Personal Health
Joel P. Rutkowski, Ph.D., Editor
December 6 , 2003
Personal Health - November 15-21
Associated Press
November 23, 2003
Five lawsuits have already been
filed against the Chi-Chi's restaurant chain over a hepatitis A outbreak that
has killed three people and sickened more than 600, and scores of other
lawsuits are likely to follow.
But legal experts say two key issues facing the company could determine
whether victims and their families get the settlements they seek: insurance and
bankruptcy.
The Mexican restaurant chain filed for Chapter 11 bankruptcy protection
on Oct. 8, citing cash flow problems, a month before the hepatitis outbreak was
confirmed.
On Friday, a bankruptcy judge gave limited approval to Chi-Chi's plans
to begin paying some expenses for those sickened in the outbreak — up to
$20,000 per claim. He did not, however, fully approve Chi-Chi's plan to pay
$500,000 on an insurance deductible so the company could tap into as much as
$51 million in liability insurance it may need to settle claims. A hearing is
set for Tuesday on the matter.
None of the lawsuits filed so far are on behalf of those who died in
what is the biggest known hepatitis A outbreak. It, like other recent outbreaks
in Georgia and Tennessee, was blamed on tainted green onions.
Another outbreak, which sickened 16 people in North Carolina, probably
stemmed from the same source as the Georgia outbreak, according to a report by
Georgia's health department obtained by The Associated Press.
The Georgia outbreak had previously been traced to green onions shipped
from Mexico, and the report said a single Atlanta Farmers' Market distributor
provided green onions from California suppliers to three Georgia restaurants
where multiple people got the liver infection.
Federal health officials said Friday that green onions from Mexico
probably were responsible for the Pennsylvania outbreak, but stopped short of
saying they came from one of three Mexican companies known to have supplied the
onions blamed for other outbreaks.
If Chi-Chi's does not emerge from Chapter 11, some hepatitis plaintiffs
might find themselves waiting in line for pennies on the dollar behind the
chain's other creditors, said Chicago attorney Robert Clifford, who led a group
of plaintiffs who settled multimillion-dollar claims after a US Airways flight
crashed near Pittsburgh in 1994. US Airways emerged from Chapter 11 about a
year before the crash.
"If, at the end, you've got a bankrupt defendant who did it, these
people are going to get (shortchanged)," he said. "Bad things happen
to good people every day in America."
Also unclear is whether Chi-Chi's has enough insurance to settle the
cases in the same fashion as other restaurants that faced similar food
poisoning lawsuits.
Hundreds of people sued the Jack in the Box fast-food chain after it
served hamburger tainted with E. coli in 1993 that killed three children and
sickened hundreds.
The burger chain offered to pay medical bills and some lost wages.
Still, the linchpin to settling the lawsuits was $100 million in liability
insurance, said William Marler, a Seattle attorney who has filed three of the
five Chi-Chi's lawsuits so far.
Chi-Chi's has stated in bankruptcy documents that it has $51 million in
liability insurance — about half as much as Marler believes the company will
need.
Marler represents some 80 people who contracted hepatitis A or received
shots to prevent it after eating at the restaurant, about 25 miles northwest of
Pittsburgh. The three suits Marler has filed have been put on hold by a judge
to protect creditors of the Louisville, Ky.-based chain.
Chi-Chi's attorney David Ernst of Portland, Ore., refused to discuss
liability issues.
"It is absolutely within the best interests of Chi-Chi's to do
right by its customers," Ernst said. "But that (insurance and lawsuit
settlement) part of it is not like the Jack in the Box case — we have to comply
with the bankruptcy court."
Pittsburgh attorney Robert Peirce, who has filed two suits, said his
clients want more than reimbursement for doctor bills and missed work.
"Pain and suffering and loss of enjoyment of life are
important," Peirce said. "But I don't want clients looking for some
big payday, because that's not what I'm here to do."
Chi-Chi's Exec Calls Restaurants
Safe
Associated Press
November 22, 2003
State and federal health officials
said Saturday that Pennsylvania's hepatitis A outbreak is winding down, even as
the number of those infected climbed over 600. The investigation shifted to how
green onions linked to the outbreak became contaminated.
Sen. Arlen Specter, R-Pa., met Saturday with Dr. Julie Gerberding, director
of the Centers for Disease Control and Prevention (news
- web
sites), and state health officials at a community college near the Beaver
County Chi-Chi's restaurant where the outbreak was first confirmed Nov. 3.
"We do feel like this particular outbreak has been successfully
ended," Gerberding said, although the number of cases probably will rise
over the next few days as lab test results come back.
With 605 infections and three deaths confirmed, health officials have
found no secondary cases — meaning all those infected were sickened at the
restaurant by the scallions, not through contact with infected people. Most of
the green onions were used in a mild salsa and a cheese dip.
Hepatitis A is a virus that attacks the liver and can cause fever,
nausea, diarrhea, jaundice, fatigue, abdominal pain and loss of appetite.
Hepatitis A usually clears up on its own in about two months.
Nearly 10,000 people have been screened for the virus and more than
9,100 received antibody injections, which prevent hepatitis A from taking hold
within the first 14 days of exposure.
Specter, who chairs the Senate subcommittee that controls the CDC's
budget, called health officials' work stopping the virus the "gold
standard of response."
What remains is pinpointing how the onions were tainted.
The Food and Drug Administration (news
- web
sites) already has identified eight brands of Mexican-grown green onions
believed to have caused the Pennsylvania outbreak. Green onions also are
suspected of causing outbreaks in Georgia and Tennessee that have sickened more
than 330 people, and the strains of hepatitis A found in those states and
Pennsylvania are very similar.
But the FDA has yet to determine how and where — from the onion fields
to the Chi-Chi's northwest of Pittsburgh and more than a dozen restaurants in
the other states — the contamination occurred.
Chi-Chi's chief operating officer Bill Zavertnik flew to Pittsburgh on
Saturday to read a short statement saying federal and state health officials
found no wrongdoing by the company.
"There is currently no industry-accepted means of testing produce
for the hepatitis A virus, and beyond that, there is no possible way to wash
hepatitis A off contaminated green onions," he told reporters. Zavertnik,
who did not take questions, said the chain did everything possible to prevent
the outbreak.
But a food safety expert said grocery stores and restaurants
have to do more than just properly handle fresh vegetables — they also need to
ensure their suppliers are safe.
Associated Press
November 21, 2003
A third pill to treat impotence was
approved for sale in the United States on Friday, intensifying competition in a
billion-dollar slice of the drug market.
The new pill will be sold under the name Cialis. It joins Viagra, the
oral drug that went on the market in 1998, and Levitra, which was approved
earlier this year by the Food and Drug Administration (news
- web
sites).
All three drugs act on an enzyme that helps prompt and maintain
erections by relaxing muscles in the penis and blood vessels. The duration and
onset of the drug action is different, however, with each pill.
Cialis, manufactured by Eli Lilly & Co., was found in studies to
stay longer in the body than Viagra. Studies suggest that a 20 mg dose of
Cialis is active for 24 to 36 hours. In France, where the drug has been on the
market for some time, Cialis is called "Le weekend" pill. Levitra and
Viagra reach their full effectiveness in an hour, on average.
Some market studies suggest that about 30 million men over the age of 40
have symptoms of impotence. The sales of Viagra last year were reported at $1.2
billion.
Cialis, whose chemical name is tadalafil, was tested in trials with
4,000 men. The studies found that it helped promote erection within a half hour
and enhanced that ability for up to 36 hours.
The drug is not recommended for patients on some heart medications, such
as nitroglycerin tablets or some alpha blockers, because the combination can
cause a sharp drop in blood pressure. This can cause fainting or even death in
some men.
Recommendations call for dosage limitations of Cialis for patients with
kidney or liver disorders. The drug should not be taken by men for whom sexual
activity is inadvisable because of heart conditions.
The most common reported side effects from clinical trials
of Cialis were headache, indigestion, back pain, muscle aches and flushing.
Associated Press
November 21, 2003
A few figures on headaches from the
Mayo Clinic and National Headache Foundation (news
- web
sites).
·
_
One in eight Americans suffers from recurring, severe headaches and migraines
that interfere with daily life.
·
_
About 15 percent of women and 7 percent of men suffer from migraine headaches.
·
_
Seventy percent of migraine sufferers are found to have some sort of headache
history in their family tree.
Associated Press
November 21, 2003
They are excruciating headaches
that last for days and return at a moment's notice. Often, they surface in the
teenage years and last through much of adulthood.
It's a condition that has existed for centuries, doctors say. But only
recently has it been given a name: "chronic daily headaches," or CDH,
defined as migraines or neck- and head-squeezing tension headaches that are
present 15 or more days each month.
Some might think it sounds like just another excuse to skip school. But
young people such as Rachel Gohmann, an 18-year-old college freshman from St.
Cloud, Minn., know how serious the condition can be.
Blinding headaches that often left her bedridden caused her to miss more
than 100 days of her senior year of high school — with her worst migraine
lasting nearly a month.
Medication and a tutor helped her make it to graduation. But, now a
freshman at St. Cloud State University, she's still missing some classes and
making at least one trip a month to the emergency room, where she's given
narcotic drugs that help her sleep.
"And that's a good month," Gohmann says.
Doctors say that anywhere from 1 percent to 5 percent of the population,
including young people, suffer from chronic daily headaches.
Roughly an equal number of boys and girls suffer from them in the
elementary years. But once adolescence hits, young women are about three times
as likely to have them, partly due to hormonal changes related to menstruation.
Other factors, such as a family history of headaches, stress and
depression, also can play a role for both genders.
"It's really sad because these headaches take all the pleasure out
of life at a time when high school and college students should be enjoying
their lives," says Dr. Michael Cutrer, a neurologist who specializes in
primary headache disorders at the Mayo Clinic.
If left untreated, he says, the severity of the headaches often
increases — making it imperative that treatment begin in the early years.
Gohmann is one of Cutrer's many young patients. She says that when she
first started getting the headaches last year, her friends didn't really
understand.
"There was confusion about why I was gone so much; they thought I'd
gotten in with a bad crowd," says Gohmann, an honors student who wants to
be a psychologist. "They thought I was making it up."
Abigail Rey experienced much the same response from her doctor in
Virginia when she first got bad headaches five years ago.
"My doctor said to just deal with it," says the 16-year-old,
who now lives in Shoreline, Wash., and has since found a physician to treat her
chronic migraines.
When Rey moved, she started seeing Dr. Sheena Aurora, co-director of the
headache clinic at Swedish Medical Center in Seattle.
Aurora says it's not unusual for people, especially teens, to avoid
treatment, partly because the public and even some doctors don't understand the
condition — or that treatment is available.
She says even some parents don't believe their children's headaches are
so bad.
"They just think they're complaining — that it's not a real
disorder, things like that," Aurora says. "But if it's interfering
with the quality of life — keeping them from everyday activities — then it's
probably time to seek help."
Still, even the most experienced of headache specialists say that
finding relief for chronic daily headaches isn't always easy.
The director of the pediatric headache clinic at the University of
Maryland Hospital for Children in Baltimore says that at least half the young
patients who come to see him suffer from chronic daily headaches.
"These patients remain complex and perplexing," says Dr. Jack
Gladstein, who founded the Maryland clinic in 1989.
Often, it is a matter of trying various migraine medications. Among the
most common are prescription drugs called "triptans," which are
marketed under such names as Maxalt, Amerge, Imitrex and Zomig. They're taken
at the onset of a headache.
Because chronic headaches often run in families, some doctors give their
young patients drugs that have worked on relatives. Others also have found that
antidepressants sometimes help, since depression can be an underlying factor.
And some accompany the use of prescription drugs with acupuncture or botox injections
to relax stiffened head and neck muscles.
Doctors say it's also important that their young patients stay on a
regular sleep schedule and avoid stress and skipping meals.
Gohmann has tried all of it — and says a new triptan medication seems to
be helping. Still living at home because of the headaches, she's still hoping
she'll be able to go away to college.
In the meantime, she's discovered that several of her classmates — and
even some of her professors — have trouble with severe headaches, too.
"We swap horror stories," Gohmann says. "It helps when
people understand."
___
On the Net:
American Council for Headache Education: http://www.achenet.org
National Headache Foundation (news
- web
sites): http://www.headaches.org
Associated Press
November 21, 2003
Dozens of villagers in northeastern
China have contracted the AIDS (news
- web
sites) virus by selling blood and at least 20 have died, a human rights
organization said Friday.
Blood tests have proven that 62 villagers from Soudengzhan in Jilin
province are HIV (news
- web
sites)-positive, part of a total of 300 people who may be infected, said
the Hong Kong-based Information Center for Human Rights and Democracy.
"It is urgent to get the spread of disease under control in the
area," said Frank Lu, who runs the organization.
Government officials at various levels have covered up the infections to
protect Liu Baozhong, party secretary of Soudengzhan, who has been singled out
for praise by former President Jiang Zemin (news
- web
sites), Lu said.
"It is because of this that officials have covered up this serious
matter," he said. "AIDS is spreading in that town and other places
around the country."
A woman who answered the telephone at the Soudengzhan town government
said only that "no one has contracted AIDS here." She would give only
her family name, Yao.
At Jilin's city health bureau, which oversees Soudengzhan, a man who
answered the telephone said he "hadn't heard anything about the cases."
He refused to give his name.
About 1 million people in China are HIV-positive, mostly intravenous
drug users and people infected from blood-buying schemes in central China.
Chinese officials and the United Nations (news
- web
sites) warn that 10 million people could be infected by 2020 without more
effective prevention.
Thousands of villagers sold their blood to the donation station after it
opened in 1992, the center said. The station closed three years later, it said,
but did not give a reason or provide more details.
In the central province of Henan, thousands were infected with the AIDS
virus by an unsanitary blood-buying industry in the 1990s, when dealers bought
blood from villagers and pooled it, mixing healthy blood with HIV-infected
blood.
They extracted plasma, a blood component with medical uses,
and re-injected the rest back into the sellers.
Associated Press
November 21, 2003
A nursing assistant died while
undergoing stomach reduction surgery, and the hospital said Thursday it is
suspending such operations while it investigates.
Brett Davey, spokesman for Roger Williams Medical Center, would not say
went wrong during the surgery or whether any doctors would be disciplined.
Robert Messa Jr., 27, who worked at the hospital, died Tuesday about a
half-hour into the laparoscopic gastric bypass operation, Davey said.
It was the third death among the 340 gastric bypass procedures performed
at the hospital over the past three years, chairman of surgery Paul Liu said.
Liu said the hospital will stop performing both open and laparoscopic
procedures. The newer laparoscopic technique uses smaller incisions and leads
to less scarring and quicker recovery.
He said the doctor who performed the surgery has not been suspended. He
would not identify the doctor, but said he's "very experienced."
Liu would not disclose a cause of death, saying the hospital is awaiting
autopsy results. The state Department of Health is also looking into the
incident.
Last month, Boston's Brigham and Women's Hospital stopped performing the
laparoscopic procedure after a 38-year-old woman there died after the staple
gun apparently misfired during the procedure.
Gastric bypass surgery aids (news
- web
sites) weight loss in a morbidly obese patient by shrinking the stomach
from the size of a football to the size of an egg.
"I think what's happening is the fact that it's become so visible
with celebrities and others who have had it done ... the numbers who are having
it done are going up dramatically, and I think the true risk of this procedure
is becoming more known," said Dr. Vincent Pera, director of the weight
management program at Miriam Hospital in Providence.
Pera said the death rate for gastric bypass surgery is one in 200.
The smaller stomach pouch is created by stitching or stapling part of
the stomach closed. A part of the small intestine is bypassed to reduce
nutrient absorption, causing the patient to lose weight. Typically, patients
lose 70 percent to 80 percent of their excess body weight in about a year.
But the surgery comes with risks, including postoperative complications
that can include blood clots floating to the lungs or stomach juices leaking
into the blood and causing infections.
Though the procedure is commonly known as stomach stapling,
the hospital would not confirm whether staples were used during Messa's
procedure.
Janice Billingsley
HealthDay Reporter
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- As the days grow shorter and the night air colder, that means one thing -- the start of the common cold season with all its attendant symptoms.
Like stuffy nose. Headaches. Post-nasal drip.
But it's also prime time for one of the most common chronic health conditions in the country -- sinusitis, whose symptoms include stuffy nose, headaches and post-nasal drip.
So how do you tell what ails you?
With difficulty.
"It's very hard for patients to distinguish between a cold and sinusitis because very often the symptoms are the same," says Dr. Stanley Blaugrund, chairman of the department of otolaryngology, Head and Neck Surgery at Lenox Hill Hospital in New York City.
Nasal congestion, a runny nose, bad breath, facial pain, headache and night cough are all signs of both maladies. The symptoms are caused by swelling of the sinus passages so they can't drain the fluid that builds up there, Blaugrund says.
With a cold, the swelling typically goes down in three days to a week, allowing the mucus to pass through and out of the nose and giving people relief from their symptoms.
Sinusitis occurs, however, when the swelling persists, blocking the nasal passages so the mucus has no way of escaping, leaving the sinuses vulnerable to infection.
"The majority of these illnesses are just colds," says Dr. George Zalzal, professor of otolaryngology and pediatrics at George Washington University in Washington, D.C.
"But if the symptoms last for 10 days or more, you could be dealing with sinusitis," Zalzal says.
Sinusitis is one of the most common chronic health problems in the United States, affecting about 37 million people a year, according to the National Institute of Allergies and Infectious Diseases. If not treated properly, the condition can become acute, lasting anywhere from three to eight weeks, or chronic, lasting for months or even years, doctors say.
So health experts recommend going to the doctor sooner rather than later if you suspect sinusitis. This is particularly true for children, says Zalzal.
"For children, especially if a child is very young, any symptom that lasts beyond two or three days, particularly a cough or a fever, could be a sign of something else as well," such as sinusitis or bronchitis, he says. des/factsheets/chemicals/1file.htm
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- Brazilian scientists claim they've restored feeling to people who have been paralyzed for at least two years, says a report in Chemistry and Industry magazine.
The scientists harvested stem cells from the blood of 30 people with spinal cord injuries. The stem cells were reintroduced to the patients' bodies by injecting them into the artery supplying blood to the area of spinal cord damage.
After a few months, 12 of the patients responded to electrical stimulation of their paralyzed limbs, the report says.
The claim has raised some eyebrows.
"Nothing like this has been done in humans before, but the worry is that human studies have tended to be unscientific," Sam Pfaff, a professor of molecular biology at the Salk Institute of Biological Sciences, comments in the Chemistry and Industry report.
The Brazilian research may also pose ethical problems.
"Our concern is that stem cells have the potential to keep growing. They may even do more harm than good," Pfaff says.
The Brazilian research is currently being reviewed for publication in a peer-reviewed journal.
More information
Here's where you can learn more about paralysis.
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- The American Association of Neurological Surgeons (AANS) has launched a new public Web site for people seeking information about a variety of neurosurgical information.
"We have organized the information on this site using state-of-the-art navigational tools. This information can better prepare a patient for a neurosurgical consult, but it does not replace medical advice from a board-certified neurosurgeon," Dr. Robert Harbaugh, editor of the new Web site, says in a prepared statement.
The Neurosurgery Today Web site provides the public with credible neurosurgical information crafted by AANS neurosurgeons. Through the site, people can become better informed about disorders of the central nervous system and how they can be treated.
"Neurosurgeons report that more and more people are using the Internet as a primary tool for obtaining information about their condition, or that of a friend of family member," Thomas A. Marshall, AANS executive director, says in a prepared statement.
"This new site's design is more convenient for those who are researching disorders of the nervous system and potential neurosurgical treatments," Marshall says.
More information
Here's where you can find the Neurosurgery Today site.
HealthDay Reporter
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- With all the talk of amyloid precursor protein, gene alleles and cholinesterase inhibitors, some Alzheimer's researchers have bucked the trend by setting their sights on something far simpler:
The daily crossword puzzle.
A June 19 study in the New England Journal of Medicine found that activities that require mental energy -- such as reading, playing board games, doing crossword puzzles and playing bridge -- may help stave off Alzheimer's disease.
Researchers at Albert Einstein College of Medicine in New York City followed 469 senior citizens for an average of five years. And they found the more a person pursued one of these brain-teasing activities, the less likely they were to develop a dementia, including Alzheimer's.
For instance, older people who did crossword puzzles four days a week had a risk for dementia that was 47 percent lower than those who only tried the puzzle once a week.
Although previous studies have obtained similar results, it was never clear whether the people who weren't reading or playing bridge actually had early Alzheimer's.
This study, on the other hand, excluded everyone who developed a dementia during the first seven years of the study, which ran from 1980 to 2001. The puzzlers and readers who ended up in the study probably had been engaging in those activities over a lifetime, says study author Dr. Joe Verghese, an assistant professor of neurology at Albert Einstein.
The next question is why the mental gymnastics seem to pay off.
Although not proven, some experts subscribe to a use-it-or-lose-it theory, also known as the cognitive reserve theory.
"According to this theory, by engaging in cognitive stimulating activities or being highly educated or having a mentally challenging occupation is building a buffer against the disease," Verghese explains.
And why is that?
Possibly because tasks that require mental energy help with new cell formation and with making new connections in the brain.
"It's almost like if you do regular physical exercise and you build up muscle strength, then if you get sick you will be able to resist the effects of sickness," Verghese says. "The cognitive reserve theory suggests that maybe the same thing happens to the brain.
"For the most part," he adds, "everyone has an equal chance of developing Alzheimer's. If you engage in cognitive-stimulating activities, more cells or more cell connections form so when the disease starts attacking cells it has to destroy more cells."
Serena Gordon
HealthDay Reporter
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- Kicking back with a few glasses of wine after dinner may be relaxing, but it might not be so good for your health, say Australian researchers.
In a study in the November issue of Alcoholism: Clinical and Experimental Research, researchers found drinking the equivalent of three glasses of white wine after eating a carbohydrate-laden meal caused insulin levels to drop.
Insulin is a hormone necessary for the body to process sugar (glucose) and starches. Without enough insulin, the body's cells don't get the energy they need, the researchers say. People with diabetes either don't produce any insulin or don't produce sufficient levels of the hormone. A lack of insulin is one cause of diabetes. Normally, when you consume food, your blood glucose levels immediately rise and, in response to that rise, the body produces insulin to process the glucose.
"[Our findings] suggest that drinking white wine on its own after a meal may alter glucose metabolism and produce a pseudo-diabetic condition," says study author Anna Kokavec, a research psychologist affiliated with La Trobe University in Bundoora, Australia. "There is possibly no safe level of white wine consumption and this may extend to other commercially available alcohol products. Furthermore, white wine is probably not a product that should be recommended for consumption by diabetics."
Others aren't convinced, however.
"There is nothing in this study that is relevant to advice that physicians should give their patients about the consumption of white wine," says Dr. Kenneth Hupart, chief of endocrinology, diabetes and metabolism at Nassau University Medical Center in East Meadow, N.Y.
Kokavec and her colleagues recruited eight nondiabetic males between the ages of 19 and 22 years for this study. All were admitted binge drinkers. None were obese.
The researchers had the volunteers eat non-vegetarian pizza -- the study does not specify how much pizza each person consumed -- and drink a nonalcoholic soft drink. Then they were asked to drink three average-sized glasses of wine slowly over 90 minutes.
Blood glucose and insulin levels were measured before the study participants ate and then again at 45 minutes, 90 minutes and 135 minutes after eating.
Insulin levels dropped quickly after the consumption of wine, in some cases to a very low level, Kokavec says. Glucose levels also dropped.
Hupart points out that insulin and glucose levels normally drop off as a meal is processed by the body. He suggests a better measure of how alcohol affects insulin and glucose levels would be to compare these levels in people who drink wine after a meal to people who don't.
"This study does not show any effect that is medically relevant," he adds.
Kokavec, however, says that "any disruption in energy metabolism or utilization could have serious consequences to the health of the individual. The efficient regulation of insulin is vital in meeting the energy needs of cells located largely outside the brain and any disregulation in insulin could lead to some cells being starved of energy, which could cause serious disease."
Hupart does say it's wise for people with diabetes to limit their alcohol consumption, especially people who are taking medications to control their diabetes. Hupart suggests discussing your alcohol consumption with your doctor.
More information
To learn more about how alcohol affects people with diabetes, visit the American Diabetes Association or the Joslin Diabetes Center.
Steven Reinberg
HealthDay Reporter
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- If you are short, you may be predisposed to hearing problems.
That's the conclusion of a new study by Swedish researchers that appears in the Nov. 22 issue of the British Medical Journal.
"The potential for adult hearing problems may develop during the prenatal period," says study author Marie-Louise Barrenas, an associate professor of otorhinolaryngology at the Goteborg Pediatric Growth Research Centre of Goteborg University.
This appears to be particularly prevalent among shorter-than-average adults, she adds.
Barrenas' findings are based on the "thrifty phenotype theory," which says that events before birth -- such as malnutrition or exposure to alcohol or nicotine -- may cause disease in adulthood.
"This may also be the case for hearing loss," she says.
Barrenas's team tested the hearing of 479 men, aged 20 to 64, who were exposed to noise in their jobs. Then they randomly selected 500 other men born in 1974. For both groups of men, the researchers collected data on height, weight, exposure to noise, heredity for hearing loss and other medical disorders, including use of medication.
The researchers report that among the randomly selected men, short men were twice as likely to have hearing loss. They also found shortness was associated with a family history of hearing loss. However, there was no association with exposure to noise and hearing loss in this group.
Among the workers, the researchers found short workers had worse hearing than expected for their age. Short workers were also three times more likely to have hearing loss compared with taller workers. In addition, short workers were 12 times more likely than taller workers to be taking medication.
During the fetal period, there are factors that can affect growth, Barrenas says. So when you are born shorter than normal, that may affect your health as you grow older, she adds.
In the fetus, a low level of the growth hormone (IGF-1) might be a marker for adverse events, leading to a reduced number of cells at birth, which may cause shortness and the risk for early onset of age-related problems, Barrenas notes.
Barrenas's group is continuing its research by looking at adults who were born short for gestational age. "We are finding similar results," she says.
"We are looking for hearing treatment to prevent sensorineural hearing loss," Barrenas notes. "If we can show an association between growth disturbances and hearing, we think that we might be able to treat sensorineural hearing loss with growth stimulating substances."
"Our goal is to have a treatment instead of hearing aids," she says.
Dr. Thomas Murry, a professor of clinical otolaryngology head and neck surgery at Columbia University, says the Swedish study is very interesting but is "open to many critical factors, none the least of which is the type of noise exposure the subjects were exposed to.
"We are only at the beginning of studies that relate problems such as hearing loss to nonauditory factors such as growth, types of medicines and early childhood activities -- especially early childhood middle ear infections. Additional studies of factors such as early childhood health are very important in ascribing hearing-loss causes," he says.
More information
To learn more about hearing loss, visit the American Speech-Language-Hearing Association and the National Institute on Deafness and Other Communication Disorders.
HealthDayNews
November 21, 2003
FRIDAY, Nov. 21 (HealthDayNews) -- Buckwheat may help people with diabetes better manage their condition.
That's the conclusion of a Canadian study in the Dec. 3 issue of the Journal of Agricultural and Food Chemistry.
University of Manitoba researchers found that extracts of buckwheat seed fed to diabetic rats lowered their blood glucose levels by 12 percent to 19 percent.
"With diabetes on the rise, incorporation of buckwheat into the diet could help provide a safe, easy and inexpensive way to lower glucose levels and reduce the risk of complications associated with the disease, including heart, nerve and kidney problems," study leader Carla G. Taylor, an associate professor in the department of human nutritional sciences, says in a prepared statement.
"Buckwheat won't cure diabetes, but we'd like to evaluate its inclusion in food products as a management aid," Taylor says.
But she says that until studies are done on humans with diabetes, it's not clear how much buckwheat flour or extract a person would have to consume to gain a beneficial effect on glucose levels.
More information
Here's where you can learn more about controlling diabetes.
Associated Press
November 20, 2003
An inspection of deeper-water Caribbean
coral reefs found them healthier than previously believed, scientists said.
A three-year survey of 20 coral reef areas in the western Atlantic found
those in 20 feet to 65 feet of water had an average of 26 percent living coral
cover.
Previous studies in both shallow and deep water have found as little as
15 percent coral cover, said Robert Ginsburg, a professor of marine geology and
geophysics at the University of Miami.
However, the new study used more consistent methods. "There were no
data done in the same way," Ginsburg said of earlier studies. "That's
really our contribution, to have done all of the surveys in the same
method."
The results were published in the July edition of the Smithsonian
journal "Atoll Research Bulletin," which is just being distributed.
British researchers in July released their own study on the health of
coral reefs across the whole Caribbean basin. The scientists found coral cover
had declined by about 80 percent in some areas. In others, the cover had
dropped from 50 percent to only about 10 percent in just three decades.
The new study found the healthiest coral reefs were far from land — or
next to small populations. The healthiest were the Flower Gardens near Texas,
the Windward Netherlands Antilles east of Puerto Rico, and Bonaire and Los
Roques islands north of South America.
The healthy reefs likely benefited from favorable water quality, and
isolation from land and people.
Areas of damaged reefs were scattered across the Caribbean — near
populated areas and in remote areas, according to the study.
"The stressors on these reefs are not simply associated with where
people live," said Philip Kramer, assistant research professor of geology
at the University of Miami.
Damaged reefs suffered from a combination of problems, including
disease, overfishing and other human damage, global warming (news
- web
sites) and weakening from the warmer waters of El Nino.
___
On the Net:
Atlantic Gulf and Rapid Reef Assessment: http://www.coral.noaa.gov/agra/index.html
Rosenstiel School of Marine and Atmospheric Science: http://www.rsmas.miami.edu
Associated Press
November 20, 2003
The nation's syphilis rate has
climbed for the second year in a row, mostly because of an increase in cases
among gay and bisexual men, the government said Thursday.
Between 2001 and 2002, the syphilis rate rose 9.1 percent from 2.2 cases
per 100,000 people to 2.4 cases, the Centers for Disease Control and Prevention
(news
- web
sites) said. The rate had dropped every year between 1990 and 2000 before
reversing course.
The actual increase in cases was small — 759 more people, for a total of
6,862 new cases — but the rise among gay and bisexual men has caused concern
that the public health safeguards and safe-sex practices adopted over the last
two decades during the AIDS (news
- web
sites) epidemic continue to crumble.
"The vast majority of the United States is not seeing any syphilis
at all," said Dr. John Douglas, director of the CDC's division of sexually
transmitted diseases. "We're seeing syphilis rise primarily in groups of
gay and bisexual men."
Syphilis cases in the West soared 64.3 percent (1.4 cases per 100,000 to
2.3) between 2001 and 2002 and climbed 54.5 percent in the Northeast (1.1 cases
per 100,000 to 1.7 per 100,000), a rise caused in part by outbreaks in these
regions' major cities — San Francisco, Los Angeles, New York and Miami.
But the CDC also reported that prevention efforts appeared to be working
in the South, which for the first time since 1984, no longer accounts for half
of the country's syphilis cases. Also, women and non-Hispanic blacks saw a
decline for the 12th consecutive year.
In the past two years, the government has repeatedly warned that gays
and bisexuals may be letting down their guard against sexually transmitted
diseases. About 40 percent of the new cases are from these groups, the CDC
said.
___
On the Net:
www.cdc.gov
Associated Press
November 20, 2003
The American Red Cross (news
- web
sites) collected more than 3 million blood donations during a six-month
nationwide campaign, a spokeswoman said.
The Red Cross on Thursday formally ended a traveling campaign that
visited more than 300 communities to educate people about the need for a
continually replenished blood supply and encourage donation.
During the campaign, 3.1 million blood donations were made, a
spokeswoman said; the goal was 3 million.
The nation needs 38,000 blood donations a day — almost 14 million a year
— to treat patients suffering trauma, cancer and other diseases. Sixty percent
of the population is eligible to donate blood but only 5 percent do, causing
periodic shortages.
To find a donation site, contact the Red Cross at 1-800-GIVE
LIFE or America's Blood Centers at 1-888-USBLOOD. Each of the organizations
collects almost half the nation's blood supply.
Associated Press
November 20, 2003
Computerized health records could
significantly cut dangerous medical mistakes, but government-created standards
are needed to spur a seamless network accessible nationwide, a scientific group
that advises the government said Thursday.
Some doctors, hospitals and pharmacies already use electronic health
records, such as paperless prescriptions and software that links a patient's
medical history to guidelines on how his or her disease is best treated.
But electronic medicine still isn't widely used, and most of today's
computerized medical records are hospital- or pharmacy-specific. That's far
from the goal of allowing instant access to, say, medical records of a patient
lying unconscious in an emergency room far from home.
Yet routine use of electronic health records could help reduce the tens
of thousands of deaths and injuries caused by medical mistakes every year, said
the Institute of Medicine (news
- web
sites), an arm of the National Academy of Sciences (news
- web
sites). It is chartered by Congress to advise the government on medical
matters.
To improve the use of electronic records, the institute recommended that
the government help create data standards for the secure collection, storage
and dissemination of medical information electronically.
That would form the basis for a network that would allow widespread
exchange of critical health information, said the independent group, which
advises the government on medical issues.
The report urges the government to model the system after the airline
industry's air traffic and weather information systems.
"Pilots have instantaneous access to the data they need on weather
conditions and mechanical functions to make informed decisions about
navigation, delays and midcourse corrections," said report co-author Dr.
Paul Tang of the Palo Alto Medical Foundation. "In health care, no such
universal information system exists."
It will be expensive, the report acknowledges. Government health care
programs should get the private sector to contribute by encouraging adoption of
electronic standards in federal contracts.
The Department of Health and Human Services (news
- web
sites) has taken some steps toward developing such standards, including a
program to adopt uniform medical vocabulary.
Associated Press
November 20, 2003
Attorneys for an HIV (news
- web
sites)-positive man said the state's Medicaid program should cover his
liver transplant because there is no evidence that otherwise healthy
HIV-positive patients have a worse chance of surviving organ transplants than
those who don't have the virus.
Attorneys for Lambda Legal and the AIDS (news
- web
sites) Law Project of Pennsylvania are appealing a decision by the state's
Medicaid program to not cover a transplant for William Jean Gough.
An administrative law judge conducted a hearing on Wednesday.
Attorneys asked the judge to expedite a decision because Gough might not
be healthy enough to undergo a transplant if he waits much longer, said Hayley
Gorenberg, AIDS Project director at Lambda Legal.
The judge is not likely to make a ruling until December.
"There have been similar cases in other states where, by the time a
decision to not cover a transplant has been overturned, the patient is too sick
to go through the transplant or dies," Gorenberg said.
The state Department of Public Welfare, which oversees the state's
Medicaid program, will not comment on Gough's case until the judge makes a
decision, said department spokeswoman Stephanie Suran.
Doctors diagnosed Gough, 46, with hepatitis C the same year they
diagnosed him with HIV. Physicians warned Gough he might eventually need a
liver transplant, and his condition significantly worsened in the last year,
Gough said.
In August, Gough was deemed medically qualified for the transplant.
Gough said he does not suffer from disabling HIV symptoms.
Officials initially told Gough the state Medicaid program could not
cover his liver transplant because the surgery is experimental and not
medically necessary, Gorenberg said.
But at Wednesday's hearing, attorneys for the state argued the Medicaid
program cannot cover transplants for patients who have other life-threatening
conditions, Gorenberg said.
Other HIV- and AIDS-infected patients have successfully campaigned to
persuade insurers to cover transplant operations.
In October, Kaiser Permanente, one of the nation's largest health
maintenance organizations, approved a kidney transplant for a Denver man with
the AIDS virus, reversing an earlier decision.
Gough sees the cases as necessary steps in creating a better insurance
system.
"If I don't live long enough to receive a liver
transplant, someone behind me will benefit from my actions, my fight,"
Gough said.
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- The anti-clotting drug ximelagatran may prove a safe and effective alternative to warfarin for people with atrial fibrillation at high risk of stroke, says new research.
Atrial fibrillation increases the risk of cardiac blood clots, which can result in ischemic stroke. Warfarin, which thins the blood, has been used for decades to treat people at high risk of stroke. But warfarin has numerous potential problems, including an increased risk of bleeding and a possible interaction with food and other medications.
This study, published in the Nov. 22 issue of The Lancet, included 3,407 patients in Europe, Asia and Australia who had atrial fibrillation and at least one risk factor for stroke. The patients were randomly given either warfarin or oral ximelagatran. Average patient follow-up took place after 17 months.
The study found oral ximelagatran was at least as effective as warfarin in reducing the frequency of stroke or systemic blood clots. The study also found the rates of disabling or fatal stroke, death and major bleeding was similar in both groups.
More information
Here's where you can learn more about atrial fibrillation.
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- For people with arthritis and other forms of chronic pain, stomach trouble brought on by frequent use of anti-inflammatory painkillers is always a concern.
The U.S. Food and Drug Administration has just approved the Prevacid NapraPac, which combines the popular non-steroidal anti-inflammatory Naprosyn with Prevacid, a widely used acid suppressor that can help ward off gastric ulcers.
The package is specifically approved for people with symptoms of rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis who also have a history of gastric ulcer.
Naprosyn, among a class of anti-inflammatories called NSAIDs, is known to cause ulcers by interfering with the stomach's ability to protect itself from irritants such as acid. But in 12-week clinical trials, 80 percent to 93 percent of patients who combined Naprosyn with different doses of Prevacid remained ulcer-free, compared with 51 percent who took Naprosyn alone.
TAP Pharmaceuticals, which produces the combination product, says some 14 million Americans take an NSAID daily. About 100,000 people are hospitalized and up to 20,000 die each year from NSAID-related ulcer complications, the company adds.
For more information about gastric ulcers and risk factors like NSAID use, visit the National Library of Medicine.
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- A device that makes it easier for doctors to remove smaller, noncancerous breast tumors without major surgery has been approved by the U.S. Food and Drug Administration.
The tumors, called fibroadenomas, are common among women in their late teens through their 30s. The typically solid, benign tumors have the feel of a marble inside a woman's breast, according to Ethicon Endo-Surgery, producer of the device called the Mammatome system.
The system, originally approved in 1995 to help doctors perform breast biopsies, involves insertion of a probe into a quarter-inch-long incision. Guided by ultrasound, the doctor uses the device to remove tissue in a procedure that typically lasts less than an hour, the company says. As compared to conventional biopsy/tumor removal surgery, no stitches are normally required, there is less scarring and recovery is much faster, Ethicon adds.
Fibroadenomas occur in about 10 percent of all women and account for about half of the 1.6 million breast biopsies performed each year in the United States, according to a company news release.
Visit this company site for more about the Mammatome system. To learn more about fibroadenomas, go to the National Library of Medicine.
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- Dronabinol, a synthetic version of the active ingredient in marijuana, helps reduce agitation in people with Alzheimer's disease.
So say researchers at Monmouth Medical Center in Long Branch, N.J.
Their Phase II, open label, randomized, parallel-group study of 54 patients also concluded that the reduced agitation experienced by Alzheimer's patients may offer some relief to family caregivers.
"Our results show dronabinol [also known as Marinol] is an effective treatment for behavioral agitation in patients with Alzheimer's and may ultimately help reduce the stress often experienced by caregivers," lead investigator Dr. Joel S. Ross says in a prepared statement.
"While difficult for the patient, the effects of agitation can greatly impact the emotional and physical health of family members and caregivers. By reducing patients' agitation, caregivers are able to focus more time and energy on their patients' overall well being," Ross says.
Agitation affects about 75 percent of people with Alzheimer's and is the most common behavioral management problem in patients with the disease. Agitation can result in symptoms such as physical and/or verbal abusive postures, pacing and restlessness, screaming and repetitive requests for attention.
The Alzheimer's Association reports that nearly 80 percent of caregivers report frequent high levels of stress and nearly half say they suffer from depression.
More information
Here's where you can learn more about Alzheimer's disease and caregiving.
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- A $10-million, five-year grant from the National Institutes of Health will be used by researchers at Montefiore Medical Center in New York City to investigate how a diet high in fat and phosphorus and low in calcium and vitamin D may predispose people with genetic mutations to develop cancer of the intestine.
This is the first major national study to explore how a Western-style diet that mimics the key risk factors for colon cancer interacts with genetic factors and molecular pathways to increase the risk of intestinal cancer.
Researchers will use a genetic research tool called microarray analysis and other technologies designed to image gene expression and analyze protein structure.
They plan to determine on a molecular level how each component of the Western diet by itself, and in combination with genetic mutations known to initiate tumor formation, influences 27,000 specific genes and the mechanisms of intestinal cell growth that can lead to tumor formation.
The study will link data from both animal research and human clinical trials.
More information
Here's where you can learn more about diet and cancer risk.
Amanda Gardner
HealthDay Reporter
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- It may not be what we eat that's making us obese as much as what we drink.
In 1996, Americans consumed 83 more calories each day from caloric sweeteners than they did in 1997. Eighty percent of that (66 calories) came from soft drinks and fruit drinks, a new study says.
But Americans are not the only ones experiencing a surge in the use of these sweeteners (a general category that includes sugar, high fructose corn syrup, maltose, dextrose and other products). The average diet increased by 74 calories per day worldwide, although it's not clear how much of that increase was due to beverages.
Consuming an additional 10 calories per day adds one extra pound per year, says Barry Popkin, lead author of the study appearing in the November issue of Obesity Research. Popkin is a professor of nutrition at the University of North Carolina School of Public Health in Chapel Hill.
One way or another, the change is contributing to the rising tide of obesity, which in turn is increasing the risk of diabetes, heart disease, stroke and other conditions.
"If we are going to consume more beverages, we are going to gain weight," Popkin states. "We consume a little more from ready-to-eat cereals, candy, a little extra dessert, but those pale in comparison to the soft drinks and fruit drinks."
Not so, says the National Soft Drink Association (NSDA), which represents the makers. The group assailed the study as "short on significant new information" and a "self-selected collection of old information and discredited theories."
One concern is that calories from fluids are less satisfying than those from solid foods. "When you drink highly sweetened beverages, they don't feel like a thick, rich, creamy, high-calorie treat -- but they are," says Samantha Heller, senior clinical nutritionist at New York University Medical Center. "You don't necessarily feel it until you step on the scale or try to fit into your blue jeans."
Another problem is that these highly sweetened drinks may be replacing healthier choices such as nonfat milk or even high-fiber foods. "In children and teens this may increase the risk of nutrient deficiencies like calcium and vitamin D," Heller adds.
Popkin and his co-author, doctoral student Samara Joy Nielsen, looked at food data from 103 countries in 1962 and 127 countries in 2000 along with U.S. Department of Agriculture surveys from the 1970s, 1980s and 1990s. Worldwide, the average diet increased by 74 calories a day, 82 percent of that change attributable to urbanization and income growth. The caloric intake of sugar increased more in lower- and middle-income countries than in higher-income countries between 1962 and 2000.
The 83 calorie-per-day increase in caloric sweetener use in the United States represented a 22 percent spike in the proportion of energy people were deriving from the sweeteners. After soft drinks and fruit drinks, desserts and sugar/jellies represented the major sources of caloric sweeteners in this country.
And soft drinks and fruit drinks are disproportionately consumed by the under-30 crowd, particularly 10-to-30-year-olds. "That's the time when it's even scarier, when we get our bone density, when we need milk and need many of the foods that have nutrients, not just nothing which is what sugar has," Popkin says. "Sugar has calories to make us fat with no other benefit."
The only good news is that at least researchers now know what the culprit is, certainly in the United States and quite probably in other parts of the world as well.
"The bottom line is we've got to do several things in this country," Popkin says. "We've got to think about labeling added sugar on all products. We don't know it's hidden. Secondly, most of the soft drinks in America come from parents so we've got to start educating them. They've got to start feeding their kids milk and slow down themselves on soft drinks."
The World Health Organization (WHO) recommends limiting "added sugar" (which includes other caloric sweeteners) to 10 percent of total calories.
"Sugar isn't necessarily evil," Heller says. "It's just that added sugars are more calories than we need and they're not nutritive."
The NSDA says other studies have found no connection between being overweight and drinking nonalcoholic beverages. Rather, it says, the obesity problem is rooted more in lack of exercise. "When you slash physical activity in schools, when television and computer time skyrockets, when only 'lip service' is paid to increasing energy expenditure, it is no wonder obesity rates increase," the group says in a statement.
More information
The World Health Organization has more on nutrition. The American Dietetic Association has a statement on added sugars.
Ed Edelson
HealthDay Reporter
HealthDayNews
November 20, 2003
THURSDAY, Nov. 20 (HealthDayNews) -- University of Iowa researchers say they've stumbled upon a possible new way to treat high blood pressure.
Calcium channels are proteins that let calcium flow into cells, regulating important cellular functions, most notably muscle cell contraction.
And calcium channel blockers are medications used to slow the rate at which calcium passes into the heart muscle and vessel walls. This relaxes the vessels so blood flows more easily through them, thereby lowering blood pressure.
However, any new medications that might come from this latest research would be designed to increase the activity of calcium channels, rather than block them. So says Kevin Campbell, a professor of physiology and biophysics at the University of Iowa and leader of a research group reporting its surprising finding in the Nov. 21 issue of Science.
It's even more surprising because the calcium channels the researchers investigated weren't supposed to have anything to do with heart muscle cells, Campbell says.
Calcium channel blockers designed to treat high blood pressure target so-called L-type calcium channels.
Campbell and his colleagues were working on a different class of calcium channels -- T-type channels -- that are known to act only in muscles outside the heart.
"We were trying to look at the role of these channels in skeletal muscles," Campbell says. "But when we genetically engineered mice to lack the T-type channels, to our surprise we found that the skeletal muscles worked fine, but the heart muscles became damaged."
Arteries in the mice were found to be misshapen and constricted. Detailed studies by a postdoctoral fellow, Chien-Chang Chen, traced the problem to the smooth muscle cells that surround the blood vessels of the heart. Without the T-type channels, the smooth muscle malfunctioned, Campbell says.
The researchers theorize a drug that would make the heart calcium channels more active could relax blood vessels and lower blood pressure.
"We're working on trying to characterize interacting proteins and understand the mechanism involved, and to better understand ways of activating the channels," Campbell says.
It's too early in the research for pharmaceutical companies to start looking at a potential new class of high blood pressure medications, Campbell says. The long-term outlook is that such medications would provide "maybe a different approach for patients where current calcium channel blockers aren't working," he says.
The finding could also shed light on other heart problems, such as vasospasm, a sudden abnormal constriction of heart arteries, Campbell says.
More information
To learn more about calcium channel blockers, visit the American Heart Association and the Texas Heart Institute.
HealthDayNews
November 20, 2003
THURSDAY, Nov, 20 (HealthDayNews) -- The biological function of two tumor-suppressor proteins, BRCA1 and BRCA2, linked to hereditary breast cancer has been identified by researchers at the Wistar Institute in Philadelphia.
The scientists report their finding in the November issue of Molecular Cell.
They also discovered proteins that interact with BRCA1 and BRCA2 and may also play a role in causing breast cancer. These new proteins offer potential new targets for anti-cancer drugs.
While the association between hereditary breast cancer and BRCA1 and BRCA2 was first revealed in the early 1990s, scientists haven't been able to identify the biological function of the two proteins.
In this study, the Wistar scientists demonstrated that BRCA1 and BRCA2 combine with other proteins to form a complex called BRCC. The scientists also defined the role of BRCC in regulating gene repair.
The Wistar scientists also discovered two new proteins that are part of BRCC. They linked one of those new proteins, BRCC36, to sporadic breast cancers.
"We know that BRCA1 and BRCA2 are normally tumor-suppressor genes that, when mutated, can lead to cancer, but they only account for a fifth of all hereditary breast cancers and about 15 percent of breast cancers overall," senior author Ramin Shiekhattar says in a prepared statement.
"The BRCC36 gene and the other genes that factor into the creation of the BRCC complex are good candidates for additional breast cancer susceptibility genes," Shiekhattar says.
More information
Here's where you can learn more about breast cancer.
Associated Press
November 19, 2003
Canada is easing SARS (news
- web
sites) screening at its international airports, including a halt in the use
of thermal scanners to detect people with fever, Health Minister Anne McLellan
announced Wednesday.
The change comes more than five months after the last new case of severe
acute respiratory syndrome was detected in Canada, where the disease killed 44
people and sickened more than 200 others in the Toronto area earlier this year.
"Right now, SARS is nowhere in the world," McLellan said at
the opening of a new federal emergency operations center in Ottawa.
She said the fever-detecting scanners could be quickly reinstalled if
needed, but acknowledged the machines have limited effectiveness.
"We know that people can come and go from this country and they can
be SARS carriers and these machines will never pick them up," McLellan
said.
The government also will phase out the colored SARS alert cards given
international air travelers, replacing them with a brochure about infectious
diseases, she said.
During the Toronto SARS outbreaks last spring, the World Health
Organization (news
- web
sites) issued a warning against unnecessary travel to Canada, in part
because the government was slow to implement the screening of incoming
passengers for fever and other symptoms of the disease.
In Geneva, WHO spokesman Dick Thompson said Wednesday that Canada
informed the U.N. agency about the screening changes.
"We supported their decision," Thompson said. "This is a
decision each country has to make about resource allocation. And without SARS
circulating in humans, we have no recommendations at this time about
screening."
McLellan said the government is preparing for another possible outbreak
of the pneumonia-like illness that originated in Asia.
New quarantine officers are being trained to assess ill
travelers on international flights, and an Internet-based alert system will be
developed in major cities and ports of entry, she said.
Associated Press
November 19, 2003
The government could require drug
companies to test medicines to assure that dosages were appropriate for
children under legislation given final approval Wednesday by Congress.
The measure, passed by the House on a voice vote, is aimed at
eliminating the guesswork for doctors who prescribe for children medicines that
have been tested only for adults. The bill already had passed the Senate.
"Doctors were cutting adult pills in half, hoping they would work
with children, often with life-threatening results," said Rep. Anna Eshoo,
D-Calif.
The bill "will have the effect of dramatically improving the health
and well-being of our nation's children," said Rep. Deborah Pryce, R-Ohio.
The legislation was sponsored in the Senate by Sen. Mike DeWine, R-Ohio.
It expands on 1997 legislation championed by DeWine and Sen. Christopher Dodd,
D-Conn., that extended patent rights time periods for pharmaceutical companies
that volunteered to carry out pediatric studies to develop labeling standards
for children.
The Food and Drug Administration (news
- web
sites) in 1998 issued what it called the "pediatric rule" giving
the agency the authority to require tests for adult drugs prescribed more often
for children. But last year a federal court struck down the rule, stressing
that it was up to Congress to pass legislation giving the FDA the authority it
needed.
The legislation would ensure that the FDA can require testing on
children when drug companies lack the financial incentives to voluntarily
conduct testing.
It applies to all medications, such as vaccines, whose intended use for
children is the same as that for adults.
Sen. Hillary Rodham Clinton (news
- web
sites), D-N.Y., another co-sponsor of the Senate bill, said it was
"important to ensure that no future administration and no court of law
could stand in the way of a sensible measure designed to protect our
children."
Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS (news
- web
sites) Foundation, said the legislation was a major victory for children.
"This is a law that will benefit every child and every family by finally
guaranteeing children the same access to safe and effective medicines that we
demand for ourselves as adults."
Now only a fourth of the drugs on the market are tested and properly
labeled for safe use by children. Because children and adults react to drugs in
different ways, trying to calculate dosages on the basis of what is appropriate
for adults can lead to overmedication and under-medication for children.
FDA Commissioner Mark McClellan and Health and Human Services (news
- web
sites) Secretary Tommy Thompson, in a joint statement, welcomed passage of
the bill. "Children are a unique population with special medical
needs," they said. "We are delighted that Congress has recognized
this need, too."
___
The bill is S. 650.
On the Net:
Congress: http://thomas.loc.gov/
Associated Press
November 19, 2003
The National Institute of Mental
Health is reducing the portion of its $1.3 billion budget that goes for
research on serious mental illness while supporting studies on such subjects as
fish communication and the mental processes of pigeons, advocacy groups say.
A report Wednesday by the Treatment Advocacy Center and Public Citizen
said that the institute was spending 5.8 percent of its research budget on
"clinically relevant" serious mental health issues.
"NIMH is not doing its job," said Dr. E. Fuller Torrey, a
research psychiatrist and the co-author of the report.
Institute officials were provided copies of the report, but a spokesman
said the agency had no comment.
Torrey said severe mental illness accounts for 58 percent of all mental
illnesses in the United States, but the institute is spending only 28 percent
of research funds on those problems and "only 5.8 percent on clinical
issues that may actually help people."
He said that from 1997 to 2002, the institute's budget doubled from $661
million to $1.3 billion, but the percentage of these funds applied to research
into serious mental illness declined by 11 percent — from 32.1 percent of all
research dollars to 28.5 percent.
At the same time, said Torrey, the institute is spending millions of
dollars in grant money for studies on the mental processes of animals.
For instance, the report noted that in 2002, the institute gave 18
grants to study pigeons, including one award of $208,931 to analyze the
learning processes of the birds. There were also grants to research the
perception and learning skills of bowerbirds and quails.
Studies estimate that about 11.6 million adults in the
United States have a serious mental illness. The federal government spends
about $40 billion yearly through Medicaid, Medicare and other programs to
benefit patients with serious mental conditions. About 250,000 patients with
mental disorders are either homeless or incarcerated, the report said.
Associated Press
November 19, 2003
The government has developed a
broad, decade-long research plan to help fight autism, including hunting
genetic causes of the complex brain disorder and providing better educational
services for children who have it.
Aiding the work will be a research partnership between government
scientists and a parents' group, the National Alliance for Autism Research.
The alliance, for several years, has been gathering databases of
affected families for both the gene hunt and separate research to find ways to
diagnose autism earlier. National Institutes of Health (news
- web
sites) scientists will work with the group on those projects instead of
having to start similar ones from scratch, a collaboration that the alliance
said represented a joint commitment of more than $5 million.
Autism is a neurological disorder featuring a wide range of symptoms,
from mild to severe, that include problems communicating and with social
interaction. Some studies suggest it might affect at least 40 per 10,000 U.S.
children. That is 10 times higher than estimates a decade ago, which many
scientists think reflects better diagnosis. The exact cause is unknown,
although both genetics and environmental factors are suspected of playing a
role.
Under demand from Congress, the NIH came up with a broad strategy to
improve scientific understanding of autism and how to help patients. There are
few specifics, and no details on how NIH will fund the work.
But the 10-year plan calls for a mix of research into biological markers
that signal autism before today's usual diagnosis around age 3; genetic and
environmental causes; and exactly what behavioral, educational or other
services best treat different degrees of autism.
Along with biomedical research, the plan calls for
collaboration with the Education Department to improve families' early access
to important services.
Associated Press
November 19, 2003
The European Parliament urged
European Union (news
- web
sites) governments Wednesday to allow the union's money to be spent on
research with new embryonic stem cells.
The vote was for a non-binding resolution, but the parliament's position
is likely to complicate an upcoming meeting of EU government ministers to
discuss what to do when a moratorium on EU funding for stem cell research ends
Dec. 31.
That meeting appears set to block new guidelines that would allow such
funding such reseach, forms of which are illegal in some EU member states —
Germany and Austria, in particular.
The EU assembly in Strasbourg, France, voted 300 to 210 in support of
funding of embryonic research from the EU's 2002-2006 research budget of $17.5
billion. There were 19 abstentions. The resolution stated that the research
must be conducted "under tight ethical conditions."
German conservative Peter Liese said he was "disappointed"
with the vote.
"By the end of the year we've got to decide what rules European
researchers have to apply if they want to use European funding," said
Liese. "This is an important issue."
The European Commission (news
- web
sites) presented a funding proposal in July, arguing that Europe risked
falling further behind in research. The proposal would allow researchers to
spend EU money to harvest new stem cells from frozen human embryos under
certain conditions.
Yet it ran into immediate opposition from those opposing such work since
it requires destroying a potentially viable human embryo.
EU officials have said that if a compromise by EU governments is not
found, the moratorium would probably be extended.
Germany, Italy, Portugal and Austria, all of whom limit the use of such
research, have enough votes to block the plans, officials said. EU government
ministers are expected to meet over the matter Tuesday. If they block the
plans, the proposal could be sent back to the European Commission.
The parliament also ruled that a date limiting the use of human
supernumerary embryos should be scrapped, backing Sweden, Finland, Greece, the
Netherlands and Britain.
These countries allow harvesting stem cells from so-called supernumerary
embryos — extras resulting from in vitro fertilization — under certain
conditions. Britain is the only member state that allows the creation of human
embryos for stem cell procurement.
However, the parliament said that research using adult stem cells and
reprogrammed adult cells should "get priority for financing."
The Commission had proposed that research could only be done
on existing human supernumerary embryos that were created before June 27, 2002.
Associated Press
November 19, 2003
In 17 states that participated in a
$128 million government program to discourage tobacco, the prevalence of
smoking dropped nearly a percentage point faster than in the rest of the
country, a study found.
If the anti-tobacco program was used in all states and the District of
Columbia it could reduce the number of smokers by about 278,700, said Frances
A. Stillman, the first author of the study appearing Wednesday in the Journal
of the National Cancer Institute (news
- web
sites).
The study evaluated the effect of an eight-year demonstration project
called American Stop Smoking Intervention Study, or ASSIST, that was sponsored
by NCI.
The anti-smoking project trained local advocacy groups to lobby for
passage of higher cigarette excise taxes and to promote regulations for
smoke-free environments. The program also mounted a public relations effort to
counter an estimated $47 billion spent by industry to market tobacco products
during the study period and included efforts to limit underage access to
tobacco.
States included in the study were Colorado, Indiana, Maine,
Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New Mexico, New York,
North Carolina, Rhode Island, South Carolina, Virginia, West Virginia,
Washington and Wisconsin.
At $128 million, the program spent about $1,200 for each smoker who
kicked the habit. Elizabeth A. Gillian, a University of California, San Diego,
researcher and a co-author of the study, called that cost "a real
bargain."
"Most smoking cessation programs will spend that (for each
smoker)," said Gillian. "That's just for a few hours of a counselor's
time. When you think about what you save in health care costs, $1,200 is a real
bargain."
Studies by the Centers for Disease Control and Prevention (news
- web
sites) suggest that cigarette smoking is responsible for more that 440,000
deaths a year in the United States. Smoking has been linked to heart disease,
emphysema and other respiratory system diseases, stroke and a number of
different types of cancer.
To evaluate the impact of ASSIST, researchers used industry cigarette
sales figures and tobacco use surveys that showed that smoking decreased
nationally by 2.41 percentage points during the eight-year period.
In the 17 states where the ASSIST program was in action, the percentage
of smokers dropped by 3.02 percentage points during the eight years, compared
to a decline of only 2.11 percentage points in the other 33 states and the District
of Columbia.
During the eight years of the ASSIST program, smoking among all the U.S.
population dropped from 24.67 percent to 22.26 percent; in the 17 states, it
dropped from 25.19 percent to 22.17 percent; and in the rest of the country, it
declined from 24.41 percent to 22.30 percent.
Stillman said the 17 states included some that already had strong
anti-smoking programs and some that didn't.
She said the results showed that "states can reduce smoking
prevalence and the enormous health and economic burden of smoking if they put
in place proven programs and policies."
Associated Press
November 19, 2003
A new analysis shows a small but
surprising upswing during the 1990s in the proportion of women with newly
diagnosed breast cancer (news
- web
sites) who have unusually large tumors, which are more likely to prove
fatal.
Experts are uncertain why this happened, but they speculate that both
obesity and hormone replacement therapy may have fueled the growth of larger
cancers, even during a time when the discovery of small tumors rose
dramatically as a result of widespread mammography.
The analysis, prepared by the American Cancer Society (news
- web
sites), found that the incidence of large tumors increased by just over 2
percent a year between 1992 and 2000, but only in white women.
"The great majority of tumors in white women are small and at a
localized stage," said Dr. Michael Thun, senior author of the report.
"But we were surprised to see there has been an increase in tumors of five
centimeters or more."
The analysis is based on the National Cancer Institute (news
- web
sites)'s Surveillance, Epidemiology and End Results program, a database of
cancer incidence and survival data that covers about 14 percent of the U.S.
population. It was published in the latest issue of the cancer society's
journal CA.
In 2000, there were 6.3 cases of breast cancer larger than five
centimeters for every 100,000 white women in the United States, compared with
5.6 cases in 1992. Still, smaller tumors are much more common. In 2000, there
were 90 tumors size two centimeters or smaller per 100,000 and 34 that were
between two and five centimeters.
Large tumors are about twice as common in black women. The cancer
society attributes this to less access to high-quality screening, particularly
for poor women. In 2000, there were 12 cases of large tumors for every 100,000
black women, a figure that changed little throughout the 1990s.
Overall, breast cancer survival is improving. Since about 1990, the
breast cancer death rate has been falling by 2 1/2 percent annually for whites
and 1 percent for blacks. Experts say they think better treatment, including
widespread use of the drug tamoxifen, as well as mammogram screening are
responsible for the improvement.
However, cancer can take many years to kill after it is discovered, and
the increase in newly diagnosed large tumors is worrisome, because they are
more likely to have spread and are harder to cure.
"I'm not sure what to make of it. It's a surprise," says Dr.
Phyllis Wingo, an epidemiologist at the Centers for Disease control and
Prevention (news
- web
sites). She said other studies that follow women's health for long periods
of time could help confirm the finding as well as help doctors figure out its
cause.
The hormone estrogen can fuel the growth of breast cancers. Thun said
the most likely explanation for the rising tumor size is increases in women's
estrogen levels resulting from obesity and hormone replacement therapy, or HRT,
after menopause.
Fat tissue itself makes estrogen. About two-thirds of U.S. women over 50
are overweight. The cancer society estimates weight contributes to between
one-third and one-half of all breast cancer deaths among older women.
The use of hormone replacement pills, which include estrogen, has fallen
since last year, when a study showed that the widely used treatment after
menopause increases the risk of breast cancer, heart attacks and stroke. That
study found breast tumors were slightly larger, on average, among the hormone
users.
"Is it biologically tenable that HRT and obesity could have
contributed? The answer is clearly yes," said Dr. Larry Norton, deputy
physician-in-chief for breast cancer programs at Memorial Sloan-Kettering
Cancer Center in New York City.
Dr. Daniel Kopans, director of breast imaging at Massachusetts General
Hospital, noted that breast cancer deaths began to decline five to seven years
after mammograms became widespread.
"I am at a loss to understand why there was the blip in very large
cancers," he said. "I can speculate that women who do not want to be
screened also neglect to bring their cancers to their doctor's attention and
delay seeking care even longer than before screening was available."
Dr. Cheryl Perkins, senior clinical adviser at the Susan G. Komen Breast
Cancer Foundation, said the push during the 1990s to increase mammography,
especially among poorer women, may have led to the discovery of large tumors in
those who had never been screened before.
"If you bring new women into the screening arena, you may find
larger tumors initially," she said. "If you continue to screen, you
will find smaller ones."
___
EDITOR'S NOTE: Medical Editor Daniel Q. Haney is a special correspondent
for The Associated Press.
___
On the Net:
Journal: http://caonline.amcancersoc.org
Amanda Gardner
HealthDay Reporter
HealthDayNews
November 19, 2003
WEDNESDAY, Nov. 19 (HealthDayNews) -- Conventional treatments for psoriasis, a common and debilitating skin condition, have been limited either because of extreme toxicity or extreme inconvenience.
But new hope has been placed in "targeted biologic therapies," and two of these receive a big boost from studies appearing in the Nov. 20 issue of the New England Journal of Medicine.
Both efalizumab (brand name Raptiva) and etanercept (Enbrel) were shown to produce significant improvements for people suffering from moderate-to-severe cases of this incurable autoimmune disease. Both are given by injection.
Two other biologic therapies, alefacept (Amevive) and infliximab (Remicade), are also used to treat moderate-to-severe cases of psoriasis. Alefacept is approved for psoriasis, while infliximab is approved for Crohn's disease and rheumatoid arthritis but is also prescribed "off-label" for psoriasis.
"Before, psoriasis was treated intermittently because the treatments were toxic, assuming that patients were offered something definitive to begin with," says Dr. Alice Gottlieb, senior author of one of the studies.
"Biologics provide real hope for safe and effective long-term clearing, and we've never had that," says Gottlieb, a professor of medicine and director of the clinical research center at UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J.
Dr. Jeffrey Weinberg, director of the clinical research center in the department of dermatology at St. Luke's-Roosevelt Hospital Center in New York City, adds, "My feeling is that these [biologics] are a significant step forward in what we have. Certainly, the options are increasing and for the vast majority of people who take either of these two drugs, they will have good efficacy and no side effects."
That's not to say these drugs are completely without risks, Weinberg adds.
"Every package insert talks about the risk of malignancy and the risk of infection, not that these have been observed in any greater number but because you are interfering with the normal function of the immune system, that's the long-term concern," Weinberg says. "The drugs vary in how long they've been used. Enbrel has been used continuously in some people for six years, and we haven't seen any more malignancies."
Most of the data available, however, covers an even shorter period of time, which leaves open the question of what the long-term effects may be, he notes.
Biologics are drugs that target specific receptors on molecules or specific chemicals without affecting the entire immune system, doctors say. That means they have far fewer side effects than conventional treatments.
Psoriasis is a genetic disease affecting the skin and/or the joints. It is a non-contagious and lifelong skin disease that takes different forms. Some people may have a spot or two, while others may have extensive coverage on their body.
Psoriatic arthritis is a form of joint disease that is strongly associated with psoriasis. This form of arthritis damages the bone and connective tissue around the joints, according to the National Psoriasis Foundation.
Both are serious diseases, affecting more than 4.5 million people in the United States.
The first new study looked at the safety and efficacy of efalizumab, which was approved by the U.S. Food and Drug Administration (FDA) last month. This trial was sponsored by Genentech, which makes the drug.
In all, almost 600 people were randomly picked to receive either efalizumab or a placebo for 12 weeks. Depending on the results, the participants either continued the drug or the placebo for another 12 weeks.
By the 12th week, 22 percent of the participants receiving a lower dose of efalizumab and 28 percent of the participants receiving a higher dose had an improvement of 75 percent or more in the psoriasis area-and-severity index (PASI). By contrast, only 5 percent of the placebo group experienced an improvement. PASI is a score used to assess the extent of the skin surface area affected by psoriasis.
In the efalizumab group, improvement was seen as early as the fourth week. About three quarters (77 percent) of the participants who experienced an improvement of 75 percent or more at week 12 maintained that improvement through week 24. Even after stopping the drug at week 24, 30 percent of the participants maintained an improvement of 50 percent or more in the PASI during the next 12 weeks. By contrast, only 20 percent who were switched to a placebo at week 12 maintained the improvement for the next 12 weeks. While the drug's long-term effects remain unknown, few side effects were seen in this study.
The second study looked at the safety and efficacy of three different regimens of etanercept, which is approved for psoriatic arthritis and several other indications but not for psoriasis. An application to use the drug for psoriasis is on file with the FDA, Gottlieb says. This study was supported by Immunex-Wyeth and Amgen, which make the drug.
A total of 652 patients received either a placebo or varying doses of etanercept for 12 weeks. Etanercept is injected under the skin.
At week 12, 14 percent of those in the low-dose group, 34 percent in the medium-dose group and 49 percent in the high-dose group had experienced an improvement of 75 percent or more in the PASI score. Only 4 percent in the placebo group experienced comparable improvements.
Also, Gottlieb adds, "more was better, longer was better and more was faster." The longer a person took the drug, the better the response. And there was no price to pay in toxicity, the study says.
"At 24 weeks the report was no increased toxicity," Gottlieb says. "One got the good effects without taking on increased bad effects."
The patients themselves also reported significantly improved quality of life.
Weinberg feels the drugs will make a difference in psoriasis care. His personal favorites are etanercept and efalizumab. Alefacept, the first biologic to be approved, is not as effective and has to be administered by injection in a doctor's office. Infliximab also has to be injected.
Right now, all these drugs are used for people with relatively severe cases of psoriasis.
The real debate, Weinberg says, is going to come when a mild-to-moderate patient wants one of these.
More information
For more on psoriasis treatment, visit the National Psoriasis Foundation or the American Academy of Dermatology.
Janice Billingsley
HealthDay Reporter
HealthDayNews
November 19, 2003
WEDNESDAY, Nov. 19 (HealthDayNews) -- Keeping the pounds off in middle age not only lowers your risk of disease, it could also help you enjoy a more active and enjoyable old age.
Northwestern University researchers surveyed nearly 7,000 men and women 26 years after an initial study recorded their weights in middle age. They found those who had a healthy body mass index (BMI) when they were younger felt mentally, physically and emotionally better than people who were overweight or obese in their middle years.
Study coauthor Kiang Liu says previous research has shown a relationship between too much weight in middle age and an increased risk for cardiovascular disease and diabetes as people age. But the new study goes beyond disease to find that overall quality of life is affected as well.
"We found that BMI in middle age really influences the quality of life when people age," says Liu, a professor of internal medicine at Northwestern's Feinberg School of Medicine in Chicago.
"When people get older it is important that they can function, like walk up stairs, and do the things they want," Liu says. "But if they are limited in that, they don't have the quality of life they want, and it's problematic."
The findings appear in the current issue of the Archives of Internal Medicine.
Dr. Mary Jo DiMilia is an assistant professor of medicine and pediatrics at Mount Sinai School of Medicine and a medical consultant to Weight Watchers International Inc. "This is something we think is true, but it's nice to see hard evidence of following people for a long period of time to see proof of it," she says of the results.
Another Mount Sinai doctor who deals with overweight patients says the new study is valuable because of the "self-reported" nature of the data.
"This is information that comes from the patient. This is really novel," says Dr. Laurie Edelman, also an assistant professor of medicine at the hospital.
In the study, Liu, lead author Dr. Martha Daviglus and their colleagues studied 6,766 men and women who had enrolled in the Chicago Heart Association Detection Project between 1967 and 1973 and who completed a follow-up questionnaire in 1996, which was, on average, 26 years later.
At the start of the study, the participants were between 36 and 64 years old, and free of heart disease and diabetes.
For the follow-up, participants filled out a four-page questionnaire that included information about current illnesses and medications. But it also included self-reports of health-related quality of life and regular exercise patterns.
Liu says questions included whether one could walk for several blocks, climb stairs and carry groceries. Respondents were also asked to rate their own health compared to others their age. The average age of the respondents was 75.
After weighing other factors, including blood pressure, cholesterol, smoking and educational level, the researchers found a strong association between a healthy BMI in middle age and a better quality of life later in life.
Nearly half the women and more than half the men with healthy weights -- a BMI between 18 and 25 -- at the beginning of the study reported being in excellent or very good health as they aged, 46.8 percent and 53.8 percent, respectively.
Men and women who had been overweight -- defined as a BMI between 25 and 29 -- in middle age were less satisfied with their health as they aged, 37.9 percent of women and 49.1 percent of men.
And those who had been obese -- a BMI above 30 -- in middle age reported a far lower quality of life in old age than their thinner peers. Only 24.3 percent of the women and 36.5 percent of the men in this group reported being in good or excellent health.
It's not clear why the men consistently reported feeling better about their quality of life than the women, Liu says.
"In every calculation the men always seem to be doing better, but whether that's really the truth we don't know because this was self-reported," Liu says. The research group is planning further studies to physically assess the respondents to see how their answers match up with their actual health.
In the meantime, Liu says, it's clear that people in middle age should try to keep their weight down, not only for the known risk factors of cardiovascular disease and diabetes, but to aim for a better life later in life.
"We need to pay more attention to the problems of obesity -- increasing exercise and watching diet," he says. "Don't just think about this moment, but about the future."
More information
A good overview of the risks of too much weight can be found at the National Institute of Diabetes & Digestive & Kidney Diseases. You can calculate your body mass index at the National Heart, Lung, and Blood Institute.
HealthDayNews
November 19, 2003
WEDNESDAY, Nov. 19 (HealthDayNews) -- A genetic variation that may help predict the severity of cystic fibrosis in individual patients has been identified by researchers at Johns Hopkins Medical Institutions.
Cystic fibrosis is an inherited and often fatal lung disease. It stems from mutations in a gene called CFTR. When specific mutations appear in both copies of the gene, a person experiences a buildup of sticky mucus in the lungs. That makes breathing difficult and traps bacteria that can cause serious and deadly infections.
One CFTR mutation, known as 5T, doesn't always cause cystic fibrosis. Even when 5T and one of the traditional mutations that cause cystic fibrosis are present, a person can be free of cystic fibrosis. But there's no reliable way to predict whether the 5T combination will result in disease or not.
The Johns Hopkins researchers uncovered the existence of specific short repeats of particular genetic building blocks in the CFTR gene. They say this repetitious pattern may help predict the severity of cystic fibrosis.
The study was presented at the recent meeting of the American Society for Human Genetics in Los Angeles.
More information
Here's where you can learn more about cystic fibrosis.
HealthDayNews
November 19, 2003
WEDNESDAY, Nov. 19 (HealthDayNews) -- A new class of antipsychotic drugs may offer improved relief for elderly people with schizophrenia, says an international study in the American Journal of Geriatric Psychiatry.
Most elderly people with schizophrenia are treated with conventional antipsychotic drugs. This study concludes they would have better treatment results if they were switched to a new class of atypical antipsychotic medications now widely used to treat people in other age groups.
These atypical antipsychotic drugs have generally proven to be more effective and to cause fewer side effects than conventional antipsychotic drugs, study author Dr. Dilip V. Jeste, director of the Advanced Center for Interventions and Services Research at the University of California, San Diego and VA San Diego Healthcare System, says in a prepared statement.
Until now, there was no large-scale trial of atypical antipsychotics in geriatric patients.
"One of the implications of this study is that schizophrenia in the elderly is not to be simply endured but to be treated with the latest that medical science has to offer. Almost all the previous studies of these drugs involved people under the age of 60 or 65. But the research did not provide the evidence doctors need to safely and effectively administer these medicines to elderly patients," Jeste says.
He and his colleagues tested the drugs risperidone and olanzapine in 175 elderly people with schizophrenia. The study concluded that safe, effective dosages for these elderly patients were about half of what's recommended for younger patients.
When used appropriately, these drugs provide the same benefits for elderly patients as they do for younger patients. These include better functioning and fewer side effects compared with conventional antipsychotic drugs.
This study was funded by Janssen Products Inc., which manufactures the drug risperidone under the brand name Risperdal.
More information
Here's where you can learn more about schizophrenia.
Associated Press
November 18, 2003
Cases of West Nile virus (news
- web
sites) in horses have dropped off sharply across the country, and experts
say a campaign of vaccinations is one reason why.
More than 15,000 horses were struck last year, but only about 3,500
cases have been reported this year. In Nebraska, the number dropped off from
1,100 to only 38 so far this year.
Experts say other factors, including naturally developed immunities and
underreporting of cases, also may be partly responsible for the decline.
The West Nile virus was first detected in the United States in New York
City in 1999, and is believed to spread west by migratory birds bitten by
mosquito carriers. The virus causes encephalitis, or inflammation of the brain.
Most people who are bitten by an infected mosquito won't get sick, but the
virus poses a serious threat to horses.
People in Nebraska's horse industry say their numbers might never have
climbed so high if more of them had heeded warnings that the virus would hit
the state in 2002. Even though a vaccine became available the year before, many
owners didn't want to spend the vaccination cost of $50 per animal.
"In a sense we did create the problem ourselves," said Wayne
Kramer, Nebraska's state entomologist and a board member of the Nebraska Horse
Council.
Failure to vaccinate more horses before the virus arrived cost Nebraska
and Colorado an estimated $1 million last year in treatment and horse losses,
according to a federal study. Colorado reported 378 cases that year.
Though other vaccines commonly used for horses can be administered by
the owner, the West Nile vaccine cannot. It is only sold directly to
veterinarians, according to its sole manufacturer, Fort Dodge Animal Health.
That means an owner must pay for both the vaccine and a doctor's visit,
pushing up the cost.
Both the company and veterinarians say the current arrangement is
necessary for safety, but some people say the cost prevents more people from
vaccinating their animals.
Cost concerns were a factor in the spike of cases in Colorado this year.
State Veterinarian Wayne Cunningham said most of the 586 cases reported in his
state were in animals that hadn't been vaccinated, and most of that was
explained by cost.
For an owner of more than a few horses, the costs can add up.
Wanda Cooksley said her family chose not to vaccinate 20 mares at her
family's ranch in Anselmo, located in Nebraska's Serengeti-like Sandhills
region, because they felt the animals probably were out of reach of mosquitos
and West Nile.
"We would vaccinate them if it were financially more
feasible," she said. None of the mares have been stricken so far.
Vaccinations may cost $50, but that's a lot cheaper than dealing with a
sickened animal. That treatment includes an antibody that can run as much as
$500.
Although its maker and veterinarians claim the vaccine is safe, some
owners claim it has caused foal weakness and birth defects.
Cunningham said the evidence was only anecdotal.
"Even if they had a problem with the vaccine, it is so minor in
comparison," Cunningham said.
The experiences of states like Nebraska, Colorado and Pennsylvania might
provide a cautionary tale to western states as the virus continues its westward
expansion. In Pennsylania, cases jumped from less than 100 in 2002 to 430 this
year.
Dr. Timothy Cordes, equine veterinary specialist with the USDA, points
out most of Pennsylvania's cases have been in Lancaster County, a center for
the state's Amish residents, who generally have not vaccinated their horses.
"My prediction is that next year we'll see it become very, very
active on the West Coast," Kramer said.
Meanwhile, the race is still on to find a successful West Nile vaccine
for humans.
Of the 8,219 human cases reported to the federal Centers for Disease
Control and Prevention (news
- web
sites) so far this year, 182 have died.
"I don't know when they'll come out with a vaccine for
people," said Stacy Van Horn, a veterinarian who runs a horse clinic in
Grand Island. "But I'll be there."
___
On The Net
Equine West Nile cases by state:
http://www.aphis.usda.gov/vs/nahps/equine/wnv/map2003.html%und_off
Associated Press
November 18, 2003
Black men do not survive as long as
white men after treatment for localized prostate cancer (news
- web
sites), according to a new study.
Researchers at the University of North Carolina at Chapel Hill analyzed
the records of 5,747 black men and 38,242 white men who had been treated for
prostate cancer that had not spread. They found that the median survival time
for black men was 1.7 years less than the survival time for white men.
The difference was even greater, 1.8 years, for patients who received
surgery. Black prostate surgery patients lived an average of 10.8 years, while
white patients lived 12.6 years.
For patients of either race who received radiation treatment, however,
the differences in median survival was not significant, the researchers report.
Specialized radiation therapy is the preferred treatment for locally
advanced prostate cancer, but black patients may have less access to this
therapy, the researchers said. There may also be biologic factors that affect
the way black men and white men react to prostate cancer treatment, the study
suggested.
"Researchers should continue to investigate racial disparities in
treatment outcomes as well as the specific social, biologic or environmental
conditions that may be responsible for these disparities," the researchers
conclude in the study.
Dr. Paul A. Godley of the Lineberger Comprehensive Cancer
Center at the University of North Carolina was head of a team that conducted
the research.
Associated Press
November 18, 2003
A volunteer has received the first
human inoculation of an experimental vaccine designed to prevent infection by
Ebola (news
- web
sites), a highly lethal African virus that some officials fear could be
used as a weapon of bioterrorism.
Researchers at the Vaccine Research Center of the National Institute of
Allergy and Infectious Diseases (news
- web
sites), one of the National Institutes of Health (news
- web
sites), administered the vaccine to a volunteer on Tuesday at the NIH
clinical center in Bethesda, officials announced.
The first human trial comes just three years after researchers from the
vaccine center announced that an experimental Ebola vaccine had protected
monkeys fully from the usually lethal virus.
A part of the experimental vaccine used on monkeys is now being assessed
for safety in human volunteers, the NIAID announced. The vaccine is based on
DNA technology and is similar to other trial vaccines that may be used to
control AIDS (news
- web
sites), malaria and hepatitis.
"An effective Ebola vaccine not only would provide a lifesaving
advance in countries where the disease occurs naturally, it also would provide
a medical tool to discourage the use of Ebola virus as an agent of bioterrorism,"
said Dr. Anthony S. Fauci, director of NIAID.
Ebola, which causes extensive internal bleeding and rapid death, is
highly infectious. No effective treatment currently exists. In Africa, up to 90
percent of patients infected in an Ebola outbreak die.
An African outbreak of Ebola occurred in 1976 and again in
1995, a gap of almost two decades. Experts fear that, for reasons unknown,
outbreaks of Ebola will occur with increasing frequency.
Associated Press
November 18, 2003
Technology that allows the
screening of newborns for several rare genetic diseases at once can help
prevent mental retardation and other complications more effectively than
conventional tests done after symptoms develop, researchers say.
A study found that because the technology allows earlier diagnosis and
prompt treatment, retardation among infants was much less common and
hospitalization was less frequent.
All states require testing of newborns for phenylketonuria and hypothyroidism,
which can cause retardation if untreated, but not all use the newer method.
States differ on the other diseases for which testing is required.
The new technology, called tandem mass spectrometry, uses a single drop
of blood to screen for at least 20 diseases and is either in use or under
consideration in about 25 states, said Dr. Nancy Green, medical director of the
March of Dimes. The technology has been around since the 1990s.
The expanded testing can cause more false-positive findings, but overall
it led to less stress for the babies' parents, the government-funded study
found.
The findings appear in Wednesday's Journal of the American Medical
Association (news
- web
sites).
One of the researchers is a founder of Neo Gen Screening, a company that
does the expanded tests, but the company, now called Pediatrix Screening, was
not directly involved in the research and provided no funding, said lead author
Dr. Susan Waisbren of Harvard University and Children's Hospital in Boston.
Parents of affected children have strongly pushed for the expanded
screening, which requires a $400,000 machine and special training.
The March of Dimes supports the expanded screening method, especially
for a rare metabolic disease called MCAD, an inherited enzyme deficiency that
is easily treated with diet if detected early but can otherwise cause death or
severe retardation.
But expanded testing can also sometimes "open a can of worms"
because infants might have mild cases of disease that do not require any
treatment or they might have ailments for which early diagnosis makes no
difference, Green said.
The study included families of 50 infants whose diseases were identified
at birth through the expanded screening and 33 infants diagnosed by doctors
after symptoms developed.
Only one ill child diagnosed through expanded screening developed mental
retardation, compared with eight in the non-screened group, Waisbren said.
Screened infants were 5 days old on average at diagnosis versus 4 months
in the non-screened group. And within the first six months of life, 28 percent
of the screened infants were hospitalized compared with 55 percent of the
non-screened infants.
Waisbren said longer-term follow-up is needed to better
evaluate expanded screening.
Associated Press
November 18, 2003
College football players who suffer
concussions are left prone to another one, especially if they return to action
too soon, and they also become slower to recover from such blows to the head,
researchers say.
The research — designed to help schools decide when and if to play
injured athletes — support guidelines that say athletes who have had a
concussion should wait seven days after symptoms disappear to get back in the
game.
The results add to previous research suggesting that concussions might
make athletes prone to more lasting head injury from another blow.
Some smaller studies have also suggested one concussion might make an
athlete more likely to suffer a second one. But this study found that the
reason may have nothing to do with the athlete's position or playing style.
Instead, the findings suggest that one concussion might cause tissue
injury that leaves players more vulnerable to additional concussions, said
Kevin Guskiewicz, director of the sports medicine research laboratory at the
University of North Carolina at Chapel Hill.
Multiple concussions are known to increase the risk of permanent brain
injury, and Guskiewicz said after three or more concussions it "might be
time to think about taking up tennis or golf."
Concussions are a blow to the head that jostles the brain. Symptoms can
include confusion, loss of consciousness, headaches and nausea.
Several pro football players have ended their careers early after
suffering multiple concussions, including quarterbacks Troy Aikman of the
Dallas Cowboys and Steve Young of the San Francisco 49ers.
The latest findings were published in Wednesday's Journal of the
American Medical Association (news
- web
sites).
The findings are contained in two related studies of a total of 2,905
players at 25 U.S. colleges from 1999 to 2001. Guskiewicz helped conduct both
studies, which were funded in part by the National Collegiate Athletic
Association.
In one study, players with three or more concussions within seven years
of the study period were three times more likely to suffer a repeat concussion
than players with no concussions. And 30 percent of players with three or more
concussions had symptoms lasting more than a week, compared with 7 percent of
players with a first concussion.
Ninety-two percent of repeat concussions occurred within 10 days of the
first head injury, and 75 percent occurred within a week, Guskiewicz said.
About 34 percent of college football players reportedly have had one
concussion, and 20 percent have had more than one. In the NCAA (news
- web
sites) alone, which represents 1,200 colleges and universities, there were
nearly 58,000 football players in the 2001-02 season, the most recent data
available, said David Klossner, NCAA assistant director of education outreach.
An NCAA sports medicine handbook says players knocked unconscious should
not return to play that same day, and that those who have had a concussion but
no loss of consciousness should be cleared by a doctor to resume playing,
Klossner said.
Otherwise, the NCAA has no specific conference-wide restrictions and
leaves it up to individual schools to decide when to allow a concussion-injured
athlete to resume playing football, he said.
A seven-day waiting period has been recommended by some medical groups,
including the American Academy of Neurology (news
- web
sites), but doctors and athletic directors do not always heed the
recommendation, Guskiewicz said.
Dr. James Kelly, a co-author of the JAMA studies, said thorough
mental-function tests should be given to all athletes after a concussion.
Klossner said that an NCAA committee on safety will review the data to
help provide guidance for colleges, but that decisions on how to handle
concussions should be made on an individual basis.
"We can't make that decision for them," Klossner said.
___
On the Net:
JAMA: http://jama.ama-assn.org
NCAA: http://www.ncaa.org
Associated Press
November 18, 2003
Devastated by their son's suicide
during his sophomore year in college, Donna and Phillip Satow channeled their
grief into reaching other students who have contemplated taking their own
lives. Now, three years later, the Jed Foundation is working with 120 colleges
and universities around the country, providing resources that include
Ulifeline, a free Web site linking students to mental health centers and
confidential help.
It's one sign, some experts say, that colleges are becoming more attuned
to the issue — even if it's just one step.
"A Web site doesn't solve the problem," said Donna Satow,
whose son, Jed Satow, was at the University of Arizona when he died in 1998.
"But it might help one or two kids."
Second only to automobile accidents, suicide is the leading killer of
college students — claiming the lives of an estimated 1,100 each year,
according to the Jed Foundation. The American Association of Suicidology
reports on its Web site that the suicide rate for 15-to-25 year olds is 300
percent higher than it was in the 1950s.
In the aftermath of three apparent suicides this fall at New York
University, nearly 100 colleges and universities contacted the Jed Foundation
about offering the non-profit's services to their students.
The Jed Foundation also recently joined with Columbia, Harvard, Yale and
the Massachusetts Institute of Technology (news
- web
sites) to begin developing more effective suicide prevention programs on
campuses.
Ron Gibori, the executive director of Ulifeline, credits schools for
recognizing the problem. Colleges often have campaigns urging students not to
binge drink, or to protect themselves from sexually transmitted diseases. But
suicide gets less attention, he says.
Some schools are focusing on the causes of suicidal tendencies.
Counselors say perfectionism — in combination with the long-recognized problems
such as depression, bipolar disorder and drug abuse — is starting to play a
larger role in college-age suicides.
"The good sign is that (students are) driven, they're motivated and
they're highly conscientious," said Connie Horton, the director of
counseling and consultation services at Illinois Wesleyan University in
Bloomington.
"But the downside is that they can be really hard on themselves and
normal failures can be viewed as disasters."
An unprecedented pressure to excel — often beginning in early childhood
— may contribute to an apparent increase in suicidal tendencies among today's
college students, said Kansas State University psychologist Sherry Benton.
"There's a culture of perfectionism that really wasn't there before,"
said Benton, the co-author of a study on college suicides released earlier this
year.
"Students were just as high-achieving a generation ago. But they
didn't have this sense of perfectionism at this level."
Based on 13,257 consultations at the Kansas State counseling center over
a 13-year period, Benton and other KSU researchers determined that the number
of students at the school with suicidal tendencies tripled between 1988 and
2001.
Last year, Illinois Wesleyan began offering "perfectionistic thinking
seminars" to teach students that a less-than-flawless academic effort
doesn't equal failure.
"We try to help them put things in perspective," said Horton.
"That this is just one exam in one class in one semester of their
lives."
Communication is the real key to prevention, said Ross Szabo.
In appearances before high school and college students on behalf of the
National Mental Health Awareness Campaign, Szabo relates how his battles with
bipolar disorder, depression and anger resulted in a failed suicide attempt
when he was in high school.
He encourages students not to suppress their problems but to share them
with friends, family or counselors.
"One of things I see is that young people feel alone and don't know
that they can talk about it," said Szabo, 25, a graduate of American
University in Washington, D.C. "A lot of times they don't have the words
to start talking about it. And their form of expression is to wind up taking
their own lives."
___
On the Net:
The Jed Foundation:
Ulifeline:
The National Mental Health Awareness Campaign:
Associated Press
November 18, 2003
While Arkansas remains near the
bottom in a national health report, state officials are confident that programs
paid for by the national tobacco settlement will eventually improve its
standing.
Arkansas ranked 47th of 50 states in 2002 and again in the 2003 report
released Monday by United Health Foundation, the American Public Health
Association (news
- web
sites) and the Partnership for Prevention.
Despite hitting a plateau the last two years and dropping from a high
rank of 41st in 1993, David Bourne of the state Health Department was confident
that Arkansas could improve.
"The whole nation is progressing," said Bourne, medical
director of the state's tobacco control program. "We are too, but we're
not catching up. But give the tobacco control program some time and we should
see a return on investment."
National health activists, including former President Clinton (news
- web
sites), have praised Arkansas for putting all of its tobacco settlement
money into improving public health. Only three states spent more money per
capita on tobacco control.
The United Health Foundation, a private nonprofit, made the prevalence
of smoking the most important of nine risk factors measured.
The 14th annual report takes 17 weighted measurements and averages them
together to measure total health for the country and each state. It says the
nation is 16.9 percent healthier than the inaugural 1989 survey found, based on
measurements of risk factors — like smoking, crime and poverty — and specific
outcomes such as like workplace death rates, cancer deaths and infant
mortality.
Arkansas, like every state, is noticeably healthier now than in 1990,
having improved its ranking 13.5 percent.
But the improvement was slower than the average state. Arkansas is only
5.6 percent healthier now than the U.S. average in 1990, while Minnesota's
health rating is 37.7 percent higher than the 1990 average.
Mississippi is the only state that is still less healthy than the
national average 13 years ago.
Arkansas still ranks last in childhood poverty. The report says that
28.3 percent of Arkansas children under 18 live in poverty, higher than last
year's 27.5 percent.
Bourne said the entire southeast suffers from greater obesity,
infectious disease, poverty and other detrimental factors, explaining why
Tennessee, Arkansas, South Carolina, Louisiana and Mississippi were the five
worst states.
But Bourne noted Arkansas' innovative program to use school reports to
note and, thus, combat obesity among children. It drew national attention when
introduced earlier this year.
High levels of obesity lead to greater incidence of heart disease, one
of the measures used in the report. Arkansas' heart disease rate has slowly
declined, but its ranking compared with other states has steadily worsened.
Associated Press
November 18, 2003
Residents of Ohio's Appalachian
counties suffer more from lung, colon and cervical cancers than those who live
elsewhere in the state, according to the American Cancer Society (news
- web
sites) and the Ohio Department of Health.
The 29-county southeastern Ohio region, home to 13 percent of the
state's population, is plagued by poverty, limited medical resources, lack of
education and a higher incidence of unhealthy lifestyle choices.
Although no one factor explains why these cancers are more common and
deadly in Appalachia, state experts say smoking plays a major role.
The lung-cancer rate is 10.8 percent higher in Appalachia and the
mortality rate is 9 percent higher.
Among those 18 or older, about 31 percent smoke compared with about 26
percent in the rest of the state, according to the Ohio Behavioral Risk Factor
Surveillance System.
Data released Monday by the American Cancer Society and the Ohio
Department of Health also show that residents in those areas are less likely to
exercise and more likely to eat a fatty diet, which can contribute to higher
incidences of cancer.
They also have fewer hospitals and private physicians, less insurance
coverage, smaller incomes and are less likely to have regular screening tests,
including Pap smears.
"We can tell these people to go online and look at some
information, but they don't have access to the Internet. Some of them don't
even have running water," said Leigh Anne Hehr, the southeastern Ohio
cancer control director for the American Cancer Society.
Others don't have long-distance service and can't call their oncologist
or hospital to schedule appointments, Hehr said.
Some patients are unwilling to go to the doctor, or wait too long to
report symptoms, she said.
Appalachia did have lower rates of breast and prostate cancers, a
difference health officials say is a mystery.
The region became a focus for the American Cancer Society 2 1/2 years
ago with the creation of the Appalachian Cancer Task Force, said Nancy A.
Single, vice president of cancer control for the society's Ohio division.
This year, more than 60,000 Ohioans will be diagnosed with cancer,
according to the Cancer Society. More than 25,000 will die of the disease.
Prostate and cervical cancer death rates have plummeted in Ohio, while
female lung cancer deaths and cases of melanoma have increased.
Ohio's cancer death rate remains higher than that in most of
the country.
Adam Marcus
HealthDay Reporter
HealthDayNews
November 18, 2003
TUESDAY, Nov. 18 (HealthDayNews) -- One of the new painkillers touted as being easier on the stomach than conventional medications doesn't appear to undercut aspirin's protective effect on the blood vessels of patients with artery disease.
But it doesn't appear to be helpful, either.
So says a study which found that one of the drugs, Vioxx, sold by Merck and Co., neither reduced nor increased the markers of inflammation and vessel health in patients taking aspirin and other drugs to control coronary artery disease. Vioxx is one of several medications called cox-2 inhibitors, named for their ability to block an inflammatory molecule called cyclooxygenase-2. Cox-2 shows up in narrowed arteries but not in healthy ones, leading researchers to speculate that cox-2 inhibitors might reduce inflammation associated with vessel disease.
The new work, reported in the Nov. 19 issue of the Journal of the American College of Cardiology, undermines a Swiss study released earlier this year. That study showed that another cox-2 inhibitor, celecoxib -- sold as Celebrex -- appeared to reduce inflammation and promote the healthy widening of blood vessels.
Nor does the latest study support, at least indirectly, fears of some researchers that cox-2 inhibitors may spur the formation of blood clots linked to abnormal vessel cells.
Dr. Subodh Verma, a heart specialist at the University of Toronto, calls the findings "reassuring." However, Verma, co-author of an editorial accompanying the journal article, says the neutral results apply only to patients also taking low doses of aspirin for their heart disease. "It's hard to know what the results would be without aspirin," Verma says. "This discussion and debate might be completely different."
Vioxx and Celebrex, sold by Pfizer Inc., have been heralded as major additions to arthritis care. Arthritis is a common condition -- one form, osteoarthritis, affects roughly 20 million Americans -- and many patients are older, and thus prime candidates for heart disease. Thus, there's ample overlap between the two conditions, and that means treatments often overlap, too.
The new study followed 60 men and women diagnosed with coronary heart disease. All were taking a daily, low dose of aspirin to prevent heart attacks, and half were also given 25 milligrams a day of Vioxx (or rofecoxib).
After eight weeks of treatment, the researchers, led by Dr. Lawrence Title of Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, compared several aspects of vessel health and inflammation between the two groups. These included the ability of vessels to dilate and levels of C-reactive protein, a potent signal of inflammation. But they found no meaningful differences between the two groups in these or other markers -- suggesting that piggybacking Vioxx onto aspirin therapy neither worsened nor improved vessel disease.
Dr. Frank Ruschitzka, a cardiologist at University Hospital in Zurich, Switzerland and leader of the Swiss study that contradicts the latest research, calls the new finding "interesting, as it indeed shows that rofecoxib doesn't decrease endothelial function, as hypothesized by some of the scientists worrying" that it might.
However, Ruschitzka says, what's true in Vioxx doesn't necessarily hold for Celebrex. Celebrex improves vessel cell function in patients with coronary artery disease and hypertension, he says. What's more, a head-to head comparison his group conducted found that Celebrex, but not Vioxx, improves vessel cell function and reduces oxidative stress and inflammation associated with high blood pressure in rats.
"This could fully explain the differences seen with rofecoxib and celecoxib," he says. A report on that study appears in the Nov. 11 issue of Circulation.
More information
For more on C-reactive protein, try MedlinePlus. For more on heart disease, check out the American College of Cardiology or the American Heart Association.
Steven Reinberg
HealthDay Reporter
HealthDayNews
November 18, 2003
TUESDAY, Nov. 18 (HealthDayNews) -- Sound waves to tame tendonitis in the shoulder?
German researchers say they've done just that -- using extracorporeal shock wave therapy to successfully treat chronic calcifying tendonitis of the rotator cuff in patients who'd otherwise need surgery.
"For the first time in the treatment of chronic calcifying tendonitis of the rotator cuff we have found a nonsurgical technique that is effective," says lead researcher Dr. Ludger Gerdesmeyer, an orthopedic surgeon at the Technical University of Munich.
How ESWT works is not fully known. It delivers shock -- or sound -- waves that may disrupt calcium deposits, increase the spread of enzymes across blood vessel walls, stimulate blood vessel growth, and/or promote new bone formation. One or more of these mechanisms may aid in healing, the researchers say.
According to a report in the Nov. 19 issue of the Journal of the American Medical Association, Gerdesmeyer and his colleagues studied 144 patients with chronic tendonitis of the rotator cuff. The rotator cuff is comprised of the muscles and tendons that surround the top of the upper arm bone and hold it in the shoulder joint. These patients had all undergone other therapies, including massage therapy and steroid injections, which did not fix the problem.
Gerdesmeyer's team divided the patients into three groups. Some patients received low-energy ESWT, some got high-energy ESWT, and the remainder were given a sham procedure that had no therapeutic effect.
The patients were given two treatment sessions that were administered two weeks apart. After treatment, the patients also received additional physical therapy.
During six months of follow-up, those who received ESWT showed significant improvement, compared with patients who did not receive the treatment, the researchers report. They also found that patients receiving high-energy ESWT showed greater improvement than those who got low-energy ESWT.
Normally, these patients would have to undergo surgery, Gerdesmeyer says. However, given these findings, "people with chronic pain of the rotator cuff should be treated with ESWT, not surgery," he adds.
Gerdesmeyer and his group are looking to refine their treatment by finding the best energy levels and the most effective number of treatments.
Dr. David S. Bailie, an orthopedic surgeon and a sports medicine expert, says, "ESWT is effective for this problem, and we have had some success in our practice with low-energy ESWT treatment."
Bailie notes that ESWT is noninvasive and takes only several treatments. "Early results from an ongoing study demonstrate about an 85 percent success rate thus far," he adds.
"ESWT can be viewed as an alternative to surgery with few, if any, side effects. And it's probably better and safer than repeated steroid injections," Bailie says.
"Before undergoing any treatment, patients with tendonitis of the rotator cuff should ask about all options and consider the risk/benefit of all treatments," he advises. "A procedure should not 'burn a bridge' for successful subsequent procedures, should they be needed."
More information
To learn more about rotator cuff problems, visit the American Orthopaedic Society for Sports Medicine. For more on extracorporeal shock wave therapy, visit the American College of Foot and Ankle Surgeons.
Amanda Gardner
HealthDay Reporter
HealthDayNews
November 18, 2003
TUESDAY, Nov. 18 (HealthDayNews) -- The number of medication errors reported by U.S. hospitals are on the rise, a new report says, and more than a third of these mistakes involve senior citizens.
The good news is the report doesn't necessarily mark a rise in errors; rather, it reflects an increase in the reporting of them.
In 2002, 482 hospitals and health-care facilities nationwide voluntarily reported 192,477 medication errors to MEDMARX, the national reporting database operated by U.S. Pharmacopeia (USP), a nonprofit based in Rockville, Md. In 2001, 368 facilities reported 105,603 errors.
"This increase is a positive step toward identifying and eliminating medication errors and ensuring the safety and well-being of all hospital patients. By identifying medication error trends and problem areas, hospitals will be able to prevent future errors and reduce patient harm and injuries," Diane D. Cousins, vice president of USP's Center for the Advancement of Patient Safety, said Tuesday during a Webcast news conference.
While most of these errors never harmed the patient, 3,213 mistakes, or 1.7 percent of the total, did result in patient injury (contrasted with 2.4 percent in 2001). Of this total, 514 errors required some hospitalization, 47 required life-sustaining interventions, and 20 (less than 1 percent) were fatal.
The categories of drugs most commonly involved in errors were opioid analgesics, sedatives/hypnotics and anticonvulsants. High-alert medications including insulin, heparin and morphine were responsible for the most severe injuries.
There were 14 types of error, the top five being missing one or more doses; giving an improper dose/quantity; making a prescribing error, using the wrong drug and giving a drug at the wrong time.
"These five actually constitute 88 percent of all types of errors reported," Cousins said.
Incorrect administration techniques (when medications are incorrectly prepared or delivered, or both) were responsible for the largest number of harmful errors (6.2 percent).
In all, hospitals reported 54 different causes of errors. The three most involved with causing harm were performance deficit, procedure or protocol not being followed, and communication errors (usually between different health-care professionals). "What we have found over the years is that the errors we're seeing in the database are often the results of environmental factors that we call contributing factors -- such as distractions or increased workload and use of temporary staff," Cousins said.
Computer entry mistakes are accounting for a greater proportion of the total and are now number four in the list, up from number seven in 2000.
Individuals aged 65 and over were the most vulnerable to errors. The majority (55 percent) of fatal medication errors involved seniors, while 9.6 percent of prescribing errors in this group were harmful.
The most common errors were omission, improper dose or quantity and unauthorized drug errors.
The most common harmful errors in this group were wrong route (for example, a feeding tube inserted intravenously) and wrong administration technique (for example, not diluting a medication).
Again, high-alert medications were involved in many of the harmful errors.
Cousins had tips for seniors and their families to help protect them from becoming victims of medication errors:
More information
For more on medication error reporting, visit the U.S. Pharmacopeia . The U.S. Food and Drug Administration also has information on medication errors.
HealthDayNews
November 18, 2003
TUESDAY, Nov. 18 (HealthDayNews) -- A genetic mutation may cause the metabolic disorder primary iron overload, which is common among blacks.
The discovery is described in three studies in the November/December issue of Blood Cells, Molecules and Diseases.
Italian and American scientists report finding a variation in a gene called SCL40A1, which encodes the protein ferroportin 1, used by the body to transport iron.
Mutations in this gene lead to an increase in levels of the iron storage protein ferritin. This, in turn, results in an accumulation of iron in macrophages -- the body's scavenger cells.
"There are probably multiple causes (of primary iron overload disease), and we have found one of them," Dr. Ernest Beutler, chairman of the department of molecular and experimental medicine at the Scripps Research Institute, says in a prepared statement.
Beutler led one of the studies and co-authored a second.
Mutations in the SCL40A1 gene occur almost exclusively in black populations and may help explain the disproportionate number of black Americans who have primary iron overload.
In people with the disorder, excessive amounts of iron are deposited in the liver, pancreas and other organs. Primary iron overload can lead to diabetes, cirrhosis of the liver and cardiovascular disease. Severe forms of the disorder can be fatal.
More information
Here's where you can learn more about iron disorders.
HealthDayNews
November 18, 2003
(HealthDayNews) -- If you step on a nail or broken glass, it may not be a good idea to pull out the embedded object, advises St. John Ambulance. This may cause more damage and bleeding.
Instead:
Get medical help from a nearby clinic or emergency room
HealthDayNews
November 18, 2003
TUESDAY, Nov. 18 (HealthDayNews) -- A method of delivering antimicrobial drugs directly to the infectious parasites that cause diseases such as toxoplasmosis has been developed by a team of American and British researchers.
A report on their work appears in the Nov. 17-21 issue of the Proceedings of the National Academy of Sciences.
This new antimicrobial delivery system works even when the target parasites are hidden and inactive within cysts, where they can't be touched by current medications.
The researchers say this delivery system offers the first effective, non-toxic way of transporting drugs across multiple membrane barriers and into cysts of Toxoplasma gondii, the single-celled microorganism that causes toxoplasmosis.
The disease, which is spread by cats and by eating undercooked meat, can be dangerous to people with weakened immune systems or when it's transmitted from a mother to her unborn child.
Each year, about 3,000 babies in the United States are born with toxoplasmosis, which results in severe eye damage, mental retardation and death. It's estimated that it costs more than $500 million a year to care for children born with toxoplasmosis.
"This is a major step forward in developing ways to treat one of mankind's most common chronic infections," study director Dr. Rima McLeod, a professor of ophthalmology and visual sciences at the University of Chicago, says in a prepared statement.
"For the first time, we have access to this microbe in its latent stage, a part of its life cycle that was previously inaccessible," McLeod says.
The delivery system uses a short chain made up of eight connected arginines, a naturally occurring amino acid, to transport an antimicrobial drug across membranes.
More information
Here's where you can learn more about toxoplasmosis.
Associated Press
November 17, 2003
Flu outbreaks are already going
strong in parts of the country, months before the season typically peaks, and
this year's vaccine does not exactly match the strain doctors are seeing so
far, the government warned Monday.
"This is very serious," said Dr. Julie Gerberding, director of
the Centers for Disease Control and Prevention (news
- web
sites). She warned that this flu season could be worse than usual.
Gerberding begged people to get early flu shots to avoid a potentially
staggering flu season nationwide.
The shot is recommended for adults over 50, children between 6 months
and 2 years, people with chronic medical conditions and people who work in
health care. The vaccine is readily available this year, Gerberding said.
In an average year, the disease infects up to 20 percent of the U.S.
population, killing about 36,000 Americans and hospitalizing 114,000.
So far this season, the outbreaks were strongest in Texas and Colorado
in October and early November. Most of the country has had only sporadic flu
infections.
But doctors are worried this year's flu season could be brutal. Not only
were the outbreaks early in Texas and Colorado, they involved a strain of
influenza not targeted by the vaccine.
The strain of flu showing up this year is part of a deadly group called
H3N2, a type of flu that leads to more deaths and hospitalizations than other
flu strains.
But because this year's flu vaccine targets a slightly different type of
H3N2 flu than patients are getting, doctors have no idea how well the vaccine
will work. The virus changes slightly over time, a change doctors call
"drift," which is why doctors suggest getting a new flu shot every
year.
Gerberding said the vaccine should still protect most people, because
the strains are very similar.
"In the past this has happened. It's a very common thing," she
said. "Whatever the drift is, the vaccine will still provide some
cross-protection, so we're optimistic that will be the case this year, but of
course we'll be watching it very carefully."
___
On the Net:
CDC Flu: http://www.cdc.gov/nip/flu/gallery.htm
Simple Test Helps
Identify Lung Killer
Associated Press
November 17, 2003
Millions of Americans at risk for a breath-robbing disease leave the doctor's office every year not knowing they missed out on a simple test that could tell if their lungs have begun scarring and dying.
Just breathing into a little machine can diagnose the nation's No. 4
killer, called chronic obstructive pulmonary disease, or COPD, a term that encompasses
the lung destruction of emphysema and chronic bronchitis.
Half of the 24 million people thought to have COPD don't know it. Few
patients are diagnosed until they've lost more than half their lung function
and are left breathless merely crossing a room. And deaths are rising, more
than 119,000 a year.
Now there's a move to have patients treated sooner, by getting
lung-testing machines once used only by specialists into family doctors'
offices — and having those primary-care physicians test every at-risk person
who comes in the door.
Who's at risk? Smokers and ex-smokers in their 40s, and anyone with
shortness of breath, an unexplained prolonged cough or increased phlegm.
The bottom line: "The test is easy, and you should do it," Dr.
Barry Make of Denver's National Jewish Medical and Research Center said as he
taught use of the machine, called a spirometer, at a medical meeting last week.
Simply take a deep breath and then exhale as hard and long as you can
into the mouthpiece, like blowing out lots of birthday candles. The machine
automatically analyzes whether your lung capacity is normal for your age and
size. Insurance covers the $30 test.
Diagnosis is only the first hurdle. Sadly, many patients don't get the
right treatment, either. While there's no cure, there are ways to help patients
preserve their remaining lung capacity and feel better day-to-day.
"This is a disease ... that has a very, very negative image,"
laments Dr. Sonia Buist of Oregon Health & Science University.
"Pitifully little is understood about it in the public.
"The tools we have available can make life better," she adds.
"They're simply not being used."
Healthy lungs are elastic, inflating and deflating like balloons as they
take in oxygen and remove carbon dioxide. With COPD, that elasticity gradually
erodes until the lungs can't deflate fully. Patients need deeper and deeper
breaths to get air into the remaining healthy portion, even as trapped stale
air balloons the lungs until they fill the diaphragm and deep breaths become
physically impossible.
Smoking is the main cause, but other risk factors include exposure to
certain pollutants, including second-hand smoke, and repeated childhood
respiratory infections.
COPD's lung damage is irreversible, but quitting smoking will
dramatically cut worsening — and learning your lungs already are damaged can be
a powerful motivator.
But damage usually is advanced before symptoms appear. When
shortness of breath does hit, patients at first shrug it off as a sign of aging
or poor fitness, further delaying a lung check — and most see primary-care
physicians who seldom own spirometers anyway.
Randy Dotinga
HealthDay Reporter
HealthDayNews
November 17, 2003
MONDAY, Nov. 17 (HealthDayNews) -- New research suggests the tiny number of people who are immune to AIDS are the descendants of Europeans who developed resistance to smallpox in the Middle Ages.
"Smallpox has left a signature on our genetic makeup, providing a benefit to us 700 years later," says study coauthor Alison P. Galvani, an epidemiologist at the University of California at Berkeley.
If Galvani is correct, she may have punctured the prevailing wisdom that the prime suspect behind AIDS immunity is bubonic plague, the deadly disease that wiped out a third of Europe in the 14th century.
The new research is "fascinating and provocative," says Cheryl Ann Winkler, a genetic scientist at the National Cancer Institute who helped develop the plague theory in the late 1990s.
Unfortunately, the findings may reveal more about the past than the future. Experts don't expect their research to have any effect on treatment of people with AIDS.
The existence of AIDS immunity itself isn't new. Researchers discovered it in the 1980s during the early years of the AIDS epidemic, when they noticed that some people were repeatedly exposed to the virus but didn't get infected.
In total, about 1 percent of people descended from Northern Europeans are virtually immune to AIDS. They share one trait in common: a pair of mutated genes that prevent their immune cells from developing a "receptor" that lets HIV, the AIDS virus, break in. It's like a lock and key, Galvani explains: The virus can't gain entry because the lock isn't there.
To be born with a pair of the mutated genes, people must inherit them from both parents. About 10 percent to 15 percent of descendants of Northern Europeans have just one mutated gene, which provides limited protection: It takes longer for those infected with the HIV to actually develop AIDS.
The gene mutations are essentially unknown among East Asians, Africans, American Indians and Middle Easterners, although they do appear in Central Asian countries. In Europe, they're most common in Swedes -- 14 percent have at least one of mutated genes -- and less common in southern European countries such as Greece. The percentages imply that the roots of the gene mutations lie somewhere in the history of Northern Europe.
In 1998, a team of researchers calculated the mutations are about 700 years old and began searching for an explanation. "Some strong selective pressure must have jacked up [their] frequency from a single mutation of one chromosome in one individual to approximately 10 percent of the European population," Winkler says.
The prevailing theory is those who had the mutation were spared infection by one or more diseases and lived to pass the mutation to future generations.
Winkler and colleagues pointed a finger at the plague, a disease that killed as many as 40 percent of Europeans during the Black Death around 1350 and made a return visit two centuries years later. The plague appears to use attack immune cells in a similar way as HIV.
The 1998 study left open the possibility that other diseases -- such as smallpox, syphilis or influenza -- could have spurred the spread of the genes. In the new study, published in this week's issue of the Proceedings of the National Academy of Sciences, researchers argue that the clues point to smallpox, not plague.
Smallpox makes more sense for a variety of reasons, the researchers say, including its stubbornness. While plague came and went in huge waves, smallpox was always around and influencing the genetics of humans.
There's other evidence for smallpox, which was eradicated in the 1970s. The illness largely attacked children, while plague sickened people of all ages. A protective gene is more likely to survive through generations if people who have it spend a lot of time reproducing after they avoid death. Older people "have much less impact because they're not going to have children anyway," Galvani says.
But things aren't necessarily all wonderful for those with these kinds of mutations. When nature giveth, nature also taketh away. Or, as scientists like Galvani put it, "there's a cost of resistance."
For example, one type of gene mutation protects people against malaria, but also makes them more susceptible to sickle cell anemia. While the mutation currently in question may make people immune to smallpox and HIV, its effects on immune cells could cause people to be more susceptible to other illnesses. Galvani, however, thinks the effects are probably minor.
The impact of the new findings may also be minor. Neither Winkler nor Galvani expects they'll directly lead to new treatments for AIDS. But the debate over the origins of HIV immunity is sure to continue as long as scientists such as Galvani are intrigued by the possibilities.
"I just find it really fascinating that diseases have left their signatures on our genome," she says.
More information
Learn about bubonic plague from Brigham Young University. Get the facts about smallpox from the Centers for Disease Control and Prevention.
Karen Pallartino
HealthDay Reporter
HealthDayNews
November 17, 2003
MONDAY, Nov. 17 (HealthDayNews) -- Is it cost-effective to continue to use mammograms to screen women for breast cancer after age 65? The answer appears to be a qualified yes, a new study reports.
An analysis in the Nov. 18 issue of the Annals of Internal Medicine finds, in general, the benefits of screening women over 65 for breast cancer every two years outweigh the costs and possible side effects, like false-positive results. That conclusion is drawn from a review of 10 previously published cost-effectiveness studies, the researchers say.
Based on current medical spending, it costs an additional "$34,000 to $88,000 per year-of-life saved" to perform those biennial tests, the study found.
"It's very comparable with other spending," says Dr. Jeanne Mandelblatt, a cancer outcomes researcher at Georgetown University's Lombardi Cancer Center and the lead author of the study.
Treating adults who have mild to moderate hypertension with a blood pressure-lowering medication, for example, costs roughly the same: $16,000 to $72,000 per year-of-life saved, the researchers note.
Many older women are being screened annually, "especially because Medicare covers that," says Cheryl Kidd, director of education at the Susan G. Komen Breast Cancer Foundation in Dallas.
The cost-benefit question looms, in part, because of a lack of data on the issue. Few older women were included in the original trials of mammography screening, according to the report.
Women are urged to have an annual mammogram beginning at age 40 to detect breast cancer before symptoms arise. Experts agree the years of life saved more than justify the cost of performing the tests.
But some women over 65 who suffer from other health problems, like diabetes, heart disease, hypertension or other cancers, may not realize the full benefit of early breast cancer detection. A woman might die of a heart attack, for instance, before breast cancer would kill her, Mandelblatt says.
The study authors also note that diagnosing breast cancer and treating it in someone dying of another disease can reduce her quality of life, especially if early detection and treatment fail to extend her life.
Individual health status also makes a difference. A vigorous 80-year-old may receive more benefit from mammography screening than a frail 70-year-old, Mandelblatt says.
Screening "becomes more costly and harms begin to outweigh benefits in the sickest women, such as those with dementia" or other conditions that limit life expectancy, the authors note.
The report's findings are consistent with guidelines established by the American Cancer Society. The society recommends women have a mammography every year beginning at age 40, citing no upper limit on age. It does say further research is needed on the risks and benefits for women with serious chronic health problems or short life expectancy.
For these women, especially, screening is "a personal choice," says Dr. Cheryl Perkins, the Komen Foundation's senior clinical advisor. "If she feels that screening would increase her quality of life and she feels it would increase her quality of health, then I think it's beneficial."
Mandelblatt says the new report is intended to guide future research and policymaking, not a woman's decision to get screened or not. Women still need to make those decisions in consultation with their health-care providers, she says.
While many Americans remain squeamish about rationing health care, studies like this one help to put a fine point on the costs, benefits and risks of investing in certain services and tests, the researchers say.
"If you have unlimited funds, it's not an issue," Mandelblatt says. "If you're in a third-world country, $100 per year-of-life saved may be more than you can afford."
More information
To learn more about mammography, visit the National Library of Medicine. For more on breast cancer, visit the National Cancer Institute.
HealthDayNews
November 17, 2003
MONDAY, Nov. 17 (HealthDayNews) -- Time is a factor in determining whether clot-busting drugs or balloon angioplasty offer the best early treatment for heart attack.
That's what a French study reports in the Nov. 17 online issue of Circulation.
The randomized study compared the effectiveness of clot-busting drugs given to heart attack patients en route to hospital with balloon angioplasty given to heart attack patients upon arrival at hospital.
The study found the clot-busting drugs seemed to offer more benefit when given within two hours of the onset of heart attack symptoms. Patients treated two to six hours after the start of heart attack symptoms seemed to do better when treated with balloon angioplasty.
More information
Here's where you can learn more about how heart attack is treated
Serena Gordon
HealthDay Reporter
HealthDayNews
November 17, 2003
MONDAY, Nov. 17 (HealthDayNews) -- Belying the common belief that calcium contributes to kidney stones, a new study of young women has found eating foods rich in this mineral may actually reduce the risk of getting the painful condition.
Dietary calcium, whole grains and vegetables all appear to lower the chances you'll get kidney stones, while a high sugar intake may do the opposite, the study finds.
Contrary to what was believed in the past, eating more protein doesn't increase your risk of kidney stones either, the researchers say. The study also found no additional risk from taking calcium supplements.
"Dietary factors are important," says study author Dr. Gary Curhan, an associate professor of medicine and a nephrologist at Brigham and Women's Hospital in Boston. "Dietary modification may reduce an individual's risk of kidney stones. Our findings challenge the belief that calcium should be restricted."
Curhan presented the findings Nov. 16 at the American Society of Nephrology's annual meeting in San Diego.
Curhan and his colleagues gathered data from the large Nurses' Health Study II, which includes more than 100,000 women. For this study, the researchers focused on 96,000 women between the ages of 27 and 44 at the start of the study who had completed dietary information surveys in 1991 and 1995.
At the start of the study, none of the women had kidney stones. At the end of the eight-year study period, 1,223 women had developed kidney stones.
Kidney stones form from substances in the urine. The most common type of stone forms from calcium oxalate in the urine. Other substances that contribute to stone formation include uric acid, struvite and cystine, the researchers say.
Stones come in varying sizes -- from a grain of sand to the size of a golf ball. Some stones pass through the urinary tract system on their own, but some get stuck and block the flow of urine. When this happens, medical intervention is necessary.
The researchers found women who had the highest dietary calcium intake from foods such as milk, cheese and yogurt reduced their risk of kidney stones by 27 percent. Consumption of phytate, a naturally occurring substance found in whole grains and vegetables, lowered the risk of kidney stones by 37 percent, and a higher fluid intake also appeared to reduce the risk of kidney stones.
What did raise the risk of developing kidney stones was sugar. Sugar increased kidney stone risk in young women by slightly more than 30 percent. Meat and calcium supplements didn't appear to significantly increase or decrease the risk.
Dr. Khalid Zafar, a nephrologist at William Beaumont Hospital in Royal Oak, Mich, says, "The take-home message here is that people with kidney stones should not decrease dietary calcium and they can take supplements and eat meat."
He says the finding that supplements don't increase the risk of kidney stones in young women is especially important, because women need calcium to prevent osteoporosis, and many don't get sufficient amounts from their diet.
More information
To learn more about kidney stones, visit the National Institute of Diabetes and Digestive and Kidney Diseases or the Kidney Foundation of Canada.
Associated Press
November 16, 2003
Women with common, usually nonfatal
forms of skin cancer face double the risk of having unrelated cancers,
according to a large study, suggesting that the initial diagnosis may be more
worrisome than previously thought.
The skin cancer link was found for several malignancies, including
cancer of the brain, breasts, lung, liver, ovaries and uterus.
Previous studies have shown that men and women with skin cancer face an
increased risk of skin cancer returning. Some studies also have found that
people with non-melanoma skin cancer are prone to later developing non-skin
cancers.
But according to the new report's lead author, Dr. Carol Rosenberg of
Evanston-Northwestern Healthcare, part of Northwestern University's medical
school, the earlier research did not adequately consider other risk factors
that might explain the connection.
Her study, involving 92,835 post-menopausal women participating in a
continuing federal study, considered other factors that influence cancer risk —
including smoking, weight and education level — and still found an increased
risk of unrelated cancers associated with skin cancer.
Rosenberg said she suspects her results would also apply to men, since
previous studies involved both genders.
Given previous research, the authors presumed that skin cancer preceded
development of other cancers, though the study lacks information on which
developed first, Rosenberg said.
The results appear in the January issue of Cancer, an American Cancer
Society (news
- web
sites) journal, being published online Monday.
Of the more than 85,000 women who did not have skin cancer, just over 11
percent, 9,927, reported having had other cancers.
Of the 7,665 women who reported having had a mild form of skin cancer,
nearly 25 percent, 1,878, said they had also had other types of cancer.
The skin cancers implicated — basal cell and squamous cell — affect more
than 1 million Americans each year. Those skin cancers grow more slowly than
melanoma, the most serious skin cancer.
Eugenia Calle, the American Cancer Society's director of analytical
epidemiology, questioned whether the increased risk is as high as the study
suggests, considering that earlier studies found lower risks.
Calle said the study design may have exaggerated the risk, since women
with non-skin cancers might be more likely to remember having had mild skin
cancer than women who have only had mild skin cancer, especially since it is
often dismissed as a minor inconvenience, Calle said.
___
On the Net:
HealthDayNews
November 16, 2003
SUNDAY, Nov. 16 (HealthDayNews) -- Popular folklore says rain can bring on depression. Can it?
Probably not.
According to the National Institutes of Health (NIH), depression can be caused by genetic factors, such as a family history of the disease, though not everyone who suffers from depression has a relative who has had depression. Other factors in depression include biochemical, environmental, psychological and social causes. The NIH defines environmental factors as a difficult relationship, a significant loss, a major illness or a major change in any life pattern.
A lack of sunlight is implicated, however, in seasonal affective disorder (SAD), and depression is one of the symptoms of this disorder. Other symptoms include changes in eating and sleeping habits, symptoms that occur only in the winter, and a craving for sugary or starchy foods, according to the National Mental Health Association.
As many as one in four Americans suffer from a mild form of SAD during the winter months. No one knows exactly what causes SAD, but researchers do know that when the days are shorter and there is less natural light, production of the sleep-related hormone melatonin goes up.
Because this hormone has been linked to depression in some studies, maybe all those people who think the rain can bring on the blues aren't all wet after all.
More information
If you think you're suffering from more than just the rainy day blues, take this depression screening test from the National Mental Health Association.
Associated Press
November 15, 2003
Six months ago, the newly opened
Chengdu Snacks was one of thousands of businesses forced to shut down as the
streets of Beijing emptied and people stayed home in fear of SARS (news
- web
sites). The eatery reopened after a month, but business hasn't been the
same.
Though lunchtime is packed with people slurping spicy noodles and
snagging dumplings from bamboo steamers, customers are slowly vanishing again
amid fears that SARS — which first appeared in southern China last Nov. 16 —
could resurface with the cold weather.
"People think SARS is on the way back, so they're eating at
home," said Yi Binglong, 28, who moved to the capital from China's
southwest to open Chengdu Snacks. "In September and October, there would
be customers through the afternoon. Now they disappear after lunch."
Yi isn't the only one on tenterhooks.
"It all feels a bit funny at the moment, just this waiting to see
what will happen," said Julie Hall, the SARS team leader at the World
Health Organization (news
- web
sites)'s Beijing office.
The Chinese government, which was harshly criticized both at home and
abroad for withholding news of the SARS outbreak in its early months, has
unleashed a stream of rhetoric aimed at persuading the masses that improved
surveillance and reporting can avoid another epidemic.
This month, Vice Premier Wu Yi, who is also health minister, said China
is "capable of preventing and controlling a resurgence of SARS."
A Chinese scientist at the forefront of SARS research was more adamant.
"With these active measures, I believe there will not be an outbreak of
SARS this winter," Professor Zhong Nanshan was quoted as saying on the Web
site of People's Daily, the Communist Party newspaper.
When the first known human case of severe acute respiratory syndrome
occurred in southern China's Guangdong province a year ago, no one noticed;
SARS had never been seen before and had yet to be named. It was only later that
researchers tracked down what is believed to be that first victim.
By early spring, cases were popping up around the globe, most notably in
Hong Kong and Canada, causing mass panic. In all, 774 people died and more than
8,000 were sickened, according to WHO.
Mainland China accounted for more than half the cases and deaths but
kept its figures secret until April, when the government — under pressure from
the international community — vowed to be more open and aggressive.
Sweeping, sometimes draconian measures were taken, especially in
Beijing, the hardest-hit area in the world. Mass temperature-taking began.
Coughers were shunned, spitters condemned. Officials ordered schools, movie
theaters and restaurants closed. They sealed hospitals and quarantined
thousands of people at home.
The central government and local authorities have reactivated some of
those measures, beefed up others and instituted new ones.
In September, the Ministry of Health revived its nationwide system of
daily reports on SARS cases. So far, the tally of suspected or confirmed cases
has remained at zero.
A new computerized reporting system went into effect in early November,
with plans to have all national, provincial and county hospitals linked.
Chinese cities, meanwhile, have started checking travelers for fever
again. The port city of Tianjin, east of Beijing, reports any traveler with a
temperature above 100 degrees. In Urumqi, in the far west, people with
temperatures above 99.5 degrees are not allowed on public buses.
Scientific knowledge about SARS remains elusive. The disease's origin
remains unknown, no cure has been found, and WHO says a vaccine is at least two
years away.
Researchers believe people may have gotten the virus from animals that
were infected by another, still mysterious disease, but it's still unclear how
the sickness jumps from animals to people. Raccoon-dogs, ferret badgers and
civet cats in southern China have been found harboring a germ almost identical
to SARS.
WHO's Hall said mobilizing against a disease that may or may not return
has been an unusual challenge.
"People feel like they've learned from the last
time," she said. "But everyone just feels a tiny bit jittery, a tiny
bit jumpy. That's the worry: You get one case and all this pent-up energy just
explodes in panic. We really hope that's not the case."
Associated Press
November 15, 2003
Federal regulators worried about
increased cancer risks to children said Friday they might recommend the use of
wood sealants to contain the arsenic within a pesticide-treated wood used in
playground equipment.
Three months into an 18-month study by the Consumer Product Safety
Commission (news
- web
sites) and the Environmental Protection Agency (news
- web
sites), researchers are finding some success in sealing off the pesticide,
chromated copper arsenate, that is used in almost all wooden playgrounds, with
an oil-based semitransparent stain, said Jim Jones, director of EPA's Office!
of Pesticide Programs.
"The early results are that some sealants are very effective in
preventing the arsenic from leaching out of the wood," he said in an
interview with The Associated Press.
EPA released a new draft study this week that shows what Jones calls
"a marginally increased risk of cancer" for children, ages 1 to 6,
who are exposed to the pesticide. The added chances of a child this age getting
cancer ranged from one-in-1 million, which is considered negligible, to
one-in-100,000, he said.
"Americans now face a risk of one in four chances of getting
cancer. This adds to it rather marginally," Jones said.
At year's end, the industry will complete its phaseout of any new
products built with the pesticide. EPA removed the pesticide, used mainly to
protect lumber from decay and insect damage, from its list of approved
chemicals.
An industry group, the Wood Preservative Science Council, maintains the
pesticide-treated wood has been used safely for 70 years. It said the study is
incomplete, "an insufficient tool for regulatory decision making."
The Environmental Working Group, a research advocacy organization that
has sought a ban on the treated wood, criticized EPA for its earlier assurances
that playground equipment need not be replaced if certain precautions were
followed.
In announcing the phaseout of the treated wood in virtually all
residential uses, EPA said in February 2002 that it "has not concluded
that CCA-treated wood poses unreasonable risks to the public ... (and) does not
believe there is any reason to remove or replace" playgrounds and other
structures built with the wood.
"That assurance was then wholly without scientific merit, as no EPA
risk assessment had been performed," said Kenneth Cook, the environmental
group's president.
Jones said the assurances were made because "we knew that arsenic
posed hazards, but we didn't know what the risks were ... so we gave some
commonsense recommendations that we still stand by."
Those recommendations to parents include making sure children wash their
hands after playing and don't eat on the play sets or let food come into
contact with the wood.
In the long run, however, sealants may be the answer.
"What we'd like to do is find a stain or sealant that people can
purchase and apply to their deck or child's playground to reduce the amount of
arsenic that is dislodged," said Eric Criss, a spokesman for the Consumer
Product Safety Commission. The commission decided a ban on the
pesticide-treated wood in playground equipment was unnecessary because of the
industry phaseout.
"We're telling people there is reason for concern, but not
alarm," he said.
___
On the Net:
CPSC: http://www.cpsc.gov
EPA: http://www.epa.gov/pestici
HealthDayNews
November
15, 2003
SATURDAY, Nov. 15 (HealthDayNews)
-- Sweaty feet and winter are a bad combination.
Not only do you run the risk of developing frostbite, but you could also
be prone to trench foot and athlete's foot, experts say.
According to the U.S. Centers for Disease Control and Prevention, wet
feet lose heat 25 times faster than dry feet. To compensate, the body shuts
down peripheral circulation. Less blood circulating to the feet means less
oxygen and nutrients, and skin tissue begins to die, a condition which can lead
to trench foot.
Because wet feet get cold more quickly, they're also at an increased
risk of developing frostbite.
Athlete's foot, a fungal infection, is also more likely to thrive in
moist, damp places such as feet when they're sweaty.
Fortunately, these prevention strategies can stave off all three of
these conditions:
More information
The Podiatry Network has more on athlete's foot.
HealthDayNews
November
15, 2003
SATURDAY, Nov. 15 (HealthDayNews)
-- Goldfinger was James Bond's archenemy, and Coldfinger could be yours if
you're not careful when you use power tools in cold, wet weather.
Vibration white finger (VWF) is the most common form of a condition
called Hand Arm Vibration Syndrome (HAVS), which affects blood vessels, joints,
nerves and muscles in the hands, wrists and arms, says the University of
Central Lancashire.
There are a number of symptoms that may indicate HAVS. You may initially
have a tingling sensation and numbness in your fingers. In cold, wet weather,
fingers will turn white, then blue, then red and be very painful.
You may have difficulty picking up objects such as nails because you'll
have reduced feeling in your fingers, along with loss of strength and grip in
your hands. There may also be pain, tingling and numbness in your arms, wrists
or hands.
You could be at risk of developing HAVS if you regularly use certain
hand-held power tools, including hammer drills, jigsaws, sanders and angle
grinders, concrete breakers, chipping hammers or power lawnmowers.
There are a number of ways to avoid vibration white finger and other
forms of HAVS. All tools and machines you use in cold weather should be
designed so they can be operated by workers wearing gloves. Keep your body warm
and dry to ensure good circulation.
Quit or cut down on cigarette smoking, which reduces your body's blood
flow. When you have lunch or a break, massage and exercise your fingers. Keep
tools in warm storage areas when they're not being used. That way, the handles
won't be cold when you go to use them.
Try to do work in a way that doesn't require using vibrating power
tools. If you have to use such tools, choose ones that produce lower levels of
vibration. Keep power tools sharpened, well maintained and repaired. Vibration
increases when tools are dull or in poor condition.
More information
Here's where to go to get more information about occupational vibration hazards.
HealthDayNews
November
15, 2003
SATURDAY, Nov. 15 (HealthDayNews)
-- A chewable birth control pill that tastes like spearmint?
That's exactly what Ovcon 35 is -- an oral contraceptive tablet that can
be chewed and swallowed. This new version of Ovcon 35, which received U.S. Food
and Drug Administration approval on Friday, provides one more alternative to
the many types of oral contraceptives currently on the market, the agency says.
Ovcon 35 contains a progestin and an estrogen found in contraceptives
that are already marketed.
The pill can be swallowed whole or chewed and swallowed. If the pill is
chewed and then swallowed, the woman should drink a full glass -- 8 ounces --
of liquid immediately afterward so the full dose reaches the stomach and no
residue is left in the mouth, according to the product's directions.
The FDA says Ovcon 35 is available only in a 28-day regimen. Each
package contains 21 round, white, active tablets, to be followed by seven
reminder, green inactive tablets to complete a four-week cycle.
The product is manufactured by Bristol Myers Squibb Company of
Princeton, N.J., and will be marketed by Warner Chilcott, Inc., of Rockaway,
N.J., the FDA says.
More information
To learn more about Ovcon 35, visit this FDA site.