The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
December 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 July 3-9


  1. McDonald's Sued Over Fat in Cooking Oil
  2. U.N. Warns of Global HIV Women's Crisis
  3. Firesetting, Animal Cruelty Tied to Poor Parenting
  4. Doctors Skimp on Hand Hygiene
  5. Risk of Dementia Increases After Stroke
  6. Burn Calories, Lose Weight
  7. Stress Boosts Immunity, But Only in the Short Term
  8. Blood Test Predicts Kids' Food Allergies
  9. Pregnancy Risky for Women with Heart Defect
  10. Added Protein Gives Sports Drinks Extra Kick
  11. Report: Teens Seeing Too Many Magazine Alcohol Ads
  12. Adult Stem Cells Transfer Improves Heart Function
  13. Gene Shutoff Prevents Epilepsy in Mice
  14. Study: Fake Sweeteners Boost Rats' Eating
  15. Depression Ups Risk of 'Metabolic Syndrome'
  16. New Clue to Depression
  17. Lead Exposure Still Poses Health Hazard - U.S. Govt
  18. Soy Safe When It Comes to Breast Cancer
  19. Statins Can Be Given Soon After a Heart Attack
  20. New Drug for Alzheimer's Disease to Be Tested
  21. CDC Suggests Boosting Dose of Prevnar Vaccine
  22. Pet Allergens Found in All U.S. Homes
  23. Asthma Often Does Not Go Away as Kids Get Older
  24. Genetic Privacy Needs Protection
  25. Thyroid Disorders Common with Hepatitis C
  26. Gene Discovery Could Change Psychiatric Care
  27. Age at Menopause Not Linked to Death from Stroke
  28. Gene Therapy Offers Alternative to Heart Drugs
  29. Test Predicts Prostate Cancer Death, Study Says
  30. Strong Parenting Cuts STDs in Black Teen Girls
  31. Syphilis Becoming Resistant to Oral Antibiotic
  32. A Little Dust Could Be Good for Tender Skin
  33. Obesity Risk Doubled for Kids of Obese Moms
  34. Lack of Insurance Tied to Early Death
  35. Aspirin Not Good for People with Heart Failure
  36. Health Tip: After a Tonsillectomy
  37. Triple Therapy Improves Diabetes Control
  38. Health Tip: Reducing Jet Lag
  39. Brief Screening Spots Domestic Abuse
  40. Cutting Down on Cutting During Surgery
  41. Arthritis Spares Flexible Fingers
  42. Genes Up Heart Attack Risk for African Americans
  43. Studies: New Blood Thinners No Better
  44. Study: Overweight Children Risk Iron Deficiency
  45. Early Vitamin Use Linked to Asthma, Study Finds
  46. Mediterranean Diet May Reduce Inflammation
  47. Parents Urged to Fight Kids' Obesity
  48. Soy Protein No Substitute for Hormones-Dutch Study
  49. Researchers Hunt for New Stem Cell Sources
  50. Fiber Curbs Estrogen in Breast Cancer Patients
  51. Milk, Calcium Intake May Lower Colon Cancer Risk
  52. Study Finds Cough Drugs No Better Than Sugar Syrup
  53. Parents Set Rules, But Kids Still See TV Violence
  54. Fosamax Boosts Bone in Older Women with Diabetes
  55. Brain Chemical Linked to Teen Suicides in Study
  56. Steady Dose of Stress Stresses Immune System
  57. Alzheimer's Mutations Found in Brain Cells
  58. High Scores on Video Games Pack on Pounds
  59. Ginseng Reduces Effects of Blood-Thinning Drug
  60. Silencing Huntington's Disease
  61. Leukemia Drug Side Effects Worse When Vitamins Low
  62. Findings Shed Light on Why Doctors Don't Wash Hands
  63. The ABCs on More Restful Zzzzzs
  64. Alzheimer's Gene Tied to Better Diet Response
  65. Health Tip: Ticked Off
  66. Chinese Herbs Hold Little Benefit for Hepatitis C
  67. Health Tip: Mountain Sickness
  68. Rural Poor Struggle to Find Healthy Food
  69. Saving Your Skin
  70. Experts Debate Effects of Violent Games
  71. Drug Breakthroughs Offer Hope for Parkinson's Patients
  72. Thalidomide Eyed for Virulent Cancers
  73. Cool Down When It's Hot


Friday, July 9, 2004


McDonald's Sued Over Fat in Cooking Oil



Friday, July 9, 2004

SAN FRANCISCO (Reuters) - A San Francisco area talk show host has filed a lawsuit against McDonald's Corp. accusing the world's largest fast-food restaurant company of failing to switch to healthier lower-fat cooking oil as it had pledged.

McDonald's said it had not yet seen of a copy of the lawsuit, filed on Thursday in federal district court in San Francisco.

The lawsuit was filed on behalf of radio talk show host Katherine Fettke by attorney Stephen Joseph, who also has sued to stop Kraft Foods Inc. from selling its popular Oreo cookies in California to children because the cookies contain trans fatty acids.

Trans fatty acids have been linked to increased levels of bad cholesterol and associated with clogged arteries.

The lawsuit filed on Thursday, which is seeking class action status, alleges McDonald's was not fully using a cooking oil with reduced levels of trans fatty acids and has yet to publicly disclose that in an effective manner.

The company had said in September 2002 it would switch cooking oil for use in its fried foods in a step toward eliminating trans fatty acids from its menu.

In the suit, Fettke claims that she would not have bought McDonald's Filet-O-Fish and French fries for herself and Happy Meals, Chicken McNuggets and crispy chicken sandwiches for her children several times last year had she known the oil switch had not taken place.

"If they had a solution, what's the problem here?" Fettke told Reuters. "I thought I was getting a better choice as far as fast food goes."

McDonald's spokeswoman Lisa Howard said the company's oil switch was progressing, though at a slower-than-expected pace.

"In February of 2003, we made a broad public statement that the change in our cooking oil was taking longer than anticipated and would be delayed," she said in a statement.

Since then, McDonald's has reduced levels of trans fatty acids in its McNuggets and other chicken foods and the company is "committed to getting it right for our customers," Howard said.

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U.N. Warns of Global HIV Women's Crisis


By Vijay Joshi

Associated Press Writer

The Associated Press

Friday, July 9, 2004

BANGKOK, Thailand - The United Nations (news - web sites) warned Friday of a global health crisis among women due to a dramatic rise in HIV (news - web sites) infections among them, largely because poverty has robbed them of the confidence to demand safe sex.

Since 1985, the percentage of HIV/AIDS (news - web sites) suffers who are adult women has risen from 35 percent to 48 percent. Young women now make up 60 percent of the 15-to-24-year-olds living with the disease, said the U.N. Development Fund for Women.

"Women are now firmly in the grip of the HIV/AIDS epidemic," Stephanie Urdang, UNIFEM's gender and HIV adviser, told a news conference.

The rising rate of infections among women is due largely to the fact that they are much less likely to be financially independent, are fearful of violence by men and in many parts of the world are regarded as socially inferior.

Women also bear the burden of caring for family members with the disease. Girls are withdrawn from schools to become caregivers for family members, and women are often required to work harder than men even though they may themselves be suffering from the disease.

Widows trying to provide for their children are frequently driven into the sex trade, the U.N. says. But because they desperately need the money, they are in no position to demand their customers wear condoms.

"They are often powerless to negotiate safe sex," said Urdang. "This should be a surprise to no one. Women have always been the most vulnerable group to HIV."

UNIFEM will release a comprehensive report on the emerging female crisis on Wednesday at the 15th International AIDS Conference in Bangkok, calling for greater political commitment, funding and collective leadership to be placed on gender issues, especially in Africa and Asia, the continents hit hardest by the epidemic.

Some 77 percent of all HIV positive women in the world live in sub-Saharan Africa.

"Some countries such as Uganda and Senegal have shown the political commitment but there is a long way to go," said Urdang.

Gender inequality is not just in Africa and Asia but also in the United States, where the HIV prevalence rate among women has jumped from 20 percent to 25 percent between 2001 and 2003, according to UNIFEM. A vast majority 80 percent of them are African-American and Hispanic.

In part, this is because women are not given adequate sex education in schools and the U.S. government does not believe in promoting condom use among young people.

Around the world, monogamy in marriage is also no guarantee for women against HIV, because they often cannot force unfaithful husbands to wear condoms.

There is now fear that Asia could become the next Africa because of a number of similarities such as endemic poverty, low levels of education and second-class status of women, said Lucita Lazo, UNIFEM's regional director.

The biggest danger zones are Cambodia, Myanmar and Thailand, where a recent U.N. study showed that only 23 percent of women aged 15 to 24 had a comprehensive understanding of HIV/AIDS.

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Firesetting, Animal Cruelty Tied to Poor Parenting


Reuters Health

Friday, July 9, 2004

NEW YORK (Reuters Health) - More evidence linking family dysfunction to conduct behavior problems in children, and eventually adolescent delinquency, comes from a new study.

Specifically, the findings show a link between childhood firesetting behavior and marital violence and paternal abuse of animals and alcohol. The study also ties cruelty to animals by children to marital violence and harsh parenting.

Dr. Kimberly D. Becker from the University of Hawaii and colleagues analyzed information provided in 1990 by 363 mothers and one of their 6- to 12-year-old children as part of a 10-year prospective study into the impact of marital violence on children's mental health.

The researchers conducted interviews with 86 percent of the original cohort in 1996 and 1998 and reviewed court records to gather information on juvenile delinquency.

As reported in the Journal of the American Academy of Child and Adolescent Psychiatry, children residing in homes where marital violence prevailed or where the father abused the family pet were more likely to set fires than children residing in homes in which they were not confronted with these behaviors. Having a father who drank alcohol also increased the odds of firesetting behavior.

Likewise, children from violent homes were 2.3 times more likely to be cruel to animals than were those from nonviolent homes. "Harsh parenting" also significantly increased the likelihood that a child would be cruel to animals.

Becker's team also found that children who set fires were 3 times more likely than non-firesetters to be referred to juvenile court and 3.3 times more likely to be arrested for a violent crime.

This study shows that firesetting behavior "is a statistically significant predictor for juvenile delinquency," the authors write. "Any indication of these behaviors should be taken seriously and addressed at an early age," they suggest.

Source: Journal of the American Academy of Child and Adolescent Psychiatry, July 2004.

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Doctors Skimp on Hand Hygiene

By Karen Pallarito
HealthDay Reporter


Friday, July 9, 2004

FRIDAY, July 9 (HealthDayNews) -- Many doctors fail to wash their hands when they should, and the worst offenders are those who work in operating rooms or emergency departments.

So finds a small study involving 163 medical students, residents and staff physicians at the University of Geneva Hospital in Switzerland.

Anesthesiologists were the least compliant, washing up only 23 percent of the times they should have. Surgeons, ranking second from the bottom, had only a 36 percent compliance record of practicing proper hand hygiene. Doctors in emergency medicine complied only 50 percent of the time, according to the report, which is published in this week's issue of the Annals of Internal Medicine.

"They are extremely busy and therefore it is difficult to comply," explained study author Dr. Didier Pittet, director of the Infection Control Program at University of Geneva Hospitals.

Overall, doctors practiced proper hand hygiene only 57 percent of the time when opportunities for hand washing arose, the study found.

Doctors in internal medicine, by contrast, had an 87 percent compliance rate -- the best of all of the medical specialties.

Despite efforts to encourage doctors to use good hand-hygiene practices, compliance remains universally low, experts said.

In the United States, "hand hygiene rates average 40 percent to 60 percent on a good day," Dr. Robert A. Weinstein, chairman of the Division of Infectious Diseases at Chicago's Stroger (Cook County) Hospital, noted in an accompanying editorial in the journal.

However, there's more at stake than personal grooming habits. Poor hand hygiene poses a real risk to patients, said Dr. Paul Schyve, vice president of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). It puts individual patients at risk of hospital-acquired infections and could lead to the spread of drug-resistant bacteria throughout a hospital.

In 2002, the U.S. Centers for Disease Control and Prevention (news - web sites) issued revised national recommendations that promote the use of alcohol-based hand rubs to decontaminate hands if they are not visibly soiled. Infection control experts say the rubs are effective, and because they are easy to use they should remove any obstacle to hand washing.

At University of Geneva Hospital, individual bottles of alcohol-based liquid hand disinfectant are available in all areas, and doctors are encouraged to carry bottles of the solution with them.

Still, two thirds of the doctors in the study perceived hand hygiene as a difficult task, "which is a disappointing response to the recently revised guidelines," Weinstein noted.

To understand why doctors are lax about hand hygiene, Pittet and his colleagues deployed trained observers to count the number of times that doctors should have cleaned their hands and record the number of times they actually did. Afterward, the physicians were asked to complete a questionnaire on their attitudes and beliefs about hand washing.

Researchers found adherence was higher but still not great when doctors were aware they were being observed --61 percent compared to 44 percent.

The authors say the findings underscore the importance of role models in motivating physicians to adopt better hand-washing habits.

"If a senior physician adheres appropriately to the practices, the odds for a junior to adopt the same behavior are high," Pittet explained.

Unfortunately, the opposite is also true. Poor adherence to hand hygiene practices, he added, sets a bad example that quickly will be replicated among trainees and more junior doctors, even if students and junior staff had planned to comply.

Recognizing the importance of hand hygiene, the JCAHO in 2004 set a new patient safety goal for all of its accredited hospitals in the United States aimed at reducing heath care-acquired infections. To maintain accreditation, hospitals must demonstrate that they comply with the CDC's hand hygiene guidelines.

There will be lapses, acknowledged Schyve. The point is to make sure hospitals have systems in place to encourage hand hygiene.

"We want to see what the organization has done to try to facilitate this," he said.

Weinstein argued that hand hygiene -- including use of alcohol rubs -- needs to be ingrained in doctors.

"Reasoning with people doesn't work anymore," he said. "Cleaning your hands with this stuff has to be your religion."

More information

Visit the U.S. Centers for Disease Control and Prevention to learn more about hand hygiene.

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Risk of Dementia Increases After Stroke

Reuters Health

Friday, July 9, 2004

NEW YORK (Reuters Health) - The likelihood of developing dementia is high after stroke, according to the results of a study published in the medical journal Neurology.

The study also found that the characteristics of post-stroke dementia appear to shift. In the first years after stroke it seems to be an Alzheimer-type disease, then changes to a vascular dementia type in later years.

Dr. Marta Altieri, of the University of Rome "La Sapienza," in Italy, and colleagues followed non-demented 191patients from 6 months after stroke onset for 4 years. The subjects underwent annual neuroimaging and neuropsychological tests.

Forty-one patients (21.5 percent) had developed dementia by the end of the follow-up period.

"Among the 41 patients who became demented, 26 (63.4 percent) met the criteria for probable vascular dementia and 15 (36.6 percent) for possible Alzheimer's disease (news - web sites)," Altieri and colleagues write.

The study "confirms data showing that dementia is a frequent consequence of stroke," the authors conclude.

Source: Neurology, June2004.

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Burn Calories, Lose Weight


Friday, July 9, 2004

FRIDAY, July 9 (HealthDayNews) -- While there is debate about the specific amount of time you need to exercise each week to get maximum health benefits, many experts agree that burning calories is a good way to maintain healthy weight.

Burning an extra 700 to 2,000 calories a week through exercise provides significant health benefits, says an article in the Harvard Heart Letter.

The number of calories you burn during exercise depends on your weight and the intensity and duration of your workout. For example, a 155-pound person:

The intensity of your exercise determines how fast you burn calories. Brief sessions of intense activity burn the same number of calories as longer or more frequent, but less intense, workouts.

Walking is an inexpensive and accessible way of burning calories, the Harvard Heart Letter says. Walking prevents or helps control high blood pressure, high cholesterol and diabetes. Treadmills are also a good way to burn calories.


More information


The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about physical activity and weight control.

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Stress Boosts Immunity, But Only in the Short Term

By Alison McCook

Reuters Health

Friday, July 9, 2004

NEW YORK (Reuters Health) - A short burst of stress appears to help the body fight off infections, but chronic stress may produce the opposite effect, according to a new report.

After reviewing 300 studies that investigated the link between stress and immunity, researchers found that short-term stress appears to rev up the immune system, while chronic stress produces changes in the body that seem to diminish immune functioning.

So are people who are under stress for months at a time -- a result of unemployment, for instance -- more prone to illness? Unfortunately, more research is needed to before researchers can make that conclusion, study author Dr. Suzanne C. Segerstrom cautioned.

This question is "not easy to answer from this body of research," she said.

Segerstrom and her co-author, Dr. Gregory Miller, based their report on a review of 293 studies conducted between 1960 and 2001, in which almost 19,000 people took part.

The researcher, who is based at the University of Kentucky in Lexington, explained that when we are stressed, our bodies release stress hormones, such as adrenaline and cortisol. When these hormones are intermittently present during brief periods of stress, they cause the body to release immune cells capable of quickly and efficiently fighting off infections.

"In essence, you're getting 'first responders' on the scene, in case something happens," Segerstrom told Reuters Health.

However, the picture is quite different once those stress hormones are present for prolonged periods, the authors report in the journal Psychological Bulletin.

Segerstrom explained that our bodies carry immune cells that respond only to specific triggers, such as one virus or bacterium. We don't have enough room to carry legions of each type of these cells, so when a particular trigger is present, the cell that targets that trigger makes multiple copies of itself and responds.

However, when people are under prolonged periods of stress, these trigger-specific cells don't multiply as well, thereby reducing their ability to fight the triggers, she said.

In an interview, Segerstrom explained that it makes sense that humans would develop a system that enables their bodies to fight off infections during short bursts of stress. When early humans were running from danger, for instance, they were more likely to get injured and a subsequent infection, and that short-term boosting of their immune system was likely a good source of protection, she said.

However, the change in immune system functioning with long-term stress "does not make as much sense," she said, and is likely an "unintended consequence" of chronic stress, which is relatively new, in evolutionary terms.

Long-term stress, such as from unemployment or poverty, "was just not characteristic of the kinds of things people experienced, until very recently," said Segerstrom.

Source: Psychological Bulletin, July 2004.

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Blood Test Predicts Kids' Food Allergies


Friday, July 9, 2004

FRIDAY, July 9 (HealthDayNews) -- Using a blood test to measure food-specific allergy antibodies can help pediatric allergists determine when to reintroduce children to food they may have been allergic to, a new study says.

The report provides pediatric allergists with guidelines on how to use these allergy antibody levels to determine which children should be given an additional allergy test, called a food oral challenge.

In this test, a child eats small amounts of a food allergen to determine whether the child is actually allergic to that particular food.

Researchers at Johns Hopkins Children's Center recommend the food oral challenge for milk, egg and peanut be performed on children with at least a 50-50 chance of passing. This recommendation is based on the results of the researcher's investigations into how well IgE antibody levels could predict children's reaction to the oral food challenge.

"These findings make it clear that doing a blood test to measure IgE levels can accurately predict how a patient will fare during a food challenge, and we recommend its routine use in clinical practice to screen children with suspected allergies before a food challenge is performed," study senior author Dr. Robert Wood, a pediatric allergist, said in a prepared statement.

The report appears in the July issue of the Journal of Allergy and Clinical Immunology.

More information

The U.S. Food and Drug Administration (news - web sites) has more about food allergies.

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Pregnancy Risky for Women with Heart Defect

Reuters Health

Friday, July 9, 2004

NEW YORK (Reuters Health) - Women with a congenital heart defect called tetralogy of Fallot can have successful pregnancies, but overall they have an increased risk for miscarriage and their offspring are at increased risk for birth defects, results of a study indicate.

In tetralogy of Fallot, major arteries are misconnected to the wrong chambers of the heart. The anomaly is usually corrected surgically in childhood.

"Although successful pregnancy has been documented in small series, data are incomplete for maternal and fetal outcomes in women with tetralogy of Fallot," Dr. Gruschen R. Veldtman and colleagues from the Mayo Clinic in Rochester, Minnesota note in the Journal of the American College of Cardiology.

In a review of data on 72 women with tetralogy of Fallot, the researchers found that 43 of the women had a total of 112 pregnancies and 82 of these pregnancies were successful. In eight women, tetralogy of Fallot remained unrepaired at the time of their successful pregnancies.

Adverse events for the mother were rare, but when they occurred they were often heart-related, the team reports. This was the case in five of the six women who experienced adverse events.

Unrepaired tetralogy of Fallot and abnormalities in the pulmonary artery were linked with low infant birth weight.

While premature delivery affected just 1 percent of women, 8.5 percent of infants were small for their gestational age; six out of the seven low-birthweight infants were born to women with unrepaired tetralogy of Fallot.

According to the medical records, the rate of spontaneous fetal loss was 24 percent, which is substantially higher than the national average of 10 percent, the team notes.

Birth defects, including congenital heart disease and stomach outlet obstruction, occurred in 6 percent of the infants, a rate double that seen in the general population.

In the journal, Dr. John S. Child comments that the findings are "reassuring in that women with well-repaired tetralogy of Fallot ... appear at an overall low risk of morbidity from pregnancy."

However, the editorialist from the Ahmanson-UCLA Adult Congenital Heart Disease Center in Los Angeles, adds that the relatively high rates of successful pregnancy plus the increased odds of birth defects in the children means that "the number of tetralogy of Fallot patients will steadily increase with each coming year."

Source: Journal of the American College of Cardiology, July 7, 2004.

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Added Protein Gives Sports Drinks Extra Kick


Friday, July 9, 2004

FRIDAY, July 9 (HealthDayNews) -- Adding protein to conventional sports drinks improves athletic performance and reduces post-exercise muscle damage, says a study in the July issue of Medicine & Science in Sports & Exercise.

The James Madison University study compared Gatorade to a new protein-containing sports drink called Accelerade in a double-blind, placebo-controlled study with bicycle athletes.

The cyclists drank either Gatorade or Accelerade and then completed an endurance test until they were exhausted. The athletes returned 15 hours later for a second endurance test. At that time, researchers took blood samples to measure CPK, a primary marker of muscle damage.

Those who drank Accelerade had a 29 percent improvement in endurance in the first exercise test and a 40 percent improvement in the second test, compared to those who drank Gatorade. The athletes who drank Accelerade had an 83 percent decrease in muscle damage compared to Gatorade drinkers.

"This study provides further confirmation of the value of adding protein to a conventional carbohydrate electrolyte sports drink. Our results suggest that athletes in all sports, including running, cycling, soccer and tennis, where endurance and recovery are critical would benefit from a protein-containing sports drink such as Accelerade," principal investigator Mike Saunders, director of the Human Performance Laboratory at James Madison University, said in a prepared statement.

"Although we did not evaluate the impact of a carbohydrate-protein sports drink on everyday athletes and weekend warriors, the fact that Accelerade significantly reduced muscle damage would be a great advantage because muscle soreness is a frequent post-exercise complaint," Saunders said.

The study was conducted and funded by the School of Kinesiology and Recreation Studies at James Madison University.

More information

The American Academy of Orthopaedic Surgeons has advice about sports nutrition.

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Report: Teens Seeing Too Many Magazine Alcohol Ads

By Amy Norton

Reuters Health

Friday, July 9, 2004

NEW YORK (Reuters Health) - Teenagers may be more likely than adults of legal drinking age to come across alcohol ads in their favorite magazines, new research suggests.

The study of advertisements in 103 national magazines found that while readers between the ages of 12 and 20 were seeing fewer alcohol ads in 2002 than in 2001, they were still exposed to such images more often than older readers were. And girls appeared particularly likely to be bombarded with alcohol advertisements.

The researchers say they would like to see the alcohol industry do a better job of targeting its ads toward legal drinkers while minimizing underage exposure.

They report the findings in the July issue of the Archives of Pediatrics & Adolescent Medicine.

The authors estimate that in 2002, a reader between the ages of 12 and 20 saw 45 percent more ads for beer and ale than one who was at least 21 years old. Underage readers also saw more ads for distilled spirits and beverages known as low-alcohol refreshers.

That latter category -- a group of typically sweet, fruity drinks -- was the only one for which teen ad exposure grew between 2001 and 2002. Girls saw 216 percent more ads for low-alcohol refreshers in 2002, while boys saw 46 percent more.

In general, the study authors found, teenage girls were particularly overexposed to alcohol advertising in magazines. They estimate that ads for beer and low-alcohol refreshers were slightly more effective in reaching underage girls than women between the ages of 21 and 34, the age group the alcohol industry considers its prime target.

There's no evidence that the industry is deliberately targeting underage readers with its ads, study leader Dr. David H. Jernigan told Reuters Health.

But the findings suggest a need for tighter control over who sees such advertising, according to Jernigan, who is research director at the Center on Alcohol Marketing and Youth at Georgetown University in Washington, D.C.

"We hope that the industry will do a better job of keeping ads from the eyeballs of youths," he said.

Jernigan also advocated ongoing research -- conducted, possibly, by public health officials -- to monitor how well alcohol advertisers are regulating themselves.

The question of whether alcohol advertising actually encourages kids to drink is controversial, and Jernigan noted that research has yielded mixed results. Parents and peers, he said, are clearly big influences.

Still, concern over the effects of ads is high enough that the Institute of Medicine (news - web sites), an independent organization that advises the federal government, has recommended that alcohol companies put stricter limits on where they place ads.

In the current study, a handful of magazines -- such as Cosmopolitan, Rolling Stone, Sports Illustrated and Entertainment Weekly -- were responsible for the bulk of teenagers' exposure to alcohol ads.

Why girls appeared particularly overexposed to the ads is unclear, Jernigan said, but one reason could be that girls read women's magazines more often than boys read publications for men.

An editorial published with the study calls for more research into the relationship between advertising and underage drinking. In it, Dr. Ralph Hingson of the Boston University School of Public Health points out that the alcohol industry spent $4 billion to promote its products in 2001.

"Given the unprecedented surge in alcohol advertising and promotion," he writes, "new rigorous studies are needed to establish whether those practices are increasing youth exposure to alcohol ads and in turn increasing their alcohol use."

Source: Archives of Pediatrics & Adolescent Medicine, July 2004.

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Thursday, July 8, 2004


Adult Stem Cells Transfer Improves Heart Function



Thursday, July 8, 2004

LONDON (Reuters) - Adult stem cells taken from bone marrow can improve heart function in patients who have suffered a heart attack, German researchers said on Friday.

Stem cells are master cells that can develop into specialized cells. They hold the promise of treating a range of illnesses such as Alzheimer's, diabetes and heart disease.

But their use is controversial because the most promising stem cells are derived from human embryos.

Dr Helmut Drexler, of the Medical University of Hannover in Germany, used adult stem cells from bone marrow of heart-attack patients to see if they could improve heart function.

"Our results lend support to the concept that ... bone-marrow cells can be used to enhance ... functional recovery in patients," he said in a report in The Lancet medical journal.

Drexler and his team randomly selected 60 patients who had had treatment following a heart attack to receive either an injection of the stem cells into the artery supplying the damaged area of the heart or standard therapy.

Six months later, the stem cell transfer patients had about a 7 percent improvement in function of the heart, compared to 0.7 percent in the other group.

Although the results are encouraging, Drexler said larger trials are needed.

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Gene Shutoff Prevents Epilepsy in Mice



Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- Switching off a specific gene prevents epilepsy in mice, says a study in the July 8 issue of Neuron.

Scientists from Duke University and the University of Texas Southwestern Medical Center found they were able to prevent epilepsy in mice by switching off the TrkB gene. This means the TrkB gene could prove a useful target for the development of new drugs to prevent development of epilepsy.

These kinds of drugs could be an improvement over current medications that reduce seizures in people who already have epilepsy but don't prevent development of the disorder.

While this study shows that TrkB may be an important target for drugs to prevent epilepsy, the researchers say there may be other potential targets that contribute to the development of epilepsy.

More information

The Epilepsy Foundation has more about epilepsy.

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Study: Fake Sweeteners Boost Rats' Eating


By Rick Callahan

Associated Press Writer

The Associated Press

Thursday, July 8, 2004

INDIANAPOLIS - Rats fed artificial sweeteners ate three times the calories of rats given sugar, a finding the study's authors said suggests sugar-free foods may play a role in the nation's obesity epidemic.

July issue of the International Journal of Obesity. The scientists said their rodent findings could help explain why Americans have grown fatter over the past two decades even as the nation's consumption of artificially sweetened sodas and snack foods has soared.

They contend that artificial sweeteners could be interfering with people's natural ability to regulate how much they eat by distinguishing between high- and low- calorie sweets.

As part of their study, they fed two groups of rats sweet-flavored liquids for 10 days. One group got only sugar-sweetened liquids, while the other was fed liquids sweetened by both sugar and saccharin.

After the 10 days, both groups of rats were given a sugary, chocolate-flavored snack and regular rat chow.

Both groups of rats ate about the same amount of the chocolate snack. But the rats fed both sugar and saccharin ate three times the calories of the rat chow than the rats fed only the sugar-sweetened drink.

Susan Swithers, an associate professor of psychological sciences at Purdue, said the findings suggest the rats given the saccharin-sweetened drink ate more rat chow because they experienced an inconsistent relationship between sweet taste and calories.

That, in turn, could confound their natural ability to keep track of calories.

"Consuming artificially sweetened products may interfere with one of the automatic processes our bodies use to regulate calorie intake," said Swithers, the study's co-author.

Adam Drewnowski, director of nutritional sciences at the University of Washington in Seattle, said that whatever caused the rats to overeat is unclear and could have been caused by something other than the sugar-free liquid they were fed. He said the rat results have no bearing on human research.

"They're extrapolating and saying that humans may not be adjusting to the artificial sweeteners because they're expecting calories and the calories are not coming in. I just think this is nonsense," he said.

Drewnowski said a 1994 French study he helped direct compared people given yogurt artificially sweetened with aspartame with people who ate yogurt sweetened with sugar. The study found no differences in eating behavior between the two groups.

Terry Davidson, a Purdue professor of psychological sciences, said the team's findings involving saccharin cannot be extended to more commonly used artificial sweeteners such as aspartame and sucralose, sold as Splenda.

G. Harvey Anderson, a professor of nutritional sciences at the University of Toronto who was not involved in the Purdue research, said its findings could be explained by the fact that rats like the taste of saccharin.

He said the rats who overate could have favored the saccharin-flavored drink and then compensated for its lack of calories by eating more rat chow. "I just find this data hard to interpret," Anderson said.

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Depression Ups Risk of 'Metabolic Syndrome'


By Alison McCook

Reuters Health

Thursday, July 8, 2004

NEW YORK (Reuters Health) - Women who have had an episode of depression have increased odds of having "metabolic syndrome" -- a cluster of conditions such as abdominal obesity, high blood pressure, elevated blood sugar and unhealthy cholesterol levels, that set the stage for type 2 diabetes, heart disease and stroke.

These findings, reported the journal Psychosomatic Medicine, may help explain why depression has long been linked to heart disease and other cardiovascular ills, the researchers write.

"Depressed individuals are more likely to engage in unhealthy behaviors, such as smoking, eating an unhealthy diet, leading a sedentary lifestyle, and being noncompliant with medical treatment," which may increase their risk of developing metabolic syndrome, Dr. Leslie S. Kinder told Reuters Health.

Kinder added that depression may also be linked to body changes that predispose people to metabolic syndrome and, consequently, cardiovascular disease.

"Women with depression should be aware that they may be especially vulnerable to medical problems, and therefore they should make special efforts to attend to their physical as well as their psychological health - through appropriate treatment and preventative therapies," noted the researcher, who is based at Stanford University School of Medicine in California.

To investigate whether depression's link to heart troubles stems from its effect on metabolic syndrome risk, Kinder and colleagues reviewed health data collected from 6189 men and women between the ages of 17 and 39 between 1988 and 1994. All participants were free of heart disease and diabetes.

The investigators found that women who had experienced an episode of major depression were twice as likely to have metabolic syndrome as women with no history of depression.

Women who were depressed were particularly likely to have high blood pressure and a high level of blood fats.

The relationship between depression and metabolic syndrome persisted even after the investigators removed the influence of smoking, age, physical activity and other factors that could affect the results.

The investigators found no such relationship in men, however, a finding they cannot yet explain, Kinder said.

The researcher noted that these results suggest that clinicians should be especially attentive when treating women with a history of depression.

"Clinicians should be aware that depression is a important concern among women with the metabolic syndrome," Kinder noted.

Source: Psychosomatic Medicine, May/June 2004.

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New Clue to Depression


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- Low brain levels of the inhibitory transmitter GABA and high levels of the excitatory neurotransmitter glutamate seem to be strongly associated with melancholic depression, says a Yale University study in the current issue of the Archives of General Psychiatry.

Melancholic depression is a common form of depression. Its symptoms include insomnia, loss of appetite and loss of pleasure.

"Depressed subjects with melancholic features appear to have the largest and most consistent GABA reductions," research leader Gerard Sanacora, director of the Yale Depression Research Program, said in a prepared statement.

"This also appears to be especially clear in the subset of melancholic subjects who also have psychotic features. In contrast, normal or near normal GABA concentrations were found in the majority of atypically depressed subjects," Sanacora said.

He and his colleagues used proton magnetic resonance spectrometry to record the levels of GABA and glutamate in 33 people with major depression and 38 healthy people.

The findings could help doctors more accurately diagnosis depression and provide more effective treatment.

"At the moment, we have limited ability to predict how a patient will respond to one treatment for depression compared to another," Sanacora said.

"We are very interested in exploring the usefulness of these and other biological markers in identifying various subtypes of depression and predicting specific treatment responses," he said.

More information

The American Medical Association has more about depression.

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Lead Exposure Still Poses Health Hazard - U.S. Govt


Thursday, July 8, 2004

WASHINGTON (Reuters) - Fewer U.S. adults are showing up with dangerously high lead levels, but lead remains a health threat, especially in the workplace, government researchers said on Thursday.

Lead in folk medicine and ceramics can also poison people, causing problems such as brain damage and miscarriages, the Centers for Disease Control and Prevention (news - web sites) said.

The CDC found 10,658 adults with high lead levels in 2002, 37 percent fewer than in 2001.

"Despite improvements in control of lead exposures, this hazard remains an occupational health problem in the United States," the CDC said in its weekly report on death and disease.

A sample of adults in 35 states showed that 95 percent of people with dangerously high levels of lead -- defined as 25 micrograms of lead per deciliter of blood for adults -- were exposed at work.

The CDC found that 58 percent were exposed in the manufacturing industry, 22 percent in the construction industry and 8 percent in mining.

Among the 338 people who did not get lead exposure at work, 23 percent were poisoned while shooting guns, 19 percent from remodeling projects, presumably as a result of breathing old lead paint, and 11 percent from bullets in their bodies.

Another 12 cases came from ayurveda, a traditional form of medicine practiced in India and other South Asian countries.

"Ayurvedic medications can contain herbs, minerals, metals, or animal products and are made in standardized and nonstandardized formulations," the CDC said.

In one New Hampshire case, a 37-year-old woman with rheumatoid arthritis ended up in the emergency room with abdominal pain, nausea, and vomiting. She had taken ayurvedic pills containing lead and had to undergo therapy using chemicals to attract and strip the lead out of her blood.

A 31-year-old California woman miscarried after taking nine ayurvedic medications for infertility, the CDC said.

Glazes on ceramic plates and serving dishes can also leach lead into food, the CDC warned. It described the case of a New York baby who had abnormally high lead levels at 12 months and again a year later. Water and paint in the house were untainted.

It turned out ceramic dinnerware imported from France was the culprit, the CDC said.

A complete listing of dinnerware that should not be imported because of lead content is available on the Internet at

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Soy Safe When It Comes to Breast Cancer


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- High dietary levels of natural plant estrogens found in soy don't appear to increase the risk of breast or uterine cancer, says a Wake Forest University Baptist Medical Center study.

"This is convincing evidence that at dietary levels, the estrogens found in soy do not stimulate cell growth and other markers for cancer risk," veterinarian and lead researcher Charles E. Wood said in a prepared statement.

"The findings should be especially interesting to women at high risk for breast cancer who take soy products," he said.

There's debate among experts about whether high levels of dietary soy -- which contain estrogen-like compounds called isoflavones or phytoestrogens -- are safe for postmenopausal women.

The most common form of hormone therapy, estrogen plus progestin, has been linked to an increased risk of breast cancer in postmenopausal women.

"Evidence from observational studies in women indicates that soy intake may help prevent breast cancer. But there has still been reluctance to conduct research studies in women because of concerns that isoflavones may stimulate breast cell growth and increase the risk of breast cancer," Wood said.

The study, which was conducted on monkeys, appears in the current issue of the Journal of Clinical Endocrinology & Metabolism.

More information

The American College of Obstetricians and Gynecologists has more about herbal products for menopause.

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Statins Can Be Given Soon After a Heart Attack

By David Douglas

Reuters Health

Thursday, July 8, 2004

NEW YORK (Reuters Health) - People who suffer a heart attack can be safely treated within a day with cholesterol-lowering "statin" drugs, Australian researchers report.

"We've shown that the standard dose of pravastatin (Pravachol) can be started within 24 hours of onset, without causing any adverse effects, and a with a trend toward a better outcome," lead investigator Dr. Peter L. Thompson told Reuters Health.

As described in the American Heart Journal, Dr. Thompson of Sir Charles Gairdner Hospital in Perth, and colleagues, studied 3408 patients who were randomly assigned to four weeks of daily treatment with pravastatin or to placebo.

Therapy was begun within 24 hours of the onset of severe chest pains or a heart attack.

By the end of the study, 11.6 percent of the pravastatin patients had died, had had another heart attack, or had been readmitted because of chest pains. In placebo patients, the figure was 12.4 percent.

This amounted to a relative risk reduction of 6.4 percent, which was not a statistically significant difference.

"Physicians are becoming aware that statins should now be regarded as an essential part of the treatment of a heart attack patient," Thompson commented, "and this trial shows that they can safely be started on day-1 in the coronary care unit."

He said the prognosis of patients with acute coronary disease "can be improved considerably by the commencement of statin therapy, even after the coronary occlusion has occurred, and the earlier these benefits can be brought to the unstable coronary patient, the better."

Source: American Heart Journal, July 2004.

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New Drug for Alzheimer's Disease to Be Tested


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- A potential new drug to treat Alzheimer's is being studied by researchers at about 40 sites around the world, including 34 in the United States.

Researchers are enrolling Alzheimer's patients with mild to moderate memory loss in the 12-week study to compare different doses of the drug -- which has no name -- to a placebo.

"We want to see if this drug will improve cognition or memory in Alzheimer's disease (news - web sites)," Dr. Jeffrey L. Rausch, vice chairman of the department of psychiatry and health behavior at the Medical College of Georgia, said in a prepared statement.

Rausch is one of the study's principal investigators.

This new drug, developed by Sanofi-Synthelabo, Inc. of France, may reduce the accumulation of destructive plaque that is the hallmark of Alzheimer's disease. Previous research found that the drug appears to improve memory and learning in animals.

More information

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

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CDC Suggests Boosting Dose of Prevnar Vaccine


Thursday, July 8, 2004

ATLANTA (Reuters) - U.S. health officials on Thursday recommended increasing the number of vaccine doses given to protect infants against meningitis and deadly blood infections, citing improved supplies of Wyeth's Prevnar.

The Centers for Disease Control and Prevention (news - web sites) said it is now advising doctors to administer three doses of the Prevnar vaccine per child. Earlier this year, the Atlanta agency had recommended cutting back doses to two per child from the full schedule of four in the wake of limited supplies.

Prevnar protects against strains of pneumococcal bacteria. It is recommended that the vaccine be given to children in four doses, at 2 months, 4 months, 6 months and 12 to 15 months of age.

In a statement, Wyeth said an increased supply of Prevnar was now available because of plant upgrades and added capacity. It also said it would assist doctors in calling back children who had missed their third dose.

The CDC said it would continue to monitor supplies and make additional recommendations if the supply situation changes.

Before a vaccine was available, pneumococcal infections caused more than 700 cases of meningitis, 13,000 blood infections and about 5 million ear infections, the CDC said.

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Pet Allergens Found in All U.S. Homes

By Amanda Gardner
HealthDay Reporter


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- The truth about pet dander is it may be more ubiquitous than you think.

Regardless of whether a dog or cat is in permanent residence, all homes in the United States contain dog and cat allergens, a new study claims. As a matter of fact, pet dander was present in almost 100 percent of the homes surveyed, even though dogs and cats only lived in half of those residences.

"Folks' sensitivity to cat and/or dog allergens are in all likelihood going to be exposed to detectable levels of those allergens in their environment regardless of where they live," said Dr. Darryl Zeldin, head of the asthma research program at the National Institute of Environmental Health Sciences (NIEHS). He is senior author of the study, which appears in the July issue of the Journal of Allergy and Clinical Immunology.

Such allergens are believed to contribute to asthma.

The researchers used data from the first National Survey of Lead and Allergens in Housing, which had been gathered in 1998 and 1999. The surveyors collected vacuumed dust samples from the bed, bedroom floor, living room floor and living room sofa in 831 housing units containing 2,456 people in 75 locations around the United States.

Dog and cat allergens were detected in 100 percent and 99.9 percent of homes, respectively, even though only 49.1 percent of the homes actually had such a pet. Most of the homes surveyed had levels that surpassed the proposed thresholds.

Sofas had the highest concentration of dog and cat allergens, indicating either that the pet ruled the house or the allergens rubbed off human clothing.

It's also likely allergens will be lower in communities where dog and cat ownership is less common, such as inner cities, Zeldin added.

Why would these allergens be found in homes without cats or dogs?

"One explanation is that the cat and dog allergies are transported on clothing," said Samuel J. Arbes, lead author of the study and clinical research coordinator at the NIEHS. "It's been shown that dog and cat allergens are present in public places -- on bus seats, in taxis, on park benches, in movie theaters, in hospitals, and even in the offices of allergists." This means they can easily be picked up and taken back home.

It's also possible that a pet lived in the house in the past.

The upshot is that reducing exposure to allergens may not be the most efficient route to controlling asthma and allergies. "For people who are allergic to dogs and cats, allergen avoidance may be very difficult, and it may be that people who are very allergic to dogs and cats may have to rely on medications as opposed to trying to avoid exposure," Arbes said.

"So long as the allergens are ubiquitous in communities, it can be very difficult for folks to avoid those allergens," Zeldin said. "Perhaps the approaches should not be on environmental intervention per se, but on other types of ways to modulate the response of an individual to those exposures such as medications, immune therapy or allergy shots."

According to Dr. Michael Marcus, director of allergy, immunology and pediatric pulmonology at Maimonides Medical Center in New York City, decreasing exposure should still help, but it's also necessary to focus on the underlying disease responses, especially because different people have different tolerance levels.

"We have to understand the underlying disease better, whether we're talking about allergic rhinitis or eczema or asthma," he said. "We need to look at the basic problem of the disease instead of trying to avoid the triggers of the disease as the only way of dealing with it."

More information

For more on asthma and allergy prevention, visit the National Institute of Environmental Health Sciences.

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Asthma Often Does Not Go Away as Kids Get Older

By Will Boggs, MD

Reuters Health

Thursday, July 8, 2004

NEW YORK (Reuters Health) - Contrary to the commonly held view, asthma does not remit during adolescence in many cases, according to a new study.

"Complete remission of asthma in adolescence and adulthood is less common than commonly believed," lead author Dr. Stefano Guerra from the University of Arizona College of Medicine, Tucson, told Reuters Health.

"Our findings are consistent with those from other longitudinal cohorts showing that more severe asthma cases are the ones less likely to remit in adulthood," he added

Guerra and colleagues used data from the Tucson Children's Respiratory Study to look at the factors influencing persistence and remission of childhood asthma after puberty.

After an average of 4 years following the onset of puberty, 58 percent of children continued to have wheezing episodes, the authors report in the American Journal of Respiratory and Critical Care Medicine.

Higher amounts of wheezing, recurrent cough, rhinitis, and sinusitis before puberty were associated with persistent asthma symptoms after puberty, the team found.

Also, children with persistent wheezing had a significantly higher body-mass index (BMI) than did children whose asthma remitted, the researchers note.

"The implementation of correct dietary and activity patterns among children with and without asthma is very much needed," Guerra said.

Increasing evidence "suggests that obesity in childhood cannot be considered a transitory condition with little long-term consequences," he commented. "Disrupted dietary patterns are frequently 'inherited' into adult life, and obesity in childhood not only affects respiratory symptoms and lung function in children, but it could even increase their susceptibility to develop chronic respiratory diseases as adults."

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

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Genetic Privacy Needs Protection

By Ed Edelson
HealthDay Reporter


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- More and more people are having their genetic information stored on databases, and not enough thought has been given to protecting their privacy, Stanford University researchers say.

Genetic databases are "a growth industry," said Dr. Russ B. Altman, a professor of genetics and medicine at the university, and lead author of a report in the July 9 issue of Science. "Now is the time for society to think about privacy issues and come up with answers," he said.

Keeping genetic information private is important because there are concerns about "discrimination, stigmatization or loss of insurance or employment for individuals and their relatives," said the report by Altman and his colleagues. Their research has found that a determined, knowledgeable person can extract specific information about people from databases, something that had been regarded as impossible.

Genetic databases have been made possible by the Human Genome Project (news - web sites), which has recorded the complete sequence of DNA units that govern the operation of the human body. Genetic information about hundreds of thousands of people now are in databases, some because they volunteered for scientific or medical studies, some because it was needed for medical treatment.

Each individual has his or her own genetic pattern, resulting from differences in DNA sequences called single nucleotide polymorphisms (SNPs). It had been assumed the sheer number of DNA units and SNPs would make it impossible to identify a person from the information in databases. But Altman said confidentiality appears to a lost hope, even if safeguards are built into databases.

The Stanford database run by Altman has about 5,000 entries. Efforts to manipulate the data so that secrecy about individuals could be maintained failed because "everything we tried ruined it for research," he said.

"This is an exhortation to policy makers to sit down and make significant rules about genetic databases because they have special characteristics that make them different from all other databases," he said.

One solution would be to set strict limits on who can create genetic databases and to establish systems that would limit access to those databases, Altman said.

Dr. Paul R. Billings is chairman of the Council for Responsible Genetics, a Massachusetts-based public interest group. He said the new Stanford report is important because "these are very highly qualified biostatisticians" who show that there are strategies "that result in a situation where anyone with a limited amount of genetic information about a person can find very intimate information about that person."

"It is easy to create databases, so we have to curb their creation and also punish people who use them for purposes that are not in the individual's or public good," said Billings, who is a professor of anthropology at the University of California, Berkeley.

Billings said he wrote a scientific paper more than a decade ago saying that "no matter how you do it, people will find a way to hack into them [genetic databases] for insurance purposes, marketing purposes or whatever. Currently, technological fixes for this challenge to privacy are inadequate."

More information

Learn more about the uses and possible misuses of genetic information from the National Human Genome Research Institute.

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Thyroid Disorders Common with Hepatitis C

By Will Boggs, MD

The Associated Press

Reuters Health

Thursday, July 8, 2004


NEW YORK (Reuters Health) - People chronically infected with hepatitis C virus (HCV) have a significantly increased rate of thyroid abnormalities, according to a new report.

This association "implies that these patients should be screened for thyroid function on a periodic basis," lead author Dr. Alessandro Antonelli from the University of Pisa School of Medicine, Italy, told Reuters Health. "A substantial proportion -- 13 percent in our series -- have hypothyroidism, and thus might benefit from treatment."

Thyroid involvement in HCV-infected patients has been reported previously, the authors explain in The American Journal of Medicine, but little is known about the prevalence and nature of thyroid disorders in such patients. Antonelli and colleagues looked into this in a study of 630 patients with chronic hepatitis due to HCV infection.

Significantly more HCV-infected patients than uninfected subjects or hepatitis B virus-infected patients were positive for anti-thyroid autoantibodies, the authors report.

Also, low thyroid function (hypothyroidism) was significantly more common among HCV-infected patients (13 percent) than among the comparison groups (3-5 percent).

"We are planning a population based epidemiological study to assess the association between thyroid disorders and HCV infection," Antonelli added. A possible association of HCV infection with thyroid cancer and diabetes is also under investigation.

Source: American Journal of Medicine, July 1, 2004.

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Gene Discovery Could Change Psychiatric Care

By E.J. Mundell
HealthDay Reporter


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- For the first time, researchers working with mice have identified a naturally occurring genetic mutation that affects brain levels of serotonin, a neurochemical linked to depression, anxiety and other psychiatric conditions.

The discovery may help explain why some patients feel much better after taking serotonin-altering antidepressants such as Paxil, Prozac and Zoloft, and why others do not.

The findings "suggest that there really are heritable differences in how the brain makes or synthesizes serotonin," said Dr. Jerrold Rosenbaum, chief of psychiatry at Massachusetts General Hospital in Boston.

"It gives us a whole new line of inquiry, both as to tailored treatment and to understanding how treatments work, and why there are differences in the response," he said.

Serotonin is a neurotransmitter, part of the chemical circuitry of the brain responsible for putting thought, emotion and action together to shape human behavior. In healthy individuals, serotonin and another neurotransmitter, dopamine, work together in a kind of "chemical balance" to keep mood and emotions relatively stable.

When that balance is upset, however, conditions such as chronic depression can result. Medications called selective serotonin reuptake inhibitors (SSRIs) work to keep serotonin at elevated concentrations, restoring that balance and elevating mood in the process.

But for years, psychiatrists have realized that SSRIs such as Celexa, Paxil, Prozac and Zoloft don't always work as expected in every patient.

In fact, "only 30 to 40 percent of people given an SSRI really get a high-quality response" from the drug, Rosenbaum said. "There are a lot of people who are getting a partial or incomplete response, or no response at all."

To better understand differences in serotonin concentrations between individuals, researchers led by Marc G. Caron, a professor of cell biology at Duke University, used mice to look closely at genes responsible for producing a brain enzyme called tryptophan hydroxylase-2 (Tph2).

Tph2 is suspected of being the main chemical instigator for serotonin production within the brain. When the Duke team focused on genes responsible for generating Tph2, they found startling differences between individual mice.

Reporting in the July 9 issue of Science, the researchers said one Tph2 gene variant was associated with normal levels of serotonin production within the mouse brain.

On the other hand, a second Tph2 gene -- varying from the first by only a single unit of DNA -- was associated with reductions in brain serotonin concentrations of between 50 percent to 70 percent.

Caron cautioned it's still not been proven that similar genetic differences will show up in humans. "We're hoping, however, that the results of our study give us a hint, a clue, as to what might be the potential differences in individuals."

But because humans tend to show much wider genetic variance than laboratory mice, Caron said he expects there will be more Tph2 gene variants in humans, not less. Studies focusing on differences in human DNA are already under way at Duke, he said.

Caron stressed that the Tph2 gene discovery marks the first time scientists have identified a "functional" gene variant linked to serotonin -- one that has a direct impact on levels of the neurotransmitter within the brain.

Although this research is in its infancy, the finding is "very exciting," he said, because it might someday help us understand "why patients have different sensitivities to various medications, or why they have varying susceptibilities to specific psychiatric conditions."

Rosenbaum said a better understanding of each patient's genetic vulnerabilities might also lead to what's known as psychiatric pharmacogenetics, "where you can screen for the presence or absence of a gene coding for one or the other of these enzymes. If there are differences between people, doctors will be able to predict in advance who'll respond to a serotonin-augmenting drug and who is less likely to do so, so you could spare the person ineffective trials or side effects."

"This is something we've always hoped to do," he said. "Rationally tailor treatment to the individual patient."

More information

To learn more about depression, visit the National Institute of Mental Health.

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Age at Menopause Not Linked to Death from Stroke

Reuters Health

Thursday, July 8, 2004

NEW YORK (Reuters Health) - Women who experience menopause at an early age seem to be prone to coronary heart disease, several recent studies have shown. However, a woman's age at menopause does not appear to be related to death from stroke, new research suggests.

As such, women who go through menopause in their early 40s are no more or less likely to die from stroke than women who don't experience this life transition until their 50s.

As reported in the medical journal Stroke, Dr. Bjarne J. Jacobsen, of the University of Tromso, Norway, and colleagues studied a group of 19,731 Norwegian women. There was a low rate of smoking in this population, and few women used hormone replacement therapy.

Over 37 years of follow-up, 3561 women died of stroke. There was no significant relationship between age at menopause and death from stroke. This held true for the two main types of stroke -- those that arise from blood vessel blockage and those that occur when a blood vessel ruptures.

"In summary, we find that age at...menopause is not related to stroke mortality," Jacobsen and colleagues conclude.

Source: Stroke, July 2004.

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Gene Therapy Offers Alternative to Heart Drugs


Thursday, July 8, 2004

THURSDAY, July 8 (HealthDayNews) -- A gene therapy that mimics the action of calcium channel blockers has been developed in research with guinea pigs by scientists at Johns Hopkins Medical Institutions.

Calcium channel blockers are widely used to treat heart diseases such as angina, hypertension, arrhythmias, and an enlarged heart.

It's believed this is the first successful effort to create gene therapy that mimics calcium channel blockers. The research may help scientists develop a gene therapy alternative to calcium channel blockers, which can cause severe side effects.

The study appears in the July 8 online issue of Circulation.

"Calcium channel blockers are a valuable tool in combating arrhythmias and other forms of heart disease, but they can cause low blood pressure, heart block, and constipation," study author Dr. Eduardo Marban, chief of cardiology at the Hopkins Institute of Molecular Cardiology, said in a prepared statement.

"Our basic research is trying to find new ways of harnessing the benefits of calcium channel blockers while avoiding the negative side effects of existing pill therapies, especially on other organs of the body. Our initial results with gene therapy are very promising," Marban said.

More information

The National Library of Medicine has more about calcium channel blockers.

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Wednesday, July 7, 2004


Test Predicts Prostate Cancer Death, Study Says


By Gene Emery


Wednesday, July 7, 2004

BOSTON (Reuters) - The PSA blood test widely used to detect prostate cancer can also predict who is most likely to die from the disease, researchers said on Wednesday.

The study, in this week's New England Journal of Medicine (news - web sites), added to evidence that the rate of increase in prostate-specific antigen level may be more important for predicting cancer than the actual PSA number.

The researchers said their study of 1,095 men showed that men need annual PSA tests so that their year-to-year change -- called PSA velocity -- can be monitored.

They found that when PSA levels rose by at least 2 points during the year before surgery, about one in four patients was dead from prostate cancer within seven years. It raised the risk of death 10-fold.

But if the PSA level had been increasing slowly before surgery, there was very little chance the patient would die from a prostate tumor.

"This study provides, for the first time, solid evidence that PSA testing over a period of time is a reliable indicator of possible risk of death from prostate cancer," said Dr. Anthony D'Amico of Massachusetts General Hospital in Boston, who helped lead the study.

Prostate specific antigen is a protein produced by cells in the prostate, the walnut-sized organ that sits against a man's rectum and produces the semen that carries sperm. The higher the PSA, the more likely the prostate is irritated by an infection or, perhaps, by cancer.

Prostate cancer (news - web sites) affects 220,000 U.S. men a year and kills about 29,000, according to the American Cancer Society (news - web sites).

PSA High

If a man's PSA looks high or looks like it has risen recently, a urologist will usually recommend a biopsy to remove some tissue from the organ to see if it is cancerous.

"A man whose PSA is 3.5 may have nothing to worry about if it was 3.49 the year before, but a lot to worry about if PSA last year was 1," D'Amico said in a telephone interview.

Starting around age 35 or 40, men need annual screening to set their "baseline" PSA level, against which change can be measured, he said.

"The nice thing about starting at age 40 is most men at 40 have a PSA that is like 0.6 or something like that," added Dr. William Catalona of Northwestern University in Chicago, who also helped direct the study.

"If your next annual PSA goes to 1.4, well, you shouldn't wait until next year to check it again."

This contradicts the usual guidelines, which suggest that men can relax until their PSA level reaches 4, Catalona said.

He got the idea of checking "PSA velocity" while doing a large study of 36,000 men over 12 years.

"I had some men come in and their PSA would be 0.6 one year, then 1.4 the next, then 2.4, then 3.2. There would be an obvious trend, and I would say 'We can't do a biopsy until the PSA reaches 4'," Catalona added.

"Then they'd come in and have a PSA of 6," he said. The men would get immediate surgery to get their prostates out and many times the cancer had already spread.

"Then they'd be really angry," Catalona said.

Prostate cancer can be a slow-growing disease and some men are advised just to watch it carefully -- especially if they are older and likely to die of something else before the prostate cancer becomes serious. (Additional reporting by Maggie Fox in Washington)

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Strong Parenting Cuts STDs in Black Teen Girls



Wednesday, July 7, 2004

WEDNESDAY, July 7 (HealthDayNews) -- Parental supervision may help reduce the risk of some sexually transmitted diseases (STDs) in black teenage girls, says a study in the July issue of the Archives of Pediatrics & Adolescent Medicine.

Johns Hopkins researchers found that black teenage girls who had high levels of parental supervision had lower rates of gonorrhea and chlamydia infections than girls with low levels of parental supervision.

The study included 158 girls, aged 14 to 19, recruited from two urban health clinics -- one a public STD clinic and the other a hospital-based adolescent medicine clinic. Fewer than 20 percent of the girls' parents were married or living together.

While high levels of parental supervision were linked with reduced levels of gonorrhea and chlamydia infections, high levels of parental discussion about STDs were not, the study found.

"Parental involvement as a strategy for promoting protective behaviors among adolescents is increasingly a subject of research, and our results provide further evidence that interventions designed to increase parental involvement may affect not only adolescent behavior but disease acquisition as well," the study authors write.

More information

The Nemours Foundation has advice on how to talk with your children about sexually transmitted diseases.

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Syphilis Becoming Resistant to Oral Antibiotic


By Megan Rauscher

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - Some strains of the bacterium that causes syphilis have developed a mutation that makes them resistant to Zithromax (known generically as azithromycin), doctors warn in this week's New England Journal of Medicine (news - web sites).

"This is important because an increasing number of physicians are azithromycin using for treatment of patients with syphilis and for sexual contacts," Dr. Sheila A. Lukehart, from Harborview Medical Center in Seattle, told Reuters Health.

The recommended treatment for syphilis is penicillin, to which there is currently no evidence of resistance. "However, penicillin injections are painful for the patient," Lukehart noted, "and physicians have been looking for an alternative treatment that can be taken by mouth. Azithromycin has looked very hopeful in this regard."

In their report, Lukehart and colleagues describe one syphilis patient, "among several cases that have been recognized," for whom treatment with azithromycin failed. A specimen from this patient revealed a mutation in one of the microbe's genes and lab tests confirmed that the bug was resistant to azithromycin.

Lukehart's team subsequently found this azithromycin-resistance mutation in 11 percent to 88 percent of syphilis samples obtained in four different regions in the US and Ireland.

"These findings suggest that physicians should be very cautious about using azithromycin for treatment of syphilis until they know whether the strains in their geographical region are sensitive or resistant," Lukehart told Reuters Health.

Two editorialists agree, saying that azithromycin for syphilis "is not recommended unless careful follow-up can be ensured."

Source: New England Journal of Medicine, July 8, 2004.

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A Little Dust Could Be Good for Tender Skin


Wednesday, July 7, 2004

WEDNESDAY, July 7 (HealthDayNews) -- High levels of endotoxin, a bacterial toxin found in house dust, may protect infants from eczema, says a study done as part of the ongoing Boston-based Home Allergens and Asthma study.

Researchers collected dust samples from the living rooms of homes that had 400 infants. The dust samples were analyzed for endotoxin, a component of cell walls of various bacteria.

Infants in homes with higher levels of endotoxin were less likely to be diagnosed with eczema in their first year of life. Infants in homes with dogs were also less likely to have eczema, but this relationship weakened after the researchers adjusted for endotoxin exposure.

The risk of eczema was higher in infants whose fathers had a history of eczema and whose mothers were sensitive to at least one allergen.

This study appears to support the controversial theory that early exposure to infectious inflammatory agents changes infants' immune systems and makes them less likely to develop allergies later in life.

But parents shouldn't buy pets or stop cleaning their homes to protect their infants from eczema, said study leader Dr. Wanda Phipatanakul, a pediatric allergist and immunologist at Children's Hospital Boston and assistant professor of pediatrics at Harvard Medical School (news - web sites).

"We now know that there are things in the environment that may be important in eczema. But you need lots of studies to be able to come up with recommendations," she said.

It's not clear what endotoxin does to the immune syste, and previous research has linked endotoxin exposure with wheezing and airway inflammation in people with asthma, she said.

More information

The Nemours Foundation has more about eczema.

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Obesity Risk Doubled for Kids of Obese Moms

By Merritt McKinney

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - Children whose mothers were obese when they became pregnant are at increased risk of becoming obese themselves, according to a new study.

The results highlight the importance of starting early to prevent childhood obesity, the study's author told Reuters Health.

"Compared to children born to mothers who are of normal weight in early pregnancy, those children born to mothers who are obese in early pregnancy are twice as likely to be obese by the time they reach school age," said Dr. Robert C. Whitaker of Mathematica Policy Research, Inc., a nonpartisan firm in Princeton, New Jersey.

"Obesity prevention strategies should begin at, or even before, birth," said Whitaker, who was at the University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center in Ohio when the study was conducted.

Obesity is well known to run in families, but until now there has been no study on the relationship between a mother's weight during pregnancy and her child's odds of becoming obese by preschool age.

Whitaker studied more than 8,000 preschool children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition program.

More than 30 percent of the children's mothers had been obese during the first trimester of pregnancy.

By age 4, almost one out of every four children born to an obese mother was obese, compared to fewer than one out of 10 children born to non-obese mothers, Whitaker reports in the online edition of the journal Pediatrics. The risk was increased even after taking into account birth weight.

There are several possible explanations for the apparent link between maternal obesity and an increased risk of child obesity, according to Whitaker. A child may inherit maternal genes that increase the risk of obesity. Another possibility is that a mother's obesity may somehow affect a child's development in the womb.

An obese mother may also increase her child's risk of obesity by the choices she makes about a child's food and physical activity, Whitaker notes.

The bad news, according to Whitaker, is that many children in WIC are at risk for obesity because so many women in the program are obese.

But a more optimistic attitude is that the period before conception, during pregnancy and a child's first years all offer "important opportunities to prevent obesity by affecting an intergenerational cycle that promotes obesity," Whitaker notes in the report.

Source: Pediatrics, July 2004.

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Lack of Insurance Tied to Early Death

By Amanda Gardner
HealthDay Reporter


Wednesday, July 7, 2004

WEDNESDAY, July 7 (HealthDayNews) -- Americans who lack health insurance when approaching retirement age are 43 percent more likely to die prematurely than their peers who have insurance.

That translates into 105,000 potentially preventable deaths in the next eight years, or about 13,000 annually, among people aged 55 to 64 who lack health insurance, said the authors of an article appearing in the July issue of Health Affairs. The study is the first in more than a decade to look at this particular topic.

"We were surprised by the sheer number of deaths," said study author Dr. J. Michael McWilliams, a medical resident at Brigham and Women's Hospital in Boston. "That would place uninsurance third on the list of causes of death after heart disease and cancer for this age group, although obviously that's double-counting."

About 3.5 million people aged 55 to 64 were uninsured in the United States in 2002. This age group is expected to double to about 62 million within the next 10 years. Assuming the same rate of uninsured people, that means the number of potentially preventable deaths may rise to more than 30,000 a year.

"That is more than the number of adults in this age group currently dying from diabetes, stroke and lung disease combined," McWilliams said.

The new research surfaces as presidential candidates prepare to address the issue of health-care coverage. "Both candidates have plans, but both have major challenges," McWilliams said.

The near-elderly age group is a particularly vulnerable one as health problems start to increase during this period, before these people are eligible for Medicare. "The consequences of being uninsured are more severe," McWilliams said.

Some experts feel an opportunity is being missed.

"This is the age group that is probably the most important age group from a health standpoint," said Dr. Michael L. Freedman, a professor of geriatric medicine and internal medicine at New York University School of Medicine. "This is the kind of group you do all your screening in, where your highest yield and the biggest cure rate comes up. The study has shown that this could affect a lot of the health of the country. These are the people that everyone should be going after."

The researchers followed 8,736 near-elderly adults, 7,199 of whom had private insurance and 1,537 of whom were uninsured in 1992. The study lasted eight years, until 2000.

Uninsured participants were 43 percent more likely to die early during the study period than those who were insured. Uninsured adults with low incomes were 53 percent more likely to die prematurely, while those with diabetes, hypertension or heart disease were 56 percent more likely to die before their time.

Death rates did not differ significantly between insured and uninsured black adults, indicating that health insurance alone may not be enough to reduce premature deaths.

Although the association is not a definitive, cause-and-effect one, it certainly raises a red flag. "It's hard to prove, but certainly there's a strong association between being uninsured and poorer health outcomes. And this study targets a population where that association may be particularly strong, and where reform may be particularly beneficial," McWilliams said.

Expanding coverage to this segment of the population could save thousands of lives, McWilliams added.

The authors point out, however, that all of the major policy options put forth have limitations. A Medicare buy-in would require premium subsidies. The tax credits proposed by President Bush (news - web sites) are unlikely to be large enough, although those proposed by the presumptive Democratic presidential nominee, John Kerry (news - web sites), are more generous, they said.

Taking care of chronic diseases early and engaging in preventive medicine will also limit the burden on Medicare as this population becomes eligible for that program, McWilliams added.

More information

AARP has more on insurance before being eligible for Medicare.

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Aspirin Not Good for People with Heart Failure

By Will Boggs, MD

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - People with heart failure are often put on blood-thinning regimens with aspirin or sometimes Coumadin (warfarin), but a new study indicates that this is not helpful and could even be harmful.

Heart failure patients have an increased risk for thrombosis-related events like stroke or heart attacks, but as the authors of the study point out in the American Heart Journal, "Just because patients are at increased risk of events does not mean that antithrombotic therapy is safe or effective."

And in fact, results from the Warfarin/Aspirin Study in Heart Failure (WASH) show that aspirin and warfarin provide no meaningful benefit to patients with heart failure.

"I am sure that with time the medical scientific community will come round to the view that the benefit/risk ratio for antithrombotic therapy in heart failure is unclear and that further placebo-controlled studies (as in WASH) will be necessary," lead author Dr. John G. F. Cleland from University of Hull, UK, told Reuters Health.

Cleland and his colleagues compared no antithrombotic therapy with aspirin or warfarin in 279 patients with heart failure requiring diuretic therapy.

There was no significant difference in rates of death, nonfatal heart attacks, or nonfatal stroke among the three groups, the authors report.

However, those participants assigned to aspirin therapy were twice as likely as patients on warfarin to be hospitalized or to die of a cardiovascular cause during the first 12 months of follow-up.

The three groups experienced similar numbers of serious adverse events, the researchers note, but aspirin patients were significantly more likely to have serious gastrointestinal events.

Minor bleeding complications were also more common in the aspirin and warfarin groups than in the no-antithrombotic group, the researchers found.

Treatment with multiple drugs "is a big problem in patients with heart failure," Cleland noted. "Treatments that are not shown to be effective should be withdrawn."

He added, "The data on aspirin in particular is worrying and suggests that any theoretical benefit is outweighed by real evidence of harm."

Source: American Heart Journal, July 2004.

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Health Tip: After a Tonsillectomy


Wednesday, July 7, 2004

(HealthDayNews) -- If your child is scheduled for a tonsillectomy, you can expect him to feel lousy for a week or more after surgery, says Winnipeg Children's Hospital.

Expect your child to have:

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Triple Therapy Improves Diabetes Control

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - Treatment with insulin plus two types of insulin sensitizing drugs improves glucose control in people with type 2 diabetes, without triggering weight gain, according to a new study.

Dual therapy with insulin and Glucophage (metformin) or insulin and Rezulin (troglitazone) has been shown to lower blood glucose levels in type 2 diabetic subjects, the authors explain in the July issue of Diabetes Care, but combined therapy with all three drugs has not been investigated.

Rezulin was withdrawn from the market in 2000, but other "glitazone" drugs in this class such Avandia (rosiglitazone) and Actos (pioglitazone) are available.

Dr. Philip Raskin and colleagues from University of Texas Southwestern Medical Center, Dallas, compared dual therapy with triple therapy in 28 subjects with type 2 diabetes.

Control of glucose levels improved with dual therapy and further improved after 4 months of triple therapy, the authors report. Triple drug therapy was also associated with a significant decrease in the total daily insulin dose.

Subjects initially assigned to take insulin and troglitazone gained an average of about 10 pounds in weight after 4 months, but gained no more when metformin was added. In contrast, the researchers note, those who started out on insulin and metformin did not gain weight during the initial 4 months or during the 4 months after troglitazone was added.

"These results suggest that weight gain and possibly hypoglycemia can be minimized if insulin and metformin are administered before the addition of a (glitazone) if further improvement in glycemic control is desired," the investigators write.

With more than one-third of people with type 2 diabetic individuals in the U.S. having inadequately controlled glucose levels, the authors conclude, "Triple therapy using insulin and both classes of insulin sensitizers provides a pharmacologic alternative in the pursuit of improved glycemic control."

Diabetes Care 2004;27:1577-1583.

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Health Tip: Reducing Jet Lag


Wednesday, July 7, 2004

(HealthDayNews) -- Do your summer plans include traveling by air across several time zones? If so, you're bound to experience some form of jet lag as your body's internal clock tries to adapt.

Reduce the effects of jet lag with these suggestions, courtesy of Valley View Hospital in Colorado.

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Brief Screening Spots Domestic Abuse

By Alison McCook

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - It takes only a few minutes and a couple of questions to spot many hidden cases of domestic abuse in adults accompanying children to their pediatricians, new research shows.

Investigators found that asking parents to answer a few questions while waiting for their children to be seen by the doctor spotted 24 cases of home violence over a three-month period. In contrast, during the same three-month period in the previous year, clinicians uncovered only five cases of domestic abuse.

"That's kind of how we know it works," study author Doris Sisk told Reuters Health.

Sisk added that it is important to screen adults who accompany children to the doctors' office because research shows that where there is domestic abuse, there is often child abuse as well.

She and her colleagues screened mothers "with the hope that we could be preventing some child abuse if we intervene with the mom," she said.

According to the report, approximately 10 million children are exposed to domestic violence every year in the U.S. alone. Up to 30 percent of women may experience domestic violence at least once over the course of their lives.

During the experiment, Sisk and her colleagues asked every parent bringing a child to an out-patient pediatric clinic to complete a short questionnaire about domestic violence while waiting to see the doctor. Questionnaires were designed differently for children of different ages, and the longest included 12 questions.

Questions included whether a parent had been or was currently in a relationship where they were hit, kicked, slapped or punched; whether they were physically hurt by anyone during pregnancy; and whether their partner was verbally abusive.

During the first three months that Sisk's team distributed the questionnaire, 1,622 children visited the pediatric clinic, the authors report in the journal BMC Medicine.

Sisk and her colleagues at the University of Arizona found that the questionnaire increased the odds of identifying instances of current domestic abuse by more than three-fold.

In an interview, Sisk said that this is the first time clinicians have tried to administer a screening tool for domestic abuse in a pediatric clinic. She noted that the goal is to reach out to mothers, but that the tool would likely work best if offered to every adult that brings a child to the pediatrician.

She explained that research has shown that women do not necessarily volunteer the fact that they are experiencing home violence, but will often admit it if they are asked.

She added that when women say they are being abused, doctors and social workers will often meet with them in private, and discuss what services can help them deal with their current situation, such as shelters or counseling.

They will also often ask mothers if they have noticed any changes in their children's behavior, such as acting out or depression, which can be related to the domestic abuse, Sisk noted.

She added that she is obligated to report if a child is being abused, but she will often include the child's mother in that process to ensure she realizes that the purpose is to protect the child, and not punish the mother for reporting the problem.

Source: BMC Medicine, June 30, 2004.

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Cutting Down on Cutting During Surgery


Wednesday, July 7, 2004

WEDNESDAY, July 7 (HealthDayNews) -- A new minimally invasive surgical technique that eliminates the need for abdominal incisions may mean less pain, quicker recoveries and fewer complications than traditional open abdominal surgery.

This new technique, flexible transgastric peritoneoscopy (FTP), was developed by scientists at Johns Hopkins Medical Institutions. Animal studies indicate it's safe, but it has not been tested in human clinical trials.

With FTP, a flexible mini-telescope (endoscope) and related surgical tools are inserted through the mouth and into the stomach. After puncturing the stomach wall and the thin membrane surrounding the stomach, surgeons are able to see and repair any of the abdominal organs, including the intestines, liver, pancreas, gallbladder and uterus.

"FTP may dramatically change the way we practice surgery," study author Dr. Anthony Kalloo, an associate professor of medicine and director of gastrointestinal endoscopy, said in a prepared statement.

"The technique is less invasive than even laparoscopy because we don't have to cut through the skin and muscle of the abdomen, and it may prove a viable alternative to existing surgical procedure," Kalloo said.

The study appears in the July issue of Gastrointestinal Endoscopy.

More information

The Cleveland Clinic Foundation has information about laparoscopic intestinal surgery.

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Arthritis Spares Flexible Fingers

Reuters Health

Wednesday, July 7, 2004

NEW YORK (Reuters Health) - People with unusually flexible fingers seem to be able to give the slip to osteoarthritis in the hand, new research suggests.

The study of 1,043 men and women found that the 4 percent with "hypermobile" joints -- commonly called double-jointedness -- were two-thirds less likely than their less flexible peers to have arthritis in the middle joint of the finger.

A similar benefit was seen among adults whose joints were highly flexible in their youth but had since grown rusty, according to findings published in the journal Arthritis & Rheumatism.

All of the study participants were at risk of extensive hand arthritis because all had a family history of the condition and each had shown X-ray evidence of arthritis in the joint near the fingertip.

The results are somewhat surprising since joint hypermobility has been suspected of raising the risk of osteoarthritis, the form of arthritis associated with aging and caused by wear and tear of the joints.

One study has linked extreme joint flexibility to a higher risk of knee arthritis. It's thought that excessive range of motion in a joint may put abnormal stress on it, as well as raise the risk of injury -- both of which may predispose a person to arthritis.

But in this study, flexibility -- and limber fingers, in particular -- appeared to be an asset.

The researchers, led by Dr. Virginia B. Kraus of Duke University Medical Center in Durham, North Carolina, assessed hypermobility with a series of standard tests. Two of the tests looked at how far backward the little finger and thumb could bend. An analysis of a sub-group of the participants showed that all who were deemed hypermobile owed the label, in part, to highly bendable digits.

A previous study found that joint hypermobility appeared to protect against arthritis in musicians who need nimble fingers, such as flutists and string musicians.

The current findings, Kraus and her colleagues conclude, suggest that extreme joint mobility may stave off hand arthritis even in people who are genetically predisposed.

According to the researchers, a person's grip strength may sway the risk of developing arthritis in the fingers, and research suggests that hypermobile people tend to have lesser grip strength. It's possible, they suggest, that hypermobility alters joint stress produced during gripping or pinching motions.

Source: Arthritis & Rheumatism, July 2004.

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Tuesday, July 6, 2004


Genes Up Heart Attack Risk for African Americans


By Will Boggs, MD

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - African Americans are more likely than European Americans to have variations in their genes that have been linked to an increased heart attack risk, according to a new report.

The findings open up the possibility that genetic testing might one day be used to identify people with a high risk for heart disease.

"This is not yet reality but one could easily imagine a panel of genetic variants that would help predict risk of coronary artery disease (CAD), or risk of events in those with known CAD," Dr. David E. Lanfear from Washington University School of Medicine in St. Louis, Missouri, told Reuters Health.

Lanfear and colleagues examined DNA from 95 healthy African Americans and 95 healthy European Americans for variations in three genes that have been found to correlate with heart attacks in Japanese subjects.

The high-risk types of two of the three genes (termed MMP-3 and PAI-1) were found significantly more often in African Americans than in European Americans, the authors report in the Journal of the American College of Cardiology.

Moreover, having two copies of at least two high-risk genes was far more common among African Americans (51 percent) than among European Americans (3 percent), the report indicates.

There is a large ongoing study "in which we will be connecting these and other variants to clinical outcomes in both African Americans and European Americans," Lanfear concluded. "This will help determine if there is predictive value to these variants for those with established CAD."

Source: Journal of the American College of Cardiology, July 2004.

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Studies: New Blood Thinners No Better

By Tara Burghart

Associated Press Writer

The Associated Press

Tuesday, July 6, 2004

CHICAGO - A newer blood thinner is no better than the old standby at treating victims of heart attacks or chest pain, according to two major studies involving nearly 14,000 patients.

While the newer drug enoxaparin is more convenient to use than heparin, it also caused modest increases in bleeding, the studies found.

The results are likely to add to the debate among cardiologists over which drug to use.

The studies appear in Wednesday's Journal of the American Medical Association (news - web sites). One was funded by enoxaparin's maker, New Jersey-based Aventis Inc.

Dr. David Moliterno, author of a JAMA editorial, said the results "look pretty darn lackluster," given earlier, smaller studies clearly favoring enoxaparin over heparin.

He estimated 30 percent of heart patients receive enoxaparin but said most doctors have a favored drug and predicted the studies would do little to change their preferences.

"I think this gives some fodder for each argument naysayers who say we don't need to bother using enoxaparins, that they only provide a marginal benefit but still a bleeding risk. And supporters who say ... you can use this drug and it's safe," said Moliterno, chief of cardiovascular medicine at the University of Kentucky at Lexington.

A third study also funded by Aventis analyzed results from six studies including the two new ones and found that enoxaparin was more effective than the old standby, heparin. But other doctors questioned the findings since the analysis included older data from when treatment practices were different.

Heparin has been used for several decades to treat blood clots in heart patients. Enoxaparin, which is sold under the brand name Lovenox, is one of several newer, more potent heparin varieties with a lower molecular weight. Enoxaparin was approved by the Food and Drug Administration (news - web sites) in the late 1990s for use in heart patients.

Enoxparin costs about $100 a day, several times more than heparin, Moliterno said. But enoxaparin supporters say the newer drug is ultimately the same in cost or cheaper because it is easier to administer. Unlike heparin, it can be delivered by injection rather than a continuous IV drip and does not require blood tests to monitor how it is working.

Both studies were conducted by researchers at Duke Clinical Research Institute in Durham, N.C., and other institutions.

The larger study looked at about 10,000 patients and found that 14 percent of those who got enoxaparin died or suffered repeat heart attacks in the 30 days afterward, compared with 14.5 percent of those who were given heparin.

However, patients treated with enoxaparin did experience more bleeding usually at the site in the groin where a heart catheter was inserted but rarely enough to cause complications.

The smaller study involved almost 4,000 patients who were also treated with other drugs commonly given to heart patients. It found no difference in effectiveness between enoxaparin and heparin.

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Study: Overweight Children Risk Iron Deficiency


Tuesday, July 6, 2004

CHICAGO (Reuters) - Overweight children are at double the risk of being iron deficient, perhaps because of bad diet or lack of exercise, a study said on Tuesday.

Iron deficiency is a global problem most commonly found in poorer people lacking proper nutrition, but the study concluded that the rising number of obese people in the developed world should be checked and treated for it.

Too little iron in the blood can cause anemia and lead to learning and behavioral problems as well as pose limits on work and exercise.

One out of seven U.S. children is overweight, a three-fold increase in the past 30 years, and many do not get screened for iron deficiency, Yale University researcher Karen Nead wrote in the journal Pediatrics.

In her study of 10,000 children aged 2 to 16, nearly one in 10 of the overweight teenagers was iron deficient. Among 2- to 5-year-olds, 6 percent were iron deficient.

Overall, the rate of iron deficiency was double among overweight children compared to normal-weight children and was more likely the higher the children's body mass index, a ratio of weight to height known as BMI.

The association between iron deficiency and being overweight may be caused by lack of exercise or a diet lacking in iron-rich foods, the study said.

It also said that genetics could play a role, and that overweight girls tend to grow faster than their peers, making it difficult for them to keep up with their bodies' iron requirements.

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Early Vitamin Use Linked to Asthma, Study Finds


Tuesday, July 6, 2004

CHICAGO (Reuters) - A study of more than 8,000 infants found a possible link between the use of multivitamin supplements and the risk of asthma and food allergies, researchers said on Tuesday.

The report from Children's National Medical Center in Washington and other research centers said the reason for the apparent link was not clear. It suggested more study is required to find if the link is a factor in an increase in asthmatic and allergic disease in recent years.

The research was based on data from a government study that began following mothers and infants in 1991.

It found "an association between early infant multivitamin intake and asthma among black infants and an association between early infant multivitamin intake and food allergies in formula-fed infants."

It also found an increased risk of food allergies among all children given multivitamins at age 3.

The researchers said more than half of all toddlers in the United States are taking multivitamins, which are also often added to infant formula. The report said animal tests have found certain vitamins may cause cell changes that can increase the odds of an allergic response when certain antigens are encountered.

If the line of research bears out, "recommendations for vitamin supplementation and the actual multivitamin formulation may need to be changed to reduce the risks of allergy and asthma," the study said.

There could be a number of reasons why black children had the higher asthma risk, including "physician-parent communication issues," the authors said in urging further research into the issue.

The study appeared in the July issue of Pediatrics, the journal of the American Academy of Pediatrics.

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Mediterranean Diet May Reduce Inflammation

By Merritt McKinney

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - Some of the benefits of a Mediterranean-type diet -- rich in vegetables, fruits, legumes and olive oil and light on red meat -- may stem from the diet's effect on inflammation, new research suggests.

In a study from Greece, markers of inflammation and blood clotting that are related to heart disease were lowest in people who adhered most closely to the traditional Mediterranean diet.

It is too soon to say whether the Mediterranean diet was responsible for the low levels of inflammation and blood-clotting markers, but the findings do provide a plausible explanation of the diet's benefits, according to the study's lead author.

"There is growing scientific evidence that diets high in fruits, vegetables, legumes and whole grains and that include fish, nuts and low-fat dairy products offer protective health benefits," Dr. Demosthenes B. Panagiotakos of Harokopio University in Athens told Reuters Health.

He noted that in the past few decades, a large body of evidence has linked the Mediterranean diet to reductions in heart disease, overall deaths and some kinds of cancer.

The latest results suggest that the Mediterranean diet protects the heart by reducing inflammation, Panagiotakos said.

"Our findings render this dietary pattern extremely attractive for public health purposes and should be adopted by almost everyone," he said.

The results of the study appear in Wednesday's issue of the Journal of the American College of Cardiology.

A Mediterranean-style diet is rich in fruits, vegetables, grains and nuts. It includes few saturated fats like the ones in red meat but plenty of healthier fatty acids like ones found in olive oil.

Inflammation is a prime suspect in a number of health problems, including heart disease, so Panagiotakos and his colleagues set out to measure the effect of a Mediterranean-style diet on inflammation and blood-clotting.

Over the course of a year, the researchers interviewed roughly 3,000 Greek men and women. The researchers also measured several proteins and other markers that are associated with inflammation and blood clotting.

People who stuck most closely to a traditional Mediterranean diet tended to have significantly lower levels of the inflammation and blood-clotting markers, the researchers report.

To make sure that the low levels of these markers were truly related to diet and were not a reflection of better overall health, the researchers accounted for many other factors, including physical activity, smoking, age, gender, socioeconomic status and several health conditions.

Even after taking into account the other factors, the Mediterranean diet was still associated with lower levels of inflammation and blood-clotting markers.

Source: Journal of the American College of Cardiology, July 7, 2004.

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Parents Urged to Fight Kids' Obesity

By Rick Callahan

Associated Press Writer

The Associated Press

Tuesday, July 6, 2004

INDIANAPOLIS - Susan Hedrick and her 18-year-old daughter are turning the tide on years of fast food and sedentary living. In a bid to shed a combined 180 pounds, they have been eating healthier and taking long walks this summer.

And they are doing it together something health and diet experts believe is a key to combating the nation's growing obesity epidemic, particularly among kids.

Research suggests healthy-eating, active parents often pass their habits onto their kids, just as sedentary parents do, said Edward Laskowski, co-director of the Sports Medicine Center at the Mayo Clinic in Rochester, Minn.

Laskowski suggests overweight parents serious about making themselves and their kids healthier start by holding a family meeting.

"You've got to say, `Hey kids, you know we've been doing the wrong thing here. Mom and Dad are wrong too, and we've got to lose some weight. We don't want you to make the mistakes we've made,'" he said.

Family bike rides, walks, hikes or doubles tennis are ways to get the whole family burning calories. And making sure everyone sits down together for a healthy dinnertime meal is another important step, he said.

Since the early 1970s, the percentage of American children and adolescents defined as overweight has more than doubled, to about 15 percent, according to the Centers for Disease Control and Prevention (news - web sites).

Three out of four overweight teenagers remain overweight into adulthood. And with two-thirds of American adults now overweight, they face an increased risk of diabetes, heart disease and other illnesses.

Barbara Dennison, an associate professor of clinical pediatrics at Columbia University, said so many children are now overweight or obese that it has changed parents' frame of reference. She said parents particularly those who are obese often do not realize their child is overweight.

Two years ago, in interviews with 1,180 parents of overweight children, Dennison found that only about 25 percent of those parents realized their child had a weight problem.

Her research also found that parents of overweight children treat mealtime differently than parents of healthy children, often allowing the child to choose the meal typically something less nutritious. Some parents even used sweets to encourage their child to finish a meal.

With America's youth getting fat on calorie-packed fast foods and snacks and spending too much time in front of the TV or the computer, Dennison said parents need to practice what they preach.

"Parents are children's best and first role models. You can't have Mom watching TV for hours and saying, `No, Johnny, you can't watch TV, it's bad for you,'" she said.

Betsy A. Keller, an associate professor of exercise and sport sciences at Ithaca College in New York, recently surveyed 130 parents about their children's weight and lifestyle.

She found that half of the parents of overweight children underestimated their child's weight status, deeming them at a normal weight. Keller said her study also found that parents misjudge how much exercise their children get.

"I don't think we're going to get at this issue of obesity until we ask the hard questions: What are you feeding your kid? What are you putting on the table? Why are you not doing some kind of physical activity with your kids?" she said.

Hedrick, a 39-year-old pediatric nurse who has struggled with her weight since childhood, is trying to do just that because she is determined to make sure Niki does not carry her extra weight into adulthood.

A recent high school graduate, Niki had been thin, like her two brothers, until unhealthy habits she adopted early in high school led to a 50-pound weight gain.

After Hedrick enrolled earlier this year in a diet and exercise program sponsored by the Indianapolis hospital where she works, she showed Niki some information about the program.

At first, the teen was not very interested, but in the past month or so she has been eating healthier, drinking fewer sugary sodas, doing sit-ups and taking long walks either with her mother or alone.

Niki has shed about 5 pounds from her 5-foot-6 frame and is down to about 170 pounds. She is aiming to lose 40 pounds more. "It's just for my own personal self," she said.

Hedrick, who hopes to lose about 130 pounds, believes she and her daughter can use the buddy system to make sure both of them stick to their diet and exercise plans.

"I really don't see it as dieting," Hedrick said. "I see it as a life-changing journey to make myself and Niki healthier."

(SUBS 15th graf 'She found ...' to correct 'underestimate' to 'misjudge.' Pickup 16th graf pvs 'I don't ...')

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Soy Protein No Substitute for Hormones-Dutch Study


Tuesday, July 6, 2004

CHICAGO (Reuters) - Soy protein, which has been recommended to menopausal women as a substitute for hormone replacement therapy, did not fend off symptoms such as bone loss in a study of Dutch women released on Tuesday.

Naturally occurring compounds called isoflavones found in soybeans are thought to mimic estrogen compounds in hormone replacement therapy.

Some women want to avoid hormone therapy since recent studies showed long-term use can raise the risk of stroke, dementia and some forms of cancer.

In a one-year study of 175 Dutch women, half of the participants consumed a soy protein supplement daily, while the other half took a milk-based protein. Researchers found the soy protein did not have any effect on declining bone mineral density, elevated cholesterol levels and cognitive difficulties associated with menopause.

However, the researchers said the study may not be conclusive because of the women's relatively advanced age, which ranged from 60 to 75, when menopausal symptoms may already be entrenched.

For instance, loss of bone mineral density is often greater when menopause begins and then tends to slow, said lead researcher Sanne Kreijkamp-Kaspers of the University Medical Center, Utrecht, the Netherlands.

While soy protein can still be a healthy source of protein, its effect on menopausal symptoms needs to be studied further, she wrote in the report, which was published in the Journal of the American Medical Association (news - web sites).

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Researchers Hunt for New Stem Cell Sources

By Serena Gordon
HealthDay Reporter


Tuesday, July 6, 2004

TUESDAY, July 6 (HealthDayNews) -- While embryonic stem cell research has been stymied by limited federal funding, researchers continue to look for other cell sources that offer the same promise for treating disease.

To that end, Tufts University researchers now report there may be a previously unrecognized and untapped source of fetal cells in the blood of women who have been pregnant. And researchers from Yale University believe adult stem cells from bone marrow may have more potential than researchers have realized because they discovered that bone marrow cells play a role in the development of the endometrial lining of the uterus every month in women who have undergone marrow transplants.

Results of both studies appear in the July 7 issue of the Journal of the American Medical Association (news - web sites).

"There's a whole political controversy over embryonic stem cells," said one study's author, Dr. Hugh Taylor, of Yale School of Medicine. "The question is, do we need to use embryonic stem cells, or are there other stem cells, like those in bone marrow?"

Taylor added he believes researchers "haven't realized the full potential of the bone marrow," and said there may be many applications for marrow cells.

Likewise, the author of the Tufts study, Dr. Diana Bianchi, said another potential source of stem cells is women who have been pregnant.

"Studies have virtually ignored the role of pregnancy, but women who have been pregnant potentially have cells with therapeutic potential from their fetus," she said.

Stem cells are unspecialized cells that can develop into many different types of specialized cells. Researchers believe these cells may be the key to developing treatment for diseases such as Parkinson's, Alzheimer's, spinal cord injuries, arthritis and many others.

Embryonic stem cells, which are harvested from human embryos, hold the most promise because they are "pluripotent." That means they can develop into many different types of cells. Adult stem cells are considered "multipotent" and aren't believed to be able to transform into as many types of cells as embryonic stem cells.

Research on embryonic stem cells is limited because of President Bush (news - web sites)'s decision in August 2001 to only allow federal funding for research on stem cells derived from embryos that had already been destroyed. Most researchers depend, at least in part, on federal funding.

Bianchi and her colleagues retrieved cells from the tissue samples of 10 women who had male sons and compared them to tissue samples from 11 women who had never had male offspring. The reason the researchers chose women with male offspring is that it would be easy to detect cells from male offspring because male cells carry the Y chromosome, while female cells do not.

The tissue samples were from the thyroid, cervix, liver, lymph node, intestine, spleen and gallbladder. Skin samples were also collected from 11 women in a control group.

Bianchi said that not only did they find fetal cells present in the mothers' tissue samples, but that the fetal cells had taken on the characteristics of the mother's cells.

For example, she said, "in the thyroid, there were fetal cells that looked and acted like thyroid cells, and we knew they were fetal cells because they had the Y chromosome."

The next step, according to Bianchi, is to figure out how to harvest these cells before they have transformed. And, she said, that's exactly what the Tufts researchers are working on in experiments with mice.

Taylor's study, unlike Bianchi's, focused on adult stem cells.

He tested samples from the endometrium of four women who had received bone marrow transplants. The endometrium is the lining of the uterus that is shed and then regenerates every month to prepare the body for a potential pregnancy.

Up until now, said Taylor, it was believed that a small layer of cells inside the uterus was what prompted that regrowth every month. But, Taylor found cells in the endometrium that matched the bone marrow transplant donors, rather than the recipients.

"Apparently cells from outside [the uterus] can come in and contribute. Bone marrow cells enter and turn into endometrial cells," said Taylor.

He said these findings could explain why some women with the disease endometriosis -- in which endometrial tissue grows outside of the uterus, usually in the abdominal cavity -- sometimes have endometrial cells in faraway places, such as the lung or brain.

"Bone marrow has the ability to regenerate many cell types thought not to be possible," said Taylor. "We're finding more and more that the body has remarkable plasticity, and bone marrow seems to be very rich in cells that have potential to turn into cells of other organ systems."

More information

To learn more about stem cells, visit the National Institutes of Health.

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Fiber Curbs Estrogen in Breast Cancer Patients

By David Douglas

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - A high-fiber low-fat diet reduces blood levels of estrogen in women with breast cancer, researchers report. This may help keep the disease in check, as breast cancers are sometimes driven by female hormones.

As lead investigator Dr. Cheryl L. Rock told Reuters Health, "The results of this study show that diet composition, especially increased fiber intake, may affect levels of reproductive steroid hormones in women. Previous studies that have examined change in diet composition and steroid hormone levels were confounded by concurrent weight loss."

As reported in the Journal of Clinical Oncology, Dr. Rock of the University of California, San Diego, and colleagues studied 291 women at an average of 2 years after a diagnosis of breast cancer.

They were divided into one group given dietary advice for cancer prevention and another comparison group given general dietary guidelines.

Those in the cancer-prevention diet group were advised to have a high intake of vegetables and fruit and a low intake of fat. They also attended 12 cooking classes, had telephone counseling and were given relevant printed materials.

Those in the comparison group attended four cooking classes not aimed at cancer prevention and were given standard government dietary materials.

At one-year follow-up, the high-fiber, low-fat group reported a significantly reduced intake of energy from fat (21 percent) compared to those in the comparison group (28 percent). They also had a significantly higher intake of fiber (29 grams per day) than the comparison group (22 grams per day).

No significant weight loss was seen in either group.

In the high-fiber, low-fat group there was a significant drop in estrogen, while in the comparison group there was a slight increase.

The change in fiber intake had the most effect on estrogen levels.

"These findings," Rock concluded, "illustrate one mechanism by which diet may affect risk for breast cancer."

Also, she added, "these observations may be relevant to other health concerns in women in which reproductive steroid hormones play a role, such as problems with ovulatory function and infertility."

Source:  Journal of Clinical Oncology, June 15, 2004.

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Milk, Calcium Intake May Lower Colon Cancer Risk

By Megan Rauscher

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - Higher milk and calcium consumption is linked with reduced odds of developing colorectal cancer, according to an analysis of ten studies.

"Our findings, with those from several clinical trials on calcium supplements and colorectal (tumors) including one published last month, strongly suggest that calcium reduces colorectal cancer risk," Dr. Eunyoung Cho from Harvard Medical School (news - web sites), Boston told Reuters Health.

The studies reviewed by Cho's team involved a total of 534,536 individuals, of whom 4992 developed colorectal cancer over a 6 to 16-year period. Dietary information was gathered by questionnaire.

The risk of cancers of the colon and rectum decreased with increasing milk consumption, according to the results published in the Journal of the National Cancer Institute (news - web sites). Compared with the lowest category of milk intake, the highest intake was associated with 15 percent reduction in the risk of colorectal cancer.

A higher dietary and total calcium intake also significantly reduced the risk of colorectal cancer, for both men and women, the investigators found.

However, as Cho pointed out, the data for calcium "were suggestive of a threshold effect in which little further reduction in the risk of colorectal cancer was observed for intakes above 1000 milligrams per day."

Because some studies have suggested that a high intake of calcium may increase the risk of fatal prostate cancer, "we need to understand better the full range of health effects of calcium before making recommendations for optimum amount of calcium intake to reduce the risk of colorectal cancer," the researcher added.

Source: Journal of the National Cancer Institute, July 7, 2004.

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Study Finds Cough Drugs No Better Than Sugar Syrup

By Michael Conlon


Tuesday, July 6, 2004

CHICAGO (Reuters) - Two ingredients commonly used in cough syrup are no better than sugar water in suppressing night-time coughing in children, according to a study published on Tuesday.

The two ingredients are dextromethorphan -- often listed on labels as "DM" -- and diphenhydramine, an antihistamine. The former is the most common nonprescription cough suppressant on the U.S. market, and commonly abused by adolescents who try to get high on cough medicine.

"Consumers spend billions of dollars each year on over-the-counter medications for cough," said Ian Paul, a physician and assistant professor of pediatrics at Penn State Children's Hospital.

"Our study showed that the two ingredients used in most over-the-counter medications were no better than a placebo ... in providing night time relief for children with cough and sleep difficulty as a result of upper respiratory infection," he added.

Paul was the chief author of the study appearing in the July issue of Pediatrics, the journal of the American Academy of Pediatrics.

The findings were based on 100 children aged 2 to 18 with upper respiratory infections. Their parents were quizzed about the severity of the children's cough and how well both parents and children slept the previous night.

In the evening of the day the parents were questioned the children were given either one of the commercial preparations or an inert placebo -- in this case simple syrup.

"There was a significant improvement for all symptoms over the previous night, which should reassure clinicians and parents that, regardless of treatment, the natural history of an upper respiratory infection favors resolution of symptoms with time," Paul said.

In an interview, Paul said the improvement in symptoms across-the-board was due to both the natural progression of an infection easing one day to the next and the well-documented "placebo effect," where symptoms diminish because a patient believes a treatment is helping.

He said the sleep of both parents and children improved but the improvement was the same in the group given sugar syrup as for the children given the drugs.

Asked what parents should do, Paul said "my advice has been to do things that are harmless but could help -- saline nose drops, good hydration and humidified air."

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Parents Set Rules, But Kids Still See TV Violence


By Amy Norton

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - Most parents think their children regularly see TV violence despite their efforts to impose limits, a study published Tuesday shows.

Researchers say the findings highlight the tough job parents face when they try to curb their kids' exposure to media mayhem.

The study, published in the journal Pediatrics, included 677 Washington, DC-area parents who answered questions on their children's exposure to television, videos and video games. The respondents were part of a larger study looking into parents' approaches to raising their children.

The TV-centered questions revealed that in families where the youngest child was allowed to watch television, 53 percent of parents said they always limited kids' exposure to violent programs. Yet nearly three-quarters thought their child saw TV violence at least once a week.

Although the study did not ask why there was such "monitoring failure," the study authors offer some potential explanations. Parents may, for instance, not be aware beforehand that a particular program will contain violence, or they may not have the time to keep a close eye on everything child sees.

The fact that parents who thought they were being vigilant still had to admit their kids were probably seeing media violence "speaks to the pervasiveness of violence on TV," study co-author Dr. Joseph L. Wright told Reuters Health.

By highlighting the challenge to parents, the study may encourage pediatricians to offer more advice, according to Wright, who is medical director of advocacy and community affairs at the Children's National Medical Center in Washington.

The American Academy of Pediatrics recommends that parents limit children's exposure to TV, video games and other media to no more than two hours per day. It also suggests that parents watch television with their children and keep kids' bedrooms TV-free.

The concern over children viewing media violence arises from the body of research tying such exposure to aggressive behavior. The new study was an attempt to see what parents are typically thinking and doing when it comes to their own children's exposure to violence.

Overall, 75 percent of parents said their youngest child watched TV. In these families, more than half of parents had rules limiting TV violence, while 45 percent said they "usually" or "always" watched TV with their youngest child. But the older that child was, the less likely parents were to watch TV with them or to limit their exposure to violent programs. Few parents of children older than 10 said they always reined in their child's violence viewing.

Parents were more vigilant when it came to sex on TV, with 70 percent saying they always limited their children's exposure to sexual content. Again, the rules were more lax with children older than 10.

On average, children spent between two and three hours a day in front of the TV, according to parents. Kids also devoted an average of one to two hours each day to playing video games -- the content of which the study did not address.

Still, the researchers call the amount of time given to video games concerning, given that some evidence suggests violent video games may have a more harmful impact on children than TV violence.

Source: Pediatrics, July 2004.

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Fosamax Boosts Bone in Older Women with Diabetes

Reuters Health

Tuesday, July 6, 2004

NEW YORK (Reuters Health) - Fosamax, a drug used to increase bone mineral density in older women, works well for women with type 2 diabetes, according to a new report.

Older women with diabetes have an increased risk for fractures, so "preservation of bone mineral density is particularly important," Dr. Theresa H. M. Keegan, of Stanford University School of Medicine, California, and colleagues write in the medical journal Diabetes Care.

Fosamax, known technically as alendronate, has been tested in general populations of postmenopausal women, "but its effect is unknown in women with type 2 diabetes," the team points out.

To look into this, the researchers used data from the Fracture Intervention Trial to compare changes in bone mineral density during three years of alendronate treatment versus placebo in diabetic women.

The trial included 6458 women between the ages of 54 and 81 years with low bone density who were randomly assigned to take either an inactive placebo or a daily 5-milligram tablet of alendronate for two years, followed by 10 milligrams daily for the rest of the trial.

A total of 297 women had type 2 diabetes.

Diabetic women treated with alendronate had increases in bone mineral density of the spine and hip and at all sites; women in the placebo group experienced only a slight increase in spine bone density, and decreases at all other sites.

These differences were similar to those seen in women without diabetes.

"The safety/tolerability of alendronate was similar to placebo, except for abdominal pain, which was more likely in the alendronate group," Keegan and colleagues write.

They add that the number of women with diabetes in the trial was too small to determine if alendronate reduced the number of fractures, so "further studies may be needed to evaluate the antifracture effectiveness of alendronate in diabetic women with and without low bone mineral density."

Source: Diabetes Care, July 2004.

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Monday, July 5, 2004


Brain Chemical Linked to Teen Suicides in Study



Monday, July 5, 2004

CHICAGO (Reuters) - A brain enzyme known to be involved in mood disorders may be in short supply in the brains of teenage suicide victims, a finding that could point to possible drug therapy, researchers said on Monday.

Whether the lack of the enzyme, protein kinase C (PKC), was a cause or an effect of the mental state that led to suicide was not clear from the post-mortem study of the brains of 34 teenagers, half of whom had committed suicide and the rest who died from other causes.

The researchers said the lower levels of the enzyme may be related to abnormalities in the interactions between the brain and hormonal glands. The enzyme is targeted by some mood-stabilizing drugs.

Whatever the mechanism, the decreased level of the enzyme is a "vitally important observation that will help not only in understanding the neurobiological profile of teen suicide but also in advancing ideas for therapeutic intervention," said study author Ghanshyam Pandey of the University of Illinois at Chicago.

Thirty thousand Americans die of suicide annually and it is the second-leading cause of death among U.S. teenagers.

The suicide rate has risen sharply among male teenagers in the past two decades, said the study, published in the July issue of The Archives of General Psychiatry.

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Steady Dose of Stress Stresses Immune System



Monday, July 5, 2004  

MONDAY, July 5 (HealthDayNews) -- While short spurts of stress can boost the immune system, lengthy doses lead to a breakdown of immune function, says a study in the July issue of the Psychological Bulletin.

Canadian and American researchers analyzed the findings of 293 studies that included a total of 18,941 people. This review of previous research confirmed that stress does alter the immune system.

It also revealed a distinctive pattern. Short-term stress cranks up the immune system. This is an adaptive response that prepares the body to fight infection or injury. But chronic stress inflicts a great deal of wear and tear on the immune system, causing it to collapse.

The study also found the immune systems of older people and those who are already sick are more prone to stress-induced change.

More information

The American Academy of Family Physicians (news - web sites) offers advice on how to cope with stress.

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Alzheimer's Mutations Found in Brain Cells



Monday, July 5, 2004

WASHINGTON (Reuters) - The genetic mutations that lie behind most cases of Alzheimer's disease (news - web sites) may be found inside cell powerhouses known as mitochondria, U.S. researchers said on Monday.

They said they found mutations in mitochondrial DNA in 65 percent of patients in a study who died of Alzheimer's, and none of the patients who died of something else.

Their finding, published this week in the Proceedings of the National Academy of Sciences (news - web sites), could help shed light on the most common form of Alzheimer's, which affects more than 4 million people in the United States alone.

Most DNA is carried on the chromosomes. But an important form is found in the mitochondria of cells, which are structures that help provide energy.

Douglas Wallace of the Center for Molecular and Mitochondrial Medicine and Genetics at the University of California at Irvine and colleagues looked at the brains of 23 people who died of Alzheimer's and 40 people who died free of dementia.

They looked especially for mutations in mitochondrial DNA. They found variations of a particular mutation in 65 percent of the brains of Alzheimer's patients and none of the others.

Several mutations have been linked to early-onset Alzheimer's, but it has been difficult to pin down a cause of the most common form, known as late-onset, sporadic Alzheimer's.

The mutations are associated with reductions in the total amount of mitochondrial DNA, Wallace's team said. It could be that they impair energy production in the cells, increase the generation of free radicals that can damage cells, and destroy the connections between brain cells, they said.

Or the mutations could be a symptom rather than a cause.

"The question remains: is the increase in (the mitochondrial DNA) mutations seen in AD brains simply a reflection of accelerated aging, or is it a distinct pathological phenomenon?" they wrote.

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High Scores on Video Games Pack on Pounds



Monday, July 5, 2004

MONDAY, July 5 (HealthDayNews) -- Children who spend a lot of time racking up high scores on video games are also more likely to pack on too many pounds, says a U.S.-Swiss study.

It found a strong association between video game use and obesity among school-age children. The study also found childhood obesity was associated with television watching, father's smoking, and mother's working outside the home.

"The goal of this study was to identify environmental and behavioral factors, in particular type and duration of sedentary activities, associated with obesity in children living in Switzerland," primary investigator Dr. Nicolas Stettler, a pediatric nutrition specialist at the Children's Hospital of Philadelphia, said in a prepared statement.

"To our knowledge, this study provides the strongest evidence for an independent association between time spent playing electronic games and childhood obesity. Our findings suggest that the use of electronic games should be limited to prevent childhood obesity," Stettler said.

The study included 872 children in first, second, and third grades. If found non-Swiss children living in Switzerland were about twice as likely to be obese as Swiss children. These non-Swiss children watched more television and got less physical activity than Swiss children.

Obesity was independently associated with lack of physical activity, time spent playing video games, and time spent watching television.

"Evidence-based prevention of childhood obesity requires the identification of modifiable risk factors. Because obesity is difficult to treat once it has been established, obesity prevention during childhood is an essential component of the efforts to combat this global epidemic and further research on obesity prevention is necessary," Stettler said.

The study appeared in the June issue of Obesity Research.

More information

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

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Ginseng Reduces Effects of Blood-Thinning Drug


By Anthony J. Brown, MD

Reuters Health

Monday, July 5, 2004

NEW YORK (Reuters Health) - Patients being treated with the blood-thinning drug Coumadin (warfarin) should probably avoid using ginseng, as the popular herb seems to reduce the drug's effects, new research indicates.

Among other indications, Coumadin is often given to patients with an irregular heartbeat called atrial fibrillation to reduce the risk of blood clots and stroke. A blood test called the INR is measured on a regular basis to ensure that the dose being given is not thinning the blood too much or too little.

"The first evidence of a possible interaction between ginseng and (Coumadin) came from a widely cited case report published in 1997," study author Dr. Chun-Su Yuan, from The University of Chicago, told Reuters Health. In that report, a patient on Coumadin "experienced a significant drop in the INR after using ginseng for 2 weeks. When the ginseng was stopped, the patient's INR returned to the desired level."

Still, Yuan said that some subsequent studies in humans and animals have not supported an interaction between the two agents.

To clarify the association, Yuan's team conducted a study involving 20 healthy volunteers. In the 4-week study, the subjects took Coumadin during the first week, took American ginseng or placebo for the second and third weeks, and then took Coumadin during the fourth week.

The researchers' findings appear in the Annals of Internal Medicine.

In agreement with the case report, ginseng use for two weeks was tied to a significant reduction in the INR, meaning that the blood was now less thin and more prone to clotting.

Yuan said that past studies may have failed to show a drug interaction because ginseng was not used long enough. "One week of ginseng therapy is probably not enough to" turn on the liver enzymes that break down Coumadin -- the apparent reason why the herb and the drug interact.

Yuan favors not using ginseng at all for people on Coumadin treatment. When people take ginseng and the Coumadin dose is adjusted to compensate, "it's possible that the INR could go dangerously high if the patient suddenly stops the ginseng."

Source: Annals of Internal Medicine, July 6,2004.

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Silencing Huntington's Disease


Monday, July 5, 2004

MONDAY, July 5 (HealthDayNews) -- Gene therapy designed to silence a disease gene in the brains of mice prevented neurological damage and symptoms caused by an ailment similar to Huntington's disease in humans, a new study says.

If this method can be used in humans, it could offer a way to treat Huntington's disease and other related neurological diseases.

"This is the first example of targeted gene silencing of a disease gene in the brains of live animals, and it suggests that this approach may eventually be useful for human therapies," senior author Beverly Davidson, a professor of internal medicine, physiology and biophysics, and neurology at the University of Iowa, said in a prepared statement.

"We have had success in tissue culture, but translating those ideas to animals models of disease has been a barrier. We seem to have broken through that barrier," she said.

The research appears in the July 4 online issue of Nature Medicine.

More information

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

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Leukemia Drug Side Effects Worse When Vitamins Low

Reuters Health

Monday, July 5, 2004

NEW YORK (Reuters Health) - Findings from a new study suggest that kids with leukemia do not take enough antioxidant vitamins, which raises their risk of side effects during chemotherapy.

Chemotherapy produces changes that stress the body's antioxidant defense system, Dr. Kara M. Kelly, of Columbia University, New York, and colleagues write in the American Journal of Clinical Nutrition (news - web sites). Therefore, it's important that the diets of cancer patients contain adequate amounts of antioxidants.

In a 6-month study, the researchers examined antioxidant intake and chemotherapy side effects in 103 children with acute lymphoblastic leukemia (ALL), the most common cancer in kids.

During the study period, "subjects ingested vitamin E, total carotenoid, beta-carotene, and vitamin A in amounts that were 66, 30, 59, and 29 percent, respectively, of the US recommended dietary allowance or of the amounts specified in the third National Health and Nutrition Examination Survey," the investigators note.

The authors also found that greater intake of vitamin C was associated with fewer therapy delays, less side effects, and fewer days spent in the hospital. Similarly, the risk of infection and side effects decreased as vitamin E and beta-carotene intake increased.

"Our results suggest that it would be prudent for children with ALL to receive nutritional counseling to ensure that they are meeting their needs for antioxidant nutrients," the authors conclude.

Source: American Journal of Clinical Nutrition, June 2004.

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Findings Shed Light on Why Doctors Don't Wash Hands

Reuters Health

Monday, July 5, 2004

NEW YORK (Reuters Health) - Having a busy workload and being in a technical medical specialty increase the odds that a physician will not follow hospital

Previous reports have shown that compliance with such guidelines typically falls below 50 percent. Yet, the reasons why many physicians fail to comply are unclear, according to the report published in the Annals of Internal Medicine.

To investigate, Dr. Didier Pittet, from the University of Geneva in Switzerland, and colleagues used direct observation and self-report questionnaires to evaluate handwashing factors among 163 physicians at a large university hospital.

Adherence with hand hygiene guidelines averaged 57 percent, with internists having the highest rate - 87 percent -- and anesthesiologists having the lowest - 23 percent.

Factors associated with sticking to handwashing rules included awareness of being observed, belief of being a role model for other colleagues, a positive attitude toward handwashing after patient contact, and easy access to wash facilities, the authors note.

As noted, a high workload and being in a technical specialty like surgery or anesthesiology were identified as predictors of not complying with hand hygiene guidelines.

"After more than 150 years of prodding, cajoling, educating, observing, and surveying physicians, hand hygiene adherence rates remain disgracefully low," Dr. Robert A. Weinstein, from Rush Medical College in Chicago, notes in a related editorial.

"We must change the rules so that health care workers expect to be observed (when washing their hands) and given direct, immediate feedback until the behavior or role models becomes everyone's ritual," he adds.

Source: Annals of Internal Medicine, July 6, 2004.

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The ABCs on More Restful Zzzzzs

By Adam Marcus
HealthDay Reporter


Monday, July 5, 2004

MONDAY, July 5 (HealthDay News) -- Sleepless in Seattle? Sleepless in America is more like it.

Approximately 70 million Americans have some form of sleep disorder, from difficulty falling asleep to waking up too early, according to the National Sleep Foundation. Most people who have trouble sleeping never seek medical attention, the group says.

That's a trend the pharmaceutical industry would like to change. Sleep aids have become big business. A recent Business Week article said the market for sleep drugs is projected to balloon to $5 billion in 2010 from $2.5 million today.

Some critics argue that drug makers have largely created the market for sleep aids, and that people don't need medication to overcome insomnia.

"They're wrong," says Dr. Tom Roth, director of the sleep disorders center at the Henry Ford Hospital in Detroit.

While it's true that not everyone with insomnia requires sleep aids or should take them, for many patients the drugs are essential. The drugs are the most common treatment for insomnia, according to the National Sleep Foundation. One in four Americans takes some kind of medication for sleep in any given year, the group says.

On the other hand, Roth said, there's no conclusive evidence that drugs work better than non-drug sleep aids, like shifting bed and wake times or altering the way a person thinks about sleep.

Valium and Xanax were perhaps the best-known prescription sleeping aids for years. These medications belong to a family of drugs called benzodiazepines. They're effective for insomniacs, but they carry the risk of serious side effects, including depression, aggression and memory trouble. They're also habit-forming, and long-term use can lead to tolerance of the drugs.

The benzodiazepines have been pushed aside by two new prescription drugs, Ambien and Sonata, which now dominate the market for sleep aids. Neither is a benzodiazepine, though they're not free of side effects.

Ambien, made by Sanofi-Synthelabo, can cause daytime drowsiness, dizziness, lightheadedness and difficulty with coordination. Furthermore, the drug's manufacturer doesn't recommend operating machinery or performing tasks that take extreme coordination.

Sonata, from Wyeth-Ayerst Laboratories, has the same side effects as Ambien. It doesn't appear to be effective in increasing a patient's total sleep time as its competitor. Nor does Sonata decrease the number of times a patient may wake up after falling asleep.

Scientists don't know yet if Ambien and Sonata are addictive, or whether they continue to work over time. Doctors recommend that patients take the drugs nightly only for insomnia that lasts a week or two.

Two new sleep drugs are expected to win regulatory approval in the near future. One is Estorra from Sepracor. The other is Indiplon, from Neurocrine Biosciences Inc.

Both Indiplon and Estorra are based on the same chemical structure as Ambien and Sonata, so patients should expect similar side effects from the new drugs if they're approved, Roth said. "I know of no drug in any arena which is free of side effects," he said. "That's the nature of drugs."

Joyce Walsleben, director of the Sleep Disorders Center at the New York University School of Medicine, said of the new drugs: "My thinking is, the more the merrier. Not every drug is right for everyone."

Walsleben believes that modifying sleeping behavior is ultimately a more solid solution to sleeping disorders than medication. "There's evidence that's behavior therapy is better over the long term. But the combination [of drugs and habit change] is really great," she said. And "clearly, there are times when medication is the only way to go."

In her own clinic, Walsleben sees "very few" side effects from Ambien and Sonata. Sonata doesn't always work, however, and Ambien occasionally leads to confusion. "If you're up and about with any sedative on board, you're likely to forget what you're doing," she added.

Many people with sleeping trouble look to over-the-counter and alternative remedies for help. But Dr. Richard Schwab, co-director of the sleep center at the University of Pennsylvania Medical Center, said people who do turn to these products should be cautious.

"In my experience, prescription sleep aids are much more effective than over-the- counter sleep aids" such as those with benadryl and melatonin, he said.

Schwab prescribes Ambien, Sonata and the benzodiazepine drug sold as Restoril to his patients with insomnia. He also advocates behavior therapy, though that approach takes "a lot of time. You need a physician or a psychologist to sit down and meet weekly or bi-weekly" for months to change poor sleep habits, he says.

More information

The National Sleep Foundation has an excellent explanation as to why people can't sleep.

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Alzheimer's Gene Tied to Better Diet Response

Reuters Health

Monday, July 5, 2004

NEW YORK (Reuters Health) - A genetic variant that has been linked with Alzheimer's disease (news - web sites) may have a beneficial effect in patients with type 2 diabetes. In a new study, patients with this variant, known as apoE4, experienced a greater drop in "bad" LDL cholesterol levels when dieting than their peers without this variant.

Dr. Masaaki Eto and colleagues, from Kawasaki Medical School, in Kurashiki, Japan, put 11 diabetic patients with ApoE4 and to 24 patients without this variant on a calorie-restricted diet. The results are published in the medical journal Diabetes Care.

Both groups lost a modest amount of weight and experienced a drop in blood sugar levels. In the ApoE4 group, total cholesterol, LDL cholesterol, and triglyceride levels all decreased significantly with dieting, the authors note. In contrast, patients lacking the variant only showed a reduction in triglyceride levels.

Further studies are needed to clarify how apoE4 improves the cholesterol response to dieting and to look at the effects of other genes that may be involved, the authors state.

Source: Diabetes Care, June 2004.

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Health Tip: Ticked Off


Monday, July 5, 2004

(HealthDayNews) -- After trampling through wooded areas, make sure you inspect your body for ticks, advises Lifespan Hospitals.

If you spot a tick, here's what to do:

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Chinese Herbs Hold Little Benefit for Hepatitis C

By Alison McCook

Reuters Health

Monday, July 5, 2004

NEW YORK (Reuters Health) - A Chinese herbal treatment often used to treat hepatitis in Asia does not appear to reduce liver inflammation or improve quality of life in people with hepatitis C, new research reports.

Moreover, after 3 months of treatment, herb-takers who participated in the study did not show any change in the amount of virus in their bodies.

"Unfortunately, our results suggested that the herbal compound was no different than placebo," study author Dr. Jeffrey H. Albrecht told Reuters Health.

"At this point in time, I am aware of no conclusive data that these herbs provide any meaningful benefit in" hepatitis C, added the researcher, who is based at the University of Minnesota in Minneapolis.

Albrecht noted that the Chinese herbs may have been ineffective either because they simply do not work, or because he and his colleagues used an incorrect dose or combination of herbal agents.

"I think that the long tradition of herbal treatments for viral hepatitis in China and Japan suggest that there may indeed be useful agents that should be tested," he said.

Hepatitis C is a liver disease caused by infection with the hepatitis C virus (HCV), which is spread through contact in some way with contaminated blood. In many patients, the virus is never completely cleared from the body and, after years of infection, serious liver problems, such as scarring and cancer, can occur.

The recommended treatment for HCV -- interferon injections and orally administered ribavirin - is effective in, at most, 60 percent of patients. It also has potentially severe side effects such as nausea, fatigue, depression and, in some cases, suicidal impulses.

As a result, many HCV patients either fail to clear the virus from their bodies or cannot tolerate the treatment.

In the current study, Albrecht and his team investigated whether 12 weeks of treatment with either a combination of 10 Chinese herbs often used to treat hepatitis in Asia or a placebo drug helped 45 HCV patients.

The researcher explained that even though no research supports the use of Chinese herbs in HCV, the treatment likely remains popular due to "positive publicity" from the alternative health industry, which leads people to believe these treatments work.

Alternative medicine is also largely unregulated, Albrecht noted, which makes it easy for people to obtain treatments without the added step of going through a healthcare provider. And many HCV patients are willing to try whatever treatments they can get their hands on, he noted.

"In the case of HCV, many patients can't be successfully treated with pharmaceuticals, and are willing to try unconventional approaches out of desperation," Albrecht said.

He added that the preparation and dosage of the herbs used in the current study were likely safe, but other herbal treatments have been linked to liver problems.

Source: Archives of Internal Medicine (news - web sites), June 28, 2004.

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Health Tip: Mountain Sickness


Monday, July 5, 2004

(HealthDayNews) -- If you're traveling to mountainous areas this summer, get used to the new heights before starting any strenuous activities, advises the University of Maryland.

By not allowing your body time to adapt to a new altitude, you risk developing acute mountain sickness, which can result in headache, nausea, vomiting, insomnia, fatigue, and increased respiration and heart rate.

These symptoms will generally resolve themselves if you rest, drink lots of fluids, and eat a high-carbohydrate diet.

Severe altitude sickness can lead to fluid in your lungs or swelling in your brain. The best treatment is to get to a lower altitude as quickly as possible.

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Sunday, July 4, 2004


Rural Poor Struggle to Find Healthy Food


By J.M. Hirsch

Associated Press Writer

The Associated Press

Sunday, July 4, 2004

PITTSBURG, N.H. - William Laste thinks nothing of driving more than 400 miles roundtrip to buy groceries, or of supplementing his shopping with fiddlehead ferns and dandelion greens gathered in fields near his home.

In this mountainous outpost of 870 people along the Canadian border, good food at fair prices is hard to find. There are no supermarkets, and the community's two convenience stores offer little fresh produce and plenty of high prices.

Laste's fixed income can't accommodate $2.99 for his favorite cheesy crackers. He gets around it by combining shopping with monthly visits to friends in cities to the south, where the same crackers cost half the price.

"Up here, you're so far out they've got you over a barrel," the 69-year-old retired plumber said recently. "I couldn't afford to shop up here."

Such is life in "food deserts," increasingly common rural and sometimes urban areas where supermarkets with healthy and affordable food are many miles away.

For people like Laste, who have the vehicles, time and patience to go the distance, it's an inconvenience. For the poor and elderly, it can mean stocking the refrigerator with the pricey, fatty fare of gas station convenience stores.

"It's going to be more chips and canned and processed foods, which just play into high rates of obesity, diabetes and other fat-related diseases," said Andy Fisher, executive director of the Community Food Security Coalition in Venice, Calif.

"It's kind of a real perverse irony that the people who have the least are paying the most."

The term food desert was coined more than a decade ago in Great Britain, where it was used to describe the phenomenon of supermarkets withdrawing from cities to build larger stores on the outskirts.

Few formal studies have been done in the United States, but sociologists and social service workers believe research eventually will show that life in food deserts is financially, mentally and physically costly.

The majority of U.S. food deserts are rural areas, but researchers say a large number of people also are affected by a relatively small number of urban areas with poor grocery access.

But isn't it a bit unreasonable for people who choose to live in the boondocks to complain that they don't have a supercenter around the corner?

Not necessarily. Experts say the grocery landscape in the United States hasn't always been this way. Not so long ago, most communities had mom-and-pop grocers. That was before the suburbanization of shopping.

Americans want bargains, and they want them in big stores. But big stores don't fit in crowded inner cities and small towns can't support them. So supercenters grew up in the suburbs, where land is cheaper and shoppers are plentiful.

While making food and other products cheaper than ever before for millions of people, those massive stores siphon shoppers away from smaller markets in surrounding communities and city centers, forcing many to close.

During the 1950s, more than half of all grocery stores were mom-and-pop operations. Today, just 17 percent are, according to Walter Heller, research director for Progressive Grocer magazine.

For 17 years, Jerry and Dot Nering have run a small shop in Weld, Maine, a remote town of 400 people. In its heyday the shop was stocked with meats, cheeses and produce, and shoppers swapped gossip around a wood stove.

Today, many of the Weld General Store's shelves are bare and customers only trickle in. The Nerings blame the two Wal-Mart Supercenters that have opened within 20 miles of their shop.

Business is so bad the couple even struggles to get suppliers to deliver to their western corner of the state.

"Our cost is higher than Wal-Mart sells for, so you can't compete," Jerry Nering said.

The U.S. Department of Agriculture (news - web sites) estimates that groceries average 10 percent more in food deserts than at suburban grocers. That might be a bargain. A gallon of milk in Concord, N.H., a city of 40,000 people with seven supermarkets, recently cost $2.69. The price spiked to $4.25 about 120 miles north in Milan, a town of 1,300 with no supermarkets.

The definition of food deserts is relative. In cities, where fewer people own automobiles, it might mean having to walk a mile, said Troy Blanchard, a sociologist at Mississippi State University. In rural communities, it could mean a 30-mile drive.

And public transportation a rarity in rural areas, anyway doesn't always help.

"Imagine trying to get a week's groceries if you have a couple of kids, carry that onto a bus, transfer it to a subway and carry it home," said Blanchard, one of only a handful of people studying the food desert effect in the United States.

Using Census and other federal data, Blanchard charted supermarket access nationally. He found it was worst in the West, where 44 percent of the average county's population has poor access to grocers.

The Midwest followed with 34 percent, the South with 24 percent and the Northeast with 10 percent.

"Sometimes the food pantries have a better selection of food than the grocery store in town," said Dawn Girardin, who works on hunger and other welfare issues at Western Maine Community Action in Wilton, Maine.

For Lorraine Karchenes, who lives with her husband and 4-year-old son in Eustis, Maine, the inability to get organic and specialty foods in their town of 715 people forced her to look both further afield and closer to home.

For vitamins and wheat-free products for her son's allergies, Karchenes, 32, turned to the Internet. For fresh produce she turned to the 90 acres of farmland that stretch out behind her home.

The farming has gone so well that others now seek out her produce. A small sign at the end of her driveway advertises what's in season, and the local shop recently began selling some of her vegetables.

But for most working families and the elderly, few of whom have experience growing and storing food, farming isn't practical, said Thomas Lyson, a sociologist at Cornell University who studies food deserts.

"Even farmers tend not to grow their own food," he said. "What are you going to do, have a cow so you can milk it 12 months a year? We're not asking to become peasants again."

Few people think the grocery industry intentionally puts food out of reach of rural shoppers; supermarket chains locate their stores where it makes the most financial sense and they can cater to as many people as possible.

Jim Harrison, president of the Vermont Grocers Association, said the industry isn't actively addressing the food desert problem, but supermarket chains always are searching for ways to serve more customers.

Wal-Mart spokeswoman Daphne Moore says her company, which has 1,500 supercenters nationally, has a history of catering to underserved regions and is looking to build more urban stores to help with grocery access in those areas.

Some grocers, as well as senior living homes and social service agencies, have experimented with shuttles that bring people to the stores. But these aren't always cost effective or efficient, especially over long distances.

Heller notes that the fastest growing segment of the grocery industry is so-called limited assortment shops, stores with perhaps 1,500 items, similar to Trader Joe's.

These shops, which require less real estate and fewer customers, might help alleviate urban food deserts, but he acknowledges most aren't likely to be placed in rural communities.

Fisher thinks the blame and responsibility for fixing the problem goes to local and state governments, few of which have recognized supermarket access as a basic need.

"They haven't really focused on food as being a public issue," he said. "Planning departments aren't out there drawing maps of where there are food deserts."

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Saving Your Skin



Sunday, July 4, 2004

SUNDAY, July 4 (HealthDayNews) -- With skin cancer rates soaring, protecting your skin from the sun has never been more important.

And there's much more you can do than simply staying in the shade.

Start with a sunscreen. The American Academy of Dermatology recommends using a product with a sun protection factor (SPF) of at least 15, and applying it generously at least 20 to 30 minutes before going out into the sun.

Make sure to cover not only your legs, arms, face and neck, but also your feet (if you're wearing sandals) and hands. If you're going to be swimming or perspiring heavily, it's a good idea to reapply sunscreen, because toweling yourself dry can rub off the previous application.

Hats are a great way to keep the sun off your face. But if you're using a baseball cap, don't forget to apply sunscreen to the back of your neck and ears.

If you think you don't need protection because it's cloudy or overcast, think again. Experts say the sun's harmful UV rays can pass through clouds, and even water.

Be especially careful in places ranging from the beach to snow. Sand, water and snow can reflect sunlight and increase the amount of UV radiation you receive. In such high-glare settings, you should wear a higher SPF and protect your nose and lips with zinc oxide.

If you have sensitive skin, it's important to read sunscreen labels before using them. Even if products claim to be "hypoallergenic" or "dermatologist tested," some people may still have some skin irritation. So make sure to apply a small amount on your skin for three days; if your skin doesn't turn red or become tender, the product is probably OK to use.

More information

Another good way to protect your skin from the sun is to check the current UV index forecast for your area.

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Experts Debate Effects of Violent Games


By Nick Wadhams

Associated Press Writer

The Associated Press

Sunday, July 4, 2004

NEW YORK - It's hard to find clear answers in the debate between the makers of video games and activists who claim the electronic diversions are destroying an entire generation.

One side claims there is no evidence that games have any damaging psychological effect on the people who play them. The other says the link between game-playing and aggression is as strong as the link between cigarettes and cancer.

A 2001 report by the surgeon general wasn't much help: While noting that media violence had a small effect on physical aggression and a moderate impact on "aggressive thinking," it concluded by saying, "The impact of video games on violent behavior remains to be determined."

When defending games, the industry often cites a 2000 Washington State Department of Health study that found "research evidence is not supportive of a major public concern that violent video games lead to real-life violence."

Another 2000 report in the Applied Developmental Psychology journal found that "the overall picture that emerges from the present pattern of findings is that computer game play is one manifestation of an active and well-adjusted lifestyle."

Gaming opponents, however, have sources of their own.

A 2000 report from six health care organizations, including the American Medical, Pediatric, and Psychiatric associations, said preliminary studies on the effects of violent games "indicate that the negative impact may be significantly more severe than that wrought by television, movies, or music."

Research by Craig Anderson, an Iowa State University professor frequently asked to file supportive briefs on behalf of legislators trying to restrict the sale of games, generally goes further than other studies in showing a strong link between game aggression and violence.

Anderson frequently measures aggression by the pushing of a button or aggressive play. Game advocates question how that can be equated with real world violence.

One of the main overall weaknesses with research in this field is that it generally deals with older games, so the effects of technological advancement and more mature games released since about 2000 have yet to be seen.

And even the researchers who find evidence that violent games can lead to bad behavior will not say how games rank among a host of other so-called "risk factors" like poverty, abuse or neglect.

"Media violence is only one of many factors that contribute to societal violence," Anderson has written, "and is certainly not the most important one."

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Drug Breakthroughs Offer Hope for Parkinson's Patients

By Barry Hoffman
HealthDay Reporter


Sunday, July 4, 2004

SUNDAY, July 4 (HealthDayNews) -- A drug approved in April by the U.S. Food and Drug Administration (news - web sites) brings yet another source of relief to those who suffer from the debilitating malady known as Parkinson's disease (news - web sites).

The FDA (news - web sites) granted approval to the drug Apokyn (apomorphine), made by Bertek Pharmaceuticals, which treats periods of immobility that affect some people with Parkinson's disease.

During these "off-period" episodes, medically known as "hypomobility," some people on standard anti-Parkinson's drugs can lose the ability to speak, rise from a chair, or walk. These episodes tend to occur as the drugs begin to wear off between dosing cycles.

The debilitating condition affects about 10 percent of the patients who take standard Parkinson's therapies.

Apokyn must be taken with another medication to counter its nasty side effects, which include severe nausea and vomiting, the FDA said. The drug's labeling also includes specific warnings about low blood pressure, fainting, hallucinations and excessive sleepiness.

Parkinson's disease involves the steady loss of brain cells that produce dopamine, a chemical messenger essential to proper motor function. As levels of dopamine decrease, chemical messages between brain cells misfire, triggering symptoms such as tremors, loss of balance, rigidity and other abnormalities.

An estimated 1 million to 1.5 million Americans have Parkinson's disease, a brain disorder that can cause tremors, difficulty walking and rigid muscles. In severe cases, patients can develop dementia and die from the disease. Parkinson's is largely a disease of the elderly, and is estimated to affect one in every 100 Americans over the age of 60.

Within the past year, the U.S. government has approved other drugs for Parkinson's treatment, among them Stalevo, which helps the "staying power of other Parkinson's medications like levodopa, from "wearing off" over time. Levodopa is the most widely used agent to treat Parkinson's, but its effects last for shorter and shorter periods over prolonged use. Where initially levodopa may have prevented the tremors and other symptoms of Parkinson's for as long as eight hours, a dose may eventually only last one or two hours, according to the manufacturer of Stalevo, Novartis Pharmaceuticals Corp.

A second ingredient in Stalevo, entacapone, blocks the enzymatic breakdown of levodopa, allowing the medication to control Parkinson's symptoms longer.

Meanwhile, a drug that may receive U.S. government approval later this year eases the symptoms of Parkinson's disease and may even slow progression of the degenerative condition, researchers have found.

There is currently no drug clinically proven to put the brakes on the steady destruction of cells within the brains of Parkinson's patients. The new drug, rasagiline, is the first medication to be tested under a new study protocol that looks at whether a medication can do more than just mask symptoms, the researchers said.

"Rasagiline works for helping signs and symptoms of Parkinson's -- and this study gives us hope that it does something beyond that," said study co-author Dr. Karl Kieburtz, a professor of neurology at the University of Rochester Medical Center.

The study appeared in the April 19 issue of Archives of Neurology.

New research into common factors in people with Parkinsons disease is pointing toward finding a way to cure it. One of those is finding the relationship between Parkinson's and the amount of iron and manganese a person has in his or her body.

Researchers suspect the minerals are somehow connected to the development of Parkinson's disease, but it's far from clear whether iron and manganese, found in a variety of healthy foods, actually make people ill.

"We don't know about cause and effect," said study author Karen Powers, a research scientist at the University of Washington. "We are not saying that we know what causes Parkinson's, and it's way too soon for us to make any recommendations about diet."

Researchers have suspected a link between iron and Parkinson's disease, but the new study is the first to look at the combined effects of both iron and manganese, Powers said.

Powers and her colleagues looked at two groups of people -- 250 who were newly diagnosed with Parkinson's disease and 388 healthy people. The researchers interviewed members of each group about their diets.

The findings appeared in the June 10 issue of Neurology.

Finally, the use of fetal cell transplantation -- long hoped to provide relief -- proved to be just the opposite, at least in initial trials.

More information

Learn more about Parkinson's disease from the National Institute for Neurological Disorders and Stroke.  

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Saturday, July 3, 2004


Thalidomide Eyed for Virulent Cancers


By Amanda Gardner
HealthDay Reporter


Saturday, July 3, 2004

SATURDAY, July 3 (HealthDayNews) -- The rehabilitation of thalidomide continues with two preliminary studies showing it may have a place in the treatment of multiple myeloma and melanoma.

The drug first achieved notoriety in the 1960s when it was pulled from the market after it was found to cause birth defects in the babies of women who had been taking it for morning sickness.

Thalidomide was reintroduced to the market, with stringent birth-control restrictions, as a treatment for leprosy in 1998.

At the recent meeting of the American Society of Clinical Oncology (news - web sites) (ASCO) in New Orleans, two sets of researchers showed it may have some benefit in patients with multiple myeloma, a type of blood cancer, and melanoma.

In the multiple myeloma trial, Italian researchers found thalidomide, combined with melphalan and prednisone in a Phase II clinical trial, elicited a better response than conventional chemotherapy. After being treated with the three drugs, 93 percent of participants had myeloma protein reductions of greater than 50 percent. Moreover, 26 percent had a complete remission, while near-complete remissions were seen in 19 percent. These response rates are similar to those observed in those who have had bone marrow transplants.

Though the response rate was promising, thalidomide therapy came with some unpleasant and dangerous side effects. In the Italian study, for instance, 26 percent of the 42 patients got infections, 19 percent were treated for deadly blood clots, 14 percent developed an unusually low level of infection-fighting white blood cells, and 28 percent were constipated. Two patients died during the study, and 36 percent discontinued thalidomide therapy because of the side effects.

Still, "it appears that thalidomide is useful when added to standard chemotherapy in newly diagnosed multiple myeloma patients," said Alan Kinniburgh, vice president of research at the Leukemia & Lymphoma Society. "The real take-home message is that this isn't a cure for myeloma."

Kinniburgh said the side effects aren't as serious as they are with some other cancer drugs such as Velcade, so it "is another weapon to treat myeloma that can help the patient live longer."

New treatments are desperately needed for multiple myeloma, the second most common blood cancer in the United States. "The five-year survival rate is under 30 percent," Kinniburgh said. "There is no cure. It is a clearly fatal disease."

There may be more hope in combining thalidomide with the drug Velcade, Kinniburgh added. Those studies are under way.

Thalidomide is under review by the U.S. Food and Drug Administration (news - web sites) (FDA (news - web sites)) for this indication. "It's another drug in the arsenal and, hopefully, with some of the clinical trials ongoing, physicians will find out how to use it with other new drugs," Kinniburgh said. "Velcade comes to mind, and it may perhaps be useful in the post-transplant setting as well. Time will tell."

The second trial looked at thalidomide in combination with another cancer drug, temozolomide, for metastatic melanoma in people who were currently free of the disease but were at a high risk for recurrence. Melanoma is a particularly virulent form of skin cancer.

The study, done at Memorial Sloan-Kettering Cancer Center in New York City, is still ongoing, but the researcher, Dr. Wen-Jen Hwu, a physician at the cancer center, said they were achieving "excellent results."

Both studies were sponsored by Celgene Corp., which makes thalidomide.

Thalidomide may also have benefit for patients with metastatic prostate cancer.

In a phase II randomized trial conducted by the National Cancer Institute (news - web sites), 75 patients were randomly assigned to receive either docetaxel (a chemotherapy drug) on its own or docetaxel plus thalidomide.

After a median follow-up of just over two years, those in the docetaxel-plus-thalidomide group had a median progression-free survival of 5.9 months vs. 3.7 months in the docetaxel group. At 18 months, overall survival in the docetaxel/thalidomide group was 68.2 percent, compared to 42.9 percent in the docetaxel group. The regimen was well tolerated after the patients received heparin, a blood thinner.  

The results appeared in the July 1 issue of the Journal of Clinical Oncology.

Hwu is involved in yet another study looking at the promise of thalidomide in patients whose melanoma has spread to the brain. She said she has found "efficacy and increased survival time."

More information

The U.S. Food and Drug Administration has more on thalidomide.

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Cool Down When It's Hot



Saturday, July 3, 2004

SATURDAY, July 3 (HealthDayNews) -- You don't have to be lost in the Sahara Desert to be in danger of heat stroke or heat exhaustion.

In America over the past 20 years, more than 8,000 people have died of excessive heat exposure. That's a higher number of deaths in that period than those caused by hurricanes, lightning, tornadoes, floods and earthquakes combined, according to the U.S. Centers for Disease Control and Prevention (news - web sites).

Those at greatest risk of heat exposure are the elderly, the very young and those with chronic disease and mental illness.

While people are generally able to cool down their bodies by sweating, when it's too hot sweating may not be enough. So, the CDC recommends that on very hot days, those at risk of heat stroke stay in an air-conditioned area or go to a public place that is air-conditioned. People should also drink a lot of water, reduce strenuous activities and wear loose-fitting, lightweight clothing.

During hot days, people should also limit their time outdoors and ensure that no one is left in a hot car for any period of time. You may also want to periodically check on neighbors who don't have air-conditioning.

If a person is suffering from heat exhaustion, you should quickly get them to a cool place. If they are awake, have them drink a glass or water, but not too quickly. Loosen tight-fitting clothing, apply cool, wet towels and call 911, according to the American Red Cross (news - web sites).

If a person collapses with heat stroke, medical help is essential since this is a life-threatening condition. You should call 911 and then follow the steps above, including applying ice or an ice pack wrapped in a cloth to the person's wrists, neck, ankles and armpits. Watch for signs of breathing problems and keep the person lying down, says the Red Cross.

More information

For health and safety tips about heat illnesses, visit the American Red Cross.

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