Personal Health
Joel P. Rutkowski, Ph.D., Editor
March 20, 2006
- Teen Girls Sip More Soda as They Age
- Virus Found in Prostate Cancer Patients
- Adult Ecstasy Use Tied to Childhood Depression
- Green tea may protect the aging brain
- Gene Test Could Spot Athletes' Cardiac Risk
- Heavy ex-smokers remain at high risk for stroke
- Age Could Alter PSA
- Weakly acidic reflux can also cause heartburn
- Two Rare Clotting Genes Hike Heart Disease Risk
- Rheumatoid arthritis costly for employers
- Protein Interactions Offer Up Clues to Disease
- Wheezy allergic kids may grow into asthmatic adults
- Health Tip: Seniors Who Exercise
- Weakened Immune System May Cause Crohn's Disease
- Obesity, estrogen breakdown tied to breast cancer
- Vitamin D Protects Against Tuberculosis
- Soup Giant Finds a New Way to Cut Sodium
- Teflon-Linked Dangers May Not Stick
- High mortality risk of anorexia nervosa confirmed
- Smoking Boosts Risk for Root Canal
- Sweaty Cotton Socks Worst for Blisters
- Health Tip: Rare Condition Predisposes People to Cancer
- Potato lovers may have higher diabetes risk
- Health Tip: Paxil and Pregnancy Don't Mix
- Group Says Chromium Risks Withheld
- Flu's Resistance to Some Drugs Causes Concern
- "Prehypertension" increases cardiovascular risk
- When It Comes to Kids' Ear Infections, Hold the Antibiotics
- Supplements fail to help mild knee arthritis: study
- No Link Between Cholesterol, Suicide in Alcoholics
- Alzheimer's decline faster in more-educated people
- Loud Music Helps Drive Ecstasy Brain Damage
- Doctors may offer heart ops without missing a beat
- Depression, anxious personality tied to allergies
- Vitamin C helps preserve vitamin E in smokers
- This Chip Could Be a Lifesaver
- Panel Wants Infants to Get Rotavirus Shots
- Health Tip: Are Artificial Sweeteners Safe?
- Hockey body checking increases injury risk in kids
- Two Drug-Coated Stents Perform Equally Well
- Mother's stress linked to early miscarriage
- Exercise, Learning Help Shield Against Alzheimer's
- Bird flu likely to burst out again and again: study
- Corticosteroids May Harm ICU Patients
- Delaying solid food by 6m doesn't prevent allergy
- Health Tip: Signs of Autism
- Fake drugs, including Tamiflu, thrive on Internet
- Grapefruit May Sweeten Way to Lower Cholesterol
- Health Tip: Exercise Is Good for You
- Heavy drinking tied to worse eating habits
- Many Elderly Women Going Without Bone Density Tests
- Doctors Want to Find Spreading Cancer
- Gene Mutations May Boost Breast Cancer Risk
- Ovarian cancer survival influenced by MD specialty
- Discovery Could Disarm Flesh-Eating Bacteria
- Organic Food Fends Off Pesticides
- Acupressure Eases Low Back Pain
- Gum chewing helps bowels after surgery: study
- Allergy Relief Can Come Cheaply
- Gene May Explain Men's Raised Risk for Parkinson's
- Western diet helps raise S.Korea breast cancer rate
- Focus, Flexibility Speed Heart Attack Care
- Study sees more benefit from some heart drugs
- Health Tip: When Snoring Is Dangerous
- Diet study confusion will not change habits-analysts
- A Lifesaving Stroke Drug That Few People Get
- Scientists See Growing Animal-Disease Risk
- Autism surrounded by misunderstanding-experts
- Candy Makers Cater to the Health-Conscious
- Leisure Brings Little Relief to Busy Moms
- Study: Watching Calories Takes Commitment
- Protein Predicts Marrow Transplant Trouble
- MDs: Make Stroke Victims Use Weak Arm
Friday, February 24, 2006
Teen Girls Sip More Soda as They Age
By Kathleen Doheny
HealthDay Reporter
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- As teenage girls get older, they drink less milk and more soda, which translates into lower intakes of calcium and higher body-mass indexes, a new study finds.
Soda consumption among teens has been a concern of nutrition experts for years, with excess soft drink intake linked to increased risk for dental decay and weight gain, among other health problems.
Now, in a study published in the February issue of The Journal of Pediatrics, researchers followed 2,371 girls who kept food diaries from age 9 or 10 through age 19. The findings mirror those of other studies, but what's new is the length of time the girls were tracked.
"We have 10 years of details," said study co-author Douglas Thompson, a senior statistician at the Maryland Medical Research Institute, in
As participants in the National Heart, Lung and Blood Institute Growth Health Study, the girls turned in food diaries during annual visits. Over the years, the researchers looked at three-day food records and evaluated them. Participants noted, among other information, their intake of milk, regular soda, diet soda, fruit juice, fruit-flavored drinks and coffee/tea.
Milk consumption decreased by more than 25 percent during the course of the study, while soda intake nearly tripled, becoming the No. 1 beverage consumed by the older girls. Because beverage habits have been associated with characteristics such as age and race, the researchers looked separately at white and black teens.
The consumption of regular soda among white girls rose from about 4.7 ounces a day at age 9 to 13.2 ounces daily by age 18. Among black girls, regular soda consumption was 4 ounces daily at age 9, and rose to 11.8 ounces by age 18. Milk consumption among white girls was 12.3 ounces daily at age 9 but only 8.4 ounces at age 18. Black girls averaged 8.5 ounces of milk a day at age 9, but just 5 ounces by age 18.
The more soda girls drank, the lower their calcium intake and the higher their body-mass index (BMI), the researchers found.
"The nutrient impacts are a great concern," Thompson said, referring to the calcium intake finding. "A girl who drank 200 grams [about 8 ounces] a day decreased calcium intake by 7 milligrams, compared to one who drank only 100 grams [4 ounces]."
Advice for parents? Give your daughter more milk, and fewer other beverages. "The beverages associated with poor nutrient profiles were regular sodas, fruit-flavored drinks, coffee and teas," Thompson said.
"Girls who drank more of those -- regular soda, fruit-flavored drinks [not fruit juice], coffee and teas -- take in more calories generally, have more sugars and less calcium in their diets," he added.
Moderation of soda is key, said Lona Sandon, a spokeswomen for the American Dietetic Association and an assistant professor at the
"It is pretty clear that as intake of sugary beverages increases, the intake of beverages with higher nutritional quality decreases," Sandon said. "Replacing milk with sodas or fruit drinks means less protein needed for growth and healthy immune systems, less calcium for strong bones for the future, less potassium, less vitamin D and other nutrients needed for optimal health."
"Sweetened beverages providing calories without nutrition should be consumed with caution," she added. "An adolescent eating a diet that meets the dietary guidelines for Americans and nutrients needed for growth and development can safely enjoy a sugary drink occasionally."
By occasionally, Sandon said she meant no more than three to four times a week.
More information
To learn more about nutrition, visit the American Dietetic Association.
Virus Found in Prostate Cancer Patients
By Paul Elias
AP Biotechnology Writer
The Associated Press
Friday, February 24, 2006
Researchers said Friday they have found a virus in the prostates of some cancer patients, a remarkable discovery that may suggest disease could play a role alongside genetics and the environment in causing this cancer.
The virus, closely related to one previously found only in mice, was found in cancerous prostates removed from men with a certain genetic defect. The findings open new avenues for studying the most common major cancer among men in the
The researchers, with the
"We have made a very fascinating discovery never before seen in humans that is very similar to one found in a mammal that causes cancer," Dr. Eric Klein of the Cleveland Clinic said at a news conference. "But we have not proven this virus causes prostate cancer."
Infectious disease-causing viruses are already blamed for some liver cancers and cervical cancer. That has planted nagging suspicions in the minds of scientists that some diseases may play important roles alongside genetics, environment and chance in causing breast, stomach and several other forms of cancer.
Researchers are not sure how the mouse virus infected people, but suspect it has been passed on genetically for many generations.
"This is a class of virus no one would have looked for in prostate cancer," said UCSF researcher Joe DeRisi, who developed the so-called "gene chip" that made the discovery. DeRisi's chip contains 20,000 snippets of vital genetic material from every known virus. It is the same chip that confirmed a previously undiscovered virus in the cold family that caused the SARS outbreak three years ago.
Klein sent samples of 86 cancerous prostates he removed from patients to DeRisi. DeRisi then placed DNA from the cancerous tissues on the chip, and DNA from eight of 20 patients with two copies of a mutated gene matched with DNA from the mouse virus.
The gene is a vital cog in the body's defense system, coding for an enzyme that helps kill invading viruses. The men with the mutated genes make fewer such enzymes than those with normal versions of the gene.
The virus was found in just one of the 66 other patients, suggesting that genetics play a significant role in the virus' connection to cancer.
The researchers said they will now test hundreds more prostate patients and are developing a diagnostic tool to test for the virus in the blood. That way they could test thousands of patients and non-patients alike and figure out if there is any link between prostate cancer and the virus, which causes cancer in mice.
The researchers also want to determine how widespread the virus is in humans and whether it is exclusive to prostate patients. Prostate cancer is the most frequent cancer and the second leading cause of death among men older than 50 in the
Others are expected to look for other potential viral links to prostate cancer beyond the well-trod investigative areas of environmental, racial and genetic backgrounds. Prostate cancer, for instance is found more often as men age, among blacks and the overweight than in the general population. There also are hereditary links to prostate cancer.
Now, researchers have another, potential viral suspect to investigate.
"We haven't really been thinking along those lines," said Dr. Anthony Zietman, a radiation oncologist at
On the Net:
ASCO: http://www.asco.org/
NIH cancer agent list: http://ntp.niehs.nih.gov/ntp/roc/eleventh/known.pdf
Adult Ecstasy Use Tied to Childhood Depression
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- Childhood anxiety or depression could boost risks for adult use of the illicit drug ecstasy, Dutch researchers report.
The nearly 1,600 participants in the study were first assessed in 1983 when they were children, and then again 14 years later. People who had signs of depression and anxiety in 1983 also had an increased risk of later ecstasy use as adults, the research team found.
Reporting in the Feb. 24 online issue of the British Medical Journal, researchers at
However, they added that long-term use of ecstasy may lead to an increase in depressive symptoms, which may partially explain the link between ecstasy use and later depression found in previous research.
Particular social environments, seeking out new experiences, or parental substance abuse are other factors that appear to increase the likelihood of ecstasy use in some people, the researchers said. They did not test for these factors in this study.
"Focusing on these vulnerable individuals in future studies will increase our insight into the potential harmful effects of ecstasy on brain neurotransmitter systems and associated psychopathology," the study authors wrote.
More information
The Nemours Foundation has more about ecstasy.
Green tea may protect the aging brain
By Amy Norton
Reuters Health
Friday, February 24, 2006
People who regularly drink green tea may have a lesser risk of mental decline as they grow older, researchers have found.
Their study, of more than 1,000 Japanese adults in their 70s and beyond, found that the more green tea men and women drank, the lower their odds of having cognitive impairment.
The findings build on evidence from lab experiments showing that certain compounds in green tea may protect brain cells from the damaging processes that mark conditions like Alzheimer's and Parkinson's disease.
But while those studies were carried out in animals and test tubes, the new research appears to be the first to find a lower risk of mental decline among green-tea drinkers, according to the study authors.
They speculate that the possible protective effects of green tea may help explain
Dr. Shinichi Kuriyama and colleagues at Tohoku University Graduate School of Medicine report the findings in the current issue of the American Journal of Clinical Nutrition.
The study included 1,003 adults age 70 and older who completed detailed questionnaires on their diets over the previous month, as well as their overall physical health and lifestyle habits. They also completed a standard test of cognitive functions such as memory, attention and language use.
The researchers found that older adults who drank two or more cups of green tea per day were about half as likely to show cognitive impairment as those who drank three cups or less each week. Men and women who averaged one cup per day fell somewhere in between.
The connection between green tea and mental function persisted when the researchers accounted for overall diet and factors such as smoking and exercise habits.
However, the findings cannot demonstrate a cause-and-effect relationship.
The study was observational, not a controlled experiment, and there may be something about green-tea drinkers that explains the link between the beverage and sharper mental function, Kuriyama told Reuters Health.
For example, healthier, more active individuals may simply drink more green tea -- which, in
"We think that the potential protective effects of green tea should be confirmed in further studies," Kuriyama said.
Given the high prevalence and heavy burden of dementia, the researchers conclude, any benefit of drinking green tea could have a "considerable" public health impact.
Source: American Journal of Clinical Nutrition, February 2006.
Gene Test Could Spot Athletes' Cardiac Risk
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- A rare, often fatal heart condition in young athletes could have its roots in a group of mutations in one gene, new research suggests.
According to scientists at
The finding may soon lead to a blood test to screen for the problem, the researchers said.
ARVD is marked by a poorly functioning right cardiac ventricle that beats irregularly. Over time, a buildup of excess fat and scar tissue weakens the muscle. Untreated ARVD can cause a fatal heart rhythm irregularity.
The
"We believe we have pinpointed the genetic mutations responsible for the syndrome in many people, and we expect to have a blood test to identify those at risk of developing ARVD clinically available within the next couple of months," study senior author and cardiac geneticist Dr. Daniel P. Judge said in a prepared statement.
The findings were published online Feb. 20 in Circulation.
Judge said it makes sense to screen close family members of people who've been diagnosed with ARVD. However, he noted that the presence of the mutations does not predict the risk of fatal arrhythmia or the need for preventive therapy, such as an implanted defibrillator.
ARVD accounts for about 5 percent of the 300,000 sudden cardiac deaths each year in the
More information
The Heart Rhythm Society has more about sudden cardiac death.
Heavy ex-smokers remain at high risk for stroke
By Martha Kerr
Reuters Health
Friday, February 24, 2006
People who smoked heavily in the past before quitting carry a long-term risk for stroke, warned doctors at the American Stroke Association's International Stroke Conference.
"How much you smoked matters more than how long ago you quit," Dr. Sachin Agarwal told Reuters Health. "Smokers should quit as soon as possible, and new smokers should be aware that there will be a lifelong risk. Cessation can reduce risk but it can't erase it," he said.
Agarwal and colleagues at Johns Hopkins Hospital in Baltimore, Maryland, used magnetic resonance imaging to compare aortic wall volume, as well as carotid (neck) artery thickness, in 27 former smokers and 15 people who had never smoked.
Many strokes occur when one or both of the neck arteries narrow due to plaque build up and a clot plugs the artery and shuts off blood flow to the brain. Thickening of the neck arteries precedes the build up of plaque and contributes to increased stroke risk.
The former smokers had quit an average of 30 years previously and had an average exposure of 20 pack-years -- derived from the number of years smoked and the number of packs of cigarettes smoked daily.
They were divided into four groups: group 1 had smoked 20 pack-years or less and had quit more than 15 years previously, on average; group 2 had smoked 20 pack-years or less and had quit fewer than 15 years previously; group 3 had smoked 20 pack-years or more and had quit more than 15 years or more; and group 4 had smoked 20 pack-years or more and had quit within the past 15 years.
Comparing all of the former smokers with the never smokers, Agarwal's team found that the aortic walls of former smokers were thicker than the aortic walls of never smokers. Wall dimensions increased progressively with the length and intensity of smoking history.
Similarly, carotid artery wall volume was higher in former smokers than never smokers, with differences correlated with smoking history.
"We saw there was a strong and direct relationship between arterial wall thickness and increasing levels of risk of former smoking," Agarwal said in a statement.
The associations between smoking and arterial wall thickness remained significant after accounting for age, gender, history of high blood pressure, diabetes, alcohol intake, and cholesterol levels.
Agarwal said the message is clear: "Smokers should quit as soon as possible."
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- Doctors have long used prostate specific antigen (PSA) testing to spot the early signs of prostate cancer. But a new study suggests that men 70 years of age and younger require a different PSA criterion for diagnosing prostate cancer than older men.
Researchers at
The current threshold for PSA velocity (PSAV) is 0.75 ng/ml/yr. This means that if a man's PSA level increases more than 0.75 in one year, he should consider a biopsy for prostate cancer. However, this study concluded that using that PSAV criterion prevented doctors from diagnosing prostate cancer in men younger than 70.
The optimal PSVA threshold for men under 60 is 0.4 ng/ml/yr and 0.6 ng/ml/yr for men between 60 and 70, the researchers concluded.
"Finding that PSA velocity is more effective when it is age-adjusted is very important, especially since the oldest of the Baby Boomers turn 60 this year," study lead author Dr. Judd W. Moul, chief of urologic surgery at Duke, said in a prepared statement.
"In the past few years, 60 or younger has become the peak age for prostate cancer diagnosis. Using PSAV makes it much more likely that we will detect cancers in men of this age," Moul said.
The findings were to be presented Friday at the Prostate Cancer Symposium in
More information
The U.S. National Cancer Institute has more about prostate cancer screening.
Weakly acidic reflux can also cause heartburn
By Anne Harding
Reuters Health
Friday, February 24, 2006
Reflux doesn't have to be extremely acidic in order to give you that burning feeling, a new study shows.
In fact, burping can result in heartburn even when no liquid accompanies the gas up the esophagus, Dutch researchers report.
It remains unclear why reflux episodes don't always cause heartburn, Dr. A J. Bredenoord of St. Antonius Hospital in Nieuwegein, the
To investigate, they monitored 32 patients with gastroesophageal reflux disease, or GERD, symptoms for 24 hours using traditional pH testing as well as a technique called impedance.
Impedance allows researchers to evaluate how far reflux extends up from the stomach, measure the volume of reflux, and evaluate acidity with greater precision. "It's a completely new way of looking at reflux," Bredenoord said.
All of the study subjects had stopped taking acid-suppressing medication.
A total of 1,807 episodes of reflux occurred, with 203 causing symptoms. Episodes that caused symptoms showed a larger increase in acidity within the esophagus, more acidity, and extended further up the esophagus. The volume of reflux in heartburn-causing episodes was larger than for those that caused no symptoms, while the liquid also took longer to clear from the esophagus.
Nearly 15 percent of reflux episodes were caused by more weakly acidic reflux material.
The researchers also identified 426 gas-only reflux episodes, 12 of which caused symptoms. Symptoms were more likely with gas reflux if they were accompanied by a rise in acidity.
The findings show, Bredenoord said, that "if you only focus on looking at whether these symptoms are related to acid, you will certainly miss a few patients who symptoms are also related to weakly acid reflux." And volume of reflux, as well as its acidity, plays a role in whether it causes symptoms, he added.
He points out that some drug companies are developing medications designed to reduce the number of reflux episodes, rather than targeting acidity, as all currently available GERD drugs do. This could be helpful for the minority of patients whose symptoms are due to more weakly acid reflux, he said.
Also, Bredenoord said, instruments for measuring impedance have been approved in both the
Source: Gut, March 2006.
Two Rare Clotting Genes Hike Heart Disease Risk
By Ed Edelson
HealthDay Reporter
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- Some rare variant forms of genes that control blood clotting can increase the risk of heart disease, a British study finds.
The genes are not common enough and the risk they pose is not great enough to warrant screening for them now, said Dr. John Danesh, a professor of epidemiology and medicine at the
"But it is helpful to identify genetic variants that may be associated with increased risk," Danesh said. "This helps increase our understanding of the biological pathways that lead to heart disease. These findings could have implications for designing new therapies that target blood clotting pathways to help prevent heart disease."
There has been a back-and-forth controversy about the possible role of such genes in heart disease, Danesh said. "The whole purpose of this exercise was to try to pool the studies that have been reported and produced conflicting results, and clarify the evidence by pooling the data," he said.
Danesh and his colleges analyzed results of 191 studies that included 66,155 people with heart disease and 91,307 people with no heart trouble, looking for the incidence of seven variants of clotting genes that have been associated with increased risk in some studies. Most of the studies were done in
The analysis showed no significant association with increased risk for five of the genes. But there was a moderately increased risk for one variant of a gene for plasma protein V and one for the protein prothrombin. Both genetic variants increase the body's production of thrombin, an enzyme that encourages formation of blood clots.
The increased risk is not great, Danesh said. Persons who carry the variant genes have a 15 percent to 20 percent higher risk of developing heart disease than those who do not, the analysis showed. And the genetic variants aren't common, with about 3 percent of whites carrying the protein V version and 1 percent carrying the prothrombin version.
"They are not common enough or associated with enough risk to warrant screening for them," Danesh said. "In the future, if a number of weakly acting gene variants are identified, that might warrant screening. At the moment, the question is hypothetical."
More information
The role of heredity in heart disease is discussed by the American Heart Association.
Rheumatoid arthritis costly for employers
By Amy Norton
Reuters Health
Friday, February 24, 2006
The medical costs of employees with rheumatoid arthritis are among the highest of any chronic health condition, new research suggests.
In a study of nine large
Considering direct medical expenditures and indirect costs -- like disability payment and lost work days -- RA was second only to kidney failure in expense. Nearly all of the excess costs of RA were for direct medical care.
Still, lost productivity was not "unimportant," lead study author Dr. Ronald J. Ozminkowski told Reuters Health. The typical RA patient, he said, lost about 12 days of work per year for sick days, and three to four more due to short-term disability.
To help cut these costs, the study authors conclude, employers should try to recognize which on-the-job factors contribute to disability among workers with RA.
Ozminkowski, a researcher at Thomson Medstat in
Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the lining of the joints, causing repeated episodes of inflammation, stiffness and pain. Over time, the affected joints may lose their normal shape and alignment, leading to disability.
Treatment includes a number of costly options: medications known as disease-modifying antirheumatic drugs, like methotrexate, which aim to slow the course of RA; and newer drugs called TNF-inhibitors that alter the abnormal immune response seen in the disease, and are given in injections or through an IV.
In addition, some people with RA eventually need surgery, such as joint reconstruction or replacement.
According to Ozminkowski and his colleagues, the high cost of RA is "potentially manageable" for employers as well as workers, who foot at least part of the medical bill.
For one, they recommend, employers should carefully consider RA-related benefits when choosing a health plan.
Health plans should allow "quick access" to specialists so that RA can be diagnosed early and treated properly, Ozminkowski said. Access to more-advanced drugs, rather than simple painkillers, he added, should happen "up front," rather than only later in the course of the disease.
"RA needs to be diagnosed quickly," he noted, "so that early treatment with disease-modifying drugs can be used to slow the progress of the condition."
Changes in the work environment might also help minimize absenteeism and disability costs, according to Ozminkowski and his colleagues.
One study found that employees with RA whose work areas were modified in some simple way -- such as a change in the computer keyboard position or a footstool added to the desk area -- were 2.6 times less likely to have a work disability than employees without such modifications.
Source: Journal of Occupational and Environmental Medicine, February 2006.
Protein Interactions Offer Up Clues to Disease
HealthDay News
Friday, February 24, 2006
FRIDAY, Feb. 24 (HealthDay News) -- The first large-scale analysis of interactions between proteins in human cells has revealed information that may help scientists identify new genes that cause genetic diseases.
Researchers at
The researchers found that proteins encoded by mutated genes involved in inherited disorders were likely to interact with proteins already known to cause similar disorders. The study also disputes the long-held belief that a specific protein's relative importance is always indicated by the number of other proteins it interacts with in a cell.
The findings appear in the March issue of the journal Nature Genetics.
"Genes are important because they are the blueprints for proteins, but proteins are where the action is in human life and health," Dr. Akhilesh Pandey, an assistant professor in the Institute of Genetic Medicine and the departments of biological chemistry, oncology and pathology at Johns Hopkins University School of Medicine, said in a prepared statement.
"This ability to find links between sets of proteins involved in different genetic disorders offers a novel approach for more rapidly identifying new candidate genes involved in human diseases," he added.
More information
The U.S. National Human Genome Research Institute explains genetics.
Wheezy allergic kids may grow into asthmatic adults
By Michelle Rizzo
Reuters Health
Friday, February 24, 2006
Children who have airway hyperresponsiveness, a symptom of asthma, and allergic manifestations have an increased risk of developing asthma by the time they become adults, according to Danish researchers.
Dr. Celeste Porsbjerg, of
At entry in 1986, roughly 4 percent of the group had asthma. This increased to nearly 12 percent by the second survey.
According to the team, wheezing in childhood raised the risk of asthma and allergic sensitization to house dust mites in adulthood more than threefold. Having dermatitis as a child also raised the risk of asthma in adulthood.
"The development of asthma in young adults could be predicted in 67 percent of cases by factors that were already present in childhood," Porsbjerg explained in an interview with Reuters Health. "Among people who do not have any of these factors in childhood only a very few (4 percent) went on to develop asthma in adulthood."
If it's possible to identify those at risk of developing asthma, then "early intervention is a possibility," Porsbjerg noted. "An example of intervention could be immunotherapy," she said. "Individuals who are allergic to house dust mites and who also have hyperresponsive airways, have a very high risk of developing asthma, and in these subjects immunotherapy could be indicated in order to stop this development."
Source: Chest February 2006.
Health Tip: Seniors Who Exercise
HealthDay News
Friday, February 24, 2006
(HealthDay News) -- Certain sports injuries are more common in people over age 50. These include muscle strains to the neck, back, shoulder, knee and ankle. These areas may be rigid from infrequent use or they may be weakened by conditions such as osteoporosis.
To help prevent injuries, Barnes-Jewish St. Peter's Hospital recommends you:
Stand on one leg for up to 30 seconds to build muscle strength and improve balance. Warm up for at least 10 minutes before exercising or participating in a sporting event. Alternate the type of physical activities that you engage in. Start a strength-training program, by beginning with strength training machines and progressing to free weights. Make sure you have expert guidance. Allow time for a cool-down period after exercising, so your heart can accommodate the change. Always check with your doctor before starting an exercise program.
Thursday, February 23, 2006
Weakened Immune System May Cause Crohn's Disease
By Amanda Gardner
HealthDay Reporter
HealthDay News
Thursday, February 23, 2006
THURSDAY, Feb. 23 (HealthDay News) -- A weak immune system, rather than an overactive one, may be responsible for Crohn's disease, a new study reports.
Even more surprising, the researchers also believe Viagra may aid in the treatment of Crohn's by restoring normal blood flow to the intestines.
"When you see a patient with Crohn's, you find they have a lot of inflammation, so it's been assumed that they have a hyper-inflammatory response," said Dr. Anthony W. Segal, a professor of medicine at University College London. "But we believe that the underlying problem is not hyper[activity], but failure of the acute inflammatory response."
Segal is the senior author of a paper detailing the findings in the Feb. 25 issue of The Lancet.
But others feel that the work does not really break new ground. "There have been other studies in the last year or two that Crohn's disease is really a problem dealing with bacteria in the colon and the inflammation is set up because there's more of a defective immune response to the bacteria in the gut," said Dr. John Thompson, director of the division of pediatric gastroenterology and nutrition at the University of Miami's Miller School of Medicine.
People with Crohn's disease have chronic inflammation, usually of the small intestine, which results in pain and diarrhea.
Many experts believe that disease flare-ups are caused when immune system cells release excess amounts of molecules called cytokines, which attack the intestinal cells and cause the inflammation.
The actual cause of the disorder remains unknown.
These British researchers investigated the possibility that immunodeficiency might be at the root of the problem.
Segal and his colleagues measured the number of neutrophils (white blood cells) produced by Crohn's patients in response to trauma in the bowel and on the surface of the skin.
Surprisingly, these patients produced 79 percent fewer neutrophils and inflammatory mediators compared with healthy individuals subjected to the same trauma.
When a harmless form of bacteria was injected under the skin, blood flow in healthy volunteers increased tenfold over 24 hours. But in people with Crohn's disease, blood flow increased only fourfold.
"There's nothing wrong with the cells. The messages to accumulate cells are missing," Segal explained.
"Zillions of bacteria are growing in the lining of the bowel and there's a very effective barrier, but sometimes it breaks down," he continued. "When this happens, bacteria get through to the wall of the bowel."
In normal people, the bacteria is gobbled up and cleared away. Not so in Crohn's, where a weakened immune response allows the bacteria to linger.
Restoring normal blood flow allows the necessary cell "workers" to clear away the problem. And because Viagra works by enhancing blood flow, the researchers decided to try it.
"We showed that Viagra restored the blood flow to almost normal levels, suggesting that it might be an effective therapy," Segal said.
Which doesn't mean Crohn's patients should go off their medication and start taking Viagra.
"Existing treatments are the best we've got," Segal warned. "We don't want people to go off them."
Thompson, however, said that the size of the study sample was too small to draw any real conclusions and also dismiss Viagra a non issue.
"It happened that the people with Crohn's, after the bacteria was injected, had a significantly diminished blood flow response, which Viagra was able to reverse. But the Viagra thing is really not at all important," he added.
More information
Learn more about Crohn's disease from the National Digestive Diseases Clearinghouse.
Obesity, estrogen breakdown tied to breast cancer
Reuters Health
Thursday, February 23, 2006
Among women not using hormone therapy, obesity and the byproducts of estrogen breakdown appear to raise the risk of breast cancer, according to findings published in the International Journal of Cancer.
"Hormone therapy and body mass index (BMI) have been associated with postmenopausal breast cancer," Dr. Francesmary Modugno, of the
BMI is the ratio of body weight and height, and a score of 30 or higher is considered obese.
The researchers analyzed data from subjects enrolled in the Observational Study of the Women's Health Initiative to examine relationships among obesity, hormone therapy, estrogen metabolism and breast cancer. They compared levels of two estrogen metabolic chemicals, 2-OHE1 and 16-alpha-OHE1, in 200 women who developed breast cancer and in 200 who did not.
In women who used hormone therapy, there was a modest but significant increase in 16-alpha-OHE1 and significantly higher 2-OHE1 levels in both groups. For these subjects, there was no association among BMI, estrogen metabolism and breast cancer risk.
For women who did not use hormone therapy, however, "greater BMI and higher 16-alpha-OHE1 were individually and jointly associated with increased cancer risk," the investigators found. Compared with women with low BMI and low estrogen metabolite levels, those with a high BMI and high 16-alpha-OHE1 were 3.5-times more likely to develop breast cancer.
Estrogen metabolism is affected by both BMI and hormone therapy, the team concludes, "potentially explaining the interaction between BMI and hormone therapy in relation to breast cancer risk."
Source: International Journal of Cancer, March 2006.
Vitamin D Protects Against Tuberculosis
By Ed Edelson
HealthDay Reporter
HealthDay News
Thursday, February 23, 2006
THURSDAY, Feb. 23 (HealthDay News) -- Discovery of the molecular mechanism that the body uses to fight off tuberculosis could open the way to use of ordinary vitamin supplements to help prevent the disease, researchers report.
The finding also helps explain why blacks are more vulnerable than whites to tuberculosis and why they develop more severe cases when infected, according to a study in the Feb. 23 online issue of Science.
The story starts about a decade ago, when research revealed that the immune system of fruit flies produces a protein that attacks bacteria and fungi, explained study author Dr. Robert L. Modlin, chief of dermatology at the
"In 1999, it became clear that there were equivalents in humans, a family of proteins," Modlin said. "Each recognizes a defined biochemical from a bacterium or virus."
Studies showed that in mice, the defense involved production of nitric oxide to fight infection. However, that was not found to happen in human cells, Modlin said.
Four years of work led to the finding that the human defense mechanism involves vitamin D, he said. White blood cells are stimulated to convert ordinary vitamin D -- which is produced, in large part, by exposure to sunlight -- into an active form that is used to make a protein that kills the tuberculosis bacteria.
"Our other main finding was that African-Americans, who are known to be more susceptible to tuberculosis, have lower levels of vitamin D in their blood," Modlin said. Melanin, the pigment that darkens skin, absorbs the ultraviolet rays of sunlight, reducing vitamin D production in blacks, he explained.
Cells grown in blood serum from black individuals produced 63 percent less of the bacteria-fighting protein than those grown in blood serum from white people. Adding vitamin D to the cultures increased production of the protein, Modlin said.
One question raised by the discovery is whether giving vitamin D to humans can do the same thing, he said, adding, "Were hoping this paper will raise interest in that."
If the vitamin does have a protective effect, "a vitamin D supplement I think is the way to go," Modlin said. As a dermatologist, he noted, he is acutely aware of the damage that can be done by overexposure to sunlight.
However, "I can't recommend that people take vitamin D supplements yet," Modlin said. "We need to do more studies." His group is doing studies along that line, looking at "what effects vitamin D might have on the immune system."
There's a possibility that the work might have implications beyond tuberculosis, Modlin said. "Our results indicate we have much yet to learn about human immune responses to infections," he said.
More information
Questions about tuberculosis are answered by the U.S. Centers for Disease Control and Prevention.
Soup Giant Finds a New Way to Cut Sodium
The Associated Press
Thursday, February 23, 2006
Executives at the Campbell Soup Co. have heard the same thing almost since Andy Warhol was making art out of their cans in the 1960s: Lower the sodium in soup without sacrificing taste and people will eat even more of it.
Now, after years of gradually reducing the sodium in its soups, the Camden-based company says it has made a breakthrough: natural, low-sodium sea salt. It will be used in about 30 soups — both new and reformulated recipes — scheduled to be on supermarket shelves in August,
"We've been everywhere on the globe trying to find a sea salt with all the characteristics of this one," Chief Executive Douglas R. Conant told The Associated Press in an interview.
The company is hoping the lower-sodium salt will help soup sales, which have stabilized recently after losing ground to other convenience foods in the 90's.
Regular table salt is 99.7 percent sodium chloride. The federal Food and Drug Administration says that adults should eat no more than 2,300 milligrams a day — or just under a teaspoon.
A few years ago, the average serving of a
The sea salt in the new soups has 40 percent less sodium than the regular stuff, said George Dowdie,
The salt change will give the company room to tout other health benefits of its soups, like it did back in the 1980s with its "Soup is good food" ads. The company agreed to halt that campaign after the government complained in 1989 that it was misleading because of the high sodium levels.
Under FDA rules, foods must meet several criteria — such as containing certain nutrients and having low cholesterol levels — before its label and advertisements can bill it as "healthy." Many of
Some of the soups — including four to six varieties of the hearty Chunky soups — will get below that threshold thanks to the sea salt. The company then will market them as healthy and advertise how they are low-calorie, low-fat, vegetable-rich foods.
"We look at it as the enabler to talk about the other health benefits of soup," said Denise Morrison, president of
The sea salt also is being used in Campbell's 12 child-oriented soups, such as Chicken Alphabet and Kids Shapes, and versions of the soups the company calls its icons — chicken noodle, tomato and cream of mushroom.
The sodium reduction is the latest phase of efforts to revive a once-mighty company that fell into hard times in the late 1990s. When Conant took over in 2001, he promised to revive the condensed soup business, which had been slipping for years as more convenient quick-meal options emerged.
The company has made strides in quality, using a new process to mix its soups that allows for bigger chunks of vegetables and a fresher taste, and introducing a higher-priced line of gourmet soups. It has also worked on convenience, adding microwavable soup bowls, drinkable soups, putting pop-top lids on cans and coming up with a new system to organize the soups in supermarkets.
Wall Street was mildly encouraged by the changes.
"In terms of the actual soup business, they're doing as much as they can do," said Thomas C. Morabito, an analyst who follows the company for Susquehanna Financial. He said there's just not much room for growth in the soup business, which
On the Net:
Campbell Soup Company: http://www.campbellsoup.com
Information on sodium: http://www.americanheart.org/presenter.jhtml?identifier4708
Teflon-Linked Dangers May Not Stick
By E.J. Mundell
HealthDay Reporter
HealthDay News
Thursday, February 23, 2006
THURSDAY, Feb. 23 (HealthDay News) -- You could almost hear a resounding clank across America this month as thousands of health-conscious cooks tossed out their Teflon non-stick cookware, following the news it might emit a suspected carcinogen.
But there may be hope for all those once-beloved, now-beleaguered pots and pans.
So says George B. Corcoran, a noted toxicologist and chairman of the department of pharmaceutical sciences at
Corcoran is a member of the U.S. Environmental Protection Agency advisory committee that issued its report labeling the compound -- perfluorooctanoic acid (PFOA) -- a "likely carcinogen" earlier this month. It was that announcement, along with recent EPA and industry moves to eliminate PFOA from Teflon and other stain-resistant coatings, that sent the issue from the frying pan straight into the media firestorm.
But Corcoran said there was no need to panic.
"Do I still use Teflon cookware, even though I've been on this panel for over a year and a half now?" he said. "The answer is: Yes."
According to Corcoran and other experts, the evidence for PFOA-related harm from everyday cooking remains slim. "My sense is that we [scientists] are being prudent in reducing further exposure, because we just don't know what the bottom line is yet," he said.
For its part, the EPA on its Web site says that, because of "scientific uncertainties at the present time, EPA does not believe there is any reason for consumers to stop using any consumer or industrial related products that contain PFOA."
PFOA is what industrial chemists call an "intermediate chemical" -- something produced during the manufacturing process, but not necessarily present in the finished product, or present in only small amounts.
In fact, another EPA advisory panel member, James E. Klaunig, a professor of toxicology at the Indiana University School of Medicine, said, "My understanding from experience with the PFOA studies is that once the Teflon is produced as a coating, the PFOA is no longer available chemically. Thus it can not leach from the Teflon."
That statement is echoed by French cookware maker T-FAL. On their Web site, the company explains that PFOA is a breakdown product of polytetrafluoroethylene, an ingredient in non-stick coatings. As part of the manufacturing process, the company "cures" T-FAL pots and pans at very high heat (572 degrees Fahrenheit) which they say eliminates PFOA from the finished product. The result: "T-FAL non-stick coatings DO NOT contain PFOA," according to the company.
Experts note, as well, that trace residues of PFOA in cookware would only escape at very high heat -- although pinning down that heat threshold is tricky. While T-FAL cites a threshold of 752 degrees F, experts elsewhere tend to place it at about 600 degrees F. Experts at the Washington-based Environmental Working Group -- which has lobbied hard to ban PFOA -- note that a preheated pan placed on high heat can reach over 600 F in two to five minutes.
Corcoran said that even though he's holding on to his non-stick cookware, he does tend to cook at somewhat lower temperatures now.
Numerous animal studies have suggested that PFOA, which is also used in the manufacture of fast-food paper containers, stain-resistant fabric coatings, and other products, can boost liver toxicity and raise risks for liver, pancreatic and thymus cancers.
Studies in humans have so far been largely restricted to workers exposed to high levels of PFOA in their environment. "These workers are exposed to a range of other things, of course, so interpreting the data in those studies is extraordinarily difficult," Corcoran said.
However, "a big concern is that PFOA-related substances tend to have long half-lives in the body," explained Kendall Wallace, president of the Society of Toxicology and a professor of biochemistry and molecular biology at the University of Minnesota Medical School, in
That's important, he added, because most non-epidemiological studies done so far have involved only short-term exposures in animals.
"That may or may not reflect what might happen in a real-life system, where you or I might get low doses [that accumulate] over months, years or decades," Wallace said. "Time won't allow us to do those studies, of course."
The bottom line, according to Wallace, is that actual human exposures from everyday use of cookware or other products remains "a big question mark." He believes consumers need to follow the data as it emerges and make up their own minds on the issue. As scientists, he said, "we try and take a very conservative approach and try and limit any unanticipated health risks."
For those still contemplating a switch away from Teflon, Corcoran noted that alternatives may have risks, too.
"We're talking in my house about pulling out all of our well-aged cast-iron skillets," he noted. "But you get iron coming off of those, and scientists know that iron stimulates free-radical production in your body. So, who knows -- maybe that higher load of iron is more dangerous than what we're now getting off of Teflon."
More information
Head to the EPA for more on PFOA.
High mortality risk of anorexia nervosa confirmed
Reuters Health
Thursday, February 23, 2006
Full recovery from anorexia nervosa is slow, and women with the disease have close to a nine-fold increased risk of death, according to a new 12-year study of severely ill anorexia patients.
"The long-term course of anorexia nervosa is not very favorable," Dr. Manfred M. Fichter of the
Fichter and his team followed 103 women who had been hospitalized for anorexia nervosa at an average age of about 25. The researchers point out that anorexia nervosa patients who are treated during adolescence fare much better than those who undergo treatment as adults, like the women in the current study. Patients in this study had unusually severe disease and some resistance to treatment, and most had attempted treatment previously.
Overall, the study participants fared worse in the 2 years following treatment, then showed gradual improvement over the next 10 years.
At 12 years after hospitalization, almost 30 percent of the study participants still had anorexia nervosa. Just over half had no major eating disorder. Overall outcome was good for 27.5 percent of patients, intermediate for 25.3 percent, and poor for 39.6 percent. Seven patients had died, all from causes related to the disease.
The researchers found that women who fared poorly were more likely to also have sexual problems and impulsively. They also had suffered from their eating disorder longer before receiving treatment for the first time.
Overall mortality was 8.8 percent, the researchers found, nearly nine times higher than would be expected in a group of healthy women of the same age over the same time period. Other studies have found similar, "alarmingly high" mortality rates for anorexic patients treated during adulthood, they note.
Source: International Journal of Eating Disorders, March 2006.
Smoking Boosts Risk for Root Canal
HealthDay News
Thursday, February 23, 2006
THURSDAY, Feb. 23 (HealthDay News) -- Cigarette smokers have something new to add to their list of reasons to quit: Research shows they are 70 percent more likely to need a root canal than nonsmokers.
"The findings substantiate what most of us already know: smoking is detrimental to your health," study author Elizabeth Krall Kaye, an epidemiologist at the Boston VA Hospital and a professor in the department of health policy and health services at Boston University's School of Dental Medicine, said in a prepared statement.
Cigar and pipe smokers were only at a slightly increased risk for root canal, according to the study, which tracked the dental and physical health of a group of more than 800 men for 30 years.
The men's dental health was checked every three years, along with information about their smoking habits.
"But because root canal is so common -- it's estimated that half of
She discussed the findings Thursday at a media briefing sponsored by the American Dental Association and American Medical Association. The study will appear in the April issue of the Journal of Dental Research.
"The total amount of time smoked and the total time they remained smoke-free was directly related to their risk [of root canal]," Kaye said. "For example, the teeth of a man who smoked for less than four years had a likelihood of treatment that was 20 percent greater than that of nonsmokers, but the risk doubled in men who smoked anywhere between five and 12 years, and was 120 percent greater for men who smoked for more than 12 years. The good news is that after being smoke-free for nine years, the risk returned to the level of men who never smoked."
"While our research doesn't explain why the risk is increased among cigarette smokers, we suspect that the body's reduced infection-fighting capabilities as a result of smoking may contribute," Kaye said.
"Other studies have also suggested that smokers experience more dental cavities, which is a major reason for root canal treatment. Hopefully, future research will be able to identify the mechanisms that explain why cigarette smokers have more root canal treatments."
More information
The American Dental Association has more about root canal.
Sweaty Cotton Socks Worst for Blisters
By Jeff Douglas
Associated Press Writer
The Associated Press
Thursday, February 23, 2006
Sweaty socks made from 100 percent cotton are the worst when it comes to causing nagging blisters, a study found.
But doctors say there's no reason to get your cotton socks in a bunch, unless your feet are regularly active and you are prone to blisters. The study results are mostly useful to athletes, diabetics with circulation problems and people who wear prosthetics.
Biological engineering students at the University of Missouri-Columbia tested 10 popular brands of athletic socks and separated the good from the bad with a device that measured moisture and friction, which causes blisters.
All-cotton socks are most likely to cause blisters on sweaty feet, according to research data, while nylon socks performed the best. Socks that were a cotton-synthetic blend scored somewhere between the two.
"The uniqueness of this study is they took a wide variety of socks and examined different levels of moisture," said John Viator, the assistant professor who advised the researchers.
The findings showed that the sock's material matters most, not brand or price, he said.
In the coming weeks, Markus Smiley and his student colleagues plan to take the research to its final and possibly most unpleasant step.
They'll measure the sweat on different socks worn by intramural basketball players after an hour of activity to determine the amount of moisture an average foot produces.
"It seems disgusting and I'm not too excited about it," Smiley said. "But it's going to let us know how significant our data for moisture is compared to real life."
The study was sponsored by Tamarack Habilitation Technologies, Inc. in
A survey by the American Podiatric Medical Association found that 29 percent of people buy socks made for specific activities such as running, hiking or skiing.
"Being aware of the sock's material is something that we typically tell patients to do," said Dr. Jim Christina, a podiatrist and spokesman for the APMA.
Christina said diabetics often have trouble detecting foot blisters because poor circulation dulls the awareness of problems.
"Really, it depends, if you're not on your feet all day, cotton socks are fine," he said. "But it's those special instances that you want to pay more attention to what you wear."
On the Net:
American Podiatric Medical Association: http://www.apma.org
Health Tip: Rare Condition Predisposes People to Cancer
HealthDay News
Thursday, February 23, 2006
(HealthDay News) -- Some people are at high risk for colorectal cancer because of a genetic mutation known as Lynch syndrome.
People with Lynch syndrome have more than an 80 percent chance of developing colorectal cancer, usually at a younger age than colorectal cancer attributed to other causes, according to the Mayo Clinic.
Lynch syndrome is responsible for about 3 percent to 4 percent of colorectal cancer cases, the Mayo Clinic says.
Symptoms of Lynch syndrome, typical of colorectal cancer in general, include:
Constipation or diarrhea that persists for several days. Visible blood in the stool. Abdominal cramps or pain. Fatigue or weakness. Loss of appetite. Unexplained weight loss.
Genetic testing can determine if you have the disorder.
Potato lovers may have higher diabetes risk
Reuters Health
Thursday, February 23, 2006
Holding that side of fries might help thwart type 2 diabetes, new research suggests.
In a long-term study of nearly 85,000
The link was strongest among obese women, who are already at increased risk of the disease, suggesting that heavy potato consumption may pose a particular problem for them, the researchers point out.
The findings are published in the American Journal of Clinical Nutrition.
Though potatoes have healthful attributes, they also have a high glycemic index (GI) -- meaning they cause a rapid, strong rise in blood sugar. Over time, these surges may damage the pancreatic cells that produce the hormone insulin, which is needed to metabolize blood sugar.
Overweight or sedentary adults may be particularly vulnerable to the effects of high-GI foods because they often have underlying insulin resistance -- a precursor to diabetes in which body cells lose their sensitivity to insulin.
So it would make sense for these individuals to lay off the french fries, Thomas L. Halton, the lead author of the new study, told Reuters Health.
He and his colleagues found that women with the highest potato intake were 14 percent more likely than those with the lowest intake to develop diabetes over 20 years. And women who ate the most french fries, specifically, had a 21 percent greater risk of diabetes than those who ate the fewest.
Overall diet and other lifestyle habits did not explain the link, and potatoes seemed to be more problematic when a woman ate them instead of whole grains.
Whole grains -- as well as many high-fiber vegetables, fruits and legumes -- have a lower GI than potatoes and white-flour products. So eating those foods in place of potatoes, Halton's team concludes, could potentially cut diabetes risk.
Source: American Journal of Clinical Nutrition, February 2006.
Health Tip: Paxil and Pregnancy Don't Mix
HealthDay News
Thursday, February 23, 2006
(HealthDay News) -- Researchers have found that taking Paxil, a popular antidepressant, in the first three months of pregnancy can increase the risk of birth defects, the U.S. Food and Drug Administration said in a December 2005 news release.
"FDA is advising patients that this drug should usually not be taken during pregnancy, but for some women who have already been taking Paxil, the benefits of continuing may be greater than the potential risk to the fetus," the agency said.
The FDA recommends that expectant mothers who are taking -- or considering taking -- Paxil and similar antidepressants discuss with their doctors the potential risks and benefits.
Group Says Chromium Risks Withheld
By Hope Yen
Associated Press Writer
The Associated Press
Thursday, February 23, 2006
Worried about stricter regulations, the chromium industry withheld key data from the government involving the health risks of workers exposed to the carcinogenic metal, according to a study released Thursday.
The paper by
Hexavalent chromium, the chemical featured in the 2000 movie Erin Brockovich, is used in chrome plating, stainless steel welding and the production of chromate pigments and dyes. Approximately 380,000 welders, steelworkers and jewelers are exposed to it on the job.
The new findings come one week before the U.S. Occupational Safety and Health Administration was scheduled, by court order, to issue a new standard on acceptable workplace levels of chromium. A federal appeals court set the Feb. 28 deadline after Public Citizen sued over delays in issuing a rule.
"The circumstances regarding this study raise troubling questions about the ability of the government to effectively issue rules protecting public health when studies are conducted, controlled and selectively published," said Peter Lurie, deputy director of Public Citizen's Health Research Group.
OSHA said it was working hard "to produce a final rule that complies with the court's order." A spokeswoman, Sharon Worthy, declined additional comment.
Kate McMahon, an attorney representing the trade group Chrome Coalition, called charges that the industry was scheming to manipulate data "completely unfounded and wrong."
She said the industry told OSHA in 1998 that it was planning a four-site study — two in the
According to the paper, in 1997 industry groups commissioned the study on chromium's risks in anticipation of an OSHA move to further restrict workplace levels of the metal.
But once the study was completed in 2002, industry groups gave OSHA selected data suggesting that only the highest — and not intermediate — exposure of chromium led to a significantly higher risk of lung cancer death.
"Public health rulemakings should not be based on partial records or limited by scientists' career concerns, particularly when lives hang in the balance," the paper says.
Public Citizen and the paper's lead author, David Michaels of
Public Citizen says it has submitted the complete four-site data to OSHA. But it's unclear whether OSHA is considering the information because it came after the agency stopped accepting material for its rule-making process, the watchdog group said.
Currently, OSHA regulations cap chromium levels at work to 52 micrograms per cubic meter. It supports restricting levels to 1 microgram per cubic meter, which is slightly lower than "intermediate" exposure levels of 1.2 to 5.8, according to the paper.
Public Citizen is urging OSHA to restrict the level to 0.25 microgram per cubic meter.
On the Net:
A copy of the paper: http://www.ehjournal.net/content/5/1/5
Public Citizen: http://www.citizen.org/
OSHA: http://www.osha.gov/
Flu's Resistance to Some Drugs Causes Concern
By Meryl Hyman Harris
HealthDay Reporter
HealthDay News
Thursday, February 23, 2006
THURSDAY, Feb. 23 (HealthDay News) -- The most common type of seasonal flu has now become resistant to widely used antiviral medications, experts say.
Writing in the Feb. 23 issue of the New England Journal of Medicine, Dr. Frederick G. Hayden repeated the recent warning from the U.S. Centers for Disease Control and Prevention that H3N2 (influenza A) has become resistant to two members of the M2 ion-channel inhibitor family of drugs, amantadine and rimantadine.
Prior surveillance had shown that the drugs failed against resistant flu strains in about 2 percent of cases. But that statistic jumped dramatically to about 70 percent in Asian countries by the 2004-2005 flu season, and 15 percent in North America and
"This is really unprecedented," said Hayden, a professor of internal medicine and pathology in the Division of Infectious Diseases and International Health and the
Flu experts stress, however, that seasonal strains are still responsive to two antivirals being stockpiled to combat bird flu -- Relenza (zanamivir) and Tamiflu (oseltamivir). And vaccines aimed at preventing flu in the first place continue to be effective.
Amantadine is available over-the-counter in
Growing resistance to the two drugs led doctors to write 1.7 million prescriptions for Tamiflu last year, according to the article. However, the drug isn't yet available in quantities to satisfy current needs for seasonal flu and meet government stockpiling efforts in anticipation of a potential bird flu pandemic.
Inhaled Relenza, effective against both kinds of flu, is also available in limited quantities, in part because it has not been widely used and insurance companies won't pay for it when other drugs are cheaper.
Bucher said there is sometimes resistance to Tamiflu, but Relenza generally works in those cases. "I thought it was very interesting that Hayden said a combination of M2 [ion-channel inhibitor drugs] and neuraminidase inhibitors enhanced antiviral effects. They have to do more work on that, but that's good news," she said.
Generally, viruses become less virulent as they become resistant to medications, Bucher added. But that hasn't been the case with the influenza A.
To combat the illness, there has to be better identification of resistance in viruses and individuals, and the supply of drugs has to be increased, Hayden said. Fewer than 40,000 courses of inhaled Relenza are available in the
"We have to increase production capacity and bring other alternatives to approval so we aren't dependent on the single drug, Relenza," said Hayden.
But it's not time to disregard the other medications, he said.
"We don't know when the [avian flu] pandemic may occur or what the virus type may be," he said. "It could be susceptible to the older class of drugs."
More information
For more on influenza and how to prevent it, head to the U.S. Centers for Disease Control and Prevention.
Wednesday, February 22, 2006
"Prehypertension" increases cardiovascular risk
By Will Boggs, MD
Reuters Health
Wednesday, February 22, 2006
People who have "prehypertension," blood pressure levels just below the cut-off for a diagnosis of high blood pressure, have an increased risk of cardiovascular disease, according to a report in The American Journal of Medicine.
Individuals with prehypertension, in the range of 120/80 to 139/89 mm Hg, who are elderly, obese, diabetic or African American have an even higher risk of cardiovascular disease, Dr. Abhijit V. Kshirsagar from the
Kshirsagar and colleagues investigated the relationship between prehypertension and the risk of new cardiovascular disease in nearly 9,000 men and women participating in the Atherosclerosis Risk in Communities study.
At the beginning of the study, patients with high-normal blood pressure also had a greater prevalence of traditional risk factors for cardiovascular disease compared with the optimal blood pressure group, the authors report.
The rate of cardiovascular disease over the 11.6 years of follow-up increased significantly as blood pressure levels increased.
Compared with patients with optimal blood pressure, those with high-normal blood pressure had a 2.5-fold risk of developing cardiovascular disease, after consideration of other recognized cardiovascular risk factors.
Compared with optimal blood pressure, normal and high-normal blood pressure were associated with the development of cardiovascular disease among all subgroups, the results indicate. Most of the cardiovascular diseases that emerged were related to coronary heart disease rather than stroke.
Cardiovascular disease risk was especially high among blacks, diabetics, obese patients and those with LDL levels, the "bad" type of cholesterol, between 100 mg/dL and129 mg/dL, the investigators observed.
Prehypertension is clearly associated with a significant increase in cardiovascular disease," the researchers conclude.
"The prehypertensive population is large," Kshirsagar added. "Studies targeted at this population have the potential to make a significant impact."
Source: The American Journal of Medicine, February 2006.
When It Comes to Kids' Ear Infections, Hold the Antibiotics
By Karen Pallarito
HealthDay Reporter
HealthDay News
Wednesday, February 22, 2006
TUESDAY, Feb. 22 (HealthDayNews) -- Your infant is running a fever and has been clingy and inconsolable most of the night. You immediately think "ear infection," and rush to the doctor's office for a prescription for an antibiotic.
At least that used to be the drill. But under new guidelines, pediatricians are more apt to recommend treating the pain but holding off on the amoxicillin. In fact, they may not prescribe an antibiotic at all.
That's a message many pediatricians are sharing during February, Kid's ENT (Ears, Nose, & Throat) Health Month.
The guidelines address the growing public health threat of antibiotic resistance. Because repeated and inappropriate antibiotic use creates "superbugs" -- bacteria that resist even the strongest antibiotics -- medical professionals are being urged to limit the overuse of these drugs.
Many parents seem to appreciate the new approach, according to Dr. Kathi J. Kemper, a professor of pediatrics at Wake Forest University School of Medicine.
"I find that a lot of parents aren't in a hurry to give antibiotics and are reassured by knowing that 80 percent of ear infections are cured by the child alone without any meds," said Kemper, author of the book, The Holistic Pediatrician: A Pediatrician's Comprehensive Guide to Safe and Effective Therapies for the 25 Most Common Ailments of Infants, Children, and Adolescents.
Middle ear infection, known as acute otitis media, is the most common bacterial illness in children and the one most commonly treated with antibiotics, according to the
This type of infection starts when germs spread to the middle ear, resulting in a build-up of pus or fluid that can cause painful pressure on the eardrum in some children. The infection can be either bacterial or viral, according to the American Medical Association.
Parents should not confuse ear infection with fluid in the middle ear. This chronic condition, called otitis media with effusion, often is picked up in a physical exam of the child because it does not cause discomfort. It has a different set of management guidelines
To treat middle ear infection, the AAP and the
"The whole purpose of these guidelines was to give people a way to intelligently and safely use this option of observing an ear infection," said Dr. Richard M. Rosenfeld, professor and director of pediatric otolaryngology at
Some health professionals avoid using antibiotics at all, while others favor more liberal use of the drugs. Each position has its downside, explained Rosenfeld. Untreated bacterial ear infections can lead to serious complications, including mastoiditis -- when infection spreads to the mastoid bone of the skull -- and meningitis -- an infection of the brain. On the other hand, treating every ear infection with antibiotics is unnecessary, and every course can make it more difficult to treat future infections in a given child, he said.
Rosenfeld sees room for a middle ground. Under the guidelines, for example, antibiotics are recommended for any child under 2 or who has severe symptoms, he said. These are the kids who benefit the most, he said.
But for a child who is 2 or older with mild symptoms or whose diagnosis is unconfirmed, it's best to watch and wait. The physician may write a prescription for an antibiotic with the stipulation that the parent should observe the child's progress before having it filled.
Parents needn't worry that they are causing their child undo misery. Studies show that antibiotics do not make the kids feel better in the first 24 hours compared with observation, assured Rosenfeld.
For pain relief, all children should be given ibuprofen or acetaminophen, especially in the first 24 hours, the guidelines recommend. Kemper prefers ibuprofen for kids who don't have a contraindication to it, since it lasts longer -- about 8 hours -- so fewer doses are needed each day.
Your pediatrician also may prescribe anesthetic ear drops to reduce pain in the ear. "I know some folks recommend them and there's good data to support them, but as a mother of a former toddler, I just couldn't get excited about holding him down and putting something in the ear," Kemper said. Gentler alternatives include using a hot water bottle swaddled in a towel or an ice bag wrapped in a wash cloth, she said.
For children requiring repeated courses of antibiotics or antibiotic injections to treat ear infections, parents may need to consider having ear tubes implanted in their child to drain liquid from the middle ear, said Rosenfeld, who discusses the regimen in his new book, A Parent's Guide to Ear Tubes.
AAP has not surveyed members to determine whether their prescribing habits have changed. But based on calls to the academy, most pediatricians are complying with the guidelines, a spokeswoman said. Many were cautious about prescribing antibiotics even before the guidelines were released, she added.
So it your child wakes up at 3 a.m. with a suspected ear infection, feel free to reach for the ibuprofen but don't worry about paging your pediatrician in the middle of the night.
"You don't have to panic," Rosenfeld insisted, "but certainly persistent symptoms need attention and clarification by the doctor."
More information
To learn more about the new guidelines for managing ear infections, visit the American Academy of Pediatrics.
Supplements fail to help mild knee arthritis: study
By Gene Emery
Reuters
Wednesday, February 22, 2006
Two food nutritional supplements widely taken by consumers including U.S.
But the study of glucosamine and chondroitin also suggested that combining them, rather than consuming one or the other, might help ease moderate to severe knee pain.
"The bottom line is, over all there wasn't any benefit over placebo," said Daniel Clegg of the University of Utah School of Medicine and the chief author of the study, which will appear in Thursday's edition of The New England Journal of Medicine.
He said the findings from tests at 16 medical centers also show that the supplements, either alone or in combination, are unlikely to stop the pain from developing in the first place.
Consumers spend about $730 million a year on the supplements, usually hoping to find relief from a condition that afflicts at least 20 million people in the
Past tests of the supplements, taken by millions of arthritis sufferers worldwide, have shown some benefit. But the rigor of some of those studies has been questioned.
The Council for Responsible Nutrition, a trade association that represents the dietary supplement industry, said Clegg's study revealed that the combination "provide significant pain relief for moderate to severe sufferers of osteoarthritis."
Clegg told Reuters that the council is focusing on the "interesting finding" in a subset of the study that only looked at volunteers whose pain was rated as moderate to severe.
Those people "did have a pretty rigorous response" to the supplements, he said.
No Better Than Placebo
But the number of people who fell into that group -- just 354 of the 1,583 volunteers -- was "not big enough to make definitive comments," so a further test would be needed to see if the benefits were real, Clegg said.
"We need to look more."
For now, "there is no evidence that these agents prevent osteoarthritis in healthy persons or in persons with knee pain" whose knees have a normal-looking X-ray, said Marc Hochberg of the University of Maryland School of Medicine, in a journal editorial.
Hochberg said it was clear that the two substances alone were no more effective than a placebo.
In the study, in which all volunteers had evidence of osteoarthritis and had been dealing with some degree of knee pain for a least six months, 60.1 percent of the people taking the placebo had a 20 percent decline in knee pain after 24 weeks.
That compared to 64 percent taking 1,500 milligrams of glucosamine each day, 65.4 percent getting 1,200 milligrams of chondroitin, and 66.6 percent taking both.
None of those improvement rates were statistically significant.
In contrast, the response rate was 70.1 percent for those taking the Pfizer Inc. pain reliever Celebrex, known generically as celecoxib.
No Link Between Cholesterol, Suicide in Alcoholics
HealthDay News
Wednesday, February 22, 2006
WEDNESDAY, Feb. 22 (HealthDay News) -- Rebutting previous research, a new study refutes the idea that low cholesterol levels can help predict alcoholics' suicide risk.
While this study of 110 alcoholic psychiatric patients found no link between cholesterol levels and suicide attempts, it did identify a "profile" of alcoholic patients at risk for suicide. The findings appear in the March issue of Alcoholism: Clinical & Experimental Research.
"Up to 7 percent of alcoholic patients die from suicide, and about one-third of these patients attempt suicide at least once in life," study corresponding author Eberhard A. Deisenhammer, an associate professor of psychiatry at
"However, since many alcoholics are reluctant to seek treatment for their problem, a significant portion of potentially suicidal alcoholic patients go undetected. We wanted to investigate if elevated serum cholesterol levels could serve to identify these individuals early enough to help them," he said.
While recent studies have found that individuals with lower cholesterol levels may be more likely to either attempt or complete suicide, there is no firm evidence linking cholesterol and suicide risk.
For their study, Deisenhammer and his colleagues interviewed and took blood samples from the 110 study volunteers grouped according to whether or not they had attempted suicide during their lifetime. The blood samples were checked for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides.
The researchers found no association between cholesterol levels and suicide attempts. However, they did identify a profile of alcoholics at risk for suicide. Those who had attempted suicide were younger, more often smokers, had more frequently co-abused benzodiazepines (used to relieve anxiety and insomnia), and scored higher on the two standard tests, the
"Maybe future studies will show that there are subgroups of patients for which cholesterol may be useful as a biological suicide marker," Deisenhammer said. "Until that time, doctors and relatives of alcoholics should consider the possibility that their patient/husband/colleague may be, or become, suicidal. Until we have easily applicable biological risk markers at our disposal, they will need to assess suicide risk primarily through conversation."
More information
The American Medical Association has more about suicide.
Alzheimer's decline faster in more-educated people
Reuters Health
Wednesday, February 22, 2006
The rate of mental decline seen with in patients with Alzheimer's disease is directly related to the educational level of the affected individual, according to a report in the Journal of Neurology, Neurosurgery, and Psychiatry.
The new findings are based on a study of 312 patients living in
Overall, mental agility fell by 9 percent of a standard deviation each year, lead author Dr. Nikolaos Scarmeas and colleagues, from
Memory and executive speed, which includes the ability to adapt to change and organize thoughts, were the primary areas affected by education level, the report indicates.
Further analysis showed that the link between education and mental decline was not influenced by age, mental function at the time of diagnosis, or other factors known to influence brain function, such as depression and vascular disease.
Previous studies have provided evidence that high levels of education can delay Alzheimer's disease. The "cognitive reserve" hypothesis has been put forth to explain the effects of education on Alzheimer's disease, Scarmeas and colleagues note.
This theory, they explain, holds that highly educated individuals have more intellectual reserve so the onset of overt Alzheimer's disease symptoms is delayed. However, once symptoms become apparent, more damage has accumulated than in less educated brains, so the subsequent decline in mental function is more rapid.
Source: Journal of Neurology, Neurosurgery, and Psychiatry, March 2006.
Loud Music Helps Drive Ecstasy Brain Damage
HealthDay News
Wednesday, February 22, 2006
WEDNESDAY, Feb. 22 (HealthDay News) -- Research with hard-rockin' rats suggests that loud music extends the harmful brain effects of the club drug ecstasy for up to five days.
Researchers in
If the rats weren't exposed to loud music, the drug's effects wore off within a day.
During the experiment, the team at the
Without music, a low dose (3mg/kg) of ecstasy did not modify the rats' brain activity any more than a dose of saline solution. However, loud music prompted significant changes in the brain activity of rats who received a low dose of the drug.
A high dose (6mg/kg) of ecstasy alone caused a reduction in the rats' brain activity and that effect was enhanced when loud music was played and lasted for up to five days. The brain activity of rats that received a high dose of the drug but were not exposed to loud music returned to normal within a day.
Rats that received saline solution and were exposed to loud music showed no changes in brain activity.
More information
The Nemours Foundation has more about ecstasy.
Doctors may offer heart ops without missing a beat
Reuters
Wednesday, February 22, 2006
Surgeons may soon be able to operate on a beating heart using software that synchronises its pumping action with the movement of robotic surgical tools, New Scientist magazine reported on Wednesday.
Special motion software, developed at Imperial College London, has been designed for use with a surgical robot to perform procedures such as bypass surgery, the magazine said.
In traditional bypass surgery, the heart is usually stopped and an artificial pump used to keep the blood flowing around the body. But this is traumatic as it involves opening up the heart and means the blood must be rerouted through a machine.
The new software, used with a robot called da Vinci, uses a two-camera endoscope that feeds images to a viewer. The software models the heart and creates a three-dimensional image which appears to the surgeon to be stationary.
At the same time, the software tracks the beating of the heart and instructs the robot's instruments to move back and forth in time with the movement.
The software has so far only been tested on artificial silicone hearts using a robotic arm.
Depression, anxious personality tied to allergies
Reuters
Wednesday, February 22, 2006
Women with major depression are more likely than women who are not depressed to have allergies, and allergies also appear to be more common in men with nervous, anxious personalities, a study has found.
The findings, from a national survey of 3,032
Past studies have linked depression and allergies, though it's not clear if one leads to the other. One hypothesis has been that people with "neurotic" personalities -- who have a tendency to be nervous, anxious and moody -- might be prone to both depression and allergies. The trait is already thought to be a risk factor for depression.
To test this idea, the authors analyzed data from a nationally representative survey of Americans between the ages of 25 and 74. Depression and personality traits were all measured using a standard battery of questions.
Overall, the researchers found, both depression and "neuroticism" were associated with a greater likelihood of allergy. Study participants with major depression were 50 percent more likely to have allergies than those without depression, while adults with neurotic personalities were 22 percent more likely to have allergies than their peers without neurotic personalities.
However, a closer analysis showed that depression and allergies were linked only among women, and neurotic personality did not explain the relationship.
In contrast, men with neurotic personalities had a higher risk of allergies, but there was no connection between depression and allergies.
Dr. Renee D. Goodwin of
More research, according to Goodwin's team, is needed better understand the connections between depression and allergies, and between neuroticism and allergies -- as well as why there are sex differences.
In the case of depression, the researchers speculate, it's possible that the disorder contributes to allergy development by impairing the immune system or through some other biological effect.
On the flip side, the stress of dealing with chronic allergies may lead to depression in some people.
Similarly, the relationship between neurotic personality and allergies could work in either direction, according to the study authors.
They note that people who are naturally anxious, for example, may be more sensitive to allergic responses and seek treatment for milder symptoms that other people might ignore.
On the other hand, although personality traits are thought to form early in life, it's possible that allergies cause some people to think more negatively in general and respond to daily stresses with more anxiety.
Source: Psychosomatic Medicine, January/February 2006.
Tuesday, February 21, 2006
Vitamin C helps preserve vitamin E in smokers
By David Douglas
Reuters Health
Tuesday, February 21, 2006
Vitamin C supplements can help reduce the high rate of vitamin E depletion that occurs in smokers, according to the findings of a small study published in the journal Free Radical Biology and Medicine.
As senior investigator Dr. Maret G. Traber told Reuters Health, "if you are under oxidative stress, have low vitamin C intakes, then vitamin E doesn't do its job as well as it should and gets destroyed."
Vitamin C supplements appear to reduce this tendency in smokers, Traber of Oregon State University,
"We studied college-age people who smoked a half a pack to a pack of cigarettes per day," she said. The subjects were randomly assigned to receive vitamin C supplements at 500 mg twice daily for 2 weeks or placebo.
After 2 weeks, the study participants switched over to the other treatment. In both phases of the study, the subjects did not know if they were receiving a supplement or placebo.
The researchers found that during the placebo phase, tocopherols, the active form of vitamin E, disappeared significantly faster in smokers than in non-smokers. The disappearance rates of blood levels of alpha-tocopherol in smokers were inversely correlated with blood levels of vitamin C.
Vitamin C supplements in both groups slowed the disappearance rate of alpha-tocopherol by 25 percent and blood levels of gamma-tocopherol by 45 percent.
"Vitamin E and vitamin C have been predicted to interact based on more than 50 years of test tube studies," Traber continued. "This is the first demonstration that vitamin E reacts with vitamin C in the human body."
Source: Free Radical Biology and Medicine, February 15, 2006.
This Chip Could Be a Lifesaver
By E.J. Mundell
HealthDay Reporter
HealthDay News
Tuesday, February 21, 2006
TUESDAY, Feb. 21 (HealthDay News) -- In the future, patients arriving in the emergency room who need immediate access to their medical records may be armed -- literally -- with a tiny, high-tech helper.
More than 1,000 Americans have already volunteered to get a microchip about the size of a grain of rice embedded in their arms. The chip -- similar to those now used to identify thousands of pets nationwide -- allows EMS and ER crews to gain quick access to patients' medical e-files should they be unable to provide them.
"So, if a patient comes in and has the chip in their arm, the hospital's system will recognize them and pull up their entire medical record," explained David Ellis, who has examined the new VeriChip in his dual capacities as corporate director for Planning and Future Studies at the Detroit Medical Center, and as co-founder of the Michigan Electronic Medical Record Initiative.
Right now, he said, emergency care staff lose precious time tracking down incoming patients' medical histories. In many cases, a patient's files are incomplete or scattered among various clinics and hospitals.
"These are often people who are outside the system or they are too old or frail to know what's happened to them in the past," Ellis said. "In many cases they may simply be unconscious, traumatically injured."
The VeriChip, developed by Applied Digital Solutions, of
Experts stress that the chip itself does not contain the patient's medical records, just a 16-digit code that a hospital scanner picks up on. That digital identifier is then used to track down the patient's medical files via computer.
While the technology sounds like a win-win for everyone, it does have its critics -- namely privacy advocates who worry the embedded chip could lead to a "Big Brother" state where computers track an individual's every move.
But Ellis believes those fears are unfounded.
"First of all, the chips are voluntary, and we believe that they should always remain that way," he said. "This technology is also very easily removed if anyone later changes their mind about having one."
He also noted that scanners can only read the chips from distances less than a few feet. "You can't be tracked by satellite," Ellis said.
Finally, "all that can be read on the chip is that ID number," he added. "So it requires that someone not only be able to read that ID number but also have access to the database that matches the ID number with the actual patient name and details."
The VeriChip is gaining slow acceptance: former U.S. Health and Human Services Secretary Tommy Thompson pledged to be "chipped" once he joined the VeriChip Corp. board of directors. And last summer, Dr. John Hamalka of
Hamalka, an avid mountain climber, said having the chip gave him added peace of mind that emergency staff would be better able to care for him should he become seriously injured. Speaking with HealthDay, he said that without the chip, "if I were to be hurt in any way, there's not a whole lot people would find on my body that would identify me."
Still, the notion that these technologies will undermine privacy remains a roadblock inhibiting their wider use, Ellis said.
"It's my job at the Detroit Medical Center to track trends, and if we think that at some point the technology makes enough sense and brings enough benefit to patients, then it's probably going to be adopted," he said. "But again, we have to be sensitive like everyone else to public perception. It's not something that we can rush into."
More information
For more on high-tech methods of improving medical care, head to the Agency for Healthcare Research and Quality.
Panel Wants Infants to Get Rotavirus Shots
By Mike Stobbe
Associated Press Writer
The Associated Press
Tuesday, February 21, 2006
An influential federal advisory panel recommended Tuesday that
Children should receive a three-dose vaccination series during roughly the first six months after birth, according to a unanimous vote by the Advisory Committee on Immunization Practices.
The panel's recommendation cannot become policy unless it is adopted by the federal Centers for Disease Control and Prevention. But the panel's recommendations commonly are adopted by the CDC, which issues vaccination guidelines to doctors and hospitals.
"This could have a substantial impact," potentially preventing tens of thousands of hospitalizations a year, said Dr. Jon Abramson, the panel's chairman.
The Food and Drug Administration on Feb. 3 licensed an oral rotavirus vaccine for infants, named RotaTeq. Manufactured by Merck & Co., the vaccine has a proposed sale price of $62.50 a dose.
Rotavirus is the leading cause of severe diarrhea in infants and children, according to the CDC. But what's of greatest concern is the vomiting and potentially fatal dehydration the disease causes, said Dr. Paul Offit, a vaccine specialist at the Children's
Worldwide, the virus causes millions of hospitalizations and an estimated 500,000 deaths each year in children under 5.
The disease's impact has been less severe in the
In children under age 5 in the
In the
"It's 'that winter vomiting thing.' And I think people don't know the name," Offit said.
According to the manufacturer, the first dose of the three-dose vaccine regimen should be administered to children between 6 weeks and 12 weeks old. The series should be completed by the time the child is 32 weeks old.
A recent study involving 72,000 infants mainly in the
The vaccine is not advised for certain children, including those with compromised immune systems and those with allergies to vaccine components.
GlaxoSmithKline is developing another rotavirus vaccine, RotaRix, which is awaiting approval by European regulators. The company expects to apply for
An earlier vaccine, RotaShield, was licensed in the U.S. in 1998, but the manufacturer — Wyeth Laboratories — withdrew it from the market a year later after rare instances of infants developing a potentially fatal condition in which the small intestine folded in on itself, like a closing telescope.
The RotaShield side effect, called intussusception, was thought to be due to the strain of virus used by Wyeth to develop its vaccine. That virus came from a rhesus monkey. The vaccines developed by Merck and GlaxoSmithKline are based on bovine and human strains, and have not had the same reported side effect.
Because of RotaShield's
If the CDC adopts the panel's recommendation, there will be 15 illnesses for which
On the Net:
CDC info: http://www.cdc.gov
Health Tip: Are Artificial Sweeteners Safe?
HealthDay News
Tuesday, February 21, 2006
(HealthDay News) -- Between meals, snacks and drinks, the average American eats the equivalent of about 20 teaspoonfuls of sugar a day, the U.S. Food and Drug Administration says.
To save calories and still satisfy a craving for sweets, many people have turned to artificial sweeteners such as saccharin and aspartame.
In an article published in the online magazine FDA Consumer, the agency said, "Questions still linger about whether saccharin may cause cancer in humans, and though the sweetener is still widely used, it carries a label that warns of its potential risks."
Aspartame, the agency continued, "has come under fire in recent years from individuals who have used the Internet in an attempt to link the sweetener to brain tumors and other serious disorders. But FDA stands behind its original approval of aspartame, and subsequent evaluations have shown that the product is safe."
"A tiny segment of the population is sensitive to one of the sweetener's byproducts and should restrict intake. However, the agency continually monitors safety information on food ingredients such as aspartame and may take action to protect public health if it receives credible scientific evidence indicating a safety problem," the FDA publication said.
Hockey body checking increases injury risk in kids
By Amy Norton
Reuters Health
Tuesday, February 21, 2006
Ice hockey players younger than high school age may not be ready for the game's hard knocks, according to Canadian researchers.
Their study of nearly 5,000 boys in youth hockey leagues found that injury rates were higher among children on teams where "body checking" was allowed as early as age 10. Broken bones and concussions were among the risks.
The findings, published in the journal Pediatrics, add to the debate over when to begin teaching young hockey players how to body check.
Body checking refers to legal moves in which hockey players knock into an opponent to get the puck. Medical groups such as the
Others argue, however, that it's best to teach children how to check properly starting at an early age. This, they say, could prevent serious injuries later on, when teenage players are much bigger and stronger.
The Canadian Hockey Association allows body checking to be introduced at age 12, and in one province --
The investigators, led by Dr. Alison Macpherson of
Between 1995 and 2002, the researchers found, 63 percent of injuries treated in hospital emergency rooms occurred in the
The children on
"On the basis of our results, we suggest that children should play hockey only in noncontact leagues until at least the age of 14," Dr. Macpherson's group recommends of
"In our opinion, it's better if better if body checking is introduced later," she told Reuters Health.
The study, Macpherson said, found no support for the notion that it's safer for children to learn checking when their bodies are smaller. Among players age 14 and up, who all practiced checking, those in early-checking leagues still had nearly twice the risk of suffering a checking injury.
The findings are based on government data collected from pediatric emergency departments in
On teams where checking was allowed, 10- to 13-year-olds were 86 percent more likely to suffer a checking-related injury than their peers on teams that limited the practice to older players. They were also 42 percent more likely to sustain a concussion and 25 percent more likely to suffer a broken bone.
Hockey Canada, the national governing body for amateur hockey, currently has several pilot projects in place to research the effects of teaching body checking to players as young as 9.
Source: Pediatrics, February 2006.
Two Drug-Coated Stents Perform Equally Well
By Ed Edelson
HealthDay Reporter
HealthDay News
Tuesday, February 21, 2006
TUESDAY, Feb. 21 (HealthDay News) -- Surgeons use them to open clogged arteries, but a major European study finds no significant difference in the performance of two models of drug-coated stents.
The results of the head-to-head comparison of the two expensive, drug-emitting mesh tubes could have major financial and medical implications.
The study, reported in the Feb. 22 issue of the Journal of the American Medical Association, was sponsored by Cordis Corp., a Johnson & Johnson unit that markets a stent coated with the drug sirolimus. That device competes with another stent coated with the drug paclitaxel, marketed by Boston Scientific.
In line with previous studies, both of the coated stents outperformed bare-metal devices in keeping arteries open. The real question has been whether one is clearly better than the other. Sirolimus has come out slightly ahead in some European studies, and it did so again in this trial --- but not overwhelmingly so.
This study, led by doctors at the Cardiovascular Institute Paris South in
The average narrowing of the artery in which a stent was placed was 9.6 percent for the sirolimus devices and 11.1 percent for the paclitaxel devices -- a difference that was not statistically significant.
The incidence of major heart problems in the 12 months after the stents were implanted was 10.7 percent in the sirolimus group and 11.4 percent in the paclitaxel group, again missing statistical significance.
A longer follow-up may be needed to see whether the differences eventually reach the threshold of statistical significance, the researchers said.
So what's a physician to do in the meantime? According to Dr. David Zimrin, director of the cardiac catheterization laboratory at the University of Maryland Medical Center, doctors may need to tailor treatment to the individual patient.
The very small differences between the two products may make one kind of stent more appropriate for one type of patient than another, he said.
For example, the paclitaxel stent is easier to implant, so it can be preferable for a patient whose arterial anatomy makes implantation difficult, Zimrin said.
On the other hand, "if there is a patient in whom you think the chances of [arterial] re-narrowing are very high, because of diabetes or already narrow arteries, you might choose the sirolimus stent," Zimrin said. "It might make a difference in that particular patient."
For patients in the middle, "the differences are small enough so that financial considerations might matter," he said.
A coated stent usually costs in the neighborhood of $2,000, Zimrin noted, and medical centers often try to drive that price down. So, all else being equal, a stent's price tag may end up being the deciding factor, he said.
One more financial issue might influence a doctor's decision, added Dr. Gene Chang, director of the catheterization laboratory at
For older people on a fixed income, that extra four months on an expensive drug can be a big factor, Chang said.
As for the medical issues, in terms of hard outcomes, there does not seem to be an difference in the published data in large-scale trials to date, Chang said. The feeling of most people that the sirolimus stent is better is based on small trials. The quagmire is that it hasn't translated into clinical benefits, he added.
More information
For more on stents, head to the
Mother's stress linked to early miscarriage
Reuters Health
Tuesday, February 21, 2006
Pregnant women who experience stress in the first few weeks of pregnancy appear to have an increased risk of miscarriage, according to findings from a small study of women in
Maternal stress is often considered a risk factor for miscarriage, yet data supporting this association are lacking, lead author Dr. Pablo A. Nepomnaschy, from the National Institutes of Health in
Previous studies looking at this topic may have failed to identify a link because they focused on women at least 6 weeks after their last menstrual period. By contrast, most miscarriages occur earlier in pregnancy, usually within three weeks of conception.
In the study reported in the Proceedings of the National Academy of Sciences Early Edition, levels of the stress hormone cortisol levels were measured in the urine during the first 3 weeks of 22 pregnancies. Thirteen of the pregnancies eventually ended in miscarriage, usually within a few days after the first missed period.
Women with cortisol levels that were higher than normal were nearly three times more likely to experience a miscarriage than women without increased cortisol levels.
The researchers suggest that pregnancy may be particularly sensitive to maternal stress during the early period when the embryo is attaching to the mother's womb.
Source: Proceedings of the National Academy of Sciences USA 2006.
Exercise, Learning Help Shield Against Alzheimer's
HealthDay News
Tuesday, February 21, 2006
TUESDAY, Feb. 21 (HealthDay News) -- Being good to your heart and making the right lifestyle choices -- exercising, learning new things, and staying socially connected -- may help keep your brain healthy as you grow older, researchers conclude.
"Many of the factors that can put our brain health at risk are things we can modify and control," William Thies, vice president of medical and scientific affairs for the Alzheimer's Association, said in a prepared statement.
The report is published online Tuesday in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.
The report's authors reviewed previous studies and concluded that controlling cardiovascular risk factors plays an important role in maintaining brain health as people age. And controlling those risk factors is within most people's grasp: losing weight, reducing blood pressure and cholesterol, avoiding smoking, and preventing or controlling diabetes are all proven heart-healthy activities, the experts said.
The report also found a close correlation between physical activity and brain health. Three large studies found that older people who exercise are less likely to suffer cognitive decline. But the report's authors said more research is needed before specific recommendations can be made about the type and duration of exercise that's best for the brain.
Certain factors did seem to boost brain health in old age, including "higher education level, higher socio-economic status, emotional support, better initial performance on cognitive tests, more physical exercise, moderate alcohol use, and use of vitamin supplements," the researchers said.
"Psychosocial factors, such as social disengagement and depressed mood, are associated with both poorer cognitive and emotional health in late life," they added.
Curiosity and a thirst for learning might help, too. According to the report, increased mental activity through life, such as learning new things, may boost brain health.
Currently, the genetic factors that impact cognitive and emotional health as people age are poorly understood, the authors said.
"This article points to the possibility that healthier living can significantly contribute to reducing the numbers of sick and mentally declining older people, and reduce health care costs," Thies said. "To accomplish that, we need more research to show us which specific combinations of lifestyle choices, and also future therapies, will maintain our brain and emotional health."
More information
The
Bird flu likely to burst out again and again: study
By Maggie Fox,
Health and Science Correspondent
Reuters
Tuesday, February 21, 2006
Bird flu is likely to cross over into people again and again if it ever even once acquires the ability to pass from human to human, experts predicted on Monday.
In theory, the virus only has to mutate once, in one person, to spark a pandemic. But the researchers argue that this could happen again and again, in several places around the world.
They said even if the current pandemic killing birds passes, no one should breathe a sign of relief because the threat to people will not be gone.
"At best, a containment policy will only postpone the emergence of a pandemic, 'buying time' to prepare for its effects," Dr. Marc Lipsitch and colleagues from the Harvard School of Public Health and Dr. Carl Bergstrom from the
This is what officials hope they are doing now by culling birds when new outbreaks of H5N1 avian influenza occur. Public health experts agree the world is nowhere near ready to cope with a pandemic, but with a few years' preparations, some countries might be.
"We argue here that if a single introduction of a pandemic-capable strain is expected, multiple introductions should also be expected," Lipsitch's team wrote in the Public Library of Science Medicine, an online medical journal.
"Each containment effort would likely be more difficult than the last as manpower, antiviral stockpiles, and other scarce resources become depleted," they wrote.
H5N1 avian influenza has spread in chickens from
It has killed or forced the culling of more than 200 million birds in 32 countries and
No one can say if or when it would happen, but if H5N1 acquired the ability to pass easily from human to human, it could spark a pandemic that would kill millions or even tens of million within a few short months.
Temporary Containment
Some experts have published theoretical models showing that quick action with antiviral drugs, culling of birds and isolation of cases could quell such a pandemic before it started.
But it would require a lot of luck, noted Lipsitch and colleagues -- not the least identifying those cases right away, before they spread the disease.
Other experts have also noted this and also said there is no reason to believe that the mutations needed to make H5N1 a human disease would occur only once. Lipsitch's team ran some mathematical models based on known disease outbreaks.
Their article, published online at http://dx.doi.org/10.1371/journal.pmed.0030135, suggests that an H5N1 pandemic could only be contained temporarily. And the longer the virus is around, the harder it will be to stop it from spreading.
"Even if each successive containment effort is no more difficult than its predecessor, the chance of at least one failure increases with the number of introductions," they wrote.
"Since the last pandemic nearly 40 years ago, we have observed dramatic changes in social and ecological factors thought to facilitate emergence of a pandemic-capable strain," the researchers wrote.
"Surging human and bird populations in Asia have increased the frequency of contact between birds and humans -- and these changes might facilitate emergence by permitting 'crossing over' of a mutated avian influenza to humans, or by allowing human and avian influenzas to reassort in the same animal host."
Corticosteroids May Harm ICU Patients
HealthDay News
Tuesday, February 21, 2006
TUESDAY, Feb. 21 (HealthDay News) -- Corticosteroid drugs may help lead to poorer outcomes, even death, for patients in the trauma intensive care unit (ICU), a new study finds.
Corticosteroid medications are used in ICUs to treat a number of conditions, including systemic blood infection (sepsis), spinal cord injury and swelling of the airway. While evidence suggests they are an effective treatment for sepsis, they also suppress the immune system and leave patients susceptible to infections and other complications, according to researchers at
They published their findings in the February issue of the Archives of Surgery.
The study found that 100 patients in a trauma-burn ICU who received corticosteroids had more infections, longer stays in intensive care or longer periods on a ventilator, and a higher death rate than 100 ICU patients in a control group who did not receive corticosteroids.
The patients who received corticosteroids were more likely to develop pneumonia (26 percent vs. 12 percent), bloodstream infection (19 percent vs. 7 percent), or urinary tract infection (17 percent vs. 8 percent).
Patients in the corticosteroid group also stayed in the ICU longer (17.6 days vs. 10.2 days), were on a ventilator longer (9.9 days vs. 4.9 days), and were more likely to die than patients who did receive corticosteroids.
The researchers also noted that corticosteroid use may not have been appropriate for many of the patients in this study.
"Thirty-nine of the 100 patients in our study received corticosteroids for an indication supported by the literature," they wrote. "The remaining 61 should not have received corticosteroids based on strict interpretation of the current literature. Certainly the risk of infection outweighs the potential benefit in these cases."
"Caution must be taken to carefully consider the indications, the risks and benefits of corticosteroids when deciding on their use," the
More information
The
Delaying solid food by 6m doesn't prevent allergy
Reuters Health
Tuesday, February 21, 2006
Delaying the introduction of solid food beyond 6 months of age does not protect against the development of allergic dermatitis, the results of a new study show. However, delayed introduction of solid food for the first 4 months of life "might offer some protection."
Scientific evidence in support of World Health Organization feeding guidelines for the prevention of allergic diseases, which call for introduction of solid foods to be delayed until 6 months of age, is "scarce, inconsistent, and based on a few studies only," researchers from
Dr. Anne Zutavern from the
Giving infants a high diversity of solid foods within the first 4 months of life increased the risk of allergic dermatitis within 6 to 24 months of life, the authors note. However, there was no increase in doctor-diagnosed allergic dermatitis or sensitization, they point out.
There was also no evidence to support a protective role of delaying the introduction of solid foods on the development of allergic dermatitis and sensitization in children who had parents with allergies.
Allergy symptoms may develop very early in life, the authors also suggest, before parents decide when to introduce solids.
Source : Pediatrics, February 2006.
HealthDay News
Tuesday, February 21, 2006
(HealthDay News) -- Autism, a complex neurological disease, often appears in infants as a lack of responsiveness to others.
The U.S. National Institute of Neurological Disorders and Stroke says symptoms of the disease include:
Impaired social interaction, which can range from inability to connect with others, to an obsessive focusing on one thing to the exclusion of anything else. Problems with verbal or nonverbal communication. Repetitive behaviors, such as rocking or twirling. Failing to respond to one's name and avoiding eye contact.
Researchers do not know what causes autism, though there may be a genetic link.
There is no cure for autism. But some with the disorder can improve with therapy.
Fake drugs, including Tamiflu, thrive on Internet
By Laura MacInnis
Reuters
Tuesday, February 21, 2006
Criminals are using the Internet to sell increasing quantities of counterfeit medicines, including fake versions of bird flu drug Tamiflu, a senior U.N. health expert said on Tuesday.
Vitamin and health supplements, so-called "lifestyle medications" like erectile dysfunction drugs, and steroids bought over the Internet were especially likely to be false.
Antibiotics, anti-malarials and pain killers were also susceptible to fraud because of the huge demand, while Tamiflu, made by Swiss firm Roche, had also entered the market amid rising avian flu fears.
"Yes, there have been cases reported in counterfeit Tamiflu," said Howard Zucker, the World Health Organisation's assistant director general for health technology and pharmaceuticals.
But he declined to give details on the quantity or where the fake drugs had been found.
The WHO has estimated as many as 10 percent of drugs on the world market are mislabeled or fake, with the phoney medicines sometimes causing illness and even death in consumers.
Speaking to reporters after a high-level meeting in
At the meeting, the U.N. health body said it would help set up an international expert group to raise awareness about fake drugs and to improve cooperation between governments, industry groups and international agencies on the issue.
"Counterfeiting medicines should be distinguished from other types of counterfeiting which do not affect human health and should be combated and punished accordingly," the conference participants said in a statement at the end of their meeting.
Harvey Bale, director general of the International Federation of Pharmaceutical Manufacturers Associations, said fake medicines remain more prevalent in developing countries than in places like
Still, Bale stressed patients in the rich world were increasingly vulnerable to counterfeit drugs distributed online. He said the new task force would look into that growing sector.
"The Internet needs to be addressed, clearly," he said.
Grapefruit May Sweeten Way to Lower Cholesterol
HealthDay News
Tuesday, February 21, 2006
TUESDAY, Feb. 21 (HealthDay News) -- Red grapefruit appears to lower cholesterol and fight heart disease, Israeli researchers report.
The study included 57 people with high blood cholesterol who'd recently had coronary bypass surgery and whose high lipid levels failed to respond to statin drugs, commonly prescribed to lower cholesterol.
The patients were divided into three groups. One group received a single daily serving of fresh red grapefruit for 30 consecutive days, another group received white grapefruit, and a third group received no grapefruit. All three groups were also fed regular, balanced meals.
Those who received red or white grapefruit showed significant decreases in blood lipid levels. The patients who did not eat grapefruit showed no changes in lipid levels. The researchers found that red grapefruit was more effective than white grapefruit in lowering lipid levels, particularly blood triglycerides. Elevated levels of this type of cholesterol are often associated with heart problems.
The antioxidants in grapefruit are likely responsible for the health benefits and the fresh fruit and juice are equally beneficial, the study authors said.
They also noted that red grapefruit generally has higher levels of antioxidants than white varieties. It may also be possible that red grapefruit has some unknown chemicals that help reduce triglycerides. The researchers plan to conduct further studies.
One caveat: a number of studies have shown that grapefruit interacts with certain medications, so the researchers advise individuals contemplating a boost in their grapefruit consumption to consult first with their pharmacist.
The findings were published online by the Journal of Agricultural and Food Chemistry.
More information
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Monday, February 20, 2006
Health Tip: Exercise Is Good for You
HealthDay News
Monday, February 20, 2006
(HealthDay News) -- Studies show that exercise and staying physically active can help you stay healthy and independent, according to the U.S. National Institutes of Health.
As little as 30 minutes of moderate exercise per day can do the trick, the agency says.
Before you begin an exercise program, talk to your doctor to make sure it's a good idea. It most cases, it makes far more sense than remaining inactive.
Heavy drinking tied to worse eating habits
By Anne Harding
Reuters Health
Monday, February 20, 2006
The more alcohol a person drinks, the less likely he or she is to be eating a healthy diet, a new study shows.
"People who drank the largest quantity, even infrequently, had the poorest diets," Dr. Rosalind A. Breslow of the National Institute on Alcohol Abuse and Alcoholism in Bethesda, Maryland, the study's lead author, told Reuters Health.
A number of studies have linked moderate alcohol consumption with a lower risk of dying from heart disease, Breslow and her colleagues note in the American Journal of Epidemiology. But healthy habits -- like drinking in moderation and eating plenty of fruits and vegetables -- tend to go hand in hand, they add, so it is difficult to separate out how much of alcohol's heart healthy effects may be due to the way moderate drinkers tend to eat.
Most studies evaluate average volume of alcohol consumption over time, the researchers note, which does not take into account how frequently a person drinks or how much he or she drinks on "drinking days." So Breslow and her team looked at frequency and average consumption on drinking days, as well as average volume, for 3,729 adults aged 20 and over from the 1999-2000 National Health and Nutrition Examination Survey. They rated diet quality using the Healthy Eating Index, which measures how closely a person's eating habits resemble US Department of Agriculture's Food Guide Pyramid recommendations.
The average Healthy Eating Index score for participants who consumed one drink on an average drinking day was 65.3 (out of a possible 100), compared to 61.9 for people who had three drinks a day or more on the days when they drank. There was no significant difference in diet quality between people who drank the most based on average volume and those who drank the least.
But the more frequently a person drank, the better his or her diet; people who drank the least frequently scored 60.9, compared to 64.9 for those who drank the most often. The people who drank the most alcohol, but drank the least often, had the worst diets, but diet quality was best among the more-frequent, lower-quantity drinkers.
Breslow admits the findings, which were conducted to help better analyze studies looking at how diet and alcohol consumption influences health, are confusing. But basically, she adds, they underscore the importance of eating a healthy diet and drinking moderately --one alcoholic beverage daily or less for women, two or less for men -- for health.
"People who drank in lower amounts closer to the recommendations had better diets, so you're seeing sort of healthy behaviors traveling together," she said. "It's sort of like a puzzle -- healthy behaviors are all intertwined."
Source: American Journal of Epidemiology, February 15 2006.
Many Elderly Women Going Without Bone Density Tests
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- Even though they have the highest risk for hip fractures, elderly women are least likely to get bone density screening, a new study finds.
Researchers at the Medical College of Wisconsin analyzed the Medicare records of nearly 44,000 women, ages 65 to 90, to see how many of them had bone density screening between 1999 and 2001.
Reporting in the March issue of the Journal of the American Geriatrics Society, they found that 27 percent of women ages 65 to 70 had the test, compared with 25.6 percent of women ages 71 to 75, and less than 10 percent of women older than 75.
The
"Since osteoporosis can be helped with appropriate therapy, it is especially important for older women to find out whether or not they need the therapy. Treatment with hormones or bone-building drugs can slow the process, rebuild some bone and reduce the risk of fracture by one-third," study lead author Dr. Joan M. Neuner, assistant professor of medicine, said in a prepared statement.
She and her colleagues suggested a number of reasons why older women are less likely to get bone density screening. Doctors may not understand the importance of bone density testing or may not be aware that just three years of osteoporosis treatment can reduce the risk of fractures.
In addition, women may not like to take prescription drugs or may be put off by side effects. Women may not realize they're at risk for osteoporosis or mistakenly believe that it's a natural part of aging.
The study's findings indicate the need for greater doctor and patient education in order to increase rates of bone density screening among older women, the authors said.
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Doctors Want to Find Spreading Cancer
By Lauran Neergaard
AP Medical Writer
The Associated Press
Monday, February 20, 2006
No one ever checked whether Leslie Bather's breast cancer was spreading to her brain, until the day tumors caused three frightening seizures. MRI scans can help spot when cancer in another part of the body sends seedlings into the brain, but few patients get routine checks.
Neurology specialists say it's time to change that: More patients are surviving initial tumors long enough for their brains to be at risk, as treatments get better at battling cancer below the neck yet fail to protect the brain. And improved technology is making it easier and safer to treat those new brain tumors, if they're caught early.
"If I were diagnosed with cancer tomorrow, the first thing I'd want is a brain scan," says Dr. Leonard Cerullo, director of the Chicago Institute of Neurosurgery and Neuroresearch.
This type of brain cancer "is becoming a bigger and bigger clinical problem," adds Dr. Frank Lieberman, neuro-oncology chief at the
Already, about 150,000 Americans a year are diagnosed with what is called a "metastatic brain tumor" — cancer that spread into the brain from some other part of the body.
Any cancer can spread to the brain. But lung cancer is the leader; it will happen in up to 40 percent of lung cancer patients, often very early in their disease.
Up to a third of breast cancer patients will experience a brain metastasis. Also common spreaders are melanoma and kidney and colon cancer.
Not too many years ago, doctors mostly discovered metastatic brain cancer when its victims already were close to dying from tumors riddling other parts of their bodies.
Now, breast specialists in particular are reporting an increasing number of women who beat back cancer elsewhere in the body, only to have it flare in the brain. It seems to be a special concern among users of Herceptin, a powerful drug that targets an aggressive type of breast cancer — everywhere except in the brain, because it's too large a molecule to penetrate the blood-brain barrier, explains Lieberman.
But it's a more widespread concern. While the American Cancer Society doesn't yet have a count of the reported increase, it notes that cancer patients overall are living longer, providing more time for microscopic tumor cells incubating in the brain to take root.
Scientists are beginning to fight back:
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Studies are under way to see if an experimental drug called lapatinib, made by GlaxoSmithKline, can treat breast cancer that spreads to the brain. Lapatinib targets the same aggressive breast cancer as Herceptin does but is thought to easily penetrate the brain.
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Also under study is whether some commonly used cancer drugs could ever cross into the brain, especially if used in conjunction with brain radiation.
§
And neurology specialists are urging general oncologists to start checking patients, especially those with lung or breast cancer, for spread to the brain well before symptoms appear.
There are no formal guidelines, but at
High doses of whole-brain radiation once were the only treatment for metastatic brain cancer, and could cause such troubling side effects as memory loss, Cerullo says.
Now, treatment is more sophisticated, especially for tumors caught early. Topping the list: radiosurgery, using focused beams of radiation to zap just the cancerous cells and not surrounding healthy brain tissue.
Whole-brain radiation today comes in safer doses with fewer side effects, but when to use it is controversial. Some studies suggest a preventive course could protect certain lung cancer patients, for example.
Lieberman and Cerullo advise patients to ask about a brain scan.
It's advice that Bather, the
"You want to think you're OK," says Bather, 52, whose brain seems clear after treatment of more than 40 tumor sites, but she still is battling cancer elsewhere. Instead, "what you don't know can hurt you."
Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in
Gene Mutations May Boost Breast Cancer Risk
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- Women with a genetic mutation in one of two related genes are at an increased risk of developing breast cancer, a new study suggests.
Mutations in the LEP and LEPR genes result in high serum levels of the hormone leptin and to overexpression of leptin in fatty tissue. Both mutations could be used as markers to identify people at increased risk for breast cancer, the study authors said.
They also noted that the mutations are associated with shorter survival time after breast cancer diagnosis, so they may prove useful as predictors of prognosis for breast cancer patients.
Researchers in
Women with the LEP mutation had a higher risk of breast cancer than women without the mutation. Women with two copies of the mutation had three times the risk of breast cancer than women without the mutation, the study found.
The researchers also found that the LEPR mutation was much more common in the breast cancer patients than in the control group.
The LEP mutation was associated with a large tumor size at diagnosis and the LEPR mutation was associated with shorter overall survival time.
Previous research found no link between the LEPR mutation and increased risk of breast cancer.
The findings appear in the current issue of the journal BMC Cancer.
More information
The American Cancer Society has more about breast cancer..
Ovarian cancer survival influenced by MD specialty
Reuters Health
Monday, February 20, 2006
The survival rate of women with ovarian cancer is improved when surgery is performed by a gynecologic oncologist rather than by a general gynecologist, according to the findings of a new study.
The results also indicate that gynecologic cancer specialists (oncologist) are more likely to follow surgical guidelines for cancer surgery and are more likely to completely remove the tumor.
The findings are based on a study of 512 women from the
The five-year survival rate was higher for patients treated by a gynecologic oncologist, senior author Dr. Ate G. J. van der Zee, from the University Medical Center Groningen, and colleagues note.
In patients treated by gynecologic oncologists, 5-year survival rates for less advanced cancers was 86 percent and for more advanced cancers was 21 percent. The corresponding rates for patients treated by general gynecologists were significantly lower, at 70 percent and 13 percent.
When other factors that can influence patient outcome were considered, researchers found that the overall risk of death was reduced by 21 percent and the risk of death among patients younger than 75 years of age was reduced by 29 percent if a gynecologic oncologist performed the surgery.
As noted, gynecologic oncologists adhered to surgical guidelines more often than did general gynecologists. For example, in patients with stage I-II disease, 55 percent of gynecologic oncologists followed guidelines compared with 33 percent of general gynecologists.
In patients with stage III disease, complete tumor removal was achieved by gynecologic oncologists more often than by general gynecologists.
"Specific surgical training appeared to be important, because a surgeon's patient volume alone had no effect on survival," the authors point out in the medical journal Cancer.
"These results imply that every patient who has suspected ovarian carcinoma deserves to undergo surgery performed by a gynecologic oncologist," the authors conclude.
Source: Cancer, February 1, 2006.
Discovery Could Disarm Flesh-Eating Bacteria
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- Scientists say they've discovered a secret weapon wielded by the family of Streptococci bacteria that causes strep throat, toxic shock and, in rare cases, the "flesh-eating bacteria."
These "group A" Streptococcus bacteria use a specific enzyme to escape defensive nets set up by the body's immune system, researchers at the
The discovery could lead to new treatments for serious infections, the scientists say.
"These findings suggest a novel approach to treating serious Strep infections, such as flesh-eating disease, by assisting our body's own defense system," senior author Dr. Victor Nizet, associate professor of pediatrics at UCSD and an infectious diseases physician at Children's Hospital in San Diego, said in a prepared statement.
He and his colleagues studied the interaction between Strep bacteria and neutrophils, specialized white blood cells that play an important role in protecting the body against pathogenic microbes. Previous research found that neutrophils release "nets" composed of DNA and toxic compounds. These nets entrap and kill bacteria that have invaded the body.
But this study found that Strep bacteria release an enzyme that degrades these nets. This enables the Strep bacteria to escape the net and spread throughout the body. However, disabling the gene that creates this enzyme makes Strep bacteria vulnerable again to the nets.
"Deprived of this single enzyme, the mutant Strep strain was easily killed by human neutrophils. In addition, the mutant Strep bacteria no longer produced a spreading infection when injected into the skin of experimental mice," lead author John Buchanan, research scientist in the UCSD department of pediatrics, said in a prepared statement.
The findings appear in the Feb. 21 issue of the journal Current Biology.
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Organic Food Fends Off Pesticides
By Randy Dotinga
HealthDay Reporter
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- If you are looking to banish pesticides from your child's diet, new research suggests that organic food will do the trick, at least when it comes to two common pesticides.
Researchers found that pesticide levels in children's bodies dropped to zero after just a few days of eating organic produce and grains. "After they switch back to a conventional diet, the levels go up," said study co-author Chensheng Lu, an assistant professor of environmental and occupational health at
But Lu acknowledged that organic food is often more expensive than conventional food, and he added that the health risks of the pesticides in question aren't entirely clear.
According to the study, it has been difficult to figure out exactly how much pesticide residue children are exposed to when they eat food that was treated as it grew in the field.
Lu said the impetus for the new study was a previous research project that examined pesticide levels in 110 children and only found one child whose body was pesticide-free -- a child who regularly ate organic food.
His team looked at two common pesticides known as organophosphorus. According to Lu, their use in residential areas is banned, but they're still used by growers.
In 2003, researchers recruited 23 children from Seattle-area schools, all aged 3-11. Researchers monitored levels of two organophosphorus pesticides -- malathion and chlorpyrifos -- in their urine during a 15-day period in which they alternated between their regular diets and diets featuring organic fruits, vegetables and grain products.
The findings were to be discussed Sunday at the annual meeting of the American Association for the Advancement of Science in
The researchers found that the pesticide levels dropped immediately when the children started eating the organic foods. The staying power of the pesticides was "relatively short," Lu said.
"Whether that is important in terms of health effects remains to be seen," Lu added, noting that scientists don't know exactly how the pesticides affect the body over time.
There is evidence that they're dangerous, said Dr. Nathan M. Graber, a fellow in pediatric environmental health at the Mount Sinai School of Medicine. "We know that at high doses, these pesticides can cause serious symptoms because they are toxic to the nervous system," he said, adding that there's "sound scientific reasoning" suggesting that low doses can hurt the developing brain.
What should parents do? Kids should be eating lots of fresh fruits and vegetables, regardless of whether they are organically grown, because the benefits greatly outweigh the risk, Graber said. "Parents should not feed their children less nutritious foods out of fear of pesticides."
Foods that are especially vulnerable to pesticide residue include strawberries, nectarines, peaches, apples, pears and cherries, Lu said. Some other foods, such as bananas and oranges, aren't as vulnerable, he added.
More information
Learn more about organic diets from CNN.com.
Acupressure Eases Low Back Pain
By Ed Edelson
HealthDay Reporter
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- Acupresssure -- pushing with the fingertips at the same body points used in acupuncture -- gave patients better, long-lasting relief for low back pain than conventional physical therapy, Taiwanese researchers report.
"Acupressure was effective in reducing low back pain in terms of disability, pain scores and functional status," doctors at the
The researchers recruited 129 people with chronic low back pain from a specialist orthopedic clinic. All of them filled out a standard disability questionnaire before being assigned to one of two different treatment regimens, with 64 people receiving six sessions of acupressure and 65 receiving standard physical therapy.
"Acupressure conferred an 89 percent reduction in physical disability compared with physical therapy," the researchers reported. The people who got acupressure also scored better on measures of pain and had fewer days taken off from work or school, the researchers said.
However, they cautioned that the effectiveness of any manipulative therapy such as acupressure "is highly dependent on the therapist's technique and experience." All the people in this study received treatment from the same therapist, to eliminate any difference in the treatment given.
"We hope that this technique can be imparted to other therapists now that its efficacy has been shown in our study, so that acupressure can be used in other populations," they wrote. "How acupressure can be generalized to patients with low back pain is the subject of ongoing research."
Dr. Marcos Hsu is an acupuncture specialist at the University of Maryland Center for Integrative Medicine who got his training in acupuncture and acupressure at the Maryland Institute of Traditional Chinese Medicine. He called the
Hsu said he routinely uses acupressure supplemented with acupuncture to treat low back pain. "I have seen good responses similar to those in the paper, but some people do not respond to it," he said. The response generally is good for musculoskeletal problems such as sprains, Hsu said, but when the pain is caused by problems with structural bones and tissues, as in arthritis, the treatment "may take longer to take effect."
Hsu's patients usually receive painkillers, as well, because "most people who come to us are on painkillers, so it is not advisable to stop," he said. Patients can have anywhere from five to 15 treatments, with pressure applied "by our thumbs, hands, wrists, knuckles, elbows, every joint we can use," Hsu said.
People seeking acupressure or acupuncture treatment for low back pain should be cautious whenever they seek out help, Hsu recommended. "Check their credentials first," he advised.
The
Harris said he'd like a more detailed account of the treatment given -- which acupressure points were pressed, for example. And he noted that the participants weren't blinded to the treatment they were given. Patients who got acupressure knew they were getting it, which might have influenced their response, Harris said.
Nonetheless, the report that acupressure seems to be better than physical therapy for back pain is significant and deserves follow-up, he said.
More information
For the lowdown on low back pain, head to the U.S. National Library of Medicine.
Gum chewing helps bowels after surgery: study
Reuters
Monday, February 20, 2006
Chewing gum after intestinal surgery can help reactivate paralyzed bowels and get patients out of the hospital sooner, a study said on Monday.
Patients who have abdominal surgery often suffer a slowdown or shutdown of the bowels called ileus that causes pain, vomiting and abdominal swelling, and they may not be able to tolerate food or even water, the report published in the Archives of Surgery said.
Study participants had no problem chewing sugarless gum three times a day. Chewing stimulates nerves that promote the release of hormones responsible for activating the gastrointestinal system, wrote study author Rob Schuster of Santa Barbara Cottage Hospital in
Seventeen of 34 patients who chewed gum beginning a few hours after surgery passed gas several hours sooner than the half who did not chew, and they had their first bowel movements an average of 63 hours after surgery compared with 89 hours for non-chewers.
The gum chewers got out of the hospital an average of 4.3 days after surgery versus 6.8 days for non-chewers, reducing costs and lowering the risk of complications.
All had had a section of their lower intestines removed because of cancer or chronic infection.
"We conclude that gum chewing early in the postoperative period following (surgery) hastens time to bowel motility and ability to tolerate feedings," the report said. "This inexpensive and well-tolerated treatment resulted in earlier hospital discharge."
Allergy Relief Can Come Cheaply
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- When it comes to allergy-linked congestion, an over-the-counter drug may clear up your nose without emptying your wallet, researchers report.
A new study finds that Sudafed 24 Hour, a decongestant available on most drugstore shelves, is as effective at relieving hay fever symptoms as Singulair, a prescription drug that costs almost four times as much.
Researchers at the
Pseudoephedrine costs about 80 cents a day, while montelukast costs about $3.20 a day.
As reported in the February issue of the Archives of Otolaryngology - Head & Neck Surgery, Sudafed was as effective as the prescription medication in relieving hay fever symptoms such as nasal congestion, runny nose, sneezing and itching. The cheaper drug was also as effective at improving quality of life for hay fever patients, without causing any additional side effects.
"This came as a genuine surprise," study director Dr. Fuad Baroody, an associate professor of surgery, said in a prepared statement. "Our hypothesis was that montelukast would have additional benefits and pseudoephedrine would interfere with sleep, but when we compared them head-to-head we found that for treatment of allergic rhinitis, these drugs at these doses were virtually identical."
The study was funded in part by a grant from Merck & Co., the maker of Singulair.
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Gene May Explain Men's Raised Risk for Parkinson's
By E.J. Mundell
HealthDay Reporter
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- For years, it's been a puzzle: Why are men 50 percent more likely than women to develop Parkinson's disease?
Researchers now say that a gene long associated with fetal gender is also crucial to a Parkinson's-linked area of the male brain.
The gene, called Sry, appears to help neurons residing in the brain's substantia nigra -- a locus for motor control -- secrete the neurochemical dopamine. In Parkinson's disease, these neurons gradually die off, lowering dopamine levels and causing the gradual loss of motor function that's a hallmark of the illness.
Before this study, scientists studying Parkinson's had little to go on when it came to understanding why this neuronal death and dysfunction occurs.
That may no longer be the case.
"We now have a starting point with this one gene that we know for sure works directly upon the neurons that secrete dopamine," said senior researcher Dr. Eric Vilain, an associate professor of human genetics at the University of California, Los Angeles' David Geffen School of Medicine.
His team's findings are published in the Feb. 21 issue of Current Biology.
Experts at the Parkinson's Disease Foundation estimate that more than 1 million Americans, most of them over 50 years old, suffer from the degenerative neurological illness. Parkinson's disease often starts with a slight tremor of one arm, leg or hand, then moves to the rest of the body, causing constant trembling, head shaking and difficulty in walking, among other symptoms. While dopamine replacement can help slow or ease symptoms, there is currently no cure for Parkinson's disease.
In fact, very little is known about the root causes of this disease, or why men are more likely to be affected.
Vilain explained that he was a member of a team that originally identified Sry in 1990. In the developing fetus, "this gene makes the gonads, which start out as undifferentiated, turn into either testicles or ovaries, thus making the fetus male or female," he said.
In studies in mice a few years ago, Vilain said he noticed unexpected Sry activity in the rodents' brains. Intrigued, he reviewed the literature and found that experts elsewhere had noticed the same thing. None of them had been able to pinpoint the neurological locus of this activity, however.
"So, in this rat study, we have looked closer," he said. "We found that the gene is expressed in the substantia nigra. It's a real surprise, because this part of the brain has nothing to do with gender identity."
Instead, the substantia nigra is all about dopamine-mediated control of motor function -- the messages brain cells send to the nervous system and (ultimately) muscles to spur and direct movement.
Sry appears to affect only the substantia nigra in the male rat brain, however. In fact, when the UCLA team lowered Sry activity in males' brains, the animals began to exhibit the impaired movement characteristic of Parkinson's disease.
"This means that the mechanisms by which neurons in the substantia nigra function are dependent on a gene in males and on something else, as yet unknown, in females," Vilain said.
Although the finding itself doesn't answer the nagging question of why men are more at risk for Parkinson's, it does offer some suggestions. "Maybe females have another way to make these dopamine-secreting neurons work nicely -- estrogens, for example," Vilain said. "It's just a hypothesis, but maybe Sry compensates for the lack of estrogens [in men]."
Unfortunately, for some men, this gene-based compensation may not be enough, he added, rendering them more vulnerable to neuronal dysfunction and Parkinson's.
One expert said the finding is exciting, but needs to be replicated in human studies.
"Clearly, this animal study should lead to human investigation," said Paul Sanberg, director of the
Sanberg noted, however, that "rat studies have been predictive of how to develop treatments for Parkinson's disease. This allows one to start studying this gene in post-mortem Parkinson's brains, to see if it's related."
In fact, Vilain said his team is already doing just that -- comparing Sry levels in the brains of people who died of Parkinson's to samples from individuals who died of other causes.
Vilain stressed this research is still in the discovery stage, and much of it remains speculative.
And while it's tempting to think about a gene-based "fix" for Parkinson's, "treatments are a long way off," he said.
Still, the
Vilain also noted that other brain areas contain dopamine-secreting neurons.
"These areas have functions other than motor behavior," he said. "They can affect some psychiatric disorders like schizophrenia, for example. It's pure speculation right now, but that's another area we'd like to explore."
More information
For more on Parkinson's disease, head to the Parkinson's Disease Foundation.
Western diet helps raise S.Korea breast cancer rate
By Jon Herskovitz
Reuters
Monday, February 20, 2006
Breast cancer among South Korean women is increasing at a rapid rate due in part to a more Western lifestyle and consumption of more fatty foods, according to a paper made available on Tuesday.
In the paper published in the February issue of the Archives of Surgery, a Journal of the American Medical Association publication, South Korean scientists found that South Korean women have increased risk factors for breast cancer in recent years.
"We believe that the younger generations of Korean women have been directly affected by the progressive Westernization of the Korean lifestyle," the authors wrote.
Medical researchers at
Apart from diet, the authors did not mention any specifics about how South Korean lifestyles have become more Westernized. However, other studies have shown that in recent years, South Korean women are having babies later in life and fewer of them than previous generations.
The study found that the proportion of patients with risk factors such as late menopause, high-fat diets and obesity had increased dramatically between 1996 and 2000.
The study found that while the rate of breast cancer in
"The present results suggest that the rate of breast cancer in
The authors said more efforts should be made in
Last year, a team of researchers at Seoul National University said in a separate study that the number of South Korean women who will die from breast cancer will likely rise in 2020 to over 3,000 from just over 1,000 in 2000.
That study from the Medical College of Seoul National University said one of the reasons came from a change in the diet where South Korean women were eating more high-fat Western foods.
The UN World Health Organization said breast cancer is the most common cancer among women worldwide and the authors of the study at
(With additional reporting by Lee Jin-joo)
Focus, Flexibility Speed Heart Attack Care
By Ed Edelson
HealthDay Reporter
HealthDay News
Monday, February 20, 2006
MONDAY, Feb. 20 (HealthDay News) -- Researchers have identified key factors that help hospitals treat heart attack patients as quickly as possible.
The next step is to use the findings, which appear in the Feb. 21 issue of Circulation, to improve emergency practice at hospitals everywhere.
It's an unusual study, said lead researcher Dr. Harlan J. Krumholz, because most such studies gather data on a very large scale.
In this case, however, his team focused on just 11 hospitals that were able to consistently restore blood flow to damaged hearts in 90 minutes or less.
"In order to understand what makes great places great you have to get on the ground and talk to people to learn how these places achieve things that are beyond the reach of other places," said Krumholz, a professor of medicine at
The 11 hospitals are listed in a national registry of heart attack treatment. They were not identified in the study, and there were some major differences among them -- for example, the hospitals ranged in size from 111 beds to 870 beds.
What they did have in common was getting heart attack patients artery-opening balloon angioplasty in just 90 minutes or less. Time-to-treat ranged from an average of just 55.5 minutes at one hospital to 87 in another.
The hospitals shared eight common characteristics: commitment to an explicit goal of getting the fastest treatment possible; getting support from senior management; innovative protocols; flexibility in changing those protocols if the need arose; having uncompromising leaders; teamwork; quick data retrieval to identify problems; and an organizational culture that could learn from its mistakes.
But there was something paradoxical in the finding, said Elizabeth H. Bradley, director of the Yale Health Management Program, a member of the research team.
"In every organization there are conflicts," Bradley said. "These organizations were able to balance two things -- intense data feedback, but in a blame-free way that could allow changes in rigid protocols."
And while teams typically were headed by a strong leader, "we also found participatory teams that balanced that 'cowboy' leader," she said. "There was an ability to tolerate polar opposites -- flexibility with standardization."
The common denominator in all the hospitals was "amazing people who are so devoted to meeting this problem," Bradley said. "There were a lot of impressive leaders, but also impressive team members."
The research group now is working with "a variety of national organizations" to translate the findings into action that can help improve hospital performance everywhere, Krumholz said.
"We are in the midst of developing a national campaign by the
However, simply providing a set of instructions is not enough, Bradley warned.
"You need a whole cultural commitment to making these changes, and that takes a lot more than what you do when you read the book," she said.
More information
To learn the signs and symptoms of heart attack, head to the American Heart Association.
Study sees more benefit from some heart drugs
By Lisa Richwine
Reuters
Monday, February 20, 2006
Taking prescription beta blocker or statin drugs may boost the chances of having only mild chest pain instead of a heart attack as the first symptom of heart disease,
The scientists studied 1,400 patients newly diagnosed with heart disease to try to pinpoint why some had a heart attack while others experienced chest pain known as exercise-induced angina, which is far less dangerous.
Twice as many of the chest pain patients had filled prescriptions for a beta blocker or a statin during the previous five months, they found.
Previous studies had shown those types of drugs cut heart disease risk overall, but the new research is the first to demonstrate they may reduce the chances of someone having a sudden heart attack without earlier symptoms.
"If there are warning symptoms like angina with exercise, there is enough time to see a doctor and get started on effective treatments that reduce risk," said Mark Hlatky, one of the study's authors and a professor of cardiovascular medicine at Stanford University in California.
"Having a heart attack causes permanent damage, even if it doesn't kill you," he added.
Heart disease is the leading killer of Americans.
Statins, which reduce artery-clogging cholesterol, include Pfizer Inc.'s Lipitor, Merck & Co. Inc.'s Zocor and Bristol-Myers Squibb Co.'s Pravachol.
Beta blockers, prescribed to lower high blood pressure, include GlaxoSmithKline Plc's Coreg and several generic drugs such as sotalol.
The study involved patients enrolled in a Kaiser Permanente health insurance plan in
Among 916 patients whose first heart disease symptom was a heart attack, 20 percent were taking statins. In a group of 468 patients with chest pain, 40 percent took statins.
Nineteen percent of heart attack patients were on beta blockers, compared with 48 percent of those with chest pain.
Researchers also reviewed use of hormone therapy for women and drugs called alpha-blockers, ACE inhibitors and angiotensin II receptor blockers among both genders.
"We looked at all the medications used to prevent heart disease, but only statins and beta blockers lowered the risk of heart attack," said Dr. Alan Go, the study's lead author and a researcher at Kaiser Permanente of
The researchers said more study was needed to confirm their findings. The health records did not specify in all cases whether patients were taking aspirin, which also protects the heart and could have influenced cardiac outcomes, they said.
Side effects of statins may include liver or muscle problems. Beta blockers can lower blood pressure and slow the heart rate, causing fatigue, Go said.
The study, published in the Annals of Internal Medicine, was conducted by Kaiser and Stanford researchers as well as scientists at the
It was funded by the Donald W. Reynolds Foundation, a Las-Vegas based philanthropy that provides grants for medical research and other programs.
Health Tip: When Snoring Is Dangerous
HealthDay News
Monday, February 20, 2006
(HealthDay News) -- Snoring is not only annoying. It could indicate a serious health problem.
When you sleep, the muscles of your throat relax and your tongue falls backward, the National Sleep Foundation says. Your throat becomes narrow.
Breathing in and out while asleep can cause vibrations in your throat that, if significant enough, cause snoring.
Often the narrower your airway becomes, the louder your snoring. Sometimes the walls of the throat can temporarily block your airway. This is called sleep apnea and should receive prompt medical attention.
Treatments include surgery, oral appliances and an airway pressure device that blows room air into the back of the throat to keep it from narrowing too much, the foundation says.
Sunday, February 19, 2006
Diet study confusion will not change habits-analysts
By Nichola Groom
Reuters
Sunday, February 19, 2006
New studies indicating a low-fat diet does not reduce the risk of cancer and calcium supplements do little to prevent broken bones are unlikely to change consumers' habits and may only add to confusion about the link between diet and health.
In the last year, researchers have released a series of medical studies that fly in the face of conventional wisdom, which holds that weight loss, nutritional supplements and diets low in fat and calories help fight disease and prolong life.
But three studies in the Journal of the American Medical Association published earlier this month showed that women who ate less fat and more fruits and vegetables did not reduce their risk of cancer or heart disease. And Wednesday's New England Journal of Medicine found that calcium and vitamin D supplements were unlikely to prevent broken bones in women as they age.
The research comes on the heels of statistics published last year that questioned the
The studies prompted headlines suggesting consumers would take the news as carte blanche to eat as they please, but experts said that was unlikely.
"Consumers are used to the fact that there are often multiple medical studies coming out that often have conflicting findings," said Michael Allenson, a principal at food industry consulting firm Technomic. "Until they see a greater consistency ... they are likely not to make a change."
Consistency, however, appears to be a long way off as theories about diet and health are constantly changing. In the last two decades, fats and carbohydrates have alternately been praised and demonized by health experts. Most recently, fear of carbohydrates like pasta and bread led to a boom in low-carb, high-protein diets in 2004 that quickly vanished.
The headline-grabbing studies against a background of diet trends like low-carb, low-sugar and low-fat forces consumers to sift through masses of conflicting as well as confusing information and ultimately draw their own conclusions.
"The public gets information in little, fragmented pieces through the news," said Dr. Walter Willett, a nutrition professor at
Adding to the confusion, according to some, is that while some consumers take their long-term health into consideration when eating, those concerns are typically outweighed by a preoccupation with saving time and money.
"The real problem with health is that there is no immediate payback," said Harry Balzer, vice president with The NPD Group, which tracks consumer eating trends. "If I have low-fat milk today, what do I get? Did it save me time, did it save me money? The feedback is going to get to you 40 years from now."
In addition, Allenson said, consumers usually go on diets so they can lose weight, not so they can prevent disease.
"That's not the only reason why people go on diets or eat low-fat foods," Allenson said. "A lot of people are looking to lose weight because they do feel better about themselves."
In the meantime, while researchers duke it out over the long-term benefits of diet and exercise, experts said consumers can rest assured that the conventional wisdom about maintaining a healthy weight and eating a balanced diet is more likely to help than hurt.
"What we know about diets hasn't changed. It still makes sense to eat lots of fruits and vegetables, balance calories from other foods, and keep calories under control," said Marion Nestle, a nutrition professor at
A Lifesaving Stroke Drug That Few People Get
By Janice Billingsley
HealthDay Reporter
HealthDay News
Sunday, February 19, 2006
SUNDAY, Feb. 19 (HealthDay News) -- An 80-year-old stroke victim was brought recently to
Ninety minutes later, she was able to move and talk again, her neurologist, Dr. Eric Smith, recalled.
While Smith said there's no way to know if the woman might have recovered without tPA, the textbook use of the drug was just what the doctor ordered.
Unfortunately, it is the exception rather than the rule in treating stroke, according to doctors who work with stroke victims.
"The number of acute stroke victims who are given tPA is very low -- 94 to 97 percent of stroke patients do not get the drug," said Smith, associate director of acute stroke services at Massachusetts General.
Approximately 700,000 people suffer a stroke every year, and it is the leading cause of serious, long-term disability in the
Tissue plasminogen activator (tPA) is a very effective clot-busting drug that can result in a dramatic reversal of stroke symptoms. It's approved for use in certain patients having a heart attack or stroke, and works by dissolving blood clots, which cause most heart attacks and strokes. It was approved by the U.S. Food and Drug Administration for treating strokes almost 10 years ago, but is still not given to most stroke victims who could benefit from it.
There are several reasons for this disconnect, according to doctors who treat stroke victims.
First, tPA can only be given within three hours of the onset of stroke, because the risk of hemorrhage is too high after that time. Because many stroke victims don't seek treatment quickly enough -- often they ignore the symptoms or the stroke occurs while they're sleeping -- it's too late to get the drug when they get to the hospital.
Second, patients must have a CT scan before receiving the drug because tPA is only effective in treating ischemic strokes, which are those caused by a blood clot. While 85 percent of strokes are due to clots, the rest are caused by bleeding, and tPA cannot be used to treat them.
"A lot of hospitals don't have the systems in place [to get CT scans done quickly]," he said. "Time is of the essence."
And third, some doctors, particularly those who work in an emergency room, where stroke victims are often admitted, are reluctant to give the drug because of its possible risks. It can cause potentially fatal hemorrhaging in about 5 percent of those patients who get the drug, Smith said.
"There have been concerns on the part of some practitioners that the drug is too risky," Smith said.
Their worries are echoed in the conflicting guidelines offered about tPA by various medical organizations, with the American Heart Association, the
Dr. Phillip A. Scott, an assistant professor of emergency medicine at the University of Michigan, said, "Emergency medical practitioners understand that the drug works in a clinical setting with doctors with stroke expertise, but are concerned about being asked to do something that hasn't been shown to be effective in a community setting. Can community physicians replicate what very dedicated researchers did in a study?"
Scott thinks doctors can deliver tPA safely and effectively, and is heading up a study among 24 randomly selected
"We want to prove that the program can work anywhere," Scott said.
Making doctors more comfortable in prescribing tPA when appropriate is an important goal of the study, he said.
Because one in 20 stroke patients who receive the drug could develop symptomatic bleeding in the brain, doctors are naturally hesitant to prescribe it despite the fact that statistics favor its use, he said.
But, while doctors are taught the ancient oath, "First, to do no harm," they must also learn that in an era of scientific examination of effective therapies, "sometimes to do nothing is to do harm," he said.
Scott explained that, on average, if you don't treat 100 people who suffer from stroke and who meet the criteria for receiving tPA, 21 will die within three months, 20 will be able to return home with normal functioning, and the remainder will have some impairment. But if those same 100 people are given tPA, 17 will die within three months, 31 will return to normal functioning and the remainder will suffer less impairment than those who did not receive the drug.
"There's a natural avoidance behavior, and you have to get around the emotions and the fear of malpractice, which is of considerable importance to emergency room physicians," Scott said.
More information
To learn more about stroke and tPA, visit the American Heart Association.
Scientists See Growing Animal-Disease Risk
By Andrew Bridges
Associated Press Writer
The Associated Press
Sunday, February 19, 2006
Humans risk being overrun by diseases from the animal world, according to researchers who have documented 38 illnesses that have made that jump over the past 25 years.
That's not good news for the spread of bird flu, which experts fear could mutate and be transmitted easily among people.
There are 1,407 pathogens — viruses, bacteria, parasites, protozoa and fungi — that can infect humans, said Mark Woolhouse of the
Experts fear bird flu could prove an exception. Recent advances in the worldwide march of the H5N1 strain have rekindled fears of a pandemic. The virus has spread across Asia into Europe and
Controlling bird flu will require renewed focus on the animal world, including the chickens, ducks and other poultry that have been sacrificed by the tens of millions to stem the progress of the virus, experts said at a news conference late Sunday at the annual meeting of the American Association for the Advancement of Science.
"The strategy has to be looking at how to contain it in the animal world, because once you get into the human side, you're dealing with vaccines and antiretrovirals, which is a whole new realm," said Nina Marano, a veterinarian and public health expert with the National Center for Infectious Diseases.
Bird flu has killed at least 91 people — most of them in
"It is very unlikely that it would maintain that kind of case mortality rate if it made the jump," Lemon said.
Each year for the last 25 years, one or two new pathogens and multiple variations of existing threats have infected humans for the first time. Without speculating about earlier infection rates, Woolhouse told reporters it appears impossible the human species could endured such a rapid pace of new infections over thousands of years.
"Humans have always been attacked by novel pathogens. This process has been going on for millennia. But it does seem to be happening very fast in these modern times," Woolhouse said.
Woolhouse argues that either many of those diseases and other afflictions will not persist in humans or that there is something peculiar today allowing so many of them to take root in humans.
One explanation may be the recent and wide-scale changes in how people interact with the environment in a more densely populated world that is growing warmer and in which travel is faster and move extensive, Marano said. Those changes can ensure that pathogens no longer stay restricted to animals, she added. Examples from recent human history include HIV,
That prospect leaves open the question of what future threats await humans.
"It always surprises us. We think that avian flu will be the next emerging disease. My guess is something else might come out before that," said Alan Barrett, of the
On the Net:
American Association for the Advancement of Science: http://www.aaas.org/
Autism surrounded by misunderstanding-experts
By Maggie Fox
Health and Science Correspondent
Reuters
Sunday, February 19, 2006
People with autism are more intelligent and able to function better than previously believed, but mistrust of doctors, biased tests and the Internet have bred myths about the condition, experts said on Sunday.
At a meeting of the American Association for the Advancement of Science, researchers presented reports showing that even autistics who do not speak can have above-average intelligence. They also offered additional studies disputing claims that vaccines can cause autism.
"The current figures are that 75 percent of autistic people are mentally retarded, with the mute the most ... impaired," said Dr. Laurent Mottron, an autism researcher at
But Mottron believes the wrong intelligence tests are used to assess autistic children. Many are tested using the Wechsler scale, a common IQ test that includes questions about words and concepts learned in school.
The Raven's Progressive Matrices test measures abstract reasoning and consistently gives autistic children higher scores, Mottron said.
The average boost in score is 30 points, Mottron said, enough to put someone previously considered mentally retarded into the normal range and the average to gifted status.
Mottron was so impressed by the abilities of one autistic student, Michelle Dawson, that he made her a co-author of some of his papers.
Autism is a term used to describe a broad range of symptoms, from an inability to use language normally, to exhibiting deeply disturbed and repetitive behaviors. The U.S. Centers for Disease Control and Prevention says it affects anywhere between one in 500 and one in 166 children.
Morton Gernsbacher at the University of Wisconsin-Madison questioned a common idea among autism researchers that autistic people lack a "theory of mind," which, among other things, gives an ability to empathize with others.
Again, she said, the wrong tests are used to assess this ability.
No Autism Epidemic?
Dr. Judith Grether, a
She said it is impossible to find out how many cases of autism there were in the past, because many people with autism were often diagnosed as retarded, or never diagnosed. Without that information, it is impossible to say if the number of cases has grown, she said.
"We have to do the studies to find the answers," she said.
Grether said researchers in
The studies found no link with vaccines, said Dr. Irving Gottesman, a psychiatrist at the
New studies are focusing on genetic susceptibilities.
Gottesman said the studies may help ease the fears of parents that a vaccine-autism link has been covered up.
But he said scientists are battling a plethora of Internet Web sites devoted to the idea that mercury causes autism like http://www.safeminds.org/.
Gernsbacher, the mother of a child with autism, said some parents may join these lobbying groups over the advice of doctors because they get "pat answers" to initial concerns about their children. Many may have been told that boys develop later than girls, for instance.
"The mistrust (of government-funded studies and of their pediatricians) may have arisen from those kind of experiences," she said.
Candy Makers Cater to the Health-Conscious
By Elliott Minor
Associated Press Writer
The Associated Press
Sunday, February 19, 2006
It's every chocolate lover's wish that their favorite indulgence could somehow be healthy for them. Now, chocolate makers claim they have granted that wish.
Mars Inc., maker of Milky Way, Snickers and M&M's candies, next month plans to launch nationwide a new line of products made with a dark chocolate the company claims has health benefits.
Called CocoaVia, the products are made with a kind of dark chocolate high in flavanols, an antioxidant found in cocoa beans that is thought to have a blood-thinning effect similar to aspirin and may even lower blood pressure. The snacks also are enriched with vitamins and injected with cholesterol-lowering plant sterols from soy.
But researchers are skeptical about using chocolate for its medicinal purposes and experts warn it's no substitute for a healthy diet.
"To suggest that chocolate is a health food is risky," said Bonnie Liebman, nutrition director for the Center for Science in the Public Interest.
Recent research has not established a link between flavanols and a reduced risk of cancer or heart disease, she said. And with obesity already a serious health problem, "the last thing we need is for Americans to think they can eat more chocolate."
A paper published by the American Heart Association concluded that chocolate contains chemicals, including flavanols, that have the potential to reduce heart disease. But it added researchers still don't know enough about flavanols to make dietary recommendations.
Other major chocolate companies also have started promoting the flavanol content of their dark chocolates, such as Hershey's Extra Dark, introduced last fall with highlights on its label touting its 60 percent cocoa content and high level of flavanol.
Dark chocolate, which contains more flavanols than regular chocolate, is the fastest growing segment of the $10 billion-a-year chocolate market. Hershey reports that its dark-chocolate sales have grown 11.2 percent over the past four years.
Last year, Hershey Co. acquired San Francisco-based Scharffen Berger Chocolate Maker Inc., known for its dark chocolate with high cocoa content and baking products, and plans to add new dark-chocolate products.
Mars created a new division, Mars Nutrition for Health & Well-Being, to distribute CocoaVia. The company has sold the CocoaVia products online for a couple years. They are already available at retail stores in 34 states, selling for nearly $1 a bar.
"Chocolate ... is the number one flavor ingredient in the world," said Jimmy Cass, Mars' vice president of marketing. "Heart health is the No. 1 concern of adults over the age of 40 in every civilized nation. Putting those two together is automatically a big idea."
The industry, trying to appeal to baby boomers, has been focusing on products that may provide health benefits, including gourmet chocolates, organic chocolates and "functional" chocolates such as CocoaVia.
Rachael Brandeis, a national spokeswoman for the American Dietetic Association in
"Dark chocolate can fit into a healthy diet," she said. The fat in chocolate is a type that does not raise cholesterol levels, but it can add unwanted pounds if a person overindulges, she said.
"I would say if you enjoy the taste of dark chocolate, enjoy it," she said. "But you always have to be conscious of how much you're eating."
Mars adamantly defends its health claims for CocoaVia.
The company has done research studies that have shown it can improve blood flow, said Mars' chief scientist Harold Schmitz.
"We believe ... there can be a significant benefit around blood pressure, but we have not conclusively proven that," he said.
The soy extract was included in the products because it has been shown to reduce cholesterol, Cass said.
Norman Hollenberg, a professor at the
More studies are needed to determine whether it is the cocoa consumption or other factors that make them healthier, Hollenberg said.
"The data assigning it to one mechanism just isn't there yet," he said.
Regardless of the research, Mars'
It is a sterile environment of gleaming stainless machinery and highly polished floors where workers wear white suits or smocks, hair nets, safety glasses and white helmets.
The health bars pass through a machine that cools them, several that cut them to size and another that dribbles decorative swirls across the top and gives the underside a final coating of dark chocolate.
The Wellness Letter, a health and fitness newsletter published by the University of California-Berkeley, evaluated CocoaVia and advised readers to enjoy the snacks on occasion for pleasure, but not as a health food.
"CocoaVia's benefits are still unproven," the newsletter said. "Eat it only if you like it and are willing to pay the premium price."
Fruits and vegetables are still the best source of the antioxidants found in dark chocolate and they also contain vitamins, minerals, fiber and plant chemicals not found in chocolate, the newsletter said.
CocoaVia was just an expensive candy bar, concluded John Swartzberg, chairman of the newsletter's editorial board and clinical professor of health and medical science at
"But it did taste good," he said.
Leisure Brings Little Relief to Busy Moms
HealthDay News
Sunday, February 19, 2006
SUNDAY, Feb. 19 (HealthDay News) -- Kicking back during free time does wonders for men's mood, but might not ease the strain for busy wives and moms, a new study shows.
"Among mothers, free time may be too entangled with caregiving to be the 'pause that refreshes,'" study co-author Liana Sayer, assistant professor of sociology at
Even during their free time, women may be more responsible than men for meeting the needs of their children, she said.
Reporting in the February issue of the Journal of Marriage and Family, Sayer's team analyzed time diary data from two U.S national surveys conducted in 1975-1976 (708 people) and 1998-1999 (1,151 people).
Men who had more free time said they felt less pressured than men with less leisure time. However, even when women had more free time from paid work and household chores, they said they didn't feel any less rushed.
According to the researchers, the findings suggest that women -- particularly mothers -- may still feel the pressure of household and childcare duties even when they do have leisure time.
"The meaning of free time for men's and women's lives are quite different," Sayer said. "Especially for wives and mothers, it appears free time is still combined with other activities or responsibilities."
In effect, women pay a "family penalty," she said.
Sayer noted that the study found that married men with children felt no more rushed in their daily lives than single men without children. But married women with children were 2.2 times more likely to feel sometimes or always rushed, compared to single women with no children.
"It's not that women don't enjoy spending free time with their children, but it is a different experience than spending time with friends. To ease time pressure, women need more free time that is not combined with other activities or responsibilities," Sayer said.
More information
The American Medical Association has information about the stresses of parenting.
Saturday, February 18, 2006
Study: Watching Calories Takes Commitment
The Associated Press
Saturday, February 18, 2006
Losing that extra weight is one thing. Keeping it off requires a lifetime of counting calories. That's the message from a more than two-decade study of monkeys conducted by Barbara Hansen of the
Genetic differences allow some primates to remain thin and others to grow fat when fed an identical diet over the years, the study found.
Other monkeys, when forced to slim down by as much as 25 percent, regained the weight they'd lost once caloric restrictions were lifted — regardless of whether they'd been on a diet for two months or two years, Hansen said.
"The price of leanness is eternal vigilance," said Hansen, who presented her research Friday at the annual meeting of the American Association for the Advancement of Science.
Hansen has long studied the effects of calorie restriction in roughly 300 rhesus monkeys.
Cutting calories can pay off when it comes to longevity: Monkeys fed 30 percent less over the long term extended their lifetimes to 30 years from an average of 23 years, Hansen said.
The slimmer monkeys staved off the diabetes, high cholesterol, hypertension and other weight-related ailments that typically shortened the lives of their heavier peers, she added.
Protein Predicts Marrow Transplant Trouble
HealthDay News
Saturday, February 18, 2006
SATURDAY, Feb. 18 (HealthDay News) -- Measuring levels of a specific protein seven days after bone-marrow transplant helps predict which patients are likely to develop the serious and potentially deadly complication called graft vs. host disease (GVHD), researchers report.
The protein, called tumor necrosis factor (TNF), is known to be elevated in people who develop GVHD, which occurs when the transplanted bone marrow immune cells attack the patient's skin, liver and gastrointestinal cells, resulting in a massive inflammatory response that can cause death.
This
The researchers pointed out that the 94 patients had elevated TNF levels a week after their transplant, but before they showed any signs of GVHD.
They also found that patients with elevated TNF levels seven days after transplant had a 20 percent lower survival rate: just 62 percent of these patients were alive a year after their transplant, compared with 85 percent of patients with lower TNF levels.
"This suggests we could target patients to prevent graft vs. host disease based on their post-transplant level of TNF," study author Dr. John Levine, associate professor of pediatrics and internal medicine, said in a prepared statement. "If we can develop a test that can reliably predict this complication, we can look at treating it before any symptoms develop. This is one small step in a long road to making transplants safer and more effective."
The findings were presented Friday at the annual meeting of the American Society for Blood and Marrow Transplant in
More information
The National Marrow Donor Program has more about bone-marrow transplantation.
MDs: Make Stroke Victims Use Weak Arm
By Marilynn Marchione
AP Medical Writer
The Associated Press
Saturday, February 18, 2006
It sounds cruel: binding a stroke victim's good arm to force use of the weak one.
But those who tried it for two weeks were better off in the long run, greatly improving their ability to do everyday tasks like answering the phone, doctors reported Saturday.
Attending an American Stroke Association conference, they presented the results of the first large study of the treatment, called constraint or "forced-use" therapy. It is especially promising because it involves no drugs or surgery and therefore is relatively free of risk.
"About 23 to 30 percent of the stroke population would appear to benefit from this kind of treatment," said Dr. Steven Wolf, a stroke rehabilitation specialist at
More than 5 million Americans have suffered a stroke — 700,000 occur each year — and many are left with paralyzed or weak arms and legs.
Ordinary physical therapy helps rehabilitate them but only up to a point because of the brain damage a stroke causes. And if a stroke victim becomes reluctant to use an impaired limb, "there's a learned suppression of movement" that gradually makes the situation even worse, Wolf explained.
Doctors wondered whether forcing patients to use the weak arm might encourage the brain to rewire itself and send more signals to restore movement. Two small studies gave encouraging results, and Wolf's large nationwide study was launched.
He and researchers at seven other medical centers around the country randomly assigned 222 people who had suffered moderate strokes in the previous 3 to 9 months to get standard rehabilitation therapy or the forced-use treatment, either right away or a year later.
The forced-use group had their "good" arms immobilized with a splint-like mitt for two weeks while they received six hours of intense physical therapy a day on their weak arms.
The amount and quality of movement the participants had in their wrists, shoulders, arms and fingers were assessed before and after treatment began. To be sure they were getting an accurate picture, researchers videotaped participants' movements at times when they didn't know they were being observed.
The result was that both groups improved with therapy but patients who had their strong arms constrained improved more and by every measure, Wolf said. They completed far more movement tests within the two minutes allowed for each task, he said.
Wolf would not give details because they are soon to be published in a major medical journal.
However, a videotape shown at the conference of a man at the start of the study showed him awkwardly trying to grasp a phone, repeatedly knocking it off the cradle as he struggled to wrap spastic fingers around the receiver. It took him a minute and 11 seconds.
Six weeks after the forced-use treatment, the man appears in a second video, more smoothly wrapping his hand around the device and pressing numbers to make a call.
Researchers are still analyzing whether those who got the treatment a year after their strokes improved as much as those who got it sooner. That's an important issue for insurance reasons, said Dr. Daniel Hanley, a
"Many don't get insurance if they don't start rehabilitation within 30 days" of the stroke, he explained, "and they're often cut off early if they're not improving."
"The data looked encouraging," said Dr. Steven Warach, a stroke researcher at the National Institute of Neurological Disorders and Stroke, the federal agency that funded the study.
But specialists will be better able to analyze how good the treatment really may be once the details are published, he said.
On the Net:
Stroke information: http://www.strokeassociation.org
The study: http://www.excite.wustl.edu/