The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
December 26, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 18-23


  1. Eating Fish Protects Against Stroke
  2. Record Number of Flu Vaccines to Be Made
  3. Eating Vegetable Protein May Spare Gallbladder
  4. ISU Research Says Fat Good With Veggies
  5. Sports Physicals Should Be Thorough, Expert Says
  6. Listeria Can Linger
  7. Report Warns Against Overregulating Health Care
  8. New Devices Seal Hole in Heart
  9. ADHD May Go Hand-In-Hand with Seizures in Kids
  10. Stenting Works on Smaller Arteries
  11. Yes, Weather Ups Headache, But Less Than You Think
  12. Tourists Bring Sex Diseases Back with Souvenirs
  13. Stroke Severity Deems Where Patients Go Later
  14. Strokes Drop on Sundays, Spike on Mondays
  15. New Pathway to Epilepsy Discovered
  16. Cell Profiling May Help Pick Best Cancer Treatment
  17. Health Updates from the Mouths of Babes
  18. Deaths from Asbestos Exposure Surge in U.S. Report
  19. Babies Do See World Differently Than Adults
  20. Urate-Lowering Therapy Curbs Gout Attacks
  21. Generic Drugs Bought Online Short on Quality Control
  22. Meningitis C Vaccine Shows Promising Results
  23. Progress on Alzheimer's Dramatic Researcher
  24. Small Kids Have Better Memories Than Parents-Study
  25. Two Alzheimer's Drugs Show Potential - U.S. Studies
  26. Study: Vaccine Slows Alzheimer's Decline
  27. Cancer Drug Buys Time -- But at Woefully High Price
  28. Study Backs Antidepressant-Suicide Link
  29. Companies Need Help on 'Superbug' Drugs Experts
  30. Health Tip: Don't Depend on Antacids
  31. 'Good' Cholesterol Protects Women Against Dementia
  32. Blacks, Hispanics Develop Alzheimer's Earlier
  33. Protein Sports Drink May Boost Endurance
  34. Smarter Kids Become Healthier Adults
  35. US Moves to Force Hospitals, Doctors to Go Digital
  36. Amphetamines Dull Your Desire to Win
  37. Glucosamine and MSM Synergistic for Arthritis
  38. Vitamin K Might Prevent Liver Cancer
  39. AIDS Drugs May Fight Cervical Cancer, Study Finds
  40. 'Mild' Cigarettes Don't Cut Nicotine Intake
  41. Wendy's Adds Healthier Meals for Kids
  42. Intensive Arthritis Therapy Helps Symptoms
  43. Alzheimer's Risk Increases After Coronary Bypass
  44. When Your Child Struggles With Sleeplessness
  45. High Dose Chemotherapy Not Seen Saving More Lives
  46. Health Tip: Brain Exercises
  47. Study: Antidepressant Suicide Risk Not Due to Drugs
  48. Health Tip: Feeling Sluggish?
  49. Dutch Study Backs Cholesterol Drug for Children
  50. New Clues to Cause of Lou Gehrig's Disease
  51. Blood Pressure Dives During Diabetics' Heart Attack
  52. Something's Fishy About Store-Bought Red Snapper
  53. Synthetic Antibody Targets Prostate Cancer
  54. No Drop in Incidence of Heart Failure
  55. Lose Weight, Stay Active, Prevent Alzheimer's-Studies
  56. Health Tip: Beans Talk
  57. Eating Fish Can Cut Risk of Heart Rhythm Disorder
  58. Thermal Scanner Spots Early Arthritis in Hands
  59. Gene Defect Found in Some 'Crib Death' Cases
  60. Depression May Explain Fatigue of Cancer Patients
  61. Permanent Hair Dyes Tied to Adult Leukemia Risk
  62. High Meat Intake May Raise Odds of Endometriosis
  63. Alzheimer's Spending to Triple by 2015 Study
  64. Stronger Pot May Make Reefer Madness Real, U.S. Fears
  65. With Sporadic Exercise, Seniors Live Longer
  66. Easing the Pain of Tonsillectomies


  Friday, July 23, 2004


Eating Fish Protects Against Stroke


Reuters Health

Friday, July 23, 2004

NEW YORK (Reuters Health) - More evidence that fish consumption reduces the chances of having a stroke comes from an analysis of results from several large studies.

In fact, the findings suggest that "the incidence of ischemic stroke might be significantly reduced by consuming fish as seldom as 1 to 3 times per month," Dr. Ka He, at Northwestern University in Chicago, and associates comment in their report in the medical journal Stroke.

Ischemic stroke refers to a blockage of blood supply to the brain, as opposed to hemorrhagic stroke, which is caused by bleeding in the brain.

The team's search of the medical literature on the topic of risk factors for stroke turned up eight independent studies published since published since 1966. All told, there were more than 200,000 study participants aged 34 to 103 years, who were followed for anywhere from 4 years to 30 years.

Most studies were conducted in the U.S.; one was from Europe, one from China and one from Japan.

The risk of stroke was 13 percent lower among those who ate fish at least once weekly compared with those who did so less than once per month, and the results were consistent across most studies.

However, the benefit was limited largely to reduced risk of ischemic stroke. The three large studies that included data regarding different types of stroke showed no less risk for hemorrhagic stroke with increasing fish intake.

Dr. He's group cautions that these findings should not be presumed to mean that fish oil supplements would provide the same benefit. They say the possibility that other, unknown components of fish should get the credit "cannot be ruled out."

Source: Stroke, July 2004.

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Record Number of Flu Vaccines to Be Made

By Paul Elias

AP Biotechnology Writer

The Associated Press

Friday, July 23, 2004

 SAN FRANCISCO - In the heat of summer, the flu is probably the last thing on most minds. But July is when the nation's two main vaccine makers begin shipping shots to wholesalers, who in turn parcel them out to hospitals, clinics and doctors' offices nationwide. This year, health officials and shot producers vow not to run out as they did during last year's exceptionally early season start.

So this year, the Centers for Disease Control and Prevention (news - web sites) plans for the first time to stockpile 4 million vaccines for children and the two vaccine makers Chiron Corp. of Emeryville and Aventis Pasteur plan to make a combined 100 million doses. That's about 17 million more than were available last year.

On Friday, Chiron said it shipped 1 million doses to wholesalers as part of a production run that will ultimately yield 52 million shots this year, the most the company has produced in a single year.

Last year, the company made 38 million shots, accounting for about $230 million in revenue. That supply was quickly exhausted because the flu started in early October and quickly swept across the nation. By December, both makers had exhausted their supplies and many clinics ran out of shots before season's end.

"Last influenza season hit early and hit hard," said Howard Pien, Chiron's president and CEO.

A spokesman for Pennsylvania-based Aventis didn't return a telephone call Friday.

The CDC recommends that about 185 million Americans including the elderly, children, and people with weakened immune systems get flu shots each year. However, far fewer are actually vaccinated. Health officials expect a record number of people to request vaccinations this year owing to the publicity generated by last year's season and the subsequent shortage.

Vaccine manufacturing is a risky business much guesswork goes into which strains to protect against each year and how many doses to make.

Two years ago, three manufacturers made 95 million doses but only 80 million were used. The companies had to absorb the cost because the government doesn't pay for unused doses, prompting Wyeth to drop out of the business.

Based on the mild 2002-2003 flu season, the two remaining major manufacturers scaled back production last year and were unprepared for the surge in demand.

A third company, MedImmune Inc. of College Park, Md., produced a needle-free vaccine called FluMist last year, the first new vaccine on the market in 50 years. FluMist is squirted in the nose and the company had hoped it would be a popular alternative to the conventional vaccines, which are brewed in chicken eggs and delivered with a needle jab. But FluMist failed miserably, selling only 450,000 of 4 million doses it produced, and reported only $33 million in revenue.

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Eating Vegetable Protein May Spare Gallbladder

Reuters Health

Friday, July 23, 2004

NEW YORK (Reuters Health) - Women who get a lot of their dietary protein from vegetables are at reduced risk for having their gallbladder removed, which is usually performed for gallstones and related problems, new research suggests.

"In animals, vegetable protein can inhibit gallstone formation," Dr. Chung-Jyi Tsai, from the Harvard School of Public Health in Boston, and colleagues note. However, few studies have looked at this association in humans.

As reported in the American Journal of Epidemiology, the researchers studied data from some 121,000 women participating in the Nurses' Health Study. Over 20 years of follow-up, 7831 women underwent gallbladder removal, also called cholecystectomy.

Total protein intake and animal protein intake had no effect on the risk of cholecystectomy. For vegetable protein, however, the risk of cholecystectomy dropped as intake increased.

"These results suggest that increased consumption of vegetable protein in the context of an energy-balanced diet can reduce the risk of cholecystectomy in women," the authors conclude.

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

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ISU Research Says Fat Good With Veggies

The Associated Press

Friday, July 23, 2004  

AMES, Iowa - Don't use a fat-free dressing on your salad, an Iowa State University researcher says. A bit of fat added to fresh vegetables helps bodies absorb cancer-fighting lycopene and alpha- and beta-carotenes, said Wendy White, an ISU associate professor of nutrition.

If vegetables remain free of fat, the body won't consume the essential nutrients that can help prevent cancer and heart disease, White's research shows.

About 2 fluid ounces, or four tablespoons, of salad dressing would be an adequate amount of dressing for a large salad, White said. Fans of add-ons such as cheese, bacon bits, fried chicken, egg yolk and avocados should opt for a fat-free dressing, she said.

"If a person is going to eat a brownie anyway with the meal, that's fine as long as it's done in moderation," White said. "In that case, I would go with fat-free dressing on the salad."

"That's good news for us," said Karen Boelling, who on Thursday was munching on a garden salad with a healthy dose of Parmesan dressing at Big Leagues Skybox Grill & Deli in downtown Des Moines. "I like the salad dressing. It makes it worth eating."

The results of the study, paid for by Procter and Gamble's Nutrition Science Institute, surprised Wells Fargo employee Laura Bock, who was eating a salad during lunch break Thursday.

"You always think of salad dressing as fattening and bad," she said.

White cautioned that too much dressing can lead to health problems.

"In the absence of fat, people are probably not deriving the benefits from the beta-carotenes and other carotenoids," White said. "They have to balance that knowledge, along with the knowledge that fat is excess calories, and excess body weight is a huge problem in America."

Nearly one-third of U.S. adults are obese, and 300,000 deaths each year can be linked to unhealthy eating and exercising habits, according to the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (news - web sites).

Information from: The Des Moines Register,

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Sports Physicals Should Be Thorough, Expert Says

By Alison McCook
Reuters Health
Friday, July 23, 2004

NEW YORK (Reuters Health) - As students prepare for the fall sports season by getting physicals, parents should take certain steps to make sure the exam is really measuring if students are fit to play, according to an expert.

For instance, the most common cause of sudden death among athletes is a heart condition known as hypertrophic cardiomyopathy. A simple physical won't detect if someone is at risk, but a detailed medical history - that asks about a family history of sudden death or a personal history of fainting during exercise, for instance - will, Dr. Jay Noffsinger told Reuters Health.

History forms should also include questions about concussion and heat stroke, Noffsinger noted. People who have experienced a concussion are between 5 and 6 times more likely to have another one, he said, and one case of heat stroke often predisposes people to another.

Parents should also make sure their children get sports physicals around 6 weeks before they begin practicing, he added, so that if students have some type of physical weakness that predisposes them to ankle sprains, for instance, they can complete any rehabilitation they need.

However, "If you did it 6 months ago, that's not ideal either," he said. That's because children can develop injuries or other health problems in between the physical and the time they start training.

Another one of Noffsinger's tips: don't let students fill out history forms themselves. "It's important to not just have the student athlete fill out the family history, but the parent as well," he said.

Research shows that, when filling out history forms, parents and athletes agree only 39 percent of the time, he said, so having the input of both will help save doctors from missing an important detail.

Noffsinger, who is based at Saint Louis University School of Medicine in Missouri, added that parents should also beware the "locker room" sports physical, in which athletes line up and doctors look them over head-to-foot. "That really is the worst possible method," he said.

Another type of physical is the "station method," he said, in which students get checked by many different experts such as cardiologists and orthopedic surgeons who look for whatever problems fall under their expertise.

Another option is for students to ask their personal, private physician to perform the entire exam, Noffsinger said, which can help if the doctor remembers or has access to students' records and personal history.

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Listeria Can Linger


Friday, July 23, 2004

FRIDAY, July 23 (HealthDayNews) -- Food retailers and food-processing plants might try to maintain a clean environment, but new research has found that strains of the deadly Listeria monocytogenes pathogen can persist for up to a year or longer.

Listeria can cause listeriosis, a disease that primarily affects pregnant women, newborns, and adults with weakened immune systems. Each year some 2,500 people are infected in the United States, of whom a fifth die.

The bacterium was found directly on food in 47 of 50 retail food stores examined by Cornell University food scientists. When the 50 stores were re-inspected weeks, months, or even a year later, about 34 percent had persistence of the same strains of Listeria.

Listeria also was found in seven food-processing plants, and three had persistent strains of the bacterium.

"This is disturbing because this points the finger at retail stores and some processors as a continuing source of food contamination," said doctoral candidate Brian D. Sauders, who worked on the study published in the July issue of the Journal of Food Protection.

The foods in which Listeria was found included ready-to-eat delicatessen foods such as ham, beef bologna, chicken, pastrami, roast beef, and smoked fish. It also was found in hummus, imitation crab, cheeses, and in foods requiring cooking before consumption, like hot dogs and raw beef.

Listeria can be eliminated through pasteurization or cooking.

More information

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

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Report Warns Against Overregulating Health Care


Friday, July 23, 2004  

WASHINGTON (Reuters) - Lawmakers should resist piling too many regulations on the U.S. health care industry and try instead to foster more competition, antitrust authorities said on Friday.

In a sweeping report on the U.S. health care market, antitrust officials with the Justice Department (news - web sites) and Federal Trade Commission said imposing too many rules and regulations could hobble competition and ultimately be bad for consumers.

Instead, the government could help consumers more by finding ways to open up the health care market and to get patients more information about price and quality, it said.

"Vigorous competition promotes the delivery of high-quality, cost-effective health care," FTC Chairman Timothy Muris said in a statement.

The report notes the surge in U.S. health care costs since the 1970s. It acknowledges that market competition "is not a panacea for all of the problems with American health care."

But it says regulations, like those that mandate coverage of particular medical services, can have unintended consequences, which hurt competition even when they are designed to help patients, the agencies said.

Governments "should consider that such mandates are likely to reduce competition, restrict consumer choice, raise the cost of health insurance, and increase the number of uninsured Americans," the FTC said in its report.

The agencies also advised state lawmakers to resist proposals to waive antitrust laws and allow doctors to bargain collectively with insurance companies. And it said states should review programs and licensing procedures in an effort to make it easier for new, upstart companies to enter the market.

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New Devices Seal Hole in Heart



Friday, July 23, 2004

FRIDAY, July 23 (HealthDayNews) -- An innovative set of devices can close a slit between the upper chambers of the heart that increases the risk of stroke for one in four people.

That's according to an article in the August issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions.

The slit, also known at the foramen ovale, is essential during fetal development because it lets blood circulate through the body while bypassing the undeveloped lungs. After birth, the slit normally closes up.

But for a quarter of people, the slit remains open. It lets blood cross from one side of the heart to the other, placing people at increased risk for blood clots and stroke.

Researchers at Emory University Hospital in Atlanta found that two new devices -- the CardioSEAL and STARFlex -- can both seal up the hole.

Consisting of a knitted polyester fabric patch attached to a flexible metal frame, the devices are like umbrellas joined by a common spring-loaded handle. Deployed into the heart by a catheter, the devices seal up the slit by opening the "umbrellas" on either side of the heart wall.

More information

The American Heart Association (news - web sites) has more about congenital heart defects.

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ADHD May Go Hand-In-Hand with Seizures in Kids


Reuters Health

Friday, July 23, 2004

NEW YORK (Reuters Health) - Attention-deficit/hyperactivity disorder (ADHD) seems to be a risk factor for unprovoked seizures in children.

"ADHD and seizures may be co-morbid conditions," say the authors of a report in the Archives of General Psychiatry.

ADHD does occur more frequently than would normally be expected in people with epilepsy, Dr. Dale C. Hesdorffer, of Columbia University, in New York, and colleagues note.

While this has been attributed to the epilepsy or its treatment, "It is impossible to determine in previous studies which condition occurs first," they point out.

To look into this chicken-or-egg question, the researchers studied newly diagnosed, unprovoked seizures among Icelandic children younger than 16 years. The team matched each child who had a seizure to two similar but seizure-free children from the population registry, and looked for an existing diagnosis of ADHD among both groups.

Children with ADHD had a 2.5-fold higher likelihood of unprovoked seizures than children without ADHD.

The association was statistically significant for ADHD predominantly of the inattentive type, but not for the predominantly hyperactive-impulsive type of ADHD, or combined types.

Hesdorffer and colleagues suggest that the findings indicate that ADHD and seizures "may occur together owing to a causal relationship between them or owing to an underlying vulnerability to both disorders."

Source: Archives of General Psychiatry, July 2004.

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Stenting Works on Smaller Arteries


Friday, July 23, 2004

FRIDAY, July 23 (HealthDayNews) -- Stenting is an effective way to restore and maintain blood flow to the heart even in small coronary arteries.

That analysis appears in the August issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions.

The research could put to rest a controversy over whether stents -- tiny metal scaffolds that prop open once-clogged coronary arteries -- should be used in arteries less than 3 millimeters in diameter.

The analysis encompassed nine clinical studies and nearly 2,600 patients. "Only by pooling the results of a handful of small studies in a meta-analysis can we finally say with confidence that stents reduce restinosis (renarrowing of the artery) in small vessels," said study author Dr. Paul T. Vaitkus, of the University of Illinois at Chicago.

Vaitkus found that patients treated with stenting were only 62 percent as likely to experience restenosis, when compared to those people treated with balloon angioplasty alone.

More information

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

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Yes, Weather Ups Headache, But Less Than You Think

Reuters Health

Friday, July 23, 2004  

NEW YORK (Reuters Health) - Certain weather conditions indeed appear to increase the risk of migraine, but people still tend to overestimate weather's influence on their headache, new research shows.

"We showed that patients are susceptible to multiple weather variables and that more patients thought weather was a trigger than was the case," write the researchers, led by Dr. Patricia B. Prince of the Children's Hospital in Boston.

This is not the first study to investigate weather's effect on headache, but most have shown conflicting results. For instance, one investigation found that people tended to get more headaches on days with low barometric pressure, and stronger headaches on days with many hours of snow-reflected sunlight.

Another study, in contrast, found that a variety of weather conditions, including fog, sunshine, changing pressure and temperature, had no bearing on headache risks.

During the current investigation, Prince's team asked 77 adults suffering from migraines to report whether they thought their headaches were influenced by weather, then to record the intensity of their headaches every day for between 2 and 24 months. The researchers also recorded weather conditions from three reporting stations close to where participants lived.

Reporting in the journal Headache, the investigators found that around one-third of people were sensitive to temperature and humidity, and around 14 percent experienced headaches in response to changing weather patterns. Another 13 percent were sensitive to barometric pressure changes.

Overall, approximately 50 percent of people experienced headaches in response to some weather-related factor. However, more than 62 percent of people said they believed their headaches were sensitive to weather-related changes, a significantly higher number than actually were.

The most common conditions people believed caused their migraines included rain, bright sunshine, high humidity and hot temperatures.

The researchers conclude: "If patients and their physicians pay close attention to personal patterns in weather sensitivity, it may be possible to prevent the onset of headache in many situations, and in others prepare to be armed to initiate treatment when headache begins."

Source: Headache, June 2004.

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Thursday, July 22, 2004


Tourists Bring Sex Diseases Back with Souvenirs


By Patricia Reaney


Thursday, July 22, 2004

LONDON (Reuters) - Young travelers and sex tourists are returning from exotic locations with more than just tans and souvenirs. For some, infections such as syphilis and HIV (news - web sites) are lingering reminders of a holiday romance.

"A large proportion of people are having sexual intercourse with new partners when they go abroad...and are putting themselves at risk of sexually transmitted infections (STIs)," said Dr Karen Rogstad of the Royal Hallamshire Hospital in Sheffield, England.

In a report published in the British Medical Journal on Friday, Rogstad reviewed research studies on STIs and searched global health Web Sites and others that could be expected to provide information about traveling to other countries.

"Travel abroad seems to be responsible for a small but increasingly important proportion of acute STIs in the United Kingdom," she said.

In one study of heterosexual men in Britain, 21 percent of syphilis infections were from sexual contacts abroad and 9 percent of gonorrhea sufferers had had sex in a foreign country in the previous three months.

"Between 2000 and 2002, 69 percent of United Kingdom born men with heterosexually acquired HIV were infected through sex while abroad, as were a quarter of women. Of these men, 22 percent were probably infected in Thailand," Rogstad said.

Young people under 25 years old face a high risk of bringing home more than they had expected from a holiday abroad because foreign tourists are often perceived as easy prey, alcohol may cloud their judgment and there is an increasing use of the date rape drug Rohypnol.

But Rogstad said sex tourists who traveled abroad with the intention of having sex faced the ultimate holiday gamble.

"A study of male German sex tourists in Thailand showed that most were aged 30-40 and single, with a well-paid job. Of these, 30-40 percent used condoms," she added.

Only about three percent of travel brochures contain advice on safe sex and few companies supply information about the risk tourists face, according to the research.

"More worrying is tour operators' encouragement of sex with new partners by presenting prizes," she added.

Rogstad believes educating travelers about the risks they may face abroad and supplying information when tourists book their holidays or receive medical treatment before leaving could help to reduce the problem.

"Prevention advice should be offered to all people going on holiday but particularly those going to the developing world," she added.

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Stroke Severity Deems Where Patients Go Later



Thursday, July 22, 2004

THURSDAY, July 22 (HealthDayNews) -- The stronger a stroke is, the more likely the victim will be sent to a rehabilitation or nursing home rather than back to his own home, new research says.

The study traced the release of 546 patients from three countries who had suffered severe strokes as measured by the National Institutes of Health (news - web sites) Stroke Scale. All were treated with powerful clot-busting drugs.

About 44 percent of the patients were discharged to home, while 56 percent were sent to rehabilitation or a nursing facility, said the researchers from the University of Pennsylvania Medical Center in Philadelphia.

Researchers concluded that stroke severity is the predominant way to predict where a stroke victim will be discharged. They also found their study reinforced the usefulness of the stroke scale in measuring stroke severity.

The study appears in the July issue of the Archives of Neurology.

More information

The National Institute of Neurological Disorders and Stroke has more about stroke.

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Strokes Drop on Sundays, Spike on Mondays


Reuters Health

Thursday, July 22, 2004

NEW YORK (Reuters Health) - The risk of having a stroke caused by a blockage of bloodflow to the brain is lower on Sundays than on any other day of the week, new findings from Finland suggest. On Mondays, the occurrence of these so-called ischemic strokes is strikingly higher, at least among certain demographic groups.

These findings from a World Health Organization (news - web sites)'s (WHO) study are published in a rapid access issue of the American Heart Association (news - web sites)'s journal Stroke.

Dr. Jakovljevic Dimitrije and colleagues at the National Public Health Institute of Finland in Helsinki examined the weekly variation in ischemic stroke occurrence and the effect of socioeconomic status. They identified a total of 12,801 ischemic strokes occurring between 1982 and 1992.

The lowest number of strokes occurred on Sundays, regardless of age, gender or socioeconomic status, they found.

The weekly variation was most prominent among persons aged 60 to 74 years, of low taxable income and with no more than 9 years of full-time education.

Among men of low income, the stroke rate was 14% below the weekly average on Sunday and 18% above average on Monday. In contrast, there was no Monday excess observed in persons with high socioeconomic status.

This finding is of "substantial public health interest," Dimitrije's group notes, and may "open up some possibilities for prevention."

Stroke 2004;35.

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New Pathway to Epilepsy Discovered


By Steven Reinberg
HealthDay Reporter


Thursday, July 22, 2004

THURSDAY, July 22 (HealthDayNews) -- Working with rats, scientists have uncovered a previously unknown change in brain cells that appears to be responsible for the seizures associated with the most common type of adult epilepsy.

In rats with a condition resembling the condition, known as temporal lobe epilepsy, the ends of these neurons, called dendrites, were more sensitive than normal brain cells. Epilepsy causes neurons to die, and the resulting fewer-than-normal number of dendrites allows too much potassium to pass through the cell. This, in turn, caused increased sensitivity and seizures.

Targeting this potassium channel may open the way to new treatments for epilepsy, researchers report in the July 23 issue of Science.

Epilepsy is a brain disorder in which neurons fire abnormally. The normal pattern of brain activity becomes disturbed, causing strange sensations, emotions and behavior. It can also sometimes lead to convulsions, muscle spasms and loss of consciousness.

According to the Epilepsy Foundation, some 2.5 million Americans suffer from epilepsy and seizures.

"We have been exploring the properties of dendrites, which are the tree-like parts of neurons that receive connections from other neurons by way of synapses," said lead researcher Daniel Johnston, a professor of neuroscience at Baylor College of Medicine.

Dendrites have many ion channels, which are specialized proteins that allow ions to flow in and out of brain cells, Johnston explained. These ions control the electric activity of neurons.

Johnston's team found that, in epilepsy, the number of potassium ion channels was significantly reduced. "The channels that remained were altered," he added.

The net effect of fewer potassium channels and damaged channels made the cells more likely to fire in a hyperexcitable state. "That is the hallmark of epilepsy," Johnston said.

"Drugs that target this ion channel would be a totally novel way of potentially suppressing this hyperexcitable state," he added.

How potassium channels become altered is not known. It is possible that seizures themselves may damage the neurons, and once that begins, the damage continues until epilepsy develops, said co-researcher Dr. Nicholas P. Poolos, an assistant professor of neurology at the University of Washington.

In addition, in epilepsy that is inherited, which most temporal epilepsy isn't, the cause has been identified as mutations in genes that control ion channels, he added.

"Ion channels are really the basis of a number of epilepsy syndromes. And our studies in animals are getting us to think more about how ion channels are affected in humans when epilepsy is not inherited but acquired later in life," Poolos said.

"We would like to understand the period from the first seizure and development of chronic epilepsy, which leads to fewer potassium channels," Johnston said.

"This is another big clue to how the brain circuits are changing and why epileptics are predisposed to seizures," said Dr. Kevin J. Staley, a professor of pediatrics and neurology at the University of Colorado Health Sciences Center.

"These findings give a molecular target to dampen seizures and gives us an understanding of how neurons adapt to changing conditions," said Staley, who wrote an editorial accompanying the article. "These finding also help us understand how we recover from brain injury."

More information

The National Institute of Neurological Disorders and Stroke helps explain epilepsy.

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Cell Profiling May Help Pick Best Cancer Treatment


Reuters Health

Thursday, July 22, 2004

NEW YORK (Reuters Health) - The response of cancer cells to various stimuli may help doctors determine which chemotherapy drug will work best, new research suggests.

This technique could reveal subtle differences that are missed with standard microscopic analysis.

With the technique, the researchers look for signaling proteins that are produced by the cancer cell in response to various stimuli. From this, they are able to create a signal profile for that particular cell that can be used to distinguish it from others, according to the report in the scientific journal Cell.

In the study, Nolan's team evaluated the responses of individual leukemia cells to environmental stimuli. This allowed the researchers to identify unique signaling profiles that correlated with treatment response and disease outcome.

The authors also found that not all cells from a particular cancer responded to the stimuli in the same way, indicating that even within a cancer, the cells often differ from each other.

"This is the first time we've been able to look at cancer signaling messages in a population of individual cells to distinguish treatment options," senior author Dr. Garry P. Nolan, from Stanford University in California, said in a statement.

Evaluating the signaling response at the individual cell level "provides a fuller understanding of how cells process information in normal and diseased states," the researchers add.

Source: Cell, July 23, 2004.

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Health Updates from the Mouths of Babes


Thursday, July 22, 2004

THURSDAY, July 22 (HealthDayNews) -- Doctors have found that if they ask the right questions, children as young as 6 can adequately understand and accurately report on their own health.

A review of published research on child report questionnaires found plenty of evidence that children can communicate about their health.

Doctors at the Johns Hopkins Bloomberg School of Public Health who conducted the review also developed questionnaires that physicians can use to seek health information from children aged 6 to 11.

The report appears in the July/August issue of Ambulatory Pediatrics.

"Children can tell us how they feel in a way that no one else can, and their future health is influenced by their early experiences," lead researcher Dr. Anne Riley said in a statement. "It is worth the trouble to ask children about their health before their habits and risk behaviors become established."

More information

The American Academy of Pediatrics has more about pediatric health.

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Deaths from Asbestos Exposure Surge in U.S. Report

By Paul Simao


Thursday, July 22, 2004

ATLANTA (Reuters) - Deaths from asbestos exposure have surged in the United States and are set to keep rising in the next decade as more workers succumb to the lung disease caused by the industrial mineral, federal health experts warned on Thursday.

The number of Americans who died of asbestosis, which is caused by inhalation of asbestos particles, jumped to 1,493 in 2000 from 77 in 1968, according to the Centers for Disease Control and Prevention (news - web sites).

The incurable disease, marked by shortness of breath and persistent cough and linked to a higher risk of cancer, is now a bigger killer than silicosis and black lung and the deadliest of all work-related respiratory illnesses.

The Atlanta-based CDC warned that the death toll would likely continue rising because of the lag -- often as much as 45 years -- between initial exposure to asbestos fibers and death.

"What we're dealing with is a legacy of the past," said Michael Attfield, an epidemiologist in the CDC's National Institute for Occupational Safety and Health and one of the study's authors.

Prized for its heat-resistant and insulation properties, asbestos was mined for use in U.S. shipyards and construction sites after World War II. Its use declined sharply in the 1980s after warnings about health risks.

Attfield said that asbestos-tainted materials were still in some factories, workplaces and other buildings across the nation, posing a continued risk of exposure to occupants.

Coastal states such as Alaska, Washington, Mississippi, Virginia, Massachusetts and Maine were among those with the highest rates of asbestosis mortality between 1982 and 2000, according to the CDC study, which analyzed data from death certificates.

The rise in asbestosis deaths has occurred amid a decline in mortality from other occupational lung diseases such as coal workers' pneumoconiosis, or black lung, and silicosis.

The death rate from silicosis and other unspecified pneumoconiosis was 70 percent lower in men between 1982 and 2000 than in the 1968-1981 period. Male mortality due to black lung fell 36 percent over the same time periods.

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Babies Do See World Differently Than Adults


Thursday, July 22, 2004

THURSDAY, July 22 (HealthDayNews) -- Babies too young to speak see the world differently from adults, but they're capable of noticing distinctions they may not be able to make once they learn language, says an article in the July 22 issue of Nature.

Researchers found that 5-month-old infants reacted differently when watching objects being placed inside a container that fit either tightly or loosely. The infants looked at the objects longer when there was a change between a tight or loose fit.

However, English-speaking adults shown the same activity did not spontaneously make the same distinction.

The researchers theorized that's because such a distinction is not marked in English as it is in other languages, such as Korean. For instance, a pen on a table is perceived as just that in English, but in Korean it is considered a "loose fit" relationship between the two objects.

"Adults were glossing over the distinction that the babies were actually detecting," said co-author Sue Hespos, an assistant professor of psychology at Vanderbilt University.

"These findings suggest that humans possess a rich set of concepts before we learn language," added co-author Elizabeth Spelke, a professor of psychology at Harvard University. "Learning a particular language may lead us to favor some of the these concepts over others, but the concepts already existed before we put them into words."

More information

New York University has more about infant perception.

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Urate-Lowering Therapy Curbs Gout Attacks

Reuters Health

Thursday, July 22, 2004

NEW YORK (Reuters Health) - Treatment with drugs that reduce levels of urate in the blood leads to a significant reduction in gouty arthritis attacks, according to Japanese researchers.

Gout is caused by the accumulation of uric acid crystals in the joints. The condition can flare up periodically, causing extreme pain.

Dr. Hisashi Yamanaka and colleagues at Tokyo Women's Medical University note in the journal Arthritis and Rheumatism that urate-lowering drugs are known to improve the long-term prognosis of gout. However, the researchers point out that it is unclear whether the frequency of attacks is reduced.

To investigate, the team studied 267 patients who had had at least one gout attack before visiting their clinic. The participants were followed for up to three years.

After accounting for initial urate concentrations and the number of previous attacks, the investigators found that a reduction in urate levels and the use of urate-lowering drugs reduced the frequency of gout attacks.

From their data, the team concludes that reduction of urate concentrations to 6 milligrams per deciliter or lower "will eventually result in a reduced frequency or prevention of future gouty attacks."

Source: Arthritis and Rheumatism, June 2004.

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Generic Drugs Bought Online Short on Quality Control

By Amanda Gardner
HealthDay Reporter


Thursday, July 22, 2004

THURSDAY, July 22 (HealthDayNews) -- A basic measure of the quality of prescription drugs is lacking when it comes to many generic medications ordered online, a new study says.

This raises the specter that other measures may also be substandard, or that some of the drugs may be counterfeit, the authors stated.

An estimated 1,000 Internet pharmacies are currently operating, according to the study, which appears in the July 23 issue of Science.

One-third of the countries producing drugs for sale have regulatory controls similar to those in the United States. Another third have regulatory controls but no enforcement, while the remaining third have no regulation. Because of the Internet, any drug, regardless of where it is manufactured, could turn up for use in the United States, the authors said.

The basic quandary for many Americans is that the medications they need often cost more than they can afford. As a result, many people as well as cities are turning to countries such as Canada, where drugs cost up to 50 percent less. On Wednesday, Boston became the latest and largest U.S. city to offer prescription drugs from Canada -- a program expected to save about $1 million in its first year, according to the Boston Globe.

For brand-name drugs purchased anywhere, quality should not be an issue, said Dr. Marc Siegel, clinical associate professor of medicine at New York University School of Medicine.

"The drug industry is floating around an idea that they can't preserve quality outside of these borders, but I don't buy that," he said. "I think that we can certainly preserve quality among brand-name medications. The companies have the obligation to make sure that's the case."

Siegel agreed, however, that the quality of generic drugs ordered over the Internet can be questionable.

To compare quality measures, the study researchers ordered generic versions of the cholesterol-lowering drug simvastatin (Zocor) from Internet sites in Brazil, India, Mexico and Thailand. These tablets were then compared to brand-name pills that had been purchased at a U.S. pharmacy with a regular prescription.

This particular statin was chosen largely because the brand name is relatively expensive in the United States, making it likely that people would look for less-expensive substitutes on the Internet.

"Drug price may be a big factor in seeking out this drug on the Internet, particularly for senior citizens who may be on limited incomes," said study author Michael A. Veronin, an assistant professor in the School of Pharmacy at Texas Tech University Health Sciences Center.

Veronin found that a 30-day supply of Zocor costs about $140 in a U.S. pharmacy, while generic versions of the drug cost only $50 to $60 on the Internet.

He and a colleague then tested for something called "blend uniformity."

"We looked at one major aspect of quality, how well the tablet's active ingredient was blended," Veronin explained. "This could have an impact on how well the tablet dissolves and allows the active ingredient to be available to the body to be effective."

The level of blending was erratic across the samples, with the pills from the United States and Thailand exhibiting the best quality. "It appears that although the tablets are labeled as the same drug and strength, there were differences in manufacturing processes from different countries," Veronin said.

The study authors also imaged the internal structure of the tablets, giving a visual representation of each chemical component. The images revealed pockets or clumps of the active ingredient, somewhat like clumps of cake mix that remain in the batter if you don't mix it well enough, Veronin said.

Although blending is just one aspect of tablet quality, it is one of the more basic ones. "My thinking is if it wasn't well-blended, it makes the other attributes suspect," Veronin said.

These results are in line with a U.S. Food and Drug Administration (news - web sites) (FDA (news - web sites)) analysis this month of three drugs -- Viagra, Lipitor (news - web sites) and Ambien -- obtained from a Web site advertised as Canadian. The FDA described the drugs as "fake, substandard and potentially dangerous."

Although many Americans feel they have no choice because of cost considerations, the message from the FDA and now this study is to exercise caution when purchasing drugs online.

For Siegel, however, there are other options.

"We can work toward consistency among generics overseas. That's something we can look at," he said. Until then, "an ask-your-physician line is good. If you bring back something from another country, please ask your physician if it is the same dose and the same quality."

More information

Visit the U.S. Food and Drug Administration for more on buying drugs online.

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Meningitis C Vaccine Shows Promising Results

By Patricia Reaney


Thursday, July 22, 2004

LONDON (Reuters) - A vaccine against meningitis C that was introduced in Britain five years ago is highly protective and prevents more than 800 cases of the illness annually, researchers said on Friday.

But after the first year its effectiveness in infants declines, so a booster, or alternative vaccination schedules, may be needed to insure protection.

"The vaccine is highly effective overall," Dr Mary Ramsay, of Britain's Health Protection Agency which monitors infectious diseases, said in an interview.

"The only concern is that in one particular age group, that protection declines fairly quickly," she added.

Britain became the first country to launch a vaccination program against meningitis C in 1999. Since then, the number of confirmed cases of the illness, which causes an inflammation of the lining of the brain and spinal cord, has dropped dramatically.

"There were 885 cases a year before the vaccine was introduced. Last year we had 60 cases. That is over 800 cases a year being prevented by the vaccine," said Ramsay.

The vaccine was initially given to babies and extended to other age groups and to under 25s in 2002.

It gives high levels of protection for children aged five months to 18 years but for young babies who are given it at two, three and four months of age in Britain, its effectiveness declines quickly after the first year, according to the researchers.

The incidence of the illness, which can develop very quickly, is very high in infants which is why they are vaccinated early in life.

"It protects in the short term but declines. What we are really saying is that it is time to think about the schedule we use in babies," added Ramsay, who reported the findings in The Lancet medical journal.

Giving the last dose later than five months old, or adding a booster, may produce a better response.

Meningitis is caused by meningococcal bacteria. There are three types - A, B and C. The disease, which can strike without warning, can kill or leave sufferers severely handicapped.

Fever, headaches and vomiting are early symptoms of the illness but they can be mistaken for flu. A stiff neck and purplish rash are other signs.

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Progress on Alzheimer's Dramatic Researcher

By Jon Hurdle


Thursday, July 22, 2004  

PHILADELPHIA (Reuters) - A cure for Alzheimer's disease (news - web sites) is unlikely in the near future, but big advances are coming soon in the treatment and prevention of the fatal brain illness, a leading researcher said on Thursday.

Researchers have made strides in learning about causes and possible therapies, and just in time, too, as the burden of Alzheimer's threatens Medicare, said Dr. William Thies, vice president for medical and scientific affairs at the Alzheimer's Association.

"We will see drastic improvements in ways of treating and preventing the disease," Thies said in an interview at the end of an international Alzheimer's conference. "It might be three, five, seven, 10 or 12 years away -- something like that."

Thies said researchers have made a "staggering amount" of progress on finding causes, developing medications that have the potential to treat it, and identifying preventive steps, particularly lifestyle changes that may delay the onset of the brain-wasting disease.

Research presented at the conference suggests, for example, that risk factors for heart disease may also lead to dementia. A study in Sweden and Finland found that participants who were obese in middle age were twice as likely to develop dementia in later life.

Another study from Harvard Medical School (news - web sites) found that women who ate vegetables such as spinach and broccoli in middle age preserved more of their cognitive abilities as they entered their 70s.

Drug trials presented to the conference appear to show that beta-amyloid, the abnormal protein that is a prime suspect as the cause of Alzheimer's, can be broken down in the brain using medication, slowing the process of cognitive decline.

16 Million Cases

Such preventive measures could help cut the number of Alzheimer's cases in the United States, which is expected to hit 16 million by the middle of this century -- almost four times the current number -- as the baby boom generation ages and lives longer.

That number could be even greater because of the higher incidence of Alzheimer's in the U.S. black and Hispanic populations, which are growing faster than the white population, Thies said.

The financial burden of treating the expected increase in Alzheimer's sufferers threatens to bankrupt the U.S. health care system, Thies said. Alzheimer's patients often have other illnesses, and the cost of treatment to Medicare -- the state-federal health insurance system for the elderly -- averages $13,207 per patient per year.

That amount is more than three times the average for other Medicare patients, according to the Alzheimer's Association.

Seeking to avert a crisis, the association is asking for a 32 percent increase in federal research funding, to $1 billion a year.

The association's campaign have been helped by the Alzheimer's-related death of former U.S. President Ronald Reagan (news - web sites), whose widow Nancy has called for more government support to fight the disease.

"Congress would like to recognize the contribution of Mr. Reagan, and rather than putting his face on a $20 bill, funding to find a cure for this awful disease would be the right decision," Thies said.

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Small Kids Have Better Memories Than Parents-Study


Thursday, July 22, 2004

WASHINGTON (Reuters) - Next time, maybe you'll believe your kid. Small children apparently have better memories than their parents, researchers reported on Thursday.

They found a 5-year-old could beat most adults on a recognition memory test, at least under specific conditions. And the reason is that adults know too much.

"It's one case where knowledge can actually decrease memory accuracy," said Vladimir Sloutsky, director of the Center for Cognitive Science at Ohio State University, who led the study.

For their study, researchers showed 77 young children and 71 college students pictures of cats, bears and birds. The study was designed to make the volunteers look at the pictures but they did not know what was being tested.

Writing in the journal Psychological Science, the researchers said the children, with an average age of 5, were accurate 31 percent of the time in identifying pictures of animals they had seen earlier, while the adults were accurate only 7 percent of the time.

The reason, Sloutsky believes, is that children used a different form of reasoning called similarity-based induction when they analyzed the pictures. When shown subsequent pictures of animals they looked carefully to see if the animal looked similar to the original cat.

Adults, however, used category-based induction -- once they determined whether the animal pictured was a cat, they paid no more attention. So when they were tested later, the adults didn't recognize the pictures as well as the children.

"The adults didn't care about a specific cat-- all they wanted to know was whether the animal was a cat or not," Sloutsky said.

And when taught to use category-based induction like adults, the children's ability to remember dropped to the level of adults.

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Wednesday, July 21, 2004


Two Alzheimer's Drugs Show Potential - U.S. Studies


By Jon Hurdle


Wednesday, July 21, 2004

PHILADELPHIA (Reuters) - Two experimental Alzheimer's drugs have the potential to prevent or halt the progress of the brain-wasting disease, doctors said on Wednesday.

Both focus on beta-amyloid, a protein that is suspected of causing Alzheimer's. It accumulates into the characteristic clogs called plaques that distinguish the brains of people who have died from Alzheimer's.

An estimated 4.5 million Americans have the disease, a number that is expected to grow to 16 million by 2050 as the baby boom generation ages. More than 15 million people globally have Alzheimer's.

In one study at Georgetown University Medical Center in Washington, 58 people with mild to moderate Alzheimer's disease (news - web sites) took a drug called Alzhemed or a placebo for three months, then for an additional 21 months.

Alzhemed, made by Montreal, Canada-based Neurochem Inc., is a pill just beginning Phase III trials, the final stage before a company seeks approval from regulators for a new drug.

The study, reported at a meeting of Alzheimer's experts in Philadelphia, found a significant drop in the level of beta-amyloid among patients who took the drug and no change among those taking the placebo.

The researchers also found Alzhemed in cerebral spinal fluid, which indicates it was finding its way to the brain where it is needed. The drug reduced the levels of beta-amyloid in the spinal fluid and was generally safe and well tolerated, the researchers found.

Trail Set To Expand

Among patients who began the trial with mild Alzheimer's, there was no further cognitive decline after 12 months of taking the drug, said Dr. Paul Aisen, who leads the study.

There are now 26 patients who have taken the drug for 16 months, and 19 who have taken it for 20 months, Aisen told a news conference. He said the trial will now be expanded.

"It will be a large, long trial that will provide a definitive answer on the efficacy of Alzhemed in inhibiting Alzheimer's," Aisen said.

In another study, Eli Lilly & Co. is trying to prevent beta-amyloid from forming in the first place.

A trial of 37 healthy adults aged over 45 found blood levels of beta-amyloid were reduced after they took LY450139, an experimental drug designed to interfere with the formation enzymes called secretases, which generate beta-amyloid.

The trial found reduced levels of beta-amyloid in the blood after the drug was administered. Higher doses produced a greater reduction.

Although the drug was detected in cerebral spinal fluid, it did not reduce concentration of beta-amyloid in the fluid.

Researchers need to know the most effective dose before starting a larger trial, said Dr. Eric Siemers of Eli Lilly.

Alzheimer's begins with mild memory loss but can quickly progress to destroy learning, memory and patients' ability to care for themselves. There is no cure and it is always fatal.

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Study: Vaccine Slows Alzheimer's Decline


By Malcolm Ritter

AP Science Writer

The Associated Press

Wednesday, July 21, 2004

An experimental vaccine for Alzheimer's disease (news - web sites) slowed memory decline somewhat even though the research was stopped before the full treatment could be administered, a study suggests.

There's no indication that the effect made any noticeable difference in the patients' day-to-day functioning. The study wasn't set up to look for that.

But the memory result was surprising and encouraging for the general idea of using the immune system to attack Alzheimer's, said researcher Sid Gilman.

"I think there's a positive signal here," said Gilman, a professor of neurology at the University of Michigan.

The vaccine was intended not to prevent Alzheimer's, but to treat it. The experiment was halted in early 2002 after 18 of 300 participants developed brain inflammation. The vaccine formulation has been abandoned, but the general immune-system strategy is still being pursued.

Gilman spoke in a telephone interview before presenting the vaccine results Wednesday at the International Conference on Alzheimer's Disease and Related Disorders in Philadelphia. The study was sponsored by Elan Corp., based in Dublin, Ireland, and Wyeth Pharmaceuticals of Collegeville, Pa., which are collaborating on the idea of treating Alzheimer's through the immune system.

People with Alzheimer's have amyloid plaque clumps in their brains, and the vaccine was designed to develop blood proteins call antibodies to attack the plaque. Autopsy studies of three people who had received the experimental vaccine show that the plaque clumps had been cleared from areas of the brain, Gilman said.

Originally, study participants, who had mild to moderate Alzheimer's, were to get six injections over 12 months. But because of the brain inflammation, nobody got more than three and most got only two. The new research looked at psychological tests done 12 months after the first injection.

The study compared test results from patients who had a certain level of antibodies in response to the vaccine versus patients who were given inert injections for comparison purposes.

Not all patients completed each psychological test. Among those who responded to the vaccine, the various tests were completed by 34 to 41 patients; the range for the inert-injection group was 45 to 52.

Results showed no performance difference between the groups in several tests, including two standard ones used for tracking treatment effects. That was no surprise, since the treatment had been interrupted, Gilman said.

But researchers found that the treated group did better than the other group in tests that measure ability to retain memory up to a half-hour. They also found that higher levels of antibody were associated with better scores on the memory tests, further suggesting an effect of the vaccine.

"I think it's a very interesting preliminary finding," commented Bradley Axelrod, a neuropsychologist at the Veterans Affairs Medical Center in Detroit, who didn't participate in the study.

It will take more research to see whether similar therapies can also create detectable differences in mental functioning, and to see precisely what aspects of mental ability they improve, he said.

Elan and Wyeth have started early human studies of infusing antibodies into Alzheimer's patients rather than spurring the immune system to create antibodies.

Dr. Sam Gandy, an Alzheimer's Association spokesman and researcher at Thomas Jefferson University, said human studies of therapies that attack the amyloid clumps are the only way to end the long-standing debate over whether that plaque really causes symptoms of the disease.

Even if they do, scientists will have to figure out how early such treatment is needed to slow the effects of the devastating disease. Gandy said an amyloid-attack treatment might prove effective in preventing the disease rather than stopping it.

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Cancer Drug Buys Time -- But at Woefully High Price


By Gene Emery



Wednesday, July 21, 2004

BOSTON (Reuters) - Dying colon cancer patients may live an extra two months with help from a new drug called Erbitux but the price tag is a hefty $30,000, cancer experts said on Wednesday in a report that may add to the woes of its already battered maker, ImClone Systems.

A report and commentary in the influential New England Journal of Medicine (news - web sites) note that Erbitux seems to give older chemotherapies a boost, buying patients with advanced colon cancer a few extra months of life.

The study in this week's Journal found that Erbitux could add just under two months, on average, to the lives of terminal colon cancer patients. But it costs more than $30,000 for a full course of treatment -- $2,400 per weekly injection.

Sold by ImClone and Bristol-Myers Squibb under the generic name cetuximab, Erbitux was approved by the U.S. Food and Drug Administration (news - web sites) earlier this year.

It is also licensed to Germany's Merck KGaA, which paid for the study. Five of the study's 12 authors have drug company ties.

According to the report, when given to 218 colon cancer patients for whom the anti-cancer drug irinotecan had stopped working, the typical survival time was 8.6 months.

By comparison, 111 volunteers given Erbitux alone after the irinotecan stopped working typically lived 6.9 months.

Colon cancer strikes about 150,000 people in the United States each year and kills 57,000.

The results, released more than a year ago at a meeting of the American Society of Clinical Oncology (news - web sites), suggest the benefits of Erbitux were "modest in terms of stopping the cancer, patients' response to the drug, and survival," wrote Dr. Charles Erlichman of the Mayo Clinic in Rochester, Minnesota in a commentary.

And Dr. Deborah Schrag of the Memorial Sloan-Kettering Cancer Center in New York said the high cost of colon cancer treatments highlights the need to restructure the way drugs are developed and priced.

She noted that while the median survival rate for colon cancer has nearly doubled over the past decade, it has been accompanied by a 340-fold jump in the cost of drugs used to treat the disease.

"Physicians find themselves in the undesirable position of having to help patients make decisions about whether the potential clinical benefits warrant the financial strain that even co-payments for these medications may create," Schrag wrote.

One reason for the high drug prices is that Congress has prohibited Medicare and Medicaid, which buys more drugs than any other organization in the United States, from negotiating discounts with drug companies, she said.

The high cost of colon cancer-fighting drugs means that non-Medicare health plans are likely to deny coverage or to raise premiums, she said.

"For some patients who lack or have been denied coverage, drug costs will be insurmountable; others will obtain loans and remortgage their homes to finance their treatment," Schrag wrote.

ImClone's share price plunged 19 percent near the close of trading Wednesday despite posting a quarterly profit on strong sales of Erbitux.

"It was a great full first quarter for Erbitux," said SG Cowen analyst Eric Schmidt. "But because it didn't hit the highest expectations fast money is coming out of the stock."

Erbitux was the drug at the center of an insider trading scandal that landed ImClone founder Sam Waksal in jail and led to the conviction of home stylist Martha Stewart (news - web sites) on charges of lying about a suspicious stock sale. Stewart was sentenced last week to five months in prison.

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Study Backs Antidepressant-Suicide Link


By Lindsey Tanner

AP Medical Writer

The Associated Press

Wednesday, July 21, 2004

CHICAGO - A study of nearly 2,800 British adults and children bolsters the evidence that patients are prone to suicidal impulses when they are first put on antidepressants. But it found no difference in risk between newer and older drugs.

The study looked at four drugs and found that suicidal thoughts or attempts were four times more likely during the first 10 days of treatment than they were after three months. Suicide was almost 40 times more common early on than later in treatment, though there were only 17 suicides, all in patients older than 19.

But the study is unlikely to resolve the debate over whether the drugs themselves increase the suicide risk.

And it may not soothe skeptics who maintain that newer drugs such as Paxil and Prozac that increase brain activity of the mood-regulating chemical serotonin are particularly risky for children. The study found no clear-cut evidence to support that idea, and the researchers did not specifically compare children on antidepressants with those not taking medication.

Some doctors argue that patients just starting on antidepressants are usually in the deepest throes of depression which itself can cause suicidal behavior and that the risks subside as the drugs take hold. Others say a medication-induced mood boost may give a profoundly depressed person just enough energy to act on suicidal thoughts.

But some relatives of people who have committed suicide blame the drugs themselves, and British health authorities have said that most serotonin-affecting antidepressants are unsuitable for children. GlaxoSmithKline, the maker of Paxil, has been hit with a lawsuit accusing it of suppressing studies indicating the drug might increase suicidal tendencies in children.

The U.S. Food and Drug Administration (news - web sites) is investigating and earlier this year issued a public health advisory asking makers of 10 drugs to add or strengthen suicide-related warnings on their labels. Doctors were warned to watch patients on antidepressants carefully, especially when they first start taking the drugs.

The FDA (news - web sites) advisory includes Paxil and Prozac but not the two other drugs studied amitriptyline and dothiepin, older medications that work differently. The newer drugs have gained favor in part because they have fewer side effects.

The study, by Drs. Herschel and Susan Jick and James Kaye at Boston University, appears in Wednesday's Journal of the American Medical Association (news - web sites). It was funded by the Boston Collaborative Drug Surveillance Program, which received consultation fees from Glaxo in connection with other research. The authors said Glaxo had no role in the current study's design.

The data "simply means that antidepressants are being prescribed for the right indication, and that they do not immediately eliminate suicide risk," Drs. Simon Wessely and Robert Kerwin of London's Institute of Psychiatry said in a JAMA editorial. Still, careful monitoring of youngsters is essential, they said. Wessely has received funding from pharmaceutical companies including Prozac maker Eli Lilly and Co.

The researchers looked at 2,791 first-time users ages 10 to 69 of any of the four drugs from 1993 to 1999.

Suicidal tendencies were 29 percent more common among Paxil users than among dothiepin users studied. Kaye said that finding was statistically insignificant and could reflect doctors' tendency to prescribe the newest drug for more serious cases. Still, he said it "doesn't exclude the possibility" that Paxil is more risky.

Dr. David Fassler, a Vermont psychiatrist not involved in the research, said the study leaves key questions unresolved: "This study isn't specific to children and adolescents, and that's been the area of most recent concern."

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Companies Need Help on 'Superbug' Drugs Experts


By Maggie Fox


Wednesday, July 21, 2004

WASHINGTON (Reuters) - Drug companies are not developing new antibiotics fast enough to fight emerging, resistant "superbugs" and the government needs to give them tax breaks or other incentives to do it, infectious disease experts said on Wednesday.

They support calls from the pharmaceutical industry to relax requirements for testing potential new antibiotics, offer tax breaks to developers and to extend patent protection.

Otherwise, the Infectious Diseases Society of America says, evolving new bacteria will have nothing to stop them.

"There simply aren't enough new drugs in the pharmaceutical pipeline to keep pace with the evolution of drug-resistant bacteria, the so-called superbugs," said IDSA president Dr. Joseph Dalovisio. "This crisis has the potential to touch us all because drug-resistant infections can strike anyone -- young or old, healthy or chronically ill."

The Centers for Disease Control and Prevention (news - web sites) estimates that nearly 2 million people in the United States will become infected with bacteria while in the hospital this year alone, and that 90,000 of them will die.

More than 70 percent of these bacteria resist at least one drug and many resist several.

The CDC said this month that methicillin-resistant Staphylococcus aureus or MRSA was beginning to show up among high school and college athletes, prisoners and small children who have not been near a hospital.

Some bacteria even resist vancomycin, a strong antibiotic used as a last resort.

But very little is in the works to fight these new mutants. Since 1998, only two truly novel antibiotics have been approved.

The industry says it does not pay to make an antibiotic, in part because they work quickly. Drugs to treat chronic conditions such as high cholesterol or diabetes are much more lucrative.

So, companies need a little encouragement, said Dr. John Bartlett, chief of the division of infectious diseases at the Johns Hopkins University School of Medicine.

"Policy-makers must act now because it can take 10 or more years to bring a new antibiotic to market, and drug-resistant bacteria are evolving fast," Bartlett said in a statement.

Bartlett said there was precedent for this.

"The Best Pharmaceuticals for Children Act, the Orphan Drug Act, and Project BioShield, which President Bush (news - web sites) is signing today, are three examples," Bartlett said.

Project BioShield includes government guarantees to companies that develop drugs or vaccines for use against potential bioterror agents that may never see a market.

Several members of Congress expressed support for the IDSA call but none proposed any specific legislation.

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Health Tip: Don't Depend on Antacids



Wednesday, July 21, 2004

(HealthDayNews) -- Occasional use of antacids is fine, but taking them too often for too long may cause serious health problems.

Antacids may contain calcium, magnesium or aluminum. In large doses, each of these ingredients can cause potentially harmful side effects, warns Dr. Robert Rude, a professor of medicine at the University of Southern California.

Antacids that contain calcium can cause kidney stones if they're taken in high doses for months or years. Antacids that contain magnesium can cause diarrhea if they're taken too often, and they're especially dangerous for people with kidney disease. In these people, too much magnesium can result in low blood pressure, breathing problems and even death.

Taking too many antacids that contain aluminum can results in a disease that causes bones to become brittle and painful.

People who continually need to take antacids should see a doctor, Rude advises.

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'Good' Cholesterol Protects Women Against Dementia


By M. Mary Conroy

Reuters Health

Wednesday, July 21, 2004

PHILADELPHIA (Reuters Health) - For women, maintaining high levels of "good" HDL cholesterol may be one of the most effective strategies for fending off Alzheimer's disease (news - web sites), according to new research.

Data from the ongoing Women's Health Study indicate that women with the highest HDL levels -- ranging from 60 to 75 -- have half the risk of becoming mentally impaired as those with the lowest levels.

The findings were reported here at the International Conference on Alzheimer's Disease and Related Disorders, organized by the Alzheimer's Association.

Lead investigator Elizabeth Devore, a graduate student at the Channing Laboratory at Harvard Medical School (news - web sites) in Boston, said women with the highest LDL ("bad") cholesterol levels had a slight increase in risk of Alzheimer's, but "clearly HDL is the more important in determining a woman's risk."

From 1992-95, the Women's Health Study -- an ongoing study of cardiovascular risk factors -- collected baseline health and lifestyle data from 39,000 female health professionals, including blood samples from 75 percent of the cohort.

During the 1998-2000 evaluations, cognitive assessments were conducted on 4,081 subjects aged 65 or older. The odds of cognitive impairment declined with increasing levels of HDL.

Even "subtle decrements in cognitive function strongly predict eventual development of Alzheimer's disease," Devore and her colleagues point out in their report.

Their findings are "good news because we know how to modify HDL," Devore said at a press conference. She noted that exercise, weight loss and moderate alcohol intake -- one to two drinks a day -- have all been shown to increase HDL levels. "But exercise is the most important element, even more important than diet."

Asked if the findings could be generalized to men, Devore declined to speculate.

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Blacks, Hispanics Develop Alzheimer's Earlier



Wednesday, July 21, 2004

WEDNESDAY, July 21 (HealthDayNews) -- Hispanic and black Americans are more likely to suffer symptoms of Alzheimer's disease (news - web sites) at an earlier age than their white counterparts, new research says.

Hispanics suffer symptoms of the disease an average of seven years earlier than white Americans, said a study presented by Dr. Christopher Clark of the University of Pennsylvania School of Medicine.

Another study found that blacks suffered much higher rates of Alzheimer's at a younger age than did whites.

Both were presented at the International Conference on Alzheimer's Disease and Related Disorders in Philadelphia, which runs from July 17 to 22.

Blacks aged 55 to 64 years were more than three times likely to have Alzheimer's as whites, while from ages 65 to 84 they were more than twice as likely, said lead researcher James Laditka of the University of South Carolina at Columbia.

"Studies like this should serve as a wake-up call to Congress and the nation," said Dr. James Jackson, a member of the Alzheimer's Association Medical and Scientific Advisory Council. "As minority populations get older, they will see a dramatic rise in their risk of Alzheimer's disease. This will overwhelm their families and communities unless we take action now."

More information

The National Institute of Neurological Disorders and Stroke has a page on Alzheimer's disease.

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Protein Sports Drink May Boost Endurance


Reuters Health

Wednesday, July 21, 2004

NEW YORK (Reuters Health) - A sports drink with a shot of protein may give endurance athletes some extra juice, new research suggests.

The study of 15 male cyclists found that a sports drink containing carbohydrates and protein appeared to boost endurance better than a traditional carb-only sports drink. It also seemed to lessen the muscle wear-and-tear that comes with intense exercise.

While water may be enough for the average moderate exerciser, it's thought that sports drinks, with their added carbohydrates and electrolytes, may be the better choice during long workouts. The idea of adding protein to the mix is that it may further stretch an athlete's endurance, and possibly aid in repairing the muscle damage that occurs during grueling exercise.

The new study compared Accelerade, a brand of sports drink with a dose of whey protein, with the carb-only standby Gatorade. It found that trained cyclists pedaled further when they refueled with the protein-fortified beverage.

The findings suggest that for endurance athletes, a protein-containing sports drink may be the way to go, lead study author Dr. Michael J. Saunders said in a statement.

Athletes in sports where "endurance and recovery are critical," such as running, cycling and tennis, could benefit, according to Saunders, who directs the Human Performance Lab at James Madison University in Harrisonburg, Virginia.

The university's School of Kinesiology and Recreation Studies funded the study, which is published in the July issue of the journal Medicine & Science in Sports & Exercise.

Saunders and his colleagues tested the sports drinks by having trained cyclists pedal a stationary bike to the point of exhaustion while replenishing with either the protein-added or carb-only drink every 15 minutes. The athletes performed a second, more demanding ride the next day. One to two weeks later, they went through the process again, this time with the other drink.

Saunders' team found that the men lasted 29 percent longer during the first test and 40 percent longer during the second test when they drank the protein-containing drink.

There were also signs of less exercise-induced muscle damage, according to the researchers. After the exercise tests, the cyclists' blood levels of creatine phosphokinase -- an enzyme released from muscles under stress -- were lower when they consumed protein during the workout.

It's "plausible," Saunders and his colleagues note in the report, that the drink aided protein synthesis and repair of muscle fibers.

However, they also point out that the extra calories in the protein-added beverage may have contributed to the performance benefits. They say more research is needed to see whether "specific protein-mediated mechanisms" should get the credit.

Source: Medicine and Science in Sports and Exercise, July 2004.

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Smarter Kids Become Healthier Adults



Wednesday, July 21, 2004  

WEDNESDAY, July 21 (HealthDayNews) -- Smart kids are less likely to develop serious adulthood diseases than their less intelligent peers, a long-term study finds.

Harvard School of Public Health researchers surveyed 633 people in Providence, R.I., between the ages of 30 and 39 to see whether they had suffered any major illnesses. The same people had taken a comprehensive IQ test when they were 7 years old.

The illnesses asked about included heart disease, diabetes, cancer, asthma, arthritis, stroke, bleeding ulcer, tuberculosis and hepatitis.

Higher intelligence scores at age 7 were associated with lower overall risk of serious disease, even when adjusted to account for other factors. People with lower IQ scores were more likely to report serious disease.

Every extra 15 points on the intelligence score at age 7 cut the chance of illness as an adult by a third, the research found.

The researchers speculate that intelligence may reduce the likelihood of risky and unhealthy behaviors. It also could help patients navigate health-care systems and enhance their sense of personal control, which would minimize the stress response and subsequent wear and tear on the body.

The study appears in the current issue of the Journal of Epidemiology and Community Health.

More information

The National Association for Gifted Children has more about childhood IQ testing.

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US Moves to Force Hospitals, Doctors to Go Digital


By Maggie Fox, Health and Science Correspondent


Wednesday, July 21, 2004

WASHINGTON (Reuters) - Medical records, a last bastion of paper and pen, may be dragged into the electronic age under a new strategy outlined by the U.S. government on Wednesday.

Health and Human Services (news - web sites) Secretary Tommy Thompson said he was starting by appointing a panel of executives to figure out how much it will cost to switch hospitals, pharmacies and other bits and pieces of the health care system to computer-based technology.

By the end of this year the panel is also to report on the potential benefits of such a switch.

Health care experts agree that going digital will reduce errors that kill up to 98,000 patients a year, will speed many aspects of health care and reduce the paperwork burden.

Handheld computers are seen everywhere from the carrier who delivers packages to stock-checkers in stores, but doctors still scribble out prescriptions and notes in notoriously illegible script.

Only 13 percent of hospitals and 14 to 28 percent of physicians' practices say they have electronic health systems, HHS said.

Computer-based records could be accessed from anywhere, and would be less likely to be lost, although care must be taken to ensure privacy, the Institute of Medicine (news - web sites), which advises the federal government on health matters, reported in 2002.

As a first step, the Center for Medicare and Medicaid Services plans to introduce an Internet-based portal that Medicare beneficiaries can use to see their claims information.

Improve Health Care Safety

Medicare also will press for the use of electronic health records, said CMS Administrator Dr. Mark McClellan, although writing prescriptions electronically, known as e-prescribing, will remain optional.

"Promoting the adoption of e-prescribing is an essential step toward improving the safety and quality of health care," McClellan said.

The 10-year plan announced by HHS includes goals to get individual doctors, clinics and hospitals to install computer-based systems, and building an interconnected system to link different facilities.

To encourage hospitals and clinics to go electronic, the government plans to look at incentives such as regional contracts, grants and low-interest loans.

The discussion has already spawned a small industry of companies that want to offer electronic record systems.

"This plan sorts out the myriad of issues involved in achieving the benefits of health information technology, and it lays out a coherent direction for reaching our goals," Thompson told a news conference.

"Our goal is to bring about improvement in health care from the inside out," added Dr. David Brailer, the National Health Information Technology Coordinator appointed in May.

"This transformation will require the collaborative efforts and leadership of clinicians, consumers, hospitals, purchasers, payers, technology companies and informatic thought leaders to make this groundwork for change a reality."

Last April President Bush (news - web sites) said he wanted to ensure that most Americans have electronic health records within 10 years. He has proposed an additional $50 million in his 2005 budget to assist that effort.

The American Medical Association, which represents about 300,000 doctors, welcomed the announcement.

"Electronic health records have the potential to be revolutionary, but work remains to be sure they deliver on this promise," AMA chair Dr. James Rohack said.

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Amphetamines Dull Your Desire to Win


Wednesday, July 21, 2004

WEDNESDAY, July 21 (HealthDayNews) -- You really don't care if you win or you lose when you're on amphetamines, researchers at Stanford University have found.

Doctors discovered that people on dextroamphetamines were less likely to get excited at the prospect of a cash reward for successfully completing a task.

The subjects also were less likely to be upset at the possibility of losing, leading researchers to theorize that such drugs might help "maintain motivation even in the face of adversity."

Magnetic resonance imaging (MRI) scans of the subjects' brains during the task revealed a selective damping of peak activity in a region of the cortex known as the ventral striatum. Prior study has shown that region is activated by anticipation of reward.

The subjects also were asked to rate their feelings of happiness, excitement, unhappiness, and fearfulness after each task.

The study appears in the July 22 issue of Neuron.

More information

The National Institute on Drug Abuse has more about stimulant abuse.

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Glucosamine and MSM Synergistic for Arthritis

Reuters Health


Wednesday, July 21, 2004

NEW YORK (Reuters Health) - Two popular supplements work together to treat arthritis caused by wear and tear on the joints, a new study confirms.

Combined glucosamine and methylsulfonylmethane -- better known as just MSM -- is more effective against osteoarthritis than either agent alone, according to Indian researchers.

In the journal Clinical Drug Investigations, Drs. P. R. Usha and M. U. R. Naidu report that although the individual agents did improve pain and swelling in patients' affected joints, the combined therapy was more effective than the single agents in reducing these symptoms and improving the function of joints.

In a clinical trial conducted at Nizam's Institute of Medical Sciences in Hyderabad, 118 patients with mild to moderate osteoarthritis were treated three times daily with either 500 milligrams of glucosamine, 500 milligrams of methylsulfonylmethane, a combination of both, or an inactive placebo.

After 12 weeks of treatment, the average pain score had fallen from 1.74 to 0.65 in the glucosamine-only group. In MSM-only participants, it fell from 1.53 to 0.74. However, in the combination group, it fell from 1.7 to 0.36.

The researchers also found that the combination treatment had a faster effect on pain and inflammation compared to glucosamine alone.

All of the treatments were well tolerated.

"It can be concluded," they observe, "that the combination of methylsulfonylmethane with glucosamine provides better and more rapid improvement in patients with osteoarthritis."

Source: Clinical Drug Investigations, June 2004.

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Tuesday, July 20, 2004


Vitamin K Might Prevent Liver Cancer


By Serena Gordon
HealthDay Reporter


Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- Researchers trying to prevent bone loss in women with cirrhosis of the liver have made an unexpected yet welcome discovery -- that vitamin K may help prevent liver cancer in those most at risk of the disease.

The study, which appears in the July 21 issue of the Journal of the American Medical Association (news - web sites), was originally designed to assess the effects of vitamin K supplementation on bone loss in women with viral cirrhosis of the liver. However, at the end of the study, the researchers realized the women who took the vitamin K had significantly lower rates of liver cancer.

"The results suggest a possible role for vitamin K2 in the prevention of liver cancer in women with viral cirrhosis," said study co-author Dr. Susumu Shiomi, a professor of nuclear medicine at the Graduate School of Medicine at Osaka City University in Japan. Shiomi added that "vitamin K2 is cheap and safe to use."

Dr. Jay Brooks, chief of hematology/oncology at Ochsner Clinic Foundation Hospital in New Orleans, explained that people with viral cirrhosis from diseases such as hepatitis C are at an increased risk of developing liver cancer. While researchers still don't know why, Brooks said, "we do know that they run an incredibly increased risk." And, he said, the problem will likely only increase because hepatitis C is being diagnosed in more people.

Between 1996 and 1998, 40 women with viral cirrhosis were recruited for a study in preventing bone loss. The women were randomly assigned to either the treatment group or the placebo group. The treatment group took a pill containing 45 milligrams of vitamin K2 daily.

Vitamin K is a fat-soluble vitamin that is produced in the intestines. It can also be found in leafy green vegetables such as broccoli and spinach, vegetable oils, cereals and some meats and cheeses. Excess amounts of this vitamin are stored in the liver. The recommended daily allowance of vitamin K in the United States is 75 micrograms to 90 micrograms (a thousandth of a milligram) per day for women and 75 micrograms to 120 micrograms for men.

Most of the women enrolled in the study had hepatitis C. The average age of the study participants was around 60.

Two of 21 women in the treatment group developed liver cancer, while nine out of 19 women in the placebo group did. After adjusting for age, severity of disease and treatment, the researchers found the women receiving vitamin K supplementation were nearly 90 percent less likely to develop liver cancer.

The researchers said it wasn't clear how vitamin K could prevent liver cancer, but theorized that it may dampen cancer cell growth.

"A number of findings indicate that vitamin K2 may play a role in controlling cell growth. But the mechanisms responsible for the vitamin K-mediated inhibition of cell growth remains unexplained," Shiomi said.

"It's an interesting early observation, but it's a very small study," Brooks said. Both the authors of the study and Brooks said these results need to be confirmed with a much larger group of people.

And, Brooks added, "it would be extremely premature for anyone with hepatitis C to start taking vitamin K." He said that in the past there have been studies on vitamins that initially looked promising in the prevention of cancer, but then with further study, were found to be ineffective or, worse, harmful.

More information

To learn more about vitamin K, visit the U.S. Department of Agriculture (news - web sites)'s Agricultural Research Service.

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AIDS Drugs May Fight Cervical Cancer, Study Finds



Tuesday, July 20, 2004  

WASHINGTON (Reuters) - Drug cocktails used to control the AIDS (news - web sites) virus may also work to prevent cervical cancer, U.S. researchers reported on Tuesday.

It is not clear whether the drugs have a direct effect on precancerous lesions or if they allow the immune system to naturally battle them, the researchers report in this week's issue of the Journal of the National Cancer Institute (news - web sites).

But it marks one more benefit of the drug cocktails called highly active antiretroviral therapy, or HAART, which do not cure HIV (news - web sites) infection but can help control it.

The human immunodeficiency virus can allow the spread of a range of infections as it destroys the body's immune cells. Among its effects is an increased risk of abnormalities in the cervix called squamous intraepithelial lesions.

Doctors believe these lesions, which can progress to cancer, are caused by human wart virus or human papillomavirus. HIV infection also raises the risk of HPV infection and both can be sexually transmitted.

Usually the lesions clear on their own. But they are more likely to progress to cancer in women infected with HIV.

Linda Ahdieh-Grant of Johns Hopkins University and colleagues analyzed data from 2,000 women taking part in a study of HAART.

Before women started HAART, the lesions regressed in none. After women started HAART the regression rate was 12.5 percent.

"These findings underscore the importance of ensuring that women who are immunosuppressed have full access to antiretroviral therapy," Ahdieh-Grant and colleagues wrote.

"It should be emphasized, however, that HIV-infected women on HAART must still receive careful gynecologic follow-up and close routine monitoring."

Pap smears look for the abnormalities associated with the precancerous lesions. Cervical cancer is easily prevented but kills rapidly if left to progress on its own.

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'Mild' Cigarettes Don't Cut Nicotine Intake



Tuesday, July 20, 2004  

TUESDAY, July 20 (HealthDayNews) -- "Light" or "mild" cigarette brands don't substantially reduce nicotine intake, a new study of Japanese smokers claims.

Smokers who switch to cigarette brands that yield 0.1 milligrams of nicotine from brands that yield 1.1 milligrams might expect to lower their nicotine intake by a factor of 11.

But researchers at Kyoto First Red Cross Hospital found that the actual reduction in nicotine intake was less than twofold. Their research appears in the July 20 online issue of the journal BMC Public Health.

The doctors assessed the nicotine intake of 458 smokers by measuring the concentration of nicotine residue in the smokers' urine.

They found that people who smoke more than 40 cigarettes per day hardly reduced their nicotine intake at all by switching to mild brands.

Lead researcher Atsuko Nakazawa found that smokers "may actually increase their risk due to compensatory behavior" by taking more puffs per cigarette or by increasing the depth of their inhalation.

More information

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

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Wendy's Adds Healthier Meals for Kids


The Associated Press

Tuesday, July 20, 2004

DUBLIN, Ohio - Wendy's International Inc. said Tuesday it has added more nutritious options to kids' menus, allowing customers to choose fruit over fries and adding chocolate milk as a substitute for soft drinks.

Reduced fat (2 percent) white milk and lowfat (1 percent) chocolate milk in 8-ounce plastic containers can be substituted at no additional cost with a kid's meal, said Bob Bertini, a spokesman for Dublin, Ohio-based fast food chain.

White milk previously had been offered in cardboard containers, but Bertini said research showed children prefer colorful, kid-oriented packaging.

Customers can order a mandarin orange fruit cup instead of fries.

The changes follow a nine-month test offering at 420 Wendy's restaurants in Columbus, Ohio, Miami, Philadelphia and Raleigh, N.C.

Wendy's has 5,760 stores nationwide and is neck-and-neck with rival Burger King for the No. 2 restaurant chain spot behind McDonald's Corp.

McDonald's began offering apple slices instead of fries and juice or lowfat milk instead of soft drinks with their Happy Meal options last month.

Wendy's also is testing a meal promotion for adults allowing customers to substitute chili, a baked potato or side salad for fries at no added cost. Some stores in New Orleans and Baton Rouge, La., Portland, Ore., and Charleston, W. Va., are offering that option.

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Intensive Arthritis Therapy Helps Symptoms



Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- Monthly treatment with antirheumatic drugs and steroid injections can substantially improve symptoms of rheumatoid arthritis compared to the standard outpatient treatment schedule of every three months.

Doctors at Gartnavel General Hospital in Glasgow, Scotland, investigated whether a more intensive approach could be better at improving arthritis symptoms.

About 82 percent of patients given intensive therapy responded well to treatment, compared to 44 percent of patients in the group that received standard treatment.

Also, 65 percent of people receiving intensive treatment were in remission by the end of the 18-month study, as opposed to 16 percent of patients receiving standard care.

The study, which appeared in the July 16 issue of The Lancet, found that costs did not rise despite the more intense treatment.

"Despite initial concerns, cost did not differ between intensive management of patients and routine treatment," lead researcher Dr. Duncan Porter said in a statement. "More importantly, our results show that a strategy of optimizing current techniques and treatment regimens can deliver substantial patient benefits."

More information

The National Institute of Arthritis and Musculoskeletal and Skin Diseases has a Q&A about arthritis.

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Alzheimer's Risk Increases After Coronary Bypass


By M. Mary Conroy

Reuters Health

Tuesday, July 20, 2004

PHILADELPHIA (Reuters Health) - Mental impairment is a known risk following coronary bypass surgery, and now researchers have found that the procedure may hasten the emergence of Alzheimer's disease (news - web sites).

The results of a large study indicate that the risk of developing Alzheimer's disease within five years is 70 percent higher following coronary artery bypass grafting (CABG) than after percutaneous coronary angioplasty (PCTA). Both procedures are used to deal with restore blood flow to the heart when coronary arteries become blocked.

The researchers compared outcomes of over 5000 coronary bypass patients and nearly 4000 angioplasty patients treated at the Hines VA Hospital in Illinois. All patients were 55 or older at the start of the study and had no dementia. They were followed for five years after their procedures.

"Seventy-eight of the CABG patients and 41 of the PTCA patients were diagnosed with Alzheimer's disease during the follow-up," Dr. Benjamin Wolozin, professor of pharmacology at Boston University School of Medicine, reported here at the International Conference on Alzheimer's Disease and Related Disorders.

While this translates to a higher risk for Alzheimer's after coronary bypass than after angioplasty, Wolozin cautioned that the results should not "affect the decision to treat a patient with CABG, which is an excellent, life-saving surgery."

In an interview with Reuters Health, Dr. Martin Bednar, the lead author of the study, pointed out that the recognized mental deficits that can occur after coronary bypass are diagnosed soon after surgery. "This is the first study to report on Alzheimer's disease risk," he said.

Bednar is senior director of clinical trials at Pfizer Global Research and Development in, Groton, Connecticut. Pfizer offered partial support for the study, which was also funded by the Hines VA and Loyola University, where Wolozin worked during the study.

Wolozin said he thinks the increased risk of Alzheimer's disease is a result of stress caused by surgery that triggers an increase in stress hormones, which "may trigger a cascade of events that reduce the oxygen to the brain."

While not advising against coronary bypass, Wolozin said that some CABG patients may benefit from approaches that could reduce stress, including possibly increasing the supply of oxygen and glucose to the brain during surgery.

Bednar said Pfizer is "committed to developing neuroprotective drugs," that eventually might be used in patients undergoing CABG and other open-heart procedures.

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When Your Child Struggles With Sleeplessness


By E.J. Mundell
HealthDay Reporter


Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- It's 2 a.m. and for the third night this week your 3-year-old scrambles into your room, fretting that he can't get back to sleep.

As a parent, you assumed that your child's frequent nighttime awakenings would end with infancy. So what's going wrong?

Not to worry, say pediatric sleep experts. Sleeplessness in young children -- from toddlers to pre-teens -- is a common phenomenon linked to overstimulation and poor bedtime habits, both of which are relatively easy to change.

In young children, "probably the most common thing we treat we'd describe as 'settling problems' -- difficulty falling asleep, nighttime awakenings. They may be as common as 25 percent," said Dr. Carol Rosen, medical director for Pediatric Sleep Services at Rainbow Babies and Children's Hospital in Cleveland. She said most parents can help their kids sleep better at night by teaching them to drift off on their own.

Because they are busy growing physically and processing unfamiliar neurological data, children need a lot more sleep than adults. Experts estimate the average baby sleeps 16 to 20 hours a day, while toddlers average about 13 hours a day, naps included. Total daily sleep time declines gradually with age.

But sleep has lots of competition for a child's time in today's hyperactive world.

"Ours is a 24/7 society," said Dr. Judith Owens, a pediatric sleep expert at Brown University Medical School, in Providence, R.I. "There are many more competing priorities for sleep now than there were 50 years ago, ranging from the Internet to TV to social activities, things like hockey practices that are held at 8 o'clock at night."

In fact, American children may be counting sheep almost as often as their parents do, according to a recent survey from the National Sleep Foundation.

According to the survey of almost 1,500 parents, almost two-thirds of American kids under the age of 10 don't get the sleep they need, 30 percent experience problem nighttime awakenings on a regular basis, and about a third have serious trouble waking up for school each morning.

Sleep requires that the mind and body be relaxed, so one way to ensure that children sleep well is to turn off TVs and computers and put an end to "roughhousing" or physical play during that crucial hour before bedtime, the sleep experts said.

"These are all stimulating activities that occur at a time when children should be preparing themselves psychologically, mentally, physically for that transition from wake to sleep," Owens said.

Ideally, the last half-hour before sleep time should be devoted to some type of soothing parent-child interaction, such as reading. "Turn off the TV and read, listen to music, talk -- do things that aren't going to stimulate a child and make it harder for them to fall asleep," Owens advised.

But experts agreed that kids, especially toddlers, can also become too dependent on intimate parental contact.

"The most common mistake that parents make that leads to sleep disruption is that the parents are too intimately involved in the child's transitioning to sleep," said Dr. Gerald Rosen, a pediatrician at the Minnesota Regional Sleep Disorders Center in Minneapolis. "Particularly in the toddler age, if they learn to transition to sleep with intimate contact with their parents -- rocking, bottle, breast -- then when they have a normal nighttime awakening, some of those kids aren't able to transition back to sleep quickly without re-instituting the same triggers."

No two children are alike when it comes to sleep, however, and parents have to pay attention to their child's "natural sleep-wake rhythm," Rosen said. A strategy that works well for one child might prove ineffective for another.

Daytime distractions can keep kids awake at night, too. Caffeine lurks in colas and other soft drinks, and it has a much more stimulating effect on children than adults, experts said.

And, like adults, children can also toss and turn at night because of stresses in their lives. In school-age children, there's often "anticipatory anxiety about school or social relationships," Owens said. "We see a lot of 9-, 10-, 11-year-olds who come in and they just can't fall asleep because they're worried about stuff."

Talking over problems with kids can often help restore sound sleep patterns.

All of the experts agreed, though, that the leading cause of problem sleep in young children is irregular bedtimes.

"The analogy that we draw for families is that if you have a child that's going to bed three or four hours later on Friday and Saturday night, it's like they're getting jet lag," Owens said. "Come Monday morning they're not going to be in very good shape."

Sticking to a set bedtime helps kids set their own internal circadian clock, helping them wake up refreshed and ready to tackle the day.

Added Rosen: "The pattern kids sleep best at is if they have a regular time that's the right time, and they make the transition from wake to sleep in an environment that's not overly stimulating."

More information

Learn more about children and sleep at the National Sleep Foundation.

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High Dose Chemotherapy Not Seen Saving More Lives



Tuesday, July 20, 2004

WASHINGTON (Reuters) - Another study has found that using high doses of chemotherapy to treat women with breast cancer saves no more lives than a gentler approach, British researchers said on Tuesday.

The report, published in the Journal of the National Cancer Institute (news - web sites), adds to evidence that flooding a patient's body with toxic chemicals and then using a bone marrow transplant to restore her immune system does little to save her life.

But it is bad news for men and women whose breast cancer has spread, because it shows how difficult it is to cure them.

"Approximately two-thirds of patients with four or more lymph nodes that contain cancer cells at surgery will develop fatal metastases," Dr. Robert Leonard, of the South West Wales Cancer Institute in Swansea, Britain, and colleagues wrote.

Chemotherapy can help. "Although cure is rare, survival is increased by more than one or two years," they added.

The hope was that super-high doses of chemo could kill off the cancer, and that the patient's dead bone marrow could be replaced with a transplant of their own cells taken before treatment.

To test this idea, Leonard's team randomly treated 600 breast cancer patients with either the high-dose approach or a more conventional course of chemotherapy.

The patients were followed for about six years.

There were no differences between the two groups in either relapse or survival. "There were five treatment-related deaths in the high-dose arm," the researchers added.

Their conclusion -- high-dose chemo costs more, makes patients sicker but does not help them any more than the standard approach.

Last year, Dr. Martin Tallman of Northwestern University in Chicago and colleagues and a team in the Netherlands published two studies that also found the high-dose approach to be more toxic without saving any extra lives.

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Health Tip: Brain Exercises



Tuesday, July 20, 2004

(HealthDayNews) -- Just like your body, your mind needs exercise to remain healthy as you grow older.

One way to keep your brain nimble is to practice a technique called neurobics, which uses your senses to help create new connections in areas of the brain that process sensory input. Done regularly, these simple practices can help keep your mind sharp and ready to tackle new challenges, says a Duke University article.

A neurobic exercise is one that involves the use of one or more or your senses in a novel way, engages your attention, and adds an unexpected element to a routine activity.

Here are some examples:

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Study: Antidepressant Suicide Risk Not Due to Drugs


By Michael Conlon


Tuesday, July 20, 2004

CHICAGO (Reuters) - Patients on antidepressant drugs run a higher risk of suicide in the first few days of therapy, but the risk is similar with any of the most popular mood-lifting drugs and may be rooted not in them but in the underlying depression, a study said on Tuesday.

The report, published in this week's Journal of the American Medical Association (news - web sites), was designed to find out if drugs called selective serotonin reuptake inhibitors -- most often sold as GlaxoSmithKline's Paxil and Eli Lilly and Co.'s Prozac -- were associated with a higher suicide risk than other mood lifters.

The serotonin-related drugs work by providing more of that brain chemical, a substance thought to regulate depression and anxiety; but the use of such drugs has triggered suicide-related lawsuits and specific concerns about their impact on adolescents.

Researchers at Boston University said they looked at data on nearly 160,000 users of four antidepressants in England from 1993 to 1999. The four drugs were fluoxetine (Prozac), paroxetine (Paxil), amitriptyline and dothiepin, the last two part of an older class of antidepressants called tricyclic drugs that also act on nerve cells in the brain.

The researchers reported they found nonfatal suicidal behavior was four times more likely to occur within 10 days of when any of the drugs was first prescribed -- and three times more likely in the following 19 days -- than was the case after the patient had been on a drug for three months.

"Similar associations were present for all four of the study drugs," the report said

"We think the most likely explanation for this finding is that antidepressant treatment may not be immediately effective, so there is a higher risk of suicidal behavior in patients newly diagnosed and treated than in those who have been treated for a longer time," the authors said.

"It is also possible that this observation reflects patients starting to take an antidepressant when their depression, which naturally fluctuates over time, is at its worst..." they added. "We cannot exclude what we think is a less likely possibility, namely that the drug itself 'causes' depression to worsen rapidly, thus leading to suicidal behavior."

Persuasive Evidence

But whatever the reason the study offers persuasive evidence that the effect is the same for all four antidepressants, they said.

The U.S. Food and Drug Administration (news - web sites) earlier this year asked the makers of 10 different antidepressant drugs to include label warnings recommending close observation of adults and children for worsening depression or the emergence of suicidal tendencies.

The authors also aid that "based on limited information, we also conclude that there is no substantial difference in effect of the four drugs on people aged 10 to 19 years" though "some important difference in effect cannot be ruled out based on this study."

The school's Boston Collaborative Drug Surveillance Program said the research was carried out with its own general funds and not money from drug companies.

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Health Tip: Feeling Sluggish?


Tuesday, July 20, 2004

(HealthDayNews) -- If you often feel tired and unable to concentrate, it may be due to your diet.

If you're always gobbling down foods such as muffins, pizza, french fries and donuts, you may not be getting the vitamins and minerals needed to fuel your brain, says the University of Toronto Health Services.

Foods that help keep you alert include fruits and vegetables, fish, and grains such as breads, cereal, pasta, rice and barley.

Choose fruits and vegetables high in vitamin C (citrus, kiwi, broccoli), chromium (apples, bananas, potatoes), and potassium (bananas, seeds, nuts, beans). Vitamin C helps fight fatigue associated with anxiety and stress. Chromium helps maintain steady blood-sugar levels and helps the body produce energy. Potassium helps regulate the nervous system, which may boost mental energy.

Fish is a good source of protein and contains omega-3-fatty-acids, which are believed to enhance communication between brain cells, in turn improving concentration and memory.

Grains are packed with carbohydrates, a source of energy for the body and brain.

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Dutch Study Backs Cholesterol Drug for Children


Tuesday, July 20, 2004

CHICAGO (Reuters) - Children suffering from an inherited condition that causes high cholesterol levels have been successfully treated with a statin drug with no adverse impact on their growth, a study said on Tuesday.

Researchers at the University of Amsterdam who reported the finding said the long-term effectiveness and safety of cholesterol-lowering drugs have not been evaluated in children previously, and the new study offers an extensive look.

The drug involved in the study was pravastatin, marketed as Pravachol by Bristol-Myers Squibb Co. . The study was paid for by the Dutch government and by a grant from the drug company that had no role in the design and conduct of the research, the authors said.

The study involved 214 children, aged 8 to 18, who were recruited between 1997 and 1999 and followed for up for two years. In addition to a fat-restricted diet and encouragement to take part in regular physical activity, half of the children were given daily doses of the drug and half an inert placebo.

The children had familial hypercholesterolemia, which causes high levels of low-density lipoprotein cholesterol -- so called bad cholesterol. The condition also restricts the blood vessel's ability to respond to changes in blood flow by expanding or contracting, and causes increased thickness of the wall of the carotid artery.

The children who received the drug showed an average 24.1 percent reduction in bad cholesterol levels, while those who received the placebo showed an average 0.3 percent increase, the authors reported.

In addition the drug led to toward a lessening of thickness in the carotid artery wall, the report said. But no differences between the two groups were found when it came to growth, maturation, hormone levels or muscle and liver enzymes, the study said.

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New Clues to Cause of Lou Gehrig's Disease

By Ed Edelson
HealthDay Reporter


Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- Animal studies are pointing to problems with mitochondria, the energy factories of human cells, as an important element in Lou Gehrig's disease (news - web sites), the relentlessly fatal wasting-away condition.

There is "growing evidence" that mitochondrial malfunction, not only in nerve cells but also in skeletal muscle cells, may play a crucial role in the disease, says a report in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites). The French study was led by Jean-Philippe Loeffler, research director at the National Center for Scientific Research in Paris.

Bolstering this theory is research indicating that mice bred to develop Lou Gehrig's disease, formally called amyotrophic lateral sclerosis (ALS), survived longer when fed a high-energy diet.

"What the exact molecular mechanism is, we don't know," Loeffler said. "We are working on it."

The researchers found what they call "a metabolic deficit" in mice with ALS -- a failure to effectively turn food into energy in both nerve and muscle cells. This results in an increased but inefficient expenditure of energy to keep cells functioning.

"There are two important things in the paper," said Lucie Bruijn, science director of the ALS Association, which helped fund Loeffler's work. "One is to reinforce the fact that mitochondria are likely to play an important role in ALS."

Researchers at the University of California, San Diego, recently reported an animal study that also implicated mitochondrial malfunction in ALS, she added.

"The involvement of muscle cells is also very interesting." Bruijn said. "Until now we have thought of ALS as a neuron [nerve cell] disease. The idea that the muscle cell itself might be involved is clearly important."

Much more research is needed to clarify the issue, Bruijn said. "We can't say yet whether the muscles are involved first and then the neurons," she said.

One potentially important aspect of the study was that feeding the mice a fat-enriched, high-energy diet appeared to have a beneficial effect. Loss of nerve cells decreased in mice fed the diet, and their overall survival time was 20 percent longer than that of mice fed a normal diet.

But both Loeffler and Bruijn said it is much to early to try such a diet on humans with ALS because more basic work is needed.

"It is a line of research we would pursue," Loeffler said.

"This was a laboratory study using a mouse model," Bruijn said. "We have to be very careful before we make a diet change in people. It could be harmful, because in many patients a careful balance is needed."

More information

What is known about ALS can be found at the ALS Association.

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Blood Pressure Dives During Diabetics' Heart Attack

By Megan Rauscher

Reuters Health

Tuesday, July 20, 2004

NEW YORK (Reuters Health) - People with diabetes are known to fare worse after a heart attack than people without diabetes. Now, new research suggests that this is because diabetics experience a greater drop in blood pressure when the coronary vessels are blocked during an attack.

Finnish cardiologists led by Dr. K. E. Juhani Airaksinen from the University of Turku compared the blood pressure response in 238 non-diabetic and 32 diabetic patients during angioplasty. This procedure temporarily blocks blood flow to the heart as the balloon is inflated in the coronary artery.

The investigators report in the International Journal of Cardiology that patients with diabetes developed seriously low blood pressure nearly three times as often as non-diabetic patients.

Women were also more likely than men to experience low blood pressure during coronary blockage.

When a coronary artery suddenly becomes blocked in a diabetic patient, this blockage often induces a seriously low blood pressure, Airaksinen told Reuters Health. "This may increase the risk of sudden death during the early minutes of (a heart attack) in diabetics," the investigator said.

Source: International Journal of Cardiology, June 2004.

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Something's Fishy About Store-Bought Red Snapper


Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- Think you got a good deal on that red snapper at the supermarket?

Chances are, you bought some fishy fish, according to graduate students at the University of North Carolina at Chapel Hill (UNC).

While taking a course on how to extract and sequence DNA, the students discovered that more than 75 percent of fish tested and sold as red snapper in eight states actually were other species.

"Red snapper is the most sought-after snapper species and has the highest prices, and many people, including me, believe it tastes best," said Dr. Peter B. Marko, a UNC assistant professor of marine sciences. "Mislabeling to this extent not only defrauds consumers, but also risks adversely affecting estimates of stock size for this species if it influences the reporting of catch data used in fisheries management."

The team conducted molecular analyses of 22 fish bought from nine vendors in Delaware, Florida, Illinois, Massachusetts, New York, North Carolina, South Carolina and Wisconsin. They found that 17 of the fish sold as red snapper -- some 77 percent -- were actually other species.

The students were surprised to find that more than half the DNA sequences came either from fish from other regions of the world or from rare species about which little is known.

A report on the group's research appears in the July 15 issue of Nature.

More information

Scientific Testimony has more about DNA testing.

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Synthetic Antibody Targets Prostate Cancer

By David Douglas

Reuters Health

Tuesday, July 20, 2004

NEW YORK (Reuters Health) - Most prostate cancers at first are driven by male hormones -- androgens -- but they then become androgen independent, often spreading to other areas of the body. At this stage, treatment is difficult, but a new "smart drug" holds promise.

Researchers have developed an antibody, J591, that homes in on a specific molecule on prostate cancer cells. With a radioactive isotope attached, the antibody produced an anti-tumor effect in an early-stage (phase I) trial involving men with androgen-independent prostate cancer.

Senior investigator Dr. Neil H. Bander told Reuters Health that the agent "can target prostate cancer metastases wherever they are in the body."

Accumulation of the isotope-tagged antibody at tumor sites, he added, "led to the delivery of therapeutic radiation only to tumor sites but not to normal tissues. As a result, patients tolerated the treatment very well."

Bander, of Cornell University Medical Center, and colleagues tested increasing doses of J591 in 29 patients with androgen-independent prostate cancer.

None of the participants mounted an immune response to the compound, which might have limited its effectiveness, the researchers report in the Journal of Clinical Oncology

One patient showed an 85 percent drop in prostate specific antigen (PSA) levels -- an indicator of tumor suppression -- which lasted for 8 months. Another had a decline of 70 percent for 8.6 months. Moreover, PSA levels stabilized in an additional six patients.

Thus, Bander continued, "the potential benefit of this treatment approach was further supported by the finding of several significant anti-tumor responses."

"A phase II trial is approved, " he added, "and expected to begin in the near future."

Source: Journal of Clinical Oncology, July 1, 2004.

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No Drop in Incidence of Heart Failure


By Ed Edelson
HealthDay Reporter


Tuesday, July 20, 2004

TUESDAY, July 20 (HealthDayNews) -- A Midwestern study finds little improvement over the last 20 years in the incidence of heart failure, a major cause of debility and death in older Americans.

Perhaps 5 million Americans have heart failure, a condition in which the vital organ progressively loses its ability to pump blood. The new study, using data on more than 5,500 residents of a Minnesota county, found no decrease in the incidence of heart failure over the past two decades.

There is some good news, said Dr. Veronique L. Roger, lead author of the report in the July 21 issue of the Journal of the American Medical Association (news - web sites), but not nearly as much as hoped.

While the overall incidence of heart failure did not go down over the past two decades, "survival after onset of heart failure has increased, with less improvement among women and elderly persons," the researchers said.

"It's better news than if it were increasing, but we'd like to see it go down further," said Rogers, a professor of medicine at the Mayo Clinic.

There are economic as well as medical reasons to understand why the heart failure picture remains static and to hope for improvement, Roger said. Heart failure is the leading cause of hospitalization in 65-and-older Americans, costing the nation billions of dollars, yet there have been surprisingly few studies of the condition, she said.

The Mayo results are in general agreement with those of the Framingham Heart Study, which has followed residents of a Massachusetts community for decades. But there are some signs of improvement in both studies, said Dr. Ramachandran S. Vasan, an associate professor of medicine at Boston University School of Medicine and a leader of the Framingham study.

"The incidence rate has come down in men, and there are improvements in survival," Vasan said. "Maybe there are some measures in place that have yet to take effect and will lead to improvements over a period of decades rather than a few years."

In the Mayo study, the incidence of heart failure in men was 378 per 100,000; in women, it was 289 per 100,000. Those numbers did not change significantly over the course of the study.

But there was an improvement in survival, with a the five-year age-adjusted survival rate at 52 percent in 1996-2000, compared to 43 percent in 1979-1984.

"Men and younger persons experienced larger survival gains, contrasting with less or no improvement for women and elderly persons," the researchers reported.

There is a gaping hole in both the Mayo and Framingham studies. The overwhelming number of participants in both studies happen to be white. There are no comparable studies in minority populations, in whom the incidence of heart failure is believed to be high, Vasan and Roger said.

Nevertheless, the new study does add valuable information, both said.

"Any time we gain an understanding in what may be happening, it is good news because it helps focus the efforts of health providers," Roger said.

And Vasan sees reason for hope. "There may be some measures in place that still have to take effect," he said. "Improvement may occur over a period of decades rather than a few years. I am optimistic that the rate will come down."

More information

Learn about heart failure, its symptoms and its treatment from the American Heart Association.

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Monday, July 19, 2004


Lose Weight, Stay Active, Prevent Alzheimer's-Studies


By Jon Hurdle


Monday, July 19, 2004

PHILADELPHIA (Reuters) - Losing weight, eating more fruits and vegetables and exercising your brain and body sounds like a formula to prevent heart disease, but it is also a way to prevent Alzheimer's, researchers said on Monday.

Midlife obesity, high cholesterol and high blood pressure appear to affect the brain as well as the heart, they said.

"There are a variety of lifestyle factors that people can engage in that will reduce their risk of cognitive decline," said Dr. Marilyn Albert, chair of the Alzheimer's Association's medical and scientific council.

"The brain is much more plastic than we thought," Albert added in an interview.

"It has more capacity to renew and regenerate. ... We have to tell people that they need to think about their cognitive health in a way that they typically thought about their physical health."

Early is better, she added. "The pathology of Alzheimer's disease (news - web sites) develops over 10 years, possibly longer. People should start as early in life as possible."

Several studies presented to a meeting sponsored by the Alzheimer's Association in Philadelphia this week support the contention.

A study in Finland of 1,500 elderly people found that those who were obese in middle age were twice as likely to develop dementia when they got old as those who were of normal weight. For those who also had high cholesterol and high blood pressure in middle age, the risk of dementia was six times higher than those who were not affected.

Another study, of 13,000 women, found that those who ate vegetables such as iceberg lettuce, spinach, broccoli and Brussels sprouts in middle age preserved more of their cognitive abilities as they entered their 70s than women who ate few vegetables.

"Women with the highest average intake of those vegetables appear to experience less cognitive decline," Dr. Jae Hee Kang of Harvard Medical School (news - web sites), told a news conference.

Another study suggested that leisure activities that combine social, mental and physical activity are the most likely to prevent dementia.

Each activity is less important than all of them together, said Laura Fratiglioni of Sweden's Karolinska Institute.

Mental activities such as reading books, doing crossword puzzles or playing bingo can help to prevent mental decline, Albert said. "It should be anything that will push people to encounter something that isn't routine."

An estimated 4.5 million Americans currently have Alzheimer's, and that number is expected to balloon as high as 16 million by 2050 as the baby boom generation ages.

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Health Tip: Beans Talk



Monday, July 19, 2004

(HealthDayNews) -- Eating plenty of legumes -- such as lima beans, kidney beans and black-eyed peas -- can reduce your risk of heart disease and stroke and help prevent cancer.

Other beneficial legumes include navy beans, garbanzos, black beans, lentils and fava beans, according to Duke University Medical Center.

A serving (one-third cup of cooked beans) contains about 80 calories, little fat, no cholesterol, and plenty of complex carbohydrates. These legumes also provide a good source of B vitamins, potassium and fiber.

Legumes make a great side dish and can also be used as a substitute for meat. While legumes don't contain complete proteins such as meat, you could supplement your diet by eating grain or dairy products along with legumes.

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Eating Fish Can Cut Risk of Heart Rhythm Disorder



Monday, July 19, 2004

WASHINGTON (Reuters) - Chalk up another benefit of eating fish -- it can reduce the risk of deadly irregular heartbeats, researchers reported on Monday.

Baked or broiled but not fried, fish helped reduce the risk of atrial fibrillation, Dr. Dariush Mozaffarian of Brigham and Women's Hospital and Harvard Medical School (news - web sites) in Boston and colleagues found.

"The results suggest that regular intake of tuna or other broiled or baked fish may be a simple and important deterrent to atrial fibrillation among older men and women," Mozaffarian said in a statement issued by the American Heart Association (news - web sites).

More than 2 million Americans are affected by atrial fibrillation, a chronic condition that causes fatigue, shortness of breath and an inability to exercise.

The heart's two upper chambers, called the atria, quiver instead of beating effectively. Blood is not pumped out properly and may pool and clot.

These clots cause about 15 to 20 percent of strokes.

Writing in the journal Circulation, Mozaffarian and colleagues said they studied 4,815 people over the age of 65.

They asked them to describe what they ate, beginning in 1989, and then watched them for 12 years.

Doctors discovered 980 cases of atrial fibrillation in the volunteers. Those who reported eating more baked or broiled fish were the least likely to have atrial fibrillation.

Those who said they ate fish one to four times per week had a 28 percent lower risk, compared to those who ate fish less than once a month.

The researchers credit the omega-3 fatty acids found in many types of fish as well as in walnuts, flaxseed and many green leafy vegetables. Omega-3's are also believed to reduce the risk of a range of heart disorders, and are important to brain development and function.

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Thermal Scanner Spots Early Arthritis in Hands



Monday, July 19, 2004

MONDAY, July 19 (HealthDayNews) -- A thermal scanner used to find defects in computer circuit boards can also detect the early signs of hand arthritis, researchers at Duke University Medical Center have found.

Finger joints in the first stage of osteoarthritis tend to be warmer, and the scanner is sensitive enough to pick up fluctuations as minute as a tenth of a degree Fahrenheit.

The $16,000 scanner could be much more useful than X-rays, which produce inconclusive findings at earlier stages of arthritis.

The Duke study involved 91 people with clinical hand arthritis in both hands. Researchers found significant temperature differences between healthy joints and joints affected by arthritis. The scanner was key in picking up those differences.

"As we learn more about the early stages of the disease, I think we'll be able to intervene earlier, when there will be more chance of making a difference," said Dr. Virginia Kraus, a rheumatologist with Duke.

The study appears in the July issue of Rheumatology.

More information

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

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Gene Defect Found in Some 'Crib Death' Cases



Monday, July 19, 2004


WASHINGTON (Reuters) - A faulty gene may be responsible for some cases of sudden infant death syndrome, also known as crib or cot death, U.S. researchers said on Monday.

Tests on Amish families from Pennsylvania turned up a new disorder that causes sudden death and sometimes malformation of the genitals, the researchers report in this week's issue of the Proceedings of the National Academy of Sciences (news - web sites).

The finding could help explain some of the inexplicable, unexpected deaths of 3,000 infants a year in the United States and thousands elsewhere around the world.

The researchers have named their newly found disorder sudden infant death and dysgenesis of the testes syndrome or SIDDT. Babies must inherit two flawed copies of the gene to develop symptoms, which include organ dysfunction.

They die before they are a year old from sudden cardiac and respiratory failure.

In two generations, 21 infants from the Belleville Amish community in southeastern Pennsylvania have died from SIDDT, Dietrich Stephan of the Translational Genomics Research Institute in Phoenix, Arizona and colleagues at the Clinic for Special Children in Strasburg, Pennsylvania reported.

To find the gene, they analyzed DNA from four affected infants, as well as from their parents, siblings, and other relatives.

Males with SIDDT may have underdeveloped testes. Girls appear normal and have normal female hormones, yet both male and female infants with SIDDT die suddenly at the same age.

"One infant died in the hospital while awake and attached to a cardiac-respiratory monitor," the researchers wrote. The monitor showed the child's heart and breathing function stopped suddenly at the same moment.

"Another infant died suddenly and unexpectedly at home, with no premonitory signs. In both cases, neuropathological examinations were done by experts in sudden infant death syndrome. Brain and peripheral nerves were normal," the researchers added.

"This is one of the first genetic sub-classifications of SIDS," Stephan said in a statement. "And it's going to be helpful in offering parents answers for sudden infant deaths, recognizing predisposition early, and hopefully saving a number of these babies."

While SIDS is a general term for such deaths, doctors suspected different causes may be at fault.

For example, campaigns in Britain and the United States to educate parents and caretakers to put babies down to sleep on their backs instead of their tummies cut SIDS deaths in half, but did not eradicate them.

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Depression May Explain Fatigue of Cancer Patients



Monday, July 19, 2004

MONDAY, July 19 (HealthDayNews) -- The fatigue suffered by patients with blood cancer is most likely caused by depression and reduced physical performance, and not the disease itself, a new German study contends.

Up to now, fatigue symptoms were thought to be the result of anemia, a flagging immune system or other physical effects associated with leukemia, lymphoma, myeloma and other blood cancers.

In the study, doctors looked at more than 70 patients in remission who had been free from treatment for at least three months.

The doctors could find no correlation between the fatigue and any physical symptoms, lead researcher Dr. Fernando Dimeo, of the Charite University Medical Center in Berlin, said in a statement.

However, the scores for depression were 10 times greater for people who suffered high fatigue, compared with people who reported little fatigue. Patients with high fatigue also had physical performance scores that were five times lower than people without fatigue.

The research appears in the July 19 issue of the Annals of Oncology.

More information

The Leukemia & Lymphoma Society has more about leukemia.

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Permanent Hair Dyes Tied to Adult Leukemia Risk


By Amy Norton

Reuters Health

Monday, July 19, 2004

NEW YORK (Reuters Health) - People who spent years using older permanent hair dyes may have somewhat higher odds of developing leukemia, a new study suggests.

Researchers found that among men and women surveyed in the late 1980s, those who had used permanent hair dyes prior to 1980 were more likely to develop leukemia than adults who had never dyed their hair.

Acute leukemia is a quickly progressing form of leukemia in which immature, non-functioning blood cells accumulate and crowd out normal cells. Hair dyes have long been studied as a potential risk factor for a number of cancers, but research has yielded conflicting findings.

Older formulations contained potentially cancer-causing chemicals, and there is evidence tying hair dyes to the risk of blood-related cancers such as leukemia and multiple myeloma. Not all studies, however, have come to this conclusion.

The new study compared 769 acute leukemia patients with 623 adults without the disease. It found that men and women who had used permanent dyes one to five times per year for 15 years or longer were more than twice as likely to develop leukemia as people who had never dyed their hair.

Temporary hair dyes that wash out with a few shampoos and hair dye use beginning in 1980 or later were not linked to the disease.

Together with past research, these findings suggest hair dye use is a "potential but not an especially strong risk factor" for leukemia and other blood-related cancers, according to lead study author Dr. Garth H. Rauscher of the University of Illinois in Chicago.

And it does appear that long-term use and use of older coloring products are key factors, Rauscher told Reuters Health.

He and his colleagues report the findings in the current issue of the American Journal of Epidemiology.

The findings are similar to those of a study earlier this year that linked long-term use of older permanent hair dyes to an increased risk of non-Hodgkin lymphoma in women. Again, women who used hair dyes after 1980 did not have an elevated cancer risk, and the researchers speculated that changes in product formulations made in response to cancer concerns could be the reason.

Rauscher said evidence so far suggests that while people who have colored their hair do not seem to face a greater risk of most cancers, the "possible exception" is cancer of the blood or lymph nodes-which includes leukemia and non-Hodgkin lymphoma.

The reason is unclear, but it may have to do with the fact that the blood is the "first point of contact" for cancer-promoting chemicals that are able to penetrate the scalp, Rauscher noted.

However, he also pointed out that while some studies like his -- comparisons of leukemia or lymphoma patients with healthy adults -- have linked hair dyes to a higher cancer risk, other studies that have followed hair dye users over time have failed to do so.

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

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High Meat Intake May Raise Odds of Endometriosis

Reuters Health

Monday, July 19, 2004

NEW YORK (Reuters Health) - What a woman eats can influence her risk of endometriosis, according to a new study.

Endometriosis occurs when endometrial tissue, which normally lines the uterus, grows elsewhere in the pelvis. The new research indicates that women who eat the most green vegetables or fresh fruit have a reduction in risk for the condition, while those who eat the most beef or ham have an increased risk.

While endometriosis is relatively common, little is known about its cause, the authors explain in a report in the medical journal Human Reproduction.

Dr. Fabio Parazzini from the University of Milan, Italy, and colleagues surveyed 504 women with endometriosis, and 504 age-matched "controls" regarding their dietary habits.

The risk was significantly reduced among women with the highest intake of green vegetables (a 70-percent risk reduction) or fresh fruit (a 40-percent reduction), the researchers report, and significantly increased among women with the highest intake of beef and other red meat (a doubling of risk) and ham (a 1.8-fold increase).

In contrast, consumption of milk, liver, carrots, cheese, fish, whole grain foods, coffee, alcohol, butter, margarine, and oil were not significantly related to endometriosis.

"With a prevalence of 5 percent in endometriosis in Italy," Parazzini said in a news release, "this means that if our findings are confirmed in prospective studies, we have the potential to cut the prevalence of endometriosis to around 3-4 percent."

That would translate to about 200,000 fewer cases in Italy and "probably" 800,000 fewer cases in Europe.

Source: Human Reproduction, July 15, 2004.

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Alzheimer's Spending to Triple by 2015 Study

By Jon Hurdle


Monday, July 19, 2004

PHILADELPHIA (Reuters) - Federal spending on Alzheimer's disease (news - web sites) could triple by 2015 as the population ages, putting increasing strain on the Medicare health program for the elderly, researchers said on Monday.

The study for the Alzheimer's Association projects that Medicare spending on people with the disease will rise to $189 billion by 2015 from $62 billion in 2000.

Current Medicare spending on Alzheimer's patients is three times as high as for the average beneficiary and currently accounts for 34 percent of total costs in the federal program for elderly patients, the report said.

"The presence of Alzheimer's makes it much more expensive to treat people who often have other illnesses," said Alzheimer's Association spokesman Stephen McConnell.

"And we're looking at a demographic explosion of Alzheimer's patients," McConnell added in an interview.

An estimated 4.5 million Americans have the disease and that number is expected to balloon as high as 16 million by 2050 as the baby boom generation ages.

McConnell said Alzheimer's researchers are urging the federal government to increase funding for research into the disease to $1 billion from the current $680 million, to pay for more trials and more imaging technology that allows doctors to make quick assessments of a patient's brain.

In Memory Of Reagan

He urged Congress to pass a bill that would double funding for research to $1.4 billion. The bill, which has 63 co-sponsors in the Senate, was introduced in memory of former President Ronald Reagan (news - web sites), who died in June with Alzheimer's.

The cost to Medicare of treating people with Alzheimer's averages $13,207 per year compared with $4,454 for other beneficiaries, McConnell said.

Medication such as Pfizer's (NYSE:PFE - news) drug Aricept may delay the onset of the disease until later in old age, McConnell told a meeting on Alzheimer's disease. Postponing the average onset by six years would reduce the number of patients by 1.5 million, saving Medicaid $51 billion a year, he said.

"They will get it later in life and fewer people will progress to the advanced stages," he said.

Current national direct and indirect costs of caring for people with the disease have reached at least $100 billion, according to estimates from the Alzheimer's Association and the National Institute of Aging.

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Stronger Pot May Make Reefer Madness Real, U.S. Fears

By Maggie Fox, Health and Science Correspondent


Monday, July 19, 2004

WASHINGTON (Reuters) - Alarmed by reports that marijuana is becoming more potent than ever and that children are trying it at younger and younger ages, U.S. officials are changing their drug policies.

Pot is no longer the gentle weed of the 1960s and may pose a greater threat than cocaine or even heroin because so many more people use it. So officials at the National Institutes of Health (news - web sites) and at the White House are hoping to shift some of the focus in research and enforcement from "hard" drugs such as cocaine and heroin to marijuana.

While drug use overall is falling among children and teens, the officials worry that the children who are trying pot are doing so at ever-younger ages, when their brains and bodies are vulnerable to dangerous side effects.

"Most people have been led to believe that marijuana is a soft drug, not a drug that causes serious problems," John Walters, head of the White House Office of National Drug Control Policy, said in an interview.

"(But) marijuana today is a much more serious problem than the vast majority of Americans understand. If you told people that one in five of 12- to 17-year-olds who ever used marijuana in their lives need treatment, I don't think people would remotely understand it."

Jump In Pot-Related Detox

The number of children and teen-agers in treatment for marijuana dependence and abuse has jumped 142 percent since 1992, the National Center on Addiction and Substance Abuse at Columbia University reported in April.

According to the report, children and teens are three times more likely to be in treatment for marijuana abuse than for alcohol, and six times likelier to be in treatment for marijuana than for all other illegal drugs combined.

And it found the age of youths using marijuana is falling. The teens aged 12 to 17 said on average they started trying marijuana at 13-1/2. The same survey found that adults aged 18 to 25 had first tried it at 16.

For National Institute on Drug Abuse director Dr. Nora Volkow the final straw was a report her institute published in May in the Journal of the American Medical Association (news - web sites) showing the steady growth in the potency of cannabis seized in raids.

According to the University of Mississippi's Marijuana Potency Project, average levels of THC, the active ingredient in marijuana, rose steadily from 3.5 percent in 1988 to more than 7 percent in 2003.

Volkow said many studies have shown the brain has its own so-called endogenous cannabinoids. These molecules are similar in structure to the active ingredients in marijuana and are involved in a range of activities and emotions ranging from eye function to pain regulation and anxiety.

Getting Into The Brain

Brain cells have receptors -- molecular doorways -- designed specifically to interact with these cannabinoids.

The cannabinoids in marijuana may use these ready-made doorways into brain cells and this is why they cause a high and reduce pain sensations. But Volkow believes the effects may go beyond the general feeling of well-being that most marijuana users seek.

"I would predict that stronger pot makes the brain less likely to respond to endogenous cannabinoids," Volkow said in an interview. The effects could be especially marked in young brains still growing and learning how to respond to stimuli, she said.

While the research so far is inconclusive, Volkow believes that cannabinoids affect the developing brain and that stronger pot, combined with earlier use, could make children and teens anxious, unmotivated or perhaps even psychotic.

As an analogy, Volkow said opiate addicts are more sensitive to pain, as their overuse of drugs have raised the threshold at which the body responds and their own bodies produce fewer natural opiates.

NIDA is seeking proposals from researchers who want to investigate such possibilities for cannabis, she said.

Proponents of legalizing marijuana disagree with the official line. Krissy Oechslin of the Marijuana Policy Project disputes the finding that cannabis products are stronger.

"They make it sound like the THC levels in marijuana were almost nonexistent, but no one would have smoked it then if that was true," she said.

"And there's evidence that the stronger the THC, the less of it a person smokes. I don't want to say it's good for you, but I'll say (more potent marijuana) is less bad for you."

While Walters stresses that drug abusers are patients and not criminals, he hopes to crack down more on producers. And he says, there is a way to go in getting cooperation from local law enforcement officials. "For many in enforcement, marijuana is still 'kiddie dope'," Walters said.

Walters is quick to stress he does not want to overreact.

"We shouldn't be victims of reefer madness," he said, referring to the 1930s propaganda film "Reefer Madness" that became a 1970s cult classic for its over-the-top scenes of marijuana turning teens into homicidal maniacs.

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With Sporadic Exercise, Seniors Live Longer

By Charnicia E. Huggins

Reuters Health

Monday, July 19, 2004

NEW YORK (Reuters Health) - Staying physically active during the golden years may help seniors live longer, according to a team of Swedish researchers.

They found that men and women aged 65 years and older who engaged in even occasional physical activity during their leisure time were much less likely to die during a 12-year period than their sedentary peers.

In light of this finding, "preventive resources among the elderly should include moderate exercise such as walking," Dr. Kristina Sundquist of the Karolinska Institute in Stockholm, and her colleagues write in the American Journal of Preventive Medicine.

In the current report, Sundquist and her team investigated the association between varying levels of physical activity and death from any cause among 3,206 elderly study participants.

Overall, 925 women and 881 men died during the 12-year follow-up period, the researchers report. Death rates were highest among smokers, those with lower levels of education, those who reported engaging in little to no physical activity and those who said they had poor health as well as among the underweight, obese and those with diabetes and high blood pressure.

Seniors who said they sometimes took hour-long walks, went skiing, picked mushrooms or otherwise participated in occasional physical activity were 28 percent less likely to die from any cause than those who admitted getting "practically no exercise at all."

Further, those who were more active -- who reported going on fast walks, jogging or cycling about once a week -- were 40 percent less likely to die.

These findings remained true even when the researchers took into consideration the seniors' smoking status, weight and height, self-rated health and other factors that may have contributed to increased longevity, the report indicates.

The exact reason for the reduced death risk among the active elders is unknown, but Sundquist and her team suspect that it may be due to their lower risk of dying from cardiovascular disease, one of the most common causes of death in Western countries. In fact, findings from a review of several studies involving older adults point to the cardio-protective effects of physical activity among older men.

"Physical activity has a lowering effect on blood pressure and lipid levels and reduces the risk of diabetes, which in turn has a protective effect on the heart and the blood vessels," Sundquist told Reuters Health.

Yet seniors who were physically active twice a week or more frequently did not have an even further reduced risk of dying than those who exercised just once a week, and the researchers do not know why.

"We cannot explain why those who exercised more frequently did not have an even further reduced risk of death," Sundquist said. "Perhaps the cut point for physical activity in order to achieve a reduced risk of death is lower for elderly than for middle-aged people."

In light of the findings, Sundquist and her team advise seniors to get moving. "We recommend fast walks, skiing, swimming, jogging, cycling at least once a week," she said.

If once a week is too grueling, however, older adults should at least try to engage in physical activity every once in a while. "Our results showed that even occasional physical activity significantly reduces mortality, however to a lesser extent than once a week," Sundquist said.

Source: American Journal of Preventive Medicine, July 2004.

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Sunday, July 18, 2004


Easing the Pain of Tonsillectomies


By Randy Dotinga
HealthDay Reporter


Sunday, July 18, 2004

SUNDAY, July 18 (HealthDayNews) -- Like many rites of childhood, tonsillectomies are painful procedures that kids would happily skip if they had a choice.

However, doctors have started using a new technique that appears to make the experience a lot easier to swallow.

In so-called coblation tonsillectomies, doctors use a wand-like device and radiofrequency energy to obliterate the tonsils. While the procedure doesn't sound appealing, it's an improvement over the traditional approaches, which require doctors to either burn the tonsils or literally cut them out of the throat, said Dr. Udayan Shah, an otolaryngologist at The Children's Hospital of Philadelphia.

"It's not a pretty picture," he said. "There's a rough recovery. That's where the idea of coblation comes in. People are always looking for a better way to do things when they anticipate a painful recovery."

As bad as tonsillectomies can be, the alternatives are worse. Doctors typically turn to the operations to prevent continued cases of strep-throat infections or, more recently, to stop breathing problems during sleep.

"It's still a very common procedure," Shah said. Children with breathing difficulties may even have the operation before the ages of 5 to 7. Often, tonsillectomies are scheduled during summer to give kids time to recuperate before school.

Tonsillectomies were more common in the 1950s and 1960s when the potential risk of complications from strep infections was higher, explained Dr. Nina Shapiro, an assistant professor of pediatric otolaryngology at the University of California, Los Angeles. If children had one or two strep infections, their tonsils would come out, she said.

While the number of the surgeries went down for some time, they've risen in the last five to 10 years because they can correct breathing problems. An estimated 500,000 American children have the procedure each year.

The tonsils are lymph nodes, part of the immune system. But they're troublesome because they can block the breathing passages when infected. Removal doesn't seem to harm people, Shapiro said.

Doctors typically perform tonsillectomies with a "hot" approach -- cauterizing -- or a "cold" approach in which they cut out the tonsils with a tool. "For years, and even now, people refer to their technique as 'I do a cold tonsillectomy' or 'I do a hot tonsillectomy,' " Shah said.

Doctors also have to figure out how to control bleeding. A variety of approaches are used, including sutures and even applications of vinegar or tannic acid.

Since its introduction in 2000, the coblation technique has become more popular; an estimated 80,000 surgeries have been performed worldwide. During the procedures, surgeons break up the tonsils using the energy from a radio-frequency wand to dissolve tissue.

Patients who have the procedure seem to bleed less and recover more quickly, although it can still take two weeks for full recovery in some cases, Shapiro said.

"With the traditional tonsillectomy, patients suffered sore throats, needed more pain medication and took a week or two to recuperate," Shapiro said. "Now, I'm finding that with this technique, patients can drink and eat a few hours after surgery, require less pain medication, and return to normal activity within a few days."

It's not entirely clear which factors -- the child, the surgeon or the technique used -- are most important in reducing recovery time, Shapiro said. She cautioned that parents should not shop around for doctors who perform a specific tonsillectomy technique.

"My advice to parents is that they first pick a doctor they can trust and worry about the technique second," she said.

Shah agreed. "The most important thing is to pick a doctor you trust. Go with what that doctor says. Every surgeon has their own experience. You want them doing what they're great at doing and believe in."

More information

Learn more about coblation tonsillectomies from the University of California, Los Angeles.

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