FRIDAY, JULY 11, 2003
- Inflammation Linked to Cognitive Decline
- Skip Breakfast, Get Fat
- New Insight into Graves Disease
- Is Inactivity Causing Diabetes among Kids?
- Upper-Ear Piercing
- The Test Expectant Moms Shouldn't Skip
- Heart Failure Common in Pacemaker Patients
- ‘Watchful Waiting' Best for Infections in Newborns
- Arthritis Outlook Worse for Women
- U.S. Team Finds Hints of How, Why Cancer Spreads
- Food May Trigger Life-Threatening Asthma
THURSDAY, JULY 10, 2003
- New Hope for Peanut Allergy Sufferers
- Surgery Not Needed for Many Brain Aneurysms
- Get All the Facts on Breast Cancer Screening
- Breakthrough for Muscular Dystrophy
- More Schooling Leads to Smarter Eating
- A Closer Look at Autism
- New Treatment for Blood Clots
- Air Sick?
- Deep-Vein Thrombosis
- FDA Orders Revised Epilepsy Drug Warning
- New Blood Test May Help With MS Diagnosis
- FDA Loosens Food Label Requirements
TUESDAY, JULY 8, 2003
- Child-Friendly Drug Repellant
- Group Targets Stroke Death Rate in South
- Heart Disease, Not Always a Death Sentence
- Anti-Malaria Pill Comes with Risk Guide
- Drug Cuts Blood Clot Risk in Cancer Patients
- Chromosome Linked to Deafness, Lymphomas Sequenced
- New Blood Test May Help with MS Diagnosis
- Bad Gene Ups Prostate Cancer Risk in Black Men
- Government Requires Trans-Fat Labels on Food
MONDAY, JULY 7, 2003
- Macular Degeneration
- Is It Anorexia Nervosa?
- Urinary Tract Infection Germ Impervious
- Chilling Heart Patients Saves Their Brains: Study
- FDA OKs New Device to Manage Diabetes
- Studies Predict Outcome of Kidney Transplants
- Brushing Right After Drinking Soda May Harm Teeth
- What to Watch for with West Nile Virus
- S.C. Man Has First U.S. Case of West Nile
- Death Rate Higher on Very Hot, Cold Days: Study
- Sleep Disorders May Have Roots in Brain Chemicals
- Premature Girls Have Better Growth Rate
- Possible Gene Found for Lou Gehrig's Disease
- Third Congenital Heart Defect Gene ID'd
- Children Hit by Migraines
SUNDAY, JULY 6, 2003
- Ceramic Revolutionizes Hip-Replacement Surgery
- Third Congenital Heart Defect Gene ID'd
- Fight Foot Fungi.
- Keep Your Cool While Exercising in Summer Heat
SATURDAY, JULY 5, 2003
- Stomach Surgery for the High School Set
- B-Vitamin Problems May Cause Depression in Some
- The Silent Killer
- Study Finds No Link Between Cooked Potatoes, Cancer
FRIDAY, JULY 11, 2003
Inflammation Linked to Cognitive Decline
By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Friday, July 11, 2003
FRIDAY, July 11 (HealthDayNews) -- Inflammation in the body, measured by blood tests, is linked to cognitive decline in older adults, a team of researchers has found.
The new study, published in the July 8 issue of Neurology, adds weight to the hypothesis that inflammatory mechanisms in the body play a role in several age-related diseases, including Alzheimer's.
"There has been a lot of [medical] literature suggesting that inflammation may contribute to Alzheimer's disease and other disorders or aging," says study author Dr. Kristen Yaffe, an assistant professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.
What was not known, she says, was which comes first -- the inflammation or the disease. "My idea was, OK, let's look at blood levels of inflammation. Those who start off with higher levels of the blood markers should have more cognitive decline [over time]. And that is indeed what we found," she says.
Yaffe and her co-researchers followed 3,031 black and white men and women, average age 74, who were enrolled in the ongoing Health, Aging and Body Composition Study. The scientists took blood levels of three known markers of inflammation, including interleukin-6 (IL-6), C-reactive protein and tumor necrosis factor. They repeated the tests two years later.
A battery of mental tests was also given to evaluate concentration, memory, language and other measures of cognitive functioning, both at the start and two years later.
After adjusting for age and other factors, they found that those who had the highest levels of inflammation -- whose blood levels of IL-6 and C-reactive protein were in the highest one-third -- had more cognitive decline compared to those whose blood levels of those substances were in the lower third.
If their IL-6 result was high, they were 34 percent more likely to have cognitive decline than those whose scores on the tests were in the lower third. If their C-reactive protein levels were in the top third, they were 41 percent more likely to have cognitive decline than those in the lower third.
Although those who suffered cognitive decline also had higher levels of tumor necrosis factor, the differences weren't statistically significant, Yaffe says.
While the next logical step -- which is already being studied -- is to determine if preventing inflammation with medication makes any difference, Yaffe says it's too soon to recommend taking drugs to ward off age-related cognitive decline.
And the study found no relationship between the use of anti-inflammatories and inflammation levels.
The study "is a very large, well-done study," says Bill Thies, vice president of medical and scientific affairs for the Alzheimer's Association. The finding "fits with the idea that excess inflammatory activities are somehow related to Alzheimer's."
"And it does suggest that some of these inflammatory markers might be useful" to identify those at high risk for developing cognitive problems, Thies adds.
But to date, Thies says, research looking at anti-inflammatory drugs shows more promise as a preventive option, rather than as a treatment.
Adds another expert, Dr. Joseph Quinn, a neurologist at the Portland (Oregon) VA Medical Center, "There are only two other studies that have suggested that inflammatory markers predict future cognition. And this one is different because it includes multiple markers of inflammation and includes large numbers of African-Americans."
"It is a very solid study," Quinn says. But he adds a caveat: "It is also important to note that these results do not mean that people should start taking anti-inflammatory medicines for the prevention of Alzheimer's."
More information
For more information on Alzheimer's disease, see the Alzheimer's Association. Read about how anti-inflammatories may protect against Alzheimer's disease.
Back to the Top
Skip Breakfast, Get Fat
Randy Dotinga
HealthDay Reporter
HealthDayNews
Friday, July 11, 2003
FRIDAY, July 11 (HealthDayNews) -- It's a prime piece of conventional wisdom: Eat right before you go to bed and you'll get fat.
But new research suggests that late eaters are no more likely to be overweight than anyone else. It's what you consume the rest of the day -- especially in the morning -- that counts.
Americans who regularly skip breakfast are 4.5 times more likely to be fat, researchers found. But, in good news for the nibblers among us, those who eat four or more meals a day are actually on the thinner side.
"We tend to eat because of external cues instead of internal cues -- we eat until the plate's clean. If the plate has a lot less food on it, perhaps you'll be eating less," says Ruth Kava, director of nutrition with the American Council on Science and Health.
Researchers launched their study because experts don't fully understand how eating habits -- such as the timing and frequency of meals -- are tied to obesity, says study co-author Yunsheng Ma, an assistant professor of epidemiology at the University of Massachusetts Medical School.
The researchers examined a national cholesterol study that took place from 1994 to 1998. A total of 499 people reported five times a year on what they ate over 24 hours.
The findings of the study appear in the current issue of the American Journal of Epidemiology.
Ma and his colleagues found people who ate more than three times a day were about half as likely to be fat as those who ate three or fewer times a day. Ma suspects the difference may have something to do with fewer spikes in blood sugar levels among the frequent eaters.
Insulin levels go up when blood sugar rises, contributing to hunger and the buildup of fat, Ma says. Similar factors may be at work among those who frequently eat breakfast or dinner away from home, he says. The study found they were 4.5 times more likely to be fat.
Someone who eats breakfast at home might settle for a small, convenient meal, Kava says. "But if you go out, there's all kinds of tempting things like bacon and eggs and hash browns. Maybe you tend to indulge a little bit more. You don't have to do the work or clean up."
And what about the link between skipping breakfast and tipping the scales?
"You have not broken the fast soon enough to only need a moderate amount of calories," says Gail Frank, a professor of nutrition at California State University at Long Beach and a spokeswoman for the American Dietetic Association. "You are starving. How does the normal person respond? They eat, and they keep eating to compensate."
As for the study's rebuttal of the time-honored belief in the fattening properties of late-night meals, Ma says more research is needed to confirm that finding.
But it makes sense, Frank says, and counteracts the "myth" about the hazards of midnight munching.
The body continues digesting through the night, she says, even when people are asleep and not active. "The body doesn't know when the lights go off," she says.
More information
The American Dietetic Association offers plenty of resources about healthy eating. Or try the U.S. Centers for Disease Control and Prevention.
Back to the Top
New Insight into Graves Disease
Amanda Gardner
HealthDay Reporter
HealthDayNews
Friday, July 11, 2003
FRIDAY, July 11 (HealthDayNews) -- Scientists have long known that people suffering from Graves' disease have certain molecules that mistakenly attack their bodies, sending their thyroids into overdrive.
But for 40 years, no one has been able to identify these elusive molecules, known as autoantibodies. Now, in the July 12 issue of The Lancet, British researchers report they have finally managed to isolate the human monoclonal autoantibody that causes the thyroid to overproduce.
Although the molecule was isolated in only one patient, a 19-year-old man with Graves' disease, it could hold significant promise for the future diagnosis and treatment of the disease.
"Monoclonal" means that the antibodies come from one line of cells. "It's thought to be one rogue cell that then multiplies itself," says Donald Bergman, president of the American Association of Clinical Endocrinologists. "It means a single clone of cells that's gone awry is producing this antibody that's causing all this damage. It's a very, very exciting discovery."
Because only one cell line appears to be involved, researchers may be able to find extremely targeted treatments for the disease.
"The identification of this antibody and its availability to medical scientists represents a major step forward. Further studies will likely lead to a better understanding of Graves' disease," says Dr. Kenneth Hupart, chief of endocrinology, metabolism and diabetes at Nassau University Medical Center in East Meadow, N.Y. "More importantly, this report offers the promise of new therapies that may benefit patients with Graves' disease, the disfiguring eye problems that they can develop and can give rise to new approaches to caring for patients with thyroid cancer."
But Hupart also has a caveat. "These potential benefits will not be realized today or tomorrow, but they may help doctors lessen the burden of these thyroid diseases for patients in future years," he says.
The leading cause of hyperthyroidism, Graves' disease represents a basic defect in the immune system, causing production of antibodies that stimulate and attack the thyroid gland, causing growth of the gland and overproduction of thyroid hormone, according to the National Graves' Disease Foundation.
The disease comes about through a complicated process of reactions and counter-reactions. First, plasma cells in the body produce autoantibodies that attack the TSH (thyroid-stimulating hormone) receptor on the thyroid gland. In response, mirror-image antibodies are produced which stimulate the TSH receptor to neutralize the original autoantibodies. This causes the thyroid gland to overproduce thyroid hormone.
Graves' disease is unusual in this respect. "Most autoimmune processes are destructive. Either an antibody or an immune cell is programmed to destroy something," Bergman explains. "In Graves', that antibody is being produced to stimulate. It's mighty unusual."
But, if this is going to happen, it's just as well that it involves a monoclonal antibody, or just one cell line. This means that not all of the immune cells are being programmed to interfere with the thyroid gland, which in turn is good news when it comes to treatment possibilities.
"You certainly don't want to destroy the whole immune system," Bergman says. With this finding, it may be possible to devise an extremely targeted treatment which would affect only that one cell line and not the whole immune system.
Right now, treatment options for Graves' disease involve incapacitating or removing the thyroid gland. According to the National Graves' Disease Foundation, there are three standard methods of treatment. A patient might take drugs to inhibit the production of active thyroid hormone; he or she might take radioactive iodine to destroy part or all of the gland; or most of the gland could be surgically removed.
"Roughly half who take these drugs are cured," Bergman says. "Otherwise you have to destroy the thyroid or take it out. People who take synthetics [hormones] feel OK, but they don't feel quite like they did before because they lose the ability to make second-to-second adjustments. It's better than nothing."
More information
For more on Graves' disease, visit the National Graves' Disease Foundation or the American Thyroid Association.
Back to the Top
Is Inactivity Causing Diabetes among Kids?
HealthDayNews
Friday, July 11, 2003
FRIDAY, July 11 (HealthDayNews) -- Suspecting that inactivity is to blame for the skyrocketing rate of diabetes among children, a Georgia researcher plans to monitor and test third graders to find out for sure.
"Type 2 diabetes used to be called adult-onset diabetes because kids didn't get it," says Dr. Catherine Davis, an assistant professor of pediatrics at the Medical College of Georgia. "Now, kids are getting it in record numbers."
In fact, 10 times more kids have diabetes today than in 1990, she says.
Type 2 diabetes occurs when the body can't regulate blood glucose levels. Complications, which usually occur 20 years after diagnosis, affect many organs and can lead to heart attacks, stroke, kidney failure, pregnancy complications, blindness and poor blood circulation, which can require limb amputation.
In August, Davis will begin charting and testing 240 overweight third graders. For four months, one group will do 40 minutes of aerobic exercise daily, a second group will do 20 minutes of aerobic exercise, and a third group will not take part in the exercise. She plans to continue with different groups of children for three years, measuring the children's body composition and glucose tolerance before and after the exercise program.
Although high-fat diets probably contribute to the problem of overweight and diabetic kids, Davis says, a sedentary lifestyle may have more to do with it. People ate high-fat diets 100 years ago, she notes, but they had active lifestyles. Kids today sit in front of televisions and computers, rarely walk anywhere, and have fewer physical education classes at schools because of funding cutbacks.
More information
Here's where you can learn more about diabetes.
Back to the Top
Upper-Ear Piercing
HealthDayNews
Friday, July 11, 2003
(HealthDayNews) -- It may be a fashion statement, but is piercing your upper ear a safe thing to do?
According to the Mayo Clinic, it's a bad idea, primarily because an infection in the upper ear can quickly lead to cartilage damage and serious, permanent deformity of the ear.
While cartilage establishes the shape of your ear, it doesn't have its own blood supply. So if an infection does develop, antibiotics are often ineffective since there's no blood to transport the medication to the cartilage. This means that infected cartilage usually needs to be surgically removed.
Back to the Top
The Test Expectant Moms Shouldn't Skip
By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Friday, July 11, 2003
FRIDAY, July 11 (HealthDayNews) -- When women visit Dr. William Frumovitz late in their pregnancy, they're probably thinking about bassinettes, baby clothes and breast-feeding.
So the California obstetrician makes it a point to tell them about a very important test they need between their 35th and 37th week of pregnancy -- one that will tell them whether they have a bacterium called Group B streptococcus, which can threaten the life of their newborn.
Also known as GBS, or Group B strep, it is the most common cause of sepsis and meningitis in newborns, according to the U.S. Centers for Disease Control and Prevention (CDC). Just last year, the CDC revised its 1996 guidelines for GBS testing and now recommends universal screening of all pregnant women at 35 to 37 weeks of pregnancy. In addition, the National Institutes of Health has declared July as National Group B Strep Awareness Month.
Before the screening guidelines were strengthened, about 8,000 infants in the United States got Group B strep every year, and one of every 20 infected babies died. Those who survive often have long-term problems with hearing, vision and learning.
Problems related to Group B strep, which usually is found around the vagina and rectum, can occur a few hours after birth. Sepsis, meningitis and pneumonia are the most common, the CDC says. But diseases related to Group B strep can also crop up months after birth.
In the past, Frumovitz says, doctors had a choice: Screen at 35 to 37 weeks of pregnancy and decide on a course of action based on the result, or follow a "risk-based" method. That meant identifying women who would be likely to need intravenous antibiotics during labor -- the treatment to prevent transmission -- by their individual risks. These could include delivery before 37 weeks or a fever just before labor.
Like most doctors, Frumovitz has switched to routine screening. The test itself is relatively inexpensive, about $25. And the benefits of catching the bacterium early are immense, says Frumovitz, who is also an assistant visiting professor at University of California Los Angeles' David Geffen School of Medicine.
While not all women who have the bacterium will pass it on to their babies, if they do it can be a life-threatening problem, he says. And treating it is fairly simple.
Awareness about the dangers of Group B strep for newborns is growing, says Dr. Laura Riley, an assistant professor of obstetrics and gynecology at Harvard Medical School who chairs the committee on obstetric practice for the American College of Obstetricians and Gynecologists. The college also now recommends universal screening of all pregnant women.
While many women have known about the dangers of Group B strep, Riley says, some may not be aware that the guidelines for detecting it have changed.
"Until last year, doctors could culture at 35 to 37 weeks and treat those with a positive culture, or not culture anyone and during labor if risk factors arose those women would get antibiotics," she says.
"Now, we culture all pregnant women between 35 and 37 weeks," says Riley, a specialist in infectious diseases. All women should expect their doctor to give them this test. If they don't, women are encouraged to ask about it.
Riley also tells pregnant women to follow up with their doctor about test results. Don't assume you're fine, she says. Be sure to get the results. Then, if they're positive, you will be advised about getting antibiotics during labor.
"The antibiotics a mom gets during labor decreases the Group B strep in the vagina and the amount the baby comes into contact with," Riley explains.
While the prospect of Group B strep sounds scary, Riley add, it's also important to put it in perspective.
"Twenty to 40 percent of pregnant women will have a positive culture. Of those, a teeny percentage will go on to have a baby who is infected," she says.
More information
For more on Group B strep screening, visit the American College of Obstetricians and Gynecologists. For information on Group B strep and newborns, check out the U.S. Centers for Disease Control and Prevention.
Back to the Top
Heart Failure Common in Pacemaker Patients
Reuters Health
Friday, July 11, 2003
NEW YORK (Reuters Health) - Patients who have a pacemaker often develop heart failure, British doctors have found. Sometimes, the patients are not aware of the problem.
Dr. Simon Thackray and colleagues at the University of Hull examined some 300 patients who were being seen for a routine pacemaker check-up. At that point, the patients had had a pacemaker for an average of 5 years.
The doctors found that 94 patients -- nearly a third -- had an improperly working left-heart chamber, a sign of heart failure. Of these patients, 83 had symptoms such as shortness of breath and fatigue, but the other 11 did not report any symptoms.
Heart failure was seen more often in patients with single-chamber pacemakers than in those with double-chamber pacemakers, Dr. Thackray's team reports in the European Heart Journal.
Patients who could walk only relatively short distances during a 6-minute test were more likely to have heart failure, as were those who had previously been diagnosed with coronary heart disease, and those who had been on pacing the longest time.
The physicians recommend that patients with pacemakers have regular echo tests to make sure impending heart failure is caught early and treated.
Source: European Heart Journal June 2003
Back to the Top
‘Watchful Waiting' Best for Infections in Newborns
Reuters Health
Friday, July 11, 2003
NEW YORK (Reuters Health) - The best way to combat a potentially serious newborn infection may be to just watch and wait, new research suggests.
Pregnant women who are infected with bacteria called Chlamydia trachomatis can pass the bug to their infant during birth, resulting in serious problems for the baby such as pneumonia. In the past, doctors gave the antibiotic erythromycin to all exposed infants to prevent infection.
Recently, however, this approach was stopped when studies showed that erythromycin may cause a serious stomach problem known as pyloric stenosis. A new approach, called watchful waiting, was recommended, in which only babies with infection symptoms received the drug.
In the new study, Dr. Marc B. Rosenman, from the Indiana University School of Medicine in Indianapolis, and colleagues used a special statistical program to compare the pros and cons of each approach in a hypothetical group of 100,000 newborns exposed to Chlamydia at birth.
The current findings are reported in the Archives of Pediatrics and Adolescent Medicine.
Giving erythromycin to all the infants, whether they had symptoms or not, would cost $28.3 million, almost twice the amount of watchful waiting approach, the researchers note.
Giving the drug to everyone would prevent nearly 6000 cases of pneumonia and over 1000 hospital admissions, but it would also result in 3284 cases of pyloric stenosis, the researchers found. This translates to one case of pyloric stenosis for every 30 infants who received erythromycin.
Still, there may be certain situations in which giving erythromycin to everyone is better than watchful waiting. For example, if more than 3.4 percent of the newborns were hospitalized with Chlamydia pneumonia, then giving everyone the drug was preferable to watchful waiting, the investigators point out.
The question of which approach is better could become moot if other drugs, such as azithromycin, can be shown to be safe and effective for preventing infection in exposed infants, they add.
Source: Archives Pediatrics and Adolescent Medicine June 2003
Back to the Top
Arthritis Outlook Worse for Women
By David Douglas
Reuters Health
Friday, July 11, 2003
NEW YORK (Reuters Health) - Both women and men with early rheumatoid arthritis improve rapidly with treatment, but ultimately women fare worse than men, new research from Sweden suggests.
Rheumatoid arthritis is a chronic disease that involves inflammation of the joints, resulting in pain and decreased mobility. The exact cause is unknown, but it is classified as an autoimmune disease--meaning that the patient's own body is actually attacking itself.
Drug therapy is effective at limiting joint damage in patients newly diagnosed with rheumatoid arthritis, Dr. Thomas Skogh told Reuters Health. Unfortunately, these patients still experience a decline in their functional abilities over time, he added.
In his study, men had joint disease that was equal to, if not worse than, that of women, Skogh noted. Still, men showed "signs of more pronounced improvement and a more favorable course than the women with regard to functional abilities," he said.
Skogh, from the University of Linkoping, and colleagues came to these conclusions after following 284 patients with early rheumatoid arthritis. The severity of their disease was gauged by a number of factors and a special questionnaire was given to the patients to determine their functional ability.
The new findings are reported in the Annals of the Rheumatic Diseases.
Disease severity improved in all patients during the first 3 months of treatment, but then it leveled off. At 1 year, the patients began to notice a drop in their functional abilities.
When the study began, men and women were equal in terms of functional ability. However, when they were tested again 1 and 2 years later, women had experienced a greater drop in their abilities than men.
"The reasons for this are not obvious," Skogh concluded, "but may reflect a more aggressive disease course in women."
Source: Annals of the Rheumatic Diseases July 2003
Back to the Top
U.S. Team Finds Hints of How, Why Cancer Spreads
By Maggie Fox
Health and Science Correspondent
Reuters Health
Friday, July 11, 2003
WASHINGTON (Reuters) - Researchers said on Friday they were starting to find clues left by cancer when it begins to spread, and hoped to develop them into tests that may save the lives of future patients.
They found several of the genetic and protein markers in the blood and tissue of patients whose cancer had killed them.
Some of those markers should serve as early tests for the spread, or metastasis, of cancer, they told a meeting of the American Association of Cancer Research.
If caught early enough, cancer is highly curable.
"People don't die because they got cancer. People die because they got cancer and we didn't detect it at a point where we could do something about it," Dr. Andrew von Eschenbach, head of the National Cancer Institute, told a news conference.
Metastasis is responsible for 90 percent of cancer deaths, according to the American Cancer Society.
Joan Massague, a Howard Hughes Medical Institute researcher at the Memorial Sloan-Kettering Cancer Center in New York, and colleagues have been making a painstaking search for the products used by cancer cells to spread.
The tumor cells must first travel around the body, find the bone, brain or other tissue they will invade and then literally break in. Each process will require different genes and proteins.
The research team started with tissue samples taken from a patient who died of breast cancer, but Massague said they were making similar findings in samples from other breast cancer patients as well as those with prostate cancer and melanoma.
First, they inoculated them into specially bred mice -- a standard first step in cancer research. The mice develop tumors made up of human cells, which can be studied.
They noted which genes were overactive in those tumors and then did a reverse test -- genetically engineering normal cells with those genes and seeing if they metastasized in mice.
Using that method, they identified 48 genes and their protein products that seem to help tumor cells spread, Massague said.
Some of them are "secretory products" -- proteins sent out by the cells, which can be measured in the blood.
One is MMP-1 or matrix metalloproteinase 1, an enzyme frequently targeted by cancer researchers.
It is used by cells to break open the collagen bonds that hold other cells together.
"We are finding in serum samples of patients with metastatic breast cancer that they have high levels of MMP-1," Massague said.
Another is interleukin-11, which is active in osteoclasts -- the cells that break down bone. "The tumor cell growing as it metastasizes in bone needs to eliminate the bone matrix in order to have room to grow," Massague said.
Back to the Top
Food May Trigger Life-Threatening Asthma
Megan Rauscher
Reuters Health
Friday, July 11, 2003
NEW YORK (Reuters Health) - For the first time, food allergy -- especially to peanuts -- has been shown to be a major cause of life-threatening asthma in children.
Asthma attacks are the most common reason for children to be hospitalized, say Dr. Graham Roberts from St. Mary's Hospital in London and a team of experts. Despite great strides in treatment, death due to childhood asthma has not dropped. Roughly 50 children in the U.K. and more than 200 in the U.S die each year from asthma.
Dr. Roberts' team studied 19 children who required emergency ventilator treatment for a life-threatening asthma attack, matching each patient to two other patients treated for a non-life-threatening asthma attack.
In the medical publication the Journal of Allergy and Clinical Immunology, they report that 53 percent of children with a life-threatening asthma attack were food allergic compared with only 10 percent of those who had asthma but did not require ventilation. Of those with known food allergy, most appeared to be to peanuts or other nuts.
Commenting on the findings, Dr. Hugh A. Sampson of Mount Sinai in New York said "perhaps some of the life-threatening asthma that we are seeing may in fact be related to food allergic reactions and have been misdiagnosed only as asthma."
He added, "This is particularly relevant to the inner-city population of the U.S.," which has a lot of illness due to asthma. "Really, at this point in time we have very little information about food allergy in this population."
Dr. Sampson hopes this paper "stimulates an awareness of the importance of food allergy" in connection with severe life-threatening asthma.
Source: Journal of Allergy and Clinical Immunology, July 2003.
Back to the Top
THURSDAY, JULY 10, 2003
New Hope for Peanut Allergy Sufferers
By Adam Marcus
HealthDay Reporter
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- Children with mild peanut allergies have at least even odds they'll outgrow the problem, but a few who do may experience a rerun of the reactions.
So says a new study that followed 80 children with a history of peanut allergies, considered one of the most severe food reactions. Overall, the scientists say, between 20 percent and 25 percent of kids with peanut allergies will ultimately shed the affliction.
"It's better than we used to think," says research leader Dr. Robert Wood, a pediatrician and allergy expert at the Johns Hopkins Children's Center in Baltimore.
In a different study, Wood and his colleagues also found they can identify who is likely to outgrow their peanut allergy by looking at their immune system's reaction to small bits of peanut protein.
"It turns out that if you are reacting to a certain portion of the protein you have a far lesser chance of outgrowing it. But if it's a different part, you have a much better chance," Wood says.
Eventually, doctors could measure that reaction with a simple blood test. "The same is likely to be done with milk and egg allergies, where we're finding the same kinds of differences," he adds.
Dr. Hugh Sampson, an allergist at the Mount Sinai School of Medicine in New York City and a co-author of the peanut protein study, says such a test for peanuts could avoid up to 90 percent of future allergy tests to determine which children have outgrown the condition. These tests can provoke unpleasant and possibly dangerous reactions.
The studies appear in July issue of the Journal of Allergy and Clinical Immunology, which this month is devoted to peanut allergy research. Researchers held a press briefing Thursday to discuss the findings.
An estimated 1.5 million Americans are allergic to peanuts, and each year nearly 100 die after contact with them, according to the Food Allergy and Anaphylaxis Network. For some people, as little as 1/1,000th of a peanut can trigger a deadly reaction.
Until only recently, doctors believed peanut allergies were lifelong affairs. But a recent study by Wood's group showed that as many as 20 percent of toddlers allergic to peanuts grow tolerant to them by the time they enter school.
The latest study extends that work. Wood and his colleagues followed 80 children, aged 4 to 14, with a history of peanut allergy. All had blood levels of IgE -- the immune molecule that binds to peanut proteins -- of 5 kilounits per liter of blood, and many had much less of the antibody.
When tested again with a bit of peanut protein, 55 percent of the children passed the test, suffering no allergic reaction. That rate was even higher among those whose IgE levels were 2 kilounits or less.
Although 55 percent of children in the new study outgrew their allergy to peanuts, as many as three-quarters of those who reacted to the food have IgE levels above 5, Wood says. The study found that 23 percent of peanut allergy sufferers overall would lose their sensitivity with time.
"The incidence and prevalence of peanut allergy is increasing markedly," says Dr. Donald Leung, an allergy specialist at National Jewish Medical and Research Center in Denver. Peanut allergies account for roughly half of the 200-odd fatal food reactions in the United States each year, he adds.
While serious allergic reactions can be avoided with a prompt shot of epinephrine, eight in 10 people who die of food allergies never receive proper instruction in how to self-administer the injection, Leung says.
Researchers would like to prevent food allergies from occurring, rather than treat them in their throes. Sampson is helping lead an effort at Mount Sinai to create a peanut allergy vaccine, a gel-filled suppository that would activate a regulatory element of the immune system.
Work in rodents has been successful, he says, and the group hopes to test the vaccine in humans as early as next year.
More information
Check out the Food Allergy & Anaphylaxis Network or the American Academy of Allergy Asthma & Immunology.
Back to the Top
Surgery Not Needed for Many Brain Aneurysms
By Adam Marcus
HealthDay Reporter
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- As scary as a looming brain aneurysm seems, most people who have one don't need emergency surgery, claims the largest study yet of how patients with the condition fare over time.
Indeed, the risk of operating on many unruptured aneurysms may outweigh the potential benefits, especially in older patients with relatively small artery defects, the study found.
"Most aneurysms in the general population don't rupture, but it's important to sort out which ones are more likely to," says Dr. David O. Wiebers, a neurologist at the Mayo Clinic and leader of the research, which appears in the July 12 issue of The Lancet. "In some cases, the risk is so low it's not advisable to do any procedure."
However, Wiebers adds, in patients for whom quick action is needed, doctors have ways of repairing aneurysms: "There are more options now than there ever have been before, and the technical quality is improving as time goes on."
According to the Brain Aneurysm Foundation, roughly 2 million Americans live with unruptured brain aneurysms -- areas of weakness in an artery wall that allow small balloon-like cul-de-sacs to form. Each year, 30,000 people in this country suffer ruptured aneurysms. Half die within minutes, while many of the rest either die soon after or face severe debilitation. Although unruptured aneurysms can cause headaches and other symptoms they often do not, lying in wait to be discovered on brain scans for other reasons, such as trauma or migraine headaches.
The latest study included 4,060 men and women with unruptured brain aneurysms who were seen at 61 clinics in the United States, Canada and Europe. Of those, 1,917 had surgery to repair the pouched vessels and 451 had small coils packed into the bulges to create clots and wall off the area. That left 1,692 patients whose aneurysms weren't repaired.
The patients were followed for as long as nine years, during which time 51 suffered a rupture. But the risk of a breach was minuscule -- almost 0 percent -- for people whose aneurysms were smaller than seven millimeters across. The rupture rate jumped to 3.3 percent for aneurysms between 7 millimeters and 12 millimeters wide, and to17 percent for those wider than that.
Several other factors also influenced the odds that an aneurysm would rupture. Aneurysms toward the back of the brain, though rarer, were more prone to breaking than those in the front. People with a previous history of a ruptured aneurysm in another site were more likely to have a break, too.
Older people weren't more likely than younger patients to have their aneurysms rupture, but they tended to do worse when operated on.
Patients who had coil implants did better in the short run than those who had surgery to clip off the bulging artery. Their risk of death or serious disability was 20 percent to 30 percent lower after a year.
"The thing that's not known is the long-term outcomes and durability of the coils," Wiebers says. "That's what we're hoping to do in the next phase of this." Average follow-up in the study ran four to five years, and the researchers hope to extend that to 10 years or so, he says.
Data from an earlier phase of the international study suggested that unruptured aneurysms smaller than about 10 millimeters didn't require repair. "The magical number was 10, now it's seven," says Dr. Jacques E. Dion, a brain surgeon at Emory University who is familiar with the new findings. "Is it going to hold there? I don't know."
Dr. Kieran Murphy, a neurosurgeon at Johns Hopkins University and an expert in coil therapy, agrees more evidence of their long-term effectiveness would be nice. "Always it's prudent to look at how much coil compaction takes place over time," Murphy says. Yet coil technology is advancing rapidly, he adds, and newer devices are designed to be more rugged than previous models.
Ultimately, Murphy says, the most important thing for patients is to get the option of surgery or coil implants -- and that often doesn't happen because coiling is still relatively uncommon.
More information
Try the Brain Aneurysm Foundation or the National Institute of Neurological Disorders and Stroke for more on aneurysms and their consequences.
Back to the Top
Get All the Facts on Breast Cancer Screening
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- Women need better information about breast cancer screening to fully understand the potential benefits and risks, says an article in this week's British Medical Journal.
Breast cancer screening is common in many countries of the world, but there's ongoing debate about its value. There are wide variations in the estimates of the effectiveness of screening in preventing breast cancer deaths. Women are often given limited information in a language they may find difficult to understand, the article says.
Because of that, the potential harmful effects of breast cancer screening are often simply chalked up as the price worth paying for the perceived benefit.
Research into breast cancer screening programs should be done to develop flexible decision aids to provide women with balanced information.
The article says it's unacceptable that women undergoing breast cancer screening tests continue to suffer damage and regret because they didn't fully understand the potential harm.
More information
The American Cancer Society has updated breast cancer screening guidelines.
Back to the Top
Breakthrough for Muscular Dystrophy
Ed Edelson
HealthDay Reporter
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- Italian scientists report a possible solution to a major problem plaguing researchers working on gene therapy for muscular dystrophy: how to get the right gene to the right place to stop the muscle-wasting process that cripples people with the condition.
A newly discovered kind of stem cell has successfully carried a corrective gene to muscles in mice with one form of muscular dystrophy, says a report in the July 11 issue of Science. The researchers are based at the Stem Cell Research Institute in Milan and the Institute of Cell Biology and Tissue Engineering in Rome.
It's much too early to think about human trials, says Sharon Hesterlee, director of research and development at the Muscular Dystrophy Association, but "this is a really significant piece of work. It's the first time we've been able to do a stem cell transplant and see an actual increase in function."
The researchers used a kind of cell they discovered only last year and have named mesoangioblasts. These cells are found in blood vessel walls and are stem cells, meaning they can transform themselves into a variety of other cell types -- blood, bone, muscle and connective tissue. Most important, the Italians have found, they can migrate into muscle cells around blood vessels, carrying genes with them.
In the newly reported experiments, the gene for alpha sarcoglycan, a protein whose mutation or absence causes a form of muscular dystrophy, was inserted into mesoangioblasts, which were then grown in cell cultures. The engineered cells were injected into the arteries of mice lacking the gene.
Three months later, the researchers found active alpha sarcoglycan proteins in the muscles of the treated mice, downstream from the injection site. The treated muscles contained a large number of apparently normal fibers, and the mice were able to walk on a rotating wheel longer than untreated animals -- although not as long as healthy mice.
"I'm convinced that this is an important result, but this is still not the therapy, for mice or for patients," says a statement by research leader Dr. Giulio Cossu.
For one thing, the mesoangioblasts used in the study were taken from fetal mice, which might cause serious problems for researchers in the United States, where strict limits have been put on fetal stem cell research.
The goal of the researchers is to extract mesoangioblasts from muscular dystrophy patients and inject them back into the same patients after the addition of the needed gene, avoiding an attack on the cells by the immune system.
Different genes would have to be used for the many varieties of muscular dystrophy, but Hesterlee sees no major problem. "We have lots of experience with many forms of muscular dystrophy already, with good mouse models," she says. But until now, efforts to implant the corrective genes using other cells or viruses have been disappointing, she adds.
An American laboratory made an important contribution to the research. "Our laboratory contributed the mice, reagents and technical advice," says Kevin P. Campbell, a professor of physiology and biostatistics at the University of Iowa College of Medicine. "They needed a well-characterized animal model of muscular dystrophy, and we have a very good model."
The Iowa laboratory now has replicated the Italian experiment and will continue to do work on the subject, Campbell says.
Decisions on what to do next can't be made until all researchers doing work on muscle regeneration get together, Hesterlee says. "We have a meeting of researchers in the next two weeks, and they will plan strategy," she says.
More information
You can get an overview of muscular dystrophy from the National Institute of Neurological Diseases and Stroke or the Muscular Dystrophy Association
Back to the Top
More Schooling Leads to Smarter Eating
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- Your education level may influence how smart you are about eating a healthy diet.
A new study says Americans are eating healthier diets than they did in 1965, but college-educated people are eating healthier than high school dropouts.
That's a change from the 1960s, when college graduates, those who'd completed high school and people who hadn't finished high school all had about the same level of diet quality.
The current gap in diet between those with more education and those with less schooling may explain the large disparity in health between people in the higher and lower socioeconomic groups in the United States, researcher Barry Popkin, department of nutrition, University of North Carolina at Chapel Hill, says in a statement.
The study appears in the July issue of the American Journal of Preventive Medicine.
Popkin and his colleagues compared the dietary habits of 6,475 people in 1965 and 9,241 people in 1994-96.
In 1965, college-educated people consumed more calcium, iron and servings of fresh fruit than less-educated people. However, the college-educated group also ate more saturated fats. In 1994-96, people with a college education ate a much healthier diet than those with less schooling.
"In general, extra years of schooling related to small upward shifts in diet quality. The highest diet quality level was found among white women who attended college and for those with income far above the poverty line," Popkin says.
More information
Here's where you can learn more about nutrition.
Back to the Top
A Closer Look at Autism
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- Early problems with simple face-to-face interaction may be responsible for the difficulties autistic children have in pointing and showing objects to other people, says new British research.
The results of the two-year study from the University of Durham could provide better understanding of the early language and communication problems found in children with autism.
"We have known for a long time that children with autism have special difficulties with pointing and showing objects to other people. Until recently, however, many researchers believed that this problem was due to the child's lack of awareness that people's thoughts and reactions were directed towards objects and events in the world around them," lead author Dr. Susan Leekam says in a statement.
"Our new research suggests a different interpretation -- that the failure to point and show things to others may emerge from much simpler beginnings of face-to-face interaction. These findings indicate that the problems may start even earlier in development than previously recognized," Leekam says.
The study included 20 pre-school children with autism and 20 developmentally delayed children in a comparison group. The two groups were matched for mental age.
The use of voice and touch by adults playing with the children was measured by a computer-based digital video analysis system. The system also measured the use of pointing and showing by the children.
Using this method, the researchers were able to examine in detail the effectiveness of touch or gaining a child's eye gaze and other methods of attention-seeking used by the adults.
The researchers found an autistic child's difficulty in responding to face-to-face interaction was strongly related to the problem of pointing and showing. Autistic children who did no pointing or showing objects to the adults were those most impaired in face-to-face interaction.
"This finding has implications for early intervention. Many parents are aware of difficulties long before a diagnosis of autism is made. By gaining greater understanding of these very early problems we hope that ways can be found to target them before other difficulties emerge," Leekam says.
More information
Here's where you can learn more about autism.
Back to the Top
New Treatment for Blood Clots
HealthDayNews
Thursday, July 10, 2003
THURSDAY, July 10 (HealthDayNews) -- A new method to combat blood clots may prevent bleeding in people who've had surgery or suffered a stroke.
That's the finding of a new study in the August issue of Nature Biotechnology.
This new approach involves attaching an anti-clotting agent called tissue plasminogen activator to the surface of red blood cells. That prolongs the life of the clot buster in the blood and targets the newly forming blood clots that are most lethal to patients.
Most treatments to dissolve blood clots have only a short lifespan in the blood and can cause bleeding and serious brain injuries by indiscriminately attacking clots around the body.
Researchers at the University of Pennsylvania Medical School tested the new method's ability to dissolve clots in mice and rats. They found the new anti-clotting agent was more stable in circulation and avoided the problems of diffusion from blood vessels, which can cause harmful bleeding.
The study concluded that coating a patient's red blood cells with the anticlotting agent could prevent many clot-related deaths that can't be prevented using current therapies.
More information
Here's where you can learn more about blood clots.
Back to the Top
Air Sick?
HealthDayNews
Thursday, July 10, 2003
(HealthDayNews) -- Are you plagued by motion sickness whenever you take a plane trip?
The Aerospace Medical Association offers this advice:
- When you check in, ask for a seat over the wing.
- Book your flights on larger airplanes.
- Request a window seat.
- Avoid alcohol for the 24 hours before you fly and during the journey.
- Keep your seatbelt fastened.
- If necessary, before you fly, ask your doctor about motion sickness medication.
Back to the Top
Deep-Vein Thrombosis
HealthDayNews
Thursday, July 10, 2003
(HealthDayNews) -- When the legs are confined to one position for any length of time, whether due to work, travel or illness, your risk of deep-vein thrombosis (DVT) increases. It's a condition caused by a blood clot developing in the leg veins.
The Johns Hopkins Health After 50 newsletter suggests these measures for decreasing your risk of DVT:
- Maintain a healthy lifestyle that includes achieving a healthy weight, not smoking, and exercising regularly.
- Whenever your movement is restricted, try to flex your ankles and move your legs frequently.
- When you sit or lie down, elevate your legs using a stool and pillows.
- Wear clothing that doesn't constrict blood flow.
Back to the Top
FDA Orders Revised Epilepsy Drug Warning
The Associated Press
Thursday, July 10, 2003
WASHINGTON - The government has ordered more detailed information to be provided with an epilepsy drug that did not warn about decreased sweating and hyperthermia.
The order for updated information on Topamax is based on clinical trials and the experience of more than 2 million users worldwide, the Food and Drug Administration said Thursday.
Most of the reports of problems have involved children. Most cases have occurred in connection with exposure to hot temperatures, vigorous activity or both. Children using the medication should be closely observed under these conditions, the FDA said.
The FDA said potential cases of decreased sweating were observed in about 35 per 1 million Topamax patients; 1.6 users per 1 million had serious problems with it.
On the Net:
Food and Drug Administration: http://www.fda.gov
Back to the Top
New Blood Test May Help With MS Diagnosis
Linda A. Johnson
Associated Press Writer
The Associated Press
Thursday, July 10, 2003
Scientists have developed a blood test that appears to be the first reliable way to predict whether patients with neurological problems such as tingling or blurred vision will soon develop the debilitating disease multiple sclerosis.
Austrian researchers studying patients with possible MS symptoms found that those with two kinds of antibodies in their blood early on were 76 times more likely to develop the tough-to-diagnose disorder than those with neither antibody.
Some of the potential early symptoms of MS can have numerous other causes, such as a stroke or a brain tumor. Moreover, one-third of patients with these initial symptoms recover and never develop MS; others can go for years before they have a second flare-up showing they have MS.
Up to now, "nobody was able to predict for an individual patient what will be in the future," said lead researcher Dr. Thomas Berger of the department of neurology at University of Innsbruck.
MS is incurable. But Berger said the blood test could help doctors decide whether to offer a patient early treatment with drugs recently proven to reduce flare-ups and slow the progression of the disease in some people.
The best current diagnostic test, an MRI scan for lesions on nerves in the brain and spinal cord, can only predict the chances of developing multiple sclerosis over the next decade, and its accuracy ranges from 80 percent down to 11 percent, Berger said. The blood test is 95 percent accurate in predicting which people will have a flare-up within several months, he said.
"These antibodies seem to predict the next attack and therefore a diagnosis of MS," said Dr. Stuart Cook, a neurologist and president of the University of Medicine and Dentistry of New Jersey. "I think it's an important contribution."
About 400,000 Americans, mostly women, have multiple sclerosis, which usually strikes between age 20 and 40.
MS is poorly understood but involves damage to nerve fibers and their protective myelin sheath in the brain, spinal cord and eyes. The cause is unknown, but doctors suspect a virus or other infection makes the immune system attack the myelin and nerve fibers.
Symptoms include weakness, tremors, difficulty walking, blindness, incontinence and emotional problems.
The disease can lie dormant for months or years, then worsen steadily or cause repeated flare-ups. Some victims become disabled; others lead fairly normal lives.
Often, MS is not diagnosed until the second episode of symptoms. Many doctors just monitor patients until then, rather than starting treatment, because the initial symptoms often are not due to MS at all; because medications do not work for some people and have serious side effects; and because MRIs, even when combined with spinal fluid tests and patient history, can be inaccurate.
In the Austrian study, reported in Thursday's New England Journal of Medicine, doctors tested 103 patients with possible early symptoms for their levels of antibodies called anti-MOG and anti-MBP; MRI scans were used to determine how many nerve lesions they had.
After repeated testing for about four years on average, the doctors found only 23 percent of patients with neither antibody had a relapse, after 3 3/4 years on average. Among those with both antibodies, 95 percent had such a disease-defining relapse, within just 7 1/2 months on average. Among those with just anti-MOG protein, 83 percent had a relapse, on average within 14 1/2 months.
The results must be confirmed, among more patients and with a longer follow-up, Cook said.
He and Berger both said that the study does not prove whether the antibodies cause the nerve damage, or are a response to it.
Cook noted that unlike the lesions spotted by MRI scans, the antibodies did not help predict the eventual severity of the disease.
In an accompanying editorial, Drs. Jack P. Antel and Amit Bar-Or of the Montreal Neurological Institute said the findings, once confirmed, could identify subgroups of patients that particular drugs would help the most. Choosing the right drug now is hit-or-miss.
On the Net:
New England Journal: http://www.nejm.org
Multiple Sclerosis Foundation: http://www.msfacts.org
Back to the Top
FDA Loosens Food Label Requirements
Lauran Neergaard
AP Medical Writer
The Associated Press
Thursday, July 10, 2003
WASHINGTON - The government is loosening restrictions on how much scientific proof is required to advertise a food's possible health benefits on its package, a move welcomed by food makers but one that critics fear will leave consumers prey to quackery in the grocery aisles.
The Food and Drug Administration announced Thursday that it will accept applications to place "qualified" health claims on food labels beginning Sept. 1. Among the first to be considered: that eating several servings a week of salmon and certain other fish rich in omega-3 fatty acids is thought to, but not proved to, reduce the risk of heart disease.
"We want to help increase America's nutritional grade-point average," said FDA Commissioner Mark McClellan. "Americans shouldn't need a science degree to figure out how foods can fit into a healthy diet. Information should be accurate, honest and easy to understand."
Until now, the FDA has enforced a very strict standard about what health claims could be made on food labels. Before oatmeal could boast heart-healthy labels, for example, there had to be significant scientific consensus that oatmeal's fiber helps maintain low cholesterol levels.
Under the new program — backed by food manufacturers — FDA will give a grade to applications for new food claims: A for scientifically proven claims; B where the science is good but not conclusive; C when there's limited science to support a claim; and D when there's hardly any.
A-rated claims — such as "calcium prevents bone-weakening osteoporosis" — are the kind already permitted, and won't change.
Claims rated a "B, "C," or "D" would be considered qualified, and for the first time could be put on a food label right next to a short disclaimer that describes the level of proof. Whether the letter grade itself also will go on packages is still under consideration.
A congressman influential in passing a decade-old law that governs food labeling said the FDA is essentially violating that law.
"FDA's decision is going to permit virtually unsupported health claims on foods," said Rep. Henry Waxman, D-Calif. "When consumers see a claim on a product and later learn it was a false claim, they're going to decide perhaps none of the labels on those food products mean anything."
At best, it means wishy-washy health advice will suddenly appear on foods, confusing consumers, said Bruce Silverglade of the consumer advocacy group Center for Science in the Public Interest
"This action represents the biggest rollback in food-labeling standards in 20 years," said Silverglade. His group is talking with Waxman about a possible legal challenge.
The Grocery Manufacturers of America says low-rated claims make sense in the wake of recent court rulings that allow more loosely regulated dietary supplements to make more far-reaching claims about health effects.
The influential Consumer Federation of America agrees that the court pressure is real, and says the FDA's new program would probably safeguard against abuse.
The budget-stretched FDA will give priority to a number of claims expected to win a good B-rating: The omega-3's heart benefit; that products made with vegetable oils are more heart-healthy than those made with solid fats; that substituting nuts for other fatty proteins also is heart-healthy. Various health groups, such as the American Heart Association, already make some of those recommendations.
Other examples — some controversial — the food industry expects to seek: That the antioxidant lycopene, rich in cooked tomato products, can prevent prostate cancer; that lowfat dairy products lower blood pressure; that fiber prevents colon cancer; that compounds in grapes are heart-healthy.
McClellan thinks few manufacturers would bother advertising low-rated claims, instead doing better research or making a product healthier.
"You'd have to do a lot better than a 'C' to attract consumers to your product," he said. "Good nutrition should also be good business."
Back to the Top
'WEDNESDAY, JULY 9, 2003
Child-Friendly Drug Repellant
HealthDayNews
Wednesday, July 09, 2003
(HealthDayNews) -- When your kids head outdoors, it's advisable to apply insect repellant to ward off any disease-carrying mosquitoes.
According to the U.S. Centers for Disease Control and Prevention (news - web sites), most guidelines say it's okay to use products containing DEET on kids over age two.
Here are some pointers when using repellant on your child:
- Apply it first to your own hands and then rub them on your child.
- Don't apply it to your child's hands; they tend to put their fingers in their mouths.
- Don't allow your child to self-apply repellant.
- Don't rub it on the skin under your child's clothing. And wash clothing that's been treated with repellant before it's worn again.
Back to the Top
Group Targets Stroke Death Rate in South
Murray Evans
Associated Press Writer
The Associated Press
Wednesday, July 09, 2003
LEXINGTON, Ky. - A national group is trying to get family doctors to talk about stroke risk factors and prevention more with patients in the South, which has the some of the highest stroke death rates in the country.
The National Stroke Association launched its campaign in Kentucky on Tuesday and has sent letters to all family care doctors in the state. The group will focus initially on the so-called "Stroke Belt," 12 states, mostly in the South, in which stroke death rates are consistently more than 10 percent higher than the rest of the country.
Doctors suspect the South has a higher stroke death rate because it has more poor communities with less access to health care and greater risk factors such as obesity, smoking and lack of physical activity.
Kay Wan, a spokeswoman for the National Stroke Association, said about 50 percent of Americans cannot recognize even one stroke symptom, and that family doctors are on the front line of seeing people at risk.
"We felt there was a huge need to reach out ... and ask them to talk about stroke with their patients a little bit more," she said.
Strokes affect 700,000 Americans every year, and 165,000 of them die as a result. A stroke occurs when a blood clot blocks the blood flow in a vessel or artery or when a blood vessel breaks, interrupting blood flow to an area of the brain.
Symptoms include sudden blurred or decreased vision, loss of balance or coordination, difficulty speaking or understanding simple statements and numbness or paralysis in the face, arm or leg.
Back to the Top
Heart Disease, Not Always a Death Sentence
HealthDayReporter
Wednesday, July 9, 2003
WEDNESDAY, July 9 (HealthDayNews) -- A gene called macrophage scavenger receptor 1 (MSR1) plays an important role in the development of prostate cancer in black American men.
So says a study in the July 1 issue of Cancer Research.
The finding comes from a larger project called the Flint Men's Health Study, which is meant to identify prostate cancer risk factors in black American men.
"African-American men have the highest incidence of prostate cancer in the world. The severity is higher and they tend to die more quickly after diagnosis," study author Dr. Kathleen Cooney, an associate professor of internal medicine at the University of Michigan Comprehensive Cancer Center, says in a statement.
"We don't know why this is, but part of the difficulty is that African-American men are underrepresented in most genetics studies," Cooney says.
This study included black men, aged 40 to 79, living in Flint, Mich. DNA samples were collected from 134 men diagnosed with prostate cancer and 340 men without the disease. After analyzing the DNA samples, the researchers concluded that rare germ-line MSR1 mutations were associated with an increased risk of prostate cancer.
Previous studies found the same association in white men.
"This study adds to an expanding body of evidence in support of germ-line MSR1 mutations as risk factors for prostate cancer. Although our study was modest in size, the public health burden of prostate cancer in the African-American community warrants further attention to potential genetic risk factors," lead author Dr. David Miller, a urology resident at the University of Michigan Medical School, says in a news release.
More information
Here's where you can learn more about prostate cancer.
Back to the Top
Anti-Malaria Pill Comes with Risk Guide
The Associated Press
Wednesday, July 09, 2003
WASHINGTON - People prescribed Lariam to prevent malaria before a trip abroad will now get a government-ordered brochure along with the pills describing what to do if some rare but serious side effects strike.
The FDA announced Wednesday that every Lariam prescription now will come with a medication guide that explains its pros and cons in consumer-friendly language.
The new warnings stress that some people shouldn't take the drug: those with active or recent depression, a history of other psychiatric disorders, or epilepsy.
The guide also advises patients who suddenly experience psychiatric side effects to promptly contact a doctor — they may need to stop the Lariam and switch to another anti-malaria pill.
Last year, the FDA strengthened warnings on the drug's label that it can cause some rare but potentially serious psychiatric side effects, ranging from anxiety and dreams to hallucinations, depression, occasionally even psychotic behavior.
FDA's Dr. Leonard Sacks said the new guide addresses concerns that the information was still not reaching those who need it. About 800 Americans a year return home infected with malaria, most because they didn't know to take the pills or skipped them from worry about side effects.
Most of the several million Americans who travel to malaria-plagued countries come home healthy thanks to one of several protective drugs. Lariam is the most prescribed among them.
The guide will not imply that Lariam is a worse choice than other anti-malaria pills, Sacks said. Each has side effects, and Lariam has advantages that make it an important option.
Back to the Top
Drug Cuts Blood Clot Risk in Cancer Patients
HealthDayNews
Wednesday, July 09, 2003
WEDNESDAY, July 9 (HealthDayNews) -- The potentially fatal blood clots that plague many cancer patients are better treated with an injectable heparin drug than with an oral blood-thinning agent, a major international study finds.
This is a straightforward medical finding, yet the potential difficulty of putting it into clinical practice illustrates how financial considerations can influence medical decisions, says a physician who took part in the study.
In the study, only 27 of the 336 patients who used self-injected dalteparin, a sophisticated low-weight heparin, had recurrences after their first clot, compared to 53 of the 336 patients who were given coumarin, a standard oral drug, says a report in the July 10 issue of the New England Journal of Medicine (news - web sites).
Other studies have shown similar results, says Dr. Steven R. Deitcher, head of the section of hematology and coagulation medicine at the Cleveland Clinic. He has done one of those studies, which used another low-weight heparin, enoxaparin.
While Deitcher cannot give detailed results of his study because it has not yet been published in a medical journal, he says those findings are in general agreement with those of the newly published study.
Yet doctors continue to use coumarin, in large part for monetary reasons, he says. Dose for dose, a low-weight heparin costs at least 10 times more than coumarin, and Medicare does not pay for it.
It's an important issue, Deitcher says: "Cancer patients are in a very high-risk group with regards to development of blood clots, because of the underlying disease as well as many treatments."
To give just one example, the catheters that are implanted to administer drugs increase the risk of clots. "Some feel that thrombosis [clotting] is one of the most proximate causes of death in cases of solid tumors," Deitcher says.
Coumarin is a notoriously difficult drug to manage. Blood levels must be kept in a narrow range, yet they can swing erratically, especially in cancer patients. Those patients must have frequent blood tests, and they often must be hospitalized.
Avoiding those problems makes low-weight heparin "comparable in terms of cost- effectiveness," says study author Dr. Mark N. Levine, professor of medicine and clinical epidemiology and biostatistics at McMaster University in Canada.
"When you consider not only the cost of the drug but also the cost of downstream events avoided, it's a wash," he says.
Levine says he believes doctors treating cancer patients for blood clots will "undoubtedly" switch to low-weight heparin, now that they can cite the results of this study. The switch will not come quickly, but it is under way, he says.
"People now have to go through the appropriate regulatory approvals, but the first step is to prove the science," Levine says.
More information
You can learn the language of thrombosis from the American Heart Association. Read about other complications from cancer from the National Cancer Institute.
Back to the Top
Chromosome Linked to Deafness, Lymphomas Sequenced
Patricia Reaney
Reuters Health
Wednesday, July 09, 2003
LONDON (Reuters) - Scientists have finished sequencing human chromosome 7, which contains genes linked to hand and facial development, cystic fibrosis, deafness, lymphoma and other cancers.
It is the sixth and largest chromosome to be sequenced so far and contains 153 million letters of DNA and about 1,150 genes, including one which may help to explain why cancer cells are resistant to some drugs, and others that are involved in the body's immune response.
"This is another volume in the encyclopedia that is research ready. There are a number of genes that are involved in human cancers that are going to give us a good understanding of what goes on in the genomes of people that have these types of cancer," Dr. Richard Wilson, the director of Washington University's Genome Sequencing Center in St. Louis, Missouri, said in an interview.
"It gives us a leg up on designing new therapeutics that will help us treat them," he added.
Scientists from several centers in the United States and Germany completed the sequence, which is reported in the latest edition of the science journal Nature.
In addition to the gene for cystic fibrosis, chromosome 7 also contains several genes for Williams-Beuren syndrome (WBS), a rare disorder that causes unusual facial appearance and mild mental retardation.
"I think it will help us understand some of the genetic components of head and face development. There are a number of genes for that. There are also a number of genes involved in various types of white blood cell cancers, lymphoma and leukemia," Wilson added.
The finished sequence, which is freely available on the Internet, provides a treasure chest of information for scientists studying those diseases.
It will allow scientists to look at people who have these diseases to understand the underlying genetics and to develop treatments, such as the leukemia drug Glivec, which are aimed at gene products.
"If we can correlate other genes on chromosome 7 with some of these lymphomas and leukemias it may be possible to design drugs that go right after those types of (gene) products," Wilson added.
Each chromosome is made up of a molecule of DNA in the shape of a double helix which is composed of four chemical bases represented by the letters A (adenine), T (thymine), G (guanine) and C (cytosine). The arrangement, or sequence, of the letters determines the cell's genetic code.
Back to the Top
New Blood Test May Help with MS Diagnosis
Linda A. Johnson
Associated Press Writer
The Associated Press
Wednesday, July 09, 2003
Scientists have developed a blood test that appears to be the first reliable way to predict whether patients with neurological problems such as tingling or blurred vision will soon develop the debilitating disease multiple sclerosis.
Austrian researchers studying patients with possible MS symptoms found that those with two kinds of antibodies in their blood early on were 76 times more likely to develop the tough-to-diagnose disorder than those with neither antibody.
Some of the potential early symptoms of MS can have numerous other causes, such as a stroke or a brain tumor. Moreover, one-third of patients with these initial symptoms recover and never develop MS; others can go for years before they have a second flare-up showing they have MS.
Up to now, "nobody was able to predict for an individual patient what will be in the future," said lead researcher Dr. Thomas Berger of the department of neurology at University of Innsbruck.
MS is incurable. But Berger said the blood test could help doctors decide whether to offer a patient early treatment with drugs recently proven to reduce flare-ups and slow the progression of the disease in some people.
The best current diagnostic test, an MRI scan for lesions on nerves in the brain and spinal cord, can only predict the chances of developing multiple sclerosis over the next decade, and its accuracy ranges from 80 percent down to 11 percent, Berger said. The blood test is 95 percent accurate in predicting which people will have a flare-up within several months, he said.
"These antibodies seem to predict the next attack and therefore a diagnosis of MS," said Dr. Stuart Cook, a neurologist and president of the University of Medicine and Dentistry of New Jersey. "I think it's an important contribution."
About 400,000 Americans, mostly women, have multiple sclerosis, which usually strikes between age 20 and 40.
MS is poorly understood but involves damage to nerve fibers and their protective myelin sheath in the brain, spinal cord and eyes. The cause is unknown, but doctors suspect a virus or other infection makes the immune system attack the myelin and nerve fibers.
Symptoms include weakness, tremors, difficulty walking, blindness, incontinence and emotional problems.
The disease can lie dormant for months or years, then worsen steadily or cause repeated flare-ups. Some victims become disabled; others lead fairly normal lives.
Often, MS is not diagnosed until the second episode of symptoms. Many doctors just monitor patients until then, rather than starting treatment, because the initial symptoms often are not due to MS at all; because medications do not work for some people and have serious side effects; and because MRIs, even when combined with spinal fluid tests and patient history, can be inaccurate.
In the Austrian study, reported in Thursday's New England Journal of Medicine, doctors tested 103 patients with possible early symptoms for their levels of antibodies called anti-MOG and anti-MBP; MRI scans were used to determine how many nerve lesions they had.
After repeated testing for about four years on average, the doctors found only 23 percent of patients with neither antibody had a relapse, after 3 3/4 years on average. Among those with both antibodies, 95 percent had such a disease-defining relapse, within just 7 1/2 months on average. Among those with just anti-MOG protein, 83 percent had a relapse, on average within 14 1/2 months.
The results must be confirmed, among more patients and with a longer follow-up, Cook said.
He and Berger both said that the study does not prove whether the antibodies cause the nerve damage, or are a response to it.
Cook noted that unlike the lesions spotted by MRI scans, the antibodies did not help predict the eventual severity of the disease.
In an accompanying editorial, Drs. Jack P. Antel and Amit Bar-Or of the Montreal Neurological Institute said the findings, once confirmed, could identify subgroups of patients that particular drugs would help the most. Choosing the right drug now is hit-or-miss.
On the Net:
New England Journal: http://www.nejm.org
Multiple Sclerosis Foundation: http://www.msfacts.org
Back to the Top
Bad Gene Ups Prostate Cancer Risk in Black Men
HealthDayNews
Wednesday, July 09, 2003
WEDNESDAY, July 9 (HealthDayNews) -- A gene called macrophage scavenger receptor 1 (MSR1) plays an important role in the development of prostate cancer in black American men.
So says a study in the July 1 issue of Cancer Research.
The finding comes from a larger project called the Flint Men's Health Study, which is meant to identify prostate cancer risk factors in black American men.
"African-American men have the highest incidence of prostate cancer in the world. The severity is higher and they tend to die more quickly after diagnosis," study author Dr. Kathleen Cooney, an associate professor of internal medicine at the University of Michigan Comprehensive Cancer Center, says in a statement.
"We don't know why this is, but part of the difficulty is that African-American men are underrepresented in most genetics studies," Cooney says.
This study included black men, aged 40 to 79, living in Flint, Mich. DNA samples were collected from 134 men diagnosed with prostate cancer and 340 men without the disease. After analyzing the DNA samples, the researchers concluded that rare germ-line MSR1 mutations were associated with an increased risk of prostate cancer.
Previous studies found the same association in white men.
"This study adds to an expanding body of evidence in support of germ-line MSR1 mutations as risk factors for prostate cancer. Although our study was modest in size, the public health burden of prostate cancer in the African-American community warrants further attention to potential genetic risk factors," lead author Dr. David Miller, a urology resident at the University of Michigan Medical School, says in a news release.
More information
Here's where you can learn more about prostate cancer
Back to the Top
Government Requires Trans-Fat Labels on Food
Maggie Fox
Reuters Health
Wednesday, July 09, 2003
WASHINGTON (Reuters) - All packaged foods sold across America will have to carry labels telling people how much artery-clogging trans-fats they contain under new U.S. government regulations issued on Wednesday.
Trans-fatty acids are a component of fat and are found in all animal fats, from meat to butter. They are also made synthetically when food processors harden fat to make it more like butter in a process called hydrogenization.
Found in meat, milk, cookies and fries, trans-fats raise cholesterol, especially "bad" or LDL cholesterol.
"Trans-fats are bad fats. The less trans-fat you and I eat, the healthier we will be," Health and Human Services Secretary Tommy Thompson told a news conference.
He promised more regulation regarding nutrition claims and labeling. "This is just the beginning of a lot more rules and regulations about this. We are moving now very rapidly," Thompson said.
While food labels warn consumers about saturated fats, which also raise cholesterol, there is currently no way to know for sure whether a food contains trans-fats.
The new requirement, which takes effect as of January 2006, comes a year after government advisers at the Institute of Medicine recommended it. It was first proposed in 1999 but HHS and the Food and Drug Administration re-opened the comment period twice.
"Trans-fats can no longer lurk, hidden, in our food choices," said Food and Drug Administration commissioner Dr. Mark McClellan.
GROUPS WELCOME NEW MOVE
The Center for Science in the Public Interest, which has been pressing for labels, said the move "will spur companies to reformulate products and to let consumers know how much of this dangerous and heretofore hidden fat is in packaged foods."
"It will be hard, though, for people to tell if a given number of grams of trans-fat is a lot or a little. Five grams may not seem like a lot, but it is," CSPI nutrition policy director Margo Wootan said in a statement.
McClellan said his agency had no scientific findings to use in recommending a set level of trans-fats in the diet. People should simply aim to eat as little as possible, he said, and should look for words such as "saturated" and "hydrogenated" on labels.
The rule does not apply to restaurants but Thompson said he had also been talking to the restaurant industry. "People all over the industry are beginning to recognize the problem of obesity and overweight Americans," Thompson said.
Manufacturers have already begun making foods without trans-fats, including some soft margarines, cookies, crackers and other products.
"Modern margarine products are significantly reduced in trans-fat as well as overall fat and saturated fat," Keith Keeney, vice president of the National Association of Margarine Manufacturers, said in a statement.
The National Food Processors Association said it was happy with the new requirement.
"This rule's effective date of 2006 will enable food companies to undertake the substantial process of redesigning and relabeling their products within a workable timeframe." Dr. Rhona Applebaum, executive vice president of the NFPA, said in a statement.
Back to the Top
MONDAY, JULY 7, 2003
Macular Degeneration
HealthDay Reporter
Monday, July 07, 2003
(HealthDayNews) -- Macular degeneration, a leading cause of blindness in people over age 55, affects millions of Americans, according to the American Macular Degeneration Foundation.
Here are some ways you can reduce your risk of developing the disorder:
- Eat lots of dark green, leafy vegetables rich in carotenoids, especially spinach and collard greens.
- Protect your eyes from potentially harmful ultra-violet and blue light.
- Antioxidant vitamins and zinc supplements may help.
- Don't smoke.
- Eat a low-fat diet, and avoid junk food.
- Exercise regularly
