The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
October 4, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 June 5-11

 

  1. Vitamin C Protects Against Rheumatoid Arthritis
  2. Home Monitoring Improves Blood Pressure Control
  3. Low-Carb Spud to Hit U.S. Market Next Year

  4. CDC: Suicide Rate Falls Among Youngsters
  5. Genetics May Leave Some People Prone to Cancers
  6. Sinus Headaches Often Really Migraines: Study
  7. Stem Cells Not Alzheimer's Priority
  8. Fitness May Cut Death Risk in Metabolic Syndrome
  9. Alcohol Abuse Up, but Alcoholism Down
  10. More Americans Abuse Alcohol, Study Finds
  11. U.S. Candy Makers Slim Down Their Treats
  12. Women Need More Mammograms, Study Finds
  13. Health Tip: Cinnamon for Diabetics
  14. Kids Often Overuse Headache Medicine – Study
  15. Migraines Masquerade as Sinus Headaches
  16. The Brain May Start to Age at 40 Years
  17. Alzheimer's Patients Don't Forget Everything
  18. Suffocation Suicides Rising Among Youth – Study
  19. Brain Genes Can Go Bad Early
  20. Study Links Vaccine Ingredient to Autism in Mice
  21. Research: Pregnant Women May Exercise
  22. Too Much Fructose May Skew Appetite Hormones
  23. Study: Exercise Important for Strong Bones
  24. Alzheimer Patients Retain Unexpected Skills –Study
  25. Study: Virus May Predict Cancer's Spread
  26. Gene Variation Linked to Pregnancy-Related Diabetes
  27. CT Screening for Lung Cancer Questioned
  28. Acetaminophen, Ibuprofen Both OK for Kids
  29. 'Safe' Lead Levels Not Safe for Arteries
  30. Seasons May Be Involved in Timing of Menopause
  31. Urban Teens Not Getting Enough Vitamin D
  32. FDA Approves Israeli Spinal Repair Robot
  33. Possible Marker for Alzheimer's Disease Found
  34. Symptoms of 'Silent Killer' Not So Quiet – Study
  35. Genetic Disparity Gives Chemo Insight
  36. New Breast Cancer Drug Saves Lives
  37. Organic Diet Requires Planning, Thrift
  38. U.S. 2003 Health Cost Rises Slowed, But Still High
  39. Soda May Increase Female Diabetes Risk
  40. Critics Want Supplement Risks Reported to FDA
  41. Dietary Supplement Law Said Inadequate
  42. Fresh Air Blows Cold Germs Away
  43. British Scientists Find Prostate Cancer Gene
  44. More Patients Using Medical Marijuana Than Thought
  45. Prostate Cancer Slow But Deadly, Study Finds
  46. More Patients Using Medical Marijuana Than Thought
  47. Statins Not Linked to Increase in Bleeding Strokes
  48. Higher Costs Mean Fewer Take Lifesaving Drugs
  49. Air Pollution May Slightly Increase SIDS Risk
  50. Predicting Lifespans for Dementia Patients
  51. Heart Failure Rate High in People with Diabetes
  52. The Right Workout for Those With Congenital Heart Defects
  53. New Devices May Offer Painless Blood Sugar Tests
  54. Fewer Minorities Than Ever in U.S. Cancer Trials
  55. Blood Thinner Doesn't Work for All
  56. Computer Use a Boost to Young Minds, Study Finds
  57. Study Examines Deaths at Pediatric ICUs
  58. For-Profit Hospitals Cost More -Canadian Study
  59. Smoking May Boost Diabetes Risk
  60. Epilepsy, MS Patients Swear by Marijuana – Study
  61. New Drug Prolongs Life of Prostate Cancer Patients
  62. U.S. Warns Breast-Feeding Women About Drug
  63. Type 1 Diabetes Prevented in Mice
  64. More Evidence Bone Drug Prevents Breast Cancer
  65. New Weapon Against Pancreatic Cancer Found
  66. Epilepsy Drugs Hasten Bone Loss in Older Women
  67. Breast Cancer Risk May Soon Increase for Black Women
  68. Autism Probably Not Caused by Single Factor
  69. Health Tip: Purchasing Medications on the Internet
  70. Study Raises Questions About Teen Violence
  71. Health Tip: Finger Sprains
  72. Melanoma Vaccine Shows Promise
  73. Predicting Progress of Colon Cancer
  74. Depression Can Hamper Diabetes Control
  75. Lower Blood Sugar Helps Memory in Diabetes –Study
  76. Blood Pressure, Cholesterol Are Problems for Many Diabetics

 

Friday, June 11, 2004

 

Vitamin C Protects Against Rheumatoid Arthritis

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Friday, June 11, 2004

FRIDAY, June 11 (HealthDayNews) -- An apple, orange and a few carrots a day may keep rheumatoid arthritis away.

British researchers report that people with a high daily intake of vitamin C from fruits and vegetables are three times less likely to develop the painful joint illness than those with less healthy diets.

The findings "support current recommendations for eating five or more pieces of fresh fruit and vegetables a day," said study co-author Dorothy Pattison, an arthritis researcher at the University of Manchester, England.

Her team published its findings in the June issue of the Annals of the Rheumatic Diseases.

About 2.1 million Americans suffer from rheumatoid arthritis, an inflammation of the lining of the joints caused by dysfunction in the body's immune system. Rheumatoid arthritis is distinct from osteoarthritis, a much more common condition of unknown origin, characterized by a gradual deterioration of bones and joints.

In the Manchester study, Pattison and her colleagues compared the diets of 73 middle-aged or elderly rheumatoid arthritis patients to those of 146 individuals without the disease.

Study participants with the lowest levels of daily fruit and vegetable intake were at double the risk of developing rheumatoid arthritis, compared to people with the highest intake of these nutrient-packed foods, the researchers found.

The results were even more striking it came to vitamin C: Individuals with low daily levels of vitamin C were three times more likely to develop joint inflammation compared to those with the highest daily intake, the researchers said.

According to Pattison, levels of daily vitamin C deemed sufficient to protect against rheumatoid arthritis are easily obtained within current U.S. "five-a-day" dietary guidelines. In fact, "this amount of a variety of fruits and vegetables will provide an intake of vitamin C above that found to be protective in this study," she said.

At first glance, the new findings may seem at odds with the results of another, similar study released just last week. That study, conducted by researchers at Duke University, found that excessively high levels of vitamin C might encourage the development of osteoarthritis.

But Dr. John H. Klippel, president of the Arthritis Foundation, said the two studies may not be so far apart.

"First of all," he said, "we have to remember that these are two different disease processes." According to Klippel, vitamin C may be especially effective in preventing rheumatoid arthritis because it's a powerful antioxidant, fighting molecules that trigger rheumatoid inflammation.

Pattison agreed, noting that vitamin C "also has a critical role as a cofactor in collagen synthesis, the main protein found in [joint] tissue and bone, critical for bone and joint health."

Vitamin C may fight rheumatoid disease in a third way. According to Pattison, infection can trigger flare-ups of the rheumatoid immune response, and vitamin C's "integral role in fighting infection" may work to keep infection-linked inflammation at bay.

Finally, Klippel pointed out that both studies stress moderation in vitamin C intake as the best route to healthy bones and joints.

"It's excessive amounts of intake that seems to be the problem in osteoarthritis," he said.

For her part, Pattison stressed the British study only looked at dietary sources of vitamin C "and do not support the use of supplemental vitamin C to prevent rheumatoid arthritis."

More information

For more on the connections between diet and arthritis, visit the Arthritis Foundation.

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Home Monitoring Improves Blood Pressure Control

 

By Stephen Pincock

 

Reuters Health

Friday, June 11, 2004

LONDON (Reuters Health) - People with high blood pressure do better when they monitor their blood pressure at home, a UK study shows. Home monitoring is linked to a greater number of people achieving target blood pressure, compared with those monitored in the usual way in their doctor's office.

Professor Francesco Cappuccio, from St George's Hospital Medical School, London, UK, and colleagues analyzed 18 randomised controlled trials involving a total of 1359 patients who monitored their pressure at home, and 1355 whose blood pressure was monitored in the healthcare system.

Their results are reported in the British Medical Journal, and are also being presented at the European Society of Hypertension meeting in Paris on 16th June.

The TEAM found that systolic (upper reading) and diastolic (lower reading) pressure were both lower in people who had home blood pressure monitoring. After factoring in various adjustments, systolic and diastolic pressures were about 2 points lower.

The likelihood of having blood pressure above predetermined targets was also lower when people measured their blood pressure at home, the researchers add.

The difference "is not due to the fact that when you go out of the clinic you relax and your blood pressure is lower," Cappuccio told Reuters Health, referring to the so-called "white coat effect."

That's because the trials were designed such that, while people either monitored their blood pressure at home or in the clinic, the final readings for both groups were taken in the clinic.

Cappuccio said, "It is the procedure of taking care of your blood pressure throughout the trial that has led to the blood pressure being lowered when you get to the clinic."

In clinical terms, the differences in blood pressure are quite small, the authors point out in the journal. But considering the millions of people with high blood pressure, those differences "would add up to many, many more strokes and heart attacks as a saving," Cappuccio pointed out.

It isn't clear why home monitoring makes this difference, he noted, although increased awareness of blood pressure probably makes people more likely to engage in healthy lifestyle "and so on."

Regardless, he said, because home blood pressure monitoring is now feasible, acceptable and generally reliable, it's a useful way to involve people more closely in the management of their blood pressure.

Source:  British Medical Journal online first, June 11, 2004: http://www.bmj.com.

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Low-Carb Spud to Hit U.S. Market Next Year

 

HealthDayNews

Friday, June 11, 2004

FRIDAY, June 11 (HealthDayNews) -- Is a low-carb potato a half-baked idea?

Not according to University of Florida potato expert Chad Hutchinson. He believes a low-carb spud that will be available in the United States next January will appeal to people on high-protein diets and anyone else concerned about eating too many carbohydrates.

"Consumers are going to love the flavor and appearance of this potato and the fact that it has 30 percent fewer carbohydrates compared to a standard Russet baking potato," Hutchinson, an assistant professor of horticulture, said in a prepared statemnent.

He said 3 1/2 ounces of this new potato has about 13 grams of carbohydrates. There are about 19 grams of carbohydrate in a similar-sized serving of a Russet Burbank potato.

"The potato doesn't look or taste like anything that's now on the market, and it's not a genetically engineered crop. When it comes to beautiful potatoes, this one is a real winner for growers and consumers," he said.

The potato was developed by HZPC, a seed company based in the Netherlands. Hutchinson spent five seasons evaluating the new potato, which will be marketed in the United States as a premium, gourmet potato.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has information about healthy eating.

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CDC: Suicide Rate Falls Among Youngsters

 

By Daniel Yee

Associated Press Writer

The Associated Press

Friday, June 11, 2004

ATLANTA - Suicide among American youngsters and teens fell about 25 percent in the last decade, reflecting a dramatic dropoff in gun suicides, the government said Thursday.

In fact, hanging and other forms of suffocation — including use of belts, ropes or plastic bags — overtook self-inflicted shootings in the 1990s as the most common method of suicide among 10- to 14-year-olds, the Centers for Disease Control and Prevention (news - web sites) said.

CDC researchers did not immediately know why the overall rate dropped, but a specialist in adolescent medicine said new safety measures for keeping guns out of children's hands and greater acceptance of gays may have played important roles.

Sexual orientation has been a factor in many suicides among young males, said Dr. Charles Wibbelsman, chief of The Teenage Clinic of Kaiser Permanente in San Francisco.

"There are shows (concerning gays and lesbians) today that weren't on nine years ago," said Wibbelsman, a member of the American Academy of Pediatrics' committee on adolescents. "It's been much more 'Out' and in that respect, we've saved a lot more people's lives."

The suicide rate for those ages 10 to 19 fell from 6.2 deaths per 100,000 people in 1992 to 4.6 per 100,000 in 2001, the CDC said. The number of suicides also fell in that period, from 2,151 to 1,883.

The decrease in gun suicides was most dramatic among children 10 to 14, dropping from 172 in 1992 to 90 in 2001. Among those 15 to 19, deaths from self-inflicted shootings dropped from 1,251 to 838 during the same period, the CDC said.

Trigger locks, lock boxes and other measures for keeping guns out of youngsters' hands have become more common in recent years, but CDC officials said they did not know whether that accounts for the decrease in suicides.

The number of suicides by hanging or other forms of suffocation, meanwhile, rose among young people from 1992 to 2001.

Such methods of suicides — including use of belts, ropes or plastic bags — rose from 96 to 163 in that period among youngsters 10 to 14.

Among teens ages 15 to 19, suicides by suffocation rose from 333 deaths to 551.

CDC researchers said they were surprised by the switch in suicide methods and said they first noticed the trend in the early 1990s. By the end of the decade, suffocations had surpassed self-inflected shootings.

The nation's suicide rate among all age groups also has dropped in recent years, although it rose from 10.44 deaths per 100,000 in 2000 to 10.69 per 100,000 in 2001.

On the Net:

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

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Genetics May Leave Some People Prone to Cancers

 

By Adam Marcus
HealthDay Reporter

HealthDayNews

Friday, June 11, 2004

FRIDAY, June 11 (HealthDayNews) -- All cancers are said to be "genetic" in origin. That is, they stem from mutations in DNA that cause cells to grow unchecked. But that's different from saying they're inherited, or passed from parent to child.

Cancer experts believe that between 5 percent and 10 percent of cancers are the results of single genes that have gone awry and that get transmitted across generations. These "susceptibility genes" put a person at substantially greater risk of developing cancer in specific organs.

The trigger for the tumor might simply be the passage of time, but it might also be a constellation of contact with things in the environment, such as cigarette smoke, certain chemicals, or other exposures.

Among the most well-known inherited tumors are those that affect the breasts and ovaries linked to mutations in two genes, BRCA1 and BRCA2. These gene flaws raise the lifetime risk of breast cancer to between 56 percent and 87 percent, compared to 11 percent in the general population. They increase the risk of ovarian cancer to between 16 percent and 44 percent from about 2 percent.

BRCA1 and its sibling mutation have also been associated with inherited forms of colorectal cancer and with prostate cancer in men. Inheritance is implicated in a rare form of colon tumor called hereditary nonpolyposis colorectal cancer, or HNPCC. And researchers have identified susceptibility genes for thyroid cancer and skin cancer.

A recent study by researchers in Germany and Sweden found that children whose parents had cancer were much more likely than their peers to develop the same illness.

The family connection was particularly strong for certain tumors. Men had a 15 percent chance of getting prostate cancer, anyone with a parent who'd had intestinal cancer had a 10 percent risk of the same ailment, and women had an 8.5 percent risk of breast cancer if their mother had it.

Sons of fathers with testicular cancer had four times the risk of developing the disease compared to sons from fathers without it. Brothers of affected men had a ninefold higher risk than normal of developing it, too.

But cancer experts stress that inheriting a susceptibility gene isn't the same as inheriting cancer. "If we have a mutation, it poses a greater risk or liability [of illness] but not a certainty," says Carolyn Farrell, director of the clinical genetics service at the Roswell Park Cancer Institute in Buffalo, N.Y.

Genetic counselors advise people with a strong family history of cancer to be especially vigilant about screening for the disease, such as breast mammography or colon imaging.

In the case of breast cancer, they may also encourage women to consider taking the drug tamoxifen to prevent tumors, and even discuss the possibility of removing the breasts and ovaries with women whose family history of these diseases is particularly lethal.

What about the remaining 90 percent of cancers -- what causes them? The vast majority -- perhaps 70 percent -- are thought to occur sporadically, Farrell says. That leaves about 20 to 25 percent which likely arise from an interaction between genes, the environment, and other factors that are not yet well understood.

More information

The National Cancer Institute has more information about genetics and cancer.

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Sinus Headaches Often Really Migraines: Study

 

By Merritt McKinney

Reuters Health

Friday, June 11, 2004

NEW YORK (Reuters Health) - If you think you have a sinus headache, think again, according to an Arizona headache specialist. You may have a migraine.

In a new study, almost nine out of 10 people who thought they had sinus headaches actually had migraines, according to Dr. Eric J. Eross, an associate consultant in neurology at the Mayo Clinic in Scottsdale.

Eross and his colleagues studied 100 people who thought they had a sinus headache. After evaluating the patients, however, the researchers concluded that 63 percent had migraines and another 23 percent had probable migraines.

Eross presented the results of the study in Vancouver at the annual meeting of the American Headache Society.

Misclassification of migraines as sinus headaches is a problem of "guilt by provocation, location and association," Eross said in an interview with Reuters Health.

In many cases, headache symptoms were provoked by changes in weather, seasonal changes and exposure to allergens, Eross explained. Headache sufferers often assume that these triggers cause sinus headaches, but they can all trigger a migraine, Eross explained.

Also, the location of headache pain can often confuse people, according to Eross. When people experience pain over their sinuses, they often assume it is caused by a sinus headache when, in fact, migraine can cause pain in that region, too, Eross noted.

Furthermore, migraines often affect just one side of the head, so people believe that a headache that affects both sides is not a migraine, according to the Arizona researcher. But migraines can affect both sides at once, he said.

Headaches are sometimes mistakenly classified as sinus headaches because they occur along with symptoms that are associated with allergy and sinus trouble, including a runny nose and watery eyes, Eross said.

But in most people in the study, the headache pain itself triggered these symptoms, he found. And in a smaller group of people, symptoms of allergic rhinitis, such as a runny nose, actually triggered a migraine.

The misclassification of headaches can have a long-term impact on quality of life, as people are less likely to receive the most effective treatment, according to Eross.

In the study, over-the-counter pain relievers were the most commonly used medications, followed by non-prescription antihistamines. Only about 10 percent of headache sufferers had been prescribed drugs called triptans, which Eross described as the "gold standard" for treating migraine.

Although triptans were used the least, people who took them were most satisfied with the treatment, according to Eross.

He noted that people in the study had been experiencing what they thought were sinus headaches for an average of 25 years.

Eross encouraged people who think they are having sinus headaches to ask their doctor if they might have a migraine. In many cases, it may be a good idea to see a headache specialist, he said.

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Stem Cells Not Alzheimer's Priority

By Malcolm Ritter

AP Science Writer

The Associated Press

Friday, June 11, 2004

NEW YORK - Despite the high profile that Nancy Reagan and others have given the idea of using embryonic stem cells to treat Alzheimer's disease (news - web sites), advances are likely to come faster from other approaches.

Experts cite other more promising efforts that in five to 10 years may be used to fight the disease that led to President Reagan's death.

"I just think everybody feels there are higher priorities for seeking effective treatments for Alzheimer's disease and for identifying preventive strategies," said Marilyn Albert, a Johns Hopkins University researcher who chairs the Medical and Scientific Advisory Council of the Alzheimer's Association.

Stem cells from human embryos can form all types of cells, and the hope is that they one day could be used to replace cells damaged from such conditions as diabetes, spinal cord injury or Parkinson's disease (news - web sites). But experts say Alzheimer's, by the very nature of how it attacks the brain, would pose a far more daunting challenge to that approach.

"There's an awful lot going on right now that perhaps holds a little bit more immediate promise for trying to slow the disease, or even cut off its development," said Marcelle Morrison-Bogorad, associate director of the National Institute on Aging's neuroscience and neuropsychology of aging program.

She and Albert cited, for example, efforts to attack the buildup of clumps of protein called amyloid in the brain, and methods for spotting the disease early. That research will probably pay off in five or 10 years, earlier than any expected advances from stem cells, Albert said, because so much has to be learned about how to make stem cells useful against the disease.

"All the more reason we should start (stem cell efforts) now, because it's going to take a long time," she said.

About 4.5 million Americans have Alzheimer's, a progressive brain disorder that gradually destroys memory and ability to learn, reason, communicate and do everyday activities. Patients die on average eight years after symptoms appear, although the disease can linger for 20 years.

"What you're dealing with here is a mind in disarray," Morrison-Bogorad said. Connections between brain cells are being lost, neurons are dying and becoming dysfunctional, the amyloid plaques are building up between brain cells and protein tangles are showing up within cells. And there's inflammation.

"It's just a mess in there," she said. "But the mess means there are so many targets for intervention."

The amyloid plaques have emerged as a favorite target, and scientists and drug companies around the world are studying ways to prevent or destroy them.

One high-profile approach is a vaccine that primes the body to attack amyloid. Studies on animals were encouraging, but in 2002 a study on people was halted when several vaccine recipients developed brain inflammation. Last year, researchers reported that the vaccine did appear to reduce the accumulation of plaques in one study participant.

Work is continuing now on a safer vaccine, because the available evidence suggests "this is an important avenue to pursue," Albert said.

Another popular approach seeks to keep the brain from making the abnormal form of amyloid that creates the plaques. It's a high priority at "every major drug company," Albert said.

The overall focus on amyloid makes her optimistic.

"Everybody's working on it," she said. "What we've learned from the past is that if everybody works really hard at something that is sensible, they're likely to make a lot of progress. So there's just enormous optimism that in five years, or certainly 10 years, we'll have much more effective treatments."

Another key research area is finding a way to predict who will get Alzheimer's before symptoms appear. Because the disease develops over many years, much damage has been done by the time it's diagnosed. So scientists want to identify people at an earlier stage for the day when more effective treatments become available.

In the same vein, scientists want to find ways to track the progress of the disease in people being treated, so they can quickly tell if the treatment is helping.

So researchers are doing long-term studies to see if different kinds of brain scans, mental tests and spinal or blood tests can predict development or progression of the disease.

Lifestyle factors too, such as taking anti-inflammatory drugs and vitamins like E and C, are being studied to see if they can help prevent Alzheimer's or delay it.

Researchers are also exploring the use of cholesterol-lowering drugs. A relatively recent idea, Albert said, is that things like keeping cholesterol and blood pressure low and staying physically active may help. Those steps are well-known for countering heart disease, she noted.

But it's becoming clearer, she said, that "if you do things that are good for your heart, they'll be good for your brain."

On the Net:

www.alzheimers.org

www.alz.org

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Fitness May Cut Death Risk in Metabolic Syndrome

 

Reuters Health

Friday, June 11, 2004

NEW YORK (Reuters Health) - Being fit seems to counter the effects of having the so-called metabolic syndrome, a cluster of risk factors for diabetes and cardiovascular disease, a large study suggests.

People with metabolic syndrome have several disorders -- such as abdominal obesity, high blood pressure, elevated blood sugar and unhealthy cholesterol levels -- that set the stage for type 2 diabetes, heart disease and stroke. Up to one in four U.S. adults have such a cluster of risk factors.

Researchers with the new study -- involving more than 19,000 men followed for up to 17 years -- found that those with the metabolic syndrome who were fit were less likely to die during the study period.

Among the nearly 3,800 men with the condition, those who were deemed to be out of shape during treadmill tests were twice as likely as those who were fit to die of cardiovascular disease, or any other cause.

And while men with metabolic syndrome were 89 percent more likely than healthy men to die of cardiovascular disease over the years, this difference was slashed when researchers factored in the men's fitness levels at the start of the study.

Healthy men also showed the benefits of fitness: those who were out of shape at the outset were more than three times as likely as their fit peers to die of cardiovascular disease, according to findings published in the Archives of Internal Medicine (news - web sites).

Dr. Peter T. Katzmarzyk of Queen's University in Kingston, Ontario, Canada, led the study.

Overall, he and his colleagues report, fitness appeared to lower men's death risk regardless of body weight. Those who had metabolic syndrome but were fit were generally overweight and carried much of their fat in the abdomen.

The study participants had all attended the Cooper Clinic in Dallas for evaluations between 1979 and 1995. Previous research there has supported the notion that people can be "fat but fit," and that they can still reap the health benefits of fitness.

In one recent study that followed 2,200 men for 15 years, Cooper researchers found that diabetic men who were overweight yet fit had a death risk similar to that of their fit, healthy peers. They estimated that moderate exercise -- such as walking for 30 minutes five times per week -- would be enough to achieve protective fitness levels.

Exactly why physical fitness may cut death risk even in the face of the metabolic syndrome is unclear, according to Katzmarzyk and his colleagues. Regardless, they conclude, this study "strengthens the argument for aggressive public health campaigns aimed at increasing physical activity levels in the population."

Source: Archives of Internal Medicine, May 2004.

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Alcohol Abuse Up, but Alcoholism Down

By Randolph E. Schmid

Associated Press Writer

The Associated Press

Friday, June 11, 2004

 WASHINGTON - Alcohol abuse is up in America — sharply for most groups — a government study said Friday. At the same time alcoholism was down.

Some 4.65 percent of the adult population reported alcohol abuse in 2001-2002, up from 3.03 percent a decade earlier, the National Institute on Alcohol Abuse and Alcoholism reported.

During the same period, the share of the population who were judged to be alcoholics slipped from 4.38 percent to 3.81 percent of people aged 18 and over, the institute said.

"What is surprising, then, is that the prevalence of alcohol abuse increased in the face of slightly declining rates of heavy drinking," said the research team led by Bridget F. Grant of the institute, a division of the National Institutes of Health (news - web sites).

"That alcohol abuse seems to be increasing presents intriguing questions," she said.

Alcohol abuse, which increased, is defined as drinking-related failure to fulfill major obligations at work, school or home, interpersonal social or legal problems and drinking in hazardous situations. Alcoholism, which declined, is characterized by compulsive drinking, preoccupation with drinking and tolerance to alcohol.

Combined, alcohol abuse and alcoholism affected 17.6 million Americans in 2001-2002, up from 13.8 million in 1991-1992.

Alcoholism declined over the decade in males, from 6.33 percent to 5.42 percent, and in females from 2.58 percent to 2.32 percent.

The increase in alcohol abuse was noted across many groups, minorities in particular.

"A group that showed an especially sharp increase was young adult Asian males, a group that has not previously attracted attention as being at elevated risk for alcohol use disorders," the researchers said. The rate for Asian males jumped from 1.65 percent to 3.20 percent, with almost all the increase between the ages of 18 and 44.

While the overall alcohol abuse rate jumped from 3.03 percent to 4.65 percent, it rose from 3.33 percent to 5.1 percent for whites; climbed from 1.46 percent to 3.29 percent for blacks; declined from 8.14 percent to 5.75 percent for American Indians; rose from 1.08 percent to 2.13 percent for Asians; and climbed from 2.52 percent to 3.97 percent for Latinos.

By age, overall alcohol abuse rose from 6.54 percent to 6.95 percent for people age 18-29 and from 3.02 percent to 5.95 percent for ages 30-44. For ages 45 to 64 it was up from 1.35 percent to 3.54 percent, and it rose from 0.25 percent to 1.21 percent for those 65 and older.

For alcoholism, the rate fell from 4.38 percent to 3.81 percent. For whites it dropped from 4.35 percent to 3.83 percent; it edged down from 3.84 percent to 3.57 percent for blacks; among Indians, it declined from 9.01 percent to 6.35 percent; for Asians it edged upward from 2.26 percent to 2.41 percent; and for Latinos, the rate declined from 5.78 percent to 3.95 percent.

The alcoholism rate fell from 9.4 percent to 9.24 percent for those aged 18 to 24; from 4.25 percent to 3.77 percent for ages 25 to 44; from 2.12 percent to 1.89 percent for ages 45 to 64; and from 0.39 percent to 0.24 percent for those 65 and older.

The study, published in the journal Drug and Alcohol Dependence, is based on interviews with 43,093 people in 2001-2002. The results were compared with a similar study in 1991-1992.

On the Net:

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

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Thursday, June 10, 2004

 

More Americans Abuse Alcohol, Study Finds

 

Reuters

Thursday, June 10, 2004

WASHINGTON (Reuters) - More Americans are abusing alcohol than in the 1990s, but fewer are technically alcoholics, U.S. government researchers said on Thursday.

They found that the number of American adults who abuse alcohol or are alcohol dependent rose to 17.6 million or 8.46 percent of the population in 2001-2002 from 13.8 million or 7.41 percent of the population in 1991-1992.

The researchers cannot say why heavy drinking is up.

"The fact that alcohol disorder rates are highest among young adults underscores the need for concerted research on drinking patterns that initiate in adolescence," said Dr. Ting-Kai Li, Director of the National Institute on Alcohol Abuse and Alcoholism.

The NIAAA study defines alcohol abuse as causing a failure to fulfill major role obligations at work, school, or home; interpersonal social and legal problems; and/or drinking in hazardous situations.

Alcohol dependence, also known as alcoholism, is characterized by impaired control over drinking, compulsive drinking, preoccupation with drinking, tolerance to alcohol and/or withdrawal symptoms.

Across the decade, the rate of alcohol abuse increased to 4.65 percent of the general population from 3.03 percent, while the rate of alcoholism fell to 3.81 percent of the general population from 4.38 percent, Li's team reported in the journal Drug and Alcohol Dependence.

The survey was done by the U.S. Census Bureau (news - web sites), which interviewed more than 43,000 people face to face.

The survey found men more likely to abuse alcohol than women and people aged 18 to 44 were more likely to abuse alcohol than older people.

"Alcohol abuse is more prevalent among whites than among Hispanics, Blacks, and Asians. Alcohol dependence is more prevalent among Native Americans, Hispanics and whites than among Asians," the NIAAA, one of the National Institutes of Health (news - web sites), said in a statement.

"That rates of dependence overall decreased is not surprising in light of other surveys that indicate a decline in heavy drinking," said Bridget Grant, who led the study.

"That alcohol abuse seems to be increasing presents intriguing questions. What is clear is that no single environmental cause can explain the increase. Further research is an important public health priority."

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U.S. Candy Makers Slim Down Their Treats

 

By Dave Carpenter

AP Business Writer

The Associated Press

Thursday, June 10, 2004

CHICAGO - Call it Candy Lite. Long viewed as a slightly naughty self-indulgence, candy is getting a makeover as companies try to concoct sweets that are a little healthier.

From low-carb to low-cal to sugar-free to "guilt-free," many of the estimated 1,400 new products on the market this year come with a health pitch of some kind. And the array of soon-to-be-released offerings on display at this week's All Candy Expo, North America's largest candy trade show, shows the pro-health movement is just getting rolling.

Tinkering with treats is part of the low-carb boom being served up by the U.S. food industry in response to the growing popularity of the Atkins and South Beach diets. Candy makers also are anxious to avoid any repercussions from rising obesity among children, although the National Confectioners Association trade group contends kids' candy consumption hasn't increased.

So far the strategy appears to be working. Sales of "diet candy," the industry's feel-good term for sugar-free and reduced-carb sweets, soared 90 percent to more than $273 million last year as overweight Americans fretted more about nutrition and health. And supermarket shelves are being stocked regularly with new low-carb goodies, likely ensuring the fad won't fade any time soon.

"There's no doubt that the buzz in the industry right now is really health-conscious candy," said Barry Sokol of Sorbee International, a Philadelphia-based company that touted its new sugar-free products at the All Candy Expo. "This low-carb craze is beyond going through the roof."

Sugar-lovers, relax — it's not all about health. Low-carb or sugar-free items still comprise just a fraction of the $24 billion-a-year confectionery industry. And gobs of teeth-tingling sugar candies still commanded attention at the three-day trade show, which ended Thursday.

Debut items included jumbo-sized Smarties, one-pound chocolate wreaths and chili-pepper flavored candy called Diablo Ignited Sours. In the ever-popular gross-out category, there were Mean Green Blow Pops that turn your tongue green and Brain Drain Liquid Candy, which maker Kandy Kastle promotes as feeling like "brains rolling around in your mouth."

But the focus on sour and "extreme" tastes that influenced new products a year or two ago has shifted to a more healthful approach featuring low-carb fudge and licorice, sugar-free jellybeans, calcium-fortified wafers and a whey protein diet bar.

Hershey Foods is sinking a bigger investment into the new trend with the introduction of 1 Gram Sugar Carb Bars after recording first-year sales of $12 million for its line of sugar-free Reese's Peanut Butter Cups and Hershey's chocolate bars.

Smaller companies are following suit.

Albanese Confectionery Group is repackaging its World Best Gummi Bears as World's Best Zeros, with a label boasting "0 Fat - 0 Sugar - 0 Net Carbs." "We were making sugar-free products for years (for diabetics), but never thought of the idea of marketing them as low-carb," said Scott Albanese, owner of the Merrillville, Ind., company.

Innovative Candy Concepts of Atlanta launched a line of bite-sized candies last year called Sinfully Delicious, advertising them as no-guilt candy because they are sugar-free, fat-free and contain just two calories. This year it has reformulated its popular Too Tarts kids' candy to eliminate refined sugar and add fruit juice concentrate, with 50 percent to 60 percent fewer calories.

The Atlanta company says orders of Too Tarts have tripled since it announced the product a month ago.

"When we first started making kids' candy about seven years ago, we thought 'Isn't it nice to do something that's fun?'" said CEO Armand Hammer, no relation to the late famous industrialist. "But when I saw my grandkids eating it, I thought there must be something better I can give them than pure high-fructose corn syrup."

Improved technology has made it easier for companies to replace sugar than was the case with fat during the low-fat craze of the 1990s.

Do the new candy products taste as good? It depends who you talk to.

A few random samplings found such items as sugar-free Reese's Pieces and low-carb Gummi Bears tasted pretty much the same as the regular recipe, but some others failed to delight.

"It's easier to do low-carb and taste good than it is to do low-fat and taste good," explained analyst Mark Hugh Sam, who follows food companies for Chicago-based Morningstar Inc.

Joe Dutra, whose Kimmie Candy Co. makes chocolate-covered sunflower seeds, contends most low-carb candies still don't taste good. He calls the low-carb boom a marketing ploy for candies that are "low-carb but high-calorie."

"It's like sex — you really want to enjoy it when you have it," he said. "You don't want to eat candy and have it taste like cardboard."

Nonetheless, he admitted somewhat sheepishly, his small, Sacramento, Calif.-based company will probably follow the herd next year with a low-carb version of its ChocoRocks chocolate candies. "You have to go with the trend. And new products are always interesting for consumers."

While chocolate sales have remained stable in the face of all the health concerns, according to analyst Sam, sugar-based candies have "gone down quite a bit" recently.

Candy makers, however, remain confident the long-term prospects are bright.

Diet or no diet, said Albanese: "People will always indulge themselves with some kind of a treat, with something sweet to eat."

On the Net:

National Confectioners Association at www.candyusa.org

Candy trade show at www.allcandyexpo.com

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Women Need More Mammograms, Study Finds

By Maggie Fox, Health and Science Correspondent

Reuters

Thursday, June 10, 2004

WASHINGTON (Reuters) - Training more technicians to do mammograms and making it easier for women to get them will do far more to prevent breast cancer deaths in the near future than new technology, the Institute of Medicine (news - web sites) reported on Thursday.

Women across the United States are forced to wait months to get mammograms because facilities are overstretched, the report from a panel of experts found.

Although new technology promises to make breast cancer screening easier and perhaps more efficient, it will be years before these techniques are perfected and approved.

"In the meantime, because current mammography technology is good but imperfect, and because there are many barriers hindering women's access to mammography, too many women will die from breast cancer this year," committee chair Edward Penhoet of the Gordon and Betty Moore Foundation in San Francisco said in a statement.

"Improving and increasing the use of current mammography technology is the most effective strategy we have right now for further reducing the toll of breast cancer."

Instead, radiologists are leaving the field for fear of lawsuits and clinics are closing, the report found.

"Between 2000 and 2003, the number of mammography facilities operating in the United States has dropped from 9,400 to 8,600 -- an 8.5 percent decrease," the Institute, an independent organization that advises the federal government on health matters, said in a statement.

"As a result, women are being made to wait up to five months for mammograms in some areas."

Jean Lynn, who operates a free mobile screening clinic at George Washington University, said a lack of demand was not the main problem.

"Our schedule is booked a year ahead of time -- fully booked," Lynn told a news conference.

Technicians, Computers

The committee, which included breast cancer specialists, activists, nurses and business and policy experts, turned to other countries for ideas.

"For instance, in the United Kingdom radiologic technologists, who are not physicians, are trained to meet national certification standards, and have proven comparable in accuracy and speed to radiologists," the report says.

Computer-aided detection to back up the laborious process of reading mammogram X-rays should also be developed, it says.

New technologies will help someday, but not now.

"Recent headlines to the contrary, it will be many years -- if ever -- before blood tests replace mammograms," the report says. "No existing blood test -- for breast or any other cancer -- rivals mammography as a screening method."

Lives would be saved if more women got mammograms, although it is hard to put a number on it, said Dr. Martin Abeloff, a breast cancer specialist on the panel.

"Between 62 and 65 percent of women in this country who should be getting mammography according to current guidelines are getting mammography," Abeloff said in an interview.

"The breast cancer mortality rates in the United States and U.K. are falling steadily. It is really felt that it is a combination of two things -- one is screening for breast cancer with mammography and the other is the utilization of adjuvant therapy" such as the drug tamoxifen, Abeloff said.

More than 200,000 new cases of breast cancer will be diagnosed this year in the United States alone, and more than 40,000 women will die from it.

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Health Tip: Cinnamon for Diabetics

 

HealthDayNews

Thursday, June 10, 2004

(HealthDayNews) -- If you have type 2 diabetes, you may want to sprinkle cinnamon on your cappuccino.

According to the Johns Hopkins University newsletter Health After 50, a recent study found that when people with diabetes consumed between 1 and 3 grams of cinnamon daily, their blood glucose, triglyceride, low-density lipoprotein, and total cholesterol levels dropped significantly.

Cinnamon extracts appear to enhance the efficiency of insulin and to help fat cells recognize and respond to the hormone.

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Kids Often Overuse Headache Medicine – Study

 

Reuters

Thursday, June 10, 2004

VANCOUVER, British Columbia (Reuters) - Children who suffer frequent headaches may be using far more over-the-counter pain relief medicine than parents realize and risking their health, according to a study released on Thursday.

Researchers who studied 680 children between the ages of six and 18, found more than 20 percent were overusing pain relief medicines, according to the report released at the American Headache Society annual meeting in Vancouver.

"I've been astounded by the large numbers of kids using over-the-counter medications five or six times a week, some times 15 to 20 times per week," David Rothner, the study's lead researcher said in a statement.

One in five children in the study overused medications, which is defined as taking more than three doses of pain relievers per-week for more than six weeks, according to the study by the Cleveland Clinic in Ohio.

The researchers found about one in seven of the children and adolescents did not tell their parents about the heavy medication use, often because they did not realize they should be consulted.

The study said doctors need to specifically ask kids who suffer frequent headaches how much medicine they use. Overuse can lead to medical problems such as kidney failure and gastrointestinal bleeding.

It is estimated that 15 percent of all 15-year-olds in the United States suffer daily or nearly daily from tension and migraine headaches.

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Migraines Masquerade as Sinus Headaches

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Thursday, June 10, 2004

THURSDAY, June 10 (HealthDayNews) -- Despite what your doctor might tell you, migraines often masquerade as sinus headaches, a new study shows.

Nearly nine in 10 people who think they have sinus headaches are really having migraines, Mayo Clinic researchers reported June 10 at the American Headache Society's annual meeting in Vancouver, British Columbia.

The bad news is that some sufferers may be taking too many unnecessary over-the-counter sinus medications because of the missed diagnosis, the researchers said.

"Most folks who come into the clinic with a self-diagnosed or physician-diagnosed sinus headache actually don't have sinus headache at all," said lead researcher Dr. Eric Eross, an associate consultant in neurology from the Mayo Clinic in Scottsdale, Ariz.

In their study, Eross and his colleagues examined 100 people who answered a newspaper ad seeking people who thought they had sinus headache. Each patient had an extensive evaluation and some had imaging tests.

The researchers found that 63 percent were actually suffering from migraines, 23 percent had probable migraine and 9 percent had headaches that couldn't be classified. The patients with unclassified headaches probably have sinus headache, Eross noted.

In addition, 3 percent had headaches secondary to a sinus infection, 1 percent had cluster headaches and 1 percent had hemicrania continua, a rare type of chronic headache, he added.

On average, the people who actually had migraine had gone 25 years without a correct diagnosis, Eross said. About 28 million Americans suffer from migraines.

"Most folks who think they have sinus headache are most likely using sinus medication to treat what is really migraine, and so they are not getting the appropriate and most effective treatment," Eross said.

Ninety-five percent of the patients were taking some medication: 33 percent were taking ibuprofen and naproxen; 25 percent were taking acetaminophen; 21 percent were taking other non-prescription pain relievers, 21 percent were taking non-prescription sinus medications and 9.5 percent were taking triptans.

Triptans are the most effective migraine prescription medications available, Eross noted. Those taking triptans had the best results by far, he added. In the study, 92 percent of the people were candidates for triptans, but only 12 percent were actually taking them the researchers said./p>

If you think that you have sinus headaches, he said, most probably you have migraines. "Make sure you see someone who specializes in headache, either a headache specialist or neurologist," he stressed.

One expert said the findings mirror her experience.

"The results of this study of sinus headache are very consistent with my clinical experience," said Jeanetta C. Rains, a headache specialist from Elliot Hospital and Dartmouth Medical Center. "Quite often, these individuals have undergone extensive treatments for allergies, sometimes sinus surgeries, etc., only to discover that their chief complaint of headaches persists."

"Patients and physicians may have a difficult time sorting out the overlapping symptoms. I think the bottom line for patients and physicians alike, when symptoms persist despite our best efforts at treatment, sometimes we need to take a step back and reconsider our diagnoses and appreciate that it may be difficult to discriminate among the various types of headache," she added.

Results of another study presented at the same meeting showed that, while weather is often the trigger for a migraine, many more people believe weather changes trigger their migraine than is actually the case.

Among the 77 migraine patients in the study, the researchers found that 51 percent were actually sensitive to weather, but 62 percent thought they were sensitive to weather.

Of those whose migraines were triggered by weather, 34 percent were sensitive to temperature or humidity, 14 percent to a changing weather pattern and 13 percent to a change in barometric pressure, and one in 10 were sensitive to more than one type of weather change.

More information

The National Headache Foundation (news - web sites) can tell you about migraines.

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The Brain May Start to Age at 40 Years

 

Reuters Health

Thursday, June 10, 2004

NEW YORK (Reuters Health) - US researchers studying the brains of people 26 to 106 years of age have found evidence that brain function starts to slow around age 40.

In science journal Nature, Dr. Bruce A. Yankner, from Harvard Medical School (news - web sites) in Boston, and colleagues report that they've identified a set of genes in the brain that show reduced activity after age 40. These genes, they note, play key roles in a variety of cell functions.

According to the team, DNA damage begins to accumulate in these genes. This damage could affect vital brain activities, such as learning and memory. Moreover, this may initiate a program of brain aging "that starts early in life."

The researchers acknowledge that exactly when aging begins and what triggers its onset is "one of the major conundrums of biology." In early adulthood and then again in late adulthood, there is not much difference from one individual to the next regarding gene activity in the brain. In contrast, from 40 to 70 years of age, it's possible to see wide differences in gene activity between two individuals of the same age.

"Thus, individuals may diverge in their rates of aging as they transit through middle age, approaching a stage of 'old age' at different rates," the authors conclude. It will be interesting, they say, to study this relationship in different populations.

Source: Nature, June 9th online issue, 2004.

http://us.rd.yahoo.com/dailynews/nm/hl_nm/storytext/SIG=11716jacm/*http://dx.doi.org/10.1038/nature02662

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Alzheimer's Patients Don't Forget Everything

 

HealthDayNews

Thursday, June 10, 2004

THURSDAY, June 10 (HealthDayNews) -- Some forms of memory may remain intact in people with Alzheimer's disease (news - web sites), says a Howard Hughes Medical Institute study.

The researchers, reporting in the June 10 issue of Neuron, found people in the early stages of Alzheimer's disease still possess a specific form of memory used for rote learning of skills, even when these people have lost memories of loved ones and significant events.

The finding may help improve training and rehabilitation programs meant to bolster cognitive function in people with Alzheimer's disease and in healthy older people.

"From this and other studies we have done, it appears that a number of brain systems are more intact in Alzheimer's than we had anticipated," researcher Randy L. Buckner said in a prepared statement.

"The findings suggest that if we can help people use these brain systems optimally by providing the right kinds of cues or task instructions, we may be able to improve their function," Buckner said.

The study included 24 older adults in the early stages of Alzheimer's, 33 healthy older adults and 34 young adults. The researchers compared the memory capabilities of the three groups. Each person was shown a series of words and asked to decide whether the words represented living or non-living objects.

"For this task, we found that all three groups showed a significant reduction with practice in the time required to decide on a word, which is the hallmark of implicit learning," Buckner said.

The people were then asked to repeat the task while their brains were scanned using magnetic resonance imaging (MRI).

"What was surprising and novel in this study is that the brain region with the greatest activity during the task was the high-level region of the frontal cortex," Buckner said.

"We didn't expect this because high-level cognition is affected in Alzheimer's disease. These results suggest that despite the damage to these areas in Alzheimer's, certain memory processes that seem to depend on them remain functionally intact," he said.

More information

The U.S. National Institute on Aging has more about Alzheimer's disease.

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Suffocation Suicides Rising Among Youth – Study

 

Reuters

Thursday, June 10, 2004

ATLANTA (Reuters) - Though fewer U.S. youngsters are taking their own lives, suffocation has replaced guns as the chief method of suicide among Americans 10 to 14 years old, federal health researchers said on Thursday.

The Centers for Disease Control and Prevention (news - web sites) said reasons for the change in suicide methods were not fully understood, and called on public officials to develop prevention programs.

A CDC study found that the suicide rate for people 10 to 19 years old dropped to 4.6 per 100,000 people in 2001 from 6.2 per 100,000 in 1992. Guns and suffocation were the chief methods of suicide, accounting for 90 percent of deaths in that age group, the agency said.

Among those 10 to 14 years old, gun suicides fell to 90 in 2001 from 172 in 1992, while suffocation suicides rose to 163 in 2001 from 96 in 1992.

Among teens 15 to 19 years old, deaths from self-inflicted shootings dropped to 838 in 2001 from 1,251 in 1992, while suffocation suicides rose to 551 in 2001 from 333 in 1992.

Suicide is the 11th-leading cause of death in the United States, and the third among U.S. residents 10 to 24 years old, the CDC said.

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Wednesday, June 9, 2004

 

Brain Genes Can Go Bad Early

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Wednesday, June 9, 2004

WEDNESDAY, June 9 (HealthDayNews) -- Some genes in brain cells involved in basic thinking functions begin to go bad as early as middle age, says a new study that opens the way to a better understanding of age-related mental conditions such as Alzheimer's disease (news - web sites).

The study looked at the pattern of gene expression in 30 postmortem brain tissue samples from individuals as young as 26 and as old as 106. It found the degeneration often begins at age 40.

"We found a set of genes whose expression changed significantly as a function of aging," said study author Dr. Bruce A. Yankner, a professor of neurology at Children's Hospital Boston. "These genes include those that play a role in synaptic plasticity, the ability of brain cells to form new connections and to strengthen or weaken existing connections."

The finding is "a first step in the application of genomic technology to what it is that happens in the brain that causes cognitive changes in aging," Yankner said. The ultimate goal of the research is to identify individuals whose brain cells are particularly vulnerable to damage and to prevent or reverse the damage, he said. The report appears in the June 10 issue of Nature.

"We could use our model system to determine whether these changes in the aging brain give rise to Alzheimer's disease," Yankner said. "Some brains compensate for the damage better than others. If we understood the interface between normal and diseased cells, we might be able to intervene early."

The study used a sophisticated screening technique called transcriptional profiling that can evaluate the function of thousands of genes at a time. It found the expression of genes that play a role in learning and memory was significantly reduced in older brains.

All genes are vulnerable to damage caused by environmental pollutants and fast-reacting molecules called free radicals, Yankner said, but the vulnerability appears to be greater in some individuals.

"We would like to be able to genetically identify those who are likely to develop damage and prevent it," he said.

It is a "provocative" study, said Zaven Khachaturian, senior science advisor to the Alzheimer's Association, but there are some drawbacks to it.

One is the relatively small number of brains that were examined, he said: "For the conclusions to be valid, you need a much larger number of subjects."

Another problem is that "there is no information about the cognitive ability of the individuals involved," said Khachaturian. That information would link the changes in gene expression to mental function.

Nevertheless, the study "is giving us some clues of what to look for," he said. "It might be a hypothesis-generating kind of study. We could use the results to explore further."

One possible study would compare gene function in 20-year-olds with memory problems and those without such problems, Khachaturian said. "Then you could look at 100-year-olds and see if the findings hold up," he explained.

More information

You can keep abreast of the latest work on Alzheimer's disease by consulting the Alzheimer's Association.

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Study Links Vaccine Ingredient to Autism in Mice

 

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, June 9, 2004

WASHINGTON (Reuters) - A study of specially bred mice suggests that a mercury preservative in vaccines could potentially cause some of the brain changes in autism, U.S. researchers said on Wednesday.

The publication of the study gives fuel to an alliance of environmentalists, parents of children with autism, anti-vaccine advocates and politicians who say they will continue to fight to prove that vaccines can cause autism in susceptible children.

But experts who issued a report last month saying there was no link between vaccines and autism said they had already seen the study and rejected it.

Dr. Mady Hornig of Columbia University in New York said her study shows the possibility that a genetic predisposition could leave certain children vulnerable to a range of toxins in vaccines, including a mercury-based preservative called thimerosal.

Writing in the journal Molecular Psychiatry, Hornig said specially bred mice that have deficient immune systems did show changes in behavior after getting the equivalent of the childhood vaccinations given to U.S. babies and toddlers.

"I think that these findings suggest that it is very plausible that there could be a genetic factor that creates risk for some individuals with autism," Hornig said in a telephone interview.

Institute Of Medicine Report

Hornig presented her findings in February to an Institute of Medicine (news - web sites) committee examining the potential link between vaccines and autism.

The institute is an independent body that advises the federal government on health matters.

The committee issued a report last month saying there was no evidence that vaccines or thimerosal could cause autism and advised that research funds looking for the cause of autism would be better spent elsewhere.

Hornig said her research could at the very least be used to reassure parents worried about the safety of vaccines.

Her study was done using a combination of private and federal funds, including money from SafeMinds, a group pursuing the link between all types of mercury and brain disease.

But Dr. Marie McCormick of Harvard University's School of Public Health, who chaired the panel, said Hornig's research stretched credibility. For instance, it is not clear that children with autism have impaired immune systems.

And using specially bred mice takes research a long way away from real-life situations in people.

"Even though she says these behaviors are like autism, it is not clear that these behaviors are analogous to autism," McCormick said.

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Research: Pregnant Women May Exercise

 

By Alicia Chang

Associated Press Writer

The Associated Press

Wednesday, June 9, 2004

ALBANY, N.Y. - The last thing Rachel Pisciotta wanted was to be a couch potato during her pregnancy. So with her doctor's support, the three-time marathon runner tweaked her workout routine to accommodate her growing belly.

Pisciotta scaled back on her running to avoid overheating, but managed to compete in two 5K races during the first trimester. When the jerky motions of running were too uncomfortable, she switched to brisk walking during the last three months. She also did weight training and exercised on an elliptical trainer.

Not so long ago, many doctors took a conservative approach on recommending physical activity for expectant mothers. There were fears about the unknown effects of exercise and concern that overexertion might cause a miscarriage or harm the fetus.

In the late 1980s, new research forced the medical community to rethink old notions. Scientists found that active pregnant women often had trouble-free pregnancies and did not increase their or their baby's risk for health problems. Some studies even found that women who exercised regularly endured labor better, although exercise did not shorten the time spent in labor.

Even more recent research has further pointed to the growing benefits of physical activity during pregnancy, most notably the finding that exercise may reduce by half a woman's risk for a type of diabetes known as gestational diabetes mellitus.

For Pisciotta, who gave birth to son Joseph in April 2003, working out relieved the stress of impending motherhood and made her feel in control of her inevitable weight gain.

"I was terrified that if I went from exercising a lot to doing nothing, I'd blow up to a very large size," said Pisciotta, who works at the University of Rochester Medical Center in upstate New York.

After her son was born, she took up running again to lose the 38 pounds. A year later, her fitness is close to her pre-pregnancy level and she even ran a half-marathon in May, her first major competition in 13 months.

Two years ago, the American College of Obstetricians and Gynecologists revised its guidelines to relax previous restrictions on how much exercise mothers-to-be should get.

Healthy, active women with uncomplicated pregnancies are now encouraged to follow the federal guidelines for adults, which calls for at least 30 minutes of moderate exercise a day several times a week. Women who never regularly worked out, but who want to start during pregnancy should talk to their doctors first.

Fitness centers around the country are increasingly recognizing this change in attitude. Community gyms are adding new exercise programs designed for pregnant and postpartum women. Their popularity has also spurred the opening of specialty gyms that focus on prenatal exercises such as yoga.

Raul Artal, who heads the department of obstetrics, gynecology and women's health at St. Louis University School of Medicine, noted that pregnancy is a good time to introduce lifestyle changes such as increased exercise to otherwise sedentary women.

"Pregnancy should not be a state of confinement. It's a unique time for behavior modification," said Artal, who helped draft the exercise guidelines for expectant mothers.

Despite the boom in fitness, pregnant women are still advised to avoid contact sports like basketball and hockey. Activities such as horseback riding and downhill skiing are also discouraged because of the risk of falling and possible injury.

While swimming is generally safe, expectant mothers are warned against scuba diving because it may create gas bubbles in the fetus' circulatory system. They should also take into account altitude sickness and avoid activities higher than 6,000 feet.

Fitness experts warn that pregnant women who experience dizziness, vaginal bleeding, or any sign of discomfort should immediately halt their workout.

On the Net:

American College of Obstetricians and Gynecologists: http://www.acog.org

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Too Much Fructose May Skew Appetite Hormones

 

By Alison McCook

Reuters Health

Wednesday, June 9, 2004  

NEW YORK (Reuters Health) - Consuming too much fructose -- a form of sugar found in corn syrup, honey and fruit -- appears to alter levels of hormones involved in appetite regulation in such a way as to encourage overeating, a new study suggests.

After people in the study ate a meal followed by a drink flavored with the same amount of fructose found in two cans of soda, they showed relatively low levels of insulin and leptin, hormones that help people know that they are full.

On the other hand, they showed relatively high levels of ghrelin, a hormone that stimulates eating.

These hormonal changes "we think could promote overeating," and subsequently obesity, study author Dr. Karen L. Teff told Reuters Health.

Teff explained that sugar occurs in two forms, fructose and glucose. Glucose, but not fructose, stimulates insulin secretion, which in turn regulates leptin production.

Both fructose and glucose are naturally found in fruit and fruit juices. However, over the years manufacturers have sweetened sodas and some foods with corn syrup, which contains concentrated amounts of fructose, she said.

"If people are drinking five sodas a day, they're getting a huge amount of calories, plus they're getting a large amount of fructose," she said.

Based on these findings, Teff recommended that people limit their intake of soda and other drinks containing large amounts of fructose. "I've changed my eating patterns because of this, honestly," she said in an interview.

To investigate whether drinking fructose plays a role in obesity, Teff and her colleagues asked 12 normal-weight women to wash down balanced meals with drinks sweetened with either fructose or glucose.

When the women drank the fructose drink, their levels of insulin and leptin were lower than when they consumed a drink flavored with glucose, and levels of ghrelin were higher, the researchers report in the Journal of Clinical Endocrinology and Metabolism.

In addition, drinking the fructose drink was associated with a spike in levels of blood fats, a known risk factor for cardiovascular disease.

Teff, who is based at the Monell Chemical Senses Center in Philadelphia, explained that drinking glucose-sweetened beverages may not encourage overeating as much as fructose drinks because glucose triggers insulin release from the pancreas, which tells people they are no longer hungry. Moreover, glucose is metabolized in a healthier way by the liver than fructose, she noted.

Teff emphasized that there is no way to avoid fructose, which is a natural molecule. But drinking large amounts of it in soda, without any other nutrients, is not natural, she said.

"I don't think there's anything wrong with (fructose), it's just that people are drinking it in large quantities," Teff noted.

Source: Journal of Clinical Endocrinology and Metabolism, June 4, 2004.

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Study: Exercise Important for Strong Bones

 

By Dan Lewerenz

Associated Press Writer

The Associated Press

Wednesday, June 9, 2004

STATE COLLEGE, Pa. - Got exercise? A study published in the latest issue of Journal of Pediatrics indicates that exercise is more important than calcium intake in developing strong bones in girls and young women.

Researchers at Penn State University and Johns Hopkins University found that even among girls whose calcium intake was far below the recommended daily allowance, calcium did not significantly affect bone strength, said Tom Lloyd, professor of health evaluation sciences at Penn State's College of Medicine at the Milton S. Hershey Medical Center.

However, when the girls were asked about their exercise habits, a strong correlation was found between exercise and bone strength.

Lloyd said in tests conducted over the course of a decade, 17 percent of bone strength could be attributed to exercise habits. What's more, girls with better muscle development also had stronger bones.

"When we looked at their lean mass, what we saw was that a 1 kilogram increase in lean mass was associated with a 2 1/2 percent increase in their bone strength," said Moira Petit, assistant professor of health evaluation sciences at Penn State. Lean body mass is the mass of the body minus the fat.

The Penn State Young Women's Health Study began in 1990 with 112 12-year-old girls from central Pennsylvania. The ongoing study has tracked the cardiovascular, reproductive and bone health of the subjects, now in their mid-20s. The paper in the Journal of Pediatrics used data generated between 1990 and 2000.

Studies have shown that women build most of their bone mass in their early and mid-teens. That bone mass then slowly erodes as women age. Building good bone mass in adolescence, then, is thought to be the best way to prevent osteoporosis in old age.

In the Penn State study, calcium intake among the girls varied widely — from 500 milligrams per day to 1,800 milligrams per day. Most recommendations call for teenage girls to consume about 1,300 milligrams per day.

But even at the lower levels, Lloyd said, calcium intake seemed to have little effect on bone strength.

"Now a caveat to this study ... was that the lowest intake in our population was about 500 milligrams per day. Twenty-five percent of teen women in the United States get less than 500 milligrams per day," Lloyd said. "For those kids, having additional calcium to bring them up to at least 500 milligrams per day may be an important determinant of bone health."

But above that baseline, Lloyd said, exercise appeared to be the most important factor in developing bone strength.

John Patnott, professor of kinesiology at Hope College in Holland, Mich., said he was not surprised by the findings.

Bones "are very similar to muscles — you have to use them to develop strength," Patnott said. "I think that calcium in the diet is very important, ... but calcium by itself won't accomplish what is necessary without bone stress."

The Journal of Pediatrics is published in Pennsylvania, and is not the official journal of the Academy of Pediatrics in Chicago. That journal is called Pediatrics.

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Alzheimer Patients Retain Unexpected Skills –Study

 

By Maggie Fox, Health and Science Correspondent

Reuters

Wednesday, June 9, 2004

WASHINGTON (Reuters) - Alzheimer's patients may be capable of learning new ways to use their brains, scientists said on Wednesday in a study that suggests it may be possible to help loved ones and caregivers better cope with their disease.

The study, published in the journal Neuron, shows that the brains of Alzheimer's patients are more intact than had been thought, at least early on in the disease. They may retain what is known as implicit, or unconscious, memory.

"We are not suggesting that this is any kind of cure for the problem," said Cindy Lustig, a memory researcher at Washington University in St. Louis. "What we are saying is that this is preserved, at least in the early stages, so let's work on this to try and help them out."

Alzheimer's is an incurable, fatal condition that eventually destroys the brain, leaving patients helpless before they finally die.

But it can take years to become seriously ill from Alzheimer's. Some drugs may slow its progression. Former U.S. President Ronald Reagan (news - web sites), who died on Saturday with Alzheimer's, was diagnosed 10 years ago.

Alzheimer's, which affects an estimated 4.5 million Americans, starts out with mild memory loss and confusion.

Lustig and Howard Hughes Medical Institute researcher Randy Buckner worked with Alzheimer's patients at these very early stages.

Lustig and Buckner asked 34 young adults, 33 older adults without any Alzheimer's symptoms, and 24 older adults showing memory loss and other symptoms of early-stage Alzheimer's to classify words on a computer screen.

While they did this, the researchers used functional magnetic resonance imaging to look at how and where their brains were working.

Easier With Repetition

It was a simple task and one that people could be expected to get quicker at doing as they practiced.

All three groups did get quicker, even the Alzheimer's patients, Lustig and Buckner reported.

This is a characteristic of implicit memory -- one type of which is developed by repetition or "priming."

Lustig said a good analogy is saying the memory is unconscious. "When you ask an Alzheimer's patient to try to deliberately remember something and they have to deliberately retrieve it, it is difficult for them," she said in a telephone interview.

But implicit memory lets someone remember how to do something without having to think about it -- for instance, many of the actions involved in touch-typing.

While the volunteers used this implicit memory, their brains lit up on the fMRI in a characteristic way. The brains of the Alzheimer's patients and to a degree the healthy older people worked harder at the task than the brains of the young people.

But as they practiced, the MRI scans indicated that the task was becoming easier.

"The findings suggest that if we can help people use these brain systems optimally by providing the right kinds of cues or task instructions, we may be able to improve their function," said Bruckner.

The findings can be used to help caregivers of Alzheimer's patients, said Lustig.

"Let's say if you have to administer some kind of medication to them, if they need to hold their arm a certain way. If you could always do that in same room, always at the same time, preferably with same person, as long as you can try to keep everything the same, they will get into the groove," she said.

Her team saw it in their experiments with the Alzheimer's patients.

"They don't remember explicitly that they have ever been there before. But when we take them into the scanner room, they automatically know, 'I sit on the bed, I take my shoes off,"' Lustig said.

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Study: Virus May Predict Cancer's Spread

 

By Janet McConnaughey

Associated Press Writer

The Associated Press

Wednesday, June 9, 2004

High concentrations of the virus that causes mononucleosis can help doctors predict the spread of a type of cancer that develops behind the nose, a study found.

Epstein-Barr virus levels in the blood may also help predict the course of Hodgkin's disease and some other cancers of the immune system, said lead researcher Jin-Ching Lin of Taiwan.

Researchers do not know exactly how the virus is connected to those cancers, but a link has been found in the past.

The study is too small to draw any final conclusions, said Dr. Ralph Vance, national volunteer president of the American Cancer Society (news - web sites).

"It will be interesting to see if it can be duplicated by others," said Vance, a professor in the University of Mississippi School of Medicine's department of oncology.

Epstein-Barr is one of the most common human viruses — as many as 95 percent of U.S. residents have been infected by age 40. Most have no symptoms, though up to half of those infected as adolescents and young adults develop mono, according to the National Institutes of Health (news - web sites).

After infection, the virus can lurk in a few cells, occasionally becoming active again.

Lin, of the department of radiation oncology at Taichung Veterans General Hospital, studied a cancer that is rare in the United States but common in southeastern China — cancer of the nasopharynx, an area above the soft palate.

All 99 patients in the study in Thursday's New England Journal of Medicine (news - web sites) got chemotherapy followed by radiation. Researchers looked for fragments of DNA from the Epstein-Barr virus in patients' blood, before and after treatment.

The 18 who had relapses within two years all started with more than 1,500 fragments per milliliter. The 81 others all started with fewer.

After treatment, the virus could be found in only 10 patients' blood; within two years, the cancer had spread in seven of them.

Epstein-Barr has also been associated with Burkitts lymphoma and T-cell lymphomas, as well as breast and stomach cancer.

On the Net:

http://www.cancer.org/docroot/CRI/CRI_0.asp

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Gene Variation Linked to Pregnancy-Related Diabetes

 

Reuters Health

Wednesday, June 9, 2004

NEW YORK (Reuters Health) - Some women are prone to develop diabetes during pregnancy, and new research indicates that a variation in a specific gene may be the cause in some cases

Austrian scientists have found that a variant of a gene called calpain-10 gene is associated with the development of so-called gestational diabetes, according to a report in the medical journal Obstetrics and Gynecology.

Calpain-10 produces an enzyme involved in the processing of glucose in skeletal muscle cells, the authors explain. A particular form of the gene, designated haplotype 112/121, has already been linked to impaired glucose tolerance and type 2 diabetes.

Dr. Christof Worda and colleagues from the University of Vienna Medical School examined the 10 most common variants of calpain-10 in 80 pregnant women 40 with gestational diabetes and 40 without.

Gestational diabetes was present in all women with the haplotype 121/221 form, the team found.

"Our results indicate that the haplotype 121/221 of the calpain-10 gene may be associated with disturbances of glucose metabolism during pregnancy," the authors conclude.

Source: Obstetrics and Gynecology, June 2004.

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CT Screening for Lung Cancer Questioned

 

HealthDayNews

Wednesday, June 9, 2004

WEDNESDAY, June 9 (HealthDayNews) -- There's no proof that using computed tomography (CT) to screen for lung cancer offers any patient benefits, claims a study by researchers at Duke University Medical Center and the Mayo Clinic.

They concluded the medical literature offers no evidence to support the widely held belief that CT saves lives because it can detect lung cancers at a smaller size than other screening methods.

"Finding a lung cancer when it is smaller does not necessarily mean the cancer is at an earlier stage of development," Dr. Edward Patz, a professor of radiology and of pharmacology/cancer biology at Duke, said in a prepared statement.

"The genetic characteristics of a tumor likely dictate its behavior more than its size. Smaller lung tumors can represent late-stage cancer," Patz said.

The study appears in the June 1 issue of the Journal of Clinical Oncology.

More information

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

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Acetaminophen, Ibuprofen Both OK for Kids

 

By Alison McCook

Reuters Health

Wednesday, June 9, 2004

NEW YORK (Reuters Health) - Ibuprofen (in painkillers such as Advil) and acetaminophen (for example, Tylenol) both appear to treat children's common aches and pains equally safely and well -- based on a review of published medical studies.

"There has been a tendency for (general practitioners), pediatricians, pharmacists and nurses to emphasize the common perception that acetaminophen is safer than ibuprofen," study author Dr. David A. Perrott told Reuters Health. "But, taken as a whole, the studies we reviewed provide no evidence that one drug is any less safe than the other," he noted.

Perrott cautioned that these findings are based on scant research comparing how well and safely ibuprofen and acetaminophen work for children.

Indeed, in the Archives of Pediatrics and Adolescent Medicine report, he and his colleagues recommend "more research" into the safety and effectiveness of these two drugs in treating kids' pain or fever from ailments such as headaches, muscle aches and colds or the flu.

Currently, acetaminophen and ibuprofen are the most common treatments used to relieve pain and fever. Research in adults suggests that the two drugs stack up equally well, yet investigations into their use in children have yielded mixed results.

To get a clearer picture, Perrott and colleagues reviewed 17 trials involving children and teens less than 18 years old "receiving either drug to treat fever or moderate to severe pain."

The investigators found that both drugs appeared to treat children's pain equally well, although ibuprofen appeared somewhat better at reducing fever.

Both drugs also appeared to be equally safe, and just as harmless as an inactive placebo.

Perrott, who is now based at TrialGraphix in Chicago, explained that ibuprofen may do a slightly better job of reducing kids' fever than acetaminophen partly because it relies on a different mechanism to reduce temperature.

He added that the current study looks only at instances where kids got a single, regulated dose of the drugs. "We did not review studies examining what happens when you take combinations of the drugs or repeated doses over time," Perrott noted.

The study was partly funded by Boots Healthcare Australia Pty Ltd, a division of Boots Healthcare International, which makes a form of ibuprofen.

Source: Archives of Pediatrics and Adolescent Medicine, June 2004.

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'Safe' Lead Levels Not Safe for Arteries

 

HealthDayNews

Wednesday, June 9, 2004

WEDNESDAY, June 9 (HealthDayNews) -- Blood levels of lead and cadmium currently considered safe may increase the risk of peripheral artery disease, says a study in this week's issue of Circulation.

The study of 2,125 adults found those with the highest blood concentrations of lead or cadmium were nearly three times more likely to develop peripheral artery disease than people with the lowest levels of the two metals in their blood.

The study findings suggest that experts "need to think more carefully about this association and do more experiments with cadmium and lead at lower doses to determine what exposures (to the metals) might be problematic in terms of risk for cardiovascular disease," study author Dr. Eliseo Guallar, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, said in a prepared statement.

Peripheral artery disease (PAD), which affects 8 million to 12 million Americans, occurs when fatty deposits build up in artery walls and cause reduced blood circulation, mainly in the arteries to the legs and feet. People with early-stage PAD often experience fatigue or cramping in their legs and buttocks during activity. These symptoms disappear when the person is still.

Lead and cadmium is found in cigarette smoke and in air near industrial plants. The metals are also in certain foods and sometimes in drinking water.

More information

The U.S. National Institute of Environmental Health Sciences has more about lead.

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Seasons May Be Involved in Timing of Menopause

 

Reuters

Wednesday, June 9, 2004  

LONDON (Reuters) - Seasonal changes could impact the timing of menopause, adding to factors such as a woman's dwindling supply of eggs, Hungarian fertility experts said on Thursday.

They found that the spring and autumn equinoxes played a role in when women experience menopause.

"We found that there was a high peak after the spring equinox and another, lower one, after the autumn equinox," said Dr. Janos Garai, of the Baranya County Teaching Hospital in Pecs, Hungary.

He and his team questioned 102 women about when they had their last monthly period. Thirty recalled only the season of the year but 72 remembered the exact month.

March, April and June were cited most often, and August and December the least.

"The seasonality we found seems to support the influence of environmental factors on female human reproductive functions even when they are declining," Garai, who reported his finding in the journal Human Reproduction, added in a statement.

He and his colleagues called for more research into factors that could influence the onset of menopause, including the role of the hormone melatonin, which is linked to body rhythms such as the 24-hour body clock.

Menopause usually occurs between the ages of 45 and 60 but it can happen earlier or if the ovaries are removed or stop functioning.

"What we already know, coupled with our new findings, means it is plausible that this process is not just due to the ovaries no longer being able to produce developing egg follicles that provide an adequate hormone supply," Garai said.

He suggests internal and external factors affected by conditions such as the length of day, temperature and humidity could have an impact on the ovaries.

"Length of day is likely to be only one of several factors operating and melatonin might not be the only agent involved so we need to research this further," he added.

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Urban Teens Not Getting Enough Vitamin D

 

HealthDayNews

Wednesday, June 9, 2004

WEDNESDAY, June 9 (HealthDayNews) -- Many adolescents living in American cities have low levels of vitamin D, which is crucial for calcium absorption and bone growth.

Researchers examined vitamin D deficiency among 307 healthy urban adolescents, aged 11 to 18, who had blood tests and nutrition and activity assessments.

The study found that 74 (24.1 percent) of the adolescents were vitamin D deficient. Of those, 14 (4.6 percent of the total) were severely vitamin D deficient. The study also found that 129 (42 percent) of the adolescents were vitamin D insufficient.

Ethnicity, milk and juice consumption, time of the year, body mass index and physical activity were significant predictors of vitamin D insufficiency.

"Vitamin D deficiency was present in many U.S. adolescents in this urban clinic-based sample. The prevalence was highest in African-American teenagers and during winter, although the problem seems to be common across sex, season and ethnicity," the study authors wrote.

The study appears in the June issue of the journal Archives of Pediatrics and Adolescent Medicine.

More information

The U.S. National Institutes of Health (news - web sites) has more about vitamin D.

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FDA Approves Israeli Spinal Repair Robot

 

Reuters

Wednesday, June 9, 2004

WASHINGTON (Reuters) - A miniature robot that helps point surgeons to just the right place for spinal repairs has been approved by the U.S. Food and Drug Administration (news - web sites), its inventors said on Wednesday.

Called the SpineAssist, the robot was made at the Technion-Israel Institute of Technology and manufactured by its inventor Moshe Shoham's company, called Mazor Surgical Technologies.

The soft-drink-can-sized device is attached to a patient's body, guiding and positioning tools and implants so that surrounding nerves are not damaged.

"SpineAssist minimizes the risk of working freehand in sensitive regions of the spine," Shoham said in a statement.

"It conceives a plan for locating the spinal implants, but neither replaces the surgeon nor performs any operations. After examining and approving the recommendation, the surgeon inserts surgical instruments through the arm of the robot, thereby minimizing the danger of damaging vital organs."

The $100,000 device will be tested at the Cleveland Clinic Foundation in Cleveland, Ohio and Sheba Medical Center in Tel Hashomer, Israel.

More than 500,000 spine operations are performed annually in the United States alone, the Institute said in a statement.

It cited analyst reports as saying the spinal industry is expected to triple its growth over the next eight years, reaching annual sales of $7 billion.

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Possible Marker for Alzheimer's Disease Found

HealthDayNews

Wednesday, June 9, 2004

WEDNESDAY, June 9 (HealthDayNews) -- Measuring levels of certain antibodies may improve diagnosis and treatment of Alzheimer's disease (news - web sites), say researchers at the Medical College of Georgia and Veterans Affairs Medical Center in Augusta.

They studied leukocytes -- white blood cells that are part of the immune system -- in 33 Alzheimer's patients and 42 healthy people. They found that leukocytes in Alzheimer's patients had four times higher levels of markers for amyloid-b peptide and receptor for advanced glycation end products (RAGE).

The findings could help scientists develop a method for early diagnosis of Alzheimer's, when treatment has the most potential to help. It could also lead to a way to identify people at risk of the disease and to the development of a new treatments.

The study results lend support to the theory that autoimmunity and resulting inflammation play a major role in Alzheimer's.

The study will appear in the September issue of the Neurobiology of Aging.

More information

The National Women's Health Information Center has more about Alzheimer's disease.

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Tuesday, June 8, 2004

 

Symptoms of 'Silent Killer' Not So Quiet – Study

 

Reuters

Tuesday, June 8, 2004

CHICAGO (Reuters) - Ovarian cancer, called the silent killer because it often goes undetected, does have pronounced symptoms if doctors and patients would only heed them, researchers said on Tuesday.

A bloated abdomen, pelvic pain and an urgent need to urinate, which some associate with menstruation, may signal an ovarian tumor especially if the symptoms are severe, frequent and simultaneous, they said.

The importance of early diagnosis is illustrated in five-year survival rates that approach 90 percent if the disease is caught early versus 20 percent if diagnosed after it has progressed, a study published in the Journal of the American Medical Association (news - web sites) said.

Comparing women who turned out to have malignant tumors and cancer-free women who visited a health clinic during the same six-month period in 2001, those with cancer were much more likely to have a combination of increased abdominal size, bloating, pelvic pain and a frequent and urgent need to urinate. Back pain, constipation and fatigue were commonly reported symptoms, but were not associated with cancer.

"The important difference is that (vague) symptoms (reported by noncancerous women) are less severe and less frequent when compared with women with ovarian cancer," wrote study author Barbara Goff of the University of Washington School of Medicine, Seattle.

"In addition, women with ovarian cancer typically have symptoms of recent onset and have multiple symptoms that coexist," she wrote. "This study adds further evidence that ovarian cancer is not a silent disease."

Ovarian cancer is the fifth-leading cause of cancer death among U.S. women after cancers of the lung, breast, colon, and pancreas. About 23,000 women are diagnosed with the disease each year, and 14,000 die from it -- a relatively high fatality rate caused by the failure to catch many cases early.

Strategies to screen for ovarian cancer have proven to be elusive but this study demonstrated what to look for, an editorial accompanying the study said.

"The importance of this study is not the validation of a symptom cluster as a precise way to diagnose ovarian cancer, but rather the reinforcement of the need for an ongoing process of communication between patients and their physicians," Mary Daly and Robert Ozols of the Fox Chase Cancer Center in Philadelphia wrote.

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Genetic Disparity Gives Chemo Insight

 

By Daniel Q. Haney

AP Medical Editor

The Associated Press

Tuesday, June 8, 2004

NEW ORLEANS - Genetic differences among cancer patients may help explain why some become terribly sick during their treatment and others find chemotherapy a relative breeze.

The genetic defects that trigger cancer vary from person to person. Individualizing treatment to target the genetic signals driving each patient's tumor is an often-discussed goal, though still not routinely achieved.

Less attention has been paid to the genetic differences in the rest of the body that influence how miserable patients become while going through cancer therapy. Reports at the annual meeting in New Orleans of the American Society of Clinical Oncology (news - web sites), which concluded Tuesday, described the beginning attempts to sort this out.

Understanding individual genetic differences "may explain why one person will benefit from a drug and another will not or why someone has severe toxicity," said Dr. Harry Bleiberg of the Jules Bordet Institute in Brussels.

For now, this research is unlikely to have much effect on how patients are treated. But someday, it may be possible to tailor treatments to patients' side effects as well as their likelihood of being cured.

"It is really important. This could dictate the size of the dose we give or maybe whether we don't give a drug at all," said the oncology organization's president, Dr. Margaret Tempero of the University of California at San Francisco.

In one study involving 494 patients, Dr. Jeff Sloan and others from the Mayo Clinic looked for differences in genes that regulate the body's use of the vitamin folate. He found these genetic patterns seem to influence how well patients do on a three-drug combination for advanced colon cancer. Possible side effects from the treatment include fatigue, diarrhea, nausea, vomiting, dehydration, low white-cell counts and numbness of the hands and feet.

Many normal genes are found in slightly variant forms. The Mayo team looked at a gene called DPYD and found that people with two variations were significantly less likely than those with the usual form to suffer fatigue.

In addition, those with a bit of genetic code called TSER near another folate gene known as TYMS were more likely to report a positive outlook while on chemotherapy.

"We believe we have found evidence of a relationship between the genetic makeup of cancer patients and their quality of life, even before treatment begins," Sloan said.

Another study, conducted by Dr. Rebecca Suk of Massachusetts General Hospital, identified a genetic variation that seems to influence whether people treated for advanced non-small cell lung cancer experience vomiting and other severe gastrointestinal side effects while on chemotherapy.

Her team looked for variations in a gene involved in DNA repair in 147 patients. They found that 30 percent of those with unusual forms of this gene were likely to have particularly bad side effects, compared with just 14 percent who had the standard gene.

The researchers speculate that people with the variant form of this gene, called ERCC1, do a worse job of repairing damage caused by the chemotherapy, and this explains their severe side effects.

"A lot more studies need to be done before we can apply this in the clinic," Suk said. "But it may be possible to identify people who are at high risk and use that to choose their therapy."

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

On the Net:  http://www.asco.org

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New Breast Cancer Drug Saves Lives

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, June 8, 2004

WASHINGTON (Reuters) - A new class of breast cancer drugs that women can take after the standard five years of tamoxifen therapy saves lives as well as preventing the return of tumors, researchers from Canada reported on Tuesday.

Femara, made by Swiss drugmaker Novartis (NOVZn.VX), reduced the risk of death by 39 percent in women who took it, compared with women who took a placebo.

It reduced the spread of cancer, called metastasis, by 40 percent, they told a meeting of the American Society of Clinical Oncology (news - web sites) in New Orleans.

The findings add to the evidence that the drugs, called aromatase inhibitors, are a valuable extra weapon in the arsenal against breast cancer, which will affect 1.2 million people globally this year and kill 40,000 in the United States alone.

For the study, Dr. Paul Goss, from Princess Margaret Hospital in Toronto, has been studying 5,100 women who took the standard treatment, tamoxifen, for five years.

Tamoxifen cuts the risk of breast cancer in half and greatly reduces the risk that it will come back in women who have already had one bout with the disease.

But the hormone-based therapy stops working well after five years and can have adverse effects. Doctors have been testing the aromatase inhibitors to see if adding them to the treatment regime after the five years of tamoxifen will help even more.

Goss and his colleagues reported last year that Femara, known generically as letrozole, reduced even further the risk that breast cancer would return in women who took it after tamoxifen.

"We in fact did reduce internal metastases, which are inevitably fatal," Goss said in a telephone interview.

"We also reduced the risk of dying. We have a survival advantage for women taking this drug."

Among women taking Femara, 28 died of breast cancer during the study. Among women taking the placebo, 45 died. Goss noted that some women took Femara for longer than others did.

The women took the drug for a median of two-and-a-half years.

Goss said the drug seemed safe, except that Femara seems to increase the risk of the bone-thinning disease osteoporosis .

"There is an apparent slight increase in bone loss," he said. "A slightly increased number of women developed osteoporosis during the trial. But there was no difference in fractures. At least we know about it and it is easy to fix and prevent."

Goss said 8 percent of the women taking Femara developed osteoporosis, compared with 6 percent of women on placebo.

"There will be some women in whom cancer is such a low risk and whose risk of osteoporosis is so high that this drug might not be suitable," Goss added.

Another drug in the same class is Arimidex, made by AstraZeneca (AZN.L) and known generically as anastrozole.

The aromatase inhibitors work through a different mechanism from tamoxifen, perhaps offering an advantage. Both reduce the effects of estrogen, a hormone that can fuel tumor growth.

Novartis is trying to distinguish Femara from Arimidex and has filed for the drug to be used by post-menopausal women who have completed standard therapy in North America, the European Union (news - web sites) and Switzerland.

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Organic Diet Requires Planning, Thrift

 

By Michael Hill

Associated Press Writer

The Associated Press

Tuesday, June 8, 2004

ALTAMONT, N.Y. - They buy rice at a co-op, fruit at farm stands and organic beef on Sundays, when supermarkets cut prices to clear the shelves.

Janelle Fletcher and her husband adopted those strategies to achieve two goals that can seem incompatible: Feeding their family of five organic food and staying within a middle-class budget.

Even as organics move from its health food niche into the mainstream, premium prices remain in many cases. Health-conscious families are left to find creative solutions to eat naturally on a budget. It can involve a bit of hunting and gathering, bulk-buying, and thinking outside the grocery cart.

"We do eat well despite not being wealthy," Fletcher said. "That's one thing I don't quibble about."

Organic food — produced without pesticides, growth hormones or other additives — accounts for slightly less than 2 percent of U.S. food sales. But the market has been on a healthy growth spurt. Organic food sales almost tripled from 1997 through 2003 to $10.38 billion, according to the Organic Trade Association. Industry officials expect the double-digit annual growth to continue.

Mad cow disease scares and concerns about pesticide-laden produce are among the factors cited for organic's popularity. But an overarching reason appears to be that consumers are more interested about what is in their food, whether it's carbs, fat, hydrogenated oils or chemicals. Organic advocates offer one more reason: flavor.

"Anybody who tries the organic stuff, you don't go back," said Fletcher, whose family lives near Albany, N.Y. "My chicken soup with organic chickens is so much better. The fat is better. It has a better quality."

Organic food can be costlier for a number of reasons, including higher labor costs and economies of scale. A recent trip to the supermarket showed organic broccoli selling for a dollar more a head than conventional broccoli and organic carrots costing a third more. Organic ribeye steaks were priced for two dollars more a pound.

Ronnie Cummins of the Minnesota-based Organic Consumers Association said people always ask him how to eat organic affordably. He points them beyond the supermarket.

Cummins suggests food buying clubs, which allow a bunch of people to pool their purchasing power and buy straight from wholesalers. Liz Welch, Cummins' sister-in-law, said her family teams up with four others in their Minneapolis neighborhood to order — then split up — cases of organic macaroni & cheese, tomatoes and natural sodas.

Cummins also advocates Community Supported Agriculture, in which people agree to pay a "share" of a farm's operating expenses. In return they get regular deliveries of whatever crop is coming in, be it peas, patty pan squash or rhubarb.

Alice Waters, the Berkeley, Calif., restaurateur and sustainable agriculture guru, advises people to go straight to the source and buy food at farmers' markets. She also says people should grow their own, noting that even city dwellers have access to community gardens.

A keystone of many organic strategies is buying grains and other dry goods in bulk. Local food cooperatives are stocked with bins of brown rice, quinoa, cayenne, raisins and nuts. The cooperatives shave costs by having shoppers provide their own packages. Shoppers also can get discounts in return for working a set number of hours each month.

While buying in quantity makes economic sense, it requires planning. What can a family cook do with a mound of bulgur? Fletcher made organic meatballs. Waters suggests preserving and pickling when possible, like canning tomatoes when the harvest bounty makes them dirt cheap.

Waters admits the organic lifestyle can be time-consuming but said the canning, pickling and preparation can be an enjoyable activity shared by the family.

And yes, getting kids to eat their grains can be a challenge. But parents report success.

"I've convinced my 6-year-old to eat oatmeal and raisins in the morning instead of what he'd like to eat, which would be a breakfast cereal with a lot of sugar in it," Cummins said.

The good news, in Cummins' view, is that it's getting easier to root out organic bargains. He said the organic market is getting big enough so that sales are more common. Holly Givens of the Organic Trade Association said the margin between organic and conventional products has been closing.

Higher prices linger, though. Fletcher recalls passing over tempting organic strawberries for $3.50 a pint after seeing non-organic berries at half the price.

"I could get two of them for the same price, so I didn't buy (organic)," she said.

On the Net:

Organic Trade Association: http://www.ota.com

Organic Consumers Association: http://www.organicconsumers.org/

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U.S. 2003 Health Cost Rises Slowed, But Still High

 

By Kim Dixon

Reuters

Tuesday, June 8, 2004  

CHICAGO (Reuters) - The pace of growth in medical costs eased significantly in 2003, but still bounded well ahead of economic expansion, making it among the biggest burdens facing corporate America, a report released on Wednesday said.

A sharp slowdown in prescription drug spending growth offset by a steep rise in hospital prices fueled a jump in underlying medical costs of 7.4 percent, well below the 9.6 percent rise recorded in 2002, the study by the non-profit Center for Studying Health System Change found.

The report analyzed health care revenues to hospitals, doctors and for prescription drugs for privately insured individuals, compiled by research group Milliman USA for 2003.

Medical care costs continue to soar at more than double the rate of overall price inflation, with most of the costs borne by big employers and the federal government.

"I hate to hear the word 'slowdown' because it makes people think things are better," said Helen Darling, president of the National Business Group on Health, whose members include Fortune 500 companies like Cisco Systems Inc. and Xerox Corp. that lobby on health cost issues.

"Nothing else in our businesses or the economy grows at this rate."

Underlying medical cost trends are critical because they drive health insurance premiums, which rose by 13.9 percent in 2003, according to the Kaiser Family Foundation.

The United States spends twice as much on health care per capita compared to other rich countries. Health care spending is expected to comprise 18.4 percent of the gross domestic product over the next decade, up from 14.9 percent in 2002, government data show.

Drug Prices Rise More Slowly, Hospitals Costs Spike

Hospital spending, which makes up the lion's share of health costs, also accounted for 53 percent of the total increase in health spending in 2003.

In recent years, spending on prescription drugs has garnered headlines and the wrath of consumers.

But in 2003, prices for inpatient and outpatient hospital care rose 8 percent, after a 5.2 percent rise in 2002. That's the biggest one-year increase since the government began tracking those figures, the study by the Washington, D.C.-based center said.

"Hospitals are struggling with a lot of pressures on the cost side that are driving up the prices they need -- like wage pressures," said Caroline Steinberg, a vice president at the American Hospital Association, a trade group that represents big nonprofit and for-profit hospitals.

Consolidation among hospital companies has given them the upper hand in bargaining with health insurers over prices in recent years, a trend found by the study and confirmed by industry experts.

"Hospital behavior in the past couple of years has really been unreasonable," said Darling of the employers' group, adding that some hospitals were "refusing to negotiate in some markets."

Spending on prescription drugs, meanwhile, grew by 9.1 percent in 2003 -- a significant slowdown from 13.2 percent in 2002 and the peak of 18.4 percent growth set in 1999.

Increased use of cheaper generic drugs, more cost sharing by patients, and patent expirations have contributed to that trend, the report said.

The study concluded that health costs are rising at a rate that employers will not continue to bear in the long term, co-author Paul Ginsburg said.

"Employers don't see this as sustainable," he said. "This year's results are not going to convince (people) that the affordability crisis is over."

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Soda May Increase Female Diabetes Risk

 

By Mike Branom

Associated Press Writer

The Associated Press

Tuesday, June 8, 2004

ORLANDO, Florida - Chugging more than one sugar-sweetened soft drink a day appears to significantly increase a woman's chances of developing diabetes, says a Harvard study that found the extra sugar does more than just add pounds.

Women in the study who drank at least one sugar-sweetened soda a day were 85 percent more likely to develop type 2 diabetes than those who drank less, said Matthias B. Schulze, who presented the Harvard School of Public Health research at the American Diabetes Association's 64th scientific sessions.

In addition to the sodas' excess calories, their large amount of rapidly absorbable sugars could contribute to obesity and a greater risk of diabetes, said Schulze, a postdoctorate student from Germany.

"It's not that sugar everywhere is important, but it seems that sugar specifically in liquid foods may be relevant," Schulze said. "So, sodas and other energy-providing drinks may lead to an overconsumption of energy that would lead to obesity and weight gain."

Diet sodas with sugar substitutes, however, did not increase the chances of developing diabetes, Schulze said. He added that the women who drank diet sodas tended to lose weight.

Diabetes is an illness that develops, often in middle age, when a body loses the ability to turn blood sugar into energy. There were 18.2 million Americans — 6.3 percent of the population — with diabetes in 2002, and it is the nation's fifth-deadliest disease, says the American Diabetes Association.

Worse yet, diabetes is a growing problem. The prevalence of diabetes was fairly flat during the 1980s, but nearly doubled from 1990 to 2002.

According to Schulze's study, the women most prone to gaining weight had increased their consumption of sugary soft drinks from less than one a week to more than one a day. On average, those women gained 9-10 pounds in a four-year period. But women who cut their intake of soft drinks gained an average of 3 pounds or less.

The research followed more than 91,000 adult women over an eight-year period. It is part of the Nurses Health Study at Boston's Brigham and Women's Hospital.

The research comes two months after the release of a British study showing school programs that discouraged drinking sodas appeared to be effective in reducing obesity among children.

Mike Jacobsen, executive director for the Center for Science in the Public Interest consumer advocacy group, said he wasn't surprised by the study's findings — but he was pleased.

"It provides ammunition for education efforts, labeling changes and restricting soft drink consumption in schools," Jacobsen said.

The National Soft Drink Association labeled the study as "unconvincing and inconclusive," because it has yet to be peer-reviewed and raises questions over factors that could create inaccuracies.

Schulze acknowledged the study's limitations in that its data came from observations, such as body weight the women themselves reported.

On the Net:

American Diabetes Association: http://www.diabetes.org/

Harvard School of Public Health: http://www.hsph.harvard.edu/

Center for Science in the Public Interest: http://www.cspinet.org/

National Soft Drink Association: http://www.nsda.org/

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Critics Want Supplement Risks Reported to FDA

 

By Lisa Richwine

Reuters

Tuesday, June 8, 2004

WASHINGTON (Reuters) - Congress should change the 10-year-old law that governs sales of vitamins and other dietary supplements to require makers to report potential safety risks to regulators, senators and other critics said Tuesday.

An industry group, the American Herbal Products Association, agreed mandatory reporting of serious health problems in patients taking supplements would help the government better police unsafe products.

The Food and Drug Administration (news - web sites), however, believes it has sufficient power to act against risky supplements and is not seeking any changes to the law, said Robert Brackett, director of the agency's Center for Food Safety and Applied Nutrition.

The agency is trying to make the most of its current powers under the 1994 law "before we ask for any new authority," Brackett said at a hearing before a Senate Governmental Affairs subcommittee.

"That approach is so timid even the industry is against it," replied Sen. Richard Durbin, an Illinois Democrat.

"How can you protect American consumers from risk .... if you are not receiving notice from these companies?" Durbin asked.

The American Medical Association also called for mandatory reporting of serious health problems as well as pre-market testing requirements for supplements.

Millions of Americans take vitamins, herbs and other supplements widely available in drug, grocery and health-food stores. The industry's annual sales are estimated at $18 billion.

Under the 1994 law, companies can sell supplements without putting them through the extensive safety and effectiveness testing required for pharmaceuticals. The FDA has the burden of proving a supplement is risky.

Earlier this year the FDA for the first time banned a supplement, the herbal weight-loss pill ephedra, after it was linked to heart attacks, strokes and deaths.

Durbin said the years it took for the FDA to ban ephedra showed the law was not strong enough to keep dangerous products from the public.

"If the object of this law is to protect American consumers, (the law) fails on its face," Durbin said.

The FDA also came under criticism for failing to set manufacturing standards for supplement makers as the law required. "It's unacceptable," said Ohio Republican Sen. George Voinovich, the subcommittee chairman.

The agency proposed the manufacturing standards last year and has been reviewing more than 1,600 pages of comments from the public, Brackett said. The rules are designed to ensure supplements contain the ingredients listed on the label and are free from contamination.

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Dietary Supplement Law Said Inadequate

 

By Ira Dreyfuss

The Associated Press

Tuesday, June 8, 2004

WASHINGTON - A decade-old federal law on dietary supplement safety and the FDA (news - web sites)'s enforcement are not up to the job of protecting Americans' health, two senators told an FDA official Tuesday.

Sen. Richard Durbin of Illinois, ranking Democrat on the Governmental Affairs Committee's oversight subcommittee, criticized the law as a failure. Subcommittee Chairman George Voinovich of Ohio, singling out one aspect, said it was unacceptable that Food and Drug Administration has not set regulations for good manufacturing processes in the 10 years since the law was passed.

The Dietary Supplement Health and Education Act requires the FDA to prove that a dietary supplement is harmful, rather than having the manufacturer prove it is safe as is required with drugs. The law also does not require supplement manufacturers to report adverse reactions, as drug companies must.

"If the object of this law is to protect American consumers, it fails," Durbin told the director of the FDA's Center for Food Safety and Applied Nutrition, Robert Brackett, who is responsible for enforcing the law. "How can you meet that responsibility when the law is so weak?"

Durbin, who requested the subcommittee hearing, is sponsoring a bill that would make manufacturers report serious adverse reactions such as hospitalizations, permanent injuries or deaths involving users of supplements. The bill also would let the government require manufacturers to prove a product is safe if FDA had received information that suggested adverse reactions from a supplement.

Before the agency would ask for any more power, it wants "to maximize our activities under the current (law)," Brackett responded. "The administration at this time has no plans to make any changes."

He said the FDA is working with the National Institutes of Health (news - web sites) and with academic researchers to identify ingredients and has set up a system to track adverse reactions reported by consumers, health workers or manufacturers.

The law requires require the FDA to set standards for good manufacturing processes so products do not contain contaminants such as bacteria and lead but do contain labeled ingredients in the proper amounts. The agency published a proposed rule in March 2003 and is reviewing responses to it.

That's not good enough, Voinovich told Brackett. "I just cannot believe that it has taken that long after this law is passed," the senator said. "It's unacceptable that it takes 10 years to get something done."

The regulations will be "done as soon as possible, that is our goal," Brackett said.

The law allows the FDA to ban ingredients that are proved unsafe, and the agency announced in April that its ban on the diet aid ephedra had taken effect. The substance had been linked to 155 deaths, including that of Baltimore Orioles pitcher Steve Bechler in 2003.

"Consumers are endangered by the FDA's inability to act on particular supplements," and ephedra is a case in point, Durbin said. "It took years — literally years — for the FDA to ban this substance under this law, DSHEA."

(Subs 2nd  graf to correct George sted Richard)

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Fresh Air Blows Cold Germs Away

 

Reuters Health

Tuesday, June 8, 2004

NEW YORK (Reuters Health) - The more outdoor air is pumped into office ventilation systems, the lower the inside levels of viruses that cause the common cold -- according to a new report.

Few studies have considered the possible link between the ventilation of buildings and respiratory illness in their occupants, note the authors of the study in the American Journal of Respiratory and Critical Care Medicine.

Dr. Donald K. Milton from Harvard School of Public Health in Boston, Massachusetts, and colleagues sampled the workday air from three office buildings and used molecular techniques to detect and identify rhinoviruses in air samples and in nasal mucus from building occupants.

The concentration of carbon dioxide in the air was used as a measure of exhaled breath and the supply rate of outdoor air.

There was a significant relationship between the detection of airborne rhinoviruses and the amount of stale indoor air, the investigators report.

Also, one rhinovirus present in a nasal mucus sample from an occupant with a cold proved to be identical to a rhinovirus collected on an air filter from the same building during the occupant's illness, the team notes.

"These data suggest that lower ventilation rates and resulting increased carbon dioxide concentrations are associated with increased risk of exposure to potentially infectious droplets," Milton's team concludes.

"Although this study does not provide definitive proof that rhinovirus is transmitted through the aerosol route and is modulated by outdoor air supply rates," they add, "it does provide support for this hypothesis."

"The findings...of increasing virus detection with rising carbon dioxide concentration indicates one possibility for reducing transmission -- increasing exchange of indoor with outdoor air," writes Dr. Jonathan M. Samet from Johns Hopkins University in Baltimore, Maryland in a related editorial.

Samet agrees with Milton's group that other environments, "particularly schools" should be investigated in the same way.

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

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British Scientists Find Prostate Cancer Gene

 

Reuters

Tuesday, June 8, 2004

LONDON (Reuters) - British scientists have identified a gene that plays a crucial role in prostate cancer and could lead to a test to detect the most aggressive tumors.

Researchers at the Institute of Cancer Research and the University of Liverpool in northern England found that a gene called E2F3 is overactive in prostate cancer tumors.

"A test to distinguish between aggressive tumors, the tigers, and those that are pussycats has been the holy grail of prostate cancer research," Professor Colin Cooper of the Institute of Cancer Research said Tuesday.

"Now we know that the E2F3 gene is implicated in prostate cancer and that it is key in determining how aggressive the cancer is, we hope to be able to develop such a test within the next five years," he added in a statement.

Prostate cancer (news - web sites) is one of the most common male cancers. It accounts for about 200,000 deaths worldwide each year.

The only test for prostate cancer measures PSA, prostate specific antigen, a protein made by the prostate gland. A raised PSA level can be a sign of the disease or something less serious.

Cooper and his colleagues, whose findings will be reported in the journal Oncogene, believe the protein produced by the gene is a key to determining how aggressive the cancer is.

An overactive gene means too much protein is produced, which leads to excessive proliferation and the development of a tumor.

In a study comparing healthy and cancerous prostate cells, the scientists found that 67 percent of prostate cancer cells they examined had an indication of the presence of E2F3. A worse prognosis was linked to a higher level of the protein.

"We now find ourselves in the unique and exciting position of being able to test new early markers of prostate cancer progression, which previously had not been possible," said Professor Peter Rigby, the chief executive of the Institute of Cancer Research.

"A rapid and immediate expansion of our research in this area is required so that our scientific advances can be translated into patient benefit without delay," he added.

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More Patients Using Medical Marijuana Than Thought

 

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- Despite limited evidence of marijuana's medicinal value, it's being used by many people with multiple sclerosis and epilepsy who believe the drug is an effective treatment, say two Canadian studies in the June 8 issue of Neurology.

One study included a survey of 136 patients from the University of Alberta Epilepsy Clinic. Nearly half said they'd used marijuana in their lifetime; one in five had used it in the past year; 15 percent had used it in the past month; 13 percent used marijuana more than 48 days a year; and 8 percent used it more than half the days of the year.

Odds of frequent marijuana use were 10 times greater for those who had had epilepsy for at least five years, and eight times greater for those who had frequent seizures.

The researchers suggest that epilepsy patients who experience more frequent seizures may be more likely to try alternative treatments such as marijuana.

"Studies suggest one-third of the general population use alternative health care on a yearly basis," study author Dr. Donald Gross said in a prepared statement.

"Not surprisingly, patients tend to look to alternative therapies in situations where conventional medicine has been unsuccessful, in particular, for chronic medical situations. The finding of increased marijuana use in epilepsy patients with longer duration of disease and frequent seizures is consistent with the findings regarding other forms of non-conventional therapies," Gross said.

It may also be possible that increased marijuana use results in increased seizure frequency, he added.

The second study included a survey of 205 multiple sclerosis patients in Halifax, Nova Scotia. Of the 34 patients who said they were medical marijuana users, more than half believed it was a very effective treatment and more than half also said they'd used it within the previous 24 hours.

Nearly 20 percent of the patients said they used marijuana more than one time a week. Eight of them said they use it more than once a day.

"We have learned several things from these patients," study author Mark Ware, of McGill University in Montreal, said in a prepared statement.

"Firstly, that pain and spasms are not the only reasons for use, and the effects of marijuana on mood, sleep and stress are important areas of therapeutic need and should be addressed in clinical trials. Secondly, there is a wide variance in doses used, ranging from single puffs to more than a gram at a time. Clinical trials will also need to include early dose-finding phases and allow for subject variability in dose adjustments," Ware said.

"Thirdly, marijuana appears to be well-tolerated, though some subjects experienced intolerable side effects and deterioration of symptoms," he added.

More information

Here's what the U.S. Drug Enforcement Administration says about medical marijuana.

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Prostate Cancer Slow But Deadly, Study Finds

 

Reuters

Tuesday, June 8, 2004

CHICAGO (Reuters) - Prostate cancer (news - web sites) can become aggressive and deadly after the 10 to 15-year no-treatment monitoring period recommended for some older men with the disease, Swedish researchers said on Tuesday.

"Even without initial treatment only a small proportion of all patients with cancer diagnosed at an early clinical stage die from prostate cancer within 10 to 15 years," said the study from University Hospital, Orebro.

"However, to our knowledge, no study has hitherto adequately analyzed whether patients who escaped metastasis (cancer spread) and death during those 10 to 15 years without treatment continue to have an indolent (slow), nonfatal disease course," it added.

The study published in this week's Journal of the American Medical Association (news - web sites) looked at 223 patients aged 41 to 91 from central Sweden with prostate cancer that was caught early and initially left untreated.

Three times as many people died more than 15 years after diagnosis as died in the first 15 years after diagnosis.

"Postponement of death is not the only treatment objective because local progression may create substantial suffering," the study added.

"Our data indicate that the probability of progression to a more aggressive and lethal (disease) may increase after long-term follow-up of prostate cancers that are diagnosed at an early stage and initially left without treatment," it added.

"These findings argue for early radical treatment of patients with long life expectancy," it concluded.

According to the U.S. National Cancer Institute (news - web sites) prostate cancer is rare in men younger than 45 but the chance of getting it increases sharply with age after that. Most victims in the United States are older than 65.

The institute also says that the 10- to 15-year wait-and-see approach is usually offered to older men who have other medical problems and are in the early stage of the disease. For patients in good health younger than 70 surgery is usually offered, it adds.

Radiation and hormone therapy are other possibilities for treatment.

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More Patients Using Medical Marijuana Than Thought

 

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- Despite limited evidence of marijuana's medicinal value, it's being used by many people with multiple sclerosis and epilepsy who believe the drug is an effective treatment, say two Canadian studies in the June 8 issue of Neurology.

One study included a survey of 136 patients from the University of Alberta Epilepsy Clinic. Nearly half said they'd used marijuana in their lifetime; one in five had used it in the past year; 15 percent had used it in the past month; 13 percent used marijuana more than 48 days a year; and 8 percent used it more than half the days of the year.

Odds of frequent marijuana use were 10 times greater for those who had had epilepsy for at least five years, and eight times greater for those who had frequent seizures.

The researchers suggest that epilepsy patients who experience more frequent seizures may be more likely to try alternative treatments such as marijuana.

"Studies suggest one-third of the general population use alternative health care on a yearly basis," study author Dr. Donald Gross said in a prepared statement.

"Not surprisingly, patients tend to look to alternative therapies in situations where conventional medicine has been unsuccessful, in particular, for chronic medical situations. The finding of increased marijuana use in epilepsy patients with longer duration of disease and frequent seizures is consistent with the findings regarding other forms of non-conventional therapies," Gross said.

It may also be possible that increased marijuana use results in increased seizure frequency, he added.

The second study included a survey of 205 multiple sclerosis patients in Halifax, Nova Scotia. Of the 34 patients who said they were medical marijuana users, more than half believed it was a very effective treatment and more than half also said they'd used it within the previous 24 hours.

Nearly 20 percent of the patients said they used marijuana more than one time a week. Eight of them said they use it more than once a day.

"We have learned several things from these patients," study author Mark Ware, of McGill University in Montreal, said in a prepared statement.

"Firstly, that pain and spasms are not the only reasons for use, and the effects of marijuana on mood, sleep and stress are important areas of therapeutic need and should be addressed in clinical trials. Secondly, there is a wide variance in doses used, ranging from single puffs to more than a gram at a time. Clinical trials will also need to include early dose-finding phases and allow for subject variability in dose adjustments," Ware said.

"Thirdly, marijuana appears to be well-tolerated, though some subjects experienced intolerable side effects and deterioration of symptoms," he added.

More information

Here's what the U.S. Drug Enforcement Administration says about medical marijuana.

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Statins Not Linked to Increase in Bleeding Strokes

 

Reuters Health

Tuesday, June 8, 2004

NEW YORK (Reuters Health) - Theoretically, cholesterol-lowering medications might increase the risk for intracerebral hemorrhage -- that is, bleeding in the brain -- because abnormally low cholesterol is known to be a risk factor for the condition. However, a recent study has found cerebral hemorrhages have not increased with the widespread popularity of "statin" drugs such as Lipitor (news - web sites) or Zocor.

In the medical journal Stroke, Dr. Daniel Woo of the University of Cincinnati, Ohio, and a multicenter team report findings from their population-based study of genetic and environmental risk factors for bleeding stroke.

The researchers compared 188 patients with intracerebral hemorrhage and 366 matched subjects who did not have a stroke. They found that treatment with statins was not associated with an increased risk of intracerebral hemorrhage.

The authors point out, however, that they lacked data on subjects' cholesterol levels and cholesterol subgroups, such as HDL ("good") and LDL ("bad") cholesterol levels. The researchers knew which subjects were treated with statins, but they didn't know whether treatment was effective in lowering cholesterol levels.

They say a possible explanation for their results is that treatment with statins may be a strong indicator of high cholesterol levels, and that "this factor alone is protective." But that is speculative, they add. "We report only that the widespread use of statins in our population does not appear to have increased the risk of intracerebral hemorrhage."

Woo's group concludes that more studies are needed "to determine if lowering levels of cholesterol artificially using medications and statins bears the same risk of intracerebral hemorrhage as low cholesterol levels that occur naturally."

Source:Stroke, June 2004.

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Higher Costs Mean Fewer Take Lifesaving Drugs

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- Many patients are not taking cholesterol-lowering drugs even though they can help prevent a second heart attack or stroke, and high insurance co-pays are the main reason why, researchers report.

The study found that almost half of patients who had prescriptions for the drugs, called statins, did not take them often enough or stopped taking them. The report appears in the June issue of the Journal of General Internal Medicine.

"Patients' adherences to statin therapy is much less than we would like to see it," said Dr. James Stevenson, director of pharmacy services at the University of Michigan Health Services.

"People don't take the drugs regularly and discontinue therapy at a rapid rate," he added. "Since these are drugs that are known to improve survival in patients with cardiovascular disease, this is not a good thing. There will be increased mortality and disease."

In addition, Stevenson's group compared people who had had a heart attack or stroke to patients who had had neither. Surprisingly, they found those who had had a heart attack or stroke were just as likely not to take their statins as those who didn't suffer either ailment.

To come to their conclusions, the research team collected data from the insurance records of 4,802 patients.

"The amount of the patient's co-pay was a clear predictor of poor compliance," said study co-author Dr. A. Mark Fendrick, a professor of internal medicine and health policy at the University of Michigan. "As the amount of money that you had to pay to fill your cholesterol-lowering drug went up, the likelihood of you staying on it went down substantially."

Among patients whose co-pay was less than $10 a month, 50 percent remained on the drug after four years; in contrast, 50 percent of patients whose monthly co-pay was more than $20 stayed on their statin for only one year.

"This confirms that the amount of money that people actually have to pay for their drugs out of pocket, even if they have pharmacy benefits, is a critical aspect of getting drugs to people who need them," Fendrick said.

Fendrick believes that one way to solve this problem is to lower or eliminate co-pays for patients who have had a heart attack or stroke. This might help insure that these patients, who are most at risk for another event, will continue to take their medication. Statins, he noted, have a proven benefit in preventing a second event.

"As opposed to drug discount cards or expanding benefits, we need to identify the people who need the medication most and provide the financial incentives to insure they take their medicine as prescribed," Fendrick said.

"The really interesting part of the study is the inverse relationship between patient co-payment and medication adherence," said Dr. Michael Fischer from the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital in Boston.

"While many people intuitively suspect that this sort of behavior is going on, it's important to demonstrate that it occurs. Hopefully, it will further the debate about the best ways to structure prescription drug reimbursement plans; anything that decreases patient adherence to statins represents a clinical problem," Fischer added.

"If one could eliminate risk factors that cause heart attacks and strokes, then billions of dollars and hundreds of thousands of lives would be saved," said Dr. Lawrence M. Brass, a professor of neurology at Yale University School of Medicine.

Brass added that, each year, 20 percent of those who have had a heart attack or stroke suffer another one, and 20 percent of them die. After five years, fewer than 20 percent of patients haven't had a repeat attack.

"That's terrible," he said. "And that's in a country where we spend $1.4 trillion per year on health, and we don't do better than countries that spend half that."

Lowering co-pays could have an impact on the first- and third-leading killers (heart attack and stroke), Brass said. "If people aren't taking the drugs because of $10 a month, that is a problem."

"We end up paying for this," he added. "The patient may not, but when they get re-hospitalized, then Medicare or their HMO absorbs those costs."

Statins, Brass noted, are "very cost-effective medicines. Forget about the fact that you're saving lives and improving the quality of peoples' lives. It's cheaper to prevent disease than to treat it."

More information

The American Heart Association (news - web sites) can tell you about statins.

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Air Pollution May Slightly Increase SIDS Risk

 

By Alison McCook

Reuters Health

Tuesday, June 8, 2004

NEW YORK (Reuters Health) - High levels of common air pollutants may cause a slight increase in the risk of sudden infant death syndrome, or SIDS, new research shows.

Canadian investigators found that the rate of SIDS increased by almost 18 percent following days with particularly high levels of sulfur dioxide and nitrogen dioxide.

Study author Dr. Robert Dales noted that "most urban areas" will have days when sulfur dioxide and nitrogen dioxide reach the levels that may increase SIDS risk.

However, he cautioned that SIDS is very rare, occurring in about 1 out of every 1,000 babies. And air pollution appears to exert only a small effect on an already uncommon condition, he told Reuters Health.

"The risk of SIDS is small, so the percentage increase in the small risk is even smaller," Dales explained.

For parents who are concerned about SIDS, Dales recommended protecting infants from clearly established risk factors, like secondhand smoke, sleeping on the stomach, and sleeping in couches or beds not made for infants.

The University of Ottawa researcher added that parents should bring their infants to a doctor if they notice they are having any trouble breathing.

To investigate the role air pollution plays in SIDS, Dales and his team reviewed daily air pollution data collected from 12 Canadian cities -- with a total population of over 10 million people -- between 1984 and 1999. The researchers compared that data to daily rates of SIDS.

In the report in the journal Pediatrics, the researchers defined SIDS as the sudden, unexplained death of a child less than 1 year old.

The investigators found a higher rate of SIDS on the day following an increase in levels of sulfur dioxide and nitrogen dioxide. This pattern persisted even when the researchers accounted for the influence of season, temperature, humidity and barometric pressure.

Ozone and carbon monoxide appeared to have no influence on SIDS rates, the authors report, but sulfur dioxide and nitrogen dioxide did.

Dales explained that these two pollutants are by-products of combustion, and one of their major sources is automobile exhaust. In their article, Dales and his team suggest that the air pollution may increase SIDS risk by affecting infants' respiratory system, preventing them from breathing normally.

Source: Pediatrics, June 2004.

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Predicting Lifespans for Dementia Patients

 

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- A model to help predict the six-month death risk for people with advanced dementia living in nursing homes has been created by U.S. researchers.

Dr. Susan Mitchell of Beth Israel Deaconess Medical Center and Harvard Medical School (news - web sites) and her colleagues pinpointed factors associated with the risk of death among people with advanced dementia newly admitted to nursing homes.

They used this information to create their risk model, which shows a higher six-month death risk for people with more of the following factors: male, cancer, the need for oxygen therapy, congestive heart failure, shortness of breath, bowel incontinence, unstable condition, older than 83 years, not awake most of the day, no more than 25 percent of food eaten at most meals, and an Activities of Daily Living score of 28.

The research appears in the June 9 issue of the Journal of the American Medical Association (news - web sites).

This type of life expectancy information can be important in guiding end-of-life decision-making and determining a patient's eligibility for hospice admission, the researchers said.

"The risk score derived in this study offers a practical approach for estimating with reasonable accuracy the six-month prognosis of older nursing home residents with advanced dementia," the study authors write.

More information

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

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Heart Failure Rate High in People with Diabetes

 

Reuters Health

Tuesday, June 8, 2004

NEW YORK (Reuters Health) - The incidence of congestive heart failure in patients with type 2 diabetes may be significantly higher than previously estimated, new study results suggest.

The findings, presented at the American Diabetes Association's meeting in Orlando this week, come from a review of medical records and 6-year follow-up of more than 8,000 patients with type 2 diabetes and a similar number non-diabetic matched "control" subjects.

Among those with diabetes, the incidence rate of heart failure was equivalent to 30.9 case per 1,000 persons per year, 2.5 times higher than the rate among non-diabetic controls.

Previous estimates of heart failure incidence in diabetic patients range from between 2 and 10 cases per 1,000 persons per year. But these were based on "smaller samples, shorter follow-up, or cases requiring hospitalization," Dr. Gregory A. Nichols of Kaiser Permanente in Portland, Oregon, and colleagues note in meeting materials.

Analysis of the data showed that age, coronary heart disease, poorer control of glucose levels, and greater body weight were "important predictors" of the development of heart failure.

This study indicates that more people with type 2 diabetes are developing heart failure than previously thought, and highlights the importance of controlling risk factors for CHF such as obesity and high blood sugar levels, Nichols team says.

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The Right Workout for Those With Congenital Heart Defects

 

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- Children, teens and young adults with genetic heart disease can exercise recreationally but need to get advice from their doctors about the kinds of physical activity that are safe, a new American Heart Association (news - web sites) scientific statement recommends.

The statement, published in the June 7 issue of Circulation, is meant to help doctors counsel patients who have an increased risk for sudden death while they're doing physical activity.

This includes people with a number of kinds of genetic heart disease such as: hypertrophic cardiomyopathy; arrhythmogenic right ventricular cardiomyopathy; Marfan syndrome; and ion channel diseases, including long QT syndrome, Brugada syndrome and catecholaminergic polymorphic ventricular tachycardia.

The statement was prepared by the Working Groups of the American Heart Association Committee on Exercise, Cardiac Rehabilitation and Prevention, and the councils on Clinical Cardiology and Cardiovascular Disease in the Young.

"This document does not address organized competitive sports, including community sports teams, school and professional sports. Rather, it covers what these patients can do in a wide range of recreational, sporting and physical activities outside the competitive arena," Dr. Barry J. Maron, association committee chairman and director of the Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, said in a prepared statement.

The statement makes it clear that people with these genetic heart diseases can and should exercise.

"The impetus of the document is to emphasize that the mere presence of a genetic cardiovascular disease should not be regarded as a reason to be sedentary. Instead, this document tries to discern which exercises are preferable and which should be avoided, as well as help clinicians make decisions about how they advise their patients when it comes to recreational exercise," Maron said.

More information

The American Heart Association has more information about congenital heart disease.

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New Devices May Offer Painless Blood Sugar Tests

 

By Anthony J. Brown, MD

Reuters Health

Tuesday, June 8, 2004

NEW YORK (Reuters Health) - US and Australian researchers have come up with painless methods of checking blood sugar levels that could one day replace the finger pricks all too familiar to people with diabetes, according to reports at the annual scientific meeting of the American Diabetes Association in Orlando, Florida.

The method developed by the US group relies on the analysis of gases exhaled in the breath, whereas the test developed by the Australian team measures changes in the skin surface. At this point, however, both tests are in the early stages of development and are not immediately available.

"Some people claim that finger sticks are not that bad, but we've done some screening studies and found that many children do not want such sticks," Dr. Pietro Galassetti, lead researcher of the US team, told Reuters Health. "So an easy-to-use, (painless) method of measuring blood glucose would be an advance."

Using sophisticated analytical techniques, Galassetti's team, from the University of California at Irvine, was able to measure very low levels of gases that were exhaled by 10 volunteers during a special blood sugar test.

"We looked at levels of about 80 different gases present in exhaled breath," Galassetti said. "The two that best correlated with (sugar levels) were ethanol and acetone." Using these compounds, we were able to predict the subjects' blood sugar levels with a fair degree of certainty, he added.

Larger studies are needed to determine how practical this technique will be for the average diabetic patient, Galassetti said. At present, he said his group is working alone without any corporate sponsorship.

In the second study, Dr. Nejhdeh Ghevondian and colleagues, from AiMedics Ltd. in Sydney, Australia, tested the ability of a device they developed called HypoMon to detect low sugar levels in patients with type 1 diabetes. Although most people think of diabetics as having sugar levels that are too high, low sugar levels (or hypoglycemia) can be a life-threatening problem in such patients.

The device consists of a chest-belt transmitter that continuously monitors subtle changes in the skin. This transmitter then sends the data to a hand-held receiver that actually "learns" the changes characteristic of hypoglycemia.

In a small group of diabetic patients and healthy subjects, HypoMon detected the actual blood glucose level with a high degree of accuracy.

Further studies are underway to validate the device's use in detecting sugar levels that fall too low during sleep, the authors note.

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Fewer Minorities Than Ever in U.S. Cancer Trials

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Tuesday, June 8, 2004

TUESDAY, June 8 (HealthDayNews) -- Efforts over the past decade to make enrollment in cancer treatment trials more representative of the U.S. patient population have largely failed, a new report says.

Despite public concern and Congressional action, black and Hispanic patients make up an even smaller fraction of clinical trial participants today than they did in 1994, according to a study published in the June 9 issue of the Journal of the American Medical Association (news - web sites).

"We have to allow every American who has cancer to get equal access to clinical trials, regardless of their race or economic situation," said Dr. Harold P. Freeman, director of the National Cancer Institute (news - web sites)'s Center to Reduce Cancer Health Disparities in Bethesda, Md.

Research conducted over the past few decades has consistently shown a race, age and gender gap when it comes to access to cutting-edge clinical trials for patients diagnosed with cancer. Public outcry on the issue led Congress to pass the 1994 National Institutes of Health (news - web sites) Revitalization Act, which explicitly encouraged the increased participation of groups traditionally underrepresented in trials.

At the same time, the budget of the National Cancer Institute (NCI) -- the leading source for new trials -- doubled from $2 billion in 1993 to $4 billion in 2003, while the number of Americans enrolled in clinical trials swelled from 8,000 in 1996 to 12,000 in 2002.

To find out if any of these changes has affected what type of patients are enrolling in clinical trials, a group of Yale University researchers led by Dr. Vivek H. Murthy examined data on participants in NCI trials for breast, colorectal, lung and prostate cancers conducted between 2000 and 2002. They compared the demographics of participants enrolled in those trials to those of participants in similar NCI trials conducted between 1996 and 1998.

The Yale team reports things are getting worse, not better. In 1996, for example, black patients represented 11 percent of all cancer trial participants, but by 2002 that number had dropped to just 7.9 percent. Hispanics -- who make up 9.1 percent of the U.S. population -- made up just 3 percent of participants in clinical trials in 2002, down from 3.7 percent in 1996.

Women and the elderly remain underrepresented as well, although their percentages remained relatively unchanged from levels seen in the mid-1990s. In particular, the researchers noted the "strikingly low" representation of elderly patients in cancer trials. While the elderly make up about two-thirds of patients with either breast, colorectal, prostate or lung cancer, they represented only one-third of clinical trial participants, according to the report.

Commenting on the racial disparities outlined in the study, Freeman said he was "not surprised, because we've been aware of the problem for a while." In fact, the NCI created the Center to Reduce Cancer Health Disparities in 2001 to tackle just these types of issues, which Freeman believes are rooted in long-term social inequities.

Access to health care remains a key issue, he said, with large percentages of low-income blacks and Hispanics left unable to afford health insurance. "We've got a big problem right there," Freeman said, "dealing with populations that don't have access to even standard care."

Secondly, the past exploitation of black patients by white researchers -- most notably the 1932-1972 Tuskegee, Ala., trials in which physicians intentionally infected black men with the syphilis virus -- have left many blacks with a deep distrust of clinical trials in general. "That still resonates somewhat in the black community," Freeman said.

Numerous studies also suggest health-care professionals often treat minority patients differently than whites for a variety of reasons. "It's not always the case, but if you look across the country, something's going on there. Race does seem to matter," Freeman said. ""We need to work on creating better sensitivity between doctors and [minority] patients."

The Yale study does cite some success stories, however. In the late 1990s, concerns about the heightened death rate of black men with prostate cancer vs. whites led to greater scientific outreach to the black community. Now, enrollment for blacks in prostate cancer trials is "slightly greater than for whites," according to the Yale researchers -- reversing statistics from a decade ago.

Those results prove that community outreach can get results, Freeman said.

One outreach initiative currently under way at the center involves selecting knowledgeable individuals in the community to help minority patients "navigate through the clinical trials process," Freeman explained.

"It's important to help people get over the barriers they face getting into a clinical trial, and that's something we're testing right now," he said. "Our theory is that it might be helpful."

More information

Read about efforts to make health care accessible to all Americans at the National Cancer Institute's Center to Reduce Cancer Health Disparities.

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Monday, June 7, 2004

 

Blood Thinner Doesn't Work for All

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- New Israeli research suggests Plavix, a blood thinner often used in place of the troublesome clot buster Coumadin, doesn't work in many of the heart patients it's designed to help.

While Plavix doesn't appear to actually harm patients, about a quarter of those studied failed to respond to it, according to the small study. But the fact that Plavix (clopidogrel) still works much of the time indicates that it remains a good weapon for doctors to use, said cardiologist Dr. Stephen Wiviott, who co-wrote a commentary about the findings in the June 7 online issue of Circulation.

"What we do need to do is work harder to find either how to better use of this particular drug or find drugs that work for the people who aren't getting the benefit," said Wiviott, a cardiologist at Brigham and Women's Hospital in Boston.

Plavix is a fairly new drug and has been available in the United States only since 1997. Although it's expensive, cardiologists commonly use it to treat patients who've had heart attacks and strokes along with those undergoing angioplasties, operations that widen the arteries to prevent blockages. Like Coumadin (warfarin), its well-known cousin, Plavix makes it harder for the blood to clot and form new blockages.

Coumadin is a tricky drug to use because its levels must be closely monitored through blood tests to prevent the blood from becoming too thin. Severe bleeding, both internally and externally, can happen if the blood doesn't clot properly. "Coumadin, as a general statement, is a difficult drug to use," Wiviott said.

Although they accomplish the same thing, the two drugs work differently, with Plavix acting more like aspirin, which also thins the blood. Doctors continue to turn to Coumadin to treat some kinds of blood clots, including those in the legs and around the heart, said Dr. Eric Eichhorn, a cardiologist and medical director at the Cardiopulmonary Research Science and Technology Institute in Dallas.

In the new study, researchers in Israel examined the effects of Plavix on 60 patients who were treated with angioplasties and devices known as stents that keep the arteries open. The average age of the patients was 58.

In addition to aspirin treatment, the patients all got a high dose of 300 milligrams of Plavix after their angioplasties and then received smaller, 75-milligram doses for three months. To measure the blood's ability to clot, researchers turned to a test that gauges how well blood components known as platelets stick together.

In about one in four patients, the blood's ability to clot remained essentially unchanged. Those patients apparently had more severe heart attacks and were more likely to suffer from blood clots and heart attacks after their operations.

The authors acknowledged their study is small, and said more work needs to be done to determine if higher doses would make Plavix more effective in those patients.

Both Eichhorn and Wiviott said the findings won't hurt Plavix's reputation as an excellent drug. And while Eichhorn said the research is interesting, he added: "I don't know that it will change how we approach treating these patients."

More information

Get more details about blood thinners from the Texas Heart Institute.

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Computer Use a Boost to Young Minds, Study Finds

 

Reuters

Monday, June 7, 2004

CHICAGO (Reuters) - Preschool children who use a computer appear to develop better learning skills than peers who lack computer savvy, U.S. researchers said on Monday.

In a study of 122 children aged 3 to 5, those exposed to a home or school computer either alone or with someone else three to four times a week scored higher on tests that gauge school readiness and cognitive development than non-users, said the study published in the journal Pediatrics.

Some earlier studies have found computer use improves children's fine motor skills and improves recognition of numbers and letters.

But other research has found no relationship between computer use and children's knowledge or language capability, and some experts believe computer use displaces essential childhood experiences such as playing with toys or with peers.

But researchers found no benefit to children having electronic or video games in the home. Of the 56 percent of children with computers at home, a majority had such games, wrote study authors Xiaoming Li, a pediatrician at Wayne State University in Detroit, and psychologist Melissa Atkins of Ohio State University in Columbus.

The authors said the study was limited, using parents' estimates of time spent on the computer and not assessing how often educational software was used. The study did adjust for the wealth and educational status of the children's families.

They said young children "use" a computer in a variety of ways: typing, playing games, using learning software, jiggling the mouse or joystick, watching images, or observing and imitating parents or siblings when they use the computer.

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Study Examines Deaths at Pediatric ICUs

 

By Tara Burghart

Associated Press Writer

The Associated Press

Monday, June 7, 2004

CHICAGO - Sick children who are admitted to pediatric intensive care units during the evening rather than during the day are slightly more likely to die in the first 48 hours of care, a study found.

Researchers did not determine why the difference exists, but fatigue, lighter staffing levels and less experienced doctors and nurses working night shifts could all be factors, said one of the study's authors, Dr. James P. Marcin.

Lab results and certain equipment — like MRI machines — also are not always as readily available at night, said Marcin, a pediatric ICU physician at the University of California Davis Children's Hospital.

The study, which analyzed 20,547 admissions to 15 pediatric ICUs from 1995 to 2001, appears in the June edition of Pediatrics, being issued Monday.

The study focused on the less than 500 deaths that occurred within 48 hours of admission, since they would be the ones most likely to be affected by the early hours of care. Researchers also made adjustments to make sure the severity of cases being compared was similar.

Children can be admitted to pediatric ICUs because they have cancer, after being treated in emergency rooms for illnesses like asthma or pneumonia, or after surgery.

The mortality rate for children admitted during the day was 2.2 percent. But for children admitted during the evening — defined as 5 p.m. to 7 a.m. — the death rate increased to 2.8 percent, researchers found.

Marcin said that although the difference is small, it is statistically significant, and it increases when considering the cases of the sickest children for whom prompt and expert treatment might be the most needed.

For instance, for children admitted with shock, the death rate rose from 4.7 percent for daytime admissions to 12 percent when the patients were admitted at night. For children with congenital cardiovascular disease, the mortality rate increased from 1 percent to 3.3 percent when admitted at night.

Denise Goodman, an attending physician in the pediatric ICU at Children's Memorial Hospital in Chicago, said she thought the study was interesting, but she wished more than 15 pediatric ICUs had been studied.

The study's message isn't that parents should wait to get medical treatment for their children until daytime, Goodman said, but that hospitals need to evaluate their nighttime care.

"As hospitals look at ways to improve patient safety, they need to look at things not just in a global way — like how many nurses they have or how many pharmacists they hire or buying the fanciest piece of equipment — but they have to look much more methodically at the ebb and flow of care through the course of an individual patient encounter," she said.

Marcin and Goodman both noted the data was collected before new regulations went into place last year limiting the amount of hours residents can work in a week — which could decrease the role fatigue plays in mortality rates.

The results echo a Canadian study that suggested patients were more likely to die in a hospital if they were admitted on a weekend compared to during the week, and a German study of 380,000 births that found higher mortality rates among babies born at night — although less than 100 infants died total.

The latest study found no difference in mortality rates between weekend and weekday admissions.

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For-Profit Hospitals Cost More -Canadian Study

 

By Maggie Fox, Health and Science Correspondent

Reuters

Monday, June 7, 2004

WASHINGTON (Reuters) - U.S. hospitals owned by investors with the aim of making money are less cost-efficient than nonprofits, Canadian researchers said on Monday.

And experts who wrote a commentary on the study said converting all investor-owned hospitals to nonprofit status could have saved $6 billion in 2001.

The report, published in Monday's issue of the Canadian Medical Association Journal, adds fuel to the debate over whether health care should follow a business model.

Dr. P.J. Devereaux and colleagues at McMaster University in Hamilton, Ontario, reviewed medical studies on hospital care in the United States, covering 350,000 patients and hundreds of hospitals.

Devereaux, a cardiologist, said he had to study U.S. hospitals because "the U.S. is really the only country which has any large degree of investor-owned, for-profit health facilities," he said in a telephone interview.

But he said he wanted to contribute to a debate over Canadian health care.

"In Canada, there has been an intense debate for a number of years now over whether we should move beyond our current not-for-profit health care facility," he said.

"We all want to know what is the most effective way to deliver health care," he added. "It should be driven by evidence, not people's ideology."

Devereaux and colleagues earlier showed that for-profit hospitals had higher death rates.

"The reality is that for-profits face significant economic challenges. The first is they have to generate revenues that will satisfy shareholders," Devereaux said.

"Second, they have high executive bonuses. Thirdly, they are very top-heavy and have high administrative costs. Also, they have to pay taxes. That is a lot of extra money that they have to come up with," Devereaux added.

"Instead of finding new efficiencies, folks were cutting corners in quality health care, and also people were having to pay more for care."

In a commentary published in the journal, Dr. Steffie Woolhandler and Dr. David Himmelstein of Harvard Medical School (news - web sites) commented that 13 percent of all U.S. hospitals are for-profit, and said converting them to nonprofit status could have saved $6 billion of the $37 billion spent on care at investor-owned hospitals in 2001.

Woolhandler and Himmelstein, both prominent in a group called Physicians for a National Health Program, have long argued for comprehensive, nonprofitmaking health insurance for all Americans.

"Investor-owned hospitals charge outrageous prices for inferior care," Woolhandler said in a statement.

"The for-profits skimp on nurses, but spend lavishly on their executives and paper-pushers."

Himmelstein pointed to fraud cases involving for-profit health care companies including Columbia/HCA Healthcare Corp., which was hit by a Medicare scandal in 1997; Tenet Healthcare Corp., which is being investigated for allegedly overbilling Medicare; and HealthSouth, where 15 former executives have pleaded guilty to criminal fraud charges.

 "In health care, crime pays handsomely," Himmelstein commented.

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Smoking May Boost Diabetes Risk

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- Smokers already worried about their risks for cancer and heart disease now have another reason to quit: Tobacco may raise the risk for type 2 diabetes, say two new studies.

"This increased risk for type 2 diabetes could be due to increased insulin resistance, which has previously been shown to occur after an acute episode of smoking," said Dr. Valdemar Grill, a professor at both the University of Science and Technology in Trondheim, Norway, and the Karolinska Institute in Stockholm, Sweden.

He presented the findings of the first study on June 7 at the annual meeting of the American Diabetes Association (ADA) in Orlando, Fla. A second study presented by Johns Hopkins researchers at the meeting came to the same conclusion.

Experts have long understood that smoking does serious damage to arteries while raising risks for lung cancer. But studies are beginning to suggest it may encourage the development of diabetes, too.

In the latest study, Grill and his colleagues analyzed Norwegian government health data on nearly 39,000 adult men and women tracked over a period of 11 years.

They found that, regardless of gender, age, weight, physical activity and use of alcohol, smokers who smoked at least a pack of cigarettes a day faced a 64 percent higher risk of developing type 2 diabetes compared with nonsmokers.

The vast majority of diabetics -- about 95 percent -- are affected by type 2 diabetes, which develops when the pancreas fails to produce enough insulin to meet the body's demand or when body tissues become resistant to the effects of insulin. As insulin fails, blood sugar rises to unhealthy levels, raising the risks for cardiovascular disease and other health problems. Experts estimate that more than 18 million Americans have diabetes.

According to Grill, previous studies have suggested smoking contributes to insulin resistance. And since similar associations were found in people who used smokeless "snuff" tobacco, "it is likely that it is nicotine, the common substance in cigarettes and snuff, that is the culprit," he said.

"It is also possible that nicotine has a negative effect on insulin secretion," Grill added. "We have some data in animals to support this notion."

Curiously, the Norwegian study also found smoking was associated with lowered risks for two more rare forms of diabetes -- autoimmune diabetes (associated with dysfunction in the immune system), and type 1 diabetes. According to Grill, animal studies have suggested nicotine may actually help prevent the triggers behind autoimmune diabetes.

The risks far outweigh this potential minor benefit, however, and Grill strongly advises that all smokers "stop smoking because of the many proven and grave health hazards" associated with the habit.

Another study presented at the meeting seemed to back up the Norwegian findings. Researchers led by Dr. Hsin-Chieh Yeh of the Johns Hopkins School of Public Health examined data on nearly 9,000 older U.S. adults tracked for nine years.

They found that after adjusting for age, sex, race, weight and other factors, long-term smokers faced a 50 percent higher risk of developing diabetes compared with people who never smoked -- with risks rising as the number of years spent smoking increased.

Commenting on the two studies, Dr. Nathaniel Clark, the ADA's national vice president for clinical affairs, admitted he was "a little surprised" by the findings.

"When we usually list the risk factors for diabetes, smoking is never on that list. In that sense, this is new information," he said.

Although the findings are too preliminary to prompt any change in official ADA policy when it comes to preventing diabetes, Clark said quitting smoking should be a no-brainer.

"There are so many reasons not to smoke. I can't imagine that a fear of developing diabetes would trump dying from lung cancer, or any of the other terrible things smoking does," he said.

More information

For more on diabetes, visit the American Diabetes Association.

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Epilepsy, MS Patients Swear by Marijuana – Study

 

Reuters

Monday, June 7, 2004

WASHINGTON (Reuters) - Close to half of all epilepsy and multiple sclerosis patients in Canada have tried using marijuana although few of them believe it helped their symptoms, researchers reported on Monday.

About one in four epilepsy patients and one in six multiple sclerosis patients surveyed said marijuana was an effective treatment for their disease symptoms, according to the surveys published in the journal Neurology.

Marijuana can be legally prescribed by a doctor in Canada and is provided to patients by Canada's health service.

Dr. Donald Gross of the University of Alberta in Edmonton and colleagues surveyed 135 epilepsy patients and found nearly half had used marijuana in their lifetime and that one in five had used marijuana in the past year.

And Dr. Mark Ware of McGill University in Montreal and colleagues surveyed 205 multiple sclerosis patients and found 34 of them, or 16.5 percent, were using medical marijuana but just half of them thought it worked effectively.

"We have learned several things from these patients," Ware said in a statement.

"Firstly, that pain and spasms are not the only reasons for use, and the effects of marijuana on mood, sleep and stress are important areas of therapeutic need and should be addressed in clinical trials. Secondly, there is a wide variance in doses used, ranging from single puffs to more than a gram at a time."

Gross said marijuana could be considered an alternative or complementary therapy.

"Studies suggest one-third of the general population use alternative health care on a yearly basis," Gross said in a statement.

"Not surprisingly, patients tend to look to alternative therapies in situations where conventional medicine has been unsuccessful, in particular, for chronic medical conditions."

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New Drug Prolongs Life of Prostate Cancer Patients

 

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- The drug docetaxel, made from yew tree needles, extends the lives of people with advanced prostate cancer.

That finding was presented June 7 at the annual meeting of the American Society of Clinical Oncology (news - web sites) in New Orleans.

The study of 1,006 people in 24 countries found the drug decreased the odds of dying by 24 percent in advanced prostate cancer patients resistant to hormone therapy.

The findings offer hope that earlier use of docetaxel alone or in combination with other treatments will result in longer improvements in survival for such patients, the researchers said.

"This is good news for our prostate cancer patients," Dr. Mario Eisenberger, study co-chairman and an oncology professor at Johns Hopkins Kimmel Cancer Center, said in a statement.

"These data indicate that the current standard of care for these patients should be docetaxel therapy, and we should try adding new agents to build upon this success and test it in patients with aggressive disease before the cancer spreads," Eisenberger said.

The study was funded by Aventis Pharmaceuticals Inc.

More information

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

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U.S. Warns Breast-Feeding Women About Drug

 

Reuters

Monday, June 7, 2004

WASHINGTON (Reuters) - Breast-feeding women should not take the drug domperidone to boost milk production, because it may put them at risk of serious heart problems and sudden death, the U.S. government warned on Monday.

Domperidone is touted on the Internet as a safe way to stimulate milk production, because it may increase the amount of lactin, a hormone needed for lactation.

The drug is not approved in the United States but is sold in other countries in intravenous and oral forms to treat stomach disorders.

The Food and Drug Administration (news - web sites) said domperidone poses serious risks and is not approved in any country for enhancing milk production.

Some people in other countries who were treated with the intravenous version have experienced irregular heartbeats, cardiac arrest and sudden death, the FDA said.

"Because of the possibility of serious adverse effects, FDA recommends that breast-feeding women not use domperidone to increase milk production," an FDA statement said.

In many countries, the oral form of domperidone comes with a warming that the drug is excreted in breast milk and the risks to breast-feeding infants are unknown, the FDA said.

The FDA said some women in the United States had obtained domperidone from "compounding" pharmacies that prepare medicines for patients from bulk ingredients or from foreign sources.

The agency sent warnings to six pharmacies and firms that it said were supplying domperidone to tell them the sales were illegal.

Regulators also alerted border inspectors to watch for attempts to import domperidone and told them to detain the drug if they find it.

Bill Swail, president of Peoples Pharmacy in Austin, Texas, said he was unaware of any safety concerns with domperidone until he received the FDA's warning letter. He said he would ask the FDA to provide more information about the drug's possible risks.

"We don't want to dispense anything that could be dangerous," Swail said.

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Type 1 Diabetes Prevented in Mice

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- Researchers have succeeded in preventing type 1 diabetes in mice that were genetically programmed to develop the disease.

Although rodents, in the laboratory as in the field, are a long way from humans, this approach does hold promise for both prevention and treatment.

"It's many, many steps from human adaptation, but it's a big leap in terms of understanding where you can intervene in a specific way," said Dr. Bonita H. Franklin, a clinical associate professor of pediatrics at New York University School of Medicine in New York City.

The study appears in the June 7 issue of the Journal of Experimental Medicine.

Type 1 diabetes is an autoimmune disease in which certain cells from the body's immune system mistakenly attack and destroy the insulin-producing beta cells of the pancreas. Islet cell transplantation is one way by which scientists have been hoping to treat the disease. Although this allows the body to start producing insulin again, it doesn't resolve the underlying immune system dysfunction, requiring individuals to take toxic immunosuppressive drugs.

A key to preventing and treating type 1 diabetes would be to go back a step to correct these underlying immune-system deficiencies. This would be especially helpful in those who have antigens but who have not yet developed the disease. "Finding antigens is the most predictive thing, but then what?" Franklin asked. "What do you do if you know someone is at risk?"

Recently, scientists discovered that a certain type of T-cell in the immune system has a specific regulatory function, meaning they turn off the "killer" cells. When there are enough suppressor cells and they are functioning correctly, they make sure the body doesn't turn on itself.

In people with type 1 diabetes and other autoimmune diseases, however, the balance has been upset. "It appears that regulatory T-cells are either deficient or dysfunctional, quantitatively or qualitatively abnormal, in people with autoimmune diseases," said Dr. Richard Insel, executive vice president of research at the Juvenile Diabetes Research Foundation in New York City, which partially funded the study.

The authors of this study tried to restore the balance by expanding and activating regulatory T-cells in mice, using dendritic cells. Dendritic cells basically screen antigens in the body and tell other immune system cells how to respond.

"They're like a cipher. They look at antigens and determine if this is something foreign or self," Insel explained. "They screen or filter, then they send signals to the immune system, saying, 'Respond aggressively and destructively, or this is something we should tolerate and not respond to.'"

These dendritic cells, it turns out, can be used to "educate" the regulatory T cells.

"A paper from our lab about a year ago showed that in normal mice, dendritic cells would give the signals needed for these [regulatory] cells to proliferate," said study author Kristin Tarbell, a postdoctoral fellow in Rockefeller University's Laboratory of Cellular Physiology and Immunology in New York City. "In this study, I used the dendritic cells to expand the regulatory cells, then used those to block diabetes."

The reprogrammed T-cells were essentially able to turn off the attacking cells, thereby saving the beta cells and warding off diabetes.

"We envision taking blood from a recently diagnosed individual and, from that blood, making dendritic cells, isolate the regulatory T-cells, and then put them together with the islet antigen to get more regulatory cells and put them back in the patient," Tarbell said. "The concept is that we would change the balance of the immune response, and halt autoimmunity."

Although this paper looked specifically at prevention, there is also a potential for this technique to treat the disease.

"This study is important because it takes you back an extra step before the destruction of the pancreas occurs," Franklin said. "If it could be done, it would be very specific. Autoimmunity would be prevented only where you wanted it to be prevented. The rest of the immune system would function fine."

More information

The Juvenile Diabetes Research Foundation has more on the basics of type 1 diabetes.

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More Evidence Bone Drug Prevents Breast Cancer

 

Reuters

Monday, June 7, 2004

NEW ORLEANS (Reuters) - Doctors presented more evidence on Sunday to show that Evista, a drug used to prevent bone thinning (that is, osteoporosis), can also prevent breast cancer in some women.

Women who took Eli Lilly and Co.'s Evista every day for eight years had a 59 percent lower risk of breast cancer compared to women given a placebo, the researchers said.

The study adds to earlier findings that Evista, known generically as raloxifene, lowered the risk of breast cancer by 72 percent among postmenopausal women with osteoporosis who took it for four years.

Evista was the first of a new class of drugs, called selective estrogen receptor modulators, or SERMs, that have estrogen-like effects on tissue without the cancer-causing effects of the hormone. It acts on bone like estrogen does, keeping an older woman's bones strong.

"While it is still premature to recommend that postmenopausal women take raloxifene outside of a clinical trial to reduce their risk of breast cancer, our results add to the evidence suggesting that SERMs can have a dramatic effect on breast cancer risk," said Silvana Martino of the John Wayne Cancer Institute in Santa Monica, California.

Another drug approved to prevent breast cancer in high-risk women -- tamoxifen -- has been shown to reduce the risk by nearly 50 percent in these women. Researchers are studying tamoxifen and raloxifene head-to-head to see which one is better at preventing breast cancer.

In the study presented on Sunday, Martino's team studied 3,510 women taking Evista and 1,703 taking a placebo or dummy pill.

Less than 1 percent of the women taking Evista developed invasive breast cancer, compared to 1.6 percent of the women taking placebos, he told a meeting of the American Society of Clinical Oncology (news - web sites).

But the women who took raloxifene were slightly more likely than those who took a placebo to develop potentially life-threatening blood clots in their legs or lungs.

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New Weapon Against Pancreatic Cancer Found

 

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- An experimental vaccine to treat pancreatic cancer appears safe and stimulates immune activity, according to preliminary results from a study.

Researchers report the finding June 7 at the annual meeting of the American Society of Clinical Oncology (news - web sites) in New Orleans.

These early findings indicate that the vaccine, a synthetic version of the molecule MUC1 expressed on pancreatic tumor cells, works in combination with a patient's own antigen cells (dendritic cells) to boost immune activity. This boost in immune activity may slow progression of pancreatic cancer.

"Studies have shown that chemotherapy or radiation treatments are not very effective for pancreatic patients and surgery can be very complicated, contributing to high mortality rates," principal investigator Dr. Ramesh Ramanathan, an associate professor at the University of Pittsburgh School of Medicine, said in a prepared statement.

"By working on ways to stimulate the immune system in these patients, we have found that MUC1 vaccines are in general well-tolerated and stimulate in some patients immune responses that can potentially benefit patients who receive the vaccine," Ramanathan said.

The study included 12 patients with pancreatic cancer who had surgery to remove the cancer.

More information

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

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Epilepsy Drugs Hasten Bone Loss in Older Women

 

By Anthony J. Brown, MD

Reuters Health

Monday, June 7, 2004

NEW YORK (Reuters Health) - Use of anti-epileptic drugs (AED) appears to accelerate bone loss in elderly women, new research indicates. Over a 5-year period, continuous use of such drugs is estimated to increase the risk of a broken hip by 29 percent.

Previous studies have linked AED use with thin bones, lead author Dr. Kristine E. Ensrud, from the VA Medical Center in Minneapolis, told Reuters Health. "Our study is different in that it shows the effect of AED use on bone loss over time," she added.

"The take-home message for (doctors) is that older people taking AEDs should be screened for osteoporosis" and treated as necessary, Ensrud said. "In a recent survey, only 20 percent of neurologists said they screen AED users for bone disease and only about 7 percent reported prescribing therapies to protect against bone loss."

The new findings, which are reported in the medical journal Neurology, are based on a study of 9704 elderly women who were surveyed about AED use and then followed for several years to assess changes in the thickness of their bones.

The more often AEDs were used, the faster bone loss seemed to occur, the authors note. For example, women who used AEDs on a continuous basis lost more bone over a year than intermittent users who, in turn, lost more bone than women who didn't use such drugs at all.

"When the current data were collected, the AEDs in use were primarily the older ones, which induce (liver) enzymes that may affect" the breakdown of calcium and vitamin D, which play a key role in strengthening bones, Ensrud noted. These older drugs include Dilantin (phenytoin), phenobarbital, and Tegretol (carbamazepine).

Further studies are needed to look at the effects of the newer AEDs on bone loss, she added.

Source: Neurology, June 8, 2004.

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Breast Cancer Risk May Soon Increase for Black Women

 

HealthDayNews

Monday, June 7, 2004

MONDAY, June 7 (HealthDayNews) -- Lower pregnancy rates and reduced breast-feeding among black women may mean they will soon face an increased risk of breast cancer compared to white women, says a study in the June 7 online issue of Cancer.

University of Southern California Keck School of Medicine researchers compared the effects of live births and breast-feeding on the risk of breast cancer in white and black women aged 35 to 64 in the United States.

The study found live births and breast-feeding lowered the risk of breast cancer in both white and black women. Among women aged 35 to 49, the risk reduction of breast cancer per live birth was 13 percent for white women and 10 percent for black women. Among women aged 50 to 64, that breast cancer risk reduction was 10 percent for white women and 6 percent for black women.

The study also found the risk of breast cancer decreased the longer a woman breast-fed. This risk reduction applied only to younger women and was most pronounced in the five years after pregnancy.

The researchers identified a potentially alarming trend. They found that young black women are getting pregnant less than they did in the past and breast-feeding less often and for shorter duration than white women.

If this trend continues, "then this could result in a more rapid increase in breast cancer rates in this group than in whites," the study authors write.

More information

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

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Autism Probably Not Caused by Single Factor

 

Reuters Health

Monday, June 7, 2004

NEW YORK (Reuters Health) - In a new study, researchers have identified a number of birth factors that are associated with an increased risk of autism.

Several pregnancy complications were linked to autism, but the author's don't believe that these complications cause the disorder, but rather that they're the result of the same genetic factors that lead to autism.

Dr. Emma J. Glasson, from the University of Western Australia in Crawley, and colleagues report their findings in the Archives of General Psychiatry.

The study involved 465 patients born in Western Australia between 1980 and 1995 and diagnosed with autism or a related disorder by 1999. Comparison groups included 481 siblings of the autistic patients and 1313 subjects randomly selected from the population.

Compared with other subjects, autistic patients were more likely to be first born and to have older parents, the authors note. In addition, mothers of autistic patients were more likely than other mothers to experience a near-abortion episode and to have labor lasting less than 1 hour.

Obstetric complications linked to autism included delivery by c-section and a low Apgar score -- a standard test to see how the baby is doing immediately after delivery.

"It is unlikely that single factors or events cause (autism), although it is possible that early non-genetic influences" may play a role in some cases, the investigators state. The current findings support the theory that the development of autism primarily depends on genetic factors, they add.

Source: Archives of General Psychiatry, June 2004.

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Health Tip: Purchasing Medications on the Internet

 

HealthDayNews

Monday, June 7, 2004

(HealthDayNews) -- If competitive prices and convenience have persuaded you to purchase your medicines online, you need to be wary about where you shop.

The U.S. Food and Drug Administration (news - web sites) cautions consumers:

Here are some buying tips:

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Study Raises Questions About Teen Violence

 

By Michael Conlon

Reuters

Monday, June 7, 2004

CHICAGO (Reuters) - Adolescents in the United States are no more violent than their counterparts surveyed in four other countries, but are more likely to die a violent death, researchers reported on Monday.

The difference may involve the availability of lethal weapons in the United States or perhaps varying attitudes about life and death, the report said.

The National Institute of Child Health and Human Development study analyzed data from a World Health Organization (news - web sites) survey. The analysis zeroed in on data involving 10,610 boys and 11,530 girls aged 11 to 15 in Ireland, Israel, Portugal, Sweden and the United States during the 1997-1998 school year.

It found that about 60 percent of the Americans had not been involved in a fight during the previous year, a figure also the average for the five countries. Similarly, 89 percent of U.S. youths had not carried a weapon in the previous year, identical to the average for all five, and more than 84 percent said they had not been injured in a fight, also similar across the board.

Of the youths involved in fighting, most fought only occasionally, a rate similar in all of the countries studied.

"Even though our youth are no more likely to fight than are youth in the other developed countries in the study, they're still more likely to die of violent causes" said Duane Alexander, a director of the child development institute.

The report, published in the June issue of The Archives of Pediatrics and Adolescent Medicine, said, "An important question raised by our findings is why violence-related mortality in the United States is substantially higher than countries in which the rates of nonfatal violent behaviors (fighting, weapon carrying, and injuries from fighting) in young adolescents are extremely similar."

A possible explanation, it said, is that U.S. youngsters have greater access to lethal weapons.

The report also cited an earlier study which found that American youngsters are more likely to believe it's appropriate to kill to protect their property than were youth in Estonia, Finland, Romania, and Russia. In addition U.S. adolescents in that study were more likely to approve of war than were youth in any of the other countries.

In the five-country study published on Monday, statistics on bullying varied. Israeli students were the most likely to have been bullied in the last school term, at 42 percent, while Swedish students were the least at 14 percent. Forty-one percent of U.S. student said they had been bullied.

The authors said educational campaigns in Scandinavia had targeted bullying -- perhaps important information given that one earlier study had found bullying or ridicule was the most common cause behind deadly school shootings in the United States.

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Health Tip: Finger Sprains

HealthDayNews

Monday, June 7, 2004

(HealthDayNews) -- Finger sprains commonly occur in ball sports when the ball bounces off the tip of your finger. A ligament gets torn or stretched, and this causes pain, swelling and tenderness, according to the University of Michigan Health System.

Here are some home-treatment tips:

 

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Sunday, June 6, 2004

 

Melanoma Vaccine Shows Promise

 

HealthDayNews

Reuters

Sunday, June 6, 2004

SUNDAY, June 6 (HealthDayNews) -- A peptide-derived vaccine to treat melanoma shows promise, a new study has found.

The finding suggests it may be possible to activate a patient's own immune system to combat melanoma. The research was presented June 6 at the annual meeting of the American Society of Clinical Oncology (news - web sites) in New Orleans.

"This is the first time we have evaluated peptide-derived melanoma vaccine results from a multicenter cooperative group trial. We have found evidence that the vaccine stimulates an immune response, and that it is reasonable to evaluate the correlation between disease course and immune response for patients who receive the vaccine," principal investigator Dr. John Kirkwood, director of the Melanoma Center at the University of Pittsburgh Cancer Institute, said in a prepared statement.

The multiepitope CD8 T-cell vaccine is comprised of three peptides derived from tumor-associated antigens of melanoma.

More information

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

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Predicting Progress of Colon Cancer

 

HealthDayNews

Sunday, June 6, 2004

SUNDAY, June 6 (HealthDayNews) -- An enzyme biomarker that may help doctors predict how colon cancer patients will respond to a specific chemotherapy regimen has been identified by Fox Chase Cancer Center researchers.

This enzyme, thymidine phosphorylase (TP), is found in some, but not all, cancers.

The study of 67 people, aged 40 to 81, with colorectal cancer found those whose tumors expressed TP had a much higher response rate to a chemotherapy regimen with the drugs capecitabine plus irinotecan.

The response rate for those whose primary tumors tested positive for TP was 65 percent, compared with 27 percent for those whose tumors tested negative for the enzyme. The response rate was 61 percent for people with metatastic tumors that expressed TP, compared with 14 percent for those who didn't have TP in metatastic tumors.

"These data suggest that TP expression may be useful as a marker in predicting a positive response to chemotherapy with capecitabine plus irinotecan for colorectal cancer patients," Dr. Neal J. Meropol, director of the gastrointestinal cancer program at Fox Chase, said in a prepared statement.

"With that information, we can begin personalizing treatment. If we know the enzyme is present to activate the drug, we may be able to identify those patients who should receive capecitabine," Meropol said.

He presented the study June 6 at the annual meeting of the American Society of Clinical Oncology (news - web sites) in New Orleans.

More information

The American Cancer Society (news - web sites) has information about colorectal cancer.

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Saturday, June 5, 2004

 

Depression Can Hamper Diabetes Control

 

HealthDayNews

Saturday, June 5, 2004

SATURDAY, June 5 (HealthDayNews) -- Depression and demanding insulin regimes are linked to poor diabetes control, according to a Duke University Medical Center study of 1,000 people with diabetes.

The Duke researchers found depressed diabetic patients who have to self-administer at lease three insulin shots per day have a much greater risk of having poor control over their disease than diabetics who require less or no insulin.

The researchers note depression only affects diabetes control in some patients. But they recommend that diabetes patients who require higher amounts of insulin pay close attention to symptoms of depression.

"We know that patients who require more insulin on a daily basis have less residual pancreatic activity and a more difficult time regulating their glucose levels," Richard Surwit, vice chairman of research, department of psychiatry and behavioral medicine, said in a prepared statement.

"Their metabolic control is going to be more vulnerable to disruption by behavioral and neuroendocrine factors. This means that at any level of depression, diabetics who experience more difficulty regulating their glucose levels are more likely to get thrown even farther off balance by depression," Surwit said.

The study was presented June 5 at the annual meeting of the American Diabetes Association in Orlando, Fla.

More information

The U.S. National Diabetes Education Program offers four steps to control your diabetes.

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Lower Blood Sugar Helps Memory in Diabetes –Study

By Maggie Fox, Health and Science Correspondent

Reuters

Saturday, June 5, 2004

WASHINGTON (Reuters) - Poor memory and brain function is an important but overlooked side effect of diabetes, but controlling blood sugar helps, researchers said on Saturday.

Patients with type-2 diabetes are likely to have trouble remembering, multi-tasking and learning new things, said Dr. Richard Nesto, chairman of Cardiovascular Medicine Department, at the Lahey Clinic in Burlington, Massachusetts.

"Cognitive decline is often a precursor to Alzheimer's disease (news - web sites) and other types of dementia, and even mild cognitive impairment can negatively impact learning and memory and may impact the ability to perform learning tasks efficiently," Nesto told reporters from a meeting of the American Diabetes Association in Orlando, Florida.

Dr. Christopher Ryan, a psychiatrist at the University of Pittsburgh and Dr. Mark Strachan of Western General Hospital in Edinburgh, Britain, tested a group of diabetic patients and found that controlling their blood sugar with drugs helped considerably.

They found 141 volunteers with an average age of 60 who had type-2 diabetes but no other serious medical issues. All took drugs such as metformin to help control their blood sugar.

The volunteers, spread across 20 centers, all continued to take metformin but also either took GlaxoSmithKline's Avandia or glyburide, a member of a group of older diabetes drugs called sulfonylureas.

Avandia, known generically as rosiglitazone, helps the body use insulin more efficiently. So does metformin, but it is an older drug that works through a different pathway.

In type-2 diabetes, which affects more than 17 million people in the United States alone, the body gradually loses its ability to use insulin. Blood sugar levels can shoot up, damaging blood vessels and nerves and causing blindness, limb loss and heart disease.

Ryan said he believes high blood sugar levels damage tiny blood vessels in the brain, causing the mental decline.

Diabetes patients often do not take their drugs consistently and have trouble controlling insulin, but doctors have noted for years that patients in clinical trials take their drugs more regularly.

Patients in both groups were helped by the medications. They were carefully followed and tested for six months.

Working Memory Improved

"Improving glycemic control (blood sugar) had really no effects on learning ability or cognitive efficiency," Strachan said.

"However, we find that in both arms in the study there was a significant improvement in working memory across the 24 weeks. We saw there was a 39 percent improvement in errors that patients made across the study."

Ryan said this may be the more important factor.

"We were especially interested in what we call working memory," Ryan said.

"This is the ability that we all use when we are multi-tasking, when we are trying to remember a number and dial it, while we are looking for some notes on our desk and we are listening to a question that our colleague is asking."

Avandia caused considerably fewer side-effects, the researchers noted. These side-effects include hypoglycemia -- blood sugar going too low -- and diarrhea.

Glaxo helped fund the study. Several other companies make drugs in the same class as Avandia, including Actos made by Eli Lilly and Co. with Japan's Takeda.

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Blood Pressure, Cholesterol Are Problems for Many Diabetics

By Ed Edelson
HealthDay Reporter

HealthDayNews

Saturday, June 5, 2004

SATURDAY, June 5 (HealthDayNews) -- Too many people with diabetes aren't getting the kind of blood pressure and cholesterol control they need to limit their high risk of heart attack, stroke and other cardiovascular problems.

That was the assessment of a succession of experts addressing the American Diabetes Association's annual meeting June 5 in Orlando, Fla.

Four studies that looked at the issue in different ways came to the same conclusion: Many physicians are not aggressive enough in recommending preventive measures, and many patients fail to follow their doctors' orders.

The broadest-based study was reported by Dr. Lawrence Leiter, head of the division of endocrinology at St. Michael's Hospital in Toronto. The survey of more than 2,000 diabetes specialists in 50 countries found only half their patients achieve the desired goal of 100 milligrams or less per deciliter of blood of LDL cholesterol, the "bad" kind that clogs arteries.

"The most common explanation was poor patient compliance," Leiter said. "But despite all the efforts of groups like the American Diabetes Association, physicians were treating patients with diabetes but without heart disease much less aggressively than they should."

Many doctors don't recognize that diabetes in itself puts a patient in the same risk category for heart problems as someone who has already had a heart attack, Leiter added.

The same point was made by researchers at the Henry Ford Health System in Detroit who looked at 9,642 people with diabetes enrolled in that health maintenance organization.

In the five years starting in 1997, the number of patients who reached the desired LDL goal did increase, but not spectacularly -- from 22 percent to 37 percent.

"Once patients have a serious cardiovascular event, they are treated more aggressively," said Jennifer Lafata, director of the organization's Center for Health Services Research. "If the same process was implemented before a cardiovascular event, some of those events could be prevented."

A strikingly similar number came from a study of 8,855 people with diabetes done by Health Core, a health outcomes and research group in Wilmington, Del. Again, just 37 percent of the patients reached the target number for LDL cholesterol control, said Vincent Willey, the organization's vice president for research.

It's hard to tell exactly why the percentage is so low, Willey said. One possible reason is that people with diabetes often have a number of medical problems -- including high blood pressure and high cholesterol -- that require them to take a bewildering variety of drugs. The doctor often will prescribe a cholesterol-lowering statin drug, "but you're lucky if someone is still on it at the end of a year," he said.

"So many things can be going on that sometimes it is overwhelming," Willey said.

A similar story surrounds blood pressure, said Dr. Janet McGill, an associate professor of medicine at Washington University in St. Louis. Her report on more than 10,000 people in a free screening program found that 48.7 percent of those with diabetes but no kidney disease had uncontrolled high blood pressure.

Because more than 90 percent of the people had health insurance and more than 80 percent had personal physicians, "it is shocking that their blood pressure was not controlled," McGill said.

"It's not clear where the problem was," McGill said. It's possible these people don't see their doctors as often as they should, she said. But another factor could be what others have called "physician inertia," a failure of doctors to communicate to diabetes patients the importance of keeping blood pressure under control.

But "we don't want to play a blame game," Lafata said. Besides studying physicians' and patients' behavior, "people are trying to think about systems approaches to what comes into play in such a complex situation," she said, "things like the information that is available to clinicians and to patients."

In a related matter, the American Diabetes Association has issued new guidelines to doctors to help their diabetes patients lower their risk of heart disease.

The guidelines recommend a blood pressure goal of less than 130/80. They also call for lowering blood glucose levels, as measured by the A1C test, to less than 7 percent for most people with diabetes and less than 6 percent for individual patients when appropriate.

Aspirin therapy is also recommended for those with diabetes unless their doctor says otherwise.

The guidelines also state that smoking as a risk factor for cardiovascular disease among diabetics is not being adequately addressed by health-care providers. The new recommendations urge doctors and nurses to determine if their patients are smokers and, if they are, to encourage them to quit.

More information

The Veterans Administration explains the importance of controlling cholesterol levels in those with diabetes.

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