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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 8-14

 

 

  1. New Scans Spot More Small Breast Tumors
  2. Electrical Device Promising for Spinal Cord Injury
  3. Drug Reduces Frequency of MS Relapses
  4. High Blood Pressure: The New Childhood Scourge
  5. Anxiety May Worsen Disability in Older Women
  6. Health Tip: Polly Want an Illness?
  7. Genes, Low Iron Tied to Restless Legs in Kids
  8. Health Tip: Avoid Alcohol, Caffeine While Pregnant
  9. Carnitine Compound Eases Diabetic Nerve Pain
  10. Carefree People May Miss Rectal Cancer
  11. Physician-Nurse Team Improves Blood Pressure Control
  12. Cutting Down on Health-Care Costs
  13. Muscle Loss Can Point to Heart Failure
  14. U.S. Finds Gaping Racial Disparities in Public Health
  15. States Fall Short in Fight Against Cervical Cancer
  16. Sleep Apnea Linked to Heartbeat Irregularities
  17. Iron Deficiency Sends Cells Into Tailspin
  18. New U.S. Food Guidelines Stress Vegetables, Grains
  19. Zinc Supplements May Guard Against Oral Cancers
  20. Prostate Cancer Treatment Poses Bone Risk –Study
  21. Antibody May Salvage Sight
  22. FDA Warns Pfizer Over Painkiller Ads
  23. U.S. Campaign Urges Cautious Use of Antibiotics
  24. More Research Needed on Alternative Therapies –Study
  25. Few Seniors Surf the Web for Health Information
  26. Obese Heart Failure Patients Fare Better Than Lean
  27. Beer May Raise Gout Risk, Wine May Not
  28. Lifestyle May Explain Much of Drop in Heart Deaths
  29. Possible Marker for Osteoarthritis Found
  30. High Red Meat Consumption Linked to Colon Cancer
  31. Fruits, Vegetables Don't Protect Against Breast Cancer
  32. Health Tip: Get Enough Magnesium
  33. New Asthma Guidelines Issued for Pregnancies
  34. Drug Stents Outperform Angioplasty in German Trial
  35. Health Care Costs a Top American Concern
  36. Health Tip: When Headaches Are More Than a Pain
  37. Westernization Linked to Breast Cancer Rise
  38. Do Pharmacy Errors Spike at Start of the Month?
  39. Bran in Diet Seen to Lower Risk of Heart Disease
  40. Dealing With Vision Loss
  41. Diabetes, Pre-Diabetes Linked to Cancer Risk
  42. Vitamin C Doesn't Boost Your Workout
  43. Too Little Sleep May Pack on Pounds
  44. Stay Thin by Sleeping More?
  45. Health Tip: Beware of Phony Diets
  46. Study: Weight Loss Precedes Dementia in Elderly
  47. Health Tip: Resolve to Live Better
  48. Colon Cancer Screening Still Underused
  49. Musks in Fragrances May Weaken Immune System, Study Says
  50. Heavy Pesticide Exposure May Up Parkinson's Risk
  51. Delirium Can Be Side Effect of Stem Cell Transplant
  52. Anti-Inflammatory Protein Cuts Heart Attack Risk
  53. Elderly Avoiding Colorectal Cancer Screening
  54. Oleic Acid Key to Olive Oil's Anti-Cancer Effect
  55. Deep Breathing Beats Stress
  56. Alcohol Increases Co-eds' Risk of Sexual Assault

 

Friday, January 14, 2005

 

New Scans Spot More Small Breast Tumors

 

HealthDayNews

Friday, January 14, 2005

FRIDAY, Jan. 14 (HealthDayNews) -- A new technique that uses a specially designed gamma camera improves detection of small breast tumors, says a study in the January issue of Mayo Clinic Proceedings.

"By optimizing the camera to detect smaller breast lesions, this technique should aid in the detection of early-stage breast cancer, something that was not possible with conventional gamma cameras," Mayo radiologist Dr. Michael O'Connor said in prepared statement.

The Mayo team used the technique, called molecular breast imaging, on 40 women who had suspicious mammogram findings. The imaging detected 33 of the 36 malignant lesions confirmed in 26 of the women during surgery. Overall, molecular breast imaging had an 86 percent detection rate of small breast tumors.

Mammography uses differences in the anatomic appearance of tumors and normal tissue to detect breast cancer. These differences can be subtle and can be obscured by dense breast tissue. Molecular breast imaging detects cancer by identifying differences in the metabolic behavior of tumors and normal tissue, according to the researchers.

"Approximately 25 to 40 percent of women have dense breast tissue, which decreases the chance that a cancer will be visible on their mammograms," Mayo radiologist Dr. Douglas Collins said in a prepared statement.

"With molecular breast imaging, the visibility of the tumor is not influenced by the density of the surrounding tissue, so this technique is well-suited to find cancers in women whose mammograms may not be very accurate," Collins said.

More information

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

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Electrical Device Promising for Spinal Cord Injury

 

Reuters Health

Friday, January 14, 2005

NEW YORK (Reuters Health) - Early tests are raising hopes that a new device can help people who've injured their spinal cord.

Implantation of an oscillating field stimulator, which generates an electrical field, is a safe, well-tolerated treatment that may improve motor and sensory function in such patients, findings from a pilot study suggest.

The device, which was developed at Purdue University, is placed near the site of injury and is designed to stimulate nerves to regenerate and, it's hoped, restore some degree of function.

After seeing encouraging results in dogs with spinal cord injury, Dr. Scott Shapiro, from Indiana University School of Medicine, Indianapolis, and colleagues tested the device in humans. The researchers' findings appear in the Journal of Neurosurgery-Spine.

The early-stage trial involved 10 patients with a complete spinal cord injury but no evidence on an MRI scan that the nerves had been actually severed.

Average pain-scale scores were 8 at the time the device was implanted. After six months, the scores had dropped to 2, and in most patients remained there after a year.

Treatment with the oscillating field stimulator was associated with significant improvements in sensitivity to light touch, pinprick sensation and motor function.

"This isn't a home run, but it warrants additional investigation," Schapiro said in a statement. "The big question was whether the procedure, which is very invasive and requires two surgeries, is efficacious and the initial results indicate that it is."

Based on these findings, the US Food and Drug Administration (news - web sites) has approved another trial of the device, which should begin early this year, the researchers note.

Source: Journal of Neurosurgery-Spine, January 2005.

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Drug Reduces Frequency of MS Relapses

HealthDayNews

Friday, January 14, 2005  

FRIDAY, Jan. 14 (HealthDayNews) -- Once-a-month intravenous therapy with the drug Tysabri appears to reduce relapses among people with multiple sclerosis (MS), according to a Rush University Medical Center study.

"We have seen a dramatic two-thirds reduction in the relapse rate and a significant decrease in the development of new or enhancing brain MRI lesions, which also point to controlling the disease. I believe this is a major advancement that will benefit patients with MS," Dr. Dusan Stefoski, a neurologist and director of the Rush MS Center, said in a prepared statement.

The Rush MS Center is taking part in a Phase III clinical study of Tysabri.

In November 2004, the U.S. Food and Drug Administration (news - web sites) (FDA (news - web sites)) approved Tysabri as a treatment for all relapsing forms of MS. The drug is now available for general use in appropriate MS patients.

MS relapses, also known as attacks or exacerbations, consist of sudden, new or worsening old symptoms of MS. Tysabri is the first humanized monoclonal antibody approved by the FDA for the treatment of MS.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about MS.

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High Blood Pressure: The New Childhood Scourge

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Friday, January 14, 2005

FRIDAY, Jan. 14 (HealthDayNews) -- Add high blood pressure -- that's right, high blood pressure -- to the list of childhood ills that have historically included diseases like chicken pox and the mumps.

A recent study in the Journal of the American Medical Association (news - web sites) found a strong upward shift in the blood pressure levels among 5,582 American children, aged 8 to 18, who were tracked for the last 16 years.

"This is not a good sign because, although these children may not be having heart attacks in their teens, one of the strongest predictors of heart disease in adults is high blood pressure in childhood," said Paul Muntner, an epidemiologist at the Tulane University School of Medicine and the study's lead author.

"The overall increase in blood pressure levels was only 1 or 2 percent, but the big issue is that there was a significant shift in the whole blood pressure distribution to higher levels," Munter added.

From 1988 to 1994, the children's average systolic blood pressure (the force on the arteries when the heart beats) was 104.6 mm Hg and their average diastolic pressure (the force on the arteries when the heart is resting between beats) was 58.4 mm Hg. By 1999-2000, their average systolic pressure was 106 mm Hg and their average diastolic reading was 61.7 mm Hg.

A big reason for the blood pressure problem among many American kids is that too many of them are carrying too much weight, Muntner said.

An estimated 15 percent of American children between the ages of 6 and 19 are overweight, according to the U.S. Centers for Disease Control and Prevention (news - web sites). But other factors, such as poor diets and a lack of exercise, are also to blame.

In response to the blood pressure problem and its potential health implications, the American Heart Association (news - web sites) has published guidelines to help doctors and parents focus on the risks of cardiovascular disease in children. They include a recommendation to track blood pressure in kids.

And the National Heart, Lung, and Blood Institute, part of the National Institutes of Health (news - web sites) (NIH), is formulating new clinical guidelines that revise blood pressure tables and recommend lifestyle and drug therapies for children with high blood pressure, also known as hypertension, Muntner said.

"The focus on high blood pressure in adults seems to have been quite effective since the 1970s, and substantial improvements have been made, and the NIH is now serious about pursuing a similar effort in children," he added.

Still, there are difficulties unique to children and blood pressure, Muntner said.

First of all, there traditionally have been no clear recommended guidelines for blood pressure levels in children the way there are for adults, because children are still growing.

"Age, gender and height all affect recommended blood pressure levels. It's a complicated rubric," Muntner said. "A children's chart is quite complex, even to me, and makes it much more difficult to communicate the message of what's a healthy blood pressure level."

But a pediatrician will know how to calibrate your child's weight, height and gender to assess what his or her blood pressure should be, Muntner said, adding that the new guidelines issued by NIH will help doctors in this task.

Second, the problem of high blood pressure is often connected to a weight problem, and overweight is an emotional issue with many parents, said Dr. Rae-Ellen W. Kavey, head of cardiology at Children's Memorial Hospital in Chicago.

"Parents can accept it when I tell them about a heart defect in their children. But if I say the child is overweight, the parents take it personally. It's a very sensitive topic," she said.

To surmount that hurdle, Kavey said she explains to parents that many children have a genetic predisposition to weight gain and that they can address the problem the same way they deal with other unique qualities of their child.

"I tell a parent that her daughter has gorgeous hair and also a tendency to gain weight easily, and put it in a practical context," she said, which can defuse a potentially emotional confrontation.

The good news, Kavey added, is that doctors and parents are increasingly aware of the perils of overweight and high blood pressure among children and are willing to do something about it.

"There is major concern among pediatricians about obesity in children and how to address that because of its association with hypertension and type 2 diabetes," she said. "And parents are very concerned as well."

To help parents, Kavey and Muntner recommend the following:

Kavey also recommends some simple lifestyle changes that can help your child stay healthy and avoid weight gain. Limiting juice intake to a small glass at breakfast is a good idea, because large quantities can lead to overweight, she said.

Encouraging physical activity is also important. Many schools are reintroducing physical education to promote exercise in school, she said, but you can do some things at home as well that would be fun for your kids. For instance, buy some hula hoops or jump ropes for the family.

 

More information

 

To read a summary of the study on the increase in pediatric blood pressure levels, visit the National Institutes of Health.


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Anxiety May Worsen Disability in Older Women

Reuters Health

Friday, January 14, 2005

NEW YORK (Reuters Health) - Symptoms of anxiety may speed the progression of certain physical disabilities in older women, new research suggests.

The study of 1,000 women with physical limitations such as trouble walking or performing other daily routines found that those who reported at least two anxiety symptoms at the outset were at greater risk of their disability worsening over the next 3 years.

Frequent anxiety symptoms -- such as feeling nervous, tense, "shaky" or fearful -- were linked to a 41 percent higher risk of deterioration in what researchers refer to as activities of daily living. These include the basic routines of getting out of bed, bathing, dressing and eating.

Women with two or more anxiety symptoms were also more likely to develop problems doing light housework, according to findings published in the Journal of the American Geriatrics Society.

Dr. Gretchen A. Brenes of Wake Forest University School of Medicine in Winston-Salem, North Carolina, led the study.

Brenes and her colleagues followed 1,002 women age 65 or older who started the study with limitations such as difficulty walking more than a short distance, limited mobility in their arms, and problems with bathing and other everyday routines.

The women completed standard measures of anxiety and depression symptoms at the study's start. Nineteen percent said they had frequently had two or more anxiety symptoms over the previous week, and were considered to be suffering from anxiety.

Overall, Brenes and her colleagues found, these women were more likely than their less anxious peers to have worsening problems with daily activities and light housework over the next three years.

This link was independent of depression, which has been implicated in disability, and of any use of medications called benzodiazepines -- sedatives that can have adverse health effects, including raising the risk of falls and bone fractures.

"This study provides evidence that anxiety is associated with the progression of disability in vulnerable older women, independent of several potential confounding factors," the study authors write.

They speculate that anxiety could have direct physical effects that worsen disability. For instance, shakiness or dizziness could make walking or other daily activities too difficult. Anxiety may also be a risk factor for high blood pressure and heart disease, which in turn can exacerbate disability.

"Anxiety is a common yet understudied problem for many older adults," Brenes and her colleagues write.

Clinical trials, they conclude, should look into whether treating anxiety can delay or prevent disability.

Source: Journal of the American Geriatrics Society, January 2005.

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Health Tip: Polly Want an Illness?

HealthDayNews

Friday, January 14, 2005

(HealthDayNews) -- If you got a pet bird as a holiday gift, the Mayo Clinic wants you to be aware of an illness you can get from birds: parrot fever.

Psittacosis, as it's formally known, is a bacterial disease that affects more than 100 species of wild and domestic birds, including parrots, macaws, cockatiels and parakeets. Though some birds with psittacosis don't display any signs or symptoms, others lose feathers or change their eating habits.

In people, psittacosis symptoms include cough, chest pain, fever, chills, headache and muscle pain.

You can catch the infection through contact with bird feces or with the dust that accumulates in birdcages. Psittacosis also is transmitted by bird bites, holding your bird or touching your mouth to your bird's beak.

The disease is treated with antibiotics. To prevent parrot fever, regularly rinse and refill your bird's water and food dishes, and clean the cage daily.

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Genes, Low Iron Tied to Restless Legs in Kids

By Amy Norton

Reuters Health

Friday, January 14, 2005

NEW YORK (Reuters Health) - Family history and iron deficiency appear to play important roles in childhood restless legs syndrome, according to a new study.

 Restless legs syndrome (RLS) is a neurological condition that causes unpleasant sensations in the legs and an irresistible urge to move the limbs to relieve the discomfort, particularly at night. As a result, people with the condition often have sleep disturbances that make for daytime drowsiness.

Though family history and low iron stores in the body have been thought to play a role in at least some cases of restless legs syndrome, until now there has been little research on children with the disorder.

Traditionally, there's been a tendency for pediatricians to describe children with leg discomfort as having "growing pains," Dr. Suresh Kotagal, the lead author of the new study, told Reuters Health.

"But some may actually have restless legs," said Kotagal, a pediatric neurologist at the Mayo Clinic in Rochester, Minnesota.

The new study, which included 32 children with RLS, is the largest of its kind to date, according to Kotagal. He and colleague Dr. Michael H. Silber report the findings in the Annals of Neurology.

The researchers evaluated the records of 538 children seen in their sleep disorders clinic between 2000 and 2004. Six percent were found to have RLS.

Of these 32 children, 72 percent had a parent with RLS, most often a mother.

In addition, blood iron levels were lower than expected among the children who were tested, according to the report. One-third of the children were near the bottom of the established norms for their age and sex, while three-quarters were in the bottom half of that range.

Iron deficiency has been found in adults with restless legs, Kotagal noted, but at a lower rate than was seen in these children. It's unknown whether diet or a genetic predisposition to low iron is at work, he said.

Iron deficiency may contribute to RLS by way of its relationship with dopamine, a brain chemical that helps regulate movement. "Iron is a co-factor for the synthesis of dopamine in the brain," Kotagal explained, and scientists believe that dopamine deficiency is involved in restless legs.

Medications that boost dopamine levels in the central nervous system are used as part of RLS treatment, though there is also some evidence that treating iron deficiency improves some patients' symptoms, Kotagal noted.

It's unclear, though, he said, whether preventing iron deficiency in children at risk of RLS due to family history can in turn prevent the syndrome from developing.

Restless legs can take a toll on a child's quality of life and education, since the condition typically gets in the way of a good night's sleep. Kotagal noted that research suggests some children with attention-deficit hyperactivity disorder, or ADHD, may also have restless legs syndrome -- leading to the question, he said, of whether RLS-related sleep disturbances are causing those children's attention problems.

In this study, 87 percent of the children with RLS had problems falling asleep or staying asleep.

Source: Annals of Neurology, December 2004.

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Health Tip: Avoid Alcohol, Caffeine While Pregnant

HealthDayNews

Friday, January 14, 2005

(HealthDayNews) -- If you're pregnant and want to have a healthy baby, you need to avoid the wine glass and coffee cup, the U.S. Centers for Disease Control and Prevention (news - web sites) says.

Pregnant women who drink alcohol risk giving their infants fetal alcohol syndrome, which causes growth retardation, facial abnormalities and central nervous system problems.

Caffeine, found in more than 200 foods and beverages including tea, coffee, soft drinks and chocolate, also should be avoided. Check the labels of the products you eat or drink carefully for this ingredient.

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Carnitine Compound Eases Diabetic Nerve Pain

By Megan Rauscher

Reuters Health

Friday, January 14, 2005

NEW YORK (Reuters Health) - People with diabetes-related nerve damage may find pain is relieved by taking a compound related to the popular supplement L-carnitine -- provided the treatment is started early -- according to a re-analysis of data from two large clinical trials.

Acetyl-L-carnitine (ALC) is not currently approved in the US for treating nerve pain, "but it is used widely for painful neuropathy in patients with diabetes and AIDS (news - web sites) in Europe," Dr. Anders A. F. Sima from Wayne State University School of Medicine in Detroit, noted in a telephone interview with Reuters Health.

The original two trials -- one conducted in Europe and the other in the US and Canada -- involved over 1000 patients with diabetic neuropathy who were given ALC (500 or 1000 milligrams taken three times a day) or an inactive placebo for 52 weeks.

Those tests showed ALC had no significant effect on nerve conduction velocity, an indicator of improvement in nerve damage, but when Sima's group looked into the data they found certain patients did benefit.

Apparently, ALC at the higher dose significantly alleviated pain in the 27 percent of patients who reported pain as "the most bothersome symptom" at the beginning of the studies, the team notes in the medical journal Diabetes Care.

"Pain is very common in patients with diabetic peripheral nerve diseases, occurring in 30 percent to 35 percent of patients," Sima said. "It is usually extremely bothersome for the patients and in extreme cases drives them to suicide. We found that ALC has a significant effect on pain."

The greatest reductions in pain were seen in patients who had had diabetic neuropathy for a short time. "This is an axiom that goes for any of these treatments in chronic disorders like this -- the earlier you can start treatment the better," Sima advised.

He added, ALC is "very tolerable."

Sima said his team is currently working with the US Food and Drug Administration (news - web sites) to get ALC formally approved for painful diabetic neuropathy.

Source: Diabetes Care, January 2005.

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Carefree People May Miss Rectal Cancer

HealthDayNews

Friday, January 14, 2005

FRIDAY, Jan. 14 (HealthDayNews) -- Carefree, optimistic people are more likely to ignore symptoms of rectal cancer for long periods of time and receive treatment at a later stage than people who are more anxious by nature, says a study by researchers at Washington University School of Medicine in St. Louis.

The study of 69 patients with rectal cancer found those with at least moderate levels of anxiety tended to recognize rectal bleeding and other symptoms of rectal cancer as signs of a serious illness. People with low overall anxiety levels were more prone to disregard such symptoms for a long time.

"Almost everyone has heard about people who had cancer symptoms long before they sought help. I was curious about the psychology behind this," researcher Stephen Ristvedt, an assistant professor of medical psychology in psychiatry, said in a prepared statement.

"Most people assume the explanation is fear or denial or a reluctance to hear the 'C-word' from a doctor. So, I was surprised to find those who are generally optimistic and unconcerned had the longest delays," he said.

The findings suggest that different approaches need to be used to encourage carefree people to pay attention to symptoms of cancer or other health problems.

"We would like to figure out how to reach these people and get them to understand that their positive attitude may actually interfere with healthy behaviors," Ristvedt said.

The study will appear in the May issue of Psycho-Oncology and is currently available on the journal's Web site.

More information

The American Cancer Society (news - web sites) has more about rectal and colon cancer.

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Physician-Nurse Team Improves Blood Pressure Control

Reuters Health

Friday, January 14, 2005

NEW YORK (Reuters Health) - Success in achieving target blood pressure levels seems to be improved using home blood pressure measurements to guide treatment in a physician-supervised, nurse-managed clinic, a new study suggests.

It is estimated that fewer than half of people who are taking medication for high blood pressure actually have their condition under control, Dr. Vincent J. Canzanello and colleagues at Mayo Clinic College of Medicine in Rochester, Minnesota, point out in the journal Mayo Clinic Proceedings.

The team developed their new approach in hopes of reducing the inconvenience and cost related to blood pressure monitoring.

The study included 106 patients who first attended the Hypertension Care Clinic for several days in a row. A drug treatment plan was drawn up for each of the patients, and they were educated about hypertension and cardiovascular disease preventive measures.

The subjects were then instructed to measure their blood pressure twice daily at home for a 7-day period at 1, 3, 6, 9, and 12 months. The results were sent to the clinic nurse and drug treatment was intensified if blood pressure readings were not less than 135/85.

With this strategy, the percentage of patients who achieved this target level of blood pressure control increased from 0 percent at the start of the study to 63 percent after one year.

"This model should reduce both cost and inconvenience associated with the treatment of hypertension," Canzanello's group suggests.

"Too often, patients with hypertension are 'fit into' the course of a busy practitioner's day through a series of visits over weeks to months, and patients never receive the focused attention necessary at the outset of care," Dr. Andrew B. Covit, at UMDNJ-Robert Wood Johnson Medical School in South River, New Jersey, maintains in an accompanying editorial.

He believes that the approach described by Canzanello and colleagues emphasizes to patients "the true gravity of the disease and its future implications."

Source: Mayo Clinic Proceedings, January 2005.

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Cutting Down on Health-Care Costs

 

HealthDayNews

Friday, January 14, 2005

FRIDAY, Jan. 14 (HealthDayNews) -- Requiring enrollees to get permission before filling prescriptions for proton pump inhibitor (PPI (news - web sites)) anti-ulcer drugs enabled the Georgia Medicaid program to cut its prescription drug costs by $20.6 million in a year, says a study in latest issue of the American Journal of Managed Care.

PPIs are brand name drugs used to treat acute upper gastrointestinal conditions such as ulcers and esophagitis.

A budget review revealed that PPIs accounted for 5.6 percent of Georgia Medicaid's pharmacy costs and ranked first in costs among all classes of prescription drugs. The review found that some program enrollees were receiving PPIs for a number of conditions that didn't warrant PPI use.

It was noted that lower-cost generic histamine type-2 antagonists (H2As) were possible alternatives for these patients.

In February 2002, Georgia Medicaid put in place new rules that required enrollees to get approval before they filled prescriptions for PPIs. The new rules increased the use of generics from 31 percent to 79 percent.

PPI expenditures decreased from $44.1 million to $13.2 million, and H2A expenditures increased from $6 million to $13.5 million. There was a net savings of $20.6 million for the year.

The study, conducted by pharmacy benefit management company Express Scripts, said that requiring prior authorization for PPIs did not result in any adverse health consequences for enrollees.

More information

The American Academy of Family Physicians (news - web sites) has more about ulcers.

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Thursday, January 13, 2005

 

Muscle Loss Can Point to Heart Failure

 

HealthDayNews

Thursday, January 13, 2005

THURSDAY, Jan. 13 (HealthDayNews) -- The link between weight loss caused by muscle wasting and congestive heart failure is outlined in a Tulane University Medical Center study in the current issue of the Journal of Clinical Investigation.

It's known that congestive heart failure -- the leading cause of cardiovascular disease and related death -- is associated with elevated blood levels of angiotensin II, which causes blood vessel contraction, high blood pressure and muscle wasting.

While it was recognized that weight loss caused by muscle wasting is an important predictor of poor outcomes in patients with heart failure, researchers had a poor understanding of the mechanisms underlying this association.

In previous research with rats, the Tulane scientists found that administration of angiotensin II resulted in a reduction in body weight and a decrease in levels of insulin-like growth factor-1 (IGF-1) in both blood and skeletal muscle.

In this new study, the Tulane team found that angiotensin II inhibited IGF-1 signaling in skeletal muscle. They concluded that this is causally related to the loss of skeletal muscle.

The scientists also found a complete reversal of angiotensin-induced muscle loss in mice genetically engineered to overproduce IGF-1.They found strong evidence that a specific signaling kinase pathway is involved in the ability of IGF-1 to prevent muscle loss.

More information

The American Heart Association (news - web sites) has more about congestive heart failure.

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U.S. Finds Gaping Racial Disparities in Public Health


By Paul Simao

Reuters

Thursday, January 13, 2005

ATLANTA (Reuters) - Black people in the United States are far more likely than whites to die from strokes, diabetes and other diseases, according to a federal study that shows wide racial disparities persist in health care.

The finding, released on Thursday in a report by the Centers for Disease Control and Prevention (news - web sites), confirms a sobering decade-long trend seen by public health officials throughout the nation.

U.S. researchers have been warning that high-fat diets, smoking and poor access to quality health care were leading to gaping racial disparities in the rates for heart disease, stroke and cancer.

In its report, the CDC revealed that the number of potential years of life lost in 2002 due to strokes, diabetes and perinatal diseases was three times higher for black Americans under 75 than for whites of the same age.

That gap increased to about 11 times for AIDS (news - web sites) and nine times for homicide, the CDC said. African-Americans also had substantially higher rates of some types of cancer in 2001, including stomach and colon/rectal cancer.

The CDC also noted black Americans were less likely to have health insurance, get vaccinated for influenza and pneumococcal disease, receive prenatal care in the first trimester and engage in regular moderate physical activity in adulthood.

"Insufficient resources at the community level and unequal use of effective interventions maintain the black-white gap in avoidable illness, injury and premature death," said Dr. Ben Truman of the CDC's office of minority health.

An estimated 35 million black people live in the United States, or 13 percent of the population, Census figures show.

Separate but related CDC studies released on Thursday found that blacks suffer higher rates of hypertension and appear to have a greater likelihood of getting gonorrhea, chlamydia and a number of other reportable infectious diseases.

They also report greater disability after a stroke. Strokes, which occur when blood supply to the brain is suddenly cut, are the third-leading cause of death in the nation after heart disease and cancer and a major cause of disability.

High blood pressure and cholesterol, diabetes and smoking are major risk factors.

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States Fall Short in Fight Against Cervical Cancer

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, January 13, 2005

THURSDAY, Jan. 13 (HealthDayNews) -- States are not doing enough to prevent cervical cancer.

That's the conclusion of a report released Thursday, which found that no state in the country is doing what it should to screen for cervical cancer, to provide coverage of routine screening tests in public insurance programs, or to pass legislation making elimination of the disease a priority.

"We're doing a fair job, but we can do much better," said Beverly Hammerstrom, a Michigan state senator and chairwoman of Women in Government, the bipartisan educational association for women in state government that published the report, A Call to Action: The 'State' of Cervical Cancer in America.

Women in Government has made eliminating cervical cancer a priority.

According to the report, more than 10,000 women in the United States were diagnosed with this largely preventable disease in 2004, and almost 4,000 women died from it.

Almost all cases of cervical cancer are caused by the human papillomavirus (HPV). While most women will have the virus at some point in their lives, the vast majority will not go on to develop cancer. In most cases, the virus clears on its own. There are some forms of the virus, however, that persist and eventually turn into cancer.

Up-to-date screening methods can detect which women may be progressing toward cancer. The Pap test is the traditional screening test to identify early signs of cancer and pre-cancer. Since the Pap smear was introduced half a century ago, cervical cancer mortality rates in the United States have plummeted by 75 percent.

There is a new test for HPV itself that's more effective than the Pap smear; it's approved for women 30 and older when used in conjunction with the traditional test. The two tests together boost accuracy to about 100 percent, the report stated.

When done together, a Pap test and an HPV test detect 93 percent to 100 percent of precancerous changes, compared with 51 percent to 85 percent for the Pap alone.

"They're both so accurate," said Dr. J. Thomas Cox, director of the Women's Clinic at the University of California, Santa Barbara. "The chances of missing a significant lesion that could go on to cancer before the next test or the next evaluation is so miniscule that it gives tremendous reassurance that the woman should not get cervical cancer. It's kind of a double punch."

About half of cervical cancer cases arise in women who have never been screened, while 10 percent of the cases show up in women who have not been screened in the previous five years.

In the report, states received an overall "grade" on cervical cancer prevention based on three areas: incidence and mortality; access and use of health services; and legislation.

No state received an "excellent" grade. Massachusetts received the highest overall score, followed by Illinois, Maryland and North Carolina. These four states ranked in the "very good" grade category.

The lowest overall performers were Tennessee and Texas, followed by Wyoming and Nevada.

Delaware had the highest screening rate, at 89.3 percent. Maryland and Washington, D.C. were close behind at 88.6 percent and 87.6 percent, respectively.

All but two states had 80 percent or higher screening rates.

In Utah, however, only 77.4 percent of women were screened, while in Idaho, only 78.4 percent were screened.

Incidence rates varied from a low of 5.5 cases per 100,000 women in North Dakota to a high of 14.3 cases in the District of Columbia. Mortality rates ranged from 1.3 deaths per 100,000 women in Minnesota to 6.1 deaths per 100,000 women in the District of Columbia.

Medicaid programs in all states covered Pap tests, while 46 states plus Washington, D.C. covered HPV tests, at the time of the report. Twenty-three states plus the District of Columbia had some type of Pap screening coverage requirement. Only North Carolina, however, required coverage for all FDA (news - web sites)-approved cervical cancer screening technologies.

Improving the picture will require education, said Susan Crosby, acting executive director and president of Women in Government. "The surprise was that no state was really doing the job," she said. "But the good news is now we're showing what they need to do the job."

"There are so many opportunities for states to see where they are gapping in providing the education we need and make sure we eliminate cervical cancer," she continued. "This gives them a benchmark to go ahead and proceed."

More information

Read more about the report at Women in Government.

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Sleep Apnea Linked to Heartbeat Irregularities


Reuters Health

Thursday, January 13, 2005

NEW YORK (Reuters Health) - People with obstructive sleep apnea syndrome -- in which airways become blocked periodically during sleep and breathing stops for brief periods -- experience a relatively high number episodes of irregular heart rhythm, Spanish investigators report.

The findings are based on a study of 21 patients with sleep apnea syndrome, 12 snorers, and 15 healthy comparison subjects who were evaluated with sleep studies and 24-hour monitoring of their heart rhythm.

Obstructive sleep apnea syndrome seemed to increase the frequency of both daytime and nighttime heartbeat irregularities, Dr. Alberto Alonso-Fernandez, from Hospital Universitario La Paz in Madrid, and colleagues report in the medical journal Chest.

Compared with the other two groups, the sleep apnea patients also experienced more nighttime episodes when their heart showed signs that it was not getting enough oxygen.

In sleep apnea patients, the lowest levels of oxygen in the blood were linked to the rhythm disturbances, the researchers point out.

The results show that these heart problems may affect people with obstructive sleep apnea syndrome, but not people who just snore, the researchers conclude.

Source: Chest, January 2005.

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Iron Deficiency Sends Cells Into Tailspin

HealthDayNews

Thursday, January 13, 2005  

THURSDAY, Jan. 13 (HealthDayNews) -- Iron deficiency forces cells to preserve what little iron they have and to maintain essential functions by dramatically reducing the activity of more than 80 different genes.

That's the conclusion of a Duke University Medical Center study in the Jan. 14 issue of Cell.

"We discovered that iron deprivation actually reprograms the metabolism of the entire cell. Literally hundreds of proteins require iron to carry out their proper function, so without this nutrient, there is a complete reorganization of how cellular processes occur," researcher Dennis J. Thiele, a professor of pharmacology and cancer biology, said in a prepared statement.

Some of the genes affected by iron deficiency are known to play important roles in generating energy, aging, protecting the cell from free radicals and copying the cell's genetic code. But the function of many of the affected genes is unknown, meaning that some side effects caused by iron deficiency may go unrecognized.

The Duke team conducted its research in yeast cells. The findings may help in the diagnosis and treatment of health problems caused by iron deficiency, the researchers said.

Iron deficiency affects more than 2 billion people, and is the most common and severe nutritional disorder worldwide. Anemia is the most widely recognized symptom of iron deficiency. Other symptoms include fatigue, weakness, cognitive problems, heart complications and developmental disorders.

Iron is found in red meats, dried fruits, shellfish, spinach, whole grains, seeds and a number of other foods.

More information

The U.S. National Institutes of Health (news - web sites) has more about iron.

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Wednesday, January 12, 2005

 

New U.S. Food Guidelines Stress Vegetables, Grains

 

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, January 12, 2005

WASHINGTON (Reuters) - New eating guidelines issued by the U.S. government on Wednesday stress that most Americans are overweight and need to eat more vegetables, fruits and whole grains.

The guidelines, updated every five years, recommend eating up to 13 servings of fruits and vegetables a day and specify that at least three of the daily servings of grains be whole grains such as whole wheat, oats or brown rice.

They also emphasize getting at least 30 minutes of exercise every day -- an hour for children. And officials said the "food pyramid" may be replaced by something easier to understand.

Health and Human Services (news - web sites) Secretary Tommy Thompson said the guidelines are meant in part to help Americans understand they are responsible for their own health.

"Let's face it. Everyone in America is looking to NIH (the National Institutes of Health (news - web sites)) to come up with that (diet) pill. It's not going to happen," he told a news conference.

The guidelines, published on the Internet at http://www.healthierus.gov/dietaryguidelines, set standards for U.S. school breakfasts and lunches and other federal programs, but are also aimed at the average consumer.

The Center for Science in the Public Interest, which lobbied to change the guidelines, praised them.

"They look to me like they are the strongest diet guidelines yet produced," said Michael Jacobson, the group's director. "There is a major emphasis on fruit, vegetables, whole grains and low-fat dairy products."

While not setting limits on processed sugar, the guidelines steer Americans away from sweetened foods in several places.

"Many of the recommendations are not significantly different from what has been recommended in the past, whether it is eating a diet rich in fruits and vegetables, whole grains, low-fat milk and dairy sources," Agriculture Secretary Ann Veneman told the news conference.

Countering The Ads

The consumer groups and Thompson said it was up to them to counter aggressive food advertising and educate Americans about a healthy diet.

"Most Americans currently are not eating a healthy diet," said Margo Wootan, nutrition director of the Center for Science in the Public Interest. Only 12 percent follow the 2000 guidelines, she added.

"While school meals programs are required to meet dietary guidelines ... the USDA is going to have to issue more regulations," Wootan said.

Iowa Democrat Tom Harkin, a member of the Senate appropriations panel that funds health care initiatives, agreed.

"Much more needs to be done in Congress and throughout our communities to give Americans the tools they need to eat right and maintain a healthy weight," he said.

The report said Americans should avoid trans-fats, which are created in processing vegetable oils and have been found to be as unhealthy as pure cholesterol.

"The guidelines should specifically recommend Americans avoid meat, dairy, and fish," said Dr. Neal Barnard, president of the Physicians Committee for Responsible Medicine, which advocates a strict vegetarian diet. "The USDA must take the Big Meat, Big Sugar, and Big Dairy industries' money and influence out of the guidelines process."

Veneman denied the food industry had much influence on the guidelines.

"The process that was used to develop these guidelines was more rigorous, more science-based and more transparent than ever before," she said.

Many major U.S. food manufacturers had stepped up their efforts to make food more nutritious.

General Mills Inc., for instance, announced last year it would begin using whole grains in all of its breakfast cereals and Kellogg Co. recently introduced a new whole-grain cereal aimed at children called Tiger Power.

(Additional reporting by Nichola Groom in New York)

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Zinc Supplements May Guard Against Oral Cancers

 

HealthDayNews

Wednesday, January 12, 2005

WEDNESDAY, Jan. 12 (HealthDayNews) -- Zinc supplements may help prevent oral and esophageal cancers in people at high risk for such cancers due to zinc deficiency, says a study by researchers at Thomas Jefferson University in Philadelphia.

They found that giving zinc orally to zinc-deficient rats reversed the development of precancerous conditions in the esophagus and on the tongue, and also reversed high expression of the enzyme cox-2. The study results suggest that zinc supplements may help prevent oral and esophageal cancers.

It was already known that a rise in the expression of cox-2 is connected with oral and esophageal cancers, which are associated with a lack of zinc in the diet. Zinc deficiency is especially prevalent in developing countries.

It's estimated that up to 2 billion people in developing nations are zinc-deficient, compared to up to 10 percent of Americans. Red meat and seafood provide the majority of zinc in the diet.

"Zinc treatment restores many systems affected by the lack of zinc. Zinc deficiency upregulates cox-2. Zinc replenishment restores it to near normal levels," study author Louise Fong, an assistant professor of microbiology and immunology, said in a prepared statement.

The study is published in the current issue of the Journal of the National Cancer Institute (news - web sites).

More information

The U.S. National Library of Medicine has more about the importance of dietary zinc.

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Prostate Cancer Treatment Poses Bone Risk –Study

 

By Gene Emery

Reuters

Wednesday, January 12, 2005

PROVIDENCE, R.I. (Reuters) - An increasingly popular prostate cancer treatment also makes bones brittle and may be responsible for over 3,000 fractures each year in the United States, researchers reported on Wednesday.

The treatment calls for blocking the effects of the male hormone testosterone, either with drugs or by castration. Until now, doctors have regarded the treatment as relatively harmless, Vahakn Shahinian, chief author of the new research, told Reuters.

He said that given the new findings, doctors and patients should be aware of the risks of the therapy, which seems to slow the growth of prostate tumors, but may not always help patients live longer.

The findings, reported in Thursday's New England Journal of Medicine (news - web sites), add another layer of complexity to the already-difficult question of how best to treat prostate cancer, which strikes 220,000 U.S. men each year.

Sometimes a tumor is growing so slowly it's hard to know whether treatment is necessary.

Neutralizing testosterone is one option. More than 88,000 men a year get the drug treatment, and the number has been "exploding," Shahinian said.

But the Shahinian team, which studied the records of nearly 51,000 cancer patients, found 19.4 percent of men who survived at least five years after anti-testosterone therapy broke a bone. In other patients, the rate was 12.6 percent.

"Our findings, along with those of smaller clinical series, underscore that such treatment is not benign" and there is no hard evidence it helps patients live longer, the researchers warned.

They also said doctors should be testing whether drugs designed to prevent brittle bone disease can counteract the side effects of anti-testosterone treatment.

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Antibody May Salvage Sight

 

HealthDayNews

Wednesday, January 12, 2005

WEDNESDAY, Jan. 12 (HealthDayNews) -- Using an antibody to block the action of a protein called SDF-1 prevented blindness in mice with a condition similar to retinopathy in humans, says a University of Florida study in the current issue of the Journal of Clinical Investigation.

Retinopathy -- characterized by rampant blood vessel growth in the eyes -- is a complication of diabetes and the leading cause of blindness in working-age Americans. Diabetic retinopathy results in 12,000 to 24,000 cases of blindness in the United States each year, says the American Diabetes Association.

This study is the first to describe a link between SDF-1 and retinopathy. It also describes how the researchers injected an SDF-1 antibody into the eyes of the afflicted mice to silence SDF-1's signaling to blood stem cells.

"SDF-1 is the main thing that tells blood stem cells where to go," researcher Edward Scott, director of the program in stem cell biology and regenerative medicine at the university's College of Medicine, said in a prepared statement.

"If you get a cut, the body makes SDF-1 at the injury site and the repair cells sniff it out. The concentration of SDF-1 is higher where the cut occurs and it quickly dissipates. But the eye is such a unique place, you've got this bag of jelly -- the vitreous -- that just sits there, and it fills up with SDF-1. The SDF-1 doesn't break down. It continues to call the new blood vessels to come that way, causing all the problems," Scott explained.

In people with diabetes, high blood pressure and blood sugar levels cause leaks in the blood vessels of the eyes. This hampers the flow of essential chemicals. In response, the eyes grow new blood vessels. These new blood vessels begin to clog the eyes and cause even more leaks. The retina is gradually damaged until it can no longer capture images.

The next step in this research is to test the SDF-1 antibody in monkeys, the researchers said.

More information

The U.S. National Eye Institute has more about diabetic retinopathy.

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FDA Warns Pfizer Over Painkiller Ads

 

Reuters

Wednesday, January 12, 2005  

WASHINGTON (Reuters) - The U.S. Food and Drug Administration (news - web sites) has warned Pfizer Inc. that television and print advertisements for its painkillers Celebrex and Bextra misled consumers, according to a letter made public on Wednesday.

Five ads did not disclose side effects and other risk information and made "unsubstantiated effectiveness claims," the FDA (news - web sites) said in the letter dated Jan. 10 that was posted on its Web site, www.fda.gov/cder/warn/2005/12560-letter.pdf.

Shares of Pfizer, after closing down 12 cents at $26.03 in regular trading on the New York Stock Exchange (news - web sites), slipped to $25.90 in after-hours trading.

Company spokeswoman Mariann Caprino said the Celebrex advertisements cited by the FDA were no longer running.

She had no comment on the other materials, including a Bextra patient brochure and a promotional television infomercial. "There's very little (direct-to-consumer advertising) on Bextra, anyway," she said.

Caprino said the company would discuss "appropriate" next steps with the FDA. Pfizer must respond to the agency by Jan. 26, the letter said.

The National Institutes of Health (news - web sites) (NIH) suspended on Dec. 17 a cancer trial using Celebrex after researchers found an increased risk of heart attack. An NIH study on Alzheimer's disease (news - web sites) using Celebrex, which was also canceled, found no signs of heart attack risk.

The FDA has said it asked the drug company in December to suspend Celebrex ads while agency officials reviewed the data, and the company agreed. Pfizer also has placed a note on Bextra warning of an increased heart risk in patients who had recent heart bypass surgery.

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U.S. Campaign Urges Cautious Use of Antibiotics

 

HealthDayNews

Wednesday, January 12, 2005

WEDNESDAY, Jan. 12 (HealthDayNews) -- A public education campaign to remind people to be careful in their use of antibiotics has been launched by the U.S. Centers for Disease Control and Prevention (news - web sites).

The "Get Smart" campaign features a series of print and radio ads meant to raise awareness about proper antibiotic use and to correct mistaken perceptions that antibiotics cure everything.

"Taking antibiotics when they are not needed can cause some bacteria to become resistant to the antibiotics," Dr. Richard Besser, director of the campaign, said in a prepared statement.

"The fact is these resistant bacteria are stronger and harder to kill. They can stay in your body and cause severe illnesses that can't be cured with antibiotics. It's so important to get smart about antibiotic use and work with your doctor to get the right remedy," Besser said.

The Get Smart campaign supports new American Academy of Family Physicians (news - web sites) guidelines that encourage doctors to limit the use of antibiotics when treating ear infections in children.

"If you or your child gets sick, don't use an antibiotic unless a doctor specifically prescribes one for you," Besser said. "You should also ask your doctor or other health professionals about what you can do to feel better. There are many treatments available that can reduce your symptoms and get you back on your feet more quickly."

More information

The American Academy of Family Physicians has more about antibiotics.

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More Research Needed on Alternative Therapies –Study

 

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, January 12, 2005

WASHINGTON (Reuters) - More research is needed to show that alternative therapies such as acupuncture and herbal supplements work and this may mean changing laws that protect the industry, a committee of experts said on Wednesday.

Nearly a third of Americans use such therapies and it is increasingly important to standardize those treatments and show whether and how they work, the Institute of Medicine (news - web sites) committee said.

It did not say who should be responsible, but urged Congress and federal regulators to work with industry, researchers, consumers and advocates to find a way to test alternative approaches.

"The main message is that complementary and alternative therapy use is widespread and here to stay," Dr. David Eisenberg, an expert in complementary and integrative medical therapies at Harvard Medical School (news - web sites) in Boston, said in a telephone interview.

"The same rules of evidence of effectiveness and safety should apply regardless of the origin of the therapy."

The Institute of Medicine, an independent group that advises the federal government on health matters, was asked to identify barriers to better research on complementary and alternative therapies.

"Health professionals and patients should have sufficient information about safety and efficacy to take advantage of all useful therapies," said committee chair Dr. Stuart Bondurant, executive dean of the Georgetown University School of Medicine in Washington.

"We believe that the same research principles and standards for showing effectiveness should apply to both conventional and complementary and alternative treatments," he added in a statement.

"And because evidence is a key element of prudent decision-making, we need to change the current regulation of dietary supplements in this country to encourage more studies of these widely used products and to ensure their quality."

The Dietary Supplement Health and Education Act, commonly known by the acronym DSHEA, says supplements can be regulated as foods rather than drugs.

This lets supplement manufacturers off the hook for the safety and efficacy tests required of drugs.

"Given that manufacturers are not required to conduct testing and are unable to patent many supplements, there is little incentive for supplement makers to invest in research on the effectiveness of these products," the Institute said in a statement.

The report includes a survey done at Harvard Medical School showing that 35 percent of Americans used complementary or alternative medicine in 2002, virtually unchanged from 1997.

It found a 50 percent increase in the use of herbal supplements, growing from 12 percent of adults in 1997 to 18.6 percent, or 38 million adults, in 2002.

More than 10 million adults, or 5 percent of the population, practice yoga, the survey found.

The survey was based on the National Health Interview Survey of 31,000 adults done by the National Center for Health Statistics.

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Few Seniors Surf the Web for Health Information

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Wednesday, January 12, 2005

WEDNESDAY, Jan. 12 (HealthDayNews) -- Even as the Internet becomes an increasingly rich source of health information, most American seniors remain out of the loop, a new survey finds.

Less than a third of the 65-and-older population has ever gone online, and only 21 percent has sought health information online, the Kaiser Family Foundation reported Wednesday.

Those with lower incomes and less education are less apt to tap into the Web's wealth of offerings. Only 15 percent of seniors with household incomes under $20,000 a year, for example, have gone online. The proportion that uses the Internet rises to 40 percent among seniors with incomes of $20,000 to $49,000, and to 65 percent among those with incomes of $50,000 or more a year.

Prior studies have shown a similar "digital divide" within the general population based on socioeconomic status. "Seeing it so starkly among seniors was an eye-opener," said study author Victoria Rideout, vice president and director of Kaiser's Program for the Study of Entertainment Media and Health.

"As long as that divide is there," she added, "it limits the potential of the Internet to be useful to those in need of health information."

That worries some senior advocates, particularly as Medicare prepares to roll out a new outpatient drug benefit scheduled to take effect in 2006.

"The Internet is a wonderful tool for relatively sophisticated, well-trained counselors. It's sometimes a valuable tool for children or other caregivers for people with Medicare. [But] it's only occasionally useful for Medicare consumers themselves," said Robert M. Hayes, president and general counsel of the Medicare Rights Center, a New York City counseling service for Medicare beneficiaries.

At the time of the Kaiser survey, only 2 percent of all seniors had gone online to Medicare.gov, and further studies indicate the proportion of older users remains small.

The Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, provides extensive online tools for deciphering Medicare benefits. The same information is available by calling 1-800-Medicare, a spokesman said. And many beneficiaries are able to tap into the Internet via counselors at senior centers or Web-savvy relatives.

Kaiser's report is the first to closely examine seniors' use of the Internet for health information and how that may change as the baby boom generation ages. The results are based on a nationally representative telephone survey of 1,450 adults aged 50 and older conducted last March and April.

Seniors said they don't use the Internet at all or not very often mainly because they never learned how (44 percent); it is too complicated (33 percent); and there's nothing on the Web that interests them (27 percent). One in four said it was too expensive; the same number believe that someone will try to cheat, steal or take advantage of them online.

Among the minority that goes online for health information, 37 percent said they've looked for drug information -- the most popular online topic.

There's reason to believe the Internet will play a larger role in informing older Americans as baby boomers age into Medicare. The survey shows substantial numbers of people aged 50 to 64 -- America's next generation of senior citizens -- are going online (70 percent) and more than half are using the Internet to look for health information (53 percent).

The challenge facing health advocates and policymakers is to make the Internet accessible and useful for the current senior population.

"First of all, I think we need to start a dialogue about what it's going to take to get more seniors online so they can make use of this tool," Rideout said.

But she also stressed the continued need for community-based outreach efforts by skilled health-benefits counselors. With Medicare's drug discount program launched last June and the upcoming prescription drug benefit, seniors are being called on to make increasingly complex choices, Rideout explained: "The Internet is not an instant solution for making those choices."

More information

Survey results are available online at the Kaiser Family Foundation.

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Obese Heart Failure Patients Fare Better Than Lean

 

Reuters Health

Wednesday, January 12, 2005

NEW YORK (Reuters Health) - Although obesity is usually linked to detrimental health consequences, new research indicates that overweight people with heart failure have a lower mortality risk than those of normal weight.

This is not the first study to describe a protective effect for obesity in heart failure patients, senior author Dr. Harlan M. Krumholz and colleagues, from Yale University School of Medicine in New Haven, Connecticut, note. However, past studies were typically small in size and focused on patients with severe heart failure, mostly ignoring the larger population of outpatients with a less severe condition.

The current study, which is reported in the Archives of Internal Medicine (news - web sites), involved 7767 patients with stable heart failure who were followed for an average of three years. Using standard definitions, the patients were divided into four groups: underweight, healthy weight, overweight and obese.

During the follow-up period, obese and overweight patients were 19 percent and 12 percent less likely to die, respectively, than healthy weight patients. By contrast, underweight patients were 21 percent more likely to die than their healthy weight peers.

As to why obesity is linked to better outcomes in heart failure patients, the authors speculate it may be because weight-related problems cause them to be diagnosed at an earlier stage.

So what does this mean for overweight or obese heart failure patients? Until further data are available, the findings suggest that they shouldn't try to lose weight, the report states.

Source: Archives of Internal Medicine, January 10, 2005.

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Beer May Raise Gout Risk, Wine May Not

Reuters Health

Wednesday, January 12, 2005

NEW YORK (Reuters Health) - There is substantial difference between alcoholic drinks in their effect on blood levels of uric acid -- and this could affect the likelihood of developing gout -- Harvard investigators have found.

For example, they report in the medical journal Arthritis and Rheumatism, "beer confers a larger increase than liquor, whereas moderate wine drinking does not increase serum uric acid levels."

Because of this, and because gout is caused by the deposition of uric acid crystals in joints, different drinks may result in "variation in the risk of incident gout," Drs. Hyon K. Choi and Gary Curhan, from Harvard School of Public Health, Boston, conclude.

The researchers examined the association between consumption of beer, liquor, and wine in relation to blood levels of uric acid in a nationally representative sample of subjects -- that is, 14,809 participants at least 20 years of age enrolled in the Third National Health and Nutrition Examination Survey.

Uric acid levels were greatest for high beer consumers, followed by those with the highest intake of liquor, the team reports.

No association was found between wine intake and uric acid levels.

This pattern held true for men and women, and for all categories of body weight. "No association was found with wine intake in any of the subgroups," the investigators report.

Source: Arthritis and Rheumatism, December 15, 2004.

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Lifestyle May Explain Much of Drop in Heart Deaths

By Amy Norton

Reuters Health

Wednesday, January 12, 20051

NEW YORK (Reuters Health) - The sharp drop-off in UK heart disease deaths in recent decades may owe much more to prevention than to advances in treatment, a new study suggests.

Researchers estimate that "risk factor changes," such as lower smoking rates and improved blood pressure and cholesterol levels, were largely responsible for the decline in heart disease deaths in England and Wales between 1981 and 2000.

Medical treatments -- from drugs and surgical procedures for existing heart conditions, to prescription medicines for overt high blood pressure and high cholesterol -- also prevented many deaths, the study authors found.

But the reduction in risk factors for heart disease appeared to play a much bigger role, according to findings published in the American Journal of Public Health.

Statistics show that over the 1980s and 90s, deaths from heart disease fell by half in England and Wales. The new study, which is based on the cumulative data from past research, found that there were 68,230 fewer heart disease deaths in 2000 than in 1981.

This, the study authors estimate, added nearly a million years, in total, to the lives of English and Welsh adults between the ages of 25 and 84.

Changes in risk factors for heart disease accounted for a "massive" 79 percent of those added years, said the study's lead author, Dr. Belgin Unal of Dokuz Eylul University School of Medicine in Izmir, Turkey.

These changes included a substantial decline in smoking, and lower average levels of blood pressure and blood cholesterol in the general population -- a measurement that excludes people treated for high blood pressure and high cholesterol

The gains in longevity came in spite of a steep increase in obesity, declining physical activity, and an escalating diabetes rate during the same time period -- trends, Unal told Reuters Health, that caused "considerable loss in life years."

It's likely, he noted, that many more years would have been added to people's lives were it not for the negative trends in obesity, exercise and diabetes. "These risk factors," Unal and his colleagues write in the report, "represent a major public health target for coronary heart disease in the new millennium."

Source: American Journal of Public Health, January 2005.

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Tuesday, January 11, 2005

 

Possible Marker for Osteoarthritis Found

 

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- Scientists have identified a possible biomarker to predict osteoarthritis (OA), says a study in the January issue of Arthritis & Rheumatism.

The study of blood samples from 753 white and black American men and women found a strong association between high levels of hyaluronic acid and severe knee and hip arthritis. Hyaluronic acid is a component of connective tissue that's widely distributed throughout the body and plays an important role in joint function.

Researchers from the University of North Carolina at Chapel Hill and Duke University Medical Center found that hyaluronic acid levels were higher in people with more severe OA and with OA in more than one joint.

The study found no independent links between high hyaluronic acid levels and other health problems seen in the OA patients, such as high blood pressure, diabetes, cancer, chronic pulmonary disease, or persistent liver, kidney, prostate or bladder conditions.

Gout was the only condition that showed a sustained independent association with elevated hyaluronic acid (HA) levels. Like osteoarthritis, gout causes joint inflammation and damage.

"The results of this study suggest that serum HA measurements are useful for assessing overall OA load. The lack of independent associations of serum HA levels with several comorbid conditions commonly associated with OA further supports its promise in the study of OA," study co-author Dr. Alan L. Elliott, of the Thurston Arthritis Research Center at the University of North Carolina at Chapel Hill, said in a prepared statement.

It's hoped that early identification and intervention can improve outcomes for people with OA, a common cause of pain and disability among older Americans. Knee OA affects up to 6 percent of older Americans and hip OA affects about another 3 percent.

More information

The Arthritis Foundation has more about osteoarthritis.

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High Red Meat Consumption Linked to Colon Cancer

 

Reuters Health

Tuesday, January 11, 2005

NEW YORK (Reuters Health) - Long-term high consumption of red and processed meat may increase the risk of cancer in the colon and rectum, a new study shows.

Dr. Michael J. Thun, with the American Cancer Society (news - web sites) in Atlanta, and colleagues followed 148,610 adults, average age 63 years, who completed questionnaires in 1982 and again between 1992 and 1993 regarding their diet, exercise, medical history and other lifestyle habits.

By 2001, there were 1667 new cases of colorectal cancer, according to a report in Wednesday's Journal of the American Medical Association (news - web sites).

The participants who consistently ate the most red meat and processed meats had a 50 percent higher rate colorectal cancer than those who ate the least red or processed meat.

Prolonged high consumption of poultry and fish was marginally associated with about a 25 percent lower risk of colon cancer, but not rectal cancer.

Meanwhile, in another study in the journal, European investigators report that eating a lot of fruit and vegetables doesn't do anything to prevent breast cancer.

Dr. Petra H. M. Peeters, at University Medical Center in Utrecht, the Netherlands, and colleagues analyzed data on approximately 285,000 women ages 25 to 70 from eight European countries who were followed for an average of 5.4 years. The participants had completed dietary questionnaires.

There were 3659 cases of invasive breast cancer among this group of women.

Even though the highest intake of total fruits and vegetables was 2- to 3-times more than the lowest level of intake, the team saw no significant differences in breast cancer risk.

In an accompanying editorial, Dr. Walter C. Willett, at Harvard School of Public Health in Boston, comments that, despite the negative results for breast cancer risk, "reductions in blood pressure and epidemiological evidence for lower risks of cardiovascular disease provide sufficient reason to consume" fruits and vegetables in abundance.

Regarding the association between meat consumption and colorectal cancer, he adds, "prudence would suggest that red meat, and processed meats in particular, should be eaten sparingly to minimize risk."

Source: Journal of the American Medical Association, for January 12, 2005.

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Fruits, Vegetables Don't Protect Against Breast Cancer

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- A survey of a quarter of a million European women found that eating fruits and vegetables did not protect against breast cancer.

The findings seem to fly in the face of previously published research.

"It was really surprising to me. I was kind of speechless," said Bridget Bennett, an oncology nutritionist at Beth Israel Cancer Center in New York City.

Dr. John Cole, section head of hematology/oncology at the Ochsner Clinic Foundation in New Orleans, added, "It certainly contradicts what many people have said and preached over the years."

But both Bennett and Cole pointed out that there are still numerous reasons to include plenty of fruits and vegetables in your diet.

"There's so much good information on fruits and vegetables in preventing other types of cancer, heart disease, diabetes, obesity," Bennett said. "We need to keep this in perspective."

The new findings appear in the Jan. 12 issue of the Journal of the American Medical Association (news - web sites).

Many previous studies had shown that eating fruits and vegetables decreased the risk of breast cancer. This made biological sense, the new study authors stated, because many fruits and vegetables have high amounts of fiber, antioxidant vitamins and minerals, and other compounds thought to protect against cancer.

The current study looked at 285,526 women, 25 to 70 years old, from eight European countries. Each participant was asked to complete a questionnaire on diet at the beginning of the study and then were followed for a median of 5.4 years.

"Our study is the largest on-going study on nutrition and cancer in Europe with a large variation in intake of fruit and vegetables," said two of the study authors, Dr. Petra Peeters and Carla van Gils of University Medical Center in Utrecht in the Netherlands. "Furthermore, this study is famous for its calibration study, by which we can measure the usual consumption more precisely."

During that follow-up period, 3,659 invasive breast cancer cases were reported, but there was no association between fruit and vegetable intake and risk for breast cancer. Nor were there any associations for six specific subgroups of vegetables. This lack of an association was seen in almost all the countries involved.

The authors did not rule out other possibilities. "We can not exclude the possibility that protective effects may be observed for the specific constituents or in specific subgroups of women, such as those with a family history of breast cancer or estrogen receptor positive breast tumours," Peeters and van Gils said.

One drawback to the study, which the authors acknowledged, was the relatively short follow-up period. "That's a fairly short follow-up time," Bennett said. "You see a positive effect when you do it for a long time."

Overall, though, the study was a strong one, Cole said. "To me, the take-home message is not that fruits and vegetables are bad for you in any way, shape or form, but that breast cancer is a very complicated process and that the role of fruits and vegetables in the prevention of breast cancer is one that certainly is not straightforward or easy to discern."

"Fruits and vegetables, by themselves, probably have a relatively limited impact, but we also have to keep in mind that any type of dietary measure is very difficult to look at," he continued. "I would certainly hope that this doesn't dissuade people from thinking fruits and vegetables are important."

As Peeters and van Gils noted, "Although the findings for fruit and vegetable consumption and breast cancer risk may be disappointing, there are indications that it may be protective for developing stomach cancer, esophageal cancer, head and neck tumors and possibly colorectal and lung tumors."

They added, "Furthermore, fruit and vegetable consumption has been shown to lower blood pressure and the risk of cardiovascular disease, therefore there are enough reasons to keep eating lots of fruit and vegetables."

More information

The American Cancer Society has more on breast cancer.

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Health Tip: Get Enough Magnesium

HealthDayNews

Tuesday, January 11, 2005

(HealthDayNews) -- Magnesium is a mineral that's important to every cell of your body, the U.S. National Institutes of Health (news - web sites) says.

Magnesium is needed for more than 300 biochemical reactions that keep you healthy. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, and helps maintain strong bones.

The mineral is present in many foods, but usually is found in small amounts. Green vegetables such as spinach are excellent sources, as are nuts, seeds and some whole grains.

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New Asthma Guidelines Issued for Pregnancies

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- Inadequate control of asthma is a risk to a pregnant woman and her fetus, and most asthma medications are safe to use during pregnancy, say updated guidelines that emphasize asthma control in pregnant women.

The recommendations were released Tuesday by a U.S. National Asthma Education and Prevention Program (NAEPP) expert panel.

"The NAEPP expert panel's review of the evidence concludes that it is safer for pregnant women with asthma to be treated with asthma medications than for them to have asthma symptoms and exacerbations," Dr. Barbara Alving, acting director of the U.S. National Heart, Lung, and Blood Institute, said in a prepared statement.

"The guidelines also recommend that obstetric care providers become part of the patient's asthma management team to help ensure that the patient's asthma is evaluated frequently and her care plan is adjusted as needed to help her have a healthy pregnancy," Alving said.

The updated guidelines appear in the January issue of the Journal of Allergy & Clinical Immunology.

It's estimated that asthma affects up to 8 percent of pregnant women. That makes it potentially the most common serious medical problem to complicate pregnancy. The condition becomes worse in about 30 percent of pregnant asthma patients.

The updated guidelines include recommendations for a step-by-step approach for treatment based on asthma severity and a summary of gestational safety data for specific asthma drugs. They also include recommendations for monitoring asthma control during pregnancy so necessary treatment adjustments can be made to maintain the mother's lung function and ensure the fetus has an adequate oxygen supply.

More information

The American Academy of Allergy, Asthma & Immunology has more about asthma and pregnancy.

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Drug Stents Outperform Angioplasty in German Trial

Reuters

Tuesday, January 11, 2005

CHICAGO (Reuters) - Johnson & Johnson's drug-coated stent slightly outperformed Boston Scientific's version in reopening arteries that had been clogged by lesions following the earlier insertion of bare-metal stents, a study said on Tuesday.

The results of the year-long trial involving 300 patients favored J & J's Cypher stent over Boston Scientific Corp.'s Taxus model, while both products outdid balloon angioplasty in propping open narrowed arteries.

"Both stents are significantly better than a simple balloon angioplasty," said Dr. Brian Firth of Johnson & Johnson's Cordis subsidiary. The company had no role in the study.

"Is there a difference (between the two stents)? The answer is yes there is, particularly in terms of key end-points," Firth told Reuters.

J & J's Cypher "may be superior" to Boston Scientific's Taxus, study author Adnan Kastrati of Technical University in Munich wrote in the Journal of the American Medical Association (news - web sites). He said a head-to-head trial was needed to determine whether the differences were significant.

The coated, or "drug-eluting" stents, are thin metal mesh tubes that are inserted into the narrowed artery or inside other stents and release drugs that help prevent artery-blocking lesions from forming. Balloon angioplasty involves inserting a balloon to widen the artery.

Of 91 patients who received J & J's Cypher drug-eluting stent to open arteries clogged by lesions, 13 suffered restinosis, or a re-narrowing of the artery by at least 50 percent. By comparison, 20 of 92 Taxus recipients suffered restinosis, and 41 of 92 angioplasty patients did.

The German researchers who conducted the study said its main purpose was to compare the drug-eluting stents with balloon angioplasty, and the stents were clearly more effective.

The Cypher stent employs a drug used to prevent organ rejection in transplant patients that is released within three months, while Taxus uses an anti-cancer formulation that is released over a year, Firth said.

Many patients whose arteries become reclogged undergo radiation therapy, but that technique has been found not to last much beyond one year, Firth said.

Johnson & Johnson first received U.S. regulatory approval for a drug-eluting stent in 2003. The precursor bare metal stents were introduced in the mid-1990s, but up to 40 percent of patients develop lesions that narrowed the artery again.

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Health Care Costs a Top American Concern

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- Almost two-thirds of Americans say that lowering the costs of health care and health insurance should be a top priority for President Bush (news - web sites) and Congress in 2005, a new post-election survey finds.

Although malpractice reform and the importation of prescription drugs from Canada have been hot political topics in recent months, both were viewed as less pressing priorities by the survey respondents, despite the fact that a significant majority favored the idea of both.

The issue of health care tied with "terrorism/national security" as No. 3 on the public's list of most pressing problems, just behind the war in Iraq (news - web sites) and the economy, according to the results reported Tuesday by the Kaiser Family Foundation and the Harvard School of Public Health.

Many Americans did feel that passing malpractice reforms could help reduce the cost of health care, saying it would help "a lot" or "some" if laws were passed limiting the amount of money patients can receive for pain and suffering and prohibiting individuals from filing lawsuits unless a medical specialist reviews the claim.

But reducing jury awards in malpractice lawsuits ranked 11th overall among the public's top 12 priorities for federal lawmakers this year, trailed only by increasing federal funding for stem cell research.

Bush, who blames runaway jury awards for driving up the cost of health care, recently renewed his call to make malpractice reform a top priority in his second term. The message seems to resonate with the public -- but only to a certain degree.

"When they hear President Bush talking about fixing the malpractice system as a way to lowering costs, that sort of rings true to them," said Mollyann Brodie, vice president and director of public opinion and media research at the Kaiser Family Foundation. "That's not to say they would make it their top priority."

In addition, 73 percent of those polled favored changing the law to allow Americans to buy prescription drugs imported from Canada, but the issue was ranked eighth in priority.

The survey is based on a nationally representative sample of 1,396 adults polled by telephone last November. The findings were released at a Washington briefing for reporters and policymakers.

Health care and "terrorism/national security" were each dubbed the most important issue facing lawmakers by 10 percent of respondents, sharply trailing the war in Iraq (27 percent) and the economy (17 percent).

Although the survey covered many health topics, concern over cost stood out as a defining issue. Sixty-three percent of those surveyed cited it as a top health priority for the President and Congress. Majorities also agreed that lawmakers should focus on making Medicare more financially sound (58 percent) and increasing the number of Americans with insurance (57 percent).

The most important cause of rising health-care costs? Twenty-nine percent of Americans blamed high profits made by drug and insurance companies, 22 percent said it was the high number of malpractice lawsuits in this country, and 15 percent pointed to the amount of greed and waste that occurs in the health-care system. Only 7 percent faulted what economists say is a major culprit behind escalating health-care costs: the use of expensive, high-tech medical equipment and drugs.

"It's hard for people to see that it's their own desires and expectations that are driving some of these costs," Brodie said.

When employers in the late 1980s began instituting measures to contain health-care spending, consumers mounted an angry rebellion, Brodie noted, and once those restraints were eased or lifted, health-care spending became to climb once again.

"We as a public aren't necessarily willing to give up a lot -- or to sacrifice a lot -- in order to get health-care costs to come down," Brodie continued.

That same sentiment came into play on the question of expanding coverage for the uninsured, the survey showed. While the public placed a relatively high priority on increasing the ranks of insured Americans, there was little agreement on the best approach for doing so. And consumers were split on whether they were willing to pay more in taxes or health-care premiums to help cover the uninsured.

"They're afraid it's going to hurt them and their family," Brodie explained.

But Kathleen Stoll, director of health policy at Families USA, said that a critical piece of the equation is often overlooked in the debate over how to finance coverage of the uninsured.

Studies show that covering all of the uninsured in a state can reduce premiums for the insured population by 10 percent to 15 percent, she said.

"The truth is that investment will be savings for all of us," regardless of how the expansion is financed, she added.

In other findings from the poll, 80 percent favored changing the law to allow the federal government to use its buying power to negotiate with drug companies for lower prescription drug prices for Medicare beneficiaries.

And 32 percent said the most important reason for rising health-care costs was too many lawyers filing unwarranted lawsuits; 9 percent said the main reason was too many juries making larger-than-justified awards.

More information

Survey results are available online at the Kaiser Family Foundation.

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Health Tip: When Headaches Are More Than a Pain

 

HealthDayNews

Tuesday, January 11, 2005  

(HealthDayNews) -- During the past year, nearly 90 percent of men and 95 percent of women have had at least one headache, according to the American Council for Headache Education.

Although very few headaches are signs of serious medical conditions, call your doctor immediately if:

Westernization Linked to Breast Cancer Rise

 

By David Douglas

Reuters Health

Tuesday, January 11, 2005

NEW YORK (Reuters Health) - The breast cancer rate is rising among women in Singapore and appears to be approaching that seen in Europe, researchers report. The introduction of a Westernized lifestyle and child-bearing pattern may underlie this trend, they suggest.

Lead investigator Dr. Kee-Seng Chia told Reuters Health that the breast cancer incidence in Singapore will continue to increase over the next decades. "In the year 2015, one out of every 10 women is likely to develop breast cancer in her lifetime."

Chia, at the National University of Singapore, and colleagues came to this conclusion after comparing data for more than 10,000 breast cancer cases reported in Singapore from 1968 to 1997 with more than 135,000 Swedish cases in the same period.

The incidence rate of breast cancer increased in Sweden from 54 to 77 per 100,000 women. However, in Singapore the rate increased 20 to 44 per 100,000, the researchers report in the International Journal of Cancer.

They note that the incidence rate was increasing almost three times faster among the youngest age group of women in Singapore than in the corresponding group in Sweden.

In addition, continued Chia, an "increasing number of post-menopausal women will also be coming down with breast cancer as our pattern shifts from the pre-menopausal to post-menopausal age group."

"It is too late for these women to avoid the risk factors," Chia said. However, "Increased self-awareness and early diagnosis can catch the cancer at an early stage and improve prognosis."

Source: International Journal of Cancer, January 1, 2005.

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Do Pharmacy Errors Spike at Start of the Month?

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- Statistics suggest Americans are more likely to die at the start of each month than any other time, and now researchers think they've found one possible culprit: mistakes in prescription drug use.

The primary suspect, the researchers said, could be a beginning-of-the-month increase in pharmacists' workloads and a subsequent rise in error rates. While such errors wouldn't account for the entire trend, they may be a major factor in the higher death rates, according to the study that said deaths from drug mishaps rose by as much as 25 percent during the first days of each month.

Why the jump in deaths around that time? Perhaps because that's when many people are suddenly flush with cash, said study co-author David Phillips, a professor of sociology at the University of California, San Diego. Patients get Social Security (news - web sites) and welfare checks at the beginning of the month, and that's when "they rush in to get medicines that they can't afford in the preceding month," he said.

But Stephen Setter, an assistant professor of pharmacotherapy at Washington State University, cautions that many people -- including caregivers and patients themselves -- are responsible for drug errors.

Phillips had previously discovered that deaths as a whole increase by about 1 percent at the start of each month. "I was interested in whether one or another particular cause of death shows the spike more strongly," he said.

To figure out if medication errors played a role, Phillips and his colleagues analyzed 131,952 U.S. death certificates from 1979 to 2000 that indicated deaths were caused by accidental effects from legal drugs.

The findings appear in the January issue of Pharmacotherapy, the journal of the American College of Clinical Pharmacy.

Nearly all the deaths -- 96.8 percent -- resulted from errors, not because someone took the correct dose of the correct drug. However, the statistics didn't point to the responsible party.

For those who died quickly -- including those in the emergency room or on their way to a hospital -- deaths were 25 percent above normal at the beginning of the month.

The death rate due to medication errors went up by only 6.6 percent among people already hospitalized, perhaps indicating they weren't as likely to run out and buy medicine at the beginning of the month, Phillips said.

The researchers also found that the rise in beginning-of-the-month deaths affected both young and old, rich and poor. But why would the wealthy be just as likely to die if they weren't waiting until the start of the month to buy prescription drugs with money from welfare checks?

Phillips has a theory: Pharmacists are overwhelmed by poorer people coming in at the beginning of the month. "When pharmacists are unusually busy, they're more likely to make mistakes."

Setter agreed that it seems pharmacists do get busier at the start of the month. "As you increase the speed that the work has to be done, we set ourselves up for more errors," he said.

But the additions of computer systems and extra technicians over the last few years should help prevent errors, he said. And, he added, some medication errors have nothing to do with pharmacists.

"You see patients take their medicine in the dark, they take their wife's medicine, their dog's medicine," Setter said. "There's a lot that goes into that definition of medication error. We really need to have more specific information."

Phillips agreed and said he hopes to see more research. For now, however, he said pharmacists and patients need to make extra efforts to check prescriptions at the beginning of the month. "There's the potential there to save a lot of lives," he said.

More information

To learn more about pharmacists, visit the U.S. Department of Labor.

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Bran in Diet Seen to Lower Risk of Heart Disease

By Amy Norton

Reuters Health

Tuesday, January 11, 2005

NEW YORK (Reuters Health) - A diet rich in whole grains does seem to lower a man's risk of developing heart disease, with the bran component of grains playing a key role, a large study suggests.

Researchers found that among nearly 43,000 middle-aged and older men, those who ate the most whole grains -- such as oatmeal, brown rice and some breakfast cereals -- were less likely than men with the lowest consumption to develop coronary heart disease over 14 years.

When the investigators looked at two of the major components of whole grains, bran emerged as the lead player. Men who added the most bran to their diet were 30 percent less likely to develop heart disease than their peers who ate no added bran.

Whole grains have three basic components: the outer layer of bran, the inner germ and the starchy layer known as the endosperm. In highly processed grain products, such as white bread, the bran and germ are removed before milling -- which also takes away the fiber, vitamins and other nutrients found in those constituents.

Diets rich in whole grain foods such as cooked oatmeal, whole barley, bulgur, popcorn, and breakfast cereals and breads made from whole grains, have been linked to better weight management and a lower risk of type 2 diabetes and heart disease.

The new findings, published in the American Journal of Clinical Nutrition (news - web sites), come from a long-running study of U.S. male health professionals. The study began in 1986, when the men were between the ages of 40 and 75, and has since periodically collected information on the men's health, diet and lifestyle.

Senior study author Dr. Eric B. Rimm of the Harvard University School of Public Health said he and his colleagues developed a database that allowed them to estimate how many grams of whole grains, as well as how many grams of bran and germ, the men typically ate each day.

That included the bran and germ found naturally in grains, plus any that was added to processed foods or that the men added to food themselves.

Overall, men with the highest intake of whole grains had an 18 percent lower risk of heart disease compared with those who ate the least. And those who consumed the most grams of added bran had a 30 percent lower risk than those who ate no added bran.

But that does not mean that people need to add bran to their food to get the benefit, or that sprinkling bran on that gooey morning doughnut makes it a health food, according to Rimm.

"Added bran is one way to go about it," he told Reuters Health. But, he added, eating whole grains, rather than highly processed grain products, will help bulk up the diet with bran.

That, though, means not mistaking refined grain products that list the ingredient "wheat flour" for a whole-grain food. Rimm advised making sure the word "whole" is on that ingredient list. When it comes to bread, he said, choosing one "where you can actually see the grain" is a good move.

As for why bran, and whole grains in general, may ward off heart disease, Rimm said the fiber content probably contributes, but it is likely that the full complement of nutrients -- including B vitamins, antioxidants, minerals and various plant chemicals -- is involved.

He also pointed out that people looking to boost their whole grain intake have a range of options, including ones that are not hard to swallow, like popcorn and some breakfast cereals.

"Unfortunately," Rimm said, "many people kind of associated whole grains with eating cardboard. But they should know that they have a lot of choices."

The research received partial funding from cereal maker Kellogg Company.

Source: American Journal of Clinical Nutrition, December 2004.

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Dealing With Vision Loss

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- A program that educates people with advanced age-related macular degeneration (AMD) about the disease and provides them with the skills to live with vision loss leads to lasting improvements in mood and function.

That's the conclusion of a report in the January issue of the Archives of Ophthalmology.

The 12-hour self-management program is especially effective for depressed patients and helps reduce the incidence of depression in AMD patients over time, say researchers at the University of California, San Diego Shiley Eye Center.

AMD is the leading cause of vision loss in older adults. Most cases are caused by cell degeneration in the macula, the area of the eye responsible for central vision. AMD patients lose their central vision but still have peripheral vision. Some forms of AMD are caused by blood vessel leakage in the macula.

This study was a six-month follow-up assessment of a group of AMD patients who took the self-management course and a control group of AMD patients who didn't take the program. Those who took the course had improved function and less distress than those in the control group.

Depression was more than twice as common in the control group as in the self-management group.

"Too often the vision loss that results from this incurable disease is accompanied by anxiety, hopelessness and depression. As we continue to seek effective treatments and cures for AMD, we have made it an immediate priority to help patients develop the confidence and skills to continue leading fulfilling lives despite their impaired vision," Dr. Stuart I. Brown, director of the Shiley Eye Center, said in a prepared statement.

More information

The U.S. National Eye Institute has more about AMD.

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Diabetes, Pre-Diabetes Linked to Cancer Risk

Reuters Health

Tuesday, January 11, 2005

NEW YORK (Reuters Health) - Diabetes, or even high blood sugar levels that can lead to diabetes, appear to raise the risk of several major cancers, according to a large Korean study.

In previous studies, diabetes has been consistently linked to cancers of the pancreas, liver and colon/rectum, the researchers note, but the link with other types of cancer has been less clear.

Dr. Sun Ha Jee, from Yonsei University in Seoul, and colleagues conducted a 10-year forward-looking study involving more than 1 million Koreans ranging in age from 30 and 95 years who had a medical evaluation between 1992 and 1995.

During follow-up, men and women with high fasting blood glucose levels were about 25 percent more likely to die from cancer than those with normal or low levels, the investigators report in the Journal of the American Medical Association (news - web sites).

High glucose levels were most strongly linked to pancreatic cancer for both men and women. Other malignancies linked to high glucose levels included cancer of the esophagus, liver, and colon/rectum in men, and liver and cervix in women.

"While the generalizability of the findings is uncertain, we have shown that fasting serum glucose level and diabetes are associated with cancer risk in a population far leaner than the Western populations in other studies," the investigators note.

Since most of the Korean population is relatively lean, taking obesity out of the equation, the findings suggest that excessive insulin levels triggered in response to decreased insulin sensitivity may be the underlying cause of the increased cancer risk.

In a related editorial, Dr. Kathleen A. Cooney and Dr. Stephen B. Gruber, from the University of Michigan Medical School in Ann Arbor, comment: "As diabetes becomes an increasing public health concern in modern societies, the cancer risks looming on the horizon are now being recognized. Strategies to address the emerging epidemics of diabetes and obesity are likely to have a broad impact on public health."

Source: Journal of the American Medical Association, January 12, 2005.

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Vitamin C Doesn't Boost Your Workout

 

HealthDayNews

Tuesday, January 11, 2005

TUESDAY, Jan. 11 (HealthDayNews) -- Vitamin C doesn't pump up your exercise performance, says a University of Colorado study.

The findings contradict previous research that suggested ingestion of vitamin C reduced oxidative stress and, therefore, could provide a boost during workouts.

The new study found that while vitamin C did reduce oxidative stress during endurance exercises such as running, cycling and walking, neither short-term nor long-term use of vitamin C helped aerobic performance. This was true for both men and women in two age groups -- 23 years old and 61 years old.

"We did see a decrease in oxidative stress with large does of vitamin C, but this decrease didn't improve aerobic abilities either for younger or older subjects," study author Christopher Bell said in a prepared statement.

The study appears in the current online edition of the Journal of Applied Physiology.

More information

The U.S. National Library of Medicine has more about vitamin C.

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Monday, January 10, 2005

 

Too Little Sleep May Pack on Pounds

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Monday, January 10, 2005

MONDAY, Jan. 10 (HealthDayNews) -- It sounds like the best diet plan of all time -- sleep more, weigh less.

It could be a reality, say researchers who have produced more evidence linking less sleep to obesity.

The findings, which appear in the Jan. 10 issue of the Archives of Internal Medicine (news - web sites), don't say which came first -- sleepy people or fat people.

But study co-author Dr. Robert Vorona, an assistant professor of sleep medicine at Eastern Virginia Medical School, suspects that lack of sleep sets off hormonal changes that affect appetite. "It's very possible that, over the long haul, restrictions in sleep could dispose you to obesity," Vorona said.

He acknowledged that his theory is a bit odd, especially considering that people use more energy when they're awake. "It's counterintuitive that restricting sleep should lead to obesity, that sleeping more should make you more apt to lose weight," he said. "That doesn't sound like it makes sense."

Other researchers are on the same track, however. "There's a mounting body of evidence that suggests the systems that regulate sleep and appetite are linked," said Dr. Joseph Bass, a professor of medicine at Northwestern University Feinberg School of Medicine who studies sleep.

Vorona and his colleagues first became interested in the link between sleep and obesity after reading that insufficient sleep disrupts the body's endocrine system, which regulates hormone levels. Vorona said they decided to launch a study to see if weight was affected, too.

The researchers surveyed 1,001 people from southeastern Virginia about their sleep habits. They also checked where the subjects landed on the body-mass index scale, which uses a mathematical formula to indicate whether a person is of normal weight, overweight, obese or severely obese. The typical subject was 48 years old and obese.

The researchers found that people of normal weight got more sleep than their overweight and obese counterparts, by an average of 16 minutes per night, or 1.9 hours a week.

The research reflected previous studies in Japan that linked lack of sleep to obesity in children, Vorona said.

Oddly, this latest study found that severely obese people actually got more sleep than other people. According to Vorona, this may be because their bodies are more likely to produce sleep-inducing chemicals.

The next step, Vorona said, is to launch more definitive studies that will closely track how much people sleep each day -- instead of relying on their own memories -- and examine changes in sleep and obesity levels over time. He hopes to "get funding to see if extending sleep really does help people lose weight effectively."

It's possible that further research into the link between insufficient sleep and obesity may explain why shift workers -- who often don't get enough sleep -- are more likely to develop diabetes, said Bass, who wrote a commentary that accompanied Vorona's study.

"Sleep is a fascinating, enigmatic process," Bass said. "We kind of hand-wave at it as physicians, and maybe we shouldn't."

More information

Get the myths and facts about sleep from the National Sleep Foundation.

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Stay Thin by Sleeping More?

 

By Michael Conlon

Reuters

Monday, January 10, 2005

CHICAGO (Reuters) - A study published on Monday found that people who sleep less tend to be fat, and experts said it's time find if more sleep will fight obesity.

"We've put so much emphasis on diet and exercise that we've failed to recognize the value of good sleep," said Fred Turek, a physician at Northwestern University.

"In fact society emphasizes just the opposite," in work places where billed hours are crucial and long work days are common, he added.

Monday's study from Eastern Virginia Medical School in Norfolk covered 1,000 people and found that total sleep time decreased as body mass index -- a measure of weight based on height -- increased.

Men slept an average of 27 minutes less than women and overweight and obese patients slept less than patients with normal weights, it said. In general the fatter subjects slept about 1.8 hours a week less than those with normal weights.

"Americans experience insufficient sleep and corpulent bodies. Clinicians are aware of the burden of obesity on patients," the study said.

An Extra 20 Minutes

"Our findings suggest that major extensions of sleep time may not be necessary, as an extra 20 minutes of sleep per night seems to be associated with a lower body mass index," it added.

"We caution that this study does not establish a cause-and-effect relationship between restricted sleep and obesity (but) investigations demonstrating success in weight loss via extensions of sleep would help greatly to establish such a relationship."

The study was published in the Archives of Internal Medicine (news - web sites) along with an editorial by Turek and Northwestern colleague Joseph Bass commenting on it and related research.

In an interview with Reuters, Turek said some studies have shown sleep deprivation causes declines in an appetite suppressing protein hormone called leptin, and increases in another hormone that causes a craving for food. In addition neuropeptides in the brain governing sleep and obesity appear to overlap, he said.

"It is now critical to determine the importance of lack of sufficient sleep during the early formative years in putting our youth on a trajectory toward obesity ... a trajectory that could be altered if sleep loss is indeed playing a role in this epidemic," the editorial said.

Obesity has been rising dramatically in developed countries and reached epidemic levels in the United States, it added, leading to a variety of health problems.

"In recent years, a new and unexpected 'obesity villain' has emerged, first from laboratory studies and now ... in population-based studies: insufficient sleep," it said.

"However, while there is a growing awareness among some sleep, metabolic, cardiovascular, and diabetes researchers that insufficient sleep could be leading to a cascade of disorders, few in the general medicine profession or in the lay public have yet made the connection," it added.

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Health Tip: Beware of Phony Diets

HealthDayNews

Monday, January 10, 2005

(HealthDayNews) -- Lots of people will be looking to shed those holiday pounds by starting a new diet plan.

But beware, the American Heart Association (news - web sites) (AHA) warns. Some phony diet sponsors are wrongfully claiming that their plans are sanctioned by the AHA.

Three-day or seven-day cabbage soup diets that have surfaced recently are prime examples.

Another phony diet purports to include vanilla ice cream, hot dogs, eggs and cheddar cheese. The plan promises a 10-pound weight loss in three days. The poorly typed and photocopied phony diet has been offered by mail for $2 per copy.

If the fat-laden contents of these phony plans don't offer enough proof, the Association says you can tell the phonies from the real deal because the fake diets specify recommended daily servings of various food categories, not specific foods. Also, AHA diets are meant to be followed for a lifetime, not for a limited period.

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Study: Weight Loss Precedes Dementia in Elderly

 

Reuters

Monday, January 10, 2005

CHICAGO (Reuters) - Weight loss in elderly men appears to be a harbinger of dementia and contributes to their increasing frailty, researchers said on Monday.

While preventing weight loss was unlikely to prevent mental decline, maintaining weight could help stave off the physical dependence on other people, falls and poor wound healing that can accompany old age, the report published in the Archives of Neurology journal said.

In a three-decade study of 1,890 Japanese-American men aged 77 or older called the Honolulu-Asia Aging Study, researchers identified 112 men who developed dementia.

A high proportion of the impaired subjects had lost at least 11 pounds (5 kg), or 10 percent of their body weight, in the two to four years prior to the onset of dementia symptoms.

There was a similar association between weight loss and Alzheimer's disease (news - web sites) and vascular dementia, wrote study author Robert Stewart of the Institute of Psychiatry in London.

In an accompanying editorial, Michael Grundman of Elan Pharmaceuticals in San Diego, California, said further study was needed to find out if maintaining nutrition and preventing weight loss could at least slow the course of dementia.

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Health Tip: Resolve to Live Better

 

HealthDayNews

Monday, January 10, 2005

(HealthDayNews) -- New Year's resolutions seem as easy to break as they are to make. But the Mayo Clinic says you can make relatively small changes that can have a major impact on your health:

Colon Cancer Screening Still Underused

 

By Amy Norton

Reuters Health

Monday, January 10, 2005

NEW YORK (Reuters Health) - Many people with colon cancer may not be diagnosed until after symptoms arise, even though the disease can be caught earlier with routine screening, a study released Monday suggests.  

In an analysis of data from a large U.S. cancer registry, researchers found that more than half of older adults with colorectal cancer had a disease-detecting procedure within 6 months of their diagnosis -- making it likely that the procedure was performed not as part of routine screening, but as a diagnostic test spurred by colon cancer symptoms.

Forty-four percent of the nearly 6,000 patients had a test -- such as fecal occult blood testing (FOBT) or colonoscopy -- more than 6 months before their cancer diagnosis. In these cases, the procedures were probably done as part of colon cancer screening, study co-author Dr. Gregory S. Cooper told Reuters Health, and patients in this group were more likely to be diagnosed at an earlier stage in the disease.

"This is another piece of evidence that screening is beneficial," said Cooper, a gastroenterologist at Case Western Reserve University and the University Hospitals of Cleveland.

But the findings, being published in the journal Cancer, also provide yet more evidence that colon cancer screening is underused in the U.S, according to Cooper and colleague Jonathan D. Payes.

Medical groups such as the American Cancer Society (news - web sites) advise that adults at average risk of colon cancer begin routine screening for the disease at age 50, with the frequency depending on which test doctors and patients choose.

FOBT, which detects hidden blood in stool samples, is the least sensitive test, and experts recommend that it be done every year -- preferably in combination with a sigmoidoscopy procedure every 5 years. Another option is to have a colonoscopy every 10 years.

Sigmoidoscopy and colonoscopy both involve inserting a thin, flexible scope into the colon to look for cancer or polyps, which are growths that can become cancerous. Sigmoidoscopy investigates only the lower portion of the colon, while colonoscopy inspects the entire length of the colon.

Colonoscopy is considered the most sensitive way to screen for colon cancer, Cooper noted, though many people balk at having the procedure and not all insurance plans cover the test when it's used for screening.

Colonoscopy cannot only detect cancer, Cooper said, but can also prevent it by allowing doctors to find and remove polyps.

In his team's study, which looked at data on 5,806 U.S. adults age 70 and up who were diagnosed with colorectal cancer in 1999, colonoscopy was the most frequently performed procedure.

However, most of those exams were done within 6 months of patients' diagnoses, which indicates they were often performed as a diagnostic test for suspected cancer -- and not as part of routine screening.

In contrast, when the researchers looked at the 44 percent of patients who'd had a procedure more than 6 months before their cancer diagnosis, FOBT was the most commonly performed procedure. Six percent of these patients had a colonoscopy.

Most importantly, Cooper's team found, these 44 percent of patients -- who were most likely to have gotten tests for screening purposes -- were less likely to be diagnosed with colon cancer at a more-advanced stage.

That means, Cooper said, that these patients were also likely to have better survival rates.

Source: Cancer, February 15, 2005.

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Musks in Fragrances May Weaken Immune System, Study Says

HealthDayNews

Monday, January 10, 2005

MONDAY, Jan. 10 (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 mussel gill 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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Heavy Pesticide Exposure May Up Parkinson's Risk

By Alison McCook

Reuters Health

Monday, January 10, 2005

NEW YORK (Reuters Health) - People who come into regular contact with pesticides at work -- such as farmers and pesticide sprayers -- appear to have a slightly higher risk of developing Parkinson's disease (news - web sites), according to new study findings released Monday.

However, the study is relatively small, and the possibility that the relationship between past exposure to pesticides and Parkinson's could be due to chance cannot be ruled out, lead author Dr. Jordan A. Firestone of the University of Washington in Seattle told Reuters Health.

Nevertheless, "I think there very likely may be" an increased risk of developing Parkinson's after heavy exposure to toxic pesticides, Firestone noted.

Previous laboratory research has shown that certain pesticides can damage the brain. People who ingest large doses of pesticides can develop symptoms such as seizures, confusion, or coma, Firestone explained.

However, it's less clear what effects chronic, low-level exposures -- perhaps through daily contact -- can have on the brain, he added. "Lower levels of many exposures ... whether those accumulate to cause problems, that's not so clear," Firestone said.

To investigate, he and his colleagues asked 250 men and women with Parkinson's disease and 388 people without to recall their lifetime exposure to pesticides.

They found that pesticide workers who applied the chemicals had approximately twice the risk of developing the disease. Animal and crop farmers also had a slightly higher risk of being diagnosed, the researchers note.

Exposure to pesticides at home did not appear to influence the risk of Parkinson's, although lifelong drinking of well water did, Firestone and his team report in the Archives of Neurology.

In an interview, Firestone explained that farm workers typically have higher exposures to pesticides than people who eat fruits and vegetables because they come in direct contact with produce sooner after spraying, and handle the produce before it is washed and prepared.

However, he noted that there may still be "a possible risk" of Parkinson's from eating produce sprayed with pesticides, and the risk will be higher or lower for people with different genetic susceptibilities.

"By definition," organic foods are supposed to contain fewer -- if any -- pesticides, Firestone added, but noted that early research shows that people who opt for organic foods still have some pesticides in their bodies.

Biologically, some pesticides may affect the brain by disrupting a system that is important for normal brain function, and one that is also disrupted in people with Parkinson's, Firestone noted. The chemicals may also cause harm by affecting energy production within brain cells, he added.

Firestone noted that another study is currently looking at Parkinson's risk among thousands of former pesticide sprayers, and may offer more clues about the risk from these chemicals.

Source: Archives of Neurology, January 2005.

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Delirium Can Be Side Effect of Stem Cell Transplant

HealthDayNews

Monday, January 10, 2005

MONDAY, Jan. 10 (HealthDayNews) -- Half of cancer patients who have stem cell transplants show signs of delirium after the procedure, says a study to be published in the Feb. 15 issue of Cancer.

These signs of delirium can be subtle and easily missed by doctors, the study noted. The symptoms include disturbances in the sleep-wake cycle, impaired attention and memory, and hypoactive behavior.

Classic symptoms of delirium include hallucinations, delusions, agitation and disorientation.

The study found the severity of delirium is associated with the levels of distress, pain and fatigue experienced by patients. This is the first research to identify this link between stem cell transplantation and delirium, the researchers said.

Delirium is associated with increased risk of falls, wound infections and aspiration pneumonia. In cancer patients, delirium is also associated with an increased risk of death while in a hospital and within five years of follow-up.

Researchers at the University of Washington and the Fred Hutchinson Cancer Research Center tracked 90 cancer patients for 30 days after they had hematopoietic stem cell treatment. Half the patients suffered delirium episodes afterward.

The study authors concluded that doctors shouldn't rely on classic delirium symptoms to recognize the problem in this group of patients.

"More subtle symptoms of hypoactive psychomotor behavior, altered sleep-wake cycle, and impaired attention and working memory should be early indicators for increased monitoring and identification of possible causes of delirium," the authors wrote.

More information

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

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Anti-Inflammatory Protein Cuts Heart Attack Risk

Reuters Health

Monday, January 10, 2005

NEW YORK (Reuters Health) - High circulating levels of a protein called mannan binding lectin (MBL), which prompts scavenger cells to remove various inflammatory agents, appear to reduce the risk of having a heart attack -- especially for people with diabetes -- Icelandic researchers report.

Although the protein was known to have potentially beneficial anti-inflammatory effects, the ability of MBL to ward off heart attacks had not be studied before, according to the report in The Journal of Experimental Medicine.

Dr. Helgi Valdimarsson, from Landspitali-University Hospital in Reykjavik, and colleagues analyzed data from the Reykjavik study, which includes 20,000 subjects recruited starting in 1967.

Among about a thousand 70-year-old participants from the original enrollment, high MBL levels were linked to a 36 percent reduced risk of heart attack compared with lower levels.

To confirm this finding, the researchers followed another 1300 middle-age subjects. In this analysis, the link between high MBL levels and a reduced likelihood of having a heart attack was not as strong as in the original group and was not significant from a statistical standpoint for the whole group, or for subsets of smokers or those with high blood pressure.

However, the analysis did show that high levels were tied to greatly reduced risks for a heart attack among subjects with diabetes or high cholesterol. In fact, people with diabetes with high MBL levels had a risk on par with non-diabetic subjects.

For people with diabetes, the team concludes, measuring MBL "might actually aid in the evaluation of the need for preventive treatment" for heart disease.

Source: Journal of Experimental Medicine, January 3, 2005.

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Elderly Avoiding Colorectal Cancer Screening

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Monday, January 10, 2005

MONDAY, Jan. 10 (HealthDayNews) -- Less than half of the Medicare patients diagnosed with colorectal cancer had any screening in the six months before being diagnosed, troubling new research shows.

In addition, almost 94 percent of them had never had a colonoscopy until the one that diagnosed their cancer, according to the report in the Jan. 10 online issue of Cancer.

"Even though colorectal screening is recommended, among patients with cancer, only a minority of them underwent a screening procedure," said study author Dr. Gregory S. Cooper, an associate professor of medicine and epidemiology at Case Western Reserve University. "Most of the procedures that were done were those that lead to the cancer diagnosis."

Had patients been screened regularly, Cooper added, many would have had their cancer caught early enough for successful treatment.

In their study, Cooper and his colleague, Jonathan D. Payes, collected data on 5,806 men and women aged 70 and older who were diagnosed with colorectal cancer.

Cooper and Payes found that only 44 percent of these patients had had a screening test more than six months before they were diagnosed.

The most common screening test was the fecal occult blood test (FOBT). "This is the most widely available test, and least expensive," Cooper said. "But is also the least accurate."

Most patients (63 percent) had undergone a colonoscopy, but most of those were done only at the time of or shortly before their cancer diagnosis. Only 6 percent had a colonoscopy more than six months before being diagnosed with cancer.

Moreover, those patients who had been screened had early-stage disease, which is usually more treatable, Cooper and Payes noted. "Patients who did have a test done compared to the ones who didn't were less likely to come in with advanced-stage cancer," Cooper said.

Cooper believes people are reluctant to undergo colorectal screening. "It hasn't gained the popularity that Pap testing or mammography has. People don't like talking about their bowels, and there is an inherent resistance to get testing done," he said.

There is not enough screening being done, Cooper added. "Screening is potentially a lifesaving procedure. It will either prevent you from getting cancer, or if it does pick up cancer, it will be at an earlier more curable stage," he said.

Cooper suggests that if you haven't been screened before, you should bring it up with your doctor. "There are a variety of different options," Cooper said. The best is colonoscopy. "But there are other tests that may not be as accurate as colonoscopy, but they're certainly better than doing nothing," he noted.

"This is something I see all the time," said Dr. Joseph Martz, an attending physician in the department of colorectal surgery at Beth Israel Medical Center in New York City. "Unfortunately, most people who present with colorectal cancer are presenting with cancer because of bleeding or obstruction."

Although the patients in this study were 70 and older, Martz said the same findings apply to patients 50 and older.

Martz recommends that everyone undergo some form of screening at 50. "However, nothing compares to the gold standard of colonoscopy," he added.

The current recommendation for colonoscopy is to have one every 10 years. "Unfortunately, we know that the polyp-to-cancer progression is between two to five years," Martz said. "My personal recommendation is to have one at least every five years. Patients who have had a history of polyps or a family history of colon cancer should have one every three years."

"It is a problem in this country that screening for colorectal cancer is not well integrated in primary care," said Robert Smith, director of cancer screening at the American Cancer Society (news - web sites).

Early detection not only makes colorectal cancer more curable, but also is likely to prevent a recurrence of cancer, Smith added.

"There needs to be greater emphasis in integrating colorectal screening in primary care," Smith said. "And we are seeing progress in that area."

More information

The American Cancer Society can tell you more about colorectal cancer.

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Sunday, January 9, 2005

 

Oleic Acid Key to Olive Oil's Anti-Cancer Effect

 

By Patricia Reaney

Reuters

Sunday, January 9, 2005

LONDON (Reuters) - Scientists have discovered why eating a Mediterranean diet rich in fruits, vegetables and particularly olive oil can help to protect women from developing breast cancer.

The key is oleic acid, the main component of olive oil.

Dr Javier Menendez, of Northwestern University Feinberg School of Medicine in Chicago, said oleic acid blocks the action of a cancer-causing oncogene called HER-2/neu which is found in about 30 percent of breast cancer patients.

"We have something now that is able to explain why the Mediterranean diet is so healthy," Menendez told Reuters.

Doctors and researchers had been aware that eating a Mediterranean diet reduced the risk of breast cancer and other illnesses such as heart disease. But until now they did not know how.

Menendez and his colleagues in the United States and Spain studied the impact of oleic acid in laboratory studies of breast cancer cells.

"We are able to demonstrate that the main component of olive oil, oleic acid, is able to down-regulate the most important oncogene in breast cancer," Menendez explained.

"The most important source of oleic acid is olive oil."

They found that oleic acid not only suppressed the action of the oncogene, it also improved the effectiveness of the breast cancer drug Herceptin, a targeted therapy made by Swiss drug maker Roche Holding AG that works against the HER-2/neu gene.

Breast cancer patients with HER-2/neu positive tumors suffer from an aggressive form of the disease and have a poor prognosis.

"There is no evidence at all that olive oil is toxic," said Menendez, who reported his findings in the journal Annals of Oncology, explained.

"It is totally safe to consume olive oil," he added.

More than one million cases of breast cancer are diagnosed worldwide each year. In 1998, the disease caused 1.6 percent of all female deaths, according to the International Agency for Research on Cancer in Lyon, France.

Although oleic acid works against the oncogene in a different manner than Herceptin and enhanced the drug's effectiveness.

But Menendez stressed that although the laboratory results are promising, more research is needed. They are hoping to uncover the mechanism by which the acid targets the oncogene and are planning studies of animals with breast cancer to see if a diet high in olive oil can alter the activity of the oncogene and the impact of Herceptin.

"We have a molecular link than can explain why the Mediterranean diet is demonstrating all these benefits," Menendez added.

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Deep Breathing Beats Stress

HealthDayNews

Sunday, January 9, 2005

SUNDAY, Jan. 9 (HealthDayNews) -- Stressed out? Try some deep breathing.

It can help you relax by easing muscle tension, slowing your heart rate, and lowering your blood pressure, says an article in the January issue of Mayo Clinic's Women's HealthSource. As little as five minutes of deep breathing a day can help you feel more calm, refreshed and alert.

The article offers some advice on how to achieve relaxation through breathing:

Practicing deep breathing can help you reduce anxiety, conserve energy, relieve muscle tension, and improve your sleep and concentration, the article noted.

 

More information

 

The American Academy of Family Physicians (news - web sites) has more about dealing with stress.


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Saturday, January 8, 2005

 

Alcohol Increases Co-eds' Risk of Sexual Assault

 

By Holly VanScoy
HealthDay Reporter

HealthDayNews

Sunday, January 9, 2005

SATURDAY, Jan. 8 (HealthDayNews) -- Most women college students are well aware of the dangers of drinking and driving. But there's an equally threatening risk tied to alcohol consumption that may not leap to mind -- sexual assault.

Seventy thousand cases of sexual assault or date rape that occur each year on college campuses are attributable to alcohol use, a federal task force found.

That conclusion is reinforced in a recent study by scientists at the Research Institute on Addictions (RIA) at the University of Buffalo who compared the drinking patterns of college-aged women to their experiences of physical or sexual assault.

On days when women in the study sample drank heavily -- defined as five or more servings of an alcoholic beverage -- they were nine times more likely to experience sexual aggression than on days when they didn't drink at all.

And on days the women consumed fewer than five drinks, their odds of being the victim of some type of attack were still elevated.

"The odds of experiencing sexual or nonsexual aggression were three times higher on days when the women consumed one to four alcoholic drinks than on days when they did not drink at all," said lead investigator Kathleen A. Parks, a senior research scientist at RIA. "Overall, these findings suggest that college-age women have a much greater chance of being a victim of aggression or violence on the days they drink."

The research appeared in the April issue of Alcoholism: Clinical & Experimental Research.

Parks is quick to point out the study was not about blaming women -- whether they drink heavily, moderately or not at all -- for becoming the victim of a sexual assault or aggressive behavior.

"The perpetrators of violence and aggression are the ones responsible for hurting others," she said. "Obviously, women who don't ever drink can also be victimized."

Even so, Parks added, women should be aware of the role alcohol appears to play in creating settings in which victimization is more likely to occur.

"Women can't control their friends' or dates' drinking behaviors, but they can control their own," Parks explained. "When a woman drinks, she may be placing herself in a more dangerous position and, at the same time, she may be reducing her ability to avoid, escape from or counter an aggressive attack. While we are not yet certain about all of the ways that drinking and victimization are related, this presently seems to be a rather strong association."

The findings are consistent with the conclusions of an earlier study of college drinking that was commissioned by the National Institute on Alcohol Abuse and Alcoholism. The institute's Task Force on College Drinking showed that drinking on college campuses contributes to an estimated 1,400 student deaths, 500,000 injuries and 70,000 cases of sexual assault or date rape each year. The results were published in the March 2002 issue of the Journal of Studies on Alcohol.

"The harm that college students do to themselves and others as a result of excessive drinking exceeded what many would have expected," said study author Ralph W. Hingson, a professor of social behavioral sciences at Boston University's School of Public Health. "Our data clearly pointed to the need for better interventions against high-risk drinking in this population."

T.K. Logan is a researcher in the Center on Drug and Alcohol Research at the University of Kentucky. She believes all the evidence to date points to alcohol's negative effect on a woman's ability to make good choices.

"While we are not yet certain about all of the pathways that connect drinking with victimization, that much is already clear," Logan said. "Women do not make the best decisions they are capable of making when they have been drinking. This places them at greater risk of being in a situation they will not be able to control."

"Whether deciding it's fine to walk to their car alone, or accepting a ride from someone she doesn't really know well, or another decision that has an unfavorable result, alcohol can contribute to a woman placing herself in harm's way," she added.

More information

To learn more about alcohol consumption among college students, visit the National Institute on Alcohol Abuse and Alcoholism.

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