The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
August 1, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 May 1-7

 

PERSONAL HEALTH

 

 

  1. U.S. Probing Safety of Chemical in Some Heated Foods
  2. Carb-Linked Dip in 'Good' Cholesterol OK, Study Finds
  3. Health Officials: No N.J. Disease Cluster
  4. Can Autoimmune Disease Be Detected Early?
  5. Flu During Pregnancy Linked to Schizophrenia
  6. Artery-Clearing Surgery Can Prevent Stroke
  7. CDC: Folic Acid Helps Limit Birth Defects
  8. The Ins and Outs of Radiation Therapy
  9. Delayed Care Affects Prostate Cancer in Blacks
  10. Some With Sickle Cell Disease Face Stroke Risk
  11. Experts Comment on Angioplasty X-Rays
  12. Morphine Doesn't Ease Pain in Preemies
  13. Moderate Exercise May Cut Breast Cancer Risk
  14. Health Tip: Dandruff Dissected
  15. Lyme Disease at Highest Level in 2002
  16. Early Insulin May Help Diabetics Avoid It Later
  17. Health Tip: The Benefits of Beer
  18. Treating Sleep Apnea Could Cut Road Deaths
  19. Soy Nuts May Dampen Hot Flashes
  20. Surgery Found to Halve Stroke Risk in Some Patients
  21. Lyme Disease at Highest Level in 2002
  22. Lawsuits May Be Tool for Fighting U.S. Obesity
  23. Health Tip: Food Sensitivities in Infants
  24. U.S. Says Folic Acid Behind Drop in Birth Defects
  25. More Young People Developing Diverticulitis
  26. U.S. States Do Poorly in Women's Health Report
  27. Protein Can Trigger Anemia in Inflammatory Diseases
  28. Diabetes Common After Pregnancy-Related Diabetes
  29. New Target For Pain Relief Found
  30. Antibiotic-Allergic People Can Be Desensitized
  31. Trial Pill Helps Elderly Insomniacs
  32. Forearm Artery Not So Great for Heart Surgery
  33. Walnuts May Protect the Heart
  34. One-Two Punch Urged for Head, Neck Cancers
  35. Study: 20M Workers Have No Health Coverage
  36. Health Tip: Bone Density Testing
  37. Study Examines Insulin-Producing Cells
  38. Stressed Kids Can Become Depressed Adults
  39. Wyoming Cancer Rates Rise Slightly
  40. Antioxidant May Prevent Prostate Cancer
  41. Marijuana Abuse Is Up Among U.S. Adults
  42. Gene Mutation May Up Your Risk of Heart Attack
  43. Companies Rush to Sell Low-Carb Products
  44. Health Tip: Veggies That Cause Sparks in the Microwave...
  45. Arsenic in Chicken Feed Being Studied
  46. FDA Panel Backs More Study of Anemia Drug Risks
  47. Nutraceutical Sues FDA Over Ephedra
  48. Breast Milk Protects Again
  49. Silicon to Be Used in Liver Cancer Trials
  50. Study: Low-Fat May Not Be Best for Heart
  51. Group Warns of Risks to Teenage Mothers
  52. Health Tip: Dry Socket After Tooth Extraction
  53. Lawmakers Seek to Remove Lead from Tap Water
  54. Hidden Costs of Depression for Seniors
  55. Government: Cars Kill, Even When Standing Still
  56. Brain Cells Show Gender Difference
  57. Selenium May Protect Against Prostate Cancer
  58. Blood Pressure Rising in Kids
  59. Fatty Acid Cream Improves Knee Arthritis
  60. Statins May Cut Death Risk After Surgery
  61. Ultra Low-Dose Estrogen Improves Bone Density
  62. Hope for Those Who Can't Use Their Hands
  63. Coke, Pepsi to Face Off in Carb Battle
  64. Marijuana Abuse and Dependence on the Rise
  65. W.Va., Miss. Battling High Obesity Rates
  66. U.S. Lags in Key Health Care Areas
  67. Report Summarizes Health Effects of 9/11
  68. Stopping Sleep Apnea Would Make Roads Safer
  69. Study: Creativity May Help Aging Brains
  70. Obstetricians Told to Talk, Write More Clearly
  71. Study: Ohio Teen Health Habits Improve
  72. Protein Plays Role in Ovarian Cancer
  73. Virus Protein Shells Can Be Broken
  74. Watchful Waiting Urged for Mild Ear Infections
  75. Race May Be Factor in Children's Care in Ers
  76. Study: Caffeine May Up Black Teens' Blood Pressure
  77. Alternatives to Mammograms on Horizon
  78. Screening Tests Overused in Sick, Elderly Women
  79. Vitamin E May Increase 'Bad' Cholesterol
  80. Targeted Diabetes Screening Seen Best
  81. Overweight Moms Have Trouble Nursing
  82. School Program Helps Kids with Asthma
  83. Weighing the Worth of Whooping Cough Vaccine
  84. Cholesterol-Lowering Drug May Delay Diabetes Onset
  85. Health Tip: Panic Attack
  86. Anemia Linked to Disability in Elderly
  87. Immune System May Protect Against Cognitive Disorders
  88. Hypertensive Blacks May Have Thick Hearts
  89. Delivering Heart Drugs From the Inside
  90. Companies Rush to Sell Low-Carb Products
  91. Study: Breast Feeding Cuts Infant Death 20 Percent

 

Friday, May 7, 2004

 

U.S. Probing Safety of Chemical in Some Heated Foods

 

Reuters

Friday, May 7, 2004

WASHINGTON (Reuters) - U.S. scientists are studying whether a chemical found in certain canned, jarred and other foods may cause cancer in people, officials said on Friday.

The chemical, called furan, is produced at low levels in some foods when they are heated, the Food and Drug Administration (news - web sites) said.

"Some animal data suggests that high levels of furan exposure might have a carcinogenic effect in humans, but its true effects in humans - especially at such very low levels - are not known," an FDA statement said.

FDA scientists tested a range of foods including canned fruits and vegetables, jarred baby foods, spaghetti sauce and coffee. Furan levels varied widely.

"FDA's preliminary estimate of consumer exposure is well below the level that would be expected to cause harmful effects," Dr. Robert Brackett, director of the FDA's Center for Food Safety and Applied Nutrition, said.

The agency has scheduled a June 8 meeting to gather input from a panel of outside experts on what types of data should be collected to assess the possible impact of furan on people.

"Until more is known, FDA does not advise consumers to alter their diet," Acting FDA Commissioner Lester Crawford said.

The existence of furan in many types of foods has been long known, said Richard Jarman, vice president of food and environmental policy for the National Food Processors Association.

"The results of FDA's research are not a warning to consumers nor are they a finding of risk associated with any particular foods or individual brands," Jarman said in a separate statement.

The FDA also has an ongoing assessment of whether another chemical found in some foods, called acrylamide, may cause cancer. Acrylamide is naturally formed in some starchy foods when they are fried, baked or roasted.

Back to the Top

Carb-Linked Dip in 'Good' Cholesterol OK, Study Finds

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- In the pre-Atkins era, high-carbohydrate, low-fat diets were all the rage, and they remain the American Heart Association (news - web sites)'s ideal regimen for cardiovascular health. However, proponents of low-carb, high-fat diets have pointed out that high consumption of carbohydrates can lower blood levels of high-density lipoprotein (HDL) -- the "good" cholesterol -- over time.

Now a new study suggests that carbohydrate-based dips in HDL pose no real threat to health, because blood levels of low-density lipoprotein (LDL), the "bad" cholesterol, tend to fall in equal proportion at the same time.

"If that ratio doesn't change when HDL goes down, then there's no real reason for concern," said Dr. Alice H. Lichtenstein, director of the cardiovascular nutrition laboratory at Tufts University and a spokeswoman for the American Heart Association (AHA).

Through the 1990s, food products with labels proclaiming them "nonfat" or "low-fat" were ubiquitous in American supermarkets, as consumers sought to trim waistlines and improve cardiovascular health by avoiding fat in favor of carbs.

At the same time, studies began show that these types of diets could produce a decline in blood levels of HDL, a form of cholesterol that actually helps arteries stay healthy.

The issue caused "a fair amount of concern" for dietary experts, Lichtenstein said.

The latest research, presented Friday at the AHA's annual conference on Arteriosclerosis, Thrombosis, and Vascular Biology in San Francisco, may allay those concerns.

A research team led by Sophie Desroches, a doctoral student in nutrition at Laval University in Quebec City, Canada, had 65 adult men consume the AHA's recommended diet for six weeks. The AHA regimen advises that people consume 58 percent of their total daily calories from carbohydrates, 26 percent from fat (less than 7 percent from saturated fat), and 16 percent from protein.

According to the researchers, blood levels of HDL cholesterol fell by an average of 10 percent in men placed on this diet over the six-week study period. However, levels of LDL fell in equal proportion, so that the all-important ratio of good-to-bad cholesterol remained stable.

In a statement, Desroches said the findings suggest that carbohydrate-linked reductions in HDL "should not raise concerns about cardiovascular health."

Lichtenstein agreed. "When you institute any kind of dietary modification, you want to make sure you don't decrease HDL without also decreasing LDL," she explained. "You want to make sure that that ratio doesn't go up."

She said advocates of the dietary craze of the moment, the Atkins diet, have long pointed to lowered HDL levels as a reason to abandon carbohydrates. But Lichtenstein said high-calorie intakes -- not carbs -- are most responsible for extreme dips in HDL, whatever the diet.

In the 1990s, "there was a proliferation of low-fat and nonfat products," she pointed out, "so many people started gorging on low-fat ice cream, cookies, and chips in the mistaken notion that they wouldn't gain weight."

Waistlines expanded, she added, and "when your body weight increases, that does have an adverse effect on blood lipids."

"That's when people said, 'Aha! See? This high-carbohydrate diet causes weight gain; it's really bad for you,'" she said.

What's needed, she believes, is a change in attitude among the American public towards eating in general.

Whether it's a high-carb or low-carb diet, "there's this feeling that 'Oh, if I choose this side or that side, I can eat what I want and still lose weight,'" she said. "The bottom line is that that never turns out to be the case."

Experts at the AHA continue to reject the Atkins regimen because of its reliance on artery-clogging fats. As to Atkins' effects on HDL cholesterol, Lichtenstein says there's not enough long-term data to show an effect one way or another.

"We really don't know," she said.

When it comes to the AHA's recommended diet -- which emphasizes carbohydrates sourced from whole grains, vegetables and fruits -- "everyone is simply recommending moderation," Lichtenstein said. "In all diets, it's all about calories -- that's the bottom line."

More information

Learn more about fat in your diet from the National Heart, Lung and Blood Institute, and get tips on eating well from the American Dietetic Association.

Back to the Top

Health Officials: No N.J. Disease Cluster

 

By Linda A. Johnson

Associated Press Writer

The Associated Press

Friday, May 7, 2004

TRENTON, N.J. - State and federal health officials said Friday an investigation showed there was nothing unusual about the number of deaths from a rare brain-destroying disease among people linked to a now-closed racetrack.

"There is no cluster. There is no outbreak," Dr. Clifton R. Lacy, commissioner of the New Jersey Department of Health and Senior Services, said after releasing a report on the investigation. "It is well within what's expected."

The investigation was prompted by a businesswoman's research into the deaths of several people who worked at or frequented the Garden State Racetrack in Cherry Hill between 1988 and 1992. All died of Creutzfeldt-Jakob disease (news - web sites), a brain-destroying disorder, or neurological problems.

Janet Skarbek, an accountant, believes the deaths were caused by eating mad-cow tainted meat served at the track, which closed in 2001.

Lacy said top scientists in his department, other states, the federal Centers for Disease Control and Prevention (news - web sites) and the top U.S. research center for such nerve-destroying diseases so far have investigated 17 deaths from 1995 through 2004.

Tests indicate three people had other diseases, three investigations are not yet complete and 11 cases have been ruled as naturally occurring, or sporadic, Creutzfeldt-Jakob disease.

That number is well within the expected range, which would be up to 45 cases, Lacy and state epidemiologist Dr. Eddy Bresnitz said.

Eating mad cow-tainted beef causes a form of the always-fatal disorder called variant Creutzfeldt-Jakob disease. It has killed about 150 Europeans infected before their countries slaughtered large numbers of cattle.

Sporadic CJD, with no known cause, is responsible for about one in 10,000 U.S. deaths each year. The disease involves the unexplained the mutation of proteins in the brain called prions. Tests can clearly distinguish the variant and sporadic forms, experts say.

CDC spokesman Llelwyn Grant also said Friday there is no evidence of a cluster.

The CDC says there has never been a case of anyone in the United States acquiring CJD from eating tainted meat.

Skarbek insisted the state has not done a thorough enough investigation, and is downplaying the issue.

"This is not about causing a panic. This is about getting the New Jersey department of health to do a full epidemiological study," interviewing victims' relatives about their eating habits, whether they have had surgery or blood transfusions and the like, Skarbek said.

Skarbek believes the CDC has pressured state officials to discount her research, a claim the CDC and state officials deny.

Skarbek said she confirmed 16 track patrons or employees including former New York Giants general manager George Young have died of sporadic CJD; she is researching another dozen cases.

She said half ate at the racetrack's upscale Phoenix Restaurant exclusively.

Young's widow, Kathryn Mary Love Young of Baltimore, said Creutzfeldt-Jakob disease killed her husband barely 13 weeks after he first developed symptoms. He died in 2001. The couple ate at the Phoenix twice, she said.

"This is a horrible death," she said. "I'd like people to become more aware of this disease."

On the Net:

State report: http://www.state.nj.us/health/

CDC report: http://www.cdc.gov/mmwr/

Back to the Top

Can Autoimmune Disease Be Detected Early?

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- For many autoimmune diseases, such as type 1 diabetes, lupus, multiple sclerosis, Addison's disease and rheumatoid arthritis, antibodies to the diseases appear years before symptoms.

Knowing that antibodies are present before the disease develops, doctors can alert patients to symptoms to watch out for, and researchers may be able to develop early treatments, according to a report in the May 8 issue of The Lancet.

Antibodies are specific proteins made by the body's immune system to fight infection or harmful foreign substances.

However, in autoimmune disease, the body makes autoantibodies that attack the body itself, said study author Dr. Hal Scofield, an associate member of the Oklahoma Medical Research Foundation.

"It is now clear that these antibodies, which are markers of autoimmune diseases, appear in people's blood long before the clinical illnesses begin," he added.

These autoantibodies are preclinical markers to the disease, and that appears to be true for almost every autoimmune disease, Scofield explained.

"It may be possible to identify people with the potential of developing these diseases before they get sick," Scofield said. "As we can identify many of these diseases before people get sick, you can imagine prevention trials taking place."

This approach is being done now in a trial of type 1 diabetes in children with autoantibodies that are markers for the disease. The children are being administered nasal insulin to try to prevent diabetes from developing, Scofield said.

In addition, Scofield believes, if patients knew they were at risk for an autoimmune disease, they could be told what to watch out for. They might also be able to avoid some of the most serious complications, such as diabetic coma or Addisonian crisis, a life-threatening condition that happens when the adrenal gland fails to produce enough of the hormone cortisol.

The next step, according to Scofield, is to study large groups of people with autoantibodies to various diseases to see how predictive these autoantibodies are in determining who develops a disease and how long it takes for symptoms to appear.

Scofield cautioned that right now the benefit of identifying autoantibodies has little practical application. "There is the potential in the next few years to identify people who go on to get an autoimmune disease, and that kind of identification may lead to preventive therapies," he said.

"I am very enthusiastic about this approach," said Dr. Noel Rose, director of the Center for Autoimmune Disease Research at Johns Hopkins University. "This is an extremely important report."

"These autoantibodies are a warning sign of impending disease, and it opens the possibility of predicting disease and possibly benefiting patients by early treatment or even interrupting the autoimmune responses," he added.

"Antibodies in diseases such as lupus, rheumatoid arthritis, multiple sclerosis, diabetes and others can be measured and should allow the development of patient-specific therapies," said Dr. Paul J. Utz, an assistant professor of medicine at Stanford University School of Medicine.

"As newer technologies are developed, we will be able to measure thousands of unique antibodies at one time. Their measurement will be an important component of future drug development for biotechnology and pharmaceutical companies," Utz said.

"This paper really shows the importance of early screening, particularly in people with early symptoms," said Virginia Ladd, the president of the American Autoimmune Related Diseases Association.

Earlier diagnosis will lead to preventing major organ damage, she added.

Today, even when patients have autoantibodies, doctors dismiss them, Ladd said, "but this paper says that it is important to follow patients who have low levels of autoantibodies."

More information

The American Autoimmune Related Diseases Association can tell you about autoimmune disorders. Also, the National Institute of Allergy and Infectious Diseases (news - web sites) explains how the immune system works.

Back to the Top

Flu During Pregnancy Linked to Schizophrenia

 

By Anthony J. Brown, MD

Reuters Health

Friday, May 7, 2004

NEW YORK (Reuters Health) - Children born to women who contract the flu during pregnancy appear to have an increased risk for schizophrenia later in life, new research suggests.

Prenatal influenza exposure may account for about 14 percent of schizophrenia cases, according to the findings presented here this week at the annual meeting of the American Psychiatric Association.

"This is the first time that this association has been shown using" blood tests that confirmed influenza infection during pregnancy, lead author Dr. Alan S. Brown, from Columbia University in New York, told Reuters Health. "It provides what I think is the strongest evidence to date linking (prenatal) influenza exposure with schizophrenia."

Previous studies investigating this topic have either relied on maternal surveys to determine prenatal influenza exposure or have simply correlated an earlier influenza outbreak with schizophrenia risk in a defined population, Brown noted.

In the present study, stored maternal blood samples from 64 patients with schizophrenia and 125 subjects without the disease were tested for antibodies to determine if flu exposure had occurred during pregnancy.

First trimester exposure to influenza raised the risk of schizophrenia by sevenfold, the authors report. Exposure at any time during the first half of pregnancy increased the risk threefold.

"I was a little surprised that we observed an effect during both middle and early pregnancy," Brown said. In previous studies, the effect has largely been confined to the middle period, he explained.

Exactly how prenatal influenza exposure may lead to schizophrenia is unclear, but it could involve direct effects from the virus or indirect effects involving chemicals that are released in response to the virus, Brown noted.

The findings reinforce recommendations that women of childbearing age be vaccinated against influenza, Brown continued. However, because the mechanism underlying the schizophrenia connection is unknown, "we may not want to give the vaccine during pregnancy," he said. Until more is known, "it's possible that vaccination (during pregnancy) could have a harmful effect."

Back to the Top

Artery-Clearing Surgery Can Prevent Stroke

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- Surgery to clean out deposits that narrow the main artery to the brain can halve the risk of stroke for people who have no telltale symptoms of impending trouble, a British study finds.

Only 6 percent of people with significant blockage but no symptoms who had the procedure, called carotid endarterectomy, suffered strokes over the next five years, compared to 12 percent of those with the same condition who did not have surgery, said a report in the May 8 issue of The Lancet.

"We think the balance of risk is strongly in favor of surgery," said Dr. Alison Halliday, a consultant vascular surgeon at St. George's Medical School in London, who led the Asymptomatic Carotid Surgery Trial.

The new results settle a controversy that arose from a similar but smaller American trial done from 1987 to 1993, said Dr. James Toole, a professor of neurology at Wake Forest Baptist Medical Center who led that trial.

Both trials produced essentially similar results, but the British study had nearly twice the number of participants, 3,120 compared to 1,662.

"The data we had were very suggestive, but skeptics said a larger study of longer duration was needed," Toole said.

"We actually began our study before his study was reported," Halliday said. "After that report, we sat down and discussed the results. We decided that there was not sufficient evidence to know whether the operation would be of value from a European perspective, so we decided to recruit a larger number of patients."

There was one major difference in the two trials. Toole's group found a benefit for men but not women, while Halliday's trial found similar benefits for both sexes. One explanation is that the British trial included a large enough group of women to show a benefit, Halliday said.

"Their data and our data were hand in glove all the way down the line with that one difference," Toole said.

There is general agreement that carotid endarterectomy is needed for patients who have evident problems, such as a previous minor stroke, he said. The issue has been whether surgery will help patients whose carotid narrowing is discovered before symptoms develop.

That issue now appears to have been settled, Toole said. The two studies show that carotid endarterectomy should be considered for any patient whose artery has been narrowed by 60 percent or more, he said.

But the procedure need not be done at once, Toole said, because there are other ways to improve blood flow through the carotid artery.

A symptom-free person with 60 percent or more blockage should be told to take aspirin and a cholesterol-lowering drug, to reduce blood pressure, and to stop smoking, among other lifestyle changes, Toole said.

"I would give it six months and have the test again to see if the blockage has gone away," he said. "The condition can get better. If it does not, surgery should be considered."

But the British results indicate that age might be an issue, Halliday said. The study found no benefit from surgery for people 75 or older. The researchers will follow those participants for another 10 years, to see whether evidence of a benefit emerges, she said.

More information

Questions about carotid endarterectomy are asked and answered by the National Institute of Neurologicl Diseases and Stroke. Find out if you are at risk for a brain attack from the National Stroke Association.

Back to the Top

CDC: Folic Acid Helps Limit Birth Defects

 

By Daniel Yee

Associated Press Writer

The Associated Press

Friday, May 7, 2004

ATLANTA - Severe brain and spinal birth defects have dropped 27 percent in the United States since the government in 1998 began requiring makers of cereal, pasta, bread and flour to fortify their foods with folic acid, health authorities reported Thursday.

Folic acid is known to reduce the risk of spina bifida and anencephaly, which are also called neural tube defects.

Before fortification, about 4,130 babies had such neural tube defects each year in the United States, and nearly 1,200 died. After fortification, the yearly average dropped to about 3,000, with 840 deaths, the Centers for Disease Control and Prevention (news - web sites) reported.

Spina bifida cases dropped 31 percent, and anencephaly cases fell 16 percent, the CDC said.

Early in pregnancy, the neural tube creates the brain, skull and spine.

In spina bifida, the neural tube fails to close properly at the lower end. It can cause paralysis of the legs or result in the loss of bowel or bladder control.

Anencephaly is a fatal condition in which the brain never completely develops or is absent. It is caused by the failure of the neural tube to close at the upper end.

Since 1992, the U.S. Public Health Service has recommended that women of childbearing age get 400 micrograms of folic acid daily, whether through enriched foods or supplements or both.

Yet only 30 percent to 35 percent of women in this age group take folic acid supplements, said Jenny Williams, a CDC researcher. And only 37 percent of doctors tell women to do so, she added.

"We know that we could avert another 1,000 neural tube defects if all women of childbearing age consumed 400 micrograms of folic acid daily," Williams said.

On the Net:

CDC info: http://www.cdc.gov

Back to the Top

The Ins and Outs of Radiation Therapy

 

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- Patients facing radiation therapy for cancer now have a new tool to help them make informed decisions.

The American Society for Therapeutic Radiology and Oncology (ASTRO) has published a new patient information brochure that walks patients through every step of radiation therapy, from preparing for treatment to recovery afterward.

The booklet talks about the different types of radiation therapy, lists questions to keep in mind when meeting with a radiation oncologist, and provides a glossary of terms relating to cancer and radiation therapy.

"A diagnosis of cancer can be overwhelming, and we hope that this booklet can be a source of comfort and knowledge to help them to develop a better understanding of their treatment options," ASTRO spokeswoman Dr. Francine Halberg said in a prepared statement.

The 28-page brochure is titled "Radiation Therapy for Cancer: Facts to Help Patients Make an Informed Decision," and can be viewed online.

More information

The National Cancer Institute (news - web sites) has more about radiation therapy.

Back to the Top

Delayed Care Affects Prostate Cancer in Blacks

 

By Alison McCook

Reuters Health

Friday, May 7, 2004

NEW YORK (Reuters Health) - Black men are more likely to die from prostate cancer than whites, and new research suggests that some of that disparity may stem from differences in how soon blacks receive medical care.

U.S. investigators found that, among men who were diagnosed with prostate cancer and had no other diagnosed illnesses, black men were more likely than white men to die of prostate cancer as well as other illnesses.

However, the more additional illnesses black and white men had prior to being diagnosed with prostate cancer, the more similar their death risks for both prostate cancer and other causes became.

These findings suggest that, for black men, being diagnosed with additional illnesses may indicate that they have regular contact with health professionals, study author Dr. Vincent Freeman told Reuters Health. He explained that black men who had no additional diagnoses prior to finding out they had prostate cancer likely had other illness that were simply not detected.

"Compared to men with no apparent health problems at the time their prostate cancer was diagnosed, patients with multiple health problems may have been more connected to their healthcare system due to a greater degree of awareness and surveillance of potential problems," elaborated the researcher, based at the Midwest Center for Health Services and Policy Research.

For their study reported in the American Journal of Public Health, Freeman and his colleagues reviewed the records of 864 black and white men diagnosed with prostate cancer in Chicago hospitals between 1986 and 1990.

The researchers found that black men were more than 80 percent more likely to die of prostate cancer and 70 percent more likely to die of other illnesses than white men.

However, black men who had received diagnoses of additional illnesses before finding out they also had prostate cancer tended to survive just as long as white men, according to report.

Freeman said that he and his colleagues were "very surprised" by their findings. He added that he hopes these results inspire people to examine closely how different races fare differently in the healthcare system.

"We have to confront the factors in our society and healthcare system that lead to racial/ethnic disparities in healthcare access and quality," he noted.

Source: American Journal of Public Health, May 2004.

Back to the Top

Some With Sickle Cell Disease Face Stroke Risk

 

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- Although they may appear normal, many children and teens with a common variety of sickle cell disease suffer silent strokes or have circulatory problems that put them at risk for overt stroke.

That warning comes from a study in this week's online edition of the Annals of Neurology.

The authors recommend neurological screening for all people with the beta-thalassemia form of sickle cell disease.

"All sickle beta-thalassemia patients should be routinely screened with MRI and tests of brain blood flow in order to detect abnormalities not easily seen in clinical examination," study author Dr. Dimitrios I. Zafeiriou, of the Aristotle University of Thessaloniki, Greece, said in a prepared statement.

He and his colleagues did extensive testing on 21 children and young adults with S-beta-thalassemia. More than a third (38 percent) showed MRI evidence of previous silent strokes, even though they didn't exhibit significant deficits during neuropsychological testing.

And nearly a third of the patients, including many who hadn't suffered silent strokes, had abnormal blood flow to the brain.

"The next step will be to follow these patients in order to see if they will experience clinically overt stroke," Zafeiriou said.

More information

The U.S. National Library of Medicine has information about beta-thalassemia.

Back to the Top

Experts Comment on Angioplasty X-Rays

 

By Susanna Loof

Associated Press Writer

The Associated Press

Friday, May 7, 2004

VIENNA, Austria - X-rays used during angioplasty can cause severe skin burns, and many cardiologists need more training in how to minimize radiation exposure to patients undergoing the procedures, experts warned on Friday.

The benefits of the operation far outweigh the side effects, but experts from the International Atomic Energy Agency said doctors they must learn how to reduce the radiation risks.

During angioplasty, a catheter attached to a balloon is threaded through the blood vessels to open a blocked artery by squeezing the plaque against the walls. The technique often eliminates the need for open-heart surgery. To guide the catheter to the right spot, doctors use fluoroscopy, a technique that provides live X-ray images.

But the radiation used in fluoroscopy is much stronger than that used in normal X-rays, and a small number of patients suffer skin damage. Some could later develop cancer because of the exposure, said Dr. Madan Rehani, a radiation safety specialist with the IAEA.

The radiation problem is not new the U.S. Food and Drug Administration (news - web sites) in 1994 alerted U.S. hospitals about the risk for radiation injury in the procedures but many cardiologists still lack training about how to handle the radiation danger, Rehani said.

"It is shocking," Rehani said."X-rays have been used for decades safely, so people think they are safe."

He estimated that about one in 10,000 angioplasty patients suffer severe skin injuries some so bad that they require skin grafts. About 1 million angioplasties are performed worldwide each year, and the number is growing fast.

Cardiologists should educate themselves about the radiation risks and take steps to reduce them, for example, by keeping the radiation source as far away from the patient as possible, and by moving the beam in extended procedures to avoid exposing the same patch of skin, Rehani said.

Patients with radiation skin burns often are misdiagnosed because their physicians or dermatologists don't see the connection between the skin damage and the fluoroscopy, Rehani said. Early symptoms, which arise days or weeks after the angioplasty, include a rash.

The benefits of angioplasty a procedure that is less risky than by-pass surgery and has saved the lives of many heart patients far exceed the risks of radiation exposure, said Dr. Guglielmo Bernardi, a cardiologist based in Udine, Italy.

"We can do better and better if we perform the procedure in an optimized way," he added.

The Vienna-based U.N. nuclear agency held a two-day meeting ending Friday to teach cardiologists from 25 mostly developing countries about the problem. Of the 27 cardiologists taking part in the program, 88 percent said the meeting was their first formal training in radiation risks.

The meeting was part of an agency action plan to reduce the radiation dangers facing patients.

Back to the Top

Morphine Doesn't Ease Pain in Preemies

 

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- Morphine does not relieve acute pain felt by premature infants when they undergo routine care and invasive procedures in the Neonatal Intensive Care Units (NICUs), says a French study.

It included 42 premature babies born at 23 weeks to 32 weeks gestation. Half received morphine at a loading dose of 100 mcg/kg, followed by infusions of 10 to 30 mcg/kg/h according to gestation. The other half received a placebo.

Heelsticks were then used to check the babies' responses to acute pain. There was little or no difference between the babies who received morphine and those who got the placebo. The study authors concluded morphine doesn't provide adequate acute pain relief for premature babies.

These babies, who are highly sensitive to pain, undergo many painful procedures as part of their standard care while in the NICU, the study noted. That's why it's critical to identify a safe and effective way to provide them pain relief.

The research was presented this week at the annual meeting of the Pediatric Academic Societies in San Francisco.

More information

The U.S. National Institutes of Health (news - web sites) has more about children and pain.

Back to the Top

Moderate Exercise May Cut Breast Cancer Risk

 

Reuters Health

Friday, May 7, 2004

NEW YORK (Reuters Health) - Increased physical activity significantly reduces levels of estrogens in postmenopausal women and thus may reduce the risk of breast cancer, according to a report in the medical journal Cancer Research.

This may be one more motivation for patients to exercise, lead researcher Dr. Anne McTiernan told Reuters Health. Moreover, "women don't need to become athletes to see beneficial effects on bio-markers of breast cancer risk."

Postmenopausal women who engage in regular physical activity are known to be less likely to develop breast cancer, she and her colleagues point out, but the factors behind this association remain uncertain.

To investigate, McTiernan at the Fred Hutchinson Cancer Research Center in Seattle and her colleagues examined the effect of a 12-month program of moderate-intensity exercise in 173 sedentary, overweight or obese, postmenopausal women who were not receiving hormone therapy.

Women who exercised experienced significant declines in blood levels of the female hormones estrone, estradiol, and free estradiol, compared with smaller declines or increases among controls, who did not increase their activity level.

Fat mass decreased in exercisers and greater losses of body fat were associated with larger decreases in blood hormone levels.

These results, the authors conclude, "support our hypothesized mechanism that exercise could lower breast cancer risk in postmenopausal women by reducing body fat and ultimately circulating estrogen concentrations."

Source: Cancer Research, April 15, 2004.

Back to the Top

Health Tip: Dandruff Dissected

 

HealthDayNews

Friday, May 7, 2004

(HealthDayNews) -- Dandruff is caused by a fat-eating yeast-like fungus called malassezia, which lives on most people's scalps without causing a problem, according to the Ontario government.

Sometimes, however, this fungus grows out of control and causes faster cell production than usual. New cells thus move much more quickly from the deepest layer of your scalp to the outer layer, where they flake and fall off.

While doctors don't know why only some people are affected, increased oil production may be partly to blame.

Here are some flake control suggestions:

Back to the Top

Lyme Disease at Highest Level in 2002

 

By Daniel Yee

Associated Press Writer

The Associated Press

Friday, May 7, 2004

ATLANTA - Lyme disease has climbed to its highest level on record in the United States, in part because of the building of more and more homes in the woods, the government reported Thursday.

During 2002, a total of 23,763 cases were reported to the Centers for Disease Control and Prevention (news - web sites) up 40 percent from the previous year.

"It is alarming to us," said Dr. Erin Staples, a CDC researcher. "People really have to know they can reduce their risk of Lyme disease."

Lyme disease bacteria are transmitted to humans by ticks that are carried by deer. The CDC attributed the rise in cases to growing populations of deer that support deer ticks, more homes being built in wooded areas and better recognition and reporting of the disease.

Lyme disease was named in 1977 when a cluster was identified in Lyme, Conn. The 2002 cases were mainly in the Northeast, mid-Atlantic and north-central states. Only Hawaii, Montana and Oklahoma reported no cases in 2002.

People can lower their risk of getting the disease by using insect repellent and promptly removing ticks from the body, the CDC said.

The disease is often identified by an expanding "bulls-eye" rash that develops days to weeks after a tick bite. Other symptoms include tiredness, fever, muscle aches and joint pain.

If untreated, the disease can cause joint swelling and brain inflammation.

On the Net:

CDC Lyme disease info: http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

Back to the Top

Early Insulin May Help Diabetics Avoid It Later

 

Reuters Health

Friday, May 7, 2004

NEW YORK (Reuters Health) - A short course of insulin therapy may help people newly diagnosed with type 2 diabetes avoid this therapy later, Canadian researchers report.

In type 2 diabetes, insulin production continues (unlike the situation in type 1 diabetes) but the body's response to the hormone is blunted. Standard drug treatment is aimed at increasing sensitivity to insulin, but in some cases extra insulin becomes necessary on an ongoing basis to ensure that glucose is processed properly.

The new findings, which appear in the medical journal Diabetes Care, are based on a study of 16 patients with newly diagnosed type 2 diabetes who were treated with intensive insulin therapy for 2 to 3 weeks. All of the subjects had high blood sugar levels when the study began.

This short-term therapy produced a marked improvement in sugar levels, lead author Dr. Edmond A. Ryan and colleagues, from the University of Alberta in Edmonton, note. Moreover, this improvement was still present one year later.

At 1-year follow-up, only one patient required insulin, while the rest were able to control their sugar levels with diet or pills. Predictors of good control with diet alone included requiring less insulin during the initial treatment phase, and having a lower sugar level at the end of that phase.

"The ease with which (normal sugar levels are) achieved on insulin may predict those patients who can later succeed in controlling glucose levels with attention to diet," the researchers conclude. "However, the numbers in this study were small, and the results need confirmation with larger studies before being considered as a routine clinical option."

Source: Diabetes Care, May 2004.

Back to the Top

Health Tip: The Benefits of Beer

 

HealthDayNews

Friday, May 7, 2004

(HealthDayNews) -- Beer drinking may lead to more than just a beer belly.

According to the Friedman School of Nutrition Science and Policy at Tufts University, beer contains high levels of an ingredient that helps deposit calcium and other minerals into bone tissue.

And a recent study found the antioxidants present in dark beer help prevent clogged arteries, which should reduce the risk of heart disease.

Most research showed the optimum benefits can be reaped with up to one drink a day for women and up to two a day for men.

Still, it's a good idea to take a look at the size of your beer belly before you knock back a pint or two. The extra calories found in beer may cancel out any health benefits.

Back to the Top

Treating Sleep Apnea Could Cut Road Deaths

 

By Amy Norton

Reuters Health

Friday, May 7, 2004

NEW YORK (Reuters Health) - Nearly 1,000 deaths from vehicle collisions could be avoided each year in the U.S. if all drivers with the obstructive sleep apnea received a standard treatment, according to researchers.

Obstructive sleep apnea is the most common form of sleep apnea, a disorder marked by repeated stops and starts in a person's breathing during sleep, sometimes hundreds of times during the night. These breathing disruptions make for poor-quality sleep and daytime symptoms such as drowsiness, concentration problems and dulled reaction times -- potential hazards on the road.

The new study suggests that of an estimated 1,400 traffic deaths related to obstructive sleep apnea in 2000, 980 could have been prevented if all the drivers had been treated with continuous positive airway pressure (CPAP).

The estimates, based on data from the National Safety Council and published medical studies, also indicate such treatment could save Americans $11 billion a year in collision costs.

Dr. Alex Sassani of the University of California San Diego and his colleagues report the findings in the journal Sleep.

In obstructive sleep apnea, tissues in the throat temporarily collapse during sleep, hindering airflow. CPAP devices deliver air, via a facemask, into the airways to keep them open. It's a common treatment for sleep apnea, but many people with the disorder go undiagnosed and, therefore, untreated.

One reason is that it's a "silent" disorder that many people simply aren't aware they have, Sassani told Reuters Health. In addition, he said, most primary care doctors do not screen people with risk factors -- such as being older than 40 and overweight -- because "it's not drilled into their heads" to do so.

Sassani and his colleagues estimate that more than 800,000 drivers were involved in vehicle crashes related to obstructive sleep apnea in 2000, at a cost of nearly $16 billion and 1,400 lives. They say the numbers represent a "small but significant" portion of the road collisions and deaths that occurred in the U.S. that year.

As an example of sleep apnea's potential impact on the road, Sassani noted that one recent study of commercial truck drivers found that 28 percent had the condition.

Because the breathing difficulties occur during sleep, a person can easily be unaware of having it. According to Sassani, some potential indications of sleep apnea include daytime drowsiness and snoring -- although neither of these are necessarily related to the condition.

In addition, he said, people who have diabetes or high blood pressure are at greater risk of having sleep apnea. Research suggests that sleep apnea helps promote these conditions.

The study received funding from the medical-device company ResMed Corporation, which makes CPAP devices. Other treatment options for sleep apnea include dental devices, surgery and, when appropriate, weight loss.

Source: Sleep, May 2004.

Back to the Top

Soy Nuts May Dampen Hot Flashes

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Friday, May 7, 2004

FRIDAY, May 7 (HealthDayNews) -- Looking to throw some cold water on hot flashes? Head to the health-food section of your supermarket.

New research suggests soy nuts, coupled with exercise, might be a good treatment for women struggling with those troubling side effects of menopause.

Daily hot flashes fell by nearly half in women who ate a half cup of roasted soy nuts each day and exercised more than 4.5 hours a week. Hot flashes dropped by 27 percent in women who consumed the same amount of soy and exercised just 30 to 90 minutes a week, the researchers found.

The findings were presented May 7 at the American Heart Association (news - web sites)'s annual conference on Arteriosclerosis, Thrombosis and Vascular Biology in San Francisco.

The study is the first to show a combined benefit of soy consumption and exercise, said co-author Dr. Francine Welty, director of cardiovascular care for women at Beth Israel Deaconess Medical Center in Boston. Soy may be a good option for women who are worried about taking estrogen supplements, she added.

"Now that we know that estrogen increases the risk of stroke, women are looking for alternatives to treat their hot flashes. This is a potentially good alternative," she said.

Welty and a colleague enrolled 60 postmenopausal women in their study and put them on a diet low in saturated fat. For eight weeks, half the women ate soy nuts each day, while the other half did not. Then the two groups switched regimens for another eight weeks.

Before the study, the women reported having an average of five hot flashes a day.

Seventy percent of the women in the study didn't exercise vigorously, but instead took part in activities such as walking. Hot flashes dropped by 46 percent in women who exercised four or more days a week, and 25 percent among those who exercised between one and 2.5 days a week.

The link between soy and postmenopausal health isn't new. Researchers have investigated the connection since they noticed hot flashes are rare among Asian women who eat a lot of soy products, Welty said. The female hormone estrogen is a part of soy and may explain its effects, she said.

An estimated 40 percent to 70 percent of menopausal and postmenopausal women experience hot flashes, said Jodi Anne Flaws, an associate professor in the Department of Epidemiology and Preventive Medicine at the University of Maryland.

While they typically contribute to problems such as fatigue and irritability, there are signs that hot flashes may be linked to Alzheimer's disease (news - web sites), osteoporosis and depression, Flaws said.

Doctors don't fully understand hot flashes or why some women have them and some don't, although some experts suspect hormonal changes disrupt the brain's body temperature regulation system. Hot flashes begin at menopause in many women and can plague them at high levels for two to three years, Welty said. Typically, they end within five years.

"I've had some patients tell me if they need to give a presentation at work, they may turn beet red [during a hot flash]," Welty said. "It appears that stress aggravates them. Their clothes can become wet, and night sweats can cause them to change their nightgowns and sheets."

Welty suggests women eat soy nuts throughout the day to spread their benefits around. The women in the study ate nuts four times daily and stuck to a healthier, low-salt, dry-roasted brand.

She also cautioned that soy didn't help every woman in the study.

Flaws, the University of Maryland professor, said the study findings are promising but must be confirmed by additional research. She added that better understanding of hot flashes could lead to more effective ways to prevent them.

More information

Learn more about hot flashes and other aspects of menopause from the National Institutes of Health or the American Academy of Family Physicians.

Back to the Top

Thursday, May 6, 2004

 

Surgery Found to Halve Stroke Risk in Some Patients

 

By Patricia Reaney

Reuters

Thursday, May 6, 2004

LONDON (Reuters) - Surgery can halve the odds of a stroke, one of the leading killers worldwide, in high-risk patients, scientists said on Friday.

Severe narrowing of the carotid artery that carries blood to the brain raises a person's chance of having a disabling or fatal stroke, which accounts for one in 10 of the 55 million deaths that occur each year worldwide.

But researchers at St George's Hospital in London said a two-hour operation, under general or local anaesthetic, can alleviate the narrowing.

"It's clear from our trial that immediate surgery is the best option for some patients with severe narrowing of the carotid artery," said Alison Halliday, a vascular surgeon who reported the finding in The Lancet medical journal.

In a trial of 3,000 patients in 126 hospitals in 30 countries, she and her colleagues found that surgery halved the risk of stroke from 12 to six percent in high-risk patients after a five-year follow-up.

"Most of the patients we found who benefited were under the age of 75," Halliday said in an interview.

Stroke is the second leading cause of death, after ischemic heart disease, according to the World Health Organization (news - web sites). It is also among the five most important causes of disability and occurs when a blockage stops the flow of blood to the brain.

But it is also largely preventable with efforts to reduce blood pressure and raised cholesterol levels.

Although surgery itself can cause stroke, the risk is much less that it would be without an operation.

Anyone with a blockage in the artery of between 70 and 90 percent would be a candidate for surgery, according to Halliday. Blockages occur in the carotid artery just as they do in arteries linked with heart attack.

People who have high blood pressure, who smoke, who have diabetes or have high cholesterol have an increased risk of stroke.

Ultrasound screening on the neck will detect narrowing of the carotid artery.

"We hope this research provides hope for people," said Halliday, adding she plans to follow up patients for an additional five years.

Back to the Top

Lyme Disease at Highest Level in 2002

 

By Daniel Yee

Associated Press Writer

The Associated Press

Thursday, May 6, 2004

ATLANTA - Lyme disease has climbed to its highest level on record in the United States, in part because of the building of more and more homes in the woods, the government reported Thursday.

During 2002, a total of 23,763 cases were reported to the Centers for Disease Control and Prevention (news - web sites) up 40 percent from the previous year.

"It is alarming to us," said Dr. Erin Staples, a CDC researcher. "People really have to know they can reduce their risk of Lyme disease."

Lyme disease bacteria are transmitted to humans by ticks that are carried by deer. The CDC attributed the rise in cases to growing populations of deer that support deer ticks, more homes being built in wooded areas and better recognition and reporting of the disease.

Lyme disease was named in 1977 when a cluster was identified in Lyme, Conn. The 2002 cases were mainly in the Northeast, mid-Atlantic and north-central states. Only Hawaii, Montana and Oklahoma reported no cases in 2002.

People can lower their risk of getting the disease by using insect repellent and promptly removing ticks from the body, the CDC said.

The disease is often identified by an expanding "bulls-eye" rash that develops days to weeks after a tick bite. Other symptoms include tiredness, fever, muscle aches and joint pain.

If untreated, the disease can cause joint swelling and brain inflammation.

On the Net:

CDC Lyme disease info: http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

Back to the Top

Lawsuits May Be Tool for Fighting U.S. Obesity

 

By Charles Abbott

Reuters

Thursday, May 6, 2004

WASHINGTON (Reuters) - Lawsuits may be the only way to force U.S. foodmakers to produce healthier foods or curb ads that encourage over-eating, speakers at an obesity conference said on Thursday.

Two-thirds of adult Americans are overweight or obese. Poor diet and inactivity is now the No. 2 cause of preventable death, killing about 400,000 Americans each year, the government says. Fifteen percent of U.S. children are overweight.

Some speakers at an annual Consumer Federation of America conference on food and nutrition lamented that restaurant menus did not carry calorie counts and there were no restrictions on aiming advertisements for sugar-rich food at children or minimum-nutrition standards for childrens' food.

"Trial lawyers and (state) attorneys general can be extremely helpful," said Michael Jacobson, head of the consumer group Center for Science in the Public Interest, by "filing innovative suits" that prompt foodmakers to produce healthier foods.

Walter Willett, nutrition chairman at Harvard University, asked if food companies were liable for the obesity explosion with misleading ads or making foods with little value in a balanced diet.

Lawsuits were "the least desirable option," Willett said in an interview, but "it may be the default."

Barbara Moore, president of Shape Up, America, a group advocating physical exercise, said she was "a strong believer in taking responsibility for my eating behavior."

Executives from PepsiCo Inc., Kraft Foods Inc and McDonald's Corp. said their firms were modifying their products to reduce calories or unhealthy ingredients such as trans fats.

Michael Mudd, Kraft executive vice president for global corporate affairs, criticized "senseless finger-pointing" that "portrayed (obesity) as a morality play."

Food executives said 78 percent of meals are eaten at home. Consumer groups said one-third of calories are eaten outside the home.

An aide to Florida Republican Rep. Ric Keller was optimistic Congress would pass a law this year to ban lawsuits that blame the food industry for making people fat. The House of Representatives passed Keller's bill to ban the lawsuits and a companion bill is pending in the Senate.

"There should be common sense in the food court," said Keller aide Mike Shutley, rather than going to court.

The proposed legislation would dismiss any existing lawsuits against the makers, distributors or sellers of food related to obesity claims and prevent any new ones from being filed.

Northeastern University law professor Richard Daynard said lawsuits against deceptive marketing were a way to reform the food industry. Daynard is involved in a movement to have the tobacco industry take responsibility for smoking-related deaths.

Back to the Top

Health Tip: Food Sensitivities in Infants

 

HealthDayNews

Thursday, May 6, 2004

(HealthDayNews) -- Because some infants have sensitivities or allergies to certain foods, the Children's Hospital in Richmond, Va., suggests you choose single-ingredient infant cereals and plain fruits and vegetables until you know what your child can tolerate.

And introduce new foods one at a time and wait three to five days in between each new food.

Food sensitivities can manifest themselves in several ways. Your child may develop a rash, wheezing, diarrhea or vomiting.

But before you blame food for your infant's ailments, have your pediatrician rule out other possible causes.

Back to the Top

U.S. Says Folic Acid Behind Drop in Birth Defects

 

By Paul Simao

Reuters

Thursday, May 6, 2004

ATLANTA (Reuters) - The number of fetuses developing two severe types of birth defects each year has fallen about 26 percent since the United States started adding folic acid to some foods, federal officials reported on Thursday.

But the decrease in prevalence of spina bifida and anencephaly was smaller than what had been expected by researchers, raising doubts that the nation will be able to achieve a 50-percent reduction in these devastating neural tube defects by 2010.

Spina bifida, a deformation of the spine, is the leading cause of childhood paralysis in the United States. Anencephaly, the congenital absence of much of the brain and spinal cord, results in miscarriage, stillbirth or an infant's death shortly after birth.

The Food and Drug Administration (news - web sites) made it mandatory in 1998 for enriched bread, pasta and other cereal grains to be fortified with folic acid, which is also found in leafy green vegetables, some beans and orange juice.

The incidence of neural tube defects has been shown to drop by up to 70 percent when women take 400 micrograms of folic acid daily before conception and in the first trimester of pregnancy.

There were an estimated 3,020 pregnancies affected by spina bifida and anencephaly annually in 1999-2000, compared with 4,130 annually from 1995 to 1996, according to a study by the Centers for Disease Control and Prevention (news - web sites).

"Women have increased the folic acid that they're getting from their diet, but it's not enough," said Jenny Williams, a nurse epidemiologist in the CDC's national center on birth defects and developmental disabilities and one of the study's authors.

Williams said at least another 1,000 babies could be born without neural tube defects each year if all women of childbearing age consumed 400 micrograms of folic acid each day in addition to a healthy diet.

A fetus's neural tube develops early in the first trimester, before many women are aware that they are pregnant. About half of all pregnancies in the United States are unplanned, according to the CDC.

Back to the Top

More Young People Developing Diverticulitis

 

HealthDayNews

Thursday, May 6, 2004

THURSDAY, May 6 (HealthDayNews) -- More young city dwellers in the United States have acute diverticulitis than previously believed, says a University of Maryland study, and higher rates of obesity may be to blame.

The study included 100 patients with acute diverticulitis, which occurs when pouches called diverticula push through weak spots in the colon and become inflamed. Fifty of the patients were between the ages of 20 and 50 (19 of them were younger than 40), and 50 patients were over 50.

The findings show the disease is as common in younger people as it is in those who are older. The study was presented May 3 at the American Roentgen Ray Society annual meeting in Miami Beach, Fla.

"Traditionally, acute diverticulitis has been considered a disease of the over 50 year age group. Many radiologists and other physicians do not recognize that acute diverticulitis is now a disease that may occur at any age in adult life and do not consider it as a possible cause when younger adults present with abdominal pain," study co-author Dr. Barry Daly said in a prepared statement.

He and his colleagues are trying to identify why this condition is becoming more common in young people.

"We are examining the relationship between acute diverticulitis and overweight body habitus, as there appears to be a strong association between the rising incidence of acute diverticulitis in younger adults and the evolving obesity epidemic in this country," Daly said.

More information

The U.S. National Digestive Diseases Information Clearinghouse has more about diverticulitis.

Back to the Top

U.S. States Do Poorly in Women's Health Report

 

Reuters

Thursday, May 6, 2004

WASHINGTON (Reuters) - Not a single U.S. state meets basic federal goals for caring for women's health, and the nation as a whole fails except in two areas -- mammograms and dental check-ups, researchers said on Thursday.

Millions of women lack health insurance, and states make it difficult to enroll in Medicaid, the state-federal health insurance plan for the poor, according to the report.

And few states are doing anywhere near enough to help women quit smoking -- the leading cause of death in the United States.

"The nation as a whole and the individual states fall short of meeting national goals," reads the report, put together by the National Women's Law Center and the Oregon Health & Science University.

"These health objectives, primarily set for the nation by the U.S. Department of Health and Human Services (news - web sites)' Healthy People 2010 agenda, provide a roadmap for assessing the status of women's health."

But of 27 measures examined by the group, from screening for diseases to actually treating them, the nation passes on only two, the researchers said.

"The nation is so far from the Healthy People goals that it receives an overall grade of 'unsatisfactory'," they wrote.

The problem seems to be a lack among states of an overall plan for health in general, the NWLC said.

"State policy makers' piecemeal approach to our health care crisis has resulted in a complex and ineffective system that fails to meet the health care needs of women," Judy Waxman, NWLC Vice President for Health, said in a statement.

"Lawmakers need to take a comprehensive, long-term approach to meeting women's health needs and tackle this serious problem that plagues so many families."

For example, Healthy People 2010 has a goal of providing early and adequate prenatal care in 90 percent of pregnancies. In 1998, only 74 percent of pregnant women got this care.

Massachusetts is almost there, with 89.9 percent of women receiving first trimester care. Most other states are above 80 percent but in New Mexico only 69 percent of women got adequate early pregnancy care.

Healthy People 2010 aims to reduce the obesity rate to 15 percent of adults. But 25 percent of adult women in Alaska are obese and overall 30 percent of Americans are obese.

Minnesota ranks first overall in the survey, followed by Massachusetts, Vermont, Connecticut, New Hampshire, Hawaii, Colorado, Utah, Maine and Washington. The 10 states ranking the lowest were Mississippi, Louisiana, Arkansas, West Virginia, Oklahoma, Texas, Alabama, the District of Columbia, Kentucky, and Tennessee.

Back to the Top

Protein Can Trigger Anemia in Inflammatory Diseases

 

HealthDayNews

Thursday, May 6, 2004

THURSDAY, May 6 (HealthDayNews) -- Interleukin-6, an immune system protein, sets off a chain reaction that results in chronic anemia in many people with infections and major inflammatory diseases.

That's the conclusion of a University of California, Los Angeles study in the May 1 issue of the Journal of Clinical Investigation.

This finding may help scientists develop new ways to prevent anemia in people with inflammatory bowel disease and rheumatoid arthritis, the researchers say.

The chain reaction occurs when interleukin-6 stimulates an increase in the hormone Hepcidin, which then lowers the amount of iron in the bloodstream.

"We knew previously that the iron level in the blood drops during an infection or inflammatory state, but didn't know the molecular mechanism that sparks this response," principal investigator Dr. Tomas Ganz, a professor of medicine and pathology, said in a statement.

"For the first time, we now can show the complete biological sequence of events leading to anemia in specific inflammatory diseases and infections," Ganz said.

More information

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

Back to the Top

Diabetes Common After Pregnancy-Related Diabetes

 

Reuters Health

Thursday, May 6, 2004  

NEW YORK (Reuters Health) - Diabetes that develops during pregnancy normally clears up after delivery. Nowadays, however, full-blown diabetes often develops in women with previous so-called gestational diabetes mellitus (GDM), according to a new study.

This appears to be the result of a substantial increase in body weight among women with GDM.

In a study published in the medical journal Diabetes Care, Dr. Jeannet Lauenborg, of Copenhagen University Hospital, in Denmark, and colleagues examined the incidence of diabetes among Danish women with previous GDM. They also assessed risk factors for the development of diabetes.

The researchers studied 241 women with diet-treated GDM during 1978 to 1985 (old cohort) and 512 with GDM between1987 and 1996 (new cohort). A total of 481 women were followed for an average of almost 10 years after their pregnancy.

By the end of follow-up, diabetes was present in 192 (40 percent) of the participants while another 130 (27.0 percent) had impaired glucose tolerance, Lauenborg and colleagues report.

Diabetes developed in 41 percent of the new cohort, compared with only 18 percent of the old cohort.

Pre-pregnancy body mass index (weight related to height) was significantly higher in the new cohort compared with the old cohort, the team found.

"Women with previous GDM represent a target group for intervention to postpone or prevent the development of overt diabetes," the authors conclude.

Source: Diabetes Care, May 2004.

Back to the Top

New Target For Pain Relief Found

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, May 6, 2004

THURSDAY, May 6 (HealthDayNews) -- German researchers report the discovery of a key link in the molecular pathway that sends pain-generating signals to the brain.

The finding could open the way to a new generation of more effective painkillers, said Ulrike Mller, a neurobiologist at the Max-Planck-Institute for Brain Research in Frankfurt and a member of the team reporting the discovery in the May 7 issue of Science.

The molecule they describe is a receptor that sits on the surface of cells in the spinal cord. The function of that receptor, designated GlyR alpha3, is to block transmission of pain signals generated by injury or inflammation, Mller explained.

But GlyR alpha3 activity is blocked by prostaglandins, molecules that are produced by pain-causing activity, she said.

"What we have to do now is find a substance that keeps the receptor open," she said. "There is no known substance that would do that now."

Today's painkillers such as aspirin act by inhibiting production of prostaglandins, "but these can have serious side effects," Mller said. "One could imagine a second generation of analgesics that specifically target this receptor."

Scientists have known about the existence of GlyR alpha3 for years, she said, but its function was not known. "Our goal was not to cure pain," Mller said. "Our goal was to find the function of the receptor."

Research with mice bred to have a deficiency of GlyR alpha3 outlined that function. Those mice experienced less pain from inflammation or injury than normal mice, the researchers found.

Pain is a complex function, it appears. When something happens to cause pain -- a flare-up of arthritis or a pinched finger -- prostaglandins are generated both at the site of pain and in the spinal cord.

"One has known that prostaglandins are produced in the spinal cord, but it has not been known what the target of those prostaglandins might be," Mller said.

Now they know. But one problem in putting the discovery to work is that this receptor is a member of a family of molecules that have only slight -- but nevertheless critical -- differences in structure.

"It will be crucial to find compounds with high selectivity for the alpha3 subunit," Mller said.

More information

News about pain and efforts to relieve it is available from the American Pain Foundation or the American Academy of Pain Management.

Back to the Top

Antibiotic-Allergic People Can Be Desensitized

 

By Megan Rauscher

Reuters Health

Thursday, May 6, 2004

NEW YORK (Reuters Health) - Imagine this: You have a serious bacterial infection but you're allergic to the only antibiotics that can knock out the infection. In such a "challenging" situation, desensitization is a useful option, doctors report.

"Rather than denying these patients potentially life-saving therapy, antibiotic desensitization should be considered," Dr. Stuart E. Turvey, of Children's Hospital in Boston, told Reuters Health.

Desensitization involves administering the antibiotic in small, increasing doses "until the full therapeutic dose is clinically tolerated," he said.

Turvey and his colleagues reviewed the medical records of all 21 patients who underwent antibiotic desensitization at their institution during a five-year period. Nineteen of the patients were people with cystic fibrosis, who are predisposed to develop allergy to a wide range of antibiotics because they often have to take multiple courses of antibiotics over their lifetime.

A total of 57 desensitizations were performed involving 12 different antibiotics, with successful outcomes in 75 percent of cases, Turvey's team reports in the Annals of Allergy, Asthma, & Immunology.

Of the 11 (19 percent) of antibiotic desensitization procedures that were terminated due to an allergic reaction, none were fatal or required intubation or other aggressive measures.

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

Back to the Top

Trial Pill Helps Elderly Insomniacs

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Thursday, May 6, 2004

THURSDAY, May 6 (HealthDayNews) -- A new pill helps older insomniacs sleep longer and more soundly at night and cuts down on their daytime napping, new research has found.

The drug, called eszopiclone, is a derivative of an older medicine called zopiclone, said Dr. W. Vaughn McCall, chairman of psychiatry and behavioral medicine at Wake Forest University Baptist Medical Center. He was to present the research May 6 at the annual meeting of the American Psychiatric Association in New York City.

Eszopiclone (brand name Estorra) has not yet been approved for marketing by the U.S. Food and Drug Administration (news - web sites).

McCall's research team assigned 264 insomniacs, aged 65 to 85, to a placebo group or a group receiving eszopiclone nightly for two weeks. They then measured the quality and quantity of their slumber in a sleep lab.

The drug group slept better and longer and napped less during the day, he said. "During the course of two weeks of treatment, the people who were on placebo were awake about 75 minutes per night [after having fallen asleep], and eszopiclone reduced that to about 63 minutes. It was a small but statistically significant difference."

Total sleep time improved, too. "In the placebo group, it was 350 minutes a night [or about 5.8 hours]. The drug-treated group got 25 more minutes a night on average," McCall said.

Those taking the sleeping pill also napped less during the day. "Of those who napped -- and that was about 50 percent of both groups -- those who were on placebo typically napped three times a week, and in those on eszopiclone it was reduced to two times a week," McCall said.

The newer drug is similar to Ambien (zolpidem) and Sonata (zaleplon), two commonly prescribed sleeping pills, said McCall, whose study was funded by Sepracor Inc., eszoplicone's maker. No sleeping pill is meant for long-term use, he warned. "Currently the FDA labeling requires that sleeping pills be prescribed not more than two to three weeks and then the patient is re-evaluated," he said.

"It sounds like a very good report," said William Wohlgemuth, a psychologist and assistant clinical professor of psychiatry at Duke University Medical Center. "As people get older, they have more difficulty maintaining sleep," he said. If the new sleeping pill helps them stay asleep and maintain daytime functioning without getting sleepy, "that's exactly what you want in a sleeping pill."

Insomnia is the most common sleep complaint at any age, according to the National Institute on Aging (NIA). It's defined as taking a long time to fall asleep, such as more than 30 to 45 minutes, waking up many times during the night, waking up too early, and being unable to get back to sleep and waking up feeling tired.

Besides sleeping pills, other ways to coax sleep, according to the NIA, are to go to sleep and get up at the same time and to try not to nap during the day. Experts also advise those with insomnia to avoid caffeinated beverages late in the day and not to drink alcohol before bed, which can disrupt sleep.

Developing a daily bedtime routine, such as reading a book, soaking in a warm tub, or watching television, can also help.

More information

To learn more about a good night's sleep, visit the National Institute on Aging. To learn about sleep and aging, click on the National Sleep Foundation.

Back to the Top

Forearm Artery Not So Great for Heart Surgery

 

By Anthony J. Brown, MD

Reuters Health

Thursday, May 6, 2004

NEW YORK (Reuters Health) - With cardiac bypass surgery, a blood vessel found elsewhere in the body is used to bypass the blocked arteries feeding the heart. Findings from a new study suggest that a vessel in the forearm called the radial artery may not be the best choice.

This is because the radial artery is less likely than other "grafts" to remain open after surgery. On long-term follow-up, only about half of radial artery grafts are still open. In contrast, up to 90 percent of other graft types remain open. When a graft closes, patients often need to undergo heart surgery again.

According to the new report, the best choice for cardiac bypass surgery was a blood vessel on the inside of the chest called the internal mammary artery (IMA). The next best choice was a vessel in the leg called the saphenous vein (SVG). The findings are reported in Circulation: Journal of the American Heart Association (news - web sites).

"Most studies comparing radial artery grafts with SVG and IMA grafts have looked at outcomes within 1 year of surgery," lead author Dr. Umesh N. Khot, from Indiana Heart Physicians in Beech Grove, told Reuters Health. "In that time frame, all three graft types tend to do well."

"Our study looked at patients a little bit farther out in time and it included patients who were returning with problems," Khot noted. "The results suggest that radial artery grafts aren't doing as well as we expected them to."

The findings are based on a study of 310 patients who underwent heart surgery at The Cleveland Clinic between 1996 and 2001. Because more than one blood vessel is typically bypassed with heart surgery, all of the patients had radial artery grafts as well as other types.

Women appeared to be particularly poor candidates for radial artery grafts. At follow-up, just 39 percent of their grafts remained open compared with 56 percent of those in men.

"The findings suggest that instead of having 100% enthusiasm for radial artery grafts, we need to pause for a moment and really question whether they're doing what we're claiming them to be doing," Khot said.

Source: Circulation, May 4th online issue, 2004.

Back to the Top

Walnuts May Protect the Heart

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Thursday, May 6, 2004

THURSDAY, May 6 (HealthDayNews) -- Eating certain plant-based foods, such as walnuts, opens the arteries and may help lower cholesterol, a small study finds.

People in the study had a 33 percent improvement in vascular function -- blood flow -- after eating a plant-based diet rich in alpha-linolenic acid (ALA), compared to eating a typical American diet. Walnuts and walnut oil were the prime source of ALA in the study.

"It looks like a good study," said Dr. David Jenkins, a professor in the department of nutritional sciences at the University of Toronto. He cited several studies suggesting the type of omega-3 fatty acid found in plants like walnuts may be as beneficial to the heart as eating fatty, cold-water fish, such as mackerel, salmon and herring.

But Paul Coates, director of the National Institutes of Health (news - web sites)'s Office of Dietary Supplements (ODS), offered a more cautious point of view. "With few detailed studies on the effects of omega-3 fatty acids from plants on cardiovascular disease, this is an area requiring further research," he noted.

The ODS is sponsoring a review of scientific literature on omega-3 fatty acids for a variety of health conditions.

More than 930,000 Americans die of cardiovascular disease each year, according to the U.S. Centers for Disease Control and Prevention (news - web sites).

To help the heart, the American Heart Association (news - web sites) recommends that people eat at least two servings of fish a week, particularly fish containing omega-3 fat, which has been shown to boost levels of high-density lipoprotein -- the "good" cholesterol -- and may help lower triglycerides, a blood fat.

The heart association also recommends eating tofu and other plant-based sources of omega-3, such as walnuts, soybeans, flaxseeds, and their oils. But it says more studies are needed to show a cause-and-effect relationship between ALA and heart disease.

Sheila West, an assistant professor of biobehavioral health at Pennsylvania State University and lead author of the new study, was expected to present the findings Thursday at the American Heart Association's annual conference on Arteriosclerosis, Thrombosis, and Vascular Biology in San Francisco.

Her report follows a small Spanish study in the March 23 online edition of the journal Circulation that said walnuts protect against heart disease.

Both studies were funded by California Walnut Board, which petitioned the U.S. Food and Drug Administration (news - web sites) more than two years ago for permission to attach a health claim to walnut labels. The board proposed a label advising consumers that walnuts can reduce the risk of heart disease.

After reviewing the scientific evidence, the FDA in March approved a "qualified health claim" for whole and chopped walnuts. It reads, in part: "Supportive but not conclusive research shows that eating 1.5 oz. of walnuts per day, as part of a low saturated fat and low cholesterol diet, and not resulting in increased caloric intake, may reduce the risk of coronary heart disease."

To examine the potential benefits of plant-based ALA, West and her colleagues randomly assigned 13 adults with high cholesterol to eat three different diets. Each participant ate one diet for a six-week period and then took a two-week break before starting the next one.

One regimen in the study replicated the fat and calories of a typical American diet.

The other two diets had the same amount of total fat, but were low in saturated fat and cholesterol and high in polyunsaturated fatty acids. Half of the fat in those diets came from walnuts and walnut oil. Participants ate 1.3 ounces, or about a handful, of walnuts, and 0.53 ounces, or roughly a tablespoon, of walnut oil each day.

The two diets reflect a subtle difference. One contained varying amounts of ALA and linoleic acid. The other, dubbed the "high-dose" ALA diet, contained additional ALA from flax oil.

After each six-week diet, every participant had a noninvasive ultrasound test called flow-mediated dilation. The test showed how their blood vessels responded to changes in blood flow.

Cholesterol levels improved after people ate the two diets that replaced saturated fat with plant-based omega-3 fats. Low-density lipoprotein -- the "bad" cholesterol -- was reduced 10 to 12 percent with either diet, West noted.

But only the high-dose ALA diet improved vascular function. "The dilation responses were bigger when people consumed the high ALA diet," she said.

"I think one of the more important messages is that we didn't add nuts and oils on top of the regular diet," West said. Those healthy fats replaced saturated fats that people typically consume.

What's not entirely clear is whether the improvements noted in the study stemmed from eating plant-based ALA or from cutting out bad fats and replacing them with good ones.

It's a difficult question to test, West conceded. But Jenkins, the Canadian researcher, said diets that simply remove saturated fat have not uniformly succeeded in reducing heart disease to the extent seen with ALA.

And, West added, "It does give people a sort of grocery list idea about how to change a diet."

More information

The U.S. Food and Drug Administration has more on walnuts and heart disease. Or see the American Heart Association's recommendations for eating fish and other omega-3 fatty acids.

Back to the Top

Wednesday, May 5, 2004

 

One-Two Punch Urged for Head, Neck Cancers

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Wednesday, May 5, 2004

WEDNESDAY, May 5 (HealthDayNews) -- Giving radiation and chemotherapy to patients with advanced head and neck cancer reduces the risk of a tumor recurrence and, in some cases, also extends their lives.

Two studies appearing in the May 6 issue of the New England Journal of Medicine (news - web sites) looked at the same combination regimen and both showed a reduction in recurrence. One also showed a longer survival.

"We consider this to be an important study that adds one more piece of evidence that patient outcome can be improved by coordinated multiple specialties and multiple therapies," said Dr. Walter Curran, group chairman of the Radiation Therapy Oncology Group, which coordinated one of the studies, and clinical director of the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia.

Head and neck cancer is a difficult disease, with almost one third of patients having it spread to distant parts of the body.

Combination radiation and chemotherapy with cisplatin has become common for tumors that are have spread locally but aren't operable, said study author Dr. Jay S. Cooper, head of radiation oncology at Maimonides Medical Center in New York City.

This latest research extended the practice to people who had undergone surgery.

Cooper's trial, which was conducted in the United States, enrolled 459 patients who had had all apparent vestiges of their tumors removed by surgery. The patients were then randomly assigned to receive either radiation on its own or to receive radiation plus cisplatin.

After about two years, 82 percent of the combined therapy group had had no local recurrences compared to 72 percent in the group receiving only radiation. While disease-free survival was longer in the combination group, overall survival was not.

"If you don't find a mathematically statistically significant change, it doesn't mean one doesn't exist," Cooper said. It's possible that, over time, an overall survival would be seen. It's also possible that other lifestyle issues that contributed to the cancer (such as heavy drinking and smoking) caused other problems such as heart disease.

"Even if you do a better job of controlling tumors, it may not translate immediately into better survival because they'll still die of other things," Cooper explained.

The combination therapy was more toxic, with more adverse effects and four patients who died directly as a result of the treatment.

The second trial, which took place in Europe, randomly assigned 167 patients to receive radiation and an equal number to receive radiation plus cisplatin.

Participants in the combination group had higher disease-free survival, with their five-year survival estimated to be 47 percent. For those in the radiation group, the estimate was 36 percent. Overall survival was also higher, with five-year estimates at 53 percent and 40 percent, respectively.

The findings are likely to change clinical practice, Curran predicted. "Up until now, people who track evidence-based oncology would not recommend chemotherapy simultaneous with radiation in postoperative settings for head and neck cancer," he explained. "Now with this study and the study from Europe, they can say there's a disease control benefit to doing it. I think we will see a shift in care to include chemotherapy in the high-risk patients receiving post-operative radiation."

"These two studies report a benefit when chemotherapy in the form of cisplatin is added to postoperative radiation in patients with high-risk head and neck cancer," added Dr. Stephen Shibata, a staff physician in medical oncology and therapeutics and director of the GI Multi-Disciplinary Strategic Program at City of Hope in Duarte, Calif. "Based on this, a combination of chemotherapy and radiation should be considered in patients with head and neck cancers at high risk for local recurrence. One issue is that the addition of chemotherapy leads to more side effects during treatment. Therefore, this treatment may not be appropriate for all patients."

The questions now involve figuring out how much radiation and exactly how to administer the chemotherapy, Cooper said. "At least in theory, there might be other ways to do it, ways that have a lesser cost in terms of toxicity," he noted.

More information

For more on head and neck cancer, visit the National Cancer Institute. Learn about treatment options for cancer from the American Cancer Society.

Back to the Top

Study: 20M Workers Have No Health Coverage

 

By Mark Sherman

Associated Press Writer

The Associated Press

Wednesday, May 5, 2004

WASHINGTON - More than one in five working adults in Texas and five other Southern and Southwestern states don't have health insurance, a new study says.

In another 37 states and the District of Columbia, at least one in every 10 working adults is uninsured, according to the Robert Wood Johnson Foundation, which is leading a campaign to build support for expanding health coverage.

Organizers of the effort hope to alter public perception of health insurance as an issue that mainly affects the poor by emphasizing that the problem affects working families.

"I think this puts a different face on the uninsured. When people have a sense that it is someone like my neighbor or it could be me it does give you a different political face to work from," said Mary Grealy, president of the Healthcare Leadership Council, an association of health care executives.

Ron Pollack, president of Families USA, a liberal consumer group, said the focus is now on "self-interest as well as altruism."

But unlike past attempts to extend coverage to everyone, getting more people insured has to occur in smaller steps, groups across the political spectrum say.

The most likely place to begin is in trying to cover the 8.5 million children without health insurance, they say.

Former Presidents Jimmy Carter and Gerald Ford are serving as co-chairmen for Cover the Uninsured Week. A coalition of diverse groups, including business, labor and several health organizations, has come together to push the issue in 1,500 events next week.

The campaign's organizers are pointing to 2005 without the distraction of a presidential campaign to press Congress to pass legislation to cover a chunk of the 43.6 million Americans who, according to the Census Bureau (news - web sites), lack insurance.

The study to be released Wednesday says nearly 20 million working Americans, many with families, are uninsured. More than a quarter of working Texans, 2.5 million people, have no insurance.

Other states in which more than a fifth of the work force is uninsured are: Louisiana, Mississippi, Nevada, New Mexico and Oklahoma.

The study was led by researchers at the University of Minnesota's School of Public Health that analyzed data from the federal Centers for Disease Control and Prevention (news - web sites).

Many studies have found that people without insurance are less likely to see doctors, more likely to be diagnosed with illnesses late and report being in poor or fair health more often than those with insurance.

The coalition sponsoring next week's activities, which includes health fairs and seminars, brings together groups often at odds with each other. They have pledged to set aside their differences to push for action on the issue.

Some other organizations involved are the U.S. Chamber of Commerce (news - web sites), the AFL-CIO and America's Health Insurance Plans.

President Bush (news - web sites) has proposed giving people tax credits to help them pay for insurance that they purchase on their own. Democratic presidential candidate John Kerry (news - web sites) wants to extend health coverage to most uninsured Americans through a combination of insurance pools, tax credit and subsidies that he would pay for by raising taxes on the top 2 percent of taxpayers.

On the Net: http://covertheuninsuredweek.org/

Back to the Top

Health Tip: Bone Density Testing

HealthDayNews

Wednesday, May 5, 2004

(HealthDayNews) -- Bone density accounts for about 80 percent of the strength of your bones, and a prime indicator of future fractures is a bone density test.

Because insurance doesn't always cover these tests, fewer than 10 percent of women with significant bone loss have them, according to The John Hancock Center for Physical Activity and Nutrition at Tufts University.

You should have a bone density test if:

Several different procedures are used to test bone density. All are safe, painless, quick and precise.

Back to the Top

Study Examines Insulin-Producing Cells

By Andrew Bridges

AP Science Writer

The Associated Press

Wednesday, May 5, 2004

A new study shows that insulin-producing cells in the pancreas can regenerate themselves, suggesting future treatments for diabetes that could eliminate the need to inject the hormone.

In type 1, or juvenile, diabetes, the body's immune system attacks and destroys a type of specialized cell that makes insulin. The hormone is vital in maintaining the right blood sugar levels.

Regenerating and maintaining these cells in the pancreas could help people with type 1 diabetes make their own insulin. The research does not address the vast majority of diabetes cases, type 2, which are linked to obesity.

Researchers have been seeking ways to produce more of these specialized insulin-producing cells, called beta cells. The new study, done in laboratory mice, suggests there is no need to look beyond the cells themselves. Details are in Thursday's issue of the journal Nature.

Previous studies have suggested that embryonic stem cells or adult stem cells also could be sources for the insulin-producing cells.

The new research found no evidence that adult stem cells which some groups have hoped would offer an alternative to human embryos are involved in the regeneration of the insulin-producing cells.

"That's now been eliminated in my mind and gives us two cell types to concentrate on," said study co-author Douglas Melton, a Howard Hughes Medical Institute researcher at Harvard University.

Other experts disagreed, saying differently designed experiments could reveal that adult stem cells do play a role.

"We need to keep all the options open, absolutely," said Vijay Ramiya, who researches pancreatic beta cells at the University of Florida.

It also remains unclear whether beta cells could replicate themselves in sufficient numbers to be useful.

And coaxing embryonic stem cells into forming new insulin-producers appears difficult too, since the cells tend to form tumorous growths, said David Prentice of Indiana State University and a founder of Do No Harm, a group opposed to the use of embryonic stem cells.

Worldwide, there are about 171 million diabetics but only about 10 percent of those have type 1 diabetes. The vast majority have type 2 diabetes, which is linked to obesity. In the United States, about 900,000 to 1.8 million people have type 1 diabetes, the American Diabetes Association says.

On the Net: http://www.nature.com

Back to the Top

Stressed Kids Can Become Depressed Adults

HealthDayNews

Wednesday, May 5, 2004

WEDNESDAY, May 5 (HealthDayNews) -- If your children suffer high levels of stress, they are likely to be depressed and anxious as young adults.

That's the conclusion of a study in the May issue of The Archives of General Psychiatry, based on 1,803 interviews among a sample of young adults aged 18 to 23 in a southern Florida community.

Interviewers asked about specific kinds of stressful events or traumatic incidents over the course of the participants' lifetimes. They also assessed the young adults for a wide range of emotional disorders.

The researchers found the level of lifetime exposure to adversity was associated with an increased risk of developing depression or anxiety disorders.

"In some cases the experience itself may be implicated in the observed elevation in risk, whereas in others the event may represent simply a marker for the occurrence of other stressors and/or the presence of other significant risk factors," researchers R. Jay Turner and Donald A. Lloyd, of Florida State University, said in a statement.

More information

The National Institute of Mental Health has more about anxiety disorders.

Back to the Top

Wyoming Cancer Rates Rise Slightly

The Associated Press

Wednesday, May 5, 2004

CHEYENNE, Wyo. - The American Cancer Society (news - web sites) estimates cancer the second leading cause of death in Wyoming will claim 1,000 lives in the state this year.

The organization also estimates there will be 2,430 new cases of cancer in Wyoming in 2004.

The number of state residents reporting kidney/renal pelvis, melanoma of the skin and prostate cancer has been on the rise since 1998, according to 2001 statistics compiled by the state Department of Health's Cancer Surveillance Program.

The report also showed lung cancer was the number one cause for cancer deaths in both men and women in 2001, followed by colorectal, prostate, cancers with an unclear source of origin and breast cancer.

Cancer has been the second leading cause of death in Wyoming and across the country since about the mid-1950s, said Joseph Grandpre, a state health department epidemiologist.

The leading cause of death in the country is heart disease.

There could be many reasons why the cancer incidence rates in Wyoming have been on the rise, Grandpre said.

"Cancer is mainly a disease of the elderly," he said. "Some areas have more older people moving in, retiring here because the quality of life seems to be better."

Another reason could be an increase in the number of people getting cancer screenings, said Bev Gross, area director of the American Cancer Society's Rocky Mountain Division.

"I think people are detecting it earlier," she said. "They're a little more aware than they used to be. Twenty years ago, people didn't even think about going in for a mammogram."

But Gross said there's still a lot of room for improvement in terms of prevention and early detection in Wyoming, particularly in the area of colorectal exams.

It's recommended that at age 50, men and women have annual exams called fecal occult blood tests, which involve a chemical test of three consecutive stool samples to detect bleeding in the digestive tract.

But in 2002, only 12.5 percent of Wyoming residents 50 years and older reported having had the test within the last year, according to American Cancer Society surveillance research. Only Utah had a lower rate, with 12.2 percent.

Gross also said minorities tend to get fewer screenings and know less about prevention techniques.

The American Cancer Society has been trying to increase awareness about the topic among different ethnic groups in Wyoming, she said.

Another obstacle is the simple fear of getting a bad test result.

Grandpre and Gross both said people should know their families' cancer histories and talk to their doctors about when they should start getting screening exams.

"The sooner they find it, the better their chances are of doing better," Gross said.

Back to the Top

Antioxidant May Prevent Prostate Cancer

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Wednesday, May 5, 2004

WEDNESDAY, May 5 (HealthDayNews) -- Men whose diets include high levels of selenium significantly reduce their risk of progressive prostate cancer, researchers report.

In this new study, researchers found high blood levels of selenium decreased the risk of advanced prostate cancer. In addition, for men who had above-normal levels of prostate-specific antigen (PSA) at the start of the study, high selenium levels significantly reduced risk of all prostate cancer. PSA is a protein that is found in all men, but it shows up in high levels in men with prostate cancer or other prostate problems.

Selenium is an antioxidant that can be found in most plant foods and in some meats and shellfish. Nuts, particularly Brazil nuts, are also a good source of dietary selenium.

"We found a relationship between blood levels of selenium and the risk of developing advanced prostate cancer over 13 years of follow-up," said lead researcher Dr. Haojie Li, a research fellow at the Channing Laboratory of Harvard Medical School (news - web sites).

Li and her colleagues collected data on 586 men diagnosed with prostate cancer over a 13-year period and 577 normal subjects. All the men participated in the Physicians Health Study, according to the report in the May 5 issue of the Journal of the National Cancer Institute (news - web sites).

The protective effect of selenium was most pronounced in patients with slightly abnormal PSA levels, Li said. However, among men who had normal PSA at the beginning of the study there did not seem to be significant benefit from selenium in preventing prostate cancer, she added.

Men with an elevated PSA can reduce their risk of progressive prostate cancer by as much as 50 percent, Li said.

"Our interpretation of the findings is that higher levels of selenium may slow prostate cancer tumor progression," Li explained. Elevated PSA indicates that a tumor exists, and selenium seems to prevent the tumor from growing, she said.

Li said this data is not sufficient to suggest that men take selenium supplements to ward off prostate cancer. She added that a trial to test the effects of selenium on prostate cancer prevention is under way.

This trial may show whether or not men should increase their selenium intake to fight prostate cancer, she said.

"Right now, all we can say is that eating foods with higher levels of selenium seems to be beneficial in terms of prostate cancer prevention," Li said. But at this point, "we can't say that everyone with elevated PSA should be taking selenium supplements."

Dr. Scott M. Lippman, chairman of the department of clinical cancer prevention at the University of Texas M.D. Anderson Cancer Center, said this study confirms findings from animal and cell studies showing that selenium reduces the progression of prostate cancer.

There is some debate about the value of selenium in preventing prostate cancer in men with normal PSA levels, said Lippman, co-author of an accompanying editorial. But a study of selenium and skin cancer, "did find that selenium was associated with a reduced risk of prostate cancer in men with normal PSA," he added.

The data from the study by Li suggests selenium slows the progression of prostate cancer in men who have cancer that cannot be detected. "Selenium may slow the clinical expression of prostate cancer, which is equivalent to prevention," Lippman said.

Lippman agreed it is too early to recommend taking selenium supplements. "I would not recommend taking selenium supplements until the results of the ongoing trials are known," he said. "All of the evidence we have to date [is] encouraging, but not definitive."

More information

The National Institutes of Health (news - web sites) can tell you about selenium, and the American Cancer Society (news - web sites) explains prostate cancer.

Back to the Top

Marijuana Abuse Is Up Among U.S. Adults

By Lindsey Tanner

AP Medical Writer

The Associated Press

Wednesday, May 5, 2004

CHICAGO - Habitual marijuana use increased among U.S. adults over the past decade, particularly among young minorities and baby boomers, government figures show.

The prevalence of marijuana abuse or dependence climbed from 1.2 percent of adults in 1991-92 to 1.5 percent in 2001-02, or an estimated 3 million adults 18 and over.

That represents an increase of 800,000 people, according to data from two nationally representative surveys that each queried more than 40,000 adults.

Among 18- to 29-year-olds, the rate or abuse or dependence remained stable among whites but surged by about 220 percent among black men and women, to 4.5 percent of that population, and by almost 150 percent among Hispanic men, to 4.7 percent.

Among all adults ages 45 to 64, the rate increased by 355 percent, to about 0.4 percent of that population.

The report, published in Wednesday's Journal of the American Medical Association (news - web sites), was led by Dr. Wilson Compton of the National Institute on Drug Abuse, who said the rise in dependence was probably due at least partly to increases in the potency of pot over the past decade.

Also, the figures may indicate that baby boomers "bring their bad habits with them into old age," he said.

The researchers said adults were considered marijuana abusers if repeated use of the drug hurt their ability to function at work, in school or in social situations, or created drug-related legal problems.

Drug users were considered dependent if they experienced increased tolerance of marijuana, used it compulsively and continued using it despite drug-related physical or psychological problems.

Overall use of the drug that is, casual use and habitual use remained stable at around 4 percent of adults.

"This study suggests that we need to develop ways to monitor the continued rise in marijuana abuse and dependence and strengthen existing prevention and intervention efforts," said Dr. Nora Volkow, the institute's director. Programs that target young black and Hispanic adults are particularly needed, she said.

Increases in dependence among young minorities may reflect their growing assimilation into sectors of white society where marijuana use is more accepted, Compton said.

Researchers from the National Institute on Alcohol Abuse and Alcoholism contributed to the report.

On the Net:

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

NIDA: http://www.drugabuse.gov

NIAAA: http://www.niaaa.nih.gov

Back to the Top

Gene Mutation May Up Your Risk of Heart Attack

By Serena Gordon
HealthDay Reporter

HealthDayNews

Wednesday, May 5, 2004

WEDNESDAY, May 5 (HealthDayNews) -- A mutation in one gene could significantly raise your risk for a heart attack, a new Japanese study suggests.

The researchers found that a mutation in a gene called LGALS2, which produces a protein called galectin-2, was associated with an increased risk of heart attack. This knowledge could lead to the eventual development of medications that could suppress this defective protein and reduce the risk of heart attack, the researchers say.

"Decreased expression of galectin-2 might be protective against the risk of myocardial infarction [heart attack]. So, drugs that can reduce the function of galectin-2 can be therapeutic agents," said study co-author Dr. Toshihiro Tanaka, Laboratory Head at The Institute of Physical and Chemical Research in Tokyo.

Results of the study appear in a letter in the May 6 issue of Nature.

More than 1 million people have a heart attack every year in the United States, according to the National Heart, Lung, and Blood Institute. More than 500,000 Americans die from heart attacks annually, and about half of those die within the first hour of experiencing symptoms.

A heart attack occurs when the blood supply to the heart becomes blocked because of clogged arteries.

According to the new study, inflammation is believed to play a role in the development of heart attack. In previous studies, researchers discovered that an inflammation-mediating molecule called lymphotoxin-alpha (LTA) was associated with a higher risk of heart attack.

For the new study, the Japanese researchers looked for proteins that interacted with LTA. They found that galectin-2 binds to LTA and increases susceptibility to heart disease.

To test their findings, the researchers compared blood samples from 600 people who had had a heart attack to 600 healthy people in a control group. Then they compared blood samples from another 2,302 people who had had a heart attack to another 2,038 "controls."

The researchers found galectin-2 was associated with a significantly higher risk of heart attack.

Tanaka added this is not "the" single gene that causes heart attacks, so even people who don't have it could still be at risk.

"Unlike monogenic diseases, including cystic fibrosis or Duchenne muscle dystrophy, in which case mutation equals disease-causing, the causes of [other] common diseases [such as heart disease] are a combination of environmental factors as well as several to many genetic factors," Tanaka said.

Dr. Stephen Siegel, a cardiologist at New York University Medical Center in New York City, said, "This study is helping to define the actual trigger of heart attacks."

Siegel likened inflammation to the trigger of a gun and said that while researchers know that pulling the trigger will "fire a bullet" and cause a heart attack, they don't know exactly how that process occurs. He said this new study is getting closer to the true cause, like looking at a firing pin on a gun.

"The more we learn, the more possibility we have of preventing this devastating disease," Siegel said.

In the meantime, Siegel recommended "taking care of the risk factors we do know about." That means controlling high blood pressure and high cholesterol, making exercise a regular part of life, eating a nutritious diet, and quitting smoking.

More information

To get an idea of what your risk is for a heart attack, complete this risk assessment quiz from the American Heart Association (news - web sites). For information on ways you can prevent a heart attack, go to the National Heart, Lung, and Blood Institute.

Back to the Top

Tuesday, May 4, 2004

 

Companies Rush to Sell Low-Carb Products

 

By Ira Dreyfuss

Associated Press Writer

The Associated Press

Tuesday, May 4, 2004

CHICAGO - Take a piece of pita bread, a little tuna, some olives and capers and presto it's a low-carb "sort of Mediterranean" pizza. The impact of the Atkins diet, the South Beach diet and other low-carbohydrate eating plans is everywhere at this year's food industry show of new products.

Food companies are trying hard to fit the current low-carb diet craze into their familiar product lines, and Margaret Dennis' easy-to-make pita pizza was just one contribution at the exposition organized by the Food Marketing Institute. Also on display were low-carb candies, cereals and salad dressings.

In her white chef's uniform, Dennis, a culinary consultant to Del Monte, was handing slices to passers-by. On the pita bread, she spread a corporate-brand pizza sauce, added flavored tuna that Del Monte sells in a pouch for the quick-lunch crowd, and threw on olives and capers.

And as long as the cook uses pita instead of standard pizza dough, the result will be a thin-crust product with 12 grams of carbohydrate per slice, roughly half the carbs of regular Mediterranean-style pizza, Dennis said.

Kellogg Co. has reformulated a version of its calorie-sparing Special K cereal to be low-carb as well. "Consumers are looking for a low-carb lifestyle," said Mike Greene, vice president of customer marketing. "It's about alternatives."

Kraft Foods Inc. also is exhibiting shelves of carb-oriented products, some already in stores and others waiting to be launched. Supermarkets now have four Kraft salad dressings without carbs.

In June, consumers could get a steak sauce with one gram of carbohydrate per serving to slather on their Atkins-approved meats. Also in June, Kraft will launch CarbWell cereals. And the company that put out SnackWell cookies in the days when consumers only watched fat calories will expand the line with SnackWell's CarbWell cookies.

Kraft is not putting all its high-protein, low-carb eggs in one basket. "For folks who are watching fat, there's the sugar-free SnackWell as well," said spokeswoman Pat Riso.

The food industry knows from experience it is subject to being swept by waves of diet fads.

Michael Sansolo, senior vice president of the Food Marketing Institute, said the current distaste for carbohydrates might be supplanted in a couple of years by avoidance of trans fats. Those substances have been linked with clogged arteries, and the federal government is beginning to require that amounts of trans fats be listed on labels.

The industry also knows that consumers want to go with what tastes good, regardless of the current craze.

At the Hershey Foods Corp. exhibit, there were dishes of bite-sized, individually wrapped Carb Alternative candies. Matt Podhajsky, an associate marketing manager for grocery products, said Hershey also had created a chocolate sauce with half the carbohydrates of its standard sauce.

This does not mean that the traditional fully carbed chocolate sauce will be driven off the shelves, Podhajsky said.

"There's a lot of people who are looking for it just purely for that decadent value," he said. "Especially people with ice cream."

On the Net:

Food Marketing Institute: http://www.fmi.org/

Back to the Top

 

Health Tip: Veggies That Cause Sparks in the Microwave...

 

HealthDayNews

Tuesday, May 4, 2004

(HealthDayNews) -- If you've wondered why your green beans cause sparks to fly when you microwave them, blame it on their density.

According to the Canadian Food Inspection Agency, dense vegetables such as green beans, carrots, and green peppers have higher amounts of minerals than other food items. The minerals act like tiny pieces of metal and can create arcing effects in a microwave.

While this doesn't harm your veggies, it may prevent them from heating thoroughly.

Please note that you should never deliberately microwave anything metal, unless it is microwave approved.

  Back to the Top

 

Arsenic in Chicken Feed Being Studied

 

The Associated Press

Tuesday, May 4, 2004

BALTIMORE - The poultry industry's widespread use of drugs to raise chickens is exposing people who eat them to more arsenic than previously estimated, according to a researcher at the Johns Hopkins Bloomberg School of Public Health.

In a paper published Monday in the journal Environmental Health Perspectives, Ellen K. Silbergeld said arsenic-laced drugs intended to keep the birds healthy might pose an increased risk of cancer for consumers. She also said the drugs could create manure that is contaminating Eastern Shore ground water.

Silbergeld's research essentially disputed the conclusions of a U.S. Department of Agriculture (news - web sites) study, released in the journal in January, which concluded that the drugs did not pose a serious health problem.

She said the Agriculture Department underestimated the amount of arsenic found in chickens and used outdated data to estimate the health risks of ingesting arsenic.

"This paper had serious problems," Silbergeld said of the USDA report.

Her findings, based on data published by the USDA and other health experts, could have major implications for the Eastern Shore, where 10 percent of the nation's poultry is raised.

A spokesman for the poultry industry said concerns about arsenic in chicken feed are unfounded and that tests consistently show arsenic levels in chickens are well below standards set by the Food and Drug Administration (news - web sites).

"This study appears to be much ado about nothing," Richard Lobb, a spokesman for the National Chicken Council, told The (Baltimore) Sun.

But Silbergeld, a toxicologist who won a MacArthur Foundation "genius" grant in 1993 for her work linking mercury poisoning with infectious diseases, disagreed. She said arsenic in chicken feed creates potential problems in the meat produced and the ground water affected by the waste.

When chickens excrete arsenic in manure, sunlight breaks it down and it migrates to the soil, where it can contaminate ground water supplies, she said. She noted that Europe bans arsenic in chicken feed because of these health concerns.

"This is arsenic. We shouldn't lose sight of the sheer outrageousness of this," Silbergeld said.

Geologists have been closely monitoring arsenic levels in the Eastern Shore's water supply for years without finding serious hazards. Health officials in Queen Anne's, Talbot and Dorchester counties require new wells to be tested for arsenic because of concerns about contamination of the local aquifers, said David Bolton, program director of the hydrogeology section of the Maryland Geological Survey.

A recent U.S. Geological Survey (news - web sites) study of the Pocomoke River Basin found slightly elevated levels of arsenic in shallow layers of ground water that could be the result of tainted manure, said Tracy Connell Hancock, a USGS (news - web sites) hydrologist.

But she and Bolton said further studies are needed to prove any connection between the manure and arsenic in the water.

"Whether arsenic gets into the ground water from chicken waste is an open question that people are just beginning to investigate," Hancock said.

Back to the Top

FDA Panel Backs More Study of Anemia Drug Risks

 

By Lisa Richwine

Reuters

Tuesday, May 4, 2004

GAITHERSBURG, Md. (Reuters) - A U.S. advisory panel voiced support on Tuesday for further research to determine whether widely used anemia drugs sold by Johnson & Johnson and

Both companies told the U.S. Food and Drug Administration (news - web sites) committee of outside experts there was no evidence to link the drugs, Johnson & Johnson's Procrit and Amgen's Aranesp, to a tumor risk. Officials from both firms said they had studies ongoing that should shed light on the issue.

Shares of Amgen fell 24 cents to close at $57.70 on Nasdaq. Johnson & Johnson shares slipped 13 cents to close at $54.80 on the New York Stock Exchange (news - web sites).

The FDA advisers suggested modifications to the research but generally supported the companies' plans.

"Several of these (studies) will be addressing the important issues that bought us here today," said Dr. Bruce Cheson, head of hematology at the Lombardi Comprehensive Cancer Center in Washington and the panel's acting chairman.

The drugs are bioengineered versions of a human protein, erythropoietin, that stimulates production of red blood cells. Combined sales of the anemia drugs, which are often given to cancer patients, amount to several billion dollars a year.

Safety questions about Aranesp and Procrit arose after two studies revealed shorter survival times for patients given similar drugs sold in Europe.

"We have these evolving safety concerns. They cannot be dismissed," Dr. Harvey Luksenburg of the FDA's division of therapeutic, biological and oncology products, told the committee.

Matt Geller, an analyst who follows Amgen for CIBC World Markets, said he did not think the concerns would weigh down sales of the drugs. The panel agreed no conclusions can be drawn from current data, and new findings will not be ready for at least two years, he said.

"I think this is one more worry that people have had that should be removed from the investors' bag of worries," Geller said.

FDA officials stressed the products offer a valuable alternative to blood transfusions for fighting anemia, a shortage of red blood cells that can cause severe fatigue.

The European studies were evaluating a different, unapproved use. They were testing a theory that the anemia medicines could make chemotherapy and radiation more effective by pushing hemoglobin levels even higher than what is recommended for quelling anemia.

An increase in blood clots, a known risk of the anemia drugs and of cancer, might have accounted for the difference in survival times, Johnson & Johnson officials said.

The controversy may lead some patients to avoid the drugs, said Musa Mayer, a cancer survivor and the panel's patient representative.

"Some may choose to have transfusions and to avoid (erythropoietin) until these issues are resolved, while others may decide it's a reasonable risk to take," she said.

Back to the Top

Nutraceutical Sues FDA Over Ephedra

 

The Associated Press

Tuesday, May 4, 2004

SALT LAKE CITY - Nutraceutical Corp. and its subsidiary Solaray have filed a federal court lawsuit challenging the Food and Drug Administration (news - web sites)'s ban on dietary supplements containing ephedra.

Ephedrine supplements were widely used for weight loss and bodybuilding, but have linked to 155 deaths, including that of Baltimore Orioles pitcher Steve Bechler. The FDA's ban on all dietary supplements containing ephedrine alkaloids went into effect April 12.

Nutraceutical, a dietary supplements company based in Park City, claims in the lawsuit filed Monday in U.S. District Court that ephedra "has been safely consumed for millennia."

The company contends its product is safe because it contains only low doses of the ephedrine.

The lawsuit claims that the FDA did not meet its burden of proving that all ephedrine dietary supplements present "a significant or unreasonable risk of illness or injury at every dose level and as labeled."

It also contends that banning dietary supplements but allowing ephedrine-containing conventional foods is "an arbitrary and capricious agency action."

The suit seeks to have the FDA's rule declared illegal. Nutraceutical asks that if the court does not find the rule to be illegal that it be paid compensation from the government for its losses.

In a similar case, U.S. District Judge Joel Pisano in Newark, N.J., last month refused to grant a temporary restraining order that would have prevented the FDA from banning the products.

Back to the Top

Breast Milk Protects Again

 

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- Human milk helps ward off sepsis infection in extremely low birth weight babies, says a Cincinnati Children's Hospital Medical Center study.

Sepsis is a major cause of death, illness and long-term disability in extremely low birth weight infants. As many as 30 percent of babies with sepsis develop an overwhelming infection and as many as 20 percent die.

Researchers analyzed data on 1,270 infants at 15 medical centers. The 39 percent of those infants who had sepsis received significantly less human milk than infants who didn't have sepsis, the study found.

The extremely low birth weight infants who developed sepsis received human milk as 29 percent of their total nutritional intake, while infants who weren't infected received milk as 33 percent of their total intake.

"Despite all the technological advancements of recent years, outcomes for extremely low birth weight infants haven't improved all that much. But human milk makes a difference, and there's no reason to believe the benefits wouldn't extend to higher birth weight infants," researcher Jareen Meinzen-Derr, from the hospital's Center for Epidemiology and Biostatistics, said in a prepared statement.

The study was presented this week at the Pediatric Academic Societies' annual meeting in San Francisco.

Extremely low birth weight infants weight 1 pound to just less than 2.2 pounds. They're too tiny to be nursed by their mothers and must be fed through a mouth tube.

"We encourage mothers to pump and collect their own breast milk and bring it to the hospital to be fed to their baby. It's not an easy thing to ask of mothers, and I think caregivers can probably do a better job of supporting them in this endeavor," study co-author Dr. Edward Donovan, neonatologist at Cincinnati Children's, said in a prepared statement.

More information

The Nemours Foundation has more about sepsis.

Back to the Top

Silicon to Be Used in Liver Cancer Trials

 

The Associated Press

Tuesday, May 4, 2004

SINGAPORE - Cancer-fighting silicon particles will be injected into the diseased livers of inoperable patients this month in Singapore as part of new cancer treatment research, a hospital spokeswoman said Tuesday.

A small batch of radioactive silicon particles, measuring about 20 microns each, will be injected into liver tumors via the patient's abdomen as part of the three-month trial at Singapore General Hospital, spokeswoman Angela Ng said.

Each injection is designed to kill cells within an 8 millimeter (0.31 inch) radius, Ng said. By injecting the particles into the heart of the cancerous cell mass, researchers hope more of the healthy liver can be preserved, and exposure to radiation minimized, she said.

Dr. Pierce Chow, a consultant surgeon with the Singapore General Hospital, described the treatment as "not a new drug but just a new way of introducing drugs to system."

The hospital has yet to recruit the eight to 10 patients needed for the clinical trials, Ng said. Patients will remain conscious throughout the operation.

The research is a joint effort between Singapore General Hospital and U.K.-based pSiMedica Ltd., Ng said. Similar trials are also planned for the United Kingdom, she said.

Liver cancer is the third-leading killer among cancers in men in East and Southeast Asia, according to the World Health Organization (news - web sites)'s Web site. It is the fifth most common form of cancer worldwide with some 560,000 cases, the WHO said.

Singapore General Hospital is the island nation's largest public hospital, and is managed by SingHealth, a government-linked company.

Back to the Top

Study: Low-Fat May Not Be Best for Heart

 

By Amy Norton

Reuters Health

Tuesday, May 4, 2004

NEW YORK (Reuters Health) - A relatively high amount of fat in the diet may be a boon to a healthy person's cholesterol levels, a small study suggests. On the other hand, limiting fat intake too much could have the opposite effect.

Researchers at the State University of New York at Buffalo found that when 11 healthy but sedentary adults followed a very low-fat diet (19 percent of calories from fat) for three weeks, they saw a drop in their HDL cholesterol -- the "good" cholesterol believed to protect against heart disease.

In contrast, three weeks on a diet that provided 50 percent of calories from fat boosted participants' HDL levels, according to findings published in the Journal of the American College of Nutrition.

To circulate in the blood, cholesterol must be attached to a protein, forming a complex called a lipoprotein. HDL, or high-density lipoprotein, molecules carry cholesterol away from the arteries and to the liver to be cleared from the body. Experts believe that an HDL level of 60 or more helps lower the risk of heart disease, while a level lower than 40 raises the risk.

The new findings suggest that adequate fat intake can help ward off heart disease by raising HDL.

"That isn't to say we think everyone should be on a 50-percent fat diet," study co-author Dr. David R. Pendergast told Reuters Health.

But, he said, the findings do indicate that moderation, and not tight restriction, is the way to go. According to Pendergast, that means getting about 30 to 35 percent of calories from fat -- at or slightly more than the level health officials currently recommend.

But he also stressed the importance of calorie balance, which means eating only enough to meet the body's calorie expenditure. Fat has more calories per gram than either carbohydrates or protein, and if a person takes in more calories as a result of eating more fat, weight gain may follow.

While saturated fat is blamed for raising "bad" LDL cholesterol levels, Pendergast said it may in fact be the combination of lots of fat and too many calories that makes for unhealthy cholesterol profiles.

In his team's study, the high-fat diet -- rich in foods such as red meat and olive oil -- provided roughly the same number of daily calories as participants' regular diets, which contained about 30 percent of calories from fat.

The 19-percent low-fat diet had fewer calories, and men and women in the study lost a small amount of weight while following it. Their HDL levels, however, were significantly lower on this diet than on the high-fat one-an average of 54 milligrams per deciliter (mg/dL), versus 63 mg/dL, Pendergast and his colleagues found.

What's more, the high-fat diet did not boost LDL cholesterol beyond the levels participants had on their regular diets.

Although the men and women followed each diet for only three weeks, Pendergast said he does not think the cholesterol effects are "transient."

He and his colleagues had previously conducted a similar study with endurance runners, in which a very low fat intake had negative effects on HDL cholesterol and on immune function. Pendergast said this research suggests that both healthy, sedentary people and healthy athletes are "probably not well served" by diets very low in fat.

Whether high- and low-fat diets have the same effects in obese individuals or those with cardiovascular disease is not yet clear, he noted.

As for why a high-fat, calorie-conscious diet might bump up HDL levels, one theory is that dietary fat leads to higher levels of the chief HDL transporter protein, ApoA1.

Source: Journal of the American College of Nutrition, April 2004.

Back to the Top

Group Warns of Risks to Teenage Mothers

 

By Andrea Evans

Associated Press Writer

The Associated Press

Tuesday, May 4, 2004

NEW YORK - An aid group warned Monday of increasing risks linked to teen pregnancy worldwide, saying as many as a million babies born to young mothers die of childbirth complications each year.

A report by the humanitarian group Save the Children Poor urged all nations, but especially those in the developing world, to do more to prevent young girls marrying before they are physically ready for parenthood.

Referring to earlier studies by UNICEF (news - web sites) and the World Health Organization (news - web sites), the group said an estimated 70,000 girls 19 years old and younger and one million babies of young mothers die each year in childbirth or in related complications.

"In developing countries, pregnancy and childbirth are the leading cause of death among teenage girls," Mike Kiernan, a spokesman for Save the Children, told The Associated Press in an interview.

The study, which based its findings on analysis of information provided by governments, research groups and international agencies, said about 12.5 million of the 125 million babies born worldwide are born to mothers who are teenagers.

"Mother's Day is such a joyful occasion in our culture, but (motherhood) is a dance with death for young girls," in the developing world, Mary Beth Powers, the reproductive health adviser at Save the Children, told the AP.

The annual State of the World's Mothers report ranks motherhood in 119 countries.

Among industrialized nations, the United States has the most teen mothers, followed by Russia and New Zealand. The Republic of Korea has the lowest numbers of teen mothers, followed by Japan and the Netherlands.

The report said nearly 900,000 teenage girls in the United States become pregnant each year.

"The teen pregnancy and birth rates (in the United States) are high even compared to some developing countries," Kiernan said.

"The main difference between the United States and these high-risk countries is that far fewer (U.S.) girls and their babies die from complications, and that's because of access to health care," he added.

Kiernan said abstinence and improved contraceptive use are reducing the pregnancy rate in the United States, but much more needs to be done.

The report found that education was the single biggest factor in helping girls postpone pregnancy.

"The longer a girl stays in school, the less likely she is to be married young (and) give birth young," said Powers.

The report ranked the world's nations in the conditions they provide to produce healthy mothers and children.

The 10 best in descending order were Sweden, Denmark, Finland, Austria, the Netherlands, Norway, Australia, Canada, the United Kingdom and the United States.

Niger had the lowest ranking. It was following by Burkina Faso, Ethiopia, Mali, Guinea-Bissau, Chad, Sierra Leone, Yemen, the Central African Republic and Mauritania.

On the Net:

The full report: www.SavetheChildren.org

Back to the Top

Health Tip: Dry Socket After Tooth Extraction

 

HealthDayNews

Tuesday, May 4, 2004

(HealthDayNews) -- Dry socket is the most common post-operative complication of a tooth extraction.

This painful condition occurs when the newly formed blood clot at the site of the extraction doesn't form properly or is disturbed.

Here are tips from the U.S. Army Medical Department on how to help prevent dry socket:

Back to the Top

Lawmakers Seek to Remove Lead from Tap Water

 

Reuters

Tuesday, May 4, 2004

WASHINGTON (Reuters) - U.S. lawmakers on Tuesday introduced a bill to eliminate lead in the nation's drinking water supply after high levels of the toxic metal were found in the capital's tap water.

The Lead-Free Drinking Water Act, introduced in the Senate and the House of Representatives, would require utilities around the country to test their water immediately, and sets stricter standards for notifying customers of problems.

It also would provide $200 million a year for four years to utilities to help them meet new tougher standards for replacing lead service lines, believed to be a main source of lead in drinking water.

"It is time to get the lead out of the pipes, out of the water and out of our families and out of our lives," said Vermont Sen. James Jeffords (news - web sites), a bill co-sponsor and an independent member of the Environment and Public Works Committee.

The Environmental Protection Agency (news - web sites) estimates that the United States needs to spend $265 billion over the next 20 years to maintain and improve drinking water systems, according to Jeffords.

"If we don't address this, we'll be facing more and more health and environmental issues as our nation's water infrastructure degrades," he said.

So far the bill has no Republican sponsors, but Jeffords said he was confident they would sign on quickly.

It would set aside $40 million for pipe replacement in Washington, where tap water in thousands of homes last year showed lead levels above 15 parts per billion -- the point at which federal law requires public notice and remedial action.

The water in some homes showed levels more than 30 times higher than the federal threshold, but residents say the city sent only a proforma letter informing them of the results and health authorities failed to follow up.

The problems did not grab public attention until media reports highlighted them in January.

EPA officials say Washington's problems are isolated, but Jeffords said he had little confidence in the agency.

The Washington Post reported last month that concentrations of lead in Boston-area drinking water exceeded EPA national standards.

Rep. Edward Markey, a Massachusetts Democrat, is co-sponsoring the drinking water bill in the House of Representatives.

Back to the Top

Hidden Costs of Depression for Seniors

 

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- Depressed senior citizens in the United States require the equivalent of $9 billion worth of unpaid help each year to do daily activities.

The burden of that assistance is carried by the depressed seniors' spouses, children and friends and represents a huge, unrecognized cost of depression, says a University of Michigan and VA Ann Arbor Healthcare System study.

Even moderately depressed seniors require many more hours of help doing everyday activities than seniors with no depression, regardless of other health problems they may have.

The researchers estimated that it would cost society $9 billion a year if the family and friends who take care of depressed seniors were paid the wages (about $8.23 an hour) of a home health aide worker. That total means depression is second only to dementia in the national annual cost for informal caregiving.

For this study, researchers analyzed data from 6,651 people over the age of 70 from across the country and found 18 percent of them reported four to eight depressive symptoms within the previous week. Another 44 percent reported one to three depressive symptoms.

Of the seniors who had many depressive symptoms, 38 percent reported receiving informal care from family or friends. That figure was 23 percent among seniors with few depressive symptoms and 11 percent among seniors with no depressive symptoms.

"People with depressive symptoms also had a significantly higher likelihood than others of needing help with tasks such as dressing, bathing, eating, grocery shopping, taking medicines, paying bills and using the telephone," study author Dr. Ken Langa, an assistant professor of general medicine, said in a prepared statement.

"Even those with just a few depressive symptoms were more likely to need help with these everyday activities than those without signs of depression," Langa said.

The study appears in the May issue of the American Journal of Psychiatry.

More information

The U.S. National Institute on Aging has more about seniors and depression

Back to the Top

Government: Cars Kill, Even When Standing Still

 

Reuters

Tuesday, May 4, 2004

DETROIT (Reuters) - About 350 people die in the United States every year in non-traffic-related accidents involving vehicles that are standing still or just barely moving, federal safety regulators said on Tuesday.

The victims, many of them children, die from unintentional carbon monoxide poisonings, vehicle backovers, excessive heat inside passenger compartments and rare strangling incidents involving children caught in power windows or sunroofs, according to a report from the National Highway Traffic Safety Administration (news - web sites).

The report, and its national estimate of the death toll from "certain non-traffic and non-crash events," was based on more than 4,000 death certificates from 1998 that NHTSA received from 35 states and the District of Columbia.

It said the single biggest cause of non-traffic deaths was carbon monoxide poisoning, which takes the lives of about 200 people a year.

People struck by vehicles backing up is the second leading cause, claiming some 120 deaths a year, the report said. It said most of the victims of backovers, which cause as many as 6,000 injuries a year, were either very young children or people over 70 years old.

Back to the Top

Brain Cells Show Gender Difference

 

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- Injured brain cells die differently in females and males, and that means the two genders may need different treatments for brain injuries, says a Children's Hospital of Pittsburgh study.

In research with animals, the researchers found that levels of glutathione, a molecule that protects brain cells from death when they're deprived of oxygen, remain constant in females who've suffered a brain injury. But in males with the same kind of injury, levels of glutathione drop by as much as 80 percent. Brain cells die much more quickly when there's a drop in glutathione levels.

"There is a built-in difference at the brain cell level between males and females," principal investigator Dr. Robert Clark, of Children's Hospital, said in a prepared statement.

"Injured brain cells may eventually die, but they take different pathways to get there in males and females. This means that we may need to develop or use gender-specific therapies for brain injury from any cause," Clark said.

The study was presented May 1 at the Pediatric Academic Societies' annual meeting in San Francisco.

More information

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

Back to the Top

Selenium May Protect Against Prostate Cancer

 

By Anthony J. Brown, MD

Reuters Health

Tuesday, May 4, 2004

NEW YORK (Reuters Health) - Use of supplements containing selenium may reduce the risk of advanced prostate cancer, new research suggests. The fact that no effect was seen against early prostate cancer suggests that selenium works by slowing cancer progression rather than by preventing it all together.

The current study is one of several recent looks at the link between selenium levels and prostate cancer. "Our study is the largest in terms of the (number of participants) and the follow-up period," lead author Dr. Haojie Li, from Harvard Medical School (news - web sites) in Boston, told Reuters Health.

As reported in the Journal of the National Cancer Institute (news - web sites), the researchers analyzed data from men enrolled in the Physicians' Health Study. When the study began, the men, who were cancer-free at the time, gave blood samples that were tested for selenium among other things.

Selenium levels from 586 men who later developed prostate cancer were compared with levels from 577 similar men who didn't develop prostate cancer.

Men with the highest selenium levels were 48 percent less likely to develop advanced prostate cancer than men with the lowest levels. Moreover, this association was observed for men diagnosed before and after PSA testing to detect early prostate cancer came into widespread use in October 1990.

High selenium levels were linked to a reduction in the overall risk of prostate cancer, Li said. "However, on further analysis, only the association with advanced cancer," was statistically significant, not early cancer.

A specially designed study, "known as the Selenium and Vitamin E Cancer Prevention Trial (SELECT), is underway," Li noted, and this should definitively answer whether selenium use is beneficial in preventing prostate cancer.

Source: Journal of the National Cancer Institute, May 5, 2004.

Back to the Top

Blood Pressure Rising in Kids

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- Weight isn't the only thing that's risen dramatically among children in the last decade: So has their blood pressure.

Across-the-board increases in the blood pressure of boys and girls of different ethnic and racial backgrounds could set the stage for an explosion of hypertension, heart disease and stroke in as little as 20 years, according to a study in the May 5 issue of the Journal of the American Medical Association (news - web sites).

And that's not the only bad news. A study in the May issue of the Archives of Pediatrics and Adolescent Medicine found caffeine may increase blood pressure and, therefore, the risk of hypertension, in adolescents, particularly among blacks. It's also possible caffeine intake may simply be associated with other dietary and lifestyle habits that have a harmful effect on blood pressure.

Previous research has shown the proportion of overweight boys has grown from 11.3 percent in 1988-1994 to 15.5 percent in 1999-2000. For girls, the increase was from 9.7 percent to 15.5 percent. No one had yet looked at possibly related changes in blood pressure.

A team led by Paul Muntner, an assistant professor of epidemiology and medicine at Tulane University School of Public Health and Tropical Medicine, analyzed data on 5,582 children and adolescents aged 8 to 17 collected during the government's National Health and Nutrition Examination Survey. Blood pressure data for 3,496 kids in the 1988-94 period was compared to data for 2,086 kids in the 1999-2000 period.

Between the two time periods, systolic (the upper figure, which indicates the number of heartbeats) increased an average of 1.4 millimeters of mercury (mmHg), while diastolic blood pressure (the lower number, indicating the between-beat intervals) increased 3.3 mmHg.

The mean systolic blood pressure levels increased 1.9 mmHg among non-Hispanic blacks, 2.3 mmHg among Mexican-Americans, and 1.9 mmHg among children aged 8 to 12 years old.

"Blood pressure has increased over the past 15 years in children," Muntner said. "These increases are both significant and substantial, and the increases we saw were across the board -- among blacks, among Mexican-Americans, among boys, among girls."

About 30 percent of the increases could be attributed to increases in body mass index, a ratio of height to weight. "We can't be certain that it's not more," Muntner said. "We have uncertainty around the estimate, so I think it's larger, but hard to pinpoint the exact percent."

Other factors could be dietary changes as well as declines in physical activity.

"We see the roots of adult hypertension in childhood," said Muntner. "Although we're not talking about the need to treat these children with drugs, we need to be aware that more children are at a higher risk for developing high blood pressure over the next 20 years as they become adults. It doesn't mean that we have to be treating these children. However we do have to track blood pressure in children. We have to encourage lifestyle modifications such as weight loss, since our body size is a major determinant of blood pressure."

Any attempts to change behavior and health in this age group are going to be challenging. "We know that there are interventions that can help, but with adolescents it gets a little difficult," said Dr. Mary Jo DiMilia, an assistant clinical professor of medicine and pediatrics at Mt. Sinai School of Medicine in New York City. "The best treatment for hypertension is diet and exercise."

More information

The American Heart Association (news - web sites) has more on hypertension in children, and the National Institute of Diabetes and Digestive and Kidney Diseases has more on overweight children.

Back to the Top

Fatty Acid Cream Improves Knee Arthritis

 

Reuters Health

Tuesday, May 4, 2004

NEW YORK (Reuters Health) - People with the wear-and-tear kind of arthritis of the knee may benefit from a proprietary cream containing a blend of cetylated fatty acids. Pain relief and improved functional performance may be experienced as early as half an hour after the cream is applied to the affected joint.

In the Journal of Rheumatology, researchers describe a study involving 40 patients with osteoarthritis of one or both knees who were randomly assigned to treatment with either Celadrin cream (made by Imagenetix, Inc., of San Diego, California), or an inactive placebo cream.

Each patient was assessed for knee range of motion, timed "up-and-go" from a chair, stair climbing, and other tests before the study began, at 30 minutes after the first application of the cream, and after 30 days of twice-daily application.

Dr. William J. Kraemer, of the University of Connecticut in Storrs, and his colleagues observed significant improvements among treated patients in the stair-climbing and up-and-go tests at 30 minutes, as well as after 30 days.

Supine range of motion had also improved significantly at both these time points in the treated patients.

"Topical treatment with cetylated fatty acids significantly increased ... balance, stair climbing ability, ability to rise from a chair, and walking," the authors point out. They add, "A unique finding was an immediate effect of this treatment 30 minutes after initial cream application."

These findings support the use of cetylated fatty acids as part of pain relief treatment in patients with osteoarthritis of the knee, the investigators conclude.

The study was partially supported by Imagenetix. Inc.

Source: Journal of Rheumatology, April 2004.

Back to the Top

Statins May Cut Death Risk After Surgery

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- Giving cholesterol-lowering statin drugs to everyone who has any kind of surgery could save lives, new research indicates.

A study of more than 780,000 surgical patients found a significantly lower death rate among those who were given statins in the day or two before the operation -- 2.13 percent, compared to 3.05 percent for those who didn't get the drugs, said a report in the May 5 issue of the Journal of the American Medical Association (news - web sites).

Previous studies have found statins reduce risks for patients who have heart surgery. This one was limited to noncardiac surgery, and it got essentially similar results.

The benefits don't appear to be due primarily to the ability of statins to lower blood cholesterol levels, said study author Dr. Peter K. Lindenauer, an assistant professor of medicine at the Baystate Medical Center in Springfield, Mass.

Instead, the drugs act in other ways to reduce the risk that surgery will trigger a heart attack or other major cardiovascular problem that could be fatal, he said.

Statins have been shown to help reduce formation of artery-clogging clots, to have a soothing effect on the delicate endothelial tissue that lines blood vessels, and to lower blood levels of C-reactive protein, a marker of the inflammatory process that can cause a fat-laden plaque deposit to tear loose from the artery wall, he said.

"It is believed that death can be caused by the rupture of unstable plaque when it is exposed to stress around the time of surgery," Lindenauer said. "We hypothesize that statins may have a beneficial effect in the postoperative period, helping to stabilize plaque."

But it is "far too early" to make a blanket recommendation for statins in surgery, he said. The new report comes from an observational study, "and that is subject to bias," Lindenauer said. "Clearly what we need at this point is a controlled clinical trial."

"Observational" means that the study covered the experience of a large number of patients for whom data were available -- in this case, people who had any noncardiac operation at 329 hospitals in the United States in the years 2000 and 2001.

Just under 10 percent of those patients were given statins in the first two days after they were admitted to the hospital before surgery. The mortality rate for those patients was 28 percent lower than for patients who did not get statins, the researchers reported.

But a number of questions need answers before any recommendation is made about use of statins in surgery, Lindenauer said -- for example, how far in advance of the operation should drug treatment be started.

Despite its limitations, the report is a valuable "hypothesis-generating study," said Dr. Albert W. Chan, associate director of the catheterization laboratory at the Ochsner Clinic Foundation in New Orleans.

Chan has reported a study showing that statins improve the outcome for patients undergoing artery-opening procedures such as angioplasty. Those results cannot be applied to all surgery patients, he said.

"The reason is that patients who have heart disease need to be on statins anyway," Chan said. "We would have to look at people who do not need statins. Such a study would include people with no coronary disease. We would have to test that group to see if adding statins before surgery saves lives or not."

That trial would have to include "a large number of people," Chan said. He said he knows of no plans for such a study.

More information

The everyday role of statins is described by the American Heart Association. Get tips on what to ask your doctor before surgery from the Agency for Healthcare Research and Quality.

Back to the Top

Ultra Low-Dose Estrogen Improves Bone Density

 

By Pam Harrison

Reuters Health

Tuesday, May 4, 2004

PHILADELPHIA (Reuters Health) - Among older postmenopausal women, treatment with a skin patch delivering ultra-low doses of estrogen significantly increases bone mineral density (BMD), report US investigators.

At the same time, there's no worrying increase in thickness of the endometrium, a possible risk factor for uterine cancer.

The findings come from a clinical trial reported here during the annual meeting of the American College of Obstetricians and Gynecologists.

Dr. Bruce Ettinger at the University of California, San Francisco and colleagues randomly assigned 417 postmenopausal women between 60 and 80 years of age to wear a placebo patch or one delivering 14 micrograms of estradiol per day -- equivalent to about one quarter or less of the standard estrogen dosage.

All the participants had reduced bone density and were given daily calcium and vitamin D supplements. On average, women were already consuming approximately 700 milligrams of calcium a day, bringing their total daily calcium consumption to approximately 1500 milligrams.

BMD was measured at the start of the study, and at one and two years later. Endometrial thickness was measured either by biopsy or by ultrasound at the same time points.

At the 2-year follow-up, there was an "impressive" increase of almost 3 percent in BMD in the lumbar spine among women in the estradiol patch group compared with a 0.6 percent increase in BMD in placebo controls, the investigators found.

As expected, changes in hip bone density in the active treatment group were less than seen in the spine, increasing by 0.4 percent, while there was a decrease of 0.8 percent in the placebo group

Fracture risk was not a formal part of the study, "but the trend was in the right direction," Ettinger indicated, with four fractures being documented among the women in the estradiol group versus 10 in placebo group.

Importantly, only one woman in the estradiol group had evidence of excess endometrial growth at 24 months follow-up, compared with none in the placebo group.

There was also no difference in reports of breast tenderness between the two groups, and there was no increase in bleeding in the ultra low-dose estradiol group.

"Ultra -low dose transdermal estradiol prevents bone loss in the spine and hip and it avoids the usual side effects associated with hormonal therapy," Ettinger concluded, "and it is also safe for the endometrium."

Within the next few months, the Food and Drug Administration (news - web sites) is expected to comment on whether or not the ultra low-dose preparation used in this study will be approved.

If it is approved, the preparation will likely be available for use within the year.

Back to the Top

Hope for Those Who Can't Use Their Hands

 

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) --It is feasible that someone denied the use of their hands may one day be able to use their own brain signals to operate external devices.

A Duke University research team presented that finding May 4 at the American Association of Neurological Surgeons' annual meeting in Orlando, Fla.

In their first human study of a brain-machine interface, the researchers determined that arrays of electrodes can provide the vital signals of human hand movements necessary to control a prosthetic hand.

Doctors asked patient volunteers to squeeze a ball and play a video game while their neural activity was monitored. The researchers determined which signals effectively predicted each patient's hand motions.

"The results of this study are preliminary, but extremely promising," senior study author Dr. Dennis Turner said in a prepared statement. "A brain-machine interface that utilizes neuronal activity to control a neuroprosthetic device could be life-changing for patients who suffer from severe neurological injury such as Parkinson's disease (news - web sites) or for quadriplegic patients."

The team is working to develop prototypical interfaces that would let paralyzed people operate prosthetics or other external devices, such as a wheelchair or keyboard.

More information

Here's where you can learn more about the brain.

Back to the Top

Coke, Pepsi to Face Off in Carb Battle

 

By Ira Dreeyfuss

Associated Press Writer

The Associated Press

Tuesday, May 4, 2004

CHICAGO - Coke and Pepsi, trying to put more fizz into their soda sales, are about to launch new brands that taste like their flagship drinks but contain half the sugar, carbs and calories.

Coke's C2 and Pepsi's Edge are to hit the market nationally this summer. In advance, the companies offered tastes to supermarket executives, restaurant owners and other potential retail distributors at the Food Marketing Institute's annual trade show in Chicago.

The new sodas are targeted at people who don't like the calories in regular colas but are dissatisfied with diet versions.

These midcalorie sodas may work, said Donna Albertson, who co-owns The Good House, a steak and seafood restaurant, with her husband, Buck, in Ragersville, Ohio. Sipping Pepsi Edge from a paper cup, she said the soda tasted as good as regular and did not have the aftertaste of diet.

It could be a hit with people concerned about their weight, especially women, she said: "It's going to be a gal thing. Gals are always watching their weight."

The sodas are designed to appeal to "people who would like less calories but don't want to compromise on taste," Coca-Cola spokesman Mart Martin said in a telephone interview from the company's headquarters in Atlanta.

Martin dismissed the notion that Coca-Cola C2 might become another New Coke, a new taste the company introduced in 1985 as a replacement for its regular soda, only to see it rejected by consumers. Coke returned to its traditional drink less than three months later, marketing it as Classic Coke.

"This is a completely different proposition, an addition to the portfolio, not a replacement," Martin said.

Pepsi estimates a potential buyers' pool of more than 60 million. It wants to keep them loyal to sodas so they don't drift into competing beverages such as teas and juices, said David DeCecco, a spokesman at Pepsi's headquarters in Purchase, N.Y.

The new drinks contain the standard high-fructose corn syrup that sweetens regular soda but in smaller amounts. The corn syrup is supplemented with Splenda, a no-calorie, no-carbohydrate sweetener made from sugar.

The result is a soda with fewer calories than regular but more than no-cal. For instance, Pepsi says a 12-ounce can of Edge has 20 grams each of sugar and carbohydrates, and 70 calories, compared with regular's 41 grams each of sugar and carbohydrates, and 150 calories.

Although the products are new, the midcalorie soda category is not. Coke sells a midcalorie drink in Norway, Martin said. Pepsi had tried two other products in the United States, the latest in the mid-1990s, and had to withdraw both, DeCecco said.

Technology opened the way for Pepsi to try again, DeCecco said. Splenda was not available for the earlier brands, and the sugar-based sweetener is a key ingredient toward creating a lower-calorie soda that tastes like regular, he said.

Another big difference is a shift in consumer preferences, said John Sicher, editor and publisher of the trade publication Beverage Digest, in Bedford Hills, N.Y. Americans are paying more attention to their diets, especially to counting carbs and calories.

"There's a whole different consumer awareness now that makes this a timely product," Sicher said.

That new awareness shows up in sales figures, Sicher said. The growth in beverages has been in sports drinks and bottled water. Even in sodas, sugared soft drinks have been losing market share, slipping from 74.1 percent in 2002 to 72.6 percent in 2003, while diet drinks have been gaining, he said.

The companies have a lot at stake in keeping consumers happy. Even though Coke and Pepsi make other products that could satisfy thirst, soft drinks are their mainstays, Sicher said.

On the Net:

Food Marketing Institute: http://www.fmi.org/

Back to the Top

Marijuana Abuse and Dependence on the Rise

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- While the number of people smoking marijuana hasn't changed much in the past 10 years, the number of people getting hooked on the drug has increased dramatically, especially among minority groups.

That's the conclusion of a new study in the May 5 issue of the Journal of the American Medical Association (news - web sites). And the researchers suspect the increasing potency of marijuana may be to blame for the rise in dependence.

"The quick answer is, we don't know for sure why there's been an increase, but we think it can partly be explained by the potency of marijuana -- marijuana is about twice as potent now as it was 10 years ago," said study author Dr. Wilson Compton, director of the National Institute on Drug Abuse's division of epidemiology, services and prevention research.

"This study reminds us that marijuana is not a harmless substance. It can lead to abuse and dependence just like any other drug," he said.

Compton and his colleagues compared data collected in two large national surveys. The first, the National Longitudinal Alcohol Epidemiologic Survey, was conducted from 1991 to 1992 and included 42,862 participants. The second, the National Epidemiologic Survey on Alcohol and Related Conditions, took place from 2001 through 2002 and included more than 43,000 participants. All of the participants were interviewed in person.

The researchers found the number of people who use marijuana remained largely unchanged during that 10-year period; about 4 percent of the U.S. population uses the drug.

What did change dramatically was the number of marijuana users who were abusing the drug or who had become dependent on it. Marijuana abuse and dependence among users was up nearly 20 percent in 10 years.

"These numbers translate to about 3 million adults dependent on marijuana compared to 2.2 million previously," Compton said.

The greatest increases in abuse and dependence were seen in minority populations. The number of blacks abusing or dependent on marijuana was 21.2 percent in 1991-1992. By 2001-2002 that number was up to 38.6 percent.

Among Hispanics, 23.7 percent reported abuse or dependence during 1991-92; that number jumped to 37.1 percent by 2001-2002.

Among whites, 31.8 percent of marijuana users reported either abusing or dependent on the drug in 1991-1992. In 2001-2002, that number was 34.4 percent.

Dr. Gopal Upadhya is medical director of the Areba Casriel Institute, a private substance-abuse treatment center in New York City. "People have a tendency to think this is a safe drug, but there is no such thing as a safe drug," he said.

Upadhya said it was interesting to see that as the purity of marijuana has increased, the number of addicts has also increased. He likened it to the difference between crack and cocaine.

"One reason crack is difficult for people to get off is because it's purer," he said.

Upadhya said he very rarely sees people seek treatment for marijuana abuse. Often, he said, people start using marijuana and then begin using more and more addictive drugs. The problem, he said, is that people still consider marijuana harmless.

But, according to the National Institute on Drug Abuse, marijuana use can cause memory and learning problems, loss of coordination, a distorted perception of reality, reasoning difficulties, an increased heart rate and an increased risk of cancer. Studies have also associated marijuana use with depression, anxiety and personality disturbances.

Compton said if you continue to use marijuana, even though it's getting you into trouble at work or with family and friends, you may be dependent. Also, if you need more and more of the drug to achieve the same high feeling, you're probably developing a tolerance, which also signals a probable addiction, he said.

More information

To learn more about marijuana and its effects on your health, go to the National Institute on Drug Abuse. Take this quiz from Marijuana Anonymous to learn if you may have a problem with marijuana dependence.

Back to the Top

W.Va., Miss. Battling High Obesity Rates

 

By Michelle Saxton

Associated Press Writer

The Associated Press

Tuesday, May 4, 2004

HAMLIN, W.Va. - On Monday nights, Peggy Lucas joins about a dozen other women to face the scales and share their stories about an old adversary their weight.

The 57-year-old retired social worker from West Hamlin has battled her weight since she was a teenager.

"I would starve myself to death, and 164 pounds was the least I could ever get down to," Lucas said at a Weight Watchers meeting in Hamlin. "I'd go days and drink nothing but water. And then I'd eat one meal on Sunday, I'd gain five or six pounds and I'd starve it off again."

Lucas believes that over the years she has lost and regained nearly as much as her current weight of about 330 pounds. She's attended Weight Watchers meetings on and off since 1969. She took the drug Redux before it was pulled from the market.

"We have a mental problem, people that are morbidly obese, we do," said Lucas, who suffers from diabetes and high blood pressure. "It's just like we're feeding a demon."

In West Virginia, second in the nation in adult obesity, Lucas is far from alone. According to the Centers for Disease Control and Prevention (news - web sites), West Virginia's rate was 24.6 percent, while Mississippi led the nation with 25.9 percent. The U.S. rate was 20.9 percent.

Those 2001 rates were based on self-reporting, however. A more scientific study based on weight measurements puts the U.S. obesity rate at about 30 percent, a figure health experts believe is more accurate. There was no similar study of individual states.

Obesity is measured with a height-to-weight ratio called the body mass index, or BMI.

At Lucas' height of 5 feet 7 inches and weight of 330 pounds, she is considered severely obese. She's one of 34 percent of the Lincoln County adults who fall into the obese category, meaning they have a BMI of 30 or more.

Lincoln and Boone counties share West Virginia's highest obesity rate, according to the state Department of Health and Human Resources.

Convenience foods, bigger portions and less exercise all contribute to the problem.

"Our biology is geared up to eat when food's available, and rest," said Dr. James Hill, director of the Center for Human Nutrition at the University of Colorado in Denver. "We've created an environment where there's always food available and you never have to be physically active."

Colorado had the nation's lowest obesity rate in 2001 at 14.4 percent, but, like other states, is still seeing an increase from years past.

Dr. Mary Armstrong, medical director for Mississippi's Office of Health Promotion, said the United States has become a "nation of convenience."

"We need to get back out there and enjoy the activities that get us moving and going, and not worry about getting that parking space that's right next to the door," Armstrong said. "Take the stairs instead of the elevator."

Mississippi is pushing several initiatives that include educating adults and working with schools on their physical activity and nutrition programs.

In West Virginia, Joel Halverson of the West Virginia University Health Sciences Center is trying to unravel the mystery of why some areas have a higher rate of obesity than others. But so far he has no answers.

In rural Lincoln County, some say a lack of exercise facilities is a factor.

Karen Morton, a 47-year-old paralegal, started gaining weight after high school, "when I started sitting at a desk and not getting any exercise."

The former cheerleader and majorette found that getting exercise became more difficult after she left her job in Charleston to work in Boone and Lincoln counties, where "there's no place to go work out."

"When I get home from work it's either too dark to go walking, or it's too cold," she said.

The Lincoln County Primary Care Center's new WELL Center is trying to improve the situation. So far, about 150 people have paid a $10 monthly fee to use the center's treadmills, stationary bicycles and weights. Aerobics, dance and stretching classes and a diabetic cooking school and support group are also offered.

Eating smaller, healthier portions is a challenge too, in a place where tradition calls for biscuits and gravy and bacon, said Brian Crist, the center's chief executive officer.

"Overeating is like an addiction, like being on drugs or smoking or anything else, and most of the time you need help to deal with it," Morton said.

Lucas, who would "love to see 200 (pounds) again," has had trouble with her goal, and is considering gastric bypass surgery.

Still, the group meetings help.

"It's just good to get out and talk to people and see what they've done and see what things have helped them through the week," she said. "I know I'll have good weeks and bad weeks, but I'm still going to go."

Back to the Top

U.S. Lags in Key Health Care Areas

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Tuesday, May 4, 2004

TUESDAY, May 4 (HealthDayNews) -- The United States far outspends other English-speaking countries on health care, yet doesn't seem to be getting any better value for its dollars.

So says the first international comparison of health care quality indicators, released Tuesday by the Commonwealth Fund and appearing in a set of articles in the May/June issue of the journal Health Affairs.

The comparisons are intended to help health-care professionals and policy makers determine where to focus their efforts, according to the reports' authors.

"We think of it as a critically important demonstration project and hope that one day it will be replicated on an annual or biannual basis," Dr. Arnold Epstein, co-author of one of the reports and chairman of the department of health policy and management at the Harvard School of Public Health, said at a news teleconference Tuesday. "It represents an unprecedented international collaboration to allow countries to compare their performance with that of other countries, to permit benchmarking and to guide policy makers."

This is indeed the first time experts have even agreed on what measures to use when comparing health-care quality. Not surprisingly, it took five years to arrive at a consensus.

Out of an initial list of 1,000 possible indicators, 21 were agreed upon, including five-year cancer survival rates, 30-day heart attack death rates, breast cancer screening rates, and asthma mortality rates. In addition to the United States, the comparisons included Australia, New Zealand, Canada and England.

"None of the five countries is consistently the best or the worst on all 21 indicators," said co-author Gerard Anderson, director of the Bloomberg School of Public Health at Johns Hopkins University. The report did not explore the reasons or possible reasons for the discrepancies.

The United States, which spent $4,887 per capita on health care in 2001, had the best five-year survival rates for breast cancer, but the worst five-year survival rates for kidney transplants. On the plus side also, cervical cancer screening rates were very high.

But the United States was the only one of the five countries that showed asthma mortality rates on the rise.

Canada, whose per capita spending was $2,792, topped the charts for five-year survival after kidney and liver transplants, but scored the worst for 30-day heart attack survival rates. In general, cancer survival rates were average or above average and were particularly good for childhood leukemia. Stroke death rates were on the low side.

On the other hand, death from heart attacks, especially in older age brackets, was higher than in Canada than in Australia and New Zealand, the only two other countries measured in this category.

Australia, which spent $2,513 per capita, ranked the best for breast cancer screening rates, but was the worst in childhood five-year survival rates for leukemia. Other than this leukemia indicator, Australia had generally good cancer survival rates. It also had high breast cancer screening rates, low asthma mortality, and high rates of flu and polio vaccinations.

England, with a $1,991 per capita spending rate that reflected the entire United Kingdom, had the lowest suicide rates of the five countries, yet did poorly in five-year breast cancer survival rates, along with several other cancer indicators. (More recent data not included in this report indicated that England might be improving its breast cancer marks.) England also had the highest polio vaccination rates, but low cancer survival rates and low breast and cervical cancer screening rates.

New Zealand, with the lowest per capita rate of $1,710, outshone the other nations in five-year survival rates for colorectal cancer, yet it also had the highest suicide levels, especially among young people. Kiwis also had the highest colorectal cancer survival rates. But its influenza and polio vaccination rates were relatively low.

Smoking rates (measured as a percentage of the population) were the lowest in the two North American nations surveyed.

There were also many gaps in the data. "We don't have information on diabetes, Alzheimer's," Anderson said. "There are definite gaps in the future we would love to complete. It does give you a snapshot, but it does not give you the whole picture."

It's unclear how much of an effect this snapshot will have.

"My guess is that this will have a modest impact. People will be interested; it will raise awareness of quality of care internationally," Epstein said. "If this gets adopted by the OECD [Organization for Economic Development and Cooperation] and becomes an institutionalized report and comes out annually or bi-annually in the years ahead, I could see this having an enormous effect."

The OECD is, in fact, emulating and expanding the model. Quality of care will be the first topic discussed at a meeting next week, said Peter Scherer, counselor of OECD's employment and social affairs directorate. The organization is planning to do similar comparisons with 21 countries and more than 100 indicators.

"The bottom line is that the example that has come from this exercise had really inspired a lot of other countries with very diverse healthcare systems to join in a similar cooperative exercise," Scherer said.

More information

The Commonwealth Fund has the series of reports. The OECD also has information on health.

Back to the Top

Report Summarizes Health Effects of 9/11

 

The Associated Press

Tuesday, May 4, 2004

NEW YORK - The Sept. 11, 2001 attacks on the World Trade Center caused "the largest acute environmental disaster that ever has befallen New York City" and could lead to long-term health problems in rescue workers and city residents, according to a new report.

The report an overview of work by six research centers that have studied health effects of the attacks found that dust from ground zero had caused a rise in cases of asthma and severe cough, particularly among firefighters and other rescue workers. In one study of 183 cleanup workers, 33 percent were found to have new-onset cough, 18 percent had a wheeze and 24 percent experienced phlegm production, the report said.

Asbestos in the dust had led to increased risk of mesothelioma, a type of cancer, according to the report, published in the May issue of Environmental Health Perspectives.

Risk of illness was lower among office workers and residents in lower Manhattan than in ground zero workers, the report said.

The report said the long-term effects of the attacks would become clear only with time and further study.

On the Net: http://ehis.niehs.nih.gov/  

Back to the Top  

Monday, May 3, 2004

 

Stopping Sleep Apnea Would Make Roads Safer

 

HealthDayNews

Reuters Health

The Associated Press

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Sleep apnea treatment could cut down on traffic crashes and save hundreds of lives and billions of dollars each year in the United States, according to a University of California, San Diego School of Medicine study in the May issue of Sleep.

The study concluded that using continuous positive airway pressure (CPAP) to treat drivers who have obstructive sleep apnea could save about 980 lives and $11.1 billion in accident costs per year.

Obstructive sleep apnea, a breathing disorder caused by intermittent blockage of the airway, affects millions of Americans. People with this condition stop breathing for 10 to 30 seconds at a time, as many as 400 times a night. The resulting poor quality sleep leads to excessive daytime sleepiness.

The researchers noted that about 1,400 traffic fatalities each year are caused by sleep-deprived drivers with obstructive sleep apnea. It's estimated that the prevalence of obstructed sleep apnea among drivers in the United States is 3 percent, or 4.7 million drivers.

Of those 1,400 fatalities, about 980 could be prevented if the drivers were treated for their sleep apnea, the study said. That figure is based on a 70 percent success rate using CPAP, the most common treatment for obstructive sleep apnea.

With CPAP, patients wear a mask over the nose while they sleep. An air blower connected to the mask forces air through the nasal passage and prevents the throat from collapsing during sleep.

It's estimated that as many as 40 million Americans have undiagnosed sleep apnea.

More information

The American Medical Association has more about sleep apnea.

Back to the Top

Study: Creativity May Help Aging Brains

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, May 3, 2004

WASHINGTON - It's an odd medical meeting that features Rodgers & Hammerstein and brilliantly colored paintings rather than, say, X-rays. What does belting out "Oklahoma" or putting oil to canvas have to do with brain health?

Perhaps a lot, when the singers are active 70- and 80-year-olds and the painters are in the throes of dementia. Creativity, some scientists say, may play an important role in healthy aging conversely, the ill can shed extraordinary light on just how the brain perceives art.

"Even though our brains age, it doesn't diminish our ability to create," says Dr. Bruce Miller, a behavioral neurologist at the University of California, San Francisco.

The big question, as arts projects become more common in retirement and nursing homes, is whether tapping elders' creativity truly brings them physical health benefits as well as joy. And if so, what works best?

The National Institute on Aging and Society for the Arts in Healthcare brought scientists and artists together last month to galvanize interest in research on creativity to find out.

Mental decline once was thought inevitable with aging. Scientists now know that's not true, and the brain continually rewires and adapts itself even in old age.

Even dementia "doesn't wipe out all aspects of creativity," says Miller. Indeed, some forms release astounding abilities to draw by people who never before did so, providing important clues to where the brain houses creative abilities.

Take Jack, a businessman who claimed he'd never even been in an art museum. About the time he noticed problems speaking, he also began compulsively painting canvases full of brightly colored lines.

His painting improved he even won awards as the language center of his brain decayed. By the time he painted a stunningly vivid purple and yellow portrait of a parrot, "He no longer knew what a bird was," recalls Miller.

Jack had an illness often confused with Alzheimer's called "frontotemporal dementia." It initially spares the parietal lobes important for visual artistry even as it destroys other regions crucial for verbal skills, Miller explains.

With Alzheimer's, in contrast, early damage to visual-artistry areas leaves patients unable to copy simple geometric designs.

So illness can affect creativity but how does being creative affect healthy elders? Consider the show tune-belting Senior Singers Chorale, who are part of an unusual four-year study.

Dr. Gene Cohen of George Washington University is tracking the Arlington, Va.-based chorus and similar arts programs for independent seniors in New York and San Francisco. His theory is that the challenge of learning from professionals "we're way beyond bingo" improves mental, and possibly physical, health.

The singers' average age is 80; the youngest is 65 and the oldest 96. Some have even shown up for weekly rehearsal grieving a spouse's death, and "afterward they say, `I feel better,'" said chorus director Jeanne Kelly of the Levine School of Music. "It's emotionally really good for them."

Final study results are due next year, but preliminary data suggest participants get more than support: Compared with their elderly neighbors, they suffer less depression, make about three fewer doctor visits a year, take two fewer medications and have increased their other activities.

"We all probably could have told him that to begin with," laughs Betty Gail Elliott, 73, who joined the chorus with her 84-year-old sister. "When you have interesting things to do, you tend to be more outgoing and have a more positive attitude, and therefore you are more healthy."

In a poem to Cohen and Kelly, she wrote: "Our eyes may be dimmer than they were, our hearing may not be too hot. But friends, you just better believe we make the most of what we've got."  

Taken together, research like Miller's and Cohen's could help arts groups better select projects to offer to different groups of elders.

It even could influence what art decorates their walls: Older people won't see blues as well as reds. The eye's light-sensing abilities change with normal aging, says University of California, Los Angeles, neuroscientist Dahlia Zaidel, who flips through masterpieces by an aging Renoir to show the color-perception changes hit just about everyone.

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

Back to the Top

Obstetricians Told to Talk, Write More Clearly

 

Reuters

Monday, May 3, 2004

PHILADELPHIA (Reuters) - Obstetricians were told on Monday that they could improve patient safety and combat soaring rates for malpractice insurance by stressing simple teamwork, better communication with nurses and by writing more clearly.

By making those and related reforms, U.S. hospitals and doctors would be drawing on the best safety practices of the airline industry and the military in a bid to make the process of childbirth less risky, experts said on Monday.

"We are trying to get people to think in terms of systems, not individuals," Dr. Lucian Leape, an adjunct professor of health policy at Harvard School of Public Health in Boston, said at a meeting today of the American College of Obstetricians and Gynecologists.

Doctors at the conference stressed simple measures such as clearer handwriting, better medical test tracking and more communication between nurses, doctors and other staff as ways to reduce medical errors.

"Most problems are not due to an individual, they are system problems," said Dr. Stanley Zinberg, the medical specialty group's vice president for practice activities.

A 1999 report from the Institute of Medicine (news - web sites) estimated that 1 million people are injured annually by treatment errors at U.S. hospitals, with as many as 98,000 deaths caused by those errors.

"As the American health care system grows more complex, the potential for human error only compounds," Zinberg said.

Yet improving communication in the traditionally hierarchical medical setting is easier said than done. "It is very countercultural to the way we were taught," Leape said. "And hanging over all of this is the specter of malpractice."

He has called for a system of no-fault medical liability insurance which would offer limited compensation to anyone injured by medical error.

Dr. Benjamin Sachs, chief obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, is leading a study, funded by the U.S. Department of Defense (news - web sites), to test whether 15 hospitals can improve childbirth safety with techniques used by commercial airlines and the military.

The standards -- developed after the National Aeronautics and Safety Administration found that human error and failures of communication were involved in a majority of accidents -- stress teamwork and communication as well as better information systems.

"Why should we be practicing medicine the way Marcus Welby did?" said Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services (news - web sites).

Leape, estimating the agency's annual budget at around $250 million, said the U.S. spends about 1 percent of what it spends on developing new health therapies "to assess whether they are making any difference."

The safety study led by Sachs is not yet complete, but he said the rate of "adverse outcomes" at his own hospital has fallen by more than half in the last four years. Over the same period, the doctors malpractice premiums have fallen 10 percent, Sachs said.

Back to the Top

Study: Ohio Teen Health Habits Improve

 

The Associated Press

Monday, May 3, 2004

COLUMBUS, Ohio - Ohio's teenagers exercise, wear seat belts and avoid drugs, alcohol, tobacco and sex more often than their counterparts five years ago, according to a new study.

In fact, the Ohio Department of Health study released last week indicates that almost all of the health habits of Ohio teens have improved during the past five years.

"Ohio's teenagers understand healthy behaviors are important," department director J. Nick Baird said.

"This bodes well for Ohio's future, as we often carry learned behaviors into adulthood."

The study, conduct last year of about 1,200 high school students, found:

·        68 percent of Ohio teens reported that they exercise regularly, up from 62 percent in 1999, the last time the statewide survey was conducted.

·        76 percent reported having tried alcohol, down from 85 percent in 1999.

·        90 percent said they didn't drink and drive in the month before the survey.

·        Tobacco use fell 45 percent to 22.2 percent.

State officials credit intervention programs, including the Healthy Ohioans Program and anti-smoking programs such as "stand," part of the Ohio Tobacco Use Prevention and Control Foundation, for the improvements.

"Teenagers in Ohio are getting some of the diverse messages," said Kristopher Weiss, a +health+ department spokesman.

The Healthy Ohioans initiative is sponsored by the +health+ department and American Cancer Society (news - web sites) and targets businesses, schools and state employees. The Buckeye Best Healthy School Awards Program recognizes schools that put a high priority on healthy outcomes for children.

The Ohio Grocers Association has been promoting training for retailers to keep teenagers from buying alcohol and tobacco, said Julie Carrier, director of the Ohio Food Industry Foundation.

The state youth survey was modeled after similar studies in 1993, '95, '97 and 99. It was developed by the Centers for Disease Control and Prevention (news - web sites).

In some areas teens did not show improvement since 1999.

About 32 percent of Ohio teens reported watching three or more hours of television on school days, up from 30 percent in 1999, and more students, 14 percent, describes themselves as overweight, up from 10 percent in 1999.

About 12 percent reported attempting suicide one or more times during the year, up from nearly 8 percent in 1999.

For the first time, the study asked questions about youth development. Nearly 60 percent of the teenagers said they volunteer at least one hour a month and participate in extracurricular activities.

And 84 percent said they would be comfortable asking an adult for help.

On the Net:

Ohio Department of +Health+:

http://www.odh.state.oh.us/ODHPrograms/YouthRsk/Youthrsk1.htm

Ohio Tobacco Use Prevention and Control Foundation:

http://www.standonline.org

Healthy Ohioans Program:

(www.healthyohioans.org)

Back to the Top

Protein Plays Role in Ovarian Cancer

 

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Reduced or lost protein expression of the tumor-suppressing gene Rb2/p130 may play a key role in ovarian cancer, says a study in the May 1 issue of Clinical Cancer Research.

Researchers at the Sbarro Institute for Cancer Research and Molecular Medicine in the Center for Biotechnology at Temple University in Philadelphia analyzed 45 primary ovarian cancer samples. They found 40 percent of those samples had a decrease or total loss of Rb2 protein expression.

"In the samples where the protein was decreases or lost, there was an inverse correlation to the aggressiveness of the cancer," study author Giuseppina D'Andrilli, a research fellow at the Sbarro Institute, said in a prepared statement.

"This is consistent with the theory that if the Rb2 protein is still present in the tumor tissue, the aggressiveness of the tumor is less," D'Andrilli said.

The researchers then introduced correct copies of the Rb2 gene into the ovarian tumor cells that had reduced or no Rb2 protein expression.

"Introducing the gene Rb2/p130 allowed the cells to produce more proteins, and this increased protein production brought about a dramatic arrest of cells in the G1, or initial phase of the cell cycle," D'Andrilli said.

"This study is just one step in saying, 'OK, we have observed that the Rb2 gene has a role in ovarian carcinogenesis. We have demonstrated that it is a protein that has to be considered in the future in ovarian cancer patients,'" D'Andrilli said.

This line of research could lead to new ways to detect and treat ovarian cancer, which will develop in about one out of every 57 women in the United States.

More information

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

Back to the Top

Virus Protein Shells Can Be Broken

 

By Randolph E. Schmid

Associated Press Writer

The Associated Press

Monday, May 3, 2004

WASHINGTON - The protein shell that surrounds a virus is elastic but can be broken, according to scientists who repeatedly poked shells with a special microscope.

The shell, called a capsid, is about as strong as a hard plastic, but is only about a billionth of a yard long, according to the researchers. Their findings are reported in this week's issue of Proceedings of the National Academy of Sciences (news - web sites).

Tests of the shell of a virus called phi29 showed its strength was "close to that of Plexiglas," said Gijs Wuite of the Free University in Amsterdam, Netherlands.

"At the same time, however, we found that you can deform the shell by 30 percent without breaking it. Thus the shell is quite strong and yet dynamic enough to resist cracking," Wuite said in an interview by e-mail.

Phi29 is a bacteriophage, a virus that infects bacteria, and it has a protein shell to encase its DNA during transfer from one host cell to another.

Wuite said the researchers are using the same technique, an atomic force microscope, to study other viruses. The instrument works by scanning a fine ceramic or semiconductor tip over a surface and can measure the resistance of the surface.

"The research might reveal new insight in the transport stages of different viruses," said Wuite. "The shell strength might also relate to the time a virus stays infectious outside the host cell, which would also be important from a medical point of view."

Since the shell is crucial to protecting a virus when it is outside the host cell, "knowing more about the properties of these shells might help with the understanding and fighting viral infections," Wuite said.

On the Net:

Proceedings: http://www.pnas.org

Back to the Top

Watchful Waiting Urged for Mild Ear Infections

 

Reuters

Monday, May 3, 2004

CHICAGO (Reuters) - Mild childhood ear infections may be best left untreated to see if they clear up on their own, the American Academy of Pediatrics said on Monday.

The condition, otitis media with effusion, afflicts nearly every toddler and preschooler at some point, the group said, with about 2 million cases diagnosed in the United States each year.

For children who are not at risk for speech, language or learning problems, "watchful waiting" for at least three months is recommended instead of treatment.

The statement, published in the May issue of the group's journal, "Pediatrics," said decongestants and antihistamines were not effective treatments and that corticosteroids or antibiotics such as penicillin were not recommended for "routine management" of the condition.

If a child needs surgery, it added, insertion of drainage tubes was the preferred initial treatment.

The condition is different from acute otitis media, which involves intense signs and symptoms of infection and inflammation, the statement said.

Back to the Top

Race May Be Factor in Children's Care in Ers

 

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Race may be a factor in the care received by children at emergency departments in the United States, according to a University of Rochester Medical Center study.

Researchers analyzed 2003 data from emergency departments at 25 hospitals across the nation. They focused on the black and white children who came to the ER with asthma or fractured arms and legs.

Among 181 children with fractures, pain control was documented 2.3 times more for the 131 white children than for the black children.

The study found no statistically significant difference in the medications given to 635 children (211 white) with asthma. But the researchers did determine that white children were using medications to prevent sudden asthma attacks 1.7 to 2 times more often than black children.

Patterns of social worker consultation and child abuse referrals were also examined in the study. Among 499 children (336 of whom were white) who had head trauma, burns, poisonings or fractures, black children were 2.9 times more often referred for social work or child abuse consultation than white children.

The study was presented May 3 at the Pediatric Academic Societies' annual meeting in San Francisco.

"This study could not examine why these disparities are occurring, but this is a critical first step to describe them and to acknowledge that they exist," study author Dr. Julius Goepp, chief of pediatric emergency medicine at the University of Rochester Medical Center's Golisano Children's Hospital, said in a prepared statement.

"The next step should be to conduct larger studies that will allow us to identify the causes of disparities, so we can offer a level playing field to all children," Goepp said.

More information

The American Academy of Pediatrics has more about children and emergency care.

Back to the Top

Study: Caffeine May Up Black Teens' Blood Pressure

 

Reuters

Monday, May 3, 2004

CHICAGO (Reuters) - Black adolescents who drink four cans of caffeinated sodas a day could be raising their risk of high blood pressure, according to a study published on Monday.

The study in the Archives of Pediatrics & Adolescent Medicine comes as sales of sodas in schools are already coming under fire for contributing to obesity.

"This paper indicates that the concern about soda consumption in children and teens should not be limited to the fact that soft drinks add more calories to the diet," Margaret Savoca, nutritionist and postdoctoral fellow at the Medical College of Georgia and lead author on the study, said in a news release.

"Caffeine consumption may also impact their blood pressure," she said.

According to the report, the frequency of hypertension among youth is rising, and black adolescents have higher systolic blood pressures -- the top blood pressure number -- than white adolescents. Hypertension can lead to stroke, heart failure and kidney damage.

"Caffeine is considered a preventable risk factor for hypertension and cardiovascular disease," the study authors wrote, adding that it is estimated that 68 percent of boys and 62 percent of girls aged 12 to 17 drink at least one soft drink a day, with a lower number drinking coffee or tea,

In the study, 81 black teens and 78 whites were put on a sodium controlled diet for three days and then made choices from a menu of food and drinks they would consume over three days. Based on their choices, they were categorized into three levels of caffeine intake.

Blacks who consumed the most caffeine, more than 100 milligrams a day -- or the equivalent of four 12-ounce sodas, or four cans -- had higher systolic blood pressure readings than all others in the study, including whites in the highest caffeine intake category, the authors found. Their average systolic blood pressure was 119.3, while a healthy young adult has a blood pressure of 110/75.

While blacks are more likely to have high blood pressure in general, the study did not show a significant difference between blacks and whites in other caffeine intake categories, Gregory Harshfield, associate director of the Georgia Prevention Institute, said.

Back to the Top

Alternatives to Mammograms on Horizon

 

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Three new electromagnetic imaging techniques are being tested for their ability to detect breast abnormalities, including cancer, and provide an alternative to mammography.

In a study in the May issue of Radiology, Dartmouth Medical School researchers used a combination of the three techniques to image the breasts of 23 women.

Electrical impedance spectroscopy, microwave-imaging spectroscopy and near-infrared spectroscopy used low-frequency electrical currents, microwaves and infrared light, respectively, to create a computerized cross section image of breast tissue.

"This study was the first stepping stone in our ongoing research to gain a better understanding of the electromagnetic properties of breast tissue," Dr. Steven Poplack, a professor of radiology at Dartmouth Medical School and co-director of breast imaging and mammography at Dartmouth-Hitchcock Medical Center, said in a prepared statement.

"Once we establish normal ranges for specific breast characteristics, we'll begin working on recognizing breast abnormalities, including cancer," Poplack said.

If they're proven effective, these electromagnetic imaging techniques could help boost breast cancer screening rates.

"If we can offer an alternative breast imaging technique that addresses (mammography) radiation concerns and is also more comfortable, the hope is that more women may elect to be screened for breast cancer," Poplack said.

More information

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

Back to the Top

Screening Tests Overused in Sick, Elderly Women

 

Reuters Health

Monday, May 3, 2004

NEW YORK (Reuters Health) - Screening mammograms and Pap tests are being used too often in elderly women with limited life expectancies, new research shows. In contrast, such tests are being underused for healthy older women.

Health status should be considered before screening older women because harm can outweigh benefits in this population, Dr. Louise C. Walter and associates explain in the Annals of Internal Medicine.

On the other hand, age alone should not be the basis for making screening decisions.

To see if these guidelines are being used in routine practice, the research team, based at the University of California in San Francisco, evaluated data from the 2001 California Health Interview Survey, stratifying women by age and health status. Nearly 5000 women completed the healthy survey.

Although testing decreased as women aged, within each age group the number reporting either a recent mammography or Pap test did not decrease with worsening health status. In fact, younger women with serious diseases often underwent screening at higher rates than healthy women who were older.

Walter's group notes that women with a life expectancy of less than five years may be harmed by screening because of unnecessary tests and procedures ordered because of faulty results, treatment of insignificant disease, and psychological stress.

Doctors should take into account a woman's general health status, not just her age, when considering various screening tests, the authors stress.

In an editorial, Dr. H. Gilbert Welch of the VA Outcomes Group in White River Junction, Vermont, suggests that women may be screened for the wrong reasons. People may believe that such tests are their responsibility, expect that screening will help keep them healthy or want reassurance that they are still valued and being cared for accordingly.

However, Welch adds, deaths due to breast and cervical cancer decline as patients age. "We certainly ought to be able to find better ways to help older patients feel valued and better ways for them to take an active role in keeping themselves healthy," he concludes.

Source: Annals of Internal Medicine, May 4, 2004.

Back to the Top

Vitamin E May Increase 'Bad' Cholesterol

 

By Steven Reinberg
HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- You've probably heard that antioxidants such as vitamin E are good for you, but new research finds antioxidants may actually help produce "bad" cholesterol.

Experiments in cells and mice indicate that oxidation is necessary to reduce the amount of low-density lipoprotein (LDL) cholesterol produced in the liver. That's why polyunsaturated fatty acids, which are oxidants, can reduce cholesterol production.

Oxidation, also called oxidant stress, is a chemical reaction of a substance with oxygen. In the body, oxidant stress releases free radicals that damage cells.

"Not all oxidant stress is bad for you," said lead researcher Dr. Edward A. Fisher, a professor of cardiovascular medicine and cell biology at New York University. "Oxidant stress also has some benefits in terms of the cardiovascular system, by decreasing the liver production of the lipoproteins that cause atherosclerosis."

"Sometimes oxidative stress is good, and sometimes it's bad," said co-researcher Dr. Kevin Jon Williams, a professor of medicine at Jefferson Medical College. For example, humans breathe oxygen because they need oxidation to convert food into energy, and oxidant stress is also how the immune system kills bacteria, he added.

Fisher's team found liver cells under oxidative stress release free radicals made by the normal conversion of polyunsaturated fatty acids to so-called lipid peroxides.

When these free radicals are released, they destroy a critical protein called ApoB100. Without ApoB, the liver cannot make LDL cholesterol, and the amount of cholesterol released into the blood is therefore substantially reduced.

The researchers found that when vitamin E was introduced to these liver cells, it prevented the destruction of ApoB, which lets the liver make more LDL cholesterol, according to their report in the May issue of the Journal of Clinical Investigation.

In large studies, "vitamin E has flunked as a protection against coronary artery disease," Fisher said. So the "blanket recommendation for the use of antioxidants, such as vitamin E, for lowering the risk of heart disease is not warranted."

However, the findings also confirm that diets rich in polyunsaturated fatty acids, such as those found in fish, can substantially reduce the amount of bad cholesterol your body makes, Fisher added.

Williams said the he would "take vitamin E supplements only in circumstances where there has been proven clinical benefit, and that is not the case in cardiovascular disease."

Dr. Ronald Krauss, director of atherosclerosis research at the Children's Hospital Oakland Research Institute, said this study shows how diet can affect blood fat levels.

"This study reminds us that even though there are number of benefits of antioxidants in the diet, we can't assume that all antioxidants will benefit all aspects of health," said Krauss, who wrote an accompanying editorial.

There may be a lack of benefit from antioxidants on blood fat levels, Krauss said. "In order to determine whether antioxidants benefit heart disease, we have to rely on clinical studies," he noted.

"The studies that have been done to date have not shown a benefit from antioxidants. Maybe this study gives us one reason for that negative result," Krauss said.

"If one wants to take advantage of antioxidants, which can have many health benefits, one should rely on eating foods that are rich in antioxidants and not rely on taking supplements to prevent heart disease," Krauss advised.

More information

The American Heart Association (news - web sites) can tell you about cholesterol, and the National Institutes of Health (news - web sites) has more on vitamin E.

Back to the Top

Targeted Diabetes Screening Seen Best

 

Reuters Health

Monday, May 3, 2004

NEW YORK (Reuters Health) - The balance between the costs and benefits of screening for diabetes is most favorable when efforts focus on older individuals with high blood pressure, new research suggests.

In contrast, testing everyone for diabetes -- that is, universal screening -- is not cost-effective, Dr. Thomas J. Hoerger, from RTI International in Research Triangle Park, North Carolina, and colleagues report in the Annals of Internal Medicine.

Hoerger's team estimated the costs and benefits of the two approaches using special statistical tests and known healthcare costs.

At all ages, "diabetes screening targeted at persons with (high blood pressure) is more cost-effective than screening the general population," Hoerger told Reuters Health. All things being equal, thousands of dollars can be saved by screening an older patient with high blood pressure than screening one without this problem.

In an editorial, Dr. David M. Nathan of Massachusetts General Hospital in Boston and Dr. William H. Herman of the University of Michigan in Ann Arbor, note that the rationale for any screening program is that earlier detection will lead to earlier treatment.

"Unfortunately, the current state of delivery of care to persons with diagnosed diabetes in the United States does not bode well for the treatment of patients identified through screening," they write. "Unless we optimize care after we diagnose diabetes, screening cannot be effective or cost-effective."

Source: Annals of Internal Medicine, May 4, 2004.

Back to the Top

Overweight Moms Have Trouble Nursing

 

By Kathleen Doheny
HealthDayNews

Monday, May 3, 2004  

MONDAY, May 3 (HealthDayNews) -- Overweight new mothers are more likely to quit breast-feeding early or not try it at all, and now researchers have found a reason why.

Women who are heavy have a diminished response to their baby's suckling, and this can adversely affect milk production, said Kathleen M. Rasmussen, a professor of nutrition at Cornell University and lead author of the study, which appears in the May issue of Pediatrics.

Immediately after birth, levels of the hormone progesterone fall, triggering the onset of milk secretion for breast-feeding. But for a continuing adequate milk supply, a baby's suckling must prompt an adequate increased concentration of prolactin, a hormone produced in the pituitary gland that stimulates the mammary glands to produce milk.

"The amount of prolactin the woman releases in response to the baby's suckling is what determines how much milk she makes between this feeding and the next," Rasmussen said.

In the study, Rasmussen and her co-author, Dr. Chris L. Kjolhede of Bassett Healthcare Research Institute in Cooperstown, N.Y., evaluated 40 mothers of infants, some normal weight and some not, measuring blood levels of prolactin and progesterone before and 30 minutes after the beginning of breast-feeding 48 hours after delivery and again at seven days after birth.

Overweight women had a lower prolactin response to suckling, they found. "In addition to other reasons [that many overweight women don't start and stay with breast-feeding], we have a strong biological explanation why," Rasmussen said. "They don't have an adequate prolactin response to suckling."

In theory, she added, that means less milk will be available, although the researchers did not directly measure the amount of milk the women produced.

Besides the biological explanation, Rasmussen said, heavier women may have a harder time positioning a baby for nursing, due to their size. It may be harder for the baby to "latch on" as well.

For the study, the researchers defined overweight as having a body mass index (BMI) of 26 before the pregnancy began. A woman 5 feet 5 inches tall who weighs 155 pounds has a BMI of 26. The normal-weight women in the study had an average BMI of 22 (a woman 5 feet 5 inches tall and 130 pounds), and the heavier women had an average BMI of 31.8 (nearly 190 pounds for a woman of the same height).

Exactly why the excess weight affects the prolactin response wasn't investigated, Rasmussen said.

The take-home point for women hoping to conceive and breast-feed successfully is clear, she added. "This is just another reason why women should conceive their babies at a healthy weight."

If that's not possible, the next best thing is to give an overweight new mother maximal support in her breast-feeding efforts, Rasmussen said. "We are talking about a substantial effort required," she said. In the study, the women's breast-feeding was assessed during every shift while they were in the hospital, and there were lactation consultants on call.

Another expert called the study "very interesting" and said help is available to these women. "These women can be helped to breast-feed even if their supply is lower," said Katy Lebbing, a registered lactation consultant and manager of the Center for Breast-feeding Information at LaLeche League International in Chicago.

The league maintains a specialty file, with names of leaders who are experts in specific areas. "One of our categories is large-breasted women," Lebbing said.

Another specialty area are babies who fail to thrive or gain weight slowly, which might be the case if a mother does not have enough milk.

Another option for overweight women who have trouble breast-feeding is to turn to human milk banks, Lebbing said. Women with excess milk donate to the banks. "Let's get these two groups of women together," Lebbing suggested.

The milk that is donated is screened for disease organisms and then heat-treated, she said. The professional association for human milk banking is the Human Milk Banking Association of North America.

More information

To learn more about breast-feeding, visit the La Leche League International. To learn more about human milk banking, try the Human Milk Banking Association of North America.

Back to the Top

School Program Helps Kids with Asthma

 

Reuters Health

Monday, May 3, 2004

NEW YORK (Reuters Health) - A school-based program that included provision of steroid inhalers markedly improved symptoms and reduced absenteeism in a group of urban children with asthma, new research indicates.

However, the benefit was only seen in children not exposed to second-hand smoke.

"Most children included in this study were poor and from minority populations, and represent the group with the greatest need for assistance with this common chronic illness," the researchers point out.

The findings, which appear in the Archives of Pediatrics and Adolescent Medicine, are based on a study of 180 children with mild-to-severe persistent asthma who were randomly selected to participate in the school-based program or to receive their usual care.

Children in the program had more symptom-free days during the early winter months than those in the usual-care group, lead author Dr. Jill S. Halterman, from the University of Rochester School of Medicine in New York, and colleagues report.

Also, participation in the program was associated with a drop in absenteeism of about 2 days.

Compared with parents of other children, parents of program participants experienced a greater improvement in quality of life, the researchers say. Further analysis also showed a link between program participation and a reduction in rescue medication use and emergency visits for asthma.

The authors found that these program benefits only applied to children not exposed to second-hand smoke.

"If these findings are replicated in other settings, this school-based system of preventive care could become standard for the management of childhood asthma in underserved communities," Halterman's team concludes

Source: Archives of Pediatrics and Adolescent Medicine, May 2004.

Back to the Top

Weighing the Worth of Whooping Cough Vaccine

 

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Vaccinating teenagers against whooping cough may be cost-effective in certain circumstances, says a study meant to help U.S. health officials evaluate the potential benefits, risks and costs of a national booster vaccination program.

Whooping cough vaccinations in the United States began in the mid-1940s and led to steep reduction in the prevalence of whooping cough over the ensuing 25 years. But over the past two decades, immunity to whooping cough has waned and this serious illness has re-emerged in the United States.

Adolescents and adults in Canada can now get a combined acellular pertussis vaccine (TdaP), which has fewer side effects than previous vaccines. This new vaccine may be considered for use in the United States.

"In the past, vaccination programs were cost-saving and lifesaving. However, newer vaccines are now focused on reducing morbidity, rather than mortality, and we need to carefully weigh the risks and benefits of vaccination. By examining medical and non-medical costs as well as quality-of-life issues, we can determine the optimal strategy," study author Dr. Grace Lee, an infectious disease specialist at Children's Hospital Boston and the Center for Child Health Care Studies at Harvard Medical School (news - web sites) and Harvard Pilgrim Health Care, said in a prepared statement.

After reviewing the data, she and her colleagues concluded that all whooping cough vaccination strategies were more costly and less effective compared to no vaccination. They did find that an adolescent booster strategy against whooping cough may be effective under certain circumstances defined by cost, vaccine efficacy and disease incidence.

The study was presented over the weekend at the Pediatric Academic Societies' annual meeting in San Francisco.

More information

The American Medical Association has more about whooping cough.

Back to the Top

Cholesterol-Lowering Drug May Delay Diabetes Onset

 

Reuters Health

Monday, May 3, 2004

NEW YORK (Reuters Health) - Treatment with bezafibrate to lower cholesterol in people with heart disease also reduces the risk of developing full-blown diabetes in those who have high blood sugar levels, doctors in Israel report.

Their research suggests that the benefit is similar to that achieved with anti-diabetes medication.

While bezafibrate is used to lower cholesterol levels, it is already recognized as effective in reducing blood glucose levels in people with overt diabetes, Dr. Alexander Tenenbaum and associates explain in the rapid access issue of the American Heart Association (news - web sites)'s journal Circulation.

The investigators, at Chaim Sheba Medical Center in Tel-Hashomer, studied 303 patients with a history of heart attack or heart-related chest pain (angina) or both, and who had fasting blood glucose levels in the high range but were not being treated for diabetes.

Among the 156 patients randomly assigned to treatment with bezafibrate, fasting blood glucose levels declined during the first year, but this did not happen among the 147 assigned to a control group. Blood sugar levels then remained lower in the treatment group over an average of six years.

New-onset diabetes was diagnosed in 54 percent of the control group and 42 percent of the bezafibrate group, and the average time until diabetes started was 3.8 years and 4.6 years, respectively.

"Whether the combination of bezafibrate with other recommended drugs for secondary prevention (statins and ACE inhibitors) would be as efficacious as suggested by our results remains to be determined," Tenenbaum's team points out.

Source: Circulation, May 11, 2004.

Back to the Top

Health Tip: Panic Attack

 

HealthDayNews

Monday, May 3, 2004

(HealthDayNews) -- Panic attacks can be intense and disabling. In fact, people sometimes mistake a pounding chest and racing heart rate -- common panic attack symptoms -- for a heart attack, according to Barnes Jewish Hospital.

Here are some other signs of a panic attack:

If you think you suffer from panic attacks, speak to your doctor. The condition can be treated with medication and therapy.

Back to the Top

 

Anemia Linked to Disability in Elderly

 

Reuters Health

Monday, May 3, 2004

NEW YORK (Reuters Health) - About 1 in 10 older adults in Italy are anemic, a new study shows, and the condition raises the risk of disability, poor physical function and reduced muscle strength.

These effects "can threaten the independence of older adults," lead author Dr. Brenda W. J. H. Penninx, from Vrije Universiteit in Amsterdam, said in a statement. "Physicians should be aware of their older patients' anemia status, even if there is no apparent disease."

The findings, which appear in the Journal of the American Geriatrics Society, are based on data from 1156 older adults living in the Chianti area of Italy.

Anemia was detected by measuring specific levels of hemoglobin, the oxygen-carrying component in blood, for women and men, and a variety of measures were used to assess disability, physical performance, and muscle strength.

The researchers found that 11.1 percent of men and 11.5 percent of women were anemic.

Participants with anemia had an average of nearly two disabilities, whereas non-anemic people averaged about one. Those with anemia scored significantly worse than their non-anemic counterparts on a standard test of physical performance. Leg strength and handgrip strength were also significantly weaker in the anemia group.

"Our research suggests that anemia deserves more attention," Penninx said. "We need to learn whether treatment can help restore physical function or prevent a physical decline."

Source: Journal of the American Geriatrics Society, May 20046.

Back to the Top

Immune System May Protect Against Cognitive Disorders

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- Israeli researchers believe they have demonstrated a link between immune system functioning and cognitive impairment, at least in mice.

While some scientists find the research promising, others point out that applying the findings to human ailments -- such as Alzheimer's disease or schizophrenia -- requires an extraordinary leap.

"It's an extremely exciting study, but it's in mice, so we've got to be very careful how we translate those conclusions to humans," said Dr. Marc Siegel, clinical associate professor of medicine at New York University School of Medicine.

"It's one thing to look at a mouse brain and make comparisons about more primitive emotions, but something like schizophrenia involves cognitive function, and that's very tricky. We have to be cautious about transferring the conclusion about this preliminary data in mice to humans with severe psychiatric illness."

Dr. David Knopman, a neurologist at the Mayo Clinic in Rochester, Minn., was also careful not to take the conclusions too far. "I think that this work in mice linking the immune system to behavior is very interesting and may have implications in the future for human disease," he said. "But the astonishing leap on the part of the authors to state that these findings point to critical factors likely to contribute to age and AIDS-related dementias is far too speculative."

According to the Israeli researchers, some mental disorders have clear physiological characteristics. Schizophrenia, for instance, involves a loss of neurons in the hippocampal area of the brain and also a reduction in the size of the hippocampus.

"There is some speculation afoot that the immune system might be involved in keeping the neurons of the brain in shape to handle high-level stress," Siegel said. "It's metaphoric. If you want to keep your car running at high speed, you better make sure every part is working. There's a theory that the immune system is involved in keeping nerves from degenerating under periods of high stress."

The study authors, who published their findings in the May 3-7 issue of the Proceedings of the National Academy of Sciences, conducted a series of experiments involving mice that had been genetically engineered to have drastic immune deficiencies. The immune-deficient mice were found to have more cognitive problems compared to normal mice.

The researchers then injected the genetically engineered mice with T cells -- key components of the immune system -- to see if the cognitive deficiencies improved. They did -- as evidenced on certain learning tests, such as a water maze.

As the authors state, "The results. . . by suggesting that peripheral T cell deficit can lead to cognitive and behavioral impairment, highlight the importance of properly functioning adaptive immunity in the maintenance of mental activity and in coping with conditions leading to cognitive deficits. These findings point to critical factors likely to contribute to age- and AIDS-related dementias and might herald the development of a therapeutic vaccination for fighting off cognitive dysfunction and psychiatric conditions."

It's this last statement that has some outside experts, such as Knopman, worried. Mice, it has been demonstrated time and again, are not humans. So to extrapolate research findings based on rodents to humans can be tricky, if not impossible.

Nevertheless, Siegel added, the research does indicate "a direction for further research looking at neurodegenerative and psychiatric illness to see whether modulating the immune system helps to treat the condition."

More information

For more on Alzheimer's disease, an age-related dementia, visit the Alzheimer's Disease Education and Referral Center. For more on schizophrenia, check with the National Institute of Mental Health.

Sources: David Knopman, M.D., neurologist, Mayo Clinic, Rochester, Minn.; Marc Siegel, M.D., clinical associate professor of medicine, New York University School of Medicine, New York City; May 3-7, 2004, Proceedings of the National Academy of Sciences

Back to the Top

Hypertensive Blacks May Have Thick Hearts

 

By Renee C. Lee

Associated Press Writer

The Associated Press

Monday, May 3, 2004

DALLAS - Researchers say they may have found a new clue as to why blacks are at greater risk of dying from heart disease than whites. In the largest study of its kind, blacks with high blood pressure were found to have thicker hearts than whites with high blood .

"This is a marker for increased damage to the heart and may explain why there is a more adverse outcome of cardiovascular mortality, heart attacks, stroke and heart failure among blacks," said lead researcher Dr. Jorge Kizer, an assistant professor of medicine and public health at Weill Medical College of Cornell University in New York.

Blacks suffer from hypertension more than other racial groups. In 2000, heart disease deaths were 29 percent higher among blacks and stroke death rates were 40 percent higher than other groups, according to the Centers for Disease Control and Prevention (news - web sites).

In the study, researchers assessed 1,060 blacks and 580 whites by measuring their blood pressure, heart wall thickness and vascular tone. The findings revealed that blacks had a higher average of left ventricular mass index and wall thickness that persisted even after researchers adjusted for age, gender, and clinical risk factors such as blood pressure treatment and artery stiffness.

When researchers adjusted for additional factors such as socio-economic level, education, smoking and cholesterol, they found that ventricular hypertrophy was nearly double that of whites and the increase in heart-wall thickness among blacks was 2 1/2 times that of whites.

"It has been well-documented that blacks have higher cardiovascular mortality rates, but the basis of that is not clear," said Dr. Mark H. Drazner, an associate professor of medicine at the University of Texas Southwestern Medical Center. "This study could be a clue that explains the difference in mortality."

Drazner said the findings, published in Tuesday's issue of Hypertension: Journal of the American Heart Association (news - web sites), indicate that the effect of hypertension on blacks is likely the contributing to the mortality rate.

"The effects of hypertension need to be targeted if you're going to reduce cardiovascular mortality gap between the two ethnic groups," he said.

Kizer said that while more studies are needed to confirm the findings, the study could lead to the development of more drugs that can slow left ventricular hypertrophy.

Some studies already suggest that some high blood pressure medications, such as angiotensin receptor blockers or ARBs, help reduce heart thickening. A recent study, however, showed that the drugs worked better for whites than blacks.

Kizer said that could have been a statistical glitch, but it indicates that more work is needed to sort out strategies in how to treat hypertension in blacks.

Back to the Top

Delivering Heart Drugs From the Inside

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Monday, May 3, 2004

MONDAY, May 3 (HealthDayNews) -- German researchers are reporting the successful test of a biodegradable coating for stents, the flexible mesh tubes used to keep arteries open in heart patients.

Coated stents release drugs designed to prevent arteries from becoming clogged again, and they're widely used because they are clearly more effective than plain metal stents. The drugs are contained in polymers that stay on the stents permanently.

The advantage of the new biodegradable polymer tested by the German scientists is that it provides a potential way of delivering other drugs into the arteries, something existing permanent polymers can't do, the researchers said.

The still experimental stent, made by Guidant Corp., uses a biodegradable polymer that disappears once it has delivered the drug. The German scientists report in the May 4 issue of Circulation that the new stent is at least as effective as existing coated stents, said Dr. Peter M. Fitzgerald, an associate professor of medicine and engineering at Stanford University Medical Center. He was also leader of the group that analyzed the data from the study.

The point of the study was not to show that the new coating is more effective at keeping arteries open than existing polymers, Fitzgerald said. "The rates [of unclogged arteries] are so incredible [for any type of coated stent] in terms of efficacy that you would need tens of thousands of patients to know whether they can improve on them," he said.

The Guidant stent releases everolimus, which inhibits cell growth and reproduction. It is a chemical relative of serolimus, one of two drugs used in coated stents that gained U.S. Food and Drug Administration approval in the last year.

To Fitzgerald, the important thing is not the drug that is being released from the stent, but the nature of the biodegradable compound that carries it and then dissolves harmlessly after the drug is released.

There is the convenience of "timing the vehicle with its job, knowing that once you deliver the drug it goes away," Fitzgerald said.

More important, there is the concept of "delivering other drugs [that currently must be delivered in pill form] with a biodegradable polymer," he said. "Once you show that it works, you can think of expanding treatments that take advantage of a polymer that delivers a drug on the inside rather than the outside. You can treat a broader range of cardiovascular sites that we need to deal with."

The new study included 42 patients who had artery-opening procedures, such as balloon angioplasty, at the Heart Center in Siegberg, Germany.

Fifteen patients had plain metal stents implanted after the procedures. The other 27 got stents coated with the biodegradable polymer that released everolimus.

At the start of the trial, the coated-stent patients had artery narrowing averaging 64.1 percent; after six months, the narrowing was only 2.6 percent. In patients who got the plain metal stents, narrowing was reduced from 62.1 percent to 27.8 percent.

Guidant executives reported last November that the company planned to start two trials in 2004 -- an 800-patient study aimed at getting approval of the new stent in Europe, and a 975-patient study with a similar goal in the United States.

More information

To learn more about stents, visit the American Heart Association and the National Institutes of Health.

Sources: Peter M. Fitzgerald, M.D., Ph.D, associate professor, medicine and engineering, Stanford University Medical Center, Palo Alto, Calif; May 4, 2004, Circulation .

Back to the Top

Companies Rush to Sell Low-Carb Products

By Ira Dreyfuss

Associated Press Writer

The Associated Press

Monday, May 3, 2004

CHICAGO - Take a piece of pita bread, a little tuna, some olives and capers and presto it's a low-carb "sort of Mediterranean" pizza. The impact of the Atkins diet, the South Beach diet and other low-carbohydrate eating plans is everywhere at this year's food industry show of new products.

Food companies are trying hard to fit the current low-carb diet craze into their familiar product lines, and Margaret Dennis' easy-to-make pita pizza was just one contribution at the exposition organized by the Food Marketing Institute. Also on display were low-carb candies, cereals and salad dressings.

In her white chef's uniform, Dennis, a culinary consultant to Del Monte, was handing slices to passers-by. On the pita bread, she spread a corporate-brand pizza sauce, added flavored tuna that Del Monte sells in a pouch for the quick-lunch crowd, and threw on olives and capers.

And as long as the cook uses pita instead of standard pizza dough, the result will be a thin-crust product with 12 grams of carbohydrate per slice, roughly half the carbs of regular Mediterranean-style pizza, Dennis said.

Kellogg Co. has reformulated a version of its calorie-sparing Special K cereal to be low-carb as well. "Consumers are looking for a low-carb lifestyle," said Mike Greene, vice president of customer marketing. "It's about alternatives."

Kraft Foods Inc. also is exhibiting shelves of carb-oriented products, some already in stores and others waiting to be launched. Supermarkets now have four Kraft salad dressings without carbs.

In June, consumers could get a steak sauce with one gram of carbohydrate per serving to slather on their Atkins-approved meats. Also in June, Kraft will launch CarbWell cereals. And the company that put out SnackWell cookies in the days when consumers only watched fat calories will expand the line with SnackWell's CarbWell cookies.

Kraft is not putting all its high-protein, low-carb eggs in one basket. "For folks who are watching fat, there's the sugar-free SnackWell as well," said spokeswoman Pat Riso.

The food industry knows from experience it is subject to being swept by waves of diet fads.

Michael Sansolo, senior vice president of the Food Marketing Institute, said the current distaste for carbohydrates might be supplanted in a couple of years by avoidance of trans fats. Those substances have been linked with clogged arteries, and the federal government is beginning to require that amounts of trans fats be listed on labels.

The industry also knows that consumers want to go with what tastes good, regardless of the current craze.

At the Hershey Foods Corp. exhibit, there were dishes of bite-sized, individually wrapped Carb Alternative candies. Matt Podhajsky, an associate marketing manager for grocery products, said Hershey also had created a chocolate sauce with half the carbohydrates of its standard sauce.

This does not mean that the traditional fully carbed chocolate sauce will be driven off the shelves, Podhajsky said.

"There's a lot of people who are looking for it just purely for that decadent value," he said. "Especially people with ice cream."

On the Net:

Food Marketing Institute: http://www.fmi.org/

Back to the Top

Sunday, May 2, 2004

 

Study: Breast Feeding Cuts Infant Death 20 Percent

 

Reuters

Sunday, May 2004  

CHICAGO (Reuters) - Breast-fed children in the United States are 20 percent less likely to die during the first year of life than whose who are not nursed, according to a study released on Sunday.

Researchers at the National Institute of Environmental Health Sciences said they based their finding on a survey that included nearly 9,000 infant deaths in 48 states.

It found breast-fed babies were 20 percent less likely to die between 1 and 12 months of life than those who were not, and that the longer babies were breast-fed, the lower the risk of early death.

Aimin Chen, a physician who was one of the authors of the study, said in an interview that the protective effect appears to come from the "package of child care skills" that goes along with nursing as well as the benefits of the milk.

He said data from 2000 show that 70 percent of U.S. newborns are breast-fed when they leave the hospital and at 6 months almost one third are. But there are still racial and economic disparities in how widely the practice has been adopted.

Other studies have shown breast-fed babies are less likely to be overweight, have fewer behavioral problems and may show differences in intelligence. They also may grow up to have lower blood pressure.

Groups such as the American Academy of Pediatrics recommend that all mothers breast-feed their babies for the first year, and two years if possible.

The study was published in the May edition of Pediatrics, the journal of the American Academy of Pediatrics.

Back to the Top