The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
August 11, 2004

Important Medical Disclaimer: The content displayed in Personal Health is designed to educate and inform. Under no circumstances is it meant to replace the expert care and advice of a qualified physician. Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Personal Health assumes no responsibility for how information presented is used.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL HEALTH for the week of May 8-14

 

PERSONAL HEALTH

 

 

  1. Moderate Drinking May Raise Healthy Hormone Levels
  2. Researchers: Exercise Lowers Employers' Health Costs
  3. Inflammatory Bowel Disease Drugs Don't Harm Fetus
  4. HIV Drugs Raise Risk of Artery Plaques
  5. Sleep Breathing Disorder Linked to Stroke Problems
  6. Computers Miss Errors in Drug Prescribing – Study
  7. Predictors of Arthritis Remission Identified
  8. Cholesterol Drugs Promising in Multiple Sclerosis
  9. Woman Without Part of Skull for Months
  10. Breastfeeding Cuts Cardiovascular Risk –Study
  11. Smoking Big Killer of Black Men
  12. U.S. Worried by High Rates of Arthritis
  13. Health Tip: Big Bellies Can Cause Backache
  14. Researchers: Pollution Could Affect Unborn Children
  15. Health Tip: Chill Out
  16. Nonalcoholic Beer May Be Good for Heart: Study
  17. Low-Carb Diets Can Cause Bad Breath
  18. Eating Fish During Pregnancy May Up Fetal Growth
  19. Drunkenness No Barrier to Getting More Booze
  20. Angioplasty Linked to Higher Death Risk in Diabetics
  21. How Memories Are Made, Stored
  22. Blood Test Shows When Fetus Is in Womb
  23. Maternal Drinking, Childhood Asthma Not Linked
  24. Poor Growth in Kids Linked to Postnatal Depression
  25. Despite Advances, Lupus Still a Formidable Foe
  26. Chickenpox Milder in Vaccinated Kids
  27. Don't Worry When Kids Can't Size Things Up
  28. Calif. Immigrants Outlive Native Residents – Study
  29. Vitamins May Lower Osteoporosis Fractures
  30. Fish Consumption in Pregnancy Boosts Fetal Growth
  31. Study Compares Colon Cancer Surgeries
  32. Dads Deliver More Than Just DNA, Scientists Say
  33. Cranberry Juice Washes Away UTIs
  34. High Rate of Chlamydial Infection Seen in Young Adults in US
  35. Schools Struggle to Control Steroid Use
  36. Take Action Now on Childhood Obesity, Expert Says
  37. Health Tip: Arthritis and Teeth Brushing
  38. Report: Mass Smallpox Terror Vaccination Not Needed
  39. Health Tip: Good Eating Habits
  40. Fast-Food Breakfast May Inflame Blood Vessels
  41. Stress Level Tied to Education Level
  42. Echinacea Does Little to Prevent Colds: Report
  43. Beta Blockers Safe for Those With Peanut Allergies
  44. Stroke Survivors Have a High Risk of Dementia
  45. Neurotics More Prone to Depression
  46. Student Athletes at Risk for Addiction: Study
  47. Botox May Ease Enlarged Prostate Symptoms
  48. Blood Vessel Blockers Show Promise Against Cancer
  49. Amino Acid Linked to Bone Fractures
  50. Chest Pain Doesn't Worsen Heart Disease in Diabetics
  51. Age, Weight Predict Fatal Heartbeat After Surgery
  52. U.S. Uninsured Health Care Cost Put at $125 Billion
  53. Health Tip: Migraines in Children
  54. Chlamydia Cases on the Rise in Washington
  55. Study: American Pesticide Levels Are High
  56. Latina Moms May See Heavy Kids as Healthy Kids
  57. Chlamydia May Affect More Than Thought
  58. Outlook Good for Most Prostate Cancer Patients
  59. Ear Infections May Raise Kids' Asthma Risk
  60. Gum Disease Hits High-Income Blacks the Hardest
  61. Vaccine Cuts Rates of Pneumonia, Meningitis
  62. Parents Affect Risk of Heart Attack and Stroke
  63. Soap Can Protect Those With Peanut Allergies
  64. Echinacea Does Little to Prevent Colds: Report
  65. Reducing the Odds of Breast Cancer
  66. Study: Small Doses of Caffeine Best to Stay Awake
  67. Health Tip: Why Older People Bruise Easily
  68. PSA Test a Thing of the Past?
  69. Discoveries Show How Obesity Kills
  70. Gonorrhea Ups Risk of Prostate Cancer
  71. Childhood Ear Infections Predict Asthma
  72. Macular Degeneration Linked to Shorter Life Span
  73. Pregnancy Thyroid Testing Being Debated
  74. Botox Treats Bladder Problems
  75. Study Finds More Evidence Cigars Not a Safe Smoke
  76. Scientists Find New Way to Attack TB
  77. Most Cleaners Rid Surfaces of Peanut Allergen
  78. Experts: U.S. Not Only Obesity Contributor
  79. Heart Surgery in Kids Linked to Stress Disorder
  80. Food Makers Don't Fear Low-Carb Craze
  81. Older Hearts Not So Great for Transplants
  82. Anemic Seniors Face Other Health Problems
  83. Brain Stimulation May Help Spinal Injury Patients
  84. Health Tip: Medication for Children
  85. AIDS-Related Skin Cancer Down Sharply, Study Finds
  86. Health Tip: Household Mold

  87. Fish Still a Good Health Bet
  88. Spring's a Great Time to Launch an Exercise Program
  89. Obesity Becoming Major Global Problem

 

 

  Friday, May 14, 2004

 

Moderate Drinking May Raise Healthy Hormone Levels

 

By Merritt McKinney

Reuters Health

Friday, May 14, 2004

NEW YORK (Reuters Health) - Moderate drinking may boost levels of a hormone that is believed to help protect against artery disease. The findings could help explain some of the cardiovascular benefits of moderate drinking.

"People consuming alcohol in moderate amounts may have a healthier hormone status," Dr. Henk F.J. Hendriks at TNO Nutrition and Food Research in the Netherlands told Reuters Health.

"The implication of this piece of research is that it further substantiates the notion that moderate alcohol consumption is consistent with a healthy lifestyle," Hendriks said.

Many studies have shown that moderate drinking is associated with a reduced risk of cardiovascular disease. Moderate tippling may lower the risk of artery disease through its effects on inflammation, blood clotting and on the way the body metabolizes fats in the blood.

There is growing evidence that sex hormones also may be involved in the development artery disease. For example, some studies suggest that high levels of a hormone called DHEAS, or dehydroepiandrosterone, may help keep blood vessels healthy. Levels of DHEAS naturally decline with age.

Hendriks and his colleagues set out to measure the effect of moderate drinking on levels of DHEAS and other sex hormones.

The study included 10 middle-aged men and 9 postmenopausal women, all of whom were healthy nonsmokers and moderate drinkers.

For 3 weeks while on a standardized diet, volunteers consumed moderate amounts of beer or nonalcoholic beer with dinner each night. Participants completed another 3-week cycle during which they switched the type beer they drank.

After drinking regular beer for 3 weeks, blood levels of DHEAS were almost 17 percent higher than after drinking nonalcoholic beer, the researchers report. The increase in DHEAS was similar in men and women.

In contrast, levels of testosterone dropped about 7 percent in men after drinking beer. Women's testosterone levels stayed steady throughout the study.

Levels of a type of estrogen called estradiol remained steady in both men and women throughout the study.

But levels of HDL cholesterol, which is associated with better cardiovascular health, increased about 12 percent in both men and women.

The results of the study bolster the idea that moderate drinking may boost blood levels of DHEAS, the researchers conclude. The rise in this hormone may help explain some of the beneficial cardiovascular effects of moderate drinking, the authors note in the May issue of the journal Alcoholism: Clinical and Experimental Research.

Hendriks said that he and his colleagues now would like to study alcohol's effect on other hormones, such as hormones that regulate the uptake and distribution of sugar in the body.

The Dutch researcher noted that the combination of increasing body weight and greater longevity means that more and more people are developing diabetes. Hendriks said that one of the next steps would be to study the effects of moderate alcohol consumption on several hormones that are influenced by the development of diabetes.

"These studies should further substantiate the suggestions from epidemiological studies that moderate alcohol consumption may protect against diabetes type II," Hendriks said.

The current study was funded by the Dutch Foundation for Alcohol Research.

Source: Alcoholism: Clinical and Experimental Research, May 2004.

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Researchers: Exercise Lowers Employers' Health Costs

 

Reuters

Friday, May 14, 2004

WASHINGTON (Reuters) - Companies can save millions in health-care costs simply by encouraging their employees to exercise a little bit, researchers reported on Friday.

They said obese employees have higher health-care costs, but lowered those expenses by exercising just a couple of times a week -- without even losing any weight.

Feifei Wang and colleagues at the University of Michigan studied 23,500 workers at General Motors.

They estimated that getting the most sedentary obese workers to exercise would have saved about $790,000 a year, or about 1.5 percent of health-care costs for the whole group.

Company-wide, the potential savings could reach $7.1 million per year, they reported in the Journal of Occupational and Environmental Medicine.

Of the whole group of workers, about 30 percent were of normal weight, 45 percent were overweight, and 25 percent were obese. Annual health-care costs averaged $2,200 for normal weight, $2,400 for the overweight, and $2,700 for obese employees.

But among workers who did no exercise, health-care costs went up by at least $100 a year, and were $3,000 a year for obese employees who were sedentary.

But adding two or more days of light exercise -- at least 20 minutes of exercise or work hard enough to increase heart rate and breathing -- lowered costs by on average $500 per employee a year, the researchers found.

"This indicates that physical activity behavior could offset at least some of the adverse effects of excess body fat, and in consequence, help moderate the escalating health-care costs," Wang and colleagues wrote.

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Inflammatory Bowel Disease Drugs Don't Harm Fetus

Reuters Health

Friday, May 14, 2004

NEW YORK (Reuters Health) - Medications used to treat inflammatory bowel disease (IBD) in pregnant women do not appear to harm the fetus, according to a report in the American Journal of Gastroenterology.

A number of drugs are used to induce and maintain remission in patients with IBD, the authors explain, but there are few studies that have evaluated the effect of these medications on pregnancy outcome.

Dr. Daniel H. Present from Mount Sinai School of Medicine, New York and colleagues examined the possible effects of 5-aminosalicylic acid (5-ASA), metronidazole, ciprofloxacin, prednisone, 6-mercaptopurine, azathioprine, and cyclosporine on pregnancy outcome in 39 women with ulcerative colitis, 73 with Crohn's disease, and 1 with indeterminate colitis.

In 113 patients, the authors report, there were 16 spontaneous abortions, 6 premature deliveries, 2 ectopic pregnancies, 1 multiple birth, and 86 full-term deliveries. Three infants had major defects, including a heart defect and immature lungs.

"We observed a malformation rate of 2.9%, a number consistent with that seen in the general population," the investigators write. "Prior literature reports have shown the rate of spontaneous abortion to be similar in IBD patients."

They observed no association between any of the drugs or drug classes and unsuccessful pregnancy outcome. Additional analyzes that examined the use of the drugs alone or in combinations similarly showed no association between drug use and unsuccessful pregnancy outcome.

"The main concern in previous studies as well as ours has been the inability to make definite statements about safety due to small numbers of patients," the authors caution.

"Until further information is available we advise no pregnancy should be attempted unless the patient is in clinical remission on adequate medication."

Source: American Journal of Gastroenterology April 2004.

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HIV Drugs Raise Risk of Artery Plaques

Reuters Health

Friday, May 14, 2004

NEW YORK (Reuters Health) - Findings from an Italian study provide further evidence that HIV (news - web sites) drugs called protease inhibitors may increase the risk of artery "plaques."

Because these drugs have been shown to markedly improve the survival of HIV-infected patients, the authors do not recommend simply abandoning them. Rather, patients treated with the drugs should undergo periodic ultrasound tests to look for these plaques. If these tests show worsening of the plaque then a treatment regimen that doesn't include these drugs may be warranted.

Dr. Paolo Maggi from University of Bari and colleagues used ultrasound to evaluate the association between anti-HIV drugs and artery plaques in a total of 293 HIV-infected patients. Specifically, they looked for plaques in a blood vessel in the neck called the carotid artery. The findings are reported in the medical journal AIDS (news - web sites).

One hundred five patients were treated with regimens that included protease inhibitors. The remaining patients were either treated with regimens that didn't include protease inhibitors or with nothing at all.

On follow-up, 52 percent of patients treated with protease inhibitors displayed plaques on ultrasound. In contrast, the rate among other patients was only about 15 percent. Age, smoking, and immune status all seemed to influence the risk of plaques, but the strongest predictor was the use of protease inhibitors, the authors note.

These findings support previous research by the same investigators reported in 2000.

Protease inhibitor regimens appear to be "major" players in the development of artery plaques, the authors conclude. Additional studies, they say, are needed to clarify exactly how such drugs may cause plaques.

Source: AIDS, April 30, 2004.

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Sleep Breathing Disorder Linked to Stroke Problems

Reuters Health

Friday, May 14, 2004

NEW YORK (Reuters Health) - Sleep apnea, a condition involving brief periods in which breathing stops during sleep, is associated with worse outcomes after stroke and with an increased risk of death, UK researchers report.

Dr. Mark W. Elliott and colleagues report in the medical journal Thorax that airway blockage, a problem that occurs with sleep apnea, is associated with reduced blood pressure, oxygen levels, and blood flow to the brain. Their study, conducted in the Leeds Teaching Hospitals NHS trust, was designed to assess the impact on stroke outcomes.

Stroke patients with sleep apnea spent around 43 days in the hospital, whereas patients without breathing problems only spent 24 days. Most importantly, the rate of death among sleep apnea patients was 45 percent, much higher than the 25-percent rate seen in other patients.

Low oxygen levels at night were associated with increased disability among stroke patients, the authors note.

The results suggest that sleep apnea is a risk factor for serious problems after stroke, but larger studies are needed to confirm this finding, according to a related editorial.

Elliott's group believes that CPAP, a treatment in which airway blockage is prevented with a continuous puff of air, may improve the outcomes of stroke patients with sleep apnea.

Source: Thorax, May 2004.

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Computers Miss Errors in Drug Prescribing – Study

By Patricia Reaney

Reuters

Friday, May 14, 2004

LONDON (Reuters) - Computers have reduced medical errors by making prescriptions clearer and more legible but some do not warn doctors of potentially deadly problems, British researchers said on Friday.

About 95 percent or more of prescriptions from family doctors in Britain are issued on computers, so previous problems such as difficult to read handwriting or unclear doses are no longer an issue.

But computer programs do not issue alerts to doctors for contraindications or other conditions for which the medication should not be prescribed.

"The computer has the potential to help us even more in terms of trying to prevent us from making mistakes but at the moment that potential is not being realized," Professor Anthony Avery, of the University of Nottingham, said in an interview.

The wrong drug combinations, for example prescribing oral contraceptives for a patient with a history of deep vein thrombosis or blood clots, could be deadly.

"Patients are being admitted to hospital and dying, although not in large numbers, as a result of contraindication prescribing," he added.

Avery and his colleagues and researchers at the University of Edinburgh in Scotland tested four computer systems being used by about three-quarters of general practitioners. All of the systems failed to detect known prescribing errors, especially where drugs were contraindicated.

"The good news is that it (the problem) can be overcome without too much difficulty," Avery, who reported the results in the British Medical Journal, explained.

Computers have databases on drugs and conditions for which they should not be prescribed but there has not been a systematic way for the computer suppliers to make the links between the patient's prescription and contraindications.

"It is going to take some time but having identified this problem, there is a fairly straightforward solution," Avery said.

"It is something that could help prevent serious problems in the future."

Robin Ferner, director of the West Midland Center for Adverse Drug Reaction Reporting in Birmingham, England, said computers have already reduced prescribing errors by as much as 60 percent.

"Contraindications account for about four percent of adverse drug events in general practice. The systems could be improved. They might list every contraindication to a drug whenever it was prescribed," he said in a commentary in the journal.

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Predictors of Arthritis Remission Identified

Reuters Health

Friday, May 14, 2004

NEW YORK (Reuters Health) - In a new study, French researchers have identified markers of disease activity and scores on X-ray imaging that predict remission in patients with early rheumatoid arthritis.

The results indicate that factors that predict remission in patients in the early stages of rheumatoid arthritis are mainly disease activity score, clinical symptoms of disease activity and X-ray scores, the authors report.

Because of its variability, predicting the disease course of rheumatoid arthritis has proven difficult. Yet, the ability to predict the course of disease is critical for optimal patient treatment.

As reported in the Annals of the Rheumatic Diseases, Dr. B. Combe, from Center Hospitalier Universitaire Montpellier, and colleagues evaluated various factors in 191 patients with early rheumatoid arthritis to identify remission predictors. All of the patients had a disease duration of less than 1 year and were followed for 5 years. Remission was defined as a disease activity score of less than 1.6.

After 3 years, 48 patients were in remission, the investigators note. By 5 years, this number had dropped to 30 patients.

On initial analysis, several clinical, laboratory, and radiographic factors were found to be predictive of remission. On further analysis, the strongest independent predictors included an initial disease activity score of less than 4, morning stiffness duration of less than 60 minutes and a low total radiographic score.

Age and gender were not associated with remission.

Patients with an initial disease activity score of less than 4 were nearly five times more likely than other patients to be in remission after both 3 and 5 years of follow-up, the investigators note.

Source: Annals of the Rheumatic Diseases, June 2004.

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Thursday, May 13, 2004  

Cholesterol Drugs Promising in Multiple Sclerosis

 

By Ben Hirschler

European Pharmaceuticals Correspondent

Reuters

Thursday, May 13, 2004

LONDON (Reuters) - Cholesterol-lowering drugs, widely used to reduce the risk of heart attack, could also be effective in treating multiple sclerosis, according to new research published on Friday.

The news underscores the reputation of statins as potential miracle pills to rival aspirin.

Already hailed for revolutionizing the management of heart disease, the drugs -- which will soon be available over the counter in Britain -- are also being studied in the fight against Alzheimer's disease (news - web sites) and osteoporosis.

Researchers from the Medical University of South Carolina have produced the first clinical evidence that statins can help in multiple sclerosis in an article in The Lancet medical journal.

A group of 30 patients with MS given 80 mg a day of Merck & Co Inc's Zocor, or simvastatin, had a 44 percent reduction in brain lesions after three months of treatment, their study showed.

Brain lesions are areas of inflammation, and are markers of the progression and severity of MS -- a debilitating disease in which nerve cells lose their insulating sheath, leading to muscle weakness, fatigue, bladder problems and impaired vision.

Since existing MS treatments, such as interferons, are expensive injections and are only partially effective, swapping to statin pills -- which are already taken by millions of people every day -- would offer clear advantages.

But Professor Chris Polman, an MS expert at the VU Medical Center in Amsterdam, said more research was needed, including a large placebo-controlled clinical trial. The first of these trials is about to commence and could take around two years.

"It's a very good start but it's not conclusive," Polman said in a telephone interview, adding it was possible some brain lesions may have disappeared spontaneously given the relapsing-remitting nature of the disease.

The successful preliminary results recorded by Timothy Vollmer and colleagues in South Carolina follow earlier findings that statins can reverse paralysis caused by a similar condition to MS in mice.

Anti-Inflammatory

Statins were first developed for their ability to block an enzyme involved in the liver's production of cholesterol. But researchers have since found they also counter key inflammatory processes that may be central to several chronic degenerative diseases.

Mike O'Donovan, chief executive of Britain's MS Society, said the latest findings were encouraging.

"These are early days but we must hope statins can prove to be an effective weapon in the growing armory of treatments to attack this very distressing life-long disease," he said.

Still, much work remains to be done, including discovering the optimal dose for statins in MS, since initial indications suggest it may have to be higher than for people with raised levels of LDL or "bad" cholesterol.

In the meantime, Polman urged MS sufferers not to switch from existing medications, warning that premature use of statins could develop into a "dangerous boomerang."

That risk may be heightened in countries like Britain which this week became the first in the world to approve the sale of simvastatin without prescription, although only at a low 10 mg dose.

Other major manufacturers of statins include Pfizer Inc, whose Lipitor (news - web sites) drug is the world's largest-selling prescription medicine with sales last year of $9.23 billion, and AstraZeneca Plc, which recently launched Crestor.

The current market leaders in MS treatment are Serono SA, Biogen Idec and Schering AG -- all of which sell versions of beta interferon -- and Teva Pharmaceutical Industries Ltd, which makes Copaxone.

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Woman Without Part of Skull for Months

 

By Alexandria Sage

Associated Press Writer

The Associated Press

Thursday, May 13, 2004

MIDVALE, Utah - After a lot of red tape, Briana Lane has her skull back in one piece. The 22-year-old woman was injured in an auto accident in January, and doctors temporarily removed nearly half her skull to save her life.

But for nearly four months afterward, the piece of bone lay in a hospital freezer across town — and Lane had to wear a plastic street hockey helmet — because of a standoff with Medicaid and the hospital over who would cover the surgery to make her whole again.

The surgery finally came through after an excruciating wait, during which she suffered extreme pain just bending down and would wake up in the morning to find that her brain had shifted to one side during the night.

"When you think of weird things happening to people you don't think of that," Lane said. "It's like taking out someone's heart — you need that!"

Sonya Schwartz, a health policy analyst for Families USA, a consumer health care group, said insurance horror stories happen every day. But "this particular story is outlandish."

On Jan. 10, Lane's car rolled over on an icy canyon road above Salt Lake City. Lane, who was not wearing a seat belt, was thrown through the windshield. (She was later charged with driving under the influence and not having a driver's license.)

Doctors at the University of Utah Health Sciences Center in Salt Lake City removed the left side of her skull to treat bleeding on her brain. Lane's doctor originally scheduled the replacement surgery for mid-March, a month after her release from the hospital, said her mother, Margaret McKinney, a nurse who works in another division of the medical center.

But the operation was canceled the night before because the hospital was waiting to see whether Medicaid would cover it — a process that can take at least 90 days.

Lane, a waitress with no insurance, was sent home from the hospital with a big dent in her head where the bone had been removed but the scalp had been sewn back into place. She stayed at home, able to walk around but not go to work, and had to wear the helmet during the day.

During the wait for a decision from Medicaid, the hospital could have declared an emergency, moved ahead with the surgery, and figured out afterward who would pay — the hospital, Medicaid, or the patient. But the hospital did not do so.

Lane's mother said that she argued with the hospital: "We just want what you've taken away. Can you just give us back the skull and we'll go on with our lives?"

After months of delay, Lane contacted a local TV station, a move she believes hastened the surgery. "All of a sudden — top of the list!" she said. The operation took place April 30.

Exactly what broke the impasse is unclear.

The operation took place after Lane's mother's insurance decided to cover the surgery, as well as her nearly $200,000 in medical bills.

But hospital spokeswoman Anne Brillinger, while refusing to comment on certain specifics of Lane's case because of federal privacy rules, said the medical center decided to go forward with the surgery before it learned the insurance would pay.

Utah's Medicaid program has yet to decide whether Lane qualifies.

Robert Knudson, director of eligibility services at the Utah Health Department, which oversees Medicaid, said the agency has not yet seen enough evidence to decide whether her injuries entitle her to benefits under the law.

He would not comment on whether her four-month wait was unreasonable. But he said the decision over how fast Lane should have gotten treatment was up to the doctors, not Medicaid. "We only pay the bills," he said.

A neurosurgeon at Indianapolis' St. Vincent Hospital, Ronald Young, said such surgery would not be considered an emergency, but is typically performed within three to four weeks — the swelling has to go down first — because the risks to the patient are high.

"There's no reason not to replace that as soon as you can," Young said. "I don't like to have people who are walking not have their skull."

He added: "For a person who is walking, who is ambulatory, to not have their skull is a problem because you get a lot of brain shift. A simple fall, hitting her head or something could be horrendous."

Today, Lane's close-cropped hair barely covers the long curved scar on her scalp. The blackouts and dizziness are happening less often, and simple tasks are no longer excruciatingly painful.

But she said the experience has left her a little more cynical about the health care system.

"Just because they don't have money doesn't mean they should be treated differently from anyone else," she said. "I'm a good person. I just happen to be not as rich as some of them."

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Breastfeeding Cuts Cardiovascular Risk –Study

 

By Patricia Reaney

Reuters

Thursday, May 13, 2004

LONDON (Reuters) - Breastfeeding reduces the risk of a heart attack or stroke later in life and could prevent hundreds of thousands of deaths each year, researchers said on Friday.

Babies who are breastfed suffer fewer childhood infections and allergies and are less prone to obesity. British scientists have now shown that breastfeeding and slow growth in the first weeks and months of life has a protective effect against cardiovascular disease.

"Diets that promote more rapid growth put babies at risk many years later in terms of raising their blood pressure, raising their cholesterol and increasing their tendency to diabetes and obesity -- the four main risk factors for stroke and heart attack," said Professor Alan Lucas of the Institute of Child Health in London.

"Our evidence suggests that the reason why breast-fed babies do better is because they grow more slowly in the early weeks."

Lucas said the effects of breastfeeding on blood pressure and cholesterol later in life are greater than anything adults can do to control the risk factors for cardiovascular disease, other than taking drugs.

"My provisional estimate suggests that hundreds of thousands of deaths in the western world could be prevented by breastfeeding," he said in an interview.

"Obviously more could be prevented if the uptake in breastfeeding was even higher."

An estimated 17 million people die of cardiovascular disease, particularly heart attack and strokes, each year, according to the World Health Organization (news - web sites).

Lucas and his colleagues compared the health of 216 teenagers who as babies had either been breastfed or given different nutritional baby formulas. They reported their findings in The Lancet medical journal.

The teenagers who had been breastfed had a 14 percent lower ratio of bad to good cholesterol and lower concentrations of a protein that is a marker for cardiovascular disease risk.

The researchers also found that, regardless of the child's weight at birth, the faster the infants grew in the early weeks and months of life, the greater their later risk of heart disease and stroke.

The effect was the same for both boys and girls.

"The more human milk you have in the newborn period, the lower your cholesterol level is, the lower your blood pressure is 16 years later," Lucas said.

He suspects there is a hormonal trigger very early in life that influences infant growth and sets the system for cardiovascular risk later in life.

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Smoking Big Killer of Black Men

 

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- Overall cancer death rates for black American men could be cut by more than 60 percent if their exposure to smoking could be extinguished.

That's the claim of a study in the May issue of Preventive Medicine.

The University of California, Davis study helps explain the disparity in cancer death rates between black and white men in the United States.

"African-American men have had the highest cancer burden of any group in this country for decades. This study demonstrates, for the first time, that this excess cancer burden can be clearly linked to smoking. Smoke exposure appears responsible for African-American males' high overall cancer mortality rates, not just their lung cancers," study author Bruce Leistikow, an associate professor of epidemiology and preventive medicine, said in a prepared statement.

Using lung cancer death rates as a measure of smoke exposure, Leistikow analyzed the correlation between annual smoke exposure and non-lung cancer death rates for American black men from 1969 to 2000.

He found a close link between the smoke exposure rate and the non-lung cancer death rate. There was a 34 percent increase in the rate of non-lung cancer deaths among black men during the first 20 years of the study, which parallels a sharp rise in smoke exposure among black men.

As smoking declined during the final decade of the study, 1990 to 2000, the non-lung cancer death rate among black men decreased by 11 percent.

"During two decades of a steep rise, and subsequent decade of steep fall, U.S. black male smoke exposures and non-lung cancer death rates have moved in near-perfect lockstep up and down. The associations are very strong and have been consistent year-by-year for over 30 years," Leistikow said.

More information

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

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U.S. Worried by High Rates of Arthritis

 

By Paul Simao

Reuters

Thursday, May 13, 2004

ATLANTA (Reuters) - Approximately one-quarter of American adults have been diagnosed with arthritis and another 17 percent may be suffering from the crippling disease, the Centers for Disease Control and Prevention (news - web sites) said on Thursday.

Arthritis, a musculoskeletal disease that causes painful inflammation in the joints, is the leading cause of disability in the United States and a major financial drain on the nation's health care system.

The percentage of those diagnosed with a form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia ranged from a low of 17.8 percent in Hawaii to a high of 35.8 percent in Alabama in 2002, according to a CDC survey of 30 states.

The median rate was 27.6 percent.

"That is a huge number compared to most other diseases," said Dr. Chad Helmick, a CDC arthritis expert, who noted that the number of Americans with arthritis was expected to increase sharply as the baby boomer generation headed into retirement.

The CDC also found that about 20 percent of respondents in a number of states in the survey had chronic joint pain, aching or stiffness indicating possible arthritis that had not been diagnosed.

Besides causing untold human suffering, the disease is also exacting a heavy financial toll.

The estimated direct and indirect costs of arthritis and other related rheumatic diseases was $86.2 billion in 1997, equivalent to about 1 percent of the nation's gross domestic product, the CDC said in a separate study.

Americans spent $51.1 billion on medical treatment for arthritis and related diseases in 1997, while lost earnings due to hospitalization, illness and disability added up to $35.1 billion.

Health experts believe that a combination of proper diet, weight control, exercise and regular medical treatment are effective in controlling both the prevalence and severity of arthritis.

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Health Tip: Big Bellies Can Cause Backache

 

HealthDayNews

Thursday, May 13, 2004

(HealthDayNews) -- If you're suffering from backache, your potbelly may be to blame.

The weight of a bulging tummy increases the curvature of the back, which places greater strain on the vertebra and lower back muscles, according to the Rabin Medical Center in Israel. It's also difficult for the weakened, distended abdominal muscles to support the spine.

So, if there is no medical explanation for your aching back, try eating less and exercising more. Swimming, especially backstroke, is an excellent way to exercise and strengthen your abs.

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Researchers: Pollution Could Affect Unborn Children

 

Reuters

Thursday, May 13, 2004

WASHINGTON (Reuters) - Soot and other types of air pollution can not only affect animals and people, but their unborn children, too, researchers reported on Thursday.

They found that genetic mutations known to be caused by some pollutants can be passed through sperm to baby mice. Presumably, the same thing could happen to human beings, they report in Friday's issue of the journal Science.

Mice that breathed polluted air from a steel mill were much more likely to father offspring with clear genetic mutations than mice that breathed filtered air, the team at McMaster University in Toronto found.

"Our study identifies airborne particulate matter as a contributor to heritable mutation induction in mice; however, a direct link between ... mutations and health effects has not yet been established," they wrote.

"Nonetheless, structural changes in DNA have been detected in human sperm after air pollution exposure."

Air pollution has also been linked to heart disease, lung cancer and birth defects, they noted, citing many studies.

Christopher Somers and colleagues put caged mice downwind of steel mills in Hamilton, Ontario. Some got filtered air and some got what the wind brought.

"Mice exposed to HEPA-filtered air at the urban-industrial site had paternal mutation rates that were 52 percent lower," they wrote.

How the inhaled pollutants cause mutations is not yet clear, they said.

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Health Tip: Chill Out

 

HealthDayNews

Thursday, May 13, 2004

 

(HealthDayNews) -- While stress is an unavoidable part of life, learning how to manage the tension can help ward off stress-related health problems.

Here are some stress-busting tips from the Detroit Medical Center:

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Nonalcoholic Beer May Be Good for Heart: Study

 

By Merritt McKinney

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - Drinking nonalcoholic beer may provide some of the same cardiovascular benefits seen with moderate alcohol consumption in previous studies, research from Germany suggests.

In a new study, nonalcoholic beer had a powerful short-term effect on two processes believed to be involved in heart disease.

"Because of the negative implications of alcohol use and abuse, drinking de-alcoholized beverages may offer an alternative to alcoholic beverage consumption without losing beneficial effects," Dr. Steffen Bassus of Deutsche Klinik fuer Diagnostik in Wiesbaden told Reuters Health.

Many studies have shown that moderate drinking is associated with a reduced risk of cardiovascular disease. Some researchers have suggested that the beneficial effects of moderate drinking come not only from alcohol itself, but from other substances found in alcoholic beverages.

Red wine, for example, contains a compound called resveratrol, which is believed to be heart-healthy.

Since beer is the most popular alcoholic beverage in Germany, Bassus and his team set out to see whether some of beer's beneficial effects stem from substances other than alcohol.

The researchers examined the effects of three beverages: normal beer, nonalcoholic beer and alcohol mixed with water.

The participants, 12 healthy men 19 to 36 years old, consumed 3 liters of one of the beverages over the course of 3 hours. Blood samples were taken before, during and after the drinking sessions.

Eventually, the men consumed all three types of beverages on separate days.

The nonalcoholic beer inhibited the formation of thrombin, a key factor in blood clotting. In contrast, beer and the alcohol/water mixture both seemed to promote clotting.

The findings appear in the May issue of the journal Alcoholism: Clinical and Experimental Research.

Although reduced thrombin production can sometimes be harmful because it makes it difficult to stop bleeding, it can also have the effect of reducing the risk of blood clots, Bassus said.

One limitation of the study is that it only examined the short-term effect of nonalcoholic beer, the investigators point out. More research is needed to see whether the long-term use of nonalcoholic beer is beneficial, according to the report.

The study was funded by a grant from Bitburger, a German beermaker.

Source: Alcoholism: Clinical and Experimental Research, May 2004.

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Low-Carb Diets Can Cause Bad Breath

 

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- The Atkins diet might chase away more than just unwanted pounds -- it could lead to bad breath that chases away your friends.

But there are ways to battle halitosis caused by low-carb dieting, says the Academy of General Dentistry.

Low-carb diets work by getting the body to burn stored fat as fuel rather than carbohydrates. As that fat burns, chemicals known as ketones build up in the body. They are released through the breath and urine, and they can be smelly.

The types of food ingested also play a role, academy spokesman Dr. Bruce DeGinder said in a prepared statement.

"Most cases of bad breath originate from the breakdown of food particles that produce sulfur compounds, and from bacteria on the gums and tongue," DeGinder said. "High protein foods can produce more sulfur compounds, especially overnight on the surface of the tongue when saliva production is diminished."

To combat this bad breath, the academy suggests that dieters:

More information

 

Here's where you can learn more about halitosis.

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Eating Fish During Pregnancy May Up Fetal Growth

 

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - Women who regularly eat fish during the late stages of pregnancy appear to be less likely have a low-birth weight infant, according to new study findings published on Thursday.

A group of British investigators found that the infants of women who ate no fish while pregnant had a 37-percent higher chance of being very small for their stage of development, a condition known as intrauterine growth retardation (IUGR), than the infants of women who ate the most fish.

Study author Dr. Imogen Rogers warned that more research is needed before it can be recommended that all pregnant women boost their fish intake. "However, (the results) reinforce the current advice given to pregnant women in the UK, which is to eat two portions of fish a week, including one portion of oily fish," she noted.

Rogers added that some fish contains high levels of mercury, which can damage the fetus' developing nervous system if eaten in high quantities. She recommends that women who are pregnant or trying to become pregnant should avoid eating marlin and swordfish and limit their intake of tuna, all of which contain high levels of mercury.

"However, most fish contain relatively low levels of mercury, and the potential dangers of low-level mercury consumption need to be balanced against other potential benefits of eating fish," she said.

To investigate whether fish intake influences fetal growth, Rogers of the University of Bristol and her team asked more than 11,000 women at 32 weeks of pregnancy how much fish they ate, then noted their babies' birth weights.

On average, women ate almost 33 grams of fish each day, equivalent to one third of a small can of tuna.

Rogers told Reuters Health that the reasons why fish may help fetuses grow remain unclear. Fish contains omega-3 fatty acids, she said, which may boost blood flow to the placenta, bringing more nutrients to the fetus.

Rogers and her team report their findings in the Journal of Epidemiology and Community Health.

Source: Journal of Epidemiology and Community Health, June 2004.

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Drunkenness No Barrier to Getting More Booze

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- Most bars and liquor stores continue to sell alcohol to obviously intoxicated patrons regardless of laws that prohibit it, a new study says.

Although most states have laws that forbid bars and liquor stores from selling alcohol to people who are obviously drunk, these laws are often not enforced by the police and are ignored by bar and liquor store owners. Serving alcohol to intoxicated people leads to car accidents and violence associated with alcohol abuse.

"Despite laws prohibiting sales of alcohol to obviously intoxicated people, the vast majority of businesses licensed to sell alcohol would sell to someone that appeared to be intoxicated," said lead researcher Dr. Traci L. Toomey, an associate professor of epidemiology from the University of Minnesota.

In their study, Toomey and her colleagues had trained actors try to buy alcohol while appearing intoxicated. Over 10 months, actors visited 372 bars and liquor stores in 11 communities.

The research team found 79 percent of the establishments sold alcohol to these pretend drunks.

In addition, liquor store clerks who appeared younger than age 31 were significantly more likely than older servers at bars to sell alcohol to clearly intoxicated buyers, according to their report in the May issue of Alcoholism: Clinical and Experimental Research.

Toomey believes that in many cases servers do not know what the law is. "That should be a key part of server training programs," she said.

Sometimes even though servers are aware of the law, they may not know how to handle the customer. "They don't want to have a hostile drunk person to deal with," Toomey said.

In addition, other research by Toomey's team found that, in many cases, management policy insists on serving intoxicated patrons. Also, communities have not paid the same attention to this problem as they have to underage drinking, she noted.

These laws are difficult to enforce, Toomey said, adding there are few systemic enforcement campaigns.

Penalties for violating the law vary by state and include fines and eventual loss of a liquor license. In addition, under what is called dram shop liability, bars and liquor stores can be sued for damages by victims of drunk drivers or other alcohol-related crimes.

Toomey recommends aggressive training programs for servers and management that will clarify the law and give servers and managers the skills to help enforce the law.

"This is a risky type of alcohol service," Toomey said. "We need to figure out ways to pay more attention to it, and either work with establishments or find ways to put pressure on these establishments to make sure that they comply with the law."

James F. Mosher, the director of the Center for the Study of Law and Enforcement Policy at the Pacific Institute for Research and Evaluation, said the findings are "completely predictable."

"The laws prohibiting sales to intoxicated persons are not being enforced, and they are not being complied with by retailers," he added.

These are very important laws in terms of drinking and driving, Mosher said. "We know that as many as 50 percent of drunk drivers are leaving bars," he noted.

These laws need to be enforced and complied with, Mosher said. There needs to be strict enforcement and voluntary responsible beverage service programs, he added.

If these laws are enforced, Mosher said, there would be significant drops in drunk driving rates and in alcohol-related problems such as violence.

More information

Learn about responsible marketing and the service of alcohol from Mothers Against Drunk Driving. Meanwhile, the American Dietetic Association discusses drinking responsibly.

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Angioplasty Linked to Higher Death Risk in Diabetics

 

By Michelle Rizzo

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - Diabetic patients who undergo angioplasty, a minimally invasive method of opening blocked heart vessels, are more likely to die in the years following treatment than their peers without diabetes, new research shows.

"Diabetic patients are known to have reduced survival following...angioplasty compared with nondiabetic patients," Dr. David L. Brown and colleagues from Beth Israel Medical Center, New York, write. "However, it is unknown whether this survival disadvantage has persisted" into the current era in which new drugs and devices are available that make angioplasty more effective and safe.

In the medical journal Diabetes Care, the researchers compared survival between diabetic and nondiabetic patients who underwent angioplasty for heart disease. More than 4000 patients were included in the study.

During 3 years of follow-up, 13 percent of diabetic patients died compared with just 8 percent of nondiabetic patients. After accounting for other related factors, the authors calculate that diabetics were 46 percent more likely to die than were nondiabetics.

Diabetics may fare worse because they have more severe blood vessel plaques than nondiabetics, Brown said in an interview with Reuters Health.

"These findings suggest that angioplasty...may not be the best form of treatment for diabetics," he said. "Diabetics may require more intensive medical therapy or even bypass surgery to achieve the best long-term outcomes."

Source: Diabetes Care, May 2004.

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How Memories Are Made, Stored

 

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- Researchers have found that two different areas of the brain are probably responsible for storing and retrieving short-term memories.

According to an article in the current issue of Neuron, the hippocampus, a structure long believed to be important for short-term memory, apparently shares this function with another brain area known as the subiculum.

Using multiple electrodes smaller than the size of a human hair, the researchers from Wake Forest University recorded brain activity in rats performing a memory task.

The results showed both the hippocampus and subiculum encode information, but do it at different times.

"Surprisingly, we found that the shortest memories were controlled almost exclusively by the subiculum, which is exactly the opposite from what was previously believed," lead researcher Sam Deadwyler said in a prepared statement. "For the first 10 or 15 seconds of the task used to examine this in rats, we found that the memory function of the hippocampus actually shuts off."

The research also found that memory stored in the hippocampus is biased by past experience, allowing the brain structure to anticipate future events based on past outcomes.

This could explain why a person who takes the same highway exit to work each day might accidentally take it on a day he's headed somewhere else, Deadwyler said.

More information

BrainInfo has more about the hippocampus.

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Blood Test Shows When Fetus Is in Womb

 

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - Swiss researchers have developed a test that can tell when a fetus is developing in the womb, as it should be, or elsewhere, according to a new report. The test relies on three blood "markers" associated with pregnancy.

Dr. Michael D. Mueller and colleagues at the University of Bern, Switzerland used the test in women with normal pregnancies and in women with pregnancies developing outside of the womb, also known as ectopic pregnancies.

In the medical journal Fertility and Sterility, the researchers found that the test could accurately differentiate the two groups of women. The test worked best when the pregnancy was at least in the 7th week.

Further studies are needed to confirm these findings and to investigate the test in other groups of women, the authors note.

Source: Fertility and Sterility, April 2004.

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Maternal Drinking, Childhood Asthma Not Linked

 

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- There is no link between alcohol consumption during pregnancy and childhood asthma, claims a study in the May issue of Alcoholism: Clinical and Experimental Research.

Researchers at the Shanghai Institute of Planned Parenthood (news - web sites) Research gathered data on 10,440 infants born between 1984 and 1987 in Denmark.

They found children whose mothers drank alcohol during pregnancy did not have a greater risk of hospitalization for asthma compared with children of mothers who did not drink.

Dr. Wei Yuan cautioned that the findings should not be interpreted to say that alcohol is safe to drink during pregnancy.

"Maternal alcohol intake has many public and health concerns other than asthma," Yuan said. "In addition, the timing of alcohol exposure and its subsequent effects on fetal growth remain an essential topic of research."

More information

The National Institute for Alcohol Abuse and Alcoholism has more about the fetal alcohol syndrome.

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Poor Growth in Kids Linked to Postnatal Depression

 

By Michelle Rizzo

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - Mothers of children who are not gaining weight appropriately are nearly twice as likely to have postnatal depression as mothers of children who are gaining weight as expected, according to a new study.

Dr. Louise Margaret O'Brien, of the University of Louisville School of Medicine, in Kentucky, and colleagues identified children from community child health surveillance records who were younger than 2 years and were below normal growth levels.

Mothers of 196 children underwent tests for depression and anxiety. Records of the weights of 567 normal-weight children were obtained, and the mothers of these children also completed the same questionnaires.

Clinical interviews showed that 21% and 11% of mothers of low-weight and normal weight children, respectively, fulfilled criteria for a depressive episode, according to the report in the journal Pediatrics.

"The increased risk of postnatal depression was observed even after we had taken into account other factors that could influence the results, such as birth weight, gender, maternal and child ages, number of other children in the family, and socioeconomic status," O'Brien said in an interview with Reuters Health.

The investigators note that management of maternal depression or of faltering weight in infants is usually done by focusing on either the mother (for depression) or the child (for poor weight gain).

"We suggest that future management should be considered within the context of the mother-baby pair such that the mother of a baby with poor weight gain should be screened for postnatal depression, and conversely, the baby of a depressed mother should have his/her weight gain checked," O'Brien said.

"The treatment of a depressed mother does not always include an assessment of her interactions with her baby, yet this is vital to their well-being since maternal depression is already known to have a negative impact on infant emotional and cognitive development," O'Brien added.

Source: Pediatrics, May 2004.

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Despite Advances, Lupus Still a Formidable Foe

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- Deaths from lupus surged 44 percent in the United States from 1998 to 2001, and hospitalizations soared 128 percent.

This followed a 60 percent to 70 percent jump in deaths from 1979 to 1989 due to the autoimmune disease that has no cure, according to the U.S. Centers for Disease Control and Prevention (news - web sites).

And while scientists continue to make incremental strides against lupus, it remains one of the most difficult diseases to diagnose and one for which there have been no new treatment advances in more than 30 years.

Despite this grim portrait, a conference held Wednesday at the 2004 International Congress on Lupus in New York City aimed to shed some hope on efforts to treat and manage the illness.

Lupus is an autoimmune disease that primarily affects women between the ages of 15 and 44. It causes the immune system to attack the body's own tissue and organs, including the joints, kidneys, heart, lungs, brain, blood or skin. The disease may eventually cause tissue damage, organ failures, disability and even death.

An estimated 1.5 million Americans have a form of the disease. Black women are three times more likely to get the disease as white women; Hispanic and Asian women are also at higher risk.

One of the primary challenges of lupus diagnosis and treatment has been the lack of any "biomarkers" -- or physical indicators -- to gauge who has the disease and how it is progressing.

"There is an urgent need for biomarkers," said Dr. Joseph Ahearn, senior author of one of the studies presented at the conference and co-director of the University of Pittsburgh's Lupus Center of Excellence. "We need improved methods of diagnosing lupus so we can make sure that when we are evaluating and treating patients we know this is lupus and not some other disease."

Symptoms of lupus can mimic other illnesses, and range from mild to life-threatening. They include achy joints; frequent fevers of more than 100 degrees F.; arthritis; prolonged or extreme fatigue; and skin rashes. The disease can also enter periods where symptoms aren't present, only to flare up unexpectedly, according to the Lupus Foundation of America.

Doctors also need blood tests so they can monitor the activity of the disease, Ahearn added. "It would be nice to be able to monitor disease activity more accurately and perhaps even predict upcoming flares, which would allow us to institute therapy earlier, prevent hospitalizations and reduce the time of the flare," he said.

The right biomarkers might also provide incentives to pharmaceutical companies to develop drugs to treat lupus. As it stands now, drug manufacturers have no way of knowing whether a particular drug is working, so they have been reluctant to participate in clinical trials, Ahearn said.

Ahearn and his Pittsburgh colleagues have determined that measuring fragments of two different proteins might provide the right clues as to what the disease is doing to the body. After looking at hundreds of patients, they discovered that the fragments attach to red blood cells. "Not only are the fragments abnormally elevated on red blood cells but the levels fluctuate as the level of activity of the disease fluctuates," Ahearn said.

The Pittsburgh researchers also found the fragments on platelets, meaning they may be implicated in blood clotting. "We think this is an extremely promising route to pursue," said Ahearn, who indicated that the team is working with the U.S. Food and Drug Administration (news - web sites) to bring this research to fruition.

Another study presented Wednesday found the incidence of stroke and heart attacks were elevated in women with lupus. Ethnicity, however, did not emerge as a separate risk factor, said study co-author Dr. Sergio M.A. Toloza, of the University of Alabama at Birmingham.

A third study found that damage from lupus, rather than damage from the steroids that are used to treat the disease, was likely responsible for low bone mineral density in women with the disease.

"One of the problems has been to separate how much of the low bone mineral density is related to corticosteroids or to the disease itself," said study co-author Dr. Chin Lee, of Northwestern University. "We were able to show that the trend for lower bone mineral density seems to be associated with disease damage independent of steroid exposure." There may be ways to start compensating for this damage as soon as a diagnosis is made, the researchers said.

Finally, one study examined part of lupus' social toll. Edward Yelin, of the University of California, San Francisco looked at almost 900 people with lupus and found that while about 71 percent were working at the time of their diagnosis, only 46 percent were still in the labor force 12 years later -- a 48 percent drop. Among those who continued working, there were declines in the number of hours worked per week and the number of weeks worked per year.

"Work disability in lupus occurs much earlier in life and at much higher rates [than for other diseases]," Yelin said. "If you get a disease like lupus, then you leave work early in life and you also lose your long-term financial stability."

Also, because of the severity of the disease (seizures were one of the main reasons cited for inability to work), there were few opportunities to make accommodations in the work environment sufficient to let people keep their jobs, Yelin said.

"At this point, we do not have interventions in the disease process to change that process," Yelin said. "The work prognosis, in short, is quite poor in relation to other diseases, including forms of cancer and rheumatoid arthritis."

More information

To learn more about lupus, visit the Lupus Foundation of America or the National Women's Health Information Center.

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Chickenpox Milder in Vaccinated Kids

 

By Karla Gale

Reuters Health

Thursday, May 13, 2004

NEW YORK (Reuters Health) - In a chickenpox outbreak in Michigan last year, children vaccinated against the virus had a more limited rash and less severe disease than their unvaccinated peers. Interestingly, this milder form of chickenpox may have indirectly made the outbreak worse.

The chickenpox vaccine, also called the varicella vaccine, helps reduce the risk of contracting chickenpox. However, it is not perfect and a small percentage of vaccinated individuals still get the disease.

"Disease was so mild in the vaccinated kids that the parents thought they were well enough to go to school," senior author Dr. Darline K. El Reda, from the Michigan Department of Community Health, told Reuters Health. The fact that vaccinees missed less school may have contributed to the extent of the outbreak.

The outbreak affected 73 of 580 students attending one elementary school. According to parent surveys, 442 pupils had been vaccinated at appropriate ages, while 13 had no history of vaccination or previous chickenpox. The findings are published in the Morbidity and Mortality Weekly Report.

Nearly 12 percent of vaccinated children contracted chickenpox compared with 76 percent of unvaccinated children. Vaccinated children had a more limited rash and were less likely to develop a fever.

"A lot of parents told us it looked like mosquito bites, and that they would never have thought it was chickenpox if it were not for the notification from the school or the health department," El Reda said.

Vaccinated children typically missed 1 day of school, whereas unvaccinated children missed 3 to 4 days. Even though the rash is less severe in vaccinated children with chickenpox, El Reda advised that they be kept home until it completely disappears.

Source: Morbidity and Mortality Weekly Report, May 14, 2004.

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Don't Worry When Kids Can't Size Things Up

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Thursday, May 13, 2004

THURSDAY, May 13 (HealthDayNews) -- You may fret when your child tries to slide down a miniature slide, climb inside a tiny toy car, or squeeze her feet into doll shoes.

Relax and enjoy the visual humor, suggest researchers who report in the May 14 issue of Science that such errors of perception are a normal part of development.

"We're quite confident that on some level the kids know that it's too small," said study co-author David H. Uttal, an associate professor of psychology and education at Northwestern University.

He and his fellow researchers, from the University of Virginia and University of Illinois, have dubbed such errors "scale errors," and they think they are the result of immaturity and a lack of communication between two brain systems.

The trio of researchers decided to conduct a formal study after each had observed his or her own child -- or those they had seen in research settings -- try to interact or play with an object that was clearly too small to be used in the way the children attempted to use it.

For the study, the researchers first observed 54 children, aged 18 months to 30 months, in a playroom. They were interacting with a large indoor slide they could walk up and slide down, a child-sized chair they could sit in, and a car they could get inside and propel with their feet.

Then the children were taken for a walk and brought back to the playroom. They found miniature replicas of the slide, chair and car. The researchers drew the children's attention to the objects if they weren't already playing with them.

The researchers witnessed 40 "scale errors" -- incidents in which the children tried to interact or play with the miniature objects -- by 25 of the 54 children. The errors were most common among children 2 years of age and declined in the older kids.

The mistakes are similar, Uttal said, to what researchers call "slips of action" in adults. For instance, an adult sitting by a warm fire that's starting to flicker out may get up from the sofa intending to stoke the fire but mistakenly flip the television remote.

"We don't know if slips of action in adults and scale errors in kids are the same thing," Uttal said.

What the researchers think is happening among the children is, first, a failure of "inhibitory control." In other words, the brain doesn't say, "Stop, you're too big for the miniature slide." This reflects immaturity of the prefrontal cortex area of the brain, Uttal said.

There may also be a lack of communication between two brain systems, Uttal said.

"The visual recognition of an object, and the motor control of your brain telling your body how to move, are [controlled by] different parts of the brain," he said. "The part of the brain that actually controls the act of putting your body in the chair is not the same part of the brain that identifies the chair as something to sit in. Occasionally, the two don't talk to each other."

And that's when the errors occur.

Another expert praises the new research, saying it should help reassure parents of young children. "I think it's an extremely interesting and important study," said Susan Carey, a professor of psychology at Harvard University.

"If parents notice their kids doing this, I can't imagine them being worried about it," she said. "I think parents would just think it's hilarious and that's exactly the right reaction."

The researchers' explanation about the inhibitory system, Carey said, is probably correct. But, she added, more evidence is needed to prove the speculation that the two brain systems aren't "talking" to each other.

Uttal's team plans to continue the research. They invite parents to send examples of their children's scale errors to Uttal at scale@psych.northwestern.edu.

More information

To learn more about children's scale errors, visit the University of Virginia. Click on "Current Projects" to view video clips. To learn more about parenting, visit the American Academy of Pediatrics.

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Wednesday, May 12, 2004

 

Calif. Immigrants Outlive Native Residents – Study

 

Reuters

Wednesday, May 12, 2004

SAN FRANCISCO (Reuters) - California immigrants live an average of four years longer than U.S.-born residents of the state but researchers concede they do not know why, according to a study released on Wednesday by the Public Policy Institute of California.

Immigrants on average have a life expectancy of 81 years versus 77 years for U.S.-born residents of the nation's most populous state.

The study -- The Demographics of Mortality in California -- was based on data from the 2000 U.S. Census and the state's Department of Public Health (news - web sites).

"There is no certain answer for why immigrants live longer but there are some suggestions that are persuasive," said researcher Hans Johnson, lead author of the study.

Johnson cited a "selection effect" for California immigrants, healthier diets and lower rates of smoking, and social and cultural support groups in place for new arrivals.

"Immigrating hundreds or thousands of miles can be difficult and stressful and it is likely that people who select to immigrate tend to be healthier," Johnson said.

Immigrants following healthier diets and avoiding risky behaviors like smoking also may contribute to longer life expectancies, he said.

"The findings are counterintuitive because groups with higher incomes and greater access to health care and medical information generally have better health outcomes," said Johnson.

The study found that one exception for the foreign-born mortality advantage is among Asians: U.S.-born Asians have life expectancies of 83 years, more than two years longer than immigrant Asians.

Generally, Asians have longer life expectancies than any other racial or ethnic group in California.

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Vitamins May Lower Osteoporosis Fractures

 

By Linda A. Johnson

Associated Press Writer

The Associated Press

Wednesday, May 12, 2004

Folate and other B vitamins seem even more of a wonder drug than anyone suspected: Already known to prevent severe birth defects and heart attacks, they may also ward off broken bones from osteoporosis, two major studies suggest.

The findings underscore doctors' longstanding recommendation that people take multivitamins. They could also further support the government's decision to require bread and cereal makers to fortify their products with folate, also known as folic acid.

B vitamins are known to reduce levels of homocysteine, an amino acid already linked, at high levels, to an increased risk of heart attacks, strokes and Alzheimer's disease (news - web sites). Now research shows high levels of homocysteine at least double the risk of osteoporosis-related fractures.

A report from Holland found that the risk of such fractures was twice as high in men and women with homocysteine levels in the top 25 percent, compared with those with lower levels. Similarly, a U.S. study found the risk nearly quadrupled in the top 25 percent of men and nearly doubled in the top 25 percent of women, compared with the 25 percent with the lowest levels.

"The basic way to keep your homocysteine down in a healthy range is to have plenty of B vitamins," said Dr. Douglas P. Kiel, senior author of the U.S. study and director of medical research at Hebrew Rehabilitation Center for Aged Research and Training Institute in Boston.

The studies were reported in Thursday's New England Journal of Medicine (news - web sites).

Kiel said a standard multivitamin, taken once a day, would bring a person's homocysteine levels below the danger point. Foods naturally rich in B vitamins and calcium — including dairy products, broccoli and other green, leafy vegetables, carrots, avocados, cantaloupes, apricots, almonds and peanuts — can also reduce the risk of broken bones.

Since 1998, when the U.S. government began requiring that folate be added to bread, cereal and other flour products, the resulting drop in Americans' homocysteine levels has been credited with preventing about 48,000 deaths from heart attacks and strokes each year. Also, severe brain and spinal birth defects have dropped 27 percent — the strategy's original purpose.

Researchers say it is unclear why the same benefit with fractures has not yet been documented. There is also uncertainty as to how homocysteine levels affect bone strength. The prevailing theory is that it interferes with crucial chemical bonds within the bones.

Experts say it is too soon to recommend routine testing of homocysteine levels, which can cost from $100 to $200. That is partly because the new studies do not actually prove that high homocysteine levels — rather than some other factors — cause weaker bones.

Kiel's research examined 825 men and 1,174 women, aged 59 to 91, who were part of the Framingham Heart Study, which since 1948 has been studying heart disease risk factors in residents of the Boston suburb. Homocysteine levels in blood samples taken from the patients between 1979 and 1982 were later measured, and the patients were followed for 12 to 15 years to see how many had hip fractures.

Hip fractures are the leading cause of elderly people being forced into nursing homes; they lead to death within a year for about 20 percent of patients, because of infections and other complications, said Dr. Felicia Cosman, clinical director of the National Osteoporosis Foundation.

Among the study participants with the highest homocysteine levels, men were about four times more likely to fracture a hip and women about twice as likely, compared with the 25 percent with the lowest levels.

"This should be another wake-up call to eat better, when you're older, especially," Kiel said.

Kiel said the highest homocysteine levels would result in about 9 extra hip fractures per 100 men and 9.5 extra fractures per 100 women over 14 years, the average time the patients were studied.

The report from Erasmus Medical Center in Holland analyzed data from two studies, one in Rotterdam and one in Amsterdam, involving a total of 2,406 people age 55 or older. Those with the highest levels were 1.9 times more likely than the others to suffer osteoporosis-related fractures.

Research reports since at least 1985 have hinted at a relationship between homocysteine and osteoporosis, said Dr. Todd Stitik, associate professor of physical medicine and rehabilitation at University of Medicine and Dentistry of New Jersey-Newark.

"This is providing more pieces to that puzzle," he said.

Stitik said that starting a healthier lifestyle even before middle age can head off problems.

Besides taking a multivitamin with folate, vitamin B12 and vitamin B6, he recommends plenty of walking or other weight-bearing exercise and eating foods rich in B vitamins.

On the Net: http://www.nejm.org

National Osteoporosis Foundation: http://www.nof.org

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Fish Consumption in Pregnancy Boosts Fetal Growth

 

Reuters

Wednesday, May 12, 2004

LONDON (Reuters) - Eating lots of fish in the later stage of pregnancy can increase fetus growth but does not prolong the pregnancy, British scientists said on Thursday.

In a study of more than 11,580 women they found that the more fish the women ate at 32 weeks into their pregnancy, the lower the rate of restricted growth in the baby.

"These results lend some support to the hypothesis that raising fish or omega-three fatty acids intake during pregnancy may increase fetal growth rate," Dr Imogen Rogers, of the University of Bristol in southwestern England, said in a report published in the Journal of Epidemiology and Community Health.

Fish are a rich source of omega-three fatty acids which are essential for cell function. They are also found in canola oil, flaxseed and flaxseed oil and nuts.

The women were questioned about how much fish they ate. Levels of omega-three fatty acids were calculated by the amount of fish the expectant mothers had consumed.

On average the women ate almost 33 grams of fish, or the equivalent of about a third of a small can of tuna a day, which equated to 0.15 grams of omega-three fatty acids.

Higher levels of fish seemed to boost the birth weight of the baby. Restricted growth of the fetus occurs in about one in 10 pregnancies but in women who ate no fish toward the end of their pregnancy it increased to one in eight.

Although fish consumption had no impact on the duration of pregnancy in women in the study, Rogers said trials of fish oil supplements, which have levels higher than in the normal diet, seemed to lengthen pregnancy but had no impact on the growth of the fetus.

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Study Compares Colon Cancer Surgeries

 

By Linda A. Johnson

Associated Press Writer

The Associated Press

Wednesday, May 12, 2004

A decade-long study comparing conventional colon cancer surgery with "keyhole" surgery found identical success rates, disproving fears that tumors would be more likely to return if surgeons did not open up the patient's belly for a full view.

In conventional surgery, doctors remove a cancerous colon segment through an eight-inch cut down the abdomen. In keyhole, or laparoscopic, surgery, they operate with a laparoscope, or tiny video camera, and miniaturized surgical instruments that are inserted through half-inch incisions. The diseased section of colon is removed through a two-inch cut.

The biggest comparison of the two procedures to date, involving 48 U.S. and Canadian hospitals, found the same rates of survival, tumor recurrence and surgical complications. In addition, patients who had laparoscopic surgery had less pain and less time in the hospital.

Experts predicted the results will end the virtual moratorium on such surgery that began in 1994 because of spotty evidence that tumors returned in up to 21 percent of patients getting laparoscopic procedures — much more frequently than with open surgery.

The study was funded by the National Cancer Institute (news - web sites) and published in Thursday's New England Journal of Medicine (news - web sites).

"Now we can say it's safe, it's effective and it's beneficial for patients with colon cancer," said lead researcher Dr. Heidi Nelson, chairwoman of colon and rectal surgery at the Mayo Clinic in Rochester, Minn. "Patients recovered faster with fewer days in the hospital and fewer days on painkillers."

She said the laparoscopic procedure and the much smaller scars it leaves are less intimidating to many patients.

About 100,000 colon cancer operations are performed in this country each year.

Nelson and other experts predict the laparoscopic surgery now will be performed more frequently.

However, surgeons trained more than a decade ago first must learn the more-difficult laparoscopic technique, which requires lots of practice.

"I don't see an immediate boom," said Dr. Philip B. Paty, a colorectal surgeon at Memorial Sloan-Kettering Cancer Center in New York.

In addition, the technique is appropriate only when the tumor is easily reached with laparoscopic instruments and has not spread widely to nearby organs and lymph nodes.

Still, Paty hailed the study, because it included 66 surgeons across North America, showing good results can be achieved in many hospitals.

In an accompanying editorial, Drs. Theodore Pappas and Danny Jacobs of Duke University said cancer surgeons now are deciding whether to endorse laparoscopic procedures for cancer of the liver, pancreas, stomach and esophagus.

The study involved 872 patients. Half were randomly chosen for the laparoscopic procedure, while the rest got open surgery, with strikingly similar results.

Complications, such as wound infections and bleeding, occurred in 21 percent getting laparoscopy and 20 percent getting open surgery, while 86 percent of patients getting the laparoscopic procedure and 85 percent getting open surgery were alive three years later. Cancer returned in 16 percent of patients getting laparoscopy, versus 18 percent getting open surgery.

Also, patients getting laparoscopic surgery needed intravenous narcotics and pain pills about two days less and went home a day earlier.

The patients all had potentially curable cancer. Forty-eight of the laparoscopic patients and 61 of the open surgery patients died of cancer within 4 1/2 years.

Paty said the study's only weakness was that 21 percent of patients slated for the laparoscopic surgery had to be switched to open surgery during the procedure because of problems such as the cancer having spread more than doctors thought.

Surgeons first tried laparoscopic surgery on colon cancer in 1990, after it became popular for removing the appendix and gallbladder. Most stopped voluntarily a few years later, at the urging of major medical organizations, because of some poor results.

In both types of colon cancer surgery, the diseased section and some adjacent lymph nodes are cut out, and the two ends are sewn together.

If a laboratory examination of the lymph nodes finds cancer, the patient is usually given chemotherapy.

On the Net: http://www.nejm.org

American Society of Colon and Rectal Surgeons: http://www.fascrs.org

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Dads Deliver More Than Just DNA, Scientists Say

 

By Patricia Reaney

Reuters

Wednesday, May 12, 2004

LONDON (Reuters) - Men can breathe a sigh of relief.

Despite the specter of cloning and the birth of a fatherless mouse, scientists have uncovered evidence that men play a more vital role in procreation than they may have thought.

Male sperm not only fertilizes the female egg, it also delivers male chromosomes and messenger RNA, molecules that carry codes which may help the embryo develop and grow.

"Men have a greater role in early development than we previously thought," said Stephen Krawetz, of Wayne State University in Detroit, Michigan.

Krawetz and colleagues in the United States and Britain have identified six messenger RNAs found in sperm and fertilized eggs but not in unfertilized eggs.

The finding, reported in the science journal Nature on Wednesday, suggests that messenger molecules are delivered when the sperm fertilize the egg. It may also improve understanding of infertility and cloning.

"We have been able to show that in humans, along with delivering the DNA component, there is an RNA component which is also delivered. This is the first time that has been shown," Krawetz said in an interview.

"Dad is delivering more than just his DNA."

Krawetz suspects the paternal RNA plays an important role in the early development of the embryo and believes the research could help to explain why cloning is so difficult.

"We think the RNA that is being delivered could possibly act as a developmental or mechanistic switch that sets off the correct developmental program early on," he said.

In cloning, the egg develops without sperm fertilization and although it can be manipulated or 'tricked' in the laboratory some of the time, if the RNA isn't being delivered by the sperm it could explain the very small success rate in cloning.

Last month scientists in Japan and Korea reported creating the first mammal without using sperm. The mouse is the daughter of two female mice. Although bees, ants and some fish and reptiles reproduce without having sex in a process known as parthenogenesis, it was thought to be impossible in mammals.

Mammals inherit one set of chromosomes from their mothers and another from their fathers. Embryos containing only female chromosomes usually die early in the womb and those with only male genetic material are abnormal.

The fatherless mouse sparked headlines and suggestions that males could soon be obsolete.

"In contrast, we show that men are not obsolete," said Krawetz.

"Men do have a function," he added.

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Cranberry Juice Washes Away UTIs

 

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- Cranberry juice may taste tangy, but it holds sweet relief for women who regularly suffer from urinary tract infections (UTIs).

Drinking cranberry juice can help prevent UTIs in some women, according to an article in the May 15 issue of Clinical Infectious Diseases.

Sexually active adult women with recurring UTIs are the most likely to reap benefits from regular doses of cranberry juice. Researchers have noted up to a 50 percent drop in infection rates among that group.

Doctors know that cranberries contain two compounds that keep infection-causing bacteria from adhering to the lining of the urinary tract, and have been studying the positive benefits since 1966.

However, the studies have not tended to be uniform, making it hard to compare them.

"In general, we need more clinical studies with different population groups, different dosages, and comparison between juice and capsules," author Dr. Raul Raz of Haemek Medical Center in Afula, Israel, said in a prepared statement.

More information

Here's where you can learn more about urinary tract infections.

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High Rate of Chlamydial Infection Seen in Young Adults in US

 

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - About 4 percent of young adults in the US have Chlamydia trachomatis, a sexually transmitted infection, according to a report published in the Journal of the American Medical Association (news - web sites). The highest and lowest prevalence of chlamydial infection is found in black women and Asian men, respectively.

Dr. William C. Miller, from the University of North Carolina at Chapel Hill, and colleagues used urine testing to determine the prevalence of chlamydial infection and gonorrhea in a nationally representative sample of 12,548 subjects between 18 and 26 years.

Overall, 4.19 percent of subjects had a chlamydial infection, 0.43 percent had a gonococcal infection, and 0.030 percent had both, the investigators report.

Consistent with previous reports, women (4.7 percent) were more likely to have chlamydial infection than were men (3.7 percent), the authors found.

Black women had the highest prevalence of infection, at 13.95 percent--and Asian men had the lowest rate, at 1.14 percent.

In terms of geographic regions, the highest rate--5.39 percent--was in the South, while the lowest was in the Northeast--2.39 percent.

The prevalence of gonorrhea was varied strongly by race. For blacks, the rate was 2.13 percent, whereas, for whites, the rate was just 0.10 percent.

"The high prevalence of chlamydial infection in both men and women suggests that current screening approaches that focus primarily on clinic-based testing of young women are inadequate," the authors note.

"The reduction of disparities in the prevalence of both chlamydial and gonococcal infections across racial/ethnic groups must also be a priority," they add.

Source: Journal of the American Medical Association, May 12, 2004.

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Schools Struggle to Control Steroid Use

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- The abuse in U.S. high schools of steroids and other muscle-building substances is moving beyond athletics, experts say, with both boys and girls taking the drugs in increasing numbers to achieve what they believe to be "perfect" bodies.

"If you look at national studies, there are about a half million to a million kids in high school who have used or are using steroids," said Dr. Linn Goldberg, an expert on steroid abuse at Oregon Health Sciences University in Portland. "If you look at the data on athletes, they've gone anywhere from 4 percent to 12 percent on a statewide basis -- some states have a much bigger problem than others."

High school administrators are beginning to realize they have relatively few weapons with which to fight rising rates of steroid abuse. Testing for the drugs simply "isn't feasible," Goldberg said, because the average steroid screening costs more than $100 per sample. Some "schools in the United States can hardly afford books," he noted.

Testing may even be counterproductive, said Mitch Finnegan, director of health and physical education at the Weston Public Schools, in eastern Massachusetts.

"In some ways, testing almost normalizes the use of it," he said. "If I'm a high school athlete and suddenly it's such a major concern that they're testing me every year or every season to make sure I'm not using it, I'm probably going to assume that there's a lot of athletes who are using it."

But the problem keeps growing, fueled by headline-grabbing media coverage of pro athletes caught using steroids or steroid precursors such as androstenedione, linked to home run slugger Mark McGwire's then record-breaking 1998 season.

Steroids "really blasted onto the scene" in the 1988 Summer Olympics (news - web sites), Goldberg said, after Canadian sprinter Ben Johnson (news - external web site) set new records -- only to be stripped of his medals after testing positive for steroids. Goldberg, who is also the U.S. Olympic Committee's crew chief for drug surveillance, said the Johnson scandal effectively "answered the question, 'Do steroids work?'"

Since that time, steroid and supplement scandals involving player after player have only heightened the drugs' mystique.

"I think pro athletes have a huge responsibility as role models, whether they want to accept it or not," Finnegan said. "It's almost as if, at the pro level, anything goes to increase your performance, which increases your marketability as an athlete."

But the price for increased performance can be dangerously high. Possible side effects of steroid abuse include high blood pressure and heart disease; liver damage and cancers; stroke and blood clots; nausea and vomiting; severe acne; and baldness. In addition, steroids can reduce sperm production, shrink the testicles, and cause impotence and irreversible breast enlargement in boys and men. Girls and women can develop more masculine characteristics such as deepening of the voice and excessive body hair, according to the National Institutes of Health (news - web sites).

Finnegan and Goldberg agree that even if the biggest sports stars warn kids about the dangers of steroids, it won't do much to curb abuse of the muscle-building substances.

And more and more teens are taking steroids not to make the team but to simply look "buff" and "hot."

"The national statistics show that steroid use is clearly not limited to athletes," Finnegan said. "There are many non-athletes who are using steroids to get the body they see on the magazines."

Girls are taking steroids, too -- U.S. Centers for Disease Control and Prevention (news - web sites) survey of Louisiana high schools found 11.2 percent of boys taking the drugs, and 5.7 percent of girls.

Goldberg said girls are "taking them for different reasons. Coaches often say to girls, 'You know, you'd be faster if you lost a little weight.' It's a body-shaping thing -- you increase muscle tissue and lose fat."

So what can school administrators do to fight steroid and supplement abuse? Goldberg and his team of researchers think they've found a solution. With funding from the National Institute on Drug Abuse, they've developed a school-based, peer-to-peer educational program called Adolescent Training and Learning to Avoid Steroids (ATLAS) that seems to work.

Grim lectures from coaches and pro athletes can change the minds of children in grade school and middle school, "but when you get to high school you start to have much more peer influences," Goldberg said. In ATLAS, older boys talk teen-to-teen with boys a few years their junior.

"There's a big difference between a 14-year-old and a 17-year-old, and the 17-year-old wields a lot of power. These kids are a lot more influential than someone who's a national quarterback, a Barry Bonds, a Phil Jackson," Goldberg explained. Recent studies suggest the ATLAS program can result in an average 50 percent reduction in high school steroid abuse.

Finnegan has been using ATLAS at Weston for the past three years. "I've been in the [drug] prevention and treatment field, as well as teaching, for the past 20 years," he said, "and it's probably the most effective prevention program we've ever seen." He plans to introduce ATLAS's "sister" program for girls, ATHENA, to the Weston schools next year.

Parents have a major role to play, as well, Finnegan said. "Parents need to help their kids learn how to develop in healthy ways. I think the vast majority of parents are doing a great job on that, but there are a minority who push their kids so hard, and that includes pushing them to use supplements and steroids."

On Capitol Hill, lawmakers are moving to keep steroids and other supplements out of kids' reach. The Steroid Act of 2003, sponsored by Sens. Joseph Biden (D-Delaware) and Orrin Hatch (R-Utah), seeks to ban the sale of andro and other steroid precursors, and to fund programs like ATLAS and ATHENA in schools.

And in March, the U.S. Food and Drug Administration (news - web sites) ordered a crackdown on online sales of andro. That's a move in the right direction, Finnegan said, since the Internet "is where most kids are getting supplements these days."

More information

For more on the dangers of steroids, visit the American Academy of Pediatrics. And for more details on the ATLAS program, check with Oregon Health & Science University.

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Take Action Now on Childhood Obesity, Expert Says

 

By Patricia Reaney

Reuters

Wednesday, May 12, 2004

LONDON (Reuters) - Ten percent of children, or at least 155 million youngsters worldwide, are overweight or obese, a leading health expert said Wednesday, citing new evidence of the extent of the problem.

"We need urgent action. The time for action is now," said Professor Ricardo Uauy, chair of public health nutrition at the London School of Hygiene and Tropical Medicine.

Uauy, an editor of a new report on childhood obesity, called for a global strategy to stem the rising number of obese children everywhere.

"We are facing an epidemic in children," he told Reuters. "We thought obesity was a problem for adults -- it is a global problem in children and it is going to get worse before it gets better."

Although it is most severe in the United States, where the prevalence of obese children aged five to 17 is about 10 percent and more than 30 percent are overweight, numbers are rising in Europe, the Middle East and in the Asia/Pacific region, according to the report by the London-based International Obesity Task Force (IOTF).

Ten to 20 percent of children in northern Europe show a prevalence toward being overweight, while further south in Europe the numbers increase to 20-35 percent.

What was once a health problem for the industrialized world with its high calorie foods, labor-saving devices and dwindling levels of physical activity has now spread to developing countries.

In South Africa, about 25 percent of girls from 13-19 are overweight or obese -- a number approaching U.S. levels, according to the report.

"These figures are extremely high, especially figures emerging from developing countries where we thought malnutrition was a problem," Uauy added "Now we are seeing that stunted children become obese as soon as they start getting the regular diet and physical inactivity of other countries."

Social Trends

In the report, Uauy and his colleagues identified social trends which have contributed to the problem and called for the World Health Organization (news - web sites) (WHO) to help developing countries organize strategies to prevent childhood obesity.

It would include efforts to improve maternal nutrition and to promote breast feeding, to encourage schools to teach children how to eat better, to provide clear nutrition information to consumers and safe play facilities in local neighborhoods.

Changes in diet, a decrease in physical activity and too much time spent in front of computer or television screens have been blamed for the growing number of overweight children.

Obesity increases a child's risk of suffering type 2 diabetes and, later in life, of developing heart disease, stroke and certain types of cancer.

"A global strategy means keeping children active at school and at play and making sure that foods that are energy-dense be limited. We cannot have high-energy food so that a child in 15 minutes will eat 80 percent of his calories for the day," Uauy added.

"In some countries, over the past decade, the figure has tripled. I think it is never too late but it is time we start getting serious about doing something about it."

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Health Tip: Arthritis and Teeth Brushing

 

HealthDayNews

Wednesday, May 12, 2004

(HealthDayNews) -- Arthritis can turn a daily task such as brushing your teeth into a painful and awkward chore.

One solution is to attach your toothbrush handle to your hand with a wide elastic band, or to strap it to a sponge or similar object, according to the Johns Hopkins University Geriatrics Center.

If you have restricted shoulder movement, try lengthening the brush's handle by attaching a longer piece of wood or plastic.

You can also limit motion by using an electric toothbrush.

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Report: Mass Smallpox Terror Vaccination Not Needed

 

Reuters

Wednesday, May 12, 2004

LONDON (Reuters) - Mass vaccination may not be necessary to contain smallpox in the event of a biowarfare attack, scientists said on Wednesday.

Instead, they suggested that spotting an outbreak early and vaccinating affected individuals and front-line workers will be enough to ensure safety.

"Our results suggest that outbreaks can be contained by a strategy of targeted vaccination combined with early detection without resorting to mass vaccination of a population," Dr Stephen Eubank, of the Los Alamos National Laboratory in New Mexico, said in a report in the science journal Nature.

Smallpox is a serious and sometimes fatal infectious disease that was eradicated decades ago after a successful worldwide vaccination program.

Small stocks of the virus have been kept in laboratories in the United States and Russia. After the September 11 attacks on New York and Washington and deaths from anthrax-tainted letters in the United States, there have been fears that other nations could develop smallpox as a biological weapon.

Britain has admitted that it was preparing for a mass smallpox vaccination of its population in the event of a bioterror attack.

Several vaccine companies, including Britain's Acambis and Bavarian Nordic of Denmark have secured lucrative government contracts for the supply of stockpiles of smallpox vaccine.

But Eubank and his team believe it may not be needed. Using models of a smallpox outbreak in a city similar to Portland, Oregon, they tested several strategies to restrict the spread of the disease.

They concluded that the time it takes for people to get home is by far the most important factor, followed by any delay in response to an outbreak.

"This indicates that targeted vaccination is feasible when combined with fast detection," Eubank added.

Smallpox produces flu-like symptoms and a distinctive and disfiguring rash. It has an incubation period of around 12 days. Symptoms include tiredness, chills, fatigue and fever followed by pustules that erupt mainly on the face and limbs.

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Health Tip: Good Eating Habits

 

HealthDayNews

Wednesday, May 12, 2004

(HealthDayNews) -- Eating less isn't the only way to drop a few pounds.

If you eat the right foods, you can actually eat more and weigh less, says Genesys Regional Medical Center in Michigan.

Skip high-calorie, sugary foods that are quickly eaten and digested, and make you hungry again sooner. Rather, opt for high-fiber, low-calorie foods that take more time to eat and make you feel full longer.

Here are some more good suggestions:

On the other hand, here are eating habits that can be counter productive:

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Fast-Food Breakfast May Inflame Blood Vessels

 

By Amy Norton

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - Downing a big fast-food breakfast may spur a temporary but large inflammatory response in the blood vessels, a small study suggests.

Researchers say that while an occasional indulgence in such high-fat, high-carbohydrate fare probably poses no concern, the new findings suggest that making it a regular routine could lead to chronic blood vessel inflammation and complications, such as heart attack and stroke.

The study included nine healthy, normal-weight adults who were fed a breakfast of one Egg McMuffin, a Sausage McMuffin and two servings of hash browns from McDonald's. The meal weighed in at 910 calories, 81 grams of carbohydrates, 51 grams of fat and 32 grams of protein.

While the hearty breakfast may be on the supersize side, lead study author Dr. Ahmad Aljada of the State University of New York at Buffalo said it reflects what many Americans order up at fast-food restaurants.

"We wanted to look at a typical American meal," he told Reuters Health. "We're not targeting McDonald's."

Dr. Catherine Adams, corporate vice president of worldwide quality at McDonald's and a registered dietitian, cautioned against reading too much into the findings.

The normal metabolic response to eating involves some inflammation and the production of molecules called oxygen free radicals. Any heavy meal, compared with water, will generate a much greater inflammatory response, Adams noted.

And no one, she told Reuters Health, advocates regularly consuming a 900-calorie fast-food breakfast.

However, Aljada said additional research suggests that it's not the size, but the content of the breakfast that may be the problem when it comes to inflammation in the blood vessels.

He said he and his colleagues found that 900 calories' worth of an American Heart Association (news - web sites) (AHA)-endorsed breakfast high in fruit and fiber did not produce the inflammatory responses seen with the fast-food breakfast.

"The number of calories is not the issue," Aljada said. "It's the type of food."

There may be something about the metabolism of fat, for example, that spurs significant inflammation, according to the researcher.

In past studies, he and his colleagues found that both pure glucose (sugar) and fat trigger greater inflammatory responses than protein does. The AHA-based breakfast, while high in carbohydrates, contains complex, fiber-rich carbs, as well as antioxidant vitamins that may ward off inflammation, Aljada explained.

For the new study, the researchers gave nine adults the fast-food breakfast and another eight a glass of water after an overnight fast. They took blood samples before the meal or drink, then again one, two and three hours afterward.

The blood samples showed that in the fast-food diners, markers of inflammation and free-radical production rose and remained high for hours after the meal.

Chronic inflammation is key in the development of the artery disease atherosclerosis, a hardening and narrowing of the arteries that can lead to heart attack and stroke. Aljada said that the concern is that, over time, repeated inflammatory responses like those seen in the study could lead to chronic inflammation in the blood vessels.

He said his advice to fast-food fans is to "eat moderately."

"And," the researcher added, "you may want to look into eating more fruit and fiber."

Adams echoed the call for moderation, saying fast-food fare can fit into a balanced diet. Ordering that Egg McMuffin with a glass of orange juice-rich in free radical-squelching antioxidants is one way to strive for better balance, she noted.

Aljada said he and his colleagues are studying the inflammatory effects of other types of food as well, including Atkins-style high-fat, high-protein meals, and foods with a high glycemic index. Foods in this latter group are digested quickly to glucose and cause a swift surge in blood sugar; they include carbohydrates such as white bread and potatoes.

Source: American Journal of Clinical Nutrition (news - web sites), April 2004.

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Stress Level Tied to Education Level

 

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- People with less education suffer fewer stressful days, according to a report in the current issue of the Journal of Health and Social Behavior.

However, the study also found that when less-educated people did suffer stress it was more severe and had a larger impact on their health.

From this, researchers have concluded that the day-to-day factors that cause stress are not random. Where you are in society determines the kinds of problems that you have each day, and how well you will cope with them.

The research team interviewed a national sample of 1,031 adults daily for eight days about their stress level and health. People without a high school diploma reported stress on 30 percent of the study days, people with a high school degree reported stress 38 percent of the time, and people with college degrees reported stress 44 percent of the time.

"Less advantaged people are less healthy on a daily basis and are more likely to have downward turns in their health," lead researcher Dr. Joseph Grzywacz, of Wake Forest University Baptist Medical Center, said in a prepared statement. "The downward turns in health were connected with daily stressors, and the effect of daily stressors on their health is much more devastating for the less advantaged."

Grzywacz suggested follow-up research to determine why less-educated people report fewer days of stress when it is known their stress is more acute and chronic.

"If something happens every day, maybe it's not seen as a stressor," Grzywacz says. "Maybe it is just life?"

More information

Here's where you can learn more about stress.

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Echinacea Does Little to Prevent Colds: Report

 

By Alison McCook

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - Stocking your medicine cabinet with Echinacea may be a waste of time, as a new study shows the herbal medicine does not help prevent colds.

After exposing 48 healthy adults to a virus that causes the common cold, U.S. investigators found that people who took Echinacea were no less likely to develop colds than people who took an inactive placebo pill.

Consequently, people may be better off leaving Echinacea off of their grocery list, study author Dr. Steven Sperber of Hackensack University Medical Center in New Jersey told Reuters Health. "Echinacea did not prevent infection with the cold virus," he said.

The research was funded by the German company Madaus Aktiengesellschaft, which sells the Echinacea product used in the current study.

In the U.S. alone, consumers spend more than $300 million each year on Echinacea products, for the purpose of preventing and treating colds.

However, recent research has also cast doubt on whether the herbal preparation can treat colds. A study published last year found that children who took Echinacea as soon as they developed a cold showed no difference in the severity or duration of cold symptoms than children who took a placebo pill. (http://nccam.nih.gov/health/alerts/echinacea/index.htm)

To test the benefits of Echinacea in preventing colds, Sperber and his team asked 48 adults to inhale a strain of rhinovirus, a group of viruses that causes approximately 40 percent of colds in adults.

As described in the journal Clinical Infectious Diseases, half the participants took Echinacea pills for 7 days before being exposed to the virus and for 7 days after, while the others took a placebo pill over the same time period.

More than 90 percent of participants became infected with the virus. Although slightly fewer people taking Echinacea developed colds, statistical calculations showed that the difference could have been due to chance.

Similarly, although people taking Echinacea appeared to have fewer symptoms than the placebo group, those differences were also too small to rule out the effect of chance, the authors report.

Sperber noted that although Echinacea may not help prevent or treat colds, none of the people who took it reported any side effects linked to the medication. However, he added that people who take herbal products should be aware that they can interact with prescription medications.

Sperber added that additional experiments that include larger numbers of participants are likely needed to establish whether Echinacea can at least help reduce cold symptoms.

Clinical Infectious Diseases, May 15, 2004.

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Beta Blockers Safe for Those With Peanut Allergies

 

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- Heart disease patients with peanut allergies should not fear using beta blockers to prevent a heart attack, says a study in the May issue of the Journal of Allergy & Clinical Immunology.

Beta blockers can reduce or eliminate the effectiveness of epinephrine, the best available treatment for severe allergic reactions.

But doctors studying survival rates found the benefit of using beta blockers outweighed the increased chance of dying from an allergic reaction.

In the same issue, another research team found common household cleaners are effective in removing peanut allergens from hands and tabletops.

Except for dishwashing liquid, common cleaning agents easily removed peanut allergen from tabletops. Hands were cleaned free of peanut allergen except when washed with either plain water or antibacterial hand sanitizer.

More information

The Texas Heart Institute has more about beta blockers.

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Stroke Survivors Have a High Risk of Dementia

 

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - The results of a study published in the journal Stroke suggest that patients who have suffered a stroke have twice the risk of dementia compared with healthy subjects.

"Identification of risk factors for dementia after stroke is best performed in comparison with stroke-free controls, because older subjects at high risk for stroke also have a substantial risk of dementia in the absence of stroke," Dr. Philip A. Wolf and colleagues from Boston University School of Medicine, write.

Dr. Wolf's group prospectively examined these risk factors in members of the community-based Framingham Study. They compared 212 dementia-free subjects in January 1982 who had a first stroke after that date with 1,060 healthy control subjects.

The researchers calculated 10-year risk of dementia and estimated the risk within subgroups defined by various risk factors.

Over 10 years of follow-up, 41 (19.3 percent) stroke patients and 117 (11.0 percent) controls developed dementia. The risk was not reduced by adjusting the data for other possible contributing factors, such as age and sex.

Subjects younger than age 80 years had a higher risk of dementia (2.6-times the risk). The risk was also higher in those who had completed high school (2.4-times) compared with those who did not graduate (1.7-times).

In addition, subjects with a specific genetic pattern of apolipoprotein E, a blood protein associated cardiovascular disease, had more than 3-times the risk.

These findings reinforce the importance of stroke prevention measures, not only to reduce death, illness and disability directly attributable to the stroke, but to also reduce the risk of dementia, Dr. Wolf and colleagues conclude.

Source: Stroke, June 2004.

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Neurotics More Prone to Depression

 

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- Neurotic people are more likely to suffer episodes of major depression, particularly following stressful life events, claims a study in the current issue of the American Journal of Psychiatry.

The study assessed 14 symptoms for major depression in 7,517 male and female twins. It found that at every level of stress exposure, neuroticism -- unresolved emotional or psychological disturbance -- increased the risk of major depression.

"We clearly showed that, as your level of vulnerability goes up, the impact of stress becomes greater and greater," study author Dr. Kenneth S. Kendler, director of the Virginia Institute for Psychiatric and Behavioral Genetics at Virginia Commonwealth University, said in a prepared statement.

Neuroticism was measured by a 12-item scale that included such questions as, "Are you the type of person who is easily hurt?" and "Are you the type of person who is a worrier?"

Higher levels of neuroticism in men and women predicted an increased risk for major depression, especially in stressful situations such as personal assault, divorce, major financial problems, or serious illness.

Major depression affects an estimated 17 million Americans annually. It is marked by persistent sadness, apathy, a feeling of worthlessness, irritability and recurring thoughts of death or suicide.

More information

The National Institute of Mental Health has more about depression.

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Student Athletes at Risk for Addiction: Study

 

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - Many college athletes may have problems with gambling, alcohol abuse, eating disorders and other addictive behavior, according to the results of a small study.

Male athletes in the study were more likely to have problems with gambling, drugs and alcohol, while their female counterparts were more likely to have problems with eating disorders and excessive exercise.

Drs. Victoria L. Bacon and Pamela J. Russell, both at Bridgewater State College in Massachusetts, surveyed 99 male and 86 female college athletes. The students, most of whom were white, all competed in Division III athletics.

The researchers measured five types of addictive behavior: gambling, substance abuse, disordered eating, exercise and alcohol abuse.

Students' responses were used to determine whether they had problematic addictive behavior or a full-fledged addiction.

The survey revealed that "large numbers" of student athletes had at least one addiction or problematic behavior, according to a report in the spring issue of The Sport Journal.

For problem behavior, which does not meet all of the diagnostic criteria for addiction, excessive exercise was the most common problem and substance abuse was the least common.

Gambling was the leading addiction, with about 15 percent of students meeting the diagnostic criteria for gambling addiction.

Addictive behaviors occurred in two major clusters. One cluster included substance abuse, gambling and alcohol abuse, while the other included eating and exercise problems.

According to the researchers, "Collegiate student-athletes are unique and face different challenges than their non-athlete peers."

Challenged to succeed not only in the classroom but also on the athletic field, student athletes face many types of stress, including time management and peer pressure, the researchers point out.

The study did not include students who did not play sports, so it is uncertain whether athletes are more prone to addictive behavior than other students.

More study is needed to determine the best ways to help student athletes steer clear of addictive behavior, according to the report.

Source: The Sport Journal, Spring 2004.

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Botox May Ease Enlarged Prostate Symptoms

 

By Serena Gordon
HealthDay Reporter

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- Botox, which has already proven its worth banishing wrinkles and battling migraines, is now emerging as a possible treatment for prostate problems.

Researchers from the University of Pittsburgh Medical Center say Botox may help alleviate symptoms of an enlarged prostate -- a condition called benign prostatic hyperplasia (BPH). They presented their findings May 11 at the American Urological Association meeting in San Francisco.

At another presentation at the same meeting, researchers reported that higher levels of so-called "free" testosterone were associated with an increased risk of prostate cancer.

The University of Pittsburgh scientists injected Botox into the prostates of 11 men between the ages of 50 and 82. All had an enlarged prostate, which causes symptoms such as frequent urination, an inability to completely empty the bladder and urinary tract infections.

The men had all tried alpha-blocker treatments, and had not responded to the therapy.

Within three to seven days of the injections, the men's average score on a prostate symptom scale had decreased by 62 percent, and a quality-of-life scale score increased by 57 percent.

"We have completed a number of studies that have shown Botox injections are a safe and effective treatment for conditions of the lower urinary tract," Dr. Michael Chancellor, a professor of urology and gynecology, said in a statement. "In this study, we have shown the same may be true for using Botox injections for enlarged prostate."

In the testosterone study, researchers found higher levels were associated with an increased risk of prostate cancer.

One of the study authors, Dr. J. Kellogg Parsons, said the researchers wanted to see if higher levels of testosterone were linked to a higher incidence of prostate cancer because testosterone-replacement therapy is becoming more widespread.

"In this cohort of aging men, we did see a significant association between the serum testosterone index and prostate cancer," said Parsons, an instructor of urology at Johns Hopkins School of Medicine.

He said that men whose testosterone levels placed them in the upper 75th percentile had an 88 percent higher risk of prostate cancer than men in the 25th percentile. Men in the lowest 25th percentile, he added, had levels of free testosterone considered clinically low.

Each year, more than 230,000 men are diagnosed with prostate cancer, according to the American Cancer Society (news - web sites) (ACS). Over a lifetime, prostate cancer strikes one of every six men, according to the ACS. Almost 30,000 American men die annually from the disease.

In its early stages, prostate cancer often has no symptoms. As it advances, it can cause impotence, blood in the urine and pelvic or hip pain.

For the testosterone study, Parsons and his colleagues tested blood samples from 794 middle-aged and older men, including 114 who had prostate cancer. The samples had been collected over a 40-year period as part of another study. The average age of diagnosis for the men with prostate cancer was 75.

Overall levels of testosterone weren't associated with an increased risk of cancer, said Parsons, but high levels of "free" testosterone were. Free testosterone, Parsons explained, is different from other forms of testosterone because it isn't bound to any proteins and can be taken up into the body's tissues, including prostate cells.

Parsons said it's important to note that this research doesn't mean testosterone causes prostate cancer.

"Our study raises the question whether increasing testosterone levels may potentially increase the risk of prostate cancer," Parsons explained.

Dr. Simon Hall, chairman of the department of urology at Mount Sinai Medical Center in New York City, said he doesn't think this study will change the way men with low testosterone levels are treated. He said for every study that shows a potential increase in risk, there seems to be another that doesn't find an increase. More important, larger studies haven't found a correlation between testosterone levels and prostate cancer, he said.

"I don't think this should alter how someone makes a decision" on testosterone therapy, said Hall. If you have low levels of testosterone, you "should be treated and monitored just the same. You should have a PSA test and a rectal exam before starting therapy, and if any abnormalities show up after starting therapy you should be reevaluated and you may have to stop hormone treatment."

More information

To learn more about prostate cancer, visit the National Cancer Institute or the American Cancer Society.

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Blood Vessel Blockers Show Promise Against Cancer

 

By Megan Rauscher

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - Results from recent studies suggest that vascular disrupting agents, a new class of drugs designed to cut off blood flow to cancers, may improve the survival of cancer patients, particularly when combined with standard therapies.

In the medical journal Cancer, Dr. Dietmar W. Siemann, from the University of Florida Shands Cancer Center in Gainesville, and colleagues review the current state of research on vascular disrupting agents.

"This has been an area of interest for some time, and certainly one that my lab has been involved in for a number of years," Siemann told Reuters Health. "I felt it would be valuable to review and summarize the available information and to attempt to put together a perspective of the field."

Animal studies have shown that the leading vascular disrupting agents--DMXAA, CA4DP, and ZD6126--can effectively destroy various cancers by cutting off the blood supply, the investigators report.

"Because a single blood vessel provides nutritional support to thousands of tumor cells, damaging that vessel can lead to the death of those tumor cells," Siemann said.

However, because vascular disrupting agents invariably leave a ring of unharmed tumor cells, it's likely that the greatest benefits will come when they're combined with standard cancer drugs or radiation therapy, he added.

Several early studies have shown that vascular disrupting agents can enhance the effectiveness of standard therapy without increasing the toxic effects.

Source: Cancer, May 10, 2004.

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Amino Acid Linked to Bone Fractures

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Wednesday, May 12, 2004

WEDNESDAY, May 12 (HealthDayNews) -- High levels of homocysteine, an amino acid found in the blood, appears to be a risk factor for hip fractures in older people.

Experts aren't yet sure, however, if homocysteine is the actual cause of the fractures or if it is associated in a more "innocent" way.

If it were a cause, this finding could have a major public health impact because homocysteine levels can be manipulated through dietary changes.

"Homocysteine can be easily lowered and that would potentially reduce the risk," said Dr. Douglas P. Kiel, senior author of one of two articles on the subject appearing in the May 13 issue of the New England Journal of Medicine (news - web sites). He is also director of medical research at the Hebrew Rehabilitation Center in Boston.

At present, however, "we aren't sure how important it is," said Dr. Lawrence G. Raisz, author of an accompanying editorial in the journal and a professor of medicine at the University of Connecticut Health Center in Farmington.

Elevated homocysteine levels are already recognized as a risk factor for cardiovascular disease as well as cognitive impairment. It's also known that people with homocystinuria, a genetic disease marked by high levels of homocysteine, have an increased prevalence of osteoporosis.

In the first study, Kiel and his colleagues decided to delve further into the subject by examining the association between homocysteine levels and the risk of hip fractures in a group of 825 men and 1,174 women ranging in age from 59 to 91.

The participants were divided into four groups, depending on their homocysteine levels. Men in the highest quartile had almost four times the risk of hip fracture as men in the lowest quartile, while women in the top group had 1.9 times the risk.

The second study, this one done by researchers in the Netherlands, also found increased homocysteine levels seemed to be an independent risk factor for osteoporotic fractures in a group of 2,406 men and women over the age of 55. People in the highest quartile had about double the risk of fracture as people in the other three quartiles.

"The question still remains, is it the homocysteine itself or is the homocysteine a marker for some other risk factor that has the direct adverse effect on the skeleton," Kiel said.

The arguments in favor of homocysteine as a causal factor include the fact that, in individuals with homocystinuria, high homocysteine levels weaken the collagen of the bones, Kiel noted.

"The Dutch study didn't see a difference in bone density to go with an increase in fractures so the total amount of bone wasn't different," Raisz pointed out. "It may be the quality of the bone. One possibility is that high homocysteine levels cause bone of poorer quality to be made."

It's also possible that other, associated phenomena may be responsible, such as nutrition, low estrogen levels or some as yet unknown factor, Raisz added.

For the moment, more studies are needed to try to get at the underlying mechanisms at work.

If it does turn out that homocysteine levels are responsible for an increased risk of fractures, the solution could be as simple as increasing intake of folic acid and vitamins B 6  and B 12, Kiel said.

More information

The American Heart Association (news - web sites) has more on homocysteine and heart disease. The National Osteoporosis Foundation has more on osteoporosis.

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Chest Pain Doesn't Worsen Heart Disease in Diabetics

 

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - The presence of cardiac chest pain, or angina, does not seem to affect the heart disease outcomes of patients with diabetes, according to a report in the European Heart Journal. By contrast, the presence of high blood pressure or shortness of breath predicted a worse outcome.

Dr. Daniel S. Berman from Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, and colleagues assessed the rate of heart disease in 1737 diabetic patients without a history of heart disease and evaluated the impact of patient symptoms on their outcomes.

Nearly half the patients had no symptoms, yet a proportion still had evidence of heart disease. Patients with angina did just as well as these symptom-less patients. Patients with shortness of breath or high blood pressure, however, were more likely than their symptom-less counterparts to experience fatal and non-fatal heart attacks.

High blood pressure increased the risk of such events by 83 percent, the results indicate, and shortness of breath more than doubled the risk.

Source: European Heart Journal, April 2004.

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Age, Weight Predict Fatal Heartbeat After Surgery

 

By David Douglas

Reuters Health

Wednesday, May 12, 2004

NEW YORK (Reuters Health) - People over 65 years of age and those who are overweight are at increased risk for potentially fatal heartbeats after bypass surgery, according to a report in the Journal of the American College of Cardiology.

These heartbeat irregularities, ventricular tachycardia and ventricular fibrillation, demand immediate treatment to prevent death.

Patients who develop ventricular tachycardia or ventricular fibrillation after heart surgery are at very high risk for death, lead author Dr. Raimondo Ascione told Reuters Health. Our study identifies several risk factors for these irregular heart rhythms, he added.

Ascione and colleagues, from Bristol Royal Infirmary in the UK, gathered data on 4411 patients undergoing heart bypass surgery. Of these, 26 percent underwent "beating heart" surgery in which the organ is not temporarily stopped as is usually done.

In all, 69 patients experienced ventricular tachycardia or ventricular fibrillation and 15 were among the 61 patients who died within 30 days of surgery.

In addition to older age and being overweight, female gender, poor heart function, and treatment with a device to help the heart pump were all linked to an increased risk of irregular heart rhythm. In contrast, patients who underwent beating heart surgery had a reduced risk of ventricular tachycardia or ventricular fibrillation.

The team notes that although the in-hospital death rate was high in the ventricular tachycardia/ventricular fibrillation group, nearly all patients who survived this period were alive 2 years later.

Source: Journal of the American College of Cardiology, May 5, 2004.

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Tuesday, May 11, 2004

U.S. Uninsured Health Care Cost Put at $125 Billion

By Joan Gralla

Reuters

Tuesday, May 11, 2004

NEW YORK (Reuters) - The cost of providing health care for U.S. citizens who have no insurance will total $125 billion this year, with taxpayers and private entities footing most of the bill, a report issued on Monday said.

The report by a health care research foundation estimated that there are 44 million Americans without any health insurance, and soaring health care costs have become a presidential campaign issue.

On Monday, Democratic presidential candidate John Kerry (news - web sites) accused President Bush (news - web sites) of letting skyrocketing health care costs push families to the brink of financial ruin.

Bush signed legislation last year adding a prescription drug benefit to Medicare, but that measure is now embroiled in controversy, including much higher-than-projected costs.

The new report, sponsored by the Washington, D.C.-based Henry J. Kaiser Family Foundation, argued that the country can afford health care for all of the uninsured.

"Leaving 44 million Americans uninsured exacts a substantial price on society as well as individuals, while covering the uninsured would improve their health care without generating large increases in overall health spending," said Diane Rowland, executive director, Kaiser Commission on Medicaid and the Uninsured.

The nation would have to spend an extra $48 billion to cover the so-called newly uninsured, the report said. But that would only increase health care spending's share of gross domestic product by 0.4 percent.

Still, the extra $48 billion would be on top of the $125 billion that will be spent this year on health care for the uninsured, the report said. Its recommendation would push the total to $173 billion.

This estimate was based on the out-of-pocket expenses incurred by uninsured patients, the hospitals' costs, and insurance payments for any coverage the individuals had during the year.

In 2004, each person who is covered by a health care plan will spend about $2,975 on medical bills, the study said.

That works out to about twice the amount individuals who lack insurance will spend out of their own pockets.

Partly because they lack insurance, an additional 18,000 adults die each year, the report estimated, citing figures from a branch of the National Academy of Sciences (news - web sites).

People who have no health insurance typically get less preventive care, are diagnosed with more advanced diseases, and "tend to receive less therapeutic care and have higher mortality rates," the report said.

Hospitals will spend billions of dollars treating the uninsured, though these organizations typically get big government subsidies, the report said. In 2001, hospitals accounted for more than 60 percent of what was spent on uncompensated care.

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Health Tip: Migraines in Children

 

HealthDayNews

Tuesday, May 11, 2004

(HealthDayNews) -- Many adults who suffer from migraines can tell the difference between a severe headache and a true migraine.

But when your child complains his head is pounding, how do you know if it's a migraine? Since medications for migraine are more potent than common headache remedies, it's important to tell the difference.

According to the Children's Hospital in Richmond, Va., to be migraine, a child must have recurrent headaches or other neurological symptoms separated by symptom-free intervals and at least three of the following:

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Chlamydia Cases on the Rise in Washington

 

The Associated Press

Tuesday, May 11, 2004

SEATTLE - The known incidence of chlamydia rose 12 percent in Washington state last year, leading health officials to recommend that sexually active women under 25 be tested for the sexually transmitted disease at least once a year.

Nearly three-fourths of the reported cases were found in people 15 to 24 years old, said Katherine Gudgel, coordinator of the Washington state chlamydia screening project.

"This is a disease of young people," Gudgel said.

The number of cases went from 14,935 in 2002 to 16,796 last year, an all-time high, according to an annual report of sexually transmitted diseases that was issued Monday. The overall incidence rate increased from 247 per 100,000 residents to 275 per 100,000, still below the last reported national rate of 296 per 100,000.

Among women 15 to 19 in the state, the chlamydia infection rate was 2,273 per 100,000 residents compared with 391 per 100,000 for men the same age.

Syphilis, a more severe venereal disease, also increased in Washington with 82 cases last year compared with 70 in 2002.

Chlamydia, the most commonly reported infectious disease nationwide, is curable with antibiotics but shows no symptoms in about 90 percent of the infected women and 60 percent of the infected men.

Symptoms in both sexes may include painful urination, pain in the lower abdominal area and pain and discharges in the genital area.

Left untreated it can lead to pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain and infertility in women, infertility in men and higher susceptibility to infection with HIV (news - web sites) among both sexes.

In mailings last week to about 13,000 private doctors, the state +Health+ Department asked them to test more patients for chlamydia, but Gudgel said women should not wait for doctors to raise the idea.

"If we can get women to understand how common this infection is and how silent it is ... they will hopefully say, 'I'm a young sexually active woman. I better ask my doctors to test me,'" she said.

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Study: American Pesticide Levels Are High

 

By Terence Chea

Associated Press Writer

The Associated Press

Tuesday, May 11, 2004

SAN FRANCISCO - Many U.S. residents carry unhealthy levels of pesticides in their bodies, with children, women and Mexican Americans disproportionately exposed to the toxic chemicals, according to a study to be released Tuesday.

The Pesticide Action Network analyzed data collected by the U.S. Centers for Disease Control and Prevention (news - web sites) in a study of more than 2,648 people tested for levels of 34 pesticides, the environmental group said.

The PAN study — called "Chemical Trespass: Pesticides in Our Bodies and Corporate Accountability" — found that a large percentage of people who had their blood and urine tested carried pesticides above levels considered safe by government health and environmental agencies.

"The pesticide body burden data represents a failure of our approach to how we protect people from toxic pesticides," said Kristin Schafer, the study's lead author and PAN's program coordinator. "We really hope that it will help us move toward a different system of how we control pests in agriculture and all other areas."

San Francisco-based PAN, which advocates for alternatives to pesticide use for pest control, found that the average person in the study carried 13 of the 23 pesticides they evaluated. Many of the pesticides have been linked to infertility, birth defects, cancer and other serious health ailments, said Margaret Reeves, a senior scientist at PAN.

"A growing body of research suggests that even at very low levels, the combination of these chemicals can be harmful to our health," Reeves said.

The PAN study found that children between 6 and 11 years old were exposed to the nerve-damaging pesticide chlorpyrifos at four times the level deemed acceptable by the U.S. Environmental Protection Agency (news - web sites). Chlorpyrifos is designed to kill insects by disrupting the nervous system.

"It does appear to have some validity," said Francis B. Suhre, of the EPA. "The crux of the matter is what does it all mean and is it reflecting past effects as opposed to current. At first blush, it requires further screening."

The study said one company — Dow Chemical Corp. — was responsible for 80 percent of the chlorpyrifos in Americans' bodies. The figure was derived from the amount of the chemical in the bodies of the people tested and a "conservative estimate of Dow's market share," said Skip Spitzer, a program coordinator for PAN and one of the study's authors.

Dow spokesman Garry Hamlin confirmed the company is the largest manufacturer of the pesticide in the country, but said the pesticide leaves the body quickly without doing harm. He said the CDC has noted that the measurement of an environmental chemical in a person's blood or urine does not mean that the chemical causes disease.

"Chlorpyrifos is widely used, and studies by the Centers for Disease Control suggest that people are exposed to chlorpyrifos at very tiny levels. ... When people are exposed, the product breaks down readily and is eliminated from the body in a matter of days," he said.

The report said that women carry "significantly" higher levels of three pesticides called organochlorines known to reduce birth weight and disrupt brain development in infants.

PAN's analysis also found that Mexican Americans carried higher levels of chemicals linked to the insecticides lindane, DDT and methyl parthion than other ethnic groups.

The PAN study didn't reveal why certain groups were more exposed to certain chemicals because the CDC data didn't include information about where the test subjects lived or what kinds of jobs they held. People are thought to ingest pesticides through air, water and food.

CDC spokeswoman Stephanie Creel said the center would not comment on the findings because it did not participate in the analysis.

PAN researchers believe pesticide makers should be held responsible for the "pesticide body burden" and its financial and health impacts.

"There's a case to be made that the primary responsibility for these pesticides in our bodies lies with the folks that manufacture and market them," Schafer said.

The study recommends that Congress investigate corporate responsibility for pesticide contamination, an EPA ban on using hazardous pesticides, and requiring manufacturers to demonstrate that a pesticide doesn't harm human health before using it.

On the Net:

Pesticide Action Network: http://www.panna.org

CropLife America: http://www.croplifeamerica.org

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Latina Moms May See Heavy Kids as Healthy Kids

 

Reuters Health

Tuesday, May 11, 2004

NEW YORK (Reuters Health) - When it comes to signs of a healthy child, low-income Hispanic-American mothers may put more stock in a bright smile than a slim body, a new study suggests.

According to researchers, women in the study generally felt that being moderately overweight in early childhood is all right as long as the child "looks and feels good." In fact, when shown pictures of thin and heavy children, mothers often said a heavier child looked healthier because her hair was "shining" and her face looked happy.

In contrast, thinness was often viewed as a worrisome sign -- especially among immigrant Latina women, who considered malnutrition and intestinal infections a greater threat to child health than excess pounds.

The findings suggest that the traditional way of counseling mothers on child nutrition -- such as emphasizing the ill health effects of being overweight -- might not work for many Hispanic mothers, according to the study authors.

Instead, they say, focusing on the health benefits of a good diet and exercise, which go beyond weight control, may be more effective.

Dr. Patricia B. Crawford of the University of California, Berkeley, and her colleagues report the findings in the Journal of the American Dietetic Association.

According to the researchers, national data on low-income children show that 12 percent of Hispanic children between the ages of 2 and 5 are overweight -- a figure higher than that among black, white or Asian children the same age.

To get a sense of Latina mothers' attitudes about weight issues, Crawford's team surveyed 43 mothers with children between the ages of 2 and 6. The women were recruited from California sites offering the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a federal program that provides nutrition education to low-income families with young children.

Overall, the researchers report, mothers in the study were "reluctant to label their children as overweight," and even when they acknowledged that a child was heavy, they often believed he or she would "grow out of it." In addition, many mothers thought their child's weight problem was a matter of heredity rather than diet and exercise.

Mothers also highly valued a child's happiness, consistently ranking the importance of "being happy with family" above good health, according to Crawford and her colleagues.

They suggest that nutrition counseling might help Latina mothers more if it connects health to happiness, and focuses on the positive effects of nutritious foods and exercise instead of the consequences of being overweight.

Source: Journal of the American Dietetic Association, March 2004.

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Chlamydia May Affect More Than Thought

The Associated Press

Tuesday, May 11, 2004

CHICAGO - More than 4 percent of young adults in the United States are infected with chlamydia, and the sexually transmitted disease is six times more common in blacks than in whites, researchers say.

In a nationally representative study of 14,322 people ages 18 to 26 conducted in 2001-02, University of North Carolina researchers found that 4.7 percent of women and 3.6 percent of men had chlamydia. The overall prevalence was 4.2 percent.

The researchers said their figures are slightly higher than some previous nationwide estimates, which were based on different methodology.

The prevalence was lowest among whites — 1.94 percent — and highest among blacks — 12.54 percent. Other infection rates were 10.4 percent of Native Americans, 5.9 percent of Hispanics and 2 percent of Asian-Americans.

Similar racial and gender disparities have been found in previous studies.

While current screening strategies focus on testing young women, the high rates found in men suggest better methods are needed, said lead author Dr. William C. Miller of UNC-Chapel Hill.

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

The UNC study is based on in-person interviews with young adults and analysis of urine specimens.

Chlamydia is the most common bacterial sexually transmitted disease nationwide, with an estimated 3 million people infected each year, according to the Centers for Disease Control and Prevention (news - web sites).

Chlamydia infections can be cured with antibiotics. Left untreated, they can cause pelvic pain and infertility in women and increase susceptibility to the AIDS (news - web sites) virus in men and women.

In 2002, 834,555 cases of chlamydia were reported in the United States.

Human papilloma virus, which can cause cervical cancer, is the most common sexually transmitted disease nationwide, with more than 5 million new cases each year, according to the CDC.

On the Net:

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

CDC: http://www.cdc.gov

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Outlook Good for Most Prostate Cancer Patients

By Ed Edelson
HealthDay Reporter

HealthDayNews

Tuesday, May 11, 2004

TUESDAY, May 11 (HealthDayNews) -- The outlook for most men diagnosed with prostate cancer is good, especially for those who have surgery to remove the gland, according to new studies just reported at the annual meeting of the American Urological Association.

A study of patients treated at Memorial Sloan-Kettering Cancer Center in New York City found "this operation has the ability to cure three of every four men, 15 years after the diagnosis," said Dr. Fernando J. Bianco, Jr., an oncology fellow at the center who delivered the report.

Even for men in whom the cancer recurs after surgery, "the chances that they will make it to 15 years is very high," Bianco said.

Recurrence is indicated by a rising level of prostate-specific antigen (PSA), a protein produced by both normal and cancerous prostate tissue. However, the PSA test is not the best and only indicator of prostate cancer

"Even for those who developed a rising PSA after radical prostatectomy, the probability of death from cancer at 10 and 15 years was 23 percent and 38 percent," Bianco said.

The study included 1,700 men who had radical prostatectomy, an operation to remove the cancerous gland, since 1983. The cancer recurred in only 261 of them.

Even when the cancer had spread beyond the prostate to nearby lymph nodes or elsewhere in the body when it was first diagnosed, the 15-year survival rate was 70 percent or better, the study found.

A study of more than 3,000 prostate cancer patients at the Washington University School of Medicine in St. Louis also demonstrated the effectiveness of cancer surgery. That study compared survival rates for men treated by surgery, external beam radiation, hormonal therapy or brachytherapy -- in which radiation-emitting pellets are implanted in the body -- and for cases in which the physician chose watchful waiting.

Only 13 percent of men classified as low-risk because the cancer was confined to the prostate at the time of diagnosis had died after an average follow-up time of 68 months. The mortality rate for men at intermediate risk because the cancer had spread to nearby lymph nodes was 20 percent. For high-risk men, in whom the cancer had spread further, the death rate was 41 percent.

Brachytherapy also gave encouraging results, with a mortality rate of less than 10 percent of low-risk men and 17 percent of intermediate-risk men in a 42-month follow-up. But the death rate for high-risk men treated with brachytherapy was 59 percent.

Results for external beam radiation were less impressive, with a five-year survival rate for low-risk men of 83 percent. Survival rates for low-risk men treated with hormonal therapy and watchful waiting were much lower. Because of the relatively small number of patients, the survival estimates were very broad -- between 23 and 71 percent for hormonal therapy and 22 and 56 percent for waiting.

While the results of surgery are good, "it is hard to make a statement in favor of just one treatment," said Dr. Misop Han, a staff urologist at Northwestern Memorial Hospital in Chicago, who has worked with the Washington University physicians and delivered another report at the meeting.

"There is a role for radiation therapy and hormone therapy and watchful waiting," Han said. "It depends on the characteristics of the individual patient."

Han's paper covered radiation treatment of men who experienced recurrence of cancer after surgery. The salvage radiation treatment eliminated the cancer in only 25 percent of those men in a 10-year follow-up, but many of those men were still alive, Han said, so "the mortality rate data are not mature yet."

The study shows that recurrence of prostate cancer "can be effectively treated with salvation radiation therapy in properly selected patients," Han said.

More information

What you need to know about prostate cancer is outlined by the National Cancer Institute, while the American Cancer Society discusses treatment options.

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Ear Infections May Raise Kids' Asthma Risk

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Tuesday, May 11, 2004

TUESDAY, May 11 (HealthDayNews) -- Painful ear infections are tough on kids and their parents, and new research suggests they might also raise a child's risk for asthma.

"Higher rates of asthma were observed as the number of infections increased," said Kamal Eldeirawi, a researcher at the University of Illinois at Chicago's School of Public Health. "Children having three or more ear infections were approximately twice as likely to have asthma compared to those with no prior history of ear infections."

The findings appear in the May issue of Chest.

Pediatric experts estimate that 69 percent of American children will suffer an ear infection at some point in their early development, while a much smaller but still significant number of children -- about 5 percent -- will develop asthma.

Until recently, "there haven't been many studies that looked at asthma and ear infection," Eldeirawi said.

As part of their research, Eldeirawi and his team analyzed federal government health data collected between 1988 and 1994 on more than 7,500 children aged 2 to 11 years. Comparing rates of ear infection with any history of diagnosed asthma or wheezing, they found a significant association between early childhood ear infections and asthma.

Overall, children with any history of ear infection were at a 57 percent higher risk for asthma and a 70 percent elevated risk of non-asthmatic wheezing. Increasing recurrence of ear infection was associated with a steady rise in overall asthma risk, the researchers added.

Eldeirwai stressed, however, that the findings are preliminary and "long-term, follow-up studies" are needed before any recommendations can be made.

"Our findings aren't conclusive," he said. "They are only suggestive. Hopefully they will open up this avenue of research so people will start looking at it."

Dr. Stephen Wasserman, a professor of medicine at the University of California, San Diego, said he "wasn't particularly surprised" by the findings because experts have long noted a connection between ear infections and another common respiratory complaint, allergies.

Parents of ear infection-prone children need not become overly alarmed, he said, especially when it comes to links between ear trouble and wheezing. "Many kids wheeze in their early childhood from about age 1 through 3," Wasserman explained, "and they do not go on to wheeze later. It's now just called 'transient wheezing,' probably stemming from the fact that little kids' airways are just so small."

Still, the association between diagnosed asthma and ear infections remains puzzling. Eldeirawi said experts have already floated any number of theories to explain possible links between the two ailments.

"Studies have looked at repeated episodes of fever, which is a common symptom of ear infection, and found them to be related with asthma," he said. Other studies "have looked at the frequency of antibiotic use and the subsequent risk of having asthma, and they found a relationship there."

Viruses or bacteria that cause ear infection might also upset a child's immune system and encourage asthma, Eldeirawi said. Finally, a child's genetics might somehow predispose him or her to both ear infections and asthma, he added.

It may be years before scientists uncover the links -- if any -- between ear trouble and asthma. In the meantime, there's a lot parents can do to prevent their child from contracting either illness.

"For example, helping kids avoid tobacco smoke or avoiding environmental exposure to smoke," Eldeirawi advised, because secondhand smoke is strongly tied to both pediatric ear infection and respiratory illness. "Breast-feeding has also been found to reduce risk for ear infections, and in some studies it's even been found to reduce asthma," he said.

If children do develop an ear infection, Eldeirawi suggests avoiding unnecessary antibiotic therapy. "If their doctor prescribes antibiotics, [parents] should ask the doctor 'Is this really necessary? Will it go away without antibiotics?' Because a lot of ear infections will simply resolve without them."

More information

For tips on helping children through painful ear infections, visit the American Academy of Pediatrics. For more on pediatric asthma, check with the American Academy of Allergy, Asthma & Immunology.

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Gum Disease Hits High-Income Blacks the Hardest

By Merritt McKinney

Reuters Health

Tuesday, May 11, 2004

NEW YORK (Reuters Health) - High income and educational levels often go hand-in-hand with better health, but this does not seem to be the case with African Americans and gum disease, researchers report.

"Our study shows that income and education do not translate to the same meaning across racial/ethnic groups in this country," Dr. Luisa N. Borrell of the Mailman School of Public Health at Columbia University in New York told Reuters Health.

"Blacks with high incomes and higher level of education exhibited higher rates of periodontal diseases than their white and Mexican-American counterparts regardless of their income and education," Borrell said.

"This study's findings suggest that income and education are intertwined with race and ethnicity in our society," Borrell said. "In other words, there appears to be other issues in the social fabric of our society that limit the benefits of income and education for blacks."

The results appear in the May issue of the American Journal of Public Health.

Borrell and her colleagues based the findings on dental exams conducted on more than 3,000 people aged 50 or older. The nationwide study included Mexican Americans and non-Hispanic blacks and whites.

Overall, about 6 percent of people in the study had gum disease. It was most common in men, people without health insurance, those who had not gone to the dentist during the previous 6 months, people with diabetes, and smokers.

To examine the relationship between gum disease and income and education, the researchers divided the participants into groups based on whether they had graduated from high school as well as by annual income.

Blacks who had graduated from high school and who made at least $20,000 per year were significantly more likely to have gum disease than whites and Mexican Americans with similar levels of education and income, Borrell and her team report.

Among whites, people with higher income and more education were least likely to have gum disease. The pattern was a bit different in African Americans and Mexican Americans, however. In those groups, gum disease was least common in people with higher education but with a low income.

In fact, blacks with higher incomes were more likely to have gum disease than their lower-income counterparts, the study showed.

The study did not examine reasons for the differences. But according to Borrell and her colleagues, one possibility is that higher rates of gum disease among higher-income African Americans may be related to work-related stress and racism.

Source: American Journal of Public Health, May 2004.

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Vaccine Cuts Rates of Pneumonia, Meningitis

HealthDayNews

Tuesday, May 11, 2004

TUESDAY, May 11 (HealthDayNews) -- A vaccine on the market since 2000 has reduced the incidence of childhood pneumonia and meningitis, particularly among black Americans, according to a study in the May 12 issue of The Journal of the American Medical Association (news - web sites).

Blacks in the United States historically have had a higher incidence of the two diseases than whites. The widest disparities occur among children in the first two years of life and among adults 18 to 64 years old.

A new vaccine for children, Prevnar, was recommended in October 2000. Before the vaccine's release, blacks had a 2.9 times higher risk of contracting pneumonia and meningitis than whites; afterwards, that risk dropped to 2.2 times higher, according to the study by the U.S. Centers for Disease Control and Prevention (news - web sites).

The risk among black children younger than 2 dropped from 3.3 times higher than white children to 1.6 times higher.

Researchers found that from 1998 to 2002, annual disease rates decreased from 19 to 12.1 cases per 100,000 among whites and from 54.9 to 26.5 cases per 100,000 among blacks.

The report jibes with another recent study that found infants inoculated with Prevnar were less likely to spread the pneumococcal germ to their parents and siblings.

More information

The Immunization Action Coalition has more about pneumococcal conjugate vaccine.

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Parents Affect Risk of Heart Attack and Stroke

Reuters Health

Tuesday, May 11, 2004

NEW YORK (Reuters Health) - Even after accounting for well known risk factors, a person's chance of having a heart attack or stroke seems to depend on whether their parents experienced such problems, new research shows.

Although several reports have linked parental cardiovascular disease (CVD) with CVD in their children, it was unclear if the relationship held true after considering other risk factors like smoking, according to the report in the Journal of the American Medical Association (news - web sites).

To investigate, Dr. Christopher J. O'Donnell, from the National Institutes of Health (news - web sites) in Bethesda, Maryland, and colleagues analyzed data from 2302 subjects who enrolled in the Framingham Offspring Study. When the study began, the participants were an average of 44 years and all were free from CVD.

During 8 years of follow-up, 164 men and 79 women experienced a heart attack or stroke. Having at least one parent with CVD raised the risk of such events by up to twofold. The highest risks were seen when the parent's CVD occurred at a relatively young age: younger than 55 years for the father and younger than 65 years for the mother.

Considering parental information may help doctors and patients decide which interventions are warranted to prevent CVD, the authors note. "These data also support further research into genetic determinants of cardiovascular risk."

Source: Journal of the American Medical Association, May 12, 2004.

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Soap Can Protect Those With Peanut Allergies

HealthDayNews

Tuesday, May 11, 2004

TUESDAY, May 11 (HealthDayNews) -- Good news if you're allergic to peanuts -- most soaps and household cleaners will remove enough allergen from hands and dining surfaces to prevent an attack.

However, dishwashing liquid and alcohol-based hand sanitizer left trace amounts of peanut allergen on hands and tables, says a study by Johns Hopkins Children's Center in the May issue of the Journal of Allergy and Clinical Immunology.

Doctors found the failure of hand sanitizer most troubling, since many teachers find it more convenient to use the gel rather than sending children to the bathroom to wash up.

"Their use may not really remove the allergen, but just spread it around," pediatric allergist Dr. Robert A. Wood said in a prepared statement.

In the study, researchers applied a teaspoon of peanut butter to the hands of 19 allergy-free volunteers. Hand wipes, liquid soap, bar soap, plain water and a hand sanitizer were tested, with only the sanitizer failing to remove the allergen.

Researchers also compared the performance of plain water, dishwashing liquid, Formula 409 cleaner, Lysol sanitizing wipes and Target-brand household cleaner with bleach in removing peanut butter from a clean table. Only dishwashing liquid failed.

"It's possible that dish soap creates a film over eating surfaces, making it difficult to clean underneath," Wood said. "But our results suggest that even if a child licked the table vigorously after it had been cleaned with dish soap, he probably still couldn't get enough allergen to cause a reaction."

More information

The Food Allergy and Anaphylaxis Network has more about food allergens.

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Echinacea Does Little to Prevent Colds: Report

By Alison McCook

Reuters Health

Tuesday, May 11, 2004

NEW YORK (Reuters Health) - Stocking your medicine cabinet with Echinacea may be a waste of time, as a new study shows the herbal medicine does not help prevent colds.

After exposing 48 healthy adults to a virus that causes the common cold, U.S. investigators found that people who took Echinacea were no less likely to develop colds than people who took an inactive placebo pill.

Consequently, people may be better off leaving Echinacea off of their grocery list, study author Dr. Steven Sperber of Hackensack University Medical Center in New Jersey told Reuters Health. "Echinacea did not prevent infection with the cold virus," he said.

The research was funded by the German company Madaus Aktiengesellschaft, which sells the Echinacea product used in the current study.

In the U.S. alone, consumers spend more than $300 million each year on Echinacea products, for the purpose of preventing and treating colds.

However, recent research has also cast doubt on whether the herbal preparation can treat colds. A study published last year found that children who took Echinacea as soon as they developed a cold showed no difference in the severity or duration of cold symptoms than children who took a placebo pill. (http://nccam.nih.gov/health/alerts/echinacea/index.htm)

To test the benefits of Echinacea in preventing colds, Sperber and his team asked 48 adults to inhale a strain of rhinovirus, a group of viruses that causes approximately 40 percent of colds in adults.

As described in the journal Clinical Infectious Diseases, half the participants took Echinacea pills for 7 days before being exposed to the virus and for 7 days after, while the others took a placebo pill over the same time period.

More than 90 percent of participants became infected with the virus. Although slightly fewer people taking Echinacea developed colds, statistical calculations showed that the difference could have been due to chance.

Similarly, although people taking Echinacea appeared to have fewer symptoms than the placebo group, those differences were also too small to rule out the effect of chance, the authors report.

Sperber noted that although Echinacea may not help prevent or treat colds, none of the people who took it reported any side effects linked to the medication. However, he added that people who take herbal products should be aware that they can interact with prescription medications.

Sperber added that additional experiments that include larger numbers of participants are likely needed to establish whether Echinacea can at least help reduce cold symptoms.

Clinical Infectious Diseases, May 15, 2004.

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Reducing the Odds of Breast Cancer

HealthDayNews

Tuesday, May 11, 2004

TUESDAY, May 11 (HealthDayNews) -- Doctors have found a molecular indicator in breast cancer tumor cells that could become a reliable way of predicting whether cancer will recur in a patient.

A specific pattern of molecular abnormalities in the cells appears to almost double the risk of a patient suffering cancer again, says a study published in the May issue of Clinical Cancer Research.

The study involved the examination of a decade's worth of tumor samples, collected from patients who underwent cancer surgery between 1990 and 2001.

The researchers hope that by finding a way to predict the long-term risk of cancer recurrence, they will reduce the number of women who have to go through adjuvant chemotherapy. Adjuvant therapy is a follow-up measure done after the main procedure to make sure all microscopic traces of cancer in the body are eradicated.

"The ability to identify patients who are at such a low risk of recurrence that they can safely forego the discomfort and potential complications of adjuvant therapy would be a major breakthrough," study co-author Dr. Thomas Julian, associate director of the Breast Care Center at Allegheny General Hospital in Pittsburgh, said in a prepared statement.

More information

The National Institutes of Health (news - web sites) have more about adjuvant chemotherapy.

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Study: Small Doses of Caffeine Best to Stay Awake

Reuters

Tuesday, May 11, 2004

CHICAGO (Reuters) - Small, frequent doses of caffeine are best for truck drivers, doctors and others who need to stay awake over a long period of time, according to a U.S. study published Tuesday.

The regular doses of caffeine build up to counteract the body's natural desire for sleep and builds up the more one stays awake, the study said.

Small, frequent doses are more effective than a large jolt of caffeine in the morning, which wears off just as the body begins to feel the need for sleep, according to the study's lead author, James Wyatt.

"Most of the population is using caffeine the wrong way by drinking a few mugs of coffee or tea in the morning, or three cups from their Starbucks grande on the way to work," Wyatt, laboratory director of the Sleep Disorder Center at Rush University Medical Center in Chicago, said in a news release.

"This means that caffeine levels in the brain will be falling as the day goes on," he said. "Unfortunately, the physiological process they need to counteract is not a major player until the latter half of the day."

That process is the system that builds up the appetite for sleep. Caffeine is thought to block the receptor for adenosine, a critical chemical messenger involved in the body's drive for sleep, the report said.

Researchers at Rush, along with others at Brigham and Women's Hospital in Boston and Harvard Medical School (news - web sites), studied men in private suites who had no way of knowing what time it was for 29 days.

The men were scheduled to stay awake nearly 29 hours straight, simulating the amount of time some doctors, military and emergency services personnel have to up.

Those who were given a caffeine pill every hour equivalent to the caffeine in two ounces of coffee did better on tests than those who received an inert placebo, the study said. The subjects who took the caffeine pill also felt sleepier than the others when bedtime finally arrived, it said.

The research was published in the May issue of SLEEP, the journal of the Associated Professional Sleep Societies.

"While there is no perfect substitute for sleep, our results point the way toward a much better method for using caffeine in order to maintain optimal vigilance and attention, particularly when someone has to remain awake longer than the traditional 16-hour wake episode," Wyatt said.

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Health Tip: Why Older People Bruise Easily

 

HealthDayNews

Tuesday, May 11, 2004

(HealthDayNews) -- Have you wondered why the older you get, the more easily you seem to bruise?

Aging and sun damage weaken tiny veins in the skin, which are easily broken. This causes bruises to develop more easily, and the bruises take longer to heal than when you were younger, according to the U.S. Army Medical Department.

The black-and-blue color of bruises is the result of blood seeping from the veins into skin tissue. Without a fresh supply of oxygen, the blood turns dark blue. The blood will keep seeping until the tissue is saturated or the vein constricts.

Anticoagulant medications can react with aspirin and other drugs to cause easy bruising. And in some people, aspirin alone will increase bruising.

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Monday, May 10, 2004

 

PSA Test a Thing of the Past?

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, May 10, 2004

MONDAY, May 10 (HealthDayNews) -- The PSA test, long the gold standard for deciding who should have a biopsy for prostate cancer, may have outlived its usefulness for the most part.

Stanford University researchers say PSA (prostate specific antigen) levels bear little relationship to the severity of a cancer these days. They presented their finding May 9 at the American Urology Association's annual meeting in San Francisco.

"We need to recognize that PSA is no longer a marker for prostate cancer," said study author Dr. Thomas A. Stamey, a professor of urology at Stanford University School of Medicine. "We urgently need to find a new marker for prostate cancer, and that marker must be proportional to how much cancer you have."

"We have been so thorough and effective in screening for prostate cancer over this 20-year period that PSA no longer has a relationship to prostate cancer," Stamey said. "Because we all develop the cancer, we're now removing prostates from men whose cancer is so small that they do not need the procedure. We're finding all these little cancers that are never going to be a danger to the patient."

"In smaller cancers, the PSA test is not relevant anymore," Stamey explained. "You might as well biopsy a man because he has blue eyes."

PSA is a protein produced by the cells of the prostate gland. Because blood levels of the antigen tend to rise as the gland enlarges, it has been used for years as a test of whether a person needs a biopsy for cancer. The test, however, is not foolproof.

"People's perceptions [are] that if your PSA is a certain level, you're very likely or you do have prostate cancer, and that is incorrect," said Dr. Mark Soloway, chairman of the department of urology at the University of Miami School of Medicine.

"The PSA test is a very good test. It's not a perfect test, especially in younger men," added Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in New Orleans.

To see how the efficacy of the PSA test might have waned, researchers in Stamey's lab reexamined every prostate that had been removed since 1983 (1,317 of them) and compared the size of the cancer with blood PSA levels. None of the cancers had been treated with chemotherapy, radiation, or hormones before surgery.

Each cancer was rated on eight or 10 different parameters thought to indicate how aggressive the cancer was, including the size of the tumor and its grade.

Stamey then divided the samples into four five-year periods to see what had happened to the qualities of the cancers over time.

"What we showed was that in the first five years, the cancers were related to the level of serum PSA," Stamey said. "Then in the next five years, they were still bad but not as bad as the first five years. Then in the third five-year period, they were better and better. And in the last five years ending Jan. 1 of this year, the cancers were so small they had no relationship to serum PSA."

Twenty years ago, 80 percent of cancers were detected by digital rectal examination; only 20 percent of cancers are now detected that way, Stamey explained.

Instead, PSA levels today are driven by benign enlargement of the prostate, a condition that does not usually require surgery.

The concept that the PSA test is not foolproof is not an entirely new one. "The point is well taken that in microscopic disease, the volume of cancer is clearly overshadowed by the volume of noncancer, so that the cancer cannot be the cause of the elevated PSA," said Dr. John Phillips, physician-in-charge of urologic oncology at Beth Israel Medical Center in New York City.

The question now is what can replace it. "People are trying to find other ways of finding cancer," Phillips added.

As a matter of fact, University of Pittsburgh researchers who presented at the same conference reported that additional testing for a protein called early prostate cancer antigen (EPCA) might mean prostate cancer could be detected as many as five years earlier than with just the PSA test.

"We would like a perfect test that would only find biologically significant cancers," Soloway said. "Today we can't distinguish between those with indolent cancer and those whose cancers threaten their life. We need another way. That's going to be a difficult task."

In the meantime, the American Urological Association issued a statement that, for the time being, the PSA test in combination with a digital rectal exam and a full medical history is the best way to determine when a biopsy might be necessary.

More information

The National Cancer Institute (news - web sites) has more on the PSA test while the American Urological Association has more on prostate cancer screening.

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Discoveries Show How Obesity Kills

 

By Daniel Q. Haney

AP Medical Editor

The Associated Press

Monday, May 10, 2004

Research into the biology of fat is turning up some surprising new insights about how obesity kills. The weight of the evidence: It's the toxic mischief of the flesh itself.

Experts have realized for decades that large people die young, and the explanation long seemed obvious. Carrying around all those extra pounds must put a deadly strain on the heart and other organs.

Obvious but wrong, it turns out. While the physical burden contributes to arthritis and sleep apnea, among other things, it is a minor hazard compared to the complex and insidious damage wrought by the oily, yellowish globs of fat that cover human bodies like never before.

A series of recent discoveries suggests that all fat-storage cells churn out a stew of hormones and other chemical messengers that fine-tune the body's energy balance. But when spewed in vast amounts by cells swollen to capacity with fat, they assault many organs in ways that are bad for health.

The exact details are still being worked out, but scientists say there is no doubt this flux of biological crosstalk hastens death from heart disease, strokes, diabetes and cancer, diseases that are especially common among the obese.

"When we look at fat tissue now, we see it's not just a passive depot of fat," says Dr. Rudolph Leibel of Columbia University. "It's an active manufacturer of signals to other parts of the body."

The first real inkling that fat is more than just inert blubber was the discovery 10 years ago of the substance leptin. Scientists were amazed to find that this static-looking flesh helps maintain itself by producing a chemical that regulates appetite.

Roughly 25 different signaling compounds — with names like resistin and adiponectin — are now known to be made by fat cells, Leibel estimates, and many more undoubtedly will be found.

"There is an explosion of information about just what it is and what it does," Dr. Allen Spiegel, director of the National Institute of Diabetes and Digestive and Kidney Diseases, says of fat. "It is a tremendously dynamic organ."

Fat tissue is now recognized to be the body's biggest endocrine organ, and its sheer volume is impressive even in normal-size people. A trim woman is typically 30 percent fat, a man 15 percent. That is enough fuel to keep someone alive without eating for three months.

The fat cell's main job is to store our excess calories as fat. When people grow obese, their fat cells swell with fat and can plump up to three times normal size. As very overweight people get fatter still, they may also layer on many more fat cells.

The problem is the volume of chemicals these oversize cells churn out, says Dr. George Bray of Louisiana State University. "The big cell secretes more of everything that it secreted when it was small. When you get more of these things, they are not good for you."

Many scientists are trying to learn exactly what these excess secretions do that is so harmful. The answers will help explain — and perhaps offer solutions to — the real tragedy of the obesity epidemic, its disastrous effect on health.

Obesity is a huge and growing killer, in the United States just slightly behind smoking. Moderately obese people live two to five years less than normal-size folks. For the severely obese, the reduction in life span may be five to 10 years.

By far the biggest single threat of obesity is heart disease. Someone with a body mass index over 30 has triple the usual risk. Scientists can visualize many ways that fat cells' chemical flood contributes to heart attacks, heart failure and cardiac arrest.

For instance, it has long been known that weight increases blood pressure. Once doctors thought this was a matter of physics, the force needed to push blood through the many more yards of blood vessels that nourish the extra flesh.

But now it is clear that fat can trigger high blood pressure by making blood vessels narrow in several chemical ways. For instance, it produces a substance called angiotensinogen that is a powerful constrictor. At the same time, it stimulates the sympathetic nerves to squeeze the circulatory system. And that may just be the beginning.

"It's a very complicated system, and the more we learn about it, the more complicated it becomes," says Dr. Xavier Pi-Sunyer, head of obesity research at St. Luke's Roosevelt Hospital Center in New York City.

One of the clearest hazards of overfilled fat cells is their influence on the body's production and use of insulin, the hormone that instructs the muscle to burn energy and the fat cells to store it. Oversize fat cells blunt the insulin message, in part by leaking fat into the bloodstream. So the liver must compensate by making more insulin and other proteins.

Scientists now understand that increasing insulin levels — part of a condition called insulin resistance — are particularly harmful. They can directly damage the walls of arteries and lead to clogging.

That leaking fat may also infiltrate the heart muscle, contributing to congestive heart failure. Misplaced deposits of fat can also ruin the liver and have become the second-leading reason for liver transplants after hepatitis B.

Fat cells churn out a variety of proteins that cause inflammation, too. These may be especially destructive to the gunky buildups in the arteries, causing them to burst and triggering heart attacks and strokes.

These inflammatory proteins and other fat-driven chemicals, such as growth hormones, may also contribute to one of the less appreciated consequences of obesity — cancer.

"There is now conclusive evidence that obesity causes some cancers and strong evidence that it contributes to a wide variety of others," says Dr. Michael Thun, epidemiology chief at the American Cancer Society (news - web sites).

The cancer society estimates that staying trim could eliminate 90,000 U.S. cancer deaths a year. Among the varieties most clearly linked to weight are cancer of the breast, uterus, colon, kidney, esophagus, pancreas and gallbladder.

The best evidence of how obesity causes malignancy is in breast cancer in older women. When the ovaries shut down after menopause, fat tissue becomes the primary producer of estrogen, which in turn can fuel the growth of breast tumors.

The heavier women are when diagnosed with breast cancer, the more likely they are to die from the disease, says Dr. Michelle Holmes of Boston's Brigham and Women's Hospital. "Presumably it's because their cancers are dependent on estrogen, and heavier women have more estrogen."

Still, big ticket killers like heart disease and cancer only start the long list of obesity's health ills. Among other things, obese people are more prone to depression, gallstones, even dying when in car accidents.

Says Dr. Michael Jensen of the Mayo Clinic, "There are so many ways that obesity can kill you."

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

On the Net:

http://obesityresearch.nih.gov/

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Gonorrhea Ups Risk of Prostate Cancer

 

HealthDayNews

Monday, May 10, 2004

MONDAY, May 10 (HealthDayNews) -- Men who have had gonorrhea are more likely to be diagnosed with prostate cancer, says new research from the University of Michigan Health System.

Having more than 25 sexual partners in a lifetime also increases the odds of prostate cancer more than 2.5 times, compared to men with five or fewer sexual partners, according to the study presented May 9 at the annual meeting of the American Urological Association in San Francisco.

The conclusions are part of the Flint Men's Health Study, which surveyed black men aged 40 to 79 who live in Flint, Mich. The study sought to explain why black men are twice as likely as white men to develop prostate cancer and twice as likely to die from the disease.

About 65 percent of men with prostate cancer reported having had gonorrhea, compared to 53 percent of men without prostate cancer.

"Although we are unable to show that gonorrhea directly causes prostate cancer, we suspect the inflammatory effect of the gonorrhea infection may trigger preexisting cancerous cells to multiply," lead author Aruna Sarma, an assistant research scientist at the Univerisity of Michichan Medical School, said in a prepared statement.

More information

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

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Childhood Ear Infections Predict Asthma

 

Reuters Health

Monday, May 10, 2004

NEW YORK (Reuters Health) - A history of ear infections during childhood appears to raise the risk of asthma later in life, new research suggests.

"The (rate) of ear infections has increased significantly over the years, paralleling the rise in asthma rates," lead author Kamal Eldeirawi, from the University of Illinois at Chicago, said in a statement. "Our study confirms the association between the two conditions."

The findings, which appear in the medical journal Chest, are based on data from 7538 children who participated in the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. Participants or their proxies were surveyed to assess ear infection and asthma histories.

Children with a history of ear infections were 57 percent more likely than other children to be diagnosed with asthma and 70 percent more likely to have had wheezing in the previous year, the investigators note. Moreover, the risk of asthma and wheezing increased as the number of ear infections rose.

Factors associated with an increased risk of ear infection included non-Hispanic white ethnicity, higher parental education level and smoking during pregnancy.

According to Eldeirawi, the link with higher parental education may be due to such parents being more likely to enroll their children in daycare centers, a well-known risk factor for recurrent ear infections. However, it is also possible that higher education means better access to healthcare and, therefore, such cases are simply more likely to be diagnosed and reported.

So how might childhood ear infections lead to asthma? "Specific viruses or bacteria that cause recurrent ear infections may play a major role in the development of asthma," Eldeirawi noted. "It is also possible that antibiotics that are commonly used to treat ear infections increase the risk of asthma, but more research is needed in this area."

Source: Chest, May 2004.

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Macular Degeneration Linked to Shorter Life Span

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Monday, May 10, 2004

MONDAY, May 10 (HealthDayNews) -- People who develop age-related macular degeneration tend to die earlier than those who don't get the vision-robbing disease, a new study reports.

Why this happens isn't known, but experts suspect eye problems such as age-related macular degeneration (AMD) and cataracts may be a sign of early aging or other pervasive systemic health problems, such as heart disease.

"This study confirms what other studies have shown, that people who have cataracts are more likely to die than people who don't," said lead researcher Dr. Frederick L. Ferris III, clinical director of the National Eye Institute. "A new finding is that the same is true for AMD."

AMD is the loss of central vision due to changes, often related to aging, in the macula, which is the back portion of the retina responsible for clear, sharp vision. This central vision is used for "straight-ahead" activities such as reading, sewing and driving.

Ferris and his colleagues collected data on people who participated in the Age-Related Eye Disease Study. This research included 4,753 people, aged 55 to 81. Some of the subjects were randomly assigned to receive high-dose antioxidants, zinc, antioxidants plus zinc or a placebo.

During a period of 6.5 years, 534 patients died, according to the report in the May issue of Archives of Ophthalmology.

The research team found people with AMD had about a 41 percent increased risk of death compared with those without AMD. In addition, the deaths of those with advanced AMD were mostly from heart disease.

Patients with poor vision had about a 36 percent increased risk of death; and those who had cataract surgery had a 55 percent increased risk, Ferris's group found.

Those patients who received zinc had a 27 percent lower mortality rate, compared with those who did not receive the mineral.

Ferris said the findings might indicate that people with AMD are aging faster than those without AMD; they may also indicate other ongoing disease.

"There is nothing here that says that if you have AMD or a cataract you are about to die," Ferris cautioned. "But this finding may be useful in understanding the aging process."

As for the association of zinc with longer life, Ferris couldn't explain the possible connection. "It may be a chance finding," he said.

Dr. Stephen R. Russell is an associate professor of ophthalmology at the University of Iowa. "We have known for a long time that patients with AMD have higher incidence of cardiovascular disease, and they are also weaker than normal," he said.

Why this is the case isn't known, he added, "but it does go along with the idea that there is general systemic disease."

Another study in the journal confirms research that sunlight has no effect on the development of macular degeneration.

In this study, researchers collected data on the association between sunlight exposure and sunlight sensitivity and the incidence of AMD in people aged 43 to 86 who participated in the so-called Beaver Dam Eye Study. Of all the subjects, 3,684 were followed for five years, and 2,764 were followed for 10 years.

"We failed to find any relationship between light exposure and AMD," said lead researcher Dr. Ronald Klein, a professor of ophthalmology and visual sciences at the University of Wisconsin Medical School.  

"Although there is not a strong association between light exposure and AMD, there seems to be some evidence that earlier sunlight exposure may increase the risk of developing signs of AMD," he said, but he added he's not sure why that's the case.

Klein's team found that people who reported more than five hours of sun exposure a day during their teens, 30s and at the beginning of the study were more than three times likely to develop early stages of AMD within 10 years.

And those who reported more than 10 severe sunburns during their youth were 2.5 times more likely than those who experienced one or no sunburns to develop AMD within 10 years, the researchers found.

Klein said the study found no relationship between UV-B ray exposure, winter leisure time spent outdoors, skin sun sensitivity and the risk for AMD.

Since the findings weren't consistent, Klein said, he wasn't able to draw any definitive conclusions about exposure to sunlight and the risk of developing AMD.

Russell added, "This has been a controversy for several decades."

However, he agreed with Klein that light exposure is not related to the development of AMD. "Sunlight gets a bad rap," he said.

"Rather, AMD is probably a systemic disease, which is not directly related to light exposure," Klein said.

More information

The National Eye Institute can tell you more about age-related macular degeneration. The Foundation Fighting Blindness has information about vision problems.

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Pregnancy Thyroid Testing Being Debated

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, May 10, 2004

WASHINGTON - Even a mildly underactive thyroid — too mild for symptoms — may cause serious problems during pregnancy, such as premature birth or babies born with lower IQs.

Yet whether to test every pregnant woman's blood for thyroid deficiency is controversial.

Now specialists have come up with a compromise: a call to test women who are at high risk for thyroid disease, before they conceive or when they are in very early pregnancy, while pushing for major studies to settle whether even more should be checked.

Who's at high risk? women who have thyroid disease in the family, or who themselves have a history of thyroid problems or other autoimmune disorders such as Type 1 diabetes, rheumatoid arthritis or lupus, says the American Thyroid Association.

"There are a lot of women being missed currently who would fall in these categories," says Dr. Gregory Brent of the University of California, Los Angeles, who helped lead an ATA-called meeting last month on the issue.

The thyroid, a bow tie-shaped gland in the neck, produces hormones that regulate metabolism and stimulate almost every type of tissue.

An overactive thyroid increases heart rate and blood pressure, and can cause weight loss, depression, confusion and vision problems.

Far more common is an underactive thyroid — hypothyroidism — that can slow body functions. Symptoms are often vague: fatigue, weight gain, depression, forgetfulness, a hoarse voice, dry skin, mood swings, intolerance to cold.

Overt thyroid disease increases the risk of heart disease, bone-thinning osteoporosis and infertility. Fortunately, it's easily treated, and people with symptoms are supposed to get a simple $25 blood test for diagnosis.

But some people have a mildly underactive thyroid that hasn't yet caused symptoms — only blood testing can detect it — and that's the crux of the pregnancy debate.

A 1999 study found that untreated hypothyroidism in pregnancy increases the risk of having children with lowered IQs — even if the mother has no symptoms. Thyroid hormones are important for brain development, and in the first trimester, the fetus depends solely on the mother for them.

Now a new study shows those asymptomatic women are almost twice as likely to have premature babies.

Researchers at the University of Texas Southwestern Medical Center tested more than 17,000 women seeking routine prenatal care, and found 4 percent of the 404 with asymptomatic hypothyroidism delivered prematurely — compared with 2.5 percent of women with normal thyroids. Prematurity might explain the lower-IQ link, says lead researcher Dr. Brian Casey, who presented his results at last month's thyroid meeting.

Obstetricians say there isn't enough evidence yet to warrant testing all 4 million-plus pregnant women each year to find the roughly 2.5 percent thought to have asymptomatic hypothyroidism.

No one yet knows if treating those women reduces the risks, Casey stresses. Because crucial brain development occurs so soon after conception, "identifying women in pregnancy may be identifying them too late to have an impact," he cautions.

Plus, hormone levels fluctuate during pregnancy, so there's even debate about how to analyze women's tests.

But with potentially thousands affected, the American Thyroid Association is pushing the government to fund such research now. Already, British scientists have begun testing 22,000 pregnant women to see if the resulting children of those treated for asymptomatic thyroid deficiency have better brain function. Results will take years; checking an impact on premature birth could be done more quickly.

Meanwhile, in addition to preconception or early pregnancy thyroid testing for high-risk women, the ATA advises:

_Women already diagnosed with hypothyroidism need additional testing during pregnancy, because they may need a 30- to 50-percent higher dose of thyroid hormone.

_Pregnant women should ensure their prenatal vitamins contain iodine, important for proper thyroid function. New research shows about a third of prenatal vitamins contain no iodine, and few of the rest contain a full dose. Pregnant and nursing women need 220 to 290 micrograms a day, more than the 150 required for other adults.

Most Americans get enough iodine, which is commonly added to salt, but studies suggest intake is dropping and no one knows how much pregnant women get. Iodine also is found in seafood, dairy products and bread.

Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

American Thyroid Association: http://www.thyroid.org

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Botox Treats Bladder Problems

 

HealthDayNews

Monday, May 10, 2004

 

MONDAY, May 10 (HealthDayNews) -- Some say botox will keep your face looking young, but evidence continues to grow that it will keep your bladder fit as well.

Botox injections have become a promising new treatment for a variety of lower urinary tract dysfunctions, according to a study presented May 9 at the annual meeting of the American Urological Association in San Francisco.

Dr. Michael Chancellor of the University of Pittsburgh School of Medicine has used botox since 1998 to treat 110 patients suffering a variety of bladder dysfunctions. The dysfunction cause all of them to experience incontinence, unable to hold their urine or completely empty their bladders.

About 67 percent of the patients reported a decrease or absence of incontinence after receiving the botox injections, Chancellor said. The decrease happened within seven days of treatment and lasted about six months.

Treatment involves injecting botox into the muscle that controls the bladder. The botox weakens the muscle and alleviates involuntary contractions, restoring normal bladder function.

More information

The American Foundation for Urologic Disease has more about bladder dysfunction.

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Study Finds More Evidence Cigars Not a Safe Smoke

 

Reuters Health

Monday, May 10, 2004

NEW YORK (Reuters Health) - Puffing on one cigar may be enough to harden the body's main artery for hours afterward, a small study shows. Researchers say the findings add to evidence that, far from being a "safe" alternative to cigarettes, cigars increase the risk of cardiovascular disease.

The study of 12 healthy men who smoked cigarettes and cigars found that shortly after smoking a cigar, the men showed evidence of greater stiffness in the aorta, the main artery carrying blood from the heart to the rest of the body. The degree of stiffness in large arteries is key in how well the heart's main pumping chamber can work and blood can flow.

The new findings provide the first evidence that cigar smoking immediately increases stiffness in large arteries, according to the study authors, led by Dr. Charalambos Vlachopoulos of Athens Medical School in Greece. They report the findings in the American Journal of Hypertension.

Tobacco use in its various forms has long been known to carry serious health risks. Yet there's been a popular perception that cigars, which enjoyed a surge in popularity starting in the 1990s, offer a safer way to smoke.

But research shows that cigar smoking does boost the risk of heart disease, stroke and several types of cancer, including lung and oral cancers.

In the new study, the researchers used a measure called pulse wave velocity to gauge aortic stiffness in 12 young, male smokers for two hours after they smoked a cigar, and after they puffed on an unlit cigar.

The men's aortic stiffness increased "promptly" after they smoked the cigar and stayed elevated for the two-hour study period, according to Vlachopoulos and his colleagues.

It's unclear what these immediate effects mean for the long term, the researchers point out. But, they add, hours of daily arterial hardening over time would "logically" put a burden on heart and artery function.

This study, they conclude, "provides further evidence that cigar smoking increases cardiovascular risk, and fights the promoted perception that cigars are innocuous alternatives to cigarettes."

Source: American Journal of Hypertension, April 2004.

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Scientists Find New Way to Attack TB

 

The Associated Press

Monday, May 10, 2004

MADISON, Wis. - Researchers at the University of Wisconsin-Madison have discovered a new way to attack tuberculosis, which could lead to more effective antibiotics.

The research, appearing Monday in the online edition of the journal Nature Structural & Molecular Biology, has taken four years.

TB remains a deadly disease and antibiotics used to treat it are losing their effectiveness.

Lead scientist Laura Kiessling said the TB bacteria divide and reproduce frequently, finding new ways to outsmart the antibiotics and stay alive.

"Bacteria have all kinds of different ways to get around the antibiotics," Kiessling said. "They've even changed so they have pumps that pump the drugs out."

Kiessling, a UW-Madison chemistry professor, and other researchers discovered how an enzyme and vitamin work together to build a multilayered cell wall around the bacteria. That discovery will allow drug manufacturers to design medicine that inhibits that chemical partnership.

"We've figured out how the enzyme works," Kiessling said. "Because we understand the mechanism better, we can design inhibitors of the enzyme."

The same enzyme, Kiessling said, is found in numerous other diseases, including African sleeping sickness, malaria, and leprosy. But it is the promise of new and more effective treatments for TB that is most significant.

It could take years and millions of dollars to bring the discovery to market, but the science is now there for development of the drugs, Kiessling said.

Information from: Wisconsin State Journal, http://www.wisconsinstatejournal.com

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Most Cleaners Rid Surfaces of Peanut Allergen

 

By Alison McCook

Reuters Health

Monday, May 10, 2004

NEW YORK (Reuters Health) - For patients allergic to peanuts, it might take just trace amounts of peanut residue to trigger a deadly reaction. However, the environment can quite easily be made safe, as new research shows that most cleaners remove peanut allergens from surfaces.

After asking 19 adults who had no allergies to peanuts to touch peanut butter, U.S. investigators found that handwashing with liquid soap, bar soap or commercial wipes removed all traces of Ara h 1 -- the main substance in peanuts that triggers allergic reactions.

Washing with plain water removed Ara h 1 from three-quarters of hands. Using antibacterial hand sanitizer purged only one-half of hands of the allergen.

Study author Dr. Robert Wood told Reuters Health that these results were "mostly reassuring."

His team also found that common household cleaners appeared to remove all traces of the allergen 1 from tabletops, and surveys of six schools and preschools did not turn up any Ara h 1 on the surfaces of desks or cafeteria tables.

Wood said that he and his colleagues were overall "very impressed by the ability of most cleaning products to remove peanut allergen, and by the lack of peanut allergen in schools."

Ara h 1 was found on 1 out of 13 tested water fountains. Wood thought that this may have resulted from a child eating peanut butter and then drinking from the fountain.

Wood, who is based at Johns Hopkins Hospital in Baltimore, explained that he and his colleagues decided to conduct this study because Ara h 1 is capable of causing severe allergic reactions at very small doses, making it particularly important to understand if traces of the allergen linger in unsuspected places.

As part of the study, the researchers asked volunteers to clean peanut butter off of their hands using various cleaners, tested the environment of schools and preschools, and asked participants to eat peanut products in environments designed to mimic school cafeterias, sporting events, and airplanes.

Reporting in the Journal of Allergy and Clinical Immunology, the investigators found that while household cleaning products removed Ara h 1 from tabletops, washing with dishwashing liquid left traces of the allergen on 4 of 12 tables.

In the environments designed to simulate a cafeteria, sporting event and airplane, the researchers could find no sign of the allergen in the air after participants ate peanut butter, shelled peanuts or unshelled peanuts.

Wood noted that soaps and detergents are created to break down fats and proteins, and are consequently expected to be able to remove most foods from eating surfaces.

He noted that although dishwashing liquid did not rid every surface of the allergen, plates and utensils are probably safe from Ara h 1, since the combination of dishwashing liquid, scrubbing and rinsing with water will probably do the job.

However, Wood cautioned that people should use the right cleansers when washing their hands. "The amount of Ara h 1 left on hands after using an antibacterial gel might be able to cause a reaction," he said.

Source: Journal of Allergy and Clinical Immunology, May 2004.

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Experts: U.S. Not Only Obesity Contributor

 

By J.M. Hirsch

Associated Press Writer

The Associated Press

Monday, May 10, 2004

It's all America's fault, right? In the global give and take, it seems only fair that the blame for bloating the world go to the nation that gave it rivers of Coke, mountains of Big Macs and an endless fitness-quashing entertainment feed from Hollywood. But not so fast.

America may have led the world down a path lined with fast food and soft drinks that has left 1.7 billion people battling the bulge, but experts say there's plenty of blame to go around.

"America has been a contributing cause in what is a very complex disease," said Jim Mann, an expert on global obesity and nutrition professor at New Zealand's University of Otago. "But it is not the cause. Nothing is as simple as that."

The United States is a tempting scapegoat for the global obesity epidemic. Its worst behaviors and foods, even its language for them — Supersize me! Want fries with that? — have permeated the world's diet and lexicon.

Consumption has been glamorized by America and the world eagerly bought into that, said Neville Rigby, policy director for the International Obesity Task Force. Food has replaced cigarettes as the cool must-have American accessory.

This Westernization — in some circles, Americanization — of the global culinary landscape no doubt contributed to the fattening of the world. But many obesity experts say it's hard to know where to place the blame.

"What we're looking at is not solely an American phenomenon, but a transnational corporation phenomenon," Rigby said. "Of course, there are multinational corporations on both sides of the Atlantic."

Those companies certainly helped the spread of cheap fatty and sugary foods, but some experts say even blaming them may be unfair. Several decades ago, there was fear of a world food shortage.

"A lot of chief executives are really in a state of shock right now," said Andrew Prentice, an expert in international nutrition at the London School of Hygiene and Tropical Medicine.

"You have to have some sympathy. You can see their point, that they've produced this stuff cheaper and cheaper, feeding the world etc., and now suddenly we're all saying stop doing this, it's causing us a great deal of damage."

Much can be attributed to changes in how the world eats and works. Physical labor is declining and more people than ever are gaining unprecedented access to cheap, high-calorie food.

Though he doesn't doubt the power of America's food culture, or the appeal of junk food itself, Mann said those factors don't diminish individual choice. More people simply are choosing to eat like Americans.

"We could act independently, but we choose not to," he said.

Choice also applies to foreign governments, which Paul Zimmet, director of the International Diabetes Institute in Melbourne, Australia, said have played an equal role in allowing poor diets to become a health crisis.

Governments haven't done enough to make healthy foods affordable and physical fitness accessible, he said.

Barry Popkin, a leading scientist in the field of nutrition in developing countries, notes that in many parts of the world the United States isn't the only influence.

"American television gets a lot of the blame, but in some parts of the world the BBC dominates and people see how the British eat, not how the Americans eat," said Popkin, a nutrition professor at the University of North Carolina-Chapel Hill.

Even the growth in portion size, though certainly popularized by America, may have European roots. Rigby said the bigger-is-better mentality was exported to the United States from Central Europe, where it is associated with hospitality.

"You're being kind to people when you give them food," he said. "Give them more food. Give them extra."

Where most experts don't hesitate to blame the United States is on solutions.

Recently, the United States has been criticized for allegedly yielding to the food industry and trying to dilute a World Health Organization (news - web sites) health plan calling for less sugar and fat in people's diets.

"If I were to blame the United States for anything," Mann said, "I think it would be for the power of the food industry to influence government policy of the United States, which has been imposed worldwide."

Editor's Note: Medical Writer Emma Ross in London contributed to this report.

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Heart Surgery in Kids Linked to Stress Disorder

 

By Megan Rauscher

Reuters Health

Monday, May 10, 2004

NEW YORK (Reuters Health) - Children who undergo heart surgery are at increased risk for developing post-traumatic stress disorder (PTSD), particularly if they require more than 48 hours in the intensive care unit, new research shows.

As the name implies, PTSD involves psychologic stress that occurs after a traumatic event. Often, it occurs in people exposed to combat and other life-threatening situations.

The association with heart surgery "is of particular importance to doctors who manage these children before, during, and after surgery," lead investigator Dr. Dana Connolly, from New York University, told Reuters Health. "This places them in a unique position to identify risk factors and changes in behavior and to make appropriate recommendations for screening, intervention and referral."

Connolly and colleagues evaluated psychological responses to cardiac surgery for congenital heart defects, and the factors that influence such responses, in 43 children aged 5 to 12 years. The findings were reported in The Journal of Pediatrics.

Before surgery, none of the children had PTSD. After surgery, five children were diagnosed with PTSD and five had symptoms of PTSD, but not enough to be formally diagnosed with the disorder.

According to the team, the only predictor of PTSD was a stay in the intensive care unit (ICU) of more than 48 hours. "The fact that the (rate) of PTSD increases with length of ICU stay is an issue that doctors need to be aware of in terms of minimizing stressful procedures and expediting discharge from the ICU as soon as medically possible," Connolly added.

Co-author Dr. Michael Artman of NYU said in a statement that despite the relatively small number of patients, "it is impressive that roughly 1 in 10 children develop full blown PTSD after undergoing heart surgery." The findings, "clearly demonstrate the need for future research."

Source: The Journal of Pediatrics, April 2004.

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Food Makers Don't Fear Low-Carb Craze

 

By Ira Dreyfuss

Associated Press Writer

The Associated Press

Monday, May 10, 2004

CHICAGO - The public's fascination with low-carbohydrate diets has yet to remove the luster from pies, potatoes and other high-carb foods. Some makers of these products watched with interest, but not deep concern, as new low-carb foods — special breads, salad dressings, cereals and candies — grabbed a lot of attention at the Food Marketing Institute's recent trade show.

People like comfort food and will keep eating cake and pie for dessert, even while watching the carbs in other parts of their diet, said Matt Hall, a Sara Lee spokesman.

"You could call it maybe mental health," said Hall, who stood near his company's display of noncarb-reduced baked goods. The attitude is, "I've worked really hard; I deserve something."

The low-carb diet trend seems to have lots of followers. In a survey last month, 12 percent of adults telephoned at random said they were on a low-carb diet while an additional 32 percent said they were making attempts to restrict their carbohydrates, said Larry Shiman of Opinion Dynamics of Cambridge, Mass.

Shiman presented his firm's data at a conference in Washington that was organized by LowCarbiz, a trade publication.

Low-carb foods are a small fraction of the overall market, and promoters of higher-carb products expect their sales to be strong.

Sara Lee's noncarb-reduced products are getting a piece of the pie.

Some new offerings have seen double-digit increases in sales and buyers include people who are watching their carbs, Hall said. Unless low-carb shoppers are sticking to a strict diet, "they are not divorcing themselves from indulgent products," he said.

Sales of other high-carb staples also are growing.

Shoppers bought about 4.6 billion pounds of potatoes in 2003, 2.6 percent more than 2002, said Tim O'Connor, president and chief executive officer of the U.S. Potato Board, a Denver-based association of growers and handlers.

All is not good for potatoes, however. French fry sales have been soft, reflecting a consumer aversion to fats as well as carbohydrates. But they, too, are beginning to recover, O'Conner said.

In the 1990s, food companies saw opportunity in low-fat diets and saturated the market with new low-fat or no-fat products. People who ate them often were not paying a lot of attention to calories.

"The problem is, consumers don't want to eat less calories, they just want to eat different foods that somehow magically they will lose weight on," said Frank Muir, president and chief executive officer of the Idaho Potato Commission, a state agency that promotes the crop.

Low-carb fans might find low-fat history repeating itself, Muir said.

"All the manufacturers, they are launching all these new food products," he said. "What that's telling you is, people are going to eat a whole lot of calories again."

The history of the low-fat diet also indicates that if people sour on low carbs, piemakers and fry cooks will still find some people shying from their products, Shiman said.

"Even though the idea of a low-fat diet is not nearly as in vogue as it once was, low-fat is part of our consciousness," he said. "I think something similar might happen with the low-carb diet."

Demand for new low-carb foods is still strong, with no other big diet trend on the horizon, said Gus Valen, chief executive officer of The Valen Group, a Cincinnati-based marketing consultant firm.

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Older Hearts Not So Great for Transplants

 

Reuters Health

Monday, May 10, 2004

NEW YORK (Reuters Health) - The greater the age of a heart donor, the more likely is the recipient to die after the procedure.

Nonetheless, very sick patients still fare better than they would by remaining on the waiting list, according to a report in the Journal of the American College of Cardiology.

Increasing demand for heart transplantation and a diminishing donor pool has led to greater use of older donors, the authors point out. Whether more liberal donor selection has affected transplant outcomes has been unclear.

Dr. Catherine Lietz and colleagues from Columbia Presbyterian Medical Center in New York investigated post-transplant outcomes in 479 adult heart transplant recipients, 28 percent of whom received organs from donors who were at least 40 years old.

The 30-day post-transplant mortality rate was 5 percent in recipients of hearts from donors less than 40 years old, the authors report, but it rose 2.5-fold (to 13 percent) in those receiving hearts from donors in their 40s. The mortality rate was 22 percent among those receiving hearts from donors over the age of 50 years.

However, the risk of death within 6 months from the time of enrolling on the waiting list for a heart was far higher among patients who did not receive a transplant than among those who did, the investigators note.

Overall the investigators conclude that "it is more beneficial in terms of patient survival to receive (a transplant) from a donor more than 40 years old than to remain on the waiting list."

In a related editorial, Dr. Howard J. Eisen from Temple University School of Medicine, Philadelphia, agrees, pointing out that "it is clear that these potential risks in older donors should not in any way dissuade transplant cardiologists and surgeons from using these hearts."

Source: Journal of the American College of Cardiology, May 5, 2004.

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Anemic Seniors Face Other Health Problems

 

HealthDayNews

Monday, May 10, 2004

MONDAY, May 10 (HealthDayNews) -- Older adults with anemia have less strength, more disabilities and poorer physical performance than older adults without anemia.

So says a Wake Forest University Baptist Medical Center study in the current issue of the Journal of the American Geriatrics Society.

"Our results suggest that anemia is a risk factor for disability, poor physical function and low muscle strength -- all which can threaten the independence of older adults," lead researcher Brenda Penninx said in a prepared statement.

"Physicians should be aware of their older patients' anemia status, even if there is no apparent disease," she said.

She and her colleagues examined data from a study of 1,156 older adults in Italy.

"Participants with anemia reported an average of 1.7 disabilities, compared to an average of 1.0 for the non-anemic subjects," Penninx said.

People with anemia also had much less strength in their hand and knee muscles and scored lower on performance tests.

"Our research suggests that anemia deserves more attention. We need to learn whether treatment can help restore physical function or prevent a physical decline," Penninx said.

Anemia, a reduced level of oxygen-carrying red blood cells, affects about 13 percent of people over age 70. It has a number of causes, including iron or vitamin B-12 deficiencies and chronic diseases such as liver disease or cancer.

More information

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

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Brain Stimulation May Help Spinal Injury Patients

 

By Patricia Reaney

Reuters

Monday, May 10, 2004

LONDON (Reuters) - Stimulating an area of the brain with magnetic pulses may help patients with partial damage to their spinal cord improve muscle movement and feeling, scientists said Monday.

In a preliminary study of four partially paralyzed patients who had been injured more than 18 months or years earlier, repetitive transcranial magnetic stimulation (rTMS) improved the patients' ability to move and feel.

"Through rTMS we may be able to help people who have suffered partial injuries to the spinal cord recover some of their movement and feeling," said Dr Nick Davey, of Imperial College London and Charing Cross Hospital, who tested the method.

All of the patients in the study had incomplete spinal cord injuries. Their spinal cord had not been completely severed. Davey said the treatment is not suitable for patients with more severe injury because it does not repair the spinal cord.

"If you image the spinal cord as a blocked motorway, it helps to clear the block but if it is completely cut off, if the bridge has broken down, there is no way we can get through," Davey added in an interview.

He and his colleagues think the treatment works by strengthening the information leaving the brain through the undamaged neurons in the spinal cord, similar to the way physiotherapy repeats a physical movement.

"I think it is activating the same pathways in the brain as repeated movement," he said.

"It is exciting neurons in the brain in the same way you would if you made a natural movement."

The team of scientists gave rTMS and a placebo treatment to an area of the brain called the cerebral cortex of all of the patients. Their results are published in the journal Spinal Cord.

The patients received one hour a day of rTMS over five consecutive days and repeated the process with the placebo treatment. After each series, the researchers tested intracortical inhibition. If it is weak, it is easier for messages from the brain to pass to the spinal cord to the rest of the body.

rTMS reduced intracortical inhibition compared to the placebo treatment in the patients and improved movement and feeling.

Davey and his colleagues are now planning to extend their research to more patients and to study its impact on people with recent spinal injuries.

"Our gut feeling is that this tool ... is going to be more effective if you get the patients earlier," Davey added.

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Health Tip: Medication for Children

 

HealthDayNews

Monday, May 10, 2004

(HealthDayNews) -- Medication errors can occur at any age, but the consequences can be most grave when the mistake involves a child.

Here are some medication safety tips, courtesy of St. Louis Children's Hospital:

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AIDS-Related Skin Cancer Down Sharply, Study Finds

 

By Paul Simao

Reuters

Monday, May 10, 2004

ATLANTA (Reuters) - The number of HIV (news - web sites) patients with Kaposi sarcoma, a once-rare cancer that became a marker for AIDS (news - web sites) in the early days of the epidemic, has declined sharply due to the use of antiretroviral drugs, according to a European study released on Monday.

The annual incidence of the cancer fell 39 percent between 1994 and 2003, according to a study of nearly 10,000 people with HIV by the Royal Free and University College in London and a handful of other European hospitals and health centers.

Kaposi sarcoma first appears as a brownish-colored skin lesion, although it can also develop in the lungs, liver and other internal organs. Until AIDS surfaced in 1981, the cancer was seen primarily in elderly Mediterranean men.

It became one of the most common ailments plaguing AIDS patients in the 1980s.

But the introduction a decade later of highly active antiretroviral therapy (HAART) -- a treatment based on a combination of drugs -- gave doctors a powerful new weapon against the opportunistic diseases that killed many AIDS victims.

Anecdotal data and small studies had indicated Kaposi Sarcoma cases were declining as the new drugs suppressed levels of HIV in patients' blood and allowed their immune systems to recover.

The large European study was, however, the first conclusive indication of a link between the therapy and declining cases of Kaposi sarcoma. The findings were published in the May 10 online edition of the American Cancer Society (news - web sites) journal Cancer.

In their study, the Europeans noted that those with a higher current CD4 count -- a measure of immune system health -- or who had been on HAART therapy for a longer period of time had a decreased incidence of the cancer.

"This indicates that the current CD4 count remains one of the most important prognostic factors for Kaposi sarcoma, and patients who start HAART should experience a reduction in the risk of Kaposi sarcoma if the CD4 count starts to rise," the researchers said.

The good news was partly overshadowed by a significantly increased incidence of the disease among gay men and in patients from Central and Western Europe. Kaposi sarcoma makes up 6 percent of all AIDS-defining illnesses each year.

AIDS has killed more than 21 million people around the world, including about 500,000 Americans since 1981. About 40,000 Americans become infected with HIV every year.

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Health Tip: Household Mold

HealthDayNews

Monday, May 10, 2004

(HealthDayNews) -- If during your annual spring cleaning you find a suspicious dark spot, you can check to see if it's mold by dabbing the spot with a small amount of chlorine bleach. If the color changes or disappears, the stain is likely mold, says Health Canada.

If you do find mold:

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Sunday, May 9, 2004

 

Fish Still a Good Health Bet

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Sunday, May 9, 2004

SUNDAY, May 9 (HealthDayNews) -- Every so often, Americans get wind of some report that calls into question the safety of the nation's fish supply.

For years, people have heard about the dangers of eating fish contaminated with PCBs, a group of cancer-causing chemicals used in industrial manufacturing until the late 1970s.

There's also a risk associated with eating fish tainted with methylmercury, another known toxin that affects the nervous system and can cause permanent brain damage to unborn or young children.

In March, the U.S. government rekindled fish lovers' worries with a special methylmercury advisory. The bulletin urged pregnant women, nursing mothers, women who may become pregnant, and young children not to eat shark, swordfish, king mackerel or tilefish because they contain high levels of mercury.

While it's true the primary danger from methylmercury is to the developing nervous system of an unborn child, it is "prudent for nursing mothers and young children not to eat these fish as well," said the joint advisory from the U.S. Food and Drug Administration (news - web sites) and the Environmental Protection Agency (news - web sites).

Women and children may eat up to 12 ounces a week of fish and shellfish that are low in mercury, such as shrimp, canned light tuna, salmon, pollock and catfish, the advisory said. But they should limit their intake of albacore -- or white -- tuna to no more than 6 ounces a week because that fish is higher in methylmercury.

All of this begs the question, is it safe to serve fish for dinner? With a few notable exceptions, the answer is "yes," say food safety and nutrition experts.

"I have tuna in my kitchen right now, as well as salmon," said Gail Frank, a professor of nutrition at California State University at Long Beach and a spokeswoman for the American Dietetic Association.

The joint FDA-EPA advisory seeks to avoid exposing unborn or young children to unsafe levels of methylmercury at a time when their organ systems are still developing.

That's an important message, Frank said. The trouble is, other Americans hear it and think they, too, should limit their fish intake. The general population is not at risk unless they eat fish every day, especially if they're only eating tuna, she noted.

"You don't want people to become so concerned so that they eliminate fish from their diet," said Joan Rothenberg, director of food science at the International Food Information Council in Washington, D.C.

Yet some health and environmental experts contend the latest government advisory doesn't go far enough to protect women and children from the harmful effects of mercury in fish.

Eating 12 ounces of certain fish in a given week, as the government suggests, could result in exposures well over the "reference dose" (RfD) -- the daily amount the EPA considers safe over a lifetime, according to the Mercury Policy Project, a Vermont-based group dedicated to reducing mercury exposure. The group is particularly concerned about the amount of mercury that these sensitive populations are getting in canned albacore and fresh tuna.

"A 22-pound toddler eating only 2 ounces of albacore tuna per week with the average mercury concentration found by the FDA would have an intake nearly three times the EPA's RfD," Michael Bender, director of the Mercury Policy Project, said in a statement.

Children, because of their smaller size, get a much greater dose of mercury from even a smaller serving of certain fish, Bender added. The government needs to issue more specific advice on what not to feed children based on a child's weight and the mercury content of different fish, he said.

About 3 million children aged 3 to 6 are eating mercury-contaminated fish at or above the level the EPA considers safe, according to the project.

Still, health experts insist that, overall, fish is a good, low-fat source of protein that's rich in omega-3 fatty acids and other nutrients. The American Heart Association (news - web sites) recommends that people eat fish, particularly fatty fish such as mackerel, lake trout and salmon, at least two times a week.

Nutritionists say the best bet for overall good health is to eat a variety of foods in moderation. "If you eat a variety of foods, you create a safety net for your body," Frank said.

Charles Santerre, an associate professor of foods and nutrition at Purdue University, is conducting a survey of low-income women in Indiana who are in their childbearing years. Of the more than 500 sampled so far, 32 percent haven't eaten fish in the last year.

"To me, that's a much greater concern," he said, because they are missing out on the health benefits of fish.

More information

The U.S. Food and Drug Administration has more information on mercury in fish. The Mercury Policy Project can tell you more about its efforts to educate the public about mercury.

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Saturday, May 8, 2004

 

Spring's a Great Time to Launch an Exercise Program

 

HealthDayNews

Saturday, May 8, 2004

SATURDAY, May 8 (HealthDayNews) -- With the arrival of spring's warmer weather, you may be eager to shake off that winter lethargy by starting an exercise program that includes running or walking.

However, if you've been fairly inactive during the winter, you need to ease into your spring exercise routine, advises Duke University Medical Center.

Your first step should be to your doctor's office. That's especially important if you haven't been active for a long while or if you haven't had a recent medical checkup. That way, your doctor can identify any potential problems or concerns before you start putting your body through its paces.

Identify your goals and preferences. Are you trying to shed 10 or 15 pounds? Is your goal to complete a 5K or 10K run? Or do you simply want to develop a healthy lifestyle habit? Knowing and setting clear goals helps you decide whether you should adopt a moderate or more challenging exercise program.

You should also choose an exercise or activity that you enjoy. Whether it's bicycling, swimming, in-line skating or dancing, you'll be more likely to stick with it if you like doing it.

Even if you can only fit in five or 10 minutes of exercise several times a day, you'll achieve significant health benefits. For example, walk to work or park your car a good distance from the office door.

Also, put your trash can as far from your desk as possible, so you'll have to get up and walk to it every time you want to throw out something. And use a cordless phone and walk around the office while you talk.

At home, remember that house chores such as vacuuming or floor mopping are really forms of exercise. And get rid of the remote control and walk from your sofa to the TV to change channels.

More information

The Penn State Digital Collegian has more about preparing for your spring exercise program.

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Obesity Becoming Major Global Problem

By Emma Ross and Joseph B. Verrengia

Associated Press Writers

The Associated Press

Saturday, May 8, 2004

It's a bitter truth to swallow: About every fourth person on Earth is too fat. Obesity is fast becoming one of the world's leading reasons why people die. In an astonishing testament to globalization, this outbreak of girth is occurring just as doctors everywhere but sub-Saharan Africa are winning the fight against infectious diseases from smallpox to malaria.

Now a new enemy is emerging in the 21st century — our appetite. Around the globe, about 1.7 billion people should lose weight, according to the International Obesity Task Force. Of those who are overweight, about 312 million are obese — at least 30 pounds over their top recommended weight.

Already, a third of all deaths globally are from ailments linked to weight, lack of exercise and smoking. And perhaps most worrisome is obesity's spread beyond wealthy western nations.

From the glaciers of Iceland to the palm-fringed beaches of the Philippines, there are now more fat people in the world than hungry people. And in extreme cases, people who are heavy since childhood could die as much as five to 10 years early.

"The developing world in particular is going to bear the enormous brunt of this weight gain," said Neville Rigby, policy director of the IOTF.

"We're even seeing obesity in adolescents in India now. It's universal. It has become a fully global epidemic — indeed, a pandemic."

No country immune

Certainly the United States — home of the Whopper and the Super Big Gulp — remains a nation of scale-busters, with two of every three Americans overweight.

But there are a dozen places even worse.

South Pacific islands like Tonga, Kosrae and Nauru, where traditional meals of reef fish and taro are replaced by cheap instant noodles and deep-fried turkey tails.

Greece, birthplace of the Olympic Games (news - web sites). Kuwait and other wealthy, oil-soaked Gulf States.

Soon China will be the world's biggest country in more ways than sheer population, experts predict. It's a stunning reversal from the Mao Zedong era when as many as 40 million people starved in the Great Leap Forward famine of 1958-61.

When university student Li Guangxu was a baby, rice was rationed. Now he eats cookies for breakfast.

Shopping at a CarreFour supermarket in western Shanghai, Li fills a shopping cart with cookies, chips, soda and beer.

"I like these things. They taste great," Li said. "I don't have time for anything else. Older folks don't eat this stuff, but we do."

And a food fix always is within arm's reach. Almost no one can resist.

"I compare the propensity to eat as somewhere between the propensity to breathe and the propensity to have sex," said Stephen Bloom, chief of metabolic medicine at the University of London's Imperial College. "It's much worse than stopping smoking."

Weight's health effects

Type 2 Diabetes is the illness most directly linked to obesity. A condition that often leads to heart disease and kidney failure, it is blamed for more than 3 million deaths a year. It afflicts 154 million people — nearly four times the number who have HIV (news - web sites) or AIDS (news - web sites) — and the WHO forecasts more than twice as many people will develop diabetes in the next 25 years.

Obesity can triple the risk of heart disease. One-third of all deaths globally — about 17 million — are blamed on heart disease, stroke and related cardiovascular problems, WHO figures show.

Countries with extensive health care have stalled the onset of heart disease into old age. But in much of the world, fatal heart attacks and strokes are much more common among working age adults. Over the next 30 years, the trend is projected to worsen.

Researchers from Columbia University's Earth Institute examined Brazil, China, India, South Africa and the Russian republic of Tartarstan. They found that the heart disease death rate for adults ages 30-59 was up to twice as high as the U.S. rate, and in Russia the rate was up to five times higher

Obesity was cited as a primary factor, along with smoking, lack of exercise and untreated high blood pressure. The researchers described the influence of unhealthy diets as "surprising."

Obesity also plays a significant, if poorly understood, role in many cancers. WHO data shows cancer accounts for about 12.5 percent of the world's deaths, and that rate is expected to increase dramatically, mostly in developing countries.

The global trend toward weight gain and its associated illnesses is not restricted to the well-off. High-fat, high-starch foods tend to be cheaper, so poor people eat more of them.

In Mexico, 40 percent of its 105 million people live in poverty. Yet two-thirds of men and women there are overweight or obese.

How it happened

Many factors contribute to the widening of the world's waistline.

For starters, there is cheap, plentiful food. Even in poor nations, the relative cost of eating is declining.

And the consumption of oils and fats used in processed foods has doubled over the last 30 years.

"One year they had very expensive butter and the next year edible oil came on the scene," said Barry Popkin, who heads nutrition epidemiology at the University of North Carolina and serves as a WHO adviser. "All of a sudden for very little money you could make your food taste better."

Nutritionists say cheaper sugar is another factor, despite the industry's strenuous denials.

James E. Tillotson, director of Tufts University's Food Policy Institute, calculates the average American drinks the equivalent of a 55-gallon drum of soda every year, compared to 20 gallons of sweetened beverages a year in 1970.

Increases almost as dramatic have occurred in Europe, and soft drink factories are increasingly popping up in developing countries.

"We never thought people would abuse them," said Tillotson, who developed fruit-based drinks for Ocean Spray in the 1980s.

Another factor is how food is promoted and distributed.

In 1990, no more than 15 percent of food bought in Latin America came from supermarkets. Now, 60 percent is from six supermarket chains.

There are demographic changes, too. In many nations, women in the work force created a demand for convenience foods.

"We already are tired from working and we buy only packaged foods," said Bertha Rodriguez of Mexico City. The 61-year old great-grandmother supports herself by frying quesadillas in a streetside stand.

Technology triumphs

People spend more time sitting in the car, at the computer and especially in front of the television — an average of 1,669 hours a year in the United States, a habit that is extending internationally.

With such low activity levels, as little as 100 extra calories a day translates into 10 pounds in a year.

Technology is changing activity levels even in the poorest nations.

"Telephones, cars, computers all come from the freedom from hunger and fear," Bloom said. "But it's had a bad side effect."

Some governments are taking steps.

Singapore schools have added physical activities and replaced soft drinks with bottled water. Brazil is making school lunch programs serve fruits and vegetables.

But it's a battle against human nature.

"It would be a huge public health achievement if we simply stopped the weight gain where it is now," said Stephen Blair, research director at the Cooper Institute of Aerobics Research in Dallas.

"I think that's what we're stuck with."

Editor's Note:  Medical Writer Emma Ross reported from London and Science Writer Joseph Verrengia reported from Denver. Elaine Kurtenbach in Shanghai and Morgan Lee in Mexico City contributed to this report.

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