More information
It never hurts to keep yourself in healthy shape. The American
Heart Association ( news
- web
sites) has this
primer on exercise.
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Rise
in Body Weight Linked Directly to Heart Risk
By Alison McCook
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - The risk of developing heart failure
increases with a person's weight: rising slightly in those who are
only slightly overweight, and eventually doubling in those who are
obese, US researchers report.
Based on these findings, Dr. Ramachandran S. Vasan of the National
Institutes of Health ( news
- web
sites) and his colleagues propose that body weight itself can
influence the risk of developing heart failure, independent of other
obesity-related factors that affect heart health.
"There seems to be an independent effect of obesity on
heart failure," Vasan told Reuters Health.
Almost 60% of Americans are either overweight or obese, and
these results suggest that strategies that target the nation's bulging
waistlines could reduce the incidence of heart failure, Vasan added.
"There is a huge list of conditions associated with being
obese. And heart failure is now added to that list," he said.
Vasan and his colleagues base their findings on surveys of
nearly 5,900 adults. The researchers followed the study participants
for an average of 14 years and noted their weights and whether they
developed heart failure.
The investigators measured body weight according to a person's
body mass index (BMI), which is a measurement that factors in both
height and weight. People classified as obese have BMIs of at least
30, while those with BMIs of 25 to 29.9 are considered to be overweight.
During the study period, 496 participants developed heart failure.
Using statistics to eliminate the influence of other risk factors
for the condition, the researchers found that the risk of heart
failure rose by 5% for every increase of 1 point in BMI for men.
Each time women increased their BMIs by 1 point, their heart failure
risk jumped by 7%. Both men and women who were obese had twice the
risk of heart failure compared with people with healthy BMIs.
Based on the study findings, obesity itself likely accounts
for 11% of the cases of heart failure in men and 14% of those in
women, Vasan's team reports in the August 1st issue of The New England
Journal of Medicine ( news
- web
sites).
In an interview with Reuters Health, Vasan said that researchers
previously suspected that morbid obesity (BMI of 40 or more) could
directly cause heart failure, while lower BMIs likely contributed
to the risk by simply increasing other factors related to heart
health, such as diabetes and high blood pressure.
However, the fact that even slight increases in BMI over normal
values can increase heart failure risk indicates that excess body
weight--even small amounts--can independently and adversely affect
health, Vasan noted.
In an accompanying editorial, Dr. Barry M. Massie of the Veterans
Affairs Medical Center in San Francisco, California, notes that
these findings should throw a log on the fire of determination in
those motivated to reduce obesity in this country.
"An increased risk of heart failure is yet another reason
to encourage lifestyle modification for the prevention or treatment
of obesity," Massie writes.
"Recognition of the excessive risk of heart failure and
other vascular events associated with overweight and obesity should
lead to more frequent inclusion of overweight and obese patients
in clinical trials, which would, in turn, help to identify additional
therapies that may be particularly effective in preventing adverse
cardiovascular outcomes in this population," he adds.
Source: The New
England Journal of Medicine 2002;347:305-313, 358-359.
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Making
Pre-Cooked Foods Safter
HealthScoutNews
Wednesday, July 31,
2002
WEDNESDAY, July 31 (HealthScoutNews) -- University of Arkansas
food scientists have created an edible film that can prevent the
growth of Listeria bacteria on ready-to-eat chicken and other
pre-cooked foods.
The film consists of two proteins called zein and nisin. While
the combination is harmless to humans, it kills Listeria
bacteria that can contaminate chicken and other foods such as deli
meats and hot dogs between the cooking and packaging stages.
Listeria bacteria, which can survive refrigeration,
can cause serious illness and poses a special risk to children and
the elderly and causes miscarriage in pregnant women.
To test their protective film, the researchers bought chicken
breast tenders, froze them and irradiated them to eliminate bacteria.
They then cooked and cooled them and immersed them in Listeria
cultures.
The researchers then dipped the chicken pieces in two solutions,
one containing a combination of zein and nisin and one containing
zein alone. The combination of the two proteins was the most effective
in lowering bacterial counts.
The findings will be published in an upcoming issue of the
Journal of Food Science.
More Information
The Centers
for Disease Control and Prevention has all the facts about listeria
and other foodborne diseases.
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Deaths
Prompt Deer Disease Probe
By Robert Imrie
Associated Press
Writer
The Associated
Press
Wednesday, July
31, 2002
WAUSAU, Wis. (AP) - The deaths of three outdoorsmen from brain-destroying
illnesses are under investigation by medical experts who want to
know whether chronic wasting disease has crossed from animals into
humans, just as mad cow disease did in Europe.
The men knew one another and ate elk and deer meat at wild
game feasts hosted by one of them in Wisconsin during the 1980s
and '90s. All three died in the 1990s.
Investigators want to know whether the deaths were just a coincidence
or whether the men contracted their diseases from the meat of infected
game.
There has never been a documented case of a person contracting
a brain-destroying illness from eating wild animals with chronic
wasting disease.
"We are not saying it absolutely can't happen. We know
that it's a mistake to say that," said Dr. Larry Schonberger,
a specialist at the Centers for Disease Control and Prevention (
news
- web
sites) in Atlanta. "It gets a lot of people scared and
it has economic consequences and everything, so we need to check
it out."
In February, chronic wasting disease — an incurable, brain-destroying
illness that causes deer, elk, moose and caribou to grow thin and
die — was found in Wisconsin deer, marking the first time it was
discovered east of the Mississippi River. It was identified in Colorado
elk more than three decades ago and is now known to exist in deer
or elk in eight states and Canada; thousands of animals are now
being slaughtered to contain it.
Chronic wasting disease is related to mad cow disease in cattle
and Creutzfeldt-Jakob disease ( news
- web
sites) in humans. All three diseases are caused by mutant proteins
called prions that make spongelike holes in the brain.
During the 1990s, scientists confirmed that people in Europe
developed Creutzfeldt-Jakob from eating beef from cattle infected
with mad cow disease. The finding devastated Europe's beef industry.
If elk and deer meat prove to be a similar threat, the effects
would not be nearly as disastrous, in part because beef eating is
far more widespread. But such a finding could raise fears of the
disease spreading from wild animals to livestock and endangering
the food supply.
Also, hunting where the disease is known to exist would drop
off dramatically, said Steve Torbit, a National Wildlife Federation
biologist.
"It may be possible hunting persists as a way to collect
hides or heads and antlers," he said. "It is a rocky ride
we are in for."
The Wisconsin Division of Health and the CDC are looking at
autopsy results and other records regarding James Botts, Wayne Waterhouse
and Roger Marten. Waterhouse, of Chetek, Wis., and Marten, of Mondovi,
Wis., both 66, died in 1993. Botts, 55, of Blaine, Minn., died in
1999. Waterhouse and Marten were avid hunters; Botts fished.
Waterhouse and Botts died of what was diagnosed as Creutzfeldt-Jakob,
their families said. Creutzfeldt-Jakob is always fatal and occurs
in just one in a million people. Marten died of Pick's disease,
a more common brain-destroying disorder, said his son, Randy.
Jeff Davis, the state epidemiologist, said four or five cases
of Creutzfeldt-Jakob are diagnosed in Wisconsin each year. What
makes the deaths of Waterhouse, Botts and Marten worth investigating
is that the men knew one another and attended game feasts that Waterhouse
held at his cabin near Superior, Davis said.
Botts' widow, Judy, believes her husband's illness came from
the meat he ate at the feasts. She said the gatherings were the
only thing the three occasional friends had in common, other than
their love of hunting or fishing.
In 1999, a World Health Organization ( news
- web
sites) panel concluded there was no scientific evidence that
chronic wasting disease can infect humans. But it also said no part
of a deer or elk believed to be infected should be eaten.
After years of suspicions, it was not until 1994 that there
was enough evidence for scientists to conclude that humans could
get a form of mad cow disease from beef.
Dr. G. Richard Olds, chairman of medicine at the Medical College
of Wisconsin in Milwaukee, said it is possible scientists could
come to same conclusion about chronic wasting disease, though it
could take as long as 15 years.
"I am not trying to scare people inappropriately,"
he said. "But we need to be honest about this situation."
On the Net:
National Prion Disease Pathology Surveillance Center: http://www.cjdsurveillance.com
CDC:
http://www.cdc.gov
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Moms
Who Breast-Feed Reduce Infants' Asthma Risk
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - Mothers who breast-feed infants
for 4 months or longer may help protect their children from developing
asthma, according to a new study conducted in Australia.
In general, breast-feeding is the best nutrition for infants.
It is full of beneficial hormones, enzymes and growth factors, and
reduces infections, respiratory illness and diarrhea in babies.
However, previous studies of the effects of breast-feeding
on infants of asthmatic mothers have been mixed, with some showing
decreases in asthma while another reported the opposite.
To investigate, Dr. Wendy H. Oddy, of the Telethon Institute
for Child Health Research in Perth, and colleagues evaluated asthma
outcomes of more than 2,600 infants that they followed from preterm
to age 6 years. Mothers answered questions about their own asthma
status and how long they breast-fed, if at all.
The risk of childhood asthma increased by 28% if exclusive
breast-feeding was stopped and other milk was introduced before
the infant was 4 months old, the authors report in the July issue
of the Journal of Allergy and Clinical Immunology. This was true
regardless of whether the mother had asthma.
"Among many other health benefits, breast-feeding provides
protection against infection through defense agents in the milk,"
Oddy and colleagues write.
"Given our findings, we continue to recommend that infants
with or without a maternal history of asthma be exclusively breast-fed
for 4 months and beyond," the authors conclude.
Asthma remains an incurable chronic illness, and death from
the disease is highest among children aged 1 to 4 years--an age
group accounting for about half of all asthma-related emergency
department visits.
Source: Journal
of Allergy and Clinical Immunology 2002;110:65-67.
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Making
Pre-Cooked Foods Safer
HealthScoutNews
Wednesday, July 31,
2002
WEDNESDAY, July 31 (HealthScoutNews) -- University of Arkansas
food scientists have created an edible film that can prevent the
growth of Listeria bacteria on ready-to-eat chicken and other
pre-cooked foods.
The film consists of two proteins called zein and nisin. While
the combination is harmless to humans, it kills Listeria
bacteria that can contaminate chicken and other foods such as deli
meats and hot dogs between the cooking and packaging stages.
Listeria bacteria, which can survive refrigeration,
can cause serious illness and poses a special risk to children and
the elderly and causes miscarriage in pregnant women.
To test their protective film, the researchers bought chicken
breast tenders, froze them and irradiated them to eliminate bacteria.
They then cooked and cooled them and immersed them in Listeria
cultures.
The researchers then dipped the chicken pieces in two solutions,
one containing a combination of zein and nisin and one containing
zein alone. The combination of the two proteins was the most effective
in lowering bacterial counts.
The findings will be published in an upcoming issue of the
Journal of Food Science.
More Information
The Centers
for Disease Control and Prevention has all the facts about listeria
and other foodborne diseases.
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Seniors
Report Fewer Psych Problems Than Young
By Charnicia E.
Huggins
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - Senior citizens may have more chronic
medical problems than their younger counterparts, but they may be
less likely to be depressed or have other psychological disorders,
new study findings suggest.
"Thus, the assumption that aging is associated with increased
psychological distress may not fit in older primary care patients,"
lead study author Dr. Joshua Klapow, of the University of Alabama
at Birmingham, told Reuters Health.
"However, the findings in no way should be interpreted
as evidence for discounting the possibility of psychological disorders
in older primary care patients," he added. "Rather, they
highlight the importance of understanding how age may influence
physical and psychological symptoms."
To investigate, Klapow and his colleagues studied 3,000 patients,
including 534 individuals aged 65 years and older. The patients
completed mental health questionnaires and assessments of their
general health-related quality of life.
Five percent of the seniors reported having a psychological
disorder, such as depression or anxiety, in comparison to 17% of
the younger patients, the investigators report in the July/August
issue of Psychosomatic Medicine. Furthermore, younger patients reported
experiencing more severe psychological symptoms and stressors, including
worries about their health, weight or finances.
Overall, younger patients experienced more frequent and more
severe psychological symptoms than did older patients. This finding
remained true even after the study participants' gender, race, education,
and number of physical conditions was taken into consideration,
the researchers note.
Younger patients also reported visiting the doctor more often
and taking more days off for disability than did the seniors, even
though the seniors had two to three times more chronic medical conditions,
the report indicates.
It is not known why psychological disorders were more common
among the younger patients than among the seniors, Klapow said.
He speculates that "older patients may develop coping strategies
that enable them to manage multiple medical conditions and stressful
life events more adaptively than younger patients."
In light of the findings, Klapow advises that both older and
younger patients be screened for "distress-related symptoms"
and that doctors "recognize that age alone is not necessarily
associated with greater psychological distress."
Source: Psychosomatic
Medicine 2002;64:635-643.
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Study:
Birth Control Pill Does Not Make Teens Fat
By Charnicia E.
Huggins
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - The idea that taking birth control
pills leads to weight gain appears to be a myth, new study findings
show.
"Perceived weight gain is the number-one reason for adult
women discontinuing use of oral contraceptives," Dr. Tom Lloyd,
director of the Pennsylvania State Young Women's Health Study at
Pennsylvania State College of Medicine, told Reuters Health. "Our
study demonstrated that oral contraceptive use by teen women does
not affect body weight or body composition."
To investigate, Lloyd, a professor in health evaluation sciences,
and his colleagues conducted a 9-year study of 66 white girls who
were age 12 at the start of the study. Thirty-nine of the girls
were taking oral contraceptives at age 21.
The birth control users reported being on the Pill for an average
28 months, yet their increases in weight, body mass index (a measurement
of weight in relation to height) and percent body fat was similar
to that of their peers, the investigators report in the August issue
of Obstetrics and Gynecology.
The two groups also had similar increases in height and decreases
in percent lean body mass, the report indicates.
On the other hand, the birth control users exhibited much greater
increases in their levels of total cholesterol, LDL (the "bad"
cholesterol), and triglycerides than did their peers who did not
use oral contraceptives--a finding opposite to what has been observed
among adult women, the researchers note.
Still, the girls' total cholesterol, LDL cholesterol and trigylceride
levels were all within the normal range, Lloyd said.
"The present study provides evidence that oral contraceptive
use by teenage girls...does not affect body composition, and we
suggest that potential users be counseled accordingly," Lloyd's
team concludes.
Because the study was conducted among healthy white females,
however, "the results might differ (among other individuals)
according to ethnicity, obesity, and exercise patterns," Lloyd
added.
Source: Obstetrics and Gynecology 2002;100:235-239.
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Humming
a Few Bars May Bar Sinusitis
By Amanda Gardner
HealthScoutNews Reporter
HealthScoutNews
Wednesday, July 31, 2002
WEDNESDAY, July 31
(HealthScoutNews) -- Could it be possible to hum your way to better
health?
Swedish scientists have found that humming increases ventilation
in the sinuses, raising the prospect that daily "tune-ing"
might reduce the risk of sinusitis in patients who are susceptible
to upper respiratory infections.
"Since humming increases sinus ventilation dramatically,
we speculate that daily periods of humming could be helpful to prevent
sinusitis in certain patients where bad ventilation is a part of
the disease process," says Dr. Jon Lundberg, one of the study
authors and an associate professor of physiology and pharmacology
at the Karolinska Institute in Stockholm. "This is, of course,
speculative and must be tested in controlled studies."
The findings, which appear in the July issue of the American
Journal of Respiratory and Critical Care Medicine, may also
lead to a more accurate way to diagnose sinusitis.
Some 14 percent of the U.S. population suffers from this condition,
which involves inflammation of one of the sinus cavities -- usually
from upper respiratory infections. The illness has so far defied
effective diagnosis and treatment.
The sinuses are cavities within the facial bone that lie next
to the nasal cavity. The two chambers communicate with each other
through openings called ostia. Previous researchers have pointed
out that blocked or partly blocked ostia lead to reduced exchange
of air between the two areas, which in turn helps foster the growth
of bacteria, Lundberg says. This is a perfect setting for sinusitis.
Dr. Eddie Weitzberg, lead author of the study and an associate
professor in the department of anesthesiology and intensive care
at Karolinska Hospital, likens the sinuses to a bad basement that
constantly needs to be ventilated.
One measure of how well the sinuses are ventilated is the amount
of nitric oxide being expelled. When the sinuses are working properly,
exhaled air contains a high concentration of nitric oxide. Less
nitric oxide can indicate the presence of a problem, including asthma.
In this study, the researchers tested 10 healthy adult males
with no history of allergy or airway disease and found that humming
increased the nitric oxide rate 15-fold, compared with "quiet
exhalation." In a mechanical model of the nose and sinus, humming
also caused a dramatic rise in gas exchange between the two cavities
-- almost the entire volume (96 percent) of the sinus was turned
over in one exhalation, vs. only 4 percent during a regular exhalation.
Humming might end up as one of the easiest diagnostic tools
available.
"Measuring nitric oxide during humming could be a measurement
of the size of the holes from the sinus to the nose [ostia], and
that could be of great interest to ear-nose-throat doctors, because
one of the main promoters of sinusitis is narrow ostia," Weitzberg
says.
"The idea is that if the passage between the sinus cavity
and the nose is reduced, the humming-induced increase in nasal nitric
oxide would be reduced," Lundberg adds.
What To Do
The theories aren't proven yet but, since humming appears to
pose few health risks, why not try humming your sinus troubles away?
For more information on sinusitis, check out the National
Institute of Allergy and Infectious Diseases or the American
Academy of Allergy, Asthma and Immunology.
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Fish
Oils Soften Arteries, May Fight Heart Attack
By Melissa Schorr
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - Eating fatty acids found in fish
oils may help reduce the risk of a heart attack by keeping arteries
flexible, Australian researchers report.
"This is good evidence that eating fatty fish improves
the health of the large arteries," lead author Dr. Paul Nestel,
head of cardiovascular nutrition at the Baker Medical Research Institute
in Melbourne, Australia, told Reuters Health.
It has been found that fish--especially fatty fish such as
tuna, salmon and sardines--contain omega-3 fatty acids, which have
protective effects on the cardiovascular system. However, the mechanism
for this is still being explored.
The researchers investigated whether omega-3 fatty acids can
help prevent hardening of the arteries, which constricts blood flow
from the heart and can lead to high blood pressure and heart attacks.
In the study, which included 38 men and women with high cholesterol,
patients received either a capsule containing one of two forms of
purified omega-3 fatty acids--eicosapentaenoic acid (EPA) or docosahexaenoic
acid (DHA)--or a dummy placebo pill for 7 weeks. The researchers
then measured the elasticity of the participants' arteries by ultrasound.
According to the findings, published in the American Journal
of Clinical Nutrition ( news
- web
sites), those who received the omega-3 fatty acids had a significant
reduction in arterial hardness, while those taking the placebo pill
had no change. Those taking EPA had a 36% increase in systemic arterial
compliance, a measure of the large artery's elasticity, while those
who took DHA had a 27% increase.
"We found a significant improvement in arterial elasticity
after 7 weeks on either EPA or DHA," Nestel said. "Eating
fish is possibly the best nutritional advice to reduce risk of fatal
heart attacks."
The study was partially funded by the drug company F Hoffmann-La
Roche.
Source: American Journal of Clinical Nutrition 2002;76:326-330.
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For
Women, Weight Control is Mind Control
By Kathleen Doheny
HealthScoutNews Reporter
HealthScoutNews
Wednesday, July 31, 2002
WEDNESDAY, July 31 (HealthScoutNews) -- Attitude is everything,
and that's especially true if you're a woman trying to maintain
your weight.
Women who believe that weight maintenance is under their control
rather than entirely predetermined by genetics are thinner, a new
study has found.
Fred Kuchler and Biing-Hwan Lin, both researchers with the
U.S. Department of Agriculture ( news
- web
sites)'s Economic Research Service, used data from two government
surveys that polled 5,274 men and women. (One was the Continuing
Survey of Food Intake by Individuals; the other, the Diet and Health
Knowledge Survey.)
The aim was to find which diet and lifestyle choices mattered
for weight control and whether the choices varied by gender. The
analysis was meant to help those who design weight maintenance programs.
As expected, the studies linked several habits to effective
weight control, including getting regular exercise and eating breakfast
regularly. "A lot of what we found confirms [findings] from
other studies," says Kuchler, whose report appears in the current
issue of the International Journal of Obesity.
Then they asked both men and women to tell whether they agreed
or disagreed with this statement: "Some people are born to
be fat, others thin; there is nothing I can do." They called
it the "gene theory."
"About the same proportion of men to women agreed with
the statement," Kuchler says.
But when they correlated the response to the statement with
the person's body mass index (BMI), a measure of height to weight
to assess optimal weight, they found that women (but not men) who
disagreed that there was nothing that could be done tended to have
lower BMI's.
"What's important is that women who disagreed with the
statement had lower BMIs than those who agreed with it," Kuchler
says. The difference was a shade under a point.
Lowering the BMI by a point could mean the difference between
optimal weight or overweight. A five-foot, four-inch tall woman
who weighs 145 pounds, for instance, has a BMI of 25, which is considered
overweight. A woman of the same height who weighs 140 pounds has
a BMI of 24, considered an appropriate weight.
"Women who disagreed [with the gene theory] were thinner,"
Kuchler says.
Why did attitude about weight not seem to matter for men?
"I can't really say why," Kuchler says. His goal,
he says, was to look at the variables that seem to matter for weight
control to advise those who design weight loss programs what to
include.
A weight loss expert who has studied the causes of overeating
says the finding about attitude is interesting and bears out his
experience with persons trying to lose weight.
"I think that attitude is very important," says Edward
Abramson, professor of psychology at California State University,
Chico, and author of several weight control books. "The notion
of efficacy -- that you have some control -- is critical in any
weight loss program. To maintain the motivation, to persist [in
losing weight and keeping it off], you need the sense of being able
to have an impact based on your behavior."
The take-home point, at least for women, is that genetics plays
a role but doesn't write the entire script.
"While it is true there are some women who will never
be petite, they can be more healthy and feel better about their
bodies if they take control of their weight," Abramson says.
What To Do
For information on people who have lost weight and kept it
off, see the National
Weight Control Registry. Calculate your body mass index at the
National
Heart, Lung, and Blood Institute.
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Drug
May Help Quiet Behavior Problems in Autism
By Linda Carroll
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - A medication commonly used to treat
schizophrenia may help quiet tantrums and other serious behavioral
problems in certain autistic children, researchers suggest.
More than two thirds of the autistic children treated with
the antipsychotic drug risperidone showed significant improvements
in behavior, according to the report published in the August 1st
issue of The New England Journal of Medicine ( news
- web
sites).
Risperidone is one of a newer class of antipsychotic medications.
The drug was appealing as a possible treatment for autistic children
because it produces fewer side effects than some other antipsychotic
medications, study co-author Dr. Lawrence Scahill, an associate
professor of child psychiatry and nursing at Yale University in
New Haven, Connecticut, said in an interview with Reuters Health.
Approximately 1 in 500 children are diagnosed with autism,
a developmental disorder that generally becomes apparent in the
first couple of years of life. The condition is typified by social
isolation, disinterest in having reciprocal relationships with others,
delayed and unusual speech and repetitive behaviors, Scahill explained.
The study was a multi-site clinical trial that followed 101
children, aged 5 to 17, for 8 weeks. At the outset, the children
were rated as to how irritable they were.
Children included in the study had serious behavioral problems
on a daily basis. The behavior problems are not rooted in maliciousness,
Scahill pointed out. "Children with autism want things to be
the same," he noted. "They like routine. If the routine
is changed their reactions can be rather extreme."
These reactions can include hitting or biting themselves, throwing
things, knocking things over, screaming and yelling for extended
periods of time, Scahill said. He estimates that such serious behavior
problems occur with regularity in about one third of autistic children.
Scahill and his colleagues found that risperidone produced
significant improvements in 69% of the children. After 8 weeks of
treatment, children treated with risperidone had a decrease in irritability
scores of almost 57%, compared with 14% in the group given an inactive
placebo.
What this means, Scahill said, is that "children weren't
yelling or screaming when things didn't go exactly the way they
thought they should go."
Tantrums and incidents of biting and scratching others dropped
from a couple of times a day to a couple of times a week. Such improvement
was a relief to parents, Scahill added.
The researchers suspect that by quieting the bad behaviors,
the drug will allow the children to benefit more from other kinds
of therapy.
"We assumed if this medication worked, that it would make
a child more amenable to educational and rehabilitation interventions,"
Scahill said.
The study was funded by the National Institute of Mental Health.
Source: The New England Journal of Medicine 2002;347:314-321.
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Flavoring
Ups Lung Disease Risk in Popcorn Factory
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - Some workers who mix and package
flavored microwave-popcorn or are involved in other flavoring manufacturing
may have up to 11 times the expected risk for a serious lung obstruction
disorder, the results of a new study suggest.
The report is a follow-up to last year's widely published news
of severe lung illnesses in eight people who all worked in a small
Missouri microwave-popcorn factory. Initially, health officials
did not associate their illnesses with their jobs. After the eight
cases accumulated and came to the attention of a lawyer, an eagle-eyed
physician brought it to the attention of the state.
Missouri brought the CDC's National Institute of Occupational
Safety and Health (NIOSH) in to investigate and their new report
on the matter is published in the August 1st issue of The New England
Journal of Medicine ( news
- web
sites).
The eight workers had no other risk factors for lung disease,
but became severely ill with a respiratory illness called bronchiolitis
obliterans--a severe, obstructive lung disease that has normally
been seen in people exposed to a toxic irritant in a big spill.
In these workers, it appears they became ill from long-term exposure
to a chemical used in making artificial butter flavoring.
After studying conditions at the plant, investigators concluded
that workers were likely getting sick from exposure to chemicals
being given off by flavor additives being mixed into the popcorn.
Soybean oil, salt and flavorings are mixed in a large, heated
vat. The heat produces visible dust, aerosols and vapors with a
strong buttery odor.
The vapors were found in greatest concentration around the
mixers, and in lesser amounts near the packaging operation. Not
surprisingly, mixers were at higher risk of developing illness than
packagers.
In their investigation, which was conducted in November 2000,
lead investigator Dr. Kathleen Kreiss of NIOSH in Morgantown, West
Virginia and colleagues conducted medical exams and environmental
surveys of 117 workers in the plant.
All of these workers were 2.6 times more likely than those
in the general population to experience chronic cough and shortness
of breath, and twice as likely to have these symptoms compared to
people diagnosed with asthma and chronic bronchitis, the study indicates.
"Overall, the workers had 3.3 times the expected rate
of airway obstruction (and) those who had never smoked had 10.8
times the expected rate," the authors write.
In other findings, chemical analysis of the air in the mixing
room revealed high levels of the artificial butter-flavoring ingredient
diacetyl (2,3-butanedione).
According to Kreiss and colleagues, studies of the effects
of butter-flavoring vapors with diacetyl levels at 352 parts per
million "damaged" cells lining the respiratory tract of
rats. Mixers at the microwave-popcorn plant in question may have
been exposed to levels between 3 and 4 times that amount, they note.
"Our findings of excess rates of lung disease and associations
between indexes of exposure to volatile organic chemicals and obstructive
lung disease support the conclusion that an agent in butter flavoring
caused occupational bronchiolitis obliterans in exposed workers
at this popcorn plant," Kreiss and colleagues conclude.
"Clearly, work in the mixing room of this microwave popcorn
plant conferred a high risk of this rare, severe lung disease,"
writes Dr. E. Neil Schachter of Mount Sinai School of Medicine in
New York City in an accompanying editorial.
"As for the health effect of microwave-popcorn products
in the general population, there are no findings to date to suggest
that consumers are at any risk," Schachter concludes.
Source: The New England Journal of Medicine 2002;347:330-338,
360-361.
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TO TOP
Natural
Proteins in Brain Wipe 'Fear' Slate Clean
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - The brain contains naturally-occurring
substances that can wipe away fearful memories and with time may
help soften the jolt of fear that can become associated with innocuous
triggers, according to a new study in mice.
The compounds are known as cannabinoids, and they share some
similarities with the active ingredient in marijuana, THC. Mice
that lacked a particular cannabinoid receptor in the brain stayed
forever fearful of a certain sound that once was accompanied by
an electric shock.
In contrast, normal mice quickly lost their fear of the sound
if it was no longer heard in tandem with the painful jolt, according
to a report in the August 1st issue of the journal Nature.
The discovery may lead to a better understanding, and perhaps
treatment, for people who experience post-traumatic stress disorder
(PTSD)--a condition that can affect survivors of natural disasters,
violent crimes and serious accidents. Symptoms of PTSD include flashbacks
to the trauma, nightmares and emotional withdrawal.
In the study, Dr. Beat Lutz of the Max Planck Institute of
Psychiatry in Munich, Germany and colleagues looked at mice genetically
engineered to lack a particular cannabinoid receptor known as CB1.
The researchers conditioned the mice to associate a sound with
an electric shock. The mice were repeatedly exposed to the sound
and the shock for several days. All of the mice that lacked CB1,
as well as normal mice, developed a fear response to the sound.
The mice were later exposed to the sound without the shock
and the researchers noted a different response in those lacking
CB1.
The normal mice "quickly recovered from (their) fear reaction,"
Lutz explained. In contrast the CB1-deficient mice, showed little
reduction in fear and seemed unable to forget their past experience.
"Until now, the function of the endogenous cannabinoid
system in memory processing has not been clear," Lutz said.
"Our work could assign, for the first time, a specific function
of memory processing to the endogenous cannabinoid system--extinction
of aversive memories."
With regard to people, the authors note that ordinarily healthy
people are equipped with "balanced" emotional responses
to potentially dangerous situations. For example, if a person sees
a poisonous snake, they relax relatively quickly once the imminent
threat of being bitten has passed. An individual who has a phobia,
on the other hand, can not adapt to such situations and may develop
an uncontrollable over-reaction, which could lead to an anxiety
or panic attack.
Similarly, individuals with PTSD may have uncontrollable emotional
reactions to triggers that others might find innocuous.
"We think that our work could stimulate novel therapeutic
approaches for the treatment of phobias or post-traumatic stress
disorder," Lutz added.
However, Lutz stressed, "we do not recommend to smoke
marijuana to get rid of bad memories or to treat PTSD or phobics."
The compounds found in marijuana are unlikely to have the same
effect because they are not specific enough for these receptors,
according to Lutz.
The active ingredient in marijuana, THC, "binds to all
cannabinoid receptors in the body, irrespective of whether or not
(they are) involved in extinction in aversive memories," he
said.
"However, it might be possible that the combined action
of psychiatrist or trained psychologists together with pharmacological
interventions targeting the endogenous cannabinoid system may lead
to novel therapeutic concepts to treat above mentioned conditions,"
he said.
Source: Nature 2002;418:530-533.
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Study
Looks at Breast Cancer in Young Black Women
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - Young African-American women who
develop breast cancer ( news
- web
sites) appear to be more likely to die from the disease than
their white counterparts, according to the results of a new study.
But the investigators also found a bit of good news--the percentage
of African-American women who have their breast cancer detected
while it is still in an early stage, and therefore more treatable,
has nearly doubled during the 1990s. This finding suggests that
education campaigns targeting African-American women may be working.
However, detection rates in blacks still lag behind detection rates
in whites, the researchers point out.
In their investigation, Dr. Lisa A. Newman of Wayne State University
in Detroit, Michigan and colleagues evaluated the outcomes of 507
African-American and 1,378 white women diagnosed with breast cancer
before age 40. All of the women lived in Detroit.
Although most study patients with localized breast cancer survived,
Newman's team found that black women were nearly twice as likely
to die as white women.
"Young African-American women are clearly facing increased
risks for breast cancer mortality, and this public health issue
warrants further investigation and research," Newman and colleagues
write.
With regard to detection of breast cancer among women with
disease that has yet to spread, African-American women jumped up
from a rate of 6.4% in the early 1990s to 11.3% in the later part
of that decade. White woman actually saw a slight decrease in their
rates of early detection--from 16.4% to 15.7%.
The study authors are calling for more education campaigns
to be targeted at African-American women, and that this group be
included in more clinical research.
"These are not new findings," said Dr. Vilma Cokkinides,
a spokesperson for the American Cancer Society ( news
- web
sites). "Racial disparities for young women with breast
cancer have been reported over and over."
With regard to the current study, Cokkinides notes that socioeconomic
factors including level of education and access to healthcare "have
not been properly accounted for," and if they were, the death
rate differences may be "somewhat reduced."
Regardless, what remains controversial is the cause for the
differences in cancer rates and death rates attributed to the disease,
according to Cokkinides.
There is currently a "big debate" as to whether the
differences are related to socioeconomic factors or cancer tumor
biology, Cokkinides noted. In other words, experts are not sure
if African-American women are more likely to develop more aggressive
forms of breast cancer or if other, society-related factors play
a role. Researchers continue to investigate the issue, Cokkinides
said.
Source: Cancer 2002;95:21-27.
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Many
Asthmatics Skip Anti-Inflammatroy Meds: Survey
Reuters Health
Wednesday, July
31, 2002
NEW YORK (Reuters Health) - The results of a new US survey
suggest that up to 75% of asthmatic patients may not be taking anti-inflammatory
medications, which are an important part of asthma treatment.
"The results from this representative national population
study present a bleak picture of the status of asthma treatment
in the United States," according to Dr. Anne L. Fuhlbrigge
of Brigham and Woman's Hospital in Boston, Massachusetts, and colleagues.
Asthma is marked by inflammation in the airways, which leads
to wheezing, breathlessness and coughing that can range from mild
to severe. Asthma attacks are often triggered by an allergic response
to an environmental irritant such as tobacco smoke, mold, pollen
or other allergic triggers. The disease is becoming more common
worldwide, particularly among US children living in urban areas.
One primary treatment for asthma involves the use of anti-inflammatory
medications, which help combat the underlying inflammation that
can contribute to asthma. Other types of medication include beta-agonists,
which work to open constricted airways.
To assess the rate of asthma medication use, the researchers
conducted a telephone interview with 2,509 adults; 721 were the
primary guardian of a child with asthma and the remaining 1,788
had asthma themselves. The findings are published in the July issue
of the Journal of Allergy and Clinical Immunology.
Roughly 90% of those surveyed reported that they experienced
limitations in their lives due to asthma. For people in this group,
only 21% who described some limitations from asthma reported current
use of anti-inflammatory medication, and only 26% with severe limitations
reported such current use, the authors report.
In other findings, significantly fewer poor, uninsured, unemployed,
less educated and nonwhite persons with asthma reported anti-inflammatory
medication use.
About 80% of those with persistent asthma and 43% of those
with mild intermittent asthma used "reliever medication,"
drugs designed to relieve symptoms but not combat inflammation.
"The starkness of our findings on the disparities of medication
(use) by socioeconomic status, and in particular by race-ethnicity,
emphasize that the current systems used for asthma management are
failing to provide adequate care for a large proportion of the population,"
Fuhlbrigge and colleagues write.
"Attainment of optimal asthma care remains elusive,"
they conclude.
The study was funded by the drug company GlaxoSmithKline.
Source: Journal of Allergy and Clinical Immunology
2002;110:58-64.
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US
Experts Target Elderly, Adolescent Immunizations
By Todd Zwillich
Reuters Health
Wednesday, July 31, 2002
WASHINGTON (Reuters Health) - Government health officials announced
a new round of projects Wednesday aimed at narrowing the gap in
immunization rates between elderly white and minority Americans.
The US Department of Health and Human Services ( news
- web
sites) (HHS) unveiled a 2-year plan to organize doctors, insurers
and community groups in five locations to boost the number of elderly
minorities receiving annual influenza and pneumococcal shots.
Influenza and pneumococcal illnesses including pneumonia together
kill 24,000 to 30,000 seniors each year, and experts have long sought
ways to expand yearly vaccination against the diseases. Sixty-seven
percent of white seniors but only 56% of Hispanics and 48% of blacks
were vaccinated against influenza in 2000, according to HHS. Fifty-seven
percent of whites and 30% of blacks and Hispanics were immunized
for pneumococcal diseases.
Claude Allen, the 2nd-ranking official at HHS, called the figures
"unacceptable."
"In the areas of adult immunization, we are not doing
as well as we should be doing," he said.
Officials said they would spend $250,000 to $400,000 in each
of five minority communities looking for ways to help doctors and
community groups bring in more elderly persons for vaccinations.
Planners intend to send out money starting in September for
year-long implementation programs and then follow them with a year
of evaluation. Funds will be sent to Rochester, New York; Chicago,
Illinois; Milwaukee, Wisconsin; San Antonio, Texas; and Mississippi.
Experts also warned that few adolescents are receiving the
full recommended course of vaccinations, leaving many of them vulnerable
to infectious diseases.
Just 44% of adolescents in one 2000 survey had received the
full series of shots against hepatitis B, a serious liver disease
that is transmitted through sexual contact or contact with tainted
blood.
Adolescents usually go to the doctor only when sick, and few
doctors check up on immunizations when they do see adolescent patients,
said Dr. Bonnie Word, a pediatrician who serves on CDC's Advisory
Committee for Immunization Practice.
"The adolescent has not fared as well" as younger
children, she said. Many laws requiring vaccinations for all elementary
and middle school children are not properly enforced, and many low-income
parents remain unaware that federal programs pay for all childhood
and adolescent vaccines, according to Word.
Officials reported that overall childhood immunization rates
held steady in 2001, despite shortages of several key vaccines.
National vaccination rates ticked up slightly from 76% of children
in 2000 to 77% in 2001, though regional disparities remain, said
Dr. Walter Orenstein, director of the National Immunization Program
at the Centers for Disease Control and Prevention ( news
- web
sites).
Most states in the Northeast and Southeast sustain child vaccination
rates between 80% and 90%, while most Midwestern and Western states
lag in the 70% to 79% range.
Experts faced widespread concern earlier this year that shortages
in five vaccines covering 11 childhood infectious diseases could
damage immunization rates. Only one vaccine, the pneumococcal conjugate
vaccine known as PCV7, remains in short supply.
Officials will not know until next year if vaccine production
shortfalls affected child vaccination rates in 2002.
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FDA
Pressed for Action on Ephedra
By Randolph E.
Schmid
Associated Press
Writer
The Associated
Press
Wednesday, July
31, 2002
WASHINGTON (AP) - A leading senator took the Bush Administration
to task Wednesday for its failure to act on the potentially dangerous
food supplement ephedra. "Today I am asking the Secretary of
Health and Human Services ( news
- web
sites) to determine whether the dietary supplement ephedra poses
an 'imminent hazard' to the public's health, and if so, use his
authority to suspend sales of the product in the U.S. until we can
ensure that it is safe," said Sen. Richard J. Durbin, chairman
of the Senate Governmental Affairs Committee ( news
- web
sites)'s oversight panel.
"This is a strong step, but one that must be taken if
we are serious about protecting the health and well-being of our
citizens," the Illinois Democrat said.
His comments came just over a month after the administration
outraged doctors by delaying action on ephedra, instead launching
a new safety review of the herbal stimulant.
Durbin spoke at the end of a Senate hearing called to examine
the validity of claims made for weight-loss supplements and the
government's system of oversight for the supplements.
The food supplement industry has grown explosively in recent
years and is on track to reach $19 billion in sales this year, Durbin
said.
Joseph A. Levitt, director of the FDA ( news
- web
sites)'s Center for Food Safety and Applied Nutrition, said
the agency does have a plan to deal with ephedra but lacks enough
data, which is currently being collected.
The use of food supplements is growing rapidly and represents
a "significant challenge" for the agency, Levitt said.
Durbin retorted: "Evidence keeps piling on about the danger
of this product. Proposed rules are fine, but nothing has been done."
Canada a year ago warned consumers not to use ephedra and it
has been banned by the International Olympic Committee ( news
- web
sites), National Football League and National Collegiate Athletic
Association.
Because ephedra, made from herbs, is sold as a food supplement,
U.S. law does not require its manufacturers to prove safety, meet
standard drug manufacturing rules or provide any specific warning
labels.
To remove a supplement from the market, the FDA has to prove
it is dangerous. It has blocked sales of synthetic ephedra.
Three years ago, citing death reports, the agency attempted
to bar certain high doses of ephedra. Industry protests killed the
move, and a General Accounting Office ( news
- web
sites) report said that while ephedra clearly was risky to some
people, the FDA's statistics were sloppy.
So FDA officials reanalyzed and began working toward warning
labels. The consumer group Public Citizen petitioned for a ban.
But instead of deciding on either option, the Department of
Health and Human Services ( news
- web
sites) in June surprised the medical community and hired Rand
Corp. to review all scientific reports on ephedra's safety. Results
are due this fall, when the National Institutes of Health ( news
- web
sites) will determine what additional research is needed.
Michael F. Mangano, principal deputy inspector general of the
department, noted that the FDA's system for supplement makers to
report customers who suffer bad reactions to their products is voluntary.
"For the year 1999, we found that FDA received 460 reports
compared to 13,000 reports that poison control centers reported
receiving nationwide related to dietary supplements," Mangano
said.
In written testimony submitted to the subcommittee, the Council
for Responsible Nutrition, a trade association of the dietary supplement
industry, contended that it had commissioned a study that showed
ephedra is safe under the recommended uses with a daily dose of
90 milligrams.
Durbin noted that at least one product on sale in the United
States is a pill containing 325 milligrams of ephedra.
Michael McGuffin, president of the American Herbal Products
Association, said in testimony that members of his group engage
in self-regulation, recommending business and safety practices.
The Consumer Healthcare Products Association issued a statement
urging improvements in the FDA's system for learning of bad reactions
to products and calling on the agency to establish standards for
good manufacturing practices.
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When
to Stop Driving
HealthScoutNews
Wednesday, July 31, 2002
(HealthScoutNews) --
To many people, the ability to jump in the car and go where and
when they want translates to independence. And that freedom can
be hard to give up.
But the American Academy of Family Physicians ( news
- web
sites) warns that as all of us age, it can eventually impair
our ability to safely handle a car.
Reasons to consider an end to your driving career include conditions
such as arthritis, poor eyesight, and memory loss. The academy says
it's important to follow your doctor's advice to keep yourself and
others safe.
TUESDAY,
JULY 30, 2002
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Calling
Your Doctor
HealthScoutNews
Tuesday, July 30,
2002
(HealthScoutNews) -- Trying to get your doctor on the phone
when you or a loved one is sick can be frustrating. And when she
finally comes to the phone, she always seems to be in a hurry.
The University of Michigan's M-Care says it's important to
get right to the point when calling your doctor. Before dialing,
write down the questions and symptoms you have, including whether
you have a fever or diarrhea.
Be ready to write down any instructions the doctor gives you
and have your pharmacist's phone number handy, in case your doctor
prescribes medication. Be sure to ask if you need to come to the
office and whether your condition could worsen enough to merit a
visit to the emergency room.
And, M-Care says, manners count. Say thank you when you're finished.
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Program
Gets Kids Moving, Eating Better
By Merritt McKinney
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - The encouraging results of a health
initiative in the border city of El Paso, Texas, suggest that school-based
health programs can succeed in encouraging children to exercise
more and eat a healthier diet.
In most of the schools involved in the program, the time children
spent in moderate to vigorous physical activity increased and the
fat in school meals and sodium in school breakfasts decreased, according
to a report in the August issue of the journal Health Education
and Behavior.
There is still room for improvement, since not all of the schools
met or maintained the healthy goals, but the results show that a
program can improve children's health, according to one of the study's
authors, Dr. Karen J. Coleman of the University of Texas at El Paso.
"You need faith, tenacity, community money and mouths,
and good, clear data, and you can change the health of your community,"
Coleman told Reuters Health.
It is no secret that eating a healthy diet and exercising regularly
can go a long way toward preventing heart disease, diabetes and
other diseases, but most Americans are still missing the boat when
it comes to personal fitness. Though Americans of all backgrounds
have expanding waistlines, physical inactivity and obesity are "especially
prevalent" among Hispanics, according to Coleman and her co-author,
Dr. Edward M. Heath, of Utah State University in Logan.
With the aim of preventing later health problems by promoting
exercise and a healthy diet among schoolchildren, the non-profit
Paso del Norte Health Foundation funded the implementation of a
health program called Coordinated Approach to Child Health (CATCH)
in elementary schools in the El Paso area. In national studies,
children participating in CATCH programs became more physically
active and ate healthier diets.
The CATCH program has several components, but the El Paso program
focused on physical education classes and school meals. The program
started in the El Paso region in 1997 and included 83 area schools
during the 2000-2001 school year.
To evaluate the impact of CATCH in El Paso, Coleman and Heath
compared 20 elementary schools in the program with 4 schools that
did not participate in the program. The study findings suggest that
CATCH has encouraged healthier lifestyles in children in the El
Paso area, although the results were somewhat inconsistent.
In most of the schools in the CATCH program, children's levels
of physical activity increased during the first year of the program.
However, in many of the schools, levels of physical activity dropped
somewhat after the first year of the program.
Results of the drive to make school meals healthier were somewhat
mixed, the report indicates. All schools seemed to meet the goal
for breakfast--less than 30% of calories from fat and sodium below
1,000 milligrams. Schools had a harder time reaching the nutritional
goals for lunch, however.
Though the study identified several improvements, Coleman and
Heath caution that due to a lack of baseline information from some
of the schools, they cannot prove that the CATCH program was responsible
for the improvements. They note, however, that in schools not enrolled
in the program, physical activity did not increase and the percentage
of fat in school lunches did.
According to Coleman, taking a "cookie-cutter" approach
to improving the health of schoolchildren is a "recipe for
failure."
"School-wide interventions must be built from the ground
up," Coleman said, "with special considerations for the
culture of the school, not just the community in which the schools
are located."
Coleman said that the success so far in the El Paso program
is due to a combination of "sheer determination," private
funding and "a few dedicated, overworked souls."
Besides the CATCH program, Coleman said that the El Paso community
has taken other steps to improve the health of its schoolchildren.
For example, she said that the city's largest school district turned
down a $20 million contract that would have granted a soft drink
company exclusive rights to supply the school system for 10 years.
Instead, the school district and the beverage company agreed on
a 2-year contract to provide water, 100% fruit juice and nonfat
milk in all elementary andmiddle schools, according to Coleman.
Source: Health Education and Behavior 2002;29:444-460.
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Senators
Introduce Obesity Bill
The Associated
Press
Tuesday, July 30,
2002
WASHINGTON (AP) - Like a trio of relentless aerobics instructors,
three senators want Americans to start feeling the burn.
The senators — Bill Frist, Jeff Bingaman and Christopher Dodd
— introduced legislation Tuesday aiming at reducing obesity, especially
among children.
"Obesity is, for the most part, preventable," said
Frist, R-Tenn. "There is no single solution, but better information,
improved nutrition and greater opportunities for physical activity
will guarantee progress."
To provide those resources, the three senators are proposing
spending as much as $217 million next year and additional money
in future years on a variety of programs to encourage better nutrition
and more physical activity.
The money would go to the Institutes of Medicine, the Centers
for Disease Control and Prevention ( news
- web
sites) and the Department of Health and Human Services ( news
- web
sites) to identify risk factors, analyze government food assistance
programs and work with state governments on nutrition and exercise
programs.
Obesity is a factor in heart disease, diabetes and cancer.
According to statistics cited by the senators, an estimated 61 percent
of U.S. adults and 13 percent of children are overweight. An estimated
300,000 deaths per year are associated with obesity. There are twice
as many overweight children and three times as many overweight adolescents
as there were 30 years ago.
"Obesity is our nation's fastest rising public health
problem," said Bingaman, D-N.M. "As a nation, we can no
longer afford to ignore the escalating costs associated with obesity
and unhealthy lifestyles, such as physical inactivity and poor dietary
habits."
Dodd, D-Conn., said a failure to address the problem of obesity
would endanger more and more children.
On the Net:
Sen. Bill Frist ( news,
bio,
voting
record): http://frist.senate.gov
Sen. Jeff Bingaman ( news,
bio,
voting
record): http://bingaman.senate.gov
Sen. Christopher Dodd ( news,
bio,
voting
record): http://dodd.senate.gov
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Talking
Women Through Exam Spurs Repeat Mammograms
By Merritt McKinney
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - Having an unpleasant experience
during a mammogram screening, particularly a negative interaction
with the technologist performing the screen, may discourage women
from having another mammogram, researchers report. The problem may
be more common in heavier women, the findings suggest.
"Further research should focus on how best to coach women
through the mammographic experience," Dr. Patricia A. Carney,
of Dartmouth Medical School in Lebanon, New Hampshire, and colleagues
state in the July 15th issue of the journal Cancer.
The study included 625 New Hampshire women aged 50 years and
older who had a mammogram. The researchers had the women complete
a questionnaire to see if they could identify any differences between
women who did and did not return for another mammogram within the
next 2 years.
To the surprise of the researchers, the women were similar
in many respects. There were no differences between the groups in
the number of relatives who had been diagnosed with breast cancer
( news
- web
sites), in women's age at their first menstrual period or first
childbirth, or in the number of previous breast biopsies.
The women were not identical, though. Women who returned for
another mammogram were more likely to be taking hormone replacement
therapy, suggesting that they may have been more likely to have
a regular source of healthcare. And women who did not have another
mammogram were less likely to have health insurance, although the
difference was so small that the researchers question whether it
had a significant effect on women's likelihood of getting another
mammogram.
In what the investigators call a key finding, the study indicated
that women who returned for another mammogram and those who did
not had significantly different experiences with previous mammograms.
Surprisingly, 66% of women who did not return for another screen
said their mammogram experience was positive, compared with 50%
of women who had another screen. And just 9% of women who did not
have another screen said their last mammogram was a negative experience
compared with 29% of women who came back for another screen.
Among women who had a negative experience, though, the reasons
for the unpleasant screen varied between the two groups. For women
who continued having mammograms, the number-one complaint was trouble
getting an appointment, but the most frequent complaint for women
who did not have another mammogram was pain.
To have a positive mammogram experience, both groups of women
placed high importance on the technologist who performed the screen,
including the technologists' skill in talking women through the
procedure. The study "may lay the groundwork for future intervention
research to enhance technologists approaches to patients,"
according to the report.
Carney's team found that women with a higher body mass index
(BMI)--a measure of obesity that takes into account weight and height--were
less likely to have a repeat mammogram.
Heavier women may be more likely to have a negative experience
with a mammogram, "perhaps due to embarrassment or greater
sensitivity among heavier women about how they are coached or how
their bodies are handled during this very personal procedure,"
Carney and colleagues conclude.
The American Cancer Society ( news
- web
sites) advises women to have an annual mammogram beginning at
age 40. Some experts, however, believe that most women can wait
until age 50 to begin annual mammograms. In 1997, a consensus panel
convened by the National Institutes of Health ( news
- web
sites) determined that there was not enough evidence to advise
all women in their 40s to have mammograms.
Source: Cancer 2002;95:219-227.
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When
You Can't Fall Asleep
HealthScoutNews
Tuesday, July 30,
2002
(HealthScoutNews) -- More than 100 million Americans often
have trouble getting a good night's sleep, according to the St.
Francis Hospitals and Medical Centers of Indiana.
So, what can be done? St. Francis says most sleep problems
can be remedied with lifestyle changes. If you have insomnia, the
hospital advises:
- Avoid caffeine or tobacco
six hours before bedtime;
- don't nap;
- don't use your bedroom
as an office or to watch TV;
- and set aside time earlier
in the day to worry about things that are bothering you, so you
don't lie awake thinking about them.
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Some
Kids' Modeling Clays May Post Health Risk: Group
By Melissa Schorr
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - Certain polymer modeling clays
may pose a health risk for children and should be removed from the
market for further safety testing, according to a report issued
Tuesday by the Vermont Public Interest Research Group (VPIRG), a
consumer watchdog organization.
The products are a form of modeling clay that are soft at room
temperature but can be molded into an item, which then hardens when
baked at a low temperature in a conventional oven.
"These products contain chemicals that have potential
to damage the health of our children, and possibly their fertility,"
Jeremiah Baumann, environmental health advocate for the US Public
Interest Research Group in Washington DC, a consortium for the state-run
advocacy groups, told Reuters Health. "There's no excuse for
a regulatory system that allows these products to go onto store
shelves and be marketed to children."
The group investigated the safety of plastic-based modeling
clays that contain phthalate plasticizers, chemical compounds that
keep clay soft and pliable. Some human and animal studies have suggested
that phthalates may be linked to liver damage and infertility. In
addition, when overheated or accidentally burned, polyvinyl chloride
(PVC) in the clay may also release toxic hydrochloric acid gas,
the report asserted.
Previous concerns about the presence of phthalates in toys
intended for children's mouths led the European Union ( news
- web
sites) to ban such products from containing more than 0.1% of
phthalates two years ago. The US government asked manufacturers
to voluntarily discontinue their use, Baumann said.
VPIRG conducted laboratory testing on two popular polymer clay
products, Sculpey and Fimo, and found that Fimo clay contained from
11% to 14% phthalates while Sculpey contained from 3% to 4% phthalates.
The group reported that exposure to phthalates approached or exceeded
various state drinking water standards and federal guidelines for
air transmission.
The researchers measured the amount of phthalates remaining
on workers' hands after they used the clay and washed it off. They
then extrapolated that a higher than recommended dose of the chemical
might be ingested if children worked with the clay and then placed
their hands in their mouths.
The group is calling for the US Consumer Product Safety Commission
( news
- web
sites) (CPSC) to recall or suspend the sale of such clays until
further safety testing can be conducted.
"Our recommendation would be that CPSC should issue a
moratorium unless and until studies show there's no health risk,"
Baumann said.
The group also advocates that a warning label be placed on
the product advising children and pregnant women to avoid handling
the clay. Adults who still want to use the clays should use gloves
and avoid inhaling fumes when baking the product, he advised.
"I would recommend not using them," Baumann said.
"When there's evidence of a hazardous chemical, we should not
be exposing ourselves to it if we don't need to. There are safer
alternatives out there--nothing about this product justifies the
risk."
Polyform Products Co., the makers of Sculpey, referred all
comments to the Arts and Creative Materials Institute, a trade group
for arts and crafts manufacturers based in Hanson, Massachusetts.
Executive Vice President Deborah Fanning said the group's toxicologist,
Dr. Woodhall Stopford of Duke University, disputed the report's
findings on the exposure levels to phthalates, as well as the risk
assessment of the potential health hazard.
"We think this report is inaccurate, overkill and sensational,"
she told Reuters Health. "We'd rather see research not blown
out of proportion; some of the information may be totally incorrect
and have everybody worrying."
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Support
Groups May Boost Busy Mom's Exercise Level
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - Moms with young children who join
forces in an effort to get more exercise may gain some benefits,
at least in the short run, new study findings from Australia suggest.
Young women between the ages of 18 and 22 with children are
particularly unlikely to be adequately physically active, according
to lead investigator Dr. Wendy J. Brown of the University of Queensland
and colleagues.
"Less than half (46%) of this group of women engaged in
adequate physical activity compared with 56% of women without children,"
the authors report in the August issue of the American Journal of
Preventive Medicine.
In their report, Brown's team wondered what effect, if any,
organized group discussions to motivate women to get more exercise
would have on otherwise busy moms.
A total of 554 women were enrolled into one of three groups.
One group of women received an informative booklet that outlined
ways to "overcome physical activity barriers." Another
group got the same booklet and also met once a week in a support
group that focused on how mothers with young children could boost
their physical exercise habits. A third group, which acted as the
"control" group, received nothing.
After 8 weeks, 60% of women who participated in the group motivational
sessions reported getting an amount of exercise considered to be
adequate for a health benefit, compared with only 50% of the women
who only received the booklet, and 46% of the control group.
However, after 5 months, the women were back to physical activity
levels seen before the study started, Brown and colleagues found.
Nevertheless, the researchers note that community support groups
"are promising strategies" for increasing physical activity
among women with young children.
Source: American Journal of Preventive Medicine
2002;23.
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Gingko
Biloba Will Be Tested on Leg Artery Disease
HealthScoutNews
Tuesday, July 30,
2002
TUESDAY, July 30 (HealthScoutNews) -- Stanford University researchers
want to see whether the popular herbal extract ginkgo biloba can
actually walk the walk when it comes to treating peripheral artery
disease -- narrowing of the arteries caused by a buildup of cholesterol.
They're looking for volunteers who suffer from leg discomfort
caused by peripheral artery disease to take part in a study of ginkgo
biloba.
"Many with peripheral artery disease are surprisingly
unaware of the impairment of their arteries. Only about one-quarter
have clear-cut pain when walking," says Christopher Gardner,
an assistant research professor of medicine at Stanford University
Medical Center.
"The main goal of this study is to find out if people
who take gingko biloba will be able to increase the distance they
are able to walk free of pain or discomfort," Gardner says.
The 72 study volunteers will be randomly given ginkgo biloba
or placebos. Over the course of the 48-week trial, they'll have
to report four times to walk on a treadmill and give blood samples.
Gingko biloba is commonly prescribed by doctors in Europe for
patients with peripheral artery disease. But whether it's actually
effective is open to debate. Gingko biloba is one of the most popular
herbal products in the United States.
Peripheral artery disease affects about 14 percent of Americans
over age 50. It's most common in people who have diabetes, high
blood pressure, and heart disease and in those who smoke.
Walking is considered one of the best self-help treatments
for peripheral artery disease. But people with advanced artery narrowing
may suffer extreme pain after walking for just short periods.
More information
If you're interested in participating in the study, call coordinator
Joel Nicholus at 650-723-7022. For a fuller explanation of peripheral
artery disease, you can read this American
Heart Association primer.
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Caffeine
Boosts Stress Level All Day Long: Study
By Alison McCook
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - People who consume caffeine may
experience an increase in blood pressure, feel more stressed and
produce more stress hormones than on days when they opt for decaf,
US researchers report.
Furthermore, Dr. James D. Lane and his colleagues at Duke University
in Durham, North Carolina found that the effects of caffeine appear
to persist until people go to bed, even if they don't consume any
caffeine after 1 p.m.
Given the long-lasting effects of caffeine, the authors suggest
that regular consumption of the substance could contribute to the
risk of developing heart disease. Furthermore, Lane told Reuters
Health that any condition influenced by stress could also be aggravated
by caffeine.
For example, in people with the type 2 form of diabetes--often
associated with obesity--stress can worsen the condition by influencing
how well the body regulates blood sugar, Lane said. He added that
people with stress-related disorders, such as post-traumatic stress
disorder or social anxiety, could also experience adverse effects
from caffeine consumption.
"Any stress-related disease could be aggravated by caffeine,"
Lane said.
In the US, approximately 85% of adults drink caffeine every
day, in the form of coffee, soft drinks, or tea.
In the current study, the participants--47 regular coffee drinkers--consumed
500 milligrams of caffeine, in the form of two pills. This quantity
of caffeine is roughly equivalent to that contained in 4 small (8
ounce) cups of coffee. The second pill was taken no later than 1
pm. Each participant took caffeine pills during one workday, and
inactive pills during another workday, and frequently recorded how
stressed they felt. The participants never knew whether the pills
contained caffeine ora placebo.
The researchers monitored the participants' blood pressure,
heart rate, and the quantity of certain substances they excreted
in their urine.
Reporting in the July/August issue of Psychosomatic Medicine,
Lane and his colleagues found that people had slightly higher blood
pressure levels, produced 32% more of the stress hormone epinephrine,
and felt more stressed on days when they took a caffeine-containing
pill compared to the days they took the placebo.
In an interview with Reuters Health, Lane said that the effects
of caffeine likely persist in the body because the substance takes
a long time to deteriorate. More specifically, caffeine has a "half-life"
of an average of 4 hours, meaning that however much caffeine you
consume, it will take your body 4 hours to rid itself of half that
amount. And 4 hours later, your body will contain only one-quarter
of the original amount. Consequently, 12 hours after consuming caffeine,
Lane explained, your body still contains one-eighth of what you
first drank.
Lane added that he hesitates to tell people exactly how much
caffeine they should consume each day. However, for those with conditions
that are aggravated by stress, or have high blood pressure, "one
simple thing they can try is to cut back on caffeine," he said,
and see if that helps alleviate their symptoms.
Cutting out caffeine "doesn't cost a thing, and it may
make you feel better. So it's worth a try," Lane advised.
Source: Psychosomatic Medicine 2002;64:593-603.
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Doctors
No Better Than Patients at Sun Protection
By Alison McCook
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - Doctors are no more likely than
patients to protect themselves from the sun, despite the fact that
they are familiar with the medical risks associated with exposure
to the sun's harmful rays, a new study shows.
There are many possible reasons doctors don't protect themselves
from the sun any more than others, lead author Dr. Christopher N.
Sciamanna of Brown University in Providence, Rhode Island told Reuters
Health.
Doctors may spend less time in the sun than their patients,
he suggested, or may not believe that sun exposure poses any real
danger to them.
Furthermore, the skin cancers linked to adult sun exposure
are less deadly than those associated with exposure to sun as a
child, Sciamanna said. Consequently, doctors often learn in medical
school that adults should protect themselves from the sun for mainly
cosmetic reasons.
"There are benefits and costs to every health behavior,"
Sciamanna said. "It's probable that the benefits of protecting
yourself from the sun, at least for physicians, doesn't outweigh
the costs they perceive--such as inconvenience or mess."
However, previous research has demonstrated the costs of spending
time in the sun. In 2000, over one million people developed one
of two largely curable forms of skin cancer, basal or squamous cell
carcinoma. In addition, the American Cancer Society ( news
- web
sites) estimates that 53,600 people will be diagnosed with melanoma--the
deadliest form of skin cancer--in the United States in 2002.
To help people protect themselves from the sun's harmful rays,
a number of organizations recommend that people adopt protective
behaviors, such as using sunscreen, wearing protective clothing,
and avoiding the sun during the midday hours when exposure is at
its peak.
In order to assess how often doctors and patients followed
those recommendations, Sciamanna and his colleagues conducted surveys
of 100 patients and 84 doctors about their behaviors when outside
for more than 1 hour on a sunny summer day. Doctors consisted of
a sample of primary care physicians and specialists. The authors
report their findings in the July/August issue of American Journal
of Health Promotion.
Sciamanna and his team found that about 46% of all respondents
said they used some form of sun protection, including sunscreen,
choosing shade, and wearing a hat or long-sleeved shirt. Overall,
doctors were no more likely to use sun protection than patients,
although the choice of sun-protection strategies differed between
the two groups of people.
More than 42% of doctors said that they would use sunscreen,
a behavior adopted by only 28% of patients. However, patients were
almost twice as likely as doctors to stay in the shade during sunny
summer weather, and were also more likely to wear a wide-brimmed
hat or long-sleeved shirt.
In an interview with Reuters Health, Sciamanna said that it
was unclear why doctors opted for sunscreen over other protection
strategies. However, the doctors in this sample were, overall, younger
than patients, and younger respondents tended to be less likely
to wear a shirt or stay in the shade.
Numerous studies have demonstrated that doctors advise their
patients to adopt the same healthy behaviors the doctors themselves
employ, and Sciamanna and his team found that doctors who reported
fewer sun protection strategies were less likely to tell their patients
to protect themselves from the sun.
"Docs preach what they practice," Sciamanna said.
Consequently, one possible way to improve physicians' behavior--and
in turn, the advice they give to their patients--might be to include
programs in medical school that encourage students to practice healthy
lifestyles, including protecting themselves from the sun.
"If we want doctors to spread the word, we've got to intervene
on them," Sciamanna said.
Source: American Journal of Health Promotion 2002;16:319-322.
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Cervical
Plugs Give Fetus Protection from Bacteria
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - In pregnant women, the mucus plug
in the cervix (located between the vagina and the uterus) serves
as a physical barrier between a developing fetus and germs that
can lead to pre-term labor and other complications.
Now, researchers report that it also has anti-microbial properties
that kill bacteria, such as group B Streptococcus and E. coli.
In fact, anti-microbial proteins in cervical mucus plugs were
found to be similar to those in nasal fluid. Both mucus plugs and
nasal fluid, the researchers point out, provide barriers for sterile
environments, such as the lungs and the uterine cavity, and the
germ-rich outside world.
The findings suggest that women who are predisposed to infections
in their uterus and other complications may have deficiencies in
the composition of their mucus plugs, conclude researchers in the
July issue of the American Journal of Obstetrics and Gynecology
( news
- web
sites).
"The cervical mucus plug is not only a physical barrier
to microbial entry into the uterine cavity, but it also contains
diffusible substances that exhibit antibacterial activity,"
Dr. Tomas Ganz from the University of California, Los Angeles, and
colleagues, write.
At conception, mucus that is normally present in the cervical
canal thickens to form a plug between the uterus and the vagina.
The plug remains intact during pregnancy to keep out bacteria, which
can cause intrauterine infection and increase the risk of pre-term
labor and neurologic and developmental delays among the fetus.
To determine whether the plug's powers of protection are more
than just as a physical barrier, the researchers analyzed 60 cervical
mucus plugs from healthy women, aged 28 to 33.5 years, at full-term
delivery, as well as cervical mucus from women who were not pregnant.
Cervical plugs and mucus both contained immune system proteins
that fight infection, the study found.
Source: American Journal of Obstetrics and Gynecology
2002;187:137-144.
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Living
Liver Donors Recuperate Well, No Regrets
By Alison McCook
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - A sample of adults who donated
a portion of their livers to a child who needed a liver transplant---in
most cases, their own child-- said they eventually recuperated well
from the procedure, US researchers report.
Furthermore, the majority of donors said they endorsed so-called
"living donation," regardless of how well the receiving
child fared after the procedure.
"Even when you look at adults whose babies did not do
well, they still don't regret it," study author Dr. John F.
Renz of the University of California, Los Angeles told Reuters Health.
When an adult donates a portion of his or her liver to a child,
doctors extract up to one-quarter of the adult's liver and transplant
it into a child. The procedure differs markedly from living donations
from one adult to another, which require that the donor offer up
to 65% of their own livers. The donor and recipient need not be
genetic matches, but both must share a blood type.
Incredibly, adult donors typically recover up to 95% of their
original liver volume within 7 days, on account of the organ's powerful
ability to regenerate itself. Consequently, most of the recuperation
period stems from elements of the operation itself, such as the
size of the incision and the need to divide abdominal muscles to
reach the liver.
Children need new livers for a variety of reasons, such as
end-stage liver disease as a result of chronic illness, or sudden
liver failure, which can develop within a matter of days.
While living-donor liver transplants have cut children's waiting
time for organs and reduced their risk of death while waiting, 10%
to 15% of donors experience complications from the procedure, ranging
from bleeding, developing a potentially fatal blood clot in the
lungs, hernia, or bowel obstruction after the procedure.
To determine how adult donors felt after portioning off some
of their liver to a child, Renz and his team conducted surveys of
41 adults who had donated a portion of their livers to a child between
1992 and 1999. Donors completed the survey after an average of more
than 1 year following the procedure.
The authors found that most donors (74%) said they believed
they completely recuperated from the procedure in less than 3 months,
while 16% said they thought their recuperation took between 3 and
6 months. Only 10% of donors said they needed more than 6 months
to recover from the transplant operation, the authors write in the
July issue of the Annals of Surgery.
Furthermore, Renz and his team report that 89% of donors said
living-donor liver transplantation should be used in more than just
"emergency" situations, when the child needs a liver immediately.
In an interview with Reuters Health, Renz said he suspected
these results applied strictly to adults who donate livers to children.
Transplanting from one adult to another is a more extensive procedure,
and as such, the recovery period can take longer. In some cases,
liver donors have died after the operation.
Furthermore, when an adult donates a portion of his or her
liver to another adult, the relationship between the two is likely
different than when a parent donates to a child, Renz said.
Based on studies of living-donor kidney transplantation, donors
can feel differently about the procedure depending on their relationship
with the recipient, the researcher added. "There's always,
always higher donor satisfaction among first degree relatives than
among any other group," Renz said.
Source: Annals
of Surgery 2002;236:120-126.
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Belgium
to Ban Fluoride Tablets, Chewing Gum
Reuters
Tuesday, July 30, 2002
BRUSSELS (Reuters) - Belgium plans to ban the sale of tablets
and chewing gum that have fluoride in them because of the risk that
they may cause fluoride poisoning if overused, a health ministry
spokesman said on Tuesday.
But it will stop short of banning toothpaste with fluoride,
which protects teeth from decay, he said.
The move is believed to be the first such ban in the European
Union ( news
- web
sites), officials said, and may spark renewed debate about the
safety of fluoride, which some countries add to public drinking
water supplies as a means of improving dental health.
It will probably come into force by late August, said Belgian
health ministry spokesman Tom Ruts.
"Those products are used excessively and often abused,"
he told Reuters, confirming comments made by Health Minister Magda
Aelvoet in the latest issue of the weekly magazine, Humo.
Aelvoet told the magazine she hoped her European Union partners
would follow her example.
"In these cases, a harmonization within the European Union
is of course desirable but I can't always wait until the European
Union is ready," she was quoted as saying.
"We will however communicate our official decision to
the other European member states in the hope that they will follow
us swiftly."
Fluoride supplements--such as fluoride tablets or fluoride
chewing gum--are promoted by dentists to fight dental caries.
They have been sold in Belgium without a prescription.
The ministry made its decision after the results of a study
commissioned by an advisory board to the ministry, the spokesman
said. It found that excessive use of fluoride products could cause
fluoride poisoning, damage the nervous system and foster osteoporosis.
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Germany
Spending More, Not Less, on Medication
By Ned Stafford
Reuters Health
Tuesday, July 30, 2002
FRANKFURT (Reuters Health) - Drug spending in the German public
health insurance system rose in the first half of this year leaving
little hope the government will achieve its ambitious goal of cutting
drug costs by 5% this year, a leading pharmacist said on Tuesday.
The Federal Union of German Associations of Pharmacists (ABDA)
reported that first-half 2002 drug spending by the public system
reached 10.77 billion euros, up 450 million euros, or 4.4%, from
the first 6 months of 2001.
Frank Diener, head of the ABDA's department of economics and
social affairs, told Reuters Health that the system will almost
certainly spend more on drugs this year than last year, when spending
totaled around 21 billion euros, up 11.2% from 2000.
"I do not see a realistic chance that there can be an
effective decrease in drug spending this year," he said.
"With so many innovative drugs in the pipeline, none of
the industrialized countries will be able to cut drug spending.
It is not possible."
The ABDA noted that drug makers had made a one-time payment
of 200 million euros earlier this year in an agreement with the
health ministry to avoid a 4% price-cut of on-patent drugs. If that
payment is taken into account, actual spending in the first half
of 2002 would be 10.57 billion euros, up 2.4% from a year ago.
Diener's assessment backs statements made a couple of weeks
ago by Dr. Leonhard Hansen, chairmen of the National Association
of Statutory Health Insurance Physicians (KBV). Hansen said it would
not be possible for doctors to fulfill a pledge made in January
to cut public health insurance funded prescriptions in 2002 by nearly
5% from 2001 levels.
His confession was greeted the next day by stern criticism
from German Health Minister Ulla Schmidt, who reminded the KBV of
their January pledge and said she "expected doctors to do their
part in the urgently required task of cost-cutting in the medicine
sector."
Rising healthcare costs--with politicians pointing fingers
at the rise in drug prices as a major culprit--have become a major
campaign issue in national elections scheduled for Sept. 22. Schmidt's
fellow SPD party member Chancellor Gerhard Schroeder is battling
to be re-elected.
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Campaign
Urges Diabetics to Prevent Heart Disease
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - A new campaign urges Hispanics
and Latino Americans with diabetes to reduce their risk of heart
disease by controlling their blood sugar, blood pressure and cholesterol.
The campaign, "Si Tiene Diabetes, Cuide Su Corazón"
(If You Have Diabetes, Take Care of Your Heart), was unveiled last
week by the National Diabetes Education Program (NDEP) during the
National Council of La Raza's annual conference in Miami, Florida.
"This important new national campaign will do exactly
what its name implies--help people all over the country with diabetes
take better care of their hearts," US Health and Human Services
( news
- web
sites) Secretary Tommy G. Thompson said in a statement.
Diabetes currently affects more than 2 million Hispanic and
Latino Americans, the NDEP estimates. And recent study findings
have shown that these individuals are more likely to die from heart
disease than their non-diabetic peers.
"At least 65% of people with diabetes die from heart disease
or stroke, and yet only one in four Hispanic and Latino Americans
with diabetes know they are at risk for heart disease," Yanira
Cruz Gonzalez, chair of the NDEP's Hispanic/Latino work group said
in a statement.
To minimize their risk of heart disease, diabetics ( news
- web
sites) should have their blood glucose levels checked at least
twice annually, their cholesterol levels checked annually and their
blood pressure checked during every visit to the doctor, the NDEP
advises. Levels of LDL ("bad") cholesterol should be below
100 milligrams per deciliter (mg/dL) of blood and blood pressure
readings should be lower than 130 mm Hg systolic (the first number
in a blood pressure reading) and 80 mm Hg diastolic (the second
number).
People with diabetes should also maintain a healthy lifestyle
by engaging in physical activity for at least 30 minutes each day,
taking their prescribed medications and staying on a healthy diet
in order to control their blood sugar, blood pressure and cholesterol.
To that end, the NDEP is offering a free recipe booklet featuring
flavorful Hispanic and Latino recipes that are low in fat and salt,
and additional bilingual Spanish and English diabetes education
information. Both can be obtained from the National Diabetes Information
Clearinghouse via their toll-free number--1-800-438-5383.
"It's more than just food--it's life," Gonzalez said.
"If people know what to do, and they take care of their hearts,
they can remain the heart of their families for a long time."
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Motorcycle
Deaths Drop After Helmet Law Reinstated
By Charnicia E.
Huggins
Reuters Health
Tuesday, July 30, 2002
NEW YORK (Reuters Health) - A controversial motorcycle helmet
law that was reinstated in Maryland in 1992 appears to have led
to a more than one-third decrease in the number of motorcycle deaths,
new study findings show.
"Maryland's controversial motorcycle helmet law appears
to be an effective public health policy and may be responsible for
saving many lives," according to lead study author Kimberly
M. Auman, of the University of Maryland in Baltimore, and her colleagues.
Yet, "it's the helmet, not the law that protects against
brain injury," Auman told Reuters Health.
The law, which requires both motorcycle drivers and motorcycle
riders to wear helmets approved by the state department of motor
vehicles, was first instituted in 1967. In 1979, however, the law
was modified so that only minors were required to wear state-approved
helmets. Fourteen years later, in 1992, the original law was reinstated.
To investigate the law's effectiveness, the researchers compared
the number of motorcycle fatalities that occurred before the law
was enacted--from January 1, 1990 to September 30, 1992--with the
number of fatalities that occurred from January 1, 1993 to September
30, 1995.
Of the 212 overall deaths, 61% occurred in the pre-law period
and nearly 40% occurred afterwards, representing a roughly 37% drop
in motorcycle fatalities, the investigators report in the August
issue of the American Journal of Public Health, journal of the American
Public Health Association ( news
- web
sites).
What's more, the death rate among motorcyclists decreased by
56% over the 5-year period after the law was enacted, from a high
of 10.3 deaths per 10,000 registered motorcycles in 1992 to 4.5
deaths per 10,000 vehicles in 1996, the report indicates. The number
of registered vehicles essentially remained the same during that
period.
In contrast, the percentage of motorcyclists wearing helmets
at the time of a fatal crash jumped from roughly 25% in the pre-law
period to 80.5% in the post-law period, the investigators found.
During both the pre-law and the post-law periods, however,
motorcyclists who wore helmets were 70% less likely to suffer a
traumatic brain injury than were their peers who did not use helmets,
study findings indicate.
"Helmets protect against brain injury," Auman said.
The Maryland Department of Transportation funded the study.
Source: American Journal of Public Health 2002;92:1352-1355.
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Red
Wine May Cut Heart Disease Risk in Obese: Study
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - While it is well established that
obese people have a greater risk of developing heart disease, a
new report suggests that this risk may be offset, at least in part,
by consuming moderate amounts of red wine.
In their study, Dr. J. B. Dixon and colleagues of Alfred Hospital
in Melbourne, Australia, found that obese people who consumed moderate
amounts of red wine had lower levels of a blood protein called homocysteine.
High levels of homocysteine have been linked to an increase
in cardiovascular disease risk, so keeping homocysteine levels under
control may cut heart disease risk, the report indicates.
In the study, Dixon's team measured blood levels of homocysteine
in 350 obese men and women, and interviewed them about their alcohol
consumption habits. The findings are published in the July issue
of the European Journal of Clinical Nutrition.
According to the investigators, red wine consumers had blood
homocysteine concentrations that were 17% lower than those consuming
no alcohol and 13% lower than individuals who reported primarily
drinking beer or spirits.
The slightly lower homocysteine levels were seen in people
consuming less than 100 grams of wine per week, which is roughly
equivalent to six to eight 5-ounce glasses of wine.
Mild to moderate red wine consumption in obese individuals
is associated with lower homocysteine concentrations, the authors
conclude, and this may reduce their cardiovascular risk.
Source: European Journal of Clinical Nutrition 2002;56:608-614.
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New
Research ID's Eating Disorder Risk Factors
HealthScoutNews
Tuesday, July 30,
2002
TUESDAY, July 30 (HealthScoutNews) -- Girls who do gymnastics,
ballet, and other sports that emphasize low weight are 50 percent
more likely than other girls to have eating disorders, new research
suggests.
A study in the July/August issue of the American Journal
of Health Promotion also says certain other risk factors --
depression, history of sexual abuse, or abuse of cigarettes, alcohol,
or tobacco -- can be used to identify girls in these sports who
are particularly vulnerable to eating disorders.
"Although weight-related sports involvement has been associated
[in previous studies] with elevated risk for eating disorders, not
all youth involved in [these sports] display symptoms," says
lead author Nancy E. Sherwood, University of Minnesota, Twin Cities.
She and her colleagues analyzed data from 5,174 female public
school students in grades 7,9, and 11, collected in a 1995-1996
Connecticut adolescent health survey. They found that girls involved
in weight-related sports were 1.5 times more likely to have an eating
disorder.
When they identified other risk factors for these girls, they
found that being underweight wasn't a reliable indicator of an eating
disorder.
The authors say coaches, school officials, and doctors should
monitor girls in weight-related sports who have the additional risk
factors for eating disorders.
The authors suggest coaches be careful about the messages they
give these girls about weight related issues. Coaches should emphasize
healthy approaches to exercise and eating.
More information
The Food and Drug Administration ( news
- web
sites) offers this fact
sheet on teens and eating disorders.
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US
School Lunches Cause Many Illnesses: Report
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - Over the last 25 years, outbreaks
of food-borne illness linked to subsidized school lunches sickened
tens of thousands of students and school staff, sent hundreds to
the hospital and caused one death, according to a new report.
Currently, the US Department of Agriculture (USDA) spends about
$7 billion annually to provide food or funding for more than 33
million lunches and breakfasts served daily to American schoolchildren.
"However, USDA directly provides only a small percentage
of food served in schools," according to lead author Dr. Nicholas
A. Daniels of the University of California, San Francisco, and colleagues.
Roughly 83% of food served in the federal program is purchased
by local schools with USDA funding, the report indicates, with the
remainder donated directly to schools by the USDA in the form of
beef, poultry, fruits, vegetables, grain and milk.
In the current report, Daniels and colleagues evaluated information
collected by the Centers for Disease Control and Prevention ( news
- web
sites)'s Foodborne Outbreak Surveillance System between 1973
and 1997. Their findings are published in the July issue of the
Pediatric Infectious Diseases Journal.
Outbreaks of foodborne illness linked to subsidized school
lunches sickened an estimated 49,963 children and teachers, sent
slightly more than 1,500 individuals to the hospital and caused
one death, the researchers report.
During that time, a total of 604 outbreaks of foodborne disease
were reported, with the number of annual outbreaks ranging from
9 to 44. Salmonella was the most commonly identified illness-causing
bug, accounting for 36% of outbreaks, the findings indicate.
Salmonella can cause vomiting, diarrhea and fever in healthy
adults, and can be deadly for the elderly or people with weak immune
systems.
Foods containing poultry (18.6%), salads (6%), Mexican-style
food (6%), beef (5.7%) and dairy products excluding ice cream (5%)
were most commonly identified as being contaminated. Improper food
storage and holding temperatures, and food contaminated by a food
handler were the most commonly reported food handling practices
associated with outbreaks, according to the report.
"Strengthening food safety measures in schools would better
protect students and school staff from outbreaks of foodborne illness,"
the authors write.
"Infection control policies, such as training and certification
of food handlers in the proper storage and cooking of foods, meticulous
hand washing and paid sick leave for food handlers with (gastrointestinal
illness) could make meals safer for American students," Daniels
and colleagues conclude.
Source: Pediatric Infectious Diseases Journal 2002;21:623-628.
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Take
Warnings About Sleep Apnea to Heart
By Serena Gordon
HealthScoutNews Reporter
HealthScoutNews
Tuesday, July 30,
2002
TUESDAY, July 30 (HealthScoutNews) -- The snoring caused by
sleep apnea isn't just a nuisance -- it can increase your chances
of developing cardiovascular disease.
In a new study published in the American Journal of Respiratory
and Critical Care Medicine, researchers found that people with
obstructive sleep apnea had a dramatically higher risk of developing
cardiovascular disease than people without the condition.
But the good news is that with treatment, the risk drops.
"Obstructive sleep apnea was associated with an almost
five-fold increase in risk for development of cardiovascular disease
independent of age, body mass index, blood pressure and smoking,"
says study author Dr. Yuksel Peker, a pulmonologist at Sahlgrenska
University Hospital in Gothenburg, Sweden.
Adds Dr. David Rapoport, medical director of the Sleep Disorders
Clinic at New York University School of Medicine, "This is
one more piece of evidence that even if you control for other known
risk factors, there is a higher risk of cardiovascular disease in
people with obstructive sleep apnea."
Almost one-in-four middle-aged American men and 9 percent of
women have sleep apnea, the study says. People with sleep apnea
stop breathing frequently while they sleep. Because their sleep
is interrupted many times, they're often excessively sleepy during
the day. Some of the risk factors for sleep apnea are being overweight,
male and over 40, according to the American Sleep Apnea Association.
For this study, the researchers recruited 182 middle-aged men
to observe them over a seven-year period. Sixty of the men were
diagnosed with obstructive sleep apnea. None had any other known
health problems when the study began.
After seven years, 22 of the 60 men with sleep apnea had developed
some form of cardiovascular disease, which includes high blood pressure,
heart disease and stroke. By contrast, only eight of the 122 who
didn't have sleep apnea had developed cardiovascular disease by
the end of the study.
Peker says he suspects the increased risk comes from the intermittent
periods of low oxygen supply, which stresses the body.
The researchers also found that treatment for sleep apnea was
an effective way to reduce cardiovascular risk. Fifteen of the study
participants with sleep apnea were considered "effectively"
treated. Only one man in that group developed cardiovascular disease.
But, 21 men out of the 37 who were "incompletely" treated
-- for example, they may not have followed the therapy described
by the doctors -- developed some form of cardiovascular disease,
the study reports.
Treatment for sleep apnea can include surgery, oral devices
that keep the airway open or a machine that patients wear during
sleep that supplies continuous "positive airway pressure,"
or forcing air into the lungs.
"There was a very big difference between the treated and
the untreated groups," says Dr. Glenn Gomes, medical director
of the sleep lab at the Ochsner Foundation Clinic in New Orleans,
who says this study further illustrates the need for people who
suspect they have sleep apnea to get properly diagnosed and then
seek treatment.
What To Do
To learn more about sleep apnea, visit the American
Sleep Apnea Association, or Stanford
University.
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Brain
Receptor May Be Key to Non-Addictive Morphine
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - Blocking a particular brain receptor
may minimize the addictive nature of morphine without diminishing
the drug's pain-killing effects, new research suggests.
Morphine is widely used to treat severe pain, but one of its
drawbacks is that patients can become addicted to the drug. A structure
in the brain called the M5 muscarinic acetylcholine receptor is
a component of the brain system involved in the pleasurable effects
of morphine. Researchers set out to see whether blocking the receptor
would minimize the risk of morphine addiction.
The investigators first genetically engineered mice to deactivate
the gene for the M5 receptor. Switching off the M5 receptor substantially
reduced the desire for morphine in these mice.
When normal mice were given morphine, the animals, presumably
in search of another fix, spent extra time hanging around the part
of the cage where they had received the drug. In contrast, mice
that had the receptor turned off did not linger in this part of
the cage unless they were given a very high dose of the drug.
Dr. Anthony S. Basile, formerly of the National Institute of
Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland,
is the lead author of a report on the findings published in the
Early Edition of the Proceedings of the National Academy of Sciences
( news
- web
sites). Basile is now at Alkermes, Inc. in Cambridge, Massachusetts.
The researchers wanted to make sure that blocking the receptor
did not affect the pain-killing powers of morphine. Even though
switching off the receptor seemed to make morphine less addictive,
the engineered mice experienced the same level of pain relief as
normal mice, the report indicates. And the investigators also found
that the genetically engineered mice experienced fewer withdrawal
symptoms after being taken off morphine.
The findings suggest that a drug that blocks the M5 receptor
may be an effective way to reduce the risk of addiction to morphine
without sacrificing pain relief, according to Basile and his colleagues.
They note that the receptor is present mainly in the brain, so a
drug that blocks the receptor is unlikely to cause serious side
effects.
Because nicotine, alcohol, cocaine and other drugs all affect
similar brain circuitry as morphine, the M5 receptor may also be
involved in other types of addiction, the researchers report.
Eli Lilly Research Laboratories provided some of the funding
for the research.
Source: Proceedings of the National Academy
of Sciences 2002;10.1073/pnas.162371899.
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Meningitis
Cases Tied to Cochlear Implants
By Adam Marcus
HealthScoutNews Reporter
HealthScoutNews
Tuesday, July 30,
2002
TUESDAY, July 30 (HealthScoutNews) -- A Texas ear surgeon who
has implanted hundreds of hearing devices like those recently linked
to fatal cases of meningitis said it would be "foolish"
to undergo the procedure without getting vaccinated against two
forms of bacteria known to cause brain inflammation.
The Food and Drug Administration ( news
- web
sites) announced last week that more than two dozen cases of
meningitis, leading to nine deaths, have been detected in people
who have received cochlear implants in the United States and abroad.
Dr. Peter Roland, a specialist at the University of Texas Southwestern
Medical Center in Dallas, said people shouldn't forgo the high-tech
hearing aids ( news
- web
sites) because of the potential risk. But Roland said anyone
who receives them should be immunized against Streptococcus pneumoniae
(also called pneumococcus) and Haemophilus influenzae,
both of which can cause meningitis, an infection of the brain lining.
FDA officials said 13 cases of meningitis associated with the
implants have been confirmed in this country, and seven more are
unconfirmed. Two of these involved deaths of children, ages 2 and
3, with the most recent fatality occurring in June.
Officials said germ typing from 11 patients revealed seven
confirmed cases of pneumococcus and four likely cases of
the bug. As a result, the agency is recommending that people considering
implants or who've already received them also consider getting vaccinated
against meningitis-causing bacteria. None of the five patients for
whom vaccination histories were available had been immunized against
pneumococcus, the FDA said.
The infections occurred in the very young as well as the elderly,
with ages ranging from 21 months to 63 years, officials said. Symptoms
of meningitis sometimes appeared within hours after the procedure,
or as long as more than five years later.
Cochlear implants are electronic devices embedded deep in the
ear that shuttle sound impulses directly into the auditory nerve.
The agency said two of the three American makers of the implants
have reported cases of meningitis in patients who received their
products, and that preliminary surveys indicate that the problem
is larger than reported cases alone would indicate.
Although officials haven't identified the source of the infections
-- or even if there truly is an increased risk of meningitis from
the devices -- one company, Advanced Bionics Corp., has stopped
selling its version of the product. Investigators are focusing on
a positioning wedge deployed with that device, called the Clarion,
that sits in the inner ear and may be a harbor for bacteria.
Douglas Lynch, a spokesman for Advanced Bionics, said there's
"no direct evidence" connecting the wedge and meningitis.
However, Lynch said, the majority of cases involving the Clarion
occurred in patients who'd received the positioner, which is sometimes
not used in Europe.
Lynch said Advanced Bionics first noticed a potential problem
earlier this year, and that it seemed centered largely in two areas
of Europe. The company reported the infections to the FDA about
two months ago, he said.
Ironically, bacterial meningitis is a leading cause of deafness
in children -- and thus a principal reason they receive the hearing
implants. Children with abnormal earway architecture are at increased
risk of the disease.
In addition, children who receive the devices are often in
day-care settings, like speech therapy classes, where they're exposed
to meningitis-causing germs, Lynch said. For these reasons, experts
said, it's hard to determine if the devices are to blame for the
meningitis or whether the illnesses aren't simply reflecting a high-odds
group.
Roland said officials may ultimately find that the meningitis
scare proves unfounded, or that only the positioning component of
the Clarion device increases the risk of the disease. "I think
it's probably a mixed bag," he said.
Peg Williams, executive director of the Cochlear Implant Association
in Washington, D.C., said people considering implants or who already
have them should be aware that the surgery, like all operations,
carries an infection risk. Still, she said, that shouldn't deter
them from seeking the aids.
"It's not an issue I think should create panic or great
concern, and I do not think it's enough of an issue that it would
create enough of a problem for a person to consider not having an
implant," Williams said.
Since the late 1970s, roughly 60,000 children and adults worldwide
have undergone the operation, which can restore hearing even to
the profoundly deaf. The success of the devices has sparked an emotional
debate within some families, as deaf parents worry that if their
children receive them, they will become estranged from their children.
That tension is easing "considerably," Williams said,
as parents discover that the devices don't intrude on their ability
to communicate with their children.
What To Do
For more on the investigation, visit the Food
and Drug Administration. To find out more about cochlear implants,
try the Cochlear
Implant Association or Cochlear
Implant Central.
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Study
Looks at Dual-Action Heart Failure Drug
By Linda Carroll
Reuters Health
Tuesday, July 30,
2002
NEW YORK (Reuters Health) - A drug called omapatrilat that
blocks two enzymes is at least as good and may be slightly better
for certain heart failure patients than standard therapy that blocks
just one, new study findings show.
Death or hospitalization among patients with both heart failure
and high blood pressure was less likely in those treated with omapatrilat
compared with those treated with ACE-inhibitors, researchers report
in the July 30 rapid track release of Circulation: Journal of the
American Heart Association ( news
- web
sites).
For patients with heart failure alone, the two drugs were essentially
the same, according to the report.
There still needs to be more research done to confirm the results
of the new study, said study co-author Dr. Milton Packer, a professor
of medicine at Columbia University's College of Physicians and Surgeons
in New York.
"But the take-home message is that there may be a special
role for this drug in the treatment of patients with high blood
pressure and heart failure combined," he said.
Standard ACE-inhibitors help keep blood vessels from narrowing
by blocking angiotensin-converting enzyme (ACE), a substance that
encourages blood vessel constriction. Omapatrilat not only blocks
ACE, but also blocks a neighboring enzyme called neutral endopeptidase
(NEP).
When NEP is blocked, there is an increase in the levels of
substances that widen arteries, Packer said. "So if you inhibit
both of them, you get a better effect," he added.
The new study reported the results of a multi-center trial
that included 5,770 heart failure patients who were randomly assigned
to receive either omapatrilat or the ACE-inhibitor, enalapril.
The patients were followed for an average of 14.5 months. In
the group treated with omapatrilat, there were 914 deaths, compared
with 973 in the enalapril-treated group. And when the researchers
compared the two groups, they found that those treated with omapatrilat
were about as likely to die or end up in the hospital because of
heart problems as those treated with enalapril.
When the investigators re-examined their data and only looked
at patients with heart failure and high blood pressure, omapatrilat
appeared to have an effect. Among these patients, those who received
omapatrilat were less likely to die or end up in the hospital because
of heart problems.
"This was very interesting to us, because high blood pressure
and heart failure co-exist in many people," Packer said. "And
high blood pressure is hard to control in people with heart failure."
That's because some of the drugs commonly prescribed for high
blood pressure can't be taken by patients with heart failure, Packer
said.
"So we tend to run out of options," he added. "What's
nice about omapatrilat in patients with high blood pressure and
heart failure, is that we were not only able to lower blood pressure,
but it seems as if lowering blood pressure translated into an advantage
in terms of lowering the risk of death or hospitalization."
Three of the study's authors, including Packer, serve as consultants
for Bristol-Myers Squibb, which funded the research.
Source: Circulation 2002;10.1161/01.CIR.0000029801.86489.50.
MONDAY,
JULY 29, 2002
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Dirty
Air Pollutes the Heart, Too
By Ed Edelson
HealthScoutNews Reporter
HealthScoutNews
Monday, July 29,
2002
MONDAY, July 29 (HealthScoutNews) -- Pollution isn't just hard
on the lungs -- it's bad for the heart, too.
A new study that confirms what many would deem to be common
sense says that fine pollution particles squeeze off the oxygen
supply to heart patients when they exercise.
"It's really been the last couple of years that data have
accumulated showing a relationship between air pollution and heart
disease -- increased incidence of heart attacks and admissions to
hospitals during periods of high air pollution," says Dr. Murray
A. Mittleman. "But we don't understand the mechanisms by which
this happens. This study addresses that issue."
Finnish researchers put 45 patients with heart disease on exercise
bicycles and had them pedal for six minutes, sometimes when the
outdoor air was clear, sometimes when it was polluted, as the researchers
recorded their electrocardiograms and looked for effects on the
heart and blood supply.
What they found, says a paper in tomorrow's issue of Circulation:
Journal of the American Heart Association ( news
- web
sites), was that many of the volunteers were much more likely
to experience ischemia, a reduced supply of oxygen to the heart
muscle, after exposure to polluted air. They also were more likely
to have an abnormal ECG pattern called an ST segment depression,
which is linked to ischemia.
And the research indicates that these cardiac problems are
related to specific air pollutants -- the fine particles that come
primarily from factory smokestacks and the ultra-fine particles
that come from diesel exhausts, among other sources.
The Finnish study thus "highlights myocardial ischemia
as a significant potential mechanism responsible for adverse cardiac
outcomes associated with poor air quality," says an editorial
accompanying the Finnish report co-authored by Mittleman, who is
director of cardiovascular epidemiology at Beth Israel Deaconess
Medical Center in Boston.
The study won't change the advice he gives to patients, Mittleman
says. "I've been telling my patients who are at high risk to
avoid excessive exposure to outdoor air on days of high pollution,
to try to avoid exercise and to spend more time in an air-conditioned
environment," he says.
But the finding could have implications about measures to reduce
the health problems associated with air pollution, "because
the sources of the fine and ultra-fine particles are different from
those of larger particles," Mittleman says.
And it does indicate locations that people with heart trouble
should avoid, he adds. Fine and ultra-fine particles do not have
a long life in the atmosphere; they tend to clump together to form
larger particles. So it is wise to avoid the emission sources of
those small particles, such as bus depots, he says.
Dr. Len Horovitz, a pulmonary physician at Lenox Hill Hospital
in New York City, says the Finnish study, done at the Unit Environmental
Epidemiology of that country's National Public Health Institute,
produced a logical result.
"It is the reduction of the oxygen level in the air that
is causing ischemia," he says. "Evidently, an area that
is polluted has the same kind of reduced oxygen level as seen in
high-altitude areas."
Horovitz says the results are important for people with lung
disorders as well as those with heart disease.
"We all need a certain level of oxygen" he says.
"People who need more oxygen are at risk when air pollution
is high."
Running the air conditioner is one way to remove particulate
pollutants from a room, Horovitz says. He also recommends use of
portable air filter units, which do the same removal job without
cooling the air.
Research to determine what different kinds and levels of air
pollution cause health problems is going on at the Environmental
Protection Agency ( news
- web
sites) and other centers, Horovitz says. The results of those
studies will have "broad implications for the kind of legislation
that is passed," he adds.
Meanwhile, Mittleman says, people who don't have heart or lung
problems "can do the common-sense thing. If they have the choice
to avoid excessive exposure on very polluted days, they should do
so."
What To Do
You can learn about air pollution and the heart from the American
Heart Association or the Environmental
Protection Agency.
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Tick
Disease Poses Threat to Blood Supply
By Steve Mitchell
UPI Medical Correspondent
From
the Science & Technology
Desk
United Press International
Monday, July 29, 2002
A potentially
fatal disease spread by ticks may be on the increase and government
and public health officials are concerned it could be infiltrating
the blood supply.
Babesiosis,
a mild malaria-like illness, is transmitted by Ixodes scapularis,
the black-legged tick, the same creature that carries Lyme disease.
So far, babesiosis largely has been confined to Nantucket and Martha's
Vineyard, Mass., and parts of Long Island, N.Y.
In recent
years, however, the tiny black-legged ticks -- also called deer
ticks -- that carry the disease appear to be expanding their range,
Sam Telford, a researcher at Harvard University, in Cambridge, Mass.,
who focuses on tickborne diseases, told United Press International.
"We
do believe it's probably spreading," Peter Krause of the Connecticut
Children's Medical Center in Hartford and the University of Connecticut
School of Medicine in Farmington, told UPI. Krause noted people
have become infected with the disease in New Jersey and farther
inland in Connecticut, indicating it is spreading westward in that
state.
This
raises concern on two levels. People who pick up the disease from
a tick are at risk of death because the disease can be fatal in
5 percent of cases and there is a risk they could transmit the protozoan
that causes the disease to others if they donate blood, Krause said.
More
than 30 cases of people contracting the disease through blood transfusions
have been documented but the total number of cases is likely much
higher because the disease often goes unrecognized and unreported,
he said. In most people, the disease causes fever and aches for
about a week, but it can have severe consequences and some people
may have to be placed on life support.
"This
disease is definitely underestimated," Krause said. "There
are more cases than we realize and it's increasing." He added
many physicians are becoming more aware of the disease and more
labs are starting to test for it, "so we're going to be seeing
more cases just because of increased recognition. Scientists know
the risk of transmitting babesiosis via blood transfusions is a
problem ... and they are looking for ways to decrease the possibility
of this."
Krause
noted both the American Red Cross and the Centers for Disease Control
and Prevention in Atlanta are involved in a study to determine the
prevalence of the disease and the risk posed to the blood supply.
Barbara
Herwaldt, a medical epidemiologist with the CDC, told UPI the threat
of babesiosis getting into the blood supply is "of concern,"
but she declined to elaborate further on the study or how much of
a risk contaminated blood poses to the general population.
The Red
Cross did not respond to phone calls from UPI seeking comment. Other
blood bank organizations also are worried about the threat of babesiosis.
"It
is relatively high on our priority list for transfusion infections,"
said Louis Katz, vice president of medical affairs at the Mississippi
Valley Regional Blood Center in Davenport, Iowa, and chair of the
American Association of Blood Banks transfusion/transmitted diseases
committee.
"The
reason it is an issue in blood banking now is due to environmental
and demographic changes over the past years and people are now living
where ticks are," Katz said. This means babesiosis infections
are increasing so it is more likely infected people will donate
blood, he said.
Although
there is no test for screening blood for babesiosis, the Food and
Drug Administration does require blood centers to ask about the
disease and bar people from donating if they report ever having
the disease, an FDA spokesman told UPI. However, this may not catch
everyone infected with the disease because often people will catch
it but the symptoms are so minor they do not realize they are infected,
Krause said.
The FDA
spokesman stressed, "The benefit of receiving a blood transfusion
far outweighs any theoretical risk associated with receiving that
transfusion." But he said, "The FDA would be very interested
in a blood screening test (for babesiosis) being brought forward
for evaluation," adding the agency is attempting to develop
such a test.
People
at greatest risk of contracting babesiosis via blood transfusions
are the elderly, patients whose spleens have been removed and those
with weakened immune systems due to surgery, cancer or HIV/AIDS,
Krause said. In these patients, babesiosis is more likely to cause
serious health problems or death. The disease also could interfere
with recovery from surgery.
Krause
said children also are at risk of contracting the disease but they
seem to be protected from the serious complications.
Scientists
likely will continue to focus on babesiosis in the near future.
Telford said "the disease will get a lot of interest"
next month at an international conference on Lyme and other tickborne
diseases in New York City. He also predicted it will continue to
spread and become more of an issue with the public at large.
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Antiobiotics
May Be Useful Against 'Mad Cow' Disease
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - A common antibiotic may be a useful
weapon against the abnormal proteins that cause "mad cow"
and other brain-wasting diseases, researchers in Italy report.
Mad cow disease, or bovine spongiform encephalopathy ( news
- web
sites) (BSE ( news
- web
sites)) as it is officially called, is an incurable brain-wasting
disease in cows. More than 100 people in Europe, almost all of them
in Britain, have developed a similar ailment, new variant Creutzfeldt-Jakob
disease ( news
- web
sites) (vCJD), from eating BSE-infected meat.
BSE, vCJD and other related illnesses, such as the animal disease
scrapie, are marked by the build-up in the brain of abnormal versions
of proteins called prions. The abnormal prions are resistant to
enzymes that would otherwise remove them, which leads to degeneration
of brain cells.
There is no treatment for vCJD and other prion diseases, although
several compounds do interfere with prion formation. Unfortunately,
these compounds either cannot travel from the blood into the brain,
cause severe side effects, or both.
But a report in the online Proceedings of the National Academy
of Sciences ( news
- web
sites) Early Edition suggests that tetracyclines, a class of
commonly used antibiotics, may affect the ability of prions to cause
disease.
Dr. Fabrizio Tagliavini of the Istituto Nazionale Neurologico
Carlo Besta in Milan, Italy and colleagues treated tissue samples
taken from patients with vCJD and cows with BSE with the drug tetracycline.
When the prions were exposed to the antibiotic, they became less
resistant to digestion by enzymes. The greater the dose, the less
resistant the prions became to enzymatic digestion and, therefore,
removal.
After these promising results, the researchers tested tetracycline
in hamsters with scrapie. When the prions were exposed to tetracycline
before injection, the hamsters did not become sick until significantly
later and lived longer. And this delay was accompanied by a lag
in brain abnormalities that normally develop in brain-wasting diseases.
The findings suggest that tetracyclines, which are already
approved for human use, could be helpful for people with brain-wasting
diseases, the report notes. "Tetracyclines should be reconsidered
for pharmacological effects independently from the antibiotic activity,"
the authors state.
Antibiotics could also have a role in preventing infections,
the investigators suggest. When Tagliavini's team mixed tetracycline
into a highly diluted solution containing scrapie, one third of
the hamsters exposed to the solution did not develop the disease.
The results suggest that it may be possible to use antibiotics
to inactivate prions in potentially contaminated products, the authors
conclude.
Source: Proceedings of the National Academy
of Sciences Early Edition 2002;10.1073/pnas.162195499.
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Morning
Exercise Could Increase Infection Risk
HealthScoutNews
Monday, July 29,
2002
MONDAY, July 29 (HealthScoutNews) -- Do you like to start your
day with an invigorating run or swim? If so, you may be more likely
to get tripped up or torpedoed by an infection.
New research from Britain now says early morning exercise may
increase a person's susceptibility to infection.
The researchers studied 14 competitive male swimmers, average
age 18. The swimmers swam the 400-meter crawl five times, with a
minute rest between each swim. They did this on two days at 6 a.m.
and 6 p.m. each day.
Samples of spit were taken from the swimmers before and after
each swim in order to measure their saliva production. The saliva
was measured for levels of cortisol, a stress hormone that suppresses
the immune system.
The researchers also checked the swimmers' saliva for IgA secretory
rate. IgA helps defend the body from infections in the nose and
mouth.
The study found the swimmers' cortisol levels were higher in
the morning than in the evening before exercise. The levels were
significantly higher after the swimming sessions. IgA secretory
rates were much lower in the morning than in the evening, but only
slightly affected by the swimming.
Salivary flow rate was significantly reduced by both the morning
and evening swims. The salivary flow rate was lower before the morning
swims.
The authors say their findings indicate that a person's body
clock has a considerable impact on the immune system. They suggest
it's best to do your exercise or training in the evening when you
have lower levels of cortisol and a higher rate of saliva flow,
which also helps protect against infections.
People returning to exercise and training after an illness
or injury should avoid early morning workouts, the authors advise.
The same is true for athletes who have increased stress levels because
of an upcoming competition and those training at high altitudes.
Both of those can depress the immune system.
The findings are reported in the latest issue of the British
Journal of Sports Medicine.
More information
The American Council on Exercise has more insight into exercise
and the immune system.
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Huntington's
Study Looks Promising
By Paul Recer
AP Science Writer
The Associated
Press
Monday, July 29,
2002
WASHINGTON (AP) - A bile acid the body produces in small amounts
is able in laboratory studies to slow the progress of Huntington's
disease, a fatal, inherited brain disorder that destroys the mind
and has affected about 30,000 Americans.
"We found in mouse studies that this compound protects
the animals' neurons (brain cells) from the effects of the Huntington's
disease gene," said C. Dirk Keene, first author of a study
appearing this week in the Proceedings of the National Academy of
Sciences ( news
- web
sites).
Keene, a researcher at the University of Minnesota, said many
more laboratory studies are needed before the drug could be considered
for testing in humans, but he said the research is important because
it offers the hint of a future treatment for a lethal disorder that
now has no treatment.
"We hope it will be as effective in humans as it seems
to be in rodents," Keene said.
"It is an interesting finding that needs to be followed
up," said Dr. James F. Gusella, a Huntington's disease researcher
at Massachusetts General Hospital and the Harvard Medical School
( news
- web
sites). But he cautioned that although animal research provides
clues about Huntington's, "They are still quite distant from
being able to treat human patients."
Huntington's disease, or HD, is caused by a single defective
gene that is inherited. About one in every 10,000 babies worldwide
is born with the gene mutation and about 30,000 Americans have been
diagnosed with HD.
The disease causes a progressive loss of neurons in the brain,
leading to changes in personality, mood and judgment. As the disease
progresses, patients develop slurred speech, an unsteady walk and
difficulty in swallowing. Symptoms can appear as early as age 2
or as late as age 70 and will lead to death in 10 to 25 years.
Researchers discovered the gene that causes Huntington's in
1993, but there are still no approved drugs or treatments to slow
its progression.
In the study, Keene and his co-authors used a type of mouse,
called R6/2, that was developed to have a part of the flawed HD
gene and to develop symptoms of the disorder.
For comparison, the researchers also tested a group of mice
with normal genes.
Starting at about six weeks of age, half of the R6/2 mice were
injected with a compound called tauroursodeoxycholic acid, or TUDCA.
Earlier studies had shown that TUDCA, a type of bile acid, tended
to block cell death. The new study was designed to see if it would
prevent the HD-caused death of brain cells.
At 10 weeks, the two groups of R6/2 mice and the normal mice
were tested in a maze and on a treadmill. Keene said TUDCA-treated
mice could perform up to 50 percent better on the tests than the
R6/2 mice not given TUDCA.
"The treated animals were no different than the ... non-Huntington's
disease animals," said Keene.
An examination of the animals' brains after 13 weeks showed
that TUDCA-treated mice had significantly fewer dead neurons than
the R6/2 mice not given TUDCA.
Keene said researchers now want to start the TUDCA treatments
on R6/2 mice at an earlier age to see if it can extend their life.
The mice usually die of HD symptoms at about 14 weeks. He said it
is believed that HD starts killing brain cells long before symptoms
of the disorder appear.
The flawed gene that marks HD can now be detected before birth.
If a drug can be found that prevents the death of brain cells starting
at an early age, it may be possible to control the disorder throughout
life, said Keene.
On the Net:
Proceedings of the National Academy of Sciences: http://www.pnas.org/
Huntington's Disease Society of America: http://www.hdsa.org/
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Clot-Busting
Protein May Lead to Clogged Arteries
By Linda Carroll
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - A protein that is commonly used
as a clot-busting drug may worsen atherosclerosis if it is supplied
in large quantities through gene therapy, the results of a new study
suggest.
Urokinase-type plasminogen activator is a naturally-occurring
protein that is used as a drug to dissolve dangerous blood clots
in patients with atherosclerosis (hardening of the arteries). Because
it works by thinning blood, a potential side effect is excessive
bleeding in other areas of the body.
Researchers have previously discovered that they could use
gene therapy to induce the body to produce excess amounts of the
protein only at the location of the thickened arteries. This targets
the blood-thinning effects without the risk of bleeding elsewhere.
In the current study, published online in the Proceedings of
the National Academy of Sciences ( news
- web
sites) Early Edition, researchers sought to discover if there
were any adverse effects of this gene therapy approach.
Using rabbits as subjects, the investigators found that high
levels of urokinase can actually lead to thickened blood vessels,
according to study co-author Dr. David Dichek, a professor of medicine
and associate director for research in the division of cardiology
at the University of Washington School of Medicine in Seattle.
"We were interested in engineering blood vessels so they
wouldn't form blood clots inside them," Dichek said. "Our
approach was to get the blood vessels to express larger quantities
of a molecule that would prevent or dissolve blood clots."
Dichek and his colleagues started by cloning the gene for urokinase
in rabbits and then used a virus to carry the gene into rabbit arteries.
The rabbits were fed a special high-cholesterol diet, which presumably
would make them more likely to develop clogged arteries. A second
group of rabbits received an inactive placebo injection and were
also fed an artery-clogging diet.
The researchers then checked the rabbits' arteries every week
for 4 weeks after the gene was injected.
Even after one week the results were surprising, Dichek said,
noting that rabbits in the genetically-engineered group had narrowed
arteries. Scientists have noticed that arteries tend to narrow in
the early stages of atherosclerosis, Dichek said.
During the second week of the study, there were no major differences
between the normal rabbits and those with higher levels of urokinase.
But between the third and fourth weeks, the researchers noticed
that inner linings of the arteries of the genetically-engineered
rabbits were starting to thicken.
Ultimately, the study showed that gene therapy with urokinase
would be a poor choice for patients with clogged arteries, Dichek
said. Still, the results may help researchers better understand
the processes that lead to atherosclerosis, he added.
Other studies have shown that patients with clogged arteries
have higher levels of urokinase in their blood vessels, Dichek said.
This study shows that the protein may be part of the cause of atherosclerosis
rather than the result of the disease.
"I think gene therapy has gotten a bit of bad press,"
Dichek said. "This is an example of where, if you proceed slowly
and carefully, you can gain useful information even if the results
are negative. They may help you understand the disease you're treating
better."
Source: Proceedings of the National Academy
of Sciences Early Edition 2002;10.1073/pnas.162236599.
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Vegetarian
group calls Atkins diet unsafe
By Steve Mitchell
UPI Medical Correspondent
From
the Science & Technology
Desk
United Press International
Monday, July 29, 2002
WASHINGTON, July 29 (UPI) -- A vegetarian advocacy group
says high-fat/low-carbohydrate diets -- such as the Atkins diet
-- are dangerous and will launch an ad campaign later this week
targeted at physicians and consumers.
The Physicians
Committee for Responsible Medicine "is particularly concerned
about the health effects of these high-fat diets" because "more
people are going on them," spokeswoman Simon Chaitowitz told
United Press International.
The goal
of the ad campaign, which will appear on the Internet on Yahoo.com
and in a medical journal, is to "alert both consumers and physicians
to the dangers of high-protein diets," Chaitowitz said.
PCRM
also will launch a Web site -- scheduled to premiere on Thursday
-- for consumers who have had problems with high-fat/low-carb diets
to register their experiences. PCRM will compile this information
to help evaluate these types of diets. The group's main objections
to the high-fat diets is they are composed of foods -- particularly
animal products -- that may increase the risk of colorectal cancer,
osteoporosis, heart disease, kidney problems and diabetes complications.
"Even
if the diets induce weight loss ... people need to focus beyond
weight loss and focus on overall health," Brie Turner-McGrievy,
a clinical research coordinator and registered dietician with the
physicians committee, told UPI. She noted little research has been
done on these diets so the long-term effects are unknown, adding
there are concerns diets high in protein can lead to kidney problems
and diets rich in saturated fats found in meat and dairy products
can lead to clogged arteries and cancer.
Katherine
Tallmedge, a registered dietician and spokeswoman for the American
Dietetic Association, said, "Diets high in fruits and vegetables
produce a lower risk of cancers and without them you have a higher
risk." Fruits and vegetables "have also been shown to
lower blood pressure and the risk of stroke and heart disease."
"Diets
high in saturated fat raises LDL ("bad" cholesterol) in
most people," which increases the risk of heart disease and
heart attacks, Tallmedge said, noting that Atkins himself recently
developed heart problems.
Low-carbohydrate
diets often are touted for their ability to reduce LDL and triglycerides,
but this effect is caused by the initial weight loss, Tallmedge
said. "Once the weight loss has stopped, they often go higher
than ever before," she said.
Another
dangerous facet of the high-fat diets is ketosis -- state the body
goes into when it is deprived of carbohydrates. In ketosis, the
body mainly relies on fat and protein for energy, but it can lead
to a variety of physical problems, including calcium loss from the
bones and kidney stones. "Ketosis is not a state you want to
be in," Turner-McGrievy said.
There
are other health consequences of these diets. Tallmedge said an
unpublished, six-month study funded by Atkins found 68 percent of
the people in the study who were on his diet experienced constipation,
63 percent had bad breath, 51 percent had headaches and some also
experienced hair loss.
Some
people swear by the high-fat diets and insist nothing else has worked
for them, but two studies found people on these diets only lost
about an average of 20 pounds in six months. That is similar to
the type of weight loss that could be achieved by any kind of diet
you would put people on, Turner-McGrievy said.
She said
a study conducted by the U.S. Department of Agriculture found vegetarians
had lower body mass indexes and were slimmer overall than people
on high-fat diets. Turner-McGrievy conceded people may lose weight
on the Atkins or similar diets, but said, "A lot of things
help people lose weight. Smoking can help you lose weight ... but
it's about overall health. There are definitely a lot better weight
loss diets out there for people to try."
Tallmedge
agreed. "You don't have to go through a depressing angst-ridden
diet to keep the weight off," she said. Long-term studies have
shown most people who successfully lose weight and keep it off did
so with a low-fat diet consisting of fruits, vegetables, lean meats
and whole-grain foods, she said.
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Boiling
Best Bet to Avoid Harmful Food By-Product
By Adam Marcus
HealthScoutNews Reporter
HealthScoutNews
Monday, July 29, 2002
MONDAY, July 29 (HealthScoutNews) -- The best bet to avoid
the cancer-causing chemical acrylamide created during cooking is
to boil your food, according to a report by Swedish researchers.
Of course, that impractical suggestion would leave many taste
buds begging for mercy. But it underscores the pickle caused by
recent revelations that much of what we eat -- especially baked
and fried goods, such as french fries -- contains acrylamide when
cooked at high temperatures. The substance has been linked to cancer
in lab animals, though there's no agreement on what levels are harmful
to humans.
Earlier this summer, a panel for the World Health Organization
( news
- web
sites) and the United Nations ( news
- web
sites) called the presence of the chemical a "serious problem"
that merited further study. However, the group stopped short of
advising people to reduce their intake of things like bread, potato
chips, and other foods heavy in acrylamide.
That judgment was based in large part on work by environmental
chemists at Stockholm University, whose study results appear for
the first time in a peer-reviewed publication, the Aug. 14 Journal
of Agricultural and Food Chemistry.
Until recently, scientists believed that smoking was the principal
source of acrylamide exposure. But a Swedish study showed that even
nonsmokers could have high levels of the substance.
So the Stockholm University group sought to learn how much
of the chemical enters the body through cooked food. In one study,
they showed that rats fed fried feed for one or two months had more
than those on a regular diet.
The new report extends that work to address factors that influence
acrylamide formation in various foods, especially cooking times
and temperature.
Frying and baking brought out the most acrylamide, particularly
in carbohydrate-laden and potato products like french fries, potato
pancakes, and chips. And while protein-rich foods like beef and
fish tended to have levels of acrylamide 10 to 100 times lower than
that in potatoes, the quantity rose with cooking temperature.
Cooking for nearly 20 minutes at the boiling point of 212 degrees
Fahrenheit didn't change the acrylamide content of potatoes, the
researchers said. However, the chemical's concentration did rise
markedly at about 250 degrees Fahrenheit.
The researchers couldn't detect acrylamide in boiled potato,
hamburger, or fish, or in the broth left behind -- prompting this
statement from Margareta Tornqvist, the study's lead author: "I
would say that boiling at 100 degrees Celsius [212 degrees Fahrenheit]
is the only safe cooking method."
Tornqvist and her colleagues shy away from recommending that
people cook their food lightly to avoid acrylamide. Doing so might
increase the risk of serious and potentially deadly food poisoning
from germs that thorough cooking kills.
Ultimately, the scientists said, people who eat hot foods may
take in acrylamide at well above the safe levels in water set by
the World Health Organization.
The Snack Food Association, a U.S. snack industry group, has
estimated that acrylamide may be present in up to 90 percent of
the world's food supply.
Rick Jarman, vice president for food and environmental policy
at the National Food Processsors Association, said he couldn't confirm
that figure. However, Jarman said, "there is certainly a significant
part of the food supply where acrylamide might be." But what
that means, if anything, for human health isn't known, he said.
Jarman said the publication of the Swedish study, with its
full methodology and the list of foods tested, will help researchers
probing the issue further. "It should be very helpful as different
companies and organizations try to determine what priorities and
work is appropriate. But in terms of the implication for public
health, at this stage that is still a looming question that is being
pursued with all due diligence."
Jarman said his group's members haven't discussed any plans
to start carrying acrylamide warnings on their labels.
That doesn't mean labeling hasn't become a hot issue, though.
After the Swedish team first reported their results, a California
attorney demanded that McDonald's and Burger King put cancer warnings
on their french fries in compliance with California's Proposition
65, a law that requires companies to list carcinogens, including
acrylamide, in consumer products.
More recently, the American Council on Science and Health,
a New York public health group, announced plans this month to sue
Whole Foods Market for failing to comply with the California provision.
The group accuses Whole Foods of neglecting to warn its customers
about the acrylamide content of its whole wheat organic bread.
Jeff Stier, associate director of ACSH, said his organization
doesn't believe acrylamide poses a health threat in bread or any
other food product. Rather, ACSH is suing Whole Foods to point up
the "absurdity" of Proposition 65. The law "doesn't
take into account the number one rule of toxicology, which is that
the dose makes the poison," Stier said.
ACSH also hopes to needle Whole Foods about what Stier called
the "fraudulent" nature of its business plan: proclaiming
the relative safety of organic foods over conventional products.
"Even the most wholesome whole wheat bread has carcinogens,"
Stier said.
Whole Foods has hired a high-profile law firm, Gibson, Dunn
& Crutcher, to fight the lawsuit. The company has threatened
to sue ACSH if it doesn't drop its claim, which its lawyers say
has brought "adverse and unwarranted" publicity.
What To Do
For more on acrylamide in food, visit the United Nations' Food
and Agriculture Organization or the World
Health Organization.
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Some
Student Vaccine Rules Relaxed
By Shannon Dininny
Associated Press
Writer
The Associated
Press
Monday, July 29,
2002
INDIANAPOLIS (AP) - At least four states are relaxing student
immunization standards at the start of the school year because of
lingering shortages in vaccines for many common childhood diseases.
The Centers for Disease Control notified doctors in a July
11 bulletin that shortages were over for two vaccines, one for measles,
mumps and rubella and another for diphtheria, tetanus and pertussis.
But parts of the country still lack sufficient supplies. New
Jersey, Indiana, Minnesota and Nebraska are among the states that
will allow students with incomplete immunizations to enroll in school
this fall.
"Physicians and patients are going to have some catching
up to do," said Buddy Ferguson, spokesman at Minnesota Department
of Health.
The shortage for the MMR and DTP vaccines was caused by several
factors, including a dwindling number of suppliers, manufacturing
changes and equipment modifications that caused some production
facilities to shut down longer than expected.
Indiana health officials last week pushed back a fall deadline,
requiring students to be fully immunized by Jan. 31. Minnesota waived
its tetanus/diptheria shot for junior high and high school students
until next fall.
"Although they do have enough vaccine now, obviously they're
going to go have to go back and immunize people who haven't had
their booster," Ferguson said.
The New Jersey Health Department will allow students who aren't
immunized to begin school as long as the child has a doctor's note
indicating they are still trying to get the vaccine.
"If they can demonstrate a good faith effort and the physician
is working with a family to get vaccine, we don't want to keep the
child out of school," said assistant health commissioner James
Blumenstock.
Children are supposed to get shots for measles-mumps-rubella
at 12 to 15 months and again at 4 to 6 years. During the shortage,
the CDC recommended postponing the second shot.
The
DTP vaccine is usually given to children in five doses over their
first 4 to 6 years. The CDC had suggested parents put off the fourth
and fifth doses while supplies were low.
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Older
Husbands Relied on by Wives Outlive Peers
By Suzanne Rostler
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - Elderly men who are the rock of
their relationship may outlive their peers who are not cited as
a source of strength by their spouse, according to researchers.
Investigators found that men aged 65 and older who were named
as a source of emotional strength by their wives were more likely
to be alive 6 years later, after economic and medical factors were
taken into account.
A person who is relied on by a spouse may feel valued, which
can improve self-esteem and feelings of usefulness, Dr. Roni Beth
Tower, who conducted the study while at Yale University in New Haven,
Connecticut, and colleagues suggest.
The report, published in a recent issue of Psychosomatic Medicine,
adds to a growing body of research into the effects of marriage
on physical and emotional well-being. Previous studies have tied
marriage to longevity and lower levels of depression, particularly
in men.
To investigate whether closeness within a marriage plays a
role, the researchers interviewed 305 healthy couples at least 65
years old. The average length of marriage was more than 43 years
and 85% of couples were in their first marriage.
Couples were deemed close if they named their spouse as a confidant
or source of emotional strength, and if they were named by their
spouse as a confidant or source of strength. From this definition,
four patterns of marital closeness were possible: both the wife
and husband naming the other; only the wife naming the husband;
only the husband naming the wife; or neither naming the other as
an emotional support.
The researchers found that a husband who named his wife was
less likely to remain alive, possibly due to the stress of contemplating
the eventual death of a wife who is a source of strength. Indeed,
husbands who named their wives as sources of strength were also
less likely to have faith that things would work out in the future,
the study findings suggest.
This type of marriage may reflect a conflict with societal
norms for gender roles, Tower said in an interview, particularly
among older couples.
Wives who were cited as a confidant were less likely to die
only if they did not have children. Wives who had children and were
named as a source of strength were slightly more likely to die,
possibly due to the burdens associated with family ties. These women
tended to be involved in the lives of their children and grandchildren.
Women were equally happy and hopeful whether they had children
or not, the report indicates.
"Perhaps the sheer burdens associated with presumably
positive social ties took their toll through the stress associated
with being relied on by loved ones," the authors suggest.
Tower and colleagues caution against generalizing the results
to younger couples, since husbands and wives in the study belonged
to a generation with different beliefs about marriage and the roles
of men and women than younger generations may have.
"Conditions have changed during the 20th century and we
are not claiming that the impact of specific configurations of marital
closeness will be the same for later generations," they write.
Source: Psychosomatic Medicine 2002;64:644-659.
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West
Nile Spreads Quickly in U.S.
By Lauran Neergaard
AP Medical Writer
The Associated
Press
Monday, July 29,
2002
West Nile virus ( news
- web
sites) is sickening people far earlier this summer than usual,
and is spreading so quickly — it's hit 33 states, as far west as
South Dakota — that health officials believe it will reach California
this year or next.
Nobody knows how bad the mosquito-borne illness will get —
although a rapidly growing outbreak among 32 people in Louisiana
began a month earlier than West Nile has ever struck in this country,
a big worry. But it's clear the virus first detected in New York
City a mere three years ago has become a permanent summertime threat
in most states.
Yet it's fairly easy to prevent: Spray on DEET-containing mosquito
repellent when you go outdoors, and don't let puddles collect in
flower pots, wading pools or other spots where mosquitoes can breed.
One specialist equates the safety steps to the routine of buckling
a seat belt before driving.
"That's the level of worry people should have," says
Dr. Lyle Petersen of the Centers for Disease Control and Prevention
( news
- web
sites). "You should be concerned enough about it to do
something but not have it change your whole lifestyle."
West Nile virus has struck other countries for decades, from
the tip of Africa up to Europe and throughout Asia, so its move
here probably was inevitable. The CDC has confirmed 161 U.S. cases,
including 18 deaths, since the first Americans were diagnosed in
1999.
Officials are investigating if West Nile just killed two people
in Louisiana. In addition to 32 West Nile-caused encephalitis cases
there, a Mississippian is sick and health officials are investigating
10 similarly ill Texans.
The virus doesn't discriminate: A dead crow was even found
on the White House lawn.
West Nile can cause a potentially fatal brain inflammation.
Anyone suffering such symptoms as a high fever, severe headache,
confusion or difficulty thinking, stiff neck or severe muscle weakness
should see a doctor right away. It has struck Americans as young
as 16, but those most at risk are over 50.
For every case of West Nile encephalitis, 150 more people are
thought to be mildly infected — not sick enough to see a doctor.
They get a flu-like illness, with fever, headache and muscle pains,
that lasts two or three days.
How does West Nile spread? It infects numerous types of wild
birds, from house sparrows to crows. Mosquitoes spread it among
birds, and then to people. A spate of dead birds can be an early
warning signal that the virus is circulating in a certain spot.
Aside from people, the mammals most vulnerable are horses.
There is a horse vaccine but not a human one, nor is there any anti-viral
treatment — victims get supportive care.
So preventing mosquito bites is important. Some health departments
track bird deaths in deciding when to spray insecticides, but the
CDC says consumers can do a lot on their own:
·
Wear a mosquito repellent containing DEET; those without DEET aren't
nearly as effective. Follow the label's instructions carefully,
especially when applying to children.
·
Stay indoors at dawn and dusk, when mosquitoes are most active.
·
Get rid of mosquito breeding grounds on your property. Don't allow
water to stand for more than two days. Mosquito eggs need only a
little water to hatch, and many species don't fly long distances,
so West Nile-bearing mosquitoes were probably born nearby. Typical
culprits are empty paint cans collecting water under decks, unused
pools, blocked rain gutters, flower pots and forgotten buckets.
·
Those highly touted gadgets that catch bugs by mimicking the carbon
dioxide people exhale aren't proven to reduce the number of mosquito
bites. They might attract a neighbor's mosquitoes to your yard,
or kill only one species instead of another type more likely to
carry West Nile.
"It's a lot less expensive to rely on the old-fashioned
methods," Petersen says.
The Mosquito Control Association also recommends frequently
changing birdbath water, stocking ponds with mosquito-eating minnows
and using larvicides in unavoidable standing water.
People can't get West Nile from each other or by touching an
infected animal. Zoos with exotic birds are not considered particularly
risky — wild birds spread West Nile, and exotic birds that get it
usually die quickly.
But even as West Nile races across the country, there's no
real predicting how big a threat it will pose each year. Abroad,
West Nile hides for years between periodic epidemics — a pattern
likely here, too, says Petersen.
Editor’s Note — Lauran Neergaard covers health and medicine
for The Associated Press in Washington.
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Man
Contracts Hepatitis A Despite Vaccination
Reuters Health
Monday, July 29,
2002
FRANKFURT (Reuters Health) - Germany's Paul Ehrlich Institute
said on Monday it would investigate the case of a man reported to
have contracted hepatitis A despite having been vaccinated.
The case was first reported in the journal Deutsche Medizinische
Wochenschrift by a team of doctors in Bielefeld, led by Prof. Ulrich
Junge. On Sunday, Germany's mass circulation Bild newspaper ran
a story about the case, bringing it national attention.
The 55-year-old German man was said to have received a full
immunization with Twinrix Adult, marketed by GlaxoSmithKline, but
some 47 days later became ill after eating shellfish.
Junge and his team concluded that "combined hepatitis
A/B vaccination according to the recommended schedule does not guarantee
protection in elderly persons."
Dr. Johannes Loewer, head of licensing and inspection at Paul
Ehrlich Institute, said in a statement that the agency took Prof.
Junge's data seriously and would conduct an investigation. However,
he said he currently sees no reason to question the use of Twinrix.
He noted that immunity in people over 40 years old can be less
than in people younger than 40. Twinrix Adult was approved in 1996
by the European Agency for the Evaluation of Medicinal Products,
and during the approval process it was found to be effective for
older people, he said.
Loewer suggested that any older people who have been vaccinated
with Twinrix Adult and are nonetheless concerned could be tested
to ensure they have effective levels of antibodies against hepatitis
A virus.
The Institute said it believed the vaccine to be safe and effective
and saw no reason to question its use.
"We are nearly certain that this was not a quality problem,"
said Susanne Stoecker, spokeswoman at the Institute.
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Child
Added to Nev. Cancer Cluster
The Associated
Press
Monday, July 29,
2002
RENO, Nev. (AP) - A sixteenth case of childhood leukemia has
been confirmed in a cancer cluster that has baffled scientists and
frightened residents in the northern Nevada town of Fallon, state
health officials announced.
Acute lymphocytic leukemia was diagnosed in a 2-year-old former
resident of Churchill County, according to the Nevada State Health
Division. The child's name and gender were not released.
"This is devastating news," Gov. Kenny Guinn said
in a statement Sunday. "We are diligently working, using every
resource, to find answers for the families coping with this health
crisis."
Health officials have said that, given an average rate of about
three childhood cases per 100,000 children, they would normally
expect to see about one case every five years in the Fallon area,
which has a population of 26,000.
Of the confirmed childhood leukemia victims linked to Fallon
since 1997, two have died.
Floyd Sands, the father of one of those who died, called news
of the latest Fallon case disturbing.
"When are these people going to do something real?"
he asked the Reno Gazette-Journal. "I don't believe those people
have done anything real so far."
The federal Centers for Disease Control and Prevention ( news
- web
sites) has been testing for potential environmental contaminants
since September 2001, according to the state.
One focus of attention has been a jet fuel pipeline that serves
Fallon Naval Air Station. In May, two federal agencies investigating
the cancer cluster ruled the pipeline out as a public health hazard.
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Soil
Bacteria Compound Potential Transplant Drug
By Alison McCook
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - Researchers have isolated a compound
from soil bacteria that may one day offer a safer, more potent way
to prevent organ rejection in transplant patients.
The compound is called tautomycetin (TMC) and it acts as a
specific inhibitor of the body's T cell-mediated immune response
while leaving other components of the immune system untouched.
The body's immune system typically attacks all substances that
it deems foreign, which includes viruses, bacteria and new organs.
In the case of a transplanted organ, the body launches an immune
response mediated by T cells, the key immune cells that normally
destroy foreign invaders.
In order to ward off the response of T cells to the foreign
organ, transplant recipients typically have to take strong drugs
to suppress the immune system, such as cyclosporin. However, these
drugs can leave the patient vulnerable to viral illnesses and other
infections, and they can cause debilitating side effects, such as
liver and kidney toxicity and increased susceptibility to cancer.
Furthermore, in many cases, the treatments do not completely
work, and the body rejects the organ anyway.
However, researchers led by Dr. Sang-Kyou Lee of Yonsei University
in Korea say TMC may offer stronger protection for patients with
fewer side effects. When tested in rats that underwent a heart transplant,
those given TMC had comparable survival to animals given cyclosporin
and had less damage to other body organs.
"If we find the drug very specific to T cells, that would
be a very optimal immune suppressor," Lee told Reuters Health.
Lee added that the drug is currently in the early stages of
investigations into whether it will actually work as an anti-rejection
therapy. It still remains to be determined if the compound is safe
for humans and if so, it could take years before it becomes available.
Reporting their findings in the online Early Edition of the
Proceedings of the National Academy of Sciences ( news
- web
sites), Lee and his team identified TMC by passing thousands
of potential compounds through a screening test, designed to measure
how well the compounds inhibit T cells.
TMC was the most effective compound, the investigators found.
In fact, TMC was able to block the proliferation of T cells when
given in a dose that was 100-fold lower than that needed to achieve
a similar effect with cyclosporin.
In an interview with Reuters Health, Lee explained that the
specificity of TMC results from the fact that it zeros in specifically
on active T cells, ensuring that only those cells involved in the
rejection of new organs will be targeted. In contrast, other anti-rejection
drugs target substances that are ubiquitous in the body, thereby
increasing the risk of side effects from the treatment.
In addition, other conditions also involve the activity of
T cells against substances the body needs, and TMC may one day be
used to treat these conditions, as well, Lee explained. For example,
people with multiple sclerosis have T cells that target a protein
in the sheath that surrounds nerve cells, thereby damaging nerve
cells by exposing them to the outside environment.
The compound also only acts on active T cells, not those at
rest, Lee added, so there is no danger of the drug destroying all
of these important immune cells in the body. However, the compound
could target all of the body's active T cells, which suggests that
researchers will have to determine how to administer the drug to
a specific region of the body.
There are also concerns that people taking the drug may be
at increased risk of infections. However, with careful monitoring,
Lee said that patients should be safe.
Weakened immunity "is not that difficult a problem to
get around," Lee explained.
Source: Proceedings of the National Academy
of Sciences 2002;10.1073/pnas.162522099.
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Teenagers'
Anxiety Tracked in Real Time
By Felicity Stone
HealthScoutNews Reporter
HealthScoutNews
Monday, July 29,
2002
MONDAY, July 29 (HealthScoutNews) -- Anxiety-ridden teenagers
get angry, sad and tired more frequently. They're also more likely
to overeat and smoke.
Unfortunately, the problem may be more prevalent than previously
thought, suggests a new study that tracked the teens' feelings in
real time.
While adolescent angst is hardly a new phenomenon, the rates
of teenagers' anxiety are unexpectedly high, says a report in a
recent issue of the Journal of the American Academy of Child
and Adolescent Psychiatry.
In a study of 150 ninth graders, researchers from the University
of California, Irvine, and the University of California, Los Angeles
(UCLA), used hand-held computer diaries to measure and analyze their
moods and behavior.
The investigators say the innovative method contributed to
their findings.
"The electronic journals gave us greater insight into
the teenage mind than the traditional questionnaire, as we were
able to look at patterns and situations that couldn't be tapped
very accurately before," says researcher and UCLA psychology
professor Barbara Henker.
Because the students could log "as they happened"
accounts of their emotions, they were more candid, Henker says.
"If they felt extremely upset and we caught them in that moment,
they told us that. Whereas when we asked them with the traditional
pencil and paper method, 'Have you been extremely upset today?'
they said 'No.'"
For two four-day intervals, the adolescents recorded their
moods, activities and social settings, as well as their food, tobacco
and alcohol intake in journals equipped with a specific software
program.
The computers beeped them every 30 minutes, and questions appeared
on screen. The first few asked things like where they were, who
they were with, and what they were doing. Others were mood-related.
Each question offered a range of answers. So the response to "How
anxious are you?" for example, could be anything from "slightly
nervous" to "highly agitated."
Their responses disappeared after they'd keyed them in -- a
feature that Henker says fostered honesty and spontaneity.
"They weren't worrying about parents prying, nor could
they look back and check what they'd said before," she says.
The researchers used the journal entries to classify the students
into low-, middle-, or high-anxiety groups and examined when each
one experienced anxiety, where and with whom.
On average, the participants reported being apprehensive in
about 45 percent of their logs.
The ones who felt the most anxious tended to spend more time
alone, but were less anxious when they were with their friends.
The high-anxiety adolescents were seven times more likely than their
less anxious peers to recount feelings of anger, and 11 times more
likely to report sadness.
Moderate- and high-anxiety teens were two to three times more
likely to smoke, and between 70 and 80 percent were more likely
to drink alcohol and experience urges to eat.
Contrary to previous studies that have found girls more anxious
than boys, this investigation revealed no gender differences.
Katharina Manassis, a psychiatrist and director of the anxiety
disorders program at the Hospital for Sick Children in Toronto,
says the study confirms what many in the profession have long suspected.
"Many of us have always thought that when people are anxious,
particularly in their teens, they're prone to using maladaptive
ways of dealing with that, like overeating, drinking or smoking,"
she says.
However, Henker cautions that although the results reveal anxiety
and negative behaviors often occur simultaneously, it's difficult
to say which comes first. "My best guess is sometimes anxiety
leads kids to smoke or overeat, and sometimes smoking or overeating
makes kids anxious," she says.
While the researchers suggest their findings may deter adolescents
from picking up harmful habits, Manassis believes merely pointing
out the relationship between anxiety and teenagers' destructive
practices will have little effect on their actions.
"But if someone's there to help the adolescent identify
the situations where they get anxious and to say, 'Hey, this is
one situation where you said you get very anxious, so instead of
picking up a cigarette or eating those doughnuts, what else could
you be doing now?' That would be helpful," she says.
What To Do
For more on helping teenagers with anxiety and other mental
health problems, try the Center
for Mental Health Services or the American
Academy of Child and Adolescent Psychiatry.
BACK
TO TOP
Fast
Food Chains Display Fat Content
By Vivian Chu
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters) - Ranch 1, a popular Manhattan fast-food
chain, is not shy about telling customers how many calories their
customers will put on if they eat their grilled chicken sandwiches.
In fact, Ranch 1 lists the calories of its food on its napkins--and
compares them with the calories in a McDonald's Big Mac and a Burger
King Whopper. The New York chain promotes itself as a healthy alternative
to other fast foods, and its sandwiches have about half the calories
of its bigger rivals.
Subway, North America's biggest sandwich restaurant chain,
is doing the same. Like Ranch 1, Subway's napkins detail the nutritional
information of its leaner sandwiches versus those of the 800-pound
gorillas of the industry, McDonald's and Burger King.
"We try to position ourselves as a healthier alternative
to fast food restaurants. I thought that napkins were the best way
to get the message out," said Ranch 1 marketing director Izabela
Halifax. The differences are displayed on Ranch 1's red and white
napkins, reflecting the shift in fast food toward diet-conscious
and away from all-American burger-and-fries fare. The chains are
part of a small but growing number of quick-service restaurants
starting to flaunt the nutritional content of their food on order
menus and other prominent places.
It's more than a marketing ploy. A campaign led by consumer
and health groups is heating up to get the nation's leading fast
food chains to list calories along with prices on their menus. The
move would follow the lead of many packaged foods.
"We've suggested it be required for chain restaurants,
not mom and pops, but chains of 10 or more outlets," said Michael
Jacobson, executive director of the Center for Science in the Public
Interest, a nonprofit nutrition watchdog group. "The restaurant
industry hates the idea because they might sell less food."
Threat of lawsuits could speed up the movement. Last week,
a 272-pound New York City man sued four major fast food chains,
claiming that their food made him obese and damaged his health.
The suit--which the restaurant industry has dismissed as frivolous--seeks
to have chains label individual products with fat, salt and cholesterol
content, as well as warn consumers of their health effects.
The trend also could gather momentum as the government and
consumers search for ways to counter obesity, which is reaching
crisis levels in the United States. More than 60% of American adults
are overweight, and over 25% are obese, meaning they are 20% over
their ideal weight and face real health problems.
The issue has been gaining urgency, as the rising costs of
being overweight add to an overburdened healthcare system. Obesity-related
health costs totaled $117 billion in 2000, according to the Health
and Human Services ( news
- web
sites) Department. The US government estimates that one-third
of all cancer and heart disease and up to 80% of diabetes could
be prevented if people ate less, ate healthier food and exercised
more.
Washington lawmakers are on the case: The US Senate on Tuesday
is expected to introduce a bill that frees up more government money
for educating people about the dangers of excess weight.
A 'Mass Of Numbers'
McDonald's and Burger King contend they have long disclosed
the nutritional content of their meals on their Web sites, as well
as on posters and brochures available in stores. However, consumer
advocates say the posters do not go far enough.
"The posters are a mass of numbers, and they're very inconvenient
to read. Most people don't want to lose their place in line looking
at a poster," said CSPI's Jacobson. "I suspect very few
people use that information, though it allows companies to say they
are providing all that information to the public."
McDonald's, which also makes its nutritional content available
through a toll-free number, "strongly believes in providing
customers with complete nutrition information about all our products,"
said a spokesman for the Oak Brook, Illinois-based company.
A visit to a McDonald's in midtown Manhattan found no brochures
available, even upon request. A staffer pointed to a poster by the
front counter listing in exhaustive detail the ingredients, serving
size, calories, fat, cholesterol, sodium and other information for
each of the items on its menu.
Burger King, the nation's No. 2 hamburger chain, said that
listing all the nutritional information on napkins or food packaging
would not be feasible, given the variety of ways that customers
can order their food.
"There's more than 1,500 ways to order a Whopper, for
example without mayo or cheese that would reduce the amount of fat
and calories," said a spokesman for the Miami-based chain.
"We couldn't put all that information on a napkin because there's
so many different ways to have it."
Full-Flavored Taste
Despite the concern about the health risks of consuming too
much fast food, most consumers don't want to know the fat content
of those fries they are eating, restaurant professionals argue.
"There's a perception among many chains that consumers
don't really care," notes Bob Goldin, executive vice president
of food service consulting firm Technomic in Chicago. "My feeling
is that consumers who eat out want full-flavored taste. They don't
want the calorie content in their face."
Many healthier items launched by the fast-food industry in
recent years proved to be flops --witness McDonald's McLean Deluxe
hamburger and Taco Bell's Border Lites--both of which were pulled
after they failed to sell well, he noted.
Still, with the fast-food industry increasingly blamed for
the country's growing weight problems, restaurants that do play
up their healthier attributes could end up stealing away customers
from the large chains.
"It doesn't necessarily make me want to eat here more,
but it sure makes me never want to eat at McDonald's," said
Hugh Kojima, a 28-year old investment banker in New York, eating
a Subway sandwich as he studied a napkin.
"I knew that a Big Mac had a lot of calories, but 590
calories is like, really a lot. I would definitely think twice about
going there again," he said.
BACK
TO TOP
Kneedy
Tests
HealthScoutNews
Monday, July 29,
2002
(HealthScoutNews) --
If you experience pain in your knees, your doctor might any of a
battery of tests to diagnose the problem. In addition to a standard
X-ray, CT scan, bone scan, magnetic resonance imaging (MRI) and
arthroscopy are all possibilities.
The National Institute of Arthritis and Musculoskeletal and
Skin Diseases explains the differences.
- A CT scan (computerized
axial tomography) takes pictures of the knee for fractions of
a second from different angles. Unlike regular X-rays, a CT scan
can show soft tissues like cartilage and ligaments.
- A bone scan uses radioactive
material injected into the patient's bloodstream that is tracked
as it flows to the bone, offering a look at possible abnormalities
in cell activity.
- An MRI uses a powerful
magnet to create pictures of sections of the knee. This test is
particularly useful in detecting soft-tissue injuries.
- Arthroscopy uses a lighted
optical tube inserted into the knee. A doctor moves the scope
inside the knee looking for problems. The scope may be used to
help fix any damage found.
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Illness
Prompts FDA Warning About Lettuce
Reuters
Monday, July 29,
2002
WASHINGTON (Reuters) - US health officials on Monday warned
Americans not to eat Spokane Produce brand romaine lettuce after
the product was associated with an E. coli outbreak at a cheerleading
camp in Washington state.
Twenty-nine people at the camp in mid-July had confirmed cases
of E. coli, the Food and Drug Administration ( news
- web
sites) (FDA) said. A salad made with the lettuce is considered
a "primary source" of the E. coli, FDA spokeswoman
Ruth Welch said.
"Consumers should ask at the place of purchase in order
to assure that they do not consume Spokane Produce brand romaine
lettuce until this health emergency is resolved," the FDA
said in a statement.
The lettuce, which is sold under several brand names, was packaged
in 5-pound bags and distributed by Food Services of America,
the FDA said. It also may be sold at stores in various size
packages, the agency said.
"FDA urges consumers to throw out this product,"
an agency statement said.
E. coli causes diarrhea, often with bloody stools. Most healthy
adults recover within a week, but some people, including young
children and the elderly, can develop a form of kidney failure
that can be deadly.
Welch said investigations were ongoing and officials were unsure
where the lettuce had been distributed. In the past, Food Services
of America had distributed the product to restaurants and institutions
in Idaho, Montana and Oregon, the FDA said.
A woman who answered the phone at Spokane Produce, and who
declined to give her name, said the company had no comment.
Gary Odegard, a spokesman for Food Services of America, said
the company had stopped distributing the lettuce while the investigation
continued.
"We are not distributing any more, but we don't know yet
if the product is tainted at all," he said.
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Come
in from the Cold
HealthScoutNews
Monday, July 29,
2002
(HealthScoutNews) -- Some people just seem to be colder than
others. How often has your spouse's cold hands sent a shiver
up your spine? Most people probably just ignore the problem.
The Johns Hopkins Bayview Medical Center in Baltimore says
that might not be such a good idea. Cold hands can be a sign
that the thyroid, the gland that regulates body temperature,
is malfunctioning. The problem is called hypothyroidism. Its
symptoms can be vague, so mention even mild changes to your
doctor.
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Panel:
Soften Rules to Increase Heart Donors
By Alison McCook
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - Transplantation programs should
relax certain requirements on donor hearts to increase the availability
of the organs to those who desperately need them, according
to a group of experts involved in heart transplantation.
Specifically, the experts suggested that transplantation centers
consider hearts of healthy people older than 55, which are often
rejected automatically. In addition, the panelists recommend
that hearts be used even if they have not been thoroughly examined
if the donor is in relatively good health. Currently, if no
cardiologist is available to check the health of the donor's
blood vessels, during a procedure called angiography, some transplant
centers will not accept the donor's heart.
If these recommendations are implemented by medical centers
across the country, many more hearts could become available,
Dr. Jonathan G. Zaroff of the University of California, San
Francisco, lead author of the report, told Reuters Health.
"We're hoping we could gain an additional 400 to 800 available
hearts for transplant per year in the US," he said.
Not enough people who need hearts receive them due to chronic
shortages in the number of donors. Currently, between 6,000
and 8,000 people in the US are placed on a waiting list to receive
a new heart each year, during which time only 2,500 new hearts
become available.
Some people are simply unable to wait, the authors write; about
17% of those placed on a waiting list die each year before their
new heart appears.
Consequently, several experts in the field of organ transplantation
convened to discuss how to increase the number of available
hearts. The conference included medical experts, researchers,
and representatives of the United Network for Organ Sharing
(UNOS). Their recommendations are described in the rapid access
issue of Circulation: Journal of the American Heart Association
( news
- web
sites).
In an interview with Reuters Health, Zaroff explained that
once a donor is declared brain dead, doctors evaluate the donor's
heart to see if it is healthy enough to transplant. However,
often the donor is in a condition where an ultrasound can mistakenly
report that the heart is not pumping well.
Consequently, Zaroff said the most important recommendation
to emerge from the committee is that doctors should stabilize
donors before evaluating their hearts, and try to resuscitate
the heart if at first it appears weak. The message: "Don't
give up if the heart looks weak--try to make it better,"
he said.
How resistant different transplant centers will be to these
recommendations will depend on how conservative each center's
doctors are about which hearts they choose to transplant, the
researcher noted. In 1999, the percentage of donors who yielded
hearts deemed viable to transplant varied from 19% to 62% across
the country, in part due to the flexibility of different centers
in which donors they chose to accept.
"It is likely that regions of the country that are already
more aggressive would not find these at all controversial, but
for regions conservative about using nonstandard heart donors,
they will be considered controversial," Zaroff said.
Another important recommendation to emerge from the committee,
Zaroff added, is that researchers should keep investigating
which hearts can still be salvaged from donors.
"The panel recommended ongoing research efforts to further
improve our knowledge regarding appropriate selection and management
of heart donors," Zaroff concluded. "It's clear that
more work needs to be done."
Source: Circulation 2002;10.1161/01.CIR.0000025587.40373.75.
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Alcohol,
Mental Problems Rife in U.S. Workforce
By Jennifer Thomas
HealthScoutNews Reporter
HealthScoutNews
Monday, July 29,
2002
MONDAY, July 29 (HealthScoutNews) -- Think your co-worker is
having problems?
You might be right: A new report finds 25 percent of the U.S.
workforce experiences at least one mental or substance abuse
disorder each year.
The most common mental disorders among workers aged 18 to 54
are alcohol abuse or dependence (9 percent), major depression
(8 percent), and social phobia (7 percent), says the report.
Mental illness and addictions cost employers billions of dollars
and take a staggering emotional and financial toll on workers
and their families.
"The rates are extremely high," says Robin Hertz,
study author and a senior director of population studies at
Pfizer Pharmaceuticals Group. "As a nation, we have to
be more attentive to these types of problems ... There is a
mythology out there that if you are at work you are healthy.
That is not really true."
The report found companies pay more than $17 billion a year
in "unproductive" wages to workers with mental disorders.
Of that, about $5 billion goes to pay workers who miss workdays
because of their substance abuse; about $12 billion is lost
because productivity declines due to the illness.
Mental illness and substance abuse are also hurting the person
with the illness financially. Men and women with mental disorders
earn on average 22 percent less than people without mental disorders.
The study used data from the National Comorbidity Survey and
the National Mortality Followback Survey, which are conducted
by academic and government researchers.
Dealing with mental illness and substance abuse disorders is
especially difficult because people often try to hide their
problem or aren't aware treatment is available, Hertz says.
The study found of the 28 million workers who have a mental
disorder, 66 percent had never been diagnosed. Just 14 percent
of workers with mental disorders had been treated in the prior
year.
"It tells me people aren't seeking treatment. It's also
possible when they go to a health-care provider, there is a
lack of attention to their problem," Hertz says. "Many
people don't realize they can be helped. Or perhaps it's a matter
of stigma."
Mary Graham, senior policy advisor for the National Mental
Health Association, said she's not surprised by the findings.
"We suspected the rates were high, but we didn't have
any hard data," she says. "I'm very glad it's in print."
One reason the rate could be so high is that better treatment
for mental disorders lets people who otherwise might not be
able to get or hold a job stay in the workforce.
However, the statistics show not nearly enough of people are
getting the treatment they need. Graham's organization advocates
better insurance coverage for mental health disorders and better
education of primary-care doctors to spot it.
"Stigma is still a big obstacle," Graham says. "There
is still a lot of misperception and shame around having a mental
illness or a substance abuse disorder. As a result, people hide
it and don't seek care."
Hertz recommends employers establish confidential screenings
and employee-assistance programs at work, and make sure workers
know they are available and private.
"It makes sense to do what we can to optimize the health
of the workforce," Hertz says. "It's good for the
employer, and it's really good for the employee."
What To Do
For a list of the symptoms of common mental illnesses, visit
the National
Institute of Mental Health. For information about getting
treatment for mental health disorders or substance abuse problems,
try the Substance
Abuse and Mental Health Services Administration or the National
Mental Health Association.
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Senators
Plan Bill to Combat Child Obesity
By Niala Boodhoo
Reuters
Monday, July 29,
2002
WASHINGTON (Reuters) - Lawmakers on Tuesday plan to introduce
a bill that tries to tackle America's weight problem with a
host of health measures aimed at helping obese children.
The World Health Organization ( news
- web
sites) has declared obesity a global epidemic--in the United
States, 61% of adults aged 20 to 74 are considered overweight
or obese. About a quarter of American youth are overweight or
obese.
"There's a lot of evidence that the lifestyles we have
adopted in this country have gotten us into an epidemic of overweight
and obese problems," said Sen. Jeff Bingaman, who is sponsoring
the bill along with Connecticut Democrat Christopher Dodd and
Tennessee Republican Bill Frist, the first medical doctor in
the Senate since 1928.
The Improved Nutrition and Physical Activity Act, IMPACT, proposes
to give health professionals more training on weight issues,
fund new parks, bike paths and recreational centers and provide
more money for already-existing exercise and nutrition programs
in US schools.
The bill would spend more than $200 million to fund new and
existing programs.
"This was the result of concern that all of us have shared
about the rising incidence of obesity among children, and adolescents,"
Bingaman, a New Mexico Democrat, told Reuters in a recent interview.
In the United States, over 34% of people are overweight and
50 million Americans, 27%, are considered obese, according to
the National Institutes of Health ( news
- web
sites).
Obesity is determined by body mass index (BMI), a calculation
that takes into account a person's height, weight and age. According
to the US Surgeon General's guidelines for adults 20 years or
older, a six-foot tall adult 20 years or older with a weight
of 140 to 180 lbs. would be considered healthy, 190 to 210 lbs.
overweight and 200 lbs. or more obese.
The Surgeon General's report on weight released last December
said that the number of overweight adolescents has tripled over
the past two decades. Former Surgeon General David Satcher,
who issued the report, said children are weighing more because
they are eating higher-fat, lower-nutrition food and exercising
less.
Bingaman said he is also co-sponsoring a bill with Vermont
Democrat Patrick Leahy that would try to limit the sale of soft
drinks and other junk food in schools during mealtime.
Texas and California have already proposed legislation that
would also limit the sale of snacks in schools.
A Good Start
Food industry groups, who have fought those efforts and the
numerous lawsuits that have been filed against the fast food
industry recently, applauded the bill as a "good start."
"It falls in line with a lot of other organizations and
people in the food industry are recommending--promotion of exercise
and a balanced diet," said Mike Burita, a spokesman for
the Center for Consumer Freedom, which represents 30,000 restaurants
and food and beverage suppliers across the country.
But the bill has raised the ire of others who said lawmakers
have succumbed to an overblown "obesity hysteria."
"We're fat by choice, not because we're stupid or ignorant.
Some of us enjoy stuffing our faces with double-burgers, extra
cheese," wrote Sam Ryan in a Chicago Tribune editorial
published on Friday.
"We know that fruits and vegetables are healthier for
us than ice cream and Cheetos. And we don't need some million-dollar
public awareness program to tell us so. We'd rather use that
taxpayer money to super-size our Happy Meals."
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A
Sunny Outlook on Aging Lengthens Life
By Robert Preidt
HealthScoutNews Reporter
HealthScoutNews
Monday, July 29,
2002
MONDAY, July 29 (HealthScoutNews) -- Starting to notice a few
gray hairs? Don't worry, be happy.
A positive attitude about aging may actually help you live
longer. On the other hand, if you have a tarnished view of your
golden years, you may cut your life short, says a study in the
August issue of the Journal of Personality and Social Psychology
( news
- web
sites).
The study found that older people with positive self-perceptions
of aging lived 7.5 years longer than people with negative self-perceptions
about getting older.
That negative attitude may shorten your life by affecting your
will to live, says lead author Becca R. Levy, an assistant professor
of epidemiology and public health at Yale University.
Levy says she wasn't surprised by this study's finding that
aging self-perception affects a person's lifespan. Her previous
research indicated that's the case. But she hadn't expected
to find such a significant impact.
The study included 660 people (338 men and 322 women) from
a small Ohio town who in 1975 gave responses to questions asked
as part of the Ohio Longitudinal Study of Aging and Retirement.
At the time they gave their responses, all the people were 50
or older. They were asked to agree or disagree with statements
such as, "As you get older, you are less useful."
"In this study, we did a snapshot of their perception
of aging," Levy says.
She and her co-authors compared the participants' responses
to their death rates over the past 23 years and found that people
with more positive attitudes toward aging had 7.5 years higher
longevity.
That finding takes into account other factors such as age,
gender, overall health, loneliness, and socioeconomic status.
While the effect of negative attitudes about aging on the will
to live does have an impact on longevity, it isn't the only
influence, Levy says. Her research indicates that those negative
stereotypes of aging may also have an adverse influence on older
people's cardiovascular response to everyday stress.
Where do we get these pessimistic thoughts about growing old?
Levy says we pick them up from society and we may not even
be aware it's happening.
"Stereotypes of aging are probably internalized in childhood
or adulthood and carried through into old age," Levy says.
She suggests people consciously challenge gloomy views about
aging.
"I think older adults can think about ways to question
some of the negative stereotypes that they encounter in everyday
life. I think there is reason to believe that that may have
a positive impact over time," Levy says.
A leading psychologist who promotes mental and emotional health
as a key to longevity praised the research, even if he didn't
find the conclusion earth-shattering.
"I think the study was very well-defined and very well
done," says Michael Brickey, author of the book Defy
Aging. "I don't find the results all that surprising.
To me, they kind of fit with common sense."
Brickey says the findings remind him of research on optimism
by University of Pennsylvania psychology professor Martin E.P.
Seligman.
"He found that optimists live longer, healthier, happier,
they're more successful, they earn more money -- on and on,"
Brickey says.
The study's focus on the connection between the will to live
and longevity impressed Brickey.
"It's what I'd normally call sense of purpose in life.
I think that having a sense of purpose is one of the real keys,
and it's become trickier and trickier," he says.
Fifty years ago, the typical American grew up and lived his
entire life in the same town, stayed married to one person,
and worked for the same company until he retired.
"There weren't as many choices and options. Now, we have
so much change and so much choice that it's easy to lose your
footing," Brickey says. "So we need to periodically
take a look at our sense of purpose and make sure that we haven't
lost our footing."
Brickey suggests negative stereotypes of aging can be countered
by promoting role models of vital, active older people and by
encouraging people to blaze their own trails as they grow older
instead of succumbing to negative ideas and expectations.
What To Do
To help keep your outlook positive, Michael Brickey offers
36
defy-aging beliefs. Older Americans can find information
about health and wellness at the AARP.
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Football
Deaths May Be Linked to Supplements
By Suzanne Rostler
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - A surge in the use of two popular
dietary supplements over the past 7 years may have helped to
fuel the rate of death from heatstroke among professional football
players, according to a team of scientists.
Ephedrine, sold as a weight-loss supplement and energy enhancer;
and creatine, promoted to build muscles, can both increase the
risk of dehydration, particularly during the hot summer season.
Campaigns to raise awareness about the dangers of dehydration
helped to reduce deaths from heatstroke among American football
players in recent years. Six athletes died of heatstroke between
1985 and 1994, compared with 44 between 1965 and 1974. But 15
deaths from heatstroke were recorded between 1995 and 2001--all
during the summer pre-season period, researchers report in the
August issue of Neurosurgery.
"Dehydration and programmed drinking and electrolyte replacement
are all appreciated among athletes and coaches," Dr. Julian
Bailes, the article's lead author and chairman of neurosurgery
at West Virginia University in Morgantown, said in an interview
with Reuters Health.
"So the most obvious thing to us is changes in athletes'
behavior, and there is no bigger change that we're aware of,"
said Bailes, who also works as a health consultant to the National
Football League Players Association.
The popularity of ephedrine has spurred the National Football
League (NFL) and the National College Athletic Association (NCAA
( news
- web
sites)) to ban the use of these products. Professional players
who are found to be taking ephedrine or pseudoephedrine, found
in over-the-counter cold remedies, can be suspended for four
games during the 2002 football season.
Nonetheless, many athletes continue to take ephedrine and related
compounds to get an edge over their competitors.
"There is a lot of pressure to comply with what everyone
else is doing, to get a competitive edge," Bailes explained.
He said studies have shown that more than 70% of college athletes
and up to 50% of high school athletes are taking some type of
performance-enhancing supplement, including steroids. These
figures may actually be higher, he said, since they are based
on numbers of athletes who admitted to taking supplements.
Ephedrine, also known as Ma-huang or "herbal energy,"
has amphetamine-like effects and has been linked to a series
of deaths among both athletes and regular people trying to shed
a few pounds.
The compound stimulates the central nervous system and causes
an increase in heart rate. However, it can also raise the body's
core temperature and lower the ability to sweat--the body's
cooling mechanism. What's more, the energy-boosting effects
of ephedrine can mask signs of fatigue and dehydration, causing
an athlete to push on.
Creatine monohydrate is marketed as an energy enhancer and
muscle-building supplement, but its purported effects have not
been backed up by scientific studies. The supplement may also
cause a shift in body fluid to muscles from the blood, increasing
the risk of dehydration, especially when the risk is already
high, such as during the summer.
Indeed, there have been several reports of diarrhea, muscle
cramps and heat intolerance among athletes who took creatine,
Bailes and colleagues note.
The report is based on a review of data from the National Center
for Catastrophic Sports Injury Research, a group that issues
annual reports on deaths and injuries from amateur and professional
sports.
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Study:
Retiring drivers lack alternatives
From the Science & Technology
Desk
United Press International
Monday, July 29, 2002
BETHESDA,
Md., July 29 (UPI) -- Older people in America are driving longer
than ever before, but a new study suggests men and women who
give up driving might have to depend on alternative transportation
for a decade or more.
According
to the study, by the National Institute on Aging, hundred of
thousands of older people quit driving voluntarily each year
in the United States. This requires them to rely on alternative
transportation, which "can create unforeseen economic and
social burdens that need to be addressed in the same way we
have encouraged people to think about planning for retirement
and end-of-life care," said Dan Foley, the study's lead
author.
"I
think it leaves us with the need to understand that older people's
demand for alternative transportation can't be confined to the
bus or the subway," Foley told United Press International.
"We must encourage community-based organizations, such
as church groups, to pull together to meet the needs of their
elder members who have given up driving but still require transportation."
The
problem, Foley explained, arises from the fact that although
elder drivers begin to stop driving in their seventies, those
who reach that age range can expect to live another 14 years
to 20 years, depending on gender.
Foley
and colleagues analyzed data collected in 1993 and 1995 by a
previous NIA-supported study. It involved a nationwide sample
of people ages 70 or older and included 4,996 men and women
who were able to drive and had access to a car. These drivers
represented statistically the 13.7 million Americans aged 70
or older who were driving at the time. Overall, 82 percent of
men and 55 percent of women in this age group drove that year.
Within the group, driving declined with age, ranging from 88
percent of men in their early 70s to 55 percent of those 85
or older. Among women, about 70 percent drove in their early
70s compared with 22 percent still driving at age 85 or older.
By
1995, the figures showed, 7 percent of the drivers had died.
Another 9 percent were alive, but had quit driving for other
reasons. The findings suggest more than 600,000 people ages
70 or older stop driving each year and become dependent on others
to meet their transportation needs. About 400,000 older drivers
die of all causes annually. Poor vision, memory impairment and
an inability to perform daily living activities were common
reasons older people stopped driving.
"Driving
skills are dependent on three areas of wellness: physical fitness,
thinking clearly and seeing well," Foley said. "Whether
a person can continue driving hinges on the severity of the
disability or functional loss in one or more of these three
areas. Over time, people seem to reach thresholds where they
believe they can no longer safely drive."
The
analysis showed the average number of years a person continued
to drive was significantly less than overall life expectancy,
Foley said. Men and women who still drove at ages 70 to 74 were
expected to drive, on average, another 11 years. But these men
were expected to live about 17 more years, and the women nearly
21 more years. Therefore the gap between driving expectancy
and overall life expectancy means men in this age group who
stopped driving could be dependent on alternative transportation
for an average of six years. For women, the gap translated into
about 10 years dependence on other transportation modes.
At
age 85, those still driving had a driving expectancy of about
two years. But even at this age, men would have four non-driving
years of life remaining and women nearly six years. Researchers
found no differences in driving expectancy between urban and
rural areas.
"Driving
has an essential role in helping older men and women live independently,
Foley said. "However, with age, a person's competence and
confidence behind the wheel may erode to the point that quitting
becomes an unfortunate necessity and dependence on other means
of transportation becomes an inevitable reality. If we, as a
society, fail to take steps to help older people prepare for
and cope with this transition, then the goal of improving the
quality of life in old age will be greatly compromised, both
now and in the foreseeable future."
Audrey
Straight, a project manager at the American Association of Retired
Person's Public Policy Institute in Washington and a specialist
in senior transportation issues, said the standard measure of
mobility among seniors is the number of trips they make away
from their homes.
In
a recent report by AARP on senior mobility, Straight and colleagues
found a considerable drop in trip making by age 75. "This
reduction in the number of trips may indicate social isolation
and an inability to maintain independence," she said. "However,
little research has been done on how older persons themselves
perceive their transportation options or the reduced mobility
that accompanies old age."
The
report found the median number of trips by older drivers is
three times that of older non-drivers. "Regardless of age
or sex, older drivers report taking more trips than older non-drivers,"
the report said.
The
NIA study appears in the August 2002 issue of the American Journal
of Public Health.
(Reported by Phil Berardelli, UPI Deputy Science
& Technology Editor, in Washington)
BACK
TO TOP
Drug
Suggests Promist for Heart Failure
From the Science & Technology
Desk
United Press International
Monday, July 29, 2002
NEW
YORK, July 29 (UPI) -- A new type of drug to treat heart failure
is more effective than a current common medication because it
also improves blood pressure levels, an international study
to be released Tuesday suggests.
Dr.
Milton Packer, of Columbia University's College of Physicians
and Surgeons, and colleagues compared the effects of the new
drug omapatrilat to those of a drug called enalapril, one of
a standard class of heart failure drugs called ACE inhibitors.
Enalapril works by blocking the body's angiotensin-converting
enzyme, which breaks down protein components called peptides
that benefit heart function. Omapatrilat also blocks the angiotensin-converting
enzyme, but it also blocks NEP, another enzyme that breaks down
heart-benefiting peptides.
In
the study, 5,770 heart failure patients at 704 institutions
in 42 countries were assigned randomly to receive either omapatrilat
or enalapril. The average age of each group was 63 and about
80 percent of the study group was male. Researchers evaluated
patients every one month to four months for an average of 14.5
months to see how the treatment was doing.
The
results showed 914 patients died or were hospitalized for serious
heart failure among the omapatrilat group compared to 973 patients
in the enalapril group -- a 6 percent difference. However, researchers
said, further evaluation showed in some cases omapatrilat worked
better than enalarpil because patients with both hypertension
and heart failure showed greater improvements from omapatrilat.
They said omapatrilat's dual action against the two damaging
enzymes and its benefits in lowering blood pressure appear to
be the key.
Enalapril
patients also were more likely to experience declining heart
and kidney function. Angioedema -- severe swelling of the neck
and head that can cause breathing problems -- occurred in both
groups, though this side effect was rare, researchers said,
and never serious.
"Obviously
these are interesting results and it seems because of dual action
of the medication, the study suggests (omapatrilat is) beneficial
to patients who have a combination of high blood pressure and
heart failure," Dr. Nieca Goldberg, chief of cardiac prevention
and rehabilitation at Lenox Hill Hospital in New York and a
spokeswoman for the American Heart Association, told United
Press International. "But you have to caution that this
particularly needs further study."
Not
everyone agrees omapatrilat is promising, however.
Dr.
Christopher Granger, director of the cardiac care unit and a
professor at Duke University Medical School in Durham, N.C.,
said 6 percent is too small a figure to indicate omapatrilat
could have more to offer than standard ACE inhibitor drugs.
"There
did look like there was a small benefit, but the primary endpoint
did not reach statistical significance and therefore it was
disappointing," Granger told UPI. "This is a good
example of a drug that had tremendous enthusiasm that might
be a real breakthrough ... there's now even less enthusiasm
than there were even a few weeks or a few months ago."
Granger
added, "I don't think the class of (this) drug is dead,
but it certainly is a setback." Proving this drug's promise
is "more now in a salvage mode."
The
findings were fast-tracked to be published in the July 30 issue
of Circulation, a journal of the American Heart Association.
Dr. Packer was unavailable for comment.
(Reported
by Katrina Woznicki, UPI Science News, in Washington)
BACK
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Med
Students May Be Tested for Bedside Manner
The HealthScout
News Service
Monday, July 29,
2002
If you think your doctor lacks any bedside manner, take solace
in knowing that your children or grandchildren may be more fortunate.
A pilot program that essentially has med students "playing
doctor" with pretend patients may soon be a requirement
for a medical license, reports the Associated Press.
The clinical skills program is being tested at three Philadelphia
hospitals, and other cities are likely to follow. The National
Board of Medical Examiners could make the program a licensing
requirement as early as 2004, the AP says.
The American Medical Association (AMA), however, says the current
$1,000 price tag plus any travel expenses may be too steep for
already overburdened medical students to afford. The AMA has
asked the board to hold off on making the test a requirement
until the effectiveness of the test is proven and published
in a peer-reviewed medical journal. Presumably by then, the
price would also come down.
Some medical schools already have a clinical skills test, but
the pilot program would set a national standard, according to
experts quoted by the AP. Such a test was once required
nationwide for a medical license, but the test was dropped in
1964 amid questions about its reliability.
BACK
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Whole
Grains Can Help Cut Insulin, Cholesterol
By Suzanne Rostler
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - Whole-grain foods, such as fiber-rich
bread and bran cereal, may lower the risk of heart disease,
type 2 diabetes and certain types of cancer by reducing cholesterol
and making the body more responsive to insulin, researchers
suggest.
In their study of close to 3,000 middle-aged adults, these
foods were associated with lower levels of total cholesterol
and LDL (the so-called "bad" cholesterol) and improved
insulin sensitivity. Insulin, the body's key blood-sugar-regulating
hormone, tends to be elevated in those at risk of type 2 diabetes.
People who consumed the most whole-grain foods also had a lower
body mass index (BMI), a measure of weight in relation to height
that is considered a more reliable gauge of overweight than
weight alone. Indeed, adults who were overweight or obese had
the highest insulin levels and consumed the least amount of
whole-grain foods, researchers report in the August issue of
the American Journal of Clinical Nutrition ( news
- web
sites).
The findings help to explain how whole-grain foods may protect
against several chronic disorders and point to the importance
of including several daily servings of these foods in the diet.
Current dietary guidelines recommend about nine daily servings
of carbohydrates for adults, mostly in the form of whole-grain
foods.
However, more research is needed into how carbohydrates affect
insulin levels and obesity and the subsequent risk of type 2
diabetes and heart disease, Dr. Paul Jacques, the study's lead
author, told Reuters Health.
Some health experts blame America's obesity epidemic on carbohydrates,
pointing out that rates of obesity have risen in tandem with
carbohydrate consumption over the past 30 years. Others argue
that whole-grain foods, which are high in fiber, vitamin E and
magnesium, do not have the same effect on insulin as refined
carbohydrates that have been stripped of many nutrients.
"The importance of understanding the role of different
carbohydrate sources in the development of insulin resistance
is becoming even more critical because Americans appear to be
increasing their intake of dietary carbohydrates," Jacques
explained.
"Our results suggest that higher whole-grain intakes might
help prevent development of insulin resistance, and the influence
of whole grains may be strongest in those who are overweight
and have the greatest risk of insulin resistance," he said.
The researchers analyzed detailed dietary information and blood
samples from study volunteers over a 4-year period, and divided
individuals into four groups according to their intake of whole-grain
foods. Those with the highest intake of whole grains also tended
to have healthier lifestyle habits such as moderate alcohol
and meat consumption, not smoking, taking a multivitamin pill
and eating lots of fruits and vegetables.
Source: American Journal of Clinical Nutrition 2002;76:390-398.
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Infected
Moms May Transmit H. Pylori to Children
Reuters Health
Monday, July 29,
2002
NEW YORK (Reuters Health) - Children whose parents are infected
with Helicobacter pylori (H. pylori), the bacterium associated
with stomach ulcers, have a higher risk of becoming infected,
according to German researchers.
Their study shows that the risk of infection among a group
of children aged 5 to 7 years rose fourfold when the mother
was infected and increased twofold when the father was infected.
While the precise route of transmission is still unclear, the
findings support previous research demonstrating that H. pylori-infected
mothers are a major risk factor for H. pylori during childhood,
when most people tend to be infected.
"This makes sense given that the peak incidence of the
infection seems to occur during the first few years of life
when the mother has closer contact to the child than the father
in most societies," Dr. Dietrich Rothenbacher from the
German Center for Research on Aging in Heidelberg, Germany,
and colleagues write.
"Whether the route of infection is oral-oral, gastro-oral
or fecal-oral, however...must be determined by further research,"
they add.
The researchers screened 305 schoolchildren for H. pylori using
a breath test, and they measured antibodies for the bacterium
in the saliva of their parents. Parents were also interviewed
about living conditions, economic status and demographic factors.
About 10% of children were infected overall, according to the
report in the July issue of the Pediatric Infectious Disease
Journal. Nearly 42% of mothers and 28% of fathers were infected.
A child's gender, the number of siblings and the parents' education
were not associated with increased risk of infection among children.
However, children who lived in crowded homes and had not used
antibiotics in the past were more likely to be infected, the
investigators found.
"This study strengthens previous evidence that infected
parents, especially infected mothers, play a key role in transmission
of H. pylori to the child," Rothenbacher and colleagues
conclude.
Source:
Pediatric Infectious Disease Journal 2002;21:674-679.
SUNDAY,
JULY 28 , 2002
BACK
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Enzyme
Works as 'Tool Kit' to Repair Gene Damage: Study
The HealthScout
News Service
HealthScout News
Sunday, July 28,
2002
Mutated genes can be
the culprits behind diseases ranging from cancer and cystic
fibrosis to hemophilia, but British researchers say they've
identified a natural enzyme that appears to correct such mutations.
Laboratory tests show that mice that lack the enzyme, called
MBD4, are as much as three times more likely to have gene mutations,
reports the BBC.
While environmental factors like smoking and exposure to sunlight
can cause genetic mutations, as many as one in three disease-causing
mutations occur naturally when the body tries to prevent genes
from over-producing by shutting them down.
But
in the study, published in the journal Science, the researchers
say the MBD4 enzyme represents a "tool kit" the body
uses to repair damage to genes, and without part of that tool
kit, the risk of diseases such as cancer increases.
BACK
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Growing
Your Own Cartilage
HealthScout News
Sunday, July 28,
2002
SUNDAY, July 28 (HealthScoutNews) -- A new cartilage repair
technique developed by Massachusetts Institute of Technology
( news
- web
sites) (MIT) engineers could offer significant advantages
over the current method used to treat people disabled by osteoarthritis,
sports injuries and other accidents.
In this new procedure, cartilage cells are grown in a special
gel. Once the cartilage cells have "seeded" in the
gel, the gel is placed in the damaged joint. The MIT researchers
believe the cells will grow and integrate with the normal cartilage
and the gel will slowly degrade.
Their research appeared in a recent online edition of Proceedings
of the National Academy of Sciences ( news
- web
sites).
The technique hasn't been tested on animals, but the MIT researchers
say their engineered cartilage has mechanical and biochemical
properties similar to natural cartilage.
Only one procedure to repair defective or damaged cartilage
has U.S. Food and Drug Administration ( news
- web
sites) approval. In the approved method, cartilage cells
are taken from a person and made to multiply. These new cells
are then implanted back into the area of damaged cartilage.
But the MIT researchers say this is expensive -- about $30,000
-- and doesn't lead to the generation of true articular cartilage.
They say their cartilage gel method could be implanted using
a small external incision. That kind of surgery is less expensive
and reduces patient recovery time.
More information
To learn more about cartilage disorders, visit the U.S. Government's
MEDLINEplus
health database.
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Virtual
Doctor Visits Are a Virtual Reality
By Felicity Stone
HealthScoutNews Reporter
HealthScout News
Sunday, July 28,
2002
SUNDAY, July 28 (HealthScoutNews) -- Heart patients with implantable
cardioverter defibrillators (ICDs) now only need to pick up
the phone for a check of their lifesaving device.
New technology has made "virtual office visits" an
option for the 200,000 Americans with ICDs. Instead of making
the standard three monthly trips to their doctors, they can
relay information about their defibrillators via phone lines.
ICDs are mechanical heart aids ( news
- web
sites) prescribed for people who suffer abnormally rapid
and potentially life-threatening heart rhythms.
The device is implanted under a patient's skin in the upper
chest area and when an irregular rhythm is detected, the ICD
administers an electric shock that returns the heart to its
normal rate.
With a "virtual office visit," doctors retrieve and
review their patients' defibrillator data via the Internet.
The transmitted data provides readings on the device's mechanics
and how a patient's heart has functioned since the last check-up.
"I think at some point this will become the standard way
to follow defibrillators," says Dr. Ken Riff, a physician
with Medtronic Inc., the company that developed the technology.
While the system won't make office visits obsolete, Riff predicts
it will decrease them: "We anticipate doctors seeing patients
once a year, with in-between visits done over the Internet."
The new technology means almost everything that takes place
during a face-to-face ICD consultation can occur even when the
doctor and patient are miles apart.
Here's how it works: Patients collect information by holding
a cell phone-like wand over their defibrillator. The wand is
wired to a monitor plugged into a standard home phone line.
Once the monitor receives the information, it automatically
dials up the Medtronic CareLink Network and sends the data.
It takes about 10 minutes from the time the wand scans the implant
until the readings appear.
By logging on with a secure password, doctors and nurses can
read patients' data off the system's Web site.
The system has been running for about six weeks. People who
are already hooked up have been advised to prearrange times
for their cyber check-ups, Riff says: "They can't merely
transmit the information because the doctor may not pick it
up for a while."
According to Dr. Masood Akhtar, a physician with Wisconsin
Electrophysiology Group Heart Care Associates in Milwaukee,
certain problems will make some office visits unavoidable.
"If the data tells you the patient got two or three shocks
because the first one didn't work, you may want to increase
the energy for the first shock. There are multiple things you
may have to do depending on what information you get, but you
have to reprogram the device in the office," he says.
Although the technology for remote programming is available,
"until everyone's comfortable it can be done remotely,
we won't do that," Riff says. "We first have to build
up patients' and doctors' confidence in the system."
Akhtar believes patients will welcome this development, especially
those who travel long distances for check-ups. Still, he adds,
technology will never replace the gut feeling a doctor gets
when he sees a patient personally.
"When people come in they might not volunteer information,
but when you look at them they appear pale and unwell. You won't
pick that up by remote control," he says.
What To Do
To learn more about the remote monitoring of ICDs, visit Medtronic
Inc. For more information on heart arrhythmias, go to National
Heart, Lung, and Blood Institute.
SATURDAY,
JULY 27, 2002
BACK
TO TOP
First
W. Nile Case Found in S.D.
The Associated
Press
Saturday, July
27, 2002
SIOUX FALLS, S.D. (AP) - A dead crow was found infected with
the West Nile virus ( news
- web
sites) in South Dakota, the farthest west the disease has
been detected, officials said Friday.
The bird was found Monday in Aberdeen in northeastern South
Dakota, said Dr. Lon Kightlinger, state epidemiologist. The
virus has now been detected in 32 states and the District of
Columbia.
The virus is transmitted by mosquitos. Since its detection
in New York City in 1999, more than 150 people have been infected
with the virus and 18 have died nationwide, according to the
Centers for Disease Control and Prevention ( news
- web
sites).
The virus has spread south and west over the past three years.
Authorities advise people to use mosquito repellent and wear
long-sleeved clothes.
On the Net:
Centers for Disease Control West Nile virus page: http://www.cdc.gov/ncidod/dvbid/westnile
BACK
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Wine,
Cheese and a Bit of Botox
By Jennifer Thomas
HealthScoutNews Reporter
HealthScoutNews
Saturday, July
27, 2002
SATURDAY, July 27 (HealthScoutNews) -- Remember when Tupperware
was all the rage for themed get-togethers at home?
Oh, how times have changed.
Hip hostesses today are inviting their closest friends over
for Botox injections.
Ever since the U.S. Food and Drug Administration ( news
- web
sites) approved the toxin's use for certain cosmetic procedures
this spring, Botox parties have become a big hit in many parts
of the nation. Doctors offer their services in homes for groups
of mainly women, who make the occasion festive with hors d'oeuvres
and chardonnay.
However, the trend is causing some physicians to furrow their
own brows with worry. They warn the procedure should be taken
more seriously. Not only can there be unwanted side effects
from poorly done Botox injections, doctors are walking a fine
line of medical ethics, critics contend.
"It heralds a real degeneration of ethics in medicine,"
says Dr. Lisa Donofrio, an assistant clinical professor of dermatology
at Yale University School of Medicine. "What's next? At-home
liposuction? If we don't draw the line, this could become more
and more pervasive until patients are really being put at risk."
Botox is no mere anti-wrinkle cream. Botulinum Toxin Type A
-- popularly known as Botox -- is derived from the bacterium
that causes the illness botulism. For the cosmetic procedure,
small doses of Botox are injected into a facial muscle, blocking
the nerve impulses that cause the muscle to contract.
By essentially paralyzing the muscle, Botox can decrease the
appearance of wrinkles around the eyes and forehead. The American
Society of Plastic Surgeons estimates 1.6 million Botox procedures
were done last year, making it the No. 1 non-surgical cosmetic
procedure performed in the United States.
To solicit clients, some physicians are sending out invitations
advertising the Botox party concept. A Botox treatment on one
area of the face typically involves four to 15 injections and
costs from $300 to $600, although some doctors offer group rates
for women at parties. The effect lasts about three months.
While Botox injections at home are becoming more common, many
plastic surgeons and dermatologists refuse to do them anywhere
than their medical office.
"When you take something out of the office setting, you're
setting yourself up to be more casual and less safe," says
Dr. Melanie Grossman, a clinical assistant professor of dermatology
at Columbia University in New York City. "And I would never
mix alcohol with any medical procedure."
In rare cases, people can faint at the sight of a needle or
have a dangerous allergic reaction to the procedure, she says.
Only a physician can legally buy Botox. However, Donofrio says
she knows of cases in which physicians buy it, and then permit
nurse practitioners and even medical assistants to do the injections.
"They're using their office as a money-making factory,"
Donofrio says.
For example, she says, spas often have a medical director.
However, the doctor may rarely be there and, instead, medical
assistants do the injections.
Improperly done, Botox injections can cause partial facial
paralysis and drooping eyelids.
Some plastic surgeons have different reasons for objecting
to the Botox-and-brie trend.
Botox is being over-hyped as a cure for facial wrinkles, says
Dr. Gustavo Colon, chief of the division of plastic surgery
at Ochsner Clinic Foundation in New Orleans.
"Botox is not the end all be all," Colon says. "It's
just one more arrow in the quiver of rejuvenation. The ultimate
thing to remove facial lines and wrinkles is surgical procedures
such as face-lifts. It's the only thing that will correct sagging
skin and take away lines."
"For facial wrinkles around the mouth, Botox won't work,"
Colon adds. "It only works in certain areas of the face,
and is only good for some people. A woman who comes in with
a lot of wrinkles and a lot of sagging skin, she may not be
a good candidate for Botox."
Donofrio says patients should carefully check the credentials
of the physician doing the injections, and receive an individual
evaluation before the procedure. People with certain neurological
disorders should not receive Botox injections, she adds.
What To Do
To read more about Botox and to see before-and-after pictures,
visit Dermnet.
Or read this American
Academy of Dermatology Patient Alert that includes questions
to ask before you have the procedure.
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Lactose
Lore
HealthScoutNews
Reporter
HealthScoutNews
Saturday, July
27, 2002
SATURDAY, July 27 (HealthScoutNews) -- Too many people are
having a cow about lactose intolerance and needlessly avoid
dairy products, says a new poll sponsored by McNeil Nutritionals,
maker of the lactose supplement Lactaid.
The poll of 1,088 adults finds that while a majority of Americans
claim to know about lactose intolerance, more than half mistakenly
believe the only way to deal with the condition is to shun all
dairy products.
Perpetuating myths like these means that Americans often wind
up depriving themselves of the health benefits of dairy products,
says Laura Brainin-Rodriguez, a nutritionist for the San Francisco
Department of Public Health ( news
- web
sites).
"Dairy in the diet is essential to fend off osteoporosis
and possibly other diseases," she says.
The survey found that 81 percent of respondents say they know
what lactose intolerance is and 57 percent believe that a person
with lactose intolerance can't consume any dairy products. Only
31 percent correctly answered that lactose intolerance and difficulty
digesting dairy products are synonymous.
Lactose intolerance affects 3 out of 10 Americans, including
50 percent of Hispanics, 80 percent of blacks and more than
90 percent of Asian Americans.
The condition occurs when a person doesn't produce enough of
the lactase enzyme needed to digest milk sugar (lactose). It
can cause bloating, cramps, gas or diarrhea.
Brainin-Rodriguez says the symptoms can be controlled without
having to give up dairy products. Here are some tips:
·
Consume small amounts of dairy products several hours apart.
- Eat other foods along
with those that are milk-based.
- Choose hard or aged cheeses,
like cheddar or Swiss. They contain less lactose than other
cheeses.
- Choose yogurt with active
cultures. These active cultures contain enzymes that digest
lactose on their own.
- Use lactose-free milk
and supplements, which make lactose easier to digest.
More information
For details about lactose intolerance, visit the National
Digestive Diseases Information Clearinghouse.
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Nuts
Over Pecans
HealthScoutNews
Reporter
HealthScoutNews
Saturday, July
27, 2002
SATURDAY, July 27 (HealthScoutNews) -- Feel free to go nuts
for pecans.
University of Georgia (UGA) researchers say pecans are a consistent,
rich source of the antioxidant vitamin E, no matter where they're
grown in the United States.
"This study helped to demonstrate that basically all pecans
are created equal when it comes to this important antioxidant,"
says study author Ron Eitenmiller, a food scientist at the UGA
College of Agricultural and Environmental Sciences.
He analyzed pecans grown in two different years in several
states, finding that their vitamin E content was stable, regardless
of the year, variety or region. The study was published in the
latest issue of the Journal of Food Science.
Eitenmiller says pecans have both the alpha and gamma tocopheral
forms of vitamin E. The alpha form has been most studied for
its health benefits but the gamma form is now also receiving
close scrutiny.
"Vitamin E is the primary antioxidant we use. It protects
our bodies when chemical reactions produce oxidation in the
body, which can be dangerous. Antioxidants, in essence, serve
as a tool that inhibits oxidative stress that can be detrimental
to many cellular functions," Eitenmiller says.
But humans don't make their own vitamin E, so we have to get
it from plant sources. They include: pecans and other tree nuts
such as walnuts, cashews, almonds and pistachios; peanut products;
and liquid vegetable oils.
Vitamin E isn't the only benefit offered by pecans. They're
a good source of fiber and contain more than 19 vitamins and
minerals. They may even be good for your heart.
Now for the bad news. While pecans themselves are beneficial,
there's nothing here that says you can actually consider pecan
pie a health food.
More information
For details on the health benefits of pecans, visit Texas
A&M University.
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Study
Links Autism with Smoking in Early Pregnancy
HealthScoutNews
Reporter
HealthScoutNews
The HealthScout
News Service
Saturday, July
27, 2002
A new report shows that women who smoke regularly during the
early stages of pregnancy can increase the risk of their child
developing autism by as much as 40 percent.
The findings, published in the journal Epidemiology,
come from a Swedish study of more than 2,000 children.
The researchers, with the Karolinska Institutet, in Stockholm,
note that previous research on animals has shown that exposure
to nicotine while in the womb can cause physical and behavioral
effects and that smoking in early pregnancy is known to influence
fetal grown and a child's birthweight.
Still, the researchers say they were surprised to see smoking
in early pregnancy as an independent risk factor for autism,
which has not been seen before, reports the BBC.
Autism is a developmental condition that can cause learning
disabilities and adversely affect how people communicate and
interact with others.
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Meat
Recall Delay Jeopardized Public, Lawmakers Charge
HealthScoutNews
Reporter
HealthScoutNews
The HealthScout
News Service
Saturday, July
27, 2002
Thousands of consumers were exposed to potentially deadly bacteria
because the Agriculture Department was slow to investigate evidence
that tainted meat had entered the U.S. marketplace, which possibly
contributed to some illnesses, members of Congress said yesterday.
Though federal law requires daily inspections, there was an
almost-100 day lapse between the time ConAgra Beef meat was
found to be contaminated with E. coli in mid-April and
last week, when the department announced the second-largest
meat recall in U.S. history, Democrats in the House and Senate
said.
"The long delay between contamination and recall is striking,"
the Democrats, including Sen. Richard J. Durbin of Illinois
and Rep. Henry A. Waxman of California, wrote in a letter to
Agriculture Secretary Ann M. Veneman.
According to The New York Times, the lawmakers characterized
the delay as a "red flag for our nation's food safety system."
The criticism was issued as the scope of the E. coli outbreak
continued to expand. At least 28 people in seven states have
fallen ill from the meat, 9 more than initially reported when
the 19-million-pound recall was announced, the Times
reports. Seven people have been hospitalized.
Meanwhile, Colorado state officials confirmed that prison inmates
had been fed ground beef that authorities knew had been recalled.
Department of Corrections officials say the reason why hundreds
of inmates were fed the estimated 2,500 pounds of meat was because
they felt that by properly cooking and serving the meat, it
could be safely consumed, reports the Associated Press.
There were no reports of any of the inmates becoming ill after
eating the beef. The meat was reportedly served to prisoners
and possibly some guards at the Buena Vista Correctional Complex,
the Delta Correctional Center and the Rifle Correctional Centers,
all state prisons.
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