The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
July 16, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 24-30

 

PERSONAL HEALTH

 

  1. More Kids Are Using Alternative Meds
  2. Head Injury in Children Has Lasting Impact: Study
  3. Gene Defect Linked to Premature Aging
  4. Dakota Growers Roll Out Low-Carb Pasta
  5. Lawn Chemicals Can Cause Cancer in Some Dogs
  6. Activity May Raise Ovarian Cancer Risk in Older Women
  7. Anger Fuels Prejudice
  8. Calif. Lawmakers Promote Weight-Loss Plan
  9. Effects of Caffeine Differ in Men and Women
  10. New Medicare Site Has Inaccurate Drug Prices
  11. Laser Catheter Helpful for Stroke
  12. Building Defenses Against Allergies a Mixed Bag
  13. Premenstrual Syndrome Predicts Menopausal Symptoms
  14. Understanding Food Labels
  15. Flu Shots Now Urged for the Very Young
  16. Cancer Find May Help Shape Drug Treatment
  17. Depression Precedes Eating Disorder in Some Women
  18. Group Wants Lower Fat Milk in Schools
  19. 41 Million Americans at Risk of Diabetes
  20. Study Examines Penicillin Allergies
  21. U.S. Alarmed by Jump in Drug Resistant Gonorrhea
  22. Women Born in Summer Have Fewer Children
  23. Wrist MRI Predicts Rheumatoid Arthritis Outcome
  24. U.S. Sees Sharp Drop in Food Poisoning
  25. Biomarkers May Predict Diabetes in Women
  26. New Liver Cancer Treatment Targets Tumors
  27. Report Predicts Asthma Epidemic from Pollution
  28. Lethal Genetic Heart Defect Found
  29. Military Service May Raise Risk of ALS
  30. Spinach May Offer Blindness Treatment
  31. Paramedics Accurately Assess Stroke Symptoms
  32. Dental Headaches
  33. Study: Siblings, Pets, Farms Help Stop Allergies
  34. School Takes Aggressive Swipe at Obesity
  35. Marriage Patterns Make Deafness More Common in US
  36. Artery Thickening Found in Obese Children
  37. FDA Finds Possible New Risks of Bowel Drug
  38. N.Y. College Spearheading Epilepsy Study
  39. Treatments for Prostate Cancer Produce Similar Results
  40. Distracted Young Women May Need More Iron
  41. One-Quarter of Poor NYC Toddlers Are Overweight
  42. N.H. Schools Serving 'Bunless' Burgers
  43. Prozac Affects Babies, Sexual Function, Report Says
  44. Calif. Schools Still Have Fat on Menus
  45. Some Migraines Raise Stroke Risk, Study Finds
  46. KFC Reportedly Changing Menu for Health
  47. New Pox Vaccine Uses Genes Only
  48. Vitamin D Use Cuts Risk of Falls in Elderly
  49. Wendy's Testing Low-Carb Menu in 6 Cities
  50. Smoke Cuts Anti-Inflammation Protein in Babies
  51. Dyslexia May Be More Common in Boys
  52. Impact of Anthrax Lingers Year After Attack
  53. Blood Proteins May Be Sign of Diabetes
  54. Measles Deaths Drop Worldwide, Still Big Killer
  55. Gov't to Recommend Gonorrhea Treatment
  56. New Method Gives Cancer Patients Look Ahead –Study
  57. N.C. Spending Millions in Obesity Fight
  58. 'Living Bandages' Heal Burns with Patients' Cells
  59. CDC Ranks Mississippi Atop Obesity List
  60. Cholesterol Drugs May Cut Breast Cancer Risk
  61. Simple Steps Can Stave Off Infection
  62. Stress Protein May Predict Heart Attack Death
  63. Study Backs Standard Hernia Surgery
  64. Summer Brings Lower Cholesterol Levels, Study Shows
  65. Body's 'Fat Hormone' Gives Up More Secrets
  66. Diabetes Reportedly to Double Worldwide by 2030
  67. Study Favors Premarin for Osteoporosis
  68. Calcium May Reduce Kidney Stone Risk in Young Women
  69. Parkinson's Drug Stills Restless Leg Syndrome
  70. Stroke No Excuse for Lazing About, Report Reveals
  71. The Mechanics of Muscular Dystrophy
  72. Bypass Beats Angioplasty in Risky Patients –Report
  73. Report: Many Mexican Candies Contain Lead
  74. Arsenic Poisonings Provide Valuable Data

 

Friday, April 30, 2004

 

More Kids Are Using Alternative Meds

 

By Robert Preidt

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- An increasing number of American children and adolescents are using dietary supplements, says a Wake Forest University Baptist Medical Center study.

The researchers found more than 50 percent of young children and more than 30 percent of adolescents in the United States have used a dietary supplement.

This increased use of these supplements leads to greater risk, the researchers say.

"We surveyed 145 families and 45 percent reported giving their child an herbal product. Most of these caregivers did not believe or were uncertain if herbal products had any side effects, and only 27 percent could name a possible side effect. We found that more than half of caregivers were unsure or thought that herbal remedies did not interact with other medications," Dr. Kathi J. Kemper, a pediatrician at Brenner Children's Hospital, said in a prepared statement.

"And of those giving their children herbal products, only 45 percent reported discussing their use with their child's primary health-care provider," Kemper said.

Her study appears in the April issue of the Pediatric Annals.

Parents give their children dietary supplements to treat acute and chronic diseases and to prevent disease and maintain good health, Kemper said.

"Efficacy, safety dosage and product recommendation should all be considered before recommending supplement use," she said.

"Children have their own unique physiology and metabolize, excrete and absorb supplements differently from adults. Even if a supplement has proven clinical efficacy and safety, the lack of standardization and limited federal regulation of supplements are obstacles in making recommendations," Kemper said.

Parents should get expert advice when considering giving dietary supplements to their children and should inform the child's pediatrician of any herb or dietary supplement being taken by the child.

More information

The U.S. National Center for Complementary and Alternative Medicine has more about dietary supplements.

Source: Wake Forest University Baptist Medical Center, news release, April 2004

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Head Injury in Children Has Lasting Impact: Study

 

By Merritt McKinney

Reuters Health

Friday, April 30, 2004

NEW YORK (Reuters Health) - Children with even mild head injury may be at risk for long-term complications, including personality changes and behavioral and learning problems, according to a new study from the UK.

"Many children with mild injury do not receive routine follow-up after discharge home from hospital, yet a significant proportion of them do have some lasting problems which may affect their behavior and ability to learn," Dr. Carol A. Hawley of the University of Warwick in Coventry told Reuters Health.

"This may put them at a disadvantage at school," Hawley said.

To identify children suffering from the lingering effects of a head injury, Hawley's team is working on a questionnaire that physicians could send to parents after children with head injury are sent home from the hospital.

Children found to be at risk of problems could be offered a follow-up assessment, Hawley said. If necessary, children could be referred to an appropriate health professional, such as an educational psychologist, the UK researcher said.

Hawley's study included more than 500 children who had experienced a head injury over a 6-year period.

"We asked parents to tell us what changes they noticed in their child after the head injury, and what follow-up they had received from clinicians," Hawley explained.

The researchers also received questionnaires from a control group of parents of 45 children who had not had a head injury.

"Even after a mild head injury, one in five children had a change in personality according to their parents," Hawley said.

Parents often described the personality change as "like having a different child" than before the head injury, according to Hawley.

And 43 percent of children with mild head injury had behavioral or learning problems that led to them being described as having a "moderate disability," she said.

Among children with more serious head injuries, about two thirds had moderate disability, and about half experienced a major change in personality after the head injury, Hawley said.

All of the children in the study had been treated in a hospital after having a head injury, but only 30 percent of parents said that doctors at the hospital had made a follow-up appointment for their child. In fact, 161 of the 252 children with moderate disability did not receive any follow-up care, according to the report in the May issue of the Journal of Neurology, Neurosurgery, and Psychiatry.

"It is likely that there are considerable numbers of children in the community, and back at school, who have suffered a head injury in the past and who might have subtle but important difficulties relating to that head injury," Hawley said.

Source: Journal of Neurology, Neurosurgery, and Psychiatry, May 2004.

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Gene Defect Linked to Premature Aging

 

By Robert Preidt

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- A gene defect linked to premature aging that may offer a new way to treat cancer has been identified by researchers at Johns Hopkins Kimmel Cancer Center.

Using genetically engineered mice, the scientists found that when the gene PASG is altered, it causes cells and animals to age prematurely and die. This gene may provide a new target for therapies that force cancer cells to an early death.

The study appears in the May 1 issue of Genes and Development.

Mice with the mutated PASG gene suffered numerous problems such as low birth weight, graying and loss of hair, reduced fat, skeletal abnormalities and early death.

"To keep body tissues working correctly, the PASG gene appears to help cells regenerate, mature and prevent early aging. Each cell is programmed with a set number of replications before it dies. With a mutated PASG gene, the cell may replicate only a fraction of the time, and then it dies prematurely," study director Dr. Robert Arceci, King Fahd Professor and director of pediatric oncology, said in a prepared statement.

If PASG's activity could be blocked in cancer cells, it may be possible to make them age faster and die earlier, he said.

More information

The American Academy of Orthopaedic Surgeons has information on the effects of aging.

Source: Johns Hopkins Medical Institutions, news release, April 30, 2004

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Dakota Growers Roll Out Low-Carb Pasta

 

By Dale Wetzel

Associated Press Writer

The Associated Press

Friday, April 30, 2004

BISMARCK, N.D. - Trying to buck an anti-carbohydrate trend that has hammered pasta sales, a North Dakota company is unveiling a new brand of pasta it hopes will appeal to dieters who have been shunning noodles and spaghetti.

The Dakota Growers Pasta Co. product, called Dreamfields, is joining an assortment of new, reduced-carbohydrate offerings on the nation's grocery shelves. Dreamfields' developers say its flavor is virtually indistinguishable from regular pasta.

It is made mostly from semolina, a granular flour that is used to make conventional pasta, with a patented fiber blend added to block digestion of most of the product's carbohydrates.

"We think we have an edge, because along with being low-carb, it is authentic pasta. This is the real deal," said Jack Hasper, Dakota Growers' vice president for marketing.

Dakota Growers is part of a group of four businesses, which formed a separate company to develop and market the pasta. It got its formal introduction Thursday at a news conference at Tavern on the Green, a restaurant in New York City's Central Park.

It includes spaghetti, elbows, penne rigate and linguine shapes, and will be sold through grocery stores, discount outlets and Dreamfields' Web site. A one-pound box will sell from $2.39 to $2.69, compared to 79 to 99 cents a pound for regular pasta, Hasper said.

Dreamfields is advertised as having only 5 grams of digestible carbohydrates for each 2-ounce serving. Dakota Growers' regular product has about 42 grams.

Jon Anfinsen, a biochemist and one of the project's business partners, says Dreamfields' fiber blend blocks digestion of most carbohydrates, causing the colon to treat them as dietary fiber.

In human tests, the product did not have a laxative effect, Anfinsen said. Blood sugar testing confirmed the pasta's low levels of digestible carbohydrates, said Dr. John Abernethy, owner of a medical clinic in Gainesville, Fla., where testing has been conducted for six months.

"We've done hundreds of test meals with several dozen subjects," Abernethy said.

The Food and Drug Administration (news - web sites) currently does not regulate claims about foods' carbohydrate content. The agency is considering three requests to define the meaning of some terms, including low- and reduced-carbohydrate, a spokeswoman said. The petitions were brought by ConAgra Foods Inc., Kraft Foods Inc. and the Grocery Manufacturers of America.

Tim Dodd, Dakota Growers' president, said Dreamfields initially should appeal to two large customer groups — dieters who favor low-carbohydrate meals, and people with diabetes. Starchy foods can cause a diabetic's blood sugar levels to rise quickly.

Rick Mendosa, an Aptos, Calif., writer who maintains a Web site with a comprehensive trove of diabetes information, tried the Dreamfields pasta recently over several days.

It caused minimal increases in his blood-sugar levels, said Mendosa, who posted test results on his site, http://www.mendosa.com.

"Some people have weaned themselves off pasta because it is so high in carbs generally, but I think there will be a big market, a huge market in this for people with diabetes," Mendosa said in an interview.

He has heard from other diabetics who experienced big jumps in their blood-sugar levels after eating Dreamfields, but that may have happened because they were extremely resistant to insulin, Medosa said. Insulin regulates how the body uses blood sugar, which is extracted from carbohydrates.

Laurie Kuntz, chief executive officer of LowCarbiz, a Denver-based newsletter, magazine and Web site that tracks low-carbohydrate products, said the lack of scientific information about Dreamfields so far has bred skepticism about its benefits.

"I know that in the diabetic world, there are a number of people who have been showing insulin spikes, so they're not believing what they are reading on the label," she said.

Anfinsen said he had expected some disbelief. The pasta brand's Web site will feature extensive research information on the product for consumers to examine, he said.

"What we have here is something that is very good. It is good for the health of the population," he said.

The number of low-carbohydrate foods has mushroomed in recent months. Kuntz estimates there are 1,300 products that advertise themselves as low-carb, and the number is rising.

"There are chips, salad dressings, hot cereals, bars, pasta, pancake mix, cereals, ketchup, jellies, ice cream. You name it," she said.

On the Net:

Dreamfields: http://www.dreamfieldsfoods.com

LowCarbiz: http://www.lowcarbiz.com

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Lawn Chemicals Can Cause Cancer in Some Dogs

 

By Robert Preidt

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- Scottish terriers exposed to lawn chemicals have an increased risk of bladder cancer, a finding that may provide new knowledge about bladder cancer in humans, says a Purdue University study.

The team of veterinary researchers surveyed owners of Scottish terriers that had recently developed bladder cancer.

The study found the risk of transitional cell carcinoma in the bladder was found to be between four and seven times more likely in Scottish terriers that had been exposed to lawn chemicals.

"While we hope to determine which of the many chemicals in lawn treatments are responsible, we also hope the similarity between human and dog genomes will allow us to find the genetic predisposition toward this form of cancer found in both Scotties and certain people," said Lawrence T. Glickman, a professor of epidemiology and environmental medicine at Purdue's School of Veterinary Medicine.

Scottish terriers develop bladder cancer about 20 times more often than other dog breeds. In this study, Glickman and his colleagues examined possible diet, lifestyle and environmental factors linked to bladder cancer in these dogs.

The study appears in the current issue of the Journal of the American Veterinary Medicine Association.

More information

The American Cancer Society has more about bladder cancer.

Source: Purdue University, news release, April 2004

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Activity May Raise Ovarian Cancer Risk in Older Women

 

Reuters Health

Friday, April 30, 2004

NEW YORK (Reuters Health) - Frequent and vigorous physical activity appears to increase the risk of ovarian cancer in postmenopausal women, according to the results of a 15-year follow-up of women enrolled in the Iowa Women's Health Study.

High body mass index (BMI) in early adulthood may do the same, but current height and weight are not major risk factors for the development of the disease, according to the study reported in the journal Cancer.

Reports on the relation between ovarian cancer and factors such as height, weight and physical activity have been inconclusive, Dr. Jeffrey P. Anderson and colleagues from the University of Minnesota note in their report.

The Iowa Women's Health Study enrolled over 40,000 women between the ages of 55 and 69 years old in 1985. Seven years into the study, the researchers noted a positive link between ovarian cancer rate and physical activity and waist-to-hip ratio but not BMI (the ratio between height and weight.) In an attempt to verify these data, they repeated their analyzes after 15 years of follow up.

According to the team, 223 cases of ovarian cancer were identified in participating women.

The previously reported link between regular leisure-time physical activity, especially frequent vigorous activity, and ovarian cancer "holds after 15 years of follow up," they report.

Women with the highest levels of activity had a 42-percent increased risk of ovarian cancer compared with those with the lowest levels. Participation in vigorous activity more than four times per week more than doubled the risk.

Overall, there was no association between ovarian cancer and current height, although height appeared to be associated with a modest increased risk of serous ovarian tumors, they report.

While current weight was not associated with ovarian cancer, women who were obese at age 18 had an 83-percent increased risk compared with women who were not overweight at this age. This association was even stronger when they excluded the first two years of follow up.

Waist-to-hip was also associated with ovarian cancer, with a 59-percent increased risk among women with the highest activity levels compared with those with the lowest levels.

Source: Cancer, April 1, 2004.

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Anger Fuels Prejudice

By Robert Preidt

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- In situations that require quick decisions, anger can fuel automatic, immediate prejudice against people of a different race, religion, or creed, says a study in the spring issue of Psychological Science.

The study included New York City residents and college undergraduates. First, they were made to feel either angry, sad, or emotionally neutral. They then had to rapidly categorize peoples' faces that were preceded by quickly displayed words that were either positive or negative.

Those in the sad and neutral groups showed no automatic bias against those who weren't like them. But the people in the angry group reacted negatively to the faces of people they identified as being different from them.

"Much as the experience of fear leads individuals to adaptive behaviors to avoid dangers (e.g., quickly recoiling from a snake in one's path), the experience of anger, due to its association with preparation for conflict, automatically shifts individuals' rapid appraisals of social groups outside of their awareness or control," researcher David DeSteno, psychology professor at Northeastern University, said in a prepared statement.

"When conflict is likely, different equals bad, and the brain prepares to shape our behavior accordingly," he said.

These study results may prove important in understanding the behavior of people in certain occupations or situations, said study co-author Nilanjana Dasgupta, a University of Massachusetts psychology professor.

"The findings hold important implications by suggesting that anger may increase the likelihood of aggressive or derogatory behaviors in certain situations required rapid judgments (e.g., a police officer or soldier judging an approaching member of an unfamiliar group as representing a threat and acting accordingly)," Dasgupta said.

"It is useful to note that these automatic prejudices can be overcome by exerting time and effort to consider judgments of social groups, but these are luxuries that individuals often do not have," she said.

More information

The American Psychological Association has more about anger.

Source: Northeastern University, news release, April 2004

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Calif. Lawmakers Promote Weight-Loss Plan

 

The Associated Press

Friday, April 30, 2004

SACRAMENTO, Calif. - California legislators are urging residents to follow their lead and shed those unnecessary pounds in the name of health.

Holding a sign that read "Will not work for food, I am a state lawmaker," Assemblyman Todd Spitzer joined 14 other legislators in front of the Capitol Thursday in the first "Bipartisan Weigh Off" event.

"It's basically a message to the public: When you see us, everybody wants to feed us, and now it's like, don't feed us!" Spitzer, R-Orange, said about his sign, noting that he just hopes to "redistribute," not lose, weight.

Fifteen lawmakers — weighing in collectively at 2,600 pounds — joined the monthlong weight loss program.

The six Democrats and nine Republicans hope to raise awareness about obesity though a series of exercise events that include a workout with California Highway Patrol cadets, a soccer game, and a "bipartisan jog" around the Capitol grounds. At then end of the month, they'll weigh in again to see how they did.

They hope Californians will follow their lead and join the challenge to get fit.

Assemblymen Abel Maldonado and Lou Correa came up with the idea as they felt themselves, over the years, become a little rounder than they want to be.

"We have to prioritize losing the weight," said Correa, a Democrat from Anaheim who wants to lose 10 pounds in 30 days. "I'm a walking heart attack. I got a cholesterol of 300, OK, I'm overweight. And that problem's the same for a lot of us in this society. So, we've got to change our lifestyles."

Californians of all ages have become increasingly unfit over the past decade, leading to more preventable deaths and a continued drain on the budget, said Maldonado, R-Santa Maria.

The U.S. Department of Health and Human Services (news - web sites) has reported that for every $5 spent on health care, $3 goes toward an obesity related illness, he said.

"It is amazing how much of our state budget and federal budget goes into this," said Maldonado, who also hopes to lose 10 pounds. "That's why are we are here today. We need to take this seriously, we need make healthy choices and we need to lead by example."

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Effects of Caffeine Differ in Men and Women

 

By Alison McCook

Reuters Health

Friday, April 30, 2004

NEW YORK (Reuters Health) - Researchers have long known that caffeine increases blood pressure. Now, new findings show that this blood pressure rise may occur for different reasons in men and women.

The investigators found that, in women, caffeine tends to raise blood pressure by increasing the activity of the heart, causing it to pump blood faster and raising so-called cardiac output. In contrast, caffeine ups men's blood pressure by narrowing blood vessels, increasing the resistance of blood vessels to the flow of blood.

Although caffeine appears to raise pressure for different reasons in men and women, blood pressure increased by the same amount in both sexes, suggesting that the potential health risks of caffeine are the same for men and women, study author Dr. William R. Lovallo told Reuters Health.

"Caffeine can increase blood pressure, and it can elevate pressure still further when a person is under mental stress," he said. "If you are developing high blood pressure, or if you already have high blood pressure, give up caffeine."

During the study, Lovallo and his colleagues asked premenopausal 42 women and 35 men of similar ages to take either an inactive pill or a pill containing as much caffeine as 2 to 3 cups' worth of coffee. All participants were in good health, had normal blood pressure and drank coffee regularly.

To induce mental stress, the researchers then asked some of the people who took caffeine to make a speech in front of a video camera and two researchers wearing white coats.

The investigators found that caffeine raised blood pressure by the same amount in men and women. However, men responded to the caffeine pills by showing an increase in blood vessel resistance, with no change in cardiac output. In contrast, women showed no change in vessel resistance, and instead showed an increase in cardiac output, according to the American Journal of Cardiology report.

Lovallo, who is based at the Veterans Affairs Medical Center and the University of Oklahoma Health Sciences Center in Oklahoma City, explained that previous research has established that caffeine tends to increase blood pressure in men by increasing constriction of blood vessels.

Although the reasons why women showed a different response are not clear, researchers have shown that public speaking may provoke more anxiety in women than in men, he noted.

"When women are experiencing anxiety, they may have greater increases in how forcefully their hearts contract, in comparison to men. As a result, caffeine may have intensified the anxiety and response of the heart in the women, creating the difference in responses we saw," Lovallo said.

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

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New Medicare Site Has Inaccurate Drug Prices

HealthDayNews

Friday, April 30, 2004

A new Medicare Web site that allows people to compare drug prices is already drawing complaints that the information is incorrect.

The site is designed to enable people using the new Medicare-approved drug discount card to search for the lowest drug prices.

"Everybody seems to be finding problems with inaccuracies with the posted prices," Walgreens' spokeswoman Laurie Meyer told the Associated Press.

Two other sponsors of the new Medicare drug discount card also reported inaccurate prices on the new Web site. Some drug prices were too high while others were too low.

A California company, Destination Rx, manages the Web site. Medicare hired the company without seeking any other bids, the AP reported.

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Laser Catheter Helpful for Stroke

 

By Karla Gale

Reuters Health

Friday, April 30, 2004

NEW YORK (Reuters Health) - Breaking up clots with a special laser catheter can quickly restore blood flow to the brain in stroke patients, physicians report in the medical journal Stroke.

Clot-busting drugs are a common treatment for stroke, but not all patients are candidates for such therapy. In contrast, the clot-busting catheter, known as EPAR, doesn't use drugs but rather breaks up the clots by mechanical means.

EPAR is ideally suited for patients who, because of bleeding disorders, are at increased risk for problems with clot-busting drugs, according to Stephanos Papademetriou, president of California-based Selva Medical, which is marketing the catheter.

The device delivers laser energy that is converted to acoustic energy and produces "cavitation bubbles," which cause the clot to be "sucked" into the catheter tip where it is emulsified. "To my knowledge, no other method (of clot busting) uses a true emulsification device that gets close to the (clot) and breaks it down to" tiny particles, Papademetriou told Reuters Health.

In the current study, Dr. Ansgar Berlis at the University of Freiburg, Germany, and associates examined the outcomes of 34 patients treated with EPAR.

Reopening of the blocked blood vessel was achieved in 11 of 18 patients whose EPAR treatment was successfully completed. Treatment could not be completed in 16 patients because of such factors as vessel location or device malfunction. Still, blood vessel opening was accomplished in three of these patients.

Papademetriou expects that results of future clinical trials will be better because the catheter has been redesigned to be operated continuously over a guide wire when the laser is on. Because the catheter is now more flexible, it is more easily navigated through twisted vessels, he added.

Source: Stroke, May 2004.

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Building Defenses Against Allergies a Mixed Bag

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- A household full of hairy pets and siblings can be a protective environment for allergy-prone children.

But that's not the case not if those children suffer an infection -- such as a cold -- during the first six months of life, a new Danish study says.

The study, which looked at more than 24,000 mother-and-child pairs prone to allergies, contradicts just one premise of the "hygiene hypothesis." This theory, promulgated since the 1980s, holds that exposure to allergens in the environment early in life reduces the risk of developing allergies by boosting immune system activity.

The one part of the hypothesis that did not stand up maintains that having an infection -- a cold, ear ache, pneumonia or other infectious disease -- early in life does good by strengthening immune responses, said Dr. Christine Stabell Benn. She is a research fellow at the Danish Epidemiology Science Centre, and lead author of the research that appears in the April 30 issue of the British Medical Journal.

"We show that infectious diseases early in life do not have a protective value," Benn said.

The study looked at the incidence of atopic dermatitis -- a skin allergy that keeps people scratching -- in the allergy-prone children.

It found the incidence of the condition decreased 21 percent for children with three or more brothers and sisters, and for those who owned pets, lived on a farm or attended day care -- all of which increase early life exposure to allergy-causing environmental factors.

But the study also found the risk of dermatitis increased with each infectious disease contracted before 6 months of age.

"That finding goes against the common wisdom which says that infections transferred from older siblings help to mature the immune system," Benn said. "We find that infectious diseases do not have a protective effect."

Benn's advice is "to stop following advice," because "the advice we have been giving for infants may not be on solid ground."

Dr. Clifford W. Bassett, an allergist in private practice in New York City and a spokesman for the American Academy of Allergy, Asthma & Immunology, opts for a family-by-family approach.

The Danish study, he said, "supports the hygiene hypothesis that things that are bad for you may be good for you." But the "common wisdom" that advises an allergy-prone family to have a pet for its protective value may be good or bad, depending on individual circumstances, Bassett said.

Overall, the Danish statistics are solid, he said. A child with one allergic parent has a 25 percent chance of developing an allergy; two allergic parents raise the risk to 50 percent. Environment and genetics both contribute to the risk, he added.

"But we don't want to make a single recommendation for everyone," Bassett said. "It is so difficult to tell someone in a family with allergy and asthma to go out and get a pet. We need to individualize when we make recommendations."

"Our job is to find out which patients and which families benefit, and I don't think we're there yet," he said.

More information

A full explanation of the hygiene hypothesis can be found at the American Academy of Allergy, Asthma & Immunology. For more on pets and how they may protect children from allergies, visit the National Institute of Allergy and Infectious Diseases.

Sources: Christine Stabell Benn, research associate, Danish Epidemiology Science Centre, Copenhagen; Clifford W. Bassett, M.D., allergist, New York City; April 30, 2004, British Medical Journal

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Premenstrual Syndrome Predicts Menopausal Symptoms

 

Reuters Health

Friday, April 30, 2004

NEW YORK (Reuters Health) - Women who have premenstrual syndrome (PMS) appear to have an increased risk of developing symptoms such as hot flushes, depressed mood, and poor sleep during menopause, according to a report published in Obstetrics and Gynecology.

The findings are based on a study of 426 women who were surveyed about PMS and then followed for 5 years to assess the emergence of menopausal symptoms. Of the 320 women who completed the 5-year study trial, 144 remained premenopausal.

The likelihood of reporting PMS at the start of the study was inversely related to patient age and menstrual stage, Dr. E. W. Freeman, from the University of Pennsylvania in Philadelphia, and colleagues note.

Compared with their peers without PMS at study entry, women with PMS were significantly more likely to report hot flushes, depressed mood, poor sleep, and decreased libido during menopause. With the exception of decreased libido, these symptoms were significantly associated with variability in estrogen levels.

"Clinicians should recognize that their patients with a history of PMS may experience more troublesome menopausal symptoms and that these symptoms are experienced early in the transition to menopause as indicated by changes in cycle length," the investigators conclude.

Source: Obstetrics and Gynecology, May 2004.

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Understanding Food Labels

By Robert Preidt

HealthDayNews

Friday, April 30, 2004

FRIDAY, April 30 (HealthDayNews) -- A program to help consumers learn to interpret nutrition information on food labels and apply that knowledge to their personal daily requirements has been developed by University of Illinois at Urbana-Champaign experts.

The "See it, Do it, Teach it" program is designed to instill more confidence in people when it comes to understanding nutrition labels and using that information in planning their meals.

"One of the goals of the project was to help particularly teenaged girls and menopausal women understand how they can get the daily requirement for calcium in their diet in order to help prevent osteoporosis," Karen Chapman-Novakofski, an associate professor and nutritionist at the College of Agricultural, Consumer and Environmental Sciences, said in a prepared statement.

She said food labels can be divided into two parts. The first part is what you should limit, such as total fat, saturated fat, cholesterol, sodium and, perhaps, total carbohydrates. The second part is what you should try to get enough of in your diet, such as calcium, iron, vitamin A and vitamin C.

The "See it, Do it, Teach it" program has three sections. First, people are taught how to read nutrition labels on packaged food items using a government guide. Next, participants do simple math based on the food labels to learn how the nutrition label information relates to their own daily intake of calories and nutrients.

In third section, participants "teach" others in the class about the nutritional information of a food product.

The program was tested in an eight-week study. The results will be published in the Journal of Nutrition Education and Behavior.

More information

The U.S. Centers for Disease Control and Prevention offers healthy eating tips.

Source: University of Illinois at Urbana-Champaign, news release, April 2004

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Thursday, April 29, 2004

 

Flu Shots Now Urged for the Very Young

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- Recommendations for annual flu vaccines have been expanded to include children 6 months through 23 months of age.

Both the American Academy of Pediatrics (AAP) and the U.S. Centers for Disease Control and Prevention have released their own versions of these recommendations.

Recent research has shown that children under the age of 2 have hospitalization rates from influenza that approach those of adults 65 and over, traditionally considered a high-risk group and one that is urged to get an annual flu shot.

"In the past few years it has become appreciated that hospitalization rates for flu are quite high in young children -- essentially the same as in people over 65 -- and although the death rates are much lower in children, perfectly healthy children can die from influenza," said Dr. Margaret Rennels, chairwoman of the AAP's Committee on Infectious Diseases and professor of pediatrics at the University of Maryland School of Medicine.

Last year was the first in which the CDC listed reports of pediatric deaths. In all, 140 children died of the flu during last year's season.

In the past year or so, children 6 months to 23 months were "encouraged" to get the vaccine. "Now it's a formal recommendation," said Dr. Raymond Strikas, a medical epidemiologist at the CDC's National Immunization Program. "It's not just nice to do. We think this is something they should do."

The CDC also stated that children under the age of 9 years receiving the flu vaccine for the first time will need two doses, one month apart.

Both the AAP and the CDC are also recommending that people who have a lot of contact with this young age group also get vaccinated. This would include parents, caretakers, and other people in the household.

The vaccine is already recommended for children over the age of 6 months who have chronic conditions such as asthma, cystic fibrosis, diabetes, sickle cell disease, HIV, and others.

Only one influenza vaccine, trivalent inactivated influenza vaccine (TIV), is licensed for use in children between 6 and 24 months and with high-risk medical conditions. This vaccine contains no live virus. The most common side effects are a sore arm and possibly a little achiness. "They can't get the flu because it's killed," Rennels said.

The CDC made one other change in its new recommendations -- that health-care workers receiving the FluMist vaccine only need to avoid immunosuppressed people for seven days after getting the vaccine, not 21 days, Strikas said.

Experts are hoping there will be enough vaccine to accommodate the expanded recommendations. "Enough depends on the demand, and one can't precisely predict demand," Rennels said. "Practitioners have known that these recommendations were coming. This should not surprise them, and the AAP has instructed their members to order the vaccine early."

The reports of deaths in children last year may have caused a one-time stampede, she added.

"There's an appropriate concern about influenza vaccine supply in general, although our colleagues at the FDA [Food and Drug Administration] and the vaccine companies tell us that production this year is so far going well," Strikas said.

An estimated 90 million to 100 million doses will be available, which Strikas believes will be "ample."

There will also be more vaccines available with reduced levels of thimerosal, a mercury-containing preservative.

"My understanding from the companies is that together they produced just over 3.2 million doses of [reduced thimerosal] vaccine last year, and estimates we have now are 6 to 8 million doses with reduced thimerosal," Strikas said. "There will be increased options for those concerned about this."

More information

For more on the flu vaccine, visit the National Immunization Program or the American Academy of Pediatrics.

Sources: Margaret Rennels, M.D., chairwoman, Committee on Infectious Diseases, American Academy of Pediatrics, and professor of pediatrics, University of Maryland School of Medicine, Baltimore; Raymond Strikas, M.D., medical epidemiologist, National Immunization Program, U.S. Centers for Disease Control and Prevention, Atlanta; American Academy of Pediatrics statement; April 30, 2004, Morbidity and Mortality Weekly Report

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Cancer Find May Help Shape Drug Treatment

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Thursday, April 29, 2004

WASHINGTON - In a step toward more tailored cancer therapy, scientists have discovered some lung cancer patients harbor gene mutations that make a new drug dramatically help them — even as it fails most.

Now the race is on to develop a test to figure out in advance whom Iressa will help, so patients who need it might benefit sooner and others won't waste time and money and risk unnecessary side effects.

The discovery, by two teams of Boston scientists, ultimately could benefit thousands battling the nation's top cancer killer. And it points the way toward more targeted therapy of other cancers.

"It's incredibly important," said Vanderbilt University lung cancer specialist Dr. David Johnson, president-elect of the American Society of Clinical Oncology (news - web sites). "This is just the beginning of personalized medicine."

But it also raises some intriguing questions: The mutations aren't inherited, they just occasionally arise inside the cancer itself — yet they seem more common among Japanese patients, women and nonsmokers. Why? No one knows.

Iressa, which began selling a year ago, was designed to target "epidermal growth factor receptor," or EGFR, growth-spurring signaling posts for lung cancer cells. The idea was that lung cancer might make excess EGFR, and blocking it might slow growth with less toxicity than chemotherapy.

Doctors have reported terminally ill patients who lived months or even years longer than expected on Iressa. But they were rare: Only about 10 percent of U.S. patients respond to the drug, frustrating doctors who felt they had to offer it to most advanced-stage patients to find the fraction it helps.

Now scientists working separately at Massachusetts General Hospital and the Dana-Farber Cancer Institute have made the same discovery: Blocking excess EGFR didn't matter. Instead, Iressa works in people whose lung tumors harbor certain gene mutations that make abnormal EGFR.

This growth protein contains a little pocket to capture an energy-spurring molecule called ATP, said Dr. Daniel Haber, who led the Mass General team. Iressa apparently targets that pocket — and when the protein is mutated, Iressa fits inside the pocket much better, blocking ATP from getting in and thus inhibiting cancer-cell growth, he explained.

"This was a targeted therapy before the target was really known," added Dr. Matthew Meyerson, who co-led the Dana-Farber team.

The teams report their research Thursday in the journals Science and the New England Journal of Medicine (news - web sites).

The discovery won't immediately help patients — there is no commercial test. The Mass General scientists are negotiating with companies to create one, and large hospitals might also eventually offer in-house laboratory testing. Once testing is available, patients would need tumor samples on file after their initial lung surgery to get it.

In the next step, researchers will begin studies to see whether mutation-harboring patients fare better if given Iressa early in the disease, maybe even before chemotherapy, instead of receiving it as a last-ditch treatment.

Helping even a subset of lung cancer patients is important because the killer disease is so prevalent, cancer specialists stress. Some 170,000 Americans will be diagnosed with lung cancer this year, and it kills more than 150,000 annually.

Still, they caution the studies were small and need confirmation.

At Mass General, eight of nine patients who had responded to Iressa had mutation-containing tumors; seven patients not helped by Iressa didn't.

The one other responder suggests there may be other Iressa-susceptible mutations to discover.  

In 25 tumors from patients not given Iressa, Mass General found only two had the mutations. Laboratory studies of cancer cells found the mutated receptors were 10 times more sensitive to Iressa than were normal receptors.

The Dana-Farber team first scanned tumors from 58 Japanese and 61 U.S. patients and found the mutations in 15 of the Japanese and just one American. Then they looked at tumors from nine Iressa users, and found the mutations in all five who responded to the drug and no mutations in the four Iressa didn't help.

The Japanese findings were intriguing because 20 percent to 25 percent of patients there respond to Iressa, much higher than the 10 percent U.S. response rate, Meyerson said.

Also, the mutations were more common in women, people who had never or not recently smoked, and people who had a subtype called bronchoalveolar cancer — characteristics doctors already had noticed.

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Depression Precedes Eating Disorder in Some Women

 

Reuters Health

Thursday, April 29, 2004

NEW YORK (Reuters Health) - Women with eating disorders who have attempted suicide may have had a depressive disorder long before their problems with food began, the results of a small study suggest.

Researchers found that among 27 eating-disorder patients with a history of suicide attempts, two thirds had major depression before the onset of the eating disorder. That compares with just one of 27 patients who had never attempted suicide.

Women in the suicidal group also developed depression and anxiety disorders at a younger age than the other women did.

A substantial number of people with eating disorders purposely injure themselves or attempt to take their lives, according to the study authors, led by Dr. Lisa R. R. Lilenfeld of Georgia State University in Atlanta.

The new findings show that for these women, "the eating disorder may be secondary to a mood disturbance," the researchers report in the International Journal of Eating Disorders.

That stands in contrast to some past research suggesting that depression typically arises after a woman develops an eating disorder like anorexia or bulimia. According to Lilenfeld and her colleagues, depression may often be a consequence of the eating disorder, but this may not be true of suicidal patients.

They say that understanding such differences between eating-disorder patients who do or do not attempt suicide should aid in treatment.

For the study, the researchers interviewed 54 women with anorexia, bulimia, or other eating disorder, half of whom had a history of suicide attempts and self-inflicted injuries such as cuts and burns.

The authors found that while suicidal and non-suicidal women did not differ much in their rates of depression--most women in both groups had a history of major depression--those with a history of attempted suicide developed depression at a younger age.

Excluding the subjects who developed an eating disorder and major depression in the same year, more suicidal women developed major depression before they developed the eating disorder.

In addition, women in the suicidal group had a higher rate of anxiety disorders--93 percent versus 56 percent--and, on average, developed anxiety at a younger age.

According to the researchers, the findings suggest that for most women with eating disorders and no history of suicidal behavior, depression may be a consequence of the eating disorder. But for those who are suicidal, the first and perhaps most "central" psychological problem may often be major depression.

Therefore, the authors write, women with eating disorders and a history of depression may be at increased risk for suicide. This, they note, suggests the need to put more emphasis on regulating emotion and mood in treating these patients.

Source: International Journal of Eating Disorders, March 2004.

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Group Wants Lower Fat Milk in Schools

 

By Frederic J. Frommer

Associated Press Writer

The Associated Press

Thursday, April 29, 2004

WASHINGTON - An advocacy group that promotes healthy diets called on the dairy industry to work with Congress to ensure that that less high-fat milk is offered as part of the school lunch program.

The Center for Science in the Public Interest in Washington accused the industry of pushing for language in the school lunch program that will result in schools serving more high-fat milk.

Legislation to reauthorize the program passed the House this year with language that requires schools to offer milk with "variety of fat contents."

The CSPI's nutrition policy director, Margo G. Wootan, said Monday that since only two types of milk are considered low in fat — fat free and 1 percent — schools will likely wind up offering at least one kind of high-fat milk to go with it to meet the definition of "variety."

The other types of milk are 2 percent and whole milk, both of which have higher fat contents.

Susan Ruland, a spokeswoman for the International Dairy Foods Association, challenged that interpretation of the legislation.

"Variety means more than one," she said. "So a school could decide to offer fat free and 1 percent" and still meet the bill's guidelines.

Wootan said schools won't necessarily read it that way.

"Variety could mean two, three or four," she said. "When they have to have a variety, it greatly increases the chances that schools will feel like they have to offer high-fat milk."

CSPI sent a letter Monday, signed by 200 nutritionists and researchers, urging the International Dairy Foods Association, the National Milk Producers Federation, and Dairy Management Inc. to work to allow more lowfat milk products in schools.

"The most important thing to remember from a nutritional point of view is that limiting milk choices is a recipe for disaster in schools," said Jean Ragalie, dietitian with Dairy Management Inc., which promotes milk consumption. She argued that would lead children0 to drinking soft drinks with no nutritional value.

A National Milk Producers Federation spokesman, Chris Galen, said he would let the other dairy groups speak on his group's behalf.

The CSPI also criticized another provision in the bill that would keep schools from restricting the sale of milk in vending machines.

"Many flavored milks that could be available in school vending machines or snack lines contain more calories than a 20-ounce soda, and contain considerably more saturated fat," the nutritionists wrote in their letter.

But Ruland said that provision was aimed at ensuring that exclusive contracts with soda companies don't force milk out of vending machines.

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41 Million Americans at Risk of Diabetes

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- Forty-one million Americans have blood sugar levels high enough to put them at risk of developing diabetes -- more than twice the previous estimate.

The new number means two of every five adults aged 40 to 74 is now considered to have pre-diabetes, the U.S. Department of Health and Human Services reported Thursday.

"These latest numbers show how urgent the problem really is," said Health and Human Services Secretary Tommy Thompson, the Associated Press reported. "We need to help Americans take steps to prevent diabetes or we will risk being overwhelmed by the health and economic consequences of an ever-growing diabetes epidemic."

About 18 million Americans have diabetes, with 1.3 million new cases diagnosed every year. Most have type 2 diabetes, which develops as the body gradually loses its ability to metabolize blood sugar. Diabetes is a leading cause of heart disease, blindness, kidney failure and amputations, killing more than 200,000 Americans every year.

Pre-diabetes "puts someone at risk not only of diabetes but also of heart attack and stroke," said Linda S. Geiss, chief of diabetes surveillance at the U.S. Centers for Disease Control and Prevention.

There are no agreed-upon estimates of the percentage of people with pre-diabetes who will develop the full-blown disease, Geiss said. But it is known that "taking preventive measures can return a pre-diabetic person to normal," she said. Those measures include proper nutrition and exercise.

Pre-diabetes can be diagnosed by the "impaired glucose tolerance" test, which measures blood sugar levels before eating anything in the morning. Until last November, a level below 110 milligrams of glucose per deciliter of blood was described as normal. The new guideline lowers the bar, so a reading of 100 or higher classifies someone as pre-diabetic.

The new estimate comes from applying that standard to data from the latest National Health and Nutrition Examination Survey, Geiss said.

The American Diabetes Association is using the new guideline to call for what it says are relatively simple lifestyle changes to reduce the risk of developing diabetes.

"The biggest drivers include the high prevalence of obesity, which in turn is driven by exercise habits and diet habits," said Dr. Gene Barrett, president of the association and professor of medicine at the University of Virginia.

Adults should be doing the minimum amount of exercise recommended by many health organizations -- 30 minutes of moderate activity at least three days a week, Barrett said. They also should avoid "high-calorie, high-density foods," he said.

Parents also should be looking after their children, with an eye not only toward having them exercise regularly but also "the easy availability of soft drinks and fast foods in school meal programs," Barrett said.

Losing just 5 percent of body weight -- 10 pounds for a 200-pound adult -- can move someone out of the pre-diabetic state into better health, he said.

Unless those steps are taken, "you will wind up with a lot of people in trouble," Barrett said.

More information

Get a thorough description of pre-diabetes and what can be one about it from the American Diabetes Association. For more on diabetes, visit the U.S. Centers for Disease Control and Prevention.

Sources: Gene Barrett, M.D., professor, medicine, University of Virginia, Charlottesville, and president, American Diabetes Association; Linda S. Geiss, director, diabetes surveillance, U.S. Centers for Disease Control and Prevention, Atlanta; April 29, 2004, statement from the U.S. Department of Health and Human Services

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Study Examines Penicillin Allergies

By Joann Loviglio

Associated Press Writer

The Associated Press

Thursday, April 29, 2004

PHILADELPHIA - A study by University of Pennsylvania researchers casts doubt on the conventional wisdom that most penicillin allergies are forever.

The researchers found that the number of people who had an allergic symptom after taking penicillin and then had another episode after taking the antibiotic again was far fewer than expected.

However, the researchers stressed that more study is needed before doctors start writing penicillin prescriptions for patients who say they're allergic.

Previous smaller studies had concluded that about 60 percent of people who have an allergic reaction once to penicillin will have another one if they take the antibiotic again. However, the Penn researchers' review of 3.4 million electronic medical records for people in Great Britain who were prescribed penicillin from 1987 to 2001 found the number of second allergic responses to be less than 2 percent.

Researchers are trying to find out just how common the allergy really is and better understand the risk of re-prescribing penicillin, said Dr. Andrea J. Apter, a Penn allergist and associate professor of medicine. While more work is necessary before that happens, the study suggests that some patients labeled as allergic can safely take the antibiotic if there's an emergency or alternatives would be inferior, she said.

Of the 6,000 patients who had an allergic response such as a rash or wheezing after the first prescription, about half — 3,014 — received a second dose. Among those patients, only 57 — 1.9 percent of the total — had a similar recurrence.

If it turns out that a larger number of people can safely take penicillin, which is highly effective and relatively inexpensive, it would benefit public health as well as patients' wallets, said Penn professor and senior researcher Dr. Brian L. Strom.

Penicillin skin testing is currently imperfect and typically unavailable to doctors because some of the testing materials aren't widely available, Apter said.

The limitation of the study is that people who think they're allergic to penicillin may not be, said Dr. Clifford W. Bassett, a New York City allergist and a spokesman for the American Academy of Allergy, Asthma and Immunology.

"It's very important to understand that the history of penicillin allergy is anecdotal. A lot of those probably were not true positives," he said. The Penn study didn't involve actual blood or skin tests on patients, so it's hard to determine how many truly were allergic, he said.

Some people may have had a rash or hives that came from their illness and not the medicine. Also, every year that an allergic person avoids penicillin may reduce their sensitivity, Bassett said.

The study appears in this month's Journal of Allergy & Clinical Immunology.

On the Net:

University of Pennsylvania School of Medicine: http://www.med.upenn.edu

American Academy of Allergy, Asthma and Immunology: http://www.aaaai.org

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U.S. Alarmed by Jump in Drug Resistant Gonorrhea

By Paul Simao

Reuters

HealthDayNews

Thursday, April 29, 2004

ATLANTA (Reuters) - A jump in drug-resistant gonorrhea among gay and bisexual men prompted U.S. health officials on Thursday to recommend that the antibiotics usually used to treat the sexual infection be avoided in some cases.

The Centers for Disease Control and Prevention (news - web sites) advised doctors to stop prescribing ciprofloxacin and other fluoroquinolones as a first-line treatment for men who likely have contracted gonorrhea from other men.

The recommendation to limit use of fluoroquinolones, which are relatively inexpensive and administered in a single oral dose to cure gonorrhea, could complicate the nation's efforts to combat sexually transmitted diseases in high-risk groups.

Ceftriaxone and spectinomycin, the drugs now recommended by the CDC for gonorrhea infections in gay and bisexual men and some heterosexuals, require injection.

The federal agency said these drugs should also not be used for heterosexuals who had been infected in Asia, the Pacific Islands, California, parts of Britain and other areas where drug-resistance gonorrhea is more prevalent.

Gonorrhea, which made a comeback in the United States in the late 1990s after two decades of steady decline, can cause chronic pelvic pain, infertility and arthritis if left untreated. It also facilitates the spread of the AIDS (news - web sites) virus.

Although the majority of the estimated 700,000 to 800,000 Americans infected each year are heterosexuals, there is heightened concern about the resurgence of the disease among men who have sex with men.

Almost five percent of gay and bisexual men infected last year were resistant to fluoroquinolones, about three times more than in 2002, according to a CDC study of preliminary data from sexually transmitted disease clinics in 23 U.S. cities.

The incidence of drug resistance in heterosexual men with gonorrhea doubled to 0.4 percent last year, researchers said in the study, which was published in the CDC's weekly morbidity and mortality report.

Data from New York City and Massachusetts also found considerably higher drug resistance -- up to eight times that of heterosexual men -- in gay and bisexual men with the infection.

CDC officials said a more-relaxed attitude to safe sex, the use of some illicit drugs prior to sex and the growing practice of finding sex partners on the Internet were factors that likely contributed to the alarming data.

Dr. John Douglas, director of the CDC's STD prevention programs, speculated that travelers returning from parts of the world where drug-resistant gonorrhea was more endemic were helping to fuel the rising trend.

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Women Born in Summer Have Fewer Children

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- Women born in June, July and August have fewer children than women born in other months, a new study by Austrian researchers contends.

However, they can't pinpoint a reason for the finding. And an American expert in reproductive medicine said the study shouldn't worry women born in summer who are hoping for a houseful of children.

The study appears in the May issue of Human Reproduction.

The finding confirms a previous study of "pre-modern" women in Canada, as well as other studies, said Susanne Huber, a researcher at the University of Veterinary Medicine in Vienna.

"In contrast to the other studies all dealing with pre-modern women of historic populations, we are the first to investigate the association between birth month and reproductive performance in contemporary women," she said.

The researchers evaluated a representative sample of more than 3,000 Austrian women. They found that women born in July had 0.3 fewer children than women born in December, Huber said. Put another way, those women born in July had 13.4 percent fewer children than the 2.24 mean number of children borne by women overall, she said.

The average offspring count among women born in June, July or August was lower than those women born during any other month, Huber said.

The sample included women over the age of 45 and born after 1945 who were part of an Austrian database that has been ongoing since 1967.

Huber said that despite the potential influence of contraception and other realities of modern life, birth month effects on reproduction seem to remain the same in pre-modern and contemporary women.

An American expert called the study interesting, but said the findings might not hold up. "The data supports what they say, but these papers are very tricky," said Dr. Alan DeCherney, a professor of obstetrics and gynecology at the University of California, Los Angeles' David Geffen School of Medicine.

"If you look at enough variables, it will find something," added DeCherney, who is also editor of Fertility and Sterility. In the study, the researchers looked at 12 different variables, he noted.

Huber can't say exactly what's behind the birth-month effect she found. "We can only speculate about possible causes as this has not been investigated yet," Huber said. One possibility, she said, is that the lower fertility could be due to conditions experienced during fetal and neonatal life that affect early development before and immediately after birth.

"Our results are just of statistical relevance," Huber said. "That is, individual summer-born women may also have, for instance, 10 children. But on the average, women born in summer have fewer children."

While research like this attracts interest, DeCherney said, it may needlessly worry women born in summer hoping for children. "It's just going to alarm people born in June and July that their fertility is decreased," he said.

DeCherney's advice about the study's conclusion? "Disregard this."

More information

To learn more about women and reproductive health, visit the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine.
Sources: Susanne Huber, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna; Alan DeCherney, M.D., professor, obstetrics and gynecology, University of California, Los Angeles' David Geffen School of Medicine; May 2004 Human Reproduction

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Wrist MRI Predicts Rheumatoid Arthritis Outcome

 

Reuters Health

Thursday, April 29, 2004

NEW YORK (Reuters Health) - Magnetic resonance imaging (MRI) of the wrist in patients in the early stages of rheumatoid arthritis can be used to predict functional outcomes six years later, researchers in New Zealand report. "We suggest that MRI may be used as a useful adjunct to standard clinical and laboratory determinants of prognosis," they report

Reliable prediction of outcomes is an important part of the treatment rheumatoid arthritis, the authors explain in the Annals of the Rheumatic Diseases, because early treatment may reduce or even completely prevent joint damage during the early years of the disease.

Dr. Nicholas Benton from Auckland Hospital and colleagues used MRI of the dominant wrist, conventional X-rays, and the clinical assessments of disease in 42 patients with early rheumatoid arthritis who were followed for six years.

Detection of fluid around the bone (bone edema) using MRI strongly predicted bone erosion scores after six years, the authors report. None of the clinical measurements, except blood levels of C-reactive protein, were similarly predictive.

MRI bone edema at the beginning of the study also correlated strongly with health assessment scores, the report indicates. Total MRI score and bone erosion after six years showed a good correlation with measures of function.

"In summary," the investigators conclude, "this is the first study to show that early features seen on MRI can predict six-year functional outcome in rheumatoid arthritis. MRI bone edema is the most significant predictor of function, probably because of its combined ability to reflect joint inflammation and to predict erosive damage."

Source: Annals of the Rheumatic Diseases, May 2004.

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U.S. Sees Sharp Drop in Food Poisoning

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- The U.S. government on Thursday reported substantial declines in the incidence of important food-borne infections since 1996 and, more dramatically, between 2002 and 2003.

Perhaps most significantly, the number of infections from Escherichia coli 0157:H7, which can be fatal, dropped 36 percent between 2002 and 2003. Since 1996, the overall incidence of infection from this pathogen has gone down 42 percent.

Infections from other sources including Campylobacter, Cryptosporidium parvum, Salmonella, and Yersinia enterocolitica also declined.

"The decline in E. coli is very promising, although it is too soon to know if it will be a sustained decrease," Dr. Robert Tauxe, chief of the U.S. Centers for Disease Control and Prevention's Foodborne and Diarrheal Diseases Branch, said at a news conference. "We have seen much year-to-year variation in this organism's infection patterns, but the decline we observed between 2002 and 2003 was statistically significant for the first time."

"We are showing real progress toward meeting our Healthy People 2010 goals," added Janice Oliver, deputy director of the U.S. Food and Drug Administration's Center for Food Safety and Applied Nutrition. "While the numbers show a decrease, we need a further reduction."

Food-borne pathogens are responsible for an estimated 76 million illnesses annually in the United States, resulting in 323,000 hospitalizations and 5,000 deaths, Tauxe said.

In 1996, the CDC, the FDA, and the U.S. Department of Agriculture set up Foodnet, a surveillance network, to monitor the incidence of these illnesses. Foodnet now operates out of nine sites and monitors about 14 percent of the American population -- 41.5 million people.

The latest data from Foodnet, which appears in the April 30 issue of the CDC publication Morbidity and Mortality Weekly Report, find that, since 1996, Campylobacter infections have dropped 28 percent and Salmonella infections have gone down 17 percent.

At the same time, Yersinia infections have decreased 49 percent, and Cryptosporidium infections have fallen 51 percent.

The incidence of Listeria did not decline in 2003, although it had decreased over the previous four years. Similarly, the incidence of Salmonella enteritidis has not changed significantly since 1996.

Experts attribute the declines to several different factors. "There have been efforts to educate consumers, efforts to improve the safety of [food] processing all along the way, and more and more efforts that are focused on what happens in the actual farm or field," Tauxe said.

The new report pointed specifically to the Pathogen Reduction/Hazard Analysis and Critical Control Point (HACCP) systems implemented by the government in 1997 in the meat and poultry slaughter and processing plants. The 2003 decline of human E. coli 0157:H7 infections, the article stated, followed a notice sent to manufacturers of raw ground beef products to reevaluate their HACCP plans.

Elsa Murano, under secretary for food safety at the USDA, reported that regulatory samples collected from meat and poultry plants showed a reduction in contamination. For instance, 0.86 percent of products were contaminated with E. coli in 2000, compared with 0.78 percent in 2002 and 0.3 percent in 2003.

In 2000, 5.3 percent of samples were positive for Salmonella, compared with 3.8 percent in 2003. "These decreases in regulatory sample data match the decrease that we have seen reported by the CDC," Murano said.

Unfortunately, children continue to bear the brunt of food-borne illnesses, Tauxe said.

For instance, 12 percent of Salmonella cases occur in children younger than 1 year old, and 19 percent occur in children 1 to 4 years old. For Yersinia, 33 percent of cases occur in children under 1, and 19 percent in children 1 to 4 years old, the CDC said.

"It's too early to declare victory. More time is needed to know whether this is going to be sustained," Tauxe added. "That said, I think the overall trends for these important infections suggest that efforts by industry, efforts by individuals, and certainly efforts in every arena seem to have us headed in the right direction."

More information

For more on foodborne illnesses and how to avoid them, visit the Virginia Department of Agriculture and Consumer Services or the Foodborne Illness Education Information Center, which is co-run by the FDA and the USDA.

Sources: April 29, 2004, press conference with Robert Tauxe, M.D., chief, Foodborne and Diarrheal Diseases Branch, U.S. Centers for Disease Control and Prevention, Atlanta; Janice Oliver, deputy director, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Rockville, Md.; Elsa Murano, Ph.D., under secretary for food safety, U.S. Department of Agriculture, Washington, D.C.; April 30, 2004, Morbidity and Mortality Weekly Report

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Biomarkers May Predict Diabetes in Women

 

Reuters Health

Thursday, April 29, 2004

NEW YORK (Reuters Health) - Elevated levels of biomarkers that reflect abnormal functioning of cells that line blood vessels and the heart (endothelial dysfunction) may help doctors identify women who are at increased risk of developing type 2 diabetes, according to a new study.

These findings provide new evidence for the hypothesis that endothelial dysfunction precedes cardiovascular diseases and type 2 diabetes, Dr. James B. Meigs told Reuters Health.

Meigs of the Massachusetts General Hospital in Boston and colleagues point out that endothelial dysfunction is seen in diabetics, but may also precede development of the condition. Identification of endothelial dysfunction as a type 2 diabetes precursor, they note, "might expand options for diabetes prevention and treatment."

The researchers evaluated a subgroup of 737 women, who were enrolled in a larger ongoing study. The subjects were initially free of diabetes, cardiovascular disease and cancer, but eventually developed diabetes. These women were compared with 785 control subjects.

At the beginning of the study, levels of biomarkers of endothelial dysfunction--namely E-selectin, adhesion molecule 1 and vascular adhesion molecule 1--were significantly higher in cases than controls.

After adjusting for factors such as body mass index and smoking, those with the highest levels of E-selectin had a risk of diabetes 5.43 times that of those with the lowest levels. Higher levels of the other two biomarkers also correlated with increased diabetes risk.

Endothelial dysfunction appears to predict the development of type 2 diabetes in women independent of other known risk factors, the researchers report in the Journal of the American Medical Association (news - web sites).

"If this hypothesis is supported by additional studies," Meigs added, "endothelial dysfunction may be the fundamental abnormality underlying the insulin resistance syndrome. Thus, therapies which improve endothelial dysfunction may prove to play an important role in the treatment of insulin resistance and type 2 diabetes."

Source: Journal of the American Medical Association, April 28, 2004.

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New Liver Cancer Treatment Targets Tumors

 

By Robert Preidt

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- A new interventional radiology treatment for liver cancer that delivers radiation directly to the tumor is safe even in patients with compromised liver blood flow.

That's the conclusion of a study in the April issue of the Journal of Vascular and Interventional Radiology.

The radiation is delivered using a technique called embolization, a well-established procedure designed to block a tumor's blood supply, causing the tumor to shrink.

When performing embolization, an interventional radiologist inserts a catheter into the fermoral artery through a tiny incision in the groin. The catheter is guided through the artery to its target.

Through the catheter, tiny particles called microspheres (about the size of grains of sand) are released into the blood vessels feeding the liver tumor. The microspheres block the flow of blood to the tumor.

This new treatment combines a radioactive isotope into the microspheres. These isotope-loaded microspheres move to the tumor, without bothering to cause much blockage of blood flow, and deliver the isotopes directly to the tumor.

This in-patient procedure allows for a higher, local dose of radiation to be used on liver tumors without exposing healthy tissues to radiation, the study found.

"This interventional radiology treatment is a particularly elegant way to give patients a cancer treatment that doesn't harm the healthy cells. So they don't feel sick or have many of the side effects that happen with standard cancer treatments," study author Dr. Riad Salem, an interventional radiologist at Northwestern Memorial Hospital in Chicago, said in a prepared statement.

His study included 15 patients who received a total of 29 treatments using this new technique.

More information

The American Cancer Society has more about liver cancer.

Source: Society of Interventional Radiology, news release, April 2004

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Report Predicts Asthma Epidemic from Pollution

 

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, April 29, 2004

WASHINGTON (Reuters) - Poor and minority children are likely to develop asthma at worsening rates due to global warming and air pollution, environment experts predicted on Thursday.

They released a report showing that as the climate gets warmer, allergens such as pollen and mold will flood the air, interacting with urban pollutants such as ozone and soot to fuel an already growing epidemic of asthma.

"It is affecting the trees, the molds, the subsurface organisms," Dr. Paul Epstein of Harvard Medical School (news - web sites)'s Center for Health and the Global Environment, told a news conference.

"The combination of air pollutants, aeroallergens, heat waves and unhealthy air masses -- increasingly associated with a changing climate -- causes damage to the respiratory systems, particularly growing children, and these impacts disproportionately affect poor and minority groups in the inner cities," the report reads.

The report finds that asthma among U.S. preschool children, age 3 to 5, grew 160 percent between 1980 to 1994.

"This is a real wake-up call for people who think global warming is only going to be a problem way off in the future or that it has no impact on their lives in a meaningful way," said Christine Rogers, a senior research scientist at the Harvard School of Public Health.

"The problem is here today for these children and it is only going to get worse."

Rogers, Epstein and the American Public Health Association (news - web sites) worked together on the report.

Most climate experts agree that the world is becoming steadily warmer, and that human activity is much to blame. Burning fossil fuels such as coal and gas releases carbon dioxide into the air.

Invisible Blanket

The carbon dioxide forms a kind of invisible blanket that traps the sun's radiation.

While average temperatures warm, the effects are not predictable and even. Storms may become more severe and some areas may get colder weather.

The report finds that in some regions, winter is ending weeks earlier than before, and plants are releasing their pollen earlier than ever, accelerating the hay fever season.

Pollen and fungal spores can worsen asthma, a serious medical condition whose symptoms include shortness of breath, cough, wheezing, chest pain or tightness.

The Centers for Disease Control and Prevention (news - web sites) said nine million U.S. children have been diagnosed with asthma and more than 4 million have had an asthma attack in the past 12 months. It says 4,487 people died from asthma in 2000, most of them adults.

Asthma affects blacks more than any other group and affects 16 percent of children from poor families as opposed to 11 percent of children living above the poverty line.

The CDC also says 9 million U.S. children were reported with respiratory allergies in 2002.

The report makes clear links among asthma, allergies and urban air pollution.

"Rising levels of carbon dioxide, in addition to trapping more heat, promote pollen production in plants, increase fungal growth and alter species composition in plant communities by favoring opportunistic weeds like ragweed and poison ivy," the report reads.

"Diesel particulates help deliver and present pollen and mold allergens to the immune system in the lungs," it adds.

"The good news is we can do something about this," Epstein said. "Green" buildings with roof gardens to keep them cool and insulation to keep heat from leaking would help, as would improving public transport and encouraging the use of hybrid vehicles that rely less on fossil fuels.

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Lethal Genetic Heart Defect Found

 

By Robert Preidt

HealthDayNews

Thursday, April 29, 2004

THURSDAY, April 29 (HealthDayNews) -- Researchers have identified a genetic "time bomb" that eventually leads to heart failure in some people with congenital heart disease even after they've had corrective surgery.

The study found surgery on people with familial forms of congenital heart disease called atrial septal defects may not correct the underlying molecular problem that causes progressive heart failure and sudden death later in life.

In research with mice and humans, University of California, San Diego scientists found that defects in the gene Nkx2-5, which plays a critical role in embryonic heart formation, continue to cause trouble by degrading the heart's electrical wiring and by encouraging excessive overgrowth of heart tissue.

The study appears in the April 30 issue of Cell. The researchers say their findings may also apply to other forms of congenital heart disease.

Congenital heart defects are structural problems that are present at birth. They're the most common kind of birth defect in newborns.

Babies with atrial septal defects have a hole between the heart's two upper chambers. Surgery to close the hole is the most common treatment.

"If a child is born with a hole in the heart, it can be patched," study author Dr. Kenneth Chien said in a prepared statement.

"However, as these patients survive, it is now clear that there is an intrinsic, progressive problem with the heart that makes them get late-stage heart failure and, in certain cases, sudden death due to electrical problems," said Chien, a professor of medicine and director of the Institute of Molecular Medicine at UCSD.

More information

The American College of Cardiology has more about congenital heart disease.

Source: University of California, San Diego, news release, April 29, 2004

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Military Service May Raise Risk of ALS

By Martha Kerr

Reuters Health

Thursday, April 29, 2004

SAN FRANCISCO (Reuters Health) - People who've served in the military have a 60- percent higher risk of developing amyotrophic lateral sclerosis (ALS), or "Lou Gehrig's disease (news - web sites)," than people without a military history, Harvard researchers announced here during the annual meeting of the American Academy of Neurology (news - web sites).

Using data from the American Cancer Society (news - web sites)'s Cancer Prevention Study II, Dr. Marc Weisskopf and colleagues used death certificates to determine cause of death in 268,258 veterans and 126,414 non-veterans. The investigators adjusted for risk factors for death other than ALS, including smoking and age.

Although veterans had an elevated risk of ALS compared with non-veterans, "the overall risk of ALS is still very low," Weisskopf stressed. "We can't say that serving in the military in itself is the cause. But there is the suggestion that periods of conflict increase risk."

He pointed out that all of the veterans in this study served before the Gulf War (news - web sites).

"The real advance here is that it opens up the field of research. We now have to look for other factors that might contribute (to increased ALS risk)," he told Reuters Health. These might include factors such as age, family history, lead exposure, viral infections, or extreme physical exertion.

The highest risk of ALS was seen with service in the Coast Guard followed by service in the Navy. However, Weisskopf cautioned that the number of subjects who served in the Coast Guard was very small so the risk estimate may not be reliable.

Interestingly, service in the Marines was actually associated with a decreased risk of ALS. "We need to look at what increases risk (in some branches of service) and maybe look at what the Marines are doing right," Weisskopf commented.

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Spinach May Offer Blindness Treatment

HealthDayNews

Thursday, April 29, 2004

Researchers at Oak Ridge National Laboratories in Tennessee are hoping to come up with a garden-variety treatment for blindness: spinach.

New Scientist reports that the researchers plan to add light-absorbing pigments from spinach to nerve cells in the retina. The hope is that the nerve cells fire when hit by light.

A team led by Eli Greenbaum has shown that adding plant pigments to human cells makes the cells respond to light. Even if successful, however, the experiment would only partly restore vision, and subjects would be color-blind.

Greenbaum told New Scientist, however, that it could provide far better resolution than the electronic retinal implants being developed. Retinal implants are offered to people suffering from degenerative eye diseases like retinitis pigmentosa.

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Paramedics Accurately Assess Stroke Symptoms

 

Reuters Health

Thursday, April 29, 2004

NEW YORK (Reuters Health) - By assessing speech disturbance and weakness in the face and arms, paramedics can quickly and accurately identify patients likely to be having a stroke, British investigators report.

"The main purpose of the FAST (Face Arm Speech Test) is to rapidly recognize stroke to ensure that patients are fast-tracked to be imaged and assessed by an expert stroke team as soon as possible," senior investigator Dr. Gary A. Ford said in a press statement.

But until now, there have been no studies comparing paramedics' findings with those of neurologists in routine clinical situations, Ford and his associates note in their article in the online issue of Stroke: Journal of the American Heart Association (news - web sites).

The team, based at Royal Bournemouth and Christchurch Hospital in Dorset, therefore compared findings between paramedics and stroke physicians regarding 278 suspected stroke patients transported by ambulance. Stroke was confirmed in 189 patients.

The paramedics reported arm weakness in 96 percent of patients with stroke, facial weakness in 68 percent, and speech problems in 79 percent.

When a neurologist examined the same patients several hours later, they nearly always agreed with the arm weakness finding, usually agreed with the speech disturbance finding, and often agreed with the facial weakness finding.

Moreover, it's likely that the rates of agreement would have been even higher if the neurologists had seen the patients at the same time as the paramedics instead of a day or so later, the authors note.

They believe that "the FAST assessment may be sufficiently reliable to use as a stroke diagnostic instrument for prehospital diagnosis, including the potential involvement of ambulance paramedics in drug administration in" trial settings.

Source: Stroke, April 29th online issue, 2004.

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Dental Headaches

HealthDayNews

Thursday, April 29, 2004

(HealthDayNews) -- One in eight Americans suffers from headaches, according to the U.S. Army Medical Department. While diet, stress and fatigue can be leading causes, a poorly aligned bite or missing teeth can also lead to frequent headaches.

Signs that your mouth may be causing your headaches include:

If you suffer from frequent headaches and have these symptoms, speak to your dentist. The problem may be easy to treat.

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Study: Siblings, Pets, Farms Help Stop Allergies

 

Reuters

Thursday, April 29, 2004

LONDON (Reuters) - Having siblings, pets and living on a farm reduces the risk of allergic illnesses in babies but having early infections increases it, Danish researchers said Friday.

Sterile, modern environments have been blamed for the increase in asthma, dermatitis and other allergic diseases over the past century because the immune systems of babies are simply not exposed to many microbes.

Scientists also thought that early infections would have a protective effect against allergies but Christine Stabell Benn, of the Danish Epidemiological Science Center in Copenhagen, found they increase the risk of developing allergies.

"We found that having older siblings protects against allergic diseases but it is not by means of transferring infectious diseases because those diseases are actually associated with an increased risk of disease in the child," Stabell Benn said in an interview.

"With each infection the risk (of an allergic illness) increases."

The human immune system developed to deal with many different microbes. Scientists believe that when it doesn't encounter them early in life, it overreacts later and allergic diseases develop.

Pets, living on a farm, attending day care and having older siblings increase a baby's exposure to microbes.

Benn and her team interviewed 24,000 women during pregnancy and when their children were six and 18 months old. Their findings are reported online by the British Medical Journal.

About 10 percent of the children suffered from dermatitis at 18 months old. The researchers found that the risk of allergic illness increased with each infectious disease the child suffered before six months old, but it decreased if the child had three or more siblings, attended day care or lived on a farm or with pets.

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Wednesday, April 28, 2004

 

School Takes Aggressive Swipe at Obesity

 

By Noreen Gillespie

Associated Press Writer

The Associated Press

Wednesday, April 28, 2004

NEW HAVEN, Conn. - At Nathan Hale School, candy bars are confiscated. Bake sales are frowned upon. The vending machines don't carry soda — only water, milk, or juice.

This is a "junk food-free school," an early phase of a districtwide initiative to fight childhood obesity. It's where third-graders have salads if they don't like the main course, and where seventh-grade girls take Pilates after school.

Nationwide, many schools are reconsidering their vending machine offerings and changing their lunchroom food lineup. But New Haven, an urban district on Connecticut's shoreline, is particularly committed.

"There isn't a candy bar in this school," says principal Kim Johnsky as she surveys the maze of lunch tables.

Nathan Hale, a K-8 school, is the first to go completely junk-free. Next fall, all schools will get a touch of the healthy treatment as the program expands.

Vending machine choices will be overhauled: baked chips will replace fried, granola will replace cookies. Cafeterias in elementary and middle schools have already rolled out baked versions of things like chicken nuggets and french fries, and fried foods will be gradually phased out of high schools, too.

The program doesn't stop in the cafeteria.

The district has started cooking classes for parents and infuses regular science classes with nutrition lessons. Building renovations include designs for larger gyms to encourage physical activity.

Even the bake sale, a traditional source of fund-raising for classes and parent organizations, is being discouraged in favor of plant sales and penny drives.

District Superintendent Reginald Mayo vows to lose 30 pounds by doing the same things he's trying to teach his students. (Up 2 pounds after three weeks on a diet, he admitted he wasn't off to a great start, though.)

"I'm going to look pretty hypocritical if I'm talking about healthy eating to kids and parents, and I'm walking around at 217 pounds," he said.

In New Haven, an urban district on Connecticut's shoreline, the poverty rate is so high the system has a universal free lunch program. The district doesn't have hard data on how many students are obese, but officials say a significant number of its 20,400 students have diabetes.

Nationally, about 15 percent of children and adolescents between the ages 6 and 19 are obese, according to government figures.

Dr. Stephen Updegrove, a medical adviser for New Haven Schools and one of the primary architects of the district's policy, said one goal is to create a "ripple effect" from the school to community.

But the program has met some resistance, particularly among school officials who fear that the program will trade healthy budgets for healthy eating.

The junk food- and soda-stocked vending machines pull in up to $10,000 in extra income for some of the high schools each year, and some schools fear income won't be as high with healthier snack options.

"That's considerable, considerable dollars," said Mayo, who is looking for ways to make up the lost revenue.

Schools across the country have made similar moves. Next year, six schools in other Connecticut cities will test a junk food-free vending project with the help of a federal grant.

"We can't guarantee they won't lose money," said Susan Fiore, a nutrition specialist with the state Department of Education (news - web sites). "But maybe the payoff is worth it. There's a lot of research out there that kids who eat better learn better, and that's a pretty easy sell."

A separate program will work with 10 local school systems to create nutrition policies. For example, teachers start rewarding students with something other than candy, and birthday parties might mean extra recess instead of cupcakes, Fiore said.

"It's slow," she said. "There's a lot of ingrained things that take time to change. You talk about not having cupcakes at birthday parties, and people freak out."

Schools that develop nutrition programs, however, are in uncharted territory. There is little research on their effectiveness.

Dr. David McCarron, president of Portland, Ore.-based Academic Network and a specialist in childhood obesity, has been conducting a survey of school programs across the nation.

"There's a desire in the school districts that are trying to do the right thing," he said. "The problem is, I don't think we have a handle on what the right thing is. Very few of these efforts have ever had measured outcomes, so we don't know if these things are going to make a difference."

New Haven officials say their program has already created some results. In the parents' cooking class, some of the participants have started to lose weight, said Jene Flores, a family educator in the district.

Meanwhile, in the cafeteria at Nathan Hale, the new lunches are getting mixed reviews.

Angela Cable, a 9-year-old with glasses and a long brown ponytail, is just fine with the salad option.

"I'm not a vegetarian, but I don't eat a lot of meat," she explained.

Stephanie Aurora, a seventh-grader with blue-and-white manicured fingernails, is more blunt. She wants soda, and doesn't like the tuna fish that is on her salad.

The new food choices aren't her favorite, "but they're OK," she says.

On the Net:

www.shapingamericasyouth.com

http://www.nhps.net/

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Marriage Patterns Make Deafness More Common in US

 

Reuters

Wednesday, April 28, 2004

WASHINGTON (Reuters) - The findings from a computer simulation indicate that a high rate of marriage between deaf people may have caused a doubling of rates of genetic deafness seen in the past 200 years, which has coincided with the development of a coordinated system of sign language, U.S. researchers reported on Tuesday.

Marriages among the hearing impaired started to increase about 1800 after the first schools to teach sign language were opened, improving the social and economic status of the deaf and allowing them to communicate more easily.

Many deaf people prefer to marry other deaf people and prefer also to have deaf children.

"In the United States, at least 85 percent of individuals with profound deafness marry another deaf person," said Dr. Walter Nance, a professor of human genetics at Virginia Commonwealth University who led the study.

"Because we now know that more than 100 different genes are responsible for deafness, most deaf parents have children with normal hearing because they pass different genes to their offspring," he added in a statement.

But writing in the June issue of the American Journal of Human Genetics, Nance and colleagues noted that intermarriage could eventually cause a variation of a gene called connexin, which causes deafness, to become more common.

"In the case of marriages among couples who both have the same form of recessive deafness, all their children will be deaf and capable themselves of also passing on the altered gene to their offspring," Nance said.

In addition, as much as 3.5 percent of the entire population of the United States may carry single mutations involving the connexin gene, making it one of the most commonly recognized single gene defects, he said.

The findings may help shed light on how humans acquired language--spoken and otherwise, Nance said.

"When you think about how the onset of selective marriages among deaf populations led to an increase in specific mutations for deafness, you easily can see how these same forces might have contributed to the spread of genes for speech among Homo sapiens 160,000 years ago," Nance said.

"If you were one of the first primates with an ability to communicate by speaking," he said, "wouldn't you want to select a partner who could whisper sweet nothings in your ear?"

Source: American Journal Human Genetics, June 2004.

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Artery Thickening Found in Obese Children

 

The Associated Press

Wednesday, April 28, 2004

SYDNEY, Australia - New research shows obese children as young as 10-years-old have arteries resembling heavy smokers and face the prospect of coronary disease in early middle age.

Using ultrasounds to monitor children's blood vessels, doctors from Hong Kong and Sydney's Royal Prince Alfred Hospital found some of the children's arteries had thickened to look like those of adult smokers.

"It means these children are at risk of heart attack or stroke in their 40s or 50s, rather than their 70s or 80s. This has terrible implications for later in life," said Royal Prince Alfred Hospital cardiologist David Celemajer.

Even flabby children were at risk, Celemajer said Tuesday. The research will be published in next month's issue of "International Journal of Obesity."

RPA director Kate Steinbeck said a study has found that with a healthy low-fat diet and sustained exercise over one year, the children's blood vessels returned to normal.

About 60 percent of Australian adults are overweight, and Steinbeck said children were increasingly starting preschool "significantly overweight."

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FDA Finds Possible New Risks of Bowel Drug  

 

The Associated Press

Wednesday, April 28, 2004

WASHINGTON - Some users of the irritable-bowel treatment Zelnorm have suffered diarrhea so serious they require hospitalization, and four have died from an intestinal problem, the government said Wednesday.

The Food and Drug Administration (news - web sites) stressed that it has not proved a link between the intestinal condition, called ischemic colitis, and the drug.

But the agency ordered that a precaution about the intestinal condition go on Zelnorm's label, along with a larger warning about severe diarrhea.

Irritable bowel syndrome is a mysterious disorder that gives millions of people, mostly women, abdominal pain and either severe diarrhea or constipation or both. Zelnorm is the only FDA-approved therapy for the constipation-causing form of the ailment. It is supposed to be used only by women.

The drug speeds the colon's movement of stools, so diarrhea is a potential side effect. But the FDA has 21 reports of diarrhea so severe that it caused such complications as low blood pressure and fainting. Sixteen patients required hospitalization, said the FDA's Dr. Robert Justice.

Zelnorm should not be used by anyone who frequently experiences diarrhea, and should be stopped immediately if patients get dizzy or faint, the FDA said.

As for the intestinal inflammation, there were no cases of ischemic colitis in studies of 7,000 Zelnorm patients. But since Zelnorm went on sale in 2002, the FDA has received 20 reports of ischemic colitis, plus three reports of a similar intestinal problem, Justice said. Fourteen patients were hospitalized. Four died, although they had numerous other serious medical conditions, he said.

The FDA advised patients who experience new or worsened abdominal pain or blood in their stools — ischemic colitis symptoms — to stop taking the drug and call a doctor.

In a statement Wednesday, officials with Novartis Pharmaceuticals in New Jersey stressed that "no causal link between the administration of Zelnorm and ischemic colitis has been established." Novartis added that reports of serious consequences of diarrhea and ischemic colitis have been rare.

The company said it is working closely with FDA to revise prescribing information for Zelnorm.

Several years ago, cases of ischemic colitis derailed sales of a drug, Lotronex, that treats diarrhea-predominant IBS.

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N.Y. College Spearheading Epilepsy Study

 

The Associated Press

Wednesday, April 28, 2004

ROCHESTER, N.Y. - The University of Rochester Medical Center is taking part in a $30 million nationwide epilepsy study, one of the largest in recent years.

The study, taking place at 19 universities, is funded through the National Institutes of Health (news - web sites). Researchers hope to determine whether brain surgery or medication is preferable for treating mesial temporal lobe epilepsy, one of the most common forms of the disease.

The study will examine 200 people nationwide. Strong Memorial Hospital hopes to recruit 10 to 20 participants to follow for more than two years. The study will look at patients between the ages of 12 and 70 who have been diagnosed in the last two years.

Half of the people will receive new drug treatments, and the other half will have the surgery. Strong has three patients lined up so far.

About one percent of the U.S. population has epilepsy. Two out of three patients respond to medication, but others try several medications with no success.

Brain surgery is successful in 70 to 95 percent of cases, but is typically not favored because it involves removing a ping-pong-ball sized portion of the brain.

In mesial temporal lobe epilepsy, people might stare or tune out during a seizure and cannot remember what happened afterward. The frequency of such seizures varies from several times a day to just once every few months.

Information from: Rochester Democrat and Chronicle, http://www.democratandchronicle.com

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Treatments for Prostate Cancer Produce Similar Results

 

By Robert Preidt

HealthDayNews

Wednesday, April 28, 2004  

WEDNESDAY, April 28 (HealthDayNews) -- Three leading prostate cancer treatments -- radical prostatectomy, external beam radiation therapy and brachytherapy -- all have similar outcomes, says a study in the April issue of Radiotherapy and Oncology.

The seven-year study included more than 1,800 men with early stage prostate cancer treated at the Cleveland Clinic Foundation and the Memorial Sloan-Kettering Cancer Center in New York City.

Of those patients, 746 had radical prostatectomy, 340 had external beam radiation therapy, and 732 had brachytherapy, in which radioactive seeds are implanted into the prostate. The study found all three treatments had statistically similar outcomes at seven years.

"This study is important because we have not seen much side-by-side randomized data for patients with clinically localized prostate cancer, who are treated with only one therapy," study author Dr. Louis Potters, director of the New York Prostate Institute, said in a prepared statement.

"The fact that the study was unencumbered by mixing treatments, and that there was sufficient follow-up in each study group, strengthens the power of the results," Potters said.

More information

The American Cancer Society has more about prostate cancer.

Source: New York Prostate Institute, news release, April 2004.

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Distracted Young Women May Need More Iron

 

By Dan Lewerenz

Associated Press Writer

The Associated Press

Wednesday, April 28, 2004

STATE COLLEGE, Pa. - Young women who have trouble concentrating might just need more iron in their diets, researchers say.

Women in the Penn State study who were iron-deficient performed significantly worse on memory and attention tests than healthy women, and an iron supplement was all it took to correct the problem.

"We were able to bring it right back to normal, back to the level of the iron-sufficient women," said Laura Murray-Kolb, a Penn State nutritional researcher.

Iron, an oxygen-carrying component of blood, is especially important for women, whose bodies absorb less iron than men and lose it more frequently because of blood loss during menstruation.

Doctors have long known that anemia brought on by iron deficiency can cause fatigue, irritability and difficulty concentrating. But most research on less-severe iron deficiency has been limited to children, said Lisa Ritchie, director of the dietetics program at Harding University in Searcy, Ark.

The study, presented last week at an American Society of Nutritional Sciences conference, found that women ages 18 to 35 suffered many of the same effects from iron deficiency.

The women were given several computerized tests to gauge attention and memory. Women who were anemic were both slower and less accurate than healthy women. Women who were iron-deficient but not anemic completed the tests as quickly as healthy women but were significantly less accurate.

Women who did poorly in the initial tests performed as well as the others after they increased their iron intake.

Scientists said younger women may be particularly at risk for iron deficiency because of their diet. Red meat is loaded with easily absorbable iron; fruits and vegetables not only have less iron, the iron they have is not easily absorbed.

Fully 20 percent of the women in the Penn State study — many of them university students — were either iron-deficient or anemic.

"Taking a look at the typical college student, they may be financially strapped, so buying a lot of iron-rich foods may not be their top priority, especially for females," Ritchie said.

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One-Quarter of Poor NYC Toddlers Are Overweight

 

By Alison McCook

Reuters Health

Wednesday, April 28, 2004

NEW YORK (Reuters Health) - Some 22 percent of 2- to 4-year olds participating in a New York City nutrition program are overweight, and another 18 percent are dangerously close to becoming so, new research shows.

"Even these very young children are already overweight," study author Dr. Mary Ann Chiasson told Reuters Health.

These findings suggest that intervention programs designed to ward off weight gain in kids should start early, she noted. "Waiting until children start school may be too late," said the researcher, who is based at the Medical and Health Research Association of New York City.

All of the children were enrolled in the New York City Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a branch of the federal nutrition program for poor families.

According to the report, published in the American Journal of Public Health, 45 percent of U.S. children are served by WIC at some point in their lives. Nationwide, more than 3 million children between the ages of 1 and 4 participate in the program each month.

During the study, Chiasson and her team asked 1255 families to complete a questionnaire about family diet, background and exercise habits. They also calculated 557 children's body mass index (BMI), which factors height into a person's weight.

The researchers found that 22 percent of the children were overweight, meaning they had BMIs in or above the 95th percentile for their gender and age. Another 18 percent had BMIs that fell between the 85th and 95th percentile, indicating they were at risk of becoming overweight. Only 5 percent of children were underweight, meaning their BMIs fell below the 5th percentile.

Latino children were more than two times as likely to be overweight as other children, according to the American Journal of Public Health report. In addition, 3- and 4-year olds were 36 percent more likely than 2-year olds to be overweight or at risk of becoming so.

According to the nutrition surveys, 73 percent of children drank whole milk, and around 44 percent ate fruits or vegetables less than once per day.

In an interview, Chiasson explained that while many people may associate poverty with not having enough food, poverty really means eating only inexpensive foods, which are often unhealthy. For instance, fresh fruits and vegetables are very expensive, she said.

"I think it is much harder to eat healthier foods when you're low-income," she noted.

Chiasson added that she hopes these results inspire researchers to conduct further studies into what young kids are eating and drinking and what steps are needed to help them ward off excess pounds.

"There are minimal interventions that can be done to really help kids," she said.

Source: American Journal of Public Health, March 2004.

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N.H. Schools Serving 'Bunless' Burgers

The Associated Press

Wednesday, April 28, 2004

DOVER, N.H. - The Dover school system will be serving hot lunch without the buns for hot dogs, hamburgers or chicken patties.

"There are too many servings for little kids," food service administrator Mark Covell said. "We are cutting out the roll and just giving them the protein. I've found students are eating more of their lunch and aren't getting filled up on carbohydrates."

Covell removed french fries from all school cafeterias in January, and replaced potato chips and candy bars in the high school vending machines with baked chips and granola bars.

He also has started using whole wheat bread on grilled cheese sandwiches instead of white for increased fiber. Although he had some complaints at first, students have gotten used to the change.

"Everyone is pleased with the steps we've taken this year especially with childhood obesity in the news," he said. "We need to look at the big picture."

Covell, other food service professionals and Dover school nurses are gearing up for a nutritional makeover.

The nurses are starting a three-year program called "Changing the Scene," at Woodman Park School that includes a kit on how to educate the community on healthy eating habits and exercise.

Food service professionals also are hoping to change fund-raisers so students sell non-food items like candles rather than brownies, cakes, pies or candy bars to raise money.

Woodman Park School nurse Claudia Lynch said she hopes to start a walking club during recesses, hang nutritional posters throughout the school and give students more choice in the lunch line. Nurses already have talked with the food service staff about a bagel bar with different topping options.

She said only 2 percent of students are meeting the recommended servings from the five food groups. Nineteen percent of New Hampshire third-grade girls and 23 percent of third-grade boys are considered obese.

Lynch said parents also should get involved at home.

"We can start to teach the basics, but we also have to set an example for kids," she said. "We want to make it fun enough so they don't know they are learning. When they go home at night they can share the nutrition lessons."

Information from: Foster's Daily Democrat, http://www.fosters.com

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Tuesday, April 27, 2004

 

Prozac Affects Babies, Sexual Function, Report Says

 

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, April 27, 2004

WASHINGTON (Reuters) - One of the most popular antidepressants, best known by the brand name Prozac, can affect the development of babies when pregnant women take the drug, according to a government report released on Tuesday.

Normal doses can cause babies to be born lighter and sleepier than normal, or make them jittery or cause respiratory problems, the panel appointed by the National Toxicology Program said.

"These effects appear to result more readily from in utero exposure late in gestation," the report, issued for public comment, reads.

The report is a summary from a working group of experts who studied dozens of medical studies using the drug, known generically as fluoxetine.

"The observed toxicity may be reversible, although long-term follow-up studies have not been conducted to look for residual effects," it adds.

"The evidence suggests that developmental toxicity can also occur in the form of shortened gestational duration and reduced birth weight at term."

The experts also noted several reports that found fluoxetine could affect a patient's ability to achieve sexual climax -- both male and female.

It can get into breast milk and is found in the blood of newborns of mothers taking the drug.

The report, available on the Internet at http://cerhr.niehs.nih.gov/news/fluoxetine/fluoxetine_final.pdf ,says fluoxetine is widely used and can now be found in the environment.

"Fluoxetine has been reported in U.S. surface waters, presumably derived from urine and feces of people on therapy," the report reads. One researcher found fluoxetine in bluegill fish.

"The presence of fluoxetine ... in wastewater/groundwater/sediment should be investigated," the report recommends.

But the report noted it could be more dangerous for an expectant or new mother to be seriously depressed.

"Mood disorders are common in women of child-bearing years and it has been estimated that 15.6 percent of women meet criteria for major depression during the third trimester of pregnancy," the report reads.

The panel also said more study was needed to find out how and why antidepressants such as fluoxetine can stimulate production of new brain cells. That could also affect a fetus or newborn baby in unexpected ways, they said.

Prozac is made by Eli Lilly and Co. and is also available in generic form.

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Calif. Schools Still Have Fat on Menus

 

The Associated Press

Tuesday, April 27, 2004

SACRAMENTO, Calif. - A survey of meals offered in public schools found that most met federal guidelines for protein, calcium and vitamins, but only half of the meals met the federal guidelines for fat content, state officials said Friday.

The California Department of Education (news - web sites) conducted the survey over five years at about half of the state's schools.

"For many of our students, a school lunch is the only healthy meal of the day," said Jack O'Connell, the state superintendent of schools. "This survey shows us that while most California schools are doing a good job in providing healthy meals, we can do better."

The federal guidelines call for school lunches to have no more than 30 percent of calories from fat. About 30 percent of schools were close to making that goal, O'Connell said, and had limited their lunches to no more than 35 percent of calories from fat.

Elementary schools scored better than middle or high schools, the survey found.

While some meals didn't make the federal benchmarks, O'Connell said the school lunches are often healthier than other options, such as fast food or prepackaged meals, that children often choose.

"While we need to work on making all school lunches healthy, we also need to encourage more kids to take advantage of school lunch programs," O'Connell said.

Three million California children are eligible for free or reduced-price meals at schools, but only 2 million of them take advantage of the program.

O'Connell urged lawmakers and Gov. Arnold Schwarzenegger (news - web sites) to work toward increasing the number of children enrolled in the school lunch programs.

The superintendent also said he would also work to make more fruits and vegetables available to schools. Earlier this year he established a task force on obesity that brings together educators and health and nutrition experts.

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Some Migraines Raise Stroke Risk, Study Finds

 

Reuters

Tuesday, April 27, 2004

WASHINGTON (Reuters) - Women who get migraines with a characteristic "aura" have a higher risk of stroke than women who do not suffer from this kind of debilitating headache, U.S. researchers reported on Tuesday.

Women who suffer migraines without an aura -- described as a glowing effect around objects as the headache develops -- do not seem to have a higher stroke risk, the researchers said.

The women with aura migraines had a 50 percent increased risk of total stroke and 70 percent higher risk of ischemic stroke -- the kind caused by a blockage, the researchers told a meeting of the American Academy of Neurology (news - web sites) in San Francisco.

Dr. Tobias Kurth of Brigham and Women's Hospital and Harvard Medical School (news - web sites) in Boston and colleagues analyzed the records of 40,000 women in the Women's Health Study, an ongoing trial examining the effects of aspirin and vitamin E on heart disease and cancer.

Stroke is the third leading cause of death in the United States, affecting 700,000 people in 2003 and killing 170,000.

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KFC Reportedly Changing Menu for Health

 

The Associated Press

Tuesday, April 27, 2004

LOUISVILLE, Ky. - The fast food giant that once had the word "Fried" in its name is looking to tout healthier food.

KFC on Tuesday will unveil plans for a menu overhaul as an answer to falling sales and demands for healthier food, USA Today reported.

The former Kentucky Fried Chicken will also sell oven-roasted chicken in boneless strips, in wraps and in salads. The paper said the new menu will be in place May 10.

KFC, a unit of Louisville-based Yum Brands, late last year dropped an ad campaign emphasizing that fried chicken was part of a healthy diet. The ads had prompted a complaint from the Center for Science in the Public Interest filed with the Federal Trade Commission.

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New Pox Vaccine Uses Genes Only

 

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, April 27, 2004

WASHINGTON (Reuters) - A vaccine using just four genes can protect monkeys against monkeypox and, in principle, its much more deadly cousin smallpox, U.S. government researchers said on Tuesday.

The vaccine should be safer than the existing smallpox vaccine, which uses a live relative of the smallpox virus called vaccinia and which can cause serious and sometimes fatal side effects.

"This work represents important progress toward a smallpox vaccine that is as effective as the current product, but safer," said Col. Erik Henchal, commander of the U.S. Army Medical Research Institute of Infectious Diseases in Fort Detrick, Maryland, where the work was done.

Writing in the May issue of the Journal of Virology, the USAMRIID team said they identified four key genes in the vaccinia virus used to make smallpox vaccines.

"Rhesus macaques vaccinated with a DNA vaccine consisting of four vaccinia virus genes were protected from severe disease after an otherwise lethal challenge with monkeypox virus," the researchers wrote.

A vaccine using a single gene saved the monkeys' lives, although they did develop a severe monkeypox infection.

Smallpox was eradicated as a naturally occurring disease in 1979 and general vaccination against it stopped in the United States in 1972. But bioterrorism and security experts fear that some groups may have developed smallpox-based weapons.

The United States has vaccinated 500,000 troops and about 40,000 health and emergency workers against smallpox just in case of attack.

Heath-Threatening Side Effects

But the vaccine is suspected of causing a few cases of heart inflammation and in the past it killed up to two in every 1 million people vaccinated. People with suppressed immune systems, such as the elderly, cancer patients and young children, are most at risk.

And there may be a need to vaccinate people against monkeypox. Monkeypox kills between 1 percent and 10 percent of its human victims in the rain forests of central and western Africa.

An outbreak in the United States last June, traced to imported exotic pets, infected about 30 people.

Virologist Jay Hooper, who led the USAMRIID study, said he would eventually like to test a vaccine using genes from the actual smallpox virus.

His goal would be a vaccine that could protect humans and animals against all three related viruses -- vaccinia, smallpox and monkeypox.

But tests using smallpox, called variola by scientists, are a long way off.

"It is not on track to go into humans right now," Hooper said in a telephone interview.

And to get samples of smallpox virus genes requires permission from the World Health Organization (news - web sites), which controls the two known repositories of smallpox virus in the United States, at the U.S. Centers for Disease Control and Prevention (news - web sites), and Russia.

"People can work with the variola genome. You just can't possess more than a certain percentage of the genome," Hooper said.

Genetically, the three viruses are so similar that it should be possible to find a few genes that will protect against all three viruses in a vaccine.

"It is just a matter of figuring out which genes from which viruses make the best protection," Hooper said.

There is another hurdle -- making it work well.

"The problem with needle-injected DNA vaccines is they haven't worked that well in humans," Hooper said.

Hooper said his work can help scientists understand just how vaccination protects against smallpox. The word vaccine comes from vaccinia and the first vaccine was against smallpox 200 years ago.

But scientists still do not quite understand the body's immune response to the vaccine.

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Vitamin D Use Cuts Risk of Falls in Elderly

 

Reuters Health

Tuesday, April 27, 2004

NEW YORK (Reuters Health) - The findings from a new study suggest that older persons may cut their risk of falls by more than 20 percent by taking vitamin D supplements. Further studies, however, are needed to determine what type of vitamin D works best and at what dose, and to clarify the benefits in men.

Although a few studies have shown a reduced risk of falls with vitamin D use, many others have failed to show a benefit. To better understand whether vitamin D protects against falls, Dr. Heike A. Bischoff-Ferrari, from Harvard Medical School (news - web sites) in Boston, and colleagues analyzed data from ten previous studies that looked at the association in elderly populations.

Five of the studies were included in the main analysis, while the remaining five were used to verify the results, according to the report published in the Journal of the American Medical Association (news - web sites).

In the main analysis, vitamin D users were 22 percent less likely to experience a fall than patients who received inactive "placebo" pills or calcium. The authors estimate that 15 subjects would need to receive daily vitamin D supplements in order to prevent one person from falling.

In the second analysis, the risk reduction seen with vitamin D use fell to 13 percent, but was still statistically significant, the investigators note. Moreover, the protective effects were not dependent on calcium use, duration of therapy, vitamin D type or gender.

Due to limited numbers of subjects, the protective effect observed for vitamin D use in men was not statistically significant, the authors point out.

"The role of calcium and the optimal amount necessary in combination with vitamin D could not be clearly determined," the researchers note.

Source: Journal of the American Medical Association, April 28, 2004.

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Wendy's Testing Low-Carb Menu in 6 Cities

 

The Associated Press

Tuesday, April 27, 2004

DUBLIN, Ohio - Wendy's has started testing the low-carb market by offering "bunless" sandwiches at 248 of the fast-food chain's restaurants in six U.S. cities.

"We're actively exploring new, creative ways to highlight the many options our menu provides," Tom Mueller, president and chief operating officer of Wendy's North America, said Monday.

"By eliminating the bun and substituting a Caesar side salad for french fries, we're creating terrific meal choices for customers watching their carbohydrate intake."

Earlier this month, McDonald's announced it was phasing out super-sizing, and introduced "Go Active" Happy Meals that include a salad, bottled water and a pedometer to measure the distance a person walks.

Burger King started promoting burgers without buns in January, following the lead of smaller chains, Hardee's and Carl's Jr.

Wendy's calls its entry "Meals for Carb Counters." They feature either a cheeseburger or grilled chicken breast on a bed of Romaine lettuce, topped with slices of tomato and red onion; a Caesar side salad; and a medium Diet Coke.

The cheeseburger meal has six grams of carbs, while the grilled chicken meal has eight. Recommended pricing for both will be the same as Wendy's regular combo meals.

Test market locations include Tulsa, Okla.; Virginia Beach, Va.; Salt Lake City; Kansas City and St. Joseph, Mo.; and Wichita, Kan.

On the Net:

Wendy's: http://www.wendys.com

McDonald's: www.mcdonalds.com/usa/eat.html

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Smoke Cuts Anti-Inflammation Protein in Babies

 

Reuters Health

Tuesday, April 27, 2004

NEW YORK (Reuters Health) - Infants exposed to second-hand smoke produce decreased amounts of interleukin-10, an anti-inflammation protein that may protect against asthma and allergies, new research shows.

In the Annals of Allergy, Asthma and Immunology, Dr. Deborah Gentile and colleagues at Allegheny General Hospital, Pittsburgh note that the production of interleukin-10 is diminished in children and adults with asthma and atopy.

They also note that exposure to second-hand smoke is a known risk factor for the development of childhood asthma. They therefore hypothesized that there might be an association between smoke exposure in early childhood and diminished interleukin-10 production.

To investigate, the researchers studied 21 infants who were exposed to second-hand smoke and 16 without such exposure. Blood samples were obtained at 2 weeks, 3 months and 5 months of age.

At the two earlier time points, there was no difference in interleukin-10 levels between the two groups of infants. In the coming months, however, the number of infants with detectable levels of interleukin-10 rose in the unexposed group and fell in the exposed group.

By 5 months, 36 percent of babies in the unexposed group had detectable levels compared with just 7 percent of those in the exposed group.

The researchers conclude that there is an association between second-hand smoke and interleukin-10 production, and they call for larger studies to establish whether this mechanism is involved in the development of asthma and allergy.

Source: Annals of Allergy, Asthma, and Immunology, April 2004.

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Dyslexia May Be More Common in Boys

 

By Linsey Tanner

AP Medical Writer

The Associated Press

Tuesday, April 27, 2004

CHICAGO - Dyslexia really is more common in boys than girls, new research says, contradicting studies suggesting that boys are simply more likely to be diagnosed with the problem because they tend to act up in class when they get frustrated.

The findings suggest boys are at least twice as likely to have dyslexia, a learning disability that involves trouble with reading, said the authors, led by Dr. Michael Rutter of King's College in London. They said the findings should prompt research into why this is so.

Rutter and colleagues based their findings on data from four large studies involving more than 10,000 children who had been given standard reading tests in New Zealand and Britain.

Dyslexia was found in 18 percent to about 22 percent of the boys, compared with 8 percent to 13 percent of the girls. Children took reading tests at various times in each study, between ages 7 and 15.

Rutter and colleagues said the results are strong because the studies did not rely on children who were already known to be having learning difficulties — a weakness that plagued some previous research.

Rutter's report appears in Wednesday's Journal of the American Medical Association (news - web sites).

It is unlikely to settle a debate among learning specialists over the gender issue.

Sheldon Horowitz, director of professional services at the National Center for Learning Disabilities, said boys are not necessarily more likely to have reading problems. Instead, he suggested girls' reading problems may be more likely to go unnoticed by teachers.

"Boys who are sitting in class and not getting it are going to be acting out with greater frequency than girls because that's not 'girl' behavior," Horowitz said.

Girls are more likely to sit quietly and may have verbal skills that make it appear as though they are understanding when they are not, he said.

Of the nearly 3 million U.S. youngsters with learning disabilities, Horowitz said about 80 percent have dyslexia. Children with the disorder have normal intelligence but reading problems that can include difficulties identifying words and letter sounds.

Some data have suggested that male and female brains process reading differently, and girls are believed to become proficient in language skills earlier.

Horowitz said there is strong evidence suggesting there are no significant gender differences when it comes to dyslexia.

Some of the strongest evidence favoring that theory came from Dr. Sally Shaywitz's study of more than 400 Connecticut schoolchildren, published in 1990. The Yale University researcher found that boys were much more likely than girls to be placed in special reading classes, but that there were no substantial differences between the numbers of boys and girls with reading difficulties.

Horowitz said research is needed to determine if there are any sex-linked genes that would explain Rutter's theory.

On the Net:

JAMA: http://jama.ama-assn.org

National Center for Learning Disabilities: http://www.ld.org

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Impact of Anthrax Lingers Year After Attack

 

By Merritt McKinney

Reuters Health

Tuesday, April 27, 2004

NEW YORK (Reuters Health) - People who were infected with anthrax in the fall of 2001 continued to experience physical and mental health problems a year after the bioterrorist attacks, researchers report.

The symptoms did not seem to be directly related to the anthrax exposure but instead reflected the health problems that often occur in people who have gone through a traumatic experience, an official at the Centers for Disease Control and Prevention (news - web sites) (CDC) in Atlanta told Reuters Health.

"These individuals (were) still suffering a year after their infection," said Dr. Dori B. Reissman of the CDC's National Center for Injury Prevention and Control said in an interview.

There was not a "causal link" between anthrax and symptoms, Reissman said. The anthrax victims had symptoms similar to those who have experienced other types of trauma, including hurricanes, tornadoes and violent personal assaults.

The persistence of health problems a year after anthrax exposure demonstrates the importance of providing both physical and mental health care immediately after a traumatic event, according to Reissman.

Because "there isn't a split" between physical and psychological health, we need to "think about integrating systems of care right up front," she said.

In the fall of 2001, there were 22 cases of anthrax in the U.S.--11 by inhalation of anthrax spores and 11 by skin contact with anthrax. Of the 17 survivors, six had inhalational anthrax and 11 had cutaneous anthrax.

About a year after the anthrax attacks, Reissman and her colleagues interviewed 15 of the 16 adult survivors. The researchers also reviewed the medical records of some of the victims.

People who had been exposed to anthrax reported a wide variety of health symptoms, according to a report in Wednesday's issue of the Journal of the American Medical Association (news - web sites). Some of the most common symptoms included chronic cough, shortness of breath, swelling, pain and memory problems.

When the researchers reviewed the medical records of several patients, they could not find explanations for the symptoms.

People who had had inhalational anthrax reported more physical symptoms than those who had experienced cutaneous anthrax.

Anthrax survivors also reported above-average levels of psychological distress. Eight of the survivors had not returned to work since their exposure to anthrax.

The results of the investigation support other studies that have shown that terrorism may cause long-term physical and mental health problems, Reissman and her colleagues conclude.

Coordinating psychiatric and physical care may minimize these problems and improve quality of life, the authors advise.

Source: Journal of the American Medical Association, April 28, 2004.

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Blood Proteins May Be Sign of Diabetes

The Associated Press

Tuesday, April 27, 2004

CHICAGO - Blood proteins suggesting early artery damage might also be early warning signs of diabetes, researchers say.

Diabetics are known to face an increased risk of circulatory problems, artery disease and heart attacks. But this study found possible evidence of artery damage as much as eight years before diabetes was even diagnosed.

The study, which appears in Wednesday's Journal of the American Medical Association (news - web sites), strengthens the evidence linking diabetes with silent inflammation, which also has been associated with heart disease.

The results stem from blood tests given to 32,826 women who participated in a study of U.S. nurses that began in 1976. Whether the findings apply to men, too, is uncertain, the researchers said.

The women provided blood samples in 1989 and 1990; during the next decade, 737 developed diabetes.

The researchers looked for three proteins that when elevated in the blood suggest the presence of irritation or damage to cells lining blood vessel walls: E-selectin, ICAM-1 and VCAM-1.

Women with the highest initial levels of E-selectin were about five times more likely to develop diabetes than women with the lowest levels. Those with the highest ICAM-1 levels faced more than triple the risk of women with the lowest ICAM-1 levels. Elevated VCAM-1 levels were associated with an increased risk in some but not all analyses.

E-selectin is produced by vessel-lining cells, sometimes in response to inflammation, while the two other proteins are produced by those cells and by white blood cells in response to inflammation, said lead author Dr. James Meigs of Harvard Medical School (news - web sites) and Massachusetts General Hospital.

Blood vessel linings are supposed to be slippery to allow blood to flow smoothly. Meigs theorized that in "pre-diabetes," inflammation might hamper this process by irritating or roughening up vessel linings, ultimately leading to high blood sugar levels and diabetes.

The researchers said treatments that improve the functioning of blood vessel walls could prove helpful in slowing "the accelerating worldwide epidemic of type 2 diabetes."

An estimated 18 million Americans have diabetes, mostly adult-onset or Type 2, which increasingly is affecting children, too. In diabetes, the body does not produce or properly use insulin, a hormone that converts sugar and other foods into energy. High blood sugar levels result, which can lead to organ damage, heart disease and blindness.

Tests measuring the three proteins are not routinely available. Meigs said more studies are needed to determine if the substances are better predictors of diabetes than such factors as obesity, blood sugar levels and family history.

Dr. Nathaniel Clark of the American Diabetes Association said even if doctors could routinely measure these biomarkers, their recommendations for people at risk for diabetes probably would not change.

"We need to treat them aggressively, talk about weight reduction" and reducing other cardiovascular risk factors including smoking, he said.

On the Net: http://jama.ama-assn.org

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Monday, April 26, 2004

 

Measles Deaths Drop Worldwide, Still Big Killer

 

Reuters

Monday, April 26, 2004

GENEVA (Reuters) - The number of people, mostly children, killed by measles each year dropped by 30 percent over three years, putting the world on track for a targeted 50 percent fall by 2005, United Nations (news - web sites) agencies said Tuesday.

But the World Health Organization (news - web sites) (WHO) and the U.N.'s Children's Fund (UNICEF (news - web sites)) said more money and continued commitment by government leaders in affected countries was needed to meet the goal.

Although a safe, effective and inexpensive vaccine has been available for the past 40 years, measles remains the leading killer among children of all diseases preventable by vaccines, the agencies said in a statement.

"We have to keep up the work and the funding as still far too many children's lives are lost to measles," said UNICEF Executive Director Carol Bellamy.

The 30 percent fall to 610,000 deaths was achieved between 1999 and 2002, the latest year for which figures are available. Africa registered the strongest improvement with a 35 percent reduction.

In all, 311,000 people died in Africa, 196,000 in southeast Asia and 70,000 in the east Mediterranean area in 2002.

The percentage of children being vaccinated in affected countries remained at around 73 percent, slightly below the recommended 80 percent. The drop in the death rate was largely due to the fact that more children were being routinely re-vaccinated every three to four years.

"Countries have proved that routine immunization and supplemental measles immunization will reduce measles deaths. This is an extremely important step," said WHO chief Lee Jong-wook.

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Gov't to Recommend Gonorrhea Treatment

By Daniel Yee

Associated Press Writer

The Associated Press

Monday, April 26, 2004

ATLANTA - The government is expected to recommend this week that doctors switch to another antibiotic for treating gonorrhea because of an alarming rise in drug-resistant cases of the sexually transmitted disease, top experts said Monday.

The class of antibiotics commonly used to treat gonorrhea, including Cipro, is no longer effective against certain strains of the bacteria, said Dr. Jeffrey Klausner, deputy health officer and director of STD prevention for the San Francisco Department of Public Health (news - web sites).

In place of Cipro, administered as a pill, the Centers for Disease Control and Prevention (news - web sites) is expected to recommend ceftriaxone, which is less convenient because it is injected, Klausner told The Associated Press. Another recommended drug, cefixime, is in pill form but is no longer made in the United States.

CDC spokeswoman Jessica Frickey said the agency plans to announce new recommendations Thursday for treating gonorrhea, but would not give details. Klausner and another health official who worked with the CDC on its new guidelines disclosed them.

Cipro has been used for at least four years to fight gonorrhea.

In some areas, such as in Los Angeles County, Cipro-resistant strains account for asmany as 12 percent of all cases, said Dr. Peter Kerndt, director of the sexually transmitted disease program for the Los Angeles County Public Health Department.

"What's remarkable for us is how quickly it went up from 1 or 2 percent" in 2001, Kerndt said.

In recent years, the government has recommended ceftriaxone for treatment of gonorrhea only in Hawaii and California because of the growing number of Cipro-resistant cases in those states.

Cipro-resistant gonorrhea has apparently spread eastward across the country after first appearing 15 years ago in Southeast Asia. A rash of cases among men in Seattle, Chicago, New York and other areas in recent months prompted the CDC to review its national recommendations for treatment, said Dr. H. Hunter Handsfield, director of the STD control program for Seattle and King County.

In Seattle, health officials have already revised their guidelines, as resistant cases of gonorrhea increased from 3.8 percent to 16.5 percent last year. About 90 percent of the cases were among gay and bisexual men.

The new recommendations may present problems for health officials and patients. Cipro was easy for patients to use and commonly found in doctors' offices. However, ceftriaxone must be injected by a doctor or nurse, and clinics do not have ample supplies, Klausner said.

Cipro became widely known during the anthrax scare in 2001, when it was given to people exposed to the lethal spores. Five people were killed and 17 sickened in the anthrax attacks.

On the Net:

CDC: http://www.cdc.gov

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New Method Gives Cancer Patients Look Ahead –Study

 

Reuters

Monday, April 26, 2004

WASHINGTON (Reuters) - A new way of analyzing a cancer patient's situation could give a personalized look ahead at survival and the chance the cancer will come back, U.S. researchers said on Monday.

The team at Duke University in North Carolina combined genetic and clinical information for its new analysis, which it hopes could help doctors decide just how aggressively to treat someone's cancer.

"Currently, it is primarily traditional clinical information alone that aids in understanding a patient's risk profile," said Mike West, a professor of statistics and decision sciences at Duke who led the study.

"However, the resulting predictions typically lump patients into broad categories. Access to detailed genomic information now provides the opportunity to move far beyond this -- toward customized risk predictions and prognoses more widely, for the individual patient," West added in a statement.

Writing in the Proceedings of the National Academy of Sciences (news - web sites), West and colleagues said they tested their method on 158 breast cancer patients in Taipei, Taiwan.

Clinical information for breast cancer patients includes whether a lymph node near the breast tumor contains cancer cells that have spread and whether the tumor cells respond to the hormone estrogen.

West's team also looked at the "genetic fingerprints" of each patient's tumor -- a pattern of genetic activity for more than 12,000 different genes.

"Every cancer has its own distinct properties," said molecular geneticist Joseph Nevins, who worked on the study. "Our approach allows us to capture characteristic patterns underlying those different disease states and to utilize that information to make informed predictions about a patient's risk of recurrence that can then be applied to make the best treatment decisions."

The study was not big enough to show exactly how accurate the method is, but the researchers believe it has the potential to be about 90 percent accurate.

There are always surprising exceptions, they noted.

One young women had a large tumor that had spread to 10 sites. "She was, by choice, not treated aggressively but, despite her clinical high-risk profile, survived recurrence-free up to a surprising 75 months," the researchers wrote.

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N.C. Spending Millions in Obesity Fight

 

By Steve Hartsoe

Associated Press Writer

The Associated Press

Monday, April 26, 2004

RALEIGH, N.C. - North Carolina is spending more than $10 million to help overweight adults and children in an elusive battle of the bulge.

The trouble is, nobody knows if it will be money well spent. No one — including doctors, the N.C. Health & Wellness Trust Fund Commission and the CDC — has pinned down what convinces people to choose a fit lifestyle.

"If we knew that answer we wouldn't have a problem," says Dr. Robert P. Schwartz, professor of pediatrics at Wake Forest University medical school and a member of the commission, which is spearheading the state campaign.

"It's not information, it's motivation."

A recent report from the federal Centers for Disease Control said 27 percent of North Carolina's high school students are overweight or at risk of becoming overweight. According to the CDC, more than half of North Carolina adults are overweight or obese.

Excess weight brings with it increased risk of heart disease, diabetes and certain cancers. Nationally, obesity could soon overtake smoking as the leading cause of preventable deaths in the country.

State officials cross their fingers that information can be a spur to change — even if some of the advice sounds silly.

Can standing up to change channels on the television really cause excess poundage to drop off a couch potato? Pushing a lawn mower instead of riding on one?

Dr. William Dietz, a CDC pediatrician specializing in nutrition and physical activity, believes the ubiquitous toys of the American easy life — remote controls, riding lawn mower, electric toothbrushes and automatic garage door openers — have combined to make this a sedentary nation.

"In 100 little ways we've removed physical activity," he said. "How many people manually roll down the window in their car?"

The slide into obesity started about two decades ago, Schwartz said. Increased calorie intake via fast food, larger food portions, soft drinks and juice drinks coupled with reduced physical activity has caused the condition to triple among teens nationally. Obesity has doubled among all children in that time frame, he said.

North Carolina's effort to fight back includes a public education campaign and an interactive Web site.

A three-year project dubbed "Fit Together" is being funded with $1.5 million in tobacco settlement money and $3 million from Blue Cross and Blue Shield of North Carolina.

That's on top of about $9 million in grants being awarded to communities across the state to develop programs that educate adults and children about eating better and exercising.

The state money comes from North Carolina's share of the 1998 tobacco settlement, which is overseen by the health and wellness commission. The effort is a pet project of Lt. Gov. Beverly Perdue, who chairs the commission.

"Our partnership will make North Carolinians aware of community activities and best practices from Murphy to Manteo," Perdue said in announcing the partnership with Blue Cross earlier this month.

"From there, it's about making healthy choices. And healthy choices result from having the right information."

People can be motivated to change their behavior by events like divorce or heart attack, says Dr. Steven Zeisel, a pediatrician and chairman of the nutrition departments at the University of North Carolina-Chapel Hill.

Media reports on the increase in obesity and its health risks are also stirring the public to take notice, Zeisel said.

"That explains why these diets are so popular all of a sudden," Zeisel said.

But broader changes than ditching the TV remote or jumping on the Atkins bandwagon are needed if youth obesity is to be stemmed, Zeisel and other said. Schools and communities need to encourage more activity. Local governments must ensure neighborhoods are built with sidewalks and places where youngsters can play safely.

Zeisel advises physicians to be more bold in telling parents their children have a weight problem and what can be done to stop it.

There's no proof that efforts like those in North Carolina can create a state of trim and fit people, Dietz said, but encouraging small steps is a start.

"I don't think people can be easily motivated to lose weight externally," he said.

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'Living Bandages' Heal Burns with Patients' Cells

 

By Patricia Reaney

Reuters

Monday, April 26, 2004

LONDON (Reuters) - British scientists have developed "living bandages," made from a patient's own cells, which speed healing for burns and diabetes sufferers.

The biological bandages, launched at the British Burns Association meeting on Tuesday, have been used successfully on patients with severe burns and diabetics with chronic wounds.

"It is a convenient way of using the patient's own cells to heal wounds," Professor Sheila MacNeil, of the University of Sheffield, said in an interview.

"This is a simple dressing to take laboratory-expanded cells and deliver them back to patients' wounds."

MacNeil, who developed the bandages called Myskin with her Sheffield colleague Professor Robert Short, said the bandages can be placed on wounds five to seven days after a sample of cells has been taken from the patient and grown on specialized discs in the laboratory.

After the bandage has been applied to the wound, the discs release the cells and prompt new layers of skin to grow in the damaged areas. The bandage is removed after the cells have migrated to the wound.

Doctors have been using patients' own cells to heal wounds for years. Myskin, which was developed after 10 years of research, takes the technique further because the cells are grown on the bandage surface and it is put directly on to the patient's wound.

"It makes it simpler all round," said MacNeil. "You can get a much faster healing than you would have done without them."

Myskin has been successfully used on a young boy suffering burns to his legs and chest from a bonfire accident, a 28-year-old with similar injuries and an 80-year-old man who had been badly burned on his face and body.

There are around 1,000 severe burn injuries in Britain each year.

The biological bandages have also helped to heal chronic wounds from persistent ulcers in diabetes patients. In Britain alone, three million people suffer from chronic wounds and 5,000 foot or toe amputations are performed on diabetics because of ulcerous wounds.

MacNeil said Myskin also speeds the healing of donor sites where skin grafts are taken to replace burned skin.

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CDC Ranks Mississippi Atop Obesity List

 

By Lynda Edwards

Associated Press Writer

The Associated Press

Monday, April 26, 2004

JACKSON, Miss. - The Centers for Disease Control usually fires off reports about contagious diseases like SARS (news - web sites), smallpox and AIDS (news - web sites). But Mississippi hit the top of one CDC list — along with Louisiana and West Virginia — for the states with the worst obesity epidemics.

More than 25 percent of Mississippi adults are obese and childhood obesity is rampant, according to the CDC.

The CDC is giving $1 million in grants to 25 Mississippi elementary and secondary schools to fight the fat plague.

Oxford Elementary School principal Larry Christman accepted his $40,000 grant from USDA Under Secretary Eric Bost in a Friday ceremony at the school. It is the first school to be selected as a grant winner out of 170 applicants. The other 24 will be announced before the school year ends.

Now, Christman faces a demanding and Herculean task. He must convince his pupils fruit and vegetables are more fun to eat than Cheetos, Milky Ways and belly busting burgers.

Christman has become the beloved "Mr. C" to students over his 35 years on the job. His school offers free breakfast to students regardless of income.

"If I heard that one of my children was going to bed hungry, I would do something immediately to ensure the child's family had food to feed him," Christman said. "But I'm worried that too much to eat of the wrong foods has become a bigger threat to my children's health than hunger is."

The school menus offer kids raw veggies with dip, baked catfish, and fresh fruit bowls. The daily meals also have richer temptations like pork chops, chili cheese fritos and bacon burgers.

Amy Murphy, the Oxford School District's director of child nutrition, said that the fat content of the menus cannot exceed the recommended daily allowance set by the state.

She believes that the diet dangers for children come from fast food restaurants and junk food rather than comfort food. Christman and Murphy are brainstorming painless and innovative ways to teach children eat well to stay fit and slim.

The school already contains a miniature Kroger grocery with a working scanner and plastic replicas of steak, bagels and fruit.

"Just about everything a real Kroger would have except junk food and beer," Christman said.

He wants children to learn how to deflect splashy marketing displays while scouting out tasty, heart-friendly treats.

And he has a solution for the late afternoon munchies.

"We're going to spend some of the money on a kiosk that we can load with grapes or tropical fruits and roll from one classroom to the next," Christman said.

A nutritionist will teach the health benefits of the snack as the kids chow down.

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Cholesterol Drugs May Cut Breast Cancer Risk

 

Reuters Health

Monday, April 26, 2004

NEW YORK (Reuters Health) - Treatment with cholesterol-lowering drugs, such as Lipitor (news - web sites) and Zocor, does not increase the risk of breast cancer in women past menopause, new research suggests.

On the contrary, the data suggest that long-term use of such drugs, called statins, may actually reduce the risk of breast cancer, according to the findings in the journal Cancer.

"The current study results both provide reassurance concerning the safety of statin use among older women and support the emerging evidence that statins may" protect against breast cancer, the Seattle-based investigators conclude.

There are conflicting reports on the risk of cancer associated with statins, Dr. Denise M. Boudreau from the Center for Health Studies, Group Health Cooperative, and colleagues note in their report. They therefore investigated the association between breast cancer and statin use in a study involving 975 older women with breast cancer and 1007 without the disease.

"We found no evidence of an increased risk of breast carcinoma among statin users," the authors report. In fact, current users who had taken statins for more than 5 years had a 30-percent lower risk of breast cancer compared with non-users.

Source: Cancer, June 1, 2004.

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Simple Steps Can Stave Off Infection

 

By Rebecca Cook

Associated Press Writer

The Associated Press

Monday, April 26, 2004

BELLEVUE, Wash. - To prevent Scott Adams' knee surgery from getting infected, doctors at Overlake Hospital Medical Center didn't need fancy new medicine or expensive equipment.

Instead, they took simple steps that are proven to prevent infection. They kept Adams warm during surgery, clipped his leg hair instead of shaving it, and administered antibiotics at the right time.

Easy, cheap and effective — but many hospitals fail to take these steps.

A national survey of 39,000 operations in 2002 found that nearly half of patients didn't get antibiotics at the correct time, which is one of the best ways to prevent infection. And the stakes are high: getting a surgical infection doubles a patient's chance of dying.

Health care leaders are trying to reduce that risk. Fifty-six hospitals participated in a national collaborative last year, co-sponsored by the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention (news - web sites). By concentrating on those simple preventive measures, the hospitals succeeded in decreasing their overall surgical infection rate by 27 percent.

The results were even more dramatic at Overlake Hospital, a 337-bed community hospital in suburban Seattle. The hospital recently participated in a 13-month surgical infection prevention program run by Qualis Health, a Seattle-based health care quality improvement organization. The hospital cut its number of surgical infections by more than half, from 12 in 2002 to five in 2003. The hospital performs more than 14,000 operations annually.

Adams, a jovial 31-year-old engineer who blew out his knee playing flag football, noticed the emphasis on preventing infection.

"Pretty much anybody who put a needle in me talked about the risk of infection," he said.

His leg hair was clipped instead of shaved because shaving causes tiny skin abrasions that can let in infection. He got antibiotics exactly 20 minutes before his surgeon made the first cut, the optimum time for getting the most infection-fighting power from the drugs. And doctors and nurses kept him warm, which helped his body fight infection.

Adams particularly enjoyed the "bear hugger," a comfortable puffy blanket filled with warm air, that he wore during surgery.

"I've got to get one of those for me at home," Adams said. He was recovering comfortably and infection-free a few days after his anterior cruciate ligament, or ACL, reconstruction surgery.

"I'll be back playing football again next year," he predicted.

About 780,000 surgeries lead to infections in the United States each year, which is 2.6 percent of the nearly 30 million operations performed. On top of the health risk, surgical infections cost a lot. A 1992 analysis published in the medical journal "Hospital Infections" found that surgical infections added an average of $3,152 to hospital bills for patients with the infections.

Other studies estimate that 40 to 60 percent of surgical infections are preventable. The most powerful preventive medicine is antibiotics, administered within one hour of incision. Give the drugs too early or too late, and they'll either wear off or won't get into the bloodstream fast enough to work.

This isn't new information. Studies dating back to 1957 have told doctors about the need for well-timed antibiotics. So what's the holdup?

"There are problems translating good research into actual practice," said Dr. Dale Bratzler, principle clinical coordinator for the Oklahoma Foundation on Medical Quality and a leader of the national Surgical Infection Prevention Project. He's working with the authors of major antibiotic studies to create a set of consistent national guidelines.

"There are 10,000 randomized trials published every year. There is no physician that can keep up with all the publications," Bratzler said. "We need to make it more systematic."

He said the best thing patients can do to protect themselves is to talk with their surgeons — ask about antibiotic treatment, and make sure to tell doctors in detail about any drug allergies. Also, general good nutrition and health will help, he said. The healthier a patient is going into surgery, the smaller the chance of infection.

At Overlake, surgical director Mahin Wright used a combination of charm and reason to get surgeons to embrace the infection prevention measures.

"It was really hard to get everyone on board. The surgical arena has strong individuals who are highly opinionated. I did a lot of hallway talking," she said. "You just romance them, keep massaging them and telling them how great it is for patients. If you focus on patients, they respond very quickly."

She made the operating rooms warmer and gave surgeons cooling vests so they wouldn't get too hot. She asked doctors to stop giving patients antibiotics after surgery — there's no evidence it helps, and overuse of antibiotics can breed drug-resistant "superbugs" that are a huge problem in hospitals.

The Overlake project started with knee and hip surgeries but soon spread to the rest of the operating rooms.

A midwife-turned-hospital administrator, Wright said she wasn't surprised that simple steps yielded strong results. Technology is great, she said, but often the simplest lifesaving measures work the best.

"A lot of the time it's the basics," Wright said. "We need to pay attention to common sense."

On the Net:

National Surgical Infection Prevention Project: http://www.medqic.org/sip

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Stress Protein May Predict Heart Attack Death

 

Reuters

Monday, April 26, 2004

WASHINGTON (Reuters) - Heart attack patients whose bodies produce higher levels of a so-called stress protein called ST2 are more likely to die or develop the chronic condition known as heart failure, U.S. researchers reported on Monday.

Testing patients for the protein may offer a way to predict who is at highest risk of dying or getting heart failure in the weeks after a heart attack, the researchers said.

The ST2 protein is involved in immune system responses and inflammation. Earlier research showed that "stressed-out heart cells" produced ST2, said Dr. Richard Lee of Brigham and Women's Hospital and Harvard Medical School (news - web sites) in Boston, who led the study.

"When some heart muscle dies during the heart attack and the living heart muscle is stretched, the heart cells put out more ST2," Lee said in a statement.

Levels of ST2 increase in patients after a heart attack, peaking about 12 hours afterward. "First, the data suggest that this pathway of inflammation may occur in the early events of heart attack," Lee said.

"Second, ST2 levels provide a novel biomarker that can offer prognostic information on heart attack victims, independent of the usual clinical predictors."

Lee and colleagues measured ST2 in 810 patients who had just suffered heart attacks.

The initial levels of ST2 were significantly higher in patients who later died or developed new or worsening congestive heart failure within 30 days after a heart attack, they found.

Heart attack patients with the highest 25 percent of ST2 levels were seven times more likely to die within 30 days after heart attack than patients with the lowest 25 percent, Lee's team reports in this week's issue of the journal Circulation.

"The big picture is that despite all the things we do for heart attack patients, some will go on to die or develop heart failure," Lee said. "We need more tools in our toolbox to not only pick out those patients who may do worse, but also to stop the development of heart failure."

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Study Backs Standard Hernia Surgery

 

By Janet McConnaughey

Associated Press Writer

The Associated Press

Monday, April 26, 2004

Groin hernias repaired by laparoscopic surgery are twice as likely to reopen as those fixed by the standard operation, a Veterans Affairs study has found.

There was one exception: Surgeons who had done more than 250 laparoscopic or "keyhole" hernia repairs had about the same recurrence rate as those who used an open incision, Dr. Leigh Neumayer of the VA Medical Center in Salt Lake City was to report at a conference Sunday.

Groin hernias, in which a gap in the muscle of the lower abdomen allows a bit of intestine to stick out, are common. U.S. doctors repair about 700,000 a year.

The VA patients in this study all had the standard basic repair: very thin, flexible mesh was placed behind the gap in the muscle to hold in the gut. Surgeons tacked the mesh in with a few stitches or with surgical tacks or staples, Neumayer said.

The difference was whether the surgeons worked through an open incision, usually 2 to 4 inches long, or used laparoscopic surgery, in which doctors make tiny incisions and insert slender instruments and a miniature camera.

Overall, 87 of the 862 patients who had laparoscopic surgery needed a second repair of the same hernia within two years, compared to 41 of the 834 who got open incision repairs. That works out to 10.1 percent and 4.9 percent.

Twenty of the 78 surgeons doing laparoscopic surgery had done more than 250 such operations for groin hernias, also called inguinal hernias, and their recurrence rate was less than 5 percent, said Neumayer, a staff surgeon at the VA hospital and associate professor of surgery at the University of Utah.

She was to present her study Sunday to the American College of Surgeons in Boston. It also will be published Thursday in the New England Journal of Medicine (news - web sites), which released it early.

The results aren't surprising — there has been great debate for years about whether laparoscopic surgery would be safer for groin hernias, said Dr. Danny O. Jacobs of Duke University, who wrote an accompanying editorial.

Keyhole surgery started with operations to remove the gall bladder. Instead of a 4- to 6-inch incision in the abdomen, it used four small holes, none bigger than a dime.

That made a huge difference in the amount of pain and length of recovery. Patients could go home from the hospital in a day or less rather than five to eight days, and could return to work within a week instead of one to two months.

But hernia repair is already an outpatient procedure taking 45 minutes to an hour. The open incision version is generally done under local anesthetic, while laparoscopic surgery needs general anesthesia.

Neumayer found that laparoscopic surgery cut one day from the average time before people could resume normal activities — four days, as opposed to five for open surgery.

There was less pain for about two weeks after surgery, but it was about the same after three weeks.

"There's less to be gained in those areas. So the difference in recurrence becomes a much bigger matter," she said.

Hernia repair is a more complicated laparoscopic operation than others, because there are more nearby bits and pieces that can be inadvertently injured, Jacobs said. These include part of the spermatic cord — the 18-inch tube which holds mature sperm, plus the arteries, veins, nerves, and lymphatic vessels which surround it.

For Jacobs, the most striking discovery was the large number of operations needed to repair recurrences after keyhole surgery.

"We need to get a little more detail now about the nature of that relationship, and why it occurs," he said.

On the Net:

Nat'l Library of Medicine: http://www.nlm.nih.gov/medlineplus/tutorials/inguinalhernia.html

American College of Surgeons: http://www.facs.org/public_info/operation/hernrep.pdf

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Summer Brings Lower Cholesterol Levels, Study Shows

 

Reuters

Monday, April 26, 2004

CHICAGO (Reuters) - Blood cholesterol levels peak during autumn and winter but decline in spring and summer, perhaps because warm weather and more activity add volume to the blood, researchers said on Monday.

The report from the University of Massachusetts Medical Center in Worcester was based on a study of 517 healthy men and women who were tracked quarterly over a year on their diet, physical activity, exposure to light, general behavior and cholesterol.

It found that the average cholesterol level was 222 milligrams per deciliter of blood in men and 213 in women. If a patient's total blood cholesterol is between 200-239 milligrams per deciliter, that reading is considered borderline high and means lifestyle changes are needed to avoid a heart attack, according to a National Heart, Lung and Blood Institute Web site. A reading above 240 milligrams is considered high or in the "danger zone," the Web site said.

Among men studied, cholesterol levels increased on average by 3.9 milligrams per deciliter of blood, peaking in December, and in women by 5.4 milligrams, peaking in January.

In general the increases were greater in those who had elevated cholesterol levels to begin with. Nearly a quarter of those studied went above the 240 marker in the winter, the study said.

The report, published in the Archives of Internal Medicine (news - web sites), said warmer weather in the summer and more activity probably contribute to a dilution of the blood cholesterol. Among other things exercise facilitates sodium and water retention, the report said.

The authors said it is possible that some people may be misdiagnosed with high cholesterol if measurements are taken in winter -- if the damage to arteries that high cholesterol does is based on an absolute amount, diluted or not.

But it said season-specific cholesterol guidelines are not warranted based on this study. The authors called for more research "to better understand the mechanism through which physical activity and temperature control systems could aid in the prevention of coronary heart disease, morbidity and mortality."

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Body's 'Fat Hormone' Gives Up More Secrets

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Monday, April 26, 2004

MONDAY, April 26 (HealthDayNews) -- It's supposed to tell the brain to stop eating when body fat levels get too high, but for some reason the hormone leptin fails those people who need it the most, the overweight and obese.

Now scientists believe they've found out why.

The discovery could someday lead to safe, effective treatments in the war against widening waistlines, the researchers say.

"We're very, very excited," said study author Dr. William A. Banks, a physician at the VA Medical Center in St. Louis. "In the pre-leptin days, which were not that long ago, we had to tell our obese patients, 'No, you don't have a hormonal problem, you just eat too much.'"

"Our thinking has now changed 180 degrees to where we realize that, no, obesity has some underlying endocrine problems -- and if we figure those out, we can treat it," he said.

The study appears in the May issue of Diabetes.

The discovery a decade ago of leptin, a natural appetite-suppressing hormone secreted by fat cells, has been hailed in recent years as a breakthrough in obesity research.

"It's a peptide or protein that's produced by fat, goes to the brain, and makes the brain make you eat less," Banks explained. "It also increases your body temperature slightly, so you burn calories a little faster."

Eat less, burn more calories: In a perfect world, leptin should be the perfect weight-control agent. But scientists quickly discovered the "leptin paradox" -- as body fat rises and leptin output increases, leptin's appetite-suppressing effect on the brain actually declines.

It's been "a puzzle," said leptin expert Dr. Roger H. Unger, chairman of the University of Texas Southwestern's Touchstone Center for Diabetes Research in Dallas. "People have wondered why, if leptin keeps going up as you get fatter and fatter, you don't see its [appetite-suppressing] effects, which you do see when you give leptin to a normal-weight person."

Banks and his team suspected the problem could lie in leptin being denied full access to the brain. "Because it's so special, the brain, unlike other tissues, is protected by the blood-brain barrier," he explained. This means all blood vessels within the brain are specially sealed to prevent the infiltration of chemicals and pathogens that could cause it harm.

"Leptin is a large molecule," Banks said, "so the only way it can get from the blood into the brain is being transported across the barrier by its own transport system." In the obese, something appears to stop leptin from jumping this barrier.

That something may be high levels of blood fats called triglycerides, the researchers report. In experiments conducted with mice, the St. Louis team discovered a rise in triglyceride levels appears to prevent leptin from crossing the brain's protective barrier.

Triglycerides are unhealthy fats that come from many types of food. While leptin functioned normally in mice fed triglyceride-free skim milk, the hormone had little or no effect in curbing the appetites of mice fed whole milk loaded with triglycerides, the researchers report.

The take-home message for humans is clear, according to Banks: "If you're unfortunate enough to be one of those people who ups their triglycerides when they are obese, you're going to have more trouble getting leptin into the brain, so the brain isn't going to see the leptin." The result, he said, is that appetite centers in the brain continue to crave high-calorie meals -- even as the overweight pack on the pounds.

Banks cautioned that although mice do present "a very nice model" for human weight gain, much more research into leptin and triglycerides remains before any solid recommendations can be made.

"There are drugs that will lower triglycerides," he said, "but it would be inappropriate to suggest that people try these drugs on their own or even ask their physician for them. We still need to do more studies to test this out in a controlled, safe way. And triglyceride-lowering drugs are not without side effects."

However, healthy eating and regular exercise remains a safe, effective method of lowering triglyceride levels in the blood. "People, if they diet and exercise, can fight this," he said. "You don't have to wait on the science -- we can all be exercising more and eating more sensibly."

Unger called the finding "a step forward" in obesity research. But he's disappointed the researchers didn't go further, comparing the eating patterns of high-triglyceride and low-triglyceride mice over time.

"This study shows that leptin's access to the brain is going to be reduced if the levels of fat [in blood] are high. What the researchers didn't do, though, is see if that's going to change food intake," he said.

The St. Louis researchers said they plan more studies into the relationship between triglyceride-lowering diets and medications and their effect on leptin-induced appetite control.

"We can help leptin be more effective," Banks said. "Leptin isn't the bad guy; leptin is struggling like all of us, against our lifestyles."

More information

Get an overview of obesity and overweight from the U.S. Centers for Disease Control and Prevention. Find a review of leptin and other molecules involved in obesity at Duke University.

Sources: William A. Banks, M.D., physician, VA Medical Center, and professor, geriatric medicine, St. Louis University, St. Louis; Roger H. Unger, M.D., chairman, Touchstone Center for Diabetes Research, University of Texas Southwestern Medical Center, Dallas; May 2004 Diabetes

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Diabetes Reportedly to Double Worldwide by 2030

 

Reuters

Monday, April 26, 2004

WASHINGTON (Reuters) - Diabetes rates will double worldwide by 2030, to 366 million people with the disease, even if the obesity rate remains stable, an international team of researchers reported on Monday.

But the rate will go up even higher if, as expected, more and more people become overweight, eat a so-called Western diet and stop exercising, the researchers said.

"The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030," the researchers wrote in the latest issue of Diabetes Care, published by the American Diabetes Association.

Diabetes is a disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy.

Sarah Wild of the University of Edinburgh in Britain and colleagues in Australia, Denmark and Switzerland, looked at type-2 diabetes figures from around the world, using United Nations (news - web sites) data to project future diabetes rates based on current trends.

"Assuming that age-specific prevalence remains constant, the number of people with diabetes in the world is expected to approximately double between 2000 and 2030, based solely upon demographic changes," Wild and her colleagues said.

"The greatest relative increases will occur in the Middle Eastern Crescent, sub-Saharan Africa, and India."

The figures do not include type-1 or juvenile diabetes, which is an autoimmune disease separate from type-2 diabetes.

Columbia University's Earth Institute in New York was to issue a report on Monday finding that heart disease, once an illness of the rich, is killing more and more people in poor countries.

The report blames cigarette smoking, cheap food and urban living and said heart disease was taking the lives of middle-aged people in the developing world, just as they reach their peak economic potential.

The Columbia researchers noted that obesity and diabetes were also on the rise on the developing world.

Diabetes and heart disease are closely linked. Both are strongly associated with a poor diet and lack of exercise.

"The human and economic costs of this epidemic are enormous," Wild and colleagues said, calling for "a concerted, global initiative" to address the epidemic.

A 2001 study by the U.S. Centers for Disease Control and Prevention (news - web sites) projected that 29 million Americans would be diagnosed with diabetes by 2050. Currently an estimated 16 million Americans have type-2 diabetes.

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Study Favors Premarin for Osteoporosis

 

HealthDayNews

Monday, April 26, 2004

MONDAY, April 26 (HealthDayNews) -- When it comes to preventing osteoporosis, conjugated equine estrogen (CEE) seems to work better than raloxifene, says a study in the April 26 issue of the Archives of Internal Medicine.

New Zealand researchers compared the effectiveness of the two drugs. Raloxifene helps prevent bone loss and increases bone mineral density and CEE, sold under the brand name Premarin, helps increase bone density. Before this study, there was little information comparing the two drugs.

The study included 619 postmenopausal women, average age 53, who'd had a hysterectomy. The women were randomly assigned to receive either 60 milligrams or 150 milligrams per day of raloxifene, 0.625 milligrams per day of Premarin, or placebo.

Over the course of the three-year study, researchers measured bone mineral density in the women's spines and femur (a large bone in the leg).

Bone density declined by 2 percent in the placebo group, remained stable in the two raloxifene groups, and increased by 4.6 percent in the CEE group.

"Raloxifene and CEE have beneficial effects on bone density and bone turnover, although effects of CEE are more marked," the study authors wrote.

The study was supported by a grant from Lilly Research Laboratories.

More information

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

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Calcium May Reduce Kidney Stone Risk in Young Women

 

Reuters Health

Monday, April 26, 2004  

NEW YORK (Reuters Health) - The findings from a new study suggest that increased intake of dietary calcium may help protect younger women from developing kidney stones. However, the use of calcium supplements had no effect on the risk.

An inverse association between dietary calcium and kidney stone risk has been noted in older women and men, but studies have not adequately addressed this relationship in younger women, lead author Dr. Gary C. Curhan, from Harvard Medical School (news - web sites) in Boston, and colleagues note.

To investigate, the researchers analyzed data from more than 96,000 young women who participated in the Nurses' Health Study II, a study spanning several years. The women completed dietary questionnaires in the early 1990s and were followed until a kidney stone was diagnosed, death occurred, or May 31, 1999--whichever came first.

During follow-up, 1,223 symptomatic kidney stones were diagnosed, the researchers report in the current issue of the Archives of Internal Medicine (news - web sites). Women with the highest levels of dietary calcium intake were 27 percent less likely to develop stones than those with the lowest levels.

Dietary levels of phytate, a salt that contains magnesium and calcium, was also tied to a decreased risk of stone formation. The risk reduction between women with the highest and the lowest levels of phytate intake was even higher than that seen with dietary calcium--37%. The consumption of animal protein and fluid was associated with a reduced risk, while sugar intake seemed to raise the risk.

In older adults, there has been evidence that supplemental calcium can raise the risk of stones, but no such effect was seen in the current group of younger women.

The findings reinforce the idea that "routine restriction of dietary calcium in patients who have had a kidney stone is no longer justified," the authors state. Also, they suggest that "dietary phytate may be a new, important, and safe addition to our options for stone prevention."

In this study group, cold cereal, dark bread, and beans" were the most common source of dietary phytate, they add.

Source: Archives of Internal Medicine, April 26, 2004.

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Parkinson's Drug Stills Restless Leg Syndrome

 

HealthDayNews

Monday, April 26, 2004

MONDAY, April 26 (HealthDayNews) -- The drug pergolide, commonly used to treat symptoms of Parkinson's disease, seems to be effective in treating restless legs syndrome (RLS).

That's what an international study reports in the April 27 issue of Neurology.

People with RLS have sensory and motor abnormalities of the limbs associated with an urge to move. The condition affects 5 percent to 10 percent of people. Pain and discomfort caused by RLS during the night can cause severe sleep disruption and resulting daytime fatigue.

This study, funded by drug maker Eli Lilly and Co., included 100 RLS patients in seven countries. (Lilly developed the drug under the brand name Permax, but sold the marketing rights to Amarin Pharmaceuticals, Inc.) All the study volunteers were given an anti-nausea medication for 10 to 14 days before taking pergolide or a placebo. That's because pergolide is known to cause nausea.

Sleep efficiency and periodic limb movements during sleep (PLMS) were measured in the study volunteers. The severity of their RLS was assessed by the validated RLS Scale.

"Our study demonstrates that pergolide substantially improves PLMS measures and subjective sleep disturbances associated with RLS, " study author Dr. Claudia Trenkwalder, of Georg August University in Germany, said in a prepared statement.

"We are also satisfied by how well tolerated the low-dose pergolide treatment was, and that its efficacy was maintained over the long term," Trenkwalder said.

More information

You can learn more about this condition from the Restless Legs Syndrome Foundation.

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Stroke No Excuse for Lazing About, Report Reveals

 

Reuters

Monday, April 26, 2004

WASHINGTON (Reuters) - Having a stroke is no reason to take it easy, and in fact stroke survivors can benefit by getting up off the couch and exercising, the American Heart Association (news - web sites) said on Monday.

New guidelines from the group recommend at least 20 minutes of aerobic exercise three to seven times a week to help reduce the risk of another stroke. Writing in the journal Circulation, the association's scientific committee also advised stroke patients to do some strength training.

Stroke is the third leading cause of death in the United States after cancer and heart disease, killing nearly 170,000 people in 2003. An estimated 700,000 suffer a stroke every year, and many stroke victims suffer from reduced ability to bathe, dress, speak and get around.

Those disabilities can in turn lead to depression, said Dr. Neil Gordon, who co-chaired the committee.

Patients descend into "a vicious circle of further decreased activity and greater exercise intolerance, leading to secondary complications such as reduced cardiorespiratory fitness, muscle atrophy, osteoporosis and impaired circulation to the lower extremities in stroke survivors," the committee concluded.

But exercise improves all these things. The guidelines recommend stroke survivors do 20 to 60 minutes of walking or similar exercise three to seven days a week.

"But the sessions don't have to be done all at once," Gordon said in a statement. "The exercise can be done in 10 minute intervals with the goal being at least 20 minutes in one day."

The guidelines also call for strength training using weights or resistance for about 10 to 15 repetitions two to three times a week. Exercisers should aim to do eight to 10 different exercises working the legs, arms, back and other muscle groups.

"In a healthy person, typically we would recommend eight to 12 repetitions, but for stroke survivors we recommend lighter weights and more repetitions," Gordon said.

And because stroke survivors often have balance problems, which put them at risk for falls, the statement suggests two to three sessions each week of balance or coordination exercises.

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The Mechanics of Muscular Dystrophy

 

HealthDayNews

Monday, April 26, 2004

THURSDAY, Dec. 11 (HealthDayNews) -- The loss of key proteins seems to be linked to the symptoms seen in the most common form of adult-onset muscular dystrophy (MD), says a study in this week's issue of Science.

University of Florida and University of Rochester scientists say symptoms of myotonic dystrophy seem to be caused by a form of "genetic stuttering" that blocks the actions of these key proteins in cells.

The proteins, which help eye and muscles cells mature, stick to warped copies of RNA molecules that build up in a cell's nucleus. This prevents the proteins from carrying out their normal functions. Normally, RNA transmits information from DNA to trigger protein production.

The researchers studied more than 100 mice bred to lack the gene associated with producing one form of the "muscle-blind" protein. These mice developed the muscle and eye abnormalities that are characteristic of myotonic dystrophy.

The mice also developed other features associated with myotonic dystrophy, including defects in proteins that are essential for normal heart function.

More information

Here's where you can learn more about myotonic dystrophy.

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Bypass Beats Angioplasty in Risky Patients –Report

 

Reuters

Monday, April 26, 2004

WASHINGTON (Reuters) - Seriously ill heart disease patients do better if they get bypass operations than if they have their clogged arteries cleared out using angioplasty, according to a report published on Monday.

Patients who received the bypasses were half as likely to die within five years as those who got angioplasty, researchers report in the journal Circulation.

"The sicker the patient, the more bypass surgery helped," said Dr. Sorin Brener, an assistant professor of medicine at the Cleveland Clinic Foundation in Ohio.

"The findings were somewhat surprising." Brener said even when the angioplasty patients got stents -- little mesh tubes to hold their arteries open -- and advanced medications called glycoprotein IIb/IIIa antiplatelet drugs, bypass surgery saved more lives.

The finding is surprising because bypass surgery is a major operation, involving cracking open the chest, stopping the heart, putting the patient on a heart-lung machine and then suturing in one or more new arteries to get blood in and out of the heart.

Angioplasty is much less invasive. But arteries that are reamed out often clog back up, even when drugs and stents are used to prevent it.

Brener and his colleagues examined survival records for 5,161 patients who had bypass surgery and 872 who had angioplasty at the Cleveland Clinic.

About half the patients in both groups had diabetes or significant left ventricular dysfunction -- which affects how much blood the heart is able to pump to the body.

Overall, the survival rates looked similar -- at first. Then the researchers factored in individual risk characteristics such as high blood pressure, smoking and diabetes.

"Mortality rates for patients who underwent surgical bypass were almost half the rate of those treated with angioplasty who had similar cardiovascular risk profiles," said Brener.

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Sunday, April 25, 2004

 

Report: Many Mexican Candies Contain Lead

 

The Associated Press

Sunday, April 25, 2004

SANTA ANA, Calif. - More than 100 brands of candy sold in California, most of them from Mexico, have tested positive for dangerous levels of lead in the past decade and little has been done about it.  

In nearly every case, the candy — mostly marketed to Latino kids — stayed on store shelves and no action was taken against the Mexican manufacturers, the Orange County Register reported in Sunday's editions, citing state and federal records.

The public was rarely informed of test results, the newspaper found.

"Children are eating poison," said Leticia Ayala, of San Diego-based Environmental Health Coalition, a nonprofit group that urged the state to better regulate Mexican candies.

State officials said they lack the resources to tackle the problem and have little jurisdiction over Mexican candy manufacturers.

"We have a lot more responsibilities than looking for lead in candy," said Jim Waddell, chief of the state Health Department's Food and Drug Branch.

Lead poisoning can cause brain and nerve damage and result in intelligence and behavioral problems, particularly in children. Concerns about lead poisoning led to a ban on lead-based house paint in the 1970s and on lead compounds in gasoline in the 1980s.

The state Department of Health Services has conducted more than 1,500 tests on Mexican candy since 1993 and found high levels of lead in one of every four samples, the newspaper reported.

As many as 15 percent of California children who suffer lead poisoning — about 3,000 over the past three years — have eaten Mexican candy, according to state statistics. About three-quarters of them are Hispanic.

The government did little to release the information to the public, the paper said.

For example, it knew of high lead levels for years in Chaca Chaca, a popular Mexican treat made from apple pulp and chili powder, but no public warnings were issued until last month.

The Register conducted its own tests on 180 samples purchased over the counter in Southern California, an 32 percent of the tests showed high levels of lead.

The newspaper sent reporters to Mexico, and reported that raw ingredients were carelessly tainted with lead before being shipped to factories, where unsafe manufacturing procedures were commonplace.

Mexican manufacturers said they had no knowledge their candies contained dangerous levels of lead until contacted by the newspaper.

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Saturday, April 24, 2004

 

Arsenic Poisonings Provide Valuable Data

 

By David Sharp

Associated Press Writer

The Associated Press

Saturday, April 25, 2004

PORTLAND, Maine - Medical researchers stymied by a lack of data on arsenic say the mass poisoning a year ago at a church will help them rewrite textbooks on toxicology.

It also may help doctors fine-tune drug treatments for people poisoned with arsenic.

The crime — arsenic in the coffee at a New Sweden church — killed one man and sickened 15 others, some of them critically in the biggest case of arsenic poisoning in the nation's history.

Until the tragedy, doctors had little information for treating arsenic poisoning. Now they have a better understanding about how to quickly diagnose it and about which symptoms predict bad outcomes. They also have data on an experimental drug given to some of the 15 survivors.

They've even learned that some types of dentures can be contaminated by arsenic and must be discarded.

Dr. Marsha Ford, one of the nation's top arsenic experts, said past research has been based on a case here and there. The church poisonings provided an unprecedented number of cases to be examined.

Ford is preparing to add information from the church poisonings in her chapter on arsenic in the emergency room reference book, "Goldfrank's Toxicologic Emergencies."

"It's going to give us lots of information about signs and symptoms. How did they look when they came into the emergency department? And how did they progress when they were in the hospital?" said Ford, director of the Carolinas Poison Center in Charlotte, N.C.

Doctors and researchers hope to learn more as the patients continue their recoveries. Eventually, researchers hope to publish in the New England Journal of Medicine (news - web sites).

"The more important issues are going to be the longtime complications or outcomes of these patients," said Dr. Carl Flynn, medical chief at Cary Medical Center in Caribou, which treated most of the victims.

It was at the 65-bed hospital that doctors working with the Northern New England Poison Center began to suspect arsenic as church members flooded the emergency room last April.

Food poisoning typically strikes at least an hour after eating, but these people fell ill right away. Their blood pressures, dangerously low, fit with metal poisoning.

Within 24 hours, with one person dead and several in critical condition, the state health laboratory in Augusta confirmed it was arsenic. The state began shipping antidotes stockpiled at Maine Medical Center after the Sept. 11, 2001, terrorist attacks.

Arsenic is treated with chelation agents, compounds that bind with the metal and are flushed out in the urine.

But there are downsides to the two commonly used chelation drugs. One requires painful shots directly into muscle and the other is taken orally, a method of little use to a vomiting patient.

Health officials finally found a California pharmacy that carried a medicine available in other countries that can be given intravenously, said poison center managing director Karen Simone. The drug had to be given experimentally because it wasn't certified by the Food and Drug Administration (news - web sites).

Comparing all three drugs may point to the most effective treatment, Simone said.

The poisonings already have yielded some other practical information. For example, the New Sweden victims who had impaired renal function were the ones who fared the worst, with most ending up on life support, Flynn said.

The poisonings also demonstrated the value of preparedness, said Dr. Anthony Tomassoni, a toxicologist who is medical director of the poison center. Quick access to the antidotes meant no delay for shipments from other regions.

"When we look at chemical agents, time is critical. Having what you need on site, or very close to a site, where you need it, is probably the difference between success and failure," Tomassoni said.

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