serum cotinine in children might simply be a surrogate marker for less intelligence in the parents."

While this possibility should be considered and studied further, the facts of the study are simple, Katz noted.

"As if we didn't already know this, children should not be exposed to tobacco smoke, period," he said. "To expose children to tobacco smoke is, for all intents and purposes, to poison them." The study has "simply clarified another of this insidious poison's likely consequences."

More information

The U.S. National Cancer Institute (news - web sites) explains secondhand smoke and its dangers.

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Study: Test Detects Pregnancy Complication

Reuters

Tuesday, January 4, 2005  

CHICAGO (Reuters) - Testing for a protein in the urine of pregnant women accurately predicts whether they will develop preeclampsia, a potentially deadly condition that affects one in 20 U.S. pregnancies, a study said on Tuesday.

The finding may pave the way for a simple screening test that could allow doctors to treat the condition before it develops into eclampsia, an uncontrollable rise in blood pressure that threatens the life of the mother and her fetus, researchers said.

Preeclampsia is the rise in blood pressure that precedes eclampsia.

Eclampsia, in which blood vessels feeding the placenta constrict instead of expanding as they should, is one of the world's leading causes of maternal and infant mortality.

The condition usually occurs after the 20th week of gestation and can cause seizures, kidney failure or stroke in the mother and can kill or cause premature birth of the fetus.

Doctors try to detect preeclampsia by monitoring the blood pressure of expectant mothers, but by the time pressure becomes elevated it may be too late.

Researchers have previously proposed other tests to predict preeclampsia, but these have ultimately turned out to be flawed.

Five years ago, Harvard Medical School (news - web sites) researcher Ananth Karumanchi discovered that depressed levels of the protein placental growth factor and elevated levels of another protein heralded the onset of preeclampsia.

In his study, screening on stored urine specimens from 120 women who developed preeclampsia and 118 women who had normal pregnancies showed the former had a sharp drop in levels of the placental growth factor protein six to eight weeks before the onset of symptoms.

To gauge its effectiveness, screening for the protein was also performed on urine from pregnant women who developed two other conditions -- gestational hypertension and delivery of a small-for-gestational-age infant. There was no similar drop in levels of the protein.

"A simple urine test could help predict the onset of this disease (preeclampsia) one to two months before the onset of clinical symptoms and that could make a tremendous difference in outcomes for patients, in particular those women who have limited access to specialized medical care," Karumanchi said.

The study appeared in the Journal of the American Medical Association (news - web sites).

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Study Unlikely to Change Use of Hypertension Drugs

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, January 4, 2005

TUESDAY, Jan. 4 (HealthDayNews) -- Doctors welcomed a new study finding that commonly used hypertension drugs have a long-term heart benefit even though they increase the risk of diabetes, but added that the results probably won't change their prescribing practices.

The study found that treating elderly people who have high blood pressure with the drugs, called diuretics, lowered their rate of death from heart attacks and strokes over the long haul -- even among those who developed diabetes while taking the pills.

Although the results affirm the overall safety record of diuretics, several experts said they are still likelier to turn to other blood pressure drugs, especially among patients who are at risk for acquiring the blood sugar disorder.

"I'm not sure that this changes anything dramatically, but I think it's another supportive piece of evidence," said Dr. Michael Fischer, an associate physician at Brigham and Women's Hospital and instructor in medicine at Harvard Medical School (news - web sites).

"The trial is informative, but it's not going to change much in the way of practice other than to confirm what we probably suspected, which is it's the blood pressure that kills you, not the blood sugar," added Dr. Richard Milani, section head of preventive cardiology at the Ochsner Clinic Foundation in New Orleans. "I still think the first-line therapy for hypertension and metabolic disorder and diabetes should be an ACE inhibitor or an angiotensin receptor blocker. If an additional agent was needed I would have no hesitation in adding a diuretic, and I think most people have been practicing that way."

Doctors have known for years that the chance of getting diabetes is about 2 to 3 percent higher in people who take diuretics.

"Some physicians don't use diuretics in all or some patients because of this fear of diabetes," said Dr. John Kostis, lead author of the study appearing in the January issue of the American Journal of Cardiology and chair of the department of medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.

Other experts felt that the question of whether to give diuretics was never really answered because most of the relevant studies lasted only about four to five years -- not long enough to see if the diabetes really caused significant harm.

The new study followed 4,732 participants for more than 14 years and is therefore meant to allay those concerns. They took either the diuretic chlorthalidone or a placebo. Even though diuretics increased the risk of diabetes, the overall mortality rate was lower in people taking the diuretic.

"This is reassuring, and it shows that those who had diabetes to begin with or those who developed diabetes did better if they took diuretics than if they did not take diuretics," Kostis said.

"This article shows that the increase in blood sugar you see with these medications, at least based on what they're finding here, is just a mild increase and doesn't seem to have huge consequences in the long term for patients," Fischer said.

Although diuretics are already widely used, this information may boost their use even more.

"Diuretics have been reasonably widely used, although not to the extent that the evidence would suggest," Fischer said. "There's been a general feeling that the use has been increasing in the last few years, and that's as good thing."

One major advantage to diuretics is that they are cheap. "It's good in terms of affording medications," Fisher said.

On the other hand, Milani pointed out, many ACE inhibitors are now available in generic form, and are less inexpensive. These drugs do not increase blood sugar levels.

"There should not be an enormous fear of using diuretics in people with pre-diabetes or metabolic syndrome or diabetes, but, likewise, if there is another drug that would give them additional benefit and wouldn't cost more, that would be probably my first choice," Milani said. "If everything's equal and every drug has the same effect and costs the same and you walked into my office and you had metabolic syndrome or diabetes, I'm going to pick an ACE inhibitor or an angiotensin receptor blocker."

But having two types of drugs that are affordable is definitely a good thing.

"It's nice to have a few inexpensive alternatives to pick from," Fischer said.

More information

The American Heart Association has more on blood pressure medications.

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Monday, January 3, 2005  

 

Study Shows No One Knows Which Diets Work Best

 

Reuters

Monday, January 3, 2005

WASHINGTON (Reuters) - No one really knows which diets work and which are a waste of time, with the possible exception of Weight Watchers, U.S. researchers reported on Monday.

A review of 10 separate studies of weight-loss programs showed there was very little hard data to support any commercial or nonprofit diet approach, the researchers found.

Only Weight Watchers had scientific research to back up its simple approach of keeping a food diary and focusing on low-calorie foods, especially vegetables and whole grains, they wrote in the Annals of Internal Medicine.

"With the exception of one trial of Weight Watchers, the evidence to support the use of the major commercial and self-help weight-loss programs is suboptimal," Dr. Adam Tsal and Thomas Wadden of the University of Pennsylvania wrote.

The pair started out scanning more than 1,500 diet studies, but rejected most because they were done outside the United States, had fewer than 10 participants, lasted only a few weeks or differed from the diet as offered to the public.

They also looked for at least one year of follow-up and did not include commercial self-help programs based on books alone or meal replacement plans.

They ended up with 10 studies that included Weight Watchers, Jenny Craig, eDiets.com and the nonprofit Overeaters Anonymous group.

"Currently, the three largest nonmedical commercial programs in the United States are Weight Watchers, Jenny Craig and LA Weight Loss," Tsal and Wadden wrote.

The largest trial showed dieters using the Weight Watchers program lost and kept off 3.2 percent of their weight after two years.

"Weight Watchers, at $12 per week, is moderately priced, whereas the weekly costs of Jenny Craig's prepackaged meals ($70 to $100) make it expensive," they noted.

"Controlled trials are needed to determine the amount of weight lost and health benefits associated with Jenny Craig and LA Weight Loss programs," the study said.

Some diets can be dangerous, according to the researchers.

"Medifast offers both very-low-calorie and low-calorie meal replacement plans, which participants may purchase directly from the manufacturer," they wrote. But it does not require medical supervision, as is advised by government experts for very-low-calorie diets.

"Serious complications, including death, have been reported in obese persons who consumed very-low-calorie diets without medical supervision," they wrote.

Many Internet-based programs are available, but there is little study to show whether they work, the researchers said.

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Health Tip: Mullin' Melons

 

HealthDayNews

Monday, January 3, 2005

(HealthDayNews) -- Choosing the healthiest melon doesn't necessarily mean picking the one that looks, feels or sounds the ripest.

Casaba has the fewest calories -- 26 calories for 3 1/2 ounces raw or 2/3 cup, cubed. Watermelon has 32 calories and cantaloupe or honeydew each has 35.

But cantaloupe wins hands down for the most nutrients, according to the "Berkeley Wellness Encyclopedia of Food and Nutrition." It has the most vitamin C, 42 milligrams; the most potassium, 309 milligrams; and the most beta carotene, 2 milligrams.

Honeydew is not even a close second, with 25 milligrams of vitamin C, 271 milligrams of potassium but only a trace of beta carotene.

Casaba follows, with 16 mg of Vitamin C, 210 milligrams of potassium and again only a trace of beta carotene.

And watermelon, living up to its name, trails the pack: 10 mg of vitamin C, 116 mg of potassium and two-one-hundredths of a milligram of beta carotene.

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Painkillers Damage Intestine, U.S. Expert Says


By Maggie Fox, Health and Science Correspondent

Reuters

Monday, January 3, 2005

WASHINGTON (Reuters) - More than 70 percent of patients who took painkillers such as ibuprofen for more than three months suffered damage to their small intestines, U.S. researchers reported on Monday.

The study is yet another blow to patients trying to find ways to treat arthritis pain, after reports that the most advanced drugs, called COX-2 inhibitors, can raise the risk of heart death.

Dr. David Y. Graham of the Baylor College of Medicine in Houston and colleagues studied 21 patients taking a range of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS. They compared them to 20 patients taking either acetaminophen, an unrelated painkiller, or nothing.

"Small-bowel injury was seen in 71 percent of NSAID users compared with 10 percent of controls," they wrote in Monday's issue of the journal Clinical Gastroenterology and Hepatology.

"We have always known that NSAIDs can cause potentially deadly stomach complications, but the extent of the impact on the small intestine was largely unknown until now," Graham added.

Arthritis pain is incurable but can be treated with a range of drugs, including NSAIDS such as aspirin, ibuprofen or naproxen; acetaminophen; or the newer drugs called COX-2 inhibitors.

NSAIDS work very well but damage the stomach and intestine. They are blamed for 16,500 deaths a year in the United States alone, Graham said.

Benefit v. Risk

"Anybody who takes aspirin or (other) NSAIDS for a year has a 1 to 4 percent risk of serious gastrointestinal complications," Graham said in a telephone interview.

"If the drugs didn't have such benefits, we'd have taken them off the market some time ago."

Acetaminophen, sold generically and also under the brand name Tylenol, does not work for many patients, Graham said.

The COX-2s were designed specifically to overcome the deadly side-effects of NSAIDS. But a series of studies has linked them to heart disease and one, Merck and Co. Inc.'s Vioxx, was pulled from the market in September.

In December the U.S. Food and Drug Administration (news - web sites) issued an advisory telling doctors to limit their prescribing of other COX-2s, including Pfizer's Celebrex and Bextra.

And a study published in December indicated that an over-the-counter NSAID called naproxen might also raise the risk of heart attack and stroke.

Graham's team used an endoscope in the form of a swallowed camera in a capsule to examine the intestines of their volunteers. Although people taking NSAIDs frequently suffer stomach pain or anemia, none of the volunteers in this study had any symptoms.

"We saw some ulcers and we saw lots of erosions," Graham said.

Some experts have recommended using antacid drugs called proton pump inhibitors (PPI (news - web sites)) to reduce the damaging effects of stomach acid in NSAID patients. But PPIs do not affect the small intestine, Graham said.

Instead, he said, an older drug called misoprostol can help protect the stomach lining.

"It is the only drug approved to reduce the rate of bleeding," Graham said.

A U.S. government study published last month found that acupuncture can help to further relieve arthritis pain in the knee in patients getting more standard treatment.

The American Gastroenterological Association estimates that more than 30 million Americans take over-the-counter or prescription drugs for headaches and arthritis.

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Aspirin Use Lags Among Diabetic Women

 

HealthDayNews

Monday, January 3, 2005

MONDAY, Jan. 3 (HealthDayNews) -- Too few diabetic women use aspirin to reduce their risk of heart disease, claims a study by researchers at Northwestern University Feinberg School of Medicine.

They noted that adults with diabetes have a high risk of cardiovascular disease, and that taking aspirin is an effective and inexpensive way to reduce the risk of first and subsequent heart attacks.

The researchers assessed the self-reported use of aspirin among diabetics over age 35 from 1997 to 2001. They found that in recent years there's been an overall increase in aspirin use among adults with diabetes. However, there was a significant difference in aspirin use between diabetic men and women that wasn't present a decade ago.

The study found 42 percent of adult men with diabetes who hadn't been diagnosed with cardiovascular disease took aspirin regularly, compared with 34 percent of women in the same category. Younger and middle-aged diabetics also took aspirin less often than older adults.

Among adults with diabetes and diagnosed cardiovascular disease, 83 percent of men and 65 percent of women reported that they took aspirin regularly.

There are a number of possible reasons for this disparity between women and men, the researchers said. Doctors may underestimate women's risk for heart attack and other cardiovascular disease events.

Doctors may also have concerns that aspirin is less effective for women than men in preventing cardiovascular disease events.

"Observational data suggest that aspirin prevents initial myocardial infarction in women, yet women were not well represented in early randomized trials of aspirin for the prevention of initial cardiovascular disease events," study co-author Dr. David W. Baker said in a prepared statement.

The low use of aspirin among younger adults with diabetes may be due to the belief of doctors and patients that the risk of cardiovascular events is too low at that point to justify regular use of aspirin, the researchers added.

"Health professionals may have a large role to play in increasing appropriate aspirin use among adults with diabetes. Simple interventions such as offering professional advice about aspirin may be adequate to increase appropriate usage, given that past studies have shown a strong association between current aspirin use and report of professional counseling," study co-author Dr. Stephen D. Persell said in a prepared statement.

The study appears in the current issue of the Archives of Internal Medicine (news - web sites).

More information

The American Diabetes Association has more about aspirin therapy for people with diabetes.

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Dual Pacemakers Worth the Cost, U.S. Study Finds

 

Reuters

Monday, January 3, 2005

WASHINGTON (Reuters) - Pricey pacemakers that regulate the heart's upper and lower chambers separately are worth the extra cost because they help keep patients out of the hospital, U.S. researchers reported on Monday.

The fancier dual-chamber models cost about $3,000 more than single-chamber devices and do not help patients live any longer on average, but still save money over time, the government-funded study found.

"The dual-chamber devices significantly reduced the rates of atrial fibrillation and heart failure hospitalizations, which over the long term results in a highly favorable cost-effectiveness ratio," said Dr. David Cohen of Harvard Medical School (news - web sites) in Boston, who led the study.

Atrial fibrillation is a type of irregular heartbeat that can cause stroke and heart failure.

Single-chamber or right-ventricular pacemakers help control one of the two ventricles, the heart's two lower pumping chambers. Dual-chamber devices also pace one of the atria -- the smaller, upper chambers.

In the first four years after implant, the dual-chamber devices had a cost-effectiveness ratio of $53,000 per quality adjusted year of life gained, Cohen's team reported in the American Heart Association (news - web sites) journal Circulation.

For the report, Cohen's team studied 2,010 patients for four years. About half got dual-chamber devices and half the single-chamber devices.

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Saliva Holds Clues to Oral Cancer

 

HealthDayNews

Monday, January 3, 2005  

MONDAY, Jan. 3 (HealthDayNews) -- A major advance in using saliva to detect oral cancer is outlined in a study funded by the U.S. National Institute of Dental and Craniofacial Research.

Scientists found they were able to measure for elevated levels of four distinct cancer-associated molecules in saliva. Using this method, they had a 91 percent accuracy rate in distinguishing between healthy people and those diagnosed with oral squamous cell carcinoma.

This is the first study to report that distinct patterns of cancer-linked messenger RNA can be measured in saliva and indicate the presence of a developing tumor. The findings appear in the current issue of Clinical Cancer Research.

Messenger RNA provides a chemical record that a particular gene has been expressed.

The researchers used saliva and blood samples from 32 people who'd been diagnosed with oral squamous cell carcinoma but hadn't yet received treatment. They plan a larger study to determine if they can use saliva samples to distinguish between various stages of oral cancer.

More information

The Cleveland Clinic Foundation has more about oral cancer.

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Italian Study: Shy Children Don't Read Emotions Well

 

Reuters

Monday, January 3, 2005

CHICAGO (Reuters) - Shy children tend to have muted reactions to joy or anger in the facial expressions of others, inhibitions that may lead to the anxieties many experience later in life, Italian researchers said on Monday.

Shy children seem to miss emotional cues that are "socially relevant," wrote study author Marco Battaglia of the San Raffaele Scientific Institute in Milan. That missing information may lead to the higher rates of anxiety disorders and social phobias suffered by shy children later on in life, he said.

In the study of 49 shy Italian children aged 8 and 9, researchers found the children had a tendency to misread joy, anger or neutral feelings depicted in photographs of faces they were shown.

Electrodes monitoring the children's brain waves showed less activity in regions normally associated with reactions to others' emotions, said the report, which was published in The Archives of General Psychiatry.

The presence of a form of the gene that suppressed the hormone serotonin was also associated with the muted reactions, according to the report.

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Artificial Hip a Story of Setbacks, Triumph

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, January 3, 2005

MONDAY, Jan. 3 (HealthDayNews) -- Medicine is the story of countless triumphs and countless disappointments, followed eventually by more triumphs.

Rarely, though, is one man so inextricably linked with these ups and downs to emerge victorious over one mysterious, man-made disease -- one that he helped beget in a groundbreaking effort to heal another ailment.

The tales of modern-day hip replacements, one of the major medical breakthroughs of our age, and Dr. William Harris, an orthopaedic surgeon at Massachusetts General Hospital, are so intertwined that they are figuratively joined at the hip.

"He's had a huge impact on the field of joint replacement," said Dr. Peter Slavin, president of Mass General. "There are lots of great clinicians in the world, but it's rare to have one of those physicians also be so inquisitive and looking for ways to improve the procedures that he's performing every day. That's indeed what Bill did."

"He first described the biology of this process, then looked at what was causing it, and then attacked the material to say, 'How can we make material better to lessen this problem?'" added Dr. Harry E. Rubash, chief of orthopaedics at Mass General, who did his fellowship under Harris. "He's made a remarkable contribution in developing the new low-wear plastics [as joint prostheses]."

Hip replacements entered the world in the 1960s, with Harris as one of the practitioners. "It was an absolutely dramatic change in what we could do in the treatment of severe end-stage osteoarthritis of the hip," attested Harris, who was one of the pioneers in the field. Harris detailed his accomplishments in an article in the December issue of Clinical Orthopedics and Related Research.

The initial delight would eventually give way to disappointment. Within a few years, people who had undergone hip replacements were beginning to suffer a mysterious erosion of the bone next to the implant, a disease process called periprosthetic osteolysis. "This would prove to be the number one long-term problem associated with total hip replacement," Harris said. Periprosthetic osteolysis was a prelude to the eventual failure of the implant.

No one knew why this was happening, but several theories began to circulate. One leading hypothesis held that the cement used as grouting material was responsible. But when scientists found a way to fix the implant to the skeleton without the cement, the same thing happened.

"It was absolute anguish when I saw the first problem in a cement-less device," Harris recalled. "The whole industry had gone cement-less and you say, 'What do I do now?' And then gradually you're able to peel the layers off the onion and unravel the whole thing."

Because Harris had feet in the worlds both of practice and research, he was key in this unraveling process.

When reoperating on people with periprosthetic osteolysis, he had noticed a thick membrane surrounding the implant, a membrane that was usually thrown away. "It seemed to me that that membrane had to have the key," he said. He studied some salvaged membrane under a microscope and saw that the cells were macrophages, or immune-system cells that go after foreign substances. "The questions were, 'Why are they there, and what are they doing?'" Harris said.

Harris eventually unearthed a complex biologic cascade whereby the metal head of the implant rubbed against the polyethylene joint socket, sending off particles of polyethylene less than a micron in size. The body detected the particles and sent in scavenger cells called macrophages to destroy them. While the macrophages had little effect on the plastic, they kept multiplying and eventually started destroying the surrounding bone tissue. The implant would get looser and looser until it no longer worked.

"This is a unique disease, never seen before in the history of mankind," Harris said. "We were looking at something nobody had ever seen before. We hadn't the foggiest idea what it was, and it was bad. Millions of people were being helped, and now you were getting large numbers of people who were being harmed."

Harris also discovered the metal ball was rubbing down an area of the plastic so that it became oriented in the direction of the person's main movement (usually walking back and forth). The problem arose when a person crossed her legs or climbed stairs, movements that shaved off tiny particles from the weaker areas of the joint. Harris realized they needed to prevent the implant from orienting itself to one movement.

Along with polymer chemists at the Massachusetts Institute of Technology (news - web sites), Harris eventually developed a new material called cross-linked polyethylene. Traditional ultra-high-molecular-weight polyethylene is like a bowl of spaghetti with all the pieces intertwined. When radiation is introduced, the strands link to each other to form cross-linked polyethylene, which resists orienting in just one direction. This is now the standard compound used in joint replacements.

Millions of people have now had successful joint replacement, without the fear of loosening or failure in five or more years.

More information

For more on hip replacements, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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High Body Weight Linked to Kidney Cancer Risk

 

Reuters

Monday, January 3, 2005

NEW YORK (Reuters Health) - The risk of developing a type of kidney cancer, renal cell carcinoma, is directly related to body mass index (BMI) and to the increase in BMI since age 20, according to the findings from two new European studies.

In the first study, Dr. Boukje A. C. van Dijk, from Maastricht University in the Netherlands, and colleagues analyzed data from the Netherlands Cohort Study on Diet and Cancer, covering more than 120,000 older men and women.

During 9 years of follow-up, a total of 275 confirmed cases of renal cell carcinoma (RCC) were identified, the researchers report in the American Journal of Epidemiology.

For each 1 point in BMI above normal at the start of the study, the risk of RCC rose by 7 percent in men and women. Also, if BMI increased since age 20, the risk of RCC was elevated.

Unexpectedly, in women, for each 5-cm increase in height above 160 cm there was a 23 percent increase in RCC risk, the team notes. This was not seen in men, and it runs counter to what has been seen in most other studies, the researchers add.

In the second study, published in the same journal, Dr. Anders Engeland from the Norwegian Institute of Public Health in Oslo and colleagues conducted a similar analysis involving two million men and women living in Norway. During follow-up between 1963 and 2001, a total of 6453 cases of RCC were recorded.

In a separate analysis of 227,000 adolescents, 154 cases of RCC were seen.

In both age groups, the risk of RCC increased as BMI rose. The risk of the malignancy also increased with height, but further analysis showed this finding was confined to smokers and former smokers. In contrast, the link between BMI and RCC risk was strongest in those who never smoked.

"An effort should be undertaken to elucidate possible underlying mechanisms between factors such as BMI, BMI gain in adulthood, physical activity, and energy intake and cancer risk, specifically RCC risk," van Dijk's team notes.

Source: American Journal of Epidemiology, December 15, 2004.

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Only Moderate Drinking Wards Off Stroke

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Monday, January 3, 2005

MONDAY, Jan. 3 (HealthDayNews) -- Moderate drinking has been associated with a lower risk of heart attacks, but the picture has been less clear in the case of stroke.

Now, a new study points out just how moderate your drinking has to be to protect against a brain attack: It should be no more than one drink every other day, and the libation of choice should be red wine.

Consuming more alcohol than that will invite cardiovascular trouble, the researchers said. For men who drink three or more glasses of alcohol a day, the increased risk of stroke reaches almost 45 percent, compared with nondrinkers, according to the report in the Jan. 4 issue of the Annals of Internal Medicine.

"There has been an assumption that moderate drinking prevents heart attacks and prevents strokes," said study author Dr. Kenneth Mukamal, an associate professor of medicine with Harvard Medical School (news - web sites). "In the last few years, it has become increasingly clear that that might not be the case for stroke."

"As men drink more, the risk for stroke becomes particularly clear," Mukamal added.

Over 14 years, Mukamal's team collected data on 38,156 men who participated in the Harvard School of Public Health's Health Professionals Follow-up Study. Every four years from 1986 to 2000, the men completed questionnaires about their diet and how much they drank.

Men who drank one drink every other day had the lowest risk -- 32 percent lower than that of nondrinkers. Men who drank three or more drinks a day had about a 42 percent higher risk than nondrinkers, Mukamal said.

"It is clear that there is a delicate balance between alcohol use and stroke," Mukamal said.

"The amount of alcohol at which that lower risk may occur is lower than it is for heart disease," Mukamal said. "One drink every other day is where we begin to see the lowest risk for heart disease, but that is the only amount that was linked to a lower risk of stroke."

Moreover, the protective effect from drinking is not as great for stroke as it is for heart disease, Mukamal added. Although moderate drinking does not necessarily increase the risk of stroke, it is not clear that it reduces the risk.

Furthermore, any beneficial effect from alcohol was confined to drinking red wine, Mukamal said. "In the past, we hadn't seen an advantage of one beverage type over another," he said. "In this case, clearly red wine had a different relationship with stroke. The more red wine men drank, the lower the risk for stroke."

Mukamal speculated that these findings would hold true for women.

This study emphasizes the importance of asking your doctor about how much you should drink, Mukamal said. "These results suggest that there is a very delicate balance between how much alcohol people drink and what happens to their risk of stroke," he said.

"Nobody should take up drinking to prevent stroke on the basis of results like ours," he added. "People who are drinking more than recommended amounts should have good reason to quit."

"This study helps confirm some of the connections between slight to moderate drinking and no effect on the risk of stroke," said Dr. Ralph L. Sacco, associate chairman of neurology and director of the Stroke and Critical Care Division at Columbia University College of Physicians and Surgeons.

"Our own studies have found that heavy drinking increases the risk of stroke," Sacco said. "If you are drinking one to two drinks a day, the good news is that there is no increased risk of stroke, and there may even be some protective effects."

However, this study adds to the growing evidence that drinking more than two drinks a day could put you at an increased risk for stroke. "And you need to cut back immediately," Sacco stressed.

More information

The American Stroke Association can tell you more about stroke.

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More Awareness Needed of Toddlers' Risk for Scalds

By Charnicia E. Huggins

HealthDayNews

Monday, January 3, 2005

NEW YORK (Reuters Health) - Despite repeated recommendations to cook on the back burners of the stove and to turn pot handles toward the back, many parents still fail to recognize their child's potential risk for burns and scalds, new study findings suggest.

During a six-year period, more than 17,000 burns to children aged 5 years and younger were treated in emergency departments across the United States, and half occurred when children pulled a pot down from an elevated surface such as a stove or somehow spilled a pot's contents onto themselves.

"Although the hazards of motor vehicles, poisons, and small parts seem to be well understood by parents, there seems to be no comparable understanding of the potential for kitchen burns and scalds," writes study author Dorothy A. Drago, a Massachusetts-based product safety consultant.

"I'd like to see parents become as aware of the danger of hot liquid as they seem to be about, say, the danger of small parts," Drago told Reuters Health.

Drago investigated the ways in which young children suffer household burns and scalds in an analysis of 1997 to 2002 data collected by the U.S. Consumer Product Safety Commission (news - web sites).

Of the estimated 17,237 burns treated in the emergency department during that time, nearly 66 percent were scalds resulting from hot liquids, and 34 percent were thermal burns from contact with some hot surface.

One-year-old children were the most likely to experience both types of injuries, scalds in particular -- and were more likely to be hospitalized for a scald. Further, scalds were about five times more common among this age group than among younger children and almost twice as likely as among 2-year-olds, Drago reports in the medical journal Pediatrics.

One-year-olds also comprised at least 44 percent or more of those who were scalded when they pulled a pot from some elevated surface or when they spilled the contents of a pot onto themselves - the two most common methods of scald injury. These youngsters were also likely to be scalded after putting their hands in a pot.

"The high frequency of scalds among 1-year-olds can be related to their inherent nature to explore their environment," Drago writes.

Studies conducted in the Netherlands, the United Kingdom and the United States suggest that 2-year-olds are able to grip objects placed about 41 to 42 inches off the ground. Since stoves typically measure 36 inches from the ground, pots on the front burner are often within reach of 1 and 2 year-old children, the report indicates.

"It is not unusual for parents to fail to recognize what their children are developmentally capable of," Drago said. "Toddlers are constantly learning new skills, and they are highly motivated to explore and imitate."

Five-year-olds, on the other hand, were most likely to be scalded when they collided with a pot or with someone holding a pot, the report indicates.

Since 1977, various teams of researchers have recommended strategies to help parents reduce their child's risk of scalds. Yet several studies have shown that such strategies -- including turning pot handles toward the wall, placing hot beverages in the middle of tables, rather than within a toddler's reach, and removing tablecloths from tables -- have been ineffective. Parents do not always put such recommendations into practice, the report indicates.

"Because the frequency of kitchen scalds has not been reduced, we need to change our intervention approach," Drago said.

"For example, it is not sufficient to tell parents to turn pot handles toward the rear," she explained. "We need to teach them that the front burners are within reach of young children, so the back burners should be used when possible."

An ideal solution, Drago added, "would be to keep toddlers out of the kitchen, but that is not always practical." When such restriction is impractical, children should be placed in a high chair or otherwise confined while in the kitchen, she said, "but the high chair should be placed well away from the stove, counters, and table where hot items might be located."

Parents and caregivers "need to recognize that hot liquids, and especially hot water, even in small amounts, can cause severe scald injury," Drago said.

Source: Pediatrics, January 2005.

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Protein Plays Key Role in Alcohol Abuse

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, January 3, 2005

MONDAY, Jan. 3 (HealthDayNews) -- A protein that plays a critical role in dissolving blood clots also appears to have a role in alcohol addiction.

Mice who lacked the protein, called tissue-plasminogen activator (tPA), were less likely to become physically dependent on ethanol, a derivative of alcohol, according to a new study.

This protein may play a role in dependence and on the sometimes violent withdrawal symptoms that alcoholics experience, the study authors said.

Researchers reporting in the Jan. 3-7 issue of the Proceedings of the National Academy of Sciences (news - web sites) feel the findings may suggest new targets for drug therapies for alcoholism.

Alcohol addiction is an extremely complicated phenomenon affecting many parts of the brain.

"The problem with alcoholism is it pretty much effects everything in the brain -- all possible receptors and neurotransmitter systems -- and we don't know which are relevant for which," explained Dr. Adam Bisaga. He is an assistant professor of psychiatry at Columbia University and an addiction psychiatrist at the New York State Psychiatric Institute, both in New York City. Bisaga was not involved in the study.

There are two main receptors involved in alcohol addiction, called GABA and NMDA (N-methyl-D-aspartic acid). "In the past, we used to think GABA was where most of the effects of alcohol were, but recently NMDA has become much more of a focus," Bisaga said. "When we make animals physically dependent on alcohol, the NMDA receptor goes up."

Previous research had also suggested that tPA levels went up as a result of physical addiction to various opiates.

The authors of the new study wanted to see if tPA was related to any other aspects of addiction in the brain.

They looked at ethanol, which is often found in alcoholic beverages. People who are alcoholics frequently develop a tolerance to ethanol's effects and, when they quit abruptly, may experience seizures and other withdrawal symptoms that can be life-threatening.

The authors found that mice that were deficient in the gene that produces tPA that were made physically dependent on ethanol were less likely to go through withdrawal.

Conversely, an agent called ifenprodil blocked the effects of tPA in producing withdrawal seizures.

The findings indicate that tPA's interaction with the NMDA receptors is involved in withdrawal. Specifically, the authors believe the interaction between tPA and a subunit (NR2B) of the NMDA receptor may be responsible for promoting physical dependence on alcohol, including the symptoms of withdrawal.

The question is whether this new information has any therapeutic implications.

"Alcoholics are already dependent, so the question is whether this mechanism is also involved in other aspects of addiction," Bisaga said. "We're not yet at the point of preventing addictions. We have people who already are dependent. The question is how can we reverse that."

He added, though, that tPA may be involved in other effects of alcohol.

According to the American Heart Association (news - web sites), tPA is a clot-busting drug that's approved for use in certain patients having a heart attack or stroke.

More information

For more on alcoholism, visit the National Institutes of Health.

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With Diabetes, Women Do Worse After Stenting

Reuters Health

Monday, January 3, 2005

NEW YORK (Reuters Health) - When people with diabetes undergo coronary artery stenting to open clogs, women are more at risk for major adverse events than men, doctors in Germany report.

In particular, re-clogging of the arteries is more likely to occur among women.

Consequently, diabetic women may benefit even more than diabetic men from coronary bypass surgery, as well as from anti-platelet drugs or drug-eluting stents to prevent re-clogging, Dr. Gjin Ndrepepa and colleagues suggest.

Ndrepepa's group, at Technischen Universitat Munich, followed 4460 patients who underwent coronary artery stenting for angina between 1995 and 2000. The group included 658 men and 312 women who had diabetes.

Six months after the stent procedure, women with diabetes were 50 percent more likely to see their arteries re-clog than nondiabetic women, but this was not the case for diabetic and nondiabetic men, the team reports in the American Journal of Medicine.

The cumulative rate of death, heart attack, and need for another procedure after one year was also 50 percent higher in women with diabetes than those without. For men, the increased risk with diabetes was only 7 percent.

Diabetes seems to accentuate menopause-related vascular alterations, Ndrepepa's team proposes, and this may heighten a woman's propensity to form blood clots.

Source: American Journal of Medicine, December 1, 2004.

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These Drugs Pull Double Duty

By Mark Bloom
HealthDay Reporter

HealthDayNews

Monday, January 3, 2005

MONDAY, Jan. 3 (HealthDayNews) -- Call them the quick-change artists of medicine -- drugs or procedures designed to treat one problem that yield unexpected results with other conditions.

Consider the case of Botox, developed from a deadly toxin for a rare condition marked by spastic eyelid blinking. And what did it become? The great wrinkle remover of its day.

But that's not all. Recently a University of Pittsburgh team of researchers has tried Botox (botulinum toxin) for men who head for the bathroom frequently because of a condition called benign prostatic hyperplasia (BPH) -- or an enlarged prostate. It was a small study, but the results were encouraging. The participants' "quality of life" scale increased 57 percent.

Perhaps the classic example of a drug with an unexpected benefit is aspirin. Touted for decades for its analgesic properties -- bumps and bruises, headaches, and the lot -- and then for its anti-inflammatory effect on arthritis and other joint problems, aspirin turned out to have yet another plus. For many patients a small nightly dose can help prevent heart attacks.

Another candidate for the MVP of drugs is the class of anti-cholesterol agents known as statins. Emerging from Nobel Prize-winning research on how the liver works, statins were designed to prevent coronary-artery disease and heart attacks by reducing LDL, the so-called bad cholesterol.

Now, statins are being tested to see if they have properties that would prevent liver disease itself, and colorectal and prostate cancer. One study suggests that statins could delay or prevent Alzheimer's disease (news - web sites). Another suggests that giving statins after surgery can reduce postoperative mortality.

And if statins can't prevent liver disorders, maybe the stimulant caffeine can do the trick. A study reported last year by National Institutes of Health (news - web sites) (NIH) researchers suggested that drinking coffee and other caffeinated beverages may perk up liver function in people at high risk of liver disease. Similar results were shown in a study on caffeine and diabetes.

There's also alcohol, arguably the oldest of all medicines. Many studies have found that a daily drink, particularly red wine, is beneficial to one's heart.

There's early evidence that the cardiovascular benefit of such light drinking might outweigh the potential liver damage for patients with chronic hepatitis C virus (HCV) who have been instructed not to drink at all.

Outside the realm of drugs is the world of medical tests, where an exam for one problem may reveal another. Perhaps a test may reveal a value that might be a telltale marker for a seemingly unrelated condition.

Take Epstein-Barr virus (EBV), for instance. EBV is a common virus that usually comes and goes uneventfully. Some people develop mononucleosis from it. Now, there's preliminary evidence that the presence of EBV is related to the degree of treatment success for nasopharyngeal cancer, a rare tumor that was responsible for Babe Ruth's death.

Finally, a new blood test for kidney function seems to predict heart function as well.

A study reported last year found that the new kidney test, which measured blood levels of a molecule called cystatin C, gave a highly accurate prediction of the likelihood of survival for patients who suffered heart attacks. The study of 726 patients with a type of heart attack called non-ST-elevation acute coronary syndrome found that 55 percent of those with the highest blood levels of cystatin C died, compared to 7 percent of those with the lowest levels, the report said.

More information

For more information on heart disease, visit the American Heart Association.

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Brain Surface Stimulation May Ease Parkinson's

By Anne Harding

Reuters Health

Monday, January 3, 2005

NEW YORK (Reuters Health) - Electrical stimulation of regions deep in the brain has become fairly common in recent years for treating Parkinson's disease (news - web sites) symptoms, but there may be a simpler and safer alternative.

The results of a study in baboons suggest that stimulation of the motor control area on the brain's surface works too.

Delivering electrical stimulation to deep brain regions has been shown to help some people with Parkinson's, but the skill required to implant the electrodes, as well as the risks of electrode misplacement, have limited the use of this procedure.

Parkinson's symptoms have been tied to abnormal electrical activity in neurons in the main area that controls movement -- the motor cortex -- which is in the outer layer of the brain, a French team notes in the medical journal Neuron.

To see if stimulating the motor cortex at the surface of the brain might reduce symptoms "with fewer technical constraints," Dr. Stephane Palfi of the Henri Mondor Hospital in Creteil and colleagues conducted experiments with baboons.

The animals had chemically induced Parkinson's symptoms and were implanted with a four-contact electrode along the left primary motor cortex to deliver high-frequency, low-voltage stimulation.

During stimulation, the baboons with moderate to severe disability showed a significant improvement in rigidity and slow movements. There were no adverse effects seen in any of the animals.

"Motor cortex stimulation is a simple and safe procedure to alleviate ... parkinsonian symptoms without requiring deep brain stereotactic surgery," the researchers conclude in their report.

The next steps in the research will be preliminary clinical trials with patients, Palfi told Reuters Health.

Source: Neuron, December 2, 2004.

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Sunday, January 2, 2005

Teen Obesity Is a Ticking Time Bomb

 

By Mark Bloom
HealthDay Reporter

HealthDay

Sunday, January 2, 2005

SUNDAY, Jan. 2 (HealthDay) -- The American Heart Association (news - web sites)'s warning last week that more children than ever are heading toward heart trouble is primarily due to the nation's obesity epidemic.

But the damage caused by too much weight isn't limited to the heart.

In its annual assessment of cardiovascular disease, the top killer in the United States, the AHA reported that about 1 million children between 12 and 19 years old, or about 4.2 percent, now have metabolic syndrome. This is an umbrella term for a host of controllable risk factors for heart disease such as abnormal blood lipids, high blood sugar, high blood pressure, and overweight or obesity.

However, those same teens may also be flirting with another health condition called insulin resistance, which is also marked by obesity. Insulin resistance is closely related to a condition called Syndrome X and to metabolic syndrome. In fact, all three terms are so similar they are often used synonymously.

The notion of Syndrome X -- a constellation of insidious symptoms characterized by the body's inability to use insulin or blood sugar -- was first proposed in 1988 by Dr. Gerald M. Reaven, an endocrinology professor at Stanford Medical School.

The bad news is that the effects of insulin resistance now appear to be under way much earlier in life than had previously been suspected. Teenagers are beginning to be seen with insulin resistance, a condition that had been relegated largely to people twice their age.

This isn't entirely a surprise in view of the widely reported epidemic of obesity among the nation's youth. But if baby fat is somehow associated with serious illness -- and research indicates this is so -- it portends a grim future for America's children.

Insulin resistance accounts for many of the interlocking serious side effects that often spin off from obesity. These include type 2 diabetes, high blood pressure, and the ravages of bad cholesterol (LDL), which can all lead to heart disease. Diabetes, which can make heart disease worse, has its own set of terrible complications, such as blindness and amputations. Adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes.

The fact that insulin resistance was already at work in teenagers was reported in October by a group led by Dr. Alan Sinaiko, a professor of pediatrics at the University of Minnesota in Minneapolis.

"This study shows that insulin resistance is present at a very young age," Sinaiko said. "Even though children don't have the same degree of heart risk factors as adults, the findings suggest that insulin resistance has an early influence on what happens to people as adults."

According to the American Heart Association, more than 60 million Americans have insulin resistance. One in four of them will develop type 2 diabetes. The term "resistance" comes from the resistance of the body's cells to respond properly to even high levels of insulin. This can lead to the glucose build-up in the blood that is the hallmark of type 2 diabetes.

By monitoring teenagers every five years, Sinaiko and his colleagues found that insulin resistance was associated with higher systolic blood pressure and obesity. It was also associated with more ominous levels of cholesterol and other lipids.

The study participants were 357 healthy children recruited through the Minneapolis school system whose average age was 13 when the research began. Over the next 5.5 years, all the teens had three evaluations of their body's response to insulin: at enrollment, at age 15 and at age 19.

At the start, none of the participants had high blood pressure, and the average blood pressure for the study group was 109/55 mm Hg in 198 boys and 106/58 mm Hg in 159 girls. Recent federal guidelines set an acceptable standard of 115/75 mm Hg for adults.

By age 19, blood pressure was higher, as one would expect in older kids, but it had an extra rise for each unit of insulin resistance and another boost for each unit increase in body mass index, the standard measurement of obesity.

Sinaiko said that a key to preventing high blood pressure is to start thinking about it in childhood. "By the time people are in their 20s and 30s, a lot of the risk is already set, and we are treating the disease instead of preventing it," he noted.

Testing for insulin resistance is a complicated and expensive procedure not commonly available in doctors' offices. Doctors use a technique called the euglycemic clamp -- infusing a small amount of insulin into the blood for three hours while glucose is infused through another vein.

The link between insulin resistance and teenagers is only a new wrinkle in the campaign by some heart researchers to tie the start of coronary heart disease to dietary habits in children as young as 3.

A study of Louisiana youngsters, called the Bogalusa Heart Study and first reported in 1991 by Dr. Gerald S. Berenson and his colleagues at Tulane University School of Public Health, found grossly visible fatty streaks in the aortas of children after age 3 and in the coronary arteries beginning after age 10.

More information

For more information about children and high blood pressure, visit the American Heart Association.

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Saturday, January 1, 2005

Fibromyalgia: New Insights Into a Misunderstood Ailment

 

By Holly VanScoy
HealthDay Reporter

HealthDay News

Saturday, January 1, 2005

SATURDAY, Jan. 1 (HealthDay News) -- Fibromyalgia was once dismissed by many traditional medical practitioners as a phantom illness.

But that view is changing rapidly. Not only is fibromyalgia accepted as a diagnosable illness, it is also a syndrome that researchers are finding more complicated as new information emerges.

As recently as a year ago, many physicians still associated some of fibromyalgia's symptoms with emotional problems, but that's no longer the case.

A simple description of fibromyalgia is that it is a chronic syndrome characterized by widespread muscle pain and fatigue.

For still unknown reasons, people with fibromyalgia have increased sensitivity to pain that occurs in areas called their "tender points." Common ones are the front of the knees, the elbows, the hip joints, the neck and spine. People may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety and other symptoms.

According to the American College of Rheumatology, fibromyalgia affects 3 million to 6 million Americans, 80 percent to 90 percent of whom are women. The condition is most often diagnosed during middle age, but at least one of its symptoms appears earlier in life.

But is there a psychological tie-in strong enough to differentiate fibromyalgia from other similar diseases and conditions? Apparently not.

"Fibromyalgia patients are such a diverse group of patients, they cannot all be the same," said Dr. Thorsten Giesecke, a University of Michigan research fellow.

Giesecke and his colleagues evaluated 97 fibromyalgia patients, including 85 women and 12 men. The patients underwent a two-day series of tests, answering questions about their coping strategies and personality traits -- particularly their emotional well-being. They were also tested for sensitivity to pressure and pain.

"It's generally been thought that fibromyalgia patients who have higher distress have higher pain sensitivities," Giesecke said.

In other words, it was believed that those with fibromyalgia who were prone to emotional difficulties such as depression and anxiety were more likely to experience greater physical pain.

But his study didn't bear that out. In fact, patients in one of the three groups in the study who had the highest pain levels had the lowest anxiety.

The term fibromyalgia comes from the Latin word for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Tender points are specific locations on the body -- 18 points on the neck, shoulders, back, hips and upper and lower extremities -- where individuals with fibromyalgia feel pain in response to relatively slight pressure.

The U.S. government's National Institute of Arthritis and Musculoskeletal and Skin Diseases says fibromyalgia patients often experience combinations of many other chronic and frustrating symptoms, including:

Latest research indicates that fibromyalgia is the result of internal biochemical imbalances that cause physical symptoms such as pain, weakness and mental impairment. Because it is a syndrome -- a collection of signs and symptoms -- rather than a disease, fibromyalgia can't be diagnosed by an invariable set of specific symptoms or reproducible laboratory findings.

 

Even with the findings about relatively small psychological influence, practical experience seems to indicate that stress may play a role. Roger H. Murphree, a Birmingham, Ala., chiropractor who specializes in treating patients with fibromyalgia and chronic fatigue syndrome, said he has seen a link between stress and the intensity of fibromyalgia.

 

"Most of us live in a world of stress," Murphree said. "Something has to give, and it's usually sleep. Meanwhile, we subsist on junk food, caffeine, alcohol and prescription medications. Such a lifestyle isn't good for anyone. But for an unlucky few, the toll is severe."

 

Dr. Jacob Teitelbaum, whose practice in Annapolis, Md., led him to do research into fibromyalgia and the closely related chronic fatigue syndrome, concluded that the body's endocrine system could hold the clue to treatment. It's a matter of how the body's energy is marshaled, he said.

 

"Fibromyalgia is like the body blowing a fuse," he explained. "The hypothalamus serves as humans' internal fuse box. When the demands of living build up, stress increases and the hypothalamus shuts down. Because the circuit is overtaxed and the fuse is blown, the body simply can't generate enough energy."

"That causes muscles to cease functioning in a shortened position, resulting in pain all over the body and a general feeling of fatigue or weariness," Teitelbaum said.

 

Murphree's experience with hundreds of patients confirms Teitelbaum's analogy. Most, he said, are either "Type A" perfectionists or "Type B" caregivers.

 

"Type A fibromyalgia patients work and work and work until they burn out," said Murphree. "Type B patients give and give and give -- nurturing their spouses, children, family and friends -- until they break down. Anyone whose lifestyle includes very little downtime is at risk."

 

Teitelbaum recommends a four-pronged approach to repair the "blown fuse" and turn the body's current back on:

Teitelbaum uses the acronym SHIN to summarize his treatment regimen. "S is for sleep, H for hormone balance, I for infection control, and N for nutrition," he explained. "The important thing is that all four should be implemented in concert with one another for maximum therapeutic effect."

 

More information

 

The National Institute of Arthritis and Musculoskeletal and Skin Diseases offers more information on fibromyalgia.


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