Personal Health
Joel P. Rutkowski, Ph.D., Editor
July 31, 2003
Oxygen Bars Not a Breath of Fresh Air By Jennifer Thomas FRIDAY, May 23 (HealthScoutNews) -- Oxygen bars made their big-city debut during the flash and sizzle of the Clinton administration. Now, customers pay through the nose to breathe scented, purified, highly oxygenated air in nightclubs and day spas in cities big and small, from Sacramento, Calif., to Ann Arbor, Mich., from Las Vegas to Asheville, N.C. The average price per minute of air: about $1. But critics -- and there are many -- wish oxygen bars would go the way of the Y2K bug and 21-year-old dot-com millionaires. They say there are no medical studies that show breathing oxygen in the manner it's dispensed at oxygen bars has any health benefits whatsoever. And too much oxygen, especially for people with certain medical conditions, can be harmful. "Based on our understanding of the science, it's very hard to believe that the oxygen used in oxygen bars can be of any benefit," says Dr. Norman Edelman, consultant for scientific affairs with the American Lung Association and vice president for health sciences at Stony Brook University in New York. "And we also want to caution people that breathing pure oxygen for extended periods of time can cause respiratory problems," Edelman adds. But oxygen bar proprietors such as Lisa Hinchey shrug off the criticism. She runs the 2202 Oxygen Bar and Organic Cafe in San Francisco. "Doctors don't want you to do it because it takes money away from them. It detoxifies your blood cells, it gives you more stamina, it gives you pure, fresh energy, not like caffeine energy," she says. Hinchey says she breathes the oxygen at her bar for 40 minutes, three times a week. "I feel really good and relaxed," she says. "I sleep more soundly. I wake up more happy, it lifts up my spirit, it rejuvenates me. I'm more at peace with oxygen in my bloodstream." She says her clients include marathon runners, students preparing for their SATs, even older couples before they have sex. Oxygen bars first appeared in Japan, Mexico and South America, where concerns about air pollution lead to an interest in breathing purified air, says Dr. Ron Balkissoon, a pulmonologist at the National Jewish Medical and Research Center in Denver. By the late 90s, oxygen bars began appearing in major U.S. cities. Actor Woody Harrelson, best known for his role as the dim-witted bartender on the sitcom Cheers, opened one of the first on the Sunset Strip in Los Angeles. Then the U.S. Food and Drug Administration (news - web sites) got wind of what was going on. Under the Federal Food, Drug and Cosmetic Act, any type of oxygen that's "used for breathing and administered by another person is a prescription drug," according to a recent article in the FDA Consumer magazine. That means oxygen bars violate FDA regulations. Still, the agency leaves enforcement up to each state licensing board. "Many states choose to allow oxygen bars; others discourage the businesses by requiring strict compliance with the law," according to the article. No matter if those rules are enforced or not, there's one thing oxygen bar owners can't do in any state -- make claims that oxygen can treat or cure illnesses. To stay out of trouble, most oxygen bar owners avoid those claims, Balkissoon says. Instead, they say oxygen helps you relax, reduces stress, increases energy or alertness, and promotes general feelings of well-being. But there's no medical evidence that says any of this is true, Balkissoon says. Besides, all the oxygen that healthy people need is right under their nose. Air normally contains about 21 percent oxygen. At an oxygen bar, customers typically breathe the oxygen through a cannula, a two-pronged tube that fits loosely in the nostrils. While the air coming out of the cannula might be nearly 100 percent oxygen, the person inhaling it will probably breathe from 50 percent to 75 percent oxygen because they're still inhaling some room air, Balkissoon says. If that sounds super healthy, think again. In a healthy person, the hemoglobin in blood that transports oxygen is already 98 to 99 percent saturated with oxygen. Upping it another percentage point by breathing highly oxygenated air will have "absolutely no physiological effect," says Balkissoon. "Any extra oxygen gets exhaled right back out. Your body can't hold onto it." And while it probably would not happen in an oxygen bar, too much oxygen can be toxic. Excess oxygen can increase the production of free radicals, which can damage tissues and kill cells, he says. Over time, this can hinder brain, heart, lung, muscle and memory function. Complications of excessive oxygen can also include pulmonary edema, or fluid on the lungs. There are other concerns. Some oxygen bars used scented air in flavors ranging from eucalyptus to raspberry to mint. If the scent is oil-based, it's possible that tiny droplets of oil can be inhaled into the lungs, leading to a type of pneumonia called lipoid pneumonia, Edelman says. People with emphysema or other chronic pulmonary obstructive disease should definitely stay away. For people already oxygen-compromised, breathing in too much oxygen can actually suppress their drive to breathe, Balkissoon says. This can cause a buildup of carbon dioxide in their lungs, he says. Finally, if you see an oxygen bar in a nightclub where people smoke, stay away, Balkissoon says. Oxygen feeds fires. "If you have any kind of a flame, and it comes into contact with pure oxygen, the flame will get bigger and bigger," he says. "They could blow up the bar." More information Read more about oxygen bars at the National Jewish Medical and Research Center. The American Lung Association has more on how oxygen supplementation is used for people with certain lung diseases. Smoking May Speed Lung Cancer Patients' Death Reuters Health NEW YORK (Reuters Health) - Smokers who continue to puff away even after a lung cancer diagnosis seem to die more quickly than smokers who quit during cancer treatment, new study findings suggest. The study looked at patients with small cell lung cancer, which accounts for about one quarter of all newly diagnosed lung cancers. Most cases are only identified after the cancer has spread to distant sites such as the brain and liver. Patients typically live for only a matter of months after diagnosis, and few survive two years or more. It is well known that smoking causes cancer, and previous research has suggested that people with cancer who continue to smoke during treatment tend to do more poorly, according to a team led by Dr. Gregory M.M. Videtic of Brigham and Women's Hospital in Boston, Massachusetts. However, the effect of continued smoking on people being treated for small cell lung cancer is less certain, the researchers point out in a report in the Journal of Clinical Oncology. To investigate, Videtic's team reviewed the medical records of 186 people with small cell lung cancer who underwent chemotherapy. The researchers found that the average survival for former smokers was 18 months compared to 13.6 months for those who smoked during their treatment. The researchers ruled out other characteristics, such as age and sex, or differences in treatment, as a cause of the survival difference. "We conclude that (small cell lung cancer) patients who are offered (chemotherapy) as definitive management of their disease are at risk if they continue to smoke while receiving treatment," the authors write. As such, the authors recommend that physicians ask their patients about their smoking status before beginning treatment and make suggestions about how they can kick their habit. Source: Journal of Clinical Oncology 2003;21:1544-1549. Gene Mutation Behind Hemochromatosis HealthScoutNews FRIDAY, May 23 (HealthScoutNews) -- German and American researchers have linked a gene mutation in the liver to hemochromatosis, a disease that causes a person's intestine to absorb too much iron. If left untreated, the condition can lead to an overload of iron in the body, which can result in heart disease, liver cancer or other fatal conditions. This study offers new information about how hemochromatosis develops. "The mutation that causes the disease was thought to have its major effects in the intestine, where cells absorb iron from food. Our current study has changed that picture," researcher Martina Muckenthaler, of the European Molecular Biology Laboratory in Heidelberg, says in a news release. People with hemochromatosis have inherited a defective copy of a gene called Hfe from each parent. This gene mutation can be traced back several centuries in Celtic history, where it originated in a single person who passed it down to descendents. The disease has now spread to become the most common inherited disease in the Western world, affecting about one in every 250 people. The study appears in a recent issue of Nature Genetics. More information Here's where you can learn more about hemochromatosis. Mental Decline After Heart Bypass Not Permanent HealthScoutNews FRIDAY, May 23 (HealthScoutNews) -- Cognitive problems experienced by many people after they have coronary artery bypass surgery are mostly temporary, says a study by researchers at Johns Hopkins Medical Institutions. More than two thirds of people who have coronary artery bypass surgery suffer a decline in their ability to think, remember and learn. They may also be slower at such tasks as writing and drawing immediately after the surgery. The Johns Hopkins researchers found these mental effects are mostly reversible and generally last for no more than three months. The study appears in the May issue of The Annals of Thoracic Surgery. The study compared 140 people who had coronary artery bypass surgery with 92 people with coronary artery disease who didn't have the surgery. The researchers found no differences in cognitive function between the groups when the surgery patients were tested three months and a year after their surgery. The tests included measures of attention, learning and memory, spatial abilities and speed of processing. The researchers plan to follow the study volunteers for three to five years to determine whether the people who had coronary artery bypass surgery suffer any long-term cognitive effects compared to those who didn't have the surgery. More information Here's where you can learn more about heart bypass surgery. HealthScoutNews FRIDAY, May 23 (HealthScoutNews) -- A virus that infects and destroys bacteria may be responsible for spreading strep and some other infectious diseases. That's the conclusion of a Rockefeller University study in the June issue of the journal Infection and Immunity. This bacteria-eating virus, called a bacteriophage, causes disease by transferring toxins and other disease-causing genes between bacteria, the study found. It's the first research to show that bacteriophage -- previously believed to not be infectious to humans -- could offer a new target for scientists trying to develop ways to combat certain bacteria that produce toxins. The study author suggest that controlling the bacteriophage, also known as phage, may be as important as controlling the bacteria. "It's possible that phage present in the saliva of a child or another individual can cause the conversion of an existing non-toxigenic organism to a toxigenic one. We always believed that phage were not infectious to humans, but in a sense they are," senior author Vincent A. Fischetti says in a news release. Humans are able to carry colonies of bacteria -- such as strep -- without becoming sick as long as the microbe doesn't carry a toxin-encoded phage. But a harmless microbe can be converted into a virulent bug when a toxin-producing phage moves into the previously benign microbe. More information Here's where you can learn more about strep infections. HealthScoutNews (HealthScoutNews) -- Foot fungus isn't very serious, but it can be annoying. So here are some general recommendations from the dermatology department at the Tokyo Medical and Dental University for avoiding athlete's foot:
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to the Top HealthScoutNews FRIDAY, May 23 (HealthScoutNews) -- Younger athletes take longer to recover from a sports-related concussion, says a University of Pittsburgh study in the May 19 issue of the Journal of Pediatrics. The study, the first to examine age as a factor in sports concussion recovery, found high school athletes with concussions suffered prolonged memory problems that required longer recovery times compared to college athletes. The finding supports the idea that high school athletes with concussions need more conservative management and comprehensive assessment. The study may also have important implications for guidelines about when high school athletes who've suffered a concussion can return to play. The researchers compared post-concussion recovery of high school and college athletes at 24 hours, three days, five days and seven days after the concussion. In tests of self-reported symptoms and neurocognitive function, the high school athletes had much worse memory performance at seven days after concussion than age-matched control subjects. Despite sustaining more severe injuries, concussed college athletes at three days after injury showed memory performance similar to age-matched control subjects. "Our finding that high school athletes did not recover from concussion as quickly as college athletes is a cause for concern because the largest majority of at-risk athletes are at the high school level or below," principal investigator Dr. Melvin Field says in a news release. "Furthermore, existing return-to-play guidelines assume a standard use for all age groups and levels of play, from school-age to professional. Our study is the first to suggest that there may be differing vulnerabilities to concussion at different ages and that current guidelines may not be appropriate for all age groups," Field says. Recent studies show more than 62,000 concussions occur each year in high school sports in the United States. Football accounts for 63 percent of those concussions. More information Here's where you can learn more about concussion. Adderall Improves Life for Those With ADHD HealthScoutNews THURSDAY, May 22 (HealthScoutNews) -- The quality of life for children with attention-deficit/hyperactivity disorder (ADHD) improves with long-term use of a once-daily stimulant called Adderall XR. The results of this, the largest ADHD clinical trial to date, were presented May 21 at the American Psychiatric Association annual meeting in San Francisco. The seven-week, open-label study included 2,900 children previously treated with a stable dose of ADHD medication, either methylphenidate HC1 or another methylphenidate product or a mixed salts amphetamine product. After they were switched to once-daily Adderall XR, the children showed better symptom management and significant improvement in their quality of life as measured on the 23-item Pediatric Quality of Life Inventory, the study says. "This largest study ever of ADHD patients establishes the significant improvements that treatment with the once-daily mixed salts amphetamine medication brings in decreasing symptoms. Such symptom control allows children to functionally improve and participate in life, such as engage in sports, get along with other kids, or help with chores," lead investigator Dr. Paul J. Ambrosini, a professor of psychiatry at Drexel University College of Medicine in Philadelphia, says in a news release. In a separate study, researchers at the University of North Carolina at Chapel Hill found adults with ADHD treated long-term with an extended-release mixed-salts amphetamine medication maintained significant symptom improvement. The study of 248 adults with ADHD was also presented May 21 at the American Psychiatric Association annual meeting. "ADHD is not just a childhood disorder. While hyperactivity may sometimes diminish by adulthood, inattention and impulsivity often remain," researcher Dr. Richard Weisler, adjunct professor of psychiatry, says in a news release. "Our findings suggest that, as in children with ADHD, adults who have this condition can benefit from treatment with this product. This medication can significantly improve adults' ADHD symptoms and, subsequently, their ability to work, socialize and be more productive in everyday activities," Weisler says. More information Here's where you can learn more about ADHD. Lyme Disease: A Seasonal Scourge By Dennis Thompson Jr. THURSDAY, May 22 (HealthScoutNews) -- It's been more than 30 years since scientists first identified the tick-borne illness now known as Lyme disease. While much has been learned about this rarely fatal condition that can cause chronic physical pain and mental distress, questions remain. And because May is Lyme Disease Awareness Month, doctors and medical activists are spreading the word about the disease and how people can avoid it. Lyme disease is caused by the bacterium Borrelia burgdorferi, according to the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC). These bacteria are transmitted to humans through the bite of infected deer ticks and cause more than 16,000 infections in the United States each year. Lyme disease was discovered in 1977 when arthritis was observed in children in and around Lyme, Conn. People with Lyme generally have a rash in the shape of a bulls-eye at the site of infection, and they also can suffer from such symptoms as fever, malaise, fatigue, headache, muscle aches and joint aches, the CDC says. The incubation period from infection to the onset of the rash is typically seven to 14 days but may be as short as three days and as long as 30 days. If left untreated, more dire symptoms can arise: arthritis, including intermittent episodes of swelling and pain in the large joints; neurologic abnormalities, such as aseptic meningitis, facial palsy, motor and sensory nerve inflammation and inflammation of the brain; and, rarely, cardiac problems, such as an enlarged heart or acute inflammation of the tissues surrounding the heart, federal health officials say. Some doctors believe the disease also can affect people's rational mind. "If people have neurologic Lyme, it directly affects their emotions and moods," says Dr. Lesley Ann Fein,a New Jersey doctor who specializes in the disease. Because there are so many symptoms, and because only 60 percent to 80 percent of sufferers develop the telltale "bulls-eye" rash, Fein believes many people are infected with Lyme but remain undiagnosed. She says efforts are under way to establish a national committee that would set up clearer guidelines for diagnosis and treatment of the disease. Antibiotics provide the only effective treatment for Lyme disease, says Fein and Tom Forschner, executive director of the non-profit Lyme Disease Foundation. Other drugs can be used to treat related symptoms, but antibiotics kill off the bacterium that causes Lyme. However, there's disagreement among doctors regarding how long antibiotic treatment should last. "There is no definitive test to tell us the bacteria is gone, so there's no end point for treatment everyone can agree on," Forschner explains. Some doctors believe antibiotic treatment should last two to four weeks, while others will extend it for several months, he says. Early stage Lyme disease is typically treated with the antibiotics doxycycline or amoxicillin for three to four weeks. Later-stage Lyme, particularly with "neurologic manifestations," may require intravenous treatment with ceftriaxone or penicillin for four weeks or more, depending on the severity of the symptoms, the CDC says. Lyme disease is mostly found in northeastern and mid-Atlantic states; states in the upper north-central region of the country; and several counties in northwestern California. Ninety-two percent of cases reported to the CDC in 1999 -- the most recent numbers available -- came from Connecticut, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin. Forschner says that since Lyme disease can be spread by ticks that cling to birds, migration patterns provide a clue to what areas are at risk. "Basically the ticks go the same place birds go during migration," Forschner says. The best way to avoid Lyme disease is to avoid areas likely to be infested with ticks, particularly in spring and summer. Ticks favor a moist, shaded environment, especially wooded, brushy or overgrown grassy habitats. If you're going to be in an area that's likely infested with ticks, wear light-colored clothing so ticks can be spotted more easily and removed before becoming attached. Wear long-sleeved shirts and tuck your pants into socks or boot tops to keep ticks from reaching your skin. When you come in from outside, perform a tick check on yourself. Run your hands through your hair, and thoroughly inspect your body. Since transmission of the disease is not immediate, removing an attached tick as soon as possible will more than likely keep you from contracting Lyme. "If you find an attached tick that's engorged, call your doctor so you can get treated," Forschner says. "If it's had a chance to feed, it's had a chance to infect." Attached ticks should be removed using fine-tipped tweezers. Grasp the tick firmly at its mouthparts, as close to your skin as possible. With a steady motion, pull the tick's body away from the skin. If the tick's mouthparts remain in the skin, don't be alarmed. The bacterium that causes Lyme is contained in the tick's midgut or salivary glands. Then cleanse the area with an antiseptic, health experts advise. More information To learn more about Lyme disease, visit the Centers for Disease Control and Prevention or the National Institutes of Health. WHO Says More Money Needed to Fight Measles Reuters Health NEW YORK (Reuters Health) - More than 770,000 children died from measles in 2000, international health experts said Thursday, and the World Health Organization (news - web sites) (WHO) is asking for more money to fight the disease in developing nations. Inadequate vaccination in the regions where most of these deaths occur, the new report suggests, is due to insufficient internal and international investment in the health infrastructures and vaccination programs of poorer countries. As such, a resolution to the World Health Assembly, on Saturday, will ask countries to "contribute actively" to achieve United Nations (news - web sites) goals for cutting childhood measles deaths worldwide, the WHO said in a press release. The WHO and the U.N. Children's Fund estimate that an additional $200 million will be needed to implement a comprehensive measles strategy over the next three years in the 45 countries that account for nearly all measles deaths globally. Measles is a respiratory disease caused by a virus, with symptoms including rash, fever, cough and a runny nose. In some cases, the infection causes serious complications such as pneumonia or brain inflammation, and is sometimes fatal. However, measles vaccination -- given routinely in developed nations -- usually provides lifelong immunity against the disease. A dose of measles vaccine costs only 25 cents, which includes the equipment to provide a safe injection, according to the WHO. Nevertheless, about 777,000 children died from measles worldwide in 2000, researchers from the WHO and elsewhere report in the May 23rd issue of the Morbidity and Mortality Weekly Report. Of these deaths, 58 percent occurred in Africa and 26 percent in Southeast Asia. "The measles deaths occurred overwhelmingly among children living in poor countries with inadequate vaccination services," the researchers write. "To prevent these deaths, stronger political commitment is needed to provide all children worldwide with two opportunities for measles immunization." In 2000, measles was the fifth-leading cause of death worldwide among children younger than 5, according to the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC). "Like human immunodeficiency virus (HIV (news - web sites)), malaria, and tuberculosis, measles can be considered a disease of poverty," the CDC notes in an editorial published with the report. "However," the agency adds, "unlike these diseases, measles can be prevented through vaccination." Source: Morbidity and Mortality Weekly Report 2003;52;471-475. Chew Aspirin if You're Having a Heart Attack HealthScoutNews (HealthScoutNews) -- Experts advise that if you think you're having a heart attack, the first thing you should do is chew an aspirin tablet. But because aspirin starts to break up as soon as it touches your tongue, why chew it instead of swallowing it? Here's why, according to the American Journal of Cardiology. Researchers at the University of Texas Southwestern Medical School recruited 12 volunteers and measured the length of time it took for the aspirin to inhibit blood clotting, which is the reason to take it after a heart attack. They found that swallowing a whole aspirin takes 12 minutes to have any effect on your blood's clotting time; drinking a liquid remedy containing aspirin takes seven minutes to work, but chewing a regular aspirin tablet begins showing benefits in only five minutes. Laughter at Dinner Cuts Blood Sugar in Diabetics By Alison McCook NEW YORK (Reuters Health) - A small study shows that diabetics (news - web sites) may be better able to process the sugar they consume during meals if they order a side of laughter with their food. Laugh if you will, but a group of researchers in Japan found that people with type 2 diabetes -- the most common form of the disease -- had a smaller rise in post-meal blood glucose (sugar) when they watched a comedy show than when they listened to a humorless lecture. The researchers, led by Dr. Keiko Hayashi from the University of Tsukuba, also found the same results in people without diabetes. Poorly controlled blood sugar can increase the risk of diabetes complications such as heart disease, kidney failure and blindness. Hayashi told Reuters Health that people with diabetes have a lot to worry about -- diet, exercise and keeping their glucose and insulin levels in check. And stress is known to increase the risk of elevated blood glucose, the researcher noted. "If positive emotion such as laughter reduced blood glucose, both patients and medical providers would recognize the importance of it, and it would improve their mental health" and quality of life, Hayashi said. "We should laugh more," the researcher added. Plenty of studies have shown that laughter can combat many common ills. For instance, research suggests that humor may lower blood pressure and release endorphins. Laughter is also thought to improve circulation, stimulate the nervous system, heighten the immune system and make the heart stronger. All of the diabetic patients included in the study had type 2 diabetes, which occurs when the body fails to respond to insulin, the hormone that clears the blood of sugar after a meal and deposits it into cells to use for energy. During the study, reported in the May issue of the journal Diabetes Care, Hayashi and colleagues measured the blood glucose levels of 19 diabetics and five non-diabetics before and after they ate the same meal, on two separate days. On one day, participants listened to a 40-minute lecture, which the researchers describe as "monotonous" and "without humorous content." On the second day, participants were included in an audience of 1,000 people who watched a Japanese comedy show. At the end of the show, "most" participants "considered that they laughed well," the authors note. The researchers found that post-meal blood glucose levels were higher after the boring lecture than after the comedy show, in diabetics and non-diabetics alike. Hayashi noted that the reasons why laughter might reduce blood glucose are not clear, but suggested that laughter could increase energy consumption by working the abdominal muscles. Alternatively, the researcher said, laughter might affect the neuroendocrine system, which controls glucose levels in the blood. Source: Diabetes Care 2003;26:1651-1652. Lower Steroid Doses Effective in Severe Asthma By Ed Edelson THURSDAY, May 22 (HealthScoutNews) -- Doses of inhaled steroids for patients with chronic, severe asthma can be reduced sharply to cut the risk of side effects while still keeping the condition under control, a Scottish study shows. This is the first carefully controlled trial to show that this "stepdown" approach works in chronic, severe cases of asthma, says a report in the British Medical Journal. "Patients with more severe asthma who require high doses of inhaled steroids account for approximately 15 percent of all asthmatics," says Dr. Neil Thomson, professor of respiratory medicine at the University of Glasgow, leader of the study. "This is the group we studied." Inhaled steroids are the recommended treatment for chronic asthma, but they are accompanied by a number of side effects, including weakened bones and eye problems, such as cataracts and glaucoma. Obviously, doctors prefer to keep dosage at a minimum. The study included 259 adult asthma patients with symptoms severe enough to require high steroid doses, an average of 1,400 micrograms a day of beclomethasone, a commonly used drug, or equivalent amounts of other steroids. After a month of data gathering, 130 patients began taking half the previous dose, while 129 continued their old dosage. As is common in such controlled studies, none of the patients knew what they were taking. After a year, the researchers say, the treatment results were essentially the same for the two groups, with 109 of the 130 reduced-dose patients and 105 of the 129 higher-dose patients meeting the criteria for good control. "It should therefore be possible for a substantial proportion of patients receiving inhaled corticosteriods at high dose to reduce their doses, thereby reducing the risk of side effects while maintaining control," the researchers write. No record was kept of side effects. The study is a welcome reminder that doctors treating asthma patients should look toward reducing steroid dosage, says Dr. John J. Costa, assistant clinical professor of medicine at Harvard Medical School (news - web sites), and a spokesman for the American Academy of Allergy, Asthma and Immunology. Often, asthma patients go to their doctors when the disease flares up, and doses are prescribed to bring things back to normal, he says. "The importance of this paper is to remind practitioners that when they see asthmatics and decide that a certain amount of medicine is needed to address what is going on at that moment, once stability is achieved, it may not be the amount of medicine needed when the patient in not in the middle of a flare-up," Costa says. Asthma specialists usually ask a patient to make a follow-up appointment, but patients often don't, he says. "So many patients might be treated on the assumption that if you don't hear from them, they are doing OK," Costa says. "The doctor should follow up to see if it is possible to reduce the dosage." More information You can learn almost anything you need to know about asthma from the National Institute of Allergy and Infectious Diseases or the American Academy of Allergy, Asthma and Immunology. Among Young with Breast Cancer, Blacks Fare Worse Reuters Health NEW YORK (Reuters Health) - Among women with breast cancer (news - web sites) who are younger than 65, black women do not survive as long as whites, researchers report. In contrast, their study found race had little bearing on survival among older women with the disease. Taken together, these findings suggest that a racial gap in treatment exists for younger U.S. women with breast cancer that is narrowed among older patients, possibly due to Medicare coverage, according to the study's authors. Their findings add to a growing body of evidence that suggests breast cancer treatment, and possibly outcomes, are inferior for African-American women. To assess the effect of race on breast cancer outcomes, Dr. Kenneth C. Chu, from the National Cancer Institute (news - web sites) (NCI) in Bethesda, Maryland, and colleagues analyzed data from a registry of breast cancer cases in 11 U.S. regions from 1992 to 1999. Overall, six-year survival rates were lower for black women than for white women, the investigators report in the June 1st issue of Cancer. However, the results were somewhat different when the researchers took into account a couple of factors -- the type of treatment women received and whether their tumors were dependent on estrogen to grow. In this analysis, only black women younger than 50 whose tumors were responsive to estrogen and black women younger than 65 whose tumors were not estrogen-dependent had significantly lower survival rates than their white counterparts. But in every age group, black women were less likely to be diagnosed with early, stage I cancer, the authors report. The results suggest there is a need for "more early diagnosis of breast (cancer) for black females," and for a "focus on racial differences in treatments for younger black females," Chu's team writes. "In addition, the racial differences in stage (at diagnosis) indicate that black females of every age need to focus more on early diagnosis." Experts recommend that women have a yearly mammogram to detect early breast cancer, starting at age 40. Women at higher-than-average risk due to factors like family history should talk to their doctors about when and how often they should be screened for the disease. Source:Cancer 2003;97:2853-2860. New Insights into Preventing Deadly Strokes By Ed Edelson THURSDAY, May 22 (HealthScoutNews) -- They're called subarachnoid strokes, and they're about as deadly as strokes come. They also tend to strike young and middle-aged adults. Yet, new research shows they can be prevented. Fifty-five thousand to 60,000 Americans suffer a subarachnoid hemorrhage each year, and 40 percent to 50 percent of them die, half within two days of the attack. "Most subarachnoid hemorrhages in young and middle-aged people are preventable," says Dr. Joseph P. Broderick, chairman of the department of neurology at the University of Cincinnati. He's also leader of the study that appears in the May 23 issue of Stroke. The key to prevention: "People have to change their behavior," Broderick says. To determine which behavior changes are most important, Broderick and his colleagues questioned 312 young and middle-aged men and women who had suffered these hemorrhages between 1994 and 1999. They asked about lifestyle and other factors that could be related to the risk of such strokes. Then the researchers compared the answers with those of 618 similar people who had not had such strokes. One risk factor that stood out was family history. The risk was 3.8 times higher for people with a close relative who had had a subarachnoid stroke, compared to those without such a family history. Another culprit, to no one's surprise, was smoking. Two-thirds of the stroke patients were smokers, compared to 30 percent of the healthy people. "It should be emphasized that current cigarette smoking is the most important modifiable risk factor," says Dr. Thomas Brott, a professor of medicine at the Mayo Medical School in Jacksonville, Fla., and a member of the research team. Another common risk factor was one that's behind most cardiovascular disease: high blood pressure. People with the condition had 2.39 times the normal risk of subarachnoid hemorrhage. Diabetes and high blood cholesterol, two other familiar cardiovascular risk factors, don't seem to play a role in subarachnoid hemorrhage, the study indicates. But drug use might. The numbers are small, but it's significant that three of the stroke patients reported cocaine use, while none of the healthy people did, Broderick says. One unexpected finding was that the stroke risk was higher for thin people -- a low body mass index (23 or lower) was associated with a 50 percent higher risk of subarachnoid hemorrhage. "The association was strongest among four-pack-a-day smokers, so this might be an indirect effect of smoking," says Brott, noting that heavy smoking can keep people thin. You can't change family history, the leading risk factor, Broderick says. So for those with such a history, he says, "it becomes more critical and more important to make lifestyle changes." Those changes should include controlling blood pressure, Brott says. Just last week, the American Heart Association (news - web sites) issued new guidelines that say any reading between 120/80 and 139/89 is now considered "prehypertensive;" previously that was considered within the normal range. Broderick says a genetic-based effort to identify people who might be at especially high risk of subarachnoid stroke has begun. "We're trying to identify genes that are related to high risk," he says. "Any results are probably a couple of years away." More information To learn more about preventing a stroke, visit the American Heart Association or the National Institute of Neurological Disorders and Stroke. Milk-Based Baby Formula Linked to Blood Pressure By Maggie Fox WASHINGTON (Reuters) - Babies fed a dairy-based formula grew up to have higher blood pressure than babies who were breast-fed, British researchers reported on Thursday. Their study, published in the American Journal of Clinical Nutrition (news - web sites), supports several others that show substituting cow's milk for breast milk might promote heart disease later in life. The American Academy of Pediatrics says mothers should breast-feed babies for at least a year and longer if possible, while the World Health Organization (news - web sites) says two years should be the minimum. Babies who get breast milk are healthier, less likely to become obese and may have better brain function, studies have shown. Infant formula manufacturers have taken note and regularly adjust their formulas to more closely resemble human milk. But in the 1970s, formulas were based on dried cow's milk, and breastfeeding was out of fashion in countries such as the United States and Britain. Richard Martin of the University of Bristol and colleagues followed up on babies first studied between 1972 and 1974. Now in their 20s, those who were fed the most cow's-milk formula were taller but had the highest blood pressure, Martin's team found. High blood pressure can lead to heart disease and stroke. It could be that the high sodium content of cow's milk affects the development of young babies, the researchers said. It might also be that cow's milk is higher in fat and calories overall, and overfed babies -- especially those who gain weight too rapidly early in life -- are prone to obesity and heart disease later in life. More-subtle factors could also be at work, they said. "Mothers in the United Kingdom who breastfeed are likely to be better educated and to encourage healthier eating habits for their children than are mothers who do not breastfeed," the researchers write in the report. Fortified cow's milk is an important source of calcium and vitamin D -- key to preventing rickets and osteoporosis -- but a second study in the same journal suggests that, at least for adults, orange juice could substitute. Dr. Michael Holick and colleagues at Boston University School of Medicine found that adults who drank orange juice fortified with vitamin D absorbed it just as well as from milk. Orange juice is already available fortified with calcium. Blacks More Susceptible to Colorectal Cancer HealthScoutNews THURSDAY, May 22 (HealthScoutNews) -- Blacks who live in Pennsylvania, West Virginia and Kentucky have a greater risk of developing and dying from colorectal cancer than whites who live in those states. So claims a study by researchers at Penn State Milton S. Hershey Medical Center. The scientists analyzed data from more than 62,000 cases of colorectal cancer in the three largely rural states from 1994-98. The authors say the study findings confirm that unexplained health disparities exist for blacks in those areas. The study was presented May 21 at the 2003 Digestive Diseases Week meeting in Orlando, Fla. The researchers found blacks were 18 percent more likely to have proximal, or upper, colon cancer than whites. They were also 56 percent more likely to have proximal colon cancer diagnosed at a later stage, when there is only a 9 percent survival rate. Overall, the study found that blacks living in the three states were 33 percent more likely to die from colon cancer. There may be a number of reasons for this disparity, including differences in diet, lifestyle, education, environment and access to cancer screenings. Blacks are more likely to develop all cancers than people in other racial or ethnic groups, and blacks are more frequently diagnosed after the cancer has spread to other areas of the body. Colorectal cancer is the third leading cause of cancer death in black Americans. The researchers say their study indicates the importance of regular colon screenings for everyone. They also believe it heightens awareness about potential health disparities that exist for blacks and may lead to recommendations about improving access to colon screenings for blacks. More information Here's where you can learn more about colorectal cancer. Scientist Warns Against Cancer 'Breakthrough' Hype By Richard Woodman LONDON (Reuters Health) - So many "breakthroughs" are being reported in the battle against cancer that skepticism may set in and research funding dry up, a British scientist said on Thursday. Professor Rob Newbold, dean of the Faculty of Life Sciences and head of the Institute of Cancer Genetics and Pharmacogenomics at Brunel University, near London, called for a halt to "breakthrough fever" in cancer research. "A new cancer gene is discovered almost every month. This is great progress; however it does raise the question of when these discoveries could translate into treatments," he said in a statement. Newbold pointed out that genetic discoveries could take years to translate into benefits and that if clinical trials failed, the drugs designed as cures might never appear. "Despite responsible reporting by cancer research organizations, this can create a public perception that discoveries seldom amount to action -- resulting in widespread skepticism about the true value of cancer 'breakthroughs."' Reports of research studies into dietary, environmental and other factors on cancer are also increasing, are often conflicting, and could cause confusion over what exactly constitutes a serious cancer risk, he added. HealthScoutNews THURSDAY, May 22 (HealthScoutNews) -- You may be able to DASH your way to lower blood pressure. The good news comes from a study just released online in the journal Hypertension. The study says a diet that stresses vegetables, fruits and low-fat dairy products may act as a natural diuretic that could let people lower their blood pressure without the use of medication. Previous research found this Dietary Approaches to Stop Hypertension (DASH) diet significantly reduced blood pressure, but it was unclear how it did it. This new study says the DASH diet promotes salt excretion, similar to that of diuretic drugs, resulting in increased urine production. The benefits of the DASH diet seem to be most noticeable in people sensitive to the blood pressure effects of salt. The study included 375 adults with normal to moderately elevated blood pressure. They were randomly assigned to consume a DASH diet or a control diet for three consecutive 30-day periods. During each of those 30-day periods, they had different levels of salt intake. People on the DASH diet excreted salt easier and in greater amounts and also had reduced blood pressure. The study also found the impact of the DASH diet decreased as the level of salt intake decreased. Diuretic drugs can cause side effects, so the DASH diet may offer a safer alternative. "I think the DASH diet acts as a natural diuretic without the adverse effects. The DASH diet provides healthy food for people of all ages. I think the diet should be recommended for everyone, regardless of age, not only for reducing blood pressure but also to prevent heart disease and cancer," the study's author, Dr. Genjiro Kimura of the Nagoya City University Graduate School of Medical Sciences in Japan, says in a news release. More information Here's where you can learn more about the DASH diet. Kids Who Live with Smokers Miss School More Often Reuters Health NEW YORK (Reuters Health) - New study findings show that fourth-graders who live with at least one smoker are more likely than those who don't to miss school because of a respiratory illness. Living with more than one smoker further increased the likelihood that kids would call in sick, especially if the child had asthma, according to the report. These findings indicate that even kids who are old enough to attend school full-time, and therefore spend every weekday away from home, still feel the effects of secondhand smoke, write Dr. Frank Gilliland and colleagues at the University of Southern California in Los Angeles. "Thus, although (secondhand smoke) exposure among school-aged children is likely to be substantially lower than that among preschool children, the adverse effects appear to be substantial," they write in the May 15th issue of the American Journal of Epidemiology. While missing a day of school here and there may appear somewhat harmless, absences can be markers of much larger problems, according to editorialists led by Dr. Anthony J. Alberg of the Johns Hopkins Bloomberg School of Public Health in Baltimore. "Lurking behind a school absence may lie sleepless nights, physician visits, emergency department visits, hypersomnolence (excessive sleepiness), poor concentration, parents missing work, and poor asthma-specific quality of life," Alberg and his colleagues write. The current study "adds to the importance of promoting smoking cessation among parents who smoke cigarettes," they add. Gilliland and his team obtained their findings from information about illness-related absences among 1,932 California fourth-graders during 1996. Parents or guardians reported whether a doctor had ever diagnosed their children with asthma, and how many smokers lived in their households. Children who lived with at least one smoker were 27 percent more likely to have been absent from school due to respiratory illness than children whose homes were smoke-free. And the more smokers in the house, the worse off children were, the authors note. Children who lived with at least two smokers were 75 percent more likely than those from non-smoking homes to miss school due to respiratory illness. Having asthma also made the situation worse, Gilliland and his team write. Children with asthma who lived with smokers were more than twice as likely to stay home because of respiratory illness than non-asthmatic kids from smoke-free households. In asthmatic kids who lived with at least two smokers, the risk of such absences shot up by more than four-fold. Gilliland and his colleagues point out that secondhand smoke may help cause or aggravate respiratory infections, or worsen pre-existing asthma. In the editorial, Alberg and his colleagues suggest that school officials could interpret repeated absences as a sign that a child has undiagnosed asthma, or, if already diagnosed, needs better treatment. Source: American Journal of Epidemiology 2003;157:861-869,873. HealthScoutNews (HealthScoutNews) -- Infants -- particularly tiny ones born with a low birth weight -- don't have many ways to communicate distress. But there are some clues. Members of the British Columbia Research Institute for Children's and Women's Health in Vancouver observed 64 preterm babies to see how they responded to pain. Among other factors, they monitored the babies' heart rate, which is a good indicator of pain. As reported in the Clinical Journal of Pain, when a preemie jumps, twitches or squirms, that's usually not a sign of discomfort. It's just normal movement. On the other hand, when a preemie spreads his fingers or extends his legs, that's a sign of pain. And when a preemie raises his eyebrows, it doesn't indicate immediate pain -- but it does suggest that the infant has been in pain within the past 24 hours, and that he's still recovering from it. Potent Pneumonia Drug Treats TB, Too WEDNESDAY, May 21 (HealthScoutNews) -- A potent new antibiotic approved to fight tough cases of pneumonia also appears to work against tuberculosis, researchers say. Linezolid, which goes by the brand name Zyvox, is the first in a new class of synthetic drugs called oxazolidinones to be approved for use in the United States. The drug, which won the nod from the U.S. Food and Drug Administration (news - web sites) in 2000, works by stopping bacterial growth. In one study, Richard Wunderink compared the use of linezolid with vancomycin (Vancocin), the traditional antibiotic of last resort, in patients with a form of hospital-acquired pneumonia called MRSA, for methicillin-resistant Staphylococcus aureus. Up to 100,000 persons are hospitalized each year with MRSA infections, according to Wunderink, citing CDC statistics. This type of pneumonia typically develops in hospitalized patients who are elderly or very sick, but also it also occurs in nursing home patients admitted to the hospital. In Wunderink's study, those getting linezolid were twice as likely to survive as those on vancomycin. The drugs were given intravenously every 12 hours for seven to 21 days. "MRSA is the cause of up to 30 percent of hospital-acquired pneumonias," says Wunderink, a physician at Methodist Health Care Memphis and a clinical associate professor of medicine at the University of Tennessee in Memphis. He predicts linezolid will begin to be used more with the news of a survival difference, although he points out that linezolid is much more expensive. "It's at least 50 percent more than vancomycin," he says. Pharmacia, manufacturer of Zyvox, funded the study. In another study, linezolid proved promising for multi-drug resistant tuberculosis treatment. Dr. Nicos Hadjiangelis and his colleagues from the New York School of Medicine/Bellevue Chest Service in New York City reported it was well tolerated and safe for a small group of five patients, all diagnosed with what doctors call multi-drug resistant tuberculosis. Tuberculosis, a bacterial infection that typically attacks the lungs, can also affect other organs. In 2001, 15,898 new cases of TB were reported n the United States, according to the American Lung Association. Multi-drug resistant TB, defined as a strain resistant to treatment by two commonly used drugs, isoniazid and rifampin, is a major health problem worldwide. When the researchers added linezolid to other drugs that weren't working well enough, the sputum cultures in all five turned negative for TB. "It means the treatment is effective," Hadjiangelis says. Another expert says that while the pneumonia study is "not very newsworthy," the TB study is "of interest for several reasons." Multi-drug resistant tuberculosis occurs all over the world, says Dr. David N. Gilbert, a physician at Providence-Portland Medical Center in Oregon and immediate past president of the Infectious Diseases Society of America. While scientists know linezolid appears to work in the laboratory test tube, "it's nice to get some clinical data," he says. But he does think giving all the credit to the linezolid for the TB patients may be overstatement. "With the combination of drugs used, it's difficult to say linezolid did it. It may have contributed." What is needed next, he says, is a controlled study of linezolid in an area where the drug-resistant TB is a problem. The presentations were made this week at the 99th International Conference of the American Thoracic Society this week in Seattle. More information To find out more about tuberculosis, click on the American Lung Association, which also has a primer on pneumonia. Lithium Inhibits Enzyme Involved in Alzheimer's By Stephanie Riesenman NEW YORK (Reuters Health) - Lithium, a manic depression drug first used in the 1960s, blocks an Alzheimer's disease (news - web sites)-related enzyme in the brains of mice, according to new research. The findings could lead to more effective treatments for Alzheimer's patients, investigators say. "What our work shows is that lithium can reduce production of amyloid ... in tissue culture cells and in mice that have mutations that are the same as mutations that cause inherited Alzheimer's disease," Dr. Peter Klein, an assistant professor of medicine at the University of Pennsylvania in Philadelphia, said in an interview with Reuters Health. Klein and his colleagues have identified the point where lithium works in the brain. The drug affects an enzyme called glycogen synthase kinase-3, or GSK-3. The enzyme is involved in the production of amyloid plaques, which accumulate in the brains of people with Alzheimer's disease. After being exposed to standard doses of lithium for three weeks, the drug reduced the presence of amyloid plaques in the brains of mice by 40 to 50 percent. The mice, a special genetically engineered strain, are used as a model of Alzheimer's disease. The findings are published in Thursday's issue of Nature. However, the findings do not mean that everyone with Alzheimer's should now be given lithium, Klein said. The drug, which is most often used in patients with bipolar disorder, or manic depression, can have side effects, he said. Side effects can include increased urine output, excessive thirst, nausea and trembling hands. "This is early data, and you can't just run out and give lithium to old people and people with Alzheimer's. Lithium does have side effects, which are more common in older people," he said. People who are already taking lithium for bipolar disorder or manic depression will probably be the first patients studied. Klein says researchers will look to see if these people are less likely to get Alzheimer's disease than peers not taking the drug. He says clinical trials using lithium in relatively young people who are showing early signs of Alzheimer's disease would also be worth looking into. Also, researchers will try to find more specific drugs that target GSK-3. Lithium inhibits two forms of GSK-3 present in the human body -- alpha and beta. Only alpha is involved in Alzheimer's-related plaques, Klein said. "Since we identified alpha -- and this was a surprise that only alpha is involved -- this is very important because now we can try to develop drugs that can inhibit alpha without affecting beta, and that will get around the global side effects," said Klein. He says drug companies have been focusing on GSK-3 for some time, but the results of this study will probably encourage them to "redouble their efforts." "I think it will be hard to ... focus on GSK-3 alpha specifically, because the two of them are so similar," said Klein. "It's going to take some clever ideas to do that, but it's worth trying." Source: Nature 2003; 423:435-439. Dogs Are Pet Peeve to Asthmatic Lungs By Adam Marcus WEDNESDAY, May 21 (HealthScoutNews) -- Rex may be your best pal, but if you've got asthma he is your lungs' worst enemy. More people are allergic to cats than dogs. However, a new study shows dog allergens are more ferocious irritants to asthmatics than cat dander, cockroaches, mold and dust mites. The researchers presented their findings May 20 at a meeting of the American Thoracic Society in Seattle. The study included 809 men and women with mild to moderate asthma who underwent skin tests for various irritants. To measure their sensitivity to an allergen, the researchers tested subjects in four areas: their ability to exhale while exposed to an irritant (weaker is worse); the amount of nitric oxide gas in their breath (more signals inflammation); and the nature of the phlegm, if any, they coughed up (cells called eosinophils present in mucus reflect inflammation). They also provoked their lungs with a drug that simulates constricted airways. Cat allergens were most likely to trigger at least one of these reactions, doing so in nearly three-quarters of the volunteers, the most of any irritant. Dog dander, by comparison, did so only about half as frequently. However, dog dander was the irritant most likely to decrease lung function, constrict the airways and provoke inflammation. Recent research has suggested cats in the home can protect infants from early-childhood asthma. However, the new study shows that both dogs and cats are a problem for adults with the breathing problem. "Once you have asthma, both of the critters can increase inflammation and decrease the stability of asthma," says Dr. Tim Craig, a pediatrician at Pennsylvania State University College of Medicine and a collaborator on the work. Interestingly, the researchers say, pollens didn't seem to exacerbate the lungs as much as dog and cat dander and other indoor irritants. "Though they cause significant symptoms, like runny noses and itchy eyes, they may not be as important triggers of asthma as indoor allergens are," Craig says. Dr. Clifford Bassett, a New York City allergy specialist, says the new findings run counter to what most asthma experts have believed. "Normally we think cat dander is most provocative," says Bassett, who sits on the public education committee of the American Academy of Allergy, Asthma and Immunology. Some doctors say pets are a no-go for asthma patients. Bassett says it's possible to keep animals around, as long as you take steps to reduce your exposure to their allergens. Using special air filters to intercept the particles is one way, while lower-tech measures such as wearing cotton (wool's a magnet for pet dander) and keeping your animal out of the bedroom help, too. "Keeping your pet out of the bedroom can reduce your allergy symptoms by 30 percent," Bassett says. Also important, Bassett adds, is that everyone with asthma should be tested for allergies. "Certain allergies can be modified" with lifestyle changes, prevention or medication, he says. More information An estimated 4 million to 5 million children in this country have asthma. For more on the breathing disorder, try the American Academy of Allergy, Asthma and Immunology or the U.S. Environmental Protection Agency. Atkins Diet Bolstered by Two New Studies By Janet McConnaughey A month after Dr. Robert C. Atkins' death, his much-ridiculed diet has received its most powerful scientific support yet: Two studies in one of medicine's most distinguished journals show it really does help people lose weight faster |