The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
April 10, 2003

 

 

 

Important Medical Disclaimer: The content displayed in Personal Health is designed to educate and inform. Under no circumstances is it meant to replace the expert care and advice of a qualified physician. Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Personal Health assumes no responsibility for how information presented is used.

Personal Health for the Week of February 1-6

  1. Doctors Pursue Pill to Aid Heart Valves
  2. Kids with Behavioral Problems at Risk of Injury
  3. Carbon Monoxide Poisoning
  4. Ephedra Has More Side Effects Than Other Herbs

 

FRIDAY, FEBRUARY 7, 2003

Depression Can Dampen Sense of Smell: Study

By Hannah Cleaver
Reuters Health
Friday, February 7, 2003

BERLIN (Reuters Health) - People with serious depression seem to have an impaired ability to smell, German researchers report. Their discovery suggests there is an interaction between olfactory function and state of mind.

The work could lead to the use of smell tests to confirm depression diagnoses, or even as a diagnosis tool in people with communication difficulties, according to Dr. Bettina Pause, of Kiel University.

Pause and colleagues examined the sense of smell in 20 depressed patients being treated in hospital, and compared the results with a "control group" of 20 people who were not depressed.

The depressed patients had more difficulty picking up faint odors, even at concentrations easily detected by people in the control group.

"Compared to the control group they only began to perceive smells at higher concentrations than the control," Pause told Reuters Health.

The researchers "also conducted the tests using EEG to give an objective check," she said, and found the same reduced sensitivity to smell. "Their brains reacted later and only to stronger smells," said Pause.

The findings are to be published in March in the journal Psychophysiology.

"This is the third such study we have conducted," she said. "The results are the same and show a clear association between depression and reduced sensitivity to smell."

It's not clear why sense of smell seems to be associated with depression, according to Pause.

"I would not like to say the reduced olfactory sensitivity is the reason for the depression or the other way around but they do seem to be associated," she said. "A clue could be that the area of the brain responsible for smell and that for emotions are parallel in the brain, they are almost identical areas."

The smell sensitivity was not affected by the nature of the smell used in the tests, but Pause is also working on further experiments examining olfactory perception in people with schizophrenia.

Previous studies on schizophrenics have shown that they have confused perceptions of smell, reacting strongly to unpleasant smells but often not appreciating pleasant ones.

Other work involving people with seasonal affective disorder (SAD) has shown they have a more acute sense of smell than those without the condition, adding to the growing body of evidence of a link between olfactory function and mood.

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Wine List for Heart Health Narrows

By Serena Gordon
HealthScoutNews Reporter
HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- Red wine's delicate ability to benefit your health has just been, well, refined.

Not just any red wine will do, it seems.

In the current issue of the Journal of the American College of Cardiology, German researchers say wines from their country probably aren't as good at reducing the risk of heart disease as French wines are.

"French wines are richer in flavonoids, polyphenols and phytoalexins than are German wines tested in this study," explains lead author Dr. Ulrich Forstermann, head of pharmacology at Johannes Gutenberg University in Mainz.

An enzyme called endothelial nitric oxide synthase (eNOS) protects blood vessels from clotting and from plaque buildup. This enzyme is dysfunctional in many disorders, such as diabetes, high cholesterol and high blood pressure, and also with cigarette smoking, Forstermann says.

To see if alcohol could increase the amount of eNOS available in the body, Forstermann and his team cultured cells from human umbilical cords and then exposed them to six French red wines, three German red wines and pure alcohol or nothing as controls.

The researchers found that some of the French wines caused eNOS expression to quadruple, while the German wines showed little change when compared to the controls. Pure alcohol had no effect on the eNOS present in the cells.

"Good red wines contain ingredients that are able to stimulate eNOS gene expression and eNOS activity. Therefore, they have the potential to protect against atherosclerosis (hardening of the arteries)," Forstermann says.

French wines probably aren't the only ones that would have this beneficial effect. Any wine rich in flavonoids and other heart-healthy compounds, such as those found in Italy, California and South Africa, would probably produce similar findings, he says.

The reason some wines are so rich in these substances comes from the way they are grown, especially the soil they are grown in, he adds.

The researchers also tested to see if the way the wine is fermented had any effect -- it didn't. Wine matured in oak barrels or steel tanks showed the same beneficial effects.

"This study doesn't tell us much about what happens when people drink," comments Dr. Robert Vogel, a professor of medicine at the University of Maryland Hospital, who wrote an accompanying editorial to the study. "It's an interesting study, but it's not clinically relevant. They incubated human cells in wine concentrations. What that means to human beings is still unknown."

However, Vogel adds, the study may point to a reason why there have been so many conflicting studies on the benefits of red wine. He says that studies done in America have tended to show little difference between red wine and other forms of alcohol in protecting heart health, while many European studies have found that red wine is superior.

The bottom line, says Vogel, is that one or two drinks a day will probably help prevent heart disease for people over 40.

Forstermann agrees: "One or two glasses of red wine in the evening are good for you. Besides the relaxing, calming and stress-reducing effect of a moderate dose of alcohol, good red wines contain compounds with protective effects on the cardiovascular system."

Vogel cautions, however, that too much of a good thing can be bad for you. "Too many people drink a lot, and the ravages of alcohol are devastating," he notes.

More information

To read more about wine and its effects on your health, visit Yale-New Haven Hospital or Duke University.

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Short-Course Steroids for Asthma May Not Harm Bone

Reuters Health
Friday, February 7, 2003

NEW YORK (Reuters Health) - Children who take oral steroids for short periods of time to control asthma may not harm their bone density, new research suggests.

Oral corticosteroids are effective at easing the airway inflammation that marks asthma attacks. But the medications can, over time, thin the bones or cause other significant side effects--including dysfunction in the adrenal gland, which provides the body with its natural supply of corticosteroids and other hormones.

Less clear has been whether short courses of the drugs can control asthma without affecting bone and adrenal function.

The new study found that, among children brought to the hospital for an asthma attack, those who'd had several five-day rounds of oral steroids in the past year were no more likely to have thinning bones or adrenal problems than youngsters not given the drugs.

"Repeated short courses of oral (steroids) in the treatment of asthma seem to be reasonably safe," researchers report in the February issue of Pediatrics.

However, the complete safety of the drugs "cannot be assumed" until their effects on growth, the immune system and other functions have been studied more, the authors add.

Dr. Francine M. Ducharme of Montreal Children's Hospital in Quebec, Canada, led the study.

It included 83 children and teens who had come to the hospital emergency room for an asthma attack over a 15-month period. Forty-eight of these children were prescribed a five-day course of oral steroids and had received such treatment at least twice during the past year.

These patients were compared with the other children, who had no exposure to oral steroids during the past year.

The researchers found that the treated children saw a short-lived dip in a bone protein called osteocalcin. But levels returned to normal within a month, and bone density was comparable between the two groups of children, according to the report.

Similarly, there was no sign of adrenal insufficiency in either group.

However, Ducharme's team points out, the average bone density in both groups was lower than would be expected.

The reason for this "disconcerting" finding is unclear, according to the researchers. They speculate that a lack of exercise or inadequate intake of protein, calcium and vitamin D might be involved.

And while the study "may alleviate some concerns" about the safety of short-course oral steroids, the researchers write, it's better to prevent children's asthma attacks in the first place with other therapies.

Inhaled steroids, which are safer than the oral version, are the cornerstone of such preventive treatment.

Source: Pediatrics 2003;111:376-383.

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Legs May Provide Stem Cells for Failing Hearts

By Ed Edelson
HealthScoutNews Reporter
HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- An international experiment to rebuild failing hearts using stem cell implants is under way, researchers report.

The trial will enroll up to 300 patients in as many as 30 medical centers in the United States and Europe. The idea is to strengthen failing heart muscle by removing stem cells from the patient, growing them in the laboratory, and then injecting them into a scarred region of the heart during surgery so they can grow into healthy heart muscle.

The technique was pioneered in France, and physicians at the George Pompidou European Hospital in Paris now report in the Feb. 8 issue of The Lancet on the first patient to receive an implant. The patient, a 72-year-old man, had marked improvement of heart function until his death 18 months later of causes unrelated to the implant, the report says.

The implanted cells were taken from stem cells of the muscles that support the bones. However, stem cells can grow into cells of different tissues, depending on their surroundings.

A biopsy showed the implanted stem cells formed functioning heart tissue, says Dr. Albert A. Hagege, a member of the research team and lead author of the journal report. "This is the first demonstration of the concept in humans and confirms animal experiments," he says.

Since then, the procedure has been performed on 10 patients in France in a Phase 1 trial, the first of three steps required to gain U.S. Food and Drug Administration (news - web sites) (FDA) approval for wide-scale use, Hagege says. "This trial supports the feasibility and safety of the procedure," he adds.

The American branch of the study, a Phase 2 trial in the process aimed at FDA approval, will be done in collaboration with the Genzyme Corp., a Massachusetts-based biotechnology company, Hagege says. Selection of patients has already begun in Europe and will begin "in the coming months" in the United States, says Daniel Quinn, a Genzyme spokesman.

Candidates for the treatment will be people whose hearts are beginning to fail because of a heart attack, Quinn says, with the implant aimed at "stopping the progression to heart failure." Because the cells must be injected directly into the heart, the procedure will be done during bypass surgery, he says. Research aimed at allowing the cells to be put in the heart without surgery is under way, Quinn says.

In practice, the stem cells will be removed from a patient through a small biopsy in the leg two to three weeks before bypass surgery is scheduled, and they will be multiplied in laboratory cultures in the Genzyme facility for about three weeks. After that, they will be injected into a scarred region of the heart. This will be a scientifically controlled study, meaning that some patients will get the stem cell implant and others will get a dummy injection. The condition of all the patients will be monitored continually to see whether those getting the real implant do better than those getting the dummy injection.

"The results of the Phase 2 study will probably be available within two to three years," Quinn says. If the trial is successful, a Phase 3 trial aimed at final FDA approval will be done.

More information

Learn about stem cell research from the American Heart Association. The National Institutes of Health has a general primer on stem cells.

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Many Docs May Misinterpret Colon Cancer Test

Reuters Health
Friday, February 7, 2003

NEW YORK (Reuters Health) - If the results of a survey conducted at one hospital are any indication, nearly 1 out of every 8 doctors may misread the results of a colon cancer screening test, called a fecal occult blood test, a new study found.

The fecal occult blood test is used to detect blood in the stool. If blood is found, patients may undergo colonoscopy, during which a flexible, lighted tube is inserted into the rectum and passed through the colon. A video camera connected to the tube allows a doctor to examine the inside of the intestine for any unusual growths.

In the current study, Dr. Roanne R. E. Selinger of the University of Washington School of Medicine in Seattle and colleagues evaluated how well 162 health care providers interpreted fecal occult blood test results at one hospital.

According to the report, "12% of patient care providers were unable to interpret sample (fecal occult) test cards correctly, of which 80% reported a false-negative result." A false-negative result means the health professionals detected no blood in the feces when in fact there was blood.

"Overall, 28% of providers did not meet the criteria to pass a quality assurance test of fecal occult blood testing," the authors write in the January issue of The American Journal of Medicine.

Given their data, suggesting that even experienced health care personnel have difficulty interpreting fecal occult blood testing, the authors recommend creating a "centralized location for the collection, processing, and interpretation of all tests."

In the absence of adequate quality assurance measures, "bedside or clinic-based test result interpretation by providers should be discourged," according to the report.

Cancer of the colon or rectum is the fourth most common cancer among both men and women in the US. In 2002, almost 150,000 Americans were diagnosed with the disease and approximately 56,000 will likely die as a consequence.

Colorectal cancer screening methods include fecal occult blood testing to identify blood in the stool, colonoscopy and sigmoidoscopy. CDC guidelines suggest everyone over 50 have a fecal occult blood test once a year, a colonoscopy once every five years and a full x-ray of the colon every 10 years.

Source: The American Journal of Medicine 2003;114:64-67.

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Low Estrogen Levels Linked to Coronary Disease

HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- Estrogen deficiency in premenopausal women is linked to an increased risk of coronary artery disease.

That what a study in the current issue of the Journal of the American College of Cardiology found.

The research is based on an analysis of statistics from a major ongoing investigation of heart disease in women called the Women's Ischemia Syndrome Evaluation (WISE), led by researchers at Cedars-Sinai Medical Center.

Coronary artery disease is the leading killer of premenopausal women, ahead of even breast cancer (news - web sites).

Despite that, most previous studies focused on heart disease in older women. This is the first study to show that premenopausal women with low estrogen levels have a significantly greater prevalence of coronary artery disease.

For this study, the researchers collected data on 95 women. They focused on women with low estrogen levels caused by a dysfunctional hypothalamus. The hypothalamus regulates the ovaries in the production of estrogen and other reproductive hormones.

While the study makes a link between low estrogen and increased risk of coronary heart disease, it wasn't designed to investigate cause and effect.

The study also found that psychosocial stress may be a factor in development of coronary heart disease in these women.

More information

Here's where you can learn more about coronary artery disease in women.

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Fruit and Veggie Consumption Levels Are Bleak

Reuters Health
Friday, February 7, 2003

NEW YORK (Reuters Health) - While Americans are continually reminded to eat at least five servings of fruits and vegetables daily and keep calories from fat to a minimum, the message doesn't appear to be catching on, a new survey suggests.

Consuming a diet rich in fruits and vegetables, whole grains, lean meat, poultry and fish and low in fat and sodium has been shown to significantly reduce a person's risk of developing heart disease. In fact, the evidence is so strong that recent studies have suggested that individuals try to eat up to nine daily servings of fruits and vegetables.

Researchers at the Mayo Clinic in Rochester, Minnesota surveyed 732 local residents in Olmstead county Minnesota and found that only 16% of adults scarf down five or more servings of fruits and/or vegetables each day and get no more than 30% of calories from fat.

"More effective interventions are needed to improve dietary habits in all subgroups of this community," writes lead author Dr. Stephen W. DeBoer and colleagues in the February issue of the journal Mayo Clinic Proceedings.

Previous national surveys have suggested that only about 33% of the US population adhere to the American Heart Association (news - web sites)'s recommendations for a heart healthy, low-fat diet, and a 16-state survey showed that less than a quarter of adults consumed the daily recommended amount of fruits and vegetables.

If public health officials hope to get upwards of 75% of the population eating more fruits and vegetables--one goal of Healthy People 2010, the US Department of Health and Human Services (news - web sites)' program designed to improve the health of US residents--more public outreach is going to be needed, according to the report.

"Local public health campaigns...and national campaigns will need to partner with local health care practitioners and community organizations to develop effective methods to promote healthier dietary habits among all subgroups of the population," the authors conclude.

Source: Mayo Clinic Proceedings 2003;78;161-166.

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Mixed Meds Can Pack a Deadly Punch

By Randy Dotinga
HealthScoutNews Reporter
HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- Millions of Americans, especially women, could be putting themselves at risk by taking combinations of common medications with potentially deadly side effects.

Or, they might not be in much danger at all.

Those are the conflicting messages of a new study that examines how many people get prescriptions for drugs that could work together to create havoc in the heart.

"The next step that's really crucial is for us to better understand what the real risks are associated with these drugs," says study co-author Lesley Curtis, a research associate with Duke University's Clinical Research Institute.

Many drugs have the potential to disrupt the heart's rhythm and cause a condition known as torsade de pointes. In some cases, especially among susceptible people, the condition could make the heart thrash uncontrollably and lead to death.

Some common drugs that could cause the condition include the antibiotics clarithromycin, levofloxacin and erythromycin, and the antidepressants Prozac and Zoloft, says Dr. Joe Selby, director of research for the Kaiser Permanente Health Plan in Northern California.

Medical reference books let doctors know that the drugs could potentially lengthen the "QT interval," the time between beats when the heart reboots itself electronically, Selby says.

To determine how often patients were prescribed the drugs, Curtis and colleagues examined statistics compiled by a pharmaceutical benefits company about prescriptions for nearly 5 million people.

The study appears in the new issue of the American Journal of Medicine.

The researchers found that 23 percent of the subjects received prescriptions for one or more of 50 drugs that could cause irregular heartbeats. About 10 percent of these subjects were prescribed at least two potentially risky drugs or one drug that could cause the condition and another that could relieve it.

Half of all potentially risky prescriptions were for antidepressants, and 64 percent of all the subjects were women, who are more likely to suffer from depression.

Both Curtis and Selby says it's not clear how much danger the subjects face by taking the drugs either by themselves or in combination with others.

It's possible that many of the doctors who prescribe the drugs know about the possible side effects and consider the potential benefits to be worth the risk, Selby says. "We can't tell whether these [prescriptions] are mistakes or conscious decisions," he says.

According to Curtis, patients who are currently taking the drugs with potential side effects should talk to their doctor if they are concerned.

"The message should not be to stop taking your drugs," she says.

More information

For information about the pitfalls of drug interactions, visit the U.S. Food and Drug Administration or the Council on Family Health.

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Many Have Subconscious Bias Against Obese: Study

By Alison McCook
Reuters Health
Friday, February 7, 2003

NEW YORK (Reuters Health) - New study findings show that even when people don't believe they are biased against the overweight, those biases often exist at subconscious levels, and may creep out in subtle ways.

Dr. Bethany A. Teachman and her colleagues discovered that even when people say they do not have negative feelings toward the overweight, a word association exercise shows that they do.

These negative stereotypes about the overweight appeared even when people were told before the word exercise that obesity mostly results from a person's genetic makeup, the authors report.

People who are overweight are the subjects of discrimination in many areas of life, Teachman said, and these "anti-fat" societal messages may influence our thinking in subtle ways, even if we try to fight against them.

"One possibility is that despite our best intentions to be tolerant and nonjudgmental, we are still greatly affected by the cultural message that being overweight is a moral weakness, and messages that negatively portray overweight people in the media," Teachman said.

"Another possibility is that implicit biases reflect attitudes and beliefs that a person is aware of, but does not feel it is socially acceptable to report," the University of Virginia researcher added.

During the study, Teachman, along with Dr. Kelly Brownell and colleagues asked 144 people to report how they felt about what "fat people are like." Some participants were first shown a made-up "research study" that said obesity was caused primarily by genetics; other participants were given a different "study" to read, this one said extra pounds were most often due to overeating and lack of exercise. A third group was given no study to read.

The participants then completed a word exercise designed to tease out negative biases that they might unconsciously hold against the obese.

In the current issue of Health Psychology, Teachman and her colleagues report that the word exercise revealed that many people--even those who say they have no anti-fat biases--have subconscious, negative associations with being overweight.

These subconscious biases may crop up in many situations of daily life, Teachman said in an interview, such as when we walk down the street, hear a "fat joke," or any situation in which we have to react spontaneously to an overweight person.

"For example, past research has found that implicit anti-fat biases predicted how far people wanted to sit from a person who was overweight," she said.

Other studies have shown that focusing on images of positive African-American role models can help people overcome their unconscious race biases, and the same technique could help combat the stigma of obesity, Teachman offered.

"I hope that we will continue to see changes in the media's presentation of overweight persons," she added, "including more common portrayals and reflections of overweight persons in all of life's diverse professional, family, and romantic roles, rather than the typical negative portrayal."

Other changes that could dispel some negative stereotypes about the obese include discouraging "fat jokes," and encouraging education about the causes of obesity, "so that the current myths that obesity is entirely an individual's fault because of lack of will power and over eating can be corrected," Teachman said.

The research was funded by the Rudd Foundation.

Source: Health Psychology 2003;22:68-78.

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College Takes Toll on Mental Health

HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- There's been a dramatic increase in American college students' mental health problems over the last 13 years.

A new study of 13,257 students seeking help at the counseling center of a large Midwestern university found the number of students seen each year with depression doubled over the last 13 years. The report appears in the February issue of Professional Psychology.

The number of suicidal students coming in to the counseling center tripled and the number of students seeking help after a sexual assault quadrupled.

Overall, the study found there were more students seeking help to deal with 14 of 19 mental health problem areas.

Until 1994, relationship problems were the most frequently reported issue for college students. Since then, stress and anxiety have been reported more often than relationship problems.

Some serious problems had no significant change in frequency over the course of the 13-year study. Those include substance abuse, eating disorders, legal problems and chronic mental illness.

More information

Here's where you can find mental health information for college students.

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Older Cancer Patients Fare Well with Chemotherapy

Reuters Health
Friday, February 7, 2003

NEW YORK (Reuters Health) - People over age 70 who have cancer appear to be able to handle chemotherapy treatment, a small study suggests.

While the bulk of cancer patients are over the age of 65, previous research has found that older patients are less likely to be given chemotherapy compared to younger cancer patients. Doctors may avoid chemotherapy treatment in older patients because they underestimate a patient's life expectancy or they fear the toxic side effects may be too much for older people, according to the report.

However, despite experiencing the general toxicity associated with chemotherapy drugs, older patients with cancer who are otherwise healthy appear to tolerate the treatment, report lead study author Dr. Hongbin Chen and colleagues from the University of South Florida in Tampa.

The study included 37 patients, 70 years or older, with a variety of cancers including breast, lung, colon, ovary, prostate and uterine, among others. All of the cancer patients were followed for about 130 days and were assessed for various aspects of their physical and mental health and quality of life, according to the report in the February 15th issue of the journal Cancer.

The patients all received various chemotherapy regimens. Thirteen (35%) had a beneficial response, either partially or completely, nine remained stable, and in seven patients the cancer became worse. Seven patients required additional chemotherapy.

While many of those in the study experienced decreases in physical and emotional functioning, "changes in most (test) scores were small in magnitude clinically," the authors report.

"Older cancer patients undergoing chemotherapy may experience toxicity but generally can tolerate it with limited impact on independence, comorbidity (other illnesses) and quality of life levels, write Chen and colleagues.

"It is important to recognize and monitor these changes during geriatric oncology treatment," they conclude.

Source: Cancer 2003;97:1107-1114.

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New Hope for Non-Hodgkin's Lymphoma

HealthScoutNews
Friday, February 7, 2003

FRIDAY, Feb. 7 (HealthScoutNews) -- A customized vaccine against non-Hodgkin's lymphoma (NHL) is undergoing a clinical trial to test its effectiveness.

The vaccine, tailored to individual patients, is made from a protein found on cells taken from the patient's lymph nodes. The protein is mixed with a substance that increases the immune system's ability to recognize a molecule on the surface of lymphoma cells.

That molecule is unique to the lymphoma cells of each individual patient. That means the molecule can be used as a specific target for developing immune system response.

The vaccine, called Favid, is injected into the patient following an autologous stem cell transplant. In that procedure, the patient's stem cells are removed before they receive high-dose chemotherapy. After the chemotherapy, the patient's stem cells are returned to help replenish the body's supply of blood cells.

The patients in the study were given the vaccine three months after the transplant. They received four monthly vaccine injections, and then a fifth injection two months after the fourth injection.

This Phase II clinical trial is meant to find out if post-transplant patients develop an immune response to the vaccine and, if they do, will the vaccine keep patients in remission longer than would be expected following transplant alone.

There has been an 81 percent increase in NHL cases since 1973. There were 54,000 new cases of NHL in the United States in 2002.

More information

Here's where you can learn more about NHL.

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System Can Detect 'Mad Cow'-Linked Prions in Blood

By Stephen Pincock
Reuters Health
Friday, February 7, 2003

LONDON (Reuters Health) - Preliminary experiments conducted in Scotland could lead to a blood test for the errant proteins that cause Creutzfeldt-Jakob disease (news - web sites), a fatal brain-wasting disorder that can be caused by eating mad-cow contaminated meat, researchers said this week.

If the study results are confirmed, the technology--from Australian firm Gradipore--could make it feasible to screen donated blood for the proteins, known as prions. It might also definitively diagnose prion diseases such as CJD before death-something that is currently not possible.

The experiments were designed by the Scottish National Blood Transfusion Service, which has been working with Gradipore since last year to develop a way to find the proteins in plasma, the clear liquid left after cells are removed from blood.

Tests that are currently available are based on measurements in brain tissue, where prion levels are very high and readily detectable. This means that mad cow disease and other prion diseases cannot be confirmed in humans or animals until after death.

"The problem is that in biological materials such as plasma, it is not certain that abnormal prion does exist," said Dr. Ian McGregor, lead scientist with the Scottish blood service. "So we have to have extremely sensitive assays to determine whether they are there or not."

The system could also be applied to screening donated blood for the prions.

All the indications are that prions cannot be transmitted via transfused blood, McGregor said, but a definitive test could remove any doubt. In the wake of Britain's outbreak of mad cow disease in cattle and Creutzfeldt-Jakob disease in humans, countries like the US do not allow people who have spent many years in the UK to donate blood.

"There is no indication of transmission, but if you have a very sensitive test method then you could ensure that it was indeed safe," he said.

In the experiments, conducted by Q-One Biotech in Glasgow, researchers deliberately added prion proteins to plasma, to mimic what might happen in real life. They ran a sample of the plasma through the Gradiflow equipment, which proved able to separate out prions based on their size and electrical charge.

In a statement, Gradipore's CEO Robert Lieb said the results could allow early prion diagnosis, and possibly assist in treatment of prion diseases.

"Indeed, what they show is that Gradiflow may fill the unmet need for a non-invasive prion diagnostic tool for animals and humans, and can provide pure isolates of various proteins useful for research, development, and therapeutic purposes," he said.

McGregor stressed there was more work to be done before a test based on the technology could be put into practical application.

"Our view is that the results are encouraging, but still some way off from being applied to what we want to apply them to," he said.

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New Test to Detect Peanuts in Processed Food

Reuters
Friday, February 7, 2003

LONDON (Reuters) - Scientists have developed a new, highly sensitive test that detects even the tiniest amount of peanuts in processed foods.

Britain's Food Standards Agency, which funded the research, said the test will be a relief for the one in 200 people in Britain who are allergic to peanuts.

"This new test is a small but important step forward in our work to protect people who are affected by food allergy," Dr. Andrew Wadge, the acting director of food safety policy at the agency, said in a statement on Friday.

People allergic to peanuts must be very careful about what they eat. Eating the wrong food can cause life-threatening anaphylactic shock, which kills about 10 people with a food allergy each year in Britain.

The test can distinguish peanuts from other nuts and detects minuscule traces of peanut DNA in food products. It will allow food manufacturers to tell customers if their products contain even a few parts per million of peanut.

Wadge said more research is needed to determine if the test can be adapted and used by food manufacturers in all types of food.

Peanut allergy usually begins early in life and rarely goes away. Parents of children with the allergy must be extra vigilant about what their youngsters eat.

Severe allergic reactions include swelling of the lips and throat, difficulty breathing and unconsciousness. If an attack occurs, emergency medical attention is needed.

Scientists suspect the allergy may be triggered by early exposure to peanut proteins through the mother eating peanuts during pregnancy, through breastfeeding, or if the child is given peanut products early in life.

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THURSDAY, FEBRUARY 6, 2003

Lose Weight, Caveman Style

HealthScoutNews
Thursday, February 6, 2003

(HealthScoutNews) -- According to researchers at Colorado State University, the caveman expended about 3,000 calories of energy a day. This was burned off by the hearty exercise involved in hunting and the gathering of food.

Today, the average person burns off about 1,700 calories of energy, but most people eat much higher amounts.

So what's the answer? Rather than drastically cutting your calorie intake, up your exercise to burn off more.

An American study says that occasionally expressing anger may offer protection against stroke and heart disease. The research appears in the January/February issue of Psychosomatic Medicine.

The study of 23,522 men, aged 50 to 85, found those with moderate levels of anger expression had about half the risk of nonfatal heart attacks and a major reduction in stroke risk compared to those who bottle up their anger.

For stroke, the study found the risk of stroke decreased in proportion to increased levels of anger expression.

Previous research suggests chronic anger increases the risk of cardiovascular disease. However, there aren't many studies that investigate how different styles of anger expression affect cardiovascular disease.

More information

Here's where you can learn more about anger.

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'Closeted' Men May Play Key Role in STD Spread: CDC

Reuters Health
Thursday, February 6, 2003

NEW YORK (Reuters Health) - Young black men who have sex with other men are more likely than their peers to be closeted, meaning they have not disclosed their sexual orientation to others, according to a new report from the Centers for Disease Control and Prevention (news - web sites) (CDC).

And while such closeted men don't have a higher risk of HIV (news - web sites) and other sexually transmitted diseases (STDs) than "out" gay and bisexual men, "nondisclosers" are less likely to know that they carry the virus that causes AIDS (news - web sites) and are more likely to have recently had sex with a woman, the CDC survey suggests.

The findings make it clear, the report's authors say, that more effort should be made to test closeted men and their sex partners--male and female--for HIV and STDs.

Men who have sex with other men but don't disclose their sexual orientation "are thought to be at particularly high risk for HIV infection because of low self-esteem, depression or lack of peer support and prevention services that are available" to men who are more open about their homosexuality, D. A. Shehan of the University of Texas Southwestern Medical Center in Dallas and colleagues write.

But the risks of HIV and other STDs that such men actually face are "unknown," the researchers note in the February 7th issue of the CDC's Morbidity and Mortality Weekly Report.

To investigate, the researchers evaluated a survey examining the sexual practices and attitudes of 5,589 men who have sex with men. Men aged 15 to 29 living in six US cities participated in the survey, which was conducted between 1994 and 2000.

All of the men also underwent testing for HIV and hepatitis B, a sexually transmitted disease that can harm the liver.

In all, 637 men reported that they were "not out to anyone" about the fact that they had sex with men. Of this group, 55% were between the ages of 15 and 22.

Tests revealed that overall, 8% of the closeted men were HIV-positive compared to 11% of men who were open about their sexuality.

Among blacks, the prevalence of HIV infection was 14% among closeted blacks compared to 24% of openly gay or bisexual blacks. About 18% of blacks said they had not disclosed their sexual orientation compared with 8% of whites, and 14% of black nondisclosers were HIV infected compared with 5% of nondisclosers of other ethnicities.

The researchers also found that among HIV-positive men, those who were closeted were less likely than "out" men to be aware of the infection. Of those with HIV, 98% of nondisclosers were unaware of the infection compared with 75% of those who were openly gay.

Although this study didn't find closeted men faced a higher HIV risk, "the data suggest that a substantial portion of nondisclosers are infected with HIV and other STDs and are at high risk for transmitting these infections to their male and female sex partners," the CDC states in an accompanying editorial note.

The survey finding that more than one in three closeted men reported having had sex with women recently suggests that such "nondisclosers" may play a major role in spreading HIV and STDs to women, according to the CDC.

This might be particularly true for closeted black men, the CDC adds, as about one in five were positive for hepatitis B and about one in seven were HIV positive.

"The findings in this report suggest that public-awareness and prevention programs should be developed" for closeted men "to reduce internalized homophobia and other factors that influence nondisclosure," the CDC concludes.

Source: Morbidity and Mortality Weekly Report 2003;52:81-85.

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Organic Foods

HealthScoutNews
Thursday, February 6, 2003

(HealthScoutNews) -- These days, most supermarkets have a section for organic foods. And lots of people think if it's organic, it must be more nutritious. Well, according to Harvard Medical Schools, organic foods contain the same nutrients as non-organic foods -- and in the same amounts.

The only advantage of organic foods is that they contain little, if any, pesticides or herbicides. Still, foods may contain cancer-causing ingredients, whether grown organically or not.

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More Steps, Less Bites Stop Weight Gain: Experts

By Alison McCook
Reuters Health
Thursday, February 6, 2003

NEW YORK (Reuters Health) - The current US environment makes it easy to overeat and forgo exercise, but a few small changes in diet and lifestyle could go a long way, experts said Thursday.

These simple changes consist of walking a few extra minutes throughout the day and putting down your fork after fewer bites than usual at each meal, they suggest.

In the US, tasty food is now available in large, affordable portions, note Dr. James O. Hill, of the University of Colorado Health Sciences Center in Denver, and his colleagues. At the same time, fewer people are expending energy throughout their days, spending more time sitting in front of a television or computer, they add.

In response, the rates of obesity and overweight have skyrocketed in recent years, Hill and his team write in the February 7th issue of the journal Science. At least 31% of US adults are now obese, and if the current trend continues, officials predict that rate will climb to almost 40% in 2008.

Although the government has encouraged people to adopt major changes such as going on a diet or taking up regular exercise, these recommendations do not seem to be stopping the trend of expanding waistlines, Hill told Reuters Health.

"Whatever we're doing, it isn't working," he said. "Because we're losing the battle on obesity."

As another approach, he and his colleagues say that subtle changes in lifestyle may help people stop gaining weight and, perhaps in the long-term, even shed pounds.

Specifically, Hill and his team propose that people try adding 15 minutes of extra walking throughout their day and taking a few less bites at every meal.

Smaller changes in lifestyle may be easier to make than drastic changes, Hill said in an interview, and these relatively simple recommendations are meant to enable people to keep up the changes over the long term. "Almost sneaking small behavior changes in so that you don't even know it," he said.

Fifteen extra minutes of walking is roughly 2,000 extra steps, Hill said. The state of Colorado is now arming some residents with step counters, which enable them to make sure they get those extra steps throughout the day. The next step, Hill said, is to see if this program keeps people from adding pounds.

"Time will tell whether that program affects weight gain," he said.

He stressed that the suggestions of extra steps and fewer bites are meant to stop all people--thin, overweight, or obese--from gaining weight. More long-term recommendations--such as cutting portion sizes in the food industry--are needed to help people lose weight, he noted. But until those changes appear, Hill said, stopping further gains is a good first step.

Small changes in lifestyle could also lead to larger changes like adding even more steps to the day or cutting back on fatty foods, Hill added.

"Starting people to make small changes can lead to other small changes, which can lead to weight loss," he said.

In the same issue of the journal, which contains a special section on obesity, researchers argue that overweight and obese people face many obstacles when trying to lose weight.

Dr. Jeffrey M. Friedman of The Rockefeller University in New York City notes that a person's genes play a significant role in his or her weight, and research has shown that obesity is just as inheritable as a person's height. The genes linked to obesity are those involved in regulating the balance between how many calories we take in and how many we burn, he writes.

In another report, Dr. Xavier Pi-Sunyer of Columbia University in New York City writes that it is very difficult to treat obesity. Changes that would improve treatment involve spending more time teaching doctors about obesity, allowing doctors to spend more time with overweight patients, better drugs and more research into the disease, he notes.

Source: Science 2003;299:853-860.

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Venting May Protect a Man's Heart

HealthScoutNews
Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- Hey guys, the next time you smash your thumb with a hammer, go ahead and vent your anger: It may actually be good for your health.

An American study says that occasionally expressing anger may offer protection against stroke and heart disease. The research appears in the January/February issue of Psychosomatic Medicine.

The study of 23,522 men, aged 50 to 85, found those with moderate levels of anger expression had about half the risk of nonfatal heart attacks and a major reduction in stroke risk compared to those who bottle up their anger.

For stroke, the study found the risk of stroke decreased in proportion to increased levels of anger expression.

Previous research suggests chronic anger increases the risk of cardiovascular disease. However, there aren't many studies that investigate how different styles of anger expression affect cardiovascular disease.

More information

Here's where you can learn more about anger.

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Lead May Impair Male Fertility: Study

By Merritt McKinney
Reuters Health
Thursday, February 6, 2003

NEW YORK (Reuters Health) - Lead exposure may cause some cases of unexplained male infertility by impairing sperm function, new research suggests.

In a study of 140 couples who were trying to conceive through in vitro fertilization (IVF), the more lead a man had in his semen, the lower the odds were that his partner would conceive.

Lead may be "a significant cause of human male infertility," the study's lead author, Dr. Susan Benoff, told Reuters Health in an interview.

Additional testing, including measuring lead levels in sperm, may be a good idea for men who are infertile for unknown reasons, said Benoff, who is at North Shore-Long Island Jewish Research Institute in Manhasset, New York.

But Benoff cautioned that the public should not "get frightened that there is an epidemic of lead poisoning" in men. She noted that the men in the study had normal levels of lead in the blood, but their semen contained elevated levels of the metal. Benoff explained that "the testis is often a storage depot for environmental exposures" including lead.

Although none of the men were exposed to high levels of lead on the job, Benoff said that there are many ways lead exposure can occur. Sources include lead pipes, paints, ceramic glazes, pewter and some types of metal utensils.

Lead seems to impair normal sperm function, Benoff and her colleagues report in the journal Human Reproduction. When the researchers took sperm from fertile men and exposed it to the metal, two out of three signs of healthy sperm function were abnormal.

If an infertile man does turn out to have too much lead in his semen, it may be possible to lower lead by taking zinc supplements, Benoff said. She and her colleagues found that "lead seems to be competing with zinc" in semen. As lead levels rose, zinc levels dropped, she said.

Benoff noted that zinc was used in the past to treat some sorts of infertility. Although zinc may not always work, it may help some men, she said.

Ironically, insights into how lead may contribute to infertility could eventually help researchers develop ways to help people who do not want to conceive, according to Benoff.

While giving lead to men to prevent conception would be a terrible idea, Benoff said that it may be possible to develop a male contraceptive that would hit some of the same targets as lead does.

According to Benoff, in about half of all couples who cannot conceive, male infertility is to blame. She added that in nearly half of these cases, the cause of male infertility is unknown.

Source: Human Reproduction 2003;18:374-383.

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What's Behind Pulmonary Hypertension

HealthScoutNews
Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- American researchers have pinpointed a gene pathway that causes pulmonary hypertension.

Pulmonary hypertension is a form of high blood pressure in the lungs. It kills about 1 percent of Americans each year.

In this study, which appears in the Feb. 6 issue of The New England Journal of Medicine (news - web sites), researchers at the University of California, San Diego (UCSD) School of Medicine identified an overactive gene called angiopoietin-1 and the molecular events it triggers that lead to acquired cases of pulmonary hypertension.

The study findings provide the first specific molecular targets for the development of therapies to deal with pulmonary hypertension.

Currently, lung transplantation is the only treatment for most types of pulmonary hypertension, although some patients benefit from surgery to remove blood clots from their lungs.

Angiopoietin-1 is normally involved in the growth of smooth muscle in developing blood vessels in embryos. However, the UCSD researchers found the gene can be inappropriately turned on in adulthood, leading to a molecular chain of events that result in muscle cell proliferation within the lining of the lung's blood vessels.

As the walls of the lung blood vessels become thicker, the small lung arteries become narrowed and blocked.

Most people with pulmonary hypertension develop the disease as the result of congenital heart defects, autoimmune disease, left-sided heart failure, blood clots in the lungs, drug interactions or vascular diseases. A few people inherit a rare form of pulmonary hypertension caused by a genetic mutation.

More information

Here's where you can learn more about pulmonary hypertension.

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Study Shows His 'Biological Clock' Is Ticking Too

Reuters Health
Thursday, February 6, 2003

NEW YORK (Reuters Health) - While much has been made of women's "biological clocks," new research confirms that men have them too--although the male clock is slower to wind down.

According to researchers, the findings show that a caution often directed at women may apply to men as well: Waiting till middle age to try to have kids may dampen the odds of success.

The small study suggests that as healthy men age, their sperm begin to slow down and lose sight of their goal--swimming in circles rather than sprinting for the female egg.

The scientific term for speedy, goal-oriented sperm movement is "progressive motility." And among the 97 study participants, progressive motility declined 3.1% each year.

Overall, the number of men with abnormal sperm concentrations or movement increased with each decade of age, according to findings published Thursday in the journal Human Reproduction.

"Because semen quality is a proxy for fertility, these data suggest that men may become progressively less fertile as they age," write the authors, led by Brenda Eskenazi of the University of California, Berkeley.

For women, fertility is known to markedly decline around the mid-30s. The new findings indicate that a 30-year-old man has about a 50% chance of having abnormal progressive motility--odds that increase to 67% by age 50 and 84% by age 80.

"Women tend to be the focus in fertility issues," Eskenazi said in a statement. "What we are saying is that men are not scot-free in this."

She added that, although everyone has heard of men fathering children in their 70s and beyond, the true odds of success "may be lower than we thought."

The study included 97 volunteers ages 22 to 80 who were all employees or retirees from the Lawrence Livermore National Laboratory. The men provided semen samples and details about their lifestyle habits, medical conditions and occupational exposures.

All of the men were non-smokers, and there was no evidence that occupational exposures at the government research facility explained the age-related decline in semen quality, according to the researchers.

They speculate that certain physiological changes that come with aging--such as narrowing of the testicular tube or normal changes in the prostate--may explain their findings.

Another possibility, they add, is that older men, by virtue of their longer lives, were more likely to have been exposed to tobacco smoke or some other environmental toxin that may harm semen quality.

Source: Human Reproduction 2003;18:447-454.

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Yo-Yo Dieting Tugs on Your Heart's Strings

By Colette Bouchez
HealthScoutNews Reporter
HealthScoutNews
Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- Yo-yo dieting -- gaining, losing and gaining back those extra pounds -- is never a healthy way to control your weight.

Now, doctors say it may also damage your heart -- particularly if you're a woman.

In a study conducted at the University of Michigan Health System, cardiologist Dr. Claire Duvernoy found women who fall prey to the gain-loss-gain syndrome, particularly if it occurs five or more times during their life, face a higher risk of cardiovascular disease beginning shortly after menopause.

"We already know that heart disease is the number one killer of women. And what this study tells us is that gaining and losing weight throughout your lifetime can increase your risks even more," says Duvernoy, director of the Cardiac Catheterization Laboratory at the VA/Ann Arbor Healthcare System.

Duvernoy believes the link between yo-yo dieting and heart disease may involve the endothelial cells, which line blood vessel walls. When people gain and lose weight repeatedly, these cells become damaged so blood can't flow as freely. When blood flow to the heart becomes restricted, the stage is set for heart attack and stroke, especially with women, Duvernoy says.

While obesity is certainly an established risk factor for heart disease -- in men as well as in women -- other heart experts aren't so sure the yo-yo syndrome plays a role.

"What we don't know about the women in this study is how much weight they gained, how many years they were heavy before dieting, and whether their yo-yo losses still left them overweight -- all of which can increase the risk of heart disease," says Dr. Daniel C. Fisher, a cardiologist at New York University Medical Center.

One message women shouldn't take from this study is that obesity is better than dieting, Fisher says.

"The best approach is to lose weight and keep it off," he says. "But even if you slide back up again, it's still important to keeping trying to lose the weight because while we're not sure if yo-yo dieting is going to lead to heart disease, what we do know is that obesity definitely does."

The small study involved 16 postmenopausal women, aged 54 to 66. The women were of varying weights, from thin to obese, and they shared a mixed bag of risk factors for heart disease. Some of the women smoked, some had high cholesterol and some were taking medication for high blood pressure.

The research involved a PET (positron emission tomography) scan of each woman's heart, as well as numerous other tests designed to measure blood flow under varying conditions. The study also recorded the women's current weight, their weight at age 18, their highest lifetime weight and the number of times each had a weight swing -- defined as a gain or loss of 10 or more pounds in a year, excluding pregnancy.

After analyzing all the data, Duvernoy says she found that women who experienced weight gains and loses of 10 pounds or more at least five times in their life had the most problems with blood flow and thus, appeared at greatest risk for heart disease.

For Fisher, the research provides interesting new ground for more study. However, the overall message, he says, is likely to remain the same: "Controlling your weight means controlling a major risk factor for heart disease," he says.

Duvernoy says the best way to do that is "to avoid yo-yo dieting and instead make healthy food choices and get plenty of exercise over the course of your lifetime."

She presented her findings at a recent meeting of the American Heart Association (news - web sites).

More information

For more on women and heart disease, visit The National Women's Health Information Center. To learn about healthy weight loss, check with The National Institutes of Health.

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Antioxidant Can Protect Kidneys During Heart Test

By Keith Mulvihill
Reuters Health
Thursday, February 6, 2003

NEW YORK (Reuters Health) - Two new studies shed light on ways to reduce kidney damage in patients undergoing a heart disease test known as angiography. One study suggests an antioxidant could help protect the kidneys, while the second suggests that some dyes used in the test are less toxic than others, according to the reports released this week.

Doctors have long known that diabetics (news - web sites) and people with kidney disease can suffer further damage to their kidneys when contrast dye is injected into the bloodstream during angiography.

During the procedure, doctors take a series of X-rays as the dye travels through the heart arteries to determine whether or not blockages are present.

While people with healthy kidneys can tolerate the dyes, those with kidney disease can suffer further kidney damage and, in rare cases, may even require kidney dialysis to help remove toxins from their blood.

"The magnitude of the problem is difficult to appreciate," Dr. Peter Aspelin of Huddinge University Hospital in Stockholm, Sweden, noted in an interview with Reuters Health.

He pointed out that about 2 million angiographies and similar interventions were performed worldwide in 2001, and roughly a quarter of patients undergoing the procedure likely had diabetes or poor kidney function.

In Aspelin's study, he and his colleagues studied kidney function in 129 diabetic men and women receiving angiography. About half were injected with the dye iodixanol. The others were given a different dye, iohexol.

During the three days following the procedure, the patients who got iohexol had roughly four times as much creatinine in their blood as those who received iodixanol. Higher levels of this protein, found mostly in muscle tissue, indicate worse kidney function. The findings were published Thursday in the February 6th issue of The New England Journal of Medicine (news - web sites).

"So, the new message is that this is the first randomized control study that shows the benefit of iodixanol," said Aspelin.

The study was supported by Amersham Health, the maker of iodixanol, which is sold as Visipaque.

In a related editorial, Dr. Carl M. Sandler from the University of Texas Houston Medical School comments that although these findings are "encouraging, one should not conclude that iodixanol is the answer to the problem."

"Since previous clinical studies have yielded conflicting results, there is reason to believe that future studies of iodixanol may provide conflicting data as well," Sandler notes.

The second study, published Wednesday in the February 5th issue of the Journal of the American Medical Association (news - web sites), examined the ability of the antioxidant acetylcysteine to help protect patients undergoing angiography.

This study involved 200 patients with moderate kidney impairment who received either acetylcysteine or placebo before and after coronary angiography. Dr. Jay Kay of Grantham Hospital in Hong Kong and colleagues found that pretreatment with acetylcysteine did, in fact, protect against contrast-induced kidney toxicity.

Patients treated with the drug were 68% less likely than those not given the drug to experience a 25% or higher increase in blood creatinine levels within two days of receiving the dye. In addition, acetylcysteine-treated patients had significantly lower blood creatinine levels during this period, the study indicates.

In a related editorial, Dr. Gary C. Curhan from Harvard Medical School (news - web sites) in Boston notes that "although the absolute clinical benefit is unproven," the reduction in the amount of time spent in the hospital that could be achieved with acetylcysteine pretreatment is probably important enough "to recommend considering this approach" for any patient with reduced kidney function who must undergo an imaging test requiring dye injection.

Asked to comment on both studies, Dr. David Warnock said: "I would vote for acetylcysteine being that it is cheaper and appears to be just as effective as iodixanol...especially in high-risk patients."

Warnock is the president-elect of the National Kidney Foundation and director of the Division of Nephrology at the University of Alabama at Birmingham.

Nonetheless, Warnock told Reuters Health in a telephone interview that "the perfect study" would evaluate acetylcysteine in a comparison trial of iodixanol and iohexol.

Source: The New England Journal of Medicine 2003;348:491-499, 551-553; Journal of the American Medical Association 2003;289:553-558, 606-607.

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Are We Driven to Overeat?

By Jennifer Thomas
HealthScoutNews Reporter

HealthScoutNews

Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- If you're thin, you may have wondered: Why don't obese people just stop eating so much?

Because eating is a powerful, primal drive, one that trumps willpower or the desire to be thin in people genetically predisposed to obesity, argues Dr. Jeffrey Friedman, head of the laboratory of molecular genetics at Rockefeller University in New York City.

"The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty," Friedman writes. "This is the feeling the obese must resist after they have lost a significant amount of weight."

Friedman's article appears in the Feb. 7 issue of Science.

While Friedman's article argues that genetics is the primary determinant for obesity, an article by James Hill, a researcher at the University of Colorado Health Sciences Center in Denver, points to a different culprit -- the environment.

Supersized portions. Calorie-dense fast food. Too little exercise and too much to eat.

The rate of obesity in the United States increased from 23 percent in 1991 to 31 percent in 2000, Hill says, citing previous research.

Using data from the National Health and Nutrition Examination Survey (NHANES), Hill and his colleagues estimated that Americans are gaining, on average, 1.8 to 2 pounds each year, or 14 to 16 pounds in eight years.

If the current trend continues, 39 percent of the U.S. population will be obese in 2008, Hill says. Obesity is defined as having a body mass index (BMI) of 30 or more.

Hill has proposed a simple solution to halt the creeping weight gain: Eat 100 fewer calories a day. That's equal to the calories in a cookie or three bites of a fast-food burger.

It takes just a slight energy imbalance to cause a gradual increase in weight, Hill says. Say you ate just 50 excess calories a day, that is, you ate 50 more calories than you burned during physical activity. That means five extra pounds in a year.

"Even one extra LifeSaver a day, 10 calories, is a pound of weight a year," Hill says.

One pound of weight gain is about 3,500 calories.

Another option for "closing the energy gap" is walking another mile a day, which burns about 100 calories. Since it takes most people about 2,000 to 2,500 steps to complete a mile, people could fit this in fairly easily, he says.

"We believe that what we've been doing isn't working," Hill says. "Trying to tell people to get out and change their whole lives isn't helping. We have to stimulate people to think differently about this."

Most adults eat about 2,000 to 2,500 calories a day, Hills says. So a 100-calories difference is small. Restaurants could help the process by reducing portion size a tad.

Though some might argue that if you burn more calories through walking, you'd get hungrier and eat an additional 100 calories, Hill says previous research has shown a moderate increase in physical activity doesn't mean you eat more.

Adam Drewnowski, a spokesman for the American Dietetic Association and director of the Center for Public Health Nutrition at the University of Washington in Seattle, says he believes the environmental argument more than Friedman's genetic argument.

In his paper, Friedman argues that the tendency toward obesity is rooted in evolution. Survival meant being able to withstand periods of famine. Those who were able to store fat well had a better chance of surviving. And now, many Americans can thank (or curse) their ancestors for their battles with weight.

Friedman points to the hormone leptin as a key player in the biology of obesity. Some obese people, shown to lack leptin, lost dramatic amounts of weight when they were give leptin injections.

However, Drewnowski says the genetic argument doesn't explain why minorities, the poor, and people with low education have the highest rates of obesity.

"In the last 20 years, as obesity has doubled and tripled, the genetic pool has remained the same," he says. "You can't tell me all those people don't have enough leptin."

It will be lifestyle changes, not medical interventions, that will ultimately stem the tide of obesity in this country, he says.

"It all comes back to this issue of eating less and exercising more," Drewnowski says. "The Romans used to say, 'To avoid corpulence eat less and take physical activities.' After 2,000 years of research, we've come back to the same conclusion."

He favors Hill's 100-calorie-a-day approach. "It's simple. It's easy," Drewnowski says. "What he's saying is that you don't have to make drastic changes."

More information

For tips on adding extra walking -- "steps" -- into your routine, visit Colorado On the Move! Calculate your BMI with help from the National Heart, Lung, and Blood Institute.

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Shrimp Is Secret Ingredient in New US Army Bandage

By Gina Keating
Reuters
Thursday, February 6, 2003

LOS ANGELES (Reuters) - Shrimp shells and vinegar may become staples for US Army troops in Iraq--not as rations but in a new bandage that staunches heavy bleeding in minutes.

A team of Portland, Oregon-based scientists searching for a solution to an age-old problem--how to keep soldiers from bleeding to death on the battlefield--stumbled on the kitchen pantry combination and, through high-tech wizardry, turned it into a super-sticky, combat-ready field dressing.

"Death from bleeding hasn't changed since the (1898) Spanish-American war," Dr. Kenton Gregory, the Portland cardiologist who led the team, said on Wednesday in a telephone interview.

"Even with armor, people bleed from gunshot or shrapnel wounds because the field medics have the exact same thing in their rucksacks as medics in earlier wars--gauze dressings."

HemCon Inc., the company Gregory formed with retired Col. Bill Wiesmann, a former director of the Army's Combat Casualty Care unit, has taken orders for 10,000 of the bandages, which won expedited FDA (news - web sites) approval last month. The first shipments will go to US soldiers in the Gulf in case of a war there.

About three years ago, the Army asked Gregory and Wiesmann to do what military surgeons have puzzled over since the Trojan War: develop the perfect field dressing.

"It had to be easy to use, light and stable with a long shelf life and had to be able to withstand a lot of temperature variation," Wiesmann said. "And it obviously had to be safe."

And cheap. The Army gave the team a $400,000 grant to develop a prototype.

"It was unreasonable but we gave it a shot," Gregory said.

It took about a year of testing different substances--some unorthodox--for the team to settle on chitosan, a naturally occurring protein found in shrimp shells.

"One of the guys (researchers), Rui-Qing Qian, remembered something from the 1950s that the component that makes up shrimp shells...when it comes in contact with red blood cells causes them to clot," Gregory said.

The substance quickly stopped aortic bleeding in pigs but test bandages kept falling apart, Gregory said. Australian scientist Simon McCarthy added vinegar and a chain of about 20 chemical reactions to stabilize the bandage and make it stick tight to wounds so soldiers could be transported from field to hospital without disturbing the clot.

The first tests, done in November at the Army Institute of Surgical Research at Fort Sam Houston, Texas on swine whose livers were lacerated, were a success, Gregory said.

The Army scientists who tested the HemCon bandage praised its simplicity and minimal storage requirements after it saved all but one of eight gravely wounded animals.

Dr. Tony Pusateri, who tested the bandage, described it as "very promising," adding that more testing is needed.

"It's one of the few dressings that we have studied that stopped...heavy bleeding that kills soldiers on the battlefield," Pusateri said. "It's very promising that this dressing has made it this far."

The HemCon team is under "intense pressure to roll these bandages out pretty soon," Gregory said, adding that he expects the first batch to complete production in the next two weeks.

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Hormone Sharply Cuts Premature Births

By Ed Edelson
HealthScoutNews Reporter
HealthScoutNews
Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- In what they describe as a notable first, researchers today report the successful test of a treatment to reduce the incidence of premature births in high-risk women.

Injections of 17-alpha-hydroxprogesterone caproate (17P), a derivative of the hormone progesterone, reduced premature births by more than a third in a group of women at high risk because they had borne preemies before, Dr. Paul J. Meis, a professor of obstetrics and gynecology at Wake Forest University Baptist Medical Center, told the annual meeting of the Society for Fetal-Maternal Medicine in San Francisco.

"The evidence of this treatment's effectiveness was so dramatic, the research was stopped early," Meis says in a statement released before the presentation. "This drug is readily available and can be used by doctors to improve outcomes for mothers and babies."

"This report is being greeted with remarkable enthusiasm by clinicians, who tend to be reserved," says Dr. Nancy S. Green, medical director of the March of Dimes Birth Defects Foundation, which has just launched a major campaign to reduce premature births. Results of the study were eagerly awaited, she says.

Studies have shown that prematurity, defined as delivery before the 37th week of gestation, is associated with learning and developmental difficulties. In 2000, 11.9 percent of babies were born prematurely in the United States, and the government's Healthy People program has a goal of reducing that to 7.6 percent by 2010.

The study reported by Meis was done in the 19 centers belonging to the government-funded Maternal Fetal Medicine Units Network. All the women in the study had a history of premature birth, a major risk factor for another premature birth. Some were given weekly injections of 17P, starting at the 16th to 18th week of pregnancy; the others got placebo injections.

The intention was to enroll 500 women in the study. Only 463 were enrolled when it was found the 17P injections reduced birth before the 37th week by 34 percent and the incidence of birth before 32 weeks by 42 percent.

"This is the first well-documented demonstration of a successful treatment to reduce pre-term births in women at risk," says the Meis statement.

This study was undertaken because the researchers remembered several small-scale studies done in the 1960s and 1970s in which 17P showed promise, Meis says in an interview.

"After that, for no good reason it just fell into inattention," he says. The existence of the fetal medicine units network, which performs over 80,000 deliveries a year, made the study possible, he says.

The mechanism by which 17P acts remains uncertain, Meis says. One theory is that it quiets the muscular activity of the uterus.

"This is a tangible example of research not only promising but also delivering," Green says.

It's too early to say whether the 17P treatment could help women at high risk because of other factors, such as having had a Caesarean section, obesity or being black, she says. Black women are at higher risk for no known reason, Green says. In the study, the 17P treatment was effective in all ethnic groups.

The group that did the 17P study will move on to another study that includes both the hormone and omega-3 fatty acids. Eating fish, which are rich in those fatty acids, has been found to be associated with a decreased risk of prematurity, and soon the acids themselves will be tested as a treatment.

More information

You can learn more about premature birth from the March of Dimes Birth Defects Foundation or the National Institute of Child Health and Human Development.

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Scans Show Dramatic Brain Cell Loss in Alzheimer's

By Maggie Fox
Reuters
Thursday, February 6, 2003

WASHINGTON (Reuters) - Dramatic new scans show brain cells quickly and steadily disappearing in patients with Alzheimer's disease (news - web sites), an international team of researchers reported on Thursday.

They used magnetic resonance imaging, also known as MRI, to chart a 5% annual loss of brain cells in Alzheimer's patients--up to 10% in key memory areas.

In contrast, healthy volunteers monitored in the study lost less than 1% of their brain cells a year.

"For the first time, you can see Alzheimer's disease progressing in living patients," said Paul Thompson, an assistant professor of neurology at the University of California Los Angeles school of medicine, who led the study.

"We were stunned to see a spreading wave of tissue loss. Initially confined to memory areas, this loss moved across the brain like a lava flow, destroying more and more tissue as the disease progressed."

Writing in the Journal of Neuroscience, the researchers said their findings would help doctors check to see if treatments are helping, and perhaps help chart the course of the disease.

Alzheimer's is assessed using standard tests of a patient's behavior and performance, rather than any physical evidence.

This will probably continue to be the case, said Dr. Sid Gilman, director of the Alzheimer's center at the University of Michigan.

"The diagnosis of Alzheimer's disease really depends upon demonstration of cognitive dysfunction," Gilman said in a telephone interview.

"No amount of PET scanning or MRI scanning will make the diagnosis. There are anecdotal stories of people dying who had scored normal on tests of cognitive function a few weeks before and upon death the brain can show definitive signs of Alzheimer's."

However, such a test would be extremely useful in charting future treatments, Gilman said.

"Currently all we have is symptomatic treatment," he said. "We have no treatment that stops the progression."

But, he added, researchers are working on ways to stop the now-incurable disease, such as vaccinations that might stop the buildup of toxic proteins in the brain.

"We are on the verge of some very exciting discoveries in Alzheimer's disease, so that a biomarker that told us the disease itself was not progressing would be extremely important," Gilman said.

For their study, Thompson and colleagues at UCLA, in Britain and in Australia scanned the brains of 12 Alzheimer's patients and 14 healthy volunteers. MRI gives a finer image of bodily structures than x-rays.

"They got a scan every three months," Thompson said in a telephone interview.

They were able to put together time-lapse images, which can be seen on the Internet at http://www.loni.ucla.edu/~thompson/AD_4D/dynamic.html.

On average, the Alzheimer's patients lost 5.3% of their brain cells each year. In memory regions they lost up to 10%.

"Memory systems go first and then the frontal areas involved in inhibition and self-control and later areas involved in emotion," Thompson said.

"Another feature is that some parts of the brain are completely spared. One example is the visual area. Why it is, is a mystery."

Thompson hopes the method could not only be used to compare treatments for Alzheimer's, but perhaps to see if exercise and mental exercise could prevent or delay Alzheimer's in people at a high risk of the disease.

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New Link to DiGeorge Syndrome

HealthScoutNews
Thursday, February 6, 2003

THURSDAY, Feb. 6 (HealthScoutNews) -- A gene that helps blood vessels form in developing babies is a key player in a chromosomal abnormality that causes birth defects in the heart and throughout the body.

An international study in the February issue of Nature Medicine says that abnormalities in vascular endothelial growth factor (VEGF) are a cause of DiGeorge syndrome.

This syndrome can cause a wide range of heart defects. It can also cause mental retardation, problems in the thymus and parathyroid gland, and craniofacial defects.

Finding out how and why abnormalities occur in VEGF may help scientists find ways to prevent them.

In this study, scientists studied animals, including mice and zebra fish, and DNA samples from people with DiGeorge syndrome.

More information

Here's where you can learn more about DiGeorge syndrome.

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Serotonin, Some Antidepressants Can Fight Fungus

By Stephen Pincock
Reuters Health
Thursday, February 6, 2003

LONDON (Reuters Health) - The neurotransmitter serotonin could one day form the basis of new antifungal drugs, according to Austrian researchers who have shown in the lab that serotonin can kill one type of fungus that frequently infects humans.

Two years ago, the University of Innsbruck team showed that antidepressants called selective serotonin reuptake inhibitors (SSRIs) could also inhibit fungi. Their new findings bring an explanation of this phenomenon a step closer.

"Understanding the mode of action could help in the development of new antifungal agents--on the basis of the chemical structure of SSRIs or serotonin," said lead researcher Dr. Cornelia Lass-Floerl.

Her group began this line of investigation when a doctor noticed that Pfizer's SSRI Zoloft (sertraline) seemed to suppress the symptoms of vaginal candidiasis, or yeast infection, in three women.

The patients found they had no flare-ups of the yeast infection while taking Zoloft to treat premenstrual dysphoric disorder, but when they stopped taking the drug the infection returned.

"My colleague who had these patients asked me to test the antifungal effect of sertraline," Lass-Floerl told Reuters Health.

In 2001, her group reported that sertraline--and other SSRIs including Prozac (fluoxetine), Paxil (paroxetine) and Edronax (reboxetine)--all hindered the growth of Aspergillus and Candida species. Fungi belonging to the Candida family are responsible for yeast infections, and can also cause thrush, an infection of the mouth and throat. Aspergillus fungi can also infect humans.

"Sertraline is the strongest substance," she told Reuters Health. And, she added, it has fewer side effects than other drugs used to treat fungal infections.

"Pfizer Austria is very interested on research on sertraline as an antifungal agent," she added.

Because SSRIs increase serotonin levels during treatment, the researchers tested the neurotransmitter directly against a range of Candida species.

The researchers report in this month's issue of the Journal of Medical Microbiology that serotonin was active against all four species tested.

A variety of clues also suggest that serotonin may play a role in natural defenses against fungi, the researchers said, although to what extent is not clear.

They are currently subjecting SSRIs and serotonin itself to a battery of tests to figure out its mode of action. Animal experiments have been started, and the researchers are screening patients with various conditions to investigate the role of serotonin levels in susceptibility to infections.

More details on the specific effects of sertraline on fungal virulence will be published soon, Lass-Floerl said.

Source: Journal of Medical Microbiology 2003;52:169-171.

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New Therapies for Liver Damage on the Horizon

By Amy Norton
Reuters Health

Thursday, February 6, 2003

NEW YORK (Reuters Health) - Two studies released Thursday could lay the ground work for new treatments for a number of serious liver diseases, according to researchers.

Their early work with cells and animals points to potential ways to treat hepatitis B infection and liver damage done by alcohol and other toxins.

Reports on both studies appear in the February 7th issue of Science.

In one study, researchers found that a growth factor naturally produced in the body appears to set off a cascade of events that protects the liver from damage. The substance, called vascular endothelial growth factor A (VEGF-A), is produced by cells that line the blood vessels, and is best known for its role in spurring new blood-vessel growth.

But the new findings, gleaned from work with mice and cells, show that VEGF-A is able to spur the release of certain other growth factors from a network of vessels that feed the liver. These growth factors, in turn, trigger a proliferation of liver cells.

Similarly, activation of one of the cell receptors for VEGF-A--called VEGFR-1--also appeared capable of protecting liver cells and initiating liver regeneration.

All of this suggests that a drug that would activate VEGFR-1--a so-called VEGFR-1 agonist--could help prevent liver damage caused by alcohol abuse, certain medications or viral hepatitis, one author told Reuters Health.

"We propose that a VEGFR-1 agonist could be useful in a variety of conditions where one wishes to prevent hepatocyte (liver cell) death," said Dr. Napoleone Ferrara, a research fellow with the San Francisco biotech company Genentech.

Importantly, he pointed out, VEGFR-1 activation seems to trigger the release of growth factors for liver cells without promoting new blood-vessel formation--a process called angiogenesis.

This is a concern because abnormal angiogenesis is believed to encourage cancer growth by giving small tumors the blood supply they need to thrive and spread.

In the second study, German and US scientists at Bayer Corp. found that a new class of compounds may fight the hepatitis B virus (HBV) in a way that differs from current medications.

Hepatitis B is a serious liver infection that, for a small percentage of people, can become chronic and lead to permanent liver damage or cancer. A few drugs, including interferon, can treat chronic hepatitis B, but side effects and viral resistance have limited the therapies' success, according to the study authors.

Their work showed that the new class of compounds, known as HAP, can block the formation of the protein coat that normally envelops HBV particles. Earlier research had already shown that the compounds inhibit human HBV in mice.

"These inhibitors have potential for future therapeutic regimens to combat chronic HBV infection," conclude Dr. Karl Deres and his colleagues.

An estimated 1.25 million Americans have chronic HBV infection. The infection, which is passed mainly through sex or contact with infected blood, can be prevented with the hepatitis B vaccine.

Source: Science 2003;299:890-893,893-896.

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WHO Says New Meningitis Vaccine Ready for Shipment

By Doug Macron
Reuters Health

Thursday, February 6, 2003

NEW YORK (Reuters Health) - The World Health Organization (news - web sites) (WHO) said on Thursday that British drugmaker GlaxoSmithKline Plc. has developed a vaccine to treat a relatively rare type of meningitis found only in Africa.

In September 2002, WHO began asking top vaccine makers to develop a low-cost treatment for the W135 form of meningitis after an outbreak of the disease occurred in Burkina Faso. Until then, the disease had only sporadically affected those in the 21 countries that compose Africa's so-called meningitis belt.

GlaxoSmithKline "responded favorably and developed the vaccine in just a few months," WHO said in a statement.

The initial supply of the vaccine--roughly 3 million doses, paid for mostly by the Bill and Melinda Gates Foundation (news - web sites)--will be shipped to meningitis belt nations for use in upcoming months, and will cost about $1.50 per dose. WHO said that the only other treatment available for W135 costs between $5 and $50.

The first 100,000 doses of the vaccine are now being shipped to Burkina Faso, where 1,349 cases of W135 meningitis have been confirmed, 244 of which have been fatal.

"It is possible that the W135 strain will not remain contained in Burkina Faso, but that it will spread to other countries in the meningitis belt," Daniel Tarantola, director of vaccines and biologicals at WHO, said. "But we have great hopes that this newly formulated vaccine will save many lives."

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Microwave Cooking

HealthScoutNews
Wednesday, February 5, 2003

(HealthScoutNews) -- Microwaves are great for defrosting, heating and cooking, but they can also harbor food-borne illnesses and lead to other problems.

The University of Arizona recommends these microwave safety techniques:

  • Remove food from its store wrap before defrosting. Foam trays and plastic wraps may melt and cause chemicals to leak into the food.
  • Never stuff a bird that will be cooked in a microwave, since it may not cook thoroughly.
  • Never use brown paper bags, newspaper, metal or foil in the microwave.
  • Reheat foods until they're steaming or hot to the touch. Cover foods and stir them from the outside in for even heating.

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Study Finds a Drink or Two a Day Cuts Stroke Risk

Reuters Health
Wednesday, February 5, 2003

NEW YORK (Reuters Health) - Moderate drinkers who consume one to two alcoholic drinks a day reduce their risk of having a stroke, but downing more than five drinks daily has the opposite effect, doubling a person's risk of one type of stroke, according to a new study.

Previous research has suggested moderate alcohol consumption may have protective effects against various types of stroke, according to Kristi Reynolds of Tulane University School of Public Health in New Orleans and colleagues.

To investigate further, the research team evaluated 35 previously published studies of alcohol consumption and stroke risk.

Their analysis found that consuming more than five alcoholic beverages per day, compared with abstention from alcohol, was associated with a 64% increase in overall stroke risk. This level of alcohol consumption boosted the risk of ischemic strokes--the most common type, which occur when a clot or narrowed artery cuts off blood flow in the brain--by 69%. People who had more than five drinks a day more than doubled their risk of the less common type of stroke, which is caused by bleeding in the brain and called a hemorrhagic stroke.

But moderate drinkers, meaning those who had between one and two drinks a day, had a roughly 30% lower risk of stroke than teetotalers, the authors report in the February 5 issue of the Journal of the American Medical Association (news - web sites).

And the risk of stroke for people who had about one drink or less of alcohol a day, but did not abstain entirely, was about 20% lower than the risk for abstainers.

While the findings suggest health benefits of moderate alcohol consumption, the researchers caution against using them to make blanket recommendations on drinking and stroke risk.

"Any advice regarding the consumption of alcohol should be tailored to the individual patient's risks and potential benefits," the authors conclude.

Source: Journal of the American Medical Association 2003;289:579-588.

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Senior Spills

HealthScoutNews
Wednesday, February 5, 2003

(HealthScoutNews) -- Each year, thousands of elderly people slip and break their hips or suffer other serious injuries.

According to Yale University, you can take certain steps to reduce your risk of falling:

  • Ask your health-care provider about special exercises to improve balance and strength.
  • Have an occupational therapist assess and fix hazards unique to each home, such as removing throw rugs and adding stair rails.
  • Wear hip protectors -- plastic or padded cushions that act as shock absorbers in the event of a fall.

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U.S. Food Industry Begins to Embrace Irradiation

By Jerry Bieszk
Reuters
Wednesday, February 5, 2003

CHICAGO (Reuters) - Stung by record recalls of tainted meat last year, the U.S. food industry is stepping up the use of new technology to irradiate meat as an extra protection against deadly bacteria such as E. coli and listeria.

Just a small part of the 9 billion pounds of ground beef sold in the United States last year was irradiated, but the amount is growing rapidly, despite concerns voiced by some consumer groups about the unknown long-term effects on health.

"I would estimate the total volume currently being irradiated under 5 percent (of beef production), but we are anticipating an exponential growth curve," said Janet Riley, spokeswoman for the American Meat Institute (AMI).

Irradiation exposes products to ionizing radiation that kills insects, molds and bacteria. The U.S. government approved irradiation treatment of ground beef in January 2000, and the first batch was processed in May of that year.

Big Increases

Irradiation began to ramp up late last year after the largest meat recall in U.S. history. In October, Pilgrim's Pride Corp. recalled 27.4 million pounds of poultry products because of an outbreak of listeria, a potentially deadly bacteria. The outbreak that prompted the recall was blamed for killing eight people and making more than 40 sick.

The U.S. Agriculture Department said this week that 60 percent of the largest U.S. meat plants failed to meet federal food safety regulations for preventing the E. coli bacteria (news - web sites) in their products. The bacteria causes an estimated 73,000 infections and 61 deaths in the United States each year, according to government data.

Food companies see irradiation as another barrier of protection against bacteria that can cause food-borne illness, especially to protect children, the elderly and those with weakened immune systems.

SureBeam Corp., the largest provider of the technology, said it expects to process between 300 million and 350 million pounds of beef this year, up from about 15 million in 2002.

"Irradiation eliminates 99.9 percent of the pathogens such as E. coli, salmonella and listeria without changing the taste, texture, appearance or nutritional value of the meat," said John Fox, associate professor of agricultural economics at Kansas State University. "In spite of its name, the process cannot make food radioactive."

The Food and Drug Administration (news - web sites) permits three types of ionizing radiation on foods: gamma rays, high-energy electrons and X-rays.

Irradiation is widely used to sterilize many non-food products, including toothbrushes, home-use adhesive bandage strips and surgical tools, although at doses much higher than used for food. Irradiation has been used to kill insects in wheat flour since 1963 and used on common kitchen spices since 1983.

Still, critics say irradiation may deplete vitamins and nutrients, and that irradiated food contains chemical byproducts that may be harmful. They say irradiation is an effort by meat packers and processors to cover up sloppy food-handling processes.

Washington-based consumer group Public Citizen, for example, is calling for studies on the long-term effects of treated meat on children. In the meantime, they oppose the use of irradiation for beef supplied by the Agriculture Department for school meals.

"A decision to feed schoolchildren irradiated food would mean this agency (USDA) is willing to put our children's health at risk to help cover up the meat industry's sanitary failures," said Wenonah Hauter, director of Public Citizen's Critcal Mass Energy and Environment Program.

Also, if irradiated food is permitted in school lunches, it will not be labeled in the way that irradiated retail food must be, making it impossible for parents to know what school cafeterias are feeding their children, critics point out.

The FDA requires irradiated meat be labeled with a symbol resembling a stylized flower and the words "treated by irradiation."

Immediate Benefits

Meat industry experts said irradiation is no "silver bullet" and proper food handling at home remains critical. Meat can be contaminated by residue from other foods or by utensils used to prepare other meals. Cooking of ground beef to an internal temperature of 160 degrees Fahrenheit (72 degrees Celsius) can kill E. coli and listeria, the Beef Council said.

Still, the proven benefits are clearly winning over many consumers and health care officials, and use of the technology is taking off.

A nationwide survey conducted by the National Cattlemen's Beef Association (news - web sites) found that 48 percent of Americans would purchase irradiated meat. That response in November 2002 was up from 38 percent in February. Industry officials said that small doses of irradiation should not affect the taste of the meat.

The World Health Organization (news - web sites) has endorsed irradiation, saying it is one of the most effective food decontamination methods available for meat and poultry products.

"On the average, one major retail (food) chain has rolled out irradiated ground beef every week basically since last August," said Ron Eustice, executive director of the Minnesota Beef Council. He said about 4,000 supermarkets carry either fresh irradiated ground beef or frozen products.

Supermarket companies Safeway Inc., Albertson's Inc. and Giant Eagle Inc. have all signed on to sell irradiated meat at some of their stores.

Meat Processors Take Action

The number of packers and processors irradiating beef is growing rapidly. They are beginning to contract for irradiation capability in their plants instead of at remote locations.

Excel, a division of Minnesota-based Cargill Inc., plans to install electron beam irradiation facilities at its packing plants in Schuyler, Nebraska, and Plano, Texas. Rochester, Minnesota-based TeMeats, and Minnesota-based W.W. Johnson Co. have announced plans to market irradiated product.

The former ConAgra Foods Inc. slaughterhouse in Greeley, Colorado, now operating as Swift and Co., has committed more than $4 million to increase food safety and plans later this year to have some of its meat irradiated. In July, the plant was the focal point of the third-largest beef recall in history when the company recalled almost 19 million pounds of beef because of E. coli concerns.

"Irradiated ground beef will become the gold standard at food service in the next two to three years," said the Minnesota Beef Council's Eustice. "Food irradiation will take its rightful place as the fourth pillar of public health alongside pasteurization of milk, immunization against disease and chlorination of our water supply -- and that will take place in the next decade."

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Holding Onto Memory

HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews) -- People with early-stage Alzheimer's disease (news - web sites) can engage additional brain areas to do well on memory tests.

A Canadian study, which appears in the current issue of the Journal of Neuroscience, is the first to find a link between this compensatory activity in the prefrontal regions of the brains of people with early-stage Alzheimer's and their ability to perform well on memory tests.

This compensatory effect doesn't last forever and diminishes as the mind-robbing disease progresses. Even so, the study authors feel it's an area that warrants further investigation. It may lead to treatments that can extend the compensatory effect and delay the degenerative effects of Alzheimer's.

The study included 12 healthy older adults and 11 older adults with probable early-stage Alzheimer's disease. All of the people with Alzheimer's were taking medication for their cognitive impairments.

All the study subjects performed memory tasks that were flashed on a computer screen. Overall, the people with Alzheimer's performed less accurately than the healthy study subjects.

However, some of the people with Alzheimer's did score within the normal range on the memory tests. The researchers found these people had more expansive activity in their brain's prefrontal network than the people with Alzheimer's who made more errors in the memory tests.

More information

Here's where you can learn more about Alzheimer's disease.

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Some Ovarian Cancer Survivors Can Retain Fertility

Reuters Health
Wednesday, February 5, 2003

NEW YORK (Reuters Health) - Women with a certain type of ovarian cancer can be treated with surgery and chemotherapy and still go on to have healthy children later in life, new research shows.

The study involved women with malignant germ cell tumors, an uncommon type of ovarian cancer that is usually diagnosed in adolescence or the early 20s. These tumors develop from the cells that produce eggs, and most are noncancerous. Those that are cancerous are treated with surgery to remove one or both ovaries followed, in most women, by chemotherapy.

In women who have just one ovary removed, there have been some concerns about whether they would be able to conceive and bear healthy children.

"Patients with this disease and their family members should be reassured about the high chance of retaining the patient's ability to conceive and have normal children after conservative surgery and combination chemotherapy," Dr. Peter Schwartz and colleagues at Yale University School of Medicine in New Haven, Connecticut, write in the February issue of Obstetrics & Gynecology.

The study involved 86 women treated between 1975 and 1995. In this group of women, 64 had just one ovary removed.

Follow-up surveys by mail or phone with these 64 women revealed that 38 had tried to get pregnant and 29 were successful. Even some women whose cancer has spread outside the ovaries before being treated were able to get pregnant, according to the report.

Of the 38 children born to these women, follow-up information was available for 16, none of whom had birth defects.

"To date, children born to these patients have not experienced an increased risk for congenital malformations or developmental abnormalities," the researchers write.

The study also found that four patients who were treated for cancer before having had their first menstrual period went on to menstruate normally after treatment. One of these women attempted to conceive later and was successful.

"This information is extremely important to parents of young girls diagnosed with malignant germ cell tumors of the ovary who are concerned about their daughters' future reproductive function," the study authors said.

Fertility-sparing surgery is sometimes also performed on young women with very early stages of other types of ovarian cancer.

Source: Obstetrics & Gynecology 2003;101:251-257.

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Death of Child Raises Mom's Risk of Dying Early

By Gary Gately
HealthScoutNews Reporter

HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews)-- When a child dies, the mother faces a much higher risk of early death than the father, Danish researchers say.

Compared with parents who had not lost a child, mothers were 43 percent more likely to die of any cause within 18 years of a child's death; fathers, 9 percent, the researchers report in the current issue of The Lancet.

The greatest risk of early death for parents came in the three years after a child died, the study found. During that time, mothers were nearly four times as likely to die of unnatural causes, while fathers had a 57 percent greater risk of early, unnatural death.

Unnatural deaths consisted mainly of motor vehicle accidents and suicides, and some of the accidents might actually have been hidden suicides or linked to alcohol consumption, depression or grief, says Jorn Olsen, a co-author of the study.

"I think the most significant finding is definitely this high mortality of unnatural causes we see after the death of a child, especially among mothers," says Olsen, an epidemiologist at the Epidemiology Science Centre at University of Aarhus in Denmark. "Losing a child is considered to be one of the most extreme stressors. This type of life event clearly puts the parents in a high-risk position, especially the mothers and especially shortly after the death of a child."

The study focused on information from Danish death registries from 1980 to 1996, tracking about 20,000 parents who lost a child and a control group of 293,000 whose children were alive.

The likelihood of a parent's unnatural death declined with the passage of time. However, four to eight years after a child's death, mothers were still nearly twice as likely as those who did not lose children to die of unnatural causes. And nine to 19 years later, they were 70 percent more likely to face that fate. Fathers were 13 percent more likely to die of unnatural causes nine to 19 years after a child's death.

The death of a child also increased the likelihood of a parent's death from natural causes, including circulatory and digestive diseases, the study found.

Compared with those who had not lost children, bereaved mothers had a risk of death from natural causes 6 percent higher the first three years after the death of a child; 16 percent, the fourth through eighth years; and 44 percent, the ninth through 18th years.

Fathers, by contrast, had a higher death risk from natural causes, 19 percent, only in the nine to 19 years after the death of a child.

Olsen suggests mothers may be more likely to die early after losing a child because they're more attached to children than fathers.

Among the study's other findings:

  • For mothers, the risks of unnatural death were highest after the death of a child aged 3 to 9 and lowest for those less than a month old.
  • The likelihood of parents dying early after losing a child decreased when they had more than one child.
  • Long-term effects of stress after a child's death can affect the nervous and immune systems, among other things. That can make parents more susceptible to infectious diseases and increase the risk of cardiovascular disease.
  • Stress also can lead to lifestyle changes such as smoking and drinking alcohol, altering the diet or reducing physical activity -- all of which could increase risk of both natural and unnatural deaths.

Barbara J. Paul, a Philadelphia psychologist who specializes in grief counseling, says the study shows the devastating impact of the loss of a child.

"It does have a catastrophic impact on the family," Paul says. "The health-care profession, as well as the mental health profession, need to be aware of that."

Early intervention to improve physical and mental health of grieving parents is crucial, Paul says, and often, increasing physical ailments start to show up nine to 18 months after the death of a child.

However, both parents are often so grief-stricken that they can't help each other and thus need support from friends and others, she adds.

Paul says the loss of a child can be more difficult for mothers: "They will often talk about the death of a child as the death of a part of themselves. They feel a part of themselves has died."

Grieving fathers, by contrast, may be at lower risk of early death because they become more involved in work and keeping the family together and functioning, Paul says.

More information

For more on parents grieving the death of a child, visit The Compassionate Friends and The MISS Foundation. You can also check out this AARP article.

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More Focus Needed on Post-Hospitalization Safety

Reuters Health
Wednesday, February 5, 2003

NEW YORK (Reuters Health) - If the results of an investigation at one hospital are any indication, nearly one in five people discharged from a hospital stay may experience an adverse medical event, such as a misdiagnosis or a medication error.

The good news, researchers say, is that their investigation also indicates that many of the adverse events could be prevented if health care providers took a few simple steps.

Few studies have been conducted to examine the experience of patients at home immediately after being discharged from the hospital, according to the report published in the February 4th issue of the journal Annals of Internal Medicine.

To investigate, lead author Dr. Alan J. Forster of the University of Ottawa in Ontario, Canada, and colleagues followed 400 men and women discharged from a single hospital. The researchers evaluated the medical records of each patient and conducted telephone interviews at two and five weeks after discharge.

Adverse events included new and or worsening symptoms such as a rash, constipation or insomnia, unanticipated need to visit their doctor and medication errors, according to the report.

In all, 76 of the patients (nearly 20%) experienced some kind of adverse medical event, Forster and colleagues report.

"One third of the adverse events were preventable," write Forster and colleagues. "Another third were ameliorable, that is, although they were unavoidable, their severity could have been decreased by earlier corrective actions.

"We conclude that many patients have adverse events during the transition of care from the hospital to home," the authors add.

The authors also point out that modifications in hospital systems regarding discharge could improve patient safety after hospital release.

"These system changes should focus on four areas: evaluating patients at the time of discharge; teaching patients about drug therapies, side effects, and what to do if specific problems develop; improving monitoring of therapies; and improving monitoring of patients' overall condition," Forster and colleagues conclude.

Source: Annals of Internal Medicine 2003;138:161-167.

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Anesthesia for Kids Damages Rat Brains

HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews) -- Common anesthesia drugs used on children caused brain damage and learning and memory problems in infant rats, a new study says.

Researchers from the University of Virginia Health System and Washington University School of Medicine in St. Louis anesthetized 7-day-old rats with a combination of drugs commonly used in pediatric surgery -- midazolam, nitrous oxide and isoflurane.

After the rats recovered from anesthesia, they were divided into three groups. One group was killed and had their brains examined the next day. The second group was kept alive until they were about a month old and the third group grew into adulthood.

The latter two groups were tested to see how the anesthesia affected their learning and memory. The researchers also recorded electrical activity in the rats' hippocampus. That's a brain structure that plays an important role in learning and memory.

The study found moderately severe brain cell death occurred in several brain regions, including the hippocampus, in every rat brain they examined. The researchers also found the anesthesia caused significant learning and memory problems in the rats, both at 1 month of age and in adulthood.

The rats were tested in several kinds of mazes used to evaluate memory and learning. In all the tests, the rats that had been anesthetized in infancy performed much worse than rats that had not been subjected to the anesthesia.

The findings appear in the Feb. 1 issue of the Journal of Neuroscience.

More information

Here's where you can learn more about anesthesia.

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Family Environment Influences Eating Disorder Risk

By Alison McCook
Reuters Health

Wednesday, February 5, 2003

NEW YORK (Reuters Health) - New research shows that girls may be more likely to develop eating disorders if they usually eat alone or if their parents are not married.

The risk of an eating disorder also increased among girls who spent a lot of time reading magazines targeted to young girls or listening to the radio.

Mass media may have its influence on a young girl's life by affecting her sense of what is beautiful and how her body compares to others', Dr. Miguel Angel Martinez-Gonzalez and his colleagues from the University of Navarra, Pamplona, Spain, suggest.

Changes in the family environment like divorce or the death of a parent can add stress to a teen's life, they add, a situation that may encourage her to adopt unhealthy eating habits. Additionally, mothers and fathers can influence a teen's eating habits, and having only one parent at most meals may limit how well parents can encourage healthy eating, the authors note.

Based on these findings, Martinez-Gonzalez told Reuters Health that a young girl's parents and people who care about her should always stay in communication with her, "increasing her self esteem."

"And she should not be left eating alone," he added. "Eating with others represents a potential restraint of eating disorder behaviors."

During the study, Martinez-Gonzalez and his colleagues surveyed 2,862 girls between the ages of 12 and 21. Eighteen months later, the researchers re-examined the girls who were initially free of an eating disorder and noted who had since developed an unhealthy eating pattern and whether they had any characteristics in common.

During the study period, 90 girls developed a new case of an eating disorder. Most of these new cases were girls who showed some symptoms of an eating disorder, but not enough to be clinically identified as having anorexia or bulimia.

Whether these so-called "partial" eating disorders will all lead to full-fledged eating disorders is not known, Martinez-Gonzalez said. "One could be the first step toward the other, but there is no specific evidence on this," he said.

The researcher and his team found that young girls who said they usually ate alone were almost three times as likely as others to develop a partial or full-fledged eating disorder during the study period.

Girls whose parents were no longer married--whether divorced, separated or widowed--were twice as likely to have developed an eating disorder within the previous 18 months, as were girls who reported frequently reading girls' magazines or listening to the radio, the authors write in the February issue of the journal Pediatrics.

Although the girls included in the study all lived in Spain, the researcher said he suspected that the same risks for eating disorders are present in other developed countries.

"The harmful messages of mass media and teen magazines, as well as the family problems, are unfortunately similar in Spain to what is happening in other Western countries such as the UK or US," Martinez-Gozalez said.

Source: Pediatrics 2003;111:315-320.

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Study Identifies Major Viruses Tied to Cervical Cancer

By Amanda Gardner
HealthScoutNews Reporter
HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews) -- A new study may help tweak the development of tailor-made vaccines against cervical cancer by identifying 18 strains of a sexually transmitted virus that causes most cases of the disease.

Researchers have identified 18 types of human papillomavirus (HPV) that have been linked to cervical cancer. While most of the types were already known, three more have been added to the list of "probable" carcinogens.

The results appear in the Feb. 6 issue of The New England Journal of Medicine (news - web sites).

"This codifies what's been the clinical practice in Western countries for at least five years with worldwide justification," says Dr. Giuseppe Del Priore, assistant director of gynecologic oncology at New York University Medical Center and director of the Cancer and Fertility Society. "It estimates the risk perhaps more precisely."

The authors revisit 11 existing studies, the results of which have already been incorporated into clinical practice, Del Priore says.

Virtually all cases of cervical cancer are caused by HPV, which is sexually transmitted. While more than 80 types of HPV have been identified, only 30 or so have been linked with malignancies. According to an accompanying article by Dr. Thomas Wright of Columbia University College of Physicians and Surgeons, the vast majority of cervical carcinomas contain one of 18 types of HPV DNA, as shown in this report.

Cervical cancer is the second most common cancer in women worldwide and the main cancer afflicting women in most developing countries.

In 1995, the International Agency for Research on Cancer (IARC) ruled that there was enough evidence to classify HPV types 16 and 18 as carcinogenic. Last November, researchers announced that a vaccine appears to be highly effective against HPV 16, which accounts for about 50 percent of all cervical cancer cases.

When the IARC made its conclusions, data on other types of HPV were limited, the study authors say. Seven additional studies have been completed since then, giving researchers enough information to draw additional conclusions.

Here, the study authors pooled data from those seven studies, in addition to the four earlier ones that had formed the basis of the IARC's 1995 announcement. These 11 studies came from nine countries and involved 1,918 women with confirmed cervical cancer as well as 1,928 women without cervical cancer.

HPV DNA was detected in almost 91 percent of the women with cancer and in slightly more than 13 percent of the control women. The most common types of HPV in the women with cancer, in descending order of frequency, were 16, 18, 45, 31, 33, 52, 58 and 35.

Among the control women, the most frequent types were 16, 18, 45, 31, 6, 58, 35 and 33.

Based on this information, 15 types of HPV were classified as high-risk. They were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82.

Three types -- 26, 53, and 66 -- were classified as probable high-risk types. Twelve were categorized as low-risk.

Eight types -- 16, 18, 45, 31, 33, 52, 58 and 35 -- accounted for 95 percent of the cervical cancers seen in the 11 studies.

"[These findings] imply that an effective vaccine against the five most common HPV types could prevent about 90 percent of the cases of cervical cancer worldwide," the authors write. Vaccines catering to specific geographical regions would have to take into account differences in the distribution of HPV.

Commercial tests already look for most of these strains, Del Priore says. The ones that aren't included represent such a small number of total cases that adding them into the mix probably wouldn't be worth it.

The study points out that the Hybrid Capture II test hunts for all the high-risk HPV types except 26, 53, 66, 73 and 82. Still, according to the study, in this sample of women, the test would have missed only 1.1 percent of infections in the group of patients with cancer and 0.4 percent in the control group.

"It's really nothing we're going to change practice on. It's a miniscule change," Del Priore says.

The key to cervical health is prevention. Women should make sure they get screened regularly.

More information

For more on cervical cancer, visit the National Cancer Institute or the American Cancer Society.

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Kids, Families Outgrow Stress of Early Medical Care

Reuters Health
Wednesday, February 5, 2003

NEW YORK (Reuters Health) - While a critically ill newborn's sickness can lead to difficulties for families in the first years of the child's life, such problems resolve by the time the child reaches age 12, according to a new study from Finland.

"This is encouraging for a large group of families that experience early separation from their newborn infant as a result of hospitalization," write Dr. Paivi Rautava of the University of Turku and colleagues.

Nearly 10% of newborns in Finland receive care in a neonatal unit, the researchers note. Past research has suggested that hospitalization of a newborn can lead to problems for parents and families, as well as later behavioral problems for the child. The researchers theorized that critical illness of a newborn, not necessarily hospitalization itself, would have detrimental effects on a child's behavior and family relationships.

To investigate, they compared 134 infants who received care in neonatal units and 952 children who did not receive such care, following them until they reached age 12. Their findings are published in the February issue of the journal Pediatrics.

All of the children in the study who were hospitalized were classified according to the severity of their illness. Parents of the children were interviewed when their child was 3 months, 9 months, 3 years and 12 years old about their own well being, their child's well being and their child's behavior problems, if any.

The Finnish researchers found that a newborn's critical illness did indeed have "long-lasting effects" on families and on a child's behavior.

Specifically, parents of critically ill newborns reported more child behavior problems at three years, such as problems falling asleep or temper tantrums. These parents also reported needing more support during the first year after delivery.

But by the time the children reached age 12, those hospitalized for critical illness had no more behavior problems than those who didn't require such care, according to parental reports.

In addition, the authors found that "the hospitalization of a newborn with a low medical risk did not have any negative consequences on family or child behavior."

The fact that this hospitalization--which requires early separation of newborn and mother--has no long-term consequences if the child is not seriously ill "is comforting and encouraging for the thousands of parents who experience this distressing situation," the authors conclude.

Source: Pediatrics 2003;111:277-283.

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Melanoma Transferred Via Donated Organs

By Amanda Gardner
HealthScoutNews Reporter
HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews) -- It was as if a hand had reached back from the grave, perpetrating a particularly cruel twist of fate on the living.

Sixteen years after a Scottish woman was first diagnosed with melanoma, the deadly cancer was transferred to two more people via the woman's donated kidneys.

"It's very worrisome," says Dr. Rona MacKie, lead author of a letter that appears in the Feb. 6 issue of the New England Journal of Medicine (news - web sites). "The amazing thing about this patient is the gap between having the melanoma diagnosed and giving her kidney."

It was double the length of time of any other case, which testifies to the resilience of tumor cells in the blood stream, MacKie says.

The cascade of events started out hopefully enough. In May 1998, a woman in Glasgow finally received the kidney that would enable her to go off dialysis.

All went well until a year and a half later, when a routine mammography turned up a spot on the woman's left breast. A biopsy uncovered something highly unusual: secondary melanoma, but no primary site. (Secondary cancers are those that have spread from another part of the body. Primary cancers refer to tumors at the original site.)

"We looked carefully for evidence of primary melanoma and didn't find it. I suggested to the renal doctors that it was possible this melanoma could have been in the transplanted kidney, but they were quite sure that was quite impossible," MacKie says.

Four months later, a second transplant patient arrived at the same hospital with a lump in his kidney that turned out -- again -- to be secondary melanoma with no indication of a primary site.

"What I found interesting was the dates of the transplants," MacKie recalls. "They were 24 hours apart."

The donor in both cases turned out to be the same person, a 62-year-old woman who had been treated for melanoma in 1982. When she died, 16 years later, ostensibly of a hemorrhage, her doctors had considered her cured.

While both kidney recipients had the organs removed and were treated for melanoma, only one survived.

How did this happen?

While the absolute reason will never be known because an autopsy was not performed on the donor, two scenarios emerge as possibilities, says Dr. Daniel Coit, chief of gastric and mixed tumor service at Memorial Sloan Kettering Cancer Center in New York City.

One is that the donor actually died of undetected metastatic melanoma. The second is that individual melanoma cells were lurking in her body, waiting for the opportunity to flourish.

MacKie prefers the second scenario.

"I think the cells were lying dormant in these two kidneys," she says. "As long as the patient has a normal immune system, the immune system copes and keeps them under control. Then you have a changed situation where they're put into other recipients who are required to have their immune system damped down. This allows the tumor to grow out."

All transplant recipients take immunosuppressant drugs to minimize the chances that the donated organ will be rejected.

It's an odd case, but not entirely without precedent, Coit says.

Eight or 10 years ago, Coit recalls, the heart of a young man who had been killed in a motorcycle accident was donated. An autopsy performed after the transplant showed that the donor had metastatic melanoma. By this time, though, it was too late. The recipient died of metastatic melanoma as well.

"Melanoma is easily transplantable," Coit says.

In another case, a lab technician stabbed her finger with a piece of glass that had been in contact with melanoma tissue. She developed a tumor on her finger. It was removed and she recovered, Coit says.

Although cancers have been transferred with a transplanted organ, melanoma seems to be particularly dangerous.

"There is a significant risk in patients with melanoma even after 10 or 15 years. It's not the same with other cancers," say Dr. Robert Fisher, professor of surgery and director of liver transplantation and transplantation research at Virginia Commonwealth University Medical Center.

"Melanoma is a very, very, very problematic cancer in that it can actually be like a hidden reservoir," Fisher adds. "At least in our practice, we have always considered melanoma to be a bad actor."

The moral of the story: People who have had invasive melanoma should not donate organs, the study says. In fact, they are already prohibited from donating blood, according to the American Red Cross (news - web sites).

And while the transplant surgeons should have checked the Scottish woman's background, she died on a weekend and her primary care physician couldn't be reached.

"They had to do it quickly. It was a question of time," MacKie says. "We now have a rule in Glasgow that for all patients who are possible donors, the general practitioner has to be consulted."

More information

For more on melanoma, visit the American Academy of Dermatology. The U.S. Department of Health and Human Services and TransWeb have information on organ donation.

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Mothers Better at Baby Talk Than Men, Study Says

Reuters
Wednesday, February 5, 2003

LONDON (Reuters) - Although infants don't really understand when their parents speak to them, women seem to be better at baby talk than men.

A computer program designed by scientists in the United States to study how voice pitch, rhythm and stress communicate meaning suggests that mother's coochy-coos are less ambiguous than dad's.

The program evaluated the properties of speech of six sets of parents who were told to encourage their babies and then to warn them to avoid dangerous objects.

It correctly differentiated between the majority of disapproval and approval tones.

"But to the researchers' surprise, the program correctly identified 12% more of the comments made by the mothers, suggesting that women use less ambiguous sound than men to convey to babies what they mean," an article in New Scientist magazine said on Wednesday. Gerald McRoberts, of Lehigh University in Pennsylvania, and Malcolm Slaney, of IBM's Almaden Research Center in San Jose, California, who designed the program, said the fathers could have been nervous or the computer may have failed to pick up nuances in their speech.

"But the experiment does show unequivocally that the mothers and fathers talked to children differently," the magazine added.

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Soy-Tea Combo May Thwart Prostate Cancer

By Colette Bouchez
HealthScoutNews Reporter

HealthScoutNews
Wednesday, February 5, 2003

WEDNESDAY, Feb. 5 (HealthScoutNews) -- The same two foods that many scientists believe reduce the risk of breast cancer (news - web sites) in women may also protect men from prostate cancer (news - web sites).

That's the conclusion of a new Harvard University study that looked at the power of tea and soy to inhibit the growth of prostate tumors in mice.

Unlike other studies that examined the food's individual effects on tumor growth, the new research focused on the power that came from the combined effect of tea and soy together.

"I think the most important finding is that consumption of both soy and tea has a synergistic effect," says study author Jin-Rong Zhou, adding that each appears to reinforce the power of the other to fight cancer.

The study appears in the February issue of The Journal of Nutrition.

Zhou says he got the idea to test the soy-tea combination when statistical data showed that China had one of the lowest prostate cancer risk profiles in the world. Sensing that diet may play a key role, he dissected Chinese food habits and looked at what the men were eating most.

While a number of foods made the list, Zhou says tea and soy jumped out, mostly because previous studies showed they may possess anti-cancer properties.

"By combining the facts that soy and tea are more commonly consumed [in China] and their bioactive components are more potent than other dietary components, we proposed that they are effective dietary components, especially in combination, for prostate cancer prevention," Zhou says.

Zhou and his colleagues put their theory to the test on 16 mice, each genetically engineered to grow tumors in the prostate region. All the mice ate a diet of protein, carbohydrates, vitamins and minerals, while some were also fed daily doses of soy compound in varying amounts. Infusions of both black and green tea were given to all the mice to drink.

The amount of soy consumed by the mice would be equivalent to about 250 milligrams per day for a human, while the tea dose was equivalent to about 6 to 8 cups a day, Zhou says.

At the end of the study, the mice were examined for not only the presence of prostate tumors, but also the size of the tumors, their rate of growth and how much the disease had spread. These figures were then analyzed in regard to soy and tea consumption.

What the researchers found: Individually, the soy complex, and the black and green tea reduced the rate at which tumors developed. When tumors did grow, they were smaller when either tea or soy was consumed.

However, when taken together, the tea-soy combination was even more powerful, not only at inhibiting tumor growth, but also at reducing the weight of any tumors that did develop, as well as controlling the spread of cancer to nearby lymph nodes. The soy and green tea combination also reduced hormone concentrations linked to prostate cancer.

Ultimately, both tea-soy combinations inhibited angiogenesis, a process in which tumors grow blood vessels to stay alive.

The bottom line: Alone and especially together, tea and soy exhibited powerful anti-prostate cancer effects, the study says.

For nutritionist Jyni Holland, the research holds promise, but she doesn't think men should flood their diet with tea or soy just yet.

"Keep in mind that it was a mouse study, and many promising animal results never translate to human success," says Holland, a clinical nutritionist at New York University Medical Center.

At the same time, she says that since both tea and soy have been shown in other studies to yield many important health benefits, adding them to your diet in moderation could have positive results.

"I wouldn't run out and buy soy or green tea supplements. But if you want to include these foods in your diet, then you may be well ahead of the game if and when this research does prove true in humans," Holland says.

More information

To learn more about the heath benefits of tea, visit Kansas State University. For more information on prostate cancer, check with The National Prostate Cancer Coalition.

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TUESDAY, FEBRUARY 4, 2003

Low Estrogen Linked to Heart Risk in Young Women

By Alison McCook
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Women with relatively low levels of estrogen in their bodies before menopause appear to be at higher risk for clogging of the heart arteries than their peers with higher levels of estrogen, researchers announced Tuesday.

Relatively young women are more than twice as likely to die from a heart attack as relatively young men, and the current findings suggest that low estrogen may hinder a woman's recovery from the heart attack, Dr. Noel Bairey Merz said.

"Low estrogen may lead to worse physiological response to a heart attack and make the women less responsive to (heart attack) treatments," she suggested.

Bairey Merz and her colleagues discovered that women with relatively low levels of estrogen who were being checked out for heart disease were more than seven times as likely to show signs of clogged arteries as women with normal estrogen levels who were also being checked for possible heart disease.

The women were all under 55 years of age, and had hormone levels that indicated they had not yet gone through menopause.

Bairey Merz and her team also discovered that women who were taking antidepressant medications or other psychiatric medications were more likely to have low levels of estrogen, indicating that stress may play a role in how much estrogen is in the body.

In the current study, all of the women with low levels of body estrogen had this condition as a result of problems with a region of the brain known as the hypothalamus. However, loss of functioning in the ovaries or surgical removal of the ovaries can also reduce estrogen levels in the body, explained Bairey Merz, who is at Cedars-Sinai Medical Center in Los Angeles.

She said that estrogen may help protect women from factors that would normally put them at risk of heart troubles.

"Animal models suggest that estrogen buffers damage from traditional risk factors--cholesterol, cigarettes, high blood pressure--so its absence results in loss of this protection," she said.

Women with low estrogen often have outward symptoms of the condition, Bairey Merz noted. In some cases, they may not menstruate, or have irregular cycles.

For women that know they have low estrogen and want to stay heart healthy, the researcher recommended working on aspects of health that have been shown to reduce heart risks, such as cutting smoking, eating healthy, getting regular exercise, and reducing stress.

Studies have shown that taking estrogen as part of hormone replacement therapy does not cut the risk of heart disease, and may even increase the risk.

Bairey Merz and her colleagues stress in the February 5th issue of the Journal of the American College of Cardiology that this study only links coronary artery disease to low estrogen, and cannot say that one causes the other. Coronary artery disease itself could reduce estrogen levels in relatively young women, they note, and another factor like stress could be responsible for both conditions.

The findings are based on scans of the cardiovascular systems of 95 premenopausal women, all of whom had undergone angiography, which involves threading a catheter through a vein into the heart and then injecting dye into the coronary blood vessels.

Among women with clogged arteries, 69% had low estrogen levels as a result of hypothalamic problems, while only 29% of women without clogged heart arteries had low estrogen levels.

Source: Journal of the American College of Cardiology 2003;41:413-419.

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Alzheimer's Caregivers at Greater Risk of Blood Clotting

HealthScoutNews
Tuesday, February 4, 2003

TUESDAY, Feb. 4 (HealthScoutNews) -- People looking after loved ones with Alzheimer's disease (news - web sites) could be at increased risk of excessive blood clotting.

That's the finding of a new study in the January-February issue of the journal Psychosomatic Medicine.

The University of California, San Diego-led study included 54 men and women providing home care for a spouse with Alzheimer's disease. The researchers collected information from each person about stressful life circumstances, unrelated to their caregiver role, in the four weeks before the start of the study.

Each person in the study was evaluated for depression, and information was collected about their overall health and medication use. The researchers took a blood sample from each person to measure levels of three indicators of excessive blood clotting.

The study found the caregivers who reported a higher number of recent negative life events (for example, the death of a child from cancer) were more likely to have higher levels of an excessive blood clotting indicator called fibrin D-dimer (DD).

The researchers note that an increase in DD, even within the normal range, may predict heart attacks and other coronary problems in healthy people, as well as in people with coronary disease.

The study indicates that serious life stress may cause excessive blood clotting in these caregivers. This hypersensitivity to blood clotting can play a major role in clogging and blockage of coronary arteries, which are the major vessels that carry blood to the heart.

More information

Here's where you can learn more about coronary disease.

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Vitamin A May Shield Former Smokers

HealthScoutNews
Tuesday, February 4, 2003

TUESDAY, Feb. 4 (HealthScoutNews) -- A chemical cousin of vitamin A may shield former smokers from lung cancer.

Researchers at the University of Texas M.D. Anderson Cancer Center found that giving a vitamin A derivative called 9-cis retinoic acid (9-cis-RA) to former smokers restored production of a protein believed to protect against lung cancer. Their report appears in the Feb. 5 issue of the Journal of the National Cancer Institute (news - web sites).

The study found no evidence that three months of therapy with 9-cis-RA restored health to cells that were already precancerous. However, the study shows that "chemoprevention" of future lung cancer may be feasible.

There are about 45 million former smokers in the United States. By quitting smoking, they've reduced their risk of developing lung cancer. However, the genetic damage caused by smoking doesn't immediately disappear when someone stops smoking.

Half of all new lung cancer cases are diagnosed in former smokers. Researchers are trying to find ways to stop smoking-related genetic damage from turning into cancer.

More information

Here's where you can learn more about lung cancer.

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Many With Scoliosis Can Skip Treatments

By Lindsey Tanner
AP Medical Writer
The Associated Press

Tuesday, February 4, 2003

CHICAGO - Many adolescents diagnosed with spine curvatures can skip braces, surgery or other treatments without developing debilitating physical impairments later in life, a 50-year study suggests.

Previous research presented a grim prognosis and led to mandatory school screening programs in 26 states, based on the misperception that spine deformities inevitably lead to severe, even life-threatening disabilities.

Untreated patients did have more back pain and more body-image concerns than study participants with normal spines and three deaths were considered possibly linked to the deformity.

But untreated patients had similar death rates and were just as functional and likely to lead productive lives 50 years after diagnosis as people with normal spines.

"The bottom line is most patients are doing very well," said lead author Dr. Stuart Weinstein, an orthopedic surgery professor at the University of Iowa.

The study's results are based on 50 years of follow-up information on 117 patients diagnosed with scoliosis between 1932 and 1948. They appear in Wednesday's Journal of the American Medical Association (news - web sites).

The study only compared untreated patients with people who didn't have scoliosis so no conclusions can be drawn about whether untreated people would fare as well as treated patients, Weinstein said.

Dr. Paul Sponseller, a Johns Hopkins University orthopedics specialist who wrote an accompanying editorial in JAMA, said it is unclear whether today's image-conscious adolescents would accept deformity without treatment.

Still, Sponseller said school screening programs often result in "over-referrals" for treatment, and he suggested the study could lead to more effective screening focusing on youngsters with the most critical need.

The study involved a spine curvature that develops after age 10, runs in families and has no known cause. Formally called late-onset idiopathic scoliosis, it has been estimated to affect at least 2 percent of Americans, including about 60,000 adolescents.

A normal spine looks like a straight line down the middle of the back when viewed from behind. But in patients with scoliosis, the spine may have a noticeable "S" or "C" shape and the shoulders and sides of the waist may appear uneven.

Severely curved spines can encroach on the chest cavity and interfere with normal heart and lung function, but the study suggests those cases are rare.

Modern treatments — surgery to correct curves of about 50 degrees or more, or back braces to prevent worsening in less severe cases — were not available at the study's outset, Weinstein said.

When the spine stops growing, the average curve of scoliosis patients studied was about 50 degrees, and most got worse throughout adulthood.

The study participants were among 444 people diagnosed beginning in the early 1930s. Some were not eligible for follow-up or died; the authors also were not able to interview 127 patients and lacked information on cause of death in several patients. Weinstein said he does not believe that affected the results.

On the Net:

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

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Exercises in Pregnancy Avert Incontinence Later On

By Alison McCook
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Women who perform strengthening exercises for their pelvic floor muscles during pregnancy appear to reduce their risk of developing urinary incontinence during pregnancy and after childbirth, new research shows.

Indeed, the investigators calculated that the training program targeted to pelvic floor muscles helped one of six women avert incontinence during pregnancy, and prevented the condition in one in eight women after childbirth.

Study author Siv Morkved of the Norwegian University of Science and Technology in Trondheim told Reuters Health that any reduction in the risk of incontinence--a distressing problem--likely provides enough incentive for women to complete the training program.

The program does not require much time, Morkved said, and has no known side effects.

The researcher added that strengthening pelvic floor muscles has shown to help people prevent and treat other conditions, and the program can arm women to deal with future difficulties like fecal incontinence, pelvic pain and sexual health problems.

"During the training course, the women learn how to train the pelvic floor muscles themselves, and they get information about why this training is important throughout life," Morkved said. "It gives women control over this part of their own health."

The researcher explained that the pelvic floor muscles are designed to squeeze around the vagina and the openings of the urethra and anus. These muscles provide structural support to keep pelvic organs where they need to be, a job that is especially important during pregnancy, Morkved said.

During the bodily stress of pregnancy and vaginal childbirth, however, the pelvic floor muscles may be injured or have impaired function due to injury to the nerves that feed them.

"This means that because of the injury, the muscles that should give support to keep the bladder and urethra in position and contract to help close the urethra do not function optimally," Morkved explained. This raises the risk of incontinence.

During the current study, Morkved and colleagues assigned 148 pregnant women to a pelvic floor muscle strengthening program, during which they spent one hour weekly for 12 weeks with a physiotherapist. Women were also asked to spend a few minutes practicing at home each day.

Reporting in the February issue of Obstetrics and Gynecology, Morkved and colleagues discovered that at the 36-week point in pregnancy, 32% of women who underwent training reported incontinence, relative to 48% of the 153 pregnant women who did not receive the program.

Three months after childbirth, only 20% of those given the training program reported urinary incontinence, relative to 32% women who were not trained during the study.

In an interview, Morkved explained that strength training likely reduced the risk of incontinence by forming a stronger and thicker support for the bladder, urethra and other pelvic organs.

Source: Obstetrics and Gynecology 2003;101:313-319.

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Heart Attack Symptoms

HealthScoutNews
Tuesday, February 4, 2003

(HealthScoutNews) -- Although chest pain is often a warning signal of a heart attack, nearly half of all cardiac arrests begin without this classic symptom.

In a study by the University of California, San Francisco, 47 percent of heart attack victims showed other symptoms, including shortness of breath, dizziness, light-headedness, and in some cases, stomach pain, nausea and vomiting.

Cardiologists advise that if you go to the emergency room with breathing problems and you don't have a history of asthma, make sure the resident physician considers the possibility of a heart attack.

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HIV Drugs May Promote Artery Disease: Mouse Study

By Merritt McKinney
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Powerful drugs used to fight HIV (news - web sites), the virus that causes AIDS (news - web sites), are known to increase triglycerides and cholesterol in the blood, both of which can promote the development of artery disease.

Now, new research in mice suggests that the drugs, known as protease inhibitors, may directly contribute to artery disease even before triglyceride and cholesterol levels rise.

Since the research was carried out in animals, it is too soon to say whether protease inhibitors have the same effect in people, Dr. Eric J. Smart, the study's lead author, told Reuters Health in an interview.

"We now are checking to see if the same thing happens in patients," said Smart, who is at the University of Kentucky Medical School in Lexington.

"This doesn't mean that the protease inhibitors should be stopped," Smart said. He noted that the drugs, which are mostly used in combination with other anti-HIV drugs, can suppress HIV and extend life in many people.

But if protease inhibitors turn out to have the same effect on the arteries in humans as they do in mice, Smart said, "we may have to be a little more careful" in how the drugs are used.

Current screening for triglycerides and cholesterol do not detect the kind of artery problems found in the mouse study, according to the Kentucky researcher. There are several research screens, however, that might be developed into a clinically useful test, he said. Of course, Smart noted that whether such a screen will be needed depends on whether the mouse results are confirmed in humans.

In the study, Smart's team found that three different protease inhibitors--ritonavir, indinavir and amprenavir--increased levels of a protein called CD36 and enzymes called cholesteryl esters in cells called macrophages. These changes, which are typical of what happens in the lesions that build up to clog arteries, occurred both in mice and in samples of human cells.

And when the researchers tested low doses of the protease inhibitors in mice, the animals developed early artery disease. This was true even though their triglycerides and cholesterol levels remained normal.

The study provides the first evidence that protease inhibitors have a direct effect on the development of artery disease, according to Dr. David Y. Hui of the University of Cincinnati College of Medicine in Ohio.

It is possible that protease inhibitors increase the risk of artery disease not only by boosting levels of triglycerides and cholesterol but also by acting directly on macrophages, Hui notes in an editorial that accompanies the study.

Both of these actions share a common pathway, so if future evidence confirms the findings, it may be possible to develop drugs that would prevent the artery complications of protease inhibitors, Hui suggests.

The study was funded by the National Institutes of Health (news - web sites) and drugmaker Bristol-Myers Squibb.

Source: Journal of Clinical Investigation 2003;111:317-318,389-397.

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Fright Nights

HealthScoutNews
Tuesday, February 4, 2003

(HealthScoutNews) -- Night terrors are scary -- not just for kids but for parents, too.

They're different than nightmares, which are disturbing dreams that happen during deep REM sleep and can be remembered for years. With night terrors, your child may wake up with a blood-curdling scream and look terrified, but not remember a thing.

According to the Nemours Foundation, night terrors are common among children between ages 3 and 5. They usually occur about an hour or two after a child goes to sleep.

While these events can be disturbing, they're not harmful to your child.

Here are a few things you can do:

  • Ensure your child gets enough rest. Fatigue may spur an episode.
  • Know what upsets your child and try to minimize the distress.
  • If your child's night terrors tend to occur at the same time each night, wake him about 30 minutes before they usually happen. Get him out of bed and have him talk to you for about five minutes before letting him go back to sleep.

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Diving Safe for Healthy Seniors: Study

By Merritt McKinney
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Being a little long in the tooth should not stop scuba enthusiasts from plunging into the ocean, according to North Carolina researchers.

Despite concerns that changes in lung function that naturally occur as we age would make diving more dangerous for older people, the results of a new study suggests that diving is safe for healthy older folks.

About 30% of the lung capacity we use to breathe in and out is "dead space," according to Dr. Richard E. Moon, the senior author of the study. This dead space neither brings oxygen to the blood nor removes carbon dioxide, explained Moon, who is at Duke University Medical Center in Durham.

"As we age, this percentage tends to increase," Moon told Reuters Health. And, for reasons that are not well understood, during diving, the percentage of dead space jumps to 40% to 45% in younger people, he said.

Since dead space naturally increases with age, Moon said, "We were therefore concerned that aged divers may have an even higher dead space during diving." This extra dead space, he explained, could lead to too much carbon dioxide in the blood, which can make a person confused and lead to loss of consciousness.

To test the effect of age on divers, Moon's team studied two sets of healthy divers--one group aged 19 to 39 and another aged 58 to 74. None of the volunteers had heart or lung disease.

Using a special chamber to simulate the conditions of a dive almost 60 feet below the surface of the ocean, the researchers measured levels of gases, including carbon dioxide and dead space, in the blood of participants.

As expected, dead space was higher than normal in both older and younger participants when they were in the underwater simulation, the researchers report in the February issue of the Journal of Applied Physiology. The dead space was "slightly higher" in older participants than in younger ones, Moon said.

But there was no significant difference between the age groups in levels of carbon dioxide in arteries.

"In this first study of respiratory physiology in older people, we found that in healthy older subjects--no respiratory or heart disease--significant carbon dioxide elevation does not seem to occur at a depth of 60 feet or less," Moon said.

The study did not look at whether age has an effect on decompression sickness, or the "bends," a complication that can occur when a diver comes to the surface too quickly.

The study was funded by the Divers Alert Network, a diving safety group affiliated with Duke.

Source: Journal of Applied Physiology 2003;94:507-517.

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Scientists Probe Kidney Patients' Heart Risk

By Richard Woodman
Reuters Health

Tuesday, February 4, 2003

LONDON (Reuters Health) - A new study to find out why patients with kidney failure are at such high risk of developing cardiovascular disease is to be carried out in Britain.

The British Heart Foundation said researchers at the University of Birmingham would follow up over 300 kidney failure patients who took part in a study four years ago to assess cardiovascular risk factors.

Results of the previous study already showed that 72 patients had died and that 95 vascular events had occurred in 66 individuals, the charity said in a statement.

Patients taking part in the follow-up study will be interviewed by a research nurse who will record demographic details alongside a history of their kidney disease and any cardiovascular events. Other details including weight, current medication, blood pressure, a blood sample and results of an electrocardiogram (ECG) will be considered.

Lead researcher Dr. Jonathan Townend said: "With approximately 34,000 people in the UK suffering from kidney failure, the potential for the results of this study to help improve the quality of life for these patients is huge.

"We hope that the results of the follow-up study will provide a greater understanding of why patients with renal failure develop cardiovascular disease--and ultimately lead to a reduction in the number of people suffering."

Statistics show that in dialysis patients younger than 45, the risk of cardiovascular death is 100 times that of the general population. One in five patients starting dialysis already has a heart condition and more than three-quarters have evidence of structural heart disease.

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Moderate Drinking Can Keep Stroke at Bay

By Ed Edelson
HealthScoutNews Reporter

TUESDAY, Feb. 4 (HealthScoutNews) -- Want more proof that moderate alcohol consumption can do you some good, but heavy drinking does great harm?

A new, wide-ranging study says heavy drinking -- more than 60 grams, or five shots of hard liquor a day -- increases the risk of stroke by more than 60 percent, compared to those who don't drink at all.

But lighter drinking -- less than 12 grams, or one shot a day -- reduced the risk of stroke by 20 percent, compared to teetotalers.

To arrive at those numbers, researchers at the Tulane University School of Public Health and Tropical Medicine gathered 122 studies that examined the health benefits and hazards of alcohol and settled on 35 that focused on drinking and stroke.

Compared to non-drinkers, heavy drinkers had a 69 percent greater risk of ischemic stroke, the kind that occurs when a clot blocks blood flow to the brain. And the heavy drinkers had about double the risk of hemorrhagic stroke, which happens when a blood vessel in the brain bursts.

However, those who consumed less than one shot a day reduced their risk of ischemic stroke by 20 percent, compared to teetotalers.

And those who drank two or three shots a day had a 28 percent reduction in risk of ischemic stroke, compared to abstainers, says the study, which appears in the Feb. 5 Journal of the American Medical Association (news - web sites).

The researchers' numbers come from a "meta-analysis" of the 35 studies -- a sophisticated mathematical method of summing up multiple findings, says lead author Kristi Reynolds, a graduate research student at Tulane. The analysis was done, she says, because there have been conflicting results from studies about the relationship between drinking alcohol and stroke risk.

"Some studies have shown alcohol to be both a risk factor and a protective factor, and some have found it increases the risk of both hemorrhagic and ischemic stroke," she says. This new report clarifies alcohol's benefits and risks, she adds.

Dr. Robert H. Eckel is professor of medicine at the University of Colorado Health Sciences Center and chairman of the American Heart Association (news - web sites)'s scientific council on nutrition, physical activity and metabolism.

Eckel recently told HealthScoutNews: "The American Heart Association is aware of the potential benefits of alcohol."

The association is also aware of the potential dangers of drinking, he said. Among the health threats listed on the heart association's Web site are high blood pressure, heart failure and excessive calorie intake that can lead to obesity, a major risk factor for stroke and other cardiovascular diseases.

"If you look at alcohol as a drug, the potential adverse effects would be sufficient enough to limit its use," Eckel said.

The heart association does not encourage any abstainer to take up drinking because of its possible beneficial effects. "We encourage adults to discuss the use of alcohol with their physicians," Eckel said.

More information

You can learn more about alcohol and cardiovascular disease from the American Heart Association. To learn more about stroke, visit the National Institute of Neurological Disorders and Stroke.

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Easy Sleepers May Have Leg Up on Longevity

By Alison McCook
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Older adults who have no problems sleeping, such as waking up during the night or taking a long time to fall asleep, may have a survival advantage over their peers who find sleep more of a struggle, new research suggests.

The study discovered that people who were seemingly healthy but spent more than 30 minutes trying to fall asleep were more than twice as likely to die within an average of 13 years than people of similar age who fell asleep more quickly.

Dr. Mary Amanda Dew and her colleagues also found that people who spent a smaller percentage of their time in bed snoozing were also almost twice as likely to die within the same period as their easy-sleeping peers.

The researchers also report a shorter lifespan among people who spend the least or the most time in REM--the dream phase of sleep--compared with those with an average amount.

Dew said that minor sleep problems may act as a "subtle indicator" that seemingly healthy people have undetected problems that could, in future years, affect their well-being.

As such, slight changes in an older person's sleep behavior may act as "an early harbinger that other things were going to go wrong," Dew noted.

For example, researchers have shown that people with dementia or depression may experience changes in their sleeping patterns, and these two conditions can hasten death, Dew added. Consequently, recent patterns such as taking a long time to fall asleep or waking up often during the night may be a reflection of early signs of dementia or depression, she noted, which may, in future years, put someone's health in jeopardy.

Dew cautioned that occasional difficulties falling asleep and waking from time to time during the night can be perfectly normal. However, if an older adult experiences a change in his or her sleeping pattern that seems to persist over time, it might be wise to consult a doctor, Dew said.

During the study, the University of Pittsburgh, Pennsylvania researcher and her colleagues measured the brain activity of 185 people between 59 and 91 years old during sleep, then followed the same people for an average of 13 years. None of the people had health problems that are known to affect sleep.

More older adults report having problems sleeping than any other age group, Dew and her colleagues note in the report in the journal Psychosomatic Medicine. Consequently, it makes sense for all older adults to adopt certain habits to help them rest well, Dew said in an interview.

These healthy sleeping habits include dedicating an area strictly to sleep, which is kept quiet and dark when sleeping. People should avoid caffeine and alcohol immediately before falling asleep, she added, and be careful that lengthy naps don't interfere with nightly sleep.

Sleeping too much during the day can make it hard to fall asleep at night, Dew said. For people who need to take naps during the day, she recommended sleeping in bouts of 15 to 20 minutes, which may provide the benefits of longer sleep without disrupting a person's general sleeping schedule.

Napping is like most things in life, Dew said. "If you do it in moderation, it's probably helpful. If you do it too much, it itself could be an unhealthy thing."

In an accompanying editorial, Dr. Daniel F. Kripke of the University of California, San Diego writes that the current study, "surprisingly," did not report that sleeping too little can hurt health.

This is particularly remarkable, given that 40% of the people included in the study slept less than six hours each night, he notes.

Source: Psychosomatic Medicine 2003;65:63-73.

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Harvard Researchers Discover Why Youthful Sun Damage Leads to Skin Cancer

By Colette Bouchez
HealthScoutNews Reporter

HealthScoutNews
Tuesday, February 4, 2003

TUESDAY, Feb. 4 (HealthScoutNews) -- Doctors have long known that getting a severe sunburn when you're young increases your risk of skin cancer later in life.

Now, researchers from Harvard's Dana-Farber Cancer Institute say they may finally know why.

In a study that appears in this week's Proceedings of the National Academy of Sciences (news - web sites), the researchers used newborn mice to illustrate how the sun's rays damage something called the Rb pathway -- a chain of biochemical signals that regulate cell activity, including suppressing the growth of malignant tumor cells.

"I think the key finding of our study is the observation of Rb pathway being hit specifically by UV [ultraviolet rays] and the potential implication of this," says study author Dr. Lynda Chin, an assistant professor of dermatology at Harvard Medical School (news - web sites).

Essentially, a tumor develops when normal cells experience environmental or other types of damage, causing them to reproduce at an alarming rate. Under normal conditions, Chin says the Rb pathway will sense something is not right within the cell and turn off its ability to clone itself. This, in turn, stops tumor formation.

However, if the Rb pathway becomes damaged by UV rays, particularly before the age of 17, researchers say the pathway's tumor-suppressing powers are compromised. With each new environmental assault, including sun exposure, the chances of malignant cells developing increases.

What's more, Chin says, damage to the Rb pathway appears to be a direct link to melanoma, the deadliest form of skin cancer.

"Rb pathway is presumably constraining growth of to-be melanoma cells; the UV inactivates this [protection] to allow melanoma to develop," Chin explains.

If not treated early, melanoma is among the most aggressive cancers and rapidly spreads to cells throughout the body. According to the American Cancer Society (news - web sites), nearly 8,000 people are expected to die of melanoma in 2003 -- a 44 percent increase since 1973.

However, if caught early, those damaged cells can be surgically removed, halting the spread of disease and dramatically decreasing the risk of death, experts say.

For dermatologist Dr. Ted Daly, the new research represents a departure from the way in which doctors previously viewed the sun's role in skin cancer.

"The accepted dogma was that the solar radiation hits a gene spot and causes kind of like a break in a zipper, so the cell no longer can divide correctly," says Daly, director of Pediatric Dermatology at Nassau University Medical Center. The new theory points up an entirely different path of destruction that, while hopeful, remains to be proven in humans, he adds.

"The negative is that mice are not men, so there's still a long way to go," Daly says.

Researchers arrived at their conclusions studying newborns of two strains of genetically engineered mice -- both bred to be susceptible to cancer. The mice then experienced various stages of cell damage, including some who received UV damage to the Rb pathway. Ultimately, the incidence of tumor growth in all the mice was compared.

What they found: The mice with the damaged Rb pathway were the ones most likely to develop melanoma. They also developed twice as many tumors, and their lesions appeared up to six weeks sooner than mice that experienced other types of cell damage.

If Chin's theory proves true in humans, she says doctors can use the Rb pathway as a guide to help distinguish between cancerous and non-cancerous skin lesions -- without the need for surgery.

That could be the most significant part of the new research, Daly says.

"You could take a biopsy, look for the Rb pathway and if it was inactivated -- indicating early UV damage -- you would know it's a typical lesion that should be removed," he says. If it worked, Daly adds, it would be "more than wonderful; it would be miraculous."

More information

Learn more about the risks for melanoma skin cancer at The Skin Cancer Foundation.

For more information on saving your skin from sun damage, visit The American Academy of Family Physicians.

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Berries a Good Source of Plant Antioxidant

By Stephen Pincock
Reuters Health

Tuesday, February 4, 2003

LONDON (Reuters Health) - Berries such as cranberries and blackcurrants are good sources of a compound that may fight cancer and heart disease, researchers from Finland have found.

They discovered that eating berries popular in Finland--lingonberries, which are closely related to cranberries; blueberry-like bilberries and blackcurrants--translated into higher levels of a flavonoid called quercetin in the blood.

Flavonoids, found in a variety of fruits and vegetables, are thought to combat oxidation, a process in which cell-damaging substances called free radicals accumulate. "Berries are kind of a forgotten source of many potentially beneficial components--fiber, vitamin C, and many flavonoids and other phenolic compounds," study author Dr. Iris Erlund told Reuters Health. "They are also low in energy and fat."

Quercetin is one of the most potent dietary antioxidants, according to lab research, and most studies performed so far indicate that it may protect against cardiovascular diseases, Erlund said. Animal studies also indicate an anti-cancer effect, but evidence from human populations is not as strong in this respect.

The researchers randomly assigned 40 60-year-old men to two diets. Twenty ate 100 grams a day of blackcurrants, lingonberries and bilberries for eight weeks, while the others ate as normal.

While the men were eating the berries, their blood quercetin level increased 32% to 51% compared to men eating their normal diet, the researchers report in the European Journal of Clinical Nutrition. After eight weeks, men eating berries were taking in about 12 milligrams per day of quercetin, compared to about 5.8 mg per day in the control group.

Overall, the best source of quercetin is yellow or red onion, Erlund said. Berries contain a little less, but many have higher levels than tea and red wine, which are often mentioned as good sources.

But not all berries are good sources, she noted. "The best berry sources in Scandinavia are cranberries, lingonberries, bilberries and black currants, in the order of quercetin content."

Heating and freezing destroy many antioxidants, the Finnish researchers said, so it is best to eat fruits like berries uncooked. "However, not everything is destroyed, and there is still plenty left after storage in the freezer or heating to make jam for instance," Erlund said.

Juices, on the other hand, often contain less of the beneficial compounds because processing does not completely release them from the berry skin, she said.

Source: European Journal of Clinical Nutrition 2003;57:37-42.

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Colonoscopy Riskier Than Sigmoidoscopy

HealthScoutNews
Tuesday, February 4, 2003

TUESDAY, Feb. 4 (HealthScoutNews) -- Perforation of the colon occurs twice as often during colonoscopy as it does during sigmoidoscopy.

So says an American study in the Feb. 5 issue of the Journal of the National Cancer Institute (news - web sites).

The Columbia University-led study compared the risks of colon perforation in people aged 65 and older by analyzing a database of people who were cancer-free and had undergone at least one colonoscopy or sigmoidoscopy between 1991 and 1998.

Of the 39,288 colonoscopies included in the analysis, there were 77 colon perforations. That works out to 1.96 perforations per 1,000 colonoscopies.

That compares to 31 perforations in 35,298 sigmoidoscopies, a rate of 0.88 perforations per 1,000 sigmoidoscopies.

After adjusting for factors such as age, race and gender, the researchers determined the perforation risk from sigmoidoscopy was about half that of colonoscopy.

The study also found that about 5 percent of the people who had a colon perforation died within 14 days of having their procedure.

Doctors use a colonoscopy to check the entire length of the colon for cancer or precancerous abnormalities. Sigmoidoscopy is a similar, less expensive technique that's limited to the section of the colon closest to the rectum.

More information

Here's where you can learn more about colonoscopy and sigmoidoscopy.

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Moderate Exercise Doesn't Alter Breast Milk: Study

By Jacqueline Stenson
Reuters Health

Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Despite some concerns that exercise might change the quality of a woman's breast milk, new study findings indicate that moderate physical activity has no such effect.

A 1997 report found that exercise could lower the amount of immune-boosting proteins that a mother passes on to her baby through breast milk within the hour after the physical activity. But that study involved women who exercised to exhaustion.

"Many doctors are concerned that new moms are exercising strenuously and this will compromise their breast milk," study author Dr. Cheryl Lovelady, an associate professor of nutrition at the University of North Carolina at Greensboro, told Reuters Health. "But we found no effect for moderate exercise."

The study compared 29 new moms who engaged in aerobic exercise for at least 30 minutes three times a week to another 24 women who exercised once a week or less. Results showed no differences in the amount of the proteins immunoglobulin A, lactoferrin or lysozyme that were present in the breast milk of women in the two groups, all of whom had given birth three months prior.

Next, 17 of the women who reported frequent exercise participated in a 30-minute exercise session in the lab so the researchers could analyze breast milk samples taken 10 and 60 minutes after exercise. The exercise consisted of walking briskly or jogging on a treadmill.

Again, the researchers found nothing to suggest moderate exercise adversely affected the breast milk. Protein levels measured in the hour after exercise were similar to those measured after periods of rest, according to results published in the February issue of Pediatrics.

The findings offer reassurance that women who have recently given birth can get out and engage in moderate exercise for their health without the worry of adversely affecting their breast milk, Lovelady said.

Most of the women in the study who exercised regularly reported they got 30 to 60 minutes of aerobic activity three to five days a week.

"Once women get their doctor's permission, they can exercise but they should start out gradually," Lovelady said, particularly if they didn't exercise during pregnancy.

Exercise is key in helping women lose those pregnancy pounds, she noted, and that's an important goal. Many women never shed the weight they gain in pregnancy, contributing to obesity and associated health problems later in life.

Source: Pediatrics 2003;111:e148-e152.

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Ceramic Hip Replacement

HealthScoutNews
Tuesday, February 4, 2003

TUESDAY, Feb. 04 (HealthScoutNews) -- The U.S. Food and Drug Administration (news - web sites) has approved the first ceramic-on-ceramic hip replacement, which its manufacturer says will absorb more wear and tear than traditional metal and metal/polyethylene systems.

U.S. clinical trials on the Trident Ceramic Acetabular System began in 1996 and involved more than 1,100 people at 16 sites, says manufacturer Stryker Howmedica Osteonics. The device was developed for "younger and more active patient populations who have demonstrated higher wear rates with conventional implants," according to one of the clinical trials' lead investigators.

The product will be available in the United States in the second quarter of 2003, the company says.

Here is the company announcement of the FDA approval. For more information about hip replacement, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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Many Hospitals Dispense Beer, Other Alcohol: Study

By Merritt McKinney
Reuters Health
Tuesday, February 4, 2003

NEW YORK (Reuters Health) - Two thirds of major teaching hospitals in the US give alcohol, such as beer, wine or IV-dispensed ethanol, to patients as a treatment or even sometimes as a "courtesy," according to survey results released Tuesday.

Alcohol is often used to treat patients who go into withdrawal after abusing alcoholic beverages, even though a class of sedative drugs is the treatment of choice for such patients, Kentucky researchers report.

By making alcohol available, hospitals may be sending the inappropriate message that alcohol is an effective treatment for illness, researchers say. What's more, such policies may even lead to drug/alcohol interactions--only six of the surveyed hospitals had policies requiring pharmacies to notify food services when a patient was taking a drug that might interact with alcohol.

Since at least the 1920s, hospitals have used ethanol, the form of alcohol in beer, wine and spirits, to treat people who are in withdrawal from alcohol dependence, according to lead author Dr. Richard D. Blondell of the University of Louisville in Kentucky. Alcoholics would be given two beers or a shot of whiskey with every meal, he said, noting that while the practice is "slowly dying out...it's probably time to stamp it out altogether."

The evidence is "overwhelming" that sedative drugs called benzodiazepines, which include Valium, are the treatment of choice for people who go into alcohol withdrawal, Blondell said in an interview with Reuters Health.

To see how often alcohol is given to hospital patients, the researchers polled 116 US teaching hospitals.

The survey showed that 72% of hospitals had dispensed alcohol to patients during the previous year. Depending on the hospital, alcohol was given intravenously, orally or both.

In most hospitals, alcohol was used to treat or prevent alcohol withdrawal syndrome.

But at 38 of the hospitals, alcohol was available for "patient courtesy," according to the report in the February 5th issue of the Journal of the American Medical Association (news - web sites). A few hospitals provided alcohol to sedate patients and a handful used it to stimulate appetites.

At some hospitals, alcohol was dispensed by the pharmacy, but at others, the food service provided alcohol. Of the 15 hospitals that allowed food service to provide alcohol, only six hospitals had a policy that required the pharmacy to notify food service when a patient was taking medications that should not be taken with alcohol.

"Beer was dispensed at 53 hospitals, distilled spirits at 31, wine at 25, brandy at 10 and grain alcohol at 7," according to the report. In some hospitals, a patient or family member could provide their own alcohol to prevent alcohol withdrawal syndrome.

In the interview, Blondell said that there are some situations when giving a patient alcohol may be appropriate. Benzodiazepines are not perfect, he said, and can be addictive themselves. Also, the drugs can make it difficult to observe patients with head injury, Blondell said. In alcoholics with head injury, he said, intravenous alcohol may be a better choice.

If alcohol is to be used in hospitals, however, it is better to "treat it as a drug," Blondell said, rather than to give patients beers or other drinks.

"If we are going to use alcohol, we ought to prescribe it as a drug dosed at a specific time," Blondell said. And he added that, rather than use alcohol based on experience, it should be studied in clinical trials just as other drugs are.

Source: Journal of the American Medical Association 2003;289:552.

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Faulty Gene May Contribute to Pancreatic Cancer

By Kathleen Doheny
HealthScoutNews Reporter

HealthScoutNews

Tuesday, February 4, 2003

TUESDAY, Feb. 4 (HealthScoutNews) -- Mutations in the BRCA2 gene, already known to increase the risk of breast and ovarian cancers, may also make people susceptible to a hereditary form of pancreatic cancer, German researchers conclude.

Their findings echo those of previous studies.

"We have found mutations which are likely to explain in a subgroup of families with pancreatic cancer cases why the disease occurs," says Dr. Stephan A. Hahn, a professor of oncology at the Knappschaftskrankenhaus University of Bochum in Bochum, Germany.

Hahn is also co-author of the new study, which appears in the Feb. 5 issue of the Journal of the National Cancer Institute (news - web sites).

Hahn and his colleagues identified 26 European families with at least two first-degree relatives -- a sister or father, for instance -- with pancreatic cancer. After testing them, the researchers found that 19 percent of the families had at least one member who had either a mutation or a variant of BRCA2.

While the new research confirms findings in previous studies, including one done by Johns Hopkins University researchers, Hahn says the study population for his study is broader.

Taken together, the studies "make a strong case that a certain percent of familial pancreatic cancer is likely caused by BRCA2 mutations," Hahn says. Exactly why is not known, he adds.

The pancreas, a six-inch gland located deep in the abdomen between the stomach and the spine, makes insulin to help the body's cells use the sugar brought to them by the blood, and makes digestive chemicals that help break down food.

In the United States, pancreatic cancer kills about 29,000 persons a year, according to the National Cancer Institute, making it the fifth-leading cause of cancer deaths.

A genetic counselor at the UCLA Jonsson Comprehensive Cancer Center in Los Angeles calls the new study "important," and says it is a welcome contribution to the body of knowledge about pancreatic cancer, which remains a puzzle to cancer experts.

"We don't know that much about pancreatic cancer," says Joyce Seldon, a certified genetic counselor.

Men are more likely than women to get pancreatic cancer, and cigarette smokers have two to three times the risk of nonsmokers, according to the National Cancer Institute. Diabetics (news - web sites) are also more likely to get it. And about 10 percent of pancreatic cancer patients may have an inherited form of the disease, Hahn says.

"What this study is breaking ground on is the association between BRCA2 and pancreatic cancer," Seldon says. "What the actual risks are is not yet known."

What should people do at this point? Hahn says if a family has "familial pancreatic cancer" -- defined as families with at least two first-degree relatives with pancreatic cancer -- members should seek information from a specialized center that has genetics counselors on staff.

"It's hard to tell them how much of a risk [they have]," Hahn says.

"Proper counseling is important," adds Gloria Petersen, a research scientist and professor of epidemiology at the Mayo Clinic in Rochester, Minn., who co-authored an editorial accompanying the study. "But we also recommend [getting it from] a research setting at this time."

Those who may already know they have the BRCA 2 mutation should not be alarmed, Seldon says. "We know [from the research] the risk [of pancreatic cancer for those with BRCA2] is higher than the general population. How much higher, I don't think we know," she says.

More information

For information on pancreatic cancer, check with the American Cancer Society and the National Cancer Institute.

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MONDAY, FEBRUARY 3, 2003

Doctors Pursue Pill to Aid Heart Valves

By Lauran Neergaard
AP Medical Writer

The Associated Press

Monday, February 3, 2003

WASHINGTON - Tens of thousands of Americans face the heart valve replacement that Sen. Bob Graham underwent last week, open-heart surgery that is likely to increase dramatically as the population ages.

But what if a simple pill could slow the rusting of the aortic heart valve and let patients postpone, maybe even avoid, the surgery that is today's only fix?

Scientists have uncovered tantalizing evidence that statins, those pills so popular to lower cholesterol, might do just that — and not through any cholesterol effect, but by a completely different action that suggests even patients with low cholesterol might benefit.

"It's very exciting," says Dr. Ann Bolger of the American Heart Association (news - web sites), who is monitoring early research that suggests bad valves are half as likely to worsen if patients take statins. "No one expected this."

The aortic valve shunts oxygen-rich blood from the heart's main pumping chamber to the rest of the body. It looks something like a rounded tulip, with three leaflets that open and close with each heartbeat.

But it can essentially start to rust shut and cause the heart to pump harder and harder to force blood through the narrowed opening. Eventually, patients with this "aortic stenosis" require open-heart surgery to replace the faulty valve or face life-threatening heart damage.

Aging is the biggest culprit, as with Graham, the 66-year-old Florida senator and possible Democratic presidential candidate whose aortic valve was replaced last week. Just as older people's arteries harden, something sometimes scars the aortic valve's tender leaflets. Calcium deposits build amid the leaflets, further narrowing and stiffening the opening.

Another significant cause is a birth defect, a two-leaflet, or bicuspid, aortic valve. Those naturally narrower valves can accumulate calcium sooner, which can lead to valve replacements for patients in their 30s and 40s.

Five in 10,000 Americans have significant aortic stenosis, Bolger says, and more than 20,000 aortic valves are replaced each year.

It's highly successful surgery; even 90-year-olds can experience huge relief. But it's a painful operation, with a 4 percent risk of death, one that will show dramatic increases as the baby boom generation ages. And while some patients qualify for biological replacements like pig or cow valves, many receive a mechanical heart valve that requires taking blood-thinners for the rest of their lives.

Hence excitement about a possible pill.

Scientists at the Mayo Clinic tracked 156 people with aortic stenosis, including 38 who took statins, cholesterol-lowering drugs sold under such brand names as Lipitor (news - web sites) and Pravachol.

Initially, the researchers were disappointed: Patients' cholesterol levels had no bearing on how quickly their aortic stenosis worsened.

Yet in almost four years, the statin users were half as likely to see their valves worsen. Other small studies have suggested a similar effect.

If cholesterol didn't matter, why would statins help heart valves? They're thought to fight inflammation, one key to stiffening heart tissues, and to increase bones' calcium absorption. That leaves less calcium floating in the blood to deposit in the wrong spot, explains Mayo lead researcher Dr. Maurice Sarano.

Within a year, Mayo hopes to begin a 1,000-patient experiment giving either statins or dummy pills to people whose aortic valves are going bad, in hopes of proving if the pills truly help. European scientists are pursuing similar experiments.

Some 8 million Americans already take statins to lower cholesterol, and while the drugs do have some side effects, serious problems are rare. So, with surgery at some point inevitable, should patients with bad aortic valves try the pills now?

If they also have high cholesterol, definitely, says Dr. Robert Bonow, president of the American Heart Association. Many doctors also prescribe statins for atherosclerosis, a type of hardening of the arteries.

Sarano has a few patients with normal cholesterol trying statins just for their valves. But other cardiologists advise awaiting more proof.

"You do have to be very careful" with such early research, says Bolger, of the University of California, San Francisco. But hunt another reason to prescribe statins, she adds: "Atherosclerosis and coronary plaques are the American disease. You'd have to look pretty hard to find somebody who doesn't have some."

Editor’s Note — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net: American Heart Association: http://www.americanheart.org/

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New U.S. Guidelines Stress First Colon Screening

Reuters
Monday, February 3, 2003

WASHINGTON (Reuters) - It is more important to get your first colonoscopy at age 50 than it is to follow up three years after suspect polyps are removed during the examination, according to new US guidelines issued on Monday.

Doctors currently recommend that everyone get a colonoscopy at the age of 50. The exam can find early signs of colon cancer--the third biggest cancer killer in the United States.

Tiny polyps in the colon that can become tumors if left to grow can be removed at the time of the examination, done while the patient is sedated but not unconscious.

Patients are usually told that if they get a polyp removed, they should return for repeat checks every three years.

But new guidelines issued by the US Multisociety Task Force on Colorectal Cancer say the first screening detects the largest, most dangerous polyps.

Writing in the February issue of Gastroenterology, the journal of the American Gastroenterological Association, the task force says follow-up colonoscopies after three years may not be terribly useful because polyps do not grow that fast.

"Colonoscopy allows us to visualize the entire colon, and to detect and remove polyps in one procedure. It's invaluable in patients who are at high risk of developing colorectal cancer," Dr. Douglas Rex of the Indiana University School of Medicine, one of the task force members, said in a statement.

The American Cancer Society (news - web sites) predicts that 105,000 Americans will be diagnosed with colorectal cancer this year and 57,000 will die of it.

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New Jersey Issues New Warning on Seafood

By John Curran
Associated Press Writer
Monday, February 3, 2003

ATLANTIC CITY, N.J. - For the third time in the past year, New Jersey has warned that some of the seafood from its waters is contaminated by dangerous chemicals.

A recent government advisory to consumers said elevated levels of PCBs in bluefish and striped bass mean they should be eaten only once a year — and not at all by pregnant women and small children.

PCBs, or polychlorinated biphenyls, once widely used as insulating material, are believed to cause cancer.

"We hope this information will allow families to make informed choices about the levels of fish consumption in their diet," Bradley Campbell, commissioner of the Department of Environmental Protection, said last week.

In July, the state issued an advisory about unsafe levels of mercury in fresh water bass, walleye and lake trout. Earlier last year, a warning was issued about dioxin contamination in the blue claw crab.

"It shows that we're still living in the legacy of our toxic past," said Jeff Tittel, executive director of the state chapter of the Sierra Club (news - web sites).

State laws ban large commercial catches of dangerous fish. But those who make their living on the water said the new warning may cause consumers to quit eating fish.

"The tendency for consumers is to sort of generalize," said Nils Stolpe, spokesman for the Garden State Seafood Association. "They read about PCBs in New Jersey bluefish, then they generalize that to all New Jersey fish. That's of concern."

PCBs haven't been produced since 1979, but refuse to go away. They typically enter the environment through stormwater. When it rains, the water penetrates PCB-contaminated soil at hazardous waste sites or washes over tainted equipment in old factories and runs off into rivers, lakes and streams.

New Jersey sport fishermen are permitted to harvest striped bass, but it is illegal to sell them. One commercial fisherman said he worried about backlash from the PCB alert.

"We've been down this road before," said Jim Lovgren, 46, of Point Pleasant. "It affects us economically."

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Pre-Diabetic Condition Linked to Memory Loss

By Alison McCook
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Middle-aged and older adults with a condition that often precedes diabetes appear to show signs of memory loss not visible in their peers without the condition, researchers announced Monday.

In addition, people with insulin resistance--a loss of sensitivity to this key blood-sugar-regulating hormone--tended to have a relatively small hippocampus, a region in the brain associated with short-term memory.

"This (finding) might give baby boomers a motivation to get off their couches and on their treadmills," said Dr. Antonio Convit of New York University and the Nathan Kline Institute for Psychiatric Research in Orangeburg, New York.

Although insulin resistance commonly results from excess weight and lack of exercise, most people who have the condition don't know it, and may consider themselves to be perfectly healthy, Convit told Reuters Health.

So while people may not be motivated to exercise and diet to improve their appearance, Convit said he hoped that the thought that their lifestyle was affecting their memories, as well as the shape of their brains, might do the trick. Past studies have suggested that full-fledged diabetes can also put people at risk of memory problems.

In the new study, Convit and his team obtained their findings from brain scans, memory tests, and tests of insulin resistance in 30 people without diabetes who were between 53 and 89 years old. They reported their results in the early online edition of the Proceedings of the National Academy of Sciences (news - web sites).

In an interview, the researcher explained that when people become resistant to insulin--a condition also known as impaired glucose tolerance--they have trouble getting glucose (blood sugar) out of the blood and into the tissues that need it.

During the test of glucose tolerance, Convit and his colleagues injected people with a certain amount of glucose--roughly equivalent to two donuts' worth, Convit said--and took many blood samples.

The authors discovered that people who had more trouble clearing glucose from their blood also tended to perform less well during tests of short-term memory. Brain scans also revealed that the size of the hippocampus tended to be smaller in people with insulin resistance.

Convit explained that the brain relies on glucose for fuel, and the hippocampus is especially vulnerable to stress. People with insulin resistance are unable to bring glucose to where it needs to go, he said, and a lack of fuel might affect how well the brain--in particular, the hippocampus--develops.

Whether these memory problems are permanent or not remains unclear, he said. However, diabetics (news - web sites) who get their condition under control often also see an improvement in their memory, Convit noted, a sign that reduced memory is also reversible in pre-diabetics.

For people who know or fear they are insulin resistant and "want to retain as much of their marbles as possible," Convit recommended that they exercise and lose any excess weight--the best methods of getting blood sugar under control, he noted.

SOURCE: Proceedings of the National Academy of Sciences 2003;10.1073/pnas.0336073100.

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Study Looks at Effects of Medical Mistakes

By Michael Rubinkam
Associated Press Writer

The Associated Press

Monday, February 3, 2003

PHILADELPHIA - Patients are often harmed by inadequate care and outright medical mistakes in the days after they are sent home from the hospital, according to new research.

The study, conducted at one large hospital, found that nearly one in five patients had "adverse events" after they go home — new or worsening symptoms resulting from the treatment they received, not from their underlying disease. Most problems could have been prevented or eased with better care.

The researchers said the problems often occur because hospitals fail to communicate effectively with patients and their primary care physicians after discharge, and neglect to follow up to identify symptoms and complications before they become more serious.

Many studies have looked at patient safety inside hospitals, including a review by the Institute of Medicine (news - web sites) that blamed medical mistakes for the deaths of 44,000 to 98,000 hospitalized Americans each year. The latest report, in Tuesday's Annals of Internal Medicine, is the first to assess how often discharged patients become sick as a result of their treatment.

Researchers at the University of Ottawa and Harvard Medical School (news - web sites) contacted 400 patients who were hospitalized at an unidentified urban teaching hospital.

They found 76 patients had adverse events after they were sent home. Of those, 23 were deemed preventable and 24 would have been less severe with better care.

Two-thirds of the problems resulted from drug side effects. In one case, an asthmatic patient who had a heart attack was prescribed a beta blocker, a drug that slows the heart rate but can cause asthma attacks. The patient developed wheezing and a cough.

In another case, a patient with an inflamed pancreas was sent home after his X-ray was misread. He was readmitted four days later with worsening symptoms.

Study co-author Dr. David Bates said the results demonstrate a need for better follow up.

"The current reimbursement structure does not reward providers for giving post-discharge care," but "hospitals ought to support having someone get in touch with (discharged patients)," said Bates, of Harvard's Brigham and Women's Hospital.

The study's results are not surprising because patients are discharged from the hospital more quickly than in the past — and in worse shape, said Dr. Kenneth Kizer, president of the National Quality Forum, which is working to develop better ways of measuring medical care. "They are still vulnerable, their needs still have to be looked after and they need to be tended to."

On the Net:

Annals of Internal Medicine: http://www.annals.org

National Quality Forum: http://www.qualityforum.org

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Drug Looks Promising for Huntington's: Mouse Study

By Keith Mulvihill
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - An experimental drug appears to delay symptoms in mice with a condition similar to the degenerative brain disorder Huntington's disease, scientists announced on Monday.

The drug is called SAHA (suberoylanilide hydroxamic acid) and the researchers "found that it dramatically improved movement impairment in a mouse model of Huntington's disease," said Dr. Gillian P. Bates of King's College London, UK.

Such mice, which are genetically modified to develop symptoms similar to those of Huntington's in humans, "are the closest models that we have to the human disease," added Bates.

SAHA is in a class of drugs known as histone deacetylase (HDAC) inhibitors, according to the report in the February 3rd issue of the journal Proceedings of the National Academy of Sciences (news - web sites). Such inhibitors are aimed at the root cause of Huntington's disease--the transcription of DNA into working proteins.

Huntington's disease is a genetic disorder afflicting about 35,000 to 50,000 people in the United States. The disease is characterized by the death of brain cells, usually starting in middle age, leading to involuntary jerky movements, personality changes and mental deterioration. It is inherited through a mutated gene that produces an abnormally long version of a protein.

One effect of the faulty gene, explained Bates, is that it alters the extent to which other genes important for the function of brain cells are switched on. In most cases, the level at which these genes are switched on has been turned down.

"It could be compared to a rail network in which certain trains start to run at a reduced speed. The function of the whole network becomes affected," Bates told Reuters Health.

The precise molecular interactions that lead to genes being turned down is not yet understood, although many clues are emerging from research, according to Bates.

So far, HDAC inhibitors have shown promise when used to treat laboratory-grown cells and fruit flies that share some of the same DNA transcription problems associated with Huntington's disease.

In the new study, the drug was administered in water and appeared to readily cross the blood-brain barrier, which shields the brain from contact with body substances.

Typically, the genetically engineered mice develop severe movement problems at five to six weeks of age. Those treated with SAHA for three weeks had a delay in symptoms compared with mice given a placebo.

At 12 weeks of age, the treated mice performed as well as untreated mice at eight weeks of age. The drug did appear to be somewhat toxic, and mice did not gain weight at the same rate as placebo-treated mice.

"It is extremely exciting that one of these drugs is effective in the mice and this has provided the green light to further develop HDAC inhibitors for use in the clinic to treat Huntington's disease (in people)," said Bates.

However, much more study is needed to determine if such drugs are safe and effective for humans.

"Our research into HDAC inhibitors will continue on two fronts," noted Bates. "First, we aim to develop effective HDAC inhibitors that could eventually be used in the clinic as treatments for Huntington's disease and in parallel to gain a better understanding of their mechanism of action."

Memorial Sloan-Kettering Cancer Center and Columbia University jointly hold the patents to SAHA and similar compounds, and license the drug to Aton Pharma Inc., which was founded by two of the study's co-authors.

SOURCE: Proceedings of the National Academy of Sciences 2003: 10.1073/pnas.04378700100.

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Iron Supplements Fine for Anemic Kids With Colds

HealthScoutNews
Monday, February 3, 2003

MONDAY, Feb. 3 (HealthScoutNews) -- Iron supplements benefit anemic children even when they have colds.

A new study found that when anemic children with a cold or other upper respiratory tract infection (URTI) took iron supplements, it improved their iron status without increasing stomach upset or causing any other side effects.

Conflicting findings from previous research has made doctors cautious about giving iron supplements to anemic children with colds or other upper respiratory tract infections.

This study included children recruited from a hospital in Colombo, Sri Lanka. During the study, 127 children with URTIs were given iron supplements of 60 milligrams a day, and 52 other children with URTIs were given a placebo.

Also, 134 children without URTIs were given iron and 50 were given the placebo.

The study found that of the children with infections, those who received the iron supplements had 29 percent fewer upper respiratory episodes than the children who received a placebo. And the children with infections who received the iron supplements had infectious episodes that were 40 percent less severe than the children who received placebos.

The findings appear in the January issue of the American Journal of Clinical Nutrition (news - web sites).

More information

Here's where you can learn more about anemia.

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Kids with Behavioral Problems at Risk of Injury

By Melissa Schorr
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Children with behavioral disorders such as attention deficit/hyperactivity disorder (ADHD) have a substantially greater risk of being injured than other kids, Canadian researchers report.

"Anyone who has a kid with a behavioral disorder is not going to find that result particularly surprising," lead author Dr. Jamie Brehaut, a post-doctorate fellow at the Ottawa Health Research Institute in Canada, told Reuters Health.

It has been assumed that the specific characteristics of these children may put them in jeopardy, he noted. "Overactivity, impulsivity, inattention--the main three benchmarks of ADHD--are certainly some of the causes that can give rise to these injuries," Brehaut said.

Several previous studies have noted an association between a diagnosis of behavioral disorder and injury, but few studies have attempted to quantify the risk.

Brehaut and colleagues conducted a population-wide study examining the hospital records of more than a million children younger than 19 in British Columbia between the start of 1990 through the end of 1996.

The records documented both the type of injury, such as bone fracture, concussion or poisoning, as well as the external cause, such as a car crash or fall.

The researchers divided the children into two groups: those who had been prescribed Ritalin (news - web sites) and those who had not. Ritalin (methylphenidate) was used as an indication that the child had been diagnosed with ADHD or, more rarely, another behavioral disorder.

They found 1.6% of the children, or 16,806, had been prescribed Ritalin during the study.

The researchers then compared the injury risk for the two groups of children, taking into account other factors that could influence this risk such as such as socioeconomic status and gender. The findings were published in the February issue of the journal Pediatrics.

Children taking Ritalin were found to have a 1.5 times greater risk of injury than children presumed not to have a behavioral disorder. "They have a 50% increase in risk for a whole host of different kinds of injuries," Brehaut noted.

The researchers caution that these findings should not be interpreted as showing that the drug Ritalin itself is the cause of the injuries. Previous research has shown that the drugs seem to reduce rather than increase the risk of certain types of injuries.

The researchers found that the children with behavioral disorders also had injuries that were difficult to attribute to their overactive nature, such as adverse drug reactions and adverse post-operative reactions.

"The kinds of injuries extended beyond the kinds of things you'd expect from an active child," Brehaut said, and included injuries that "overactivity and impulsivity can't easily explain."

Possible explanations, Brehaut and his colleagues note, include a greater likelihood that children with behavior problems also have motor coordination problems, or that their parents may have psychological problems or may be doing a poor job of monitoring them.

The researchers advise parents of children with behavioral disorders to counsel their children on strategies to avoid injury. These children may also benefit from specialized driver training, they note.

Source: Pediatrics 2003;111:262-269.

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Carbon Monoxide Poisoning

HealthScoutNews
Monday, February 3, 2003

(HealthScoutNews) -- Carbon monoxide (CO) -- a colorless and odorless gas that can leak out of faulty furnaces, gas stoves, water heaters or any other gas appliances -- is known as a silent killer.

Besides equipping your home with an essential CO detector, you should learn the warning signs of a carbon monoxide leak.

According to the American Association of Poison Control Centers, CO poisoning feels like flu without the fever. Symptoms include dizziness, fatigue, nausea, headache, and irregular breathing. The most glaring clue is if your symptoms vanish when you go outdoors and return when you reenter.

So, if you ever suspect a CO leak, evacuate your family immediately and call the nearest poison control center.

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Ephedra Has More Side Effects Than Other Herbs

By Alison McCook
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Ephedra is linked to more than 100 times as many reports to US poison control centers as other herbs, and the substance should be banned or restricted out of safety concerns, US researchers said Monday.

Based on an analysis of reports to the American Association of Poison Control Centers, Dr. Stephen Bent and his colleagues discovered that products with ephedra made up 64% of the bad reactions to herbal products reported in the US in 2001.

This finding is remarkable, the authors note, given that less than 1% of herbal products sold that year contain ephedra.

Ephedra, also known as ma huang, is contained in some supplements touted for weight loss. The herb affects the cardiovascular and central nervous systems, and has already been linked to the risk of seizure, heart attack and sudden death, even in healthy people.

Last year, Canadian health officials issued a voluntary recall of a wide range of products containing the herb or its chemical derivative ephedrine.

In the US, dietary supplements, including those that contain ephedra, are not evaluated by the Food and Drug Administration (news - web sites) for safety and effectiveness before hitting the market.

Although awareness of the potential dangers of ephedra is growing among consumers, many still purchase ephedra-containing products, Bent told Reuters Health.

"I think people are starting to learn that ephedra may be dangerous, but the mere fact that companies are still producing and selling this product suggests that the public is still buying it, and some people are not fully aware of these substantial risks," said the researcher, who is with the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center.

Bent noted that there is resistance among product manufacturers to the idea that ephedra be banned or restricted. They argue that all studies into hazards of ephedra are cases where one person taking the drug experienced, for example, a heart attack. In that instance, Bent said, it's difficult to show that the heart attack was a result of the drug.

But the finding that ephedra is linked to many more side effects than other herbs adds support to the theory that it can be dangerous, Bent said.

How ephedra stacked up against other products varied from herb to herb, Bent and his colleagues note--but in all cases, it outnumbered other products in bad reactions by a factor of at least 100, the authors write in the advance online edition of the March 18 issue of Annals of Internal Medicine.

Overall, there were 1,178 adverse reactions reported for ephedra, compared with 28 for ginkgo biloba, 31 for St. John's wort and 69 for echinacea (news - web sites), among others.

Bent said that he believes that ephedra should be banned or at least restricted. "In my opinion, if substances used to treat illness have not been proven to have significant benefits, and have a high chance of causing significant bad reactions, they should be banned," he noted.

And if these products continue to be available, consumers should be clearly warned about the potential dangers associated with their use, Bent added.

"I would like to see warning labels on these products if they continue to be sold, similar to the situation with cigarettes, so people clearly understand that use of ephedra may cause very severe side effects."

Source: Annals of Internal Medicine 2003;138.

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Girls Who Dine Alone May Pay a High Price

By Amanda Gardner
HealthScoutNews Reporter

HealthScoutNews

Monday, February 3, 2003

MONDAY, Feb. 3 (HealthScoutNews) -- Young women who eat alone, live with a single parent, read lots of teen magazines or listen to lots of radio risk developing an eating disorder.

That's the conclusion of a study by Spanish researchers that appears in the February issue of Pediatrics.

Curiously, spending extra time in front of the television was not a risk factor, the study found.

The researchers looked at more than 2,500 Spanish girls between the ages of 12 and 21 who were initially free of eating disorders. During the course of an 18-month follow-up, the investigators found 90 new cases of eating disorders, more than 80 percent of which seemed closer to bulimia than anorexia.

Eating meals alone translated into a three times greater risk for developing an eating disorder. Girls who read teen magazines and listened to lots of radio were at double the risk. So were girls whose parents were widowed, separated or divorced, according to the study, which was led by Dr. Miguel A. Martinez-Gonzalez, of the University of Navarra, Pamplona.

Anorexia, bulimia and other eating disorders affect primarily girls and young women in Western countries. People with anorexia tend to starve themselves, while those with bulimia often fall into a pattern of binge eating, followed by vomiting or excessive use of laxatives.

In explaining the study's findings, Martinez-Gonzalez says the low self-esteem that could result from a single-parent home environment might help explain the onset of an eating disorder. Also, single-parent families may not have the resources to teach their children about food and eating. In these situations, the children may also eat alone more often simply by necessity, the researchers say.

As for the teen magazines and radio, the researchers say mass media's infatuation with unrealistically thin ideals have been shown to contribute to eating disorders.

Dr. Ira Sacker, director of the HEED (Help End Eating Disorders) Foundation and author of Dying To Be Thin, calls the new research "a very valuable report. I think this is the largest population that I've ever seen of 12- to 21-year-olds."

He says the most surprising revelation was the one regarding solitary eating. "We haven't even really looked at that before," Sacker says. "Solitary eating points to isolation, and that is one of the early signs of an eating disorder."

"The individual who retreats winds up not wanting to eat with anyone else," Sacker adds. "Eating is not something social; it becomes a control factor. You've got loneliness, separation and issues of abandonment and isolation."

Martinez-Gonzalez says the real effect, however, may be a cumulative one.

"We think that the conjunction of predisposing factors leading to a weak personality in a girl -- high neuroticism, low self-esteem, troubled family atmosphere because parents are divorced/separated -- plus environmental messages from mass media act together to induce eating disorders," Martinez-Gonzalez says.

It's not clear why television did not factor more into the results, he says.

"One reason may be that we have only analyzed the total time spent watching TV. But the 'quality' or 'content' of the TV shows that a girl watches could be more important than the quantity or total amount of time spent watching TV," he adds.

Martinez-Gonzalez says he has another article, this one dealing with neuroticism and low self-esteem and their connection to eating disorders, appearing in an upcoming issue of the International Journal of Eating Disorders.

In a related study, researchers from Virginia Commonwealth University say they've found a link between a tendency toward perfectionism in women and the likelihood of developing anorexia or bulimia. The researchers hope the finding may be another clue in the quest to discover a genetically influenced trait that predisposes a person to developing an eating disorder.

Their study appears in the February issue of the American Journal of Psychiatry.

More information

For more on eating disorders, visit the Harvard Eating Disorders Center or the National Eating Disorders Association.

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Blocking Genetic Switch Could Nip Cancer in the Bud

Reuters
Monday, February 3, 2003

LONDON (Reuters) - Scientists have discovered how a genetic switch that allows cancerous cells to divide and spread works in a finding that could open up a new avenue to treat many of the most common cancers.

The switch controls an enzyme called telomerase.

In normal cells, the gene that regulates it is tightly packaged and coiled and the switch is off, so the enzyme is not produced and the cells can only divide a finite number of times.

But British and Swiss researchers found that cancer cells manage to unravel the gene and flip the telomerase switch back on. Blocking the process cuts off the enzyme and causes cancerous cells to stop multiplying, the researchers report.

"The discovery of how the switch works is what we have done, and, of course, that has implications for therapies because there is a great interest in new drugs that will modify the way genes express (or work)," Professor Robert Newbold, of Brunel University north of London, told Reuters.

Cancer develops when the control signals in a cell go awry and it mutates. Instead of destroying itself, the cell multiplies uncontrollably and forms a tumor. Although there are more than 200 types of cancer, they all start in the same way.

Newbold and scientists from the Swiss Cancer Research Institute in Lausanne flipped off the telomerase switch in cancerous cells in the laboratory by adding genes from normal cells that made the telomerase gene recoil into its compact form.

"We know that if we stop telomerase working in cancer cells they stop dividing. The question is how we go about stopping it," added Newbold, whose research is reported in the journal Cancer Research.

New Drugs

The scientists believe that a drug that targets the gene and the way it is packaged could switch off telomerase in cancerous cells.

Because telomerase is active in about 85 to 90% of cancers, a drug that blocks its production could potentially be effective against many different types of cancer.

Newbold is setting up a European-wide collaboration between research institutes and pharmaceutical companies to design drugs to block the production of telomerase.

In normal cells it switches off when a fetus is about 20 weeks old. Newbold believes the shutting down is a protective process to prevent the development of cancer because without the enzyme, cells have a finite lifespan--they can only divide a certain number of times.

Newbold thinks the mechanism evolved to protect humans against cancer.

"If evolution has used this route to protect us from cancer," Newbold said, "the logic goes that it should be the route to use to treat it."

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Bored Students More Likely to Smoke

By Kathleen Doheny
HealthScoutNews Reporter

HealthScoutNews

Monday, February 3, 2003

MONDAY, Feb. 3 (HealthScoutNews) -- Teens who aren't interested in school, along with those whose parents smoke, are more likely to accept a tobacco promotional item.

And researchers already know that accepting these promotional items -- T-shirts or other attire emblazoned with cigarette brand names -- raises the risk that teens will become smokers.

Researchers from Boston University and the University of Massachusetts at Boston polled 467 teens, aged 12 to 15, who had not smoked in the past 30 days and did not have any tobacco promotional items, and then interviewed them again four years later.

They asked whether their parents smoked, how much they liked school, whether they were rebellious, and whether they were depressed, among other questions.

At the four-year follow-up, 71 of the children had acquired a promotional item and 396 had not. Then the researchers looked for associations.

"Kids who scored high on academic disengagement [those who said they were disinterested in school] were two times as likely to own promotional items," says study co-author Lois Biener, a senior researcher at the Center for Survey Research at the University of Massachusetts at Boston.

The children of smokers were also three times more likely to accept the promotional items, the researchers found.

The study appears in the February issue of Pediatrics.

Previous research has found that teens who accept promotional items are more likely to smoke. For the new study, the researchers wanted to find out what factors would make a teen more likely to accept a promotional item.

Why does disinterest in school drive the desire for promotional items?

"I think we are picking up on kids who don't see a place for themselves at school," Biener says. "They are not hooking in to the social circles at school. And they are looking for some kind of identity for themselves. Being attracted to a T-shirt with a Marlboro sign on it offers them a particular kind of identity. That's our supposition."

At the four-year follow-up, 45 percent of the teens who owned a promotional item had become smokers, while only 15 percent of those who did not had become smokers.

Dr. David Baron, chairman of the department of family practice at Santa Monica-UCLA Medical Center, says the study "makes a case for protecting kids from tobacco advertising and promotion."

The study results may help the creators of teen smoking prevention programs to fine-tune their approach, he says. If you know that kids who are bored at school accept promotional items, he says, you want to find ways for kids to avoid that boredom.

"That's where the study is strong," Baron says. "It continues to make the case that primary prevention is where it's at. You stop kids from becoming smokers."

For parents, Biener says, "it's important to be aware of your kids' need to define themselves. They need to find a group they can feel comfortable with. Kids involved in organized after-school activities are less likely to smoke."

Baron also believes that family doctors should do more to help spread the anti-smoking message. About five years ago, he headed a campaign, urging fellow doctors in the community to follow his lead and refuse to keep magazines that carry tobacco advertisements in the waiting room.

More information

To learn more about how to help teens avoid tobacco, see the U.S. Centers for Disease Control and Prevention's Tobacco Information and Prevention Source or the American Lung Association's Teens Against Tobacco Use.

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Seizure Medication Turns Down Hot Flashes

By Linda Carroll
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - A seizure medication may help cool menopause's hot flashes, a new study shows.

Women who took gabapentin reported fewer and less severe hot flashes, according to a study published in Obstetrics and Gynecology.

The drug may be an option for women who experience frequent hot flashes, but who are worried about taking hormone replacement therapy (HRT), the study's lead author, Dr. Thomas Guttuso, Jr., pointed out.

While gabapentin has been used to treat a variety of medical problems in the past, including seizures, migraines and nerve pain, no one thought the drug might help menopausal women.

The discovery that the drug might have an impact on hot flashes was completely serendipitous, according to Guttuso, who is at the University of Rochester in Rochester, New York

"My interest in this started four years ago when a patient of mine with migraines told me that her hot flashes went away after I placed her on gabapentin," Guttuso said in an interview with Reuters Health. "And a small study I did with seven patients was published in 2000."

The new study followed 59 postmenopausal women who had, on average seven or more hot flashes per day. The women were randomly assigned to receive gabapentin or a sugar pill at the beginning of the study. Thirty ended up in the gabapentin group, while 29 received placebos.

Until the end of the study, neither the patients, nor the researchers who evaluated them, knew which women received gabapentin.

Four of the women who took gabapentin dropped out of the study because they experienced unpleasant side effects, compared to one person in the placebo-treated group. Side effects included dizziness, rash, and fluid retention in the limbs.

Among women who receive gabapentin, hot flashes dropped 45%, as compared to 29% among the women treated with a placebo.

The researchers aren't sure why gabapentin works.

"We also don't know much about the mechanism behind hot flash physiology," Guttuso said. "We're trying to identify how gabapentin is working specifically for hot flashes. If we know what are the therapeutic targets in the brain we could develop other hot flash medications."

Guttuso is listed as "inventor" on a new-use patent that is owned by the University of Rochester for the use of gabapentin in the treatment of hot flashes. Guttuso would receive a portion of funds derived from the patent.

Source: Obstetrics and Gynecology 2003;101:337-345.

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White Tea Cream Counters Sun Damage

HealthScoutNews
Monday, February 3, 2003

MONDAY, Feb. 3 (HealthScoutNews) -- The ingredients in white tea boost the immune function of skin cells, helping protect your skin from the damaging effects of the sun that cause aging and cancer.

Researchers at the University Hospitals of Cleveland and Case Western Reserve University applied white tea extract cream to a patch of skin on the subject's buttocks -- an area not ordinarily exposed to much sunlight -- and left another area unprotected.

Both skin areas were exposed to artificial sunlight. The white tea extract cream was then reapplied to the same area previously coated with the cream. Three days later, the researchers did cellular level comparisons of the coated and uncoated areas of skin.

The researchers examined Langerhans cells located in the outer layer of the skin. These Langerhans cells are immune system sentinel cells that detect germs and mutated proteins caused by cancerous cells. Langerhans are sensitive to damage by sunlight.

The researchers found the white tea cream extract protected the Langerhans cells. They also found the cream limited sunlight-caused DNA damage in skin cells.

White tea is the least processed form of tea. It's rarely used in consumer products.

More information

Here's some advice on how to protect your skin from the sun.

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Anorexia in Teen Boys Found to Stunt Growth

Reuters Health
Monday, February 3, 2003

NEW YORK (Reuters Health) - Teen boys with the eating disorder anorexia nervosa (news - web sites) may suffer from stunted growth, according to a small study from Israel.

The findings underscore the need for parents and physicians to identify young people with the self-starvation disorder and help them get treatment, according to the study authors. In many cases, once a healthy diet is resumed, the chance for catch-up growth improves greatly, they note.

While nutrition experts are quite knowledgeable about the adverse effects of starvation and illness on developing children, there is little scientific research about the consequences of "undernutrition" during puberty on growth rate, according to the new report.

To investigate, lead author Dr. Dalit Modan-Moses of Tel Aviv University and colleagues evaluated the medical records of 12 boys between the ages of 12 and 17 who were diagnosed with and treated for anorexia nervosa.

Eleven of the boys exhibited growth retardation during the course of their treatment, the authors report. The boys were followed for up to 38 months after their diagnosis of anorexia nervosa, the authors report in the February issue of the journal Pediatrics.

Weight gain of more than one kilogram (about two pounds) a year was associated with roughly seven centimeters of average annual growth among the boys, while boys who did not gain weight or lost weight grew about three centimeters (about one inch) per year on average, the researchers found.

While boys who achieved a weight normal for their age and size during treatment showed restoration of normal growth, 9 of the 12 boys did not achieve complete catch-up growth and are likely to remain smaller in size in adulthood as a result of their insufficient eating.

"Whatever the reason, a delay in the diagnosis of anorexia nervosa in male adolescents may result in severe malnutrition and compromised height," the authors write.

"Therefore, the diagnosis of anorexia nervosa should be considered in short, underweight adolescents, as well as in youths who demonstrate growth deceleration with hitherto normal height progression," Modan-Moses and colleagues conclude.

The investigators call for a larger study to verify their observations.

Source: Pediatrics 2003;111:270-276.

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Ripe for Pregnancy

HealthScoutNews
Monday, February 3, 2003

(HealthScoutNews) -- If you're trying to get pregnant, the day you ovulate may not be your most fertile period, contrary to popular belief.

Researchers at the University of Utah found that a woman is most likely to become pregnant one to two days prior to ovulation.

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Drug May Prevent Stroke Damage

By Linda Carroll
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - A naturally-occurring protein appears to protect brain cells after a stroke, according to a new study in mice. A genetically engineered version of the same protein is already on the market in the US, approved in 2001 for the treatment of sepsis, a life-threatening reaction to infection that can lead to organ failure.

The new findings may eventually lead to better treatments for people who suffer strokes, study co-author Dr. Berislav V. Zlokovic, said in an interview with Reuters Health. When a stroke blocks oxygen from reaching brain cells, the cells begin to die in two to three hours.

This drug, called activated protein C (APC), actually prevents damaged cells from dying, added Zlokovic, a professor of neurosurgery and chief of the division of neurologic biology at the University of Rochester Medical Center in Rochester, New York.

"The window of opportunity with this drug could be a little wider than it is with currently used drugs," Zlokovic said. "Cells continue to die in the brain after the stroke insult. Of course, just as in the case of the (heart attack) the sooner you intervene, the better."

About 80% of strokes are ischemic, or due to a lack of blood flow caused by a blood clot or other problem. If such patients can get to the hospital quickly enough, a clot-dissolving drug called tissue plasmogen activator, or tPA, can help.

While tPA, does open blocked blood vessels by dissolving clots clogging them, the drug can also cause damage, Zlokovic said. APC might protect the brain from that damage, he added.

In the new study, scientists found that APC protected brain cells after a stroke in a mouse model, according to a report published in the advance online version of Nature Medicine.

They also found that the APC protects human brain cells that are subjected to stroke-like conditions in a test tube.

Zlokovic and his colleagues examined the effects of the drug on human brain cells that were deprived of oxygen and glucose--exactly what happens to cells in the brain when a stroke occurs. Normally the cells sense they are damaged and self-destruct in a process called apoptosis.

But when treated with APC, most of the cells survived, Zlokovic said.

"What we are showing is that we can prevent the activation of the apoptotic pathway," he added. "This has not been shown before in humans."

A genetically engineered version of APC, called Xigris (drotrecogin alfa), has been approved for treating sepsis.

Source: Nature Medicine 2003:DOI:10.1038/nm823.

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Gum Disease Tied to Pregnancy Complication

By Linda Carroll
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Severe gum disease may raise a pregnant woman's risk of developing a dangerous condition known as preeclampsia, a new study shows.

Women with severe periodontal disease were more than twice as likely as those with healthy gums to develop the condition, according to a study published in the journal Obstetrics and Gynecology.

Preeclampsia, which is characterized by the sudden onset of high blood pressure, can lead to eclampsia, or seizures late in pregnancy or after delivery. Eclampsia can cause organ damage and even death.

The new findings are too preliminary for public health officials to make any blanket statements regarding oral health and pregnancy, the study's lead author Dr. Kim A. Boggess said in an interview with Reuters Health.

But "this report emphasizes to me that obstetricians should be inquiring about dental care and oral health among their patients," added Boggess, an assistant professor of obstetrics and gynecology in the department of maternal-fetal medicine at the University of North Carolina at Chapel Hill.

Boggess and her colleagues followed 885 pregnant women, checking their gums when they started the study and within 48 hours of delivery.

At the beginning of the study, 125 women had severe periodontal disease. And out of the 763 women who delivered babies during the course of the study and received exams after delivery, 100 had severe periodontal disease.

Two percent of women who had healthy gums before 26 weeks of pregnancy developed preeclampsia, while 3% of those whose gums were healthy at delivery developed the condition. But 5% of women with mild periodontal disease early in pregnancy or at delivery developed preeclampsia. Among women with severe gum disease, 6% diagnosed with the condition early in pregnancy developed preeclampsia, and 10% of women with severe gum disease at delivery had preeclampsia. Ultimately, the researchers found that women with severe gum disease at delivery were more than twice as likely as those with healthy gums to develop preeclampsia.

Boggess isn't sure why gum disease might be associated with preeclampsia, but she suspects that inflammation in the gums may lead to inflammation throughout the body. And such inflammation could produce abnormalities in the placenta that bring on preeclampsia, she explained.

It is also possible that the bacteria involved in gum disease somehow manage to migrate to the blood vessels of the placenta or uterus and do damage there, Boggess said. Or, perhaps, the gum disease is simply a marker for some maternal characteristic that predisposes women to preeclampsia, she added.

Source: Obstetrics and Gynecology 2003;101:227-231.

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Women Now Living Longer with Ovarian Cancer

By Alison McCook
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - A woman with ovarian cancer is now more likely than ever to live for years after her diagnosis, researchers announced Saturday.

Based on analyzes of information collected on roughly 33,000 women diagnosed with ovarian cancer, the investigators discovered that the chance of a woman living two years after her diagnosis has increased 25% between 1973 and 1997, while the chance of her living five years after diagnosis went up 15%.

As it stood at the end of the study, a woman's chance of living two years after an ovarian cancer diagnosis was 62%, and 43% for living at least five years after being diagnosed.

"It's a small improvement, it's a small change, but it's positive," study author Dr. Adnan Munkarah of Wayne State University in Detroit told Reuters Health.

However, African-American women and women at least 60 years old tend to live fewer years after a diagnosis of ovarian cancer than other women, Munkarah added, and more research is needed to narrow those gaps.

Munkarah and his colleagues presented their findings on Saturday during the Society of Gynecologic Oncologists' Annual Meeting on Women's Cancer in New Orleans.

Ovarian cancer is considered to be a very lethal disease. Most cases are diagnosed when the cancer has already spread beyond the ovaries and is difficult to treat. In 2002, an estimated 23,100 American women were diagnosed with ovarian cancer and 14,000 died from the disease.

In an interview, Munkarah explained that there are likely many reasons why women are now living longer with ovarian cancer.

For one, diagnosed women now receive platinum-based chemotherapy drugs such as cisplatin, which have improved success rates in treating ovarian cancer, he said.

Munkarah added that recent evidence has shown that even women with ovarian cancer that has spread throughout their bodies can benefit from surgery to remove the bulk of the disease. As such, more women are now being offered surgery, he said, and doing better as a result.

Many women still die every year of ovarian cancer, Munkarah noted, a sign that more improvements in diagnosis and care are still needed.

New therapies other than chemotherapy may help future generations survive longer with the disease, the researcher noted. In addition, currently very few women with ovarian cancer seek help from a cancer doctor who specializes in ovarian cancer, since the concept of specializing in oncology is relatively new, he noted. Once people become more aware that these doctors exist, Munkarah said, survival rates might improve even further.

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Thalidomide-Like Drug Has Potential to Fight Cancer

Reuters Health
Monday, February 3, 2003

LONDON (Reuters Health) - British researchers have identified a drug similar to thalidomide that triggers apoptosis, a cell suicide program, in laboratory-grown tumor cells. The drug has the potential to fight a number of different types of cancer, they suggest.

The investigators, from St. George's Hospital Medical School in London and the US company Celgene, were assessing the anti-tumor properties of thalidomide itself, along with two groups of molecules similar to thalidomide, dubbed ImiDs (immunomodulatory drugs) and SelCIDs (selective cytokine inhibitory drugs).

One of the analogs, SelCID-3, "consistently" reduced tumor cell survival in a variety of types of solid tumor cells but had no effect on non-cancerous cells, the researchers write in the journal Cancer Research.

"We were surprised at the ability of this class of drug to kill cancer cells but leave normal cells apparently unaffected," said author Dr. J. Blake Marriott from St. George's Hospital Medical School.

Celgene currently markets thalidomide as a treatment for leprosy. The drug is notorious for causing the birth of hundreds of babies with missing limbs in the 1960s after it was used to prevent morning sickness during pregnancy, but is now being explored as a treatment for other conditions. Other British researchers said this week they would begin a large trial of the drug for small cell lung cancer.

The St. George's group conducted a second experiment in mice grafted with human pancreatic cancer tissue. They found mice treated daily with SelCID-3 had smaller tumors after 32 days than control mice given a placebo only.

Although the work is preliminary, the researchers think the drug has "therapeutic potential against a wide range of solid tumors, including those with mutant p53," which is found in many types of cancers.

"The most likely benefits will be when tailor-made combinations of these drugs are used, perhaps in combination with other chemotherapeutic drugs," Marriott added in a statement.

The researchers hope that clinical trials with the compound could begin within two years.

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Newborns Leave Hospital Early, Don't Get Follow-Up

By Dana Frisch
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Many women--mostly poor ones--still leave the hospital within a day of giving birth, according to a California study released Monday. What's more, two-thirds of those women are not getting timely follow-up visits, even though coverage of such visits is required by law in that state.

About half of mothers and newborns were discharged early, meaning less than or equal to a one-night stay for a vaginal birth and less than or equal to a three-night stay after a cesarean section.

Dr. Alison Galbraith, lead author of the study, said that the most common complications associated with early discharge, like jaundice, poor feeding habits or birth defects, often are not detectable until the third to fifth day of life.

If untreated, these conditions can become "dangerous," according to Galbraith, a fellow in the Robert Wood Johnson Clinical Scholars Program at the University of Washington in Seattle.

"The risk for these potential complications of early discharge could be reduced if infants received follow-up from a health care provider sometime between days three to five of life when many of the complications arise," said Galbraith, who conducted the study while at the University of California, San Francisco.

Galbraith and colleagues looked at a 1999 postpartum survey including 2,828 babies considered to be at low risk for complications.

Overall, 49% of those newborns were discharged early, but only one third had a follow-up visit within two days of leaving the hospital, as recommended by the American Academy of Pediatrics. About 44% had received no follow-up visit--either at home or the doctor's office--within one week of leaving the hospital, according to the report in the journal Pediatrics.

In the study, babies on Medicaid and those from low-income, Latino and non-English speaking homes were more likely to be discharged early and less likely to receive follow-up care within two days after discharge.

The California Newborns' and Mothers' Health Act of 1997 mandates coverage of home or office visits in accordance with the American Academy of Pediatrics' recommendations for newborns discharged early.

While almost 90% of follow-up visits occurred at a clinic or office, the 10% of visits that occurred at the baby's home were more likely to be timely, the study found.

Home visits, said Galbraith in an interview, might be one solution since they eliminate some of the barriers mothers might have to accessing care, such as transportation problems. She noted that home visits are more costly to insurers and are often not undertaken unless there are "strong medical reasons" for them.

"Part of the problem with coming up with the solutions is that it is hard to tell why this is happening," said Galbraith, adding that it could be that some physicians are not aware of the need for early follow-up, or that mothers might not feel it is necessary. She noted that education, interpreter services and eliminating barriers to care might be other possible solutions.

Source: Pediatrics 2003;111:364-370.

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Parents' False Beliefs Bring Kids to ER for Colds

By Alison McCook
Reuters Health

Monday, February 3, 2003

NEW YORK (Reuters Health) - Mistaken beliefs about the causes and cures of simple colds cause parents to schedule millions of unnecessary doctor visits each year, costing untold amounts to the healthcare system, according to new research released Monday.

Most colds are caused by viruses, and most get better on their own without the need for medical care. Despite this, 66% of parents say they believe bacteria could sometimes cause colds, and more than half report feeling that antibiotics--which target bacteria--could cure colds.

And almost one quarter of parents surveyed said they would bring their children to the emergency room if they developed a cold, while 60% said they would seek care at a doctor's office.

These findings suggest that informing parents about when to bring their cold-stricken child for medical care could have a significant effect on healthcare costs, study author Dr. Grace M. Lee of the Children's Hospital in Boston told Reuters Health.

If a child has a simple runny nose and a cough, "then there's not much a physician would do," Lee said. If there is a high fever, ear pain or if the child has difficulty breathing, then it may be important to bring him to the doctor, she said, just to make sure he does not have anything else in addition to his cold.

"But for the most part, it's just fluid and rest" to cure a cold, Lee noted, things a caregiver can provide better than a doctor.

Many parents schedule visits with doctors for children with colds that don't need a doctor's help, Lee and her colleagues report in the February issue of Pediatrics. Each year in the US, 1.6 million adults and children visit the emergency department for simple colds, and 25 million get harmless colds checked out in a doctor's office.

The results are based on a survey of 197 families with at least one child between 6 months and 5 years of age. All children spent at least 10 hours each week in childcare outside of the home and with at least five other children.

Lee and her team also discovered that parents are more likely to bring their cold-stricken children to the emergency room if the children are covered by the government health program Medicaid, or have a history of wheezing.

Parents were more likely to seek aid in a doctor's office for their child's cold if the parents were less than 30-years-old and believed that antibiotics can cure colds.

Despite an increasing awareness of the problems of antibiotic resistance due to over-prescription of the drugs, Lee explained that many parents are clearly not "getting that message."

Previous research has shown that people who are given antibiotics by a doctor to treat a cold once are, understandably, more likely to return to a doctor's office for their next cold, she noted.

This suggests that doctors can play a significant role in informing parents about how best to treat colds, Lee said, both their own and their children's.

Information campaigns within the community could also disseminate needed information, Lee added, "and get that message out there about when it's important to see a doctor, and when you should stay home."

Source: Pediatrics 2003;111:231-236.

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SUNDAY, FEBRUARY 2, 2003

Beware Carbon Monoxide

HealthScoutNews
Sunday, February 2, 2003

SUNDAY, Feb. 2 (HealthScoutNews) -- Are you letting a silent killer into your home?

High levels of carbon monoxide (CO) can kill people within minutes, but you can't see or smell the danger, says the U.S. Environmental Protection Agency (news - web sites) (EPA).

Each year, hundreds of Americans die from CO poisoning in their homes, and thousands seek medical help. Hazardous levels of CO can be produced by appliances that burn such fuel as gas, oil, kerosene, wood or charcoal if the appliances don't work properly or are used incorrectly.

Another potential source of CO poisoning comes from cars idling in garages. The CO from the car exhaust can seep into the house.

While CO poisoning is a health threat to everyone, some people are especially vulnerable. They include infants, fetuses, elderly people and people with anemia and heart and respiratory disease.

The EPA offers advice on how to prevent CO poisoning. You should have all fuel-burning appliances inspected by a trained professional at the start of every heating season.

When buying fuel-burning appliances, choose types that vent their fumes to the outside of your home. Have them properly installed and maintain them.

If you have to use an unvented gas or kerosene space heater, pay close attention to all the cautions that come with the heater. Use the specified fuel. When using the heater, keep doors to the rest of the house open and open a window enough to get ventilation and proper fuel burning.

Never idle your car in the garage, even if the garage door is open. Don't use a gas oven to heat your home and don't use a charcoal grill inside your home.

More information

The U.S. Consumer Product Safety Commission (news - web sites) offers answers to frequently asked questions about CO poisoning.

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New Therapy May Ease Stubborn Sinusitis

By Janice Billingsley
HealthScoutNews Reporter

HealthScoutNews
Sunday, February 2, 2003

SUNDAY, Feb. 2 (HealthScoutNews) -- A new treatment for chronic sinusitis shows promise by delivering medication directly to the infected sinus tissues, a Stanford University study has shown.

A small, pilot study of 42 long-term sinusitis sufferers found that by sending the medication directly up the nose to the sinus, rather than taking medicines orally or intravenously, two-thirds of the patients were free of infection for an average of 17 weeks, triple the average six-week infection-free period when taking other treatments.

"Oral antibiotics and surgery are still very effective for the majority of patients with chronic sinusitis," says lead author Dr. Winston Vaughan, but he says that this new treatment can be effective "for the 10 to 20 percent 'failures' who continue to have multiple, horrid infections after surgery."

The study, which appeared in a recent issue of the journal Otolaryngology -- Head and Neck Surgery, was funded by Stanford University, where Vaughan is the director of the Sinus Center.

Vaughan is also a member of the scientific advisory board of SinusPharma, the parent company of SinusPharmacy, a Carpinteria, Calif., compounding pharmacy. SinusPharmacy is the only one offering the medication, a liquid form of the standard oral and intravenous antibiotics used in other treatments.

Dr. Christopher Shaari, an otolaryngologist at New Jersey's Hackensack University Medical Center, who is not affiliated with SinusPharmacy, has used the new treatment over the last year on approximately 20 patients, which represents about 15 percent of his chronic sinusitis caseload. He says the treatment is effective with patients for whom traditional therapies have failed.

"This is not a first-line treatment, but for patients with serious chronic sinusitis who have failed two or three oral antibiotics courses, or who have just had sinus surgery, it has been effective," he says. "The medication is delivered right to the site of the infection."

The treatment involves a machine called a nebulizer, which patients can hook up and use to send liquid medication through a tube directly up the nose to the lining of the sinuses. The treatment takes about 20 minutes and is done two or three times daily for three weeks.

For the study, the Stanford doctors recruited 28 women and 14 men, ages 23 to 84, most of whom had been treated for recurrent sinus infections, including surgery, for at least a year. The average time between recurrent infections was six weeks. They were given the equipment and taught to use it themselves for a three-week course of antibiotics.

At the end of a course of treatment, and after another three to seven months for follow-up examinations, 28 patients, or 66 percent, were free of infection. Six other of the study participants got rid of their infection but it returned with three months.

Of the remaining eight patients, six did not respond to the therapy and two dropped out of the study, which Vaughan says could be partially due to other health problems like overlying allergies.

"We have much more research to do on these and other patients," he says.

The doctors also found the treatment resulted in statistically significant drops in nasal discharge, facial pressure, and pain due to clogged sinuses.

The study authors point out that the study lacked a control group of those on standard sinus treatments so a possible placebo effect could not be discounted. Also needed in future studies are long-term effects of the therapy, and research into the actual interaction among the antibiotic, sinus mucus, and bacteria.

"We have started several studies looking at longer-term outcomes, and comparing the nebulizer treatment directly with IV and oral antibiotics," Vaughan says.

More information

A fact sheet on sinusitis can be found at the National Institute of Allergy and Infectious Diseases. To see an illustration and explanation of the anatomy of the sinuses you can visit the American Rhinologic Society.

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Winter Weather Calls for Joints Care

HealthScoutNews
Sunday, February 2, 2003

SUNDAY, Feb. 2 (HealthScoutNews) -- When participating in winter activities, think water, water, water.

Not to swim in, of course, but to drink. Dehydration on top of cold winter temperatures can worsen blood circulation, which can cause your joints to ache when the snow falls.

"Not drinking enough water, having too many caffeinated drinks and smoking -- when this combination happens in the wintertime, you are much more susceptible to the cold," says Dr. David Halsey, an orthopedic surgeon.

The reason, he says, is that a lack of water together with caffeine and tobacco all constrict your blood vessels, making it harder for your blood to circulate in the cold weather.

"Winter sports then become a challenge to the joints," he adds.

Shoulders, elbows, knees and wrists all become more vulnerable to injury.

The answer, he says, is to make sure you drink as much water in the wintertime as you do in the summertime, dress warmly in layered clothing, and keep your body fit.

The University of Michigan Health System makes this recommendation: Indoor conditioning using the muscles that will get the most use outdoors is good; everyone should stretch and do a warm-up activity before putting on their gear, to increase performance and reduce the risk of pulling a muscle or tearing a ligament.

More information

Some tips on preparing for a healthy winter can be found here.

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SATURDAY, FEBRUARY 1, 2003

Stuck in the Dorm?

HealthScoutNews
Saturday, February 1, 2003

SATURDAY, Feb. 1 (HealthScoutNews) -- When you're a college student living in a dorm, staying faithful to a workout routine can be a challenge. So many other temptations beckon -- food, music, gossip -- that working out may land in last place on your to-do list.

But with a little imagination, you can turn the dorm into an ideal exercise environment, one that makes exercise easier, not harder, says Richard Cotton, a San Diego exercise physiologist and spokesman for the American Council on Exercise.

A good program, done in the dorm, has the same components as other exercise programs: aerobic or cardiovascular conditioning, strength training and stretching.

"For the aerobic component, just walk out the door," Cotton suggests. If the weather is nice, walk outside. If not? "Walk a flight of stairs, walk the length of the floor, take the next flight up. It's sort of like interval training."

For strength training, invest in adjustable dumbbells, which let you add on weights. Men should consider dumbbells that go up to about 40 pounds, and women, 25, depending on the condition they're in, Cotton suggests.

"Or do body weight exercises," Cotton says. Pushups are one example. "They don't have to be military style. They can be knee pushups, or pushing away from a desk."

Crunches can keep the abs under control, and all you need for those is a bit of floor space. A cushioned exercise mat might make them more comfortable, though, and also provide a good spot to do stretching, the third component of a good fitness program.

Be sure to stretch all the major muscle groups you just worked out, Cotton says.

More information

For information on how exercise reduces stress, see the American Council on Exercise.

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Stay Warm During Winter Workouts

HealthScoutNews
Saturday, February 1, 2003

SATURDAY, Feb. 1 (HealthScoutNews) -- Exercising in the cold can be a brisk, invigorating experience.

However, it also demands special attention to preserving your body heat so you can make it through the workout.

Your body's ability to retain enough heat depends partly on the insulation you have -- that means your body fat plus your clothing. Environmental factors such as temperature also play a role in whether you'll retain enough heat to stay comfortable.

About 40 percent or 50 percent of body heat is lost through the head, so wearing a hat -- or a helmet, if your sport calls for it -- is always recommended, according to the American Council on Exercise.

Dress in layers, which lets you easily change the amount of insulation needed. Avoid clothes that are all cotton, but rather pick fabrics that wick away moisture as you sweat, so you'll stay drier and warmer.

Pay close attention to keeping hands and feet warm, since lower outside temperatures result in blood shifting to the center of the body to keep your internal organs warm.

Before working out in extreme cold, warm up indoors by doing stretches and jogging in place. Check the temperature, too. If it's below freezing, extra vigilance is needed; you might even want to wait until it warms up.

Be on the lookout for symptoms of frostbite, which include numbness, a burning sensation or yellowish-looking skin. First aid includes immersing the parts in warm (but never hot) water.

Avoid icy or wet streets or sidewalks to minimize the risk of falling.

More information

More details about working out in the cold are at the American Running Association.

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