The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
May 27, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 27 to April 2

 

Friday, April 2, 2004

 

  1. Antidepressant Use Way Up in U.S. Kids, Report Says
  2. Teens and Dieting a Losing Proposition
  3. U.S. Investigates Hormone Implants in Veal Calves
  4. Virtual Colonoscopy: New Weapon in War Against Cancer
  5. FTC Supports Teva in Generic Zoloft Case
  6. Metabolism Management
  7. Depression Common After Stroke
  8. Children and Emergencies
  9. Freeze-Drying Can't Remove Virus from Tissue Transplants
  10. Drinking Increases Risk of Sexual Harassment
  11. Appendix Removal Does Prevent Bowel Disease
  12. Men Need to Track Their Blood Pressure
  13. Acetaminophen Use Linked to Asthma in Women
  14. Black Men Less Likely to Be Treated for Prostate Cancer
  15. Stress May Weaken Flu Shot Protection
  16. Which Older Women With Diabetes Should Take Vitamins?
  17. 'Wristwatch' Monitors May Miss Low Blood Sugar
  18. San Antonio Tops List of Drunken Cities
  19. Medical Schools Establishes Obesity Course
  20. New Antibiotic Fights Respiratory Infections
  21. Report: U.S. Has Wide Powers on Suspect Supplements
  22. Death Shows Danger of Silicone Injections
  23. About 900,000 U.S. Children Neglected, Abused
  24. Autism Theory on Brains Sparks Debate
  25. U.S. Says Work-Related Pickup Truck Deaths Higher
  26. Women More Sensitive to Pain Than Men
  27. Aspirin Improves Blood Flow to Heart
  28. Even Mild Psoriasis a Problem for Sufferers
  29. Huntington's May Be Simpler to Fight Than Thought
  30. Most People With Schizophrenia Don't Take Meds as Directed
  31. Fat Hormone Can Rewire Brain, U.S. Studies Show
  32. New Burn Treatment Shows Dramatic Results
  33. Preemies' Breathing Problems Tied to Moms' Smoking
  34. Nerve Damage Can Be Extensive
  35. Test Predicts Development of Rheumatoid Arthritis
  36. Science Closing in on Rare Viral Leukemia
  37. Blood Pressure Drugs Differ for Blacks, Whites
  38. Caffeine Ups Blood Pressure in Hard-Core Users Too
  39. Gum Inflammation Increases During Ovulation
  40. Wrestling Revs Up Immune System in Teens, Study Finds
  41. Mild Iron Deficiency May Drain Endurance, Study Finds
  42. Gene Works with Pesticides to Up Parkinson's Risk
  43. Military Service in Iraq Tied to Parasite Disease
  44. Nine Million U.S. Children Have Had Asthma
  45. Botanicals Might Ease Menopause Symptoms
  46. Study Questions Value of Inflammation Test
  47. Extra Pounds Increase Chances of Kidney Stones
  48. Child Vaccinations Do Not Cause Diabetes, Study Says
  49. West Nile Virus Could Hit California Hard
  50. Study: SARS Vaccine Shows Promise in Mice
  51. Spotting Scoliosis
  52. Protein Is Poor Predictor of a Heart Attack –Study
  53. When to Banish Birthmarks
  54. Personal Chefs Meet Healthy-Eating Need
  55. U.S. Regulators OK Walnut Health Claims
  56. Many Not Having Mammograms Under Medicare
  57. Acetaminophen May Raise Asthma Risk
  58. American Kids, Parents Lack Sleep, Survey Finds
  59. Strides Taken Toward Diabetes Prevention
  60. Sun May Increase Chance of Certain STD
  61. Smoking Significantly Alters Genes in Mice
  62. U.S. Faults American Red Cross Over Tissue Safety
  63. Groups ask Cananda to Ban Web Pharmacies
  64. Experts: Diet Advice Must Be Easy to Follow
  65. Diet Trends May Broaden Demographics
  66. Microwaves Can Kill Off Some Breast Cancers
  67. Wyoming Launches Meth Education Campaign
  68. Asthma Death Rates Continue to Fall in US
  69. Alcohol Enhances Nicotine's Effects
  70. Value of Pre-Workout Stretch Unclear, CDC Says
  71. Treating Paralyzed Vocal Chords
  72. Antibiotic Resistance Can Occur Without Heavy Use
  73. Heat Treatment for Breast Tumors Looks Promising
  74. Tumor Marker Predicts Good Ovarian Cancer Outcome
  75. Trout Turn Into Bullies Under Stress
  76. Painkiller Boosts Certain Pancreas Cancers in Mice
  77. Teen Smokers Fall Down on Other Health Habits
  78. People Don't Eat the Right Fruits, Veggies: Experts
  79. Single Drop of Blood Measures Stress Levels
  80. Some People Can Blame Taste Buds for Weight Gain
  81. Drug Derived From Licorice Improves Memory
  82. Dip Into Honey Pot for Good Health
  83. Women Urged to Take Heart Disease Seriously
  84. Study: Housework, Walking Lowers Cancer, Death Risk
  85. Bad Breath
  86. Older Adults' Chronic Pain May Dull Appetite
  87. Stroke Signs
  88. Breath Test Links Muscle and Bowel Conditions
  89. Slaying 'Superbugs'
  90. Prostate Cancer Therapy Not Tied to Colon Cancer
  91. Pinpointing Infections
  92. Test Predicts When Preterm Delivery Is Unlikely
  93. Studies Find Little Link Between Acrylamide and Cancers
  94. Most Asthmatic Kids Not Prepared for Sports
  95. Too much Sleep Not a Good Thing
  96. Allergy Season Can Mean Asthma Trouble
  97. More Evidence Found of How Vitamins Prevent Cancer
  98. Study: Stretching Doesn't Prevent Injuries
  99. 1st DeBakey Heart Pump Is Used for Child

 

 

Friday, April 2, 2004

 

Antidepressant Use Way Up in U.S. Kids, Report Says

 

By Maggie Fox, Health and Science Correspondent

Reuters

Friday, April 2, 2004

WASHINGTON (Reuters) - Pre-school children are the fastest-growing group of patients in the United States getting antidepressant medication, with use nearly doubling between 1998 and 2002, according to a report issued on Friday.

The Food and Drug Administration (news - web sites) warned against the use of certain antidepressants in children last month because they may make children more likely to commit suicide. The FDA said doctors should carefully monitor children and teens taking them.

Express Scripts, which keeps statistics on drug use, said the number of prescriptions written for antidepressants is growing by about 10 percent a year in children and adolescents.

The study looked at a random sample of 2 million children covered by commercial insurance between 1998 and 2002. Among children under age 5, the number of girls being prescribed an antidepressant doubled and the number of boys went up by 64 percent, the group reported.

Writing in the April issue of Psychiatric Services, Express Scripts said antidepressant use for all children under 18 increased from 1.6 percent in 1998 to 2.4 percent in 2002.

"A number of factors acting together or independently may have led to escalated use of antidepressants among children and adolescents," Tom Delate, director of research at Express Scripts, said in a statement.

"These factors include increasing rates of depression in successive age groups, a growing awareness of and screening for depression by pediatricians and assumptions that the effectiveness experienced by adults using antidepressant medications will translate to children and adolescents."

The most commonly prescribed antidepressants were the group of drugs that includes fluoxetine, sold under Eli Lilly and Co.'s brand name Prozac, and paroxetine. British health authorities have advised doctors not to prescribe most drugs in this group to anyone under 18.

Questions about a possible link with suicidal behavior arose last year when regulators were reviewing clinical trials of children who took GlaxoSmithKline Plc.'s Paxil or the generic version, paroxetine.

The other antidepressants the FDA is evaluating include Forest Laboratories Inc.'s Celexa, Solvay's Luvox, Akzo Nobel's Remeron, Bristol-Myers Squibb's Serzone, Pfizer's Zoloft and Wyeth's Effexor.

Only Prozac is approved for treating pediatric depression.

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Teens and Dieting a Losing Proposition

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 2 (HealthDayNews) -- Dieting, like dating and driving, is a time-honored ritual for many American teens.

But it's often not a productive -- or even healthy -- one.

New research suggests teens who diet frequently tend to gain more weight each year than children who don't diet. One likely explanation: Many teens resort to diets that greatly limit what and how much they can eat. Then they abandon those food plans with a vengeance, overeating and regaining all the lost weight -- and often more.

"Most people who diet tend to regain the weight. In children, we're really seeing that this is happening at a young age," says Alison Field, an assistant professor of pediatrics at Harvard Medical School (news - web sites) and co-author of a recent study on teens and dieting.

The findings come amid growing concern about childhood obesity and the attendant health threats, which include the potential for heart disease, diabetes and cancer as the children grow into adulthood. The prevalence of overweight has increased by 100 percent among U.S. teens in the last two decades. And almost 14 million children -- 24 percent of the population aged 2 to 17 -- are obese, with an additional 8.6 million children at risk for obesity, according to federal statistics.

But the answer to the weight epidemic isn't restrictive or fad diets. What's needed are lifestyle changes. Programs that teach teens and preteens how to eat nutritiously, get enough exercise and cut down on TV and computer time are much better avenues to lifelong weight control, experts say.

The "boomerang effect" of dieting and then regaining the weight is well-known to many adults who've tried to shed pounds. But it's also a very real problem for teens, according to the Harvard study that was published last fall in Pediatrics . The researchers studied the eating habits of nearly 15,000 girls and boys who were between 9 and 14 at the start of the study in 1996. Twenty-five percent of the girls and 13.8 percent of the boys said they dieted often when the study began.

As the researchers tracked the children for three years, they found the kids who dieted actually gained more weight on average than those who didn't. The dieters picked up about two pounds per year, compared to the non-dieters.

Frequent dieting may alter the metabolism so it doesn't work as quickly. Or it may lead teens on restrictive diets to abandon them and start eating too much, experts say.

Whatever the explanation, nutritionists concur that restrictive diets aren't the answer.

"Get away from the mentality of a diet," Bettye Nowlin, a registered dietitian from Calabasas, Calif., and a spokeswoman for the American Dietetic Association, tells teens trying to slim down. "Try to put the focus on healthy eating and lifestyle changes."

"If they are exercising and eating proper diets, they should lose weight," she adds.

When Nowlin counsels teens, she tells them to watch portion sizes. And rather than eliminate favorite high-fat foods, she urges teens to classify them as "sometime" food. French fries, for instance, might be a once-a-week "sometime" food. "And when you have them, get the small size," she suggests.

Marilyn Tanner, a registered dietitian who runs a program for overweight teens at St. Louis Children's Hospital, urges a similar approach. She doesn't mention "dieting" when working with kids.

"By the time they come to us they have already dieted and continued to gain weight," says Tanner, a pediatric dietitian at the Washington University School of Medicine in St. Louis and a spokeswoman for the American Dietetic Association.

"Our program is a lifestyle program," she says. "We concentrate on goals they can strive for, such as less inactivity."

"The kids wear pedometers," she adds. "We find out what their baseline steps are [each day] and add 100 steps or more."  

"We don't promise they will lose weight, but tell them what to do to eat healthier," Tanner says. "We weigh them in, but it is their option to see what the number is. Our goal is to stop the gain. Our kids are slightly overweight, such as 10 pounds, to obese."

During the 10-week program, the kids learn the basics of nutrition, such as proper portion sizes, which can go a long way toward weight control. "A serving of rice is one-third of a cup," Tanners says. "Some kids get those big white containers [from Chinese carryout restaurants] for fried rice."

They also learn about calories and a goal to shoot for daily, such as 2,000, depending on their height, weight and activity levels. "Some kids drink the equivalent of 1,000 calories a day in soda," she says.

"We encourage five [servings] a day of fruits and vegetables. We tell them to watch their fat intake," Tanner adds.

Once they follow the program for a while, she says, many "grow into their weights." But not all of them do. If that's the case, they can work on weight loss once the healthy habits are ingrained.

The "healthy habits first" approach will eventually pay off, Tanner says, and hopefully help teens control their weight for a lifetime.

More information

Learn more about nutrition and dieting for children, visit the American Dietetic Association or KidsHealth.

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U.S. Investigates Hormone Implants in Veal Calves

Reuters

Friday, April 2, 2004

WASHINGTON (Reuters) - The U.S. government is investigating the illegal use of implanted growth hormones in young calves intended to be slaughtered for veal, the Food and Drug Administration (news - web sites) said on Friday.

Inspectors from the FDA and the Agriculture Department discovered the hormone use in three different groups of animals at two Wisconsin slaughterhouses.

Officials said they do not yet know how widespread the practice is, but consumers should not be concerned if they have recently eaten veal.

"Both the FDA and USDA are investigating the extent to which this practice is occurring.... At this point in time we don't know for sure," said Stephen Sundlof, head of veterinary medicine for the FDA.

"It would be very doubtful that we would see adverse effects in people," he added.

The hormones, which increase muscle mass, can be used in adult cattle but are illegal for use in younger ones, Sundlof said. While there is no clear evidence, calves have a different metabolism that could leave traces of the hormones in the tissue, he said.

As part of the investigation, the FDA issued an industry guidance calling on veal producers who have used the implants to follow the same procedures as they would with adult cattle. If they do, the calves can then be slaughtered 63 days after implantation, the FDA said.

The guideline applies only to calves killed before June 6 and "is based on the premise that there will be no additional use of the implants in veal calves," the agency said in a statement.

If the industry does not voluntarily follow those steps, the agency can issue warning letters or take legal action, Sundlof said.

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Virtual Colonoscopy: New Weapon in War Against Cancer

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Friday, April 2, 2004

 

FRIDAY, April 2 (HealthDayNews) -- Colorectal cancer is one of the most preventable of all cancers.

Yet it's also one of the most "under-screened" malignancies.

Virtually all malignant colorectal tumors develop from polyps, which are easily identified and removed if a person just gets the proper screening. Unfortunately, "if" appears to be the operative word here.

"One of the major reasons why we still have 140,000 cases a year and 55,000 deaths, making it the number one solid-tumor killer after tobacco-related malignancies, is that our screening rates are very low," says Dr. Thomas Weber, an associate professor of surgery at Albert Einstein College of Medicine and Montefiore Medical Center in New York City.

"With these low rates, we have a major problem," Weber adds. "We need some alternatives to try and boost those rates."

One promising new alternative is the "virtual colonoscopy," which made headlines after Today show co-host Katie Couric underwent the procedure several years ago on television.

And University of Wisconsin researchers reported in a recent issue of the New England Journal of Medicine (news - web sites) that virtual colonoscopy compares favorably to the current "gold standard" of conventional colonoscopy.

For now, conventional colonoscopy remains the standard screening tool. It involves inserting a long, flexible, lighted tube called a colonoscope into the rectum, then guiding it up through the intestine. The tube snaps pictures of your bowels and then relays them out to the doctor performing the procedure.

A virtual colonoscopy, also called a CT colonography, is an imaging procedure that involves taking an X-ray of the rectum and colon from the outside. There's no tube involved. "It uses computer-based software to enhance and make two- and sometime three-dimensional images of a patient's colon," Weber says.

There are decided advantages to a virtual colonoscopy. "It's quicker, only a couple of minutes, and there's no sedation needed," says Dr. David Beck, chairman of the department of colon and rectal surgery at the Ochsner Clinic Foundation in New Orleans. And because there's no sedation, the patient can drive him or herself home.

Also, a conventional colonoscopy carries some risks, chiefly perforation of the intestine, although this is relatively rare. "One or two people per every 1,000 may have an untoward event in terms of the colonoscopy," Weber says. "The death rates are very low, less than two per 10,000."

On the other hand, one of the major drawbacks that patients complain about with a traditional colonoscopy -- having to drink copious amounts of liquids to empty out the intestine -- is still an issue with a virtual colonoscopy.

"Right now, you have to take the same kind of prep and you also have to put some air in the colon to make it easier to take pictures so there's some distension," Beck points out. The preparation can also dehydrate a person, adding to potential risk.

A conventional colonoscopy offers several important advantages over a virtual colonoscopy. It is, in a manner of speaking, a form of "one-stop-shopping." If something suspicious is identified, it can be removed immediately during the procedure.

"We know that 25 percent of all average-risk Americans who present at age 50 for their first screening colonoscopy will have polyps," Weber says. A virtual colonoscopy can only identify the presence of something; it cannot remove it for further investigation. If something shows up, the person would then have to go through a traditional colonoscopy as well.

Also, Beck says, Medicare and most insurance companies will pay for a colonoscopy, but won't pay for a virtual colonoscopy.

There is also limited availability of the virtual version. "There are a lot of CT scanners around and very few have the new software to do this kind of test," Beck says. "Most of the CT scans are pretty booked up."

Finally, there's the issue of human error with a virtual colonoscopy. You need to make sure you have a radiologist skilled in reading this type of image, which can take longer than with a conventional colonoscopy. "A very, very important issue is that the results are operator-dependent," Weber says.

That said, there's still a place for the virtual colonoscopy in the health-care world.

"Some people have a tumor in their lower rectum where they can't get the scope past so they can't see the whole colon," Beck says. "For that person, this is going to be very helpful."

Also, a virtual colonoscopy is likely to be safer for people who have had their blood thinned for problems such as heart disease, Beck adds. And it will be more palatable for those who just can't stomach the idea of an invasive colonoscopy, Weber says.

"I think [the virtual colonoscopy] is going to be complementary," Beck says. "There are over 50 million people [in the United States] over the age of 50. If every gastroenterologist and colorectal surgeon scoped five days a week, they still couldn't do them all. I think [virtual colonoscopy] is going to have a role but what that role exactly is going to be is still being worked on."

More information

The National Institute of Diabetes and Digestive and Kidney Diseases has more on conventional colonoscopies and on virtual colonoscopies.

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FTC Supports Teva in Generic Zoloft Case

By Susan Heavey

Reuters

Friday, April 2, 2004  

WASHINGTON (Reuters) - The U.S. Federal Trade Commission on Friday threw its support behind Teva Pharmaceutical Industries Ltd.'s efforts to sell a generic version of the blockbuster antidepressant Zoloft made by Pfizer Inc.

At issue is whether Teva can seek a court ruling that it does not infringe on the brand-name patent before it releases its generic version.

The FTC said the Teva case could settle an important issue over the extent to which brand-name drug companies can work with manufacturers of their choosing to delay the entry of lower-cost medicines.

Pfizer, the world's largest drugmaker, has already made a deal with Ivax Pharmaceuticals to sell a generic version of Zoloft, whose chemical name is sertraline.

Under the law, the first generic firm to seek approval for a generic is given 180 days to sell the drug exclusively after the brand-name patents expire.

Zoloft, a type of antidepressant called selective serotonin reuptake inhibitors or SSRI, has been sold since 1992. Its first patent expires in 2006, according to the FTC.

However, major drug companies could use a legal loophole to make deals with the exclusive generic maker and delay sales. The move, known as "parking," delays the 180-day period and prevents competition.

Such agreements are becoming increasingly common as large pharmaceutical firms look for ways to eke out more profits from popular drugs.

The only way around the potential delay is to seek a pre-emptive, or declaratory, court order.

A lower court denied Teva's petition for such a judgment in December, but Teva then appealed to the U.S. Court of Appeals for the Federal Circuit.

"This case could play an important role in furthering competitive pharmaceutical markets and in lowering health care cost," the FTC said.

Pfizer officials did not return calls seeking comment.

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Metabolism Management

HealthDayNews

Friday, April 2, 2004  

(HealthDayNews) -- Weight control usually involves finding the right balance between calories in and calories out. But research also suggests the way your body burns energy may be just as important.

The Moses Taylor Hospital in Pennsylvania offers these tips for accelerating your metabolism.

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Depression Common After Stroke

Reuters Health

Friday, April 2, 2004

NEW YORK (Reuters Health) - People who have suffered a stroke often have depressive symptoms, according to researchers. The time course of these symptoms varies and depends on the patient's mental functioning.

Dr. D. Leys, of the University of Lille in France, and colleagues examined 202 stroke patients for depressive symptoms and followed them for more than three years.

Patients with scores of at least 7 on an established depression rating scale were considered to have depressive symptoms. The researchers used other assessment scales to measure how much their mental and physical capacities had been affected by the stroke, their functional outcome, and if they had developed dementia.

Forty-three percent of survivors had depressive symptoms after 6 months; this declined to 36 percent after 12 months, 24 percent after 24 months, and 18 percent after 36 months, according to the researchers' article in the medical journal Neurology.

The only predictor of depressive symptoms at six months was the severity of the neurologic impairment at admission.

The investigators found that younger age and stroke on the right side of the brain were both associated with depressive symptoms at 36 months.

"The time course of the various depressive symptoms differed, sadness remaining frequent 3 years after stroke (50 percent), whereas slowness, psychic slowness, lack of energy, and concentration difficulties remained frequent at month 36 in patients with dementia," Leys's group reports.

The variability between patients "might partly explain the discrepancies observed in previous studies on poststroke depression and associated factors," they note.

Source: Neurology, March 23, 2004.

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Children and Emergencies

HealthDayNews

Friday, April 2, 2004

(HealthDayNews) -- It's a wise idea to talk to your kids about what to do in the event of an emergency, according to the Children's Hospital of Philadelphia.

Here's what you should tell them:

You can also role play an emergency situation, guiding your child through the following steps:

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Freeze-Drying Can't Remove Virus from Tissue Transplants

By Karla Gale

Reuters Health

Friday, April 2, 2004  

NEW YORK (Reuters Health) - Freeze-drying does not inactivate viruses from bone and connective tissue, according to investigators at Michigan State University in East Lansing, suggesting that this technique does not improve the safety of tissue used for transplants.

Despite rigorous screening, HIV (news - web sites) and hepatitis C transmission has occurred after transplantation of infected bone and tendon. "There has been a long-held belief based on one article published in 1985 that freeze-drying may inhibit or inactivate a virus, suggesting that it would provide an extra measure of safety," senior investigator Dr. Steven P. Arnoczky told Reuters Health.

As reported online in the American Journal of Sports Medicine, Arnoczky's group obtained tendons and bone tissues from cats infected with feline leukemia virus. Samples were freeze-dried, providing tissue with less than 2% residual moisture.

Using "an extremely sensitive" system, they compared the samples of freeze-dried and fresh-frozen tissue in cell cultures. Cultures from all samples were positive for virus, regardless of which type of tissue was used.

His group's findings are logical, if you consider that vaccines remain effective after being freeze-dried, Arnoczky said, "but ours was the first well-controlled experimental model" to provide conclusive evidence.

He noted the difficulty of eradicating virus from soft tissues, such as tendons, ligament and cartilage. "You can't do what is necessary to sterilize them without altering their mechanical properties."

He emphasized that with current screening methods, the likelihood of implanting infected tissues is minute. But screening could miss an emerging infectious disease, "and we don't know the effects of processing on prion-infected tissue," he added.

Source: American Journal of Sports Medicine 2004.

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Drinking Increases Risk of Sexual Harassment

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 2 (HealthDayNews) -- Female workers face a greater risk of sexual harassment when their male co-workers drink more alcohol in and around the workplace, such as an extra glass of beer or wine at lunch or during happy hour, says a Cornell University study.

Researchers surveyed 1,353 blue-collar and service workers (including 236 women) in the manufacturing, service and construction sectors.

The study found women face a more than twofold increased risk of harassment for every additional alcoholic drink consumed by male co-workers during and around working hours. This link remained even when the researchers controlled for a number of other factors, such as the proportion of women in a work unit or demographic characteristics.

"The survey's findings have important implications for the prevention of sexual harassment in the workplace," study co-author Samuel Bacharach, director of the R. Brinkley Smithers Institute for Alcohol-Related Workplace Studies at Cornell's School of Industrial and Labor Relations, said in a prepared statement.

"They suggest that sexual harassment prevention policies may be less effective in work contexts characterized by a strong and permissive drinking culture. In such environments, it may be more useful to focus prevention efforts on changing employee perceptions about the acceptability of drinking during or around working hours," Bacharach said.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about alcohol and the workplace.

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Appendix Removal Does Prevent Bowel Disease

By Karla Gale

Reuters Health

Friday, April 2, 2004

NEW YORK (Reuters Health) - The occurrence of ulcerative colitis -- an inflammatory bowel disease -- is reduced after people have their appendix removed, studies from Denmark show, suggesting that the surgery confers genuine protection.

However, "for patients who already have ulcerative colitis, their clinical course is not altered by performing an appendectomy," lead investigator Dr. Jesper Hallas at Odense University Hospital told Reuters Health.

Many studies have established that people who have undergone appendectomy are less likely to develop ulcerative colitis, Hallas and his colleagues explain in the medical journal Epidemiology. Why this is so is not clear, but genetic traits or factors related to childhood hygiene have been suggested, rather than a direct effect of appendectomy.

Using the Danish National Registry of Patients, Hallas' group identified approximately 230,000 individuals who had their appendix taken out between 1997 and 1999.

In this group, the incidence rates of ulcerative colitis were 17.6 per 100,000 persons per year before surgery and 13.0 per 100,000 person-years after surgery.

Based on the rates of ulcerative colitis in entire Danish population, 496 cases would have been expected in the study group in the period after they had had an appendectomy, but the actual number of cases was just 330.

"The known inverse association between appendectomy and ulcerative colitis cannot be explained by a mutual genetic determinant, childhood hygiene, or some other factor that is stable over time," the authors conclude.

Instead, something in the way the appendix processes bacteria may explain how the appendix promotes the development of colitis, they suggest.

But these findings do not justify appendectomy as a preventive measure, even among individuals at high risk of developing ulcerative colitis, Hallas said, because it is not currently possible to identify such patients. "Even in patients with a known risk factor, such as family history, ulcerative colitis is rare," he explained.

Meanwhile, in the gastroenterology journal Gut, Hallas and his team report that appendectomy has no significant effect on hospitalization rates in patients already diagnosed with ulcerative colitis.

In a group of 202 patients with ulcerative colitis who underwent appendix removal, the rate of admissions decreased by 47 percent after surgery. However, in a reference group of colitis patients who still had their appendixes, the rate of admissions similarly decreased by 49 percent.

"So even if you can prevent ulcerative colitis by doing an appendectomy, you cannot modify the clinical course by performing appendectomy once it is established," Hallas concluded.

Sources: Epidemiology, March 2004, and Gut, March 2004.

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Men Need to Track Their Blood Pressure

HealthDayNews

Friday, April 2, 2004  

FRIDAY, April 2 (HealthDayNews) -- It's important that every man know his blood pressure and know what those numbers mean, says an article in the April issue of Harvard Men's Health Watch.

Men also need to take action to maintain or bring their blood pressure down below 140/90, the article advises.

High blood pressure -- also called hypertension -- increases the risk of heart attack and stroke, the first and third leading causes of death in the United States. Hypertension also contributes to congestive heart failure, kidney failure, memory loss and dementia, visual impairment, artery damage and erectile dysfunction in older men.

To help men get motivated about achieving and maintaining healthy blood pressure, Harvard Men's Health Watch published a chart that shows what high blood pressure may mean for you.

After you provide some personal and family medical history, the chart lets you calculate your risk of dying from a cardiovascular event within the next five years. The results may help convince you that high blood pressure is a major health threat and that you need to take action.

More information

Here's where you can find the blood pressure chart.

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Acetaminophen Use Linked to Asthma in Women

Reuters Health

Friday, April 2, 2004

NEW YORK (Reuters Health) - Use of acetaminophen (Tylenol and other similar products) has been linked to asthma in several cross-sectional studies, but now findings from a forward-looking study provide further evidence to support this association.

To evaluate the effect of acetaminophen on asthma risk, Dr. R. Graham Barr, from the Columbia Presbyterian Medical Center in New York, and colleagues analyzed data from the Nurses Health Study, which has been following more than 120,000 women.

Although the study began in 1976, participants were first asked in 1990 about how often they took acetaminophen, which is known as paracetamol in some parts of the world.

During follow-up, 346 women were diagnosed with asthma, the researchers note in the American Journal of Respiratory and Critical Care Medicine.

As acetaminophen use increased, so did the risk of asthma. Compared with nonusers, women who took the drug on more than 14 days per month were 63 percent more likely to develop asthma.

"It would be premature to recommend acetaminophen avoidance for patients with asthma, but further research on (lung) responses to acetaminophen is necessary to confirm or refute these findings and to identify subgroups whose asthma may be modified by acetaminophen," Barr's team states.

Source: American Journal of Respiratory and Critical Care Medicine, April 1, 2004.

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Black Men Less Likely to Be Treated for Prostate Cancer

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 2 (HealthDayNews) -- Black men with aggressive prostate cancer are less likely to receive surgery or radiation therapy than white men with the same cancer, and that may explain why blacks are more likely to die from the disease.

That's the conclusion of a University of Michigan Health System study in the April issue of the Journal of Urology.

The researchers compared prostate cancer treatments for 142,340 black, white and Hispanic men from 1992 to 1999. The data came from the U.S. National Cancer Institute (news - web sites).

Black men with moderate grade cancers were 36 percent less likely than white men to receive treatment and Hispanic men were 16 percent less likely than white men to receive treatment.

When it came to aggressive cancers, black men were 50 percent less likely and Hispanic men were 23 percent less likely than white men to receive treatment.

"We know that African-American men are more likely to die from prostate cancer. However, when they are diagnosed with the most aggressive cancers, they are less likely to receive definitive treatment. This could possibly impact the reported racial disparity in prostate cancer mortality," lead author Dr. Willie Underwood, an associate professor of urology surgery, said in a prepared statement.

"While research has focused on a genetic cause for increased mortality in African-Americans, treatment disparities is something that could be addressed in the context of health policy. Equal treatment for equal disease is something that should be achievable," Underwood said.

More information

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

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Stress May Weaken Flu Shot Protection

By Merritt McKinney

Reuters Health

Friday, April 2, 2004

NEW YORK (Reuters Health) - New research suggests that psychological stress may decrease a person's response to the flu vaccine. In a study of college students, those who experienced the most stress during the days after getting a flu shot had lower levels of antibodies induced by the vaccine.

"Even in healthy young adults, stress influences the immune response to vaccines," Dr. Gregory Miller at the University of British Columbia in Vancouver told Reuters Health.

But Miller cautioned that the findings do not mean that stress cancels out the benefits of vaccination. "This effect is fairly modest, and we should be careful about overstating its clinical significance," Miller said.

In the study, most of the highly stressed students still gained adequate protection from the flu vaccine.

Several studies have shown that stress may reduce the effectiveness of vaccines. The strongest evidence, however, comes from studies of older people, whose immune systems may already be weakened. It has been uncertain whether stress has a similar effect in younger people with healthy immune systems.

Miller and his colleagues set out to answer that question in a study of 83 healthy college students. The students kept track of their stress levels before and after receiving a flu shot, and periodically took saliva samples that were checked for levels of the stress hormone cortisol.

The findings are published in the March/April issue of the journal Psychosomatic Medicine. As expected, most students responded to the flu shots by producing antibodies to each of the flu strains included in the vaccine.

But stress seemed to affect the response to one particular strain, the New Caledonia variety. When researchers classified students into low-, moderate- and high-stress groups, they found that highly stressed students were slower to produce antibodies to the New Caledonia strain.

Stress during the few days before vaccination and on the day of the flu shot was not related to the vaccine's effectiveness. But increased stress during the 10 days after vaccination was associated with a reduced response to the vaccine.

Miller's team examined several factors to see whether they influenced the effect of stress, but they were able to rule out physical activity, alcohol consumption, quality of sleep and smoking. The researchers also did not see a connection between production of cortisol and the impact of stress on vaccine response.

However, the number of hours students slept did seem to be related, according to the report. It is uncertain whether too little sleep led to increased stress or vice versa.

Although the findings may shed light on the relationship between stress and the immune system, the effect of stress was "fairly modest," Miller and his colleagues point out. They note that 75 percent of students in the high-stress group had an adequate response to the flu vaccine.

Source: Psychosomatic Medicine, March/April 2004.

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Which Older Women With Diabetes Should Take Vitamins?

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 2 (HealthDayNews) -- A blood test can help doctors identify older women with diabetes who would benefit -- or suffer -- from taking vitamin doses meant to protect their hearts, says a study from researchers at Technion-Israel Institute of Technology.

The simple blood test screens for genetic variations in a blood protein called haptoglobin.

Postmenopausal women with diabetes who carry two copies of the variation called haptoglobin-2 face an increased risk of narrowing of the arteries (atherosclerosis) if they take doses of the antioxidant vitamins E and C, says the study. It appears in the April issue of Diabetes Care.

But postmenopausal women with diabetes who have two copies of haptoglobin-1 seem to reduce their risk of atherosclerosis when they take the same vitamins.

"This study says that you can find subgroups of people who actually might benefit and subgroups which will actually be harmed by antioxidant vitamins, so it is important to know which haptoglobin type you are," researcher Dr. Andrew P. Levy said in a prepared statement.

He and his colleagues examined the effects of the vitamins in 299 postmenopausal women with at least partial blockage in one coronary artery.

More information

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

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'Wristwatch' Monitors May Miss Low Blood Sugar

By Megan Rauscher

Reuters Health

Friday, April 2, 2004

NEW YORK (Reuters Health) - A recently developed devices, worn on the arm, continuously monitors blood sugar levels -- a boon for people with diabetes. Glucose levels that are too high can create long-term problems, while excessively low levels can lead to disorientation or even loss of consciousness.

However, findings published in the medical journal Diabetes Care suggest that the GlucoWatch G2 Biographer (GW2B) and the continuous glucose monitoring system (CGMS) "do not reliably detect" low blood glucose levels (i.e., hypoglycemia) in children and adolescents with type 1 diabetes.

Detecting hypoglycemia is a "critically important" function of these FDA (news - web sites)-approved devices, Dr. Eva Tsalikian and other members of the Diabetes Research in Children Network (DirecNet) Study Group note in the paper. Therefore, they assessed the performance of the two glucose monitors during both spontaneous and induced reductions in blood glucose.

During a 24-hour stay at a research center, 91 children age 3.5 to 17.7 years wore one or two CGMS devices and 89 of these subjects wore one or two GW2B devices.

"Our results demonstrate that neither the GW2B nor the CGMS is accurate with respect to reporting glucose values in the hypoglycemic range," the investigators report.

For example, when the GW2B alarm level was set for glucose level of 60 or lower, it detected hypoglycemia only 23 percent of the time, while the false-alarm rate was 51 percent.

For the original CGMS device as well as a modified version that became available in November 2002, the detection rates of true hypoglycemia were 36 percent and 49 percent, respectively, with false-positive rates of 63 percent and 58 percent, respectively.

The accuracy of the GW2B and the CGMS is "considerably better" when reference glucose levels are set over 100, according to the team.

In comments to Reuters Health, Tsalikian, from the Jaeb Center for Health Research in Tampa, said: "Both the CGMS and GW2B are not as accurate during hypoglycemia as during normal and high blood glucose levels."

While both can be helpful in measuring trends and adjusting insulin doses accordingly, they are nor reliable "as a sentinel for hypoglycemia."

She and her colleagues expect that future generations of sensors will perform better in this regard.

Source: Diabetes Care, March 2004.

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San Antonio Tops List of Drunken Cities

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 2 (HealthDayNews) -- In San Antonio, they remember the Alamo but forget when to say when.

The metropolitan area around the historic Texas city has the highest rate of binge drinking -- imbibing till you're drunk -- in the entire United States, according to a new federal study. Other hotspots for booze consumption include the Midwest (particularly the Dakotas and Iowa) and Nevada, while teetotalers rule the roost in Mormon-dominated Utah as well as Chattanooga, Tenn.

So do booze-happy cities deserve a bad rap? That's not the point of the research, said study co-author Dr. Timothy S. Naimi, an epidemiologist with the U.S. Centers for Disease Control and Prevention (news - web sites).

"It's not to say they're bad people. This just points out that that kind of level [of drinking] is associated with bad things like injuries, interpersonal violence and unprotected or unplanned sexual encounters," he said.

Naimi and his colleagues examined two national health surveys from 1997 and 1999 and compared the results from 120 metropolitan areas in 48 states and Washington, D.C. They looked for people who reported binge drinking -- for men, downing five or more drinks at one time; for women, four drinks -- at least once in the past 30 days.

"The net effect of drinking five or more drinks in a short amount of time is that everyone will be impaired," Naimi said. "Drinking at that level tends to be associated with problems."

The study findings appear in the April issue of the American Journal of Public Health.

The researchers found that an average of 14.5 percent of adults surveyed were binge drinkers, with the highest level in San Antonio (23.9 percent). Of the 20 metropolitan areas with the highest levels of binge drinking, 17 are in the Midwest, Texas and Nevada.

After San Antonio at No. 1, the top 10 metropolitan areas, in descending order, are: Grand Forks, N.D.; Milwaukee; Austin, Texas; Sioux Falls, S.D.; Davenport, Iowa.; Cedar Rapids, Iowa.; Duluth, Minn.; Lincoln, Neb.; and Springfield, Mass. (Some of the metropolitan areas include residents in more than one state and more than one city.)

In the top three metropolitan areas -- San Antonio, Grand Forks and Milwaukee -- an estimated one third of adult men are binge drinkers.

Chattanooga residents reported the lowest level of binge drinking (4.1 percent). The study didn't rank other alcohol-averse metropolitan areas in order, but the driest regions include Arizona, most of the South (with the exceptions of Texas and Louisiana), and Ohio.

Utah is on list of dry states, too, but its residents who do drink tend to imbibe more than those in other states, according to the study.

Naimi said religious and cultural factors may be at play. Utah and the South report lower levels of overall binge drinking, and it may be no coincidence that Mormons in Utah and Southern Baptists in the South frown on alcohol, he said. "Another contributing factor is that prices and tax rates in different parts of the country vary," he added.

Overall, young men -- and men in general -- report more binge drinking, Naimi said. Whites and Latinos, meanwhile, report more boozing than blacks.

And what of San Antonio, which is already reeling from a newfound reputation as one of the nation's fattest cities?

"Maybe now we have another indicator that we do need to give more attention to prevention of the abuse of alcohol," said Sharon Shook, executive director of the San Antonio Council on Alcohol and Drug Abuse, who pointed out that the city already has a high rate of drunken driving.

While Shook said she's not sure if the federal study used the right measures for binge drinking, she acknowledged that San Antonio is a fast-growing city with plenty of colleges and universities where booze may be popular. She added the city could put more emphasis on alcoholism treatment and prevention.

Worthwhile programs include those that work with families, she said. "We could be teaching people how to feel great in other ways [besides alcohol consumption], and that needs to start in early childhood and go all the way through," Shook said.

From the federal perspective, Naimi said other possible strategies to combat binge drinking include higher alcohol taxes and training of bartenders to prevent them from serving booze to drunk patrons. "The problem is that there are powerful financial interests [who] are not necessarily served by some of these things," he said.

More information

Learn more about binge drinking from the Harvard School of Public Health. The State University of New York at Potsdam also offers a fact sheet on binge drinking.

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Medical Schools Establishes Obesity Course

Reuters

Friday, April 2, 2004

WASHINGTON (Reuters) - Duke Medical School said on Friday it was setting up a course in treating obesity, saying that with nearly two-thirds of Americans overweight, doctors need specialized knowledge of the condition.

Coursework will include the underlying causes of obesity and how to treat it. "The students learn how to manage overweight and obese patients non-judgmentally and counsel adults and children to make healthy lifestyle choices," the North Carolina-based medical school said in a statement.

"Duke is one of the first medical schools in the country to establish an obesity management course for medical students," added Dr. Jarol Boan, and assistant professor of medicine and surgery who set up the month-long course.

"Physicians have typically had very little exposure to obesity treatment. Part of the reason for this is that obesity is not considered a disease, so students don't get training for obesity."

The Centers for Disease Control and Prevention (news - web sites) says obesity is quickly gaining on smoking as the leading cause of death in the United States, taking 400,000 lives a year.

"There's an obesity epidemic, and students need to be able to deal with the real world," Boan said.

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New Antibiotic Fights Respiratory Infections

HealthDayNews

Friday, April 2, 2004

FRIDAY, April 02 (HealthDayNews) -- As more drugs become resistant to germs that cause respiratory tract infections (RTIs), the world's drugmakers must find new ways to treat these all-too-common conditions, including chronic bronchitis, bacterial sinusitis, and community-acquired pneumonia.

The U.S. Food and Drug Administration (news - web sites) gave the effort a boost April 1 when it approved Ketek (telithromycin), the first in a new class of antibiotics known as ketolides, which are designed specifically to treat these kinds of stubborn respiratory problems.

Ketek targets the airway germs without significantly affecting bacteria that don't cause the RTIs, manufacturer Aventis Pharmaceuticals said in a prepared statement. This may be an important factor in minimizing development of drug-resistant germs, the statement added.

More than 7 million prescriptions for the drug have been written since it was first approved in Europe in 2001, the company said. Common side effects include nausea, headache, dizziness, and diarrhea.

To learn more about respiratory diseases, visit the National Library of Medicine.

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Thursday, April 1, 2004

 

Report: U.S. Has Wide Powers on Suspect Supplements

 

By Lisa Richwine

Reuters

Thursday, April 1, 2004

WASHINGTON (Reuters) - The U.S. government does not need direct evidence of harm to humans before banning suspect dietary supplements, a study commissioned by the U.S. Food and Drug Administration (news - web sites) concluded on Thursday.

The report by the Institute of Medicine (news - web sites) and the National Research Council (news - web sites), independent scientific groups that advise the government, also said "a number of legal and regulatory barriers ... that hamper the FDA's ability to protect the public's health" should be addressed.

About 29,000 supplements such as vitamins and herbs are sold in the United States and annual sales top $18 billion, said the report into the regulation of the industry.

Under a 1994 law, supplements do not have to pass the extensive safety and effectiveness tests required for pharmaceuticals prior to marketing. Like foods, supplements are presumed safe unless the government shows they are risky.

In December, the FDA for the first time announced it would ban a supplement, the herbal weight-loss aid ephedra. The agency heard years of complaints linking ephedra to heart attacks and deaths, but officials said they could not have acted sooner because it took time to compile evidence.

While most supplements are safe, data on the safety for humans of some ingredients "are scant or nonexistent," said Barbara Schneeman, chairwoman of the scientific panel.

In those cases, the law "does not require the same level of definitive proof that would be needed to document actual harm," Schneeman said.

Animal tests, research on similar substances, or other data could build a strong case to conclude a supplement poses a "significant or unreasonable risk" to humans, the legal standard set for outlawing a supplement, the report said.

To address shortcomings in the supplements law, the report urged amending it to require manufacturers to turn over consumer complaints about possible side effects. That change also is advocated by some lawmakers and industry groups.

The report offers "a valuable process and a legitimate approach to building better tools to address the issues that have been raised with regard to safety," said Michael McGuffin, head of the American Herbal Products Association.

Dr. Susan Walker, director of the FDA's division of dietary supplement programs, said the agency "will look at the totality of the report and implement (suggestions) as feasible."

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Death Shows Danger of Silicone Injections

 

By C.G. Wallace

Associated Press Writer

The Associated Press

Thursday, April 1, 2004

ALBANY, Ga. - The death of a transsexual who received injections of industrial-grade silicone illustrates the dangers of "pumping," a thriving underground practice in motel rooms or apartments among men living as women.

Authorities say 23-year-old Andre D. Jeter suffered convulsions and fell unconscious Dec. 10 after receiving injections in her hips and buttocks during a "pumping party" here. She died a month later.

Stephen Oneal Thomas, 31, was charged last week with murder and other offenses for allegedly administering the injections. Thomas' lawyer refused on Tuesday to comment.

One of Thomas' roommates, Nikkia Scott, and other drag queens have been getting illegal, back-room injections of silicone to give themselves some of the things nature denied them when they were born male — breasts, wider hips, more prominent cheekbones.

They know the risks are extreme, and still they do it.

"Anything you put in your body that don't belong there will hurt you in the long run," Scott said of her $6,000 worth of injections. "But believe me, it has been worth it. It has been worth it."

Scott and three others were also arrested in the case and charged with conspiracy and practicing medicine without a license. They were accused, among other things, of helping Thomas by recruiting patients at drag-queen beauty pageants.

The victim was a man living as a woman, as are all four defendants.

While medical-grade silicone is implanted under the skin in sealed sacs to keep it from leaking, pumping involves injecting silicone straight into the body.

And the silicone used is the stuff sold in hardware stores as a sealant. It is not sterile and can cause infections, particularly in the lungs.

The silicone is often mixed with paraffin, oil, even peanut butter, said Dallas Denny of the transgender support group Gender Education & Advocacy. In Jeter's case, it was probably mixed with baby oil, based on how it smelled to others who received the injections, said James Paulk, an investigator for the district attorney.

There was so much silicone in Jeter's body that when incisions were made during the autopsy, a clear, brownish liquid flowed out, Paulk said.

The scope of the phenomenon is unclear. The Centers for Disease Control and Prevention (news - web sites), the Food and Drug Administration (news - web sites) and transgender groups said they do not keep track of the problem. But Paulk said a "slew" of people have been injured, including three or four in Montgomery, Ala., six or seven in Columbus, Ga., and a few in Jacksonville, Fla.

"The transgender society is a very tight-knit society. They don't like to give each other up because if you do, you get barred from the pageants," Paulk said. "If they're not hurting and they're not experiencing medical problems, they aren't calling me."

A day after his arrest, a stubble-faced Scott, wearing large hoop earrings, was back to gluing weaves to heads at a beauty parlor in Albany, a town 150 miles south of Atlanta. His roommate Jazz, also arrested in the case, was at home, wearing pajamas and pink flowered flip-flops.

Jazz and Scott compete in drag shows during "black society" nights at a bar called Queens in Albany. They dress in gowns and rhinestones and perform songs for tips.

They both strongly denied any involvement in giving silicone injections and said they did not know their roommate Thomas was "pumping."

Scott, identified as Freddie Clyde in court documents, said her silicone injections have not caused any serious health problems. But Jazz, whose legal name is Mark Edwards, said she has had three procedures — face, bust and lower body — that cost her about $3,300, and has suffered severe side effects.

Last year, she said, she started coughing heavily and discovered that the silicone had gotten into her lungs, giving her chemical pneumonia. She spent two months in the hospital and several more months on bed rest, and her weight dropped from 270 to 150.

She also lifted up her T-shirt to show the scar under one of her breasts where doctors went in to remove a hardened clump of silicone.

As for Jeter, Jazz said, she had taken the injections too far. Jeter had complained that her head itched and that her hair had stopped growing, according to Jazz. "Jeter was making herself look like a monster," Jazz said.

Despite her own health problems, Jazz said she has nothing against the woman who gave her the injections.

"I don't want to prosecute her, I want to thank her," she said. "I'm the one who wanted the work. She did nothing wrong but what I wanted."

Associated Press correspondent Elliott Minor in Albany, Ga., contributed to this report.

On the Net:

Gender Education & Advocacy: http://www.gender.org

La Gender: http://www.geocities.com/lagenderinc

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About 900,000 U.S. Children Neglected, Abused

 

Reuters

Thursday, April 1, 2004

WASHINGTON (Reuters) - Nearly 900,000 U.S. children were neglected or abused in 2002 and 1,400 died as a result, the U.S. Health and Human Services (news - web sites) department reported on Thursday.

Although there has been an improvement in the situation over the previous decade, HHS Secretary Tommy Thompson said in a statement, "The abuse of children remains a national tragedy that demands our commitment and action."

Surgeon General Dr. Richard Carmona announced he would create a working group to focus attention on the problem and find ways to tackle it.

Statistics gathered by the National Child Abuse and Neglect Data System showed child protective service agencies received 2.6 million reports of possible maltreatment in 2002. Of these, 896,000 were substantiated and most involved neglect.

HHS said the rate of child neglect and abuse in 2002 was about 20 percent lower than the rate in 1993, when maltreatment peaked at an estimated 15.3 out of every 1,000 children. The rate is now 12.3 out of every 1,000 children.

Carmona said it was appropriate for public health officials to become involved in child abuse and neglect.

"While child maltreatment has traditionally been thought of as a criminal justice issue, it is also very much a public health issue," Carmona said in a statement.

"The wrenching mental and physical health effects of child maltreatment continue for that child long after he or she is placed in a safe environment. And the frequency with which child maltreatment occurs in our society compels us to be aggressive in developing ways to stop it."

The full report, "Child Maltreatment 2002," is posted on the Internet at http://www.acf.hhs.gov/programs/cb/publications/cm02/index.htm.

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 Autism Theory on Brains Sparks Debate

By Ron Todt

Associated Press Writer

The Associated Press

Thursday, April 1, 2004

 PHILADELPHIA - Cambridge University professor Simon Baron-Cohen thinks he knows why autism strikes four times as many boys as girls, but his theory of general differences between male and female brains has generated quite a bit of debate.

Baron-Cohen theorizes that the female brain is predominantly hard-wired for empathy, and that the male brain is predominantly hard-wired for understanding and building systems — although he is quick to note that the rule doesn't always hold true.

According to his "empathizing-systemizing" theory, autism — a neurological disorder that affects social interaction and communication — and the possibly related Asperger syndrome are extreme male versions of the brain.

"What seems to be core (to autism) is an empathy problem alongside a very strong drive to systemize," he told an audience of about 150 people Wednesday at an autism conference by the Bancroft Neuroscience Institute.

Baron-Cohen cites evidence from questionnaires, psychological tests and observations of very young children showing early sex differences. Even day-old baby boys, for example, are more likely to look longer at a mechanical mobile, while girls look longer at a person's face.

Autistic-type disorders, he said, appear to be an extreme version of the male brain. What causes such a shift is unclear, he said, but possible candidates include genetic differences and prenatal testosterone. High levels of fetal testosterone mean less eye contact on the part of infants, and Canadian researchers have found that such levels mean better scores on systemizing tests, he said.

Baron-Cohen said his ideas and his new book "The Essential Difference: The Truth About the Male and Female Brain," had been greeted with interest rather than the hostility he feared after "decades of political correctness" in which the idea of any biological sex differences was anathema.

"Some individuals have contacted me to say that this kind of work is politically dangerous, so that reaction is still there," he said. "Typically the individuals who are worried by this approach haven't actually looked at the details of the science."

He emphasized that the male and female brains exist only on average.

"It would be a great shame if people took home the idea that all males think one way and all females think the other way," he said. Instead, educators should assess each individual child to see if, for example, they are good at math but may have trouble on the playground, he said.

Researchers have come up with educational software to try to help raise the emotional abilities of autistic children, and a study of the approach should be finished in the next few months, he said.

Martha R. Herbert, an assistant professor in neurology at Harvard Medical School (news - web sites), said Baron-Cohen's observations were interesting, but still had not identified a biological process responsible for autism.

"As to whether there's some core thing about male or femaleness that's related to autism, I doubt it," she said. "I think that it just distracts attention from getting at some of the more core issues of how the disorder works both psychologically and biologically."

A British researcher, for example, has found that the sex ratio was equal in autistic blind children, and that there is a different sex ratio in high IQ versus low IQ people with autism. "So it's not just a male thing; there's something else going on," she said.

Work focusing on high levels of testosterone may be more revealing, but is still not the end of the story, Herbert said.

"The testosterone may be facilitating something rather than causing it," she said.

On the Net:

Cambridge autism research: http://www.autismresearchcentre.com

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U.S. Says Work-Related Pickup Truck Deaths Higher

By Paul Simao

Reuters

Thursday, April 1, 2004

ATLANTA (Reuters) - The number of U.S. workers killed in pickup trucks nearly doubled in the decade after 1992, probably due to rising sales of the vehicles, federal health officials reported on Thursday.

A total of 210 drivers and passengers died in work-related pickup truck crashes on public roads in 2001, a 96 percent increase from 1992, according to an analysis of federal safety data by the Centers for Disease Control and Prevention (news - web sites).

The finding contrasted with data showing that work-related car fatalities declined sharply during the same period and overall occupational roadway deaths remained stable.

Motor vehicle crashes are the leading cause of death among U.S. workers. There were 13,337 such fatalities, or about 1,300 per year, reported nationwide between 1992 and 2001.

Stephanie Pratt, the study's author, suggested that the growing popularity of pickup trucks might explain the rising death toll for workers in these vehicles, which are especially common in rural parts of America.

Sales of new pickup trucks rose 50 percent between 1992 and 2001, according to Autodata Corp., a New Jersey firm that analyzes motor vehicle data.

"This reflects a change in the mix of vehicles we see on the road overall," said Pratt, of the CDC's National Institute for Occupational Safety and Health. "I don't think it's related to work as much as it is to the difference in vehicles that are out there."

But Pratt noted that despite the rising toll of pickup truck deaths, far more workers overall were killed in semi-trucks, cars and other unspecified vehicles such as SUVs during the 1992-2001 period. Work-related deaths for occupants of tractor trailers and other semi-trucks rose 49 percent.

The CDC said roadway deaths would be reduced if more workers wore seat belts. A total of 3,224 people killed in crashes on the job between 1997 and 2002 had not buckled their seat belts or did not have one available.

About 4.2 million workers, ranging from taxi to truck drivers, used motor vehicles to perform their jobs in 2001. (Additional reporting by Michael Ellis in Detroit)

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Women More Sensitive to Pain Than Men

 

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- Blacks and whites have about the same sensitivity to pain, but women appear to be more sensitive to it than men.

That's what Duke University researchers report in the April issue of the Journal of Pain.

"Many pain medications are addictive and have unpleasant side effects, so it's important for physicians to be able to understand exactly how much pain their patients are experiencing," lead researcher and psychologist Dr. Tavis Campbell said in a prepared statement.

He conducted the study while at Duke; he's now at the University of Calgary in Canada.

"This research supports well-established findings of slightly higher sensitivity to pain among women compared to men, but revealed no difference between whites and African-Americans," Campbell said.

Previous research and anecdotal evidence have suggested blacks are more sensitive to pain than whites. Campbell suggested pain assessment procedures may be responsible for such racial differences in pain sensitivity.

His study included 76 men and 59 women aged 25 to 45; 72 were black, the rest white. A blood pressure cuff was inflated on the arm of each study participant and left inflated for several minutes. That created an aching sensation. The participants rated their pain according to standard pain rating scales, which gauge both the intensity and the unpleasantness of the pain.

More information

The Nemours Foundation has more about pain.

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Aspirin Improves Blood Flow to Heart

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - A regular-strength aspirin taken every day reduces the number of episodes of restricted blood flow to the heart (coronary ischemia) experienced by people with cardiovascular disease, a Greek study shows.

The researchers found that the benefits of aspirin in reducing ischemia came about through the inhibition of various factors that promote blood-clot formation, including a substance called macrophage colony stimulating factor (MCSF).

These findings are "clinically relevant, as daily life ischemia and MCSF plasma concentrations, are both known to predict adverse outcomes" in individuals with chronic coronary artery disease (CAD), the investigators note in the medical journal Heart.

Dr. Ignatios Ikonomidis from the University of Athens and colleagues identified 40 people with chronic stable CAD who were seen to have periodic ischemia when they wore a heart monitor for 48 hours. They were then given either 300 milligrams of aspirin or an inactive placebo daily for 3 weeks, after which they were switched to the other treatment.

The total number of ischemic episodes fell from 339 during placebo treatment to 251 during aspirin treatment, and the total duration of these episodes fell from 1765 minutes to 1305 minutes.

Aspirin therapy also significantly reduced concentrations of key blood-clotting and inflammatory markers.

"We report for the first time that aspirin treatment at a dose of 300 milligrams reduces daily life ischemia in parallel to reduction of platelet activation, thrombin generation, and inflammation," Ikonomidis told Reuters Health.

"Daily life ischemia in addition to platelet activation, thrombin generation and inflammation are determinants of prognosis," the researcher said, "and thus their reduction by 300 milligrams of aspirin may prevent transient coronary flow reductions and improve long term prognosis in this group of patients."

Source: Heart, April 2004.

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Even Mild Psoriasis a Problem for Sufferers

 

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- Many Americans with small areas of psoriasis on their skin report high levels of dissatisfaction with their current treatment and also regard psoriasis as a problem in their daily life.

That's according to a study released in a recent special issue of the Journal of Investigative Dermatology.

The study found that more than 2 percent of American adults (more than 4.5 million people) have been diagnosed with psoriasis. The skin disease occurs when faulty immune system signals cause skin to regenerate every three to four days, instead of the usual 30-day cycle.

This causes extra skin cells to build up on the skin surface. These excess skin cells form red, flaky, scaly lesions that can itch, crack, and bleed. The condition can be extremely painful.

The study was based on results of a survey commissioned by the National Psoriasis Foundation. The survey included more than 27,000 Americans aged 18 or older.

"All too often we hear from psoriasis patients who have given up on treatment, and who have given up hope. Psoriasis has such a significant negative impact on lives -- physically, socially, and emotionally -- and yet society often trivializes the disease," Gail M. Zimmerman, president and chief executive officer of the National Psoriasis Foundation, said in a prepared statement.

"This study is a powerful reminder that even those patients whose psoriasis is not considered 'severe' by traditional measurements nevertheless deserve and need additional treatment options that will work for them," Zimmerman said.

She noted there are about 40 psoriasis drugs under development or in clinical trials. The recent discovery of several genes implicated in psoriasis is an important research advance.

The National Psoriasis Foundation receives major funding from a number of drug manufacturers.

More information

The American Academy of Dermatology has more about psoriasis.

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Huntington's May Be Simpler to Fight Than Thought

 

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, April 1, 2004

WASHINGTON (Reuters) - Huntington's disease may be more straightforward to fight than doctors have feared, paradoxically because the genetic brain disorder is more complicated than anyone knew, U.S. researchers said on Thursday.

Their research in fruit flies shows that nerve cells modify the mutated protein responsible for Huntington's disease, and this basic cell process could in theory be altered with a drug.

The researchers believe their finding, published in this week's issue of the journal Science, opens a new approach to treating the fatal and incurable disease.

Huntington's disease affects about 30,000 people in the United States. It is a dominant genetic defect, meaning that a child who inherits just one copy of the bad gene from a parent has a 50 percent chance of eventually developing Huntington's.

It hits late in life, usually after people have had children. It causes uncontrolled movements, loss of intellectual capacity and severe emotional disturbances before killing the patient.

Cell Must Take Action

Larry Marsh, a developmental geneticist at the University of California Irvine, has been looking for a way to fight the disease and has been focusing on just what goes wrong inside the cells carrying the mutated gene, called huntingtin, which controls production of a protein also called huntingtin.

"We used to think that you inherit this defective gene, you have got a defective protein and you have a problem. But what we have discovered is that the cell has got to take action to make it bad," Marsh said in an interview.

His team found that cells make a protein called SUMO-1 that modifies huntingtin. When the huntingtin gene is mutated, SUMO-1 makes its protein product toxic.

"In this case, presumably this goes on in a normal cell with a normal huntingtin (gene) to make it do this function," he said.

"With mutant huntingtin, it does it and screws it up."

It may be possible to develop drugs that would block SUMO-1 from modifying the Huntington's disease protein, thus slowing the disease, Marsh said.

This is good news, as completely blocking the huntingtin gene or protein is not an option, even if someone could figure out how to do it.

Huntingtin clearly does something important, Marsh said. If mice are bred that lack the gene, they die as embryos in the womb.

Application To Other Diseases?

But if SUMO-1 has a limited function, it may be safe to block it in Huntington's patients.

"It is a lot easier to prevent a cell from doing something than it is to coax a cell to do something it is not programed to do," Marsh said.

Huntington's patients get a gluey buildup of proteins similar to the so-called plaques that mark Alzheimer's disease (news - web sites).

"This is a common feature of many neurodegenerative diseases," Marsh said.

He hopes his team's findings could be used to find treatments for Alzheimer's, Parkinson's and similar diseases.

For their experiment, Marsh and colleagues made fruit flies that carried mutant human huntingtin in every cell. He said the flies carry 75 percent of the genes known to cause disease in people and make a good model for discovering basic biological processes that underlie disease.

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Most People With Schizophrenia Don't Take Meds as Directed

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- Although anti-psychotic medications can help people with schizophrenia live more normal lives, almost 60 percent don't take these medications as prescribed by their doctors.

And that non-compliance leads to higher medical costs, according to a new study in the April issue of the American Journal of Psychiatry.

"We looked at adherence to anti-psychotic medications because they form the backbone of treatment for schizophrenics," said study co-author Dr. Dilip Jeste, a professor of psychiatry and neurosciences at the University of California, San Diego. "These medications are good, but they only work when taken properly."

Schizophrenia, a chronic disease of the brain, affects about 1 percent of the U.S. population, according to the National Institute of Mental Health. Symptoms can include hallucinations, delusions, paranoia, disordered thinking and difficulty expressing emotions.

For this study, Jeste and his colleagues reviewed claims and eligibility data for 1,619 people with schizophrenia who were receiving treatment between 1998 and 2000. The data were provided by the San Diego County Adult Mental Health Services and Medi-Cal, California's Medicaid program.

Most of the study subjects were between 30 and 59 -- the average age was 42. Fifty-six percent were men. Twenty-five percent of the group also had a known substance-abuse problem. Half lived on their own, while 19 percent lived with family. Another 25 percent lived in assisted-living facilities and 5 percent were homeless.

Only 41 percent of the people studied took their medication as prescribed. Twenty-four percent were non-adherent, which meant they filled less than 50 percent of their anti-psychotic medication prescriptions, Jeste said. Seventeen percent were partially adherent, which meant they filled between 50 percent and 80 percent of their prescriptions.

What surprised the researchers was the number of "excess fillers" they discovered. Nearly 20 percent of the people studied filled prescriptions for more medication than they needed.

Not surprisingly, psychiatric hospitalizations were much higher for those who didn't take their medications as prescribed. People who were non-adherent were two and half times as likely to be hospitalized for psychiatric reasons. Those who were partially adherent or "excess fillers" were 80 percent more likely to be hospitalized.

Even hospitalizations for non-psychiatric reasons were higher for those who didn't follow their drug regimen. Those who were non-compliant or excess fillers were 70 percent more likely to be hospitalized for medical reasons than people who adhered to their drug schedule. Those who were partially compliant were 30 percent more likely to have a medical hospitalization.

Hospital costs were three times as high for people who didn't take their medication properly compared to those who did. Costs for people who were partially adherent or excess fillers were about two and half times higher.

Dr. Hiten Patel, a psychiatrist at William Beaumont Hospital in Royal Oak, Mich., said the study's findings aren't surprising. "We know that there is a very high degree of non-compliance in people with schizophrenia," he said.

Jeste said the researchers weren't able to discern the reasons for non-compliance from the available data. They did find that younger patients and substance abusers were less likely to take their medication as directed. People living with family or in assisted-living settings were more likely to follow prescriptions.

Both Jeste and Patel recommended bolstering community mental health systems, so support is available for people with schizophrenia.

"We expect these people who are seriously mentally ill to take their medication, sometimes several times a day or multiple medications, and it's really hard," Jeste said. "Instead of blaming patients, we need to provide education to help them understand why they need the medication, and case management helps. If there is someone else who is interested and helping them, medication adherence will likely improve significantly."

Patel said if you have a family member or friend who has schizophrenia, you can help them adhere to their prescriptions. He said be supportive, but also be vigilant that they're taking their medications, adding that it's a good idea to actually check the prescription bottles to make sure the right amount of pills have been taken.

More information

To learn more about schizophrenia, visit the National Institute of Mental Health or the American Psychiatric Association.

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Fat Hormone Can Rewire Brain, U.S. Studies Show

 

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, April 1, 2004

WASHINGTON (Reuters) - Leptin, a hormone that affects weight and appetite, apparently helps wire the brain in ways that might set an animal on a lifetime path to slenderness or obesity, two teams of U.S. researchers said on Thursday.

The studies, published in Friday's issue of the journal Science, may take doctors a step closer to understanding whether leptin could be manipulated to help overweight people lose weight and keep it off.

The findings might also help explain why the food a person eats when very young, or even what a mother eats while pregnant, affects weight, heart disease and other aspects of metabolism later in life.

And they help shed light on why it is so hard for many people to lose weight and keep it off.

In one study, a team at the Howard Hughes Medical Institute and Rockefeller University and at Yale University, found that leptin affects both the physical structure and the function of neural circuits in the brain.

"This is a very dynamic effect that's quite dramatic and somewhat surprising. In response to leptin, the cells create new connections," said Rockefeller's Dr. Jeffrey Friedman.

"The malleability of these feeding circuits by leptin suggest the possibility that the brain's wiring may be different in lean versus obese individuals," Friedman added in a statement.

The researchers worked with specially bred mice, but when it comes to basic biology, mice are very similar to humans.

When it was discovered in 1994, leptin thrilled scientists because it seemed so basic to obesity and appetite. Overweight rodents fed leptin lost weight and studies quickly showed that some overweight people had unusually low levels of the hormone.

But leptin's effect was not so straightforward in humans, and it became clear that simply injecting obese people with it was not going to make them lose weight.

In a second study, scientists at Oregon Health & Science University found exposure to leptin early in life affected brain structures involved in weight regulation.

Also working with mice, Richard Simerly and colleagues tracked development of neurons in a part of the brain called the arcuate nucleus of the hypothalamus.

Brain circuits there were less developed in mice genetically engineered to make no leptin compared to normal mice. Injecting baby mice with leptin restored normal brain structure, they found.

"We're excited about this finding because it shows how exposure to leptin can directly affect development of brain structures involved in regulating body weight," Simerly said in a statement.

"Our findings suggest a link between the developmental actions of leptin and early onset obesity," he added.

"We were shocked by how clear the result was. Leptin plays an important role in brain development, by acting specifically on the clusters of brain cells that regulate food intake."

The findings may help explain how some people seem to have a body weight "set point" -- "until now a nebulous concept in search of a mechanism," said Joel Elmquist and Jeffrey Flier of Harvard Medical School (news - web sites) and Beth Israel Deaconess Medical Center in Boston.

The findings support "the concept that under- and over-nutrition during critical periods of hypothalamic (brain) development may induce long-lasting and potentially irreversible effects into adulthood," they wrote in a commentary in Science.

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New Burn Treatment Shows Dramatic Results

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- A new material, produced by bacteria, dramatically speeds skin healing in burn victims, a study has found.

The material is called bacterial cellulose, said Wojciech Czaja, a research associate at the Technical University of Lodz in Poland, who presented the findings this week at the American Chemical Society's annual meeting in Anaheim, Calif.

Czaja's study included 20 burn patients treated with the new material, and 12 "control" burn patients treated with traditional wound dressings.

"Certain strains of bacteria use glucose to make cellulose," Czaja said. "We remove the bacteria from the cellulose, leaving only the cellulose."

"It's totally different than cellulose from plants," he said, and when it's made into wound dressings it has definite advantages. "It has the ability to hold a large quantity of water or liquid. You can supply an antibiotic through the dressing because it is porous. It's also transparent."

"For second-degree burns, we think this is the best," Czaja said.

Second-degree burns are typically caused by scalding injuries, flames or a hot object, resulting in blisters, deep redness, a burn area that may look wet and shiny, or skin that's painful to the touch, according to Children's Hospital Boston.

With the new dressing, he said, there was a "dramatic acceleration of the whole process of healing. At day 10, seven treated with bacterial cellulose had epidermis (skin) growing already. That's pretty fast."

In comparison, only three patients with the regular dressing showed growth of epidermis at day 10, he said.

According to Czaja, bacterial cellulose promises many new applications in wound care beyond burn treatment, including the care of surgical wounds, bedsores and ulcers.

To call the treatment "revolutionary" is not exaggerating, said R. Malcolm Brown Jr., the Johnson & Johnson Centennial Chair in Plant Cell Biology at the University of Texas at Austin. The new dressing, he said, "holds 95 percent of its weight in water."

That allows for what experts call "moist healing," considered a healthier way to heal.

In another presentation at the same session, Gonzalo Serafica of Xylos Corp. in Langhorne, Pa., discussed his company's new bacterial cellulose material, called XCELL, which has been available since January 2003.

Compared to cellulose from trees and cotton, the biosynthesized cellulose fibers are about 200 times smaller, creating a material up to 100 times more absorbent, according to the company.

More information

To find out more about bacterial cellulose, visit the Oak Ridge National Laboratory. For more on burns and treatment, visit the University of Kansas.

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Preemies' Breathing Problems Tied to Moms' Smoking

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - The occurrence of breathing abnormalities -- especially brief episodes of breathing cessation during sleep, known as apnea -- is high among preterm infants who are exposed to cigarette smoke before birth, a small study shows.

Moreover, such babies are less likely to be aroused when they experience sleep apnea -- a factor that has been linked to sudden infant death syndrome (SIDS).

"Prenatal exposure to cigarette smoke is associated with an increased risk of sudden infant death syndrome," Dr. Narong Simakajornboon and colleagues from Tulane University School of Medicine, in New Orleans, write in the American Journal of Respiratory and Critical Care Medicine.

To examine the effect of maternal smoking on preterm babies, the researchers conducted sleep studies in 16 such infants who were exposed prenatally to smoke and 14 who were not.

The number of apnea episodes in the smoke-exposed infants, at 28.6 per hour, was significantly higher than the 13.2 episodes per hour in the non-exposed group. The difference was observed only for events when breathing was obstructed and only during active sleep.

Babies in the maternal smoking group also showed significantly fewer arousals compared with controls, at 34.5 per hour versus 46.3 per hour, respectively. Arousal specifically after breathing obstruction was also less frequent, at 10.7 percent, versus 29.4 percent.

"The concomitant increase in apneic events and elevated arousal threshold after apnea may result in significant vulnerability in these infants, and could underlie the pathophysiologic mechanism of increased risk of SIDS in preterm infants born to smoking mothers," Simakajornboon's group surmises.

Source: American Journal of Respiratory and Critical Care Medicine, March 15, 2004.

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Nerve Damage Can Be Extensive

 

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- Nerve damage on one side of the body can also affect the other side of the body.

That's what researchers from Massachusetts General Hospital (MGH) found. Their report appears in the May issue of the Annals of Neurology.

The researchers found evidence of this previously unknown link between nerves on opposite sides of the body while doing experiments with rats. When a major nerve was cut in a rat's paw, there was a significant decrease in skin nerve endings in the corresponding area of the rat's opposite paw.

This study may offer important information about the care of people with nerve damage. The study also raises questions about the common practice of using tissues on the opposite side of the body as controls during research.

"Patients with pain syndromes related to nerve damage sometimes report symptoms on the side opposite their injury as well, but those reports are usually discounted because there has been no biological framework for the phenomenon," principal author Dr. Anne Louise Oaklander, director of the MGH Nerve Injury Unit, said in a prepared statement.

"Our evidence means that these reports can no longer be ignored and gives us a new direction for research," Oaklander said.

More information

The American Society for Surgery of the Hand has more about nerve injuries.

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Test Predicts Development of Rheumatoid Arthritis

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - In people who have joint pain, or early "undifferentiated arthritis," those who have detectable antibodies to compounds in the body called cyclic citrullinated peptides (CCPs) are at high risk of developing rheumatoid arthritis within the next three years, Dutch investigators report.

Distinguishing between rheumatoid arthritis and self-limiting joint pain is important, because the treatment of rheumatoid arthritis is not without side effects.

Doctors already use a test for so-called rheumatoid factor to confirm a diagnosis of rheumatoid arthritis. According to Dr. F. A. van Gaalen at Leiden University Medical Center and colleagues, testing for anti-CCP antibodies is more accurate.

Van Gaalen's group identified 936 newly referred patients with joint symptoms that had lasted less than two years, among whom 37 percent were categorized as having undifferentiated arthritis. Among 318 patients with undifferentiated arthritis who were followed for three years, 69 tested positive for anti-CCP antibodies at the beginning of the study.

Overall, 40 percent of the undifferentiated group had developed rheumatoid arthritis after three years, the researchers report in the medical journal Arthritis and Rheumatism. The rate among those positive for anti-CCP was 93 percent, versus 25 percent for those negative for the autoantibodies.

Should testing for anti-CCP replace that for rheumatoid factor in diagnosing rheumatoid arthritis? The authors point out that their study was not designed to answer that question, and that currently anti-CCP tests are more expensive and not as commonly available.

Source: Arthritis and Rheumatism, March 2004.

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Science Closing in on Rare Viral Leukemia

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Thursday, April 1, 2004

THURSDAY, April 1 (HealthDayNews) -- Patients with a rare but deadly form of leukemia linked to viral infection may now have reason for hope. Researchers are hot on the trail of medications that could stop the virus, called HTLV-1, from spreading throughout the bloodstream, according to a new study.

"It's certainly a few years in the future, but I think the results that we are reporting here are the first big steps in that direction," said lead researcher Suzanne Shuker, a professor of biochemistry at the Georgia Institute of Technology, in Atlanta.

The findings were to be reported Thursday at the annual meeting of the American Chemical Society in Anaheim, Calif.

The vast majority of leukemias, which originate in bone marrow, are caused by random mutations in genes, triggered by unknown causes. However, about 40 years ago, scientists discovered that a subset of leukemias affecting the blood's immune T-cells was strongly linked to infection with a virus called HTLV-1. They labeled the illness adult T-cell leukemia.

Experts estimate that about 15 million to 20 million people worldwide carry the HTLV-1 virus, which belongs to the same retrovirus group of infectious agents that includes HIV (news - web sites). Like HIV, HTLV-1 can be spread by sexual contact, intravenous drug use, or contaminated blood transfusions.

"The virus is endemic in four areas of the world," explained Dr. Marshall Lichtman, executive vice president for research and medical programs at the Leukemia and Lymphoma Society. "One is the islands of southern Japan, there's a certain area in the Caribbean islands, in Africa, and the southeastern United States."

Only about 3 percent of HTLV-1 carriers will go on to develop adult T-cell leukemia, which has no effective treatment or cure. Although precise records are unavailable, Lichtman estimates that a few hundred Americans now suffer from the disease.

In their study, Shuker and her team took advantage of research into drugs called protease inhibitors, which since the mid-1990s have been crucial in extending the lives of people infected with the AIDS (news - web sites)-causing HIV.

Protease inhibitors prevent HIV from replicating because they block the activity of an enzyme called protease. In HTLV-1, as in HIV, "the protease is necessary for the virus to make the protein that it needs to be infectious," Shuker explained.

As proteins emerge from the virus, they are cut into smaller segments by protease, which acts like "a pair of scissors," Shuker said.

"We're trying to find something that will block the scissors," she added.

She and her team may already be succeeding. "We're reporting at this meeting on some inhibitors that we just tested last week, and some of them look pretty good," she said.

However, roadblocks remain, and the ultimate goal --- a drug that slows or reverses adult T-cell leukemia -- is still years away. Even after suitable drug candidates are found, "there's the whole [FDA (news - web sites)] approvals process," Shuker pointed out.

Lichtman agreed, describing the research as "in an extremely early stage."

Still, Shuker believes HTLV-1 is "a very important virus to learn about, since there are no treatments and since it can be spread in similar ways to HIV."

And there's a small chance the virus could someday become even more dangerous.

"If the virus were to mutate and become more virulent, it could be a real problem," Shuker said. "So it's certainly important at this stage to try and develop treatments, before there's a larger outbreak, as we've seen with HIV."

More information

To learn more about adult T-cell leukemia and other leukemias, visit the National Cancer Institute and the American Cancer Society.

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Blood Pressure Drugs Differ for Blacks, Whites

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Several types of drugs can lower blood pressure, but some may be better than others for certain people.

Despite producing similar reductions in blood pressure, the beta-blocker drug atenolol (brandname, Tenormin) has advantages over the angiotensin-blocker losartan (Cozaar) for black patients with hypertension and enlargement of the left side of the heart, according to a report in the Journal of the American College of Cardiology.

The finding comes from a trial called the LIFE study that was conducted in several countries, which showed overall that losartan provided better cardiovascular protection than atenolol in a broad population of hypertensive patients.

However, based on an apparent effect of ethnic background in the LIFE study, Dr. Stevo Julius from University of Michigan, Ann Arbor, and colleagues, conducted a new analysis comparing cardiovascular events in black and non-black patients.

They found that white patients had a lower risk of cardiovascular mortality, stroke, or heart attack with losartan, whereas black patients appeared to have a lower risk with atenolol.

The researchers then focused on data from the U.S. arm of the study, where most of the black patients were enrolled.

During the first two years of treatment, outcomes were similar for losartan and atenolol. After four years, however, the cardiovascular event rate for black patients was 15.3 percent in the losartan group, but only 9.7 percent in the atenolol group.

As in the overall LIFE study, blood pressure reductions in black patients were similar with losartan and with atenolol.

"We believe that our finding is sufficiently convincing to generate the hypothesis that black patients with hypertension and (left heart enlargement) might not respond as favorably to losartan-based treatment as non-black patients, with respect to cardiovascular outcomes," the authors conclude, "and that these data do not support a recommendation for losartan as a first-line treatment for this purpose."

Source: Journal of the American College of Cardiology, March 17, 2004.

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Caffeine Ups Blood Pressure in Hard-Core Users Too

 

By Amy Norton

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Even people who would never start the day without their coffee fix may not become tolerant to the blood pressure-raising effects of caffeine, new research suggests.

Although it's still unclear how important caffeine is in contributing to high blood pressure, the new findings suggest that people at risk of hypertension may want to reconsider that second cup of java, researchers say.

The study of 97 adults who regularly consumed caffeine found that half showed small spikes in blood pressure shortly after taking caffeine capsules, even after spending the previous five days downing the equivalent of six cups of coffee per day.

The findings counter the idea that regular caffeine users develop complete tolerance to the stimulant's blood pressure effects, according to researchers.

Dr. William R. Lovallo, with the VA Medical Center and the University of Oklahoma Health Sciences Center in Oklahoma City, and his colleagues report the findings in the journal Hypertension.

Many laboratory studies have shown that caffeine causes a short-term rise in blood pressure, but population studies have failed to definitively link caffeine intake to a higher risk of hypertension. One of the proposed explanations is that in real life, caffeine fiends develop a tolerance to its blood pressure effects.

To test that idea, Lovallo and his colleagues had healthy adult volunteers go through a four-week trial that measured their blood pressure responses to a caffeine "challenge" -- two separate doses of caffeine, given four hours apart, that were each equivalent to two to three cups of coffee.

During one of the study weeks, participants were given placebo pills, which did not contain caffeine, for five days before the challenge tests. On another week, they took pills containing 300 milligrams of caffeine -- about three coffee cups' worth -- each day before challenge testing; and on a third week, they took daily doses of 600 milligrams of caffeine.

The idea was that, if regular users become tolerant to caffeine, participants would show much smaller blood pressure responses to the challenge tests during the caffeine weeks than during the placebo week.

The researchers found, however, that while half of participants were "completely tolerant" to caffeine after taking caffeine capsules for five days, the other half continued to show a blood pressure response. All were regular consumers of caffeine before the study, taking in the equivalent of four to five cups of coffee a day.

The blood pressure responses were small, a matter of a few points on a blood pressure reading. And for most people, according to Lovallo, the minor blood pressure change that may come with a morning coffee is likely harmless.

"For most people, it's probably fine to consume moderate amounts of caffeine," he told Reuters Health.

Where things get more complicated is with people who have a family history of hypertension or have borderline "pre-hypertensive" blood pressure. There's evidence caffeine has a greater blood pressure effect in these individuals, Lovallo said, and they might want to limit their intake.

Dr. Martin G. Myers of the University of Toronto in Ontario, Canada, agreed that moderation is in order when it comes to caffeine.

There is "little evidence," he writes in an accompanying editorial, that drinking two to four cups of coffee a day causes a blood pressure increase of "any clinical importance." He advises that people with or at risk of high blood pressure not consume any more caffeine than that.

"At the moment," Myers writes, "it would seem premature to add moderate caffeine consumption to our list of 'perils of daily living'."

Source: Hypertension, April 1, 2004.

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Gum Inflammation Increases During Ovulation

 

By Alison McCook

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Women who notice higher amounts of gum inflammation during certain times of the month are not imagining things, new research shows.

Investigators found that women tend to have higher levels of gum inflammation while ovulating, and the inflammation tends to decrease during the days before their period, and then fall even further while they are menstruating.

Whether or not these changes in inflammation are significant enough to advise women to brush gingerly or avoid certain foods during certain stages of their menstrual cycles remains unclear, according to Dr. Michael Rethman, practicing periodontist and president of the American Academy of Periodontology, who was not involved in the research.

During the study, Dr. Eli Machtei of the Rambam Medical Center and Technion Faculty of Medicine in Israel and associates followed 15 women between the ages of 20 and 50 who scheduled teeth-cleaning visits several times per year. Each visit coincided with a different point in their menstrual cycles.

As reported in the Journal of Periodontology, gum inflammation fluctuated with the menstrual cycle, but the amount of plaque and other indicators of gum health did not.

Women tended to report more oral discomfort during the days before or while menstruating - right around the time that their gum inflammation was decreasing, note the authors.

In an interview with Reuters Health, Rethman explained that most gum problems produce no symptoms, so many women would likely not notice if their gums had become slightly more inflamed.

He added that some women may simply have a "heightened awareness" of their bodies while menstruating, causing them to report more gum symptoms in the days before and during their periods.

Rethman noted that women's hormones fluctuate over the course of the month, and these dips and peaks may influence gum inflammation through their effects on blood vessels, white blood cells or the immune system.

Source: Journal of Periodontology, March 2004.

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Wrestling Revs Up Immune System in Teens, Study Finds

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - A round on the wrestling mat does more than get young athletes' adrenaline pumping. It also seems to stimulate their immune systems, researchers report.

Although scientists have known that short bouts of exercise stimulate white blood cells in adults, this is the first study to show that exercise has the same effect in healthy adolescent boys.

The "rapid and substantial" response of the immune system after exercise "suggests that stimulation of the immune system often occurs in the lives of children and adolescents and may play a role in its development," researchers report in the British Journal of Sports Medicine.

More and more research suggests that there are "distinct developmental periods" during which exercise and fitness can have a long-term effect on physical development, according to a team led by Dr. Dan M. Cooper of the University of California at Irvine.

Whether or not exercise-related stimulation of the immune system can influence the development of the body's defenses at different stages remains "an enigma," Cooper and his colleagues note.

Cooper's team evaluated the immune effects of exercise in 11 healthy 14- to 18-year-old boys. Blood samples were drawn before and after the boys participated in a 90-minute wrestling practice.

Wrestling exercise triggered a significant increase in levels of several types of white blood cells, Cooper and his colleagues report. So-called natural killer cells, which play a crucial role in the body's first line of defense against outside invaders, surged the most, according to the report.

The researchers also found that the level of immune stimulation was related to exercise intensity. However, what role these exercise-related changes play in the overall development of the immune system is not yet understood.

Source: British Journal of Sports Medicine, April 2004.

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Mild Iron Deficiency May Drain Endurance, Study Finds

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Some women who are short on iron may be short on endurance as well, even when they do not have full-blown anemia, new study findings suggest.

On the bright side, researchers report, getting enough iron may help right the problem.

Their study of 41 women who were moderately iron deficient found that iron supplements helped boost fitness among those with more depleted iron stores in their body tissue.

Thomas Brownlie and his colleagues at Cornell University in Ithaca, New York, report the findings in the American Journal of Clinical Nutrition (news - web sites).

Iron-deficiency anemia occurs when the body has too little hemoglobin, an iron-containing protein in red blood cells that carries oxygen. Anemia is well known to cause fatigue, pale skin and breathlessness during exercise, but the effects of less severe iron deficiency are not as clear.

Animal studies have suggested it can sap endurance, but human studies have not consistently shown this, according to Brownlie's team.

To study the question, the researchers looked at whether iron supplements would help modestly iron-deficient women get more out of exercise training. They had 41 iron-depleted -- but not anemic -- women between the ages of 18 and 33 take either iron supplements or placebo pills for six weeks. All of the women spent the last four weeks of the study training on stationary bikes five days a week.

Brownlie and his colleagues also looked specifically at a measure called serum transferrin receptor (sTfR) concentration, which indicates the iron status of the body's tissues. A higher concentration means greater iron deficiency in the tissue.

The researchers found that iron supplements appeared to help women with signs of "overt" tissue iron depletion make greater fitness gains during their exercise regimen.

In contrast, the supplements provided no fitness benefit to women with normal sTfR levels, who improved their endurance regardless of whether they took iron or not. This suggests that their degree of iron depletion had not been limiting their endurance in the first place, according to the Brownlie's team.

The findings also indicate that a person's sTfR levels can help distinguish diminished iron levels from a more problematic iron deficiency, the researchers note. If iron depletion is impairing fitness, they conclude, supplements may help correct the problem.

Iron supplements can, however, cause side effects such as abdominal pain, nausea, constipation and diarrhea, and experts advise consumers to consult a doctor before taking iron supplements.

They also recommend that people look at their diets before turning to pills; good food sources of iron include red meat, lentils and other legumes, spinach and iron-fortified cereals and grains.

The current study was partially funded by a grant from Mead Johnson Nutritionals, a Bristol-Myers Squibb company that makes dietary supplements.

Source: American Journal of Clinical Nutrition, March 2004.

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Gene Works with Pesticides to Up Parkinson's Risk

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Previous reports have suggested that exposure to various pesticides raises the risk of Parkinson's disease (news - web sites). Now, new research indicates that the risk is even higher in patients with a certain gene variant.

In the body, many pesticides are broken down and made less toxic by an enzyme called cytochrome P450 D6 (CYP2D6). A certain variant in the CYP2D6 gene has been shown to produce an enzyme that is less effective at breaking down pesticides. As a result, people with this variant may be more susceptible to pesticides that might cause Parkinson's disease.

The findings, which are reported in the Annals of Neurology, are based on a study of 247 Parkinson's disease patients and 676 healthy subjects enrolled in the French health insurance organization for farmers and related job classes. DNA from subjects in both groups was tested for the CYP2D6 variant.

Consistent with previous reports, Dr. Alexis Elbaz, from Hopital de la Salpetriere in Paris, and colleagues found that pesticide exposure increased the risk of Parkinson's disease, even in people without the gene variant. No elevated risk of Parkinson's disease was seen in people not exposed to pesticides, even if they had the variant.

The highest Parkinson's disease risk occurred in pesticide-exposed subjects who had no normal copies of CYP2D6, only variants, the authors note. Compared with other exposed patients, such patients were 2.4-times more likely to have Parkinson's disease.

"Larger studies and laboratory data may help to elucidate which pesticides are metabolized through (the CYP2D6) pathway and have an effect on the risk of Parkinson's disease," the investigators conclude.

Source: Annals of Neurology, March 2004.

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Military Service in Iraq Tied to Parasite Disease

 

Reuters Health

Thursday, April 1, 2004

NEW YORK (Reuters Health) - Between 2002 and 2004, Department of Defense (news - web sites) staff identified 522 cases of cutaneous leishmaniasis, a parasite infection of the skin, in US military personnel deployed in Iraq (news - web sites) and elsewhere, according to a report released Thursday.

In a related report, researchers describe two case of visceral leishmaniasis, a gastrointestinal form of the disease, involving Army soldiers who had served in Afghanistan (news - web sites).

The reports appear in the Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention (news - web sites).

Both types of leishmaniasis are spread through the bite of sand flies carrying the parasite. If not treated with appropriate drugs, the skin form can lead to permanent scars, while the visceral type can be fatal. People traveling to regions where leishmaniasis is common, such as Southwest/Central Asia, are advised to wear clothes and use chemical repellants that keep sand flies at bay.

The first report focused on 361 cases of cutaneous leishmaniasis for which demographic data were obtained during treatment at the Walter Reed Army Medical Center in Washington, DC.

Nearly all of the patients were male and 76 percent were of non-Hispanic white ethnicity. The patients ranged in age from 18 to 57 years. Based on deployment histories, almost all of the infections were acquired in Iraq with just a few acquired in Afghanistan and Kuwait.

Although skin lesion onset was reported between May 2002 and January 2004, nearly 80 percent of the lesions arose between August and November 2003.

According to the report, the Department of Defense is implementing several measures to reduce the risk of leishmaniasis among personnel in Southwest/Central Asia. These measures include improving living conditions for personnel, increasing awareness about leishmaniasis in the region, and emphasizing the importance of anti-sand fly measures.

The visceral leishmaniasis cases involved two previously healthy men in their 30s who had served in the same Special Forces unit of the Army and had traveled extensively throughout Afghanistan. In both cases, symptoms did not begin until several months after leaving the country. Although both had taken measures to prevent sand fly contact, multiple insect bites were noted in each case.

Both men developed classic signs and symptoms of visceral leishmaniasis, although these findings can be seen with other diseases. After ruling out other causes, visceral leishmaniasis was diagnosed and then confirmed with a biopsy of the liver.

Anti-leishmaniasis treatment was successful in one patient, whereas the other had a recurrence of symptoms and is currently receiving a 28-day course of stibogluconate, an investigational drug for the disease.

Source: Morbidity and Mortality Weekly Report, April 2, 2004.

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Wednesday, March 31, 2004

 

Nine Million U.S. Children Have Had Asthma

 

Reuters

Wednesday, March 31, 2004

WASHINGTON (Reuters) - Nine million U.S. children have had asthma at some point in their lives, and more than 4 million have had an asthma attack in the past year, according to federal statistics published on Wednesday.

Twelve percent of all U.S. children under the age of 18 have been diagnosed with asthma, according to the report from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (news - web sites).

But 14 percent of boys have been diagnosed, compared to 10 percent of girls. And 16 percent of children in poor families have had asthma, compared to 11 percent of children living above the poverty line.

The study also finds that almost 5 million children between the ages of 3 and 17 had been identified with a learning disability, and almost 4 million had been identified with Attention Deficit Hyperactivity Disorder (ADHD).

"Boys were more than twice as likely as girls (10 percent versus 4 percent) to have been identified with ADHD," the NCHS said in a statement.

The report also said that in 2002 nearly 10 million U.S. children had to take regular prescription medication for at least three months.

"Fifteen percent of boys were on regular medication compared with 12 percent of girls, and non-Hispanic white children and non-Hispanic black children were more likely to have been on regular medication than Hispanic children," the NCHS said.

According to the report, which can be found on the Internet at http:// www.cdc.gov/nchs, a quarter of U.S. children between 5 and 17 missed no school due to illness or injury in the past year. Six percent of children missed 11 or more days of school because of sickness or injury.

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Botanicals Might Ease Menopause Symptoms

HealthDayNews

Wednesday, March 31, 2004

WEDNESDAY, March 31 (HealthDayNews) -- Volunteers are needed for a one-year study to test the effectiveness of two herbal products -- black cohosh and red clover -- in relieving menopausal symptoms.

The study will also examine the safety of these products when used for an extended period of time.

The study will be conducted by researchers at Northwestern Memorial Hospital in Chicago, in collaboration with researchers at the UIC/NIH Center for Botanical Dietary Supplement Research in Women's Health, and Northwestern University. The study is being sponsored by the U.S. National Institutes of Health (news - web sites) and the National Center for Complementary and Alternative Medicine.

"Our goal is to determine the role of botanicals in the management of menopause. Furthermore, we will test their ability to relieve additional menopausal symptoms, such as insomnia, mood disturbances and sexual problems," Dr. Lee Shulman, chief of the division of reproductive genetics at Northwestern Memorial Hospital, says in a prepared statement.

Black cohosh and red clover are plant-based dietary supplements that act much like female hormones in the body.

"Many women already use these products for the relief of menopausal symptoms; however, studies have not yet been conducted to show these botanicals should replace hormone replacement therapy (HRT) as the first line of treatment for the short-term relief of hot flashes," Cate Stika, chief of the division of obstetrics and gynecology at Northwestern Memorial Hospital, says in a prepared statement.

"This study is particularly important in light of the confusion surrounding the use of HRT. Many women are asking about alternatives and we need to be able to provide a solid, evidence-based response," Stika says.

To be eligible for the study, participants must meet the following requirements:

Women interested in taking part in the study should phone Northwestern Memorial Hospital at 312-926-8400.

 

More information

 

The U.S. National Institute on Aging has more about menopause.

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Study Questions Value of Inflammation Test

 

By Stephanie Nano

Associated Press Writer

The Associated Press

Wednesday, March 31, 2004

A large new study casts doubt on one of the hottest ideas in the field of heart disease — that inflammation levels in the bloodstream are a powerful predictor of heart attacks.

The report in Thursday's New England Journal of Medicine (news - web sites) questions the value of a blood test already routinely used by some doctors to measure inflammation. And it challenges year-old recommendations from the U.S. government that doctors consider the test for some patients.

The researchers said their findings suggest that inflammation is only a moderate predictor of heart disease, less than some studies have indicated. They concluded that the test does not add much beyond other risk factors such as high cholesterol, high blood pressure and smoking.

"There's no good scientific reason to be using it as a predictive test," said Dr. John Danesh, one of the British researchers at the University of Cambridge.

But a key U.S. researcher in the field contends that the findings are not all that different from other studies that support the test, which he thinks should be used more widely, not curtailed.

"My concern is that even in the face of overwhelming evidence that this inexpensive blood test works, we are at risk of moving backward rather than forward," said Dr. Paul Ridker of Harvard's Brigham and Women's Hospital in Boston.

Doctors can screen for low-level inflammation in the bloodstream by testing for C-reactive protein, or CRP, which fights infection. The painless inflammation can come from minor infections or irritations somewhere in the body.

Many expert believe chronic inflammation can weaken the walls of arteries, causing fatty buildups to rupture and trigger heart attacks.

At issue is whether high CRP alone is a strong risk factor for heart disease. The British researchers do not think so, while Ridker believes it is as important as high cholesterol and can spot people who have no other signs of heart disease.

In the latest research, Danesh and his colleagues used data from an Iceland study of heart disease that began in 1967. They compared 2,459 people who had a heart attack or died of heart disease over 20 years of follow-up with 3,969 participants who did not have a heart attack. Frozen blood samples were tested for CRP levels.

The researchers calculated that those with higher levels of CRP had a 45 percent increased risk of heart disease compared with those with the lowest levels. The researchers also analyzed 22 studies on the topic and found that patients with higher CRP levels had a 50 percent higher risk of heart disease.

That is far less than the early studies indicated. Eleven of the 22 studies analyzed were done before 2000, and together they showed a 100 percent increase in risk, or a doubling of the danger, the researchers said.

"It's a cautionary tale about how high the bar really needs to be before we roll out scientific advances into the community and into the clinic," Danesh said.

The researchers said their findings suggest that the recent recommendations for CRP testing may need to be reviewed. A co-author of the guidelines, however, defended them.

Dr. Thomas Pearson of the University of Rochester said the panel noted the weakness of the evidence and urged further study when it drew up the guidelines. He said the panel members were criticized as "way too conservative, stodgy and sticks-in-the-mud" by those who wanted more widespread testing.

"I think this is validating our conservatism," he said.

The guidelines, issued last year by the Centers for Disease Control and Prevention (news - web sites) and the American Heart Association (news - web sites), do not support testing for everyone. They give doctors the option of testing those judged to be at 10 percent to 20 percent risk of heart disease, based on such factors as age, high cholesterol and high blood pressure.

Since then, many doctors have begun routinely screening patients for CRP.

Ridker said the Iceland study used a lower CRP level than his studies to determine risk in the highest group, which could account for the lower findings.

He is now studying whether using cholesterol-lowering statin drugs to bring down CRP levels in patients is beneficial. Diet and exercise can also lower CRP.

On the Net:

New England Journal: http://www.nejm.org

American Heart Association: http://www.americanheart.org

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Extra Pounds Increase Chances of Kidney Stones

HealthDayNews

Wednesday, March 31, 2004

WEDNESDAY, March 31 (HealthDayNews) -- The more overweight a person is, the more likely he or she will have kidney stones, says a University of Texas Southwestern Medical Center study in the April issue of Kidney International.

This is the first study to identify a direct link between excess body weight and uric acid kidney stones, which occur in about 5 percent of kidney-stone patients and in about 30 percent of diabetics with kidney stones.

"This is yet another price to pay for being overweight or obese," Dr. Khashayar Sakhaee, a professor of internal medicine and program director of the General Clinical Research Center (GCRC) at UT Southwestern, says in a prepared statement.

Kidney stones form when waste materials in urine do not dissolve completely. Starting as microscopic particles, they eventually grow into kidney stones, which remain in the kidney or break loose and travel down the urinary tract.

Sakhaee and his colleagues tracked about 5,000 kidney-stone patients in Dallas and Chicago. They found that overweight and obese people were more likely to develop kidney stones, even if they restricted the types of food they ate. The results were the same for men and women.

"Larger people have very acidic urine even when they control their diets. Other studies we have done in the GCRC support this concept. For the first time, we are advising weight loss as part of our therapy. That connection had not been made in the past," Sakhaee says.

More information

The American Foundation for Urologic Disesase has more about kidney stones.

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Child Vaccinations Do Not Cause Diabetes, Study Says

Reuters

Wednesday, March 31, 2004

BOSTON (Reuters) - Routine childhood vaccinations do not increase the risk of developing diabetes, according to a study of more than 700,000 Danish children.

The study, led by Anders Hviid of the Statens Serum Institute in Copenhagen, looked at all Danish children born from 1990 through 2000 and found that diabetes rates were not higher regardless of what types of vaccines were administered.

"The study will, one hopes, be the last one that is necessary to disprove an association between immunization and diabetes," said Dr. Lynne Levitsky of Massachusetts General Hospital.

In an editorial in the New England Journal of Medicine (news - web sites), where the study appears, Levitsky said researchers "should now move on to the most important tasks" of finding what actually causes the blood sugar disease and, perhaps, a way to prevent it.

In addition, the study found siblings of children who had diabetes -- and were therefore more likely to develop the condition themselves -- were not more likely to become diabetics if they were vaccinated.

The Hviid team also looked to see if the vaccinations increased the risk of diabetes two, three or four years later in life. They found it did not.

The fact that doctors are doing a better job of getting children immunized against a dozen often-serious diseases had prompted speculation vaccines might contribute to the growing incidence of childhood diabetes.

But there is already evidence from previous studies that a yet-to-be-discovered environmental factor makes the body stop producing the insulin it needs to process blood sugar.

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West Nile Virus Could Hit California Hard

 

HealthDayNews

Wednesday, March 31, 2004

WEDNESDAY, March 31 (HealthDayNews) -- California is likely to experience many more cases of West Nile virus (news - web sites) this year, predicts University of California, Davis, entomologist John D. Edman, director of the university's Center for Vectorborne Diseases.

He expects West Nile to erupt in Southern California this summer and spread to northern areas of the state. Edman notes that, despite efforts at control, there's a large mosquito population in California.

The first in-state West Nile virus infections of humans in California were confirmed last year. Those three cases were in the Los Angeles area.

"If what's happened in other places is indicative, we'll see (West Nile) first reappear in Southern California. And I think it'll make it over the Tehachapis this year. If this happens, we'll likely have a lot more human cases," Edman says.

The Tehachapis Mountains form a natural barrier between Southern California and the rest of the state. Migrating crows and other birds will likely carry the virus over that range, Edman says.

He described efforts to track and contain the West Nile virus in North America during a presentation March 31 at the national meeting of the American Chemical Society in Anaheim, Calif.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has more about West Nile virus.

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Study: SARS Vaccine Shows Promise in Mice

 

By Alicia Chang

Associated Press Writer

The Associated Press

Wednesday, March 31, 2004

An experimental SARS (news - web sites) vaccine protected mice against the respiratory illness that killed nearly 800 people worldwide last year, but a safe and effective vaccine for humans is probably still a long way off.

Results published in Thursday's issue of the journal Nature show the vaccine triggered an immune response in the mice and dramatically reduced the level of the virus in the lungs of inoculated mice.

But researchers at the National Institute of Allergy and Infectious Diseases (news - web sites), which developed the gene-based vaccine, said more experiments are needed to determine if it will work in humans.

Scientists not involved in the study called the results promising, but noted that DNA vaccines have not yet been shown to effectively treat any viral disease, and the approach is still unproven compared to conventional vaccines.

"I don't think it's a home run," said Dr. Robert Brunham, director of the University of British Columbia Centre for Disease Control in Canada.

Canada's tourism industry was devastated last year after more than 40 people in the Toronto area died from SARS infection. The SARS outbreak sickened more than 8,000 people worldwide, and at least 774 died.

SARS, or severe acute respiratory syndrome, emerged in southern China in late 2002 and spread to more than two dozen countries on four continents before it was contained last summer.

Earlier this year, China approved plans to test an experimental SARS vaccine in human clinical trials. The vaccine, made from a dead virus, had been shown to work in animals.

Vaccines are normally made from killed or weakened viruses and work by mobilizing the body's immune system to build defenses by showing it what the targeted virus looks like. That approach is used every year to develop flu shots to combat emerging strains of influenza.

But the SARS vaccine was made from a small piece of genetic material from the virus called a plasmid. It biochemically locks onto a specific protein on the outer surface of the virus. This alerts the body's immune system to launch a counterattack against the invading virus.

Scientists tested two versions of the DNA vaccine in 15 mice over a six-week period. The vaccines differed in how much genetic material scientists removed from the original piece of DNA. Both worked, although one appeared to be more effective than the other.

Dr. Gary Nabel, chief of the NIH Vaccine Research Center and the study's lead author, said the government is working with San Diego-based Vical Inc. to make a purified vaccine for human testing pending approval from the Food and Drug Administration (news - web sites).

Last May, two research teams separately published the genetic sequences of the SARS virus in an effort to find drugs to treat SARS or develop a vaccine to prevent it.

Civet cats and other mongoose-like animals that are sold in live food markets in southern China are suspected of spreading SARS to humans, although the original source of the virus has not been determined.

On the Net:

Nature journal: http://www.nature.com

Vaccine Research Center: http://www.niaid.nih.gov/vrc

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Spotting Scoliosis

 

HealthDayNews

Wednesday, March 31, 2004

(HealthDayNews) -- Scoliosis occurs when the spine begins to curve abnormally. It's more common in girls than boys and tends to strike in early adolescence.

The condition rarely causes pain or discomfort, but without treatment a child's appearance can be permanently disfigured, according to the Children's Medical Center of Akron.

Doctors often spot scoliosis during routine physical exams, but parents should also learn its warning signs:

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Protein Is Poor Predictor of a Heart Attack –Study

 

Reuters

Wednesday, March 31, 2004

BOSTON (Reuters) - Testing patients for high levels of chemicals called C-reactive protein to determine whether they are at risk for heart disease provides little new information to doctors, according to a study in the New England Journal of Medicine (news - web sites).

Researchers found that checking for the traditional indicators of heart problems such as high blood pressure, high cholesterol and smoking remain more reliable.

The C-reactive protein is believed to reflect inflammation, which may play a role in the development of heart disease.

Looking for the protein "adds little to the predictive value of standard coronary risk factors," the study said.

John Danesh of the University of Cambridge in Britain, tested 2,459 blood samples of heart patients or people who died of heart disease from Reykjavik, Iceland.

When their levels of C-reactive protein were compared to those of almost 4,000 volunteers who did not suffer from heart problems, he concluded the test was only "a relatively moderate predictor of coronary heart disease."

The U.S. Centers for Disease Control and Prevention (news - web sites) and the American Heart Association (news - web sites) recently told doctors it was "reasonable" to check C-reactive protein levels in patients to assess the risk of heart disease.

Danesh and his colleagues said groups that recommend the test should rethink their advice.

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When to Banish Birthmarks

HealthDayNews

Wednesday, March 31, 2004

(HealthDayNews) -- Some birthmarks originate in a blood vessel and are pink or purple in color. Others are brown, black or tan and are commonly called moles.

While most birthmarks are harmless, St. Louis Children's Hospital recommends a birthmark be removed if there is a strong family history of melanoma skin cancer or if the mole:

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Personal Chefs Meet Healthy-Eating Need

By Chuck Brown

Associated Press Writer

The Associated Press

Wednesday, March 31, 2004

LINCOLN, Neb. - Rod and Debbie Basler wanted to follow the South Beach Diet, but their work lives made it impossible to shop and cook for it.

With his dermatology practice and their three restaurants, the Baslers had no time for the meticulously structured meal plans that asked them to weigh, measure, bake and grill.

Enter Shalla Powell, a longtime family friend whom they hired as personal chef. At $30 an hour, she prepares three days' worth of lunches and dinners that conform to the South Beach Diet's low-fat, low-carb regimen.

Change came quickly, especially for Rod who dropped 14 pounds in two weeks. Debbie lost only 2 pounds, but said she noticed an increase in her energy level.

"You always feel better when you eat better," she said.

A growing number of culinary professionals are leaving restaurant and hotel kitchens and answering the call to provide healthier meals for well-to-do American families living life in a pressure cooker.

Between 9,000 and 10,000 personal chefs were working in the United States as of last April, compared to about 6,000 in 2001.

The typical chef does the shopping and prepares between two weeks to a month's worth of dinners at a client's home. The meals are properly stored and left with heating instructions.

Bob Stock, a physicist at the Massachusetts Institute of Technology (news - web sites), figures having his own chef makes sense because it costs him about as much as eating out regularly. He spends about $3,600 a year for a plan that offers five dinners a week, which averages about $14.30 for each dinner.

The national average for a typical plan is roughly $75 per person each week, said Candy Wallace, founder and executive director of the American Personal Chef Association.

Chefs who once catered primarily to professional athletes and people with special dietary needs are finding an expanding client pool.

"The bulk of our client base are two-income busy people who want to eat something that's healthy," Wallace said. "We basically have people tell us, 'We don't have time to take care of ourselves.'"

With the stress of preparing meals for busy restaurants and hotels, chefs are no different from other busy professionals, and many want a chance to be their own boss.

"Those with an entrepreneurial spirit ... have a little bit more control in that sense," said Wendy Higgins, assistant director of career services at the Culinary Institute of America.

Wallace said the average personal chef earns between $60,000 and $75,000 a year.

For Dane Mechlin, owner of Dane and Nadine's, a personal chef service in California's Silicon Valley, there have been financial and personal gains.

"I'm making more money, I work less hours, I take more vacations," he said.

Before he made the switch to personal chef about five years ago, Mechlin spent 15 years working in restaurants, hotels and on private yachts. That meant precious little time with his then-girlfriend.

"I am either going to never see my girlfriend," Mechlin said, describing his thought process, "or I need to come up with something."

He moved to Santa Clara in the midst of the dot-com boom, building a list of clients that included high-ranking executives of technology companies. He also started offering a less-expensive service to middle-income families.

When the economy weakened and his wealthy clients disappeared, he said the two-income families kept his business afloat. While his services were a luxury to high-end clients, his meals were a necessity for working parents.

"Here I thought I was dealing with a client that was immune from money problems," Mechlin said. "(But) it was the client that really needed me that kept me through the tough times."

The service has grown fast on both coasts, Wallace said, but has been slower to catch on in the Midwest, where the attachment to traditional family structure is stronger.

"Mom cooks and that's the way it's going to be," Powell said.

The Baslers are currently Powell's only clients, but she hopes to build from that base.

"It's hard right now in this part of the country," she said. "But I think it's changing."

Debbie Basler notices the look of intrigue in the faces of friends when they hear she has a personal chef.

"It's really not that different from having a cleaning lady," she said. "She improves the quality of my life."

On the Net:

American Personal Chef Association: http://www.personalchef.com

U.S. Personal Chef Association: http://www.uspca.com

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U.S. Regulators OK Walnut Health Claims

By Susan Heavey

Reuters

Wednesday, March 31, 2004

WASHINGTON (Reuters) - There is limited evidence that walnuts can reduce the risk of heart disease -- but there is enough information for food companies to say so on their packages, U.S. regulators said on Wednesday.

The decision marks the first time the Food and Drug Administration (news - web sites) has given final approval for food companies to list supported, but not definitive, evidence on the health claims of their products.

"While this research is not conclusive, the FDA believes that consumers will benefit from having information that may help them improve their dietary health," Acting FDA Commissioner Lester Crawford said.

But consumer groups say such unsubstantiated claims are unnecessary and can confuse the public, which they complain is already bombarded by nutritional information.

"The FDA's conclusion begs the question -- why permit the claim at all if there is only very limited, preliminary evidence," said Bruce Silverglade, head of legal affairs for the Center for Science in the Public Interest.

The non-profit group, along with consumer watchdog Public Citizen, sued the FDA last fall, saying the qualified claims violate the law. The suit is pending in federal court, Silverglade said.

In the walnut decision, the FDA will permit companies to state on packages of chopped and whole walnuts that "supportive but not conclusive research" shows eating 1.5 ounces (42 grams) of the nut each day could help fight heart disease.

The claim will also say walnuts must be part of a low saturated fat and low cholesterol diet, and not result in eating too many calories, the FDA said.

Previously, the FDA banned food producers from making health claims about products unless the agency decided they were conclusive.

Under rules announced last year, language for "qualified" claims will vary depending on how much scientific support they have. A panel of experts evaluates proposed claims, which are categorized based on the amount of data available.

The FDA allowed a similar health claim last year for various nuts -- including walnuts -- on a provisional basis as part of a separate process, officials said.

Other pending applications include claims involving omega-3 fatty acids, green tea and calcium.

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Many Not Having Mammograms Under Medicare

By Melanie S. Welte

Associated Press Writer

The Associated Press

Wednesday, March 31, 2004

DES MOINES, Iowa - Six years after Medicare began paying for an annual mammogram for women over 40, only 51.8 percent of the eligible women over 50 had at least one mammogram in 2001 or 2002, according to the federal Centers for Medicare and Medicaid Services. That translates to about 7.6 million women nationwide.

The numbers suggest older women may be misjudging the value of regular breast cancer screenings.

Two mammograms within 10 months in 1994 cleared Lorna Johns of breast cancer so she decided to skip the X-ray the following year.

"That was wrong," she said. "That was the one I shouldn't have skipped."

She was 68 when her doctor discovered a lump during a 1996 exam. A lumpectomy soon followed, then radiation therapy to help rid Johns of one of the most commonly diagnosed cancers in women.

"There's a perception, that's probably wrong, that breast cancer is a disease of young women (under 50). It's not, it's a disease of older women," said Dr. Stephen Taplin of the National Cancer Institute (news - web sites).

Thirty million mammograms are done each year in the United States. The breast X-ray has long been considered the best way to detect breast cancer, which strikes about 200,000 women a year and kills 40,000 of them.

In recent years scientists themselves may have sown doubt among women about whether an annual mammogram is any better than getting one every other year.

Taplin, however, said no study has compared the two intervals, and there is insufficient evidence to support annual over biennial mammography. "Every one or two years is not the issue. Women who are not being screened at all are the ones who are at risk of having poor outcomes," he said.

Mammography rates for Medicare-eligible women over 50 are inching up at a snail's pace, and in some states not moving at all, according to the Centers for Medicare and Medicaid Services, which run the Medicare and Medicaid programs.

Figures from the Iowa Foundation for Medical Care, which tracks Medicare claims in the state, show 52.7 percent of Medicare eligible women over 50 had a mammogram in 2001 or 2002. That rate has remained stagnant for the past five years.

Johns was part of a women's health study at the University of Iowa in 1994 and had two mammograms — one by the university, the other ordered by her doctor.

"I had two in a short time and I thought, 'I won't have one this year,'" she said.

Luckily, the cancer was found before it spread and became life-threatening. But the diagnosis meant that for five years after surgery she was on the drug tamoxifen, which slows or stops the growth of new breast cancer cells. She has remained cancer-free.

For 75-year-old Betty Grandquist, of Des Moines, a routine mammogram in 2002 found breast cancer.

"By getting it that early, it was not in the lymph nodes, so they could do a lumpectomy," she said.

The American Cancer Society (news - web sites) recommends a yearly mammogram for women starting at age 40.

On average, mammograms find about 75 percent of cancers, said Debbie Saslow, the society's director of breast and gynecological cancer. Five-year survival rates for early detection, before the cancer spreads to the lymph nodes, are between 96 percent and 97 percent, she said.

Most breast cancer risk is tied to a woman's lifetime exposure to estrogen, Saslow said.

"The older you get, the more, of course, you've had," she said. "But after menopause, things change a lot and post-menopausal breast cancer is much more common than pre-menopausal breast cancer."

In Florida, from April 2001 to March 2003, 64 percent of Medicare-eligible women aged 50 to 67 received a mammogram, a rate unchanged since 1999.

"The numbers are not great, but the fact that we can't move those numbers, that's what has us worried and trying to figure out what we need to do," said Bonnie Mason of Florida Medical Quality Assurance in Tampa, which examines Medicare claims.

Mason said the group has worked with doctors, distributed mailings and articles, and held outreach programs, health fairs and exhibits at conferences.

"Aside from bribery, I don't know what we need to do," she said.

Health officials in New Mexico might have found an answer.

The New Mexico Medical Review Association combined an aggressive media campaign targeting older women with one involving doctors and radiologists, along with reminder phone calls.

One tool doctors use is a string of beads to help patients visualize the size of lumps. The smallest bead, about the size of a baby pea, represents a lump that can be detected by regular self-exams, a mammogram and a doctor's exam; the largest, at 1.5 inches in diameter, or about the size of a golf ball, is the size that a woman might discover by chance.

The success of the campaigns has driven up the state's mammography rates among women aged 52 to 69 in the last three years — from 55.7 percent to 60 percent.

The Iowa foundation plans to work with about 2,000 physicians to encourage their patients to get a mammogram.

Grandquist understands women's fear of learning the worst, especially women her age.

"If someone had breast cancer, it was a death sentence. So they don't want to deal with it," she said. "(But) you have to get over the fear factor. It's how early you get it, the better chances of survival."

Johns, who doesn't skip her annual mammograms any more, has launched her own campaign about the importance of regular screenings.

"I feel good. And my friends have all had their mammograms," she said.

On the Net:

Medicare Mammography Campaign: http://www.cms.hhs.gov/preventiveservices/1.asp

American Cancer Society: http://www.cancer.org

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Tuesday, March 30, 2004  

 

Acetaminophen May Raise Asthma Risk

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Frequent use of the popular painkiller acetaminophen may increase your risk for developing asthma, a new study suggests.

Women taking acetaminophen at least 15 days a month for six years had a 63 percent higher incidence of developing asthma, compared with women who never used the analgesic, researchers say.

However, it's far too early to recommend that consumers shy away from using acetaminophen, the researchers add. Individual reactions to various pain relievers vary widely and "we are not trying to say that all asthmatics should stop using acetaminophen," says study author Dr. R. Graham Barr, of Columbia University.

His team's findings appear in the current issue of the American Journal of Respiratory and Critical Care Medicine.

Soaring rates of asthma across the United States have alarmed public health officials and puzzled asthma experts.

"People estimate that between the 1970s and 2000, at least in younger children, asthma cases approximately doubled," says Dr. Susan Redline, an asthma expert at Rainbow Babies and Children's Hospital in Cleveland.

However, the exact cause of this steep climb in asthma rates remains unclear. Rising rates of obesity -- which can impair lung function -- have been cited as a possible culprit, as have indoor pollutants such as dust mites and mold.

But the upswing in new asthma cases also coincided with the increasing popularity of over-the-counter acetaminophen, the study researchers note. An estimated 200 over-the-counter drugs, including cold and headache remedies, contain acetaminophen, according to the American Medical Association. One of the best known is Tylenol.

In their study, Barr and his colleagues examined data from the Nurses Health Study, a decades-long, prospective study of nearly 122,000 adult women. As part of the study, each participant was asked to keep a record of her analgesic use as well as the development of any new medical conditions, including asthma.

Among women who used acetaminophen for more than half of the days in a given month, "there was a significant increase (63 percent) in the risk of a new diagnosis of asthma," Barr says. The design of the study prevented researchers from determining whether acetaminophen was linked to worsening symptoms in women already diagnosed with asthma.

Scientists have long known that acetaminophen lowers blood levels of a natural compound called glutathione. "Glutathione has an antioxidant effect in the body, particularly in the lungs," Barr explains. When glutathione levels plummet, "that may reduce the antioxidant defenses in the body and increase the possibility of developing asthma."

However, the current study only demonstrates an association between acetaminophen and increased asthma -- not a cause-and-effect relationship. And Barr notes that other analgesics such as aspirin, ibuprofen and non-steroidal anti-inflammatory drugs (such as Celebrex and Vioxx) have also been shown to affect asthmatics in various ways.

"For example, it has been well described that some people get asthma from taking aspirin, but then a lot of people with asthma do fine taking aspirin," he says.

Barr's advice: "If individuals happen to notice that their asthma gets worse after they take aspirin or non-steroidals, or acetaminophen, it's worth reassessing that usage. But we're not making any blanket statements."

Redline, an editor at the American Journal of Respiratory and Critical Care Medicine, agrees. "Until we have more information, I think people with uncontrolled asthma should just continue to discuss the issue with their doctors," she says.

More information

For information on asthma and the control of asthma symptoms, visit the Asthma and Allergy Foundation of America or the American Academy of Allergy, Asthma & Immunology.

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American Kids, Parents Lack Sleep, Survey Finds

 

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, March 30, 2004

WASHINGTON (Reuters) - Most American children are not getting enough sleep and television and caffeine are helping keep many awake at night, the National Sleep Foundation said on Tuesday.

A survey of 1,400 parents showed that many are not aware of how much sleep their children need and may not realize that TV and caffeine can affect their child's sleep.

"Parents are paying a price for their children's poor sleep habits," Jodi Mindell, a director of the foundation and associate director of the Sleep Disorders Center at the Children's Hospital of Philadelphia, told a news conference.

"The majority of parents are being awakened at least one night a week by their children."

At the same time, researchers told a conference at the National Institutes of Health (news - web sites) that Americans need guidelines on how to get more sleep.

"The depth and breadth of sleep problems is not fully appreciated in this country," said U.S. Surgeon General Dr. Richard Carmona. "Chronic sleep loss and untreated sleep disorders have a profound impact on Americans of all ages -- they affect 70 million Americans and cost our nation $15 billion in health care expenses."

Dr. Carl Hunt, director of the National Center on Sleep Disorders Research, said the research shows that sleep disorders are common but people do not yet realize it.

"We need to define some better ways to get the message out to people," Hunt said in an interview. "It's not just a matter of 'you ought to sleep more' but why they ought to sleep more."

Dying To Get Some Sleep

Hunt said lack of sleep can be dangerous, just like high cholesterol or high blood pressure.

"We do know that it can kill you," he said. "A lack of sleep has major implications for accidents -- not only workplace accidents but highway accidents."

The Sleep Foundation said its survey showed 30 percent of all children aged 1 to 10 wake at least once a night and need attention, which then affects their parents' sleep.

The poll found 26 percent of children aged 3 or older drink at least one caffeinated beverage a day, including sodas or iced tea. Those children slept a half-hour less each night than those who did not drink caffeine.

The survey also found many children have a television in their bedroom. Parents said 43 percent of school-aged children had their own TV sets, as did one third of young children aged 3 to 5 and 20 percent of infants and toddlers.

According to the poll, children with TV sets went to sleep 20 minutes later than those without and slept on average 9.2 hours a night compared to 9.6 hours a night -- "a loss of more than two hours of sleep a week," the foundation said.

The result can be cranky children who are not learning as well as they should, the group said.

"Parents need to make sufficient sleep a family priority," said Mindell, adding that bedtime routines should exclude TV and include a reading a story.

The poll found that infants aged 3 to 11 months slept only 12.7 hours a day on average, although they need 14 to 15 hours. Toddlers aged 1 to 3 slept 11.7 hours but they need 12 to 14.

Preschoolers up to 5 slept 10.4 hours a night on average although they are supposed to get 11 to 13 hours and children up to age 10 slept 9.5 hours although they need 10 or even 11 hours a night.

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Strides Taken Toward Diabetes Prevention

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Scientists are zeroing in on proteins that contribute to the destruction of insulin-producing cells in type 1 diabetes.

Their work may lead to medications that can prevent or, in some cases, even reverse type 1 diabetes in its early stages.

To that end, researchers presented findings from two promising new studies this week. One study was presented March 29 at the International Diabetes Society Meeting in Cambridge, England, while the second was delivered March 30 at the American Chemical Society's annual meeting in Anaheim, Calif.

"We still don't know how diabetes occurs," says Dr. Stuart Weiss, an endocrinologist at New York University Medical Center. "But we're beginning to unravel the mystery," he says, adding the findings from both of these studies are exciting.

Diabetes affects more than 18 million Americans, according to the American Diabetes Association. There are two types of diabetes, type 1 and type 2. Both studies concentrated on type 1 diabetes, once known as juvenile-onset diabetes, which is an autoimmune disease. The immune system perceives normal insulin-producing cells in the pancreas as foreign invaders and mistakenly attacks and destroys these cells. The complete destruction of these cells takes time, but once all are destroyed, the body can no longer produce insulin, and people with this form of the disease must take daily insulin injections.

Weiss says the therapeutic compounds in both studies are designed to stop that process before it begins, or possibly reverse it before the complete destruction of the insulin-producing cells has occurred. He explains that these compounds aren't actually vaccines because they dampen the immune response rather than stimulate it, as most vaccines do.

The first study was a clinical trial of a drug called Diamyd, which helps the body tolerate the "GAD" protein. GAD is found in both the brain and the pancreas. In type 1 diabetes, it appears the immune system attacks the GAD protein in the pancreas. A test has been developed by UCLA researchers to identify antibodies to GAD in the blood, which can help identify who is at risk for developing diabetes. Weiss says not everyone with type 1 diabetes tests positive for GAD antibodies, but a majority do.

In the study, Swedish researchers split 47 volunteers, recently diagnosed with type 1 diabetes, into four groups. All received at least one injection of the drug, ranging from 4 to 500 micrograms, and a booster shot four weeks later. Three people in each group received a placebo injection. According to the researchers, the drug helped people maintain their insulin-producing ability when compared to placebo, and there were no side effects reported.

In the second study, researchers from the North Shore-Long Island Jewish Research Institute report they have found a compound that can block the process that causes diabetes -- at least in mice, anyway.

Study author Yousef Al-Abed says this compound, which is called ISO-1, targets a different protein -- MIF -- that is also believed to play a role in the development of diabetes.

When ISO-1 was given to mice that were also given a chemical that induces diabetes, none developed the disease. Control mice who didn't receive ISO-1 did develop the disease. Another set of mice were genetically engineered to develop diabetes, but ISO-1 prevented the disease in 90 percent of them.

Al-Abed says one of the advantages of ISO-1 is that it will likely be possible to put it into an oral form. He says that the drug could then easily be given to children who were identified as high-risk for developing diabetes, and would hopefully prevent the disease.

"This just is the beginning of a long commitment," says Al-Abed, an associate investigator at North Shore-Long Island. "But where we're heading is protecting against the onset of the disease."

More information

To learn more about diabetes, visit the National Diabetes Information Clearinghouse or the American Diabetes Association.

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Sun May Increase Chance of Certain STD

 

By Daniel Q. Haney

AP Medical Editor

The Associated Press

Tuesday, March 30, 2004

ORLANDO, Fla. - The long sunny days of summer may increase the risk of catching a common sexually transmitted infection. And it's not just because people have more sex when the weather is nice.

Researchers using data from Holland found that detection of papilloma virus infection during routine cancer screening peaks during August. Their theory: Sunlight suppresses women's immune system defenses.

Experts have long suspected that sunlight has powerful — and perhaps conflicting — effects on the body's tendency to develop a variety of diseases, including cancer. The best example is the risk of too much sun triggering skin cancer.

However, many suspect sunshine can have less obvious influences, and can even affect susceptibility to a variety of everyday viruses like papilloma. These viruses are spread through sexual contact, and they are the most common cause of cervical cancer, a disease that kills about 4,000 U.S. women annually. Although the virus can cause genital warts, most infected people have no outward symptoms.

"The sun is a kind of drug, a drug that influences whether a papilloma infection takes hold or not," said Dr. William Hrushesky, an authority on how disease patterns fluctuate over time.

Hrushesky, who is based at the WJB Dorn Veterans Administration Medical Center in Columbia, S.C., presented his findings Tuesday at a meeting in Orlando of the American Association for Cancer Research.

He looked at the results of more than 900,000 Pap tests done in southern Holland between 1983 and 1998. The test does not detect papilloma virus directly. But it reveals abnormal cells that are typically caused by the infection.

Hrushesky found that the sunnier the year and the sunnier the month, the higher the rate of human papilloma virus.

August is consistently the sunniest month in southern Holland, and the screening tests picked up twice as much evidence of papilloma virus infection then as in the winter. The virus fell off sharply in September.

The reason for the August spike? "Sexual intercourse did not appear to explain most of the variance," he said.

No one can say exactly when people are having the most sex, but one strong hint is when the most babies are conceived. Records show that conception is most likely to occur in Holland in March, although there is only about a 10 percent variation over the year.

Instead, Hrushesky theorizes that even though women are exposed to papilloma at roughly the same level year round, the extra sunlight weakens their defenses against it in the summer.

He noted that sun can dampen the body's production of antibodies and the activation of protective T cells, the main branches of the natural defenses against infection. Other research has suggested a connection between sunlight and susceptibility to herpes and adenovirus, among other things.

Dr. Bruce Armstrong of the University of Sydney in Australia said the impact can occur far from the patches of skin where sunlight hits, and an effect on infection of the cervix seems plausible.

"The relationship between sunlight and cancer is complex," he said.

Many studies have noted a link between cancer incidence and how far north people live. In general, these reports show that several kinds of cancer, including colon, prostate and breast, are less frequent in southern areas, suggesting that sunlight may protect against them.

Armstrong's own study, also presented Tuesday, found that the more sunlight people receive, the less likely they are to get non-Hodgkin's lymphoma. He looked at 1,398 people and found that those who got the most sun had a one-third lower risk than those who got the least.

Editor's Note: Medical Editor Daniel Q. Haney is a special correspondent for The Associated Press.

On the Net:

http://www.aacr.org/2004AM/2004AM.asp

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Smoking Significantly Alters Genes in Mice

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Some studies have suggested that women who smoke are more susceptible to lung cancer than their male counterparts, and now new mouse research may help explain why.

A Fox Chase Cancer Center researcher and her colleagues have identified a genetic alteration that occurred up to 13 times more frequently in the lung tissue of mice exposed to tobacco smoke than those in a control group. Even after just three weeks, the mice who breathed tobacco smoke had elevated levels of the enzyme CYP1B1, which activates estradiol, one of the body's natural estrogen hormones.

The discovery points to a possible link between changes in that hormone and lung cancer.

"It can help us understand one of the factors that can be involved in the susceptibility of women who smoke and develop more cancer," says study author Sibele I. Meireles. Since this alteration is present in human lung tumors, it could also be a target for new treatments to prevent lung cancer in smokers, she adds.

"We hadn't intended to look at gender differences in this study, but this finding about an enzyme so important to estrogen metabolism once again raises the issue of whether estrogen has a role in promoting lung cancer, as it does in breast and ovarian cancer," Meireles says in a statement.

Her finding was presented March 29 at the American Association of Cancer Research annual meeting in Orlando, Fla.

Lung cancer is the leading cause of cancer death among women in the United States, according to the American Cancer Society (news - web sites). National statistics show the incidence of lung cancer is still increasing among women, although the rate of increase has slowed.

This study suggests there may be a gender difference in the development of lung cancer.

To test the effects of cigarette smoke on gene expression, Meireles and her colleagues exposed female mice to smoke six hours a day, five days a week, for a total of eight weeks. The experiment involved a total of 30 mice, including 12 animals in the control group.

The team analyzed ribonucleic acid (RNA) from the lungs of the mice to determine which genes were being expressed. RNA is involved in carrying genetic information from the DNA and translating it into proteins.

The authors identified a total of 53 smoking-induced genetic alterations but honed in on the 13-fold overexpression of CYP1B1.

"This specific one caught our attention because of the high levels of changes," Meireles says.

George Leikauf, a professor of environmental health and director of toxicology at the University of Cincinnati, says the study is limited by its small sample size and its exclusion of male mice. More data would be needed to prove a connection between the enzyme CYP1B1 and lung cancer.

"If it's different between male and female mice, that would be very interesting data," he adds.

Margie L. Clapper, director of chemoprevention research at Fox Chase, says the experiment was rather labor-intensive, but agrees further studies will be needed to validate the results. In fact, the next step is compare male and female mice.

More information

The American Lung Association and the American Cancer Society can tell you more about lung cancer.

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U.S. Faults American Red Cross Over Tissue Safety

 

By Susan Heavey

Reuters

Tuesday, March 30, 2004

WASHINGTON (Reuters) - The American Red Cross (news - web sites) has failed to take proper steps to ensure the safety of donated human tissue at a California facility, the U.S. Food and Drug Administration (news - web sites) warned in a letter made public on Tuesday.

The nation's largest humanitarian organization did not follow all necessary procedures to prevent infectious diseases or cross-contamination in heart valves and skin, the FDA said.

The warning comes a year after the group agreed separately to stricter FDA oversight of its blood-collection programs and recently paid nearly half a million dollars in related fines.

"Our investigators documented significant violations of the requirements for human tissue intended for transplantation," the FDA said in a letter to the organization. The letter was dated March 11 and posted on the FDA Web site on Tuesday.

Human tissue used for transplants -- which can also include ligaments, tendons, and other non-organ parts -- can carry microbes that can cause bacterial and other infections. Tissue banks are supposed to take steps to prevent such contamination.

Among the violations at the Costa Mesa, California bank were a failure to properly test disinfectants or determine the impact of shipping methods on the tissue samples, the FDA said.

FDA investigators first notified the Red Cross about the problem in November 2003, and the nonprofit organization responded last month.

But the FDA said the group's efforts to fix the problem did not address wider deficiencies with the overall tissue collection system.

"We find your response to be inadequate," the FDA letter said.

Red Cross spokesman Ryland Dodge said the group had not received any reports of tissue recipients suffering any harm.

After receiving the FDA letter, the California facility voluntarily suspended its distribution of skin and heart tissues, the Red Cross said in a statement.

"The Red Cross has begun to implement certain corrective actions and is seeking to engage the services of an independent third party to evaluate the facility's compliance status," the group said.

The FDA has also repeatedly warned the Red Cross for failing to follow rules meant to keep unsafe blood from reaching the public.

In April 2003, the organization agreed to tougher FDA oversight of its blood-collection program. Earlier this year the Red Cross paid $450,000 in collective fines as part of the agreement, Dodge said.

(Additional reporting by Lisa Richwine)

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Groups Ask Canada to Ban Web Pharmacies

TORONTO - Canadian health care advocates called on the government Tuesday to ban Internet pharmacies, saying the drug outlets are putting the health of Canadians at risk.

The Canadian Treatment Action Council, an advocacy and education group for people living with HIV (news - web sites)/AIDS (news - web sites), and the Canadian Hemophilia Society were among six groups that called on Prime Minister Paul Martin in a news release to outlaw the pharmacies.

Council chairwoman Louise Binder said the surge of U.S. demand for drugs via Internet pharmacies restricts Canadians' access to the drugs and pushes drug prices higher.

"There will be shortages if we keep giving the amount of drugs that companies send into Canada outside the country," she said.

The business of marketing prescription drugs to Americans over the Internet has grown rapidly because the drugs are less expensive in Canada due to government price controls.

Americans get their prescriptions filled in Canada by placing orders through Web sites operated by Canadian pharmacies which then mail the drugs to the patients in the United States.

The U.S. Food and Drug Administration (news - web sites) and the U.S. pharmaceuticals industry oppose the practice, saying they cannot guarantee the safety of the drugs. Supporters argue the industry is just seeking to keep prices high.

The largest seniors group in the United States, the AARP, which has 35 million members, has said it will lobby drug companies, Congress and the Bush administration to legalize the imports.

The Canadian government has said it is monitoring the industry, but has so far not found any evidence Canadians are facing drug shortages because of online pharmacies.

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Experts: Diet Advice Must Be Easy to Follow

 

Reuters

Tuesday, March 30, 2004

WASHINGTON (Reuters) - Dietary advice has to be easy to follow and fit the American lifestyle to be successful, two researchers told the panel overhauling the U.S. government's 10 guidelines for healthy living on Tuesday.

The 13-member advisory committee plans to wrap up its work by summer, said chairwoman Janet King, with a technical report to the Health and Agriculture departments, which jointly publish the Dietary Guidelines for Americans.

Two-thirds of Americans are overweight and 30 percent are obese. Early this month, the Centers for Disease Control and Prevention (news - web sites) said obesity was catching up with smoking as the leading cause of death in the United States.

The current set of guidelines, issued in 2000, urges Americans to eat a variety of grains, fruits and vegetables, to limit their consumption of fat, sugar and salt, and to be physically active each day. The guidelines form the basis for the government's well-known food pyramid.

Barbara Rolls of Pennsylvania State University said people tend to eat the same amount of food, so a "low density diet" using lower-calorie foods, such as fruits, vegetables, grains, lean protein and soups, with a satisfying bulk helped them lose weight. Rolls has written a book on volumetric weight control.

Richard Mattes, a Purdue University professor of food and nutrition, said weight mattered more than volume when it came to satisfying the senses involved in eating. Some people abandon volumetric diets with a complaint it required too much effort to buy and prepare fruits and vegetables, he said.

"It did not fit their lifestyle. It was not effective," Mattes said. "Trying to force everyone into one slot is not going to work."

Rolls said dietary plans had to be affordable, employ readily available foods and fit people's lifestyles to be successful.

The government's Food Guide Pyramid was first developed in 1992 to provide a general outline on how much a healthy person should eat each day from the five major food groups. It is the main educational tool used to help consumers interpret the federal dietary guidelines.

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Diet Trends May Broaden Demographics

 

By Charles Sheehan

Associated Press Writer

The Associated Press

Tuesday, March 30, 2004

PITTSBURGH - The mass of dieters doing away with carbohydrates may be changing the demographics for companies that traditionally have marketed fiber laxatives to the silver-haired crowd.

In an advertising campaign appearing at newsstands, GlaxoSmithKline is offering a "zero-carb solution to a low-carb problem," referring to the irregularity suffered by some people on the Atkins and South Beach diets.

It was the first shot in a marketing blitz that has pharmaceutical companies seeking out consumers who might traditionally be more familiar with hair gel products than fiber laxatives.

GlaxoSmithKline said it is responding to a bump in sales and a surge in calls over the past year to consumer lines regarding Citrucel, its fiber laxative.

Just days after the GlaxoSmithKline ads appeared, Proctor & Gamble fired back, promising in advertisements that their brand, Metamucil, allows users to "Stay regular. The 0 net carb way."

Labels on Citrucel caplets now let the low-carb crowd know the fiber laxative won't set them back. The caplet form has no carbohydrates and can "help you get back on track," according to magazine ads appearing in March editions.

Patrick Seiffert, brand manager for Citrucel, said GlaxoSmithKline is targeting consumers who follow a particular lifestyle and not an age group, but acknowledges that the target audience for the product may be changing, largely because of low-carb dieters.

"About 20 percent of the population is now on a low-carb diet and about a third experience changes in regularity," Seiffert said. "That's about 13 million people. That's significant for us."

The estimated number of people on low-carbohydrate diets varies widely, as does the number of people who suffer adverse effects from eating more meats and cheeses, hallmarks of the diet.

Yet Internet forums dedicated to Atkins and South Beach are clogged with the woes of people who have not replaced the fiber that was once part of their diet.

GlaxoSmithKline Consumer Healthcare, a division based just outside Pittsburgh, is grabbing for a larger market share from industry leader Proctor & Gamble. Proctor & Gamble controls about 40 percent of the market, GlaxoSmithKline about 20 percent.

The two products are just a portion of the $350 million laxatives market, but marketing experts said companies can win customers for life if they get them first.

"That category tends to skew older, and it's intuitive that if you can broaden what is a pretty narrow demographic market, that would increase sales and presumably profits," said Lawrence Feick, a professor of marketing at Katz Business School at the University of Pittsburgh.

Proctor & Gamble boasts that Metamucil is mentioned in "The South Beach Diet" by its author, Dr. Arthur Agatston. However, no P&G market research shows younger consumers may be using more Metamucil, but the company is keeping tabs on the data, said Dr. Kurt Weingand, associate director of the P&G Health Sciences Institute.

Metamucil has three grams of carbohydrates, but they are all nondigestible dietary fiber, meaning zero net carbs for consumers, Weingand said.

"People are just coming to Metamucil with South Beach being No. 1 on The New York Times' best seller list," he said. "We've gotten a lot of play out of that."

The marketing power of carb-centered products remains a big seller, and GlaxoSmithKline says they're the market leader as far as carbs go.

"We have zero, zero, zero (carbs)," said company spokeswoman Lori Lukus. "We don't have any."

On the Net:

Citrucel: http://www.citrucel.com

Metamucil: http://www.metamucil.com

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Microwaves Can Kill Off Some Breast Cancers

 

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - Small, clearly demarcated breast tumors can be successfully treated with microwave radiation to heat and destroy the cancer -- a technique known as radiofrequency (RF) ablation.

RF ablation is being tested as a less invasive means of destroying various solid tumors. Dr. Bruno D. Fornage and associates at the University of Texas M. D. Anderson Cancer Center in Houston describe their experience treating breast tumors of 2 cm or less in diameter, in the medical journal Radiology.

The clinicians used real-time ultrasound guidance to place the umbrella-like prongs of the RF electrode around the tumor, and then maintained a temperature of 95 degrees Centigrade for 5 minutes.

To examine the effects of the procedure, the 20 women in the study underwent lumpectomy or mastectomy immediately afterward. On examination, the resected tissue showed complete loss of viability of the tumor cells.

However, in one patient who had undergone chemotherapy prior to surgery, microscopic examination showed residual areas of viable cancer surrounding the ablated lesion that could not be seen on sonograms or mammograms.

Therefore, Fornage's group no longer performs RF ablation that relies on the ultrasound visualization of tumors in patients who have undergone preoperative chemotherapy. They also advise against using RF ablation for tumors likely to harbor microscopic disease extension.

The team recommends multiple needle biopsies and assessment of lymph nodes about a month after the procedure to confirm successful destruction of the entire cancer.

It remains to be seen if scarring is less pronounced with this technique than with standard surgery, the authors add. The degree of long-term tumor control also needs to be determined.

Source: Radiology, April 2004.

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Wyoming Launches Meth Education Campaign

 

By Sarah Cooke

Associated Press Writer

The Associated Press

Tuesday, March 30, 2004

CHEYENNE, Wyo. - One is a pregnant housewife. Another is an oil worker whose grandfather was a state senator. A third has used drugs since he was 8 and spent most of his young life in jail or group homes.

They hail from all corners of the state and a variety of backgrounds. But they share one thing — all are recovering methamphetamine addicts.

A skyrocketing problem in rural America that has taken root in the West, methamphetamine has quickly become the drug of choice in Wyoming as a cheap high that's readily available and easy to make.

"Estimates show use has reached frighteningly high levels," state Department of Health Director Deborah Fleming said Tuesday. "The immediate threat to the health and safety of Wyoming residents by meth abuse is becoming increasingly apparent in our schools, our homes and our justice system. No one is immune."

To stem the growing tide, Fleming and other state health officials announced an intensive statewide meth education campaign to teach residents more about the highly addictive stimulant and its dangers.

The campaign, called "Free and True Wyoming," features the stories of recovering meth addicts in TV, radio and newspaper ads to be aired and distributed statewide this week. Facts about meth use and treatment options are also included.

"This is bringing (meth addiction) out of the shadows and bringing awareness that it's everywhere," said Diane Galloway, administrator of the department's Substance Abuse Division.

According to recent surveys, one in every 100 Wyoming residents has used meth in the past year. Another one in 200 has admitted to using it regularly, Fleming said.

Drug arrests around Wyoming jumped 700 percent between 1999 and 2002, with more than 81 percent of those involving methamphetamine, according to the U.S. Sentencing Commission.

Wyoming's wide open spaces and sparse population make it an ideal place for clandestine meth labs, and its abundance of jobs requiring long hours also leaves workers more at risk of using stimulants like meth to keep them awake, Fleming said.

To get a better grip on the problem, Fleming also asked for better cooperation among residents, local and county health departments, law enforcement and state officials to compile better data on meth use.

"Meth users are our neighbors, they are our friends and they are our co-workers," she said.

Galloway also announced a meeting of the Governor's Substance Abuse and Violent Crime Advisory Board in Casper this Thursday and Friday to address the meth problem and forward possible solutions to Gov. Dave Freudenthal and the Legislature.

"Our state cannot be free and true to our history, ideals and values so long as methamphetamine has such a hold on thousands of people in Wyoming," Fleming said.

On the Net:

Wyoming Department of Health: http://wdh.state.wy.us/main/index.asp

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Asthma Death Rates Continue to Fall in US

 

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - After stabilizing in 1989, asthma death rates have continued to drop in the US since 1999, new research shows.

"It is most likely that improved management of asthma has been responsible for much of the improvement in mortality," notes study author Dr. R. Michael Sly of George Washington University in Washington, DC.

The decline in death rates has been accompanied by an increase in prescriptions for a variety of asthma drugs, he points out.

Using data from the National Center for Health Statistics, Sly evaluated trends in asthma death rates in the US by patient age, sex, and race. The findings are published in the Annals of Allergy, Asthma, and Immunology.

Asthma mortality increased from 0.8 deaths per 100,000 people in the general population in 1978 to 2.0 in 1989. This rate remained stable for the next decade until a rate of 1.7 was noted in 1999. Asthma mortality fell further to 1.6 in 2000.

Although a new diagnostic classification for asthma was implemented in 1999, this change only partly accounted for the drop in death rates, Sly pointed out.

Both men and women have experienced a decline in asthma mortality, but rates are still higher for women than men, the findings indicate. Consistent with previous reports, asthma death rates are much higher for African Americans than whites.

For children younger than 5 years, asthma mortality has remained low and relatively stable over the last few decades. For older children, mortality has risen since the late 1970s and stabilized in recent years.

The recent stabilization and decline in asthma mortality coincides with the release of guidelines emphasizing the use of steroid inhalers to prevent acute asthma, Sly states in the article.

Source: Annals of Allergy, Asthma, and Immunology, March 2004.

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Alcohol Enhances Nicotine's Effects

 

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Even small amounts of alcohol increase the pleasurable effects of nicotine, which leads people to smoke more when they're drinking alcohol, says a Duke University Medical Center study.

The findings offer a physiological explanation for why people smoke more when they're in bars. It may also help explain why alcoholics tend to smoke more than non-drinkers and why smokers could be more likely to be alcoholics.

The study, in the February/March issue of Nicotine and Tobacco Research, may also explain why people who have quit smoking often relapse when they drink alcohol.

This new insight into the interaction between alcohol and nicotine could help in the development of new ways to help people quit smoking.

The Duke study included 48 regular smokers who were given either alcoholic or placebo beverages and either regular or nicotine-free cigarettes.

According to ratings done by the volunteers, alcohol enhanced many of the rewarding effects of nicotine, including satisfaction and nicotine's calming effects. However, they did not have the same positive response about alcohol when they smoked nicotine-free cigarettes.

That indicates that nicotine itself, rather than other aspects of smoking, is the critical ingredient in the smoking-drinking interaction, the Duke researchers conclude.

"A relatively low dose of alcohol -- below that required to induce any measurable euphoria -- was enough to increase participants' enjoyment of nicotine significantly. In light of the current finding, it makes sense that so many people who have quit smoking relapse when they drink," Jed Rose, director of the Duke Nicotine Research Program, says in a prepared statement.

More information

The U.S. National Institute on Drug Abuse has more about nicotine addiction.

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Value of Pre-Workout Stretch Unclear, CDC Says

 

By Merritt McKinney

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - Coaches and athletic trainers often recommend stretching before a workout, but a new report suggests that there is not enough evidence to prove that stretching can prevent injury.

Stretching may turn out to have benefits, but the jury is still out until additional studies are performed, according to researchers at the Centers for Disease Control and Prevention (news - web sites) in Atlanta.

"The current published research doesn't show that stretching helps to prevent injuries," said Dr. Stephen B. Thacker, who directs the CDC's epidemiology program office. "However, there is not sufficient evidence to either endorse or recommend discontinuing routine stretching," Thacker told Reuters Health.

Although more research is needed to know whether stretching prevents injury, Thacker said that there are several things exercisers can do to prevent injury.

"Studies show that proper conditioning and warm-up can help participants avoid injury," he said. "The simplest approach is to start slowly at whatever activity you plan to do."

For instance, runners should begin a long-distance run with a slow jog before they pick up the pace, Thacker advised. The CDC researcher also recommended that people who are starting a new activity be realistic about their goals and to progress slowly.

Thacker and his colleagues reviewed more than 350 studies on flexibility and identified six studies that compared stretching with other methods of preventing injury.

Based on the review, Thacker's group concluded that that stretching improves flexibility, but there is not enough data to decide whether stretching prevents injury, according to the report.

But strength training, conditioning and warming up do seem to play a role in injury prevention, the researchers note. The findings are published in the March issue of the journal Medicine and Science in Sports and Exercise.

Several questions need to be addressed in future research, according to Thacker. He noted that "normal flexibility" needs to be defined for various activities. In addition, researchers should try to identify the best stretching routine and whether it should be performed before or after exercise, he said.

Future research should also examine the effect of stretching on injuries, according to Thacker. The CDC scientist also would like to find out "what are the best ways to prevent injuries for different athletic activities."

Another question to be answered, Thacker said, is what are the best ways to prevent injuries in different groups of athletes, such as competitive athletes versus recreational athletes and youths versus adults.

Source: Medicine and Science in Sports and Medicine, March 2004.

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Treating Paralyzed Vocal Chords

 

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- The University of Pittsburgh is leading an international trial to study the effect of calcium hydroxylapatite (CaHA) injections in people with vocal cord paralysis.

The trial, at 15 international sites, is the largest such study in the field of vocal disorders. Patients taking part in the trial will be given injections of CaHA into their injured vocal cords.

The effectiveness of the injections will be measured during follow-up visits after one, three, six and 12 months.

"In this study, we are trying to determine the long-term efficacy and utility of CaHA as an injection material to treat vocal fold disorders," Dr. Clark Rosen, director of the University of Pittsburgh Voice Center, says in a prepared statement.

"Current injection materials have limitations in terms of their effectiveness and longevity; there are concerns with some of the substances being reabsorbed and other materials triggering a rejection response to the material. It is hoped that the CaHA injection material will be an improvement over presently available substances," Rosen says.

The study is sponsored with an educational grant from BioForm Medical Inc., which manufactures CaHA injections.

More information

The U.S. National Institute on Deafness and Other Communication Disorders has more about vocal cord paralysis.

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Antibiotic Resistance Can Occur Without Heavy Use

 

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - Germs that have become resistant to antibiotics can be found even in a very remote Bolivian community, where the drugs are not widely used, according to new study results.

As Dr. Alessandro Bartoloni, from Universita di Firenze in Italy, and colleagues put it, "In certain settings, the spread and maintenance of antimicrobial resistance can occur regardless of the selective pressure generated by the use of antimicrobial agents."

The setting for the study was Alto Los Zarzos, a remote community of 130 Guarani Indians who live in huts and have very little contact with health care services. The village has no sanitary facilities and collected rainwater is the sole source of water.

Stool samples were obtained and antimicrobial resistance testing was performed on 108 residents who were present on the survey day in 1999.

Although few of the participants had ever been treated with antibiotics, 72 (67 percent) of them were identified as carriers of Escherichia coli that was resistant to at least one antimicrobial agent, the authors report in The Journal of Infectious Diseases.

The highest resistance rate was for tetracycline (64 percent), followed by ampicillin (58 percent), trimethoprim-sulfamethoxazole (50 percent), and chloramphenicol (41 percent).

"The hypothesis most likely to explain (the findings) is that resistant strains have occasionally been introduced into the community after exchanges, although limited, between its population and that of other areas--and that resistant strains and resistance determinants have efficiently spread, facilitated by unhygienic conditions," the authors surmise.

Source: Journal of Infectious Diseases, April 1, 2004.

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Heat Treatment for Breast Tumors Looks Promising

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- A technique that uses heat to "cook" tumors was found safe in treating small, invasive breast cancers, a new study found.

"It is experimental, and it is preliminary. I don't want to raise false hopes," says Dr. Bruno Fornage, a professor of radiology and surgical oncology at the University of Texas M.D. Anderson Cancer Center in Houston. He is lead author of the study, which appears in the April issue of Radiology.

But he and other experts add the new approach looks promising.

Called radiofrequency ablation, the technique has been dubbed "cooking tumors with needles." Ultrasound imaging is used to guide a needle-electrode to the center of the tumor, and then a temperature of about 200 degrees Fahrenheit (or 95 degrees Celsius) is applied for about 15 minutes to destroy the cancerous tissue.

"It basically coagulates the tumor," Fornage says.

The technique is used already, Fornage says, for non-operable liver tumors and has been studied to treat lung, bone, brain, kidney and prostate tumors.

Fornage and his colleagues used the ablation technique to treat 21 breast cancers in 20 patients. All were 2 centimeters or less in diameter -- about the size of a grape.

The study was a feasibility study, Fornage says, and all the women underwent the procedure immediately before their scheduled lumpectomy or mastectomy. "We did radiofrequency ablation and then removed the specimen right away because the patient was scheduled for surgery," he says.

A pathologist then examined the tissue, "and that's what confirmed that the tumors had been completely destroyed," Fornage says.

In all 21 cases, the target tumor that was seen on the ultrasound was completely ablated, Fornage says. However, one patient whose tumor had first been shrunk by chemotherapy had residual cancer found around the ablated target.

"We decided then that we should never apply this procedure to patients who had been downstaged," says Fornage, referring to women whose tumors shrink after chemotherapy and the cancer is then downgraded to a less serious stage.

As promising as the technique looks, Fornage says one big limitation is there's no way to be sure the technique destroyed all the cancer. During surgery, he says, "you remove the tumor and the pathologist examines the margins. If there is some tumor left, the surgeon goes back and takes more tissue out."

With the ablation technique, however, no tissue is removed and there is currently no way to determine if it got all the cancer.

Another cancer expert, Dr. Ellen Mendelson, chief of breast imaging and a professor of radiology at Feinberg School of Medicine at Northwestern University, also sees that as a limitation. The main problem with the procedure, which she calls promising, "is the problem of margins -- how we can assure that the entire cancerous area has been removed."

The solution, say Mendelson and Fornage, may be to use imaging such as magnetic resonance MRI or PET scans, something that could detect cancer before mammograms are capable of doing so.

Even with the limitations, says Mendelson, "Dr. Fornage's study is a trailblazer."

And it follows what she sees as a trend in radiology and medicine that looks for less costly, less invasive techniques with less recovery time. "We're trying to accomplish the most with the least," she says.  

"This is an experimental study which I would say paves the way for other studies that will be needed," Fornage says. "Right now we have shown [radiofrequency ablation] is feasible and it is safe. But we still need to show that it is at least as good as the standard treatment."

More information

To find out more about radiofrequency ablation, visit the National Institutes of Health. To find out more about breast cancer, visit the American Cancer Society.

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Tumor Marker Predicts Good Ovarian Cancer Outcome

 

By Megan Rauscher

Reuters Health

Tuesday, March 30, 2004

ORLANDO, Florida (Reuters Health) - A protein produced by some ovarian cancers is a marker of a favorable prognosis, according to the results of a study described here at the annual meeting of the American Association for Cancer Research.

The tumor marker is called human kallikrein 8, or hK8. "With further study, quantifying the levels of hK8 in biopsy tissue may be worthwhile in women with ovarian cancer," study presenter Carla A. Borgono of the University of Toronto in Ontario, told Reuters Health.

Previously, researchers showed that the hK8 protein is increased in 55 percent of ovarian tumor tissues, and in 62 percent of blood samples from women with ovarian cancer compared to healthy women.

In the current study, the researchers measured hK8 in 136 ovarian tumor extracts, and related these measurements to outcome over an average of 42 months. According to the researchers, 25.7 percent of tumors were hK8-positive.

Compared with women with hK8-negative tumors, women with hK8-positive tumors most often had lower grade tumors, no residual tumor after surgery, and "optimal debulking success."

Women with hK8-positive tumors also survived significantly than those with hK8-negative tumors.

"Similar findings have been seen with several other kallikrein proteins as well," Borgono told Reuters Health. "We are looking in the future to develop panels of biomarkers. For example, we could combine all of the kallikreins into a panel and see if together they could predict the prognosis of a patient," she said.

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Trout Turn Into Bullies Under Stress

 

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Stressed trout may offer insight into violent and aggressive behavior in humans.

University of Oslo scientists found that dominant rainbow trout reduce their stress levels by venting their frustration on socially subordinate trout.

The scientists say this approach to stress reduction may be an evolutionary conserved strategy and could provide clues about the causes of violent and aggressive behavior in humans.

"Rainbow trout are highly territorial animals. When a dominant fish harasses a subordinate, stress levels drop off quickly in the dominant animal but remain high in the subordinate. One possible explanation for this is that beating up a subordinate relieves stress," researcher Oyvind Overli says in a prepared statement.

The study will be presented this week at the annual meeting of the Society for Experimental Biology in Edinburgh, Scotland.

Another study to be presented at the meeting found that when pinch comes to shove, losing lobsters know when to back off.

When male lobsters fight, the loser remembers the smell of the victor's urine and that recognition determines the intensity of any rematch, say Boston University Marine Program researchers.

"As soon as the loser catchers a whiff of the winner, they back off. By recognizing the winner of a previous fight and fleeing more quickly in their second fight, the losers receive less aggression from the winner," researcher Molly Steinbach says in a prepared statement.

More information

The National Youth Violence Prevention Resource Center has more about aggression.

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Painkiller Boosts Certain Pancreas Cancers in Mice

 

By Megan Rauscher

Reuters Health

Tuesday, March 30, 2004

ORLANDO, Florida (Reuters Health) - A selective COX-2 inhibitor -- a type of drug familiar to arthritis suffers -- enhances the growth of COX-2-negative pancreatic tumors in mice. In COX-2-positive tumors, the opposite is true.

"We have shown for the first time in vivo that a selective COX-2 inhibitor can stimulate tumor growth," Dr. Guido E. Eibl told Reuters Health. "Our studies probably define a subset of patients who should not take COX-2 inhibitors," he added.

Eibl, a researcher in the Hirshberg Pancreatic Cancer Laboratory at the UCLA School of Medicine in Los Angeles, described the findings during the annual meeting of the American Association for Cancer Research.

In the study, COX-2-negative and COX-2-positive human pancreatic tumor cells were injected into the flank and pancreas of mice; this was followed by injection of nimesulide, a COX-2 inhibitor used widely outside the U.S. to treat arthritis.

In mice with pancreatic cancer expressing COX-2, nimesulide decreased tumor growth. But "surprisingly," Eibl said, in those with COX-2-negative tumors, there was a significant increase in tumor growth.

Up to 40 percent of all human pancreatic cancers are COX-2 negative.

According to Eibl, three other COX-2 inhibitors gave similar results in test tube experiments.

When considering treating people who have pancreatic cancer with a COX-2 inhibitor, Eibl said, "probably the COX-2 expression profile of the pancreatic tumor should be determined."

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Teen Smokers Fall Down on Other Health Habits

 

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- Cigarettes aren't the only health threat facing young people who smoke.

A Virginia Commonwealth University study found that youths who smoke -- particularly girl smokers in high school -- are less likely to eat vegetables and dairy products, and are also less likely to exercise than their nonsmoking peers.

The study of 8,022 middle school students and 2,613 high school students enrolled in tobacco prevention programs found that high school smokers were much less likely to eat at least one serving per day of dairy products, and to exercise three or more times per week, than were nonsmokers.

Middle and high school girls who smoked were much less likely to eat one or more vegetables a day compared to nonsmokers. Middle school students who smoked were much less likely to exercise three or more times a week than nonsmokers.

The study was presented at the recent annual meeting of the Society of Behavioral Medicine.

"The combination of smoking and poor diet/less exercise together may place teens at higher risk for developing chronic diseases later in life than either behavior alone," study author Diane Baer Wilson, an associate professor of internal medicine, says in a prepared statement.

She notes that 23 percent of American high school students smoke and many teenagers don't eat enough healthy, nutrient-dense food.

"This study provides strong evidence for addressing multiple risk behaviors simultaneously, such as smoking prevention and healthy eating/exercise, in adolescent interventions and introducing this model in middle school years," she says.

More information

The American Medical Association has more about youngsters and smoking.

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People Don't Eat the Right Fruits, Veggies: Experts

 

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - Choose a rainbow of fruit and vegetable colors each day to keep the doctor away, according to experts.

Not all fruits and vegetables are created equal in terms of preventing disease, they note, and people consistently opt for choices that offer little protection against certain chronic diseases and fall short of providing added health benefits -- such as corn, potatoes, iceberg lettuce, apples and bananas.

Research suggests that people get the most disease-fighting benefits if they opt for so-called "powerhouse" choices that are particularly rich in vitamins, phytochemicals, and other properties. These include dark green and leafy vegetables like broccoli, deep yellow/orange fruits and vegetables like carrots, citrus fruits like oranges and grapefruit, and cruciferous vegetables (i.e., from the cabbage family) like cauliflower.

"When we look at how to get the most bang for your buck, the most power, it's by eating these fruits and vegetables in addition to traditional choices," study author Dr. Marilyn S. Nanney, who is based at Saint Louis University in Missouri, said in a statement.

She added that the best way to keep track of which fruits and vegetables are better than others at reducing risk for cancer, heart disease and other ailments is to choose them by color.

For instance:

White: Opt for cauliflower in addition to commonly eaten potatoes, onions or mushrooms.

Green: Add dark lettuces and spinach to commonly consumed iceberg lettuce. Select broccoli and Brussel sprouts in addition to green beans.

Yellow and Orange: Choose carrots, winter squashes, sweet potatoes, cantaloupe, oranges and grapefruit in addition to corn and bananas.

Red: Eat tomatoes, red peppers and strawberries along with apples.

So why the confusion? In the Journal of the American Dietetic Association, Nanney and her colleagues write that current dietary advice is to choose a variety of fruits and vegetables. This might not always translate to eating a wide range of colorful fruits and vegetables, as people tend to choose fruits and vegetables that are familiar and available.

For instance, the U.S. Department of Agriculture (news - web sites)'s Food Guide Pyramid provides "general guidance" about diet, Nanney's team points out. The pyramid recommends at least five servings of fruits and vegetables per day, and says little about which provide the most disease-fighting benefits.

The "5 A Day The Color Way" program, a revised form of a national program designed to help prevent cancer, provides additional guidance by making recommendations to choose colors daily, but does not identify any differences within colors.

"People need to know about the health benefits associated with particular fruit and vegetable sources as they choose their 5 a day," said Nanney.

Source: Journal of the American Dietetic Association, March 2004.

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Single Drop of Blood Measures Stress Levels

 

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- A new test can measure a person's stress level by analyzing a single drop of blood.

The test, developed by Oxford University scientists, checks the blood for immune system changes. The blood sample is exposed to a chemical that mimics bacteria and causes a reaction in white blood cells, which regard the chemical as an intruder.

The degree of white blood cell response is compared to a generic baseline and the results indicate a person's stress level. For example, a person who's under stress will have a reduced white blood cell response because the white blood cells will already be preoccupied.

The scientists used this method to test their own stress levels, such as when they were stuck in traffic jams. They also tested stress in wild animals living in harsh environments.

The Oxford researchers say they achieved encouraging results when they tested this method. They say it may prove useful in a number of applications, including stress monitoring in the workplace and insurance health screening.

More information

The Cleveland Clinic has more about stress.

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Some People Can Blame Taste Buds for Weight Gain

 

By Alison McCook

Reuters Health

Tuesday, March 30, 2004

NEW YORK (Reuters Health) - Science has confirmed it: a preference for sweet or fatty foods can indeed put inches on the waistline.

Investigators found that Pima Indians in Arizona -- who are naturally prone to obesity -- were more likely to gain weight over time if they particularly liked the taste of highly sweetened and fatty foods.

These results show that what we like to eat influences what we eat, and people who enjoy less healthy foods may pay the price in excess pounds, study author Dr. Arline Salbe of the National Institutes of Health (news - web sites) told Reuters Health.

But don't go blaming your genes for your desire to eat chips and chocolate; whether or not our genetic makeup influences our preferences for unhealthy foods remains unclear, Salbe noted. Although researchers have identified the genes for certain taste receptors, this area of study remains extremely new, and there is much yet to learn.

"I believe (our genes) may contribute to the problem, but in the end, choices are also made of free will," Salbe said.

During the study, Salbe's team asked 123 Pima Indians to taste samples of skim milk, whole milk, half and half, and cream. The investigators added varying amounts of sugar to the samples, and asked each person to indicate how much they enjoyed each sample.

The researchers then weighed 75 of the group an average of five years later, to see if their preference for fat and sweet flavors affected their size.

Reporting in the American Journal of Clinical Nutrition (news - web sites), the researchers found that the participants who particularly enjoyed the more fat- and sugar-laden samples tended to gain more weight than those who preferred the healthier choices.

"Quite simply, the more you expressed a liking for these sweet and creamy solutions, the more you were found to eat," Salbe said. The researcher believes the current findings apply to people of all racial backgrounds.

Salbe explained that while taste is influenced by genetics, environment likely plays a strong role, as well. "People often like what is familiar and that may be influenced by familial, cultural, or ethnic ties."

However, even if you grew up on a rich diet of creamy and sugary foods, tastes for such foods can change, Salbe noted. For instance, people are often reluctant to switch from whole to non-fat milk, but often find that if they do it gradually -- going from whole to 2 percent to 1 percent to non-fat -- it becomes easier.

"I believe that our taste preferences are influenced by habit and that habits can be changed," Salbe concluded.

Source: American Journal of Clinical Nutrition, March 2004.

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Drug Derived From Licorice Improves Memory

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Tuesday, March 30, 2004

TUESDAY, March 30 (HealthDayNews) -- A drug derived from licorice root improves memory in older men and may protect against age-related cognitive decline, a new study finds.

A British research team found the drug, carbenoxolone -- which has also been used for many years to treat stomach ulcers -- boosted memory in both healthy seniors and older men with type 2 diabetes.

"Based on work we had done in animals and cells, we tried out an idea to improve on the mild memory decline that happens in all of us as we get older," says lead researcher Dr. Jonathan Seckl, a professor of molecular medicine at Edinburgh University in Scotland.

Seckl's team studied 10 healthy men, aged 55 to 75, and 12 men with type 2 diabetes, aged 52 to 70. According to Seckl, the healthy men were chosen because they weren't taking any medications and the men with type 2 diabetes were picked because of the mild memory loss associated with the disease.

During the study, the subjects were given either carbenoxolone or a phony drug. The researchers used word association and verbal tests to evaluate the men's ability to learn word lists and recall paragraphs.

They found that among the healthy men, verbal ability significantly improved after four weeks of carbenoxolone. And among the men with type 2 diabetes, verbal memory significantly improved after six weeks of treatment.

These findings appear in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

The researchers chose carbenoxolone because it is known to block the enzyme called beta-hydroxysteroid dehydrogenase type 1, which is needed to allow the hormone glucocorticoid into brain cells. Research had previously found increased long-term exposure to this hormone negatively affects the brain's cognitive functioning.

"If we can extend this finding to people with common forms of memory impairment, then we have a way of approaching this problem," Seckl says. "There are very limited approaches to memory loss with aging now."

Because of some of the side effects of carbenoxolone, it might not be the ideal drug for this problem, Seckl says. "But it's very encouraging, because we have seen these same results from cells to mice to man."

The next step, Seckl says is to look at people with severe memory problems, such as people with early Alzheimer's, to see if carbenoxolone can improve their memory.

"But like all medical discoveries, it has to be put in context," he adds. "This is not the greatest breakthrough since the turn of the millennium. But it's an important step in a process and a new way of approaching memory impairments in aging."

William H. Thies, vice president for medical and scientific affairs at the Alzheimer's Association, says the findings are interesting although the study is small.

The study highlights the amazing amount of research that is being done in Alzheimer's research and how much progress has been made over the last 25 years, he adds.

Thies says the study adds important data about how cells function and what that means to people's cognitive function. "This is an area that is worth pursuing, and we will hear more about it," he adds.

But Thies cautions that to call these finding promising is an overstatement. "Today's promise is tomorrow's fish wrap," he says.

More information

Learn about memory loss and aging from the National Institute on Aging or the American Academy of Family Physicians.

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Monday, March 29, 2004

 

Dip Into Honey Pot for Good Health

 

Reuters Health

Monday, March 29, 2004

NEW YORK (Reuters Health) - Adding a little honey to your diet may do more than satisfy your sweet tooth. Honey may also boost levels of healthy antioxidants, new research suggests.

For centuries, honey has been known to have some beneficial effects, according to University of California-Davis researcher Dr. Heidrun B. Gross. In an interview with Reuters Health, Gross recalled her grandmother's advice to eat honey when she felt under the weather.

Now, Gross and her colleagues have provided scientific evidence to support what her grandmother knew all along.

"Honey is not just a sweetener," Gross said. It also has compounds called phenolics that have antioxidant properties, she explained. These substances quench free radicals, which are unstable byproducts of normal metabolism that cause damage to arteries, and to DNA that can lead to cancer and other diseases.

It is easy enough to take vitamin supplements that contain antioxidants, but Gross said she prefers "to look for foods, rather than compounds, that are already part of our diet."

In a study of 25 healthy adults, Gross and her colleagues showed that honey can boost antioxidant levels. For 29 days, participants added 4 tablespoons of buckwheat honey to their daily diet. The researchers tested two types of buckwheat honey with different amounts of antioxidants.

Blood samples taken at the beginning and end of the study showed that the total level of phenolics increased in both groups of volunteers.

Gross presented the results Sunday at a meeting of the American Chemical Society in Anaheim, California.

Previous research had shown that a single dose of honey can boost antioxidants, but Gross said that the current study is thought to be the first study of daily honey consumption.

"You can definitely increase the amount of antioxidants" by adding a little honey to your diet, Gross said. She noted that the study included only healthy people, so the jury is still out on the long-term health benefits of honey.

But for people interested in boosting antioxidant levels, the California researcher recommended adding 2 to 4 tablespoons a day to their diet. This amount of honey "definitely provides some antioxidants," she said, which may boost the body's defense system.

Gross advised people to consider substituting honey for other sweeteners that do not provide the same burst of antioxidants.

But not all honey is created equal in terms of antioxidants, Gross said. For the most part, the darker the honey, the more antioxidants it contains, she said.

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Women Urged to Take Heart Disease Seriously

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Monday, March 29, 2004

MONDAY, March 29 (HealthDayNews) -- For years, women have worried about the health of their partner's heart, tending to husbands or boyfriends when their cholesterol goes up or their heart starts to falter.

Now, it's time they start taking care of their own hearts, health experts say.

To help them do just that, the American Heart Association (news - web sites) (AHA) has issued new guidelines, offering for the first time "evidence-based" recommendations for preventing heart disease and stroke in women that are tied to their individual level of risk.

"Almost every minute, a woman in the United States dies of cardiovascular disease," says Dr. Nanette K. Wenger, a member of the AHA panel that wrote the guidelines.

The new guidelines, which are more aggressive than previous ones issued in 1999, will hopefully be taken seriously by women and their doctors, says Dr. Lori Mosca. Director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center, she is also chairwoman of the panel that wrote the recommendations.

"Hopefully these guidelines have gotten substantial attention, and I do think that will help with implementation. Unlike previous guidelines, these are also being rolled out with several continuing medical education courses for doctors," Mosca says.

Heart disease and stroke are the number one and number three killers, respectively, of American women, claiming nearly a half million lives annually. But women aren't likely to consider it their greatest health risk. In fact, a survey of more than 1,000 women taken by the American Heart Association in 2003 found most women don't view themselves as personally at risk for heart trouble. While 46 percent of those surveyed knew heart disease was the leading cause of death for U.S. women, only 13 percent said they considered it their own greatest health risk.

Mosca suspects the 1999 guidelines weren't uniformly or fully put into place and that many primary-care doctors or gynecologists -- whom women are likely to see most often -- didn't even discuss them. This time will be different, she hopes.

Under the new guidelines, a woman is urged to get her personal level of risk for heart disease assessed by her doctor and then follow the appropriate strategies.

Women will be classified as "low risk," defined as those who have less than a 10 percent chance of having a heart attack in the next decade; "intermediate risk," those with a 10 to 20 percent chance of having a heart attack in the next 10 years; or "high risk," defined as a greater than 20 percent chance of an attack.

All women are also now urged to follow heart-healthy habits, such as maintaining a healthy weight, exercising for at least 30 minutes most days, and not smoking.

The importance of a healthy lifestyle can't be stressed enough, Mosca says. "We want to reinforce the idea that lifestyle has been, is, and always will be a primary method to lower a woman's risk of heart disease," she says.

Additional recommendations are now based on risk level. "A good example of that is aspirin [therapy]," says Mosca. "There is a different recommendation for aspirin based on the three levels of risk."

High-risk women, who typically have already had a stroke or heart attack, are encouraged to take a daily aspirin.

Intermediate-risk women, who typically have two or more heart disease risk factors, such as high blood pressure or high cholesterol, may be prescribed aspirin if their doctor thinks its benefit outweighs risks, such as gastrointestinal bleeding, Mosca says.

Women at low risk, typically those with no heart disease risk factors, shouldn't be put on aspirin therapy to prevent heart attacks, Mosca says. "It may do more harm than good," she says. "Wait for the clinical trials."

Dr. Raluca Arimie, staff cardiologist at Santa Monica-UCLA Medical Center in California, is another heart expert who applauds the new guidelines. "Everything we have been trying to do before now comes in the form of the guidelines," she says.

Arimie says some of her patients who need to be on cholesterol-lowering drugs, for instance, balk at the side effects and drag their feet about starting the medications. "The guidelines will help convince patients" that when medication is needed, it's better to take it than try unproven strategies, or linger too long hoping lifestyle changes alone will work, she says.

The guidelines also urge doctors to treat risk factors such as high blood pressure and high cholesterol more aggressively, Arimie says.

Once a woman knows her risk level, she should map out a strategy with her physician, Mosca says. "A woman should develop a close partnership with her physician," she says. "She has to be a very strong partner in the process."

And, it can help to give yourself some deadlines, with the help of your doctor, she adds. Suppose your doctor tells you to get more exercise or lose weight in an attempt to bring down your blood pressure. "Talk to your physician about how long you should take to get there. How long should you give it for lifestyle?"

Then, if lifestyle doesn't bring about the desired result, you need to talk about other strategies, such as medication, Mosca says.

More information

To find out more about women and heart disease, visit the American Heart Association and the National Coalition for Women With Heart Disease.

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Study: Housework, Walking Lowers Cancer, Death Risk

 

By Maggie Fox, Health and Science Correspondent

Reuters

Monday, March 29, 2004

WASHINGTON (Reuters) - Housework may be a hated chore but it can reduce the risk of a certain form of uterine cancer, U.S. and Chinese researchers reported Monday.

And a second study showed that patients with breast cancer who exercised regularly were more likely to survive.

The reports, presented at the annual meeting of the American Association for Cancer Research in Orlando, Florida, strengthen other findings that show exercise lowers the risk of several forms of cancer, as well as heart disease and diabetes.

"Exercise in adulthood was associated with nearly a 20 percent reduction in endometrial cancer risk," a team led by Charles Matthews of the Vanderbilt University Medical Center in Nashville, Tennessee, told the meeting.

"Our results support the idea that the risk of cancer can be reduced by maintaining an active lifestyle," Matthews added in a statement.

Matthews and colleagues at the Shanghai Cancer Institute in China found that walking and household chores reduced the risk of endometrial cancer by as much as 40 percent.

They studied 974 women in Shanghai aged 30 to 69 and compared them to women of a similar age. The women were asked about current exercise as well as how much they exercised as teen-agers.

Women who walked more than 60 minutes a day and who did four or more hours of housework a day had a 30 percent lower risk of endometrial cancer -- a cancer of the lining of the uterus.

"In recent years, we have accumulated strong evidence that an active lifestyle can reduce the risk of colon and breast cancer. Now we are finding that physical activity may also reduce risk of endometrial cancer," Matthews said.

Offsetting The Effects Of Being Fat

Having too much body fat can increase the risk of endometrial cancer but Matthews said exercise may counter some of this risk.

Matthews' team did a second study in Shanghai on breast cancer but found the effects were less clear.

They surveyed 1,459 breast cancer patients and 1,556 women without breast cancer.

The heavier women were always at higher risk. As with endometrial cancer, exercise seemed to offset some of the increased risk caused by being fat.

"At this juncture, obesity prevention offers one of the few viable options for breast cancer prevention," the researchers said.

A second team, at Brigham and Women's Hospital and Harvard University, showed that exercise increased the survival of women with breast cancer.

"We already knew that exercise improves the quality of life after a breast cancer diagnosis," Dr. Michelle Holmes, who led the study, said in a statement.

They studied 2,296 breast cancer patients taking part in a large health study of nurses, following them from 1986 until they died or until June 2002.

The more the women exercised, the better their chances of beating the breast cancer.

Women who walked an hour a week or did the equivalent were 19 percent less likely to die and women who managed three hours a week were 54 percent less likely to die of breast cancer.

But the benefits dropped off -- more exercise than that did not result in better survival.

"We were able to show that even a moderate amount of physical activity improved the odds of surviving breast cancer," Holmes said.

"It is especially heartening for women recovering from breast cancer to know that the benefit is as readily accessible as walking for 30 minutes on most days of the week."

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Bad Breath

 

HealthDayNews

Monday, March 29, 2004

(HealthDayNews) -- If you're plagued by halitosis, sweeten your breath with these tips from the Naval Hospital in Camp Pendleton, Calif.:

 

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Older Adults' Chronic Pain May Dull Appetite

 

By Amy Norton

Reuters Health

Monday, March 29, 2004

NEW YORK (Reuters Health) - Chronic pain may dampen elderly adults' desire to eat, potentially leading to weight loss and malnutrition, a small study suggests.

Among 65 older men and women with chronic pain due to arthritis and other conditions (but not cancer), researchers found that appetite loss was directly related to the intensity of patients' pain. Overall, 45 percent of patients described their appetite as "fair or worse," and nearly as many complained that pain dulled their desire to eat.

The concern is that such appetite impairment could lead to weight loss and malnutrition, a common problem among the elderly, study author Dr. Debra K. Weiner told Reuters Health.

According to Weiner and her colleagues at the University of Pittsburgh Medical Center in Pennsylvania, experience tells doctors and patients alike that chronic pain can quash the desire for food, but few studies have specifically looked at the problem.

One reason is that both pain and appetite are complex, with physical, emotional and mental components at work. Depression, for example, is related to pain and appetite individually, and higher rates of depression could explain the appetite loss seen in older adults' plagued by constant pain.

For their study, in the Journal of the American Geriatric Society, Weiner and her colleagues gave patients standard surveys on pain and appetite, and on related factors such as depression, medication use and mental functioning. Many of the patients, who were 75 years old on average, had arthritis; others had fibromyalgia, nerve damage, spinal degeneration or osteoporosis-related bone fractures.

Weiner's team found that patients who said pain interfered with their appetites tended to have more severe pain, and the relationship was not explained away by depression, the side effects of pain medication or other factors.

Still, patients with appetite problems were more likely than others to be on opioid pain drugs; more than half were on these medications, compared with less than one-quarter of those without appetite loss.

This implies that when pain treatment is inadequate, appetite problems may follow, according to Weiner.

Whether better pain control might prevent or improve appetite loss is unclear. Weiner said she and her colleagues are now looking at that issue in pain intervention studies.

Source: Journal of the American Geriatric Society, February 2004.

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Stroke Signs

 

HealthDayNews

Monday, March 29, 2004

 

(HealthDayNews) -- Stroke kills 150,000 people annually, making it the third leading cause of death in the United States, according to the Texas Medical Center.

If you recognize the warning signs, you can catch a stroke in its early stages:

If you experience any of these symptoms, get medical help immediately.

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Breath Test Links Muscle and Bowel Conditions

 

Reuters Health

Monday, March 29, 2004

NEW YORK (Reuters Health) - A test for microbes in the intestine, known as the lactulose breath test (LBT), may provide a link between fibromyalgia and irritable bowel syndrome (IBS), new research suggests.

Fibromyalgia is a painful muscle condition and IBS is an intestinal disorder associated with pain, bloating, and diarrhea.

Dr. Mark Pimentel from Cedars-Sinai Medical Center, Los Angeles, California and colleagues note that nearly a third of fibromyalgia patients in some studies are also diagnosed with IBS, suggesting a link between the two disorders.

The researchers tested their hypothesis that the LBT would be abnormal in both IBS and fibromyalgia by performing the test in 42 fibromyalgia patients, 111 IBS patients, and 15 healthy subjects. The findings are reported in the Annals of the Rheumatic Diseases.

All 42 patients with fibromyalgia had an abnormal LBT result, as did 93 (84 percent) of IBS patients but only three (20 percent) of the controls. Moreover, the amount of hydrogen gas produced during the LBT seemed to correlate with the degree of pain in fibromyalgia patients.

"The additional finding in our study that the degree of pain in fibromyalgia seems to correlate with the degree of hydrogen suggests a possible link between the LBT findings and" increased pain, the investigators write.

"This study suggests that an abnormal LBT may be a common link between subjects with fibromyalgia and IBS," the authors conclude. "Further study is needed to determine if treatment and normalization of the breath test with antibiotic treatment can produce an improvement in fibromyalgia in addition to bowel complaints."

Source: Annals of the Rheumatic Diseases, April 2004.

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Slaying 'Superbugs'

 

HealthDayNews

Monday, March 29, 2004

MONDAY, March 29 (HealthDayNews) -- A newly discovered class of enzymes may prove a major advance in helping scientists understand more about how bacterial cells self-destruct when they're under stress.

The enzymes were identified by New Jersey University of Medicine and Dentistry researchers.

"These enzymes, called RNA interferases, attack extremely accurately targeted sequences in bacterial messenger RNA," Masoyori Inouye, a professor in the department of biochemistry at the Robert Wood Johnson Medical School, says in a prepared statement.

"When these interferases attack, they split the bacteria cells' genetic material -- its RNA -- completely, stopping the microbe from making protein vital for its cell growth, which eventually kills the bacteria stone dead," Inouye says.

It may be possible to produce synthetic versions of this enzyme that could target multi-drug resistant bacteria, which are a serious infection threat to hospital patients.

"This is the first enzyme discovered which cuts messenger RNA at a specific sequence. When bacteria are persuaded to make the enzyme, virtually all the messenger RNA inside the bacterial cell is chopped up, without seriously affecting any of the other protein-making machinery," Inouye says.

The research will be presented March 31 at a meeting of the Society for General Microbiology in Bath, England.

More information

The American Society for Microbiology has more about bacteria.

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Prostate Cancer Therapy Not Tied to Colon Cancer

 

By Megan Rauscher

Reuters Health

Monday, March 29, 2004

ORLANDO (Reuters Health) - There does not appear to be an increased risk of colon cancer after prostate cancer, regardless of how the prostate cancer is treated, according to findings presented at the annual meeting of the American Association for Cancer Research.

Recently, an Australian study tied colon cancer to an increased risk for prostate cancer, lead researcher Dr. Vinay K. Katukuri from Wayne State University in Detroit, Michigan noted in an interview with Reuters Health. However, it was unclear if the association also went the other way.

One area of concern has been the treatment used for prostate cancer. Specifically, radiation therapy, a common treatment for prostate cancer, has been implicated in the development of colon cancer.

To investigate, the researchers tested 34 samples from colonic washings for early evidence of cancer in cells from the colon. The samples came from 12 patients with prostate cancer treated with radiation, 12 similar patients not given radiation, and 10 high-risk patients without colon or prostate cancer.

According to Katukuri, the groups did not differ significantly in their test results, suggesting that all three were at equal risk for colon cancer.

This study is "reassuring," he said, in that it suggests that radiation for prostate cancer is unlikely to cause colon cancer. However, large forward-looking studies are needed to confirm this, he added.

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Pinpointing Infections

 

HealthDayNews

Monday, March 29, 2004

MONDAY, March 29 (HealthDayNews) -- A combination of tiny amounts of gold and a genetic "hairpin probe" causes bad bacteria, fungi and viruses to glow, providing an inexpensive and easy-to-use way of detecting potentially fatal infections.

This "sensor," developed by University of Rochester (N.Y.) scientists, may also provide doctors with new ways to identify and diagnose diseases.

"In our chip, a DNA hairpin probe carrying a fluorescent marker is attached to a tiny piece of gold. The gold normally short-circuits the fluorescent part of the probe, but when it detects a dangerous virus, fungus or bacterium, the probe attaches itself using the DNA," researcher Benjamin L. Miller says in a prepared statement.

"As the probe attaches itself, the hairpin-shaped DNA is straightened out, allowing it to fluoresce. We can immediately detect the glow using light-sensitive equipment, warning us about the infection," Miller says.

In laboratory research, he and his colleagues have shown this technique can detect Staphylococcus aureus, a drug-resistant strain of bacteria that's a major cause of infections in hospital patients.

The research will be presented March 30 at the meeting of the Society for General Microbiology in Bath, England. The University of Rochester scientists plan to seek permission to begin clinical trials on the sensor.

More information

The U.S. National Institute of Allergy and Infectious Diseases (news - web sites) has information about microbes.

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Test Predicts When Preterm Delivery Is Unlikely

 

Reuters Health

Monday, March 29, 2004

NEW YORK (Reuters Health) - Testing pregnant women for a protein called fetal fibronectin is useful for "ruling out" a preterm delivery, new research suggests. This may provide reassurance that a delivery is not imminent so it's okay to return to work or resume normal activities.

If the test is negative, the chances of delivering early are very slim. With a positive result, however, the meaning is less clear -- delivery may or may not occur early.

In the American Journal of Obstetrics and Gynecology (news - web sites), Dr. M. Patrick Lowe and colleagues at the University of Iowa Hospitals and Clinics in Iowa City, note that fetal fibronectin is present in vaginal fluids early in pregnancy, and then it disappears and doesn't return until about 34 weeks of gestation. Its reappearance is thought to signal the body's preparations for labor.

Until recently, results of fetal fibronectin tests were not available for 24 hours. Using a new test that provides results in one hour, the researchers assessed the outcomes of pregnant women who had symptoms of preterm labor. Some were given the test, others were not.

Overall, no major differences were seen between women managed with or without the fibronectin test, the investigators report.

Among the 46 women in the test group, however, some differences were noted. Specifically, women with a negative result were less likely to be admitted to the birthing service and were hospitalized for shorter periods than those with a positive result.

A negative test result was correct 97 percent of the time in predicting that delivery wouldn't occur in the next two weeks. In contrast, a positive test result was only correct 27 percent of the time in predicting that a delivery would occur.

The investigators conclude, "Although we did not study the effect of fetal fibronectin on bed rest and work recommendations, the overall consensus was to allow a woman to return to work and to care for her family if the fibronectin result was negative. This remains a potential area of study."

Source: American Journal of Obstetrics and Gynecology, February 2004.

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Studies Find Little Link Between Acrylamide and Cancers

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, March 29, 2004

MONDAY, March 29 (HealthDayNews) -- Ever since unexpectedly high levels of acrylamide were found in some popular baked and fried foods in 2002, scientists have been trying to determine how dangerous the chemical is to humans -- if at all.

Acrylamide, which forms when certain carbohydrate-rich foods such as potato chips and french fries are cooked at high temperatures, is classified as a possible human carcinogen. According to the U.S. Food and Drug Administration (news - web sites), the substance is known to cause cancer and reproductive problems in animals, and in humans it is a neurotoxin at high enough doses.

Yet few studies have looked at acrylamide's actual impact on human health. This week, the American Chemical Society is hosting a three-day symposium during its annual meeting in California that features data from the most recent research.

On the whole, there seems to be little evidence to support a link between acrylamide and human cancers, such as tumors of the colon, rectum, bladder and liver.

Lorelei Mucci, an instructor in medicine at Harvard Medical School (news - web sites), and her colleagues have conducted four studies assessing the health impact of acrylamide in Swedish populations. She is presenting them at the meeting, which ends April 1. Two of the studies have already been published.

The first of the published studies found no evidence of a higher risk of colon, rectum and bladder cancer as a result of consuming acrylamide.

The second published study found no link between acrylamide and kidney cancer. "We found absolutely no association between higher intake of acrylamide and risk of renal cancer," Mucci says.

"The mean intake of acrylamide in all of our studies was between 25 and 35 micrograms per day," she says. Current risk assessment says acrylamide might start increasing the risk of cancer at about one microgram per kilogram of body weight. For an average person (70 kilograms), that would mean 70 micrograms per day. "The mean was half that," Mucci points out.

The first of the unpublished studies, a cohort of 60,000 Swedish women followed for 12 years, again found no difference in dietary acrylamide between the women who developed colon or rectal cancer and those who didn't. The data are preliminary, however, and the authors aren't drawing any conclusions about acrylamide and the risk of cancer.

The second unpublished study followed a different group of 49,000 Swedish women for 11 years and found the mean intake of acrylamide per day was about 31 micrograms in both the group that developed breast cancer and the group that didn't. Again, no conclusions are being drawn.

"Nobody knows what the bioavailability [of acrylamide] is, how your body uses it, so you could be exposed to perhaps 100 micrograms but maybe the body flushes it out," Mucci says. "That's an important question, too."

Overall, epidemiologists are coming to believe that levels of acrylamide within the average diet are probably not increasing the risk of human cancer, Mucci says. "What epidemiology cannot do is detect a really, really small effect and we can never really prove that something doesn't cause risk," she says.

Despite the lack of proof of risk, scientists are already working on alternatives to acrylamide. Some researchers may have found a way to short-circuit the formation of acrylamide during the cooking process.

"What we found out is that acrylamide is formed from the reaction of an amino acid [asparagine] that is present in all foods," says David Zyzak, a senior scientist at Procter & Gamble in Cincinnati. The amino acid reacts with sugars such as glucose and fructose during the cooking process and results in a small amount of acrylamide.

A different enzyme, asparaginase, degrades asparagine so it doesn't form acrylamide. "We took potato byproducts and treated them with asparaginase and saw that we can get a greater-than-90-percent reduction in acrylamide," Zyzak says.

Asparaginase is used in the treatment of leukemia patients. It is not a food-grade enzyme and therefore can't be incorporated into food yet. "We're working with another company trying to develop an asparaginase that could potentially be food-grade, but we would have to get [FDA] approval," Zyzak explains. "It is potentially a solution, but it could not be acted upon tomorrow."

On March 25, the FDA released new data on acrylamide levels in more than 750 new food samples, including black olives, prune juice and Postum, a powdered beverage.

In the absence of definitive health-risk information, the agency is advising consumers to eat a "balanced diet" with a "variety of foods" low in fat and high in grains, fruits and vegetables.

Mucci concurs.

"A lot of the foods [with acrylamide] have high levels of fat and we shouldn't be eating them anyway," she says. "There's an increased risk of obesity and cardiovascular disease, and we know those are major public health problems. Your risk of cancer may be small but your risk of these other things is big and it's not because of the acrylamide."

More information

The FDA has more on acrylamide in food, along with the new sampling data. The Joint Institute for Food Safety and Applied Nutrition also has information on acrylamide.

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Most Asthmatic Kids Not Prepared for Sports

 

By Alison McCook

Reuters Health

Monday, March 29, 2004

NEW YORK (Reuters Health) - Only a small minority of kids with asthma who participate in sporting events come armed with the medication that prevents and treats an asthma attack, new research suggests.

Despite the well-known fact that exercise can trigger an attack in asthmatics, only 22 percent of children playing baseball or soccer carried so-called rescue medicine, which opens their airways during an asthma attack, U.S. investigators found.

Leaving this medicine at home can have a significant impact on kids' ability to play sports, "without a doubt," Dr. Jack Becker of St. Christopher's Hospital for Children in Philadelphia told Reuters Health.

Children with uncontrolled asthma may be slowed down during sport by persistent coughs, tightness in their chest or trouble breathing, Becker noted. And in severe cases, asthma attacks can kill, he added.

"Everyone should be carrying" their rescue medicine, Becker said, which should also be included in all first-aid kits.

Asthma is marked by inflammation in the airways, which leads to wheezing, breathlessness and coughing that can range from mild to severe. Physical activity can trigger asthma attacks in up to 90 percent of patients.

The first-line treatment during an asthma attack is an inhaler containing a medication known as a beta-agonist, which opens constricted airways.

For their study, Becker and his team interviewed the parents of 579 children ages 12 and younger who were participating in Little League baseball or soccer. Parents indicated if their children had been diagnosed with asthma, and what medications they bring to sporting events.

A total of 80 parents said their children had been diagnosed by a doctor as having asthma. However, among those who played soccer, only 25 percent brought a beta-agonist inhaler to the game, and only 12 percent of baseball players had immediate access to their inhalers.

None of the teams brought extra rescue inhalers to the games, the authors report in the Annals of Allergy, Asthma & Immunology.

All of the study participants lived in a primarily middle- to upper-class community, indicating they likely have "no significant economic or educational barriers to following accepted standards of medical care," Becker and his team write.

Children probably own beta-agonist inhalers, but choose to leave them at home during games, Becker said in an interview. "People underestimate the severity of their disease, and they think they're not going to need it today," he said.

In reality, however, asthmatics can suffer attacks at a moment's notice, and children should be prepared, he noted.

"If you have asthma, it could get set off anytime, anywhere," Becker said.

Source: Annals of Allergy, Asthma & Immunology, March 2004.

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Too Much Sleep Not a Good Thing

 

HealthDayNews

Monday, March 29, 2004

SATURDAY, March 27 (HealthDayNews) -- Like most everything else, sleep is best done in moderation.

Spending too many hours in bed each night can cause as many problems as getting too few hours of sack time, according to a University of California, San Diego study in the journal Psychosomatic Medicine.

The study found people who sleep more than eight hours a night (long sleepers) and people who get less than seven hours of slumber both report more sleep complaints than people who get just the right amount of shuteye -- between seven and eight hours per night.

"Although it is unclear why long and short sleepers should have similar types of sleep complaints, these data challenge the assumption that more than seven or eight hours of sleep is associated with increased health and well-being," study co-author Michael A. Grandner says in a prepared statement.

He and colleague Dr. Daniel F. Kripke examined data from about 100 adults interviewed during the National Sleep Foundation's 2001 Sleep in America Poll.

They found that, compared with people who slept seven to eight hours a night, long sleepers reported more problems with falling asleep, waking up during the night, waking up too early, feeling unrefreshed when they wake up and feeling sleepy during the day.

Both long and short sleepers reported more sleep problems than people who got seven to eight hours of sack time each night. Women were more likely to be long sleepers than men.

More information

The National Sleep Foundation offers advice on getting a good night's sleep.

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Allergy Season Can Mean Asthma Trouble

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, March 29, 2004

WASHINGTON - The pollen starting to blanket the country means more than stuffy noses and runny eyes for millions of Americans: Allergies actually are the most common cause of asthma.

Yet many sufferers don't know that pollen or other allergens are triggering their asthma attacks, knowledge that could help them breathe easier. For people with particularly severe allergic asthma, a new drug that works differently from any other asthma medicine — though it is expensive and somewhat difficult to use — may help.

"It's amazing how many people do not think allergies" despite clear patterns of wheezing, says Dr. Stanley Goldstein of the American Academy of Allergy, Asthma and Immunology.

More than 17 million Americans have asthma, a chronic respiratory disease that causes recurring episodes of wheezing, chest tightness, coughing and difficulty breathing. Every year, asthma kills 5,000 people and is responsible for nearly 2 million emergency-room visits and half a million hospitalizations.

Rates of asthma have more than doubled since 1980. Doctors aren't sure why, but allergies are on the rise, too. While asthma attacks can be triggered by numerous things — exercise, cold air, stress, viruses — roughly 60 percent are triggered by allergens.

Indoor allergens, such as pet dander, dust mites or cockroach debris, put these people at risk year-round. But outdoor-allergy season brings an increase in asthma attacks, prompting the AAAAI and the Asthma and Allergy Foundation of America to try to raise awareness of the connection.

"The symptoms are the same — you cannot tell the difference" by symptoms alone, cautions Goldstein, who directs Allergy and Asthma Care of Long Island in New York. "The distinguishing factor is, if you know you have allergies, you can definitely do more to prevent the asthma."

Everyone's airways can react to irritants, like lots of smoke. But an asthma patient's airways are supersensitive, drastically narrowing in response to minor irritants that wouldn't affect normal lungs.

It's a dangerous chain reaction: Someone with allergic asthma inhales an allergen. The immune system immediately sends out antibodies called IgE to hunt it down. IgE links the allergen to mast cells that line the nose, bronchial tubes and certain other spots, which in turn spurs the release of inflammation-causing chemicals such as histamine and leukotrienes. When those agents hit the bloodstream, they can cause not just allergy symptoms but, in someone with allergic asthma, airway swelling, too.

All asthma patients require drugs that can widen airways during an attack, and other medicines, such an anti-leukotrienes, that can help prevent attacks.

People with allergic asthma also are tested to learn just which allergens trigger their airway attacks so they can avoid them, or try allergy shots to reduce their sensitivity.

The antihistamines that clear allergy-driven stuffy noses won't help asthma.

But there is a new option for the estimated half a million people with severe allergic asthma not controlled by today's medicines: Called Xolair, it's the first anti-IgE treatment, able to cut asthma attacks by about a third by blocking the IgE-caused inflammation chain reaction.

It's expensive, between $5,000 and $10,000 a year. However, specialists say insurance companies are covering it without complaint for those who qualify, partly because of evidence that Xolair reduces hospitalizations and cuts patients' use of other medicines.

It requires shots administered in a doctor's office every two to four weeks. And so far it's just for those over age 12, although a study aiming to enroll 570 6- to 11-year-olds around the country has just begun.

While it's not a cure, Xolair provides the first opportunity to block the root cause of a breathing attack, instead of battling inflammation far downstream. With its success, now "there's a lot of heavy research focusing on the immunologic cause for that asthma," Goldstein says.

Studies by the National Institutes of Health (news - web sites) are under way to find other treatments, such as drugs that block cytokines, another chemical involved in airway inflammation.

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

On the Net:

American Academy of Allergy, Asthma and Immunology: http://www.aaaai.org

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Sunday, March 28, 2004

More Evidence Found of How Vitamins Prevent Cancer  

By Maggie Fox, Health and Science Correspondent

Reuters

Sunday, March 28, 2004

WASHINGTON (Reuters) - Vitamin E protects against at least two common forms of cancer -- prostate and bladder -- but popping supplements is probably not the best way to get the vital nutrient, researchers said on Sunday.

Two studies found that people who either ate the most vitamin E containing food or who had the highest levels in the blood were the least likely to have cancer.

But the researchers also noted that there are several different forms of vitamin E and the kind you eat -- in this case alpha tocopherol -- is key. And the best-absorbed form of alpha tocopherol is not found in supplements but in foods such as sunflower seeds, spinach, almonds and sweet peppers.

In one of the studies presented to the annual meeting of the American Association of Cancer Research in Orlando, Stephanie Weinstein of the U.S. National Cancer Institute (news - web sites) and colleagues found men with the most vitamin E in their systems had the lowest risk of prostate cancer.

They looked at data from 29,133 Finnish men aged between 50 and 69 taking part in a smoker's study. All gave blood at the beginning of the study and then took vitamins to see whether the supplements might prevent various forms of cancer.

This study is best known for showing that smokers who took beta carotene, which the body converts to vitamin A, actually had higher rates of lung cancer.

Weinstein looked at vitamin E and prostate cancer, and they looked at how much E the men had in their blood before they ever took a supplement. They looked at 100 men with prostate cancer and 200 men who did not.

"We found that the men who had higher serum (blood) levels of vitamin E had a lower chance of getting prostate cancer," Weinstein told a news conference monitored by telephone.

Not All E's Equal

Then they looked at the two main forms of vitamin E -- alpha tocopherol and gamma tocopherol.

Men with the highest natural levels of alpha tocopherol were 53 percent less likely to later develop prostate cancer. Men with the highest levels of gamma tocopherol, which only represents about 20 percent of the vitamin E in blood -- had a 39 percent lower chance.

Taking supplements further reduced prostate cancer rates.

"Nuts and seeds, whole grain products, vegetable oils, salad dressings, margarine, beans, peas and other vegetables are good dietary sources of vitamin E," Weinstein said.

In a similar study, Dr. Xifeng Wu of the University of Texas M.D. Anderson Cancer Center, John Radcliffe of Texas Woman's University in Houston and colleagues studied 468 bladder cancer patients and 534 cancer-free volunteers.

They asked their 1,000 volunteers what they ate, and estimated how much alpha-tocopherol and how much gamma tocopherol they got in their everyday diets and from supplements if they took them.

Those with the highest intake of alpha tocopherol from food had a 42 percent reduced risk of bladder cancer, and those who had a vitamin E-rich diet and took supplements too had a 44 percent lower risk.

But when broken down into types, they found gamma tocopherol offered no protection against bladder cancer.

"It would not be reckless to encourage people to try and meet the dietary allowance of vitamin E, which is about 50 milligrams a day," Radcliffe told the news conference. Current average U.S. intake of E is only 8 mg a day.

One of the best sources, said Radcliffe, a dietician, is a handful of sunflower seeds. Almonds, spinach, mustard greens and green and red peppers are also good sources of alpha tocopherol.

Many E supplements, he said, contain both active and inactive forms of E and may not be the best source. Plus, he said, sunflower seeds are high in selenium, another key nutrient, while greens are loaded with desirable nutrients.

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Study: Stretching Doesn't Prevent Injuries

 

By Ira Dreyfuss

Associated Press Writer

The Associated Press

Sunday, March 28, 2004

WASHINGTON - Stretching does not live up to its reputation as an injury preventer, a study has found. "We could not find a benefit," said Stephen B. Thacker, director of the epidemiology program office at the Centers for Disease Control and Prevention (news - web sites). Athletes who stretch might feel more limber, but they shouldn't count on stretching to keep them healthy, he said.

Thacker and four CDC colleagues combed research databases for studies that had compared stretching with other ways to prevent training injuries. They combined data from five studies so they could look more closely for any benefits that might emerge as a pattern. Their report is in the March issue of the American College of Sports Medicine journal, Medicine and Science in Sports and Exercise.

People who stretched were no more or less likely to suffer injuries such as pulled muscles, which the increased flexibility that results from stretching is supposed to prevent, researchers found. And the injuries found in the study typically happened within the muscle's normal range of motion, so stretching them would not have made a difference, Thacker said.

Other research has found that warmups, which increase blood flow through the muscle and make it more ready to respond to exercise, can reduce the risk of injury, Thacker said. Being in good shape also helps. Strength and balance training reduced injuries as well, he said.

People such as gymnasts and dancers might be exceptions, because their activities require great flexibility, so stretching might improve their performance, Thacker said.

In case future research does find a benefit, Thacker has no problem with athletes continuing to do gentle stretching. That's not the case with stretches that include sudden fast movements, called "ballistic stretches," which have been found in other studies to raise injury risks.

The study's findings make sense, said Mike Bracko, director of the Institute for Hockey Research in Calgary, Alberta. "We have done some work with hockey players showing flexibility is not an important variable," he said.

A strain typically happens when a muscle has to react suddenly to control an athlete's movement, Bracko said. An example would be a tear in a muscle in the back of a sprinter's leg as it contracts to keep the muscles in the front of the leg from moving the knee too far forward, he said.

Two other researchers said, however, that there may still be value in the stretches that coaches require, and athletes do.

Lynn Millar, a professor of physical therapy at Andrews University in Berrien Springs, Mich., said her experience in treating people with injuries tells her that those who don't stretch may find they can't move their arms and legs as far as they used to, and this could set them up for injury.

"Unfortunately, a lot of us don't have a normal range of motion," Millar said.

Stephen Rice, director of the sports medicine center at Jersey Shore University Medical Center in Neptune, N.J., said he values the experience of trainers and athletes.

Flexibility is an element of fitness, and stretching ought to make a person more flexible, Rice said. "I would say the conventional wisdom has a certain amount of wisdom to it," he added.

On the Net:

Medicine and Science in Sports and Exercise journal: http://www.ms-se.com

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Saturday, March 27, 2004

 

1st DeBakey Heart Pump Is Used for Child

 

The Associated Press

Saturday, March 27, 2004

HOUSTON - A 6-year-old Houston girl at Texas Children's Hospital on Friday became the first patient in the world to receive a DeBakey child heart pump.

Ann Grudziecke was recovering Friday night after receiving the device, which is a scaled-down model of the original pump designed by renowned heart surgeon Dr. Michael DeBakey.

"The idea of having an implantable pump for children is really a giant step forward," Dr. Charles D. Fraser Jr., the chief of cardiovascular surgery at Texas Children's Heart Center told the Houston Chronicle. "We hope this is the first step for developing even smaller devices for children."

Fraser, who performed the surgery said Ann still is very ill and will remain in the hospital until her heart transplant. It could take several months to receive a new heart, Fraser said.

The DeBakey ventricular assist device for children helps weakened hearts pump blood throughout the patient's body by supplementing the pumping ability of the left ventricle, the main pumping chamber of the heart.

Ann's heart muscle had thickened, causing it to stiffen and deteriorate, the newspaper reported.

Several U.S. children, including a 22-month-old Indianapolis boy, have been implanted with another heartpump, a European device called the Berlin Heart.

The U.S Food and Drug Administration (news - web sites) earlier this month gave heart transplant centers the option to use the DeBakey pump on an emergency basis. Prior to that, Fraser said, surgeons had to use pumps that worked on the outside of the body and worked only temporarily.

"Historically, when children's hearts were failing, it was kind of a desperate situation," he said. "Now we have a good option."

Adult patients have survived for more than a year with the DeBakey heart pump. It has been implanted into more than 200 patients.

In recent years heart surgeons have turned more toward heart pumps as an alternative to artificial hearts.

Several pumps are available in the United States, including HeartMate by Thoratec of Pleasanton, Calif., and the Novacor by World Heart of Ottawa, Canada. Both devices are in thousands of patients and both are larger than the DeBakey pump.

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