The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
March 31, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 19-25

 

  1. Quitting Smoking After Heart Attack Cuts Death Risk

  2. Study: Drugs May Reduce Mom-To-Baby AIDS
  3. Many Diet Studies Lack Key Data
  4. Life-Prolonging AIDS Cocktails Show Real Value
  5. Mom's Poor Diet Can Up Diabetes Risk in Child
  6. New HIV Strain May Progress Quickly
  7. Dysentery Bug Wields 'Sword and Shield'
  8. Smoking Ups Impotence Risk in Younger Men
  9. Viruses are Vaccines' New Anti-Cancer Weapon
  10. You're Never Too Old to Exercise
  11. Eating Breakfast May Do a Heart Good
  12. Ovary Syndrome Ups Risk for Liver Disease
  13. No Evidence Flu Jabs Work for Under-2s – Study
  14. Non-Surgical Treatment Offers Hope for Liver Cancer
  15. Platelet Transfusions Carry Risk of Infection
  16. Health Tip: Controlling Mold
  17. Men Likelier Than Women to Have Bowel Cancer Test
  18. Health Tip: After Hip Replacement
  19. Detergent to Cut Mad Cow Infection Risk in Surgery
  20. To Track Colitis, Listen to the Patient
  21. Nerve Cell 'Traffic Jam' May Trigger Alzheimer's
  22. Wives of Smokers Run Risk of Stroke
  23. Repeat Tests Help Spot Newborn Hearing Loss
  24. US Poll Backs Bigger Gov't Role on Drug Prices
  25. Autism Experts Collaborate to Improve Treatment
  26. US Worried by Infections in Transfusion Recipients
  27. Gene Insight May Improve Child Asthma Care
  28. Kids at Risk for Obesity Need Early Attention
  29. Spouse Most Likely Source of Elder Abuse
  30. Salt Should Be Regulated Food Additive, Group Says
  31. Health Tip: Kids with Arthritis
  32. Carotenoids May Ward Off Prostate Cancer
  33. Megavitamins: Too Much of a Good Thing?
  34. Drug Cuts Damage, Death from Brain Bleeding
  35. Soy Industry Looks for the Next Big Thing
  36. Government Paying Ever More Health Costs –Report
  37. Expert: Baby Swings May Trigger Dog Attack
  38. Study Shows How Green Tea May Fight Bladder Cancer
  39. New Clues to Protecting Diabetic Kidneys
  40. Diabetes Screening Seen to Be Worth the Cost in US
  41. Health Tip: Avoiding Kidney Stones
  42. Clotting Agent Improves Stroke Survival
  43. Tea Might Protect Transplanted Livers
  44. Too Much Red Meat Bad for Long-Term Health
  45. Study: Anti-Smoking Campaign Is Helping
  46. Free Hotline Focuses on Lymphedema
  47. Bipolar Disorder More Common Among Urban Poor –Study
  48. Health Tip: The Ins and Outs of Colonoscopy
  49. Study: Diesel Exhaust Blamed for Deaths
  50. Pot Smoking May Raise Stroke Risk
  51. A Little Meat Adds a Lot to Poor Kids' Diets
  52. Infection Control Lacking in Many Surgeries
  53. When It Comes to Kids' Ear Infections, Hold the Antibiotics
  54. Seniors Raising a Glass to Good Health
  55. Collagen Defect May Trigger Osteoarthritis
  56. Migraine Linked to Increase in Heart Risk Factors
  57. Clue to Controlling Appetite Found
  58. Report Touts Centralized Food Safety Rules
  59. Waist Circumference Predicts Heart Disease Risk
  60. CDC Seeks Earlier Detection of Autism
  61. Heart Attack Care May Be Worse for Women
  62. Steroids Risky Treatment for Brain Injury
  63. Environmental Change May Be Boosting Diseases – UN
  64. Wine Divine For Women's Hearts
  65. Many Post-Heart Attack Workers Have Psychologic Symptoms
  66. Targeted Messages Spur Healthy Eating in Young
  67. Picture Phones May Make a Doctor's House Calls
  68. ERs Underdiagnosing Psychiatric Illness
  69. Snoring May Not Signal Breathing Problems –Study
  70. Health Tip: Controlling Diabetes
  71. Exercise Can Be a Challenge for Diabetics
  72. New Tool Predicts Benefit of Mammograms
  73. Screenings Help Check Brain Function
  74. Fish Has Health Benefits, and a Few Risks

 

Friday, February 25, 2005

 

Quitting Smoking After Heart Attack Cuts Death Risk

 

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb 25 (HealthDayNews) -- It's never too late to quit smoking: A new study finds smokers who quit after a heart attack gain an immediate drop in their risk of death.

The study, involving more than 16,000 smokers admitted to the hospital for heart attack, found smokers who received in-hospital counseling to kick their habit significantly reduced their chances of dying in the first 30 days, 60 days and up to one year following the attacks.

While experts have long known that quitting smoking after heart attack reduces risks for a second heart attack and death, the fact that this effect takes hold so quickly -- within 30 days -- is a new finding, said study author Dr. Thomas K. Houston, a researcher at the Birmingham VA Medical Center in Birmingham, Ala. Previous studies have only been able to find evidence for a reduction in death risk over the first year following a heart attack.

Not every smoker will kick the habit of course, even after heart attack. But Houston believes these findings support the idea of mandating a "no-smoking" period for all hospital patients recovering from heart attack, and to strongly urge the patient to continue quitting for as long as he or she can once they leave the hospital.

"In those patients unwilling to quit for good, [the strategy] would be to recommend, at a minimum, to maintain the in-hospital mandated smoking deprivation for a brief period after discharge," he said.

The findings are reported in the February issue of the American Journal of Medicine.

More information

The American Heart Association (news - web sites) has more about smoking and heart disease.

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Study: Drugs May Reduce Mom-To-Baby AIDS

 

By Jeff Donn

Associated Press Writer

The Associated Press

Friday, February 25, 2005

BOSTON - Scientists fighting the ravages of AIDS (news - web sites) in the Third World have shown convincingly that a short and relatively inexpensive combination of HIV (news - web sites) drugs could reduce mother-to-baby transmission rates in Africa far more effectively than the single pill now used.

But the cost of the drug combinations could still be prohibitive in some of the most impoverished parts of the world.

Scientists have long been searching for an alternative to the AIDS drug now widely used in the Third World, nevirapine. Nevirapine is cheap and highly effective at preventing babies from contracting the AIDS virus from their mothers. But up to two-thirds of women become resistant to the drug.

The drug combinations appear to have an extremely low rate of resistance, and offer a relatively inexpensive and easy-to-take alternative for many women.

"This is very promising for low-income countries," said one of the researchers, Dr. Francois Dabis of Victor Segalen University in Bordeaux, France.

However, the drug combination would likely cost more than double the usual $8 for a single dose of nevirapine for mother and newborn. As it is now, some countries cannot even afford nevirapine.

"It's important not to be rapidly overoptimistic," said Dr. Mary Fowler, a U.S. Centers for Disease Control and Prevention (news - web sites) specialist in mother-to-baby HIV transmission. "The translation from trials to programs is incredibly challenging."

The findings were presented in Boston on Thursday at the 12th Annual Retrovirus Conference, the world's chief scientific meeting on AIDS.

In impoverished lands, nevirapine is widely given in single doses to infected pregnant women in labor and then to their newborns.

In the United States, the complete three-drug HIV cocktail has cut mother-to-baby transmission rates to around 2 percent. But patients in the United States are given longer treatments, and drugs that are far more effective and expensive than those tested in Africa.

The African studies — one in the Ivory Coast, one in Botswana — reduced rates at four to six weeks after birth to about 5 percent, the lowest ever recorded in Africa. Nevirapine in single doses typically reduces that rate from around 35 percent to 12 percent.

In the Ivory Coast study, French and African-based researchers used single-dose nevirapine in 329 women, but coupled it with two other common AIDS drugs: AZT and 3TC, sold collectively as Combivir. The Combivir was given to the mothers during pregnancy and for three days after birth. The newborns were also given single-dose nevirapine and AZT.

At 6 weeks of age, fewer than 5 percent of the newborns were infected. Drug resistance was also extraordinarily low in the mothers. Only 1 percent became resistant to nevirapine, and just 8 percent to 3TC.

In the Botswana study of 1,179 births, mothers were given multi-week AZT alone, and in combination with single-dose nevirapine.

The World Health Organization (news - web sites) is expected to consider broadening its guidelines soon in light of research on such new regimens. Its recommendations now include single-dose nevirapine and an AZT-nevirapine regimen.

"For a minimum additional cost, we may get many benefits," said Dr. James McIntyre, an AIDS researcher in South Africa.

However, several researchers cautioned that single-dose nevirapine will still be needed in many places.

"It is essential to preserve single-dose nevirapine as an option when more complex regimens are unavailable," said Mark Isaac, vice president of policy at the Elizabeth Glaser Pediatric AIDS Foundation in Washington.

A separate arm of the Botswana study also gave a boost to advocates of breast feeding for HIV-infected women. Some babies were breast-fed and treated with AZT for six months, while others were given formula. More of the first group contracted HIV, as expected, since the virus can be passed through breast milk. However, the two groups had almost identical rates of HIV-free survival after 18 months.

Doctors have long known that the AIDS virus can be transmitted through breast milk. But many are reluctant to discourage breast-feeding in the Third World, since formula feeding has been linked in the past to more baby illnesses and deaths from a variety of causes.

About 40 million people worldwide are infected with HIV. About 65 percent live in sub-Saharan Africa. About 3 million people died in the epidemic last year.

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Many Diet Studies Lack Key Data

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDayNews) -- Scientific studies that claim to support the effectiveness of weight-loss plans often leave out key facts that can influence the results, claims a new analysis of hundreds of diet studies.

Many of the reports omit key mitigating details about the dieters themselves -- things such as medication use, health status, ethnicity and even age.

"We had not expected such poor reporting quality," said study author Cheryl Gibson, a research associate professor of medicine at the University of Kansas Medical Center.

Her team published their findings in the Feb. 22 issue of Biomed Central Medical Research Methodology.

Studies of weight loss are plentiful, since 97 million adults are overweight or obese in the United States, Gibson pointed out. To stem the obesity epidemic, much research has focused on the role of diet, exercise and genes to maintain a healthy weight.

"We wanted to look at the reporting quality of those studies that looked at diet and exercise for weight loss," Gibson said.

To do so, she and her colleagues analyzed 231 articles in medical journals focused on the weight-loss effects for obese individuals of regimens that either included restricting diet, restricting diet plus increasing exercise, or exercise only. They also looked at studies whose main endpoints included changes in body composition, fat distribution, metabolism and aerobic fitness. The studies were published between 1966 and 2003.

Gibson's team looked closely at how the articles reported the physical, background and health characteristics of the study participants. As a guide, they used the Consolidation of the Standard of Reporting Trials Characteristics (CONSORT). This is a list of 21 different elements considered essential for a study to be validated by experts and editors of medical journals.

Gibson's team especially focused on age, gender, general health information, use of medication (other than drugs used to control weight), ethnicity and female participant's menopausal status.

Their findings: 92 percent of the studies did not report medication use, while 34 percent ignored the health status of the persons. Ethnicity was not mentioned in 86 percent of the studies; ages were missing in 11 percent.

Eight percent of studies didn't say whether women were pre- or postmenopausal; 4 percent didn't differentiate men from women when reporting results.

Besides the lack of detail on ethnicity and other factors, Gibson found the end of study sample size was often not listed, making it impossible to determine the diet dropout rate.

Missing data like this is important, the study authors conclude, because "inadequate reporting can create difficulties of interpretation, and lead to biased results."

"As researchers we need to do a better job of reporting our studies," said Gibson. "For other researchers to replicate a study there needs to be more attention to detail to enhance the reporting quality of the trials." Replicating studies helps researchers prove a particular method or approach or medicine truly works.

One expert took the study conclusions as call to do better.

"She makes a good point," said Dr. Michael Dansinger, director of obesity research for the atherosclerosis research lab at Tufts-New England Medical Center in Boston. "We have gaps to fill in reporting of obesity research studies and we should view her work with an open mind and an effort to improve."

"By identifying these gaps, we can identify areas for improvement," he said.

More information

For tips on healthy weight loss, visit the American Heart Association.

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Life-Prolonging AIDS Cocktails Show Real Value

 

By Maggie Fox, Health and Science Correspondent

Reuters

Friday, February 25, 2005  

WASHINGTON (Reuters) - Drug cocktails that can prolong the lives of people infected with the AIDS (news - web sites) virus are beginning to show their value but only about half of U.S. adults who should be receiving them are actually getting them, scientists reported on Friday.

The study was presented at a meeting in Boston of AIDS researchers at the 12th Annual Retrovirus Conference.

Dr. Rochelle Walensky and colleagues of Harvard Medical School (news - web sites) and Brigham and Women's Hospital in Boston estimated how many people had been helped by the combinations of HIV (news - web sites) drugs called highly active antiretroviral therapy or HAART, which can suppress the virus.

Although they are not a cure, have toxic side effects and often stop working after a while, they have added 1.78 million years of life to people who had progressed to AIDS, Walensky told the conference.

"When you start adding the numbers and get big numbers, you realize how much progress there has been," Walensky said in a telephone interview.

"We intentionally did our best to make this conservative," she added. They covered the time between 1989 and 2002.

Adding in the estimated 2,800 babies who were saved from HIV infection by treating them and their mothers at delivery added another 186,000 years of life saved, she said.

Eyasu Teshale and colleagues at the U.S. Centers for Disease Control and Prevention (news - web sites) estimated that 480,000 Americans aged 15 to 49 should be getting treated with HAART, but only 340,000 are.

Since learning that HAART cannot eliminate infection, doctors usually wait until the AIDS virus has seriously damaged a patient's immune system before starting therapy.

Only 55 Percent Getting Treated

"Using the largest set of national data available, we estimated that only 55 percent of eligible people living with HIV/AIDS age 15 to 49 years old are receiving antiretroviral therapy in the United States," they told the conference.

"Most of those persons who are not receiving treatment, it's because they have not been diagnosed," said the CDC's Dr. Ron Valdiserri.

In another study Dr. Geraldine McQuillan and colleagues at the National Center for Health Statistics found that HIV infection is not becoming more common among adults aged 18 to 59 in the average U.S. household.

They compared two surveys, one taken between 1988 and 1994, and another taken between 1999 and 2002, which both included blood samples from groups considered representative of the U.S. population, excluding the military, homeless and prison inmates.

They found the earlier prevalence at 0.33 percent of the population and the 1999-2002 prevalence was 0.43 percent. "These numbers are statistically basically the same," McQuillan said in a telephone interview.

But numbers of blacks doubled, from just over 1 percent of those surveyed to just over 2 percent and McQuillan said it was mainly among the oldest group, those aged 40 to 49.

"Since we are not seeing increases in youngest age groups, you feel comforted that prevention messages are at least being heard," McQuillan said.

The CDC estimates that overall, 850,000 to 950,000 people in the United States are infected with HIV, including as many as 280,000 who do not know it.

In 2003, an estimated 18,000 Americans died of AIDS. Globally, 39 million people are infected and 3.1 million people died of AIDS last year, according to the United Nations (news - web sites).

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Mom's Poor Diet Can Up Diabetes Risk in Child

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDayNews) -- Poor nutrition in moms-to-be could set their child up for diabetes later in life, new research in mice suggests.

"Low birth weight is linked with abnormal function of the cells in the pancreas that make insulin," explained lead researcher Dr. Mary-Elizabeth Patti, an assistant investigator at the Joslin Diabetes Center Research and an assistant professor of medicine at Harvard Medical School (news - web sites).

While experts have long noted an association between low birth weight and type 2 diabetes, this new research sheds light on why that may occur.

However, another expert cautioned that it's difficult to draw parallels between the diets of mice used in this study and the nutrition of modern-day humans.

The findings appear in the March issue of Diabetes.

In their study, Patti's team divided pregnant mice into two groups: One group ate as much as they wanted throughout their three-week pregnancy, while the other group was allowed to eat all they wanted only during the first two weeks of pregnancy, then had their food intake restricted during the third week of pregnancy.

Pups born to the second, calorie-restricted group weighed 23 percent less than the pups in the well-fed group, the researchers report. However, by three weeks of age, the mice pups all looked and acted the same, regardless of which group their mothers had been in.

Digging deeper, Patti's group tested the pups' blood sugar levels as they aged. They found that by two months of age both groups had similar blood sugar levels, but by four months mice that were in the low birth weight group displayed significantly higher blood glucose compared to their normal birth weight peers.

That gap continued to widen, the researchers add, so that by six months of age blood sugar levels in mice born undersized was abnormally high, reaching levels equivalent to those seen in diabetic humans.

In diabetics, poor blood sugar control comes from deficiencies in insulin secretion by the pancreas, or through cellular resistance to the effects of insulin circulating throughout the body.

The Boston team examined the mice's pancreatic cells to determine which mechanism was at fault. They found that low birth weight mice born to mothers on poor diets had damaged cells in their pancreas that severely reduced the amount of insulin the mice could produce as they aged.

"One reason why people who have had a history of low birth weight are at increased risk for developing type 2 diabetes is that they're not able to produce as much insulin as they should," Patti speculated.

"If the nutritional environment that the baby is in during development is altered, that can affect the function of organs even during adult life -- even though nutrition and everything has been normalized after birth," she added.

According to the U.S. Centers for Disease Control and Prevention (news - web sites), the number of low birth weight babies in the United States increased 12 percent between 1980 and 2000. In 2002, 314,077 low birth weight babies were born -- the highest level in over three decades. The CDC noted that part of this increase is due an increase in the number of multiple births, which are on the rise.

Anyone born undersized may be at an increased risk for type 2 diabetes as they age, Patti noted. "This study suggests that one important component of that risk for diabetes is the poor functioning of the insulin-producing cells in the pancreas," she said.

She advised people who know they were low birth weight infants to take special care to keep their weight down and get plenty of exercise, since obesity is a prime risk factor for the type 2 diabetes. "Although the damage to the pancreas is permanent, it may not be a problem unless you gain weight or become physically inactive," Patti said.

Dr. Rebecca Anne Simmons, an assistant professor of pediatrics from the University of Pennsylvania, said the findings may have limited applications for humans because, in her opinion, the calorie-restricted pregnant mice received nutrition far below what is seen in most humans.

"This is not similar to what we would observe in humans now. We don't see that severe malnutrition," she said.

Simmons also believes that any damage caused to the insulin-producing cells in the pancreas may occur because of decreased blood supply to the fetus, which restricts the flow of oxygen and other nutrients. "It is not due to malnutrition," she contended.

More information

The National Diabetes Information Clearing House can tell you more about type 2 diabetes.

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New HIV Strain May Progress Quickly

 

By Jeff Donn

Associated Press Writer

The Associated Press

Friday, February 25, 2005

 

BOSTON - Research on a recently discovered HIV (news - web sites) strain shows it holds an array of disturbing traits that help it quickly progress to full-blown AIDS (news - web sites) while resisting drug treatments, doctors said Thursday at the leading meeting on AIDS science.

The variant, discovered in a New York City patient, may have raced from infection to full-blown AIDS in as little as four months, doctors said at the 12th Annual Retrovirus Conference. Typical strains can take 10 years to progress to full-blown AIDS.

Many new infections are resistant to treatment with common HIV drugs, and a small number of HIV variants have quickly progressed to the disease. But the New York patient's doctors said the case combines both characteristics in a worrisome way.

"The unique feature of this case is the convergence of ... the transmission of a remarkably drug-resistant HIV-1 variant and the extremely rapid clinical course to AIDS," the patient's doctors said in a review of his case.

The team is led by Dr. David Ho at Rockefeller University in New York.

Aspects of the HIV variant suggest it is especially deadly. It is capable of using both main entry points to infect cells, and it grows well in the lab, unlike most drug-resistant strains. It also causes cells that it infects to clump together, allowing them to kill other uninfected cells.

The patient, in his late 40s, was diagnosed in December and has lost 10 pounds in the past three weeks alone. It took him between four and 20 months to develop AIDS, Ho said.

Lab tests showed the patient was resistant to three of the four classes of AIDS drugs. He is taking other AIDS drugs now in the hope of vanquishing the infection.

Scientists are still trying to find the source of the man's disease. New York City health authorities have alerted doctors and begun to trace the patient's sexual contacts. The patient, whose name has been withheld, had unprotected anal sex with many other men, often in conjunction with methamphetamine use.

Some researchers have suggested that the patient may simply be unusually susceptible to AIDS, but his doctors said they have found no sign that his immune system is particularly vulnerable.

San Diego health officials have said they are studying a similar strain found there in a patient.

"We don't know whether this is a single isolated event or whether in fact there are other cases out there," said Ho, who is a paid consultant to ViroLogic Inc., which makes resistance tests.

Up to 950,000 people have the AIDS virus in the United States. About 18,000 die annually.

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Dysentery Bug Wields 'Sword and Shield'

 

HealthDayNews

Friday, February 25, 2005

 

FRIDAY, Feb. 25 (HealthDayNews) -- Scientists have discovered why the body's immune system puts up so little fight against the gastronintestinal scourge dysentery.

Dysentery, also known as shigellosis, is especially prevalent in the tropics and is caused by infection with the Shigella bacterium, usually through contaminated water or food. While the illness usually lasts no more than a week, longer-lasting episodes can lead to serious diarrhea and dehydration requiring hospitalization.

Reporting in the Feb. 24 issue of Science, British and French researchers found that Shigella infects cells by using a secretion system to inject its proteins into the human host cell -- much like a striking it with a chemical "sword."

At the same time, a layer of lipopolysaccharide protein on the surface of the bacteria acts as a "shield," protecting the organism from immune system destruction.

"This is the first description of bacteria able to use this 'sword and shield' approach," researcher Dr. Christoph Tang, of Imperial College London, said in a prepared statement.

Tang said the discovery "greatly expands our understanding of how bacteria are sometimes able to evolve, although it is unlikely to result in new treatments or vaccines for dysentery. In this case, the dysentery bacteria has evolved into a highly effective and dangerous infection."

More information

To learn more about dysentery, head to the U.S. Centers for Disease Control and Prevention.

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Smoking Ups Impotence Risk in Younger Men

 

By Amy Norton

Reuters Health

Friday, February 25, 2005

NEW YORK (Reuters Health) - Adding to evidence that smoking is bad for a man's sex life, new study findings show that smoking may raise the risk of impotence, particularly in younger men.

Researchers found that among the more than 1,300 men they followed, those who smoked were at greater risk of erectile dysfunction (ED) than either former smokers or non-smokers.

Smokers in their 40s, the youngest group in the study, showed the highest smoking-related risk. Compared with other men their age, they were nearly three times more likely to have erectile dysfunction. Smoking was also linked, to a lesser extent, to impotence among men in their 50s and 60s, but not among those in their 70s.

This age difference is not surprising, according to Drs. Naomi M. Gades and Steven J. Jacobsen of the Mayo Clinic College of Medicine in Rochester, Minnesota, two of the authors of the study.

Older men often have a number of risk factors for impotence, including diabetes, heart disease and high blood pressure. In younger men, Gades and Jacobsen told Reuters Health, the association between smoking and impotence is less likely to be "masked" by these other medical conditions.

"Smoking may have a more apparent impact on erectile dysfunction in young male smokers than it does in older male smokers," the researchers report in the current issue of the American Journal of Epidemiology.

A number of past studies have pointed to the impotence risk associated with smoking. Though the reasons aren't fully clear, it's thought that the effects of smoking on the blood vessels may impair blood flow to the penis, leading to problems with maintaining an erection.

It's known that conditions in which blood circulation is impaired -- such as high blood pressure and heart disease -- raise the risk of erectile dysfunction. Increasingly, Gades and Jacobsen noted, men diagnosed with ED are being referred for cardiovascular work-ups, since the condition could be a sign of underlying artery disease.

The new findings, according to the researchers, support the idea that smoking is a direct cause of ED because the study found a "dose-response" relationship between the condition and men's smoking habits. This means that the more men smoked over their lives, the greater their risk of impotence was.

Some public health campaigns, the study authors note, have emphasized the fact that smoking may be a risk factor for ED. The rationale has been that while younger men may not be swayed by the far-off prospect of lung cancer, emphysema or heart disease, the risk smoking presents to their sex lives may grab their attention.

These messages, the researchers write, "may be well founded."

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

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Viruses are Vaccines' New Anti-Cancer Weapon

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDayNews) -- The natural infectious power of four viruses could be the key to battling colon cancer, according to research underway at Duke University's Comprehensive Cancer Center.

Scientists are using the viruses -- vaccinia, fowlpox, adenovirus and alphavirus -- to provoke the body's immune system into battling colon cancer cells.

"Cancer has a knack for eluding the immune system and masking itself as friend instead of foe," lead researcher and cancer center director Dr. H. Kim Lyerly said in a prepared statement. "We've designed vaccines that more forcefully present cancer as the enemy to the patient's immune system than earlier vaccines have been able to do."

The most promising strategy under investigation is a one-two punch called "prime and boost." In it, one vaccine is used to alert or "prime" the immune system, while a second vaccine boosts the momentum of its response.

The five-year research and clinical project is being funded by a $10 million grant from the National Cancer Institute (news - web sites). Two biotechnology companies, Alphavax Human Vaccines Inc. and Therion Biologics, will collaborate with Duke in the research.

More information

The National Cancer Institute has more about cancer vaccines.

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You're Never Too Old to Exercise

By Janice Billingsley
HealthDay Reporter

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDayNews) -- One of the best ways to ward off health problems as you age is the same as when you're young, health experts say -- exercise.

"Most of the issues we look at as aging really are disuse. We're meant to move," said Colin Milner, CEO of the International Council on Active Aging, an umbrella group of about 4,000 organizations that deal with aging populations.

"Exercising is the closest thing to a 'magic bullet,' to ensure longevity and a good quality of life," he said.

But try selling that to those 65 and older, most of whom are too sedentary for their own good, says James Blumenthal, a professor of medical psychology at Duke University Medical School, who has conducted a number of studies that link exercise to a drop in depression and a reduced risk of a second heart attack.

"There is good evidence that older people respond just as well to exercise as younger people do, but most older people don't exercise," he said.

One reason could be health, acknowledged Milner, who noted that 85 percent of people over 65 have some health problem that could deter them from exercising. Another problem: people are often more focused on external anti-aging remedies than on staying fit.

"Of the $29 billion spent annually on anti-aging, most is spent on external things, like Botox and breast implants," Milner said. "None of this impacts inner health. The challenge is to help people realize that they should focus on prevention rather than perfection."

Fortunately, a growing number of organizations are starting to preach the gospel of exercise to older adults. Milner reports that his Active Aging Council has nearly doubled its membership in one year, from 2,500 to more than 4,000 organizations representing everything from assisted-living facilities to military hospitals to corporate fitness centers, and one of their primary goals is to increase physical activity among older individuals.

Blumenthal said the medical community is paying increasing attention to the importance of exercise for older people, even the elderly.

"In the last 10 years, I've seen many more studies that reflect the benefits of exercise in reducing the risk of a wide range of medical disorders," Blumenthal said, from heart disease to depression to the effect of gall bladder surgery.

Besides trimming the risk of assorted ailments, he added, exercise has been shown to increase weight loss, and improve self-confidence and physical condition so the daily activities of living are much easier to perform.

Despite all this good news about how exercise can improve the lives of older individuals, the key is to motivate folks to get moving.

For people inclined to exercise, Milner said, "The number one motivator for exercise is turning 50 itself, as people are interested in staying healthy."

For those less likely to be self-starters, Milner said their doctors can help.

"Fifty-two percent of doctors tell their patients to exercise, but only 14 percent actually prescribe it," he said. "The message should be that exercise is not an option. It should be done as part of your routine, like brushing teeth."

Another way to encourage exercise is to explain how exercise can keep people independent.

"The number one reason why older adults need assisted living is lack of leg strength -- they can't get out of a chair, walk up stairs or function on their own," Milner said. So, if they start exercising -- only 11 percent of older people do strength training -- they'll be much more likely to live independently, carry their groceries, and play with their grandchildren.

They'll also save money. According to Milner, people 50 and older who get 90 minutes of physical activity a week could save $2,200 a year on medical bills, ranging from doctors visits to prescription drugs.

If you're older and have fallen out of the exercise habit, your first move should be to the doctor, Blumenthal said. The visit should include a stress test and a review of medications you're taking because certain drugs can affect physical abilities; beta blockers, for instance, slow down the heart rate, he said.

Once your doctor has approved you for exercise, get moving. And, Blumenthal added, "You don't have to train for a marathon."

"Modest exercise of 30 minutes a day every day is more important than the intensity," he said.

More information

The National Institutes of Health has lots of information on exercise for older adults.

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Eating Breakfast May Do a Heart Good

By Amy Norton

Reuters Health

Friday, February 25, 2005

NEW YORK (Reuters Health) - Mom may have been right when she said breakfast is the most important meal of the day. A small study suggests that skipping that morning meal may be a bad move for the heart, and possibly the waistline.

UK researchers found that when healthy, lean women skipped their morning meal, it raised their cholesterol levels and diminished their bodies' sensitivity to insulin, a hormone that helps regulate blood sugar levels.

On top of that, the women tended to eat more calories on breakfast-free days -- suggesting that over the long haul, skipping breakfast could spur weight gain.

Dr. Hamid R. Farshchi and his colleagues at the University of Nottingham in the UK report the findings in the February issue of the American Journal of Clinical Nutrition (news - web sites).

Some past studies have suggested that people who eat breakfast, particularly whole-grain cereals, have lower cholesterol and insulin levels, Farshchi told Reuters Health.

Along with past evidence, he said, the new findings suggest that making time for breakfast is likely to have long-term health benefits.

Whether one of those benefits is a smaller waistline is unclear. Some research, Farshchi noted, has found an association between eating breakfast -- again, whole-grain cereals in particular -- and lower body weight, but other studies have found no such relationship.

To study the short-term metabolic effects of having and forgoing breakfast, Farshchi's team had 10 young, normal-weight women spend two weeks on each of two diet plans. Under one plan, the women had bran flakes with low-fat milk for breakfast, then had two meals and two snacks throughout the rest of the day. Under the other, they skipped breakfast, but had the cereal around noon; as in the breakfast plan, they had two additional meals and two snacks during the rest of the day.

Under each plan, the women were allowed to indulge in a mid-morning cookie.

At the end of each two-week period, the researchers measured the women's metabolic responses to a test milkshake, using blood samples drawn before and after they had the drink.

After the breakfast-free period, the women's cholesterol levels -- including the "bad" cholesterol, LDL -- were generally higher, and they showed poorer insulin sensitivity after having the test drink.

Insulin is released after a meal in order to escort digested sugars into body cells to be used as energy. But the body can become resistant to the effects of insulin. Over time, this impaired insulin sensitivity can cause blood sugar levels to soar and possibly lead to type 2 diabetes -- which, like high LDL cholesterol, is a major risk factor for heart disease and stroke.

Besides the effects on cholesterol and insulin, skipping breakfast also seemed to make study participants eat more, as the women reported higher calorie intakes on breakfast-free days.

They showed no changes in body weight, but Farshchi said this is not surprising given the short study period. "Further long-term studies are needed to investigate the full impact of breakfast consumption on body weight," he noted.

What's interesting about this study, according to Farshchi, is that it points to the importance of eating first thing in the morning. "If the first thing somebody eats in the day is a mid-morning snack and has the cereal later in the day," Farshchi said, "he or she does not get these metabolic benefits."

Source: American Journal of Clinical Nutrition, February 2005.

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Ovary Syndrome Ups Risk for Liver Disease

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDay News) -- Women with a hormone-linked condition called polycystic ovary syndrome (PCOS) may also be at increased risk for liver disease, a new study finds.

Polycystic ovary syndrome is caused by hormone imbalance, and is characterized by insulin resistance that can interfere with normal ovulation and fertility.

Reporting in the February issue of Fertility and Sterility, researchers led by Dr. Jeffrey Schwimmer of the University of California, San Diego, noted that 30 percent of the 73 PCOS patients they studied had high levels of an enzyme strongly linked to non-alcoholic fatty liver disease (NAFLD), which also has links to insulin resistance.

The finding is important because many doctors are not aware of the link between PCOS and increased risk for NAFLD, Schwimmer said in a prepared statement.

It also means that many ob/gyns may not be screening PCOS patients for this liver disorder, and may even be treating them with drugs that are known to be toxic to the liver, he added.

Based on these findings, the researchers recommended that all women with PCOS be screened for NAFLD.

More information

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

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No Evidence Flu Jabs Work for Under-2s – Study

By Patricia Reaney

Reuters

Friday, February 25, 2005

LONDON (Reuters) - There is no evidence that vaccinating children under 2 years old against influenza reduces deaths or complications from the illness, researchers said on Friday.

They reviewed 25 studies that looked at the impact of vaccines in cutting the number of cases of influenza and its symptoms in children up to 16.

Children under 2 are vaccinated against flu in the United States and Canada.

"Immunization of very young children is not lent support by our findings," said Dr Tom Jefferson, of the Cochrane Vaccines Field in Rome, part of the international Cochrane Collaboration that evaluates medical research.

"We recorded no convincing evidence that vaccines can reduce mortality, admissions, serious complications and community transmission of influenza," he added in a report in The Lancet medical journal.

Influenza vaccine campaigns are usually targeted at people over 65.

U.S. and Canadian health officials have recommended that children aged 6-23 months should also be immunized.

Last year the American Academy of Pediatrics updated its guidelines, saying healthy babies under 2 should be routinely immunized against the virus. It followed recommendations from the U.S. Centers for Disease Control and Prevention (news - web sites).

Each year, influenza kills an average of 36,000 Americans and puts 114,000 in hospital.

"In young children below the age of 2, we could find no evidence that the vaccine was different from a placebo," Jefferson told Reuters.

He added that the findings do not mean vaccinations do not work in young children but they found no evidence that it does. There was no indication the vaccines caused any harm or reason to believe they were unsafe.

The findings are part of a bigger Cochrane Review expected to be released later this year.

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Non-Surgical Treatment Offers Hope for Liver Cancer

HealthDayNews

Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDay News) -- A new, minimally invasive technology that 'cooks' tumors using a tiny needle may be an effective first-line treatment for people with early-stage liver cancer who don't quality for surgery, according to two studies on the procedure, called radiofrequency (RF) ablation.

Liver cancer patients usually have a poor prognosis, experts say, and surgery to remove the cancerous part of the liver is often considered the best -- and only -- hope for patients. Unfortunately, most patients won't qualify for surgery and liver transplant is viable option for only a minority of candidates.

The two new studies suggest that RF ablation offers an effective new option for inoperable liver cancer, and may also help liver cancer patients waiting for liver transplantation. In RF ablation, surgeons insert an image-guided needle into spots on the liver affected by cancer. The needle then delivers heat directly to these affected regions, destroying tumor cells.

In the first study, Italian researchers at the University of Pisa used RF ablation on 187 early-stage liver cancer patients with cirrhosis who did not qualify for surgery. Ninety-seven percent of the patients survived one year, 71 percent survived three years and 48 percent survived five years; comparable to results seen in patients who undergo surgery.

In the second study, researchers at the University of California, Los Angeles used RF ablation to treat 47 liver cancer nodules in 24 patients waiting for liver transplantation. The study found that 74 percent of the tumors were successfully treated by RF ablation. The procedure was more successful with smaller tumors than with larger ones, the researchers add.

"I believe that this treatment will soon enter into the guidelines for the clinical management of liver cancer patients," Dr. Riccardo Lencioni, lead researcher for the Italian team, said in a prepared statement.

Both studies will appear in the March issue of Radiology.

More information

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

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Platelet Transfusions Carry Risk of Infection

Reuters Health

Friday, February 25, 2005

NEW YORK (Reuters Health) - Despite the fact that a blood infection called bacterial sepsis is one of the most frequent causes of death in people who have received platelet transfusions, most infectious-disease specialists are not aware of recent standards requiring bacterial testing for contamination of platelets, according to a new report.

Unlike other blood components that are stored in the cold, platelets are particularly vulnerable to bacterial growth because they are stored at room temperature.

Writing in the US Centers for Disease Control and Prevention (news - web sites)'s Morbidity and Mortality Weekly Report (MMWR), Dr. A. Arendt, with the Cuyahoga County Board of Health in Ohio, and associates describe two case reports of patients who died after receiving pooled platelets contaminated with the bacteria Staphylococcus aureus and S. lugdunensis.

They also report results of surveys sent out by the Infectious Diseases Society of America to infectious-disease consultants in the US. Among the 399 respondents, 36% reported they were unaware that "bacterial contamination of platelets is one of the most common infectious risks of transfusion therapy."

Only 20% were familiar with the 2004 standard set by the AABB (formerly the American Association of Blood Banks) for bacterial testing of all platelet components.

Even when testing is performed, false-negative results are possible, so doctors should consider the possibility of bacterial contamination when they are treating patients who develop fevers in reaction to transfusions, the MMWR's editors pointed out in a note published with the report.

Source: Morbidity and Mortality Weekly Report CDC Surveillance Summary, February 25, 2005.

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Health Tip: Controlling Mold

HealthDayNews

Friday, February 25, 2005  

(HealthDay News) -- If you suffer from seasonal allergies, your doctor probably has recommended staying indoors when pollen levels get too high.

But there may be little relief from sneezing, itchy eyes and other allergic symptoms if your home is cluttered with indoor allergens such as dust mites and animal dander.

And then there's mold, which can lead to allergy and respiratory problems that can prove deadly. The Asthma and Allergy Foundation of America (AAFA) and the American Academy of Allergy, Asthma and Immunology (AAAAI) offer these tips for keeping mold growth in your home under control:

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Men Likelier Than Women to Have Bowel Cancer Test

Agence de Presse Medicale

Friday, February 25, 2005

LONDON (Agence de Presse Medicale) - Men are more likely than women to take up invitations for bowel screening, according to a large Cancer Research UK study published in the current issue of the Journal of Medical Screening.

Almost 8,000 men and women aged 55 to 64 were sent questionnaires asking about attitudes about bowel screening six months before a flexible sigmoidoscopy screening appointment.

Of those, around 70% completed the questionnaire and turned up for their appointment. However the gender mix was unequal, with 73% of the men turning up but only 67% of the women.

Lead author Jane Wardle said women were more worried than men about the test being embarrassing or humiliating. "This is surprising given that women are assumed to be more familiar with medical procedures," she pointed out.

She added in a statement that research was underway to discover whether women would be less embarrassed, and so more likely to attend the screening, if female doctors carried out the test.

The findings come as Britain prepares to launch a national screening program for bowel cancer next year. People over 60 will be screened using the faecal occult blood test followed, if necessary, by colonoscopy to look for early cancers and polyps.

Source: J Med Screen 2005;12:20-27.

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Health Tip: After Hip Replacement

HealthDayNews

Friday, February 25, 2005

(HealthDay News) -- If you are contemplating hip replacement surgery, here are ways to make your recovery comfortable.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the American Academy of Orthopaedic Surgeons suggest:

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Detergent to Cut Mad Cow Infection Risk in Surgery

Reuters

Friday, February 25, 2005

LONDON (Reuters) - A detergent that reduces the risk of infection with the human form of mad cow disease via surgical instruments could be in hospitals later this year, scientists said on Friday.

Doctors have been concerned that variant Creutzfeldt-Jakob disease (news - web sites) (vCJD) could be transmitted through surgical equipment because the prion proteins that cause the illness are not destroyed by standard sterilization techniques.

But researchers at Britain's Medical Research Council (MRC) who developed the detergent said it would significantly cut the risk.

"It destroys prion infectivity," said Dr Graham Jackson, of the MRC's prion unit in London."We would be disappointed if it is not available for the market by the third or fourth quarter of this year."

Since vCJD was first detected and linked to eating meat contaminated with mad cow disease, or bovine spongiform encephalopathy (BSE (news - web sites)), in the mid-1990s, more than 140 people have died of the illness.

British medical officials suspect two people were infected through a blood transfusion and have taken measures to prevent further cases.

Jackson, who described the findings in the Journal of General Virology, said the detergent could be used in large sterilizing machines in hospital surgical units or the instruments could be soaked in a solution.

"It is cheap and it is easy to use," he said, adding it was designed with cost and compatibility in mind.

The scientists tested 400 combinations of chemicals before they found the right one.

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To Track Colitis, Listen to the Patient

HealthDayNews
Friday, February 25, 2005

FRIDAY, Feb. 25 (HealthDay News) -- When it comes to monitoring the progression of painful ulcerative colitis, doctors need only listen to patients, a new study suggests.

Patient-reported symptoms of ulcerative colitis -- characterized by fatigue, abdominal pain and bloody diarrhea -- provide an effective alternative to costly, invasive endoscopy as a way of tracking disease progression, report researchers at the University of Michigan Health System, Ann Arbor.

Besides sparing patients the discomfort of having regular colonoscopies, the finding may also save researchers the cost of using the high-tech procedure during clinical trials.

The study included 66 ulcerative colitis patients with varying disease activity. For five months, researchers tracked disease progression using either the results of a detailed patient questionnaire plus a blood sample, or regularly scheduled endoscopy.

They found that prediction of disease activity through the questionnaire/blood sample was nearly as good (only a 3 percent difference) as that gleaned from endoscopy.

The findings appear in the February issue of the American Journal of Gastroenterology.

"This study suggests that endoscopy does not provide physicians with enough new information about the activity of the patient's disease to make it necessary for patients to have to undergo the discomfort of an endoscopy," study lead author Dr. Peter D. R. Higgins, lecturer in the division of gastroenterology and hepatology, department of internal medicine, said in a prepared statement.

In the same statement, his UMHS co-author Dr. Ellen Zimmerman added, "While endoscopy is still necessary to diagnose ulcerative colitis and to evaluate a patient or early signs of cancer, patients may be more willing to participate in clinical trials of new treatments if there are not so many colonoscopies involved."

More information

The Crohn's and Colitis Foundation of America has more about ulcerative colitis.

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Thursday, February 24, 2005

Nerve Cell 'Traffic Jam' May Trigger Alzheimer's

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDay News) -- Like cars backed up on a freeway, blockages in nerve cell signals may lead to the neurological traffic jam that is Alzheimer's disease (news - web sites), researchers say.

The research is preliminary, but a new study in mice suggests this type of neural backup occurs much earlier in the disease than previously thought. It may also help trigger the buildup of beta amyloid protein plaques that is the hallmark of Alzheimer's, the researchers believe.

The findings "point out that this transport system [nerve cell signaling] gets disrupted in Alzheimer's," explained Dr. Bill Thies, vice president of medical and scientific affairs at the Alzheimer's Association.

"The researchers propose that it's this disruption that ultimately triggers the amyloid buildup," he said.

While he labeled the findings "outstanding science," Thies cautioned that this remains just one of many theories as to the exact cause of Alzheimer's. He also stressed that any therapies based on these findings remain years away.

Reporting in the Feb. 24 issue of Science, researchers at the University of California, San Diego (UCSD) focused their efforts on axons -- long, skinny neural highways that pass biochemical messages between nerve cells throughout the body.

Scientists have long observed that axon blockages are a characteristic feature of late-stage Alzheimer's. However, the UCSD team say they have now spotted these globular axonal "defects" in mice more than a year before the rodents develop Alzheimer's-like symptoms.

Their early appearance now points to axon blockages as a potential cause, not effect, of the brain-robbing illness, they say.

The findings yielded another intriguing possibility. In Alzheimer's, the buildup of amyloid plaques within brain tissue is accompanied by a second aberration -- the accumulation of neurofibrillary 'tangles' composed of another protein, called tau.

Tau is also "a protein that appears to regulate traffic within axons," study senior author Lawrence S.B. Goldstein noted in a written statement. That suggests these tau-related blockages within axons "may promote the generation of excess amyloid beta, the protein in amyloid plaques," he said.

According to Thies, "people have been trying to figure how plaques and tangles fit together" in Alzheimer's for a long time. While many believe amyloid deposits lead to tau tangles, others suspect it works the other way around. "There's still no agreement," he said.

"But this paper suggests that axon transport [blockage] is critical in creating amyloid," Thies said. "So, if you correct the tau problem in the axons, you'll correct the amyloid problem."

Unfortunately, no safe, effective agents to untangle this transport mechanism exist, Thies said, partially because most pharmaceutical companies continue to focus on amyloid in their search for effective Alzheimer's drugs.

Right now, Thies said, research into ways to fix impaired tau transport "is on the cutting edge of what people are working on."

"So, this is not going to be in your drugstore tomorrow," the Alzheimer's expert stressed. "It's really outstanding science, but how it fits into the overall picture of trying to treat the disease -- that's still in the offing."

Still, he said this and other discoveries should give patients with Alzheimer's -- and their loved ones -- real reason for hope.

"Alzheimer's is a reasonably complex disease hitting the most complex organ in the body, so we're going to have to know a lot about it," Thies said. "But the fact is that, right now, there are a tremendous number of potential new agents out there."

"We have so many potential pathways, and some of them are going to get us through to the other side," Thies said. "To me, that's the biggest reason for enthusiasm."

More information

For more on the potential causes of the disease, head to the Alzheimer's Association.


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Wives of Smokers Run Risk of Stroke

 

Reuters Health

Thursday, February 24, 2005

NEW YORK (Reuters Health) - Smoking by husbands is associated with an increased occurrence of stroke among their non-smoking wives, according to a new study.

"Growing evidence suggests that exposure to environmental tobacco smoke may have deleterious cardiovascular effects," Dr. Xiao Ou Shu, of Vanderbilt University, Nashville, Tennessee, and colleagues write in the American Journal of Epidemiology. "Few studies have investigated environmental tobacco smoke exposure in relation to stroke."

The researchers looked into husbands' smoking status and the prevalence of stroke among Chinese women non-smokers in Shanghai. The team notes that two thirds of men, but few women, in the region smoke.

Included in the analysis were 60,377 women between the ages of 40 and 70 years. In-person interviews were conducted in order to obtain data on husbands' smoking status and history of physician-diagnosed stroke.

The survey showed that 32,287 women (54 percent) were living with a husband who was a current smoker. A total of 5108 (9 percent) were living with a husband who was a former smoker. Overall, 526 cases of stroke were reported.

Analysis showed that women living with a current smoker had a 47 percent higher risk of stroke compared to women married to a never-smoker. The risk was not significantly higher among women married to a former smoker.

"The odds of stroke increased with increasing number of cigarettes the husbands smoked per day," Shu and colleagues write. Compared with women whose husbands had never smoked, those whose husbands were current smokers had a 28 percent to 62 percent increased risk of having a stroke, depending on how much the husband smoked.

The odds of stroke also increased with increasing duration of husbands' smoking, according to the team.

"Education about the health consequences of tobacco use and exposure to environmental tobacco smoke is urgently needed in China, a country with more than 300 million smokers," they conclude.

Source: American Journal of Epidemiology, February 1, 2005.

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Repeat Tests Help Spot Newborn Hearing Loss

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDayNews) -- Repeat testing of newborns within 10 days of delivery may be the best way to catch hard-to-spot hearing difficulties and to rule out false diagnoses, according to a new study.

Right now, many states require only one such test, conducted four hours after birth.

"It's vital to re-screen newborns shortly after birth, then again after 24 hours," Dr. Angela Shoup, assistant professor of otolaryngology-head and neck surgery, and leader of UT Southwestern's communicative and vestibular disorders program, said in a prepared statement.

"Newborns may not pass the initial hearing screening for a variety of reasons, including debris," the researcher explained. "Debris in the external ear canal and fluid in the middle ear, improperly placed earphones and/or electrodes can prevent them from hearing at full capacity and result in a wrongful referral to an audiologist."

Shoup's team conducted a four-year study involving more than 15,000 newborns. They found that pre-discharge retesting of babies who failed the standard Universal Newborn Hearing Screening (UNHS) -- usually conducted four hours after birth -- reduced the number of false-positive results.

They also found that providing outpatient hearing retesting for babies at the birth hospital increased the number of babies who were brought in for follow-up. That retesting should ideally take place when babies are about 10 days old, they said.

The report appears in a recent issue of the Journal of Pediatrics.

More information

The American Speech-Language-Hearing Association has more about hearing screening.

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US Poll Backs Bigger Gov't Role on Drug Prices

Reuters

Thursday, February 24, 2005

WASHINGTON (Reuters) - Nearly two-thirds of people want the U.S. government more involved in limiting the price of prescription drugs, according to a survey released on Thursday by a nonprofit health research group.

Sixty-five percent of the 1,200 adults polled said they want more government regulation of drug prices, while 14 percent said there was too much regulation.

Forty-six percent said they would back more price regulation even if it might lead to less research and development, as drug makers argue.

The federal Medicare program will implement broad prescription drug coverage starting next January. Medicare officials are forbidden by law from negotiating drug prices with the manufacturers. Other government agencies such as the Defense Department already negotiate prices.

The telephone poll was conducted during the first week of February by the Kaiser Family Foundation, a nonprofit health research organization.

Half of those surveyed reported taking a prescription drug daily.

Despite recent controversies about drug side effects, 77 percent of people polled said they were "very" or "somewhat" confident in the Food and Drug Administration (news - web sites)'s ability to ensure drug safety.

The poll's margin of error was plus or minus 3 percentage points.

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Autism Experts Collaborate to Improve Treatment

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDay News) -- Leading American experts in autism are banding together to form the Autism Treatment Network (ATN), a national, non-profit organization for doctors and medical centers aimed at improving autism treatment.

ATN includes doctors and other health experts from six leading medical centers who will evaluate medical conditions present in autism and provide "best-practice" guidelines for the identification and treatment of these conditions. They will also organize regular conferences and set up regional "centers of excellence" where experts can teach others the latest in state-of-the-art autism care.

"Because of the dramatic rise in autism rates in the United States during the past decade, we have seen increased attention to research and education," ATN co-founder Richard Fade said in a prepared statement. "However, treatment has not received the same focus and investment," he said.

"There are hundreds of thousands of children and families struggling with autism. They face a tremendous challenge, as considerable gaps remain in understanding how best to treat this disorder. This is especially true with regard to medical issues," Fade said. "By establishing collaboration among leading hospitals, ATN will create a better standard of care for autism and help make that care broadly available."

Autism expert Dr. Margaret Bauman, of the Massachusetts General Hospital for Children, agreed. "ATN represents the start of a cooperative venture to study and create new treatments for autism," she said in a prepared statement.

She pointed to the fight against childhood cancers as a model for the new endeavor.

"It took focused leadership to bring together the many individual units studying children's cancers 30 years ago and have them cooperate in studying new treatments. Today there are dramatic improvements in the survival of children with cancers," Baumann said.

"Many people and programs are doing important research on mechanisms of childhood autism, but so far none have developed a strong collaboration among centers focused on treating medical conditions in a similar way that revolutionized the care of childhood cancer," she said.

More information

For more information, check out the organization's website.

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US Worried by Infections in Transfusion Recipients

By Paul Simao

Reuters

Thursday, February 24, 2005  

ATLANTA (Reuters) - Americans who receive blood platelet transfusions are probably at a higher risk than generally believed to contract potentially deadly bacterial infections, according to a report published on Thursday.

Doctors are often unaware of the threat highlighted in the report by the Centers for Disease Control and Prevention (news - web sites) following a survey last year of infectious disease experts and a subsequent investigation into two transfusion-related deaths.

Platelets are irregularly shaped, colorless bodies that are important for blood clotting. Unlike other blood products, platelets must be stored at room temperature, making them vulnerable hosts to bacteria found on human skin and in blood.

Although the nation's blood banks took steps last year to improve their ability to detect and limit contamination of donated platelets, federal officials said the problem continued to affect the industry.

"Now that there is an intervention and screening going on, the rate is probably much less than it was before, but we still think it is significantly underreported," said Dr. Matthew Kuehnert, assistant director for blood safety in the CDC's national center for infectious diseases.

Contaminated platelets cause life-threatening sepsis in an estimated one in every 100,000 transfusion recipients and kill one in 500,000 immediately. Two deaths occurred in Ohio and Utah late last year.

In October, a 74-year-old leukemia patient developed hypotension after receiving a transfusion. He died about three weeks later.

In December, a 79-year-old man recovering from coronary artery bypass surgery came down with shortness of breath, chills, a fever and hypotension an hour after receiving a transfusion. He died 27 hours later.

Cultures had failed to reveal the different types of bacteria found in the men's blood before the transfusions, highlighting a gap between the nationally recognized testing standard and actual practice in blood banks and hospitals.

Testing of donated platelets varies by site and does not always include culture-based tests, which are effective but also time-consuming and costly. Dip sticks and other non-culture tests are fast and cheap, but often unreliable.

Only 36 percent of infectious disease consultants in the United States were aware that platelet contamination was one of the most common infectious risks in transfusion therapy, according to a 2004 survey by the Infectious Diseases Society of America.

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Gene Insight May Improve Child Asthma Care

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDay News) -- Researchers have identified a common genetic profile shared by children who suffer acute asthma attacks.

The finding may help in the development of treatments specifically designed for children with the most severe forms of asthma.

Using hi-tech screens to search through nearly 55,000 genes, researchers at Cincinnati Children's Hospital Medical Center identified two distinct gene expression profiles in children with acute asthma and in those with asthma stabilized by medication.

"We found that children who were having an acute asthma attack had a gene expression profile that was clearly different from those seen in someone with stable (controlled) asthma. The amazing thing was that the gene expression profiles were consistent across patients despite the likely differences with respect to the cause of asthma," senior study author Dr. Gurjit K. Khurana Hershey, director of the Center for Translational Research in Asthma and Allergy at Cincinnati Children's, said in a prepared statement.

"Now that we know what genes are turned on during an asthma attack, we will conduct studies to see if this genetic profile can be used to customize care. The current methods of treatment primarily consist of anti-inflammatory drugs, which may not be optimal for acute attacks," Dr. Hershey said.

The study appears the Feb. 10 issue of the Journal of Allergy and Clinical Immunology.

More information

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

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Kids at Risk for Obesity Need Early Attention

Reuters Health

Thursday, February 24, 2005  

NEW YORK (Reuters Health) - For children, obesity often begins in preschool, suggesting that pediatricians need to act early to prevent and treat excess weight in childhood, new research shows.

Furthermore, referring kids who have already gained too much weight to a pediatric endocrinologist does little to help them shed excess pounds.

These findings suggest that obese children need more than a visit to the doctor in order to lose weight, study author Dr. Teresa Quattrin told Reuters Health.

She explained that most parents of obese children are also obese themselves, and children are very influenced by the adults around them. So, asking a child to change her eating habits without asking her parents to change is very hard on her, Quattrin noted.

"We have to be aware that this problem starts early," said the researcher, based at the Women's and Children's Hospital of Buffalo, in New York. "We have to address it early, and use, if we can, a family approach," she said.

Teaching kids good eating and exercise habits early is essential, she added, since once kids start a routine, it's very hard to break out of it. "Once you are used to eating ice cream three times per week...making a change is very difficult," she said.

In the journal Pediatrics, Quattrin and her colleagues write that obese children are likely to become obese adults, which puts them at risk of numerous diseases related to obesity that are already being seen in children, such as type 2 diabetes.

To determine what can help obese children lose weight, the researchers reviewed the charts of 587 obese children who visited a pediatric endocrinologist, who treats childhood hormone problems.

The medical records showed that 4 out of 5 children became obese before their sixth birthdays, and came to the endocrinologist an average of 4 years after gaining weight.

More than half of children who took blood tests showed high levels of cholesterol and insulin, a sign they were at risk of diabetes. Half of mothers and more than half of fathers were also obese.

Although more than one-third of children lost weight after visiting the endocrinologist, only five lost enough weight that they no longer met the criteria for being obese.

In an interview, Quattrin explained that obese children visit the endocrinologist because there is a "very small probability" that they could have a thyroid problem. In addition, the endocrinologist can counsel the child about obesity, and how to prevent diabetes.

However, the results show that a "one-time thing doesn't make an impact," she said.

She added that asking a "team" to follow obese kids and their families will be "costly," but might save money in the long run by reducing the future costs of treating obesity-related illnesses.

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Spouse Most Likely Source of Elder Abuse

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDay News) -- Elderly people may be at increased risk of abuse if they're cared for by a spouse, especially if the spouse is coping with his or her own physical or mental health problems, according to a new study.

"Caregiving is stressful, and it breaks down the people that are providing the care -- they wear down," Scott Beach, the study lead author and director of research at University of Pittsburgh's Center for Social and Urban Research, said in a prepared statement.

Beach's team surveyed 265 caregivers and elderly recipients of care, and found that caregivers who were married to the person they were looking after were more likely to be abusive than other caregiver family members, such as adult children.

Elderly people being looked after by a spouse were more likely to report that their caregivers screamed or yelled at them, insulted them, used a harsh tone of voice, swore at them, or called them names. Some cases of harsh spousal treatment may be a continuation of previous ongoing marital conflict, Beach noted.

He said their findings suggest that family members and doctors should pay close attention to situations where an elderly person is looking after a spouse. It may also be a good idea to screen the couple and provide intervention if there are signs of trouble, they add.

Older, depressed spousal caregivers might be a particular target for screening and intervention.

"Clinicians should focus not only on treating the depression, but also on providing these caregivers with alternatives that might ease the burden of caregiving, such as support group referral or arranging for other family members, friends, or formal service providers to perform respite care," the study authors wrote.

The study appears in the February issue of the Journal of the American Geriatrics Society.

More information

The U.S. National Institute on Aging offers these caregiving resources.

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Salt Should Be Regulated Food Additive, Group Says

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, February 24, 2005

WASHINGTON (Reuters) - A consumer group sued the federal government Thursday, saying that salt is killing tens of thousands of Americans and that regulators have done too little to control salt in food.

Despite advisories to take it easy on sodium, Americans are now consuming about 4,000 milligrams a day -- nearly double the recommended limit to keep blood pressure under control, the Center for Science in the Public Interest said.

So the CSPI renewed a lawsuit first filed in 1983 to ask federal courts to force the Food and Drug Administration (news - web sites) to declare sodium a food additive instead of categorizing it as "generally recognized as safe." This would give the agency the authority to set limits for salt in foods.

"There is no way the FDA (news - web sites) can look at the science and say with a straight face that salt is 'generally recognized as safe,"' CSPI executive director Michael Jacobson said in a statement.

"In fact, salt is generally recognized as unsafe, because it is a major cause of heart attacks and stroke. The federal government should require food manufacturers to gradually lower their sodium levels."

The CSPI said Americans get most of their salt in processed and restaurant foods. In 1983 the FDA had just begun requiring labels describing sodium content on some packaged foods so the court decided to wait and see how it worked.

The new lawsuit, filed in the United States Court of Appeals (news - web sites) for the District of Columbia, contends that it has not worked well because salt content in foods is higher than ever.

"FDA is currently evaluating CSPI's report on salt, including the recommendations it contains," Kathleen Quinn, a spokeswoman for the agency, said.

The government says Americans should try to keep sodium to about 2,300 milligrams a day. "This is about 1 teaspoon," the American Heart Association (news - web sites) says.

Salt is not found only in the salt shaker. For example, a teaspoon of baking soda contains 1,000 mg of sodium.

Patients with high blood pressure and others at high risk are told to eat even less salt -- 1,500 mg a day. "Nevertheless, sodium intake has increased steadily since the 1970s," the CSPI said in a statement.

"The medical community has reached a consensus that diets high in sodium are a major cause of high blood pressure as well as pre-hypertension, or blood pressure just short of high blood pressure," said Dr. Stephen Havas of the University of Maryland School of Medicine.

"Today roughly 65 million Americans have high blood pressure and another 45 million have pre-hypertension."

The CSPI issued a report saying that processed foods and restaurant fare contribute almost 80 percent of sodium to the U.S. diet. Frozen dinners are especially high in salt, the report finds.

Depending on the brand, some salad dressings contain nearly a quarter of the day's allowance of sodium while others are low in sodium, the report finds.

One chain restaurant's breakfast contains two days' worth of sodium -- 4,460 mg -- the CSPI report said.

Chinese restaurant meals can be especially, high too. "A typical order of General Tso's chicken with rice has 3,150 mg," the group said.

Dr. Claude Lenfant, president of the World Hypertension League and a former head of the National Heart, Lung and Blood Institute supported the report.

"If we could reduce the sodium in processed and restaurant foods by half, we could save about 150,000 lives per year," he said.

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Health Tip: Kids with Arthritis

HealthDayNews

Thursday, February 24, 2005  

(HealthDay News) -- Nearly 300,000 American children have some form of arthritis or rheumatic disease. It's a disease that begs them to sit still, but in the long run not being active is worse and creates more pain. These children need to make exercise part of their daily routine -- like brushing their teeth or doing their homework.

The important thing is to keep moving, whether it's walking the dog or walking to the school bus stop. But before your child starts exercising, he or she needs to remember these tips from the National Arthritis Foundation:

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Carotenoids May Ward Off Prostate Cancer

By David Douglas

Reuters Health

Thursday, February 24, 2005

NEW YORK (Reuters Health) - Dietary lycopene and other carotenoids may protect against prostate cancer, Australian and Chinese researchers report. This is the first time such findings have been reported in an Asian population, investigator Dr. Andy H. Lee told Reuters Health.

The findings confirm those of other studies that have identified lycopene as a protective agent against some types of cancers.

Lee, of Curtin University of Technology, Perth, and colleagues conducted a study in southeast China involving 130 patients with prostate cancer, and a comparison group of 274 cancer-free "controls."

The participants were interviewed about food consumption and a variety of other matters. After factoring in age, total fat and caloric intake, as well as family history, diet appeared to have an influence on the odds of developing prostate cancer.

The risk of prostate cancer declined with increasing consumption of lycopene, alpha-carotene, beta-carotene and other carotenoids the investigators report in the International Journal of Cancer. Consumption of foods including tomatoes, spinach and citrus fruits was also associated with a reduced cancer risk.

The researchers conclude that "carotenoids in vegetables and fruits may be inversely related to prostate carcinogenesis among Chinese men."

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Megavitamins: Too Much of a Good Thing?

By Mark Bloom
HealthDay Reporter

HealthDayNews

Thursday, February 24, 2005

THURSDAY, Feb. 24 (HealthDay News) -- In the world of wellness, loading up on vitamins has been a constant source of controversy.

Mainstream medicine has given antioxidant megavitamins some major tryouts and, so far, the vitamins have failed in the key studies.

Antioxidant vitamin supplements took a real licking last year.

A Johns Hopkins University study of vitamin E suggested that a daily dose of 400 IUs (international units) or more was linked to a 6 percent increased risk of death. In the analysis of 136,000 patients, the risk of death starts to increase at 150 IU, but at 400 IU, the risk of dying from any cause rises about 10 percent.

"People take significant amounts of vitamin E because they have a perception that it will provide some health benefit, and that this will help them live longer. But just the opposite could be the case," said study author Dr. Edgar R. Miller, an associate professor of medicine. There is no recommended dose for vitamin E, although guidelines set a tolerable limit of up to 1,500 IUs per day. Daily intake of vitamin E through foods is 10 IUs, and multivitamin pills usually contain 30 to 60 IUs of vitamin E. So, 400 IUs is a lot.

But it was just another blow to the once-popular concept that extra doses of the antioxidant vitamins -- E, C and beta carotene (a plant pigment called a carotenoid that the body converts into vitamin A) -- would beef up the body's chemical reactions to dangerous free radicals, with health-promoting effects such as preventing lung cancer or heart disease for ex-smokers.

The Hopkins vitamin E study was a re-analysis of the data from 19 vitamin E studies over the past decade. The vitamin-supplement industry immediately attacked the study's methodology. And the study may not stop dedicated believers from taking high doses of vitamin E, much to the chagrin of physicians who have trouble getting patients to take agents with documented efficacy.

And beta carotene? Previously, high doses of beta carotene had been shown to increase the risk for lung cancer and death compared with the risk to those in the controlled trial who got a placebo.

Late in the year, beta carotene got more bad news, at least for women. Six years after a study was halted early because the risky effects of high-dose beta carotene to heart disease and cancer were detected, follow-ups showed that for women, the bad effects lingered. The participants took 30 milligrams a day, about 10 times the amount in a daily multivitamin supplement, combined with 25,000 IUs of retinyl palmitate, a drug also thought to be a cancer fighter.

The study organizers found the increased risk of heart disease and cancer disappeared when the men in the study, all former smokers or those with asbestos exposure, stopped taking the beta carotene supplements. But for women it didn't work. Before the study was halted, the participants who took the supplement had a 28 percent greater incidence of lung cancer and 17 percent more deaths from all causes compared with those who didn't take the beta carotene. In the follow-up, women were 30 percent more likely to develop lung cancer, 40 percent more likely to die of heart disease, and 30 percent more likely to die of all other causes.

This may be because beta carotene and vitamin E are both fat-soluble, allowing any excess to accumulate in fat-cell membranes. This could explain the adverse effects of beta carotene in women, who have more body fat than men. Vitamin C is water-soluble, and any excess leaves the body via urine.

High doses of vitamin C, while not fulfilling the claims of its advocates, have not been shown to be dangerous, although the noted hematologist and strident critic of fad diets, the late Dr. Victor Herbert of the Bronx Veterans Administration, attempted to link supplements of iron or vitamin C, or both, to iron-balance pathology.

More information

To learn more about beta carotene, visit the National Library of Medicine.

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Wednesday, February 23, 2005

 

Drug Cuts Damage, Death from Brain Bleeding

 

By Gene Emery

Reuters

Wednesday, February 23, 2005

BOSTON (Reuters) - A single dose of a drug already used to treat hemophilia can help limit brain damage caused by the deadliest and most debilitating form of stroke, according to results of an international study released on Wednesday.

Chief author Stephan Mayer said he was "stunned" by the finding involving the drug recombinant activated factor VII, which is sold for hemophilia treatment under the brand name NovoSeven by Denmark's Novo Nordisk.

The study, which Novo Nordisk financed, also found the drug posed a "small" risk of causing a heart attack or another type of stroke. Its use as a stroke treatment is still regarded as experimental.

"By preventing just 5 milliliters of additional blood -- about one teaspoon -- of bleeding in the brain, we were able to increase the chances of patient survival by nearly 40 percent," said Mayer, of Columbia University College of Physicians and Surgeons.

Strokes caused when a blood vessel breaks and releases blood into the brain, called acute intracerebral hemorrhage (ICH), are the deadliest. As many as half of those stricken die within a month and only one in five become independent again.

ICH affects 15 percent of all stroke victims in the United States, or some 70,000 cases a year. In other parts of the world the incidence of bleeding stroke is even higher -- in Asia, ICH affects 30 percent of all stroke victims.

The finding "offers new hope for targeted therapy for this frequent cause of neurologic disability and death," said Devin Brown and Lewis Morgenstern in an editorial in this week's edition of The New England Journal of Medicine (news - web sites), where the study appears.

Both Brown and Morgenstern are at the University of Michigan Health System.

According to results of the study, which involved 73 medical centers in 20 countries, more than two-thirds of the 96 patients who got a placebo died or ended up severely disabled. Yet the rate ranged from 49 to 55 percent among the 303 who got one of three varying doses of the drug.

The death rate after three months was 18 percent for the stroke patients who were given the hemophilia drug, and 29 percent among those who were not.

Unfortunately, a drug that encourages clotting also carries a risk of a heart attack or another type of stroke, where blood flowing through the brain is blocked.

The Mayer team found that while 2 percent of the patients given a placebo developed a serious heart attack or blocked blood vessel in the brain, the rate was 7 percent among those treated with the hemophilia drug.

However, the researchers characterized that risk as "small."

The Mayer team also found that the timing of the treatment seemed important.

"The best results were seen when patients were treated within three hours after the onset of symptoms," the researchers said.

That suggests that once the damage is done, brain bleeding rapidly diminishes over time, they said.

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Soy Industry Looks for the Next Big Thing

 

By Alicia Chang

Associated Press Writer

The Associated Press

Wednesday, February 23, 2005  

Soy milk, once a staple found only in natural and health food stores, is now sold side-by-side with regular milk in chain supermarkets. Soy's move into the mainstream has led to vigorous sales of such products in recent years. But those in the industry are worried about a sales slowdown and are hungry for the next new soy thing.

Will it be a more appetizing meat substitute, one that marinates easily and has a meatlike, veiny texture? Or will it be a new, tastier energy bar?

"We need another breakthrough product," said Peter Golbitz, president of Soyatech Inc., a market research firm in Bar Harbor, Maine.

Much of soy's growth occurred between 2001 and 2002, which saw an 18 percent spike in U.S. retail sales compared with just 6 percent from 2003 to 2004, according to a recent report by Mintel International Group, a market research firm.

"Those were unnaturally high growth years," said David Lockwood, a Mintel analyst. "It's slowing down to what is sustainable."

Meanwhile, manufacturers have been pumping out new soy products at a rate of 13 percent a year for the past three years.

Vegans and vegetarians have long depended on soy as an alternative protein source to meat. But in the past few years, a growing number of health-conscious meat-eaters have also relied on soy to supplement their nutrition.

Jane McGinn, a 47-year-old consultant in Bainbridge Island, Wash., is an occasional soy consumer. McGinn eats a mix of soy foods, but one thing she cannot tolerate is soy-based meat alternative because it tastes like "cardboard." Nonetheless, McGinn aims to get 15 percent of her daily protein from soy.

"I choose soy products whenever I can," McGinn said. "It's a clean alternative to meat."

The initial aggressive growth of the soy market is due in part to the shift of sales from niche to mainstream. A change in soy food labeling also helped boost the market.

In 1999, the Food and Drug Administration (news - web sites) allowed food suppliers to advertise soy-based foods as heart-healthy after studies showed that eating soy may help lower the risk of heart disease.

Industry groups such as the Soyfoods Association of North America, a Washington-based nonprofit trade association, want more. They are lobbying the FDA (news - web sites) to consider a health claim that soy protein can help lower the risk of certain types of cancer. The petition is under review.

The low-carb craze, which emphasized meat protein, is partly responsible for the slowdown of soy sales in 2003 and 2004. Unfounded claims about the benefits of soy as an effective estrogen replacement for postmenopausal women also may have led some baby boomers to abandon soy products, market analysts say.

Although the overall soy market is leveling, certain categories such as soy milk and energy bars, which account for more than half of the market when combined, continue to be popular, mainly because of their ability to adapt to mainstream tastes. Soy milk, in particular, has evolved to be lighter in color and taste, similar to cow's milk.

This is not the first time the soy market has experienced a lull. After strong, steady growth in the mid-1980s driven mostly by sales of soy milk, tofu and tempeh, the market flattened out in the early 1990s. But by 1995, a combination of factors, including new meat alternatives, helped propel the market to new heights.

Analysts expect the current soy market to remain steady the next few years. To jump-start it, they say manufacturers need to reach out to occasional consumers with innovative new products.

On the Net:

Mintel International Group: http://www.mintel.com

Soyfoods Association of North America: http://www.soyfoods.org

Soyatech Inc.: http://www.soyatech.com

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Government Paying Ever More Health Costs –Report

 

By Susan Cornwell

Reuters

Wednesday, February 23, 2005

WASHINGTON (Reuters) - Within a decade, the public sector will be paying nearly half the cost of U.S. health care, which is also swallowing an ever-larger chunk of the nation's resources, government economists reported on Wednesday.

The new Medicare drug benefit for seniors -- which has alarmed lawmakers with its rising cost projections -- is contributing to the shift toward more public funding, said the report by the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services (news - web sites).

Overall, health spending is seen hitting a record 18.7 percent of U.S. gross domestic product by 2014, up from 15.4 percent in 2004, according to the annual projection of future U.S. health spending.

The public sector's share of these health care costs will reach 49.4 percent by 2014, up from 45.7 percent in 2004, the report said. This includes spending on Medicare, the government health insurance plan for the elderly, as well as federal, state and local spending on the Medicaid program for the poor.

But experts who spoke at a press conference releasing the report said they did not think it suggested the United States was heading for a system of entirely government-financed care.

"It's unlikely that we are going to move in that direction. Americans seem more comfortable with cobbling together the kinds of health care insurance that we have," said Marilyn Moon, vice president and director of the health program at the American Institutes for Research, a nonprofit behavioral and social science research organization.

However, the experts said public policy-makers had to debate the impact of health care costs on government finances -- a debate that has been joined on Capitol Hill with recent projections that the new Medicare drug benefit will cost the government $724 billion over a decade.

Health care costs appear "destined to grow forever faster than anything else in this economy ... We haven't faced up to it," said Eugene Steurle, a senior fellow at the Urban Institute, a nonpartisan economic and social research group.

While the new Medicare drug benefit adds to the shift toward public sector spending on health, it is anticipated that it will only have a minor impact on overall health spending, the document said.

"The new Medicare benefits are not projected to significantly increase medical cost growth," Mark McClellan, the Centers for Medicare and Medicaid Services administrator, said in a statement with the report.

Some lawmakers have urged Congress to reduce the costs of the Medicare drug benefit law by granting the government power to negotiate drug prices directly with pharmaceutical companies.

Others lawmakers want legislation that would allow Americans to buy cheaper drugs from Canada.

President Bush (news - web sites) has said he would veto any legislation attempting to take away Medicare's drug coverage for seniors.

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Expert: Baby Swings May Trigger Dog Attack

 

By Janet McConnaughey

Associated Press Writer

The Associated Press

Wednesday, February 23, 2005

NEW ORLEANS - Rocking your baby to sleep in a mechanical swing may trigger a deadly attack on the child by the family dog, a coroner warns.

At least two such deaths have been documented in Maryland over a four-year period, Dr. Albert Y. Chu of the state's medical examiner's office said Wednesday at a meeting in New Orleans of the American Academy of Forensic Sciences.

The back-and-forth motion may activate the dog's instinct to chase prey, he said.

"Think about dogs chasing cars or tennis balls. They can't control their behavior — they just go," he said.

In 2003, a 2-week-old boy was dragged from his swing and killed by the family's pit bull in Baltimore after the baby's mother left him to answer the front door. In Edgemere, Md., in 1999, a 3-month-old boy was mauled to death as his parents slept in another room.

An Associated Press check of online news archives found at least one more death — that of an 18-day-old girl in Tampa, Fla., in 2000 after her mother left the room to warm a bottle for her — and at least two non-fatal attacks around the country in the past few years.

In one of those cases, in Summerville, S.C., in 2003, the dog lunged for the baby and bit her in front of the child's mother.

In 2000, Sabrina Williamson of Peru, Ind., had gone to the store while her husband napped in another room, about six feet away from 9-week-old Alex. She walked back in and found her husband wrestling their pit bull off the baby. They had had the dog eight years, since Alex's brother was 4.

"I think it could be a key factor. Our dog had never been mean towards a child before," she said in a telephone interview.

The baby's face was bitten and bloody, and his collarbone was broken and protruding from his shoulder, police said.

Dr. Marianne DiPadua of University Foggia in Italy said she is not convinced that the rocking movement sets off the dog. "It's true movement can trigger an attack," she said. But she noted that dogs have also attacked babies in cribs or beds.

Dr. Jane Sanders, a radiologist and a board member of the humane society in Jackson, Miss., said she planned to pass on the information to the shelter's director. Most dog attacks are by pets that have never been aggressive, she said.

Catherine Mills, a Marshall, N.C., dog trainer with 25 years' experience, and John C. Wright, an animal behiavorist at Mercer University, said pets should be conditioned to ignore baby swings before a baby is put into one.

"Put the swing up, leave it on without a baby in it until the dog or cat totally ignores it," Mills said.

Wright suggested even more extensive "desensitization": Get the dog used to a lifelike crying doll — with a real diaper, if one is available — then the swing, then the two together.

Everyone interviewed agreed on one thing: Do not leave even the most trusted pet alone with a baby.

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Study Shows How Green Tea May Fight Bladder Cancer

 

By Amy Norton

Reuters Health

Wednesday, February 23, 2005

NEW YORK (Reuters Health) - Green tea extract may interfere with a process that helps early bladder cancer to spread throughout the body, new laboratory research suggests.

The findings, say researchers, bolster ongoing studies into green tea extract as a cancer treatment -- and may give green tea drinkers more reason to savor every cup.

The investigators found that when they exposed human bladder cells to both a cancer-causing chemical and green tea extract, the extract interfered with a particular process by which early cancer cells become invasive and spread throughout body tissue.

This process involves the "remodeling" of actin, a structural protein in cells that is essential for cell movement. Actin remodeling allows cancer cells to move and invade nearby healthy tissue.

Based on the new findings, green tea extract may get in the way of this process by activating a protein known as Rho, which helps regulate actin's organization in cells and has been implicated in tumor development and progression.

Dr. JianYu Rao and his colleagues at the University of California Los Angeles report the findings in the journal Clinical Cancer Research.

A number of studies have suggested that green tea and extracts of the beverage may have cancer-preventing abilities, possibly due to the tea's concentration of certain antioxidants -- compounds that help ward off cell damage that can lead to cancer, heart disease and other ills.

But exactly how green tea may act in the body to fight cancer is not clear. Lab research has suggested it can act in several ways -- from hindering tumors from forming their own blood supply to forcing abnormal cells to commit suicide.

The current study points to an entirely new mechanism, Rao told Reuters Health in an interview.

Green tea extract, he explained, appears to diminish cancer cells' invasiveness -- suggesting that it could be used in the early stages of cancer treatment.

One recent study found that green tea extract brought no benefit to men with advanced prostate cancer. But Rao said that any effects of the extract on cancer would probably occur in the early stages.

He and his colleagues are now conducting a clinical trial to see whether green tea extract can reduce the risk of bladder cancer recurrence in patients with a history of smoking, which is a risk factor for the disease.

Uncovering the details of how green tea may stymie cancer could help doctors figure out which patients are likely to benefit from treatment with extracts, Rao said. It may be possible to look for specific markers of actin remodeling and Rho activation in patients' urine to determine who is best suited for such therapy.

It's also possible, Rao said, that drinking green tea could reduce the risk of developing bladder cancer in the first place -- though no one knows how many cups a person would have to sip over a lifetime.

Source: Clinical Cancer Research, February 15, 2005.

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New Clues to Protecting Diabetic Kidneys

 

Reuters Health

Wednesday, February 23, 2005

WEDNESDAY, Feb. 23 (HealthDay News) -- Drugs that block the renin-angiotensin system (RAS blockers) may help protect people with diabetes from kidney damage by improving blood flow to the kidneys, according to two new studies.

RAS blocker medications have long been successful in preventing kidney damage in diabetics, but the exact mechanisms behind that effect have remained unclear.

In the first study, researchers at Medical School Hanover studied the impact of the RAS blocker olmesartan on blood flow patterns and kidney function in 19 diabetics. Another group of 19 diabetics received a placebo. Both groups were treated for 12 weeks.

They found the drug reduced blood pressure and increased the rate of blood flow to the kidneys. This improvement in blood flow was accompanied by a reduction in renovascular resistance, a measurement of resistance to blood flow in the kidneys.

Patients taking the placebo continued to have decreased blood flow to the kidneys and a slight increase in renovascular resistance, the researchers report.

According to the study, diabetics taking olmesartan also displayed reduced signs of oxidative stress -- a buildup of unstable, potentially harmful molecules linked to cardiovascular disease. This lends support to recent research suggesting that oxidative stress may contribute to kidney damage in people with diabetes, the researchers said.

A second study, this time from researchers in Japan, resulted in similar findings.

Researchers at Kagawa Medical University studied the effects of RAS blockers in rats bred to develop diabetes as they mature. Some of the rats were given one or two types of RAS blockers, while other rats received the non-RAS-blocker drug hydralazine. The rats received the drugs while they were juveniles, before they developed diabetes.

Treatment with the RAS blockers did not prevent the rats from developing diabetes at maturity. However, the rats that received the RAS blockers did display less diabetes-related kidney damage than the rats that received hydralazine.

The findings suggest that early treatment with RAS blockers may help reduce long-term risk of kidney damage in people with diabetes. A study is underway to determine if treatment with the RAS blocker olmesartan can reduce kidney disease in people with diabetes.

Both studies appeared in recent issues of the Journal of the American Society of Nephrology.

More information

The National Kidney Foundation has more about diabetes and kidney disease.

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Diabetes Screening Seen to Be Worth the Cost in US

 

By David Douglas

Reuters Health

Wednesday, February 23, 2005

NEW YORK (Reuters Health) - The cost of routinely screening older Americans for type 2 diabetes every three years would be acceptable, researchers report.

"Screening people 45 years of age or older every three years with a blood glucose test is appropriate and affordable," Dr. Susan L. Johnson told Reuters Health. "Ideally, such screening should occur as a part of ongoing medical care."

Johnson, at the University of Michigan Health System, Ann Arbor, and colleagues note in the journal Diabetes Care that the direct and indirect cost of diabetes in the US was estimated to be $132 billion in 2002.

Because of this enormous cost and the relative ease with which type 2 diabetes can be detected before symptoms become obvious, the American Diabetes Association has recommended screening in asymptomatic people of 45 years and older.

"Approximately 5.2 million Americans have undiagnosed diabetes," Johnson added.

To estimate the cost of certain screening strategies for monitoring the US population, the researchers simulated screening subjects from 45 to 74 years of age using random blood glucose measurements at intervals of 1, 2 or 3 years.

The estimated cost of screening depended on the cut-off glucose level used and how often the test was done, the team found. The best compromise, the researchers calculated, was 3-yearly testing, at a cost of about $10 billion over 15 years.

While this may seem like a lot, the cost of detecting one undiagnosed case of diabetes when screening is performed every three years during a regular check-up is only $275, the team says.

Source: Diabetes Care, February 2005.

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Health Tip: Avoiding Kidney Stones  

HealthDayNews

Wednesday, February 23, 2005

(HealthDay News) -- During the past 20 years, the incidence of kidney stones has been increasing in the United States.

Up to 10 percent of men and 5 percent of women will form a stone during their lifetime -- and it's a pain they will never forget.

Kidney stones affect mostly young and middle-aged adults in their 20s to 40s. While they are more common in men, the number of cases of kidney stones in women has been increasing. Once you have had one or two stones, you have an increased chance of developing more.

Some people may have a disease or inherited condition that causes them to keep getting stones. Once your doctor knows the type and cause of your kidney stones, it may be possible to prevent them with medication and changes to your diet. Here are some suggestions from the National Kidney Foundation:

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Clotting Agent Improves Stroke Survival

By Anthony J. Brown, MD

Reuters Health

Wednesday, February 23, 2005

NEW YORK (Reuters Health) - Most strokes occur due to a blockage in the blood vessels that feed the brain, but some arise when these vessels rupture. Now, new research shows that survival from this latter type of bleeding or "hemorrhagic" stroke can be improved by treatment with an active form of factor VII, a clotting agent found in the body.

Treatment with activated factor VII shortly after the onset of hemorrhagic stroke limits the size of the expanding blood clot, which, in turn, improves patient survival and functional outcomes.

"The take-home message for me is that everyone with a (hemorrhagic stroke) should probably get" a clotting agent, Dr. Stephan A. Mayer, from Columbia University in New York, told Reuters Health.

Mayer noted that there was a trend toward more side effects with factor VII than with inactive "placebo" treatment, but said that the benefits of such therapy greatly outweighed the risks.

The study was primarily designed to assess growth of the expanding blood clot, he explained, and "the fact that improvements in survival and functional outcomes were also seen is testimony to the magnitude of these benefits."

The findings, which appear in The New England Journal of Medicine (news - web sites), come from a study of 399 patients who were diagnosed with hemorrhagic stroke by CT scan within 3 hours of onset. The subjects were randomly selected to receive factor VII, at one of three doses, or placebo, beginning within 1 hour of the CT scan.

The average increase in blood clot size for the placebo group was 29 percent. By contrast, the increase in all of the factor VII groups fell below this amount, ranging from 11 percent for the highest-dose group to 16 percent for the lowest-dose group.

The rate of severe disability or death in the placebo group was 69 percent, whereas the rate in the factor VII groups never exceeded 55 percent. The death rate after 90 days in the placebo group was 29 percent, much higher than the 18 percent rate seen in the factor VII groups combined.

Seven percent of factor VII-treated patients experienced clotting-related side effects, such as heart attack, compared with 2 percent of those who received placebo, the investigators point out.

Mayer said his team is currently conducting another trial that hopefully will provide the confirmatory data needed for regulators to approve factor VII as a treatment for hemorrhagic stroke.

In a related editorial, Dr. Devin L. Brown and Dr. Lewis B. Morgenstern, from the University of Michigan in Ann Arbor, comment that "this is a very exciting time in the study of (hemorrhagic stroke). It is possible that we are on the brink of having a successful targeted treatment in factor VII; only time and more investigation will tell."

The study was supported by Novo Nordisk, Denmark, which markets factor VII under the trade name NovoSeven.

Source: The New England Journal of Medicine, February 24, 2005.

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Tea Might Protect Transplanted Livers

HealthDayNews

Wednesday, February 23, 2005

WEDNESDAY, Feb. 23 (HealthDayNews) -- An antioxidant found in green tea may help protect patients recovering from liver transplant, suggests a study in mice.

Restrictions in blood flow, or ischemia, can lead to complications following liver transplantation in humans, particularly if the liver is fatty, as it can be in obese individuals.

But a natural antioxidant found in green tea may protect transplanted organs from ischemia-linked damage, according to researchers at the Medical University of South Carolina, in Charleston.

A previous study found the simple act of rinsing fatty livers in a solution containing green tea extract helped prevent transplant failure.

In their study, the Charleston team gave mice doses of EGCG, the major antioxidant flavonoid found in green tea. They then performed surgeries resulting in ischemia that threatened to injure the rodents' livers.

Mice receiving the green tea derivative showed a 100 percent post-surgery survival rate, compared to a 65 percent survival for animals not receiving the compound. Tissue analysis showed that mice receiving the tea extract experienced less liver cell death and retained a higher percentage of viable tissue.

Further research suggests the green tea extract acts as an antioxidant, protecting fatty livers from injury while reducing liver fat content by about 55 percent.

The findings appear in the March issue of Liver Transplantation.

More information

The National Institutes of Health (news - web sites) have more about liver transplants.

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Too Much Red Meat Bad for Long-Term Health  

By Alison McCook

Reuters Health

Wednesday, February 23, 2005

NEW YORK (Reuters Health) - When it comes to high protein diets and health, the source of the protein really does matter, new research suggests.

After following nearly 30,000 women for 15 years, investigators found that women were more likely to die from heart disease if they often substituted red meat for carbohydrates. In contrast, swapping vegetable sources of protein for carbs appeared to protect women from heart disease.

"Our main finding was that animal compared to vegetable sources of protein seem to have a different effect on dying from heart disease," study author Dr. Linda E. Kelemen from the Mayo Clinic College of Medicine in Rochester, Minnesota told Reuters Health.

For this reason, she recommended that people who want to follow high protein diets should stick with vegetable proteins such as tofu, nuts and peanut butter, or healthier meats like chicken or fish.

With high protein diets a now-popular eating style, few studies have examined their long-term health effects, and whether different sources of protein make a difference, Kelemen and her team write in the American Journal of Epidemiology.

To investigate, the researchers interviewed 29,017 postmenopausal women about their eating and lifestyle habits, then followed them for 15 years, noting who died and of what cause. All of the women were free of cancer, heart disease and diabetes at the beginning of the study.

The investigators found that women who most often ate vegetable protein in place of carbohydrates and animal protein were 30 percent less likely to die of heart disease.

But the more red meat and dairy products women substituted for carbohydrates, the more their risk of heart disease increased.

Overall, opting for protein over carbs had no significant influence on the risk of dying from any cause.

Kelemen explained that it's still unclear why our hearts like vegetable proteins better than animal proteins. It's possible that vegetable proteins contain different building blocks, minerals or antioxidants that are good for our bodies, Kelemen said. Vegetable proteins could also contain substances that affect hormones in healthier ways, she added.

"Protein from different sources seems to have different health effects," she noted. "Long-term adherence to higher protein intakes without distinguishing between the source of the protein may increase the risk of dying from heart disease."

Source: American Journal of Epidemiology, February 2005.

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Tuesday, February 22, 2005

 

Study: Anti-Smoking Campaign Is Helping

 

By Hilary Roxe

Associated Press Writer

The Associated Press

Tuesday, February 22, 2005

WASHINGTON - A nationwide ad campaign funded largely by the tobacco industry has helped cut youth smoking rates, a study by a health journal estimates. But anti-smoking advocates say money for such campaigns is drying up.

The American Legacy Foundation's "truth" campaign prevented about 300,000 youths from becoming smokers between 2000 and 2002, according to a study to be released Wednesday in the March edition of the American Journal of Public Health.

That's about 22 percent of the total decline in youth smoking over the period, the study found.

But the foundation, which operates an independent nationwide campaign against youth smoking, is running low on money at the same time state legislatures cut into the amount they spend on anti-smoking campaigns.

Tobacco companies agreed to pay into a fund that contributes to the "truth" campaign as part of the $206 billion settlement reached with 46 states in 1998. But the agreement allowed companies to stop paying after five years if their market share was below 99 percent.

With small manufacturers gaining a foothold in the market, tobacco giants have likely already made their last payment, said foundation president Cheryl Healton.

The public health journal study looked at surveys of 8th, 10th and 12th graders conducted annually between 1997 and 2002, measured their exposure to the campaign and accounted for factors like race, gender and income to determine the effect of the ads, which often feature teens publicly questioning tobacco companies.

The surveys showed 28 percent of teens smoked in 1997, and just 18 percent did in 2002, and the study credits the campaign with 22 percent of that drop. Researchers found the prevalence of teen smoking was falling before the campaign began, but the rate at which it fell increased dramatically after "truth" ads began.

"These truth campaign ads are the MTV of the public health world. They really get to these kids," said Joseph A. Califano Jr., President Carter's health secretary and chairman of Citizens' Commission to Protect the Truth, a group of former high-level health officials that advocates for programs designed to end youth smoking.

The foundation was not the only group trying to stop kids from lighting up. Some states launched efforts to curb youth smoking in the early 1990s, and others followed suit with their portions of the 1998 settlement.

However, state lawmakers are increasingly cutting into the money available for anti-smoking programs. Programs in Florida and Massachusetts that were once held up as national models saw their budgets slashed in recent years, and Mississippi's governor wants to use $20 million earmarked for an anti-tobacco group on the state Medicaid program.

Youth smoking is at a 28-year low, but campaign organizers said it might not stay that way without countering tobacco companies' consistent messages. In 2002, tobacco companies spent $12.5 billion to promote their products in the United States alone, Healton said.

By contrast, the foundation spent $58.9 million on the "truth" campaign last year, and gave another $37.8 million in grants.

"It's a David versus Goliath alchemy," Healton said. "In view of that, it's amazing we've had any impact."

The tobacco companies also pay for anti-smoking campaigns. Philip Morris USA, for example, has spent more than $600 million on youth smoking prevention efforts since 1998, including grants to schools and other groups that focus on youth development, said company spokeswoman Jennifer Golisch.

Though Golisch said the company has a "long-term commitment" to the effort, anti-smoking advocates said it's not enough to rely on cigarette makers.

"You can't rely on the tobacco industry to do this. They need children and teens to replace their dead and disabled smokers," Califano said. "Children are key to this industry."

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Free Hotline Focuses on Lymphedema  

HealthDayNews

Tuesday, February 22, 2005

TUESDAY, Feb. 22 (HealthDay News) -- Cancer patients and those who care for them can get free information on lymphedema, a painful side effect of cancer treatment, by calling a national toll-free hotline Feb. 25.

The hotline, sponsored by the oncology section of the American Physical Therapy Association (APTA), will run from 9 a.m. to 5 p.m. CST. The toll-free number is 1-877-NEED-A-PT (1-877-633-3278).

Callers can receive up-to-date information on how to minimize the effects of lymphedema, a treatment-related buildup of fluid in tissues that causes swelling, usually in the arms or legs. This chronic and irreversible condition can develop weeks, months or even years after surgery or radiation treatment.

Manual lymphatic drainage, compression bandaging, exercise and other physical therapy treatments can help manage and improve lymphedema, according to a prepared statement from APTA. Organizers stress that the hotline is not meant as a substitute for a visit to a health-care professional.

More information

The National Lymphedema Network has more about lymphedema.

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Bipolar Disorder More Common Among Urban Poor –Study

 

Reuters

Tuesday, February 22, 2005

CHICAGO (Reuters) - Bipolar disorder may often go undiagnosed and untreated in the urban poor, with one in 10 found to have the mental illness in a study of one New York clinic published on Tuesday.

The 13-month study at the clinic serving low-income patients found that few reported being diagnosed or treated for the illness.

Bipolar disorder is normally treated with a mood stabilizer such as lithium as well as anti-depressants to counteract the swings from dark moods to mania and associated irritability, racing thoughts, decreased need for sleep, talkativeness, and excessive involvement in risky activities.

Prescribing anti-depressants alone to bipolar patients can trigger manic behavior and rapid "cycling" between mania and depression that could lead to suicidal thoughts, said study author Amar Das of the New York State Psychiatric Institute and Columbia University.

One earlier study estimated bipolar disorder afflicted 5.7 percent of Americans earning less than $20,000 a year, and the illness is more prevalent among the poor than other income groups, the report published in this week's Journal of the American Medical Association (news - web sites) said.

Of the 112 bipolar patients identified in the study, only nine said they had been diagnosed bipolar and only seven said they had taken a mood-stabilizing drug in the past month.

Since the afflicted patients were more likely to seek treatment when they were depressed, not when manic, nearly half had been diagnosed depressive. That diagnosis risked treatment solely with an anti-depressant.

"To improve the recognition and reduce the morbidity of bipolar disorders in primary care, further efforts are needed by primary care physicians to screen selectively for past hypomania or mania among participants with known depression, anxiety, or substance use conditions," Das wrote.

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Health Tip: The Ins and Outs of Colonoscopy

 

HealthDayNews

Tuesday, February 22, 2005

(HealthDay News) -- Colon cancer is the third-leading cause of cancer death among men and women in the United States. Yet, the American Cancer Society (news - web sites) says too few Americans are getting screened for the disease, even though most doctors say they recommend a colonoscopy to patients over 50.

Here are some basic facts about colonoscopy from the National Digestive Diseases Information Clearinghouse:

Be sure to inform your doctor before the procedure of any medical conditions or medications that you take.

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Study: Diesel Exhaust Blamed for Deaths

 

By Devlin Barrett

Associated Press Writer

The Associated Press

Tuesday, February 22, 2005

WASHINGTON - Emissions from old diesel engines cause more than 20,000 Americans a year to die sooner than they would have otherwise, an environmental group estimated Tuesday.

An industry group criticized the findings as outdated and misleading.

The metropolitan areas with the highest number of early deaths from diesel engines were New York, Los Angeles, and Chicago, according to the Boston-based Clean Air Task Force. The study included the surrounding suburbs, so New York's estimated total of 2,729 deaths included parts of New Jersey and Connecticut.

The states with the most deaths were New York with 2,332, California with 1,784, and Pennsylvania with 1,170, according to the group.

The group said it based its figures on the most recent government emissions data — from 1999 — and from public health studies of the effects of various types of air pollutants.

Conrad Schneider, co-author of the report, said regulations designed to make new diesel engines cleaner don't affect millions of older trucks, buses and construction engines.

"Those are great rules, they will hold new engines to higher standards. ... In the meantime, we're stuck with a legacy of dirty diesel engines," said Schneider, advocacy director for the Clean Air Task Force, a coalition of regional and local groups.

The Environmental Protection Agency (news - web sites) last year required new diesel engines on trucks and buses to cut in half the amount of nitrogen oxides produced. In 2007 emissions are to be cut further.

Since many older diesel engines can run for 30 years, more action is needed by federal, state, and local governments to retrofit existing diesel engines to run more cleanly, the group said.

Retrofits for a typical transit bus can cost about $5,000 to $7,000.

The head of a Washington-based industry group criticized the report's assumptions and conclusions.

"I think they have overstated the risk here using data that's six years old," said Allan Schaeffer, executive director of the Diesel Technology Forum.

Schaeffer said it takes eight modern tractor trailer engines to produce the same amount of pollution generated by one such engine made twelve years ago, and that diesel exhaust comprises just 4.4 percent of fine particle pollution.

"Our industry is getting cleaner faster than most other industries out there," Schaeffer said.

Diesel pollution is blamed for contributing to asthma, respiratory diseases, and heart attacks. The study estimates the risk of health complications from diesel exhaust for people living in cities is three times higher than the risk for those in rural areas.

On the Net:

Clean Air Task Force report: http://www.catf.us/goto/dieselreport

Diesel Technology Forum: http://www.dieselforum.org

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Pot Smoking May Raise Stroke Risk

 

HealthDayNews

Tuesday, February 22, 2005

TUESDAY, Feb. 22 (HealthDayNews) -- Regular marijuana smokers could be putting themselves at risk of a stroke, suggests the case of one cannabis user in Spain.

Doctors in the town of Vizcaya report the case of a 36-year-old primary school teacher who lost his ability to speak and suffered convulsions after smoking a considerable amount of marijuana in combination with three or four drinks. The man had no known risk factors for stroke, only used marijuana occasionally, did not use other drugs, and was a moderate drinker.

A year later, following another period of heavy pot use, the same man again lost his speech and experienced weakness on one side of his body. After another 18 months, the man again drank and used cannabis, and later found himself unable to recognize sounds.

Each time, brain scans revealed signs of bleeding and blood clotting.

"Cannabis is not as safe a drug as many believe," the study authors concluded, adding that "future studies will be to needed to clarify the role of cannabis as a stroke risk factor." They stress that, despite the widespread popularity of marijuana, there have so far been only 15 other reported cases of stroke linked to cannabis use.

The findings appear in current issue of the Journal of Neurology, Neurosurgery and Psychiatry.

In an editorial accompanying the case report, Dr. Dominique Deplanque, of the Department of Pharmacology at the University of Lille, in France, said the findings should prompt health concerns among regular cannabis users, both for recreational and medicinal purposes.

"The therapeutic potential of cannabis and its derivatives should be rigorously evaluated and the benefit to risk ratio taken into account before authorising their medical use," Deplanque wrote.

More information

The National Institute on Drug Abuse has more on marijuana.

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A Little Meat Adds a Lot to Poor Kids' Diets

 

By Alison McCook

Reuters Health

Tuesday, February 22, 2005

NEW YORK (Reuters Health) - Including a few bites of meat in the diets of poor children from developing countries improves both their health and their performance in mental tests, according to reports presented at this year's annual meeting of the American Association for the Advancement of Science (news - web sites).

In one study from rural Kenya, investigators found that children who ate 2 ounces of meat every day, along with their usual lunch of corn and beans, performed better in problem-solving tests than children given supplements of milk or vegetable oils.

This small amount of meat gave children all their daily needs for vitamin B12, 68 percent of all they needed of zinc, and 26 percent of their daily iron requirements, the researchers note.

Dr. Howarth Bouis of the International Food Policy Research Institute in Washington, DC, told Reuters Health that research shows that children who don't get enough iron, zinc and other nutrients have a weakened immune system, along with growth and cognitive impairments.

And when entire generations of children aren't getting enough nutrients, that can have implications nationwide, Bouis added. For instance, the World Bank (news - web sites) estimates that micronutrient deficiencies cost South Asia 5 percent of its GDP (news - web sites) each year, he said. "When you can't work as hard, you can't think as well...it takes away from economic development," Bouis said.

He added that children in developing countries don't get enough nutrients because they can't afford them, so it's up to the government to intervene. For instance, the government could implement programs that increase production of nutrient-rich foods, which drives down the price, Bouis suggested.

He noted that the purpose of the presentation was to help the world recognize the seriousness of the problem. Adding nutrients to kids' diets "would do a lot of good," he said.

As part of the presentation, Bouis -- who also holds a position at the International Center for Tropical Agriculture in Columbia -- discussed the benefits of selectively breeding crops to create strains that are high in iron and other nutrients.

Programs that boost the supply of animal products and nutrient-rich plants become sustainable solutions to nutrition problems in childhood, he reasoned, while giving kids supplements is just a quick fix that constantly needs to be repeated.

During the two-year Kenya study, investigators gave several hundred children a usual lunch of corn and beans, but also added either 2 ounces of meat, milk or the same number of calories in vegetable oil.

They found that children given any supplementary foods gained more weight than other children, and also increased their upper arm muscle mass. Children who ate meat received significantly higher scores on problem solving tests.

Children given either meat or milk also took in significantly more vitamin B12. Indeed, after the study, only 10 percent of children given supplements had B12 deficiencies, while nearly half of untreated children still showed B12 deficiencies, the authors note.

These findings match the results from previous studies from Egypt and Mexico, they note, in which investigators found that dietary changes can make a big difference to children.

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Infection Control Lacking in Many Surgeries

HealthDayNews

Tuesday, February 22, 2005

TUESDAY, Feb. 22 (HealthDayNews) -- Only half of U.S. patients undergoing surgery are properly administered drugs important for the prevention of infection at the site of incision, according to researchers.

Reporting in the February issue of Archives of Surgery, researchers at the Oklahoma Foundation for Medical Quality, in Oklahoma City, reviewed the medical records of more than 34,000 patients from almost 3,000 hospitals across the United States.

They found that slightly less than 56 percent of patients were treated with antimicrobial drugs within one hour prior to incision, as recommended by current surgical guidelines.

In fact, almost 10 percent of patients "received their first dose more than four hours after incision, when little if any benefit would be expected based on these previously published guidelines," lead author Dr. Dale W. Bratzler said in a prepared statement.

His team also found that just over 59 percent of patients received antimicrobial medications for more than 24 hours after surgery, another violation of guidelines. That kind of extended use can promote antimicrobial-resistant bacteria and increase the incidence of antibiotic-associated complications, the researchers warn.

More information

To learn more about a wide range of surgeries, visit the American College of Surgeons.

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When It Comes to Kids' Ear Infections, Hold the Antibiotics

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Tuesday, February 22, 2005

TUESDAY, Feb. 22 (HealthDayNews) -- Your infant is running a fever and has been clingy and inconsolable most of the night. You immediately think "ear infection," and rush to the doctor's office for a prescription for an antibiotic.

At least that used to be the drill. But under new guidelines, pediatricians are more apt to recommend treating the pain but holding off on the amoxicillin. In fact, they may not prescribe an antibiotic at all.

That's a message many pediatricians are sharing during February, Kid's ENT (Ears, Nose, & Throat) Health Month.

The guidelines address the growing public health threat of antibiotic resistance. Because repeated and inappropriate antibiotic use creates "superbugs" -- bacteria that resist even the strongest antibiotics -- medical professionals are being urged to limit the overuse of these drugs.

Many parents seem to appreciate the new approach, according to Dr. Kathi J. Kemper, a professor of pediatrics at Wake Forest University School of Medicine.

"I find that a lot of parents aren't in a hurry to give antibiotics and are reassured by knowing that 80 percent of ear infections are cured by the child alone without any meds," said Kemper, author of the book, The Holistic Pediatrician: A Pediatrician's Comprehensive Guide to Safe and Effective Therapies for the 25 Most Common Ailments of Infants, Children, and Adolescents.

Middle ear infection, known as acute otitis media, is the most common bacterial illness in children and the one most commonly treated with antibiotics, according to the American Academy of Pediatrics (AAP). More than 5 million cases occur annually among kids in the United States, resulting in more than 10 million annual antibiotic prescriptions and about 30 million annual visits to doctors' offices.

This type of infection starts when germs spread to the middle ear, resulting in a build-up of pus or fluid that can cause painful pressure on the eardrum in some children. The infection can be either bacterial or viral, according to the American Medical Association.

Parents should not confuse ear infection with fluid in the middle ear. This chronic condition, called otitis media with effusion, often is picked up in a physical exam of the child because it does not cause discomfort. It has a different set of management guidelines

To treat middle ear infection, the AAP and the American Academy of Family Physicians (news - web sites) guidelines, adopted last year, emphasize pain relief over antibiotics. Parents are given the option, in many cases, to let their kids fight the infection on their own for 48 to 72 hours, and to start antibiotics after that if there is no improvement.

"The whole purpose of these guidelines was to give people a way to intelligently and safely use this option of observing an ear infection," said Dr. Richard M. Rosenfeld, professor and director of pediatric otolaryngology at Long Island College Hospital in New York City. Rosenfeld served as a consultant to the AAP subcommittee that developed the guidelines.

Some health professionals avoid using antibiotics at all, while others favor more liberal use of the drugs. Each position has its downside, explained Rosenfeld. Untreated bacterial ear infections can lead to serious complications, including mastoiditis -- when infection spreads to the mastoid bone of the skull -- and meningitis -- an infection of the brain. On the other hand, treating every ear infection with antibiotics is unnecessary, and every course can make it more difficult to treat future infections in a given child, he said.

Rosenfeld sees room for a middle ground. Under the guidelines, for example, antibiotics are recommended for any child under 2 or who has severe symptoms, he said. These are the kids who benefit the most, he said.

But for a child who is 2 or older with mild symptoms or whose diagnosis is unconfirmed, it's best to watch and wait. The physician may write a prescription for an antibiotic with the stipulation that the parent should observe the child's progress before having it filled.

Parents needn't worry that they are causing their child undo misery. Studies show that antibiotics do not make the kids feel better in the first 24 hours compared with observation, assured Rosenfeld.

For pain relief, all children should be given ibuprofen or acetaminophen, especially in the first 24 hours, the guidelines recommend. Kemper prefers ibuprofen for kids who don't have a contraindication to it, since it lasts longer -- about 8 hours -- so fewer doses are needed each day.

Your pediatrician also may prescribe anesthetic ear drops to reduce pain in the ear. "I know some folks recommend them and there's good data to support them, but as a mother of a former toddler, I just couldn't get excited about holding him down and putting something in the ear," Kemper said. Gentler alternatives include using a hot water bottle swaddled in a towel or an ice bag wrapped in a wash cloth, she said.

For children requiring repeated courses of antibiotics or antibiotic injections to treat ear infections, parents may need to consider having ear tubes implanted in their child to drain liquid from the middle ear, said Rosenfeld, who discusses the regimen in his new book, A Parent's Guide to Ear Tubes.

AAP has not surveyed members to determine whether their prescribing habits have changed. But based on calls to the academy, most pediatricians are complying with the guidelines, a spokeswoman said. Many were cautious about prescribing antibiotics even before the guidelines were released, she added.

So it your child wakes up at 3 a.m. with a suspected ear infection, feel free to reach for the ibuprofen but don't worry about paging your pediatrician in the middle of the night.

"You don't have to panic," Rosenfeld insisted, "but certainly persistent symptoms need attention and clarification by the doctor."

More information

To learn more about the new guidelines for managing ear infections, visit the American Academy of Pediatrics.

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Seniors Raising a Glass to Good Health

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Tuesday, February 22, 2005

TUESDAY, Feb. 22 (HealthDay News) -- While it's natural to cut back on drinking as you age, new research suggests recent generations of older Americans are cutting back just a little less than their parents did.

While the reason for this trend remains unclear, the researchers speculate that better access to health care and improved general health may mean today's 'young old' feel they can get away with a little more drinking than their parents did at the same age.

That doesn't mean today's seniors are out-drinking their children, however. In keeping with age-related trends, older people today still drink much less than young people, the research finds.

"It's normal to cut back on your drinking as you age. And that's probably a wise thing," said study co-author Dr. Alison Moore, a geriatrician and an associate professor of medicine at the University of California at Los Angeles.

Researchers have long known that the people consume less alcohol as they grow older. Possible explanations include illness, as well as slower metabolisms that make it harder for the bodies of older people to process booze.

This new study is unusual, according to Moore, because it examines differences between older people from different generations.

In the study, researchers examined national surveys conducted from 1971-1975 and 1982-1992 involving more than 14,000 Americans. The people surveyed were aged 25 to 74 in the early years of the surveys; in some cases, the initial researchers relied on family members for information when people who took part in the earlier surveys had died or become unable to take part themselves.

The findings appear in the March issue of the American Journal of Public Health.

Males, whites, unmarried people, smokers and the well-educated -- along with the young -- were all more likely to drink than those in other groups, the study found. (The researchers defined drinking as downing at least 12 drinks over a year).

The researchers found that people born in 1925 decreased their drinking by an average of 11 percent with each new decade of adult life. Those born in 1935, by contrast, only reduced their drinking levels by 9 percent each decade.

Why this change? Health definitely plays a role in drinking levels, and illness could explain why some people quit or drink less when they're older, said Dr. Saverio Stranges, a research instructor in social and preventive medicine at the State University of New York at Buffalo's Department of Social and Preventive Medicine.

"I also think the reason why older people in the last generation tend to keep drinking to some extent is because they're more healthy than the older people of previous generations," said Stranges, who's familiar with the findings. In other words, today's healthier 60- and 70-somethings may feel that with better diets and health care, it's safer for them to drink a little more than it has been in the past.

Moore said future research will analyze the role of health in the drinking habits of senior citizens. For now, though, older people should be a little cautious when it comes to overindulging in alcohol, she said. "It could be that drinking will place them at risk for bad things as they age," Moore said.

Stranges pointed out that moderate alcohol consumption has positive effects, but people need to use it wisely. "The way alcohol is consumed can be important: it's good to drink with food and try to split the alcohol use throughout the week rather than just the weekend," he said.

The good news for seniors: Their drinking patterns already tend to fit that pattern, and may not need to change. "Drinking without food or drinking only during the weekend -- these kinds of behaviors are much more frequent among young people," Stranges said.

More information

For tips on spotting and stopping alcoholism, head to stopaddiction.com.

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Monday, February 21, 2005

 

Collagen Defect May Trigger Osteoarthritis

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21(HealthDayNews) -- Arthritis develops five times faster in joints that lack a specific type of collagen.

That's what researchers reported Feb. 20 at the Orthopedic Research Society annual scientific meeting in Washington, D.C.

They believe the discovery -- based so far only on studies in animals -- provides a vital new clue to understanding why more than 20 million Americans develop osteoarthritis, the so-called "wear-and-tear" form of the disease.

Osteoarthritis, the most common form of arthritis, results from the degeneration of joint cartilage and is a leading cause of disability in the United States, according to the American College of Rheumatology. Osteoarthritis can affect most joints, including the neck, lower back, hips, knees and fingers.

In the study, animals who lacked type VI collagen got arthritis five times faster than those who did not lack the collagen. Collagen is a protein found throughout the body in muscle, connective tissue, cartilage and bone, and numerous types of collagen have been identified.

As a result of the study, "we have a much better understanding of the role of type VI collagen'' in cartilage, said lead author Leonidas Alexopoulos, a postdoctoral researcher at the Massachusetts Institute of Technology (news - web sites), who completed the research while a graduate student at Duke University.

Alexopoulos and his colleagues evaluated a narrow region of tissue that surrounds the cartilage cells on the joint's surface, known as the pericellular matrix (PCM). Collagen type VI (as well as other types), along with cartilage cells and the PCM, form a structure called a chondron, which is thought to provide a "buffer zone" between these cartilage cells and the remainder of the cartilage.

The team evaluated three groups of mice: one with normal type VI collagen genes producing normal amounts of the collagen; another group in which researchers had genetically engineered both parents to have the type VI collagen gene knocked out, and a third group in which just one parent had the type VI collagen gene knocked out.

When the mice were 6 months old, the researchers removed their chondrons -- the structures believed to provide a buffer between the cells and the remainder of the cartilage -- to see how they held up.

According to the researchers, 73 percent of the mice whose parents both lacked the type VI collagen gene showed evidence of mild to moderate arthritis, compared to 40 percent of those with one parent lacking the gene, and just 13 percent of the mice with normal type VI collagen production.

The study suggests that type VI collagen serves as a kind of protective scaffold that provides structure and stiffness to the PCM, the researchers said.

Another expert in the relationship between collagen and arthritis, Dr. Roland Moskowitz, called the new research "interesting and exciting."

Moskowitz, a professor of medicine at Case Western Reserve University, in Cleveland, and immediate past president of the Osteoarthritis Research Society International, helped discover a gene mutation involving type II collagen that leads to a form of familial osteoarthritis striking early in adulthood.

Researchers know there are numerous kinds of collagens, but their exact roles and effects on arthritis are not clearly known, Moskowitz and other experts said.

The new discovery that low levels of type VI collagen may help trigger arthritis "may prove to be very important," Moskowitz said. "It may have widespread applications." Down the line, he said, researchers might find an agent that could stimulate type VI collagen in those who produce too little.

"The findings are really interesting and dramatic," said another expert, Dr. Charlene Williams, associate director of research in the division of rheumatology at Thomas Jefferson University, in Philadelphia.

However, "the problem is, we really don't completely understand what type VI collagen does in cartilage," Williams said. Nevertheless, the researchers "do present an excellent model system for the study of osteoarthritis, but there is still a lot of work to be done in order to understand the complete role of type VI collagen," she said.

More information

To learn more about arthritis, visit the American College of Rheumatology.

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Migraine Linked to Increase in Heart Risk Factors

 

Reuters Health

Monday, February 21, 2005

NEW YORK (Reuters Health) - People who suffer from migraines have a higher cardiovascular risk profile than similar people who don't have these debilitating headaches, according to a new report. This is especially true for patients with migraines involving an aura.

Previous reports have linked migraine to an elevated risk of having a stroke. In the present study, Dr. Ann Scher, from the National Institutes of Health (news - web sites) in Bethesda, Maryland, and colleagues examined the possibility that this was because migraine patients have a higher cardiovascular risk profile.

In the study, published in the medical journal Neurology, the risk profiles of 620 patients with migraine were compared with those of 5135 "control" subjects without migraine.

Migraine patients were more likely to be smokers, but less likely to be alcohol drinkers than controls. In addition, a parental history of heart attack at a young age was more common among migraine patients.

Compared with controls, people who experienced migraine with aura were more likely to have unfavorable cholesterol profiles, elevated blood pressure, and to report a history of early onset heart disease or stroke.

In terms of standard risk scores, migraine patients were about twice as likely as controls to be at elevated risk for heart disease, the investigators report.

Thus, they conclude, "further research is warranted to determine why migraineurs have these risk factors more frequently than nonmigraineurs and the nature of the additional mechanism that predisposes these individuals to early-onset cardiovascular disease."

Source: Neurology, February 22, 2005.

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Clue to Controlling Appetite Found

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21 (HealthDayNews) -- For folks who have long wished that losing weight was just a matter of popping a pill, Johns Hopkins scientists report they are one step closer to finding a way to control appetite.

Injecting an enzyme that blocks fatty acid synthase (FAS) into the brains of mice acts on certain brain chemicals and results in decreased appetite, thereby reducing body weight, they report.

"We have been working on this control of food intake," explained lead researcher M. Daniel Lane, a distinguished service professor in the Department of Biological Chemistry. "Five years ago, we found a compound that we call C75 blocks food intake."

It works like this, Lane said: C75 blocks FAS and, when FAS is blocked, the amount of another compound, called malonyl-CoA, increases. That rise in malonyl-CoA suppresses some of the brain chemicals that increase appetite, he explained. In addition, the amount of other chemicals that suppress appetite is also increased.

In this latest study, Lane and his colleagues found C75 works by blocking the production of a compound called ghrelin, an appetite stimulant. Ghrelin is produced in the brain and the stomach, Lane noted.

To test their theory, Lane's team injected ghrelin into the mice. As expected, the ghrelin injection reversed the effect of C75.

"This brings us closer to the site where C75 acts," Lane said. "Now, we have to find out how malonyl-CoA prevents the secretion of ghrelin."

Lane's latest findings appear in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

C75 has not been tested in humans, Lane said. He believes, however, that C75 or a similar compound could be used to reduce appetite. "But that's way out in the future," he said.

"The tantalizing lure of a 'silver bullet' to prevent weight gain and treat obesity propagates irrepressible hope alike among the public at large and scientific researchers alike," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine. "To date, such hopes have consistently been dashed."

Katz added there are reasons to be cautious about any drug for weight control. "Weight gain occurs because of more calories in than out," he said. "The physiologic mechanisms that favor weight gain are diverse, redundant and profound. To turn them off is tantamount to shutting down much that is fundamental to human metabolism. Intuition suggests such an endeavor is fraught with hazard."

Perhaps a C75 derivative will one day be one of the weapons used to combat obesity and its consequences, Katz said. But there's "no need to hold our breath and wait," he added.

"We already own the solution to obesity: increase daily calorie output above daily calorie intake. There will likely never be a medication as supportive of overall good health as the combination of healthful, portion-controlled eating, and regular physical activity," Katz stressed.

More information

The U.S. Department of Agriculture (news - web sites) can tell you more about healthful eating.

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Report Touts Centralized Food Safety Rules

By Larry Margasak

Associated Press Writer

The Associated Press

Monday, February 21, 2005

WASHINGTON - Seven countries that each created a single food safety agency reduced overlapping inspections and focused their efforts on the greatest risks, congressional investigators found in a draft report obtained Monday. Such regulation in the United States is divided among 12 agencies.

The report did not explicitly recommend consolidation of U.S. agencies. But it said that more efficient and better-targeted inspections would outweigh the disadvantages of higher initial costs to acquire buildings and laboratory equipment.

The Government Accountability Office investigators said they could not determine whether consolidation reduced food-borne illness in the seven countries, because too many other factors were involved.

The GAO studied food safety in Canada, Denmark, Germany, Ireland, the Netherlands, New Zealand and the United Kingdom.

In those countries, the report said, "Improvements include less overlap in inspections, greater clarity in responsibilities and more consistent or timely enforcement of food safety laws and regulations."

Last March, the same congressional agency said mad cow disease and the potential for terrorist attacks on the food supply demonstrate the need for a single federal food safety agency.

The GAO said the U.S. patchwork system isn't up to the job of protecting against the new threats. Former Health and Human Services (news - web sites) Secretary Tommy Thompson said late last year that he worries "every single night" about a possible terror attack on the food supply.

Despite dramatic increases in inspections of food imports, only "a very minute amount" of food is tested at ports and airports, Thompson said.

Sen. Dick Durbin, D-Ill., one of the senators who asked for the study, is sponsoring legislation that would create a single, independent U.S. food safety agency to handle inspections, enforcement and establishment of standards. Most food safety officials are at the Food and Drug Administration (news - web sites) and the Department of Agriculture.

Durbin said the report is further evidence that a "single food safety agency is the single best way to protect families from food-related illness or attack. One agency with clear and independent authority will ensure that food safety is driven by science not politics," Durbin said.

On the Net:

Government Accountability Office: http://www.gao.gov

Food and Drug Administration: http://www.fda.gov

Department of Agriculture: http://www.usda.gov

Health and Human Services Department: http://www.hhs.gov

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Waist Circumference Predicts Heart Disease Risk

Reuters Health

Monday, February 21, 2005

NEW YORK (Reuters Health) - The circumference of your waist correlates more closely with several known risk factors for heart disease than does your body mass index (BMI) -- the measure of weight in relation to height -- according to a report in the American Journal of Clinical Nutrition (news - web sites).

The findings are based on an analysis of data from 10,969 subjects who participated in the third National Health and Nutrition Examination Survey from 1998 to 1994.

Dr. Shankuan Zhu, from the Medical College of Wisconsin in Milwaukee, and colleagues found that waist circumference was more strongly tied to cholesterol levels, blood pressure, and blood glucose levels than was BMI.

Among men, the circumferences that were equivalent in terms of cardiovascular risk to being overweight or obese were highest for whites, lowest for blacks, and intermediate for Mexican Americans. By contrast, the waist measurement cutoffs among women varied little by ethnicity.

Combining the data from the three ethnic groups, waist measurements of 89 and 101 centimeters (35 and 40 inches) in men conferred a cardiovascular risk comparable to BMIs of 25 (overweight) and 30 (obese).

The waistlines with the corresponding risks for women were 83 and 94 cm (about 33 and 37 ins).

"The present study reports waist circumference cutoffs that correspond to well-established BMI cutoffs, recommended by the World Health Organization (news - web sites) and the National Institutes of Health (news - web sites) for overweight and obesity, in their association with cardiovascular disease risk factors," the researchers conclude.

"Our findings indicate that waist circumference is a better indicator of cardiovascular disease risk than is BMI across three race-ethnicity groups."

Source: American Journal of Clinical Nutrition, February 2005.

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CDC Seeks Earlier Detection of Autism

By Daniel Yee

Associated Press Writer

The Associated Press

Monday, February 21, 2005

ATLANTA - Because half of all children with autism or similar developmental disorders aren't diagnosed until age 4 to 6, the Centers for Disease Control and Prevention (news - web sites) on Monday was launching a campaign to make doctors and parents aware of the need of early diagnosis. Children can be diagnosed as early as 18 months old.

The CDC is working to fill doctors' offices around the country with posters and checklists that describe developmental milestones for each age. The agency also created for parents a height chart with similar information.

The health agency places autism in a category called autism spectrum disorders. People with such disorders may have problems with social, emotional and communication skills. The disorders can begin in early childhood and last throughout life.

For example, the CDC's information for parents says a 2-year-old should be able to point to an object when named, use two- to four-word phrases and follow simple instructions. A 3-year-old can imitate adults and playmates, play make-believe with dolls and use pronouns or plural words.

"It's important for families and providers — if a child has a developmental concern, early intervention really can have a positive impact," said Catherine Rice, a behavioral scientist with the federal health agency. "It doesn't necessarily cure or clean up the issue, but it can help the child to a higher level" of learning and living.

About 24,000 of the 4 million children born each year eventually will be diagnosed with autism or other developmental disorders. The agency estimated that up to half a million Americans under age 21 have an autism spectrum disorder, the CDC said.

The agency says it's a pressing issue because more children than ever before fall into the category of autism or autism-related disorders, primarily because medical officials and the government widened the definition of autism in the early 1990s.

CDC officials want to make sure parents and doctors know what to look for. If parents or doctors think there could be a developmental problem in a child, they should contact a developmental pediatrician, a specialist or a local early intervention agency, the CDC said.

"It's become more clear in the case of autism that it really is an urgent public health concern — before we used to think of it as a pretty low public health disorder; it's much more common than we previously thought," Rice said.

The early detection campaign will help educate doctors about when to diagnose the condition. Doctors know a lot about autism but many times it's not recognized until later, said Joe Guzzardo, spokesman for the National Alliance for Autism Research.

Tiffany Fleming knew something was wrong with her son, Connor, when he was just 6 months old. He would let loose bloodcurdling screams with enough emotion and intensity that he would turn purple and shake.

Connor's screaming continued. The Duluth, Ga., boy earned the title of one of the "Top 10" screamers at his doctor's office. Other strange behavior developed — he would repeatedly open and close drawers and it seemed like he didn't know how to play.

At age 2, Connor was diagnosed with a form of autism. After therapy and a special diet, "he started learning how to be a kid," Fleming said.

"It was like his brain was able to be rewired," said Fleming about her son, now 6. "If he hadn't been diagnosed and we hadn't started with early intervention, I can't imagine what he'd be like today — so much happens early."

In Duluth, Connor now attends preschool and Fleming said her family and doctors are happy they "were able to stop a lot of stuff before it manifested."

"He's very social, very cute, and has lots of friends," she added. "His biggest trouble is he wants things his way ... he has some extra anxieties but just overall, he's just an amazing, sweet kid. He's still a work in progress, but aren't we all?"

On the Net:

CDC autism campaign: http://www.cdc.gov/actearly

National Alliance for Autism Research: http://www.naar.org

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Heart Attack Care May Be Worse for Women

Reuters Health

Monday, February 21, 2005

NEW YORK (Reuters Health) - Previous reports have found that although women are less likely to experience a heart attack than men, they are more likely to die afterward. Now, Scottish researchers suggest that this may be because women receive inferior care.

Our results "support the view that if women have access to the same quality of care as men then survival will be the same," senior author Dr. Christopher G. Isles, from the Dumfries and Galloway Royal Infirmary, and colleagues note.

The findings, which appear in the medical journal Heart, are based on a study of 966 men and 597 women who were admitted with a first heart attack to a hospital in Scotland between 1994 and 2000.

During a follow-up period of about 3 years, 41 percent of men and 51 percent of women died. Although the initial analysis showed a heightened death risk for women, this disappeared after accounting for other factors, such as age, smoking, and additional diseases.

Further analysis showed that women were more likely than men to be treated with cholesterol-lowering drugs, such as Zocor and Lipitor (news - web sites), but less likely to receive beta-blockers, such as Lopressor and Inderal, used to treat high blood pressure, angina and other cardiac conditions. In contrast, men and women were equally likely to be treated with clot-busting drugs.

Based on these findings, the researchers note that "it is tempting to speculate" that the survival differences reported in other studies may reflect sex bias in the way patients are treated, as well as in other factors such as age.

Source: Heart, March 2005.

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Steroids Risky Treatment for Brain Injury

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21 (HealthDay News) -- Steroid medications commonly used to reduce inflammation caused by traumatic head injuries may actually boost the risk of death, a new report suggests.

British researchers evaluated the results of more than 10,000 patients with brain injury. They found that those treated with corticosteroids after traumatic head injury were more likely to die from the injury than those who did not take the drugs.

Among those who received steroid treatment, 21 percent -- or 1,052 of the 4,985 patients treated -- died, the authors reported, compared to 18 percent who received a placebo.

"There is a 3 percent absolute increase in the risk of death such that 21 percent of patients die with steroids and 18 percent die without," said lead researcher Dr. Ian Roberts, a professor of epidemiology at the London School of Hygiene & Tropical Medicine.

Corticosteroids are hormones used to treat inflammation, whether it results from asthma or joint injury or other conditions.

Roberts and his colleagues looked at 17 studies on steroid use. They noted that corticosteroid use is widespread after serious brain injury. An estimated 1.4 million Americans suffer traumatic brain injuries each year, according to the U.S. Centers for Disease Control and Prevention (news - web sites), and 50,000 die from the injuries.

The report appears in the current issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

While it's not certain why corticosteroids may boost death risk, some experts have suggested the drugs may somehow interfere with the function of the adrenal glands. They are located on top of the kidneys and produce hormones such as cortisone, cortisol and adrenalin.

Dr. Wally Ghurabi, medical director of the emergency center at Santa Monica-UCLA Medical Center, called the new study "an eye-opener."

At his institution, he said, "we use very little" corticosteroids for head injury patients. And, he noted, when they are used, the corticosteroids are given in small doses, a fraction of what was used in some of the studies reviewed. "I question the use of megadoses," Ghurabi said.

Roberts said the study would inevitably change the way physicians think about and treat head injury.

Each year, about 1.1 million of the 1.4 million Americans who suffer a traumatic brain injury -- such as a concussion -- are treated at hospitals and released, according to the CDC. Falls are the leading cause of these brain injuries, but car accidents are another cause.

More information

To learn more about head injury, visit the National Institute of Neurological Disorders and Stroke.

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Environmental Change May Be Boosting Diseases – UN

By C. Bryson Hull

Reuters

Monday, February 21, 2005

NAIROBI (Reuters) - Environmental changes wrought by population movement, destruction of habitats and other factors may be behind a resurgence of infectious diseases, a United Nations (news - web sites) study says.

A rise in cases of diseases such as malaria and dengue fever, and the recent crossover to humans of others such as the Nipah virus, are linked to a host of changes that create more favorable conditions for their spread, according to a report by the U.N. Environmental Programme (UNEP) issued on Monday.

Deforestation, unplanned urban sprawl, poor waste management, pollution, building of roads and dams and rising temperatures are among the aggravating factors.

Infectious diseases cause about 15 million deaths annually, or about a quarter of all fatalities, UNEP says. In Southeast Asia and Africa, they account for two-thirds of all deaths, with the majority of them children and young adults.

The environmental roots of the rise in infectious diseases is one of the "emerging challenges" listed in UNEP's annual Global Environmental Outlook.

"What is good for the environment is good for health, and what is good for health is good for development," UNEP health and environment expert Hiremagalur Gopalan told a news conference.

The often fatal Nipah virus, normally found in Asian fruit bats, is believed to have crossed over to humans as the bats lost their habitats through forest fires in Sumatra and the clearance of land for palm plantations.

As the bats searched for fruit, they were brought into contact with pigs, which in turn passed the disease to their human handlers in the late 1990s, the report says.

Dengue fever, which was present in only nine countries in the 1970s, is now found in more than 100, most likely the result of increasing urban populations, the report says.

Since much urban growth occurs without planned sanitation, water treatment and sewerage, increased exposure to mosquitoes, rodents and other vermin provides more opportunities for diseases such as malaria, dengue, tuberculosis and hantavirus.

Mining, the damming of rivers and increased irrigation for agriculture also give mosquitoes more standing water in which to breed, the report says.

In the United States, cases of the tick-borne Lyme disease in New York and Connecticut have surged as humans have moved into forested areas where the deer that carry the ticks thrive, the report says.

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Wine Divine For Women's Hearts

 

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21 (HealthDay News) -- Wine, but not beer or spirits, helps women's hearts keep a healthy beat, according to a Swedish study.

The study involved 102 women under age 75 who had survived a heart attack or heart surgery for blocked arteries. The women were asked to record their alcohol intake, and one year later researchers tracked each woman's heart rate variability (HRV) on 24-hour electrocardiogram.

HRV measures changes in time intervals between heart beats. According to researchers at the Karolinska Institute in Stockholm, decreased HRV is linked with an increased risk of heart disease and death.

Their study found that HRV was highest in women who drank moderate amounts of alcohol daily (more than half a drink per day), and lowest in those who drank no alcohol.

Further analysis of the data revealed that the type of alcohol consumed by the women was an important factor, however.

Heart rate variability was highest among the women who drank wine, while beer and spirits had little effect. This finding may help explain why moderate amounts of wine may be good for the heart, the study authors said.

The findings appear in the latest issue of Heart.

More information

The American Heart Association (news - web sites) has more about alcohol, wine and cardiovascular disease.

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Many Post-Heart Attack Workers Have Psychologic Symptoms

 

Reuters Health

Monday, February 21, 2005

NEW YORK (Reuters Health) - Men and women who are fit enough to return to work within a year after a heart attack may experience ongoing psychologic distress, new study findings suggest. In comparison to other workers, these heart attack survivors have more symptoms of depression and anxiety.

"The results of the study show that the psychologic health of post-(heart attack) workers remains significantly below levels observed in other workers," study author Dr. Chantal Brisson of the Universite Laval in Quebec, Canada, and her colleagues write in the current issue of Psychosomatic Medicine.

"Psychologic distress increases the risk of recurrence and mortality," the researchers note.

Research suggests that about 50 percent of men and women experience high levels of psychologic distress after heart attack, but such distress is known to decrease in the following months. Whether this is true among the fittest heart attack patients -- those who return to work soon afterwards -- is unknown.

To investigate, Brisson and her team studied 990 men and women, no more than 60 years of age, who returned to work about four months after experiencing a heart attack. All of the study participants were interviewed within four weeks after returning to work. For comparison, the study also included 8,829 workers who had not experienced heart attack.

The researchers found that the heart attack patients scored higher on a measure of the presence and intensity of depressive symptoms, anxiety, mental disturbances and anger, than did those from the general working population.

Within the study group, however, women had higher psychiatric scores than did men, the authors report.

For example, women scored an average 32.9 in depressive symptoms, whereas men scored an average 19.9. Depression scores among the comparison group were 15.9 for women and 12.1 for men. Similarly, women who returned to work after having had a heart attack scored 45.6 in a measure of their anxiety, while men scored 32.6. Their female and male counterparts who had not experienced heart attack scored 26.6 and 23.1, respectively.

Overall, the researchers found that slightly more than half of women and nearly a third of men in the study group experienced psychologic distress upon returning to work after experiencing a heart attack. Among those in the comparison group, less than a quarter of women and about a fifth of men had similar symptoms.

In light of the findings, "further research is needed to shed light on prognosis in post-(heart attack) workers experiencing psychologic distress and on adequate intervention before and after their return to work," the authors conclude.

Source: Psychosomatic Medicine, January/February 2005.

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Targeted Messages Spur Healthy Eating in Young

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21 (HealthDay News) -- 'Eat your fruits and vegetables:' Most Americans know that's good advice, but are the nation's college-age adults listening?

According to nutrition researchers, the answer is 'yes' -- if that message is delivered in the right way and tailored to meet young people's particular needs and lifestyles.

"Even though young adults are incredibly busy, they still want to know what they can do to improve their health," University of Wisconsin-Madison nutritional scientist Susan Nitzke said in a prepared statement.

She spoke Feb. 20 at the annual meeting of the American Association for the Advancement of Science (news - web sites) annual meeting in Washington, D.C.

Nitzke was lead investigator of an multi-state study designed to increase fruit and vegetable consumption among economically disadvantaged young adults.

She believes that, ideally, nutritional information for young adults should be brief, practical and tailored to each individual's specific interests. For example, a person who hasn't thought much about healthy eating may require basic information about good nutrition. But someone who already understands the importance of good nutrition may prefer quick and easy recipes that use fresh fruits and vegetables.

Over a period of two years, the Wisconsin team conducted three rounds of interviews with more than 1,200 low-income adults, aged 18 to 24. In between those interviews, some of the study volunteers also received phone calls and materials tailored to their individual level of readiness to make changes in their diet. Other participants received only a standard, one-size-fits-all pamphlet on nutrition.

"The participants who received the tailored intervention progressed in their ability to eat five or more servings of fruit and vegetables a day, while no such progress was made in the group that got only standard information," Nitzke reported.

"People who don't eat many fruits or vegetables often cite reasons like inconvenience and a lack of knowledge about how to use fresh ingredients," she said, adding that "it becomes particularly difficult for economically disadvantaged individuals because of the perception that fresh fruits and vegetables are expensive."

More information

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

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Picture Phones May Make a Doctor's House Calls

Reuters

Monday, February 21, 2005

CHICAGO (Reuters) - Next up for cell phones with built-in digital cameras: making house calls for doctors.

Researchers in Switzerland reported on Monday the devices could be used to help diagnose and suggest treatment for some serious wounds in patients in remote locations far removed from a physician.

The report from University Hospital of Geneva looked at leg ulcers in 52 patients that were examined both in person and remotely by doctors in a nearby room who had only pictures of the same wounds taken by a first-generation camera phone.

They found remarkably high agreement between doctors who looked at the wound in person and those who saw the image.

If visiting nurses in remote locations can send such pictures in for consultation, "the transport of the patient ... to the hospital or the physician's office could be replaced, and this approach could potentially save the health care system money," the report said.

To assess the project, researchers used a statistical analysis that measures agreement when two groups rate the same object. The value ranged from one to zero, where one is perfect agreement and zero is no agreement. The wound study found the level of agreement between the remote and face-to-face evaluations "was very good, with values of up to 0.94," the study said.

The report was published in the February issue of the Archives of Dermatology (news - web sites).

"We were able to show for the first time that telemedicine for chronic wounds is feasible under routine conditions using this new generation of mobile telephones and direct transfer via e-mail," the authors said.

"We had the impression that a high percentage of the problems related to leg ulcers could be solved with this type of teleconsultation," they added.

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ERs Underdiagnosing Psychiatric Illness

 

HealthDayNews

Monday, February 21, 2005

MONDAY, Feb. 21 (HealthDay News) -- U.S. hospital emergency departments greatly underdiagnose psychiatric disorders, resulting in unnecessary suffering among patients, a new study finds.

Missing these diagnoses "is potentially the most damaging for the more vulnerable minorities and the poor, who rely on emergency departments for much of their primary health-care needs," the researchers wrote in the February issue of the Journal of Consulting and Clinical Psychology.

Investigators from Louisiana State University examined records on more than 33,000 patients at three hospital emergency departments in the South and Midwest United States. Those facilities recorded an overall psychiatric disorder rate among patients of 5.27 percent -- far below the national rate of 20 percent to 28 percent. The researchers believe this points to large numbers of missed diagnoses.

Specific differences between national and emergency department rates include:

"This underdiagnosing contributes to needless emotional suffering because many of the more common disorders, such as depression and anxiety, respond well to psychotherapy and pharmacological interventions," the authors noted.

 

More information

 

The American Psychiatric Association outlines the warning signs of mental illness.

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Snoring May Not Signal Breathing Problems –Study

 

Reuters

Monday, February 21, 2005

CHICAGO (Reuters) - A physical examination of the mouth and throat can't alone identify those whose snoring signals a more serious sleep-breathing problem, researchers said on Monday.

The only sure way to diagnose obstructive sleep apnea

is with an overnight test that monitors a number of things, including airflow through the nose and mouth, snoring, oxygen saturation, certain electrical activity of the brain and body position, according to doctors at Ludwig-Maximilians-University in Munich, Germany.

The condition, afflicting up to 4 percent of the U.S. population, causes repeated interruptions in breathing, leading to daytime sleepiness and other health consequences.

In a study published in the February issue of the Archives of Otolaryngology - Head & Neck Surgery, the German researchers said they looked at 101 patients who complained that they were having snoring problems.

They were examined under one process which included a medical history and a look at anatomy in their nose and throat, and again by overnight sleep tests.

The patients ultimately diagnosed with apnea by the overnight test had readings on the first physical tests that were not significantly different from those did not have apnea, the study found.

"None of the reported medical history and/or anatomical parameters alone or in combination could be used to distinguish patients with (apnea) from snoring patients," the report said.

"In our opinion, all patients seeking treatment for snoring should be screened overnight using a device measuring at least oxygen saturation and airflow," it added.

"If the results are suggestive of (apnea), or if patients complain of excessive daytime sleepiness, standard (overnight tests) should be applied," it concluded.

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Health Tip: Controlling Diabetes

HealthDayNews

Monday, February 21, 2005

(HealthDay News) -- Whether you need to lose weight, gain weight or stay where you are, if you're diabetic, eating the right food can help you manage the disease.

People with diabetes must take extra care to make sure that their diet is balanced with insulin and oral medications, and to exercise to help manage their blood glucose levels, says the American Diabetes Association. Sticking to a meal plan can help you improve your blood glucose, blood pressure and cholesterol numbers, and also help keep your weight on track.

This might sound like a lot of work, but your doctor or dietitian can help you create a meal plan that is best for you, one that fits into your schedule and lifestyle. When you make healthy food choices, you will improve your overall health, and you can even help prevent complications such as heart disease, some cancers, and hypertension.

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Sunday, February 20, 2005

 

Exercise Can Be a Challenge for Diabetics

 

By Mark Johnson

Associated Press Writer

The Associated Press

Sunday, February 20, 2005

ALBANY, N.Y. - During a game in her junior year, Ithaca College field hockey player Sarah Gibble knew something wasn't right.

"I started to feel very out of sorts, almost to the point of getting confused," she said. "Nothing was really working for me. I kept fumbling with the ball."

Gibble, who has type 1 diabetes, left the game and tested her blood sugar level — well below normal. Some juice and a granola bar got her back on the field.

She continued to play through her senior year, dealing with the challenges faced by thousands of athletes with diabetes. While exercise is beneficial for diabetics, helping to stave off complications and control blood sugar, it takes planning and care to participate safely.

Former NBA center Chris Dudley, golfers Scott Verplank and Kelli Kuehne, Olympic swimmer Gary Hall Jr. and Hockey Hall of Famer Bobby Clarke are among a long list of accomplished diabetic athletes.

Around 800,000 people have type 1, or juvenile, diabetes in which the pancreas produces none of the blood-sugar regulating insulin. Type 1 diabetics need to take daily injections or use an insulin pump.

Most of the nation's 18 million diabetics have type 2, or adult-onset diabetes in which insulin is still present, but isn't used properly by the body. Obesity, high cholesterol, high blood pressure, physical inactivity and family history are all risk factors for type 2. Treatments include diet, oral medication and insulin shots.

The most common problem for type 1 diabetics is hypoglycemia, or low blood sugar.

During exercise, the body depletes its stores of sugar, then cuts insulin production to compensate for the lower sugar levels. But in people taking insulin shots or using a pump, that doesn't happen. Instead, hypoglycemia sets in, causing symptoms including dizziness, sweating, confusion and nervousness. Untreated, a person can lose consciousness, become comatose or even die.

Taking too little insulin can cause problems for an athlete too, said Dr. James Desemone, director of the Goodman Diabetes Service at Albany Medical Center. During physical activity, the body releases hormones like adrenaline that counteract insulin. That increases bloodstream levels of glucose and ketones, byproducts formed when fat is burned for energy, which can be dangerous.

Diagnosed with type 1 diabetes 30 years ago, Desemone works with many athletes with diabetes, from hockey players to cyclists.

The key, he says, is setting up a regimen using insulin injections or a pump to mimic the functioning of a normal pancreas during exercise, adjusting how much insulin is given to the body and when. Drinking enough liquids is also important to maintain correct blood sugar levels, he said.

Paula Harper, 61, started the Diabetes Exercise and Sports Association in 1985, a nonprofit group with about 3,000 members in North America and Europe. A longtime runner and nurse who has competed in 35 marathons, Harper was frustrated trying to come up with the right formula to keep her blood sugar level up over long distances.

"When I started, it was all trial-and-error," said Harper, a diabetic since 1972. "And trial-and-error can get you in trouble sometimes."

She recalled races when she ate a Fig Newton every two miles to keep her blood sugar up, and with the help of her husband, pricked her finger every five miles to test it.

A recent National Institutes of Health (news - web sites) study showed that 58 percent of people with pre-diabetes — where blood sugar is elevated but not to the level of type 2 diabetes — staved off type 2 diabetes by exercising moderately 30 minutes a day and by cutting their weight by 5 to 10 percent.

"I so firmly believe exercise is important for everybody, but especially for diabetes," Harper said. Her organization is "trying to help people with type 1 exercise safely and give those with type 2 the motivation to get off the couch."

On the Net:

Diabetes Exercise and Sports Association: http://www.diabetes-exercise.org

American Diabetes Association: http://www.diabetes.org

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New Tool Predicts Benefit of Mammograms

 

By Maggie Fox, Health and Science Correspondent

Reuters

Sunday, February 20, 2005

WASHINGTON (Reuters) - If every woman aged between 50 and 79 got a mammogram every year, it would reduce deaths from breast cancer by 37 percent, according to a new statistical tool described on Sunday.

Screening these women every two years would reduce mortality by 30 percent, Sandra Lee and colleagues at Harvard Medical School (news - web sites) and the Dana Farber Cancer Institute in Boston calculated.

They hope to develop their new program into an Internet Web site that women could visit to calculate their own individual risk of breast cancer and decide when to have mammograms.

"Health policy makers can use this information to come up with public screening (recommendations)," Lee told a news conference at the annual meeting of the American Association for the Advancement of Science (news - web sites).

"An individual woman can use this to decide what is better for her. A 7 percent reduction may not be so big for some women. It may be important for other women."

The American Cancer Society (news - web sites) recommends that women 40 and older have a mammogram every year. The National Cancer Institute (news - web sites) also recommends starting at 40 and having one every one or two years.

But the British National Health Service offers mammograms only after 50 and at three-year intervals, while other European countries often offer them every two years.

It is difficult to compute the benefits of mammograms, said Lee, because it would be unethical to design a study in which half the women were denied mammograms for decades. So she and colleague Marvin Zelen came up with a statistical calculator based on various studies of breast cancer and mammograms.

"It's clear that the more mammograms you give, the more able you are to locate disease that a person didn't know about," Zelen said in a statement.

But more tests can lead to detection of non-cancerous lumps that must be biopsied, costing money and anxiety.

Lee said her model was not meant to provide an absolute guide to whether more screening is better.

"Breast cancer in a woman in her 40s is more aggressive, so it would make sense to have frequent screening," she said -- even though breast cancer is more rare in this age group.

And because breast cancer is more common in women over 50, it could also be argued that frequent screening benefits this group, she said.

There are also more benefits to having mammograms than just saving lives, said Dr. Timothy Rebbeck of the University of Pennsylvania School of Medicine.

"To the degree that you can identify tumors earlier, you can be saving some costs," he told the news conference. Women can have a smaller surgical procedure and perhaps escape the need for chemotherapy and radiation.

About 1.2 million people a year are diagnosed with breast cancer globally and the disease kills 40,000 women and men in the United States every year.

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Screenings Help Check Brain Function

 

By Jamie Stengle

Associated Press Writer

The Associated Press

Sunday, February 20, 2005

DALLAS - Bill Crist was angry and upset when his doctor diagnosed him with dementia.

But the 64-year-old retired pharmacist felt a little better after going to the Center for BrainHealth for an evaluation, which showed his language skills and memory were still quite strong. Crist suffers from a neurodegenerative disorder that is associated with Alzheimer's and Parkinson's disease (news - web sites). He said the follow-up test helped show him which brain functions "look normal."

Such exams are becoming increasingly popular as aging Americans try to differentiate between normal aging problems and the effects of neurological conditions.

The three-hour screenings cost $350 and are not covered by insurance. Many people get tested even when they aren't showing signs of brain problems.

"It's perfectly appropriate if a person has some anxiety — why not go in and have experts assess you?" said Dr. George M. Martin, professor emeritus of pathology at the University of Washington and the scientific director of the American Federation for Aging Research.

The brain center was founded in 1999 as part of the University of Texas at Dallas' School of Behavior and Brain Science.

As word has spread, the number of screenings has gone up sharply, said Jennifer Zientz, head of diagnostic services for the Center for BrainHealth. Last year the center did 160 checkups, compared with about 50 the prior year.

Molly Keebler, the center's head of community programs, even had her 84-year-old mother tested after she noticed her mother stopped doing some things she usually enjoyed, like keeping a journal.

Her mother, Naomi Williams, got a clean bill of health, and some tips on how to stay sharp. She now keeps a notebook in her purse to jot down reminders and has kept up activities such as reading and going to movies.

"The screening made me feel very uplifted," Williams said.

Zientz said the screenings look at how people process complex information. For people like Crist, who already know they have dementia, the screening helps them focus on their mental strengths.

The screening includes several verbal tests, such as interpreting and explaining proverbs. For example, a healthy person could easily interpret "Don't judge a book by its cover." But someone with cognitive problems might say it means you have to read a book to know what's in it.

When problems are found in the screening, the center refers the patient to a doctor.

Slight downward shifts in mental capacity can be a sign of strokes, kidney malfunction, stress or depression, said Dr. Sandra Chapman, the center's director.

"The earlier you detect a glitch in the brain, the more that can be done," she said.

The best candidates for screenings are people who have noticed changes in their memory, said Dr. Randolph Schiffer, chair of the department of neuropsychiatry and behavioral science at Texas Tech University.

Dr. Bill Woodfin, a Dallas neurologist, said the center not only allows people to talk frankly about the challenges of memory loss, but also helps them understand how they can improve their memory.

"I would anticipate more people in my position — physicians, psychologists who see people with these problems — to refer patients more frequently" for such tests, said Woodfin, who referred about six people to the center last year.

On a much simpler level, the exam gives patients and their families some positive news during a difficult time.

Bill Crist's wife, Peggy, said the tests give patients something positive, rather than negative, to focus on.

"I know it sounds hokey, but it's something you need when you get a diagnosis like that," she said.

On the Net:

Center for BrainHealth: www.centerforbrainhealth.org

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Saturday, February 19, 2005

 

Fish Has Health Benefits, and a Few Risks

 

HealthDayNews

Saturday, February 19, 2005

SATURDAY, Feb. 19 (HealthDayNews) -- Adding fish to your diet can help get you in the swim of things when it comes to better cardiovascular health, but experts at the Mayo Clinic also warn there are some contaminants -- most notably mercury -- to watch out for in fish, as well.

Fish is lower in saturated fat, total fat and calories than comparable portions of meat or poultry, the experts note in the February issue of the Mayo Clinic Women's HealthSource. Some species of fish -- such as fatty, coldwater fish including salmon, mackerel and herring -- are high in omega-3 fatty acids. This type of healthy fat, also found in anchovies, sardines and lake trout, appears to help prevent blood clots that can cause heart attacks.

However, fish can also contain toxins such as mercury and other pollutants. For most people, the amount of mercury ingested by eating fish isn't a health concern. But even small amounts of mercury may prove dangerous to developing fetuses, babies and young children, the Mayo authors conclude.

Children under age 5, nursing mothers and women who are pregnant or trying to conceive should avoid fish with the highest mercury levels -- tile fish, swordfish, king mackerel and shark. They should also limit their fish intake to no more than 12 ounces a week of fish and shellfish that contain low levels of mercury, foods such as shrimp, salmon, pollock, canned light tuna and catfish.

Albacore tuna is higher in mercury than canned light tuna, so consumption of albacore tuna should be limited to nor more than six ounces a week, the experts write.

Eating a variety of fish may reduce the potential negative effects of environmental pollutants. Try to avoid farm-raised fish, which tend to have more fat and calories and slightly less protein than wild fish. Farm-fed fish may also contain higher levels of contaminants due to toxins in their feed, according to the experts.

More information

The U.S. Center for Food Safety and Applied Nutrition has more about mercury in fish and shellfish.

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