The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
November 13, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 19-25

 

  1. Pain Pills May Protect Against Brain Tumors
  2. MD: Obesity Risk for Elderly Overlooked
  3. Low Zinc Levels in Mom Affect Baby's Bones
  4. Tests Sniff Out Trace Elements of Nuts
  5. Almost Half of Stroke Patients May Be Aspirin Resistant
  6. Antioxidants May Fight Alcohol-Linked Birth Defects
  7. Drug Makes Angioplasty Better for Diabetics
  8. Drug Prevents MS-Like Illness in Rats
  9. Stool Test Can Reduce Colorectal Cancer Deaths
  10. Asthma Emerging as Genetic Disorder
  11. Painkillers May Slow Healing After Shoulder Surgery
  12. Early Radiation Therapy Extends Prostate Cancer Survival
  13. Pet-Free Students Lower Classroom Allergy Triggers
  14. More Americans Surviving Cancer Than in 1970s
  15. Protein May Help People Resist HIV
  16. Health Tip: Cholesterol Control
  17. New SARS Vaccine Shows Promising Results in Monkeys
  18. Science Finds Clue to Stopping Cancer's Spread
  19. Eat More Oily Fish and Be Healthy, Say Food Experts
  20. Bad Teeth? Don't Blame Your Childhood
  21. Pregnancy Bad for Good Cholesterol
  22. Widely Used Alzheimer's Drugs Found Ineffective
  23. Needle Biopsy Linked to Breast Cancer Spread

  24. Study Details Possible Cause of Autism
  25. Overweight Women Overestimate Physical Activity
  26. Many Doctors Don't Ask Teens About Smoking
  27. Solvents, Diesel Fuel Can Make Farmers Wheeze
  28. Few Women Comply with Mammogram Guidelines
  29. Mice Offer Insights Into Rubinstein-Taybi Syndrome
  30. 100M Doses of Flu Shots to Be Available
  31. Study Questions Value of Folate in Heart Patients
  32. Plant-Made Antibody Targets Hepatitis B Virus
  33. Kidney Disease No Longer a Killer for Children
  34. Sugar Substitute Splenda Targeting Baker
  35. Simple Test Can Detect Serious Lung Disease
  36. Oral Implants Help Curb Bad Snoring
  37. Many Child Deaths Blamed on Environment
  38. Cream Made from Breast Milk Reduces Warts Study
  39. Nebraska May Test Child Nutrition Program
  40. Bulked-Up Boy Teaches Docs About Muscle Protein
  41. New Hampshire Hailed in Obesity Fight
  42. Acrylamides Pose Little Risk, Panel Decides
  43. Demand for Elderly Day Care Rising
  44. Ernst & Young Says U.S. Drug Price Controls Likely
  45. Doctors Note Progress Against Muscle-Wasting Disease
  46. Genetic Variant Ups Women's Heart Attack Risk
  47. Your Genes Can Affect Drug Activity
  48. Black Tea May Help Get Blood Circulating
  49. Health Tip: Exercising While Pregnant
  50. Exercise Boosts Teen Girls' Bones
  51. Close Female Friends Help Women Through Depression
  52. Teens Skilled at Manipulating Divorced Parents
  53. How Teens Face Stress May Affect Diabetes Control
  54. Low-Carb Fad Seen as Unhealthy and a Ripoff
  55. Virginia May Issue Fitness 'Report Cards'
  56. WHO Warns on Unsafe Use of Alternative Medicines
  57. Gene Variant Linked to Osteoarthritis in Women
  58. Study: Estrogen Later in Life No Dementia Shield
  59. Climate Tied to Asthma, Eczema Rates in Kids
  60. Do Millions of Women Get Unneeded Pap Smears?
  61. Scientists Spot Fat Cell 'On' Switch
  62. Tongue Piercing Entails Infection Risks
  63. Health Tip: Is Your Teen a Binge Eater?
  64. Exercise Cuts Fall Risk for Women with Thin Bones
  65. Environmental Toxin Linked to Parkinson's
  66. Diabetes, Impotence Linked to Silent Heart Disease
  67. Amino Acid Tied to Depression in Parkinson's Patients
  68. Study: Few Women Get Annual Mammograms
  69. Kidney Disease Often Overlooked in Heart Patients
  70. Cancer May Be Responsible for 'Chemobrain'
  71. Chemo's Effect on Cognition is Debated
  72. Arkansas Seeks Vending Machine-Fat Link
  73. 'Seizure-Alert' Dogs Protect Children With Epilepsy
  74. Depression Spells Heart Trouble for Older Women
  75. Book Gives Tips for Healthy Road Trip Food
  76. New Test Helps Determine When Antibiotics Are Needed
  77. Research: Refined Grains Expand Girths

 

Friday, June 25, 2004

 

Pain Pills May Protect Against Brain Tumors

 

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - Treatment with aspirin, Advil (ibuprofen) and other nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against a highly lethal type of brain tumor

As reported in the American Journal of Epidemiology, Dr. Niccole R. Sivak-Sears of Ohio State University in Columbus, and colleagues note that NSAIDs appear to reduce the risk of colon cancer. Because colon cancers and certain brain tumors arise from similar cell origins, they suggest that these two types of tumors may "perhaps share common preventive mechanisms as well."

The researchers conducted extensive in-person interviews with 236 subjects with glioblastoma multiforme (or their caregivers) and with 401 healthy subjects.

Subjects were shown a list of generic and brand-name NSAIDs and were asked whether they had taken any of these medications in the 10 years prior to diagnosis, or in the case of healthy subjects, in the previous 10 years. Those who had taken a total of at least 600 such pills were considered to be regular users.

Patients with glioblastoma multiforme were less likely than their healthy peers to report regular NSAID use.

The researchers conclude that "if future studies corroborate this finding, NSAIDs might be considered candidates for prevention of this rapidly fatal tumor."

Source: American Journal of Epidemiology, June 15, 2004.

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MD: Obesity Risk for Elderly Overlooked

 

By Joann Loviglio

Associated Press Writer

The Associated Press

Friday, June 25, 2004  

PHILADELPHIA - As growing rates of obesity in children and adults grab headlines, a doctor says another segment of the population is facing the same problem but has been largely overlooked: elderly people, particularly those in retirement communities and assisted care facilities.

Take three square meals a day (often high calorie, large portion affairs), combine that with little exercise and the dynamic of eating in group settings, and the end result often is weight gain that can affect health and shorten life, said Dr. Carl Wenzel, a Warminster Hospital physician who treats elderly patients.

"We've got a major problem and it's going to get worse" as the U.S. population gets older, Wenzel said. In recent years, he said he has seen a marked increase in older patients with diabetes, high blood pressure, high cholesterol, heart disease and joint problems ailments often related to weight gain.

The prevalence of obesity among people age 50 and older increased 85 percent from 1982 to 1999, the most recent figures available from the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention (news - web sites). The rate of obesity falls as age increases, but is still markedly higher in recent years.

For example, the percentage of obese people 85 and older rose from 4.1 percent in 1982 to 8.3 percent in 1999, and the percentage of obese people age 75 to 84 rose from 7.7 percent in 1982 to 15.1 percent in 1999.

Meals in retirement communities and assisted care facilities are often lavish and large, and many elderly people have difficulty burning off those calories because of arthritis and other ailments that slow them down.

Add to that the phenomena in which people tend to eat more in group situations when they're enjoying the camaraderie of others at the table, and you have a recipe for what Wenzel calls the "senior 15" weight gain of 15 pounds or more in elderly patients.

In an effort to address what he calls a potential epidemic, Wenzel has started visiting retirement homes and assisted care developments to educate residents and staff about portion control and nutrition.

Among the places he's visited are Ann's Choice, a 375-resident retirement community in Bucks County that has retooled its meal plans to provide options that are low in fat and sodium, plentiful in fresh fruits and vegetables and feature heart-smart items like grilled fish and salads.

"We're trying to help people with their diets by having heart-healthy food that people will enjoy," said Mark Diller, Ann's Choice executive chef. "We meet weekly with residents to see what they want and what they don't, and they definitely want healthy options."

That doesn't mean that burgers and mac-and-cheese have been sent packing, however. As long as people opt for those kinds of foods, they'll be available, Diller said.

"One solution is self-restraint, reminding people that they don't need to eat everything that's in front of them," Wenzel said. "We also encourage people to get as much exercise as they're capable of doing, even if it's going to the mall and walking."

Possibly the most difficult lesson to convey to older people, Wenzel said, is diet change.

"We want people to eat less meat and bread and more fruits and vegetables," he said. "But many people of this age group grew up on the traditional meat and potatoes diet. That's how they've always eaten."

Monitoring diet in such large facilities is admirable but there are weightier issues in the battle of the bulge, said Dr. Lesley Carson of the University of Pennsylvania Health System's department of geriatric medicine.

"We really need to address obesity in the young," she said. "With geriatric patients who are obese, often the damage has already been done."

On the Net:

Ann's Choice: http://www.ericksonretirement.com/ach

Warminster Hospital: http://www.warminsterhospital.com

CDC "Trends in Aging" reports: http://www.cdc.gov/nchs/agingact.htm

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Low Zinc Levels in Mom Affect Baby's Bones

 

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - The findings from a new study suggest that pregnant women need to have adequate zinc levels to ensure optimal bone growth in their developing baby. For women from countries where zinc deficiency is common, taking zinc supplements can rectify this problem.

"Maternal zinc deficiency is relatively common in developing countries, but its consequences for fetal growth are not established," Dr. Laura E. Caulfield, of the Johns Hopkins University in Baltimore, and colleagues note in the American Journal of Clinical Nutrition (news - web sites). Using ultrasound, the authors tested whether increasing zinc levels in women with a deficiency could improve fetal growth.

The study involved 242 pregnant women from Peru, a country where zinc deficiency is common. Early in pregnancy the women were randomly selected to receive vitamin supplements that did or did not contain zinc.

Fetuses of zinc-treated mothers showed much greater bone growth at the femur, or thigh bone, than fetuses of other mothers. The effect of zinc supplementation on femur growth increased with increasing gestational age.

Caulfield said in an interview with Reuters Health that "what is unique here is that we were able to detect such effects in human fetuses using ultrasound technology." Our results suggest that maternal zinc levels have an effect on fetal bone growth, she added.

Source: American Journal of Clinical Nutrition, May 2004.

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Tests Sniff Out Trace Elements of Nuts

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Friday, June 25, 2004

FRIDAY, June 25 (HealthDayNews) -- People allergic to almonds, cashews and walnuts know how hard it is to make sure the processed foods they buy don't contain them as ingredients.

But help may be on the way. Scientists say they have developed new tests that can find trace elements of these nuts -- even after they have been heated or irradiated with gamma radiation.

Being able to spot these nut proteins may lead to better consumer labeling and help prevent severe allergic reactions, they say.

"The purpose of this research was to find out if these tests can be used to detect trace amounts of these nuts after processing. We also wanted to see if these nuts, when exposed to processing such as roasting, frying, and gamma radiation, can be recognized by these tests," said lead researcher Dr. Shridhar Sathe, a professor of food science at Florida State University.

"We found that these nuts do not lose their ability to be recognized by our tests," he added. The tests identify specific proteins in the processed nuts themselves, even when they are incorporated into other food products, Sathe said.

The study appears in the June issue of the Journal of the Science of Food and Agriculture.

"Processors or users of these nuts should not be lulled into thinking that processed nuts are safe because they have been exposed to extensive heat or gamma radiation," Sathe said. "They should not think that processing will destroy the ability of these nuts to cause an allergic reaction in sensitive individuals."

Sathe strongly believes that even trace elements of these nuts should be noted on food labeling. "No matter how small the number of sensitive people may be protected, I am a firm believer that every single life is invaluable and should be protected," he said.

According to Sathe, the Florida team has evaluated currently available tests for peanuts and found them wanting. These tests are not specific or sensitive enough to detect trace elements, he said.

"If you are allergic to tree nuts, almonds, cashews, or walnuts, simple processing may not protect you from allergic reactions even when processed by gamma radiation alone or in combination with other methods," he said. "That's it, in a nutshell."

Dr. David L. Katz, an associate clinical professor at Yale University School of Public Health and director of the Yale Prevention Research Center, said that "hypersensitivity to certain nuts is among the most common and potentially dangerous of food allergies."

He added that people subject to these allergies have had to fend for themselves because nut traces can turn up in foods ostensibly free of nuts. Often food labeling is an adequate defense against this, but it's not foolproof.

"The availability of a highly sensitive and cost-effective test for nut proteins should lead to routine testing of food products subject to mixing with nut residue," Katz said.

"With suitable labeling, this simple intervention could help avoid potentially life-threatening allergic responses, and shift the burden of vigilance from individual to industry. That's just the way any scientific advance is supposed to work," he said.

More information

The U.S. Food and Drug Administration (news - web sites) can tell you about food allergies.

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Almost Half of Stroke Patients May Be Aspirin Resistant

By M. Mary Conroy

Reuters Health

Friday, June 25, 2004

VANCOUVER (Reuters Health) - The results of a small study suggest that almost half of patients hospitalized after a stroke or transient ischemic attack (TIA) that are caused by a blocked blood vessel do not develop anti-clotting effects with aspirin therapy.

Dr. Mark Alberts, of Northwestern University Medical School, Chicago, reported at the 5th  World Stroke Congress that 47 percent of stroke or TIA patients showed "aspirin resistance," which was defined as a clotting time of 171 seconds or less.

The study involved 59 patients (average age 64 years) who had been taking aspirin for at least three days before they had a stroke or TIA. The patients were tested at the time of hospital diagnosis, before treatment with additional anticlotting therapy.

The researchers used a machine that measures the clotting time of a blood sample that is pumped through a membrane, a test design that mimics the behavior of circulating blood. The results, Alberts said, are available in "about 5 minutes -- and the test costs only $15 to $20."

Sixty-three percent of patients were taking 325 mg/day of aspirin, and 37 percent were using 81 mg. Aspirin resistance was more common in patients taking low-dose aspirin. The results were normal in 73 percent of patients on the low-dose aspirin versus 32 percent of patients taking high-dose aspirin.

There also was a trend toward more resistance in patients taking enteric-coated aspirin compared with those taking uncoated aspirin (73 percent versus 39 percent).

The results suggest that "dose-adjusted antiplatelet therapy is where the field is heading," Alberts concluded. "One size fits all therapy doesn't work for aspirin."

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Antioxidants May Fight Alcohol-Linked Birth Defects

 

HealthDayNews

Friday, June 25, 2004

FRIDAY, June 25 (HealthDayNews) -- Antioxidants taken during pregnancy might help prevent birth defects in babies born to women who abuse alcohol, suggests a study conducted in mice.

Researchers report 36 percent fewer limb malformations in pups born to pregnant mice that consumed daily amounts of ethyl alcohol plus a new antioxidant compound, EUK-134.

The study is "unique," researcher Dr. Kathleen K. Sulik said in a prepared statement, because it suggests "for the first time that giving antioxidants to a pregnant mother at the same time she's exposed to alcohol can diminish the incidence of major malformation."

Sulik is a professor of cell and developmental biology at the University of North Carolina School of Medicine, in Chapel Hill.

She said these findings in mice may have implications for humans.

"The nutritional status of alcoholics isn't the best. People who are alcoholic by definition can't control their drinking and often cannot quit drinking during pregnancy," Sulik said.

"And so the practical point of this paper is that perhaps we can diminish some of the problems that might exist if the nutritional status of alcoholic mothers improves. It would be great if these women would supplement their diets with a daily [antioxidant-containing] multivitamin," she said.

Examples of antioxidants include selenium, vitamin C and E, zinc, and superoxide dismutase.

Still, the best way to protect the fetus from alcohol-induced birth defects is simple, Sulik said: "If there's a chance you could become pregnant, don't drink -- or if you're drinking, don't get pregnant."

The study appears in the June 18 online issue of FASEB-J, the journal of the Federation of American Societies for Experimental Biology.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about drinking and pregnancy.

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Drug Makes Angioplasty Better for Diabetics

 

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - Treatment with Glucophage (metformin) appears to improve the outcomes of diabetics who undergo angioplasty to open blocked heart blood vessels, new research suggests. The drug improves blood sugar levels by making cells more sensitive to insulin.

As senior investigator Dr. Jesse (news - web sites) W. Currier told Reuters Health "the use of the insulin sensitizing agent (Glucophage) to treat diabetes was associated with a better clinical outcome than traditional non-insulin sensitizing therapy."

Currier of the University of California Los Angeles and colleagues note diabetic patients who undergo angioplasty have poorer outcomes than those without the condition.

To determine whether treatment with Glucophage might be helpful in these circumstances, the researchers analyzed data from a study involving 2772 diabetics who underwent angioplasty. The findings appear in the American Journal of Cardiology.

Of these, 1110 received non-insulin sensitizing drugs and 887 were treated with Glucophage with or without other agents.

After 9 months, Glucophage-treated patients were 28 percent less likely to experience an adverse outcome compared with their peers who received the non-insulin sensitizing drugs. In particular, they were 61 percent less likely to die and 69 percent less likely to experience a heart attack.

Currier noted that "the issue of (angioplasty) in diabetics is complex. However, the use of insulin sensitizers...may ameliorate the poorer outcomes seen" in the diabetic population.

Source: American Journal of Cardiology, June 1, 2004.

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Drug Prevents MS-Like Illness in Rats

 

HealthDayNews

Friday, June 25, 2004

FRIDAY, June 25 (HealthDayNews) -- Rats with a multiple sclerosis-like disease were spared disease-related weight loss and paralysis after treatment with an experimental drug, according to a new study.

"While there is much more research to be done on this compound, these initial results are very exciting," said Bruce Bebo Jr., a researcher and assistant professor of neurology at Oregon Health & Science University.

The study was funded by San Diego-based Ligand Pharmaceuticals, which makes the drug and collaborated in the research.

The Oregon team focused on rats with autoimmune encephalitis, a disease long used as a stand-in for human multiple sclerosis (MS) in animal trials. Some of the rats received the trial drug, called LGD5552. Others were given a related anti-inflammatory steroid called prednisolone, and a third group of rats received no treatment.

All of the untreated rats developed paralysis as a consequence of their disease. Rats treated with prednisolone showed reduced symptoms, however, while rats treated with LGD5552 -- which is not a steroid -- remained completely free of weakness. LGD5552-treated rats maintained their body weights, while the other rats in the study lost weight.

Rats treated with LGD5552 also showed no signs of inflammatory lesions in the spinal cord, a hallmark of both autoimmune encephalitis and MS. The rats in the other two groups did develop the lesions.

The research was presented at the recent national meeting of the Endocrine Society.

More information

Read more about MS from the National Multiple Sclerosis Society .

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Stool Test Can Reduce Colorectal Cancer Deaths

 

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - Colorectal cancer screening by testing stool for tiny amounts of blood, known as "fecal occult blood testing" (FOBT), can reduce deaths from colorectal cancer in the general population, French researchers report in the current issue of Gastroenterology.

Studies with volunteers have shown that FOBT, followed by more intensive testing, in patients with positive test results can reduce colorectal cancer death rates, the authors point out. However, these results may not be directly applicable to the general population whose compliance with FOBT may be significantly lower.

To investigate, Dr. Jean Faivre and colleagues from Burgundy Cancer Registry, Dijon undertook a study to assess the effectiveness of biennial FOBT screening in reducing of colorectal cancer death rates. This involved almost 92,000 residents from 12 administrative districts in Burgundy.

Overall, 69.5 percent of the invited population completed at least one screening and 38.1 percent completing five or six screenings.

Having FOBT screening at least once reduced the risk of colorectal death by one third, the investigators found. Also, the 11-year survival rates of patients with cancers identified with FOBT were significantly higher in the screening group (50.5 percent) compared with individuals who were not screened (40.4 percent).

"Biennial FOBT significantly reduces colorectal cancer mortality," Faivre told Reuters Health. In fact, he added that a nationwide study of FOBT screening, involving a quarter of the French population, has already begun.

Gastroenterology, June 2004.

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Asthma Emerging as Genetic Disorder

 

By Adam Marcus
HealthDay Reporter

HealthDayNews

Friday, June 25, 2004

FRIDAY, June 25 (HealthDayNews) -- Asthma rates have risen sharply in the United States in recent decades. The chronic condition, in which the airways become inflamed and stifle breathing, now affects more than 20 million Americans, including more than five million children.

Asthma kills nearly 5,000 people a year, according to the American Academy of Allergy, Asthma and Immunology. Asthma attacks lead to 1.8 million emergency room visits and 14 million missed days of school annually, the group says.

Dr. Deborah Gentile, an asthma specialist at Allegheny General Hospital (news - web sites), in Pittsburgh, said immunologists are increasingly coming to understand asthma as a genetic disorder -- at least, in its beginnings. "We're thinking that there are different types of asthma driven by different genes."

A child with one parent who has asthma has a 30 percent chance of developing the airway condition herself. If both parents have it, her odds of getting it approach 70 percent -- not a given but a stacked deck.

Gentile said there are three factors that contribute to a person's risk of asthma. The first is the genetic legacy from parents; the second is exposure to infections and irritants that "program" the immune system and make it sensitive. The third is timing: It seems that the immune system is particularly sensitive during the first two years of life, Gentile said, so children with the right combination of genes and the right mix of exposures early in life are at the greatest risk of developing asthma.

Once a person's susceptibility to asthma has been established, he or she can suffer breathing attacks when they experience onset symptoms known as triggers. Well-known triggers of asthma include respiratory infections, breathing cold air and cigarette smoke, and even vigorous laughter or sobs. Various irritants, such as pet dander, dust mites, cockroaches, pollen and mold, also can worsen the symptoms of asthma, according to the National Institutes of Health (news - web sites).

Some evidence suggests that women who take estrogen replacement therapy during menopause may be more likely to develop asthma as they age. However, the extent of the connection isn't fully understood, experts say.

Aspirin and other painkillers are also known to exacerbate asthma in about 10 percent of people with the condition. Dr. Carlos Camargo, an asthma expert at Harvard Medical School (news - web sites), in Boston, said some recent evidence suggests that acetaminophen, the active ingredient in Tylenol, may both cause and trigger asthma attacks in rare cases.

"It's important to distinguish exposures that cause asthma versus those that exacerbate existing asthma," Camargo said. "Although these are, at times, the same, there are also factors that worsen existing asthma but are unlikely to cause disease," such as strong odors like perfumes, he said.

More information

Because asthma is so widespread throughout the American population, there are always research initiatives in progress. The federal government's National Institute of Environmental Health Sciences lists some of the research under way.

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Painkillers May Slow Healing After Shoulder Surgery

 

By Merritt McKinney

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - Anti-inflammatory drugs commonly used to relieve pain after shoulder surgery may impair healing, new animal research suggests.

Rats that were treated with anti-inflammatory drugs had poorer healing than animals that were not given the drugs, researchers reported Friday at a meeting of the American Orthopedic Society for Sports Medicine in Quebec City, Canada.

The findings "should give us pause" about the use of anti-inflammatory drugs in people who have rotator cuff surgery, study investigator Dr. Scott A. Rodeo of the Hospital for Special Surgery in New York told Reuters Health in an interview.

But Rodeo cautioned that more research is needed to confirm the results.

"At this point, we can't make recommendations" about the use of anti-inflammatory drugs after rotator cuff surgery,

If the findings are confirmed, Rodeo said it may be wise to avoid giving the drugs to patients who are likely to have problems healing after shoulder surgery, including the elderly, people with the brittle-bone disease osteoporosis and people who are having repeat surgery.

Rodeo and his colleagues tested the effect on healing of drugs called nonsteroidal anti-inflammatory drugs, or NSAIDs. This class of drugs includes over-the-counter pain relievers such as ibuprofen, aspirin and naproxen, as well as the newer prescription drugs celecoxib (Celebrex) and rofecoxib (Vioxx).

NSAIDs are often used to relieve pain after surgery to repair the rotator cuff, which is made up of the muscles and tendons that hold the upper arm bone to the shoulder.

Previous research has shown that NSAIDs have a negative effect on bone formation, Rodeo said. Because healing after rotator cuff surgery involves bone formation -- bone grows into the outer tendon -- Rodeo and his colleagues set out to see whether NSAIDs affect healing after the shoulder surgery.

Anti-inflammatory drugs "really did have an adverse effect in this model," Rodeo said.

Rodeo's team found that rats treated with the NSAIDs celecoxib or indomethacin after surgery experienced poorer healing than animals that did not receive any anti-inflammatory medication.

Among the 120 rats treated with one of the drugs, five tendons failed to heal at all. None of the tendons in rats that did not receive the drugs failed to heal.

This is the first study to suggest that anti-inflammatory medications impair healing after rotator cuff surgery, Rodeo said.

But the New York researcher cautioned that the findings need to be confirmed in a study involving larger animals, such as sheep, as well as in human trials before changes are made in clinical practice.

Still, Rodeo cautioned, "there is the potential for adverse effects."

If future studies bear out the findings, Rodeo said that there are other options for relieving pain after shoulder surgery, including narcotic pain medications. Unfortunately, narcotics can be addictive and may cause side effects, including constipation and nausea, Rodeo said.

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Early Radiation Therapy Extends Prostate Cancer Survival

 

By Holly VanScoy
HealthDay Reporter

HealthDayNews

Friday, June 25, 2004

FRIDAY, June 25 (HealthdayNews) -- Prostate cancer (news - web sites) patients who receive radiation therapy within six months of surgery typically live longer than patients who don't receive early radiation treatment, a new Italian study finds.

"Our results show that radiation therapy after prostate surgery helps limit the chances that the cancer will recur, allowing patients to live longer," said Dr. Cesare Cozzarini, a radiation oncologist at San Raffaele H. Scientific Institute in Milan, and the study's principal investigator.

"To my knowledge, this is the largest study of its kind completed at a single institution," he added.

The researchers examined the records of 415 men with prostate cancer who underwent surgery to remove their prostate and surrounding lymph nodes between 1986 and 1999 at the Institute.

Two groups of post-surgical patients were studied -- one group included men who received external beam radiation therapy within six months of their prostate operation; the other included men whose physicians followed them over time and provided radiation therapy only if their cancers showed signs of returning. None of the men whose records were studied had metastatic disease -- that is, cancer in areas of the body other than the prostate.

After eight years of follow-up, the survival rate for men receiving early radiation therapy was 69 percent, compared to 31 percent for those who had radiation therapy more than six months after their surgeries or not at all.

The researchers also found that the disease remained localized in the prostate for 93 percent of the patients in the early radiation therapy group, compared to 63 percent in the other group. The risk of death from localized prostate cancer was also significantly lower for men receiving post-surgical early radiation therapy.

Results of the study will appear in the July issue of the International Journal of Radiation Oncology*Biology*Physics, a publication of the American Society for Therapeutic Radiology and Oncology.

Dr. Eric Horwitz is associate professor and Director of the Radiation Oncology Training Program at Fox Chase Cancer Center in Philadelphia. He said the Italian study is the first to offer evidence about whether radiation treatment soon after prostate surgery actually improves a man's chances of survival.

"These results provide oncologists, urologists and radiologists with another important piece of the prostate cancer treatment puzzle," Horwitz said. "The study included a significant number of patients and included many follow-up details about these men five and eight years later. Most importantly, it also provides valuable information about whether they survived, not just about their levels of prostate specific antigen (PSA), which is what most previous studies have reported."

Dr. E. Roy Berger, M.D., founding member of the Prostate Cancer Education (news - web sites) Council, noted that the Milan research and similar recent studies are moving the treatment of prostate cancer along the same path recently traveled by breast cancer patients and physicians.

"Five years ago, radical mastectomy was the only way to go in breast cancer treatment," he said. "Today there's been so much good research about the positive outcomes of other treatment approaches that chemotherapy, radiation and less radical surgical interventions are widely used together -- and the breast cancer survival rates are improving."

Berger believes that "this is the same course the treatment of prostate cancer is likely to follow, as understanding grows of the roles radiation, hormones and chemotherapy used together can play in saving men's lives."

Dr. Ronald Smialowicz, a urologist in private practice at St. Francis Memorial Hospital in San Francisco, concurred.

"The standard of care in prostate cancer is continuing to evolve," he said. "As is now the case in the treatment of breast cancer, the best outcomes will likely occur when prostate cancer treatment is highly individualized and men themselves participate in making an informed decision about what treatments they pursue at each point in their disease and recovery process."

Prostate cancer is the second most common malignancy affecting American men. The American Cancer Society (news - web sites) estimates some 230,900 new cases will be diagnosed this year, with about 29,900 deaths. Only skin cancer is more prevalent. One American man in six will develop prostate cancer during his lifetime and one in 32 will die from the disease.

More information  

For more on prostate cancer and its treatment, visit the National Cancer Institute.

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Pet-Free Students Lower Classroom Allergy Triggers

 

Reuters Health

Friday, June 25, 2004

NEW YORK (Reuters Health) - Asking students to either change clothes when arriving at school or give up furry pets appears to reduce the amount of classroom allergy triggers by up to six-fold, new research reports.

These findings show that school administrators can take steps to help protect allergic students, the authors note.

However, they add that asking kids to give up pets was "less accepted" than having them change clothes before coming to class.

Research has shown that classrooms can accumulate levels Fel d 1, the substance that triggers symptoms in students allergic to cats. And the more cat owners there are, the more rife classrooms are with Fel d 1.

Previously, the investigators, led by Anne-Sophie Karlsson of Karolinska Institutet in Stockholm, found that increased cleaning in classrooms, removing upholstery and curtains and replacing bookshelves with cupboards did little to reduce the amount of airborne Fel d 1.

Taking another tactic, this time Karlsson and her team compared levels of Fel d 1 in six different classrooms over a six-week period. In two classrooms, children changed into different clothing when arriving at school, and stored their home and school clothes in separate lockers or in plastic bags.

In another classroom, none of the children had furred pets or birds at home. The room was also equipped with an air cleaner.

After six weeks, the investigators found that the amount of airborne Fel d 1 was between 4 and 6 times lower in classrooms where students either gave up house pets or changed their clothing.

"For the first time, it has been shown that levels of airbourne cat allergen can be reduced by allergen avoidance measures at school by using school clothing or pet ownership ban, and that both measures are equally efficient," Karlsson and her colleagues write in the Journal of Allergy and Clinical Immunology.

Moreover, in classrooms where no intervention was taken, children with cats had three times more Fel d 1 on their clothing than children without cats.

"This finding suggests that a child allergic to pets should not be seated close to pet owners, even in an allergen-avoidance class," they add.

Source: Journal of Allergy and Clinical Immunology, June 2004.

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Thursday, June 24, 2004

 

More Americans Surviving Cancer Than in 1970s

 

By Paul Simao

Reuters

Thursday, June 24, 2004

ATLANTA (Reuters) - The number of Americans who live at least five years after a cancer diagnosis has risen sharply since the mid-1970s due to increased screening, improved medical treatment and overall higher life expectancy, federal health experts reported on Thursday.

An estimated 64 percent of adults diagnosed with cancer between 1995 and 2000 could expect to be alive five years later, according to data compiled by the Centers for Disease Control and Prevention (news - web sites) and the National Cancer Institute (news - web sites).

That compared with 50 percent of adults who were told they had the disease between 1974 and 1976. The five-year survival rates -- considered a key marker for cancer patients -- excluded noncancer-related deaths.

Young teens and children also had higher cancer survival rates, according to the study, which was released by the CDC.

Seventy-nine percent of children under the age of 15 were expected to live five years after a diagnosis between 1991 and 2000. The five-year survival rate for this group was only 56 percent during the 1974-1976 period.

U.S. health officials said improving cancer survival rates indicated a need to focus more attention on the long-term health as well as social and economic well-being of cancer patients.

An estimated 9.8 million Americans, or 3.5 percent of the population, were living with cancer in 2001, compared to 3 million, or 1.5 percent of the population, three decades earlier, according to the study.

"Issues faced by cancer survivors include maintaining optimal physical and mental health, preventing disability and late effects related to cancer and its treatment, and ensuring social and economic well-being for themselves and their family," said Dr. Julia Rowland, an National Cancer Institute official and one of the study's authors.

Breast cancer was the most common primary cancer reported by survivors in 2001, followed by prostate cancer, colorectal cancer and gynecologic cancer. An estimated 60 percent of all newly diagnosed cancers in 2001 were among those 65 and older.

Cancer is the second leading cause of death in the United States after heart disease.

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Protein May Help People Resist HIV

 

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 24 (HealthDayNews) -- Scientists say they've spotted a cellular protein that might help the body ward off HIV (news - web sites) and AIDS (news - web sites).

The protein, called APOBEC3F, "may be a factor in HIV resistance. We need to discover whether these proteins are essential for keeping HIV at bay in an infected individual," lead researcher Reuben Harris, of the University of Minnesota, said in a prepared statement.

APOBEC3F joins another previously identified protein, APOBEC3G, in a class of cellular defense agents called retroviral restrictors. They're able to mutate HIV and may help explain why a minority of individuals remain resistant to the virus.

According to the Minnesota team, HIV mounts its own defense against proteins in the APOBEC family. But APOBEC3F seems especially adept at getting around this defense.

"APOBECs are a 'search and destroy' defense," Harris explained. "It's different from the defense found in some HIV-resistant people, in which the outer surfaces of their cells no longer offer footholds for the virus to attach and begin the process of infection."

The study is published June 24 in the journal Current Biology.

More information

The U.S. National Institute of Allergy and Infectious Diseases (news - web sites) has more about HIV/AIDS.

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Health Tip: Cholesterol Control

 

HealthDayNews

Thursday, June 24, 2004

(HealthDayNews) -- Medication, exercise and a proper diet can combine to effectively treat high cholesterol. Here are some cholesterol-cutting tips, courtesy of the U.S. Department of Veteran Affairs.

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New SARS Vaccine Shows Promising Results in Monkeys

 

Reuters

Thursday, June 24, 2004

LONDON (Reuters) - An experimental vaccine sprayed into the nose protects monkeys against the SARS (news - web sites) virus and could be developed to immunize humans, scientists said Friday.

Only one dose of the vaccine, developed by scientists at the National Institute of Allergy and Infectious Diseases (news - web sites) (NIAID) in the United States, was needed.

"This study shows that delivering the vaccine directly to the respiratory tract can effectively protect primates from SARS," said Dr Brian Murphy, a co-chief of the NIAID Laboratory of Infectious Diseases.

"With more research, we hope to develop a vaccine based on this approach that could be used to rapidly immunize first responders and other medical personnel, helping them control a potential outbreak," he added in a statement.

The researchers, who reported their results in The Lancet medical journal, immunized four African green monkeys with the vaccine and four others with a control vaccine. A month later all the animals were infected with the SARS virus.

The monkeys given the SARS vaccine showed an immune response and none had evidence of the virus replicating but animals in the control group did.

"The finding is important since it brings together known yet innovative technologies, knowledge and skills to address prevention of an emerging infectious disease," said Ruth Foxwell of the University of Canberra and AW Cripps of Griffith University in Australia, in a commentary in the journal.

Severe Acute Respiratory Syndrome (SARS) infected more than 8,000 people in nearly 30 countries and killed nearly 800 following an outbreak which first emerged in southern China in 2002, according to the World Health Organization (news - web sites) (WHO).

It briefly re-emerged in China last April, killing one person and fueling fears that the disease could surface in an annual cycle similar to human flu.

The experimental nasal vaccine is the third candidate SARS vaccine developed by NIAID but the first to be delivered directly into the respiratory track -- the main infection site.

"We now have three technologically unique approaches to restricting SARS replication in animals," said NIAID director Anthony Fauci in a statement.

Earlier this month, the WHO said four volunteers in China were taking part in the first human clinical trials of a SARS vaccine which had previously been tested in Rhesus monkeys.

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Science Finds Clue to Stopping Cancer's Spread

 

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 24 (HealthDayNews) -- Cancer cells commandeer a normally dormant protein to aid their spread to other organs, a new study has found.

Researchers at Whitehead Institute for Biomedical Research in Cambridge, Mass., found that tumor cells spread by reactivating and taking control of a "sleeper" protein, called Twist, that's normally switched off for good during early embryo development.

"As a result, cancer cells acquire in one fell swoop many of the abilities they need to execute the complex stages of metastasis," researcher Robert Weinberg said in a prepared statement.

While scientists have learned a great deal about how tumors originate and develop, they've been unable to find out much about how cancer spreads through the body.

In research with mice, Weinberg and his colleagues found that breast cancer cells are able to reactivate the Twist protein and use it to move to other tissues and organs.

Twist, a gene regulator, enables cells to move from one part of the embryo to another area. As an embryo develops, Twist's functions are no longer necessary and it becomes dormant.

This study found that cancer cells can reactivate Twist and use it to move throughout the body. The actual process used by cancer cells to reactive Twist is unclear.

While the research is still in its very early stages, study co-author Dr. Andrea Richardson, of Brigham and Woman's Hospital in Boston, said drugs might someday be developed that stop cancer from spreading beyond its origins.

"Something like that would turn cancer into a chronic disease, rather than a deadly one," she said.

The study appears in the June 25 issue of the journal Cell.

More information

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

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Eat More Oily Fish and Be Healthy, Say Food Experts

 

By Jeremy Lovell

Reuters

Thursday, June 24, 2004

LONDON (Reuters) - Eating up to four portions of oily fish a week poses little risk of a build up of toxins in the body and gives a major boost to a healthy heart, British government food experts said on Thursday.

The advice, issued after an investigation lasting nearly a year, quadruples the amount of oily fish like mackerel, tuna and salmon that people had previously been advised to eat each week.

"Eating just one portion of oily fish a week has clear cut health benefits," Food Standards Agency (FSA) chief John Krebs told reporters.

"This extensive review of the scientific evidence has reduced the uncertainty about how much oily fish people can safely eat without the benefits being outweighed by the risks," he added.

The FSA said its new advice to eat up to four portions of oily fish a week applied to men, boys and women past child-bearing age.

Girls and women likely to become pregnant at some stage should limit their intake to two portions a week so as to avoid any possible build up in their bodies of toxins than might be passed on in the womb, it added.

It is well established that including oily fish in the diet is a major contributor to fighting heart disease which is one of the world's biggest killers.

In Britain alone, 117,500 people died of heart disease in 2002, the FSA said.

On average Britons eat just one third of a portion of oily fish each week, with the vast majority completely excluding it from their diets.

There have been several scares about the levels of toxins such as dioxins and PCBs in fish in recent years. Both chemicals are carcinogens and persistent in the environment.

Earlier this year one study into farmed salmon said the levels of harmful chemicals in the fish were so high that they should only be eaten very sparingly. But Krebs said that Thursday's eating recommendations included farmed salmon.

"The conclusions were based on average levels of dioxins and PCBs in oily fish," he said. "Some species have lower levels and some have higher and at the levels found in farmed salmon, they would fall within the guidelines."

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Bad Teeth? Don't Blame Your Childhood

 

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 24 (HealthDayNews) -- An unhealthy adult lifestyle, and not poor childhood dental habits, is largely responsible for bad teeth in adults, British researchers say.

"Even if people aren't used to following a tooth care regime, it's never too late for them to start," lead researcher Dr. Mark Pearce of the University of Newcastle upon Tyne said in a prepared statement.

The study of 337 people, appearing in the June 24 issue of the Journal of Dental Research, found that smokers and those from deprived social circumstances were more likely to suffer tooth loss.

The more cigarettes a person smoked, the more teeth he or she was likely to lose. Smoking restricts blood flow in the gums, leading to gum disease and tooth loss.

Poor social circumstances are associated with poor oral hygiene habits, such as infrequent toothbrushing and irregular visits to the dentist.

The study also found that the link between a person's childhood dental habits and problems with teeth and gums diminished as a person aged; eventually, they became almost insignificant as a factor.

Study co-author Jimmy Steel, of Newcastle University's School of Dental Sciences, said young adulthood is often the worst period of life in terms of dental care.

"Even people who look after their teeth when they are children may slip into bad habits when they leave home and indulge in an unhealthy lifestyle as young adults," he said. "It's common for chocolate bars to be substituted for meals, or for regular teeth-brushing to stop. In fact, studies show that men aged 20-30 are the worst at looking after their oral health."

The results suggest that public health efforts to improve oral health should target adults as well as children, the researchers concluded.

"They can't turn the clock back," Pearce said, "but they can increase their chances of maintaining a good set of teeth into their old age, something which is very significant when you consider life expectancy is increasing all the time."

More information

The American Dental Association has more about cleaning your teeth and gums.

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Pregnancy Bad for Good Cholesterol

 

Reuters Health

Thursday, June 24, 2004

NEW YORK (Reuters Health) - Pregnancy seems to cause a drop in "good" HDL cholesterol levels that may persist for up to 10 years, according to the results of a new study.

"Previous studies have reported declines in HDL cholesterol 1 to 2 years after pregnancy," Dr. Erica P. Gunderson, of Kaiser Permanente Medical Center, in Oakland, California, and colleagues write in the American Journal of Epidemiology.

To look into this further, they examined the association between childbearing and changes in cholesterol levels over 10 years, in nearly 2000 US women enrolled in the Coronary Artery Risk Development in Young Adults study.

Women who had given birth experienced significantly greater declines in HDL cholesterol levels than women who did not have a baby. Having additional pregnancies, however, didn't seem to lower HDL cholesterol levels further.

Changes in hormone levels and fat deposits may interact after a first birth to adversely affect HDL cholesterol levels, Gunderson's group suggests.

"Genetic factors, changes in fat distribution, and behavioral practices (breastfeeding) that may offset the negative effects of a first birth on (cholesterol levels) should be examined," the researchers add.

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

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Widely Used Alzheimer's Drugs Found Ineffective

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 24 (HealthDayNews) -- Cholinesterase inhibitors, the most widely prescribed drugs for Alzheimer's disease (news - web sites), do not slow progression of the mind-robbing condition and do not affect the rate at which patients must be admitted to nursing homes, a British study finds.

The drugs, which include donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon), do provide some benefits, but not nearly enough to justify their widespread use, said Richard Gray, professor of medical statistics at the University of Birmingham and lead author of a report on the study in the June 26 issue of The Lancet.

The results of the study also contradict claims made by pharmaceutical companies who market the drugs on the basis of studies they have financed, he said. But the makers of the leading drug, Aricept, defended their research.

Alzheimer's drug trials financed by drug companies are often "very seriously flawed," Gray said, because they are short in duration -- usually only about six months -- and are made up of Alzheimer's patients who independently choose to take the drugs. These types of patients tend to have more benign, slowly progressing disease, so it's tough to measure whether the drugs would provide significant relief for more serious symptoms over the long term.

By contrast, the new study is a placebo-controlled, randomized, double-blind trial in which 486 participants were chosen at random from persons diagnosed with Alzheimer's disease. Neither doctors nor patients knew who was taking the active drug or an inactive sugar pill, and the patients were followed for several years.

The drug used in the trial, Pfizer, Inc.'s donepezil (Aricept), is the most widely prescribed medication of its class, but the study results should hold true for other cholinesterase inhibitors, Gray said.

Those results were not encouraging.

After an average of three years, 42 percent of those taking Aricept were hospitalized, compared to 44 percent taking the placebo, a difference that was not statistically significant. Progression of disease-related disability occurred in 58 percent of those taking Aricept and 59 percent of those taking placebo. No differences were found in symptoms, cost of care, adverse medical events, or death rates.

Aricept did improve performance on tests of mental and functional ability, but Gray dismisses them as unimportant. "They usually ask such questions as spell the word 'world' backwards," he said. "Is it worth spending £1,000 a year [about $1,800] to be able to spell the word 'world' backwards?"

A statement by Pfizer, which markets the drug in the United States, and Eisai, Inc., which markets it in England, challenged the results of the study. They "have limited value when compared to the extensive data gathered for cholinesterase inhibitors in tens of thousands of patients derived from carefully monitored and validated studies," the statement reads.

An "overwhelming body of evidence and real-world experience" supports the use of Aricept and similar drugs for Alzheimer's patients, and "doctors, in consultation with the patients and caregivers, should continue treating patients with Alzheimer's disease based on their clinical experience and expertise," the statement continued.

The drugs do have a role in treatment of Alzheimer's patients, but it is a sharply limited one, said Dr. Lon S. Schneider, director of the University of Southern California Geriatric Study Center and author of an accompanying editorial.

"It is almost an important role, but expectations about their effectiveness should be realistic," Schneider said. "They should not be prescribed in the belief that they will keep patients out of nursing homes."

Schneider said he agreed with Gray's negative assessment of company-sponsored trials, because they lack the needed controls.

"Those studies compare patients who are on the drugs and those who are not," he said. "They find that those on donepezil don't go into nursing homes, and they conclude that donepezil is keeping people out of nursing homes. But those taking donepezil might have a more benign version of the condition and might be richer. We don't know if they are staying out of nursing homes because they are taking donepezil or because they have a more benign course of the disease."

Perhaps 90 percent of the Alzheimer's patients treated at USC have been prescribed a cholinesterase inhibitor at one time or another, Schneider said, "but how many of them benefit from it is very uncertain."

A carefully worded statement from the Alzheimer's Association said that "the study should stimulate policy debate and not dictate individual treatment decisions." However, the Association advises that "no one should change an Alzheimer medication regimen, for themselves or a loved one, without careful consultation with their physician," adding that the study "has complex results that will generate wide debate."

More information

You can learn about efforts to treat Alzheimer's disease from the Alzheimer's Association.

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Needle Biopsy Linked to Breast Cancer Spread

 

Reuters Health

Thursday, June 24, 2004


NEW YORK (Reuters Health) - Having breast cancer tissue sampled with a needle seems to increase the odds that disease will also be found in an armpit lymph node called the sentinel node, new research suggests.

The spread of breast cancer to the sentinel node adversely affects a woman's survival and influences the treatment received.

As reported in the Archives of Surgery, Dr. Nora M. Hansen of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California hypothesized that the method used to obtain specimens from the breast tumor might influence the spread of cancer to the sentinel node.

To investigate, the researchers studied 663 women with proven breast cancer. Of the cancers, about half were biopsied with a needle, while the remainder involved actual removal of the tumor.

Woman who had a needle biopsy were about 50 percent more likely to have cancer in the sentinel node than women who underwent tumor removal.

The researchers suggest that the increased risk of sentinel node disease may be "due in part to the mechanical disruption of the tumor by the needle," and they call for further studies to confirm these findings.

Source: Archives of Surgery, June 2004.

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Study Details Possible Cause of Autism

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 25 (HealthDayNews) -- A glitch in brain circuitry may help explain why people with autism often display anti-social behavior.

So says a new report by Italian and French researchers that appears in the June 26 issue of Science.

For years, researchers have suspected that the brain's opioid system, involved in behaviors related to pain, pleasure and addiction, may somehow be involved in social interactions, or the lack of them, evident in those with autism.

Now, the European researchers report that mice genetically engineered to lack specific opioid receptors on the surface of brain cells responded differently when separated from their mothers. They also didn't respond, as normal mice did, to the opioid drug morphine, which normally reduces distress.

The social indifference displayed by people with autism and other "attachment" disorders may be related to the opioid signaling system, the researchers concluded.

"Brain opiates play a fundamental role in the reward circuitry -- that is to say they help the individual to understand what is good for them, in evolutionary terms," said study co-author Francesca D'Amato, a researcher at the CNR Institute of Neuroscience, Psychology and Psychopharmacology, in Rome.

Working with the mice, the researchers focused on the brain's opioid system, partially regulated by 'u-opioid' receptors lying on the surface of cells. They wanted to see if the u-opioid receptors also played a role in infant-mother attachment behavior.

To do so, they closely observed newborn mice genetically engineered to lack the receptors, watching to see how the mouse pups responded when separated from their mothers.

According to D'Amato's team, mice without the receptors made fewer distress calls to their mothers compared with normal mice.

Furthermore, when the researchers gave mice the opioid drug morphine, it reduced the distress of normal mice -- as expected -- but appeared to have no effect on mice lacking receptors.

People with autism have trouble interacting with others and appear aloof and socially indifferent, and D'Amato's team speculates that perhaps the opioid signaling system is to blame.

The researchers believe their study gives weight to the argument that opioid receptors are a "critical player" in attachment disorders, echoing the findings of previous research.

According to the Autism Society of America, autism affects nearly 1.5 million U.S. children and adults, with signs typically appearing during the first three years of life. The disorder especially affects normal brain development in areas of social interaction and communication skills. Individuals with autism typically have problems communicating, both verbally and nonverbally, and interacting with others in general.

"I think it's a very interesting study," said Andy Shih, director of research and programs at the National Alliance for Autism Research in Princeton, N.J. "As Dr. D'Amato correctly points out, the opioid receptor system has long been suspected to play a role in attachment behavior. Using knockout mice to demonstrate that is fairly convincing evidence."

Even so, he added, "the challenge of any animal study is how does it really correlate with human behavior." More research is needed, Shih emphasized.

More information

For more on autism, visit the National Alliance for Autism Research.

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Overweight Women Overestimate Physical Activity

 

By Merritt McKinney

Reuters Health

Thursday, June 24, 2004

NEW YORK (Reuters Health) - Young women, especially those who are overweight, tend to overestimate their levels of physical activity, according to a new study.

After losing weight, however, white women overestimate their physical activity levels to a lesser extent. In contrast, African American women continue to overestimate their physical activity as much as before losing weight, researchers report.

The finding could be useful in helping people keep the pounds off, the study's lead author told Reuters Health.

"It can be hypothesized that women who overestimate their physical activity may not feel the need to be as physically active," said Dr. Gary R. Hunter of the University of Alabama at Birmingham.

"This can be important for preventing weight gain since we, as well as others, have previously found that relatively high physical activity levels are important for maintaining weight," Hunter said.

Black women tend to be less physically active and more likely to be overweight than white women, previous researchers has determined. Studies have also shown that people tend to overestimate when asked how much they exercise. So Hunter's team set out to compare black and white women's perceptions about their physical activity.

The study included 20 white and 21 black premenopausal women who were overweight at the start of the study, but who lost weight during the study. The trial also included a control group of 20 white and 14 black women who were not overweight.

The women reported their physical activity levels before and after losing weight.

Most women, regardless of their weight, overestimated how much physical activity they performed, Hunter's team reports in the June issue of the American Journal of Clinical Nutrition (news - web sites).

"Premenopausal women overestimate physical activity with overweight premenopausal women overestimating physical activity almost twice as much as normal weight women," Hunter said.

After weight loss, the level of overestimation dropped dramatically in white women, so much so that they were similar to the black and white women who had never been overweight, Hunter noted. But African-American women continued the same level of overestimation even after losing weight, the study found.

"Overestimation seems to be related to muscle function, especially muscular strength," Hunter said. He noted that fit women tended to overestimate their physical activity less often than women who were not as fit.

There were signs that black women, but not white women, experienced a reduction in physical fitness after they lost weight. Physical activity may have become easier for white women who lost weight, so they may have perceived that they were less active.

Because of the decline in fitness level, physical activity may not have become any easier for black women, which may explain why they continued to overestimate their activity levels, according to the report.

The results of the study "support the concept that exercise training designed to improve fitness and especially strength fitness may be important for increasing free-living physical activity by changing how physical activity is perceived," Hunter said.

Source: American Journal of Clinical Nutrition, June 2004.

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Many Doctors Don't Ask Teens About Smoking

HealthDayNews

Thursday, June 24, 2004

THURSDAY, June 24 (HealthDayNews) -- Many doctors fail to find out if their teenage patients are smoking, according to University of Wisconsin-Madison researchers.

The team found that 55 percent of adolescents seeing a doctor over a two-year period were asked about their smoking status. Just 5 percent of adolescent patient charts including smoking status as a vital sign -- a government-backed recommendation.

Researchers, who audited Wisconsin Medicaid medical records of patients 11 to 21 years old, also found that people least likely to be asked about their smoking status were younger patients, those from rural areas, and patients who were not pregnant.

"Previous studies may have overestimated interventions with adolescents because they were based on physician self-report," lead author Dr. Tammy Sims, of the University of Wisconsin Transdisciplinary Tobacco Use Research Center, said in a prepared statement.

"Through analysis of patient charts, we have found that physicians are losing a golden opportunity to intervene with current teen smokers and to dissuade potential smokers among the younger teen population," Sims said.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has more about youth and tobacco.  

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Wednesday, June 23, 2004

 

Solvents, Diesel Fuel Can Make Farmers Wheeze

 

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- Diesel fuel and solvent use sow the seeds of wheezing in farmers, according to researchers.

A new study of 20,898 farmers in Iowa and North Carolina found that driving tractors and trucks powered by diesel fuel and regular use of solvents to clean and paint were associated with increased risk of wheeze.

The U.S. government study found that 19 percent (3,922) of the farmers reported at least one episode of wheezing in the year prior to the study, but only 5 percent noted that they had a history of asthma.

Of all farm activities, the daily use of gasoline and other solvents to clean and paint was associated with the highest odds of wheeze; the study found that those who painted every day were 82 percent more likely to have breathing problems.

The research appears in the June 15 issue of the American Journal of Respiratory and Critical Care Medicine.

More information

The U.S. National Library of Medicine has more about wheezing.

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Few Women Comply with Mammogram Guidelines

 

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Findings from a new study indicate that only 6 percent of women get a screening mammogram every year starting at age 40 as recommended by the American Cancer Society (news - web sites). Because annual screening has been shown to improve breast cancer survival, such underuse is particularly concerning.

The results, which appear in the medical journal Cancer, are based on a study of 72,417 women who underwent a total of 254,818 screening mammograms between 1985 and 2002 at a major breast center in Boston.

As noted, of the women who received a mammogram in 1992, just 6 percent remained compliant with annual screening in the next 10 years, senior author Dr. James S. Michaelson, from Massachusetts General Hospital in Boston, and colleagues note. Instead of the 10 mammograms that should have been performed during this period, the average number was only 5.1.

Entering this data into a computer program designed to consider breast cancer detection, growth, and spread, revealed a likely increase in death rates, the researchers state.

Predictors of mammogram underuse included being a member of a traditionally underserved racial, ethnic, or socioeconomic group, lacking insurance, and not speaking English. In addition, first mammogram status and not returning promptly after a previous screening were linked to lower levels of use.

Higher levels of mammogram use were seen for women between 55 and 65 years of age and for women with a history of breast cancer.

"The current study reveals that failure to receive regular mammographic screening is common enough that it is likely to reducing the life-sparing potential of this technique," the investigators conclude.

Postal and telephone reminders "are a somewhat unglamorous and neglected aspect of breast screening, but we believe that their use can have an enormous impact on breast (cancer) death rates."

Source: Cancer; June 21st  online issue, 2004.

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Mice Offer Insights Into Rubinstein-Taybi Syndrome

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- Research with mutant mice has provided scientists with a better understanding of the memory problems that affect people with a disorder called Rubinstein-Taybi syndrome (RTS).

The research, published in the June 24 issue of the journal Neuron, involved two strains of mutant mice with a crippled version of an important memory molecule called CREB-binding protein.

The researchers of the two studies suggest that certain drugs currently being tested to treat cancer and Huntington's disease may be able to restore some memory capability to people with RTS, which is characterized by mental and growth retardation and skeletal abnormalities. About one in 125,000 babies are born with RTS.

The findings of these studies could help lead to the development of treatments for RTS and other memory disorders, as well as ways to improve memory in otherwise healthy people, the researchers noted.

More information

The U.S. National Library of Medicine has more about RTS.

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100M Doses of Flu Shots to Be Available

By Daniel Yee

Associated Press Writer

The Associated Press

Wednesday, June 23, 2004

ATLANTA - Determined to avoid a repeat of last year's flu-shot shortage, the government said Wednesday that vaccine makers will have 100 million doses ready for this winter.

That figure does not include the estimated 4.5 million doses of flu shots the Centers for Disease Control and Prevention (news - web sites) is planning to keep in reserve for children in its first-ever stockpiling of the vaccine.

For the 2003-04 season, there were 86.9 million doses available, compared with 95 million in 2002.

Last year, the nation's two producers of flu shots shipped their entire supplies of the vaccine by December, thanks to an early start to the flu season and fears that a dominant flu strain would cause more severe illness than in recent years.

Clinics around the country ran out of the injected vaccine which takes months to prepare and officials urged healthy people to opt for a nasal-spray version to save the traditional flu shot for children and the elderly.

Memories of last season's flu shot shortages will compel people to get vaccinated this year, and new flu shot recommendations including having children 6 months to 23 months old get the shot also will prevent an oversupply, said Gregory Wallace, of the CDC's immunization services division.

All the vaccine must be used by the end of the season which typically ends around April because the shots cannot be used for other seasons as the flu strains vary each year.

In another change, the CDC has directed states to collect data on any children hospitalized with the flu and to report child flu deaths. Because such data has not been consistently collected, health officials do not know how many children typically die from the flu each year.

In the last flu season, the CDC found 152 children who died from the flu. Their average age was 3, and about 70 percent of them had not received flu shots.

On the Net:

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

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Study Questions Value of Folate in Heart Patients

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- The role of folate and vitamin supplements in keeping arteries clear of fatty deposits has been questioned by a study showing that they increase the risk of complications for some patients who have coronary procedures.

The risk of arteries closing again after the implantation of vessel-widening tubes called stents was higher in patients who got the supplements than in those who didn't, said a report by European researchers in the June 24 issue of the New England Journal of Medicine (news - web sites).

It's a very complicated issue, since the newly reported study conflicts sharply with an earlier Swiss study showing that the supplements reduced the risk that arteries would close, noted Dr. Harry Suryapranata, a cardiologist at the De Weezenlanden Hospital in the Netherlands and a member of the research team.

The new study did show benefits of the supplements for some patients, such as women and those with diabetes, Suryapranata said. But the two studies also differed in several ways, including the dosage of the supplements, so many questions remain unanswered, he said.

"Two randomized trials would never be conclusive on any issue," Suryapranata said. "Therefore, further trials are certainly needed."

But recent medical progress may have already weakened the significance of the two studies, said Dr. Howard C. Herrmann, director of interventional cardiology at the University of Pennsylvania, who wrote an accompanying editorial.

The European study was done when only bare-metal stents were available, Herrmann pointed out. Now cardiologists use drug-releasing stents, which are coated with medications that help prevent restenosis, the medical term for the subsequent closing of arteries.

"To most interventionalists, it isn't a big issue any more," Herrmann said. "The problem of restenosis has been solved by coated stents."

The new issue is whether folate and vitamin supplements are appropriate for patients with high blood levels of the amino acid homocysteine, which some studies have linked to an increased risk of heart attack and stroke. Those supplements can reduce homocysteine levels.

"Folate supplementation has always been considered a completely safe therapy," Herrmann said. "Now the argument is on a higher level, because we have a study which suggests possible harm. We have to be careful about which patients use it."

Folate supplements appear to be appropriate for "a small portion of the population of patients with atherosclerosis," the formal name for the process that can end with blockage of an artery, Herrmann said.

For example, folate supplements might be useful for patients who do not respond well to statins, the widely used cholesterol-lowering drugs, he said. In general, he believes folate supplements are "a good thing to try" for patients who have high blood levels of homocysteine but not other risk factors such as high blood pressure.

More information

The rhyme and reason of folate supplementation is explained by the National Institutes of Health.

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Plant-Made Antibody Targets Hepatitis B Virus

 

By Megan Rauscher

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Japanese scientists have successfully used genetically engineered cells from the tobacco plant to produce a human antibody that homes in on a molecule on the surface of the hepatitis B virus (HBV).

Currently, treatment of HBV may include infusion of serum containing antibodies, called immunoglobulin, collected from blood donors.

The new results demonstrate the feasibility of producing anti-hepatitis antibodies in plants "as an alternative to anti-HBV human immunoglobulins," Dr. Akira Yano from the National Institute of Public Health in Tokyo and colleagues write in the Journal of Medical Virology.

"Our plant-derived (antibody) has the potential to be a cheap and effective pharmaceutical" for the prevention and treatment of HBV infection, Yano told Reuters Health.

"From the technical point of view," Yano continued, "several recent reports suggest that the remaining problems could be resolved in the next several years. The most indeterminate problems might come from society," the scientist said. "Should we use transgenic-plant-derived pharmaceuticals?"

For his part, Yano said, "I would prefer to use plant-derived than blood-derived antibodies, because there is less risk of infectious contaminants."

Yano's team says they are "confident" that, in time, biopharmaceuticals derived from genetically modified plants will become "both safe and economical for promotion of global health."

Source: Journal of Medical Virology, 2004.

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Kidney Disease No Longer a Killer for Children

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- Fifty years ago, nearly all children born with severe forms of kidney disease simply waited to die. The advent of dialysis and kidney transplants changed all that, however, and most kids with the illness now live long, productive lives.

But experts say there's more that can and should be done.

"Even kidney transplantation does not restore kidney function entirely to normal," said Australian researcher Stephen McDonald, lead author of a study published in the June 24 issue of the New England Journal of Medicine (news - web sites).

Subpar kidney function increases risks for cardiovascular trouble over the long term, McDonald explained, while powerful immune-suppressing drugs used to fight organ rejection raise a child's risk for infections and even cancer.

Overall, the study found that people who survived severe kidney disease as children still faced a 30-fold higher risk of death as adults, compared to individuals with no history of kidney problems.

Kidney failure affects about 250 to 300 adults out of every 1 million, and is usually attributed to systemic chronic illness such as diabetes or cardiovascular disease. The condition is much more rare in children -- about five or 10 cases per million -- and is most often linked to congenital malformations of the kidneys or bladder.

McDonald works at the Australia and New Zealand Dialysis and Transplant Registry at Queen Elizabeth Hospital, in Adelaide. He and his colleagues analyzed the medical records all 1,634 children with severe, end-stage kidney disease, tracked by the registry between 1963 and early 2002.

Most of the children -- 1,398 -- received one or more kidney transplants as part of their therapy.

Overall, the study found that 79 percent of children who received either long-term dialysis or new kidneys were still alive 10 years after their transplant, with that number dropping to 66 percent at 20 years post-transplant.

Cardiac problems were the leading cause of death, followed by infection, and children who received dialysis were at higher risk of dying than those who underwent a transplant.

But McDonald stressed that the history of research into pediatric kidney disease is largely one of successes, not failures.

"With respect to dialysis, there have been important technological advances, which means that the process is now more efficient and safer than previously," he said. "Control of blood pressure and other metabolic complications is better with new drugs. With respect to transplantation, the major changes have been related to immunosuppressive [anti-rejection] drugs, which have greatly prolonged the survival of kidney transplants."

Other advances now allow doctors to catch kidney disease before a child is even born.

"The ability to diagnose congenital kidney malformations in the uterus with the use of ultrasound has greatly impacted many patients who would otherwise have developed kidney failure," pointed out Dr. Leslie Spry, a nephrologist at the Dialysis Center of Lincoln, in Lincoln, Neb., and a spokesman for the National Kidney Foundation.

"Getting pediatricians and family physicians to focus on kidney disease when there is family history of disease is important," he said.

Most important, a rise in the number of living individuals willing and able to donate a kidney to help an ailing child has greatly improved survival rates. According to the study, between 1963 and 1972 just 5 percent of transplanted kidneys in Australia and New Zealand came from living donors. That number rose to 35 percent for the decade spanning 1983 to 1992 and to 64 percent in the last 10 years of the study -- 1993 to 2002.

In fact, most children who need a kidney today "are transplanted reasonably early," said National Kidney Foundation spokesman Dr. William Harmon, director of the division of nephrology at Children's Hospital Boston.

"The majority have living donors, which are preferable and which can be used preemptively," he said. Furthermore, children who depend on transplants from non-living donors "get priority over adults," Harmon said. "The system provides them benefit."

Still, long-term problems associated with pediatric kidney disease mean too many patients will die too early from kidney-related diseases as they age. Most experts agree that more research needs to be done in preventing childhood kidney dysfunction and in finding better, less harmful methods of suppressing organ rejection.

"We need to get to immune intolerance [of transplanted organs] and we are not there yet with our medical management, post-transplantation," Spry said.

More information

Learn about kidney disease and how to become an organ donor by visiting the National Kidney Foundation.

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Sugar Substitute Splenda Targeting Baker

By Alicia Chang

Associated Press Writer

The Associated Press

Wednesday, June 23, 2004

Sugar replacements have existed for decades, sweetening everything from black coffee to baked goods. But some leave an aftertaste. Most don't hold up well when used for baking.

Then came Splenda, which hit U.S. supermarket shelves in 2000 at a time when Americans were concerned about their health and dieting was on the rise. Splenda, brand name for the substitute sweetener sucralose, is the only no-calorie substitute made from sugar.

It's quickly become the hottest sugar replacement on the market, appealing to low-carb followers with its sugar-like taste, but without the calories or carbohydrates.

Now Splenda is making inroads into the mainstream food market, popping up in more than 3,500 products worldwide from ice cream to sodas. And it's aiming for more: Coming this summer is a baking product that is part sugar, part sucralose.

"Splenda is enjoying at the moment a huge honeymoon period," said Dean Rotbart, executive editor of LowCarbiz, a Denver-based weekly online trade newsletter.

Judy Doherty, a self-proclaimed sweets lover from Weston, Fla., already makes her puddings, chocolate cakes and peach cobblers with Splenda. Doherty, who uses the sugar substitute to help cut calories, was initially skeptical about its taste claims, but now uses it in all her recipes.

"One time I used it in a birthday cake and no one even knew I did it," she said.

McNeil Nutritionals, the Fort Washington, Pa.-based unit of Johnson & Johnson that makes Splenda, has long touted its baking abilities as a major advantage over competitors.

On Thursday, McNeil will announce a new baking alternative aimed at consumers who normally would never think of substituting sugar. McNeil said Splenda Sugar Blend for Baking can do everything baking sugar does such as browning baked goods. McNeil says a half cup of the hybrid sweetener equals a cup of sugar in recipes.

McNeil President Colin Watts says market research predicts more than two-thirds of consumers would choose the new Splenda baking product over sugar.

Of course, there's a price. The new Splenda product, set to hit store shelves in August comes in 2-pound bags with a recommended price of $6.29 to $6.49, about three times more expensive than sugar but cheaper than the original Splenda.

Splenda's main rival, Equal, an aspartame sweetener made by Chicago-based Merisant Worldwide Inc., has launched a reduced-calorie baking product in Europe under the brand Canderel. Earlier this year, Merisant said it would sell the product in the United States in the fall under the brand Equal Sugar Lite. Unlike Splenda, the new Equal product is a mix of sugar and two sweeteners, including aspartame.

Since Splenda has no calories, it zips through the body without being absorbed. A recent survey of 1,200 adults in the United States found 85 percent consume low-calorie and reduced-sugar foods and drinks on a regular basis, according to Calorie Control Council, a nonprofit trade association.

This summer, Coca-Cola and Pepsi will roll out dueling mid-calorie sodas that claim to taste like their flagship drinks, but with half the calories, carbs and sugar. The sweetness from the new carbonated beverages is supplemented with Splenda.

For the past two years, Splenda has claimed the top spot in the $325 million U.S. retail market for sugar substitutes, eclipsing longtime leader Equal. Splenda captured 43 percent of sales in the 52 weeks ending May 16, according to Information Resources Inc., a Chicago-based market research firm.

"Artificial sweetener companies have a competitor that is playing in an arena that they've never had to play in before," said Ed Kuehnle, president of IRI North America.

However, Merisant said Equal is still the global leader of low-calorie tabletop sweeteners.

The Food and Drug Administration (news - web sites) so far has approved five sugar substitutes for general use including saccharin, aspartame, acesulfame-K, sucralose and neotame.

Of the sweeteners, sucralose, discovered in 1976, is the only one made from table sugar created by chemically altering sucrose.

Diabetics have long used sugar substitutes. But with more people looking to keep their waistlines in check without abandoning their favorite food, sweeteners are gaining wider popularity.

While too much sugar can add empty calories and pounds, health experts point out that eating sugar-free food alone will not help you lose weight if you don't cut calories or increase exercise. They point to the fat-free phenomenon when people started eating bags of fat-free food without paying attention to the calories per serving.

"It's not giving you a license to eat more necessarily just because it's sugar-free," said nutritionist Christina Stark of Cornell University.

On the Net:

Splenda: http://www.splenda.com

Equal: http://www.equal.com

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Simple Test Can Detect Serious Lung Disease

 

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- A simple lung-function test called spirometry can help detect chronic obstructive pulmonary disease in its early stages and help people with this common lung disease live longer lives.

Smokers and former smokers should have the test, National Jewish Medical and Research Center experts advise in an article in the June 24 issue of the New England Journal of Medicine (news - web sites).

COPD, the fourth leading cause of death in the United States, is caused primarily by smoking tobacco. About 10 to 20 percent of smokers develop the disease.

"Chronic obstructive pulmonary disease is a treatable and preventable disease," Dr. E. Rand Sutherland, assistant professor of medicine at the Denver center, said in a prepared statement.

"Because people do not generally recognize symptoms of COPD until their lungs are functioning about half as well as normal, lung-function testing, or spirometry, is crucial to detecting the disease before extensive lung damage has occurred," Sutherland said.

While there is no cure for COPD, early detection enables doctors to take action to slow the progressive loss of lung function, improve symptoms and quality of life, and prevent flare-ups that can require hospitalization or cause death.

Medications and pulmonary rehabilitation are used to treat people with COPD. People with COPD live longer if they quit smoking.

More information

The American Medical Association has more about COPD.

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Oral Implants Help Curb Bad Snoring

 

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Inserting small synthetic rods in the back of the mouth, in the soft palate, appears to be a safe and effective treatment for severe snoring, findings from a small pilot study suggest.

The implants work by stiffening the soft palate and preventing it vibrating excessively as air passes through the throat during sleep, according to the report in the Archives of Otolaryngology: Head and Neck Surgery. The implant procedure, which can be performed under local anesthesia on a same day basis, involves the use of a specially designed insertion device.

Dr. William I. Wei and colleagues, from the University of Hong Kong, tested the implants in 12 patients with severe snoring over a 3-month period. The study focused on nine patients, because one patient was unavailable for follow-up and two patients had their implants fall out. No side effects or complications were observed in these three patients.

Implant placement was associated with a dramatic drop in snoring loudness as assessed by bed partners, the researchers report. This coincided with a marked reduction in daytime sleepiness in the snorers.

The procedure was well tolerated and no bleeding or infectious complications occurred. Moreover, oral feeding was started immediately and all patients were sent home on the day of surgery.

"We have reported here the first clinical study on the safety and efficacy of...implants in the soft palate to relieve severe snoring," the authors state. Placement of such implants "with a 1-stage procedure represents a possible direction to relieve snoring with minimal discomfort and risk."

Source: Archives of Otolaryngology: Head and Neck Surgery, June 2004.

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Many Child Deaths Blamed on Environment

 

By Pablo Gorondi

Associated Press Writer

The Associated Press

Wednesday, June 23, 2004

BUDAPEST, Hungary - Air pollution, unsafe water and other environmental hazards kill some 100,000 children and teenagers in Europe each year, officials from the U.N. health agency said Wednesday.

That amounts to 34 percent of all deaths in Europe in the birth-to-19 age group, according to a World Health Organization (news - web sites) study presented Wednesday at a meeting in Budapest.

Indoor air pollution stemming from the use of solid fuels such as coal or wood in homes, lead poisoning, dirty water and poor sanitation were among the main causes of environment-related deaths, the group said.

"This is a very serious problem and it is our duty to respond in the best possible way," said Kerstin Leitner, the organization's assistant director general. The gathering drew about 1,000 delegates from 52 countries.

Leitner and other participants in the WHO meeting urged governments to increase spending and tighten regulations to improve environmental standards as part of a campaign to improve health, especially among children.

"What happens to people during their childhood determines their health or ill-health during the rest of their lives," Leitner told reporters during the group's Fourth Ministerial Conference on Environment and Health.

For the European Union (news - web sites) to "continue to be a benchmark" for international health and environmental standards, the bloc must help its new members catch up to the Western EU countries' standards, WHO Director General Dr. Lee Jong-Wook said.

Ten mostly eastern European countries joined the EU in May, and the gap in health standards between the old and the new members is "relatively big," said Hungarian Health Minister Mihaly Kokeny, whose country is among the new members.

"More resources are needed for the new EU members to have an equal chance," Kokeny said.

Kokeny also urged the EU to adopt indoor anti-smoking regulations to combat health problems related to secondhand smoke, citing bans recently enforced in Ireland.

"Tobacco continues to be the single major killer in Hungary," Kokeny said.

Hungarian Environment Minister Miklos Persanyi said the conference was discussing whether to include a passage in its formal declaration about the possible health hazards of toys made from PVC plastic.

Persanyi said the long-term effects of some of the chemicals used in PVC production had not been studied in sufficient detail and there were concerns that some of them could be harmful.

"It's never too early to be cautious," Persanyi said.

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Cream Made from Breast Milk Reduces Warts Study

 

By Gene Emery

Reuters

Wednesday, June 23, 2004

BOSTON (Reuters) - A cream made from human breast milk and nicknamed Hamlet can dramatically reduce, and often eliminate, stubborn common warts, Swedish doctors reported.

Human Alpha-lactalbumin Made Lethal to Tumor cells, which the researchers refer to by the whimsical acronym HAMLET, is the active ingredient that forces the wart cell to self-destruct by accumulating in each cell's nucleus and interfering with its control process.

The results, published in Thursday's New England Journal of Medicine (news - web sites), may extend well beyond wart treatment because the same class of viruses that cause those growths are also responsible for cervical cancer, genital warts, and some types of skin cancer.

Since doctors can cheaply eliminate warts by freezing, the new cream "will probably never be able to compete with existing inexpensive therapies for cutaneous viral warts," said Jan Bouwes Bavinck and Mariet Feltkamp of Leiden University Medical Center, in a Journal commentary.

"The real challenge, therefore, will be to prove it is also effective in the treatment or prevention of other conditions related to human papillomavirus," or HPV, they said.

Common warts, which usually appear on the hands and feet, can be resistant to treatment with creams.

The Swedish team, led by Lotta Gustafsson of the University of Lund, found that three weeks of daily treatments with alpha-lactalbumin and oleic acid reduced the size of the warts by 75 percent or more in all 20 volunteers. A similar reduction was seen in only 15 percent of another 20 patients who got a placebo cream.

The placebo patients were then treated with the test cream as well.

After two years, all the warts disappeared in 83 percent of the 40 volunteers.

The patients were chosen because their growths had not responded to conventional treatments.

"Such nuclear accumulation does not occur in healthy cells, which remain viable in the presence of alpha-lactalbumin-oleic acid," the Gustafsson team said.

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Nebraska May Test Child Nutrition Program

 

By Josefina Loza

Associated Press Writer

The Associated Press

Wednesday, June 23, 2004

OMAHA, Neb. - A federal nutrition program that could be tested in Nebraska would help people providing child care in rural areas expand their food service, Sen. Ben Nelson said Tuesday.

The Child and Adult Care Food program is expected to help with subsidized meals and snacks for families in need.

Nelson requested that the pilot program be created during the Committee on Agriculture, Nutrition and Forestry's reauthorization of the Richard B. Russell National School Lunch Act and the Child Nutrition Act of 1966. Nelson is a member of the committee.

The Senate approved the act and program Tuesday.

If approved by the House, the pilot program would include funding that could reach up to $1 million per year during federal fiscal years 2006 and 2007.

Lynn Goering, program coordinator at Lincoln's Family Service, said the program could help more child care providers in homes and child care centers qualify for higher reimbursement rates known as Tier I and benefit from nutrition education.

"Obesity has been in the news so much," said Goering, a dietitian. "I know that good healthy eating habits start when kids are young."

Child care providers are role models for the children they are caring for, Goering said.

"Working parents don't have time to do much cooking," Goering said. "What they are exposed to in the child care program is so important."

Since 1997, there has been a decline in licensed child care providers applying for higher reimbursement rates, Goering said.

"We felt it was really important that the program was really accessible to people," she said. "We thought to change the area eligibility so more people could benefit."

To qualify for higher reimbursements, rural schools must meet 50 percent student participation in free or reduced-priced lunches. Generally, child care providers are reimbursed under the program depending on the kind of aid their area schools are given.

That participation rate was too high for rural communities, Nelson said.

The pilot program would decrease the eligibility of meal assistance programs to 40 percent in Nebraska. In turn, the number of schools eligible in rural communities would grow from 121 to 220, and the area covered by meal assistance also would grow.

"The majority of working families in rural Nebraska rely on family child care to keep their children safe and well cared for during the work day," Nelson said. "(The program) is key to assuring that these family child care homes provide good nutrition and quality affordable child care."

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Bulked-Up Boy Teaches Docs About Muscle Protein

 

By Gene Emery

Reuters

Wednesday, June 23, 2004

BOSTON (Reuters) - Doctors are studying a 5-year-old German boy whose upper arms and legs are almost twice the size of his peers to learn what happens when the body does not produce a protein that limits muscular development.

The boy, whose mother is a professional athlete in Germany, is far stronger than other boys his age and lacks the protein, known as myostatin, doctors reported in Thursday's New England Journal of Medicine (news - web sites).

He appears healthy now, but researchers are concerned the child may eventually develop abnormalities in the heart, which is a muscle.

The discovery could help doctors find a chemical to increase muscle mass as a treatment for several medical problems, such as muscular dystrophy, or the muscle deterioration seen in the elderly and among people in the advanced stages of cancer.

Products that claim to regulate myostatin, most of them untested, are already being used by athletes and bodybuilders looking for an easier way to bulk up, Elizabeth McNally, of the University of Chicago, said in a Journal commentary.

But for now, the discovery confirms in humans what doctors discovered in rodents years ago -- that myostatin is an important regulator of muscle growth.

Deactivating the gene that makes myostatin creates "mighty mice" that are twice as muscular as their siblings.

"That gives us a great deal of hope that agents already known to block myostatin activity in mice may be able to increase muscle mass in humans too," said Dr. Se-Jin Lee of Johns Hopkins, a co-author of the study.

The child reportedly had an unusually strong mother, uncle, grandfather and great grandfather, according to the team of researchers led by Dr. Markus Schuelke of the Charite University Medical Center Berlin, in Germany.

The grandfather, for example, was a construction worker who could unload curbstones by hand.

While the cells of most people have two copies of the gene that makes myostatin, the doctors found that the boy's mother, the only person available for genetic analysis, had only one. The boy himself had no copies of the gene.

McNally said the research held great promise for the treatment of diseases that destroy the muscles but warned "the potential for abuse outside of the medical arena is substantial" and further studies of the long-term consequences are needed."

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New Hampshire Hailed in Obesity Fight

 

The Associated Press

Wednesday, June 23, 2004

BEDFORD, N.H. - New Hampshire is one of the best states in addressing the growing problem of obesity, according to U.S. Surgeon General Richard Carmona.

At a health conference in Bedford on Tuesday, Carmona said obesity soon will eclipse smoking as the nation's leading cause of preventable death. New Hampshire is no exception to the trend, but Carmona said it leads the nation in addressing the problem and informing the public.

"Your state is really advanced," he said. "They're pushing the envelope."

Carmona said rather than push for sweeping changes in the health care system, he prefers to focus on promoting the prevention of sickness and disease.

"If I gave every penny I have, it wouldn't be enough," he said. "Unless you embrace prevention, you're always going to be chasing the dollar."

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Acrylamides Pose Little Risk, Panel Decides

 

Reuters

Wednesday, June 23, 2004

WASHINGTON (Reuters) - Acrylamides, a family of chemicals recently found in cooked foods that is known to cause cancer in rats, pose little threat to the U.S. population, an expert panel reported on Wednesday.

People do not eat enough of the chemicals in their daily diet to risk the genetic damage that can lead to cancer, the committee of experts in reproductive toxicology, birth defects and others areas reported.

"Considering the low level of estimated human exposure to acrylamides derived from a variety of sources, the Expert Panel expressed negligible concern for adverse reproductive and developmental effects for exposures in the general population," the group's final report reads.

The report was commissioned by the National Toxicology Program of the National Institute of Environmental Health Sciences.

The report follows on a report in 2000 by Swedish researchers that they had found the chemical in baked and fried carbohydrate-containing foods. Agencies such as the U.S. Food and Drug Administration (news - web sites) began immediate assessments of any risks to people.

The FDA's troll of common foods turned up the chemical in olives, prune juice and teething biscuits. It is found in cigarette smoke and is used in industrial processes to make polymers.

In June a team at the City of Hope National Medical Center in Duarte, California, found that acrylamides can mutate DNA.

Experts say the best way to find out if acrylamide causes cancer in people is to do epidemiological studies -- studies of populations to see if people who eat more foods containing acrylamides have higher rates of cancer.

One such study, published by U.S. and Swedish researchers in January 2003, found no link between acrylamide consumption and the risk of bladder or kidney cancer.

The NTP committee, chaired by Jeanne Manson of the Children's Hospital of Philadelphia, concluded that most Americans would get about 0.43 micrograms per kilogram of body weight a day in the diet -- compared to 0.67 from smoking.

Comparative amounts in laboratory mice and rats do not cause cancer, they said.

While acrylamides can cause genetic mutations that can be passed on to the next generation in mice, people do not general take in enough to cause such damage, the experts found.

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Demand for Elderly Day Care Rising

 

The Associated Press

Wednesday, June 23, 2004

CROWN POINT, Ind. - A growing number of seniors living at home with their adult children is driving a demand for convenient, affordable day care centers, providers say.

Adult day care allows seniors who otherwise would be placed in nursing home to remain in their communities, said Susan Walstra of Franciscan Communities Adult Day Care Center in Crown Point.

"These aren't kids we're talking about," Walstra said. "This is a very proud generation who deep down know they're losing something in their lives."

Already, one out of every four American households cares for an elderly relative. Indiana has nearly 600,000 family caregivers who provide an estimated 630 million hours of unpaid care to loved ones each year, the National Family Caregivers Association said.

Indiana has only 43 licensed and certified adult day care centers, said Kelly Lucas, a spokeswoman for the state's Family and Social Services administration.

Nationwide, the number has grown to more than 4,000 from just 300 centers 25 years ago, the National Adult Day Services Association reports.

Many family caregivers seek out the day care centers for respites from caring for elderly parents they do not want to leave home alone.

"That's our market," said Barbara Kubiszak, director of St. Agnes Adult Day Care Center in Valparaiso. "Some are here for stimulation, others for socialization."

Most weekday mornings, Kathie Gabel of Crown Point drives her 75-year-old father, Edgar Smith, across town to the Franciscan center. The retired carpenter has Alzheimer's disease (news - web sites), and his daughter tells him either he's going to work or to a senior center, rather than to a day care.

"Sometimes it's like talking to a child," she said. "But he's my dad, a proud man."

Fees for adult day care range from $25 to $70 a day, depending on care level and facility, with the average cost that can reach $12,000 a year or more. Medicare does not cover the costs, which typically are paid by private funds or long-term care insurance.

Nursing homes typically are used only after adult day care options have been exhausted, said Darrick Thames, a family caregiver support coordinator with Northwest Indiana Community Action.

The cost for a nursing home can top $50,000 a year, and assisted living facilities average $24,000, according to American Health Care Association estimates.

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Ernst & Young Says U.S. Drug Price Controls Likely

 

Ransdell Pierson

Reuters

Wednesday, June 23, 2004

NEW YORK (Reuters) - Federal price controls on prescription medicines could be imposed within the next few years unless U.S. drug makers take steps to moderate their prices, accounting firm Ernst & Young said on Wednesday.

Ernst & Young said the average medicine in 2002 cost about 77 percent more in the United States than in Canada, the United Kingdom, Germany, France, Italy, Sweden and Switzerland. The United States is the only developed nation in the world with no price controls on drugs.

The price disparity has worsened considerably since 2000, when drug prices in the United States were 60 percent higher than Canada and Europe, the accounting firm said in its annual report on the drug industry.

"Unless the pharmaceutical industry takes steps within its own ranks to effect an alternative solution, U.S. price controls, reimportation, or both seen inevitable," Blake Devitt, a senior Ernst & Young partner, said in the report.

Reimportation is the term used to describe the importation of cheaper medicines from other countries, a practice that is illegal but is widely conducted by U.S. patients ordering medicines over the Internet.

Devitt called for "a combination of initiatives to lower prices in the United States over time and increase prices outside the country. In this way, the burden of cost will be redistributed evenly across all industrialized nations," he said in the report.

Pressure for U.S. price controls will intensify by 2006, when the federal Medicare insurance program for the elderly and disabled begins reimbursing patients for prescription medicines, Devitt said.

The recently enacted federal law that establishes the Medicare drug benefit forbids the government from negotiating prices with drug makers, a safeguard against price controls.

Devitt said new legislation could eliminate that restriction if U.S. drug costs continue to escalate, and the cost to Medicare becomes onerous.

"I'd be surprised if we do not see direct negotiations for Medicare prices," Devitt said in an interview.

He said drug companies need to be tougher with other nations about prices, and even be willing to withhold their products unless adequate reimbursement is assured.

But Larry Sasich, a research analyst for the public watchdog group Public Citizen, said there is no guarantee drug makers would actually curtail prices in the United States even if they were able to get better prices abroad.

"The U.S. government should be negotiating lower prices here rather than asking other countries to raise their prices," he said.

Jeff Trewhitt, a spokesman for Pharmaceutical Research and Manufacturers of America (PhRMA), the industry's largest trade group, said his organization routinely lobbies other governments "to change their pricing structure."

Trewhitt said U.S. antitrust laws, however, forbid individual drugmakers from jointly developing pricing strategies, including how to negotiate with other nations.

"Each individual company must make its own pricing decisions; a unified strategy is not possible," Trewhitt said.

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Doctors Note Progress Against Muscle-Wasting Disease

 

By Dennis Thompson Jr.
HealthDay Reporter

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- You feel your eyelids drooping as the day goes on, or perhaps find your speech slurring in the afternoon or evening.

Your arms and limbs become difficult -- if not impossible -- to move. You can't chew properly, or swallow, or even draw a good breath.

These are the symptoms of myasthenia gravis, an autoimmune disease that affects an estimated one of every 5,000 Americans and can become life-threatening without treatment.

Myasthenia gravis occurs when the body's immune system begins attacking the neuromuscular junction, the point where nerve impulses are transferred to muscles. This causes the muscles to misfire and grow weaker and weaker with continued use.

"The disease can become so severe that it can affect a patient's breathing process to the point where they need to be put on a breathing machine," said Dr. Henry Kaminski, director of the Myasthenia Gravis Center at the University Hospitals of Cleveland.

With June designated as Myasthenia Gravis Awareness Month, neurologists are working to spread the word about the unusual nerve disease.

Most important, they want people to know that while the disease is called myasthenia gravis -- the Greek and Latin words meaning grave muscular weakness -- it no longer should be a fatal disease.

"It really used to be myasthenia gravis -- it put people in the grave," Kaminski said. "But now we can say with modern treatment that patients can enjoy a normal life span."

Normally when impulses travel down the nerve, the nerve endings release a neurotransmitter substance called acetylcholine, according to the National Institute of Neurological Disorders and Stroke. The substance travels through the neuromuscular junction and binds to special receptors, activating them and causing a muscle contraction.

In myasthenia gravis, antibodies interfere with the receptors for acetylcholine at the neuromuscular junction, and that prevents the muscle contraction from occurring.

This leads to the hallmark of myasthenia gravis -- muscle weakness that increases during periods of activity and improves after periods of rest.

The thymus gland is believed to be linked to myasthenia gravis. The gland, which lies in the upper chest area beneath the breastbone, plays an important role in the development of the immune system in early life. In adults with myasthenia gravis, the thymus gland is abnormal, and some people with myasthenia gravis develop thymomas, or tumors on the thymus gland.

The relationship between the thymus gland and myasthenia gravis is not yet fully understood. Scientists believe the thymus gland may give incorrect instructions about the production of the acetylcholine receptor antibodies, thereby setting the stage for the attack on neuromuscular transmission.

Anyone, regardless of age, race or gender, can become afflicted with myasthenia gravis. The disorder is not directly inherited nor is it contagious, although it occasionally may occur in more than one member of the same family.

The degree of muscle weakness involved in myasthenia gravis varies greatly among patients, according to doctors.

In most cases, the first noticeable symptom is weakness of the eye muscles, which can cause blurred or double vision or a drooping of one or both eyelids. In others, difficulty in swallowing and slurred speech may be the first signs.

Other symptoms include:

 

The most serious health threat from the disorder comes when it causes the voluntary muscles that control breathing to stop working, in what is known as a "myasthenia failure."

 

The death rate associated with myasthenia gravis steadily declined during the 20th century, said Dr. James Howard Jr., a professor of neurology with the University of North Carolina.

 

In the 1930s and 1940s, more than 80 percent of people with the disease died, Howard said. By the middle of the century, that number had declined to about 50 percent.

 

It wasn't until the 1970s that doctors knew enough about the disease to effectively treat it, he said.

 

"Originally it was thought that the nerve did not release enough chemical transmitter," Howard said. But breakthrough research discovered that the nerve was healthy, but under constant attack from the body's immune system.

 

"Now, today, no one should die of myasthenia gravis," Howard said. "Everyone should live."

 

There are several therapies now available to help reduce and improve muscle weakness. Medications used to treat the disorder include drugs such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength.

 

Immunosuppressive drugs such as prednisone, cyclosporine and azathioprine also may be used. These medications improve muscle strength by suppressing the production of abnormal antibodies, but must be taken with careful medical follow-up because they may cause major side effects, experts say.

 

Thymectomy, the surgical removal of the thymus gland, has been found to improve symptoms in more than 50 percent of patients. Other treatments for myasthenia gravis include plasmapheresis, a process in which abnormal antibodies are removed from the blood, and high-dose intravenous immune globulin, which temporarily modifies the immune system and supplies the body with normal antibodies from donated blood, according to the National Institute of Neurological Disorders and Stroke.

 

More information

 

For more information, visit the Myasthenia Gravis Foundation of America.


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Genetic Variant Ups Women's Heart Attack Risk

By Megan Rauscher

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Women who have a common variation in the gene for the alpha type estrogen receptor (ESR1) face an increased risk of a heart attack after menopause, researchers report.

Dr. Stephanie C. E. Schuit and colleagues from Erasmus Medical Center in Rotterdam, the Netherlands, evaluated 2617 men and 3791 postmenopausal women for the variant form of the ESR1 gene.

As reported in the Journal of the American Medical Association (news - web sites), roughly 78 percent of both women and men had either one or two copies of the variant gene.

During an average 7-year follow up period, 115 women and 170 men had a heart attack and 168 women and 272 men had a heart disease-related event. In 97 of these cases the person died.

After taking account of other established cardiovascular risk factors, the team found that women carriers of the variant gene had more than two-fold higher odds of having a heart attack compared with noncarriers. The risk for other heart-related episodes was also raised to a similar degree.

In men, there was no apparent association between the ESR1 variant and heart attacks or other heart problems. In fact, if anything, it seemed to lower their risk.

It should be noted, Schuit and colleagues emphasize, that 78 percent of the population carries the ESR1 variant. "Perhaps we should view this not as a 'risk' allele but consider the noncarriers as having a protective (genetic make-up)."

Source: Journal of the American Medical Association, June 23/30, 2004.

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Your Genes Can Affect Drug Activity

By Ed Edelson
HealthDay Reporter

HealthDayNews

Wednesday, June 23, 2004  

TUESDAY, June 15 (HealthDayNews) -- A study showing that an individual's genetic makeup affects the response to a cholesterol-lowering drug is the latest example of a medical discipline researchers call pharmacogenetics.

Pharmacogentics' roots date back several decades and is now starting to have a significant impact on medical practice.

Dr. Paul M. Ridker, chief of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston and lead author of a report in the June 16 Journal of the American Medical Association (news - web sites), says that pharmacogentics is beginning to take hold in mainstream medicine.

"Over the next 10 years, we will see a lot of studies of this kind that will help address the issue of how we treat our patients," Ridker said.

"Burgeoning" is the word Ridker used for the field of pharmacogenetics, while Susanne B. Haga, project director of human genetics at the Center for the Advancement of Genomics, a private research group, said knowledge about the interaction between genes and drugs "is growing by leaps and bounds."

Over the long run, said Haga, co-author of an editorial accompanying the report, "information on how genetic variation affects drug efficacy and drug safety will become a basic part of drug development." But right now, she said, "the commercial ability to test for these variations is not available."

Still, the study "will be a real eye-opener for physicians and patients," Ridker said.

He and his colleagues did detailed genetic studies of 1,563 people taking pravastatin (Pravachol), one of several statin medications being prescribed to lower cholesterol levels. The researchers looked for individual variations called single-nucleotide polymorphisms (SNPs) in genes that play a role in the metabolism of cholesterol and other lipids.

One of those genes produces a molecule called HMG-CoA reductase. Two common and closely linked SNPs in that gene "were significantly associated with a 22 percent smaller reduction in total cholesterol and a 19 percent smaller reduction in LDL cholesterol following 24 weeks of pravastatin therapy," the report said.

That gene-based reduced activity was found in about 8 percent of the people studied, Ridker said, adding that the finding was more or less expected.

"We've known for some time that some patients get a greater reduction than others," he said. "We were looking for evidence that genetic variation played a role. We found it on the basis of genes that are the target of the drug itself."

The finding doesn't call for any major change in treatment of patients with the specific SNPs, at least now, Ridker said. "It could well be that just a higher dose will overcome this problem," he said.

What is important is that the effect of genetic variation on the effects of drugs used to treat cancer now has been verified for at least one drug used in cardiology, Ridker said. It's not known yet whether genetic variation acts in the same way on other statins, he said, and many more studies are needed to determine the role played by pharmacogenetics in drug therapy.

"This paper is important because it is a first demonstration, but we are in no way there yet," Ridker said.

More information

A rundown on statins and other cholesterol-lowering drugs can be found at the American Heart Association.

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Black Tea May Help Get Blood Circulating

 

By Amy Norton

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - A cup of black tea may give a quick boost to blood flow to the heart, the results of a small study suggest.

In an experiment with 10 healthy men, Japanese researchers found that blood-flow in the coronary arteries improved two hours after the men drank black tea. The same was not true of a caffeinated drink used for comparison.

Numerous studies have suggested that tea drinking may do a heart good, with effects on cholesterol, blood clotting and blood vessel function being among the proposed mechanisms.

The new study, reported in the American Journal of Cardiology, suggests it also has a more immediate beneficial effect. The authors suspect that black tea improved the dilation of the men's blood vessel, allowing better blood flow.

Tea is rich in antioxidant compounds called flavonoids, and these may be the key to the beverage's potential heart benefits, study co-author Dr. Kenei Shimada of Osaka City University told Reuters Health.

For the study, the researchers used a special ultrasound method to gauge "coronary flow velocity reserve" or CFVR. This reflects how much blood-flow can speed up when demands are put on the heart, and paints a picture of the healthiness of the coronary circulation.

Shimada's team measured the CFVR of each of the men after they drank either black tea or a caffeinated beverage, and found that it increased significantly after the black tea.

"The results of this study suggest that black tea consumption has a beneficial effect on coronary circulation," the researchers report.

They speculate that the flavonoids in black tea improve the functioning of the lining of the blood vessels, increasing how much the vessels dilate in response to blood flow. Dysfunction in this lining, called the endothelium, is one of the things that goes wrong as heart disease develops.

It's not clear what the long-term implications of the findings on CFVR might be, but Shimada said research has shown coronary flow reserve to be related to heart disease risk.

Larger studies, particularly in people with coronary artery disease, are needed to establish how tea affects the coronary circulation, the researchers conclude.

Source: American Journal of Cardiology, June 1, 2004.

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Health Tip: Exercising While Pregnant

 

HealthDayNews

Wednesday, June 23, 2004

(HealthDayNews) -- A moderate amount of exercise is good for pregnant moms and their unborn babies. But certain physical activities should be avoided, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

If you're pregnant, you should avoid:


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Exercise Boosts Teen Girls' Bones

 

By Merritt McKinney

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Exercise, not calcium, may have the strongest effect on growing bones in adolescent girls, researchers report.

In a decade-long study, calcium intake was not related to bone growth or bone strength in young women. But physical exercise was related to stronger bones, according to a report in the June issue of the Journal of Pediatrics.

"Exercise is the most important modifiable determinant of bone development for young women," Dr. Tom Lloyd of Penn State University College of Medicine in Hershey told Reuters Health. "At least 15 percent of the variation in bone strength seen among healthy women can be attributed to exercise."

Exercise is probably the most important influence on bone development in young men, too, Lloyd said, but the study included only young women.

Despite the apparent importance of exercise, teens should not skimp on calcium-rich foods, according to Lloyd.

"I believe that parents should continue to encourage teens to consume low-fat dairy products since they are convenient and are wonderful sources of macronutrients, minerals and vitamins," Lloyd said.

The study included 80 young white women who were followed for 10 years. When the study began, the girls were around 12 years old, and none had begun menstruating. One of the study's goals was to measure the effects of calcium intake, exercise and oral contraceptives on bone health.

"This study is unique in that the participants have been followed for over a decade, with measurements made every 6 months for the first 4 years and yearly thereafter," Lloyd said.

What the study found was that calcium intake, which ranged from 500 milligrams (mg) to 1,900 mg per day, was not significantly associated with bone growth or bone density.

"We have the most comprehensive dataset of calcium intake throughout adolescence of teen women extant and are therefore confident about noting that over the calcium intake ranges of our cohort, there was no significant relationship to bone development," Lloyd said.

The study also showed that the use of oral contraceptives was not related to bone health. Despite some research that has found that women on oral contraceptives have thinner bones, young women who had taken the Pill had just as healthy bones as those who had not taken oral contraceptives.

But exercise was related to bone health. The more a teen girl participated in sports, the stronger were her bones, according to the report. The results of the study support other research showing that exercise during the teen years can have a significant effect on bones.

"Regular load-bearing exercise, like walking 30 minutes a day, has a positive effect on bone development," Lloyd said.

Although the brittle-bone disease osteoporosis does not usually strike until late in life, the teen years are an essential time for bone development. In fact, girls form 40 percent of their bone mass during adolescence.

Source: Journal of Pediatrics, June 2004.

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Close Female Friends Help Women Through Depression

 

By Alison McCook

Reuters Health

Wednesday, June 23, 2004

NEW YORK (Reuters Health) - Nearly all women say they get depressed, stressed or anxious at some point in their lives, and most turn to their female friends for support during these and other tough times, according to new survey findings released Wednesday.

"Girlfriends are probably the first line of defense for women who are suffering from depression," author Vicki Iovine told Reuters Health.

"Girls, grab a girlfriend and hold on to her for life," she advised.

Iovine, author of the Girlfriends' Guide series of books, explained in an interview that girlfriends may help depressed women more than parents or husbands, who are often too invested, and may focus more on solving the problem.

In contrast, girlfriends can give each other a space to discuss their feelings, which women sometimes need more than advice, Iovine said. "We need to describe how we feel," she said.

As part of the survey, conducted by Harris Interactive, 1128 women between the ages of 25 and 54 answered questions about their mental health and their reliance on close female friends for help.

According to the findings, 95 percent of women said they had felt depressed, sad, anxious or stressed at one point in their lives, and more than 70 percent said they had felt this way during the past year.

Most women -- more than 60 percent -- also said that they often turn to their girlfriends for support when they are feeling anxious, sad or depressed, and during other tough times. Sixty-one percent reported that they believe there is nothing they wouldn't talk to their girlfriends about, and nearly one-quarter said their girlfriends know more about them than any one else.

Most women also said that they feel comfortable talking about their health problems with close female friends. Between 65 and 70 percent all reported that they are able to talk about weight changes, osteoporosis, smoking or drinking, cancer or cardiovascular health with their girlfriends.

However, slightly fewer women -- 56 percent -- said they were "extremely comfortable" talking about mental health issues like depression with their female friends.

These findings were presented Wednesday in New York by the National Association of Nurse Practitioners in Women's Health who, along with Iovine and Pfizer Inc, are launching an educational program called Girlfriends for Life, at www.girlfriendsforlife.org.

In an interview, Iovine said that women may still sometimes hesitate to discuss depression and other aspects of their mental health with female friends because they are somewhat ashamed of how they feel. "We don't want to tell people that we're not loving our fabulous lives," she said.

However, women who don't think of their girlfriends as a valuable resource during difficult times are missing out, she said.

"I am the biggest believer in the value of girlfriends," she said.

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Teens Skilled at Manipulating Divorced Parents

HealthDayNews

Wednesday, June 23, 2004

WEDNESDAY, June 23 (HealthDayNews) -- Many teens learn how to manipulate their divorced or separated parents to their own advantage, according to a Ball State University study.

"There is a perception that after a divorce or separation parents are active and children passive in their relationships. We found the opposite to be true. Adolescents are not passive," study author and sociology professor Chad Menning said in a prepared statement.

"Adolescents after divorce or separation do no simply absorb parental resources as sponges absorb water. Rather, they gather and interpret information about their parents, dodge questions, engineer images of themselves, parry parents' probes, maneuver between households, and cut ties with parents in efforts to exert their own authority and to secure their individual identities," Menning said.

The researchers interviewed 50 teens whose parents were separated or divorced. They discovered strategies that include:

"None of these options would be open to a child in a single household with two parents," Menning said. "Parents talk and form a team to raise a child. Separate the two parents and the child can use the situation to play one off the other."

 

More information

 

The Nemours Foundation has more about teens and divorce.


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Tuesday, June 22, 2004

 

How Teens Face Stress May Affect Diabetes Control

 

By Amy Norton

Reuters Health

Tuesday, June 22, 2004

NEW YORK (Reuters Health) - The approach teenage diabetics take to coping with problems may help determine how well they manage their disease, according to a new study.

Researchers found that among 103 teens with type 1 diabetes, those with more positive, practical responses to life's difficulties showed better blood sugar control than those who had more negative attitudes.

In general, teens who said that when faced with a problem, they resolve to do something about it -- what researchers call "active coping" -- had better long-term control over their blood sugar levels.

On the other hand, those who said they dealt with stress by getting angry or by giving up showed poorer blood sugar control, according to findings published in the journal Diabetes Care.

The results suggest that counseling focused on teens' "coping styles" should be integrated into routine diabetes care, according to lead study author Marit Graue, of Haukeland University Hospital in Bergen, Norway.

Unlike the much more common type 2 diabetes, which usually arises in middle age or later, type 1 diabetes is an autoimmune disease that typically begins in childhood. It leaves people with the disorder dependent on daily insulin injections -- or in some cases, an implanted insulin pump -- for the rest of their lives.

Avoiding patterns of extreme highs and lows in blood sugar is key to staving off the long-term complications of diabetes, which include heart disease, kidney failure, vision loss and nerve damage in the limbs.

It's possible, Graue told Reuters Health, that kids who favor active coping are more likely to watch their diets, closely follow their prescribed insulin regimens or take other actions that lead to better blood sugar control.

For the study, Graue's team surveyed 103 13- to 18-year-olds on how they typically coped with problems, and then looked at the relationship between different coping styles and the results of the teens' HbA1c tests, which reflect average blood sugar levels in recent months.

While active coping was associated with better HbA1c values, getting angry or feeling helpless in the face of problems were both linked to poorer blood sugar control.

It's not clear that these attitudes were the reasons for the teens' better or worse blood sugar levels, Graue noted. For example, having a tough time managing blood sugar highs and lows could make kids more negative, the researcher explained.

However, Graue pointed out, there is research indicating that when people with diabetes are taught coping skills, it improves their blood sugar control and quality of life.

Source: Diabetes Care, June 2004.


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Low-Carb Fad Seen as Unhealthy and a Ripoff

 

By Maggie Fox, Health and Science Correspondent

Reuters

Tuesday, June 22, 2004

WASHINGTON (Reuters) - Popular low-carbohydrate diets are leading Americans to poor health and spawning a rip-off industry of "carb-friendly" products, health experts and consumer advocates said on Tuesday.

They announced a new group, called the Partnership for Essential Nutrition, to help educate Americans about the need for healthy carbohydrates such as vegetables, fruits, beans and whole grains.

"When unproven science becomes a sales pitch, some people get rich and the rest of us get ripped off," Jeffrey Prince of the American Institute for Cancer Research told a news conference.

"Eating vegetables, fruits, whole grains and beans, which are all predominantly carbohydrate, is linked to a reduced risk of cancer, heart disease, stroke, diabetes and a range of other chronic diseases."

Prince said low-carb diets that advocate piling on the animal protein and fat are "increasing the risk of developing cancer, heart disease, stroke, type-2 diabetes and other chronic diseases."

The new group includes such organizations as the Alliance for Aging Research, the American Association of Diabetes Educators, the AICR and the American Obesity Association.

Its Web site at http://www.essentialnutrition.org/ is especially critical of programs, such as the Atkins diet, that advocate throwing the body into a condition called ketosis. During this phase the body sheds water as it tries to get rid of excess protein and fat-breakdown products.

"Losing weight on these extreme low-carb diets can lead to such serious health problems as kidney stress, liver disorders and gout," the group advises.

Atkins Denial

Dr. Stuart Trager, Medical Director for Atkins Nutritionals, Inc., said the Atkins diet is healthy.

"In fact, the Atkins Nutritional Approach includes spinach, eggplant, broccoli, asparagus and leafy greens, in addition to other high-fiber vegetables and fruits," Trager said in a statement. "Even during induction, Atkins requires five servings of vegetables and/or fruits a day."

The new group published a survey of 1,017 adults, done by Opinion Research Corporation, that showed 19 percent of dieters are trying to cut carbs.

The survey found that 47 percent them believed that low-carb diets can help them lose weight without cutting calories.

"They are confused. They lack an understanding of the basic science," Barbara Moore, president of Shape Up America, told the news conference.

She said a "trickle-down effect" meant other Americans were now eating fewer fruits, vegetables, whole grains and low-fat dairy products.

The U.S. government, American Heart Association (news - web sites), American Cancer Society (news - web sites), National Cancer Institute (news - web sites) and American Diabetes Association all recommend getting at least five servings a day of fruits and vegetables. They also recommend eating plenty of whole grains.

The National Consumers League said it found dieters were spending an average of $85 a month on so-called low-carbohydrate products, although the U.S. Food and Drug Administration (news - web sites) does not evaluate or regulate low-carb claims.

"Consumers are paying a premium price for a carb-friendly lifestyle," said Alison Rein of the National Consumers League. She called for the FDA, U.S. Department of Agriculture (news - web sites) and other agencies to issue immediate guidelines on such claims.

Studies show that a low-carbohydrate approach can cause people to lose weight more quickly than a low-fat diet for the first six months, but the low-fat approach catches up after a year.

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Virginia May Issue Fitness 'Report Cards'

The Associated Press

Tuesday, June 22, 2004

RICHMOND, Va. - State education and health officials will consider a report this fall that recommends Virginia public school students be graded on their physical fitness.

The "report cards" are intended to help children maintain healthy weights and exercise habits.

Virginia, like other states, is trying to do something about the growing girth of schoolchildren by improving school food choices and encouraging physical activity. A joint committee made up of members of the Virginia Board of Education and the Virginia Board of Health released a working draft of its recommendations this week.

They include school vending machines with healthier choices, ending the practice of rewarding students with food and requiring minimum nutritional standards for home-cooked foods brought to school for activities such as birthday parties.

What to do about vending machines in schools has been a source of contention. Local school systems make a lot of money off vending-machine sales, and that revenue helps pay for field trips, supplies and other things.

"We don't want to take this revenue away from schools," said Catherine Digilio-Grimes, director of school nutrition for the state Department of Education (news - web sites).

Instead, committee members talked about making vending-machine choices meet minimum nutrition standards.

Healthier choices are already available, said Jeff D. Smith III, lobbyist for the Virginia Automatic Merchandising Association Inc. They just do not sell as well as other items in vending machines, he said.

"The Nutri-Grain bars will sit there," Smith said, and eventually have to be thrown away. "The pack of Nabs will sell."

Dick Pulley, lobbyist for the Virginia School Boards Association, said the committee also needed to take a look at school lunch menus, which could also be making kids gain weight, a point made earlier by committee member Scott Goodman, a member of the Board of Education.

"You don't want to shut down vending machines and serve pizza and french fries," Goodman said.

The committee will meet again next month and is expected to have the final report ready to present to the Board of Health and the Board of Education this fall. Those boards will have to act on the recommendations, and the public will get a chance to comment on any proposals.

Information from: Richmond Times-Dispatch

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WHO Warns on Unsafe Use of Alternative Medicines

 

Reuters

Tuesday, June 22, 2004

GENEVA (Reuters) - The World Health Organization (news - web sites) (WHO) on Wednesday sounded the alarm about the unregulated and often unsafe use of alternative medicines ranging from acupuncture to herbal medicines and food supplements.

To minimize risks, the United Nations (news - web sites) agency issued new guidelines aimed at helping national health authorities develop reliable information for consumers -- who often purchase such treatments over-the-counter and fail to inform their physicians.

There are increasing reports of adverse and even fatal reactions to so-called traditional or alternative medicines as their use spreads in industrialized and developing countries, according to the WHO, which had no global statistics.

But it said that in China, there were 9,854 cases of adverse reactions reported in 2002 alone, more than double the number registered during all of the 1990s.

"It is not true that good, traditional medicines are good for everybody, every time in big quantities. This is a big mistake," Vladimir Lephakin, WHO assistant director-general for health technologies and pharmaceuticals, told a news briefing.

"There are a lot of examples of people who not only suffer but die because of drug interaction or non-proper use of traditional medicine," he said.

Xiaorui Zhang, WHO's coordinator for traditional medicines, said that consumers often assumed that "natural means safe," but lacked knowledge about using such products properly.

The U.S. Food and Drug Administration (news - web sites) last December issued a consumer alert on the safety of dietary supplements containing ephedra, also called Ma huang, a natural substance used in China to treat people for coughs, she said.

"Most countries have no regulations to control herbal products. More than 90 countries sell them over-the-counter," Zhang added.

Food supplements, which are not often regulated as medicinal products, also lack quality controls, according to Lephakin.

Some studies had found that some products in different countries contained toxic heavy metals and in extreme cases there were traces of narcotics to make the products addictive, according to Lephakin.

"There is a need for strengthening control of food supplements in all countries," Lephakin said.

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Gene Variant Linked to Osteoarthritis in Women

 

HealthDayNews

Tuesday, June 22, 2004

TUESDAY, June 22 (HealthDayNews) -- A variant in a gene called FRZB may increase the risk of osteoarthritis in women.

Researchers analyzed DNA from pairs of siblings diagnosed with osteoarthritis (OA) and found that a single nucleotide change in FRZB correlated strongly with OA in women.

This gene codes for a protein that regulates a signaling pathway that's critical in skeletal and joint development. The protein produced by the variant version of FRZB can't perform the duties of the normal protein, the researchers said.

This variant version of FRZB may disrupt proper development of joint cartilage and/or bone, making women with the variant more susceptible to OA in the hip, the researchers suggested.

Early identification of this gene variant may help in prevention, treatment and development of future treatments for OA.

The study will be published this week in the online early edition of the Proceedings of the National Academy of Sciences (news - web sites).

More information

The Arthritis Foundation has more about osteoarthritis.

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Study: Estrogen Later in Life No Dementia Shield

 

By Michael Conlon

Reuters

Tuesday, June 22, 2004

CHICAGO (Reuters) - In the second such finding in a year, researchers said on Tuesday that hormone replacement therapy does not ward off dementia when given to women age 65 and older, and may even increase the risk.

Taken together, "these studies further support last year's recommendations that menopausal hormone therapy should not be used to prevent cognitive decline or dementia in older post-menopausal women," said Judith Salerno, deputy director of the National Institute on Aging.

"Women should follow the U.S. Food and Drug Administration (news - web sites)'s recommendation that those who want to use menopausal hormone therapy to control their menopausal symptoms should use it at the lowest effective dose for the shortest time necessary," she said.

The latest study involved Premarin, an estrogen made by Wyeth, which sponsored the Wake Forest University research appearing in this week's Journal of the American Medical Association (news - web sites).

A year ago information from other women in the same study revealed that estrogen combined with progestin -- a preparation most often sold as Wyeth's Prempro -- doubled the risk of dementia and did not help concentration, language and abstract reasoning.

Similar Trend

Researchers wanted to know if last year's results would also apply to estrogen alone, the type of therapy given to women whose uterus has been removed.

"We found a similar, but slightly weaker, trend toward increased risk of dementia among the women taking estrogen alone (compared to estrogen and progestin)," said Sally Shumaker of Wake Forest Baptist Hospital, the study's chief investigator.

"Translated to a population of 10,000 older women taking estrogen alone, there would be an additional 12 cases of dementia per year. For 10,000 women taking the combined hormone therapy, there would be an additional 23 cases of dementia per year. Clearly, hormone therapy does not prevent dementia as was thought when we began this important research," she added.

Gary Stiles, Wyeth's chief medical officer, told reporters in a conference call that the findings are accurate as they apply to women 65 and over but do not reflect the real world where the average age of a woman undergoing hysterectomy is 42 and women enter menopause in their early 50s.

This study does not show whether exposure to the drugs at those ages might have an anti-dementia benefit in later years, he said.

Prescriptions for once-popular hormone replacement therapy plummeted after studies indicated it failed to reduce the risk of heart disease as thought, and increased the chances of having a stroke.

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Climate Tied to Asthma, Eczema Rates in Kids

 

HealthDayNews

Tuesday, June 22, 2004

TUESDAY, June 22 (HealthDayNews) -- Changes in weather may influence rates of asthma and eczema in children, says a study in the journal Occupational and Environmental Medicine.

The study of nearly 670,000 children concluded that season-to-season variations in temperature, humidity, altitude, and latitude all affected asthma and eczema rates.

Researchers at the University of Ulm, Germany, analyzed data collected between 1992 and 1996 from children ages 6-7 and ages 12-13 in more than 50 countries. The study found that, in Western Europe, every 10 percent increase in indoor humidity was associated with a 2.7 percent increase in asthma rates for both age groups.

House dust mites, a major allergen for asthmatics, thrive in moist air. Humidity also encourages the growth of mold, a possible respiratory irritant.

Lower rates of asthma were identified in areas where the average outdoor humidity drops below 50 percent for at least one month a year. Lower rates of asthma were also associated with higher altitude and greater seasonal temperature variations.

Higher rates of eczema were associated with increasing latitude, while lower eczema rates were associated with higher outdoor temperatures.

This link between climate and asthma and eczema suggests that climate change caused by global warming may influence rates of these diseases in the future, the study authors wrote.

More information

The Nemours Foundation has more about asthma.

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Do Millions of Women Get Unneeded Pap Smears?

 

Reuters

Tuesday, June 22, 2004

CHICAGO (Reuters) - Nearly half the 22 million American women who have had a hysterectomy and whose cervix was removed are getting unnecessary Pap smears to test for cervical cancer, researchers said on Tuesday.

"It is possible that women who have had a total hysterectomy are not aware that they are no longer at risk for cervical cancer. Or they may simply be so enthusiastic about cancer screening that they continue to have Pap smears regardless of the usefulness of the test," wrote study author Brenda Sirovich of Dartmouth Medical School in Hanover, New Hampshire.

One in five women aged 18 and older have undergone hysterectomies, the report said. Most women who underwent the surgery also had their cervix removed.

"It is also possible that physicians are largely responsible for continuing cervical cancer screening after hysterectomy," or that testing is continued to meet screening benchmarks, she said in a report published in the Journal of the American Medical Association (news - web sites).

Whatever the reason, a 1996 recommendation by a U.S. task force on preventive health to discontinue Pap smears in women who have undergone hysterectomies is being ignored.

The recommendation to stop the test did not include women who had had hysterectomies because they had cancer.

The test, formally known as Papanicolaou smear screening, was introduced in the 1940s and has been credited with substantially reducing the number of cervical cancer deaths.

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Scientists Spot Fat Cell 'On' Switch

 

HealthDayNews

Tuesday, June 22, 2004

TUESDAY, June 22 (HealthDayNews) -- With just one key signal, stem cells in mice develop into fat cells, says a Johns Hopkins Medical Institutions study.

Researchers found that the addition of a single protein, called BMP4, induced mouse stem cells to turn into fat cells. They suspect that a similar chemical switch works the same way in human stem cells.

The findings offer a deeper understanding of how humans store excess food energy in the form of fat, and could pave the way for drugs that short-circuit that process, the researchers said.

The mouse stem cells used in this study have the ability to become muscle, bone, cartilage or fat. More than a decade ago, scientists identified the signals that direct the stem cells to turn into muscle or bone. But until now, the signal that switched on fat cells remained a mystery.

"Apart from the muscle- and bone-inducing signals, not much is known about the initial switch from stem cell to labeled 'pre-fat' cell," researcher Daniel Lane, a professor of biological chemistry, said in a prepared statement.

"BMP4 is the first proven fat-cell producing signal for these stem cells," Lane said.

When he and his colleagues implanted BMP4-treated stem cells under the skin of mice, the stem cells developed into fat tissue that was indistinguishable from the animals' natural fat tissue.

"Once we know the detailed mechanism of BMP4-signalling in fat cells, we can create drugs that interfere with the generation of stem cells, and we may be able to create drugs that interfere with the generation of fat cells in both the cell culture and live animal model systems," researcher Dr. Qi-Qun Tang, assistant professor of pediatrics and biological chemistry, said in a prepared statement.

The study appears in the June 21 issue of the journal Proceedings of the National Academy of Sciences (news - web sites).

More information

The National Institutes of Health (news - web sites) has more about weight control.

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Tongue Piercing Entails Infection Risks

 

By Alison McCook

Reuters Health

Tuesday, June 22, 2004

NEW YORK (Reuters Health) - A woman developed a serious infection one week after piercing her tongue, demonstrating one of the risks of the procedure, according to experts.

People who choose to pierce their tongues "are getting a medical procedure done by a non-licensed professional," Dr. Melvin K. Pierson, spokesperson for the Academy of General Dentistry, told Reuters Health.

Pierson explained that anytime people undergo dental procedures, they open themselves up to life-threatening infections from mouth-dwelling bacteria.

And if people have a history of heart defects, they are at risk of endocarditis, a particularly serious infection that spreads to the heart. Consequently, their doctors or dentists will often give them antibiotics before tooth cleanings and other oral procedures, Pierson said.

A tongue piercing should be treated no differently than any other dental procedure, Pierson argued, and people who are planning to get one should first visit a dentist or doctor to determine if they need antibiotics beforehand.

"If the public is going to get a tongue piercing, they should be evaluated by a professional," he said in an interview.

Research has shown that tongue piercing increases the risk of another potentially deadly infection known as Ludwig's angina in which the jaw swells, sometimes to the point of closing off the windpipe. In addition, according to the National Institutes of Health (news - web sites), piercing can transmit hepatitis B, C, D and G.

In the journal General Dentistry, Dr. William J. Dunn and Dr. Teresa Reeves of the Lackland Air Force Base in Texas describe the case of a young woman whose pierced tongue had become inflamed and was oozing pus. She was also having trouble speaking and swallowing.

The doctors removed the barbell inserted into her tongue, cleaned the wound and gave her a course of antibiotics. Two weeks later, she had healed.

Although the woman featured in this report sought help for her infection, many newly-pierced people may not because they are told to expect a certain amount of soreness and swelling from the procedure, and do not recognize what is abnormal, said Pierson, who was not an author of the study.

Consequently, "anyone who goes in for a piercing can have these two severe medical problems (endocarditis and Ludwig's angina), and won't know it," Pierson warned.

He added that the same risks of tongue piercing apply to any type of oral piercing, such as the cheeks and lips.

Dunn and his co-author also advise anyone planning to pierce their tongues to make sure that their piercing parlor uses disposable or sterile needles and sterile gloves.

Source: General Dentistry, May/June 2004.

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Monday, June 21, 2004

 

Health Tip: Is Your Teen a Binge Eater?

 

HealthDayNews

Monday, June 21, 2004

(HealthDayNews) -- Does your teenager merely overeat now and then, or does she have a problem with binge eating?

According to the Nemours Foundation, a binge eater, or compulsive eater, feels a powerful urge to overeat. She regularly eats unusually large amounts of food and doesn't stop eating when she becomes full. Once she starts, she feels out of control and powerless to stop.

If you think your child has a problem with binge eating, talk to her doctor. Treatment focuses on helping children feel better about themselves and develop a healthy relationship with food.

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Exercise Cuts Fall Risk for Women with Thin Bones

 

By Amy Norton

Reuters Health

Monday, June 21, 2004

NEW YORK (Reuters Health) - Exercises that boost strength and agility may help elderly women with brittle bones lessen their odds of falling, a new study suggests.

Canadian researchers found that both strength training and agility activities lowered fall risk among women 75 to 85 years old, all of whom had reduced bone mass or full-blown osteoporosis.

Falls are a major cause of disability among the elderly, and those with osteoporosis are at particular risk of falling and sustaining a bone fracture.

The new findings are important, according to study co-author Dr. Karim M. Khan, because although older adults are generally encouraged to stay active, people with osteoporosis may be advised to avoid exercise because of safety concerns.

But this study, Khan told Reuters Health, shows that older adults with brittle bones should be active, under the proper supervision.

"This study showed very important gains in health, and the safety was excellent," said Khan, who is from the University of British Columbia in Vancouver. He and his colleagues report their findings in the Journal of the American Geriatrics Society.

For the study, 98 women were randomly assigned to perform one of three types of exercise: resistance training, agility training or stretching exercises.

Those in the resistance-training group focused on building strength through lifting light weights and doing exercises such as squats and lunges. The agility training used games, dance and obstacle courses to try to improve the women's balance, coordination and reaction times.

Women in all three groups took 50-minute exercise classes twice a week at a community center.

After six months, those in the strength-training and agility-training groups showed a greater drop in fall risk compared with women in the stretching group. Fall risk, which was estimated with a standard battery of tests, declined by about 57 percent with strength training and 47 percent with agility training, the researchers report. That compares with 20 percent in the stretching group.

According to Khan and his colleagues, much of the benefit from both types of training had to do with "postural stability." This is gauged in tests that measure how much the body sways when a person is standing still. After six months, women in the strength and agility groups were steadier on their feet than at the study's start.

The findings also suggest that strength training may be a particularly good way for elderly adults with osteoporosis to exercise. While participants found the agility program enjoyable, the researchers note, it carried a higher risk of falls, and it may be a less feasible type of activity compared with strength training.

The U.S. Centers for Disease Control and Prevention (news - web sites) (CDC) has said more older adults should be doing strength-building exercises to counter the loss of muscle and bone mass that comes with aging. In a recent national survey, the CDC found that only about 11 percent of Americans age 65 and up regularly perform any type of strength training.

Source: Journal of the American Geriatrics Society, May 2004.

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Environmental Toxin Linked to Parkinson's

 

HealthDayNews

Monday, June 21, 2004

MONDAY, June 21 (HealthDayNews) -- Environmental toxins called proteasome inhibitors cause a Parkinson's disease (news - web sites)-like movement disorder in rats, according to new research.

The findings suggest that these natural toxins may contribute to the development of Parkinson's in humans. Proteasome inhibitors are produced by bacteria and fungi. Human-made proteasome inhibitors also find their way into the environment.

"These results suggest that we should determine how widespread these toxins are in the environment, how humans are exposed to them, and how such exposures correlate with the incidence of Parkinson's disease," study lead author Kevin St. P. McNaught, of Mount Sinai School of Medicine in New York, said in a prepared statement.

The study appears in the online edition of the journal Annals of Neurology.

In humans and other animals, proteasomes act like a garbage disposal system by eliminating abnormal proteins from cells. There's growing evidence that people with Parkinson's have defective proteasomes.

In this study, McNaught and his colleagues used both man-made and naturally occurring proteasome inhibitors to interfere with proteasomes in laboratory rats. Imaging of the rats' brains showed types of changes identical to that seen in Parkinson's disease.

They began to display Parkinson's-like symptoms such as slowness of movement, tremors, and rigidity.

"These symptoms gradually worsened over a period of months, and could be reversed with drugs that are used to treat Parkinson's patients," McNaught said.

At autopsy, the rats' brains showed a reduction in levels of the brain chemical dopamine, which undergoes a similar decline in Parkinson's patients. Autopsy also revealed a pattern of nerve cell loss that closely resembled Parkinson's.

More information

Learn more about the disorder from the National Parkinson Foundation.

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Diabetes, Impotence Linked to Silent Heart Disease

 

Reuters Health

Monday, June 21, 2004

NEW YORK (Reuters Health) - If a man with type 2 diabetes also suffers from erectile dysfunction (ED), it strongly suggests that he could well have coronary artery disease that's not causing any symptoms, researchers report.

Commenting on his team's findings, Dr. Carmine Gazzaruso noted that routine screening for silent coronary artery disease (CAD) "is not justified among patients with uncomplicated diabetes since there is low probability of finding significant CAD."

In this situation, erectile dysfunction "may help in discriminating subjects to test for silent CAD," said Gazzaruso, from the Maugeri Foundation Hospital in Pavia, Italy.

A strong association between ED and obvious, symptomatic heart disease has been seen in several studies, but until now the prevalence of ED has never been studied among diabetic patients with silent CAD, the researchers note in their report in the American Heart Association (news - web sites)'s journal Circulation.

They looked at 133 men with uncomplicated diabetes and silent CAD (which was discovered by testing) and 127 with diabetes but no silent CAD. The team found that 33.8 percent of the men with silent heart disease had ED, compared with 4.7 percent of those without CAD.

Several other factors were linked to silent CAD, but "ED appeared to be the most efficient predictor of silent CAD."

Gazzaruso told Reuters Health that he believes physicians should "always" ask their male patients with diabetes about ED. In this way the doctor may "not only find more patients to treat for ED with improvement of their quality of life, but also identify a higher proportion of diabetics with silent ischemia," he said.

The researcher said he also believes that exercise testing should be considered for people with ED before they begin drug treatment, to make sure they don't have silent heart disease.

Circulation 2004.

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Amino Acid Tied to Depression in Parkinson's Patients

 

HealthDayNews

Monday, June 21, 2004  

MONDAY, June 21 (HealthDayNews) -- People with Parkinson's disease (news - web sites) who have high levels of homocysteine, an amino acid produced by the body, are likelier to suffer from depression than Parkinson's patients with normal homocysteine levels, a new study says.

Researchers say a drug used to treat Parkinson's may be behind the elevated risk.

The study, appearing in the June issue of the Archives of Neurology, included 97 people who had had Parkinson's disease (PD) for an average of 3.6 years. Fifty-four of them were taking the drug levodopa. The study subjects were divided into two groups, those with elevated homocysteine levels and those with normal levels.

All the participants completed a depression questionnaire and tested for their cognitive and motor skills.

"An elevated plasma [homocysteine] concentration... was present in 31 (32 percent) of our 97 patients with fairly recent onset PD," the study authors wrote. "An elevated [homocysteine] level is most likely due to the prevalent use of levodopa: as in previous studies, the patients taking levodopa had higher [homocysteine] levels than those not taking levodopa."

Patients with elevated homocysteine levels were slightly older (68 years vs. 62 years), were more depressed, and had worse cognitive functioning, the study found.

"Our findings, if confirmed, indicate that disease burden in PD patients, such as poor motor performance, depression, and cognitive deterioration, is associated with a high [homocysteine] level," the authors concluded.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about Parkinson's disease.

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Study: Few Women Get Annual Mammograms

 

By Daniel Yee

Associated Press Writer

The Associated Press

Monday, June 21, 2004

ATLANTA - After more than a decade of urging by doctors that women over 40 should receive mammograms yearly, few actually do so, according to a large cancer study.

Only 6 percent of women who received a mammogram in 1992 received mammograms yearly for the next 10 years, according to a study of 72,417 women of all ages at Massachusetts General Hospital, the largest look at mammography to date.

The American Cancer Society (news - web sites) recommends that all women 40 and older receive a mammogram and a breast exam yearly. Younger women are encouraged to receive a breast exam every three years.

Yet most of the women received only five exams during the 10-year-time period half the recommended amount. The study appears Monday on the Web site of Cancer, a journal of the American Cancer Society.

"I think it's very likely this is a widespread phenomenon in America, the failure of women to return promptly to get mammograms," said James Michaelson, study author and assistant professor of pathology at the hospital and Harvard Medical School (news - web sites). "Prompt annual return is really important to get the maximum life-sparing benefit of screening mammography."

Mammograms remain the best method for detecting breast cancer when it's most treatable, the Institute of Medicine (news - web sites) said earlier this month.

Women who screen annually and are diagnosed with breast cancer die from the disease half as often as those who do not get annual exams, Michaelson said.

"We have a problem in mammography in this country the message still hasn't gotten out that mammography will save lives," said Dr. Herman Kattlove, a medical editor with the American Cancer Society who was not involved with the study. "We just all need to do a better job."

Poor women, those without health insurance and those from non-white racial and ethnic groups had particularly low rates of receiving mammograms, but no group of women used mammography often, Michaelson said.

"That tells me it's the system that is failing, that is not helping women," Michaelson said. "We simply don't do a good enough job of sending reminders."

A worsening shortage of providers has also affected women's access to mammograms. In parts of the country, long waits for breast X-rays are common. That's because fewer radiologists are specializing in breast imaging because of long hours, low pay, heavy regulation and fear of lawsuits.

"Mammography is the stepchild of medical care. There's just not much incentive to do it we're beginning to face a decline in access to mammography," Kattlove said. "We need better payment for mammography if we're going to have better access."

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Kidney Disease Often Overlooked in Heart Patients

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Monday, June 21, 2004

MONDAY, June 21 (HealthDayNews) -- Doctors too often are not recognizing the subtle signs of potentially life-threatening kidney problems in older patients hospitalized for heart disease, a study finds.

Although the medical tests given to heart patients on admission include one for kidney function, the results usually are given in a hard-to-interpret form that causes trouble to be overlooked, said Dr. William M. McClellan, professor of medicine at Emory University and lead author of a paper on the study in the July issue of the Journal of the American Society of Nephrology.

The study analyzed admissions of nearly 15,000 Georgia Medicare patients, average age 74, hospitalized for either heart attacks or congestive heart failure. It found moderately reduced kidney function in 52 percent of the heart attack patients and 60 percent of those with heart failure, in which the heart progressively loses the ability to pump blood.

Yet the existence of kidney problems was recognized in only 20 percent of those patients, the study found. The gap exists primarily because the tests results list only blood levels of creatinine, a molecule whose levels depends on kidney function. It takes skilled interpretation of the creatinine level to determine whether kidney function is below normal, McClellan said, and most doctors don't do it.

The U.S. government is aware of the problem and is working with companies that market laboratory tests to make the kidney data available in more usable form, said Dr. Josephine P. Briggs, director of the Kidney, Urology and Hematology Division of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Meanwhile, McClellan said, failure to recognize kidney problems in heart patients can have serious consequences.

"Most important, frequently when you deal with patients with kidney disease you must change medication dosages, modify X-ray procedures, and otherwise account for kidney disease," he said. "Second, when you don't recognize kidney disease you don't look for complications like anemia, malnutrition, and bone disease that can go untreated. By treating them, impaired quality of life can be avoided.

"The third problem is that you don't do the things you should do to slow the progression to end-stage kidney disease."

The consequences showed up in the Georgia study. Patients with kidney problems were more likely to be re-hospitalized within a month and were more likely to die within a year -- three times more likely for patients with heart failure, the journal report said.

The NIDDK has started a National Kidney Disease Educational Program to increase the awareness of physicians of the importance of measuring kidney function in heart patients, Briggs said. A key part of that effort is to have kidney data presented in terms of the glomerular filtration rate (GFR), which is a direct indication of kidney function, she said.

"We are suggesting that commercial laboratories should do more to present data on GFR," Briggs said. About 10 to 15 percent of laboratories now give results in terms of GFR rather than creatinine levels, she said, and talks with some major companies are on the verge of producing results.

"We hope that in a year or two, a number of large companies will be doing that." Briggs said.

More information

You can get A-to-Z information about kidney and related diseases from the National Institute of Diabetes and Digestive and Kidney Diseases.

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Cancer May Be Responsible for 'Chemobrain'

 

By Daniel Yee

Associated Press Writer

The Associated Press

Monday, June 21, 2004

ATLANTA - Anti-cancer drugs may not be entirely to blame for the mild mental impairment suffered by some cancer patients undergoing chemotherapy, a study found.

The findings suggest the forgetfulness and other symptoms associated with so-called "chemobrain" may be caused by cancer itself rather than potent cancer-fighting medicines, researchers said in a study published Monday in the online version of the journal Cancer.

In a study of 84 breast cancer patients diagnosed with neurological problems, 35 percent reported cognitive problems before receiving chemotherapy drugs. Chemotherapy did cause a mental decline in the other patients.

The study was the first of its kind to find cognitive impairment in cancer patients prior to receiving chemotherapy. Other symptoms of the disorder include difficulty speaking or interacting socially.

In the past, doctors may have assumed all cognitive impairment found after chemotherapy stemmed from anti-cancer drugs because physicians never examined a patient for mental decline prior to treatment, said Dr. Christina Myers, professor of neuropsychology at the M.D. Anderson Cancer Center in Houston and one of the study's authors.

"They only looked at one point in time, and any problems they attributed to chemotherapy," Myers said. "The situation is more complex."

About half the patients in the study reported recovering from the mental symptoms within a year of receiving chemotherapy.

The findings are important because some cancer patients have been hesitant to undergo chemotherapy out of fear of developing post-treatment problems, including chemobrain.

"I think for most people, they're willing to expose themselves to adverse effects of a therapy that will prolong their life," Myers said.

The study also provides scientific data on chemobrain, not just anecdotal evidence, said Dr. Mary Simmonds, a medical oncologist and former national president of the American Cancer Society (news - web sites).

"It's human nature. If I were the patient, maybe I would be like any normal person and blame the drugs, but that's not always the case," Simmonds said.

Cancer doctors are not sure why patients with cancer develop neurological problems. Cancer cells could create substances that impair the nervous system, or the immune system could create an inflammatory response to cancer that could be responsible for the fuzzy mental symptoms, Myers said.

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Chemo's Effect on Cognition is Debated

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, June 21, 2004

MONDAY, June 21 (HealthDayNews) -- Women undergoing chemotherapy for breast cancer have been widely reported to suffer from "chemobrain," or problems with focus, concentration

But researchers reporting in the June 21 issue of the journal Cancer suggest that the incidence of chemobrain may be exaggerated.

Previous research didn't take into account cognitive deficits before chemotherapy started, the study authors state. In addition, those older studies compared a patient's intellectual function after chemotherapy to standards for women of similar age and education, instead of the patient's own cognitive ability before therapy.

"The existence of chemobrain is indeed somewhat controversial," agreed Dr. Carl Kardinal, head of the Ochsner Cancer Institute in New Orleans.

Which is not to say chemobrain doesn't exist. It's just that it may not always be due to chemotherapy.

"Chemotherapy can cause declines, there's no question about that. But some people have cognitive impairments due to their cancer which are present before treatment starts," said Christina A. Meyers, senior author of the study and professor of neuropsychology at the University of Texas M.D. Anderson Cancer Center in Houston.

"Some of the people [previous researchers] called 'decliners' may have been impaired beforehand and some who were functioning normally may have in fact declined. They were missing people on both ends," she said.

"Cancer patients are vulnerable to adverse symptoms that can be caused by disease," Meyers added. "Some have said they had fatigue and distractibility problems before diagnosis, which they attributed to overwork or what have you, and which, in retrospect, probably heralded their diagnosis."

In their study, Meyers and her colleagues were the first to evaluate cognitive skills before chemotherapy as well as after. The researchers conducted comprehensive neuropsychologic evaluations of 84 women with noninvasive breast cancer before they started chemotherapy.

During this pre-chemotherapy period, 36 percent already exhibited evidence of cognitive impairment, namely problems with verbal skills and memory function. To a lesser extent, the women also had problems with nonverbal memory, psychomotor processing speed and attention, visual tasks and some fine motor skills.

So given the fact that nearly a third of the women were showing signs of impairment before the start of chemotherapy, it may be inaccurate to blame the therapy itself for cognitive problems, the researchers said.

Not all experts agree with the new research's conclusions, however.

The critics include Dr. Stewart Fleishman, director of cancer supportive services at Continuum Cancer Centers of New York, Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center in New York City, who has been involved in a large study of chemobrain.

"They [the study authors] didn't take people with a blank slate, [they only took] people who already had breast cancer. It's much more complicated," Fleishman said, adding that any number of factors, including hormones, could be causing the cognitive changes.

Either way, Meyers said, the new research still only reveals what happens, not why. "Where [chemobrain] comes from is the uncertain part," she said. "What we've just established is that it occurs. The next step is who does it happen to and why."

Depending on what that "why" turns out to be, there could be a number of treatments, Meyers said.

"If it's an inflammatory response, then we would go after immune activity," she said. "If it's genetic susceptibility, we might screen people for that and then be very proactive with them about treating symptoms before they start."

Other treatment options include various medications, behavioral interventions, and compensatory strategies, such as learning how to organize yourself, self-hypnosis and exercise. "There are lots and lots of things we can do to attenuate symptoms and make them more manageable," Meyers said.

The main thing is not to deny that chemobrain exists, she said.

"It's real, it happens and it should be treated as aggressively as the cancer is being treated," Meyers said. "Physicians should be aware that if someone is offering complaints in this area, they should be referred because there are things to be done."

More information

The American Cancer Society has more on chemotherapy for breast cancer.

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Arkansas Seeks Vending Machine-Fat Link

 

The Associated Press

Monday, June 21, 2004

LITTLE ROCK, Ark. - Gov. Mike Huckabee wants proof that vending machines lead to childhood obesity before the state restricts the machines in schools.

Huckabee, who has lost 105 pounds in the last year after a diabetes diagnosis, says he would like scientific evidence first before regulating vending machines out of Arkansas middle schools and high schools.

He suggests restricting vending machine use in a group of schools and comparing the data with schools where access to the machines is limited.

"There are no studies that I know that clearly say if a kid has access to a soda machine that he's going to be fatter than the one who doesn't have access," he said.

Standards that aim to cut children's calorie intake by putting restrictions on vending machines in Arkansas schools are to go before the state Board of Education in coming months.

Officials who fully support the standards, say Huckabee is being disingenuous for opposing them based on a lack of research.

"I think it's really pretty much a basic that candy bars and sugar colas are not conducive to good health," said Rep. Jay Bradford, D-White Hall. "And I don't think it takes a lot of research to realize that adds a great amount of weight to certain individuals."

Huckabee said the state needs to continue carefully and consider seriously the financial implications of the standards, which he said are headed in the right direction.

Financing hasn't escaped the worries of the Child Health Advisory Committee members, who realize they are proposing potentially expensive mandates. There is no estimate how much it will cost to implement the standards and no state funding has been allotted.

Huckabee's reluctance to fully support the standards comes one month after he announced his Healthy Arkansas campaign, which aims to reduce the percentage of obese children 5 percent by January 2007. Currently state statistics show that about 22 percent of about 277,000 Arkansas public school students are obese and another 18 percent are overweight.

If the state Education Board adopts the standards, they specifically would be keeping middle and high school students from accessing vending machine food until 30 minutes after the last lunch period ends.

That would take effect in the coming school year and by the 2005-2006 school year, the standards require foods and beverages sold in schools, including those from vending machines, to meet a short list of nutritional guidelines.

The Arkansas Soft Drink Association's position on the standards is the same as Huckabee's.

"They don't have any evidence to offer," Dennis Farmer, the association's president, said. "They can't tell you what difference that's going to make in the obesity rate."

Huckabee said suggesting he is aligned with the soda and vending machine industries is ridiculous.

"I'm not running again," he said. "It doesn't matter to me."

However, Dr. James Fasules, a cardiologist with Arkansas Children's Hospital and a member of the Child Health Advisory Committee, wonders whether Huckabee is stalling.

"It's easy to call for a study. It's a very nice way of delaying things," Fasules said.

But the governor disagrees.

"We may come back and decide that these recommendations don't go far enough," Huckabee said. "If people are saying I'm trying to delay or thwart it, that's not it at all."

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'Seizure-Alert' Dogs Protect Children With Epilepsy

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Monday, June 21, 2004

MONDAY, June 21 (HealthDayNews) -- Proving again that they're man's best friend, many dogs apparently have the ability to alert families minutes or even hours in advance of a child's oncoming epileptic seizure.

What's more, a new study finds, many parents report "protective" action on the part of their pet, such as gently sitting on toddlers to prevent them from falling during an attack.

Families related "remarkable stories" of some canines' uncanny ability to predict an attack and protect children from harm, said study lead author Dr. Adam Kirton, a pediatric neurologist at Alberta Children's Hospital, in Calgary, Canada.

Presenting their findings in the June issue of Neurology, Kirton and his colleagues told of incidents gleaned from interviews with 122 dog-owning families of children with epilepsy. Among their stories:

All in all, 40 percent of the dogs in the families interviewed displayed specific reactions to a seizure, and about 15 percent of them appeared able to anticipate an oncoming seizure, the researchers report.

 

The average time between a dog showing signs of pre-seizure behaviors -- activities such as face-licking, protective maneuvers or whimpering -- and the seizure itself was 2.5 minutes, although some dogs displayed such behavior hours before an attack.

 

Female dogs were much more likely than males to be seizure-sensitive, making up 80 percent of the pets capable of sensing an attack in advance.

 

Almost four out of five of the seizure-alerting canines were from larger breeds -- dogs like German Shepherds, Retrievers, Rottweilers and Standard Poodles.

 

Dr. Douglas Nordli, who directs the Epilepsy Center at Children's Memorial Hospital in Chicago, said he has "heard this from family members" over the years, but has never had the opportunity to investigate the phenomenon in any scientific way.

 

"It could be that the dogs are cueing on some type of change in the behavior of the child," Nordli said.

 

While a dog's keen sense of smell could pick up on subtle scent changes in the child, "it's more likely that it's something that they are seeing," he added.

Nordli pointed out that many parents, especially mothers, have told him that they, too, can sense when their child is about to have an epileptic seizure.

 

"In some cases, it's through changes in the facial expression, or coloring," he said, "or sometimes the child's personality just seems 'off.' "

 

In some cases, parents said they could prevent an oncoming seizure by diverting the child's attention.

 

Among the dogs studied, the most common behavior exhibited by the seizure-sensitive ones was a sustained licking of the child's face or body -- one Golden Retriever would lick a toddler's feet during "absence" seizures, which are characterized by a mental detachment, the study found.

 

Although there's no proof to the theory, it's possible that this could be a "conditioned response by the dog to shorten or abort a seizure," the Alberta researchers wrote in their report.

 

Still, Kirton stressed that the findings are "preliminary," and his group was in no way advocating that parents of children with epilepsy get a dog to protect their child from harm.

 

"Our recommendation at this point is that people with epilepsy get a dog for the same reasons that anyone else would," he said. "Further studies are needed to see if dogs can be trained to detect seizures."

 

That research may soon be under way. According to Nordli, the best evidence that dogs can sense seizures would come from studies in which scientists examined dogs' reactions to epileptic individuals hooked up to an electroencephalograph (EEG).

 

"We're thinking about doing that," Kirton said.

 

More information

 

Learn more about epilepsy at the Epilepsy Foundation.


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Sunday, June 20, 2004

 

Depression Spells Heart Trouble for Older Women

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Sunday, June 20, 2004

SUNDAY, June 20 (HealthDayNews) -- A growing body of research suggests that state of mind -- not clogged arteries or high blood pressure -- is a big risk factor for heart disease among older women.

Mildly and moderately depressed women are estimated to be 50 percent more likely to die of heart attacks than other women, research shows. Meanwhile, scientists and doctors are trying to untangle the connection between the two illnesses.

"There's got to be a physiological link, and people are trying to look at it," said Sylvia Wassertheil-Smoller, a professor of epidemiology and population health at the Albert Einstein School of Medicine in New York City.

But the chicken-and-egg question remains: Which comes first, depression or heart disease?

In a recent study, Wassertheil-Smoller and her colleagues examined the medical records of 93,676 postmenopausal women aged 50 to 79. The study, which followed the subjects for an average of four years, was the first of its kind to track women over time, instead of looking backward by studying them after they had had heart attacks, she said.

The women were healthy when the research began, and those suffering from untreated severe depression did not participate. Fifteen percent of the women were eventually diagnosed with depression, with symptoms most common in those aged 50 to 59. Symptoms dropped by ages 70 to 79.

"Maybe by the time you're getting to be 70 to 79, you're accepting life and it doesn't get you down so much," Wassertheil-Smoller said.

Although their symptoms were mild or moderate -- perhaps due to help from antidepressants -- the depressed women were 50 percent more likely to die of a heart attack and 30 percent more likely to die of other causes.

What's more, death rates were higher for the depressed women, regardless of whether they smoked or were overweight.

The researchers based their findings on results from the Women's Health Initiative, the largest study of U.S. women's health ever undertaken. They appeared in a recent issue of the Archives of Internal Medicine (news - web sites).

Wassertheil-Smoller isn't sure why depression may contribute to heart disease. Depression might boost levels of dangerous inflammation in the body, or it may disrupt the blood's ability to clot properly, she said.

It's also possible that depression could be an early warning sign, a kind of "sentinel symptom" that appears before heart disease becomes obvious, she said.

For now, she suggests that doctors pay attention to signs of depression in older women, especially when they're not connected to an event such as the loss of a spouse. Doctors also need to follow up with depressed patients, just as they would schedule future appointments to check on a patient who reported a high cholesterol level, she said.

Dr. Francine Welty, director of cardiovascular care for women at Beth Israel Deaconess Medical Center in Boston, agreed that doctors need to pay more attention to the mental health of their patients. She added that women may become depressed or take less care of themselves when they're alone.

"A lot of my older female patients with heart disease no longer have their spouse or they may be divorced, have little family support," she said.

According to Welty, exercise can be a good antidote to both depression and heart disease in women. "No matter what their age, they need to get out there and do aerobic exercise. Walking is sufficient," she said. "Studies have shown that walking is as beneficial as other exercise."

Walking can also help combat depression by virtue of the fact that it's an enjoyable activity, she said. "If you get outside and it's a nice, sunny day and you go on a walk, you'll feel better."

More information

The American Psychological Association has more information on women and depression.

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Book Gives Tips for Healthy Road Trip Food

By Alicia Chang

Associated Press Writer

The Associated Press

Sunday, June 20, 2004

WOODSTOCK, N.Y. - If you're road-tripping this summer, chances are you'll end up at one of those nondescript highway rest stops that serve mainly juicy burgers, greasy fries and syrupy soft drinks. But the way food gurus Nikki and David Goldbeck see it, travel is no excuse for eating badly.

The couple, who penned several nutrition books including the 1973 best seller "The Supermarket Handbook," like to avoid the fast food chains that dot the nation's interstates whenever they drive from their Woodstock home to the warmth of Florida's Miami Beach every winter.

Although many places now offer salads and healthier options like fresh fruit, the Goldbecks often find the menu selections too limited for their vegetarian taste. For years, they scoured the Yellow Pages for vegetarian-friendly restaurants, and even kept a folder of old newspaper clippings of restaurant reviews in their car.

The Goldbecks recently compiled their favorite eateries, along with other listings discovered through their own research or recommended by other health-conscious travelers, into a new book aimed at giving travelers a nutritious alternative.

"Healthy Highways: The Traveler's Guide to Healthy Eating" lists about 2,000 health-oriented restaurants and natural food stores in the 50 states all easily accessible from the exit ramp of a highway or a major road. Telephone numbers and hours of operation are also included.

While the book can help steer travelers toward more nutritious food, health experts say those on the road can also take their own simple steps toward healthy eating by planning ahead.

"You don't need to find a specific restaurant to find healthy offerings," said Tara Geise, a registered dietitian and spokeswoman for the American Dietetic Association. "If you follow some basic principles, you can find healthy food pretty much anywhere you go."

For example, on long trips, take the time to pack a cooler with sandwiches and snacks like fruit and yogurt. At rest stops, keep portion size in mind and avoid overindulging on junk food. If an entree on a menu looks unfamiliar, ask for its nutritional content before ordering.

When traveling in the summer, keep an eye out for roadside fruit and vegetable stands that offer the chance to stock the cooler with locally grown produce like Georgia peaches, Geise said.

All the entries in the Goldbecks' book are vegetarian-friendly, but not all are meat-free. The listings range from health food chains to independent owners, from organic style to fresh home-cooking, from juice bars to sit-down restaurants.

The majority are located a few miles off the highway, but others like the natural food chain Fresh City, which sells fresh-to-order salad wraps and stir-fry bowls, can be found along several stops on the Massachusetts Turnpike.

The Goldbecks admit the book is not all-inclusive and revisions and additions of new listings are made on a Web site dedicated to the book. They choose the eateries through their experience and also by mailing out 4,000 questionnaires to restaurants and natural food stores. The list was pared down after they studied menus and made follow-up contact.

According to Nikki Goldbeck, a 57-year-old nutritionist, there are other perks to straying from rest stop food.

"Aside from getting better food, part of traveling is to get the community experience," she explained. "You get to meet local people and experience what the neighborhood is like."

On the Net:

Goldbecks' book: http://www.healthyhighways.com

American Dietetic Association: http://www.eatright.org

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Saturday, June 19, 2004

 

New Test Helps Determine When Antibiotics Are Needed

 

By Adam Marcus
HealthDay Reporter

HealthDayNews

Saturday, June 19, 2004

SATURDAY, June 19 (HealthDayNews) -- One of the most pressing problems in infection care is the overuse of antibiotics, driven in part by doctors who inappropriately prescribe these drugs against viruses instead of the bacteria they're able to destroy.

The misuse of antibiotics isn't intentional, but rather a response to not knowing the source of infections. Often, viruses and bacteria create identical symptoms -- fevers, sore throats, coughing -- without advertising their identity.

Now, scientists say, a simple blood test can help determine which patients require antibiotics and which won't benefit from the drugs. In a recent Swiss study, the test, for a protein called procalcitonin, halved the number of antibiotic prescriptions given to people with lung infections without hurting overall care.

A version of the procalcitonin test is already available in Europe but it has not yet been approved for use in the United States. Administering the test would cost between $30 and $50, although experts say it more than pays for itself by reducing the unnecessary use of antibiotics.

While overuse of antibiotics typically isn't harmful to individual patients, the practice is blamed for the alarming rise in drug-resistant bacteria.

Dr. Stuart Levy, a Tufts University physician and president of the Alliance for the Prudent Use of Antibiotics, said "to have a test like this would in principle be a boon, because if we know that it's viral and not bacterial," doctors could avoid prescribing antibiotics that wouldn't work anyway.

The biggest impact of such a test -- whether for procalcitonin or another infection indicator -- would be in stopping unnecessary antibiotic therapy in the community, where the bulk of misuse occurs, Levy added.

Scott Hanes, a pharmacology researcher at the University of Illinois at Chicago, has studied procalcitonin as a potential test for bacterial infections.

"It looks like it's fairly specific when you have a more systemic infection," Hanes said. "But most literature doesn't support its use in pneumonia because it's fairly localized. The levels [of procalcitonin] never seem to diverge enough from normal to make it" particularly useful in diagnosing the disease.

Even if doctors in the United States were to adopt a procalcitonin test as they have in Europe, Hanes predicted that it would supplement other tools for identifying the causes of infections. These include blood tests for other signals of inflammation, including C-reactive protein, lactate and interleukin (IL)-6, as well as physical exams such as bronchoscopy, in the case of pneumonia.

"It's not going to be relied upon as the sole tool to determine if you're going to receive antibiotics," he said.

More information

The American Academy of Family Physicians has more information about when it's best to use antibiotics and when it isn't.

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Research: Refined Grains Expand Girths

 

By Ira Dreyfuss

Associated Press Writer

The Associated Press

Sunday, June 21, 2004

WASHINGTON - Many Americans are like a loaf of bread soft, with one side round. Their choice of bread may be part of the reason. Some researchers say white bread and other refined grains seem to go to the gut and hang out as belly fat.

"Waist circumference was very much associated with this high-refined grains pattern," said Katherine Tucker, an associate professor of nutritional epidemiology at Tufts University in Boston. She and other scientists are studying what happens to the bodies of people who eat lots of refined bread.

The researchers have tracked the eating habits of a group of healthy, largely middle-age people in Baltimore. The focus is on 459 people with a variety of eating habits. Some prefer refined grains; others favor whole grains, fruits and vegetables.

Refining removes the fibrous bran and oil-rich germ, leaving the sweeter endosperm, the whitish-colored meat of the kernel.

The Tufts researchers say calories from refined grains like to settle at the waist.

The belt size of the white bread group expanded about one-half inch a year, which probably put some of the research subjects into a larger size of pants over the three years they were tracked, Tucker said. At the end, the white bread group had three times the fiber group's gain at the gut.

It is not surprising that the waists of refined-grain eaters expanded, said Dr. David Ludwig, director of the obesity program at Children's Hospital in Boston.

Ludwig was not connected to the Tufts study, but his research involving younger adults had found something similar. One of the factors he checked was the waist-to-hip ratio whether people's torsos were more tapered or more round. People who ate less fiber were rounder.

Waist size is important for health as well as looks.

A person with a bigger gut has a higher risk of heart disease than a person who weighs the same but who does not carry extra weight around the belly.

Why that is and why refined grains would send more calories to the gut are a mystery. The Tufts researchers, who published their data in June of 2003, are seeking answers.

Their theory is that it is linked to the ease in which the body breaks down carbohydrates in the endosperm into simple sugars. When sugars flood the body, insulin levels rise to help pull the sugars out of the bloodstream and store them in cells, often as fat.

"I think abdominal fat cells may be more sensitive to insulin's effects than other fat cells in the body," said P. Kristen Newby, lead author of the Tufts study.

For consumers, white versus whole grain is not necessarily an either-or choice. About 70 percent of households have a white bread eater and about the same percentage have a whole wheat eater, according to a February report by the Mintel Group, a market research firm in Chicago.

Curbing carbohydrates as a way to rein in the insulin response is an important rationale for popular carb-curtailing diets such as the Atkins and South Beach plans. As a result, dieters are giving up refined grains.

Outside a Giant supermarket in Reston, Va., Pete Krone of Oak Hill, Va., said the South Beach diet took him from the farthest-out notch on his belt to the closest-in, and is pushing him toward a smaller belt. Cutting back on refined grains was a big part of it, he said.

"The South Beach diet gets rid of what's known as the bad carbs the high-sugar carbs, which would be white bread, potatoes, starches, pasta and gradually replace it with wheat bread, (and) cereals that are higher fiber," Krone said. "What went first was the fat around my waistline."

While it appears that people who eat more refined grain products can wind up needing bigger belt sizes, more studies will be needed to prove it, Newby said.

This caution was echoed by Cathy Nonas, a spokeswoman for the American Dietetic Association and director of obesity and diabetes at North General Hospital in New York City.

"We have to be careful about how we translate this information," she said. "We do not have enough research."

Meanwhile, even people who chew lots of whole grains find it hard to give up the white stuff.

"Don't you think you need white bread for a BLT?" said one whole wheat fan, Marykate Dougherty of Arlington, Va., who was at the Great Harvest Bakery in Herndon, Va. "There are certain things that you got to have white bread for."

On the Net:

Government background on fiber: http://www.nlm.nih.gov/medlineplus/dietaryfiber.html nutrition

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