Personal Health for the Week of January 18-24

FRIDAY, JANUARY 24, 2003 

1. Transplant Drug May Fight Lupus, Cancer
2. Double Hand Transpant Patient Doing Well
3. Parkinson's Drug May Help Smokers Quit
4. New Weapon Against Listeria
5. Women Often Start Smoking Again After Pregnancy
6. Angina Alert
7. Some Kids Have Medical Reason to Be Afraid of Dark
8. More Pain, More Gain
9. Many Austrians May Have High Homocysteine
10. New Help for Enlarged Prostates
11. Parkinson's Drug Linked to Heart Disease
12. Having a Baby to Please a Guy
13. Liver Enzyme Implicated in Artery Disease
14. New Guidelines Place More at Thyroid Risk
15. Exercise Like a Drug in Heart Disease, Study Finds
16. Rock-a-bye Baby, Sleep Through the Night
17. Drug Shown to Prevent Breast Cancer in Some Women
18. Wasting Away
19. Doctors Warn of Possible New Risk for IVF Babies
    
    THURSDAY, JANUARY 23, 2003 
    
    
20. Lead Removal Improves Kidney Function
21. Our Brain Sees Screen Flickers, Even if We Don't
22. Study Backs Common Therapy for Preeclampsia
23. Study Says Broken Homes Harm Kids More
24. Brain to Blame When You Can't Match Face with Name
25. New Patient Gets Artificial Heart in Ky.
26. Strength Training Can Build Postmenopausal Bone
27. FDA Issues Warning on Asthma Drug
28. US Reports Jump in Stomach Virus Outbreaks
29. Cutting Calories Via Any Diet Regulates Hormones
30. Hemophilia Drug Cuts Prostate Surgery Blood Loss
31. Need a Lot of Sleep? Blame It on Body Clock
32. Pot-Like Brain Compounds Affect Drinking Desires
    
    WEDNESDAY, JANUARY 22, 2003
    
    
33. Too Much Vitamin A Boosts Risk of Broken Bones
34. Domestic Violence Victims See Doctor More Often
35. Antioxidant-Amino Acid Mix Shields Blood Vessels
36. Help Prevent Colic Attacks
37. Early Menopause Not Always 'Unnatural': Study
38. Bipolar Disorder More Common Than Previously Believed
39. Feedback Technique May Boost Memory: Study
40. Blockage Can Be Death Knell in Heart Condition
41. Weight Loss Surgery Changes Food Preferences
42. TV Soothes Low Self-Esteem
43. Junk Food Diet Brings Scurvy to Modern Age
44. Lasers Zap Varicose Veins for Good
45. Big Increases Seen in '03 U.S. Bio-Corn, Soy Crops
46. Tots Tune Into TV
47. Red Dye Helps Huntington's-Like Disease in Mice
48. Mopping Up Lead from Body Helps Ailing Kidneys
49. Old Drug Still Best at Pregnancy Seizure Prevention
50. Jungle Remedy Eases Perils of Primate Pregnancy
    
    TUESDAY, JANUARY 21, 2003
    
    
51. Most Doctors Behind the Times
52. Women Seen Undertreated for Heart Disease
53. Too Much on Your Plate? U.S. Food Portions Balloon
54. Alzheimer's, Cholesterol Gene Linked
55. Italian Scientists Discover Migraine Gene
56. Infants and Stroke: A Very Real Concern
57. Docs' Independence Key to Job Happiness, Not Pay
58. Fiber Feast
59. Time of Day Affects Drug's Blood Pressure Control
60. Thalidomide Proving Its Mettle as Cancer Fighter
61. Doctors Lack Incentives for Improving Patient Care
62. Gene Therapy Helps Poor Circulation in Legs
    
    MONDAY, JANUARY 20, 2003
    
    
63. Macho Shoveler
64. Repeat Colorectal Exam Likely if Sedated First Time
65. Cataracts
66. Hurt Kids More Resilient Than Adults with Injury
67. Genetic Link to SIDS Found
68. Dangerous Gas May Improve Angioplasty Results
69. The Smell of Strong Emotions
70. Fat Intake Not Linked to Dementia Risk: Study
71. New Heart Therapy May Spare Surgery
72. Giving Blood May Aggravate Restless Legs Syndrome
73. Mapping Melanoma's Spread
74. Gene Linked to Alcohol Risk in Pregnancy
75. Enzyme Exacerbates Heart Disease
76. Think You're a Pro? You May Overestimate Ability
77. Alzheimer's Disease May Be in the Genes
78. Preemie Surgery Can Lead to Breast Deformities
79. Doctors Urged to Watch Diabetics' Legs
80. Chemo May Keep Ovarian Cancer at Bay
81. One in Five Depressed People Have Tried Suicide
82. New Breast Cancer Gene Discovered
83. Asthma Attacks More Common on Foggy Nights
84. Water-Filtered Infrared Light Fights Warts: Study
85. Crash Victim's Face Injury May Signal Brain Injury
    
    SUNDAY, JANUARY 19, 2003
    
    
86. Glaucoma: Straight Talk About a Dangerous Disease
87. Lift With Care
88. Slip Sliding Away
    
    SATURDAY, JANUARY 18, 2003
    
    
89. When Boils Pop Up, Don't Pop Them
90. Weighing In on Diet Plans
91. Winter Allergies: They're Real

 

FRIDAY, JANUARY 24, 2003 

Transplant Drug May Fight Lupus, Cancer 

HealthScoutNews

Friday, January 24, 2003

FRIDAY, Jan. 24 (HealthScoutNews) -- The drug Rapamycin, used to prevent organ rejection in kidney transplant patients, may also help people with lupus and some cancers, says a study in the journal Blood.

Rapamycin, like many anti-rejection drugs, suppresses immune T-cells. In this study, American and German researchers found the drug also inhibits the function and activation of dendritic cells.

These are cells that play a much earlier role in immune response because they're the first to identify foreign intruders in the body. The dendritic cells then present these intruders to other immune system cells, including T-cells.

Dendritic cells play an important role in conditions such as atherosclerosis and a number of autoimmune diseases, such as lupus, where dendritic cells create constant immune system responses.

The study also found Rapamycin disarms the trigger that allows the proliferation of dendritic cells. This trigger is a potent, naturally occurring growth factor. It also affects the proliferation of blood precursors and stem cells which, when unchecked, result in leukemia and other cancers.

More information

Here's where you can learn more about lupus.

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Double Hand Transpant Patient Doing Well

 

The Associated Press

Friday, January 24, 2003

LYON, France - A French man who received the world's first double hand transplant three years ago says he can shave, use a fork and punch the buttons on his cell phone.

At a news conference Friday to explain his progress, Denis Chatelier said he has regained normal use of his hands.

"I can eat with a fork, use my cell phone and shave," said Chatelier, 36, who still has two hours of physical therapy a day. "Little by little, I have regained the movements that I had forgotten."

Chatelier's forearms were severed in 1996 when a handmade model rocket he was trying to launch exploded before takeoff. In January 2000, the former marathon runner underwent a 17-hour transplant surgery at the Edouard Herriot hospital in Lyon.

Eighteen top surgeons, urgently assembled from across the world after a donor was found, operated on Chatelier, attaching arteries, veins, nerves, tendons and muscles, as well as setting the new bones.

The identity of the donor was not made public.

"Denis' progress was well beyond our expectations," Dr. Jean-Michel Dubernard said.

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Parkinson's Drug May Help Smokers Quit

 

Reuters Health

Friday, January 24, 2003

NEW YORK (Reuters Health) - A drug used to treat Parkinson's disease (news - web sites) may help some people quit smoking, the results of a small, preliminary study suggest.

The drug, selegiline, acts by delaying the breakdown of dopamine, the chemical that progressively diminishes in parts of the brain as Parkinson's disease advances.

"There is increasing evidence for a role of dopamine systems in the neurobiology of nicotine dependence," Dr. Tony P. George and colleagues write in the January issue of the journal Biological Psychology.

In the study, George's team evaluated the number of patients who quit smoking while taking selegiline and assessed any adverse side effects of the drug.

For eight weeks, 20 patients took selegiline and 20 took an inactive placebo. At the end of the eight-week period, 9 of the 20, or 45%, who took selegiline had quit smoking. Six months later, four people were cigarette-free, the study indicates.

By comparison, only 15% of those taking a placebo had stopped smoking by the end of eight weeks. Only one person was cigarette-free at six months, the authors report.

Among those taking selegiline, side effects were "generally mild" and included loss of appetite, gastrointestinal symptoms and insomnia, the authors report.

Given the very small number of people in the study, the authors recommend that further studies be conducted to see if selegiline can indeed help people quit smoking.

"While there are several effective treatments for smoking cessation, including nicotine replacement therapies and bupropion (Zyban), there are many smokers who do not respond to these drugs," said George, who is with the Yale University School of Medicine in New Haven, Connecticut, in a prepared statement.

"So developing new drugs for smoking cessation is an important undertaking. Selegiline (Deprenyl) appears to be a drug that might have promise for treatment of nicotine addiction," George concluded.

The study was funded by grants from the National Institute on Drug Abuse, the National Cancer Institute (news - web sites) and the Robert Wood Johnson Foundation.

Source: Biological Psychology 2003:53:136-143.

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New Weapon Against Listeria

HealthScoutNews

Friday, January 24, 2003

THURSDAY, Jan. 23 (HealthScoutNews) -- A new kind of chemical treatment may help kill Listeria monocytogenes and make it safer for you to eat lunch meats, hot dogs, smoked fish and some kinds of soft cheeses.

Texas A&M University researchers say a new product called acidified calcium sulfate shows promise in decontaminating the surface of cooked food products. They say it not only kills Listeria that may be present on food; it also prevents the bacteria from coming back.

They tested it on frankfurters that contained high levels of Listeria.

The product could offer meat processors another way to increase the safety of their products, and several want to test acidified calcium sulfate on their own products.

Listeria can grow at refrigerator temperatures and is considered a serious health threat. It doesn't affect many people, but it can be deadly. It can cause flu-like symptoms, meningitis, spontaneous abortions and prenatal septicemia. About 20 percent of listeriosis cases are fatal.

Processed food products can be contaminated by Listeria that comes from the environment or from employees in meat-processing plants.

More information

Here's where to learn more about Listeria.

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Women Often Start Smoking Again After Pregnancy

 

By Charnicia E. Huggins

Reuters Health

Friday, January 24, 2003

NEW YORK (Reuters Health) - Many women who successfully kick the smoking habit during pregnancy pick it back up after they give birth, new study findings show.

"We think this is an opportunity lost for those concerned with public health because studies show that the longer a person is away from cigarettes, the less likely she is to resume," Dr. Gregory J. Colman of Pace University in New York told Reuters Health.

"Perhaps health professionals should increase their efforts to keep women off cigarettes during this post-natal period, when these efforts are most likely to be rewarded," he added.

The findings are based on 1993 to 1999 surveys of 115,000 new mothers from 10 US states.

During the past decade, smoking has declined both among pregnant women and among women of reproductive age, note Colman and his co-author Dr. Ted Joyce, of City University of New York.

The reason for this decline, the authors suggest, could be due in part to the increased number of anti-smoking campaigns that target pregnant women, the flurry of media attention surrounding the recent tobacco settlement between tobacco companies and 46 states, and increasing cigarette prices.

In the current study, roughly one in four women reported smoking three months before pregnancy, but the proportion of women who reported quitting during pregnancy jumped from 37% in 1993 to 46% in 1999.

In fact, pregnant women were 51% more likely to quit smoking in 1999 than in 1993, the researchers report in the January issue of the American Journal of Preventive Medicine.

Still, about half of the women who quit smoking during pregnancy picked the habit back up within six months of giving birth.

Black women, college-educated women, those with private insurance, and first-time mothers were least likely to resume the habit than were their counterparts. Teenagers, on the other hand, who were more likely to quit than older women, were also more likely to start lighting up again after pregnancy.

Finally, women who smoked ten or fewer cigarettes each day before becoming pregnant were more likely to quit smoking before delivery than heavy smokers. Heavy smokers who did quit smoking during pregnancy were more likely to resume smoking after delivery, the report indicates.

"This suggests that if someone plans to quit during pregnancy, she is more likely to be successful if she starts cutting down well before she becomes pregnant," Colman said.

Yet despite their findings, Colman and Joyce say they "cannot dismiss the possibility" that women under-reported their smoking during pregnancy or over-reported their quit rates due to the stigma surrounding the practice.

"There may be less stigma associated with smoking before pregnancy and after delivery, especially if the baby is healthy," they write.

To decrease smoking after delivery, Colman recommends that health officials emphasize to pregnant women "that smoking around infants puts their health at risk."

"Since more educated women not only quit more but resume less, perhaps their better understanding of the risks of maternal smoking helps them better resist the urge to resume," he said.

A grant from the National Institute for Child Health and Human Development funded the study.

Source:  American Journal of Preventive Medicine 2003;24:29-35.

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Angina Alert

HealthScoutNews

Friday, January 24, 2003

(HealthScoutNews) -- Almost everyone experiences chest pain at one time or another. Sometimes, it's no cause for alarm, but often chest pain can be a warning sign of a serious problem. How can you tell the difference?

Cardiologists at the Columbia University Department of Surgery offer these guidelines in assessing chest pain:

• If chest pain is accompanied by shortness of breath, sweating, nausea and/or dizziness, it may be a sign of angina (news - web sites) or a heart attack.
• If it occurs with a twisting movement of the torso or with a deep breath, it is most likely not coming from the heart.
• Classic angina starts following some kind of physical exertion, for example, after walking uphill -- particularly if the activity comes after a meal or in cold weather. Rest may relieve it.

If you experience chest pain, call a doctor for guidance. If you can't reach one, or if your pain is severe, call 911 immediately.

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Some Kids Have Medical Reason to Be Afraid of Dark

 

By Alison McCook

Reuters Health

Friday, January 24, 2003

NEW YORK (Reuters Health) - In rare instances, children who say they are afraid of the dark may not just want to postpone falling asleep. They may actually suffer from a form of night blindness, according to a new report.

UK investigators report that two young children who constantly complained of fearing the dark turned out to have a hereditary form of night blindness.

Study author Dr. Gordon N. Dutton, a consultant ophthalmologist at Gartnavel General Hospital in Glasgow, Scotland, explained that this type of night blindness, called congenital stationary night blindness, is rare. The vast majority of children who say they are afraid of the dark do not have this condition, he said.

"It's important to recognize that this is a rare thing," he told Reuters Health.

But for a small number of children, those fears of darkness and shadows are real, he added.

"So when a child (with night blindness) is frightened of the dark, they are so for a very good reason," Dutton said. "They're blind in the dark."

Children with congenital stationary night blindness are unable to adjust their sight to darkness, the researcher explained. When lights first go out, people without night blindness lose their sight for an instant, but their eyes quickly adjust to the darkness so that they can faintly pick out their surroundings.

But for children with night blindness, Dutton said, that vision adjustment never occurs, rendering them "totally blind in the darkness."

In the January 25th issue of the British Medical Journal, Dutton and his colleagues describe the cases of two young girls who were diagnosed with congenital stationary night blindness.

One 3-year-old girl said she could not see when the lights were turned out, and would refuse to go into her parents' room when it was dark. When her younger sister was diagnosed with vision problems, the parents brought their older daughter to have her eyes examined, and doctors recognized her condition.

The other case involved a 2-year-old girl who had trouble navigating dark rooms. When she woke up in the dark, she felt afraid and would cry. An eye exam revealed that she had congenital stationary night blindness.

In an interview, Dutton noted that this form of night blindness is inherited, and in many instances, kids are diagnosed early with the condition because their eyes "wobble" in their sockets. However, in rare cases, such as the two described in the current study, none of these warning signs appear.

The condition is called stationary because it does not get worse over time. Dutton recommended that parents with children diagnosed with night blindness pull curtains closed before turning out lights, so that children do not become afraid of the black void they see through the windows.

Both children featured in the current report improved after they were given control of their room lighting, which allowed them to see when they wanted to.

Source: British Medical Journal 2003;326:211-212.

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More Pain, More Gain

HealthScoutNews

Friday, January 24, 2003

(HealthScoutNews) -- The latest buzz is that short-intensity exercise burns as much if not more calories as a longer, lower-intensity workout.

According to the Mayo Clinic, a 154-pound person will burn:

• 319 calories running 8 miles per hour for 20 minutes
• 238 calories walking 3 mph for 60 minutes

But high-intensity exercise also increases the risk of injury. Also, many people find it tough to sustain.

So if an intense workout is not for you, follow the advice of fitness experts. They recommend 30 minutes or more a day of moderate-intensity exercise, such as walking, biking or gardening.

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Many Austrians May Have High Homocysteine

 

By Jane Burgermeister

Reuters Health

Friday, January 24, 2003

VIENNA (Reuters Health) - As many as one in three Austrians may have high levels of homocysteine, an amino acid suspected of increasing the risk of heart disease, doctors said on Friday.

This figure, which came from a relatively small study, is much higher than the previous estimate that one in ten Austrians have raised levels of the molecule.

"We were not surprised to find that many people had high levels of homocysteine because half of all the deaths in Austria are due to heart and circulatory disease and homocysteine has been associated with these diseases," the head of the study, Dr. Bernhard Zirm, told Reuters Health.

"However, we were shocked to find it was as many as one in three," added Zirm, who is at Bad Radkersburg Hospital in southern Austria.

The results of the study support the importance of a healthy lifestyle and a diet that is rich in folic acid, Zirm said. Participants who consumed the least folic acid and vitamins B6 and B12 had the highest homocysteine levels.

In the study, which has not yet been published, the team analyzed data from 528 people between 20 and 75 years old who were living in the Bad Radkersburg area. Overall 31% of the study group had elevated homocysteine levels.

The study also found a clear link between age and homocysteine levels. Older participants tended to have higher levels of the amino acid.

"While only 11% of the subjects between 20 and 40 years had high levels of homocysteine, as many as 56% of those who were between 60 and 75 had high levels," Zirm said.

Zirm says that the second phase of his study, in which patients at a high risk of developing heart and circulatory diseases will be treated with folic acid and vitamin B supplements, should be completed in the autumn.

High levels of homocysteine have been under suspicion as a risk factor for heart disease and stroke. However, the benefits of lowering homocysteine levels have not been demonstrated, so homocysteine, unlike cholesterol, is not routinely measured.

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New Help for Enlarged Prostates

HealthScoutNews

Friday, January 24, 2003

FRIDAY, Jan. 24 (HealthScoutNews) -- The drug Avodart, used to treat symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate, is now available by prescription in the United States.

Avodart is a 5 alpha-reductase inhibitor that arrests the BPH disease process. The current most commonly prescribed treatment for BPH, alpha blockers, treat only the symptoms of BPH.

BPH is among the most common health problems in older men. More than half of men over age 60 experience BPH. It's a progressive disease in which the prostate gland surrounding the urethra enlarges. As it becomes larger, the prostate obstructs the urethra and causes urinary problems.

BPH symptoms include a hesitant, interrupted weak urine stream, urinary urgency and leaking or dribbling, and more frequent urination, especially at night. In severe cases of BPH, the bladder and kidney may be damaged.

BPH often begins after age 50. It can progress and worsen as men grow older. Men with at least a 10-year life expectancy should have a annual prostate checkup beginning at age 50, says the American Urological Association.

More information

Here's where you can learn more about prostate problems.

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Parkinson's Drug Linked to Heart Disease

 

By Alison McCook

Reuters Health

Friday, January 24, 2003

NEW YORK (Reuters Health) - People with Parkinson's disease (news - web sites) who take the drug levodopa to control their symptoms appear to have a higher than average risk of heart disease, US researchers report.

It is not clear whether levodopa itself raises heart disease risks, but previous research has shown that the drug can boost body levels of homocysteine, an amino acid associated with an increased risk of stroke and heart disease.

These preliminary findings "raise certain concerns" about the safety of levodopa, but are not meant to discourage people from taking the drug, study author Dr. Ramon Diaz-Arrastia told Reuters Health.

"I think if patients need levodopa because of (Parkinson's) symptoms, then they should be on it. It's certainly the most effective therapy," he noted.

Parkinson's disease is a progressive neurological disorder marked by the loss of brain cells that produce dopamine, a chemical key in controlling muscle activity. When dopamine levels are low, normally coordinated brain regions that control body movement become out of sync, leading to tremors, muscle rigidity, slowed movement and balance and coordination problems.

Levodopa is a precursor to dopamine in the brain, and the synthetic version can greatly alleviate patients' symptoms. It does not cure the disorder, though.

During the current study, Diaz-Arrastia, of the University of Texas Southwestern Medical Center in Dallas, and his colleagues measured homocysteine levels in blood samples from 235 people with Parkinson's, including 201 who had received levodopa. Diaz-Arrastia and his team also asked participants if they had ever had a heart attack or had undergone open-heart surgery or the artery-clearing procedure angioplasty.

People who said they had received levodopa tended to have higher levels of homocysteine in their blood than people who had never taken the drug. People with the highest levels of homocysteine in their blood were more likely to have developed heart disease.

The results of the study do not prove that levodopa causes the increases in homocysteine levels and heart disease risk, according to Diaz-Arrastia.

That said, he noted that previous studies have suggested that high levels of homocysteine can boost the risk of dementia, and approximately one third of patients with Parkinson's disease eventually develop dementia. So the question arises whether levodopa could either worsen Parkinson's or increase the risk that people with the disease will develop dementia.

"That is obviously one of the potential implications of this work," Diaz-Arrastia said.

Low levels of vitamin B12 and folic acid, or folate, are most often to blame for increases in homocysteine in the blood, the researcher added. Deficiencies in these B vitamins did not explain the differences in homocysteine levels among Parkinson's patients in the study.

Still, Diaz-Arrastia suggested that patients with Parkinson's who discover they have high homocysteine levels take a multivitamin rather than stop therapy with levodopa, if the drug appears to be helping.

Source: Archives of Neurology 2003;60:59-64.

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Having a Baby to Please a Guy

HealthScoutNews

Friday, January 24, 2003

THURSDAY, Jan. 23 (HealthScoutNews) -- Poor, black teenage girls who believe their boyfriends want a baby are 12 times more likely to wish they were pregnant than similar girls who don't feel that pressure from their boyfriends.

A study in the January issue of the American Journal of Health Behavior came to that conclusion after interviewing more than 400 sexually active black teenage girls in Alabama.

The researchers also found the girls in the study who said they wanted to become pregnant were nearly four times more likely to have a male partner who was at least five years older. Girls who wanted to get pregnant were twice as likely to report low self-esteem and low family support.

The study found those girls were also twice as likely to feel their partner would not approve of using condoms when they had sex.

All these factors could be altered by behavioral intervention, meaning they could be important points to consider when creating programs to reduce pregnancy risk in black teenage girls, the researchers say.

The study included interviews and surveys of 462 girls, aged 14 to 18, living in low-income neighborhoods in Birmingham, Ala.

Forty percent of the girls in the study had a previous pregnancy. However, the girls who said they wanted to become pregnant were less likely to report they had a previous pregnancy.

More information

Here's where you can learn more about teenage pregnancy.

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Liver Enzyme Implicated in Artery Disease

 

Reuters Health

Friday, January 24, 2003

NEW YORK (Reuters Health) - An enzyme found in the liver and intestines may play a key role in clogging of the arteries that can cause heart disease, research in mice suggests.

Just how important the enzyme is in human disease is not yet clear. But researchers say studies should now look into whether blocking the enzyme with a drug could prevent or treat atherosclerosis in humans.

Atherosclerosis involves hardening and narrowing in the arteries. The condition is a major cause of heart attack and stroke.

The new study links the disease to a cholesterol-modifying enzyme called ACAT2, which exists primarily in the liver and small intestine. ACAT2 helps change the cholesterol naturally made in cells so that it can travel in the blood. And high levels of blood cholesterol contribute to atherosclerosis.

Researchers found that in a strain of lab mice susceptible to atherosclerosis, those genetically altered to lack the ACAT2 enzyme did not develop significant signs of the disease in contrast to those with the enzyme.

In addition, the enzyme-deficient mice had lower total cholesterol levels but higher concentrations of heart-healthy HDL cholesterol.

All of this suggests that ACAT2 activity is "crucial for the development of atherosclerosis in mice," the study authors report in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

And while mouse and human atherosclerosis do differ, they add, it's possible that blocking ACAT2 in the liver and intestines could help prevent or treat atherosclerosis.

Dr. Robert V. Farese Jr., of the University of California at San Francisco, and colleagues conducted the study.

Scientists have already tried their hand at ACAT-blocking drugs, Farese and his colleagues note, but these agents were created before researchers discovered that there are actually two forms of the enzyme--1 and 2.

ACAT1, unlike its cousin, exists in many tissues throughout the body, and one study in mice has shown that blocking it could actually promote atherosclerosis.

The new findings, according to Farese's team, suggest that drugs that selectively target ACAT2 should be studied in humans.

Source: Proceedings of the National Academy of Sciences 2003.

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New Guidelines Place More at Thyroid Risk

By Amanda Gardner
HealthScoutNews Reporter

HealthScoutNews

Friday, January 24, 2003

THURSDAY, Jan. 23 (HealthScoutNews) -- When it comes to thyroid function, what was normal yesterday may not be normal today.

The American Association of Clinical Endocrinologists (news - web sites) (AACE) has announced new guidelines that will probably double the number of people with thyroid disease.

"This means that there are more people with minor thyroid abnormalities than previously perceived," AACE president Dr. Hossein Gharib said this week at a press conference. He added that earlier treatment means a lower likelihood of complications -- including depression and heart disease -- later on.

With the new guidelines, Gharib said, the prevalence of thyroid disease will be about equal to diabetes and cancer combined, affecting 27 million people, up from 13 million under the old guidelines. This would make thyroid disease the most common endocrine disorder in North America.

The announcement was made as the AACE kicked off its annual thyroid awareness month with the 2003 campaign theme: "Hiding in Plain Sight: Thyroid Undercover."

The thyroid is a small, butterfly-shaped gland in the front of the neck that produces thyroid hormone. "The hormone reaches cells through the bloodstream and affects just about every tissue in the body," Gharib said. "If your thyroid doesn't work properly, neither do you."

Basically, two things can go wrong with the thyroid. The gland can become overactive, producing too much hormone (hyperthyroidism), or it can become underactive, producing too little hormone (hypothyroidism).

Although the early symptoms of thyroid disease are often subtle (including fatigue, intolerance to cold and weight changes), long-term complications can range from depression and other psychiatric conditions to bone loss and even coma or death.

"It's important to diagnose this early before problems arise," said Dr. Donald Bergman, an endocrinologist and president-elect of AACE. "The good news is that a readily available, inexpensive blood test, which all physicians can do, provides evidence of early thyroid disease before complications develop."

Physicians use a simple blood test, the thyroid stimulating hormone (TSH) test, to determine if the thyroid is working properly. Previously, normal was between 0.5 and 5.0 micro units per milliliter of blood. The new guidelines, however, stipulate normal to be within a much narrower range: between 0.3 and 3.0.

The impetus for this change came from studies showing that even subclinical (without overt symptoms) hyperthyroidism can be shown to affect the health of untreated patients years down the line.

"If left untreated, thyroid disease can lead to significant problems," Gharib said. "We don't want to overlook signs of early disease."

Hypothyroidism is easily treated with replacement hormone. Overactive thyroid can be treated a number of different ways, including drugs and radioactive iodine.

Standards for healthy cholesterol and blood glucose levels have also been changing, said Dr. Loren Wissner Greene, clinical associate professor of medicine at New York University School of Medicine and a member of the national medical advisory board for the Thyroid Foundation of America.

"We keep on having changes in our normal values," she said. "Generally, the idea is that it is going to help more people by diagnosing them sooner. Our standards are to catch people more readily. It's still going to be a doctor's decision whether or not to treat someone."

The TSH test has also become much more accurate, Greene added. "We can now respond much more appropriately."

Because the incidence of thyroid disease increases as we age, the AACE recommends that women over the age of 35 and men over 60 be screened annually. (Women are up to eight times more likely than men to be diagnosed with thyroid disease, according to the AACE.) In addition, anyone with a family history, anyone with an autoimmune disorder such as anemia, arthritis or certain forms of diabetes, and women who are thinking about getting pregnant should be tested.

"If the TSH falls out of the normal range -- now 0.3 to 3.0 -- then you should seek advice from your physician," Bergman said. Not every single one of these people will be treated, either, he adds: "Each person should be considered on individual basis."

More information

For more on thyroid disease, visit the American Association of Clinical Endocrinologists, which also has a page on how to conduct a "neck check" at home.

The American Thyroid Association also has a wealth of information

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Exercise Like a Drug in Heart Disease, Study Finds

 

Reuters

Friday, January 24, 2003

WASHINGTON (Reuters) - Exercise can act like a drug on the blood vessels, reducing the risk of heart disease by literally getting the blood flowing, US researchers said on Thursday.

It works in a surprising way, reducing inflammation, which has recently joined high blood pressure and high cholesterol as a leading known cause of heart disease, the researchers said.

The blood stresses the walls of blood vessels as it passes over them, reducing inflammation in a way similar to high doses of steroids, the researchers report in Friday's issue of Circulation Research.

"Inflammation in blood vessels has been linked to atherosclerosis, a hardening of the arteries, and here we see how the physical force of blood