FRIDAY,
MAY 30, 2003
- TV
May Encourage Teen Smoking: Italian Survey
- Menorrhagia:
When Your Time of the Month is Too Much
- Obesity
Drug Cuts Risk Factors for Heart Disease
- Treating
Minor Burns at Home
- Levels
of Carcinogen Higher in Marlboro Cigarettes
- Vinegar
Good Medicine for Some Burns
- Sleep
Disorder Ups Risk of Heart Problem Recurrence
- Staving
off a Second Stroke
- 'Good'
Bacteria May Thwart Allergies in Toddlers
- Herb
May Help Heal Herpes
- Europeans
Nations Failing Obese Patients – Survey
- How
Much Exercise?
- Side
Effect Risk from Drug Higher in Epileptics
- Goodbye,
Flu Shots?
- Protein
Could Slow Degenerative Brain Diseases
- Nursing
Helps Undo Smoking's Damage to Baby
- Mystery
Fatigue Often Not Chronic Fatigue Syndrome
THURSDAY, MAY 29, 2003
- Study
Questions Popular Fertility Surgery for Men
- Cell
Phone Speakers in Front of Driver May Be Safer
- Childhood
Obesity Often Missed
- European
Initiative Launched to Tackle Obesity
- New
Ways to Treat Allergies
- New
Drug Approach to Irritable Bowel Syndrome
- Scientists
Grow Insulin-Producing Liver Cells
- Chronic
Headaches May Predict Men's Stroke Risk
- Bacteria
Beats Eczema
- Study:
Laziness Makes for Dangerous Fat
- Does
Adult Diabetes Trace Back to the Womb?
- Obesity
Epidemic Set to Get Worse
- A
Dose of Their Own Medicine
WEDNESDAY,
MAY 28, 2003
- Smoking
Speeds Up Memory Loss in Middle Age
- 'Rapid
Detox' Breaks Drug Habits Quickly
- To
Psychopathic Murderers, Violence Is Not So Bad
- Laziness
Makes for Dangerous Fat - U.S. Study
- Angry
Children Hurt Their Heart Health
- Breast
Feeding May Counter Maternal Smoking Harm
- No
Java Cold Turkey
- Heart
Effects of Impotence Pill Under U.S. Review
- Exercising
for Fun Better for the Heart
- Blood
Doping Rampant Among Top Cross-Country Skiers
- Men
May Need Second Prostate Cancer Test
TUESDAY,
MAY 27, 2003
- Sunburn
by Gender
- Young
Children Served Large Portions May Overeat
- Fish
Oil Prevents Irregular Heartbeats
- Hormone-Taking
Is Linked to Dementia
- Apnea
Tied to Atrial Fibrillation
- Diabetics'
Education Level May Sway Death Risk
- Setting
an Example by Kicking the Habit
- Full-Term
Fetus Knows Mom's Voice: Study
- Many
Prostate Biopsies Unnecessary
- Laser
Eye Surgery Claims Soaring in UK
- Two
Clot Busters Boost Stroke Recovery
- Families
Sought in Hunt for Male Cancer Genes
- Testing
for Stomach Bacteria Doesn't Help With Peptic Ulcers
- Wine
Tasting Takes Brains, Italian Study Finds
- Surgery
Beats Drugs for Fixing Blood Flow to Heart
MONDAY, MAY 26, 2003
- Pamphlet
with Your Pasta?
- Study:
Smallpox May Spur Malaria Defense
- Vitamins
May Cut Risk of Birth Defects in Diabetics
- Trust
Your Instincts, Skin Cancer Survivor Urges
- Youthful
Hostility Linked to Adult Heart Disease
- Skin
Cancer: More than 1 Million New Cases in U.S. This Year
- Coffee
Shop Workers Have High Blood Pressure Risk
- Handling
the Heat When You Have Heart Pain
- Demand
for Endocrinologists Outstrips Supply
- Obesity
Surgery Success Depends on Surgeon
- For
Preservative-Free Flu Shot, Ask in Advance
- Weekend
Exercise Does a Heart Good - German Study
SUNDAY, MAY 25, 2003
- A
Look at Dry Eye
- If
It's Not Colic, It Might be GERD
SATURDAY, MAY 24, 2003
- Unclogging
Your Nose
- Ear
Pain on Airplanes
FRIDAY,
MAY 30, 2003
TV
May Encourage Teen Smoking: Italian Survey
Reuters Health
Friday, May 30, 2003
FLORENCE (Reuters Health) - Italian teenagers
may take up smoking to imitate actors and TV stars, according
to a survey by the National Health Institute presented in
Rome on Friday.
The survey, released at the Fifth Conference
on Tobacco and the National Health Service, involved 498 teenagers
between 13 and 17 years old. The survey found that 12 percent
of the teens were smokers, with 16- and 17-year-olds most
likely to smoke.
Teens smoke an average of seven cigarettes
per day, and 35 percent buy them at vending machines, the
survey found.
At the meeting, public health experts
heard that Italian television stations Rai, Mediaset, La7
and MTV show someone smoking every 32 minutes.
In films, cartoons and videos, 62 percent
of smoking acts are associated with "winning" personalities
and 38 percent with "losers," according to the report. Moreover,
71 percent of smoking took place in "sexy and convivial situations"
while 29 percent was associated with anxiety, said the report.
The survey monitored programs between
11:30 a.m. and 11:30 p.m. during three weeks in October and
December 2002 and January 2003.
In a landmark ruling this month, Italy's
State Council banned indirect cigarette advertising in films
and TV programs.
Also this week, an agency that oversees
government industries, the Autonomous Administration of State
Monopolies, announced that beginning in January 2004 cigarette
vending machines will be shut between 7:00 a.m. and 11:00
p.m. in an effort to make cigarettes less accessible to teenagers.
The measure comes five months after Italy
passed a milestone law that bans smoking almost anywhere indoors
except private homes and specially designated smoking areas.
According to the latest report by the
statistics agency Doxa, more than one quarter of Italy's 58
million citizens are smokers.
Back to the Top
Menorrhagia:
When Your Time of the Month is Too Much
By Kathleen Doheny
HealthScoutNews Reporter
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScout News) -- For
most women, the average loss of blood during a menstrual period
is a little more than one ounce.
But an estimated 10 million American women
lose much more because they suffer from a condition called
menorrhagia. And most don't realize there are treatments that
can help ease the problem.
Traditionally, a hysterectomy -- removal
of the uterus -- has been the only option available to doctors
to treat the condition. But in recent years, researchers have
pioneered alternatives so the heavy bleeding can often be
eliminated or greatly reduced without radical surgery.
Dr. Philip G. Brooks, a Los Angeles gynecologist
and clinical professor at UCLA's David Geffen School of Medicine,
says menorrhagia is much more than just an annoying period.
The condition can be disabling, causing
women great difficulty working or doing other daily activities
because the flow is so great. "They wear towels, not menstrual
pads," Brooks says.
About 600,000 hysterectomies are performed
each year in the United States, according to the U.S. Centers
for Disease Control and Prevention (news
- web
sites), and about one-fifth
are done to treat menorrhagia, health experts say.
But in recent years, Brooks and other
physicians have turned to less drastic measures. They include
various types of ablation, procedures in which the lining
of the uterus -- called the endometrium -- is destroyed to
control the excessive bleeding.
Even before ablation is recommended, however,
there are other steps that can be considered, says Dr. William
Parker, a gynecologist at Santa Monica-UCLA Medical Center
in California. He often uses a hysteroscope, a tiny telescope-like
device, to do a visual inspection of the uterine cavity.
"We look to see if there are any fibroids,
polyps and lesions," he says, adding the early stages of pregnancy
can also lead to heavy bleeding.
Many women with menorrhagia are in the
40- to 50-year-old age bracket, and lack of ovulation during
cycles is a main reason for the bleeding.
If a follow-up test -- such as an ultrasound
-- of the uterine lining shows it's normal, Parker might prescribe
low-dose birth control pills or other medication to slow the
excess bleeding.
If medical treatments fail after three
months or so, Parker says he offers the option of ablation.
The U.S. Food and Drug Administration
(news
- web
sites) has approved four methods
of ablation in recent years, says Brooks, who lectured on
the topic at the recent annual meeting of the American College
of Obstetricians and Gynecologists.
Earlier techniques required a doctor to
have specialized training. However, the newer treatments are
easier for doctors to master, Brooks and Parker agree.
One of the newest, called hydrothermablation,
is done on an outpatient basis, and involves the insertion
of an hysteroscope to view the cavity during the procedure.
A hot saline solution is delivered into the uterus through
a tube inserted into the cervix. The water destroys the lining
of the uterus, or most of it, in 10 minutes or so. The type
of local anesthesia and other pain relief used varies, depending
on the woman.
Ablation "destroys the blood vessels and
endometrial glands that build up and shed," Brooks says. Basically,
it destroys the uterine lining enough to solve the bleeding
problem but sometimes not enough to stop periods.
He says about 50 percent of women who
undergo ablation no longer have periods; the other 50 percent
continue to have periods, but they are much lighter.
The results of hydrothermablation are
very effective. "We have a 94 percent success rate -- either
no period or scant periods," says Brooks, who teaches courses
to train other doctors in the technique.
Women who have ablation should have completed
their childbearing because the uterine lining is no longer
capable of sustaining a pregnancy, doctors say. But because
most women affected by menorrhagia are nearing the end of
their reproductive years, motherhood isn't usually a concern.
Yet even with the high success rates of
ablation techniques, says Parker, some women say to him, "I
don't want a 10 percent risk." And they opt instead for a
hysterectomy.
While a traditional hysterectomy requires
about four to six weeks recovery time, ablation is usually
a day or so, Parker says.
More information
For information on menstruation, see the
American
College of Obstetricians and Gynecologists.
To learn more about menorrhagia, visit the University
of California, Davis Medical Center.
Back to the Top
Obesity
Drug Cuts Risk Factors for Heart Disease
By Patricia Reaney
Reuters
Friday, May 30, 2003
HELSINKI (Reuters) - An obesity drug is
twice as effective as dieting in reducing weight in obese
patients and cuts their risk of heart disease, according to
new results from a long-running study reported on Friday.
Orlistat (news
- web
sites), produced by Switzerland's
Roche Holding AG under the brand name Xenical, works by hindering
the body's ability to absorb fat.
In the longest clinical trial to assess
the effectiveness and safety of an obesity drug, patients
taking orlistat had fewer symptoms of metabolic syndrome --
a cluster of three or more factors that increase the risk
of heart disease.
Those factors include overweight or obesity,
high blood pressure, early indications of diabetes, abnormal
cholesterol levels and high waist measurement -- or typical
beer belly.
"We know that we are in the middle of
an obesity epidemic. We are definitely in a global epidemic
of type 2 diabetes and as a third consequence we are facing
an epidemic of patients having multiple risk factors known
as the metabolic syndrome," said Dr. Jarl Torgerson, head
of the obesity unit at Sahlgrenska University Hospital in
Gothenburg, Sweden.
The Xendos study, led by Torgerson, mainly
aimed to see if it would be possible to prevent or postpone
type 2 diabetes in obese patients. The biggest risk for type
2 diabetes is excess weight.
"We could show that Xenical plus lifestyle
treatment had a better diabetes prevention effect than lifestyle
alone," Torgerson said in an interview.
Nearly 14 percent of people in the diet
group developed type 2 diabetes but only 9.8 percent taking
the drug suffered from the disease.
"These study results show that Xenical
boosts the beneficial effects of weight loss in people with
metabolic syndrome," said Torgerson, who presented the results
at the 12th European Congress on Obesity.
In the study of 3,304 patients over four
years, people taking the drug lost 14.08 pounds in weight,
compared to 6.38 pounds among those who were just dieting.
The drug group also reduced their waistlines
by 2.44 inches, compared to 1.52 inches for the dieters, and
had a greater reduction in blood pressure.
More than a billion people worldwide are
overweight or obese, according to the World Health Organization
(news
- web
sites). It is a serious risk
factor for heart disease, high blood pressure, stroke, diabetes,
muscle and respiratory problems and certain types of cancer.
Back to the Top
Treating
Minor Burns at Home
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- If
you're not certain what you need to do to help extinguish
the pain of minor burns, here's a refresher from the Mayo
Clinic.
Generally, you can provide treatment at
home for first-degree burns -- where the skin is reddened
-- and small second-degree burns -- where a blistered area
is no larger than two inches.
Here's what you need to do:
- For chemical burns, make sure the chemical
and any clothing or jewelry in contact with the chemical
are removed.
- Cool the burn under running water long
enough to reduce the pain. It usually takes about 15 to
20 minutes. If you can't use running water, immerse the
burn in cold water or cover it with cold compresses. Don't
put ice directly on the burn. Ice can cause frostbite and
further damage.
- Once the burn is cooled, apply a lotion
or moisturizer to soothe the area and prevent dryness. Don't
apply butter because it holds the heat in the tissues and
may cause more damage.
- Cover the burn with a loosely-wrapped
sterile gauze bandage. This keeps air off the burn and reduces
the pain.
- Take an over-the-counter pain medication,
unless your doctor has told you not to take these kinds
of medications.
- Don't break blisters on burn areas.
If a blister does break, wash the area with an antibacterial
soap and water, apply an antibiotic ointment and cover it
with a bandage.
More information
Here's where you can learn more about
burns.
Back to the Top
Levels
of Carcinogen Higher in Marlboro Cigarettes
By Paul Simao
Reuters
Friday, May 30, 2003
ATLANTA (Reuters) - Marlboro, the world's
No. 1 selling brand of cigarettes, contains significantly
higher levels of a cancer-causing agent than its rivals when
purchased in many of the largest markets overseas, U.S. scientists
say.
Tests by the U.S. Centers for Disease
Control and Prevention (news
- web
sites) found that the U.S. brand
contained higher amounts of tobacco-specific nitrosamines
(TSNAs) than other locally available cigarettes in 11 of 13
countries.
In 10 countries, including Japan and Germany,
Marlboro cigarettes purchased locally had at least twice the
amount of TSNAs, one of the major classes of carcinogens found
in tobacco products, than competitor brands.
The findings, published in the latest
edition of Nicotine & Tobacco Research, come at a time
when worldwide demand for American-style, blended cigarettes
is outpacing demand for other types of cigarettes.
David Ashley, a CDC tobacco expert and
the lead author of the article, said it was not known whether
higher levels of TSNAs would lead to a greater prevalence
of cancer and other smoking-related diseases.
Ashley did, however, note that reducing
TSNAs in tobacco products would not make cigarette smoking
any safer.
The World Health Organization (news
- web
sites) has estimated that there
are more than 1.2 billion smokers on the planet and that 4
million people die each year from cancer and other smoking-related
diseases.
Philip Morris USA, which markets Marlboro
cigarettes, said the CDC findings were not surprising since
the levels of TSNAs found in American cigarettes were traditionally
higher because of differences in curing and processing.
Philip Morris USA is a unit of Altria
Group Inc.
"We're aware of these higher TSNAs and
have worked to reduce them," Philip Morris USA spokesman Brendan
McCormick said. He added that the company had spent $35 million
to lower the levels of this type of carcinogen in its products.
But anti-tobacco activists said the tobacco
giants had done precious little to strip harmful contaminants
from cigarettes.
"Today's study is just the most recent
example of the tobacco industry's reckless disregard for the
health of smokers and yet another compelling reason why cigarettes
need to be regulated by the federal government," said Matthew
Myers, president of the Campaign for Tobacco-Free Kids.
About 440,000 people in the United States
die each year from lung cancer and other diseases caused by
smoking, making it the leading preventable cause of death
in the nation. There are about 46.5 million smokers in the
United States.
Back to the Top
Vinegar
Good Medicine for Some Burns
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- Vinegar
can minimize alkaline burn injuries caused by household cleaners,
plumbing products and industrial grade solvents.
A study in the May issue of Plastic
and Reconstructive Surgery says vinegar and other weak
acids can neutralize alkaline burns faster than water and
significantly reduce damage to skin and tissue.
That's contrary to the common myth that
neutralization should be avoided when a person suffers an
alkaline burn, study co-author Dr. Stephen Milner says in
a news release.
About 15,000 skin burns are caused by
alkaline agents each year in the United States. Alkaline agents
are found in many common cleaning supplies used in homes.
The first few minutes after the skin comes
into contact with an alkaline substance are the most important
in managing the burn, Milner says. Once alkalis penetrate
the skin, they react with fat in the skin and progressively
kill the tissue.
The study found that vinegar and other
weak acids neutralized alkalis more than 15 minutes faster
than water alone. But Milner says people who suffer alkaline
burns do need to wash the area off with water before they
apply vinegar.
"I've had patients with such severe alkaline
burns that they needed skin grafts to help repair the damage.
Unfortunately, these types of burns happen much more often
than we think. Through this study, we now know we may be able
to reduce the severity, some of the pain and debilitating
effects of alkaline burns," Milner says.
More information
Here's where you can learn more about
different kinds of burns.
Back to the Top
Sleep
Disorder Ups Risk of Heart Problem Recurrence
By Alison McCook
Reuters Health
Friday, May 30, 2003
NEW YORK (Reuters Health) - People who
have a common heart-rhythm disorder may be more likely to
experience a recurrence after treatment if they also have
an untreated sleep disorder known as sleep apnea, new study
findings suggest.
Researchers at the Mayo Clinic in Rochester,
Minnesota, found that, among people treated for a heart rhythm
irregularity known as atrial fibrillation, more than 8 out
of 10 patients who also had untreated sleep apnea experienced
a return of their atrial fibrillation within one year.
In contrast, only around 4 out of 10 people
treated for atrial fibrillation who had sleep apnea but received
treatment for the condition saw their heart rhythm problem
return.
Atrial fibrillation is a relatively common
form of arrhythmia. Although not the most deadly type of irregular
heart rhythm, atrial fibrillation puts patients at risk of
potentially life-threatening blood clots, due to the pool
of blood that slowly gathers in the atria when those chambers
become unable to contract regularly.
According to the report published in the
American Heart Association (news
- web
sites)'s journal Circulation,
approximately 50 percent of people treated for atrial fibrillation
who were sleep apnea-free experienced a recurrence of their
heart problem one year after treatment.
"If you've got sleep apnea and you've
had atrial fibrillation in the past, chances are your risk
of getting it again is higher," study author Dr. Virend K.
Somers told Reuters Health.
Somers noted that both sleep apnea and
atrial fibrillation can pose problems for the cardiovascular
system, and having both conditions may be worse than having
each alone.
Although this question has not yet been
investigated, "it's likely that when you put them both together,
the effects may at least be additive," he said.
Study participants with sleep apnea had
the most common form of the condition, known as obstructive
sleep apnea. This type of sleep apnea is caused by a collapse
of the throat during sleep, leading to an interruption of
breathing.
During the study, Somers and his team
followed a group of patients who had been treated for atrial
fibrillation for one year after treatment to determine if
their arrhythmia recurred. Thirty-nine of the patients had
obstructive sleep apnea, but only 12 were receiving appropriate
treatment for the sleep disorder.
One year after treatment for atrial fibrillation,
the researchers found that the heart arrhythmia had returned
in 82 percent of patients with untreated sleep apnea, 42 percent
of treated sleep apnea patients, and in one-half of a group
of 79 patients without sleep apnea.
In an interview, Somers explained that
there are many reasons why sleep apnea may increase the risk
that atrial fibrillation will occur.
During episodes of sleep apnea, the body
may not get enough oxygen, and this situation can stress the
heart into developing an arrhythmia, Somers said. In addition,
a sleep apnea episode often increases blood pressure and causes
the body to release adrenaline-like substances, both of which
can lead the heart to adopt an abnormal rhythm, he noted.
Many people have atrial fibrillation,
Somers said. While it would be nice to know who among them
has sleep apnea, as well, diagnosing the sleep disorder can
be very expensive.
However, he suggested that doctors faced
with a patient with atrial fibrillation who also has some
common risk factors for sleep apnea -- such as obesity, loud
snoring, and excessive daytime sleepiness -- should consider
the possibility of an additional problem.
"These are signs there's a reasonable
chance of coexisting sleep apnea," Somers said.
Source: Circulation
2003;107:2589-2594.
Back to the Top
Staving
off a Second Stroke
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- Stroke
is the third leading cause of death in the United States and
the leading cause of debilitation, but there's a big gap between
Americans' understanding of stroke and their efforts to prevent
it.
That's the claim of a recent survey by
the National Council on the Aging.
The survey found that although many Americans
know people who have had a stroke are at increased risk of
suffering another one, stroke survivors don't take all the
possible steps to protect their health.
A third of all strokes are recurrent ones.
Lifestyle changes and medications can help reduce the risk
of recurrent strokes.
The telephone survey of 992 people found
that 88 percent of respondents said they knew that someone
who has had a stroke has an increased risk of having another
one.
However, the survey found that many stroke
survivors were not exercising regularly (32 percent), quitting
smoking (19 percent) or watching their diet (18 percent),
even though these simple steps are known to prevent a future
stroke.
Medications can also reduce the risk of
recurrent stroke. For example, some stroke patients are put
on medications that prevent clotting. That helps reduce the
risk of stroke.
After surviving a stroke, men have a 42
percent chance of having another one within five years. Women
stroke survivors have a 24 percent chance of recurrent stroke
over the same time period.
The survey also found many respondents
incorrectly identified excessive stress (87 percent), overexertion
while exercising (56 percent), dehydration (38 percent), asthma
attacks (24 percent) and wearing constrictive clothing (16
percent) as risk factors for stroke.
Many also mistakenly said shortness of
breath (53 percent) and heart palpitations (50 percent) were
symptoms of stroke. Nearly two-thirds of the survey respondents
couldn't identify the age range (age 65 and older) of those
most affected by stroke.
More than 700,000 Americans suffer a stroke
each year. That's one person every 45 seconds. About 168,000
Americans die from strokes each year.
More information
The National Council on Aging offers a
stroke
tip sheet.
Back to the Top
'Good'
Bacteria May Thwart Allergies in Toddlers
By Keith Mulvihill
Reuters Health
Friday, May 30, 2003
NEW YORK (Reuters Health) - Giving soon-to-be
mothers and newborns doses of "good" bacteria may help prevent
childhood allergies up to age four, continuing research suggests.
The findings, a follow-up from a study
that initially looked at allergies in newborns up to age two,
may offer evidence that harmless bacteria can train infants'
immune systems to resist allergic reactions, according to
the report in the journal The Lancet.
In the ongoing study, researchers in Finland
used a type of bacteria found naturally in the gut -- called
Lactobacillus rhamnosus strain GG -- to try to prevent allergy
development in at-risk infants.
Lactobacillus bacteria have long been
used in food fermentation and are commonly found in items
such as yogurt. Some forms of the bacterium dwell normally
in the human intestines. Lactobacillus-laden foods and supplements
-- commonly referred to as "probiotics" -- have grown increasingly
popular because they are believed to promote good gastrointestinal
health.
In the original study, Dr. Marko Kalliomaki
and colleagues at Turku University Hospital gave a group of
pregnant women either probiotic capsules or placebo capsules
every day for a few weeks before their due dates. For 6 months
after delivery, women who breast-fed continued on the probiotics
or placebo, while bottle-fed infants were given probiotics
or placebo directly. All of the babies were considered to
be at high risk of developing allergies because a parent or
sibling was affected.
Kalliomaki's team originally published
results of the study when the children were two years old.
Now, the researchers report that the youngsters in the probiotic
supplement group were less likely at age 4 to have developed
an allergic skin condition called atopic eczema.
"The main finding is that administration
of probiotics (shortly before and after birth) may prevent
the development of atopic eczema during the first 4 years
of life in high-risk children," Kalliomaki told Reuters Health.
Children at high risk, he said, are those whose mother, father
or older sibling has asthma, atopic eczema or allergic rhinitis.
"The new finding is that the preventive
potential of Lactobacillus GG may extend beyond infancy ...
to the age of 4 years," the researcher added.
Probiotics have been shown to have favorable
effects on the gut, according to Kalliomaki. Moreover these
agents have clear effects on the developing immune system,
he explained.
By the age of four years, 25 of 54 children
in the placebo group had developed allergic eczema, a condition
in which the skin becomes irritated, red and itchy. But just
14 of the 53 children who had received probiotics developed
the skin condition -- a 43-percent reduction, according to
report.
The study was funded by the Academy of
Finland and Turku University Hospital.
Source: The Lancet
2003;361:1869-1870.
Back to the Top
Herb
May Help Heal Herpes
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- A
cream derived from the common herb called self-heal helps
prevents herpes in laboratory animals, says a study by researchers
at Dalhousie University in Nova Scotia.
The researchers extracted a lignin-carbohydrate
compound from the self-heal plant (Prunella vulgaris)
and put it in a cream they tested on mice and guinea pigs
with experimental herpes simplex virus-1 (HSV-1) and herpes
simplex virus-2 (HSV-2).
The guinea pigs receiving the cream had
a significant reduction in the number of skin lesions compared
to guinea pigs that received no treatment. Mice receiving
the cream also had a much better survival rate than mice that
didn't get the cream treatment.
"The anti-HSV compound form P. vulgaris
is a novel lignin-carbohydrate complex with potent activity
against HSV-1 and HSV-2 and has a different anti-herpes mechanism
than acyclovir, the current clinical anti-herpes drug," researcher
Song Lee says in a news release.
"Given the high incidence of herpes infection
and the emergence of acyclovir-resistant strains of herpes
viruses, the Prunella lignin-carbohydrate complex may prove
to be a useful new anti-herpes drug," Lee says.
Self-heal is commonly found in North American,
China, Europe and the British Isles.
The study was presented at the recent
meeting of the American Society for Microbiology in Washington,
D.C.
More information
Here's where you can learn more about
herpes.
Back to the Top
Europeans
Nations Failing Obese Patients – Survey
By Patricia Reaney
Reuters
Friday, May 30, 2003
HELSINKI (Reuters) - No country in Europe
is providing a satisfactory level of care for obese patients,
although an estimated 135 million people may need professional
advice on how to lose weight, doctors said on Friday.
A survey of medical professionals in 24
countries presented at the 12th European Congress on Obesity
revealed a lack of specialists to treat the growing number
of obese patients in Europe and wide variations in the facilities
provided for them.
The number of patients per obesity specialist
ranged from 9,000 to 100,000 patients depending on the country.
"This is a massive problem throughout
Europe," said Professor Vojtech Hainer of the European Association
for the Study of Obesity (EASO).
Although family doctors, or general practitioners,
are the first medical professionals people with weight problems
usually consult, the survey said most of them had poor knowledge
of obesity and some failed to recognize it as a disease.
"The care of obese patients is not very
good in any country. There is a lack of knowledge about obesity
among GPs, dietitians and psychologists and there are only
minor reimbursements by insurance companies," Hainer said
in an interview.
Only five European countries reimburse
patients for weight-reducing drugs, which could cost 70 percent
of a mean monthly salary in poorer countries like Romania
and Bulgaria.
Hainer said that although the survey was
conducted in Europe, he believes the situation is the same
around the globe.
"There are no unique differences," he
said. "We need educational systems in every country and for
the long-term."
More than a billion adults worldwide are
overweight or obese, according to the World Health Organization
(news
- web
sites). About 10-20 percent
of men and 10-25 percent of women in Europe are obese.
Being overweight increases the risk of
illnesses such as heart disease, type 2 diabetes, high blood
pressure, stroke and certain types of cancer. In some developed
countries, where the problem is most serious, obesity accounts
for an estimated seven percent of total health care costs.
Back to the Top
How
Much Exercise?
HealthScoutNews
Friday, May 30, 2003
(HealthScoutNews) -- Ever wondered what
the bare minimum is for exercising to stay healthy?
The Danish-language journal Ugeskrift
For Laeger includes a report from Kobenhavns Universitet
in Denmark, which recommends 30 minutes of moderate exercise
each day. The researchers note that the exercise can be in
the form of routine activities -- such as walking, cycling
and gardening.
Not only that, but you don't have to exert
yourself all at once. The 30-minutes a day can be divided
into 5- to 10-minute segments, the report says.
Back to the Top
Side
Effect Risk from Drug Higher in Epileptics
By Alison McCook
Reuters Health
Friday, May 30, 2003
NEW YORK (Reuters Health) - New research
suggests that people with epilepsy who receive an anti-seizure
drug may be more likely to experience certain side effects
than patients with anxiety and dementia who are sometimes
treated with the same medication.
The investigators found that, among people
who received the drug levetiracetam (Keppra), feelings of
depression, hostility, anxiety and nervousness appeared more
commonly in people with epilepsy than in people with dementia
or anxiety.
This finding "suggests that people with
epilepsy have a higher rate of side effects than patients
with disorders that you would expect to have these problems,"
study author Joyce A. Cramer of Yale University in Connecticut
told Reuters Health.
Cramer noted that research suggests other
anti-epilepsy drugs besides levetiracetam can also produce
similar side effects in people with epilepsy.
She cautioned, however, that the rate
of anxiety, depression and other similar side effects was
very low, even in epileptics. Furthermore, for anyone who
experiences these side effects, their doctor can often change
the dose or tell them to stop taking the drug, she noted.
She said that any doctor who treats a
patient with epilepsy is likely very careful, and probably
needs to take no extra precautions when prescribing anti-seizure
drugs to a patient with epilepsy than when offering the medications
to other patients.
"What the data showed is that these things
are very rare," Cramer said in an interview.
"I think the vast, vast majority of (epileptics)
have no trouble starting any drug," Cramer said.
To obtain their findings, Cramer and her
colleagues reviewed past studies that compared the effects
of levetiracetam to a placebo in patients with epilepsy, anxiety
and cognitive disorders -- primarily, dementia.
The current report, published in the journal
Epilepsy and Behavior, includes information collected from
2,416 epilepsy patients, 1,510 people with an anxiety disorder
and 719 people with cognitive disorders.
Pooling this data, Cramer and her team
saw that between two and four percent of people with epilepsy
reported feelings of depression, nervousness, hostility and
anxiety, rates that exceeded those found in placebo-treated
patients and patients with anxiety or cognitive disorders
who received levetiracetam.
Cramer said that levetiracetam-treated
epileptic patients also showed a slightly higher risk of psychotic
or suicidal behaviors, but that the rates of these behaviors
were very low.
In terms of why epileptics might experience
more side effects, Cramer suggested that the brains of people
with epilepsy might contain differences that allow medications
to bring out certain side effects more strongly.
Epileptics "seem to be more sensitive
to these drugs," she said.
The study was supported by UCB Pharma,
which makes Keppra.
Source: Epilepsy
and Behavior 2003.
Back to the Top
Goodbye,
Flu Shots?
By Kathleen Doheny
HealthScoutNews Reporter
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- For
all you needle phobics who hate to get your annual flu vaccine,
how does the prospect of a once-in-a-lifetime shot sound?
A prototype vaccine developed by researchers
at the Wistar Institute in Philadelphia, delivered not by
injection but by nasal spray, worked well in animal studies.
The researchers suspect it may prove effective for several
flu seasons.
If further research bears fruit, there's
a chance for the same kind of vaccine for humans, the scientists
say.
Their approach was to target a protein
within the flu virus that doesn't mutate as often as others.
"Current vaccines target two proteins
[within the flu virus] that mutate frequently," says Laszlo
Otvos Jr., an associate professor of chemistry at the Wistar
Institute and a co-author of the report, published in the
June 2 issue of Vaccine.
For that reason, public health officials
are always faced with the problem of updating the vaccine
so it will protect against the virus that's expected to be
prevalent in an upcoming flu season.
But the Wistar researchers focused instead
on the M2 protein, which is a more stable protein portion
of influenza viruses that mutates less frequently.
The experimental vaccine includes an engineered
peptide built by Otvos that mimics this M2 protein. The vaccine,
in nasal spray form, was given to the mice twice. After they
received it, a steep rise in antibodies to M2 was found in
blood samples, and the mice resisted replication of the virus
in their respiratory tracts.
Those mice that got the M2 protein had
much less virus in their respiratory tracts than those who
didn't get it, Otvos says.
The mice also had a more powerful antibody
response to the engineered vaccine than to infections by the
flu virus itself, the researchers found.
Every year, about 114,000 people in the
United States are hospitalized with influenza, a viral respiratory
infection, according to the U.S. Centers for Disease Control
and Prevention (news
- web
sites) (CDC). About 20,000 people
die because of it, most of them elderly. While the flu vaccine
is not 100 percent effective, if you get a flu shot you're
likely to be far less sick than without it, the CDC says.
Of the new vaccine, Dr. James C. King,
a professor of pediatrics at the University of Maryland School
of Medicine, says, "The idea is wonderful." His research focuses
on live, intranasal vaccines.
"People have been talking for years about
using some of the internal proteins [such as the M2] within
the virus that don't mutate as fast" to make a vaccine, he
says.
What makes the Wistar research exciting,
King adds, is the scientists were not only able to make the
mice's immune systems recognize the M2 protein pieces, but
"the mice made antibodies and it also protected them from
symptoms."
As exciting as the research is, King offers
a caveat: "It's a good five to 10 years -- minimum -- before
we'll see this in humans."
Otvos agrees it will take time to answer
some important questions, such as: Are antibodies against
M2 enough to protect you from the flu? Is the response long-term?
Will subsequent flu strains have a mutated M2 structure?
If it all bears out, he says, the flu
vaccine may become a once-in-a-lifetime preventive measure.
More information
For myths and facts on flu shots, see
the U.S. Centers
for Disease Control and Prevention's National Immunization
Program. For information on
the flu virus vaccine, check the U.S. Food
and Drug Administration.
Back to the Top
Protein
Could Slow Degenerative Brain Diseases
By Stephen Pincock
Reuters Health
Friday, May 30, 2003
LONDON (Reuters Health) - A type of protein
that helps cells respond to heat, cold and other environmental
stresses could one day be used to slow down degenerative brain
diseases like Alzheimer's, Parkinson's and Huntington's, British
researchers said on Friday.
Early research suggests that so-called
heat shock proteins could also help against conditions such
as motor neurone disease and stroke damage, said Professor
Jacqueline de Belleroche from Imperial College London.
"At present, there is no cure for neuro-degenerative
diseases, such as Alzheimer's and Parkinson's, but the discovery
of the beneficial effects of this protein in the brain may
provide us with a way to at least slow down the disease process,"
she said.
In the Journal of Biological Chemistry,
de Belleroche and colleagues report that the naturally occurring
heat shock protein Hsp27 was able to reduce brain cell death
in animal experiments.
Mice engineered to have high levels of
the protein throughout the brain, spinal cord and other tissues
had lower rates of death and brain cell death after they were
injected with a toxic substance that damages cells. The protective
effect was seen in the hippocampus, a part of the brain affected
by neurological diseases.
In earlier studies, the researchers achieved
similar results when they injected Hsp27 directly into the
brain.
"Although this is unlikely to provide
a cure for neuro-degenerative disorders, it could be vital
in slowing their progress," de Belleroche said. "Eventually
it may be possible to use a drug to increase levels of Hsp27
in the brain which could be given to those suffering from
neuro-degenerative diseases."
All cells contain a range of heat shock
proteins and the proteins are produced in response to environmental
stresses like heat, cold and low oxygen levels. Under normal
conditions they act like "chaperones" to make sure a cell's
proteins are in the right place and shape at the right time.
"It's one of the systems we think is a
natural defense system," de Belleroche told Reuters Health.
"We're looking at trying to boost the natural system and hopefully
translate it into treatment."
The heat shock proteins might achieve
their effects by stopping the buildup of solid structures
or aggregates within brain cells, a process that characteristically
triggers cell death in neuro-degenerative diseases, she said.
"What this and other heat shock proteins
do ... is stop those insoluble aggregates (from) forming,
and they help to re-fold the protein so it can arrest the
process."
The next step is to pin-point exactly
when the heat shock protein acts in the chain-reaction of
events leading to cell death, and develop drugs to affect
that process, she said.
"It's a line that we're hoping to pursue,"
de Belleroche said. "We're testing out a few compounds but
we haven't got any results yet."
Source: Journal
of Biological Chemistry 2003;278.
Back to the Top
Nursing
Helps Undo Smoking's Damage to Baby
By K.L. Capozza
HealthScoutNews Reporter
HealthScoutNews
Friday, May 30, 2003
FRIDAY, May 30 (HealthScoutNews) -- Smoking
during pregnancy has been shown to cause learning deficits
in developing babies, but a new study suggests that breast-feeding
may cancel out the negative impact of the mother's cigarette
habit.
By age 9, children of smoking mothers
perform at par with their classmates if they are breast-fed,
according to the study by Dutch researchers at the University
Hospital Groningen. However, babies of cigarette-smoking mothers
tend to score poorly on standardized tests if they are bottle-fed.
"Babies are already being put in a compromised
position when the mother smokes, and then to bottle-feed on
top of that is like a double negative for the child," says
Carol Huotari, manager of the Center for Breast-Feeding Information
at La Leche League International.
Data for the study were culled from the
experiences of 570 children born at one Dutch hospital between
1975 and 1978. Nine years after their birth, the children's
scores on math, spelling and reading tests were collected
by researchers and compared with information on the smoking
and breast-feeding habits of their mothers.
To ensure that the mothers' self-reported
feeding method was accurate, the team interviewed them at
their time of discharge from the hospital, when their children
were 9, and again when their children were 25.
The results support the new recommendations
adopted by the American Academy of Pediatrics in 2001, which
advise that smoking mothers should breast-feed because the
benefit of nursing their child far outweighs the potential
negative health effects of nicotine exposure through breast
milk.
Nicotine is easily absorbed through lungs
but is actually poorly transferred through the digestive system
and mouth, causing babies to be only minimally exposed to
the drug through breast milk, says Dr. Beth Lawrence, a professor
of pediatrics and obstetrics at the University of Rochester
School of Medicine.
The Dutch findings, published in the June
issue of the Journal of Epidemiology and Community Health,
do not provide any answers on how breast-feeding might protect
infants from the cigarettes' impact.
One theory is that the long-chain polyunsaturated
fatty acids found in breast milk promote brain development,
say the authors.
"It's the fatty acids in human milk that
enhance the brain development," agrees Huotari, which is why
formula companies are now trying to harness the benefits of
these unique fats by putting them in baby formula to make
them more like mother's milk.
Another way that mother's milk might help
an infant's cognitive development is through the nurturing
act of breast-feeding itself, which may offer psychological
benefits to the child, hypothesize the researchers.
But whatever the mechanism, one message
is clear from the findings: Pregnant women who smoke should
be encouraged to breast-feed their infants, says Lawrence.
"This suggests that for mothers who continue
to smoke, it's better to breast-feed than not, and this study
further confirms that," she says.
More information
Visit the American
Academy of Pediatrics or the
La
Leche League International to
get more information on breast-feeding.
Back to the Top
Mystery
Fatigue Often Not Chronic Fatigue Syndrome
Reuters Health
Friday, May 30, 2003
LONDON (Reuters Health) - Two out of three
people presenting to British family doctors with unexplained
fatigue do not meet the criteria for chronic fatigue syndrome,
but the condition still significantly affects their life,
researchers said on Friday.
Medical researcher Lucy Darbishire and
colleagues from Guy's, King's and St. Thomas's School of Medicine
in London collected data from 22 general practices in and
around London on patients with unexplained fatigue lasting
more than six months.
Applying the U.S. Centers for Disease
Control Prevention criteria for chronic fatigue syndrome,
the researchers found that 69 percent of patients did not
have the condition.
Several symptoms, including fatigue and
distress, were higher in the chronic fatigue syndrome group.
People with the condition were also more likely to be depressed
and more than twice as likely to be unemployed, Darbishire
and colleagues write in the June issue of the British Journal
of General Practice.
Nevertheless, 11 out of 12 symptoms assessed
by the researchers were reported by more than 60 percent of
the patients who did not have chronic fatigue syndrome, although
those symptoms were less severe, the researcher told Reuters
Health.
"I don't think we really found a characteristic
difference. It really looked as if everything was just more
severe in the CFS group. It supports that theory, really,
that it's just another end of the spectrum," she said.
"I think the take home message is to remember
that there are these two-thirds of patients that present with
fatigue that don't meet criteria for CFS because they don't
seem as severe, but they do actually have quite distinct illness."
Chronic fatigue syndrome is characterized
by a range of symptoms including fatigue, headache, sleep
problems, muscle pain and difficulty concentrating.
Patients with the condition, which can
strike suddenly, often experience a marked increase in symptoms
after only minor bouts of exertion.
The cause of chronic fatigue syndrome
is uncertain.
Source: British
Journal of General Practice 2003;53:441-445.
Back to the Top
THURSDAY, MAY 29, 2003
Study
Questions Popular Fertility Surgery for Men
By Adam Marcus
HealthScoutNews Reporter
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
A much performed surgery to relieve tangled blood vessels
in the testes isn't the fertility fix it's intended to be,
new research shows.
The problem can raise the temperature
of the scrotum by a couple of degrees, impairing normal sperm
function. The procedure, called varicocele repair, is designed
to restore healthy blood flow to the organs and bring their
temperature down into the normal range. But the latest findings
suggest that the operation doesn't deliver.
However, some experts say the latest research
focused on versions of the technique -- the most common fertility
operation among men in the United States -- that are now obsolete
and which may in fact lower the odds of conception.
"I would expect many of these operations
to make the patient worse," says Dr. Marc Goldstein, a urologist
in New York City and an expert in varicocele repair.
Goldstein, a professor of reproductive
medicine and urology at Weill Medical College of Cornell University,
helped pioneer a less-invasive form of the surgery in the
1980s that he says has much better outcomes than the conventional
approach.
Varicoceles (pronounced vahr-ih-co-seals)
are the same as varicose veins in the legs. They occur in
about 15 percent of men. Many have no fertility problems as
a result, but the swollen veins are believed to play a role
in as many as 40 percent of cases of impaired fertility (also
known as subfertility). Some men with the problem have slower
sperm with abnormal shapes that may have trouble fertilizing
an egg.
Removing the offending vessels can correct
these problems -- or so the theory goes.
In the new work, appearing in the May
31 issue of The Lancet, researchers in Holland and
Canada analyzed seven earlier studies on varicocele repair
conducted between 1979 and 2002. Compared with untreated men,
those who had the operation were no more likely to conceive.
The researchers say the limited number
of patients might have obscured small effects in various sub-groups
of men. Still, they say, "varicocele repair does not seem
to be an effective treatment for male or unexplained subfertility."
Dr. Joel Marmar, who invented the microsurgery
form of varicocele repair, says the new study has deep flaws.
Some included men whose varicoceles didn't meet more recent
criteria for who is most eligible for the procedure, he says.
And almost none of the previous trials had any information
about the woman's age or the nature of her fertility problems,
if any -- information that's vital when pregnancy is the desired
outcome.
"With pregnancy you're introducing a totally
different variable: the wife," says Marmar, a professor of
urology at the Robert Wood Johnson Medical School in Camden,
N.J.
More information
To find out about varicocele repair, try
the Cornell
Institute for Reproductive Medicine
or LaGrange
Memorial Hospital.
Back to the Top
Cell
Phone Speakers in Front of Driver May Be Safer
By Keith Mulvihill
Reuters Health
Thursday, May 29, 2003
NEW YORK (Reuters Health) - Although chatting
on a cell phone while driving ups the risk of an accident,
new research suggests that cell phone speakers mounted in
front of drivers may help them stay better focused.
That's because it's easier for people
to look and listen at the same time when all the information
is coming from the same direction, UK researchers say.
Recent concerns about the safety of driving
while dialing and talking into hand-held cell phones have
led some U.S. states to ban their use in moving vehicles.
In response, millions of cellular users have made the switch
to hands-free devices.
But studies also suggest that such hands-free
technology may not reduce the risk of car accidents among
chatty drivers -- suggesting that a driver's attention, rather
than problems with physically handling a cell phone, is the
more important factor in safe driving, according to the new
report, published in the journal Psychological Science.
In the study, Drs. Charles Spence and
Liliana Read had eight people "drive" in a simulator that
mimicked driving on suburban and city roads. While they drove,
they listened to a person's voice broadcast alternately from
one of two loudspeakers placed in different positions -- in
front of them and off to their side.
Participants were asked to repeat the
words spoken to them.
The researchers found that overall, participants
were able to repeat more words correctly when they were listening
to the audio and not driving -- 77 percent versus 56 percent
when driving.
But when the researchers compared the
two different driving conditions, they found that participants
correctly repeated 85 percent of the words when the speaker
was in front of them, compared with 49 percent when the speaker
was placed to the side.
According to the researchers, the brain
might be better able to process visual and auditory information
when both come from the same direction.
"By presenting the speaker from the direction
in which drivers typically look -- straight ahead -- they
will find it easier to combine talking and driving," Spence,
a researcher at Oxford University, told Reuters Health in
an e-mail.
"This could be achieved most simply by
mounting the loudspeaker on top of the dashboard in front
of driver, or else by use of transparent loudspeaker mounted
on the (windshield) of the car," he said.
Still, Spence pointed out that "it is
best not to use a mobile phone while driving."
"However," he added, "if you are going
to use one, you can combine driving with talking on the mobile
phone more safely if the person you are listening to speaks
from directly in front of you --where you tend to look while
driving-- and not from the side."
Source: Psychological
Science 2003;14:251-256.
Back to the Top
Childhood Obesity Often Missed
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
Despite the increased focus on childhood obesity in the United
States, few doctors or other health-care professionals are
diagnosing obesity and related health problems in young patients.
A Michigan State University study found
that between 1997 and 2000, obesity was identified in fewer
than 1 percent of children visiting a doctor's office or an
urgent care center.
That's despite the fact that about 15
percent of American children aged 6 to 19, and almost 11 percent
of preschool children, are considered obese. A child is defined
as obese when her body mass index (BMI) is at the 95th percentile
or above.
The study also found that only about 7
percent of obese children actually received a diagnosis of
obesity. It also revealed that almost 20 percent of the children
diagnosed as obese were younger than 5.
The findings were presented at the recent
annual meeting of the Pediatric Academic Societies.
For their study, the researchers analyzed
more than 45,000 ambulatory care visits by children aged 17
and under between 1997 and 2000. The data was provided by
the National Center for Health Statistics.
Lack of time was the main reason that
doctors and other health providers failed to diagnosis obesity
in children, the researchers say.
"To address obesity in the office setting
takes a little more time. In addition, we found that if a
child was obese, the visit took longer than if the child was
not," researcher Ihuoma U. Eneli, an assistant professor of
pediatrics and human development, says in a news release.
Childhood obesity can lead to a number
of health problems such as diabetes. And children who are
obese tend to grow into obese adults. That's why it's important
that obesity be diagnosed as early as possible.
More information
Here's where you can learn more about
childhood
obesity.
Back to the Top
European
Initiative Launched to Tackle Obesity
By Patricia Reaney
Reuters
Thursday, May 29, 2003
HELSINKI (Reuters) - Medical experts launched
a new initiative on Thursday to train doctors and nurses in
Europe to cope with obesity, which afflicts at least 20 percent
of adults.
Rates of obesity in Europe have doubled
or tripled in some countries in recent years creating a serious
public health problem because excess weight is a risk factor
for heart disease, stroke, diabetes and certain cancers.
Obesity and related conditions are second
only to smoking as a cause of preventable death.
"Wherever we go in Europe patients and
people are desperate for help and it has become very clear
that they have been missing out because doctors in Europe
do not know how to tackle obesity," said Professor Philip
James, the chairman of the International Obesity TaskForce
(IOTF).
"We have decided to take a radical new
step to try to cope with this problem," he told a medical
conference in Finland.
The IOTF and the European Association
for the Study of Obesity (EASO) are collaborating on a program
called SCOPE which will identify obesity experts in Europe
and provide training programs for doctors, nurses and pharmacists
to improve treatments for obese patients.
"Most doctors are poorly prepared to manage
obesity," said Professor Peter Kopelman of EASO.
SCOPE, or Specialist Certification of
Obesity Professionals in Europe, will also provide guidelines
on obesity management.
Obesity is measured by using body mass
index (BMI), which is calculated by dividing weight in kilograms
by height in meters squared. A BMI of 30 or more is considered
obese.
The first pilot program to train family
doctors in weight management will be held at the 12th European
Congress on Obesity under way in Helsinki. About 1,700 doctors,
nutritionists and researchers are attending the four-day meeting.
Back to the Top
New
Ways to Treat Allergies
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
Doctors need to educate patients about dangerous side effects
such as sedation and impairment that can be caused by first-generation
antihistamines, say new recommendations from an expert panel.
The panel recommendations conclude that
allergies, including seasonal ones, should be treated with
second-generation, non-impairing antihistamines instead of
over-the-counter, first-generation antihistamines such as
Benadryl.
Those older generation antihistamines
are often dosed and selected inappropriately. That can lead
to dangerous side effects such as sedation and impairment,
which can increase the risk of injury, as well as reduced
quality of life.
The panel's recommendations were developed
at a recent consensus conference and appear in the May issue
of the Journal of Allergy and Clinical Immunology.
Even though these first-generation antihistamines
can cause impairment and sedation, the panel says that 47
percent of people with allergies take them. The panel says
people with allergies need to avoid these first-generation
medications and discuss the use of non-impairing antihistamines
with their doctor.
More than 40 million Americans have allergies,
but only 20 percent see a doctor for diagnosis and treatment
of their symptoms. Allergy symptoms, if left untreated, can
mask more serious chronic conditions such as asthma or sinusitis.
More information
Here's where you can learn more about
allergies.
Back to the Top
New
Drug Approach to Irritable Bowel Syndrome
By Maggie Fox, Health and Science Correspondent
Reuters
Thursday, May 29, 2003
WASHINGTON (Reuters) - A drug currently
used to treat alcoholics and drug overdoses may also offer
relief in a surprising quarter -- people with irritable bowel
syndrome, corporate researchers said on Thursday.
A small trial of 50 patients with the
painful disorder showed that three-quarters of them got relief
from the drug, known best as naltrexone, the company said.
South San Francisco-based Pain Therapeutics
Inc. said tiny doses of naltrexone, which is available generically,
eased the bloating, pain, constipation and diarrhea that mark
irritable bowel syndrome (IBS) in both men and women.
"Seventy-six percent of patients on our
drug had a positive response," Remi Barbier, president and
chief executive officer of Pain Therapeutics, said in a telephone
interview.
One in five Americans has IBS, making
it one of the most common disorders diagnosed, according to
the National Institute of Diabetes and Digestive and Kidney
Diseases. More common in women than in men, it is not a true
disease and does not cause disease, but creates a great deal
of discomfort and distress.
Barbier said judging the effectiveness
of the drug is subjective. "It's like antidepression drugs
or pain drugs -- yes, it is subjective, but believe me, the
symptoms of IBS are so severe that if you are better, you
know it," he said.
Two drugs are approved by the U.S. Food
and Drug Administration (news
- web
sites) (FDA) to treat IBS --
GlaxoSmithKline's Lotronex and Novartis AG's Zelnorm. But
they are only approved for women and for short-term use.
Experts also recommend stress-reduction
and relaxation measures, such as meditation, walking, yoga
and getting enough sleep, as IBS seems to be aggravated by
stress.
Naltrexone, which Pain Therapeutics is
testing under the name PTI-901, takes a new approach to treating
IBS.
"The traditional view of IBS is that the
flusher is broken -- it is either flushing too quickly or
not quickly enough, causing diarrhea or constipation," Barbier
said.
"We disagree with that point of view.
We don't think the flusher is the problem. We think it is
an imbalance of opioids in the gut. We provide the patient
with an external source of opioid antagonists to restore bowel
function."
The current, Phase II study was designed
mostly to assess safety, and the company now plans to start
a larger, Phase III efficacy trial -- the last step before
seeking FDA approval.
"We believe a safe and effective drug
to treat both men and women who suffer from IBS represents
a $1 billion market opportunity in the United States alone,"
Barbier said.
Barbier said scientists working with his
company stumbled on the opioid-IBS connection when they compared
notes on patients who had overdosed on morphine or heroin,
both opiate drugs.
"Patients who overdose on morphine lean
over and hang on to their stomach," Barbier said. "The light
bulb went on. Maybe opioid withdrawal and IBS are one and
the same symptoms, which is an imbalance of opioids in the
gut."
Back to the Top
Scientists
Grow Insulin-Producing Liver Cells
By Amanda Gardner
HealthScoutNews Reporter
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
Scientists have managed to "grow" insulin-producing cells
from human liver cells, a feat that holds promise for treating
-- or perhaps curing -- type 1 diabetes.
"For me, this is one of the most exciting
things to come across in terms of a cure," says Dr. Henry
Anhalt, director of the division of pediatric endocrinology
at Infants and Children's Hospital of Brooklyn at Maimonides
Medical Center.
"Taking care of kids with diabetes is
all about the cure. No matter how good we do managing them,
ultimately we can't do as good a job as a cell that is capable
of sensing glucose and responding," adds Anhalt, who was not
involved with the new research.
Those with type 1 diabetes -- formerly
called juvenile-onset diabetes -- have an autoimmune disorder
that destroys the insulin-producing beta cells of the pancreas.
As a result, the body's ability to produce insulin, which
is essential for transporting and storing glucose, or blood
sugar, is shut down. There's no cure for the disease and patients
have to manage their condition by injecting insulin before
they eat.
For a longer-term solution, researchers
are pursuing ways to get the body to start producing insulin
again. One approach would be to transplant healthy beta cells,
a nice idea but one that is hampered by the severe shortage
of donated pancreases. As a substitute, scientists are looking
for ways to actually create their own cells through, for example,
genetic manipulation.
Scientists have already shown that inserting
certain genes into liver cells prompted those cells to produce
insulin. The liver and pancreas are closely related organs
and come from the same type of cell during embryonic development.
In the new study, the researchers used
fetal human progenitor liver cells (FH), a type of stem cell
obtained from fetuses that had been aborted due to medical
necessity. The cells were "precursor" cells, meaning they
were on their way to becoming a specific type of cell -- in
this case liver cells -- but had not fully developed yet.
The researchers first added a gene called
pdx-1, which is essential for beta cell development. Once
the gene was inserted into the liver cells, it caused the
cells to switch on other genes that are normally found in
pancreatic beta cells. The gene then prompted the liver cells
to secrete insulin in response to glucose.
To produce large quantities of the cells,
the researchers "immortalized" them by inserting a gene for
telomerase, which repairs the ends of chromosomes and prevents
chromosomes from shortening and being unable to divide.
When the cells were transplanted into
diabetic mice, the cells brought blood-sugar levels down within
the normal range and kept them there for several months.
"There's been a lot of interest in trying
to use stem cells to make a variety of mature products, one
of which is insulin-producing cells to treat diabetes," says
the study's co-author, Dr. Norman Fleischer, director of endocrinology
and co-director of the Diabetes Research Center at the Albert
Einstein College of Medicine in New York City.
"Here we are taking cells that are much
further along. They're already differentiated and are on their
way to becoming [liver cells]," he says.
"Other people have shown that you could
get some expression of insulin in [liver cells]... but what's
new here is combining a developing cell line which, because
it has been expressing two genes, made it develop into a functional
cell line," Fleischer adds. "It took on a number of characteristics
of beta cells, including the production of insulin."
Part of the excitement surrounding the
discovery, which appeared in a recent online edition of the
Proceedings of the National Academy of Sciences (news
- web
sites),
lies in the fact that the cells actually work within a "context."
In other words, they respond to glucose within a living creature.
"Being able to insert genes into strange cells and make them
make insulin is incredible," Anhalt says.
One big advantage of this technique is
that the cells used are human ones. Also, the "immortalization"
procedure didn't lead to the development of tumors, which
has happened in other cases of genetic engineering with mice.
Finally, the liver cells had a higher insulin content than
cells produced in different ways, the researchers say.
One big disadvantage is that the research
is still in its early stages. "It's not the first time somebody
has found cells to correct diabetes in mice," Fleischer says.
"[But] there's a long way to go before these are available.
This is just a beginning."
Another potential drawback is a political
one. "The biggest fear is that these [liver cells] are obtained
through 'medically necessary abortions,' " Anhalt points out.
"That's the political hot potato that's going to make a difference
as to whether the technology blossoms."
More information
For more on type 1 diabetes, visit the
Juvenile
Diabetes Research Foundation
or the American
Diabetes Association.
Back to the Top
Chronic
Headaches May Predict Men's Stroke Risk
Reuters Health
Thursday, May 29, 2003
NEW YORK (Reuters Health) - Men who suffer
from chronic headaches may be at increased risk of having
a stroke, Finnish researchers report.
They say that chronic headaches could
be a marker for the underlying disease process that leads
to stroke.
In the study, Dr. Pekka Jousilahti of
the University of Helsinki followed more than 35,000 Finnish
men and women for up to 23 years and compared self-reports
of headache at the start of the study with rates of first-time
stroke during the follow-up.
One year into the study, the researchers
found, men with chronic headaches -- defined as those who
said they suffered headaches "often" -- were four times more
likely to have a stroke compared with men without headaches.
As time went on, though, the stroke risk
tied to chronic headache declined, according to the report
in the Archives of Internal Medicine (news
- web
sites). Five years into the
study, men with chronic headaches were less than twice as
likely as those with no headaches complaints to suffer a stroke.
Among women, who reported chronic headaches
at nearly twice the rate of men -- 17 percent, versus nine
percent -- there was only a "weak" relationship between headache
and stroke risk, the researchers report.
According to the researchers, the association
between chronic headache and stroke in men may, in part, be
related to vascular damage caused by artery disease. Besides
raising the risk of stroke, diseased, inflamed arteries might
irritate sensitive nerves, leading to headache.
A limitation of the study, however, is
that participants were not asked about symptoms of migraine,
but only unspecified symptoms of headache, according to the
researchers.
Previous studies have implicated migraine
headaches in stroke risk.
"Thus we cannot estimate the proportion
of stroke risk observed with headache that might be due to
migraine," the authors note.
But the new findings do confirm those
observed in another study conducted in the United States,
according to Dr. Marc Fisher of the University of Massachusetts
Medical School in Worcester.
"These two studies raise the intriguing
likelihood that headache in general is associated with an
increased stroke risk," he writes in an accompanying editorial.
"What remains uncertain is the explanation
for this increased risk," Fisher adds.
He notes that the "most likely explanation"
is that chronic headaches and stroke share a common underlying
disorder.
But, he concludes, this and other possibilities
"will need to be explored in further studies that carefully
evaluate the type of headache patients have, (co-existing)
conditions and medications consumed."
Source: Archive
of Internal Medicine 2003;163:1005,1058-1062.
Back to the Top
Bacteria Beats Eczema
By Serena Gordon
HealthScoutNews Reporter
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
Probiotics, bacteria thought to be beneficial to your health,
may stop kids from getting eczema when given during pregnancy
and early infancy.
In a Finnish study appearing in the May
31 issue of The Lancet, researchers conclude that children
exposed to probiotics before birth were 40 percent less likely
to have eczema, an allergic skin disease. They didn't lessen
the chances of developing allergies or asthma, however.
"Early modification of the immune system
by probiotics may have a preventive effect on the development
of atopic eczema, at least in high-risk children," says study
author Dr. Marko Kalliomaki, a resident in pediatrics at Turku
University Central Hospital in Turku, Finland.
The findings add another piece to support
the "hygiene hypothesis" in the ongoing debate about what
is causing the rise in allergic diseases such as asthma and
eczema. The hygiene hypothesis is a theory, originally proposed
about 10 years ago, that blames the increase in allergic disease
on cleaner living. Because children's bodies don't have to
fight off as many bacteria as they did in the past, their
immune systems start mistakenly attacking harmless substances,
such as pet dander or pollen, causing allergic diseases.
For this study, the researchers hoped
that if they introduced a "good" bacteria, they could stimulate
the immune system properly and lessen allergic reactions.
Kalliomaki and his colleagues recruited
159 mothers-to-be in Turku for the study. All of the women
had a personal or family history of asthma, allergies or eczema.
Beginning two to four weeks before delivery,
the mothers were randomly assigned to take either two capsules
containing the probiotic Lactobacillus rhamnosus GG
or two capsules of a placebo daily until their babies were
6 months old if they were breast-feeding. Babies who weren't
breast-fed were given the contents of the capsules mixed with
water until they were 6 months old.
The researchers saw the children again
at 2 and 4 years of age to look for signs of allergic disease.
One hundred and seven children completed the full four years.
Of those, 14 out of 53 who received probiotic
treatment were diagnosed with eczema, compared to 25 out of
54 children who had received a placebo.
"Early probiotic supplementation may have
profound and long-lasting effects on the development of eczema,"
Kalliomaki says.
There was no significant difference between
the groups when it came to the development of asthma and allergies,
however.
Dr. Michael Wasserman, a pediatrician
at Ochsner for Children in New Orleans, says this study provides
"fairly good statistical evidence that the early introduction
of Lactobacillus has some benefit."
But he cautions that probiotics have not
been well studied in children. Though there don't appear to
be any side effects from the treatment, he says safety can't
be assumed, especially because this study was done on a small
and relatively homogenous group of people.
The probiotic treatment used in this study
looks "promising and safe," Wasserman says, but he adds there
needs to be a larger study done confirming the benefits and
safety.
Wasserman recommends talking with your
health-care provider before making any major changes in your
child's diet.
"Just because something is natural doesn't
mean it's safe. Remember, arsenic and cyanide are natural,"
Wasserman says.
More information
To learn more about probiotics, visit
the American
Dietetic Association. For more
information on eczema, read this article from the American
Academy of Pediatrics.
Back to the Top
Study:
Laziness Makes for Dangerous Fat
Reuters
Thursday, May 29, 2003
WASHINGTON (Reuters) - Everyone knows
that lazing around can lead to a growing potbelly, but U.S.
researchers say that couch potatoes build up dangerous pockets
of fat more quickly than anyone thought.
But the good news -- or perhaps the bad
news -- is that vigorous exercise can take it off pretty quickly,
the team at Duke University in North Carolina reported Wednesday.
The team of experts looked at visceral
fat -- that hidden flab tucked in among the organs. It is
often invisible, but unlike an obvious paunch or heavy thighs,
it is linked with insulin resistance -- pre-diabetes -- and
heart disease.
Speaking to a meeting of the American
College of Sports Medicine in San Francisco, Cris Slentz said
he was surprised at how rapidly fat accumulated deep in the
abdomens of patients who did not exercise.
Volunteers who did no exercise had an
8.6 percent increase in visceral fat after eight months, while
those who exercised the most lost 8.1 percent of their visceral
fat, Slentz said.
"The results of our investigation show
that in sedentary overweight adults, who continue to choose
a sedentary lifestyle, the detrimental effects are worse and
more rapid than we previously thought," Slentz said in a statement.
"We probably should not have been surprised
since this simply mirrors the increasingly rapid rise in obesity
prevalence seen in the U.S., where at present two out of three
adults are overweight or obese."
Women gained fat twice as quickly as the
men did, Slentz said.
Exercise takes the fat away quickly, but
it has to be pretty vigorous, Slentz and colleagues found.
"Participants who exercised at a level
equivalent to 17 miles of jogging each week saw significant
declines in visceral fat, subcutaneous abdominal fat and total
abdominal fat," Slentz said.
"While this may seem like a lot of exercise,
our previously sedentary and overweight subjects were quite
capable of doing this amount."
They studied 170 volunteers, putting them
into four groups who got no exercise, small amounts of moderate
exercise equivalent to walking 11 miles a week, low amounts
of vigorous exercise equivalent to jogging 11 miles a week
and a lot of vigorous exercise equivalent to jogging 17 miles
a week.
Back to the Top
Does
Adult Diabetes Trace Back to the Womb?
By Ed Edelson
HealthScoutNews Reporter
HealthScoutNews
Thursday, May 29, 2003
THURSDAY, May 29 (HealthScoutNews) --
The seeds of adult diabetes may sometimes be sown in the womb,
a new French study suggests.
The link is far from certain, the researchers
stress. However, their small study found that adult children
of mothers with type 1 diabetes, in which the body produces
no insulin, show a weakened response to sugar that could be
a precursor of type 2 diabetes. Type 2 is the kind of diabetes
that often develops in adulthood due to poor nutrition and
lack of exercise, says the report in the May 31 issue of The
Lancet.
"We are writing a proposal to follow a
larger sample of children born to mothers with type 1 diabetes
to see if they develop type 2 diabetes," says study author
Dr. Eugene Sobngwi, a diabetes specialist at Saint-Louis Hopital
in Paris.
It's not genetics, but something in the
environment of the womb that might be responsible, the researchers
say. They demonstrated that point in an ingenious way: the
control group they used consisted of people whose fathers
had type 1 diabetes.
"The main endpoint in our study was insulin
secretion," Sobngwi says. "Twenty percent of the children
born to mothers with type 1 diabetes had glucose intolerance,
but none of the offspring of fathers with type 1 did."
Glucose intolerance is caused by inadequate
production of insulin in response to sugar in the bloodstream.
A glucose tolerance test can be used to diagnose type 2 diabetes
or whether people are at risk for the disease.
When that test was given to 15 adults
whose mothers had had type 1 diabetes during pregnancy, five
of them showed glucose intolerance. But none of the 16 offspring
of fathers with type 1 diabetes did, the researchers say.
Both genetic and environmental factors
are known to contribute to the onset of type 2 diabetes. What
happens in the womb could be one of those environmental factors,
Sobngwi says.
There could be an effect on the parasympathetic
nervous system, which regulates the activity of fetal organs,
including the pancreas, which produces insulin, the researchers
speculate.
Dr. Richard Jackson, an assistant professor
of medicine at Harvard Medical School (news
- web
sites)'s Joslin Diabetes Center,
calls the new theory "interesting," but he remains unconvinced.
What Jackson does find significant is
that none of the people tested showed a decrease in insulin
sensitivity, another significant warning sign for diabetes
risk. "If what they are saying is true, you would expect that
to show up," Jackson says.
Epidemiological studies haven't found
a link between type 1 and type 2 diabetes, Jackson says, but
those studies have not looked at the kind of relationship
proposed by the French study.
And while children of mothers with type
1 diabetes are at greater risk of type 1, that risk does not
depend on whether the mother's diabetes was diagnosed before
or after the pregnancy, he says.
More information
To learn more about diabetes, visit the
Joslin
Diabetes Center or the American
Diabetes Association.
Back to the Top
Obesity
Epidemic Set to Get Worse
By Patricia Reaney
Reuters
Thursday, May 29, 2003
HELSINKI (Reuters) - Obesity has spiraled
into a worldwide epidemic affecting 250 million adults but
a leading nutritional expert believes the worst is still to
come.
Overweight adolescents are on course to
fuel an even bigger global health problem as they mature into
obese adults, he says.
"The younger generation, the generation
after us, will be even more obese than we are, which doesn't
make the future look very promising," Dr. Mikael Fogelholm
said in an interview.
The chairman of the 12th European Congress
on Obesity, which begins in Helsinki on Thursday, said the
prevalence of obesity among adolescents has increased more
rapidly than among the middle-aged population.
"We can't expect that the present generation
will die and we will have a lean generation," added Dr. Fogelholm,
who is also the director of the independent UKK Institute
for Health Promotion Research in Finland.
A steady, and in some cases life-long,
diet of high-fat fast foods and idle hours in front of the
television and computer, has taken its toll on children.
"Most obese adults now had not been obese
children," Fogelholm said. "They obtained their extra kilos
(pounds) after they were 25 or 30 years old. But now we have
more and more people who are already obese at the age of 10,
15 or 20.
"If the trend goes on, the future doesn't
look better. It looks worse unless we can find a way to prevent
obesity."
Along with expanding waistlines, being
overweight or obese increases the risk of type 2 diabetes,
heart disease, stroke and certain cancer. In the United States,
where over half of the adult population is obese or overweight,
obesity costs about $93 billion a year in medical expenses.
Elsewhere obesity rates range from two
percent in some developing countries, to 80 percent on remote
Pacific Islands and about 20 percent in Western countries.
Fogelholm believes the solution to the
problem must begin with changes that encourage people, and
particularly youngsters, to get more exercise and to make
healthy food choices. But he stressed that must include changes
in how city centers are planned, how food is marketed and
the sizes of portions in which it is served.
Ministries of transport, environment and
education should be involved in health policies, he added.
"It's a complex phenomenon especially
from a behavioral viewpoint," he said.
"If you think of smoking -- people either
smoke or they don't smoke. But everyone has to eat and what
they eat, how much and the amount of exercise they get make
weight control a very complex behavior."
About 1,500 doctors, nutritionists, researchers
and geneticists are attending the conference which runs to
June 1.
Back to the Top
A
Dose of Their Own Medicine
HealthScoutNews
Thursday, May 29, 2003
(HealthScoutNews) -- "Take this medication
exactly as prescribed."
That sort of warning accompanies most
prescriptions, but it seems that even doctors themselves ignore
it some of the time.
According to the Southern Medical Journal,
doctors are more compliant than the average patient. But they're
still not perfect.
Researchers at New York Medical College
in Valhalla, N.Y., surveyed 301 physicians and nurses on the
way they comply with instructions on taking medication.
For short-term drugs like antibiotics,
the adherence rate was about 77 percent. And for long-term
medications, such as those for high blood pressure or high
cholesterol, the rate was 84 percent.
Older physicians and nurses are better
at taking medications than younger ones, and everyone fares
better with medications that require one or two doses a day
than with drugs that need three or four daily doses, the survey
found.
Back to the Top
WEDNESDAY,
MAY 28, 2003
Smoking
Speeds Up Memory Loss in Middle Age
By Alison McCook
Reuters Health
Wednesday, May 28, 2003
NEW YORK (Reuters Health) - Cigarette
smokers who continue the habit through middle age may see
their memory suffer as a result, according to new study findings
released Wednesday.
UK researchers found that, from their
40s to their 50s, smokers showed a faster decline in their
scores on tests of word memory, relative to non-smokers.
Furthermore, people who smoked in their
40s did worse on tests that measure how fast they could pick
out certain letters from a page than non-smokers of the same
age, the authors write in the American Journal of Public Health.
The relationship between smoking and memory
loss appeared strongest in people who smoked more than 20
cigarettes each day, and persisted even when the authors controlled
for the influence of socioeconomic status, gender and a range
of medical conditions.
Just why smoking may speed up age-related
memory loss is not yet clear, study author Dr. Marcus Richards
of University College London told Reuters Health.
He said that he and his colleagues suspected
that smoking may accelerate memory loss by increasing the
risk of high blood pressure, which can damage the brain. However,
the relationship between smoking and brain functioning may
be slightly more complicated, Richards said.
"Our results for memory still held up
after taking blood pressure into account, but smoking could
have been causing changes in the brain's blood supply that
we were not able to measure," he said.
Alternatively, chemicals in cigarette
smoke could also damage the brain directly, Richards added.
Whatever the reasons for why smoking accelerates
memory loss, the message from these results should be clear,
Richards said.
"This is yet another reason to quit smoking,"
he said. "If you can't, then cut down as much as you can."
During the study, Richards and his team
reviewed information collected from 5,362 people born in 1946.
Study participants were contacted 21 times by the time they
turned 53.
Researchers measured people's mental functioning
via a series of tests. In one test, which looked at verbal
memory, the investigators showed people 15 words for two seconds
each, then asked them to write down as many as they could
remember.
During tests of speed and concentration,
people had to look for and cross out as many Ps and Ws they
could find in a page of other letters within one minute.
Although smokers in their 40s performed
just as well as non-smokers in the verbal memory tests, puffers'
performance deteriorated much faster from their 40s to their
50s.
And people who said they smoked while
in their 40s scored worse during speed tests conducted in
their 40s than non-smokers.
But the findings also suggest that quitting
may help, for the researchers discovered that people who stopped
smoking before age 53, and especially those who stopped before
age 43, tended to exhibit a slower decline in memory.
"Our results suggest that quitting may
slow down the negative impact of smoking on cognitive function,"
Richards said.
Source: American
Journal of Public Health 2003;93.
Back to the Top
'Rapid Detox' Breaks Drug Habits Quickly
By Jennifer Thomas
HealthScoutNews Reporter
HealthScoutNews
Wednesday, May 28, 2003
WEDNESDAY, May 28 (HealthScoutNews) --
Errol Dodson's drug addiction began with a prescription for
Vicodin to help treat pain in his shoulder, knees, ankles
and ribs caused by weightlifting and wrestling injuries.
A few years later, Dodson realized he
was hooked. He was spending $400 a week buying Vicodin, Lortabs
and OxyContin on the black market. In the morning, he felt
like he had the flu until he popped a pill.
"I hated myself for letting this happen,"
says the 33-year-old industrial mechanic from Greenwood, Ind.
"I was so ashamed. I was isolating myself from friends and
family. I knew I had to get help."
Dodson checked himself into a two-week
drug detoxification center. A few days after getting out,
he gave into his cravings and started taking the painkillers
again.
In February, Dodson decided to try a new
and controversial drug treatment called "rapid detox," which
promises to get you through drug withdrawal in a mere 48 hours.
It also promises far less pain and discomfort because you're
under general anesthesia during the worst of it.
Rapid detox is touted as a way to kick
opiates, including heroin, morphine and methadone, as well
as opiate prescription painkillers such as OxyContin, Percocet,
Vicodin and Lortabs. Practitioners estimate there are about
a dozen rapid detox centers around the country.
"I have detoxed attorneys and doctors
on a Friday and they are back at work on a Monday and seeing
patients or clients on Tuesday," says Dr. Rick Sponaugle,
chief of anesthesiology at Helen Ellis Memorial Hospital in
Tarpon Springs, Fla. and director of Florida Detox, located
in the hospital. "We take them through the detox in a more
humane way and what I believe is a less dangerous way."
While advocates say the procedure is highly
effective, skeptics caution that little research has been
done comparing the effectiveness of rapid detox versus traditional
methods.
Critics also point out the high costs
of the procedure -- Dodson paid about $10,000 -- which is
not covered by most insurance companies, and the risk posed
by general anesthesia.
"Rapid detox is providing a service which
has some dangers, so it's kind of hard to justify something
that is so expensive," says Dr. Michael Miller, medical director
of the NewStart Program at Meriter Hospital Program in Madison,
Wisc.
Here's how rapid detox works:
At Florida Detox, the patient is admitted
into the hospital, where they undergo psychological testing
and a urine test to determine what drugs are in their system.
The client is then given general anesthesia
for about three hours, during which time he or she is given
a dose of Naltrexone, a non-addictive drug.
When a person takes opiates, the drug
attaches to receptors in the brain, leading to the feeling
of being "high." Naltrexone, known as a narcotic antagonist,
blocks the opiates from attaching to receptors.
Patients are then given a sedative intravenously
to help them sleep through the night. By the following afternoon,
they are usually ready to go home, though Sponaugle often
keeps them in the hospital for another day.
After the detox, patients continue to
take Naltrexone tablets daily for several weeks to two years.
Sponaugle highly recommends that patients get involved with
a 12-Step program or other therapy to help them remain drug-free.
"Ongoing psychological treatment is so
important," he says. "Unless they receive that spiritual healing,
they will probably relapse."
During the six years Florida Detox has
been in business, Sponaugle has detoxed about 400 patients.
According to company information, about 75 percent of patients
stay drug-free for six months. About 50 percent to 60 percent
stay clean for one year or more.
After the rapid detox, Dodson, like other
patients, felt somewhat achy and nauseous, but the withdrawal
symptoms weren't nearly as severe as in traditional detox.
In traditional detox, a drug addict often
has to endure two to 10 days of abdominal pain, tremors, vomiting
and severe muscle aches that comes with drug withdrawal.
Dodson recalled two weeks of sheer agony.
"It was a horrible experience," he says. "It felt like snakes
were trying to crawl out of my body. I had uncontrollable
leg movement. I couldn't get out of bed."
Miller, secretary of the American Society
of Addiction Medicine, says that not every addict undergoes
so much discomfort. There are new drugs to take the edge off
during ordinary detox -- drugs that cost significantly less
and are less risky than Naltrexone.
Naltrexone has been known to cause side-effects
including delirium and confusion in some people. And there
is always some risk when a person is put under general anesthesia.
But Miller says is the more important
issue is not the detox method, but what kind of treatment
people are able to access afterwards to help them stay off
drugs.
"Detox is only the first step, and detox
in and of itself resolves no cases of addiction," he says.
"The controversies which surround rapid detoxification methods
miss the basic point, that regardless of the method of detoxification
used, patients with opiate dependence face great challenges,
and they need to have their addiction treated not simply their
withdrawal treated."
After two days in Florida, Dodson returned
home to Indiana feeling more hopeful than ever. Since he had
the procedure done in early February, he says he's had no
desire to take drugs.
Sponaugle says he would like to eventually
wean him off the Naltrexone, because the drug interferes with
the ability to experience a "natural" high from the body's
own endorphins.
"If you have the willingness to put the
drugs behind you and bury it, then rapid detox will work for
you," Dodson says. "Rapid detox saved my life."
More information
To learn more about drug addiction, visit
the National
Institute on Drug Abuse. Read
more about Naltrexone by clicking here.
Back to the Top
To
Psychopathic Murderers, Violence Is Not So Bad
By Alison McCook
Reuters Health
Wednesday, May 28, 2003
NEW YORK (Reuters Health) - Psychopaths
who have committed murder do not equate violence with something
that is unpleasant, UK researchers said Wednesday.
This relatively positive attitude toward
violence was not seen in either murderers who were not psychopaths
or other men with personality disorders who had committed
different crimes, the authors write in the journal Nature.
Psychopaths, despite evidence of charm
and skill, are commonly unable to maintain affectionate relationships
with others, while routinely engaging in impulsive, amoral
and hostile behavior unhampered by guilt.
And while psychopaths who commit murder
may often claim to think violence is wrong, the current findings
stem from the results of tests designed to measure people's
underlying attitudes toward a concept, and not simply what
they say they believe, the researchers note.
Indeed, the test, known as the Implicit
Association Test, has also been used by researchers to identify
test-takers' hidden prejudices.
Although psychopaths' relatively positive
attitude toward violence could either cause or result from
repeated acts of violence, study author Dr. Robert Snowden
of Cardiff University said some research supports the former.
As a result, Snowden said that it might
one day be possible to use a similar -- and much more developed
-- test to predict whether a person is likely to commit crimes,
such as when evaluating offenders who are up for parole.
Researchers could also use the test to
try to understand a person's motives for committing a violent
act, and determine whether treatment programs have helped
criminals change their attitudes toward crimes, Snowden added.
Snowden and his colleagues administered
the Implicit Association Test to 121 male criminals who were
admitted to a secure, therapeutic facility. The group included
13 psychopathic murderers, 17 murderers who were not psychopaths,
and 39 psychopaths who had not committed murder and 52 non-psychopathic
men who had committed other types of crimes.
During the test, the men were shown an
all-uppercase word (such as "UGLY") on a screen, and were
asked to press a button marked either "unpleasant" or "pleasant,"
according to which best described the word.
In one scenario, the button marked "unpleasant"
also contained the word "violent," and the "pleasant" button
also read "peaceful." In another scenario, "violent" and "peaceful"
switched buttons.
When test-takers were shown a lowercase
word on the screen (such as "kill"), they were asked to indicate
whether the word is more violent or peaceful, rather than
whether it was pleasant or not.
Normally, when shown a word on the screen,
people take longer to figure out which button to press when
non-related words -- such as "violent" and "pleasant" -- are
on the same button, Snowden said.
However, psychopathic murderers responded
differently, and completed the test "as if they do not associate
violence and unpleasant," Snowden said.
Snowden said that he would expect to find
the same results in psychopathic women. However, most psychopaths
are men, and research into psychopathology tends to focus
on men, so he added that he couldn't say for sure if the results
apply to both sexes.
Although the test used in the current
study could offer great benefits to law enforcement, the researcher
cautioned that it is not yet ready for prime time.
"We must emphasize that this is the very
first study of its kind, and much more research needs to be
completed before (the test) could be used for any real-life
purpose," Snowden said.
Source: Nature 2003;423:497-498.
Back to the
Top
Laziness
Makes for Dangerous Fat - U.S. Study
Reuters
Wednesday, May 28, 2003
WASHINGTON (Reuters) - Everyone knows
that lazing around can lead to a growing potbelly, but U.S.
researchers said Wednesday that couch potatoes build up dangerous
pockets of fat more quickly than anyone thought.
But the good news -- or perhaps the bad
news -- is that vigorous exercise can take it off pretty quickly,
the team at Duke University in North Carolina reported.
The team of experts looked at visceral
fat -- that hidden flab tucked in among the organs. It is
often invisible, but unlike an obvious paunch or heavy thighs,
it is linked with insulin resistance -- pre-diabetes -- and
heart disease.
Speaking to a meeting of the American
College of Sports Medicine in San Francisco, Cris Slentz said
he was surprised at how rapidly fat accumulated deep in the
abdomens of patients who did not exercise.
Volunteers who did no exercise had an
8.6 percent increase in visceral fat after eight months, while
those who exercised the most lost 8.1 percent of their visceral
fat, Slentz said.
"The results of our investigation show
that in sedentary overweight adults, who continue to choose
a sedentary lifestyle, the detrimental effects are worse and
more rapid than we previously thought," Slentz said in a statement.
"We probably should not have been surprised
since this simply mirrors the increasingly rapid rise in obesity
prevalence seen in the U.S., where at present two out of three
adults are overweight or obese."
Women gained fat twice as quickly as the
men did, Slentz said.
Exercise takes the fat away quickly, but
it has to be pretty vigorous, Slentz and colleagues found.
"Participants who exercised at a level
equivalent to 17 miles of jogging each week saw significant
declines in visceral fat, subcutaneous abdominal fat and total
abdominal fat," Slentz said.
"While this may seem like a lot of exercise,
our previously sedentary and overweight subjects were quite
capable of doing this amount."
They studied 170 volunteers, putting them
into four groups who got no exercise, small amounts of moderate
exercise equivalent to walking 11 miles a week, low amounts
of vigorous exercise equivalent to jogging 11 miles a week
and a lot of vigorous exercise equivalent to jogging 17 miles
a week.
Back to the Top
Angry
Children Hurt Their Heart Health
HealthScoutNews
Wednesday, May 28, 2003
WEDNESDAY, May 28 (HealthScoutNews) --
Hostile children may end up aggravating their health, says
a new U.S.-Finnish study.
The study by University of Pittsburgh
and University of Helsinki researchers found children and
adolescents who respond with anger to life events have a greater
risk of developing metabolic syndrome, a precursor to heart
disease.
Indications of metabolic syndrome include
high blood pressure, weight gain, insulin resistance and elevated
cholesterol levels.
The researchers examined hostility levels
and cardiovascular risk in 134 American children aged 8 to
10 and 15 to 17. They found children who had high scores on
hostility tests were more likely to exhibit metabolic syndrome
three years later than children who didn't have high hostility
scores.
Obesity and insulin resistance were the
two highest risk factors found in hostile children in the
follow-up, the study says.
Unhealthy lifestyles such as physical
inactivity, poor diet, smoking and alcohol use can be a way
that hostile children and adolescents cope, behavior that
can contribute to development of metabolic syndrome, the authors
suggest in the May issue of Health Psychology.
They say the study findings could be used
to evaluate youngsters' behavioral risk to developing these
potential health problems.
"There is a need for interventions designed
to reduce hostility in young people to prevent the precursors
to cardiovascular disease, like obesity or type 2 diabetes,
which has become a huge health problem in children in the
U.S.," researcher Karen A. Matthews says in a news release.
More information
Here's where you can find advice for teens
on dealing
with anger.
Back to the Top
Breast
Feeding May Counter Maternal Smoking Harm
Reuters
Wednesday, May 28, 2003
LONDON (Reuters) - Breast feeding may
counter the harmful affects that smoking during pregnancy
can cause to a baby's development, Dutch researchers said
Thursday.
Scientists at the University of Groningen
in the Netherlands studied school results of 570 nine-year-old
children who had been born in a Dutch hospital between 1975
and 1978 and whose mother had smoked during the pregnancy.
They found that only children who had
been bottle-fed performed poorly on the school tests.
"Our results indicate that negative effects
of maternal smoking on children's cognitive performance were
limited to those who had not been breast fed," Dr Laura Batstra
said in a report in the Journal of Epidemiology and Community
Health.
Batstra and her colleagues said psychological
or other factors could be involved but suggested that ingredients
in breast milk may promote brain development and counteract
the negative effects of maternal smoking.
"This notion has important practical implications,
especially for nicotine-addicted future mothers," Batstra
said.
"Apart from helping these mothers to stop
or diminish their tobacco consumption, they should be encouraged
to breast feed," she added.
Medical studies have shown that breast
feeding offers tremendous benefits for babies. It reduces
their risk of ear infections, allergies, vomiting and diarrhea
.
Norwegian scientists have also found a
positive association between the duration of breast feeding
and the child's mental development. The longer the child was
breast fed, the greater the benefit, even after adjusting
for maternal age, education, intelligence and smoking at the
time of conception.
Back to the Top
No
Java Cold Turkey
HealthScoutNews
Wednesday, May 28, 2003
(HealthScoutNews) -- You could see this
one coming.
Caffeine seems to be the in stimulant
these days. But if you decide to cut your caffeine intake,
there's a period of withdrawal -- and it can feel awful.
That's the official word from researchers
at the Royal Bournemouth Hospital in Dorset, United Kingdom,
who studied caffeine withdrawal in 11 women, and published
the research in Pharmacology and Biochemistry of Behavior.
The women, all suffering from caffeine
deprivation, were given a candy bar and a diet soda. Some
got a regular diet cola, while others got a caffeine-free
dose. Then they were asked how they felt.
As you'd expect, the ones who drank the
soda with caffeine felt better than the women who'd had the
caffeine-free cola.
Back to the Top
Heart
Effects of Impotence Pill Under U.S. Review
By Lisa Richwine
Reuters
Wednesday, May 28, 2003
WASHINGTON (Reuters) - An advisory panel
on Thursday meets to discuss potential heart-related side
effects from a drug vying to become the first U.S. competitor
to Pfizer Inc.'s popular impotence pill Viagra.
Levitra, by Germany's Bayer AG and Britain's
GlaxoSmithKline Plc, was launched in Europe in March. U.S.
regulators last summer said Levitra was "approvable" but asked
for more information on the drug's impact on a key heart measurement.
On Thursday, a panel that advises the
Food and Drug Administration (news
- web
sites) will hear and discuss
data on that issue related to Levitra and also a Sanofi-Synthelabo
drug called alfuzosin for treating an overgrowth of cells
in the prostate. Alfuzosin also has been ruled approvable
by the agency.
The panel is not expected to vote on whether
either product should be approved, an FDA spokeswoman said.
The FDA will ask committee members for input on how to assess
drugs' impact on the "QT interval," a measurement of electrical
activity in the heart. A prolongation of the QT interval can
at times lead to dangerously abnormal heart beats that can
be fatal.
The panel "is being asked to discuss what
all this data in the heart area might mean, what is the best
way to collect it and interpret it," the FDA spokeswoman said.
Various drugs have been shown to prolong
the QT interval, and regulators have been watching the issue
closely to determine when the prolongation may be hazardous.
A few drugs, such as heartburn treatment Propulsid, were pulled
from the market after being linked with prolonged QT intervals
and dangerous heartbeat irregularities.
Ira Loss, an analyst with Washington Analysis,
said he did not think the issue would keep either Levitra
or alfuzosin off the market. He said he thought regulators'
concerns centered on how to describe the issue on the product
label.
Loss said he believed "the QT interval
prolongations with these two products were within a comfort
zone that didn't make them pariahs in their class."
GlaxoSmithKline spokesman Michael Fleming
said the Levitra makers "believe our data further support
the safety profile of this compound."
Sanofi-Synthelabo, in a summary posted
on the FDA Web site, said alfuzosin's effect on the QT interval
"is not indicative of a prolongation of QT interval that could
be associated with ventricular arrhythmia," a type of abnormal
heart beat.
Back to the Top
Exercising
for Fun Better for the Heart
By Janice Billingsley
HealthScoutNews Reporter
HealthScoutNews
Wednesday, May 28, 2003
WEDNESDAY, May 28 (HealthScoutNews) --
Engaging in exercise in your leisure hours can decrease your
risk of a heart attack by as much as 60 percent, a German
study has found.
If your exercise comes in the form of
physical strain at work, however, the opposite is true --
your risk of heart disease goes up.
These are among the findings of a study
at the University of Ulm Medical Center in Germany, that studied
781 middle-aged men and women, 312 of whom had heart disease.
"The study provides additional evidence
that leisure time physical activity (LTPA), but not work-related
physical strain (WRPS) is associated with a decreased risk
of coronary heart disease," the authors write.
The findings appear in the May 26 issue
of the Archives of Internal Medicine (news
- web
sites).
By asking participants to fill out questionnaires
about their physical activity during the summer and winter,
both at work and at leisure, and taking blood samples, the
researchers found nonwork-related physical activity was associated
with a lower risk for heart disease.
Also significant was that those who reported
more leisure time activity had lower levels of various biomarkers
in the blood that are involved in the inflammatory response,
which is thought to be involved in the buildup of plaque in
the blood vessels.
"This study was well done for the completeness
of the inflammatory markers. The authors looked very carefully
at more markers," says Dr. Richard Stein, a spokesman for
the American Heart Association (news
- web
sites) and chief of cardiology
at Brooklyn Hospital Center.
Stein says this is important because these
inflammatory markers -- such as C-reactive protein (CRP) and
interleukin 6 (IL-6) -- could be increasingly important in
determining the causes for heart attacks.
"Coronary events are not due to how much
coronary disease you have, but to the fracturing of the plaque
that blocks the heart vessel," he says, and while you can't
say now that having high levels of inflammatory markers can
predict coronary events, research is suggesting the likelihood
of these events are associated with these markers.
In the study, there was a clear relationship
between leisure time physical activity and a decrease in risk
of heart disease, with the benefits accruing dramatically
as the amount of exercise increased. Those who exercised for
an hour or less a week reduced their heart disease risk by
15 percent compared to those who did no leisure time exercise.
People who exercised between one and two
hours a week had a 40 percent reduction in heart disease risk,
and those who exercised for more than two hours weekly reduced
their risk for heart disease by 61 percent.
"The single, most proactive thing you
can do for yourself to reduce the risk for heart disease is
to exercise regularly three or more times a week," Stein says.
Conversely, study participants who reported
work-related physical strain (WRPS) had a much higher risk
of heart disease, from a doubling of the risk for those who
reported light WRPS to more that four times the risk for those
who had heavy WRPS.
One reason for this difference, the authors
suggest, could be that work-related physical activity is probably
long-lasting and static, while leisure time activity is mainly
short-lasting and dynamic in nature. But, they add, it also
may be due to other, unknown risks.
Stein says that previous studies report
the same discrepancy between different types of exercise but
that the cause for the differences is unknown.
"It may be a mind-body connection, but
it's not clear," he says.
More information
Get suggestions for increasing your physical
activity from the American
Heart Association. An article
explaining the biomarker C-reactive protein (CRP) can be found
at the National
Library of Medicine.
Back to the Top
Blood
Doping Rampant Among Top Cross-Country Skiers
By Gary Gately
HealthScoutNews Reporter
HealthScoutNews
Wednesday, May 28, 2003
WEDNESDAY, May 28 (HealthScoutNews) --
Blood doping can boost performance enough to propel a cross-country
skier from 30th place to the medal podium in elite international
competition.
And the practice appeared to be rampant
among top skiers in the 2001 Nordic World Ski Championships,
a new study concludes.
The research, published in the May issue
of the Clinical Journal of Sport Medicine, found that
more than a third of the top 50 finalists in the cross-country
skiing competition -- and half the medal winners -- showed
evidence that suggests illegal blood doping.
University of Alberta researchers analyzed
blood samples from the top 50 competitors in nine races to
test for abnormally high levels of oxygen-carrying cells in
the blood. Athletes can use erythropoietin -- or EPO, a hormone
that stimulates red blood cell production -- so the blood
can carry more oxygen, an important factor in endurance, the
study says.
International athletic federations now
follow the Olympic Committee medical code, which recognizes
only the presence of a banned substance in urine as proof
of doping, the study's authors say. But current testing procedures
are often ineffective in detecting EPO use, the study says.
So, detecting doping will require relying
on measures such as blood tests measuring oxygen-carrying
cells, the study concludes.
"Blood doping is both prevalent and effective
in cross-country skiing, and current testing programs for
blood doping are ineffective," the authors write. "The new
formulations of erythropoietin leave athletes ... with the
choice of competing 'clean' or doping to be able to compete
with 'those other cheaters' who will not be caught by existing
controls."
And it's unlikely blood doping is less
common in endurance sports other than skiing, the study adds.
The world ski championships in Lahti,
Finland, came the year before the Winter Olympics (news
- web
sites) in Salt Lake City, Utah,
where three cross-country skiers tested positive for blood
doping, the study notes.
The researchers analyzed 203 blood samples
from 146 of the skiers at Lahti. Overall, 36 percent of the
top 50 finishers had abnormal blood test results indicating
blood doping. Among medal winners, half had "highly abnormal"
results, as did a third of those finishing from fourth to
10th place, the researchers found.
By contrast, among skiers finishing from
41st to 50th place, only 3 percent had "highly abnormal" results.
And in the general population, that level would be expected
in less than 1 percent, the researchers report.
In a World Cup or Olympic cross-country
race, the top 50 skiers typically finish within 10 percent
of the winning time, the researchers say. Blood doping can
provide up to a 10 percent improvement in performance, "making
it by far the most effective way to manipulate results in
endurance sports," the study says.
Dr. Gary Wadler, a sports medicine specialist
and an expert on doping, says the study highlights the need
for better testing to detect cheating among athletes.
Elevated EPO levels show up in tests for
only a few days, Wadler says, but the beneficial results --
improved performance -- can last for weeks. This raises a
key question, he says: "Are the athletes learning to play
the calendar rather than the game of sports?"
Wadler, a fellow of the American Academy
of Sports Medicine and a medical adviser on performance-enhancing
drugs to the White House Office of National Drug Control Policy,
says use of EPO to improve performance is dangerous and can
be fatal. The hormone, used medically to treat anemia, makes
the blood unnaturally thick, leading to increased risk of
heart attack and stroke, he says.
"It's a very serious health issue as well
as an issue of unfair athletic advantage," Wadler says.
More information
For more on EPO, visit the University
of Florida. To learn more about
doping in sports, check out the World
Anti-Doping Agency.
Back to the Top
Men
May Need Second Prostate Cancer Test
By Keith Mulvihill
Reuters Health
Wednesday, May 28, 2003
NEW YORK (Reuters Health) - Men who undergo
prostate specific antigen (PSA) testing for prostate cancer
(news
- web
sites) should undergo a second
test to confirm the results if the first is positive, according
to a report released Tuesday.
It seems the test results can vary, and
an elevated result on the first test -- a sign of prostate
cancer -- may be lower on a second test.
Indeed, the study suggests that roughly
40 to 50 percent of men with an elevated PSA level may have
a lower result the next time they are tested. This means some
men may undergo an unnecessary biopsy, a test in which a needle
is inserted into the walnut-shaped prostate to collect cells
for further testing.
"What we found was that PSA levels tend
to fluctuate over time," said the study's lead author, Dr.
James A. Eastham of Memorial Sloan-Kettering Cancer Center
in New York, in an interview.
"A single PSA test result should be taken
with a grain of salt," said Eastham.
The findings are published in this week's
issue of the Journal of the American Medical Association (news
- web
sites).
In the study, Eastham and colleagues went
back and tested blood samples from 972 men ages 35 to 89 who
had originally enrolled in a study on preventing colon polyps.
A total of five consecutive blood samples
collected during a four-year period were tested for each man.
Roughly 20 percent of the group had a
PSA level that would have called for a biopsy, depending on
the criteria used to trigger a test. About 50 percent of this
group later saw their PSA drop to levels that would not have
called for a biopsy, Eastham told Reuters Health.
PSA is a protein produced by the prostate
gland. PSA levels above 4 nanograms per milliliter (ng/mL)
of blood can signal prostate cancer, but not always -- sometimes
a rise in PSA is due to another cause, and sometimes cancer
can occur without a rise in PSA.
About 20 percent of aggressive prostate
tumors are found in men with normal PSA levels.
Men with PSA levels that warrant further
testing such as a biopsy for the presence of cancer should
undergo another PSA test between four and six weeks after
their initial test, advised Eastham.
"This would save men from having unnecessary
biopsies," he said.
The researchers said their study is somewhat
limited because some of the men in the study might have had
dropping PSA levels because they were being treated for prostate
cancer. However, they said this is unlikely because the men
filled out healthy surveys annually, which asked about newly
diagnosed conditions.
Blood testing for PSA levels has been
used as a cancer detection tool since the early 1990s, but
experts still debate whether such tests offer any additional
value to other prostate cancer screening methods. PSA tests
have not yet been shown to increase lifespan.
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 some 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.
"While PSA testing does lead to the early
detection of prostate cancer, a single abnormal PSA level
should be viewed with caution," according to the new report.
"A newly elevated level should be confirmed before expensive
or invasive tests, such as a prostate biopsy, are recommended."
About 75 percent of men who have a prostate
biopsy after an elevated PSA test are found to be cancer-free.
Source: Journal
of the American Medical Association 2003;289:2695-2700.
Back to the Top
TUESDAY, MAY 27, 2003
Sunburn
by Gender
HealthScoutNews
Tuesday, May 27, 2003
(HealthScoutNews) -- A day at the beach
can be fun for the kids, but it will be safer for them if
there's a woman along.
That's because researchers at Loyola University
in Chicago say women seem to better understand the importance
of sun protection.
As reported in the Journal of the American
Academy of Dermatology, the researchers studied the influence
of adult supervision on sunburn in children. After interviewing
503 families, they concluded that most cases of child sunburn
are associated with having too much confidence in sunscreens.
Moreover, men are more likely to allow
their children to become burned or tanned, and are more likely
to compliment a child on how good he or she looks with a tan.
Back to the Top
Young
Children Served Large Portions May Overeat
By Charnicia E. Huggins
Reuters Health
Tuesday, May 27, 2003
NEW YORK (Reuters
Health) - Giving young children meals that outsize their age
may lead to overeating -- but when left to their own devices,
kids tend to choose age-appropriate serving sizes, new study
findings show.
Researchers found that super-sizing preschoolers'
entrees generally led the children to take bigger bites and
consume more calories. But when kids were allowed to serve
themselves, they naturally selected more age-appropriate portions.
"Given the alarming and growing problem
of child obesity, the capacity of large portions to encourage
overeating among young children is concerning," study author
Dr. Jennifer Orlet Fisher told Reuters Health.
"The results of the study imply that minimizing
children's exposure to excessive portions may prevent overeating,"
said Fisher, of the U.S. Department of Agriculture (news
- web
sites)'s Children's Nutrition
Research Center at Baylor College of Medicine in Houston.
One recent study found that meal portion
sizes in the home and restaurants have jumped since the late
1970s in the U.S.
In the current study, Fisher and her team
studied 30 preschool-aged children.
During two series of lunches the children
were served either an age-appropriate portion of a macaroni-and-cheese
entrée or a portion twice as large.
The researchers found that, overall, the
children ate about 25 percent more of the entrée when
they were served a larger portion than when they were served
an age-appropriate amount.
Children took bigger bites when presented
with the bigger entrée and did not compensate by eating
significantly less of the other foods served with it, Fisher
and her colleagues report. The children's overall calorie
intake at lunch was 15 percent higher when served the large
entrée.
In addition, the children's bite size
increased along with increasing body mass index, a measure
of a person's weight in relation to their height.
In another part of the study the children
were allowed to serve themselves from bowls containing individual
servings of the larger portion sizes. They were told to eat
as little or as much as they wanted.
This time, the children did not overeat,
the researchers found. They instead chose smaller portions
and ate less than when they were served the larger portion
size.
In light of the findings, Fisher suggested
that children be served or encouraged to select "small 'first
portions' with additional helpings if (they) are still hungry."
"Also avoid the temptation of 'super-sizing"'
when eating out, she added. "Such deals appear not to represent
a good value for health."
Source: American
Journal of Clinical Nutrition (news
- web
sites)
2003;77:1164-1170.
Back to the Top
Fish
Oil Prevents Irregular Heartbeats
By Amanda Gardner
HealthScoutNews Reporter
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- For
years, scientists have known that eating such oily fish as
salmon, tuna or bluefish regularly could prevent sudden cardiac
death.
The reason for that may just have become
clearer.
According to new research appearing in
the June 3 issue of Circulation, fatty acids in this
type of fish are stored in individual heart cells and serve
to prevent irregular heart rhythms (also known as arrhythmias)
by working through the heart's calcium and sodium channels.
Sudden cardiac death causes at least 250,000
deaths each year in the United States alone, says the American
Heart Association (news
- web
sites) (AHA). As its name implies,
this type of death occurs unexpectedly and in people who may
or may not have diagnosed heart disease. Most cardiac arrests
occur as a result of life-threatening arrhythmias.
The body requires two types of polyunsaturated
fatty acids (PUFAs) in order to function: n-6 and n-3. Both
must come from the diet, because the body does not produce
them. Since 2000, AHA dietary guidelines have recommended
that healthy adults eat at least two servings a week, especially
fish high in omega-3 fatty acids, such as mackerel, lake trout,
herring, sardines, albacore tuna and salmon.
The first study to show a benefit to the
heart from n-3 PUFAs was in 1989. Since then, a number of
additional studies have also shown beneficial effects, but
no one knew what the specific mechanisms at work were.
For this study, the researchers removed
the hearts from several one- to two-day-old rat pups, then
separated and cultured the cells and placed them under a microscope
for observation. By the second day, the heart cells had clumped
together and were beating spontaneously, rhythmically, and
simultaneously -- just like a whole heart would.
The video camera taped the heart cells
as different agents were applied, including PUFAs.
"The heartbeat itself is due to electrical
activity which, in turn, results from small ions -- sodium,
calcium, and potassium -- moving through specific ion channels
in the cell membrane of heart cells. These channels recognize
the specific ions," says Dr. Alexander Leaf, lead author of
the study. Leaf is a professor emeritus of clinical medicine
at Harvard Medical School (news
- web
sites) and former chief of medicine
at Massachusetts General Hospital, both in Boston.
When a person has a heart attack, the
cells in the area that is no longer receiving blood tend to
die. There remain a few cells in the peripheral area between
the dead cells and the remaining normal heart muscle, which
become "mischief makers," Leaf says.
"They are much more ready to shoot off
an electrical signal that causes a contraction of the heart,
and they do this out of the normal electrical cycle that produces
the regular rhythm of the heartbeat," he says. "It can produce
arrhythmia."
The fatty acids eliminate the mischief
makers by blocking excessive sodium and calcium currents in
the channels of the heart. "By modulating these two ion channels,
they preserve the normal electrical activity of the heart,"
Leaf explains.
And the benefit takes place very quickly.
"The effect comes on very soon if one starts eating these
fatty acids regularly," Leaf says. "It takes just a small
amount."
Leaf recommends fresh or frozen fish,
but says that canned tuna will suffice if it is water-packed.
He also advises sticking with the AHA's recommendations of
having at least two meals of oily fish per week. "That certainly
will protect most people from cardiac death, [but] about 20
percent of the American public doesn't eat any fish oil at
all," he says. Anyone with a family or personal history of
coronary heart disease should talk to his doctor about a supplement.
While saying the research is interesting,
other experts call for prospective, randomized studies in
humans.
"I do not think what they've said is very
conclusive. There is no prospective, double-blind study that
shows the efficacy in the prevention of sudden death," says
Dr. J. Anthony Gomes, professor of medicine and director of
cardiac electrophysiology and electrocardiography at the Mount
Sinai School of Medicine in New York City.
Gomes also says that drugs that work on
sodium and calcium channels aren't always the answer. "They
do not necessarily prevent sudden cardiac death," he says.
"That's why we went to defibrillators."
But fish does deserve extra attention,
he admits.
"It might be something very interesting
and very useful," Gomes says. "After all, it is something
one can eat. It may even be pleasurable."
More information
The American Heart Association has pages
on dietary
guidelines, on arrhythmias,
and fish
and fish oil.
Back to the Top
Hormone-Taking
Is Linked to Dementia
By Lindsey Tanner
AP Medical Writer
The Associated Press
Tuesday, May 27, 2003
CHICAGO - Women who take hormones for
years run a higher risk of Alzheimer's or other types of dementia,
according to yet another startling study that turns upside
down what doctors have long believed about supplements.
"It's another nail in the coffin" for
the use of hormones during and after menopause, said St. Louis
gynecologist Dr. Robert Blaskiewicz, a Saint Louis University
professor.
The study appears in Wednesday's Journal
of the American Medical Association (news
- web
sites).
The findings in women 65 and older challenge
the long-held notion that estrogen-progestin supplements can
help women keep their minds sharp — a belief that was based
on smaller, less rigorous studies.
Last summer, a government study was abruptly
halted after finding an increased risk of breast cancer (news
- web
sites), heart attacks and strokes
in women who took one type of combined hormone pill.
That finding shattered the conventional
thinking about the health benefits of hormones and prompted
millions of American women to stop taking supplements.
Some experts say that based on what is
now known about supplements, women past menopause should not
take hormones at all. Other experts say that women needing
relief from night sweats and other menopausal symptoms should
take the lowest possible dose for the shortest time.
The new findings on dementia come from
a subset of participants in last summer's study. Despite those
earlier findings, many women have continued using supplements
to relieve menopausal symptoms and in hopes of preventing
memory loss and other mental decline, said Sally Shumaker,
a public health professor at Wake Forest University who led
the latest research.
Women in the study who took hormones for
an average of more than four years faced double the risk of
developing Alzheimer's or other forms of dementia, compared
with those on dummy pills. That means that in one year, for
every 10,000 women taking hormones, there will be 23 more
cases of dementia.
Researchers also found that hormones did
not protect against less severe mental decline, such as mild
memory loss.
One possible explanation for the confounding
new findings is that hormones raise the risk of strokes —
and strokes are known to cause brain damage and contribute
to dementia, the researchers said.
Nevertheless, the increased risk of dementia
is very small, said Marilyn Albert, head of the Alzheimer's
Association's scientific advisory council and a Johns Hopkins
University neurology professor.
Age remains the single greatest risk factor
for dementia, and the study suggests that a 65-year woman
on estrogen-progestin pills "would have the increased risk
profile of a 70-year-old woman not taking hormone replacement
therapy," Albert said.
Dr. Judith Salerno, deputy director of
the National Institute on Aging, said the results indicate
older postmenopausal women should not use estrogen-progestin
supplements in hopes of keeping their minds sharp.
"There is no benefit, and possible harm,
for older women taking this therapy," she said.
Cindy Yeast, a 50-year-old Washington-area
publicist, called the findings disappointing. She started
taking supplements two years ago — partly to stave off mild
dementia that affects her elderly parents. Still, she said
she is not sure the new findings will change her mind.
"Every time a new study comes out, you
can't just react," Yeast said. "You have to weigh what is
this doing for me now."
The results come from the Women's Health
Initiative Memory Study, which involved 4,532 women who used
Prempro estrogen-progestin pills for an average of more than
four years. It was funded in part by Prempro maker Wyeth Pharmaceuticals.
Probable dementia was diagnosed in 61
women — 40 in the hormone group and 21 taking placebo pills.
The notion that hormone supplements are
good for the mind has been around for at least a decade. Doctors
have speculated that estrogen protects against cell damage
and improves blood flow.
Wyeth estimates that 1.2 million women
are still taking Prempro pills, down from about 3.4 million
before the study was halted last summer. Other types of hormone
supplements include patches and creams.
Wyeth's Dr. Victoria Kusiak said it is
unclear whether the disappointing results would apply to younger
patients. Still, she said she agrees with those doctors who
say that hormones should be used only to treat menopause symptoms
such as night sweats and hot flashes "for the shortest duration
and the lowest dose."
An arm of the Women's Health Initiative
study involving estrogen-only supplements in women who have
had a hysterectomy is continuing. Estrogen alone is not recommended
for women with intact wombs because it increases the risk
of uterine cancer.
A new study that says hormones can increase
the risk of Alzheimer's and other forms of dementia has raised
new questions for women deciding whether to take supplements.
Here is what some experts say:
- Wake Forest University researcher Sally
Shumaker, the study's lead author, says the results suggest
women 65 and older should not take estrogen-progestin supplements
for any reason. Those who strongly feel that they would
benefit should consult with their doctors, Shumaker says.
- The National Institute on Aging says
the findings show that combined supplements should not be
prescribed for older postmenopausal women to maintain or
improve mental function. The mental risks and benefits from
hormone supplements in younger women are unknown, the NIA
says.
- The Food and Drug Administration (news
- web
sites) notes that hormone
use remains approved for younger women to relieve menopausal
symptoms such as hot flashes and night sweats. Younger women
should consult with their doctors about hormone use and,
if it is deemed appropriate, should take the lowest possible
dose for the shortest duration, the FDA says.
Agency officials are reviewing the hormone-dementia
data to determine whether additional warning labels are needed.
The FDA earlier this year issued requirements for new labels
highlighting the increased risk of heart disease, heart attacks,
strokes and breast cancer.
On the Net:
JAMA: http://jama.ama-ssn.org
Women's Health Initiative: http://www.whi.org
Back to the Top
Apnea
Tied to Atrial Fibrillation
By Ed Edelson
HealthScoutNews Reporter
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- If
you often wake up gasping in the middle of the night, talk
to your doctor about seeing a cardiologist.
That gasping wakeup is a sign of sleep
apnea, in which the lungs are not getting enough air. And
a new study finds a close association between sleep apnea
and atrial fibrillation, a heartbeat abnormality that can
be fatal.
The risk of recurrent atrial fibrillation
is doubled in people with untreated sleep apnea, says a Mayo
Clinic study reported in the May 27 issue of Circulation.
In the Mayo study, obstructive sleep apnea,
in which there is a blockage of the airway, was the single
factor most closely associated with recurrence of atrial fibrillation.
"To our knowledge, this is the first study
showing that untreated obstructive sleep apnea is associated
with an increased risk of recurrent atrial fibrillation and
that the risk is not explained by other factors," says a statement
by Dr. Virend Somers, the Mayo Clinic cardiologist who led
the study.
Atrial fibrillation makes the upper chambers
of the heart flutter uselessly, rather than pumping blood.
It can cause heart failure, heart attack or stroke. Drugs
or CPAP -- constant positive airway pressure, using a machine
to force air into the nasal passages -- can help treat it,
but it comes back in more than half of all patients within
a year.
"Cardiologists are now awakening to the
importance of identifying and treating sleep-disordered breathing
in their patients," says Dr. Barbara Phillips, director of
the University of Kentucky Sleep Disorders Center and a spokeswoman
for the National Sleep Foundation.
The Mayo study followed 79 people treated
for atrial fibrillation who had not been diagnosed with sleep
apnea and 39 patients with both fibrillation and sleep apnea.
Of the 39 apnea patients, 27 got either no treatment or inadequate
treatment for the condition. After a year, fibrillation recurred
in 22 (or 81 percent) of the apnea patients with untreated
apnea and five (or 42 percent) of the apnea patients who got
adequate treatment.
This is an important study because it
is the first to describe the results of treating sleep apnea
in atrial fibrillation patients, Phillips says. "CPAP made
a big difference for those patients who used it," she says.
Somers says the results are particularly
important because obesity increases the incidence of sleep
apnea, and Americans are getting fatter. The epidemic of obesity
in this country could be behind the rising incidence of sleep
apnea, which "may contribute to the dramatic increase in atrial
fibrillation, which has nearly tripled in the past three decades,"
Somers says in the statement.
"Appropriate treatment for those with
both conditions is CPAP first," Phillips says. "Not only can
it help a fibrillation, it improves blood pressure, reduces
the risk of heart attacks, reduces other cardiac arrhythmias,
and improves heart function in patients with heart failure."
Many patients with atrial fibrillation
should be screened for sleep apnea, Somers says. Leading candidates
for screening are those who are obese, whose spouses say they
snore loudly, or have been seen to stop breathing at night
or are constantly sleepy during the day.
More information
You can learn a lot more about sleep apnea
from the National
Sleep Foundation. Learn more
about atrial fibrillation from the American
Heart Association.
Back to the Top
Diabetics'
Education Level May Sway Death Risk
Reuters Health
Tuesday, May 27, 2003
NEW YORK (Reuters Health) - Type 2 diabetics
(news
- web
sites) with a college degree
may have a lower risk of premature death than those with only
a high school diploma, a new study suggests.
The findings support the idea that education
level makes a difference in how well people with type 2 diabetes
are able to control their blood sugar -- and, therefore, prevent
diabetes complications, according to the report in the May
issue of Diabetes Care.
People with type 2 diabetes do not metabolize
glucose, or sugar, efficiently because their bodies do not
properly respond to the glucose-regulating hormone insulin.
Uncontrolled blood sugar can eventually lead to diabetes complications
such as heart disease, stroke, kidney problems, blindness
and nerve damage that can lead to amputations.
Overall, diabetics have a higher risk
of death compared with non-diabetics their age. But research
also suggests that among people with diabetes, socioeconomic
status -- which is related to education -- influences death
risk.
To look at the relationship between education
and death risk among diabetics, Dr. Ronald P. Wilder of the
University of South Carolina in Columbia analyzed data on
nearly 2,400 men and women with type 2 diabetes. Participants
were about 62 years old, on average.
He found that death risk appeared to decline
as education level rose -- participants who graduated college
or pursued post-grad education had a lower death rate than
high school graduates.
Family income, Wilder found, was not related
to death risk, nor was race or marital status. As expected,
he notes in the report, increasing age and duration of diabetes
did raise the odds of death.
According to the researcher, the findings
support the idea that education increases a person's ability
to "invest" in his or her health.
"Education may also be a factor in the
relatively poor health status and outcomes of adults with
diabetes," he writes.
Source: Diabetes
Care 2003;26:1650.
Back to the Top
Setting an Example by Kicking the Habit
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- Where
there's no parental smoke, there's less chance children will
get fired up about cigarettes.
A study by researchers at the Fred Hutchinson
Cancer Research Center found parents who quit smoking before
their kids reach the third grade greatly reduce the risk that
the kids will become smokers by the time they're seniors in
high school.
If one parent quits smoking by the time
the child is 8 or 9 years old, the child's odds of becoming
a daily or monthly smoker by age 17 or 18 is reduced by 25
percent. If both parents quit when the child is 8 or 9 years
old, the child's odds of becoming a smoker declines by almost
40 percent.
For the study, which appears in the May
issue of the journal Addiction, the researchers analyzed
data from more than 3,000 children and parents in 20 school
districts in Washington state.
"Statistics show that if a child reaches
age 18 without becoming a smoker, his or her odds of remaining
smoke-free are around 90 percent. Therefore, our results indicate
that if all smoking parents were to quit by the time their
children were around age 8, it could prevent 136,000 young
people in the United States from becoming daily, long-term
smokers," researcher Jonathan B. Bricker says in a news release.
The study found mothers weren't more influential
than fathers in this regard and girls were no more susceptible
than boys. The study also found those least likely to smoke
were children of parents who never smoked.
Among senior high school students, the
rates of smoking were 14 percent for those whose parents had
never smoked, 37 percent among those whose parents both smoked,
and 26 percent among those whose parents had both quit smoking
by the time the child was in third grade.
More study is needed to determine the
benefits when parents stop smoking after their children reach
age 8 or 9, the researchers note.
More information
Here's where you can learn more about
smoking
cessation.
Back to the Top
Full-Term
Fetus Knows Mom's Voice: Study
By Alison McCook
Reuters Health
Tuesday, May 27, 2003
NEW YORK (Reuters Health) - New study
findings suggest that shortly before birth, a fetus may be
able to distinguish mom's voice from others.
U.S. researchers found that heart rate
in full-term fetuses increased when a recording of their mothers'
voices was played, but decreased in response to the voice
of a female stranger.
This shows that the fetus can distinguish
between the voices of its mother and other women before it
is even born, study author Dr. Barbara S. Kisilevsky of Queen's
University in Canada told Reuters Health.
"It is not the increased heart rate per
se, but the different ways in which the fetuses responded
to the two voices ... that tells us that the fetus had to
recognize its own mother's voice," she said. "If not, then
the response to both voices would have been the same."
These results add to a body of research
suggesting that biology prepares the fetus to bond to its
mother after birth and take on the daunting task of learning
language, Kisilevsky noted.
Furthermore, showing that a fetus can
distinguish its mother's voice adds credence to the theory
that both genes and experience help a fetus understand speech,
because the tendency to respond differently to different voices
"had to occur through experience," Kisilevsky said.
During the study, reported in the May
issue of the journal Psychological Science, Kisilevsky and
her colleagues played a tape recording through speakers held
around 10 centimeters over the mothers' abdomens.
The tapes consisted of two minutes of
silence followed by two minutes of either the mother or a
female stranger reading the same poem, then two more minutes
of silence.
On average, the fetuses had spent about
38 weeks in the womb, and so were full-term. Thirty fetuses
were exposed to tapes of their mothers speaking, and another
30 the voices of a female stranger.
Although mothers' voices did not appear
to elicit significantly more body movement in the fetuses
than did the voices of female strangers, fetal heart rate
increased when listening to their mothers, and appeared to
decrease in response to a recording of a female stranger.
In terms of why a stranger's voice might
lower a fetus's heart rate, Kisilevsky said that a decrease
in heart rate is often a sign of attention, and the fetus
may have paid more attention to a voice it didn't recognize.
"I think it already knew its mother's
voice, and was now learning about other voices," she said.
Source: Psychological
Science 2003;14:220-224.
Back to the Top
Many Prostate Biopsies Unnecessary
By Adam Marcus
HealthScoutNews Reporter
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- As
many as half of biopsies for prostate cancer (news
- web
sites) may be unnecessary, suggests
a new study that says blood tests that prompt the tissue exams
can swing freely from abnormal to normal.
The test looks for a protein called prostate-specific
antigen, or PSA, which is often elevated in men with prostate
cancer. However, the new study shows that men whose PSA value
is abnormally high one day frequently have a normal result
on a later retest.
Since PSA levels in blood may vary from
day to day, "it's probably prudent to recheck a level" at
least six weeks later before advising a patient to have a
biopsy, says study author Dr. James Eastham, a surgeon at
Memorial Sloan-Kettering Cancer Center in New York City. Biopsies
are costly and carry the risk of bleeding, infection and discomfort.
PSA is a protein in blood that surges
in men with prostate cancer, as well as those with other,
benign prostate conditions. In about 10 percent of men with
cancer, the protein remains in the normal range. Although
PSA testing is often encouraged for men over 50, its value
as an early-detection tool isn't certain, and evidence is
mixed about whether the exam can prevent deaths from prostate
cancer.
"Even with flaws, it is a very useful
tool. You just have to use it in an appropriate way," says
Eastham, whose research appears in the May 28 issue of the
Journal of the American Medical Association (news
- web
sites).
More than 220,000 American men will be
diagnosed with prostate cancer this year, and nearly 29,000
will die of the disease, according to the American Cancer
Society (news
- web
sites). The tumors are typically
slow-growing, however, and most men with prostate cancer die
of other causes.
In the latest research, Eastham's group
followed 972 men, whose average age was 62, enrolled in a
seven-year colon cancer prevention study. Each had five separate
PSA tests drawn over a four-year period.
About one in five men had a PSA level
considered high -- over 4 nanograms per milliliter of blood
-- on at least one reading. Yet on a subsequent test, roughly
half of them had fallen back into the normal range for the
protein, suggesting the spike wasn't a signal of prostate
cancer.
"A single abnormal PSA level should be
viewed with caution," the researchers write. Doctors should
confirm the reading "before expensive or invasive tests, such
as a prostate biopsy, are recommended."
More information
To learn about prostate cancer, try the
University
of Michigan or the National
Cancer Institute.
Back to the Top
Laser
Eye Surgery Claims Soaring in UK
Reuters Health
Tuesday, May 27, 2003
LONDON (Reuters Health) - The number of
medical negligence claims relating to laser eye surgery has
more than doubled over the past six years in the UK, the largest
insurer of British doctors said on Monday.
The Medical Defense Union (MDU) said that
the number of laser surgery claims reported by its members
rose 166 percent, and now account for one in three of all
ophthalmology claims.
Laser eye surgery, used to correct common
vision problems, is often thought of as a low-risk, straightforward
procedure, said Dr. Matthew Robson, clinical risk manager
at the MDU.
"But our experience shows that although
ophthalmology as a whole has traditionally been a low risk
specialty, negligence claims in this particular area are increasing
rapidly," he said in a statement.
He said that some of the claims resulted
from poor surgical technique, but the underlying problem is
patients' unrealistic expectations about what the surgery
can achieve.
"It is important for the doctor who is
performing the surgery to counsel possible patients about
the risks of the procedure and the possibility of an imperfect
result and other complications in order to obtain proper consent,"
Robson said.
The average cost of litigation against
laser eye surgeons is triple that of ophthalmic surgeons who
do not carry out laser eye work, the MDU noted..
Earlier this year, the insurer increased
its subscription rates for laser eye surgeon members, with
a new top rate of 22,000 (US$ 36,173) per year.
Back to the Top
Two
Clot Busters Boost Stroke Recovery
By Serena Gordon
HealthScoutNews Reporter
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- When
doctors began treating strokes with the clot-busting drug
tissue plasminogen activator (tPA), survival and recovery
rates jumped, but not all patients respond well to the therapy.
That may be because blood clots re-develop
in as many as one in five patients after initial treatment
with the clot-dissolving medication, says a new South Korean
study.
In a report appearing in the May 27 issue
of Neurology, researchers from Yonsei University in
Seoul found that in 22 percent of the stroke patients studied,
clots formed again as soon as 20 minutes after the arteries
had been cleared by tPA. But when the researchers added another
blood-thinning medication, abciximab, to the treatment, the
new clots were dissolved.
"Reappearance of blood clots after initial
successful treatment occurred frequently," says the study
author Dr. Ji Hoe Heo, an associate professor of neurology
at Yonsei University. "This study is promising because simple
but careful observation for occurrence of reappearance of
clots may improve the rate significantly by giving abciximab
in those patients."
Abciximab works specifically on the platelets
in the blood. Platelets are the blood cells that cause clots
to form, normally to stop bleeding.
Stroke is the third leading cause of death
in the United States, killing more than 700,000 people every
year, according to the American Stroke Association.
For this study, the researchers studied
18 stroke patients who were treated with tPA. Standard treatment
in the United States is to give tPA through an intravenous
line, but for this study, the researchers administered the
drugs through a catheter placed in the artery.
Dr. Keith Siller, director of the Comprehensive
Stroke Care Center at New York University Medical Center,
says administering the drugs this way may lessen the chance
for side effects, but more importantly it lets the treating
physician see exactly what is going on. He says it's similar
to the way cardiologists break up blockages in coronary arteries.
The drawback to this method, especially when treating arteries
in the brain, is the risk of causing bleeding. Plus, it is
only done in specialized hospitals, not in most community
hospitals.
The researchers found that in four of
the patients treated with tPA, clots formed again soon after
the original clot was dissolved. They treated these patients
with abciximab through the arterial catheter. Two of the patients
had no symptoms after the second treatment and one only had
minor symptoms. These three were able to return to their previous
activities and jobs. The fourth patient had a slight hemorrhage
that the researchers didn't believe was caused by the treatment.
Heo says that none of the patients suffered
any serious side effects in this study, but adds that any
type of clot-busting drug carries the risk of unwanted bleeding.
Siller says this study shows why tPA doesn't
work for all patients. "Stroke is a very complicated event.
It's not just a simple clot. It can change as you start treatment,"
he says.
That's why "controlling risk factors will
always be more effective than treating a stroke," he says.
And, he adds, most patients don't come in early enough for
any of these treatments to be effective. If you have any of
the following symptoms, call 911 right away:
- Sudden numbness or weakness of the
face, arm or leg, especially if it's one-sided;
- Sudden confusion or trouble speaking
or understanding;
- Sudden vision problems;
- Sudden dizziness, loss of balance or
coordination;
- Sudden trouble walking;
- Or sudden and severe headache with
no known cause.
Finally, Siller points out this study
was very small and no definitive conclusions can be drawn
from it yet.
More information
To learn the major risk factors for brain
attacks, visit the American
Stroke Association. You could
also go to the National
Institute on Aging to learn
more about preventing stroke.
Back to the Top
Families
Sought in Hunt for Male Cancer Genes
Reuters
Tuesday, May 27, 2003
LONDON (Reuters) - British scientists
launched a national hunt on Tuesday for families with a history
of testicular or prostate cancer (news
- web
sites) to help in the search
for genes related to the diseases.
They are looking for men who have three
or more relatives who developed prostate cancer before the
age of 70 or who have two or more family members with testicular
cancer.
By examining the genetic profiles of men
with the disease, they hope to identify genes that increase
a man's risk of developing the cancers.
"Fifteen percent of prostate cancer and
up to 30 percent of testicular cancer may be due to an inherited
predisposition," Professor Colin Cooper of the Institute of
Cancer Research (news
- web
sites), told a news conference.
"Genes are important because they provide
targets for new drugs and they help to determine the course
of the disease," he added.
Scientists have discovered genes involved
in breast cancer (news
- web
sites), but the search for male
cancer genes has lagged behind.
Six possible sites for prostate cancer
genes and one for testicular cancer have been identified,
and researchers are hoping the genetic studies will help them
pinpoint the culprits.
Cooper said testicular is the most genetic
of all cancers. A man with a brother who has testicular cancer
has an eight to 10-fold increase in the chances of getting
it himself.
Men with a family history of either testicular
or prostate cancer can contact their family doctor or a specialist
at the Institute for Cancer Research (www.icr.ac.uk) if they
want to take part in the study.
Back to the Top
Testing
for Stomach Bacteria Doesn't Help With Peptic Ulcers
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- Routine
testing and treatment for the Helicobacter pylori bacteria
in people with suspected peptic ulcers doesn't do much to
help their symptoms, but it does increase treatment costs.
So says a study in the May 26 issue of
the Archives of Internal Medicine (news
- web
sites).
The study also found most people with
doctor-diagnosed peptic ulcer disease(PUD) who are treated
in community settings do not have H. pylori infection.
Current guidelines recommend antibiotic
treatment for people with HP-positive PUD who have been receiving
long-term acid-suppression therapy, the study notes. Those
guidelines assume PUD has been diagnosed and that eliminating
HP will make further treatment unnecessary and reduce medical
costs.
But the prevalence of HP infection and
the impact of treating it has not been studied in people receiving
acid-suppression therapy for one or more years.
In this study, researchers of the Kaiser
Permanente Medical Care Program looked at 650 people who had
received acid-therapy suppression for at least a year after
being diagnosed with PUD. The study participants were randomly
assigned to be tested and treated for HP or to usual care.
The people in the usual care group did
not receive routine testing or treatment for HP infection.
They did continue to receive medical care and/or medication
for PUD.
The study found that only 17 percent of
the people had PUD confirmed by X-ray studies or endoscopy.
It also found that only 38 percent of the test-and-treat group
tested positive for HP.
After a year, people in the test-and-treat
group were less likely to report ulcer-like symptoms or use
acid-reducing therapy. But 75 percent of them used antacids
during the second half of the 12-month follow-up.
Over the course of the year-long study,
the people in the test-and-treat group had higher total medical
costs related to treatment of PUD symptoms than the people
in the usual care group.
More information
Here's where you can learn more about
peptic
ulcer.
Back to the Top
Wine
Tasting Takes Brains, Italian Study Finds
By Estelle Shirbon
Reuters
Tuesday, May 27, 2003
ROME (Reuters) - Wine-tasting takes more
than a perfect palate and a fruity vocabulary -- you have
to use your brains.
That's the finding of a study undertaken
by a team of researchers at a Rome hospital.
"We wanted to find out whether there was
a difference at brain level between a trained and an untrained
person drinking wine," said Gisela Hagberg, a Swedish bio-physicist,
at the study's presentation at the Wine Academy in Rome on
Tuesday.
"What we found is that the training does
not just educate your palate, it also affects how your brain
responds to the taste of wine."
Researchers conducted brain scans on seven
sommeliers and seven casual drinkers while they sampled wines.
The scans showed strong activity in the
amygdala, a part of the brain that reacts to sensations of
pleasure, in both groups.
But the sommeliers also displayed a burst
of activity in parts of their frontal cortexes, an area of
the brain used for thinking, while the amateurs showed no
reaction there at all.
"Both groups were asked to pay close attention
to what they were drinking, so it's not that the control subjects
weren't thinking," said Hagberg.
The difference appears to be that while
both groups' brains processed the sensory aspects of drinking,
the taste of wine triggered a rational, even intellectual
response in the experts.
Andrea Sturniolo, one of the sommeliers
who participated in the experiment at the Santa Lucia research
hospital, was thrilled with the results.
"This is fantastic. This proves the reasoning,
the intellectual effort that goes into breaking down the many
tastes of a wine and assessing its full flavor," he said.
"It's not that sommeliers are superior
beings of course, it's all in the training and the experience."
Sturniolo's only objection to the whole
experience was having to drink wine lying down and through
tubes inserted in his mouth -- a technique necessary for the
brain scan to be conducted even as the subjects tasted the
wine.
"It certainly didn't do much for the seeing
and smelling parts of wine-tasting," he said. "I wouldn't
recommend it."
Back to the Top
Surgery
Beats Drugs for Fixing Blood Flow to Heart
HealthScoutNews
Tuesday, May 27, 2003
TUESDAY, May 27 (HealthScoutNews) -- Correcting
moderate to severe blood flow restriction to the heart using
surgery or angioplasty reduces the risk of cardiac death more
than medication alone.
The observational study by researchers
at Cedars-Sinai Medical Center in Los Angeles found that people
who had coronary artery bypass or angioplasty had a lower
death rate (2 percent) than people who received drug therapy
(6.7 percent) to improve blood flow to the heart.
But people with little or no blood flow
restriction to the heart had better results on medication
alone.
Their research appears in the May 26 issue
of Circulation.
Narrowed arteries can reduce the flow
of blood and oxygen to the heart during stress (ischemia).
People with this kind of stable coronary artery disease have
the choice of using medication or surgery or angioplasty to
prevent a heart attack.
The researchers reviewed data on 10,627
people with reduced blood flow to the heart who received treatment.
None of them had a history of heart attack. During follow-up,
there were 146 cardiac-related deaths in the entire group.
Women -- particularly the elderly and
those with diabetes -- had greater overall death rates as
well as lives saved per 100 people treated with surgery or
angioplasty.
More than 17 percent of diabetic women
with large parts of their heart affected by ischemia were
predicted to die if they took drugs compared to 4.4 percent
if they had surgery or angioplasty, the study says.
More information
Here's where you can learn more about
ischemia.
Back to the Top
MONDAY,
MAY 26, 2003
Pamphlet
with Your Pasta?
By Lauren Weber
Reuters Health
Monday, May 26, 2003
CHICAGO (Reuters) - Consumers wondering
how much fat is in the fettuccine Alfredo they ordered will
soon find that information easier to come by.
Restaurant goers, concerned about obesity
and other health issues, want to know what's in their meals,
and restaurants are starting to accommodate them with brochures,
Web sites and waiters armed with information.
Nutrition breakdowns are required for
packaged foods, but it's relatively new for restaurants. And
it's not just about keeping customers happy, say some in the
food industry; it's also about being ahead of the curve on
a wave of laws that would require nutrition labeling at restaurants.
"They're hoping it won't be a law, but
they're also feeling pressure from consumers," said Ann Diesen,
the sales manager at Minneapolis-based Medallion Labs, which
offers nutrient analysis and has seen rising interest from
restaurateurs.
According to the National Restaurant Association,
four state legislatures -- Maine, New York, Texas and California
-- are considering labeling requirements for chain restaurants.
"And I bet there'll be at least 20 bills next year," the NRA's
chief lobbyist, Lee Culpepper, said in a speech on Saturday
at the NRA trade show in Chicago.
Big chains like McDonald's have provided
this information for years, through brochures and Web sites,
partly in response to criticism about the high fat and calorie
content of their foods.
Other chains are positioning themselves
as concerned purveyors of good-for-you meals. Olive Garden,
a unit of Darden Restaurants Inc., offers a "Garden Fare"
menu, with nutritional breakdown available in a pamphlet.
'Demand Out There'
Now smaller chains are getting in on the
trend. Max & Erma's Restaurants Inc., a Columbus, Ohio-based
chain with 85 units, offers four "no guilt" items. A tear-off
sheet details nutritional content.
"There's demand out there, from guests
on strict diets and those who are trying to eat healthier,"
Rob Lindeman, vice president of franchising, said.
At Pasta Pomodoro, a California-based
chain part-owned by Wendy's International Inc., waiters are
receiving more queries about calorie content, according to
Rodney Morris, director of training and human resources.
The company is figuring out how to meet
that need. "We know we have to move in that direction," Morris
said.
But nutrient analysis can be a complex,
expensive process. At Medallion Labs, a workup costs about
$658 per menu item.
It's not a pretty process: a few servings
of eggplant parmigiana, for example, get sent out to a laboratory
to be blended up, sampled and analyzed for things like fat,
carbohydrate, protein and calorie content.
If restaurants are required to do the
testing, it will open up a vast market for food technology
labs like Medallion and Q Laboratories, Covance Inc. and Silliker,
which traditionally offer those services to packaged food
companies.
"Restaurants know the consumer is more
knowledgeable about food and health. They want to see what's
in the products," said Mark Goins, director of marketing at
Cincinnati, Ohio-based Q Laboratories.
Diets have also become more specialized,
he said. "There's low-carb, low-fat. People also want to know
about allergens."
Nutrition labeling is nothing new. Almost
all packaged foods have to list things like sodium, fat, and
protein since Congress passed the Nutrition Labeling and Education
Act in 1990. But restaurants were exempted from the law.
Even as they move toward nutrient testing,
restaurateurs argue that it's harder for them to provide the
information since both chefs and patrons customize meals --
adding extra salt here and there, or ordering salad with more
dressing. The NRA opposes labeling laws, saying they are impractical.
"Looking for quick fixes like labeling
can be very problematic," Steven Anderson, CEO of the National
Restaurant Association, told Reuters.
But restaurants can use that information
to stand out from the competition, Goins said. "The more you
know about your product, the better a salesman you are."
Medallion, a division of General Mills
Inc. has gotten inquiries from both chains and independent
restaurants. At this point, it's mainly been questions, not
contracts.
"They want to know what the costs are,
what's involved. A lot of restaurants are talking about it,"
Diesen said.
Back to the Top
Study:
Smallpox May Spur Malaria Defense
By Randolph E. Schmid
Associated Press Writer
The Associated Press
Monday, May 26, 2003
WASHINGTON - A one-two punch of malaria
DNA virus and the virus used to vaccinate against smallpox
spurs the human immune system to mount a powerful defense
against malaria, researchers report.
This approach might provide a basis for
preventive and therapeutic vaccination in people, scientists
said in a paper that appears in Monday's online issue of the
journal Nature Medicine.
The research team led by Adrian V.S. Hill
of the Oxford University in England tested the combination
on 63 volunteers — the first human trials of this prime-boost
approach — and found the body's response far surpassed either
vaccine on its own.
The treatment did not induce complete
immunity to malaria, but it provided partial protection. Researchers
hope it will perform even better in field tests in Africa,
where U.N. agencies say the mosquitoborne disease infects
300 million people a year and has become increasingly resistant
to drugs.
Smallpox vaccine virus used in the tests
is a modified form that researchers said is safer than one
that has caused problems in recent vaccination programs.
The human tests were conducted after the
idea was successfully tested in mice, Hill said.
Using a strain of the smallpox vaccine
known as MVA, the researchers found it had "a rare ability
to selectively boost" T-cells — critical immune cells that
attack invading disease — that have been primed in advance
by the malaria protein, Hill said.
Thus, Hill said, "the immunization order
is critical."
The DNA vaccine induces T-cells to respond
to a malaria antigen called thrombospondin-related adhesion
protein, or TRAP; the modified smallpox virus also produces
a response to TRAP. As a result, the T-cells react strongly
to the malaria parasite, delaying its release from the liver
into the bloodstream and reducing the number of released parasites.
Programs to immunize millions of Americans
against smallpox have run into problems because of worries
about side effects from the vaccine. Hill said the MVA strain
of vaccinia is a safer strain of the smallpox vaccine.
"MVA was used in Germany in the 1970s
as a smallpox vaccine," he said. Recently, he said, the United
States has begun looking at it as a next generation vaccine.
The government began research in February to develop a safer
vaccine.
Along with its benefits in boosting response
to malaria, Hill said, "It very likely protects against smallpox
to some degree." Since naturally occurring smallpox has been
eliminated, no data are available to prove that.
MVA is also being used in trials in Africa
in an effort to boost the immune response to AIDS (news
- web
sites).
Mark James, a professor of tropical medicine
at Tulane University in New Orleans, welcomed the report.
Even though the complete immunity sought
by the scientists was not achieved, they reported a 70 percent
to 80 percent reduction in parasites in the bloodstream, said
James, who was not part of the research team.
In addition, James said, the vaccine would
be relatively cheap to produce, is stable and has been found
to be safe.
Besides Oxford, the team included researchers
from Imperial College, London; Walter Reed Army Institute
of Medical Research in Maryland; PowderJect Pharmaceutical
Plc, in Madison, Wis.; and Oxxon Pharmaccines in England.
On the Net: Nature Medicine: http://nature.com/nm
Back to the Top
Vitamins
May Cut Risk of Birth Defects in Diabetics
By Lois Barrett
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - Regular use
of multivitamins may reduce the risk of birth defects in infants
born to mothers with diabetes, results of a new study suggest.
Women of childbearing age are already
advised to take supplements containing folic acid to protect
against certain birth defects, but this study highlights the
need for diabetic women to take multivitamins, researchers
say.
"We were interested in seeing if the benefit
against birth defects could also be seen in offspring of women
with diabetes," lead author Dr. Adolfo Correa of the Centers
for Disease Control and Prevention (news
- web
sites) in Atlanta, Georgia,
told Reuters Health.
Researchers were not able to isolate which
nutrients may be producing a beneficial effect. But in the
study, diabetic women who reported regular use of multivitamins
were just as likely to have a healthy baby as non-diabetic
women who also supplemented regularly.
In contrast, women with diabetes who did
not take a multivitamin were almost four times more likely
to have a child with a birth defect than non-diabetic women
who did not take a multivitamin.
"This study will help educate patients,
rather than changing patterns of practice among physicians
and nurses, who are already recommending use of multivitamins
with folic acid to women in their childbearing years," said
Dr. Gene Barrett, the president-elect of the American Diabetes
Association.
The report emphasizes the importance of
multivitamin use during periconception, which is defined as
the three months prior to conception and the first three months
of pregnancy. It is in the first weeks of pregnancy, when
women often do not know they are pregnant, that the major
organs and systems of the body are being formed.
Women who have poorly controlled diabetes
in the first months of pregnancy are two to four times as
likely to as non-diabetic women to have a child with birth
defects, according to the March of Dimes. It is not known
why diabetic women are at greater risk for having children
with birth defects, but meticulous prenatal care has been
effective in minimizing risks during these pregnancies.
"Good prenatal care that includes diabetes
control, before and during early pregnancy as well as other
factors such as adequate nutrition are advised to all diabetic
women," Correa said. "And the study indicates that it would
be prudent to recommend that diabetic women take multivitamins
during pregnancy."
Birth defects of the brain, spinal cord
and heart are more common in the children of diabetic women
than in other women.
The group studied consisted of 3,278 women
who had children with birth defects and 3,029 women who had
healthy children in Atlanta between 1968 and 1980.
Regular supplementation was defined as
taking multivitamins three or more times a week, and use had
to occur during the three months prior to conception, as well
as the first three months of pregnancy.
Correa is planning another study, scheduled
to begin next year, in which data from more recent births
and from a broader population will be analyzed. The research
effort will include isolating multivitamin ingredients and
assessing their benefits in protecting against birth defects.
Source: Pediatrics
2003;111:1146-1151.
Back to the Top
Trust Your Instincts, Skin Cancer Survivor
Urges
By Kathleen Doheny
HealthScoutNews Reporter
HealthScoutNews
Monday, May 26, 2003
MONDAY, May 26 (HealthScoutNews) -- When
Kim Fahnley first noticed the bumpy patch of skin on the side
of her thigh, it was about a half inch in diameter.
She might not have given it a second thought,
except it was irritating. And, as a blue-eyed blonde of northern
European descent, she was well aware that skin changes can
spell cancer.
So she showed it to her dermatologist,
who wasn't initially concerned. However, he biopsied the tissue,
just in case.
The bumpy area turned out to be malignant
melanoma, the most virulent form of skin cancer.
Fahnley had surgery to remove the growth
and eventually recovered just fine.
But the going was rough for a while. At
the time of the surgery, she was just 29 and newly married.
"They told me to hold off having kids," Fahnley remembers.
"They wanted to be sure it wasn't going to reoccur."
Fortunately, it didn't. And since that
scare 13 years ago, Fahnley has survived a bout with another
type of skin cancer, opened her own sun-protective clothing
business online and given birth to two children.
Equally important, she's learned to trust
her gut instincts.
More than 1 million people in the United
States get a diagnosis of skin cancer each year, according
to American Cancer Society (news
- web
sites) estimates. And Fahnley
is convinced that most of these patients could spot their
cancers themselves, as she did.
"My advice is, when you notice a change
on your own body, to trust your own instincts," she says.
When her second cancer surfaced six years
ago, she again brought it to the attention of her doctor.
"When I'd go to kiss my kids, it hurt," Fahnley recalls of
the squamous cell cancer on her lip.
She told her dermatologist something just
wasn't right. "He detected a small tumor on the inside of
my lip," Fahnley says. Once more, surgery removed the cancer.
Always active outdoors, Fahnley had grown
up with a passion for horseback riding and, later, gardening.
But after her surgeries, she found it
difficult to keep her sun exposure to a minimum. "At my three-month
checkups, my dermatologist would say, 'You are still getting
sun,'" Fahnley says, "and I was using sunscreen."
So she launched Sun Solutions, a line
of sun-protective clothing -- jackets, pants, hats, beachwear
and other attire for adults and children -- to make it easier
to ward off the sun while enjoying the outdoors.
Her children, now 11 and 9, are walking
advertisements for the company, wearing her gear to outdoor
activities and educating others about the benefits of sun
protection. Her husband, Joel, also wears the clothes.
But the best advice, Fahnley insists,
is to follow through with medical care if you notice a change
on your skin -- even if a doctor reassures you it's nothing.
"You know your body best," she says.
More information
To learn more about protecting yourself
from the sun, visit the Skin
Cancer Foundation. For more
on skin cancer, check with the National
Cancer Institute.
Back to the Top
Youthful
Hostility Linked to Adult Heart Disease
By Alan Mozes
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - Children and
adolescents who approach the ups and downs of life with a
hostile attitude might be at a heightened risk of developing
health complications that can progress to adult heart disease,
according to U.S. and Finnish researchers.
"There is a need for interventions designed
to reduce hostility in young people to prevent the precursors
to cardiovascular disease, like obesity or type II diabetes,
which has become a huge health problem in children in the
U.S.," the study's lead author, Dr. Karen A. Matthews of the
University of Pittsburgh in Pennsylvania, said in a statement.
Parents, Matthews told Reuters Health,
should try to address any conflicts their children might be
having in order to ease hostile feelings.
Among the children and teens her team
studied, the researchers found that anger, cynicism and aggression
were associated with several cardiovascular risk factors,
including obesity, high blood pressure and a condition called
insulin resistance that can be a precursor to type 2 diabetes.
Such chronic conditions -- grouped together
under the heading of "metabolic syndrome" -- have been shown
to promote cardiovascular disease, the researchers note.
Matthews and her colleagues examined 134
children and adolescents in the Pittsburgh area who had no
history of heart disease, mental illness or drug and alcohol
abuse. The children were between the ages of 8 and 10, while
the adolescents were between 15 and 17. The participants were
divided roughly equally between male and female, and black
and white.
Blood samples -- to assess the presence
of the metabolic syndrome factors -- were drawn at the start
of the study, and then again three years later. The children
also underwent psychological testing to measure hostility
levels.
Children and adolescents who had a clean
bill of health at the start of the study but who had high
hostility levels were more likely than other children to develop
at least two components of the metabolic syndrome during the
next three years, the researchers found.
Hostility was most strongly associated
with the later development of obesity and insulin resistance,
Matthews and her team report in the May issue of Health Psychology.
The researchers stress that the study
did not explore all the variables that might contribute to
hostile attitudes or to the development of the metabolic syndrome
among young people.
For example, they suggest that future
studies might focus on the role played by hormonal changes
during puberty. They also note that diet, unhealthy lifestyle,
stress and poverty might all have an impact on the association
between hostility and heart disease.
Still, the authors conclude that taking
steps to reduce kids' hostility -- in conjunction with promoting
other lifestyle changes -- might end up reducing the risk
of future heart disease.
"Parents can encourage their children
to avoid over-eating (and to) exercise, and discuss areas
of conflict as a way to prevent the development of the metabolic
syndrome," Matthews told Reuters Health.
Source: Health Psychology
2003;22:279- 286.
Back to the Top
Skin Cancer: More than 1 Million New Cases
in U.S. This Year
By Kathleen Doheny
HealthScoutNews Reporter
HealthScoutNews
Monday, May 26, 2003
MONDAY, May 26 (HealthScoutNews) -- More
than 1 million Americans will learn this year they have skin
cancer.
That's more than twice the number who
will hear they have prostate or breast cancer (news
- web
sites), making skin cancer the
most common cancer in the United States.
While prostate and breast cancers kill
far more people, skin cancer -- usually caused by excess sun
exposure -- can be deadly, too. The American Cancer Society
(news
- web
sites) expects about 7,600 deaths
this year from melanoma, the most virulent of skin cancers.
Dermatologists like Dr. David J. Goldberg,
who practices at the Mt. Sinai School of Medicine in New York
City, are worried because their skin cancer patients are younger
and younger when first diagnosed.
"I've been in practice 17 years," he says.
"Seventeen years ago, I saw people in their 50s. Now, I see
fair-complected women in their 30s."
As discouraging as the news may sound,
there are encouraging developments to note as Americans kick
off the unofficial start of summer with Memorial Day.
Blocking out the sun's harmful rays has
never been easier, thanks to new forms of sunblock as well
as sun-protective clothing such as hats specially treated
to filter the sun.
And, if caught early, skin cancers are
highly curable.
Also, new treatments for skin cancer promise
to be less disfiguring than surgery but just as effective,
cancer experts say.
Fair-skinned, freckled, light-eyed persons
who burn easily are most at risk for skin cancer, although
others can get it as well. Changes on the skin are the most
common warning sign of skin cancer, according to the National
Cancer Institute (news
- web
sites). Not surprisingly, the
most common skin cancers -- called basal and squamous cell
-- are found mainly on areas often exposed to the sun, such
as the face, neck, hands, arms and head.
Melanomas, so named because they develop
in the pigment-producing skin cells called melanocytes, are
most often found on the trunk of men and the lower legs of
women, although they can appear on other sites as well.
Any change on the skin, especially in
the color or size of a mole, should be checked by a dermatologist,
experts say. The dermatologist may then decide to biopsy the
area, taking a small sample of skin to examine it under a
microscope for cancerous or pre-cancerous cells.
Standard treatments include removing the
cancer with surgery, laser therapy, radiation or chemotherapy
drugs in lotion or cream form applied to the skin, experts
say.
A newer approach, says Goldberg, is photodynamic
therapy. First, a light-activated drug that targets cancer
cells is applied or injected. A day or so later, a laser light
is aimed at the cancerous tissue and "switches on" the drug,
which destroys the cancer cells but does not affect healthy
cells, he says.
So far, the approach is only approved
by the U.S. Food and Drug Administration (news
- web
sites) for treating other forms
of cancer -- such as esophageal cancer -- and for pre-cancerous
skin lesions. But some doctors are now trying it for skin
cancers.
Another new approach being tested for
some skin cancers is a so-called immune modifier, says Dr.
Martin A. Weinstock, a professor of dermatology at Brown University
and chairman of the American Cancer Society's skin cancer
advisory group. A drug called imiquimod (Aldara) is applied
topically; it works by triggering an immune response, causing
the body to attack the malignant cells, he says.
Increasingly, doctors are also using digital
photography to monitor people with suspected melanomas, to
track and quantify how much the growth changes from visit
to visit.
Even with these advances, Weinstock says,
"the most important thing people can do is look carefully
at their skin once a month."
An annual skin exam by your physician
or dermatologist is also wise, says Dr. Diane Berson, an assistant
professor of dermatology at the Weill Medical College of Cornell
University in New York City and a spokeswoman for the American
Academy of Dermatology. It's crucial, she says, if you have
a family history of skin cancer or are at high risk.
Sunblocks are also vital, and an array
of new products is making it easier to follow that recommendation,
says Goldberg. Sunblocks and screens now come not only in
cream form but gels and sprays, minimizing the "ick" factor
of greasy creams. Clothing specially treated with sunblocking
agents can help, too.
Despite all that has been said about skin
cancer and the need for sunscreens, some people still don't
bother to read the directions or know how to use the products
properly, Goldberg says. Among the most common mistakes: People
wait to apply a sunscreen after they've gone outdoors.
"Put it on a half hour before you go out,"
he says. And use a product with a sun protective factor (SPF)
of at least 15. "And reapply SPF 15 every two hours," Goldberg
adds.
More information
For information on basal and squamous
cell cancers, see the American
Cancer Society. For information
on melanoma, click here.
Back to the Top
Coffee
Shop Workers Have High Blood Pressure Risk
By Stephanie Riesenman
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - Workers in
campus coffee shops are more likely to have high blood pressure
than other people their age, possibly because they dine on
the same salty and high fat foods that they serve to students,
according to Venezuelan researchers.
In a small study, the researchers found
that long-time workers in coffee shops located on a campus
were more likely to have high blood pressure than their peers.
They found that 18 percent of workers under age 30 and 41
percent of those over age 30 had high blood pressure, as did
48 percent of workers who were in the occupation for more
than five years.
"It is alarming that the people in charge
of alimentation in the university suffer a high prevalence
of high blood pressure and elevated risk for cardiovascular
disease, which means that the students are certainly at high
risk for suffering the same consequences," said Dr. Napoleon
Gabriel Macias.
Macias, along with colleagues at Universidad
Central de Venezuela in Caracas, measured the blood pressures
of 64 workers at six different coffee shops on the school
campus.
"People who have worked for many years
at a coffee shop having this unhealthy nutrition have more
pronounced high blood pressure because they have been exposed
to the risk factors for more time," said Macias.
Macias and his colleagues recommend that
schools and universities incorporate nutritional education
into job training. He says schools should create menus under
a nutritionist's supervision to help employees and students
eat a balanced diet and lower their risks for cardiovascular
disease.
The findings were presented recently at
a meeting of the Inter-American Society of Hypertension in
San Antonio, Texas.
Back to the Top
Handling
the Heat When You Have Heart Pain
HealthScoutNews
Monday, May 26, 2003
MONDAY, May 26 (HealthScoutNews) -- As
the summer season unofficially kicks off today, the millions
of Americans who have angina (news
- web
sites) need to be aware that
hot weather can spell trouble for them.
Summer heat can raise the body temperature
and result in increased blood pressure and heart rate, which
can be harmful for someone with angina, says the Preventive
Cardiovascular Nurses Association (PCNA).
If you have angina, the PCNA has some
advice on how you can cope with the hot weather.
When it comes to exercise, start slow.
Exertion can bring on angina. When the weather warms up, people
with angina who already have an exercise program should avoid
overexertion and should move slowly from their indoor winter
exercise program to an outdoor summer program.
People who are new to regular exercise
should start an exercise program in the spring before it gets
too hot. For example, add short 10-minute walks each day.
If you want to start exercising, you may also want to make
an appointment with a local cardiac rehabilitation program
for advice.
Make sure you keep your cool. Heat and
humidity make your heart work harder and bring on angina symptoms.
Wear loose-fitting and light clothing. Don't exercise in midday
and drink enough water.
Keep your nitroglycerin handy so you can
find it quickly if you do suffer angina symptoms. If you're
traveling, remember to keep all medications and prescription
information in a carry-on bag.
Keep the fun in family fun. Getting together
with relatives can be fun, but it can also be stressful. People
with angina need to avoid both physical and emotional overexertion.
Angina affects about 6.6 million people
in the United States. About 400,000 are diagnosed each year.
Symptoms include shortness of breath, fatigue and pain or
discomfort in the chest, arm, neck and back.
More information
Here's where you can learn more about
angina.
Back to the Top
Demand
for Endocrinologists Outstrips Supply
By Stephanie Riesenman
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - With a greater
proportion of the American population aging and becoming more
obese, experts are concerned that there will be a shortage
of doctors who specialize in treating diseases associated
with these conditions.
"As people get older, these endocrine-related
conditions, like diabetes and osteoporosis, are going up,
so we just have to keep our eye on the ball," said Dr. Robert
A. Rizza, a professor of medicine at the Mayo Clinic and Foundation
in Rochester, Minnesota.
In an interview with Reuters Health, Rizza
explained that he and his colleagues developed a mathematical
calculation to track the needs of endocrinologists in the
U.S. for the next 20 years.
By using the Kaiser Permanente Mid-Atlantic
States HMO as a benchmark, it was determined that the U.S.
population would need about one endocrinologist per 100,000
people.
As of 1999, the national supply of these
specialists was about 12 percent lower than needed to care
for patients with conditions such as obesity, diabetes and
thyroid-related problems. This is a concern, according to
the researchers, because the number of office visits to endocrinologists
increased dramatically in the 1990s.
Snagging one of these visits is not easy,
according to the report.
The study found that waiting times for
non-urgent visits with endocrinologists were significantly
longer on average than for other doctors. It took patients
37 days to get an appointment with an endocrinologist, but
only about 10 days to see a general practitioner.
The graying of the U.S. population may
increase the demand for endocrinologists even more, according
to the report, since the risk of osteoporosis, diabetes and
other endocrine-related diseases increases with age.
The study, published in the current issue
of Endocrine Practice, said there was a 14 percent decline
in the number of physicians enrolled in endocrine training
programs in 1999. Fellowships in other internal medicine specialties,
with the exception of nephrology and geriatrics, were also
down in 1999 -- by an average of 13 percent.
If the number of endocrinologists remains
at 1999 levels, Rizza and his colleagues estimate that demand
for the specialists will continue to exceed the supply at
least through 2020.
But the good news is the numbers of practicing
endocrinologists has started to turn around, according to
Rizza, as health experts have started to acknowledge the benefits
of being treated by a specialist.
"We don't want to seem like we are clamoring
for all these patients because these diseases are increasing,"
Dr. Robert Vigersky told Reuters Health.
"We're just saying that we know they're
increasing and we are already see a certain percentage of
them, to see the same percentage of them 10 and 20 years from
now, there's going (to) have to be many more endocrinologists,"
he said.
Vigersky is the chair of the Clinical
Affairs Committee for the Endocrine Society, which sponsored
the study along with the American Diabetes Society and the
American Association of Clinical Endocrinologists (news
- web
sites).
The researchers say this study shows that
the specialty of endocrinology needs to have a long-term plan
that includes training a sufficient amount of new physicians
to meet the needs of the population.
Source: Endocrine
Practice 2003;9.
Back to the Top
Obesity Surgery Success Depends on Surgeon
By Dana Frisch
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - Laparoscopic
stomach bypass surgery, a minimally invasive operation performed
on obese people to promote weight loss, is more likely to
result in complications if the surgeon has performed few such
operations, according to a new study.
Laparoscopic Roux-en-Y gastric bypass
(RYGB), a form of stomach bypass surgery, restricts the amount
of food the stomach can hold by making it smaller, into a
"pouch." It also reduces the amount of nutrients absorbed
because the pouch bypasses parts of the small intestine.
Laparoscopy involves making a small incision
and inserting a tube and a camera into the abdomen to perform
the surgery instead of opening up the entire abdomen. It is
less invasive than open surgery and is associated with less
post-operative pain and a shorter recovery period.
Researchers led by Dr. Richard A. Perugini,
an assistant professor of surgery at the University of Massachusetts
Medical School in Worcester, reviewed the cases of 188 patients
who underwent laparoscopic RYBG between July of 1999 -- when
surgeons first began performing the surgery at the medical
center -- and January 2002.
They found that almost 27 percent of patients
developed complications that required "invasive therapeutic
interventions" to correct. The most common complication, occurring
in 27 of this group of 50 patients, was a narrowing at the
junction where the stomach, now a pouch, was attached to the
loop of the small intestine.
Endoscopy to remove the narrowing was
successfully performed the first time around in more than
90 percent of those patients. Other complications included
bleeding where the staples were attached and bowel obstructions,
both in about three percent of cases.
Perugini's team found that the rate of
complications went down after the surgeon performed 120 operations.
Perugini told Reuters Health that there
is a "learning curve" associated with any surgery, but that
it was steeper in laparoscopic RYBG because it is such a complex
surgery.
Patients might want to go to surgeons
who have specialty training in weight-loss surgery to reduce
their risk of complications further, Perugini said in an interview.
According to the study, published in the
May issue of the Archives of Surgery, other independent predictors
of complications were high blood pressure and sleep apnea.
Another finding of the study is that diabetic
patients who underwent the surgery tended to lose less weight
than those patients who did not have diabetes.
Perugini said that despite diabetics (news
- web
sites) losing less weight, they
are likely to "reap the greatest benefits from the surgery"
in terms of improvements in qualities of life, like lowering
their mortality rates.
Source: Archives
of Surgery 2003;138:541-546.
Back to the Top
For Preservative-Free Flu Shot, Ask in
Advance
By Keith Mulvihill
Reuters Health
Monday, May 26, 2003
NEW YORK (Reuters Health) - Parents who
wish to provide their young child with a thimerosal-free flu
vaccine next flu season are being advised to let their pediatrician
know now so it can be ordered in advance.
Thimerosal has been used for over 60 years
to prevent microbial contamination in vaccines, but health
officials have begun phasing it out because it contains mercury.
While the bulk of influenza shots given
in the U.S. still contain at least some thimerosal, the U.S.
Food and Drug Administration (news
- web
sites) has approved preservative-free
flu vaccines. Previously, the pharmaceutical company Evans
Vaccines was granted approval for a thimerosal-free flu vaccine
for use in children over the age of 3.
Last September Aventis Pasteur got approval
for its Fluzone preservative-free vaccine, which can be used
in children 6 months and older. It became available to children
in late November 2002.
Still, parents may need to ask their health
care provider in advance about thimerosal-free flu vaccines
to ensure that they have it on hand come next flu season,
explained Dr. Walter Orenstein, director of the Centers for
Disease Control and Prevention (news
- web
sites)'s National Immunization
Program.
Most health care providers order their
flu vaccine supplies in the spring before the fall and winter
flu season.
"Parents have to ask their health care
professional for a thimerosal-free flu vaccine," said Orenstein.
"There is a limited supply since it is more difficult to produce,
as I understand."
Nonetheless, Orenstein stressed the fact
that thimerosal-containing flu vaccines pose no danger to
youngsters.
"There has been controversy about thimerosal
and there has been some concern that some parents might not
want to give their child the flu vaccine unless they were
offered a thimerosal-free version, explained Orenstein during
an interview with Reuters Health.
"This was offered for those who wanted
it as a potential alternative," he added.
Currently, Orenstein noted, the CDC's
advisory panel says the preservative-free vaccine is equivalent
in efficacy and safety to the one that contains thimerosal.
As such, the CDC has seen no reason to
promote the options, Orenstein noted.
Orenstein also stressed that parents need
to be aware of the risk influenza poses to very young children.
"Influenza disproportionately affects
young children," he said. "The hospitalization rate for young
children -- and the younger the child the higher the risk
-- approaches that of adults over the age of 50 who are hospitalized,"
said Orenstein.
In 2001, the vaccine advisory committee
of the CDC "encouraged" parents to have children 6 to 23 months
old vaccinated for influenza starting in the 2002-2003 flu
season.
Children in this age group are at "substantially
increased risk for influenza-related hospitalizations," the
CDC's Advisory Committee on Immunization Practices noted at
the time.
The CDC is expected to make a full recommendation
sometime in the near future that these children receive the
flu vaccine annually but are still looking into the logistics
of recommending the annual vaccination.
So, for the time being, flu vaccination
for young children remains an "encouragement," Orenstein said.
According to the CDC, vaccination is most
important for people who are at increased risk of complications
from the flu. These include pregnant women, adults 65 and
older and anyone over the age of 6 months with a chronic medical
condition such as diabetes, asthma, or heart, lung or kidney
disease. People are strongly advised to get flu shots at the
start of flu season, generally in October and November.
Because of the late release of the thimerosal-free
vaccine -- the flu season kicks off each October and parents
are encouraged to have youngsters inoculated around that time
-- demand for Fluzone was not very high last year, according
to Aventis Pasteur spokesman Len Lavenda.
"Usage of Fluzone was low last flu season
due to the timing of availability," Lavenda, who is based
in Swiftwater, Pennsylvania, told Reuters Health.
Many pediatricians most likely did not
have an opportunity to order the newer alternative.
"Our hope is that this year, with more
advanced notice we will see interest in the vaccine pick up,"
said Lavenda.
"Our current challenge is for doctors
to place orders as soon as possible to ensure timely delivery,"
he added.
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Weekend
Exercise Does a Heart Good - German Study
Reuters
Monday, May 26, 2003
CHICAGO (Reuters) - Getting up from the
couch and exercising even an hour or two a week can help stave
off heart trouble, but strenuous job-related tasks may do
more harm than good, a German study said on Monday.
Taking two hours of leisure time per week
to exercise can cut the risk of heart disease by more than
half compared to a sedentary lifestyle, the study said.
But work-related physical activity may
lead to a less-healthy cardiovascular system, said study author
Dr. Wolfgang Koenig of the University of Ulm Medical Center
in Ulm, Germany.
Even less than an hour a week of exercise
reduced the risk of heart disease by 15 percent compared to
those who did not exercise during their leisure time, the
study found. Between one and two hours of exercise a week
cut the risk by 40 percent and more than two hours of exercise
reduced the risk by 61 percent.
"Even simple activities such as low-intensity
walking may lead to considerable reductions in mortality,"
Koenig wrote in the Archives of Internal Medicine (news
- web
sites), a journal published
by the American Medical Association.
In contrast, work-related physical activity
often consists of short bursts of exercise that do not confer
cardiovascular benefits, the report said.
But it said the higher heart risk may
be related to the lower class of many physical laborers.
Cardiovascular diseases are the leading
cause of death and disability in developed countries, and
half of all such cases are attributable to coronary heart
disease.
In the study of nearly 800 Germans aged
between 40 and 68, 312 of whom suffered from heart disease,
the damage from lack of leisure-time exercise reported in
summer and winter was evident in elevated levels of certain
markers in the blood.
For instance, higher amounts of a type
of protein involved in the immune system's inflammatory response
can form harmful plaque that builds up in blood vessels and
results in narrowing and hardening of the arteries.
"The present study provides additional
evidence that leisure time physical activity, but not work-related
physical strain, is associated with a decreased risk for coronary
heart disease seen even at moderate levels," the study said.
"These data therefore strongly support the recommendation
of leisure time physical activity in the general population
for the prevention of coronary heart disease."
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SUNDAY,
MAY 25, 2003
A
Look at Dry Eye
HealthScoutNews
Sunday, May 25, 2003
SUNDAY, May 25 (HealthScoutNews) -- If
your eyes feel irritated, dry or scratchy on windy days, it
may be a sign that you have dry eye syndrome.
It's a condition in which your eyes fail
to produce enough tears or produce tears that don't have the
proper chemical composition, says the Saskatchewan Association
of Optometrists.
It's estimated about 10 million Americans
suffer from dry eye syndrome.
In many people, dry eye is a natural part
of growing older. However, it can be caused by other things,
such as blinking or eyelid problems, or medications including
antihistamines, oral contraceptives and antidepressants.
Other possible causes of dry eye include:
chemical or thermal burns to your eyes; health problems such
as arthritis or Sjogren's syndrome; general health problems;
a dry climate; and wind and dust.
Symptoms of dry eye syndrome include irritated,
dry, red or scratchy eyes. There may be a burning sensation,
blurred vision or the sensation that there's foreign material
in your eyes.
Excessive dry eye can cause damage to
eye tissue, corneal scarring, impaired vision, and make it
difficult to wear contact lenses.
If you suspect you have dry eye, see an
eye specialist for an examination. There is no cure for dry
eye, but there are treatments to keep your eyes healthy and
forestall eye damage and vision problems.
They include blinking more often, increasing
humidity levels at home and/or work, and using artificial
tears and moisturizing ointment.
In some cases, eye doctors will insert
small plugs in the corner of the eyes to slow tear drainage.
Another treatment is surgery to close tear drainage ducts.
More information
Here's where to go to learn more about
dry
eye syndrome.
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to the Top
If
It's Not Colic, It Might be GERD
By Jennifer Thomas
HealthScoutNews Reporter
HealthScoutNews
Sunday, May 25, 2003
SUNDAY, May 25 (HealthScoutNews) -- Carolyn
McGraw was beside herself. Her newborn daughter, Lauren, seemed
like she was in constant misery.
She howled through the day and night.
She spit up so often that at 4 weeks old, she was severely
underweight.
"I felt helpless," says McGraw, who lives
in southern California. "I was a new mom, and despite all
the comforting and holding my child, she was still writhing
in pain."
Lauren endured test after test until finally,
doctors diagnosed her problem -- gastroesophageal reflux disease,
or GERD. It occurs when a valve in the esophagus malfunctions,
allowing the acidic contents of the stomach to flow back into
the esophagus.
Once thought to be an adult disease, there's
increasingly awareness among pediatricians and parents that
GERD is a relatively common childhood ailment that appears
anytime between the first few weeks of life and the teen years.
According to a recent study in the Archives
of Pediatrics and Adolescent Medicine, GERD "is a common
disease of infancy with a prevalence as high as 18 percent
in [otherwise] healthy children."
Dr. Bill Sears, a pediatrician in San
Clemente, Calif., says, "For a child with GERD, it hurts them
to eat and it hurts them to sleep, so they learn to associate
eating and sleeping with pain rather than pleasure. But they're
too young to describe the feeling. When I see them in my office,
the parents say, 'I know my child hurts somewhere.'"
GERD is often dismissed as mere colic,
which really isn't a medical condition at all, but mainly
a description for a fussy baby who cries a lot, he says.
"GERD is one of the most commonly missed
diagnoses," Sears says. "Many so-called colicky babies really
have GERD and nobody knows about it."
What makes GERD easy to miss is that it's
normal and common for infants to spit up several times a day,
says Dr. William Cochran, chairman of the American Academy
of Pediatrics' section of gastroenterology and nutrition.
"I call them the 'happy spitters,'" Cochran
says. "All babies have reflux. It's OK if the baby spits up
once a day or 10 times a day, as long as the baby is happy
and if there are no other problems. About 90 to 95 percent
of them will outgrow it by 1 year of age."
It's only when the vomiting is accompanied
by pain and other problems that it becomes a disease. Severe
GERD can lead to everything from bleeding in the esophagus
to sinus and respiratory ailments. GERD that goes unchecked
for many years can even increase the chances of esophageal
cancer, Cochran says.
"If the baby is distressed, if the baby
is not eating and not gaining weight, if they're not sleeping
well and are irritable, that's when it becomes a disease,"
he says.
The respiratory problems occur because
the openings to the trachea, also known as the windpipe, and
the esophagus, which carries food to the stomach, are next
to each other. When the baby regurgitates, tiny food particles
can get into the lungs and the sinuses.
In a study of children with chronic sinus
problems, Cochran and his colleagues found treating the reflux
improved the sinus condition in about 80 percent of the children.
There are many degrees of reflux, Sears
says. Some children have mild cases that can be relieved by
making simple lifestyle changes.
When Sears suspects GERD, among the first
things he advises are:
- Position your baby on the left side
when you put him or her to sleep. This lets gravity help
keep the food down. Also, keep your child upright for at
least half an hour after eating.
- Feed a child smaller, more frequent
meals. In older children, avoid fatty foods, caffeine, tomato/citrus
products, carbonated beverages, spicy foods and junk food.
- Elevate the head of your child's bed.
- Protect the child from secondhand cigarette
smoke.
If these changes don't provide relief,
Sears says parents can try several types of medication, including:
- H2 blockers, prescription medicines
that partially block the production of stomach acid to let
the esophagus heal. One brand name: Zantac.
- Proton pump inhibitors, prescription
acid suppressant medications that block the final stage
of acid production in the stomach. One brand name: Prevacid.
For those children with a serious form
of the disease who aren't helped by any of these treatments,
surgery is an option.
By age 5, Lauren was so ill she needed
an operation called a fundoplication, in which surgeons wrap
a band of muscle around the lower esophagus to tighten the
malfunctioning valve.
The causes of GERD are not known, although
a study of five families who had more than one child with
severe pediatric GERD found what appeared to be a genetic
marker on chromosome 13. The study was published in 2000 in
the Journal of the American Medical Association (news
- web
sites).
The McGraws, one of the five families
that took part in the study, are pretty sure if there is a
GERD gene, they have it. Their second daughter, Kristen, was
born with mild reflux. They later had twin boys, Ian and Shaun,
who were both born with severe reflux.
And at 8, Lauren needed a second lifesaving
surgery.
"It was very, very difficult on me and
my husband," McGraw says. "We went for years where we only
got a few hours of sleep a night."
Seeing the agony her children went through,
McGraw got involved with the Pediatric/Adolescent Gastroesophageal
Reflux Association (PAGER), an organization dedicated to raising
awareness of GERD. She served as co-director for several years
before resigning a few months ago to focus more on raising
funds for genetic research.
"No child should have to suffer and no
child should have to be in pain," she says.
The McGraws' children, now 16, 14 and
10, are doing better. Lauren, Ian and Shaun take proton pump
inhibitors, but they still struggle with reflux-induced asthma,
chronic sinus problems, sleepless nights and bouts of pain.
The whole family eats a special diet to minimize stomach acidity.
"GERD can affect the whole family, physically,
financially and emotionally," McGraw says. "Raising awareness
is not only going to help heal the child, which is so important,
but it can help heal the whole family."
More information
To read more about GERD in children, visit
the PAGER Web site, Reflux.org.
Or check the North American Society for Pediatric Gastroenterology,
Hepatology and Nutrition Web sites at KidsAcidReflux.org
or TeensAcidReflux.org.
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SATURDAY,
MAY 24, 2003
Unclogging
Your Nose
HealthScoutNews
Saturday, May 24, 2003
SATURDAY, May 24 (HealthScoutNews) --
When you're nosing around drug store shelves for a nasal spray
to blast through those clogged nostrils, it can be difficult
to decide which one is best for you.
When it comes to over-the-counter (OTC)
nasal sprays, you should know there are different kinds: non-medicated
nasal saline sprays and medicated nasal decongestant sprays.
Nasal saline sprays can be used for all
types of nasal problems, says the American Academy of Otolaryngology-Head
and Neck Surgery. Saline nasal sprays create added moisture,
which reduces thick nasal secretions and helps remove infection-causing
agents.
Apply the nasal saline spray as a mist
to your nose up to six times a day. You can't get addicted
to nasal saline, which you can make at home. Talk with your
otolaryngologist for details on how to do that.
The other kind of nasal sprays are medicated
nasal decongestant sprays. These sprays decongest swollen
nasal membranes and clear nasal passages almost immediately
after you use them. They're useful for treating the early
stages of the common cold or viral infection.
They're also effective in stopping the
progression of sinus infections that may appear after you
have a cold. Medicated nasal decongestant sprays also prevent
problems in your eustachian tube, which connects your middle
ear and pharynx, when you're flying.
Nasal decongestant sprays are safe but
should only be used for three to five consecutive days. Prolonged
use of these sprays can cause rebound congestion and/or you
may get hooked on them.
More information
The American Academy of Family Physicians
(news
- web
sites) has information about
the correct use of nasal sprays that come in pressurized
canisters and pump bottles.
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Ear
Pain on Airplanes
HealthScoutNews
Saturday, May 24, 2003
SATURDAY, May 24 (HealthScoutNews) --
Even on the smoothest of flights, a discomfort most flyers
can count on is ears that pop as the plane is landing.
The American Academy of Otolaryngology-Head
and Neck Surgery reports that ear problems are the most common
medical complaints of airplane travelers.
The culprit behind such problems is a
part of the middle ear called the Eustachian tube, a tiny
but important passageway that connects the middle ear to the
back of the nose.
Under normal circumstances, the Eustachian
tube does its job of maintaining an equal balance of air pressure
on both sides of the eardrum.
However, when the body is subjected to
rapid changes in air pressure, such as flying on an airplane,
the Eustachian tube must open frequently and wide enough to
try to equalize the quick change in pressure.
One of the best ways to help with that
process is simply swallowing, which activates the muscle that
opens the Eustachian tube. The traditional technique of chewing
gum or sucking on mints is also effective, because both make
you swallow more often, and yawning is an even better trick.
Since you don't want to give gum to babies
and you probably can't tell them to yawn, experts advise instead
letting them suck on bottles or pacifiers to facilitate swallowing
and don't let them sleep while landing.
Adults also should avoid sleeping while
landing to prevent ear problems, and many experienced travelers
take nasal decongestants before landing to shrink the nasal
membranes and help the ears pop more easily.
If none of the methods succeed in opening
your ears, or if you're experiencing ear pain after landing,
medical help should be sought.
More information
The Hearing Alliance of America offers
more information on ear
pain and flying.
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