The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
June 23, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 April 10 - 16

 

  1. Doctors May Screen Stool Samples for Cancer
  2. Magnetic Therapy Helps Alleviate Stress Disorder
  3. Depression Not Uncommon During Pregnancy
  4. High Blood Pressure May Be Misdiagnosed in Young Adults
  5. U.S. Surgeon General Seeks Healthier Food Ads
  6. Subnormal Vision
  7. Singapore Researchers Develop Dissolving Heart Stent
  8. Brain Boosters
  9. New Drug-Resistant Type of Salmonella Identified
  10. Stomach Cancer Procedure Doesn't Improve Odds
  11. Rehab Training Cuts Heart Attack Risk Factor
  12. It's Official Drinking Causes Gout
  13. Explaining Blood Pressure Spikes During Exercise
  14. Snack Makers: Low-Carb Trend Won't Last
  15. Alzheimer's Insight Could Lead to New Therapies
  16. More Than 8 Hours Sleep Too Much of a Good Thing
  17. New Genetic Clue to Parkinson's Found
  18. Health Bills Cost Some Seniors Their Homes
  19. Two Scans Better Than One for Lung Cancer
  20. UK Campaign Highlights Morning Heart Attack Peak
  21. Study Criticizes Quality of Some Cancer Web Sites
  22. Watch Your Waistline
  23. US Children Get Uneven Health Care, Report Finds
  24. Relief for Acid Reflux
  25. Study Raises Fears of Teen Smoking Resurgence
  26. Inner Strength Helps Women After Cancer
  27. One in Five Americans Die in ICU
  28. New Target for Skin Cancer Vaccine Discovered
  29. Friends, Lovers Lower 2nd Heart Attack Risk –Study
  30. When Coughing Can Save Your Life
  31. Schools Help Hungry Kids During Weekends
  32. Sleepless Tots May Become Troubled Teens – Study
  33. Conn. May Push Schools on Fitness, Diet
  34. Low Vitamin B May Impair Memory in Some Seniors
  35. Florida Schools' Fitness Plan Delayed
  36. Low-Dose Antibiotic May Curb Heart Disease Risk
  37. Genetic Link to Liver Cancer Found
  38. Vegetable Fiber Tied to Lower Prostate Cancer Risk
  39. College Women's Drinking Raises Abuse Risk
  40. Soy Product Slows Prostate Enlargement, in Rats
  41. Genetic Tests Show Promise Against Leukemia
  42. Diabetes Control Shrinks Enlarged Heart
  43. Key Protein in Blood Vessel Formation Found
  44. Nitrates in Water Not Linked to Pancreatic Cancer
  45. Age Doesn't Matter with Kidney Transplants
  46. Chewing Gum Kills Bacteria, Freshens Breath
  47. Most Juvenile Delinquents Suffer Traumas
  48. No 'Safe' Alcohol Intake Found with Hepatitis C
  49. Study: Tobacco Industry Tried to Stall Secondhand Smoke Report
  50. Estrogen No Overall Benefit in Disease Prevention
  51. Lung Cancer in U.S. Women Is 'Epidemic'
  52. FDA Approves Human Brain Implant Devices
  53. Pneumonia Raises Death Risk Even in Midlife
  54. Causes of Blindness Differ in Blacks, Whites
  55. Arkansas City Battling Obesity in Kids
  56. Chronic Gut Pain in Kids Tied to Mood Disorder
  57. Obesity, Depression Affecting Omaha, Neb.
  58. Gene Variant May Contribute to Autism
  59. Over-the-Counter Drugs Aren't Risk-Free
  60. Latest Word on Virtual Colonoscopy: Not Yet
  61. There's a Spider in My Grapes
  62. Long-Term Diabetes Control Pays Off for the Heart
  63. Secondhand Smoke Slows Wound Healing
  64. Fat Protein Predicts Heart Attack Risk in Men
  65. Finding the First Signs of Ovarian Cancer
  66. Men Take Note of Prostate Cancer in Family
  67. Get Checked for Asthma and Breathe Easier
  68. Outlook Improving for Kids with Sickle Cell Disease
  69. Quick Hip Fracture Surgery Cuts Patient Pain
  70. Parents Urged to Leave Teen Drug Testing to Pros
  71. Predicting Odds Against Prostate Cancer
  72. Pfizer Says It Sues Web Site Selling Bogus Lipitor
  73. Heart Condition Doesn't Boost Risk of Second Stroke
  74. Commercial Jets Must Have Defibrillators
  75. Older Americans at Higher Risk of Blindness –Study
  76. Advanced Scanning Being Used for Autism
  77. Kidneys from Older Donors Work as Well - U.S. Study
  78. Va. Schools' Dilemma: Profit or Diet?
  79. Heart Attack Hospital Stays Decline, Study Finds
  80. Health Pros Warn Against Chewing Tobacco
  81. Ginger Eases Morning Sickness: Study
  82. West Virginia Battling Obesity Rates
  83. Cannabis Use Linked to Early-Onset Schizophrenia
  84. Fat-Free Fallacies
  85. Low -Calorie Diets Help Women with Ovary Condition
  86. Drinking Enough Water
  87. Spirituality Helps Older Adults Cope with Illness
  88. Help Yourself to Heart Health
  89. Outlook Improved Since 80s for Arthritis Sufferers
  90. AIDS Treatment Was Delayed for Minorities, Poor
  91. Study Suggests More Frequent Breast Exams Needed
  92. Brain Regions Work in Tandem in Math Wizards
  93. Docs, Nurses Misjudge Late Nausea After Chemo
  94. Chemo Side Effects Underestimated
  95. Home-Cooking Movement Gains Ground
  96. Spring Into Shape...
 
Friday, April 16, 2004

 

Doctors May Screen Stool Samples for Cancer

 

Reuters

Friday, April 16, 2004

LONDON (Reuters) - Doctors may soon be able to save lives by checking stool samples for DNA evidence of cancer, researchers said on Friday.

A new stool test could one day help spot colorectal cancer, one of the most common cancers in the industrialized world, which now can usually be detected only with uncomfortable invasive procedures.

Scientists have long been looking for telltale signs in the stools of cancer sufferers that would allow for a less invasive test. A team of researchers, writing in the British journal The Lancet, reported that they found such signs in DNA in the stools.

When detected at the earliest stage, colon cancer is nearly 100 percent curable, doctors say.

Hannes M. Mueller, from Austria's Medical University in Innsbruck, and colleagues were able to distinguish stools of patients with colorectal cancer from those of healthy patients by examining chemical changes to DNA found in the stool.

A gene known as SFRP2 was more likely to have undergone a chemical process called "methylation" in the stools of cancer sufferers than in those of healthy individuals.

"To our knowledge, SFRP2 methylation represents one of the most sensitive markers for identifying colorectal cancer ... in stool samples," wrote Martin Winschwendter, the study's principle investigator.

He said it still remained to be seen whether a group of markers could be found that would identify cancer at an early stage from stool samples.

Exact Sciences Corp., a small Massachusetts company, does have a test called Pregen-Plus that isolates human DNA from stool samples for early detection of colorectal cancer.

However, Pregen-Plus, which has been available in the United States since last August, looks at different markers than those cited by researchers in the Lancet report.

The Exact Sciences test has shown to be a more accurate detector of cancer than the common fecal occult blood test, which only determines the presence of blood in stool -- a possible indicator cancer, but one that could have other causes. (Additional reporting by Bill Berkrot in New York)

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Magnetic Therapy Helps Alleviate Stress Disorder

 

Reuters Health

Friday, April 16, 2004

NEW YORK (Reuters Health) - New research suggests that repeat stimulation of certain brain regions with magnets can help alleviate the symptoms of post-traumatic stress disorder (PTSD), a debilitating psychiatric condition that can occur after exposure to life-threatening events, such as military combat or violent personal assault.

A region of the brain called the prefrontal cortex has an "important role in mediating responses to stressful situations," Dr. Hagit Cohen and colleagues from Ben-Gurion University of the Negev in Beer Sheva, Israel note in the American Journal of Psychiatry.

In an earlier study, two patients with PTSD experienced improvements after treatment with magnetic stimulation, they add.

In the current study, the group evaluated the therapeutic effects of low- and high-frequency magnetic therapy as compared with fake therapy in 24 patients with PTSD.

High-frequency therapy had greater beneficial effects than low-frequency or fake therapy. Patients in the high frequency group also showed far greater reductions in anxiety than did those in the low-frequency group. Several patients in both magnetic therapy groups reported improvements in sleep after being treated.

Based on this small, preliminary study, trials of high-frequency magnetic therapy "may be a promising avenue for further research with PTSD patients," the authors conclude.

Source: American Journal of Psychiatry, March 2004.

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Depression Not Uncommon During Pregnancy

 

Reuters Health

Friday, April 16, 2004

NEW YORK (Reuters Health) - The results of a review of studies involving more than 19,000 patients suggest that rates of depression during pregnancy are high. This might be especially true during the second and third trimesters.

"Current estimates of the prevalence of depression during pregnancy vary widely," Dr. Thomas R. Einarson and colleagues from the University of Toronto, Ontario, report in Obstetrics and Gynecology. "A more precise estimate is required to identify the level of disease burden and develop strategies for managing depressive disorders."

To investigate, the researchers identified a number of relevant observational studies and surveys from a variety of databases. Ultimately, a total of 21 articles involving 19,284 patients were included in their analysis.

Among instruments employed were the Beck Depression Inventory and the Edinburgh Postnatal Depression Scales. Structured interviews were also used alone and in combination with these instruments. Structured interviews found lower rates of depression than did the Beck Depression Inventory, but not the Edinburgh Postnatal Depression Scale.

Based on their analysis, they estimate that the prevalence of depression was 7.4 percent in the first trimester, 12.8 percent in the second and 12.0 percent in the third trimester of pregnancy.

Overall rates did not differ significantly across trimesters. However, the team points out that the lower rate of depression in the first trimester, "must be interpreted with caution," because few studies were available for this period.

In light of these "substantial" rates of depression, the investigators conclude that "clinical and economic studies to estimate maternal and fetal consequences are needed."

Source: Obstetrics and Gynecology, April 2004.

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High Blood Pressure May Be Misdiagnosed in Young Adults

 

Reuters Health

Friday, April 16, 2004

LONDON (Reuters Health) - Routine blood pressure measurements in people under 35 years of age may often lead to a misdiagnosis of high blood pressure, the results of a study in the British Medical Journal suggests.

Blood pressure varies randomly from beat to beat, and any measurement is only an estimate of the true average blood pressure, notes public health lecturer Tom Marshall in his study. Guidelines recommend that doctors use three measurements when deciding whether to treat patients for high blood pressure, or hypertension.

The variation within individuals for the top reading of the blood pressure, or systolic pressure, is nearly 10 percent. The variation for the blood pressure bottom reading, or diastolic pressure, is about nine percent, notes Marshall, who is based at the University of Birmingham.

Using these figures and data from health surveys for England in 1998-2000, he calculated the values of three blood pressure measurements for men and women by age.

The predictive value of blood pressure estimates was highest in older age groups and lowest in younger people, he reports.

Of 36 men between 16 and 34 years old who were classified as needing treatment, only 11 were true positives. Of 19 women in the same age group, only five really needed treatment.

"Routine measurement of blood pressure in persons under 35 is more likely to misdiagnose than to diagnose hypertension correctly," Marshall writes.

"As 10-year coronary risk rarely exceeds five percent in adults under 35, clinicians should diagnose hypertension with caution--perhaps at a higher threshold."

The main usefulness of blood pressure monitoring, he adds, is in people with specific conditions or risk factors for heart disease.

Source: British Medical Journal, April 17, 2004.

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U.S. Surgeon General Seeks Healthier Food Ads

 

By Michele Gershberg

Reuters

Friday, April 16, 2004

MIAMI (Reuters) - Food companies and their advertising agencies should take the initiative to promote healthy eating habits to help counteract a growing U.S. obesity epidemic, U.S. Surgeon General Richard Carmona said on Friday.

Carmona said he did not seek regulatory changes to food advertising -- for example a warning note to eat the showcased product in correct proportion and as part of a balanced diet -- but cited steps already taken by marketers, including No. 1 burger chain McDonald's Corp., to revamp product lines and raise consumer awareness of healthier food.

"We took a practical approach ... so they (agencies) will always be thinking of how can I shape this client's product so they'll sell this product but there will be some healthy association," Carmona said at an advertising conference in Miami.

He said such an approach was preferable to public lawsuits that have challenged food companies for contributing to overeating by a barrage of advertising and large portions.

Carmona told advertising executives at the American Association of Advertising Agencies' Management Conference that an estimated 400,000 Americans die each year from obesity-related health problems, creeping up on some 440,000 who die from diseases tied to cigarette smoking.

The U.S. Department of Health and Human Services (news - web sites) launched an advertising campaign last month to promote simple lifestyle changes to lose excess weight by snacking on fruits and vegetables or taking the stairs instead of an escalator.

The campaign includes a partnership with public television's Sesame Street program for children. Carmona said he would like to target a message of well-being to other groups, from teenagers to families, via other media outlets including MTV and Walt Disney Co. .

Asked whether the current craze over low carbohydrate diets, such as Atkins and the South Beach diet, was healthy, Carmona said carbohydrates should not be skipped altogether.

"I'm concerned about any diet that purports to be a quick fix," he said. "The fact is that most of them fail in the long term."

Advertising executives said their clients sought new tactics for selling food without getting drawn into the obesity battle, including using well-known figures from commercials to send a new message.

"We've changed a lot of things about Ronald McDonald in terms of him being an advocate of healthy foods," Cheryl Berman, chairman and chief creative officer at the Leo Burnett USA agency, told Reuters, referring to the clown-like mascot of client McDonald's. "You have to use the icons (of advertising). They're very powerful."

Part of the Publicis Groupe, Leo Burnett also works with top food companies such as Kellogg Co.

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Subnormal Vision

 

HealthDayNews

Friday, April 16, 2004

(HealthDayNews) -- Subnormal vision, also known as low vision, is often caused by such eye diseases as macular degeneration or cataracts, according to Barnes Jewish Hospital.

Since prescriptive eyewear can't correct the condition, vision may be reduced to the point where daily activities like reading, writing or driving are difficult to perform.

If you suffer from subnormal vision, an eye care specialist can help you maximize the vision you have. Hand-held magnifiers, spectacle magnifiers, video-projected magnifiers and talking books can help improve daily living.

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Singapore Researchers Develop Dissolving Heart Stent

 

Reuters

Friday, April 16, 2004

SINGAPORE (Reuters) - A team of researchers from Singapore has made a completely biodegradable heart stent aimed at improving patient recovery and reducing infections, the city-state's Nanyang Technological University said on Friday.

Stents are small tube-like devices surgically implanted into patients to improve blood flow in the blood vessels.

Currently permanently inserted metal stents are used that can cause blood clots and re-blockage of blood vessels. Patients need to take several drugs to prevent these problems.

NTU researchers said in a statement the new stent can carry multiple layers of drugs that can be released into a patient's body at various rates over a sustained period of time from days to several months.

After that, the stent will completely dissolve in the body as lactic acid.

The product, which took two and a half years to develop, will enable doctors to tailor prescriptions for different patients for optimal treatment, said a spokesperson from NTU.

According to the statement, the stents can be used in coronary arteries, the brain, the lungs, the urinary tract, and any part in the body where fluid flow is disrupted.

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Brain Boosters

 

HealthDayNews

Friday, April 16, 2004

(HealthDayNews) -- If you've been lamenting that your memory isn't what it used to be, take heart. Memory is a skill that can be sharpened and improved at any age, according to Connecticut College.

Give your brain a regular workout by:

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New Drug-Resistant Type of Salmonella Identified

 

Reuters Health

Friday, April 16, 2004

NEW YORK (Reuters Health) - Researchers have identified a strain of Salmonella choleraesuis (S. choleraesuis) that is resistant to Rocephin (ceftriaxone), an antibiotic that has been a reliable treatment in the past. The emergence of this strain, say the investigators, could have important public health implications.

Over the years, they point out that S. choleraesuis has developed resistance to a variety of antibiotics, especially drugs like Cipro (ciprofloxacin). Until now, however, the microbe had always been sensitive to Rocephin.

In The Lancet, Dr. J. T. Ou, from Chang Gung University in Taoyuan, Taiwan, and colleagues describe a strain of S. choleraesuis that was isolated from a 58-year-old man with a severe blood infection.

The organism was found to be resistant to all standard anti-salmonella antibiotics as well as to Rocephin and Cipro. Treatment with Primaxin (imipenem-cilastatin) was unsuccessful and the patient died 7 days after hospital admission.

The Cipro resistance was due to mutations in two of the microbe's genes, whereas the Rocephin resistance resulted from a gene that had been picked up in the environment.

"The appearance of this resistant S. choleraesuis," the researchers conclude, "is a serious threat to public health. Constant surveillance is needed to prevents its further spread."

Source: The Lancet, April 17, 2004.

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Stomach Cancer Procedure Doesn't Improve Odds

 

HealthDayNews

Friday, April 16, 2004

FRIDAY, April 16 (HealthDayNews) -- Extended lymph node dissection does not increase long-term survival for people with stomach cancer, says new research in the Netherlands.

The study was the largest randomized trial of limited and extended lymph node dissection among people with gastric cancer, the fourth most common type of cancer in the world.

Extended lymph node dissection involves the surgical removal of lymph nodes near the tumor, in distant areas of the stomach and, in some patients, removal of the spleen and pancreas tail.

"Long-term follow up of limited and extended lymph node dissection clearly demonstrates that neither improved survival nor decreased relapse rates can be obtained by extended dissection. In fact, extended lymph node dissection may even be harmful because of increased morbidity and hospital mortality associated with the procedure," study author Dr. H. H. Hartgrink said in a prepared statement.

The study was published online this week in the Journal of Clinical Oncology.

An editorial in the same issue of the journal said the findings resolve a major debate among cancer experts about the benefits of extended lymph node dissection.

More information

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

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Rehab Training Cuts Heart Attack Risk Factor

 

Reuters Health

Friday, April 16, 2004

NEW YORK (Reuters Health) - Participating in a cardiac rehabilitation program for just 3 months can help patients with heart disease reduce blood levels of C-reactive protein (CRP), a marker linked to heart attack and stroke, new research indicates.

Treatment with cholesterol-lowering drugs has been shown to reduce CRP levels. The new findings suggest another way that patients can reduce their CRP levels, lead author Dr. Richard V. Milani and colleagues, from the Ochsner Clinic Foundation in New Orleans, note.

As reported in the Journal of the American College of Cardiology, the researchers compared the CRP levels of 235 patients who participated in a rehabilitation program with those of 42 similar patients who did not. In addition to CRP levels, body fat, obesity status, and exercise capacity were determined before and after the program was implemented.

Enrollment in the rehabilitation program had a number of beneficial effects, including a significant drop in body fat, an enhanced exercise capacity, and an improvement in obesity status. In the comparison group, by contrast, no beneficial effects were seen.

Rehab patients experienced a 36 percent drop in their average CRP level, the authors observe. Moreover, the CRP reduction achieved was not influenced by whether the patient had lost weight or was receiving cholesterol-lowering drugs. No significant change in CRP levels was seen in the comparison group.

Milani's team concludes that "in addition to receiving appropriate (drug therapy), patients...should be routinely referred to cardiac rehabilitation and exercise training."

Source: Journal of the American College of Cardiology, March 14, 2004.

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Thursday, April 15, 2004

 

It's Official Drinking Causes Gout

 

Reuters

Thursday, April 15, 2004

LONDON (Reuters) - It's official -- drinking causes gout. But if you must drink alcohol, drink wine, scientists say.

For centuries, the painful, crippling joint inflammation has been immortalized by poets and playwrights -- more than a few of whom wrote from personal experience -- as the curse of heavy drinkers.

But until a team of researchers from Massachusetts General Hospital took up the task, nobody had actually proved the link between the disease and the bottle.

After analyzing 730 confirmed cases of gout from among a group of 47,000 men over 12 years, the researchers not only demonstrated that drinkers are more likely to get gout, but also that beer is worse and wine is best.

Gout is caused by deposits of crystals of a chemical called uric acid in joints. Alcohol consumption leads to "hyperuricaemia" -- when the body produces too much uric acid.

"Two or three beers per day increased the risk of gout 2.5-fold compared with no beer intake, whereas the same frequency of spirits intake increased the risk by 1.6 times compared with no spirits intake," said Dr Hyon K Choi of the team. The research was published in the journal The Lancet.

Wine, in moderation, was not a problem. Two small glasses a day caused no increase in gout.

That suggested that something other than the alcohol in the drinks was also playing a role, Choi said.

He said one suspect might be a chemical called purine, which is found in larger quantities in beer than in other alcoholic drinks and could "augment the hyperuricaemic effect of alcohol itself."

But there are still mysteries for playwrights to ponder.

"Whether there are other risk factors in beer, or protective factors in wine, remains unknown," Choi said.

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Explaining Blood Pressure Spikes During Exercise

 

The Associated Press

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- Researchers at Johns Hopkins Medical Institutions say they may have identified what causes "exercise hypertension," an abnormally high spike in blood pressure that can occur in normally healthy people when they exercise.

Exercise hypertension is a known risk factor for permanent and serious high blood pressure at rest. But the cause of exercise hypertension has been unclear.

This new study suggests it may be caused by the failure of endothelial cells that line the blood vessels to let the arteries expand to accommodate the increased blood flow that occurs when a person exercises.

"Our study shows that this impaired ability of the endothelial cells, which control large blood vessel relaxation, is a potential cause of exercise hypertension," study author Kerry J. Stewart, director of clinical exercise physiology, said in a prepared statement.

"Because as many as 90 percent of adults are at risk for developing high blood pressure, knowing this may point to a cellular target for preventive therapies," Stewart said.

The study appears in the April issue of the American Journal of Hypertension.

More information

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

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Snack Makers: Low-Carb Trend Won't Last

The Associated Press

Thursday, April 15, 2004  

DETROIT - Many people nationwide may be demanding low carbohydrate offerings from food companies for their Atkins and South Beach diets, but three area snack makers say the trend won't last.

The salty snack industry has seen its share of nutritional fads over the years: low salt, low fat, healthy cooking oils. Now, millions of American adults are thought to be on low-carb diets.

"It's a fad," Sal Cipriano, president of Better Made Snack Foods Inc. in Detroit, told The Detroit News for a Sunday story. "We've seen a lot of these diets."

"Uncle Ray" Jenkins, president and chief executive of Jenkins Foods, which makes 15 flavors of distinctive potato chips at its factory on Detroit's west side, agrees with Cipriano's assessment.

"There is no such thing as a low-carb chip," Jenkins said. "You would be deceiving the customer and that's the wrong thing to do."

Low-carb diets have been around for decades, but only in the last few years made it to the mainstream. Yet, in that time they have revolutionized dieting and challenged and changed the entire food industry.

The diets restrict grains, sugars, fruits and starchy vegetables and allow larger portions of meat, eggs and cheese. Robert Jasgur, president of Detroit Popcorn Co., was on the Atkins diet himself.

"It's like every other diet: You get tired of it," said Jasgur, whose company churns out plain, caramel, cheese, almond pecan, chocolate-coated and sugar-free popcorn. "Besides, popcorn by itself is a relatively healthy snack."

Better Made Snack Foods Inc.: http://www.bettermadepotatochips.com

Detroit Popcorn Co.: http://www.detroitpopcorn.com

Information from: The Detroit News, http://www.detnews.com

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Alzheimer's Insight Could Lead to New Therapies

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, April 15, 2004  

THURSDAY, April 15 (HealthDayNews) -- Researchers may have managed to connect two "dots" in the biology of Alzheimer's disease (news - web sites) that could eventually lead to new drug therapies.

Two areas of Alzheimer's research have received much attention but their relationship to each other has been unclear, explained Dr. Sam Gandy, vice president of the Alzheimer's Association's Medical and Scientific Advisory Council. One is the characteristic and toxic build-up of amyloid beta protein in the brain of Alzheimer's patients. The other is a disturbance in the energy metabolism of nerve cells that is controlled by the cellular structure known as mitochondria.

A new paper appearing in the April 16 issue of Science proposes that the amyloid beta protein somehow invades the mitochondria and disrupts their energy-producing function. Exactly how the protein manages to overcome a cell's defenses to do this remains unclear, though.

"It's exciting in that it would link two apparently disparate parts of the research," said Gandy, who is also director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia. "But I still consider it to be somewhat preliminary."

An estimated 4.5 million Americans have Alzheimer's disease, which results in the progressive loss of mental functioning, including memory, and can eventually prove fatal.

The authors of the new study speculated that amyloid beta protein interacted with an enzyme called ABAD in the mitochondria to produce the disruption in the mitochondria.

They managed to show this interaction, both in genetically engineered mice and in brain tissue from people who had died of Alzheimer's. The interaction caused damage to not just the mitochondria but the entire nerve cell. Eventually the nerve cells died, resulting in the symptoms associated with Alzheimer's.

"The mechanisms of the cause of neuronal damage have been quite unclear, so in our study we show that amyloid beta protein accumulates in the mitochondria in transgenic mice and interacts with one protein we call ABAD to produce toxicity," said Dr. Shi Du Yan. She is lead author of the study and an associate professor of clinical pathology at the College of Physicians & Surgeons at Columbia University in New York City.

"This is perhaps one of the first studies that shows that beta amyloid can act on the mitochondria to induce toxicity," added Hao Wu, co-senior author of the study and a professor of biochemistry and structural biology at Weill Medical College of Cornell University, also in New York City.

One remaining question, however, is how the protein makes its way into the mitochondria. "No one knows how it gets there," Wu said.

Still, Wu and her colleagues hope that preventing or reducing the interaction between amyloid beta and ABAD may represent an eventual treatment for the disease. "There probably is a potential for treatment," Yan said.

Wu said that when they inhibited the interaction in this study, "we show that amyloid beta can no longer induce cell death," she said. "That says to us that it's playing a major role in beta-induced toxicity."

More information

For more on Alzheimer's, visit the Alzheimer's Association or the Alzheimer's Disease Education and Referral Center.

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More Than 8 Hours Sleep Too Much of a Good Thing

 

By Alison McCook

Reuters Health

Thursday, April 15, 2004

NEW YORK (Reuters Health) - Although the dangers of too little sleep are widely known, new research suggests that people who sleep too much may also suffer the consequences.

Specifically, investigators at the University of California in San Diego found that people who clock up 9 or 10 hours each weeknight appear to have more trouble falling and staying asleep, as well as a host of other sleep problems, than people who sleep 8 hours a night.

People who slept only 7 hours each night also said they had more trouble falling asleep and feeling refreshed after a night's sleep than 8-hour sleepers.

These findings, reported in the journal Psychosomatic Medicine, demonstrate that people who want to get a good night's rest may not need to set aside more than 8 hours a night, study author Dr. Daniel Kripke told Reuters Health.

He added that "it might be a good idea" for people who sleep more than 8 or 8 1/2 hours each night to consider reducing the amount of time they spend in bed, but cautioned that more research is needed to confirm this.

Previous studies have shown the potential dangers of chronic shortages of sleep-- for instance, one report demonstrated that people who habitually sleep less than 7 hours each night have a higher risk of dying within a fixed period than people who sleep more.

For the current report, Kripke and lead author Michael Grandner reviewed the responses of 1004 adults to sleep questionnaires, in which participants indicated how much they slept during the week - excluding naps - and whether they experienced any sleep problems.

Sleep problems included waking in the middle of the night, arising early in the morning and being unable to fall back to sleep, and having fatigue interfere with day-to-day functioning.

Kripke and Grandner found that people who slept between 9 and 10 hours each night were more likely to report experiencing each sleep problem than people who slept 8 hours.

In an interview, Kripke noted that long sleepers may struggle to get rest at night simply because they spend too much time in bed. As evidence, he added that one way to help insomnia is to spend less time in bed.

"It stands to reason that if a person spends too long a time in bed, then they'll spend a higher percentage of time awake," he said.

Alternatively, Kripke suggested that there may be a link between long sleeping and depression, noting that people who are depressed often temporarily feel better after skipping a night of sleep.

"It might be that depression is causing the long sleep, it might be that the long sleep is causing the depression," Kripke said.

Source: Psychosomatic Medicine, March/April 2004.

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New Genetic Clue to Parkinson's Found

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- Identification of a gene that causes a rare, inherited form of Parkinson's disease (news - web sites) could revolutionize research on the condition and other neurological disorders, researchers report.

"It is a completely novel and, to my mind, completely unexpected gene/protein to be involved in Parkinson's disease," said Dr. Nicholas W. Wood, a professor of clinical neurology and neurogenetics at the Institute of Neurology in London and lead author of a report on the discovery in the April 16 issue of Science. "It opens the door to a whole new area of Parkinson's disease, and perhaps other neurodegenerative disease research."

Parkinson's disease is a progressive disorder caused by degeneration of nerve cells in the part of the brain that controls movement. First described as "the shaking palsy" in 1817, it affects an estimated 500,000 Americans, with 50,000 new cases reported each year. The most famous Parkinson's patient is Pope John Paul (news - web sites) II.

The first symptoms of the condition generally occur at about age 60. The gene described by Wood and collaborators in three European countries and the United States was identified in three families in which the disease appears much earlier in life.

Close study found that members of those families all had a mutation of a gene designated PINK1, which makes a protein active in mitochondria, cellular units that convert food into energy. A first guess is the normal version of the gene protects mitochondria in brain cells against damage, but that is just a starting point, Wood said.

"We need to know more about what the protein does normally, as well as when it is mutated," he said. "This will involve structural chemistry, biochemistry, cell and animal model systems."

Another question is the role the gene might play in the common form of the condition, Wood said.

"I do not think primary pathogenic mutations in this gene are likely to contribute to lots of common forms of Parkinson's disease, but we will need to sequence a lot of individuals to be certain what proportion of cases are due to mutations in this gene," he said.

The discovery has some potential applications to the detection and treatment of Parkinson's disease, Wood said.

"Initially, I think it will be most useful as a genetic test, to sequence at-risk individuals and counsel the families," he said. "However, this new area does of course open the way for potential novel therapeutic targets."

It's an important finding because it helps confirm a suspicion about the role of mitochondrial malfunction in Parkinson's and other neurological diseases, said Dr. Robert Nussbaum, chief of the genetic diseases research branch of the National Human Genome Research Institute, a part of the National Institutes of Health (news - web sites). His group helped identify one of the families in the study.

"For many years, it has been suggested that there is a connection between Parkinson's disease and mitochondrial dysfunction," Nussbaum said. "We've never really understood what defects inside the mitochondria might lead to dysfunction. Now this points to a protein, or set of proteins, that when altered can induce the disease. This is a process that we didn't know existed, and it could be involved in the more common forms of Parkinson's disease."

More information

The role of genetics in Parkinson's disease is explained by the National Human Genome Research Institute, while you can get background on the condition from the National Institute of Neurological Disorders and Stroke.

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Health Bills Cost Some Seniors Their Homes

 

The Associated Press

Thursday, April 15, 2004

LAS VEGAS - Some Nevada senior citizens say they fear losing their homes to the state after the Nevada Supreme Court upheld state liens on the estates of people who received Medicaid health care costs.

"They should warn people when they receive Medicaid that they are given a loan," said Henry Ringel, 79, of Las Vegas. "I love this country, but when we pass away we won't be able to leave our son anything. I worked for our home and now they can steal it away."

Justices ruled April 1 that the Welfare Division can continue to put liens on homes of widows and widowers to ensure the recovery of some health care costs provided for their spouses.

State Human Resources Director Michael Willden said taxpayers should not have to cover medical costs to enable a person to pass valuable property to descendants.

"The taxpayers are putting out this money and we have an obligation under federal regulations to try recover it," he said.

Sandy Webb, Nevada's estate recovery administrator, said the state has placed 60 liens on the homes of survivors since 1998. The program nets $1.2 million to $1.4 million a year, she said.

Elder rights lawyer Jim O'Reilly said the decision gives Nevada a national black eye among seniors organizations.

"Nevada ... sues old widows and widowers on their way home from the graveyard by slapping a lien on their homes," O'Reilly said. "Now the Supreme Court has placed the Good Housekeeping seal of approval on this horrible practice."

O'Reilly represented Las Vegas resident Agnes Ullmer, 86, before the Supreme Court.

A $125,000 lien was placed against her home shortly after the death of her husband in July 2001. The state said it had paid $144,000 for his medical costs.

Justices ruled 4-2 that the Welfare Division could put liens on homes of widows and widowers, but lifted the lien on Ullmer's home because of technical violations.

Medicaid is the health care system for the poor, disabled and blind. Costs of the program in Nevada are nearly $1 billion a year, half from federal funds.

To qualify, a resident must earn less than $1,692 a month, and have no more than $2,000 in the bank and one motor vehicle. Applicants sign a form letting the state recover costs with a lien on their homes if they die, according to program officials.

Many elderly need the program because Medicare does not cover long-term care costs in nursing homes, which can cost $3,000 or more a month.

Deputy Nevada state Attorney General Chuck Hilsbeck said the program lets seniors keep their homes.

"Rather than having to sell their homes to pay for medical care, they can continue to live there," Hilsbeck said. "It's a trade-off. The state can recover against the home, but not until the surviving spouse no longer has a need for it."

Justices ruled that surviving spouses can remain in their homes as long as they live, but put the state first in line to recover its costs when they die.

Assembly Majority Leader Barbara Buckley, D-Las Vegas, said the issue should be studied at the 2005 Legislature.

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Two Scans Better Than One for Lung Cancer

 

HealthDayNews

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- Combining data from computerized tomography (CT) scans and positron emission tomography (PET) improves the targeting of lung tumors for radiation therapy.

So says a study in the April 15 issue of the International Journal of Radiation, Oncology, Biology, Physics.

Currently, the standard approach is to use CT alone to target lung tumors for radiation therapy. CT scans provide detailed images of the size and shape of cancerous growths.

In this study, Washington University researchers found that adding PET data to the mix greatly improves the ability of radiologists to precisely define the locations of tumors for radiation treatment.

PET provides radiologists with detailed information about tissue function and activity, such as increased metabolic activity of a tumor.

This study included 26 people with non-small-cell lung cancer, the most common form of lung cancer. Two therapy plans were developed for each patient. One therapy plan was created using only CT data, while the second plan was created using both CT and PET data.

Adding the PET data changed and improved patient treatment plans 58 percent of the time, the study found. Using the combined data, doctors were able to more accurately identify tumor location, which improves radiation treatment efficacy and limits side effects.

More information

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

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UK Campaign Highlights Morning Heart Attack Peak

 

Agence de Presse Medicale

Thursday, April 15, 2004

LONDON (Agence de Presse Medicale) - The first few hours of the morning are the most dangerous for heart attacks and strokes, medical charities said on Thursday.

Launching an industry-backed campaign for increased blood pressure screening, the British Cardiac Patients Association and Healthy Heart UK said ambulance data showed that emergency cardiovascular calls peaked between 8 a.m. and 11 a.m.

The morning surge in cases is believed to be associated with the rise in blood pressure that occurs every day as people emerge from their slumbers.

Dr. John Pittard, a Surrey-based general practitioner with a special interest in cardiology, told a news conference in London that twice as many ambulances were called out for suspected cardiovascular events between 8 a.m. and 10 a.m. compared with any other time of the day.

"If you look at the physiology of blood pressure, it fizzes up in the morning. It is part of the stress of getting up and racing about," he said.

The charities said recent survey findings showed that high blood pressure was still not widely recognized as a leading cardiovascular risk factor.

When asked to name three things that increased the likelihood of a stroke or heart attack, only 23 percent mentioned high blood pressure, compared with 58 percent for smoking and 32 percent for obesity. Fifty-seven percent of people surveyed also did not realize hypertension is often symptomless.

About 16 million people in the UK have blood pressure above 140/90

. Not only have many not succeeded in controlling their hypertension, many have not been diagnosed.

The media campaign was supported by Boehringer Ingelheim, which markets the blood pressure drug Micardis (telmisartan).

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Study Criticizes Quality of Some Cancer Web Sites

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- Many popular cancer sites on the Internet contain misleading information, especially those focused on complementary or alternative cancer therapies, a new study says.

In fact, the British researchers who conducted the study are urging that the United Kingdom government implement a "seal of approval" system that would help distinguish quality health sites from biased, bogus ones.

"Although full monitoring might not be achievable, a government 'seal of approval' is possible and very much encouraged," said study co-author Dr. Katja Schmidt of the Universities of Exeter and Plymouth.

The study appears in the April 14 issue of the Annals of Oncology.

Recent studies suggest that more than half of the world's estimated 600 million Internet users turn to the Web for health information. While many sites excel at providing the public with quality health information, others fall far short.

Dr. Ted Gansler, director of medical content at the American Cancer Society (news - web sites), said sites focused on non-conventional therapies are particularly prone to misleading claims and outright quackery.

"There are some sites that are clearly bogus and have no scientific basis, but there are others that can be more subtly biased by only including positive reports" on a given therapy, he explained.

But just how widespread is the problem?

To find out, Schmidt and her colleague Dr. Edzard Ernst plugged in the words "complementary," "alternative medicine" and "cancer" into some of the world's most popular search engines -- portals such as Google, Yahoo and MSN. Then they assessed the quality and accuracy of data gleaned from 32 of the most frequently cited English-language Web sites selected in those searches.

There's good news and bad news for health-conscious Web surfers, Schmidt said. Overall, the sites were of "generally good quality," she said, with academic and government sites such as those run by the U.S. National Cancer Institute (news - web sites), the University of Texas' MD Anderson Cancer Center and Columbia University placing near the top. Other sites, such as Quackwatch.org, holisticonline.com, and oncolink.com also scored high marks for ease of access, accuracy and safety, she said.

Many Web sites scored poorly, however. About one in every six sites (16 percent) actively discouraged patients from using conventional cancer treatments such as radiation or drug therapy, suggesting they rely instead on dubious alternative therapies. Three percent of the sites urged patients to disregard their doctor's advice altogether, the researchers report.

Web sites focused on alternative medicines also tended to replace sound scientific data with opinion from so-called "experts" or inspiring anecdotes detailing "miracle" cures, Schmidt said.

"All users of Web sites should pay attention to language and be careful when extreme language is being used," Schmidt warned. "Attention should always be paid to whether the site references any sources of [scientific] information, and whether the qualifications of the authors/group of authors is given."

Gansler agreed, adding that Web users should ask themselves specific questions before acting on advice taken from the Internet: "Is the information evidence-based and are the references available? Does the person writing the content have appropriate training and experience to suggest that they're an expert? And do they have any commercial conflict of interest in promoting a product?"

Gansler pointed out that in the United States, alternative therapies such as supplements are regulated as foods, not drugs, by the U.S. Food and Drug Administration (news - web sites).

"For that reason they are permitted to make claims regarding health," he explained. "They're able to say, for example, that a supplement might 'improve prostate health,' but they're not permitted to say that it will cure prostate cancer."

It may be tough to enforce adequate rules on the Internet, however. Sites examined in the new study frequently described alternative cancer therapies such as coenzyme Q10, shark cartilage, laetrile and mistletoe as cancer "cures" -- even though no scientific basis for any of these claims exists.

The challenge, according to experts, is to find a quick and easy way to alert Web users that a site meets quality standards. Schmidt admitted that comprehensive monitoring and regulation of Internet health sites is "almost impossible." However, more than 3,000 health Web sites are already voluntary members of the nonprofit Health on the Net Foundation's HON Code, which attempts to grade Web sites on the quality of information provided.

These types of initiatives are "an important step toward improving the quality of health information on the Internet," Gansler said.

In the meantime, people seeking quality information on cancer care should head first to government or nonprofit sites, such as those run by the National Cancer Institute, or major cancer hospitals such as New York's Memorial Sloan-Kettering Cancer Center, Gansler said.

It's also "extremely important for patients to discuss any complementary and alternative methods with their physician," he said.

"There may be significant interactions with the conventional therapies that they're taking that their doctor would know about," he explained. The unsupervised mixing of alternative therapies with conventional treatments "could result in either serious complications or decreased effectiveness of conventional therapies," Gansler warned.

More information

To learn more about cancer care, visit the National Cancer Institute and the American Cancer Society.

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Watch Your Waistline

 

HealthDayNews

Thursday, April 15, 2004

(HealthDayNews) -- You may have heard that a high body mass index raises your risks of cardiovascular disease and diabetes. But research has shown that other body measurements -- like your waistline -- can also affect disease risk, the Canadian Heart and Stroke Foundation says.

So take your tape measure, stand with your feet together, and measure midway between the bottom of your ribs and the top of your hipbones.

Here's what the numbers show:

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US Children Get Uneven Health Care, Report Finds

 

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, April 15, 2004

WASHINGTON (Reuters) - U.S. children are not getting the best health care and are often given inappropriate drugs and untested treatments, according to a report published on Thursday.

The report from the Commonwealth Fund also found large disparities in care for children, based on geography as well as on ethnic group and income.

"Given the fact that we spend far more on health care than other countries, we should be doing better for our children," said Sheila Leatherman, research professor at the University of North Carolina School of Public Health, who helped write the report.

"The report shows dangerous lapses in patient safety, substantial shortcomings in providing effective and recommended care, persistent racial and ethnic disparities in care, and widespread failure to provide needed preventive services to teens," Leatherman added in a statement.

The Commonwealth Fund, a private foundation supporting independent research on health and social issues, reviewed 500 different studies for the report.

It found that 25 percent of young children do not get all recommended doses of five key vaccines on time. The rates vary widely, with 14 percent of children in Massachusetts getting vaccinated late or not at all but 37 percent in Colorado.

Poorer children were less likely to be fully vaccinated, as were black, Hispanic and inner-city children, and the differences persisted from 1994 to 2002 even though overall vaccination rates went up during that time.

A third of children with asthma did not get the correct medication, and low-income children with sickle cell disease were prescribed, on average, less than half of the recommended supply of antibiotics to keep on hand and 10 got none at all.

"Medication mistakes were detected in six out of every 100 medication orders for pediatric patients," the report reads. In one of every 100 cases, the child was hurt or died.

For instance, doctors prescribed the wrong dose, or the wrong frequency, or the wrong method of administration, the report found.

Overlooking STD Risks

Looking at older children, the report found that as many as three-quarters of sexually active adolescents had not been tested for chlamydia infections in the past year, although fully half could be expected to become infected with a sexually transmitted disease at some point.

The report estimated that 79 percent of children with serious mental health problems got no evaluation or treatment and that 7.5 million children failed to get needed mental health care.

Some issues are being addressed. For instance, a federal law enacted last November allows the U.S. Food and Drug Administration (news - web sites) to require drug companies to study how children react to medicines, and which doses are best.

Experts have been complaining that children are often just given reduced doses of drugs that have been tested only on adults, although much evidence suggests children may react differently to some treatments.

"As a society, we too often think of children as little adults," said Douglas McCarthy, president of Colorado-based Issues Research, Inc., who co-wrote the report.

"But they aren't. Their unique developmental needs, different disease patterns, and dependency on adults means that quality of health care for children deserves special attention."

The report found improvements in some areas, such as reduced hospital-acquired infections in some pediatric intensive care units. Initiatives in some areas had improved lead screening in children, also.

The report found a 50 percent reduction in the number of prescriptions written by doctors for antibiotics when they saw a child who had a cold. Antibiotics are useless against colds, which are caused by viruses, and overuse can help drug-resistant bacteria evolve.

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Relief for Acid Reflux

 

HealthDayNews

Thursday, April 15, 2004

(HealthDayNews) -- Medication may relieve acid reflux symptoms, but there are other things you can do, according to the Amherst H. Wilder Foundation in Minnesota:

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Study Raises Fears of Teen Smoking Resurgence

 

By Paul Simao

Reuters

Thursday, April 15, 2004

ATLANTA (Reuters) - The number of teen-agers who consider smoking cigarettes appears to rise quickly and sharply when states cut funding for anti-tobacco programs, according to a U.S. study released on Thursday.

Researchers came to that conclusion after surveying kids between the ages of 12 and 17 in Minnesota last November and December, about six months after the Midwestern state halted an aggressive anti-tobacco campaign that targeted youth.

Nearly 53 percent of 1,105 teens surveyed did not strongly disagree when told they would smoke a cigarette in the next year. That was nearly 10 percentage points higher than those who said the same thing in a similar survey last summer.

"This is pretty bad news and potentially an early harbinger of what we're going to see in other states as well," said Dr. David Nelson, one of the authors of the study, which was published by the Centers for Disease Control and Prevention (news - web sites).

Nelson, the senior scientific advisor in the CDC's office of smoking and health, said the survey underscored how quickly smoking habits and behaviors could change in the absence of properly funded anti-tobacco campaigns.

Minnesota reduced its funding for such programs by more than 80 percent between 2000 and the summer of 2003.

Federal health officials fear that if states do not continue to fund anti-tobacco programs this could prompt a resurgence of teen smoking, which has been declining in the United States for the past five years.

Keeping this group from picking up the habit is a key part of the U.S. government's effort to cut the smoking rate in the nation in half by 2010. The majority of Americans who become regular cigarette smokers begin during adolescence.

About 440,000 Americans die each year from lung cancer and other diseases related to tobacco use, making smoking the leading preventable cause of death in the United States.

Smokers also strip an estimated $157 billion worth of medical treatment, lost wages and other expenses every year from the nation's coffers.

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Inner Strength Helps Women After Cancer

 

HealthDayNews

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- Building inner strength may help aging women with cancer improve their quality of life and health outcomes, suggests a Virginia Commonwealth University study in the April issue of the Journal of Cultural Diversity.

"As a result of improved diagnosis and treatment, more women are surviving cancer," study author Dr. Gayle M. Roux, an assistant professor of maternal child health, said in a prepared statement.

"Some women emerge from a stressful event such as cancer with an enhanced sense of inner strength or mastery, which are characteristics of improved quality of life. But for some women, cancer survival can be accompanied by negative physical and psychological syndromes, such as fear of disease and loneliness, that affect their quality of life and impact their health outcomes," Roux said.

"We have a keen interest, therefore, in helping cancer survivors to build their inner strength so they can better manage their symptoms, restore their sense of purpose, and live life more fully," Roux added.

She and her colleagues have developed and are testing an Inner Strength Questionnaire. It's designed to identify and measure the needs of women dealing with chronic health problems such as cancer.

The questionnaire includes four scales that measure spirituality, problem solving, mental spirit, and balance. These scales are accompanied by suggested interventions that doctors could use to help their women patients avoid the weight gain, depression, anxiety and other issues that commonly occur following cancer treatment. These issues can reduce longevity and quality of life.

More information

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

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One in Five Americans Die in ICU

 

By Merritt McKinney

Reuters Health

Thursday, April 15, 2004

NEW YORK (Reuters Health) - Even though nine out of ten people in the U.S. say they would prefer to die at home, a new study shows that about 20 percent of Americans die in hospital

Researchers say that, while the aim of intensive care units (ICUs) is to keep patients alive, staff members providing intensive care need to be prepared to provide quality end-of-life care, too.

The reasons why such a sizable proportion of Americans die in ICUs "are complex," according to study author Dr. Derek C. Angus at the University of Pittsburgh School of Medicine.

One important reason is uncertainty about a patient's survival odds, he told Reuters Health. Although the ICU may not be where people want to die, they do not want to die in the first place, Angus pointed out.

"That means that they, their families or their doctors pull out all the stops" to try to keep them from dying, he explained. The result is that a lot of people are admitted to the ICU with only a slim hope of survival.

"I think the future could bring better risk prediction models that might allow us to better identify who will or will not benefit from ICU care," Angus said. But the Pittsburgh researcher cautioned that this could never be predicted with absolute certainty.

"Therefore, a large number of Americans dying in ICUs is almost certainly going to be a fact for a long time," Angus said.

"That means we need to make sure that ICUs are capable of providing appropriate, compassionate end-of-life care," Angus said. Doing so may be difficult, though, "unless there is a strong will at the public and policy levels to make sure ICU staff have the training and the time to provide good, or excellent, end-of-life care."

Dr. Mitchell M. Levy of Rhode Island Hospital and Brown University School of Medicine in Providence agrees that there is room for improvement in end-of-life care in the ICU.

"It is time to move our understanding of the barriers to quality end-of-life care 'from the bench to the bedside' and make our care for those dying in the ICU - something that is inevitable for almost 20 percent of Americans - more humane, compassionate and of the highest quality," Levy notes in an editorial that accompanies the study.

To gather the facts for their study, Angus and his colleagues examined deaths and hospital discharges in 1999 in Florida, Massachusetts, New Jersey, New York, Virginia and Washington.

About 38 percent of all deaths occurred in hospitals, Angus's team reports in the March issue of the journal Critical Care Medicine. And about 22 percent of all people who died were in an ICU or had recently received intensive care.

Among people who died, infants were most likely to receive intensive care near the end of life, while people older than age 85 were the least likely to receive intensive care.

The use of intensive care varied widely depending on a person's illness, according to the report. Patients with highly fatal conditions, such as cancer that had spread throughout the body, were less likely to receive intensive care near the end of life. In contrast, almost all people with an acute heart attack received intensive care.

It makes sense that people having a heart attack would be more likely to receive intensive care than people with end-stage cancer, since the odds of surviving a heart attack are much greater. But the fact that one third of people with end-stage cancer received intensive care shows how difficult it can be to predict when death will occur even when someone has a terminal illness, the researchers note.

Source: Critical Care Medicine, March 2004.

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New Target for Skin Cancer Vaccine Discovered

HealthDayNews

Thursday, April 15, 2004

THURSDAY, April 15 (HealthDayNews) -- The cancer-specific protein SSX-2 induces the immune system to attack malignant cells in people with melanoma skin cancer.

The finding offers scientists a new target for development of therapeutic melanoma vaccine, says a study published in the April 15 issue of the Journal of Clinical Investigation.

The discovery was made by scientists from the Cancer Vaccine Collaborative (CVC), a partnership between the Cancer Research Institute and the Ludwig Institute for Cancer Research at Memorial Sloan-Kettering Cancer Center in New York City.

SSX-2 belongs to a larger group of proteins called cancer/testis (CT) antigens, which are expressed in cancer cells and on normal testes. However, the immune system only recognizes CT antigens when they're present on cancer cells.

This specific immune system response to CT antigens on cancer cells has prompted many researchers to explore the use of vaccines against CT antigens as cancer therapies.

"SSX-2 is a particularly good target for a cancer vaccine," study senior author Dr. Danila Valmori, an assistant member at the Ludwig Institute for Cancer Research, said in a prepared statement.

"We found that patients are mounting their own immunological responses against cancer cells expressing SSX-2, and although these spontaneously occurring immunological responses are apparently not sufficient for stopping tumor growth, possibly because they develop late in the disease progression, we think that a vaccine that stimulates and amplifies this naturally occurring attack will have a good chance of giving a clinical response," Valmori said.

More information

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

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Wednesday, April 14, 2004

 

Friends, Lovers Lower 2nd Heart Attack Risk –Study

 

Reuters

Wednesday, April 14, 2004

LONDON (Reuters) - Don't knock your friends: they could save your life.

Heart attack survivors with a close friend, relative or lover to confide in are half as likely to suffer further heart attacks within a year as patients without a shoulder to cry on, a study shows.

The study, published this week in the British Medical Association's journal Heart, tracked nearly 600 patients for a year after they had a heart attack.

"Patients with a close confidant had only half the risk of a further cardiac event of those without a confidant," the study said, adding that the finding held even when adjustments were made for a host of other heart disease risk factors.

Those without a close relationship were more likely to drink heavily, smoke and use illicit drugs. But those factors alone did not explain their increased risk of additional heart attacks within a year, the study found.

The scientists said they still do not know why having a confidant helps keep a second heart attack at bay, but one possibility is that a close friend or partner may make sure a patient seeks treatment early and sticks to it.

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When Coughing Can Save Your Life

HealthDayNews

Wednesday, April 14, 2004

(HealthDayNews) -- If you think you're having a heart attack, cough vigorously. It could save your life.

Coughing creates a pumping action that can push blood through the body and to the brain, thereby keeping you going until medical help arrives, according to the American Academy of Anti-Aging Medicine.

However, when and how you cough is important. It should start with a single cough every one to two seconds in bouts of five coughs.

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Schools Help Hungry Kids During Weekends

By Heather  Hollingsworth

Associated Press Writer

The Associated Press

Wednesday, April 14, 2004

ST. JOSEPH, Mo. - On a recent Friday, about two dozen children went to the Noyes Elementary School office in what has become a weekly ritual at a growing number of schools: picking up backpacks of food so they won't go hungry over the weekend.

The children don't like to talk about being hungry, said Joyce Starr, who runs the backpack program. So teachers rely on other clues.

"One of the things that we notice is sometimes in the lunchroom, kids who eat their lunch real quick. They are hungry," Starr said.

There are some children who are sorry when the weekend comes.

"They say, 'I hate it because I've got to go home.' Or they get sick here at school and don't want to go home," Starr said. "So we kind of know that school is a safe place and they know we care about them and of course we try to feed them, too."

For poor students who eat most of their meals at school through government-subsidized breakfast and lunch programs, weekends and holidays can mean going hungry.

So the St. Joseph School District, with the help of the local arm of America's Second Harvest, has started sending home backpacks filled with canned fruit, cereal bars and other single-serving foods. Similar programs serving thousands of children have started in more than a dozen other cities in the last few years.

At Noyes Elementary, where two-thirds of the students get subsidized lunches, 10-year-old Mimi Ho was lugging home two backpacks to help feed her three siblings along with five cousins temporarily staying at her home. The fifth-grader said she eats some of the food and gives some of it away — particularly the applesauce, which she doesn't like. All the food is gone before Sunday.

It's good to get the backpack of food, the girl said, but as is typical of children getting such help, she struggled when asked to elaborate.

"It's sort of hard to explain?" she said and paused. "It's sort of really, really hard to explain?"

Called Backpack Buddies, the St. Joseph program served about 40 students when it started in January 2003 and has since grown to serve 140 students. But America's Second Harvest of Greater St. Joseph said the need is as much as 20 times greater.

St. Joseph sits in the middle of an agricultural area and the poverty rate in the school district has increased during the past few years as several industries have left.

The Chicago-based headquarters of America's Second Harvest is trying to raise the money to help more of its 214 affiliated food banks and food rescue groups offer the program.

Last week, the Hasbro Children's Foundation, which is a charity of Hasbro Inc., the Pawtucket, R.I.-based toy maker, approved a $95,000 grant to help America's Second Harvest with a national backpack pilot program.

The idea of sending home food in backpacks originated with the Arkansas Rice Depot, a Little Rock-based statewide food bank, after a school nurse at an inner city school asked for help because students were coming to her with tummy aches and dizziness.

The children weren't sick — they were hungry, said Laura Rhea, president and chief executive officer of the food bank.

The food bank started giving out food at the nurse's school in spring 1995 and the program spread. The food bank now serves about 12,000 students in 339 schools, with some of the schools sending food home with youngsters during the week in addition to the weekend.  

Besides feeding the youngsters, the food bank provides soap and other personal care items that the schools can slip into the children's backpacks.

Rhea said the food deliveries have been credited with improving grades, school attendance and self-confidence.

"You give these children a little bit of love and a little bit of food and you stand back and watch how they amaze you," she said.

But the concept didn't expand nationally until the Roadrunner Food Bank in Albuquerque, N.M., decided to do something similar in spring 2001. That food bank, which now provides backpacks to about 1,500 schoolchildren, helped promote the idea.

Recent survey results from Second Harvest show at least two dozen of its affiliates have started offering the backpack program or something similar. And many more said they would do the same if they had the money.

Food bank and school officials say it's important the funding remain stable because students quickly grow to rely on the backpacks.

The St. Joseph food bank learned that lesson when one youngster moved to a new school and waited patiently for a backpack during his first Friday. He burst into tears when a school employee told him the school didn't hand out backpacks, said Nicholas Saccaro, executive direction of America's Second Harvest of Greater St. Joseph.

"It's just so tough," Saccaro said. The food bank began delivering a lone backpack to the child's school.

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Sleepless Tots May Become Troubled Teens – Study

Reuters

Wednesday, April 14, 2004

WASHINGTON (Reuters) - Sleepless toddlers are more likely to grow into troubled teens who smoke, abuse alcohol and use illegal drugs, U.S. researchers reported on Wednesday.

The study, which involved only boys, suggests that some as-yet unknown brain mechanism may be involved in both sleeplessness and a tendency to addiction, the researchers at the University of Michigan Health System said.

The finding does not mean that poor sleep causes later addiction problems, stressed University of Michigan psychiatry professor Dr. Kirk Brower.

"Our finding sees early childhood sleep disturbances as a marker, or predictor, for early use of drugs and alcohol in adolescence, not a predetermined trajectory," Brower said in a statement.

"But for parents, this is one more reason to take your child's sleep problems seriously, not to dismiss them, and to talk with your child's pediatrician or family doctor."

Brower's team, led by researcher Maria Wong, studied 257 boys and their parents for 10 years. They questioned the boys and their parents at regular intervals.

At ages 3 to 5 the mothers were asked to report whether their sons had trouble sleeping, or were overtired during the day, using a standard measure. They were asked about behavior problems when the boys were 9 to 11.

When the boys were 12 to 14, they were surveyed using a confidential written questionnaire.

Boys who slept poorly as young children were 2.3 times more likely to have started using alcohol by age 14, and 2.3 times more likely to smoke cigarettes than boys whose mothers had not noticed any sleep issues.

They were also 2.6 times more likely to have used marijuana, and 2.2 times more likely to have used any illicit drugs, the researchers report in the April issue of Alcoholism: Clinical and Experimental Research.

Overall, a third of the children were reported to have had a sleep problem in early childhood, either trouble sleeping, overtiredness, or both.

By age 12 to 14, about 32 percent of the boys had started drinking alcohol, and 40 percent said they had been drunk at least once. About 10 percent regularly smoked cigarettes, and 17 percent had used at least one kind of illicit drug.

The link between sleep problems and substance abuse held true even after depression, aggression, attention problems and parental alcoholism were taken into account, Wong's team said.

"It appears to indicate some shared neurobiological dysfunction whose details we don't yet know," said Robert Zucker, director of the research center where the work was done.

The researchers studied only white boys and are now working on data involving girls.

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Conn. May Push Schools on Fitness, Diet

By Laura Walsh

Associated Press Writer

The Associated Press

Wednesday, April 14, 2004

HARTFORD, Conn. - State lawmakers, responding to a poor showing by students taking the Connecticut Physical Fitness Assessment, are considering legislation that would require schools to provide students with more physical activity and better nutrition.

Only 35 percent of students taking the annual physical fitness test during the 2002-03 school year passed all four sections of the exam, according to the State Department of Education (news - web sites). That's virtually unchanged from a year ago and 4 percentage points lower than during the 1999-00 school year.

"That statistic is very sad," state Rep. Themis Klarides, R-Derby, said Monday. "It's very unfortunate that in a state where people put so much emphasis on our children being prepared for college or a career that somehow their health has fallen through the cracks."

During the test, students are asked to walk or run a mile, perform as many curl-ups and push-ups as they can and stretch as far as they can while in a sitting position.

The test is given to fourth-, sixth-, eighth- and 10th-graders. It aims to measure cardiovascular endurance, flexibility and upper body and muscle strength, said Barbara Westwater, acting bureau chief of Curriculum and Instruction for the state Department of Education.

Students pass the test if they meet certain benchmarks. A 9-year-old boy, for example, should be able to do nine push ups, and a 9-year-old girl is expected to do seven.

"There's definitely a lot of room for improvement," Westwater said. "What we have to recognize is that it's not just about the physical activity the children have in school, but it's what they do throughout the day."

Klarides has introduced legislation that would mandate 20 minutes a day of recess for students in kindergarten through fifth grade, as well as a 20-minute lunch with fruits, fruit juice, water and lowfat dairy products. The bill has passed the House and is now headed to the Senate.

The low percentage of students passing the physical fitness test could be a direct result of public schools sacrificing physical education for academics, Klarides said.

The 2002 federal No Child Left Behind Act has put additional pressure on schools to show substantial annual improvement in reading, writing and math scores. There are stiff penalties, including the loss of federal funding, if districts continue to fail.

"Many communities that struggle to meet those achievement gains are having more targeted programs to math or literacy," said June Bernabucci, senior director for Unified Arts for Hartford schools. "Children are spending more time in their seats to master those academics than having the time to be physically active."

Inner city students faired worse on the test than students in Connecticut's suburbs, education officials said.

Only about 20 percent of students in Hartford, New London and Waterbury schools passed the test, while 48 percent of students in Greenwich and 46 percent of students in Simsbury passed the exam.

Jeff Bovi, a physical education teacher at Chapman Elementary School in Cheshire, credits his students' involvement in outside sports teams with helping to boost the district's score to 48 percent.

"I would love to be able to claim credit for it all, but I can't and neither can any of the other P.E. teachers in affluent towns," Bovi said.

Many physical education teachers question how much the new legislation would influence the test scores.

"I think that is a step in the right direction," Bernabucci said. "But do I think it will impact Hartford in the short run? Probably not."

The majority of schools in Hartford are not providing recess because they can't find the time, Bernabucci said. She added that the 20-minute recess is not a structured form of physical activity.

"I personally would rather see that 20 minutes go to physical education classes," Bovi said. "I think that would make the difference."

On the Net:

School district profile: www.csde.state.ct.us/public/der/ssp/index.htm

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Low Vitamin B May Impair Memory in Some Seniors

Reuters Health

Wednesday, April 14, 2004  

NEW YORK (Reuters Health) - A variant of a lipid gene called APOE4 is known to increase the chances of a person developing Alzheimer's disease (news - web sites). A Swedish study has now shown that carriers of this gene are more vulnerable to the effects of low vitamin B12 levels on mental function in old age.

Among healthy individuals over age 75, APOE4 carriers have more memory lapses when vitamin B12 falls below normal levels, according to the study conducted at the Karolinska Institute in Stockholm.

Dr. David Bunce, of the University of London, and colleagues note in the journal Neuropsychology that low levels of B vitamins have been associated with decreases in mental function.

To further investigate, Bunce's team determined the APOE4 status of 167 individuals age 75 and older and performed a range of cognitive tests. Among the subjects classified as APOE4-positive, 28 had low B12 levels and 21 did not. In the non-APOE4 group, 54 had low B12 levels and 64 had normal levels.

In the most demanding test, participants were presented with a list of 12 unrelated nouns, at a rate of one word every 2 seconds. They were immediately given 2 minutes to recall the words.

In the APOE4-positive group, average scores for this test were 3.68 for those with low B12 and 6.48 for those with normal levels. Corresponding scores in the non-APOE4 group were 4.78 and 5.32. Analysis showed that recall performance was significantly lower in the low-B12, APOE4-positive group.

The investigators also found that low folate levels had a similar effect, although it was not as strong.

They conclude, "There is good reason to consider inclusion of vitamin B12 and folate supplements as part of preventive health regimens for older persons," especially APOE4 carriers.

Source: Neuropsychology, April 2004.

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Florida Schools' Fitness Plan Delayed

By Brent Kallestad

Associated Press Writer

The Associated Press

Wednesday, April 14, 2004

TALLAHASSEE, Fla. - Florida's 2.6 million public school students won't be required to take physical education and nutrition classes until at least the fall of 2005, a delay that may give school districts time to better identify ways for fighting the growing obesity epidemic among schoolchildren.

The state Department of Education (news - web sites), under a measure unanimously passed Tuesday by the Senate Education Committee, would study physical education in the state's schools, examine personnel issues related to implementation of mandatory phys-ed classes, and recommend ways to promote fitness among all students.

Gov. Jeb Bush identified the issue of fighting obesity as a priority last fall, when he directed a task force to make recommendations for lawmakers to consider this session.

"It's one step forward, but we could've done more," said Sen. Gwen Margolis, D-Aventura, and sponsor of one of the three bills incorporated into the committee substitute. "It's turned into a study. It's the kind of thing that needs action to be taken."

However, education officials and physical fitness advocates all backed the committee's measure.

"A one-year delay gives us time to prepare and get ready for this and see what the actual cost is going to be and what the actual curriculum implications are going to be," said Wayne Blanton, executive director for the Florida School Boards Association. "Without the delay it would've been a problem."

The study ordered by Bush last year recommended, but did not require, implementation of statewide physical education classes — something supporters initially wanted to see happen by the 2004-05 school year.

"There are a lot of little fat children running around on the P.E. field," said Sen. Frederica Wilson, D-Miami and former school teacher and administrator.

Under the committee's plan, school districts would be required to report their physical education policies to DOE by Dec. 1 of each year. Those districts that have no phys-ed plan by Dec. 1 would be required to offer three 30-minute sessions per week for all students in kindergarten through fifth grade.

Similar bills in the House have been referred to committee.

Bush signed an executive order in October aimed at cracking down on the epidemic that state officials fear will lead to runaway health care costs and "a tidal wave" of higher mortality rates.

The governor's executive order noted that fewer than 50 percent of the state's high school students attend physical education classes more than once a week and that nearly two-thirds of all high school students watch two or more hours of television each day.

"If it doesn't happen in our state then we need to go outside of our state because there are many states who are making it work," said Mariann Sabolic, a Tallahassee mother of three elementary-age children. "And we need to make it work."

On the Net:

Florida Legislature: http://www.leg.state.fl.us/

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Low-Dose Antibiotic May Curb Heart Disease Risk

By David Douglas

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - Chronic inflammation is being thought of more and more as an underlying cause of heart disease. Researchers now report that the antibiotic doxycycline, at doses below those needed to kill bacteria, reduce levels of a biomarker of inflammation called C-reactive protein (CRP).

"It is hoped that using low-dose doxycycline to reduce CRP will translate into reduced vascular inflammation and reduced coronary events," lead investigator Dr. David L. Brown told Reuters Health.

"However, that still needs to be demonstrated in an appropriately sized clinical trial."

Brown of Beth Israel Medical Center, New York, and colleagues note in the journal Arteriosclerosis, Thrombosis and Vascular Biology that doxycycline has the ability to inhibit various mediators of inflammation.

To determine the potential protective effects of this agent, the researchers randomly assigned 50 people with coronary artery disease to treatment with sub-antimicrobial doses of doxycycline or to an inactive placebo pill.

After 6 months, there was no significant difference between groups in heart-related deaths.

However, in 30 participants who were evaluated, CRP was reduced by 46 percent in those given doxycycline. No change was seen in the placebo group.

The researchers, who call for larger studies, conclude that doxycycline "appears to exert potentially beneficial effects on inflammation."

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

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Genetic Link to Liver Cancer Found

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- A gene that causes liver cancer in mice has been identified by researchers at the University of Illinois at Chicago.

When the researchers deleted the gene, called Foxm1b, from liver cells in lab mice, the animals didn't develop tumors. The mice with the deleted gene remained cancer-free even when the researchers tried to use artificial means to induce tumors.

"To my knowledge, this is the first time a gene has been directly linked to the growth of cancer cells in live animals," lead investigator Robert Costa, a professor of biochemistry and molecular genetics, said in a prepared statement.

The research appeared in a recent issue of Genes and Development.

"Foxm1b is expressed in many different kinds of cancer cells, which leads us to believe it plays a key role in promoting the growth of tumors other than liver cancer," Costa added.

He and his colleagues have created a prototype for a drug to block Foxm1b activity and starve tumor cells of the protein manufactured by Foxm1b. Depriving tumors of this protein prevents them from multiplying.

More information

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

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Vegetable Fiber Tied to Lower Prostate Cancer Risk

By Amy Norton

Reuters Health

Wednesday, April 14, 2004  

NEW YORK (Reuters Health) - Men who eat their veggies may be less likely than others to develop prostate cancer, a new study suggests.

Among more than 1,700 men with and without prostate cancer, those who ate the most fiber -- particularly from vegetable sources -- had a lower risk of developing the disease, Italian researchers found.

The benefit was "moderate," they report in the International Journal of Cancer, but the findings suggest that at least some forms of fiber offer prostate cancer protection.

A number of studies have suggested that eating plenty of fruits and vegetables may help ward off prostate cancer, while "Western"-style diets heavy in animal fat and dairy products may increase a man's risk of the disease. But not all studies have reached these conclusions, and the importance of diet in prostate cancer risk is still unclear.

There is evidence that fiber-rich foods may lower the risk of heart disease, diabetes and possibly certain cancers. However, studies looking at fiber and prostate cancer have generally yielded "null" findings, said Dr. Claudio Pelucchi, a researcher at the Mario Negri Institute for Pharmacological Research in Milan and lead author of the new study.

The difference in his team's study, Pelucchi told Reuters Health, is that it broke down men's fiber intake according to the type and source of fiber.

Fiber comes in two main forms, soluble and insoluble. Soluble fiber partially dissolves in water, and its food sources include vegetables, fruit, oatmeal and legumes. Insoluble fiber, which passes through the digestive system largely intact, is found in foods like whole grains, seeds and the skin on fruit.

For the study, Pelucchi and his colleagues surveyed 1,745 men between the ages of 46 and 74 about their diet and lifestyle habits. All of the men were surveyed while being treated in Milan-area hospitals between 1991 and 2002; nearly 1,300 had prostate cancer, while the rest were treated for conditions unrelated to cancer. Those with prostate cancer were asked about their eating habits during the two years before being diagnosed.

Pelucchi's team found that men with the highest overall fiber intake had a slightly lower risk of prostate cancer than men with the lowest intake.

When the researchers looked at specific types of fiber, vegetable fiber emerged as most protective. Men who got the most fiber from vegetables were 18 percent less likely than those who ate the least to develop prostate cancer.

Fiber from fruit or grain products, specifically, was not related to a lower prostate cancer risk, but soluble fiber did appear to protect against the disease.

Pelucchi pointed out that because vegetables and fruit were the chief sources of soluble fiber, it's possible that the fiber, per se, did not bestow the benefit. Other nutrients found in produce -- or the generally healthy diet and lifestyle of fiber enthusiasts -- could be at work, he said.

International Journal of Cancer, March 2004.

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College Women's Drinking Raises Abuse Risk

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- A new study unmasks another seamy aspect of party life on campus: It turns out college women face a sharply greater chance of experiencing sexual or nonsexual aggression on days when they drink.

The odds of experiencing sexual aggression were nine times higher on days the women drank heavily -- consuming five or more drinks -- compared to days they didn't drink at all. Even a more modest indulgence meant they were three times more likely to be sexually victimized than if they had abstained from drinking.

Likewise, nonsexual aggression against women increased sevenfold on heavy drinking days vs. days of no drinking and threefold on non-heavy drinking days compared with no drinking.

"We're not saying that drinking per se is the only reason this is occurring," cautioned R. Lorraine Collins, a senior research scientist at the University of Buffalo's Research Institute on Addictions. "We're just saying the risk increases with alcohol intake, and with heavier drinking the risk is even greater."

The study is a first because it examines college women's daily drinking habits and both sexual and nonsexual victimization of women over a period of weeks, the researchers said.

Previous studies showing that alcohol use is related to a higher risk of being victimized were based on very general information, Collins explained.

Collegiate-level alcohol abuse has come under intense scrutiny in recent years. In 2002, the National Institute on Alcohol Abuse and Alcoholism's Task Force on College Drinking reported that college student drinking contributes to an estimated 1,400 student deaths, 500,000 injuries and 70,000 cases of sexual assault or date rape annually.

The authors hope this new data will cause women to think about how much they drink and where they drink it. For example, the findings suggest women may reduce their risk for experiencing victimization by reducing their alcohol consumption because they'll be more aware and better able to resist.

While the legal drinking age is 21, parents are sending their 18-year-old freshmen into an environment in which underage drinking is prevalent, Collins observed.

"If you're a parent, then one of the things you would want to do is sit down with your daughter and talk to her very carefully about the range of experiences she might have to deal with in college, including her own drinking behavior," she said.

Such research is necessary because it helps to empower women, explained Karen Johnson, executive vice president of the National Organization for Women (news - web sites).

"We need to be able to understand our environment to defend against the perpetrators," she said. "That means," for instance, "that if you're going out drinking that you go out with friends who are not drinking."

The new findings are based on interviews with 94 college women from a medium-sized university in central New York. During the initial interview, each was asked to report her alcohol consumption and any sexual or nonsexual aggression she had experienced during the prior two-week period. Second and third interviews were conducted two weeks and four weeks later, respectively, for a total of six weeks of data.

Investigators used a calendar-like method to track daily alcohol consumption and incidents of sexual or nonsexual abuse during each two-week period. "What that means is that they're remembering, but it's done in a very structured way so we can enhance what they remember," Collins explained.

Over the six-week study, 15 percent of women experienced at least one incident of sexual aggression. There were no reported incidents of attempted or completed rape. Twenty percent experienced at least one incident of nonsexual aggression.

The authors were careful not to point blame at the women. Regardless of whether a woman has been drinking, any attack is the fault of the perpetrator, they said.

"It's absolutely the perpetrator's fault for any assault that happens," Johnson agreed. "At the same time, you just need to know what the dangers are."

More information

The National Advisory Council on Alcohol Abuse and Alcoholism's Task Force on College Drinking has more information on changing the college drinking culture. Meanwhile, go to the National Women's Health Information Center to learn about violence against women.

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Soy Product Slows Prostate Enlargement, in Rats

By Anthony J. Brown, MD

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - Treatment with equol, the major active form of daidzein, the estrogen-like compound found in soy, blocks prostate growth in rats, new research shows.

Equol seems to work not just by stimulating estrogen receptors but also by binding and blocking the testosterone by-product dihydrotestosterone (DHT).

With further testing, equol or a derivative could potentially be used to prevent or treat conditions resulting from male androgen hormones, such as prostate cancer or baldness, the researchers suggest.

As reported in the science journal Biology of Reproduction, Dr. Trent D. Lund, from Colorado State University in Ft. Collins, and colleagues tested the effects of equol in male rats.

Equol reduced prostate growth, the investigators found. Further testing revealed that the compound bound tightly to DHT, only modestly to the beta-type estrogen receptor, and not at all to the alpha-type estrogen receptor.

Treatment of castrated animals with DHT produced an increase in prostate growth, but simultaneous treatment with equol blocked these effects without producing a change in levels of DHT.

Equol was thought to have estrogen-like effects, Lund told Reuters Health. "We weren't expecting to see an anti-androgen effect."

Equol or a synthetic mimic could have therapeutic potential, the researcher noted. "If everyone could convert daidzein to equol, then simply eating soy products might produce therapeutic levels. Unfortunately, only about 30 percent of the population can convert regular soy into equol."

Source: Biology of Reproduction, April 2004.

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Genetic Tests Show Promise Against Leukemia

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- Scientists have moved one step closer to figuring out why different people with acute myeloid leukemia (AML) respond differently to different therapies.

Right now, a litany of factors -- including age, white blood cell count and, most importantly, the genetics of the cancer cells -- are factored into treatment decisions. But this has not been enough to determine the best therapy for each patient, new research suggests.

"Even within the so-called genetic subtypes, some patients do well and some don't and the question has always been raised, if you give the same drugs to the same group of patients, why do some do well and some do poorly?" said Dr. Stephen J. Forman, director of the Hematologic Neoplasia Program at City of Hope Cancer Center in Duarte, Calif.

However, two studies in the April 15 issue of the New England Journal of Medicine (news - web sites) report on a technique called "gene expression profiling" of AML specimens that better determines which patients should receive which therapies.

Currently, chromosomal abnormalities in the cancer cells are used to assign AML patients to low-, intermediate- or high-risk groups. Low-risk patients are treated with standard chemotherapy, while high-risk patients are treated additionally with bone marrow transplantation, which can have serious side effects. That leaves the intermediate group.

"It's the intermediate-risk group that clinicians are least sure what to do with," said Dr. Jonathan R. Pollack, senior author of one of the studies and an assistant professor of pathology at Stanford University School of Medicine. "The largest potential benefit is with that group of people, and it's quite a large group."

Physicians don't want to give an aggressive therapy with major side effects to someone who is not likely to respond. On the other hand, it may be worth it if the patient has a good chance of getting better.

"The biggest potential benefit [from gene expression profiling] for [intermediate-risk] patients is that we might be able to more accurately assign the appropriate treatment to individual patients," Pollack said. "If you can match the therapy to the given patient's disease, that patient is going to do better with less potential harm."

Pollack and his colleagues examined gene expression levels in 65 blood samples and 54 bone marrow specimens from 116 intermediate-risk adults with AML, taken before the patients began treatment. The researchers then divided the samples into subgroups according to their particular gene expression profile, and then cross-referenced these with the patients' relapse and survival information.

The researchers were eventually able to identify variations in 133 genes that distinguished groups of patients.

While the most immediate benefit could be in assigning patients to existing therapies, this information may also help in the development of new therapies.

"Even if one identifies a good drug target, the whole process [of developing a drug] can take 10 to 15 years," Pollack said. "The benefits from that will be in the much longer term compared to the potentially more immediate benefits of improved treatment stratification of existing drugs. That potential benefit could be seen in a year or two."

A second study, this one out of the Netherlands, looked at the gene expression profiles in blood and bone marrow samples from 285 AML patients.

On the basis of this information, the researchers were able to identify 16 different groups of AML patients based on their molecular "signature." The presence of certain mutations and the level of gene expression indicated which patients had a poor prognosis and which had a better one.

Essentially, these studies show that scientists are approaching a new level of precision in treating AML, experts said.

"Many years ago all we had was looking under the microscope, then we had the ability to look at leukemia cells as to what their phenotype was. The next step was cytogenetics [which looks at abnormalities in the chromosomes of cancer cells] and that really helped, and this becomes the next level, molecular genetics," Forman said.

"It isn't just true in AML. For every single human cancer, there will be molecular genetic types that distinguish and help distinguish why some people do well and some don't," he said.

The procedure is not yet ready for prime time,Forman said. However, "my guess is that in the same way that cytogenetics became what doctors expect, I think this will be, within the next couple of years, something that is there, that doctors will expect."

More information

For more on acute myeloid leukemia, visit the National Cancer Institute or the Leukemia & Lymphoma Society.

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Diabetes Control Shrinks Enlarged Heart

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - People with type 1 diabetes are prone to develop enlargement of the left side of the heart, which can lead to heart failure, but strict control of blood glucose levels reverses this process, researchers report.

In the March issue of the International Journal of Cardiology, a multicenter team led by Dr. Franz C Aepfelbacher of the Beth Israel Deaconess Medical Center in Boston, reports the results of a study involving 19 adults with long-standing type 1 diabetes.

After a year of stringent glucose control, including weekly insulin infusions for some participants, 12 of them had a significant reduction in levels of glycosylated hemoglobin, a measure of long-term glucose control.

In these 12 subjects, the thickness of the wall between the left and right sides of the heart decreased from 10.3 to 9.4 millimeters and the mass of the main left vessel of the heart "regressed from 205 to 182 grams."

These dimensions were unchanged in the patients who did not achieve improved control of glucose levels.

Ambulatory 24-hour blood pressure measurements did not change in either group, so the researchers believe it is "unlikely" that improvements in hypertension were the reason for the structural changes they observed.

However, since little is known about the cause of diabetes-related heart enlargement, "the principal mechanism for reduction of left ventricular mass with glycemic control also remains speculative," Aepfelbacher's team writes.

Source: International Journal of Cardiology, March 2004.

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Key Protein in Blood Vessel Formation Found

By Ed Edelson
HealthDay Reporter

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- The discovery of a protein that plays a critical role in the formation of blood vessels could lead to more effective treatments for heart disease and cancer, researchers report.

The protein, designated Egfl7, guides the newly born cells that will become blood vessels as they form the required tubular structure, a group led by Weilan Ye, a scientist at the biotechnology company Genentech Inc., reports in the April 15 issue of Nature.

"We have known that there are many factors that control the generation of the cells that are the building blocks of blood vessels," Ye said. "This adds knowledge about how those building blocks are put together to form the magnificent plumbing system called the vascular system."

That knowledge could help in heart disease, where "we would like to repair blood vessels," Ye said. "Without understanding how the blood vessels are put together, that would not be practical."

In cancer, the goal would be to prevent the formation of blood vessels that a tumor needs to grow. The attack against this process of angiogenesis, proposed several years ago by Dr. Judah Folkman of Harvard University, has centered on ways to prevent production of cells that will form blood vessels, Ye explained.

"In many cases, preventing their production is not possible," she said. "Now we might prevent them from doing the right thing as they try to form blood vessels. It is another way of blocking angiogenesis at a different stage."

Egfl7 is produced early in the life of the cells that will form blood vessels, she said. It plays its role as they begin to maneuver, guiding them into formation of the desired tubular structure.

"Usually, most cells in the body are not moving around a lot," she said. "These cells want to move around and align into a tubular formation, so they secrete this protein."

Cells usually stop making the protein in most parts of the body after the blood vessels have been built. In adult mice, there is some limited production only in organs that require a large blood supply, such as the lungs, heart and kidneys.

But there is a significant exception to that rule, Ye said: "In tumors, this gene is turned on again." Lacking that activity, a cancer would not have the blood supply it needs for its relentless growth.

Ye and her colleagues already have developed antibodies that interfere with the activity of Egfl7. "We are testing them in tumors to see if we can prevent the tube from being made," she said.

The finding "represents an important step towards understanding of vessel assembly," said Tao P. Zhong, an assistant professor of medicine and cell biology at Vanderbilt University Medical Center, who has done research on blood vessel formation.

Previous studies have found "very few molecules" involved in the formation of tubular blood vessel structures, Zhong said.

"I believe that determining the mechanisms of Egfl7 and its potential signaling pathways may help to unravel potential therapeutic approaches in cancer and cardiovascular disease," he said.

More information

Learn more about the formation of blood vessels from the American Heart Association or the National Cancer Institute.

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Nitrates in Water Not Linked to Pancreatic Cancer

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - Despite indications from animal studies, long-term exposure to nitrates in drinking water does not raise the likelihood of developing pancreatic cancer, according to newly published findings.

However, the risk may be increased with the consumption of dietary nitrite from animal products.

"N-Nitroso compounds, known animal carcinogens, are formed (internally) from drinking water and dietary sources of nitrate and nitrite," Dr. Mary H. Ward, of the National Cancer Institute (news - web sites), Bethesda, Maryland, and colleagues explain in the April 1st issue of the American Journal of Epidemiology.

This prompted the researchers to look at whether increased intake of nitrate and nitrite from water and diet was associated with pancreatic cancer risk.

Ward's group linked detailed water source histories with nitrate measurements from Iowa community water supplies. They then compared 189 people from the area who had pancreatic cancer with 1244 "control" subjects without cancer.

The risk of pancreatic cancer did not rise with increasing nitrate consumption from drinking water. In fact, increased intake was associated with a decreased risk in women, but not in men.

Conversely, higher levels of dietary nitrite from animal sources was linked with an elevated risk of pancreatic cancer.

Overall, the researchers conclude: "The average nitrate level in community water supplies over an approximately 25-year period was not associated with pancreatic cancer risk in this study population."

However, the findings do "suggest a role for nitrate derived from animal sources as a pancreatic risk factor."

Source: American Journal of Epidemiology, April 1, 2004.

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Age Doesn't Matter with Kidney Transplants

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- People who receive kidneys from donors aged 55 and older seem to have good outcomes, says a Brown Medical School study in the April issue of the Archives of Surgery.

The study notes the percentage of deceased kidney donors aged 55 and older in the United States has increased during the last decade. That's a result of lower death rates in people aged 18 to 35 and increased acceptance of kidneys from older, deceased donors.

Researchers studied data about 324 people who received a kidney from an adult donor aged 18 or older. The recipients were divided into groups based on donor status (living or deceased) and donor age (54 years or younger, or 55 years and older).

People who received kidneys from donors 55 years or older were older themselves compared to those who received kidneys from younger donors (53.6 years old vs. 43.6 years old).

The study found that seven transplants failed out of 55 transplants from donors 55 and older (12.7 percent) compared with 41 failures among 269 transplants from younger donors (15.2 percent). Kidney function following transplant was acceptable in all groups but was better in people who received kidneys from younger donors.

The survival of transplanted kidneys from younger and older donors did not differ at one, two and three years after transplant.

"Older donor kidneys provide good allograft function in most recipients. After proper evaluation, kidneys from older deceased or living donors are appropriate for selected candidates, including older patients awaiting transplantation and those with limited life expectancy based on their severity of illness," the study authors concluded.

More information

The American Diabetes Association has more about kidney transplantation.

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Chewing Gum Kills Bacteria, Freshens Breath

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - Chewing a stick of gum, especially cinnamon-flavored gum, may keep bad breath away, researchers report.

A new study has shown that cinnamon-flavored Big Red gum kills bacteria that are linked to bad breath. Researchers suspect that a plant oil called cinnamic aldehyde, which is used for flavoring cinnamon gum, helps kill bacteria.

But even gum without cinnamic aldehyde killed a substantial percentage of bad-breath bacteria, suggesting that other natural flavorings also play a role.

The research was supported by the Wrigley Company, which makes Big Red.

Bacteria in the mouth are thought to contribute to bad breath by producing substances called volatile sulfur compounds.

Dr. Christine Wu and colleagues at the University of Illinois at Chicago have found that several varieties of plant essential oils suppress the growth of bacteria that can cause cavities and oral infections.

"In laboratory tests, some of these oils also prevented the growth of three species of oral bacteria associated with bad breath and the production of volatile compounds that cause the unpleasant smell," Wu said in a press release.

The next step for the researchers was to test the effect of plant essential oils in chewing gum.

They evaluated the effect of Big Red, which contains a variety of plant essential oils, including cinnamic aldehyde. The study also included a version of the gum that had the cinnamic aldehyde removed but still contained other plant essential oils. Participants also chewed a gum base that had neither flavors nor oils.

Wu and her colleagues collected saliva samples before and after the 15 people chewed gum for 20 minutes. They then compared pre- and post-chewing bacteria levels.

Bacteria levels dropped after chewing gum with and without cinnamic aldehyde.

Levels of bacteria that produce the sulfur compounds dropped by about 50 percent after chewing the gum with cinnamic aldehyde. Even without the cinnamon flavoring, bacteria levels dropped by about 40 percent after chewing gum.

But the unflavored variety of gum, which did not contain any plant oils, did not have an effect on bacteria levels.

The results of the research were presented last month at a meeting of the International Association for Dental Research in Honolulu, Hawaii.

"Our study shows that chewing gum can be a functional food, having a significant impact on oral hygiene over the short term, if it contains antimicrobial agents such as cinnamic aldehyde or other natural active compounds," Wu said in the press release. "The product doesn't just mask foul mouth odor. It eliminates the bacteria that cause it, at least temporarily."

Although chewing gum reduced bacteria in the mouth, the study did not evaluate participants' breath.

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Most Juvenile Delinquents Suffer Traumas

HealthDayNews

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- Posttraumatic stress disorder is common among juvenile delinquents in the United States.

That finding comes in a Northwestern University study in the April issue of the Archives of General Psychiatry.

The study of 900 juveniles, aged 10 to 18, at the Cook County Juvenile Temporary Detention Center found that 93 percent of boys and 84 percent of girls reported at least one traumatic experience, such as witnessing violence or being threatened with a weapon.

More than 12 percent of the study subjects met the diagnostic criteria for posttraumatic stress disorder.

"While it's true that the study participants, like most juvenile detainees in the United States, live in urban areas that have high rates of violence, our findings also are consistent with research linking traumatic victimization in childhood and subsequent psychosocial problems, such as delinquency and drug use," Karen M. Abram, of the psycholegal studies program at the Feinberg School of Medicine at Northwestern University, said in a prepared statement.

She and her colleagues recommend that the mental health system needs to improve services for high-risk youth who are victims of trauma; improve the detection of posttraumatic stress disorder in juvenile detainees; and avoid re-traumatizing youth while they're in detention.

More information

The American Psychiatric Association has more about posttraumatic stress disorder.

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No 'Safe' Alcohol Intake Found with Hepatitis C

Reuters Health

Wednesday, April 14, 2004

NEW YORK (Reuters Health) - Fibrous changes in the liver caused by hepatitis C infection are worsened with any level of alcohol consumption, a study shows.

However, there may be trade-off between benefits and risk with low alcohol intake, according to the report in the journal Hepatology.

Heavy alcohol consumption may contribute to the progression of hepatitis C-related liver disease, the authors explain, but light alcohol intake has not been shown to do so and may, in fact, bestow other health benefits.

To look at this issue, Dr. Alexander Monto and colleagues from University of California at San Francisco compared liver biopsies and detailed records of daily alcohol intake from 800 patients with chronic hepatitis C virus infection.

The researchers found that there was a range of liver damage severity in each category of alcohol intake, though overall liver fibrosis was greater in patients who drank heavily than in those who did not.

The findings were somewhat different in women, the investigators report. Their fibrosis scores were lower, and the association between alcohol intake and fibrosis was less clear.

"One important question has been: is there a 'safe' level of alcohol intake in patients with chronic HCV infection?" Monto's team writes. "This study does not find this to be the case."

They point out, "Light and moderate intake exert less of an effect on fibrosis than heavy intake, however, and may indeed have minimal or no effect."

Balancing this "small risk of liver disease progression against potential cardiovascular benefit may be particularly pertinent to middle-aged men, who worldwide constitute the majority of patients with HCV, and who are also at high risk for cardiovascular disease," the researchers point out.

They conclude that risks and benefits should be individually assessed for each patient.

Source: Hepatology, March 2004.

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Study: Tobacco Industry Tried to Stall Secondhand Smoke Report

By Amanda Gardner
HealthDay Reporter

Wednesday, April 14, 2004

WEDNESDAY, April 14 (HealthDayNews) -- Researchers sifting through thousands of pages of tobacco industry documents say they have unearthed evidence of tactics the industry used to try and derail a landmark government report that declared secondhand smoke to be a killer.

The report, the first comprehensive risk assessment of the health issue, determined secondhand smoke was a Group A carcinogen that caused about 3,000 lung cancer deaths each year in nonsmokers. Although it was released by the Environmental Protection Agency (news - web sites) (EPA) in 1992, it suffered under a cloud of doubt cast by a series of stalling strategies for a decade, say the authors of an article in the current issue of the American Journal of Preventive Medicine.

The report's findings were a key catalyst for the current widespread ban on indoor smoking, the "beginning of a major movement across the country and now across the world," said article co-author Dr. Richard D. Hurt, director of the Mayo Clinic's Nicotine Dependence Center. "This was about the bottom line for [tobacco companies."

But, he charged, "the delay cost people their lives."

Jennifer Golisch, a spokeswoman for Philip Morris USA, would not comment on the specific documents referenced in the article because she had not seen them. And she refused comment on Hurt's charge.

However, she added, "Philip Morris USA believes that the public should be guided by the conclusions of public health officials regarding the health effects of secondhand smoke. Public health officials have concluded that secondhand smoke from cigarettes causes disease. This information should guide people in deciding whether to be in places where secondhand smoke is present or, if they are smokers, when or where to smoke around others."

Hurt and his colleagues pored over once-secret internal tobacco company documents, which are now available at the Minnesota Tobacco Document Depository in Minneapolis, the British American Tobacco (BAT) Document Depository in London and the online Tobacco Control Archives at the University of California, San Francisco. At the Minnesota Depository alone, the authors searched more than 2,000 boxes, each with 2,500 pages, from April 1998 and February 2002.

Although they mention RJ Reynolds Tobacco Co., the authors focus much of the article on one file found at the Minnesota Depository entitled "SCP Miles presentation." The reference is to Steve C. Parrish, vice president and general counsel of Philip Morris and Mike Miles, former chief executive officer of the company. And the presentation outlined various strategies related to the EPA document, the authors said.

According to the authors, the tobacco industry documents also showed:

Some strategies were more successful than others, the authors noted. The federal lawsuit, for instance, succeeded in delaying the release of the report for an additional seven years. At the end of 2002, however, an appeals court in Richmond, Va., overturned that decision, and Philip Morris withdrew from the suit.

 

The decade of delays has had enduring effects, Hurt added.

 

"The tobacco industry's maneuvers cast doubt on the document and damaged public confidence," he said. What's more, "the smoke-free workplace movement was not as quick or as widespread as it might otherwise have been. The industry wanted to bury the EPA document and, at the very least, slow it down with sand in the gears."

 

The revelations of the new research are not the first time the tobacco industry has been accused of heavy-handedness when pursuing its own agenda. Other allegations in recent years charged that it tried to cast doubt on a study that linked secondhand smoke and cancer and it ignored warnings that cigarette filters could release harmful substances.

 

"This is just one segment of an enormous PR campaign," Hurt said. "People need to understand that a lot of rhetoric has been made up, fabricated by the tobacco industry. This clearly demonstrates the lengths to which this industry will go to fight something that is clearly in the interest of the public health."

 

More information

 

For more information on tobacco and smoking, visit Campaign for Tobacco-Free Kids or the American Legacy Foundation.

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Tuesday, April 13, 2004

 

Estrogen No Overall Benefit in Disease Prevention

 

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - The latest analysis of data from the Women's Health Initiative (WHI) shows that estrogen replacement therapy after menopause doesn't improve long-term health. While it decreases the risk of fractures, it increases the risk of stroke.

Also, the treatment has no significant effect on coronary heart disease or death from all causes, according to the new report.

"These data support the current US Food and Drug Administration (news - web sites) recommendations for postmenopausal women to use (estrogen) only for menopausal symptoms at the smallest effective dose for the shortest possible time," Dr. Garnet L. Anderson of the Fred Hutchinson Cancer Research Center, Seattle, and other members of the WHI Steering Committee write in this week's Journal of the American Medical Association (news - web sites).

The part of the WHI that looked at the effects of estrogen plus progestin therapy was halted early in 2002 because the health risks of combined hormone replacement therapy exceeded the benefits. The estrogen-alone wing of the study was continued until February 2004, when the National Institutes of Health (news - web sites) found a significantly increased risk of stroke and advised that the trial be terminated.

The estrogen-only trial included nearly 11,000 women ages 50 to 79 with prior hysterectomy who were randomly assigned to daily estrogen or to a matching dummy pill.

During an average follow-up of about 7 years, the occurrence of coronary heart disease in the two groups was not statistically different.

Also, the occurrence of breast cancer -- the main measure of safety -- was no different in the two groups, statistically, although it was lower among those taking estrogen.

However, the occurrence of stroke was increased by 39 percent in the estrogen group, while fractures due to osteoporosis were reduced by 30 percent.

There were 291 deaths in the estrogen group and 298 in the placebo group.

Overall, the health risks and benefits balanced out, the report indicates.

In an editorial, two epidemiologists at the University of California, San Francisco, agree that hormone replacement therapy is not the way to prevent chronic disease. "Fortunately, there are other good approaches to preventing coronary heart disease and fractures for which trials have found benefits to outweigh harms," they conclude.

Source: Journal of the American Medical Association, April 14, 2004.

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Lung Cancer in U.S. Women Is 'Epidemic'

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Tuesday, April 13, 2004  

TUESDAY, April 13 (HealthDayNews) -- Many women worry that they'll get breast cancer, but a new report says lung cancer is actually a bigger threat to their health.

Last year, nearly 70,000 women died from lung cancer in the United States. That's more deaths than from breast cancer and all gynecological cancers combined. The death rate from lung cancer rose 600 percent between 1930 and 1997, according to the report, which appears in the April 14 issue of the Journal of the American Medical Association (news - web sites).

The paper, agreeing with a report issued by the U.S. Surgeon General, says the nation "is clearly in the midst of an epidemic. Lung cancer in U.S. women occurred suddenly and in numbers clearly in excess of normal expectancy."

"Smoking is the largest risk factor for lung cancer," said study co-author Dr. Jyoti Patel, an instructor of medicine in the division of hematology/oncology at the Feinberg School of Medicine at Northwestern University in Chicago.

"During World War II, women went into the workforce and started to smoke like men. Twenty years later, they started to die like men, from lung cancer," says Dr. Jay Brooks, chief of hematology and oncology at the Ochsner Clinic Foundation Hospital in New Orleans.

Nearly one in four cancer deaths in women in 2003 were expected to be from lung cancer. At the same time women's rates of lung cancer deaths have been increasing, they've been decreasing for men.

In their report, Patel and her colleagues explained that one reason for this difference may be that women are more susceptible to lung cancer than men. This is a controversial topic among researchers, however. Some studies have shown women are more prone to the disease, but others have failed to confirm these findings or have found the opposite to be true.

While it wasn't included in Patel's analysis, one of the most recent studies on the subject found female smokers had double the risk of lung cancer that male smokers do. Results of this study were presented in December 2003 at the annual meeting of the Radiological Society of North America.

The topic of women's susceptibility may still be controversial, but Patel said one thing that isn't is that there are biological differences in the way lung cancer acts in women than in men. For example, women tend to live longer than men after being diagnosed with lung cancer. That may be because lung cancer cells have more estrogen receptors than normal lung cells do, according to Patel, who added that more gender-specific lung cancer research needs to be done.

Despite the huge rise in lung cancer, and the knowledge that smoking causes other illnesses, the researchers noted that nearly one-quarter of all American women still smoke.

"Women need to realize that they can reduce their risk of cancer by one half if they don't smoke and they're not obese," Brooks says.

"We have to make smoking less socially acceptable," explained Patel, who said it's a difficult task because the tobacco industry spends billions of dollars per year on advertising and marketing, yet only about $100 million is spent on smoking cessation efforts.

Patel said it's especially important to get the message to other countries where female smoking rates are currently low, so they don't repeat the mistake.

"The tobacco industry sees a huge opportunity worldwide," said Dr. Michael Thun, head of epidemiological research for the American Cancer Society (news - web sites). Thun says Spain is an example of how tobacco marketing can work. He says that at the end of World War II, very few Spanish women smoked. But with the collapse of Franco's dictatorship, the tobacco industry marketed cigarettes using positive images coupling smoking with independence and freedom, and the rates of female smoking increased dramatically.

"Using images of liberation and democracy to ensnare women into smoking is a massive global problem, and it's appalling," Thun said. Brooks added that other tobacco marketing sends women the message that if you smoke, you will be thin.

Brooks recommended showing young women pictures of how they can prematurely age from smoking. Thun suggested appealing to a teen's sense of freedom and justice, and ask them, "Why would you want to be entrapped by a huge, lying industry?"

Finally, Thun pointed out, "Lung cancer, although a huge burden, is less than a third of all deaths that smoking causes."

More information

To learn more about lung cancer, visit the National Cancer Institute or the American Cancer Society. Try QuitNet for help in giving up the habit.

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FDA Approves Human Brain Implant Devices

 

By Justin Pope

AP Business Writer

The Associated Press

Tuesday, April 13, 2004

BOSTON - For years, futurists have dreamed of machines that can read minds, then act on instructions as they are thought. Now, human trials are set to begin on a brain-computer interface involving implants.

Cyberkinetics Inc. of Foxboro, Mass., has received Food and Drug Administration (news - web sites) approval to begin a clinical trial in which four-square-millimeter chips will be placed beneath the skulls of paralyzed patients.

If successful, the chips could allow patients to command a computer to act — merely by thinking about the instructions they wish to send.

It's a small, early step in a mission to improve the quality of life for victims of strokes and debilitating diseases like cerebral palsy or Lou Gehrig's. Many victims of such ailments can now survive for long periods thanks to life support, but their quality of life is poor.

"A computer is a gateway to everything else these patients would like to do, including motivating your own muscles through electrical stimulation," said Cyberkinetics chief executive Tim Surgenor. "This is a step in the process."

The company is far from the only research group active in the field. An Atlanta company, Neural Signals, has conducted six similar implants as part of a clinical trial and hopes to conduct more. But for now, its device contains relatively simple electrodes, and experts say Cyberkinetics will be the first to engage in a long-term, human trial with a more sophisticated device placed inside a patient's brain. It hopes to bring a product to market in three to five years.

A number of research groups have focused on brain-computer links in recent years.

In 1998, Neural Signals researchers said a brain implant let a paralyzed stroke victim move a cursor to point out phrases like "See you later. Nice talking with you" on a computer screen. The next year, other scientists said electrodes on the scalp of two Lou Gehrig's disease (news - web sites) patients let them spell messages on a computer screen.

Cyberkinetics founder Dr. John Donoghue, a Brown University neuroscientist, attracted attention with research on monkeys that was published in 2002 in the journal Nature.

Three rhesus monkeys were given implants, which were first used to record signals from their motor cortex — an area of the brain that controls movement — as they manipulated a joystick with their hands. Those signals were then used to develop a program that enabled one of the monkeys to continue moving a computer cursor with its brain.

The idea is not to stimulate the mind but rather to map neural activity so as to discern when the brain is signaling a desire to make a particular physical movement.

"We're going to say to a paralyzed patient, 'imagine moving your hand six inches to the right,'" Surgenor said.

Then, he said, researchers will try to identify the brain activity associated with that desire. Someday, that capacity could feed into related devices, such as a robotic arm, that help patients act on that desire.

It's misleading to say such technologies "read minds," said Dr. Jonathan Wolpaw, of the New York State Department of Health, who is conducting similar research. Instead, they train minds to recognize a new pattern of cause and effect, and adapt.

"What happens is you provide the brain with the opportunity to develop a new skill," he said.

Moving the experiment from monkeys to humans is a challenge. Cyberkinetics' "Brain Gate" contains tiny spikes that will extend down about one millimeter into the brain after being implanted beneath the skull, monitoring the activity from a small group of neurons.

The signals will be monitored through wires emerging from the skull, which presents some danger of infection. The company is working on a wireless version.

But Richard Andersen, a Cal Tech expert conducting similar research, said the field is advanced enough to warrant this next step.

"I think there is a consensus among many researchers that the time is right to begin trials in humans," Andersen said, noting that surgeons are already implanting devices into human brains — sometimes deeply — to treat deafness and Parkinson's disease (news - web sites). "There is always some risk but one considers the benefits."

Wolpaw said it isn't clear that it's necessary to implant such devices inside the brain; other technologies that monitor activity from outside the skull may prove as effective. But, he said, the idea of brain implants seems to attract more attention.

"The idea that you can get control by putting things into the brain appears to have an inherent fascination," he said.

Andersen, however, said that for now devices inside the brain provide the best information.

"It would be nice if in the future some technology comes along that would let you non-invasively record from the brain," he said. "MRIs do that. But unfortunately, it's very expensive and cumbersome, and the signal is very indirect and slow."

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Pneumonia Raises Death Risk Even in Midlife

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- If you're over 40 and have been hospitalized for pneumonia, you may be at greater risk of dying within the two to three years after you're sent home -- even if you have no other known life-limiting health conditions, researchers have found.

Advancing age is one of several risk factors linked to a greater-than-expected death rate after hospitalization for pneumonia, according to a report in the April issue of the American Journal of Respiratory and Critical Care Medicine.

People 41 to 60 years old who had no previous illness were particularly vulnerable, the study found. That group's mortality rate was roughly six times greater than expected, according to Dr. Grant Waterer, a senior lecturer in medicine at the University of Western Australia and lead author of the study.

Pneumonia victims aged 61 to 80 with no other observed illnesses died at roughly twice the predicted rate of death for their age group.

Younger adults, ages 18 to 40, were at no increased risk of death after discharge, the study found.

"The message is that if you are young -- under 40 -- an episode of pneumonia is just bad luck," Waterer said. "If you are over 40, it may be an indication that all is not well, and your physician needs to look closely to see if there are any underlying illnesses that may not have been previously recognized," he cautioned.

Pneumonia was the immediate cause of 3.9 million deaths worldwide in 2002 and is responsible for more than 1 million hospitalizations in the United States each year, Dr. Scott Dowell, of the U.S. Centers for Disease Control and Prevention (news - web sites)'s International Emerging Infections Program, noted in an accompanying editorial in the journal.

"Considering the importance of pneumonia, it is remarkable how little is known about what happened to patients after they recover," Dowell observed.

Waterer and colleagues were mainly interested in showing whether pneumonia cuts longer-term survival in otherwise healthy patients. Their study involved patients with community-acquired pneumonia who were admitted to Methodist Healthcare Memphis Hospitals in Tennessee and survived discharge.

Investigators were able to determine the survival status of 366 patients, or 97 percent of patients in the study, over an average of three years after discharge. One hundred twenty-five of them -- or more than a third -- died after discharge.

Other health conditions -- especially heart disease and stroke, an altered mental state, anemia, and poorly controlled diabetes -- also were shown to be predictors of mortality after discharge for pneumonia.

The new findings add to a growing body of evidence indicating that pneumonia patients can expect a modestly to substantially increased death rate up to four years after hospitalization, Dowell noted.

Given that risk, Dowell suggests that patients and their families need to remain vigilant and pursue preventive health measures. For example, he said, "The prognosis for modern-day patients who recover from a first bout of pneumonia may be substantially improved by offering an effective smoking cessation program, influenza vaccine, and pneumococcal vaccine."

All physicians should include these preventive measures in their standing discharge orders for patients who have recovered from pneumonia, he added.

More information

Learn more about pneumonia from the American Lung Association or the National Library of Medicine.

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Causes of Blindness Differ in Blacks, Whites

 

By Alison McCook

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - U.S. investigators have found that the leading cause of blindness among whites is age-related macular degeneration (AMD), while most blacks lose their sight from glaucoma or cataracts.

Furthermore, within age groups, blindness occurs nearly three times more commonly in blacks than in whites.

AMD is a frequent cause of deteriorating vision in older adults. As people age, there is a breakdown in light-sensitive cells in the macula, the tissue in the center of the retina.

In contrast, cataracts occur when proteins in the eye's lens begin to clump together, forming a milky cloud that obscures vision. In glaucoma, fluid levels rise in the eye, increasing pressure, which can damage the optic nerve.

For the current report, the researchers reviewed studies of the prevalence of blindness among different ethnic groups, then applied those results to census information to estimate the number of people living with blindness and poor eyesight in the U.S.

The investigators found that almost 1 million people - or nearly 1 percent - of Americans over 40 are blind, defined as having eyesight that is at or below 20/200. And as the U.S. population ages, the prevalence of blindness among older adults is expected to increase by 70 percent by the year 2020, the authors note.

"The key finding is that the burden of disease is large, and will become much larger as the population gets more elderly," study author Dr. John Kempen of Johns Hopkins University in Maryland told Reuters Health.

More than 50 percent of white adults became blind as a result of AMD. In contrast, more than 60 percent of cases among blacks were due to either glaucoma or cataracts, according to the Archives of Ophthalmology report.

In an interview, Kempen explained that the racial differences in the common causes of blindness may stem from both genetic differences and access to care.

For instance, he noted that cataracts are very treatable with a relatively simple surgery to replace the cloudy lens, but African Americans may undergo the procedure less often than whites. The reasons for that disparity are still unclear, Kempen said.

Source: Archives of Ophthalmology, April 2004.

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Arkansas City Battling Obesity in Kids

 

By Caryn Rousseau

Associated Press Writer

The Associated Press

Tuesday, April 13, 2004

LITTLE ROCK, Ark. - Nearly two in five Arkadelphia public school students are overweight or at risk of becoming overweight, the first statistics from the state's program to test body mass show.

The numbers were released Monday, making Arkansas the only state with a law that requires that every public school student be screened for body mass.

Statistics from Arkadelphia School District that cover 2,051 students tested last fall show that nearly two in five students are either at risk of becoming overweight or are overweight already. The average is 38.6 percent of boys and 35.7 percent of girls.

As part of a group of about 30 pilot schools to enter the screening program, statistics from Arkadelphia's five schools show that males are more likely to be overweight than females and that certain ages are heavier than others.

"The results that we're seeing in Arkadelphia are a major cause for concern," said Dr. Joe Thompson, who is directing the project for the Arkansas Center for Health Improvement.

Thompson has been saying it all along, but now he's got the numbers to prove his theory: "We do have a major problem with child and adolescent obesity."

The numbers were gathered under Act 1220, a new law that requires public schools to work up an annual body mass index, using each student's height, weight and age. It also rids school cafeterias of vending machines and creates the Arkansas Child Health Advisory Committee.

The numbers are the first in a program that aims to screen all 450,000 Arkansas public school students. To achieve this, each of the state's schools received a scale for weight and a machine to measure height. Thompson said Monday that he had about 100,000 forms at the center waiting for processing. He said he thinks he can have most of the forms ready by June 1.

Parents in Arkadelphia received a letter explaining why body mass ratings are important, what their child's height is, what their weight is and if they are overweight or not. If a child is overweight, a separate section of the letter suggests the child visit their doctor and offers solutions.

Arkadelphia Superintendent Tony Protho said he wasn't surprised by the high percentages. "To be honest with you, it was not alarming," he said. "We knew this was a problem."

The overweight figures for Arkadelphia, not including those at risk for being overweight, are 21.6 percent of boys and 17.5 percent of girls. The national average is 15 percent.

"There are also some grades in which there appear to be a more significant problem," Thompson said.

One in four graduating high school boys are overweight, statistics show, and there seems to be a larger number of overweight children in the fifth and sixth grades.

Doctors say it's too early to read into those numbers, attributing them to a one-year snapshot in one community.

Also, the statistics are categorized differently for children than for adults. Children are rated as either underweight, normal, at risk of being overweight or overweight. Children are not classified as "obese," doctors said, so that category is not used.

However, doctors said if adult categories were used, children rated as "at risk for being overweight" would be considered overweight and those rated "overweight" would be considered obese.

On the Net:

Arkansas Center for Health Improvement: http://www.achi.net

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Chronic Gut Pain in Kids Tied to Mood Disorder

 

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Children with recurrent abdominal pain often have anxiety and depression, according to findings from a small study.

Dr. John V. Campo and colleagues from the University of Pittsburgh Medical Center, in Pennsylvania, examined 42 children between 8 and 15 years old who were seen in primary care practice because of chronic abdominal pain. For comparison purposes, they were matched to 38 similar kids being seen for routine care.

The children in the pain group were considerably more likely than the comparison group to have a psychiatric diagnosis, the investigators report in the journal Pediatrics. Of the 42 children with abdominal pain, 33 had an anxiety disorder and 18 had a depressive disorder.

Also, levels of anxiety and depressive symptoms were higher in the children with recurrent pain, and they had a greater degree of functional impairment, according to the authors.

On average, the complaints of abdominal pain began at 9 years of age, whereas the first recognition of definite anxiety disorder was at 6.25 years of age, and definite depressive disorder at 9.5 years old, Campo's group found.

"Anxiety disorder was significantly more likely to precede the onset of recurrent abdominal pain, developing a mean of 35.2 months beforehand," the researchers point out.

These findings have important implications for treating children with recurrent abdominal pain, they say.

Since the "vast majority of affected children will have anxiety or a depressive disorder," they write, treatments that deal with both the physical and emotional distress "thus seem ideal."

Source: Pediatrics April 2004.

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Obesity, Depression Affecting Omaha, Neb.

 

The Associated Press

Tuesday, April 13, 2004

OMAHA, Neb. - Obesity, depression and sexually transmitted diseases are some of the problems facing residents of Douglas County, officials said in the county's first health report card.

The report released Friday found that six out of 10 of adults in the county were overweight, including 23.6 percent who were considered obese.

About 27 percent of Douglas County adults have suffered from depression for two or more years. The national average is nearly 24 percent.

The chlamydia rate for the county was 34 percent above the national average, and its gonorrhea rate was 50 percent above the national average, the report said.

The report card is a snapshot of health trends in the county, said Kerri Peterson, executive director of the 26-member Our Healthy Community Partnership, which compiled the data.

"It will take our entire community, both on an individual and group level, to take responsibility for improving the health status of our community," Peterson said.

The partnership was formed in part by Omaha area hospitals, health insurers, managed care companies and medical schools. The group then compared county data with state and national numbers in the areas of cancer, diabetes, heart disease and stroke, infant health, lung disease, mental health and substance abuse and violence and abusive behavior.

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Gene Variant May Contribute to Autism

 

By Will Boggs, MD

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Small changes within a gene called SLC25A12 are strongly associated with autism, according to a new report.

"Autism appears to be largely genetic," Dr. Joseph D. Buxbaum from the Mount Sinai School of Medicine, New York, told Reuters Health. "Genetic testing should ultimately be available to identify people at high risk."

Buxbaum and his colleagues recently narrowed down autism-linked genetic changes to a region on chromosome 2. They then focused on genes in this region in 411 families with members affected by autism.

Among nine genes analyzed in this region, the authors report in the April issue of the American Journal of Psychiatry, only two variations, both within the SLC25A12 gene, differed significantly between autistic and nonautistic subjects.

Among 411 families studied, 197 had at least one parent who carried at least one of these genetic variations, the report indicates.

Their findings "support a role for SLC25A12 as an autism susceptibility gene (rather than a modifying gene)," the authors conclude.

The protein produced by SLC25A12 is critically involved in the function of the mitochondria, the body within cells that powers many of its processes. Hence, changes in the protein "may lead to an alteration in mitochondrial function."

This genetic alteration is not the sole cause of autism, but probably contributes to development of the disorder. "If we can find the first few genes that contribute several-fold risk, it may be possible, by analyzing all these genes together, to define people with a many-fold increase in risk," Buxbaum said.

"Those people could then be treated at the earliest possible age using behavioral methods that can be beneficial."

In addition, if the current genetic findings are confirmed, they implicate mitochondrial function in autism, "and this may be a therapeutic avenue," he noted.

Source: American Journal of Psychiatry, April 2004.

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Over-the-Counter Drugs Aren't Risk-Free

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- When a miserable cold and cough strike at the same time, it's tempting to take the latest over-the-counter cold elixir and top it off with a pain relief medicine.

But you could be setting yourself up for a dangerous overdose.

Many cough and cold medications contain acetaminophen, the active ingredient in such popular remedies as Tylenol. Too much of it can lead to liver damage, and even death, the U.S. Food and Drug Administration (news - web sites) warns. So the agency advises consumers to avoid taking multiple medications that contain the same active ingredient together.

Using an off-the-shelf pain relief medicine along with a prescription medication also may pose a risk. Prescription painkillers, such as Percocet or Vicodin, for instance, combine a narcotic analgesic with acetaminophen.

"So people could overdose on it without being aware of it," said Stephen Giroux, past president of the Pharmacists Society of the State of New York.

In response, the FDA has launched an educational campaign to promote the safe use of over-the-counter pain relievers and fever reducers. The campaign focuses on products containing acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs).

Americans buy approximately 5 billion over-the-counter drug products a year, according to the FDA. Pharmacy shelves are packed with more nonprescription options than ever before. More than 700 products sold over-the-counter today use ingredients or dosage strengths that were only available by prescription 30 years ago.

That all means consumers now have more freedom to treat themselves, but it also creates a greater need for information.

"Just because they're available in a nonprescription strength doesn't mean they're always safe," Giroux cautioned.

As many as 100 people die each year and 13,000 land in the emergency room as a result of unintentional overdoses of acetaminophen, FDA statistics show.

Aleve, which contains naproxen sodium, and products like Advil and Motrin, which contain ibuprofen, are common types of NSAIDs. So is aspirin. All are staples of medicine cabinets across America and are used by more than 30 million Americans each day.

While generally safe when used as directed, NSAIDs can cause stomach bleeding in some people, particularly those over 60 who have a history of stomach bleeding or are taking prescription blood thinners or steroids, the FDA cautions.

More than 16,500 people in the United States die and 103,000 are hospitalized from serious side effects of NSAIDs each year, statistics show. Yet many Americans don't realize the risks involved.

Acetaminophen and NSAIDs aren't the only pain relievers that can cause harmful interactions. Combining anti-inflammatory drugs with antacids or an acid blocker such as Pepcid AC or Tagamet to stop the stomach irritation of anti-inflammatories may actually increase the risk of ulcers, according to the National Consumers League (NCL). And by thwarting heartburn symptoms, the acid blockers may prevent patients from getting needed treatment, the group says.

In January 2003, the NCL released results of a Harris Interactive survey in which 44 percent of Americans who had taken an OTC pain reliever in the previous 12 months admitted exceeding the recommended dose. Forty-five percent thought it was safe to take an over-the-counter pain reliever while using another OTC cold or flu medication.

Linda Golodner, president of the Washington, D.C.-based consumer advocacy group, has seen young adults take a swig from a bottle of Nyquil with no regard to safe dosing.

An adult dose of Nyquil contains a cough suppressant, an antihistamine and 1,000 milligrams of acetaminophen. Taking the correct dose along with two Extra Strength Tylenol effectively doubles your dose of acetaminophen while giving you half the recommended daily amount at one time, according to the NCL. Drinking from the bottle further skews the dosing.

"There's a point at which your mother stopped giving you the aspirin and nobody's given you instruction with how to deal with it," said Golodner, who also chairs the National Council on Patient Information and Education.

The FDA requires most over-the-counter medicines to carry a "Drug Facts" label containing information consumers need to know about a product's safe and effective use. Yet many Americans admit they don't read the entire label.

Skipping the part that indicates how long it's safe to take a particular product is one way overdoses occur, Golodner noted. Patients end up taking a product much longer than they should.

"If you're just masking the pain by taking an Advil, an aspirin or a Tylenol, and you don't end up talking to the doctor and it's a chronic pain, then you might be in trouble," she said.

Intentionally doubling up on recommended doses is also a common mistake. "Many times people think, if one is good, two is better," said Giroux.

If you're a parent or caregiver, it's best to consult your doctor or pharmacist if you're not sure which OTC medicine is best for your child, the National Council on Patient Information and Education advises. And since proper dosing for infants and young children is based on their weight, health professionals recommend that parents keep an accurate scale in the house and weigh the child before administering any medicines.

To encourage consumers to ask questions, Sharlea Leatherwood, president of the National Community Pharmacists Association, keeps the over-the-counter cold and cough section of her Kansas City, Mo.-based retail pharmacy near the pharmacy counter.

"It's just a good idea to run by your pharmacist what you're taking over-the-counter," she says.

More information

The National Council on Patient Information and Education has more on using OTC medications safely. The National Consumers League has facts on the risks of OTC pain medicines.

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Latest Word on Virtual Colonoscopy: Not Yet

 

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Disappointing results are reported from a new study of virtual colonoscopy, the much-anticipated alternative to conventional colonoscopy for screening for colon cancer and polyps.

It seems the accuracy of the non-invasive technique is still too low, even for detecting relatively large lesions, according to a report in Wednesday's issue of the Journal of the American Medical Association (news - web sites).

Several recent studies have indicated that CT colonography, as virtual colonoscopy is called technically, is pretty sensitive, even equalling that of the conventional technique.

However, those results were obtained at single, specialized centers. The study by Dr. Peter B. Cotton, at the Medical University of South Carolina in Charleston, and associates was designed to evaluate the accuracy of CT colonography in routine practice at nine major hospital centers.

Included were 615 patients referred for evaluation who underwent both CT colonography and colonoscopy within two hours of each other.

The virtual technique spotted only 39 percent of polyps up to 6 millimeters in size that were seen on regular colonoscopy, and only 55 percent of lesions 10 mm in size and up. Also, CT colonography missed two of eight cancers.

"Even if the results of CT colonography continue to be good in the hands of experts, it has yet to be proven that this expertise can be taught and disseminated reliably into daily practice," Cotton's team concludes.

Moreover, the supposed advantage of the virtual technique in terms of comfort may be illusory. When participants were surveyed after undergoing the two procedures, 46 percent said they preferred CT colonography while 41 percent preferred conventional colonoscopy.

Source: Journal of the American Medical Association, April 14, 2004.

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There's a Spider in My Grapes

 

HealthDayNews

Tuesday, April 13, 2004

(HealthDayNews) -- Spiders thrive in grape vineyards, so reports of people finding black widow spiders nestled in imported table grapes are less surprising than they may be alarming.

If you find a spider in your bunch of grapes, you should get rid of it without touching it or its web, advises the Canadian Food Inspection Agency. U.S. grape growers acknowledge an ocassional black widow being found in domestic grapes, too.

Wash your grapes thoroughly by placing them under running warm water. This will likely immobilize any live spiders by washing them off into the sink. If a spider falls into the sink, kill it; don't capture it. If necessary, report the incident to the appropriate inspection agency.

After getting rid of the spider, you can eat the grapes. The spider doesn't damage or poison the fruit.

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Long-Term Diabetes Control Pays Off for the Heart

 

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - People with diabetes are urged to keep their blood sugar levels in check to avoid multiple complications down the road. While that can be tiresome day in and day out, the effort is rewarded in the long run, Norwegian researchers confirm.

They have found that good long-term glucose control by type 1 diabetic patients preserves the automatic responses of the heart to varying situations, while a lack of adequate glycemic control leads to poor so-called cardiac autonomic function.

"Our findings confirm the important role of good glycemic control in the functioning of the autonomic nervous system in type 1 diabetes and validate after 18 years our findings from 8 years' observation in the Oslo study," the investigators write in the medical journal Diabetes Care.

Dr. Jakob R. Larsen and colleagues from Ulleval University Hospital in Oslo followed 39 patients with type 1 diabetes for 18 years. For 14 of those years, the participants adhered to intensive insulin treatment, based on studies showing that tight glucose control can slow the development and progression of abnormal autonomic function.

Levels of glycosylated hemoglobin -- an indicator of glucose control over a period of time -- were measured yearly, and the subjects underwent a battery of tests widely used to assess cardiac autonomic function, including heart rate responses to deep breathing, to being tilted into various positions, and maximal exercise testing.

The investigators found that an average glycosylated hemoglobin level of less than 8.4 percent over 18 years was "strongly associated with preserved cardiac autonomic function." Conversely, a level higher than that predicted impaired cardiac autonomic function.

For all the cardiac function tests, values stayed within normal for participants with the lowest glycosylated hemoglobin levels but were "pathological" in those with the highest levels, Larsen's team reports.

Dysfunction of the cardiac autonomic nervous system increases the risk of death in diabetic patients, the researchers note, but the risk can be lowered by reining in blood glucose levels consistently.

Source: Diabetes Care, April 2004.

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Secondhand Smoke Slows Wound Healing

 

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- Secondhand smoke impairs the ability of specialized cells to migrate toward the site of a wound, resulting in slower healing or greater scarring, a University of California, Riverside study has found.

Researchers examined the effects of passive smoke on fibroblasts, cells that play an important role in wound healing. Among other things, the study found that secondhand smoke altered the arrangement of the cells' cytoskeleton, causing the fibroblasts to become more adhesive and less mobile.

"These effects can contribute to abnormal healing and may explain why people who are consistently exposed to secondhand smoke suffer from slow healing and excessive scarring of wounds, much like smokers themselves," the study authors write.

The study appears in this week's issue of BMC Cell Biology.

More information

The American Lung Association has more about secondhand smoke.

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Fat Protein Predicts Heart Attack Risk in Men

 

By Anthony J. Brown, MD

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Men with high levels of adiponectin, a protein produced by fat cells, have a decreased risk for heart attack, new research indicates. Further studies are needed to determine if this also applies to women.

Animal research and cross-sectional studies have suggested that the risk of heart attack falls as adiponectin levels rise, lead author Dr. Tobias Pischon, from the Harvard School of Public Health in Boston, told Reuters Health. "But, ours is the first (forward-looking) study in a healthy population to look at this association."

The study, reported in the Journal of the American Medical Association (news - web sites), involved participants in the Health Professionals Follow-up Study. All of the subjects were free from heart disease at the beginning of the study when blood samples were taken. The analysis focused on 266 men who developed heart disease during 6 years of follow-up and 532 similar men who remained disease free.

Compared with men with the lowest adiponectin levels, those with the highest levels were 61 percent less likely to have a heart attack. After accounting for the subjects' cholesterol levels, this reduction in risk fell to 44 percent.

Pischon commented that "it's definitely too early to say whether measuring adiponectin levels" will offer any added value in predicting heart attacks after considering traditional risk factors, such as high blood pressure and smoking.

"Our next step is to do a similar analysis in women," Pischon said. "The association should hold up in women, but there are some differences between the sexes--women generally have higher adiponectin levels."

Source: Journal of the American Medical Association, April 14, 2004.

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Finding the First Signs of Ovarian Cancer

 

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- Specific molecular and cellular changes in the ovary may someday help doctors detect ovarian cancer at an early stage, says a Temple University study in the April issue of Gynecologic Oncology.

There is no accurate test for early detection of ovarian cancer, and it's often diagnosed only after it's reached an advanced stage.

In this study, Temple researchers compared the healthy ovaries of women with ovarian cancer to ovaries in women without cancer.

"Our study suggests that the 'normal' ovaries of women with ovarian cancer have not only structural changes, but also molecular changes that are less frequently found in the ovaries of healthy women," senior author Dr. Enrique Hernandez, a professor and chairman of obstetrics and gynecology, said in a prepared statement.

He and his team identified structural changes in the cells of the ovary lining and molecular changes that involved higher levels of a protein that prevents cell death.

"This study and others like it are building the foundation for better methods of early detection of ovarian cancer. If we are able to identify early changes along the path by which a normal ovarian cell turns into a cancerous ovarian cell, we might be able to develop a test to detect the disease earlier, even before it becomes cancerous," Hernandez said.

More information

The National Women's Health Information Center has more about ovarian cancer.

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Men Take Note of Prostate Cancer in Family

 

By Merritt McKinney

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Most men with a family history of prostate cancer are well aware that they are at increased risk of developing the disease themselves, new research indicates.

Prostate cancer (news - web sites) is the most common cancer in U.S. men, and it is the second leading cause of cancer death in men after lung cancer.

Very little is known about what causes prostate cancer, but a family history of the disease has been shown to increase a man's risk. In fact, about 42 percent of all cases of prostate cancer are thought to be hereditary.

A team led by Dr. Jennifer L. Beebe-Dimmer of the University of Michigan at Ann Arbor set out to see whether relatives of men with prostate cancer were aware of their increased risk.

The study included 111 men who had a brother who had been diagnosed with prostate cancer. The men were interviewed by telephone to see how they perceived their risk of developing prostate cancer during the next 10 years and during their lifetime.

Most brothers of men with prostate cancer accurately predicted that they were at increased risk of cancer, the team reports in the April 1 issue of the journal Cancer.

Beebe-Dimmer explained to Reuters Health that about one out of every six men in the general population will be diagnosed with prostate cancer at some point in their lifetime. "However, if a man has a brother, father or son diagnosed with prostate cancer, his chances of being diagnosed are approximately one in two," she said.

The majority of men in the study believed that they had at least a 50-50 chance of developing prostate cancer.

Although most men were aware of their increased risk, younger brothers of men with cancer were more concerned than older brothers. This is a "particularly interesting" finding, according to the researchers, as the risk of prostate cancer increases with age.

Older brothers may be less concerned because they mistakenly believe that they have passed the time of their greatest risk of cancer, according to the report.

Another possible explanation, according to the researchers, is that older men may be less concerned because they assume that they will not die of prostate cancer. This may be true, as most men diagnosed with prostate cancer after age 70 end up dying of causes other than prostate cancer.

The study also found that men with two or more close relatives were more concerned about their risk than men with a single affected relative.

The investigators discovered that men who were concerned about developing prostate cancer, particularly in the short term, were more likely than other men to use alternative medicine, such as supplements and vitamins, to try to reduce their risk.

Supplements have not been proven to prevent prostate cancer and may interfere with some medications. But the findings show that men who are at high risk of developing prostate cancer are seeking ways to reduce their risk, according to the researchers.

Source: Cancer, April 1, 2004.

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Get Checked for Asthma and Breathe Easier

 

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- Free asthma screenings are being offered at more than 350 locations across the United States during May as part of National Asthma and Allergy Awareness Month.

More than 73,500 adults and children have attended the screening sessions over the past seven years to find out if breathing problems such as coughing, wheezing, and shortness of breath are being caused by asthma. The screenings are offered by the American College of Allergy, Asthma and Immunology.

More than 20 million Americans have asthma, and about 4,500 die each year due to asthma. But proper treatment lets most people with asthma live healthy, active lives. That's why early diagnosis is important.

Here are some asthma facts:

More information

 

Here's where you can find the asthma screening dates and locations.

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Outlook Improving for Kids with Sickle Cell Disease

 

Reuters Health

Tuesday, April 13, 2004

NEW YORK (Reuters Health) - Children of African descent can be prone to sickle cell disease, an inherited disorder in which red blood cells become misshapen and cause painful, sometimes fatal, complications.

While the disease cannot yet be cured, a new study finds that fewer children are dying from sickle cell disease, the average age at death is increasing, and infection-related deaths have decreased.

"Research developments during the past several decades have improved the lives of many persons with sickle cell disease," study co-author Dr. George R. Buchanan, from the University of Texas Southwestern Medical Center at Dallas, said in a statement. "Yet, the true impact of these investigations on survival of children and adolescents with sickle cell disease has not been clear until now."

The findings, which are reported in the medical journal Blood, are based on a study of 711 Dallas-area children with sickle cell disease who were followed for an average of about 7 years.

Twenty-five deaths occurred during that period. This translated to a survival rate of 85.6 percent at 18 years of age, the investigators note. In contrast, 30 years ago, only about one half of children with sickle cell disease were expected to reach this age.

The average age of death in the current study was 5.6 years, and five of the children who (20 percent) succumbed to infection. By comparison, in a 1994 the average age of death was between 1 and 3 years, and 50 percent of deaths were due to infection.

"This work gives us contemporary and accurate data confirming the success of our research," Buchanan noted. "It was only a half-century ago that very few persons with sickle cell anemia and related conditions survived beyond 21 years of age," he added.

Source: Blood, February 5, 2004.

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Quick Hip Fracture Surgery Cuts Patient Pain

 

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- People who suffer hip fractures should undergo surgery within 24 hours of admission to the hospital, new research says.

This early surgery reduces patient pain, shortens hospital stays, and may reduce the risk of major complications such as pneumonia and arrhythmias, according to a study in the April 14 issue of the Journal of the American Medical Association (news - web sites).

The study included about 1,200 people who had hip fracture surgery in New York City hospitals. Early surgery for hip fracture had no impact on survival or functional ability by six months after patients were discharged from the hospital.

But patients who had early surgery had an average of about six to seven fewer hours of severe pain during their first five days of hospitalization than patients who had later surgery. And hospital stays for early surgery patients were, on average, nearly two days less than for later surgery patients.

The study was supported by the Agency for Healthcare Research and Quality.

More information

The American Academy of Orthopaedic Surgeons offers tips on how to prevent hip fractures.

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Parents Urged to Leave Teen Drug Testing to Pros

 

By Amy Norton

Reuters Health

Tuesday, April 13, 2004  

NEW YORK (Reuters Health) - Parents who suspect their child is using drugs can easily get their hands on an array of home drug tests, but experts say the do-it-yourself route is the wrong one.

In a study of eight Internet sites selling home drug-testing kits, researchers found that companies typically glossed over the technical difficulty of performing the tests, as well as the potential harm a home drug-screening effort could do to the parent-child relationship.

Overall, the researchers say, the sites were short on detail when it came to explaining how to collect usable test samples, and several made no mention of the risk of false-positive or false-negative results.

Dr. Sharon Levy and her colleagues at Children's Hospital Boston report the findings in the journal Pediatrics.

Levy, a specialist in adolescent substance abuse, advised that parents forego home tests and instead get professional help if they think their child is using drugs.

"We're not telling parents to ignore the problem of drug use," she told Reuters Health. However, she said, drug testing is "just too complicated" for parents to try to handle themselves.

And the Web sites in this study did not fully address these challenges, according to Levy and her colleagues.

Some of the obstacles include the potential for "cross-reacting" chemicals found in food and medication to yield false-positive results. For example, certain cold medicines, and even high doses of caffeine, may cause kids to test positive for amphetamines.

On the other hand, Levy's team notes, testing could give false-negative results if parents don't choose the correct test, don't perform it in the necessary window of time after drug use, or if teens know how to "beat" the test -- by diluting their urine with water, for example.

"Get help from a professional," Levy said.

That advice is in line with an American Academy of Pediatrics (AAP) recommendation that calls for sending children suspected of abusing drugs for a professional evaluation, rather than using widespread drug screening in schools. Levy said that, based on the new findings, the AAP is revising that policy statement to discourage home drug testing as well.

Home drug-testing products have been approved for use in the U.S. since 1997. By 1998, Levy's team notes, more than 200 such products had been approved.

Among those sold by the Web sites in their study, some allowed parents to test for alcohol on the spot via breath or saliva. A number of urine tests -- some "instant," others needing to be mailed to a lab -- -were marketed for detecting drugs such as cocaine, heroin, methamphetamine and marijuana.

The tests sold for anywhere from $2.75 for a single alcohol test to $89 for a multi-drug test kit requiring hair and urine samples.

Most of the sites gave "conflicting or incomplete information" about which drugs each test could detect, Levy and her colleagues report. Some sites claimed to have a specific test for the club drug ecstasy, even though no such test existed at the time of the study, the researchers point out.

Levy said that parents who suspect drug abuse should be up-front and honest with their children, and tell them that they want them to speak with a doctor. She noted that in her practice, even if a teenager refuses to seek help, parents are still urged to come in for advice.

Source: Pediatrics, April 2004.

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Predicting Odds Against Prostate Cancer

HealthDayNews

Tuesday, April 13, 2004

TUESDAY, April 13 (HealthDayNews) -- An interactive online calculator provides prostate cancer patients with personalized 10-year survival predictions.

The calculator makes its prognosis based on a patient's age, race, clinical measures and the kind of prostate cancer treatment he's receiving. It was developed by researchers at the Josephine Ford Cancer Center in Detroit and the Artificial Neural Networks in Prostate Cancer Project in Denver.

They developed survival probability estimates by using data about 1,611 men with clinically localized prostate cancer as well as 4,538 controls matched for age, race and co-morbidity (additional diseases).

Information about the calculator appears in the April issue of the Journal of Urology.

More information

Here's where you can find the prostate survival calculator.

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Monday, April 12, 2004

 

Pfizer Says It Sues Web Site Selling Bogus Lipitor

 

Reuters

Monday, April 12, 2004

NEW YORK (Reuters) - Pfizer Inc. said on Monday it filed a lawsuit against the operator of an Internet site selling an unapproved version of its cholesterol-lowering drug Lipitor (news - web sites), the world's top-selling prescription medicine.

The suit, filed in U.S. District Court in Delaware, seeks to stop look4generics.com from selling the drug it calls Storvas, Pfizer said in a statement. Pfizer claims the drug infringes its patent and trademark rights for Lipitor -- the first drug with sales that topped $10 billion a year.

Pfizer said its suit also seeks to remove references to Lipitor in advertising on the site and to eliminate computer links that direct patients seeking Lipitor to the copycat drug that has not been approved by U.S. regulators.

The look4generics Web Site advertises that its generic Lipitor is made by Ranbaxy.

Ranbaxy Laboratories, India's largest pharmaceutical company, was not immediately available to comment on whether it has any connection to the product being sold by look4generics.com.

The Web site also lists for sale cheap generic versions of several other prescription drugs for which there are no U.S.-approved generics, including other Pfizer products such as impotence treatment Viagra and pain drug Celebrex.

Pfizer, the world's biggest drug maker, did not immediately return calls seeking comment as to whether it intended to expand the law suit to include its other products under patent protection.

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Heart Condition Doesn't Boost Risk of Second Stroke

HealthDayNews

Monday, April 12, 2004

MONDAY, April 12 (HealthDayNews) -- People with a heart condition called a patent foramen ovale (PFO) who have had a stroke with no known cause and received treatment don't have a greater risk of suffering a second stroke than people without PFO who have had a stroke.

So says a new guideline from the American Academy of Neurology (news - web sites). The finding, published in the April 13 issue of Neurology, refutes current thinking about PFO and risk of a second stroke.

A PFO is a small opening between the two upper chambers (atria) of the heart. This opening normally closes shortly after a person is born. But the opening fails to close in up to 25 percent of people.

"There was debate within the medical community about whether PFOs should be closed or managed with medication, so we hoped to resolve that guideline," guideline co-author Dr. Scott Kasner, of the University of Pennsylvania, said in a prepared statement.

The new guideline also says stroke patients younger than 55 with both a PFO and an atrial septal aneurysm (ASA) may be at increased risk of a second stroke. An ASA is a bulge in the wall between the atria.

About 5 percent of people have an ASA and as many as 70 percent of people with an ASA also have a PFO.

The guideline also found there was inadequate evidence to determine whether either warfarin or aspirin is better at reducing the risk of subsequent stroke. It did find that minor bleeding as a side effect is more common in people taking warfarin.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.

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Commercial Jets Must Have Defibrillators

 

The Associated Press

Monday, April 12, 2004

WASHINGTON - Most commercial airplanes now must have cardiac equipment on board to help passengers who suffer heart attacks. The new Federal Aviation Administration (news - web sites) rule, which affects about 2,600 airliners, went into effect Monday.

Airliners staffed with at least one flight attendant must have the device, known as an automated external defibrillator. Some already carry the equipment. In 1998, a Boston man became the first person on a domestic flight to have his life saved by a defibrillator.

Defibrillators have already become standard equipment, like fire extinguishers, in many airports, convention centers and health clubs. The equipment can monitor a victim's heartbeat and shock the heart back to a normal beat. Chances of survival are 90 percent if defibrillation is provided within one minute of the attack.

The FAA found that there were 119 cardiac-related events aboard aircraft resulting in 64 deaths between July 1, 1998 and June 30, 1999, said FAA spokeswoman Laura Brown. During that period, automatic defibrillators were provided 17 times, saving four lives, she said.

Each year, about 250,000 Americans die from cardiac arrest. About 20 percent occur in public places, and 95 percent of victims die before reaching the hospital.

On the Net:

Federal Aviation Administration: http://www.faa.gov

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Older Americans at Higher Risk of Blindness –Study

 

By Andrew Stern

Reuters

Monday, April 12, 2004

CHICAGO (Reuters) - Americans are increasingly susceptible to blindness as they grow older, with three out of 100 of those over 40 years old suffering impaired vision and blacks at particular risk, researchers said on Monday.

In the first study in decades to estimate the prevalence of vision problems among Americans, a group of researchers concluded that 937,000 Americans older than 40 were blind in 2000.

An additional 2.4 million people, or 2.8 percent of the 120 million Americans over age 40, suffered diminished vision, leaving them unable to drive a vehicle or perform other tasks.

The report found that blacks over age 40 were three times more likely to go blind than whites, with the causes of vision loss among many blacks considered more preventable.

The study, which compiled data from a decade of research, projected that 5.5 million Americans, or 3.6 percent of those over 40, would be visually impaired by 2020. Of those, 1.6 million will be blind.

Macular degeneration, a worsening condition of the retina that is difficult to treat, caused 54 percent of blindness among whites, while cataracts and glaucoma together caused more than 60 percent of vision loss among blacks.

In contrast to macular degeneration, in which vitamins and laser surgery can help lessen vision loss, cataracts and glaucoma are usually treatable, especially if caught early.

Cataracts, which are protein fibers in the lens that turn opaque, can be removed surgically. Eye drops, drugs and surgery can ease the fluid buildup symptomatic of glaucoma, which often damages blood vessels and the optic nerve.

The racial disparity in the causes of blindness relates to several factors, including that blacks generally receive less eye care than whites, the study said.

"Blindness from glaucoma is four to five times as common among blacks (than whites), probably because of genetic differences and exacerbated by differences in access to care," the study's lead author, Nathan Congdon of Johns Hopkins University, said in a telephone interview.

Blacks were less likely than whites to suffer from macular degeneration but more likely to suffer from diabetes-related retinopathy, the study found.

Glaucoma was the leading cause of blindness among Hispanics, based on limited data.

The findings, which were published in the Archives of Ophthalmology, a journal published by the American Medical Association, point to the importance of detecting and treating vision problems early, said Paul Sieving, director of the U.S. National Eye Institute.

"Developing blindness prevention strategies could help address the potentially devastating impact of the increased prevalence of eye diseases in the next few decades," he said.

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Advanced Scanning Being Used for Autism

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, April 12, 2004

WASHINGTON - Only Michael Berman's small thumbs move inside the giant MRI machine, pushing buttons in a video game-like test as the scanner measures how the youngster's brain processes light and motion. At 6, he's one of the youngest children to undergo such advanced scanning as part of a new effort to discover what goes wrong inside brains affected by autism.

It's work that might lead to much earlier diagnosis of the mysterious neurological disorder. It usually goes undetected until age 3 or later, when much of the damage to the developing brain is thought already to have been done.

"The feeling is if you intervene early, it'll be more effective," explains Dr. Thomas Zeffiro of Georgetown University Medical Center, who is researching technology that he hopes will go a step further and one day scan preschoolers' or even infants' brains.

"It's very controversial if there is a critical period" for thwarting autism, he cautions. "If there is, there could be a dramatic change in the way we approach kids with developmental disorders."

Autism is a complex brain disorder, most common in boys, best known for interfering with a child's ability to communicate and interact with others. Symptoms range from the mild, like Michael, to so severe that children can't speak and appear profoundly retarded.

No one knows the cause and there is no cure, although intense behavioral training can improve some patients' symptoms significantly.

As part of the new research, scientists at Georgetown and Children's National Medical Center are matching youngsters' behavior and cognitive skills with advanced imaging, called functional MRI, that tracks changes in blood flow to show how their brains fire when they do tasks.

Most previous studies have focused on autism's hallmark emotional and communication problems. Lead researcher Dr. William Gaillard of Children's National says these children's brains are being scanned to track the disorder's myriad other symptoms: sensory problems, motor control, problems with planning and reasoning.

So far, only "high-functioning" autism patients can undergo such detailed testing because of the cooperation required. Michael, for instance, has Asperger syndrome — excellent language skills and the ability to read at 2, but he has social-interaction and other problems.

The scientists are attempting to perform functional MRI on children younger than ever before, to the delight of Michael, who intently quizzes them on the different sounds the noisy scanner makes as it focuses on different brain regions.

"Ooh, that one sounds kind of like an electric saw," Michael says. "Do this other one, it's the fastest, right?"

After just a day's testing, "he knows all the pulse-sequence names," marvels Zeffiro.

The taxpayer-funded MRI work is part of a bigger collaboration:

·        Scientists at Baltimore's Kennedy Krieger Institute are hunting ways to detect autism as early as age 6 months through behavioral clues, such as how babies look at their parents' faces and follow their gaze, how they manipulate toys, how they respond to language.

·        Other Kennedy Krieger scientists are studying animals to see if autism is related to abnormal levels of the brain chemical serotonin, found in some patients.

·        And Zeffiro is comparing the MRI images to easier-to-use technology that beams harmless infrared light through fiber-optic cables strapped on the head. Financed by an autism family group, the Nancy Lurie Marks Foundation, the idea holds out hope that "optical tomography" could provide a way to examine the brains of autistic toddlers or older but nonverbal patients who don't qualify for MRI.

It's all part of an increased national focus on autism spurred by families angered that the disorder has long been sparsely funded despite studies suggesting a 10-fold rise in cases in a decade. Most of the rise is thought to be better diagnosis, but autism's cause is unknown.

As a result, the National Institutes of Health (news - web sites) last year began a five-year, $65 million project, designating eight centers around the country to focus on cutting-edge autism research.

"We're trying to sift through what is the first sign of autism and how does it unfold," explains Dr. Rebecca Landa, who heads the NIH-designated Kennedy Krieger autism center and its Children's-Georgetown collaboration. But, "whatever we discover through autism is going to benefit children with a variety of developmental disabilities."

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

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Kidneys from Older Donors Work as Well - U.S. Study

 

Reuters

Monday, April 12, 2004

CHICAGO (Reuters) - Transplanted kidneys from older donors often work just as well as organs from younger donors, a study said on Monday.

In the study of 324 kidney transplant patients, 13 percent of organs from donors aged 55 or older failed, compared to a 15 percent failure rate for kidneys obtained from younger ones.

Kidneys from younger donors generally functioned better than older kidneys, but all the successfully transplanted kidneys functioned acceptably, the study said. Transplant patients' survival rates after one, two and three years were also comparable.

"After proper evaluation, kidneys from older deceased or living donors are appropriate for selected candidates, including older patients awaiting transplantation and those with limited life expectancy based on their severity of illness," Dr. Paul Morrissey of Brown Medical School, Providence, Rhode Island, wrote in the journal Archives of Surgery.

More important than the age of the donor, especially for an older patient waiting for a new kidney, is to obtain a healthy organ, whether the donor is living or deceased, the report said.

The number of Americans waiting for a transplantable kidney has steadily risen to more than 57,000, while the number of potential organ donors dying from trauma in younger age groups is declining. .

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Va. Schools' Dilemma: Profit or Diet?

 

By Bill Baskervill

Associated Press Writer

The Associated Press

Monday, April 12, 2004

RICHMOND, Va. - Public schools in Virginia are raking in millions of dollars from selling soft drinks to students, even as pediatricians urge banning soft drinks from schools and a major study shows American teens are fatter than those in 14 other industrialized countries.

Schools use lucrative and exclusive contracts with soft drink companies to pay for college scholarships, school supplies, field trips, computer software, reference books, yearbooks, scoreboards, football uniforms and security for athletic events.

"These vending machines are cash cows," said Charles Maranzano, assistant superintendent of schools in Dinwiddie County.

But Maranzano sees hypocrisy in peddling soft drinks in schools.

"We on one hand want to promote good physical health ... and yet we infuse them with megadoses of sugar," he said. "We probably shouldn't be doing that."

Said Lexington Superintendent Daniel E. Lyons: "We can't be teaching about health while being a part to contributing" to obesity.

The bottom line is money, Maranzano said. "We've had to become real scrappers in public education" to provide programs for students. "We've become dependent on this revenue."

The Associated Press made Freedom of Information Act requests for vending contracts from the state's 132 school systems; 111 responded, either by phone, fax, electronic or regular mail. Some said they had no central contract because individual schools negotiated their own deals. None of the contracts contained total revenues from soft drink sales, but further phone calls, letters or e-mail produced those figures for the state's largest school systems.

Virginia Beach, the state's second largest system, made $786,000 in commissions from vending sales in the 2002-03 school year.

But that only accounts for part of the vending income Virginia Beach is getting from Pepsi.

The five-year exclusive contract signed in 2001 included an upfront payment of $750,000 in the first year as well as hundreds of thousands of dollars more from commissions, sponsorship funds and scholarship money. The contract called for payments of nearly $1.8 million for the first year and $7 million for the life of the pact.

"Without the several million they provide we would have to provide a revenue stream from somewhere else, which is unlikely, or do without," said Virginia Beach Superintendent Timothy R. Jenney. The money is used for a number of programs, including after-school tutoring, clubs and field trips.

The Virginia Beach machines sell sodas, water, fruit juice and sports drinks. They do not operate during school hours, but still are big moneymakers.

"We provide what we think is a choice for students who may want to participate," Jenney said. "We've been very responsible."

Pepsi Bottling Group's sales pitch said its goal "is to develop and implement programs to enhance student life at Virginia Beach Public Schools while providing a high profit potential."

"Everything leads to our mantra: STUDENTS FIRST."

Pepsi Bottling notes the importance of creating brand loyalty among impressionable teens. "Establishing consumer loyalty among students is our top priority because it provides long-term growth and stability," the company notes in its contract proposal.

Pepsi Bottling declined to say how much money it makes off the deal with Virginia Beach.

"It's like any of our customers. It's not something we would provide," said Michael Goodwin, a spokesman for Pepsi Bottling. He added, however, that "schools are not the most profitable side of our business."

Hampton schools, which made $125,500 from vending sales in 2002-03, had to choose between selling sodas to students or watching them buy soft drinks at nearby convenience stores.

"If they don't get it in a school, they will get it at a 7-11 around the corner," said Joe B. Lewis Jr., interim director of finance for the school system. By selling sodas to students, the money goes back to schools to buy instructional supplies, Lewis said.

Fairfax County, the state's largest school division, said its vending profits for the 2002-03 school year were $912,032. Chesterfield County, the fourth largest system, had profits of $547,257 for 2002-03. Prince William County, No. 3 in enrollment, reported profits of $173,617. No. 5 Henrico County had profits of $101,940.

The soda company contracts with school divisions or individual schools place a high premium on exclusivity.

For instance, Buckingham High School in Buckingham County agreed in its contract with Coca-Cola to "promptly oppose" any competitor that tries to sell products in the school. In return, Coca-Cola Bottling Co. agreed to provide commissions, sponsorship fees and a scoreboard for the softball field.

Pediatricians have sharply criticized soft drink sales in schools.

The American Academy of Pediatrics recommended in January that soft drinks be eliminated from schools to help tackle the obesity epidemic.

A study published in the January issue of Archives of Pediatrics & Adolescent Medicine found that U.S. teens are more likely than those in other countries to eat sodas, snacks and fast food. Among American 15-year-olds, 15 percent of girls and nearly 14 percent of boys were fat, and 31 percent of girls and 28 percent of boys were more modestly overweight.

The findings were based on a survey of 30,000 youngsters in 15 countries in 1997 and 1998.

Last month, researchers reported finding more evidence of a link between a rapid rise in obesity and high-fructose corn sweeteners used in soft drinks and food since the 1970s.

The National Soft Drink Association, which represents most soft drink makers, said banning soft drinks from schools is a simplistic response to the serious problem of childhood obesity.

"We're all looking for an easy solution," said NSDA spokeswoman Kathleen Dezio. "Obesity is a complex issue, and there are no easy solutions." She said studies show that kids consume an average of a little more than one soft drink a week and that they are exercising less.

"If they're not consuming that many soft drinks in school, you're really not going to do anything to address the problem if you ban soft drinks from school," she said.

The state bars the sale of soft drinks and other "foods of minimal nutritional value" anywhere in a public school from 6 a.m. until the end of the breakfast period and from the beginning to end of the lunch period.

Some school divisions have banned soda sales to students. In February, the Roanoke School Board voted to allow only fruit drinks, water and milk in vending machines. Officials said concerned parents asked for the ban, citing a growing number of overweight children.

William Fleming High School led the way, banning soda sales last fall but still allowing high-sugar fruit drinks. Principal Hallie Carr said only two students complained, but not for predictable reasons.

Seniors Alisha Childress, 17, and Kathryn Hatam, 18, wanted all high-sugar beverages banned.

"If you're going to fix the problem, fix it," said Childress. "Don't go halfway."

Carr said her goal is to eventually replace the fruit drinks with 100 percent fruit juice.

Kids can still bring soft drinks into the school. "We're not the Coke police," the principal said. But "we didn't have to enable it by providing it."

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Heart Attack Hospital Stays Decline, Study Finds

 

Reuters

Monday, April 12, 2004

CHICAGO (Reuters) - Patients recovering from severe heart attacks in the United States are kept in hospitals less than a week, compared to stays of more than six weeks in the 1950s

But the change has not been accompanied by higher death rates after discharge, researchers at the University of Massachusetts Medical School in Worcester said.

"Much of the observed decline in hospital length of stay may be attributed to improvements in the management of acute myocardial infarction, including increased use of coronary reperfusion modalities (techniques to restore blood and oxygen flow to the heart muscle)," said the report published in the Archives of Internal Medicine (news - web sites).

Today's hospital stay for an acute heart attack without ensuing complications averages five days, the study said.

The findings were based on a look at 4,551 patients discharged from a number of Massachusetts hospitals between 1986 and 1999. Early in the study patients were averaging 11.7 days, a figure which had declined to 5.9 in later years, the study said.

Patients who stayed longer were more likely to be older, female and have cardiac complications, the authors said.

In the 1950s, the article said, prolonged bed rest and rehabilitation were prescribed with stays of more than six weeks common.

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Health Pros Warn Against Chewing Tobacco

 

The Associated Press

Monday, April 12, 2004

COLUMBUS, Ohio - Health care professionals hope new education programs will prevent teenagers from getting hooked on smokeless tobacco.

Dentists say they're seeing more Ohio kids — rural and suburban — using the chewing tobacco and snuff generally associated with farmhands and baseball players.

Some doctors predict a dramatic rise in oral cancers in the next several decades unless more is done to teach young people about the risks of smokeless tobacco.

"It's not (an exaggeration) to say that it represents a little bit of a sleeping-giant health risk at this point in time," said Dr. David Schuller, director of the Arthur G. James Cancer Hospital and a specialist in head and neck cancers.

In many cases, users start in middle school and think smokeless tobacco poses little risk.

A 2002 Ohio Department of Health study found that almost 12 percent of Ohio high school boys had dipped in the past month. About 1 percent of the girls had. In middle schools, about 5 percent of the boys and almost 2 percent of the girls had.

And although 77 percent of teenagers recognize the danger of cigarettes, only 40 percent know chewing tobacco can hurt them, according to a survey by the U.S. surgeon general.

To combat the problem, dentists and schools throughout the state are utilizing a new program called Operation TACTIC, for Teens Against Chewing Tobacco in the Community.

It includes print materials and a video in which Tammy Smith and her son Tyler tell the sobering story of their husband and father, Kevin Smith, of Gallipolis.

Smith died at 31 after having his tongue removed and enduring a failed attempt to replace it with muscle from his chest and tissue from his legs.

Adult use of smokeless tobacco is twice as high in Appalachia as the rest of the state.

The Ohio State University College of Dentistry is working in Hocking, Morgan, Vinton and Washington counties in southeast Ohio to compare two approaches to quitting. One is a video; the other, one-on-one intervention. The study is paid for with tobacco-settlement money.

"One of the things that's remarkable about oral cancer is that it still remains difficult to treat," said Dr. Henry W. Fields, the study's lead investigator. "Survival rates haven't changed much in the past several decades."

Oral cancer grows in the lips, cheeks, tongue, throat, gums, larynx and esophagus. Those who survive it can be disfigured after surgeons remove cancerous bone and tissue.

The first signs are white patches in the mouth, often discovered in the dentist's office.

Slightly more than half of patients with oral cancers live five years, according to statistics from the American Cancer Society (news - web sites). Doctors diagnose oral cancer in more than 18,000 people in the United States each year.

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Ginger Eases Morning Sickness: Study

 

By Merritt McKinney

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - A little bit of ginger may relieve the nausea and vomiting that plague many pregnant women, researchers report, although it does not cure the problem.

"Based on the findings from this study and other recent studies of ginger, there is evidence that ginger is helpful," Dr. Caroline Smith of the University of South Australia in Adelaide told Reuters Health.

"This increases the choices available to women on the management of their nausea and vomiting," Smith said.

Up to 80 percent of pregnant women experience morning sickness during the first trimester of pregnancy. Ginger has long been used to ease nausea, and there is some evidence that the botanical may relieve motion sickness and other types of queasiness.

But the research on ginger's ability to ease morning sickness is limited. To investigate, Smith's team enrolled almost 300 women who were less than 16 weeks pregnant and suffered from nausea or vomiting.

Vitamin B6 has been shown to improve nausea and vomiting in some pregnant women, so the researchers compared the effects of ginger with the vitamin. The participants were randomly assigned to take a capsule containing 350-milligram (mg) of ginger or one containing 25 mg of vitamin B6 three times a day for three weeks.

Ginger was equally effective as vitamin B6 at relieving nausea, vomiting and dry retching, Smith and her colleagues report in the April issue of the journal Obstetrics and Gynecology. Symptoms of morning sickness improved in a little more than half of the women in each group.

Neither ginger nor vitamin B6 caused any major side effects. However, women who took ginger were much more likely to experience belching after taking the capsules.

There have been some concerns that taking ginger during pregnancy may be harmful to babies, but there were no differences between the ginger and vitamin B6 groups in birth defects or pregnancy complications. But because of the small size of the study, Smith and her colleagues conclude that there is "insufficient data" on the safety of ginger during the first trimester.

"Firm evidence on the safety of ginger in pregnancy is essential and further systematic research on the risks and benefits of ginger during pregnancy would be of great clinical relevance," the authors conclude.

Source: Obstetrics and Gynecology, April 2004.

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West Virginia Battling Obesity Rates

 

By Michelle Saxton

Associated Press Writer

The Associated Press

Monday, April 12, 2004

HAMLIN, W.Va. - The obesity rate in West Virginia was 5 percentage points higher than the national average, according to a four-year state study ending in 2001.

Some 24 percent of West Virginians were classified as being obese in the study, compared to 19 percent in the rest of the country. The state's rate was 17 percent between 1990 and 1994.

Residents and experts give various reasons for why obesity has increased, including the rise of fast food, supersized meal portions and a drop in physical activity due to technology improvements, television and video games.

"Our biology is geared up to eat when food's available and rest," said Dr. James Hill, director of the Center for Human Nutrition at the University of Colorado in Denver. "We've created an environment where there's always food available and you never have to be physically active."

The average weight in pounds for adults rose from 177 for men and 142 for women in 1984 to 194 pounds for men and 155 pounds for women in 2000, according to the state study.

Joel Halverson is trying to unravel the mystery of why residents in some areas of West Virginia are more overweight than others.

"Why do some places have high prevalence and other places don't, what we're finding is that relationships vary," said Halverson, director for the Office of Social Environment and Health Research at the West Virginia University Health Sciences Center.

"There's not a universal explanation for why we see geographic variability in prevalence. At least at this point we don't see that."

Every Monday night Peggy Lucas joins about a dozen other women to face the scales and share their stories against an old adversary — their weight.

The 57-year-old retired social worker from West Hamlin has been battling her weight since she was a teenager concerned about her large-boned frame.

"I would starve myself to death and 164 pounds was the least I could ever get down to," Lucas said while attending a recent a Weight Watchers meeting at a Hamlin church. "I'd go days and drink nothing but water. And then I'd eat one meal on Sunday, I'd gain five or six pounds and I'd starve it off again."

Lucas, who loves to cook, believes that over the years she has lost and regained nearly as much as her current weight of about 330 pounds. She's been attending Weight Watchers meetings on and off since 1969. For a time, she took the drug Redux before it was pulled from the market after reports that some patients had heart-valve damage and dangerously high pressure in lung blood vessels.

"We have a mental problem, people that are morbidly obese, we do," said Lucas, who suffers from diabetes, high blood pressure and bad nerves. "It's just like we're feeding a demon."

For the 5-foot-7 Lucas, a weight of 160 pounds or more is overweight, with 190 marking the start of obesity. She is, however, far from alone.

In rural Lincoln County, some say a lack of exercise facilities such as a YMCA is a factor.

Karen Morton, a 47-year-old paralegal who also attends Weight Watchers meetings in Hamlin, said she started gaining weight after high school, "when I started sitting at a desk and not getting any exercise."

The former cheerleader and majorette found that getting exercise became more difficult after she left her job in Charleston to work in Boone and Lincoln counties, where "there's no place to go work out."

"When I get home from work it's either too dark to go walking or it's too cold," she said.

That's one issue the Lincoln County Primary Care Center is trying to address with its new WELL Center.

So far, 120 people have paid the $10 monthly fee to use the center's treadmills, stationary bicycles and weights. The center also offers aerobics, dance and stretching classes and a diabetic cooking school and support group.

Officials hope to eventually develop a teenage obesity program and weight loss support group.

"The response so far has been incredible. We get calls daily," said Brian Crist, the care center's chief executive officer. "People are excited about having somewhere to go to exercise."

But diet can also be a factor, especially in a state where some families traditionally serve "gravies and the biscuits and the high fat, the bacon and all these things that are filling versus a salad," Crist said.

Eating healthier, smaller portions is harder than it sounds.

"Overeating is like an addiction, like being on drugs or smoking or anything else, and most of the time you need help to deal with it," Morton said.

Lucas, who would "love to see 200 (pounds) again," has had trouble with her goal, and was considering gastric bypass surgery.

Still, she said the group meetings help.

"They have the same problems," Lucas said. "It's just good to get out and talk to people and see what they've done and see what things have helped them through the week."

"I know I'll have good weeks and bad weeks, but I'm still going to go."

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Cannabis Use Linked to Early-Onset Schizophrenia

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - Among men suffering from schizophrenia, those who had used cannabis were much more likely to experience their first psychotic episode at an early age at, Dutch investigators report.

Dr. Natalie D. Veen, from University Medical Center Utrecht, the Netherlands, and colleagues looked at gender and cannabis use in 133 patients diagnosed with schizophrenia. Seventy patients were cannabis users and 97 patients were male.

Male patients were significantly younger than female patients when they first became impaired socially or occupationally, when they first exhibited psychosis, and when they first experienced negative symptoms of schizophrenia, the team reports in the American Journal of Psychiatry.

Cannabis users were also significantly younger when they experienced these three measures of dysfunction, compared with non-users.

The two factors together meant that male cannabis users had their first psychotic episode a mean of 6.9 years earlier than those who did not use the drug.

"Since early onset is associated with a poorer prognosis of the disorder, the relationship between cannabis use and the risk of developing an early-onset type of schizophrenia is an important focus for future research," Veen and colleagues conclude.

Source: American Journal of Psychiatry, March 2004.

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Fat-Free Fallacies

 

HealthDayNews

Monday, April 12, 2004

(HealthDayNews) -- Just because a food label touts a product as being fat-free, sugar-free or low in carbohydrates, it doesn't mean you can eat all you want. Your overall calorie intake is still important.

Here are some other tidbits about diet food, courtesy of Moses Taylor Hospital in Pennsylvania:

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Low -Calorie Diets Help Women with Ovary Condition

 

By David Douglas

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - Obese women with polycystic ovary syndrome (PCOS) have menstrual irregularities that cause fertility problems and metabolic abnormalities that make them prone to diabetes. All these factors can be improved by losing weight on a low-calorie diet, according to researchers from Pennsylvania State College of Medicine, Hershey.

And it doesn't much matter whether the diet is high-protein or high-carb.

"The type of diet isn't nearly as important as losing weight," senior investigator Dr. Richard S. Legro told Reuters Health. "There is not one diet that fits all women with PCOS, and any diet that leads to weight loss will improve multiple aspects of the syndrome."

Although weight loss is beneficial in the management of PCOS, the ideal diet composition has been unclear, Legro and colleagues note in the medical journal Fertility and Sterility.

In a pilot study of two dietary approaches, the researchers randomly assigned 35 obese women to a 4-week high-protein (30 percent protein) or high-carbohydrate (55 percent carbohydrate) diet for 1 month. Fat content was 30 percent in both diets.

Each participant's energy needs and food choices were adjusted to about 1000 calories per day less than she needed to maintain her starting weight.

Twenty-six women completed the study. Participants in both groups showed significant weight loss. This amounted to an average of 3.7 kilograms in the high-protein group and 4.4 kg in the high-carbohydrate group.

Also, reproductive and metabolic abnormalities improved significantly in both groups. The women's levels of male hormones declined, and glucose and insulin levels improved. Fourteen women also menstruated while on the diet.

Although there was a trend toward a greater weight loss with the high-carbohydrate approach, the researchers conclude that definitive studies of the ideal low-calorie diet for such women will need to involve a large population and "will most likely require a multicenter trial."

Source: Fertility and Sterility, March 2004.

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Drinking Enough Water

 

HealthDayNews

Monday, April 12, 2004

(HealthDayNews) -- If you have a young athlete at home, it's important to educate him about the importance of drinking enough water, advises the Children's Hospital of Philadelphia.

Here's what your child should know:

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Spirituality Helps Older Adults Cope with Illness

 

By Alison McCook

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - Perhaps faith is outside the realm of science, but new research indicates older adults who are religious or spiritual tend to fare better when they're hospitalized with an illness.

U.S. researchers found that hospitalized adults aged 50 or older who belonged to an organized religion tended to have better health and were better able to perform day-to-day activities like getting around and doing household chores.

Daily functioning was also better in older adults who said they were spiritual, but did not participate in an organized group.

In addition, people who were religious or spiritual tended to have better social support, showed fewer symptoms of depression, and had better mental functioning.

"I think religion is a powerful factor in helping people to cope with stress, and in particular with health-related stress," study author Dr. Harold G. Koenig said.

Specifically, faith may help people make sense of why they are sick, giving a sense of meaning to their suffering, Koenig said. The extra support from other members of their spiritual community also likely helps, and having faith may often deter them from taking on unhealthy behaviors that people turn to when stressed, such as drinking and smoking, the Duke University Medical Center researcher added.

Religion is a significant part of many Americans' lives, he added. For instance, according to the report in the Journal of the American Geriatrics Society, 60 percent of people 50 to 64 years old say that religion is "very important" to them, and that figure rises with increasing age.

As part of the study, Koenig and his colleagues interviewed 838 hospitalized adults who were 50 or older about their religious beliefs and practices. Most of the patients had some form of cardiovascular disease.

The researchers also found that older adults who said they were neither religious nor spiritual tended to have worse overall health and more additional illnesses.

In an interview with Reuters Health, Koenig said that doctors often ignore a patient's religious beliefs except when they interfere with treatment, such as when a person refuses a blood transfusion or other medical procedure because of their faith.

Based on these findings, Koenig recommended that health staff ask patients about their beliefs, and acknowledge and support them as part of their care.

That said, Koenig stressed that doctors should not encourage religion in patients who are neither religious nor spiritual, as that is a private decision and one that should not be made solely for health reasons.

"Doctors should not prescribe religion to non-religious patients," he said.

Source: Journal of the American Geriatrics Society, April 2004.

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Help Yourself to Heart Health

 

HealthDayNews

Monday, April 12, 2004

MONDAY, April 12 (HealthDayNews) -- Taking the time to "learn and live" could help give you more time to live and learn.

A new American Heart Association (news - web sites) (AHA) quiz offers free, customized health information for people who have questions and concerns about their health specific to cardiovascular disease and stroke. The Learn and Live Quiz teaches people about their risk for cardiovascular disease and could help them live longer, healthier lives.

The quiz, which takes a few minutes to complete, includes 15 questions about general health, diet, exercise, smoking, and weight. Personalized results enable people to identify potential cardiovascular health issues. The quiz also offers appropriate educational information.

"Heart disease and stroke affect millions of lives. The Learn and Live Quiz will give people the lifesaving information they need to know, quickly and easily. Taking the quiz is the first step toward better health," AHA president Dr. Augustus O. Grant said in a prepared statement.

More information

You can find the Learn and Live Quiz by logging onto the American Heart Association, or you can phone 1-888-AHA-CARES. The quiz is available in English and Spanish. The American College of Cardiology has information about how to prevent heart disease.

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Outlook Improved Since 80s for Arthritis Sufferers

 

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - The rates of hospitalization to treat severe complications of rheumatoid arthritis (RA) declined between 1983 and 2001, according to an investigator at the US National Institute of Arthritis and Musculoskeletal and Skin Diseases.

"These findings suggest that since the early 1980s, the long-term health outcomes of patients with RA have improved," Dr. Michael M. Ward reports in the medical journal Arthritis and Rheumatism.

The Bethesda, Maryland-based researcher identified people with RA age 40 or older using the data files of the California Office of Statewide Health Planning and Development. He used data to spot indications of severe disease and failure of treatment to adequately control the condition.

For the period from 1983 to 1987, there were 148.7 hospitalizations for rheumatoid vascular inflammation per 100,000 patients with RA. This declined to 97.8 for the period between 1998 and 2001.

Corresponding rates for spleen removal to treat an arthritis-related condition called Felty's syndrome were 6.1 and 1.8 per 100,000.

There were increasing rates of total knee replacement between 1983 and 1997, but this reversed between 1997 and 2001. Ward describes this as "particularly noteworthy," since the rates of knee replacement more than doubled between 1998 and 2000 among Medicare recipients overall.

The investigator says the data suggest that "the decreased rates of hospitalization for manifestations of severe RA were not due to changes in the use of hospital care from 1983 to 2001, but rather were specific to manifestations of RA."

The findings are in line with greater use of disease-modifying medications in the late 1980s and early 1990s, he adds.

However, the decrease predated the widespread use of the latest anti-rheumatic medications. As these drugs are used more often and "more consistently throughout the course of the disease, further improvements in the health outcomes of patients with RA might be anticipated," Ward concludes.

Source: Arthritis and Rheumatism, April 2004.

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AIDS Treatment Was Delayed for Minorities, Poor

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Monday, April 12, 2004

MONDAY, April 12 (HealthDayNews) -- Most doctors considered gender, race and income when they decided whether to prescribe powerful drugs to AIDS (news - web sites) patients in the late 1990s, new research suggests.

The doctors seemed to think that some groups were automatically less likely to take the drugs as directed, said study co-author Dr. Mitchell D. Wong.

"Latinos got treated later than whites, women got treated later than men, and people who were poor got treated later than those who were wealthy," said Wong, an assistant professor of medicine at the University of California, Los Angeles.

And, he added, treatment for blacks often was postponed regardless of whether the doctors were scrupulous about providing treatment to patients they didn't think would follow directions.

While Wong said the study doesn't confirm the existence of racism in doctors' offices, he thinks it does seem to show physicians are making assumptions based on race and other factors. "If our hypothesis is true, physicians are perceiving these patients as being less adherent" to a drug regimen, he said.

The findings appear in the April issue of the Journal of General Internal Medicine.

Although doctors first diagnosed AIDS cases in the United States in the early 1980s, effective treatments didn't appear until the mid-1990s. Drug companies began releasing a variety of drugs known as protease inhibitors, which allow many patients to lower levels of the AIDS virus in their blood.

Initially, doctors feared patients might become more sick if they couldn't follow strict, complicated drug regimens that pinpointed the exact times they needed to take the drugs, Wong said.

Although advances since then have made the drugs easier to take, doctors still worry about patients who don't take them as directed, he added. The risk is that the virus will use the brief respites from treatment to develop resistance and become immune to the drugs.

In the new study, Wong and his colleagues examined surveys of 1,717 AIDS patients and 367 doctors from 1996 to 1998.

Almost 90 percent of the doctors said adherence -- sticking to directions -- was an important factor in their prescription practices. Those doctors were more likely to delay treatment for women, Latinos and the poor.

Almost all the doctors, including those who didn't worry about adherence, were more likely to delay treatment for blacks than for whites, the researchers found.

However, the research didn't show that any of the delays in treatment trimmed the life spans of patients.

Postponing treatment is not always a bad thing, said Dr. David Bangsberg, an associate professor of medicine at the University of California, San Francisco. It can make sense if patients need to be treated for depression or drug abuse, he added.

"The problem comes when therapy is delayed to the point where someone is severely ill or dies," he said. "There comes a point where you have to treat everybody."

Both Wong and Bangsberg said the next step is to help doctors make better decisions about starting and postponing treatment.

More information

To learn more about HIV (news - web sites)/AIDS and treatments, visit the U.S. Centers for Disease Control and Prevention or the National Institute of Allergy and Infectious Diseases.

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Study Suggests More Frequent Breast Exams Needed

 

By Paul Simao

Reuters

Monday, April 12, 2004

ATLANTA (Reuters) - Women who carry a genetic mutation linked to a higher risk of breast cancer often are at advanced stages of the disease months before they go to the doctor for an annual screening, according to a new U.S. study.

The finding by researchers at Columbia-Presbyterian Medical Center in New York suggests more frequent mammograms and ultrasound screening may be needed for the small percentage of women who carry the BRCA1 and BRCA2 genes.

These genetic markers, which are more common among Ashkenazi Jews, account for between 5 percent and 10 percent of the estimated 180,000 breast cancer cases diagnosed in the United States each year.

Carriers have a 60 percent to 85 percent lifetime risk of contracting the disease, which kills about 44,000 women in the United States each year.

In their study of 13 women aged 32 to 59 with these genes, researchers at Columbia-Presbyterian found six had developed breast cancers detected in between their annual mammograms.

The average time that had elapsed since their last annual screening was about five months, and four of the six had already developed relatively advanced cancers that had spread to their lymph nodes.

"We feel that (every) 12 months definitely is not adequate screening for women with these genetic mutations," said Dr. Ian Komenaka, a breast surgeon and lead author of the study, published on Monday in the online edition of the American Cancer Society (news - web sites) journal Cancer.

"It looks like it needs to be every six months if not every four months," Komenaka said.

Mammography, a special type of X-ray imaging used to create detailed images of a breast, is the primary method of screening for breast cancer in the United States. In 1997, the National Cancer Institute (news - web sites) recommended women 40 years and older have this exam every one to two years.

While many researchers credit regularly scheduled mammograms for helping reduce breast cancer mortality in women over the age of 50, the role and frequency of the practice remains a controversial subject.

A study by Swedish researchers four years ago suggested the average woman did not gain any survival benefit from having regular mammograms.

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Brain Regions Work in Tandem in Math Wizards

 

HealthDayNews

Monday, April 12, 2004

MONDAY, April 12 (HealthDayNews) -- A new study seems to sum up why math whizzes are better with numbers than other people.

The joint U.S.-Australian study found that mathematically gifted teenagers performed better than their average-ability peers and college students on tests that required cooperation between the left and right sides of the brain.

The study included 60 right-handed males. Eighteen (average age just under 14) were mathematically gifted, 18 (average age just over 13) had average math ability, and 24 were college students (average age 20).

Only males were selected for the study. Boys are six to 13 times more likely than girls to be mathematically gifted, according to the researchers.

The study participants viewed letter patterns flashed on the left or right sides of a computer screen. The boys had to indicate whether the patterns matched or not. These tests indicate which side of a person's brain processes different kinds of visual information and how well both sides of the brain work together.

Mathematically gifted boys showed more interaction and cooperation between the two sides of the brain than the average teens and college students, who did better on tasks that required a single side of the brain to process information.

The results support the theory that the brains of mathematically gifted people are better at relaying and integrating information between the cerebral hemispheres.

"It's not that you have a special math module somewhere in your brain, but rather that the brain's particular functional organization -- which allows right-hemisphere contributions to be better integrated into the overall cognitive/behavioral equation -- predisposes it towards the use of high-level imagery and spatial skills, which in turn just happen to be very useful when it comes to doing math reasoning," study co-author Michael O'Boyle of the University of Melbourne said in a prepared statement.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about the brain.

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Docs, Nurses Misjudge Late Nausea After Chemo

 

Reuters Health

Monday, April 12, 2004

NEW YORK (Reuters Health) - Health care providers greatly underestimate the number of people who suffer delayed nausea and vomiting after they have been given cancer chemotherapy.

The finding comes from a survey of 24 doctors and nurses and 298 patients at 14 cancer treatment centers in six countries. All of the patients had been given chemotherapy for the first time. The treatment was considered highly nauseating in 67 cases and moderately nauseating for the other 231 patients.

Despite being given anti-emetic drugs to counteract the side effects of treatment, more than 35 percent of the patients experienced immediate nausea and 13 percent experienced vomited, Dr. Steven M. Grunberg, from Fletcher Allen Health Care in Burlington, Vermont, and colleagues report in the April 12 online issue of Cancer.

Delayed nausea and vomiting were experienced by 60 percent and 50 percent, respectively, of those in the highly nauseating chemotherapy group. The corresponding proportions affected in the moderately nauseating chemo group were 52 percent and 28 percent.

Physicians and nurses were accurate in predicting immediate nausea and vomiting, but typically underestimated the numbers affected by later symptoms by 21 to 28 percentage points, the authors point out.

Increased use of newer anti-emetic agents could further reduce rates of nausea and vomiting after chemotherapy, the authors note. "However, an increased appreciation of the incidence and duration of delayed nausea and emesis, both through physician/nurse education and through structured reporting by patients of their experienced during chemotherapy, will be necessary to achieve optimal control of this problem."

The study was sponsored by Merck & Co. of Whitehouse Station, New Jersey, which employs about half of the study authors.

Source: Cancer, April 12th online issue, 2004.

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Chemo Side Effects Underestimated

HealthDayNews

Monday, April 12, 2004

MONDAY, April 12 (HealthDayNews) -- Many doctors underestimate and under-treat nausea and vomiting that occurs 24 hours or more after cancer patients undergo chemotherapy, according to a new study.

Dr. Steven Grunberg, of the University of Vermont, led a team of international investigators who surveyed staff and patients at 14 oncology practices around the world to determine whether those practices recognized the significance of chemotherapy-induced nausea and vomiting (CINV).

Acute CINV occurs in the first 24 hours after treatment, often in a medical setting. Delayed CINV can appear days after chemotherapy, when the patient is at home and can't be observed by a doctor or nurse.

In this study, doctors and nurses at the oncology practices accurately predicted the incidence of acute CINV. But more than 75 percent of the doctors and nurses underestimated the incidence of delayed CINV.

The study, published April 12 in the online edition of Cancer, also found that among patients taking highly emetic chemotherapy, the staff at the oncology clinics underestimated delayed nausea by 21 percent and delayed vomiting by 28 percent. Among patients taking moderately emetic chemotherapy, delayed nausea was underestimated by 28 percent.

Emetic refers to something that causes a person to vomit.

"An increased appreciation of the incidence and duration of delayed nausea and vomiting, both through physician/nurse education and through structured reporting by patients of their experience during chemotherapy, will be necessary to achieve optimal control of this problem using currently available tools and techniques," the study authors said in a prepared statement.

More information

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

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Sunday, April 11, 2004

 

Home-Cooking Movement Gains Ground

 

By Eliot McLaughlin

Associated Press Writer

The Associated Press

Sunday, April 11, 2004

ATLANTA - Slow Food is an international movement that urges people to find time for meals made from scratch. It also extols the benefits of regional traditions and recipes using all-natural foods grown by local farmers. And it's catching on.

"It's about slowing down, respecting people's natural rhythms and reacquainting people with the ritual of the table," said Patrick Martins, director of Slow Food USA, based in New York.

The U.S. group has 12,000 dues-paying members. You might call them the Anti-Fast Food, but they don't boycott McDonald's.

The movement started in 1986 when Italian author Carlo Petrini, incensed by a McDonald's opening near the Spanish Steps in Rome, accused corporate chains of destroying many foods and traditions.

Slow Food has since tempered its message, moving away from its origins in protest. It doesn't endorse bans or boycotts.

It doesn't even demand abstinence from the high-calorie cuisine offered in the fry-and-fly eateries that dapple the globe's Western landscapes — although that's implied.

This summer the movement is planning its first summer camp to show youngsters a new kind of "happy meal" — one that comes from farmers' markets and relies on familiar food traditions.

In Georgia, that may be as simple as a slice of pie made from the state's pecans or peaches; in Washington state, a souffle made of indigenous Olympia oysters; in New Mexico, a salsa made of native chiles; or a bowl of Zinzania wild rice in the upper Midwest.

If those dishes sound a little time-consuming, most Slow Food followers agree they don't follow the movement's tenets every day.

Atlanta mom Dawn Klempf says it's not so easy to plan long meals around her two sons' school and sports. When she gets home after an evening baseball game and her boys still have homework, she'll do something quick like heating precooked chicken and making a pot of fresh rice and chickpeas.

Another follower, physician assistant Julie Jacobson, concurs it's hard to adhere to the slow food mantra — not just because of time, but because of certain urges.

"If you put some McDonald's french fries in front of me right now, I'd eat them," she said.

But often, she'll spend the extra half-hour to 90 minutes to prepare a simple home-cooked feast.

Her grocery list typically includes free-range poultry, organic produce, fresh juices, soy milk and microbrewed beer. In the winter, when fresh produce isn't available, she buys canned.

Slow Foodies often overlook the steeper cost of organic, which can be double the supermarket alternative. Free-range turkeys, which Slow Food USA promotes, cost four times as much as the mass-produced Butterball.

Martins acknowledges that such products are more expensive. Until demand grows, he said, its patrons will make up a limited demographic.

"All of the great social movements started with an educated elite — women's suffrage, civil rights, the environmental movement. They were all embraced by a small segment of the population, then grew," Martins said. "Some say we're fighting for the rich. No, we're fighting for these foods."

Dr. Andrew Weil, author of "Eight Weeks to Optimum Health" and an admitted Slow Food fan, contends you don't have to be wealthy to join the movement. Replacing some commonly consumed items with fresh and organic alternatives is a good start.

"Start slow. Start with maybe a few items and try them," Weil said. "If done carefully, it doesn't break the bank."

Increasingly, it's easier to find indigenous and organic meats and produce at supermarkets. And smaller chains like Whole Foods and Wild Oats cater to the movement.

Skip Glover makes a living out of feeding people who follow the philosophy. He operates a farm west of Atlanta where he grows heirloom Brandywine tomatoes and other vegetables without pesticides. He sells his produce mostly in local markets, but hopes to expand to schools and hospitals.

"I started back in the '60s when my dad started getting rid of chemicals," he said. "He wasn't a pioneer; he just got on the bandwagon a little early."

Weil and 450 medical professionals who convened last month at the University of Arizona called on doctors to take nutrition more seriously. They blamed the U.S. obesity and diabetes epidemics on physicians who fail to warn their patients away from fast food and soft drinks.

Slow Food, with its emphasis on fresh foods and home cooking, is one solution, Weil believes.

"It represents a balance to the trends we've been seeing in this country."

On the Net:

Slow Food: http://www.slowfood.com

Slow Food USA: http://www.slowfoodusa.org

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Saturday, April 10, 2004

 

Spring Into Shape...

 

HealthDayNews

Saturday, April 10, 2004

SATURDAY, April 10 (HealthDayNews) -- For those battling a bulging waistline, the first signs of a thaw are often the cue to spring into action on a weight-loss program.

Yet 40 percent of American adults don't participate in any leisure-time physical activity, even though they need 30 minutes of such activity four to six days a week for optimum health, according to the Centers for Disease Control and Prevention (news - web sites).

Embracing daily workouts may be tough for those just emerging from a winter's hibernation. So start slowly with stretching exercises. They're a great way to rev up the metabolic engine and build strength -- and prevent injuries.

Follow up the stretches by heading outside for a walk or a bike ride. Low-impact activities such as walking and biking reduce the chances of injury and over-exertion, but they still offer calorie-burning benefits. Walking 30 minutes a day, five days a week is a fine part of any spring weight loss regimen.

But don't expect a miracle before summer. The U.S. Surgeon General recommends losing only half a pound to two pounds per week. To shed half a pound in a week means cutting 125 calories a day from a normal diet.

Restricting junk foods, cutting portion sizes and increasing daily exercise should be enough to achieve slow, consistent weight loss. And people who lose weight slowly and sensibly tend to have a better record of keeping it off.

More information

For more on the health benefits of exercise, visit Georgia State University.

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