The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
February 14, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 15-21

 

 

  1. Heart Attack: Less Treatment May Be Better

  2. Vioxx, Celebrex Were Overprescribed, Study Says
  3. New Colon Cancer Marker Found
  4. Health Tip: Housework Will Keep You Fit
  5. Doctor Report Cards Not Always Clear
  6. Robust DNA Repair May Lower Breast Cancer Risk
  7. New Hope for HIV Treatment
  8. Health Tip: Feel Better About Yourself
  9. Pollutants Blamed for Most Kids' Cancers in UK
  10. Elevated Phosphate Levels a Danger for Kidney Patients
  11. Secondhand Smoke Linked to Cervical Cancer
  12. Veggie Diet May Lower High Blood Pressure
  13. Smoking May Protect Against Parkinson's
  14. Abused Women Less Likely to Have Stable Relationships
  15. Bananas, Root Veggies May Cut Kidney Cancer Risk
  16. Maternal Study Finds Small Divide Between Adults, Teens
  17. Aspirin Doesn't Lead to False-Positive Stool Tests
  18. Update: Grapefruit Juice-Drug Interactions Still Pose Risks
  19. Magnetic Stimulation Alters Brain
  20. Tea Extract More Benefit Than the Brew
  21. Many Birth Defects Can Be Prevented
  22. Poor Physical Performance Linked to Heart Risk
  23. New Breast Imaging Detects Smallest Tumors
  24. Antibody Helps Reverse Alzheimer's Nerve Damage
  25. Health Tip: Exercise Can Stall Effects of Aging
  26. U.S. Birth Raises Asthma Risk for Mexican Americans
  27. Health Tip: Why You Shouldn't Start Smoking
  28. Dual Infection May Cause Serious Lung Disease
  29. Black Americans Undertreated for Esophageal Cancer
  30. Pomegranate Extract Blocks Skin Tumors in Mice
  31. More Monitoring Needed of Kids in California Mental Health Clinics
  32. Plastic Component Boosts Prostate Cancer Cells
  33. Behavior, Diet Therapies Fight Cognitive Decay
  34. Heavy Kids Slow to Recover After Ankle Sprain
  35. New Clues to Tumor Toughness
  36. Daily Drink Improves Thinking in Older Women –Study
  37. Health Tip: Brush Your Baby's Teeth
  38. Fatal Medication Errors Peak at Start of the Month
  39. Health Tip: Keep Your Nails Healthy
  40. Medicare to Pay for More Heart Devices
  41. Faulty DNA Repair Linked to Breast Cancer Risk
  42. Cancer Survival Rates Up in United States-Report
  43. New Guidelines Simplify Care for Acute Coronary Syndrome
  44. Vitamin E May Ward Off Lou Gehrig's Disease
  45. Low-Carb Diets Get New Year's Boost, Survey Says
  46. Non-Alcoholic Beer Could Help Mice Fight Cancer
  47. Anti-Fungus Drug Useful for Sinus Problem
  48. Obesity Death Figures Lowered
  49. Health Tip: Avoid Chewing Aspirin
  50. Folic Acid May Prevent High Blood Pressure
  51. HRT Increases Risk of Gallstone Trouble
  52. Studies Cite Poor CPR Methods in Restarting Hearts
  53. Raising HDL May Limit Heart Disease Progression
  54. Diabetes Linked to Reduced Risk of Prostate Cancer
  55. Vitamin C in Pregnancy Ups Child's Asthma Risk?
  56. Study: Exercise, Diet Help Keep Older Dogs Spry
  57. Absorbable Metal Stent Opens Blocked Leg Arteries
  58. Single Fecal Test Inadequate for Detecting Colon Cancer
  59. Gene Therapy Improves Alzheimer's in Mouse Study
  60. Women May Be Treated Too Aggressively for Stroke
  61. Melanoma Vaccine Triggers T-Cells to Attack Tumors
  62. Dip in Visual Memory Seen Early in Mental Decline
  63. Health Tip: Screening Tests Can Be Lifesavers
  64. More Evidence Found of Painkiller Heart Risks
  65. Health Tip: Evaluating Heart Murmur
  66. Too Much Added Sugar Worsens Kids' Overall Diet
  67. Inappropriate Drugs Can Harm Nursing Home Patients
  68. ADHD Linked to Mom's Iodine Levels
  69. Combo Treatment Slows Cancer Cell Growth
  70. Study: High Blood Pressure in Blacks Not Genetic
  71. Another Clue Explains Smoking Link to Oral Cancers
  72. Best Fitness Routine May Depend on Personality
  73. Researchers Zero In on Genetic Link to Parkinson's
  74. The Thyroid, Cholesterol Connection
  75. Weight-Loss Supplements: Do They Work?
  76. Forgive and Forget -- Stress, That Is

 

Friday, January 21, 2005

 

Heart Attack: Less Treatment May Be Better

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- Someone who has a heart attack or other life-threatening heart condition may be better off going to a general community hospital than to one with a sophisticated cardiology facility, a new, large study finds.

Because the study covers so many countries, some cardiologists are cautioning against drawing specific conclusions.

The study, which covered thousands of incidents from many countries, found the short-term death rate for patients admitted to general hospitals was no different than for those who went to hospitals equipped for catheterization, a procedure in which a very thin tube is inserted into an artery. This is done to get information that can lead to bypass surgery or other invasive treatments.

The research on more than 28,000 patients in 14 countries ranging from the United States to Europe to Australia found that the six-month death rate was 14 percent higher for those admitted to hospitals with catheterization facilities than for patients who went to a hospital without such a facility. The report is in the Jan. 21 online issue of the British Medical Journal (BMJ).

The great majority of patients in the study, 77 percent, were admitted to hospitals with cardiac catheterization facilities.

Patients in the better-equipped hospitals were 10 times more likely to have an invasive procedure such as bypass surgery, the report said; 41 percent of them had such a procedure, compared to 3.9 percent of those in the less specialized hospitals. They were also nearly twice as likely to have a bleeding complication and 33 percent more likely to have a stroke.

"International cardiological societies have developed criteria which are perhaps too liberal with regards to indications for early invasive procedures," said study author Dr. Frans Van de Werf, chairman of the department of cardiology at the University Hospital Gasthuisberg in Leuven, Belgium. "Alternatively, cardiologists may do more invasive procedures than recommended by these guidelines."

Asked whether the most important finding of the study was that someone with an acute heart problem should be taken to the nearest hospital or that invasive procedures are being overdone, Van de Werf replied, "both are equally important."

The study has important implications, not only for decisions in the first minutes when a serious heart problem occurs, but also for follow-up therapy, the journal report said.

"These findings support the current strategy of directing patients with suspected acute coronary syndrome to the nearest hospital with acute-care facilities, irrespective of the availability of a catheterization laboratory, and argue against early routine transfer of these patients to tertiary care hospitals with interventional facilities," the report said.

Asked what a patient or family member could do to influence such a decision, Van de Werf said, "I am afraid not so much can be done by the patients or accompanying people."

The findings must be approached with caution because of the sprawling nature of the study, which included 106 hospitals and a wide variety of patients, said Dr. Sidney Smith, a professor of medicine at the University of North Carolina, and a spokesman for the American Heart Association (news - web sites).

Because the patient population was so diverse, the study is important as a "hypothesis-generating mechanism," Smith said, but it is far from definitive.

"What is needed are randomized clinical trials in which specific groups of patients can be studied," he said. "This study provides fruit for thought, but not the basis for national strategies of care."

More information

The telltale signs of a heart attack or similar emergency and what to do about it are described by the American Heart Association.

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Vioxx, Celebrex Were Overprescribed, Study Says

 

Reuters

Friday, January 21, 2005

CHICAGO (Reuters) - The two popular painkillers Vioxx and Celebrex, heavily marketed as "super-aspirin," were prescribed for millions of patients who did not need them or should not have taken them, researchers said on Friday.

Merck & Co. Inc's Vioxx was recalled in September because a study linked the drug to increased risk of heart attacks and strokes, while Pfizer's Celebrex is under a cloud after data showing a similar heightened risk.

The study by doctors at Stanford University and the University of Chicago found the two COX-2 inhibitors were taken by millions of people who were not at risk of gastrointestinal bleeding, the main reason patients were told to switch from aspirin and other lower-cost painkillers.

COX-2 inhibitors cost 10 to 15 times as much as the drugs they replaced, the study published in the Archives of Internal Medicine (news - web sites) said.

"We found a rapid, nationwide shift away from older, inexpensive drugs with better established safety and efficacy to newer, costly drugs with no real history," said study author G. Caleb Alexander, a medical ethicist at the University of Chicago.

Within a year of being introduced in 1999, Vioxx and Celebrex were being heavily promoted as "super-aspirin" and bringing in billions of dollars in revenue annually, the study said. Merck spent $161 million in 2000 on direct-to-consumer marketing of Vioxx, it said.

Using data from the National Center for Health Statistics, the study concluded that 73 percent of patients considered at low or very low risk of gastrointestinal problems should not have been considered for the newer drugs. Gastrointestinal bleeding usually affects only at-risk patients who must take aspirin and other non-steroidal anti-inflammatory drugs, or NSAIDs, for long periods, it said.

By 2002, 17.6 million patients at low risk of gastrointestinal bleeding, or 66 percent of those patients, were taking one of the two COX-2 inhibitors, the study said.

The drugs were also taken by millions of people who should not have been, including 16 million people suffering from congestive heart failure, or liver or kidney dysfunction. These patients might also have been hurt by NSAIDs, it said.

"The findings demonstrate the challenge of limiting innovative therapies to the settings in which they are initially targeted and maximally cost-effective," Alexander wrote.

The U.S. Food and Drug Administration (news - web sites) is convening a panel next month to examine the COX-2 inhibitors, including Pfizer's new entry Bextra, which has also been found to raise the risk of heart attack in people who have had heart bypass surgery.

Spokesmen for Pfizer and Merck could not immediately comment.

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New Colon Cancer Marker Found

By Serena Gordon
HealthDay Reporter

HealthDayNews

Friday, January 21, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- Harvard researchers have found a new marker that may signal more invasive and lethal forms of colon cancer.

These findings could eventually lead to more targeted treatments and new ways to screen for more aggressive disease, report the researchers.

"If patients had elevated levels [of the marker], their prognosis was significantly worse," said study co-author Richard Bates, an instructor of medicine at Harvard Medical School (news - web sites) and Beth Israel Deaconess Medical Center.

During embryonic development and wound repair, the body normally undergoes a process called epithelial-mesenchymal transition (EMT), according to Bates. Occasionally, during EMT, epithelial cells can transform into tumor cells.

So, Bates and his colleagues induced EMT in colon cancer cells to see what differences they could find. They discovered that a molecule was expressed during EMT in the cancer cells. Because this marker is also released during wound repair, Bates explained, it was the levels of the marker that were critical, not its presence or absence.

The researchers then looked at samples from 488 human colon cancers, and found that elevated levels of the marker were associated with significantly reduced survival time. Those with high levels of the marker had an average survival rate of 4.8 years, while those with low expression of the marker survived an average of 16.5 years.

"This marker might be an attractive therapy candidate. It may be possible to design targeted therapy for invading or malignant tumors," said Bates. Also, he added, "if this marker shows up in early-stage tumors, we know those patients will be at far higher risk of developing metastatic disease and they can be treated more aggressively."

Bates added that because EMT only occurs during fetal development and wound repair, a treatment that interrupts the action of this marker would probably have few side effects.

"This is an interesting, but very preliminary, study," said Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation Hospital in New Orleans. "This marker may help us tell patients early on which ones are at a higher risk of more serious disease and reoccurrence. And it may help us define which patients we may need to treat earlier, and which we may not need to treat right away."

But, he added, the difference in survival rates was not dramatic, and there wasn't information on what types of treatment each patient may have received, which could also affect survival rates.

Bates said what's most important for people to remember is that "early detection is best." And, he added, "We've just come across something that may make early detection even more important."

Results of the study appear in the Feb. 1 issue of the Journal of Clinical Investigation.

Colon cancer is America's fourth leading cancer killer, according to the National Cancer Institute (news - web sites). Each year, almost 105,000 people are diagnosed with colon cancer and more than 56,000 people die from the disease, according to the American Cancer Society (news - web sites).

Risk factors include being over 50, a family history of the disease, a history of polyps in the colon, or having ulcerative colitis or Crohn's disease. Studies also suggest that a poor diet and cigarette smoking may increase your risk of developing colon cancer.

More information

To learn about preventing colon and rectal cancer, go to the National Cancer Institute.

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Health Tip: Housework Will Keep You Fit

HealthDayNews

Friday, January 21, 2005

(HealthDayNews) -- If you're stuck with housework when you'd really rather be at the gym, you'll be happy to learn that you're getting the same workout either way.

According to an article a few years back in the American Journal of Occupational Therapy, vacuuming and cleaning the bathroom both increase the heart rate and produce as much circulatory strain as a period of moderate aerobic exercise at the gym.

And while the amount of strain varies from person to person, vacuuming generally causes more strain than bathroom cleaning does.

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Doctor Report Cards Not Always Clear

 

HealthDayNews

Friday, January 21, 2005  

FRIDAY, Jan. 21 (HealthDayNews) -- Increasingly popular "doctor report cards" don't always provide clear-cut information when comparing quality of care, according to new research from Johns Hopkins Bloomberg School of Public Health.

The study, published in the January issue of The American Journal of Managed Care, compared the usefulness of quality indicators -- such as patient satisfaction or use of correct medications -- for asthma specialists.

Study senior author Dr. Albert W. Wu, an associate professor in the department of health policy and management at Bloomberg, said in a prepared statement that there are a number of difficulties when it comes to grading doctors.

"If all physicians receive the equivalent of an 'A' on a certain indicator, that does not help distinguish between the doctors. For some indicators, it can also be difficult to obtain reliable data from patients. And finally, surveying a doctor who doesn't treat enough patients won't give you an accurate picture of how the physician is performing," Wu said.

He and his colleagues analyzed surveys completed by 2,515 asthma patients at 20 California physician groups. The patients rated the doctors on six quality indicators.

The researchers concluded the patients were able to give reliable answers about the indicators. However, having a sufficient number of patients was crucial to obtaining useful results.

The authors noted that not all quality indicators are equal.

"As doctor report cards become more popular across the country, patients should know that quality of care does vary, but there are clear-cut indicators that can help them determine which doctor to go to," Wu said.

"Our research found that, for asthma patients, the following may be useful indicators to help them select among different doctors: asthma self-management knowledge, use of inhaled steroids, satisfaction with asthma care and self-reported improvement in health status," he noted.

More information

The U.S. National Library of Medicine has advice about choosing a doctor.

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Robust DNA Repair May Lower Breast Cancer Risk

 

By Anthony J. Brown, MD

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - The innate capacity to repair damaged DNA seems to affect a woman's chance of developing breast cancer. Deficient DNA repair appears to triple the risk of breast cancer, researchers have found.

"A lot of studies have looked at the link between DNA repair capacity and lung cancer risk, but few studies have evaluated the association with breast cancer risk," Dr. Regina M. Santella, from Columbia University in New York, told Reuters Health.

Santella's group used various lab techniques to compare the DNA repair capacity of cells obtained from 158 women with breast cancer and from their sisters who didn't have cancer.

The average percentage of damaged DNA that could be repaired was significantly lower in the breast cancer patients than in their unaffected siblings, the investigators report in the Journal of the National Cancer Institute (news - web sites).

Moreover, as DNA repair capacity diminished, the risk of breast cancer rose, with about a 3-fold difference between those with the highest capacity versus those with the lowest.

Santella said these findings could have implications for breast cancer screening. "The ultimate goal is to understand an individual's risk for cancer development so that you can better target screening and prevention efforts."

She noted that the assay used in the present study looked at just one of many DNA repair mechanisms. "At this point, we're interested in conducting a study using an assay that measures a different DNA repair pathway. Looking at the status of several different pathways may give a better estimate of breast cancer risk."

In a related editorial, Dr. Marianne Berwick, from the University of New Mexico in Albuquerque, and Dr. Paolo Vineis, from Imperial College in London, point out that measuring DNA repair capacity is complicated at present. Once simple and rapid assays are available, it may be possible to develop "interventions to reduce cancer incidence and mortality."

Source: Journal of the National Cancer Institute, January 19, 2005.

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New Hope for HIV Treatment

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- An artificial HIV (news - web sites) gene could help in efforts to develop an HIV vaccine, say Duke University Medical Center scientists.

They found the protein produced by an artificial HIV-1 gene called CON6 triggered anti-HIV-1 immune responses in animals. This kind of protein could serve as the basis for vaccines to protect against various HIV strains.

Demonstrating that artificial genes produce biologically functional proteins is a major advance in the development of an HIV vaccine, the researchers said.

"This study is proof that we can induce both cellular and humoral immune responses using an artificial HIV-1 gene. This is a beachhead from which we can move forward in vaccine development," study author Dr. Feng Gao, an associate research professor of medicine, said in a prepared statement.

Cellular immune responses are those made by specialized immune cells called killer T-cells, and helper T-cells. Antibodies circulating in the blood are responsible for humoral immune responses, the researchers said.

The study appears in the January issue of the Journal of Virology.

More information

AIDSinfo has more about HIV vaccine research.

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Health Tip: Feel Better About Yourself

HealthDayNews

Friday, January 21, 2005

(HealthDayNews) -- Women in America are under pressure to measure up to a certain cultural ideal of beauty, which can lead to poor body image, the National Women's Health Information Center says.

On TV and in print, women are bombarded with images of contemporaries who are extremely thin and have flawless features. These images can reinforce an already negative view of a woman's own body.

The Women's Center offers these suggestions to help you feel better:

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Pollutants Blamed for Most Kids' Cancers in UK

By Karla Gale

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - Exposure to high-temperature combustion products and volatile organic compounds before birth and shortly after probably cause most cases of childhood cancers and leukemias, a UK researcher says.

Data from the study suggest that a compound called 1,3 butadiene, which is associated with engine exhausts and is used in the manufacture of synthetic rubber, is particularly hazardous.

"It's likely that the mother inhales the stuff and concentrates it and passes it to the fetus and the placenta," Dr. E. George Knox told Reuters Health.

Knox, at the University of Birmingham, compared places of birth and death in cases of fatal child cancers recorded between 1966 and 1980 to maps of local atmospheric emissions of different chemicals.

His analysis, in the Journal of Epidemiology and Community Health, ties the risk of childhood cancers to polluted "hotspots."

Among non-methane volatile organic compounds, the pattern seen with 1,3-butadiene "strongly suggests a specific association."

This compound "is known to cause cancer in experimental animals," Knox said, "but studies of occupational exposure have produced mixed results."

He added, "Americans are particularly keen on strict control of 1,3 butadiene, but in Britain, official reports are cautious and they are waiting for more data. I'm saying, don't wait any more."

Other emissions associated with significant birth proximity were carbon dioxide, particulate matter, nitrogen oxides, and carbon monoxide (the combustion products of fossil fuels), and benzene, benz(a)pyrene and dioxins.

The researcher's calculations suggest that "most childhood cancers are probably initiated by close perinatal encounters with one or more of these high emissions sources."

Source: Journal of Epidemiology and Community Health, February 2005.

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Elevated Phosphate Levels a Danger for Kidney Patients

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- Elevated phosphate levels may indicate an increased risk of death for people with chronic kidney disease.

That finding appears in a study in the February issue of the Journal of the American Society of Nephrology.

Researchers at the University of Washington in Seattle studied nearly 3,500 people with chronic kidney disease. At the start of the study, all of the patients had recently been checked for blood phosphate levels. Phosphate levels tended to be higher for patients with lower levels of kidney function.

Many of the patients, average age 71, had other health problems such as diabetes or heart disease.

After three years, 56 percent of the patients with the highest phosphate levels were still alive, compared with 67 percent of those in the middle levels and 72 percent of those with the lowest phosphate levels.

The study found that, above 3.5 milligrams of phosphate per deciliter of blood, the overall risk of death increased by 23 percent for every additional milligram increase in phosphate level and the risk of heart attack increased by 35 percent for each milligram increase.

It was already known that high phosphate levels are a risk factor for death for people with kidney failure who require dialysis. In these patients, high phosphate levels result in calcium deposits in large blood vessels, increasing the risk of cardiovascular disease.

This new study is one of the first to focus on phosphate as a risk factor for death among people with chronic kidney disease, a much larger group of patients. More research is needed to determine whether high phosphate levels in these patients are merely a warning sign or actually cause health problems such as heart disease, the researchers said.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about kidney disease.

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Secondhand Smoke Linked to Cervical Cancer

By Anthony J. Brown, MD

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - Exposure to secondhand smoke appears to increase the risk of cervical cancer, albeit to a lesser extent than active smoking, new research shows.

"There was good reason to think that passive smoking might be associated with cervical cancer, given the link with active smoking," Dr. Anthony J. Alberg, from Johns Hopkins University in Baltimore, told Reuters Health.

He noted that studies of cross-sections of different populations have supported the link to passive smoking, but there has been a lack of evidence from forward-looking studies that follow people over a period of time to see who develops cervical cancer.

To address this issue, Alberg's team conducted a study involving nearly 25,000 women who were surveyed about household smoking in 1963 and over 26,000 who were surveyed in 1975. Cancer registry data were analyzed to determine the occurrence of cervical cancer in the two groups up to 15 years after they were surveyed.

The researchers' findings appear in the medical journal Obstetrics and Gynecology.

Exposure to passive smoking increased the risk of cervical cancer by 2.1-fold in the 1963 group and 1.4-fold in the 1975 group. The corresponding increases in risk for women who actively smoked were 2.6- and 1.7-fold.

"The twofold increased risk linked to passive smoking in the earlier cohort is almost too strong," Alberg said. "I suspect the true risk lies somewhere between the risks seen in each cohort, probably closer to the 1.4-fold increased risk. Unfortunately, we don't have a good explanation for why the risks differed so much between the cohorts."

Nonetheless, he added, there is really "no reason why passive smoking shouldn't be associated with cervical cancer if active smoking is."

Source: Obstetrics and Gynecology, January 2005.

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Veggie Diet May Lower High Blood Pressure

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- Vegetarians tend to have lower blood pressure than the general population, but it hasn't been clear whether their diet or their lifestyle guards them against hypertension.

Now, a new review of previously published studies claims that diet provides the protection.

"It's the diet itself, and it is clearly the diet of choice for people who want to get their blood pressure under control," said Dr. Neal D. Barnard, president and founder of the Physicians Committee for Responsible Medicine and co-author of the report, which appears in the January issue of Nutrition Reviews.

Barnard, a nutritionist and author of the book Breaking the Food Seduction: The Hidden Reasons Behind Food Cravings and Seven Steps to End Them Naturally, concluded that a person who suffers from hypertension and has yet to switch to a vegetarian diet is "really trying to fight their condition with one arm tied behind their back."

About 65 million American adults have high blood pressure, according to the National Heart, Lung, and Blood Institute. Hypertension is often called the "silent killer" because it usually has no symptoms but leads to increased risk for heart disease, congestive heart failure, stroke and kidney failure.

Barnard and committee nutritionist Susan Berkow analyzed 80 scientific studies, including observational studies of individuals on vegetarian diets compared with non-vegetarians and randomized, controlled trials in which outcomes of people who switch to a plant-based diet were compared with control subjects.

"The purpose of our review was to bring together what is known about the effect of the diet, but also what we know about the mechanism and try to explain why this occurs," Barnard explained.

Some of the best observational data, according to the report, come from studies involving Seventh-Day Adventists, who advocate an alcohol-free, tobacco-free, vegetarian lifestyle. About 50 percent of Adventists follow a lacto-ovo-vegetarian diet, which includes dairy products and eggs, the authors noted.

One study involving California Adventists found that vegetarians have about half the prevalence of hypertension compared to non-vegetarian Adventists. When hypertensives were defined as those taking medication intended to reduce their blood pressure, a nearly threefold difference in the prevalence of hypertension was seen between the groups.

Overall, the randomized controlled trials included in the review found that blood pressure is lowered when animal products were replaced with vegetable products in both people with normal blood pressure and those who are hypertensive.

To understand the blood-pressure-lowering effects of a plant-based diet, the authors examined changes in body weight and intake of specific food groups and nutrients.

Studies show that vegetarians tend to be slimmer, on average, which may help explain their lower incidence of hypertension. A vegetarian diet also is significantly lower in saturated fat, reducing the viscosity, or thickness, of the blood.

Blood becomes "less like oil, more like water," Barnard explained.

And because vegetarian diets are generally high in fruits and vegetables, people who follow this diet consume more potassium than those who eat a diet of meat and vegetables. The analysis cites two reviews involving a total of 52 randomized clinical trials showing potassium supplementation significantly lowered blood pressure in people with normal and elevated blood pressure.

There are those who disagree with the finding, however.

Dr. Lawrence J. Appel, a nutrition specialist at the Johns Hopkins Bloomberg School of Public Health, said the paper fails to establish a clear cause-and-effect relationship between consuming a plant-based diet and lowering one's blood pressure.

"It's a good review, but there are still unanswered questions," he said.

He also noted that very few clinical trials have been conducted, and that those that have been done are small and not tightly controlled. Much of the data is observational.

So, he said, it remains unclear whether a vegetarian diet alone is responsible for lowering blood pressure or whether some aspect of a vegetarian regimen -- such as eating lots of fruits and vegetables rich in potassium and fiber while maintaining a desirable body weight -- could have the same effect.

And then there there is the fact that not everyone who has high blood pressure eats poorly or is overweight; genetic factors significantly influence a person's risk for hypertension.

Still, Barnard insists a vegetarian diet is healthy for everyone, whether or not they have high blood pressure.

He offers this caveat for people taking blood pressure medication: "Don't throw your medication in the trash." High blood pressure is a serious medical condition requiring immediate medical attention. Even if you switch to a vegetarian diet to trim down, you won't lose the weight overnight, he said. It could take more than a year for a person who is 60 pounds overweight to drop that excess baggage.

Barnard hopes the review will prompt more doctors to recommend a vegetarian diet. Many are reluctant to do because they fear that patients won't stick with it, but there's no reason to believe patients would be less likely to go vegetarian than to comply with other diets, he said.

"They may not hit the mark 100 percent, but they'd do much better if a doctor recommended it," he said.

Barnard's group, the physicians committee, is a Washington, D.C.-based nonprofit that promotes good nutrition, opposes unethical human experimentation and advocates alternatives to animal research.

More information

The National Heart, Lung, and Blood Institute can tell you more about how to lower your blood pressure.

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Smoking May Protect Against Parkinson's

By Will Boggs, MD

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - A study in Swedish twins confirms that smoking is associated with a reduced risk of Parkinson's disease (news - web sites).

"The association in part is explained by genetic influences," Dr. Nancy L. Pedersen from the Karolinska Institute, Stockholm, told Reuters Health. "Hence, further attempts to study risk factors in general for Parkinson's disease should entertain the possibility that there are complex interactions between genetic mechanisms and putative risk factors."

Pedersen and her colleagues investigated the previously reported link between smoking and a reduced risk for Parkinson's by analyzing data from the Swedish Twin Registry.

The authors found that both current smokers and past smokers were less likely to develop Parkinson's disease than people who had never smoked.

The association was stronger in men than in women and the risk of Parkinson's decreased as the number of cigarettes smoked per week increased, the authors note in the Annals of Neurology.

As to the reason for the association, the researchers note that cigarette smoke may contains chemicals that protect nerve cells from damage.

Further analysis showed that neither alcohol nor coffee was associated with Parkinson's disease risk.

"We have not planned any further studies directly, although we may be exploring whether there is a genetic interaction between smoking and certain genes," Pedersen said.

Source: Annals of Neurology, January 2005.

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Abused Women Less Likely to Have Stable Relationships

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- Poor women who've suffered sexual or physical abuse at some time in their lives are less likely to maintain stable intimate relationships, says a study by sociologists at Johns Hopkins University and Penn State University.

The researchers surveyed more than 2,400 black, white and Hispanic women in Chicago, Boston and San Antonio.

Many of the women who'd been abused as adults said they'd decided to avoid marriage or cohabitation, at least temporarily. Women who were sexually abused when they were children were less likely to avoid relationships altogether. Instead, they tended to get involved in a series of short-term, often abusive, relationships.

Fifty-two percent of the women said they'd been physically or sexually abused at some point in their lives and 24 percent said they were sexually abused when they were children or adolescents. Of the women who'd never been abused, 42 percent were married, compared with 22 percent of the women who'd been abused at some point in their lives.

The study appears in the Jan. 21 issue of the American Sociological Review.

There's no evidence that rates of abuse have increased, but the number of women who are postponing intimate relationships may be increasing, study author Andrew Cherlin, the Griswold Professor of Public Policy at Hopkins, said in a prepared statement.

"What's changed over the past few decades is the social context of abuse. Women don't have to stay with abusive men any more because they have alternatives to marriage," Cherlin said.

More information

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

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Bananas, Root Veggies May Cut Kidney Cancer Risk

By Amy Norton

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - People who like their bananas, carrots and beets may have a lower risk of developing kidney cancer than those who turn their noses up at the foods, a large Swedish study suggests.

Some past studies, though not all, have shown that diets rich in fruits and vegetables may help stave off kidney cancer. The new findings, based on dietary information from 61,000 Swedish women, zero in on certain foods -- namely, bananas, root vegetables, salad greens and cabbage -- that may confer such a benefit.

The study found that a high overall intake of fruits and vegetables was related to a lower risk of kidney cancer, though the effect was not significant in statistical terms. There were, however, significant effects when it came to certain foods.

Women who ate bananas four to six times a week, for example, had about half the risk of kidney cancer as those who did not eat the fruit. Regular consumption of root vegetables, including carrots and beets, was linked to a 50 percent to 65 percent decrease in risk.

There are about 190,000 cases of kidney cancer diagnosed worldwide each year. Research has uncovered a number of risk factors -- including smoking, obesity, high blood pressure and occupational exposure to certain chemicals, such as asbestos and cadmium. But studies on diet have been inconsistent.

The new study is the largest to show an association between kidney cancer and fruit and vegetable intake, according to lead author Dr. Bahram Rashidkhani of the Karolinska Institute in Stockholm.

It adds to the body of research, he told Reuters Health, by suggesting that it's the consumption of particular foods, rather than total fruit and vegetable intake, that may matter.

The study, reported in the International Journal of Cancer, included 61,000 women ages 40 to 76 who were followed for an average of 13 years. At the start of the study, the women completed dietary questionnaires, reporting how often during the past 6 months they had eaten various foods. During the follow-up period, 122 women developed renal cell carcinoma, by far the most common form of kidney cancer.

Besides bananas and root vegetables, white cabbage -- widely consumed in Sweden -- and "salad vegetables," including lettuce and cucumber, were linked to a lower cancer risk.

The associations held up when Rashidkhani's team calculated the effects of other factors, such as age, weight and smoking.

Bananas, Rashidkhani noted, contain an especially high amount of antioxidant compounds called phenolics. For its part, white cabbage contains isothiocyanates, chemicals that lab research suggests may fight tumor formation.

There were a number of fruits the study did not consider because of their lack of popularity in the study population; these included peaches, plums, grapes and berries.

And when it came to fruit juice, the researchers found that high intake was associated with a greater risk of kidney cancer. The reason for the link, according to Rashidkhani, is unclear, and it could be just a "chance" finding.

Source: International Journal of Cancer, January 2005.

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Maternal Study Finds Small Divide Between Adults, Teens

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- Adult mothers lavish more affection on their babies than teen moms, who are more likely to focus on instrumental behavior such as tending to their infants' clothes or soothers, says a University of Toronto-led study of maternal behavior.

"While the study is still preliminary, this finding was very surprising," study author Katherine Krpan, currently a doctoral student in psychology, said in a prepared statement.

"We expected to see teen mothers exhibit more inappropriate behaviors towards their babies such as poking and prodding, which has been shown by previous research. Instead, they were behaving appropriately but displayed more instrumental behavior and less affection compared to the adult moms," Krpan said.

She and her colleagues studied 119 mothers in three age groups (15 to 18, 19 to 25, and 26 to 40 years old) who'd all given birth within a three-month span. The mothers were videotaped for 20 minutes as they interacted with their infants in their homes. The mothers also answered questions about their current mood and childhood experiences.

The researchers also said that mothers who had received consistent care as children were more likely to behave affectionately towards their babies than mothers who had varying caregivers when they were children.

The study appears in the January issue of Hormones and Behavior.

More information

The American Academy of Family Physicians (news - web sites) offers these parenting tips.

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Aspirin Doesn't Lead to False-Positive Stool Tests

By Will Boggs, MD

Reuters Health

Friday, January 21, 2005

NEW YORK (Reuters Health) - Patients are usually told not to take aspirin before having a stool test to screen for colon cancer, but that recommendation seems to be unnecessary, a new study shows.

The regular use of aspirin -- or similar painkillers called nonsteroidal anti-inflammatory drugs or NSAIDs -- inhibits blood clotting. This is a benefit for people with a propensity to form clots that can cause strokes or heart attacks, but it does mean that some degree of internal bleeding is more likely. Therefore, blood is more likely to show up in stool, it has been thought.

However, aspirin and NSAIDs do not increase the risk for a false-positive fecal occult blood test -- that is, a finding of blood in stool but no colon cancer -- according to a report in the American Journal of Medicine.

"If patients are able to safely stop their aspirin prior to FOBT (fecal occult blood test) without risk of adverse events and remember to stop it, then that's fine," Dr. Charles J. Kahi from Indiana University Medical Center, Indianapolis, advised.

"But if they cannot do it safely ... or they forget to do so, they can still proceed with collecting the specimens for FOBT while on aspirin without compromising the validity of the results," he told Reuters Health.

Kahi and Dr. Thomas F. Imperiale looked into the question of whether regular use of aspirin or NSAIDs increased the likelihood of a false-positive FOBT result in a study involving 193 veterans. They had all had a positive stool test result, and so underwent a colonoscopy to check for colon cancer.

For nearly 80 percent of the patients, nothing seen on the colonoscopy could explain the positive FOBT result, the authors report.

On the other hand, colon lesions were found in one-fifth of the regular aspirin or NSAID users and in a similar fraction of those using neither type of drug.

After adjusting for age, family history of colorectal cancer, and other factors, the researchers saw no association between regular aspirin or NSAID use and the lack of colonoscopy findings that would explain a positive stool test.

"Our results should not be misinterpreted as showing that positive FOBTs obtained while on aspirin are somehow less valid than positive FOBTs obtained while off aspirin," Kahi cautioned. "Any positive FOBT has to be worked up appropriately until a satisfactory explanation is found."

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

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Update: Grapefruit Juice-Drug Interactions Still Pose Risks

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Friday, January 21, 2005

FRIDAY, Jan. 21 (HealthDayNews) -- American nurses are getting a reminder that grapefruit juice is notable for more than its ability to make you pucker: In some cases, it can spell big trouble for people who take certain prescription drugs.

Grapefruit juice can interfere with the body's absorption of some two dozen medications, from the cholesterol-lowering drug Lipitor (news - web sites) to erectile-enhancing Viagra. While warnings appear in the information given to patients, they're easy to miss, said Amy Karch, a clinical associate professor of nursing at the University of Rochester Medical Center who wrote an article warning about the risks in last month's issue of the American Journal of Nursing.

"A lot of people rely on their health-care providers to alert them to anything that would be really important, but it is so hard to keep up with all of the constantly changing drug information that there probably are doctors who are not aware of the possibility," Karch said.

But don't rush to throw out your carton of grapefruit juice just yet. The fruit itself has gained a reputation as a possible fat-fighter, and one doctor speaking for fruit growers said patients shouldn't overreact when they hear about potential drug interactions.

The risks of grapefruit juice are not new, but many patients don't seem to be aware of it, Karch said.

According to researchers, grapefruit juice affects the production of enzymes in the liver, which is part of the body's filtration system. The liver also metabolizes drugs and, in some cases, the presence of grapefruit juice can boost or diminish the concentration of a drug in the body, strengthening or weakening its effects.

For example, it's conceivable that grapefruit juice could boost the effectiveness of a blood pressure-lowering medication, said Dr. Ken Fujioka, director of nutrition and metabolic research at Scripps Clinic in San Diego. "If you're driving blood pressure too low, patients can get into problems -- they can get lightheaded and pass out."

In her article, Karch tells the story of a 59-year-old retired government auditor who had several risk factors for heart disease, including obesity and high cholesterol. His doctor put him on Lipitor. Meanwhile, the man traveled to his winter home in Florida, and began drinking several glasses of fresh grapefruit juice a day.

The man developed serious kidney problems, and a nurse realized the grapefruit juice may have caused them by boosting the levels of Lipitor in his system. The patient was told to try other medications.

A long list of popular drugs interact with grapefruit juice, including AIDS (news - web sites) medications, the blood thinner Coumadin (warfarin), the antibiotic erythromycin, and the hormones estrogen and testosterone.

"The effect is not just immediate, it may last five, six, seven or 12 hours," Fujioka said. "You may have some differences in terms of where the juice is reconstituted, frozen or fresh. There could be huge variations in the effect it has on drug levels."

The good news is that most drugs don't appear to interact with grapefruit juice, and there are often alternatives to those that do, said Dr. Hartmut Derendorf, a professor at the University of Florida's College of Pharmacy, in a statement provided by the Florida Department of Citrus.

And grapefruit itself may have its own health benefits. Fujioka reported last year that people who ate one-and-a-half grapefruit a day lost more weight than those who consumed grapefruit juice, grapefruit extract or a placebo. "It may reasonable to be looking at grapefruit itself as a better alternative" to the juice, he said.

More information

Public Citizen's Health Research Group has more about potential grapefruit juice interactions.

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Thursday, January 20, 2005

 

Magnetic Stimulation Alters Brain

 

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- Just two minutes of magnetic stimulation can alter the brain for an hour, according to a University of College London (UCL) study in the Jan. 20 issue of Neuron.

The UCL team has been studying methods to improve a technique called transcranial magnetic stimulation (TMS). They're currently exploring the use of their adapted version of TMS as a possible treatment for Parkinson's disease (news - web sites) or stroke.

In this study, the researchers outline how they found ways to improve TMS so that only a brief period of stimulation produces effects on the brain that last for an hour or more.

Longer-lasting effects may enable TMS to be used to modify brain activity in order to treat a wide range of brain problems, ranging from depression to brain damage.

TMS involves the use of a magnetic coil that's held outside the skull. This coil, which can be moved over different parts of the head, creates magnetic fields that induce tiny electrical currents inside the brain. These electrical currents alter the activity of neural pathways, stimulating or inhibiting activity in different areas of the brain.

"Now that we have improved the technique, we can use it to explore whether stimulation of damaged areas in stroke patients' brains can help speed up their recovery," Prof. John Rothwell, of UCL's Institute of Neurology, said in a prepared statement.

"Alternatively, it may be that, in some patients, the 'healthy' side of the brain interferes with recovery by the damaged side, so that another approach would be to reduce its activity and stop it competing for control," he added.

More information

We Move has more about Parkinson's disease.

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Tea Extract More Benefit Than the Brew

 

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - A green tea extract may pack a stronger antioxidant punch than the beverage itself does, new research suggests.

The findings, say the study authors, indicate that a capsule can retain the benefits of tea, without the caffeine.

Green tea extract could therefore be used in clinical trials looking at whether large doses of tea antioxidants can lower the risk of certain cancers, the researchers report in the American Journal of Clinical Nutrition (news - web sites).

A number of studies have suggested that green tea may have health benefits that include a lower risk of heart disease and certain cancers. Researchers suspect the explanation may lie in plant compounds called flavonoids, which are found in tea, wine, and a variety of fruits and vegetables. Flavonoids act as antioxidants, which means they help counter the potentially cell-damaging effects of substances found in the body called oxygen free radicals.

For the new study, Dr. Susanne M. Henning and her colleagues at the University of California, Los Angeles, tested 30 volunteers' absorption of antioxidants from a single, large dose of green tea, black tea or green tea extract in the form of a capsule.

Every participant was given each of the teas and the extract, on three separate occasions. After drinking the tea or taking the capsule, the men and women gave several blood samples over the following 8 hours.

Henning and her colleagues found that while volunteers consumed equal antioxidant doses from the teas and the extract, the latter got more of the antioxidants into their blood.

The findings, according to the researchers, suggest that antioxidants from green tea extract are more easily absorbed, and lead to a "small but significant increase" in antioxidant activity in the blood.

"Our findings," Henning's team concludes, "suggest that green tea extract supplements retain the beneficial effects of green and black tea."

These extracts, they add, could be used in future cancer-prevention research to provide large antioxidant doses without the side effects of caffeine.

Source: American Journal of Clinical Nutrition, December 2005.

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Many Birth Defects Can Be Prevented

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- No matter how deeply a mother cares for her unborn child, there's no guarantee her baby will be born in perfect health. Birth defects are more common than you might think, and they're not always avoidable.

One in 33 infants in the United States is born with a birth defect, according to the National Birth Defects Prevention Network (NBDPN). Although genetic factors play a role, the causes of most birth defects remain a mystery, the group says.

But there are simple steps a woman can take to boost the odds of bearing a healthy child. That's the message the NBDPN wants women, their partners and health-care providers to heed this January, designated as National Birth Defects Prevention Month.

"What we try to do is educate women about having a healthy pregnancy to prevent any type of birth defect," said Denise Higgins, chairwoman of the group's education and outreach committee.

For example, women are advised to take folic acid at least a month before planning to become pregnant. Folic acid, or folate, is a B vitamin necessary for proper cell growth. Studies show it can decrease the risk for neural tube birth defects, including spina bifida, a leading cause of childhood paralysis, and anencephaly, a fatal condition in which parts of the brain and skull cap are missing.

About 2,200 babies are born with neural tube defects each year in the United States, according to the March of Dimes.

It's important to get enough folic acid before becoming pregnant because the neural tube -- the part of the embryo that becomes the brain and spinal cord -- develops in the first couple weeks of pregnancy. Forty percent of American women of childbearing age now get enough of the vitamin to help prevent birth defects, according to a 2004 March of Dimes survey. That's up from 32 percent the previous year -- a sharp increase, but far from the majority.

On Jan. 24, the National Council on Folic Acid is launching National Folic Acid Awareness Week to make people aware of the many benefits of this vitamin.

The U.S. Public Health Service urges all women of childbearing age to take a multivitamin containing 400 micrograms of folic acid every day. Folic acid pills and most multivitamins sold in the United States have 100 percent of the daily value of folic acid, according to the U.S. Centers for Disease Control and Prevention (news - web sites), but women should read the label to be certain.

Women who have previously had a child with a neural tube defect need even more folate: 4 milligrams daily before conceiving and during the pregnancy is recommended, says Dr. Diane Ashton, associate medical director of the March of Dimes.

Women also are advised to abstain from drinking alcohol at any time during their pregnancy. Alcohol can cause fetal alcohol syndrome (FAS), a lifelong condition characterized by abnormal facial features, growth retardation and central nervous system problems. Children with FAS may have physical, mental, social and behavioral problems.

As many as one in 1,000 children born in the United States each year suffers from fetal alcohol syndrome, the NBDPN says. And prenatal alcohol-related conditions, including alcohol-related neurodevelopmental disorder and alcohol-related birth defects, are believed to occur three times as often as fetal alcohol syndrome, the CDC notes.

"There's no healthy amount of alcohol a woman can drink," Higgins cautioned. "We don't know if one drink causes fetal alcohol syndrome or being an alcoholic does, so the message is, 'Don't drink.'"

Studies show even "social drinking" -- a drink or two a week -- may have adverse effects on the fetus, Ashton said. Yet many women are not getting the message. "And it's really important for their health-care provider to be able to convey that information to them," she said.

If you are pregnant, you will most likely have a simple blood test called an alpha fetoprotein (AFP) test to screen for fetal abnormalities, including spina bifida and anencephaly. More invasive testing, including chorionic villus sampling and amniocentesis, is generally reserved for women 35 and older, or whose AFP results suggest a higher risk for birth defects.

Whether women under 35 should request invasive testing depends entirely on their preferences, said Miriam Kuppermann, an associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco, who has studied the cost effectiveness of invasive testing.

"If they are interested, they should request clear information on the likelihood that they are carrying an affected fetus and the miscarriage risk of the procedure, as well as on other testing options," she said. Women who desire such testing should get an appointment with a genetic counselor to review the risks and benefits.

If you're planning to become pregnant, talk to your doctor about any health concerns you have. Women with diabetes and epilepsy, for example, are at greater risk of having a baby with a neural tube defect, Ashton said.

Also, ask your doctor about any medications you are taking. Certain acne and seizure medicines have been linked to birth defects, Higgins explained.

No one should have to suffer the heartache of having a child with a serious birth defect, so prenatal care experts encourage women to discuss any concerns they have with their health-care provider ahead of time.

"Preconception counseling is very important," Ashton said.

More information

The U.S. Centers for Disease Control and Prevention has more about preventing birth defects.

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Poor Physical Performance Linked to Heart Risk

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, January 20, 2005  

THURSDAY, Jan. 20 (HealthDayNews) -- Rats that are carefully bred to have a low ability to exercise have a much higher incidence of the risk factors for heart disease and stroke than those bred to run longer and better, an American-Norwegian study finds.

But that doesn't mean that anatomy (or genetics) is destiny for either rats or people, said Steven Britton, a professor of physical medicine and rehabilitation at the University of Michigan Medical School, and leader of the U.S. wing of the study.

Rather, the part of the study done at the Norwegian University of Science and Technology showed that a relatively brief exercise training program can produce significant improvement in the performance of the low-capacity mice.

The study, whose results appear in the Jan. 21 issue of Science, was designed to look at the underlying molecular factors that lead to an increased incidence of cardiovascular disease for individuals who don't get enough physical activity, Britton said.

He and his colleagues started with 168 laboratory rats that could run for an average of 23 minutes on a treadmill. Then they singled out the 13 males and females who could run the longest and the 13 who pooped out earliest. Each group served as a mating population for the next generation.

Eleven generations later, the researchers had two decidedly distinctive populations -- one group of rats that could run on a treadmill for 42 minutes before they ran out of energy, the other a group whose treadmill time averaged 14 minutes.

Studies showed the low-capacity rats scored higher on cardiovascular risk factors such as high blood pressure, insulin resistance and abdominal fat. Molecular examination of mitochondria, the energy-producing components of cells, showed that the low-capacity rats had abnormally low levels of the molecules needed to promote physical activity.

"Compared to high-capacity rats, the low-capacity rats had lower levels of oxidative enzymes and proteins used by mitochondria to generate energy in skeletal muscles," said Sonia M. Najjar, an associate professor of pharmacology at the Medical College of Ohio, who did the mitochondrial studies.

On the bright side, experiments done by Ulrik Wisloff in Norway showed that training can improve the performance of the low-capacity rats. A six-week training program on the treadmill produced significant improvement in 11 of 12 measures of exercise capacity for the low-capacity rats, although they were still outperformed by their high-capacity cousins.

The idea of the rat studies, which are continuing, is to explore both the genetic and environmental factors that influence exercise performance, Britton said.

"Some people are born with less ability to take up oxygen and transfer energy than others," he said. "These people may have to work harder and will never reach the level of a professional athlete, but almost everyone can improve their aerobic capacity and health status with regular exercise."

"Almost" is a crucial word, Britton noted. "Not everyone has the capacity to respond to exercise training," he said. "Most people do improve, but there is a whole spectrum of responses."

More information

Advice for people who are musing about starting an exercise program is offered by the American Council on Exercise.

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New Breast Imaging Detects Smallest Tumors

 

By Anne Harding

Reuters Health

Thursday, January 20, 2005  

NEW YORK (Reuters Health) - A technique called molecular breast imaging (MBI) is highly sensitive in detecting small lesions and can also spot tumors missed by mammography and ultrasound, researchers report.

The results with the first 100 patients are "just staggering," Dr. Deborah J. Rhodes of the Mayo Clinic College of Medicine in Rochester, Minnesota, told Reuters Health. "This technique really has many, many implications and many potential applications, but we certainly need further studies."

The detection system involves injection of a standard short-lived isotope, which is taken up in breast tissue and preferentially by tumors. The team built a gamma camera specifically designed to pick up the isotope signal and image the breast.

In their article, Rhodes' team describes the results when they tested the detection system with 40 patients. All of the women had small lesions that had been identified on a mammogram as "highly suggestive of malignancy," and were scheduled for needle biopsy.

That showed that 26 of the women had a total of 36 malignant lesions. When they were examined with the MBI system, it detected 33 of the lesions, as well as four lesions missed by both mammography and ultrasound.

The system the researchers developed not only identifies small lesions, they note; it also uses lighter compression than mammography, making it more tolerable to patients.

MBI may be particularly useful in patients with dense breasts, in whom standard mammography is much less sensitive, or women who are at greater risk of breast cancer, the researchers note.

The disadvantages of MBI, they continue, include the necessity of injecting radiotracers and the longer time required (40 to 50 minutes compared to 15 minutes) for the scan. However, Rhodes said her group is developing a new version of their MBI camera that will cut imaging time in half.

On the other hand, MBI has a number of advantages over MRI for detecting breast cancer, according to Rhodes. For instance, while MRI requires radiologists to sift through hundreds of images and interpretation is subjective, with MBI the picture is more clearcut. "There's either an abnormality or there's not," she said.

Source: Mayo Clinic Proceedings, January 2005.

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Antibody Helps Reverse Alzheimer's Nerve Damage

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- Scientists have discovered that an experimental plaque-clearing antibody given to mice with Alzheimer's disease (news - web sites) not only halts nerve damage in the brain but actually reverses some of it.

The study, led by Dr. David H. Holtzman of Washington University School of Medicine in St. Louis, may energize the race to develop a human treatment for Alzheimer's.

Drug developers are focusing on ways to prevent or reduce the build-up of amyloid-beta (Abeta) protein in the brain -- a hallmark of the disease. Those sticky plaques are believed to cause surrounding nerve cells to develop abnormal swellings, or neuritic dystrophy. Until now, no studies had demonstrated the actual effect of plaque-clearing treatments on the nerve cells or the progression of the disease.

"Holtzman and colleagues provide the first evidence that dystrophy is reversible, and that reversibility can be induced with anti-amyloid antibody," said Dr. Samuel Gandy, director of the Farber Institute for Neurosciences of Thomas Jefferson University in Philadelphia, and vice chairman of the National Medical and Scientific Advisory Council of the Alzheimer's Association.

The findings appear in the Feb. 1 issue of the Journal of Clinical Investigation.

Alzheimer's disease (AD) is a progressive brain disorder that eventually destroys a person's memory and abilities to learn, reason, communicate and perform daily activities. Some 4.5 million Americans suffer from it, and by 2050, the number could swell to between 11.3 million and 16 million, the Alzheimer's Association reports.

"One of the predominating hypotheses in the AD field is that Abeta peptide is a major contributor, if not the cause, of the onset and the progression of the disease," said lead author Robert Brendza, a research instructor in neurology at Washington University School of Medicine.

This study, he explained, was meant to provide scientific confirmation that altering amyloid plaques in the brains of mice can elicit a change in nerve damage.

To test the theory, Brendza and his colleagues monitored changes that occurred in live brain cells of mice genetically engineered to develop plaques and neuritic dystrophy and bred to produce a dye that let the researchers obtain detailed images of nerve cell branches. Another dye, a yellow fluorescent protein that sticks to amyloid, was injected in the mice to track brain cell changes.

After showing that the swellings in the nerve cells were mostly stable in number and size over a period of three to seven days, the investigators applied an antibody treatment directly to the surface of the mouse brains, and then they watched to see what would happen.

"Over a three-day period, you do get significant clearance of Abeta deposits, and in that same three-day period we saw like a 20-to-25 percent reduction in the number and size of (the swellings)," Brendza said.

This shows that Abeta deposits are responsible for the nerve damage that occurs in Alzheimer's disease and that some of the nerve damage depends on the continued presence of amyloid beta, he explained. What's more, it shows that at least some of this Abeta-induced nerve damage is reversible.

"It's promising, but it's not the end all, because the thing is we really don't know if all of this nerve damage is reversible," Brendza added. "We know some of it is."

While the study suggests that removing sticky deposits may have at least some benefit, more research is needed to determine whether the approach has similar effects in humans.

More information

The Alzheimer's Association has a fact sheet on beta-amyloid.

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Health Tip: Exercise Can Stall Effects of Aging

HealthDayNews

Thursday, January 20, 2005

(HealthDayNews) -- Many people think physical decline is an inevitable consequence of aging.

Think again, says the President's Council on Physical Fitness and Sports. While there are some factors beyond your control, much of the physical frailty often attributed to aging is the result of an inactive, sedentary lifestyle.

Exercise protects against heart disease and other chronic conditions such as adult-onset diabetes, arthritis, hypertension, certain cancers, osteoporosis and depression.

Research also shows physical activity eases tension and reduces stress. To put it simply, exercise is one of the best ways to stay young and healthy.

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U.S. Birth Raises Asthma Risk for Mexican Americans

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - Mexican Americans who are born in the US are at least twice as likely as those born in Mexico to develop asthma, according to a new report.

Mexican Americans have the lowest rate of asthma among Hispanics in the US. However, the group includes individuals born in the US and in Mexico who might be exposed to different risk factors and, therefore, have different asthma rates.

To investigate, Dr. Fernando Holguin, from the Centers for Disease Control and Prevention (news - web sites) in Atlanta, and colleagues analyzed data from more than 17,000 Mexican Americans who participated in the Third National Health and Nutrition Examination Survey (NHANES III) or the National Health Interview Survey (NHIS).

In both surveys, the rate of asthma among US-born Mexican Americans was around 7.5 percent, whereas the rate among their Mexican-born peers was about 2.7 percent, the investigators report in the American Journal of Respiratory and Critical Care Medicine.

On further analysis, US origin doubled the risk of asthma in NHANES III and nearly tripled the risk in NHIS, compared with Mexican origin.

The researchers also found that the rate of asthma among Mexican-born subjects increased in step with the length of time they had lived in the US.

"US-born Mexican Americans had a higher (rate) of asthma than did Mexican-born Mexican Americans, independent of access to healthcare and other" factors that might explain the relationship, the authors conclude.

"Our study suggests that both place and duration of residency should be considered when interpreting the (rate) of asthma among Mexican Americans."

Source: American Journal of Respiratory and Critical Care Medicine, January 15, 2005.

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Health Tip: Why You Shouldn't Start Smoking

HealthDayNews

Thursday, January 20, 2005

(HealthDayNews) -- The nicotine found in cigarettes and cigars is as addictive as heroin or cocaine, the U.S. National Institutes of Health (news - web sites) (NIH) says.

The more you smoke or chew tobacco, the more your body develops a tolerance for nicotine. That's what gets you hooked. And once you're addicted, it's extremely difficult to quit.

People who start smoking before age 21 have the hardest time quitting, the NIH says, and fewer than one in 10 people who try to quit succeed.

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Dual Infection May Cause Serious Lung Disease

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - Infants who become infected with both respiratory syncytial virus and metapneumovirus are prone to develop severe inflammation of the small airways of the lung, called bronchiolitis, UK researchers report.

Respiratory syncytial virus is a well-known cause of respiratory illness in toddlers, while metapneumovirus -- which was only identified in 2001-- has recently been shown to cause similar problems. The researchers in the current study investigated the effect of simultaneous infection with these viruses.

They found that dual infection was strongly associated with "admission to the pediatric intensive care unit for mechanical ventilation," Dr. Malcolm G. Semple of Royal Liverpool Children's Hospital told Reuters Health.

Bronchiolitis is endemic and peaks in the middle of winter in northern climates, Semple added. "The impact upon UK hospitals at the peak of the epidemic is such that in many pediatric hospitals additional wards are opened or routine surgery is postponed due to the influx of infants with bronchiolitis."

As they report in the Journal of Infectious Diseases, Smple's group studied children under 2 years of age who were hospitalized during the winter of 2001-2002. The team compared the rates of dual infection with respiratory syncytial virus and metapneumovirus among children who were moderately ill and were admitted to general pediatric wards, versus those with severe disease who had to be put on a respirator in an ICU.

Dual infection, the researchers found, conferred a 10-fold greater risk of requiring intensive care unit mechanical ventilation.

Given these findings, Semple said, future research into severe bronchiolitis must look into "multiple virus infection."

Source: Journal of Infectious Diseases, February 1, 2005.

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Black Americans Undertreated for Esophageal Cancer

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- Even though surgery can extend the lives of many people with esophageal cancer, only 25 percent of black Americans have the procedure compared to 46 percent of white patients, a new study reports.

The prognosis for esophageal cancer is poor, with less than 10 percent of patients surviving beyond five years. But surgery to remove the cancer enables approximately 20 percent of patients to survive beyond that time.

"If black patients undergo surgery, their survival is similar to that of white patients undergoing surgery. Yet we found that there was a twofold difference in rate of surgery, and this difference may explain why African-Americans experience a lower rate of survival," said the study author Ewout W. Steyerberg, a Netherlands scientist.

Study co-author Dr. Craig C. Earle, of Boston's Dana-Farber Cancer Institute, added: "There seems to be a problem with access to care for black patients."

The study results appear in the Jan. 20 issue of the Journal of Clinical Oncology.

In the study of 2,946 white patients and 367 black patients with esophageal cancer, 25 percent of the whites were alive two years after diagnosis, compared to 18 percent of the blacks.

The authors suggested that black Americans could have less trust in doctors than white patients do, and that might make them more reluctant to undergo surgery.

However, they wrote, "our finding that survival differed little by race among those who underwent surgery supports the value of intervention to increase the use of surgery among black patients with esophageal cancer."

Stephanie Johnson, a Duke University psychologist who heads a program to reduce the health disparities that exist in the black community, said that historic mistrust of doctors means black Americans often hear a doctor's recommendation differently than a white patient does.

"There are cultural nuances that are included in the decisions that African-Americans make because of the mistrust they have of the medical community," she said. "Physicians often aren't aware of this -- they're just trying to do their jobs."

Steyerberg is a scientist at the Center for Clinical Decision Sciences at the Erasmus MC, University Medical Center in the Netherlands. For the study, he and his Dana-Farber colleagues reviewed Medicare records of esophageal cancer patients whose cancer had not spread. All the patients were at least 65 at the time of diagnosis, and the researchers controlled the study for age, sex, type of esophageal cancer, stage of the disease and other health problems.

Compared to the white patients, the black patients were slightly younger, had less money, and had more preexisting diseases, such as heart disease and diabetes. They also were more likely to have squamous cell cancer, which arises in the middle or upper part of the esophagus. The other common type of esophageal cancer, called adenocarcinoma, begins in the lower part of the esophagus, near the stomach, the researchers said.

Surgery is the most common form of treatment for esophageal cancer, although radiotherapy is also used.

The researchers found that black patients with esophageal cancer were less often assessed by a surgeon than were white patients, 70 percent vs. 78 percent. And of those seen by a surgeon, only 35 percent of the black patients underwent surgery, compared to 59 percent of the white patients.

Despite the fact that the rate of esophageal cancer is three times higher among black Americans than whites, black patients were generally undertreated for their cancer, compared to white patients.

Twenty percent of black patients received radiotherapy as their only treatment, compared to 13 percent of white patients. And 26 percent of black patients received no treatment at all, while 15 percent of white patients were untreated, according to the researchers.

In a related study, researchers at the Department of Veterans Affairs (news - web sites) Medical Center in White River Junction, Vt., reported that adenocarcinoma cancer has increased nearly sixfold in the last 25 years.

The researchers, writing in the current Journal of the National Cancer Institute (news - web sites), found that an estimated 14,000 Americans in 2004 were diagnosed with esophageal cancer, divided fairly equally between squamous cell and adenocarcinoma cancers.

More information

To learn more about esophageal cancer and its treatment, visit the American Cancer Society.

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Pomegranate Extract Blocks Skin Tumors in Mice

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - Pomegranate fruit extract (PFE) can block skin tumor formation in mice exposed to a cancer-causing agent, according to a report in the International Journal of Cancer.

Dr. Hasan Mukhtar and colleagues from the University of Wisconsin at Madison conducted a variety of experiments to test the anti-cancer effects of PFE, a chemical with strong anti-inflammatory and antioxidant properties.

In mice, putting PFE on the skin before exposure to the cancer-causing substance TPA inhibited the skin swelling and excessive cell growth that typically occurs. Moreover, mice treated with PFE developed fewer skin tumors than untreated mice.

Further studies are needed to determine if PFE affects other cancers and whether the findings apply to humans.

Source: International Journal of Cancer, January 20, 2005.

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More Monitoring Needed of Kids in California Mental Health Clinics

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- Problems with documentation of drug responses and child abuse screening and reporting are among the gaps in quality of care for children in California's public mental health clinics, says a University of California, Los Angeles-led study.

Researchers examined the patient records of children treated at the public clinics and identified a number of strengths and weaknesses in quality of care for children with attention-deficit hyperactivity disorder (ADHD) and major depression.

The clinics received high marks for the thoroughness of mental health evaluations on the children. But the study said there was moderate to poor documentation of medical monitoring of psychoactive medications, parent consent for children's medication treatment, recommended contact with schools and other health-care providers, and child abuse screening and reporting.

The study noted that nearly 75 percent of patient records of children receiving psychoactive drug treatment failed to document adequate safety monitoring using vital signs or laboratory results.

"Findings from this study raise serious questions about the documentation of the child's response to medication treatment and the adequacy of medical monitoring," principal investigator Dr. Bonnie T. Zima, a professor in residence of psychiatry and biobehavioral science, said in a prepared statement.

"Our research team looks forward to working with the state and county mental health departments on developing programs to improve the quality of care that children receive and the documentation of that care," Zima said.

The study appears in the February issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

More information

The U.S. National Institute of Mental Health has more about child and adolescent mental health.

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Plastic Component Boosts Prostate Cancer Cells

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - An estrogen-like chemical widely used in the production of plastic food containers called bisphenol A (BPA) can stimulate the growth of prostate cancer cells in the laboratory, cancer researchers have learned.

"These preliminary findings are very interesting," Dr. Karen E. Knudsen of the University of Cincinnati in Ohio told Reuters Health, "and could potentially raise concerns about exposure of prostate cancer patients to estrogen-like chemicals. However, these observations should be validated in other systems before any lifestyle changes should be suggested," she added.

BPA plastics are used in food and drink packaging and resins are used to line food cans, milk containers, and water pipes. Close to one million tons of BPA are produced each year in the US.

Many prostate cancers depend on androgens like testosterone to grow, in which case anti-testosterone hormonal therapy may be given. During hormonal therapy, some tumors develop mutations in a receptor for testosterone called the androgen receptor.

For patients with mutated androgen receptors, exposure to BPA may put them at higher risk for increased cancer cell growth, according to the new study in the medical journal Cancer Research.

"In this study, we showed that cultured tumor cells with this type of mutation can be stimulated to grow by an estrogen-like compound found in certain plastics," Knudsen explained. Moreover, this stimulation takes place "at low, environmentally relevant doses."

The safety of BPA has been debated for several years. Some argue that human exposure to the chemical is not harmful, while others believe that it may promote the growth of human cancer cells.

The current findings as well as others hint that BPA can serve as a potential "hormone sensitizer" of the mutant androgen receptors present in advanced prostate cancers, the researchers note in their report.

Source: Cancer Research, January 1, 2005.

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Behavior, Diet Therapies Fight Cognitive Decay

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- A combination of diet and behavior therapies helps curb the progressive age-related decline in learning ability in beagles, says a University of Toronto-led study in the January issue of the Neurobiology of Aging.

"We were really surprised just how clear-cut the benefits is of using a combined therapy," lead investigator Bill Milgram, a psychology professor who specializes in aging research, said in a prepared statement.

He and his team studied the impact that four combinations of behavioral enrichment and supplementation of diet with antioxidants had on the learning ability of beagles over a period of two years.

The first group of beagles received a regular diet and regular experience, the second group received a regular diet and enriched experience, the third group received an enriched diet and regular experience, and the fourth group received an enriched diet and enriched experience.

The study found that providing enriched diet and enriched experience offered a statistically significant benefit.

"Since humans and dogs have many biological and behavioral parallels, I predict similar results would be attained in people," Milgram said.

More information

The U.S. Administration on Aging has information about aging and mental health.

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Heavy Kids Slow to Recover After Ankle Sprain

Reuters Health

Thursday, January 20, 2005

NEW YORK (Reuters Health) - Six months after spraining an ankle, overweight and obese children are more likely than their peers to still have pain, swelling or weakness, new study findings indicate.

In our study, ankle morbidity following an ankle sprain is a significant problem in children," according to Dr. Nathan L. Timm at the Cincinnati Children's Hospital Medical Center and his colleagues. "However, overweight and obese children report greater symptoms six months after an ankle injury," they add.

The number of people who are overweight has doubled over the past 20 years. Today, nearly 40 percent of children are overweight or obese, research shows.

In the current study, Timm and his team investigated how well obese children recover from an ankle sprain compared with their normal-weight peers.

Their study involved 199 children, aged 8 to 18 years, who were seen in the emergency department following an ankle injury. Eighty-five children were overweight or obese.

Six months after the ankle injury, the overweight children were more than twice as likely as the non-overweight participants to report pain with activity, persistent swelling and weakness, the researchers report in the Archives of Pediatrics & Adolescent Medicine.

Specifically, 44 percent of the overweight group reported such symptoms, in comparison to 26 percent of the normal-weight children. Further, nearly 50 percent of obese children had persistent symptoms at follow-up, in comparison to 29 percent of their non-obese peers.

In fact, the report indicates, the children's risk of experiencing such long-term ankle problems rose in step with increasing body mass index -- a measure of weight that takes height into consideration.

In light of these findings, "it may be most important to target overweight and obese children for close follow-up and rehabilitation after an acute ankle injury," Timm and his colleagues conclude.

Source: Archives of Pediatrics & Adolescent Medicine, January 2005.

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New Clues to Tumor Toughness

HealthDayNews

Thursday, January 20, 2005

THURSDAY, Jan. 20 (HealthDayNews) -- New information about how cancer cells become resistant to treatment is outlined in a study by researchers at Memorial Sloan-Kettering Cancer Center and Johns Hopkins University.

The study found that the protein P-glycoprotein (P-gp), which causes chemotherapy resistance in many forms of cancer, can transfer between tumor cells and maintain its ability to protect otherwise vulnerable cancer cells from the effects of anti-cancer treatment.

This is the first study to show that a protein that moves between cells can retain its function long enough to let recipient cells survive chemotherapy and develop their own resistance. This finding could lead to ways to improve the success of chemotherapy, the researchers said.

The study appears in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

More information

The American Cancer Society (news - web sites) has more about chemotherapy.

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Wednesday, January 19, 2005

 

Daily Drink Improves Thinking in Older Women –Study

 

Reuters

Wednesday, January 19, 2005

BOSTON (Reuters) - Women who enjoy a drink of beer or wine daily have sharper minds into old age than women who abstain, U.S. researchers reported on Wednesday.

The report, based on a study of nearly 12,500 nurses, adds to the apparent benefits of light to moderate drinking, which can also prevent heart disease and stroke.

"Our study suggests that moderate consumption might provide older women some cognitive benefits," said Dr. Francine Grodstein of Brigham and Women's Hospital and Harvard Medical School (news - web sites) in Boston, who worked on the study.

Writing in the New England Journal of Medicine (news - web sites), Grodstein and colleagues said they found that drinkers aged 70 to 81 were 20 percent less likely to experience a decline in their thinking skills over a two-year period than women who did not drink at all.

On average, the women who quaffed a beer or a glass of wine each day tended to have the mental agility of someone a year and a half younger than abstainers.

Drinking more than one glass of beer or wine didn't produce a greater benefit, the researchers said. However, few of the nurses in the study were heavy drinkers.

And it didn't seem to matter whether the women drank wine or beer, according to the team, led by Dr. Meir Stampfer, also of Brigham and Women's Hospital.

Moderate alcohol consumption -- about a 12-ounce (0.35 liters) beer or a six-ounce (0.18 liters) glass of wine -- is already known to reduce the risk of heart disease and stroke.

The Stampfer team speculated that the same effects that ward off cardiovascular conditions may also keep the blood vessels in the brain healthier, preventing small strokes that might impair thinking skills.

The researchers used the ongoing Nurses' Health Study, in which the women filled out questionnaires about drinking habits and took a telephone survey designed to assess thinking skills.

Whether alcohol produces long-term benefits is not known.

In an editorial in the Journal, Dr. Denis Evans and Dr. Julia Bienias of the Rush University Medical Center in Chicago, cautioned that the findings are not conclusive.

It may simply be, they said, "that older persons who are in good cognitive and physical health may be more likely than less healthy peers to indulge in low-to-moderate alcohol consumption as part of their social activities."

(Editing by Tabassum Zakaria; Washington Newsroom 202-898-8300)

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Health Tip: Brush Your Baby's Teeth

 

HealthDayNews

Wednesday, January 19, 2005

(HealthDayNews) -- You should clean your baby's teeth with a soft brush and water as soon as they come in, the U.S. National Institutes of Health (news - web sites) advises.

It's best to clean them each day right before bedtime.

At about age 2, most of your child's teeth will have come in. At this age, you can start brushing them with a small drop of fluoride toothpaste.

For young children who cannot get their teeth clean by themselves, you will need to help them brush. Try brushing their teeth first, then letting them finish the job. And be sure that you put the toothpaste on the brush yourself, using only a pea-sized amount.

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Fatal Medication Errors Peak at Start of the Month

 

Reuters Health

Wednesday, January 19, 2005

NEW YORK (Reuters Health) - Deaths related to medication errors appear to rise sharply during the first few days of each month, suggesting that hectic pharmacies may be at least partly to blame, according to researchers.

Their study of U.S. death certificates for the years 1979 through 2000 found that deaths attributed to prescription-drug errors showed a 25 percent spike in the first week of each month compared with the last week of the month.

No other major cause of death showed such a large calendar-related shift, according the report in the January issue of Pharmacotherapy.

Because other research has documented a glut of prescription medication purchases at the beginning of each month, the new findings point to the possibility that errors at busy pharmacies may be contributing to the monthly spike in prescription-related deaths, according to the study authors.

The early-month buying spree is believed to reflect the timing of government assistance payments to the elderly and poor. Payments in the form of welfare and Social Security (news - web sites) pensions and disability all typically arrive at the start of the month, and many recipients may use these benefits to pay for their medications.

Pharmacies, faced with a sharp upturn in demand, may be more prone to errors -- from putting incorrect information on drug labels to giving the wrong drug altogether -- and pharmacists may have less time to discuss medication precautions with patients, the study's lead author, Dr. David P. Phillips, told Reuters Health.

"We know that pharmacists are unusually busy at the beginning of the month," said Phillips, a sociologist at the University of California, San Diego.

This study, he noted, couldn't reveal the extent to which pharmacists, patients or doctors may contribute to the monthly rise in fatal prescription errors. But, Phillips said, "It's clear that something has broken down," and it's likely that pharmacy errors are at least partly to blame.

He and his colleagues considered certain other explanations -- such as the overall higher use of prescriptions leading to more early-month deaths -- and found these could not explain their findings.

If, for example, prescription use jumped at the start of the month but pharmacy errors did not, then the rise in deaths should be concentrated among low-income patients. But the researchers found no such evidence.

This study, Phillips and his colleagues note, is the first to document such a monthly spike in deaths related to medication errors. The research is based on two decades' worth of death certificates for more than 47 million Americans; however, the authors point out, it is limited by gaps in detail, including specific information about patients and their pharmacies.

Smaller, more detailed studies could help better define the reasons for the monthly increase in fatal prescription errors, according to Phillips.

There are, he noted, some potential ways to address deaths caused by pharmacy errors. Government programs, Phillips said, could spread out payments to the elderly and poor over the course of the month to discourage early-month runs on pharmacies. It might also help, he added, for pharmacists to work fewer hours at month's end, then bump up their hours during the busy first week of the month.

Source: Pharmacotherapy, January 2005.

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Health Tip: Keep Your Nails Healthy

HealthDayNews

Wednesday, January 19, 2005

(HealthDayNews) -- Healthy nails are essential, not only for good looks, but for protecting the health of your fingertips.

The Mayo Clinic offers these suggestions for keeping your nails in tip-top shape:

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Medicare to Pay for More Heart Devices

By Kim Dixon

Reuters

Wednesday, January 19, 2005

CHICAGO (Reuters) - Medicare will soon fund implantable heart devices for thousands more patients, after publication of a landmark study finding the devices can save more lives, top agency officials said in a medical journal on Wednesday.

Results of 2,500-patient trial, which found the devices cut the risk of death in heart failure patients by 23 percent, were published in the New England Journal of Medicine (news - web sites)'s Jan. 20 issue.

Officials at Medicare, the health insurance program for the elderly, said in an accompanying editorial the findings will lead to a major policy shift. The government will now pay for the devices for 500,000 patients, or two to three times more than were previously eligible.

Medicare's blessing is key because of the technology's $25,000-plus price tag. Most patients who get the devices are over the age of 65 and thus qualify for the federal health insurance program for 41 million elderly and disabled.

"Cost is obviously a major incremental expense, but just because a technology is expensive doesn't mean it's not valuable," said Sean Tunis, chief medical officer for Medicare. The agency "is poised to expand its ICD coverage substantially," he said.

The National Institutes of Health (news - web sites) study, funded by manufacturer Medtronic Inc. and drug maker Wyeth, was first presented last year at a major medical meeting. In September, CMS said it would expand coverage, pending the study's publication in a major medical journal.

Medicare had been waiting for the full results and publication before issuing its final decision, which Tunis said is now expected around Jan. 27.

Lifesaving Shock

Implantable cardioverter defibrillators, or ICDs, are pager-sized devices implanted under the skin near the collarbone and connected to the heart with insulated wires. The devices deliver a forceful shock that jolts a racing heart back into normal rhythm.

The trial, called the Sudden Cardiac Death in Heart Failure Trial, or SCD-HeFT, was the first major study to include heart failure patients whose condition was the result of clogged arteries, as well as from a variety of other conditions such as a heart rhythm disturbance,

The 2,521 patient study measured whether ICDs reduce the number of deaths from sudden cardiac arrest in patients with moderate heart failure, when compared with patients who received only conventional drug therapy.

It also tested whether the drug amiodarone could prevent deaths from sudden cardiac arrest, which claims 450,000 lives a year, making it the No. 1 killer in America.

Sudden cardiac arrest is caused by an extreme disturbance in the heart's natural electrical rhythms, as opposed to a heart attack, which typically occurs when the heart muscle does not get enough blood.

In addition to Medtronic, Guidant Corp. and St. Jude Medical Inc. both make ICDs and stand to benefit from expanded reimbursement.

Expanded Coverage

The government currently spends $1 billion per year for some 40,000 ICDs in patients.

"In my practice, Medicare will now pay for 1 in 3, or 1 in 4 patients" who need the device, said Marc Silver, a cardiologist at Raleigh Cardiology Associates in North Carolina, who had patients enrolled in the study.

With the changes, nearly all will be covered, he said.

"A lot of people are waiting for this," he said.

After discussions with doctor groups and manufacturers, Medicare is now likely to pay for the device for very sick patients in a small subgroup that were not included in the original recommendation, Tunis added.

"We are certainly very inclined in that direction," he said.

(Additional reporting by Debra Sherman in Chicago.)

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Faulty DNA Repair Linked to Breast Cancer Risk

HealthDayNews

Wednesday, January 19, 2005

WEDNESDAY, Jan. 19 (HealthDayNews) -- Shortcomings in the capability of cells to repair damaged DNA are linked with increased breast cancer risk, says a study in the Jan. 19 issue of the Journal of the National Cancer Institute (news - web sites).

Previous research suggested that deficiencies in the ability of cells to repair damaged DNA added to the accumulation of DNA damage and sped up genetic changes associated with cancer development.

In this new study, researchers analyzed cell lines in blood samples taken from pairs of sisters. In each pair, one sister had developed breast cancer and the other was free of the disease.

The study found the sisters with breast cancer had much lower DNA repair capacity than the cancer-free sisters. Overall, deficient DNA repair capacity was associated with a two-fold increase in breast cancer risk. Women with the poorest DNA repair capacity had a breast cancer risk three times greater than women with the best DNA repair capacity.

"These data support the hypothesis that deficient DNA repair capacity is associated with susceptibility to breast cancer, and may be a valuable in vitro biomarker to identify high-risk subjects, especially in familial breast cancer families," the study authors wrote.

"It is unclear at this time whether there are any interventions that could alter DNA repair capacity and what effect such interventions might have on risk," the authors wrote.

More information

The U.S. National Cancer Institute has more about breast cancer risk.

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Cancer Survival Rates Up in United States-Report

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, January 19, 2005

WASHINGTON (Reuters) - More Americans than ever before are surviving cancer and rates in general are falling, mostly because fewer people are smoking, the American Cancer Society (news - web sites) reported on Wednesday.

The group predicts that 1.372 million Americans will be diagnosed with cancer in 2005 and 570,280 will die of it. This does not include a million cases of two not very threatening forms of skin cancer called basal and squamous cell carcinoma.

This compares to 1.368 million cases in 2004 and 563,700 deaths. Overall numbers are up from 2005 because the population is growing in size and growing older, the group said, noting that 76 percent of cancer cases are diagnosed in people over the age of 55.

"The death rate from all cancers combined has decreased by 1.5 percent per year since 1993 among men and by 0.8 percent per year since 1992 among women," the group's 2005 report on cancer reads.

"Overall, the major reason for the decline in mortality rates is progress in tobacco control," Elizabeth Ward, director of surveillance research for the group, told a telephone news briefing.

She said smoking causes about one-third of all cancer cases and poor diet and a lack of exercise cause another third.

Cancer is the second-leading cause of death in most developed countries, after heart disease. One in four Americans will die of cancer.

"Death rates for all cancers at all three major sites in men have been decreasing," Ward said, referring to lung cancer, prostate cancer and colon cancer.

But rates of death among men from liver and esophageal cancer have been rising, probably because of obesity, Ward said.

Better detection and treatment have lowered breast cancer mortality, but more cases are being diagnosed.

More cases of colon and cervical cancer are also being detected, but good screening can prevent these cancers or catch them at early, more curable stages.

Thyroid cancer cases are up in women -- the group predicts there will be 19,190 in 2005 compared to 17,640 in 2004. About 860 women will die of thyroid cancer in 2005.

"Reasons for the substantial increase in thyroid cancer among women may include improvements in diagnostic techniques as well as increases in medical radiation exposure," Ward said.

The five-year survival rate for all cancers is 64 percent, up from 50 percent for those first diagnosed in 1976. But the latest data on survival comes from 2000 and rates are probably higher now, the report said.

People need to quit smoking, lose weight and exercise more, Ward said.

Only about 5 percent of all cancers are caused by inherited genetic mutations, Ward said, but there is another preventable cause -- viruses.

"Not many people know that cancers can be caused by infections, but in fact in 2005 it is estimated that 17 percent of new cancers worldwide will be attributable to infections," Ward said.

They include liver cancer caused by hepatitis B and C, cervical cancer caused by human wart virus or HPV, and Kaposi's sarcoma caused by human herpesvirus-8 and seen commonly in AIDS (news - web sites) patients.

In 2005, the American Cancer Society predicts there will be:

-- 232,090 cases of prostate cancer with 30,350 deaths

-- 212,930 cases of breast cancer, with 40,870 deaths

-- 172,570 cases of lung cancer with 163,510 deaths

-- 104,950 cases of colon cancer, with 56,290 deaths

-- 59,580 cases of melanoma, with 7,770 deaths

-- 56,390 cases of non-Hodgkin's lymphoma, with 19,200 deaths.

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New Guidelines Simplify Care for Acute Coronary Syndrome

HealthDayNews

Wednesday, January 19, 2005

WEDNESDAY, Jan. 19 (HealthDayNews) -- New, simplified "alphabet" guidelines for doctors managing patients with acute coronary syndrome are outlined in a study in the Jan. 19 issue of the Journal of the American Medical Association (news - web sites).

This alphabet approach was developed by researchers at Johns Hopkins Medical Institutions. They reviewed medical literature from 1990 to 2004 to identify the most effective and safe management practices for people with acute coronary syndrome (chest pain at rest or with mild exertion).

The new guidelines are based on results from recent clinical trials and on guidelines developed by the American Heart Association (news - web sites) and the American College of Cardiology.

The Hopkins team concluded that once doctors identify patients most likely to benefit from either an early conservative or early invasive strategy, a simple 'ABCDE' approach can be used in a comprehensive management plan.

This approach includes:

"Many doctors think existing guidelines are lengthy and complex, and therefore difficult to implement in the clinic and at home by patients," study senior investigator Dr. Roger S. Blumenthal, director of the Ciccarone Preventive Cardiology Center at Hopkins, said in a prepared statement.

 

An estimated 1.6 million Americans suffer from acute coronary syndrome each year, but less than half get optimal treatment due to the complexity of implementing and monitoring drug treatments and lifestyle changes, Blumenthal said.

 

More information

 

The American Heart Association has more about acute coronary syndrome.

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Vitamin E May Ward Off Lou Gehrig's Disease

Reuters Health

Wednesday, January 19, 2005

NEW YORK (Reuters Health) - Vitamin E supplements may play a role in preventing amyotrophic lateral sclerosis (ALS), the slowly paralyzing condition commonly known as Lou Gehrig's disease (news - web sites), new research shows.

Dr. Alberto Ascherio, of the Harvard School of Public Health, Boston, and colleagues compared the risk of ALS in individuals who regularly took the antioxidant vitamins E and C with people who did not take these vitamins regularly.

Included in the analysis were 957,740 subjects at least 30 years of age who participated in the American Cancer Society (news - web sites)'s Cancer Prevention Study II. Data on vitamin use were collected in 1982, and ALS death rates between 1989 and 1998 were obtained from the National Death Index.

A total of 525 participants died of ALS during the study period.

Mortality rates due to ALS were 62 percent lower among long-term users of vitamin E than non-vitamin-users, the investigators report in the Annals of Neurology.

No significant associations were observed for vitamin C or multivitamin supplement use. Also, occasional use of vitamin E had not effect on ALS risk.

"Oxidative stress appears to act in concert with other mechanisms that have been implicated in the pathogenesis of motor neuron degeneration in ALS," Ascherio's group writes.

The researchers suggest that "vitamin E, by reducing oxidative stress, therefore could influence several downstream events that result in the death of motor neurons."

Source: Annals of Neurology, January 2005.

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Low-Carb Diets Get New Year's Boost, Survey Says

Reuters

Wednesday, January 19, 2005

LOS ANGELES (Reuters) - The number of U.S. consumers on low-carbohydrate diets rose sharply in the first two weeks of 2005, but many Americans are likely to give up the diets as the year progresses, according to a new survey.

In the week of Jan. 10, 15 percent of 1,000 Americans surveyed claimed to be following a low-carb diet such as Atkins or South Beach, according to market research firm Opinion Dynamics. The level is the highest since Opinion Dynamics began tracking low-carb dieting in December 2003.

A survey conducted a month earlier showed 6 percent of consumers claimed to be on low-carb diets, the firm said.

The popularity of low-carb diets, which shun foods like bread and pasta in favor of proteins such as meat and cheese, soared at the beginning of 2004 and prompted major U.S. food companies to make low-carb versions of everything from cereal to cookies.

The craze, however, had died down by the end of the year and sales of low-carb products slowed.

Larry Shiman, vice president of research for Boston-based Opinion Dynamics, said many consumers had taken up the low-carb regimens as part of a New Year's resolution to lose weight.

"Some of these consumers will discontinue the diet as the year progresses," Shiman said in a statement, adding that "it is clear that there is still strong consumer interest in low-carb diets."

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Non-Alcoholic Beer Could Help Mice Fight Cancer

Reuters

Wednesday, January 19, 2005

LONDON (Reuters) - Mystery ingredients in non- alcoholic beer may protect against cancer, at least in mice.

Rodents fed cancer-causing chemicals suffered 85 percent less DNA damage to the liver, lungs and kidneys if also given non-alcoholic beer, compared to mice fed the chemicals but with only water to drink, researchers at Japan's Okayama University found.

Although drinking too much alcohol could increase the risk of certain types of cancer, researcher Sakae Arimoto-Kobayashi thinks unknown ingredients in the non-alcoholic beer prevented the toxic chemicals damaging the DNA.

"If these compounds can be identified, brewers might be able to produce beers particularly rich in them, or they could be added to foods," New Scientist magazine said on Wednesday.

The mice were given only non-alcoholic beer so the researchers could not say if moderate consumption of regular beer would have any benefit.

"The total benefits and risks of beer with alcohol are still under consideration," Arimoto-Kobayashi told the magazine.

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Anti-Fungus Drug Useful for Sinus Problem

By Anthony J. Brown, MD

Reuters Health

Wednesday, January 19, 2005

NEW YORK (Reuters Health) - Treatment with a nasal spray containing the anti-fungal drug amphotericin B reduces the swelling and inflammation that occurs with chronic rhinosinusitis, a common cause of stuffy nose and facial pain, new research shows.

Amphotericin B is an old drug that can cause serious side effects, particularly to the kidneys. However, when given as a nasal spray, the drug does not get absorbed, effectively avoiding these effects, researchers report in the Journal of Allergy and Clinical Immunology.

The findings, which stem from a study of 30 patients, lend weight to the notion that fungi are involved in the development of chronic rhinosinusitis.

In an interview with Reuters Health, lead author Dr. Jens U. Ponikau, from the Mayo Clinic in Rochester, Minnesota, said that fungi appear to play a key role in chronic rhinosinusitis by causing certain immune cells to show up in the mucous layer of the nose. Once there, the cells release toxic compounds that damage the fungi, but also the surrounding nasal tissue.

Still, the hypothesis that fungi are involved in chronic rhinosinusitis is controversial and it remains to be determined why only certain people develop the condition when nasal fungi are so common, Ponikau noted.

He and his colleagues reasoned that if the immune cells are in the mucous membranes because of the fungi, then maybe reducing the fungi would reduce the inflammation caused by the immune cells and "ultimately improve the patient's symptoms."

Compared with inactive "placebo," 6 months of treatment with amphotericin B nasal spray led to a significant reduction in mucous swelling, as determined by CT scans and other tests. Moreover, such therapy seemed to reduce the number of immune cells present.

"These findings have completely changed the way we approach sinusitis patients at Mayo," Ponikau noted, adding that "thousands of chronic rhinosinusitis patients are now being treated with antifungals."

Larger studies will begin later this year, he said.

Source: Journal of Allergy and Clinical Immunology, January 2005.

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Tuesday, January 18, 2005

 

Obesity Death Figures Lowered

 

Reuters

Tuesday, January 18, 2005

CHICAGO (Reuters) - A widely reported study released earlier this year overstated the increase in obesity-related U.S. deaths by about 35,000, a U.S. government health agency said on Tuesday in admitting the miscalculation.

"Through an error in our computations we overestimated the number of deaths caused by poor diet and physical inactivity," the Centers for Disease Control and Prevention (news - web sites) said.

"Our principal conclusions, however, remain unchanged: tobacco use and poor diet and physical inactivity contributed to the largest number of deaths, and the number of deaths related to poor diet and physical inactivity is increasing," it added.

The correction was published in the Journal of the American Medical Association (news - web sites), where the original report appeared in March 2004.

In the statement the agency said the number of obesity-related deaths in 2000 increased by 65,000 over 1990 levels, not 100,000 as originally calculated.

The original study originally concluded that in 2000 there were nearly as many obesity-related deaths, at 400,000, as there were deaths related to tobacco use, at 435,000.

It said at the time this provided evidence that obesity could overtake tobacco use as the leading cause of preventable U.S. deaths. The correction did not address that projection except to say the principal conclusions remained unchanged.

The CDC launched an internal review of the study after researchers criticized its methodology in letters published in the journal Science.

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Health Tip: Avoid Chewing Aspirin

 

HealthDayNews

Tuesday, January 18, 2005

(HealthDayNews) -- Aspirin may relieve pain and protect against heart disease, but habitual users who chew it could pay a hefty price, according to the American Dental Association.

Daily chewing of aspirin over time can cause significant damage to both the hard and soft tissues of the mouth, according to researchers from the University of Maryland Dental School in Baltimore.

The scientists noted two cases of enamel erosion that were attributed to daily chewing of aspirin tablets on a long-term basis. Both patients needed extensive dental treatment.

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Folic Acid May Prevent High Blood Pressure

 

Reuters

Tuesday, January 18, 2005

CHICAGO (Reuters) - Folic acid supplements, widely used by women to prevent birth defects, also may fight hypertension in women, perhaps because they relax blood vessels, researchers said on Tuesday.

Folic acid occurs naturally in substances such as orange juice and leafy green vegetables and is added to some products, but only high-dose supplements seem to affect blood pressure, the report said.

"This is the first major study to show an association between folate intake and prevention of high blood pressure," said John Forman, a physician and researcher at Brigham and Women's Hospital in Boston who led the study.

"While the findings are encouraging, we are not yet ready to recommend that women start increasing their folate intake until more research is conducted," he added.

The study, published in this week's Journal of the American Medical Association (news - web sites), was based on data from thousands of nurses whose health histories were tracked for years.

Among 93,803 women aged 27 to 44, those who consumed at least 1,000 micrograms a day of total folate -- in foods and supplements -- had a 46 percent decreased risk of hypertension compared with those who consumed less than 200 micrograms a day, the study found.

In a second group of 62,260 women aged 43 to 70, those with a high total folate intake had an 18 percent reduced risk of hypertension, it added.

None of those studied had a history of high blood pressure when the study started. It also was not known if the supplement would help men.

For women in the study who did not use any folic acid supplements, getting the substance from foods alone failed to lower the risk of high blood pressure, the study found.

Folic acid supplements of at least 400 micrograms per day are recommended for women before and during pregnancy to prevent neural tube defects, severe fetal growth problems afflicting the brain and spinal cord that often result in stillbirths.

Forman said the substance may help women reduce their risk of developing high blood pressure because of it relaxes blood vessels and eases blood flow.

"The prospect that folate has the potential to protect against high blood pressure is exciting given that the vitamin is both readily available and safe," he said. "The next step will be a randomized controlled trial comparing women given either folic acid supplements or placebo."

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HRT Increases Risk of Gallstone Trouble

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, January 18, 2005

TUESDAY, Jan. 18 (HealthDayNews) -- In yet another piece of bad news for hormone replacement therapy, researchers report that postmenopausal women taking estrogen therapy face an increased risk of gallbladder disease and surgery.

The effects were seen whether or not the women were also taking progestin.

This is the first time the effect had been seen in a randomized, double-blind study, considered the gold standard for scientific research.

"My own personal view is that the association is causal," said study co-author Dr. Robert B. Wallace, a professor of epidemiology at the University of Iowa College of Public Health. "This is the most persuasive level of evidence."

The findings, which appear in the Jan. 19 issue of the Journal of the American Medical Association (news - web sites), essentially mean that women considering hormone therapy now have one more thing they need to factor into their decision.

Some 10 percent to 15 percent of the U.S. population experiences gallstones in the gallbladder, with 1 million new diagnoses every year.

"Gallbladder disease is very common in this country," said Dr. Taylor Wootton, chairman of the clinical practice and economics committee of the American Gastroenterological Association. "Close to 1 million people have their gallbladder removed each year."

Previous observational studies had shown an association between estrogen and gallstones, but those studies lacked the weight of a randomized, double-blind study.

For this study, the researchers looked at more than 22,000 women aged 50 to 79 who participated in the Women's Health Initiative (WHI), the largest randomized, double-blind study of hormone use in postmenopausal women. None of the women had had their gallbladder removed.

The women were divided into two initial groups. Women who had undergone hysterectomies were randomized to receive either estrogen or a placebo. Women without a hysterectomy were randomized to receive estrogen plus progestin or a placebo.

The study was funded by the National Heart, Lung, and Blood Institute, with Wyeth-Ayerst Research Laboratories providing the drug and the placebo.

The women in the estrogen-only group were followed for a mean of 7.1 years, while the women in the estrogen-plus-progestin group were followed for a mean 5.6 years.

Women taking estrogen or estrogen plus progestin had a higher risk of gallbladder disease or surgery: a 67 percent higher risk with estrogen alone and a 59 percent increased risk with the combination.

The risk for inflammation of the gallbladder was 80 percent higher with estrogen and 54 percent higher with the combination. The risk for gallstones was 86 percent higher with estrogen and 68 percent higher for the combination.

Women taking estrogen alone were 93 percent more likely to have their gallbladder removed, while those taking the combination were 67 percent more likely to undergo this procedure.

Overall, the authors calculated that 323 women would need to take estrogen each year and 500 would have to take estrogen plus progestin to cause one excess adverse outcome.

The link between gallstone formation and estrogen is not entirely clear. "We don't know exactly because estrogen has so many bodily effects. Estrogen has the ability to have some physiological effect on almost every organ and system," Wallace explained.

The most likely effect, he added, is that estrogen changes the nature of bile so that it's more saturated, thereby leading to stones that block the gallbladder and duct, which in turn may lead to inflammation.

"It's not all that surprising. The question is, what do we do with this information," Wootton said. "If they are symptomatic, I would imagine most women are going to take the hormone replacement therapy. It's an increased risk, but it's not fourfold."

Still, any risk needs to be discussed with a physician. "Every time you prescribe any medication, the good and the bad needs to be discussed in a good doctor-patient relationship," Wootton pointed out.

"This isn't a fatal illness and may be a little less important, but it is important to people who have to go through surgery and convalescence, and the costs and disability that come with it," Wallace said.

More information

The National Institute of Diabetes and Digestive and Kidney Diseases has more on gallstones.

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Studies Cite Poor CPR Methods in Restarting Hearts

 

Reuters

Tuesday, January 18, 2005

CHICAGO (Reuters) - Many caregivers perform CPR incorrectly and fail to restart stopped hearts by not adhering to strict guidelines governing the frequency and force of chest compressions, a pair of studies said on Tuesday.

Poor and outdated training or overly complicated instructions in cardiopulmonary resuscitation (CPR) for paramedics, nurses and doctors may be to blame.

One solution may be mechanical monitors to aid caregivers to adjust their technique, one researcher suggested.

One study of heart attack victims in Stockholm, London and Akershus, Norway, found that paramedics and other caregivers failed to begin CPR quickly enough in nearly half the cases, which occurred outside the hospital.

When CPR was performed, the number of compressions were often applied too quickly -- the number should be between 100 and 120 per minute -- and less than one-third of the compressions were done with the requisite force. Also, breaths were often applied too frequently, said study author Lars Wik of Ulleval University Hospital, Oslo.

Sixty-one of the 176 patients, or 35 percent, had their heartbeats restarted and circulation resume, which must occur within a few minutes to avoid brain damage. The other 65 percent of the patients could not be revived and died.

Lives are lost when CPR is applied incorrectly in terms of the number and force of chest compressions and breaths into the victim's mouth, researchers writing in the Journal of the American Medical Association (news - web sites) said.

"Current resuscitation guidelines are not being followed," wrote Arthur Sanders and Gordon Ewy, doctors at the University of Arizona College of Medicine, in Tucson.

"In the past such inadequacies have been dismissed as an education (or) training problem. But perhaps it is not a question of how well rescuers are being taught and learn the material. In reality, the training courses for health care professionals get more complex with each revision of the guidelines. Some of the skills taught, such as two breaths in five seconds, are impossible to deliver," said their editorial commenting on the two studies.

In the other study of 67 heart attack patients at the University of Chicago Hospitals, 27 patients were revived. But university researcher Benjamin Abella said 28 percent of the time the compressions were applied too slowly, 37 percent of the compressions were not deep enough, and 61 percent of the breaths were given too frequently.

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Raising HDL May Limit Heart Disease Progression

 

By Megan Rauscher

Reuters Health

Tuesday, January 18, 2005

NEW YORK (Reuters Health) - For people with low levels of "good" (HDL) cholesterol and coronary disease, treatment aimed at increasing HDL levels is worthwhile, researchers report.

Dr. Richard A. Krasuski told Reuters Health that when patients' HDL was increased in a study, "we had direct evidence that not only did coronary plaques stop progressing but they actually regressed."

In addition, "the risk of heart events went down by 52 percent."

Krasuski, from the Wilford Hall Medical Center at Lackland Air Force Base in Houston, Texas, and his colleagues studied 143 retired military personnel with heart disease and low HDL who were randomly assigned to inactive "placebo" treatment or aggressive HDL-cholesterol-raising therapy with gemfibrozil, niacin, and cholestyramine for 30 months. They also received diet and exercise counseling.

Individuals in the active treatment arm had a 20 percent decrease in total cholesterol, a 36 percent increase in HDL cholesterol, a 26 percent decrease in LDL ("bad") cholesterol, and a 50 percent reduction in triglycerides, compared with the placebo group.

Narrowing of the coronary arteries improved by 0.8 percent in individuals on active therapy and worsened by 1.4 percent in those on placebo, the team found.

Moreover, significantly more individuals on placebo than on active therapy experienced events such as a heart attack, stroke or the need for heart surgery (26 percent vs 13 percent).

Side effects such as flushing and stomach upsets were reported more often with active therapy "but rarely led to withdrawal from the study," the investigators report in the Annals of Internal Medicine.

They point out that it is not known whether the improvements were due to reductions in LDL or increases in HDL cholesterol. Nonetheless, Krasuski told Reuters Health that he believes this study is "extremely important."

"We know very well that lowering LDL makes plaques in arteries smaller and reduces the risk of heart attacks, stroke and death. We also know that naturally having higher levels of HDL is good for patients and places them at lower risk of heart disease," he explained.

"Previous studies focusing on heart disease patients have shown that raising HDL with medications either stop plaques in the arteries from getting larger or prevents heart events, but no previous study focusing on HDL has shown both -- until this study. Our study finally ties this together," he said.

Krasuski said he "strongly believes that HDL will soon become an important target in the treatment for patients with cardiovascular disease."

Source: Annals of Internal Medicine, January 18, 2005.

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Diabetes Linked to Reduced Risk of Prostate Cancer

Reuters Health

Tuesday, January 18, 2005

NEW YORK (Reuters Health) - Men with type 2 diabetes seem to be less likely to develop prostate cancer, overall, a new study indicates.

"One previous study has suggested that diabetes may decrease risk of prostate cancer but only several years after diagnosis of diabetes," Dr. Carmen Rodriguez and colleagues from the American Cancer Society (news - web sites) in Atlanta note in the American Journal of Epidemiology.

The researchers examined the relationship between the time of diabetes diagnosis and the risk of prostate cancer among some 72,000 men enrolled in the Cancer Prevention Study II.

Subjects completed a mailed questionnaire regarding information on diabetes at the beginning of the study in 1992 and at follow-up in 1997 and 1999.

By 2002, a total of 5318 men had been documented with prostate cancer, while a total of 10,053 men reported a physician-diagnosis of diabetes.

"Diabetes was associated with lower prostate cancer incidence rates after adjustment for age, race, education, and prostate-specific antigen testing," the researchers report.

Men who were diagnosed with diabetes within the last three years had slightly higher rates of prostate cancer compared to non-diabetic men, but those who had diabetes for at least four years had a one-third lower rate of prostate cancer.

"Our results are consistent with the hypothesis that risk of prostate cancer differs by time since diagnosis of diabetes," Rodriguez's team concludes.

As for why this occurs, they suggest several possibilities. Insulin seems the be strongest candidate, since insulin levels rise in the early stages of diabetes then drop to abnormally low levels later in the course of the disease. This pattern, along with related fluctuations in other hormones, might first promote then deter prostate cancer.

Source: American Journal of Epidemiology, January 15, 2005.

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Vitamin C in Pregnancy Ups Child's Asthma Risk?

Reuters Health

Tuesday, January 18, 2005

NEW YORK (Reuters Health) - While women who take vitamin E during pregnancy seem to lower their offspring's risk of asthma in early childhood, intake of vitamin C may actually raise the risk, according to a recent study by Scottish researchers.

Several reports have linked vitamin E with an apparent protective effect. By contrast, the vitamin C finding is novel and runs counter to previous reports that suggest, at the very least, no effect and possibly a reduced risk of asthma, the investigators report in the American Journal of Respiratory and Critical Care Medicine.

Dr. Sheelagh Martindale and colleagues, from the University of Aberdeen, stand by their findings and the research methods, but acknowledge that confirmatory studies are needed before any recommendations can be made to pregnant women.

The researchers surveyed nearly 2000 healthy women to determine the impact of vitamin intake during pregnancy on the risk of asthma and eczema in the first two years of life.

Neither vitamin C nor vitamin E was associated with the risk of asthma or eczema at 1 year of age, the researchers point out.

As noted, the risk of wheezing at 2 years of age fell as vitamin E intake during pregnancy rose. Moreover, among mothers with allergies, such intake was linked to a reduced risk of eczema for their infants.

In contrast, wheezing and eczema risks at age 2 climbed as vitamin C intake during pregnancy increased. For example, the highest level of intake tripled the risk of wheezing compared with the lowest level.

"Further follow-up of these children will be used to assess whether the associations reported here persist into later childhood and to explore the possibility that any associations may be modified by childhood diet," the investigators state.

Source: American Journal of Respiratory and Critical Care Medicine, January 15, 2005.

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Study: Exercise, Diet Help Keep Older Dogs Spry

Reuters

Tuesday, January 18, 2005

WASHINGTON (Reuters) - Exercise and a diet fortified with vitamins, fruits and vegetables helped older dogs learn new tricks and kept them spry in an experiment that scientists said could teach humans a thing or two.

Beagles given either the fortified diet, regular exercise or both did much better in learning new tricks than dogs fed regular chow and allowed to lie around more, the researchers reported Tuesday.

Dogs are similar to humans in their dietary needs and the way they digest food, so the findings have implication for people, said Molly Wagster of the National Institute on Aging, which funded the study.

Dogs also can develop memory and learning problems as they age in much the same way people do.

"This research brings a note of optimism that there are things that we can do that may significantly improve our cognitive health," Wagster said in a statement.

"The combination of an antioxidant diet and lots of cognitive stimulation -- which was almost the equivalent of going to school every day -- really did improve brain function in these animals," added Elizabeth Head of the University of California Irvine, who worked on the study.

"We're excited about these findings because the interventions themselves are relatively simple and might be easily translated into clinical practice for people."

For the study, Head, William Milgram of the University of Toronto in Canada and colleagues studied 48 older beagles over two years.

Writing in the journal Neurobiology of Aging, they said they divided the dogs into four groups that got either standard care; a diet supplemented with tomatoes, carrot granules, citrus pulp, spinach flakes and supplements; standard care plus extra exercise and play; or the special diet and the special play and exercise regime.

A second set of 17 dogs aged 1 to 3 got either a standard or fortified diet.

Tests included having to find a hidden treat. The older dogs clearly benefited from the special diet and the special exercise program, the researchers said.

All 12 of the older beagles that got a supplemented diet and exercise could solve a difficult problem, compared to eight of 10 dogs that got the enriched diet alone and two of eight dogs that got no special treatment.

Last week the U.S. government issued new guidelines that encouraged Americans to eat more fruits and vegetables and to exercise for at least an hour a day to improve their health.

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Absorbable Metal Stent Opens Blocked Leg Arteries

By Megan Rauscher

Reuters Health

Tuesday, January 18, 2005

NEW YORK (Reuters Health) - Initial results with a bio-absorbable metal stent show that the novel device works as intended -- to prop open blocked leg arteries before being fully absorbed into the artery wall, so that complications common with standard stents don't occur.

The absorbable stent is a "temporary solution for a temporary problem," explained Dr. Koen Deloose, from A. Z. Sint-Blasius Hospital in Dendermonde, Belgium.

At a symposium in Miami Beach, Deloose reported results with the device in 20 patients at risk for leg amputation because of blocked blood-flow below the knee.

"After one year, 17 patients are still alive and the primary patency rate is 72 percent, which is amazing," Deloose said in a telephone interview with Reuters Health.

"Most importantly, the limb salvage rate is almost 95 percent," he added.

The problem with existing stents, he explained, "is that after a month when the positive remodeling process of the vessel is complete the stent is no longer needed and it creates some irritation and chronic inflammation."

This can lead to reblockage of the artery, "so we need a good stent giving support followed by gradual absorption so that the physical irritation and chronic inflammation is avoided."

The absorbable metal stent seems to fit the bill, according to early results.

Within the next month, a multicenter clinical trial comparing the absorbable metal stent to angioplasty alone in 120 patients will get underway, Deloose said. Researchers in Europe have also begun testing the stent in the coronary arteries of 19 patients, and preliminary results are expected later this year.

The absorbable stent, which is made of an alloy of 90 percent magnesium and 10 percent rare earth elements, is manufactured by Biotronik, Inc., a private German company with a US subsidiary in Lake Oswego, Oregon.

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Monday, January 17, 2005

 

Single Fecal Test Inadequate for Detecting Colon Cancer

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Monday, January 17, 2005

 

MONDAY, Jan. 17 (HealthDayNews) -- A single fecal blood test doesn't detect likely cases of colon cancer nearly as well as a six-pack home test does, yet many doctors continue to rely on the single test.

That's what two large-scale studies by separate research teams -- one looking at the effectiveness of fecal occult blood tests and the other studying how doctors actually use colon cancer screening techniques in their practices -- report in the Jan. 18 issue of Annals of Internal Medicine.

Fecal occult blood tests are used to look for blood in the stool, which can be an indication of colon cancer.

The first study, involving more than 2,500 people, compared the accuracy of two different fecal occult blood tests: a single office-collected stool sample and the six-sample, home-collected test. The home test was far superior, detecting 23.9 percent of likely cancers versus 4.9 percent for the office test.

Despite these differences, a survey of more than 12,000 doctors and patients found that one-third of the doctors still relied solely on the office test rather than sending the six-sample test home with their patients.

"Colon cancer is one of the most important causes of death from malignancy, and after the age of 50, it's important to screen for cancer and polyps," said Dr. Harold Sox, editor of the Annals of Internal Medicine. "Talk about it with your doctor and don't settle for the single-sample test done in the office. Insist upon the six-sample fecal occult blood test."

One of the reasons doctors still rely so heavily on the single test is because there had been no good comparison of the tests until now, Sox added, and doctors may have believed that the single test was as accurate as the home test.

"As far as I know, this is the first very high-quality study that shows the poor performance of the single-sample test," Sox said. "I hope that when doctors read about this study, they'll realize that the single sample in-office approach isn't the right way to go."

The study included 2,665 people from 13 different Veterans Affairs Medical Centers. They were between the ages of 50 and 75, and nearly all were men. None had symptoms of colon cancer.

All of the study volunteers underwent a physical exam and had a single-sample test taken at that time. They were also asked to provide fecal samples for the six-sample test. Finally, they all had colonoscopies, a procedure in which a thin, flexible tube with a light and camera attached to it is inserted into the rectum. The images are then sent back to a monitor so the doctor can view the inside of the colon.

Two hundred and eighty four people had "serious" polyps, which often turn into cancer, said study author Dr. Judith Collins, section chief of gastroenterology at the Veterans Affairs Medical Center in Portland.

The six-sample test accurately predicted those precancerous polyps almost 24 percent of the time, while the single-sample test only found 4.9 percent.

"This is an education issue for both patients and physicians," said Collins. She added that she thinks many doctors use the office test because they thought it was as reliable as the six-sample test, and they were doing the rectal exam for other reasons. And, she said, patient compliance is also an issue.

In the second study, researchers interviewed more than 1,100 primary-care physicians about their colon cancer screening practices. They also interviewed more than 11,000 people over age 50 who were eligible for colon cancer screening to see what types of screening had been performed.

About 25 percent reported having a fecal occult blood test. One-third of those had the in-office test only. Ninety percent of doctors said they used fecal occult blood testing at least once a month and one-third said they relied only on the in-office test.

Ten percent of the patients said they had abnormal fecal occult blood tests, but fewer than 50 percent were referred for further testing.

While the six-sample test was better than the single test, screening guidelines recommend not relying on either test alone. The American Cancer Society (news - web sites) recommends an annual fecal occult blood test, plus a flexible sigmoidoscopy every five years, or a colonoscopy every 10 years.

"Colon cancer screening can prevent cancer and save lives," Collins said.

More information

To learn more about colon cancer screening recommendations, go to the American Cancer Society.

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Gene Therapy Improves Alzheimer's in Mouse Study

 

Reuters Health

HealthDayNews

Monday, January 17, 2005

NEW YORK (Reuters Health) - Gene therapy might one day be an effective treatment for Alzheimer's disease (news - web sites), new experiments in mice suggest.

The study found that gene delivery of a human protein called apolipoprotein E2 (apoE2) helped cut down amyloid-beta deposits in the brains of mice. The deposits are the hallmark of Alzheimer's disease.

"Gene therapy offers the opportunity to influence the progression of this horrible disease," Dr. Inder M. Verma, who led the study, told Reuters Health.

Apolipoprotein E latches on to fats and clears them from the bloodstream. It is also found in the brain, where it is thought to perform a similar function by getting rid of unwanted substances.

People produce different forms of apolipoprotein E, and studies have shown that those with apoE2 tend to be protected against Alzheimer's disease, whereas those with apoE4 are more likely to develop the disease.

Verma, who is based at The Salk Institute in La Jolla, California, and his colleagues investigated whether gene delivery of apoE2 could directly affect the deposits of amyloid-beta in mice that had been genetically altered to develop Alzheimer's disease.

ApoE2 gene therapy resulted in a 30 percent to 50 percent reduction in amyloid-beta in the mice's hippocampus, a region of the brain that helps control memory.

Verma and his colleagues reported their findings in the January 25 issue of the online journal Proceedings of the National Academy of Sciences (news - web sites) Early Edition.

The team also plans to conduct additional studies in other animals. They hope to discover exactly how the treatment works to affect the amyloid-beta deposits.

Source: Proceedings of the National Academy of Sciences Early Edition, January 25, 2005.

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Women May Be Treated Too Aggressively for Stroke

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- Women at risk for stroke may be treated too aggressively, a new study suggests.

The problem, said lead researcher Dr. Anthony Comerota, lies in the interpretation of a standard test called the duplex ultrasound. It is used to determine when surgery or stenting -- inserting mesh tubes to prop open arteries -- is warranted to prevent a stroke.

"Duplex ultrasound involves taking ultrasound images of blood vessels and measurement of the velocities within the blood vessels," said Comerota, director of the Jobst Vascular Center in Toledo, Ohio.

"The criteria on which we based our interpretation of the test is the speed of the blood flowing through the carotid arteries (the two vessels in the neck that send blood to the brain)," he added.

The speed of the blood is believed to reflect the status of vessel narrowing, with faster-flowing blood typically meaning the vessel has narrowed due to plaque buildup, a major cause of stroke in these arteries. Experts compare it to a pipe being pinched. If you pinch it, the blood has to flow faster to get through.

When the duplex ultrasound test was being standardized, Comerota said, much of the research was performed at Veterans Administration hospitals, with mostly men as subjects.

Now, Comerota's research shows that "the velocities of blood flow in women [to begin with] are higher than the velocities of blood flow for men."

The study findings were to be presented Monday at the annual International Symposium on Endovascular Therapy in Miami Beach, Fla.

In persons without symptoms of vascular disease, a blockage of about 60 percent is reason to suggest a surgical procedure to remove the plaque or create a bypass around the plaque blockage, Comerota said.

But the finding that women's blood flows faster "means we ought to reevaluate our interpretation criteria because we may be over-diagnosing a lot of disease in these women," Comerota said.

In the study, Comerota used duplex ultrasound to analyze the carotid arteries in 328 men and 241 women and correlated the findings with an arteriogram, a test that can measure narrowing of the artery.

"When we looked at the arteriograms, we found less disease on the arteriogram in women than we expected based on the duplex results," Comerota said.

"With the same ultrasound finding, a man may be advised to have surgery, but a woman may not," he added.

According to the American Heart Association (news - web sites), someone dies from a stroke every 3.3 minutes, making it the third-leading cause of death in the United States.

Another expert, Dr. Barry T. Katzen, program director of the symposium and a clinical professor of radiology at the University of Miami School of Medicine, said the new study is important.

"One of the things this study found is that women's blood seems to be flowing faster to begin with, at least in the carotid artery, so the results of the ultrasound may not be the same for both genders."

As interesting as the study result is, Katzen added, however, that "I think we need to confirm this with other studies."

Katzen said Comerota suggested that women may not need surgery until the blockage is 80 percent or greater.

At his institution, "we actually believe that in patients who haven't had symptoms, they probably shouldn't have stents or surgery until they get to over 80 percent blockage," he said, regardless of gender.

Comerota said both women and men can do much to reduce stroke risk, such as not smoking and controlling blood pressure.

More information

To learn about stroke warning signs, visit the American Stroke Association.

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Melanoma Vaccine Triggers T-Cells to Attack Tumors

 

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- Vaccines that contain tumor proteins help fight deadly melanoma skin cancer by increasing the number of immune system killer T-cells that can attack the tumor, says research in the Jan. 17 issue of the Journal of Experimental Medicine.

It was already known that tumor protein vaccines could successfully treat some people with advanced melanoma. But this is the first research to identify how these vaccines actually work, according to the study.

A better understanding of T-cell populations that expand after vaccination may help researchers develop more effective anti-tumor vaccines.

Many melanoma patients have tumor-specific T-cells in their blood and tumors. But these T-cells don't attack and kill the tumor.

The researchers believe certain T-cells activated by the vaccine cause changes that alter the environment around the tumor, prompting other T-cells to spring into action and attack the tumor.

More information

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

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Dip in Visual Memory Seen Early in Mental Decline

 

By Amy Norton

Reuters Health

Monday, January 17, 2005

NEW YORK (Reuters Health) - Older adults with mild cognitive impairment may have problems retaining a mental picture of objects they've just seen -- a subtle memory problem that could serve as an early indicator of Alzheimer's disease (news - web sites) risk, researchers reported Monday.

Their study of elderly and young adults found that older men and women with mild signs of mental decline had problems with a test of so-called "iconic" memory. This type of memory refers to the visual image a person holds onto after briefly looking at an object.

If someone walked into a room, quickly scanned it, then turned off the lights and tried to recall the objects in the room, that would draw upon iconic memory, explained lead study author Dr. Zhong-Lin Lu, a professor of psychology at the University of Southern California in Los Angeles.

Iconic memory is by nature fleeting, regardless of a person's age, and it is distinct from short-term memory, which draws upon information deposited in the brain's temporary storage bins -- such as when someone remembers a message to pass on later that day.

In their study, Lu and his colleagues found that elderly men and women with mild cognitive impairment performed more poorly on a test of iconic memory than either young adults or older men and women with no signs of mental decline. This was despite the fact that the two groups of elderly participants performed similarly on tests of short-term memory.

The findings are published in the advance online edition of the Proceedings of the National Academy of Sciences (news - web sites).

Mild cognitive impairment -- which involves the type of "benign" forgetfulness in which a person frequently misplaces the car keys, for example -- is considered a risk factor for Alzheimer's disease. Indeed, scientists estimate that about 80 percent of people with mild cognitive impairment develop Alzheimer's within 10 years, according to Lu.

Right now, Lu told Reuters Health, mild cognitive impairment is diagnosed through standardized interviews rather than specific, sensitive tests. If a decline in iconic memory is indeed an objective marker of mild impairment, he said, then testing for it may allow doctors to detect the earliest stages of Alzheimer's.

First, however, long-range studies will need to look at how well a score on an iconic-memory test predicts the risk of developing Alzheimer's, Lu said.

Lu and his colleagues decided to study the relationship between iconic memory and mild mental impairment after a chance discovery in an earlier study. In that study, Lu said, a healthy, fully functioning 58-year-old man inexplicably performed poorly on tests of iconic memory. About two years later, the man was diagnosed with Alzheimer's disease.

The current study included nine men and women ages 74 to 98 who were mildly impaired, based on standard interviews. Sixteen healthy elderly adults and 23 college students served as comparison groups. Iconic memory was gauged with a test in which participants saw eight letters flashed on a computer screen in a circular arrangement. After the image disappeared, they were asked to name the letter that had been in a particular spot.

The group with mild cognitive impairment had significantly shorter iconic memory than either of the other two groups, the researchers found.

Finding new, objective and sensitive tests for early Alzheimer's is important, according to Lu, because current drug therapies designed to stabilize symptoms are most effective when started as early as possible.

Source: Proceedings of the National Academy of Sciences, online January 17, 2005.

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Health Tip: Screening Tests Can Be Lifesavers

HealthDayNews

Monday, January 17, 2005

(HealthDayNews) -- Screening tests are remarkably effective ways to catch diseases and conditions before they become too serious.

Be sure to ask your doctor about screening tests recommended by the American Cancer Society (news - web sites), American Diabetes Association and American Heart Association (news - web sites).

Here is a list of tests recommended for people at average risk:

Other periodic tests may be a good idea, depending on your family and personal medical history. Talk to your doctor about which tests are right for you.

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More Evidence Found of Painkiller Heart Risks

Reuters

Monday, January 17, 2005

WASHINGTON (Reuters) - More evidence of how painkillers called COX-2 inhibitors can raise the risk of heart disease was published Monday, showing Pfizer Inc.'s Bextra can triple the risk of heart attack and stroke in certain patients.

A second study shows how older drugs such as aspirin work to prevent heart disease. Both appear in this week's issue of the American Heart Association (news - web sites) journal Circulation.

The COX-2 inhibitors were designed to help treat arthritis pain and similar long-term conditions without the serious stomach side-effects of aspirin and related drugs such as ibuprofen, and other non-steroidal anti-inflammatory drugs or NSAIDS.

But in September Merck & Co. Inc. pulled its COX-2 inhibitor Vioxx from the market after clear evidence its use could raise the risk of heart attacks. And in December, the National Institutes of Health (news - web sites) halted a study involving Pfizer's COX-2 inhibitor Celebrex.

The U.S. Food and Drug Administration (news - web sites) cautioned patients and doctors to limit their use of such drugs and will hold a meeting next month to discuss them. The European Medicines Agency is holding a similar meeting this week.

Dr. Garret FitzGerald of the University of Pennsylvania School of Medicine and colleagues used a statistical approach called meta-analysis to combine the findings of two trials to estimate the risk of heart attack and stroke in people taking Bextra, another COX-2 inhibitor made by Pfizer.

Their analysis, first presented at a Heart Association meeting last November and published this week in Circulation, suggests Bextra tripled the combined incidence of heart attack and stroke in heart bypass surgery patients.

NSAIDS work by suppressing two enzymes called COX-1 and COX-2. But they can cause gastrointestinal bleeding, and research had suggested that suppressing COX-1 caused this damage.

So drug companies worked to make drugs that only affect COX-2, the enzyme associated with pain and inflammation.

But in the second study, the researchers studied mice genetically prone to hardening of the arteries or atherosclerosis and found that a compound called thromboxane or TxA2, produced by COX-1, accelerates atherosclerosis.

"This is of particular interest, as low-dose aspirin prevents heart attack and stroke by blocking COX-1 formation of TxA2 in blood cells called platelets," FitzGerald said in a statement.

When a COX-2 inhibitor was added, something happened that may help explain why the COX-2 inhibitors raise the risk of a heart attack, said FitzGerald's colleague, Karine Egan.

"Addition of the COX-2 inhibitor caused changes that, if they occurred in humans, would result in a loss of stability of the plaque, making it more likely to rupture and activate clotting, causing heart attack or stroke," she said.

"These results would have disturbing implications for patients at high cardiovascular risk treated with aspirin and a coxib (COX-2 inhibitor)," FitzGerald said.

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Health Tip: Evaluating Heart Murmur

HealthDayNews

Monday, January 17, 2005

(HealthDayNews) -- A heart murmur is an extra or unusual sound heard during the heartbeat, according to the National Heart, Lung, and Blood Institute.

Murmurs range from faint to relatively loud and sometimes sound like a whooshing or swishing noise. A murmur could be nothing to worry about or, in rare cases, could signal a serious heart problem.

A person with an innocent murmur has a normal heart and usually has no other symptoms of a heart problem. Innocent murmurs are common in healthy children.

A child with an abnormal murmur usually has other signs of a heart problem, which often is present since birth. In adults, abnormal murmurs are most often due to heart valve problems caused by infection, disease or aging.

If you suspect you or your child has a heart murmur, have a doctor evaluate the condition as soon as possible.

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Too Much Added Sugar Worsens Kids' Overall Diet

By Alison McCook
Reuters Health
Monday, January 17, 2005

NEW YORK (Reuters Health) - New research shows that the more added sugar kids get from sodas, sweets and fruit drinks, the less they get of the things they need in their diets to stay healthy.

U.S. investigators found that preschoolers who obtained a higher percentage of their daily calories from added sugars tended to get fewer calories from healthier sources, including foods rich in fiber, vitamins and minerals.

Study author Dr. Sibylle Kranz explained that kids have an "internal control" system in their bodies that limits their intake of calories, so they typically eat the same number of calories, regardless of the source. "If a child drinks a regular soda, for example, that drink is replacing another potentially high-nutrient food," she told Reuters Health.

It's important for kids to get the vast majority of their calories from foods rich in vitamins and minerals, she noted.

"Since most foods that are high in added sugar have very low nutrient density -- very little vitamins and minerals -- they contribute calories but not the important micronutrients for health and growth," said Kranz, who is based at Pennsylvania State University in State College.

Kranz noted that "added" sugars are not the same as sugars naturally found in foods like fruits and dairy. Added sugars are included during baking or manufacturing, and are primarily found in sodas, fruit drinks, desserts and candy, she said.

In an article in the January issue of the Journal of Pediatrics, Kranz and her colleagues explain that the U.S. food guide pyramid currently recommends that kids limit added sugars to between six and 10 percent of their total calories, and the World Health Organization (news - web sites) has limited added sugars to less than 10 percent of total calories. However, the National Academy of Sciences (news - web sites) recently said that it's okay for people to get up to 25 percent of their total calories from added sugar.

These recommendations matter, the authors note, in part because they are often used to help determine federal nutrition programs.

To investigate how kids' diets fare with different amounts of added sugar, Kranz and her team reviewed the diets of 5,437 children between the ages of two and five, noting how much added sugar they ate and what they consumed in important nutrients.

The study found that the more added sugar kids ate, the less they got of fiber, protein, calcium, iron, folate and other key nutrients.

Most children got less than 25 percent of their daily calories from added sugar, but those who got at least 25 percent from added sugars ate the smallest amounts of grains, vegetables, fruits and dairy.

Younger children typically ate less added sugar than older children, the authors note. Among two-year-olds and three-year-olds, average consumption of added sugar was about 14 teaspoons per day, relative to an average of about 17 daily teaspoons among four-year-olds and five-year-olds.

Although it's not clear what amount of added sugar is okay for kids, these findings suggest that the National Academy of Sciences' cutoff of 25 percent of daily calories may be too high, Kranz argued. "Based on our results, we are concerned that at the (recommended) level of added sugar intake, children do not have adequate intake of vitamins and minerals important for their health and growth," she said.

Source: The Journal of Pediatrics, January 2005.

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Inappropriate Drugs Can Harm Nursing Home Patients

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- Nursing home residents treated intermittently with drugs for common ailments such as depression, arthritis or sinus problems over a three-month period were almost 90 percent more likely to die at the end of that period than were patients who didn't take such drugs, new research shows.

Further, residents who took these potentially inappropriate medications over a two-month period had an 80 percent greater chance of being hospitalized in the third month than did patients who were not given such drugs.

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

"We're not saying that taking these medicines causes the hospitalizations and deaths. But our work shows that there's a relationship between the two and that doctors should pay attention to the drugs that they prescribe, and monitor their patients carefully," said study author Denys Lau, a professor at Northwestern University's Feinberg School of Medicine.

Adding to significance of the findings, Lau said, is that his previous work has found that at least half of all Americans aged 65 and older who stay in a nursing home for three months or longer are given at least one potentially inappropriate medicine.

"At least 50 percent of nursing home residents take these medications, so the scope is pretty dramatic and troubling," he said.

Lau said there could be several reasons for the significant association between drug intake and increased hospitalizations and deaths.

Many of the most commonly prescribed drugs for nursing home residents, such as Darvon (for pain), Elavil (for depression), Digoxin (for heart problems) and Endal (an antihistamine), have side effects that can include dizziness, blurry vision, constipation and sleepiness. These side effects can affect an elderly patient's balance and alertness, so falls and other health problems are more likely, Lau said.

So, while there might not be a direct link to a specific drug and an increased risk of health trouble, the side effects can increase the chances of complications that eventually lead to hospitalization or early death, the study found.

"The effect of these side effects could be magnified in the elderly in kind of a trickle-down effect," Lau said.

Also a factor, Lau said, is that there have been very few clinical trials on how drugs affect the elderly. As people age, drugs affect them differently: the rate of absorption of drugs by the liver changes; the way the drugs metabolize in the body changes; and drugs are often eliminated more slowly, making toxicity an issue.

But while all this is known, said Lau, there is very little evidence-based data on exactly how differently drugs affect this age group.

In prescribing drugs to the elderly, most practitioners rely primarily on the Beers criteria, a list compiled and revised in the last decade by doctors. The list names drugs that doctors should try to avoid when treating the elderly because of possibly harmful effects. If doctors do use these drugs, they are required to document why they are using them.

However, many doctors still prescribe medicines on this list, which include Darvon, Elavil and Digoxin, often because of habit on the part of both patients and doctors -- many patients have taken these drugs on and off for many years and are reluctant to change, Lau said.

But there are many newer drugs that would help these patients with fewer side effects, he said.

Interestingly, Lau noted, those nursing home residents who stayed on a drug for an extended period of time -- three months or longer -- were at no higher risk for hospitalization and death.

"The risk seemed to rise when the patient regimens fluctuate back and forth between drugs," he said.

"This is a great study, and I am not surprised at all by the findings," said C.W. Fetrow, an associate clinical professor at the University of Pittsburgh School of Pharmacy. His company, Apothecare Collaborative Services Inc., monitors the medicines residents take in nursing homes.

"As pharmacists, we're already clued into this, and now there's proof that these drugs aren't working and that there are better choices for the elderly," Fetrow said.

Fetrow added that while pharmacists monitor the drugs patients in nursing homes take, they are not the prescribing doctor and are often not included in decisions about what drugs the residents should take.

"Look to pharmacists for this information," he said. "We are trained to tease out the subtle differences in these drugs."

Lau's study was based on data from the 1996 Medical Expenditure Panel Survey Nursing Home Component, which included 3,372 residents, 65 years or older, who had nursing home stays of three consecutive months or longer.

The participants in the study were controlled for age, sex, and mental and physical health.

More information

The Medical College of Georgia explains the Beers criteria.

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ADHD Linked to Mom's Iodine Levels

By David Douglas

Reuters Health

Monday, January 17, 2005

NEW YORK (Reuters Health) - A group of Italian researchers is recommending routine thyroid-function screening for women during early pregnancy, because they believe attention deficit and hyperactivity disorder (ADHD) in children may be associated with an iodine deficiency in mothers.

The thyroid is a gland that helps regulate body growth and metabolism. The gland requires iodine to form thyroid hormone, a substance that is necessary to keep the body functioning normally. The condition in which levels of iodine in the thyroid gland are too low is called hypothyroxinemia.

Based on a study that lasted almost 10 years, the Italian researchers believe that hypothyroxinemia in mothers during pregnancy may increase the risk of ADHD in their children.

The researchers followed the children of 16 women in an area of the Italian island Sicily where iodine deficiency is common, comparing them to children in a region where iodine is sufficient.

ADHD was diagnosed in 11 of the 16 children from the iodine-deficient area, but in none of the children in the comparison group.

Dr. Francesco Vermiglio, who led the study, told Reuters Health that he believes the ADHD and a related reduction in IQ seen in the study resulted from hypothyroxinemia in the children's mothers during the first half of pregnancy. Seven of the 11 ADHD children were born to mothers who became hypothyroxinemic during early pregnancy.

Vermiglio and his colleagues at the University of Messina in Italy published the findings of their study in the December issue of the Journal of Clinical Endocrinology and Metabolism.

They note in their report that hypothyroxinemia in pregnant women can occur even in places where iodine intake is adequate, and that they therefore recommend routine thyroid screening and monitoring for all pregnant women.

Source: Journal of Clinical Endocrinology, December 2004.

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Combo Treatment Slows Cancer Cell Growth

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- A combination therapy that boosts the effectiveness of a promising cancer treatment designed to block cancer cells from continuously dividing is outlined in a Japanese study in the January issue of Cancer Cell.

This combination therapy seems to improve the action of a treatment that targets telomeres in cancer cells.

Telomeres are DNA sequences that play a crucial role in controlling the life spans of cells. Telomeres grow shorter each time a cell divides. Eventually, telomeres grow so short that they cause cell division to stop.

Cancer cells produce an enzyme called telomerase that prevents telomeres from getting short enough to stop cell division.

Healthy cells do not use telomerase, which has been identified as a target for anticancer drugs.

This study examined what happened to cancer cells when telomerase-inhibiting treatment was combined with inhibition of an enzyme called tankyrase 1, which helps make telomeres accessible to telomerase. The study found that inhibition of tankyrase 1 boosted telomerase inhibition therapy, resulting in enhanced telomere shortening and accelerated cancer cell death.

"This study provides insight into strategies for telomere-based molecular cancer therapeutics. We expect that inhibition of tankyrase 1 will compensate for incomplete inhibition of telomerase. Consequently, this strategy would shorten the time period of drug treatment that is required for the onset of telomere crisis and reduce the potential risk of acquired drug resistance," the study authors wrote.

More information

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

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Study: High Blood Pressure in Blacks Not Genetic

Reuters Health

Monday, January 17, 2005

NEW YORK (Reuters Health) - A number of studies have shown that African Americans are more likely than Caucasians to have high blood pressure. Although genetic factors are often blamed, new research suggests that this racial gap is largely due to environmental -- and potentially preventable -- factors.

The new study compared the rates of high blood pressure (hypertension) between black and white subjects in different populations.

For blacks, populations in Nigeria, Jamaica and the US were studied, while for whites, populations in the US, Canada and five European countries were studied.

If racial origin played a major role in high blood pressure, then rates of the condition for each race would be expected to be about the same regardless of where people lived. Instead, the researchers found wide variation in rates, ranging from 14 percent for blacks in some geographic regions to 44 percent in other places. For whites, the rates ranged from 27 percent to 55 percent depending on where people lived.

The lowest rate of high blood pressure (13.5 percent) was among blacks living in Nigeria, while the highest (55.3 percent) was among whites in Germany.

Among blacks, rates of the condition were higher for people living in more industrialized places. For example, Nigerians had a rate of 13.5 percent, Jamaicans a rate of 28.6 percent and US blacks a rate of 44 percent.

The traditional emphasis placed on genetics to explain the large number of African Americans with high blood pressure could be distracting the healthcare community from fighting the lifestyle factors that are actually causing the condition, the study's authors cautioned.

The authors, Dr. Richard S. Cooper from Loyola University Stritch School of Medicine in Maywood, Illinois, and colleagues, published their report in the January 5 issue of the journal BMC Medicine.

Source: BMC Medicine, January 5, 2005

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Another Clue Explains Smoking Link to Oral Cancers

 

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- Smokers have elevated levels of cox-2, a cellular protein associated with the development and progression of cancer, says a study in the Jan. 15 issue of Cancer Research.

The study found smokers produce nearly four times as much cox-2 in oral mucosal cells that line the mouth than nonsmokers.

The researchers also found these elevated cox-2 levels are caused by tobacco smoke-induced activation of epidermal growth factor receptor (EGFR), a cell membrane protein that's also linked with different kinds of cancer.

"In an oral mucosal cell line, tobacco smoke clearly activated the epidermal growth factor receptor. Tobacco smoke caused increased EGFR phosphorylation leading to increased cox-2 production," study author Dr. Andrew J. Dannenberg, director of cancer prevention at Weill Medical College of Cornell University, said in a prepared statement.

"These results strengthen the rationale for targeting not only cox-2, but also EGFR as approaches for reducing the risk of tobacco-related malignancies of the mouth and throat," Dannenberg said.

More information

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

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Best Fitness Routine May Depend on Personality

By Charnicia E. Huggins

Reuters Health

HealthDayNews

Monday, January 17, 2005

NEW YORK (Reuters Health) - Before starting a new fitness program or exercise, men and women would do well to determine which activity best suits their personality, according to a Canadian researcher.

"It's important for people, especially those new to exercise, to consider what they're getting into," Dr. James Gavin of Concordia University in Quebec told Reuters Health. "Does it fit with who the person is? Will it challenge long-standing habits?" Ignoring such considerations could lead to a lack of adherence to the regimen, he pointed out.

Gavin's article in the December issue of the journal The Physician and Sportsmedicine urges doctors to encourage their patients to complete a personality assessment questionnaire that can help them find the fitness activity that suits them best.

Currently, only about one in five North American adults participate in some type of exercise, a rate that has remained steady over the past few decades, studies show. Matching specific activities to individuals' traits and personalities may be key to increasing those physical activity levels, Gavin's report states.

An analysis of studies about personality in sports reveals seven different dimensions that should be taken into consideration, according to the report. Potential exercisers should consider whether they prefer exercising alone or in a group; the degree of control or spontaneity included; their motivation for exercising; the aggression level required for the exercise; the competitive nature of the activity; the mental focus required; and whether it involves taking risks.

Thrillseekers may prefer to participate in high-risk sports; a person who is highly social may prefer a team sport; and one who likes spontaneity might wish to avoid a highly structured fitness class.

"You might think of it this way: people have personalities...and so do sports and fitness activities," Gavin said. "People generally feel better when they do activities within their comfort zones, i.e., that match their styles."

Findings from a study of nearly 700 members of a community fitness center show that those who expressed a high interest in karate, with little or no interest in aerobic dance, yoga or running, scored highest in aggressiveness, competitiveness, risk taking, and spontaneity out of the seven dimensions. Those with a high interest in yoga scored highest in mental focus, whereas those most interested in aerobic dance were the most sociable.

To determine which activities best suit their personality, individuals can complete personality profiles and use their physician's fitness personality chart to see where a sport fits along a continuum, from the low end of a psychosocial style to the high end, the report states.

"The overarching goal of this process is to promote activity participation, especially for sedentary patients," according to Gavin. "It is critically important that patients understand likes and dislikes and behavioral tendencies (aka personality) when considering which kinds of fitness classes to take or which sports to pursue."

Source: The Physician and Sportsmedicine, December 2004.

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Researchers Zero In on Genetic Link to Parkinson's

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, January 17, 2005

MONDAY, Jan. 17 (HealthDayNews) -- Scientists have found the first evidence of a genetic mutation that would be the most common genetic cause of Parkinson's disease (news - web sites) identified thus far.

The mutation, in the LRRK2 gene, may be responsible for up to 5 percent of cases of Parkinson's in people with a family history of the disease, and 1.5 percent to 2 percent of cases in individuals without a family history.

Genetic testing for this particular mutation may be available in as little as one year, said study co-author Andrew Singleton, chief of the molecular genetics unit at the Laboratory of Neurogenetics at the National Institute on Aging. Actual therapies, however, will take much longer to develop, he added.

"The whole idea of this kind of research is to get a handle on the chain of events that cause disease," Singleton said. "Once you get a handle, you can try to interrupt the pathway. All of the therapies for Parkinson's right now are aimed at alleviating symptoms. The whole idea is to provide a cure or to prevent the disease. In terms of understanding the disease, it's a step forward. I think we're really getting somewhere."

The findings are published in two papers appearing online Jan. 18 in The Lancet.

Parkinson's disease affects at least half a million people in the United States, and possibly many more, and is the second most common neurodegenerative disease after Alzheimer's. About 1 percent of people over the age of 65 and 3 percent of people over the age of 75 are affected by the disease. It is marked by the degeneration of nerve cells in the area of the brain that controls movement, resulting in tremors, stiffness, slowness of movement, and impaired balance and coordination.

For a long time, scientists had thought the cause of Parkinson's was environmental, but more recently they have acknowledged it is likely a result of an interplay of factors. "We are understanding more and more that it is probably a mix of environment and genetics," Singleton said.

Four or five genes have already been implicated in Parkinson's but only in a rare form of the disease that affects those with a family history.

For the familial part of the new research, Singleton and his colleagues looked at 767 people with Parkinson's disease from 358 families. Of these individuals, 5 percent had the genetic mutation.

The researchers also assessed 482 Parkinson's patients who did not have a family history of the disease. The mutation was present in 1.6 percent of these people.

A mutation in just one copy of the gene can cause the disease, the researchers said.

The LRRK2 gene encodes a protein named dardarin, from the Basque word dardara, meaning tremor. It's not entirely clear how the gene works, Singleton said.

"We don't know what the gene does. We only found it two or three months ago," he said. "One would suspect that it alters kinase function but we don't know if it activates it or deactivates it." A kinase is like a switch that turns proteins on and off.

The next step is to find out how the mutation actually works so therapies can be devised.

The most immediate effect of the research, Singleton said, will be in genetic counseling: "This is something clinicians will talk to patients about."

Even though 1 percent and 5 percent may not sound high, Singleton said the percentages uncovered by the new studies were actually much higher than he had expected.

"When you think perhaps there are a million people with Parkinson's in the U.S. and you find a mutation for 2 percent, that's 20,000 people. That's pretty considerable," he said.

More information

To learn more about the disease, visit the National Parkinson Foundation.

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Sunday, January 16, 2005

 

The Thyroid, Cholesterol Connection

 

By Dennis Thompson
HealthDay Reporter

HealthDayNews

Sunday, January 16, 2005

SUNDAY, Jan. 16 (HealthDayNews) -- High cholesterol is a well-known health problem among Americans, particularly those at risk for stroke or heart disease.

By comparison, thyroid disease is a relatively obscure ailment, with many people unable to say where the gland is and what it does.

What many people also don't know is that a malfunctioning thyroid gland can cause high and potentially deadly levels of cholesterol in the blood.

An estimated 27 million Americans have an overactive or underactive thyroid gland, but more than half remain undiagnosed, according to the American Association of Clinical Endocrinologists (news - web sites).

The thyroid gland is located in the middle of the lower neck, below the voice box and just above your collarbone. It is shaped like a bow tie, with two halves called "lobes" connected by an "isthmus" in the middle, according to the American Academy of Otolaryngology -- Head and Neck Surgery.

"The thyroid gland regulates the metabolic functions of the body in virtually every cell," said Dr. Carlos Hamilton, president of the American Association of Clinical Endocrinologists. "Everything from the brain to the skin is affected by the hormone made by the thyroid gland."

And if the gland goes haywire, or comes under attack from disease, the consequences can be serious.

January is Thyroid Awareness Month, and endocrinologists and other clinicians are using the occasion to educate people about the risks posed by thyroid disease.

If the thyroid gland is producing too little thyroid hormone -- a condition called hypothyroidism -- the body's metabolism starts to slow down.

That can lead to high cholesterol levels in the blood, as the lack of thyroid hormone slows the liver's ability to process blood, said Dr. Paul Jellinger, president of the American College of Endocrinology.

"The sponge-like activity of the liver to soak up excess cholesterol from the blood doesn't work as well as it should with low levels of thyroid," Jellinger said.

This causes an increased risk of cholesterol build-up in the arteries and around the heart, increasing the risk for heart disease.

Hypothyroidism is the most common secondary cause of high cholesterol after diet, according to the National Cholesterol Education Program.

Ninety percent of patients with hypothyroidism have increased cholesterol, and the average blood cholesterol levels of patients with an underactive thyroid are often 30 percent to 50 percent higher than desirable.

Hypothyroidism also has other effects. "It slows you down," Hamilton said. "It makes you lethargic and fatigued." Your hair becomes brittle, and your skin becomes dry. You become cold much easier than the average person.

"Everything's running on a lower gear," Jellinger said. "It's like an eight-cylinder engine running on four cylinders."

Women are far more likely to have thyroid disease. More than eight out of 10 patients with the condition are women.

Pregnant women and the elderly are particularly affected by hypothyroidism.

Nearly one of 50 women in the United States is diagnosed with hypothyroidism during pregnancy, and 5 percent to 17 percent of women are diagnosed with the condition postpartum.

The incidence of hypothyroidism also increases with age. By 60, as many as 17 percent of women and 9 percent of men have an underactive thyroid.

The good news is that high cholesterol caused by hypothyroidism is highly treatable, Jellinger said. Much of the time, thyroid patients can avoid using cholesterol-lowering drugs simply by treating their condition.

"As the thyroid abnormality becomes more intense, the ability to lower cholesterol is very striking," Jellinger said. "Often the only treatment needed to lower cholesterol is thyroid medication."

People with an overactive thyroid gland, or hyperthyroidism, also must be concerned about cholesterol.

Their condition causes a high metabolic rate that can artificially lower cholesterol levels, Jellinger said. People being treated for hyperthyroidism must watch their cholesterol levels as their metabolism returns to a normal level.

Both hyperthyroidism and hypothyroidism are easily treated through medication, said Dr. Bill Law, an endocrinologist in Knoxville, Tenn.

"One little pill a day, very inexpensive, and no side effects," Law said. "If you have to have a disease, it's a good one in terms of treatment."

The bad news is the disease is genetically influenced more than anything else, meaning there's little you can do to prevent its onset.

"Other than maintaining good nutrition, there isn't really much a person does that affects their thyroid gland," Hamilton said.

The diseases are diagnosed through a simple blood test that family physicians can perform in their office.

More information

For more on thyroid disorders, visit the National Library of Medicine.

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Saturday, January 15, 2005

 

Weight-Loss Supplements: Do They Work?

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Saturday, January 15, 2005

SATURDAY, Jan. 15 (HealthDayNews) -- Now that the holiday cookies are history, you've resolved to get fit and trim. Perhaps you've even considered taking over-the-counter dietary supplements to help you reach your weight-loss goals.

Drugstores, nutrition shops and Web sites offer a plethora of supplements and combination products that claim to help burn fat, block fat absorption, modulate carbohydrate metabolism, boost energy expenditure, suppress appetite, flush out excess water weight and control cravings -- all good outcomes to an eager dieter.

So what's the harm in grabbing a bottle?

"There's a tremendous appeal for a magic pill to help lose weight -- manufacturers of weight-loss pills appeal to that, I think," said Dr. Robert Saper, director of integrative medicine in the Department of Family Medicine at Boston University Medical Center.

But in a review of the scientific evidence, published in the Nov. 1, 2004, issue of American Family Physician, Saper suggested there's no miracle pill on the market. In fact, some of the supplements out there may be dangerous or might interact with prescription medications that people are taking, he said.

"There's very few of them that show benefit for what people are taking them for," agreed Dr. Gary A. Green, a clinical professor in the Division of Sports Medicine at the University of California, Los Angeles.

Steven Dentali, vice president of scientific and technical affairs at the American Herbal Products Association, offers a somewhat more upbeat assessment: "I would say there is some preliminary evidence that some of these ingredients can be useful in combination with diet and exercise."

Dietary supplements have quite a following among many Americans. Overall, 7 percent of adults use over-the-counter weight-loss supplements, according to a five-state survey reported in 2001 in the Journal of the American Medical Association (news - web sites). The use of nonprescription weight-loss products is particularly common among young obese women -- 28.4 percent reported taking them.

One recent success story is that of former Playboy "Playmate of the Year" Anna Nicole Smith (news - web sites). The 37-year-old actress and model dropped 69 pounds in eight months using a formulation of TRIMSPA, a popular brand-name product, the supplement maker's Web site claims.

But do you know what you're getting when you buy brand-name dietary supplements, including TRIMSPA, Xenedrine, and Hydroxycut, or individual herbal products?

The Natural Medicines Comprehensive Database, a source for evidence-based information on natural brand-name products and ingredients, lists more than 50 individual supplements and 125 proprietary products, according to Saper, who examined individual ingredients found in several commercial products.

Chromium, for example, is a popular weight-loss supplement found in many products, but its efficacy and long-term safety are uncertain, he said. Guar gum, derived from the Indian cluster bean, appears to be ineffective for weight loss. Chitosan, derived from shellfish, is another one to avoid, Saper said. "I discount chitosan because, although it's safe, its role as a 'fat blocker' is not well-substantiated," he explained.

Glucomannan, a plant fiber, may be helpful for modest weight loss, he said, but the data are insufficient to support a definitive conclusion.

Overall, the amount of well-designed research to substantiate the effectiveness of many individual herbs for weight loss is sparse, Saper said. Even greater questions exist as to the safety and effectiveness of combination products and the potential for harmful interactions among different ingredients, he noted.

Dietary aids containing the herbal supplement ephedra were extremely popular until the U.S. Food and Drug Administration (news - web sites) banned their sale in April 2004 due to reports of deaths. Ephedrine, the active ingredient, is a stimulant known to increase metabolic rate, heat production and the risk of heatstroke.

Dangerous supplements still remain available on store shelves and Web sites, Consumers Union warns. The public advocacy group's Consumer Reports magazine last May published a list of the "dirty dozen" -- 12 supplement ingredients that have been linked either to serious adverse effects or to a strong theoretical risk. The list included bitter orange, a common dietary supplement that contains a compound called synerphrine, which carries risks similar to ephedrine, Saper said.

Critics of the dietary supplement industry want Congress to put some teeth into federal regulations. Under the Dietary Supplement Health and Education Act of 1994, manufacturers of dietary supplements are not required to provide evidence of safety or effectiveness. The burden rests on the FDA (news - web sites) to prove that a product is either unsafe or ineffective.

"As long as they don't claim to treat any specific disease or condition they can basically make any claims that they want," Green said.

For its part, the herbal products association has expressed support for a mandatory adverse-events reporting system for dietary supplements.

Until there's better data, motivated dieters would be better off talking to their physicians about proven weight-loss strategies, such as diet and exercise, according to Saper.

But Dentali believes herbal products can play a role in a sensible weight-loss strategy. Switching from soda to green tea, for example, may provide some health benefits, "and you're not sucking down those sodas."

More information

To learn more about dietary supplements, visit the National Center for Complementary and Alternative Medicine.

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Forgive and Forget -- Stress, That Is

 

HealthDayNews

Saturday, January 15, 2005

SATURDAY, Jan. 15 (HealthDayNews) -- Not only is being able to forgive divine, it can be a blessing to your mental and physical health, says an article in the January issue of Harvard Women's Health Watch.

The article outlines five ways you may benefit by granting forgiveness to someone who may have wronged you:


More information

 

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


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