The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
March 29, 2004

 

 

 

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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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

Personal Health for the Week of February 14-20

PERSONAL HEALTH

 

Friday, February 20, 2004

  1. Kidney Cancer Vaccine Shows Promise
  2. Science Inches Closer to Regenerating Sight
  3. Cod Liver Oil May Delay Osteoarthritis
  4. Simple Math Might Prolong Your Life

    Thursday, February 19, 2004

  5. Why Obesity Aggravates Blood-Sugar Control

    Wednesday, February 18, 2004

  6. HPV Test May Help Predict Cervical Cancer
  7. New Test Could Fine-Tune Antibiotic Use
  8. Testing for Hereditary Colorectal Cancer
  9. Exercise Need Not Be Painful: Study
  10. Playing, Working Outside Bring UV Risk
  11. Small Babies Augur Later Stillborn Risk
  12. Skin Cancer Surgery Prompts Better Sun Habits
  13. Hospice Care Can Increase Medicare Expenditures
  14. From Eyeglasses to Contact Lenses
  15. Pasta Fights Back Amid Low-Carb Trend
  16. Grieving Children
  17. Special Insoles Prevent Foot Ulcers in Diabetics
  18. Heart Tests Not for Everyone
  19. Wiping Out Stomach Bug Improves Cholesterol Level
  20. Cancer Tumors Clamp Blood Vessels Shut

    Tuesday, February 17, 2004

  21. Cord Blood Cells Transform Into Heart Muscle
  22. Aspirin May Lower Risk of Hodgkin's
  23. Statins Cut Deaths From Heart Failure
  24. Bone Density Declines in Teens with Cystic Fibrosis
  25. What Hurts the Heart Also Hurts the Kidney
  26. More People Creating Gyms at Home
  27. Baby Shows if Insulin Needed for Diabetes in Pregnancy
  28. Tests Suggest Link Between Anger, Smoking
  29. Video Game Content Ratings Not Always to Be Trusted
  30. New Lens Expands Horizons for Cataract Patients
  31. Campaign Helps Kids Get Active: Survey
  32. Marathon Training
  33. Men with Eating Disorders Have Healthy Body 'Ideal'
  34. Testicular Cancer
  35. Brain Scans Used to Monitor Effect of Cancer Drug
  36. Human Mouth Harbors Clues to Fighting Infection
  37. Cholesterol Drugs May Fight Heart Failure Study
  38. Exercise Sharpens Judgment

    Monday, February 16, 2004

  39. Antioxidants Appear to Protect Against Diabetes
  40. Teaching Hospitals Safe Place for Tricky Surgeries
  41. Study Finds Familial Link in Many Cancers
  42. Tests Suggest Some Predisposed to Smoke
  43. Diaper Rash
  44. Antibiotic Use Linked with Breast Cancer Risk
  45. If Parents Smoke
  46. Fitness Can Improve Thinking Among Aging
  47. Alcohol Sensitivity Runs in the Family
  48. More Evidence Vegetarian Diet May Cut Cancer Risk
  49. Your Heart's Health Is in Your Hands
  50. Campbell to Launch Goldfish Minus Transfatty Acids
  51. Heart Trouble Can Start in the Young

    Sunday, February 15, 2004

  52. The Fight Against Osteoporosis Should Start in Childhood

    Saturday, February 14, 2004

  53. Government Computerizes Calorie Plan

Friday, February 20, 2004

Kidney Cancer Vaccine Shows Promise

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Friday, February 20, 2004

FRIDAY, Feb. 20 (HealthDayNews) -- An experimental vaccine for kidney cancer appears to reduce the risk of recurrence and increase survival odds for people with the disease.

The findings, appearing in the Feb. 21 issue of The Lancet, have led the study authors to conclude the vaccine can be considered for patients who have tumors larger than 2.5 centimeters, the group that benefited the most from the vaccine in the study.

Outside experts, however, state that while researchers may be closer to a vaccine for kidney cancer, they still are not there.

"The findings are suggestive, but not conclusive," says Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society (news - web sites) in Atlanta.

While surgery to remove all or part of the kidney is standard practice for this type of cancer, additional treatments such as chemotherapy or radiation have not met with much success. As a result, half of patients will have a recurrence within five years.

On the other hand, there has been a great interest in developing a vaccine for this particular type of cancer because some people have had unexplained response in their tumors even without treatment.

"Kidney cancer has been recognized as a possible target for a vaccine therapy because of the way the cancer itself behaves," Lichtenfeld says. "Some people have had unexplained changes in their tumor, suggesting that the body may in fact be able to recognize kidney cancer." This unexplained behavior has long represented a hopeful window of opportunity for researchers in this field.

Although many studies are ongoing, no cancer vaccines have yet been approved for use. The idea is to take cancer cells (often from the actual patients) and process them in such a way that they can be given back to the patients to help foster an immune response.

The current trial, which used cells from the patients' own tumors, is one of the largest and furthest along of its kind. "As far as I can tell, this is the largest vaccine phase III [final stage] trial for kidney cancer that's been finished and come out," says Dr. Mayer Fishman, an assistant professor of interdisciplinary oncology at the Moffitt Cancer Center of the University of South Florida in Tampa and author of an accompanying commentary.

The study authors analyzed information on 379 patients from 55 medical centers in Germany who had had surgery for cancer of the kidney. Before surgery was performed, all of the participants were randomized to receive a vaccine (six injections in all) or no additional treatment.

More than three-quarters (77 percent) of the vaccine group and 68 percent of the control group survived without a recurrence for five years.

Patients who were at a high risk for recurrence (that is, they had a large tumor size and high tumor grade) had an even greater therapy, although this data was not outlined in the report.

The trial was sponsored by a company, LipoNova of Hannover, Germany, a factor Fishman says may have affected how the data was presented.

The paper did not include overall survival comparisons between the two groups, Fishman points out. "The primary endpoint of the study was not about survival, and the purpose of the paper was not to be the final word about data," he says. "This is an industry-sponsored trial, and every page of that they consider to be proprietary information."

At this point, the findings are specific and limited, experts say.

"We're dealing with a study that has been published that suggests tumor vaccines may work in this situation, but we still have a long way to go in knowing how really effective these vaccines may be in this type of cancer," Lichtenfeld says. "It's similar to other studies that suggest a possible effect, but more research is needed before we can incorporate it into therapy for all kidney cancer."

According to Fishman, the company has already started approval proceedings in Germany, but it's unclear if that will succeed and, even if it does, how the U.S. Food and Drug Administration (news - web sites) will respond.

"I don't think they have enough from this study to get this product approved for this indication," Fishman adds. On the other hand, the company may be using the study to find out what additional specific information the regulatory authorities need before approving the product. "In that sense, that's a reasonable commercial endeavor."

More information

For more on kidney cancer, visit the National Cancer Institute. The American Cancer Society has more on cancer vaccines.

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Science Inches Closer to Regenerating Sight

HealthDayNews
Friday, February 20, 2004

FRIDAY, Feb. 20 (HealthDayNews) -- Using a two-pronged approach to encouraging growth, American scientists say they've made an important advance in regenerating damaged nerve fibers.

A combination of activating nerve cells' natural growth state and using gene therapy to mute the effects of growth-inhibiting factors let them achieve about three times more nerve fiber regeneration than previous attempts, say researchers at Children's Hospital Boston and Harvard Medical School (news - web sites). Results appear in the Feb. 18 Journal of Neuroscience.

The experiments were conducted on the damaged optic nerves of rats.

"When we combined these two therapies -- activating the growth program in nerve cells and overcoming the inhibitory signaling -- we got very dramatic regeneration," Dr. Larry Benowitz, director of neuroscience research at Children's Hospital, says in a prepared statement.

The amount of regeneration wasn't enough to restore the rats' vision. But it was about triple the amount of regeneration achieved by stimulating growth factors alone.

Benowitz says his lab will continue trying to repair damaged optic nerves to restore vision.

"We have to fine-tune the system, and we have some ideas of how to do it," Benowitz says. "But then we come to another big hurdle."

That hurdle is getting the optic nerve fibers to link up to the correct areas in the brain in a way that visual images don't get scrambled.

"It's a mapping problem," Benowitz says. "We have to retain the proper organization of fiber projections to the brain."

More information

To learn more about eye diseases, go to the National Eye Institute .

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Cod Liver Oil May Delay Osteoarthritis

HealthDayNews
Friday, February 20, 2004

FRIDAY, Feb. 20 (HealthDayNews) -- Cod liver oil helps slow the destruction of joint cartilage in people with osteoarthritis, says a British study.

Experts say that could reduce the number of knee and hip replacements done each year and shorten waiting lists for joint replacement surgery.

The study reports that 86 percent of the arthritis patients who took 1,000-milligram capsules of extra-high-strength cod liver oil a day had no levels, or significantly reduced levels, of the enzymes that cause cartilage damage. That compares with 26 percent of the arthritis patients who took a placebo oil capsule for the study.

Those who took the cod liver oil also had a marked reduction in some of the enzymes that cause joint pain, according to the study, by researchers at Cardiff University in Wales.

"This breakthrough is hugely significant because it demonstrates the efficacy of cod liver oil in patients with osteoarthritis taken prior to their joint replacement surgery," researcher Bruce Caterson says in a prepared statement. "The data suggests that cod liver oil had a dual mode of action, potentially slowing down the cartilage degeneration inherent in osteoarthritis and also reducing factors that cause pain and inflammation."

"What these findings suggest is that by taking cod liver oil, people are more likely to delay the onset of osteoarthritis and less likely to require multiple joint replacements later in life," he says.

The study included 31 people in the United Kingdom who were on a national waiting listing for total knee joint replacement surgery. Half of the participants took cod liver oil and half took a placebo for 10 to 12 weeks before their surgery.

During surgery, samples of the patients' cartilage and joint tissue were taken from the knee joint for analysis by the researchers.

More information

To learn more about osteoarthritis, go to the Arthritis Foundation.

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Simple Math Might Prolong Your Life

HealthDayNews
Friday, February 20, 2004

FRIDAY, Feb. 20 (HealthDayNews) -- Warnings about the health dangers of trans fats seem to be everywhere -- and with good reason.

The unhealthiest of all fats, trans fats pose a double threat to your arteries. They raise the level of the bad cholesterol -- low-density lipoprotein (LDL) -- and lower the good cholesterol -- high-density lipoprotein (HDL). They're found in vegetable shortening, some margarines, crackers, candies, baked goods, cookies, snack foods, fried foods, salad dressings and many processed foods, according to the U.S. Food and Drug Administration (news - web sites).

Trans-fat consumption results in at least 30,000 deaths from heart disease each year in the United States, say Harvard School of Public Health researchers.

To help lower your intake of trans fat, the Harvard Women's Health Watch offers the following advice:

  • Read food labels. If a food product lists shortening or hydrogenated or partially hydrogenated oil as one of its first ingredients, that means it contains a lot of trans fat.
  • Do the simple math to figure out trans fat content of foods. Add the polyunsaturated and monounsaturated fats to the saturated fats. Subtract that sum from the "Total Fat" listed on the label. The result equals the amount of trans fat in the product.
  • Pay attention to margarine. The softer margarine is at room temperature, the lower its trans fat content. The best choices are margarines labeled "trans fat-free."
  • Use canola oil or olive oil when frying food. Be careful when eating in restaurants. Foods that are fried in trans fat-laden partially hydrogenated vegetable oil often are labeled as being "cholesterol free" or "cooked in vegetable oil."
  • Make your own food when possible. Commercial breads, soups, cereals, dips, salad dressings and packaged entrees usually have hidden trans fats.

More information

To learn more about food fats, go to the American Heart Association.

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Thursday, February 19, 2004

Why Obesity Aggravates Blood-Sugar Control

By Karen Pallarito
HealthDay Reporter
Thursday, February 19, 2004

THURSDAY, Feb. 19 (HealthDayNews) -- You're overweight and have type 2 diabetes. Your doctor urges you to drop those excess pounds, knowing a leaner you will have a better chance of managing your blood sugar.

Today, scientists may be a bit closer to knowing just why that's so.

A new study on mice, published in the Feb. 20 issue of Science, suggests a fat-derived hormone called resistin may promote insulin resistance, a condition in which the body fails to use insulin properly.

Insulin is the substance that controls blood sugar in the body. When there isn't enough of it or it isn't used effectively, sugar builds up in the blood, starving the cells of the fuel they need for energy.

Mice that don't have resistin are largely protected from insulin resistance, says Dr. Mitchell Lazar, director of the Penn Diabetes Center at the University of Pennsylvania and one of the study's authors.

If resistin plays a similar role in humans, the authors say, this finding could lead to new ways to diagnose and treat people with type 2 diabetes.

"We might be able to really make an impact on insulin resistance and, therefore, on diabetes," Lazar says.

About 17 million Americans have type 2 diabetes, according to the American Diabetes Association. The disease frequently goes undiagnosed yet poses serious and life-threatening complications such as blindness, kidney disease, heart disease and stroke.

Carrying extra body fat puts people at increased risk. About 80 percent of adults with type 2 diabetes are overweight, according to the National Diabetes Information Clearinghouse.

Perhaps not surprisingly, the nation's diabetes epidemic tracks a dramatic rise in obesity among adults and children in the United States. Almost two-thirds of adults are overweight or obese and about 15 percent of children and adolescents ages 6 to 19 are overweight, according to the U.S. Centers for Disease Control and Prevention (news - web sites), based on the 1999-2000 National Health and Nutrition Examination Survey.

In 2001, Penn scientists first reported the existence of a hormone produced by fat cells that seemed to promote insulin resistance. They christened it "resistin," suggesting resistance to insulin.

In the current study, the Penn team bred mice without resistin and compared their blood sugar regulation with mice possessing the hormone. Both groups of rodents gained weight on a high-fat diet, but glucose tolerance was significantly better in the resistin-free mice. Those lacking resistin also had lower fasting blood glucose levels than normal mice.

Lazar believes resistin may have played an important role in evolution, helping to keep blood sugar normal during periods of fasting. With obesity, he says, resistin may get out of whack and contribute to difficulties handling blood glucose.

Dr. Richard Hellman, medical director of the Heart of America Diabetes Research Foundation, says the study is interesting, particularly in light of a growing body of research examining the function of fat cells and fat metabolism.

"What it doesn't say is how this extrapolates to humans," Hellman observes. Nor does it say how important resistin is within the hierarchy of factors that could be contributing to insulin resistance, he adds.

Translating the results to people becomes tricky, Lazar explains, because resistin in humans is expressed mainly by white blood cells, not fat cells as in mice.

"It may not be coming from fat cells but still may be an important link between obesity and insulin resistance in people," he says.

More information

To learn more about insulin resistance, visit the National Diabetes Information Clearinghouse. For more on type 2 diabetes, go to the American Diabetes Association.

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Wednesday, February 18, 2004

HPV Test May Help Predict Cervical Cancer

HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- Testing for human papillomavirus (HPV) can help identify potential cases of cervical cancer, according to a report in the Feb. 18 issue of the Journal of the National Cancer Institute (news - web sites).

Belgian researchers reviewed data from 15 studies and concluded that, compared with a repeat Pap smear, a test for HPV infection enables a more accurate prediction of whether a woman with an equivocal cervical abnormality found on a Pap smear is likely to develop invasive cancer.

The studies were done on women with atypical squamous cells of undetermined significance (ASCUS), one of the most common cervical abnormalities.

This new study found that HPV testing accurately identified 84.4 percent of women with ASCUS who had high-grade cervical intraepithelial neoplasia (CIN2) or worse. With CIN2, abnormal cell growth on the surface of the cervix has the potential to become cancerous.

HPV testing accurately ruled out CIN2 or worse in 72.9 percent of women with ASCUS, according to the report.

When the Belgian researchers looked only at studies that used a recently developed test for HPV, called the Hybrid Capture II assay, they found that HPV testing was 94.8 percent accurate in identifying women with CIN2 or worse and 67.3 percent accurate in ruling out CIN2 or worse.

A repeat Pap smear accurately identified 81.8 percent of women with CIN2 or worse and was 57.6 percent accurate in ruling out CIN2 or worse.

More information

To learn more about cervical cancer, visit the American Cancer Society online.

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New Test Could Fine-Tune Antibiotic Use

By Emma Ross
AP Medical Writer
Reuters Health
The Associated Press
Wednesday, February 18, 2004

LONDON - A blood test could help doctors determine whether antibiotics are needed for common respiratory infections and may reduce the over-prescribing that creates drug-resistant germs, new research suggests.

About 75 percent of all antibiotics are given for lower respiratory tract infections such as bronchitis and pneumonia. Most of these infections are caused by a virus, not bacteria. Experts say antibiotics are not only useless against viral infections, but also help bacteria evolve defenses against drugs.

The new test, described this week in The Lancet medical journal, measures blood levels of a chemical marker that is elevated in bacterial infections but not so high when the cause is a virus. It yields results within an hour.

"This looks very promising," said Roy Anderson, an expert on antibiotic resistance at Imperial College in London. "Cutting the overuse of antibiotics is crucial to combatting antibiotic resistance."

Anderson, who was not connected with the study, said current tests are too expensive and cumbersome to be practical for use by family doctors.

"What you want eventually is a kind of quick and easy dipstick test that can tell you right away. It needs refining, but something like this could evolve into a dipstick where it turns one color for a positive and another color for a negative," he said.

The study involved 243 patients treated at the University Hospital in Basel, Switzerland, for suspected lower respiratory tract infections.

Half the patients got the standard care, which usually included a physical examination, temperature check and chest X-ray, while the others got standard care plus the blood test.

In both groups, the decision on prescribing antibiotics was left to doctors. However, in the blood test group, the doctors had to decide on prescribing antibiotics before learning the blood test results.

After the blood test results were revealed, the researchers then advised the doctors to prescribe antibiotics only if the blood level of the chemical marker, called procalcitonin, was above a certain level.

The rate of antibiotic prescriptions foreseen by the doctor was similar in both groups before the blood test results were disclosed.

But once test results were known, antibiotic prescriptions dropped almost in half. A total of 99 patients in the comparison group got antibiotics, compared with 55 in the blood test group.

Antibiotics were given to 22 patients with a blood test showing low levels of the chemical marker. Doctors often prescribe antibiotics to people with severe viral infections because viruses can damage the airways enough to encourage a subsequent life-threatening bacterial infection.

"Importantly, withholding antibiotic treatment was safe and did not compromise clinical and laboratory outcome," said the study, led by Dr. Beat Muller at the University of Basel.

Dr. Marc Siegel, a professor of medicine at New York University School of Medicine, said the study convinced him the procalcitonin marker may help doctors, but larger studies are needed to determine if it is safe to withhold antibiotics from high-risk patients.

The danger of missing a severe or progressing bacterial infection is too great to rely solely on the blood test, Siegel said. "You worry about antibiotic resistance, but you also worry about patients dying," he said.

On the Net:

U.S. FDA (news - web sites) on antibiotic resistance:

http://www.fda.gov/oc/opacom/hottopics/anti_resist.html

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Testing for Hereditary Colorectal Cancer

HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- Revised criteria for testing for a hereditary type of colorectal cancer have been issued by a group of international experts.

The revised Bethesda Guidelines, which appear in the Feb. 18 issue of the Journal of the National Cancer Institute (news - web sites), should help doctors determine if a patient's colorectal cancer is a specific form that is inherited, which may mean the person's family members have an increased risk of the disease.

Hereditary nonpolyposis colorectal cancer (HNPCC) usually occurs in people younger than age 45. It can lead to development of cancers in a variety of tissues, including the colon, rectum, endometrium, stomach, ovaries, brain and skin.

HNPCC results from inherited genetic mutations. That means that family members of people with HNPCC also may have the genetic characteristics that put them at increased risk for cancers.

A major genetic characteristic of HNPCC tumors is the instability of short repeated sequences of DNA known as microsatellites. This instability occurs when mutations in genes responsible for repairing damaged DNA cause microsatellites to become longer or shorter.

The revised criteria suggest that tumors from colorectal cancer patients should be tested for this instability. Subsequent genetic testing, to confirm a mutation in one of the genes responsible for colorectal cancer, is recommended if:

  • The patient is younger than age 50;
  • The patient has multiple tumors in the colon or in other areas known to be caused by the same mutations, either at the same time or occurring over a period of time;
  • A patient younger than age 60 has colorectal cancer that has microscopic characteristics indicative of the DNA instability;
  • The patient has at least one first-degree relative who had colorectal cancer at age 50 or younger;
  • The patient has at least two first- or second-degree relatives who had HNPCC-related tumors at any age.

More information

To learn more about colorectal cancer, visit the National Cancer Institute online.

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Exercise Need Not Be Painful: Study

By Merritt McKinney
Reuters Health
Wednesday, February 18, 2004

NEW YORK (Reuters Health) - "No pain, no gain" may be the mantra of coaches everywhere, but it's bad advice for most exercisers, research suggests.

In a new study, pain or displeasure was the most accurate indicator that a person had crossed a threshold believed to be the optimum level of exercise.

"As astonishingly simple as it sounds, perhaps the most appropriate level of exercise intensity for health-oriented exercise is the intensity that does not feel unpleasant," lead author Dr. Panteleimon Ekkekakis of Iowa State University, Ames, told Reuters Health.

Ekkekakis noted that it is natural for people not to want to continue doing things that are consistently unpleasant or uncomfortable.

"People will go to the gym after New Year's resolutions, but, if exercise hurts the first few times, after a while they will opt to stay home and watch TV," he said.

Most Americans could benefit from more physical activity, but Ekkekakis said that most people are not very good about estimating how hard they are exercising. People often do more or less than what is recommended, he said.

People who do too little miss out on the full benefits of exercise, but those who do too much may become exhausted and give up.

Ekkekakis explained that there is a specific level of exercise intensity that seems to be appropriate for a wide variety of people. This intensity corresponds to the level of the transition from aerobic to anaerobic metabolism--when the body switches over from burning fuel from aerobic (with oxygen) to anaerobic (without oxygen) sources.

This level of intensity is desirable for several reasons, including the fact that previously sedentary middle-aged and older people seem to get the same benefits at or just below this level than when they exercise at a higher intensity, Ekkekakis said. In addition, people who exercise significantly above this threshold quickly run out of steam.

People are often told to gauge their exercise intensity by measuring their heart rates, but this can be inconvenient, according to Ekkekakis. Another method of measuring exercise intensity involves rating a person's perceived exertion level, but doing this can be tricky, the Iowa researcher noted.

Ekkekakis' team set out to determine the best way to know when a person has reached this exercise threshold. The researchers believed that if a person exceeded the level of the aerobic-anaerobic transition, "that's precisely the point where they will start feeling gradually worse," Ekkekakis said.

"This is exactly what we found in the two samples of college students we tested," he said.

In two groups of 30 students who underwent exercise testing, feelings of pleasure and displeasure were more accurate than heart rate and other measures at determining the aerobic-anaerobic transition, the researchers report in the February issue of the journal Preventive Medicine.

For people who are just starting an exercise program, particularly those who are overweight, the intensity that corresponds to their individual aerobic-anaerobic transition may be very low, "perhaps not faster than a stroll," Ekkekakis said.

He added, "It is important that they stick to the intensity that feels comfortable rather than trying to match cultural expectations of what exercise should look like or feel like to be effective."

Preventive Medicine, February 2004.

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Playing, Working Outside Bring UV Risk

HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- A person's sun exposure correlates with the dose of ultraviolet radiation (UVR) they receive, says a Danish study in the February issue of the Archives of Dermatology (news - web sites).

UVR exposure is a risk factor for skin cancer.

The study included 285 Danish volunteers, aged 4 to 68, who wore a special device called a dosimeter that measured their UVR exposure while they were outdoors. The dosimeter readings were collected in segments over a three-year span.

The results showed indoor workers received the least UVR exposure and gardeners had the most exposure. Girls received more estimated UVR than boys. Sunbathing and going to the beach increased UVR exposure, and teenagers and children received more than half their total UVR exposure while they were at the beach.

Half of the UVR exposure received by people in the study was measured between noon and 7 p.m.

More information

The American Cancer Society (news - web sites) has more about ultraviolet radiation.

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Small Babies Augur Later Stillborn Risk

By Jeff Donn
Associated Press Writer
The Associated Press
Wednesday, February 18, 2004

BOSTON - Women who give birth to small babies whether prematurely or not are more likely to have stillborns during their next pregnancy, a study found.

The Swedish study, published in Thursday's New England Journal of Medicine (news - web sites), suggests that the same causes may underlie both stillbirths and stunted growth in fetuses.

However, since so little can be done about many growth problems, the study is not expected to bring about any big changes in obstetrics.

The researchers used a national registry with 410,021 women who had two consecutive pregnancies resulting in live or stillbirths.

Women who had small but full-term babies ran double the risk of a stillbirth in their next pregnancy.

Preterm newborns raised the later risk of a stillbirth only if they were also small for their fetal age. The risk of a later stillbirth was five times higher if the newborn was both very small for its fetal age and very early in its delivery before 32 weeks.

Newborns who were in the bottom 2.5 percent in size at a given stage of development were considered small for their fetal age.

Though small newborns heightened the risk of later stillbirths, the overall rate of stillbirths for the second pregnancy was low at 2.6 per 1,000 births. Even in the highest risk group, there were only 19 stillbirths per 1,000 births.

Infections, respiratory problems, congenital defects and other factors can cause stillbirths. This study did not consider the causes of the stillbirths, so it is not clear exactly which ones stillbirths and small-for-fetal-age births may share.

A probe called Doppler ultrasound can show blood flow in a fetus and point to possible nutritional problems and stunted growth at an early stage of development.

However, the study leaves doctors in a bind over whether to induce delivery of very preterm babies with serious growth problems. An early delivery could save the child from stillbirth but put it at risk by such an early birth.

"If you have a baby that may be suffering 14 weeks prior to delivery, how to you deal with this one? I don't think anybody knows," said one of the researchers, Dr. Sven Cnattingius of the Karolinska Institute in Stockholm.

However, pediatrician Dr. Mark Klebanoff, a researcher at the National Institutes of Health (news - web sites) who co-wrote an accompanying commentary, said the study should at least help doctors and women judge the magnitude of risk for stillbirths.

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Skin Cancer Surgery Prompts Better Sun Habits

HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- People who've had surgery to remove skin cancer are more likely to protect themselves from the sun than they were before their surgery.

That newfound common sense is detailed in a study in the February issue of the Archives of Otolaryngology.

Medical College of Wisconsin researchers studied whether there was a change in quality of life for 121 people after they had surgery to remove nonmelanoma skin cancer and whether those individuals changed their sun-protection habits and other risky behaviors, such as smoking, after their surgery.

The people were surveyed a month after surgery and again at four months.

The study found that, overall, there was little change in the people's general quality of life after surgery, but there was a significant improvement in their mental and emotional health. Many people started taking steps to protect themselves from the sun, such as using sunscreen and wearing hats. But there wasn't much change in their smoking habits.

Forty-nine percent of those surveyed had used sunscreen before surgery, and 72 percent used sunscreen one month after surgery. The number of people wearing hats outside increased from 67 percent before surgery to 74 percent after surgery, and those avoiding the sun increased from 20 percent to 44 percent.

More information

The American Academy of Family Physicians (news - web sites) has more on how to protect your skin from the sun.

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Hospice Care Can Increase Medicare Expenditures

By Will Boggs, MD
Reuters Health
Wednesday, February 18, 2004

NEW YORK (Reuters Health) - Rather than decrease costs, hospice care appears to increase Medicare expenditures in the last year of life for younger patients without cancer and for all patients older than 84 years, according to a report in the Annals of Internal Medicine.

Changes in the Balanced Budget Act of 1997 encouraged hospice enrollment for Medicare beneficiaries, especially for patients without cancer, the authors explain. How these changes affected the costs to Medicare has not been examined.

Dr. Joanne Lynn from The Washington Home Center for Palliative Care Studies, Washington, DC, and colleagues estimated the effects of hospice enrollment on national Medicare expenditures during the last year of life among elderly Medicare fee-for-service beneficiaries who died between 1996 and 1999.

Overall expenditures averaged 4 percent higher for the hospice participants than for other Medicare beneficiaries, the authors report. Costs were about 11 percent higher among non-cancer participants, but about 1 percent lower among cancer participants.

Medicare costs were about $2579 more for the average hospice enrollee without cancer than for the average non-enrollee, the report indicates, whereas Medicare costs were about $648 less for the average hospice enrollee with cancer than for the average non-enrollee.

Cost savings were especially notable among cancer enrollees between 68 and 79 years of age ($1703), the researchers note, but costs were higher among cancer enrollees over 84 years old ($1193).

Among non-cancer patients overall, the estimated savings for hospital inpatient, skilled-nursing facility, outpatient facility, and physician or supplier services did not offset the hospice costs and increased spending for home health care among hospice enrollees, the results indicate.

"We need to build comprehensive approaches to support people living with serious, eventually fatal, chronic conditions," Lynn told Reuters Health. "Those approaches need to use the principles of hospice, but probably will need to rearrange the exact services and costs."

Lynn noted that the median length of survival with serious chronic illness now is more than two years. "We need to figure out how to help people to live comfortably and meaningfully in that time," she said.

"Hospice is a part of a good care system," Lynn stressed. "Exactly what part will require serious research on health care delivery, aiming to learn what would work for all of us, at a reasonable cost."

Source: Annals of Internal Medicine, February 17, 2004.

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From Eyeglasses to Contact Lenses

HealthDayNews
Wednesday, February 18, 2004

(HealthDayNews) -- If you're trading in your eyeglasses for contact lenses, make sure each lens is the correct prescription strength and the right fit for your eye, advises Missouri Baptist Hospital-Sullivan.

Even if you can see clearly through them, ill-fitted lenses can cause serious microscopic changes in the delicate tissues at the front of your eye.

When fitting you for contact lenses, your eye-care specialist should:

  • Measure your eyes.
  • Examine them under a high-powered microscope.
  • Train you to insert, remove, and care for your contact lenses.

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Pasta Fights Back Amid Low-Carb Trend

By Tom Rachman
Associated Press Writer
The Associated Press
Wednesday, February 18, 2004

ROME - At a recent point in dining history, pasta perception spun around like spaghetti on a fork. Suddenly, noodles transformed from the diner's saucy delight to carb villains bound for the hips, buttocks and belly.

America's battle against pudginess inspired of late by the low-carb ethics of the Atkins, Zone and South Beach diets has trashed pasta. But defenders of macaroni and its floppy kin rebelled in Rome this week at a conference promoted as "Pasta Fights Back."

Their weapons at the three-day meeting that ended Wednesday were science, lectures and delectable plates of pasta handed out free to attendees. Another popular dish was denunciation of the latest American diet trend.

"How is it that it can be called a low-carb diet when in fact it is a dangerous high-fat diet? How can that happen in our culture?" railed K. Dun Gifford, president of the Oldways Preservation Trust, the Boston-based food issues think tank that organized the event.

One impassioned speaker called for a swift death to the Atkins Diet. Another skeptically cited 28 eating fads of recent years, among them the Caveman Diet, the Sex Diet and the Russian Air Force Diet. A third speaker recalled Sophia Loren's remark: "Everything you see, I owe to pasta."

The conference, officially titled "Healthy Pasta Meals," included numerous eminent scientists and was sponsored by Italian government ministries, pasta giant Barilla and the makers of Parmesan cheese, among others.

The executive chef of New York's Union Square Cafe, Michael Romano, flew in to cook. Prepping vegetables at the luxury hotel where the conference was held, Romano worried about the way Americans eat ... and eat.

"People want to eat from the time they get up till the time they go to sleep. And by the way, no exercise, please," Romano said. "It's all about proportion, it's all about balance."

The conference offered multi-course lunches wetted with appropriate Italian wines, of course featuring pasta specialties from all over Italy. A gala dinner, titled "The Glorious Healthy Pasta Meal," included spaghetti with tomatoes and air-dried tuna, flaked Parmesan drizzled with balsamic vinegar, lentil soup with scampi, and roast lamb with fava beans and egg lemon sauce.

Oldways argues that eating must be balanced not overloaded with fat and protein, nor heavy with carbohydrates. The Mediterranean diet, including fish, fruit, vegetables, breads, rice and pasta, is promoted above all.

Pasta, Oldways says, is an ideal delivery system for healthy ingredients: The carbs in high-quality pasta made from durum wheat are converted slowly into glucose, which has the benefit of more stable insulin levels, and keeps the eater feeling full longer.

John Foreyt, a professor at Baylor College of Medicine in Houston, noted that Italians have enjoyed the health benefits of pasta for over 1,000 years.

"Pasta has been wrongly injected into the good carb/bad carb debate, and we want to dispel the notion that it should be avoided," he said in the conference's closing statement.

Conference organizers acknowledge that low-carb, high-fat diets do produce short-term weight loss, but fear they could also increase the long-term risk of grave illnesses such as cancers and heart disease.

Evidence of this is hotly debated in scientific circles. Research suggests people have the best chance of avoiding heart disease, high blood pressure and cancer if they eat a varied diet with plenty of fruits, vegetables and grains.

Whatever the debate, no one can deny the low-carb diets' success.

Many dieters have enjoyed considerable weight loss through regimens that are heavy in meat, cheese and eggs and ultralight in carbs. Millions of Americans are on some form of these diets, and restaurants and food manufacturers are scrambling to offer low-carb products.

And recent studies showed these diets have success over short periods without serious health consequences.

Colette Heimowitz, the Atkins organization's research director, denied that the Atkins Diet is risky or a fad. "It's amazing how Atkins is blamed for everything," she said by phone from New York.

"If people could have moderation in everything that'd be wonderful," Heimowitz said. "We wouldn't have this discussion. But people won't, they don't, they can't. They need other options to reach their weight goals."

At the Rome conference, a little mournfulness was stirred in with dietary advice.

Cookbook writer Susan Herrmann Loomis expressed sadness about the U.S. attitude toward eating.

"Americans come with this enormous fear of what is on their plates, and it translates into fad diets," she said. "Unfortunately, that rarely has to do with just enjoying the heck out of what you're doing."

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Grieving Children

HealthDayNews
Wednesday, February 18, 2004

(HealthDayNews) -- When a family member dies, children react differently than adults. Some may act like nothing has changed, others may become more infantile, and certain kids will even blame themselves.

But how do you know whether your child's behavior is normal or something more serious?

According to Barnes Jewish Hospital, if your child shows one or more of the following signs, professional help may be needed:

  • An extended period of depression in which your child loses interest in daily activities or events.
  • Inability to sleep, loss of appetite, prolonged fear of being alone.
  • Acting much younger than actual age for an extended period.
  • Excessively imitating the dead person.
  • Repeated statements of wanting to join the dead person.
  • Withdrawal from friends.
  • Sharp drop in school performance or refusal to attend school.

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Special Insoles Prevent Foot Ulcers in Diabetics

Reuters Health
Wednesday, February 18, 2004

NEW YORK (Reuters Health) - Compared with regular shoes, therapeutic footwear insoles of various types prevent foot ulcers in patients with diabetes, according to the results of a new study from India. As a result, the need for amputation could be reduced.

As described in the medical journal Diabetes Care, Dr. Vijay Viswanathan, of the Hospital for Diabetes and Diabetes Research Center in Royapuram, and colleagues compared the effectiveness of different types of footwear insoles in 241 diabetic patients with previous foot ulcers and those considered at high risk for foot ulcers.

On average, the patients were 58 years old and had been living with diabetes for 12 years. One hundred of them were given sandals with insoles made with microcellular rubber, 59 were given sandals with polyurethane foam, 32 were provided with molded insoles, while the remaining 50 used their own footwear containing leather board insoles.

After 9 months of follow-up, the investigators found that patients using therapeutic footwear had significantly lower foot pressures than the regular-footwear group.

The rate of new ulcers in the regular-footwear group was 33 percent, much higher than the 3 to 4 percent rates seen in the groups wearing special insoles, the authors report.

They conclude: "Use of this footwear is recommended to reduce ulceration and, consequently, the amputation rate in the diabetic population."

Source: Diabetes Care, February 2004.

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Heart Tests Not for Everyone

By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- A federal task force now says that three tests commonly used to detect heart trouble are not recommended for people at low risk for cardiovascular problems who aren't showing any signs of disease.

New guidelines for the tests -- treadmills, resting electrocardiograms (EKGs) and electron beam computerized tomography scans for coronary calcium -- appear in the Feb. 17 issue of the Annals of Internal Medicine. The new recommendations, by the U.S. Preventive Services Task Force, replace ones issued in 1996.

"If you are a low-risk adult with no symptoms, there is really no reason to experience these tests," says Dr. Ned Calonge, the task force chairman. "We do not recommend them because of the risk of false positives."

Calonge, chief medical officer and state epidemiologist for the Colorado Department of Public Health (news - web sites) and Environment, says that false-positive results usually lead to further invasive tests such as coronary angiography or treatment with unnecessary medications.

The task force defines those generally considered at low risk for heart disease as men under age 50 and women under age 60 who have normal blood pressure and cholesterol levels, do not smoke and do not have diabetes.

Even for adults at increased risk for heart disease, the task force found insufficient evidence for or against using these three tests for screening.

Under the 1996 recommendations, the task force had said there was insufficient evidence for screening low-risk adults and for those at increased risk, explains Dr. Paul Frame, a member of the task force and a clinical professor of family medicine at the University of Rochester School of Medicine and Dentistry in New York.

So, the new recommendations reflect a stronger stance against screening those at low risk, Frame says.

Electron beam scanning was not evaluated in the 1996 guidelines.

An estimated 22 million Americans have heart disease, according to the task force, and more than 700,000 die from it annually.

An exercise stress test gives a general idea of how healthy your heart is. While you walk on a treadmill or pedal a stationary bike, the electrical activity of your heart is measured, as is your heart's reaction to your body's increased demand for oxygen.

A resting electrocardiogram records electric currents produced by the heart, and an electron beam computerized tomography scan is an imaging procedure that can detect blocked or clogged arteries.

The new guidelines make sense to Dr. Victor Froelicher, director of the EKG and exercise lab at the VA Medical Center in Palo Alto, Calif.

"This guideline now includes one of the newest screening tools [electron beam scans], which in consensus has been agreed on to offer no additional benefit in a low-risk population," he says.

More information

For a summary of the new recommendations, visit U.S. Preventive Services Task Force. For a calculator to estimate risk of heart disease, check out the National Heart, Lung, and Blood Institute.

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Wiping Out Stomach Bug Improves Cholesterol Level

Reuters Health
Wednesday, February 18, 2004

NEW YORK (Reuters Health) - Taking drugs to destroy a common stomach microbe called Helicobacter pylori can increase blood levels of HDL "good" cholesterol, new research shows. In theory, this could reduce a person's chances of having a heart attack or stroke.

Previous studies have suggested a link between H. pylori infection and heart disease, Dr. Hubert Scharnagl, of the University of Graz in Austria, and colleagues note in the American Journal of Cardiology. "We recently reported that chronic H. pylori infection coincides with low HDL cholesterol."

The researchers assessed changes in the cholesterol levels of 87 patients who were placed on anti-H. pylori drugs as a treatment for intestinal ulcers.

Eradication of H. pylori was associated with a significant increase in HDL cholesterol, according to the investigators. Total cholesterol levels also rose, but this increase was overshadowed by the rise in HDL cholesterol.

Scharnagl and colleagues point out that the increase in HDL Is "at least as strong" as that commonly seen in patients treated with statins, which includes drugs like Zocor and Lipitor (news - web sites).

Source: American Journal of Cardiology, January 15, 2004.

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Cancer Tumors Clamp Blood Vessels Shut

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Wednesday, February 18, 2004

WEDNESDAY, Feb. 18 (HealthDayNews) -- Scientists have now shown that cancer tumors actually clamp internal blood vessels shut, making it difficult for anti-cancer drugs traveling through those vessels to hit home.

Counteracting this might make it easier for the drugs to get where they need to go, but it also might open up another avenue for cancer cells to spread, the researchers warn.

Drug delivery can indeed be a problem in some cancer patients, says Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in New Orleans. Lack of adequate blood flow can also be a big issue for radiation therapy, which requires oxygen to get to the tumor, he adds.

"For many years, we've realized that tumors have areas where there are dead cells or blood cells don't adequately feed the centers," says Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society (news - web sites) in Atlanta. "We've been trying to find out what we can do to improve oxygenation and therapy directed at cancers by trying to overcome these areas of low oxygen that are present in cancers. It seems intuitive, but this is an actual laboratory demonstration."

The demonstration was done with mice, however, which means that much more research needs to be done before scientists can begin to know what the implications are for humans.

Rakesh K. Jain, director of the Steele Laboratory at Massachusetts General Hospital and the lead author of a brief communication on the discovery in the Feb. 19 issue of Nature, likens the process to a garden hose lying on the driveway.

If you drive the wheels of the car on top of the hose, the water flow will stop. "That's exactly what cancer cells do to vessels," he says. "They compress many of the blood vessels by proliferating around them."

While Jain, who is also a professor of tumor biology at Harvard Medical School (news - web sites), and his colleagues had long suspected this might be the case, they lacked a way to prove it. They needed a drug that would kill only cancer cells and not blood vessel cells.

"If I could kill cancer cells around the blood vessels, then the vessels should open up," Jain says.

Eventually, the researchers decided to graft human cancer cells into mice, then treat them with diphtheria toxin, a drug that kills human cells while sparing mouse cells.

As expected, the tumor cells started to die off and the blood vessels started to open up and become functional again.

But something unexpected also happened (or didn't happen). "The surprise came with the lymphatic vessels," Jain says.

The job of the lymphatic vessels is to drain fluid from organs and tumors. In this model, the lymphatic vessels opened up, but they didn't start functioning again.

"Apparently, the tumor is somehow irreversibly damaging lymphatic vessels so they are unable to function," Jain says. "We do not yet know how this is happening."

There is another unanswered question: Will restoring blood flow also allow cancer cells to escape and migrate to other parts of the body? "It might also be able to carry cancer cells out and contribute to metastasis," Jain says. "We don't know that yet. That's a worry."

The study itself is quite preliminary, and not all tumors behave the same way.

"This is a very experimental setting, but there's a whole biology of relationships between blood vessels and lymphatic control with tumors that we're going to be studying and hopefully exploiting," Brooks says.

More information

The National Cancer Institute has more on cancer metastasis. The American Cancer Society has information on bone metastasis.

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Tuesday, February 17, 2004

Cord Blood Cells Transform Into Heart Muscle

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- For the first time, scientists have shown that cord blood cells from a donor were present in the failing organs of a recipient.

Cord blood cells are stem cells that come from the umbilical cord blood and placenta after birth. They are used in medicine in much the same way as bone marrow but with a smaller chance of rejection.

In this case, the cord blood cells had actually transformed into heart muscle cells called myocytes.

Although the data does not prove the cord blood cells actually stopped heart damage from progressing, the findings are compelling.

"It gives a correlation that this could be what's happening to help stop the progression," says Kirsten Crapnell, a post-doctoral researcher in the Pediatric Bone Marrow and Stem Cell Transplant Program at Duke University Medical Center. "There have been lots of studies in animal models. They have observed the same phenomenon. This is the first time we've seen it with cord blood in humans."

Crapnell will present the research at the International Association of Bone Marrow Transplantation Research meeting being held this week in Orlando.

The findings have caught the attention of experts.

"It helps the field," says Paul Sanberg, director of the University of South Florida Center for Aging and Brain Repair in Tampa. "That's what we've seen in animals."

The type of research represented here is difficult, if not almost impossible, to do.

Researchers had noticed that, in many children with metabolic disorders, transplants stopped the progression of the damage to the organs.

The boy who was the centerpiece of this study had a disorder called Sanfilippo Syndrome B in which an enzyme needed to break down complex sugars was missing. Without the enzyme, sugar byproducts accumulate in and damage vital organs such as the liver, heart and brain.

The cord blood transplant was intended to help the boy to produce the needed enzyme.

Ironically, the success of the treatment undermines other research. "Because the children are doing so well, we can't biopsy the heart," Crapnell says.

In this case, however, the boy died of an infection so Crapnell was able to dissect and analyze heart tissue. Using a series of stains, she was also able to differentiate between cells that came from the donor and cells that came from the patient.

"There was a sex mismatch. The donor was a female and the patient was male. By using this fluorescent technique, I could distinguish the difference between male and female cells," Crapnell explains. "Then, on top of that stain, I did a surface stain to show that they were indeed myocytes and not blood cells."

A similar process might be happening in the brain, Dr. Jennifer Hall, another Duke researcher who is presenting at the same meeting, says in a statement.

The problem is that it takes time for the transplanted cells to travel to the brain from the bloodstream. If there was a way to begin differentiating the cells into brain cells before delivering them to the organ, there might be a chance to reduce the amount of damage.

Hall found that a type of stem cell (hematopoietic stem cells) appeared able to start differentiating into brain cells called oligodendrocytes in a test tube.

This may potentially aid in the treatment of spinal cord injuries and multiple sclerosis.

The area begs for more research, which could be difficult. "We need to evaluate more children, but we don't want them to die. So luckily there are none to evaluate," Crapnell says.

"It's a big step toward the next step, which is how can you treat these disorders," Sanberg says. "We don't even know if it stopped the damage."

Other groups, including Sanberg's, are investigating whether cord blood can be used to treat heart attacks in animals.

And from there, what's next?

"Experiments are going forward and one can imagine that one day we'll be squirting certain cells into our joints and we won't need joint replacement because the cartilage will regrow. Or we'll squirt cells into coronary arteries that will lodge in the damaged area and will differentiate into muscle cells," says Dr. Richard K. Shadduck, director of the Western Pennsylvania Cancer Institute in Pittsburgh. "It's an exciting area. In essence, it can be thought of as regenerative medicine."

Also presenting findings at the transplantation research meeting is another team of Duke researchers, who have identified immune system differences that make certain children more prone to die of viral infections after cord blood transplants.

The researchers are using their findings to bolster cord blood's ability to mount an effective immune response.

More information

For more on cord blood cells, visit the Cord Blood Donor Foundation or the National Marrow Donor Program.

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Aspirin May Lower Risk of Hodgkin's

By Lauran Neergaard
AP Medical Writer
The Associated Press
Tuesday, February 17, 2004

WASHINGTON - Regular use of aspirin might lower the risk of Hodgkin's disease, scientists reported Tuesday.

More research is needed to prove whether the link is real.

Even if it is, Hodgkin's disease is too rare a cancer to ever recommend aspirin as a preventive, scientists caution. After all, the pills have side effects. Instead, the research may point toward better understanding of how this cancer forms, which then might lead to better treatment.

Millions of Americans already take low-dose aspirin to help prevent heart attacks, and studies suggest it also may modestly lower the risk of a few cancers, most notably colon cancer.

Scientists at the Harvard School of Public Health uncovered aspirin's possible connection with Hodgkin's a lymph system cancer diagnosed in 7,600 Americans each year while studying what role a certain virus plays in the malignancy.

To hunt risk factors, they matched 565 Hodgkin's patients with people of similar age and demographics who didn't have the cancer.

Those who regularly used aspirin the equivalent of two or more regular-strength tablets a week for five years had a 40 percent lower risk of Hodgkin's, researchers reported Tuesday in the Journal of the National Cancer Institute (news - web sites).

Hodgkin's disease is linked to inflammation. Aspirin not only calms inflammation, but it is thought to inactivate a protein, called a transcription factor, which is important for Hodgkin's cells to survive, said epidemiologist Ellen Chang, the study's lead author.

Other painkillers don't affect that protein, and the study found no benefit from other anti-inflammatory painkillers, such as ibuprofen.

However, acetaminophen is a different type of painkiller, and the study found risk of Hodgkin's was actually 70 percent higher among regular acetaminophen users.

The researchers caution consumers not to be frightened by the acetaminophen finding, because they're concerned it could be wrong. The Hodgkin's patients may have used acetaminophen because of early symptoms of their cancer, thus mixing up the research, Chang said.

"There's no clear biologic reason why acetaminophen would be associated with higher Hodgkin's disease risk," said Chang, now with Sweden's Karolinska Institute.

But "it makes sense that aspirin could be associated with lower Hodgkin's risk" because "aspirin has this unique property" of transcription-factor inactivation, she said.

The study raises an interesting hypothesis about aspirin, but just how strong a role the transcription factor plays is controversial, said Dr. Ernest Hawk of the National Cancer Institute.

"Even if it is confirmed, these results do not mean that anybody should take aspirin to prevent cancer," stressed American Cancer Society (news - web sites) epidemiologist Eric Jacobs. After all, aspirin can have some serious side effects, including bleeding and digestive ulcers.

Both cancer specialists downplayed the acetaminophen finding.

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Statins Cut Deaths From Heart Failure

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- Widely used cholesterol-lowering drugs called statins may also benefit people with heart failure, new research shows.

A study appearing in the Feb. 18 issue of the Journal of the American College of Cardiology found statins reduced the mortality rate in patients with heart failure by 55 percent.

About 5 million Americans suffer from heart failure, which occurs when the heart muscle has been damaged or weakened as a result of conditions such as long-term blood pressure, coronary artery disease or a previous heart attack. This weakened condition makes it hard for the heart to pump enough blood to other areas of the body.

"Heart failure traditionally has a very high mortality rate," says lead investigator Dr. Gregg Fonarow, Eliot Corday chair of cardiovascular medicine and science at the University of California at Los Angeles.

Although three classes of medications have been shown to help lower the risk of mortality, the risk remains high and experts are continually looking for new treatments, Fonarow adds.

Statins are already known to reduce death rates in people who have coronary artery disease, but their effect on heart failure has not been known.

In the first study of its kind, Fonarow and his colleagues reviewed the medical records of 551 patients who had either ischemic heart failure (due to a heart attack) or non-ischemic heart failure (due to hypertension, diabetes or other causes).

Overall, patients taking statins had a 55 percent reduction in their death risk at one year compared to patients not taking statins. This was true regardless of cholesterol levels, age, gender, medications and other conditions such as diabetes.

Because mortality was independent of cholesterol levels, statins may work by a different mechanism in heart failure patients.

"[The study] points out that there are mechanisms of these drugs acting that we probably weren't aware of, and I think that is really exciting," says Dr. Edgar Lichstein, chairman of medicine at Maimonides Medical Center in New York City. "That is what advances the science. If we know what the mechanisms are, it leads to newer drugs and newer therapies."

"We've known that statins save lives, but we suspected that it was more than lowering cholesterol, and this study proves it very nicely," he adds.

It's not clear exactly what those mechanisms are, but there are several possibilities.

"Statins decrease the overactivation of the sympathetic system, which plays a major role in the risk of heart failure," Fonarow says.

Also, he adds, statins may help "remodel" the weakened heart muscle and reduce inflammation. "We recently have recognized that inflammation may play a role in the progression of heart failure," he says.

Because this is an observational study, the results need to be verified with further studies. A randomized trial is in progress now, Fonarow says.

Nevertheless, statins are already approved and widely used, so doctors could consider their use in heart failure patients right away. "The downside is minimal, if any," Lichstein says.

"We would certainly recommend that patients with heart failure be considered for statin treatment, and that's something that can be put into clinical practice," Fonarow adds.

The finding comes at the same time as another, appearing in the Feb. 17 issue of Circulation, that a four-drug regimen that includes statins reduces the risk of mortality in heart attack and unstable angina patients.

More information

For more on heart failure, visit the National Heart, Lung, and Blood Institute or the American Heart Association.

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Bone Density Declines in Teens with Cystic Fibrosis

Reuters Health
Tuesday, February 17, 2004

NEW YORK (Reuters Health) - In children with cystic fibrosis, bone mineral density is normal before puberty, but a loss in bone density appears to occur during adolescence and to become more pronounced in adulthood.

Although low bone mineral density has been identified in individuals with cystic fibrosis the range and evolution of bone disease in these patients remains unclear, Dr. H. M. Buntain, of Royal Children's Hospital in Brisbane, Australia, and colleagues report in the journal Thorax.

They compared BMD in Australian cystic fibrosis patients with that of healthy subjects ("controls"). In addition, they assessed the association between BMD and clinical factors, including physical activity, nutrition, and vitamin D. levels.

The researchers measured BMD in the lower spine, total body, top of the thighbone and wrist bones in 153 cystic fibrosis patients (between 5.3 to 55.8 years old) and in 149 controls (between 5.6 to 48.3 years old).

The average BMD was not significantly different between healthy controls and children with cystic fibrosis between the ages of 5 and 10 years.

After accounting for age, sex, and height, the team found that total body and wrist bone mineral density were reduced in adolescents. Among adults, a reduction in BMD was found at all sites except the wrist.

The investigators observed weak associations between BMD and nutritional status and disease severity in children and adolescents.

"Our study supports the advice that children, adolescents, and adults with cystic fibrosis should maintain optimal nutritional status, partake in physical activity, minimize corticosteroid usage, and maximize lung health in order to optimize BMD," Buntain and colleagues advise.

Source: Thorax, February 2004.

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What Hurts the Heart Also Hurts the Kidney

By Ed Edelson
HealthDay Reporter
HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- The same risk factors that lead to heart attack and stroke -- high blood pressure, smoking, obesity, diabetes and high cholesterol levels -- can also cause kidney failure, says the latest report from the long-running Framingham Heart Study.

"It's not necessarily a surprise," says Dr. Caroline S. Fox, lead author of the research, which appears in the Feb. 18 issue of the Journal of the American Medical Association (news - web sites). Vascular problems, the kind of damage to blood vessels that result in heart attack, stroke and other cardiovascular conditions, can also damage the kidneys, she says, although that is not a complete explanation of the relationship.

"Certainly the kidney is a vascular organ," says Fox, who is an epidemiologist at the Framingham study. "But it is more complex than that. We don't know the exact mechanism."

But the numbers showing the relationship are clear, she says. They come from data of 1,223 men and 1,362 women who had an initial medical examination between 1978 and 1982 and came back for a checkup an average of 18.5 years later.

Over that period, 224 of them developed kidney disease, defined as a substantial drop in the kidneys' ability to filter waste from the blood. Such a drop in what is formally called the glomerular filtration rate can lead to kidney failure that requires either dialysis treatment or a kidney transplant to keep the patient alive.

The relationship between cardiovascular risk factors and kidney disease was clear. Diabetes more than doubled the risk, high blood pressure increased it by more than 50 percent, smoking increased it by more than 40 percent, and obesity increased it by more than 20 percent.

A number of earlier studies have linked these individual factors to kidney disease, Fox says, "but before this they have not been studied together."

The results point the way to prevention. Because people who started with a below-average glomerular filtration rate were much more likely to develop kidney disease, their kidney function should be monitored regularly, Fox stresses.

There is a close relationship between kidney disease and cardiovascular diseases, she notes. Someone with kidney failure has a 10- or 20-fold higher risk of heart attack, stroke and other cardiovascular conditions than someone with normal kidney function.

The problem is widespread. An estimated 275,000 Americans have kidney failure, and perhaps 8 million have some form of kidney disease.

"This study re-emphasizes the importance of controlling the traditional risk factors in order to prevent not only heart attacks but also the development of kidney disease, stroke and heart failure," says Dr. Robert A. Phillips, chairman of medicine at Lenox Hill Hospital in New York City. "We need to redouble our efforts to control blood pressure and reduce smoking so that kidney disease does not get a chance to develop."

More information

Get a primer on kidney disease from the National Institute of Diabetes and Digestive and Kidney Diseases, while the American Heart Association has a page on risk factors you can and can't control.

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More People Creating Gyms at Home

By Louise Chu
Associated Press Writer
The Associated Press
Tuesday, February 17, 2004

ATLANTA - The days of long waits for sweaty machines are losing their appeal faster than a New Year's resolution. Is it any wonder more people are opting to work out at home?

Many are buying their own exercise equipment, driven partly by affordable prices and the notion sometimes unrealistic that the sight of a new cross-trainer will get them moving.

Americans spent about $4.3 billion on exercise equipment in 2002 up more than 11 percent from the previous year, which saw almost $3.9 billion in sales, according to the National Sporting Goods Association.

Home equipment has appealed to all ages, although older, more affluent people tend to purchase the more elaborate pieces, said NGSA spokesman Larry Weindruch. Treadmills, the most popular equipment category, are the biggest hit with 45- to 64-year-olds, who were responsible for 44 percent of that $2.5 billion market in 2002.

The rising popularity of home gyms seems to fit in well with an increasingly on-the-go culture, said Cedric Bryant, chief exercise physiologist for the American Council on Exercise.

"There's the ever-growing message for how important it is for people to find some time to exercise on a regular basis," he said. "I think the convenience of home offers people a very time-efficient solution."

Tom Krattenmaker, 43, of Yardley, Pa., prefers using his own treadmill and Bowflex machine which offers exercises from resistance training to rowing despite having free access to a fitness center at Swarthmore College, where he works.

"It's a hassle to do it (work out) at a public gym," he said. "Sometimes you have to wait to get on the machine you want."

Bryant added that exercise equipment has also become more affordable in recent years, making balance balls and free weights staples of many homes today.

But when it comes to bigger buys, home gyms may not be for everyone.

The wasteland of exercise equipment is vast, with the all-too-familiar site of rowing machines collecting dust in the basement and stair climbers doubling as coat racks.

Health club fans say public gyms give people an essential ingredient for their workout motivation.

"They can have the best gym in the world at home but if they don't have self-discipline to use it, then it doesn't do any good," said Leigh Crews, president of Dynalife Inc., a Rome, Ga.-based fitness education company.

Crews said she's worked with dozens of clients who started off excited about their shiny new equipment, only to drop off within a few months.

"It would be interesting to see how many people who purchase home gym equipment now would report if they still use it 18 months from now," she said.

Motivation to stay active has never been a problem for 41-year-old Sherry Fine and her husband, who've built a 15-station home gym complete with a bench press, treadmill, step machine and two abdominal exercisers.

"I like the health benefits, and I like the way I look when I workout, and I think that motivates me," she said.

The $12,000 investment for her Tulsa, Okla., home has paid dividends, said Fine, a stay-at-home mom who appreciates being able to divide her workout throughout her day while caring for a 6-year-old son and 3-year-old daughter.

The most successful home workouts happen with people who already have a strong understanding of proper training methods, said Salim Nadir, a fitness director at an Atlanta gym who also works with clients in their homes.

Less experienced people tend to limit their workout with an incomplete gym or look for quick fixes on infomercials, said Nadir, who tells clients to be ready to spend at least $2,500 to $5,000 if they want to build a well-rounded, quality home gym.

Bryant said the contraptions featured on late-night infomercials touting dramatic weight loss results or rock-hard abs may sound tempting, but many tend to be "overpromising and underdelivering."

"Many of the infomercials make claims that really promise the impossible, and I think people's expectations are so high that once they get the equipment ... they become very disappointed and disillusioned," he said.

For the novice interested in building a home gym, Bryant recommends starting with equipment that simulates "natural, real-life activities," such as treadmills, stair climbers and exercise bikes. The simplicity of these pieces make them likely to be safer and used more often, he said.

As people begin to feel more comfortable with basic equipment, it may be time to consider making bigger investments.

Fine said building her home gym took research and advice from personal trainers after years exercising in health clubs.

"I would buy it in baby steps," she said. "I do think people go out and buy a lot of things they don't use because they don't know what they want."

On the Net:

The American Council on Exercise: http://www.acefitness.org

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Baby Shows if Insulin Needed for Diabetes in Pregnancy

By Megan Rauscher
Reuters Health
Tuesday, February 17, 2004

NEW YORK (Reuters Health) - If a woman develops diabetes during pregnancy -- that is, gestational diabetes mellitus (GDM) -- she may need insulin to keep blood sugar levels under control. This is usually decided when her blood glucose levels exceed a certain cut-off point, but German researchers say a better way may be to keep a check on the size of the baby.

Babies tend to be become overly large when the mother has diabetes. Carefully monitoring the baby's abdominal circumference on a sonogram is a good way to decide if mom needs insulin -- and it can in fact spare many women insulin injections.

That's according to a report in the medical journal Diabetes Care, from Dr. Ute M. Schaefer-Graf from Vivantes Medical Center Neukoelln in Berlin, Germany, and colleagues.

The standard "glucose-only" approach to handling GDM entails intensive glucose monitoring and insulin therapy in about one-third of cases, Dr. Schaefer-Graf told Reuters Health.

But a given blood glucose level does not necessarily mean trouble for the baby, the researcher explained, especially when blood glucose levels are only moderately high.

To see whether the mother's blood sugar level or the baby's size was the best way to manage GDM, the team allocated 99 women with GDM to an ultrasound group and 100 to a standard (maternal glucose) group.

In the ultrasound group, insulin was given only when the fetal abdominal circumference exceeded the upper range of normal, regardless of the mother's blood sugar level. In the standard group, insulin therapy was started when fasting glucose levels surpassed 90, or 120 after a meal.

Pregnancy outcomes were the same using either strategy. However, insulin was not given to 34 percent of the women in the sonogram group who would have been treated with insulin according to the standard protocol.

Summing up, the researcher said that monitoring the baby's growth is a way to concentrate intensive insulin therapy where it's needed -- on GDM pregnancies where the baby is at risk for problems.

Source: Diabetes Care, February 2004.

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Tests Suggest Link Between Anger, Smoking

By Lauran Neergaard
AP Medical Writer
The Associated Press
Tuesday, February 17, 2004

WASHINGTON - If you're easy to anger, you might have a brain especially susceptible to nicotine. Scientists using powerful scanners have documented nicotine triggering dramatic bursts of activity in certain brain areas but only in people prone to anger and aggression, not more cheerful, relaxed types.

Researchers made the discovery when studying people wearing nicotine patches. Intriguingly, the nicotine jazzed up the brains of not just smokers who are aggressive, but of nonsmokers, too and at very low doses.

It's the first biological evidence that people with certain personality traits are more likely to get hooked on smoking if they ever experiment with cigarettes.

And it may help explain why it's so much easier for some people to kick the addiction than others, says psychiatrist Steven Potkin of the University of California, Irvine, who led the study.

It's almost, he says, as if some people are born to smoke.

Other scientists won't make that leap, noting that it's not clear how much of a person's personality is genetic and how much stems from childhood environments. Smoking habits, too, can depend greatly on whether people grew up surrounded by smokers and the social and cultural conditions under which they try to quit.

Still, "we're looking for the variety of things that could make people likely to smoke, and this could be one of them," says William Corrigall of the National Institute on Drug Abuse.

It also has important implications for teenagers. Adolescents are prone to periods of aggression before parts of the brain that control impulse and behavior finish forming and smokers almost universally pick up the habit as teens.

If doctors could predict who's most at risk of getting hooked after their first few cigarettes, perhaps they could better target those people with smoking prevention programs.

Previous surveys had suggested that Type A personalities are more likely to be big smokers, especially when nervous or irritated. Also, some scientists have put smokers into brain scanners while infusing them with nicotine, to see what brain areas the drug targets.

But Potkin's study took the crucial step of adding nonsmokers to the mix. And he asked 86 people to do various tests such as computer games that showed who were the sore losers while a PET scanner monitored their brain activity before and after receiving low- or high-dose nicotine patches or a sham patch.

"No one has looked at nicotine in this way," says Kenneth Perkins, a psychiatry professor at the University of Pittsburgh who also is studying predictive traits of smoking.

The PET scans showed no brain effects of nicotine on people whose personalities were more relaxed and cheerful.

But in people rated as having more hostile tendencies easier to anger, more impatient or irritable nicotine triggered dramatic changes in activity in brain regions important for controlling emotion and social response.

For some people, nicotine increased energy metabolism, for others, it decreased, depending on dose.

But despite the common assumption that nicotine can be calming, actually "nicotine made them even more aggressive," Potkin says. "They may smoke to feel better, but they don't feel better."

That's a curious finding, Perkins says, but it may be because the study used different doses. Low nicotine doses sometimes stimulate brain activity while high doses suppress other activity.

The next step: Seeing how the brain reacts when people smoke instead of having carefully controlled doses of nicotine administered via a patch. For that study, Potkin can't induce nonsmokers to start smoking, so he'll compare regular smokers to people who puff a few cigarettes every so often.

Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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Video Game Content Ratings Not Always to Be Trusted

By Alison McCook
Reuters Health
Tuesday, February 17, 2004

NEW YORK (Reuters Health) - Almost half of video games rated "T" for teens contain content such as profanity or sexual themes that is not noted on the game box, new research suggests.

As a result, in many cases, video games may contain some elements that surprise parents, study author Kimberly Thompson told Reuters Health.

"The absence of a content descriptor did not mean the absence of content that might concern parents," she said.

She added that she hopes these study results serve as a "wake up call" for parents, telling them they need to be aware of what their kids are being exposed to, both in video games and elsewhere.

Video games are a strong presence in many U.S. kids' lives, according to the Journal of the American Medical Association (news - web sites) report. A recent nationwide study found that more than 50 percent of kids between the ages of 2 and 7 live in a house with at least one video game console. Among 8- to 18-year-olds, that figure reaches 82 percent.

In a previous study, Thompson and her colleague Kevin Haninger found that the discrepancy between warnings and content is not isolated to "T"-rated games; among games rated "E" for everyone that lacked any descriptions of violence, almost 45% contained violent acts.

During the current study, Thompson and Haninger played 81 "T" rated video games for one hour, noting the content and comparing it to the warning labels on the game box.

Thompson, who is based at the Harvard School of Public Health in Boston, explained that video game ratings and content labels are set and enforced by the Entertainment Software Rating Board (ESRB), a self-regulatory body created in 1994 by the computer and video game industry. The ESRB establishes a rating and content descriptors for each game by reviewing videotaped game footage and other information about the game provided by its manufacturer.

According to the ESRB, games with a "T" rating may be appropriate for people ages 13 and up, and may contain violence, profanity, and other more adult themes.

Although most of the games' content matched their ratings, Thompson and Haninger found that 48 percent of games contained some content that was not noted on the game box.

For instance, 12 of the 81 games showed the use of substances such as tobacco and alcohol, while only 1 game had received that type of content descriptor from the ESRB. And while the researchers reported sexual content in 22 games, only 16 had received a sexual content descriptor.

In the report, Thompson and Haninger note that game players can obtain the contents of other games by entering codes provided by video game Web sites, and this may contain content that may concern parents.

Thompson said she hopes these findings encourage ESRB representatives to actually play the games they are rating, and provide the public with more "transparency" on how it designates games as appropriate for certain ages and assigns content ratings.

Source: Journal of the American Medical Association, February 18, 2004.

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New Lens Expands Horizons for Cataract Patients

By Dennis Thompson Jr
HealthDay Reporter
HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- Everyone will suffer from cataracts if they live long enough, eye doctors say.

This clouding of the eye's lens is a natural byproduct of aging. By age 80, more than half of all Americans either have a cataract or have had cataract surgery, the National Institutes of Health (news - web sites) estimates.

The good news is that cataract sufferers can enjoy better sight than ever before, thanks to new, so-called multifocal lens implants that come closer to mimicking the sight provided by the human eye.

"The natural lens you have in your eye is constantly changing its focus," says Dr. Janine Smith, deputy clinical director at the National Eye Institute. "If you look at something up close, your natural lens will change its shape to bring it into focus. At the same time, objects that are at a distance are no longer in focus. That's something that happens automatically."

Older lens implants provide clear vision for people only at one specific distance, and will not allow people to shift focus to things near to them or far away. "That's why many people still need to wear reading glasses after they have cataract surgery," Smith says.

If cataract patients wanted both short- and long-distance vision, they had to opt for "monovision" lenses. That's when a short-distance lens is placed in one eye and a long-distance lens in the other. "Some people can handle that and some can't," Smith says.

But the new multifocal lenses let people focus at different distances without the strain caused by monovision. They're still not as good as a human eye, but they allow people to read, thread a needle or perform other fine motor tasks without glasses, eye experts say.

The multifocal lenses are formed with concentric circles, like a practice target, and each circle represents a different focus distance, Smith says. People with the implants learn to adjust their vision automatically by shifting their concentration to the appropriate circle.

"It's not like bifocal lenses where you have to shift your eyes," she says. "It's all happening within the eye itself, so your eye isn't actually moving."

The surgery is the same as with single-focus lenses, although rehabilitation is different because patients must learn how to process the visual information provided by the multifocal lenses.

The lenses aren't for everyone, and do have some drawbacks, says Dr. Kerry Solomon, director of the Magill Laser Center at the Medical University of South Carolina's Storm Eye Institute.

Some people complain of poor nighttime vision caused by glare off of the lenses' concentric rings, Solomon says. Street lights can seem to have a ring around them, blurring vision.

"Someone who is a driver by trade or an airline pilot or who needs superb night vision is not a person I would recommend for these lenses," Solomon says.

The lens also must be perfectly centered by the surgeon, otherwise the patient might suffer from glare, halos or other optical phenomena, Smith says.

The size of the pupil also is important. At night, your pupil gets larger and can allow more concentric sight zones to be exposed. If the ophthalmologist has misjudged pupil size, vision could be affected.

Age-related cataracts develop in two ways. In most cases, protein contained in the lens begins to clump up, clouding the lens and reducing the light that reaches the retina. But for some people, the clear lens slowly acquires a brownish shade, tinting their vision and making them colorblind, according to the National Eye Institute.

While multifocal lenses have been available for several years, they're gaining in popularity, Solomon says.

"More and more physicians are becoming accustomed to them, and more and more patients are asking for them," he says.

And ophthalmologists expect the lenses to get better as demand increases. "We have a very demanding American public and a significantly growing elderly population," Smith says. "This significantly improves our ability to rehabilitate vision after cataract surgery."

Solomon points to one innovation he currently is studying -- a refined multifocal lens that provides the same benefits but with better reading and night vision and a shorter acclimation period for new users.

"I expect by 2005 patients will have the option to choose between the two," he says.

More information

To learn more about multifocal lenses, visit Emory University. For more information on cataracts, check with the National Eye Institute.

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Campaign Helps Kids Get Active: Survey

By Merritt McKinney
Reuters Health
Tuesday, February 17, 2004

NEW YORK (Reuters Health) - A national campaign designed to keep children from growing up to be couch potatoes seems to be making headway, according to officials at the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC).

In a national survey, children ages 9 to 13 increased the amount of free time they spent in physical activities. What's more, the "activity gap" between boys and girls narrowed, and physical activity also increased in children from lower-middle income families.

"The results are quite impressive," Dr. Janet Collins, the deputy director of the National Center for Chronic Disease Prevention and Health Promotion at the CDC, told Reuters Health in an interview.

Physical activity is important at any age, but the CDC's campaign, known as VERB, focuses on "tweens," Collins said, because physical activity tends to drop off during the teen years.

One of the goals of the campaign, Collins said, is to prevent overweight and obesity in the first place by helping children get "on the right path for lifelong health."

The aim of VERB is not to make every child an athlete, according to the CDC. Instead, the program aims to help children make physical activity a part of their everyday life.

For instance, the national campaign encourages physical activity by asking children to pick a favorite action, or verb, such as running, jumping, dancing or shooting hoops.

Since June 2002, the VERB marketing campaign has promoted physical activity through paid advertisements as well as partnerships with community organizations.

To test the effectiveness of the campaign, the CDC commissioned an independent research company to survey more than 6,000 children and parents before and after VERB began.

At the end of VERB's first year, about 75 percent of children had heard of the program, Collins said. Many of these children seem to have become more active as a result, according to the CDC official.

According to the survey, the VERB campaign led to a 34 percent increase in physical activity among children 9 to 10.

VERB also seemed to encourage girls to nearly catch up with boys in terms of physical activity. Among "tween" girls, physical activity increased 27 percent.

Children from lower-middle income households are often less active than more affluent children, but this group also improved. Lower-middle income children increased physical activity by 25 percent despite obstacles such as less access to recreational facilities and concerns about safety in their neighborhoods.

The survey also detected a positive impact of VERB in communities that were targeted for extra marketing. The number of the least active 9- to 10-year-olds dropped by 33 percent in these communities. This decline was even greater in girls and in children from lower-middle income households.

Now that awareness of VERB has been established, the next step will be "more of an activation phase," said Collins. During the next year, the campaign aims to provide more concrete activities for children, she said. In addition, Collins hopes to enlist sports celebrities to encourage children to stay active.

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Marathon Training

HealthDayNews
Tuesday, February 17, 2004

(HealthDayNews) -- If you jog regularly and have set your sights on completing a marathon, the Baylor College of Medicine in Houston offers this advice for launching a training program:

  • Focus on form, not on time or distance. Pay attention to arm swing, stride and posture.
  • Monitor your fluid intake. In hot weather, drink six to eight ounces of fluid every 25 minutes, every 35 minutes in colder temperatures.
  • Buy shoes that fit your foot type. For example, if you have high arches, select cushion shoes, and go for stability models if you're flat-footed.
  • Do your long runs on the weekend and keep weekday runs shorter, so your body has time to rest.

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Men with Eating Disorders Have Healthy Body 'Ideal'

By Amy Norton
Reuters Health
Tuesday, February 17, 2004

NEW YORK (Reuters Health) - Eating disorders in men may be fueled by a distorted perception of their own bodies, rather than an unhealthy notion of what the "ideal" body is, the results of a small study suggests.

Researchers found that while men with anorexia or bulimia saw themselves as much heavier than they actually were, their idea of an ideal body was no different from that of healthy men their age.

Distorted body image is well known to be at the roots of eating disorders. But studies have traditionally not distinguished between patients' perceptions of their own bodies and what they believe to be the ideal body, according to the new study's lead author.

"Our study suggests that the body image distortion in eating disorders is based primarily on a distorted body perception, and not on the body ideals of patients," Dr. Barbara Mangweth of the University Clinics Innsbruck in Austria told Reuters Health.

This distinction is important, according to Mangweth and her colleagues, because it could make a difference in treatment. For example, men with eating disorders may not need to be "re-educated" about healthy body fat levels, they report in the International Journal of Eating Disorders.

Whether the findings might extend to women, who suffer from eating disorders much more often than men do, is unclear, according to the researchers. However, they point to a recent study that found normal-weight, dieting women had distorted perceptions of their own bodies, but had body ideals similar to those of women who were not dieting.

The new study involved 27 men ages 19 to 43 with anorexia or bulimia, and 42 athletic and non-athletic men of the same age. Mangweth's team had the men take a computerized test that allowed them to "morph" an image of a male body to have various levels of fat and muscle.

Participants had to choose images that best represented their own bodies, the body they would like to have, and the one they thought women would prefer.

The researchers found no differences between the groups when it came to body fat ideals. However, men with eating disorders saw themselves as twice as fat as they actually were, while healthy participants showed no such distortion.

The findings, according to Mangweth, suggest that in both research and therapy, it is important to distinguish patients' beliefs about their bodies from their general body preferences.

Source: International Journal of Eating Disorders, January 2004.

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Testicular Cancer

HealthDayNews
Tuesday, February 17, 2004

(HealthDayNews) -- Testicular cancer, which usually strikes men ages 15 to 34, is one of the most common tumors seen in men under age 40, according to Seton Hall University in New Jersey.

All men in this age group should conduct monthly self-exams, especially those who may be more prone to testicular cancer.

The following factors may increase your risk:

  • You are a white male between the ages of 15 and 40.
  • You have undescended or late-descended testes.
  • There is a family history of testicular cancer.
  • You've been diagnosed with inguinal hernia.

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Brain Scans Used to Monitor Effect of Cancer Drug

By Patricia Reaney
Reuters
Tuesday, February 17, 2004

LONDON (Reuters) - British scientists said Tuesday they have used a brain-imaging technique to monitor the effectiveness of a drug on tumors.

Instead of studying the size of the brain tumor over time, the researchers used nuclear magnetic resonance imaging to monitor molecular changes in cancer cells to predict at an early stage whether the drug was working.

"The technique has been around for a while but it has not been used in this context for looking at the metabolism in cancer cells," Professor Martin Leach, of the charity Cancer Research UK, said in an interview.

"The conventional scan is an image and you can see the extent of a tumor. What this (new application) does is look at the cells and asks how they are working. It gives information on chemicals in the cells rather than just the distribution of tissue," he added

The scientists identified changes caused by the chemotherapy drug temozolomide on patients with low-grade glioma brain tumors -- one of the most difficult types of cancer to treat.

A low-grade glioma tends to be slow-growing but it can quickly change into a much more aggressive and deadly tumor.

In research reported in The British Journal of Cancer, they measured levels of a molecule called choline, which indicates that cells are dividing and that the tumor is growing. They also measured the size of the tumor with magnetic resonance imaging scans in 13 patients.

The amount of choline gave an early indication whether the drug was halting cell division and the growth of the tumor.

Leach said the results show that using nuclear magnetic resonance could give doctors an early indication of whether temozolomide is working or if a patient could benefit more by switching to another drug.

Gliomas, one of the most common types of brain tumors, can cause headaches, seizures, behavior changes and dizziness. Treatments include surgery and chemotherapy depending on the size and the location of the tumor.

Leach and his colleagues believe studying the behavior of cancer cells with nuclear magnetic resonance could be useful for doctors in identifying different types of gliomas and how various drugs affect them.

"They could then predict which tumor types are likely to respond to treatments before giving them to patients," Leach added.

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Human Mouth Harbors Clues to Fighting Infection

HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- Natural antibiotics called beta-defensins in human mouths may offer clues on how to develop new treatments for oral infections and improve the infection-battling abilities of wound dressings, mouthwashes and denture coatings.

These beta-defensins are key components of the human innate immune system.

"Innate immunity describes the defenses that we are born with; they're coded in our genes. In contrast, we develop the antibodies of our acquired immune system over time as we're exposed to bacteria and viruses. It's when our innate defenses fail that the acquired immune system picks up the slack," Dr. Beverly Dale, scientific director of the University of Washington's Comprehensive Center for Oral Health Research, says in a prepared statement.

Dale presented her findings Feb. 16 at the annual meeting of the American Association for the Advancement of Science (news - web sites) in Seattle.

The innate immune system has some notable capabilities. For example, it can distinguish between harmful and harmless bacteria.

Dale says that because the mouth is such a complex and challenging environment, it's an ideal place to study the human innate immune system.

"Our mouth is full of moist surfaces, perfect for bacteria to adhere to; we feed these bacteria at regular intervals with nutritious foods and snacks," Dale says.

Even though we brush our teeth, our mouths still contain millions of bacteria.

"Yet most of us remain healthy -- without infections -- most of the time," Dale says.

Gaining a better understanding of the innate immune system may let scientists find ways to enhance it, she says.

More information

Here's where you can learn more about the immune system.

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Cholesterol Drugs May Fight Heart Failure Study

Reuters
Tuesday, February 17, 2004

WASHINGTON (Reuters) - Cholesterol-lowering drugs called statins, which greatly reduce the risk of stroke and heart attack, may also help keep patients with heart failure alive even if they do not have high cholesterol, U.S. researchers reported on Tuesday.

Heart failure patients who took statins were 55 percent less likely to die during the year after they were prescribed the drugs than patients who did not get them, the team at the University of California Los Angeles found.

"Our results were dramatic," Dr. Gregg Fonarow, a professor of medicine who led the study, said in a statement.

"We were surprised by the magnitude of the additional benefits of statins in patients who were already on standard medications to treat heart failure."

Heart failure is a chronic but deadly condition caused by the heart's inability to pump efficiently. It gradually enlarges as it becomes weaker and weaker.

An estimated 5 million Americans have the condition, which will kill half of them within five years. It can be caused by high blood pressure, valve disease, clogged arteries or even an infection.

Writing in the Journal of the American College of Cardiology, Fonarow and colleagues said they found that heart failure patients did better when given a statin drug no matter what the cause of their condition.

They analyzed the medical records of 551 heart-failure patients and looked to see what medications each one was given. They then looked at mortality records.

They found an overall 55 percent reduction in mortality rate for heart failure patients taking a statin a year after getting the drug. This finding held no matter whether they had high cholesterol. It was also independent of age, sex, other drugs the patients were taking and other factors such as diabetes or coronary artery disease.

The next step should be randomized clinical trials in which half of a group of patients gets a statin and half gets a placebo, said Dr. Tamara Horwich.

"If randomized clinical trials mirror our results, we may have a novel treatment for heart-failure patients," she said.

Statins may work by reducing inflammation, helping to better control the heart ventricles, or by decreasing an overactive sympathetic nervous system, Fonarow said.

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Exercise Sharpens Judgment

HealthDayNews
Tuesday, February 17, 2004

TUESDAY, Feb. 17 (HealthDayNews) -- Brisk walks that improve cardiovascular fitness help aging adults sharpen their mental focus and decision-making abilities.

That simple solution to cognitive decline appears in a study in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

University of Illinois at Urbana-Champaign researchers used functional magnetic resonance imaging (fMRI) to measure changes in brain activity among adults, aged 58 to 78, before and after they completed a six-month aerobic exercise program.

The program involved gradually increasing periods of walking over the first three months. In the final three months, each person walked briskly for 45 minutes in three sessions per week.

Those who completed the aerobic exercise program reduced their level of behavioral conflict in completing a computer-based task by 11 percent from their pre-exercise levels. A group of control subjects who did only stretching and toning had a decrease of 2 percent.

"The brain circuits that underlie our ability to think -- in this case to attend selectively to information in the environment -- can change in a way that is conducive to better performance on tasks as a result of fitness. The kinds of tasks that we explored are similar to those encountered in real world situations, such as driving a vehicle or any endeavor that requires a person to pay attention despite distractions," researcher and psychology professor Arthur F. Kramer says in a prepared statement.

More information

Here's where you can learn how exercise eases symptoms of anxiety and depression.

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Monday, February 16, 2004

Antioxidants Appear to Protect Against Diabetes

By Alison McCook
Reuters Health
Monday, February 16, 2004

NEW YORK (Reuters Health) - Eating a diet rich in antioxidants, such as vitamin E, appears to ward off diabetes, new research reports.

A group of Finnish researchers found that people who ate diets that contained the most vitamin E were 30 percent less likely to develop type 2 diabetes, the most common form of the disease, than people who consumed the least amount of vitamin E.

People who consumed large amounts of carotenoids, a group of compounds that produce the red, yellow, and orange colors found in many fruits and vegetables, were also less likely to develop type 2 diabetes.

Vitamin C intake, in contrast, appeared to exert no effect on diabetes risk.

Study author Jukka Montonen of the National Public Health Institute in Helsinki told Reuters Health that more studies are needed before researchers can recommend that people at risk of type 2 diabetes switch to an antioxidant-rich diet to ward off the disease.

However, Montonen noted that antioxidants are present in whole grains and fruits and vegetables, important ingredients for an overall healthy diet.

"Our findings are in line with the general recommendation to include plenty of vegetables and fruits in one's daily diet," the researcher noted.

Losing any excess weight and staying physically fit are two other important steps people should take to ward off type 2 diabetes, Montonen added.

Previous research has shown that vitamin E and other antioxidants may protect people from type 2 diabetes by mopping up free radicals, cell-damaging particles that are a byproduct of normal metabolism.

During the current study, Montonen and colleagues followed more than 4,000 people between the ages of 40 and 69 for 23 years, noting what they ate and who developed type 2 diabetes.

The researchers linked type 2 diabetes risk to a number of different forms of vitamin E, carotenoids and vitamin C.

During the study follow-up, 164 men and 219 women developed type 2 diabetes.

Although overall intake of vitamin E and carotenoids appeared to reduce the risk of diabetes, certain forms of those antioxidants showed more of an inhibiting effect than others.

The researcher added that the complex nature of our diets makes it difficult to pinpoint whether a single antioxidant can truly reduce the risk of diabetes, perhaps explaining why vitamin C appeared to offer no protection from the condition.

"Instead of isolated nutrients, people eat meals mixing different foods, giving several nutrients a chance to interact. The effect of the complex overall diet may conceal the effect of single nutrients," Montonen explained.

Montonen added that people who ate an antioxidant-rich diet may simply have had a healthier diet overall, making it hard to determine whether the protective effect came from antioxidants themselves.

The researcher noted that people who are trying to reduce their risk of diabetes through diet should stick to fruits, vegetables and other antioxidant-rich foods, rather than vitamin supplements.

"We do not know the beneficial amount or combination of the antioxidants. Vitamin supplements should not be recommended for prevention of type 2 diabetes," Montonen said.

Source: Diabetes Care, February 2004.

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Teaching Hospitals Safe Place for Tricky Surgeries

HealthDayNews
Monday, February 16, 2004

MONDAY, Feb. 16 (HealthDayNews) -- Teaching hospitals have lower death rates for certain complex gastrointestinal surgeries than non-teaching hospitals do, says a study in the February issue of the Archives of Surgery.

University of Michigan researchers compared surgical outcomes during 1996 and 1997 at non-teaching and teaching hospitals, where medical students and surgeons are educated and trained.

The study found death rates for teaching hospitals compared with non-teaching hospitals were: 4 percent vs. 8.8 percent for pancreatic resection (removal of part or all of the pancreas); 5.3 percent vs. 8 percent for hepatic resection (removal of part of the liver); and 7.7 percent vs. 10.2 percent for esophageal resection (removal of part of the esophagus).

"The present study demonstrates that important clinical outcomes of complex surgery vary among hospitals with different organizational structures," the study authors write.

"Specifically, teaching hospitals have lower operative mortality rates for pancreatic, hepatic and esophageal resections compared with non-teaching hospitals, but these differences can be attributed to higher volume at teaching hospitals. Further studies should concentrate on the structure and process variables, other than volume, that contribute to variation in outcomes between hospitals," the authors write.

More information

Here's where you can learn more about surgery.

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Study Finds Familial Link in Many Cancers

By Andrew Conaway
HealthDay Reporter
HealthDayNews
Monday, February 16, 2004

MONDAY, Feb. 16 (HealthDayNews) -- A new study finds children of cancer sufferers may face a higher risk for inheriting the same type of cancer their parents had -- no matter which type of cancer it was.

German and Swedish researchers, looking into cancer incidences among family members, found the average risk that the children would inherit the same cancer as their parent was 5.5 percent. That contrasted with an average 3 percent risk found in the general population.

"This applies to all the cancers that we studied. The only connection that we didn't see that was significantly higher were those with a rare form of some cancers of connective tissue," says Dr. Kari Hemminki of the German Cancer Research Center in Heidelberg, Germany. "But generally we saw this link in all the cases."

Even stronger links were seen in several types of cancer. Males, for instance, had a 15 percent chance of getting prostate cancer. All persons whose parents had intestinal cancer had a 10 percent risk, while women had an 8.5 percent risk of breast cancer if their mother had it.

Some of the highest genetic risks were found in families with testicular cancer; the sons of affected fathers had four times the risk compared to sons of families without testicular cancer. Moreover, brothers of affected individuals had a nine times higher risk to develop this cancer.

Scientists had previously thought that only certain types of cancer carried a familial link. Hemminki's research, which looked through the Swedish family register, a record of all individuals born in Sweden after 1932 and comprising more than 10 million individuals, showed a link across almost all types of cancer.

Hemminki identified almost 5,000 families in which several cases of the same type of tumor occurred -- an indicator of familial cancer.

Based on the data, Hemminki calculated the familial risks for each tumor type with a high degree of accuracy.

Some caution, though, that environment might also play a role.

"The relative risks and types of cancers vary by study. It is assumed that the correlation is a function of shared genetic, environmental and lifestyle risks," says Dr. Mary B. Daly of the Fox Chase Cancer Center in Philadelphia. "As a result, the exact numbers seen in Sweden may be different from those seen in other ethnic groups."

Those in families with a known hereditary risk, such as those carrying BRCA1 or BRCA2 genes associated with breast cancer, should visit a cancer risk program, Daly adds.

"It is important to note that although the cancer risks are increased in children and siblings of cancer patients, typically two to fourfold, the absolute risk is still quite small for most cancers," says Douglas F. Easton, of Cancer Research UK. "Generally, therefore, no specific action is advised for individuals with just one affected relative." Those with a stronger family history may be referred to a cancer genetics clinic, he says.

But one need not worry as much if a relative outside the immediate family is affected, say a grandparent, uncle or cousin.

"You only inherit 50 percent of the genes from your genetic relation, so they are diluted quite fast," Hemminki says.

The report appeared in a recent issue of the International Journal of Cancer.

More information

Learn more about cancer and genetics from the American Cancer Society or the National Cancer Institute.

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Tests Suggest Some Predisposed to Smoke

By Lauran Neergaard
AP Medical Writer
The Associated Press
Monday, February 16, 2004

WASHINGTON - If you're easy to anger, you might have a brain especially susceptible to nicotine. Scientists using powerful scanners have documented nicotine triggering dramatic bursts of activity in certain brain areas but only in people prone to anger and aggression, not more cheerful, relaxed types.

Researchers made the discovery when studying people wearing nicotine patches. Intriguingly, the nicotine jazzed up the brains of not just smokers who are aggressive, but of nonsmokers, too and at very low doses.

It's the first biological evidence that people with certain personality traits are more likely to get hooked on smoking if they ever experiment with cigarettes.

And it may help explain why it's so much easier for some people to kick the addiction than others, says psychiatrist Steven Potkin of the University of California, Irvine, who led the study.

It's almost, he says, as if some people are born to smoke.

Other scientists won't make that leap, noting that it's not clear how much of a person's personality is genetic and how much stems from childhood environments. Smoking habits, too, can depend greatly on whether people grew up surrounded by smokers and the social and cultural conditions under which they try to quit.

Still, "we're looking for the variety of things that could make people likely to smoke, and this could be one of them," says William Corrigall of the National Institute on Drug Abuse.

It also has important implications for teenagers. Adolescents are prone to periods of aggression before parts of the brain that control impulse and behavior finish forming and smokers almost universally pick up the habit as teens.

If doctors could predict who's most at risk of getting hooked after their first few cigarettes, perhaps they could better target those people with smoking prevention programs.

Previous surveys had suggested that Type A personalities are more likely to be big smokers, especially when nervous or irritated. Also, some scientists have put smokers into brain scanners while infusing them with nicotine, to see what brain areas the drug targets.

But Potkin's study took the crucial step of adding nonsmokers to the mix. And he asked 86 people to do various tests such as computer games that showed who were the sore losers while a PET scanner monitored their brain activity before and after receiving low- or high-dose nicotine patches or a sham patch.

"No one has looked at nicotine in this way," says Kenneth Perkins, a psychiatry professor at the University of Pittsburgh who also is studying predictive traits of smoking.

The PET scans showed no brain effects of nicotine on people whose personalities were more relaxed and cheerful.

But in people rated as having more hostile tendencies easier to anger, more impatient or irritable nicotine triggered dramatic changes in activity in brain regions important for controlling emotion and social response.

For some people, nicotine increased energy metabolism, for others, it decreased, depending on dose.

But despite the common assumption that nicotine can be calming, actually "nicotine made them even more aggressive," Potkin says. "They may smoke to feel better, but they don't feel better."

That's a curious finding, Perkins says, but it may be because the study used different doses. Low nicotine doses sometimes stimulate brain activity while high doses suppress other activity.

The next step: Seeing how the brain reacts when people smoke instead of having carefully controlled doses of nicotine administered via a patch. For that study, Potkin can't induce nonsmokers to start smoking, so he'll compare regular smokers to people who puff a few cigarettes every so often.

Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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Diaper Rash

HealthDayNews
Monday, February 16, 2004

HealthDayNews) -- Few babies escape outbreaks of diaper rash, but you can help prevent frequent flare-ups with these tips from The Nemours Foundation:

  • Change your baby's diapers often, especially after a bowel movement.
  • Use a diaper ointment to prevent and heal rashes. Look for one with zinc oxide, which acts as a barrier against moisture.
  • Let your baby go undiapered for part of the day.
  • If you use cloth diapers, wash them in dye- and fragrance-free detergents, and avoid drying them with scented drying sheets.

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Antibiotic Use Linked with Breast Cancer Risk

Reuters Health
Monday, February 16, 2004

NEW YORK (Reuters Health) - The use of antibiotics appears to be associated with an increased risk of breast cancer and fatal breast cancer, according to the results of a new study reported in this week's issue of the Journal of the American Medical Association (news - web sites).

However, the investigators add that although a relationship has been found, their findings do not prove that antibiotic use is the cause of breast cancer in these women and they note that other factors may be involved.

Earlier reports have suggested a link between antibiotics and increased cancer risk, lead author Dr. Christine M. Velicer of the University of Washington, Seattle and colleagues note.

The effects of these drugs on the microorganisms normally found in the intestines and the way estrogen is processed, as well as their effects on the immune system and on inflammation, have been suggested as possible ways antibiotics may influence the development of cancer.

To further investigate a possible relationship, Velicer's group evaluated data collected for 2266 women with primary, invasive breast cancer between 1993 and 2001, and 7953 randomly selected women without breast cancer who were enrolled in the same health plan.

"We found that increasing cumulative days of antibiotic use and increasing cumulative number of antibiotic prescriptions were associated with increased risk of incident breast cancer, after controlling for age and length of enrollment," they report.

When compared with women with no history of antibiotic use, women with cumulative antibiotic use for 1 to 500 days had a 2.5-fold increase risk of breast cancer. "Increasing cumulative days of antibiotic use was also associated with death due to breast cancer, controlling for age, length of enrollment, and ever use of postmenopausal hormones," they write.

The investigators stress, however, that "it cannot be determined from this study whether antibiotic use is causally related to breast cancer, or whether indication for use, overall weakened immune function, or other factors are pertinent underlying exposures."

"This observation is potentially worrisome in that antibiotic exposure is common and sometimes nonessential," Drs. Roberta B. Ness and Jane A. Cauley of the University of Pittsburgh comment in an accompanying editorial. "Thus, if real, the risk of breast cancer attributable to the use of antibiotics could be large and partially preventable."

The study provides more questions than answers, they add.

Both the authors and editorialists agree that the clinical implications of the study are unclear and than more studies are needed to explore the relationship between antibiotic use and cancer risk.

Source: Journal of the American Medical Association, February 18, 2004.

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If Parents Smoke

HealthDayNews
Monday, February 16, 2004

(HealthDayNews) -- If you smoke, you must take steps to minimize your children's exposure to its ill effects.

The Texas Medical Center offers these suggestions:

  • Don't smoke in the home.
  • If you are smoking inside, designate a well-ventilated smoking room where there is fresh, outside air exchange. A ceiling fan or small air filter is not effective.
  • Never smoke in a car with children.
  • Choose to sit in the non-smoking section of restaurants.

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Fitness Can Improve Thinking Among Aging

The Associated Press
Monday, February 16, 2004

WASHINGTON - Improving fitness can also boost the thinking ability of aging adults, according to researchers at the University of Illinois.

Adults ages 58 to 78 who began a fitness program, even as simple as brisk walking, saw improvements in how their brains functioned, according to a study published in this week's online edition of Proceedings of the National Academy of Sciences (news - web sites).

In the study 41 adults began an exercise program that gradually increased over three months to a 45-minute walk three times a week. Their brain activity was measured by magnetic resonance imaging.

After three months the adults in the exercise program showed increased brain activity and had an 11 percent improvement on tests that measured their decision-making while performing a variety of tasks.

A control group of similar age and health that only did stretching and toning exercises, but not the cardiovascular walking program, had lower brain activity than the other group and only showed a 2 percent improvement in performance, which the researchers said was not statistically significant.

Earlier studies by the same researchers, led by Arthur F. Kramer of the Beckman Institute for Advanced Science and Technology at Illinois, had showed that aging adults do better mentally if they are fit. This was the first time the group had looked at whether beginning an exercise program can show changes in brain function.

"The kinds of tasks that we explored are similar to those encountered in real world situations such as driving a vehicle or any endeavor that requires a person to pay attention despite distractions," Kramer said in a statement.

On the Net:

Proceedings of the National Academy of Science: http://www.pnas.org

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Alcohol Sensitivity Runs in the Family

HealthDayNews
Monday, February 16, 2004

MONDAY, Feb. 16 (HealthDayNews) -- A person's sensitivity to alcohol and the resulting behavior -- sleepy, social, sad or happy -- may be linked to genetic influences on neurotransmitter activity.

That's according to symposium proceedings published in the February issue of Alcoholism: Clinical and Experimental Research.

"Activities of neurons, which are specialized cells of the nervous system, influence the release of neurochemicals that cause increases or decreases in brain activity," symposium organizer Kim Fromme, an associate professor of psychology at the University of Texas at Austin, says in a prepared statement.

"Virtually everything we think, feel, sense and do are determined by activity of these neurochemicals and their related neuronal activity in the brain. Approximately 100 different neurochemicals have been identified, and many of them have been found to be affected by alcohol," Fromme says.

Four presentations about alcohol's impact on these neurochemicals were given recently during the symposium at the Research Society on Alcoholism meeting in Fort Lauderdale.

More information

Here's where you can learn more about the genetics of alcoholism.

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More Evidence Vegetarian Diet May Cut Cancer Risk

By Alison McCook
Reuters Health
Monday, February 16, 2004

NEW YORK (Reuters Health) - Eating a meat-free, vegetarian diet may reduce the risk of colorectal cancer, new research suggests.

After following more than 10,000 people for 17 years, investigators found that vegetarians were 15 percent less likely to develop colorectal cancer than meat-eaters.

This study adds to the "increasing scientific evidence" that a diet rich in fruit, vegetables and fiber and low in meat--especially red and processed meat--can prevent colorectal cancer, study author Dr. Miguel Sanjoaquin of the University of Oxford, UK, told Reuters Health.

However, Sanjoaquin cautioned that only a small number of study participants -95--developed colorectal cancer, making it impossible to determine if fewer vegetarians developed cancer simply due to chance.

However, Sanjoaquin noted that a previous study featuring more cases of colorectal cancer confirmed these findings, and he added that it makes sense that eating vegetarian could cut cancer risk. The fat in red meat increases the excretion of substances called bile acids, he explained, which in turn produce other substances that encourage tumor growth.

Furthermore, meat contains natural compounds and substances formed during processing and high-temperature cooking that can disrupt the normal balance of cell growth in the colon, potentially triggering the cancer, Sanjoaquin noted.

Alternatively, substances in fruits and vegetables-- staples of the vegetarian diet--"may inhibit these adverse effects," he added.

During the current study, Sanjoaquin and his colleagues asked 10,998 adults about their eating habits and other health parameters, then noted who developed colorectal cancer.

People were classified as non-vegetarians if they ate meat or fish. Vegetarians included vegans, who avoid all dairy and meat products.

Along with a decreased risk of cancer from eating vegetarian, the investigators found that frequent fruit eaters - consuming more than 5 servings of fruit per week--were over 40 percent less likely to develop colorectal cancer.

Smoking, drinking alcohol and eating more than 15 slices of white bread per week appeared to increase the risk of colorectal cancer, according to the British Journal of Cancer report.

Sanjoaquin said the fact that white bread appeared to reduce cancer risk was "unexpected," and suggested that people who ate large amounts of white bread might have simply had a less healthy diet overall.

Alternatively, he added researchers have noted that eating large quantities of refined carbohydrates, such as those found in white bread, may raise colorectal cancer risk, suggesting that white bread itself may also play a role.

"More research will be needed to clarify this," Sanjoaquin said.

Source: British Journal of Cancer, January 12, 2004.

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Your Heart's Health Is in Your Hands

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Monday, February 16, 2004

MONDAY, FEB. 16 (HealthDayNews) -- Stopping heart disease before it starts is no longer the sole domain of doctors. These days you can do it largely by yourself if you watch what you eat, exercise when you can and keep close track of your cholesterol and blood pressure.

That also means there's no more excuses not to do it.

"It's all about keeping balance," says Dr. Ann Bolger, an associate professor of clinical medicine at the University of California, San Francisco and spokeswoman for the American Heart Association (news - web sites). "It's the stuff we do on a daily basis that is our downfall."

Many have fallen. Heart disease is the nation's top killer, claiming an estimated 700,000 lives annually. And 61.8 million people have some sort of cardiovascular trouble and 1.1 million suffer a heart attack each year, according to the AHA.

So, there's no better time to take your heart's health into your own hands, especially since February is Heart Awareness Month. Top cardiologists offer this advice on how to keep heart disease away:

  • Don't Smoke: "The number one controllable risk factor for cardiovascular disease is cigarette smoking and exposure to tobacco smoking," Bolger says. "It's an extraordinarily powerful risk factor."
  • Keep Moving: "Regardless of your weight and other risk factors, people who are active versus people who are not have a tremendous advantage in terms of cardiovascular disease," Bolger says. "There's no pill that's anywhere near as effective as exercise." The best exercise is the one that you will keep doing and, for most people, that is going to be walking. It's easy, simple and you don't need expensive equipment or club memberships.
Dr. Daniel Fisher, an assistant clinical professor of medicine at New York University School of Medicine, says government guidelines recommend at least 30 minutes of moderate physical exercise on most, if not all, days of the week. In general, Fisher adds, "the more you do the better, and the higher intensity the better." But keep it in perspective and discuss it with your doctor first. "We're not going to tell a 95-year-old to run the marathon," he says.

Any exercise you do should give you energy and make you a little thirsty. "Exercise is such an equalizer. It keeps the big swings out of your blood pressure and out of your diet," Bolger says. "It's a great stress manager and you'll sleep better. And if you sleep better, your blood pressure is in better control."

  • Eat a Healthful Diet: "Obesity and being overweight in America is now an epidemic," Fisher says. "Controlling your weight is unbelievably important. As weight goes up, so does the risk of high blood pressure."

In general, fat should make up 25 percent to 30 percent of total calories, but you also need to pay attention to the proportion of saturated fats, polyunsaturated fats and monounsaturated fats you're consuming. Protein should represent about 15 percent of calories. And carbohydrates -- from complex whole grains, fruits and vegetables -- should account for the rest of calorie consumption. You also want pay attention to portion size. "If that stuffed mushroom has lots of cheese or sausage in it, have one and eat it slowly and love it but don't have two," Fisher says.

Counter fatty foods with raw vegetables or fruit. This, in turn, can offset the risk of sudden heart attacks, which have a greater chance of occurring when there's a swift surge of fat in the blood. Follow high-salt foods with a glass of water, which will also help fill you up. And if you fall off the wagon, don't dig a deeper hole by launching a gastronomic free-for-all. Just refocus and move on. "Just because you made a bad choice doesn't mean that the next one can't be good," Bolger says.

  • Know Your Vital Statistics: That means your blood pressure and your cholesterol levels. "As your blood pressure increases, so does the risk of cardiovascular disease and stroke," Fisher says. Healthy adults need to stay under 140/90. People with diabetes and heart disease need to go lower. "The higher risk you are, the more aggressive you should be with any of these things," Fisher adds.

And make sure your doctor tells you what your numbers are. "Your doctor should write your blood pressure down as you leave," Fisher says. "If they don't tell you, you should ask." As for cholesterol levels, if your total cholesterol is less than 200 mg/dL, your heart attack risk is relatively low, unless you have other risk factors. People whose cholesterol level is from 200 to 239 mg/dL are borderline high risk.

  • Get Support: To get on the path to heart health, enlist the aid of your friends, your doctor or even your dog (if it will persuade you to go for a walk). "Look for sources of support during high-stress times," Bolger advises. "Your friends are facing the same issues. Walk with them, talk to them. Just talking about something in advance can help you." Also, consult your doctor. "You should be speaking with your doctor even if you're young, in your twenties," Fisher says. "Have your complete cholesterol panel drawn. If you're young you don't have to do it often, but you should do it."

More information

The American Heart Association's Simple Solutions Program has tips on healthy living for women. Men and women can check out lifestyle and risk reduction strategies from the association. The National Institutes of Health has a wealth of information on heart and vascular diseases.

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Campbell to Launch Goldfish Minus Transfatty Acids

By Deborah Cohen
Reuters
Monday, February 16, 2004

CHICAGO (Reuters) - Pepperidge Farm Goldfish, the cheesy fish-shaped crackers familiar to most Americans, are about to undergo a major makeover, losing their artery-clogging transfatty acids.

Pepperidge Farm parent Campbell Soup Co. is set to announce the change at a food industry conference on Tuesday, marking the first such modification from a big branded cracker line. It comes amid heightened consumer awareness about health and rising obesity rates.

Tranfatty acids, or TFAs, are made when vegetable oils are hydrogenated, hardening them to make them more shelf-stable. Manufacturers have historically used them in everything from baked goods to microwaved popcorn.

But as with saturated fats, medical experts have linked TFAs to heart disease. By 2006, the U.S. Food and Drug Administration (news - web sites) will require all food makers to label the use of TFAs on packaging.

"Frankly, this is something that came more from the consumer than it did from the FDA," Jay Gould, Pepperidge Farm's newly appointed president, said in an interview. Campbell has been working on the changes for two years, he said, prompted by inquiries from consumers.

The difficulty in modifying Goldfish crackers, Gould said, was to develop a formula that would retain the crispness that TFAs had enabled. Instead of hydrogenated oils, the new Goldfish will use unhydrogenated ones, mainly sunflower and canola.

Wellness Push

In March, the first TFA-free Goldfish to hit grocery shelves will be a new line called Goldfish Crisps. Unlike traditional puffy Goldfish, Crisps will be flat and will come in three varieties: cheddar jack, four cheese and cheesy sour cream and onion.

The entire Goldfish line, with some $300 million in North America sales yearly, will make the change by September, with new packaging that indicates the products are TFA-free.

Other major food makers, including Kraft Foods Inc. and Pepsico Co. Inc.'s snack unit Frito-Lay, have also pledged to reformulate the nutritional content of their foods. Earlier this month, meat and poultry company Tyson Foods Inc. said it was removing TFAs from some of its chicken products.

Gould said Goldfish retail prices would remain unchanged at $1.99 for a 7.2-ounce bag. Crisps, to be packaged in 10-ounce boxes, will sell for $2.99.

In the next year, Campbell also plans to remove trans fats from all of its Pepperidge Farm breads. Some 20 percent of its breads are now made without TFAs, Gould said.

The company "has a major push on a wellness effort," said Gould, who as former head of marketing for Coca-Cola Co.'s Minute Maid division was instrumental in reformulating orange juice to add calcium.

He estimated the Goldfish revamp would cost Campbell more than $10 million, modestly pressuring operating margins in the near term. The new Crisps line will be supported by an additional $10 million in advertising, including TV spots created by WPP Group Plc unit Young & Rubicam.

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Heart Trouble Can Start in the Young

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Monday, February 16, 2004

MONDAY, Feb. 16 (HealthDayNews) -- It was something cardiologist Rae-Ellen Kavey never thought she'd witness.

"For 30 years I have been doing cardiology, and I never thought I would see a child with type 2 diabetes at 10 or 12 years of age," says Kavey, chairwoman of cardiology at Children's Memorial Hospital at Northwestern University's Feinberg School of Medicine in Chicago.

The rising incidence of type 2 diabetes, once called adult-onset diabetes, in young people is just one aspect of the obesity epidemic plaguing the United States. Unfortunately, both diabetes and obesity spell heart trouble, even for kids, she notes.

"Obesity is like a marker for high blood pressure and high cholesterol. Those things all cluster together," Kavey says. "In the old days it was called the deadly triad. I'm seeing it all the time now."

The good news is that damage to arteries is reversible if children just change their behaviors.

Kavey works with her pediatric patients to get them to adopt a weight loss and exercise program. The exercise can be anything they can do in half-hour segments: hula hooping, skipping rope, jazz dancing, karate or a combination.

On the diet side, there are four simple rules:

  • Get rid of all drinks with sugar (that means no juice, no Gatorade, no soda, except diet soda, and no milk except skim milk).
  • All snacks between meals have to be raw fruit, raw vegetables or air-popped popcorn.
  • At mealtime, portions of meat and starch need to be cut by 25 percent (two pieces of toast becomes one-and-a-half). Vegetables and salad fill in any gaps.
  • No eating in front of the television. "That combination is the worst thing you could do, sitting still and eating," Kavey says.

It's not easy. One in four of Kavey's patients loses weight, one in four tries but doesn't lose and two out of four never come back. "That's considered pretty good results," she says.

A successful program, Kavey adds, needs to involve the entire family, especially since obese children often have at least one obese parent. "You can't just change the life of one child," she says. "It's the whole family."

Asked about the U.S. Food and Drug Administration (news - web sites)'s recent approval of the drug Xenical to treat obese adolescents, Kavey says drugs aren't the answer.

"Drugs for adults have been moderately successful," she says. "It's not like drugs are going to transform children who are massively overweight into normal-weight children. The drug has to be combined with diet."

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Sunday, February 15, 2004

The Fight Against Osteoporosis Should Start in Childhood

By Janice Billingsley
HealthDay Reporter
HealthDayNews
Sunday, February 15, 2004

SUNDAY, Feb. 15 (HealthDayNews) -- Fighting osteoporosis in old age is as simple as drinking four glasses of milk a day -- when you're in your teens.

The bone-thinning disease that strikes the elderly is largely preventable when children and especially adolescents get enough calcium -- 1,200 to 1,300 milligrams daily -- while their bodies are building bone density, doctors say.

The problem is that not enough teens are getting the calcium they need.

"Children and adolescents are not ingesting enough calcium, and will be victims of osteoporosis later in life, especially as people live longer," says Dr. Fima Lifshitz, director of pediatrics and a senior nutritional scientist at the Sansum Medical Research Institute in Santa Barbara, Calif.

As many as 90 percent of teenage girls and almost 70 percent of teenage boys aren't taking enough calcium to ensure strong bones for their adult years, according to the U.S. Department of Agriculture (news - web sites) (USDA).

The average teen gets between 700 and 1,000 milligrams of calcium daily, the American Academy of Pediatrics says. Girls, thinking milk is fattening, average only about 740 milligrams a day, health officials report.

An eight-ounce glass of milk contains 300 milligrams of calcium. Other dairy products rich in calcium include cheese and yogurt.

"Dietary habits have changed over time so that children and teens drink more carbonated soda than milk," says Lifshitz, who is on the nutrition council for the American Academy of Pediatrics. That trend, combined with less physical activity, puts teens at long-term risk for osteoporosis.

The USDA reports that milk consumption among teens is down 16 percent since the 1970s while soft drink consumption is up by the same amount. Also, a recent Mayo Clinic study found that from 1977 to 1996, the consumption of soft drinks among girls aged 12 to 19 increased from 207 milligrams to 396 milligrams a day, while milk consumption fell from 303 to 189 milligrams.

Fortunately, these figures aren't going unnoticed by health officials and the government.

For the last several years, the National Institute of Child Health and Human Development (NICHD) has run a national "Milk Matters" campaign to raise awareness of the need for young people to increase their calcium intake. The campaign includes brochures and educational programs as well as conferences for health professionals, and has heightened awareness that calcium consumption and physical activity should be increased for teens.

The NICHD is also funding a multi-center, three-year national study of 1,500 children aged six to 19 to track bone density as it relates to diet, particularly calcium intake; exercise; and development during puberty.

The children will be examined four times over the review period, says one of the study participants, Dr. Mary Horlick, a pediatric endocrinologist at Columbia University's Children's Hospital in New York City.

"Our goal is to understand how bone mass changes and to be able to track growth curves for bone density the way we do now with height and weight," she says.

This information will help doctors assess which children might need medical help to boost their bone density, she says.

The American Academy of Pediatrics has also addressed the problem of poor calcium intake. Several years ago, it issued a policy statement for member doctors with guidelines for adequate calcium intake. The statement also included studies reporting increases in bone fractures in children and teens with low calcium intake.

The results of all this attention have started to pay some dividends.

"Kids are beginning to increase calcium consumption a little bit more, and we're optimistic because health professionals continue to rally around this issue," says Gregory Miller, senior vice president of nutrition communications for the National Dairy Council.

The role of exercise in increasing bone density is being studied, too.

A study in the December 2003 issue of Pediatrics found bone mineral density increased by 5 percent among 191 middle school girls who participated in weight-bearing exercise such as jumping rope three times a week for about 10 minutes over a two-year period.

While calcium and vitamin D intake are important for building bone density, Horlick says, exercise seems to play a role as well.

"Weight-bearing exercises seem to be very important, particularly for the hips," she says.

Lifshitz recommends that children, adolescents and their parents follow some simple guidelines to promote strong bones while young.

"Kids should eat a healthful diet with the recommended calcium -- stay away from empty calories from fruit drinks. They should be active -- the human body isn't meant to be watching TV all day long. And number three, they should get outside to get vitamin D, which helps absorb the calcium."

An estimated 10 million Americans -- 80 percent of them women -- have osteoporosis, and almost 34 million more are estimated to have low bone mass, placing them at increased risk for the disease.

More information

Check with the National Institute of Child Health and Human Development for more about the "Milk Matters" program. To learn more about osteoporosis, visit the National Osteoporosis Foundation.

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Saturday, February 14, 2004

Government Computerizes Calorie Plan

By Ira Dreyfuss
Associated Press Writer
The Associated Press
Saturday, February 14, 2004

WASHINGTON - The government's Food Guide Pyramid cannot cover everyone, so federal dietary planners want people to build their own version. The Agriculture Department office that manages the pyramid is fitting its Web site to help people tailor individual programs for diet and exercise as part of a food guide policy that will offer more room for variation.

"The Food Guide Pyramid was viewed as being for everybody, but it wasn't related to the individual," said Eric Hentges, executive director of the department's Center for Nutrition Policy and Health Promotion. "If people wanted to make a change, they didn't see how they could use our food guidance to make the change."

As federal officials and scientific advisers update the government's dietary guidance, including the pyramid, they plan to work the Web site into the update. Hentges said the aim is to custom-fit guidance on food and physical activity.

The Interactive Healthy Eating Index offers such guidance in fine detail. For instance, entering coffee at the site produces a menu of 57 choices including coffee, ground, and coffee, Cuban, sweetened espresso as well as Little Debbie Apple Streusel Coffee Cake.

The program prompts users to list how many times a day they had that coffee or coffee cake, and the size of the servings. A diligent user going through the database can list everything consumed every day.

The payoff is a running balance on calories, carbohydrates, proteins and specific nutrients such as vitamin A.

The index ties into federal food guides, comparing a specific food item or a day's dining with what the pyramid recommends. It also rates how successful the user is in meeting the healthy eating recommendations.

The gauge is more exact than the current pyramid, which simplifies calorie choices into three levels. Inactive women and older adults might need only 1,600 calories a day, while active women and many sedentary men might require 2,200, and physically active teenagers might chew through 2,800. Based on that, a person might eat from six serving to 11 servings of grain a day.

The pyramid does not advise people how much to work out. In contrast, a physical activity tool on the Web site has about 600 choices.

Users can choose how hard they work; runners might charge ahead at 6.5 minutes per mile or jog at 12 minutes per mile. By listing their daily activities and the time they spend on them, people can add up the calories they work off just as they add the calories they consume.

The program also lets people compare their daily activities with federal targets for physical activity. For adults, the target is at least 30 minutes a day on most days of the week; younger people ought to do at least 60 minutes.

The government has increased its emphasis on exercise, but the addition of physical activity to the food mix will be a big change. Two members of an advisory committee working on revising the dietary guidelines said the result will bring more balance to the federal focus on calories.

"I hope this version of the guidelines will take a step toward drawing the two together: energy expenditure and energy intake," said Russell R. Pate, associate dean for research at the University of South Carolina.

Added Dr. F. Xavier Pi-Sunyer, director of the Obesity Research Center at the Columbia University Medical School: "It's pretty difficult to regulate intake if you don't do physical activity."

How the new guidelines will look is uncertain. One proposal calls for 12 different levels of recommended calories. That may be too complicated for what is supposed to be an easy-to-grasp graphic, which is supposed to be released in the winter of 2005.

On the Net:

Interactive Healthy Eating Index: http://www.usda.gov/cnpp/projects.html

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