Personal Health

 

Friday, December 22, 2006

 

Diabetes not linked to Alzheimer's in seniors

 

By Wil Boggs, MD

Reuters Health

Friday, December 22, 2006

For older people with diabetes, the condition does not increase the likelihood that they'll develop Alzheimer's disease, according to a report in the medical journal Neurology. However, diabetes is associated with areas of brain damage called cerebral infarction which can impair mental capacity.

Dr. Zoe Arvanitakis from Rush University Medical Center, Chicago, Illinois and colleagues reviewed autopsy results from 233 older participants in the Religious Orders Study.

The team found just over one third of participants had one or more cerebral infarctions, and patients with diabetes were about 2.5 times more likely than others to have cerebral infarction.

In contrast, the levels of Alzheimer-type damage were similar between subjects with and without diabetes.

"This finding is interesting," Arvanitakis said, "given that several recent large epidemiologic studies have found that diabetes increases risk of clinically-diagnosed Alzheimer's disease by about two-to-three fold."

"Diabetes increases risk of dementia, clinically-diagnosed Alzheimer's disease, and is associated with cognitive impairment and decline in cognition, Arvanitakis pointed out. "Researchers need to better understand mechanisms underlying these relations. This understanding may contribute toward decreasing effects of diabetes on the brain."

Source: Neurology, December 2006.

Health Tip: Keep the Blood Moving in Your Feet

HealthDay News

Friday, December 22, 2006

(HealthDay News) -- The best way to improve blood circulation to your feet is to wear comfortable shoes that fit well, according to the Johns Hopkins University Geriatrics Center.

Here are some tips on buying the right pair of shoes:

Have your feet measured each time you buy new shoes. Foot width may increase with age. The upper part of the shoe should be made of a soft, flexible material to match the shape of your foot. Shoes made from leather can reduce the possibility of skin irritation. Thick soles lessen pressure on hard surfaces. Low-heeled shoes are more comfortable, safer, and less damaging than high-heeled shoes.

 

Thursday, December 21, 2006

 

New chemical gives insight into Alzheimer's

 

By Gene Emery

Reuters

Thursday, December 21, 2006

A chemical designed by doctors in Los Angeles could give unprecedented insight into the ravages of Alzheimer's disease and provide a new way to test for treatments, a study showed on Wednesday.

Previously the only way to determine if a person suffers from the devastating brain ailment has been to remove some brain tissue or with an autopsy.

The new study by doctors at the University of California, Los Angeles, is part of a larger quest to find a better method to diagnose the condition using tracers that can be detected with a positron emission tomography, or PET, scan.

The chemical, known as FDDNP, attaches to the abnormal clumps of proteins called amyloid plaques and tau tangles that develop in Alzheimer's sufferers and inhibit messages being processed by the brain.

In the study to be published in Thursday's New England Journal of Medicine, Gary Small and his colleagues discovered that the chemical allowed doctors to pick out which of 83 volunteers had Alzheimer's, which had mild memory problems, and which were functioning normally for their age.

It was 98 percent accurate in determining the difference between Alzheimer's and mild cognitive impairment.

That was far better than the 87 percent success rate for a PET scan test that measured sugar metabolism in the brain, and the 62 percent accuracy rate when doctors used a magnetic resonance imaging scan to gauge brain deterioration.

"You can see the (telltale FDDNP) signal in people years before they get Alzheimer's," Small said.

His team also found that the distribution of the FDDNP in the brain of Alzheimer's patients matched the pattern seen in people where the diagnosis is confirmed with an autopsy.

"If patients get worse clinically, we see a buildup of the FDDNP binding. That suggests we can track the disease over time," Small said.

Finding an easier way to track brain deterioration not only would help doctors diagnose the disease, it could become easier to assess experimental Alzheimer's treatments, as researchers try to prevent the accumulation of plaques and tangles, or to reduce them if they accumulate.

Small and four of the other 15 authors named in the research paper have a financial interest in FDDNP, which has been licensed to the German conglomerate Siemens AG. He said he hopes to see it on the market within three years.

About 4.5 million people in the United States have Alzheimer's and that number will grow as the population ages. Roughly 15 million to 20 million more have the mild cognitive impairment that often leads to Alzheimer's.

Other researchers trying to track the progress of the disease are looking for telltale signs in spinal fluid or with a FDDNP-like chemical from the University of Pittsburgh known as PIB. But PIB can only find plaques and it disappears from the body 5.5 times faster than FDDNP.

One problem plaguing Alzheimer's tests is that the results are not always clear-cut. For example, some people who seem to have few memory problems can have a positive result on a test.

Study: Teens use medicines to get high

 

By Lara Jakes Jordan

Associated Press Writer

The Associated Press

Thursday, December 21, 2006

Teens increasingly are getting high with legal drugs like painkillers and mood stimulants, and they're turning to cough syrup as well, says a government survey released Thursday.

The annual study by the National Institute on Drug Abuse, conducted by the University of Michigan, showed mixed results in the nation's longtime campaign against teen drug abuse.

It found that while fewer teens overall drank alcohol or used illegal drugs in the last year, a small but growing number were popping prescription painkillers like OxyContin and Vicodin and stimulants like Ritalin.

As many as one in every 14 high school seniors said they used cold medicine "fairly recently" to get high, the study found.

It was the first year that the government tracked the frequency of teens who reported getting high from over-the-counter medicine for coughs and colds.

"It's bad that kids are buying cough syrup and using it this way it's not good for them," said John P. Walters, director of the White House Office of National Drug Control Policy.

The study found about one in 10 high school seniors have abused the painkiller Vicodin and Walters said kids may be pilfering the pills from their parents' medicine cabinets.

"That is one thing you can do take the pills that are no longer being used and throw them away, get rid of them," he said in an interview.

Walters credited public service advertising with a steady decrease in overall teen drug use over the past five years and said the agency would shift some of its 2007 advertising budget toward combating prescription drug abuse.

He challenged the recommendations of an August government audit that said the anti-drug advertising campaign wasn't working and suggested Congress consider reducing its funding. The report by the Government Accountability Office found some children were actually more likely to use marijuana after seeing the ads.

"We're pushing back," Walters told reporters Thursday as he outlined the study results. "What this shows is we're pushing back successfully."

The rise in prescription drug abuse was a troubling conclusion in a study that Walters described as good news overall because of the drop in teen use of alcohol, cigarettes, marijuana and other illicit substances.

An estimated 840,000 fewer teens reported using illegal drugs now compared to five years ago, he said.

The annual study, in its 32nd year, surveyed 50,000 students in the 8th , 10th and 12th grades at more than 400 schools nationwide. It found, that over the last year:

        Illegal drug use at all three grade levels dropped, if only slightly. An estimated 36.5 percent of high school seniors reported using illicit drugs at some point in the year.

        Marijuana remained the single most abused drug among teens, although its use also dropped slightly within all three grades. Nearly 12 percent of 8th graders reported using it, compared to 25 percent of 10th graders and 31 percent of high school seniors.

        One-third of 8th graders said they had consumed alcoholic beverages, compared to more than a half of 10th graders and two-thirds of seniors surveyed. That also was a small decrease among the three grade levels. But the number of 10th and 12th graders who reported getting drunk increased slightly.

Comparatively, the number of teens who got high from medicines and households items instead of illegal drugs was small. They included:

        Nearly 10 percent of high school seniors admitted to using excessive dosages of Vicodin, a slight increase over the last year.

        Nine percent of 8th graders sniffed glue, spray paints, cleaning fluids or other inhalants, down slightly.

        3.6 percent of 10th graders got high off Ritalin, up two-tenths of 1 percent. Ritalin is used normally to combat effects of attention deficit disorder.

That teens are turning to cough syrup to get high is particularly alarming, experts said, because the medicine is cheap and easy to get. Moreover, few people teens and their parents alike recognize the dangers of overdosing on the otherwise safe and legal drugs.

"There is this mistaken belief that intentionally abusing prescription and over-the-counter drugs is somehow safer than abusing street drugs," said Steve Pasierb, president and chief executive of the New York-based Partnership for Drug Free America. "What parents don't realize is that this is about your kids taking six pills with a beer."

The National Institute on Drug Abuse: http://www.nida.nih.gov/NIDAHome.html

White House Office of National Drug Control Policy: http://www.whitehousedrugpolicy.gov/

Partnership for Drug Free America: http://www.drugfree.org/

Sleepy with apnea could signal heart trouble

 

By Megan Rauscher

Reuters Health

Thursday, December 21, 2006

Daytime sleepiness brought on by obstructive sleep apnea (OSA), a condition in which airways become blocked during sleep and breathing frequently stops for brief periods, may go hand in hand with heart problems, a report shows.

In a study of 86 adults with OSA but no other medical conditions aside from high blood pressure, a higher score on a standardized daytime sleepiness scale was independently associated with decreases in cardiac function, the researchers found.

The cardiac function in these patients was "subtly impaired," perhaps contributing to the perception of sleepiness and fatigue," Dr. Joel E. Dimsdale, of the University of California, San Diego noted in a statement accompanying a report of the study in the journal SLEEP.

"OSA is a common sleep disorder characterized by considerable daytime sleepiness and by increased cardiovascular disease," Dimsdale told Reuters Health.

"It has been known for a long time that apnea is associated with increased risk for hypertension (high blood pressure) and increased heart-related death. However the mechanism for this mortality has not been understood," he explained.

"The current study found that OSA patients with more complaints of daytime sleepiness had decreased effectiveness of the heart's pumping action," Dimsdale continued.

"In this sense, the sleepiness that our patients report reflects not just their sleep disruption but also may be a marker for undiagnosed cardiac problems," he warned. The findings highlight the importance of taking sleep disorders seriously, Dimsdale concluded.

Source: Sleep, December 1, 2006.

Prostate Treatment Costs Substantial and Sustained

 

HealthDay News

Thursday, December 21, 2006

THURSDAY, Dec. 21 (HealthDay News) -- The average five-year cumulative cost of prostate cancer management in the United States is $42,570, a new study says.

Publishing in the Feb. 1, 2007, issue of the journal Cancer, University of California, San Francisco, researchers tracked the treatment costs of 4,553 newly diagnosed prostate cancer patients. In the first six months after diagnosis, the mean cost of treatment was $11,495. Individual costs ranged from $2,568 for watchful waiting to $24,204 for external beam radiation.

Treatment choices were influenced by patients' age and disease risk. Older, high-risk patients often required more expensive treatments, such as external beam radiation and androgen deprivation therapy. Younger, lower risk patients often required the less costly prostatectomy, the study said.

After the initial six-month period, subsequent annual costs averaged $7,740 per patient, ranging from $5,843 for those who had watchful waiting to $12,590 for patients who had androgen deprivation therapy.

The overall average per patient cost over 5.5 years was $42,570, ranging from $32,135 for patients with watchful waiting to $69,244 for patients with androgen deprivation therapy.

The findings "demonstrate that prostate-related costs per person are substantial and sustained over time, and that the short-term treatment cost comparisons most commonly found in the literature are not truly reflective of the cost of treatment over the long-term," the study authors concluded.

More information

The American Academy of Family Physicians has more about prostate cancer treatments.

 

Wednesday, December 20, 2006

 

Battling bacteria in gut may influence weight gain

 

Reuters Health

Wednesday, December 20, 2006

Body weight and obesity could be affected not only by what we eat but also by how it is digested in the gut, American scientists said on Wednesday.

They have discovered that levels of two types of good microbes or bacteria in the gut that help to break down foods are different in obese and lean people and mice.

The finding, reported in the science journal Nature, could lead to a better understanding of why some people may be prone to obesity and help find new ways of preventing or treating it.

"Our gut microbial structure should be considered when understanding the elements that might regulate our energy balance and may predispose us to obesity," Jeffrey Gordon, of the Washington University of Medicine in St Louis, Missouri, said in an interview.

"There is something very startling about the amount of fat you have and the structure of your gut microbial community," he added.

There are trillions of bacteria in the gastrointestinal tract, but two groups called the Bacteroidetes and the Firmicutes are the most dominant and their proportion varies in lean and obese mice and humans.

The scientists found that the proportion of Bacteroidetes bacteria is lower in obese mice and people than in lean people.

But when Gordon and his team studied 12 obese people who followed low-calorie diets for a year, they found their levels of Bacteroidetes rose as their weight decreased.

"They increased as the weight is lost and in proportion to the amount of weight loss," said Gordon.

The results suggest that there may be a microbial component to obesity. But scientists do not yet know if people start out with lower levels of Bacteroidetes or Firmicutes, which may make them prone to obesity.

"These are things we are exploring now. What are the signals between the amount of fat and different groups of bacteria that exist in the gut," said Gordon.

Strategies to change the levels of the microbes living in the gut could provide an approach to treating obesity.

Trip to food store a risk factor for Salmonella

 

Reuters Health

Wednesday, December 20, 2006

Exposure to reptiles and being in close proximity to meat and poultry in the supermarket are two modifiable risk factors for Salmonella infection in infants, according to what may be the largest reported study of infant Salmonella infection.

Salmonella is estimated to cause 1.4 million illnesses and 400 deaths each year in the United States. "Rates of Salmonella infection are highest in infants, but little is known about potential sources of infection in this high-risk population," note Dr. Timothy F. Jones of the Tennessee Department of Health in Nashville and colleagues in the journal Pediatrics for December.

They assessed diet and environmental exposures in the 5 days before onset of Salmonella infection in 442 infants from eight states and 928 age-matched controls who did not contract Salmonella.

"Compared with healthy controls, infants with Salmonella infection were less likely to have been breastfed and more likely to have had exposure to reptiles, to have ridden in a shopping cart next to meat or poultry, or to have consumed concentrated liquid infant formula during the 5-day exposure period," they report.

Travel outside the United States was associated with Salmonella infection in infants 3 to 6 months and older than 6 months of age. Attending day care with a child with diarrhea was also associated with infection in infants older than 6 months of age.

"Many of the risk factors identified in this study," write Jones and colleagues, "are potentially modifiable through targeted preventive education and behavioral change among the caretakers of infants."

"Attention should be directed at developing practical and effective measures to prevent Salmonella infection in this high-risk population," they conclude.

Source: Pediatrics December 2006.

Tuesday, December 19, 2006

 

Vitamin D may cut multiple sclerosis risk, study finds

 

By Will Dunham

Reuters

Tuesday, December 19, 2006

People with higher levels of vitamin D have a markedly reduced risk of developing multiple sclerosis (MS), according to a study published on Tuesday that may point to a promising way to protect against the disease.

MS is an incurable and often disabling disease of the central nervous system that appears most often among young adults and affects 2 million people globally.

Researchers at the Harvard School of Public Health in Boston combed a massive repository of serum samples from more than 7 million U.S. military personnel to find 257 people who developed MS.

Their samples were analyzed for vitamin D levels and compared with a group of randomly picked military personnel from the same broad population who did not develop MS.

Among the white people studied, the chances of developing MS fell as vitamin D levels in the body rose, according to findings published in the Journal of the American Medical Association.

Among whites, the majority of those in the study, the risks of MS fell 62 percent for those in the top fifth of vitamin D concentration.

The researchers said this suggested that many cases of MS could be prevented if people raised their vitamin D intake.

"This converges with a body of experimental evidence and other studies that strongly suggest that vitamin D could be truly protective," Alberto Ascherio, associate professor of nutrition and epidemiology at Harvard School of Public Health and the lead researcher, said in a telephone interview.

The relationship between higher vitamin D levels and MS risk was absent in the black and Hispanic people in the study, researchers said, perhaps because so few were involved or both groups had overall lower levels of vitamin D than whites.

Ascherio said more research was needed to nail down whether vitamin D leads to a reduced risk of MS.

'Could Be Enormous'

"If it is true, the implication could be enormous for MS prevention," Ascherio said.

Nicholas LaRocca of the National Multiple Sclerosis Society, an advocacy group that helped fund the study, called the findings promising but said it was premature to recommend that young people take vitamin D supplements to ward off MS.

Vitamin D, a hormone manufactured naturally in the body, promotes the absorption of calcium necessary for developing and maintaining healthy teeth and bones.

Calcium is also important to nerve cells, including the brain, while vitamin D also seems to act as a regulator of the immune system.

The body makes the vitamin after being exposed to sunlight. Not many foods are naturally rich in vitamin D, but it is found in fatty fish such as salmon, and milk commonly is fortified with it.

Vitamin D deficiency can lead to osteoporosis in adults or rickets in children.

In MS, communication between the brain and other parts of the body is disrupted. Many experts believe MS is an autoimmune disease in which the body, through its protective system, attacks its own tissues.

In some people, MS can lead to paralysis.

Brain training can have lasting benefits

 

By Lindsey Tanner

AP Medical Writer

The Associated Press

Tuesday, December 19, 2006

Brief sessions of brain exercise can have long-lasting benefits for elderly people, helping them stay mentally fit for at least five years, one of the most rigorous tests of the "use-it-or-lose-it" theory suggests.

For people age 73 on average, just 10 sessions less time than it takes to stay physically fit helped keep their brains sharp.

The brain training involved hour-long classes and included exercises done on a computer. While it is uncertain if similar results would occur with mental exercise done at home, other research has shown that intellectual tasks such as crossword puzzles and reading can help keep the brain sharp as people grow old.

The study is "the toughest test of these hypotheses to date," said Jeff Elias, chief of cognitive aging at the behavioral science research branch of the National Institute on Aging, which helped pay for the $15 million study.

The study appears in Wednesday's Journal of the American Medical Association. It was led by Sherry Willis, a human-development professor at Penn State University.

Age-related mental decline is expected to affect 84 million people worldwide by 2040, according to an accompanying editorial.

Nearly 3,000 men and women in six cities Baltimore, Birmingham, Ala.; Boston; Detroit; Indianapolis; and State College, Pa. participated in the study. Most were white; about one-fifth were black.

They were randomly assigned to six-week training sessions in either memory, reasoning or speedy mental processing, and were tested before and after. A comparison group received no training but was also tested.

About 700 of the 1,877 people who completed all five years also got short refresher sessions one year and three years after their initial training.

The memory training included organizing a 15-item grocery list into categories like dairy, vegetables and meat to make it easier to remember and locate items.

The reasoning training taught participants how to see patterns in everyday tasks such as bus schedules and taking medicines at different doses and times.

The speed training had participants quickly identify flashing objects on a computer screen. Those are some of the same reaction skills used while driving.

Nearly 90 percent of the speed training group, 74 percent of the reasoning group and 26 percent of the memory group showed almost immediate improvements in scores on tests of the mental functions they were trained in. The improvements in most cases lasted throughout the five years of the study and were most notable in people who got refresher sessions.

The comparison group participants also showed some improvement perhaps just from the stimulation of being tested but it was not as great.

After five years, the participants assessed their ability to perform everyday tasks such as shopping, driving and managing their finances. And the researchers rated the participants in their everyday functioning.

Only the group that received reasoning training reported substantially less decline than the comparison group. And only one group actually performed better, in the researchers' opinion those who got refresher sessions in speed training.

Willis said bigger differences probably were not seen because the participants were all pretty healthy throughout the study.

Sheryl Zimmerman, a University of North Carolina at Chapel Hill researcher on aging, said the study is important even if it doesn't show that mental training is a cure-all.

"The fact that a modest amount of cognitive training had ANY results five years later ... is notable," said Zimmerman, who was not involved in the research.

On the Net:

JAMA: http://jama.ama-assn.org

NIA: http://www.nia.nih.gov

 

Many probiotics may be dead on arrival

 

By Anne Harding

Reuters Health

Tuesday, December 19, 2006

 

Probiotics sold over the counter often don't contain enough live bacteria to be effective, according to a new report from ConsumerLab.com.

"There's a very high chance that you may be buying dead bacteria unless you shop very carefully," Dr. Tod Cooperman, president of ConsumerLab.com, told Reuters Health. "You should also take care once you buy the product so that you don't throw your money out the window."

Probiotics are "good" bacteria that are effective in treating irritable bowel syndrome symptoms and diarrhea due to rotavirus infection, and can also help restore normal gut bacteria among people taking antibiotics. They have become one of the most popular dietary supplements among US consumers, outselling iron, magnesium, garlic and all herbal products, Cooperman noted.

ConsumerLab.com's analysis of 13 brands of probiotics found just 9 contained at least 1 billion viable organisms per dose, the amount considered necessary for effectiveness.

Brands that fell short of the billion mark included DDS Acidophilus; Flora Source; Nature's Secret Ultimate Probiotic 4-Billion; and Rite Aid Acidophilus, Milk Free. Advocare Probiotic Restore did contain the 1 billion minimum, but claimed on its label to pack 30 billion per dose.

The group also tested three probiotics for pets, and found that two didn't contain the recommended amount of viable organisms and one of them was contaminated with mold.

The full list of results is available with a ConsumerLab subscription, but the Web site will begin posting free examples of probiotics that passed inspection in January.

Probiotic products should be stored away from light, moisture and heat in order to preserve the organisms, Cooperman said. "I like to refrigerate them," he added. "That's probably the best thing you can do."

Source: ConsumerLab.com

Immune Cells Predict Lung Cancer Recurrence

 

HealthDay News

Tuesday, December 19, 2006

TUESDAY, Dec. 19 (HealthDay News) -- Patients who've had surgery for early-stage lung cancer are more likely to suffer cancer recurrence if their tumors contain a large number of immune-suppressing T-regulatory cells, a Duke University Medical Center study finds.

T-regulatory cells reduce the action of immune system T-cell lymphocytes that fight cancer. The more T-regulatory cells, the fewer T-cell lymphocytes there are in the tumors of lung cancer patients.

This study of 64 patients found that 50 percent of those with the highest proportion of T-regulatory cells in relation to T-cell lymphocytes suffered recurrence, while patients without any T-regulatory cells did not have recurrence. The findings are published in the current issue of the journal Cancer.

"If further studies prove successful, it may be possible to measure the levels of T-regulatory cells in a lung cancer tumor as a marker to help predict which patients require additional chemotherapy following surgery to help prevent their cancer from recurring," senior investigator Dr. Ned Patz, professor of radiology, pharmacology and cancer biology, said in a prepared statement.

Currently, there is no method to predict cancer recurrence in early-stage lung cancer patients who've had surgery to remove their tumors. Typically, these patients don't receive chemotherapy after surgery because they're considered to be at low risk for recurrence. However, nearly 50 percent of these patients will suffer cancer recurrence, Patz said.

"This finding indicates that it is important to analyze the biology of the tumor cells as well as the tumor's relationship with the immune system. Testing newly diagnosed lung cancer patients for their levels of T-regulatory cells may serve as one important marker for their eventual risk of recurrence," Patz said.

More information

The U.S. National Cancer Institute has more about lung cancer.

Popular supplement doesn't help hot flashes: study

 

By Will Dunham

Reuters

Tuesday, December 19, 2006

The popular herbal dietary supplement black cohosh, often used as an alternative to risky hormone therapy, failed to relieve hot flashes for women going through menopause, a study released on Monday found.

The study, funded by the U.S. National Institutes of Health (NIH), tracked 351 women ages 45 to 55 for a year and found that black cohosh used by itself or together with other herbal supplements was no better than a placebo in relieving hot flashes.

Women receiving menopausal hormone therapy experienced strong relief from hot flashes and night sweats, according to the study in the Annals of Internal Medicine. But research has linked hormone therapy to increased risk of heart attack, stroke and breast cancer.

"I think the findings are disappointing because it would be nice to have a therapy besides hormone therapy that could be used for women, and we don't seem to have it in black cohosh," said Katherine Newton of the Group Health Center for Health Studies in Seattle and the University of Washington, who led the study.

"We went into this study with a very open mind. So we weren't convinced that it worked and we weren't convinced that it didn't work," Newton added in a telephone interview.

Black cohosh, a member of the buttercup family, is a perennial plant native to North America that was used in North American Indian medicine to treat various maladies including gynecological disorders, according to the NIH.

The most common symptoms of menopause are hot flashes -- sudden sensations of intense heat with sweating and flushing -- and night sweats. Black cohosh has gained popularity among women as a remedy for these symptoms.

Five Therapies

Women in the study were given one of five therapies: black cohosh alone; a supplement combining black cohosh with nine other ingredients including alfalfa, licorice, oats, pomegranate and Siberian ginseng; the combined supplement plus diet counseling to increase soy consumption; hormone therapy (estrogen with or without progesterone), or a placebo.

The women had experienced episodes of hot flashes or night sweats at least twice daily entering the study.

Women taking black cohosh alone or with the other ingredients diminished their hot flashes by an insignificant half an episode per day compared to women taking a placebo, the study found. Women on hormone therapy cut their symptoms by about four episodes daily compared to the placebo group.

Newton noted that menopause occurs as part of natural aging, and women should understand that symptoms like hot flashes eventually dissipate.

"In the mean time, the kinds of things that women can do are: dress in layers, drink ice water if they're getting warm, avoid triggers such as alcohol or hot liquids in some women, or spicy foods, carry a fan and sleep in a cool room," Newton said.

Mark Blumenthal, executive director of the American Botanical Council, a nonprofit group that provides information about herbal medicine and is in part funded by industry, faulted the design of the study and said the findings were at odds with existing evidence about black cohosh.

"It is definitely not the last word" on the subject, Blumenthal said of the study.

Health Tip: Symptoms of Scoliosis

 

HealthDay News

Tuesday, December 19, 2006

(HealthDay News) -- Scoliosis is a condition in which the spine is twisted or curved unnaturally, often in a "C" or "S" shape. Typically diagnosed in childhood, the condition sometimes requires surgery or a back brace to help straighten the spine.

Since the unusual shape of the spine is not always visibly noticeable, the Nemours Foundation lists these other common symptoms of scoliosis:

The body tilts to one side. One shoulder blade is higher than the other. An uneven waist. One leg appears shorter than the other.

 

Nutrients may help older people fight flu

 

Reuters Health

Tuesday, December 19, 2006

A nutritional supplement containing antioxidants, minerals and other nutrients can boost immune function in frail older people living in nursing homes, researchers report.

Those who took 240 milliliters (8 ounces) daily of the enriched supplement for 10 weeks had fewer fevers and were less likely to require antibiotics than study participants given a standard nutritional supplement. They also responded more strongly to vaccination against influenza.

Older people living in nursing homes or long-term care facilities are at high risk of infection, Dr. Bobbi Longkamp-Henken of the University of Florida in Gainesville and colleagues note in the Journal of the American Geriatrics Society.

Given the similarity between declines in immune system function due to aging and to malnutrition, the researchers wanted to whether nutritional supplements might help strengthen older people's immunity.

Fifty-two nursing home residents aged 65 and older were given the experimental formula, which contained protein, beta carotene, vitamins C and E, zinc, selenium, fructo-oligosaccharides (non-digestible sugars that help "feed" the good bacteria in the colon), and structured triacylglycerol. Forty received a standard liquid nutrition product, EnsurePlus.

Study participants were immunized against the flu after four weeks on the supplement, and then stayed on the supplements for an additional six weeks.

Columbus, Ohio-based Abbott Laboratories developed both the standard and experimental formulas, and also funded the study.

Forty-three percent of those on the experimental formula achieved levels of antibodies sufficient to protect them against the flu, compared to 23 percent of study participants on the standard formula. They also showed higher production of white blood cells targeted to the flu virus.

Among those given the experimental formula, 5 percent required treatment for fever during the course of the study, compared with 16 percent of those on the standard formula. Study participants on the experimental formula were also less likely to require a new antibiotic prescription.

"The nutritional approach of this study demonstrated a collection of improvements that presumably could reduce the risk of infection and improve quality of life," the researchers conclude.

Source: Journal of the American Geriatrics Society, December 2006.

Safety Tips for Cooks Preparing the Holiday Table

 

HealthDay News

Tuesday, December 19, 2006

TUESDAY, Dec. 19 (HealthDay News) -- When you're entertaining guests this holiday season, remember the two-hour rule to help prevent food-borne illnesses.

"Two hours is really about as long as any kind of food needs to be setting out. After that, it should be refrigerated," Laura Palmer, a registered dietitian and cooperative extension service specialist in food and nutrition at Purdue University, said in a prepared statement.

"I think people make the food and then get so involved with their families that they forget to clean up and put things away," she said.

Palmer offered the following holiday food safety tips:

Be careful at buffets. Certain foods, such as deli meats, seafood, and cheeses and dips made with dairy products, need to be chilled. If you believe a food item isn't being served or stored properly, don't eat it. When preparing food, avoid cross contamination. Wipe down countertops and other surfaces with hot water and detergent or bleach after preparing any type of raw meat. Don't chop no-cook items, such as raw vegetables or cheeses, near preparation areas for meats. Be aware that many cutting boards have porous surfaces that can harbor germs. Use food thermometers to cook food to proper internal temperature. When reheating leftovers, be sure food is heated to 165 degrees F. Wash your hands often during food preparation and when eating. Something as seemingly harmless as answering the phone can spread germs that can make people ill.

More information

The U.S. Food and Drug Administration has more holiday food safety tips.

Osteoarthritis may respond to acupuncture

 

Reuters Health

Tuesday, December 19, 2006

Patients with chronic pain related to osteoarthritis experience "marked clinical improvement" with acupuncture plus routine care, German researchers have shown.

They randomly assigned 632 patients with osteoarthritis of the knee or hip to undergo up to 15 sessions of acupuncture over a 3-month period or to a "control" group that got no acupuncture. A second group of 2921 patients did not consent to random placement, and all of these patients received acupuncture. The participants in both trials were allowed to continue on their usual treatment.

The results of the study are published in the medical journal Arthritis and Rheumatism.

After 3 months, significantly greater improvements were seen in scores on a standardized osteoarthritis severity scale in the acupuncture group than in the control group, Dr. Claudia M. Witt, of Charite University Medical Center, Berlin, and colleagues report.

Overall, 34.5 percent of the acupuncture group had a good response to treatment after 3 months, compared with 6.5 percent of the control group. Quality of life improvements were also more pronounced in the acupuncture group compared with the control group.

Treatment success was maintained through 6-month follow-up in both trials.

Adding acupuncture to routine primary care "resulted in a clinically relevant and persistent benefit," the investigators conclude, and "should be considered as a treatment option for patients with knee or hip osteoarthritis-associated chronic pain."

Source: Arthritis and Rheumatism, November 2006.

Cancer risk rises after kidney transplant, study says

 

By Will Dunham

Reuters

Tuesday, December 19, 2006

People who have had kidney transplants face a big increase in risk for a variety of cancers, particularly those caused by a virus, according to a study published on Tuesday.

The researchers, writing in the Journal of the American Medical Association, tracked cancer incidence from 1982 to 2003 in nearly 29,000 Australians who got kidney transplants after serious kidney disease.

They excluded nonmelanoma skin cancer and cancers already known to lead to end-stage kidney disease, and found that the patients experienced an overall cancer risk nearly 3.3 times higher after getting a kidney transplant than before.

"We found that cancer incidence is markedly increased after kidney transplantation but is only slightly increased in the 5 years prior to and during dialysis," Claire Vajdic of the University of New South Wales in Sydney, lead author of the study, said by e-mail.

"After transplantation, the increase in risk affects a broader than previously appreciated range of cancers across a number of organ systems."

Vajdic said the findings do not challenge the life-saving value of kidney transplantation for people with end-stage renal disease, noting the risk of dying is four times higher in patients remaining on dialysis than in those who get a transplant.

The study found that the risk for 18 different kinds of cancer increased by at least three-fold, and 13 of these cancers are known or suspected to have a viral cause.

Five of these cancers, affecting the tongue, mouth, vulva, vagina and penis, are caused by the human papillomavirus, the study said, and there are indications the same virus is responsible in four of the others -- cancers of the eye, salivary gland, esophagus and nasal cavity.

Vajdic said the new human papillomavirus vaccine could help reduce the risk of cancer among these transplant patients.

Immune system suppression, rather than the organ transplantation itself, is most likely responsible for the increase in cancer risk, Vajdic said.

Vajdic said patients who get a kidney transplant take medications that help prevent rejection of the organ by suppressing the immune system, the body's natural defense. But these drugs also yield an increased susceptibility to infection, and can awaken previously dormant viral infections.

"The hypothesis is that the immune suppression results in chronic viral infection which leads to cancer," Vajdic said.

Olive oil may hinder cancer process

 

By Amy Norton

Reuters Health

Tuesday, December 19, 2006

People who use plenty of olive oil in their diets may be helping to prevent damage to body cells that can eventually lead to cancer, new research suggests.

In a study of 182 European men, researchers found evidence that olive oil can reduce oxidative damage to cells' genetic material, a process that can initiate cancer development.

They say the findings may help explain why rates of several cancers are higher in Northern Europe than in Southern Europe, where olive oil is a dietary staple.

They also support advice to replace saturated fats from foods like meat and butter with vegetable fats, particularly olive oil, said study co-author Dr. Henrik E. Poulsen, of Copenhagen University Hospital in Denmark.

He and his colleagues report the findings in The FASEB Journal, a publication of the Federation of American Societies for Experimental Biology.

The study included healthy men between the ages of 20 and 60 from five European countries. For two weeks, the men consumed a quarter cup of olive oil throughout each day. At the end of the study, they showed an average 13 percent reduction in a substance called 8oxodG, which is a marker of oxidative damage to cells' DNA.

Such damage occurs when byproducts of metabolism called reactive oxygen species overwhelm the body's antioxidant defenses. Olive oil contains a number of compounds, called phenols, believed to act as powerful antioxidants.

However, those compounds didn't seem to account for the drop in DNA oxidative damage, according to Poulsen's team. The men in the study used three different olive oils with varying levels of antioxidant phenols, and oxidative damage declined regardless of the phenol content.

Instead, the researchers suspect that the monounsaturated fats in olive oil are behind the effect.

The findings, they say, suggest that olive oil may be part of the reason that certain cancers, including breast, colon, ovarian and prostate cancers, are less common in Mediterranean countries than in Northern Europe.

At the beginning of the study, men from Northern Europe had higher levels of 8oxodG than those from Southern Europe. This is consistent, according to Poulsen's team, with the expected effects of the olive-oil-rich "Mediterranean diet."

However, Poulsen told Reuters Health, the diet is more than just olive oil. Ideally, it's also rich in fruits, vegetables, whole grains and fish.

Moreover, regardless of its benefits, he added, olive oil is no substitute for calorie control and regular exercise.

Source: The FASEB Journal, January 2007.

U.S. wants prominent warnings on pain relievers

 

By Lisa Richwine

Reuters

Tuesday, December 19, 2006

U.S. health officials said on Tuesday they want more visible side-effect warnings on the packages of over-the-counter pain relievers such as aspirin, ibuprofen and acetaminophen.

Acetaminophen carries a risk of liver damage, while aspirin and other products called NSAIDs may cause stomach bleeding. Both complications occur in only a small fraction of patients, but can be deadly.

The risks have been known for years, but the Food and Drug Administration said new warnings could raise awareness among consumers and reduce deaths and injuries.

Tens of millions of Americans take over-the-counter drugs to relieve pain every year. FDA officials said the vast majority encounter no problems if they take recommended doses.

Experts worry, however, that people do not realize the dangers of taking too much or combining the medicines with alcohol. Or they may unknowingly use more than one product that contains the same ingredient and accidentally overdose.

"Consumers have to be more cognizant of what they're taking for pain relief," said Dr. Charles Ganley, the FDA's director of nonprescription drug products.

But consumer group Public Citizen said the FDA's action was "decades late," citing FDA panels that urged new warnings for acetaminophen in 1977 and 2002.

NSAIDs, or nonsteroidal anti-inflammatory drugs, include aspirin, ibuprofen, naproxen and ketoprofen.

The NSAIDs and acetaminophen are available in generic and brand-name versions. Acetaminophen, for example, is the active ingredient in Johnson & Johnson's Tylenol. Wyeth sells ibuprofen under the name Advil. Bayer AG makes aspirin.

The ingredients are available in dozens of over-the-counter pain relievers, as well as some cough and cold remedies. Higher prescription doses are also sold.

Many makers of over-the-counter products voluntarily changed product labels after an FDA advisory panel recommended that in 2002. But agency officials said they wanted consistent language on all packages.

Ganley said it was hard to know exactly how many people experience serious side effects from the pain relievers. One manufacturer estimated about 200 unintentional deaths a year were linked to acetaminophen.

A widely cited 1999 study linked NSAIDs to 16,500 deaths per year. Ganley said most of the complications from NSAIDs was attributable to stomach bleeding in patients who take aspirin long-term to prevent heart problems.

The FDA proposed that acetaminophen products note the risks of liver damage are greatest if people take high doses or drink more than three alcoholic drinks a day.

For NSAIDs, the warnings should say the risk of stomach bleeding is highest in people who are over 60, are taking a blood thinner, or have had prior ulcers or stomach bleeding, the FDA said. The chances also increase when patients ingest more than one NSAID, drink three or more alcoholic drinks per day or take the product for longer than directed, the FDA said.

The agency also would like the terms acetaminophen and NSAIDs displayed prominently on drug cartons. The proposal is open for comments for 90 days.

McNeil Consumer Healthcare, the Johnson & Johnson unit that sells Tylenol, said the company had already implemented some of the proposals and would "work with the FDA to ensure appropriate information is provided to consumers."

Wyeth also has updated its product labels, said Fran Sullivan of Wyeth Consumer Healthcare.

Monday, December 18, 2006

 

Evidence Shows Fibromyalgia Pain Is Real: Experts

 

HealthDay News

Monday, December 18, 2006

MONDAY, Dec. 18 (HealthDay News) -- The pain of fibromyalgia is real, and doctors need to take patients' complaints seriously, concludes a review paper by University of Michigan Health System doctors.

"It is time for us to move past the rhetoric about whether these conditions are real, and take these patients seriously as we endeavor to learn more about the causes and most effective treatments for these disorders," Richard E. Harris, research investigator in the division of rheumatology, department of internal medicine at the U-M Medical School and a researcher at the U-M Health System's Chronic Pain and Fatigue Research Center, said in a prepared statement.

Fibromyalgia is a debilitating pain syndrome that affects 2 percent to 4 percent of the population. However, the condition is often mistakenly diagnosed as arthritis or even a psychological issue, and many patients face questions about whether their condition is real, according to background information.

In their review, the U-M doctors said there is now "overwhelming data" that fibromyalgia is real. They said it's characterized by a lower pain threshold and is associated with genetic factors that can increase the risk of developing the condition.

The authors cited recent studies involving pain, genetics and brain activity, and said they hoped their findings would improve understanding and acceptance of fibromyalgia and related conditions.

The paper appears in the December issue of Current Pain and Headache Reports.

More information

The American College of Rheumatology has more about fibromyalgia.

 

Suburban sprawl may create heavier kids

 

By Amy Norton

Reuters Health

Monday, December 18, 2006

 

U.S. children who live in expansive suburbs may start to pay for it with expansive waistlines, new research suggests.

Using data from a national health survey, researchers found that teenagers living in sprawling suburbs were more than twice as likely to be overweight as teens in more compact urban areas.

The findings echo those of a 2003 study by the same researchers that focused on U.S. adults. The researchers believe the same factors may be driving the link between suburban living and teenagers' weight -- the major one being reliance on cars.

"In a sprawling suburb, you can do very little on foot," said lead study author Dr. Reid Ewing of the University of Maryland's National Center for Smart Growth Education and Research.

By contrast, he noted in an interview, people in cities are often forced to be active in their daily lives -- walking to stores and public transportation, carrying groceries up the stairs to their fifth-floor walk-up apartment.

And while suburban dwellers may be able to go to the gym for some exercise, research suggests many lack the time. This is again, in part, due to spending so much time in cars, commuting to work or driving to far-away stores and schools.

What's more, Ewing said, those cars have become "de facto snack shops" for many adults and kids, with the food often being fast food. In many spread-out suburbs in the U.S., fast food is the predominant dining option, Ewing noted.

All of this, however, is still speculation, the researcher said. The current findings, published in the American Journal of Preventive Medicine, can only point to a correlation between suburban sprawl and teenagers' weight.

But since Ewing's 2003 study, others have found a similar pattern. Even when accounting for other factors that influence weight -- such as race, family income and education -- the degree of sprawl seems to matter.

For the current study, which was funded by the U.S. National Cancer Institute, Ewing's team used data from a government survey that began following 8,984 12- to 17-year-olds in 1997.

They also used a county-by-county "sprawl index" that considers population density and street accessibility. The most compact, "walkable" county was New York County, which encompasses Manhattan; the most spread-out area was Jackson County, near Topeka, Kansas.

In general, the study found, more sprawl meant a greater risk of kids being overweight.

In communities where it's not possible for children to walk to school, or where they don't even have sidewalks to use, parents may need to make an effort to help their kids get active, according to Ewing.

"Get them away from the TV and get them into sports or some organized activity," he suggested.

A more drastic alternative is to move.

Ewing said a growing number of U.S. communities are recognizing the pitfalls of sprawl and devising "new urbanist" designs -- creating old-fashioned, pedestrian-friendly Main Streets, better public transportation and "mixed-use" zoning that places residential and commercial buildings near each other.

Source: American Journal of Preventive Medicine, December 2006.

Antibiotics Mostly Useless for Sinusitis

By Rick Ansorge
HealthDay Reporter

HealthDay News

Monday, December 18, 2006

MONDAY, Dec. 18 (HealthDay News) -- If you develop a mild sinus infection this winter -- or even a moderately severe one -- antibiotics won't necessarily speed your recovery, new research shows.

"In the vast majority of cases, rhinosinusitis is a self-limiting disease," said Dr. An De Sutter, of Ghent University Hospital in Belgium. "It can last 10 days or longer, but antibiotics do not influence the course of the disease."

So, if you don't have signs of complications or severe infection, such as a high fever or extreme pain, your best bet is to forgo antibiotics, rely on symptomatic treatments and wait for a natural recovery, De Sutter said.

De Sutter estimates that 50 percent to 70 percent of sinusitis patients are prescribed antibiotics. Although the drugs can effectively treat patients who develop bacterial sinusitis, they are ineffective against viral sinusitis, which represents the majority of cases.

In the study, De Sutter and her colleagues looked at 300 patients with mild to moderately severe sinusitis, 218 of whom received sinus X-rays. They randomly assigned patients to receive either amoxicillin or a placebo, asked them to keep a symptom diary and observed them for 15 days.

The researchers found that neither typical sinusitis signs and symptoms nor abnormal X-rays had any value in predicting the course of the disease. They also found that the disease lasted as long in patients taking amoxicillin as it did in patients taking a placebo, and that 247 of the patients recovered within 15 days.

Only two subjective complaints -- a general feeling of illness and reduced productivity -- predicted a slower recovery from sinusitis. "In patients who feel ill or who do not feel able to work, recovery will take a few days longer," De Sutter said. "But antibiotic treatment does not speed recovery in these patients."

"We don't know for sure why antibiotic treatment seemed to have no effect on the duration of the illness," De Sutter said. "But there two possible explanations: Either the illness and X-ray abnormalities were not caused by a bacterial infection, or if they were, the patients' immune systems were able to overcome the infection just as quickly without antibiotics."

The results of the study are published in the November/December issue of the Annals of Family Medicine.

"We advise antibiotic treatment only when patients have severe symptoms such as high fever and bad pain or if they have impaired immune function," De Sutter said. "This is a very small minority of patients. For all others, we advise 'watchful waiting.' "

Instead of prescribing antibiotics, doctors should focus on symptom relief: paracetamol for pain relief and intranasal decongestants in case of a blocked nose, De Sutter suggested. "Some patients experience subjective relief by inhaling hot steam," she added.

In a similar study in the same journal, researchers found the desire for pain relief was one of the main reasons why sore-throat patients demand antibiotics. They concluded that it may be preferable to treat such patients with pain medications instead of antibiotics.

In most sinusitis cases, De Sutter believes that doctors should resist patient demand for antibiotics. "Doctors should explain to patients that antibiotics do not make a difference in the speed of recovery and can cause side effects," De Sutter said. "In our trial, diarrhea was more frequent with antibiotics. Other known side effects include nausea, oral or vaginal mold or yeast infection, allergic reactions and colitis."

The over-prescription of antibiotics, especially in children, also can cause the upper respiratory tract to become colonized with antibiotic-resistant bacteria such as S. pneumoniae, De Sutter said. "These resistant bacteria may cause infections that are more difficult to treat and may be passed on to other people."

"This is an interesting study because it looked at a large population of people with acute sinusitis," said Dr. David Sherris, chairman of otolaryngology at the University at Buffalo in New York.

"Most people do not need antibiotic therapy unless symptoms persist for more than seven to 10 days," Sherris said. "Plain X-rays of the sinuses add little or nothing to the diagnosis and treatment of acute sinusitis."

But that doesn't mean that imaging is of no value in sinusitis cases, he added. With prolonged or recurrent sinusitis or complications, computed tomography (CT) is the test of choice and works well, he noted.

"Early referral to an otolaryngologist is indicated in the most severe cases or where symptoms are out of proportion with findings," Sherris said. "The specialist can perform nasal endoscopy and accurately assess the most subtle CT scan findings."

Although the new study confirms some observations that Sherris has made during years of clinical practice, it would have been stronger if it had used the symptom system from the American Academy of Otolaryngology Head and Neck Surgery, Sherris said. "It is more complete than the one presented in this article, and though not infallible, is better to diagnose acute sinusitis."

Sherris also faulted the researchers' choice of antibiotics. "Amoxicillin, unless used in very high doses, is not a good first line antibiotic in acute sinusitis," he said. "Amoxicillin-clavulanate [augmentin] is a better choice, and is now generic in the United States. If there is an allergy to penicillin, physicians should consider azithromycin or a respiratory quinolone."

More information

For more on rhinitis, head to the U.S. Centers for Disease Control and Prevention.

Health Tip: Monitor Your Child's TV Watching

HealthDay News

Monday, December 18, 2006

(HealthDay News) -- Too much time in front of the TV can lead to aggressive behavior and a tendency to engage in risky, unhealthy activities, the American Academy of Pediatrics says.

Parents should set rules around TV watching, including limiting time to no more than one hour or two hours each day, and never while doing homework. Carefully choose shows that your child is allowed to watch, and watch the shows with your child when you can.

Try to avoid watching shows that may convey stereotypes or inappropriate messages for children, the AAP says. Also look for educational, appropriate videos made to help children learn, grow, and develop mentally.

Survivors recall horror of flu pandemic

By Brett Zongker

Associated Press Writer

The Associated Press

Monday, December 18, 2006

At the height of the flu pandemic in 1918, William H. Sardo Jr. remembers the pine caskets stacked in the living room of his family's house, a funeral home in Washington, D.C.

The city had slowed to a near halt. Schools were closed. Church services were banned. The federal government limited its hours of operation. People were dying some who took ill in the morning were dead by night.

"That's how quickly it happened," said Sardo, 94, who lives in an assisted living facility just outside the nation's capital. "They disappeared from the face of the earth."

Sardo is among the last survivors of the 1918 flu pandemic. Their stories offer a glimpse at the forgotten history of one of the world's worst plagues, when the virus killed at least 50 million people and perhaps as many as 100 million.

More than 600,000 people in the United States died of what was then called "Spanish Influenza." The flu seemed to be particularly lethal for otherwise healthy young adults, many of whom suffocated from the buildup of liquids in their lungs.

In the United States, the first reported cases surfaced at an Army camp in Kansas as World War I began winding down. The virus quickly spread among soldiers at U.S. camps and in the trenches of Europe. It paralyzed many communities as it circled the world.

In the District of Columbia, the first recorded influenza death came on Sept. 21, 1918. The victim, a 24-year-old railroad worker, had been exposed in New York four days earlier. The flu swept through the nation's capital, which had attracted thousands of soldiers and war workers. By the time the pandemic had subsided, at least 30,000 people had become ill and 3,000 had died in the city.

Among the infected was Sardo, who was 6 years old at the time.

He remembers little of his illness but recalls that his mother was terrified.

"They kept me well separated from everybody," said Sardo, who lived with his parents, two brothers and three other family members. His family quarantined him in the bedroom he had shared with his brother. Everyone in the family wore masks.

The city began shutting down. The federal government staggered its hours to limit crowding on the streets and on streetcars. Commissioners overseeing the district closed schools in early October, along with playgrounds, theaters, vaudeville houses and "all places of amusement." Dances and other social gatherings were banned.

The commissioners asked clergy to cancel church services because the pandemic was threatening the "machinery of the federal government," The Washington Star newspaper reported at the time. Pastors protested.

"There was a feeling that they couldn't turn to God, other than in prayer," Sardo said. "They liked the feeling of going to church, and they were forbidden."

The flu's spread and the ensuing restrictions "made everybody afraid to go see anybody," he said.

"It changed a lot of society," Sardo said. "We became more individualistic."

In a list of 12 rules to prevent the disease's spread, the Army's surgeon general wrote that people should "avoid needless crowding," open windows and "breathe deeply" when the air is "pure" and "wash your hands before eating."

One slogan was, "Cover up each cough and sneeze. If you don't, you'll spread the disease."

Those who were healthy wore masks when venturing outside. People who were known to be infected were threatened with a $50 fine if they were seen in public. Sardo remembers people throwing buckets of water with disinfectant on their sidewalks to wash away germs from people spitting on the street.

At the time, rumors swirled that the Germans had spread the disease which Sardo did not believe.

A second flu survivor, 99-year-old Ruth Marshall, says she, her two sisters and a brother came down with what they thought was a cold. Then the fever struck and the illness became severe, she said.

Marshall, who lived just steps from the Capitol at the time, said the influenza deaths reported in the newspapers came as a surprise.

"We never thought we were going to die. We did pretty good a lot of prayers," she said.

Others were not so fortunate. As the death toll started to mount, there was a shortage of coffins. Funeral homes could not keep up. Sardo's father, who owned William H. Sardo & Co., and other funeral-home directors turned to soldiers for help embalming and digging thousands of graves.

Talk of the threat of another pandemic brings back memories for Sardo, who says he has gotten a flu shot every year they are available.

"It scares the hell out of me. It does," Sardo said.

On the Net:

Health and Human Services Department pandemic flu preparation: http://www.pandemicflu.gov/

 

Doctors' Judgment Still Trumps Mammography Advances

 

HealthDay News

Monday, December 18, 2006

MONDAY, Dec. 18 (HealthDay News) -- While computer-assisted detection (CAD) technology is helpful, it can't replace a doctor's judgment in reading mammograms, say researchers at Group Health Cooperative health system in Seattle.

They noted that radiologists can spot lesions on mammograms that aren't detected by CAD.

"Our study shows that radiologists must continue to rely on their own judgment when determining whether lesions seen on mammograms require further testing," research leader Dr. Stephen Taplin said in a prepared statement.

He conducted the research while at Group Health and is currently a senior scientist at the U.S. National Cancer Institute.

CAD uses computer software to identify and mark areas of concern on mammograms. Typically, radiologists review the CAD-marked images after they interpret the original mammography images.

For this study, 19 radiologists each read 341 mammograms with and without CAD. The technology did not improve the doctors' ability to spot cancer when it was present but did increase (from 72 percent to 75 percent) their ability to determine whether a woman was free of breast cancer and needed no further evaluation

The study also found that when the radiologists viewed CAD-reviewed mammograms with lesions that weren't marked by CAD, the radiologists were less likely to recommend further evaluation than when they detected lesions on mammograms that had not been reviewed by CAD.

"This means that the radiologists may have been deferring to CAD and believing its interpretation rather than their own interpretation," Taplin said.

"This is something the originators of the technology say radiologists should not do. This study shows that it is hard to ignore the technology," he added.

Taplin and his colleagues recommended that radiologists be trained to pay attention to mammogram abnormalities that might be missed by CAD.

The findings are published in the December issue of the American Journal of Roentgenology.

More information

The U.S. National Cancer Institute has more about screening mammograms.

 

Sunday, December 17, 2006

 

Study: Holidays can make women eat more

 

By Rodrique Ngowi

Associated Press Writer

The Associated Press

Sunday, December 17, 2006

Emi Fujiwara's holidays can hardly be called that as she juggles a full-time job and evening studies and tries to find money and time to buy presents, organize parties and cook for family and friends.

The 26-year-old trainee nurse, who works at a children's hospital, says she indulges in comfort eating during what she describes as the most stressful time of the year. The seemingly endless invitations to parties and dinners make it easier to overeat, she said.

"Well, I am a cracker-and-cheese and wine kind of girl. Once I see all that out there, it is trouble for me," she said after going to the gym for the first time in weeks, seeking to burn off excess calories.

Nearly half of all women in the United States suffer from increased stress during the holidays, a condition that contributes to rising levels of comfort eating, drinking and other coping mechanisms that can lead to weight gain, according to a survey conducted in October by the American Psychological Association.

A national stress survey the association conducted in January showed one in four people in the United States agrees that "when I am feeling down or facing a problem, I turn to food to help me feel better." The October survey showed that the proportion increases to one in three people during the holidays.

Comfort eating and unhealthy drinking increases among men too, but is more common among women.

Forty-one percent of women in the survey agreed that they eat for comfort during the holidays, compared with 31 percent during the rest of the year. Among men, 25 percent report holiday-season comfort eating, compared with 19 percent during the year, according to the survey.

Others may not even notice gaining weight, said Russ Newman, the association's executive director for professional practice.

"This time of year everyone is bundled up, so you don't really realize it until springtime when you have to pull out the T-shirts, the tank tops and that sort of thing," Fujiwara said.

The holiday season is the most emotional time of the year for many Americans, particularly for women who often feel pressured to make it special to those they care about, said Sharon Gordetsky, a psychologist who specializes in children, families and issues of female development.

Even in families where fathers play a bigger role in parenting, child caring and household work, "women tend to often still do more of the planning, do more of the nurturing, do more of the social and family organization" for the holidays, said Gordetsky, an assistant professor at the Tufts-New England Medical Center's Comprehensive Family Evaluation Center.

Too true, said Sissy McPhearson, who teaches while working on a dissertation at Harvard University's Divinity School.

"My husband and I both work and normally we divide household tasks equally. But during the holidays he doesn't care as much about decorating the house or wrapping presents or hosting dinners so I end up doing it all even though I work full-time" for about 70 hours a week, she said.

McPhearson says the stress of preparing for holidays, plus increased invitations to go out, makes it easier for many to reach out for that extra drink.

"I go out a lot more now, maybe three or four nights a week ... and have a couple of drinks. Usually I just go out maybe once a week," she said.

Women have to take care of themselves if they are to be able to take care of others, Gordetsky said.

Among the healthier methods experts recommend to cope with the holiday stress are opting for less elaborate festivities and saying no to that serving of delicious roast beef, lasagna, chocolate or chilled glass of white wine.

"Exercise helps. I work out ... and I am getting a massage Tuesday," McPhearson said.

The holiday stress survey was conducted Oct. 2-5 by the Washington-based Greenberg, Quinlan Rosner Research. The telephone poll, with a margin or error of plus or minus 3.5 percent, reached 369 men and 417 women and was weighted by gender, age, race and education.

On The Net:

American Psychological Association: http://www.apa.org

 

Saturday, December 16, 2006

 

Low-fat diets may help some dodge cancer

 

By Marilynn Marchione

AP Medical Writer

The Associated Press

Saturday, December 16, 2006

The first experiment ever to show that low-fat diets could help prevent a return of breast cancer now reveals, with longer follow-up, that the benefit was almost exclusively to women whose tumor growth was not driven by hormones.

That could be huge the new results suggest but cannot prove that these women might be able to cut their risk of dying by up to 66 percent with such diets.

"That's as great or better than any treatment intervention that we've given" for this type of cancer, which is notoriously hard to treat, said Dr. C. Kent Osborne of Baylor College of Medicine in Houston, who had no role in the study.

However, for women whose cancers are fueled by hormones the vast majority of breast cancer patients the diet change seemed to make little difference in the risk of recurrence or survival. Questions remained about whether those who did benefit truly were helped by cutting fat or by the weight loss that resulted.

"Maybe it raises as many issues as it answers," said John Milner, chief of nutrition science research for the National Cancer Institute, which paid for the first phase of the study.

Initial findings from the study were reported at a cancer conference in 2005 and will appear in this week's Journal of the National Cancer Institute. Updated results with longer follow-up on many of the original participants were presented Saturday at the San Antonio Breast Cancer Symposium.

The mixed results were a surprise because doctors had expected all women to benefit, said Dr. Rowan Chlebowski of the University of California at Los Angeles, who led the work.

Hormones might play such a strong role in some cancers that dietary changes have only weak impact on future risk, experts said.

The study involved 2,437 women with early stage breast cancer, average age 58, at 39 sites around the country. All had surgery followed by chemotherapy and five years of tamoxifen if their tumors were hormone-fueled.

At the start of the study, 29 percent of their calories came from fat 10 percent to 12 percent lower than the typical American diet. Doctors told 1,462 of them to continue their normal diets. The other 975 had counseling with dietitians to cut fat to around 20 percent of daily calories.

The diet group averaged 33.3 grams of fat a day compared to 51.3 grams for the others, and lost five to six pounds during the study.

Five years later, cancer had returned in 9.8 percent of the diet group and 12.4 percent of those on standard diets, which translated to a modest 24 percent lower risk for the group as a whole.

But the result barely reached statistical significance, meaning that the difference almost could have occurred by chance alone. The new results, with longer followup, put the difference for the overall group at 21 percent and even weaker statistically.

Researchers' ability to study the women beyond the first five years was hampered by the federal grant running out. Two charities the Breast Cancer Research Foundation and the American Institute for Cancer Research gave money so they could resume.

Ten of the original 39 study sites have provided complete information on their participants for an additional two years, and information on deaths is available for all women in the study, Chlebowski said.

The new results: 14 percent of women on low-fat diets and 17 percent of the others have had a recurrence or second cancer. About 8 percent of dieters and 10 percent of the others have died.

However, there was a huge difference in the subgroup of women whose tumors were fueled by neither estrogen nor progesterone. Only 6 percent on low-fat diets died compared with 17 percent of the others. That translated to 66 percent lower risk of death for those who trimmed fat.

Was the benefit due to weight loss, eating more fruits and vegetables or something else? Researchers do not know.

"When you change the diet, you're probably changing thousands of circulating proteins that could interact with other targets," like insulin, that might impact cancer risk in different ways depending on hormones, Chlebowski said.

"Excess calories, be they fat or otherwise, are associated with cancer risk," Milner said.

Some earlier studies did not find low-fat diets to reduce breast cancer risk. The new one's conclusion that some may benefit from substantially cutting fat "suggests that getting below a certain threshold of fat intake may be important," said Dr. JoAnn Manson, a women's health expert at Harvard-affiliated Brigham and Women's Hospital.

Chlebowski will help lead a new study in the United States and Canada that will start next year and test weight loss and increased exercise in addition to low-fat diets to try to reduce cancer risk in women whose tumors are helped to grow by estrogen.

On the Net:

Breast cancer meeting: http://www.sabcs.org

Cancer institute: http://www.cancer.gov