The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
May 11, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 March 13-19

Friday, March 19, 2004  

  1. Eat Lower-Mercury Fish, U.S. Tells Women, Children
  2. Candy Bar Said to Have Toxic Lead Levels
  3. Death from Breast Cancer Linked to Birth Interval
  4. Five Servings of Fruit and Veggies a Day
  5. Blacks Have Greater Risk of Cataracts
  6. Detecting Diabetes
  7. Timely Surgery Can Reduce Risk of Major Stroke
  8. Common Bacteria Linked to Alzheimer's Disease
  9. Milk-Duct Breast Cancer Survival Rates Good –Study
  10. Low Hormone Levels Cause Female Sexual Dysfunction
  11. Black Veterans Fare Better After Heart Failure
  12. Sherry Joins Ranks of Heart-Friendly Drinks
  13. Radiofrequency Treatment Destroys Big Liver Tumors
  14. Fish-Oil Supplements Have Contaminants, Study Claims
  15. Nutritionists Give Thumbs Up to Big Mac?
  16. Therapy Can Put Insomniacs' Drug Habit to Rest
  17. Misread X-Ray Leads to Thin Bone Diagnosis in Kids
  18. Inhalant Abuse Rebounds Among U.S. Youths, Experts Say
  19. Buffalo Restaurants Try Lower-Fat Options
  20. Study: Tuberculosis Is on the Rise in Big U.S. States
  21. Study: Brain Enzyme May Regulate Weight
  22. 'Healthy' Diet May Increase Bad Cholesterol
  23. Teenage Alcohol Abuse
  24. Chip Industry to Probe Cancer Rates of Workers
  25. Picking Best Candidates for Brachytherapy
  26. Allergy Drug Not Linked to Birth Defect, Study Finds
  27. Level of Immune Cells Predict Chances Against Leukemia
  28. Obesity Not Linked with Asthma in Kids
  29. Parkinson's Risk Higher for Men
  30. 'Designer' Orange Juice May Lower Cholesterol: Study
  31. New Way to Treat Hepatitis B?
  32. Strengthening Exercises Relieve Achilles Pain
  33. New Drug Shows Promise Against Advanced Breast Cancer
  34. Radiation May Not Help Pancreatic Cancer
  35. Supplement Companies Agree to End Cure Claims –US
  36. Breast Cancer Risk Tied to Wine, Fat Intake
  37. Study: Brain Enzyme May Regulate Weight
  38. Zebrafish May Give Clues to Stomach Problems
  39. Fosamax Has Long Lasting Effect on Bones -US Study
  40. Hypertension in Childhood a Harbinger for Heart Disease
  41. Breast Cancer Treatment Varies Across U.S. –Study
  42. Soda Patrol
  43. Revealed - How Deadly Bacteria Evade Immune System
  44. Dodging DVT
  45. Study: Parents Don't See Obesity in Their Children
  46. Containing the Damage of Spinal Cord Injuries
  47. Sinusitis Not as Common as Thought
  48. Vitamin D Compound Inhibits Breast Cancer Cells
  49. Part-Time Vegetarians Become More Common
  50. Dry Mouth
  51. Fruits and Vegetables May Strengthen Girls' Bones
  52. Surveys Examine Urinary Infections, Women
  53. Rheumatoid Arthritis May Raise Heart Failure Risk
  54. Utah Braces for West Nile Virus Season
  55. Drug Resistant TB Poses Global Problem - WHO Report
  56. Home Is Where the Heart Monitoring Is
  57. Early Radiation May Cure Recurrent Prostate Cancer
  58. Meet America's 100 'Asthma Capitals'
  59. Virus Linked with Head and Neck Cancer
  60. Researchers Flip Immune System's 'On' Switch
  61. Study: Painkilling Patch Works Like Needle Delivery
  62. Psoriasis Treatment Shows Unwanted Side Effect
  63. Your Sense of Smell Can Save Your Life
  64. Toxin Combo May Treat Leukemia
  65. Group Sues FDA Over Drug Linked to Liver Damage
  66. Alaska Dentists Want Fluoride in Water
  67. Blood Pressure Points to Heart Trouble for Women
  68. Survey Shows Blacks Unaware of Kidney Risk
  69. Arsenic Study May Point to Leukemia Treatments
  70. Surveys Examine Urinary Infections, Women
  71. Many Stroke Victims Reach Hospital Too Late, U.S. Study Finds
  72. Mice Produce SARS Antibodies
  73. High-Level Job Linked with Excessive Drinking in Women
  74. Master Blood Cell Gene Identified
  75. Brain Chemical May Help Narcolepsy, Study Shows
  76. Studies Warn of Dangers of Drinking in Pregnancy
  77. Pumping Iron Improves Insulin Effects in Diabetics
  78. Study to Test Best Diabetes Therapy for Kids
  79. Poor Sugar Control in Diabetics Affects Lungs
  80. Not All Nicotine-Replacement Products Are Equal
  81. Bowel Disease Raises Risk of Blood Clots
  82. Butting Out
  83. Acupuncture Helps Chronic Headache Sufferers-Study
  84. Protecting Your Kidneys
  85. Doctors See Vascular System as Road to Treatment
  86. The Truth About Aging
Friday, March 19, 2004  
Eat Lower-Mercury Fish, U.S. Tells Women, Children  

Reuters

Fri, March 19 2004

WASHINGTON (Reuters) - Shark, swordfish, king mackerel and tilefish should be off the menu for pregnant women, nursing mothers, children and women who may become pregnant because they contain too much mercury, the U.S. government said on Friday.

Health officials said adults can eat up to 12 ounces -- two average meals -- a week of seafood that was lower in mercury such as shrimp, canned light tuna, salmon, pollock and catfish. Only half that amount of albacore, or "white," tuna, should be eaten per week.

Consumer and environmental groups said the government had soft-pedaled the risk from eating large amounts of white tuna. "Tuna is a really popular fish and some people eat a whole lot of it," said Diana Zuckerman of the National Center for Policy Research for Women and Children.

While fish and shellfish are a good source of protein, nearly all seafood contains traces of methylmercury. High levels of mercury in the bloodstream of fetuses and young children can impair development of the nervous system.

In a joint advisory that updated guidelines issued separately, the Food and Drug Administration (news - web sites) and the Environmental Protection Agency (news - web sites) said shark, swordfish, king mackerel and tilefish should not be eaten by pregnant women, nursing mothers, children and women who may become pregnant. Methylmercury levels are highest in longer-lived, large fish.

The FDA and EPA said adults could eat up to 12 ounces per week of fish low in mercury. But they should eat no more than six ounces of white tuna or fish caught by family and friends.

The same guidelines on weekly consumption apply to children but they should be given smaller portions, officials said.

Tuna Also High In Mercury

Fish sticks and fish sandwiches commonly are made using fish low in mercury, FDA said. Tuna steaks are higher in mercury and should be limited to six ounces a week.

On Thursday, the European Union (news - web sites)'s food safety authority recommended pregnant women limit consumption of fish, including swordfish and tuna, due to high mercury levels.

U.S. consumer activists said as a rule, light tuna had higher levels of mercury than shrimp, salmon, pollock and catfish, which were listed together as "five commonly eaten fish that are low in mercury."

An EPA researcher has estimated about 630,000 U.S. children are born annually with unsafe levels of mercury in the blood.

"What concerns me is how they buried this tuna information," said Zuckerman, by putting it toward the bottom of the one-page advisory.

White tuna contains three times as much mercury as light tuna, said Jane Halloran of Consumers Union. "It is essential FDA warn women of child-bearing age to limit their intake of albacore white tuna," she said.

The Environmental Working Group said the FDA "has actually made a bad situation worse, by encouraging consumption of albacore tuna at clearly unsafe levels." EWG said some white tuna can contain excessive amounts of mercury.

Trade groups representing the food industry said the new advisory showed the benefits of fish as well as how to limit exposure to mercury. The U.S. Tuna Foundation described tuna as "nature's healthy fast food," low in fat and high in nutrients.

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Candy Bar Said to Have Toxic Lead Levels  

The Associated Press

Fri, March 19 2004

SACRAMENTO, Calif. - A Mexico candy bar contains toxic levels of lead and people should avoid eating it, state officials warned.

Chaca Chaca is made from apple pulp and chili powder and comes wrapped in red and white cellophane. The name comes from the sound a train makes on the tracks, and a train is depicted on the wrapper.

The state Department of Health Services alerted consumers Thursday. Lead could harm the nervous system and kidneys, said state epidemiologist Dr. Gilberto Chavez. Lead poisoning can also cause learning disabilities and behavioral disorders.

Chaca Chaca was tested by the state food and drug branch in June and August 2002. Those tests found the candy bar contained three to four times the lead level allowed by FDA (news - web sites) guidelines.

The health warning is the first California has issued on a candy since 2001, when consumers were cautioned about a lollipop made of fig-like tamarind discovered in the Costa Mesa home of a child with lead poisoning.

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Death from Breast Cancer Linked to Birth Interval  

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - In premenopausal women with breast cancer, the risk of death is increased if a child was born less than two years before the cancer diagnosis, Australian researchers report.

Dr. John L. Hopper from The University of Melbourne and colleagues used data from the Australian Breast Cancer (news - web sites) Family Study to assess the impact of recent childbirth before diagnosis on subsequent mortality in 750 premenopausal women with breast cancer.

The researchers report in the Journal of Clinical Oncology that five-year death rates were highest for women who gave birth within two years before diagnosis (28 percent), and somewhat lower for women in whom the interval was between two and five years (24 percent).

Mortality rates for women who never gave birth (16 percent) and for women who gave birth more than five years before their breast cancer diagnosis (14 percent) were similar.

Compared with women who never gave birth, women who gave birth within two years prior to the cancer diagnosis faced a 2.3-fold increased risk of death.

The mortality risk in those who had ever given birth was 2.4-fold higher than for women who hadn't, but this risk declined by 10 percent for each additional year between the last birth and diagnosis of breast cancer.

Women who had given birth within two years before their breast cancer diagnosis were more likely to have more aggressive tumors.

Even after accounting for these risk factors, breast cancer patients with a birth history were nearly twice as likely to die as patients who had never given birth, the investigators report.

The authors observe that the findings add to "the increasing body of evidence stating that having a recent pregnancy influences the biologic behavior of breast cancer in young women, resulting in a more aggressive" cancer.

They conclude that doctors should be aware that such patients "may have a worse outcome than might be suggested just by assessing the standard...prognostic factors of their cancers."

Source: Journal of Clinical Oncology, February 15, 2004.

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Five Servings of Fruit and Veggies a Day  

HealthDayNews
Fri, March 19 2004

(HealthDayNews) -- According to the U.S. National Cancer Institute (news - web sites), 35 percent of cancer deaths in the United States can be attributed to diets that are high in fat and low in fruit, vegetables and fiber.

And people who eat adequate amounts of fruit and vegetables -- five to nine servings daily -- may cut their cancer risk in half compared to those who don't.

To increase your consumption, the Virginia Department of Health suggests you:

  • Eat fruit or drink 100 percent fruit juice for breakfast.
  • Have a fruit or vegetable snack every day.
  • Buy fresh, frozen, canned and dried fruits and vegetables.
  • Steam or microwave vegetables for dinner.

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Blacks Have Greater Risk of Cataracts  

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - Blacks are significantly more likely to develop cataracts than are whites, investigators with the Barbados Eye Studies Group report in the journal Ophthalmology.

In fact, lead author Dr. M. Cristina Leske from Stony Brook School of Medicine in New York told Reuters Health, "this is the first paper to show a high risk of developing new cataracts...in persons of African descent." All previous studies, she added, "have been based on existing cases."

Among nearly 3000 Barbadian-born adults followed for nine years, the overall incidence of lens changes was significantly higher in blacks (46 percent) than in whites (34.6 percent).

After taking into consideration the effects of age and sex, the risk of new cataracts was 80 percent higher in blacks than in whites.

As expected, the incidence of cataracts increased with age, and women were more likely than men to experience lens changes.

The high risk of cataracts in blacks "may be related to the higher prevalence of diabetes, abdominal obesity, and in black than white populations," Leske said. Modifying these factors may reduce the risk of developing cataracts, "but that is not proven," she added.

Source: Ophthalmology, February 2004.

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Detecting Diabetes  

HealthDayNews
Fri, March 19 2004

(HealthDayNews) -- About 20 million Americans have diabetes, but half of them don't know they have it, according to the University Of Washington.

Signs and symptoms of diabetes include:

  • Frequent urination.
  • Always being thirsty or hungry.
  • Often feeling tired.
  • Blurred vision.
  • Slow wound healing.
  • Recurring urinary tract infections.
  • Obesity.

A family history of diabetes also increases a person's risk.

If you're concerned that you may have diabetes, tell your doctor. You can also take a screening test to determine your level of risk.

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Timely Surgery Can Reduce Risk of Major Stroke  

Reuters Health

Fri, March 19 2004  

NEW YORK (Reuters Health) - Surgery to clear blocked arteries that supply blood to the brain is most beneficial in preventing a major stroke if it is performed within two weeks after a minor stroke has occurred, investigators report.

If this procedure, called carotid endarterectomy, is performed more than two weeks after a patient has experienced a transient ischemic attack (TIA) or nondisabling stroke, there may be no benefits at all.

"Ideally, the procedure should be done within two weeks of the patient's last symptoms," Dr. Peter M. Rothwell, at Radcliffe Infirmary in Oxford, UK, and his colleagues advise in their report, published The Lancet.

The authors pooled data from two large trials of carotid endarterectomy, which included nearly 5900 patients recruited after a TIA, non-disabling ischemic stroke or a blockage of the retina. Subjects were randomly assigned to immediate endarterectomy or medical treatment.

For patients with at least 50-percent blockages, time from the last minor stroke symptom to surgery was significantly associated with effectiveness of the procedure. In fact, for patients with 50- to 69-percent blockages, only those treated within two weeks of the onset of symptoms achieved clinical benefits, the authors note.

Endarterectomy "is often not done until several months after the event--even if the patient seeks medical attention immediately after their warning stroke," Rothwell notes in a Lancet press release.

"Benefit from surgery is very much reduced at this time, and many patients who would have benefited have their major stroke whilst waiting for surgery."

Source: The Lancet, March 20, 2004.

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Common Bacteria Linked to Alzheimer's Disease  

HealthDayNews
Fri, March 19 2004

FRIDAY, March 19 (HealthDayNews) -- There's a link between the common respiratory bacteria Chlamydia pneumoniae and amyloid plaques found in the brains of people with non-hereditary Alzheimer's disease (news - web sites).

That's the news from a study by researchers at the Philadelphia College of Osteopathic Medicine's Center for the Study of Chronic Diseases of Aging.

The research in mice appears in the April issue of the journal Neurobiology of Aging.

The researchers have spent several years studying this link. This new research builds on their previous finding that C. pneumoniae is present in 90 percent of brains of people with Alzheimer's disease.

In this most recent study, the researchers showed that when the bacteria was sprayed into the noses of mice that are not predisposed to amyloid plaques, it caused progressive deposition of amyloid plaques, creating a partial model of Alzheimer's disease.

"We believe this could be a trigger mechanism for the pathology in Alzheimer's disease," lead researcher Brian Balin says in a prepared statement.

"People have been suspecting this for decades but could not find anything. It is very difficult to pinpoint an infectious cause for a progressive, chronic disease. We also believe that our isolation of Chlamydia pneumoniae from the human Alzheimer's diseased brain and induction of pathology in normal mice is proof of principle that this can be a causative mechanism turning on pathology," Balin says.

More information

The U.S. National Institute on Aging has more about Alzheimer's disease.

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Milk-Duct Breast Cancer Survival Rates Good –Study  

Reuters

Fri, March 19 2004

HAMBURG, Germany (Reuters) - Women with an early type of breast cancer have a good chance of surviving even if the disease returns after the initial treatment, doctors said on Friday.

Ductal carcinoma in situ (DCIS) is a non-invasive early cancer that is restricted to the milk ducts in the breast. It is becoming more common as mammograms pick up early signs of the disease, but how it is treated varies.

If DCIS is extensive, a mastectomy may be necessary. Otherwise patients may have a lumpectomy, in which only part of the breast is removed, which may be followed by a course of radiotherapy to destroy any cancerous cells left behind.

Professor Dennis Holmes of the University of Southern California Keck School of Medicine told the Fourth European Breast Cancer (news - web sites) Conference that although the risk of the cancer returning is higher with a lumpectomy, long-term survival is the same.

"These results show that nearly all patients with DCIS whose cancer recurs can be treated successfully, whether or not DCIS recurs as new DCIS or invasive cancer," he said.

About half of recurrences of DCIS are invasive cancer which is more serious because it can spread to other parts of the body.

In a study of 1,136 patients, Holmes and his colleagues said 30 percent of women who had a lumpectomy had a recurrence after 10 years compared to 18 percent who a lumpectomy and radiotherapy and 1.8 percent who had chosen to have a mastectomy.

"The 10-year rate of deaths from all causes and from breast cancer specifically is statistically similar across all three groups," he added.

In a small group of patients whose DCIS returned as invasive cancer, the chances of survival were better than 90 percent.

Holmes stressed that patients must be rigorously monitored so that any signs of a recurrence can be picked up and treated as early as possible.

"Mastectomy is associated with the lowest risk of local recurrence but provides no survival advantage when compared with breast conservation therapy," he added.

About 4,000 delegates from 80 countries are attending the five-day meeting that ends on Saturday.

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Low Hormone Levels Cause Female Sexual Dysfunction  

HealthDayNews
Fri, March 19 2004

FRIDAY, March 19 (HealthDayNews) -- Low hormone levels cause sexual dysfunction in healthy, premenopausal women, says a study by researchers at Boston University School of Medicine's Institute for Sexual Medicine.

Their study is the first to show healthy, premenopausal women with sexual dysfunction have lower serum testosterone and adrenal androgen levels than premenopausal women who are free of sexual dysfunction.

"Female sexual dysfunction has long been considered as exclusively a psychologic, emotional or relationship issue. We have now shown conclusively that biologic factors such as low serum androgen levels are also responsible for development of female sexual dysfunction issues," senior author Dr. Irwin Goldstein, directors of the university's Institute for Sexual Medicine, says in a prepared statement.

The findings appear online in the International Journal of Impotence Research.

More information

The American Association for Marriage and Family Therapy has more about female sexual problems.

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Black Veterans Fare Better After Heart Failure  

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - Despite similar readmission rates, black veterans with congestive heart failure (CHF) have better survival rates than do their white counterparts, according to a report in the Journal of the American College of Cardiology.

As lead investigator Dr. Anita Deswal told Reuters Health, "in the VA health care system, a system designed to provide financially 'equal access' to care for all enrolled patients, the racial gap in patterns of health care utilization following a hospitalization for CHF is small."

"The observation of better survival in black patients after a hospitalization for CHF is not readily explained by differences in health care utilization and needs further evaluation."

Deswal from Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas and colleagues investigated racial differences in 30-day and 2-year mortality and 1-year healthcare utilization in 4,901 black and 17,093 white veterans hospitalized for CHF in 153 hospitals of the VA healthcare system.

Mortality was lower for blacks than for whites during the initial hospitalization (3.3 versus 4.9 percent), at 30 days after admission (4.6 versus 7.3 percent), 1 year after discharge (20 versus 25.8 percent), and 2 years after discharge (30.5 versus 37.5 percent).

Readmission rates were similar for blacks and whites, but black patients received fewer medical outpatient clinic visits and more emergency room and urgent care clinic visits than did whites.

The findings are "in contrast to the non-VA setting where most studies have shown a higher number of rehospitalizations in black patients with heart failure," Deswal continued.

"We are conducting a study within the VA setting," she concluded "using medical records and more clinical data, to evaluate whether there are differences by race in the clinical severity of illness at the time of hospitalization and whether non-clinical factors contributing to hospitalization may differ by race."

Source: Journal of the American College of Cardiology, March 3, 2004.

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Sherry Joins Ranks of Heart-Friendly Drinks  

HealthDayNews
Fri, March 19 2004

FRIDAY, March 19 (HealthDayNews) -- Like red wine, sherry contains antioxidants called polyphenols that help control cholesterol levels and reduce the risk of coronary artery disease, claims a study by researchers at the University of Seville in Spain.

"Sherry is widely consumed, especially in Spain and the U.K., and we have shown that its moderate intake decreased total cholesterol and increased HDL cholesterol," researcher Juan M. Guerrero says in a prepared statement.

The polyphenols in sherry prevent the oxidation of bad low-density lipoprotein (LDL) cholesterol and can also increase production of high-density lipoprotein (HDL) cholesterol. HDL cholesterol is associated with longevity and decreased incidence of coronary artery disease.

The Spanish researchers gave rats sherry each day for more than two months. The daily amount given to each rat was the equivalent of a 150 milliliter serving consumed by a 70-kilogram human adult.

The sherry didn't affect the rats' weights and had no significant impact on any of their other metabolic processes. But the rats showed a decrease in LDL cholesterol and an increase in HDL cholesterol.

"As a general rule, moderate consumption of red wine exerts beneficial effects for health. In our research, the beneficial effects of red wine can be extensive to sherry wines," Guerrero says.

The study appears in the current issue of the Journal of the Science of Food and Agriculture.

More information

The American Heart Association (news - web sites) has more about antioxidants.

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Radiofrequency Treatment Destroys Big Liver Tumors  

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - An electrical method of destroying abnormal tissue, known as radiofrequency ablation (RFA), is a safe and effective treatment for liver tumors called hepatocellular carcinomas (HCCs)--even if they're large, new research suggests.

The high success rate in the current study may be due to the RFA approach used, lead author Dr. Ronnie T. P. Poon told Reuters Health. Instead of indirectly applying RFA through the skin as is often used, the researchers often used a "surgical approach," which required an incision.

"Large HCCs often require more than one pass of the RFA electrode for complete (tumor destruction)," he pointed out, "and this is better done with a surgical approach."

In reporting their findings in the Archives of Surgery, the investigators note that high rates of complete tumor destruction have been noted previously with the use of RFA for HCCs measuring three centimeters or smaller but the effectiveness for larger HCCs is less well established.

Poon from The University of Hong Kong and colleagues evaluated the results of RFA in 35 patients with larger HCCs with those achieved in 51 patients with smaller HCCs.

The majority of patients had disease that couldn't be removed with conventional surgery due to poor hepatic function. The choice of treatment route -- through the skin or with a surgical approach -- was based on tumor size and position. Most patients with larger tumors received the surgical approach.

Complete tumor destruction rates after a single treatment session at one month were comparable between the two groups -- 94 percent in patients with smaller tumors and 91 percent in those with larger tumors. Complication rates and survival rates were also comparable.

Although studies with longer follow-up are needed, the researchers conclude, "on the basis of immediate and short-term follow-up," RFA is an option for the treatment of HCCs larger than three centimeters.

Source: Archives of Surgery, March 2004.

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Fish-Oil Supplements Have Contaminants, Study Claims  

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Fri, March 19 2004

FRIDAY, March 19 (HealthDayNews) -- Levels of fire retardants found in cod liver oil-based dietary supplements are on the rise, a new British study claims.

Fire retardants are added to various consumer products, including furniture, computers and fabrics, to reduce the risk of fire. The chemicals have already been found in breast milk and peregrine falcon eggs. Some researchers contend the chemicals are responsible for health problems in humans.

The British study also found that levels of PCBs and pesticides in the supplements have declined in recent years, but only slightly.

The research appears in the April 7 issue of the Journal of Agricultural and Food Chemistry.

"Really, these contaminants shouldn't be there in the first place," says lead author Miriam Jacobs, a lecturer in food safety at the University of Surrey in Guildford, England.

Other experts, however, question the validity of the findings.

"These are not U.S. supplements. That's a big one," says Charles Santerre, an associate professor of foods and nutrition at Purdue University and a technical consultant for the industry group, Salmon of the Americas.

"Also, they [the researchers] didn't compare [flame retardants] in supplements. They compared salmon feed to supplements, which is apples and oranges. You can't ascribe an increase in [flame retardants] in fish oil supplements. They actually might be going down."

For her study, Jacobs measured for levels of the flame retardants in salmon feed four years ago, then compared those findings to levels found recently in supplements. Her conclusion: Levels of the retardants were more than twice as high in the cod liver oil supplements than in the salmon feed.

Annette Dickinson, president of the Council for Responsible Nutrition, says levels of all the contaminants in the study were below the council's tolerance levels. The cod liver oil figures were higher, she adds, but "they are a relatively cruder extract... The liver does concentrate these contaminants so whole-fish oils are inherently less contaminated and also are processed differently."

Many people supplement their diet with fish and vegetable oils because they contain omega-3 fatty acids, which have been shown to reduce the risk of heart disease as well as certain immunological and arthritic diseases.

But, if the fish from which the oil is taken are caught in polluted waters, the oils can turn out to be contaminated. And this contamination can have health effects. According to the study authors, there is evidence that flame retardants interfere with hormone function in wildlife and may be implicated in developmental difficulties in children.

Eight years ago, Jacobs assessed the levels of pesticides and polychlorinated biphenyls (PCBs) in different dietary supplements. She did not measure for fire retardants back then.

"Those samples eight years ago were not analyzed for flame retardants because the analytical techniques hadn't been worked up and they weren't known to be an environmental issue," she explains.

For the new study, Jacobs and her team looked at levels of PCBs, pesticides and polybrominated diphenyl ethers (PBDEs), which are widely used as flame retardants, in 21 dietary supplements containing fish and vegetable oils rich in omega-3 fatty acids. These were the same brands from the same stores in London that she had analyzed eight years ago.

Supplements based on vegetable oil and whole body fish oil showed little or no contamination in the current and previous studies, with vegetable oils containing the lowest level of contaminants.

"There was evidence of a slight reduction [of PCBs and pesticides] in the cod liver oils, but only very slight," Jacobs says. "It was still the same magnitude, but they're still present and people would still be taking in a relatively high level of PCBs compared to other sources in the diet."

The flame retardant levels in cod liver oils, however, were more than double the levels she had found four years ago in salmon feed. But whether these figures are comparable is still a question.

Santerre feels manufacturers need to set up a better system for identifying how well a product bound for supplements is refined.

As for public health implications, Jacobs says the new study "suggests that more steps need to be taken to reduce the environmental release of these compounds. The second thing is that manufacturers need to do more to try and reduce the contaminant levels."

This is not impossible, she adds. The brand that was one of the most contaminated eight years ago was, this time around, one of the cleaner supplements. "The fact that oils could be reformulated to have reduced levels is perfectly possible," Jacobs says.

More information

The Environmental Working Group has a report on fire retardants in breast milk. The American Heart Association has more on omega-3 fatty acids.

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Nutritionists Give Thumbs Up to Big Mac?  

Reuters

Fri, March 19 2004

PARIS (Reuters) - Want to stay fit and healthy? Two top French nutritionists are telling people to go for a Big Mac and keep their fingers off the traditional French quiche.

In an unexpected message to a country priding itself on the superiority of its food, a new food guide praises the McDonald's burger for having a higher and healthier protein-to-fat ratio than France's Quiche Lorraine.

"Strangely enough, the products which are the most demonized are not necessarily the worst," Jean-Michel Cohen and Patrick Serog write in their book "Savoir Manger," in which they analyze 5,000 dishes available in shops and restaurants.

The verdict published this month comes as McDonald's launches a new campaign to add healthier food choices to its menus. It has also said it is eliminating Supersize fries and soft drinks.

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Therapy Can Put Insomniacs' Drug Habit to Rest  

By Amy Norton

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - Even people who have been taking drugs for insomnia for years can be weaned off of them without significant withdrawal symptoms, a new study shows.

Canadian researchers found that most of the 76 older adults they studied were able to stop using benzodiazepines with the help of supervised medication "tapering" and psychological therapy to address their insomnia.

Benzodiazepine drugs have a sedating effect on the central nervous system and are used to treat a number of conditions, including anxiety and insomnia. Prescribing guidelines say the drugs should be used for insomnia for no more than a few weeks because of potential side effects, including tolerance to the drugs' effects, and dependence.

Despite the guidelines, many people with chronic insomnia--particularly older adults--take the drugs for years. Some doctors keep prescribing them because their patients ask for them, according to lead study author Dr. Charles M. Morin of Universite Laval in Quebec.

Patients can become caught in a "vicious cycle," he told Reuters Health, as their benzodiazepines do not relieve their insomnia, yet if they try to quit "cold turkey," their sleep problems become worse. And all the while the underlying cause of their sleepless nights is not addressed.

Patients in Morin's study, all age 55 or older, had been on benzodiazepines for an average of 19 years.

Despite such prolonged use, however, nearly two thirds were drug-free within an average of seven weeks of discontinuation therapy, Morin and his colleagues report in the American Journal of Psychiatry.

The study patients underwent one of three therapy approaches. Some were treated with medication tapering, where doctors gradually lowered their benzodiazepine doses, with the goal of cutting out the drugs in 10 weeks.

Others went through 10 weeks of cognitive behavioral therapy, which aimed to change the way patients' thought about sleep, insomnia and drug-withdrawal symptoms. The therapy also gave them tactics to battle their sleep problems--such as using their beds only for sleep and sex, getting out of bed if they couldn't fall asleep within about 15 minutes, and getting up at the same time every morning.

A third group of patients received both medication tapering and cognitive behavioral therapy.

While all three treatment tactics helped most patients eliminate or cut back on their medication, the combined approach worked best, according to the researchers.

After 10 weeks of treatment, 85 percent of men and women in the combined-therapy group were drug-free, compared with 48 percent of those who received medication tapering and 54 percent in the cognitive behavioral therapy group.

One year later, 60 percent of patients overall were still off of benzodiazepines, with the combined-therapy group still showing better results--though the difference was less marked.

What's more, the researchers say, patients reported few withdrawal symptoms, such as anxiety and "rebound" insomnia--two major side effects of abruptly stopping benzodiazepines.

Instead, those who received cognitive behavioral therapy generally had modest sleep improvements during therapy that became more significant over the long-term. Patients treated with only medication tapering showed long-term improvements in sleep.

Morin said that some long-time benzodiazepine users may do well with only medication tapering, but others may also need the help of a sleep specialist. He believes that the better results in the combined-therapy group reflect the ability of cognitive behavioral therapy to get at the roots of patients' insomnia.

Source: American Journal of Psychiatry, February 2004.

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Misread X-Ray Leads to Thin Bone Diagnosis in Kids  

Reuters Health

Fri, March 19 2004

NEW YORK (Reuters Health) - Misinterpretation of a special X-ray test called DEXA often leads to an incorrect diagnosis of osteoporosis in children, new research indicates. In the current study, more than half of the children diagnosed with osteoporosis as a result of DEXA examinations actually had normal bones.

DEXA scans are primarily used to diagnose osteoporosis--abnormally low bone density--in postmenopausal women, but in recent years their use has been extended to other patient groups, including children. The investigators point out that interpreting such scans in pediatric populations is more difficult because of ongoing bone growth.

As reported in The Journal of Pediatrics, Dr. Rachel I. Gafni and Dr. Jeffrey Baron from the National Institutes of Health (news - web sites) in Bethesda, Maryland, reviewed the DEXA scans of 34 children who were referred to their center for apparent bone thinning.

The authors found that 30 of the scans (88 percent) contained at least one interpretation error.

After correcting for the various errors, only 26 percent of children still had a diagnosis of bone thinning. Fifty-three percent of subjects were reclassified as having normal bones and 21 percent could not be definitively diagnosed.

The researchers offer two general recommendations for doctors looking at DEXA scans in children. "First, the DEXA software for pediatric patients should use...data specific for age, sex, ethnicity, and, ideally, body size and pubertal status."

Secondly, they add, "the principles of DEXA interpretation in children "should be better disseminated to healthcare providers" who read such scans.

Source: Journal of Pediatrics, March 2004.

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Thursday, March 18, 2004  

Inhalant Abuse Rebounds Among U.S. Youths, Experts Say  

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, March 18, 2004 

WASHINGTON (Reuters) - The effects of a 1990s advertising campaign credited with reducing inhalant abuse among children are starting to wear off, and a new generation is at risk, U.S. experts said on Thursday.

While abuse of many other drugs such as marijuana is declining, young teens are starting to experiment again with inhalants such as glue or nail polish, government and non-profit group experts said.

They said they will renew efforts to warn parents and children about the dangers of "huffing" or "sniffing," which can kill or leave users brain-damaged for life.

Those most likely to use them are young teens, the Partnership for a Drug-Free America said in a report.

The Partnership help organize an advertising campaign in 1995 that targeted children aged 9 to 17 and their parents. Groups including the federal Substance Abuse and Mental Health Services Administration agree it helped reduce inhalant use through its messages stressing the dangers of huffing.

"Today's sixth-graders, who were too young to benefit from the campaigns of the 1990s, are now exposed to inhalant abuse as they enter middle school and are unaware of its risks," the Partnership's report reads.

Inhalants, from glue to spray-can computer keyboard cleaners, have always been the drug of choice for the younger set, said Dr. Nora Volkow, head of the National Institute on Drug Abuse.

"They are widely available. They are cheap," Volkow told a news conference. "They are highly addictive. They are very toxic."

They can kill immediately by causing fatal heart arrhythmias, asphyxiating the user by sucking the oxygen from their lungs, or causing them to vomit and then suffocate.

Long-term abuse damages the brain's white matter, first interfering with the ability to concentrate and later causing long-term cognitive damage.

"You start to see severe mental deterioration," Volkow said.

She said the advertising campaign seemed to have helped. "In 1996 12.5 percent of eighth graders (aged 13 and 14) had used inhalants in the last year," she said.

"By 2002 we saw that number go down to 7.7 percent." But then there was a 14 percent increase in 2003. "We need to bring back that campaign," she said.

Steve Pasierb, president of the Partnership for a Drug-Free America, said, "It's important to note, these increases come against a backdrop of overall declining youth illicit drug use as well as declining alcohol and tobacco use."

A key factor may be that fewer children view inhalants as a big risk, he said. The Partnership's survey of 8,000 6th through 12th graders showed that in 2001, 68 percent of the 6th graders questioned agreed with the statement "sniffing or huffing things to get high can kill you" but in 2003 only 48 percent did.

For eighth graders the numbers fell from 73 percent to 63 percent.

An estimated 2.6 million youths aged 12 to 17 have used an inhalant, said Charles Curie, head of the Substance Abuse and Mental Health Services Administration. "It's an epidemic overshadowed and ignored perhaps because it is not considered a quote, illegal, drug," he said.

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Buffalo Restaurants Try Lower-Fat Options  

By Carolyn Thompson 
Associated Press Writer 
The Associated Press
Thursday, March 18, 2004 

BUFFALO, N.Y. - The flip side of this city's love affair with deep-fried chicken wings dunked in blue cheese and heaping roast beef sandwiches is a high rate of heart disease deaths and worries about obesity.

With such health issues straining not only hearts but pocketbooks, an area HMO has recruited restaurants to offer healthy menu options.

These items are lower in fat, cholesterol and salt, "for those of us who want to eat out but treat our bodies a little more respectfully than we have in the past," explained Dr. Michael Cropp, chief medical director of Independent Health.

Last month, more than two dozen restaurants debuted healthy options meals, such as caramelized sea bass, smoked salmon with pasta and baby greens, and curried chicken.

It's a far cry from "the dreaded cottage cheese and peach slices," said Nadja Piatka, a health food expert who worked with nutritionists and the restaurants on recipes.

"We're hopeful this program will open people's eyes to the fact that great-tasting food can be good for you," said William McHugh, president of the Independent Health Foundation, the HMO's community outreach operation.

Citing data for 2000, the Research Center for Stroke and Heart Disease in Buffalo says the Buffalo region has the worst death rate for heart disease in New York — nearly 352 cases per 100,000, compared with 258 nationwide and 305 statewide. More than half of adults in the region are overweight and one in five is considered obese.

Under guidelines established by the foundation and the American Heart Association (news - web sites), all meals must get no more than 30 percent of calories from fat and no more than 10 percent from saturated fat. They also must be lower in cholesterol and salt.

Some restaurants created new dishes while others tweaked existing recipes. One restaurant removed steak seasoning from its mango pork dish and reduced the amount of olive oil from 2 ounces to a half ounce. Early reviews of the program appeared favorable.

"Fat, I don't like — well, I like it but it doesn't like me," said JoAnne Balk as she dined at Charlie the Butcher's, popular for its hand-carved roast beef sandwiches on salt-crusted kimmelweck rolls. Charlie's healthy option is the same lean roast beef, but on a lower sodium, plain roll, said general manager Andrew Harvey.

"People are eating out a lot so it really is influencing their health," said Piatka, whose company supplies lowfat, fruit juice-sweetened brownies to schools and restaurants.

Diner Carole Tripi likes the idea of menu items with clearly defined nutritional information since she's on medicine to control high blood-pressure and cholesterol. Generally, ordering out is a challenge, she said.

"Even if you say, 'I want something broiled,' you don't know what they're putting on that thing to broil it. You have to tell them, 'Don't put any butter on it, don't do this, don't do that,'" she said.

At Charlie the Butcher's, the heart-friendlier roast beef sandwich is expected to do well, Harvey said, but don't look for Buffalo to give up on "beef on weck" altogether. "Everything in moderation," he said.

On the Net:

http://www.healthyoptionsbuffalo.com

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Study: Tuberculosis Is on the Rise in Big U.S. States  

By Paul Simao

Reuters

Thursday, March 18, 2004

ATLANTA (Reuters) - A global tuberculosis epidemic helped fuel a jump in cases last year in California, Texas and other U.S. states with large immigrant populations, according to a federal study released on Thursday.

More than 53 percent of the 14,871 new U.S. cases of active TB last year occurred among people born abroad to non-U.S.-born parents, according to a report by the Centers for Disease Control and Prevention (news - web sites). About 11.5 percent of the overall U.S. population is foreign born.

The proportion of cases for this group was the highest since 1986, when the United States began collecting birthplace data for TB patients. TB cases rose in California, Texas, New York and 16 other states in 2003, but fell in the nation as a whole.

Dr. Eileen Schneider, an epidemiologist with the CDC's tuberculosis elimination division, said the 1.9 percent drop in the U.S. infection rate last year was the smallest decline since 1992, when the disease peaked.

"We're not sure if this is just a plateau or a resurgence," said Schneider, who added that a decline in TB among U.S.-born residents contributed to the rising percentage of foreign-born patients captured in the 2003 data.

Five years ago, foreigners made up 41.7 percent of the nation's TB caseload.

Once a leading killer, tuberculosis has been declining in the United States since the height of the AIDS (news - web sites) epidemic in the early 1990s. AIDS attacks the immune system and renders the body unable to fight opportunistic infections such as TB.

Efforts to control the scourge, spread by coughing and close personal contact and usually cured with antibiotics, have been stymied in part by the spread of TB overseas. An estimated eight million new cases are reported worldwide every year, leading to 2 million deaths.

In 2003 Mexicans accounted for about one quarter of foreign-born U.S. patients with TB. Filipinos, Vietnamese, Indians and Chinese also had high rates of the infection.

The CDC said it was working to improve tuberculosis screening for U.S. visa applicants overseas as well as for high-risk groups within the United States and hoped to establish a closer relationship with authorities fighting the disease along the U.S.-Mexican border.

Three most populous states -- California and Texas, which both share a border with Mexico, and New York -- accounted for 42.4 percent of TB cases last year.

In addition to the worrying TB trend among the foreign-born, the CDC also revealed high infection rates in blacks and other minorities. U.S.-born blacks were about 7.5 times more likely than whites to have TB last year.

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Study: Brain Enzyme May Regulate Weight  

By Alex Dominguez 
Associated Press Writer 
The Associated Press
Thursday, March 18, 2004

Scientists say an enzyme in the brain that monitors energy in cells also appears to regulate appetite and weight, a discovery that could lead to new treatments for obesity.

The enzyme is known as AMP-activated protein kinase, or AMPK. Its activity is regulated by the hormone leptin, which previously was linked to appetite suppression.

Harvard researchers found in experiments with mice that when AMPK was inhibited, the animals ate less and lost weight. When AMPK levels were boosted, the mice ate more and gained weight.

Barbara B. Kahn, the lead author of the study, said the work identifies a new leptin signaling pathway and a promising new target in humans.

"It will affect drug development and approaches for new preventions and treatments," Kahn said.

The study appears Wednesday in an online version of the journal Nature.

Dr. David Cummings, a University of Washington obesity researcher who was not involved in the work, said the findings complement recent work in Britain in which the hormone ghrelin, an appetite-stimulating hormone, also was found to affect AMPK levels.

Almost a third of American adults are obese, up from 14 percent a generation ago, according to government data. Only a few prescription weight-control drugs are on the market, and they produce only modest weight loss, either by using suppressing appetite or by preventing the body from digesting and absorbing fats.

Cummings said studies show that hormone replacement therapy won't be a simple cure for the nation's obesity woes. Studies on using leptin to control weight found that obese people had lost sensitivity to the hormone, Cummings said.

Some researchers believe AMP-kinase might be more effective in weight control than leptin because its works more directly on appetite signaling at the end of the biochemical pathway in the brain. Clinical trials on human patients will take years to complete, researchers said.

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'Healthy' Diet May Increase Bad Cholesterol  

Reuters Health

Thursday, March 18, 2004

NEW YORK (Reuters Health) - There is a plethora of evidence suggesting that low-fat diets, particularly those rich in fruits and vegetables are "healthy." However, in a small study of women, a diet low in fat and high in fruits and vegetables caused an increase in the plasma levels of oxidized LDL cholesterol, the "bad" cholesterol.

This finding was unexpected, Dr. Marja-Leena Silaste from the University of Oulu in Finland and colleagues write in Arteriosclerosis, Thrombosis. and Vascular Biology: Journal of the American Heart Association (news - web sites).

To explore how alterations in diet affect LDL levels, researchers put 37 healthy women on two different diets. Both diets were low in total and saturated fat. One was low in vegetables and the other high in vegetables and fruits.

They discovered that blood levels of LDL increased by 27 percent in response to the low-fat, low-vegetable diet and 19 percent in response to the low-fat, high-vegetable diet. Both diets also produced small but significant decreases in HDL "good" cholesterol.

Silaste and colleagues think the "most likely reason" for the increase in LDL levels in response to the diets is the increase in a carrier protein called lipoprotein a.

This is certainly possible, Dr. Mohamad Navab and colleagues from the University of California, Los Angeles, write in an editorial, but there are other possibilities as well.

"Whatever the explanation, the findings by Silaste et al are sure to provide the basis for further exciting and potentially important studies," they write.

Source: Arteriosclerosis, Thrombosis, and Vascular Biology, March 2004.

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Teenage Alcohol Abuse  

HealthDayNews
Thursday, March 18, 2004

(HealthDayNews) -- For many teenagers, alcohol is the drug of choice. It's used and abused more than any other substance, according to the Texas Medical Center.

Here are some signs your teen's drinking may be out of control:

  • Increased defiance.
  • Failing grades.
  • A sudden lapse in school attendance.
  • Lying about where he's been or who he's been with.
  • Giving up usual activities, such as sports and homework.
  • Depressed attitude or mood swings.
  • Weight loss, change in sleep habits or energy level.
  • Mental confusion.
  • Increased physical complaints, such as upset stomach, and headaches.
  • Getting into trouble with the law.
  • Traffic accidents.

If this description sounds like your child, consult a professional.

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Chip Industry to Probe Cancer Rates of Workers  

By Daniel Sorid
Reuters
Thursday, March 18, 2004

SAN FRANCISCO (Reuters) - The U.S. semiconductor industry, facing allegations that its members knowingly exposed workers to dangerous chemicals, will investigate the cancer rates of chip industry employees, its trade group said on Thursday.

The Semiconductor Industry Association said it made the decision on the recommendation of researchers from Johns Hopkins University's Bloomberg School of Public Health, which found that an investigation was scientifically feasible.

The study will aim to determine "whether or not wafer fabrication workers in the U.S. chip industry have experienced higher rates of cancer than non-fabrication workers," the SIA said in a statement. Planning for the study starts immediately, the group said.

Employee lawsuits against National Semiconductor Corp. and International Business Machines Corp. portray the chip industry as rife with chemical safety hazards that the companies overlook in the pursuit of profits.

Both companies dispute those charges. The SIA has pointed to U.S. labor safety statistics that show the chip industry ranked in the top 5 percent of all durable goods manufacturing industries.

Existing studies on the risks to microchip factory workers have raised more questions than answers.

A report on existing health data commissioned by the SIA in 1999 and completed in October 2001 found no evidence to support the view that work place chemical exposure increased cancer risk, but it refused to rule out that cause.

A study by United Kingdom health officials of cancer death rates among employees at a National Semiconductor plant in Scotland called for more detailed studies to clarify any links to work place conditions.

IBM earlier this month settled a lawsuit related to claims that an employee's exposure to chemicals in a New York microchip factory caused her daughter's severe birth defects. In February, IBM prevailed in a lawsuit by two former workers who claimed their cancers were caused by chemicals in a California computer hard-disk drive factory.

National Semiconductor also faces litigation in California state court by former employees who blame the company for various illnesses.

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Picking Best Candidates for Brachytherapy  

HealthDayNews
Thursday, March 18, 2004

THURSDAY, March 18 (HealthDayNews) -- Specific physical conditions in a patient, such as urinary pain or low urinary flow, may help doctors assess a patient's vulnerability to complications of internal radiation treatment for prostate cancer, says a study in the current issue of the Mayo Clinic Proceedings.

The study included 105 men at the Mayo Clinic in Jacksonville, Fla. Of those men, 59 were categorized as being at high risk for urinary tract difficulties after radiation therapy and 46 were categorized as low-risk.

After therapy, 37 percent of the high-risk men and 15 percent of the low-risk men developed some urinary difficulties.

"The results offer physicians some simple and inexpensive pre-treatment testing that helps identify patients who would be at increased risk for developing urinary complications," study author Dr. Michael Wehle says in a prepared statement.

The study was conducted to better define which men with prostate cancer are and aren't good candidates for brachytherapy. This treatment involves placing radioactive seeds in or near the tumor. This delivers a high dose of radiation to the tumor and reduces radiation exposure in surrounding healthy tissues.

More information

The U.S. National Cancer Institute (news - web sites) has more about prostate cancer.

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Allergy Drug Not Linked to Birth Defect, Study Finds  

By Paul Simao 
Reuters 
Thursday, March 18, 2004

ATLANTA (Reuters) - U.S. researchers have found no link between the allergy medication commonly known as Claritin and a genital birth defect in boys, the Centers for Disease Control and Prevention (news - web sites) said on Thursday.

A CDC study of more than 2,000 boys across the nation showed no increased risk for hypospadias when expectant mothers had taken loratadine during a period ranging from one month before pregnancy through the first trimester.

Hypospadias is a defect in which the urethral opening is not located at the tip of the penis. It affects about seven out of every 1,000 male infants born in the United States and is normally corrected with surgery.

A Swedish study in 2002 suggested there might be an association between the defect and loratadine, a non-sedating antihistamine often sold under the brand name Claritin.

Although antihistamines such as Claritin are widely used to treat rhinitis, sinusitis and other conditions, pregnant women and women trying to become pregnant are advised to consult their doctors before taking them and other drugs.

"These results may be useful for women and health-care providers to reduce the anxiety that may occur following inadvertent exposures to loratadine during pregnancy," said the CDC, which noted that about 50 percent of all pregnancies in the United States were accidental.

The Atlanta-based agency, however, added that its study did not provide definitive information on the overall safety of loratadine. A total of 563 boys with the birth defect and 1,444 without were included in the CDC study. All were born between Oct. 1, 1997 and June 30, 2001.

Shares of U.S. drug firm Schering-Plough Corp., which owns the Claritin brand, fell two cents to close at $16.76 on Thursday on the New York Stock Exchange (news - web sites). The company's U.S. patent for Claritin expired in late 2002.

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Level of Immune Cells Predict Chances Against Leukemia  

HealthDayNews
Thursday, March 18, 2004

THURSDAY, March 18 (HealthDayNews) -- Measuring the levels of a specific kind of immune system cell helps predict whether people with leukemia and related cancers who have received a blood stem cell transplant will suffer a relapse and die or go into remission, says a University of Florida study.

These immune system cells, called dendritic cells, initiate the body's immune response to disease or infection. When produced in large enough numbers after a person has a stem cell transplant, these dendritic cells seem to launch the body's efforts to combat the return of blood-borne cancers, the study found.

The dendritic cells do this without harming healthy tissues.

The researchers took blood samples from 50 cancer patients within two to four weeks after they received a bone marrow or peripheral blood stem cell transplant from a donor. Most of the patients were being treated for leukemia, lymphoma or multiple myeloma.

The study found patients with a low dendritic cell count were nearly 12 times more prone to cancer relapse during the study period which, on average, lasted about a year and a half. Patients with a low dendritic cell count were also more than three times more likely to develop graft-versus-host disease and were nearly four times more likely to die.

These findings, published in the journal Blood, suggest doctors may someday be able to use patients' own naturally occurring dendritic cells to fight cancers.

"This is the first study to demonstrate that dendritic cells by themselves can fight off cancer," study author Dr. Vijay Reddy, an assistant professor of hematology and oncology, says in a prepared statement.

"It's the first study in any cancer patient to show that if you don't have enough dendritic cells, the cancer comes back. And it's the first study in the bone marrow transplant arena that shows that large numbers of dendritic cells are important to having a good immune system after transplant to avoid death after transplant," Reddy says.

More information

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

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Obesity Not Linked with Asthma in Kids  

Reuters Health

Thursday, March 18, 2004

NEW YORK (Reuters Health) - Obesity is not associated with asthma in children between 4 and 11 years of age, findings from a Canadian Study suggest.

The current results run counter to a recent report that identified obesity as a risk factor for asthma, primarily in boys, Dr. Yue Chen, from the University of Ottawa in Ontario, notes in a related editorial.

Given the discordant findings, "further studies in pediatric populations with better measurements of obesity are highly desirable," Chen notes.

The present study, which is reported in The Journal of Pediatrics, involved an analysis of data from a sample of 11,199 Canadian children. Asthma status, height, and weight were determined by surveying the biological mother. Obesity was defined as a body mass index at or above the 85th percentile.

Overall, nearly 10 percent of children had asthma, lead author Dr. Teresa To, from the Hospital for Sick Children in Toronto, and colleagues report.

Having a mother with asthma was a risk factor for the disease in all children, whereas being an only child and having a mother with depression were risk factors just for the girls, the authors point out.

Obesity, by contrast, was not associated with asthma in either sex.

The new findings do not support an association between obesity and asthma in young children, the investigators state. Additional follow-up of the current group will help determine "whether obesity precedes the development of asthma in older children."

Source: Journal of Pediatrics, February 2004.

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Parkinson's Risk Higher for Men  

By E.J. Mundell      
HealthDay Reporter
HealthDayNews
Thursday, March 18, 2004

THURSDAY, March 18 (HealthDayNews) -- A review of multinational studies dating back 24 years appears to confirm what experts have long suspected: Men face a much higher chance of developing Parkinson's disease (news - web sites) compared to women.

"This has been something that everyone has assumed for a while, but whenever you stand up and say it someone will say, 'There's no proof of that.' Well, now we've got the closest thing there is to proof," says Dr. Fred Wooten, chairman of the neurology department at the University of Virginia School of Medicine in Charlottesville.

According to Wooten, the most likely culprit for a 'gender gap' for Parkinson's may be the heightened vulnerability of male offspring to a genetic mutation passed down by their mothers.

The study appears in the March 17 issue of the Journal of Neurology, Neurosurgery and Psychiatry.

Parkinson's disease involves the steady loss of brain cells that produce dopamine, a chemical messenger essential to proper motor function. As the levels of dopamine decrease, chemical messages between brain cells "misfire," triggering symptoms such as tremors, loss of balance, rigidity and other abnormalities. Parkinson's is progressive and has no cure, although the use of certain drugs can ease its symptoms. The National Parkinson's Foundation estimates that 1.5 million Americans are affected with the disease.

According to Wooten, the observation that Parkinson's affects more men than women has a long history. "In the original description in 1807 by James Parkinson, he describes five men [and no women]," Wooten points out. "So from the absolute beginning of the descriptions there's always been the sense that there are more men than women affected."

Still, no one had pulled together the data to prove this gender bias until now.

In their study, Wooten's team examined data from seven population-based studies conducted in the United States, China and four European countries since 1980.

They report that, worldwide, males face a 50 percent higher risk of developing Parkinson's than do females.

Uncovering the reasons behind this trend may be a tougher problem, however. There is "weak" evidence that something about the male lifestyle -- increased exposure to pesticides, for example, or a higher incidence of head injury -- might account for men's higher incidence of Parkinson's disease, Wooten says.

A second theory holds that estrogen might help protect women against neurological illnesses such as Parkinson's. "There's a great deal of evidence, both from test-tube studies as well as some animal studies, that estrogen has a neuroprotective role and that higher levels of estrogen in women might somehow protect them from this particular neurodegenerative disease," Wooten explains.

But more intriguing theories focus on the genetics of men -- and their mothers.

First of all, genetic mutations specific to Parkinson's have recently been located on the X chromosome. "Genetic abnormalities on the X chromosome tend to affect men more than women," he says, "because men have only one X chromosome and women have two," leaving men less leeway whenever X-chromosome genes are expressed.

Men might also be more vulnerable to a Parkinson's-linked mutation of a gene found in what's known as mitochondrial DNA. Mitochondrial DNA is a relatively tiny reservoir of DNA found outside the nucleus, and it is only passed via the mother to her offspring.

For reasons that remain unclear, the sons of women who carry this mitochondrial abnormality could be at especially high risk of developing the disease.

"We are about to publish another large, more definitive [study], showing that there's an unexpected excess of maternal transmission in Parkinson's disease," Wooten explains. "If you look at a group of patients affected with Parkinson's disease, and you ask how many of them have an affected mother and how many of them have an affected father, the incidence of affected mothers is higher."

Parkinson's is not the only brain disease more likely to hit men than women. "Diseases like amyotrophic lateral sclerosis -- ALS, or Lou Gehrig's disease (news - web sites) -- are more common in men," says Dr. Jay Van Gerpen, director of the Movement Disorder Clinic, part of the Ochsner Clinic in New Orleans. He also notes tremor-type illnesses similar to Parkinson's appear to affect more men than women, too.

Can anything reduce your risk for Parkinson's? Van Gerpen says the only lifestyle factors known to decrease disease risk at this point in time are coffee-drinking and smoking.

While no one is advocating smoking, a cup or two of coffee per day might be beneficial, Van Gerpen says. "There have been a number of studies that have shown this -- that patients who consume coffee are less likely to get Parkinson's disease. As a coffee drinker myself, that's good news."

More information

To learn more about Parkinson's disease and available treatments, visit the National Parkinson Foundation or the National Institute of Neurological Disorders and Stroke.

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'Designer' Orange Juice May Lower Cholesterol: Study  

By Amy Norton 
Reuters Health
Thursday, March 18, 2004

NEW YORK (Reuters Health) - People with mildly high cholesterol may be able to drink their way to lower levels, if research findings on a souped-up brand of orange juice is correct.

Researchers found that the juice, fortified with cholesterol-fighting plant compounds called sterols, was able to lower "bad" LDL cholesterol by about 12 percent among adults who drank two glasses a day for two months.

The study received partial funding from The Coca Cola Co., which launched the sterol-fortified juice in the U.S. last year under the name Minute Maid Premium Heart Wise.

The product is among the growing ranks of so-called "functional foods" that have additives aimed at promoting health. In this case, plant sterols, which are found naturally in small amounts in vegetables and vegetable oils, provide the potential health boon. The compounds are structurally similar to cholesterol, and are thought to limit the absorption of cholesterol in the intestines.

Plant sterol-fortified margarines, such as Benecol and Take Control, have been on the market for several years. Orange juice has the advantage of being a widely consumed, and vitamin-packed, vehicle for plant sterols, according to the authors of the new study.

"Orange juice has wide appeal since it is consumed by individuals of all ages, from early childhood to old age," lead author Sridevi Devaraj of the University of California Davis Medical Center in Sacramento said in a statement.

For the study, the researchers had 72 healthy volunteers with mildly elevated cholesterol drink regular orange juice for a two-week "run-in" phase, then randomly assigned half of them to drink the fortified juice for eight weeks, while the rest stuck with standard OJ.

Blood tests showed that the fortified group's total cholesterol and LDL cholesterol had dropped by an average of 7 percent and 12 percent, respectively, by the study's end.

The findings are published in the March issue of the journal Arteriosclerosis, Thrombosis and Vascular Biology.

Dr. Robert Eckel of the University of Colorado Health Sciences Center in Denver called the study results "interesting," and noted that he sometimes recommends plant sterol-fortified margarines to patients whose LDL is not quite low enough.

The fortified orange juice could offer another option, he told Reuters Health.

The beverage, with its dose of folate, vitamin C and other nutrients, "is something we consider heart-healthy already," added Eckel, who also heads the American Heart Association (news - web sites)'s Council on Nutrition, Physical Activity, and Metabolism.

However, it's not time for people on cholesterol-lowering statin drugs to toss out their medication, as Eckel pointed out that the orange juice had only a "modest effect" on cholesterol in this study.

There is also the matter of calories. Two daily servings of the fortified juice, which give the recommended two grams of plant sterols, provide about 220 calories each day. So it should be used in place of regular beverages, and not added to a person's usual calorie intake, according to Eckel.

Participants in the current study ranged in age from 20 to 73, and none had a history of cardiovascular disease. Their average total cholesterol was just above 200, and their LDL around 140-numbers that are both considered borderline high.

Source: Arteriosclerosis, Thrombosis and Vascular Biology, March 2004.

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New Way to Treat Hepatitis B?  

By Ed Edelson
HealthDay Reporter 
HealthDayNews
Thursday, March 18, 2004

THURSDAY, March 18 (HealthDayNews) -- Swiss researchers have found that an enzyme can block reproduction of the hepatitis B vaccine, a discovery they say could lead to a new treatment for this dangerous liver infection.

Their theory is that if the enzyme can block the genetically engineered hepatitis B proteins found in the vaccine, it might also work against the virus itself.

More than 250 million people worldwide are infected with hepatitis B, which can cause cirrhosis and liver cancer. About 300,000 Americans contract the infection each year. In about 90 percent of such cases, the virus disappears after several months. But an estimated 1 million Americans are chronically infected.

Hepatitis B is spread by infected blood and other body fluids, such as semen, so drug users who share needles and people who have unprotected sex are vulnerable to the infection. There is a vaccine that can be effective if given immediately after infection. Chronic infections are treated by injections of interferon and by two relatively new antiviral drugs, which are not completely effective. Chronic infection carries the risk of potentially fatal liver conditions.

Now the researchers from the University of Geneva report in the March 19 issue of Science that an enzyme designated as APOBEC3G (understandably abbreviated to A3G) has blocked reproduction of the hepatitis B vaccine in laboratory-grown cell lines.

The discovery is something of a surprise because A3G until now has been identified only as a molecule that defends against retroviruses that have RNA as their genetic material. The best-known retrovirus is HIV (news - web sites), which causes AIDS (news - web sites) and is spread in the same way as hepatitis B, by infected blood and sexual contact.

This is the first study to show that A3G can act against a DNA-containing virus such as hepatitis B, according to study author Dr. Didier Trono, chairman of microbiology and molecular medicine at Geneva.

But, he adds, making medical use of that discovery requires a lot of work and some imagination.

"In a wild scheme, one could imagine using gene therapy to express A3G in the liver of chronically infected people," Trono says. "But one could also learn how to activate the expression of this or related genes by pharmacological means."

"We do not know precisely" what A3G does to prevent reproduction of hepatitis B, Trono acknowledges. It is a complicated subject because hepatitis B is "a retrovirus in disguise," using RNA in its reproductive cycle, he explains.

"Perhaps A3G blocks the assembly of the complex necessary for its reproduction," Trono says.

Research on how and why A3G acts as it does will continue, he adds.

More information

Facts about hepatitis B and its treatment are given by the U.S. Centers for Disease Control and Prevention and the Hepatitis B Foundation.

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Strengthening Exercises Relieve Achilles Pain  

Reuters Health

Thursday, March 18, 2004

NEW YORK (Reuters Health) - The old saying "no pain, no gain" may be true when it comes to treating a painful Achilles tendon. Researchers report that several months of painful calf-strengthening exercises may ultimately relieve chronic Achilles tendon pain.

In fact, ultrasound testing indicates that most people who performed the exercises experienced physical improvements in the structure of the Achilles tendon.

Many weekend athletes experience chronic pain in the Achilles tendon, which is located behind the ankle and helps to extend the foot. Such chronic pain, known as tendinosis, is often marked by thickening of the tendon. Treating the condition is often difficult.

Some research suggests that so-called eccentric training of the calf may help. Eccentric training involves using weights to lengthen the calf muscle as it contracts.

A team led by Dr. Lars Ohberg of the University Hospital of Umea in Sweden set out to test eccentric training in a group of 25 mostly middle-aged adults with chronic Achilles tendon pain. On average, participants had experienced pain for more than a year. None had undergone surgery to treat the pain.

All of the patients experienced some thickening of the Achilles tendon, which was painful during activity and when touched. To judge the extent of tendon abnormalities, all participants underwent ultrasound scanning before they began a 12-week program of eccentric calf muscle training with heavy weights.

At follow-up, nearly 4 years later, 22 of the 25 participants were satisfied with the effect of the treatment, the researchers report in the British Journal of Sports Medicine.

Ultrasound testing confirmed that tendon structure had improved in most volunteers. Tendon thickness was reduced at the end of the study, and the tendon structure had returned to normal in 19 out of 26 tendons (one person had pain in two tendons).

Among the seven people whose tendons were still abnormal at the end of the study, all but one continued to experience tendon pain during activity. This suggests that there may be a connection between these abnormalities and tendon pain, according to the report.

Researchers are not sure how the muscle training may work to improve tendon pain. One possibility, according to the report, is that the training may normalize levels of complex molecules called glycosaminoglycans, which make up much of the body's connective tissue.

Source: British Journal of Sports Medicine, February 2004.

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New Drug Shows Promise Against Advanced Breast Cancer

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, March 18, 2004

THURSDAY, March 18 (HealthDayNews) -- The first head-to-head comparison of the drugs tamoxifen and exemestane in women with advanced breast cancer showed the latter was not only safe, it meant an average of four additional months without any progression of the disease.

Exemestane, one of a class of drugs called aromatase inhibitors, is currently approved for women whose cancer progressed while they were taking tamoxifen. Two other aromatase inhibitors are also approved in the United States -- letrozole and anastrazole.

"We're probably moving into a transition phase where we will be using these types of drugs over tamoxifen in the near future," says Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in New Orleans.

This latest study comes just days after another trial showed the superiority of taking tamoxifen and exemestane sequentially for five years, as opposed to taking tamoxifen alone for the full five years.

The results of these and other trials mark a step forward in the evolution of breast cancer treatment, experts say.

"[Exemestane] will be a good choice for metastatic disease," says Dr. Robert Paridaens, lead author of the study who will present the findings March 18 at the Fourth European Breast Cancer (news - web sites) Conference in Hamburg, Germany.

"If someone asks me is there a subgroup where it's absolutely a must to start with exemestane, I would say the high-risk patients who are estrogen-receptor-positive who already have a metastasis," he says.

For postmenopausal women with estrogen-receptor-positive breast cancer, the gold standard has been to take tamoxifen for five years after initial treatment for the tumor. Tamoxifen, which has been around for 20 years, works by interfering with the ability of estrogen to fuel tumor growth.

While many women do benefit from tamoxifen, others fail to respond and, in general, the drug seems to lose its effectiveness after about five years, experts say.

Aromatase inhibitors may be poised to take the place of tamoxifen. As their name implies, these compounds inhibit aromatase, an enzyme that helps make estrogen. Exemestane is actually slightly different from its cousins in that it has a steroidal structure.

The new study, sponsored by drug maker Pfizer, involved 382 patients from 81 medical centers in 25 countries. The women were randomly selected to receive either tamoxifen or exemestane, but the study was an "open label" one, meaning both doctors and patients knew who was taking which drug.

The researchers wanted to see if exemestane would increase progression-free survival by three months over tamoxifen. In fact, the results were slightly better than that.

Women in the exemestane group had a median progression-free survival of 10.9 months compared with 6.7 months for those in the tamoxifen group. "You gain, in the average, four months," Paridaens points out.

Exemestane also led in other categories. Among the women receiving exemestane, 7.4 percent responded completely to the treatment, versus 2.6 percent of the tamoxifen patients. Also, 36.8 percent of the exemestane participants responded partially to treatment, compared to 26.6 percent in the tamoxifen group.

Although a number of questions still need to be answered, including how long a woman should take exemestane, the drug does seem poised to take its place alongside tamoxifen, even instead of it. How quickly this happens will depend, in part, on whether insurers are willing to reimburse patients for the drug. Exemestane is more expensive than tamoxifen, experts say.

"The question of the future would be does tamoxifen have any role to play in an adjuvant setting? We don't know," Paridaens says. In any event, the spectrum of drugs for breast cancer survivors is expanding. "The number of drugs we have at our disposal is increasing. It's fantastic," he adds.

A number of other researchers also presented findings at the conference:

  • Scientists from Hong Kong have found the drug lamivudine can help prevent the reactivation of the hepatitis B virus in women undergoing chemotherapy for breast cancer. Because chemotherapy suppresses the immune system, the virus often reemerges in these women.
  • A Swedish survey found many breast cancer survivors were unsatisfied with follow-up visits, finding them too hurried, among other things. The researchers raised the possibility of training specialized nurses to oversee such visits.
  • One leading breast cancer doctor questioned the advisability of ending clinical trials early. The practice, which sometimes happens when a treatment is more successful than anticipated, means questions about long-term benefits and side effects remain unanswered.
  • Dutch researchers have concluded that, contrary to popular belief, any primary breast cancer cells can spawn secondary cancer cells which then spread throughout the body. Because the genetic profiles of the primary and secondary cells are so similar, the spreading cells are likely to respond to the same treatment as the primary tumor.

More information

 

The National Cancer Institute (news - web sites) has more on aromatase inhibitors and on tamoxifen and exemestane.

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Wednesday, March 17, 2004  

Radiation May Not Help Pancreatic Cancer  

By E.J. Mundell
HealthDay Reporter 
HealthDayNews
Wednesday, March 17, 2004

WEDNESDAY, March 17 (HealthDayNews) -- It has been part of standard pancreatic cancer therapy for years, but the combined use of anti-cancer drugs and radiation just after surgery may do little to prolong patients' lives.

In fact, this type of "chemoradiation" therapy may even lower survival rates by delaying patients access to a more powerful drugs-only approach, a new British study contends.

"If chemoradiation was given prior to chemotherapy, the benefit of [tumor-removing] surgery was reduced," says study author Dr. John P. Neoptolemos, head of the department of surgery at the Royal Liverpool University Hospital in Liverpool.

His team's findings appear in the March 18 issue of the New England Journal of Medicine (news - web sites).

Pancreatic tumors remain one of the deadliest forms of cancer, with a five-year survival rate of less than 4 percent. Experts blame this high death rate on the fact that pancreatic cancer tends to grow without symptoms, remaining undiagnosed until it's too late. Once a tumor has spread to adjacent organs, such as the intestines or bile duct, symptoms such as jaundice or abdominal pain can occur. But by this time, surgical removal of the tumor may not be an option.

Dr. Michael Choti of Johns Hopkins Hospital adds the pancreas "is also in a strategic location in the body that's surrounded by a lot of vital structures -- arteries, veins to the intestines and the liver. So it doesn't require very much spread before it can encase or involve vital structures that simply can't be removed."

In fact, just 10 percent of patients diagnosed with pancreatic cancer are deemed eligible for surgery.

Among that 10 percent, nearly all will go on to receive either radiation, anti-cancer drug therapy (chemotherapy) or a combination of both, to help hunt down stray cancer cells lurking in the body.

In their study, Neoptolemos and his team compared the five-year survival rates of 289 pancreatic cancer patients treated with chemoradiation, chemotherapy alone, chemoradiation plus chemotherapy, or no treatment following surgery. The patients were drawn from 30 cancer centers across Europe.

The results: "Chemotherapy increases five-year survival from 10 percent for surgery alone to 30 percent for surgery plus six months of chemotherapy," Neoptolemos says.

However, the results weren't so promising when it came to chemoradiation.

While patients given drugs-only chemotherapy survived an average of nearly two years after surgery, those given either chemoradiation or chemoradiation plus chemotherapy survived just 14 months on average, the researchers found.

How might radiation work to actually lower patient survival? The answer may lie in the relative strengths of chemoradiation and chemotherapy in hunting down and killing rogue cancer cells.

"Pancreas cancer is a systemic disease," explains Neoptolemos, and "cutting out the cancer is good as it removes the bulk of the tumor. However, there are millions of cancer cells that have spread in the blood to many other organs."

"Chemoradiation will not hit these cancer cells," Neoptolemos says. On the other hand, "chemotherapy will hit all cancer cells."

Therefore, "if given before chemotherapy, chemoradiation delays the effective delivery of systemic chemotherapy, enabling cancer cells to grow and grow, making them more resistant to chemotherapy when it is finally introduced," Neoptolemos says.

The result may be a patient with a decided disadvantage in fighting off tumor recurrence, experts conclude.  

In his editorial comment on the study, Choti cautions it's still too early to completely rule out chemoradiation as post-operative therapy for patients with pancreatic cancer.

According to Choti, the British researchers were unable to track whether chemoradiation was being administered consistently across the 30 different centers in which the study took place. "It's complicated to give radiation therapy," he says. "If not given carefully, there can also be side effects that increase the [side effects], perhaps even the mortality" of patients taking the therapy.

Choti believes an even clearer picture of the relative risks or benefits of chemoradiation may come with the release of findings from a major U.S. trial, due out soon.

In the meantime, he stresses that the vast majority of patients with pancreatic cancer are not even eligible for surgery. These patients may also receive cancer-killing drugs or radiation, but with little hope of curing their condition. "You could call it palliative chemoradiation therapy. It does prolong one's life and quality of life," he says.

There's better news for the fortunate 10 percent who qualify for surgical removal of the tumor. It's a complex, multi-organ operation called the Whipple Procedure.

"Historically it was considered a very complicated and difficult operation," Choti says. "It still is, but now it can be done extremely safely, rapidly and with very low morbidity than even a decade ago. We've really mastered this operation."

More information

For information and support on battling pancreatic cancer, visit Johns Hopkins University or the National Library of Medicine.

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Supplement Companies Agree to End Cure Claims –US  

Reuters

Wednesday, March 17, 2004

WASHINGTON (Reuters) - Two California companies have agreed to stop claiming their liquid supplement called Seasilver can cure more than 650 diseases including cancer, diabetes and AIDS (news - web sites), U.S. regulators said on Wednesday.

The companies, Seasilver USA Inc. and Americaloe Inc., signed a consent decree with regulators, who said the disease-fighting claims were unsubstantiated.

"The claims for Seasilver threatened consumers' health by encouraging delays and replacements for proven treatments," Howard Beales, director of the Federal Trade Commission's Bureau of Consumer Protection, said in a statement.

Seasilver USA, in a statement on its Web site, said it agreed "any health-related claims must be supported by strict scientific evidence."

The company will continue to sell Seasilver without the claims the government objected to, said Michael Dershowitz, the company's chief compliance officer. The product is a dietary supplement that contains seaweed, aloe vera and other natural ingredients, he said.

"We believe it promotes general good health and well-being," Dershowitz said in an interview.

The company said the agreement with regulators "does not constitute an admission that the company violated the law."

Under the consent decree, the U.S. Food and Drug Administration (news - web sites) can order the companies to stop selling and to recall any products that violate the law in the future, the agency said.

Dershowitz said the companies had cooperated with the government agencies since last June, when U.S. marshals seized $5.3 million worth of Seasilver at the FDA's request.

Americaloe Inc., which has the same owners as Seasilver USA, is not currently operating, Dershowitz said.

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Breast Cancer Risk Tied to Wine, Fat Intake  

By Karen Pallarito
HealthDay Reporter 
HealthDayNews
Wednesday, March 17, 2004

WEDNESDAY, March 17 (HealthDayNews) -- A new Swedish study finds postmenopausal women who consume high amounts of alcohol, especially wine, are at a higher risk for breast cancer.

According to the study, women who drank more than roughly 1.5 glasses of wine per day were twice as likely to get the disease compared to women with little or no alcohol intake. Moderate drinkers, meanwhile, were found to be at a 12 percent lower risk of breast cancer.

Scientists had previously suspected that women who drink alcoholic beverages are at a greater risk of breast cancer. But not all studies have demonstrated a link, and the amount of alcohol required to boost the risk of the disease has been sketchy.

"There seems to be a threshold under which there is no effect of alcohol," explains study author Dr. Irene Mattisson, of the Department of Medicine, Surgery and Orthopaedics at Sweden's Lund University. "However, we cannot say anything on the exact level of the threshold because self-reported alcohol data is unreliable."

High dietary fat, long suspected to be a culprit in breast cancer, also was associated with the disease, the authors report. As amounts of fat in women's diets increased, so did their risk of breast cancer. Those who consumed the highest amounts saw their risk of getting breast cancer rise by 34 percent.

The authors observed the dietary and drinking habits of 11,726 postmenopausal women in the city of Malmö, using interviews and self-recorded diet histories. Physical exams were performed at the beginning of the study and the women were followed for an average of 7.6 years. A total of 342 breast cancer cases were documented during the study period.

While high intakes of wine boosted breast cancer risk, the study found no elevated risk for women reporting high levels of total alcohol consumption, including beer and spirits.

The study appears in the March 17 online issue of the International Journal of Cancer.

Teasing out the effects of different beverages becomes complicated due to misreporting, Mattisson notes. It's suspected that women reported the amount of wine they drank more accurately than the amount of total alcohol they consumed.

So should women who drink regularly and indulge in fatty foods modify their diets?

"If they drink alcohol regularly, they should definitely reduce their alcohol intake," Mattisson says. "There is so much evidence from different studies now pointing in the same direction. Alcohol should be used in moderation only."

Cindy Moore, a spokeswoman for the American Dietetic Association, says women should limit their alcohol intake to one drink per day to reduce their cancer risk, as the American Cancer Society (news - web sites) advises.

Women also should eat a variety of foods to get the nutrients and chemicals their bodies need to fend off disease, she says. Fruits and vegetables, for example, contain antioxidants that help prevent cell damage from chemicals called free radicals. Nutrients found in protein give the body strength to resist disease. "It's sort of like a one-two punch," she says.

Reducing total fat to recommended levels is also highly advisable, Mattisson adds.

Keep in mind that all fats are not equal. Previous studies from the Malmö Diet and Cancer Study have shown that high intakes of omega-6 fatty acids, such as those found in sunflower and corn oils, increase the risk of postmenopausal breast cancer.

Most Americans consume too many omega-6 fatty acids, research shows, but do not get enough fatty acids from the omega-3 family, which includes rapeseed oil, fatty fish, and flax seed.

Mattisson advises women to increase their intakes of polyunsaturated fatty acids from the omega-3 family and not to eat omega-6 oils in abundance.

More information

The National Cancer Institute (news - web sites) has more information on nutrition in cancer care, while the American Heart Association (news - web sites) can tell you more about dietary fats.

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Study: Brain Enzyme May Regulate Weight  

By Alex Dominguez
Associated Press Writer 
The Associated Press
Wednesday, March 17, 2004

Scientists say an enzyme in the brain that monitors energy in cells also appears to regulate appetite and weight, a discovery that could lead to new treatments for obesity.

The enzyme is known as AMP-activated protein kinase, or AMPK. Its activity is regulated by the hormone leptin, which previously was linked to appetite suppression.

Harvard researchers found in experiments with mice that when AMPK was inhibited, the animals ate less and lost weight. When AMPK levels were boosted, the mice ate more and gained weight.

Barbara B. Kahn, the lead author of the study, said the work identifies a new leptin signaling pathway and a promising new target in humans.

"It will affect drug development and approaches for new preventions and treatments," Kahn said.

The study appears Wednesday in an online version of the journal Nature.

Dr. David Cummings, a University of Washington obesity researcher who was not involved in the work, said the findings complement recent work in Britain in which the hormone ghrelin, an appetite-stimulating hormone, also was found to affect AMPK levels.

Almost a third of American adults are obese, up from 14 percent a generation ago, according to government data. Only a few prescription weight-control drugs are on the market, and they produce only modest weight loss, either by using suppressing appetite or by preventing the body from digesting and absorbing fats.

Cummings said studies show that hormone replacement therapy won't be a simple cure for the nation's obesity woes. Studies on using leptin to control weight found that obese people had lost sensitivity to the hormone, Cummings said.

Some researchers believe AMP-kinase might be more effective in weight control than leptin because its works more directly on appetite signaling at the end of the biochemical pathway in the brain. Clinical trials on human patients will take years to complete, researchers said.

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Zebrafish May Give Clues to Stomach Problems  

HealthDayNews

Wednesday, March 17, 2004

WEDNESDAY, March 17 (HealthDayNews) -- Germ-free zebrafish may help scientists better understand and find ways to treat human digestive problems.

These fish, which are transparent until they reach adulthood, offer a "window" into the relationship between all animals -- including humans -- and the friendly gut bacteria that help digest food and perform other important functions.

For the first time, researchers at Washington University School of Medicine in St. Louis have shown that zebrafish can be raised in a germ-free environment. This lets them observe gut development in the zebrafish with and without the beneficial effects of these symbiotic gut bacteria.

The researchers also offer the first description of which bacteria normally reside inside the zebrafish gut. The study appears online in this week's Proceedings of the National Academy of Sciences (news - web sites).

"To untangle the complex interactions between humans and their friendly gut bacteria, we need simple animal models that can function as living test tubes. These models are key to identifying the genes and chemicals that allow friendly bacteria to enhance our health," principal investigator Dr. Jeffrey I. Gordon, head of the molecular biology and pharmacology department, says in a prepared statement.

More information

The American Society for Microbiology has more about bacteria.

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Fosamax Has Long Lasting Effect on Bones -US Study  

By Gene Emery 
Reuters 
Wednesday, March 17, 2004

BOSTON (Reuters) - The benefits of a drug widely used to strengthen aging bones persist for years, even after patients quit taking it, a study released on Wednesday found.

The 10-year study published in the New England Journal of Medicine (news - web sites) could allay fears that the drug alendronate, also known by its trade name Fosamax, would lose effectiveness.

Its findings are important for patients who, for medical reasons, might be forced to temporarily give up the drug, which is made by Merck & Company Inc. and used to treat osteoporosis and similar diseases.

"It (alendronate) has a steady, sustained effect," Dr. Henry Bone, the chief author of the study, told Reuters. Few drugs have been studied for so long, said Bone, director of the Michigan Bone and Mineral Clinic in Detroit.

The researchers found that among post-menopausal women volunteers who took 10 milligrams of alendronate daily over 10 years, the average bone mineral density in their spines had increased by 13.7 percent. Usually, bone density declines with age in such women.

Five years after halting treatment, bone deterioration was still less than half the normal rate.

"It took several years to see a decline in the effect of treatment, and that's important information if someone has to interrupt therapy," Bone said. "But it's probably better to stay on the treatment over the long run."

The alendronate study, financed by Merck, was originally planned for only three years. It was repeatedly extended to look for long-term effects.

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Hypertension in Childhood a Harbinger for Heart Disease  

HealthDayNews

Wednesday, March 17, 2004

WEDNESDAY, March 17 (HealthDayNews) -- Children with high blood pressure are more likely to have hardened arteries when they reach middle age, says a Tulane University study.

Researchers found that the higher systolic blood pressure children have, the more likely they'll have hardened arteries when they're in their late 30s and 40s. The finding shows the importance of checking children's blood pressure, according to study author Shegnxu Li.

He and his colleagues analyzed data obtained every three to four years from Bogalusa Heart Study participants between 1973 and 2001. The Bogalusa Heart Study is the longest running, biracial, community-based study of heart disease risk factors that begin in childhood. Bogalusa is in Louisiana.

The study also found that, over the years, cigarette smoking and levels of HDL ("good") cholesterol and triglycerides also were predictive of hardened arteries early in adulthood. But systolic blood pressure in childhood was the strongest predictor.

The study appears in the March issue of Hypertension.

"The changes in our cardiovascular system that lead to heart disease begin very silently and slowly," cardiologist and Bogalusa Heart Study founder Dr. Gerald Berenson says in a prepared statement.

"Our research is showing that these changes may begin even earlier than we had thought, which means we have the opportunity to start preventing heart disease beginning in childhood," Berenson says.

More information

The American Medical Association has more about hypertension.

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Breast Cancer Treatment Varies Across U.S. –Study  

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, March 17, 2004  

WASHINGTON (Reuters) - Treatments for women with an early form of breast cancer vary widely depending on where they live, which suggests doctors and patients are uncertain about the best treatment, researchers said on Wednesday.

As wider screening leads to more women being diagnosed with ductal carcinoma in situ, or DCIS, it is becoming more urgent to develop consistent treatment guidelines, the researchers said.

"There is a fair amount of confusion out there," Dr. Nancy Baxter of the University of Minnesota, who led the study published in this week's Journal of the National Cancer Institute (news - web sites), said in a telephone interview.

Until clearer guidelines are developed, she said, "It is probably a good idea for women to get a second opinion."

About 50,000 U.S women are diagnosed with DCIS each year. It looks like cancer, but the tumor cells have not spread from the breast ducts.

DCIS itself is rarely deadly, killing just about 2 percent of patients, but it can turn into a more dangerous invasive cancer if left alone or if it returns.

"The key point about DCIS is that it lacks the ability to spread to other parts of the body. Therefore, no matter what treatment a woman chooses, her risk of dying of breast cancer is extremely low," Dr. Monica Morrow, director of breast surgery at Northwestern Memorial Hospital in Chicago, said in a statement.

Baxter studied the records of more than 25,000 women diagnosed with DCIS between 1992 to 1999.

As expected due to a rise in mammogram screenings, many more cases were diagnosed by 1999. While more than 97 percent of patients had some kind of surgery, the number who had mastectomies -- removal of the breast -- fell from 42 percent in 1992 to 28 percent in 1999.

But the treatment varies greatly by region.

More Mastectomies In Utah

For example, 74 percent of women in Connecticut got breast-conserving surgery for DCIS -- meaning they did not have full mastectomies. But only 55 percent of patients in Utah did.

"We can't say from this that you are getting bad care in Utah and good care in Connecticut," Baxter cautioned in a telephone interview.

"It may be that women in Utah are requesting mastectomy more because they live a long way from a radiation center. We don't know what led to those figures."

Experts strongly recommend that women get radiation therapy after having DCIS removed, yet Baxter found regional variations here, too. For example, just 39 percent of DCIS patients in San Francisco got radiation, compared to 74 percent in Hawaii.

"DCIS can come back," Baxter said. "It has a very high rate of recurrence if you just remove the breast and don't radiate people. And about half the time it comes back as invasive cancer -- that is cancer cancer."

She said there may be medically legitimate reasons for the variations, but treatment guidelines could help limit any unwarranted regional differences. "What we need to start doing is to start, as a group, coming up with some sort of recommendations in terms of treatment."

If doctors cannot agree, she added, then research needs to be done to find out what the most effective treatments are and for who.

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Soda Patrol  

HealthDayNews

Wednesday, March 17, 2004

(HealthDayNews) -- There's little doubt that the amount of soda kids drink has contributed to the obesity epidemic in the United States.

Help your child break his soda habit with these tips from the Texas Department of Health:

  • Save soda for a special treat.
  • Stock your fridge with low-fat milk, fruit-flavored seltzers and low-sugar juices.
  • Serve water with meals.
  • Have a soda-free week once a month.
  • Refrigerate only a few cans at a time.
  • Buy large-size containers for special occasions only.

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Revealed - How Deadly Bacteria Evade Immune System  

Reuters

Wednesday, March 17, 2004

LONDON (Reuters) - Scientists have discovered how bacteria that cause infections such as anthrax, bubonic plague and typhoid avoid the body's immune system -- a finding that could pave ways to control the deadly diseases.

In laboratory experiments using mouse cells, researchers at the University of California, San Diego (UCSD) pinpointed an enzyme called PKR that leads to the destruction of large white blood cells that protect the body against pathogens.

"If we are able to develop specific inhibitors of PKR, and the drug industry can easily produce them, we may be able to control these nasty infections," said Michael Karin, a professor at UCSD.

Karin and his colleagues, who reported their research in the science journal Nature, think their finding could also be useful in battling lethal strains of influenza.

"Every year, you have tens of thousands of deaths among people infected with the flu. We believe this super-lethal type of flu is not due to the virus alone, but to a bacterial super-infection that follows the viral infection," he said.

The large white blood cells known as macrophages are the body's defense mechanism against invading pathogens. Karin and his colleagues discovered how the bacteria that cause anthrax, bubonic plague and typhoid trigger signals that lead to the self destruction of macrophages.

"Instead of the macrophage being able to swallow the bacteria and recruit other white blood cells to the battle, it kills itself in a process called apoptosis," Karin said in a statement.

After studying the molecular components that initiated the self destruction of the macrophage, the researcher bred mice with and without PKR. They discovered that rodents without the enzyme had healthy macrophages that were resistant to the pathogens and could prevent infection.

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Dodging DVT  

HealthDayNews

Wednesday, March 17, 2004

WEDNESDAY, March 17 (HealthDayNews) -- The first Deep Vein Thrombosis (DVT) Awareness Month has been launched by the Coalition to Prevent Deep Vein Thrombosis.

The public health initiative will use public service announcements, articles and other methods to educate health-care workers and the public about this life-threatening but preventable medical condition.

As many as 2 million Americans are affected by DVT each year, according to the American Heart Association (news - web sites). DVT is a blood clot that forms in one of the large veins, usually in the lower limbs, resulting in either partially or completely blocked circulation.

DVT can lead to pulmonary embolism (PE), a serious and potentially fatal complication that claims as many as 200,000 lives each year in the United States.

Despite the serious health threat posed by DVT, 74 percent of Americans have little or no awareness of DVT, according to a national survey sponsored by the American Public Health Association (news - web sites).

"Now, more than ever, we think that a focused effort is needed to raise awareness about the signs, symptoms and risk factors associated with DVT and PE, and to educate the public that this condition is preventable," Dr. Franklin Michota, Jr., from the Society of Hospital Medicine and a coalition member, says in a prepared statement.

"Our goal is to help people recognize if they're at risk for DVT and to encourage them to speak to their doctor. In doing so, we believe our effort will help to reduce the number of people who die from complications of this condition," Michota says.

More information

The U.S. National Heart, Lung, and Blood Institute has more about DVT.

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Study: Parents Don't See Obesity in Their Children  

By Patricia Reaney 
Reuters 
Wednesday, March 17, 2004

LONDON (Reuters) - Parents are so accustomed to seeing overweight youngsters that many fail to realize when their own children are obese, British researchers said on Wednesday.

Obese children are also more likely to develop Type 2 diabetes, a disease previously seen only in adults.

"A third of the mothers and 57 percent of dads actually saw their obese child as normal," said Alison Jeffery, a member of the research team at the medical school.

"Quite a few parents are not recognizing it as a problem. They are not recognizing the health risks either," she added in an interview.

But Jeffery said it isn't a case of denial.

"We are all used to seeing people who are bigger than they used to be 20 years ago and we just see people who are overweight as normal."

Jeffery, who presented her findings to the Diabetes UK medical conference in Birmingham, England, questioned 300 seven-year old children and their parents about their perceptions of body size.

One third of mothers and half of fathers who were either overweight or obese rated themselves as "about right."

When the child was a normal weight, according to an internationally recognized measurement of obesity in children, most of their parents, regardless of their own size, knew there was no problem.

When the child was overweight but not obese, only a quarter of the parents knew it. But when the youngsters were obese, 40 percent of parents were not concerned about their child's weight.

Health experts have described the increased rates of obesity in children as a serious public health problem because of its link with diabetes as well as an increased risk of heart disease, stroke and other illnesses later in life.

The prevalence of type 2 diabetes in obese children in Poland is nearly four percent. In Hungary it is two percent and 1.6 percent in Germany, according to recent research.

"Diabetes is hugely on the increase and we know that children from as young as the age of seven have metabolic changes that are precursors to diabetes if they are very overweight," said Jeffery.

"They may not be diabetic until they are older but you can see it beginning."

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Containing the Damage of Spinal Cord Injuries  

HealthDayNews

Wednesday, March 17, 2004  

WEDNESDAY, March 17 (HealthDayNews) -- New findings from animal studies on nerve cell proteins show promise for reducing disability after someone suffers a spinal cord or other nervous system injury.

That finding comes from a Wake Forest University Baptist Medical Center study in the current issue of Cell Stress and Chaperones.

The Wake Forest researchers found they could prevent up to 50 percent of motor and sensory nerve cell death in mice with sciatic nerve injury. They did this by augmenting the stress protein response, in which cells produce proteins called Hsc70 and Hsp70.

These proteins help protect motor and sensory nerve cells from death when the cells are exposed to heat, injury or other forms of stress that threaten them.

"Our approach is based on a natural mechanism cells have for protecting themselves, called the stress protein response," lead researcher and neuroscientist Michael Tytell says in a prepared statement.

"We believe it has potential for preventing some of the disability that occurs as a result of nervous system trauma and disease," Tytell says.

The research is aimed at preventing or minimizing the secondary cell death that occurs in the hours and days after a spinal cord or brain injury. During this period, cells surround the injury site can become inflamed and die. This cascading response worsens the injured person's degree of disability.

More information

The American Association of Neurological Surgeons has more about spinal cord injuries.

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Tuesday, March 16, 2004  

Sinusitis Not as Common as Thought  

HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- The number of cases of chronic sinusitis in the United States may be much lower than previously reported, says a Mayo Clinic study in the March issue of the Archives of Otolaryngology - Head & Neck Surgery.

Chronic sinusitis is an inflammation of the sinuses that can last for 90 days or longer. Estimates from the U.S. National Health Interview Survey rank chronic sinusitis as one of the most common chronic diseases in the nation, affecting 14 percent to 16 percent of the population.

"These data rely on patient self-reporting of the disease. However, chronic sinusitis is difficult to diagnose because its symptoms overlap those of many other disease processes. As such, these prevalence data may be unreliable," the study authors write.

They conclude the overall age- and sex-adjusted prevalence of chronic sinusitis was 1,955 per 100,000 of the population, or 1.96 percent.

"Current prevalence estimates of chronic sinusitis that rely on patient reporting may be exaggerated," the authors write.

More information

The American Academy of Family Physicians (news - web sites) has more about sinusitis.

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Vitamin D Compound Inhibits Breast Cancer Cells  

By Will Boggs, MD

Reuters Health

Tuesday, March 16, 2004

NEW YORK (Reuters Health) - A vitamin D formulation, combined with antibodies against a cancer-associated protein, targets breast cancer cells in mice and inhibits tumor growth, according to a report in the International Journal of Cancer.

Specifically, researchers found that the vitamin D formulation, D5, combined with antibodies against the Her-2 protein, killed Her-2-positive breast cancer cells in both laboratory experiments and in mice.

Vitamins and other natural products that inhibit the growth of cancer cells in the laboratory could be developed to prevent or treat various types of cancer, Dr. Rajeshwari R. Mehta from University of Illinois at Chicago told Reuters Health. "Targeted delivery of micronutrients will be safe and nontoxic."

Mehta and colleagues previously showed that D5 had potent anticancer effects on breast cancer cells in laboratory experiments. Here they examined the possible therapeutic potential of targeted delivery of D5 to Her-2-overexpressing breast cancer cells implanted in mice.

The D5-Her-2 compound inhibited the growth of breast carcinoma cells in the test tube, and also significantly reduced the average tumor volumes in female mice that were transplanted with these breast carcinoma cells, the report indicates. Tumor volumes were similar to those seen in mice that received dietary D5 supplement and smaller than those seen in mice treated with Her-2 antibody alone.

D5 alone, administered directly into the abdominal cavity, did not reduce tumor volumes, the researchers note.

"We are currently testing whether Herceptin, a humanized Her-2 antibody, (combined with) D5 is more effective than either agent given alone," Mehta said. "Once we find promising results in experimental animals, the next step will be to study its toxicity."

This approach could be used for any cancer, the researcher noted.

This "immunoconjugate therapy" might also be useful in reducing drug-associated toxicity, Mehta added. "We can use reduced dose and still could get optimum effect without compromising safety."

Source: International Journal of Cancer, March 1, 2004.

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Part-Time Vegetarians Become More Common  

By J.M. Hirsch
Associated Press Writer
The Associated Press
Tuesday, March 16, 2004

CONCORD, N.H. - Even after five years, Christy Pugh has no trouble sticking to her vegetarian regimen.

The secret to her success? Eating meat.

"Sometimes I feel like I'm a bad vegetarian, that I'm not strict enough or good enough," the 28-year-old bookkeeper from Concord said recently. "I really like vegetarian food but I'm just not 100 percent committed."

Pugh is one of a growing number of part-time vegetarians whose loose adherence to the meat-free diet is transforming a decades-old movement and the industry that feeds it.

These so-called "flexitarians" — a term voted most useful word of 2003 by the American Dialect Society — are motivated less by animal rights than by a growing body of medical data that suggests health benefits from eating more vegetarian foods.

"There's so many reasons that people are vegetarians ... I find that nobody ever gives me a hard time when I say I usually eat vegetarian. But I really like sausage," Pugh said.

In recent years the market for vegetarian friendly foods has exploded, with items such as soy milk and veggie burgers showing up in mainstream groceries and fast food restaurants.

But even the diet's activists say that growth can't be attributed to committed vegetarians, who are estimated at about 3 percent of the adult U.S. population, or about 5.7 million people never eating meat, poultry or seafood.

Charles Stahler, co-director of the Baltimore-based Vegetarian Resource Group, credits the growth to flexitarians — vegetarians who dabble in meat and carnivores who seek out vegetarian meals.

"This is why Burger King has a veggie burger. It's not because of us," he said. "The true vegetarians wouldn't rush to Burger King anyway. It's because of those people in the middle. They are the driving audience."

Though flexitarian headcounts are imprecise, Stahler estimates roughly 30 percent to 40 percent of the population at least occasionally seeks out vegetarian meals.

Suzanne Havala Hobbs, a dietitian at the University of North Carolina at Chapel Hill, credits the growth of flexitarianism to the nation's better understanding of the diet-disease connection.

"Whether you make a commitment to eating strictly vegetarian or not, cutting back your dependence on meat is something most people acknowledge they know they should do," she said.

Mollie Katzen, a cookbook author and a founder of the iconic vegetarian eatery Moosewood Restaurant in Ithaca, N.Y., takes another perspective. The former vegetarian thinks people who eschew meat would be better off if they didn't.

Though she still advocates vegetable-based diets, Katzen sees room — and for many people a need — for flexibility.

"To base our diet there, yes. Absolutely," she said. "However, where the protein comes from in that diet, I don't feel it's wrong if you've got a great big plate of vegetables your protein is from a healthy, happy chicken, or a grass-fed cow."

Plenty of people seem to agree. At Wild Oats stores, a Boulder, Colo.-based chain of natural foods grocers that cater to vegetarians, the majority of shoppers aren't vegetarians.

Tracy Spencer, a spokeswoman for the company, said Wild Oats shoppers are concerned about health and want the grocer's natural and organic products, including meats.

Publishers of vegetarian magazines also are taking notice. To target the part-timers many have softened their approach to meatless diets, even at risk of alienating the far smaller reader pool of true vegetarians.

Until last year Natural Health, a Woodland Hills, Calif.-based magazine with a monthly circulation of 300,000, published only vegan recipes, which exclude even dairy and honey.

Now the recipes regularly include meat, said Barb Harris, the magazine's editorial director.

"There is a big interest in vegetarianism," she said. "But we can also tell from our readership that these are not people who are following a pure vegetarian lifestyle. These are people who are integrating a vegetarian menu in their current diets."

A similar change occurred at the 30-year-old Vegetarian Times, considered the standardbearer of vegetarianism. Though still meat-free, the once mostly vegan magazine focuses less on activism and more on recipes with broader appeal.

Carla Davis, managing editor of the Glen Allen, Va.-based monthly, said the changes were made after a survey showed 70 percent of the magazine's 300,000-plus readers weren't vegetarian.

Even the strictest of vegetarian advocacy groups considers the flexitarian trend a good thing.

Bruce Friedrich, spokesman for Norfolk, Va.-based People for the Ethical Treatment of Animals, said he doesn't see any harm in vegetarianism focusing more on food than the issues that spurred the movement.

"From our perspective, if people influenced by health consequently cut back on fish and meat consumption, that helps animals," he said. "If two people cut their meat in half it helps as much as one person going completely vegetarian."

On the Net:

Natural Health: http://www.naturalhealth1.com/

Vegetarian Resource Group: http://www.vrg.org/

Vegetarian Times: http://www.vegetariantimes.com/

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Dry Mouth  

HealthDayNews
Tuesday, March 16, 2004

(HealthDayNews) -- Dry mouth used to be considered a normal symptom of aging.

However, it's now clear that dry mouth is often a side effect of certain medications -- such as antihistamines, heart drugs and pain killers -- according to the Maryland Department of Health and Mental Hygiene. A decrease in hormones in postmenopausal women can also lead to dry mouth.

A lack of saliva causes food and bacteria to remain in the mouth for longer periods, which can lead to more plaque and cavities.

While there is no cure for dry mouth, you can get relief by drinking water, using saliva substitutes, using a humidifier or nasal spray, and by avoiding caffeine, alcohol and tobacco products.

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Fruits and Vegetables May Strengthen Girls' Bones  

By Amy Norton

Reuters Health

Tuesday, March 16, 2004

NEW YORK (Reuters Health) - Although calcium usually gets top billing when it comes to bone health, fruits and vegetables may also promote stronger bones in girls, new study findings suggest.

The study of 56 white girls ages 8 to 13 found that those who ate at least three servings of fruits and vegetables each day had bigger bones than their peers. Researchers suspect that a produce-rich diet helps limit the body's excretion of calcium from the bones.

Several studies in adults have tied fruit and vegetable consumption to greater bone density, possibly due to nutrients commonly found in these foods, such as potassium, beta-carotene, vitamin C and magnesium. There's also evidence that fruits and vegetables lower the excretion of calcium in the urine.

This is because fruits and vegetables act as "base" foods that help counteract the acid that is produced when other foods, such as proteins and grains, are metabolized. It's thought that when a diet lacks such acid-buffering foods, the bases present in bone, including calcium, may have to come to the rescue.

One study has suggested that the vast majority of calcium excreted in urine comes from bone stores rather than dietary intake.

But little is known about produce intake, urinary calcium and bone health in children, according to the authors of the new study, led by Dr. Frances A. Tylavsky of the University of Tennessee in Memphis.

She and her colleagues had the girls and their parents record the subjects' food intake on three different days over a one- to two-year period. The researchers also used X-rays to measure the girls' bone size, and took urine and blood samples.

They found that compared with girls who ate fewer than three servings of fruits and vegetables per day, those who ate more had greater bone area overall, as well as greater bone area in the wrist. These girls also excreted less calcium in their urine, according to findings published in the American Journal of Clinical Nutrition (news - web sites).

The researchers suspect that this "lower calcium output" is the reason for the fruit and veggie eaters' bigger bones. Though it's possible, Tylavsky told Reuters Health, that the higher intakes of produce were a marker of an overall healthier diet.

However, the study found no difference in protein or calcium intake between girls who ate three daily servings of produce and those who ate less. Nor were the larger bones a product of the high-consumption group getting more exercise.

Still, the researchers point out, the study was small and included only white girls from affluent families. Whether the findings extend to all groups, and whether fruits and vegetables ultimately affect a person's peak bone mass, remains unknown.

Tylavsky noted that peak bone mass--the maximum bone density a person achieves--also depends largely on genetics and exercise.

Source: American Journal of Clinical Nutrition, February 2004.

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Surveys Examine Urinary Infections, Women  

By Linda A. Johnson
Associated Press Writer
The Associated Press
Tuesday, March 16, 2004

TRENTON, N.J. - Most women who contract urinary tract infections don't know the risk factors or simple preventative strategies, while some sufferers shun medical treatment altogether, two surveys showed.

Urinary tract infections are the No. 2 reason antibiotics are prescribed, accounting for more than 8 million U.S. doctor visits and about $1.6 billion in health costs each year, says the National Women's Health Resource Center. It commissioned separate surveys of women and medical professionals.

Yet the surveys found only 13 percent of women aged 18 to 45 knew sexual activity is a primary risk factor for bladder infection, or that simple precautions — proper hygiene, emptying the bladder after intercourse, and plenty of fluids — can prevent it.

Symptoms can include burning on urination, urgency, fever and abdominal pain.

The survey also found 39 percent said they hoped the infection would go away on its own, 23 percent treated it by themselves, and 24 said they were too busy to see a doctor. Seven percent said the symptoms went away.

"Women needlessly compromise their lifestyles when they do not know how to prevent or treat a UTI," Amy Niles, president of the resource center, said Monday.

The nonprofit center is launching an education campaign, partly funded by Bayer Pharmaceuticals Corp., maker of the antibiotic Cipro, which is prescribed for UTIs.

If the UTI is untreated, there is a risk of kidney infection that could lead to stones or even kidney failure, said Dr. Roger Dmochowski, professor of urology at Vanderbilt University Medical Center.

The survey included 400 women with a past UTI culled from random calls to women last fall. It had a margin of error of plus or minus 5 percentage points, according to research consultants Wirthlin Worldwide.

On the Net:

National Women's Health Resource Center: http://www.healthywomen.org

National Kidney Foundation info: http://www.kidney.org/general/atoz/content/uti.html

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Rheumatoid Arthritis May Raise Heart Failure Risk  

Reuters Health

Tuesday, March 16, 2004

NEW YORK (Reuters Health) - Patients with rheumatoid arthritis appear to be at increased risk for developing heart failure, new research suggests. However, treatment with certain rheumatoid drugs, such as infliximab and etanercept, seems to reduce the elevated risk.

Although rheumatoid arthritis has been linked to heart disease in general, it was unclear if a specific association existed with heart failure. Animal studies have supported a possible link, whereas trials in humans have not.

To investigate, Dr. Frederick Wolfe and Kaleb Michaud, from the Arthritis Research Center Foundation in Wichita, Kansas, analyzed data from 13,171 patients with rheumatoid arthritis and 2568 patients with osteoarthritis. The findings are published in The American Journal of Medicine.

Heart failure was identified in 3.9 percent of rheumatoid arthritis patients compared with just 2.3 percent of osteoarthritis patients, the researchers note. However, in rheumatoid arthritis, those without traditional risk factors for heart failure, such as high blood pressure and diabetes, the rate was just 0.4 percent.

Treatment with rheumatoid drugs called TNF blockers seemed to reduce the risk of heart failure. Still, the authors note that this benefit was only seen in rheumatoid arthritis patients with preexisting heart disease.

"Our results suggest that rheumatoid arthritis increases the risk of heart failure, which may be ameliorated by anti-TNF therapies," the investigators state.

Source: American Journal of Medicine, March 1, 2004.

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Utah Braces for West Nile Virus Season  

By Debbie Hummel 
Associated Press Writer 
The Associated Press
Tuesday, March 16, 2004

SALT LAKE CITY - Utah doesn't want to be another Colorado when it comes to the West Nile virus (news - web sites).

Since first appearing in the United States four years ago in New York, the virus has moved steadily West. The disease found in birds and spread by mosquitos to humans and horses hit hardest last year in Colorado, where there were 2,477 human cases.

There was only one human case in Utah last year, but 34 horses were infected. State officials say those cases are certain to increase this summer.

The Utah Department of Agriculture and Food held a meeting to discuss how the state should increase mosquito abatement activities. What came out of it was the creation of a committee, which will meet March 22 to survey where the greatest needs to spray in rural areas are, said Larry Lewis, spokesman for the Utah Department of Agriculture.

"We want people to see that we're starting early and we're doing all we can," said Lewis.

Armed with $500,000 from the state Legislature to aid in the battle, part of Monday's meeting that drew mosquito abatement district representatives and state officials was to assess how the money could best be spent.

"The purpose of that was to help areas that aren't organized or don't have mosquito abatement coverage," said department director Cary Peterson. "We want to be prepared and lessen the impact on our state as best we can."

Sammie Dickson, head of the Salt Lake City Mosquito Abatement District, says he feels good about the control districts provide, but worries that there is only a month or two left to kill the mosquito larvae before they become an airborne problem.

Of the nine counties that detected West Nile virus last year, seven of them had some kind of mosquito control efforts in place, Dickson said.

"We're still going to see West Nile virus. I think mosquito control can lessen the blow but it will not stop it," he said.

People can help protect themselves by removing standing water from around their homes. They also can use an insect repellant that contains DEET if they are outdoors during dawn and dusk hours, when mosquitos are most active.

Horse owners will want to make sure they vaccinate their horses this year, said Michael Marshall, the state veterinarian.

Owners who vaccinated last year need to give their animals a booster, he said.

On the Net:

Centers for Disease Control: http://www.cdc.gov/ncidod/dvbid/westnile/index.htm

Utah Department of Agriculture and Food: http://ag.utah.gov/wnv/wnv_home.html

Utah State Department of Health: http://health.utah.gov/

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Drug Resistant TB Poses Global Problem - WHO Report  

By Patricia Reaney 
Reuters
Tuesday, March 16, 2004

LONDON (Reuters) - Cases of multi-drug resistant tuberculosis in the former Soviet Union are rising at an alarming rate and pose a global problem, the World Health Organization (news - web sites) said Tuesday.

Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan, where up to 14 percent of new patients have strains of the disease resistant to the most powerful drugs (MDR), are among the top 10 world TB hotspots.

"Tuberculosis remains a major public health problem globally," Dr Paul Nunn, of the WHO, told a news conference.

"The former Soviet Union is the multi-drug resistant (MDR) tuberculosis capital of the world. The rate of drug resistance, and multi-drug resistance there is about 10 times that of the rest of the world."

Nunn said the rising number of MRD-TB cases followed the collapse of public health infrastructure after the political and economic changes over the last several years.

"We worry about MDR because, untreated, it is a death sentence," he added.

300,000 New Cases A Year

A new WHO report on TB, an infectious airborne disease that affects nine million people each year and kills two million, focuses on the growing problem of MDR-TB.

Population growth, worldwide travel and MDR-TB have contributed to the increase in TB. Experts estimate that 300,000 new cases of MDR-TB are diagnosed each year.

The highest prevalence of MDR-TB also coincides with the world's fastest growing HIV (news - web sites) infection rates in Eastern Europe and Central Asia. Tuberculosis is one of the main opportunistic infections that kills AIDS (news - web sites) sufferers.

"We know that HIV causes an increase in the transmission of tuberculosis. We are obviously concerned that in this context HIV will cause increased transmission of multi-drug resistant tuberculosis," said Nunn.

Patients with TB are treated with the DOTS (Directly Observed Treatment, Short-course) program -- a multi-level approach adopted by WHO that involves government commitment, patient surveillance and treatment with the drugs isoniazid and rifampicin.

But people with MDR-TB do not respond to one or more of the main drugs and require different, more toxic and expensive treatments. Nearly 80 percent of MDR-TB cases are "super strains," resistant to at least three or four of the main drugs used to cure TB.

The WHO report warns of the global danger of MDR-TB and calls for expansion of the DOTS program, increased funding for a DOTS Plus program, a specific treatment program for drug-resistant disease, and more investment in better surveillance of the disease and laboratory research.

"The response to this situation has to be global," Dr Mario Raviglione, director of WHO's Stop TB Department, said at the launch of the report.

"It is in the interest of every country to support rapid scale-up of TB control if we are to overcome MDR-TB. Passport control will not halt drug resistance; investment in global TB prevention will," he added.

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Home Is Where the Heart Monitoring Is  

By Serena Gordon
HealthDay Reporter
HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- Home blood pressure monitoring may be better at predicting your risk of a heart attack or other cardiovascular problem than the readings you get at your doctor's office.

In a study appearing in the March 17 issue of the Journal of the American Medical Association (news - web sites), French researchers report that a 10-point increase in systolic blood pressure readings at home translated to a nearly 20 percent increased risk of a cardiovascular event, such as a heart attack or stroke. In comparison, no jump in risk was found for an increase in physician's office blood pressure readings.

"This study shows that home blood pressure monitoring is like a motion picture, giving us consistent views over time, rather than a single snapshot, like [doctor's] office blood pressure readings," says Dr. Frank McGeorge, director of emergency medicine at William Beaumont Hospital in Royal Oak, Mich.

He says blood pressure readings taken at a doctor's office or in the emergency room are often elevated because people are usually anxious in such settings. The phenomenon is so common it's been dubbed "white-coat hypertension."

About one in four adults in the United States have high blood pressure, according to the American Heart Association (news - web sites). Many are unaware they have hypertension because the disorder is usually without symptoms. Left untreated, it can lead to heart disease, stroke and kidney disease.

In the current study, researchers followed almost 5,000 people who had been diagnosed with high blood pressure for an average of three years. The average age of the study participants was 70, and nearly half were male.

At the start of the study, three different blood pressure readings were taken in the doctor's office. Then, over a four-day period of the participant's choosing, blood pressure was taken at least three times throughout the day for each day. Home measurements were taken in a sitting position after five minutes of rest.

The researchers then followed the volunteers for an average of three years, recording any deaths or illness from cardiovascular disease.

They found home blood pressure readings were significantly better at predicting the incidence of cardiovascular disease than doctor's office measurements were. For each 10 mm/Hg rise in systolic (the top number) blood pressure readings taken at home, there was a 17.2 percent increase in the risk of cardiovascular disease. Cardiovascular risk went up nearly 12 percent for each 5 mm/Hg increase in diastolic pressure readings taken at home. Surprisingly, there was no similar association between increased blood pressure readings and cardiovascular risk when the readings were done at the doctor's office.

"Blood pressure readings don't correlate as well to risk as readings taken at home," McGeorge says. "The at-home reading is more likely to be true blood pressure. High blood pressure at home is a more significant finding."

Dr. Dan Fisher, a cardiologist at New York University Medical Center, says, "Home readings can give you a better assessment of continual blood pressure." But he adds the study had some limitations.

He says the volunteers' physicians were made aware of the home blood pressure readings, which may have influenced how they treated them. For instance, they may have treated people with elevated home readings more aggressively, he says. Also, the researchers didn't gather information on the type of treatment the study participants were receiving.

Both Fisher and McGeorge say home blood pressure monitoring is a good idea, particularly for people with hypertension. McGeorge also recommends it for anyone with known heart disease, or known risk factors for heart disease.

The most important thing, they say, is to make sure your home machine works well. Take it with you to your doctor's appointment, so you can compare your machine's reading to the doctor's reading to make sure your machine's readings are correct, they recommend.

More information

To learn more about monitoring your blood pressure at home, read this information from the American Academy of Family Physicians or from the American Heart Association.

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Early Radiation May Cure Recurrent Prostate Cancer  

By Megan Rauscher

Reuters Health

Tuesday, March 16, 2004

NEW YORK (Reuters Health) - Early radiation treatment can cure men whose prostate cancer returns after surgery, even those at highest risk for disease progression, new research suggests.

This study, Dr. Kevin M. Slawin told Reuters Health, has "important implications" for patients because of the "widespread notion" that high-risk disease precludes the use of such "salvage" therapy.

Slawin, from Baylor College of Medicine in Houston, and a multicenter team reviewed the outcome of 501 patients who received radiation therapy for recurrent prostate cancer. They report their findings in the Journal of the American Medical Association (news - web sites).

The authors found that such patients often did well, provided that radiation was given early--before the prostate specific antigen (PSA) test level rose above 2. "If you wait until the PSA is over 2, these patients do dismally," Slawin noted.

Dr. Mitchell A. Anscher, from Duke University in Durham, North Carolina, writes in an accompanying editorial that radiation therapy after radical prostatectomy is used "too infrequently and too late in the course of the disease. This is particularly true for patients who might benefit the most"--those with high-risk disease.

Source: Journal of the American Medical Association, March 17, 2004.

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Meet America's 100 'Asthma Capitals'  

By Steven Reinberg   
HealthDay Reporter
HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- Springtime and the breathing isn't easy -- particularly if you have asthma and live in Knoxville, Tenn.; Little Rock, Ark.; St. Louis; Madison,

That's the conclusion of a new survey from the Asthma and Allergy Foundation of America that ranks the 100 largest U.S. cities by asthma risk. The just-mentioned cities occupy the top five slots. Daytona Beach, Fla.; Miami; and San Francisco conclude the list.

"The importance of the Asthma Capitals list is to help people realize that asthma is one of the most significant health problems among children and adults in the U.S.," says Mike Tringale, a spokesman for the Asthma and Allergy Foundation of America.

But asthma is a problem all over the country, he says, adding, "There is no place safe from asthma."

The researchers who compiled the list took into account many factors. They included the prevalence of asthma, deaths from asthma, outdoor air quality and pollen counts, smoking laws, the number of prescriptions for asthma medications, and the number of asthma specialists in each city.

In addition, the researchers considered poverty levels, which are associated with an increased risk for asthma and less access to health care.

They also looked at laws that prevent children from bringing their asthma medication to school, Tringale says.

Such laws must be abolished and children allowed access to their inhalers, says Dr. Thomas Robins, a professor of environmental and occupational medicine at the University of Michigan. Children have died in school from asthma attacks because they weren't allowed to have inhalers, he adds.

By examining all these risk factors, the researchers were able to construct a list based on quality-of-life factors as well as the number of reported asthma cases.

"That's why the largest cities, like New York and Chicago, are not at the top of the list, which may surprise some people," Tringale says.

"In determining the city rankings, we looked at all the factors that affect an individual with asthma, that make it more or less difficult to live in that city," he says.

So while Knoxville is at the top of the list, it doesn't mean asthma is not a problem in other cities, Tringale says.

The list is timely because allergy season has arrived early in many parts of the country, Tringale says. "And believe it or not, even people who have asthma have never heard about the most common form of asthma -- allergic asthma."

Of the 20 million Americans who have asthma, 10 million have allergic asthma, Tringale notes. Allergic asthma is a chronic inflammatory disorder of the airways, and its symptoms are made worse by exposure to allergens such as dust, mold and pollen. While allergic asthma is a problem all year long, it can strike hard in spring with the presence of more pollen in the air, he says.

This year, pollen counts are rising earlier than usual in many parts of the country because of a mild winter and more rain, Tringale says.

Dr. Stanley Goldstein, a member of the board of directors of the American Academy of Allergy, Asthma and Immunology, agrees that the most common cause of asthma is allergies.

That's why the academy and the Asthma and Allergy Foundation of America have started a campaign called "Is Your Asthma Allergic? Know Your IgE."

If you have allergic asthma, immunoglobulin E (IgE) antibodies are produced after exposure to allergens, such as dust, pet dander, pollen or mold spores. The antibodies can cause the release of chemicals that trigger the inflammation of the airways, and the coughing and wheezing of an asthma attack, Goldstein says.

Goldstein says the academy has developed an asthma screener that's available on its Web site (www.aaaai.org/allergicasthma). "Using this screener can give you an idea if you have asthma. And then you can go to an asthma specialist and get your asthma under control," he says.

Robins says asthma can be a life-threatening illness and many people with asthma don't have their asthma under control. So, there needs to be more awareness of asthma both among patients and physicians, he says.

"With proper education and medication, the vast majority of asthmatics can keep their asthma under control and lead a normal life," Robins says.

More information

The American Academy of Allergy, Asthma and Immunology has information on self-screening for asthma. The Asthma and Allergy Foundation of America has more on asthma treatments and you can also peruse through the Asthma Capitals list.

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Virus Linked with Head and Neck Cancer

Reuters Health

Tuesday, March 16, 2004

NEW YORK (Reuters Health) - Infection of cells in the mouth with certain types of human papillomavirus (HPV) is a risk factor for head and neck cancer, new research indicates.

As reported in the Journal of the National Cancer Institute (news - web sites), Dr. Elaine M. Smith of the University of Iowa and colleagues detected cancer-causing HPV in oral cells from 22.9 percent of 201 patients with head and neck cancer, but from only 10.8 percent of 333 cancer-free subjects.

HPV 16 was the most frequently detected type, present in 19 percent of cancer patients and 10 percent of healthy subjects.

After accounting for other factors like tobacco and alcohol use, the risk of head and neck cancer was still significantly greater in subjects infected with cancer-causing HPV types, compared with uninfected individuals. The risk was not increased among those infected with HPV types not associated with cancer.

Alcohol and tobacco use both raised the odds of detecting cancer-causing HPV.

The team also found an association between detection of cancer-causing HPV in oral cells and detection of such types in tumor tissue.

Head and neck cancers cause "clinically significant (disease) and disfiguration," Smith and colleagues note, making "early detection of disease and biomarkers to identify individuals at high risk of great importance."

Source: Journal of the National Cancer Institute, March 17, 2004.

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Researchers Flip Immune System's 'On' Switch  

By Randy Dotinga
HealthDay Reporter
HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- Some immune cells shut down before they've finished destroying invading viruses such as HIV (news - web sites), and scientists have been stumped as to why.

But new research in mice suggests it may have something to do with the body's need to protect itself from the havoc caused by overheated immune cells.

The findings could lead to new medical treatments if researchers can confirm the findings and develop a way to keep the worker cells on the job. "This is one of the first studies to show that it may be possible in the future to manipulate the natural immune system to make it work better," says Dr. Douglas Nixon, an associate professor of medicine at the University of California at San Francisco.

Over the past decade, drugs known as antiretrovirals have revolutionized the treatment of viruses such as AIDS (news - web sites) and hepatitis. When used in combination, the drugs often successfully stop the AIDS virus from replicating.

But the AIDS virus is slowly developing resistance to the drugs, and the medications don't work for everyone. Researchers continue to look for new ways to keep the virus and its counterparts at bay.

In the new study, federal researchers examined the interplay between two types of immune cells known as CD8+ T cells and CD4+ T cells. They wanted to find out why the immune system disengages itself and lets the body be chronically infected by a virus, explains study co-author Kim J. Hasenkrug, a researcher with the National Institute of Allergy and Infectious Diseases (news - web sites).

One theory is the immune system turns off to keep itself from losing control and attacking the body, Hasenkrug says. In autoimmune diseases such as lupus, the immune system goes haywire and assumes the body's own cells are invaders.

The suppression of the immune system is probably a "normal biological process," Hasenkrug says. "During the acute phase of infection you want to have this huge response. If you don't shut down your response as the infection goes away, you run the risk that the immune system can cause as much or more damage as the virus."

The researchers infected mice with a virus that's similar to AIDS in people and watched what happened. The findings appear in the March issue of Immunity.

The CD4+ cells, which tell the CD8+ cells whether to "kill or be quiet," eventually stopped giving orders to attack, Hasenkrug says.

But by using a disease-fighting antibody to tinker with the immune system, researchers were able to prevent the attack cells from halting their virus-killing work, Hasenkrug says.

There's still plenty of research to be done on this front, Hasenkrug adds. No one knows if the approach will work the same way in humans. "Hopefully, we can develop therapies to eliminate persistent or chronic infections."

More information

Get information on a variety of autoimmune disorders from the American Autoimmune Related Diseases Association. Or visit the University of Leicester to learn more about the immune system.

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Study: Painkilling Patch Works Like Needle Delivery  

Reuters

Tuesday, March 16, 2004

CHICAGO (Reuters) - An adhesive patch that uses a tiny electric current to deliver pain medication through the skin does the job about as well as conventional intravenous devices, researchers said on Tuesday.

The patch resembles a credit card and is affixed to the patient's upper arm or chest after surgery. Both the patch and some intravenous delivery systems allow the patient to self-medicate by pressing a button, according to a company-funded study.

The study was financed by ALZA Corp., which developed the transdermal drug delivery device with another Johnson & Johnson subsidiary, Ortho-McNeil Pharmaceuticals Inc.

"(The patch) is able to deliver a potent pain reliever through the skin with a very, very tiny electric current at the demand of the patient," said study author Gene Viscusi of Thomas Jefferson University Hospital in Philadelphia. "This is a miracle of miniaturization."

His trial of 636 patients following major surgery assigned them either to the patch with the painkiller fentanyl hydrochloride or an intravenous system that delivered morphine. Of those wearing the patch, 74 percent rated it good to excellent at relieving pain in the 24 hours after surgery while 77 percent of those getting morphine intravenously rated that method highly.

The report, published in the Journal of the American Medical Association (news - web sites), said patches allow patients to move about more freely and may replace cumbersome intravenous systems that require a needle, tubes and a pump.

The fentanyl patch system is under review by the U.S. Food and Drug Administration (news - web sites).

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Psoriasis Treatment Shows Unwanted Side Effect  

HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- People with psoriasis treated with a combination of the drug psoralen and ultraviolet A light therapy (PUVA) have increased levels of human papillomavirus (HPV) in their skin, says an Austrian study in the March issue of the Archives of Dermatology (news - web sites).

Previous research identified a link between PUVA therapy and increased risk of skin cancer, but the causes of that increased risk were not pinpointed. HPV has been closely linked to skin cancer.

"It has been suggested that PUVA may increase expression of the tumorigenic (cancer-causing) agent HPV in skin by directly stimulating virus replication, immune suppression or both, thereby leading to skin cancer formation," the study authors write.

They examined whether long-term PUVA treatment results in increased presence of HPV in the skin. They screened for HPV DNA in body hairs they collected from psoriasis patients.

Group A included 16 patients with a history of PUVA exposure and a history of skin cancer, group B included 35 with a history of PUVA exposure and no history of skin cancer, and group C included 30 with no history of PUVA exposure or skin cancer.

HPV DNA was found in 73 percent of patients in group A, 69 percent of patients in group B and 36 percent of patients in group C.

More information

The U.S. National Cancer Institute (news - web sites) has more about HPV.

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Your Sense of Smell Can Save Your Life  

By Alison McCook
Reuters Health
Tuesday, March 16, 2004

NEW YORK (Reuters Health) - People who have an impaired sense of smell appear to be at higher risk of preventable accidents, new research reports.

Investigators found that more than one third of people with a diminished sense of smell report having experienced at least one accident that could have prevented, such as burning pots and pans, eating spoiled food, and gas leaks.

In contrast, less than one fifth of people with accurate noses report having experienced similar events, according to the report.

People with olfactory impairments need to take some extra steps to protect themselves from everyday accidents heralded by smells, a study author told Reuters Health. For instance, those with a diminished sense of smell need to make sure their houses contain enough working smoke detectors, check that their gas appliances are in good condition, and properly date and label prepared foods.

"Individuals with impaired olfaction must be more vigilant regarding their surroundings and activities of daily living," said Dr. Richard M. Costanzo of Virginia Commonwealth University in Richmond. "It's not until you lose (your sense of smell) that you realize how important it really is," he added.

During the study, Costanzo and his colleagues tested 445 people on their sense of smell, and asked them how often they had experienced accidents that their noses could have prevented.

The researchers found that more than three quarters of people showed signs of some type of olfactory impairment, but only 30 percent had lost all sense of smell.

Almost half of the accidents reported by people with a loss of olfactory function were related to cooking, while eating spoiled food made up one quarter of events. Accidents that occurred because people couldn't detect a gas leak or smell a fire made up 23 and 7 percent, respectively, of the total.

Costanzo explained that people can lose some of their smelling abilities for many reasons, notably head trauma, sinus diseases, viruses and the aging process. "It has been estimated that as many as 14 million Americans of age greater than 55 years have some olfactory impairment," he said.

In the Archives of Otolaryngology Head & Neck Surgery report, he and his colleagues write that the prevalence of olfactory impairment is expected to increase, given that more and more people are living longer lives.

However, historically, problems with this sense have often been "overlooked," they write, likely a combination of a lack of awareness about the scope of the problem, little public understanding of the importance of smell impairments, and the fact that only few treatments exist.

Source: Archives of Otolaryngology Head & Neck Surgery, March 2004.

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Toxin Combo May Treat Leukemia  

HealthDayNews
Tuesday, March 16, 2004

TUESDAY, March 16 (HealthDayNews) -- A combination of two natural toxins -- arsenic and bryostatin -- may be a powerful new treatment for certain kinds of leukemia, claims a study in the March 16 issue of the Proceedings of the National Academy of Sciences (news - web sites).

Researchers at Johns Hopkins Kimmel Cancer Center found that arsenic, long used to treat certain leukemias, activates the same cellular self-destruct mechanism as bryostatin, a toxin that's found in coral-like aquatic organism called a bryozoan that attaches to piers, boat hulls, and rocky surfaces.

Arsenic is known to be effective against treatment-resistant acute promyelocytic leukemia (APL). It's a cancer of the blood and bone marrow characterized by unhealthy white blood cells. APL is a subtype of acute myeloid leukemia, the most common form of adult leukemia.

Until now, scientists didn't fully understand how arsenic actually kills cancer cells. The Johns Hopkins scientists used molecular studies to discover that arsenic activates NADPH oxidase, an oxygen-producing enzyme complex.

"When normal white blood cells engulf invading bacteria, NADPH oxidase produces a big burst of bad oxygen species which they dump into bacteria to kill it and, in the process, kill themselves," Dr. Chi V. Dang, vice dean for research and professor of medicine, cell biology, pathology, and oncology, says in a prepared statement.

"We found that in APL, arsenic triggers activation of NADPH oxidase and uses this natural bacteria-killing mechanism against the leukemia cells -- in essence, a self-destruct switch," Dang says.

But he and his colleagues found arsenic alone didn't pack quite enough punch; it left much of the NADPH dormant.

The Johns Hopkins scientists turned to bryostatin. Previous molecular studies found bryostatin also activates NADPH.

"So, we used bryostatin to wake up the rest of (the NADPH)," Dang says.

This combination requires further study in cells and animals before clinical trials can be conducted on people with APL.

More information

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

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Monday, March 15, 2004  

Group Sues FDA Over Drug Linked to Liver Damage  

By Lisa Richwine
Reuters
Monday, March 15, 2004

WASHINGTON (Reuters) - A U.S. consumer group on Monday sued the Food and Drug Administration (news - web sites) in an effort to force a ban on a Bristol-Myers Squibb antidepressant linked to life-threatening liver damage.

The group, Public Citizen, said it filed the suit because the FDA had failed to act on a petition filed more than a year ago to outlaw the drug, called Serzone.

Serzone has been pulled from the market in Europe and Canada and is slated to be withdrawn in Australia and New Zealand in May, Public Citizen said.

"It is grossly negligent for the FDA to allow doctors to continue to prescribe, and patients to continue to take, Serzone," Dr. Sidney Wolfe, head of Public Citizen's Health Research Group, said in a statement.

The group cited reports in an FDA database of 55 cases of liver failure among Serzone users, including 20 deaths. Because drug side effects typically are under-reported, the actual number of cases likely is higher, the group said.

Bristol-Myers spokesman Rob Hutchison said it would be inappropriate to comment on the lawsuit because it had been filed against the FDA, not the company.

In the past Bristol-Myers has defended Serzone as an important option for treating depression and said liver problems were rare.

FDA spokeswoman Susan Cruzan said the agency would review the lawsuit.

Since January 2002, Serzone's label has included a "black box" warning that it may cause life-threatening liver damage. The instructions urge doctors to tell patients to be alert for signs of liver problems.

Public Citizen petitioned for a ban on Serzone in March 2003.

In its lawsuit, Public Citizen asked the court to find the FDA's failure to act on the petition illegal, and to order the agency to make a decision.

The suit was filed in U.S. District Court for the District of Columbia.

Serzone has been a relatively minor drug for Bristol-Myers, even before generic competition debuted last fall. The drug's generic name is nefazodone.

Shares of New York-based Bristol-Myers, which earlier Monday revised its financial results again, fell 64 cents to close at $25.19 on the New York Stock Exchange (news - web sites).

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Alaska Dentists Want Fluoride in Water  

The Associated Press
Monday, March 15, 2004

JUNEAU, Alaska - Some Juneau doctors and dentists want fluoride back on tap, months after the city stopped adding the compound — commonly used to prevent tooth decay — to public drinking water.

City Manager Rod Swope said he is prepared to keep the fluoride out until city officials can determine whether the compound is causing the leaching of copper in residential pipes. Public Works has been out of compliance with U.S. Environmental Protection Agency (news - web sites) copper standards for the Mendenhall Wastewater Treatment Plant.

"I think folks are going to have to hang in there with us for a few months longer until we figure out what's going on here," Swope said.

The city's Public Works Department turned off the fluoride June 26, 2003, after reviewing research, director Joe Buck said. Buck wants to keep the fluoride off until July to study the effects of copper levels without fluoride in the drinking water, he said.

Buck said he was not required to notify the medical community but said, in retrospect, that he should have. Eventually a medical provider noticed that the fluoride levels were low.

On Friday, Buck sent a letter to health care professionals notifying them the fluoride had been turned off. He said the drop in copper levels so far would not be enough to recommend the removal of fluoride from the system and it may be restored July 1.

Area doctors and dentists say their patients — especially children — are being deprived of fluoride's benefits.

Dentist Kristen Schultz, president of the Juneau Dental Society, said she plans to send a letter to Mayor Bruce Botelho and the Juneau Assembly later this week, asking that fluoride be put back in drinking water.

Meanwhile, doctors and dentists are encouraging patients to take fluoride supplements daily. This will mean added costs for parents, because fluoride supplements are available only through prescription, Schultz said.

Water fluoridation provides a more frequent exposure of fluoride to teeth than topically applied gels, said Brad Whistler, dental officer with the state Department of Health and Social Services. It costs about 98 cents per person for a community the size of Juneau, he said.

Community water fluoridation was recognized by the U.S. Centers for Disease Control and Prevention (news - web sites) as one of the top 10 public health accomplishments of the last century, Whistler said.

Studies have shown a reduction in tooth decay due to water fluoridation to be as much as 60 percent in baby teeth and 35 percent in permanent teeth, Whistler said.

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Blood Pressure Points to Heart Trouble for Women  

Reuters 
Monday, March 15, 2004

WASHINGTON (Reuters) - As blood pressure goes up, a woman's risk of a second heart attack, stroke or other cardiovascular disaster also goes up, researchers reported on Monday in a rare heart study looking at women exclusively.

For each 10 points the top, or systolic blood pressure reading went up, a woman's heart risk went up 9 percent, the team at Brigham and Women's Hospital in Boston found.

"Our prospective data demonstrate that systolic blood pressure is a strong independent predictor of cardiovascular disease events among middle-aged and older women with known cardiovascular disease," said Dr. Peter Mason, who led the study.

His team studied 5,218 female health professionals with an average age of 62 who had already had one heart attack or had other known heart disease.

Writing in the journal Circulation, Mason's team said the increased risk started at a reading of 130 mm Hg, a level called "prehypertension." Officially, hypertension is diagnosed at a top blood pressure reading of 140.

"We found a strong continuous relationship between increasing blood pressure and the risk of secondary cardiovascular events in women, and that even borderline elevations in blood pressure are associated with an increased risk," Mason said in a statement.

Mason, now at Boston Medical Center, followed the women for an average of 6 1/2 years.

He said it may be important to lower blood pressure below 130 in women with known heart disease.

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Survey Shows Blacks Unaware of Kidney Risk  

The Associated Press
Monday, March 15, 2004

JACKSON, Miss. - Health officials may have an uphill battle in educating blacks about a disease that's being called a "silent killer", a survey shows.

Kidney disease is an illness that's become more prevalent, especially in the nation's black population, but a survey conducted in Jackson, Atlanta, Baltimore and Cleveland shows only 15 percent of those surveyed thought they were at risk for getting the disease.

The National Kidney Disease Education Program surveyed more than 2,000 blacks 30 and older to assess their knowledge and awareness of kidney disease.

Dr. John Bower, a member of the local coalition directing Jackson's program and former chief of nephrology at the University of Mississippi Medical Center, said the survey shows most people have no clue about how to prevent kidney disease.

"Kidney disease is a silent killer," Bower said. "People find themselves in the emergency room, on dialysis, before they even know they have a problem. That's why it's so important to control diabetes and high blood pressure and have your blood and urine regularly tested ... once you know you are at risk."

The major risk factors for kidney disease include diabetes, high blood pressure or a blood relative with the disease.

"The beautiful thing is that if we can control blood pressure and diabetes, it's a good possibility that we can do something (about kidney disease)," Bower said.

About 20 million people have kidney disease in this country. Another 400,000 are on dialysis or have had a kidney transplant because their kidneys failed.

Steven Houston, 50, of Vicksburg, said he wouldn't want others to go through what he experienced. He had a kidney transplant 10 years ago after going into renal failure while serving in the Air Force in Operation Desert Storm.

"African Americans really need to pay attention to their health and what they put into their bodies," said Houston, whose kidney failure developed despite the absence of risk factors. "We often have so many underlying health problems, such as being too heavy, failing to exercise and not keeping our high blood pressure in check."

Although 90 percent of those surveyed had heard about kidney disease, only 15 percent thought their personal risk for getting the disease was higher than average.

Fewer knew how specifically to prevent it, but 44 percent of those polled had at least one of the major risk factors.

The survey will be used as a tool to design a yearlong pilot program aimed at reducing the number of blacks affected by the disease. In the next few months, health care officials will test the program in Jackson and the other three cities before taking it across the nation.

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Arsenic Study May Point to Leukemia Treatments  

Reuters 
Monday, March 15, 2004

WASHINGTON (Reuters) - A study of arsenic and leukemia showed why the old-fashioned, slow-acting poison sometimes works against cancer and may point to new treatments for leukemia, scientists said on Monday.

A team at Johns Hopkins University in Baltimore found arsenic works in a similar way to bryostatin, a toxin made by coral-like sea animals that has been investigated as a possible cancer treatment.

Put together, the two could offer a less toxic alternative to treating some forms of leukemia, the researchers said.

Arsenic has been used for centuries in medicine. It is known to work against treatment-resistant acute promyelocytic leukemia or APL, a cancer of the blood and bone marrow that affects myeloid or white blood cells.

APL is a subtype of acute myeloid leukemia, the most common form of adult leukemia.

Dr. Chi Dang and colleagues said they set out to find how arsenic works.

Working in lab dishes, the Johns Hopkins team found that arsenic targets an oxygen-producing enzyme complex known as NADPH oxidase.

"When normal white blood cells engulf invading bacteria, NADPH oxidase produces a big burst of bad oxygen species (charged molecules of oxygen) which they dump into bacteria to kill it and, in the process, kill themselves," Dang said in a statement.

"We found that in APL, arsenic triggers activation of NADPH oxidase and uses this natural bacteria-killing mechanism against the leukemia cells -- in essence, a self-destruct switch."

But arsenic cannot activate this mechanism fully enough to kill the cancer on its own, Dang said.

"Even with arsenic treatment, much of the NADPH oxidase remains dormant in our system," Dang said.

His team knew that bryostatin also activated NADPH oxidase, "so, we used bryostatin to wake up the rest of it," he said.

They could kill tumor cells with one-tenth the usual dose of either drug given alone, they found.

That could mean a less toxic cancer treatment, said Dr. Wen-Chien Chou, who also worked on the study.

"Arsenic is similar to other chemotherapeutic agents in terms of its potential toxicity, and there's a trade-off in how much harm you do to normal cells versus cancer cells," Chou said.

"Yet, the synergistic effects of combining two drugs that activate the same pathway may allow us avoid toxicity using such low doses."

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Surveys Examine Urinary Infections, Women  

By Linda A. Johnson
Associated Press Writer
The Associated Press
Monday, March 15, 2004

TRENTON, N.J. - Most women who contract urinary tract infections don't know the risk factors or simple preventative strategies, while some sufferers shun medical treatment altogether, two surveys showed.

Urinary tract infections are the No. 2 reason antibiotics are prescribed, accounting for more than 8 million U.S. doctor visits and about $1.6 billion in health costs each year, says the National Women's Health Resource Center. It commissioned separate surveys of women and medical professionals.

Yet the surveys found only 13 percent of women aged 18 to 45 knew sexual activity is a primary risk factor for bladder infection, or that simple precautions — proper hygiene, emptying the bladder after intercourse, and plenty of fluids — can prevent it.

Symptoms can include burning on urination, urgency, fever and abdominal pain.

The survey also found 39 percent said they hoped the infection would go away on its own, 23 percent treated it by themselves, and 24 said they were too busy to see a doctor. Seven percent said the symptoms went away.

"Women needlessly compromise their lifestyles when they do not know how to prevent or treat a UTI," Amy Niles, president of the resource center, said Monday.

The nonprofit center is launching an education campaign, partly funded by Bayer Pharmaceuticals Corp., maker of the antibiotic Cipro, which is prescribed for UTIs.

If the UTI is untreated, there is a risk of kidney infection that could lead to stones or even kidney failure, said Dr. Roger Dmochowski, professor of urology at Vanderbilt University Medical Center.

The survey included 400 women with a past UTI culled from random calls to women last fall. It had a margin of error of plus or minus 5 percentage points, according to research consultants Wirthlin Worldwide.

On the Net:

National Women's Health Resource Center: http://www.healthywomen.org

National Kidney Foundation info: http://www.kidney.org/general/atoz/content/uti.html

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Many Stroke Victims Reach Hospital Too Late, U.S. Study Finds  

Reuters 
Monday, March 15, 2004

CHICAGO (Reuters) - An emergency room treatment that could help stroke victims never reaches many of them because they arrive too late for it to be effective, according to a study published on Monday.

The study reinforced recommendations by the American Heart Association (news - web sites), which says it is urgent that people who think they are having a stroke seek help immediately.

The study was conducted by researchers at the Cleveland Clinic Health Care System and published in the Archives of Neurology.

The researchers found that of 1,923 stroke patients admitted to the system's nine hospitals over a one-year period ending in 2000, only 15 percent arrived within the three-hour window when a clot-busting drug called tissue plasminogen activator, or TPA, would be effective in limiting brain damage.

Earlier studies have found a greater proportion of stroke patients arriving at an emergency room within the three-hour window -- up 46 percent in one report -- the paper said.

"However, even the highest rates are suboptimal, and shortening emergency department arrival times will have the single greatest impact on increasing (the drug's) use in the United States," the article concluded.

The TPA drug works by dissolving clots that block blood flow to the brain in so-called ischemic strokes, thereby limiting brain damage. The drug is injected in an emergency room or hospital setting, and since 1996 it has been approved by the U.S. Food and Drug Administration (news - web sites) for treatment of ischemic strokes.

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Mice Produce SARS Antibodies  

By Amanda Gardner   
HealthDay Reporter
HealthDayNews
Monday, March 15, 2004                               

MONDAY, March 15 (HealthDayNews) -- Laboratory mice can produce antibodies that will fend off an attack by the SARS (news - web sites) virus, a new study says.

This means researchers developing vaccines that work by triggering antibodies, which is the simplest and most straightforward approach, are on the right track, scientists say.

"The mouse model is a first step, so it would be an easy model in which to test candidate vaccines," says Dr. Kanta Subbarao, a senior investigator in the Laboratory of Infectious Diseases at the National Institute of Allergy and Infectious Diseases (news - web sites). "The usual path for any vaccine development is to test candidate vaccines in one or two animal models before going on."

Subbarao is lead author of the study describing the new findings, which appear in the April 1 issue of the Journal of Virology.

The researchers first infected mice with the SARS virus and discovered that while the virus did not make the mice sick, it did infect the cells lining the airways and lungs and reproduced itself.

When these mice were given a second helping of SARS 28 days later, the mice produced antibodies so the virus was not able, this time around, to replicate itself.

Finally, the researchers took the antibodies produced by the mice and injected them into another group of mice that had not yet been infected with SARS. When these inoculated mice were exposed to SARS, the virus was unable to replicate itself.

In other words, the antibodies produced by the first group of mice were enough to ward off infection in the second group.

This may also mean that humans who had SARS once will be protected from getting it again.

"It seems more than likely that [previously infected] people will not get SARS," says Robert Garry, a professor of microbiology and immunology at Tulane University School of Medicine in New Orleans.

Adds Subbarao: "You can't extrapolate directly but... we did an experiment to see whether there was any hint that people might also be protected, and we got the hint. It doesn't necessarily mean people are protected, but it's a move in the right direction. We would be more discouraged if we couldn't protect the mouse."

Vaccines can work by stimulating the immune system to produce antibodies -- usually by injecting a dead virus, specialized cells or both -- to stop invading viruses.

"It is encouraging that a protective immune response was generated in the mice and that passive antibodies were protective. Antibodies aren't always protective, for example, in AIDS (news - web sites)," says Garry.

"It is also easier to generate an antibody response by simply injecting protein than it is to produce a cellular response," he adds. "This doesn't mean that an effective SARS vaccine is right around the corner, but assuming these results translate somewhat to humans, the prospects seem a bit more likely."

Garry was part of the team to identify the structure of the SARS virus.

The new findings should also help in the development of drugs to treat people who have already been infected with the virus, experts say.

SARS -- severe acute respiratory syndrome -- first surfaced in southern China in late 2002; by early 2003, it had spread to several countries in Asia, as well as Canada. According to the latest figures from the World Health Organization (news - web sites), 8,437 people were infected and 813 people died between Nov. 1, 2002, and July 31, 2003.

Although SARS has not yet reappeared this year, experts aren't sure what the future will hold. Will the virus reemerge seasonally like the flu, or will it will be reintroduced to the human population in another, as yet unknown, way? Whatever the case, experts have been working furiously to develop ways to prevent and treat it.

For such research, they need animal models to assess any potential prevention or treatment strategies.

And that's what makes the new study significant, Garry says. "A small animal model can greatly facilitate the development of vaccines or drugs against any infectious disease," he says.

Mice represent a particularly attractive candidate for this type of work.

"A small animal model like mice are a lot less expensive than civet cats (believed to be a possible source of SARS) or chimpanzees. You can do a lot of experiments in a short period of time and at much reduced cost," Garry says.

Subbarao adds: "The laboratory mouse is a very useful model because it is small, easy to come by, and easy to do a large number of experiments. If your only model was a primate, you would be really limited in what you can do."

There are limitations to mice model, however, including the fact that the rodents didn't actually get sick from SARS, even though the virus replicated itself in their respiratory tract, Subbarao says. Nevertheless, "it's very useful for vaccine purposes. You can at least screen vaccine possibilities and take them into more expensive models," she says.

More information

Visit the National Institute of Allergy and Infectious Diseases or the U.S. Centers for Disease Control and Prevention for more on SARS.

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High-Level Job Linked with Excessive Drinking in Women  

By Alison McCook
Reuters Health
Monday, March 15, 2004

NEW YORK (Reuters Health) - Women in high-ranking jobs are more likely to have a drinking problem than are women in lower-ranked positions, according to new research from the UK.

The investigators found that around 14 percent of women in senior positions appeared to have a dependence on alcohol, compared with only 4 percent of women holding clerical jobs.

Interestingly, the same trend was not seen in men. About 11 percent of men showed signs of having a drinking problem, regardless of the seniority of their position.

Study author Dr. Stephen Stansfeld of the Institute of Community Health Sciences in London said that highly ranked women may be more likely to drink than other women because they have more disposable income and are more likely to be single. Research shows that family commitments tend to reduce the risk of heavy drinking, he told Reuters Health.

Stansfeld, who is also based at Queen Mary's School of Medicine and Dentistry, added that highly ranked women may be more likely to drink heavily than their male counterparts because men in higher positions are more likely to be married than women, who may also have to work harder and sustain more stress than men to attain a similar success.

"It is more stressful for women to get to higher grades and stay there than men," according to Stansfeld.

During the study, Stansfeld and his colleagues surveyed more than 10,000 UK civil servants about the nature of their jobs and their drinking habits.

The researchers also found that men who work in jobs in which they exert great effort but see few rewards were at significantly higher risk of becoming problem drinkers. The risk of heavy drinking was also higher among women who had few opportunities to make decisions and felt as if they had little control at work.

High demands and a lack of support at work appeared to have no relationship to drinking, contrary to the researchers' original hypothesis, according to their report published in Occupational and Environmental Medicine.

Stansfeld noted that he hopes these results encourage health officials to examine the effect of gender on health in the workplace, and focus on the relationship between women's work and drinking habits.

Source: Occupational and Environmental Medicine, March 2004.

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Master Blood Cell Gene Identified  

By Ed Edelson
HealthDay Reporter
HealthDayNews
Monday, March 15, 2004

MONDAY, March 15 (HealthDayNews) -- A gene first identified as the cause of a rare but deadly form of leukemia turns out to play a master role in controlling the body's blood system, researchers at the Dana-Farber Cancer Institute report.

The discovery could lead to new ways of treating many forms of leukemia, says Dr. Stanley Korsmeyer, director of the Dana-Farber Program in Molecular Oncology and leader of the group reporting the finding in the March 16 issue of Developmental Cell.

The gene is called MLL, for mixed lineage leukemia, an aggressive form of blood cancer that affects a small number of infants and some adults who have relapsed after treatment for other leukemias.

"This cancer is an exaggeration of the normal role of this gene," says Korsmeyer. "It is too much of a good thing."

The good thing is production of blood cells. In MLL, the gene gets stuck in the "on" position because the chromosome on which it is located suffers a break at that specific site. The result is the uncontrolled proliferation of blood cells that is leukemia.

"We are one of about three people who have cloned that chromosomal breakpoint," Korsmeyer says.

Starting from there, the Dana-Farber researchers used embryonic stem cells first to create a line of cells lacking the MLL gene, then a strain of mice that did not have the gene. Stem cells are early forms that can develop into a variety of mature cells, depending on the genetic instructions they receive.

The studies showed the absence of the gene had profound effects on the hematopoietic system, which produces the red and white blood cells required for a living animal, Korsmeyer says. The MLL gene regulates the activity of a number of other genes whose activity produces blood cells, he says.

"This would place MLL with a handful of other genes, many involved in leukemia, that are required for the commitment of stem cells to form mature blood cells," Korsmeyer says. "This one is probably in a position that influences the way multiple lines of cells are formed."

In addition to adding significantly to knowledge about the genetics of the blood cell system, the finding could lead to new ways of treating leukemias, he says.

"One current fancy concerns an enzyme that helps activate MLL," Korsmeyer says. "It would be very attractive if we could inhibit the enzyme."

A more direct possibility would be to regulate the activity of MLL itself, he says.

Both lines of attack are being explored in the Dana-Farber laboratory. Panels of cancer cells will be manipulated by either taking away the MLL gene or inhibiting the enzyme to see if their growth can be affected.

There are even broader implications, Korsmeyer says. Studies show the protein made by the MLL gene regulates some of the HOX genes, master genes that guide the formation of body tissues and organs. Malfunction of HOX genes has been implicated in several types of cancer that occur in tissues other than the blood system.

More information

Information about the genetics and treatment of leukemia is offered by the National Cancer Institute. Learn about stem cells from the Batten Support & Research Trust.

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Brain Chemical May Help Narcolepsy, Study Shows

Reuters 
Monday, March 15, 2004

WASHINGTON (Reuters) - Replacing a missing brain chemical may help people with narcolepsy, a condition that causes patients to fall asleep uncontrollably, U.S. researchers reported on Monday.

Tests on mice showed that injections of orexin, a message-carrying chemical, or neurotransmitter, that has been suspected in narcolepsy, helped the sleepy mice wake up.

"Assuming that narcoleptic humans are like these mice, which is a very plausible assumption, our experiments provide a strong proof of the concept that introducing into the brain a molecule that mimics the effect of orexin will be the fundamental cure for human narcolepsy," said Dr. Masashi Yanagisawa, a professor of molecular genetics who led the study.

Yanagisawa and colleagues at the University of Texas Southwestern in Dallas tested mice they had genetically engineered to make no orexin.

Patients with narcolepsy have been found to have no or very little orexin in their cerebrospinal fluid -- which suggests they may be deficient in the chemical.

Writing in the Proceedings of the National Academy of Sciences (news - web sites), Yanagisawa's team said their genetically engineered mice did not wake up to feed as normal mice did, and they also experienced cataplexy -- a sudden weakness in the muscles that marks narcolepsy.

"We believe these mice represent the closest model of human narcolepsy," Yanagisawa said.

When injected with orexin, the mice woke up. And they did not fall harder asleep -- a condition called "rebound sleep" -- when the orexin effect wore off.

"This is extremely important because it shows that these mice retain the ability to respond to orexin," Yanagisawa said.

The drugs used to treat narcolepsy now affect only the symptoms and all can have serious side effects. Stimulants such as amphetamines can be used to help sleepiness, while antidepressants are used against the cataplexy.

A drug called Provigil, made by Cephalon and also made generically, is approved for treating narcolepsy in the United States.

Any new drug therapies for narcolepsy would be based on developing molecules, called orexin receptor agonists, that mimic the effect of orexin and that are small enough to cross the blood-brain barrier, Yanagisawa said.

Such drugs might also help insomnia, he said.

It may also be possible to develop gene therapy to treat narcolepsy, adding orexin genes or transplanting cells that produce orexin.

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Studies Warn of Dangers of Drinking in Pregnancy  

By Serena Gordon
HealthDay Reporter
HealthDayNews
Monday, March 15, 2004

MONDAY, March 15 (HealthDayNews) -- Is it safe to drink any amount of alcohol during pregnancy?

Probably not, because maternal alcohol consumption -- whether light or heavy -- can cause harm that's evident in infancy and can continue to cause problems even into the teen years, report two new studies from the March issue of Alcoholism: Clinical and Experimental Research.

One study confirms that even small to moderate amounts of alcohol during pregnancy can cause memory and learning problems years later. The other study found that babies who had heavy prenatal alcohol exposure take longer to calm down and are slower to respond to cues in their environment than babies of mothers who imbibe less or not at all.

"The bottom line is that women should not drink during pregnancy," says the lead author of the first study, Jennifer Willford, an assistant professor in psychiatry at the University of Pittsburgh School of Medicine. "We cannot say that there is a safe level of drinking during pregnancy."

Dr. Jay Goldsmith, a neonatologist at Ochsner Clinic Foundation Hospital in New Orleans, agrees. "Fetal alcohol effects are probably more widespread than we've previously thought. Women should not be drinking in pregnancy, and more importantly, shouldn't be drinking before they get pregnant, because it's four to six weeks before you even know you're pregnant." And, he says those weeks are very important developmentally.

Willford and her colleagues collected data from a long-term study of nearly 600 children whose mothers were evaluated during each trimester of their pregnancies, and then the children were followed at regular intervals from birth to age 16. The current study looked at the children when they were 14 years old, and the researchers tested the children's learning and memory abilities.

The researchers used a test called the Children's Memory Scale, which is designed to assess learning ability in both verbal and visual-spatial areas. The test also evaluates memory function.

Light to moderate alcohol exposure during the first trimester of pregnancy was associated with memory and learning problems at 14, says Willford. Light drinking was defined as less than three alcoholic drinks per week, while moderate drinking was three drinks per week, but less than one drink per day.

Willford says the learning problems were responsible for the memory problems.

"We've shown that drinking even moderate amounts during pregnancy can have permanent effects on learning and memory," she says. "We found effects at all levels of drinking." But, she adds, the more heavily a woman drank during pregnancy, the greater the learning and memory problems were in the children.

In the second study, researchers from the Emory University School of Medicine showed 118 6-month-old infants pictures of faces and played auditory tones for them while recording changes in their heart rate and their behavioral responses.

One hundred babies were classified as low-risk and 18 were considered high-risk. Mothers of high-risk infants averaged about four drinks per day before their pregnancies and nearly two drinks per day throughout their pregnancies, compared to 1.3 drinks per day before pregnancy and less than one drink per day during pregnancy for the low-risk group. Mothers in the high-risk group were almost twice as likely to drink alone, and 35 percent had gotten into trouble because of their drinking, compared to less than 2 percent of the mothers in the low-risk group.

They found that high-risk infants took longer to respond and then had a harder time calming back down.

"If you are drinking heavily during pregnancy, how your baby responds to the environment will be slower and they'll have a harder time calming themselves down," says study author Julie Kable, an assistant professor of pediatrics at Emory.

She says from this and other research, she and her co-author, Clair Coles, theorize that prenatal alcohol exposure may disrupt the development of myelin, which then later interferes with the brain's ability to send electrical messages between nerve cells.

More information

To learn more about alcohol and its effects on pregnancy, visit the March of Dimes or the National Institute on Alcohol Abuse and Alcoholism.

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Pumping Iron Improves Insulin Effects in Diabetics  

Reuters Health
Monday, March 15, 2004

NEW YORK (Reuters Health) - Strength training improves the effects of insulin in the muscles of patients with type 2 diabetes, according to a report from Denmark.

"Physical inactivity is becoming close to the number-one leading cause of death in the US," Dr. Flemming Dela from the University of Copenhagen told Reuters Health. "Our study is one which shows how to fight this trend."

Earlier research demonstrated the value of aerobic endurance training in increasing insulin action, the authors explain in the medical journal Diabetes, but most patients with type 2 diabetes are overweight and unlikely to take up endurance training.

Dela and colleagues, therefore, investigated the impact of strength training three times weekly for 6 weeks on insulin action in 10 type 2 diabetics and 7 healthy subjects.

In addition to increasing muscle mass, strength training seemed to enhance the effects of insulin, the researchers report.

"Strength training is a realistic and effective alternative to endurance training and probably much more attractive to the 'average' type 2 diabetic patient," Dela concluded.

"We have followed up on this study by exploring the molecular mechanisms in the muscle that lies behind the effect," Dela added. These results should be published in the near future.

Source: Diabetes, February 2004.

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Study to Test Best Diabetes Therapy for Kids  

MONDAY, March 15 (HealthDayNews) -- A study to identify the best treatment for type 2 diabetes in children is under way at 12 medical centers and affiliated sites in the United States.

The five-year TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth), which will compare three treatments, is sponsored by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health (news - web sites) (NIH).

"Type 2 diabetes has increasingly become a problem in our young people. This trial will give us the information we need to most effectively help these patients," NIH director Elias A. Zerhouni says in a prepared statement.

Researchers plan to enroll 750 children aged 10 to 17 years old who have been diagnosed with type 2 diabetes in the past two years. The children and teens will be randomly assigned to receive one of three treatments: metformin (brand name Glucophage) alone; metformin and rosiglitazone (brand name Avandia) in a fixed-dose combination; and metformin plus intensive lifestyle change aimed at increasing physical activity and weight loss.

About 18.2 million people -- 6.3 percent of the U.S. population -- have diabetes, which is the main cause of kidney failure, limb amputations and new onset blindness in adults. It's also a major cause of stroke and heart disease.

Type 2 diabetes, which is most common in adults over age 40, accounts for the vast majority of all diabetes cases. The prevalence of type 2 diabetes has greatly increased over the past three decades, due mostly to rising rates of obesity.

More information

The NIH has more about the TODAY study.

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Poor Sugar Control in Diabetics Affects Lungs  

Reuters Health
Monday, March 15, 2004

NEW YORK (Reuters Health) - The findings from a new study provide yet another reason for diabetics to keep close control of their blood sugar--impaired lung function. In fact, the higher the sugar level, the worse the lungs seem to function.

Dr. Timothy M. E. Davis, of the University of Western Australia, in Fremantle, and colleagues examined the link between sugar levels and lung function in 495 type 2 diabetic patients with no history of lung disease.

At the start of the trial, the participants underwent lung testing between 1993 and 1994. A subset of 125 patients were re-examined about 7 years later.

The researchers report that from the start all of the patients showed lung function that was slightly lower than expected in the general population. Moreover, this function continued to deteriorate a little bit each year in the follow-up group.

Poor sugar control was a strong predictor of worsening lung function, the researchers note in the medical journal Diabetes Care. In turn, impaired lung function was tied to an increased risk of death.

The team concludes that the data "support the suggestion that the lung is a target organ in diabetes," and that intensive sugar control may reduce mortality "through improved ventilatory function independent of other beneficial effects."

Source: Diabetes Care, March 2004.

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Not All Nicotine-Replacement Products Are Equal  

By E.J. Mundell
HealthDay Reporter 
HealthDayNews
Monday, March 15, 2004

MONDAY, March 15 (HealthDayNews) -- Which nicotine-replacement product will work for you may depend on what kind of smoker you are.

According to a new study, blacks, the obese and those highly dependent on nicotine may have better luck quitting smoking if they use nicotine-laden nasal sprays, while whites, the non-obese and low-dependent types appear to have a better chance with the nicotine patch.

If the findings are borne out in larger trials, the day might come when "doctors might be able to choose the type of nicotine-replacement therapy based on some measures from the smoker, to pick the therapy that's going to be most effective," says study author Caryn Lerman, a professor of psychiatry at the University of Pennsylvania's Abramson Cancer Center.

Her team's study appears in the March 15 issue of Annals of Internal Medicine.

Despite decades of warnings about the dangers of smoking, a quarter of all American adults still light up. One bright spot in the war against smoking has been the emergence of nicotine-replacement agents such as nicotine patches, chewing gum and nasal sprays.

While quit rates for smokers on nicotine-replacement therapy remains low -- only about 10 percent to 15 percent of users remain nonsmokers for more than six months -- they do seem to help, "doubling the quit rate of people that go cold turkey," says Dr. Michael Thun, a spokesman for the American Cancer Society (news - web sites).

But are some nicotine-replacement products better than others? In their study, Lerman and her team assigned nearly 300 smokers with an expressed interest in quitting to either the Nicoderm patch or Nicotrol nasal spray. With the patch, a steady flow of nicotine is absorbed into the body via the skin, while the spray eases cravings with a quick spritz of nicotine-loaded mist.

According to the researchers, smoking abstinence rates at six months were similar for both groups -- about 12 percent for those using the spray and 15 percent for patch users. Those numbers are in keeping with previous studies into the effectiveness of nicotine-replacement agents.

More intriguing were results regarding which products worked best for specific types of individuals. Whites, the non-obese and low-dependency smokers had better luck quitting over the long term if they used the patch rather than the nasal spray, the researchers found.

On the other hand, blacks, smokers who were obese (a body mass index of 30 or higher) and smokers who were highly dependent on nicotine fared much better if placed on the spray.

Lerman says there are theories -- as yet untested -- explaining why the spray may work better for these types of smokers. Obese smokers "may have more of a need for reinforcement from things like food -- but also nicotine," she explains.

"The patch provides steady levels of nicotine and it's sort of 'passive' nicotine replacement, there's nothing the smoker is doing," Lerman says. "But with the spray, when a smoker feels the need for that rush of nicotine they can use the nasal spray. The nicotine goes to the brain more rapidly and provides more positive reinforcement."

This theory may also explain why the spray works better for highly nicotine-dependent individuals, as well, she says.

The smoking habits of blacks may explain why they have higher quit rates on the spray compared with those seen in white smokers. According to Lerman, menthol cigarettes are more popular among black smokers than whites, and smokers looking to replace the added sensory 'kick' of menthol may get greater satisfaction from a nasal spray than from the passive patch.

Also, "there are studies showing that [blacks] smoke their cigarettes more efficiently, they may inhale more deeply, take more puffs, and extract more nicotine," Lerman says. "So again, in that same vein, a replacement method that produces that rush of nicotine may be more pleasurable."

Thun, head of epidemiological research at the American Cancer Society, says he welcomes any fresh insights into helping smokers quit.

"Quitting smoking is hard. It's comparable in difficulty to quitting heroin, cocaine and other illegal street drugs," he says. "Any approach that makes it easier for smokers to succeed in quitting is a major advance."

Friends and family can be key in keeping smokers away from cigarettes over the long-term, and Thun suggests getting kids in on the act, as well.

"When my sister quit -- which was extremely hard -- she was very attached to my kids," he notes. "They made a calendar, and they gave her stickers. She could put stars on the calendar if she didn't smoke that day. They gave her other suggestions, too. It really brings out the best in you -- one does not want to let kids down."

Thun worries, though, that a recent slump in sales of nicotine-replacement products might be linked to recent moves by the tobacco industry. "There's a big concern that a substantial subgroup of smokers may be placing their hopes -- falsely -- in novel nicotine-delivery devices that the tobacco industry has developed," he says.

These products include so-called "light" cigarettes, smokeless tobacco and other products. "They all contained the same amount of nicotine, so they were in no way effective steps towards quitting," Thun says. "Quitting is hard, it takes a lot of guts. But these alternatives are false promises."

Both Thun and Lerman believe the ultimate goal -- quitting smoking for good -- is within each smoker's reach.

"What we need to do is design better treatments and also to be able to tailor-treat individual smokers," Lerman says. She cautions, however, that the results of this small study need to be validated in larger trials. However, "if there is a smoker who's highly nicotine-dependent and who is obese, and maybe they've tried the nicotine patch before, it may be worthwhile to ask their physician to prescribe the nicotine nasal spray and try that as an alternative," Lerman says.

The nicotine patch is available in the United States either by prescription or over-the-counter. The nicotine nasal spray is currently available only by prescription.

Lerman's study was funded by grants from the National Cancer Institute (news - web sites) and the National Institute on Drug Abuse.

More information

For help in quitting smoking, visit the American Cancer Society or the National Cancer Institute.

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Bowel Disease Raises Risk of Blood Clots  

Reuters Health
Monday, March 15, 2004

NEW YORK (Reuters Health) - The findings from a new study indicate that inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a specific risk factor for blood clots.

Although IBD has been linked to clots in previous studies, it was unclear if the association was confined to IBD or if it was also seen with other inflammatory or bowel diseases, senior author Dr. Gottfried Novacek, from the University of Vienna in Austria, and colleagues note.

To investigate, the researchers administered a questionnaire on blood clots to 618 patients with IBD, 243 with rheumatoid arthritis, 207 with celiac disease, and 707 similar healthy subjects. Any reported cases of clotting had to be confirmed with tests. The findings are reported in the medical journal Gut.

The authors used rheumatoid arthritis and celiac disease as comparison diseases, because, like IBD, the former involves inflammation and the latter involves the bowels.

The prevalence of clots in the IBD group was 6.2 percent, significantly higher than the 1.6-percent rate seen in the healthy group. In contrast, the clots rates in the other disease groups did not differ significantly from those of healthy subjects, the authors found.

In 60 percent of clot cases in the IBD group, an IBD specific factor, such as active disease or bowel narrowing, was present at the time the clotting event occurred, the researchers point out.

The findings suggest that there is a relationship between IBD and blood clots, but other inflammatory or bowel diseases do not seem to raise the risk of clots, the investigators state.

"It is noteworthy that many (clotting) events occurred during active disease or in the presence of complications such as stricture, fistulization, or abscess," Novacek's team notes.

Source: Gut, April 2004.

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Butting Out  

HealthDayNews
Monday, March 15, 2004

(HealthDayNews) -- Ex-smokers will tell you that quitting was one of the hardest things they've ever done. The physical and psychological withdrawal can be intense.

If you're thinking of "butting out," the U.S. Surgeon General offers these tips to help you handle the cravings:

  • Drink lots of liquids, especially water.
  • Avoid sugar and fatty foods, and don't skip meals.
  • Exercise regularly and moderately.
  • Get more sleep.
  • Take deep breaths when cravings hit.
  • Change your habits. For example, eat breakfast in a different place, or take a different route to work.
  • Do something to reduce your stress. Take a hot bath, read a book, or exercise.

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Acupuncture Helps Chronic Headache Sufferers-Study  

By Patricia Reaney
Reuters
Monday, March 15, 2004

LONDON (Reuters) - Acupuncture is a useful, cost-effective treatment for patients who suffer from chronic headaches or migraine, American researchers said on Monday.

In one of the largest randomized studies to assess the effectiveness of the ancient Chinese treatment, scientists found it worked better than just conventional treatments alone.

"People using acupuncture had fewer headaches, less severe headaches and they used less health resources over the course of the following year," Dr Andrew Vickers, of Memorial Sloan-Kettering Cancer Center in New York, said in an interview.

The scientists compared acupuncture plus standard treatment to normal therapy alone in 401 patients in England and Wales who suffered from headaches several days each week. Their research is published online by the British Medical Journal.

Patients who had been assigned acupuncture plus standard treatment received up to 12 treatments over three months.

Initially there was not much difference between the two groups but at the end of the year-long trial the scientist noticed a big change.

Patients receiving acupuncture had 22 fewer days of headaches per year, used 15 percent less medication, made 25 percent fewer visits to their family doctors and took fewer days off sick than the other group.

There were not many side effects and Vickers and his colleagues also found that the treatment was cost effective.

"For severely affected patients, acupuncture reduced the severity and the frequency of their headaches to make a real difference in their lives," Vickers said.

Acupuncture was first used in China about 2,000 years ago, according to Vickers. It involves inserting very fine needles into the skin at specific points in the body. It is one of the most popular forms of complementary medicine and has been shown to relieve nausea and pain.

German researchers have also said it could help women undergoing fertility treatment to conceive.

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Sunday, March 14, 2004

Protecting Your Kidneys  

By Adam Marcus
HealthDay Reporter 
HealthDayNews
Sunday, March 14, 2004

SUNDAY, March 14 (HealthDayNews) -- You probably take your garbage disposal for granted and curse it when it fails.

Don't make the same mistake with your kidneys.

These fist-sized organs, which sit near the middle of the back, just below the rib cage, are charged with removing waste and excess water from the blood, and they do so by forming urine.

Kidneys are durable, but a variety of complications can keep them from doing their job. These include infections, stones, cancer and polycystic kidney disease, a genetic disorder in which multiple cysts grow in the organs. If these problems persist, the kidneys can fail, leaving patients unable to clean their blood.

But the leading causes of kidney failure in the United States are preventable -- high blood pressure and diabetes, says Dr. Brian Pereira, a professor of medicine at Tufts University School of Medicine in Boston and president of the National Kidney Foundation.

That's a message worth sharing in March, which has been designated National Kidney Month.

"There are probably about 20 million people with chronic kidney disease in the United States," says Pereira.

Diabetes accounts for 35 percent of all kidney failure in this country, while poorly controlled or uncontrolled high blood pressure is behind 23 percent of all U.S. cases, according to the kidney group.

High blood pressure hardens the vessels in the kidneys' filtering units, or glomeruli. Ultimately, unless the pressure is relieved, the kidney cells die off.

Diabetes damages the kidneys by allowing harmful amounts of blood sugar -- called glucose -- to reach the glomeruli.

Kidney disease is typically silent in its initial stages, Pereira says. "By the time you get symptomatic, it's pretty late," he says.

Many people can have chronic kidney disease for years without feeling ill. Only when the organs have all but failed do symptoms appear, among them upset stomach, perpetual fatigue, yellowed skin and swelling in the hands and feet.

That's why early detection of kidney disease is key, Pereira says. People can take steps to prevent the progression of kidney disease to kidney failure, but once failure occurs it can't be reversed.

About 80,000 people are diagnosed with kidney failure each year in the United States, according to the National Institutes of Health (news - web sites).

"Our mantra is that if you have a family history of diabetes, hypertension or kidney disease, or if you have diabetes or hypertension, you need to get your blood pressure checked and have your urine checked for protein and your blood checked for creatinine," Pereira says. Protein in the urine and elevated creatinine in the blood are signs of kidney damage.

Once the kidneys fail, patients must have their blood cleaned mechanically, through a process called dialysis. At any given time, some 325,000 Americans are on kidney dialysis, Pereira says. Dialysis comes in two forms: hemodialysis, in which patients go three times a week to a clinic for several hours, and peritoneal dialysis, which can be done at home overnight.

Dialysis patients have two options: undergo a kidney transplant or spend the rest of a potentially abbreviated life being dialyzed. Last year, surgeons performed 23,373 kidney transplants in the United States, according to the United Network for Organ Sharing. Currently, about 60,000 people are signed up to receive a donor kidney.

Although kidney transplants are lifesaving, they're far from fail safe. New drugs to suppress the immune system have driven down rejection rates for kidney grafts -- 10 percent vs. 30 percent a decade ago -- but transplant failure remains a significant hurdle for patients. Organ failure is now the fourth-leading cause of end-stage kidney disease in this country, health officials say.

Just as people with healthy kidneys can take steps to keep them that way, those on dialysis can do things to prevent worsening of their organ damage.

"If you're on dialysis, diet is one of the most important things for you. It can help control the buildup of toxins that could" exacerbate kidney damage, says Elaine Drees, a nurse and nutritionist at Gambro Healthcare in Tucson, Ariz., which treats dialysis patients.

Two key nutrients for kidney patients to watch are potassium and phosphorous. A spike in potassium can be lethal to the heart, while poorly controlled phosphorous can lead to bone disease and hardening of the blood vessels, Drees says.

To control potassium, Drees advises avoiding foods rich in the nutrient, such as bananas, potatoes and tomatoes, in favor of lower-potassium fruits and vegetables like apples, grapes, pineapples and plums. Phosphorous can be kept in check with medication.

Kidney dialysis patients also need to load up on protein, says Drees, who chairs the patient and public education committee of the National Kidney Foundation's council on renal nutrition. They typically require 20 percent more high quality animal protein -- six to eight ounces a day -- than people not on dialysis.

Periera says scientists are working on drugs that can do the job -- at least partially -- of dialysis machines. But these are "nowhere near" being ready for patients. In the meantime, dialysis will continue to be an obtrusive, if lifesaving, technology.

"I like to think of it [dialysis] as, yes it's an intrusion, but it frees patients up for the rest of their life," Drees says. "They can work, be with their family."

More information

Visit the National Kidney Foundation and the National Library of Medicine for more on kidney health.

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Saturday, March 13, 2004  

Doctors See Vascular System as Road to Treatment  

By Debra Sherman and Julie Steenhuysen 
Reuters
Saturday, March 13, 2004

CHICAGO (Reuters) - When Dr. Jeffrey Snell looks at a patient, he sees the complex network of veins and arteries as the route to clearing clogged heart arteries, preventing strokes and keeping bulging vessels from rupturing -- all without major surgery.

Doctors long have used the winding maze of blood vessels in the vascular system to identify and treat blockages in the arteries that feed blood to the heart.

Now an arsenal of newly miniaturized devices and sophisticated digital imaging equipment allow doctors to treat other complicated conditions with minimally invasive procedures where only local anesthesia is needed.

The fast-growing discipline, known as endovascular therapy, could replace up to 70 percent of conventional surgeries by the end of the decade, by some estimates.

Forty years ago, University of Oregon radiologist Charles Dotter devised catheters that could be guided through blood vessels to clear blocked arteries. The technique, called angioplasty, was slow to catch on, but is now performed more than a half-million times a year in the United States.

"Today, the technique is used to open blockages all over the body, treat aneurysms and other things," said Dr. Barry Katzen, director of the Baptist Cardiac & Vascular Institute in Miami. "Charles Dotter predicted this would happen."

Katzen said doctors and patients tend to prefer less-invasive treatments, which reduce the risk of heart attacks, blood loss and time spent in the hospital. He predicts the market for endovascular therapy will increase by 50 percent to 9.5 million procedures in the next five years.

That will prove a boon to a number of companies that make the catheters, balloons, and tiny wire mesh tubes, known as stents, that prop open vessels.

Dr. Alexander Arrow, a medical technology analyst with Lazard Freres & Co., estimated the market for noncoronary stents at $610 million and growing at an 11 percent clip. Coronary stents, a $3 billion market, could potentially expand to $5.4 billion by 2007.

Guidant Corp., Boston Scientific Corp., Medtronic Inc., Abbott Laboratories, Johnson & Johnson, Edwards Lifesciences and privately held Cook Group Inc. all are working to expand the use of their stents to different applications within the body.

At Rush University Medical Center in Chicago, doctors are testing devices to treat dangerous bulges of blood vessels in the brain and the aorta, known as aneurysms.

They are also formulating in-vessel treatments for artery blockages that endanger the kidneys or can lead to life-threatening blood clots in the legs.

Snell, an interventional cardiologist at Rush, is participating in a early test of whether genes implanted with a catheter can stimulate diseased heart tissue to grow new blood vessels -- as a potential alternative to heart transplants.

Turf  Battles

The new procedures have put vascular surgeons on alert as specialists in the less-invasive techniques are usurping their most lucrative procedures.

"The smart vascular surgeons are trying to figure out how to do this," said Snell, whose work focuses increasingly on vascular treatments that don't involve the heart.

Bruce Perler, chief of vascular surgery at Johns Hopkins Hospital in Baltimore, said the minimally invasive procedures are an enormous growth area.

"There are turf battles breaking out all over the country," he said.

In one set of clinical trials at Rush and other medical centers, researchers are looking whether stents are as effective as surgery in clearing the carotid artery in the neck. If the artery becomes clogged with fatty deposits, or plaques, there is a high risk of stroke.

In conventional surgery, doctors scrape away plaques through a cut in the neck that requires several days of hospital recovery. But with a catheter, the artery is cleared in a one- or two-hour procedure usually followed by a one-night hospital stay.

Robert Eisen recently had his clogged carotid artery repaired through a two-hour stenting procedure using a catheter threaded through his groin at Chicago's Rush.

Eisen, 78, said the choice between major surgery and stenting was easy. He had lingering numbness on his left side from a mountain biking accident and was keen to avoid neck surgery that might worsen his condition.

"I also wanted to avoid general anesthesia," said Eisen, who had had trouble awaking from a previous surgery.

"Patients would always prefer a less painful, simpler and quick procedure as long as the outcomes are similar," said Gregg Stone, director of cardiovascular research at Lenox Hill Heart and Vascular Institute in New York. "I think that is the whole impetus of developing anything minimally invasive."

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The Truth About Aging  

HealthDayNews
Saturday, March 13, 2004

SATURDAY, March 13 (HealthDayNews) -- There's a new, free booklet that can help you separate fact from fiction when it comes to aging.

The booklet, What's Your Aging IQ?, is from the U.S. National Institute on Aging. It offers short stories about fictional older people coping with issues such as weight training and bone density, smoking cessation, vision problems, sexuality, and hypothermia.

These stories are followed by true/false, yes/no, and multiple choice questions about growing older. You record your answers on a pull-out sheet and compare them to the correct answers, which are accompanied by explanations.

The booklet helps dispel cultural myths that portray older people as frail, depressed, and forgetful. In fact, many age-related health declines are the result of lifestyle factors, including poor diet and lack of regular exercise.

More information

Here's where you can preview or order What's Your Aging IQ?.

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