The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
July 3, 2003




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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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

Personal Health for the Week of April 26 - May 2

FRIDAY, MAY 2, 2003

  1. GNC Says It Will Stop Selling Ephedra
  2. 'White-Coat' Hypertension Not Often a Major Concern
  3. Asthma Now Afflicts 15 Million Americans
  4. Better Working Conditions May Improve Patient Care
  5. Erectile Dysfunction Linked to Heart Disease
  6. Study: New Way to Help Predict Pregnancy Problems
  7. Study Sheds Light on Possible Causes of Preeclampsia
  8. Study Shows Women 50-64 at High Fracture Risk, Too
  9. Not All Sunscreens Are Created Equal

    THURSDAY, MAY 1, 2003

  10. Supplemented Formula Helps Blood Pressure
  11. Studies Revive Colon Cancer Diet Theory
  12. Thalidomide May Carry Dementia Risks: Case Report
  13. Study: Chemical May Improve Aging Brains
  14. Pesticides Linked with Prostate Cancer in Farmers
  15. Estrogen Has Healing Powers

    WEDNESDAY, APRIL 30, 2003

  16. Soy Compound Shows Promise for Menopause Symptoms
  17. Bright Light May Boost Testosterone in Men
  18. Soy Extract Helps Some Prostate Cancer Patients
  19. Investigators Question Ephedra Complaints
  20. Annoying Viruses Turn Deadly in Cancer Patients
  21. Low-Fat-Diet Guru Swims Against Swelling Tide
  22. New Pneumonia Vaccine Showing Results
  23. Annoying Viruses Turn Deadly in Cancer Patients
  24. Gene Variation Can Boost Risk of Diabetes, Thyroid Problems
  25. Freezing Shrinks Fibroids, Avoids Surgery
  26. Eat What You Watch

    TUESDAY, APRIL 29, 2003

  27. Fever Takes a Bath
  28. U.S. Health Experts Call for Focus on Minority Men
  29. Breast Cancer Screening Found Effective
  30. Regular Fasting Seems to Improve Health
  31. New Test May Help Hepatitis B Patients
  32. Men Don't Fully Understand Prostate Cancer Test
  33. Shorter Life Span for Men Called Crisis
  34. Rocket Fuel Component in U.S. Lettuce: Study
  35. Young People Skipping Sunscreen
  36. U.S. Says Preventable Injuries Serious Health Threat
  37. Elective C-Sections Reduce Incontinence
  38. Disabled U.S. Seniors Lack Needed Services: Report
  39. Shedding Light on Asthma
  40. UK Study Looks at Drug-Induced Heart Arrhythmia
  41. The Risky Lives of American Men
  42. Most Women Don't Prefer Female Doctors: Study
  43. Gene Therapy Holds Promise for Impotency
  44. Scientists Discover Cancer-Resistant Mouse
  45. Slim Fest
  46. Low-Birth-Weight Risk May Run in the Family
  47. Seniors Should Stay Healthy While on the Road
  48. Exercising During Pregnancy

    MONDAY, APRIL 28, 2003

  49. If You Feel a Migraine Coming On . . .

    SUNDAY, APRIL 27, 2003

  50. Carpal Tunnel Strikes Slowly and Steadily

    SATURDAY, APRIL 26, 2003

  51. Hysterectomy: A Surgery Many Women May Not Need


FRIDAY, MAY 2, 2003

GNC Says It Will Stop Selling Ephedra

The Associated Press
Friday, May 2, 2003

PITTSBURGH - Nutritional supplement retailer General Nutrition Centers on Friday announced that the company will stop selling products containing the weight-loss supplement ephedra at the end of June.

GNC president Michael Meyers said the Pittsburgh-based company believes the products are safe when used as directed, but the company has found that more customers are using ephedra-free products.

The Food and Drug Administration (news - web sites) has said there is evidence that products containing the herb can cause serious health problems, such as heart attacks and strokes.

GNC has more than 5,300 retail stores in the United States and 26 foreign markets, including Canada and Mexico. The company is owned by Royal Numico, of the Netherlands, a baby-food maker and supplier of nutritional supplements.

On the Net:


FDA dietary supplement site:

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'White-Coat' Hypertension Not Often a Major Concern

By Martha Kerr
Reuters Health
Friday, May 2, 2003

NEW YORK (Reuters Health) - "White-coat hypertension" -- a spike in blood pressure that occurs only in a doctor's office -- is rarely a cause for concern, researchers reported this week at a meeting of the Inter-American Society of Hypertension in San Antonio, Texas.

In a study of people referred to a hypertension clinic, most people who had blood pressure readings of 200 millimeters per liter of mercury (mmHg) or higher during an office visit actually had much lower blood pressure, reported Dr. Mihaly Tapolyai of the Cleveland Clinic Florida in Weston.

For people who get an extremely high blood pressure reading in a doctor's office, it would be a good idea to monitor their blood pressure throughout a 24-hour period before beginning treatment to be certain that the high reading isn't white-coat hypertension, according to Tapolyai.

Tapolyai and associates followed 57 people whose average systolic blood pressure (the top number in a blood-pressure reading) was at least 200 mmHg at office visits. But when blood pressure was monitored throughout the day using a device worn on the body, the average systolic pressure was about 151 mmHg -- still high, but much lower than in a doctor's office.

In comparison, a group of 80 patients with confirmed high blood pressure had an average systolic blood pressure of 146.1 mmHg during office visits and 137.9 on 24-hour monitoring. Blood pressures below 120/80 mm Hg are considered within a normal, healthy range

Tapolyai reported that only 5.3% of the patients with severe office hypertension were determined to have so-called grade IV systolic hypertension, with systolic blood pressures of 200 mmHg or greater more than 20% of the time. Meanwhile, 7% of those with severe office hypertension proved to have normal blood pressure on 24-hour monitoring.

Tapolyai pointed out in an interview with Reuters Health that the consequences of hypertension, such as congestive heart failure, stroke and death are associated with sustained high blood pressure -- not office hypertension.

He warned that treating white-coat hypertension without confirming that a person truly has high blood pressure may cause a person's blood pressure to drop below normal.

"The time has come to measure blood pressure with an ambulatory blood pressure monitor," especially in certain circumstances such as newly diagnosed cases of high blood pressure, high blood pressure that does not respond to treatment, episodic hypertension that affects people having an anxiety attack, white-coat hypertension or unusual circumstances like high blood pressure in the young, Tapolyai said.

Standard measurement of blood pressure is acceptable for screening and for follow-up once high blood pressure has been established with 24-hour monitoring, he added.

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Asthma Now Afflicts 15 Million Americans

By Dennis Thompson Jr.
HealthScoutNews Reporter
Friday, May 2, 2003

FRIDAY, May 2 (HealthScoutNews) -- You begin to take a breath, and find your chest has inexplicably tightened. Wheezing and coughing, you struggle to take in air.

Your airways have become blocked or narrowed. The small tubes that carry air through your lungs, the bronchi and bronchioles, have suddenly become inflamed. They are suffering a double assault -- constricted by tightened muscles outside and flooded by mucus inside.

You're suffering an attack of asthma, a disease that now affects some 15 million Americans.

Asthma cases have doubled over the past 15 years, with more and more people worrying whether their next breath will come easy.

May is Asthma Awareness Month, a time when doctors and activists hope to spread more information about the disease.

Asthma attacks can be triggered by allergens, tobacco smoke or exercise -- particularly when exercising in cold air.

If an attack is serious enough and left untreated, it can be fatal.

The U.S. Department of Heath and Human Services says low-income and minority groups are more likely to die during an asthma attack, probably due to lack of access to proper medication. There was an average of 38.5 asthma-related deaths per 1 million blacks from 1993 to 1995, compared with 15.1 deaths per 1 million whites during that same period.

Two factors play a part in whether you're likely to suffer from asthma: a cleaner living environment and genetics.

Many doctors believe the increase in Americans' susceptibility to allergies and asthma may be linked to the fact that children are leading healthier lives in cleaner living spaces.

The body typically grows resistant to allergies while fighting off childhood infections and diseases, says Dr. Henry Li, an allergist with the Institute for Asthma and Allergy.

But children are facing fewer and fewer infections as they grow up, which could leave them more susceptible to asthma, Li adds.

"When a society has developed and we have a cleaner and cleaner environment, there is less chance of getting childhood infections," Li says.

Heredity also plays a large part, says Stacey Schubert, an asthma sufferer who also works as an epidemiologist with the asthma program at the Oregon Department of Human Services.

Schubert's mother has asthma and her father suffers from allergies. Her brother also struggles with asthma. "There's definitely a genetic component to asthma," she says.

Schubert has had asthma since she was a child, and has seen great improvements in the treatment of the disease.

When she was young, she had to take fistfuls of medicines that weren't always effective. She found herself often dropping out of physical activities after growing short of breath, and eventually became overweight.

Now she's 36, and the newer medicines have improved to the point where she can lead a very active lifestyle with few asthma attacks. Schubert enjoys step aerobics, kickboxing, weight lifting and biking, and she enjoys them without the ever-present fear of losing her breath.

"Generally speaking, I don't have flare-ups or exacerbations," she says. "Controlling my asthma is very easy. I take my medications."

More information

To learn more about asthma, visit the Asthma and Allergy Foundation of America or the American Lung Association.

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Better Working Conditions May Improve Patient Care

Reuters Health
Friday, May 2, 2003

NEW YORK (Reuters Health) - Boosting nurse staffing levels in hospitals and nursing homes and improving communication between hospitals and other healthcare providers could lead to better patient care, the federal Agency for Healthcare Research said on Friday.

Such measures are among a handful of effective strategies for improving patient safety gleaned from a review of 115 existing studies on healthcare working conditions in healthcare and non-healthcare settings, AHRQ said.

A new report developed for AHRQ by the Evidence-based Practice Center at Oregon Health & Science University in Portland, Ore., helps shed light on what healthcare providers can do to improve the quality of healthcare.

In addition to the recommendations on staffing and communication, the report concludes that preventable complications are less likely when complex, technical procedures are handled by physicians who do them frequently. It also finds that fewer staff interruptions and distractions will likely reduce medical errors and that, for some types of clinical care, more experience means better patient outcomes.

A summary of the report is available on AHRQ's Web site ( The full report will be available later this spring.

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Erectile Dysfunction Linked to Heart Disease

Friday, May 2, 2003

FRIDAY, May 2 (HealthScoutNews) -- Men who have erectile dysfunction are more likely to suffer cardiovascular disease, according to preliminary findings from researchers at McGill University Health Center in Montreal.

The study evaluated more than 4,000 men, comparing the risk of erectile dysfunction in men with and without cardiovascular disease. They found the presence of cardiovascular disease was strongly associated with erectile dysfunction.

"Among men without diagnosed cardiovascular disease, cardiovascular risk factors such as diabetes, smoking, high blood pressure and low HDL cholesterol were more common among those who had erectile dysfunction," lead investigator Dr. Steven Grover says in a news release.

"This suggests that the men who have erectile dysfunction and have not had other symptoms of cardiovascular disease may be at increased risk for symptoms of cardiovascular disease. Accordingly, a complete diagnostic evaluation of erectile dysfunction should include screening for cardiovascular risk factors," Grover says.

The findings were presented recently at the annual meeting of the American Urological Association in Chicago.

More information

Here's where you can learn more about erectile dysfunction.

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Study: New Way to Help Predict Pregnancy Problems

Reuters Health
Friday, May 2, 2003

NEW YORK (Reuters Health) - Several weeks before pregnant women show signs of a dangerous high blood pressure disorder, they have impaired blood flow in their arteries and elevated blood levels of a hypertension-promoting substance, new study findings indicate.

"The results of this study may help the development of more accurate tests for the prediction and more effective treatment of preeclampsia," study author Kypros H. Nicolaides of King's College Hospital in London, said in a statement.

Preeclampsia is a poorly understood pregnancy-induced condition marked by high blood pressure and elevated levels of protein in the urine. It affects about 7% of pregnant women in their third trimester of pregnancy, and poses a risk to both the mother and fetus. In severe cases, preeclampsia can lead to maternal seizures and even death. The condition resolves when the baby is born.

Doctors have known that blood vessels become constricted in preeclampsia, resulting in high blood pressure. But it has been unclear whether the blood vessel problems are a cause or consequence of the disorder, Nicolaides and colleagues note in the May 3rd issue of The Lancet.

Their study included 86 pregnant women who underwent ultrasound testing during their second trimester to see if they had normal uterine blood flow. Half did, while the others did not, suggesting they were at risk for preeclampsia or other complications.

None of the 43 women who had normal uterine blood flow developed preeclampsia during their third trimesters, results showed.

But among the 43 women with abnormal uterine blood flow, 10 went on to develop preeclampsia, 14 delivered underweight babies due to growth restriction in the womb and 19 had normal pregnancies.

Second-trimester testing also showed that the half of the women with abnormal uterine blood flow had elevated blood levels of asymmetric dimethylarginine, or ADMA, which impairs the ability of blood vessels to widen. This happens because ADMA inhibits the effects of nitric oxide, which helps keep blood vessels relaxed and blood pressure in check.

Additional ultrasound testing in the second trimester showed that, compared with women who did not develop preeclampsia, those who did had more restricted blood flow in their arms. This suggests the presence of blood vessel dysfunction that occurred before preeclampsia was diagnosed. And the more restricted the blood flow, the higher the blood levels of ADMA, the researchers reported.

The findings suggest that doctors might be able to better predict preeclampsia by checking blood flow in the arms in addition to the uterus, according to the researchers.

And since an amino acid known as L-arginine can help counter the effects of ADMA, it may be worth exploring whether L-arginine can help stave off preeclampsia in high-risk women, they conclude.

Source: The Lancet 2003;361:1511-1517.

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Study Sheds Light on Possible Causes of Preeclampsia

By Colette Bouchez
HealthScoutNews Reporter
Friday, May 2, 2003

FRIDAY, May 2 (HealthScoutNews) -- Among the most serious of pregnancy complications is a condition known as preeclampsia, a blood pressure-related problem that can develop in the last trimester and threaten the life of both mother and baby.

Now a group of British doctors say they might have a way of predicting who is at risk for preeclampsia, long before symptoms occur.

In a new study appearing in the May 3 issue of The Lancet, doctors from Harris Birthright Centre, Kings College Hospital, London, say problems appear linked to a dysfunction in the cells that line blood vessels -- called endothelial cells -- and a natural chemical known as asymmetric dimethylarginine (ADMA).

"Maternal endothelial function is impaired in women who eventually develop preeclampsia, and it occurs before the development of the clinical syndrome," writes study author Kypros Nicolaides. Women who are at risk for preeclampsia, he says, appear to have high concentrations of ADMA. That chemical seems to contribute to the dysfunction of the cells within blood vessel walls.

"The results of this study may help the development of more accurate tests for the prediction and more effective treatment of preeclampsia," says Nicolaides.

While experts say the study is well done and holds promise, according to obstetrician Dr. Steve Farber it is only one of many promising theories about the cause of preeclampsia.

"With each new study we find another piece of the puzzle, and we have a little better understanding of this complex problem and why it occurs," says Farber, president of the medical staff at Maimonides Medical Center in New York City.

And while he says researchers have focused on the endothelial cells before, it remains to be seen whether ADMA is the missing piece of the puzzle everyone has been hoping to find.

"It would be great if it was, but right now, we just don't know that," Farber says.

Preeclampsia is characterized by a swelling that can occur throughout the body, usually accompanied by a rapid rise in blood pressure. It normally begins late in the third trimester and affects up to 8 percent of all pregnant women, particularly older mothers or those carrying twins or triplets.

In some instances, preeclampsia can develop into the more severe condition known as eclampsia, causing a potentially fatal swelling in the brain. In underdeveloped nations, eclampsia accounts for up to 50,000 maternal deaths a year.

Currently, the only known treatment for preeclampsia is delivery of the baby, which lets blood pressure return to normal and swelling to rapidly decrease. As such, says Farber, doctors and mothers are often forced to play a treacherous waiting game, hoping to give the baby enough time to fully develop within the womb, but still delivering early enough to avoid eclampsia.

The new study involved two groups of 43 pregnant women who had a Doppler ultrasound examination of the uterus (a test that documents blood flow) in their second trimester, while blood tests checked levels of ADMA.

In the first group of 43, the women were shown to have normal uterine arteries and no elevations in ADMA. Subsequently, they all delivered normally with no complications.

In the second group of 43, the Doppler exam revealed impaired blood flow between the uterus and the developing baby. Of this group, 44 percent went on to have normal pregnancies and healthy births. In 33 percent of these women, however, babies developed intrauterine growth restriction, putting them at risk for low birth weight.

The remaining 23 percent developed preeclampsia. Because the Doppler exams revealed abnormal blood flow within the uterine arteries, as well as abnormal blood vessel dilation, researchers suggest arterial dysfunction as a factor in the development of preeclampsia.

More importantly, the women at risk for either preeclampsia or intrauterine growth restriction also had what doctors call a "striking elevation" in the concentration of ADMA in their blood -- which the researchers say may one day serve as a marker for women at risk.

Although Farber says knowing can be important, he adds that right now it does little to change the clinical picture of preeclampsia since delivery still remains the only treatment option.

More information

To learn more about the symptoms of preeclampsia, visit the March of Dimes. To learn more about Doppler ultrasound, check out the American College of Radiology.

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Study Shows Women 50-64 at High Fracture Risk, Too

By Alison McCook
Reuters Health
Friday, May 2, 2003

NEW ORLEANS (Reuters Health) - Although the risk of bone fractures increases with age, a new study released this week suggests that many women develop dangerously low bone mass and fractures even during the first years after menopause.

Examinations of almost 90,000 women between the ages of 50 and 64 revealed that almost one-third had bone mass low enough to put them at a higher risk of fracture.

Moreover, within a sample of almost 200,000 postmenopausal women, one-third of those who developed fractures were younger than 65.

Although the natural decline in estrogen that accompanies menopause puts women at risk of fractures, most of the studies of bone mass and fracture risk focus on women who are at least 65, study author Dr. Susan K. Brenneman of drugmaker Merck & Co. -- which markets the osteoporosis drug Fosamax and funded the current study -- told Reuters Health.

And within the medical community, Brenneman said that she suspected that doctors are not "as serious" about treating and screening for fracture risk in women under 65.

"It's always thought that fracture and osteoporosis is really a disease of the older woman," she noted.

These findings, presented here during the 51st annual clinical meeting of the American College of Obstetricians and Gynecologists, suggest that doctors need to focus on the problem of low bone mass and fracture in their younger, postmenopausal patients, too, she noted.

"Some (younger women) do have low bone mass," she said. "And if they have low bone mass, they fracture as much as older women."

The women aged 50 to 64 were participants in a national study involving more than 200,000 women over 50 designed to determine the risks of the bone-weakening disease osteoporosis. Researchers measured bone mass in all participants, then followed them for a year to determine how many developed fractures.

Among the 163,935 women who completed the one-year survey, 2,440 reported bone fractures as a result of osteoporosis, 440 of which were hip fractures, a particularly debilitating type of fracture.

Twenty percent of hip fractures occurred in women between the ages of 50 and 64, and this younger age group represented 37 percent of all one-year fractures reported by study participants.

Moreover, nearly one-third of women between 50 and 64 had bone mass that was low enough to raise their risk of fracture by as much as almost three-fold, the researchers report.

Young women appeared to have a higher risk of fracture if they had low bone mass, had experienced a previous fracture after age 45, had generally poor health and if their mothers had also experienced bone fractures in old age.

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Not All Sunscreens Are Created Equal

By Janice Billingsley
HealthScoutNews Reporter
Friday, May 2, 2003

FRIDAY, May 2 (HealthScoutNews) -- When choosing a sunscreen, there's more than sunburn prevention to keep in mind, a New York City dermatologist warns.

The burning rays of the sun, called ultraviolet B (UVB) rays, are the primary cause of skin cancer, says Dr. Vincent DeLeo, associate professor of clinical dermatology at Columbia University. But new research shows that ultraviolet A (UVA) rays could also increase your risk for skin cancer, he says.

"This is an area of great controversy, but new studies say that some skin cancers could be UVA-related," DeLeo says. The reason: These rays penetrate deeper into the dermis, which is the base layer of the skin, and weaken the body's immune system, a process called immunosuppression.

This could explain why some skin cancers can appear anywhere on the body, not just where the skin has been directly exposed to the sun, DeLeo says.

DeLeo made his remarks this week at the American Academy of Dermatology's Melanoma/Skin Cancer Detection press conference in New York City, and in a subsequent interview.

This means people should seek out sunscreens that protect against UVA as well as UVB rays, something not always easy to do.

A sunscreen's sun protection factor (SPF) only measures protection from UVB rays, not UVA rays, so it's hard to know what you're getting, DeLeo says.

He cites a study that appeared last January in The Journal of Investigative Dermatology, an English Journal, in which 119 healthy, white-skinned men and women were asked to put sunscreen with an SPF of 15 on their buttocks, which had never been exposed to the sun. They were then radiated with both UVA and UVB rays.

Tests showed the protection against the UVA rays was less than half that of the UVB rays.

"The sunscreen protected against redness, but not against immunosuppression," DeLeo says.

DeLeo says trials are under way in the United States to test sunscreens that protect against UVA rays, including products that contain mexoryl and tinosorb. In the meantime, consumers must be diligent about using other methods of avoiding sun damage.

In addition to applying a sunscreen with a minimum SPF of 15, people should stay out of the summer sun between 10 a.m. and 4 p.m., wear protective clothing, and a broad brimmed hat.

"If you don't get a sunburn, it doesn't mean you're protected from an immunosuppression response," DeLeo says.

More information

The American Cancer Society has helpful information about the sun and skin cancer. The American Academy of Dermatology offers some compelling data on the dangers of tanning salons.

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Supplemented Formula Helps Blood Pressure

By Ed Edelson
HealthScoutNews Reporter
Thursday, May 1, 2003

THURSDAY, May 1 (HealthScoutNews) -- Children fed formula supplemented with long chain polyunsaturated fatty acids have significantly lower blood pressure than those given unsupplemented formula.

In fact, it's about as low as that of children who were fed mother's milk, European researchers report.

It is the latest claim to be made for such supplementation, which has been said to improve either vision or intelligence or both. And the new claim is made on the basis of a carefully controlled study backed by a scientific theory. Nevertheless, it is drawing a wary response from at least one pediatrician.

The study was done at four European centers. A report in the May 3 issue of the British Medical Journal says that at 6 years of age, the 71 children given the supplemented formula had blood pressure readings 3 millimeters lower than those of the 76 children in the unsupplemented group. And the supplemented group's readings were about the same as that of 88 children who were breast-fed.

The result is important because "blood pressure does appear to track from childhood into adulthood," says study author Dr. J. Stewart Forsyth, a consultant pediatrician at the Tayside Institute of Child Health in Dundee, Scotland. Adult high blood pressure is one the strongest risk factors for heart disease and stroke.

The theory is that the long chain polyunsaturated acids are absorbed in the cells of the endothelium, the delicate tissue that lines the blood vessels, Forsyth says, making them less vulnerable to the fatty deposits that eventually can block a blood vessel.

Until recently, it was assumed that "infants were able to make these long chain fatty acids from short-chain fatty acids in formula," Forsyth says. Newer research shows that is not so, he says.

But the study results may not be as convincing as they seem, says Dr. Michael Wasserman, a pediatrician at Ochsner for Children, a New Orleans branch of the Ochsner Clinic.

There was a high dropout rate in the study, with only about 40 percent of the children who enrolled at the start completing it, he says, and there were differences between the groups that might cloud the results.

But the main reason for skepticism is that high blood pressure is "a multidimensional condition influenced by many factors," Wasserman says. "You can't look at development of high blood pressure so simplistically. It is multidimensional in ways we don't understand."

Diet is one dimension, Wasserman says, but "you are looking at a big pie. We don't know how big a slice of the pie this is."

The question of using a supplemented formula comes up constantly in his pediatric practice, Wasserman says, because some formula makers advertise the benefits of the supplements. When he is asked, he says, "it probably does no harm and probably does some good."

The gold standard of nutrition early in life is breast-feeding, says the American Academy of Pediatrics, and Forsyth and Wasserman agree.

"I am a great supporter of breast-feeding," Forsyth says. "It is especially important in the first months of life."

More information

Advice on feeding your baby is offered by the American Academy of Pediatrics. The academy also offers A Woman's Guide to Breastfeeding.

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Studies Revive Colon Cancer Diet Theory

By Emma Ross
AP Medical Writer
The Associated Press
Thursday, May 1, 2003

LONDON - New research has revived the notion that a high-fiber diet may protect against colon cancer.

Long-standing recommendations for high-fiber diets have taken a hit over the last few years after a handful of carefully conducted studies failed to find a benefit.

But experts say two major studies published this week in The Lancet medical journal one on Americans and the other on Europeans indicate previous research may not have examined a broad enough range of fiber consumption or a wide enough variety of fiber sources to show an effect.

"These two new findings show that the fiber hypothesis is still alive," said the leader of the American study, Ulrike Peters of the U.S. National Cancer Institute (news - web sites).

Figuring out the relationship between nutrition and disease has always proved difficult, but experts say fiber is particularly complicated because there are various types and they all could act differently.

Fiber is found in fruits, vegetables and whole grains. Americans eat about 16 grams a day, while Europeans eat about 22 grams. The new studies indicate fiber intake needs to be about 30 grams a day to protect against colon cancer.

There are 2 grams of fiber in a slice of whole meal bread. A banana has 3 grams and an apple has 3.5 grams, the same as a cup of brown rice. Some super-high fiber breakfast cereals have as much as 14 grams per half cup.

In the American study, investigators compared the daily fiber intake of 3,600 people who had precancerous growths in the colon with that of around 34,000 people who did not.

They were divided into five groups, according to how much fiber they ate. The average roughage intake in the lowest group was 12 grams a day, while in the highest group it was 36 grams a day.

People who ate the most fiber had a 27 percent lower risk of precancerous growths than those who ate the least.

In the European study, the largest one ever conducted on nutrition and cancer, scientists examined the link in more than 500,000 people in 10 countries.

As in the American study, questionnaires separated the people into five groups, according to fiber intake.

Following them for an average of four years, 1,065 of them had developed colorectal cancer.

Those who ate the most fiber, about 35 grams a day, had about a 40 percent lower risk of colorectal cancer compared with those who ate the least, about 15 grams a day, the study found.

"In the top quintile (group) they were eating 15 grams of cereal fiber, which is equivalent to five or six slices of whole meal bread, plus they were eating seven portions of fruit and vegetables a day, which is basically the Mediterranean levels," said the study's leader, Sheila Bingham, head of the diet and cancer group at Cambridge University's human nutrition unit.

Discussions about the link between fiber and bowel health or, at least the relative merits of white and brown bread date back to antiquity.

In a twist on modern thought, Hippocrates, who lived in the 5th century B.C., believed white bread was more nutritious because it creates less feces than brown bread. Scientists now believe the extra feces is a benefit.

The contemporary theory that fiber wards off colon cancer began in the 1970s, when a British doctor, Denis Burkitt, noted that poor people in Africa produce more feces than Westerners and get much less colon cancer. One obvious difference between the two groups was that Africans consumed more fiber.

Scientists believe that fiber dilutes and absorbs cancer-causing agents and makes them flow more quickly through the body. Researchers have also theorized that a high-fiber diet makes protective changes to cells or curtails bile acids that irritate the intestinal lining and promote growths.

The first big dent in the theory came in 1999 from a study that tracked the eating habits of 88,757 American nurses for 16 years. The risk of colon cancer was the same, regardless of how much fiber the women were eating.

Then in 2000, two studies which used a different method also came up negative. They put people on different diets and counted precancerous growths in their colons for up to four years. There was no apparent effect from high-fiber diets or supplements.

One major difference between the former and current studies is that the new ones examine more diverse populations who eat different types of fiber and in hugely varying amounts.

However, Andy Ness, a lecturer in epidemiology at Bristol University in England, who was not connected with either study, said the latest research is not the last word.

"Across Europe, there is an amazing variation in risks of cancer. There is also a huge variation in diet, so across these cultures you can get this breadth of intake. However, what you might be picking up across this range of diet is a range of cultures. It's possible it's something else that goes with that pattern of diet," he said.

On the Net:

The Lancet,

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Thalidomide May Carry Dementia Risks: Case Report

Reuters Health
Thursday, May 1, 2003

NEW YORK (Reuters Health) - The case of one patient treated for blood cancer with the drug thalidomide suggests that reversible mental decline could be one effect of the treatment, Virginia doctors reported Wednesday.

The patient, a 66-year-old man with the blood cancer multiple myeloma, began to show signs of dementia in the months after he started thalidomide treatment, according to the report in The New England Journal of Medicine (news - web sites).

The good news is that the patient's failing memory and other dips in mental function were reversed soon after going off the drug, according to his doctors at Virginia Commonwealth University Medical Center in Richmond.

This case, they write, suggests that "physicians should consider the possibility that thalidomide may induce reversible dementia in patients with multiple myeloma."

Thalidomide was once a notorious drug, banned in the 1960s for causing severe birth defects after it was used to treat morning sickness in some pregnant women. Recently, though, it has been shown to slow the progression of multiple myeloma.

Typically, multiple myeloma patients who take thalidomide can experience side effects such as sedation and nerve pain in the extremities.

In this patient's case, though, Dr. Alexander E. Morgan and colleagues found that the man became "forgetful and manic" two to three months after going on a chemotherapy regimen that included thalidomide and the drug dexamethasone.

The man's mania ceased after the dexamethasone was discontinued, but his memory loss worsened, according to Morgan's team.

Soon, the man's wife reported that he could no longer remember how to brush his teeth or take a shower. Nor could he remember her name or their children's.

An extensive evaluation revealed no cause of the man's mental difficulties, but the answer came when he went on to develop a tremor -- a documented side effect of thalidomide.

"Discontinuation of thalidomide therapy because of tremor, a known side effect, was followed by rapid recovery of memory and other cognitive functions," Morgan and colleagues write.

They advise doctors to be aware of the potential for similar "reversible dementia" in multiple myeloma patients on the drug.

Multiple myeloma accounts for approximately 10 percent of all blood cancers. Among patients with early forms of the disease, many progress to full-blown multiple myeloma within a few years.

Source: The New England Journal of Medicine 2003;348:1821-1822.

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Study: Chemical May Improve Aging Brains

By Paul Recer
AP Science Writer
The Associated Press
Thursday, May 1, 2003

WASHINGTON - Aging brains may be sharpened and, in effect, made young again briefly by increasing the levels of a neurochemical called GABA, a study suggests.

Researchers at the University of Utah found that GABA appears to help extremely old Rhesus monkeys focus their vision and thinking processes by silencing the interfering static from other neurons.

GABA screens out the stray brain signals that may make thinking and seeing difficult in older brains, said Audie G. Leventhal, a professor at the University of Utah School of Medicine.

"It eliminates the garbage signals," said Leventhal, first author of the study appearing Friday in the journal Science.

Leventhal said that in old primates, both human and monkey, there is a decline in the levels of GABA, a chemical that inhibits neuron signals in the brain. Without enough of that control, he said, the brain is distracted and overwhelmed by stray signals, in the same way the ear is overwhelmed when trying to hear a whisper at a rock concert.

"There, you wouldn't really hear anything," he said. "But if there is screaming in an empty room, then it is very easy to hear. That is sort of what GABA does."

Without sufficient levels of GABA to drown out all of the background signals, said Leventhal, "then all of your higher brain functions go bad."

Dr. Bernard W. Agranoff, a neurochemist and professor of psychiatry at the University of Michigan, said the study showing the effect of GABA in aging brains is an important finding that should be researched further in humans.

"It doesn't automatically point toward a treatment, but it is an observation that needs to be followed up," said Agranoff, who was not involved in the research. "It is a quite interesting finding and the data looks very good."

In the study, Leventhal and his co-authors measured the electrical activity of neurons in specific parts of the brains of both young and old Rhesus monkeys as the animals were exposed to light patterns flashed on a computer screen.

Earlier work had shown that in young monkeys some neurons fired only for horizontal patterns, while others responded only to vertical or to diagonal patterns. In older monkeys, however, the neurons fired almost randomly, suggesting the brain cells had a diminished ability to distinguish shapes and motions.

When minute quantities of GABA were injected directly into neurons, the brains of the older monkeys responded just like those of the young animals, Leventhal said. Signals were sharp and clean as neurons fired appropriately for each of the patterns on the screen, he said.

The effect lasted only as long as GABA levels were maintained. When the chemical was removed, the brains of the old monkeys reverted to their aged confusion within a few minutes, Leventhal said. Added GABA appeared to have no effect on the young.

The tests were conducted on six young monkeys, age 7 to 9, and on seven old monkeys, age 21 to 32.

"These monkeys age about three times faster than humans," Leventhal said. "A 30-year-old Rhesus is equal to about a 90-year-old person."

Some tranquilizers, such as Valium, Xanax and Librium, increase the levels of GABA in the brain of human patients. This suggests that these drugs might sharpen aged minds, but that is an idea that first must be carefully tested, Leventhal said.

"The idea is counterintuitive," he said. "The idea that to get grandpa to move faster you have to tranquilize him isn't something that makes a lot of sense without these results."

On the Net:


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Pesticides Linked with Prostate Cancer in Farmers

Thursday, May 1, 2003

WASHINGTON (Reuters) - Farmers who use certain pesticides seem to have a higher-than-average risk of prostate cancer (news - web sites), U.S. government researchers said on Thursday.

The researchers, who published their study in the American Journal of Epidemiology, confirmed other findings that show farmers have an unusually high risk of prostate cancer.

"Associations between pesticide use and prostate cancer risk among the farm population have been seen in previous studies; farming is the most consistent occupational risk factor for prostate cancer," Michael Alavanja of the National Cancer Institute (news - web sites) (NCI), who helped lead the study, said in a statement.

Researchers at NCI and at the National Institute of Environmental Health Sciences and the Environmental Protection Agency (news - web sites) studied 55,332 farmers and nursery workers who worked with pesticides.

Between 1993 and 1999, 566 new prostate cancers developed among the men, compared to 495 that would normally be expected in Iowa and North Carolina, the two states studied.

The risk of developing prostate cancer was 14 percent greater for the pesticide applicators compared to the general population.

One pesticide, methyl bromide, increased the risk of prostate cancer in all men.

Six others raised the risk in men with a family history of prostate cancer. They are chlorpyrifos, coumaphos, fonofos, phorate, permethrin and butylate.

More than 220,000 U.S. men will be diagnosed with prostate cancer this year, according to the American Cancer Society (news - web sites), and 30,000 will die of it.

The biggest risk factors for prostate cancer are age and family history. African-American men have higher rates of prostate cancer, and some evidence suggests that men who eat lots of red meat and animal fat have a higher risk.

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Estrogen Has Healing Powers

Thursday, May 1, 2003

THURSDAY, May 1 (HealthScoutNews) -- Estrogen plays an important role in wound healing and age-related estrogen loss in both women and men results in an impaired ability to heal as we grow older.

So says a University of Manchester study in the May 1 issue of the Journal of Clinical Investigation.

The study found estrogen influences wound healing by inhibiting the local inflammatory response. It does this by "downregulation" of macrophage inhibitory factor (MIF).

The finding provides information about a specific target for treatment in people with delayed wound healing.

Wound healing in the skin is associated with an initial inflammatory response, which is followed by reformation of the outermost layer of skin. During that initial response, the recruitment of inflammatory cells to the wound site causes increased local expression of MIF.

That, in turn, attracts more inflammatory cells to the wound site.

In their study, the University of Manchester researchers made small incisions in estrogen-deficient mice. After receiving the incision, the mice had an unchecked increase of MIF expression in the area of the wound, leading to excessive inflammation and delayed wound healing.

The researchers also found the healing rates in MIF-deficient mice that also lacked estrogen were not significantly different than healing rates in normal mice.

The study results indicate that MIF is a crucial component in uncontrolled inflammation and slow wound healing. That suggests that wound healing might be assisted by drugs that inhibit MIF.

More information

Here's where you can learn more about wounds.

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Soy Compound Shows Promise for Menopause Symptoms

By Colette Bouchez
HealthScoutNews Reporter
Wednesday, April 30, 2003

WEDNESDAY, April 30 (HealthScoutNews) -- A new soy-based compound promises to rival estrogen by relieving hot flashes and building bone mass in menopausal women without many of the troubling side effects associated with traditional hormone therapy.

That's the news being reported April 30 at the 51st annual meeting of the American College of Obstetricians and Gynecologists (ACOG) in New Orleans. A group of Israeli researchers presented the findings, which were based on a 12-month study that involved patients, laboratory cell lines and animals.

"The conflicting data on hormone replacement therapy (HRT) has led to an intensive search for alternative treatments," reports Dr. Benjamin Chayen, on behalf of his colleagues at the Sheba Medical Center in Tel-Hashomer, Israel, where the research was conducted. That led the scientists to the soy compound known as Tofupill (DT56a).

Among the 37 women who used the soy supplement, 75 percent reported relief from hot flashes. Tests showed they also experienced a measurable increase in bone density -- up to 4 percent in the spine and 2.9 percent in the neck.

In laboratory tests, the researchers found the soy compound had no negative effects on breast cancer (news - web sites) cell lines, indicating it may not share estrogen's ability to stimulate tumor growth. And in rat studies, the soy appeared to stimulate growth of skeletal tissue without stimulating cell growth in the uterus, as estrogen therapy can do.

While experts say the results are promising, New York University nutritionist Samantha Heller believes the research makes too many "leaps of faith" about issues that remain unproven.

"It is not appropriate to extrapolate data gathered on rats and in vitro directly to humans and suggest that there is little concern regarding short- and long-term effects of supplementation," Heller says.

She also points to conflicting evidence regarding the safety and efficacy of soy supplementation in women. "I would exercise caution with soy supplementation until more research is done," she says. "But including soy products in your diet may still confer many health benefits."

Earlier in the week, doctors presented the following additional new findings at the conference:

  • Researchers from St. Luke's Hospital in Bethlehem, Pa., revealed that topical progesterone cream may be as effective as oral progesterone in treating menopause symptoms -- while still protecting the uterus from precancerous cell growth.

The research involved 20 healthy menopausal women randomly assigned to daily use of either oral estrogen and progesterone, or oral estrogen and progesterone cream, for six months. The women then switched preparations for an additional six months of study.

To keep track of uterine health, each woman received an endometrial biopsy at the start of the study and again after each six-month phase -- important since in the past topical progesterone cream was thought to be less effective in maintaining a healthy uterine lining than the oral form.

The final result: Topical progesterone was as effective as the oral version in both the treatment of menopause symptoms and the protection of the uterine lining. The finding is significant, the researchers say, because earlier studies have shown that progesterone cream may be better tolerated by some women than the oral form of the hormone.

  • A group of British researchers revealed possible new links between a deficiency in the mineral selenium and the risk of miscarriage. In studies conducted at the University of Hull in North Humberside, England, doctors examined both hair and blood samples of 25 pregnant women with no history of miscarriage, and eight with a history of three or more losses and no successful pregnancies.

What they found: Although blood levels of selenium were similar in both groups, there was a significant reduction in the level found in hair samples of the women with a history of miscarriage. Both groups had comparable diets, lived in similar geographic areas and used similar hair products. Because the differences were only noted in hair samples, doctors concluded the selenium deficiency may be chronic rather than related to recent selenium intake. They suggest more research to determine if correcting that deficiency could affect pregnancy outcome.

  • Doctors from the Robert Woods Johnson Medical School in New Jersey offered evidence that a simple, self-test for a vaginal yeast infection may be as effective as doctor-generated tests in accurately diagnosing the problem.

In studies conducted on 143 women, researchers revealed that an easy, self-performed swab test that measures the acid level in the vagina (called a vaginal pH test) could accurately diagnose a yeast infection almost as often as a physician-generated test. The researchers say vaginal pH testing by women may be a convenient way to determine the true cause of intimate infections before buying an over-the-counter yeast treatment. This, they say, could reduce the rate of inaccurate self-diagnosis and subsequent incorrect use of antifungal medications -- a problem that can sometimes lead to serious complications. Currently, pH test strips are available at most local pharmacies.

More information

To learn the latest news on women's health issues, visit ObGyn Net, or The Women's National Health Information Center.

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Bright Light May Boost Testosterone in Men

By Linda Carroll
Reuters Health
Wednesday, April 30, 2003

NEW YORK (Reuters Health) - An extra hour of bright light can lift the levels of a pituitary hormone that enhances testosterone in men, a new study shows.

Researchers found that men who were exposed to an hour of bright light before sunrise experienced an increase in luteinizing hormone (LH), a hormone produced in the brain's pituitary gland.

LH influences reproductive hormones in both men and women. Increases in LH in men drive up testosterone levels, while the hormone triggers ovulation in women.

The new findings, published in the journal Neuroscience Letters, show that testosterone could be enhanced simply by extra hours of bright light, said study author Dr. Daniel F. Kripke, a professor of psychiatry at the University of California at San Diego.

"There are many possible beneficial effects of increased testosterone," Kripke told Reuters Health. "Studies have shown that it may help with depression. It can improve libido. And there may be a muscle-building and strengthening effect."

Light also impacts women's reproductive cycles, Kripke said. In an earlier study, his group showed that when women with long and irregular menstrual cycles were exposed to bright light, the cycles regularized.

"We had some indication then that it was working through luteinizing hormone," the researcher said.

For the new study, Kripke and his colleagues studied 11 healthy young men who were between the ages of 19 and 30, dividing participants into two groups.

In the first part of the study, both groups were awakened at 5:00 am and exposed to either a bright light of approximately 150 watts or a low-wattage red light.

During the second part, the groups were switched, so that the men who were exposed to bright light in the first part were then exposed to low light, and vice versa.

The men's LH levels were tested before and after exposure to the lights.

The researchers found that the men showed a 69-percent increase in LH levels after exposure to bright light.

In the report, they note that sexual problems such as low libido are known to be part of depression, as well as a side effect of antidepressant medications.

"It is theoretically possible," they write, "that light exposure, which increases LH secretion, will alleviate sexual dysfunctions in depressed patients."

They suggest that studies like the current one be repeated in people with depression.

Source: Neuroscience Letters 2003;341:25-28.

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Soy Extract Helps Some Prostate Cancer Patients

Wednesday, April 30, 2003

WEDNESDAY, April 30 (HealthScoutNews) -- A dietary supplement that contains the soy extract genistein reduced prostate-specific antigen (PSA) levels by as much as 61 percent in men with untreated prostate cancer (news - web sites).

But the dietary supplement didn't have the same effect in men who had undergone surgery, radiation or hormone therapy for prostate cancer, say researchers from the University of California, Davis Cancer Center.

PSA is a blood marker for prostate cancer. An increase is PSA is a warning sign of first-time prostate cancer or a sign of recurrence or progression of the disease in men who have been treated for prostate cancer.

The study included 62 men with prostate cancer and elevated PSA levels. They were given 5 grams a day of genistein concentrated polysaccharide for six months. Sixteen of the men were on watchful waiting for the disease and 46 had undergone surgery, radiation or hormone therapy.

Watchful waiting is recommended for some men with prostate cancer whose cancer causes no symptoms, is expected to grow slowly, and is small and contained within one area of the prostate.

Among the 16 men on watchful waiting, three had to drop out of the study due to diarrhea. Of the 13 who completed the study, eight had a drop in their PSA levels. Those reductions ranged from 3 percent to 61 percent.

The other five in that group had increased PSA levels by the end of the study.

In the group of 46 men who had received treatment, one man had no change in his PSA level and all the rest had increases in PSA.

The study was presented April 30 at the American Urological Association meeting in Chicago.

More information

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

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Investigators Question Ephedra Complaints

By Lauran Neergaard
AP Medical Writer
The Associated Press
Wednesday, April 30, 2003

WASHINGTON - Some 16,000 customer complaints about the popular Metabolife brand of ephedra are not enough to prove whether the herb caused dozens of heart attacks and strokes, some fatal, congressional investigators say.

The report released Wednesday doesn't mean ephedra is safe, the Food and Drug Administration (news - web sites) stressed: There is evidence from other sources that the pills can cause serious health problems.

Armed with reports of more than 100 deaths and thousands of side effects linked to ephedra use, the FDA two months ago pledged to put warning labels on every bottle that say the amphetamine-like stimulant can cause heart attacks, strokes or even kill.

The General Accounting Office (news - web sites), Congress' investigative arm, examined 16,000 records of phone calls from ephedra customers with health complaints turned over to the Justice Department (news - web sites) last year by Metabolife International.

The GAO counted 92 reports of serious side effects including 18 heart attacks, 26 strokes, 43 seizures and five deaths made by Metabolife customers to a company hot line.

The GAO concluded that there was far too little information to definitively link any of the reports to the pills because patients, not doctors, reported the problems, and Metabolife employees sometimes recorded just a single word from each phone call.

The FDA noted that the Rand Corp. also reviewed Metabolife's records, and called some of the cases "sentinel events" that warrant further investigation. Also, most of the agency's evidence is from other sources compiled before Metabolife revealed its records.

"Today's report does nothing to change FDA's heightened concern that dietary supplements containing ephedra may present a significant and unreasonable risk of illness and injury," the agency said.

Metabolife insisted the GAO report supports its position "that ephedrine-containing products such as Metabolife 356 are safe and effective when used as directed."

Rep. Dan Burton, R-Ind., who requested the report, said the GAO's findings show the government needs to establish a federal tracking system for consumer complaints about any dietary supplement.

The FDA decision came just weeks after Baltimore Orioles pitcher Steve Bechler died after using ephedra. Health and Human Services (news - web sites) Secretary Tommy Thompson has advised Americans, especially those who exercise, not to take the herb.

The American Heart Association (news - web sites) and other health groups have urged a full ban on ephedra sales, calls the FDA currently is evaluating.

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Annoying Viruses Turn Deadly in Cancer Patients

By Serena Gordon
HealthScoutNews Reporter
Wednesday, April 30, 2003

WEDNESDAY, April 30 (HealthScoutNews) -- An ounce of prevention really is worth a pound of cure when it comes to people undergoing cancer treatment and those with immune-suppressing disorders.

A new study, set to appear in the May 15 issue of Cancer, found that people being treated for cancer were more likely to be seriously affected by common respiratory viruses. In fact, the researchers found death rates in cancer patients contracting such common illnesses as flu and respiratory syncytial virus (RSV) were as high as 75 percent.

"Whatever we see in the general population will be magnified a hundredfold in people with disease," says study author Krystal Hicks, a clinical practice specialist in the department of blood and marrow transplantation at the University of Texas M.D. Anderson Cancer Center in Houston.

For cancer, transplant and other immune-compromised patients, Hicks explains, "symptoms that start out innocently can progress very quickly into something life-threatening." She says that for most people, a cold stays in their upper respiratory airways, but in people whose immune systems are compromised simple colds can quickly settle in the lower respiratory tract. "Within 24 to 48 hours, you can have someone with a life-threatening pneumonia," she adds.

Other groups at high risk from these viruses include people with AIDS (news - web sites), people who have had an organ transplant, people in nursing homes and older people with two or more risk factors, such as emphysema or heart disease.

Hicks and her colleagues gathered information on the incidence of three common respiratory infections at three large bone marrow transplant centers in the United States and in Europe. The viruses studied were influenza (flu) and two common childhood viruses, parainfluenza and RSV.

Flu still claims 20,000 lives in the United States every year. RSV causes 4,500 deaths and 90,000 hospitalizations annually, mainly in children, and parainfluenza is responsible for 70,000 hospitalizations every year, according to the study.

The viruses are transmitted through direct contact with body secretions, such as saliva, or by inhaling contaminated droplets in the air.

In most healthy adults, these viruses are rarely serious, but in those with compromised immune systems they can be deadly. This study found that between 30 percent and 50 percent of those undergoing treatment at these centers had one of these respiratory infections, and the mortality rate was between 28 percent and 75 percent.

There are treatments for these infections, but Hicks says they're often ineffective, expensive and difficult to administer. That's why the authors emphasize prevention.

Prevention is also important because of new, emerging viruses, such as SARS (news - web sites) and West Nile, Hicks says.

First, she says, get a flu vaccine. Next, she recommends thorough and frequent hand washing. During months when these viruses are particularly active, she says it's best for people with cancer to avoid places with large crowds, such as movie theaters and malls. She adds you should also let family members know that, if they have a cold, they need to stay away until they're better. And at the first sign of illness, let your provider know because these illnesses can quickly progress.

Dr. Jay Brooks, chair of hematology and oncology at the Ochsner Clinic Foundation in New Orleans, says people definitely underestimate the risk of infection when they're undergoing cancer treatment.

"The flu vaccine is very important and is grossly underused," Brooks adds. The study says that only 20 percent of those at high risk get vaccinated for influenza every year. Brooks also says that if possible, immune-compromised patients should get the pneumoccocal vaccine as well.

More information

To learn more about cancer and common infections, visit the American Cancer Society. For more information on RSV, go to the U.S. Centers for Disease Control and Prevention.

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Low-Fat-Diet Guru Swims Against Swelling Tide

By Adam Tanner
Wednesday, April 30, 2003

SAUSALITO (Reuters) - Dean Ornish, America's best-known advocate of a low-fat diet, takes a few bites of his granola cereal with soy milk and pushes it across the table in rejection.

"This is not the granola that they used to serve here, so I can't eat this; it's too fatty," he says at a cafe opposite his office in Sausalito, an area of natural beauty with hundreds of boats bobbing along the panoramic waterfront.

He then orders an egg-white omelet with spinach and peppers, asking the chef to use as little oil as possible in the cooking. A slice of melon smiles from the plate's side.

Ornish, with wiry orange-brown hair and a slender frame, lives the message he preaches: Eat a low-fat diet and feel better and healthier. He laughs when pushing away his granola, but bristles at any notion he is a priggish diet freak.

"I am not trying to be the school marm, saying what you are doing is bad. I am not the food police," says the director of the Preventive Medicine Research Institute.

"I don't care what people do as long as they know what the effects of those choices are. And if most people knew if they were willing to make these changes how much better they could feel, then many people might want to try that."

Fat Nation

In recent years, many have heard about Ornish's recommended diet of lots of fruits and vegetables, whole grains and beans, and no fatty dairy products or meats. His books, such as "Eat More, Weigh Less," are best-sellers, and he even advised then U.S. President Bill Clinton (news - web sites) and the White House chefs.

The problem is, many Americans are ignoring the message.

"There is clearly an obesity epidemic," Ornish says later at his office, booting up a laptop computer at his four-story, wood-framed institute overlooking the waterfront. "Americans are eating more fat and more simple carbohydrates than ever."

He shows a series of computer maps of the United States that illustrate obesity state-by-state since 1985 to show a stunning increase in excess pounds from sea to shining sea.

Today, more than 60 percent of Americans are overweight, half of whom are obese, putting their health at risk. Yet the fat trend is ever expanding.

"There has been a bit of a backlash against not only just low-fat eating, but healthy living in general," says Ornish, who is also a professor of medicine at the University of California, San Francisco. "You used to find a lot more people interested in jogging and exercise and lifting weights and going to the gym, and there is less of that now."

The High-Fat Backlash

One reason is a recent wave of publicity around the late diet doctor Robert Atkins, advocate of a popular but controversial high-protein, low-carbohydrate diet. The Atkins approach embraces steak, cheese, butter and other items forbidden in the low-fat lifestyle.

The medical establishment has criticized the program, but several recent studies have suggested that the diet can help people lose weight without damaging their health.

Texas-born Ornish grows animated as he complains that many articles on the Atkins diet compare it to an American Heart Association (news - web sites) low-fat diet he considers not very low in fat and high in simple carbohydrates.

"People think it's like Woody Allen in 'Sleeper' ... where science finally proves that steak is good for you," he says.

In the 1973 comedy, Allen's character wakes up 200 years in the future to find a very different world in which steak, cream pies and fudge are engines of good health.

A sealed package of pork rinds does sit behind Ornish's desk, a joke from another doctor about the very foods barred under his diet approach.

"It doesn't frustrate me that some people may choose to do a diet other than what I recommend," he says. "What frustrates me is when they do it based on misinformation."

"What also frustrates me is how uncritically the media have embraced the high-protein diets because it tells people what they want to hear."

Atkins died earlier this month at age 72, yet Ornish expects that the public debate about their differing approaches will grow even more heated in the months to come.

"What we are going to see is a steady stream of articles saying Atkins diet (is) better than a, quote, low-fat diet," he predicts.

Good Science Not Enough

Ornish reels off details about studies on the benefits of a low-fat diet at machine-gun speed, including one showing how it may even help curb prostate cancer (news - web sites).

He also recalls his earlier work was the first to show that diet and lifestyle changes could reverse heart disease.

Another study highlighting the importance of diet released last week shows that heavier people face a dramatically higher risk of developing cancer.

Yet in a country where an unending barrage of advertisements invites the hungry public to consume massive portions of delectables, Ornish knows his facts and figures are not enough to change eating habits.

"I used to think that if I just did good science that would change medical practice and human behavior, and that was very naive," he says. "It is not enough to say you are going to prevent something bad from happening years down the road."

So he writes books, appears on television programs such as the popular Oprah Winfrey show, gives speeches and consults.

"We don't talk about things like living longer, risk-factor reduction and prevention, which are just boring for most people," he says. "We say there is no point in giving up something that you enjoy unless you get back something that is better, and not 30 years later for the heart attack that doesn't come."

He says his low-fat diet will make people feel better, infuse them with more energy, sweeten their breath and even improve sexual function.

Yet in the real world (news - Y! TV), it is not always easy to meet those standards (news - web sites), as Ornish himself concedes.

At a San Francisco black-tie tribute to actor Dustin Hoffman last week, diners paid $350 to $1,000 to enjoy either a thick steak or vegetarian option of "polenta and spinach tower" and listen to barbs by luminaries such as Robin Williams.

Yet even the vegetarian option, with its roasted eggplant, zucchini slivers and asparagus, fell short of Ornish's low-fat standards because of the rich cheese-flavored polenta. The doctor came prepared, however. He ate before he arrived.

Ornish later admits he might have eaten some of the polenta if he had not had to leave the dinner early. He then confesses his own food weaknesses: "I eat ice cream occasionally, and I eat a little bit of chocolate every day."

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New Pneumonia Vaccine Showing Results

By Stephanie Nano
Associated Press Writer
The Associated Press
Wednesday, April 30, 2003

A new pneumonia vaccine for infants dramatically reduces serious illness in young children and may prevent the spread of the bacteria to adults, researchers report.

The first pneumonia vaccine for babies was approved in 2000 and is now recommended for all children under age 2. It fights infections caused by pneumococcus bacteria, including pneumonia, blood poisoning, meningitis and ear infections.

Researchers say they believe the vaccine, Prevnar, reduced the rate of blood infections and meningitis in children under 2 by nearly 70 percent.

"The vaccine is working. It is not only preventing diseases in high-risk children but also in their families," said Dr. Cynthia Whitney, who led the study for the Centers for Disease Control and Prevention (news - web sites).

How many infants have been immunized isn't known yet, but the vaccine has been widely adopted.

The findings appear in Thursday's New England Journal of Medicine (news - web sites), along with a three-year study of an older pneumonia vaccine recommended for everyone over 65. In that study of 47,365 people, the vaccine cut the risk of serious blood infections almost in half, but offered no protection against pneumonia, reflecting some previous research in the elderly.

"There's a benefit of the vaccine. It's just the benefit doesn't extend to prevention of pneumonia from what we can tell," said Dr. Lisa A. Jackson, who led the CDC-funded research at the Group Health Cooperative, an HMO based in Seattle.

Pneumococcus bacteria is carried in the nose and throat of healthy people, and is spread from person to person. The very young and the elderly are most vulnerable, as well as people with medical conditions that weaken their immune system and their ability to fight the bug.

Until 2000, pneumococcal infections resulted in up to 135,000 annual hospitalizations for pneumonia and 60,000 cases of blood infections, including 3,300 cases of meningitis, according to the CDC.

Those numbers are changing because of the new infant vaccine. The CDC study examined the vaccine's impact by tracking the more serious pneumococcal infections blood poisonings and meningitis in seven areas of the country covering 16 million people.

"It's real life. It's not a controlled study," said Whitney. "Given the price of the vaccine, I think it's really important that we figure out what's going on with this. Are we getting our money's worth?" Each of the four doses costs $61, according to the vaccine maker Wyeth.

From 1998 to 2001, the findings show, the rate of blood infections and meningitis dropped by 69 percent in children under 2 from 188 cases to 59 cases per 100,000. The rate fell 44 percent for 2-year-olds but there was no change for older children.

There was evidence that less bacteria was passed from children to adults. The disease rate dropped as much as 32 percent in adults 20 to 39.

The research also indicates that the infant vaccine can prevent infections by drug-resistant strains of bacteria. In 2001, 35 percent fewer infections were caused by strains resistant to penicillin.

"These are very important findings and if they can be confirmed more broadly and more directly ... that's really powerful stuff," said Dr. Greg Poland, director of the Mayo Clinic Vaccine Research Group, who was not involved in the studies.

He said doctors need to explain to elderly patients that, despite its name, the vaccine used in adults might not protect them against pneumonia but does prevent more lethal complications.

"That alone is enough," he said.

Jackson said a different vaccine is probably needed for the elderly, and one possibility is the infant's vaccine. It protects against seven types of pneumococcal bacteria but works differently than the older vaccine, which is designed to guard against 23 types.

The medical director of adult vaccines for Merck & Co., which makes the Pneumovax 23 vaccine, said it targets the most common but not all the strains that cause pneumonia. Nor does it guard against other causes of pneumonia which were included in the study, said Dr. Joan Benson. The vaccine costs about $16.

On the Net:

New England Journal:

CDC Infectious Disease:

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Annoying Viruses Turn Deadly in Cancer Patients

By Serena Gordon
HealthScoutNews Reporter
Wednesday, April 30, 2003

WEDNESDAY, April 30 (HealthScoutNews) -- An ounce of prevention really is worth a pound of cure when it comes to people undergoing cancer treatment and those with immune-suppressing disorders.

A new study, set to appear in the May 15 issue of Cancer, found that people being treated for cancer were more likely to be seriously affected by common respiratory viruses. In fact, the researchers found death rates in cancer patients contracting such common illnesses as flu and respiratory syncytial virus (RSV) were as high as 75 percent.

"Whatever we see in the general population will be magnified a hundredfold in people with disease," says study author Krystal Hicks, a clinical practice specialist in the department of blood and marrow transplantation at the University of Texas M.D. Anderson Cancer Center in Houston.

For cancer, transplant and other immune-compromised patients, Hicks explains, "symptoms that start out innocently can progress very quickly into something life-threatening." She says that for most people, a cold stays in their upper respiratory airways, but in people whose immune systems are compromised simple colds can quickly settle in the lower respiratory tract. "Within 24 to 48 hours, you can have someone with a life-threatening pneumonia," she adds.

Other groups at high risk from these viruses include people with AIDS (news - web sites), people who have had an organ transplant, people in nursing homes and older people with two or more risk factors, such as emphysema or heart disease.

Hicks and her colleagues gathered information on the incidence of three common respiratory infections at three large bone marrow transplant centers in the United States and in Europe. The viruses studied were influenza (flu) and two common childhood viruses, parainfluenza and RSV.

Flu still claims 20,000 lives in the United States every year. RSV causes 4,500 deaths and 90,000 hospitalizations annually, mainly in children, and parainfluenza is responsible for 70,000 hospitalizations every year, according to the study.

The viruses are transmitted through direct contact with body secretions, such as saliva, or by inhaling contaminated droplets in the air.

In most healthy adults, these viruses are rarely serious, but in those with compromised immune systems they can be deadly. This study found that between 30 percent and 50 percent of those undergoing treatment at these centers had one of these respiratory infections, and the mortality rate was between 28 percent and 75 percent.

There are treatments for these infections, but Hicks says they're often ineffective, expensive and difficult to administer. That's why the authors emphasize prevention.

Prevention is also important because of new, emerging viruses, such as SARS (news - web sites) and West Nile, Hicks says.

First, she says, get a flu vaccine. Next, she recommends thorough and frequent hand washing. During months when these viruses are particularly active, she says it's best for people with cancer to avoid places with large crowds, such as movie theaters and malls. She adds you should also let family members know that, if they have a cold, they need to stay away until they're better. And at the first sign of illness, let your provider know because these illnesses can quickly progress.

Dr. Jay Brooks, chair of hematology and oncology at the Ochsner Clinic Foundation in New Orleans, says people definitely underestimate the risk of infection when they're undergoing cancer treatment.

"The flu vaccine is very important and is grossly underused," Brooks adds. The study says that only 20 percent of those at high risk get vaccinated for influenza every year. Brooks also says that if possible, immune-compromised patients should get the pneumoccocal vaccine as well.

More information

To learn more about cancer and common infections, visit the American Cancer Society. For more information on RSV, go to the U.S. Centers for Disease Control and Prevention.

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Gene Variation Can Boost Risk of Diabetes, Thyroid Problems

By Kathleen Doheny
HealthScoutNews Reporter
Wednesday, April 30, 2003

WEDNESDAY, April 30 (HealthScoutNews) -- Alterations to a key gene that helps regulate the immune system can increase a person's risk of getting early-onset diabetes or having thyroid problems, British researchers say.

The gene believed to boost risk if it has the variation is the CTLA-4 gene, they report in the May 1 online issue of the journal Nature.

"Only about 10 genetic associations in all of common disease have been established," says John Todd, a professor of medical genetics at the University of Cambridge. "And CTLA-4 can now be added to the short list."

This variation is present in about half the population, according to the researchers. The gene applies a kind of "molecular brake" to stop the immune system from running amok and causing autoimmune disorders -- diseases in which the body turns on itself and attacks normal cells instead of attacking invading organisms.

Before arriving at the conclusion, the researchers conducted genetic studies in families. They found that a small region of the human genome (news - web sites) on chromosome 2 was home to three genes associated with the immune response, and decided they would be suspect candidates for contributing to the disorders. A mouse model of early-onset (type 1) diabetes had already confirmed that susceptibility to the disease was associated with the same three genes.

When they analyzed the genes for small genetic variations, they found that having the variants on the CTLA-4 gene increased susceptibility not only to type 1 diabetes, but also to two thyroid disorders -- Grave's disease, in which the gland enlarges and overproduces thyroid hormone, and autoimmune hypothyroidism, in which the immune cells inappropriately attack the gland and make it underactive.

"The CTLA-4 gene has a very fundamental role in the immune system regulation of the T lymphocytes' [a kind of white blood cell that fights infection] activation and expansion," Todd says. "T cell activity is central to all these diseases, and hence a gene that has this critical effect on T cells will affect many diseases," he adds.

While there is no immediate benefit from the new finding to those already affected by the thyroid disorders or diabetes, the hope is that the discovery will help experts target future therapy or help identify those at high risk.

"Its a very important study in both immunology and human genetics," says Michael Curran, a postdoctoral fellow in immunology at the University of California at Berkeley. "It shows that CTLA-4 misregulation can predispose to a variety of autoimmune disorders."

It was already known, he adds, that absence of CTLA-4 can cause problems, "but this study highlights that even minor perturbations in the levels of expression of various forms of CTLA-4 can have significant autoimmune consequences."

"The authors very convincingly show that a mutation in a non-coding region of the CTLA-4 genes -- that is, a mutation which indirectly affects the type or levels of the CTLA-4 protein that is produced, rather than one [a mutation] which directly alters the coding sequence for the protein -- predisposes its bearers to Graves' and autoimmune hypothyroidism. An association with type 1 diabetes is also suggested but less strongly supported by their data," Curran says.

The weakness of the study, Curran adds, is that while the statistical linkage between these CTLA-4 mutations and disease susceptibility are well proven, the biological mechanisms by which the mutations boost risk "remain unproven and largely speculative."

The significance of the finding? "Mapping risk factors for multi-genetic disorders such as type 1 diabetes might allow you to identify individuals at higher risk and give them preventive treatment," Curran says. But he cautions that the treatment would have to have minimal side effects and be deemed safe first.

More information

To find out about thyroid disorders, click on the American Thyroid Association.. For diabetes information, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

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Freezing Shrinks Fibroids, Avoids Surgery

By Alison McCook
Reuters Health
Wednesday, April 30, 2003

NEW ORLEANS (Reuters Health) - Freezing benign uterine growths called fibroids may reduce the size and symptoms of the fibroids and allow women to avoid surgery, according to a small study presented here Tuesday.

Fibroids are non-cancerous tumors that occur in about one-fourth to one-half of women. The growths do not need to be treated unless they grow very large or cause symptoms such as heavy menstrual bleeding, abdominal pain and pressure, and frequent urination.

The latest technique joins the ranks of many other strategies proposed to treat fibroids, including hysterectomy, removal of the fibroids alone, and cutting off the fibroid blood supply. Fibroids are the leading cause of hysterectomy, or removal of the uterus, in the U.S.

The new findings were reported during the annual meeting of the American College of Obstetricians and Gynecologists, and during last year's meeting, researchers presented results of another preliminary study that suggest fibroids can be destroyed using heat, as well.

During the newest procedure, known as laparoscopic cryomyolysis, doctors make a small incision in the patient's abdomen and insert a laparoscope, a slender tube used during minimally invasive surgery.

Once the laparoscope homes in on a fibroid, doctors insert a probe into the tumor and release a gas that freezes the fibroid.

In preliminary tests of the procedure in 20 women with fibroids in their uterus between four and 10 centimeters, Dr. Duane Townsend and his colleagues discovered that the fibroids had shrunk by an average of 57 percent six months after the procedure.

Scans of the patients' abdomens revealed that the technique had also cut off most of the fibroids' blood supply, a crucial step in controlling the tumors.

Moreover, within two weeks, 15 of the 20 patients experienced a "complete resolution" of their symptoms, and four others reported "significant improvement." One woman said she had no change in urinary frequency after the procedure.

"Women return to normal (menstrual cycles), the pain disappears, the pressure disappears, the fibroid just starts to shrink up," Townsend told Reuters Health.

He added that the procedure is much easier to recover from than major surgery to remove fibroids or the entire uterus, and women can be "in and out in the same day."

While a growing body of research suggests that cutting off the blood supply to fibroids -- known as uterine artery embolization -- helps many women, that procedure can be very painful, Townsend said. In contrast, none of the women given laparoscopic cryomyolysis needed pain medications after surgery.

"This doesn't have any pain," he said.

Townsend is in private practice in Park City, Utah, and also receives speaking fees from the maker of the probes used to freeze fibroids, American Medical Systems, Inc.

He cautioned that these are very early findings in a very small group of women, and more research is needed to determine whether the fibroids return over time.

However, Townsend noted that, in his opinion, this technique will become very important soon.

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Eat What You Watch

Wednesday, April 30, 2003

(HealthScoutNews) -- If you're trying to diet, here's another angle you ought to know about.

According to the Journal of Abnormal Psychology, researchers at the University of Health Sciences at Chicago Medical School found 91 women, all of whom were trying to stick to diets, and showed them a travel movie, a comedy or a horror movie. Then they all went to a buffet:

  • The women who saw the travel movie ate properly, sticking to their diets.
  • The women who saw the comedy ate a bit more than they were supposed to.
  • The women who saw the horror movie ate the most.

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Fever Takes a Bath

Tuesday, April 29, 2003

(HealthScoutNews) -- When your baby has a fever, there are two traditional ways to bring down his or her temperature: with a tepid sponge bath or with medicine.

Researchers at the University of Arizona studied which way worked best.

As reported in the American Journal of Emergency Medicine, they treated 20 infants who had fevers. All the infants got a dose of acetaminophen, but half also were given a sponge bath.

The babies were monitored, both to see how feverish they were, and if they showed signs of discomfort -- crying, shivering or goose bumps.

In favor of sponge baths: the fever went down faster in the first hour. Against sponge baths: the babies showed a lot more signs of discomfort.

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U.S. Health Experts Call for Focus on Minority Men

By Todd Zwillich
Reuters Health
Tuesday, April 29, 2003

WASHINGTON (Reuters Health) - U.S. health experts issued a plea Tuesday for heightened attention toward minority men's health issues, calling for across-the-board improvements in blacks' and Latinos' access to health care.

They also called directly on minority men to take more control of their own health by eating right and making regular doctor visits.

"Our nation is paying a heavy cost" in chronic disease and disability among minority men, said Dr. Louis W. Sullivan, president emeritus of the Morehouse School of Medicine in Atlanta and a former Secretary of Health and Human Services (news - web sites).

Sullivan noted a now-familiar statistic indicating that African-American men die an average of five years earlier than white men. African-American and Latino men also suffer from higher rates of nearly every widespread chronic disease, including high blood pressure, diabetes and obesity.

African Americans are also nearly twice as likely to die of prostate cancer (news - web sites) than their white counterparts, according to Centers for Disease Control and Prevention (news - web sites) figures.

Experts attribute much of the difference to disparate access to health insurance and basic health care. But they also pointed to cultural attitudes that prevent many minority men from seeking early health care that can head off many diseases before they become life-threatening.

Men are nearly three times less likely than women their own age to visit a doctor, according to a joint study from the University of California Los Angeles and the Henry J. Kaiser Family Foundation.

"In my experience, men generally didn't seek care until they were in pain," said Rep. Donna Christian-Christensen, a delegate to the House of Representatives from the U.S. Virgin Islands who is also a physician.

Henrie M. Treadwell, a program director for the W.K. Kellogg Foundation noted researchers' lagging attention to health disparities in most areas.

"There is very little there other than research on prostate cancer or HIV (news - web sites)/AIDS (news - web sites)," she said. "There's very little in the (scientific) literature about men of color."

The May issue of the American Journal of Public Health is devoted to minority men's heath issues. It includes a study of approximately 1,000 African-American adults indicating that a majority would not be opposed to raising cigarette taxes in a bid to make them less attractive to smokers.

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Breast Cancer Screening Found Effective

By Ed Edelson
HealthScoutNews Reporter
Tuesday, April 29, 2003

THURSDAY, April 24 (HealthScoutNews) -- Mammography saves lives, two European cancer centers report.

Breast cancer (news - web sites) deaths in women ages 55 to 74 dropped by about 20 percent after a mammography program to screen for early signs of the disease was started in The Netherlands, says a report in the April 26 issue of The Lancet by physicians at the Erasmus Medical Center.

Mammography, rather than better treatment, was responsible for most of the decrease, since the death rate for women who did not have mammography went down by only 16 percent, the report says.

The nation's breast cancer death rate, which had been going up by 0.3 percent a year, has been declining by 1.7 percent a year since mammography screening began in 1989, the report says.

"The turning point coincided with the year mammography screening was introduced," says Dr. Harry de Koning, associate professor of public health at the medical center and lead author of the report.

And the risk of breast cancer death among women ages 40 to 69 in two Swedish counties dropped by 44 percent, compared to women who were diagnosed with the disease in the years before mammography was introduced, says a report in the same journal by physicians at Falun Central Hospital.

"The papers are not exactly comparable because they used slightly different methods," says Dr. Laszlo Tabar, chairman of the mammography department at the Falun hospital and lead author of the Swedish report.

"We could determine in every single case whether the woman actually received a mammogram or declined," he says. "The Dutch study cannot distinguish. Therefore, they are publishing the results of 'invitation to screening' while we can tell the value of 'attending screening.' "

"But taking all these differences into account, both of them clearly demonstrate that early detection and treatment in early stages decreases death from breast cancer significantly."

De Koning agrees. "Both studies show that routine screening can reduce breast cancer mortality," he says.

In the United States, the National Cancer Institute (news - web sites) affirmed its support for mammography screening in January 2002, after a survey paper raised questions about its efficacy. The United States Preventive Services Task Force recommends women 40 and older should receive mammography every one to two years, with or without clinical breast examination. Mammography every one to two years is recommended for women over 50.

Women with a higher risk of breast cancer, because of a family history of the disease or other factors, are advised to consult their doctor early.

More information

Material on every aspect of mammography is available from the National Library of Medicine or the American Cancer Society.

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Regular Fasting Seems to Improve Health

The Associated Press
Tuesday, April 29, 2003

WASHINGTON - The health benefits of sharply cutting calories may occur after periodic fasting, even if the fast does not result in eating less overall, a new report indicates.

Scientists are now planning a study to see if fasting, which seems to benefit mice, will also be good for people too.

Benefits ranging from longer life to less stress and greater sensitivity to insulin have been reported in recent studies of severe reductions in diet.

But mice that were fed only every other day, but were allowed to gorge themselves on the days they ate, had similar health benefits to ones on a diet reduced by 40 percent of normal food intake, a team of researchers reports in Tuesday's online edition of Proceedings of the National Academy of Sciences (news - web sites).

While the cause of health improvements from cutting back on diet isn't fully understood, many researchers had assumed that a long-term reduction in calories was involved.

The new study by Mark Mattson and colleagues at the National Institute on Aging found equal benefits, however, for mice that ate only every other day, even if they didn't cut total calories, because they ate twice as much on days they weren't fasting.

Mattson said a study is being planned to test the effect of fasting on people. The plan is to compare the health of a group of people fed the normal three meals a day with a similar group, eating the same diet and amount of food, but consuming it within four hours and then fasting for 20 hours before eating again.

"Overeating is a big problem now in this country. It's particularly troublesome that a lot of children are overweight. It's still unclear the best way to somehow get people to eat less," Mattson said.

"One possibility is skipping a meal a day. Our study suggests that skipping meals is not bad for you."

Dr. Carol Braunschweig of the University of Illinois at Chicago, who was not part of the study team, said she was intrigued by the suggestion that a drastic change in eating patterns might have benefits.

"With the current epidemic of obesity and physical inactivity facing the U.S. today, identification of a beneficial eating pattern that could address some of the untoward effects of excess weight would be a very significant finding," she said.

Mattson said an earlier study found that mice that fasted every other day had extended life spans. The new experiment found the mice also did better in factors involved in diabetes and nerve damage in the brain similar to Alzheimer's disease (news - web sites), he said.

"We think what happens is going without food imposes a mild stress on cells, and cells respond by increasing their ability to cope with more severe stress," Mattson said. "It's sort of analogous to physical effects of exercise on muscle cells."

He said the researchers think this stress occurs throughout the body, which might be the reason fasting seems to increase life span and the animals become more resistant to the diseases of aging.

The dieting mice consumed 40 percent less food than mice eating normally and lost nearly half their body weight (49 percent) in the experiment, while the fasting mice weighed only a little less than mice eating normally.

In recent years, some nutritionists have recommended eating smaller amounts more often, but this study did not deal with that type of eating pattern.

In the new report, the researchers said both the fasting mice and those on a restricted diet had concentrations of blood sugar and insulin that were significantly lower than mice allowed to eat whenever they wanted. Indeed, insulin levels in the fasting mice were even a bit lower than the dieting ones.

At the end of the experiment all three groups of mice were injected with a toxin that damages cells in the part of the brain called the hippocampus. Cell damage there is involved in Alzheimer's in humans.

When the mouse brains were later analyzed the scientists found that the brains of the fasting mice were more resistant to damage by the toxin than the brains of either dieting mice or those eating normally.

On the Net:

Proceedings of the National Academy of Sciences:

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New Test May Help Hepatitis B Patients

By Randy Dotinga
HealthScoutNews Reporter
Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- Researchers think they've discovered a way to tell if patients infected with a type of hepatitis will eventually fail to respond to a powerful drug.

If the researchers are right, their test could help doctors do a better job of adjusting medications for people with hepatitis B, a deadly type of liver disease.

"About half to two-thirds of patients will basically fail the therapy after two to three years because they acquire drug resistance," says study co-author Brent Korba, a professor of microbiology at Georgetown University Medical Center. "It would be nice if you could predict those who are most likely to fail so you don't treat them (with the drug)."

Hepatitis B is one of several types of liver diseases that share little but the same name. An estimated 1.25 million Americans are infected with chronic cases of hepatitis B, which is typically spread through sex, needle-sharing and transmission from mother to baby during birth. Liver disease kills as many as one in four of those who suffer from the chronic form of the disease.

Hepatitis B, like AIDS (news - web sites), responds to antiviral drugs. One of them, called lamivudine, is commonly used to keep hepatitis B under control. "It's probably the first treatment choice for chronic hepatitis B today," Korba says.

But in many patients, the hepatitis B virus mutates into forms that become immune to lamivudine and other drugs. For that reason, many doctors are hesitant about giving patients the drug until they are in the later stages of infection.

Korba and his colleagues decided to study the hepatitis B virus's genetic makeup in 26 patients who had undergone treatment with lamivudine to see if there were any early warning signs of trouble. They reported their findings Monday at the 16th International Conference for Antiviral Research in Savannah, Ga.

The researchers found DNA "markers" in the genetic makeup of the virus in the patients who either developed an immunity to lamivudine or never responded to it at all. They couldn't find the markers in the virus in patients who responded well to the drug, says study co-author John Gerin, a professor of microbiology and immunology at Georgetown University Medical Center.

The test for the DNA markers is cost-effective, he adds. Alternatives to lamivudine are scarce, however. Only two other drugs are licensed for use in hepatitis B patients.

But Gerin says new drugs are on the horizon: "We do hope there will be options."

Frank Myers, an epidemiologist at Scripps Mercy Hospital in San Diego, says the findings are promising, especially if they can be extended to predict potential drug resistance in other diseases such as AIDS.

"We can not know if this new technique could be used with other viruses like HIV (news - web sites), but if it could, the benefits could be enormous," Myers explains.

More information

To learn more about hepatitis B, visit the U.S. Centers for Disease Control and Prevention. Or try the Hepatitis B Foundation.

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Men Don't Fully Understand Prostate Cancer Test

By Eric Sabo
Reuters Health
Tuesday, April 29, 2003

NEW YORK (Reuters Health) - Most men do not understand the possible downsides of a common screening test for prostate cancer (news - web sites), according to a survey released Tuesday.

Despite the controversy surrounding the prostate-specific antigen (PSA) test, a majority of respondents held an optimistic view of the early detection method, saying that the PSA test can save lives and that doctors agree on its use.

But the truth, researchers say, is far more complicated.

"The easy sound-bite is that screening saves lives," said Dr. Evelyn C. Y. Chan of the University of Texas-Houston Medical School, who led the survey. "There is really a lot more to it."

Blood testing for PSA levels has been used as a cancer detection tool since the early 1990s, but experts are still debating whether such tests offer any additional value to other prostate cancer screening methods.

A number of prominent groups, including the U.S. Preventive Services Task Force and the National Cancer Institute (news - web sites), are opposed to routine PSA screening, saying that the risks of follow-up tests and the side effects of treatment may outweigh the possible benefits for many men.

Because prostate cancer often progresses slowly, the disease can sometimes go without immediate treatment. In some cases -- particularly when a man is elderly or in poor overall health -- it may not be worth asking the patient to risk the side effects of surgery, radiation or other therapy.

Given the controversy over PSA screening for early cancer, the American Cancer Society (news - web sites) and other test supporters urge men to discuss the pros and cons of the test with their doctors.

But the shortcomings of the test appeared largely unclear to 271 Texas men who were involved in the survey, with 60 percent failing to realize there were at least some negative aspects to screening. The findings are published in the May issue of the American Journal of Public Health.

Most troubling, Chan told Reuters Health, was the belief held by more than 90 percent of the men that the use of PSA tests has reduced prostate cancer deaths. This has yet to be proven, and results from large-scale trials that can resolve the issue are not expected for another five years.

A majority of men also said that doctors are "sure" that PSA measurements are a useful test for prostate cancer, even though professional organizations are deeply divided. Chan said that a simple PSA blood test is not as innocuous as it sounds. No test is perfect, and results that either suggest prostate cancer or give a clean bill of health can be misleading.

"The PSA test is not the end-all of diagnosing prostate cancer," Chan said, adding that abnormal PSA findings must be followed by painful biopsies to ferret out false alarms. "This test can lead you down a path where you have to make a series of difficult decisions."

Not the least of these difficult decisions is whether to seek treatment immediately or wait until the cancer appears more dangerous. This is especially important for older men with prostate cancer, who are more likely to die from causes other than the cancer.

In the survey, however, men seemed confused on this issue, as well. Nearly 90 percent responded that treating early-stage prostate cancer would prolong life, although there is debate as to whether treatment is better than "watchful waiting" when the tumor has not spread beyond the prostate.

With the watchful-waiting approach, doctors monitor early-stage tumors to see whether they progress, instead of giving immediate treatment.

At a minimum, Chan said that men should be aware that PSA tests are not foolproof and that there is still no way of knowing whether they save lives. But she admitted that this information has proven hard to get out.

"We don't have a targeted message yet," she said.

Source: American Journal of Public Health 2003;93:

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Shorter Life Span for Men Called Crisis

By Rebecca Carroll
Associated Press Writer
The Associated Press
Tuesday, April 29, 2003

WASHINGTON - Like many men, NBA all-star Alonzo Mourning used to shrug off pain.

"I, too, was one of the Superman syndrome-type guys," he said Tuesday at a briefing on men's health. "That's the mentality of many men of color."

It's also one of the reasons U.S. men die on average almost five years before women, and far sooner if they belong to racial or ethnic minorities. The American Journal of Public Health calls the phenomenon a "silent health crisis."

In its May issue, the journal reports that many minority men lack access to good health services and insurance: while 17 percent of white men are uninsured, 28 percent of black men and almost half the Hispanic men have no insurance. At the same time, it contends that cultural beliefs about masculinity also are undermining good health care.

"Men generally don't like to appear weak, needing advice, not being in control," said Louis Sullivan, former secretary of the Health and Human Services (news - web sites).

Indeed, women are twice as likely as men to visit a doctor each year, and men's visits are shorter and less likely to include advice on behavioral changes that would improve health, sociologist David Williams of the University of Michigan wrote in the journal.

Among the journal's other findings:

  • Men have higher death rates than women for each of the 15 leading causes of death except Alzheimer's disease (news - web sites). Men's death rates are at least twice as high for accidents, murder, suicide and sclerosis of the liver.
  • Women have lived longer for the past century. Although the gap is narrowing, men's life expectancy remains almost five years shorter than women's and black men normally die almost 12 years earlier than white women.
  • When it comes to chronic disease, men are slightly more likely to get high blood pressure or cancer, and twice as likely to consume more than five alcoholic drinks a day.

Joseph Betancourt, a senior scientist at the Harvard University Institute for Health Policy, said trust and image problems also hinder effective relationships between doctors and male patients, minorities in particular.

Betancourt said doctors have to understand the priorities of their patients and work with them.

Mourning, a center for the Miami Heat, said realization came for him after his diagnosis with a rare kidney-destroying disease in 2000. Now, he said, "First and foremost, I make my health a priority."

Sullivan said he hoped that health advocates like Mourning would raise awareness and result in more research on men's health issues.

"From whatever side of the political spectrum you approach this, the need to act is critical," he said.

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Rocket Fuel Component in U.S. Lettuce: Study

Tuesday, April 29, 2003

LOS ANGELES (Reuters) - California's winter crop of lettuce contains unhealthy levels of a rocket fuel component that can harm developing fetuses, according to a small study conducted for an environmental group by Texas Tech University.

The study, commissioned by the nonprofit Environmental Working Group, showed that lettuce produced in California's Central Valley farmland between October and March each year absorbs four times as much perchlorate from the Colorado River as is considered safe by federal environmental authorities.

Although just 22 samples of lettuce were examined for traces of the solid rocket fuel component, the study's organizers hoped it would spur a more comprehensive look at the situation.

"We are a small non-profit organization and we are hoping that the results from our admittedly small sample will spur the federal government to do a more definitive study," Environmental Working Group spokesman Bill Walker said on Monday. "This question has been around since 1997 yet the federal government has failed to clear it up."

Perchlorate is the explosive component of rocket and missile fuel and is highly soluble in water. Exposure to perchlorate can cause mental retardation, loss of hearing and speech, and motor skill deficits in developing fetuses.

Perchlorate contaminates the drinking water of 20 million people in 20 states, and the Colorado River, which irrigates 70 percent of the nation's winter lettuce, the study said.

The U.S. Environmental Protection Agency (news - web sites) has tentatively set the standards (news - web sites) for safe perchlorate levels in water at one microgram per liter but there are now no enforceable standards or widespread testing for the substance, the study found.

In January and February, the scientists bought 22 commercial lettuce samples for analysis, including prepackaged and head lettuces, adult and baby greens, both organically and conventionally grown from several different distributors.

Four of the samples contained an average of four micrograms per liter, the study said. Although the rest did not have measurable levels, researchers cautioned that the detection level for perchlorate in foods is relatively high.

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Young People Skipping Sunscreen

By Janice Billingsley
HealthScoutNews Reporter
Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- Forget Nicole Kidman's pale good looks. Tan, unfortunately, is in, health experts say.

Americans, who eight years ago seemed to be heeding warnings to take precautions against the sun, are now back at the beach with little protection, according to a new survey.

In 1996, 54 percent of those who were out in the sun used sunscreen regularly, according to the American Academy of Dermatology (AAD), but the organization's 2003 survey found that the percentage of Americans reporting regular use of sunscreen has dropped to 40 percent, says Dr. Darrell Rigel, a dermatologist at the New York University Medical Center.

Even more discouraging is that young people under 25, the age group for whom sun protection is most important for preventing future cancers, are even less likely to use sunscreen. Only 34 percent of this age group reports using sunscreen regularly, compared to 49 percent of those young people who claimed they used protection in 1996.

"There is clearly a disconnect. The message is out there that sun is bad for you, but people still think they look better and healthier with a tan," Rigel says.

The reasons why young people are flocking to the sun, or tanning salons, are several, say dermatologists.

"The cultural taste needs to change from the idea that a tan looks 'hot,' that you need it to look great at the prom," says Dr. James Spencer, a dermatologist at the Mount Sinai School of Medicine.

Also a problem, says Rigel, is the latent nature of skin cancer. It usually doesn't manifest itself until 10 or 20 years after sun exposure, which for most young people might as well be never.

"They're not going to get skin cancer until they're 50 or 60, and when you're 16, you're not worried about what's going to happen when you're 60 -- kids feel immortal," he says.

Rigel and Spencer made their remarks Tuesday in New York City at an AAD press conference launching the 2003 Melanoma/Skin Cancer Detection and Prevention Month, which will kick off next Monday with free skin-cancer screenings at Bryant Park in Manhattan and elsewhere in the United States.

Other findings in the study:

  • People over 35 were more diligent about avoiding sun exposure than were people under that age. Since 1996, these adults reported a 16 percent decrease in the number of sunburns they received. Among those under 18, by contrast, the numbers of people reporting at least one sunburn increased from 52 percent to 61 percent from 1996 to 2003.
  • 79 percent of people over 35 reported putting sunscreen on their children and grandchildren.
  • Use of tanning salons by those under the age of 25 jumped dramatically, from 8 percent in 1996 to 26 percent in 2003. Women use the salons far more than men.

These findings are extremely worrisome in view of the fact that the incidence of skin cancer is on the rise, Rigel says.

"This is the only major cancer that is still increasing, with incidence increasing at 6 percent a year and the death rate rising 2 percent annually," he says.

In 2003, there will be more than 1 million cases of skin cancer diagnosed in the United States, Rigel says. The most common and most easily treated type is basal cell carcinoma, which will affect approximately 900,000 people. There will be approximately 250,000 cases of squamous cell carcinoma, and 91,900 cases of melanoma, which is the most serious form of skin cancer. It is estimated that 7,600 people will die from melanoma in 2003.

Skin cancer is caused by overexposure to the ultraviolet rays of the sun.

"There is no such thing as a safe tan," says Spencer, "and we have to change the perception of what a true healthy look is."

More information

The American Academy of Dermatology reports how you can protect yourself from the sun. The Skin Cancer Foundation explains how you can examine yourself for possible skin cancer.

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U.S. Says Preventable Injuries Serious Health Threat

By Paul Simao
Tuesday, April 29, 2003

ATLANTA (Reuters) - Deaths and injuries due to accidents and violent crime have reached epidemic levels in the United States and pose a threat to the nation's economic and social well-being, federal health officials said on Monday.

Injury is the top killer of Americans in the first four decades of life and costs the nation at least $260 billion in health care, lost productivity and other expenses each year, according to the Centers for Disease Control and Prevention (news - web sites).

One in 10 people ends up in an emergency room each year as a result of car crashes, falls or violent acts.

"We have to respond to this and need to treat it with the same urgency and the same crisis mentality that we treat other emerging public health threats," Dr. Julie Gerberding, director of the CDC, said at the beginning of the agency's national injury prevention conference in Atlanta.

Gerberding, who has spent much of the past month responding to a deadly global outbreak of the pneumonia-like SARS (news - web sites) disease, said a national strategy was required to make Americans less complacent about the risk of injury.

The CDC as well as the U.S. Surgeon General's Office and other agencies have been pushing for programs targeting groups at higher risk for injuries such as teen-agers and drunk drivers.

Officials said most of the nation's injuries could be prevented if legislators, health-care providers, religious leaders, teachers and parents joined a campaign to educate people at risk.

They cited recent efforts to promote the use of seat belts and discourage impaired driving as examples of cooperation between governments and individuals that had helped reduce the toll of deaths and injuries.

"This is a disease. We know how it spreads and we know what the cure is," said Dr. Jeffrey Runge, head of the National Highway Traffic Safety Administration (news - web sites). "If we can just get all our community singing the same song."

A CDC study released on Monday suggested that the scale of the problem was, indeed, enormous.

The health-related costs of rape, physical assault, stalking and other violence directed at women by their husbands or partners is more than $5.8 billion per year, according to the CDC study, which was based on data from a 1995 survey.

The CDC said it was funding programs to support rape prevention and education efforts in all 50 states, the District of Columbia and eight U.S. territories.

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Elective C-Sections Reduce Incontinence Risk

By Amanda Gardner
HealthScoutNews Reporter
Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- Women who have elective cesarean sections without suffering the strain of labor have a far lower risk of urinary incontinence than women who undergo vaginal delivery or have C-sections after going through labor.

These findings, presented Monday at the American Urological Association's annual meeting in Chicago, add to the continuing debate on whether preventing incontinence should be a reason to schedule a C-section.

"This is the first prospective study to show a definite, persistent difference in stress urinary incontinence 12 months after delivery," says Dr. Kristene Whitmore, director of the Pelvic Floor Institute at Graduate Hospital in Philadelphia.

"From a patient perspective, it's a very provocative idea because women don't like C-sections in general, and the whole idea is that we're saying we're doing too many," says Dr. Boris Petrikovsky, chairman of obstetrics and gynecology at Nassau University Medical Center in East Meadow, N.Y.

"Clearly, [physicians] don't want to convert obstetrical service into surgical service, but in view of this information, you sort of look at the data a little differently now," he adds. "It's still very much in the gray area. It's very hard to recommend an elective C-section to a patient who may have a successful vaginal delivery."

The authors of the study maintain that using elective C-sections to prevent this type of injury remains "controversial."

The number of C-sections performed in the United States has skyrocketed, with almost one-quarter of babies now delivered this way, the highest rate since the government started collecting data in 1989.

According to the study authors, injury to the muscle tissue and nerves of the pelvic floor during vaginal delivery is the most common cause of stress urinary incontinence, or SUI. Stress incontinence is urine leakage that occurs as a result of physical activity, including laughing or coughing. Pregnancy itself, with its hormonal and mechanical changes, might also contribute to the problem.

The researchers, based in Tel Aviv, Israel, looked at 318 Israeli women who gave birth to their first baby either through vaginal delivery, elective C-section or a C-section performed as a result of difficult labor. They were assessed for stress urinary incontinence at one year after the delivery.

The prevalence of postpartum stress urinary incontinence was 12 percent for the spontaneous vaginal delivery group, and 14 percent for those who had received C-sections after obstructed labor. The women who had had elective surgery, however, had a rate of only four percent.

This doesn't mean that all these women will always be incontinent. Very often, Petrikovsky says, urinary and fecal incontinence after delivery are temporary conditions.

"When patients come with those complaints immediately after delivery, I usually advise a six-to-eight-month wait and not do anything," he says. "In the majority of them, the problem will disappear or at least diminish very significantly. So, the patients who will really have permanent problems are really a minority -- less than five percent."

Urinary incontinence is also eminently treatable, often with simple exercises that work the pelvic floor muscles, but also with surgery.

Whitmore, on the other hand, feels that women will be more likely to choose a C-section in light of this study, if their insurance will allow it. Not only would it reduce the risk of urinary incontinence, but also fecal incontinence and pelvic organ prolapse, when the bladder, uterus or bowel drops out of place.

"Up to 30 percent of women have some sort of pelvic floor disorder after labor," Whitmore says. "This study will allow women to make their own decision as to whether they want vaginal birth or not, which is not to say that C-sections do not have complications."

Petrikovsky says, "The lesson we can take out of this and other studies is that if you anticipate a difficult, long vaginal delivery, if the mother has a narrow pelvis, it's a large baby and there's a previous history of very difficult delivery, you may consider discussing C-section with the patient. Especially if she's concerned with the possibility of disruption of the pelvic floor."

More information

For more on urinary incontinence in women, visit the National Kidney and Urologic Diseases Information Clearinghouse. For more on C-sections, visit

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Disabled U.S. Seniors Lack Needed Services: Report

By Karen Pallarito
Reuters Health
Tuesday, April 29, 2003

NEW YORK (Reuters Health) - Older Americans with disabilities are striving for a level of independence that often eludes them under the current health care system, according to a study released Tuesday by the AARP.

The group said the findings raise concern that the U.S. is ill prepared to meet the demands of middle-aged and older Americans struggling to live on their own as they experience disabilities in the decades ahead.

Cost remains the largest barrier to obtaining needed services, the study found. In addition, many seniors remain unaware of existing support services that could make a difference.

"There is a gap between what's needed and what's available and a lack of a system for helping people stay independent," said John Rother, AARP's director of policy and strategy.

With more baby-boomers entering the age of high risk, "we will really need to have a system that helps people pay for the care that they need," he said.

The report, "Beyond 50," is the third in AARP's annual series examining the challenges facing America's seniors. This year's report is based in part on findings from a first-ever national survey of disabled Americans 50 and older conducted last September by Harris Interactive.

Fewer than half of seniors with disabilities receive regular assistance with daily activities like bathing, cooking and shopping, and nearly a quarter need more help with these necessities, the poll revealed.

More than a third (36 percent) would like to make modifications to their homes that would make it easier for them to live independently. Cost was far and away the major barrier to making those changes, cited by 69 percent of respondents.

The study also found that many seniors cannot afford long-term supportive services such as skilled nursing and home care.

With nursing home costs averaging $55,000 a year, an extended stay could be financially devastating, AARP said.

The report also cites a recent study estimating that only 27 percent of older Americans have enough income and assets to weather a long-term "care shock" of $150,000 over three years without impoverishing themselves.

Inadequate health insurance also remains a top concern. Nearly a third (30 percent) of disabled seniors report specific needs for special equipment and therapies, for example, not covered by health insurance, the new survey found.

"Prescription drugs are clearly part of the need here," Rother said.

While passage of a Medicare prescription-drug benefit and other broader reforms will require fundamental policy changes, even minor changes can lead to important improvements for the disabled, AARP noted.

Because of significant budget shortfalls, "many states are cutting the very programs ... that are keeping people independent," Rother observed. He said AARP supports additional financial help for states, since the first priority should be to save what's already out there.

AARP also intends to encourage a "consumer-directed" approach to enabling people with disabilities to arrange for their own support services, an idea that received strong support in the Harris Interactive survey.

Early results of a federal demonstration in Arkansas suggest that participants are satisfied and receive better care than those who rely on traditional home care agencies.

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Shedding Light on Asthma

Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- A new magnetic resonance imaging technique that uses hyperpolarized helium to light up the lungs' airways may one day improve treatment for people with asthma.

That's what researchers at Brigham and Women's Hospital found. Their study appears in the May issue of Radiology.

The technique, called dynamic hyperpolarized 3He (helium) imaging, is the first method able to provide clear resolution of the smaller lung airways. It could help doctors better understand and treat asthma and other chronic obstructive pulmonary diseases.

In this study, six healthy adult volunteers aged 22 to 40 inhaled one breath of hyperpolarized helium gas while having magnetic resonance imaging. The researchers observed the volunteers' lungs using fast gradient-echo pulse sequence.

The images using this method showed differential contrast of both distal airways and lung periphery.

"Other non-radioactive techniques have only been able to image lung peripheries. Dynamic hyperpolarized helium MR imaging offers a completely noninvasive and safe method of studying the airways," principal investigator Mitchell S. Albert says in a news release.

"Our new technique provides information on ventilation, while depicting structure and function of the airways. Other non-radioactive imaging modalities do not provide this type of information," Albert adds.

More information

Here's where you can learn more about asthma.

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UK Study Looks at Drug-Induced Heart Arrhythmia

By Richard Woodman
Reuters Health
Tuesday, April 29, 2003

LONDON (Reuters Health) - The British Heart Foundation on Tuesday announced a 1.6-million project to discover which people could be at risk of potentially fatal heart-rhythm irregularities after taking certain medications.

In a statement, the charity said around 70 over-the-counter and prescription-only drugs might affect some people's heart rhythm. Fears about the suspected link had already resulted in the withdrawal of the hay fever remedy Triludan and the heartburn medication Propulsid.

As part of the new project, researchers at St George's Hospital Medical School in London and the Drug Safety Research Unit in Southampton are asking all doctors in England to identify patients who have developed irregular heart rhythm and/or abnormalities on ECG tests after taking medicines known to have this side effect. It is hoped that around 2,000 "control" patients with no such heart abnormalities will also take part in the project.

The first phase of the study aims to generate a "unique population" for future investigation, ultimately making drug-induced heart arrhythmia predictable and avoidable. The secondary aim would be to spur the development of safer therapies that could be tailored to an individual's genetic composition.

Professor Saad Shakir of the Drug Safety Research Unit said: "This project is vitally important -- not only because it has the potential to save lives in people who may have a yet undetected risk factor, but also to avert unnecessary panic about those drugs which are largely safe and beneficial to the majority of the population.

"We do not want to see drugs withdrawn from the market, especially if there is not a viable alternative for patients. We must remember it's not these remedies per se which pose a danger -- but simply a small minority of people who cannot tolerate their effects. We therefore hope this grant will enable us to identify those people and ensure they are protected from the risk."

The foundation said it is believed that many of the people who could be at risk of sudden death from heart arrhythmia suffer from mild forms of genetic conditions such as long QT or Brugada syndromes that might only come to light after taking a particular drug.

"These are thought to be relatively rare conditions affecting the heart's rhythm ... but because they are hard to detect, it is thought these cases could represent the tip of an iceberg," the charity said.

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The Risky Lives of American Men

By Ed Edelson
HealthScoutNews Reporter
Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- There's this odd thing about American men: They're a lot sicker than women, and die a lot sooner.

At every age, American males have poorer health and a higher death rate than their female counterparts, says David R. Williams, a senior research scientist at the University of Michigan Institute for Social Research.

Williams lays it out in the May issue of the American Journal of Public Health: If you take the 15 leading causes of death in the United States, men come in first in all but one, Alzheimer's disease (news - web sites). Their death rates are at least twice as high as women for suicide, homicide, cirrhosis of the liver, and accidents.

Those numbers hint that there are men who are not following the rules of healthy, lawful behavior, Williams acknowledges. More important, he says, is that the American picture of the macho man leads to destructive behavior.

"A good example is how men respond to stress," he says. "Women are more likely than men to seek social support, particularly from other women. Men are more likely to believe that any expression of distress shows their susceptibility, so they are more likely to turn to substances."

So men are more likely to smoke cigarettes (26 percent, compared to 22 percent of women) and twice as likely to have five or more drinks a day, Williams says.

In addition, men are more likely to work dangerous jobs, he says; 90 percent of on-the-job deaths kill men.

Farming is one field in which men tend to dominate and which abounds in dangers. Another report, delivered quite coincidentally at a U.S. Centers for Disease Control and Prevention (news - web sites) meeting in Atlanta this week, illustrates one of those dangers. Men are more than twice as likely to die during thunderstorms, according to Thomas J. Songer, an assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

There were 1,442 thunderstorm-related deaths in this country from 1994 through 2000, Songer's research finds, and 70 percent of the corpses were male. Most involved either lightning strikes or flash floods, with a few caused by tornadoes.

One reason why men are more likely to die in a thunderstorm is that they tend to do the macho, hence dangerous thing. In a low-lying area, where the danger is drowning, men will often drive around a barrier, and drown.

"Driving around a barrier is not a smart thing to do," Songer says.

Williams is more concerned with everyday perils. One thing society can do is restructure factories and other workplaces so they are less dangerous, he says. Another is to improve the quality of education.

"Education is very significant because a lot of the problems men face begin early in life," Williams says. "Two-thirds of men in the prison population are high school dropouts. Being a dropout puts a man on a trajectory toward economic failure that can lead to violent behavior."

But one real demand, Williams says, is that "we need a new definition of masculinity that includes greater responsibility for oneself."

More information

Guidelines to a healthy lifestyle for both men and women are offered by the American Heart Association. Information on thunderstorm safety is given by Collier County, Florida.

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Most Women Don't Prefer Female Doctors: Study

Reuters Health
Tuesday, April 29, 2003

NEW ORLEANS (Reuters Health) - Although the question of whether women generally prefer female obstetricians and gynecologists has been long debated, new research reported Monday suggests that, to most women, gender is not an issue.

Furthermore, women appear to be equally unlikely to prefer a female doctor when the specialty is family practice or surgery.

In research presented here at the annual meeting of the American College of Obstetricians and Gynecologists, 73 percent of women said that the gender of their obstetrician or gynecologist made no difference.

Moreover, women tended to rank gender as the least important characteristic they use when selecting a gynecologist, obstetrician, family doctor or surgeon.

Instead, they cited traits related to communication as most important in their decisions.

Women generally ranked expertise and reputation as moderately important when choosing an obstetrician or gynecologist.

However, a companion survey of physicians revealed that doctors appear to have a very different perception of what is important to their patients.

Doctors ranked nearly all of the characteristics as less important to patients than the patients ranked them themselves -- all, that is, except gender, which physicians ranked higher than patients did themselves.

"Physicians think gender is more important than patients do," Dr. Peter Vasilenko of Michigan State University in East Lansing and his colleagues reported.

The findings are based on surveys of 1,059 obstetrics and gynecology patients and 72 physicians.

Only 23 percent of patients said they had chosen their current obstetrician or gynecologist because she was female, and only four percent said they had chosen their doctor because he was male.

Patients who reported they preferred female obstetricians and gynecologists thought that finding a doctor who "understands women" was much more important than women who preferred men or had no gender preference did.

And women who preferred female obstetricians and gynecologists did not show a similar preference for female family doctors or surgeons.

In other differences seen among specialties, women tended to rank the characteristic of "expert in my problem" as more important for an obstetrician or gynecologist than a family doctor. In contrast, they believed that being "easy to talk to" and having a "good reputation with friends/family" was more important in family doctors than in obstetricians and gynecologists.

Qualities more valued in a surgeon than in an obstetrician or gynecologist included "expert in my problem," "business-like and efficient," "nonemotional," and "provides a lot of information."

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Gene Therapy Holds Promise for Impotency

By Randy Dotinga
HealthScoutNews Reporter
Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- Researchers think they may have found a way to help men avoid impotence caused by nerve damage, a risk faced by diabetics (news - web sites) and those who have their prostate removed.

While they haven't tried their approach on humans yet, the researchers say tests on rats suggest that a type of gene therapy may bring back the ability to have an erection.

The treatment could make prostate removal more tolerable, says study co-author Dr. Michael Chancellor, a professor of urology at the University of Pittsburgh. "Many men are afraid of even screening for prostate cancer (news - web sites). They're afraid of finding it, and they're afraid of the treatment."

The research was reported April 28 at the annual conference of the American Urological Association in Chicago.

While prostate removal is considered the "gold standard" treatment for prostate cancer, many men refuse to have it because of the potential risks of impotency and incontinence, Chancellor says. "They'd rather settle for something else even if there's a higher risk that the cancer may recur," he adds.

An estimated 80 percent of men who have their prostate removed suffer from so-called neuropathic erectile dysfunction.

The problems come during the surgery itself, Chancellor says. "The nerves from the pelvis to the penis travel immediately adjacent to the prostate gland," he explains. "If you just look at them wrong while removing the cancer, the nerves can be cut or partially damaged. Then the men don't get normal erectile function."

Other kinds of prostate cancer treatments, including radiation and cryotherapy (freezing), can also cause impotence by harming nerves, adds Dr. Allan Pantuck, an assistant professor of urology at the University of California at Los Angeles. Potential treatments for the resulting impotency include Viagra, urethral suppositories and direct injections into the penis, he says.

To give the nerves a fighting chance, Chancellor and his colleagues began examining an agent that protects nerves and encourages them to grow. But how could they deliver it to the nerves around the prostate?

In tests on rats with injured nerves, the researchers developed a way to piggyback the agent onto a harmless herpes virus and send it into the prostate region. In some of the rats, the nerves appeared to regenerate after exposure to the agent.

Ideally, the treatment could be given to men before prostate removal or during surgery, Chancellor says. It could also be used on diabetic men.

Pantuck says the findings are promising, but he cautions that the safety of gene therapy is still unclear. He adds the study size is small -- only 11 rats -- and it's hard to tell if the results are statistically significant.

More information

Learn about the disease by visiting the National Prostate Cancer Coalition or the National Cancer Institute.

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Scientists Discover Cancer-Resistant Mouse

By Keith Mulvihill
Reuters Health
Tuesday, April 29, 2003

NEW YORK (Reuters Health) - Scientists have discovered a type of mouse that appears to the have a genetic resistance to cancer.

The findings, published Monday in the journal Proceedings of the National Academy of Sciences (news - web sites), may shed light on why cancer in humans sometimes spontaneously regresses without treatment.

The new discovery was made by accident, according to Dr. Zheng Cui of Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina.

While injecting mice with an aggressive type of tumor cell in a separate study, one particular male mouse never developed cancer -- even after repeated injections. The other mice in the study weren't as lucky and developed cancer rapidly and died, explained Cui.

By breeding the lone mouse, the researchers created a whole line of mice with genetic resistance to cancer. About half of the offspring of the lone male mouse showed cancer resistance, which indicates that the genetic trait is dominant and probably due to one gene, explained Cui.

On further study, Cui's team found that when these mice were injected with tumor cells, their immune systems launched a massive attack and white blood cells destroyed the cancer but left normal cells alone.

Some of the mice showed complete resistance, while others got cancer but then underwent spontaneous regression.

Currently the team of researchers is searching for the particular gene that activates the immune system response, explained co-author Mark C. Willingham, in an interview with Reuters Health.

"We hope to eventually find a similar gene and mechanism in people," Willingham said.

Most importantly, according to Cui and Willingham, the mice may offer a first-of-a-kind model for analyzing cancer resistance and the phenomenon of spontaneous regression.

Source: Proceedings of the National Academy of Sciences 2003;10.1073/pnas.1031601100.

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Slim Fest

Tuesday, April 29, 2003

(HealthScoutNews) -- Staying slim is all a matter of taste.

That's the conclusion of research into that favorite phrase: "Life is uncertain; eat dessert first."

Researchers from the Robert Wood Johnson Medical School in New Jersey studied what happens when you follow that line of reasoning by observing the eating behavior of lean people, comparing it with the way overweight people eat.

To do this, they invited a large group to a buffet, and took careful notes.

Though everyone got to the table at about the same time, the overweight people headed for the dessert section earlier than the lean people -- and more of their meal was composed of energy-dense foods.

The lean group ate just as much food, but they ate more of the fruits and vegetables -- low-energy density -- and didn't get to the dessert section until the very end.

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Low-Birth-Weight Risk May Run in the Family

Reuters Health
Tuesday, April 29, 2003

NEW ORLEANS (Reuters Health) - Young mothers who were small at birth appear to be significantly more likely than their peers to have a low-birth-weight baby, researchers said Monday.

According to the findings, mothers younger than 25 who weighed less than 2,500 grams -- or 5.5 pounds -- at birth were more than three times as likely as other young mothers to give birth to a low-birth-weight baby.

And the smaller the mother at birth, the larger her chances of delivering a small baby. Among women of very low birth weight -- less than 1,500 grams, or 3.3 pounds -- the chances of having a low-birth-weight baby shot up by more than 30-fold.

In contrast, the father's birth weight appeared to have no effect on the risk of low birth weight in an infant.

"Maternal low birth weight is a significant risk factor for delivery of a low birth weight infant," according to Whitney B. Lee of St. Vincent's Hospital in Indianapolis and her colleagues.

They presented their findings here at the annual meeting of the American College of Obstetricians and Gynecologists.

To obtain their findings, the researchers noted the birth weights of parents of 665 low-birth-weight infants. All infants weighed less than 5.5 pounds at birth, and were not born as part of multiple births.

Other factors that appeared to increase the risk of low birth weight included a mother younger than 20 and fewer than six prenatal care visits.

Mothers who did not receive any prenatal care were almost 10 times as likely as others to deliver a low-birth-weight baby.

In contrast, women who began prenatal care during the first trimester were less than half as likely as others to have a low-birth-weight baby.

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Seniors Should Stay Healthy While on the Road

Tuesday, April 29, 2003

TUESDAY, April 29 (HealthScoutNews) -- If you're a senior who loves to travel, the International Society of Travel Medicine (ISTM) has some travel tips for you.

Anyone over age 50 who is traveling abroad or in the United States should take the following medical precautions, the ISTM says:

  • Review your health insurance policy. If it doesn't provide you with coverage abroad, you should buy a policy that does cover you when you're in other countries. Social Security (news - web sites) doesn't cover payment of hospital or medical services you may require when you travel outside the United States, and the U.S. government can't pay to have you medically evacuated back home. Escorted medical evacuation can cost thousands of dollars.
  • If your insurance doesn't cover medical expenses state-to-state or abroad, check out medical assistance companies. They offer emergency consultation by telephone.
  • Bring an ample supply of any required medications in their original containers. Many countries have strict narcotics laws. So bring along copies of your prescriptions and, if possible, a letter from your doctor explaining the need for the drug(s). You should also carry a letter from your doctor explaining desired treatment should you become ill. If you suffer from a heart condition, bring along your most recent EKG.
  • Never carry unlabeled medicines when going through airport security. People in wheelchairs should bring their owner's manuals with them. Airport security personal sometimes remove wheelchair parts to check for bombs and weapons.
  • Get up-to-date vaccinations, especially those that protect you against diseases present in the specific areas that you plan to visit.
  • Don't overextend yourself. Physical activity associated with travel can be strenuous and sudden changes in diet and climate can have serious health consequences for older people who are unprepared for those changes.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has more information about traveler's health.

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MONDAY, APRIL 28, 2003

Exercising During Pregnancy
Monday, April 28, 2003

Although you may not feel like running a marathon - especially in the first 3 months of pregnancy - most women benefit greatly from exercising throughout their pregnancy. But during that time you'll need to make a few adjustments to your normal exercise routine.

Discuss your exercise plans with your doctor or other health care provider early on. The level of exercise recommended will depend, in part, on your level of prepregnancy fitness.

Benefits of Exercising During Pregnancy
No doubt about it - if complications don't limit your ability to exercise throughout your pregnancy, exercise is a big plus for both you and your baby. Exercise can help you:

  • feel better - At a time when you wonder if this strange body can possibly be yours, exercise can increase your sense of being in control and boost your energy level. Appropriate exercise can relieve backaches and improve your posture by strengthening and toning muscles in your back, butt, and thighs; reduce constipation by accelerating movement in your intestines; and prevent wear and tear on your joints (which become loosened during pregnancy by normal hormonal changes) by activating the lubricating synovial fluid in your joints. Exercise also releases endorphins, naturally occurring chemicals in your brain that make you feel better. It helps you look better, too, by increasing blood flow to your skin and giving you a healthy glow. And if you have trouble sleeping, there's no better cure than healthy exercise, which can relieve the stress and anxiety that might make you restless at night.
  • prepare for birth - Strong muscles and a fit heart can greatly ease labor and delivery. Gaining control over your breathing can help you manage pain, and in the event of a lengthy labor, increased endurance can be a real help.
  • regain your prepregnancy body more quickly - You'll gain less fat weight during your pregnancy if you continue to exercise (assuming you exercised before becoming pregnant). But don't expect or try to lose weight by exercising while you're pregnant. For most women, the goal is to maintain their fitness level throughout pregnancy.

What's a Safe Exercise Plan When You're Pregnant?
It depends on when you start and whether your pregnancy is complicated. If you exercised regularly before becoming pregnant, continue your program, with modifications as you need them. If you weren't fit before you became pregnant, don't give up! Begin slowly and build gradually as you become stronger. Whatever your fitness level, you should talk to your doctor about exercising while you're pregnant.

As you exercise, the key is to listen to your body's warnings. Many women, for example, become dizzy early in their pregnancy, and as the baby grows, their center of gravity changes. So it may be easy for you to lose your balance, especially in the last trimester. Your energy level may also vary greatly from day to day. And as your baby grows and pushes up on your lungs, you'll notice a decreased ability to breathe in more air (and the oxygen it contains) when you exercise. If your body says, "Stop!" - stop!

Discuss any concerns you have with your doctor. You may need to limit your exercise if you have:

  • pregnancy-induced high blood pressure
  • early contractions
  • vaginal bleeding
  • premature rupture of your membranes, also known as your water (the fluid in the amniotic sac around the fetus) breaking early

What kind of exercise should you do? It depends on what interests you. Many women enjoy dancing, swimming, water aerobics, yoga, biking, or walking. Swimming is especially appealing, as it gives you welcome buoyancy. Try for a combination of cardio (aerobic), strength, and flexibility exercises, and avoid bouncing.

Many experts recommend walking. It's easy to vary the pace, add hills, and add distance. If you're just starting, begin with a moderately brisk pace for a mile, 3 days a week. Add a couple of minutes every week, pick up the pace a bit, and eventually add hills to your route. Whether you're a pro or a novice, go slowly for the first 5 minutes to warm up and use the last 5 minutes to cool down.

Pay attention to your body's signals, and stop when your body indicates it's time. If you feel fatigue, dizziness, heart palpitations (feel your heart pounding in your chest), shortness of breath, or pain in your back or pelvis, your body is saying it's had enough. And if you can't talk while you're exercising, you're doing it too strenuously. Keep your heart rate below 160 beats per minute.

It's not good for your baby if you become overheated, because temperatures greater than 102.6 degrees Fahrenheit (39 degrees Celsius) could cause problems with the developing fetus - especially in the first trimester - potentially leading to birth defects. So don't overdo exercise on hot days. When the weather is hot, try to avoid exercising outside during the hottest part of the day (from about 10 AM to 3 PM), or exercise in an air-conditioned place. Also, note that swimming makes it more difficult for you to notice your body heating up, because the water makes you feel cooler.

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SUNDAY, APRIL 27, 2003

If You Feel a Migraine Coming On . . .

Sunday, April 27, 2003

SUNDAY, April 27 (HealthScoutNews) -- If you sense your migraines seem to get worse with changes in barometric pressure, experts say it's probably not just in your head.

In fact, a number of weather conditions can trigger migraines, including barometric pressure, humidity and even wind changes, according to the National Headache Foundation (news - web sites).

Such weather factors can cause various changes in the body's chemical balance and, though it's not common, migraines can result. Specifically, changes in barometric pressure can cause the blood and blood vessels to compensate for reductions in oxygen and the scalp arteries can swell, bringing on the migraine.

Similar problems can occur among migraine sufferers when flying in an airplane, diving or traveling at high altitudes, because changes in oxygen levels produce inflamed blood vessels and nerves around the brain.

Migraines are often described as intense pain that can be on one side of the face or head. They can sometimes be accompanied by nausea and sensitivity to bright lights or loud noises.

Because of the many possible migraine triggers, experts with the American Medical Association recommend seeing your physician if migraines are a recurring problem. A good doctor will probably recommend a management plan that includes working to identify the factors that trigger your migraines, describing various medications to prevent or treat migraine attacks and considering lifestyle changes that could further prevent such headaches.

More information

The National Headache Foundation offers helpful information about migraines.

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Carpal Tunnel Strikes Slowly and Steadily

SUNDAY, April 27 (HealthScoutNews) -- Beware of that tingling or numbness in your wrist or hand. It could be the start of carpal tunnel syndrome (CTS).

CTS is a painful progressive condition caused by compression of the median nerve, which runs from your forearm to your hand, says the U.S. National Institute of Neurological Disorders and Stroke.

Symptoms of CTS usually start gradually with frequent burning, tingling or itching numbness in the palm of the hand and fingers. Some people with CTS say their fingers feel swollen, even when there is little or no apparent swelling.

CTS symptoms often appear in one hand or both hands during the night. That's because many people sleep with flexed wrists. Someone with CTS may wake up feeling the need to "shake out" a hand or wrist.

As CTS gets worse, a person may feel tingling during the day and then may notice that decreased grip strength makes it difficult to grab small objects or perform some manual tasks. Some people become unable to use touch to tell the difference between hot and cold.

In 1998, about three out of every 10,000 American workers had to take time off work because of CTS. Half of those workers missed more than 10 days of work. Medical bills and lost time from work result in an average lifetime cost of $30,000 for each worker who suffers from CTS.

Women are three times more likely than men to develop CTS. That may be due to the fact that the carpal tunnel in women is smaller than in men. For most people afflicted with CTS, the dominant hand is affected first and has the most severe pain.

While not confined to a specific industry or job, it is common in people who do assembly line work in manufacturing or meat, fish and poultry packing. CTS is three times more common among people who do assembly work than among people who data entry.

Treatment for CTS includes drugs, exercise, acupuncture and chiropractic and different forms of surgery.

More information

The American Academy of Orthopaedic Surgeons has more about carpal tunnel syndrome.

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Hysterectomy: A Surgery Many Women May Not Need

By Janice Billingsley
HealthScoutNews Reporter
Saturday, April 26, 2003

SATURDAY, April 26 (HealthScoutNews) -- Hysterectomies are the second most common surgery for American women, after Caesarean births.

But they shouldn't be the preferred treatment for women with uterine problems, particularly fibroids, a Cleveland Clinic gynecologist says.

About one-third of U.S. women have had a hysterectomy by the age of 60, according to the National Women's Health Information Center, and that figure is far too high, says Dr. Linda Bradley.

"There is a current cultural concept of a hysterectomy as a method that's tried and true. But surgery should be the last option after failed medical therapy, or where other options may have less success," says Bradley, director of the Cleveland Clinic Foundation's Hysteroscopic Services.

This is particularly true when treating uterine fibroids in women in their 30s and 40s, Bradley says. The average age for a hysterectomy is 42, the National Women's Health Information Center says, largely because hysterectomy is the first-line treatment for fibroids.

However, less-invasive procedures that remove the fibroids but leave the uterus intact could be a better option for many women of childbearing age, Bradley says.

These procedures carry their own risks. One, called a myomectomy, removes the fibroids but carries the chance that the fibroids will return. But this is a worthwhile option for women who wish to remain fertile, she says.

"If a woman has fewer than four fibroids, there is a less than 5 percent chance of recurrence of the fibroids," Bradley says. "So a hysterectomy would be an awful choice for a woman with few fibroids in her 20s or 30s."

Similarly, Bradley says, a woman approaching menopause who is considering a hysterectomy to remove fibroids should know that time is on her side, and simply removing the fibroids alone might be enough.

"Fibroids occur less frequently with menopause, so for a woman aged 48 -- the average age of menopause is 51 -- the odds of the fibroids returning are low," she says.

Bradley isn't opposed to hysterectomies, only that they not be performed without weighing other options.

Beverly Johnson, a 50-year-old former model who had a hysterectomy to treat her fibroid tumors when she was 46, concurs.

"I thought it was a routine operation, and everything would be hunky dory, and it was not. It was major surgery," says Johnson, a spokeswoman for the Healthy U campaign, designed to inform women about their options in treating uterine illnesses.

Johnson's mother and grandmother both had hysterectomies to treat their fibroid tumors and their operations went smoothly. But Johnson was bedridden for two months after her hysterectomy, and had two follow-up surgeries before she was healthy again.

"I'm sure I needed it, but I would have liked to known about other options. The recovery took a year and it was pretty traumatic," she says.

The Healthy U campaign was launched by the National Women's Health Resource Center. It is funded by a grant from GYNECARE, a division of Ethicon, Inc., part of Johnson & Johnson Co.

About 600,000 American women a year have hysterectomies, which is the removal of the uterus and usually the cervix. The operation is typically performed to remove fibroid tumors in the uterus. Other reasons for hysterectomies include endometriosis, chronic pelvic pain or heavy bleeding during or between periods. About 10 percent of hysterectomies are performed to treat cancers in the pelvic area, according to the National Women's Health Information Center.

"I'm not saying that a hysterectomy is never called for, but a woman must never feel rushed into having the operation," Bradley says.

She recommends finding a doctor who is familiar with the new technologies and can talk to you about other options. If you're able to make an informed decision, even if it does mean a hysterectomy, you'll be better off, she says.

"Women who have had time to reach their decision are more comfortable with the outcome, Bradley says.

More information

The National Women's Health Information Center has lots of information about hysterectomies. The National Women's Health Resource Center offers a free copy of the booklet, Your Guide to Uterine Health.

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