The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
March 9, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 29 - February 4

 

  1. Constant Worry May Increase Alzheimer's Risk
  2. Seizures After Epilepsy Surgery Indicate Continuing Risk
  3. FDA Staff Questions Heart Risks of Merck's Arcoxia
  4. Put Your Heart on That To-Do List
  5. Bat Saliva Drug May Improve Stroke Outcome
  6. Migraine With Vision Loss Ups Stroke Risk
  7. Supplement May Slow Marker of Prostate Cancer
  8. Menstrual Cycle Affects Depression Symptoms
  9. Steroid Therapy Impairs Long-Term Memory
  10. New Scan Spots Drugs' Effects on Fetus
  11. Most Preschoolers Don't Get Enough Fiber
  12. Bread is Back! Or So Hopes the Industry
  13. High Fat, Sodium Intake Are Risk Factors for Stroke
  14. Scientists Get Handle on Kaposi's Sarcoma
  15. Japan Says GM Rice Could Help Combat Hay Fever
  16. Minimally Invasive Surgery Remakes Face of Medicine
  17. Cord Blood from Two Donors Okay for Leukemia
  18. Young Cell Phone Users Drive Like Seniors
  19. Rheumatoid Arthritis Raises Heart Death Risk – Study
  20. Health Tip: Be Mitey Careful!
  21. Welders Show Elevated Rate of Parkinson Symptoms
  22. Health Tip: Chest Pain Is Nothing to Sneeze At
  23. Kidney Disease Tied to Mental Impairment
  24. Mini-Strokes Need More Medical Attention
  25. Diets Rich in Rice Bran Oil May Lower Cholesterol
  26. Breast Cancer Prevention From The Sea
  27. Predictors of Sudden Death in Diabetics Questioned
  28. Many EU Cancer Patients Use Alternative Meds
  29. Blood Pressure Control Key to Preeclampsia Prevention
  30. Use of Antidepressants While Pregnant Can Affect Baby
  31. Expert Sees Obesity Hitting U.S. Life Expectancy
  32. Health Tip: Dizziness Explained
  33. Moderate Drinking Doesn't Harm Bones in Women
  34. Health Tip: Fake Nails Can Lead to Real Infections
  35. Treat Diabetes Early and Aggressively-US Experts
  36. Stopping Aspirin Therapy Boosts Stroke Dangers
  37. Red Meat Linked to One Type of Colon Cancer
  38. Medical Problems Cause Half of Personal Bankruptcies
  39. Cell Phone Users Drive Like the Elderly –Study
  40. Blacks in South at Greater Risk of Stroke Death
  41. Soy May Not Pack a Strong Antioxidant Punch
  42. Eating Disorders May Jeopardize Pregnancy Outcomes
  43. Dyslexia Slows Drivers' Reactions – Scientists
  44. U.S. Doctors Ignore Women's Heart Issues – Reports
  45. Health Tip: No Site for Sore Eyes
  46. Cervical Cancer Vaccine Expected in a Few Years
  47. Health Tip: When Vomiting Can't Be Explained
  48. U.S. Youth Antidepressant Use Drops in 2004 – Report
  49. New Tool Gauges Heart Failure Death Risk
  50. Patient Records Often Missing, U.S. Study Finds
  51. Tailor Asthma Treatment for Kids
  52. High-Risk Women Not Lowering Cholesterol Enough
  53. Smoggy Air May Harden Arteries
  54. Study Finds Brain Tumor Treatment Inconsistent
  55. Alzheimer's Troubling Behaviors Hard to Treat
  56. Phobias Linked to Fatal Heart Attacks in Women
  57. 'Bio-Barcode' Alzheimer's Test Only a 1st Step
  58. Many Parents Apply Insect Repellant Incorrectly
  59. Bone Marrow Stem Cells Generate Heart Tissue
  60. Fasting Every Other Day Cuts Weight, Ups Crankiness
  61. Statins May Increase Arthritis Risk in Elderly Women
  62. Occasion Drinking Accounts for More Injuries
  63. Weight Gain Linked to Breast Cancer Death-US Study
  64. Health Tip: Build Strong Bones
  65. Scan Older Smokers for Aneurysms, U.S. Group Advises
  66. Good Nutrition vs. Need: A Closer Look
  67. Viruses, X-Rays Join List of Cancer Agents
  68. More Evidence Links Vioxx to Heart Attacks
  69. Quality of Life Okay After Repaired Heart Defect
  70. Genetics May Drive MS Gender Gap
  71. IQ-Related Brain Areas May Differ in Men, Women
  72. Blacks More Prone to Alzheimer's Disease
  73. Exercise Can Ease Depression
  74. New Drug Targets Pancreatic Cancer Two Ways
  75. Doctors Debate Value of Vitamin E
  76. Scientists Explore Risks Posed by Steroids

 

 

Friday, February 4, 2005

 

Constant Worry May Increase Alzheimer's Risk

 

By Alison McCook

Reuters Health

Friday, February 4, 2005

NEW YORK (Reuters Health) - People who have a tendency to worry or feel very stressed out may be more likely to develop Alzheimer's disease (news - web sites) later in life, new research reports.

The relationship between stress and Alzheimer's disease also appears to be much stronger in whites than in African-Americans, the authors note in the journal Neurology.

The nature of the connection between a tendency to worry and the memory-robbing disease is still unclear, study author Dr. Robert S. Wilson of Rush University Medical Center in Chicago told Reuters Health.

However, he said that he suspects that chronic elevations of stress hormones may damage regions of the brain that regulate both behavior under stress and memory.

Wilson emphasized that this study only connects stress and Alzheimer's, and does not prove that one causes the other. The report "does not establish that distress causes dementia," Wilson noted.

But while it's too soon to recommend that people reduce their stress to help avoid Alzheimer's disease, there are many other healthy reasons to relax, he added.

"The tendency to experience psychological distress is a trait that we all have to greater or lesser degrees," Wilson noted. "Family or friends concerned about a loved one who is chronically unhappy should encourage the person to see a qualified mental health professional."

As part of the study, Wilson and his colleagues asked 1,064 white and black people at least 65 years old about their tendency toward worry and stress, then examined them 3 to 6 years later to determine if they had developed Alzheimer's disease.

They found that people who appeared prone to feeling distressed were more than twice as likely to develop Alzheimer's disease within 3 to 6 years. The relationship between stress and Alzheimer's disease was much stronger in white participants, Wilson and his team report.

Wilson added that this is the first study to examine the link between stress and Alzheimer's disease in African-Americans.

"At this point we do not have an explanation for the racial difference, but we think the finding underscores the importance of including racial and ethnic minorities in this kind of research," he noted.

Source: Neurology, January 25, 2005.

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Seizures After Epilepsy Surgery Indicate Continuing Risk

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDayNews) -- Early seizures following epilepsy surgery indicate that a patient is at high risk to continue having seizures, say Australian researchers.

Currently, it's believed that seizures in the weeks following epilepsy surgery are temporary and likely caused by swelling or minor injury to the brain during the surgery. The new findings cast doubt on that assumption, however.

The study of 325 patients found that those who suffered a seizure within four weeks following epilepsy surgery were eight times more likely to have persistent epilepsy eight months later.

"These findings have implications for patient counseling, but they are also interesting in terms of understanding epilepsy. We can speculate that some individuals who undergo this procedure have epilepsy that for some reason is more persistent," study author Anne M. McIntosh, of the University of Melbourne, said in a prepared statement.

She stressed that the results don't cast doubt on the surgery itself, since it's only performed on patients who have debilitating epilepsy.

"Many subjects who have a return of epilepsy still have ongoing benefit from the procedure in terms of reduced seizure frequency," McIntosh said.

The findings were published online Jan. 24 in the Annals of Neurology.

More information

The Epilepsy Foundation has more about epilepsy.

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FDA Staff Questions Heart Risks of Merck's Arcoxia

By Lisa Richwine

Reuters

Friday, February 4, 2005

WASHINGTON (Reuters) - Merck & Co. Inc.'s painkiller Arcoxia offers a "marginal" advantage in gastrointestinal safety but seems "worse than" other pain drugs in terms of deaths and serious cardiovascular problems, U.S. regulatory staff said in documents released on Friday.

Merck conducted studies on Arcoxia comparing it to a placebo, naproxen and other medicines known as nonsteroidal anti-inflammatory drugs.

"The results appear to demonstrate that (Arcoxia) is worse than each comparator" with regard to deaths and serious cardiovascular problems, Food and Drug Administration (news - web sites) staff reviewers wrote in an analysis posted on the agency Web site.

The FDA (news - web sites) told Merck last October Arcoxia was "approvable" after additional safety and effectiveness data were reviewed. The agency will seek input later this month from an outside advisory panel on the risks and benefits of Arcoxia and other painkillers.

Merck believes Arcoxia "has the potential to become a valuable therapeutic alternative," company spokesman Chris Loder said. The firm believes it would be inappropriate to further discuss the drug before the panel meeting, Loder said.

Arcoxia is Merck's successor to Vioxx, the arthritis drug the company pulled from the market last year after it was linked to heart attacks and strokes. Both drugs are part of a class called COX-2 inhibitors.

"It looks like this spells trouble for Arcoxia, although we already knew the drug was going to have a tough time getting approved because of concerns it raises blood pressure and causes fluid retention," said Robert Hazlett, an analyst for Suntrust Robinson Humphrey.

Even if approved, some analysts have previously said they doubt Arcoxia could garner annual sales of more than $300 million, in part because of already swirling safety concerns. The drug is already sold in 51 countries in Europe, Latin America and Asia.

COX-2 inhibitors were developed to be gentler on the stomach and intestines than older painkillers, which can cause fatal bleeding.

In Merck's studies of Arcoxia, the drug appeared to offer a "marginal" gastrointestinal advantage that was seen mainly when it was compared to naproxen in patients with osteoarthritis, the FDA reviewers said.

In a separate analysis, FDA reviewers said an experimental COX-2 inhibitor called Prexige, made by Novartis, showed it was safer on the gastrointestinal tract than other pain drugs. But the risks of heart attacks, strokes and deaths was "similar" to what was seen with Vioxx, the FDA reviewers said.

The FDA will ask the advisory panel if any COX-2 drugs should be marketed, according to a memo also posted on the FDA Web site. The agency wants to know "if there is a patient population for whom the risk is warranted, given the known potential for benefit," the memo said.

Merck shares fell six cents to close at $28.35 on the New York Stock Exchange (news - web sites).

(additional reporting by Ransdell Pierson in New York)

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Put Your Heart on That To-Do List

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDayNews) -- After sending the kids off to school, putting in a full day's work and tending to household chores, most women find there's precious little time to exercise, meditate or prepare luscious, heart-healthy meals.

So if you're one of those women and you think you're not at risk of heart disease, think again: One in three American women dies of heart disease, making it the top killer of women in the United States, the NHLBI reports.

That's why, women's health advocates say, making time for yourself is so important.

"A woman has to give herself permission to take charge and take care of her life," said Dr. Barbara Alving, acting director of the National Heart, Lung, and Blood Institute (NHLBI), which is sponsoring "The Heart Truth," a campaign to raise women's awareness of heart disease.

As a key part of that initiative, Americans are encouraged to wear red on Friday, Feb. 4, which has been designated National Wear Red Day.

Coronary heart disease, the most common form of the disease, can start early in life -- even in a woman's teen years -- and progresses over time. Without treatment, the disease will worsen, eventually causing death or disability, government data show.

If you're middle-aged, now's the time to act. From ages 40 to 60, a woman's risk of heart disease begins to rise, according to the NHLBI. But there is plenty you can do to improve your heart health and dodge the serious consequences of heart disease. The first step is to know whether you are at risk.

On Feb. 18, Sister to Sister: Everyone Has a Heart Foundation Inc. will host the fourth annual National Women's Heart Day, an opportunity for women to get free heart disease screenings and information on living a healthy lifestyle. Heart-health screenings, including tests for total cholesterol, high-density lipoprotein (or good cholesterol), blood glucose, blood pressure and body mass index will be offered at health fairs in 12 cities.

Of the 10,000 women screened during the first three years, 30 percent have discovered they are, indeed, at risk for heart disease.

"That has been the most unbelievable finding," said Sister to Sister Founder and President Irene Pollin, a psychiatric social worker.

High blood sugar, high cholesterol, elevated blood pressure, physical inactivity, smoking, obesity and overweight are all major risk factors for heart disease. Diabetes, advancing age and a family history of heart disease also can boost a woman's risk.

Such information is readily obtainable through simple screenings and patient histories. "The next step is how do you really motivate these women, and that's what we do," Pollin said.

Once a woman knows her numbers and whether she's at risk for heart disease, she can begin to do something about it. Easier said than done? Sure, but there are many ways to live healthier, medical professionals say. You just have to make it part of your routine.

"This has to become a way of life, just like brushing your teeth in the morning," Alving said.

At the NHLBI, employees walk around with pedometers provided free of charge to motivate them to increase their level of physical activity. Alving's personal goal is 10,000 steps a day, but even a less-ambitious number can mark an improvement. "If a woman only does 5,000, if she can work on 7,000, that's great," she said.

Employees also are welcome to take 10 minutes out of their workday to lift free weights, ride a recumbent bike, or use an elliptical stair climber. That equipment is provided for free in designated "take 10 rooms," allowing for a short exercise break with no need to shower afterward.

"This is our way of trying to really work it into the workday," Alving said.

And don't forget diet. The American Heart Association (news - web sites) recommends eating plenty of fruits, vegetables and whole grains and avoiding saturated fats to help reduce your risk for heart attack and stroke.

Even frequent restaurant diners can find a way to enjoy a meal without overindulging on the super-sized portions frequently served. "I have started asking for bags to take home now," Alving admitted.

More information

For a list of the cities for National Women's Heart Day, visit Sister to Sister: Everyone Has a Heart Foundation Inc.

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Bat Saliva Drug May Improve Stroke Outcome

By M. Mary Conroy

Reuters Health

Friday, February 4, 2005

NEW ORLEANS (Reuters Health) - The results of a small study suggest that desmoteplase, an investigational clot-busting drug derived from vampire bat saliva, safely restores blood supply to the brain when administered up to 9 hours after a stroke occurs.

Dr. Anthony Furlan of the Cleveland Clinic Foundation in Ohio said that the rate of blood flow restoration in stroke patients who were randomly assigned to intravenous treatment with desmoteplase was 53.3 percent, compared with 37.5 percent in patients randomly assigned to receive placebo.

Furlan presented results of the Dose Escalation study of Desmoteplase in Acute Ischemic Stroke (DEDAS) at a late-breaking clinical trials session on Friday at the American Stroke Association International Stroke Conference 2005.

A lower dose of desmoteplase was not superior to placebo. However this dose was effective in an earlier European study and Furlan said it will be investigated in a large, multinational study of desmoteplase that will begin enrollment in April.

In terms of safety, there were no symptomatic episodes of bleeding in the brain, a potential side effect of this type of therapy. An earlier study of desmoteplase reported one symptomatic bleeding episode.

"Combining both studies the hemorrhage rate was 2 percent, which is less than the 6 percent hemorrhage rate reported with tissue plasminogen activator," he said. Tissue plasminogen activator, or tPA, is another clot-dissolving drug, which is currently on the market.

Furlan presented the results for 37 patients who were treated within 3 to 9 hours after they had a stroke. All of the patients had a National Institutes of Health (news - web sites) Stroke Score (NIHSS) between 4 and 20.

Eight patients were randomly assigned to receive placebo, 14 to low-dose desmoteplase and 15 to a higher dose of desmoteplase.

After 90 days, 9 patients in the high-dose arm had clinical improvement (60 percent) versus 2 in the placebo arm (25 percent) and 4 in the lower dose arm (28.6 percent)

The study was funded by Paion Pharmaceutical in Aachen, Germany. The phase III trial will be supported by Forest Pharmaceuticals of St. Louis.

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Migraine With Vision Loss Ups Stroke Risk

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDayNews) -- Women who have migraines that include a loss of vision have a 70 percent higher risk of a stroke compared with women who don't, government researchers report.

Scientists from the U.S. Centers for Disease Control and Prevention (news - web sites) presented their findings Feb. 3 at the American Stroke Association's International Stroke Conference in New Orleans. Another study reported at the conference by Italian researchers found that the increased risk for stroke from migraine among young people is independent of other stroke risks such as drinking, smoking or using oral contraceptives.

In the first study, CDC researchers looked at women who had migraine with aura. Aura is a sensory phenomenon such as visual or hearing abnormalities. Previously, migraines with visual aura have been linked with stroke, but it has not been clear if a particular type of visual disturbance is more closely linked with an increased risk of stroke.

In their study, the researchers collected data on 963 women between the ages of 15 and 49 who had participated in the Stroke Prevention in Young Women Study conducted at the University of Maryland School of Medicine. Of the women in the study, 542 had had a stroke.

The research team, lead by Dr. Wayne H. Giles, associate director for science at the CDC's Division of Adult and Community Health, wanted to find out if migraine accompanied by vision loss increased the risk of stroke, as opposed to migraine accompanied by other visual phenomena such as seeing lines and spots.

The team found that vision loss was a significant predictor of stroke. "Women who experience loss of vision as a symptom of migraine have a 70 percent increased risk of stroke compared with women who don't have migraines," Giles said.

According to Giles, about 17 percent of women have migraine, and 5 percent of these have migraine with aura. Among women with aura, more than 90 percent have visual symptoms, such as light sensitivity, seeing lines or spots, seeing flashes of light or temporary loss of vision.

In terms of the overall risk for stroke, migraine with vision loss is a moderate risk factor, Giles said.

"It is not as strong as something like hypertension or smoking, but if these findings are confirmed, it does give clinicians something to look for as they are evaluating women who suffer from migraine," he added.

Women who have these symptoms need to see their doctor and have their symptoms evaluated, Giles advised. "It is important that women who have migraine control their other risk factors for stroke like hypertension and elevated cholesterol. It is also important that they don't smoke," he said.

In addition, women who have migraine and take oral contraceptives need to speak with their doctor about the risk and benefits of oral contraceptives, Giles added.

"Migraine has been found in other studies to be a risk factor for stroke, particularly in women," said Dr. Ralph L. Sacco, director of the Stroke and Critical Care Division at Columbia University College of Physicians and Surgeons in New York City.

"This study adds to our thinking that those with visual symptoms have a little greater risk than those without," Sacco said. "Migraine can be treated and managed. And like any other risk factor, managing the migraine would be helpful."

Sacco also advises that to reduce the risk of stroke, the other common risk factors need to be managed. "If you have migraine, then it is more important to be managing the traditional risk factors as well," he said.

In the second report, researchers led by Dr. Massimo Camerlingo, head of the neurologic unit at Policlinico San Marco in Osio Sotto (Bergamo), Italy, collected data on stroke risk among 238 men and women aged 16 to 44.

The researchers looked at the use of oral contraceptives, wine and cigarette use, blood pressure, migraine history and cardiac rhythm.

Camerlingo's team found no difference between the groups in the use of oral contraceptives, drinking wine or smoking. The researchers found that those who had migraine were 2.7 times more likely to have a stroke compared with those who did not have migraine.

When migraine was combined with high blood pressure, the stroke risk increased ninefold. "The role of migraine in precipitating a stroke in young adults appears to be independent from the usual risk factors and from the consumption of wine, cigarettes and the contraceptive pills," Camerlingo said in a prepared statement.

More information

The American Stroke Association can tell you more about stroke.

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Supplement May Slow Marker of Prostate Cancer

By Amy Norton

Reuters Health

Friday, February 4, 2005

NEW YORK (Reuters Health) - A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a biomarker for prostate cancer progression in some men, preliminary research suggests.

The study of 37 men with the disease found that 6 weeks on the supplements generally lowered patients' levels of male sex hormones, which fuel prostate cancer growth, and, in some patients, put the brakes on rising levels of prostate-specific antigen (PSA).>

PSA is a protein produced by the prostate gland; rising PSA levels in a man's blood can signal cancer or, in men already diagnosed with the disease, cancer progression.

However, the PSA effects seen in this study do not necessarily mean the supplement was hindering the men's tumors from growing, according to the study authors. The question of whether the change in patients' PSA rise translates into a change in tumor size "remains unresolved," they report in the International Journal of Cancer.

But more "thought-provoking" is the possibility that diet changes could help lower a man's risk of developing prostate cancer, said lead study author Dr. Ries Kranse, of Erasmus Medical Center Rotterdam in the Netherlands.

The supplement mixture he and his colleagues studied included a powder-based drink that contained green tea extract, a soy extract supplying estrogen-like compounds called phytoestrogens, and antioxidants such as lycopene. Patients also used margarine spiked with cholesterol-fighting plant sterols and the antioxidants vitamin E and selenium.

The men in the study, all of whom had prostate cancer and rising PSA levels, used the supplements for 6 weeks; each also used inactive, or placebo, supplements for another 6 weeks.

Kranse and his colleagues found that the patients' male hormone levels were lower when they were on the supplement compared with when they were taking the placebo.

In the 21 men who showed a dip in a hormone measure called the free androgen index, the supplement also appeared to slow rising PSA levels. When these men were on the placebo, it took an average of 36 weeks for their PSA levels to double, versus 115 weeks with the supplement.

This finding, according to Kranse, suggests that if the supplement proves capable of slowing or stopping tumor growth, it would be through the hormonal effects of the estrogen-like compounds.

If this is the case, he said, a "dietary intervention" could eventually serve as an alternative to certain hormone-suppressing drugs used in prostate cancer treatment.

"Much more thought-provoking, however, is the possible role of a change in diet in primary prevention," Kranse added.

The current findings, he noted, are in line with studies of the general population that suggest diets rich in antioxidants and phytoestrogens may lower the risk of prostate cancer. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed.

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

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Menstrual Cycle Affects Depression Symptoms

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDayNews) -- A new finding that the menstrual cycle can affect depressive symptoms could aid doctors in evaluating and treating women suffering from depression.

"Most women who have depression and most doctors who treat depression are unaware that symptoms of depression can fluctuate with the menstrual cycle," study author Dr. Susan G. Kornstein, a professor of psychiatry and obstetrics-gynecology at Virginia Commonwealth University in Richmond, said in a prepared statement.

Her team tracked symptoms in 433 women diagnosed with major depression. They report that 64 percent of these women said their depression became worse in the five to 10 days before menses. Women who reported this premenstrual exacerbation (PME) of depressive symptoms also experienced a much longer duration (30.7 months) of depression than women who didn't have PME (13.5 months), the researchers added.

Women who reported PME tended to be older and had more general medical problems than women without PME, according to the study.

"Based on our findings, this type of symptom pattern is very common, especially in women who have chronic course depression. Identifying the fluctuation of depressive symptoms in a woman's menstrual cycle will help doctors better evaluate and treat women with depression," Kornstein said.

The study is published in the current issue of Psychological Medicine.

More information

The National Mental Health Association has more about depression in women.

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Steroid Therapy Impairs Long-Term Memory

By Will Boggs, MD

Reuters Health

Friday, February 4, 2005

NEW YORK (Reuters Health) - Treatment with high-dose steroids for multiple sclerosis and other disorders may impair long-term memory, according to a report in the medical journal Neurology. The good news is that mental functioning usually returns to normal a few days after stopping the drug.

"You should know about the side effects of this therapy, and keep in mind that steroids (especially in multiple sclerosis patients) may contribute to memory impairment," Dr. Stefan Schwab from University of Heidelberg, Germany told Reuters Health.

Schwab and colleagues investigated whether high-dose steroid therapy impaired memory in 21 patients with multiple sclerosis and 9 patients with a nerve condition affecting the eye. The comparison group consisted of 33 healthy subjects not treated with steroids.

Several long-term memory functions, including learning performance, immediate recall, and delayed recall, decreased with steroid use, the authors report. Most of these functions returned to normal within 10 days of stopping the drug, although immediate recall seemed to take a little longer.

"We (advise patients) that memory function can be disturbed over a few days," Schwab said.

"The findings are important in indicating that a (steroid) therapy commonly used in clinical practice to treat neurologic inflammatory disease affects memory," write Dr. Benno Roosendaal, from University of California, Irvine, and Dr. Dominique J.-F. de Quervain, from University of Zurich, Switzerland, in a related editorial.

"It is also important to note that recent findings indicate that (steroids) do not uniformly modulate memory of all kinds of information but, rather, preferentially influence the consolidation and retrieval of emotionally arousing information," they add.

Source: Neurology, January 25, 2005.

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New Scan Spots Drugs' Effects on Fetus

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDay News) -- Scientists say they've developed a sophisticated, non-invasive new imaging tool to determine the effects of prenatal drug exposure on a fetus.

Researchers at the U.S. Brookhaven National Laboratory (news - web sites), in Upton, N.Y., combined two hi-tech scans -- magnetic resonance imaging (MRI) and positron emission tomography (PET) -- to track the intake and distribution of trace amounts of cocaine in pregnant monkeys. This combination of images enabled them to pinpoint major differences in where and how fast cocaine accumulated in the organs of both mothers and fetuses.

The findings appear in the February issue of the Journal of Nuclear Medicine.

"Understanding how drugs are transferred between a mother and her fetus during pregnancy may help us unravel the mechanisms of the drug's damaging effects on unborn children," study lead author Helene Benveniste, chair of Brookhaven's medical department, said in a prepared statement.

"While studies that follow human drug abusers and their children over decades provide valuable information, animal studies can more quickly provide clues to the underlying mechanisms of damage and suggest ways to test new treatment or prevention strategies," Benveniste explained.

This combination of imaging technology may also prove useful in assessing the effects of pain drugs given to mothers following surgery on their fetuses in utero.

"Following such surgeries, which are becoming more common to correct congenital malformations, the mother is treated with narcotics for pain -- and anesthesiologists are relying on the mother transferring the pain medication to the fetus via the placenta. But we actually do not know if what we give is sufficient to 'satisfy' the pain level of the fetus," Benveniste said.

More information

The American College of Obstetricians and Gynecologists has information on illegal drug use during pregnancy.

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Most Preschoolers Don't Get Enough Fiber

By Alison McCook

Reuters Health

Friday, February 4, 2005

NEW YORK (Reuters Health) - A national survey shows that most children between the ages of 2 and 5 don't eat even close to the recommended amount of fiber, likely the result of their preferences for fiber-poor foods.

For instance, some of the main sources of fiber among preschoolers were applesauce, fruit cocktail, and high-fat meals such as pizza.

"Other higher fiber items, such as high-fiber vegetables and fruits, were consumed in quantities too small to contribute much to total average fiber intake," Dr. Sibylle Kranz of Pennsylvania State University in University Park and her colleagues report.

"The foods that made the top-ten list were all rather low in fiber, but children consume them in such large amounts, that they become significant sources of fiber," Kranz told Reuters Health.

Young children with higher levels of fiber intake and also ate more fruits and vegetables. And when fiber intake increased, so did levels of iron, folate, and vitamins A and C.

Kranz and her team also found that, on average, all children -- regardless of their fiber intake -- did not get enough calcium. Even fiber-lovers may not get enough calcium if they opt for more fruit drinks and soda over milk and other dairy products, Kranz suggested.

In the Journal of the American Dietetic Association, Kranz and her team note that the National Academy of Sciences (news - web sites) currently recommends that everyone eat 14 grams of fiber for every 1,000 calories they consume.

In kids, fiber appears to protect against chronic constipation, and other research shows it can also stave off some cancers, obesity, cardiovascular disease and diabetes.

In the study, Kranz and her team asked the parents of 5,437 children between the ages of 2 and 5 to report what children ate over a two-day period.

Children's other main sources of fiber were soy and legumes, ready-to-eat cereals such as shredded wheat, and high-fat salty snacks.

Younger preschoolers tended to eat less fiber than the older children. However, the highest category of fiber consumption among all children was only between 9 and 10 grams for every 1,000 calories -- significantly below the latest recommendations.

Kranz added that children who are used to a high-fiber diet will likely grow up to be adults who get healthy amounts of fiber, as well, which can protect them from a host of diseases.

Parents and teachers should try to "encourage children to consume more of these high-fiber foods," she noted, perhaps adding fresh fruit or substituting whole grain bread for white bread.

"With rather small efforts, they can improve their children's diets," Kranz said.

Source: Journal of the American Dietetic Association, February 2005.

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Bread is Back! Or So Hopes the Industry

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDay News) -- Breadaholics, rejoice. Then pass the breadbasket, please. Your favorite food is making a comeback, or so hopes the industry.

This week, the Grain Foods Foundation, a newly formed group of milling and baking companies, launched a "public education" campaign to fight back against the skip-the-bread trend linked to the Atkins, Zone and other high-protein, low-carb diets.

"We're trying to get people to come back to common sense," said Judi Adams, a dietitian and president of the foundation. "Fad diets may work short term, but not long-term."

Among their key points: grain-based carbohydrates aren't the problem in obesity; diets that restrict whole categories of food such as breads aren't feasible over the long term; and grain products are good sources of vitamins, mineral, fiber and other healthy substances.

The grain foundation is also hoping, of course, to boost stale bread sales. The consumption of wheat flour, commonly found in bread, is down -- from 147 pounds per person per year in the United States in 1997, to just 136 pounds in 2003, said Adams.

While the campaign isn't meant to condemn any particular diet, Adams said, the industry hopes the public will realize the role bread can play in a healthful diet.

Clearly, there is some educating to do, as a survey of more than 2,000 adults conducted for the foundation by Harris Interactive in late December suggests. Almost one in five women aged 35 to 44 said they thought bread was fattening or unhealthful, for instance.

Americans' love affair with bread continues, although their passion for grains seems to wane with age. While 64 percent of respondents 18 to 34 years of age said they loved bread, just 39 percent of those 55 and up agreed.

And Adams said that, despite claims to the contrary, eating bread can even help folks lose weight. "Bread, especially whole grain, does actually make people feel fuller sooner," she said.

Other dietitians not involved in the campaign concede that bread has a place in a healthy diet, but they also offered some caveats to breadaholics.

If you're drifting back to bread, it's still all about portion control, said Cathy Nonas, an American Dietetic Association (ADA) spokeswoman and director of the obesity and diabetes program at North General Hospital in New York City. "You still have to stay away from the bread basket or at least manage it."

Portions of bread are often huge and have gotten bigger in recent years, Nonas noted. "A typical bagel is no longer equal to two slices of bread, it's equal to four or six slices."

Like other dietitians, Nonas and Adams suggested that if you're on a 2,000-calorie-a- day diet, you should aim to eat three ounces of whole grains (from bread and other foods) and three ounces of other grains recommended by new U.S. Department of Agriculture (news - web sites) dietary guidelines.

Whole grains means the grain has not been refined or processed. To find them, the first ingredient on the label should say 100 percent whole wheat or whole grain. Grains that are not whole, called refined, are ideally enriched with niacin, thiamin, riboflavin, iron and sometimes calcium, dietitians said.

To keep your bread intake within healthy bounds, Nonas tells her clients to ask themselves; "Where is bread most important to you?" If you love your morning toast, go for it. If you'd rather have dinner rolls and could care less about toast, skip the morning bread.

"One slice of bread is a serving," Nonas said. "If you are only eating bread as your grains and you are paying attention to weight control, you should have no more than six servings." If you are not trying to lose weight, have six to nine servings, she suggested. "That goes quickly considering serving sizes," she said.

Make half of your grains whole grains, advised Katherine Tallmadge, a registered dietitian in Washington, D.C., and another ADA spokeswoman. And she thinks mixing up a daily combination of oats, rye and wheat is best.

"I worry about people who don't get any grains in their day," she said. But Tallmadge also stressed that moderation is key. On a recent trip to the grocery store, she discovered that the seven-inch submarine sandwich on sale included six ounces of bread. That's roughly 480 calories, she said. "And that is the amount of bread you should be eating the whole day."

More information

To learn more about whole grains, visit the American Dietetic Association.

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High Fat, Sodium Intake Are Risk Factors for Stroke

By Martha Kerr

Reuters Health

Friday, February 4, 2005

NEW ORLEANS (Reuters Health) - The results of a large urban multiethnic study show that high fat and high sodium diets are both risk factors for stroke, investigators with the Northern Manhattan Study (NOMAS) reported here Thursday.

NOMAS is an ongoing epidemiological study being conducted at Columbia University Medical School in New York. Investigators administered dietary questionnaires to 3,183 area residents. The average age of the subjects was 70 years; 21 percent were white, 24 percent black and 52 percent Hispanic. During 5.5 years of follow-up, 142 strokes have occurred.

The participants were divided into four subgroups according to the level of fat in their diet. These amounts were compared dietary fat levels recommended by the American Heart Association (news - web sites), which are 65 grams of fat per day -- based on a 2,000 calorie diet with 30 percent of calories derived from fat.

The subjects who ate the most fat each day had a 64 percent greater chance of having a stroke compared with those who ate the lowest levels, postgraduate research fellow Halina White reported at the American Stroke Association's International Stroke Conference 2005.

This figure was obtained after other factors that affect stroke risk were considered including age, gender, education level, race, ethnicity, high blood pressure, heart disease, diabetes, moderate alcohol consumption, smoking, body mass index and physical activity. She said subjects in the lowest dietary fat group consumed about 24 grams per day, while those in the highest group consumed more than 115 grams per day.

"Fat, particularly saturated fat...has an almost hormonal effect on the blood, causing the release of cholesterol, among other effects," White told Reuters Health. "Polyunsaturated fats have the opposite effect."

Neurology resident Armistead D. Williams, III, also presented data from NOMAS showing that a high sodium intake increases stroke risk. The same group of subjects was divided into four subgroups according to daily sodium consumption -- more than 4 grams, 3 to 4 grams, 2.4 to 3 grams, and less than 2.4 grams.

About one fifth of the study group consumed more than 4 grams of sodium a day, Williams noted.

The investigators used 2.4 grams as a reference level because an intake of 2.4 grams sodium daily or less meets the American Heart Association recommendation.

Consumption of more than 4 grams sodium a day increased stroke risk by 90 percent compared with the reference group, Williams reported. This was consistent regardless of whether or not the subject had high blood pressure, he added.

NOMAS lead investigator Dr. Ralph L. Sacco noted that "we can't exclude the blood pressure effect, but it is small."

Williams told Reuters Health that it is possible that the sodium is increasing the rigidity of the artery walls. "That's one of the things we're going to look at when we get back to New York."

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Scientists Get Handle on Kaposi's Sarcoma

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Friday, February 4, 2005

FRIDAY, Feb. 4 (HealthDay News) -- In a potential bit of good news for people with AIDS (news - web sites), researchers think they're coming closer to understanding how a virus attacks the immune system and sets the stage for the disfiguring kind of cancer called Kaposi's sarcoma.

The cancer, which can be fatal, was rare until the 1980s, when it began to take advantage of the weakened immune systems of AIDS patients. The telltale Kaposi's lesions frequently appear on the face, often making it obvious that someone has AIDS.

The findings, reported in the Feb. 3 issue of Science, won't immediately lead to a new treatment for Kaposi's sarcoma, said study co-author Dr. Don Ganem, a professor of medicine at the University of California at San Francisco. However, "this is the beginning of understanding," he said.

Few AIDS patients in the United States and Western European countries develop Kaposi's sarcoma anymore because a new generation of powerful drugs helps boost weakened immune systems, Ganem said. But Kaposi's sarcoma continues to threaten AIDS patients in Africa and other parts of the world where the drugs are as not widely available. Also, Kaposi's sarcoma continues to infect elderly men in the Mediterranean region who are not HIV (news - web sites)-positive, Ganem said.

The cancer can strike the skin, causing ugly lesions, or -- more dangerously -- attack the lungs and internal organs.

Before Kaposi's sarcoma develops, a person must be infected by a germ called Kaposi's sarcoma-associated herpesvirus, which is related to the virus that causes genital herpes. It isn't clear how the virus spreads; it's more common in gay male AIDS patients than in heterosexuals, suggesting that homosexual sex may play a role.

The herpes virus often doesn't cause any symptoms and can remain dormant in the body for a long time, like the germs that cause shingles several decades after someone has a case of chicken pox, said Dr. Henry B. Koon, an instructor of medicine at Beth Israel Deaconess Medical Center/Harvard Medical School (news - web sites) who studies Kaposi's sarcoma.

However, AIDS infection seems to wake up the herpes virus, and the cells that house the germs "not only make more virus, but they also form tumors," Koon explained.

Ganem and his colleague, Craig McCormick, investigated how the virus takes hold in the body. Although some of the virus's strategies remain a mystery, the researchers think they've discovered a communications pathway that helps the germs call in elements of the immune system known as cytokines.

In the immune system's intricate military operation, the cytokines serve a variety of roles, Ganem said. They act as a signal corps, directing soldier cells to the sites of problems, and also serve as a kind of weapon that can be used to attack enemies, he said.

The virus boosts the production of cytokines, Ganem said. This may seem like an odd approach, but it might serve to call in other immune system cells that the virus wants to hijack, he said. "It may be that it's just trying to attract more uninfected cells to the neighborhood and take them over," he added.

The next step in research is to gain more understanding of how the virus leads to cancer and to develop better treatments to stop it from spreading throughout the body, Ganem said.

While doctors can often easily treat Kaposi's sarcoma tumors in the skin, they sometimes must turn to chemotherapy and radiation. "The chemotherapy is pretty toxic, and not always effective," said Ganem, adding that a treatment to block the communications pathway could help patients.

More information

To learn more about Kaposi's sarcoma, try the American Cancer Society.

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Japan Says GM Rice Could Help Combat Hay Fever

 

Reuters

Friday, February 4, 2005

TOKYO (Reuters) - Bad case of hay fever? Eat more rice. Japanese scientists have developed a genetically modified strain of rice they say will help alleviate the symptoms of an affliction that causes misery each year for some 10 percent of Japan's population.

The new strain of rice contains a gene that produces the allergy-causing protein, a Farm Ministry official said on Friday.

"Eating the rice ... helps mute the reaction of the body's immune system," she said, adding that the effect was similar to other allergy treatments where a small amount of allergen is released into the body to allow resistance to build up.

Millions of Japanese suffer from hay fever each spring caused by an allergic reaction to pollen from the Japanese cedar tree.

The pollen count this spring is forecast to be 5 to 10 times worse than last year.

Officials gathered on Friday to discuss steps to battle the pollen menace, including the new rice, pollen-free cedar trees and a tea-drink that helps combat symptoms.

"This is becoming quite a social problem," said Yasufumi Tanihashi, a special cabinet minister for science and technology.

Growing the new rice could draw protests from consumers concerned about the safety of genetically modified products.

The official said that if the new rice goes into production it will be the first genetically modified product to be grown in Japan.

Ironically, production of rice, Japan's staple food, has been on a long-term downtrend due to falling consumption.

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Minimally Invasive Surgery Remakes Face of Medicine

By Mark Bloom
HealthDay Reporter

HealthDayNews

Friday, February 4, 2005  

FRIDAY, Feb. 4 (HealthDay News) -- When it comes to advances in surgery, smaller is often better.

Not long ago, a torn ligament in the knee, or even a frayed cartilage, was a nightmare scenario for a patient, fraught with the prospect of open surgery, followed by painful recovery and rehab lasting many months. Knees were generally never the same afterward.

Then about 30 years ago came the revolution -- arthroscopic surgery, now known as scoping. It marked the beginning of the era of minimally invasive surgery, an approach that in various forms has essentially spread from head to toe. Since then, tens of thousands of patients every year have popped back from surgery in days instead of weeks or even months. All this because minimally invasive operations use the tiniest of incisions, aided by cameras and surgical tools in miniature.

"Almost every organ in the human body has become accessible to the surgeon's camera and scalpel," said Dr. Marelyn Medina of Rio Grande Regional Hospital in McAllen, Texas, a member of the public relations committee of the Society of Laparoendoscopic Surgeons.

At first, traditional surgeons reeled from the innovation, made possible by fiber-optic technology, and many retired rather than learn their craft all over again. But patient demand for less-painful surgery prevailed, and minimally invasive surgery is now mainstream, routinely taught to young surgeons of various stripes and, among others, cardiologists. Depending on the organ and approach, it has other names, such as laparoscopic, thoroscopic or endoscopic procedures.

Other developments also simplified surgery to the benefit of a patient's quality of life. Short-acting anesthesia enabled the expansion of outpatient surgery. Catheter-based procedures such as angioplasty -- not really surgery at all -- supplanted much open coronary-bypass surgery and other scalpel-based operations. Then cardiac surgeons developed techniques to do many coronary-bypass procedures laparoscopically -- the so-called keyhole coronary bypass. Now, even heart valves are replaced with minimally invasive procedures.

For emphysema patients in the late stages of the disease, the open-surgery for lung volume-reduction is now being done in several centers as a minimally invasive procedure via an endoscope.

Early on, flexible fiber-optics led to the colonoscope for colon-cancer screening. At the other end, endoscopes let doctors do upper GI exams with ease under light sedation.

In the knee, the then-new fiber optic technology allowed surgeons to watch on a television monitor while a small telescope, an arthroscope, peered inside the joint via one of three tiny incisions instead of cutting the whole knee open. Surgeons watching on a TV monitor used tiny instruments inserted through the second incision to cut, trim or tie. The third incision was for a cannula -- a small flexible tube -- that flushed sterile fluid through the joint. As orthopedic surgeons' hand-eye coordination improved, they devised new techniques that gave new life to once-doomed knees with ruptured anterior cruciate ligaments.

After the knee came the gall bladder, the target of one of the most common major operations in the United States, called a cholecystectomy. It's a rare gall bladder these days that isn't removed with the aid of a laparoscope. In the debate over whether to adopt the minimally invasive procedure, traditionalists argued that it was more complicated, took longer and was, as a result, more expensive and riskier. Patients pointed to the rapid near-painless recovery. Patients' quality of life won the debate in a walk.

A cholecystectomy is still not a walk in the park, but many patients go home less than 24 hours later, some the same day. With traditional open surgery, a five-day hospital stay was the minimum. With experienced surgeons, the overall laparoscopic complication rate is less than 2 percent.

"Laparoscopic cholecystectomy's tremendous success, along with the flood of new technology into general surgery, stimulated surgeons to apply laparoscopic techniques to treat other gastrointestinal diseases," said Dr. Garth Ballantyne, director of minimally invasive surgery at Hackensack University Medical Center in Hackensack, N.J.

"Many other organs can now also be approached in a similar manner," added Rio Grande Regional Hospital's Medina. "These include the stomach, intestines, pancreas and spleen, kidneys and all the female organs. More recently operations have also been developed for diseases of the bladder and the prostate in men."

Proving its worth is a so-called catheter-based procedure using only tiny incisions in the groin -- much like angioplasty -- to repair abdominal aortic aneurysms, the potentially fatal weakness of an area in the major heart artery. In a European trial, the procedure had a lower short-term death rate than a full open operation. The minimally invasive procedure is called endovascular repair, involving a patch or tube threaded upward from small incisions in the groin to strengthen the weak area.

The trial included 345 patients with a telltale bulge in the aorta, indicating a weakness and risk of rupture. This condition causes an estimated 15,000 deaths in the United States every year. It is the third leading cause of death in men over age 60.

In the study, 171 patients had conventional surgery, with the weak spot being patched through a large abdominal incision. Another 174 patients underwent endovascular repair.

Eight of the patients who had conventional surgery died in the following month, a mortality rate of 4.6 percent, said a report in the New England Journal of Medicine (news - web sites). Only two of those who had endovascular repair died, a mortality rate of 1.2 percent.

In the orthopedic world, prolapsed disks in the spine may be suctioned out of the back via a small tube inserted through the incision.

Removal of diseased or malignant kidneys has also become a common procedure.

In another arena, ophthalmologists have developed techniques to do cataract surgery in minutes, with recovery measured in hours, compared with weeks in the past.

More information

The Society of Laparoendoscopic Surgeons explains the procedures in more detail.

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Cord Blood from Two Donors Okay for Leukemia

Reuters Health

Friday, February 4, 2005

NEW YORK (Reuters Health) - Transplanting umbilical cord blood from two separate donors appears to be a safe and effective treatment for leukemia, new research suggests.

The findings suggest that umbilical cord blood transplants could be made available to thousands more adolescent and adult patients, Dr. Juliet N. Barker of the University of Minnesota in Minneapolis and colleagues write in the medical journal Blood.

Umbilical cord blood transplants have advantages over bone marrow transplantation--including rapid access and little risk of graft-versus-host disease (GVHD), a serious condition that occurs when blood cells present in the transplant actually attack the recipient. However, umbilical cord blood donations to adults have been sharply limited by the small size of a single unit, Barker and her team note.

The researchers conducted the current study to determine if this limitation could be overcome by giving adults two units of partially matched umbilical cord blood from separate donors. Twenty-three patients received the transplants for severe forms of leukemia.

While two of the patients died of infection shortly after transplantation, the umbilical cord blood transplant successfully took root or "engrafted" in all of the other patients. Engraftment is the main goal for any type of transplant.

At one year, 72 percent of the patients who had received the transplant during remission were still alive. Moreover, the rate of GVHD was no greater than that seen with single-unit umbilical cord blood transplants.

The authors conclude: "Transplantation of two partially...matched umbilical cord blood units is safe, and may overcome (the barriers that limit) the use of umbilical cord blood in many adults and adolescents."

Source: Blood, January 25, 2005.

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Thursday, February 3, 2005

 

Young Cell Phone Users Drive Like Seniors

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Thursday, February 3, 2005

THURSDAY, Feb. 3 (HealthDay News) - Driving while talking on a cell phone adds decades to a young driver's life -- at least in terms of impaired driving ability, researchers say.

A new study finds the reaction time of young drivers using cell phones slows to levels roughly equivalent to those seen in 70-year-old drivers not using cell phones.

"They aged 50 years in five seconds, just by turning on their cell phones," said researcher Frank Drews, a cognitive psychologist at the University of Utah.

The findings, published in the current issue of Human Factors, included some good news for elderly drivers: their cell phone use did not further slow their reaction time any more than that of the young.

Drews and his colleagues first came to public attention in 2001, with a study pinpointing "inattention blindness" -- a splitting of available attention between the phone conversation and the road ahead -- as the main cause of impaired driving while on cell phones. That study raised questions as to whether legislation in New York and New Jersey banning handheld cell phone use while driving (in favor of hands-free devices), was really a solution to the problem.

In their latest research, Drews and co-researcher David Strayer examined the effects of cell phone use on two groups of drivers that federal statistics suggest are at highest risk for traffic accidents -- the young (between 18 and 25 years of age) and the elderly (between 65 and 74 years of age).

Using hi-tech, virtual-reality driving simulators, they had 20 people from each age group maneuver through busy highway traffic -- first without using a cell phone, and then while engaged in a long cell phone discussion.

While on cell phones, "people exhibit what we call sluggish driving behavior," Drews said. "They basically don't respond to the onset of the pace car's brake lights as well, and they aren't applying their brakes as strongly as someone who's not talking on the cell phone."

For example, in young drivers using cell phones, reaction times in hitting the brakes slowed from an average of eight-tenths of a second to just over nine-tenths of second. That difference may not sound like much, the researchers say, but it's roughly the difference in braking reaction times between a 20-year-old and a 70-year-old.

In terms of virtual-reality "accidents" occurring during the simulation, there were six, all rear-enders. Four of the six occurred while the drivers were talking on cell phones, and only one of those four involved an older driver. The other three involved young motorists, the researchers said.

Drews stressed that these numbers were far too small to reach statistical significance, so no firm conclusions can be drawn as to whether or not cell-phone use ups accident risk. However, he pointed out, "All of the previous studies [on the issue] show more accidents when people are talking on a cell phone than when they aren't."

The study did reveal the good news for elderly drivers: "We expected to find that [cell phone-linked] impairment would be much more when you're old than when you're young," Drews said. "But we found no such interaction." That's probably because older motorists compensate by bringing extra experience and caution to their driving, he added.

The Utah researcher shied away from any recommendation that cell phone use while driving be banned altogether, preferring to let the data speak for itself.

"I'm not a politician, but I think politicians should carefully review the existing literature and make an informed decision about the risks," Drews said. "We as a society have to determine, also, at which point we are no longer willing to take the risks associated with cell phone use while driving."

Drews did point to findings from one other study he helped conduct, however.

"We compared one accepted [legal] threshold of risk -- being legally drunk -- and compared the driving behaviors of people who were drunk vs. people who were on cell phones," he said. "We didn't find a lot of difference."

More information

To learn more about cell phone use and driving, go to the National Highway Traffic Safety Administration.

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Rheumatoid Arthritis Raises Heart Death Risk – Study

 

Reuters

Thursday, February 3, 2005

WASHINGTON (Reuters) - Rheumatoid arthritis seems to raise the risk of silent heart disease in patients -- even before they know they have the chronic condition, U.S. researchers reported on Thursday.

They found patients who later were diagnosed with rheumatoid arthritis were three times more likely to have been hospitalized for an acute heart attack and five times more likely to have an unrecognized heart attack.

After diagnosis, the rheumatoid arthritis patients were twice as likely to find out they had a heart attack and did not even notice, or to die suddenly from a heart condition, the researchers wrote in the journal Arthritis & Rheumatism.

The increased risk could not be accounted for by other factors such as elevated cholesterol, blood pressure, weight or alcohol abuse, said Dr. Hilal Maradit Kremers of the Mayo Clinic in Rochester, Minnesota, who led the study of 600 patients.

"What we are finding is that though traditional cardiovascular risk factors are important, they are less important for those with rheumatoid arthritis," Maradit Kremers said in a statement.

"Something else is going on. It could be that rheumatoid arthritis and heart disease have a common origin. What we do know is that the cause cannot be explained by just one factor."

Rheumatoid arthritis, which affects more than 2 million Americans, is an autoimmune disease caused when immune cells mistakenly attack the joints and organs.

It causes chronic pain and disability and there is no cure.

The pain may make them unaware of having heart attacks, Maradit Kremers said. The heart attacks are diagnosed later during heart examinations.

"It's possible that people suffering from rheumatoid arthritis have so much pain in their joints and are receiving so many painkillers that they either don't feel the chest pain in the same way as those without rheumatoid arthritis or don't appreciate its importance," she said.

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Health Tip: Be Mitey Careful!

 

HealthDayNews

Thursday, February 3, 2005

(HealthDayNews) -- The next time you feed Spot, you may be giving him more than just his dinner. There may be mites in his food!

These miniature critters, which resemble spiders under a microscope, can live on just about anything. And they can cause allergies in pets and in people.

To keep them out of Spot's food -- and Fluffy's -- keep the food cool and dry, and don't store it in humid areas. Vacuum the place where the food is stored a least once a week. Also, keep the area around Spot's dish clean, and don't allow water from his water dish to get into his food bowl.

On warm, humid days, don't leave pet food sitting out, and vacuum the area where your pet sleeps.

He'll thank you by staying healthy.

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Welders Show Elevated Rate of Parkinson Symptoms

 

By Amy Norton

Reuters Health

Thursday, February 3, 2005

NEW YORK (Reuters Health) - Welders may have a higher-than-average rate of Parkinson's disease (news - web sites) symptoms, the results of a new study suggest.

Researchers found that among more than 1,400 welders from Alabama, the prevalence of Parkinson-like symptoms, including tremor, muscle rigidity and slowed movement, was 7 to 10 times higher than the norm for the general population.

The findings, based on a group of mostly male welders between the ages of 40 and 69 years, are published in the journal Neurology.

In an earlier study of 15 career welders, the same investigators found that the men started suffering Parkinson's symptoms at an atypically early age -- at age 46 on average, versus age 63 in a comparison group of non-welders. That led the researchers to speculate that an as yet unknown toxin in welding fumes might speed the onset of Parkinson's disease in people who would likely have developed the disease at an older age.

That study, published in 2001, has since been cited in lawsuits against welding-rod manufacturers. Late in 2003, a jury awarded $1 million to a plaintiff who claimed that years of inhaling toxic welding fumes caused his Parkinson's disease, and thousands of similar lawsuits have since been filed.

But exactly how common Parkinson's is among welders has been unknown. To find out, Dr. Bruce A. Racette of Washington University School of Medicine in St. Louis and colleagues assessed 1,423 welders, mostly men, who were referred by an attorney for Parkinson's screening. The researchers compared the welders' rates of "definite" and "probable" Parkinson's disease with those found in a previous study of people living in Copiah County, Mississippi.

Overall, 6 percent to 10 percent of the welders were diagnosed with definite Parkinson's disease, while 13 percent were found to have probable Parkinson's disease. As mentioned, their rates were 7 to 10 times higher than those in the general male population of Copiah County.

"This study is the largest, to date, implicating welding as a risk factor for parkinsonism," Racette told Reuters Health. Other studies, he added, have found no such risk, but it's unclear whether that is related to the smaller size of those study groups.

"We feel that our study is preliminary and requires follow-up with an epidemiology study that incorporates a control group without welding exposure," Racette said.

Parkinson's disease is a progressive neurological condition typically marked by four types of symptoms: tremors, muscle rigidity, slowed movement and problems with balance and coordination. The disease occurs when certain brain cells that produce the movement-regulating chemical dopamine are damaged or destroyed.

No one knows what triggers this brain damage, but scientists believe that a number of factors, genetic and environmental, likely play a role. On-the-job exposures to certain chemicals, including pesticides and herbicides, have been linked to Parkinson's disease, and overexposure to the mineral manganese can lead to Parkinson's-like symptoms.

The welding process creates fumes that contain manganese, and according to Racette and his colleagues, exposure to the metal "cannot be excluded" as the cause of their patients' symptoms.

There are many potential toxins in welding fumes, Racette noted, though manganese is the one best recognized as being damaging to nerve cells.

More research, he added, will be needed to clarify exactly what led to the Parkinson's symptoms seen in these welders.

The current study received partial funding from the Welder Health Fund, created by a group of attorneys to support Parkinson's disease screening for welders. None of the study authors has received money related the research, according to a disclosure statement in the report.

Source: Neurology, January 25, 2005.

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Health Tip: Chest Pain Is Nothing to Sneeze At

HealthDayNews

Thursday, February 3, 2005

(HealthDayNews) -- Many people get a little chest pain once in a while. Others get a lot of chest pain too often.

Pain in the chest, especially when it involves your heart, is called angina pectoris. Because it could indicate that a heart attack is imminent, doctors consider all serious chest pain complaints to be angina pectoris until proven otherwise.

Fortunately, the majority of chest pain complaints stem from something other than arterial blockages severe enough to cause angina pectoris and a heart attack, the U.S. Centers for Disease Control and Prevention (news - web sites) says.

Other causes can include:

If your chest pain feels serious, don't take chances. Check with your physician.

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Kidney Disease Tied to Mental Impairment

By Michelle Rizzo

Reuters Health

Thursday, February 3, 2005

NEW YORK (Reuters Health) - Menopausal women with chronic kidney disease have lower scores on tests of mental proficiency (cognitive function) than those without chronic kidney disease, according to a new study.

"Since chronic kidney disease is common, especially among the elderly, these findings suggest chronic kidney disease is an important risk factor for cognitive impairment," Dr. Manjula Kurella told Reuters Health.

Kurella, of the University of California, San Francisco, and colleagues assessed data for more than 1,000 women enrolled in the Heart Estrogen/Progestin Replacement Study to investigate the effect of kidney function on cognition. All subjects had established coronary artery disease at study entry.

The participants (average age of 66.7 years) underwent a battery of six cognitive function tests. Chronic kidney disease was classified as mild, moderate or severe based on the estimated glomerular filtration rate (eGFR), according to the team's report in the American Journal of Kidney Diseases.

The results showed a significant association between eGFR and impairment in global cognition, executive function, language and memory. This association was not influenced by patient age, race, education level, lifestyle factors, stroke, and other laboratory test variables.

"While persons with kidney failure on dialysis were known to have an increased risk of dementia and milder forms of cognitive impairment, the increased risk of cognitive impairment among persons with milder degrees of kidney failure (i.e. chronic kidney disease not yet on dialysis) was not appreciated," Kurella commented.

Source: American Journal of Kidney Diseases, January 2005.

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Mini-Strokes Need More Medical Attention  

HealthDayNews

Thursday, February 3, 2005

THURSDAY, Feb. 3 (HealthDayNews) -- People who suffer a "mini-stroke", or transient ischemic attack (TIA), receive less aggressive medical attention in terms of testing, treatment and education than patients with full-blown stroke do, researchers report.

That's sobering news, they say, because any failure to devote attention to TIA undermines efforts to prevent disabling or even fatal strokes later on.

"There needs to be a paradigm shift in the way the public and physicians look at TIA," lead author Dr. Bhuvaneswari Dandapani, medical director of the stroke center at Holmes Regional Medical Center in Melbourne, Fla., said in a prepared statement.

He and his colleagues compared treatment received by 91 TIA patients and 94 stroke patients. A far lower percentage (54 percent) of TIA patients received ultrasound tests compared with stroke patients (76 percent). The study also found that 35 percent of TIA patients received some kind of education about stroke and stroke warning signs, compared with 67 percent of stroke patients.

The study was presented Feb. 3 at the American Stroke Association's International Stroke Conference in New Orleans.

About a third of people who suffer from a mini-stroke will have a major stroke within five years unless they receive preventive therapy, experts say. TIA symptoms are similar to stroke symptoms but last only a short time.

"The public fails to understand that experiencing a TIA is a medical emergency, and those who have symptoms should seek attention in the emergency room. For physicians, a TIA represents an opportunity to prevent a catastrophic stroke," Dandapani said.

More information

The American Heart Association (news - web sites) has more about TIA.

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Diets Rich in Rice Bran Oil May Lower Cholesterol

By Charnicia E. Huggins

Reuters Health

Thursday, February 3, 2005

NEW YORK (Reuters Health) - New research findings pinpoint the specific component of rice bran responsible for its heart-healthy effects. Two small studies show that it is the oil, and not the fiber, that helps lower cholesterol.

"The findings provide evidence of the fact that plants contain compounds that are beneficial to our health," lead study author Dr. Marlene M. Most, an associate professor at the Pennington Biomedical Research Center in Baton Rouge, Louisiana told Reuters Health.

"Rice bran oil is a good example of functional food with a beneficial effect -- lowering cholesterol to reduce risk for cardiovascular disease," she added.

Previous research has also pointed to the heart-healthy effects of rice bran and rice bran oil, which is most commonly available in Japan and India, but may also be found in some specialty stores in the United States.

In one study, the researchers found that adding rice bran to the diet of men and women with moderately high cholesterol lowered cholesterol levels just as effectively as an oat bran-containing diet did. In the other study, investigators found that middle age and elderly study participants who substituted rice bran oil for their usual cooking oils experienced decreases in their cholesterol levels.

In the first study, 26 men and women were randomly assigned to a low-fiber diet, in which they consumed up to 22 grams of fiber per day, or a high-fiber diet with defatted rice bran, in which they consumed twice as much fiber as the other group. The defatted rice bran was used in muffins, cookies and breads.

At the end of the five-week study, none of the patients experienced great changes in their overall blood cholesterol levels. An unexpected finding was that subjects in the defatted rice bran group had higher levels of low-density lipoprotein (LDL) cholesterol -- the artery-clogging "bad" cholesterol, the investigators reported in the American Journal of Clinical Nutrition (news - web sites).

In the second study, 14 participants followed two different diets for five weeks each. During the first five-week period the study participants consumed one third of their total daily dietary fat in the form of a blend of peanut oil, olive oil, corn oil, canola oil, palm oil and butter. During the second five-week period, the oil blend was replaced with rice bran oil.

The oil blend had a fatty acid composition similar to that found in rice bran oil, the researchers note. Rice bran is high in saturated fatty acids, which has been shown to have deleterious effects on cholesterol levels. Thus, a diet consisting of rice bran oil would not be expected to lower cholesterol, Most said.

At the end of the study, however, Most and her team found that the study participants' cholesterol levels -- LDL cholesterol in particular -- were lowest when their diet consisted of rice bran oil.

The findings from both studies show that "it is the rice bran oil, and not the fiber, that lowers blood lipids in men and women with borderline high total cholesterol," Most and her team write.

Despite these findings, Most believes it is too soon to recommend that Americans immediately start adding rice bran oil to their diet. "Rice bran oil...is not commonly consumed in the United States it would be unreasonable to tell people to begin consuming large quantities."

Source: American Journal of Nutrition, January 2005.

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Breast Cancer Prevention From The Sea

By Serena Gordon
HealthDay Reporter

HealthDayNews

Thursday, February 3, 2005

THURSDAY, Feb. 3 (HealthDay News) -- More than just a slimy nuisance that wraps itself around your ankles while you walk the beach, seaweed may actually be a powerful tool in the fight against breast cancer.

That's because a diet containing kelp seaweed may reduce the amounts of estrogen circulating in the body, a new study claims. Lower estrogen levels mean there's less fuel available for the development of estrogen-dependent cancers, such as some forms of breast cancer, the researchers explain.

This study, which appears in the Feb. 2 issue of the Journal of Nutrition is the latest to examine differences between the typical Asian diet and the typical Western diet, looking at how those differences might contribute to the development of breast cancer.

Japanese women, who have a significantly lower risk of breast cancer than women in the United States, also have a much higher dietary intake of seaweed, according to the study.

In Japan, seaweed is used in the preparation of sushi dishes, in Miso soup, in stews, and as a thickening agent. In some Asian countries, seaweed is even eaten as a snack, said study author Christine Skibola, an assistant research toxicologist at the University of California at Berkeley School of Public Health.

The current study, done in rats, developed out of several case studies Skibola had conducted on women taking 700-milligram seaweed supplements daily to treat extremely irregular menstrual cycles from disorders such as endometriosis. Skibola noticed the women's menstrual cycles became longer and more regular, and that their blood levels of estradiol -- a form of estrogen -- dropped significantly.

"It was kind of amazing how much it helped their pain and how it altered their menstrual cycles, and we saw a remarkable decrease in estradiol levels," said Skibola, who stressed that while these case studies were remarkable, they were conducted in just three women.

To further test the effects of seaweed, Skibola and her colleagues had rats consume bladderwrack seaweed, which is closely related to two Japanese favorites, wakame and kombu seaweed.

The study included 24 female rats, split into three different groups. One group was given a high dose -- 70 milligrams -- of kelp, while another group was given 35 milligrams daily. These doses are about equivalent to the normal Japanese diet, said Skibola.

The third group served as a control group and was given no kelp. To ensure that the rats consumed the correct dose of dried kelp, it was sprinkled onto their favorite food, apples.

After four weeks, the researchers found that consumption of kelp increased the average length of the rodent's menstrual cycle by 37 percent. At the start of the study, the average menstrual cycle was 4.3 days. After consuming kelp, the low-dose group averaged 5.4 days, and the high-dose group increased to 5.9 days.

When the researchers tested blood levels of estradiol in rats from the low-dose kelp group they found declines in the hormone from 48.9 nanograms per liter at the start of the study to 36.7 nanograms per liter four weeks later.

According to Skibola, the researchers also tested human ovarian cells in culture and found that the cells' estrogen levels fell when exposed to kelp extract.

Skibola explained that compounds in seaweed appear to compete with estrogen for for spots on estrogen receptors in cells. The overall effect could be reductions in circulating estrogen.

By increasing the length of the menstrual cycle and decreasing levels of estrogen, the researchers suggest that seaweed could reduce the risk of estrogen-dependent breast cancers because there would simply be less estrogen available to fuel tumor growth.

Others aren't convinced, however.

"I think this is interesting, but it's another theory," said Dr. David Decker, chief of hematology and oncology at William Beaumont Hospital in Royal Oak, Mich. "They've shown that seaweed given to rats can change their estrogen levels, but we don't know for sure if that applies to humans."

"Women shouldn't go out and start eating lots of seaweed," said Decker, who added that it's probably more important for breast cancer prevention to eat an overall healthy diet and to make sure you get screening mammograms beginning in your 40s.

Skibola also hopes that no one consumes large quantities of seaweed, but says that in moderation it can be a healthy addition to the diet. But, she cautioned, seaweed does contain iodine and low levels of some heavy metals, so large amounts, whether in dietary or supplement form, may not be good for some people.

"I don't think people should go out and self-medicate, but in the diet, seaweed is generally a healthy thing to incorporate," she said.

Skibola said that the researchers are trying to isolate exactly which compounds in seaweed effect estrogen levels, in hopes that they may one day be able to develop a drug from those compounds to help prevent estrogen-dependent cancers.

More information

To learn more about preventing breast cancer, visit the National Cancer Institute.

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Predictors of Sudden Death in Diabetics Questioned

Reuters Health

Thursday, February 3, 2005

NEW YORK (Reuters Health) - A problem with the nerves that control internal body functions, known as diabetic autonomic neuropathy, was always considered the main risk factor for sudden cardiac death in diabetics, but new research suggests that heart and kidney disease play bigger roles.

Dr. Guillermo A. Suarez, at the Mayo Clinic College of Medicine in Rochester, Minnesota, and colleagues identified 21 cases of sudden cardiac death among 462 diabetic patients who were followed for 15 years.

Heart disease, including plaques in the blood vessels feeding the heart and heart attacks, was the greatest risk factor for sudden cardiac death, the team reports in the Journal of Neurology, Neurosurgery, and Psychiatry. All of the patients who died had some degree of plaque build-up.

Kidney disease was also an important risk factor for sudden cardiac death. In fact, after accounting for this risk factor, diabetic autonomic neuropathy was no longer a significant predictor of sudden cardiac death.

"In the light of our results," the investigators conclude, "the role of autonomic neuropathy as the pivotal event in sudden cardiac death in diabetic patients probably needs revision."

It's possible that "diabetic autonomic neuropathy may act as the transient factor conducive to the final event," they add, "but further studies are necessary to determine this."

Source: Journal of Neurology, Neurosurgery, and Psychiatry, February 2005.

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Many EU Cancer Patients Use Alternative Meds

HealthDayNews

Thursday, February 3, 2005

THURSDAY, Feb. 3 (HealthDay News) -- More than a third of cancer patients in Europe use complementary and alternative therapies, says a study in the latest issue of the journal Annals of Oncology.

Based on their findings, the international team of researchers who conducted the study said the use of complementary and alternative medicine in cancer care should be integrated into healthcare systems and regulated by the European Union (news - web sites).

Herbal treatments were mostly commonly used by European cancer patients, followed by treatments such as homeopathy, vitamin and mineral supplements, and spiritual therapies, the researchers found.

The Europe-wide study of almost 1,000 cancer patients found that use of these types of treatments by cancer patients ranged from a low of slightly less than 15 percent in Greece to a high of almost 75 percent in Italy.

Users of alternative or complementary therapies tended to be female, younger and more highly educated. Most users believed in the efficacy of these remedies, with only 3 percent expressing doubts as to their effectiveness. People with pancreatic, bone, liver and brain cancer (cancers with a poor prognosis) used alternative treatments far more often than other cancer patients. The mean length of treatment was 27 months, with a range from one month to 18 years, the researchers report.

The findings show that it's essential for doctors and other health professionals to be aware of alternative remedies, and to be able educate their patients about them, the study authors said.

"Irrespective of what health professionals believe about complementary and alternative medicines and how dismissive they might be, our findings show that patients are using, and will continue to use [them]," study lead author Dr. Alex Molassiotis of the University of Manchester School of Nursing, Midwifery and Social Work, said in a prepared statement.

More information

For more on alternative medicine, head to the U.S. National Center for Complementary and Alternative Therapies.

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Blood Pressure Control Key to Preeclampsia Prevention

By Anne Harding

Reuters Health

Thursday, February 3, 2005

NEW YORK (Reuters Health) - In pregnant women with high blood pressure, both the top measure (systolic) and the bottom measure (diastolic) of blood pressure are important predictors of potentially serious complications, a new study suggests.

Very high systolic pressure is a better warning sign of stroke in women with preeclampsia or eclampsia than is very high diastolic pressure, researchers report. Preeclampsia, also known as toxicemia of pregnancy, is marked by high blood pressure, fluid retention and protein in the urine. If untreated, this condition may progress to eclampsia, a life-threatening complication.

"The paradigm for ob-gyns for half a century, let's say, has been that the diastolic pressure is the most important, and that one generally doesn't start blood pressure medications for patients with preeclampsia until the diastolic pressure reaches 110," Dr. James N. Martin of the University of Mississippi Medical Center in Jackson told Reuters Health.

"What we're saying is that is not correct -- we should be paying attention to both numbers."

Martin and his colleagues analyzed case histories of 28 women who had a stroke associated with severe preeclampsia or eclampsia. The findings are published in the journal Obstetrics & Gynecology.

While only three of the patients had diastolic pressure of 110 mm Hg or higher immediately before having a stroke, they found, 23 of the patients had systolic blood pressures of 160 mm Hg or higher, and all had systolic pressures over 155 mm Hg.

Only three of the patients received treatment for their high blood pressure before the stroke occurred.

The next step in the research, Martin said, will be to see how effective existing drugs, such as hydralazine or labetalol, will be in keeping systolic blood pressure below 160, and whether controlling systolic blood pressure will prevent stroke.

"A lot of pregnant women get to that range and don't have strokes," he added. "We need to figure out why certain women do have strokes."

Martin and his colleagues found several women in the study had also developed hemolysis, elevated liver enzymes and low platelets, or HELLP syndrome.

His group's practice is to treat HELLP with corticosteroids, Martin noted. None of the women had these drugs in their systems at the time they suffered a stroke, suggesting that treating HELLP may be a key aspect of stroke prevention.

Women who have severe preeclampsia and eclampsia and very high systolic blood pressure (higher than 160) have an especially high risk of stroke, Martin's group concludes. The researchers recommend that these women receive immediate and special attention, intensive care, and blood pressure treatment to reduce their stroke risk.

Source: Obstetrics and Gynecology, February 2005.

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Use of Antidepressants While Pregnant Can Affect Baby

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, February 3, 2005

THURSDAY, Feb. 3 (HealthDay News) -- Women who take antidepressants like Paxil or Prozac while pregnant may have babies who experience withdrawal syndrome in the first few days of life, a new study finds.

Spanish scientists, using a worldwide drug alert system, found a higher-than-expected incidence of neonatal withdrawal syndrome, consisting of convulsions, irritability, abnormal crying and tremors, among babies of women who took selective serotonin reuptake inhibitors (SSRIs), the class of drugs that includes Paxil and Prozac.

Their report, which is published in the Feb. 5 issue of The Lancet, found the association seemed to be highest among women who used Paxil.

"There is an association in some cases, not in every single case," said Dr. Emilio Sanz, the lead author of the paper and a clinical pharmacology professor at the University of La Laguna School of Medicine in Tenerife. "If you have a pregnant woman that is depressed and is treated with anti-depressants, you should use the lowest effective dose or psychotherapy or other approaches if you can."

"Doctors should be more careful in prescribing SSRIs, especially paroxetine [Paxil] during pregnancy," added Dr. Vladislav Ruchkin, an associate research scientist at Yale University School of Medicine and the author of an accompanying editorial in the journal.

SSRIs, which first hit the market in 1988, are widely used to treat depression, anxiety and other mood and behavioral disorders in adults as well as children. But the drugs have been the subject of much recent controversy.

Reports last year of suicidal thinking in adolescents who use them led to a U.S. Food and Drug Administration (news - web sites) review of clinical trials of antidepressants, which confirmed the association. That, in turn, led to the FDA (news - web sites)'s ordering a "black box" warning on the labels.

There has also been concern that SSRIs triggers manic behavior in 10 to 14 year olds, although a study released just this week found that the benefits of antidepressants appeared to outweigh the risk of suicide.

Several smaller studies, however, have already shown an increased risk of complications for pregnant women taking SSRIs.

For this latest research, investigators screened an international drug surveillance system maintained by the World Health Organization (news - web sites) (WHO). The database contains three million records from 72 countries dating back to 1968. A signaling system sends alerts when there are more cases than there should be.

The investigators found a total of 93 cases of neonatal convulsions or withdrawal syndrome associated with SSRI use. About two thirds of the cases (64) were associated with Paxil, 14 with Prozac, nine with Zoloft and seven with Celexa, they said.

The database had incomplete information on dosage and duration of treatment and also doesn't include information on how many people were or are using these drugs.

Although those babies who experienced withdrawal syndrome appear to recover within a short period of time, Ruchkin is concerned that there may be a developmental impact on the infant brain, a subject on which there is little research.

"A number of studies suggest that SSRIs may have a long-term impact on the child's brain," he said, adding, however, that most such studies have been done with mice and that human studies need to be done.

For the moment, there is no clear guidance other than to exercise caution, Sanz said, with doctors assessing the severity of each woman's case before prescribing antidepressants.

More information

For more on this drug monitoring system, visit the World Health Organization.

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Wednesday, February 2, 2005

 

Expert Sees Obesity Hitting U.S. Life Expectancy

 

Reuters

Wednesday, February 2, 2005

LONDON (Reuters) - Life expectancy in the United States is set to drop within the next 50 years due to obesity, one of the world's top experts on the subject said on Wednesday.

"My colleagues and I believe that within the next 50 years, life expectancy at birth will decline, and it will decline as a result of the obesity epidemic that will creep through all ages like a human tsunami," Professor Jay Olshansky of the University of Illinois said in London.

However, Olshansky declined to say by how it would drop. It is currently 80 years for females and 74.5 for males. He said his full research would be published within 6 weeks.

"There has been a dramatic increase in obesity among the younger generation and it is a storm that is approaching," he told an audience at the CASS Business School.

More than 30 percent of Americans are classified as obese, translating to around 59 million people. Being obese triples the risk of heart disease and produces a tenfold increase in the likelihood of developing diabetes.

U.S. life expectancy has increased dramatically since 1900, when the average age of death for men and women combined was 47 and most projections see life expectancy continuing to rise.

But Olshansky said the negative impact on life expectancy would likely hit when obese Americans reached middle age, which could further burden the country's state benefit system by reducing the number of people who are able to work.

Over time, however, it could reduce the pension burden if people died before reaching retirement.

According to a recent study by the Rand Corporation, if Americans continued to get fatter at current rates, by 2020 about 1 in 5 health-care dollars spent on people aged 50 to 69 could be due to obesity, 50 percent more than now.

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Health Tip: Dizziness Explained

 

HealthDayNews

Wednesday, February 2, 2005

(HealthDayNews) -- The disorienting phenomenon we call dizziness results when the brain receives mixed signals from systems that help maintain our balance and equilibrium, according to the American Academy of Otolaryngology -- Head and Neck Surgery.

Our sense of balance is maintained by the complex interaction of four systems: the inner ears; the eyes; skin pressure receptors such as in the joints and spine; and muscle and joint sensory receptors. These systems combine to enable what doctors call our spatial orientation.

Symptoms of dizziness, motion sickness, and vertigo emerge when the central nervous system receives conflicting messages from the other four systems.

Imagine your plane is flying through a bumpy storm. Your eyes may not detect this outside motion because all you see is the inside of the airplane. At the same time, other systems tell your brain that your physical space is being tossed about. The combination of these interactions may make you airsick.

Inner-ear damage -- especially when limited to one side -- can also lead to dizziness, since the damaged ear isn't sending the same signals to the brain as the healthy ear.

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Moderate Drinking Doesn't Harm Bones in Women

 

Reuters Health

Wednesday, February 2, 2005  

NEW YORK (Reuters Health) - Drinking moderate amounts of alcohol is associated with slightly higher bone mineral density (BMD) in women, according to researchers at St. Thomas' Hospital in London, UK.

Dr. Frances M. K. Williams and colleagues conducted a twin study to examine the effect of moderate alcohol consumption on BMD and fracture risk after controlling for genetic effects and other potential risk factors.

As reported in the Annals of the Rheumatic Diseases, the team assessed BMD at the hip and lower spine in 46 pairs of identical twins who consumed different amounts of alcohol. Blood and urine tests were used to look for evidence of altered bone metabolism.

The twins identified as "minimal drinkers" consumed a mean of 0.2 units of alcohol per week, while those identified as "drinkers" consumed a mean of 8.0 units per week. One unit of alcohol equals about one small glass of wine or one half pint of beer.

The drinkers and minimal drinkers had mean BMD values of 0.982 and 0.964 grams per square centimeter, respectively, at the hip, and 1.020 and 1.011 grams per square centimeter at the spine.

"Alcohol consumption was found to be positively associated with BMD at the lumbar spine and sites at the hip reflecting both cortical and trabecular bone," Dr. Williams' team reports.

They add, "We think it unlikely that the benefits to BMD would be offset by an increased risk of falls at this moderate level of alcohol consumption."

Source: Annals of the Rheumatic Diseases, February 2005.

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Health Tip: Fake Nails Can Lead to Real Infections

 

HealthDayNews

Wednesday, February 2, 2005

(HealthDayNews) -- Some women think artificial nails do wonders for their appearance. But whether applied at home or by a professional, artificial nails can lead to bacterial and fungal infections, the U.S. Food and Drug Administration (news - web sites) warns.

A bump to a long artificial nail may cause it to lift from the natural nail at the base, leaving an opening for dirt and bacteria. If the nail is reglued without being properly cleaned, bacteria or fungi may grow between the nail and spread into the natural nail.

Also, a fungal infection can take hold when an acrylic nail is left in place too long -- three months or more -- and moisture accumulates under the nail.

Symptoms of an infection include pain, redness, itching and pus in or around the nail. If the nail becomes infected, the artificial product should be removed and the area cleaned thoroughly with soap and water. If symptoms persist, consult a doctor.

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Treat Diabetes Early and Aggressively-US Experts

 

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, February 2, 2005

WASHINGTON (Reuters) - Doctors need to check patients for diabetes if they even suspect a patient may have the condition, and start using drugs to treat it right away, according to new guidelines released on Wednesday.

An estimated 90 percent of all patients diagnosed with diabetes are not controlling it enough to prevent heart disease and other complications, the experts at the American College of Endocrinology and the American Association of Clinical Endocrinologists (news - web sites) said.

At-risk patients, such as the overweight, should start getting screened at 30. If they show poor control of blood sugar, they should go on drugs right away, the two groups said.

"Numerous studies have shown that significant cardiovascular disease develops years before the onset of diabetes," the groups said in a statement.

A measure of glucose control called A1C should bring back a result of 6.5 percent or lower, the groups said. Fasting glucose should be 110 or below and a two-hour glucose challenge test should come back 140 or below.

"Patients with diabetes are often in denial," said Dr. Jaime Davidson, an endocrinologist at the University of Texas Southwestern Medical School in Dallas and chairman of the guidelines conference.

If a family doctor or primary care doctor suspects a patient may have diabetes, even a young patient, he or she should test immediately, Davidson said.

And a fasting glucose test is no good, he said. The patient should undergo a two-hour glucose challenge to see how well his or her body controls blood sugar.

Insurance companies may balk at paying for the tests, but they shouldn't, Davidson said.

"It is cheaper to pay for that today than to pay for the first heart attack," Davidson said in an interview.

The groups acknowledged that diet and exercise can stop a person from becoming diabetic, but said most patients fail.

"Lifestyle is essential. But in the real world it doesn't really allow us to get a patient to target," said Dr. Harold Lebovitz of the State University of New York, who chaired the writing committee.

"Doctors have big hearts and patients come to them to say 'Give me another chance. Give me a diet. Give me another three months,"' Davidson said.

But he said damage can occur during those three months. "We prefer to get them on target from day one and keep them there," he said.

Diabetics also need to see their doctors often. "If they are diabetic, one time a year is not enough. Because in that time, something is going to happen."

An estimated 20 million Americans have type-2 diabetes and one-third do not know it, the groups said. Another 41 million have what is known as "pre-diabetes," which will develop into diabetes if not controlled.

Diabetes costs the economy $132 billion a year, according to the American Diabetes Association.

"Eighty percent of the money spent is not in treating diabetes. Eighty percent of that money is spent in treating complications," Davidson said.

Drug treatments include metformin, the glitazone or thiazolidinedione class of drugs which includes GlaxoSmithKline's Avandia, and orlistat, sold under the brand name Xenical by Roche. Orlistat is a weight loss drug that also appears to prevent progression to diabetes.

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Stopping Aspirin Therapy Boosts Stroke Dangers

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Wednesday, February 2, 2005  

WEDNESDAY, Feb. 2 (HealthDayNews) -- Stroke survivors who stop taking daily aspirin as recommended by their physician triple their risk of having another stroke within just one month, researchers say.

While the exact reasons for this sudden jump in danger is unknown, Swiss investigators speculate that stopping aspirin increases blood platelet activity linked to stroke-inducing clots.

The findings were reported Feb. 2 at the American Stroke Association's International Stroke Conference in New Orleans.

Researchers in Lausanne, Switzerland, evaluated 309 patients who had suffered a stroke or a transient ischemic attack (TIA), the so-called "mini-strokes" that can precede a stroke. All of the patients were placed on long-term 100-milligram or 300-milligram daily aspirin regimens to help prevent repeated episodes of stroke or heart attack. The researchers also evaluated 309 patients who had had a stroke or TIA more than six months before the study, and were on aspirin therapy due to similar risk factors, such as high blood pressure or coronary heart disease.

Among the patients with a recent stroke history, 13 had stopped taking daily aspirin in the month preceding their stroke. In contrast, just four patients in the control group had done so -- leading the researchers to conclude that those with stroke were more than three times as likely to have stopped their aspirin than those with similar risk factors, but no new stroke or TIA.

While 77 percent of the ischemic strokes (in which blood flow to the brain is decreased) related to discontinuing aspirin occurred in the first eight days after the aspirin was stopped, the other 23 percent occurred from day nine through 30, the researchers said.

How might stopping aspirin lead to increased stroke risk so quickly? Study co-researcher Dr. Alexandre Maulaz, of the Centre Hospitalier Universitaire de Vaud, Lausanne, said the exact reasons remain unclear, but he speculated that discontinuing aspirin may boost blood platelet numbers and lead to more clots forming.

And he pointed out that the control group in the study, as well as those with stroke history, all had stroke risk factors to begin with. "The possible risk of stroke after stopping aspirin was greater only in patients with many cardiovascular risk factors," he said, "mainly ischemic heart disease. This conclusion cannot be extrapolated for all kinds of persons who take aspirin."

The study findings do not surprise Dr. William Buxton, a neurologist on staff at Santa Monica-UCLA Medical Center, and an assistant clinical professor of neurology at the David Geffen School of Medicine t the University of California, Los Angeles. "The study reinforces a lot of our suspicions that going off aspirin or other anti-platelet medications, even for a short time, may put people at risk of stroke."

While most patients who are prescribed stroke prevention therapy are vigilant about following it, Buxton said, sometimes an upcoming surgery will require patients to discontinue their stroke prevention therapy. "If you have to go off aspirin therapy before surgery, the doctor must weigh the benefits and risks," he said.

Every 45 seconds, another person in America suffers a stroke, while every three minutes stroke will claim another life, according to statistics from the American Stroke Association. These "brain attacks" occur when blood flow to the brain is interrupted. Some occur when blood flow in an artery is obstructed, while other forms of stroke are characterized by hemorrhaging from a ruptured vessel.

Stroke can leave its victims with major disabilities, such as an inability to walk without assistance, trouble speaking or swallowing, or one-sided paralysis. Many stroke victims require nursing home care.

Among the warning signs and signals of stroke: a sudden numbness or weakness of the face, arm or leg, especially on just one side of the body, sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, trouble walking, dizziness, loss of balance, or sudden severe headache with no apparent cause.

Aspirin use is often prescribed to patients who have had stroke or heart attack as a way to prevent future attacks. But the American Heart Association (news - web sites) warns that no one should start aspirin therapy without first consulting their doctor.

In the Swiss study, the average patient age was 71 years, with 62 percent of study participants men. Risk factors in each group were similar, with 69 percent having high blood pressure, 20 percent diagnosed with diabetes and 14 percent smokers. Twice as many individuals -- 36 percent -- in the stroke group had heart disease, compared to 18 percent in the control group. Similar numbers in both groups were taking either 100 milligrams or 300 milligrams of aspirin daily.

The study points out the importance of following doctor's orders to take aspirin daily and not to change the regimen without permission, Maulaz said.

More information

To learn more about aspirin use and stroke prevention, visit the American Heart Association.

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Red Meat Linked to One Type of Colon Cancer

 

By Alison McCook

Reuters Health

Wednesday, February 2, 2005

NEW YORK (Reuters Health) - Women who eat more red meat appear more likely to develop cancer in the lower part of the colon, but not in the upper part of the colon near the small intestine, new research reports.

These findings reinforce the theory that the two types of colon cancer are distinct entities, and should be considered separately, the authors write in the International Journal of Cancer.

And for meat-lovers, lead author Dr. Susanna C. Larsson of the Karolinska Institutet in Stockholm, Sweden recommends eating red or processed meats "sparingly" to reduce cancer risk.

"Replacing red meat with a combination of fish, poultry, and legumes may be recommended, and it may also reduce the risk of coronary heart disease and possibly other chronic diseases," she told Reuters Health.

This is not the first study to associate eating red meat with colon cancer. In one previous report, researchers found that people who consistently ate the most red meat and processed meats had a 50-percent higher rate of colorectal cancer than those who ate the least amounts of red or processed meat.

Larsson explained that red meat contains iron, along with substances from the cooking and processing of red meat, which researchers have shown may increase the risk of colon cancer.

Recent research has also suggested that cancer that originates in the upper part of the colon - called proximal colon cancer - may have different causes and characteristics than cancer that begins in the lower part of the colon, near the rectum, called distal colon cancer.

During the current study, Larsson and her colleagues reviewed information collected from 61,433 women over an average of 14 years, noting who developed proximal and distal colon cancers, and their eating habits.

The investigators found that women who ate more red meat were more likely to develop distal - but not proximal - colon cancer. Specifically, the risk of distal colon cancer increased by 70 percent for every additional 100 grams of red meat per day women ate.

Overall, women who ate the most red meat were more than twice as likely to develop distal colon cancer than women who ate the least amount of red meat.

Eating fish had no clear influence on colon cancer risk, although eating chicken appeared to reduce the risk slightly.

Larsson explained that different types and amounts of bacteria are present in the distal and proximal colons, which may help explain why different regions respond differently to red meat.

Moreover, the distal colon contains less water than the proximal colon, which means that any potentially "harmful compounds" will be more concentrated in the lower part of the colon, which may increase cancer risk, she added.

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

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Medical Problems Cause Half of Personal Bankruptcies

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Wednesday, February 2, 2005

WEDNESDAY, Feb. 2 (HealthDayNews) -- Illness and medical bills contributed to roughly half the personal bankruptcy filings in 2001, affecting as many as 2.2 million Americans, a new Harvard study says.

More than 75 percent of the filers had insurance, but many of them lost coverage during their illness, the research showed.

The study, which appears in the Feb. 2 issue of Health Affairs, provides a rare -- and stark -- glimpse into the medical causes of bankruptcy in the United States.

People who succumb to medical debt are mostly middle-class or working-class people who own their own homes and have at least some college education, the study found.

"I think the message that we take away is, really, nobody is safe in our country. Short of (Microsoft Chairman) Bill Gates (news - web sites), if you're sick enough long enough, you're likely to be financially ruined," cautioned study author Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School (news - web sites).

"We're all one serious illness away from bankruptcy," he added.

Carol Pryor, a senior policy analyst at The Access Project in Boston, has studied the issue of medical debt and its "ripple effect" on people's lives. It can ruin an individual's credit and make it difficult to obtain and pay for medical appointments, she said. And as more health-care costs get shifted to consumers in the form of higher premiums, deductibles and co-insurance, the problem is only likely to escalate, she added.

"The medical debt issue is interesting," Pryor said, "because it just points up so many fault lines in our system."

With the cooperation of bankruptcy judges in five federal districts, the study authors distributed questionnaires to debtors at their mandatory meetings with court-appointed trustees. A total of 1,250 questionnaires -- 250 per district -- were collected, providing data on demographics, housing and specific reasons for filing bankruptcy.

Additional information from 521 homeowners filing for bankruptcy boosted the total sample to 1,771. Follow-up telephone interviews were completed with 931 families.

More than a quarter of those surveyed cited illness or injury as the specific reason for bankruptcy. When investigators examined how frequently illness and medical bills contributed to bankruptcy, the percentages swelled.

Close to half met the researchers' definition of a "major medical bankruptcy," meaning they either cited illness or injury as a specific reason for bankruptcy, had more than $1,000 in uncovered medical bills in the past two years, lost at least two weeks of income from work due to illness or injury, or mortgaged a home to pay medical bills.

More than half met the criteria for "any medical bankruptcy." This group included people who had a major medical bankruptcy or anyone reporting addiction, uncontrolled gambling, birth of a child, or death of a family member as a cause of bankruptcy.

Medical debtors were much more likely than other bankruptcy filers to have experienced a gap in health insurance coverage, the study revealed.

In follow-up interviews, researchers found that the people whose bankruptcy had a medical cause were more likely than other debtors to do without such basic necessities as phone service, water or electricity or food. Three-fifths went without a needed doctor or dentist visit, while nearly half failed to fill a prescription.

Among policymakers and opinion leaders, there's little dispute that the nation's employer-based health insurance system is flawed and vast agreement that something needs to be done to help the more than 43 million Americans who lack insurance coverage.

But that's where the consensus ends and philosophical divisions begin. To ameliorate the problem of medical bankruptcy, the authors of the new research argue for a national insurance system divorced from the existing job-based insurance model.  

Others favor targeted, incremental fixes. The Bush administration, for example, proposes making greater use of health savings accounts and allowing businesses to band together to offer health insurance coverage through "association health plans."

"That's part of the solution," agreed Grace-Marie Turner, founder and president of the Galen Institute, a research organization that promotes free-market ideas in health care. She also endorses the Bush plan to allow people to buy insurance across state lines.

"It's just so important that people have more choice to buy the kind of insurance they know protects them," she said.

Former House Speaker Newt Gingrich also has a vision for reforming health care. In Saving Lives & Saving Money: Transforming Health and Healthcare, he and co-authors Anne Woodbury and Dana Pavey propose, in part, a national reinsurance pool to spread the risk of insuring people who incur extremely high medical costs.

"It's another something to try that is more aligned with the American value set," said Woodbury, chief health advocate of Gingrich's Center for Health Transformation in Washington.

But proponents of a national health system disagree. Health savings accounts, which are tied to high-deductible health plans, have the potential to skim away affluent, healthier individuals, leaving sicker people in traditional health plans and putting them at risk of higher premiums, Pryor said.

Meantime, Himmelstein suggests Canada's low rate of medical bankruptcy is the result of a better medical and social insurance system. Every other developed nation has solved the problem, he asserted. "Why should Americans have second-class health care?"

More information

Read this story from the Pittsburgh Post-Gazette on medical bills and bankruptcy.

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Cell Phone Users Drive Like the Elderly –Study

Reuters

Wednesday, February 2, 2005

WASHINGTON (Reuters) - Drivers who talk on cell phones end up driving like elderly people, with slower reaction times and a tendency to miss what is right in front of them, U.S. researchers said on Wednesday.  

Even when they used "hands-free" devices, young drivers who normally have the quickest reflexes drove like 70-year-olds, the team at the University of Utah found.

"If you want to act old really fast, then talk on a cell phone while driving," said Frank Drews, an assistant professor of psychology who worked on the study.

"If you put a 20-year-old driver behind the wheel with a cell phone, their reaction times are the same as a 70-year-old driver who is not using a cell phone," added David Strayer, a psychology professor who led the study and who has been studying the effects of cell phone use on driving for years.

Writing in the journal Human Factors, Strayer's team said they tested people aged 65 to 74 against drivers aged 18 to 25.

Preliminary tests showed older people were slower in processing information, which is normal and expected.

Then the volunteers used a driving simulator with dashboard instruments, a steering wheel and brake and gas pedals, surrounded by three screens showing freeway scenes and traffic.

An image showed a car in front repeatedly hitting its brakes.

Each volunteer drove four simulated 10-mile freeway trips lasting about 10 minutes each, talking on a cell phone with a research assistant during half the trips and driving without talking the other times.

Only hands-free devices were used.

The older drivers hit the brakes more slowly to avoid the car in front, tended to hit the brakes twice, took longer to regain speed and had a greater following distance.

Cell phone use made older people drive even worse and younger drivers act like elderly drivers.

"Once drivers on cell phones hit the brakes, it takes them longer to get back into the normal flow of traffic," Strayer said. "The net result is they are impeding the overall flow of traffic."

Braking time slowed 18 percent when young or elderly drivers used a cell phone, the researchers found. Chatting on the telephone caused a 12 percent greater following distance, apparently an effort to compensate for paying less attention to the road.

But that tactic didn't always work.

"There was also a twofold increase in the number of (simulated) rear-end collisions when drivers were conversing on cell phones," the researchers wrote.

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Blacks in South at Greater Risk of Stroke Death

By Martha Kerr

Reuters Health

Wednesday, February 2, 2005

NEW ORLEANS (Reuters Health) - Compared with African Americans living in other regions of the United States, those in the south have a higher risk of death from stroke -- compounding their overall increased risk of stroke death compared with other ethnic groups.

Dr. George Howard of the University of Alabama at Birmingham presented his findings Wednesday at the American Stroke Association's International Stroke Conference 2005 that is underway here.

Howard and his colleagues at Birmingham and at the Centers for Disease Control and Prevention (news - web sites) in Atlanta collected information on stroke deaths from state databases from 1997 through 2001.

They found the greatest differences in death according to race occurred in those 45 to 64 years old. Differences diminished with age until 85 years, when there was no racial difference.

The researchers found that southern white men between 55 and 64 had a 29-percent higher risk of death from stroke than white men in northern states. Southern black men had a 59-percent higher risk of stroke death than northern black men -- nearly twice that of white men.

Black men between 55 and 64 in New York were 2.1 times more likely to die from stroke than white men in the same age bracket. Black men in South Carolina were 3.8-times more likely to die than white men living there.

"When it comes to your stroke risk, you get a penalty for being an African American, you get a penalty for living in the South and you get an extra penalty for being an African American living in the South," Howard commented in an American Stroke Association release.

Increased risk of high blood pressure, diabetes and lower socioeconomic status among blacks "explains about 30 to 40 percent of this difference. That leaves about 70-percent of the (racial and geographic differences) unexplained," Howard told Reuters Health.

"Unless we understand the reason for the difference, designing an intervention would be just shooting in the dark...There is more than just an additive effect of being southern and being an African American. Something else is going on," he added.

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Soy May Not Pack a Strong Antioxidant Punch

By Amy Norton

Reuters Health

Wednesday, February 2, 2005

NEW YORK (Reuters Health) - Soy may not be the antioxidant powerhouse that some research has suggested, according to a new study.

Researchers found that 6 weeks on a soy-rich diet did not seem to diminish "oxidative stress" among 42 middle-aged adults with borderline-high cholesterol and no effect was seen with a diet supplemented with soy-derived antioxidants called isoflavones.

Oxidative stress refers to the potentially cell-damaging effects of oxygen free radicals, molecules that are generated by normal metabolism. The oxidation of "bad" LDL cholesterol, for example, may contribute to the "hardening" and narrowing of arteries that can lead to heart attack and stroke.

LDL particles carry cholesterol to the arteries, and it's thought that the greater the number of particles that are oxidized, that is, interact with oxygen, the more likely they are to be deposited into artery-clogging plaques.

Antioxidants, which include various nutrients such as vitamins C and E, help absorb the oxygen free radicals roaming the body. Diets rich in soy products, such as tofu, have been linked to lower cholesterol levels and lower rates of heart disease and stroke, and some lab research has suggested that the reason may rest in the ability of soy isoflavones to fight oxidative stress.

The new study, however, found that neither soy nor isolated isoflavones had much of an impact on oxidative stress.

"There was some protection against oxidation, but nothing too striking," said Dr. Sonia Vega-Lopez, a researcher at the U.S. Department of Agriculture (news - web sites) Human Nutrition Research Center on Aging at Tufts University in Boston.

That doesn't mean it's time to swap your tofu for T-bone steak, though. Soy is a good source of low-fat, plant-based protein, Vega-Lopez noted in an interview.

"Soy might not be the magic bullet some have thought," she said, "but it's still a good food."

Vega-Lopez and her colleagues report their findings in the American Journal of Clinical Nutrition (news - web sites).

The study involved 42 men and women, age 50 or older, who had elevated LDL cholesterol levels. All participants followed each of four 6-week diets at some point in the study: one diet rich in soy, one containing soy with the isoflavones depleted, one with animal protein supplemented with isoflavones, and one based on animal protein and no added isoflavones.

During the last week of each diet, the researchers collected blood samples to look at several markers of oxidative stress, including the oxidation of LDL cholesterol.

They found that antioxidant activity in participants' blood was slightly higher on the soy-protein diet, regardless of the isoflavone content, and soy protein did seem to reduce one measure of oxidative stress. There were no effects on LDL oxidation or other markers of oxidative stress, however.

All of the diets, Vega-Lopez noted, contained healthy servings of fruits and vegetables, which are prime antioxidant sources. So it's possible that those effects masked some antioxidant benefits of the soy or isoflavones.

An editorial published with the report agrees that soy eaters should not give up on the food. More research is needed to determine the potential health benefits of soy, according to Penny M. Kris-Etherton and Sheila G. West of Pennsylvania State University in University Park.

"Until then," they write, "it remains prudent to recommend soy products in a heart healthy diet because of their nutritional value and as a healthy substitute for protein sources that are higher in saturated fat and cholesterol."

Source: American Journal of Clinical Nutrition, January 2005.

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Eating Disorders May Jeopardize Pregnancy Outcomes

By Megan Rauscher

Reuters Health

Wednesday, February 2, 2005  

NEW YORK (Reuters Health) - The results of a Swedish study confirm that fetal outcome may be compromised in women with a past or active eating disorder. "These women should therefore be recognized as high-risk patients during pregnancy," Dr. Angelica Linden Hirschberg from Karolinska University Hospital in Stockholm told Reuters Health.

She and her colleagues followed 49 pregnant women who had an eating disorder or a history of one. None of the women had previously given birth and none of the women were smokers.

Twenty-four women had anorexia nervosa, 20 had bulimia nervosa, and 5 had an unspecified eating disorders. The investigators compared their pregnancy course and fetal outcome with that of a healthy group of 68 pregnant women.

An increased risk of severe vomiting was found among the women with past or current eating disorders. These women also had a greater risk of delivering an infant with a lower birth weight and smaller head circumference compared with the healthy women, the research team reports in the journal Obstetrics and Gynecology. Similar findings have been noted in previous studies.

Women with eating disorders also had an increased risk of giving birth to a small for gestational age infant, Hirschberg told Reuters Health.

The diminished average head size in children born to mothers with a history of an eating disorder is a new finding, she and colleagues point out in their report.

While the precise mechanisms behind these negative fetal outcomes are not known, "it is likely that inadequate eating behavior during pregnancy might result in a deficient nutrient supply to the fetus," they suggest. This is supported by the tendency toward an increased rate of intrauterine growth restriction among women with eating disorders in this study.

"The long-term effects of our findings, and particularly of decreased head circumference, seem to be very important to address in future studies," Hirschberg said.

Source: Obstetrics and Gynecology, January 2005.

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Dyslexia Slows Drivers' Reactions – Scientists

Reuters

Wednesday, February 2, 2005

LONDON (Reuters) - Dyslexia, a reading and writing disorder, can slow a driver's reaction time as much as drinking moderate amounts of alcohol, according to a study on Wednesday.

When Norwegian researchers compared how long it took drivers to react to road signs, they found that dyslexics were about 30 percent slower than other volunteers.

"Drivers just over the UK's alcohol limit, which can be exceeded by drinking two pints of beer, are typically 10 percent slower than normal to react," New Scientist magazine said.

Researcher Hermundur Sigmundsson and his colleagues at the Norwegian University of Science and Technology in Trondheim gave two simulated driving tests to six dyslexic volunteers and 11 other people. They were shown road signs as they drove on simulated country and city roads at different speeds.

In both tests, the dyslexic volunteers reacted slower than the other drivers.

"The results fit in with other studies which suggest that dyslexia may affect the way the brain processes sensory information," the magazine added.

About 10 percent of the population in Britain may have some form of dyslexia, which causes difficulty in reading, writing and spelling. It tends to run in families but scientists say environmental factors may also contribute to it. Other activities that delay driver reaction time, such as drinking and talking on a mobile phone, have been outlawed in Britain.

But the researchers said larger studies are needed to confirm their results before any action is considered.

Britain's Department of Transport agrees.

"Reaction time is only one of the cognitive functions needed for driving and it has not been consistently shown to be a good predictor of driving performance," a spokeswoman told the magazine.

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Tuesday, February 1, 2005

 

U.S. Doctors Ignore Women's Heart Issues – Reports

 

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, February 1, 2005

WASHINGTON (Reuters) - Even though heart disease is the top killer of U.S. women and men, doctors are giving women short shrift when it come to preventive care, according to studies published on Tuesday.

Women are less likely to get drugs to lower their cholesterol, to get daily aspirin therapy to lower the risk of heart attack and stroke, or to be given the scans that can diagnose heart disease, researchers told a conference.

The reason is that doctors mistakenly believe that women have a much lower risk of heart disease than men do, said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital.

"These data suggest that if we educate physicians to more accurately assess risk in women, they will be more likely to receive appropriate preventive care," Mosca said in a statement.

Mosca and colleagues published two studies in the journal Circulation showing women failed to get optimal heart care.

One showed that two-thirds of women with dangerously high cholesterol levels and a high risk of heart attack and stroke were not getting drugs to lower their cholesterol.

Her team studied 8,353 women with diagnosed cardiovascular disease or who were otherwise at high risk because of diabetes or other conditions. They checked their cholesterol levels.

"We found only 7 percent of these high-risk women had optimal levels of all cholesterol measurements at the start of the study. This improved to 12 percent after three years, still far short of where we would like to see these high-risk women," Mosca said.

"We also found that only about one-third of women were receiving cholesterol-lowering medications, such as statin therapy, as recommended by national guidelines."

Fictional Patient Profiles

Mosca and another team surveyed 500 doctors, including cardiologists, gynecologists and primary care physicians.

They gave them fictional patient profiles and asked the doctors to make recommendations about managing blood pressure, cholesterol and other health aspects.

Even when a woman's heart disease risk was the same as a man's, the doctors tended to view a woman as being at a lower risk than men, the researchers told a conference called by the American Heart Association (news - web sites) to highlight the studies.

"Lifestyle is the fundamental method to prevent heart disease," Mosca said.

"Therefore, it is vital that we continue to address barriers to help women stop smoking, get regular physical activity, eat heart healthy, and maintain a healthy weight."

A third study in Circulation found that women were less likely to undergo imaging methods such as stress single photon emission computed tomography (SPECT) and stress echocardiography, even though these methods work as well in women as in men to diagnose heart disease.

And a fourth found only 35 percent of procedures done to open clogged arteries, such as angioplasty and inserting metal coils called stents, were done in women.

"These interventions can save lives and prevent subsequent heart attacks in these women. Now is the time to translate our findings into real-world practice," said Dr. Alexandra Lansky, director of Clinical Services for Interventional Cardiology at New York-Presbyterian Hospital, who led the study.

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Health Tip: No Site for Sore Eyes

 

HealthDayNews

Tuesday, February 1, 2005

(HealthDayNews) -- While computer-related eye strain probably won't permanently affect your vision, it can be disruptive and quite unpleasant.

The Mayo Clinic offers these steps to help ease the burden:

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Cervical Cancer Vaccine Expected in a Few Years

 

By Patricia Reaney

Reuters

Tuesday, February 1, 2005

LONDON (Reuters) - A vaccine that could prevent young women from developing most cases of cervical cancer could be on the market within a few years.

Researchers are testing dozens of vaccines against different types of cancer but those that protect women against strains of the human papillomavirus (HPV), which are linked to more than 70 percent of cervical cancer cases, are the most advanced.

"I believe there will be an HPV vaccine sometime in the next few years," Anne Szarewski, a clinical consultant at Britain's Wolfson Institute of Preventative Medicine, told journalists.

Results from early trials of two separate vaccines developed by drugs giant GlaxoSmithKline and Merck, which protect against HPV infection, have been promising.

HPV is a sexually transmitted infection. More than 75 percent of women are infected with HPV at some time during their lives. It usually lasts for a short time and produces no symptoms.

But in some women it can progress to cervical cancer, one of the most common cancers in women. Each year 470,000 women around the world are diagnosed with the disease and 230,000, mostly in the developing world, die, according to the International Agency for Research on Cancer (IARC) in Lyon, France.

There are more than 100 types of HPV virus, but HPV 16 and 18 are linked to the majority of cervical cancers.

"We don't know how long the immunity will last," said Szarewski. "We hope it will deliver lifetime protection against cervical cancer."

Enormous Potential

Developed countries have screening programs to detect early signs of cervical cancer, which has a good cure rate if it is diagnosed early.

Szarewski said an HPV vaccine would have enormous potential in poor countries where screening is not available.

She is beginning Phase III trials of one of the vaccines in 300 women aged 15-25. The women will be given three doses of the HPV vaccine or a hepatitis A vaccine, which will act as the control.

The HPV vaccines are two of many cancer vaccines in development or trials. Scientists are testing out different approaches to weaken cancer cell resistance and to boost various types of immune system cells to fight the disease.

They are studying very rare cases of spontaneous cancer remission, to determine what happens in the body to kill the tumour and are also vaccinating bone marrow donors to see whether the cells they donate to cancer patients act like a vaccine. Professor Peter Johnson of Southampton General Hospital in southern England, believed a combination of approaches may be needed to boost the immune system against cancer.

"In the next 5-10 years we will see more of these vaccines coming into the clinic," he said.

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Health Tip: When Vomiting Can't Be Explained

 

HealthDayNews

Tuesday, February 1, 2005

(HealthDayNews) -- Some people -- most often children -- experience bouts of severe nausea and vomiting that alternate with longer periods without symptoms.

Doctors call the condition cyclic vomiting syndrome (CVS), according to the National Institute of Diabetes and Digestive and Kidney Diseases. No one knows what causes CVS or how many people have it.

Treatment varies, but people with CVS generally are advised to:

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U.S. Youth Antidepressant Use Drops in 2004 – Report

 

Reuters

Tuesday, February 1, 2005

CHICAGO (Reuters) - Antidepressant use among children declined 10 percent in 2004, after U.S. regulators warned the drugs may be linked with increased suicide risk, pharmacy benefits firm Medco Health Solutions said on Tuesday.

Use of drugs including Eli Lilly and Co.'s Prozac and GlaxoSmithKline Plc's Paxil fell 16 percent in the final quarter of the year, a time when use of the medications typically peaks, according to Medco.

The drop began when the U.S. Food and Drug Administration (news - web sites) in October 2003 cited reports of suicidal attempts among kids on certain anti-depressants.

A year later, after intense public debate and high-profile government meetings, regulators ordered makers of all the drugs to slap tough warnings in bold letters -- so-called black box warnings -- on the drugs as a precaution.

Medco acts as a middleman between health plans and employers trying to curb prescription drug costs, and pharmaceutical companies. It processes prescriptions for 60 million people in the United States.

The overall 10 percent drop last year contrasts to a 9 percent rise in 2003, which reversed several years of upward use of the drugs in children.

After the FDA (news - web sites)'s initial decision on the new warnings, Medco did a big public campaign to patients, doctors and pharmacists.

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New Tool Gauges Heart Failure Death Risk

 

HealthDayNews

Tuesday, February 1, 2005

TUESDAY, Feb. 1 (HealthDayNews) -- Researchers say they've developed a new bedside evaluation tool to better predict death risk in hospitalized heart failure patients.

The tool should help doctors spot those patients at greater risk who may require closer monitoring and earlier, more intensive interventions, explained researchers at the University of California, Los Angeles (UCLA).

The tool, outlined in a study in the Feb. 2 issue of the Journal of the American Heart Association (news - web sites), can be used during hospital admission and involves a combination of three simple measures from blood tests and by measuring vital signs.

"The new tool is a first for the treatment of acute heart failure, and offers a simple quick way for clinicians to assess mortality risk upon hospital admission and quickly decide on a treatment strategy," study lead author Dr. Gregg C. Fonarow, a professor of cardiology, said in a prepared statement.

He and his colleagues developed a risk model based on data from a national registry of more than 100,000 heart failure patients. They tested the model using data on an additional 32,229 hospitalized heart failure patients.

They concluded that the single most important predictor for death in these patients was a high blood level of a compound called urea nitrogen (above 43 mg/dL), followed by a low systolic blood pressure (above 115 mm Hg) and a high blood level of another compound, creatinine (higher than 2.75 mg/dL).

The three-way risk assessment "provides clinicians with a practical, easy tool to use at the bedside. We were surprised that the risk tool using only three variables was able to dramatically distinguish between low, intermediate, and high risk heart failure patients," Fonarow said.

More information

The Cleveland Clinic Foundation has more about heart failure.

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Patient Records Often Missing, U.S. Study Finds

 

Reuters

Tuesday, February 1, 2005  

CHICAGO (Reuters) - Medical records are frequently incomplete or missing during patient visits to the doctor, posing potential danger and wasting time, a survey of physicians said on Tuesday.

One in seven patient visits was marred by missing information such as lab results, medication records and health histories, the survey of 253 Colorado physicians found.

The report by the University of Colorado Health Sciences Center in Aurora covered 1,614 patient visits during an eight-month period in 2003.

Nearly half the incidents of missing records could have adversely affected patients' health, the report said. Delayed care or additional services often resulted, and the doctor's or staff's time was wasted locating the records.

Patients with multiple health problems and immigrant patients were more likely to have records missing, the study said.

"If validated by future research, these results could have serious implications for the 220 million primary care visits that occur in the United States each year," study author Dr. Peter Smith wrote in the Journal of the American Medical Association (news - web sites).

"The disjointed nature of health care in the United States" is the source of the problem, wrote Nancy Elder of the University of Cincinnati and John Hickner of the University of Chicago in an accompanying editorial.

Many physicians contract with several managed care companies that results in a complicated network of referrals for consultations and testing, they wrote. The doctor's office may have to contact by telephone, fax, or electronically numerous laboratories, imaging facilities, consultants and hospitals to keep records up to date.

Information kept electronically reduced the incidence of problems, but was no guarantee of completeness, the editorial said. Patients should be enlisted in the effort, it said, by providing them updated lists of medications, lab and radiology reports, and records of diagnoses, surgeries and hospitalizations to bring with them when receiving care.

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Tailor Asthma Treatment for Kids

 

HealthDayNews

Tuesday, February 1, 2005

TUESDAY, Feb. 1 (HealthDayNews) -- Specific asthma characteristics in children may help doctors determine the most effective treatment for each child, according to researchers at the National Heart, Lung, and Blood Institute's (NHLBI) Childhood Asthma Research and Education Network.

"There is increasing evidence that children respond differently to the various treatment options for asthma," James Kiley, director of the NHLBI Division of Lung Diseases, said in a prepared statement.

For eight weeks, the researchers administered the inhaled corticosteroid drug fluticasone [Flonase] and another drug, the leukotriene receptor antagonist montelukast [Singulair], separately to 126 children with mild to moderate persistent asthma. They then evaluated each child's response to therapy, noting especially those cases where lung function improved by at least 7.5 percent.

According to the study, 17 percent of the children reached that goal when taking both medications; 23 percent reached the goal when taking only fluticasone; and 5 percent reached the goal when taking only montelukast.

Children who improved while on fluticasone had low pulmonary function and elevated markers of allergic inflammation at the beginning of the study, the researchers said. On the other hand, those children who improved while taking montelukast were younger and had a shorter duration of asthma symptoms.

Based on their findings, the researchers recommend daily treatment with inhaled corticosteroids for children with low lung function and/or elevated signs of allergic inflammation. In children who have no elevated signs of allergic inflammation, a therapeutic trial of either inhaled corticosteroids or leukotriene receptor antagonists like montelukast should be conducted, to determine which treatment is most effective.

The study appears in the February issue of the Journal of Allergy & Clinical Immunology.

"If we can pinpoint in advance which children will do better with a certain type of therapy, we can improve their lives more quickly and save them the risk of trying medications that are less effective for them. This study adds important information for identifying which children are more likely to respond well to inhaled corticosteroids," Kiley said.

More information

The American Lung Association has more about childhood asthma.

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High-Risk Women Not Lowering Cholesterol Enough

 

Reuters Health

Tuesday, February 1, 2005  

NEW YORK (Reuters Health) - New research indicates that few high-risk women are achieving the optimal cholesterol levels set forth in recent guidelines by the American Heart Association (news - web sites) (AHA). Moreover, only about one third of eligible women are receiving cholesterol-lowering drugs.

"The reason for under-treating high cholesterol in women remains uncertain; however, the need to better apply the new guidelines and educate physicians and consumers is clear," lead author Dr. Lori Mosca, from Columbia University in New York, said in a statement.

The new findings, which appear in Circulation: Journal of the American Heart Association, are based on an analysis of data from more than 1 million subjects entered in a managed care database. The study focused on 8,353 women considered to be high-risk because of a history of heart disease, diabetes or chronic kidney disease.

The AHA guidelines define optimal cholesterol levels as HDL (the "good" cholesterol) greater than 50 mg/dL; LDL (the "bad" cholesterol) less than 100 mg/dL; non-HDL cholesterol less than 130 mg/dL; and triglycerides less than 150 mg/dL.

Initially, just 7 percent of women had all of the optimal cholesterol and triglyceride levels. After 36 months, this percentage increased slightly to 12 percent, the investigators note.

As noted, only 32 percent of these high-risk women were treated with cholesterol-lowering therapy, the researchers point out.

"To the best of our knowledge, this is the first study to assess the attainment of the recent lipid benchmarks in high-risk women established by the AHA Evidence-Based Guidelines for Prevention of Cardiovascular Disease in Women," the authors note.

The findings indicate that there "is a substantial opportunity to improve lipid management and reduce morbidity and mortality caused by cardiovascular disease among high-risk women."

Source: Circulation 2005.

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Smoggy Air May Harden Arteries

HealthDayNews

Tuesday, February 1, 2005  

TUESDAY, Feb. 1 (HealthDayNews) -- Breathing in smoggy, polluted air could result in atherosclerosis (hardening of the arteries) over the long term, according to a study in the February issue of Environmental Health Perspectives.

Researchers studied almost 800 healthy men and women in Los Angeles and found the longer they were exposed to air polluted with fine particulate matter, the thicker the layers of their carotid artery, which carries blood from the heart to the head and neck.

People with the most exposure to air pollution had about eight percent more carotid artery thickening than those with the least exposure to polluted air. In general, women were much more vulnerable to this artery-thickening than men, the researchers report, while nonsmokers and people taking cholesterol-lowering medications also showed heightened vulnerability.

This new data adds to growing evidence linking air pollution with cardiovascular disease, the researchers say, offering a "biologically plausible link" between short- and long-term inhalation of particulate matter in polluted air and a thickening of arterial walls over time -- a major risk factor for fatal heart attacks and strokes.

In a prepared statement, Dr. Jim Burkhart, science editor for Environmental Health Perspectives, added that experts have "known for some time that air pollution leads to lung damage, but this study also emphasizes the role air pollution plays on the arteries. Heart disease is a primary cause of death in the western world, so more research, perhaps focusing on those at highest risk, is important."

More information

The American Academy of Family Physicians (news - web sites) has more about air pollution and health.

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Study Finds Brain Tumor Treatment Inconsistent

Reuters

Tuesday, February 1, 2005

CHICAGO (Reuters) - Patients who develop the most common kind of primary malignant brain tumor are sometimes given drugs they may not need and deprived of others that might help, medical researchers said on Tuesday.

Primary brain tumors are those that originate in the brain, rather than being spread there by cancer elsewhere in the body. Survival rates for those diagnosed with the more serious forms of the tumors, malignant glioma, run three to five years to as little as one year in the worst cases.

Researchers at the University of California in San Francisco said a look at 788 adult patients treated at 52 U.S. and Canadian sites from 1997 to 2000 found that treatment varied greatly and was sometimes in conflict with guidelines.

Their study said the use of diagnostic tools and treatments such as magnetic resonance imaging, radiation and surgery were consistent.

But it also found that fewer than 70 percent of patients were given chemotherapy, even though research indicates it is useful for brain tumors. In addition 89 percent in the study were given anticonvulsant drugs, even though only 31 percent had problems with seizures.

"While it is accepted that patients who present with seizures should receive anti-epileptic drugs, there is strong evidence that prophylactic (uses) have little value for seizure-free patients with newly diagnosed brain tumors," the report said.

Such drugs "are associated with significant side effects" and should be discontinued the first week after surgery if no seizure problems develop, it added.

"Our goal in neuro-oncology is to improve the duration and quality of survival of our patients," said Susan Chang, a physician at the school who led the research.

Brain tumor specialists need to communicate with each other but also should collaborate with "other health care providers, including emergency physicians, primary physicians, neurologists and oncologists ... so that the optimum care is provided," she said.

The report, appearing in this week's Journal of the American Medical Association (news - web sites), was supported in part by grants from Aventis Pharma Ltd.,, part of Sanofi-Aventis, and Guilford Pharmaceuticals Inc., as well as the National Institutes of Health (news - web sites).

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Alzheimer's Troubling Behaviors Hard to Treat

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Tuesday, February 1, 2005

TUESDAY, Feb. 1 (HealthDayNews) -- Along with devastating memory loss, Alzheimer's disease (news - web sites) can trigger such hard-to-manage behaviors as aggression, wandering, hallucinations and repetitive vocalizations.

The bad news for caregivers is that available medications do little to help control such problems, which affect up to 80 percent of those who get Alzheimer's, reports a new study in the Feb. 2 issue of the Journal of the American Medical Association (news - web sites).

"Alzheimer's caregivers are often looking for a magic pill. They want us to treat the problem and make it go away," said study author Dr. Kaycee Sink, a geriatric medicine specialist at Wake Forest University Baptist Medical Center.

"Alzheimer's is a complicated disease, and every person has unique characteristics," she said. "It may not be realistic to expect that one drug will work for every person or behavioral symptom."

In other words, "there is no magic pill," she added.

"When you look across the issues that affect patients and families, behavioral problems tend to have a very special place," said William Thies, vice president of medical and scientific affairs for the Alzheimer's Association.

"In dealing with the memory problems associated with Alzheimer's, people find ways to manage. But behavioral problems tend to be particularly disturbing for caregivers, and it's often the behavioral symptoms that drive placement into a nursing home," he added.

Sink and her colleagues searched several large medical literature databases to find randomized, placebo-controlled clinical trials of medications used to treat behavioral symptoms in people with Alzheimer's.

Twenty-nine studies matched their criteria. The studies looked at 15 different medications, including typical and atypical antipsychotics, antidepressants, mood stabilizers, cholinesterase inhibitors and memantine.

The studies that looked at the efficacy of antipsychotic medications, antidepressants and mood stabilizers included mostly people who were living in nursing homes. The studies evaluating cholinesterase inhibitors and memantine included mostly people still living at home.

"We found that there weren't very many effective treatments for dementia-related behavioral symptoms," said Sink.

Based on the trials, Sink said it was clear that unless the people with Alzheimer's disease had depression, antidepressant medications generally weren't effective. Mood stabilizers also weren't found to be effective in treating behavioral problems.

Overall, typical antipsychotic medications, such as haloperidol and thioridazine, achieved a slight benefit, but side effects were common. Some atypical antipsychotics, such as olanzapine and resperidone, showed a statistically significant effect, but Sink said she wasn't sure if this effect would be strong enough to be meaningful for a patient or caregiver. Also, the risk of stroke was increased with these medications.

The analysis also included two studies on memantine, a relatively new drug for treating Alzheimer's. But their results were inconclusive: One study showed no benefit, and the other showed a statistically significant benefit, but many of those in the placebo arm of that trial worsened.

There were eight trials of cholinesterase inhibitors included and, as with memantine, results were mixed or inconclusive. One drug, metrifonate, was effective but never received government approval because it had severe side effects. Other cholinesterase inhibitors showed small improvements over placebos, but again Sink cautioned these results might not be clinically meaningful.

"None of the drugs we're using are very effective. We need to focus attention on non-pharmaceutical trials, and perhaps investigate the use of other drug therapies and combine them with non-drug approaches," Sink said.

Alzheimer's experts agreed with her conclusions.

"The overall effect of the agents we have available to treat behavioral symptoms are of limited use," said Dr. John C. Morris, director of the Alzheimer's Disease Research Center at Washington University in St. Louis. "It's not that they don't work, but the degree to which they work is suboptimal. We definitely need better drugs."

One reason these drugs may not work well in people with Alzheimer's, according to Morris, is that they're simply not designed to specifically treat Alzheimer's. For example, antipsychotic medications may be very useful in treating hallucinations in someone with schizophrenia, but that same medication doesn't work well for someone with Alzheimer's disease.

While the symptoms may look the same, the underlying cause may differ, Morris explained.

Despite what would seem glum news, both Sink and Morris think caregivers do have options.

All patients first need to be assessed to make sure there are no underlying conditions causing the behavior, Morris said, and then if medication is needed, it should be started at the lowest dose possible and gradually increased. Also, he added, once the behavior is gone, patients should be gradually taken off medications.

There are non-drug therapies that may be useful also, such as music therapy and pet therapy. But, Morris said one of the most helpful strategies is caregiver education.

"If a caregiver understands what a provoking incident may be, they may be able to come up with solutions," he said.

And Thies added that it's important to remember that "there's no one-size-fits-all approach."

More information

The Alzheimer's Association offers these tips for preventing Alzheimer's disease.

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Phobias Linked to Fatal Heart Attacks in Women

 

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - New research indicates that women with phobias, such as a fear of open spaces or heights, may be at increased risk for fatal heart disease, especially sudden cardiac death. However, the link is not that strong and may be explained, in large part, by factors associated with phobias, such as high blood pressure.

Previous reports have linked phobic anxiety with heart problems in men, but until now, this association had not been investigated in women, according to the report in the Circulation: Journal of the American Heart Association (news - web sites).

The new findings are based on an analysis of data from 72,359 women who participated in the Nurses' Health Study. All of the subjects were free from heart disease in 1988 and were followed for 12 years to assess heart outcomes.

During follow-up, 97 sudden cardiac deaths, 267 heart disease deaths, and 930 non-fatal heart attacks occurred, lead author Dr. Christine Albert, from Brigham and Women's Hospital in Boston, and colleagues note.

As the score on a standard phobia test increased, the risk of sudden cardiac death and fatal heart disease, but not non-fatal heart attack, rose, the authors point out. Moreover, women with the highest scores were 59 percent and 31 percent more likely to experience sudden cardiac death and fatal heart disease, respectively, than those with the lowest scores.

On final analysis, which accounted for other risk factors such as high blood pressure, diabetes, and high cholesterol, a trend between high phobic anxiety and sudden cardiac death remained. The association with fatal heart disease, by contrast, essentially disappeared.

"One of the reasons we did this study is that anxiety disorders, and phobic disorders in particular, tend to be more common in women," Albert said in a statement. If phobias really do cause heart problems, "greater recognition and perhaps treating these disorders in women may lower their risk of dying from heart disease, especially sudden cardiac death."

Source: Circulation, February 1, 2005.

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'Bio-Barcode' Alzheimer's Test Only a 1st Step

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, February 1, 2005

TUESDAY, Feb. 1 (HealthDay News) -- A dose of reality has been administered to a new test that may be able to diagnose Alzheimer's disease (news - web sites) while the person is still alive.

The study was small, but the results were dramatic, and that has led medical experts to predict that a test for people who are living isn't that far away. But other experts are quick to point out that much larger and more comprehensive research is needed to bring such a test to reality.

Scientists reported in this week's Proceedings of the National Academy of Sciences (news - web sites) that they had successfully used a sensitive new "bio-barcode" test to detect proteins related to Alzheimer's disease in spinal fluid. The study, however, involved only 30 people, and only half of them had Alzheimer's.

"The technique has potential for being very sensitive and important, but it's still quite new and underutilized," said Mony de Leon, director of the Center for Brain Health and a professor of psychiatry at New York University School of Medicine.

"If it holds up with a large number of people, I think that's going to be very, very helpful in terms of finding ways of predicting and diagnosing the disease," said Dr. Sam Gandy, vice president of the Alzheimer's Association's Medical and Scientific Advisory Council and director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia. "Even better, if they can correlate it with the disease, it would be useful for measuring the effectiveness of anti-amyloid drugs."

The issue of diagnosing Alzheimer's disease, the most common neurodegenerative dementia, takes considerable priority among physicians. About 4 million Americans are afflicted with the disease, which progressively robs them of their memory and cognitive abilities. A growing number of people will develop the disease as the population ages, medical experts predict.

Currently, the only sure way to tell if a person had Alzheimer's is through an autopsy. While the person is living, however, the most perceptive way to tell is through neuropsychological testing.

"In the hands of a trained expert, this can really have accuracy in the 90s [percent]," Gandy said.

But diagnosing Alzheimer's can be an arduous process involving blood tests, spinal taps and imaging to rule out other causes. Most generalists are not comfortable making the diagnosis, Gandy added.

Because Alzheimer's involves the buildup of abnormal proteins in the brain, much effort has been focused on finding remnants of those proteins in other areas of the body, a task that has proved difficult.

"The material that we want to look at is in between the nerve cells inside the brain," Gandy pointed out. Because of the blood-brain barrier, it's unlikely that a blood test holds the key.

The researchers from Northwestern University decided to try a "bio-barcode" test, which has been used to detect a marker for prostate cancer. The test, which is more than 100,000 times as sensitive as conventional methods, looks for proteins and nucleic acids, and they don't always have to be inside the brain to be detected. The reason it's called a bio-barcode is because many of the substances in the strands of DNA are magnetic and can "read" the same way a consumer bar code can.

This time, they used it to detect a brain protein called amyloid-beta-derived diffusable ligand (ADDL) in spinal fluid.

They obtained samples of spinal fluid from 30 people, half of whom had Alzheimer's. The Alzheimer's group had higher levels of ADDL and the concentration of the protein tended to increase with more severe disease.

In addition, there was little overlap between the two groups. "The separation between controls and Alzheimer's patients was impressive, and if that holds up with a large number of people, I think that's going to be very, very helpful," Gandy said.

What would be even better, he added, is if levels of ADDL correlated with how far the disease has progressed. This would give scientists a way to measure the effectiveness of new therapies.

"Having an endpoint for these drugs would really accelerate drug discovery," Gandy said. "A lot of CEOs are afraid to greenlight [approve] clinical trials because they have a drug to target amyloid but absolutely zero in terms of measuring."

Another promising diagnostic tool that is in development is amyloid imaging, but the ADDL test would be more convenient and less expensive, Gandy said. It's not quite as convenient as a blood test because it involves a spinal tap, but a blood test for Alzheimer's is unlikely.

The barcode test is also biologically plausible. "It makes biological sense. That gives it some increased credence," Gandy said.

For now, anyway, diagnosis of this devastating disease is probably going to involve a number of different tests. "It looks to me that where we're ending up, at least for the short term, is an array of different diagnostic tests," de Leon said. "Any one test alone wouldn't give you the full story, but the combination would give you incontrovertible evidence."

More information

Visit the Alzheimer's Association for more on diagnosing the disease.

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Many Parents Apply Insect Repellant Incorrectly

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - More than one third of parents visiting Maryland campgrounds disregard label directions when applying potentially toxic insect repellant to their kids, new research reports.

Moreover, many parents admit to potentially dangerous habits when applying repellant to children, such as adding it to palms (where kids can rub their eyes), letting kids go to bed without washing off the spray (which can over-extend their exposure to the repellant), and using products with high concentrations of DEET, the active ingredient in many insect repellents, which can be toxic for young children.

Because most parents don't rely on label instructions, "it would be prudent to increase efforts to educate parents about recommended procedures for use of repellents on children," write Dr. Amy E. Brown and co-author Kalapurakkal S. Menon, both from the University of Maryland in College Park.

N,N-diethyl-meta-toluamide (DEET) is one of the most common and effective ingredients of insect repellants, and it is used by approximately one third of Americans. However, experts have raised concerns about DEET, noting that high concentrations may be toxic, particularly to young children.

Currently, the U.S. recommends that parents who apply repellant to kids opt for products that contain no more than 10 percent DEET, the authors report in the American Journal of Industrial Medicine.

To investigate how well parents apply bug repellant to their children, the researchers asked 301 parents visiting Maryland campgrounds about how they protect their youngest child from insects.

The researchers found that the vast majority of parents -- more than 83 percent -- used bug sprays that contain DEET. The concentration of DEET in sprays varied, but ranged from 5 percent to 95 percent.

More than one third of parents said they also put repellant on children's clothes, a practice that "may be unnecessary," the authors write.

Approximately three quarters of parents said they only put repellant on kids once during the day, or washed off old repellant before reapplying. For people who applied repellant once, children spent an average of 11 hours per day coated with repellant.

More than one third of parents volunteered the fact that they do not follow the label's directions. Only 30 percent of parents said they followed all the label's directions; the other parents did not respond to this question.

A small percentage of parents -- around 10 percent -- sprayed kids in the face with repellant, a practice that enables repellant to seep into the eyes and mouth, Brown and Menon note.

They add that education efforts should focus on fathers, "as they were more likely than mothers to disregard (or be unaware of) directions to avoid treating face and hands directly."

Source: American Journal of Industrial Medicine, January 2005.

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Bone Marrow Stem Cells Generate Heart Tissue

By David Douglas

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - A previously undescribed population of adult human stem cells, derived from bone marrow, is capable of forming three different cell types and of self-renewal.

These cells also appeared to repair the damage caused by a heart attack when they were transplanted into rats, researchers report in the February issue of the Journal of Clinical Investigation.

"These studies show that stem cells from adult bone marrow are a virtual tool kit for repairing damaged hearts," senior investigator Dr. Douglas W. Losordo told Reuters Health. "Specifically, these cells can differentiate into all of the essential cellular elements required to restore function in 'broken' hearts."

Losordo, of Tufts University School of Medicine, Boston and colleagues note that transplant of these cells into the heart led to the growth of new heart cells, cells that line the heart and smooth muscle cells.

The transplanted cells also stimulated the growth of heart tissue and prevented the destruction of endangered cells after they were deprived of oxygen.

In light of these findings, the researchers conclude that this new form of cardiac repair may improve the immediate and long-term outcome of patients with heart disease and merits further clinical investigation.

Source: Journal of Clinical Investigation, February 2005.

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Fasting Every Other Day Cuts Weight, Ups Crankiness

By Amy Norton

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - Shunning food every other day may be a feasible way to slash calories -- if you and those around you don't mind the crankiness that comes with it, according to researchers.

Their study of 16 nonobese men and women looked at the effects of alternate-day fasting, an eating plan that interspersed fasting days with "feasting" days that allowed participants to eat as much as they wanted.

The researchers were interested in whether food deprivation every second day would be easier on people than counting calories on a daily basis, lead author Dr. Eric Ravussin told Reuters Health.

They found that the diet plan was indeed "feasible," at least for the duration of the 3-week study. Overall, the men and women lost an average of 5 pounds, while shedding some body fat.

On the other hand, Ravussin said, "most people were not happy" -- a major problem being the crankiness that erupted on the fasting days and did not abate over the 3 weeks.

Ravussin and his colleagues at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, report the findings in the American Journal of Clinical Nutrition (news - web sites).

Uncovering the most tolerable ways for people to cut calories is not just a matter of trimming waistlines. A number of studies, Ravussin explained, have now shown that calorie restriction can extend the lives of everything from yeast and worms to rodents and, possibly, monkeys.

There are a number of theories on why limiting food might make for a longer, healthier life. One idea, Ravussin noted, is that slowing the rate of metabolism reduces the generation of oxygen free radicals, potentially cell-damaging molecules that are a normal byproduct of the metabolic process.

No one knows if calorie counting can extend human life as it does for some animals. Ravussin and his colleagues are currently conducting a trial, sponsored by the National Institutes of Health (news - web sites), which is examining how long-term dietary restriction affects people's health and longevity.

Studying dietary restriction in people is, of course, far more complicated than studying it in lab rats. The ongoing trial is investigating how calorie cutting affects "biomarkers of longevity" in people, such as levels of blood sugar and insulin, a hormone key in regulating blood sugar.

The trial is testing several methods of dietary restriction -- from pure calorie cutting to burning extra calories through exercise -- to see which are most viable.

In the current study, Ravussin's team evaluated the effects of alternate-day fasting, an approach not included in that trial. They wanted to see if the eating plan was feasible and whether it influenced biomarkers of longevity, as well as participants' weight and metabolism.

As mentioned, every other day for 3 weeks the men and women subsisted on calorie-free beverages and sugarless gum. On the days in between, they ate whatever they wanted.

According to Ravussin, participants were not able to "make up" for what they didn't eat on fasting days, and consequently, they generally lost a few pounds and some fat mass. In addition, their insulin levels declined by an average of about 57 percent.

However, the researchers also found that many participants said they were irritable on food-free days, and they did not appear to get used to having an empty stomach every other day.

Calorie restriction, Ravussin noted, is the only behavior that has so far been shown to prolong life. "There is a ton of data suggesting that this is the only way to the 'fountain of youth', if you want," he said. If the current findings are any indication, the researcher added, alternate-day fasting may not be the easiest path to that fountain.

Source: American Journal of Clinical Nutrition, January 2005.

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Statins May Increase Arthritis Risk in Elderly Women

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - The use of statins, cholesterol-lowering drugs such as Lipitor (news - web sites) and Pravachol, appears to be associated with an increased risk of developing osteoarthritis of the hip in elderly women, California researchers report. However, patients who already have osteoarthritis do not seem to be adversely affected by these drugs.

Dr. Nancy E. Lane of the University of California at San Francisco and colleagues note that, in theory, statins could reduce the risk of osteoarthritis because of their anti-inflammatory effects. However, their actual impact on osteoarthritis is not known.

To investigate further, the researchers examined data for 5674 women 65 years or older, of whom 7 percent were users of any commercially available statin. At the start of the study osteoarthritis, detected by X-ray imaging, was seen in 936 hips in 745 women, while 9,318 hips had no evidence of osteoarthritis.

After 8 years of follow-up, Lane's group found that statin use was associated with a 92-percent increased risk of developing osteoarthritis of the hip. However, the use of these drugs was not related to other measures of new disease, they report in the January issue of the Journal of Rheumatology.

The researchers also observed a consistent trend toward slower progression in statin users who had osteoarthritis of the hip at the start of the study. However, this trend did not reach statistical significance.

In an accompanying editorial, Dr. Christopher J. Penney of the University of Calgary notes that although there was a modest but significant increase in the chance of hip osteoarthritis, "statins were not associated with worsening of structural disease."

Source: Journal of Rheumatology, January 2005.

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Occasion Drinking Accounts for More Injuries

By Alison McCook

Reuters Health

Tuesday, February 1, 2005

NEW YORK (Reuters Health) - Moderate drinking accounts for more injuries than heavy drinking does, simply because more people tend to drink small amounts, according to a new report in the Annals of Family Medicine.

Surveys of people visiting emergency departments in Missouri found that around 1 out of 10 accidents resulted from drinking alcohol. Roughly half of the injuries attributed to alcohol occurred after people had been drinking lightly -- having fewer than five drinks for men, or fewer than four drinks for women

Overall, the researchers calculate that one million injuries treated in emergency departments in 2001 alone were attributable to drinking "what has been considered a nonhazardous amount of alcohol."

These findings suggest that the amount of alcohol considered "safe" is not completely so, study author Dr. Daniel C. Vinson, of the University of Missouri-Columbia, told Reuters Health.

However, Vinson noted that individual drinkers have a very small risk of being injured after light drinking. But since there are so many light drinkers, from the perspective of society, even having a couple of drinks becomes a problem when "all of those little, tiny risks are added together."

Previous research has shown that downing as few as two drinks of alcohol increases the chances of getting injured, and the risk appears to increase exponentially with every additional drink.

Although individuals are more likely to become injured after drinking heavily, Vinson and his co-author Dr. Maria C. Spurling wondered if society, as a whole, is more at risk from heavy drinkers or light drinkers, who greatly outnumber those who drink heavily.

This is known as the prevention paradox, which states that there may be more danger from a large number of people who have a small risk of disease than from a small number of people who have a much higher risk of disease.

For instance, the authors argue that doctors would avoid more cases of disease if they treated the many people with mildly high levels of cholesterol than if they focused all their efforts on the few people with higher levels of cholesterol.

To determine whether the same principle applies to alcohol-related injuries, the researchers interviewed 2,517 people treated at an emergency department for severe injuries and 1,856 similar non-injured people.

They found that roughly the same number of injuries stemmed from heavy and light drinking, suggesting that, when it comes to preventable injuries, both behaviors have roughly the same impact on society.

Overall, the researchers calculate that between 900,000 and 1.3 million people end up in emergency rooms each year after drinking relatively small amounts of alcohol.

In an interview, Vinson noted that, as a 150 pound man, he would have to down 5 drinks in 1 hour on an empty stomach to reach most state's blood alcohol limit for driving, 0.8.

These findings suggest that people may be impaired from much less alcohol, and drivers should take extra precautions even if they are within the law.

"Be aware that if you drink two, three, or four drinks you are slightly increasing your risk of injury," Vinson advised. "Be more careful."

Source: Annals of Family Medicine, January/February 2005.

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Monday, January 31, 2005

 

Weight Gain Linked to Breast Cancer Death-US Study

 

Reuters

Monday, January 31, 2005

WASHINGTON (Reuters) - Women who are overweight when diagnosed with breast cancer or who become overweight after learning of their condition are more likely to die or have the disease come back, U.S. researchers reported on Monday.

 The effect is particularly strong among nonsmokers, the team at Boston's Brigham and Women's Hospital and Harvard Medical School (news - web sites) found.

They found women who had never smoked and who were overweight were nearly twice as likely to die of breast cancer than nonsmokers who were normal weight.

And breast cancer patients who gained more than an average of 17 pounds (8 kg) were 1.5 times more likely to have a cancer recurrence or to die, the researchers found.

Although other studies have linked fat mass with breast cancer risk, this one teased out more and stronger detail by separating smokers, study leader Dr. Candyce Kroenke said.

"Combining smokers and nonsmokers in analyzes may mask the true relationship between weight and survival after a breast cancer diagnosis, since smoking is generally related to both lower levels of weight and a higher risk of death overall," she said in a statement.

"Researchers have also speculated that obesity acts on cancer by raising the body's levels of sex hormones such as estrogen, particularly in post-menopausal women," she added.

Writing in the Journal of Clinical Oncology, Kroenke and colleagues said they studied 5,204 breast cancer patients over 24 years who were taking part in the larger Nurses' Health Study.

They used body mass index or BMI -- the ratio of a person's height in meters to their weight in kilograms -- to classify women as overweight. A BMI of 25 or above is considered overweight and a BMI of 30 marks a person as obese.

"Women recently diagnosed with breast cancer or at high risk for the disease should take steps to maintain a healthy weight to reduce the risk of recurrence and death," Kroenke said.

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Health Tip: Build Strong Bones

 

HealthDayNews

Monday, January 31, 2005  

(HealthDayNews) -- Here's yet another benefit of regular exercise -- it will help keep your bones strong and fit, the U.S. Centers for Disease Control and Prevention (news - web sites) says.

Adequate weight-bearing exercise early in life is important in reaching peak bone mass. And a person with high bone mass as a young adult is more likely to have a higher bone mass later in life. This can ward off conditions such as osteoporosis.

Weight-bearing exercises cause muscles and bones to work against gravity. They include activities such as walking, jogging or running, tennis or racquetball, stair climbing, jumping rope, basketball, dancing, soccer and weightlifting.

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Scan Older Smokers for Aneurysms, U.S. Group Advises

 

Reuters

Monday, January 31, 2005

WASHINGTON (Reuters) - Older male smokers and ex-smokers should get at least one ultrasound scan to make sure they do not have a developing aneurysm near the heart, a team of U.S. experts advised on Monday.

Nearly 70 percent of men over 65 are or have been smokers and would benefit from such a routine check, the U.S. Preventive Services Task Force said.

"This is an important recommendation because evidence now exists that screening high-risk men for abdominal aortic aneurysms can reduce deaths from aneurysm," said task force chairman Dr. Ned Calonge, state epidemiologist for the Colorado Department of Public Health (news - web sites) and Environment.

"One of the most important things men and women can do for their health is to never start smoking and to quit if they do. People who have a family history and might be at risk for abdominal aortic aneurysm should discuss their concerns with their physicians."

Women and non-smokers are at a much lower risk of an aortic aneurysm, a weakening and then rupture of the main artery leading out of the heart. Most people with ruptured aneurysms die before they can get help.

Writing in the Feb. 1 issue of the Annals of Internal Medicine, the task force -- an advisory and review group made up of private sector prevention and primary care experts -- said new evidence has shown that screening and surgery to repair large aneurysms before they rupture can save lives.

At least 9,000 people a year die from them.

Another study, released on Sunday, defined the physical traits that put young children at risk of aneurysms, according to a team at Johns Hopkins University in Baltimore.

These children often have wide-set eyes, a cleft palate or split uvula -- the tag of tissue that hangs down in the back of the throat -- and a torturous arrangement of the body's blood vessels, they said.

"The severity of the physical traits can vary, but because the aorta ruptures so much sooner than one would expect, patients need to be identified and treated as early as possible and much sooner than is standard medical practice for other causes of aortic aneurysms," said Dr. Harry Dietz, who led the study.

Writing in the journal Nature Genetics, Dietz and colleagues described the case of an 18-month-old girl who had been brought to the clinic because of a heart murmur.

"When I walked by a photo, the girl's mother sent for the 2003 holidays, it struck me that the girl's eyes were just slightly wide-set," Dietz said.

"We had just figured out the new syndrome, so I asked the girl's local doctor to look in her mouth and tell me if she had a split uvula. The answer was yes."

They scheduled surgery, found an aneurysm, repaired it and the girl is healthy now, Dietz said.

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Good Nutrition vs. Need: A Closer Look

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, January 31, 2005

MONDAY, Jan. 31 (HealthDayNews) -- Few people picking up groceries at a New Mexico food pantry recently were focusing on the right amount of vegetables and whole-grain products that are now recommended for the daily American diet.

Instead, the people arriving at the Jewish Community Food Pantry in Albuquerque were hoping to get by with whatever they could, mostly from the kindness of strangers.

Getting healthy food is hard, said one client, Audrey, "because most of the things you're supposed to eat don't come in cans."

"Even when I have extra money," she added, "I can't get the good stuff because it won't last. It's medicine versus food. Once in a while, the medicine has to win out."

The choices most people should make when it comes to a healthy diet were delineated in the new U.S. dietary guidelines announced three weeks ago. At the time, Health and Human Services (news - web sites) Secretary Tommy Thompson told a news conference that all Americans should be able to follow them.

"Cost is not a determinant of whether or not you eat properly. A lot of inexpensive foods can be extremely healthy," he said. "You're going to spend a lot more money if you don't eat healthy in medical costs."

But healthy eating, health experts say, isn't attainable by everyone.

For those with limited funds, cost plays a role in purchasing decisions.

A pilot study in Roxbury, a low-income Boston neighborhood, found that a family of four receiving food stamps came up $227 short every month, while seniors living alone came up $103 short. The study was presented at an American Heart Association (news - web sites) meeting last year and co-authored by Dr. Paula Johnson, chief of the division of women's health at Brigham and Women's Hospital in Boston.

In addition to cost, access, including transportation, can also be a significant barrier.

In another study published last fall, Dr. Carol Horowitz, an assistant professor of health policy at Mount Sinai School of Medicine in New York City, found that only one in five stores in East Harlem carried low-fat milk, fresh fruits and vegetables, diet soda and whole-grain bread while three in five stores in the adjacent but wealthier Upper East Side carried these items. Only one in 10 East Harlem bodegas, the corner stores that many residents rely on, carried the items. And while prices were roughly the same in both regions, the median income on the Upper East Side is four times what it is in Harlem, Horowitz pointed out.

Then there's the issue of perishability.

"Fresh produce is one of the first things that low-income people eliminate," said Melody Wattenbarger, executive director of the Roadrunner Food Bank in Albuquerque. "They don't want to pay a big price for something that they might not be able to eat at all."

Wattenbarger said one senior citizen told her she hadn't had a salad in nine years.

And Audrey also pointed out, "If a salad bag is on special, I can't stock up on three."

Roadrunner, which last year distributed 10 million pounds of food, has been changing its product mix to address this problem. Roadrunner gets the food from food industry donors and they also buy in bulk. They then distribute it statewide to more than 600 emergency food pantries, group homes, low-income day care centers, shelters, soup kitchens and six smaller, regional food banks. These organizations, in turn, provide food boxes and meals to almost 200,000 low-income people each year.

Even so, the food pantries themselves find that's not enough.

In addition to supplies from Roadrunner, the Jewish Community Food Pantry, for instance, has to rely on the U.S. Department of Agriculture (news - web sites) (USDA) commodity program, on food donations, and on food it can buy with limited monetary donations for the 2.5 tons of food it gives out each month.

The pantry, a tiny adobe structure tucked behind an apartment complex, provides free food for 30 to 35 families every week. Each family gets food once a month, enough to fill one box. Most of the clients are working poor, disabled or elderly, said Erica Wyatt, outreach services coordinator for Jewish Family Service of New Mexico.

At the pantry, the USDA commodity foods, which line the shelves of the pantry, are attractive because they're free, but a quick glance at the labels reveals that they carry a different price tag.

One can of chunky beef stew provides 20 percent of a person's daily saturated fat allowance and 42 percent of the sodium allowance. A can of chili provides more than half the daily saturated fat allowance and 45 percent of the sodium allowance.

"It's a good thing to hand out because it's a meal, but it's not nutritious," Wyatt said.

Protein is particularly difficult to get," she added. "We try to buy peanut butter when it's available, but we went a couple of months without that being an option. We try to get Total cereal but we went through a period when Frankenberry's was the only thing available."

At the pantry, the clients are glad to get what's available.

Jodi DeJesus, 35, the mother of a 7-year-old and 9-year-old in Albuquerque, said she looked in her refrigerator recently and saw only milk and bananas. That's when she called the food pantry for the first time. She was leaving with crackers, goldfish (for the kids), a bag of pre-mixed salad, fruit, ramen noodles, and bread. This is the first time that DeJesus, who said she has a master's degree in counseling and is currently unemployed, has had to ask for help.

Maryann, 45, was also at the pantry for the first time. She had been laid off from her job in the public school system last June and was now collecting $263 a week in unemployment, which has to cover rent, car insurance, utilities and everything else.

"I've cut everything down," she said. And that includes food. Recently she bought three frozen pizzas at a local grocery store, for only $1.59 each.

And while they were cheap, she noted, "That's not good. That's not nutritious."

More information

America's Second Harvest has more on hunger in America.

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Viruses, X-Rays Join List of Cancer Agents

 

Reuters

Monday, January 31, 2005

WASHINGTON (Reuters) - Viruses, X-rays and compounds found in grilled meats joined the official list of known or suspected cancer-causing agents released on Monday.

The list, issued every two years by the National Institute of Environmental Health Sciences and the National Toxicology Program, also adds chemicals used in textile dyes, paints and inks.

"For the first time ever, viruses are listed in the report: hepatitis B virus, hepatitis C virus, and some human papillomaviruses that cause common sexually transmitted diseases," the NIEHS said in a statement.

They include the hepatitis B and hepatitis C viruses, which can cause liver cancer, and human papillomaviruses, also known as human wart viruses, which are sexually transmitted and can cause cervical cancer.

About 1 million U.S. residents are chronically infected with hepatitis B and 3 million with hepatitis C virus, both of which can be transmitted by injected drug use, sexual contact and blood transfusions.

An estimated 20 million people in the United States are infected with genital wart viruses, which often produce no symptoms, and 5.5 million new people are infected each year.

"Other new listings include lead and lead compounds, X-rays, compounds found in grilled meats, and a host of substances used in textile dyes, paints and inks," the NIEHS said.

"X-radiation and gamma-radiation are listed in the report as 'known human carcinogens' because human studies show that exposure to these kinds of radiation causes many types of cancer including leukemia and cancers of the thyroid, breast and lung," the agency added.

"The risk of developing cancers due to these forms of ionizing radiation depends to some extent on age at the time of exposure."

Children exposed to high levels of X-rays have a higher risk of leukemia and thyroid cancer, while men and women exposed to chest area X-rays at certain times can have higher risks of breast and lung cancer.

"Exposure to X-radiation and gamma radiation has also been shown to cause cancer of the salivary glands, stomach, colon, bladder, ovaries, central nervous system and skin," the NIEHS said.

Sources include medical scans, scientific research, military testing and nuclear accidents.

Industrial chemicals added to the suspected carcinogen list include naphthalene, an ingredient in mothballs and toilet bowl deodorants, and lead used to make lead-acid storage batteries, ammunition, and cable coverings.

Also included are heterocyclic amine compounds, which are formed when meats and eggs are cooked or grilled at high temperatures and also found in cigarette smoke.

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More Evidence Links Vioxx to Heart Attacks

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Monday, January 31, 2005

MONDAY, Jan. 31 (HealthDayNews) -- A major Canadian study solidifies evidence that the now-withdrawn arthritis drug Vioxx increases the risk of heart attack, and shows that higher doses are associated with a greater risk.

No similar increase in risk was found for Celebrex, another member of the cox-2 inhibitor family of drugs to which Vioxx belongs, said the report by researchers at McGill University in Montreal.

"This is consistent with what most of the other studies have found," said study author Dr. James A. Brophy, an associate professor of medicine at McGill. "But it included many more cases than other studies, so we were able to have more precision. And other studies have not demonstrated dose-dependency."

The findings appear in the Feb. 1 online edition of the Annals of Internal Medicine.

The study included 113,927 older residents of Quebec who took painkillers between January 1999 and June 2002. The incidence of heart attacks increased 21 percent among those who took low doses of Vioxx and by 73 percent in those who took high doses -- more than 25 milligrams a day, the study found.

Taking aspirin decreased the risk for people who took lower doses of Vioxx but not for those who took the higher doses, according to the study.

"The importance of the new study is that it separates Vioxx from other cox-2 inhibitors," said Dr. Todd Schlifstein, an assistant professor of rehabilitation medicine at New York University School of Medicine. He called it "an impressive study because of its vast size and the number of years over which it was done."

The fact that aspirin did not moderate the increased risk of high-dose Vioxx is "a pretty impressive sign that there is an increase in risk," he said.

Vioxx and other cox-2 inhibitors became popular because they decrease the incidence of gastrointestinal bleeding and stomach ulcers in people regularly taking painkillers such as aspirin and other nonsteroidal anti-inflammatory drugs. They were marketed aggressively, so that annual sales of Vioxx mounted to $2.5 billion before Merck & Co., the manufacturer, withdrew the drug from the market last September when reports of increased heart attack risk emerged.

The drug was being greatly overprescribed, said a study reported last week in the Archives of Internal Medicine (news - web sites) by Dr. C. Caleb Alexander, an instructor in medicine, and his colleagues at the University of Chicago.

The study found that 12 percent of patients at low risk of gastrointestinal problems were prescribed cox-2 drugs in 1999, and that the number rose to 40 percent in 2001 before declining slightly in 2002.

"The bottom line of our study was that we found a considerable proportion of cox-2 users had little or nothing to gain from the safety benefits of the drugs," Alexander said. "This new study is important in light of our study because it suggests that many individuals were exposed to increased cardiovascular risk unnecessarily."

Yet another study, led by Dr. David Graham, associate director for science at the U.S. Food and Drug Administration (news - web sites)'s Office of Drug Safety, estimated that Vioxx may have caused up to 140,000 excess cases of serious coronary heart disease. That report was published online Jan. 24 issue of The Lancet.

And within the last three days, there have been these other news developments involving cox-2 inhibitors:

 

More information

 

The U.S. Food and Drug Administration has more about Vioxx.

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Quality of Life Okay After Repaired Heart Defect

 

Reuters Health

Monday, January 31, 2005

NEW YORK (Reuters Health) - Adults who have undergone surgery during childhood to repair a congenital heart defect called tetralogy of Fallot have a satisfactory quality of life, although psychosocial problems and impaired thinking are often present, according to a report in the medical journal Heart.

Tetralogy of Fallot involves four problems: narrowing of the opening from the right side of the heart to the lungs, abnormal thickening of the heart muscles on the right side, an abnormal opening between the right and left side of the heart, and an abnormally positioned aorta, the large blood vessel that exits the heart.

This setup allows some blood to bypass the lungs and not pick up oxygen. This can lead to a whole host of problems and actually cause the patient to assume a bluish appearance. If not corrected with surgery, approximately 70 percent of patients will die by age 10.

Dr. Luciano Daliento, from Policlinico Universitario in Padua, Italy, and colleagues used an interdisciplinary approach to assess quality of life in 54 adults who had tetralogy of Fallot repaired in childhood.

As noted, quality of life was generally satisfactory. However, the authors did identify several adverse psychological characteristics in the group.

The subjects typically achieved a lower academic level than normal and the jobs they held often fell short of their educational level. Moreover, the subjects tended to favor overprotective familiar settings and had difficulty communicating their body image. Denial of their heart condition was also common.

In terms of thinking ability, memory, learning, and attention functions were rarely impaired. However, patients often demonstrated difficulty with problem solving and planning strategies.

"Many factors affect how children with congenital heart disease grow up, such as native cardiac defects, age at operation, type and technique of operation, family setting, and socioeconomic conditions," the authors state. "Knowledge and awareness of these factors is key in attaining adequate prevention."

Source: Heart, February 2005.

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Genetics May Drive MS Gender Gap

HealthDayNews

Monday, January 31, 2005

MONDAY, Jan. 31 (HealthDayNews) -- A genetic variant may explain why women develop multiple sclerosis (MS) nearly twice as often as men, says an international research team led by the Mayo Clinic.

"In practical terms, this is what our findings suggest: How much of the protein known as 'interferon gamma' you produce appears to be a new key variable in understanding who gets MS and who doesn't," study author and Mayo Clinic neurologist Dr. Brian Weinshenker said in a prepared statement.

"If you have a gene that produces high levels of interferon gamma, it may predispose you to developing MS. Under this scenario, men get MS less often because they have a lower frequency of a gene variant that is related to higher secretion of interferon gamma," Weinshenker said.

This finding may provide scientists with a new target for finding ways to stop MS or to improve treatment to minimize tissue and nerve damage caused by the disease.

"Our finding isn't the whole genetic cause, but it's a helpful step that could lead us to a more complete understanding of MS -- and ultimately, effective treatment. It's also a very promising lead about gender differences that may pertain to susceptibility of other diseases, too, such as rheumatoid arthritis," Weinshenker said.

The study appears in the Jan. 27 online issue of Genes and Immunity.

More information

The National Multiple Sclerosis Society has more about MS.

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IQ-Related Brain Areas May Differ in Men, Women

By Amy Norton

Reuters Health

Monday, January 31, 2005

NEW YORK (Reuters Health) - While neither men nor women may be the more intelligent sex, their brains may take different paths to reach the same intellectual level, according to one team of researchers.

Their study found that among men and women who performed equally on intelligence tests, women had far more intelligence-related white matter in their brains than men did, while men surpassed women when it came to intelligence-related gray matter.

Gray matter can be seen as the brain's "information processing centers," whereas white matter is like the wiring connecting those centers, said Dr. Richard J. Haier, a professor of psychology at the University of California, Irvine, and the study's lead author.

The findings, he told Reuters Health, suggest that women and men may have "fundamentally different brain architectures" underlying intelligence. "It has nothing to do with men being more intelligent than women, or women being more intelligent than men," Haier said.

Instead, according to the researcher, men and women may draw upon different brain designs to arrive at the same intellectual capacity. That possibility is of more than a scientific interest, Haier noted; it could help researchers better understand sex differences in stroke and degenerative brain diseases like Alzheimer's disease (news - web sites).

The study, published online January 16, 2005 in the journal NeuroImage, involved 48 men and women between 18 and 84 years old who took a standard battery of IQ tests and had MRI brain scans to gauge the volume of white and gray matter in different brain areas related to intelligence.

Overall, the researchers found, men and women performed equally on the IQ tests. However, the brain structures involved in intelligence appeared distinct.

Compared with women, men had more than six times the amount of intelligence-related gray matter, while women had about nine times more white matter involved in intelligence than men did.

In addition, women had a large proportion of their IQ-related brain matter -- both white and gray -- concentrated in the brain's frontal lobes, a region at the front of the brain involved in movement, emotions and higher functions such as speech, reasoning and judgment.

Men, on the other hand, had 90 percent of their IQ-related gray matter distributed equally between the frontal lobes and the parietal lobes -- a region right behind the frontal lobes involved in sensory perception, such as taste and touch, and skills, such as reading and math.

In addition, the large majority of the men's IQ-related white matter -- 82 percent -- was found to dwell in a third brain region, the temporal lobes. These lobes govern functions such as perceiving sound and processing memories.

According to Haier, the fact that women's IQ-related brain matter was more centralized in the frontal lobes may help explain why strokes affecting this brain area appear to inflict more damage in women than men.

Whether the different brain designs translate into differences in specific intellectual skills, like math or language, is unknown. It's possible, according to Haier, that the findings offer one explanation for the stereotypical male predilection for numbers and spatial questions and female preference for language.

But, as he pointed out, that's a complex and controversial issue.

Earlier this month, Harvard University president Lawrence Summers caused a stir when he suggested that "innate differences" between men and women could be one reason women are underrepresented in the upper strata of the science and engineering fields.

When it comes to sex differences found in the brain, though, the degree to which they are inborn is not necessarily clear. As Haier and his colleagues note in their report, there is evidence that the volume of the brain's gray matter can increase with learning, and therefore may be a matter of environment as well as genes.

Source:  NeuroImage, online January 16, 2005.

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Sunday, January 30, 2005

 

Blacks More Prone to Alzheimer's Disease

 

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Sunday, January  30, 2005

SUNDAY, Jan. 30 (HealthDayNews) -- Alzheimer's disease (news - web sites) is a silent epidemic striking black Americans, who seem more susceptible to the brain-wasting condition than any other group of Americans, new research finds.

One possible explanation: Black Americans are at greater risk of vascular disease, such as high blood pressure and high cholesterol levels. And studies have found that people with a history of either high blood pressure or high cholesterol are twice as likely to succumb to Alzheimer's disease, according to the Alzheimer's Association.

Statistics are hard to come by because black Americans aren't well represented in studies on Alzheimer's. But recent research has found dementia is anywhere from 14 percent to 100 percent more prevalent among the black American population than among whites, according to Stephanie Johnson, a research associate at Duke University Medical Center's Bryan Alzheimer's Disease Research Center.

And, she added, nearly half -- 44 percent -- of first-degree relatives of black Alzheimer's patients are at risk for the disease.

"Highlighting the racial difference in prevalence rates for Alzheimer's wasn't really on the radar screen because of all the other health disparities we focus on. But when you start to put the pieces of the puzzle together, it makes sense," said Johnson, who is also a clinical associate professor at Duke's department of psychiatry.

Most telling, she said, is the high rate of vascular disease among black Americans, a known risk factor for Alzheimer's.

"Hypertension, type 2 diabetes and high cholesterol, which are highly prevalent among African-Americans, are significant risk factors for the development of Alzheimer's disease," Johnson said, and could be the reason first-degree relatives are at high risk for the disease as well.

According to a 2002 report by the Alzheimer's Association, 65 percent of black Medicare beneficiaries have hypertension compared to only half of white beneficiaries. And blacks have a 60 percent higher risk for type 2 diabetes than do whites.

But along with the clear medical risks associated with Alzheimer's disease are less quantifiable social and economic reasons, Johnson said. Less access to health care means that diagnoses often come when the disease has progressed to a serious stage. Also, socioeconomic status keeps poorer blacks from the best nursing care. And, among older black Americans, there's often a deep-seated distrust of doctors that can affect their medical care, Johnson said.

The Rev. Henry Edmonds is director of the African-American Community Outreach Program (AACOP) at Duke University. He sees this distrust of the medical profession as a major hurdle that must be overcome if black Americans are to get the care they need.

"Many patients remember when they couldn't come to Duke University Medical Center. They're very suspicious of doctors," said Edmonds.

To address these underlying obstacles to good medical care, Edmonds heads the statewide AACOP. It's an organization that includes community leaders, caregivers and church pastors that seeks to educate the black community about the high rates of Alzheimer's within its ranks.

"Building trust is a major focus of what I do, so we can find out why African-Americans contract Alzheimer's at a greater rate than the general population," he said.

Among his goals is to persuade black Americans to seek medical care, especially preventive care, to reduce their risk for the disease and to also persuade them to work with health professionals by participating in university and government-sponsored Alzheimer's studies.

"We try to use the church as our major recruitment," he said, because the church is a central and trustworthy institution in the lives of many black Americans.

Edmond's work is part of a program at Duke that's headed by Johnson. It includes having health professionals from Duke visit rural communities throughout the state for a period of seven months, during which time they work with local doctors to offer health screenings, medical services and information about diet and lifestyle changes that might reduce the risk of Alzheimer's.

"There is a feeling in the African-American community that health professionals and scientists 'use us as subjects, but don't leave anything behind for us,'" Johnson said. "So we are offering them tangible information."

Johnson hopes further research will help unlock the genetics of Alzheimer's for black Americans. Interestingly, current studies suggest the presence of the APOE genotype, which is associated with a higher risk for Alzheimer's among whites, might not be a risk factor for black Americans.

"We know what we're working with, social, medical and biological variables, but it's a complex problem," she said.

More information

For more on blacks and Alzheimer's disease, visit the Alzheimer's Association.

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Exercise Can Ease Depression

 

HealthDayNews

Sunday, January  30, 2005  

SUNDAY, Jan. 30 (HealthDayNews) -- Aerobic exercise alone can have a significant impact on mild to moderate depression, says a study by researchers at the University of Texas Southwestern Medical Center.

The study found that taking part in 30-minute aerobic exercise sessions three to five times a week reduced depressive symptoms by nearly 50 percent in adults aged 20 to 45. The results are comparable to findings from studies in which people with mild to moderate depression were treated with antidepressants or cognitive therapy.

"The effect you find using aerobic exercise alone in treating clinical depression is similar to what you find with antidepressant medications. The key is the intensity of the exercise and continuing it for 30 to 35 minutes per day. It's not for the faint of heart," study co-author Dr. Madhukar Trivedi, director of UT Southwestern's mood disorders research program, said in a prepared statement.

The study appears in the January issue of the American Journal of Preventive Medicine.

"Numerous effective treatments for depression are available, yet many people don't seek treatments for depression because of the negative social stigma still associated with the disease. Exercise may offer a viable treatment alternative, particularly as it can be recommended for most individuals," Trivedi said.

More information

The American Medical Association has more about depression.

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Saturday, January 29, 2005

 

New Drug Targets Pancreatic Cancer Two Ways

 

HealthDayNews

Saturday, January  29, 2005

SATURDAY, Jan. 29 (HealthDayNews) -- A new drug that targets pancreatic cancer in two ways is being tested by oncologists at the University of Southern California/Norris Comprehensive Cancer Center.

The Phase II clinical trial of 90 people with metastatic pancreatic cancer will evaluate how well BAY 43-9006 works alone and when it's used with gemcitabine, the current standard treatment for pancreatic cancer.

It's believed that BAY 43-9006 disrupts cell signaling that's crucial to the development of many cancers. The drug also appears to block the ability of tumors to grow new blood vessels that they require for nourishment.

"Pancreatic cancer is a major health problem, because we do not yet have highly effective ways to deal with it," principal investigator Dr. Heinz-Josef Lenz, an associate professor of medicine at USC's Keck School of Medicine, said in a prepared statement.

"The cancer is difficult to diagnose early, when it is most treatable, and can be aggressive. Because of the lack of effective systemic therapies, only 1 percent to 4 percent of patients will be alive five years after diagnosis," Lenz said.

He said he hopes that targeted drugs such as BAY 43-9006 will prove an effective part of first-line treatment for pancreatic cancer and help patients respond better to chemotherapy.

Pancreatic cancer is diagnosed in more than 29,000 people each year in the United States.

More information

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

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Doctors Debate Value of Vitamin E

 

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Saturday, January  29, 2005

FRIDAY, Jan. 28 (HealthDayNews) -- Doctors and other health professionals defended on Thursday the safety of vitamin E, and reported on continuing studies that they said show its potential benefits in treating a variety of health problems.

The conference followed the release of a John Hopkins study in November that found elderly, ill patients who took vitamin E daily at doses of 400 International Units (IUs) or more suffered a 6 percent increase in mortality compared to those who took placebos.

One of the criticisms of the Hopkins study expressed by doctors at the conference, sponsored by the supplement industry and held in New York City, was that the conclusions were based on a group of older, ill patients, and these findings aren't necessarily applicable to the general population. The doctors also criticized the statistical method used by the researchers -- called a "meta-analysis." A meta-analysis is the use of statistical methods to combine results of separate studies.

"Meta-analysis is not a great way to do a study because not everyone agrees on the end-point," said Dr. Gerald M. Lemole, chief of cardiac surgery at Christiana Health Care Services in Newark, Del. "Also, you can't say these results apply to the general population."

Dr. Edgar R. Miller, an associate professor of medicine at Johns Hopkins and lead author of the study, defended his statistical methods as the standard way to pool analyses. The study results were representative of those people who most often take vitamin E -- older individuals seeking health benefits and longevity.

"Supplement trials focus on those with disease," Miller said, and people in their 20s, 30s and 40s aren't generally suffering from these illnesses.

"Our study showed a slightly increased risk of mortality, but certainly showed no benefit," he said. "There was a hint, however, which we noted in the study, that in the low dose -- 200 IUs or less -- there was protection," he said. "Maybe we need to reexamine what dose we're giving people."

Ongoing studies have indicated that vitamin E may help to protect against health problems ranging from Alzheimer's disease (news - web sites) to cancer to cataracts.

Dr. Mark Moyad, director of Complementary and Alternative Medicine at the University of Michigan, said the study seemed "intended to scare and raise attention." But, he added, "The good news is that it brought out the big issue of dosage."

Moyad, who researches the effects of vitamin E and other vitamins on prostate and bladder cancer, said, "There has to be a risk/benefit ratio -- what dosage and for what condition. People can't pick these vitamin doses at random."

He pointed to a National Cancer Institute (news - web sites) study now under way of 32,000 men to test the efficacy of 400 IUs of vitamin E and/or 200 micrograms of the mineral selenium in preventing prostate cancer. This study is a follow-up to earlier studies that showed benefits to taking vitamin E to prevent a recurrence of prostate cancer and decrease in mortality from the disease.

"Vitamin E is going to get objective research to reach an objective conclusion," he said. "You have to stick with the science."

Miller said vitamin E did show benefits in terms of decreasing oxidative stress in cells. But "there's a big gap between that and the bigger and more difficult question is linking these markers to clinical uses, like reducing heart attacks and cancer."

He pointed to approximately 15 NCI trials under way looking into the efficacy of vitamin E. "We should let those studies run their course so we can answer this most definitively," he said.

Other doctors at the conference reported on ongoing, small studies of the efficacy of vitamin E for treating various health problems. Those problems include:

More information

 

For more on vitamin E, visit the National Institutes of Health.

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Scientists Explore Risks Posed by Steroids

 

By Mark Bloom
HealthDay Reporter

HealthDayNews

Saturday, January  29, 2005

SATURDAY, Jan. 29 (HealthDay News) -- While Major League Baseball owners and the players' union have agreed on a stricter policy to combat the use of performance-enhancing steroids, scientists are exploring the potential dangers posed by these drugs.

Intuitively, steroids seem to put athletes in harm's way. But they also seem to give those who use them an unfair advantage over those who don't.

The problem is the scientific community has little data to back up either assertion.

"There has been a tremendous disconnect between the conviction of athletes that these drugs are effective and the conviction of scientists that they aren't," said Cynthia M. Kuhn, a Duke University professor of cancer biology and pharmacology.

"In part, this disconnect results from the completely different dose regimens used by scientists to document the correction of deficiency states and by athletes striving to optimize athletic performance," she added.

There are some documented cases in professional sports that, at the very least, indicate some links between steroid use and declining health.

Lyle Alzado, who during the best years of his 15-year pro football career weighed 254 pounds at 6' 3", died from brain cancer in 1992 at the age of 43. He told Sports Illustrated that he began taking anabolic steroids in college in 1969. After he became ill, Alzado wrote, "If you're on steroids or human growth hormone, stop. I should have."

Ken Caminiti was a Major League Baseball player who won the National League Most Valuable Player award in 1996. He died from a heart attack in October 2004 at the age of 41. And while his death has been linked to cocaine use, Caminiti was another athlete who told Sports Illustrated that he used steroids during his MVP season, when he had career-high statistics.

A more recent example is Jason Giambi, the New York Yankees first baseman whose admission that he used steroids was revealed by the San Francisco Chronicle. The newspaper cited grand jury minutes in which Giambi reportedly talked about the various substances he ingested or injected. Giambi's body essentially broke down during the 2004 season. He was a pale imitation of the slugger the Yankees obtained two years earlier from the Oakland Athletics.

Were Giambi's orthopedic woes the result of his abuse of performance-enhancing drugs? Did the benign tumor he developed -- reportedly a pituitary growth -- arise from a female fertility drug called clomiphene (Clomid) he reportedly told the grand jury he took to bulk up? There's no way to prove that either condition was caused by performance-enhancing drugs. Yet steroids can have orthopedic side effects and clomiphene can exacerbate a pituitary tumor.

From the standpoint of health risks, the best evidence of how dangerous anabolic steroids can be comes from once-secret East German medical reports dating to the 1970s and 1980s, when athletes from that country, particularly women, were setting astonishing records in track and field and swimming. Some of those records of a generation ago still stand.

Werner W. Franke, of the German Cancer Research Center in Heidelberg, reported in 1997 in the journal Clinical Chemistry that for years the East Germans gave anabolic steroids to several thousand athletes of both sexes, including minors. "Special emphasis was placed on administering androgens to women and adolescent girls because this practice proved to be particularly effective for sports performance," he wrote. "Damaging side effects were recorded, some of which required surgical or medical intervention."

These side effects resulted in some irreversible damages, like virilization, increased growth of body hair, voice changes and disturbances in libido. "The effect on the sexual drive was relatively strong in some women," he wrote. There were also cases of enlarged liver.

Today it's all much subtler, with newer "designer" steroids on the scene that can defy testing, even though they are just as risky as the old-fashioned variety. There is also the addition of recombinant human growth hormone (hGH), which enhances muscle growth, and erythropoietin (EPO) "blood doping," which increases oxygen delivery to the muscles. Both are extremely difficult to detect.

"Human growth hormone is a potentially dangerous drug, which when used by adults can lead to diseases having significant mortality rates," according to the U.S. Justice Department (news - web sites). "Its misuse in adults poses a wide array of serious side effects, including significant cardiovascular disease, irreversible enlargement of the heart, and development of polyps and malignancies of the colon."

So far, the Justice Department has offered no significant studies to back up this assertion. And human growth hormone was approved by the Food and Drug Administration (news - web sites) for use in children to increase short stature. It is also used in cases of AIDS (news - web sites) wasting.

These days, the idea for athletes is to gain an edge -- not too much of an edge to risk their health, but enough to achieve their athletic goals -- with the financial rewards that follow. The trouble is that no one knows which athletes' bodies will get away with a little cheating and not cause their bodies to fail them.

Giambi's medical troubles and his ensuing performance drop-off may have been a coincidence. Yet when he showed up at spring training last year, after his name emerged in the now-infamous BALCO probe and he presumably halted his use of the drugs, sports writers were shocked at how his body shape had changed -- almost as if a weightlifter had stopped working out. BALCO Labs was a small California company that manufactured a variety of strength-enhancing substances, including a testosterone supplement.

Giambi's grand jury testimony reportedly contained a reference to taking "the clear," a street name for tetrahydrogestrinone, the "designer" drug known as THG. It was the chance discovery of that drug that spurred the investigation of BALCO, which led to the grand jury being convened. Presumably, THG is called "the clear" because until a year ago the steroid was undetectable by standard testing.

According to a report in the May 2004 Journal of Clinical Endocrinology & Metabolism, THG is closely related to gestrinone, a 19-nor progestin, and resembles trenbolone. Trenbolone, popular among body builders, is a veterinary drug used to bulk up cattle and it is banned by the National Collegiate Athletic Association. Gestrinone, used to treat endometriosis, acts on the pituitary. It is not approved for adult males.

Giambi also reportedly testified he used an agent he called "the cream." This, too, is a "designer" steroid, said to be a mixture of the male hormone testosterone and epitestosterone.

According to the National Institute on Drug Abuse, the statistics on health effects from the long-term abuse of anabolic steroids on humans are based on anecdotal reports -- not formal epidemiological reports -- and certainly not randomized clinical trials, which would be unethical, if not illegal.

More information

For more on steroids, visit the National Institute on Drug Abuse.

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