The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
March 21, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 February 12-18

 

  1. Lead in Environment Causing Violent Crime – Study
  2. Gender Gap Closing in Heart Attack Treatment
  3. Women with Heart Disease Not Taking Aspirin
  4. Health Tip: Dry Skin, Allergy or Something More Serious?
  5. Older Women Take to Tai Chi for Exercise –Study
  6. Health Tip: Irritable Bowels?
  7. Diabetes Heart Risk Higher for Women Than Men
  8. Tying Exercise to Culture Boosts Participation
  9. High Tech Twist to Ancient Drug Kills Cancer
  10. Saliva Testing Moves Into the Mainstream
  11. Heavy Bodyweight Raises Dementia Risk in Men
  12. Nursing Home Drug May Speed Alzheimer's
  13. Obesity Poses Risk to Kidney Transplant Kids
  14. Vitamin D May Ward Off Prostate Cancer
  15. Canadian Beef Entered U.S. Due to Lax Oversight –USDA
  16. Early Epidural Won't Raise C-Section Risk
  17. Herbal Extract Shows Promise for Diabetes
  18. When Your Biological Clock Says Time's Up
  19. Group Asks FDA for Ibuprofen Warnings
  20. Health Tip: Preventing Cataracts in Children
  21. Carbohydrate Type, Not Amount, Linked to Obesity
  22. Health Tip: Stop Urinary Tract Infections
  23. Low Thyroid Activity May Lower Breast Cancer Risk
  24. Sunlight Lowers Need for Painkillers After Surgery
  25. Colon Cancer Survival Better in U.S. Than Europe
  26. Air Pollution Damages Babies in Womb –Study
  27. Health Tip: Coping With Memory Loss
  28. Coffee May Help Prevent Liver Cancer
  29. Heredity Plays a Role in Heart Artery Blockages
  30. New Test Can Detect Bladder Cancer Faster –Study
  31. Problem Drinkers Turning to the Web For Help
  32. Herbal Supplement Use Leveling Off
  33. Compound in Urine May Fight Spinal Cord Injury
  34. Older Doctors Not Always the Best
  35. New Pain Relievers Boost Blood Pressure More – Study
  36. Health Tip: Avoid Varicose Veins
  37. Flu Shots for Elderly May Not Save Lives
  38. Compound Fights Gleevec-Resistant Leukemia
  39. Low Cholesterol May Mean Poorer Mental Powers
  40. Painkiller Use Falls After Vioxx Withdrawn
  41. Arthritis Drug Seen to Cut Heart Risk
  42. Nutritional Info May Find Place on Menus
  43. Potato Vaccine Offers Hope Against Hepatitis
  44. Southern Diet Frustrates Health Officials
  45. Teen Binge Drinking Can Do Long-Term Brain Damage
  46. Schools Responding to Abuse of ADHD Drug
  47. U.S. Says J&J Arthritis Drug Promotion Misleading

  48. Older Adults' Memories Stress the Positive
  49. Quitting Smoking Improves Blood Tests in Days
  50. Reprogrammed HIV Can Hunt Down Cancer Cells
  51. Quitting Smoking Improves Quality of Life
  52. Stressed Out and Sick About It

 

 

Friday, February 18, 2005

 

Lead in Environment Causing Violent Crime – Study

 

Reuters

Friday, February 18, 2005

WASHINGTON (Reuters) - Lead left in paint, water, soil and elsewhere may not only be affecting children's intelligence but may cause a significant proportion of violent crime, a U.S. researcher argued Friday.

He said the U.S. government needs to do more to lower lead levels in the environment and parents need to think more about where their children may be getting exposed to lead.

"When environmental lead finds its way into the developing brain, it disturbs neural mechanisms responsible for regulation of impulse. That can lead to antisocial and criminal behavior," said Dr. Herbert Needleman, a professor of psychiatry and pediatrics at the University of Pittsburgh School of Medicine.

Needleman's team, using a technique called X-ray fluorescence, found very low levels of lead in the bones of children.

Needleman cited several studies that associate crime with high levels of lead either in the bodies of those accused or in the environments they came from, including one that showed the average bone lead levels of 190 juvenile delinquents were higher than those of adolescents not charged with crimes.

His study suggested that between 18 percent and 38 percent of delinquent crimes in the Pittsburgh area could be attributed to lead toxicity in the adolescents.

Another one tested 300 delinquents and found those with higher lead levels reported more aggressive feelings or behavior disorders.

"The brain, particularly the frontal lobes, are important in the regulation of behavior," Needleman told a meeting of the American Association for the Advancement of Science (news - web sites).

"Exposure to lead, at doses below those which bring children to medical attention, is associated with increased aggression, disturbed attention and delinquency. A meaningful strategy to reduce crime is to eliminate lead from the environment of children."

Taking lead out of most gasoline has contributed to a sharp reduction in the level of lead in the blood of Americans over the past 30 years.

But lead is still found in paint, some types of fuel for older vehicles, older water pipes and in the soil.

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Gender Gap Closing in Heart Attack Treatment

 

HealthDayNews

Friday, February 18, 2005

FRIDAY, Feb. 18 (HealthDay News) -- A new study suggests the gender gap in heart attack treatment that favored men may be closing as more women receive the same recommended care.

Researchers found that women who've had a heart attack or suffered chest pain are being given appropriate drug intervention upon discharge from a hospital, at rates similar to men.

American Heart Association (news - web sites) and American College of Cardiology practice guidelines recommend that people with acute coronary syndrome (ACS) -- which includes angina and heart attack -- be treated with aspirin, beta-blockers medications and lipid-lowering drugs called statins. Previous research found that women with heart disease weren't receiving as much of this recommended therapy as men after a heart attack or unstable angina.

"But significant progress has been made with more physicians/nurse practitioners following practice guidelines," Shu-Fen Wung, associate professor of nursing at the University of Arizona, said in a prepared statement. "In addition, there is not a statistically significant gap in the treatment between men and women," she said.

The research was presented Friday at the Second International Conference on Women, Heart Disease and Stroke in Orlando, Fla.

The study included 177 men and 35 women with ACS. It found that 90 percent of the men and women received aspirin and beta blockers when they were discharged from a hospital. Two-thirds of women received lipid-lowering statins, compared with 78 percent of men.

The women lived an average of 179 days following their ACS hospitalization while the men lived an average of 156 days.

"More people are following the guidelines. Women are receiving more of the recommended medications and there are less gender disparities in the usage of these medications either as a primary or secondary prevention," Wung said.

More information

The Cleveland Clinic has more about heart attack treatment.

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Women with Heart Disease Not Taking Aspirin

 

Reuters Health

Friday, February 18, 2005

NEW YORK (Reuters Health) - Only about half of women with cardiovascular disease are taking aspirin, investigators report, and rates of use are particularly low among black women and patients on Medicaid.

Dr. Jeffrey S. Berger, of Beth Israel Medical Center, New York and colleagues analyzed data obtained by following nearly 9000 women with heart disease. In total, 46 percent were on low-dose aspirin therapy, which is widely recommended for preventing heart attacks.

"The results we found were quite discouraging," Berger told Reuters Health. "The problem is that these women were those who were living in the community, and already seeing doctors and going to clinics. Despite that, they were still being undertreated."

Women who were older or college educated were the most likely to be on aspirin, while being black, having Medicaid insurance, and living in the south or west of the US were negative predictors, Berger reported Friday at the Second International Conference on Women, Heart Disease and Stroke in Orlando, Florida.

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Health Tip: Dry Skin, Allergy or Something More Serious?

 

HealthDayNews

Friday, February 18, 2005

(HealthDay News) -- The cold winter months cause many of us to itch and scratch what appears to be dry skin. But is it weather-related, an allergic reaction, or something more serious like psoriasis?

Psoriasis typically develops between the ages of 15 to 35, but it can begin at any age. Many first-time psoriasis patients may brush off a warning sign and not realize they have a condition that requires medical attention. Check with your doctor if you have:

According to the National Psoriasis Foundation, in addition to weather, diet, or allergies, triggers of the disease can include emotional stress, injury to the skin, some types of infection, and reactions to certain drugs. Also, stress can cause psoriasis to flare for the first time or aggravate existing cases.

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Older Women Take to Tai Chi for Exercise –Study

 

By Amy Norton

Reuters Health

Friday, February 18, 2005

NEW YORK (Reuters Health) - The gentle, flowing movements of tai chi may offer older women an exercise program they can live with, researchers said Friday.

In a study of 27 older Chinese women with risk factors for heart disease, researchers found that all but one woman completed their 12-week tai chi program -- a completion rate not usually seen in similar exercise studies.

Tai chi is an ancient Chinese practice that focuses on building strength, balance and flexibility through slow, fluid movements combined with mental imagery and deep breathing. Studies have suggested that the elderly can reduce their risk of falls, lower their blood pressure and ease arthritis symptoms through the practice, and some research indicates tai chi can improve heart and blood vessel function in both healthy people and those with heart conditions.

Tai chi can be as intense a workout for the heart as brisk walking -- a form of exercise commonly advocated for older adults -- and could serve as an alternative to the treadmill, according to Ruth E. Taylor-Piliae, a doctoral candidate at the University of California San Francisco and co-author of the new study.

The rate of satisfaction with the tai chi program in this study was "very high," she told Reuters Health, in large part because the exercise was "culturally appropriate" for the women.

But that does not mean women of other ethnic backgrounds won't take to tai chi, Taylor-Piliae said, noting that the study classes have continued as community classes and have grown in diversity.

She presented the study results Friday in Orlando at the Second International Conference on Women, Heart Disease and Stroke.

The study involved older Chinese women living in San Francisco who had one major risk factor for heart disease, such as high blood pressure, high cholesterol or diabetes. For 12 weeks, the women took one-hour tai chi classes three times a week at a community center.

None of the women, according to Taylor-Piliae, fell or suffered an injury, and only one woman dropped out of the classes. That so many women stuck with the program is important, she said, because women, in particular, often drop out of such exercise studies -- typically at rates of 40 percent or more.

Many factors, Taylor-Piliae said, could have kept the women interested in tai chi. Besides the relevance to the women's culture, the classes had a social aspect and were held in a community center that was easy for them to get to.

She recommended that older people who wish to try tai chi should take classes in the Yang style, which uses particularly gentle movement. In general, experts advise the elderly to look for classes where the instructor has experience working with older students and knows how to modify movements for those with physical limitations.

A local senior center, Taylor-Piliae said, is a good place to start looking for classes.

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Health Tip: Irritable Bowels?

 

HealthDayNews

Friday, February 18, 2005

(HealthDay News) -- If you're among the one in five Americans who suffers from irritable bowel syndrome (IBS), you know how discomforting it can be. Sometimes it's so disabling that you're unable to work, go to social events, or even travel short distances.

The disorder, which interferes with the normal functions of the large intestine (colon), is characterized by a group of symptoms -- crampy abdominal pain, bloating, constipation and diarrhea. These symptoms can be aggravated by large meals, bloating from gas in the colon, medications or eating/drinking certain products such as wheat, rye, barley, chocolate, milk, caffeinated drinks or alcohol.

Stress, which may be more difficult to manage, can also be a trigger. The National Digestive Diseases Information Clearinghouse (NDDIC) suggests these methods to manage stress:

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Diabetes Heart Risk Higher for Women Than Men

 

By Megan Rauscher

Reuters Health

Friday, February 18, 2005

NEW YORK (Reuters Health) - Women with diabetes run a greater risk of dying from heart disease than do men with diabetes, Australian researchers report.

"More aggressive treatment of cardiovascular risk factors among women with diabetes may help to offset the increase in mortality from coronary heart disease among older postmenopausal women," Dr. Rachel Huxley told Reuters Health.

Diabetes is a well-established risk factor heart disease, doubling the risk of a fatal cardiac event. "There is, however, much debate over whether diabetes carries different heart risks for women than for men," said Huxley, senior epidemiologist at The George Institute for International Health at the University of Sydney in Australia.

Using data on more than 450,000 adults, Huxley's group found that after adjusting for smoking, blood pressure, cholesterol, and other cardiovascular risk factors, women with diabetes had significantly greater risk of dying from heart disease than did men with diabetes.

Compared to people without diabetes, the risk of cardiovascular death was 2.48-times higher for diabetic women but only 1.87-times greater for diabetic men, according to results presented Friday in Orlando at the Second International Conference on Women, Heart Disease, and Stroke.

"This translates to a greater than 50 percent excess relative risk for diabetic women than for diabetic men," Huxley pointed out.

The researchers are currently conducting a 4-year study involving more than 11,000 people to determine whether more intensive control of blood glucose levels, combined with blood-pressure lowering, reduces heart disease mortality in people with type 2 diabetes.

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Tying Exercise to Culture Boosts Participation

 

HealthDayNews

Friday, February 18, 2005

FRIDAY, Feb. 18 (HealthDay News) -- Tailoring exercise to specific cultural backgrounds may encourage older women to start and continue a fitness program, claims a study that found the vast majority of elderly Chinese women sticking with their Tai Chi lessons over the long term.

The study, from the University of California, San Francisco School (UCSF) of Nursing, included 27 ethnic Chinese women, average age 64, who took part in one-hour Tai Chi sessions three times a week for three months. All the women had at least one major risk factor for coronary heart disease.

Many exercise programs for women with coronary heart disease have high dropout rates. But 96 percent of the women in this study completed the Tai Chi program, and there was a waiting list to join it, the researchers report.

"Tai Chi has been widely practiced in China for centuries, and is a popular form of exercise there," Ruth E. Taylor-Piliae, a doctoral candidate in the UCSF School of Nursing, said in a prepared statement.

"The exercise program was provided at a community center where a large number of Cantonese-speaking senior citizens gather daily. They readily embraced this form of exercise, and were excited. Activities within various cultures that are the equivalent of brisk walking most likely will spark interest and be readily accepted," Taylor-Piliae said.

The study was reported Feb. 18 at the Second International Conference on Women, Heart Disease and Stroke in Orlando, Fla.

More information

The U.S. National Women's Health Information Center has more about women and exercise.

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High Tech Twist to Ancient Drug Kills Cancer

 

Reuters Health

Friday, February 18, 2005  

NEW YORK (Reuters Health) - Using a high tech process to modify an ancient drug called artemisinin, researchers have created a compound that is highly lethal to cancer cells, but causes little harm to normal cells, according to a report in the journal Life Sciences.

Artemisinin, a substance derived from wormwood that is used to treat malaria in China, reacts with iron to produce "free radicals" -- toxic compounds that can destroy cells.

Because cancer cells take up more iron than do normal cells, they should be more susceptible to the toxic effects of artemisinin, Dr. Henry Lai from the University of Washington in Seattle, and colleagues reasoned. In an earlier study, Lai's team showed that, in fact, this was true.

In the current study, the researchers hypothesized that they could improve the anti-cancer potency of artemisinin further by attaching or "tagging" it to transferrin, a protein that picks up iron in the blood and then is transported into cells, especially cancerous ones. Once in the cell, transferrin releases the iron, leaving it free to interact with artemisinin and cause the deadly reaction.

The investigators tested the "artemisinin-tagged transferrin" on human leukemia cells and on normal human immune cells. As hoped for, the compound destroyed the leukemia cells, but had little effect on the normal cells.

"By itself, artemisinin is about 100 times more selective in killing cancer cells as opposed to normal cells," Lai said in a statement. By contrast, "the new artemisinin compound was 34,000 times more potent in killing cancer cells as opposed to their normal cousins. So the tagging process appears to have greatly increased the potency."

The next step will be to evaluate the new compound in animal studies, the researchers note.

Source: Life Sciences, January 28, 2005.

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Saliva Testing Moves Into the Mainstream

HealthDayNews

Friday, February 18, 2005

FRIDAY, Feb. 18 (HealthDay News) -- Simple saliva can provide detailed information on the presence of disease, dental cavities and drug abuse.

That's the conclusion of research presented Thursday at the annual meeting of the American Association for the Advancement of Science (news - web sites).

New discoveries in proteomics -- the study of proteins found in saliva and elsewhere throughout the body -- is bringing saliva testing within spitting distance of other much-used screens, such as blood or urine testing, the experts said.

"Saliva has not really been used in the mainstream. As a scientific community, it's time to bring oral fluid testing to the front line and look at what value it will bring," David Wong of the University of California, Los Angeles Jonsson Cancer Center and School of Dentistry, said in a prepared statement.

Saliva and other oral fluids contain many of the same proteins and other molecules found in blood and urine that can reveal the presence of diseases, including head and neck cancers, the researchers noted.

One team of researchers at the University of Pennsylvania found that genetic traces of lethal pathogens such as HIV (news - web sites) can be detected in saliva. Another group, this time at the University of Southern California, has identified saliva-borne molecules that help predict who's at high risk for cavities, and where in the mouth those cavities are most likely to develop.

Currently, scientists are working hard on technologies for testing saliva and identifying molecules (biomarkers) that indicate disease. In the meantime, saliva testing for illicit drug use is already becoming more common in the workplace, the panelists said.

Ease of collection is one major advantage of saliva over urine or blood samples. All a person has to do is spit in a cup to provide a sample, they said.

More Information

The Nemours Foundation has more about saliva.

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Heavy Bodyweight Raises Dementia Risk in Men

Reuters Health

Friday, February 18, 2005

NEW YORK (Reuters Health) - A link between body mass index (BMI) -- a measure of weight in relation to height -- and a hospital or death certificate diagnosis of dementia has been identified in a Swedish study.

Drawing on data collected in the Primary Prevention Study that began in Goteburg in 1970, researchers analyzed 7402 men who were between 47 and 55 years old between 1970 and 1973. None of the men had a history of stroke or heart attack at the start of the study.

Dr. Annika Rosengren of Sahlgrenska University Hospital in Goteburg and a multicenter team classified the subjects into four groups: 22 men diagnosed with Alzheimer's disease (news - web sites); 78 men with a secondary diagnosis of dementia; 154 diagnosed with dementia as a primary diagnosis or cause of death; and 7148 men who had never been diagnosed with dementia.

According to the team's report in the Archives of Internal Medicine (news - web sites), they found that the likelihood of dementia rose linearly as body mass index increased.

That is, after factoring in smoking, blood pressure, cholesterol, diabetes, and social strata, men with a BMI of about 20 at the start of the study had the lowest risk of developing dementia, and the risk rose steadily up to 2.5-times greater for men with a BMI of 30 or higher.

"Overweight and obesity," Rosengren's group says, "could be major preventable factors in the development of dementia."

Source: Archives of Internal Medicine, February 14, 2005.

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Thursday, February 17, 2005

 

Nursing Home Drug May Speed Alzheimer's

 

HealthDayNews

Thursday, February 17, 2005

THURSDAY, Feb. 17 (HealthDay News) -- The antipsychotic drug quetiapine, commonly used to treat agitation and other symptoms in people with Alzheimer's living in nursing homes, greatly speeds up cognitive decline, says a study published online in the British Medical Journal.

Researchers tracked 93 dementia patients for six months. Some people were given quetiapine (brand name Seroquel), some took a placebo and others were given another antipsychotic drug called rivastigmine (Exelon).

Those who were given the placebo showed little change. But the people who took quetiapine suffered twice the rate of cognitive decline -- memory and other higher brain functions -- as those who took the placebo. People who took rivastigmine experienced little or no worsening of their symptoms.

This finding is important, the study authors noted, because quetiapine has been considered one of the safer antipsychotic drugs. The study highlights concerns about quetiapine and suggests that it is not a viable alternative to two other antipsychotic drugs used to treat agitation in people with dementia -- risperidone and olanzapine, which may increase stroke risk.

More information

The Alzheimer's Association has more about Alzheimer's behavioral symptoms.

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Obesity Poses Risk to Kidney Transplant Kids

 

Reuters Health

Thursday, February 17, 2005  

NEW YORK (Reuters Health) - The proportion of children undergoing a kidney transplant who are obese is on the rise, researchers report.

"The concern is that kidney transplantation poses a multiple cardiovascular risk, and obesity might further contribute to the development of premature cardiac disease in these young patients," Dr. Mark M. Mitsnefes told Reuters Health.

Mitsnefes, at Cincinnati Children's Hospital Medical Center in Ohio, and colleagues studied more than 6600 children (ages 2 to 17 years) who had a kidney transplant between 1987 and 2002 in the US, Mexico or Canada.

The proportion of children who were obese increased from 8 percent before 1995 to 12 percent after that year. Obese children were significantly younger and shorter and had been on dialysis for a longer time than non-obese children.

There was no overall difference in the survival of patients or their transplanted kidneys between obese and non-obese children, the team reports in the medical journal Pediatrics.

However, obese children between 6 and 12 years old had a three-fold higher risk of dying compared with non-obese recipients. Death was due to cardiopulmonary disease in 27 percent of obese children versus 17 percent of non-obese children.

Overall, graft loss due to blood clots was more common in obese children than the non-obese (19 percent versus 10 percent).

The researchers urge pediatricians to "educate families on the potential risks of excessive weight gain during dialysis and after kidney transplantation."

Source: Pediatrics, February 2005

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Vitamin D May Ward Off Prostate Cancer

By Marilynn Marchione

AP Medical Writer

The Associated Press

Thursday, February 17, 2005

ORLANDO, Fla. - Getting a little sunshine may be one way for men to cut their risk of prostate cancer. A large study presented at a cancer conference Thursday found that men with higher levels vitamin D in their blood were half as likely to develop aggressive forms of the disease than those with lower amounts.

Doctors are not ready to recommend the "sunshine vitamin" without more study, but many see little harm in getting the 15 minutes a day that the body needs to make enough of this nutrient.

"When you were little and your mother said, `Go outside and play,' it wasn't just to get you out of her hair," but may have been instinctive advice about something good for health, said Dr. Eric Klein, a prostate cancer specialist from the Cleveland Clinic.

He had no role in the research, which involved nearly 15,000 men in the Physicians' Health Study at Brigham and Women's Hospital and Harvard Medical School (news - web sites) in Boston. Five years ago, this study found that men who consumed a lot of calcium had modestly higher rates of prostate cancer.

The new findings fit with that notion, because too much calcium lowers vitamin D, and are especially believable because researchers got them by measuring blood samples rather than relying on what men said they ate — an imprecision that has hurt past studies of food and cancer risk.

Blood samples were taken in 1982, when the study began. Eighteen years later, 1,082 of the men had developed prostate cancer. Their levels of two common forms of vitamin D in the stored blood samples were compared with those of 1,701 men in the study who did not get cancer.

Levels of one or the other vitamin D derivative did not make much difference in prostate cancer risk. However, men with higher levels of both had roughly half the risk of developing aggressive tumors — the kind most likely to kill — than men with lower levels, said Dr. Haojie Li, who led the study.

That is in keeping with what previous studies have shown about prostate cancer, Klein noted.

Men in northern latitudes have higher cancer death rates, and vitamin D levels are lower in older men, who are most prone to prostate cancer.

Melanin, which gives skin its color, blocks ultraviolet light that spurs vitamin D production. Blacks, who have a lot of melanin, also have the highest rates of prostate cancer.

Experiments also suggest vitamin D inhibits cell growth. "So there is some lab evidence that vitamin D may be anti-cancer," Klein said.

It could be that the risk comes from too little vitamin D, and that consuming lots of vitamin D is not helpful, doctors say.

How much should people get? The recommended daily amount is 400 international units, but most scientists think that is probably low, Li said.

Most milk is fortified with vitamin D, but drinking a lot of it might raise the risk of prostate cancer because of its calcium content. Getting enough vitamin D from food is difficult, but doctors do not recommend supplements because they can cause unsafe levels of calcium to build up.

"If you start overloading on vitamin D you're going to cause other problems," said Dr. Durado Brooks, chief of prostate cancer research at the American Cancer Society (news - web sites).

Hence the advice to get a little sunlight — but not too much, because that can raise the risk of skin cancer.

Researchers presented two other studies from the same group of 15,000 doctors. One found that men who were overweight were 30 percent more likely to die of prostate cancer than normal-weight men. Those who were obese were nearly twice as likely to die.

The second study examined a protein in the blood, acid-labile subunit or ALS, that blocks the effects of a hormone that spurs cells to grow and has been linked to many types of cancer.

Compared with men with low levels of ALS, men with higher amounts of it were 40 percent to 60 percent more likely to develop prostate cancer, and their chances of having advanced cancer more than doubled, said Lorelei Mucci, a Harvard epidemiologist who led the study.

ALS needs more study, but may be a new marker for predicting cancer risk and may be a target for developing new treatments, Klein said.

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Wednesday, February 16, 2005

 

Canadian Beef Entered U.S. Due to Lax Oversight –USDA

 

By Randy Fabi

Reuters

Wednesday, February 16, 2005

WASHINGTON (Reuters) - Lax oversight by the U.S. Agriculture Department and confused food safety inspectors were to blame for imports of 42,000 pounds of Canadian beef products in 2004 that violated a U.S. mad cow disease ban, federal investigators said on Wednesday.

The USDA's Office of Inspector General issued a report on the 2004 import mistakes less than a month before the federal government is scheduled to further lift restrictions on beef and cattle trade with Canada.

The report analyzed how the USDA mistakenly allowed processed Canadian beef products into the United States between August 2003 and April 2004. Some federal meat inspectors were confused by Washington's announcement in August 2003 to partially reopen the U.S. border to boneless beef from young Canadian cattle, the investigators found.

The United States banned all Canadian cattle and beef products after Canada discovered its first native case of mad cow disease in May 2003. In August 2003, the USDA decided to allow shipments of boneless beef from young Canadian cattle, which are thought to carry little risk of the disease.

But some U.S. meat inspectors independently began allowing shipments of other Canadian beef products such as cattle tongues, hearts, kidneys and lips, the report said.

"Agency officials asserted that they believed that they could add products to the list of the risk factors and risk levels associated with such products were consistent with the products listed in the initial announcement," the 50-page report said.

The USDA inspector general said it identified 42,000 pounds of product with "questionable eligibility" that entered the U.S. market.

That volume is much less than the 3.5 million pounds initially estimated by R-CALF United Stockgrowers of America, which first discovered USDA's mistake. The activist group won a court order in April 2004 to halt the Bush administration from easing its Canadian ban further.

The USDA has said the banned products that did enter the U.S. market from August 2003 through April 2004 did not pose a health risk to consumers.

The USDA said it agreed with many of the recommendations of the inspector general, including closer monitoring of import permits and the immediate posting of import policy changes on the Internet.

The USDA is scheduled on March 7 to begin allowing imports of more Canadian beef products as well as shipments of Canadian live cattle under 30 months of age.

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Early Epidural Won't Raise C-Section Risk

By Jeff Donn

Associated Press Writer

The Associated Press

Wednesday, February 16, 2005

BOSTON - Pregnant women can be given a low-dose epidural early in labor without raising their chances of a Caesarean section, according to a study that could change the way obstetricians practice and make childbirth a lot less painful for many mothers-to-be.

The finding could lead doctors to consider offering early epidurals to hundreds of thousands more American women in first-time labor each year.

Though medical authorities recently dropped their reservations about giving women epidurals early in labor, some doctors and patients still prefer to wait until labor is further along. They worry that the painkiller's numbing effect will interfere with a woman's ability to push, prolonging labor and prompting a C-section.

This study appears to debunk the notion about C-sections and calls into question the one about prolonged labor, too.

"Women often feel guilty or weak when they request an epidural early in labor. I hope this study will help women see that there is no shame in asking for an epidural," said lead author Dr. Cynthia Wong of Northwestern University in Chicago. "The message for women and their obstetricians and gynecologists is that there is no reason why women who want an epidural should not get it when they first request it."

The study was reported in Thursday's New England Journal of Medicine (news - web sites).

More than 3.5 million women go into labor each year in this country. Epidural use has greatly expanded over the past decade, to more than 1.5 million women annually.

Epidurals deliver numbing medicine through a skinny plastic tube that is threaded into the back, close to spinal nerves, mostly bypassing the mother's bloodstream. More recent techniques, sometimes called "walking epidurals," provide lighter doses, allow women to push, and even enable them to walk throughout labor.

Doctors have welcomed epidurals as an alternative to "systemic" pain medicine through the bloodstream, which can leave a woman feeling nauseated and doped-up and even enter the baby's body.

The Northwestern University study tested a type of low-dose pain relief known as a "combined spinal epidural." A small dose of pain reliever is first injected into the spinal fluid, and the epidural is later fed through the same hole into a space a bit farther from the spine.

In this study, 728 women in first-time labor were divided into two groups. One group received the spinal shot and then got epidurals when the cervix was dilated to about 2 centimeters. The other group initially received pain-relieving medicine directly into their bloodstreams, and put off epidurals until 4 centimeters if they could tolerate the pain.

In the end, the C-section rate was statistically a tie: 18 percent in the early epidural group and 21 percent in the delayed group.

The early epidural group also delivered 90 minutes sooner than the other women, who averaged eight hours in labor. However, Dr. Gary Hankins, an obstetrician at the University of Texas Medical Branch at Galveston who helped shape the medical guidelines, said it is not clear if that finding would apply broadly.

Lisa DeCook of Glenview, Ill., was a study subject in the early epidural group and delivered her daughter vaginally. She said the pain before the epidural was "intense."

"Then once I got it, I really don't remember feeling any pain or contractions. It was good for me," she said. She chose an epidural on Tuesday when she vaginally delivered her second healthy baby, a boy, at Northwestern Memorial Hospital.

The finding seems to contradict some previous research showing that women who got early epidurals underwent more C-sections. In 2002, the American College of Obstetricians and Gynecologists recommended against epidurals before 4 centimeters of dilation. In July, though, it dropped a specific threshold.

"There's really no reason to withhold the treatment if a women is in terrible pain at 1 or 2 or 3 centimeters dilation," said Dr. David Birnbach, a University of Miami anesthesiologist who is on the College of Obstetricians committee that devises the guidelines.

As for why the earlier research reached a different conclusion, it could be that some of the women had underlying problems — such as an unusually big baby — that can cause more pain, make women request early epidurals, and also require a C-section, researchers said.

This study examined only first pregnancies, but C-sections are less frequent and therefore less of a worry in later pregnancies.

Other studies would be needed to settle whether early epidurals promote C-sections at higher doses or in case of medically induced labor, doctors said.

On the Net:

New England Journal of Medicine: http://media.nejm.org

Hospital primer on pain relief during labor:  http://www.brighamandwomens.org/painfreebirthing/

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Herbal Extract Shows Promise for Diabetes

By Amy Norton

Reuters Health

Wednesday, February 16, 2005

NEW YORK (Reuters Health) - An herb long used in traditional Indian medicine appears to control the rise in blood sugar that follows a meal -- suggesting, researchers say, that it could help treat or even prevent type 2 diabetes.

Their study of 39 adults without diabetes found that a beverage made from the herb, known as Salacia oblonga, stemmed participants' normal post-meal rise in blood sugar. There was a similar reduction in blood levels of insulin, which helps shuttle sugar from the blood and into cells to be used for energy.

The herb, according to the study authors, seems to work similarly to oral diabetes drugs known as alpha-glucosidase inhibitors, which impede the body's absorption of carbohydrates.

The study, which was funded by Columbus-based Abbott Laboratories, is published in the Journal of the American Dietetic Association.

The next step is to test S. oblonga's ability to slow post-meal sugar absorption in people with diabetes, study co-author Dr. Steven R. Hertzler told Reuters Health.

"We still want to see what this does in people with type 2 diabetes," said Hertzler, an assistant professor of nutrition at Ohio State University in Columbus.

Though S. oblonga has a long tradition of use in Indian ayurvedic medicine, few studies have looked at the herb's effects in humans, Hertzler noted.

What research has been done has been conducted largely in Japan, where S. oblonga has been sold as a food supplement for several years. The plant grows in limited regions of India and Sri Lanka, and it is not yet well known in the U.S., according to Hertzler and his colleagues.

For their study, the researchers had 39 healthy adults drink four different liquid meals on four separate days. Three of the beverages had varying doses of S. oblonga, along with generous portions of protein, carbohydrates, fat and fiber; the fourth beverage did not contain the herb.

The researchers found that the drink with the largest S. oblonga dose -- 1,000 milligrams -- cut the participants' post-meal blood sugar rise by about one-quarter compared with sugar levels after the herb-free drink. An even larger decline was seen in insulin levels.

Good blood sugar control is vital in diabetes because it reduces the risk of long-term complications such as kidney dysfunction, heart disease, vision loss and nerve damage.

The hope, according to Hertzler, is that S. oblonga can help diabetics maintain healthy blood sugar levels over time, and thereby help prevent complications.

He and his colleagues are about to begin a clinical trial that will look at how the herb affects post-meal blood sugar and insulin levels in people with type 2 diabetes. Future studies will have to investigate whether there's a long-range benefit, Hertzler said.

It's also possible, he noted, that S. oblonga could prove useful in preventing type 2 diabetes.

The disease arises when the body becomes resistant to the activity of insulin, allowing blood sugar levels to soar. Maintaining normal blood sugar and insulin levels through diet, exercise and weight control cuts the risk of developing the disease. So there's the potential, Hertzler said, for S. oblonga to help prevent diabetes in people at high risk, due to factors like family history or obesity.

What's attractive about the herbal extract, he said, is that it can be incorporated into a food or beverage, such as tea, which could help people stick with it.

What's not so attractive is the gas and cramping the herb can cause, owing to its effects on carbohydrate absorption. In this study, the highest S. oblonga dose caused more bouts of gas and stomach distension.

However, the same types of problems occur with standard alpha-glucosidase inhibitors, Hertzler said, adding that it's possible that any such side effects would dissipate in a person who used the herb regularly.

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

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When Your Biological Clock Says Time's Up

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Wednesday, February 16, 2005

WEDNESDAY, Feb. 16 (HealthDayNews) -- More women are waiting longer to have children as they pursue college degrees and careers or simply enjoy young adulthood without kids in tow.

That trend could have sharp repercussions for women and couples eventually hoping to start a family. Those who wait too long could have trouble getting pregnant. Wouldn't it be nice for a woman to know in advance how many fertile years she has left?

Researchers in the United Kingdom say they've found a revolutionary way to read the tea leaves. By measuring a woman's ovarian volume using ultrasound and plugging that information into a computer model, it should be possible to predict when a woman will enter menopause and how much time is left on her biological clock, they said.

At least that's the theory.

"We are now looking for funding for a clinical study to prove our hypothesis that there is a very strong relationship between ovarian volume and ovarian reserve/age at menopause," said Dr. W. Hamish Wallace, a consultant pediatric oncologist at the Royal Hospital for Sick Children in Edinburgh, Scotland.

He and colleague Thomas W. Kelsey, a senior research fellow at the University of St. Andrews in Scotland, first unveiled their methodology last June in the journal Human Reproduction.

The occasional headline-grabbing tale of a 50-something woman becoming a new mother does not erase the fact that age remains a critical factor in determining female fertility. As a woman grows older, her ovaries produce fewer eggs. Fertility problems affect about a third of couples in which the woman is over 35, according to the National Women's Health Information Center.

A woman who delays pregnancy into her late 30s or 40s could miss the boat entirely if menopause precedes motherhood. When her monthly periods stop for good, she can no longer produce eggs or become pregnant.

Women who've had their ovaries surgically removed may experience menopause at any age. For most women, menopause occurs naturally around age 51, when the ovaries stop producing estrogen, according to the American Menopause Foundation.

But determining the precise onset of menopause is tricky. "Some women enter menopause prematurely at very young ages -- even less than 30," said Dr. Robert Schenken, president of the American Society for Reproductive Medicine and chairman of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio.

Having an accurate model for predicting when a 39-year-old will become menopausal could influence her decision about when to become pregnant, Schenken observed. "I think it's certainly worthy of further study," he said.

Physicians already use a variety of tests to evaluate female infertility, including a blood test that detects levels of follicle-stimulating hormone (FSH).

"That can tell us how hard the brain has to work to stimulate the ovaries," explained Dr. Alan Copperman, director of reproductive medicine at Mount Sinai Medical Center in New York City.

FSH and other hormone tests are generally administered as part of the workup of candidates for assisted reproductive techniques, including in vitro fertilization. But no current test is sufficiently accurate in predicting the precise age of menopause, fertility experts said; existing tests provide only pieces of the puzzle.

And there is a larger question: How many women really want to know when their baby-making days are over? "I think a lot of people don't want to know or, certainly, don't want to know bad news," Copperman said.

On the other hand, now that modern medicine has made it possible to freeze eggs for future use, a predictive test could be quite useful to a young woman who learns that she's less likely to be fertile in her mid- to late-30s, he conceded. She might consider putting away some of her eggs "almost as an insurance policy," he suggested.

Even if further studies validate Wallace's method for predicting menopause, it could be quite some time before it is recognized as a standard diagnostic tool. As far as he knows, no physicians or clinics in the United States or the United Kingdom are currently using it.

If you're trying to conceive, don't despair.

"I do not believe this paper gives any more information to women presently planning therapy than already exists," said Dr. William D. Schlaff, immediate past president of the Society for Reproductive Endocrinology and Infertility and chief of endocrinology and infertility at the University of Colorado Health Sciences Center in Denver.

More information

Visit the National Women's Health Information Center for more on infertility.

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Group Asks FDA for Ibuprofen Warnings

By Todd Zwillich

Reuters Health

Wednesday, February 16, 2005

WASHINGTON (Reuters Health) - A group of physicians and families called on US regulators Tuesday to warn the public about a rare but potentially fatal set of skin reactions linked to taking the painkiller ibuprofen.

The group filed a petition with the US Food and Drug Administration (news - web sites) asking it to strengthen labels on Advil and other ibuprofen-based drugs to warn doctors and consumers that the widely sold products can increase the risk of skin reactions, including serious conditions like Steven Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN).

SJS occurs in approximately four in every one million ibuprofen users. Those who continue taking the drug can develop TEN, which causes severe skin sloughing and is fatal in nearly one third of affected patients.

"All we're asking for is a few sentences on the box. We're not asking that the drug be withdrawn," said Dr. Michael Nicar, a toxicologist from Baylor University Medical Center in Dallas.

Nicar signed the petition along with three other physicians, all of whom have acted as expert witnesses in lawsuits against ibuprofen manufacturers. Three families that are suing drug companies, alleging that their children were injured or killed after using ibuprofen, also signed the document.

The petition also calls on the FDA (news - web sites) to launch an investigation into allegations that ibuprofen manufacturers withheld information on the risks of dangerous reactions to their products.

Drug reactions cause an estimated 5000 hospitalizations and tens of thousands of outpatient visits for SJS, TEN, and related disorders each year, according to a study published last month in the journal Pharmacoepidemiology and Drug Safety.

Approximately half of all SJS cases are caused by viruses, while the rest are caused by a variety of drugs, including anticonvulsants and antibiotics.

Ibuprofen does not generally cause the disorder in adults but can in children, said Dr. Roger E. Salisbury, a professor of surgery at Westchester Medical Center in Valhalla, New York, who also signed the petition.

"There are a lot of physicians who are not even familiar with this association," he said. Doctors and patients should know to stop the drugs immediately if a rash appears, he added.

Ibuprofen, found in popular non-prescription drugs such as Advil and Motrin, is widely used for lowering fevers in children. Some ibuprofen products marketed in Europe carry label warnings of rare severe skin reactions, though their American counterparts do not, the group said.

"We're merely asking the FDA to look at this and tighten up the warnings," Salisbury said.

Ibuprofen drug makers are facing several lawsuits over alleged injuries to children caused by ibuprofen products.

"If my doctor and my husband and I had known about these risks of SJS and TEN we would have never given her Children's Advil," said Darlene Kiss, who sued Advil maker Wyeth Consumer Healthcare last month alleging that the drug caused the death of her 3-year-old daughter Heather in March 2003.

Wyeth spokesman Doug Petkus declined to comment on any litigation facing the company, but said that Advil and Children's Advil already refer to the potential for severe allergic reactions and that the current labeling is "sufficient."

"They're safe when taken as directed," he said.

McNeil Consumer & Specialty Products, a division of Johnson & Johnson that markets several child and adult forms of ibuprofen under the brand name Motrin, issued a statement stressing that SJS is rare and can have a variety causes.

"Children's Motrin, when used as directed, is safe and efficacious," said company spokesperson Kathy Fallon.

The petition was timed to coincide with the scheduled Wednesday start of FDA hearings into the safety and effectiveness of nonsteroidal anti-inflammatory drugs, including ibuprofen and COX-2 inhibitors, such as Celebrex and Bextra.

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Health Tip: Preventing Cataracts in Children

HealthDayNews

Wednesday, February 16, 2005

(HealthDay News) -- Most parents realize that excessive sun exposure can damage the skin and increase the risk of future skin cancer.

But many parents are unaware that excessive sun exposure can also damage the eyes, leading to immediate and future problems. Your child's vision is too precious not to protect it.

Children's Memorial Hospital in Chicago recommends that parents encourage their children to wear sunglasses. Buy sunglasses that block 99-100 percent of ultraviolet (UV) light, and realize that the darkness of the lens has nothing to do with its ability to block UV rays. Sunglasses with good UV protection don't have to be expensive.

Encourage your child to wear sunglasses whenever she will be outdoors for more than 20 minutes. The worst times are between 10:00 a.m. and 3:00 p.m. The worst environments are snow, water, and high altitudes.

Above all, set a good example by wearing your own pair on a regular basis.

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Carbohydrate Type, Not Amount, Linked to Obesity

By Alison McCook

HealthDayNews

Wednesday, February 16, 2005

NEW YORK (Reuters Health) - When it comes to carbohydrates, it's not how much you eat, but which kind, that makes a difference to your bathroom scale, new research shows.

People who are overweight do not appear to eat more carbohydrates overall than people who weigh less, the researchers report in the American Journal of Epidemiology. However, they found that overweight people tend to eat more refined carbohydrates, such as white bread and pasta, which cause a rapid spike in blood sugar.

"Total amount of carbohydrate is not related to body weight," Dr. Yunsheng Ma of the University of Massachusetts Medical School in Worcester told Reuters Health. "It's the type of carbohydrate that's important."

These findings suggest that low-carbohydrate diets, which recommend people cut back on all carbohydrates, are missing the mark, Ma added.

"Carbohydrates are not the enemy," he said in an interview. "But you have to watch the kind of enemy."

Ma explained that refined carbohydrates are often found in processed foods that contain a lot of sugar. This type of carbohydrate has what's called a high glycemic index, meaning it causes a rapid increase in blood sugar. The body stores that sugar in muscle, but if it is not used, it becomes fat, he noted.

In contrast, whole grains, fruits and vegetables have carbohydrates that don't have such high glycemic index, Ma said.

In the report, Ma and his colleagues note that in the last 20 years, the rate of obesity has increased, despite the fact that people are eating less fat. To help investigate the role carbohydrates play in obesity, the researchers measured the height and weight of 572 healthy people, and asked them to regularly report what carbohydrates they ate. Ma's team followed study participants for one year.

They found that people with a higher body mass index -- a measure of weight that factors in height -- tended to eat carbohydrates with a higher glycemic index. The amount of carbohydrates people ate had no influence on body mass index.

"Refined carbohydrates are no good, but the total amount of carbohydrates is okay," Ma noted.

He added that some countries now include a food's glycemic index on the labeling, which can be helpful for people trying to lose weight or deal with diabetes.

Source: American Journal of Epidemiology, February 15; 2005

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Health Tip: Stop Urinary Tract Infections

HealthDayNews

Wednesday, February 16, 2005

(HealthDay News) -- One in five women will have at least one urinary tract infection (UTI) in her lifetime, and many have them repeatedly. A UTI can be a sign of a more serious problem, and can bring days of discomfort.

According to the National Kidney Foundation (NKF), UTIs are responsible for nearly 10 million doctor visits each year, most caused by one type of bacteria. Women are more susceptible than men, but anyone who has diabetes, a kidney stone, or for men, an enlarged prostate gland, can be more susceptible.

The NKF offers these precautions to reduce your risk:

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Low Thyroid Activity May Lower Breast Cancer Risk

By David Douglas

Reuters Health

Wednesday, February 16, 2005

NEW YORK (Reuters Health) - A new study indicates that women with abnormally low thyroid function -- a condition known as hypothyroidism -- seem to be protected to some degree against breast cancer.

"The results of this retrospective study indicated that women with hypothyroidism have a reduced risk of developing breast cancer," Dr. Massimo Cristofanilli of the M. D. Anderson Cancer Center, Houston, told Reuters Health.

And if these women are diagnosed with breast cancer, the tumor seems to be of a less aggressive type.

Cristofanilli and his colleagues note in the medical journal Cancer that the possible link between thyroid disease and breast cancer "has been debated for decades and remains controversial."

To shed more light on the matter, the team studied 1136 women with primary breast carcinoma who were matched to 1088 healthy women who had attended a breast screening clinic.

In total, 242 (about 11%) of the women in the study had hypothyroidism. However, the rate of hypothyroidism was 15% among the comparison group without breast cancer, significantly higher than the 7% rate among women with breast cancer.

Also, among the breast cancer patients, those who did have hypothyroidism were older at the time of cancer diagnosis and the disease was less advanced than in women with normal thyroid function, the team found

"These data strongly suggest a role of thyroid hormone in breast carcinogenesis, possibly in close relationship with estrogen," Cristofanilli said.

Source: Cancer, March 15, 2005.

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Sunlight Lowers Need for Painkillers After Surgery

Reuters Health

Wednesday, February 16, 2005

NEW YORK (Reuters Health) - Increasing the amount of sunlight in a patient's hospital room reduces their "perception of pain and their need for analgesic medication," according to a new report.

Dr. James D. Kang, of the University of Pittsburgh, and colleagues, enrolled 89 patients who had undergone spinal surgery into their study. Patients were randomly assigned to hospital rooms that were sunny or dim upon their return from surgery.

Measurements with a light meter showed that patients in the bright rooms received an average of 46 percent more natural sunlight per day than those in the dim rooms, the researchers explain in the medical journal Psychosomatic Medicine.

Those in the dim rooms required more opioid-type drugs on each day of their stay, averaging 28 percent more per hour. This translated to an average 21 percent reduction in the cost of painkiller medication for patients in the bright rooms.

The team also found that patients in the bright rooms had significantly lower stress scores and marginally lower pain scores when they left the hospital than did the patients in the dimmer rooms.

"These results may encourage hospital administrators to relocate patient populations with high analgesic requirements to units with higher intensity sunlight," Kang and his associates suggest.

Source: Psychosomatic Medicine, January/February 2005.

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Colon Cancer Survival Better in U.S. Than Europe

By Will Boggs, MD

Reuters Health

Wednesday, February 16, 2005

NEW YORK (Reuters Health) - Overall, patients with colorectal cancer live longer in the United States than in Europe, according to a report from Italy.

The findings suggest that the "differences in survival observed between the USA and Europe are real, and reflect earlier diagnosis in the USA," Dr. Laura Ciccolallo told Reuters Health.

"This is important, because it suggests in turn that the lower survival in Europe is a problem that is potentially remediable if adequate attention can be given to earlier diagnosis and more rapid investigation and treatment," she added.

Based on data from 10 population-based cancer registries, Ciccolallo -- from the Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan -- and her colleagues found that the greater likelihood of a colon cancer patient dying compared to someone without cancer was 1-1/2 to 2 higher in Europe than in the US.

This so-called 'excess mortality' was even higher after accounting for age and sex, the team reports in the medical journal Gut. Excess mortality in Europe was highest during the first year after diagnosis, the investigators note, and was higher for women and for patients of advanced age.

More cancers in the US than in Europe (54 percent vs. 48 percent) were diagnosed at an early stage, the report indicates, and more could be removed surgically.

"The differences in survival between the USA and Europe are likely to reflect differences in the speed of diagnosis and the stage of disease at least as much as any differences in the efficacy of treatment," Ciccolallo added.

Source: Gut, February 2005.

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Tuesday, February 15, 2005

 

Air Pollution Damages Babies in Womb –Study

 

Reuters

Tuesday, February 15, 2005

WASHINGTON (Reuters) - Babies' DNA can be damaged even before they are born if their mothers breathe polluted air, according to a study published on Tuesday.

"This is the first study to show that environmental exposures to specific combustion pollutants during pregnancy can result in chromosomal abnormalities in fetal tissues," said Kenneth Olden, director of the National Institute of Environmental Health Sciences, which funded the study.

"These findings may lead to new approaches for the prevention of certain cancers."

The team at the Columbia University Center for Children's Environmental Health in New York studied 60 newborns for the report, published in the February issue of the journal Cancer Epidemiology Biomarkers and Prevention.

As part of a larger study, they monitored the babies' exposure to polycyclicaromatic hydrocarbons, which are compounds produced by burning.

"Although the study was conducted in Manhattan neighborhoods, exhaust pollutants are prevalent in all urban areas, and therefore the study results are relevant to populations in other urban areas," said Dr. Frederica Perera, who led the study.

To determine exposure to pollution, the mothers filled out questionnaires and wore portable air monitors during the last three months of their pregnancies.

Women were rated as having high, moderate or low exposure based on average pollution levels for the group.

Then they tested the umbilical cord blood of the newborns, looking specifically at the chromosomes, which carry the DNA. Damage to chromosomes can cause cancer.

"We observed 4.7 chromosome abnormalities per thousand white blood cells in newborns from mothers in the low exposure group, and 7.2 abnormalities per thousand white blood cells in newborns from the high exposure mothers," Perera said in a statement.

The kind of damage to the chromosomes that they say was the type that tends to linger, making people more susceptible to cancer.

Other studies have linked exposure to pollution with leukemia and other cancers.

"While we can't estimate the precise increase in cancer risk, these findings underscore the need for policymakers at the federal, state, and local levels to take appropriate steps to protect children from these avoidable exposures," Perera said.

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Health Tip: Coping With Memory Loss

 

HealthDayNews

Tuesday, February 15, 2005

(HealthDay News) -- Baby Boomers with elderly parents often live with the fear that their elders will start a fire while cooking, forget to take their medications, or fail to remember an important phone number -- all signs of the memory loss that comes with aging.

The Wisconsin Department of Health and Social Services suggests these solutions:

In the kitchen, adaptive stove controls can be installed to automatically turn off an electric stove after a certain period of time or when there is an excessive amount of heat (unfortunately, they are not available for gas stoves).

A simple solution for remembering to taking medications is to set up a weekly supply of the pills or capsules in a labeled, clear plastic case. A more sophisticated solution is to use an automatic pill dispenser that dispenses medications at specific times. Pill dispensers can come with an alarm, a visual alert system, and battery backup in case of power outage.

When it comes to remembering phone numbers, attach pictures of familiar people next to their phone numbers on a sheet of paper. Or use a phone that is pre-programmed with frequently dialed numbers.

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Coffee May Help Prevent Liver Cancer

 

By Randolph E. Schmid

Associated Press Writer

The Associated Press

Tuesday, February 15, 2005

WASHINGTON - That hot cup of coffee may do more than just provide a tasty energy boost. It also may help prevent the most common type of liver cancer. A study of more than 90,000 Japanese found that people who drank coffee daily or nearly every day had half the liver cancer risk of those who never drank coffee.

The American Cancer Society (news - web sites) estimates that 18,920 new cases of liver cancer were diagnosed in the United States last year and some 14,270 people died of the illness. Causes include hepatitis, cirrhosis, excess alcohol consumption and diseases causing chronic inflammation of the liver.

Animal studies have suggested a protective association of coffee with liver cancer, so the research team led by Monami Inoue of the National Cancer Center in Tokyo analyzed a 10-year public health study to determine coffee use by people diagnosed with liver cancer and people who did not have cancer.

They found the likely occurrence of liver cancer in people who never or almost never drank coffee was 547.2 cases per 100,000 people over 10 years.

But for people who drank coffee daily the risk was 214.6 cases per 100,000, the researchers report in this week's issue of the Journal of the National Cancer Institute (news - web sites).

They found that the protective effect occurred in people who drank one to two cups of coffee a day and increased at three to four cups. They were unable to compare the effect of regular and decaffeinated coffee, however, because decaf is rarely consumed in Japan.

It's the caffeine in coffee that makes some people nervous and it has been shown in other studies to prompt mental alertness in many people. Some studies have suggested caffeine aggravates symptoms of menopause or intensifies the side effects of some antibiotics. Heavy caffeine use has been linked to miscarriage. But studies have also shown that a skin cream spiked with caffeine lowers the risk of skin cancer in mice.

"It's an excellent, interesting and provocative study and their conclusions seem justified," commented Dr. R. Palmer Beasley of the University of Texas M.D. Anderson Cancer Center in Houston.

"It will provoke a lot of new work here," said Beasley, who was not part of the research group.

While the study found a statistically significant relationship between drinking coffee and having less liver cancer, the authors note that it needs to be repeated in other groups.

And the reason for the reduction remains unclear.

However, Inoue's team noted that coffee contains large amounts of antioxidants and several animal studies have indicated those compounds have the potential to inhibit cancer in the liver.

In their study, the team also looked at green tea, which contains different antioxidants, and they found no association between drinking the tea and liver cancer rates.

"Other unidentified substances may also be responsible" for the reduction in cancers, they said.

A separate study reported in the same issue of the journal reported no relationship between drinking caffeinated coffee or tea and the rates of colon or rectal cancer.

However, that analysis did find a 52 percent decline in rectal cancer among people who regularly drank two or more cups of decaffeinated coffee.

In that study a team led by Karin B. Michels of Brigham and Women's Hospital in Boston analyzed data from two large studies — the Nurses' Health Study of women and the Health Professionals' Follow-up Study involving men. The analysis of nearly 2 million person years found 1,438 cases of colorectal cancer.

While they did not find any association between cancer rates and consumption of caffeinated coffee or tea, people who regularly drank two or more cups per day of decaffeinated coffee had about half the incidence of rectal cancer as those who never drank decaf.

The rate of rectal cancer was 12 cases per 100,000 person-years among those who consumed two or more cups of decaffeinated coffee per day. For those who never drank decaffeinated coffee, the rate was 19 cases per 100,000 person-years.

That difference may, however, be due to differences in lifestyle, the researchers commented, suggesting that drinkers of decaffeinated coffee might be more health conscious overall.

The Japanese study was funded by the Ministry of Health, Labor and Welfare of Japan. The U.S. study was funded by the National Institutes of Health (news - web sites).

On the Net:

Journal of the National Cancer Institute: http://jncicancerspectrum.oupjournals.org/

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Heredity Plays a Role in Heart Artery Blockages

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Tuesday, February 15, 2005

TUESDAY, Feb. 15 (HealthDay News) -- Some people inherit a tendency for fatty deposits to form in dangerous regions of their heart arteries, a new study shows.

Looking at angiograms -- images of heart arteries -- in 882 members of 401 families in whom heart disease was common, researchers found those deposits, called plaques, were most common at the points where a blockage shuts off blood flow to large regions of heart muscle.

Those points are the places where smaller blood vessels branch off from the main coronary artery, and the upper parts of the left and right coronary arteries, the researchers found.

"This is the first time anyone has looked at a larger number of angiograms in families with a history of heart disease," said study leader Dr. Ulrich Broeckel, an assistant professor of medicine at the Medical College of Wisconsin. "As far as we can determine, we are the first to do a large study of the genetic contribution to the location and pattern of coronary lesions."

The new findings, if confirmed, could affect heart disease screening strategies for close relatives of coronary heart patients, the researchers said.

By studying the angiograms, "we get a very powerful picture of coronary disease," said Broeckel.

The study results appear in the Feb. 15 issue of Circulation.

Cardiologists always include family history when they assess a person's risk of heart disease, Broeckel said. The new study adds significantly to the knowledge of the role played by genetics in heart disease and, thus, to steps that can be taken to prevent it, he said.

"It can be family-based prevention, showing what families require more aggressive treatment," he said. "There is a still a way to go, but that is the direction in which you want to go."

People were chosen for the study if at least one close relative had a heart attack before age 60, and if a brother or sister had a heart attack at any age or had required a procedure to reopen a blocked artery. The researchers took into account well-known factors that affect the risk of coronary disease, such as age, high blood pressure and diabetes.

Besides the tendency for plaque to form at dangerous sites, the study also found an inherited tendency for ectasia, abnormal widening of arteries associated with heart disease, and a tendency for plaque to become calcified, which increases the risk of artery blockage.

No genetic influence was found in a number of other coronary disease factors, such as whether a person had disease in one, two or three arteries.

The study was not designed to identify the genes that influence the development of coronary artery disease. "That will be our next step," Broeckel said. "It will keep us busy for the next few years."

More information

The American Heart Association has more on angiography.

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New Test Can Detect Bladder Cancer Faster –Study

 

Reuters

Tuesday, February 15, 2005

CHICAGO (Reuters) - A urine test that detects proteins given off by malignant growths can identify bladder cancer faster and perhaps reduce the use of more invasive procedures, researchers said on Tuesday.

The $30 test that can be completed in an office setting in less than an hour "advances our ability to diagnose bladder cancers more easily and less expensively," said Edward Messing, a physician at the University of Rochester Medical Center, who was involved in the research.

The test, called the NMP22 BladderChek, was developed by Matritech Inc. ., which funded the study published in this week's Journal of the American Medical Association (news - web sites). The test has been approved by the U.S. Food and Drug Administration (news - web sites).

The study, issued by the M.D. Anderson Cancer Center in Houston, covered tests on 1,331 patients in 10 states who were believed to be at higher risk for bladder cancer because of a history of smoking or other factors. It was done during 2001 and 2002.

It found the test to be about three times as effective as a visual bladder inspection, which is done by passing a thin, lighted scope through the urethra under local anesthesia. It usually takes a week for lab results from such a procedure to come back.

The urine test could reduce the need to do the invasive urethral procedure twice, once for detection and a second time in the operating room to remove tumors, the study said.

With the urine test, "we would know the cancer cells exist. Then we could schedule the (scope) procedure under anesthesia to remove the tumors in the operating room," Messing said.

Bladder cancer is the fifth most common cancer in the United States, but the five-year survival rate is 95 percent if the malignancy is detected early.

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Problem Drinkers Turning to the Web For Help

 

HealthDayNews

Tuesday, February 15, 2005

TUESDAY, Feb. 15 (HealthDay News) -- The Internet is becoming an increasingly rich source of effective help for problem drinkers trying to stay sober, according to experts.

More and more alcoholics, and people concerned about their level of drinking, are turning to online tools modeled on what counselors call "in-person brief motivational interventions" (BMIs), according to reports gathered at a recent symposium of the Research Society on Alcoholism.

Examples of these online interventions include the "Drinker's Check-Up." In a prepared statement, Reid Hester, director of the Research Division at Behavior Therapy Associates in Albuquerque, N.M., described the Drinker's Check-Up program as "the Internet equivalent of two to three face-to-face sessions with a counselor."

Other Web-based interventions focus on college-age drinkers concerned about their level of consumption. They include e-CHUG, which helps students gauge whether or not their drinking falls within healthy norms, and MyStudentBody.com, which provides college kids with information and help on a number of health concerns, including problem drinking.

"A number of studies show that people tend to respond best to certain kinds of interventions, those that provide feedback, are empathetic and nonjudgmental, emphasize personal responsibility, and give people several options for how they would like to go about changing their drinking," symposium organizer Scott Walters, an assistant professor of behavioral sciences at the University of Texas School of Public Health, said in a prepared statement.

"Interventions that have these elements are more likely to reduce drinking," he added. "In fact, many drinkers seem to prefer this format. It's a way to save face, and drinkers can begin to look at their drinking in a private and nonjudgmental way."

Web-based aids also have the advantage of being cheaper and more convenient than most 'bricks and mortar' interventions, Hester said. "[They] provide anonymity, convenience -- they can be done anytime, day or night -- and getting feedback that is objective and not influenced by counselor bias."

The symposium proceedings were published in the February issue of Alcoholism: Clinical & Experimental Research.

More information

The American Psychological Association has more about alcohol use disorders and treatment.

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Herbal Supplement Use Leveling Off

 

By Amy Norton

Reuters Health

Tuesday, February 15, 2005

NEW YORK (Reuters Health) - The surge in herbal supplement use in the U.S. may have reached a plateau, but the love affair is not over, according to a new study.

Indeed, researchers say, the trend toward adding herbs to standard multivitamins means that more Americans may be getting a regular dose of botanicals in the future.

Their survey of nearly 8,500 U.S. adults found that more people were taking herbs or other dietary supplements in 2002 versus three years earlier. However, the increase came from a spike in the use of lutein; in 2002, more than 8 percent of survey respondents took lutein in any given week, up from just 0.3 percent in 1998-1999.

Lutein, an antioxidant plant compound, has been added to many multivitamins in recent years because research suggests it can lower the risk of age-related eye diseases.

The study found that when lutein use was excluded, the number of supplement users in 2002 was virtually identical to that in 1998-1999. Roughly 14 percent of survey respondents in both periods reported taking supplements, according to findings published in the Archives of Internal Medicine (news - web sites).

The fact that lutein is cropping up in traditional multivitamins is neither a clearly positive nor negative thing, according to study co-author Dr. David W. Kaufman of Boston University.

"There's really no evidence that lutein is harmful, so I don't think that's an issue," he told Reuters Health.

The main thing, said Kaufman, is that people just be aware of what they're ingesting. Because lutein intake has jumped due to its addition to multivitamins, there are likely to be "unintentional users" out there, he noted.

According to Kaufman, the findings also underscore a new trend toward marketing standard multivitamins as a weapon against disease, rather than simply a safeguard against vitamin and mineral deficiencies.

Another antioxidant, lycopene, is also showing up in many multivitamins. Like lutein, lycopene is a pigment that colors certain fruits and vegetables. Tomatoes are the top source of lycopene, while lutein is found in foods such as leafy greens, broccoli, peas, oranges and eggs.

While lutein use may be surging, Kaufman and his colleagues found that some of the most popular supplements in 1998-1999 -- such as St. John's wort, ginseng and garlic -- had fallen out of favor by 2002, at least in certain age groups.

For example, ginseng was number one among 18- to 44-year-old men in 1998-1999, while St. John's wort was the top seller among women in that age bracket. By 2002, St. John's wort -- which is marketed as an antidepressant -- had fallen off the charts among women, and men's ginseng use was about half what it was three years earlier.

Such "waxing and waning" in individual supplements' popularity is not surprising, Kaufman said, given that people self-prescribe them-trying them for a time, then moving on to something else.

"Things are in fashion for a time, then fall out of favor," he said, noting that because many supplements have not been well researched, the effectiveness of some products in unclear.

"What is constant," Kaufman added, "is that lots of people are taking dietary supplements."

That appeared especially true of older adults in the survey, who were the biggest supplement consumers. While supplement use held steady among young and middle-aged men and women, it had doubled by 2002 among adults age 65 and up.

Again, Kaufman said, that jump is related to lutein use, though more older adults were also taking chondroitin and glucosamine, which are marketed for arthritis.

Source: Archives of Internal Medicine, February 14, 2005.

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Compound in Urine May Fight Spinal Cord Injury

HealthDayNews

Tuesday, February 15, 2005

TUESDAY, Feb. 15 (HealthDay News) -- Uric acid, a metabolic breakdown product found in urine and blood, may help reduce damage from spinal cord injury, researchers say.

In research with mice, scientists at Thomas Jefferson University, Philadelphia, found that uric acid helped lessen some of the secondary cellular damage that occurs following spinal cord injury. This secondary damage is caused when the body's inflammatory response releases potentially harmful chemicals that exacerbate the injury.

Mice given uric acid just before and after they suffered a spinal cord injury recovered motor function quicker, and to a greater degree, than mice receiving a simple saline solution. In cell culture tests, the researchers discovered that uric acid protected spinal cord neurons from damage caused by a compound called peroxynitrite, which is linked to cell damage caused by inflammation.

The findings, reported in this week's issue of Proceedings of the National Academy of Sciences (news - web sites), might someday help in the development of new treatments for spinal cord injuries, the researchers say.

More information

The American Association of Neurological Surgeons has more about spinal cord injury.

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Monday, February 14, 2005

 

Older Doctors Not Always the Best

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, February 14, 2005

MONDAY, Feb. 14 (HealthDay News) -- The older, more experienced physician may not necessarily be the better one, a new study suggests.

In fact, just the opposite may be true. According to new research appearing in the Feb. 15 issue of the Annals of Internal Medicine, older physicians appear less likely to be delivering accepted standards of care.

"I think this is a paradox. We revere our older colleagues. We have a lot to learn from them," said Dr. Niteesh Choudhry, lead author of the paper and a researcher at Harvard Medical School (news - web sites). "I anticipated that there might be declining performance for some things as time from graduation increased. I didn't expect these results would be quite so consistent as they seem to be."

As the article pointed out, these findings turn conventional wisdom on its head. Physicians with more experience, like people in many walks of life, are believed to have built up a reservoir of knowledge and skills that puts them at an advantage when delivering quality care.

There has also been some evidence, however, that the number of years in practice is inversely proportional to quality of care provided.

To investigate this relationship, Choudhry and his colleagues reviewed 59 previously published papers comprising 62 studies that had considered the issue of medical knowledge and health-care quality in relation to time in practice and physician age.

Almost three-quarters (73 percent) of the studies showed the average physician's performance declining over time. More than half (52 percent) showed performance declining for all outcomes measured, while 21 percent showed some aspects of performance deteriorating.

The current paper also looked at different categories of care. Of 24 studies that looked at a doctor's use of screening and diagnostic tests as well as preventive care, 63 percent found that older physicians were less likely than younger doctors to conform to current standards. The largest of these studies found that doctors who graduated from medical school more than 20 years ago had 38 percent to 48 percent lower odds of adhering to recommended practices than younger doctors.

All 12 studies looking at physicians' knowledge found an inverse relationship between knowledge and experience. And 14 of 19 studies (74 percent) looking at performance found that older physicians were less likely to adhere to therapeutic standards compared with younger doctors. For instance, older physicians were less likely to prescribe aspirin for stable angina, which is a widely accepted standard.

Seven of the studies looked at the effect of this performance on patients' well-being. Of those, three showed no association between length of time in practice and patient outcomes, while four showed some degree of decreasing outcome with increasing time in practice. One study found that patients were more likely to die of a heart attack if their physician had been in practice for more years.

Today's constantly changing medical business environment may have a lot to do with this.

"The pressure for productivity for physicians in practice as well as the increasing amount of paperwork that people have to do unfortunately has taken time away from both patient care as well as physician's ability to keep up with things," said Dr. Steven Weinberger, senior vice president for medical knowledge and education at the American College of Physicians, and co-author of an accompanying editorial in the journal. "It's very common for physicians, at the end of a very long day, to have several hours of work dictating charts and filling out paperwork."

"It's a struggle," confirmed Choudhry. "Being five years out of training, I attempt to read multiple journals every week. I see patients and I have lots of other responsibilities. There aren't enough hours in the day."

Science and medicine are constantly changing, Choudry added, but it's not always clear what these changes mean for day-to-day practice. "In any given disease, multiple organizations are putting out guidelines," Choudhry said. "Usually they match up pretty well but they don't always."

The solution to this issue lies in the ways physicians receive their continuing medical education, which remains a key part of every doctor's job.

"Assuming these results are right, we do know that some of the fundamental parts of passive knowledge translation -- I sit in a room and listen to a lecture -- don't work to change physician behavior," Choudhry said.

Choudhry and colleagues are presenting ideas that most schools would be wise to consider, including "active knowledge translation," involving interaction between the physician and another health-care professional.

Weinberger thinks smaller groups would work better. "There has to be a way that physicians can learn based on their own particular questions," he said. "We have to figure out ways of delivering [new knowledge] that are more relevant."

To that end, the next American College of Physicians session will include "practitioner reports," based on the "residents reports," one of the most popular educational experiences in medical school. Instead of having residents report on patients, the practitioner will come with his or her own problem cases to present and discuss in a group.

More information

The Accreditation Council for Continuing Medical Education has more information on continuing education for doctors.

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New Pain Relievers Boost Blood Pressure More – Study

 

By Lisa Richwine

Reuters

Monday, February 14, 2005

WASHINGTON (Reuters) - Arthritis drugs known as COX-2 inhibitors raise blood pressure more than older pain relievers, which may explain why the newer medicines have been linked to heart attacks, Australian researchers reported on Monday.

The increases were small and varied among the different COX-2 drugs. The risk seemed highest with Merck & Co. Inc.'s Vioxx, the researchers said after reviewing data from more than 45,000 people in 19 studies. Merck pulled Vioxx from the market last September.

The study was published online on Monday by the Archives of Internal Medicine (news - web sites).

The safety of pain relievers is under scrutiny from regulators. A U.S. advisory committee will review the medicines at a three-day meeting starting on Wednesday.

The Archives of Internal Medicine said it released the findings early because they were relevant to the meeting.

One of the authors of the new study, Henry Krum, said the blood pressure increases seen with the COX-2 drugs were small, but they may be enough to help spur heart attacks.

"One could draw the conclusion the elevations in blood pressure are contributing to the increase in cardiovascular risk," said Krum, director of the National Health and Medical Research Council of Australia's Center of Clinical Research Excellence in Therapeutics.

Some COX-2 inhibitors, as well as older pain relievers called nonsteroidal anti-inflammatory drugs or NSAIDs, had already been linked to higher blood pressure.

The new study was designed to determine if the widely used COX-2 drugs raised blood pressure more than NSAIDs such as ibuprofen and naproxen. The COX-2 drugs studied were Merck's Vioxx and Arcoxia and Pfizer Inc.'s Celebrex.

On average, systolic blood pressure -- the upper number of a blood pressure measurement -- was 2.83 millimeters of mercury higher with COX-2 inhibitors than with NSAIDs. Diastolic pressure -- the lower number -- was 1.34 millimeters of mercury higher with the COX-2 drugs.

Vioxx "clearly is the most dramatic in elevating blood pressure," while Celebrex "looks pretty clean," Krum said.

The data on Arcoxia, which is approved in some countries but not the United States, were too limited to draw conclusions, Krum said.

Merck spokeswoman Casey Stavropoulos noted the study was an analysis of previously published research. "There will be a more complete review of selective COX-2 inhibitors and blood pressure at the (Food and Drug Administration (news - web sites)) committee meeting later this week," she said.

COX-2 inhibitors were developed with the hope they would reduce pain as much as NSAIDs while being gentler on the stomach. NSAIDs can cause potentially fatal stomach and intestinal bleeding.

Only Vioxx has been shown to produce fewer serious gastric problems than NSAIDs. Vioxx was pulled after a study showed the drug doubled heart attack and stroke risk in patients who took it for at least 18 months.

"Clinicians need to weigh the risks of improved gastrointestinal safety versus potential hazards of developing elevated blood pressure when considering the use of these agents, especially in the elderly population," Krum and his colleagues wrote.

The research was funded by grants from Australia's National Health and Medical Research Council and the Royal Australasian College of Physicians.

Krum has received consulting fees from Pfizer, Merck and Novartis -- all makers of COX-2 inhibitors. Another of the study's authors was a consultant to Pfizer.

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Health Tip: Avoid Varicose Veins

 

HealthDayNews

Monday, February 14, 2005

(HealthDay News) -- For many people, varicose veins are simply a cosmetic concern. For others, varicose veins can cause aching pain and discomfort. And the condition could signal a higher risk of circulatory problems.

Varicose veins affect up to 60 percent of all Americans, women more than men; older women more than younger. Treatment may involve self-help measures, or procedures by your doctor to close or remove these veins.

The American Institute of Preventive Medicine offers these suggestions to help prevent them from forming:

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Flu Shots for Elderly May Not Save Lives

 

By Carla K. Johnson

Associated Press Writer

The Associated Press

Monday, February 14, 2005

CHICAGO - A new study based on more than three decades of U.S. data suggests that giving flu shots to the elderly has not saved any lives.

Led by National Institutes of Health (news - web sites) researchers, the study challenges standard government dogma and is bound to confuse senior citizens. During last fall's flu vaccine shortage, thousands of older Americans, heeding the government's public health message, stood in long lines to get their shots.

"There is a sense that we're all going to die if we don't get the flu shot," said the study's lead author, Lone Simonsen, a senior epidemiologist at the National Institute of Allergy and Infectious Diseases (news - web sites) in Bethesda, Md. "Maybe that's a little much."

The study should influence the nation's flu prevention strategy, Simonsen said, perhaps by expanding vaccination to schoolchildren, the biggest spreaders of the virus.

However, the U.S. Centers for Disease Control and Prevention (news - web sites) in Atlanta plans no change in its advice on who should get flu shots, saying the NIH research isn't enough to shift gears.

"We think the best way to help the elderly is to vaccinate them," said CDC epidemiologist William Thompson. "These results don't contribute to changing vaccine policy."

The CDC currently recommends flu shots for people age 50 and over, nursing home residents, children 6-23 months, pregnant women, people with chronic health problems and certain health care and day care workers. When vaccine was scarce a few months ago, healthy adults under 65 were urged to forgo the shot.

Although the study, published Monday in the Archives of Internal Medicine (news - web sites), looks at data from the whole U.S. elderly population over time, it doesn't directly compare vaccinated vs. unvaccinated elderly, Thompson said. Previous studies that made that comparison found the vaccine decreased the rate of all winter deaths.

It's also unlikely that a single study would trigger a change in policy, said CDC spokesman Glen Nowak.

But the former head of the nation's vaccine strategy, Dr. Walter Orenstein, said Simonsen's work "should make us think twice about our current strategy and (about) potentially enhancing it." Orenstein is former director of the CDC's National Immunization Program and now leads a program for vaccine policy development at Emory University.

A shift to vaccinating schoolchildren, the age group most likely to spread the flu virus, is advocated by colleagues of Orenstein's at Emory in a separate report to be published Tuesday in the American Journal of Epidemiology.

The NIH and Emory papers, one a highly technical statistical analysis of death data and the other a commentary based on field studies and mathematical modeling, come during a season that focused the nation's attention on vaccine supplies.

As a vaccine shortage loomed last fall, the CDC urged shots only for the highest-risk groups. Most of the 36,000 people who die each year of flu-related causes are elderly and the nation's strategy has focused on getting shots to them, as well as other high-risk groups.

Last week the CDC reported that about 59 percent of older Americans got shots in 2004, down from 65 percent in 2003. Based on her research, Simonsen doesn't expect to see a corresponding increase in flu-related deaths this year, something that "can be seen as good news."

The flu vaccine is less effective in the elderly than in younger people. It works, but not very well, said Ira Longini, a biostatistics professor at Emory University's Rollins School of Public Health and a proponent of vaccinating schoolchildren.

While it's smart for senior citizens to get their yearly flu shots because it can decrease their risk of getting sick, he said, a smarter government strategy would emphasize shots for children, ages 5 to 18. His statistical models show that strategy could save more elderly Americans from hospital visits and death.

"If we really want to make a difference and control influenza, we simply have to change the policy. We have to vaccinate large numbers of children," Longini said.

He and his colleague Dr. Elizabeth Halloran write that if 70 percent of schoolchildren were vaccinated, the elderly would be protected without flu shots. The strategy would require 42 million doses of flu vaccine. Even during this season's shortage, there were 57 million doses available, their report says.

Yearly flu shots have been recommended for people 65 and older since the 1960s and for those 50 and older since 2000. Vaccination rates have risen among seniors from 20 percent before 1980 to 65 percent in 2001, according to the NIH study.

Simonsen and her team of researchers could find no corresponding decrease in death rates. Their analysis took into account the fact that people are living longer and that more virulent strains of flu dominated the 1990s.

The CDC's Thompson said Simonsen didn't take into account the effect of a gradual lengthening of the average flu season over the decades. But Simonsen said that no matter what model she used to define a flu season, she came to the same result.

Older Americans should keep their risk in perspective, said Dr. Lisa Schwartz and Dr. Steven Woloshin, senior researchers at the VA Outcomes Group, a small group of researchers trying to promote the straightforward presentation of medical information.

For the average senior citizen, the annual risk of dying from the flu is low: about 1 in 1,000. They said senior citizens still should try to get flu shots, but shouldn't panic if vaccine isn't available.

On the Web:

Archives of Internal Medicine: http://archinte.ama-assn.org/

Centers for Disease Control and Prevention: http://www.cdc.gov/

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Compound Fights Gleevec-Resistant Leukemia

 

HealthDayNews

Monday, February 14, 2005

MONDAY, Feb. 14 (HealthDay News) -- The drug Gleevec has proven a lifesaver for people with a blood cancer called chronic myeloid leukemia (CML). However, a growing number of CML patients have cancers resistant to the medication.

Now, an experimental drug may offer those patients fresh hope, say researchers at the Dana-Farber Cancer Institute in Boston.

Their study, published in the February issue of Cancer Cell, found that a compound called AMN107 effectively blocked proliferation of Bcr-Ab1-dependent cells taken from CML patients. Bcr-Ab1 is a protein that's abnormally active in many CML patients. AMN107 proved to be a more potent inhibitor of Bcr-Ab1 than Gleevec (imatinib), inhibiting the growth of cells expressing numerous Bcr-Ab1 mutations resistant to Gleevec.

In addition, AMN107 prolonged the survival of mice with Gleevec-resistant CML, the researchers said.

The researchers have just started Phase I clinical trials of the experimental compound.

"If human clinical trials validate the effectiveness of AMN107 demonstrated in the preclinical studies reported here, it may be possible to either use AMN107 in selected patients with imatinib resistance, or to use both agents together, simultaneously or sequentially," research leader Dr. James D. Griffin said in a prepared statement.

More information

The U.S. National Library of Medicine has more about CML.

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Low Cholesterol May Mean Poorer Mental Powers

 

By Will Boggs, MD

Reuters Health

Monday, February 14, 2005

NEW YORK (Reuters Health) - We hear plenty about the dangers of high cholesterol levels, but low levels apparently confer their own risks. Naturally low cholesterol levels are associated with poorer performance on a variety of cognitive measures, according to a new study.

"It is not entirely surprising that lower cholesterol levels were associated with moderately lower levels of cognitive function, given (that) cholesterol is important in brain function," Dr. Penelope K. Elias from Boston University told Reuters Health.

Previous reports have related both high and low total cholesterol levels to deficits in cognitive performance, Elias and her colleagues explain in the journal Psychosomatic Medicine.

The team used data from 789 men and 1105 women participating in the original cohort of the Framingham Heart Study to examine the relationship between total cholesterol and cognitive performance.

Individuals in the lowest total cholesterol group (less than 200 units) performed more poorly than patients with higher cholesterol levels on tests of similarities, word fluency, attention/concentration, and overall, the investigators report.

Participants in the lowest total cholesterol group were 49 percent more likely than were participants in the highest total cholesterol group (240-380) to perform poorly, and 80 percent more likely to perform very poorly, the results indicate.

Do the findings raise questions about treating high cholesterol? "It is important to note that we did not examine the association between cognition (and) cholesterol-lowering via medications," Elias explained.

"In fact, a unique aspect of the study was that few of our participants were being treated with anti-cholesterol drugs; in other words, we looked at 'naturally low and high levels of cholesterol'," she pointed out.

"Naturally low levels of cholesterol and lowered levels of cholesterol may have very different ramifications for cognitive function," Elias said. "Thus, our study does not have implications for the guidelines for treatment of high cholesterol."

Source: Psychosomatic Medicine, January/February 2005.

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Painkiller Use Falls After Vioxx Withdrawn

By Linda A. Johnson

AP Business Writer

The Associated Press

Monday, February 14, 2005

TRENTON, N.J. - For years, Americans have been popping painkillers like they were candy to treat everything from headaches to arthritis. But new data show America's love affair with the medications may have cooled off after the blockbuster drug Vioxx was pulled from the market over safety concerns.

The data say sales of prescription arthritis drugs plunged at the end of 2004, after Merck & Co. Inc. of Whitehouse Station, N.J., pulled Vioxx from the market Sept. 30 and a string of recent studies raised safety concerns about other widely used pain medicines.

Nonprescription pain reliever sales jumped by double digits in late 2004, but doctors and other pain experts believe many patients are simply suffering in silence, confused about what pain medication is best for them.

"I've been in practice for 30 years and I've never seen such a mess," said Dr. Michel Dubois, director of the New York University Pain Management Center.

He estimates about 20 percent of his patients have switched from Cox-2 inhibitors, the painkiller class including Vioxx and Pfizer Inc.'s Celebrex and Bextra, to narcotic painkillers or nonprescription ones. Another 20 percent have stopped taking painkillers altogether.

Advisers to the Food and Drug Administration (news - web sites) will meet for three days starting Wednesday to try to find a balance between the benefits and potential dangers of Cox-2 drugs. The FDA (news - web sites) eventually is likely to require strong warnings on the drugs' labels, further dampening Cox-2 sales, predicted independent pharmaceuticals analyst Hemant Shah of HKS & Co. in Warren, N.J.

Meanwhile, data released Monday by IMS Health of Plymouth Meeting, Pa., show prescriptions filled for Cox-2 inhibitors — preferred by many patients and doctors because they cause less stomach and intestinal problems than older anti-inflammatory drugs — dropped 43 percent in December 2004 from a year earlier.

IMS, a pharmaceutical information and consulting company, said the number of Cox-2 prescriptions filled at retail and mail-order pharmacies and nursing homes, about 70 percent of U.S. sales, fell from 4.5 million in September to 2.7 million in December.

Lisa Morris, global marketing director at IMS, said about two-thirds of Vioxx patients switched to other Cox-2 drugs and the other third switched to other nonsteroidal anti-inflammatory drugs, or NSAIDS, if they stayed on prescription medicines.

"Whenever there is press around drug safety, you will see that people will sit it out for a while trying to figure out what to do," Morris said.

Total patients taking Cox-2 drugs or any NSAID dropped 9 percent from September until December 2004, she noted.

"It is disconcerting because it could mean there are people, due to the confusion, who are doing nothing and experiencing pain," said William Rowe, executive director of the American Pain Foundation. The foundation recommends people consult with their doctor about other pain treatments.

"There are alternatives, complementary alternatives to pain relief, things like massage and baths and acupuncture and hot and cold (packs) which are documented to provide relief," Rowe said.

Carolyn Nuth, 62, of Baltimore, who has arthritis and fibromyalgia, went off Vioxx in October and has since found other prescription and over-the-counter pain relievers don't help her as much, so she uses hot and cold packs more.

"I'm a little depressed and I feel very limited physically," said Nuth, who works at the pain foundation answering consumers' questions. She said the public seems as confused as she is, and inquiries about treatment options jumped about 15 percent after the Vioxx withdrawal.

In the week after Merck pulled Vioxx from the market worldwide because its own study had showed Vioxx increased risk of heart attacks and strokes after long-term use, Celebrex and Bextra picked up most of its share of the prescription painkiller market, according to data from Impact Rx, a Mount Laurel, N.J., a company that tracks doctors' prescribing patterns. That week, there was about a 25 percent jump in the number of patients being switched to a different prescription painkiller or starting on one for the first time.

But by the beginning of February, amid reports questioning the safety of all Cox-2s, the share of pain patients starting on or switching to Celebrex and Bextra was down from a total of about 25 percent to a combined 8 percent, according to Impact Rx. The two drugs' share was taken over by other prescription NSAIDs, including Mobic and different brands of prescription strength ibuprofen.

Naproxen, sold in prescription strength as well as over the counter under brands including Aleve, had seen a one-third jump in new prescriptions following the Vioxx withdrawal. That reversed right after the federal government on Dec. 21 halted an ongoing Alzheimer's disease (news - web sites) prevention trial because researchers documented more heart attacks and strokes among patients taking naproxen.

"Recent events in this category have clearly affected physician prescribing behavior," said Nancy Lurker, chief executive of ImpactRx. "The dramatic shift back to the older, more established drugs and away from the Cox-2s is largely unprecedented in a market this size."

Part of that trend is for patients to revert to over-the-counter drugs. Sales of nonprescription pain pills jumped about 12 percent from the July-September quarter to the October-December quarter, according to marketing information company ACNielsen, which did not have a breakdown by brand.

Shah, the analyst, said it probably will take five to seven years before drug companies can restore sales of NSAIDs, given "gun shy" consumers and expectations that FDA will require significant long-term safety data before it approves any new painkillers.

For patients in pain, that could be a very long wait.

"I'm hoping maybe something else comes out" soon, Nuth said.

On the Net:

http://www.imshealth.com

http://www.painfoundation.org

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Arthritis Drug Seen to Cut Heart Risk

By David Douglas

Reuters Health

Monday, February 14, 2005

NEW YORK (Reuters Health) - Methotrexate, used for the treatment of rheumatoid arthritis and psoriasis, may also reduce the risk of atherosclerosis and circulatory diseases affecting the heart and brain, investigators have found.

As Dr. Robert S. Kirsner told Reuters Health, "the finding that treatment of psoriasis -- and rheumatoid arthritis -- reduced the risk of development of vascular disease...suggests that patients with these diseases may derive benefit from treatment beyond control of their skin and joint disease."

Kirsner, at the University of Miami, and colleagues note in the American Academy of Dermatology that methotrexate is an analog of folate and has anti-inflammatory effects that may help reduce vascular disease. However, it may also promote higher levels of a compound called homocysteine, which can increase the risk of vascular disease.

To see how these two factors balance out in reality, the researchers studied data on 7615 outpatients with psoriasis and 6707 with rheumatoid arthritis who were treated at Veterans Administration facilities in Florida or Puerto Rico.

Those with psoriasis who were prescribed methotrexate had a significantly reduced risk of vascular disease compared with those who were not. The risk was lowest -- at 50 percent -- in those given a low dose of methotrexate. Similar but less pronounced risk reductions were seen in arthritis patients.

Despite its tendency to adversely affect homocysteine levels, methotrexate therapy "may provide further vasculoprotective benefits." the researchers conclude.

Source: American Academy of Dermatology, February 2005.

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Nutritional Info May Find Place on Menus

By Angela Delli Santi

Associated Press Writer

The Associated Press

Monday, February 14, 2005

TRENTON, N.J. - Show a group of nutritionists a 10-ounce restaurant hamburger and a side order of onion rings and have them calculate the number of calories in the meal. Easy, right?

Well, not exactly. The food experts consistently underestimated the 1,550-calorie meal — by an average of 685 calories — in a study of 200 dietitians by the Center for Science in the Public Interest and New York University.

"If well-trained food professionals can't accurately estimate calorie content in a plate of food, you can be sure the average consumer is at a loss when looking at a menu," said Claudia Malloy of CSPI in Washington, D.C., which co-sponsored the study and is lobbying to force restaurants to provide nutrition information on the foods they serve.

New Jersey is among a half-dozen states considering food labeling laws for restaurants. Under a recent proposal in the New Jersey Assembly and pending in committee, chain and fast-food restaurants with 20 or more franchises would have to post calorie counts on menu boards — Big Mac, 590 calories; Starbucks' grande cafe mocha, 400 calories — and more extensive nutrition information, such as trans and saturated fats, salt and cholesterol, on menus.

Similar legislation is pending in Connecticut, Maine, Massachusetts, Illinois and Hawaii, and is expected to be reintroduced in the U.S. Senate and House of Representatives, though no state currently has such a law, Malloy said.

Many chain restaurants, from McDonald's to Subway, already make nutrition information available, although it's not always publicly posted.

Nutrition labeling bills may have gained momentum with the recent success of "Supersize Me," an Oscar-nominated documentary exposing the health risks of a fast-food diet, and publicity over a lawsuit blaming McDonald's for the obesity of teenage customers.

To the New Jersey Restaurant Association, such proposals amount to over-regulation for an industry already struggling to turn a profit.

"Our position is that the individual who is concerned about obesity should emphasize healthy lifestyle, personal responsibility, regular exercise and moderation," said Dale Florio, legislative counsel for the state restaurateurs. "Seventy-six percent of all meals are prepared at home. That's where nutrition has to start."

No one on either side of the issue believes posting calorie and fat content will produce drastic changes in what people eat. But proponents say such information could lead diners to make healthier selections and would provide sorely needed information to those with health problems who need special diets.

"When they purchase foods at restaurants, most people are using their instincts and their desire," said Daniel J. Hoffman, assistant professor of nutritional sciences at Cook College in New Brunswick. "This is a nice compromise between telling people what they should eat when they're out at a restaurant and giving them information so they have the power to choose.

"It's not going to drive them out of the ice cream store, but it may change what they buy," he said.

Hoffman said the added regulations are especially important because people eat out more often than ever, and people are getting fatter.

"This bill pushes informed choices," he said. "The misconception is that if you are overweight you are grossly over-consuming. One hundred calories extra each day over a decade will give you 50 pounds."

Assemblyman William D. Payne, an Essex Democrat who is co-sponsor of the New Jersey measure, said he is concerned about obesity and its related health consequences, especially among minorities. He partially blames convenience foods.

"Fast foods are available, they're cheaper than preparing meals at home," he said. "What's happened is the excessive calories have contributed to the problem of obesity. It's a crisis. Anything we can do to turn it around, we should do."

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Potato Vaccine Offers Hope Against Hepatitis

Reuters

Monday, February 14, 2005

WASHINGTON (Reuters) - A hepatitis vaccine grown in genetically engineered potatoes seemed to protect most people who ate them, researchers reported on Monday.

About 60 percent of the volunteers who ate the biggest dose of potatoes showed an immune response that should protect against infection with the hepatitis B virus, Charles Arntzen of Arizona State University and colleagues reported.

They hope to develop the vaccine into something that could be used in developing nations, where most cases of hepatitis B are reported.

"There is an urgent need to make oral vaccines available in poorer countries of the world where infectious diseases are still the primary cause of death," said Yasmin Thanavala, an immunologist at the Roswell Park Cancer Institute in New York, who helped to lead the study.

The researchers tested 42 volunteers, all of whom had been vaccinated against hepatitis B already using a commercially available shot.

They all ate pieces of raw potato, some of which contained a protein from the hepatitis B virus that is known to stimulate an immune system response.

Antibodies against hepatitis rose in more than 60 percent of the volunteers who ate three pieces of the gene-engineered potatoes and more than half those who ate two pieces, the researchers reported in the Proceedings of the National Academy of Sciences (news - web sites).

About 40 percent of the volunteers did not seem to have the hoped-for immune response to the vaccine, but the researchers noted that commercially available shots also do not always prompt an immune response, either.

The hepatitis B shot must be kept refrigerated and it is expensive, meaning it cannot be used in many poor areas. Growing the vaccine in plants such as potatoes might make it more available, the researchers said.

And people may be more likely to take an edible vaccine than to get a shot.

Members of the team are also working to grow vaccines in bananas, tomatoes and tobacco.

"In 1996 it was estimated that some 115 million people were infected with HBV even though a ... vaccine isolated from yeast became available a decade earlier," the researchers wrote.

"Global mortality due to this disease is estimated to be 1 million cases per year."

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Southern Diet Frustrates Health Officials

By Daniel Yee

Associated Press Writer

The Associated Press

Monday, February 14, 2005

DECATUR, Ga. - Amid a national obesity epidemic and the South's infamous distinction as the "Stroke Belt," health officials have been trying to get diners to flinch, at least a little, at the region's trademark fried and fatty foods.

But nutritionists have found it's hard to teach an old region new tricks. How can Southerners give up delicious staples fried chicken, fried seafood, fried green tomatoes and cornbread slathered in butter?

Even at the Atlanta headquarters of the federal Centers for Disease Control and Prevention, the leader of the nation's anti-obesity campaign, the cafeteria serves up such artery-clogging regional favorites as biscuits and gravy.

CDC nutritionist Annie Carr said the agency is working to get its house in order by pushing the cafeteria to serve popular foods in healthy ways. The broader goals of the anti-obesity campaign are to educate people to cook with less fat and sugar and to promote the idea of eating five servings of fruits and vegetables a day.

And for the South, that doesn't mean vegetables and greens flavored with bacon and meat drippings.

"I don't think anything is wrong with the kind of vegetables we eat in the South — it's the way they are prepared," said former Surgeon General Dr. David Satcher, the interim president of the Morehouse School of Medicine in Atlanta, who grew up eating traditional Southern staples on a farm in Alabama. "We need more fruits and vegetables in our diet."

When Becky Cleaveland is out with her girlfriends, they all pick at salads except for the petite Atlanta woman. She tackles "The Hamdog."

The dish, a specialty of Mulligan's, a suburban bar, is a hot dog wrapped by a beef patty that's deep fried, covered with chili, cheese and onions and served on a hoagie bun. Oh yeah, it's also topped with a fried egg and two fistfuls of fries.

"The owner says I'm the only girl who can eat a whole one without flinching," Cleaveland said proudly.

Health officials' concerns with healthy eating in the South date back to 1962, when the CDC noted a large concentration of counties with high stroke death rates in the coastal states of North and South Carolina and Georgia. More than three decades later, the high stroke rates in that region seem to have shifted west to counties along the Mississippi River Delta.

Health officials have spent thousands of dollars on grants to promote healthy eating, including sending nutritionists into community centers and churches. The food experts introduce healthier cooking practices, such as alternatives to frying and methods that reduce the fat in gravy and sauces. But those efforts have found resistance from some cooks who say the healthier recipes alter the taste of their dishes.

"Flavor is a big issue — when you modify Southern cooking, then you lose a lot of the flavor," said Laurita Burley, a clinical nutrition instructor at the Morehouse School of Medicine. "The reputation of the Southern cook is at risk when you begin to modify it."

Much of the South's traditional foods date back to the days of slavery. Frying was preferable in the region's hot climate, since it didn't take as long as baking and didn't heat up a house as much. Plus, Burley said, workers didn't have all day to prepare meals; they had to get back into the fields to work. Lard was also plentiful. Today, frying still is popular, especially in poor areas of the South, because it is also inexpensive.

While it's quick, easy and adds flavor, frying loads ordinarily healthy foods with calories and fat.

"One of the common things in the South is that you fry everything," said Dr. Nicholas Lang, chief of staff of the Central Arkansas Veterans Healthcare System in Little Rock. "It's a major grease-transport mechanism — there's no idea how much calories you get when you get that."

Other research has found that frying, grilling and smoking certain foods can cause chemical reactions within the food that can increase the risk of cancer.

"The best advice is to fry less and to eat their meat medium rather than well-done — and do like their momma said and add vegetables," said Lang, also a professor of surgery at the University of Arkansas for Medical Sciences.

Back at Mulligan's in Decatur, owner Chandler Goff is quick to point out that the bar also offers healthy alternatives, such as salads and sandwiches that aren't deep-fried.

But he acknowledged that the "Hamdog" and the "Luther Burger," a bacon-cheeseburger served on a Krispy Kreme doughnut bun, are what draw attention.

As for Cleaveland, she says she doesn't think about cholesterol. "I probably should, but I do not. I'm only 25, maybe later." For now, she's able to maintain her 5-foot-7, 115-pound physique without regular exercise.

Regardless of age, Lang doesn't recommend the Hamdog, even as a one-time snack.

"If you choke that down, you might as well find a heart surgeon because you are going to need one."

On the Net:

Morehouse School of Medicine: http://www.msm.edu

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Teen Binge Drinking Can Do Long-Term Brain Damage

By Amy Norton

Reuters Health

Monday, February 14, 2005

NEW YORK (Reuters Health) - Mounting evidence shows that the still-maturing teenage brain is particularly susceptible to damage from heavy drinking, according to a report published Monday.

A number of recent studies have shown that teenagers who abuse alcohol have problems with memory, learning and other brain functions compared with their peers, while animal research suggests such effects could last into adulthood.

Such research, coming from a number of scientific areas, is making it more and more clear that the teenage brain is particularly vulnerable to the damaging effects of alcohol, according to Dr. Peter M. Monti of Brown University in Providence. Rhode Island.

Monti helped organize a recent symposium of the Research Society on Alcoholism held in Vancouver, Canada. The new report, published in the journal Alcohol: Clinical and Experimental Research, summarizes research presented at the meeting.

Some of the findings come from research using functional MRI to image brain activity in teenagers with drinking problems and those without. In one study, boys and girls with alcohol use disorders -- which refers to both alcohol abuse and alcohol dependence -- showed greater brain activity than other adolescents during a memory test, though test scores were similar in both groups.

A different pattern emerged when women ages 18 to 25 took the same test. Compared with others their age, young women who'd had an alcohol problem since adolescence showed less brain activity during the memory task and had a poorer performance.

The findings, according to the researchers, suggest that in the early stages of an alcohol use disorder, the brain may try to compensate by "recruiting" additional neurons to perform a given task. But if the drinking continues into young adulthood, the damage to brain cells may grow and become too much for the brain to overcome.

Other research presented at the symposium focused on the memory loss associated with so-called blackouts. An "alarmingly" high number of young drinkers, according to researchers, have at times had so much to drink that they could not remember what they did during the binge. In one survey of college students, half of those who drank said they'd had at least one blackout in their lives.

It's unclear whether teenagers are more susceptible to blackouts than adults are, but animal research suggests that in adolescents, a part of the brain involved in forming memories may be particularly vulnerable to the effects of alcohol.

Similarly, in a study of rats, researchers at the University of North Carolina, Chapel Hill, found that binge drinking damaged parts of the adolescent brain that were left unharmed in the adult rat brain.

Those same researchers have also found evidence that early drinking-induced brain damage could be lasting. In one experiment, adult rats that had been "binge-drinkers" as adolescents showed differences in brain structures that transport the chemical serotonin, which is involved in such essentials as mood regulation and memory.

Though research in rats does not necessarily translate to humans, animal studies are important in understanding the consequences of teen drinking, Monti told Reuters Health. For one thing, researchers obviously cannot give alcohol to teenagers and then see what happens to their brains. In addition, Monti noted, studying genetically altered rats, for instance, can give insight into the genetic underpinnings of alcohol abuse.

With more studies pointing to the harm done to the brain by adolescent drinking, one of the remaining challenges is getting kids to care, according to Monti, whose own research focuses on that issue. Drinking, and the immediate effects that come with it -- from blackouts to hangovers -- are often viewed as part of growing up.

"Every kid," Monti said, "thinks others kids are drinking more than they are."

Still, his research has shown that some teenagers will respond to an anti-drinking message. In a study of 18- and 19-year-olds whose drinking had landed them in the emergency room, Monti and his colleagues found that a brief counseling session in the ER helped cut patients' rates of drinking and driving, as well as alcohol-related injuries.

Source: Alcohol: Clinical and Experimental Research, February 2005.

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Schools Responding to Abuse of ADHD Drug

The Associated Press

Monday, February 14, 2005

BRIDGEPORT, Conn. - Staying up all night to cram for an exam is nothing new on college campuses, but the new drug of choice many students are using for that extra boost is.

Adderall, a powerful and potentially addictive drug used to treat attention-deficit hyperactivity disorder, is increasingly finding its way onto campus and, in some cases, to high schools. The illegal use of the prescription drug is a problem educators say has grown more rampant over the past 10 years.

At Fairfield University, health services officials are using creative methods to get the word out about misuse of Adderall and other prescription drugs. The campaign includes posting warnings in classrooms, bathrooms and hallways, said Dr. Susan Birge, assistant vice president of student resources.

Birge said Adderall problems may not compare with depression or binge drinking but are on the radar of the university's counseling team.

The Canadian government recently suspended sales of the latest version of Adderall, which has been linked to 20 sudden deaths, 14 of them children. A dozen strokes, two in children, were also reported in users taking the recommended doses. All the deaths, which date back to 1999, occurred in the United States.

At Sacred Heart University, counselor Richard Madwid said one of his concerns is the possibility of students mixing the drug with alcohol and suffering an adverse reaction.

"I have seen the level of abuse increase in the past 10 years," Madwid said. "It is comparable to all the other substances that are misused."

Consisting of a mix of amphetamines, Adderall is known to correct chemical imbalances in the brain. A 2002 study by the University of Wisconsin reported that one out of every five college students takes the drug, many illegally.

In Milford last year, a student at Jonathan Law High School was caught with the drug without having a prescription. The city's Health Department has enforced stringent guidelines that closely regulate how such medicines can be dispensed on school property, said School Nurse Administrator Joan Cagginello. Signatures from a parent and physician are needed on a special form before children can bring a prescribed substance to school with them.

The drug is then placed in a locked area in the school nurse's office.

"All of the nurses have medical cabinets. It is double locked," Cagginello said.

Information from: Connecticut Post, http://www.connpost.com

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U.S. Says J&J Arthritis Drug Promotion Misleading

Reuters

Monday, February 14, 2005

WASHINGTON (Reuters) - A Johnson & Johnson promotion for rheumatoid arthritis drug Remicade is misleading because it makes unsupported claims about the drug's effectiveness and omits important information about risks, U.S. regulators said in a letter released on Monday.

The Food and Drug Administration (news - web sites) told the company to immediately stop using materials that contain the misleading information.

An eight-page sales material presented to doctors "suggests Remicade is safer and more effective than has been demonstrated by substantial evidence or clinical experience," the FDA (news - web sites) said in a letter dated Feb. 11 and posted on the agency's Web site on Monday.

Michael Parks, a spokesman for Johnson & Johnson unit Centocor that makes Remicade, said the company was reviewing the letter and "will work with the FDA to resolve any issues."

Johnson & Johnson shares fell 65 cents, or about 1 percent, in afternoon trading on the New York Stock Exchange (news - web sites).

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Older Adults' Memories Stress the Positive

 

HealthDayNews

Monday, February 14, 2005

MONDAY, Feb. 14 (HealthDay News) -- As years go by, adult choices and memories about those choices are increasingly filtered through rose-colored glasses that accentuate the positive while downplaying the negative, researchers conclude.

That's especially true whenever older adults reflect on important choices they've made, according to researchers at the University of California, Santa Cruz. They found that, as people age, they seem to rely more on a comparison process that emphasizes positive emotional outcomes over negative ones. This process may be driven by a desire among older individuals to avoid feeling regret.

"The results add a twist to our understanding of how people remember things that weren't there. The way we remember one option is shaped by what we know of other options, and the comparison process changes as we age," lead researcher Mara Mather, an associate professor of psychology, said in a prepared statement.

One study found that older adults were more likely to use more emotions-based recall mechanisms that tend to guard against regret. In this type of system, individuals simply ignore or "fill in" gaps in knowledge regarding the negative aspects of a particular choice.

On the other hand, when asked to decide between two options, younger adults tended to weigh both the negative and positive aspects of each choice before they examine the next option.

"Young people are trying to learn as much as they can about each option, while older people are more focused on feeling good about their choices," Mather said.

In general, people aged 65 to 80 are more likely to initially ignore negative features and to have less memory of them than younger adults, the researchers found. Older adults were also more likely to remember good things about a particular choice, rather than any negative aspects, compared with younger adults.

Mather stressed these age-based differences aren't due to any decline in mental aptitude among older adults.

Instead, "younger and older adults' comparison processes are influenced by different goals. Even when older adults show little or no signs of cognitive decline, they make decisions differently than younger adults, in ways that should help them avoid regret," he said.

The research appears in the current issue of the Journal of Experimental Psychology.

More information

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

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Quitting Smoking Improves Blood Tests in Days

 

By Alison McCook

Reuters Health

Monday, February 14, 2005

NEW YORK (Reuters Health) - It takes only days for your body to start thanking you for butting out for good, according to new study findings reported on Monday.  

Japanese investigators found that 14 days after a group of smokers quit, their blood became significantly less likely to form clots, putting them at a lower risk of heart attack or stroke.

However, Dr. Stavros Konstantinides of the University of Goettingen in Germany, who was not involved in the study, cautioned that the findings do not suggest that it takes only days for smokers' bodies to become as healthy as non-smokers'.

These findings provide "extra motivation for people to quit smoking," he told Reuters Health, but they need to stick with it for more than two weeks to get the full health benefits.

During the study, Hirohiko Morita of the Kurume University School of Medicine and colleagues asked 27 men who had smoked at least 15 cigarettes per day for more than 5 years to quit. Half of the men were allowed to start smoking again after 2 weeks, while the other half remained abstinent for 4 weeks.

The researchers followed smokers over time, noting how their blood responded when they quit.

Reporting in the Journal of the American College of Cardiology, the researchers found that within 2 weeks, former smokers' blood underwent changes that rendered it less likely to clot, an established risk of smoking. Once people began smoking again, their apparent risk of blood clots climbed to its pre-quitting level.

"This was really an effect that can come really fast after stopping smoking," Konstantinides noted.

He added that the study did not examine the actual risk of blood clots, stroke or heart attack, just factors that tend to influence clotting.

In an interview, Konstantinides explained that blood function takes only days to respond to a non-smoking environment because smoking has a very immediate effect on the blood. However, smoking damages blood vessels much more slowly, he said, so, in turn, it takes much longer for blood vessels to recover from smoking.

He added that the study participants were all very healthy, and quitting smoking may have different effects on blood function in men who already have medical problems such as heart disease, for example.

Source: Journal of the American College of Cardiology, February 15, 2005.

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Reprogrammed HIV Can Hunt Down Cancer Cells

HealthDayNews

Monday, February 14, 2005

MONDAY, Feb. 14 (HealthDay News) -- A harmless version of HIV (news - web sites), the virus that causes AIDS (news - web sites), is being used to hunt down malignant melanoma cancer cells in mice, researchers say.

Scientists at the University of California, Los Angeles AIDS Institute used a version of HIV lacking key components that cause AIDS. This disabled form of the virus was able to spread through the body and infect cells, but without causing disease, they explained.

Next, the researchers stripped off HIV's viral coat and reprogrammed the virus to recognize and attach to P-glycoproteins, molecules located on the surface of many cancer cells.

"P-glycoproteins cause big problems by making the cell resistant to chemotherapy," institute director Irvin S.Y. Chen said in a prepared statement. "They act like soccer goalies and punt therapeutic drugs out of the cancer cell. This prevents the drug from taking effect and allows the tumor to continue growing unchecked."

The researchers also loaded the altered HIV with a fluorescent protein, the same protein that makes fireflies glow. Using a special optical camera, they used this fluorescence to track the virus' movements after injection into the mice.

"The virus traveled through the animal's bloodstream and homed straight to the cancer cells in the lungs, where the melanoma had migrated," Chen said.

The study appears in the Feb. 13 online edition of the journal Nature Medicine.

"For the past 20 years, gene therapy has been hampered by the lack of a good carrier for therapeutic genes that can travel through the blood and aim itself at a precise location, thereby minimizing harmful side effects," Chen said. "Our approach proves that it is possible to develop an effective carrier and reprogram it to target specific cells in the body."

He cautioned, however, that much more research is required before this approach can be tested as a gene therapy method in humans.

More information

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

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Sunday, February 13, 2005

 

Quitting Smoking Improves Quality of Life

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Sunday, February 18, 2005

SUNDAY, Feb. 13 (HealthDayNews) -- If you're an adult who smokes, you've heard the admonition countless times that tobacco can kill you. But did you know quitting could still add years to your life -- even if you've been a longtime smoker?

That's the encouraging news of two studies first published last year. And considering that smoking claims the lives of 400,000 Americans each year, according to federal statistics, it's a message that bears repeating.

"You can undo some of the harm of smoking, but it's not immediate," said Donald Taylor Jr., an assistant research professor at Duke University Medical Center's Center for Health Policy, Law and Management, and a co-author of one of the reports. "The point is: the earlier the better," he added.

Taylor teamed up with Dr. Truls Ostbye, a professor of community and family medicine at Duke, to measure the effects of smoking in middle-aged and older Americans. The study examined "years of healthy life," a measure of quality of life that combines risk of death and indicators of health status.

The researchers analyzed data on smoking and health from two studies -- one involving 12,652 men and women 50 to 60 years old and another focusing on 8,124 people 70 and older. The participants in each study were asked every two years to rate their health as excellent, very good, good, fair or poor.

"The idea that smoking's bad for you has hardly stopped the presses," Taylor said. "What we were trying to do is to develop estimates of the negative harm of smoking and, sort of, the positives of quitting in a way that could try to motivate people to quit."

Quitting yielded significant health benefits, indeed, after 15 years of having kicked the habit. At that point, the number of healthy years remaining in a former smoker's life is about the same as people who never smoked, according to the study, published in the journal Health Services Research.

The results suggest that a smoker who quits before turning 35 is likely to live as long and as well as someone who never took up the habit.

Researchers at the University of Oxford in England came to a similar conclusion in a prospective study involving 34,439 British doctors. Begun a half century earlier, it is the longest study ever into the effects of smoking.

While smokers die 10 years sooner, on average, than nonsmokers, quitting at 30 almost erases the risk of dying, and stopping at 50 cuts the risk in half, the researchers found.

Taken together, the two studies convey a potentially life-saving lesson: quitting works and it can greatly improve people's lives, especially in old age.

But some anti-tobacco experts fear that cautionary advice isn't reaching the smoking public.

Dr. Michael Siegel, an associate professor at Boston University School of Public Health, blames a shift within the tobacco control community. Instead of framing smoking broadly as a public health problem, some anti-smoking groups are focusing on stopping kids from lighting up. As a consequence, millions of adults already hooked on cigarettes are being left to "die off," as he put it.

"One of our priorities needs to be to get adult smokers to quit, even elderly people," he said.

As evidence of the shift, Siegel points to legislation introduced in the last session of Congress that would put the Food and Drug Administration (news - web sites) in charge of regulating tobacco products. While imposing certain restrictions on marketing to kids, he insists the measure is riddled with loopholes benefiting the tobacco industry.

What's more, he said, it fails to enhance the public's perception of the inherent risks of smoking.

Sens. Mike DeWine (R-Ohio) and Edward Kennedy (D-Mass.), introduced the bill, which received the endorsement of several public health groups, including the Campaign for Tobacco-Free Kids, a leading tobacco control group, as well as Philip Morris USA, the world's largest tobacco company.

"We supported this legislation because it granted the FDA (news - web sites) enormous new authority to regulate both current and new tobacco products and restrict tobacco product marketing," explained Vince Willmore, a spokesman for the Washington, D.C.-based Campaign for Tobacco-Free Kids. He contends the measure would better inform consumers about the health risks of smoking while strictly regulating any health claims.

As for whether tobacco control efforts should be focused on kids or the public at large, Willmore says prevention and cessation are not an either-or choice: "We must do both to reduce tobacco use and its terrible toll in health, lives and health care bills."

Emphasizing improvements in quality of life and health from quitting may be the ticket to getting adults to finally nip their habit in the bud.

"The hard part is getting people's attention and convincing them to quit before they have something really bad happen to them," Duke's Taylor said.

More information

The National Cancer Institute (news - web sites) has tips to help you quit .

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Saturday, February 12, 2005

 

Stressed Out and Sick About It

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Saturday, February 12, 2005

SATURDAY, Feb. 12 (HealthDayNews) -- Whether you're caring for a loved one who's ill, coping with the loss of a job, or recovering from an abusive relationship, it's a good bet that you're experiencing some level of stress.

Even crawling through bumper-to-bumper traffic each morning is enough to cause some people to lose their cool.

Being exposed to these stressful situations day-after-day, year-after-year can be mentally and emotionally draining -- sometimes to the point of breakdown. And the physical toll is huge. Stress can put you at risk for high blood pressure and heart disease, trigger headaches and asthma attacks, and exacerbate other medical conditions.

Some psychologists say stressed-out Americans are an increasingly common breed.

With the war in Iraq (news - web sites), the threat of terrorism, uncertain economic times, broken marriages and wayward children to worry about, "I'd say that we have a whole series of events coming together now that are more profound than any other time in history," said Don R. Powell, a licensed psychologist and president of the American Institute for Preventive Medicine, which provides stress management training to corporate employees.

Learning to cope with stress becomes all that more important, he asserted.

Now might be the time to do something about it. February is Wise Health Consumer Month, a time when Americans will be urged to empower themselves to make better health decisions. That includes learning new ways to manage stress.

"Stress is the body's non-specific response to any increased demand that's placed upon it," Powell said. Even positive changes -- getting married, changing careers -- can be stress-provoking. "You can be under a lot of stress from winning the lottery, just as you could be from losing your job," he said.

Studies show a little bit of stress actually can be a good thing. Short-term stress, the type that produces a fight-or-flight response, boosts the immune system, preparing it for possible infection or injury, according to a major review of stress-and-immunity studies in the July 2004 issue of Psychological Bulletin, published by the American Psychological Association (APA).

But when stress becomes chronic or prolonged, it can wear you down.

"In general, we think that anything that lasts longer than a fight or a flight -- a few minutes to maybe a few hours -- marks the transition from a beneficial to a harmful stress response," said Suzanne C. Segerstrom, an associate professor of psychology at the University of Kentucky in Lexington and a co-author of the review.

Older people and those who already have compromised immune systems seem to be particularly vulnerable, the analysis revealed.

What's not known is whether the relationship between stress and disease is due to changes in the immune system. It seems plausible for some conditions, such as viral cancers and heart disease, Segerstrom allowed, "but it hasn't been tested."

Just how stressed-out are we? According to the APAs online Help Center:

There's even evidence linking stress with premature aging. Researchers at the University of California, San Francisco found that prolonged psychological stress affects molecules that are believed to play a role in cellular aging and, possibly, the onset of disease. In the study, the immune cells of women who care for chronically ill children aged faster than those of women with healthy kids.

 

So what can people do to lessen the effects of stress on the body? Powell teaches a technique to help victims of stress revamp how they think about things. A traffic snarl needn't set your teeth clenching. Just turn on some soothing music.

 

"Perception is everything," Powell said.

 

For the person who's weary of running late or missing deadlines, a course in time management may be just the ticket.

 

Traditional relaxation techniques, including meditation, deep muscle relaxation and hypnosis, also can help a person de-stress. So can a good night's sleep -- a minimum of seven hours each night. And don't forget proper nutrition and exercise: these things can keep you healthy and better able to cope with stress.

 

More information

 

The American Psychological Association has more on how stress affects us.

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