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.. Weekly Health News + Safety Alerts Shildt Financial Services hopes that you find the following news items to be helpful and informative. We specialize in NO FEE Employee Benefits Insurance: Health/Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life, Legal, 401(k)/Pension and Long Term Care. Please Select Your Choice Of News items from our WEEKLY HEALTH NEWS IN REVIEW for each week dating back to September, 2008 that is located below the SAFETY ALERTS Links. SAFETY ALERTS: go to CPSC, U.S. Consumer Product Safety Commission, to help keep your family and yourself safe by checking product recalls and safety news. Or go to FDA, U.S. Food and Drug Administration, for recalls, market withdrawals and safety alerts.   WEEKLY HEALTH NEWS                    IN REVIEW:   Weather Forecast | Weather Maps | Weather Radar   Health News Back To September, 2008 Oct. 30, 2009 to Nov. 6, 2009Health Highlights **Recalled Dietary Supplements May Contain Steroids. **BPA in Canned Foods Cause for Concern. **Breast Cancer May Change When It Spreads. **Tests Can Detect Early Dementia. **Cereal's 'Immunity' Claim Outrages Experts. **Diabetes Drug Label to Address Safety Concerns: FDA. **Recalled Ground Beef Possibly Tied to Two Deaths. **Chinese Drywall Contains Higher Chemical Content. **Academy of Family Physicians' Deal with Coca-Cola Co. Sparks Outrage. **Obesity Linked to Cancer. Health Highlights (Oct. 30, 2009 to Nov. 6, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Recalled Dietary Supplements May Contain Steroids The business Bodybuilding.com has recalled 65 dietary supplement products sold online that may contain steroids, says the U.S. Food and Drug Administration. The national and international recalls announced by the Boise, Idaho-based company include all lots and expiration dates of dietary supplements that might contain ingredients that are or should be classified as steroids, including "Superdrol," "Madol," "Tren," "Turinabol," and "Androstenedione," United Press International reported. To learn more about the recall, consumers can contact Bodybuilding.com at 866-236-8417. The FDA said products with steroids pose health threats, including acute liver injury, male infertility and increased risk of heart attack, stroke and death, UPI reported. ----- BPA in Canned Foods Cause for Concern Measurable levels of the chemical additive bisphenol A (BPA) were found in a variety of canned goods, including some that claimed to be BPA-free, according to an analysis released this week by the nonprofit advocacy group Consumers Union. Studies have linked BPA to reproductive abnormalities and increased risk of diabetes and cancer. Some countries have banned the sale of baby bottles made with BPA, which is a plastic hardener and a component of epoxy resin. BPA is used in many products, including food-can linings. Consumers Union said children who eat multiple servings of some of the food products included in the analysis could ingest amounts of BPA "near levels that have caused adverse effects in several animal studies," the Los Angeles Times reported. In a letter to the U.S. Food and Drug Administration, Consumers Union said the findings lend support to calls to ban BPA from use in materials that come in contact with foods and beverages. An FDA spokesman told the Times that a review of existing evidence about BPA's health effects was nearing completion, and that the agency would "make a decision how to proceed" by the end of the month. ----- Breast Cancer May Change When It Spreads About 40 percent of breast tumors change when they spread, which means that many patients with metastatic breast cancer may require treatment alterations, say Scottish researchers. They examined 211 breast tumors that had traveled to the lymph nodes in the armpit. This is the location breast cancer usually spreads to first, BBC News reported. The researchers were surprised to find that the breast cancer had changed in so many patients and in so many ways. "This suggests there is a need to test which type of disease a woman has in the lymph nodes, because it could radically alter the course of treatment she receives," said lead researcher Dr. Dana Faratian, of the Breakthrough Breast Cancer Research Unit in Edinburgh. "This research may show why some women whose cancer has spread to the lymph nodes do not respond to treatment," said Professor David Harrison, director of Breakthrough Breast Cancer, BBC News reported. The study appears in the journal Annals of Oncology. ----- Tests Can Detect Early Dementia Early dementia can be detected using memory and language tests, say British researchers. Their 20-year study included 241 elderly people who were given regular tests to assess their thinking and cognitive abilities, BBC News reported. Scrutiny of the test results revealed subtle clues associated with later mental impairment. The researchers found that participants who had more difficulty with language expression, learning and recall tasks went on to develop mild cognitive impairment or pre-dementia. The study appears in the journal Neurology. Most dementias are diagnosed only after considerable loss of brain tissue. These findings could help lead to earlier diagnosis of dementia, which is important because treatment is most effective when started early, BBC News reported. ----- Cereal's 'Immunity' Claim Outrages Experts Health and nutrition experts are attacking Kellogg for claims that one of its cereals benefits children's immune systems because it contains increased levels of vitamins A, C and E. Bold lettering on the front of Cocoa Krispies boxes claims the cereal "Now helps support your child's IMMUNITY," a declaration likely to catch the eye of parents worried about the danger the H1N1 virus presents to their children. "The idea that eating Cocoa Krispies will keep a kid from getting swine flu, or from catching a cold, doesn't make sense," Marion Nestle, a nutrition professor at New York University, told USA Today. "Yes, these nutrients are involved in immunity, but I can't think of a nutrient that isn't involved in the immune system." After she saw the cereal box claims in August, she sent a letter to the U.S. Food and Drug Administration, which has jurisdiction over false or misleading labeling. Nestle hasn't heard back from the agency. Many others are outraged by the marketing tactic. The City of San Francisco sent a letter to the FDA asking that it make Kellogg prove its claim, USA Today reported. The claim "was not created to capitalize on the current H1N1 flu situation," said Kellogg spokeswoman Susanne Norwitz. The cereal was developed "in response to consumers expressing a need for more positive nutrition." ----- Diabetes Drug Label to Address Safety Concerns: FDA A drug used to treat type 2 diabetes, Byetta, may contribute to kidney malfunction, the U.S. Food and Drug Administration warned Monday as it moved to revise safety information on the label. Over a three-year period, the FDA received 78 reports of kidney problems, including kidney failure, among patients using Byetta, it said in a statement. Some of the patients had pre-existing kidney disease, while others were at risk of developing kidney disease. "Health care professionals and patients taking Byetta should pay close attention to any signs or symptoms of kidney problems," said Dr. Amy Egan, of the Division of Metabolism and Endocrinology Products at the FDA's Center for Drug Evaluation and Research. "Patients also should be aware that problems with kidney function could lead to changes in urine color, frequency of urination or the amount of urine, unexplained swelling of the hands or feet, fatigue, changes in appetite or digestion, or dull ache in mid to lower back." Patients with any of these symptoms should notify their physician right away. Because of the safety concerns, the FDA is working with drug make Eli Lilly and Co. to update prescribing information on the label. Altered kidney function, which causes waste products to build up in the blood, can lead to serious or life-threatening conditions. ----- Recalled Ground Beef Possibly Tied to Two Deaths Fresh ground beef that was recalled because of possible E. coli contamination may be linked with two deaths and 26 illnesses, according to a U.S. Centers for Disease Control and Prevention official. The recall includes nearly 546,000 pounds of fresh ground beef distributed by Ashville, N.Y.-based Fairbank Farms to stores from Maine to North Carolina. The ground beef was sold in a number of forms, from hamburger patties to meatloaf and meatball mix, the Associated Press reported. One death involved a New York adult with several underlying health conditions, said Lola Scott Russell of the CDC. The other death was in New Hampshire, where a patient died from complications, according to state health officials. The strain of E. coli that prompted the recall is 0157:H7, which infects about 70,000 Americans a year and kills 52, Russell told the AP. The U.S. Department of Agriculture said customers with concerns should contact the stores where they buy their meat. ----- Chinese Drywall Contains Higher Chemical Content Chinese-made drywall has higher amounts of some chemicals than American-made drywall, say U.S. government agencies that have investigated reports of health problems, foul smells and corrosion by owners of homes with the Chinese product. The Environmental Protection Agency and other departments have analyzed the drywall and say further study is needed to determine if there's a direct link between the problems and the wallboard, the Associated Press reported. During the peak of the U.S. housing boom, materials became scarce, and construction companies imported millions of pounds of Chinese-made drywall, which ended up in thousands of homes. ----- Academy of Family Physicians' Deal with Coca-Cola Co. Sparks Outrage Almost two dozen doctors have quit the American Academy of Family Physicians after the group announced a deal with Coca-Cola Co. to fund educational materials about soft drinks on the academy's consumer health and wellness Web site. "Coca-Cola, like other sodas, causes enormous suffering and premature death by increasing the risks of obesity, diabetes, heart attacks, gout and cavities," Dr. Walter Willett, a nutrition expert at Harvard University, said in an e-mail to the Associated Press. The academy "should be a loud critic of these products and practices, but by signing a deal with Coke their voice has almost surely been muzzled," Willett said. The six-figure alliance between the academy and Coke is similar to ads decades ago in which doctors said mild cigarettes are safe, Dr. William Walker, public health officer for Contra Costa County near San Francisco, told the AP. He and 20 other doctors who work with his local medical practice have quit the American Academy of Family Physicians in protest. Coke won't have any control over editorial content on the Web site, said academy CEO Dr. Douglas Henley. The new online information, to be posted in January, will note the link between soft drinks and obesity and focus on sugar-free alternatives. ----- Obesity Linked to Cancer Obesity causes about 100,500 new cases of cancer each year in the United States, according to an American Institute for Cancer Research study. Cancers most commonly associated with obesity include: breast, 33,000 cases a year; endometrial, 20,700 cases; kidney 13,900 cases; colorectal, 13,200 cases; pancreas, 11,900 cases; esophagus, 5,800 cases, and gallbladder, 2,000 cases, USA Today reported. The findings are based on an analysis of cancer data and a report released earlier this year by a panel of experts. "The list of cancers affected by obesity will almost certainly increase as more research is completed," said Michael Thun, emeritus vice president of epidemiological research at the American Cancer Society, USA Today reported. "Several other types of cancer -- liver, multiple myeloma and certain leukemias -- have been linked to obesity in some studies, but this needs confirmation," Thun said. Anemia Drug, Aranesp, Appears to Double the Risk of Stroke in Patients with Diabetes and Kidney Disease Without Substantially Improving Their Quality of Life Darbepoetin alfa, marketed as Aranesp and known as an erythropoiesis-stimulating agent (ESA), is often prescribed for diabetic patients with chronic kidney disease and mild anemia. Dr. Ajay Singh, clinical chief of the renal division and director of dialysis at Brigham and Women's Hospital, said this "landmark study" raises the fundamental question of whether epoetin or darbepoetin should routinely be used in treating anemia of chronic kidney disease. "In my own practice, I will be cautious in using ESAs for most patients with chronic kidney disease, balancing risk with benefits and reserving treatment largely for patients who need frequent blood transfusions or who are candidates for a kidney transplant," he said. Anemia Drug, Aranesp, Appears to Double the Risk of Stroke in Patients with Diabetes and Kidney Disease Without Substantially Improving Their Quality of Life   By Steven Reinberg: HealthDay Reporter SATURDAY, Oct. 31 (HealthDay News) -- A drug designed to fight anemia appears to double the risk of stroke in patients with diabetes and kidney disease without substantially improving their quality of life, a new study finds. Darbepoetin alfa, marketed as Aranesp and known as an erythropoiesis-stimulating agent (ESA), is often prescribed for diabetic patients with chronic kidney disease and mild anemia. "The benefits we assumed we would have by treating anemia were less striking and the risks were more striking," said lead researcher Dr. Marc A. Pfeffer, a professor of medicine in the cardiovascular division of Brigham and Women's Hospital in Boston. "This provides new data for doctors and patients to make their own risk-benefit assessment," he said. "There was a perception that treating anemia would make people feel so much better that we'll take risks, but the benefit in quality of life was not as great as we thought, and there was a clear doubling of your risk for a stroke." The report was published in the Oct. 30 online edition of the New England Journal of Medicine to coincide with its scheduled presentation at the annual meeting of the American Society of Nephrology in San Diego. For the study, Pfeffer's team randomly assigned more than 4,000 patients with diabetes, chronic kidney disease and anemia to receive Aranesp or placebo. During the study, 632 patients receiving Aranesp died or suffered a cardiovascular event, compared to 602 of the patients receiving placebo. As well, 101 patients taking Aranesp had a fatal or non-fatal stroke compared with 53 of the placebo patients, the researchers found. In addition, patients taking Aranesp reported only a modest improvement in their fatigue, the researchers noted. In earlier studies, Aranesp and a similar drug, epoetin alfa, marketed as Procrit or Epogen, were linked to increased risk of death in cancer and stroke patients. Pfeffer believes that people with more severe kidney disease, such as those on dialysis, might still find Aranesp beneficial and the risk acceptable. "People on dialysis generally feel even worse and generally have even more severe anemia, and this class of therapy has been very helpful to them," he said. Because the drug was beneficial to these patients, doctors assumed it would help less severely anemic patients, Pfeffer said. "But this use of ESAs exceeded the data," he said. "Now we have the data, and we will revisit how the drug is used now." Dr. Phillip Marsden, a professor of medicine at the University of Toronto and author of an accompanying journal editorial, said these findings mean that doctors and patients will have to discuss whether or not to start the medication. "For most of these patients, the modest improvement in quality of life will not be enough to subject themselves to the increased risk of stroke and death," he said. ESAs have been used for two decades, Marsden noted. "It is a bit shocking that it took us 20 years to address whether or not these drugs were safe -- and now we know more." Dr. Ajay Singh, clinical chief of the renal division and director of dialysis at Brigham and Women's Hospital, said this "landmark study" raises the fundamental question of whether epoetin or darbepoetin should routinely be used in treating anemia of chronic kidney disease. "Earlier studies raised the specter of increased risk with ESA treatment. This study definitively confirms that there is meaningful risk with routine use of ESAs," said Singh, also an associate professor of medicine at Harvard Medical School. "In my own practice, I will be cautious in using ESAs for most patients with chronic kidney disease, balancing risk with benefits and reserving treatment largely for patients who need frequent blood transfusions or who are candidates for a kidney transplant," he said.More information For more information on ESAs, visit the U.S. Food and Drug Administration. SOURCES: Marc A. Pfeffer, M.D., Ph.D., professor of medicine, cardiovascular division, Brigham and Women's Hospital, Boston; Phillip Marsden, M.D., professor of medicine, University of Toronto, Canada; Ajay Singh, M.D., clinical chief, renal division, director, dialysis, Brigham and Women's Hospital, and associate professor, medicine, Harvard Medical School, Boston; Oct. 30, 2009, New England Journal of Medicine, online FDA Issues Warning for Diabetes Drug: Reports of kidney problems for those using Byetta prompted action FDA Issues Warning for Diabetes Drug: Reports of kidney problems for those using Byetta prompted action "Patients also should be aware that problems with kidney function could lead to changes in urine color, frequency of urination or the amount of urine, unexplained swelling of the hands or feet, fatigue, changes in appetite or digestion, or dull ache in the mid- to lower back," Dr. Amy Egan said. She advised patients with any of these symptoms to immediately consult with a health-care professional. Nausea, vomiting and diarrhea are the most common side effects associated with the drug. These side effects may contribute to the development of kidney malfunction, which can lead to a build-up of waste products in the blood, resulting in serious illness and potentially life-threatening conditions. FDA Issues Warning for Diabetes Drug: Reports of kidney problems for those using Byetta prompted action   　 TUESDAY, Nov. 3 (HealthDay News) -- Reports about possible kidney problems, including renal failure, in people taking the diabetes drug exenatide (Byetta) have prompted changes to the drug's prescribing information, the U.S. Food and Drug Administration said Monday. From April 2005 to October 2008, the FDA received 78 reports of kidney function problems in patients taking Byetta. Most of the problems occurred in patients with pre-existing kidney disease or one or more risk factors for developing kidney problems. Byetta is prescribed for type 2 diabetes; 7 million prescriptions were filled between April 2005 and September 2008, according to the agency. "Health-care professionals and patients taking Byetta should pay close attention to any signs or symptoms of kidney problems," Dr. Amy Egan, of the Division of Metabolism and Endocrinology Products at the FDA's Center for Drug Evaluation and Research, said in an FDA news release. "Patients also should be aware that problems with kidney function could lead to changes in urine color, frequency of urination or the amount of urine, unexplained swelling of the hands or feet, fatigue, changes in appetite or digestion, or dull ache in the mid- to lower back," Dr. Amy Egan said. She advised patients with any of these symptoms to immediately consult with a health-care professional. Byetta, made by San Diego-based Amylin Pharmaceuticals Inc., is used to control blood sugar levels. Nausea, vomiting and diarrhea are the most common side effects associated with the drug. These side effects may contribute to the development of kidney malfunction, which can lead to a build-up of waste products in the blood, resulting in serious illness and potentially life-threatening conditions.More information The American Academy of Family Physicians has more about kidney failure. -- Robert Preidt SOURCE: U.S. Food and Drug Administration, news release, Nov. 2, 2009 CDC Study Links 2 Antibiotics to Birth Defects: No added risk was found, however, for most commonly used infection-fighters The study found that two types of antibiotics were linked with a higher risk for several birth defects: nitrofurantoins and sulfonamides, sometimes called "sulfa drugs," which are prescribed for urinary tract and other infections. Women whose children had anencephaly, a fatal malformation of the skull and brain, were three times more likely to have taken sulfonamides, the study found. Sulfonamides were also tied to an increased risk for such heart defects as hypoplastic left heart syndrome and coarctation of the aorta, choanal atresia (a blockage of the nasal passage), transverse limb deficiency and diaphragmatic hernia, an abnormal opening in the diaphragm that results in severe breathing difficulties. Nitrofurantoins were also associated with multiple birth defects, including anophthalmia and microphthalmos (eye defects) and several congenital heart defects..... CDC Study Links 2 Antibiotics to Birth Defects: No added risk was found, however, for most commonly used infection-fighters By Jennifer Thomas: HealthDay Reporter MONDAY, Nov. 2 (HealthDay News) -- Taking antibiotics during pregnancy does not raise the risk for most birth defects, though there are some exceptions, new research has found. Penicillin, which is the most commonly used antibiotic during pregnancy, as well as erythromycin, cephalosporins and quinolones, other widely prescribed antibiotics, were not associated with increased risk for about 30 different birth defects. However, the study found that two types of antibiotics were linked with a higher risk for several birth defects: nitrofurantoins and sulfonamides, sometimes called "sulfa drugs," which are prescribed for urinary tract and other infections. Women whose children had anencephaly, a fatal malformation of the skull and brain, were three times more likely to have taken sulfonamides, the study found. Sulfonamides were also tied to an increased risk for such heart defects as hypoplastic left heart syndrome and coarctation of the aorta, choanal atresia (a blockage of the nasal passage), transverse limb deficiency and diaphragmatic hernia, an abnormal opening in the diaphragm that results in severe breathing difficulties. Nitrofurantoins were also associated with multiple birth defects, including anophthalmia and microphthalmos (eye defects) and several congenital heart defects. Mothers whose children were born with a cleft lip or cleft palate were twice as likely to have taken nitrofurantoins, the study found. But pregnant women should not be overly worried if they need an antibiotic to treat an infection during pregnancy, stressed the study's lead author, Krista Crider, a geneticist with the National Center on Birth Defects and Developmental Disabilities, part of the U.S. Centers for Disease Control and Prevention. "The most important message is that most commonly used antibiotics do not seem to be associated with the birth defects we studied," Crider said. The findings are published in the November issue of Archives of Pediatrics & Adolescent Medicine. Crider and her colleagues analyzed data on more than 13,000 women whose babies had one of more than 30 birth defects, including cleft palate, heart or limb defects and anencephaly. They compared the women's rates of antibiotic usage, from the month leading up to pregnancy through the end of the first trimester, with that of almost 5,000 women whose children did not have a birth defect. The data was culled from the National Birth Defects Prevention Study, which began in 1997 and includes about 30,000 women from 10 states. Information on the impact of many prescription drugs on developing fetuses is sorely lacking, Crider pointed out. Much of that stems from the fact that ethical considerations preclude conducting drugs trials in pregnant women, she said. Though many antibiotics have been used safely for decades, resistant strains of bacteria are forcing doctors to use a wider array of antibiotics. For some, little data exist. The researchers found that about 30 percent of women took an antibiotic between the three months prior to conception and the end of the pregnancy. Even antibiotics that generally were safe were found to be associated with a few specific birth defects. Women whose babies were born with a certain type of limb malformation were three times more likely to have taken penicillin. Erythromycin, cephalosporins and quinolones were also associated with an increased risk for one or two specific birth defects. However, the researchers said they did not know if the birth defects were caused by the antibiotics or the underlying infection. One expert said women need to remember the good antibiotics can do mom and baby, as well. Though many pregnant women want to avoid taking any drugs during pregnancy, infections pose a risk to mother and baby and often need to be treated, said Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City. "Untreated infections during pregnancy can lead to severe consequences, such as maternal sepsis [blood infection] and preterm labor," Wu said. "Yet many patients are afraid to take medications such as antibiotics during pregnancy." The study "supports the evidence that antibiotics are safe for pregnant women," she said. "It is reassuring for doctors and patients to have more data on necessary drugs for pregnancy." Crider also stressed that the chances of having a baby with a birth defect remain small, even if an antibiotic has been linked to an elevated risk. For example, the risk of having a child with hypoplastic left heart syndrome is about one in 4,200. Sulfonamides were associated with a three-fold increase, making the likelihood about one in 1,400, she said. Brand names for nitrofurantoins include Furadantin, Macrobid and Macrodantin. Bactrim and Septra are among the brand names of sulfonamides. Given the data, Crider said, women should be cautious about taking either of those types of drugs during pregnancy and should discuss other options with their physicians,. According to the study, the overall risk for having a child with a birth defect is about three percent. The study did not look at chromosomal defects, including Down syndrome.More information The U.S. Centers for Disease Control and Prevention has more on birth defects. SOURCES: Krista Crider, Ph.D., geneticist, National Center on Birth Defects and Developmental Disabilities, U.S. Centers for Disease Control and Prevention, Atlanta; Jennifer Wu, M.D., obstetrician-gynecologist, Lenox Hill Hospital, New York City; November 2009, Archives of Pediatrics & Adolescent Medicine Focused Radiation May Help Some With Lung Cancer: Study reports successes, especially for those with good lung function Three-year survival was 100 percent for people with early-stage lung cancer and good lung function who were treated with radical stereotactic radiosurgery using CyberKnife, according to a new study funded by the product's maker. Stereotactic radiosurgery, despite its name, is not surgery but rather a type of radiation therapy that focuses high-powered X-rays on abnormal tissue only, sparing nearby healthy tissue. "What we also learned from this study is that patients with poorer lung functioning don't do nearly as well," Dr. Brian T. Collins stated in the news release. The overall survival in this group of patients was only 30 percent, the researchers found. "This information is important for the doctor and patient when making treatment decisions. In treating someone with poor lung function, it would seem prudent to..... Focused Radiation May Help Some With Lung Cancer: Study reports successes, especially for those with good lung function   　 WEDNESDAY, Nov. 4 (HealthDay News) -- Three-year survival was 100 percent for people with early-stage lung cancer and good lung function who were treated with radical stereotactic radiosurgery using CyberKnife, according to a new study funded by the product's maker. Standard care for people with small lung tumors calls for surgical removal of the affected lobe, but some people cannot have surgery because of other medical conditions, such as heart disease or emphysema. "Our goal has been to find a reasonable option for patients who don't want or can't tolerate surgery," the study's lead author, Dr. Brian T. Collins, a radiation oncologist at the Lombardi Comprehensive Cancer Center at Georgetown University Hospital, said in a news release from the university. "What we discovered is a very promising option that may be relevant for other stage 1 patients as well. More follow-up with these patients is planned to see how they progress five years after treatment." Stereotactic radiosurgery, despite its name, is not surgery but rather a type of radiation therapy that focuses high-powered X-rays on abnormal tissue only, sparing nearby healthy tissue. The study included 24 people with early-stage lung cancer. Three years after undergoing stereotactic radiosurgery, overall survival was 79 percent. Five deaths were attributed to progressive lung dysfunction. But among those with better lung function, survival was 100 percent, the researchers reported. The treatment was found to be well tolerated, with most people reporting only mild fatigue. "What we also learned from this study is that patients with poorer lung functioning don't do nearly as well," Dr. Brian T. Collins stated in the news release. The overall survival in this group of patients was only 30 percent, the researchers found. "This information is important for the doctor and patient when making treatment decisions. In treating someone with poor lung function, it would seem prudent to modify the treatment dose in order to reduce further damage to the lungs that stereotactic radiosurgery causes," Collins added. The study was scheduled to be presented Nov. 3 at the American Society of Chest Physicians annual meeting in San Diego. It was funded by the CyberKnife Society, a nonprofit group supported by Accuray, which makes CyberKnife systems. Collins has been a paid clinical consultant for Accuray.More information The Radiological Society of North America has more about stereotactic radiosurgery. -- Robert Preidt SOURCE: Georgetown University, news release, Nov. 3, 2009 Diet Soda, Sodium Tied to Kidney Trouble: It's more proof that what you eat and drink affects health, researchers say A diet high in salt or artificially sweetened drinks increases the risk of kidney function decline, two studies show. "While more study is needed, our research suggests that higher sodium and artificially sweetened soda intake are associated with greater rate of decline in kidney function," said Dr. Julie Lin. The association between artificially sweetened beverages and kidney function decline persisted after Lin and colleague Dr. Gary Curhan accounted for other factors, such as age, obesity, high blood pressure, diabetes, smoking, physical activity, caloric intake and cardiovascular disease. Diet Soda, Sodium Tied to Kidney Trouble: It's more proof that what you eat and drink affects health, researchers say   　 MONDAY, Nov. 2 (HealthDay News) -- A diet high in salt or artificially sweetened drinks increases the risk of kidney function decline, two studies show. "There are currently limited data on the role of diet in kidney disease," researcher Dr. Julie Lin, of Brigham and Women's Hospital in Boston, said in a news release. "While more study is needed, our research suggests that higher sodium and artificially sweetened soda intake are associated with greater rate of decline in kidney function." The first study looked at diet and kidney function decline in more than 3,000 women enrolled in the national Nurses' Health Study. The researchers found that "in women with well-preserved kidney function, higher dietary sodium intake was associated with greater kidney function decline, which is consistent with experimental animal data that high sodium intake promotes progressive kidney disease." The second study looked at the association between sugar- and artificially-sweetened beverages and kidney function decline in the same group of women. The researchers found an association between two or more servings per day of artificially sweetened soda and a two-fold increased risk of faster kidney function decline. There was no connection between sugar-sweetened beverages and kidney function decline. The association between artificially sweetened beverages and kidney function decline persisted after Lin and colleague Dr. Gary Curhan accounted for other factors, such as age, obesity, high blood pressure, diabetes, smoking, physical activity, caloric intake and cardiovascular disease. Further study is needed to better understand how artificial sweeteners influence kidney function decline, the researchers said. The studies were to be presented this week at the annual meeting of the American Society of Nephrology, in San Diego.More information The U.S. National Kidney Disease Education Program offers tips on how to keep your kidneys healthy. -- Robert Preidt SOURCE: American Society of Nephrology, news release, Oct. 31, 2009 Virulent Strain of MRSA Resists Treatment: Type that causes bloodstream infections can be quickly fatal, study finds New research holds bad news for health officials worried about a potentially lethal infection called MRSA that haunts hospitals: A strain that infects the bloodstream is five times more deadly than other strains. To make matters worse, the USA600 strain appears to be at least partially immune to an antibiotic that's used to treat the condition. A full half of patients infected with the strain died within a month. That's nearly five times the death rate of other people infected with MRSA, and 10 to 30 percent of those who acquire MRSA infections in the bloodstream die within a month, the study found. MRSA, or methicillin-resistant Staphylococcus aureus, causes infections in the skin and bloodstream. It can also infect surgical wounds and cause pneumonia. In most cases, it sickens people in the hospital, but cases are becoming more common outside the health-care community. Virulent Strain of MRSA Resists Treatment: Type that causes bloodstream infections can be quickly fatal, study finds   　 SUNDAY, Nov. 1 (HealthDay News) -- New research holds bad news for health officials worried about a potentially lethal infection called MRSA that haunts hospitals: A strain that infects the bloodstream is five times more deadly than other strains. To make matters worse, the USA600 strain appears to be at least partially immune to an antibiotic that's used to treat the condition, the researchers have found. A full half of patients infected with the strain died within a month, according to a study scheduled to be presented at the annual meeting of the Infectious Diseases Society of America, held Oct. 29 to Nov. 1 in Philadelphia. That's nearly five times the death rate of other people infected with MRSA, and 10 to 30 percent of those who acquire MRSA infections in the bloodstream die within a month, the study found. MRSA, or methicillin-resistant Staphylococcus aureus, causes infections in the skin and bloodstream. It can also infect surgical wounds and cause pneumonia. In most cases, it sickens people in the hospital, but cases are becoming more common outside the health-care community, according to information in a news release from the Henry Ford Health System. Researchers think it's possible that the USA600 strain is unique. But they don't know if other factors -- such as the age of patients -- could be at play. Those who developed the USA600 strain tended to be older than those who acquired other MRSA strains, averaging 64 compared with 52 years old, the study noted. "While many MRSA strains are associated with poor outcomes, the USA600 strain has shown to be more lethal and cause high mortality rates," Dr. Carol Moore, the study's lead author and a research investigator at the Henry Ford Hospital's division of infectious diseases, said in the news release. "In light of the potential for the spread of this virulent and resistant strain and its associated mortality," she said, "it is essential that more effort be directed to better understanding this strain to develop measures for managing it." MRSA is challenging to treat because strains can be immune to many medications. The USA600 strain appears to be more immune than other strains to the drug vancomycin, which often still has the power to vanquish MRSA.More information The U.S. Centers for Disease Control and Prevention has more about MRSA. -- Randy Dotinga SOURCE: Henry Ford Health System, news release, Oct. 31, 2009 Nicotine Patch Plus Lozenge Best for Quitting Smoking: This combo wins out in first head-to-head study of various smoking-cessation aids The first head-to-head comparison of different quit-smoking products finds that a nicotine patch combined with a nicotine lozenge had the most success. More than other methods, including antidepressants, this combination best mimics the actual highs and lows of smoking to help smokers kick their habit, experts said. "The reasoning behind it is that the patch supplies a steady supply of nicotine replacement and the lozenges give a boost of nicotine which you can use when you have an extra craving. It gives people control," said Dr. Whiteson, who was not involved in the research. "But also remember that in this study people got a lot of counseling. It was that combination that resulted in a 40 percent quit rate [at six months out]," added Megan E. Piper. Coupling the patch with the lozenge was the only intervention that performed better than a placebo. Nicotine Patch Plus Lozenge Best for Quitting Smoking: This combo wins out in first head-to-head study of various smoking-cessation aids By Amanda Gardner: HealthDay Reporter MONDAY, Nov. 2 (HealthDay News) --The first head-to-head comparison of different quit-smoking products finds that a nicotine patch combined with a nicotine lozenge had the most success. More than other methods, including antidepressants, this combination best mimics the actual highs and lows of smoking to help smokers kick their habit, experts said. "The study shows that, yes, one therapy came out on top, the patch and the lozenge [together]," said Dr. Jonathan H. Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at NYU Langone Medical Center in New York City. "The reasoning behind it is that the patch supplies a steady supply of nicotine replacement and the lozenges give a boost of nicotine which you can use when you have an extra craving. It gives people control," said Whiteson, who was not involved in the research. "If you combine these different types of nicotine replacement you're going to get the best bang for your buck," added Megan E. Piper, lead author of the new study and an assistant professor at the Center for Tobacco Research and Intervention at the University of Wisconsin, Madison. "But also remember that in this study people got a lot of counseling. It was that combination that resulted in a 40 percent quit rate [at six months out]." In fact, coupling the patch with the lozenge was the only intervention that performed better than a placebo, reported the study, which appears in the November issue of the Archives of General Psychiatry. The study adds insight to a field that's long suffered from too little research. "As each medication comes out, it is tested against a placebo," but not against other methods, Piper explained. "There just hasn't been the funding or the availability of a program to do something like that." This research was funded by the U.S. National Institutes of Health. Medication was provided free by drug maker GlaxoSmithKline. Several of the study authors reported financial ties to different pharmaceutical companies. For this study, 1,504 adults who had smoked at least half a pack a day for the past six months and wanted to quit were randomly assigned to a placebo or one of five different quit-smoking interventions: nicotine lozenge, nicotine patch, bupropion (Wellbutrin, an antidepressant), nicotine patch plus nicotine lozenge, and bupropion plus nicotine lozenge. All groups received six individual counseling sessions with a case manager. The nicotine patch, which has been available for more than two decades, is currently the most widely used pharmacotherapy to help people quit smoking. However, only the combination of the nicotine patch and the lozenge performed significantly better than placebo six months after the person smoked their last cigarette, the team found. People taking the patch-lozenge combination were also more likely to have sworn off cigarettes after one week and were more likely to have attained one full day without smoking, the researchers said. The 40 percent (at six months) success rate reported here will decline as time goes on, Whiteson noted. He added, however, that in the smoking cessation arena, "even the 30 percent range is very good." Another expert said the study raised some key concerns. "The question is, how many of them had to continue on the lozenge in order to stay off cigarettes? I always tell people not to do the lozenge alone because it mimics the very thing that smoking does, which gives you a spike. Then, when you reach a trough, you pick up a lozenge -- or cigarette," said Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital in New York City. "Once they stopped everything, could they do without the spikes and troughs [of the lozenge], which mimics physiologically everything the cigarette is doing? Smoking is a two-pronged problem. There's nicotine dependence and a behavioral aspect to it." Dr. Elliot Wineburg, assistant clinical professor of psychiatry at Mount Sinai School of Medicine in New York City, felt the study suffered from some limitations, namely lack of individual attention to individual smokers' habits. "The authors said that they gave the patients lozenges according to the company's [instructions]," he said. But this doesn't take into account how much people smoke or how strong their cigarettes are. "They don't even look into the amount of nicotine a person takes."More information There's more tips on successfully quitting smoking at the American Cancer Society. SOURCES: Megan E. Piper, Ph.D., assistant professor, Center for Tobacco Research and Intervention, University of Wisconsin, Madison; Jonathan H. Whiteson, M.D., co-director, Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center, NYU Langone Medical Center, New York City; Elliot Wineburg, M.D., assistant clinical professor of psychiatry, Mount Sinai School of Medicine, New York City; Len Horovitz, pulmonary specialist, Lenox Hill Hospital, New York City; November 2009 Archives of General Psychiatry Switch to 'Light' Cigarettes Makes Quitting Tougher: Smokers may mistakenly believe they're 'healthier,' researchers say According to the authors, an estimated 84 percent of cigarettes sold in the United States are so-called low-tar and low-nicotine, with many of them called "lights." Some smokers may assume they're healthier than other cigarettes, but medical researchers say smokers still suck in about the same level of carcinogens. And research has shown that "lighter" cigarettes don't reduce smoking-related illness and death. Regardless of what brand they smoke, "the average smoker dies 13 to 14 years earlier than he or she would die if he or she did not smoke," Dr. Hilary Tindle said. Regardless of how cigarettes are marketed, Tindle said, "the best solution for the problem of how to live longer and healthier is to quit smoking now." Switch to 'Light' Cigarettes Makes Quitting Tougher: Smokers may mistakenly believe they're 'healthier,' researchers say   By Randy Dotinga: HealthDay Reporter TUESDAY, Nov. 3 (HealthDay News) -- Experts have long known that "low-tar" and "light" cigarettes aren't any healthier than regular cigarettes, and new research suggests they have another drawback: People who switch to them are less likely to quit, even those who switch specifically because they want to stop smoking. In fact, "switching to ['light' cigarettes] for any reason is associated with continuing to smoke," said study author Dr. Hilary Tindle, a researcher at the University of Pittsburgh's Division of General Internal Medicine. However, she acknowledged that the research does not prove that switching leads directly to a lower rate of quitting. According to the authors, an estimated 84 percent of cigarettes sold in the United States are so-called low-tar and low-nicotine, with many of them called "lights." Some smokers may assume they're healthier than other cigarettes, but medical researchers say smokers still suck in about the same level of carcinogens. And research has shown that "lighter" cigarettes don't reduce smoking-related illness and death. Regardless of what brand they smoke, "the average smoker dies 13 to 14 years earlier than he or she would die if he or she did not smoke," Tindle said. In the new study, published online Nov. 3 in the journal Tobacco Control, researchers examined the results of a 2003 survey of 30,800 people in the United States who had smoked within the past year. Thirty-eight percent of them had switched to "lighter" cigarettes, with the largest percentage of those -- 26 percent -- saying they'd done so for better flavor. Forty-three percent mentioned one, two or three reasons for switching, with quitting smoking being one of those reasons. However, those who had switched were 46 percent less likely to have quit smoking. Why might switchers be more likely to continue smoking? "Prior research suggests that switching may resolve smokers' cognitive dissonance about smoking -- something along the lines of, 'Well, since I'm smoking a [supposedly] healthier cigarette, I really don't have to worry about lung cancer, heart disease, impotence, wrinkles, early death [fill in the blank] because my health is not at risk,'" Tindle said. "This type of rationale may keep more health-conscious smokers smoking." But there are other possible explanations, added Robert West, a researcher who studies tobacco use at University College London in England. It's possible, for example, that people who switch are already more dependent on cigarettes and less able to quit, he said. What to do? "In Europe, tobacco companies are not allowed to call cigarettes low tar or imply that they are in any way safer," West said. Regardless of how cigarettes are marketed, Tindle said, "the best solution for the problem of how to live longer and healthier is to quit smoking now." In related news, a study published Nov. 3 in the Journal of Epidemiology and Community Health finds that smoking during pregnancy is linked to a higher level of behavioral problems in offspring later in life, even among those as young as 3. A team from the University of York in the England tracked 14,000 mother-and-child pairs and found that maternal smoking during pregnancy was associated with significantly higher odds for attention-deficit hyperactivity disorder (ADHD) and other behavioral woes, compared to children born to nonsmoking mothers.More information Find out more about smoking and its consequences at the U.S. Centers for Disease Control and Prevention. SOURCES: Hilary Tindle, M.D., MPH, researcher, Center for Research on Healthcare, division of general internal medicine, University of Pittsburgh; Robert West, Ph.D., Health Behavior Research Center, department of epidemiology and public health, University College London, U.K.; Nov. 3, 2009, Tobacco Control, online Oct. 23, 2009 to Oct. 30, 2009Health Highlights **FDA Warns of Bogus Swine Flu Products. **EPA Seeks to Expand Lead Safety Rules. **Cancer Drug Prevents Premature Labor. **FDA Lax on Drug Follow-Up Studies. **Cell Phones Linked To Brain Tumors. **Unhealthy Breakfast Cereals Heavily Marketed to Children. **Antibody May Benefit Trauma Patients. **Enzyme May Be Key in Nerve Fiber Regeneration. **Cars Big Threat To Trick-or-Treaters. **High-Fiber Foods May Protect Against Inflammatory Diseases. **Immune-Suppressing Drugs May Boost Bladder Cancer Risk. **Curry Spice Chemical Kills Esophageal Cancer Cells. **Radiation Treatment Required For Fresh Gulf of Mexico Oysters. **Antibody May Benefit Trauma Patients. **FDA Panel Recommends First Non-Drug Asthma Treatment. Health Highlights (Oct. 23, 2009 to Oct. 30, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: FDA Warns of Bogus Swine Flu Products Fake Tamiflu is one of many bogus products being sold over the Internet that claim to prevent, treat or diagnose swine flu, says the U.S. Food and Drug Administration. The agency has issued warnings about fraudulent claims to the Web marketers of more than 140 products, ranging from sprays or devices that supposedly sterilize surfaces or the air to dietary supplements touted for strengthening the immune system, the Associated Press reported. Shortly after swine flu emerged last spring, about 10 bogus products a day were appearing online, according to Alyson Saben, the head of the FDA swine flu consumer fraud team. That rate slowed as the flu abated in the summer, but recently "we are seeing new sites pop up," Saben said. Fake Tamiflu causes the most concern for the FDA. The agency purchased and tested five of the products and found that one contained powdered talc and general Tylenol, but no Tamiflu. Others contained some Tamiflu but weren't approved for sale in the United States, the AP reported. "We have no idea of the conditions under which they were manufactured. They could contain contaminated, counterfeit, impure or subpotent or superpotent ingredients," Saben said. ----- EPA Seeks to Expand Lead Safety Rules An expansion of a rule that requires contractors who renovate, repair or paint older homes to be trained and certified in "lead safe" work practices is being proposed by the U.S. Environmental Protection Agency. Currently, contractors working on homes built before 1978 are required to take precautions to reduce potential paint-associated lead exposure if pregnant women or children under age 6 live in the home. The proposed change would cover most homes built before 1978, regardless of who lives in them, the Wall Street Journal reported. The change would mean a 50 percent increase in the number of contractors who would need to abide by the "lead-safe" rule for older homes, according to EPA spokesman Dale Kemery. The EPA also wants to re-examine the hazard standard for lead in dust and possibly modify the regulatory definition of lead-based paint. Some groups say that current regulations are outdated, the Wall Street Journal reported. Comments on the proposal will be accepted for 30 days and the EPA expects to finalize the changes by April 2010. ----- Cancer Drug Prevents Premature Labor The cancer drug Trichostatin A (TSA) can stop contractions and may point to new ways to prevent premature labor, according to English researchers. They tested the drug on muscle tissue taken from 36 women who had cesarean sections and found that the drug increases levels of a protein that controls muscle relaxation, BBC News reported. Specifically, the Newcastle University team found that TSA reduced contractions for spontaneously contracting tissue by an average of 46 percent and reduced contractions induced by the labor drug oxytocin by an average of 54 percent. The drug works by increasing the levels of a protein that controls muscle relaxation. "We will not give this drug to a patient because it can damage as many as 10% of the genes in a cell," said study leader Professor Nick Europe-Finner, BBC News reported. "But it does show us that other more specific agents that act on the same enzymes but only one at a time are worth investigating." The study appears in the journal Cellular and Molecular Medicine. ---- FDA Lax on Drug Follow-Up Studies The use of several drugs to treat cancer and other conditions has been allowed to continue even though follow-up studies showed they didn't extend patients' lives, says a U.S. Government Accountability Office report to be released Monday. The GAO also said that the Food and Drug Administration has never ordered a company to take a drug off the market because promised follow-up studies about the drug's benefits haven't been completed. In some cases, that follow-up information is more than a decade overdue, the Associated Press reported. The FDA also needs to do more to monitor whether drugs approved under its so-called "accelerated approval" program actually fulfill their promise, the GAO said. The accelerated approval program is designed to speed availability of treatments for the most serious diseases. The GAO said that since 1992, the FDA has requested follow-up 144 studies of drugs approved under the program, but only 64 percent have been completed and more than one-third are still pending, the AP reported. The GAO report presents an overly-negative assessment of the program and there are no plans to get more aggressive about follow-up, according to the FDA. "Millions of patients with serious or life-threatening illnesses have had earlier access to new safe and effective treatments," through the accelerated approval program, the agency said, the AP reported. ----- Cell Phones Linked To Brain Tumors Long-term cell phone users are more likely than other people to develop brain tumors later in life, according to a World Health Organization study that included 12,800 people in 13 countries. People who used cell phones for 10 years or longer had a "significantly increased risk" of brain tumors, study leader Elisabeth Cardis told The Daily Telegraph, United Press International reported. Cardis recommended restricting cell phone use by children, but they shouldn't be banned from using them because they're important in emergencies and for maintaining contact with parents. As for adults, they should moderate their use and reduce direct contact by using wireless ear devices, headsets and other hands-free devices. More than 30 previous studies have found no link between cell phone use and harmful health effects, said a representative of the Mobile Operators Association, UPI reported. ----- Unhealthy Breakfast Cereals Heavily Marketed to Children Breakfast cereals marketed to children contain 85 percent more sugar, 65 percent less fiber, and 60 percent more sodium than those targeted at adults, says a Yale University study. The least nutritious cereals -- such as Reese's Puffs, Lucky Charms and Cap'n Crunch -- are often the most heavily marketed to children, found that researchers at Yale's Rudd Center for Food Policy and Obesity, USA Today reported. Among the other findings: Major cereal makers do make products that receive good nutrition marks, but not many of these are marketed to children. The average sugar content of children's cereals has decreased from 3.5 teaspoons to 3 teaspoons of sugar per serving. Cereal makers spend more than $156 million a year marketing to children. The average American preschooler sees 642 TV cereal ads a year and most of those are for cereals with the poorest nutrition ratings. Some cereals with the worst nutrition ratings have health claims on the boxes. The Yale researchers said cereal company pledges to self-regulate haven't "shielded kids from the barrage of messages" to eat the least healthy cereals, USA Today reported. "Industry regulation is an abject failure," said Kelly Brownell, director of the Rudd Center. "The worst cereals are being marketed very heavily to children." The study is being presented Monday at the annual meeting of the Obesity Society. ----- Antibody May Benefit Trauma Patients An antibody that could help control major internal bleeding in patients with major trauma injuries from car crashes, bullets and other causes has been identified by U.S. researchers. A protein called histone is responsible for much of the internal bleeding in trauma patients, according to the Oklahoma Medical Research Foundation team. They also found that a certain type of antibody blocks the ability of histone to cause damage, BBC News reported. In experiments in mice with sepsis, the antibody stopped the toxic effects of histones, and the mice recovered. The findings appear in the journal Nature Medicine. The researchers want to conduct studies in primates and eventually humans. "These findings offer some clues as to why people suffering from one traumatic injury often experience a catastrophic 'cascade' of secondary traumatic events," said Dr. Stephen Prescott, president of OMRF, BBC News reported. "If we can figure out how to control the initial injury, perhaps that will stop the domino effect that so often follows." ----- Enzyme May Be Key in Nerve Fiber Regeneration An enzyme that plays a critical role in regenerating damaged nerve fibers has been identified by U.S. researchers, a finding that could lead to new treatments for brain and spinal cord injuries. In experiments with rats, the team at Children's Hospital Boston found that the enzyme Mst3b appears to be an important regulator of a cell-signaling pathway that controls nerve fiber (axon) growth, United Press International reported. When Mst3b was absent, damaged optic nerves in the rats showed little regeneration, said the study, which appears in the journal Nature Neuroscience. "All the growth factors we've tested -- oncomodulin, inosine, brain-derived neurotropic factor, nerve growth factor -- act through Mst3b," said researcher Larry Benowitz, UPI reported. "In fact, activating Mst3b by itself is enough to cause growth even if there are no growth factors around. In terms of basic understanding of nerve cells, this is a very exciting finding." ----- Cars Big Threat To Trick-or-Treaters The dangers faced by children on Halloween are more pedestrian than supernatural. Safe Kids USA says youngsters are more than twice as likely to be killed by a car while walking on Halloween than on any other night of the year, USA Today reported. An analysis of 2002-06 data showed that an average of 2.2 children are killed in pedestrian accidents between 4 p.m. and 10 p.m. on Halloween, compared with an average of one death during the same time period on every other night of the year. "Halloween is consistently the most dangerous day of the year for kids to walk," Safe Kids spokeswoman Kate Jones told USA Today. There are a number of reasons for this increased risk. Dark costumes can make it hard for drivers to see trick-or-treaters and masks can impair children's ability to see around corners. Many suburbs don't have sidewalks and children are more likely to dart out from between parked cars. "We need to get the message out to drivers," Moira Donahue, director of pedestrian safety at SafeKids, told USA Today. "On Halloween, slow down, turn your lights on and be prepared that there are going to be more kids out." ----- High-Fiber Foods May Protect Against Inflammatory Diseases A high-fiber diet may boost the immune system and help prevent inflammatory diseases such as asthma, diabetes and arthritis, say Australian researchers and their colleagues. In the gut, high-fiber foods are converted by bacteria into short chain fatty acids, which are known to ease some inflammatory diseases in the bowel. This new study identified a molecule that binds to short chain fatty acids and also functions as an anti-inflammatory, Agence France Presse reported. The study appears in the journal Nature. "The important point about our work is that we provide the molecular explanation that links fiber in the diet to the microorganisms in our gut to the effect on the immune response," Professor Charles Mackay told AFP. "We believe that changes in diet, associated with Western lifestyles, contribute to the increasing incidences of asthma, type 1 diabetes and other auto-immune diseases," he said. "Now we have a new molecular mechanism that might explain how diet is affecting our immune systems." ----- Immune-Suppressing Drugs May Boost Bladder Cancer Risk People who take immune-suppressing glucocorticoid drugs may be at increased risk for bladder cancer, according to a U.S. study. Glucocorticoids are used to prevent organ rejection in transplant patients and to treat diseases such as asthma and rheumatoid arthritis. Dartmouth Medical School researchers examined the long-term use of glucocorticoids by 786 bladder cancer patients and 1,083 controls, United Press International reported. The finding that glucocorticoids may increase bladder cancer risk "might indicate the need for closer monitoring of individuals who regularly take glucocorticoids," epidemiologist Margaret Karagas and colleagues said in a news release. The study was published in the British Journal of Cancer. Previous studies found an association between glucocorticoids and increased risk of lymphoma and skin cancer, UPI reported. ----- Curry Spice Chemical Kills Esophageal Cancer Cells A chemical found in the curry spice tumeric kills esophageal cancer cells, according to U.K. researchers. It's long been believed that the chemical curcumin has healing powers and it's being tested as a treatment for conditions such as arthritis and dementia, BBC News reported. In lab tests, researchers at the Cork Cancer Research Center found that curcumin started to kill esophageal cancer cells within 24 hours and that the cancer cells began to digest themselves after curcumin triggered cell death signals. The study appears in the British Journal of Cancer. "Scientists have known for a long time that natural compounds have the potential to treat faulty cells that have become cancerous and we suspected that curcumin might have therapeutic value," said study author Dr. Sharon McKenna, BBC News reported. "This is interesting research which opens up the possibility that natural chemicals found in turmeric could be developed into new treatments for oesophageal cancer," said Dr Lesley Walker, director of cancer information at Cancer Research UK. ----- Radiation Treatment Required For Fresh Gulf of Mexico Oysters Beginning In 2011 Beginning in 2011, raw oysters harvested from the Gulf of Mexico during warm months will have to be treated with low-dose radiation to kill a potentially deadly bacteria, say U.S. health officials. There will be a ban on sales of oysters that aren't treated. Each year in the U.S., about 15 people die after eating fresh oysters infected with Vibrio vulnificus, a bacteria typically found in coastal waters between April and October, the Associated Press reported. Oyster industry officials say the low-dose radiation procedure is too expensive and contend that adequate safety measures are already in place. Two-thirds of oysters consumed in the U.S. come from the Gulf of Mexico, the AP reported. ------ Antibody May Benefit Trauma Patients An antibody that could help control major internal bleeding in patients with major trauma injuries from car crashes, bullets and other causes has been identified by U.S. researchers. A protein called histone is responsible for much of the internal bleeding in trauma patients, according to the Oklahoma Medical Research Foundation team. They also found that a certain type of antibody blocks the ability of histone to cause damage, BBC News reported. In experiments in mice with sepsis, the antibody stopped the toxic effects of histones, and the mice recovered. The findings appear in the journal Nature Medicine. The researchers want to conduct studies in primates and eventually humans. "These findings offer some clues as to why people suffering from one traumatic injury often experience a catastrophic 'cascade' of secondary traumatic events," said Dr. Stephen Prescott, president of OMRF, BBC News reported. "If we can figure out how to control the initial injury, perhaps that will stop the domino effect that so often follows." ----- FDA Panel Recommends First Non-Drug Asthma Treatment A new technology from a small California-based company should be approved as the first non-drug treatment for asthma, a U.S. Food and Drug Administration advisory panel recommended Wednesday. Asthmatx's Alair System employs bronchial thermoplasty, which uses radiofrequency wave-generated heat to burn away lung tissue that impairs breathing and causes wheezing and coughing spasms, the Associated Press reported. The radiofrequency waves are delivered via a catheter controlled by a respiratory specialist. The procedure, performed over three sessions of a half hour each, is appropriate only for adult patients with severe asthma that doesn't respond to drug treatment. The FDA panel voted six to one to recommend approval of the new system under certain conditions, including long-term safety monitoring of patients, the AP reported. The FDA usually follows the advice of its advisory panels. The Alair System is already approved in Europe. If the FDA does approve the system, it may be available in the United States in the first half of 2010. Adding Chemo Helps Head, Neck Cancer Patients: Study found it doubled survival time Combining chemotherapy with radiation treatment for patients with advanced head and neck cancer increases their event-free survival to 2.2 years from just one year with radiotherapy alone, finds a new study. According to the study authors, "events" include cancer recurrence, new tumors or death. Overall, non-platinum-based chemotherapy given at the same time as radiotherapy reduced deaths and cancer recurrence in patients who hadn't undergone surgery, with acceptable toxicity. But patients who'd undergone surgery didn't benefit from this combined treatment. The researchers also found that chemotherapy given after radiotherapy was ineffective, didn't improve survival, and doubled the rate of toxicity. Adding Chemo Helps Head, Neck Cancer Patients: Study found it doubled survival time   　 TUESDAY, Oct. 27 (HealthDay News) -- Combining chemotherapy with radiation treatment for patients with advanced head and neck cancer increases their event-free survival to 2.2 years from just one year with radiotherapy alone, finds a new study. According to the study authors, "events" include cancer recurrence, new tumors or death. British researchers looked at the 10-year outcomes of 966 patients with locally advanced head and neck cancer. Those who hadn't undergone surgery for their cancer were randomly assigned to one of four groups: radiotherapy alone (233 patients); two courses of simultaneous (SIM) chemotherapy given at the same time as radiotherapy (166 patients); two courses of chemotherapy after (subsequent -- SUB) completing radiotherapy (160 patients); or both SIM and SUB (154 patients). Patients who'd had surgery were randomly assigned to radiotherapy alone (135 patients) or SIM alone (118 patients). Overall, non-platinum-based chemotherapy given at the same time as radiotherapy reduced deaths and cancer recurrence in patients who hadn't undergone surgery, with acceptable toxicity. But patients who'd undergone surgery didn't benefit from this combined treatment. The researchers also found that chemotherapy given after radiotherapy was ineffective, didn't improve survival, and doubled the rate of toxicity. Among patients who didn't have surgery, median survival time was 2.6 years in the radiotherapy group, and 4.7 years, 2.3 years and 2.7 years, respectively, in patients who received SIM alone, SUB alone, and SIM plus SUB. Median event-free survival among patients who didn't have surgery was one year in the radiotherapy group, 2.2 years in patients who received SIM alone, and one year in those who received either SUB alone, or SIM plus SUB. The findings show the long-term benefit of non-platinum chemotherapy drugs, which are "inexpensive, relatively easy to deliver, and have lower toxicity than platinum therapies ... [which] considerably improves the likelihood of completing treatment, essential for improving the chances of a cure," wrote the U.K. Head and Neck Cancer Group researchers in their report published in the Oct. 27 online edition of The Lancet Oncology. Combination chemotherapy/radiation treatment should be standard for all advanced head and neck cancer patients for whom surgery isn't appropriate, they concluded.More information The U.S. National Cancer Institute has more about head and neck cancer. -- Robert Preidt SOURCE: The Lancet Oncology, news release, Oct. 27, 2009 Migraine With Aura Can Double Stroke Risk: Young women who smoke and use birth control pills are most susceptible, researchers say Women who get migraine headaches with aura should stop smoking and using birth control pills because they may increase their risk of stroke, researchers say. For people who suffer migraine headaches with aura -- visual disturbances before or during the migraine -- the risk for ischemic stroke is doubled, they found. Being female, under 45, smoking and using oral contraceptives that contain estrogen added to the risk. "The risk of stroke for most people with migraine is low -- stroke is an uncommon event -- and so a doubling of that low baseline risk is not cause for alarm,"Dr. Elizabeth Loder said. "Although it's not a reason for panic, having aura is a reason to pay extra attention to other stroke risk factors that can be modified. These include high blood pressure, high cholesterol, smoking and use of estrogen-containing contraceptives." Migraine With Aura Can Double Stroke Risk: Young women who smoke and use birth control pills are most susceptible, researchers say   By Steven Reinberg: HealthDay Reporter TUESDAY, Oct. 27 (HealthDay News) -- Women who get migraine headaches with aura should stop smoking and using birth control pills because they may increase their risk of stroke, researchers say. For people who suffer migraine headaches with aura -- visual disturbances before or during the migraine -- the risk for ischemic stroke is doubled, they found. Being female, under 45, smoking and using oral contraceptives that contain estrogen added to the risk. Ischemic stroke is caused by a blockage in a blood vessel. The connection between migraine and stroke was already suspected. What was unknown was the extent of risk and who is most at risk, the researchers said. Migraine headaches affect up to 20 percent of the population. Women are up to four times more likely than men to get migraines, and as many as one third also experience an aura before or during a migraine. "Migraine with aura is associated with a twofold increased risk for ischemic stroke compared to people without migraine, while migraine without aura does not appear to change the risk," said lead researcher Dr. Markus Schurks, from the division of preventive medicine at Brigham and Women's Hospital in Boston. "But, considering the low absolute risk, there is no reason to panic, but modifiable risk factors such as smoking and oral contraceptive use should be considered," he said. The report is published in the Oct. 27 online edition of the British Medical Journal. For the study, Schurks and colleagues analyzed nine studies concerning the association between migraine, with and without aura, and cardiovascular disease. "The risk appears to be highest among women with migraine with aura who smoke and use oral contraceptives," Schurks said. In contrast, migraine alone does not appear to alter the risk for heart attack and death from cardiovascular disease, he added. "In the scheme of things, aura is just one among many potential risk factors for stroke, so it is important to put this in context," said Dr. Elizabeth Loder, chief of the division of headache and pain at Brigham and Women's Hospital and author of an accompanying journal editorial. "The risk of stroke for most people with migraine is low -- stroke is an uncommon event -- and so a doubling of that low baseline risk is not cause for alarm,"Dr. Elizabeth Loder said. "Although it's not a reason for panic, having aura is a reason to pay extra attention to other stroke risk factors that can be modified. These include high blood pressure, high cholesterol, smoking and use of estrogen-containing contraceptives." Other experts agreed. Dr. Vincent Martin, an associate professor of medicine at the University of Cincinnati, said that "we have always known that the risk of stroke increased in patients with migraine, but this clarifies the situation in terms of which groups of migrainers are at more risk." "If you are a female and you've got migraine with aura, you really need to be careful about managing your risk factors for stroke, because your risk for stroke is increased," he said. Smoking and birth control pills just aren't a good idea, he added.More information For more information on migraine, visit the U.S. National Library of Medicine. SOURCES: Markus Schurks, M.D., division of preventive medicine, Brigham and Women's Hospital, Boston; Elizabeth Loder, M.D., M.P.H., chief, division of headache and pain, Brigham and Women's Hospital, and associate professor, neurology, Harvard Medical School, Boston; Vincent Martin, M.D., associate professor, medicine, University of Cincinnati, Ohio; Oct. 27, 2009, BMJ, online Toxins Make Halloween Face Paints Scary: Report finds all products tested contained lead and some had known skin allergens "All 10 face paint products tested contained lead, and six out of 10 had known skin allergens, including nickel, cobalt or chromium, at levels above recommendations of industry studies," said Stacy Malkan. Dr. Wally Ghurabi believes that even once-a-year use of the face paints may not be worth it. "Concerned parents should skip it," he said. If those who apply the paints aren't careful, he said, and get the paint too close to the eyes or nose, that could be potentially harmful. Another option is to "go natural," said Jessa Blades. First, look up "safe" or green cosmetics on the campaign's Web site. Then, consider black eye pencil for whiskers. Or mix a quarter teaspoon of the spice turmeric with unscented lotion to make "war paint." For fake blood, mix corn syrup, Castile liquid soap and a dash of red food coloring, Blades said. Toxins Make Halloween Face Paints Scary: Report finds all products tested contained lead and some had known skin allergens By Kathleen Doheny HealthDay Reporter TUESDAY, Oct. 27 (HealthDay News) -- If your little goblins or vampires are set to paint their faces this Halloween to look all the more believable, you may want to think twice, according to a new report released just in time for the holiday. The report, issued by the Campaign for Safe Cosmetics, is titled: Pretty Scary: Could Halloween Face Paint Cause Lifelong Health Problems? Researchers tested 10 face paint products, the types widely available via the Internet or in craft or Halloween stores. "All 10 face paint products tested contained lead, and six out of 10 had known skin allergens, including nickel, cobalt or chromium, at levels above recommendations of industry studies," said Stacy Malkan, the campaign's co-founder and a co-author of the report. Malkan is also the author of Not Just a Pretty Face, a 2007 book detailing what she sees as the potentially hazardous ingredients in cosmetics. For the new report, she said, "We looked for a range of heavy metals, and we didn't find mercury or arsenic. Other countries have found those in face paints. We did unfortunately find lead in all the products." Exposure to lead can cause developmental and behavioral problems, experts agree. Then there were the labeling problems, with some products claiming to be hypoallergenic when they were not. One product "was advertised on the package as nontoxic and hypoallergenic, [and] had some of the highest levels of nickel, cobalt and lead," Malkan said. The lead found ranged from 0.054 parts per million to 0.65 parts per million. Four of 10 products had nickel, ranging from 2.1 to 5.9 parts per million; two of 10 had cobalt, with levels from 4.8 to 5.5 parts per million. Five of 10 had chromium, ranging from 1.6 to 120 parts per million. According to the report, levels of each should not exceed 1 part per million for consumer products. Earlier this year, a face paint from China was recalled by the U.S. Food and Drug Administration when some children had rashes and itching; the FDA later found microbial contamination in the product. Malkan says more oversight is needed by the FDA to regulate products, including face paints. Cosmetic products and ingredients are not subject to premarket approval by the FDA, except color additives. Recalls of cosmetics are done voluntarily by manufacturers or distributors if products are found hazardous or deceptive; the FDA can take regulatory action through the federal court system. But this level of oversight is not strong enough, Malkan and others believe. What's a parent to do? Using the face paint just once a year "is probably not going to do anything at all [healthwise]," contended Dr. Dennis Woo, former chair of pediatrics at Santa Monica-UCLA and Orthopaedic Hospital, Santa Monica, Calif., who reviewed the report. But he said he is surprised by the amounts of heavy metals found in the face paints. "We should start looking at this stuff. There's no reason these heavy metals need to be in cosmetics." His colleague, Dr. Wally Ghurabi, chief of emergency services, Santa Monica-UCLA and Orthopaedic Hospital, believes that even once-a-year use of the face paints may not be worth it. "Concerned parents should skip it," he said. If those who apply the paints aren't careful, he said, and get the paint too close to the eyes or nose, that could be potentially harmful. Malkan, too, votes that parents avoid face-paint use in children. But if you are using them, the FDA advises that parents: � Follow directions carefully, including instructions not to use the products around the eyes. � If the face paint smells bad, don't use it as it could be contaminated. � Consider a test of the face paint a few days before Halloween to be sure your child doesn't get an allergic reaction to it. Another option is to "go natural," said Jessa Blades, a natural makeup artist and green living expert based in New York City. First, look up "safe" or green cosmetics on the campaign's Web site. Then, consider black eye pencil for whiskers. Or mix a quarter teaspoon of the spice turmeric with unscented lotion to make "war paint." For fake blood, mix corn syrup, Castile liquid soap and a dash of red food coloring, Blades said. More information: There's more on the hazards of lead for children at the U.S. National Institute of Environmental Health Sciences. SOURCES: Stacy Malkan, co-founder, Campaign for Safe Cosmetics, and co-author, Pretty Scary: Could Halloween Face Paint Cause Lifelong Health Problems? Oct. 27, 2009, Campaign for Safe Cosmetics; Jessa Blades, natural makeup artist and green living expert, New York City; Wally Ghurabi, D.O., chief of emergency services, Santa Monica--UCLA and Orthopaedic Hospital, Santa Monica, Calif.; Dennis Woo, M.D., former chief of pediatrics, Santa Monica--UCLA and Orthopaedic Hospital, Santa Monica, Calif., and associate professor, pediatrics, David Geffen School of Medicine, University of California Los Angeles; U.S. Food and Drug Administration Antipsychotic Drugs Spur Rapid and Dramatic Weight Gain in Kids: Researchers urge other alternatives, close monitoring of patients Children and teens who take medicines for conditions such as schizophrenia, bipolar disorder and autism tend to put on a substantial amount of weight, a new study finds. The worry is that excessive weight gain and other metabolic changes in childhood can place kids at risk for chronic health problems as adults. The study focused on four antipsychotics commonly prescribed to children: aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal). After nearly 11 weeks, the treated kids gained an average of 18.7 pounds on Zyprexa, 13.4 pounds on Seroquel, 11.7 pounds on Risperdal and 9.7 pounds on Abilify, while the control group gained less than half a pound. Antipsychotic Drugs Spur Rapid and Dramatic Weight Gain in Kids: Researchers urge other alternatives, close monitoring of patients   By Karen Pallarito: HealthDay Reporter TUESDAY, Oct. 27 (HealthDay News) -- Children and teens who take medicines for conditions such as schizophrenia, bipolar disorder and autism tend to put on a substantial amount of weight, a new study finds. The worry is that excessive weight gain and other metabolic changes in childhood can place kids at risk for chronic health problems as adults. Some of these medicines, collectively known as "atypical antipsychotics," have been linked to increased blood-fat levels. "We are very much afraid that this will lead to diabetes and metabolic syndrome," said study author Dr. Christoph Correll, medical director of the Recognition and Prevention program at the Zucker Hillside Hospital in Glen Oaks, N.Y. The study, reported in the Oct. 28 issue of the Journal of the American Medical Association, is the largest analysis of its kind, Correll said. Jeanette M. Jerrell, a professor of neuropsychiatry at the University of South Carolina School of Medicine in Columbia, is the co-author of a similar study published last year in the Archives of Pediatrics and Adolescent Medicine. "We found that obesity/weight gain, type 2 diabetes mellitus and cardiovascular conditions were more prevalent in the treated cohort," she noted. Her study also found that kids taking multiple antipsychotics were at significantly higher risk for obesity/weight gain, type 2 diabetes, abnormal blood-fat levels and cardiovascular problems. "This new study is important because it draws further attention to the safety profile of antipsychotics in young populations, and the critical need for expanding the evidence base to guide clinical decisions," she said. Concerns about the safety of atypical antipsychotics are not new. In 2003, the U.S. Food and Drug Administration ordered manufacturers of these drugs to add a warning about the risk for hyperglycemia and diabetes. What's more, a 2008 report in The Lancet suggested that some of these drugs -- sometimes called "second-generation" antipsychotics -- may be no better than older, "first-generation" medicines. The authors concluded that each drug must be weighed individually based on its efficacy and side effects. Correll's study was designed to assess the safety and effectiveness of the newer class of drugs in youth. His team followed 272 patients, aged 4 to 19, who were taking an antipsychotic for the first time. Patients were being treated for mood spectrum, schizophrenia spectrum or aggressive behavior spectrum disorders. Fifteen pediatric patients who refused to participate or discontinued their antipsychotic medication within four weeks of starting served as a control group. The study focused on four antipsychotics commonly prescribed to children: aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal). After nearly 11 weeks, the treated kids gained an average of 18.7 pounds on Zyprexa, 13.4 pounds on Seroquel, 11.7 pounds on Risperdal and 9.7 pounds on Abilify, while the control group gained less than half a pound. Between 10 percent and 36 percent became overweight or obese during the treatment period, according to the study. "In these kids that we studied, there was rapid and dramatic weight gain, more than has been described before," said Correll, who is also a scientist in the Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research in Manhasset, N.Y. Use of each drug was linked to wider bellies and increased "fat mass" -- the proportion of the body comprised of fat. The drugs had varying effects on metabolic levels. Zyprexa and Seroquel users experienced significant adverse changes in total cholesterol and trigylcerides. Risperdal use resulted in a significant increase in triglycerides. Abilify, however, appeared "metabolically neutral," Correll said. "Some of these kids are maintained on these medications for many years if not indefinitely, so it's definitely a concern," said Ronald T. Brown, dean and professor of public health at Temple University Health Sciences Center in Philadelphia. "For children who really don't absolutely need these drugs, they need to be doing more behavioral approaches in psychotherapy." In an accompanying editorial, Drs. Christopher K. Varley and Jon McClellan of Seattle Children's Hospital concluded that large, independently funded studies are needed to establish the long-term safety and benefit of these drugs in children. "Until those data are available, consideration of less risky treatment interventions and scrupulous attention to metabolic parameters in children and adolescents who receive atypical antipsychotic medications are essential," they wrote. Correll, in fact, is currently involved in a longer-term follow-up study to assess the health effects of these drugs in children over an extended period of time. For now, Dr. Christoph Correll advises clinicians and families to carefully weigh the risks and benefits of the medications against the risk of the illness, and to consider other pharmaceutical and non-pharmaceutical options. It's also important to teach children about healthy lifestyles and to closely monitor kids' weight, lipid levels and blood glucose, he said.More information The National Institute of Mental Health has more on mental health medications. SOURCES: Christoph Correll, M.D., medical director, Recognition and Prevention Program, Zucker Hillside Hospital, and scientist, Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, N.Y.; Jeanette M. Jerrell, Ph.D., professor, neuropsychiatry and behavioral science, University of South Carolina School of Medicine, Columbia, S.C.; Ronald T. Brown, Ph.D., dean and professor, public health, Temple University Health Sciences Center, Philadelphia; Oct. 28, 2009, Journal of the American Medical Association Even Light Smoking Affects Young Adults' Arteries: Damage makes it harder to run and climb steps, researcher says Smoking just one cigarette stiffens the arteries of young adults by 25 percent, says a new study. The stiffer a person's arteries, the greater their risk for heart disease or stroke, noted researcher Dr. Stella Daskalopoulou. "Our results are significant because they suggest that smoking just a few cigarettes a day impacts the health of the arteries," Daskalopoulou said. "In effect, this means that even light smoking in otherwise young healthy people can damage the arteries, compromising the ability of their bodies to cope with physical stress, such as climbing a set of stairs or running to catch a bus," she said. "It seems that this compromise to respond to physical stress occurs first, before the damage of the arteries becomes evident at rest." Even Light Smoking Affects Young Adults' Arteries: Damage makes it harder to run and climb steps, researcher says     WEDNESDAY, Oct. 28 (HealthDay News) -- Smoking just one cigarette stiffens the arteries of young adults by 25 percent, says a new study. The stiffer a person's arteries, the greater their risk for heart disease or stroke, noted researcher Dr. Stella Daskalopoulou, an internal medicine and vascular medicine specialist at McGill University Health Center in Montreal. She measured arterial stiffness in smokers and non-smokers, ages 18 to 30, at rest and after exercise. To establish a baseline measurement, the smokers, who smoked five to six cigarettes a day, were asked to refrain from having a cigarette for 12 hours before their first exercise test. Before the second exercise test, smokers were allowed to have one cigarette. Before the final test, they were asked to chew a piece of nicotine gum. After exercise, arterial stiffness in non-smokers decreased 3.6 percent. But the smokers' arterial stiffness increased 2.2 percent after exercise. In smokers, arterial stiffness increased 12.6 percent after they chewed nicotine gum and 24.5 percent after they had one cigarette. There was no difference in arterial stiffness between smokers and non-smokers at rest. "Our results are significant because they suggest that smoking just a few cigarettes a day impacts the health of the arteries," Daskalopoulou said in a news release from the Heart and Stroke Foundation of Canada. "This was revealed very clearly when these young people were placed under physical stress, such as exercise." "In effect, this means that even light smoking in otherwise young healthy people can damage the arteries, compromising the ability of their bodies to cope with physical stress, such as climbing a set of stairs or running to catch a bus," she said. "It seems that this compromise to respond to physical stress occurs first, before the damage of the arteries becomes evident at rest." The study was to be presented Oct. 27 at the Canadian Cardiovascular Congress 2009.More information The U.S. Centers for Disease Control and Prevention has more about the health effects of smoking.-- Robert Preidt SOURCE: Heart and Stroke Foundation of Canada, news release, Oct. 27, 2009 Light Touch Helps Grip of MS Patients: Study shows ways to optimize hand movements People with MS use excessive force when lifting objects, which can lead to fatigue and make everyday tasks difficult, physical therapists from the University of Illinois at Chicago explained. Using the finger of the opposite hand to apply a gentle touch to the affected hand may help improve control and coordination, they stated. In each case, the grip force required to lift an object decreased," said Alexander Aruin. "When we use our second hand and touch the wrist of the target hand, available information to the central nervous system about the hand-object interaction may increase. Without the touch, the information needed to manipulate an object comes only through vision and sensory input from just the target arm and hand." Light Touch Helps Grip of MS Patients: Study shows ways to optimize hand movements   　 FRIDAY, Oct. 23 (HealthDay News) -- Using a gentle touch may help make it easier for people with multiple sclerosis to pick up and hold objects, a new study suggests. People with MS use excessive force when lifting objects, which can lead to fatigue and make everyday tasks difficult, physical therapists from the University of Illinois at Chicago explained in a school news release. Using the finger of the opposite hand to apply a gentle touch to the affected hand may help improve control and coordination, they stated. "We studied how this light-touch application changes the way people apply force to an object they want to grip. In each case, the grip force required to lift an object decreased," study author Alexander Aruin, a professor of physical therapy, said in the news release. The study included eight adults with MS who were asked to grip and lift a variety of objects and move them in several different ways, directions and velocities. When they used the gentle finger touch, the force of their grip was reduced and the task became easier. The study was published in the October issue of the journal Neurorehabilitation and Neural Repair. "We look forward to developing training and rehabilitation procedures on how to use this. We know that MS patients are prone to fatigue and muscle weakness. This finding may enable them to perform daily activities more independently to improve their quality of life," Aruin said. It's not clear why the finger touch is helpful, but Aruin offered a possible explanation. "It could be due to auxiliary sensory information from the contralateral arm," he said. "When we use our second hand and touch the wrist of the target hand, available information to the central nervous system about the hand-object interaction may increase. Without the touch, the information needed to manipulate an object comes only through vision and sensory input from just the target arm and hand." The researchers plan to test the finger-touch method on people with other neurological and muscular diseases.More information The National Multiple Sclerosis Society has more about promoting function, mobility and independence. -- Robert Preidt SOURCE: University of Illinois at Chicago, news release, Oct. 14, 2009 Radiation From Medical Scans Soaring: Americans now get 6-fold more exposure than in 1980, researchers say In 2006, almost 380 million diagnostic and interventional radiological procedures were performed in the United States, on top of 18 million nuclear medicine examinations. "Back in about 1980, 15 percent of radiation that the U.S. population got was from medicine and the rest was predominantly from natural background radiation," noted Dr. Fred Mettler Jr. In the last 20 years, medical exposure has gone up between 600 and 700 percent from what it was, and it is now the biggest source of radiation to the U.S. population." "The issue," Mettler continued, "is that this is a controllable source. We regulate the effluent from nuclear power plants so the public doesn't get exposure but medical exposure is essentially unregulated. The largest source in the U.S. is essentially unregulated, and it's up to your family doctor or any other doctor to hand it out." Radiation From Medical Scans Soaring: Americans now get 6-fold more exposure than in 1980, researchers say   By Amanda Gardner: HealthDay Reporter TUESDAY, Oct. 27 (HealthDay News) -- Americans' exposure to radiation from medical procedures has exploded over the past few decades, to six times the level of 1980, a new report shows. In 2006, almost 380 million diagnostic and interventional radiological procedures were performed in the United States, on top of 18 million nuclear medicine examinations. "Back in about 1980, 15 percent of radiation that the U.S. population got was from medicine and the rest was predominantly from natural background radiation," noted Dr. Fred Mettler Jr., U.S. Representative to the United Nations Scientific Committee on the Effects of Atomic Radiation and a professor of radiology at the University of New Mexico in Albuquerque. "In the last 20 years, medical exposure has gone up between 600 and 700 percent from what it was, and it is now the biggest source of radiation to the U.S. population." "The issue," Mettler continued, "is that this is a controllable source. We regulate the effluent from nuclear power plants so the public doesn't get exposure but medical exposure is essentially unregulated. The largest source in the U.S. is essentially unregulated, and it's up to your family doctor or any other doctor to hand it out." Mettler is lead author of a paper appearing in the November issue of Radiology that summarizes the conclusions of two previous reports on radiation sources in the U.S. Those reports were issued by the U.S. National Council on Radiation Protection and Measurements and the United Nations Scientific Committee on Effects of Atomic Radiation. The findings are in line with previous studies, one of which attributed up to two percent of all cancers to CT scans alone and another which concluded that cumulative exposure to radiation from CT scans increases the risk for malignancy by as much as 12 percent. The last comprehensive assessment of radiation exposure was conducted in 1980-1982, a veritable eternity by medical and scientific standards. "We needed to get a grip on how much radiation the U.S. was getting and where it was coming from," Mettler said. In the intervening years, the number of procedures performed has risen "by leaps and bounds," he said. "The biggest chunk of that is CT scanning, which has been growing at better than 10 percent a year while the U.S. population is growing at less than 1 percent." Widely used as a diagnostic tool, CT scans provide detailed images of organs, allowing more accurate diagnoses of conditions such as cancer. But CT involves a higher radiation dose than most other imaging tests. According to this paper, CT provides half of the country's total radiation dose, even though it represents only 17 percent of total procedures. Emergency room physicians may be at the epicenter of the surge in scan use, Mettler said. "Twenty-five to 40 percent of CT scans are ordered out of the ER," he noted. "The emergency physicians are in a tough box because they're worried about getting sued. And they tend to get patients who they haven't seen before. This is a one-time walk-in and their mantra is, 'We can't afford to miss anything.'" Of course, the trend is not limited to the U.S., although it may be more extreme here. Globally, the per-capita annual dose from medicine has doubled in the past decade or so. Still the U.S. leads the pack, with 12 percent of all radiologic procedures and half of nuclear medicine procedures performed here. "We have a little under 5 percent of the world's population and 25 percent of X-ray studies in the world and double and triple that of other developed countries," Mettler said. "Nobody thought about how much radiation goes with this." But not all of uptick in scans has been unnecessary, said Dr. Robert Zimmerman, executive vice chair of radiology at Weill Cornell Medical Center in New York City. "We don't really know how much of it is overuse. We do know some of it is overutilization, but CT is a valuable imaging modality. CT is a great test. There's no question that in the appropriate cases it's going to save lives." There are things radiologists can do to curb its use, including reducing the doses, while manufacturers are working on new and improved machines, Zimmerman said. Physicians can also tailor their use, thinking twice about using this type of technology in children, who are more sensitive to radiation and have longer to develop side effects. "When I get a call for a CT scan, my first question is, 'How old is the patient?' If it's 40 or under my antennas go up and if they're 70 my antennas don't get so excited. Mostly my idea is a CT might be a good thing but you would like to think about radiation beforehand," Mettler said. "There's a lot of stuff going on now that isn't justified. Nobody's ever shown that many of these things we do make a difference in outcome."More information There's more on radiation exposure from CT scans at the American College of Radiology. SOURCES: Fred A. Mettler Jr., M.D., U.S. representative to the United Nations Scientific Committee on the Effects of Atomic Radiation, and professor, radiology, University of New Mexico, Albuquerque; Robert Zimmerman, M.D., executive vice chair, radiology, Weill Cornell Medical Center, New York City; November 2009 Radiology New Clues to How Fish Oils Help Arthritis Patients: Findings may boost treatments for other inflammatory diseases, researchers say The body converts an ingredient in fish oils called DHA into a chemical called Resolvin D2, which reduces the inflammation that can lead to various diseases. "We have known for some time that fish oils can help with conditions like arthritis, which are linked to inflammation. What we've shown here is how the body processes a particular ingredient of fish oils into Resolvin D2. We've also looked in detail at this chemical, determining at least some of the ways it relieves inflammation. It seems to be a very powerful chemical and a small amount can have a large effect," said Mauro Perretti. Unlike current anti-inflammatory drugs, Resolvin D2 doesn't appear to suppress the immune system, the researchers noted. New Clues to How Fish Oils Help Arthritis Patients: Findings may boost treatments for other inflammatory diseases, researchers say 　 WEDNESDAY, Oct. 28 (HealthDay News) -- Researchers think they now understand the way that fish oils benefit people with rheumatoid arthritis and other conditions linked to inflammation. The body converts an ingredient in fish oils called DHA into a chemical called Resolvin D2, which reduces the inflammation that can lead to various diseases, the scientists from Queen Mary, University of London and Harvard Medical School explained in their study published in the Oct. 28 issue of the journal Nature. "We have known for some time that fish oils can help with conditions like arthritis, which are linked to inflammation. What we've shown here is how the body processes a particular ingredient of fish oils into Resolvin D2. We've also looked in detail at this chemical, determining at least some of the ways it relieves inflammation. It seems to be a very powerful chemical and a small amount can have a large effect," Mauro Perretti, a professor of immunopharmacology at Queen Mary, University of London, said in a university news release. "This research is important because it explains at least one way in which fish oils can help in different types of arthritis. We can also work on this chemical and see if it can be used not only to treat or even prevent arthritis, but also as a possible treatment for a variety of other diseases associated with inflammation," said Perretti, who led the U.K. research team. Unlike current anti-inflammatory drugs, Resolvin D2 doesn't appear to suppress the immune system, the researchers noted. In arthritis, the body's immune system attacks healthy tissue. An important part of this process occurs when white blood cells (leukocytes) stick to the inner lining (endothelium) of blood vessels. In lab tests, Perretti and colleagues found that Resolvin D2 prompted endothelial cells to produce small amounts of nitric oxide, which acts as chemical signal that discourages white blood cells from sticking to the endothelium, thus preventing inflammation.More information The American Academy of Family Physicians has more about rheumatoid arthritis. -- Robert Preidt SOURCE: Queen Mary, University of London, news release, Oct. 28, 2009 Tai Chi May Help Ward Off Knee Pain in Seniors: Two hours per week can improve osteoarthritis symptoms in older patients Half of the group took part in Yang-style Tai Chi sessions for an hour at a time, twice weekly over a period of three months. The Tai Chi session consisted of 10-minutes of self-message and review, a half hour of movement, 10 minutes of breathing exercises and 10 minutes of relaxing. The other participants took two 60-minute classes per week for three months and learned about issues such as diet and nutrition, and treatments for osteoarthritis. They also stretched for 20 minutes. Those who practiced Tai Chi had significantly less knee pain than the other group and also reported less depression, more physical function and better overall health. Tai Chi May Help Ward Off Knee Pain in Seniors: Two hours per week can improve osteoarthritis symptoms in older patients   　 THURSDAY, Oct. 29 (HealthDay News) -- Want to improve that osteoarthritis in your knee? New research suggests that regular Tai Chi exercise can reduce pain and help your knee function better. "Tai Chi is a mind-body approach that appears to be an applicable treatment for older adults with knee osteoarthritis," Dr. Chenchen Wang, co-author of a study published in the November issue of Arthritis Care & Research, said in a news release from the journal's publisher. In the United States, an estimated 4.3 million adults over 60 suffer from this form of arthritis. As many as half of American adults may develop symptoms by age 85, the U.S. Centers for Disease Control and Prevention reported recently. Wang and colleagues from Tufts University School of Medicine recruited 40 patients, with an average age of 65, who had been diagnosed with knee osteoarthritis. Half of the group took part in Yang-style Tai Chi sessions for an hour at a time, twice weekly over a period of three months. The Tai Chi session consisted of 10-minutes of self-message and review, a half hour of movement, 10 minutes of breathing exercises and 10 minutes of relaxing. The other participants took two 60-minute classes per week for three months and learned about issues such as diet and nutrition, and treatments for osteoarthritis. They also stretched for 20 minutes. Those who practiced Tai Chi had significantly less knee pain than the other group and also reported less depression, more physical function and better overall health. "Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of Tai Chi to extend its benefits to a broader population," Wang said.More information Learn more about osteoarthritis from the Arthritis Foundation. -- Randy Dotinga SOURCE: Arthritis Care & Research, news release, Oct. 29, 2009 Oct. 16, 2009 to Oct. 23, 2009Health Highlights **Botulism Fears Trigger Baby Food Recall. **Turtle-Related Salmonella Outbreak in 2007-2008 Sickened 107 People. **Car Booster Seats Significantly Reduce Crash Injuries Among Children Ages 4 to 8. **FDA Cracks Down on Misleading Food Labels. **Check Commercial Drivers, Ship Pilots for Sleep Apnea: NTSB. **German Study Suggests the Placebo Effect Isn't in Your Head; It's in Your Spinal Cord. **Suspected Negative Health Effects Associated With Regular Marijuana Use Include Breathing and Cardiovascular Harm, Psychotic Episodes, Poor School Grades and Car Accidents. **Special Bracelets Don't Help Arthritis Patients. Health Highlights (Oct. 16, 2009 to Oct. 23, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Botulism Fears Trigger Baby Food Recall Concerns over possible botulism contamination have prompted a recall of some apple and carrot portable pouch baby food made by Plum Organics of California. Botulism is a serious and sometimes life-threatening condition. The recalled product is in 4.22-ounce pouches, with a "best by" date of May 21, 2010, and UPC 890180001221, the Associated Press reported. The baby food pouches were sold nationwide at Toys-R-Us and Babies-R-Us stores. The products should not be consumed, even if they appear normal. No illnesses have been reported in connection with the baby food. No other Plum Organics products are affected, according to the company. For more information, consumers can call Plum Organics at 888-974-3555 or go to the company's Web site, the AP reported. ----- Turtle-Related Salmonella Outbreak in 2007-2008 Sickened 107 People A new study says that 107 people became ill in the largest turtle-caused salmonella outbreak in the United States. The outbreak occurred in 2007-08. Of those patients, one-third had to be hospitalized. The outbreak involved mostly children in 34 states, said the U.S. Centers for Disease Control and Prevention study, which noted that many parents didn't know that pet turtles can carry salmonella, the Associated Press reported. The sale of small turtles as pets was banned in the United States in 1975, but millions continue to be sold illegally. The number of pet turtles nationwide increased from 950,000 in 1996 to almost two million in 2006, according to the American Veterinary Medical Association. "It's very easy to think of turtles as being a very gentle and nice pet," but many are salmonella carriers and don't show any signs, said study lead author Julie Harris, the AP reported. Salmonella on turtles' shells and body can spread to people who handle them. ----- Car Booster Seats Significantly Reduce Crash Injuries Among Children Ages 4 to 8 Car booster seats significantly reduce crash injuries among children ages 4 to 8, confirms a new analysis of nine years of data from 15 states and Washington, D.C. Researchers found that children in belt-positioning booster seats were 45 percent less likely to suffer injuries in a crash than children using only standard seat belts. There was no notable difference in risk of injury between the use of backless and high-back booster seats, CBS News reported. The study, which confirms earlier findings, also found that booster seats reduced the risk of injury by 68 percent for near-side impact crashes and 82 percent for far-side impacts. The findings were published Tuesday in the journal Pediatrics. To prevent falls, car seats should be placed on a hard, flat floor, experts advise. ----- FDA Cracks Down on Misleading Food Labels The U.S. Food and Drug Administration announced Tuesday that it plans to put an end to food labeling it believes makes consumers think foods have more nutritional value than they do. The agency will target the front panels of packages bearing logos or language suggesting that the product is healthier than the actual ingredients indicate, FDA Commissioner Margaret Hamburg said in a news conference Tuesday afternoon, the Chicago Tribune reported. "There's a growing proliferation" of symbols that suggest healthfulness and "some nutritionists have questioned whether this information is more marketing-oriented than health-oriented. Judging from some of the labels we've seen, this is a valid concern," Hamburg said. The front of packages often catch consumers' eyes, while shoppers are less likely to read the nutritional information boxes on the side or back of packages, Hamburg explained. While not naming specific products, she said some that are labeled with the "check mark" logo under the industry-supported Smart Choices food rating program, "are almost 50 percent sugar." Smart Choices has emerged as a lightning rod among some nutritionists, who say its ratings are too lax, the Tribune reported. The program is under investigation by the Connecticut attorney general for its labeling practices. Mike Hughes, chair of the Smart Choices Program, said it's unfair to focus on one ingredient in a single product. "I think you should look at the whole product and what it delivers," he said. ----- Check Commercial Drivers, Ship Pilots for Sleep Apnea: NTSB Commercial truck and bus drivers and merchant ship pilots need to be screened for sleep apnea, the U.S. National Transportation Safety Board says in letter sent to the Federal Motor Carrier Safety Administration and the Coast Guard. The NTSB said medical examiners should be required to ask commercial drivers and ship pilots about sleep apnea and develop programs to identify the disorder, which involves disruptions of breathing during sleep, the Associated Press reported. Earlier this year, the agency made similar recommendations for airline pilots and train operators. The letters cited a number of incidents in which sleep apnea was believed to play a role in fatal incidents, including a 2008 bus crash in Utah that killed nine and injured 43, and a 2001 train crash in Michigan that killed two crew members, the AP reported. ----- German Study Suggests the Placebo Effect Isn't in Your Head; It's in Your Spinal Cord The placebo effect isn't in your head; it's in your spinal cord, suggests a German study. The study included 15 men who had the same ointment rubbed on two areas of their forearms. The men were told that each area had a different cream -- a "lidocaine" cream that was a strong local anesthetic and a non-medicinal control cream. After application of the creams, a hot stimulus was placed on both areas of the forearm and kept there for 20 seconds, the Los Angeles Times reported. Even though both creams were identical, the men said the lidocaine ointment reduced pain by an average of 26 percent. Using MRI, the researchers detected less activity in the men's spinal cords when they believed they were being protected by the lidocaine. The findings show that a painful stimulus just needs to get to the spinal cord, not all the way to the brain, to be influenced by the placebo effect, the researchers wrote, the Times reported. ----- Suspected Negative Health Effects Associated With Regular Marijuana Use Include Breathing and Cardiovascular Harm, Psychotic Episodes, Poor School Grades and Car Accidents Nearly 4 percent of adults worldwide use marijuana, say Australian researchers who analyzed data from the United Nations' office on drugs and crime. In 2006, 166 million people ages 15 to 64 used cannabis. Use was highest among young people in the United States, Australia, New Zealand and Europe, but the drug is becoming increasingly popular in low- and middle-income nations, Agence France-Presse reported. About 9 percent of people who ever use marijuana become dependent on it, said the study. The risk of addiction for nicotine is 32 percent, 23 percent for heroin, 17 percent for cocaine and 15 percent for alcohol, they noted. The researchers listed suspected negative health effects associated with regular cannabis use, including breathing and cardiovascular harm, psychotic episodes, poor school grades and car accidents, AFP reported. The study appears in The Lancet. ----- Special Bracelets Don't Help Arthritis Patients They may be popular, but magnetic wrist straps and copper bracelets don't relieve arthritis pain, says an English study. It included 45 osteoarthritis patients, aged 50 and older, who used a copper bracelet, two types of magnetic wrist straps and a demagnetized wrist strap. They wore each of the devices in random order over 16 weeks, BBC News reported. None of the patients reported any improvements in pain, stiffness or physical function, said the University of York researchers. The findings appear in the journal Complementary Therapies in Medicine. "It appears that any perceived benefit obtained from wearing a magnetic or copper bracelet can be attributed to psychological placebo effects," said study leader Dr. Stewart Richmond, BBC News reported. "People tend to buy them when they are in a lot of pain, then when the pain eases off over time they attribute this to the device," he said. "However, our findings suggest that such devices have no real advantage over placebo wrist straps that are not magnetic and do not contain copper." "The FDA is working with other groups to improve the use of several drug disposal methods, including drug take-back programs," said Dr. Douglas Throckmorton, deputy director of the FDA's Center for Drug Evaluation and Research, UPI reported. "However, for some potent medicines ... the FDA currently recommends flushing them down the sink or toilet to immediately and permanently remove them from the home." Babies Injured in Car Seats Used Outside of Cars: Study found more than 43,000 emergency-room visits during five-year period Accidents occur when unrestrained babies, especially those older than 2 months, rock and fidget inside an unattended seat, causing the device to tip over or fall, said Dr. Peter Richel. According to Parikh, the most common injuries during the five-year period were to the head, followed by fractures and dislocations. Three babies died. The study comes two months after another study advised parents to remove their children from infant car seats after a car trip because the seats can compress the chest and lower levels of oxygen. However, experts all agree that car seats are critical inside a vehicle to protect children from injury in a collision, just like seatbelt restraints protect adults. Babies Injured in Car Seats Used Outside of Cars: Study found more than 43,000 emergency-room visits during five-year period   By Peter West: HealthDay Reporter TUESDAY, Oct. 20 (HealthDay News) -- Infant car seats have saved countless young lives, but those same seats are also responsible for injuring thousands of youngsters when improperly used outside a vehicle, a new study found. More than 43,000 infants in the United States required emergency room care between 2003 and 2007 after falling in car seats that were improperly placed on tables, counters and other elevated surfaces. Accidents were even reported after seats rolled over on soft surfaces, such as beds and sofas, the study discovered. "In our hospital, we saw some fractures caused by these falls, and decided it was probably a wider problem," said study author Dr. Shital Parikh, a pediatric orthopaedist at Cincinnati Children's Hospital Medical Center. "These injuries are not common compared with some other causes, but they are significant enough to take notice." Parikh was to present the research Monday at the American Academy of Pediatrics' annual meeting in Washington, D.C. Accidents occur when unrestrained babies, especially those older than 2 months, rock and fidget inside an unattended seat, causing the device to tip over or fall, said Dr. Peter Richel, chief of pediatrics at Northern Westchester Hospital Center, in Mount Kisco, N.Y. According to Parikh, the most common injuries during the five-year period were to the head, followed by fractures and dislocations. Three babies died. The study comes two months after another study advised parents to remove their children from infant car seats after a car trip because the seats can compress the chest and lower levels of oxygen. However, experts all agree that car seats are critical inside a vehicle to protect children from injury in a collision, just like seatbelt restraints protect adults. In Parikh's study, 62 percent of the accidents involved infants younger than 4 months old. About half the accidents occurred at home, and 8 percent of the infants had to be hospitalized, said Parikh, who based his findings on data from the U.S. Consumer Product Safety Commission. "Babies older than 2 months are capable of real movement," said Richel, who was not part of the study. "We as physicians and health-care providers have to be aware of these kinds of accidents when we advise parents." To prevent harm, Richel and Parikh recommended that car seats be used only in cars and only when the infants are properly restrained. "The best thing is for babies to come out [of the car seat] when you come home," Richel said. "Barring any danger to the child, such as an aggressive dog, put the car seat directly on the floor." Parikh also recommended that car-seat manufacturers do a better job of informing consumers about the danger of misusing their products, including offering explicit printed instructions. Car seat companies should also strive to engineer more stable seats, he added. In related news, researchers confirmed earlier reports that booster seats significantly reduce the risk of crash injury in children ages 4 through 8. According to the study, reported online Monday in the journal Pediatrics, children in belt-positioning booster seats were 45 percent less likely to sustain injuries than similarly aged children in standard vehicle seat belts. Booster seats with and without backs provided similar protection.More information Visit the American Academy of Pediatrics for more on car-seat safety. SOURCES: Shital Parikh, M.D., associate professor, orthopedics, Cincinnati Children's Hospital Medical Center; Peter Richel, M.D., chief, pediatrics, Northern Westchester Hospital Center, Mount Kisco, N.Y.; Oct. 19, 2009, presentation, American Academy of Pediatrics annual meeting, Washington, D.C.; Oct. 19, 2009, Pediatrics, online Suicidal Thoughts May Vary by Antidepressant: Men face higher risk when taking nortriptyline than escitalopram, study finds Men who take the antidepressant nortriptyline (Aventyl) are nearly 10 times more likely to have suicidal thoughts than those who use the antidepressant escitalopram (Lexapro, Cipralex), a new study has found. The study included 811 people with moderate to severe unipolar depression. Though it found an overall reduction in suicidal thoughts, men who took nortriptyline were found to have a 9.8-fold increase in emerging suicidal thoughts and a 2.4-fold increase in worsening suicidal thoughts, compared with those who took escitalopram. "The study also refutes the idea that newer antidepressants such as the SSRIs [selective serotonin reuptake inhibitors] are worse than older medications in terms of increasing suicidal thoughts," Dr. Nader Perroud added. Suicidal Thoughts May Vary by Antidepressant: Men face higher risk when taking nortriptyline than escitalopram, study finds 　 THURSDAY, Oct. 15 (HealthDay News) -- Men who take the antidepressant nortriptyline (Aventyl) are nearly 10 times more likely to have suicidal thoughts than those who use the antidepressant escitalopram (Lexapro, Cipralex), a new study has found. The study, published online Oct. 15 in BMC Medicine, included 811 people with moderate to severe unipolar depression. Though it found an overall reduction in suicidal thoughts, men who took nortriptyline were found to have a 9.8-fold increase in emerging suicidal thoughts and a 2.4-fold increase in worsening suicidal thoughts, compared with those who took escitalopram. "Our findings that treatment-emerging and worsening suicidal thoughts may also be associated with psychomotor activation triggered by antidepressants need to be investigated in future studies," the study team's leader, Dr. Nader Perroud, from the Institute of Psychiatry at King's College London, said in a news release from the journal's publisher. "The study also refutes the idea that newer antidepressants such as the SSRIs [selective serotonin reuptake inhibitors] are worse than older medications in terms of increasing suicidal thoughts," Perroud added. Nortriptyline is a tricyclic antidepressant that inhibits the reuptake of noradrenaline and, to a lesser degree, that of serotonin, according to background information in the news release. Escitalopram is an SSRI.More information The U.S. Agency for Healthcare Research and Quality has more about antidepressants. -- Robert Preidt SOURCE: BioMed Central, news release, Oct. 15, 2009 Breast Cancer Gene Tied to Diagnosis at Younger Age: Researchers concerned that disease may be developing earlier Women with a high genetic risk of developing breast cancer are being diagnosed sooner than similar women in the past, which may suggest that tumors are developing earlier in the younger generation, researchers say. The median age of diagnosis in the newer generation was 42, but 47 in the older women. The study authors report that this is worrisome because it could mean that the cancer is developing earlier. "These findings are certainly concerning and could have implications on the screening and genetic counseling of these women," said study co-author Dr. Jennifer Litton. "In BRCA-positive women with breast cancer, we actually might be seeing true anticipation -- the phenotype or cancer coming out earlier per generation. This suggests more than the mutation could be involved, perhaps lifestyle and environmental factors are also coming into play." Breast Cancer Gene Tied to Diagnosis at Younger Age: Researchers concerned that disease may be developing earlier   　 FRIDAY, Oct. 16 (HealthDay News) -- Women with a high genetic risk of developing breast cancer are being diagnosed sooner than similar women in the past, which may suggest that tumors are developing earlier in the younger generation, researchers say. The finding, presented at the 2009 Breast Cancer Symposium, held last week in San Francisco, could potentially affect how women are screened for breast cancer. About 5 percent to 10 percent of breast cancer cases are thought to be connected to a genetic mutation that's also linked to ovarian cancer. Women with the mutations, known as BRCA1 or BRCA2, have an increased risk of developing breast tumors. Over a lifetime, 60 percent of them will develop the disease, according to the American Cancer Society. By comparison, 12 percent of women in the general population will develop breast cancer. Women who have the genetic mutation -- or whose mothers or aunts have it -- are advised to be screened for breast cancer starting when they are 25. Mammography and MRI are now recommended for these women. In the new study, the researchers examined the medical records of 132 women with the genetic mutation who took part in the University of Texas M.D. Anderson Cancer Center's clinical cancer genetics program between 2003 and 2009. Of those, 107 had a mother or aunt with breast or ovarian cancer. The median age of diagnosis in the newer generation was 42, but 47 in the older women. The study authors report that this is worrisome because it could mean that the cancer is developing earlier. "These findings are certainly concerning and could have implications on the screening and genetic counseling of these women," said study co-author Dr. Jennifer Litton, an assistant professor at M.D. Anderson Cancer Center, in a news release from the center. "In BRCA-positive women with breast cancer, we actually might be seeing true anticipation -- the phenotype or cancer coming out earlier per generation. This suggests more than the mutation could be involved, perhaps lifestyle and environmental factors are also coming into play."More information Learn more about the BRCA genetic mutation from the U.S. National Cancer Institute. -- Randy Dotinga SOURCE: University of Texas M.D. Anderson Cancer Center, news release, Oct. 16, 2009 Timing of Oxygen After a Stroke May Matter: Treatment while blood flow is blocked protects tissue, animal study finds Contradicting previous research, scientists have shown in animal studies that providing supplemental oxygen during an ischemic stroke can reduce brain damage. But it's not a simple matter. Success in preventing brain damage, their new study says, depends on when 100 percent oxygen is given. "The use of supplemental oxygen after blood flow is restored in the brain appears to actually cause harm by unleashing free radicals," said Savita Khanna. "Ultimately, the supplemental oxygen after blood flow is restored is more than the tissue can handle and is more than it needs," said Cameron Rink. "Why add oxygen on top of tissue that's already oxygenated? Supplemental oxygen during the blockage, on the other hand, is highly protective." Timing of Oxygen After a Stroke May Matter: Treatment while blood flow is blocked protects tissue, animal study finds   　 MONDAY, Oct. 19 (HealthDay News) -- Contradicting previous research, scientists have shown in animal studies that providing supplemental oxygen during an ischemic stroke can reduce brain damage. But it's not a simple matter. Success in preventing brain damage, their new study says, depends on when 100 percent oxygen is given. "The use of supplemental oxygen after blood flow is restored in the brain appears to actually cause harm by unleashing free radicals," Savita Khanna, an assistant professor of surgery at Ohio State University and principal investigator of the new study, said in a university news release. "The resulting tissue damage was worse than stroke-affected tissue that received no treatment at all." The findings were scheduled to be presented Oct. 19 at the Society for Neuroscience annual meeting in Chicago. According to the study authors, earlier research in people suggested that administration of oxygen actually could hurt those who'd had a stroke. But Khanna said it's crucial to consider the status of blood flow through the brain when someone is given oxygen. The researchers looked at ischemic strokes, in which a blockage stops blood flow in the brain. In the other type of stroke, called hemorrhagic stroke, a blood vessel in the brain ruptures. In the study, oxygen was given to five groups of rats that had induced strokes. Four groups were given normal oxygen or pressurized oxygen; some got it while blood flow was restricted, and others received it when blood flow was restored. One group of mice just breathed room air. The researchers scanned the brains of the rats after two days to determine how much brain tissue was damaged. They found brain damage in the rats that were given supplemental oxygen while blood flow was blocked. "Ultimately, the supplemental oxygen after blood flow is restored is more than the tissue can handle and is more than it needs," Cameron Rink, an assistant professor of surgery at Ohio State and a study co-investigator, said in the news release. "Why add oxygen on top of tissue that's already oxygenated? Supplemental oxygen during the blockage, on the other hand, is highly protective."More information The U.S. National Institute of Neurological Disorders and Stroke has more about stroke. -- Randy Dotinga SOURCE: Ohio State University, news release, Oct. 19, 2009 Heart Failure Treatment Underused: Two-thirds of patients in U.S. hospitals fail to get recommended therapy, study finds The use of aldosterone antagonist therapy in patients with heart failure is designated as "useful and recommended" in chronic heart failure guidelines established by the ACC/AHA but this study found that less than one-third of patients hospitalized for heart failure receive the treatment. "These data confirm that in the context of a hospital-based performance improvement program, aldosterone antagonist therapy can be used according to guidelines with little inappropriate use. Given the substantial morbidity and mortality risk faced by patients hospitalized with HF and the established efficacy of aldosterone antagonist prescription in HF, a stronger uptake of aldosterone antagonist therapy indicated by evidence-based guidelines may be warranted," the researchers concluded. Heart Failure Treatment Underused: Two-thirds of patients in U.S. hospitals fail to get recommended therapy, study finds 　 TUESDAY, Oct. 20 (HealthDay News) -- A recommended treatment for heart failure is underused in U.S. hospitals, a new study finds. The use of aldosterone antagonist therapy in patients with heart failure is designated as "useful and recommended" in chronic heart failure guidelines established by the American College of Cardiology/American Heart Association (ACC/AHA), but this study found that less than one-third of patients hospitalized for heart failure receive the treatment. Researchers analyzed data on 43,625 patients admitted with heart failure and discharged home from 241 hospitals participating in a hospital recognition program called Get With The Guidelines -- HF between 2005 and 2007. The study found that 12,565 patients (28.8 percent) from 201 hospitals met ACC/AHA heart failure management guidelines criteria, and 4,087 eligible patients received an aldosterone antagonist when they were discharged from hospital. Overall, treatment increased from 28 percent to 34 percent during the study period, but there was wide variation in aldosterone antagonist use among hospitals -- ranging from 0 percent to 90.6 percent. "Aldosterone antagonist use in eligible patients was associated with younger age, African-American race/ethnicity, lower systolic blood pressure, history of implantable cardioverter-defibrillator use, depression, alcohol use and pacemaker implantation, and with having no history of renal insufficiency," wrote Nancy M. Albert of the Cleveland Clinic and colleagues. "These data confirm that in the context of a hospital-based performance improvement program, aldosterone antagonist therapy can be used according to guidelines with little inappropriate use. Given the substantial morbidity and mortality risk faced by patients hospitalized with HF and the established efficacy of aldosterone antagonist prescription in HF, a stronger uptake of aldosterone antagonist therapy indicated by evidence-based guidelines may be warranted," the researchers concluded. The study was published in the Oct. 21 issue of the Journal of the American Medical Association.More information The American Heart Association has more about heart failure. -- Robert Preidt SOURCE: Journal of the American Medical Association, news release, Oct. 20, 2009 Tylenol May Weaken Effectiveness of Kids' Vaccines: Giving analgesic to prevent fever at shot time could be counterproductive, researchers say Fever after a vaccination is a normal and essential part of building an immune response, and giving children acetaminophen -- best known in the U.S. as Tylenol -- after a shot could dampen that response, a new study finds. Therefore, "unless your doctor specifically recommends it, do not administer fever-reducing medicines at the same time as vaccination to prevent your child from developing a fever," said Dr. Robert T. Chen. "It is still okay to use antipyretics [acetaminophen or ibuprofen] to treat a fever, but just not recommended to prevent fever," he added. "High fevers can be serious, especially in infants. It is important to work with your doctor to provide the best care for your child." Tylenol May Weaken Effectiveness of Kids' Vaccines: Giving analgesic to prevent fever at shot time could be counterproductive, researchers say By Steven Reinberg: HealthDay Reporter THURSDAY, Oct. 15 (HealthDay News) -- Fever after a vaccination is a normal and essential part of building an immune response, and giving children acetaminophen -- best known in the U.S. as Tylenol -- after a shot could dampen that response, a new study finds. With some vaccines, transient fever means that a child's immune system is processing the immunization, providing them with the best protection, explained Dr. Robert T. Chen, a blood safety specialist at the U.S. Centers for Disease Control and Prevention. Therefore, "unless your doctor specifically recommends it, do not administer fever-reducing medicines at the same time as vaccination to prevent your child from developing a fever," said Dr. Robert T. Chen, who wrote an editorial accompanying a report in the Oct. 17 issue of The Lancet. "It is still okay to use antipyretics [acetaminophen or ibuprofen] to treat a fever, but just not recommended to prevent fever," he added. "High fevers can be serious, especially in infants. It is important to work with your doctor to provide the best care for your child." For the study, a research team led by Dr. Roman Prymula, from the University of Defence in Hradec Kralove, Czech Republic, did two studies, one when children received their first vaccination and another when they received their booster shot. The vaccinations were routine for protection against pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus. The 459 infants in the studies were randomly assigned to get acetaminophen every six to eight hours for 24 hours after vaccination or no acetaminophen. Prymula's team found that fewer infants who received acetaminophen had a fever, but these babies also had significantly fewer antibodies against pneumococcal disease, Haemophilus influenzae type b, diphtheria and tetanus toxoids, and for one of the whooping cough antibodies compared with infants who did not get acetaminophen. They believe the pain reliever's anti-inflammatory activity might trigger "interference" to healthy immune system antibody responses, explaining the weakened immunization. "Unless there are specific reasons for controlling fever, for example, in a child with history of febrile convulsions, Tylenol and other fever reducers should not be routinely given along with immunizations," Chen said. Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine in New York City, said that "the conclusion that Tylenol not only suppresses fever, but also decreases immune response is plausible. After all, what is an immune response? It's an inflammatory response." Siegel agrees that acetaminophen should not be routinely given to infants to prevent fever after vaccination. "But, if the kid is sick, treat the sickness. If the kid is very sick, I would get the fever down," he said. And what about the vaccine for the H1N1 flu? According to Siegel, "giving an infant Tylenol before an H1N1 flu vaccine shot may not be a problem, because the immune response to the vaccine has been so robust."More information For more information on vaccines, visit the U.S. Centers for Disease Control and Prevention. SOURCES: Robert T. Chen, M.D., blood safety specialist, U.S. Centers for Disease Control and Prevention, Atlanta; Marc Siegel, M.D., associate professor, medicine, New York University School of Medicine, New York City;Oct. 17, 2009, The Lancet Prolonged Use of Pacifier Linked to Speech Problems: Kids with sucking habit for more than 3 years may be at increased risk, researchers say In a study of 128 children aged 3 to 5 in Patagonia, Chile, researchers found that children who used a pacifier or sucked their fingers for more than three years were three times as likely as other kids to develop speech impediments. The study also found that children will have a lower risk of developing speech disorders if they don't start using bottles until they're at least 9 months old. "These results suggest extended use of sucking outside of breast-feeding may have detrimental effects on speech development in young children," study author Clarita Barbosa said. Prolonged Use of Pacifier Linked to Speech Problems: Kids with sucking habit for more than 3 years may be at increased risk, researchers say   　 WEDNESDAY, Oct. 21 (HealthDay News) -- A pacifier is fine for a while, but don't let your child use one too long, experts say. In a study of 128 children aged 3 to 5 in Patagonia, Chile, researchers found that children who used a pacifier or sucked their fingers for more than three years were three times as likely as other kids to develop speech impediments. The study, published online in the journal BMC Pediatrics, also found that children will have a lower risk of developing speech disorders if they don't start using bottles until they're at least 9 months old. "These results suggest extended use of sucking outside of breast-feeding may have detrimental effects on speech development in young children," study author Clarita Barbosa, said in a news release from the journal's publisher. "Although results of this study provide further evidence for the benefits of longer duration of breast-feeding of infants, they should be interpreted with caution as these data are observational," Barbosa added. The study doesn't prove that there's a direct cause-and-effect relationship between use of pacifiers and bottles and speech impediments, the researchers noted.More information Learn more about breast-feeding from the U.S. National Women's Health Information Center. -- Randy Dotinga SOURCE: BioMed Central, news release, Oct. 20, 2009 Radiation Treatments Made Safer for Cancer Patients: In mice, scientists say they can protect healthy tissue The key is a biochemical signaling pathway that can influence how radiation exposure affects both healthy and cancerous cells. In experiments with mice, the researchers found that blocking a molecule called thrombospondin-1 from binding to its cell surface receptor (CD47) resulted in nearly total protection for normal tissue when exposed to standard and very high doses of radiation. "This dramatic protective effect occurred in skin, muscle and bone marrow cells, which is very encouraging. Cells that might have died of radiation exposure remained viable and functional when pre-treated with agents that interfere with the thrombospondin-1/CD47 pathway," Dr. Jeff S. Isenberg said. The researchers also found that blocking this pathway delayed the regrowth of tumor cells after radiation exposure. Radiation Treatments Made Safer for Cancer Patients: In mice, scientists say they can protect healthy tissue 　 WEDNESDAY, Oct. 21 (HealthDay News) -- U.S. researchers say they may have found a way to protect healthy tissue and also increase tumor death when cancer patients undergo radiation therapy. The key is a biochemical signaling pathway that can influence how radiation exposure affects both healthy and cancerous cells. In experiments with mice, the researchers found that blocking a molecule called thrombospondin-1 from binding to its cell surface receptor (CD47) resulted in nearly total protection for normal tissue when exposed to standard and very high doses of radiation. "We almost couldn't believe what we were seeing," study co-author Dr. Jeff S. Isenberg, an associate professor in the division of pulmonary, allergy and critical care medicine at the University of Pittsburgh School of Medicine, said in a news release. "This dramatic protective effect occurred in skin, muscle and bone marrow cells, which is very encouraging. Cells that might have died of radiation exposure remained viable and functional when pre-treated with agents that interfere with the thrombospondin-1/CD47 pathway," Dr. Jeff S. Isenberg said. The researchers also found that blocking this pathway delayed the regrowth of tumor cells after radiation exposure. The findings were published Oct. 21 in the journal Science Translational Medicine. Isenberg and colleagues are investigating the pathway's role in several other conditions, including hypertension, sickle cell disease, heart attack and wound healing.More information The American Cancer Society has more about radiation therapy. -- Robert Preidt SOURCE: University of Pittsburgh, news release, Oct. 21, 2009 Want Sun Protection? Wear Deep Blue or Red: Fabric color affects absorption of UV radiation, researchers say Deep blue and red cotton fabrics are better than yellow at protecting skin against damaging ultraviolet (UV) radiation from the sun, according to Spanish scientists. The researchers dyed cotton fabrics in a wide range of red, blue and yellow shades and measured the ability of each to absorb UV light. Deep blue shades had the highest UV absorption, while yellow shades had the least, they found. The results could be used by clothing makers to design more effective anti-sun clothing, Ascension Riva and colleagues suggested. Want Sun Protection? Wear Deep Blue or Red: Fabric color affects absorption of UV radiation, researchers say   　 THURSDAY, Oct. 15 (HealthDay News) -- Deep blue and red cotton fabrics are better than yellow at protecting skin against damaging ultraviolet (UV) radiation from the sun, according to Spanish scientists. The researchers said their findings could lead to clothing fabrics that offer improved sun protection. The color of fabric is one of the most critical factors in determining how well clothing protects people against UV radiation. But there are gaps in knowledge about exactly how color interacts with other factors to influence the degree of UV protection offered by a fabric, explained Ascension Riva of the Universidad Politecnica de Cataluna in Terrassa, Spain, in a news release from the American Chemical Society. The researchers dyed cotton fabrics in a wide range of red, blue and yellow shades and measured the ability of each to absorb UV light. Deep blue shades had the highest UV absorption, while yellow shades had the least, they found. The results, scheduled to be published in the Nov. 4 issue of the journal Industrial & Engineering Chemistry Research, could be used by clothing makers to design more effective anti-sun clothing, Ascension Riva and colleagues suggested.More information The U.S. Food and Drug Administration has more about sun safety. -- Robert Preidt SOURCE: American Chemical Society, news release, Oct. 15, 2009 Oct. 9, 2009 to Oct. 16, 2009Health Highlights **Immune System Linked to Osteoporosis In Celiac Patients. **Falls Common Cause Of Seniors' ER Visits. **Web Site Evaluates Swine Flu Severity. **Breast Cancer Cells Mutate As Disease Progresses. **Ill College Students Can Keep Health Insurance. **FDA Considers New Insulin Inhaler. **Death Caused By Improper Relenza Use. **Adult Stem Cells Used to Create Jaw Joint. **Learning Juggling or Other Complex New Skills Benefits Brain. **Aspirin Overdoses May Have Caused Some 1918 Pandemic Deaths. Health Highlights (Oct. 9, 2009 to Oct. 16, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Immune System Linked to Osteoporosis In Celiac Patients People with celiac disease may be at increased risk for osteoporosis because their immune system attacks a protein called osteoprotegerin, which plays an important role in bone health, say U.K. researchers. It had been believed that osteoporosis in celiac patients was caused by an inability to absorb calcium or vitamin D. This study found that 20 percent of celiac patients tested had antibodies that stopped osteoprotegerin from working effectively, BBC News reported. "This is a very exciting step forward. Not only have we discovered a new reason to explain why osteoporosis occurs in celiac disease, but we have also found that it responds very well to drugs that prevent bone tissue removal," said lead researcher Professor Stuart Ralston, of the Institute of Genetics and Molecular Medicine at the University of Edinburgh. "Testing for these antibodies could make a real and important difference to the lives of people with celiac disease by alerting us to the risk of osteoporosis and helping us find the correct treatment for them," he added, BBC News reported. The study appears in the New England Journal of Medicine. ----- Falls Common Cause Of Seniors' ER Visits Each year, more than two million American seniors are treated in hospital emergency departments for injuries caused by falls, finds a federal government report. In 2006, treatment for head wounds, broken bones, cuts and other fall-related injuries suffered by seniors cost hospitals about $7 billion for emergency and subsequent inpatient care, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. Among the other findings from the analysis of hospital emergency department data: Falls accounted for 10 percent of emergency department visits by seniors. Fall-related visits increase with age. One in 10 men and one in seven women over age 85 have an emergency department visit for treatment of fall-related injuries. Of the seniors treated at emergency departments for fall-related injuries, 41 percent had fractures, primarily of an upper extremity or hip. Other common fall-related injuries are open wounds (21 percent), sprains and strains (10 percent), internal organ injuries (five percent), and joint dislocations (1.5 percent). Hospitalization was required for 63 percent of patients with internal organ injuries and 51 percent of those with fractures. About 41 percent of patients with fractures and 33 percent of those with internal organ injuries were transferred to a nursing home or other type of long-term care facility. ----- Web Site Evaluates Swine Flu Severity An interactive Web site designed to help people decide if their case of swine flu is serious enough to require a visit to the doctor was unveiled Wednesday. The site uses a self-assessment tool from Emory University in Atlanta. That tool is based on key risk factors for bad flu outcome determined by the U.S. Centers for Disease Control and Prevention, the Associated Press reported. The tool "reflects the best available science," Emory emergency specialist Dr. Arthur Kellerman told the AP. Users of the online assessment type in their age (it's only for those over 12) and answer questions about their underlying health and symptoms, such as fever. The program may advise rest and fluids, a non-emergency call to your doctor, or immediate medical attention. The site was created by Microsoft Corp. The CDC (www.flu.gov) also offers a list of flu signs that indicate a person should seek emergency care. ----- Breast Cancer Cells Mutate As Disease Progresses The discovery that breast cancer cells mutate as the disease progresses is an important finding that may lead to new treatments, researchers say. They analyzed the DNA of healthy cells and cancer cells at three different stages of breast cancer in one patient. Nine years after her initial diagnosis, the woman's cancer had spread (metastasized) to other parts of her body. There were 32 DNA mutations in the metastasized cells. "When we looked back to see if (the mutations) were present in the primary tumor, we found only five mutations that could have been present in all cells," lead researcher Samuel Aparicio of the British Columbia Cancer Agency in Canada, told Agence France Presse. "This is a watershed event in our ability to understand the causes of breast cancer and to develop personalized medicines for our patients," he said in a news release. The findings "will lead to a shift in perspective" in how cancer is treated, he told AFP. The study appears in the Oct. 8 issue of the journal Nature. ----- Ill College Students Can Keep Health Insurance A new U.S. law that allows college students to take up to one year off school for medical reasons while remaining on their family's health insurance plan could benefit thousands of seriously ill or injured college students. No longer will they have to choose between taking time off from their education or keeping their health coverage. "Michelle's Law," which took effect Friday, is named for Michelle Morse, who decided to keep her full course load at Plymouth (N.H.) State University while undergoing chemotherapy for colon cancer so that she wouldn't be dropped from her parents' health insurance plan. The aspiring teacher died at age 22 in 2005, six months after she graduated, the Associated Press reported. Her mother AnnMarie Morse lobbied for changes in New Hampshire, which enacted its version of Michelle's Law in 2006. Morse then started pushing for a new national law, which Congress passed last year. At a news conference Friday, Morse said it was "a very bittersweet day," the AP reported. "I wish I could turn back time and have the family my husband and I were given: one daughter, one son." ----- FDA Considers New Insulin Inhaler An insulin inhaler that may offer a more convenient alternative to insulin injections for people with diabetes is being considered for approval by the U.S. Food and Drug Administration. The palm-sized inhaler contains an insulin powder called Afresa, which dissolves in the lungs and then travels the bloodstream, The New York Times reported. The device and powder were developed by California-based MannKind Corporation, which is asking the FDA to approve the system's use in people with type 1 and type 2 diabetes. "The patient's breathing action does the job," Matthew J. Pfeffer, chief financial officer at MannKind, told the Times. "The airflow through the cartridge allows the powder to be inhaled." Patients put insulin doses -- pre-packaged in cartridges -- into the inhaler and turn the mouthpiece to release the insulin. The inhaler uses no electricity or compressed gas. "The patient's breathing action does the job," Pfeffer said. "The airflow through the cartridge allows the powder to be inhaled." An insulin inhaler introduced by Pfizer in 2006 was taken off the market less than two years later due to poor sales. The inhaler was too large and awkward, according to some experts, the Times said. ----- Death Caused By Improper Relenza Use Inappropriate use of the anti-flu medication Relenza has been linked with at least one death, drug maker GlaxoSmithKline says in a letter sent to doctors. The letter was posted online Friday by the U.S. Food and Drug Administration. The death occurred after the drug was reformulated into a liquid form, an action not recommended by the FDA. Glaxo said Relenza should only be used in the prescribed manner. The letter didn't provide any details about the person who died, the Associated Press reported. Relenza, which comes in powder form to be used with a special inhaler device, is approved by the FDA to treat symptoms of seasonal flu when taken within two days of the start of the flu. Millions of doses of Relenza and Roche's Tamiflu have been stockpiled by the United States, the AP reported. ----- Adult Stem Cells Used to Create Jaw Joint U.S. researchers who used human adult stem cells to create part of a jaw joint in the laboratory said their success could lead to new ways to treat jaw problems and other types of bone disorders. Stem cells taken from bone marrow were seeded into a tissue scaffold, which had been formed into a temporomandibular joint by using digital images from a patient. The cells were infused with the exact amount of nutrients found during natural bone development, BBC News reported. The Columbia University study appears in the journal Proceedings of the National Academy of Sciences. "The availability of personalized bone grafts engineered from the patient's own stem cells would revolutionize the way we currently treat these defects," said lead researcher Dr. Gordana Vunjak-Novakovic, BBC News reported. "We thought the jawbone would be the most rigorous test of our technique; if you can make this, you can make any shape," she noted. ----- Learning Juggling or Other Complex New Skills Benefits Brain Learning juggling or other complex new skills prompts improvements in the brain's signaling network, a finding that could lead to new ways to treat people with diseases such as multiple sclerosis, say U.K. researchers. The researchers used MRI imaging technology to monitor the brains of healthy young adults who were given weekly juggling training sessions for six weeks and then practiced for 30 minutes a day. The jugglers showed a 5 percent increase in brain white matter compared with non-jugglers, BBC News reported. The Oxford University study appeared in the journal Nature Neuroscience. "MRI is an indirect way to measure brain structure and so we cannot be sure exactly what is changing when these people learn," said team leader Dr. Heidi Johansen-Berg, BBC News reported. "Future work should test whether these results reflect changes in the shape or number of nerve fibers, or growth of the insulating myelin sheath surrounding the fibers." "Of course, this doesn't mean that everyone should go out and start juggling to improve their brains," she added. "We chose juggling purely as a complex new skill for people to learn." ----- Aspirin Overdoses May Have Caused Some 1918 Pandemic Deaths A researcher suggests that aspirin overdoses may have caused some deaths during the 1918 flu pandemic, which killed more than 50 million people worldwide. Dr. Karen M. Starko said that high doses of aspirin -- amounts considered unsafe today -- were used to treat patients in the pandemic. She also noted that doctors may have had difficulty distinguishing symptoms of aspirin overdose from those of the flu, especially among patients who died soon after they became ill, The New York Times reported. At the time, aspirin packages didn't have any warnings about toxicity and included few instructions for use. Federal officials recommended aspirin as a symptomatic treatment for the flu, and the U.S. military purchased large quantities of the drug. During the pandemic, the Journal of the American Medical Association suggested an aspirin dose of 1,000 milligrams every three hours. That's the equivalent of 25 standard 325-milligram aspirin tablets in 24 hours, about twice the daily dosage considered safe today, the Times reported. The research, which appears in the Nov. 1 issue of the journal Clinical Infectious Diseases, is "intriguing," said Peter A. Chyka, a professor of pharmacy at the University of Tennessee. "In the context of what we know today about aspirin and aspirin-like products, Starko has made an interesting effort to put this together," he told The Times. "There are things other than flu that can complicate a disease like this."   Shared Bed May Raise SIDS Risk: Parental use of alcohol, drugs noted in about a third of deaths, study finds Researchers analyzed 80 cases of sudden infant death syndrome (SIDS) in southwest England between January 2003 and December 2006. Of the deaths, 54 percent occurred while parent and child were sharing a bed or sofa, called co-sleeping. Parental use of alcohol or drugs before co-sleeping occurred in 31 percent of the cases, and 17 percent of the deaths occurred while co-sleeping on a sofa. One-fifth of the infants were found with a pillow and one-quarter were swaddled, the study authors noted, suggesting these situations as potential risk factors. The study included a number of different social groups, and the results suggest that the risk factors were similar throughout the entire community, which the study said indicates that the deaths were not related to social deprivation. Shared Bed May Raise SIDS Risk: Parental use of alcohol, drugs noted in about a third of deaths, study finds   　 WEDNESDAY, Oct. 14 (HealthDay News) -- More than half of sudden infant deaths involve babies who share a bed or sofa with a parent, and alcohol or drug use by parents appears to be a factor in many of the cases, says a U.K. study. Researchers analyzed 80 cases of sudden infant death syndrome (SIDS) in southwest England between January 2003 and December 2006. Of the deaths, 54 percent occurred while parent and child were sharing a bed or sofa, called co-sleeping. Parental use of alcohol or drugs before co-sleeping occurred in 31 percent of the cases, and 17 percent of the deaths occurred while co-sleeping on a sofa. One-fifth of the infants were found with a pillow and one-quarter were swaddled, the study authors noted, suggesting these situations as potential risk factors. The study included a number of different social groups, and the results suggest that the risk factors were similar throughout the entire community, which the study said indicates that the deaths were not related to social deprivation. The findings appear online Oct. 14 in BMJ. The safest place for an infant to sleep is in a separate bed beside the parents' bed for the first six months of life, according to the researchers, from the University of Bristol and University of Warwick. They urged parents to never put themselves in a situation where they might fall asleep with a young infant on a sofa and to never co-sleep with an infant in any environment if they've been taking drugs or drinking alcohol. SIDS is largely preventable, but parents have to be educated about proper infant care practices, Edwin Mitchell, professor of child health research at the University of Auckland, wrote in an accompanying editorial.More information The Nemours Foundation has more about sudden infant death syndrome. -- Robert Preidt SOURCE: BMJ, news release, Oct. 14, 2009 Swine Flu Can Move Quickly to Severe Illness: Canadian, Mexican studies suggest U.S. hospitals need to be ready for surge of cases Canadian and Mexican intensive care units were swamped with patients who rapidly became critically ill with H1N1 flu this past spring and summer, new reports find. Many of these patients were relatively healthy adolescents and young adults who needed to be treated in an intensive care unit (ICU) within a day or two of being admitted to the hospital, note doctors from both countries. Many patients required mechanical ventilators. Indications are that, overall, most cases of H1N1 flu remain mild. But with more people getting sick overall, the number falling severely ill will swell. The average age of the 168 confirmed or probable H1N1 swine flu cases in the Canadian study was 32.3 years. In Mexico the mean age was older (44 years) but still relatively young. Swine Flu Can Move Quickly to Severe Illness: Canadian, Mexican studies suggest U.S. hospitals need to be ready for surge of cases   By Amanda Gardner: HealthDay Reporter MONDAY, Oct. 12 (HealthDay News) -- Canadian and Mexican intensive care units were swamped with patients who rapidly became critically ill with H1N1 flu this past spring and summer, new reports find. Many of these patients were relatively healthy adolescents and young adults who needed to be treated in an intensive care unit (ICU) within a day or two of being admitted to the hospital, note doctors from both countries. Many patients required mechanical ventilators, say the reports, slated to be published in the Nov. 4 issue of the Journal of the American Medical Association. The papers, coupled with another report released last week that detailed the impact of the pandemic on ICUs in Australia and New Zealand, indicate the need for the United States and other countries to prepare carefully for what very well could be an escalating number of hospitalized patients as the pandemic continues, experts said. "These people were not just a little bit ill. They were spectacularly ill," said Dr. Anand Kumar, the Canadian lead author of one of the JAMA studies. "To see 40 patients like this simultaneously in the ICU, all struggling for their lives, all in the space of a few weeks -- that's really unusual." "Without preparation, there would be some chance that some areas would be overwhelmed," Kumar said. "As long as we prepare, it should be handled." Kumar, an associate professor in critical care and infectious disease at the University of Manitoba, Winnipeg, believes that "the value of this paper is to alert and sharpen the thinking of the authorities in terms of making sure that we do have strategies in place to mitigate what's likely to happen." Another expert worried that many U.S. hospitals might not be up to the challenge. "The concern is that we would have difficulty meeting the demand because our health-care system operates near capacity most of the time, and there's not a lot of excess capacity in the system," said Dr. John J. Treanor, a professor of medicine and of microbiology and immunology at the University of Rochester Medical Center. "I think there's a cause for alarm -- though not undue alarm -- because one would predict a pretty intense flu season and there will be a lot of demand placed on emergency rooms and hospitals." Indications are that, overall, most cases of H1N1 flu remain mild. But with more people getting sick overall, the number falling severely ill will swell. The types of people hospitalized in Canada, Mexico and Australia are consistent with U.S. trends seen so far. "What all of them have in common is the burden was seen primarily in older adolescents and young adults as opposed to the elderly, which is what is typically seen with seasonal influenza," noted Dr. Nathan Litman, director of pediatrics and chief of pediatric infectious diseases at the Children's Hospital at Montefiore Medical Center in New York City. The average age of the 168 confirmed or probable H1N1 swine flu cases in the Canadian study was 32.3 years. A large proportion was female (113), 50 were children and 43 were aboriginal. Although average time from the onset of flu symptoms to hospitalization was four days, the patients' condition typically deteriorated so quickly upon admission that they were sent to an ICU within 48 hours. More than 80 percent of these very sick individuals needed mechanical ventilation, many experienced shock or organ failure and, by one month after admission, 14.3 percent of them had died. Although many patients had other health conditions, including obesity, these conditions tended not to be severe and included being smokers, being overweight or having high blood pressure, Kumar said. This pattern of the virus affecting younger, healthy people is similar to that seen in the deadly 1918 Spanish pandemic, the authors noted. In a second study, researchers in Mexico -- where H1N1 first arose in the spring -- found critical illness in 58 of 899 total patients admitted to the hospital. Here the mean age was older (44 years) but still relatively young. About one-quarter were obese. Again, patients moved from the hospital to the ICU quickly, and most received mechanical ventilation. Within two months of admission, 41.4 percent of the critically ill patients had died, four of them while waiting for ICU beds. Overall, prompt and proper care did save most lives, the researchers stressed. A final paper, this one out of New Zealand and Australia, found a rise in the use of a system called extracorporeal membrane oxygenation, which provides extra oxygen to a patient's blood. The survival rate for patients critically ill from H1N1 flu was high in this group. After reading the reports, Dr. Tamara Kuittinen, an emergency physician with Lenox Hill Hospital in New York City, said that she will be more inclined to err on the side of caution, especially if patients have one or more other health conditions. "If it were borderline, I would admit [the patient to the hospital] right off the bat," Kuittinen said. She also said she would be advising outpatients to monitor their conditions closely and seek more medical care if symptoms worsen or don't get better. But the experience observed in the spring might not be as dire this fall, one expert added. "We're all hoping that a substantial portion of the population in fact was infected [earlier this year], and, if so, they will be immune and they will not get infected," said Dr. Edward Walsh, professor of medicine at the University of Rochester Medical Center and chief of infectious diseases at Rochester General Hospital. "That will reduce the burden, the pool of susceptible people. It will also reduce the potential transmission from person to person." And the previous experiences that are now coming to light form a strong argument for getting the swine flu vaccine, Treanor added.More information The U.S. Centers for Disease Control and Prevention has much more on H1N1 influenza. SOURCES: Anand Kumar, M.D., intensivist, Winnipeg Regional Health Authority, and associate professor, critical care and infectious disease, University of Manitoba, Winnipeg, Canada; Tamara R. Kuittinen, M.D. emergency physician, Lenox Hill Hospital, New York City; John J. Treanor, M.D., professor, medicine and microbiology and immunology, University of Rochester Medical Center, Rochester, N.Y.; Nathan Litman, MD, director, pediatrics, and chief, pediatric infectious diseases, Children's Hospital, Montefiore Medical Center, New York City; Edward Walsh, M.D., professor, medicine, University of Rochester Medical Center, and chief, infectious diseases, Rochester General Hospital, Rochester, N.Y.; Nov. 4, 2009, Journal of the American Medical Association Shingles Raises Stroke Risk: Patients with the virus should be monitored for high blood pressure, expert says Adults with the skin disease shingles appear to be at raised risk for stroke, especially when it affects the area around the eyes, researchers report. Kang and his colleagues studied data on 7,760 adult Taiwanese who were treated for shingles between 1997 and 2001. In the year after treatment, 133 of them, or 1.7 percent, had strokes. The incidence in a control group of 23,280 adults who were not treated for shingles was 1.3 percent (306 people). Analysis of the data found that the risk of stroke in that one-year period was 31 percent higher in the shingles group. The incidence was dramatically higher for those with a shingles infection in or around the eye -- nearly 4.3 times higher than in the control group. Shingles Raises Stroke Risk: Patients with the virus should be monitored for high blood pressure, expert says   By Ed Edelson: HealthDay Reporter THURSDAY, Oct. 8 (HealthDay News) -- Adults with the skin disease shingles appear to be at raised risk for stroke, especially when it affects the area around the eyes, researchers report. Previous reports have linked shingles with stroke risk, but "the exact frequency and risk for these phenomena are still unknown," said study lead author Dr. Jiunn-Horng Kang, a principal investigator in the Neuroscience Research Center of Taipei Medical University Hospital, Taiwan. His team published their findings in the November issue of Stroke. "Our study is the first to explore these issues with a nationwide population-based data," Kang said. Shingles is a painful skin rash resulting from infection by the varicella zoster virus, which causes chickenpox. The virus remains in the body after recovery from chickenpox and can erupt again to cause shingles. Kang and his colleagues studied data on 7,760 adult Taiwanese who were treated for shingles between 1997 and 2001. In the year after treatment, 133 of them, or 1.7 percent, had strokes. The incidence in a control group of 23,280 adults who were not treated for shingles was 1.3 percent (306 people). Analysis of the data found that the risk of stroke in that one-year period was 31 percent higher in the shingles group. The incidence was dramatically higher for those with a shingles infection in or around the eye -- nearly 4.3 times higher than in the control group. Strokes can be ischemic, caused by a blood clot blocking a brain artery, or hemorrhagic, due to rupture of a blood vessel. The study found a 31 percent higher incidence of ischemic strokes, the most common kind, and a 2.79-times higher incidence of hemorrhagic stroke in the shingles group. "The major mechanism of our findings is that stroke results from herpes zoster virus-induced vasculopathy [blood vessel damage]," Kang said. "The vessel to the brain damaged by the virus could be occluded [blocked] or ruptured." "However, several other factors could also be involved," he added. No known treatment exists to reduce the apparent risk of stroke that results from shingles infection, Kang said. "Our interest and ongoing research are focused on whether early anti-viral treatment for herpes zoster can reduce the risk of stroke," he said. "Also, from the clinical view, patients who have a shingles attack should be aware of the risk of stroke, and intensive monitoring and management of pre-existing risk factors for stroke, such as hypertension, hyperlipidemia [raised lipid levels] and diabetes, should be emphasized." Shingles usually starts as a rash on one side of the face or body, which often causes pain, itching and tingling. Attacks can last for two to four weeks. The incidence of shingles increases with age, and the U.S. Centers for Disease Control and Prevention recommends most people over 60 be vaccinated against the virus, with the major exception being those with weakened immune systems. While there have been scattered reports about a possible association of shingles with stroke, "to my knowledge this is the first study to link shingles very specifically with stroke," said Dr. Daniel Lackland, professor of epidemiology and medicine at the Medical University of South Carolina, and a spokesman for the American Stroke Association. "It might be a little too early for a lot of clinical implications here," Lackland said. "But a physician who is treating someone with shingles should emphasize the importance of traditional risk factors for stroke, and let the patient know that your risk might be a little bit increased and you should pay more attention to high blood pressure, cholesterol and the like."More information Learn the basics about shingles from the U.S. National Library of Medicine. SOURCES: Jiunn-Horng Kang, M.D., principal investigator, Neuroscience Research Center, Taipei Medical University Hospital, Taiwan; Daniel Lackland, M.D., professor, epidemiology and medicine, Medical University of South Carolina, Charleston; November 2009 Stroke With Hormone Therapy, Tender Breasts May Signal Cancer Risk: Symptom might warrant a reassessment of treatment, experts suggest Women taking estrogen plus progestin who reported developing breast tenderness after starting the hormone therapy were 48 percent more likely to develop invasive breast cancer than women on hormone therapy who did not experience breast tenderness. Researchers said more study is needed before they would recommend that women who experience this symptom discontinue taking the hormones. But women who develop breast tenderness might want to reassess if the hormones are really necessary to control their menopausal symptoms. Researchers aren't certain why some women on hormone therapy develop breast cancer while others don't, though the breast tenderness may provide a clue, Crandall said. Tenderness could be a sign that the cells of the breast are multiplying rapidly. Cell proliferation is a risk factor for cancer. With Hormone Therapy, Tender Breasts May Signal Cancer Risk: Symptom might warrant a reassessment of treatment, experts suggest   By Jennifer Thomas: HealthDay Reporter MONDAY, Oct. 12 (HealthDay News) -- Breast tenderness in women taking estrogen/progestin hormone replacement therapy could signal increased chances of developing breast cancer, a new study says. Women taking estrogen plus progestin who reported developing breast tenderness after starting the hormone therapy were 48 percent more likely to develop invasive breast cancer than women on hormone therapy who did not experience breast tenderness. Researchers said more study is needed before they would recommend that women who experience this symptom discontinue taking the hormones. But women who develop breast tenderness might want to reassess if the hormones are really necessary to control their menopausal symptoms. "It's too soon to tell women to quit their hormone therapy, but it is something for women to think about in balancing the risks versus the benefits," said the study's lead author, Dr. Carolyn J. Crandall, a clinical professor of general internal medicine and health services research at the David Geffen School of Medicine at the University of California, Los Angeles. "Breast tenderness is a symptom that may be a risk marker for breast cancer," she said. The study is in the Oct. 12 issue of the Archives of Internal Medicine. Researchers used data from the Women's Health Initiative, a landmark federal study that was halted in 2002 after investigators determined that hormone replacement therapy increased the risk for heart attack, stroke and invasive breast cancer. Since then, most women have been advised to use hormone replacement therapy -- which physicians now call menopausal hormone therapy -- either not at all or for the shortest duration possible to get them through their most uncomfortable menopausal symptoms, usually hot flashes, Crandall said. Women are strongly advised to avoid taking hormones for longer than five years, when the risk for breast cancer doubles. In the new study, more than 8,500 women took estrogen plus progestin, and more than 8,100 took a placebo. Participants were given a mammogram and breast exam at the start of the trial and annually thereafter. At the one-year mark, women on the combination therapy were three times more likely to report experiencing breast tenderness than women on the placebo. About 36 percent of women on the hormone therapy reported new breast tenderness, compared with nearly 12 percent of women on a placebo. During 5.6 years of follow-up, 0.6 percent of women who reported new breast tenderness were diagnosed with breast cancer each year, compared with 0.36 percent of women taking hormones who did not experience new breast tenderness. Researchers aren't certain why some women on hormone therapy develop breast cancer while others don't, though the breast tenderness may provide a clue, Crandall said. Tenderness could be a sign that the cells of the breast are multiplying rapidly. Cell proliferation is a risk factor for cancer. Mary B. Daly, director of the Personalized Cancer Risk Assessment Program at Fox Chase Cancer Center in Philadelphia, said the findings of the study, which she described as well done, should prompt women and their doctors to reassess the need for hormone replacement if such tenderness develops. Yet individual differences -- why this happens to some women and not others -- are still not well understood, Daly said. "Some women who start taking hormone therapy may have cells that are much more receptive to it, or more sensitive to it, while other women must be more resistant," Daly said. "Something must be different about the breast tissue to make it more or less responsive to the hormones. If we could figure that out, that would be great." Women in the study were taking daily doses of oral conjugated equine estrogens (0.625 milligrams) plus medroxyprogesterone acetate (2.5 milligrams). The findings apply only to women taking the combination therapy, not women who've had hysterectomies and are taking estrogen alone, Crandall said. In a statement, Wyeth Pharmaceuticals, which makes the estrogen-progestin therapy Prempro, called the study "interesting" but added that, "breast tenderness is not an established risk factor for breast cancer." According to the company, up to a quarter of women who take combination hormone therapy will develop some tenderness in the breast, typically transient. The company also noted that the "small" increase in breast cancer risk for women on combo therapy and those on placebo, "has previously been reported and is included in the Prescribing Information (labeling) for Prempro."More information The U.S. National Heart, Lung and Blood Institute has more on menopausal hormone therapy. SOURCES: Carolyn Crandall, M.D., clinical professor, general internal medicine and health services research, David Geffen School of Medicine, University of California, Los Angeles, and faculty member, Iris Cantor-UCLA Women's Health Center; Mary B. Daly, M.D., Ph.D., director, Personalized Cancer Risk Assessment Program, Fox Chase Cancer Center, Philadelphia; Oct. 12, 2009, news statement, Wyeth Pharmaceuticals; Oct. 12, 2009, Archives of Internal Medicine Vitamin D Good for Breast Cancer Patients: Supplements help fight treatment-related bone loss, researchers say "Vitamin D is essential to maintaining bone health, and women with breast cancer have accelerated bone loss due to the nature of hormone therapy and chemotherapy. It's important for women and their doctors to work together to boost their vitamin D intake," said Luke Peppone. Peppone and colleagues studied 166 women undergoing treatment for breast cancer and found that nearly 70 percent had low levels of vitamin D in their blood. The researchers found that weekly supplementation with high doses of vitamin D (50,000 IU or more) boosted the levels of the vitamin among all the women. Along with strengthening bones, vitamin D plays an important role in cell growth and keeping the immune system strong. Vitamin D Good for Breast Cancer Patients: Supplements help fight treatment-related bone loss, researchers say   　 FRIDAY, Oct. 9 (HealthDay News) -- Many breast cancer patients have low levels of vitamin D, which could lead to weaker bones and increased risk of fractures, say U.S. researchers who recommend high doses of vitamin D for them. "Vitamin D is essential to maintaining bone health, and women with breast cancer have accelerated bone loss due to the nature of hormone therapy and chemotherapy. It's important for women and their doctors to work together to boost their vitamin D intake," Luke Peppone, a research assistant professor of radiation oncology at the University of Rochester Medical Center, said in a news release from the medical cwnter. Peppone and colleagues studied 166 women undergoing treatment for breast cancer and found that nearly 70 percent had low levels of vitamin D in their blood. The average level among the women was 27 nanograms of vitamin D per milliliter of blood. Levels of 32 nanograms per milliliter are adequate, according to the U.S. Institute of Medicine. The lowest levels of vitamin D were in non-whites and those with late-stage breast cancer. The researchers found that weekly supplementation with high doses of vitamin D (50,000 IU or more) boosted the levels of the vitamin among all the women. The study was to be presented Oct. 8 at the American Society of Clinical Oncology's breast cancer symposium in San Francisco. Previous studies have shown that nearly half of all women and men have vitamin D levels below 32 nanograms per milliliter. Along with strengthening bones, vitamin D plays an important role in cell growth and keeping the immune system strong. People obtain Vitamin D through exposure to sunlight and from foods such as milk and fortified cereals.More information MedlinePlus has more about vitamin D. -- Robert Preidt SOURCE: University of Rochester Medical Center, news release, Oct. 8, 2009 Impotence, Incontinence Risk Casts Doubt on High-Tech Prostate Surgery: Marketing is buoying use of the technique, researchers say, but surgeon's experience is key The presumed good stemming from the robotic technique are being oversold to a public that is all too willing to believe, said Dr. Jim C. Hu. "Given the expense of the procedure and the hype around it, expectations are being raised that are too high," said Hu. "Patients are demanding it," agreed Dr. Stephen J. Freedland. The numbers in the new study "are really worrisome," Freedland said. "They are finding an incontinence rate that is 30 percent higher and an erectile dysfunction rate that is 40 percent higher, and those are really important." And the robotic technique is not readily mastered by surgeons, he said. "The learning curve is 150 to 200 patients, so the first 150 you do, you're practicing on them," Freedland said. Impotence, Incontinence Risk Casts Doubt on High-Tech Prostate Surgery: Marketing is buoying use of the technique, researchers say, but surgeon's experience is key   By Ed Edelson: HealthDay Reporter TUESDAY, Oct. 13 (HealthDay News) -- Heightened risks for post-operative incontinence and impotence may outweigh any benefits from minimally invasive "keyhole" surgery for prostate cancer, a new study suggests. The presumed good stemming from the robotic technique are being oversold to a public that is all too willing to believe, said Dr. Jim C. Hu, a genitourinary surgeon at Brigham and Women's Hospital in Boston who led the study. "Given the expense of the procedure and the hype around it, expectations are being raised that are too high," said Hu, whose team published the findings in the Oct. 14 Journal of the American Medical Association. Men who have the prostate-removing surgery, which requires only a small incision and is helped along by robotic technology, do get out of the hospital faster than those who have the older operation, according to the report. Patients who underwent the more high-tech surgery spent an average of two days hospitalized rather than the three-days seen with traditional procedure. They were also less likely to require blood transfusions or suffer respiratory or surgical complications, researchers found. But the study of more than 8,800 men also found a higher incidence of genitourinary complications, including impotence and incontinence, among those having the keyhole procedure (4.7 percent) versus those who got traditional surgery (2.1 percent). And yet the popularity of minimally invasive prostatectomy, especially when done with robotic assistance, continues to grow. It accounted for more than 40 percent of all prostate operations in 2006, up from 1 percent in 2001, the report said. That growth has been fueled by "widespread direct-to-consumer advertising," according to the report. The minimally invasive technique is especially popular among patients in high-income areas, the research team said. This may be the result of a "highly successful robotic-assistant MIRP [minimally invasive radical prostatectomy] marketing campaign disseminated via the Internet, radio and print media channels, likely to be frequented by men of higher socioeconomic status," they wrote. "Patients are demanding it," agreed Dr. Stephen J. Freedland, associate professor of urology and pathology at Duke University Medical Center, who performs prostate surgery but does not do the minimally invasive version. "In many cases, if the surgeon is not offering it, the patient will not come to you. So you have no choice. You do robotic surgery, or you don't do surgery." Men who have been diagnosed with prostate cancer usually go directly to the Internet for information, and what they usually find are reports about the benefits of minimally invasive robotic surgery, Freedland said. "But we are learning more and more that there are not all the benefits that have been touted," he said. "There are some benefits. But for long-term outcomes, there is no benefit and perhaps some detriment." The numbers in the new study "are really worrisome," Freedland said. "They are finding an incontinence rate that is 30 percent higher and an erectile dysfunction rate that is 40 percent higher, and those are really important." And the robotic technique is not readily mastered by surgeons, he said. "The learning curve is 150 to 200 patients, so the first 150 you do, you're practicing on them," Freedland said. Men who are considering minimally invasive prostate surgery should first check carefully about the training of the surgeons doing the procedure, Hu said. "They should go online to see how long the procedure has been available [at the clinic]," he said. "They should ask about how surgeons have been trained to do it, whether they have extensive training or just a standard three-day course." Minimally invasive robotic surgery for prostate cancer is in an early stage of evolution, Hu said, and the surgical techniques needed to preserve urological function and prevent incontinence and impotence still have not been perfected.More information There's more on prostate cancer surgeries at the U.S. National Library of Medicine. SOURCES: Stephen J. Freedland, professor, urology and pathology, Duke University Medical Center, Durham, N.C.; Jim C. Hu, M.D., genitourinary surgeon, Brigham and Women's Hospital and Harvard Medical School, Boston; Oct. 14, 2009 Journal of the American Medical Association Drop in Certain Visual Skills May Precede Alzheimer's: Decline in spatial understanding can occur 3 years before diagnosis, study finds The ability to perceive relationships between objects (visuospatial skills) may decline years before a person is diagnosed with Alzheimer's disease, a new study suggests. The researchers used data from the cognitive assessments to chart declines in various areas before participants were diagnosed with dementia. They found an inflection point (sudden change to a steeper slope of decline) in visuospatial abilities three years before clinical diagnosis of dementia. Declines in overall cognition occurred the next year, while inflection points for verbal and working memory weren't seen until one year before diagnosis. "These findings suggest that research into early detection of cognitive disorders using only episodic memory tasks, such as word lists or paragraph recall, may not be sensitive to all of the earliest manifestations...." wrote David K. Johnson. Drop in Certain Visual Skills May Precede Alzheimer's: Decline in spatial understanding can occur 3 years before diagnosis, study finds 　 MONDAY, Oct. 12 (HealthDay News) -- The ability to perceive relationships between objects (visuospatial skills) may decline years before a person is diagnosed with Alzheimer's disease, a new study suggests. It included 444 people who were dementia-free when they were enrolled in the study and underwent tests on a number of cognitive abilities, including visuospatial skills. The assessments were repeated at least once before the end of the study. After an average follow-up of 5.9 years, 134 participants had developed dementia. Of those, 44 underwent brain autopsies that confirmed they had Alzheimer's disease. The researchers used data from the cognitive assessments to chart declines in various areas before participants were diagnosed with dementia. They found an inflection point (sudden change to a steeper slope of decline) in visuospatial abilities three years before clinical diagnosis of dementia. Declines in overall cognition occurred the next year, while inflection points for verbal and working memory weren't seen until one year before diagnosis. The findings appear in the October issue of the Archives of Neurology. "There are several implications of this study," wrote David K. Johnson, of the University of Kansas, and colleagues. "Some of the earliest signs of preclinical disease may occur on tests of visuospatial and speeded psychomotor skills. Furthermore, the greatest rate of preclinical decline may occur on executive and attention tasks. These findings suggest that research into early detection of cognitive disorders using only episodic memory tasks, such as word lists or paragraph recall, may not be sensitive to all of the earliest manifestations of disease or the most rapidly changing domain." "In summary, converging longitudinal evidence suggests that after a sharp departure from the relatively flat course of normal aging, there is a preclinical period in Alzheimer's disease with insufficient cognitive decline to warrant clinical diagnosis using conventional criteria but that can be seen with longitudinal data from multiple domains of cognition and not just memory."More information The U.S. National Institute on Aging has more about Alzheimer's disease. -- Robert Preidt SOURCE: JAMA/Archives journals, news release, Oct. 12, 2009 Oct. 2, 2009 to Oct. 9, 2009Health Highlights **Web Site Evaluates Swine Flu Severity. **Convertibles Pose Serious Hearing Threat. **Exercise Helps Rheumatoid Arthritis Patients. **Menu Calorie Info Doesn't Change Eating Habits. **Eating Licorice During Pregnancy May Harm Children. **FDA Panel Backs PegIntron as Skin Cancer Treatment. **EU Regulators Approve Diabetes Drug Onglyza. **U.S. Poisoning Deaths Nearly Double Since 1999: Drugs Played a Major Role. **No Scientific Evidence for Probiotic Health Claims: EU Panel. **Kidney Cancer Drug May Cause Liver Damage: FDA. Health Highlights (Oct. 2, 2009 to Oct. 9, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Web Site Evaluates Swine Flu Severity An interactive Web site designed to help people decide if their case of swine flu is serious enough to require a visit to the doctor was unveiled Wednesday. The site uses a self-assessment tool from Emory University in Atlanta. That tool is based on key risk factors for bad flu outcome determined by the U.S. Centers for Disease Control and Prevention, the Associated Press reported. The tool "reflects the best available science," Emory emergency specialist Dr. Arthur Kellerman told the AP. Users of the online assessment type in their age (it's only for those over 12) and answer questions about their underlying health and symptoms, such as fever. The program may advise rest and fluids, a non-emergency call to your doctor, or immediate medical attention. The site was created by Microsoft Corp. The CDC (www.flu.gov) also offers a list of flu signs that indicate a person should seek emergency care. ----- Convertibles Pose Serious Hearing Threat Riding in a convertible can seriously damage your hearing, researchers warn. A study found that noise levels with the top down reach 88 to 90 decibels when the car is traveling at 50, 60 and 70 miles an hour, BBC News reported. Noise louder than 85 decibels poses a risk of permanent hearing damage. The findings were published in the journal Otolaryngology -- Head and Neck Surgery and discussed at a U.S. meeting of ear, nose and throat experts. Wind, road, engine and traffic noise levels in a convertible can be nearly as loud as the sound of a pneumatic drill, researchers say. They recommend that drivers and passengers wear some form of hearing protection, as motorcyclists do. "Regular exposure to noise levels of 88-90 decibels when driving a convertible for several hours a day can lead to permanent hearing loss over time," Dr Mark Downs, of England's Royal National Institute for Deaf People, told BBC News. "By winding up the windows or wearing basic ear protection, such as earplugs, drivers of convertibles can still enjoy driving whilst protecting their hearing." ----- Exercise Helps Rheumatoid Arthritis Patients People with rheumatoid arthritis (RA) can benefit from exercise programs meant to improve strength and stamina, say Dutch researchers who reviewed eight previous studies involving 575 RA patients. Based on their findings, "we would recommend aerobic capacity training combined with muscle strength training as routine practice for RA patients," lead researcher Emalie Hurkmans, of the Leiden University Medical Center, said in a news release, United Press International reported. "But we need more research to establish the recommended length and type of exercise programs, whether patients need to be supervised and if these programs are cost effective," Hurkmans added. The review appears in the Cochrane Library. ----- Menu Calorie Info Doesn't Change Eating Habits A law requiring New York City restaurant chains to list calories on menus hasn't changed the eating habits of low-income people, according to a study published Tuesday. New York University and Yale researchers studied people eating at Burger King, Kentucky Fried Chicken, McDonald's and Wendy's in lower-income neighborhoods with high obesity rates and found that half of the customers noticed the calorie information, CBS and the Associated Press reported. Twenty-eight percent said the calorie postings influenced what they ordered and 90 percent of those people said they made healthier food choices as a result. However, the researchers analyzed the customers' receipts and found they ordered slightly more calories than the typical customer did before the law took effect in July 2008. The findings show that calorie postings don't have enough impact, study lead author Brian Elbel, an assistant professor at the New York University School of Medicine, according to published reports. The study was published in the journal Health Affairs. ----- Eating Licorice During Pregnancy May Harm Children Eating large amounts of licorice during pregnancy could have a detrimental impact on a child's intelligence and behavior, say European researchers who studied 8-year-old children in Finland, where many young women consume licorice. The study found that children born to women who ate a lot of licorice while pregnant scored lower on tests than other youngsters, BBC News reported. A component in licorice called glycyrrhizin may enable stress hormones to cross through the placenta from mother to child. These hormones may affect fetal brain development and have been linked to behavioral disorders, the researchers said. The findings show "that eating licorice during pregnancy may affect a child's behavior or IQ and suggests the importance of the placenta in preventing stress hormones that may affect cognitive development getting through to the baby," said Professor Jonathan Seckl, of Edinburgh University's Centre for Cardiovascular Science, BBC News reported. The study was published in the American Journal of Epidemiology. ----- FDA Panel Backs PegIntron as Skin Cancer Treatment Even though it carries toxic risks, the drug PegIntron should be approved for treatment of patients with late-stage skin cancer that's spread to the lymph nodes and requires surgery, a U.S. Food and Drug Administration advisory panel decided Monday. Studies by drug maker Schering-Plough showed that treatment with the drug delayed cancer recurrence by about nine months. However, patients who received PegIntron didn't live longer than those who weren't given the drug, the Associated Press reported. Forty-four percent of patients dropped out of the study due to the drug's toxic side effects such as nausea, skin reactions and fatigue. Even so, the FDA panel decided in a 6-4 vote that the drug's benefits outweigh its side effects. "I'm leaning in the direction that this may be helpful given that there are very few options for these patients," said panel chair Dr. Gary Lyman, of Duke University Medical Center, the AP reported. Even though it's not required to, the FDA usually follows the recommendations of its expert panels. PegIntron is already approved in the U.S. as a treatment for hepatitis C. ----- EU Regulators Approve Diabetes Drug Onglyza The diabetes drug Onglyza has been approved for sale in the European Union and will be launched there by the end of year, drugmaker Bristol-Myers Squibb said Monday. Based on six studies that included more than 4,100 patients, Onglyza was approved for use with three other standard diabetes drugs, the Associated Press reported. Onglyza belongs to a newer class of diabetes medicines call DPP-4 inhibitors, which increase insulin production and lower glucose production. Merck's Januvia is also a DPP-4 inhibitor. The U.S. Food and Drug Administration approved Onglyza on July 31 and the drug is already on sale in the U.S., the AP reported. ----- U.S. Poisoning Deaths Nearly Double Since 1999: Drugs Played a Major Role Drugs played a major role in the near doubling of poisoning fatalities in the United States between 1999 and 2006, according to a U.S. government report. During that time, poisoning death increased from almost 20,000 to more than 37,000, said the National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention. In 2006, more than 90 percent of poisoning deaths involved drugs, United Press International reported. Opioid analgesics were involved in about 20 percent of poisoning deaths in 1999 and almost 40 percent in 2006. Methadone-related poisoning deaths increased nearly seven-fold, from 790 in 1999 to 5,420 in 2006. That rate of increase is far greater than for other opioid analgesics, cocaine, or heroin. The government report said poisoning is the second leading cause of injury death overall in the United States, and the leading cause of injury death for people ages 35 to 64, UPI reported. ----- No Scientific Evidence for Probiotic Health Claims: EU Panel General health claims for probiotic yogurts and drinks aren't backed by science, say European Union experts who studied 523 health claims related to 200 foods and food components, including fiber, fats, carbohydrates, vitamins and minerals, botanical substances and probiotic bacteria. Of those claims, about two-thirds (350) were rejected, CBC News reported. Nearly half were rejected because they lacked information about the component on which the claim was based, including probiotic bacteria and botanical substances. While those claims were dismissed, the EU expert panel said they found sufficient scientific evidence to support claims related to vitamins and minerals, dietary fibers or fatty acids for maintenance of cholesterol levels, along with the use of sugar-free chewing gum for dental health, CBC News reported. The general health claims review was the first stage. Next, the panel will examine more specific health claims made by individual companies. ----- Kidney Cancer Drug May Cause Liver Damage: FDA An experimental kidney cancer drug called pazopanib may cause liver damage that outweighs the its ability to slow the cancer, according to U.S. Food and Drug Administration documents posted online. GlaxoSmithKline is seeking FDA approval of pazopanib for treatment of advanced kidney cancer. However, the FDA documents say there have been three liver damage-related deaths among patients taking the pill, and other patients have shown elevated levels of enzymes that often predict liver damage, the Associated Press reported. These cases "strongly suggest that pazopanib may be associated with a significant risk of severe idiosyncratic hepatic injury if used in a large patient population," FDA reviewers said in the documents. It was also noted that the drug causes side effects common to other cancer drugs, including blood clots, internal bleeding and hypertension, the AP reported. An FDA panel of experts will decide Monday whether to recommend approval of the drug. The agency isn't required to follow the advice of its expert panels, but usually does. Fresh Blood Boosts Survival in Trauma Patients: Death risk rises when transfused blood is more than 28 days old, study finds People who've suffered severe trauma and are given a major transfusion of red blood cells that have been stored for a month or longer are twice as likely to die as those who receive fresher red blood cells, U.S. researchers have found. Reseachers found that even one unit of red blood cells stored more than 28 days doubled the incidence of deep vein thrombosis and increased death secondary to multiple organ failure. The increased risk of death persisted for up to six months after the transfusion. "With the widespread use of red blood cell transfusion for critically injured patients, this study has the potential to cut deaths in hospitals around the world," they wrote. Fresh Blood Boosts Survival in Trauma Patients: Death risk rises when transfused blood is more than 28 days old, study finds   　 FRIDAY, Oct. 2 (HealthDay News) -- People who've suffered severe trauma and are given a major transfusion of red blood cells that have been stored for a month or longer are twice as likely to die as those who receive fresher red blood cells, U.S. researchers have found. In a study of 202 severe trauma patients who were treated with five or more units of red blood cells, researchers found that even one unit of red blood cells stored more than 28 days doubled the incidence of deep vein thrombosis and increased death secondary to multiple organ failure. The increased risk of death persisted for up to six months after the transfusion, a finding that's consistent with previous studies of cardiac surgery patients. The new study, published online Sept. 21 in Critical Care, shows that the risk of adverse complications can be reduced if doctors give fresh red blood cells to severe trauma patients who require major transfusions for life-saving procedures, the researchers said. "The preferential use of younger red blood cells to critically ill patients has the potential to increase waste due to outdating," Philip Spinella, a pediatric intensivist at Connecticut Children's Medical Center in Hartford, said in a news release from the journal's publisher. "Since blood is often a scarce resource, this is important, and methods need to be developed to minimize waste while providing the most efficacious and safe blood product for a given patient." Spinella and his colleagues wrote that their "findings should encourage research into the effects of old blood and coagulation in critically ill patients." "With the widespread use of red blood cell transfusion for critically injured patients, this study has the potential to cut deaths in hospitals around the world," they wrote.More information The U.S. National Heart, Lung, and Blood Institute has more about blood transfusion. -- Robert Preidt SOURCE: BioMed Central, news release, Sept. 21, 2009 Cow's Milk Protein Could Help Save Preemies' Lives: Bovine Lactoferrin could cut serious blood infections by about two-thirds in babies born weighing less than 3.3 pounds However, when isolated from milk and then concentrated -- as it was in this study -- bovine lactoferrin is not yet approved for use in the United States. "Preventive strategies in these infants are really critical. Many preterm babies don't survive because of infection. I hope this treatment gets fast-tracked for approval, because this is a big effect from what seems like a safe and minimal intervention," said David Kaufman. He explained that in these small infants, the lining of the gastrointestinal tract is often underdeveloped, which can allow bacteria to migrate from the digestive system into the bloodstream, causing infection. Lactoferrin helps kill bacteria and fungi, first in the stomach and then in the gastrointestinal tract. Cow's Milk Protein Could Help Save Preemies' Lives: Bovine Lactoferrin could cut serious blood infections by about two-thirds in babies born weighing less than 3.3 pounds By Serena Gordon: HealthDay Reporter TUESDAY, Oct. 6 (HealthDay News) -- A protein from cow's milk could reduce by about two-thirds the rate of serious blood infections in babies born weighing less than 3.3 pounds. That's the conclusion of a study published in the Oct. 7 issue of the Journal of the American Medical Association that found when these tiny newborns were given a daily dose of the milk protein lactoferrin along with a probiotic bacteria during the first weeks of life, the incidence of the blood infection sepsis dropped dramatically. "Prevention of sepsis in neonates can be achieved through supplementation of a simple, easily available, cost-effective intervention that is well-tolerated and may be implemented in all settings, including Third World [countries]," said study author Dr. Paolo Manzoni, a neonatologist at S. Anna Hospital in Torino, Italy. However, when isolated from milk and then concentrated -- as it was in this study -- bovine lactoferrin is not yet approved for use in the United States. "The biggest hurdle if I was to use this, is that it's not FDA-approved," said the author of an accompanying editorial in the same issue of the journal, Dr. David Kaufman, assistant medical director of the neonatal intensive care unit at the University of Virginia Medical School in Charlottesville. "Preventive strategies in these infants are really critical. Many preterm babies don't survive because of infection. I hope this treatment gets fast-tracked for approval, because this is a big effect from what seems like a safe and minimal intervention," said David Kaufman. Because bovine lactoferrin is naturally found in cow's milk, Manzoni said the researchers don't expect any long-term safety problems. Lactoferrin is also found in breast milk, but because of the concentrations needed, has to be genetically engineered, making it more expensive, according to Manzoni. The current study included 472 Italian newborns who weighed less than 3.3 pounds (1,500 grams) at birth. Doctors classify these infants as "very low birth weight." Within this category, a baby who weighs less than 2.2 pounds (1,000 grams) at birth, may also be classified as "extremely low birth weight." Generally, such tiny infants are also born prematurely. The babies were randomly assigned to one of three groups: a control group that received a placebo, a group that was given 100 milligrams (mg) daily of bovine lactoferrin, and a group that was given 100 mg of bovine lactoferrin plus the probiotic Lactobacillus rhamnosus GG. The addition of the probiotic is believed to enhance the antibacterial and antifungal properties of lactoferrin, according to the study. Treatment continued for 30 days with the very low birth weight infants and for 45 days for the extremely low birth weight infants. The incidence of late-onset (after a baby is 72 hours old) sepsis in the control group was 17.3 percent compared to 5.9 percent in the group receiving lactoferrin. The babies who received lactoferrin plus the probiotic fared best of all, with just 4.6 percent developing sepsis. In his editorial, Kaufman pointed out that the smallest babies had even better results, and suggested that by increasing the dose and length of treatment in the babies who were a little heavier, the results might be even better. He explained that in these small infants, the lining of the gastrointestinal tract is often underdeveloped, which can allow bacteria to migrate from the digestive system into the bloodstream, causing infection. Lactoferrin helps kill bacteria and fungi, first in the stomach and then in the gastrointestinal tract. "That makes the mucosal lining barrier stronger and keeps bacteria from moving from the gut into the bloodstream," Kaufman explained. An added benefit to this treatment, noted Manzoni, is that it could reduce the use of antibiotics as well.More information Learn more about infections and other possible complications that can occur in premature infants from the Nemours Foundation. SOURCES: Paolo Manzoni, M.D., neonatalogist, S. Anna Hospital, and coordinator, Italian Network for the Study of Neonatal Infections, and, chairman, scientific committee, Neonatalogy Foundation, S. Anna Hospital, Torino, Italy; David Kaufman, M.D., associate professor, pediatrics, assistant medical director, neonatal intensive care unit, and director, the Neonatal Clinical Trials Unit, University of Virginia Medical School, Charlottesville, Va.; Oct. 7, 2009, Journal of the American Medical Association Liver Cancer Patients May Get Hope: Finding could help identify patients who will benefit from interferon therapy, researchers say A short strand of RNA (microRNA) may help doctors identify liver cancer patients who would benefit from treatment with interferon, say U.S. and Chinese researchers. "Our findings are exciting because we are rediscovering a drug that may have great potential for patients with a particular genomic profile," added senior author Xin Wei Wang. A separate analysis of liver tumor samples from 135 patients who had had surgery revealed that those with low levels of miR-26 benefitted from receiving adjuvant interferon therapy. Patients who received interferon lived at least 7.7 years longer than those who didn't receive the drug. Interferon didn't benefit patients with normal levels of miR-26. The findings suggest that checking miR-26 levels in liver tumors may help determine patient prognosis and identify patients who might benefit from interferon treatment..... Liver Cancer Patients May Get Hope: Finding could help identify patients who will benefit from interferon therapy, researchers say   　 WEDNESDAY, Oct. 7 (HealthDay News) --A short strand of RNA (microRNA) may help doctors identify liver cancer patients who would benefit from treatment with interferon, say U.S. and Chinese researchers. "Interferon is an experimental therapeutic agent that has been used for many years to treat cancer patients, but with modest benefit," study first author Junfang Ji, of the liver carcinogenesis section at the U.S. National Cancer Institute's Center for Cancer Research, said in a news release. "Our findings are exciting because we are rediscovering a drug that may have great potential for patients with a particular genomic profile," added senior author Xin Wei Wang, chief of the liver carcinogenesis section. "Being able to treat patients with an existing drug based on a tumor's genomic profile should improve its efficacy and reduce the cost of treatment." The study of 241 liver cancer patients found that those with low levels of a microRNA called miR-26 lived about four years less than those with higher expression levels of the microRNA. A separate analysis of liver tumor samples from 135 patients who had had surgery revealed that those with low levels of miR-26 benefitted from receiving adjuvant interferon therapy. Patients who received interferon lived at least 7.7 years longer than those who didn't receive the drug. Interferon didn't benefit patients with normal levels of miR-26. The findings suggest that checking miR-26 levels in liver tumors may help determine patient prognosis and identify patients who might benefit from interferon treatment in order to prevent disease relapse, the researchers said. The study appears in the Oct. 8 issue of the New England Journal of Medicine.More information The American Cancer Society has more about liver cancer treatment. -- Robert Preidt SOURCE: U.S. National Cancer Institute, news release, Oct. 7, 2009 Tiny Batteries Can Cause Big Problems for Young Children: Ingestion of 'button' batteries may have serious consequences, researchers say Some kids swallow the batteries, while others stick them up their nose. An estimated 3,000 people of all ages accidentally ingest the batteries each year in the United States. About two-thirds of the cases involve children under age 5, with 1- and 2-year-olds at highest risk, the researchers noted. In the most severe cases, serious consequences can develop, such as vocal paralysis, the need for throat and gastrointestinal tubes, and perforation of nasal passages, according to the study authors. According to the U.S. National Institutes of Health, ingested batteries can cause a variety of symptoms, including abdominal pain, chest pain and vomiting. Tiny Batteries Can Cause Big Problems for Young Children: Ingestion of 'button' batteries may have serious consequences, researchers say 　 MONDAY, Oct. 5 (HealthDay News) -- Parents beware: It's not unusual for children to ingest the "button" batteries that power everything from wristwatches to cameras, a new study warns. Some kids swallow the batteries, while others stick them up their nose, researchers found after monitoring cases at a pediatric hospital over a 10-year period and checking case reports from elsewhere. But, the study authors pointed out, parents and health-care providers often aren't aware of the dangers posed by these miniature disc batteries. Button batteries, which are about the size of a coin or smaller, power a variety of devices, including hearing aids, calculators, small toys and musical greeting cards, according to information in a news release from the American Academy of Otolaryngology--Head and Neck Surgery Foundation. An estimated 3,000 people of all ages accidentally ingest the batteries each year in the United States. About two-thirds of the cases involve children under age 5, with 1- and 2-year-olds at highest risk, the researchers noted. In the most severe cases, serious consequences can develop, such as vocal paralysis, the need for throat and gastrointestinal tubes, and perforation of nasal passages, according to the study authors. The experts say it's vital for physicians to promptly identify and treat ingestion of button batteries. They also call for better packaging and markings on button batteries. According to the U.S. National Institutes of Health, ingested batteries can cause a variety of symptoms, including abdominal pain, chest pain and vomiting. The study findings were scheduled to be presented by Dr. Dale Amanda Tylor of Vanderbilt University Medical Center, Nashville, Tenn., and Dr. Seth Pransky of San Diego, at the 2009 American Academy of Otolaryngology--Head and Neck Surgery Foundation annual meeting, held Oct. 4 to 7 in San Diego.More information To learn more about battery ingestion, visit the U.S. National Library of Medicine.-- Randy Dotinga SOURCE: American Academy of Otolaryngology--Head and Neck Surgery Foundation, news release, Oct. 4, 2009 Drug Combo May Prevent Heart Attacks, Strokes: 'Inexpensive, well-proven medications' could have huge impact, expert says Giving daily doses of a statin and a blood pressure-lowering ACE inhibitor to people at high risk for a heart attack or stroke reduced their incidence by more than 60 percent in two years, researchers report. People in the study all had diabetes or a history of cardiovascular disease, but the drug regimen probably could provide similar benefits to anyone vulnerable to cardiovascular trouble because of obesity, high blood pressure or simply old age, said Dr. R. James Dudl. "This was accomplished by using three inexpensive, well-proven medications that don't have significant side effects," Dudl said. Drug Combo May Prevent Heart Attacks, Strokes: 'Inexpensive, well-proven medications' could have huge impact, expert says   By Ed Edelson: HealthDay Reporter FRIDAY, Oct. 2 (HealthDay News) -- Giving daily doses of a statin and a blood pressure-lowering ACE inhibitor to people at high risk for a heart attack or stroke reduced their incidence by more than 60 percent in two years, researchers report. People in the study all had diabetes or a history of cardiovascular disease, but the drug regimen probably could provide similar benefits to anyone vulnerable to cardiovascular trouble because of obesity, high blood pressure or simply old age, said Dr. R. James Dudl, diabetes clinic lead at the Kaiser Permanente Care Management Institute in Oakland, Calif., and lead author of a report in the October issue of the American Journal of Managed Care. The study was based on a model that assumed that high blood cholesterol and high blood pressure were each responsible for about 25 percent of cardiovascular risk, Dudl said. "We hypothesized that while there were different mechanisms, the effects are additive," Dudl said. "Our model showed a potential 71 percent drop in cardiovascular risk." The study was done on a large scale and included 170,024 members of the Kaiser Permanente health plan in California, all aged 55 or older. They were divided into three groups: 21,292 who took the bundled drugs more than half the time in 2004 and 2005, 47,262 who took the drug bundle less than half the time and 101,464 who took neither or just one drug during the study. Their use of the medications was determined by monitoring their prescription refill records. Participants were also advised to take low-dose aspirin daily, but their use of that medication could not be determined because it is not a prescription drug, Dudl said. After taking the drugs for two years, the rate of heart attacks and strokes in the next year was reduced by 26 per 1,000 people among those in the high-use group and 15 per 1,000 people in the middle-use group, compared with those in the no-use group, the study found. "This was accomplished by using three inexpensive, well-proven medications that don't have significant side effects," Dudl said. The ACE inhibitor used in the study was lisinopril (Prinivil, Zestril), given at 20 milligrams a day, and the statin was lovastatin (Altoprev, Mevacor), given at 40 milligrams daily, but any combination of drugs in the two families could be used, Dudl said. "We feel that these are class actions, not specific to any one drug," he said. The program has since been extended to include more than 256,000 Kaiser Permanente members across the country and is being offered in community health centers, a company spokesman said. "However the atherosclerotic process is advanced, we feel that these treatments would work," Dudl said. Atherosclerosis is the hardening of arteries that can lead to a heart attack, stroke or other cardiovascular problem. "We went for people with the highest risk, but the program could benefit anybody with the atherosclerotic process caused by any mechanism, particularly hypertension [high blood pressure]." Dr. Michael A. Blazing, an associate professor of medicine and cardiology at Duke University, said that the study confirms in one large sweep what has been seen in smaller studies of individual preventive drug treatments. "The key is bundling the drugs and the distribution system," Blazing said. "Much of the effect is due to getting the drugs to the population that needs them. What they are doing is validating the bits and pieces that have been shown in different studies in different ways. They are also validating the work that shows that individuals who stay on these drugs do better."More information The American Heart Association has more on risk factors for coronary heart disease. SOURCES: R. James Dudl, M.D., diabetes clinic lead, Kaiser Permanente Care Management Institute, Oakland, Calif.; Michael A. Blazing, M.D., associate professor, medicine/cardiology, Duke University, Durham, N.C.; October 2009 American Journal of Managed Care Daily Dose of Vitamin D Helps Prevent Falls in Seniors: Supplements of 700 to 1,000 IU linked to reduced risk, study finds The analysis revealed that taking between 700 and 1,000 international units (IU) of supplemental vitamin D per day (vitamin D2 or D3) reduces falls by 19 percent and by up to 26 percent with vitamin D3. The beneficial effect was significant within two to five months of starting treatment, extended beyond 12 months, and was independent of age, type of dwelling, or additional calcium supplementation, the researchers noted. Supplemental vitamin D doses of less than 700 IU per day didn't reduce falls, wrote Dr. Heike A. Bischoff-Ferrari. Active forms of vitamin D didn't appear to be more effective than the 700 to 1,000 IU supplemental vitamin D, said the study authors. They added that active forms of vitamin D cost more than standard supplemental vitamin D and are associated with increased risk for hypercalcemia -- elevated calcium levels in the blood. Daily Dose of Vitamin D Helps Prevent Falls in Seniors: Supplements of 700 to 1,000 IU linked to reduced risk, study finds   　 FRIDAY, Oct. 2 (HealthDay News) -- A daily high-dose vitamin D supplement can reduce the risk of falls in seniors, say researchers who reviewed the findings of eight fall prevention studies involving participants aged 65 and older. The analysis revealed that taking between 700 and 1,000 international units (IU) of supplemental vitamin D per day (vitamin D2 or D3) reduces falls by 19 percent and by up to 26 percent with vitamin D3. The beneficial effect was significant within two to five months of starting treatment, extended beyond 12 months, and was independent of age, type of dwelling, or additional calcium supplementation, the researchers noted. The study, published in the Oct. 2 online edition of BMJ, concluded that all people aged 65 and older should take at least 700 to 1,000 IU of supplemental vitamin D a day to reduce the risk of falling. Higher doses may be even more effective, which should be explored in future studies, the researchers wrote in a news release from the journal. Supplemental vitamin D doses of less than 700 IU per day didn't reduce falls, Dr. Heike A. Bischoff-Ferrari, director of the Center on Aging and Mobility at University Hospital Zurich, Switzerland, and colleagues, wrote. Active forms of vitamin D didn't appear to be more effective than the 700 to 1,000 IU supplemental vitamin D, said the study authors. They added that active forms of vitamin D cost more than standard supplemental vitamin D and are associated with increased risk for hypercalcemia -- elevated calcium levels in the blood.More information The U.S. National Institute on Aging has more about falls and older adults. -- Robert Preidt SOURCE: BMJ, news release, Oct. 1, 2009 As TV Drug Ads Increase, So Do Concerns: There is concern in the medical community that the drug ads could be damaging to both patients and the health-care system,br>You can't channel surf at all these days without stumbling across drug advertisements featuring happy people, sunny days, vague descriptions and a quickly mumbled list of side effects. The amount of money spent by pharmaceutical companies on direct-to-consumer advertising more than tripled between 1997 and 2005, growing from $1.3 billion to $4.2 billion since restrictions governing drug ads were relaxed by the U.S. Food and Drug Administration. Only the United States and New Zealand allow pharmaceutical companies to advertise their medications directly to consumers, according to the FDA. Concerns about drug ads focus on several issues: Do they prompt patients to ask for the wrong treatment?; Do the ads lead to overprescribing?; and Do the ads increase medical costs and patient risks? As TV Drug Ads Increase, So Do Concerns: There is concern in the medical community that the drug ads could be damaging to both patients and the health-care system   By Dennis Thompson: HealthDay Reporter SUNDAY, Oct. 4 (HealthDay News) -- You can't channel surf at all these days without stumbling across drug advertisements featuring happy people, sunny days, vague descriptions and a quickly mumbled list of side effects. If you think you're seeing more of these ads than ever before, you're right. The amount of money spent by pharmaceutical companies on direct-to-consumer advertising more than tripled between 1997 and 2005, growing from $1.3 billion to $4.2 billion since restrictions governing drug ads were relaxed by the U.S. Food and Drug Administration, according to the California Public Interest Research Group, a public advocacy group nicknamed CalPIRG. Only the United States and New Zealand allow pharmaceutical companies to advertise their medications directly to consumers, according to the FDA. Doctors and patient advocates say the companies are getting good returns on their investment. Spending on prescription drugs has grown faster than any other type of health-care spending in the United States. "If you just look at the number of prescriptions issued since restrictions have lifted, they've definitely gone up," said Michael Russo, a health-care advocate for CalPIRG. However, there is concern in the medical community that the drug ads could be damaging to both patients and the health-care system. "I think the advertisements can serve a useful purpose by making people aware of products available to them," said Dominick L. Frosch, an assistant professor of medicine at the University of California, Los Angeles. "We want people to make informed decisions so they understand the specific risks and benefits of following a certain treatment. "But the benefit information in these ads is often described in vague, general and emotionally driven terms, and the risk information also is not presented in a very helpful way," Frosch said. "The current format of the ads doesn't do a very good job of making sure patients are well-informed." Concerns about drug ads focus on several issues: � Do they prompt patients to ask for the wrong treatment? "The side effects get read out very quickly," Russo said. "The ads also can give a very misleading idea of what the benefit of the drug is." People could be asking for drugs from a doctor without having a solid understanding of what they could gain or lose by taking the medication.� Do the ads lead to overprescribing? Patients come in asking for a medication they saw on television, and many doctors will probably go along with the requests rather than argue with their patients, Frosch said. "Doctors and patients don't have a lot of time. About 15 minutes these days," he said. "If a patient asks for a product and the doctor thinks it's not an appropriate product, it could take some time for a patient to be dissuaded."� Do the ads increase medical costs and patient risks? Experts say this could happen because the ads generally promote newer, more expensive and less-tested drugs over tried-and-true medications. Pharmaceutical companies spend their advertising money marketing drugs that are just hitting the market, and people are more likely to ask for those new medications than allow their doctor to provide them with an older, more established drug that could be just as effective, Russo said. This increases medical costs because the newer drugs are more expensive, and patients are at greater risk because newer drugs have not been "road-tested," he said. As an example, Russo cited Vioxx, a pain medication that was heavily marketed by its maker but later yanked off shelves when it became apparent the drug increased the risk of heart attack in some people. "The fact that it was so heavily marketed magnified its ultimate damage," Russo said. Frosch provided a basic prescription for improving the ads and making them more helpful to consumers: Clearly describe who the drug will help and provide accurate and unemotional information about its benefits and risks. "When you watch the ads now and you hear the risk information, you often see imagery of people being happy and doing nice things while the information is telling you about some not-so-nice things that could happen," Frosch said.More information The U.S. Food and Drug Administration has more about drug advertising. SOURCES: Michael Russo, J.D., health-care advocate and staff attorney, California Public Interest Research Group, Los Angeles; Dominick L. Frosch, Ph.D., assistant professor, general internal medicine, David Geffen School of Medicine, University of California, Los Angeles Sept. 25, 2009 to Oct. 2, 2009Health Highlights **Drug Deaths Outnumber Traffic Fatalities In 16 States: CDC. **Tylenol Maker Recalls Some Products for Kids. **FDA Advisers Back New OxyContin Pill. **Possible Link Between Diabetes Treatment Januvia and Pancreatitis. **Whooping Cough Vaccination Recommended for Adults and Teens. **Toxins in Drinking Water at Thousands of U.S. Schools. **Hundreds More Nursing Homes Candidates for Inspection. **Switch to Digital Patient Records Driven by Big Hospitals. **Neocate Infant Formula Recalled: FDA. **EPA Warns About PCBs in School Window/Door Caulking. **Swine Flu-Related School Closings Could Cost $47 Billion. Health Highlights (Sept. 25, 2009 to Oct. 2, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Drug Deaths Outnumber Traffic Fatalities In 16 States: CDC Drugs now claim more lives than traffic crashes in 16 states, a new federal government report shows. Traffic crashes remain the leading cause of injury-related death in the United States, but drug-related deaths roughly doubled between the late 1990s and 2006, according to the U.S. Centers for Disease Control and Prevention, the Associated Press reported. The number of states in which drug-related deaths outnumber traffic deaths has increased from eight in 2003, to 12 in 2005, and 16 in 2006 -- Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington. The CDC said illicit drugs such as heroin and cocaine continue to be major killers, but prescription painkillers such as methadone have accounted for most of the increase in recent years, the AP reported. ----- Tylenol Maker Recalls Some Products for Kids The manufacturer of Tylenol is voluntarily recalling more than 20 liquid medications for children and infants because some ingredients in the medicines didn't meet the company's testing standards. McNeil Consumer Healthcare, a division of Johnson & Johnson, which makes the products, reported that there were no injuries associated with the recall, according to Dow Jones. The company also said all of the medicine that reached store shelves meet qualifications. The recalled products, made between April and June 2008, include about 50 batches of children's and infants' liquid Tylenol products. The company began recalling the products in August from warehouses and retail stores after bacteria was detected in an inactive ingredient that was not used in the final products but was manufactured at the same time. Consumers with questions about the recall should call the company at 1-800-962-5357. For a complete list of the recalled products, go to the Tylenol Web site. ----- FDA Advisers Back New OxyContin Pill U.S. health advisers on Thursday recommended approval of a new version of the painkiller OxyContin that is designed to lessen its misuse. The U.S. Food and Drug Administration's panel of experts voted 14-4 in favor of the reformulated Purdue Pharma drug, which has a plastic-like coating that makes it harder to crush or dissolve in water. But the experts also recommended the company be required to conduct a follow-up study to track patients taking the drug over the long term, the Associated Press reported. The FDA is not required to follow its experts' advice, though it usually does. OxyContin was hailed as a breakthrough treatment for severe chronic pain when it was introduced in 1996. But drug abusers quickly discovered they could get a heroin-like high by crushing the pills and snorting or injecting them. On Tuesday, FDA scientists called the new version's resistance to abuse "limited," but said that "may provide an advantage over the currently available OxyContin." Last year, an FDA advisory panel told Purdue that it needed to conduct more tests to demonstrate the tamper resistance of the new version. ----- Possible Link Between Diabetes Treatment Januvia and Pancreatitis There may be a link between the diabetes treatment Januvia and cases of acute pancreatitis, the U.S. Food and Drug Administration announced Friday. The agency said that between October 2006 and February 2009, there were 88 cases of acute pancreatitis reported in patients taking Januvia, the Associated Press reported. "It is recommended that health care professionals monitor patients carefully for the development of pancreatitis after initiation or dose increases," the FDA said in a news release. Januvia should be used with caution and with appropriate monitoring in patients with a history of pancreatitis. The FDA is working with drug maker Merck & Co. to include new warning information on the drug's label, the AP reported. ----- Whooping Cough Vaccination Recommended for Adults and Teens Most adults and teens should be vaccinated against whooping cough (pertussis), says the American Academy of Family Physicians. Many people believe that whooping cough is no longer a major public health concern in the United States, but health experts estimate there are up to 600,000 cases each year in adults alone, according to the AAFP. The organization this week launched a public health initiative to promote awareness about the importance of whooping cough vaccination to protect adolescents and adults from this highly contagious respiratory disease. "For protection against whooping cough, health experts ... recommend that most adolescents and adults get a single dose of the Tdap (tetanus, diphtheria, acellular pertussis) vaccine to replace Td (tetanus and diphtheria toxoids)," Dr. Ted Epperly, president of the AAFP, said in a news release. ----- Toxins in Drinking Water at Thousands of U.S. Schools Unsafe levels of lead, pesticides and other types of toxins have been found in drinking water at thousands of schools across the United States over the last decade, according to an analysis of Environmental Protection Agency data by the Associated Press. Toxic contamination of drinking water is most common in schools with wells, which account for up to 11 percent of the 132,500 schools in the country. About 20 percent of schools with their own water supply violated the Safe Drinking Water Act in the past decade. The number of violations increased over that time because of stricter standards for such contaminants as arsenic and some disinfectants, the EPA told the AP. The EPA doesn't have the power to require drinking water testing for all schools. "It's an outrage," Marc Edwards, an engineer at Virginia Tech who has been honored for his work on water quality, told the AP. "If a landlord doesn't tell a tenant about lead paint in an apartment, he can go to jail. But we have no system to make people follow the rules to keep school children safe?" ----- Hundreds More Nursing Homes Candidates for Inspection: Report Hundreds of potentially sub-par nursing homes aren't included in a U.S. government program that pays special attention to poorly performing nursing homes, says a Government Accountability Office report. The report looked at a Centers for Medicare and Medicaid Services program that identifies as many as 136 nursing homes as "special focus facilities" that warranted more frequent inspections, the Associated Press reported. But GAO investigators said as many as 580 nursing homes could be considered candidates for the program. The GAO report didn't identify the nursing homes. The findings suggest that the Centers for Medicare and Medicaid services program has too narrow a focus, said Sen. Herb Kohl, D-Wisc., chairman of the Senate Special Committee on Aging, the AP reported. "If far more than 136 nursing homes boast the bleakest conditions, then perhaps we should consider expanding" the program, Kohl said. At the least, he said he wants stronger warnings used on Medicare's Nursing Home Compare Web site. ----- Switch to Digital Patient Records Driven by Big Hospitals Large hospitals seeking to improve patient care and gain a competitive edge are driving the United States' move toward computerized medical records, The New York Times reported. One example is North Shore-Long Island Jewish Health System. On Monday, the regional hospital group was scheduled to announce plans to offer its 7,000 affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records, the newspaper said. That amount would be in addition to a federal program that offers up to $44,000 over five years for doctors who switch to computerized medical records. Around the nation, similar incentive programs to assist affiliated doctors are in place at Memorial Hermann Healthcare System in Houston and Tufts Medical Center in Boston, the Times reported. Electronic health records can be shared by hospitals, doctors' offices, and labs to coordinate patient care, prevent unnecessary tests, and reduce medical mistakes. In addition, doctors may form a stronger association with hospitals that subsidize the switch to computerized records. Those doctors may be more likely to admit their patients to those hospitals, the Times said. ----- Neocate Infant Formula Recalled: FDA A blending error has prompted a recall of some cans of Neocate specialized infant formula, the U.S. Food and Drug Administration said Tuesday. About 3,700 cans of the formula contain protein levels lower than that declared on the label, United Press International reported. Short-term use of the recalled formula would be unlikely to cause nutritional problems for infants, but long-term consumption may affect growth in certain infants, said Nutrica North America Inc. of Gaithersburg, Md. The FDA said the recalled 14-ounce cans were distributed to pharmacies, healthcare professionals and consumers nationwide. The recall includes cans with "Lot#P91877" printed on the bottom of each can. The lot number also appears on the right hand side of the case label, UPI reported. For more information, consumers can call the company at 800-365-7354, options 8-6061. ----- EPA Warns About PCBs in School Window/Door Caulking Schools across the United States need to check window and door caulking to see if it contains potentially cancer-causing PCBs, says the Environmental Protection Agency. If significant amounts of PCBs are found, the caulking should be removed. Although an exact number isn't known, PCBs may be present in many schools that were built or renovated before the chemicals were banned in the late 1970s, said EPA Administrator Lisa Jackson, according to the Associated Press. The danger to students is uncertain. "We're concerned about the potential risks associated with exposure to these PCBs, and we're recommending practical, common sense steps to reduce this exposure as we improve our understanding of the science," Jackson said in a news release. The agency plans to conduct research into the link between PCBs in caulk and in the air and will conduct tests on PCBs in schools, the AP reported. The EPA has set up a PCBs-in-caulk hot line (1-888-835-5372) and Web site at www.epa.gov/pcbsincaulk. ----- Swine Flu-Related School Closings Could Cost $47 Billion It would cost between $10 billion and $47 billion to close U.S. schools and day-care centers because of swine flu, according to a new report. Keeping children home from school would mean that parents would have to stay home from work, including some who are health-care workers, said the paper issued by the Brookings' Center on Social and Economic Dynamics, the Associated Press reported. Among the other estimates: The value of lost class time would be $6.1 billion. The cost of sweeping school closures in specific cities would be $65 million for Washington, D.C., $1.5 billion for Los Angeles, and $1.1 billion for New York City. Large-scale school closures would cause 12 percent of workers to be absent from their jobs. Workplace absenteeism could be higher in lower-income households with only one employed person. Schools are being told to close only as a last resort, such as when large numbers of students or staff have swine flu, the AP reported. As of Monday, at least 187 schools across the United States had closed, affecting nearly 80,000 students, according to the U.S. Department of Education.     FDA Issues Health Alert on Kids' Tamiflu Dosages: Warning follows report that dosing instructions for liquid medication don't match syringe measurements The alert, issued late Thursday, followed a warning by scientists that parents could give the wrong dose of Tamiflu to their children as treatment for the H1N1 swine flu because the dosing instructions don't always coincide with the measurement markings on the syringe that comes with the liquid medication. It advised health-care providers to "write doses in mg [milligrams] if the dosing dispenser with the drug is in mg. Pharmacists should ensure that the units of measure on the prescription instructions match the dosing device provided with the drug." "Tamiflu is one of the main courses of treatment right now for H1N1, and it is being widely used among children, even infants." Michael Wolf warned that an overdose could be toxic, and an underdose could be ineffective. FDA Issues Health Alert on Kids' Tamiflu Dosages: Warning follows report that dosing instructions for liquid medication don't match syringe measurements   　 FRIDAY, Sept. 25 (HealthDay News) -- U.S. health officials have issued a public health alert to pharmacists and pediatricians about potential dosing errors involving liquid Tamiflu for kids. The alert, issued late Thursday, followed a warning by scientists that parents could give the wrong dose of Tamiflu to their children as treatment for the H1N1 swine flu because the dosing instructions don't always coincide with the measurement markings on the syringe that comes with the liquid medication. In its alert, the U.S. Food and Drug Administration said "the agency has received reports of errors where dosing instructions for the patient do not match the dosing dispenser." It advised health-care providers to "write doses in mg [milligrams] if the dosing dispenser with the drug is in mg. Pharmacists should ensure that the units of measure on the prescription instructions match the dosing device provided with the drug." The earlier warning, published online Wednesday in a letter in the New England Journal of Medicine, also urged doctors and pharmacists to be on the lookout for this potential dosing mismatch and to help parents figure out exactly how much Tamiflu to give their child. The letter authors, from Northwestern University Feinberg School of Medicine in Chicago, Emory University in Atlanta and Weill Cornell School of Medicine in New York City, cited a case that they said was probably happening all over the United States: The parents of a 6-year-old girl diagnosed with the H1N1 virus received a prescription for Tamiflu Oral Suspension that told them to give her three-fourths of a teaspoon of the medicine two times a day. However, the dosing syringe inside the box was marked in milligrams. The confused parents, both of whom are health professionals, had to figure out how to convert the measurement, something most parents would find too daunting to do. "It's an egregious error that there is a conflict in the prescription labeling instructions and the dosage device that comes in the exact same box. It's incredibly confusing to parents," letter co-author Michael Wolf, an associate professor of medicine and learning sciences at Northwestern University Feinberg School of Medicine, said in a news release from the university. "Tamiflu is one of the main courses of treatment right now for H1N1, and it is being widely used among children, even infants." The letter's authors recommended that all pharmacies and physicians be instructed to ensure that the prescription label instructions for use are in the same dosing units as those on the measurement device. "Parents being prescribed Tamiflu for their children need to make sure they understand exactly how to take it at the time they pick it up at the pharmacy," lead letter author Dr. Ruth Parker, a professor of medicine at Emory, said in the release. Michael Wolf warned that an overdose could be toxic, and an underdose could be ineffective. And even more complex calculations might be necessary now that the U.S. Food and Drug Administration has approved Tamiflu for off-label use among children under the age of 1, because the syringe doesn't include small enough measuring increments for these youngest patients. "We need to have a better system for ensuring there are standardized directions for administering drugs to children," letter co-author Dr. Alastair Wood, a professor of medicine and pharmacology at the Weill Cornell School of Medicine in New York City, said in the news release. "We need to move to a system where all doses are given in the same units, preferably milliliters." Meanwhile, a report released Thursday supported recent U.S. Centers for Disease Control and Prevention recommendations not to use negative rapid test results for management of patients that may be infected with the pandemic swine flu virus. Researchers in Connecticut assessed the performance of the rapid influenza diagnostic test (RIDT) used during outbreaks of pandemic influenza A (H1N1) at two schools in Greenwich in May. Of the 63 people tested at Greenwich Hospital, infection was confirmed in 49 patients. The results of the RIDT were compared with the reverse transcription --polymerase chain reaction assay. A low sensitivity of 47 percent was found for the rapid test. This poor performance couldn't be explained by the clinical features of the patients or by the timing of the specimen collection, said Dr. James R. Sabetta, of the Greenwich Department of Health and the Connecticut Department of Public Health, and colleagues. While a positive rapid test for influenza is helpful, a negative test doesn't rule out pandemic swine flu, the researchers said. The report appears in the Sept. 25 issue of the Morbidity and Mortality Weekly Report, published by the CDC.More information The CDC has more about H1N1 flu. -- HealthDay Staff SOURCES: U.S. Food and Drug Administration, news release, Sept. 25, 2009; U.S. Centers for Disease Control and Prevention, news release, Sept. 24, 2009; Northwestern University, news release, Sept. 23, 2009 New Treatment May Beat Melanoma: In trials, advanced cancers shrunk rapidly, researchers say "We are very excited about these results. Of the 22 patients we have been able to evaluate so far, 20 have had some objective tumor shrinkage. This is impressive as they all had metastatic disease, and most of them had failed several prior therapies," said Dr. Paul Chapman. "A lot of these patients were pretty sick, but many of them had a significant and rapid improvement in the way they function. We've had patients come off oxygen, and we've got several patients who have been able to come off narcotic pain medication soon after starting treatment," Chapman said. "PLX4032 is different because it attacks the genetic program that is causing the cells to divide uncontrollably, and we think the BRAF mutation is driving that program. The drug is blocking the genetics of the tumor, rather than trying to interfere with the proliferation of the cells and....." New Treatment May Beat Melanoma: In trials, advanced cancers shrunk rapidly, researchers say   　 THURSDAY, Sept. 24 (HealthDay News) -- An experimental treatment for advanced melanoma promotes rapid shrinking of tumors, according to a new study. The phase I extension trial includes patients with the cancer-causing mutation of the BRAF gene, which is associated with about 50 percent of melanomas and 5 percent of colorectal cancers. The patients were given 960 milligrams of PLX4032 twice a day. Of the 22 patients evaluated to date, 14 (64 percent) showed at least 30 percent shrinkage in the diameter of tumors for at least a month -- the official criteria for partial response to the treatment. Another six of the 22 patients also showed a response, but it was too early to determine whether the tumors would shrink enough to meet the criteria for partial response. The findings were scheduled to be presented Thursday in Berlin at a meeting of the European Cancer Organization and the European Society for Medical Oncology. "We are very excited about these results. Of the 22 patients we have been able to evaluate so far, 20 have had some objective tumor shrinkage. This is impressive as they all had metastatic disease, and most of them had failed several prior therapies," trial co-leader Dr. Paul Chapman, an attending physician on the melanoma/sarcoma service at Memorial Sloan-Kettering Cancer Center in New York City, said at a news briefing. "A lot of these patients were pretty sick, but many of them had a significant and rapid improvement in the way they function. We've had patients come off oxygen, and we've got several patients who have been able to come off narcotic pain medication soon after starting treatment," Chapman said. "What makes this treatment different from standard chemotherapy is that standard chemotherapy attacks the machinery involved in cell division; so to stop the cancer cells dividing uncontrollably, most standard chemotherapy aims to block the mechanism of division by interfering directly with DNA replication or with microtubules in the dividing cells," he explained. "PLX4032 is different because it attacks the genetic program that is causing the cells to divide uncontrollably, and we think the BRAF mutation is driving that program. The drug is blocking the genetics of the tumor, rather than trying to interfere with the proliferation of the cells and, as a result, there are fewer side effects, although there are some. We are seeing some pretty dramatic and rapid responses, and they are occurring in sites where we rarely see responses to chemotherapy, such as in the bone." Chapman noted that "we don't know yet how long these responses will last, and we have had patients whose cancer has progressed after initially responding; so we are putting a lot of effort into studying the patients who do relapse, trying to understand how their tumors have become resistant. "In addition, one of the main side effects we've seen is that some patients develop early, non-melanoma skin cancers, such as squamous cell skin cancer. We are very vigilant about this, and although they are very easy to cut out, it's something we are keeping a close eye on." A phase II trial involving 90 patients will start at the end of this year, and a phase III trial involving several hundred patients is scheduled to begin at the end of this year or early next year. In related news from the cancer meeting in Berlin, researchers said they've shown that ultrasound can be used to identify whether cancer has started to spread in melanoma patients, and to what extent. This information can help doctors decide how much surgery, if any, a patient requires and predict the patient's likelihood of survival. "We have identified two ultrasound patterns of lymph node metastasis in melanoma patients which can identify correctly any amount of tumor cells in the sentinel lymph nodes in 75 to 90 percent of cases before proceeding to surgery on the sentinel lymph nodes," Dr. Christiane Voit, head of the diagnostic unit at the Skin Cancer Center at the Medical University of Berlin, said in a news release prepared before the meeting. Since 2001, she and her colleagues have tested the use of ultrasound in diagnosis and treatment planning of 850 melanoma patients. The research findings need to be confirmed in multi-center, randomized trials, Voit said.More information The U.S. National Cancer Institute has more about melanoma. -- Robert Preidt SOURCE: European Cancer Organization, European Society for Medical Oncology, news release, Sept. 23, 2009 Smoking in Pregnancy Linked to Psychotic Symptoms in Kids: Study also connects maternal alcohol use to psychiatric disturbances If women need yet another reason to avoid smoking during pregnancy, researchers now say that tobacco use by expectant mothers may raise the risk that their children will develop psychotic symptoms. The researchers found that the children whose mothers smoked during pregnancy were more likely to have the symptoms, and the risk rose in those whose mothers smoked the most while pregnant. The study authors suspect that tobacco exposure in the womb may indirectly affect the development and function of a child's brain, impacting impulsivity, attention or cognition. Smoking in Pregnancy Linked to Psychotic Symptoms in Kids: Study also connects maternal alcohol use to psychiatric disturbances 　 THURSDAY, Oct. 1 (HealthDay News) -- If women need yet another reason to avoid smoking during pregnancy, researchers now say that tobacco use by expectant mothers may raise the risk that their children will develop psychotic symptoms. The new research, published in the October issue of the British Journal of Psychiatry, doesn't prove that smoking during pregnancy causes the psychotic behavior, but it does suggest a link. In the study of 6,356 children in the United Kingdom, more than 11 percent of the 12-year-olds appeared to have definite or suspected symptoms of psychosis. The researchers found that the children whose mothers smoked during pregnancy were more likely to have the symptoms, and the risk rose in those whose mothers smoked the most while pregnant. Maternal alcohol use was also linked to more psychotic symptoms in children, but only among those whose mothers drank more than 21 units of alcohol a week during the early weeks of pregnancy (with one unit being roughly equivalent to a half-pint of beer or a glass of wine). The researchers couldn't find any link between maternal marijuana use and psychotic symptoms in children among the few women who reported using the drug during pregnancy. The study authors suspect that tobacco exposure in the womb may indirectly affect the development and function of a child's brain, impacting impulsivity, attention or cognition. "If our results are non-biased and reflect a causal relationship, we can estimate that about 20 percent of adolescents in this cohort would not have developed psychotic symptoms if their mothers had not smoked," study author Dr. Stanley Zammit, a psychiatrist at Cardiff University's School of Medicine in Wales, said in a news release from the journal. "Therefore, maternal smoking may be an important risk factor in the development of psychotic experiences in the population."More information Learn tips for a healthy pregnancy from the U.S. Centers for Disease Control and Prevention. -- Randy Dotinga SOURCE: British Journal of Psychiatry, news release, Oct. 1, 2009 Men Not Being Told Enough About PSA Tests: Pros, cons of cancer screen not understood, research shows Although PSA tests can detect prostate cancer, they can't predict which cancers are aggressive and which are so slow-growing that they don't need to be treated. This leads to over-treatment, which can have immediate consequences, such as impotence and incontinence, and only a tiny increase in survival, researchers say. Pignone noted that the consequences of prostate cancer treatment, such as impotence and incontinence, occur with treatment. "You suffer the down sides right away," he said. "You only get the benefits, in most cases, far into the future." Pignone noted that even men with prostate cancer are more likely to die from heart disease or dementia than their cancer. Your chance of dying from prostate cancer is one in a 1,000, while the odds of dying from another cause is 113 in 1,000, he said. Men Not Being Told Enough About PSA Tests: Pros, cons of cancer screen not understood, research shows   By Steven Reinberg: HealthDay Reporter MONDAY, Sept. 28 (HealthDay News) -- Most men are not being told the pros and cons of PSA tests, two new studies find. Although PSA tests can detect prostate cancer, they can't predict which cancers are aggressive and which are so slow-growing that they don't need to be treated. This leads to over-treatment, which can have immediate consequences, such as impotence and incontinence, and only a tiny increase in survival, researchers say. "Men in the United States have not been adequately told about the questions regarding the efficacy of prostate cancer screening," said Dr. Otis W. Brawley, chief medical officer at the American Cancer Society, who was not involved in either study. "They have been misled and over-promised," he said. "People have replaced the hope that prostate cancer screening is beneficial with the message that it is definitely beneficial." The reports are published in the Sept. 28 issue of the Archives of Internal Medicine. In the first study, a team led by Dr. Richard M. Hoffman, from the New Mexico VA Health Care System, collected data on 3,010 men 40 and older reached by telephone. Among these men, 375 had undergone or discussed PSA screening in the past two years. In all, 69.9 percent of the men had discussed screening with their doctor before making a decision. Of these men, 14.4 percent chose not to have the test. In most cases the doctor brought up having the test (64.6 percent), with 73.4 percent recommending it, which was the only point of the discussion, the researchers said. "Thirty percent of the men said it wasn't even discussed at all," Hoffman said. "Men who did discuss screening heard about the benefits of screening; very few heard about the side effects of screening." In addition, most men didn't know a lot about prostate cancer, Hoffman said. In fact, only 47.8 percent of men correctly answered any of three questions about prostate cancer risk and screening, Hoffman said. "This is a very important decision. We think it should be an informed or shared decision, and it's not happening," he said. The problem with getting the test is that a positive result is going to lead to a biopsy, and only one out of four men who have a biopsy have cancer, Hoffman said. One reason these discussions aren't taking place is that doctors don't have enough time to discuss screening and prostate cancer in general with their patients, Hoffman said. Men should educate themselves about the pros and cons of PSA testing, Hoffman said. There are various aids for making such a decision both on the Internet and in print, he said. In the second report, Kirsten Howard, a senior lecturer in health economics at the University of Sydney in Australia, and colleagues created a statistical model, based on family history, to provide information for men who have low, moderate and high risk for prostate cancer. "The results of the model predict that benefits and harms of annual PSA screening vary with age and risk level," Howard said. For example, screening 1,000 men every year from age 40 to 69 only reduces the number who will die from prostate cancer by age 85 from 30 to 28, Howard said. "So instead of 30 out of the thousand dying from prostate cancer by age 85, only 28 will die of prostate cancer. By the time they are 85, about 640 will have died from all causes of death whether they were screened or not," she said. "Higher risk men have more prostate cancer deaths averted, but also more prostate cancer diagnosed and related harms." From the model, screened men are about two to four times more likely to be diagnosed with prostate cancer than men who do not get the screening, but death rates from prostate cancer and from other causes are similar in both groups, Howard said. "The net mortality benefit is small, and this needs to be weighed against the increased chances of being diagnosed and treated for prostate cancer," she said. "Before undergoing PSA screening, men should be aware of the possible benefits and harms, and of their chances of these benefits and harms occurring." Dr. Michael Pignone, an assistant professor of cancer prevention and control at the University of North Carolina at Chapel Hill and author of an accompanying journal editorial, said that "when you total up the potentially beneficial and potential detrimental consequences of PSA screening, it is not clear that the net effect of PSA screening is beneficial." Pignone noted that the consequences of prostate cancer treatment, such as impotence and incontinence, occur with treatment. "You suffer the down sides right away," he said. "You only get the benefits, in most cases, far into the future." Pignone noted that even men with prostate cancer are more likely to die from heart disease or dementia than their cancer. Your chance of dying from prostate cancer is one in a 1,000, while the odds of dying from another cause is 113 in 1,000, he said. Brawley noted that the American Cancer Society is reviewing its recommendations for PSA screening, and is expected to change them next year. "Men should know that there are huge question marks, and for some men who are very concerned, perhaps they should get screened. For some men who are less concerned about prostate cancer, perhaps they should not get screened," Brawley said. "But men should not be told that prostate cancer screening is more beneficial than we have evidence to show."More information For more information on prostate cancer, visit the American Cancer Society. SOURCES: Richard M. Hoffman, M.D., M.P.H., New Mexico VA Health Care System, associate professor of medicine, University of New Mexico School of Medicine, Albuquerque; Kirsten Howard, Ph.D., senior lecturer, health economics, University of Sydney, Australia; Michael Pignone, M.D., M.P.H., assistant professor, cancer prevention and control, University of North Carolina, Chapel Hill; Otis W. Brawley, M.D., chief medical officer, American Cancer Society; Sept. 28, 2009, Archives of Internal Medicine Type 2 Diabetes Drug May Increase Fracture Risk: Study adds to evidence of possible link between thiazolidinediones and bone fractures, researchers say In the study, Dr. Ian Douglas of the London School of Hygiene and Tropical Medicine and colleagues searched a database of more than 6 million patients in the United Kingdom and found 1,819 people aged 40 and older who had had a bone fracture and had been prescribed a type of thiazolidinedione. The drugs were introduced in the 1990s and are used to treat type 2 diabetes. After adjusting their figures to account for the fact that older people are more likely to break bones, the researchers found that those taking thiazolidinediones had almost 1.5 times as many fractures while taking the drugs as they did when they weren't taking the drugs. The risk grew the longer the people took the medications. Type 2 Diabetes Drug May Increase Fracture Risk: Study adds to evidence of possible link between thiazolidinediones and bone fractures, researchers say   　 MONDAY, Sept. 28 (HealthDay News) -- Patients who take the diabetes drugs known as thiazolidinediones may be at higher risk of bone fracture, new research suggests. In the study, Dr. Ian Douglas of the London School of Hygiene and Tropical Medicine and colleagues searched a database of more than 6 million patients in the United Kingdom and found 1,819 people aged 40 and older who had had a bone fracture and had been prescribed a type of thiazolidinedione. The drugs were introduced in the 1990s and are used to treat type 2 diabetes. After adjusting their figures to account for the fact that older people are more likely to break bones, the researchers found that those taking thiazolidinediones had almost 1.5 times as many fractures while taking the drugs as they did when they weren't taking the drugs. The risk grew the longer the people took the medications. The findings support previous research that has suggested a link between these medications and bone fractures. But the researchers acknowledge that the study didn't follow the gold standard of research, which is to randomly assign people to take the drug or not take it. Still, Douglas and colleagues conclude that the findings "should be taken into consideration in the wider debate surrounding the possible risks and benefits of treatment with thiazolidinediones." The study appears in the Sept. 29 online edition of the journal PLoS Medicine.More information Learn more about diabetes from the American Diabetes Association. -- Randy Dotinga SOURCE: Public Library of Science, news release, Sept. 28, 2009 New Hope for Treatment of Pancreatic Cancer: By inhibiting key enzyme, researchers shrank tumors, prolonged survival in mice Inhibiting the action of an enzyme called TAK-1 reverses pancreatic cancer resistance to chemotherapy, a finding that could lead to the development of a new way to treat the disease, researchers say. Pancreatic cancer is resistant to every currently available anti-cancer treatment. "The use of this TAK-1 inhibitor increased the sensitivity of pancreatic cells to all three chemotherapeutic drugs," Dr. Davide Melisi said. "By combining it with classic anti-cancer drugs, we were able to use doses of drugs up to 70 times lower in comparison with the control to kill the same number of cancer cells. In mice, we were able to reduce significantly the tumor volume, to prolong the mice survival, and to reduce the toxicity by combining the TAK-1 inhibitor with very low doses of a classic chemotherapeutic drug, gemcitabine, that would have been ineffective otherwise." New Hope for Treatment of Pancreatic Cancer: By inhibiting key enzyme, researchers shrank tumors, prolonged survival in mice 　 FRIDAY, Sept. 25 (HealthDay News) -- Inhibiting the action of an enzyme called TAK-1 reverses pancreatic cancer resistance to chemotherapy, a finding that could lead to the development of a new way to treat the disease, researchers say. Pancreatic cancer is resistant to every currently available anti-cancer treatment. "During the past few years we have been studying the role played by a cytokine or regulatory protein called transforming growth factor-beta [TGFbeta] in the development of pancreatic cancer. Recently we focused our attention on a unique enzyme activated by TGFbeta, TAK-1, as a mediator for this extreme drug resistance" in pancreatic cancer, study author Dr. Davide Melisi said in a news release from the European Cancer Organization. He and his colleagues developed a TAK-1 inhibitor and tested it on its own and in combination with the anti-cancer drugs gemcitabine, oxaliplatin and SN-38 (a metabolite of the anti-cancer drug irinotecan) in pancreatic cancer cell lines. They also tested the TAK-1 inhibitor combined with gemcitabine against pancreatic cancer in mice. "The use of this TAK-1 inhibitor increased the sensitivity of pancreatic cells to all three chemotherapeutic drugs," Dr. Davide Melisi said. "By combining it with classic anti-cancer drugs, we were able to use doses of drugs up to 70 times lower in comparison with the control to kill the same number of cancer cells. In mice, we were able to reduce significantly the tumor volume, to prolong the mice survival, and to reduce the toxicity by combining the TAK-1 inhibitor with very low doses of a classic chemotherapeutic drug, gemcitabine, that would have been ineffective otherwise," Melisi added. The study was scheduled for presentation Sept. 24 at the joint meeting of the European Cancer Organization and the European Society for Medical Oncology in Berlin. "This is the first time that TAK-1 has been indicated as a relevant target for the treatment of a solid tumor and that it is a valid approach to reverting the intrinsic drug resistance of pancreatic cancer," Melisi stated. "The TAK-1 inhibitor used in this study is an exciting drug that warrants further development for the treatment of pancreatic cancer."More information The American Cancer Society has more about pancreatic cancer. -- Robert Preidt SOURCE: European Cancer Organization, news release, Sept. 24, 2009 New Treatments Hold Hope for Failing Eyes: As the U.S. ages, macular degeneration rates are expected to swell Macular degeneration comes in two forms, wet and dry. Current treatments for the wet form of the disease -- in which abnormal new blood vessels in the eye cause leakage and bleeding -- have proven quite successful. The wet form is more rare but can cause rapid vision loss if not caught early. Researchers have discovered a combination therapy of vitamins and antioxidants that reduces the risk of progressive vision loss by more than 20 percent, said Dr. David W. Parke II. Other progress against the wet form of the disease has come through the use of drugs that target vascular endothelial growth factor, or VEGF, a substance in the body that promotes the growth of new blood vessels. No effective treatments have been found for the dry form of macular degeneration, which causes less catastrophic vision loss but accounts for 85 percent of all macular degeneration cases. New Treatments Hold Hope for Failing Eyes: As the U.S. ages, macular degeneration rates are expected to swell By Dennis Thompson: HealthDay Reporter SUNDAY, Sept. 27 (HealthDay News) -- Already a leading cause of vision loss among people older than 60, age-related macular degeneration is expected to skyrocket in numbers over the coming decades as the U.S. population grows older. However, a series of new treatments now under study or in development should mean that eye specialists will be well-prepared to treat the coming surge of macular degeneration cases. These include refinements of treatments that have proven effective against some forms of the disease as well as new therapies targeting forms of macular degeneration that have so far proven impossible to treat. Age-related macular degeneration involves the breakdown of the macula, which is located in the retina and helps provide clear central vision. As the macula deteriorates, people see a blurred spot in the center of their vision that grows over time. Macular degeneration comes in two forms, wet and dry. Current treatments for the wet form of the disease -- in which abnormal new blood vessels in the eye cause leakage and bleeding -- have proven quite successful. The wet form is more rare but can cause rapid vision loss if not caught early. Researchers have discovered a combination therapy of vitamins and antioxidants that reduces the risk of progressive vision loss by more than 20 percent, said Dr. David W. Parke II, executive vice president and chief executive of the American Academy of Ophthalmology. Other progress against the wet form of the disease has come through the use of drugs that target vascular endothelial growth factor, or VEGF, a substance in the body that promotes the growth of new blood vessels. "We now have treatments where, when we catch people early in the course of the disease, the chance of vision loss is less than 10 percent over a two-year period," said George Williams, chairman of ophthalmology and director of the Eye Institute at William Beaumont Hospital in Royal Oak, Mich. Those treatments also provide a 20 to 30 percent chance of significant vision improvement over the same period. No effective treatments have been found for the dry form of macular degeneration, which causes less catastrophic vision loss but accounts for 85 percent of all macular degeneration cases, according to the U.S. National Eye Institute. The dry form occurs when the light-sensitive cells in the macula begin to slowly break down. New advances in the treatment of the wet form involve further research into vitamin combinations that can help slow the progress of macular degeneration, Parke said. An ongoing trial is looking into whether diet or supplements can better improve a person's chances of retaining clear vision late in life. "Around the world, there are culturally different rates of progression," Parke said. "The question becomes, how much of this is dietary?" Research also has focused on the two drugs currently used to target VEGF, with a head-to-head study now looking into which of the two is more effective. "It's a very important trial, and I think all involved are looking forward to seeing if these drugs have a lot of differences," Parke said. Other anti-VEGF drugs are in the pipeline, Williams said, and studies are testing ways to combine anti-VEGF medications with radiation or laser therapy to produce better results. Cutting-edge research also may have found another way to tackle the wet form of macular degeneration. In the June 14 issue of Nature, doctors reported that blocking the activity of a specific protein can reduce the same blood vessel growth that leads to the wet form. "We now have the opportunity to develop drugs that target this protein that may be safer and more effective than our current treatments," Parke said. As far as the dry form of macular degeneration, eye experts are exploring ways that drugs used to treat other nerve-damaging diseases such as Alzheimer's might be able to help save people's eyesight, Williams said. "We're fairly optimistic that within three to five years we'll have a treatment for the dry form of macular degeneration," he said. "We know what happens is the nerve cells that sense the light are dying off. The thought here is if we attack the process that makes them die, we can save the vision."More information The U.S. National Eye Institute has more on macular degeneration. SOURCES: David W. Parke II, M.D., executive vice president and chief executive, American Academy of Ophthalmology; George Williams, M.D., chairman of ophthalmology, and director, Beaumont Eye Institute, William Beaumont Hospital, Royal Oak, Mich.; U.S. National Eye Institute Sept. 18, 2009 to Sept. 25, 2009Health Highlights **Obesity Could Become Leading Cause of Cancer in Women. **FDA Requests Review Of Medical Device Approval System. **Green Tea May Protect Bones. **Personal Emergency Response Button Poses Choking Hazard: FDA. **New OxyContin Offers 'Limited' Resistance to Abuse. **Exercise Boosts Postmenopausal Women's Cardiovascular Fitness. **Eye Test Detects Stroke Better Than MRI. **U.S. Issues Alert About Cocaine Laced With Veterinary Drug. **Model Predicts Postnatal Depression Risk. **Sunshine, Vacation Linked to Lower Summer Death Rate. **Aspirin May Reduce Colon Cancer Risk. **Patients in Vegetative State Able to Learn. **Delinquents Misinterpret Facial Expressions. **FDA Approves New AIDS Test. **FDA Warns About Stolen Respiratory Medicines. **Brain Infection Warning Added To Safety Info About MS Drug. Health Highlights (Sept. 18, 2009 to Sept. 25, 2009) Here are some of the latest health and medical news developments, compiled by editors of HealthDay: Obesity Could Become Leading Cause of Cancer in Women For women in Western nations, being overweight or obese could become the leading cause of cancer within 10 years, says a new study. Currently, obesity accounts for up to 8 percent of cancers. But European researchers said that could dramatically increase due to the obesity epidemic and a sharp decline in major causes of cancer such as smoking and hormone replacement therapy for women, the Associated Press reported. The researchers calculated that in 2002, being overweight or obese was associated with 70,000 of two million cancer cases in 30 European countries. By 2008, at least 124,000 cases of cancer were linked with obesity. The researchers found that colorectal cancer, breast cancer in postmenopausal women and endometrial cancer accounted for 65 percent of all cancers associated with being overweight or obese. The study was presented Thursday at the joint meeting of the European Cancer Organization and the European Society for Medical Oncology. "Obesity is catching up at a rate that makes it possible it could become the biggest attributable cause of cancer in women within the next decade," said Andrew Renehan, a cancer expert at the University of Manchester in England, the AP reported. ----- FDA Requests Review Of Medical Device Approval System In response to criticism by safety advocates and others, the U.S. Food and Drug Administration has asked the federal Institute of Medicine to review the agency's approval system for certain types of medical devices. The institute will examine the FDA's 510k review procedure, which allows companies to immediately introduce products similar to those already on the market, the Associated Press reported. This system was designed to hasten approval of simple medical devices such as wheelchairs and bandages, but has been used to approve high-risk devices such as heart implants and hip replacements. ----- Green Tea May Protect Bones Chemicals in green tea may help slow bone breakdown, according to a Chinese study. Researchers at the Chinese University of Hong Kong exposed cultured bone-forming cells (osteoblasts) to a number of major ingredients of green tea for several days. One of the compounds, epigallocatechin, increased the activity of an enzyme that promotes bone growth by as much as 79 percent, United Press International reported. Also, high concentration of epigallocatechin blocked the activity of osteoclasts, which are cells that break down or weaken bones. There was no evidence that epigallocatechin had any toxic effects on bone cells, the news service said. The study was published in the Journal of Agricultural and Food Chemistry. ----- Personal Emergency Response Button Poses Choking Hazard: FDA A type of personal emergency response button worn around the neck poses a choking hazard, the U.S. Food and Drug Administration warned Tuesday. Between 1998 and 2009, there were six reports of serious injury or death, including four deaths in the United States, after the cord on the Philips Lifeline Personal Help Button became entangled on other objects, the FDA said. The choking risk is greatest for people with mobility limitations or for those who use wheelchairs, walkers, beds with guard rails, or other objects that could entangle with the device's neck cord. Users and caregivers should consult with health-care providers to determine which style of emergency button is best for an individual patient, the FDA said. Some emergency buttons are worn on the wrist. ----- New OxyContin Offers 'Limited' Resistance to Abuse: FDA A new version of the painkiller OxyContin is somewhat harder to abuse than the current version, say U.S. health officials. The new version, made by Purdue Pharma LP, has a plastic-like coating that's designed to make it more difficult to crush, snort or inject the drug, the Associated Press reported. On Tuesday, U.S. Food and Drug Administration scientists said the new version's resistance to abuse is "limited," but "may provide an advantage over the currently available OxyContin." Last year, an FDA advisory panel told Purdue that it needed to conduct more tests to demonstrate the tamper resistance of the new version. On Thursday, the panel will decide whether new data submitted by Purdue is sufficient to recommend approval of the new version of OxyContin, the AP reported. ----- Exercise Boosts Postmenopausal Women's Cardiovascular Fitness Despite changes in hormones and body composition, postmenopausal women show significant cardiovascular improvements when they do regular, vigorous exercise, according to a U.S. study. The study included 10 healthy but sedentary women, average age 55, who did endurance training on an exercise bike for one hour, five days a week, at 65 percent of their maximum lung capacity, United Press International reported. The women's ability to consume and use oxygen increased by an average of 16 percent, and their resting heart rates decreased by an average of four beats per minute. By the end of the study, the women had the cardiovascular and metabolic traits of women 16 years younger, said the University of California, Berkeley researchers. The study appears in the journal Metabolism. ----- Eye Test Detects Stroke Better Than MRI A quick, inexpensive eye movement test was better than magnetic resonance imaging (MRI) at identifying patients with strokes, a U.S. study found. The one-minute eye exam reveals eye movement changes associated with stroke damage in various areas of the brain, United Press International reported. "The idea that a bedside exam could outperform a modern neuroimaging test such as MRI is something that most people had given up for dead, but we've shown it's possible," Dr. David E. Newman-Toker, of the Johns Hopkins University School of Medicine, said in a news release. Some stroke patients can't immediately adjust their eye position if they turn their heads quickly to the side, while others may have jerky eye movements when trying to focus on a doctor's finger positioned on either side of their head, UPI reported. The study was published in the journal Stroke. ----- U.S. Issues Alert About Cocaine Laced With Veterinary Drug Doctors, substance abuse treatment centers and other public health officials need to be aware that cocaine laced with the veterinary anti-parasitic drug levamisole is a widespread problem, the U.S. Substance Abuse and Mental Health Services Administration said in a nationwide public health alert issued Monday. To date, there have been about 20 confirmed or probable cases of a serious blood disorder called agranulocytosis among people who've used cocaine that contains levamisole. Two people have died, the agency said. The official number of cases of affected people is expected to increase as more health professionals become aware of this issue, SAMHSA said. Ingestion of cocaine laced with levamisole can cause a serious decrease in white blood cell levels, leading to a weakened immune system that's unable to fight off even minor infections. This means that people who used levamisole-contaminated cocaine can suffer rapidly developing, life-threatening infections, the agency said. ----- Model Predicts Postnatal Depression Risk A model to predict postnatal depression is 80 percent accurate in the months after a woman gives birth, Spanish researchers say. The researchers studied 1,397 women who gave birth and used a type of modeling they call artificial neuronal networks, United Press International reported. The model includes a number of risk factors, including a mother's amount of social support, emotional changes during birth, neuroticism, mutations in the serotonin transport gene, and family history of psychiatric problems. During the study, the researchers found that being older and working during pregnancy decreased a woman's risk of postnatal depression, UPI reported. The study was published in the journal Methods of Information in Medicine. "Now (the model) needs clinical evaluation, and for psychiatrists to start to test it directly on patients in order to study that true potential of these tools," lead author Salvador Tortajada, of the Polytechnic University of Valencia, said in a news release. ----- Sunshine, Vacation Linked to Lower Summer Death Rate The health benefits of increased exposure to sunlight and vacations may explain why fewer people in northern countries die in late summer and early fall, according to a new study. American and Greek researchers found that death rates are lowest in August in North America and Sweden, in September in the Mediterranean, and in March in Australia, CBC News reported. The link between these times of the year and lower death rates may be due to the physiological effect of increased vitamin D production by the body due to sun exposure, coupled with the stress-lowering benefits of vacation, the study authors suggested. Vitamin D "may have beneficial effects for cardiovascular disease, renal failure, certain malignant diseases, autoimmune disorders and infections, including influenza," wrote Dr. Matthew Falagas, of the Alfa Institute of Biomedical Sciences in Greece, and his colleagues, CBC News reported. ----- Aspirin May Reduce Colon Cancer Risk Taking aspirin daily can reduce the risk of colon cancer in people with a genetic susceptibility to the disease, according to European researchers who studied more than 1,000 people. The participants had Lynch syndrome, a genetic mutation that puts them at increased risk for colon and other types of cancers. The syndrome causes about 5 percent of all colon cancer cases, the Associated Press reported. For about four years, half the participants took aspirin daily while the others took a placebo. Six people in the aspirin group developed colon cancer, compared with 16 in the placebo group. The findings were presented Monday at a meeting of the European Cancer Organization. "We are delighted" with the results, study leader John Burn of Newcastle University in Britain said in a news release, the AP reported. "All the more so because we stopped giving the aspirin after four years, yet the effect is continuing." Further research to determine how aspirin fights colon cancer might lead to new treatments, the researchers said. ----- Patients in Vegetative State Able to Learn Patients in a persistent vegetative state may still be able to learn, according to British scientists who studied 22 patients with severe brain damage who didn't appear to have any signs of consciousness. The researchers played a noise prior to delivering a puff of air to the patients' eyes and found that some of the patients learned to anticipate the puff, causing their eye muscles to twitch, BBC News reported. "They were clearly anticipating the stimulus would come, so there is some kind of perception and from the point of view of the patient who is allegedly unconscious this could have profound implications," said study leader Dr. Tristan Bekinschtein of Cambridge University. He said it had been believed that learning to link one stimulus with another was dependent on explicit awareness of the association, BBC News reported. The findings, published in the journal Nature Neuroscience, may lead to tests to identify severely brain damaged patients who could recover, the researchers said. ----- Delinquents Misinterpret Facial Expressions Teen boys who run afoul of the law appear to have difficulty interpreting other peoples' facial expressions, Japanese researchers say. The researchers showed photos of faces expressing six basic emotions to 24 young male offenders and found that they were more likely to mistake disgust for anger than peers who hadn't been in trouble with the law, BBC News reported. The findings offer the first real evidence that young offenders may have difficulty telling the difference between disgust and anger in others. This type of misinterpretation may cause them to regard a situation as more hostile than it actually is, the researchers said. "This bias towards misrecognising other emotions as anger is particularly significant because anger appears to play an important role in delinquency," said study leader Wataru Sato of Kyoto University, BBC News reported. "Taken together the data suggest that delinquents might be projecting their own heightened angry emotions onto others when they misperceive others' negative, but not hostile, emotional states as anger." ----- FDA Approves New AIDS Test The U.S. Food and Drug Administration has approved a new test that detects both types of the virus that causes AIDS. The FDA said Friday that Abbott Laboratories' Abbott Prism HIV O Plus test can detect HIV types 1 and 2. HIV type 2 is mostly found in West Africa, while HIV type 1 is made up of various virus subgroups found in both the United States and West Africa, the Associated Press reported. The test will be used to screen for HIV in blood and organ donations. HIV attacks the body's immune system, eventually causing AIDS. More than 1.1 million Americans are estimated to have HIV and 232,000 do not know it, according to the federal Centers for Disease Control and Prevention. ----- FDA Warns About Stolen Respiratory Medicines Consumers should be watchful for stolen respiratory medications that may not have been stored or handled properly, the U.S. Food and Drug Administration warned Thursday. The medications are Ipratropium Bromide Inhalation Solution, 0.02 percent, and Albuterol Sulfate Inhalation Solution, 0.083 percent, made by Dey L.P., a subsidiary of Mylan Inc. The medications were part of a shipment on a tractor trailer that was stolen in Tampa, Fla., United Press International reported. The stolen drugs are from the following lots: Albuterol Sulfate Inhalation Solution with the brand name "Dey," lot numbers 9GO4, 9FD8, 9FD9, and 9FE1. Ipratropium Bromide Inhalation Solution with the brand name "Dey," lot numbers F09089, C09119 and C09120. The FDA said consumers can get more information by contacting Dey at 800-527-4278, UPI reported. ----- Brain Infection Warning Added To Safety Info About MS Drug A warning about cases of rare brain infection has been included in updated safety information about the multiple sclerosis drug Tysabri, says the U.S. Food and Drug Administration. The agency's update says the risk of developing progressive multifocal leukoencephalopathy (PML) "appears to increase with the number of Tysabri infusions received." The average number of infusions received by patients before they were diagnosed with PML was 25, Dow Jones reported. "There is minimal experience in patients who have received more than 35 infusions of Tysabri," according to the FDA update. Patients receive the drug through an intravenous infusion about once a month. The FDA emphasized that the overall rate of PML among patients taking Tysabri remains below the one-in-1,000 rate noted on the label, Dow Jones reported. Concerns about PML prompted the FDA to pull Tysabri from the market for 18 months in 2005. Since the drug was allowed back on the market, there have been 13 confirmed cases of PML.   Leukemia Drug in High Dose Helps Survival in Patients With Acute Myeloid Leukemia [AML]: Two trials find daunorubicin benefits certain subsets of patients A pair of studies independently reported higher rates of complete remission and overall survival in those who received high doses of the chemo drug daunorubicin, compared to those who receive the standard dose. Though those benefits were mostly limited to specific subsets of patients -- those younger than 50 or between 60 and 65, who had so-called "favorable" or "intermediate" genetic profiles -- they also came without any apparent increase in serious side effects. "The bottom line is survival," Dr. HUgo Fernandez said. "We achieved it without great cost to the patients, and without any new fancy drugs, either. This wasn't reinventing the wheel; it was using the drugs optimally. We finally got the right dose." Fernandez noted there are "nay-sayers"...."But my retort is, with the high dose, they are more likely to be alive." Leukemia Drug in High Dose Helps Survival in Patients With Acute Myeloid Leukemia [AML]: Two trials find daunorubicin benefits certain subsets of patients   By Jeffrey Perkel: HealthDay Reporter WEDNESDAY, Sept. 23 (HealthDay News) -- Patients with acute myeloid leukemia (AML), take note: A new standard of care is emerging -- at least for those younger than 50, or between 60 and 65. That's the take-home message of  a pair of studies published Wednesday in the New England Journal of Medicine. Two research teams -- the U.S.-based Eastern Cooperative Oncology Group (ECOG) and a team of scientists in the Netherlands, Belgium, Germany and Switzerland -- studied almost 1,500 patients and independently reported higher rates of complete remission and overall survival in those who received high doses of the chemo drug daunorubicin, compared to those who receive the standard dose. Though those benefits were mostly limited to specific subsets of patients -- those younger than 50 or between 60 and 65, who had so-called "favorable" or "intermediate" genetic profiles -- they also came without any apparent increase in serious side effects. In essence, said Dr. Hugo Fernandez of the Moffitt Cancer Center and Research Institute in Tampa, Fla., the lead author on the U.S. study, the data suggest that oncologists have nothing to lose in using the high-dose regimen, 90 mg per square meter of body surface area compared to a standard 45 mg per square meter. That's because AML must be treated aggressively, yet it can take days for genetic analyses to come back from the lab. "The bottom line is survival," Dr. HUgo Fernandez said. "We achieved it without great cost to the patients, and without any new fancy drugs, either. This wasn't reinventing the wheel; it was using the drugs optimally. We finally got the right dose." In an editorial accompanying the two studies, Drs. Herve Dombret and Claude Gardin from Paris, wrote, "Do we have a new standard of care in AML? The lack of an increase in toxic effects and the benefit in overall survival strongly argue for incorporating high-dose daunorubicin into the initial treatment of younger patients with AML, at least for those with favorable- and intermediate-risk cytogenetic profiles, unless an increased rate of toxic effects is feared when high-dose daunorubicin is used in association with new agents, such as FLT3 inhibitors, currently in ongoing trials." According to the Leukemia & Lymphoma Society, 13,290 Americans were "expected to be diagnosed" with AML last year. Half of all AML patients are older than 65. Treatment usually includes a so-called "7+3" induction regimen, in which patients are given cytarabine for seven days and daunorubicin (or a related drug, such as idarubicin) for three. The daunorubicin is typically administered at 45 mg per square meter of body surface area, yet anecdotal evidence suggested higher doses might be more effective, Fernandez said. The two research teams set out to determine whether that was actually the case -- in patients younger than age 60 in the ECOG trial, or older than age 60 in the European trial. Rates of complete remission and overall survival improved in both studies. Yet the effects were most pronounced when the researchers focused on specific subgroups, rather than the entire study population. For instance, in the ECOG study overall, complete remission rates jumped from 57.3 percent for the standard treatment group, to 70.6 percent for the high-dose group, while median survival improved from 15.7 months to 23.7. For those patients younger than 50, survival improved from a median of 19 months, to 34.3 months. But no benefit was seen for patients 50 or older. Similarly, survival improved from 20.7 to 34.3 months for patients with "favorable" or "intermediate" genetic profiles, but no benefit at all was observed in patients with an "unfavorable" profile. In the European trial, overall complete remission rates rose in the high-dose group from 54 percent to 64 percent, with no overall improvement in two-year overall survival. Yet when looking only at patients aged 60 to 65, remission improved from 51 percent to 73 percent, while two-year survival improved from 23 percent to 38 percent. "I think the take-home message is that the outcomes seem to be sufficiently improved, at least in patients less than 50, and aged 60 and 65, that this is a reasonable standard of care," said Dr. Michael Millenson, director of the hematology service at the Fox Chase Cancer Center in Philadelphia. He added, "Since we don't necessarily have all the cytogenetic information back when we have to make a decision about dosing, I think the reassuring thing is that there didn't seem to be excessive toxic side effects." Dr. Anthony Stein, of the City of Hope in Duarte, Calif., who sees "at least two new AML patients per week," uses idarubicin rather than daunorubicin. But, he said, "based on these two papers, it didn't look like using the higher dose led to more toxicity, so if I were going to use daunorubicin, I would use the higher dose." Dr. Barton Kamen, chief medical officer at the Leukemia & Lymphoma Society, said the studies highlight the heterogeneity of AML and the power of "personalized medicine" -- as well as the need for more research. "To me the tagline is, AML is lots of different diseases," Kamen said. "And we need to know as much as we can of the patient and the disease to treat them. This is a spectacular example of that." "But," he added, "they still have a lot of work to do." Kamen doesn't advocate giving high-dose daunorubicin to all patients, only those who are likely to benefit. "There are short- and long-term side effects we don't know yet," he said. Of particular concern, daunorubicin can damage the heart. Indeed, Fernandez noted there are "nay-sayers" in the oncology community who suggest that, five or six years down the road, patients might be better off had they received the lower dose. "But my retort is, with the high dose, they are more likely to be alive."More information For more information on AML, visit the Leukemia & Lymphoma Society. SOURCES: Hugo F. Fernandez, M.D., associate member and associate chair, department of blood and marrow transplantation, Moffitt Cancer Center and Research Institute, Tampa, Fla.; Anthony S. Stein, M.D., professor, hematology and hematopoietic cell transplantation, associate member, hematologic malignancies program, Comprehensive Cancer Center, City of Hope, Duarte, Calif.; Barton A. Kamen, M.D., Ph.D., chief medical officer, Leukemia & Lymphoma Society; Michael Millenson, M.D., director, Hematology Service, Fox Chase Cancer Center, Philadelphia; Sept. 24, 2009, New England Journal of Medicine Leukemia Cells May Hide in Fat Tissue: Finding explains why obese children are more likely to develop chemotherapy resistance and have higher relapse rates, researchers say A previous study found that obese children with leukemia are 50 percent more likely to relapse than lean children. Dr. Steven D. Mittelman and his colleagues also found that four chemotherapy drugs used in children -- vincristine, nilotinib, daunorubicin and dexamethasone -- all worked less effectively in culture when fat cells were nearby. The study findings offer "striking experimental support for the clinical observations that obesity is associated with poor prognosis in multiple cancers," said Dr. David Hockenbery. Leukemia Cells May Hide in Fat Tissue: Finding explains why obese children are more likely to develop chemotherapy resistance and have higher relapse rates, researchers say   　 TUESDAY, Sept. 22 (HealthDay News) -- Leukemia cells can hide in fat tissue to evade chemotherapy, which may explain why obese children with leukemia are more likely to develop chemotherapy resistance and have higher relapse rates, researchers say. A previous study found that obese children with leukemia are 50 percent more likely to relapse than lean children. In this new study, researchers observed that obese mice with leukemia had higher relapse rates than lean mice after they were treated with the first-line chemotherapy drug vincristine. In the mice that relapsed, leukemia cells were found to be hiding in fat tissue during chemotherapy. "We were surprised to find leukemia cells in the fat tissue," lead researcher Dr. Steven D. Mittelman, the fellowship research director with the Division of Endocrinology at Children's Hospital Los Angeles, and assistant professor of pediatrics, physiology and biophysics at the Keck School of Medicine, University of Southern California, said in a news release from the American Association for Cancer Research. Dr. Steven D. Mittelman and his colleagues also found that four chemotherapy drugs used in children -- vincristine, nilotinib, daunorubicin and dexamethasone -- all worked less effectively in culture when fat cells were nearby. The study appears online Sept. 22 in the journal Cancer Research. Mittelman said further research is needed to determine how body fat affects chemotherapy. The study findings offer "striking experimental support for the clinical observations that obesity is associated with poor prognosis in multiple cancers," Dr. David Hockenbery, a member of the Fred Hutchinson Cancer Research Center and a professor of internal medicine at the University of Washington, said in the news release.More information The U.S. National Cancer Institute has more about obesity and cancer. -- Robert Preidt SOURCE: American Association for Cancer Research, news release, Sept. 22, 2009 New Chemo Regimen May Benefit Ovarian Cancer Patients: Dose-dense treatment improved survival, but too toxic for some Currently, paclitaxel and carboplatin given every three weeks is considered standard first-line chemotherapy for advanced epithelial ovarian cancer. However, dose-dense weekly treatment with paclitaxel is seen as a way to increase progression-free and overall survival in these patients, according to the new study findings. Women in the dose-dense group had a 29 percent lower risk of cancer progression and a 25 percent lower risk of death, the authors explained. Toxicity forced 113 patients in the dose-dense group and 69 patients in the conventional therapy group to stop treatment, the researchers noted. Severe anemia occurred in 214 patients (69 percent) in the dose-dense group and in 137 (44 percent) of the standard therapy group. The survival benefits seen in the dose-dense group are rare in patients with advanced ovarian cancer....concluded Dr. Noriyuki Katsumata. New Chemo Regimen May Benefit Ovarian Cancer Patients: Dose-dense treatment improved survival, but too toxic for some   　 SUNDAY, Sept. 20 (HealthDay News) -- Dose-dense chemotherapy improves survival in women with advanced ovarian cancer, Japanese researchers say. Currently, paclitaxel and carboplatin given every three weeks is considered standard first-line chemotherapy for advanced epithelial ovarian cancer. However, dose-dense weekly treatment with paclitaxel is seen as a way to increase progression-free and overall survival in these patients, according to the new study findings. This phase 3 study of 637 women compared the two approaches. The participants had advanced epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. The 320 patients in the conventional regimen group received six cycles of paclitaxel (180 milligrams per meter squared; three-hour intravenous infusion). The 317 patients in the dose-dense group received paclitaxel (80 milligrams per meter squared; one-hour intravenous infusion) on days one, eight and 15. Both groups received carboplatin on day one of a 21-day cycle. The patients in the dose-dense group had longer median progression-free survival than those in the standard treatment group (28 months versus 17 months), and longer overall survival at three years (72 percent versus 65 percent). This means that women in the dose-dense group had a 29 percent lower risk of cancer progression and a 25 percent lower risk of death, the authors explained. Toxicity forced 113 patients in the dose-dense group and 69 patients in the conventional therapy group to stop treatment, the researchers noted. Severe anemia occurred in 214 patients (69 percent) in the dose-dense group and in 137 (44 percent) of the standard therapy group. The survival benefits seen in the dose-dense group are rare in patients with advanced ovarian cancer, and this regimen offers a new treatment option for women with advanced epithelial ovarian cancer, concluded Dr. Noriyuki Katsumata, of the National Cancer Center Hospital in Tokyo, and colleagues. The study, published in an upcoming print issue of The Lancet, was released online Sunday to coincide with the European Cancer Organization meeting held Sept. 20 to 24 in Berlin. "The use of such dose-dense therapy should be decided on an individual basis together with other options for women with advanced-stage ovarian cancer," Dr. Michael A. Bookman, of the Arizona Cancer Center in Tucson, wrote in an accompanying commentary in The Lancet.More information The U.S. National Cancer Institute has more about ovarian cancer. -- Robert Preidt SOURCE: The Lancet, news release, Sept. 19, 2009     New Drug May Offer Hope to Some With Lung Cancer: Pemetrexed improves survival with advanced non-small-cell tumors, study finds Maintenance therapy with the drug pemetrexed improves the survival of people with non-small-cell lung cancer whose disease has not progressed after chemotherapy, a new study has found. Those in the pemetrexed group had a 50 percent reduction in the risk for disease progression or death and a 21 percent reduction in the risk of death only, the researchers said. "Pemetrexed maintenance therapy is well tolerated and offers significantly improved progression-free and overall survival compared with placebo, making it a new treatment option for patients with advanced non-squamous, non-small-cell lung cancer who do not progress after initial induction therapy," Dr. Chandra Belani and her colleagues concluded. New Drug May Offer Hope to Some With Lung Cancer: Pemetrexed improves survival with advanced non-small-cell tumors, study finds   　 SATURDAY, Sept. 19 (HealthDay News) -- Maintenance therapy with the drug pemetrexed improves the survival of people with non-small-cell lung cancer whose disease has not progressed after chemotherapy, a new study has found. Nearly 90 percent of all people who die from lung cancer have non-small-cell tumors. At the time the cancer is discovered, it's considered advanced about 40 percent of the time, according to background information in a news release from The Lancet, which is publishing the study. Chemotherapy reduces the tumors in just 40 percent of advanced cases, it said. The phase 3 study included 663 people in 20 countries who had an advanced stage of the cancer but no disease progression after four cycles of platinum-based chemotherapy. They were randomly selected to be given pemetrexed or a placebo in 21-day cycles. The cancers did not progress for 4.3 months, on average, in people in the pemetrexed group, compared with 2.6 months in the placebo group, the study found. People given pemetrexed survived an average of 13.4 months, compared with 10.6 months for those given the placebo. That means that those in the pemetrexed group had a 50 percent reduction in the risk for disease progression or death and a 21 percent reduction in the risk of death only, the researchers said. Drug-related toxic effects caused discontinuation of treatment in 5 percent of the pemetrexed group and 4 percent of the placebo group. No deaths were found to be related to pemetrexed, according to the study. "Pemetrexed maintenance therapy is well tolerated and offers significantly improved progression-free and overall survival compared with placebo, making it a new treatment option for patients with advanced non-squamous, non-small-cell lung cancer who do not progress after initial induction therapy," Dr. Chandra Belani, of the Penn State Hershey Cancer Institute, and her colleagues concluded. The study, which appears online and in an upcoming print issue of The Lancet, was released Sept. 19 to coincide with the European Cancer Organization meeting. Dr. Thomas Stinchcombe of the Lineberger Comprehensive Cancer Center at the University of North Carolina, and Dr. Howard West, of the Swedish Cancer Institute in Seattle, wrote in an accompanying editorial that the use of pemetrexed as maintenance therapy "merits being considered as a strong option, reflected by the recent approval of pemetrexed in this setting by the European Medicines Agency and the U.S. Food and Drug Administration."More information The American Cancer Society has more about non-small-cell lung cancer. -- Robert Preidt SOURCE: The Lancet, news release, Sept. 19, 2009 Hormone Therapy May Make Lung Cancer More Likely: Expert says finding supports doubts about value of treatment After eight years, 73 women taking the hormone therapy and 40 women in the placebo group had died of lung cancer. That meant, according to the researchers, that women who took the drug were 71 percent more likely to die from the disease. The researchers urged that the findings "be incorporated into risk-benefit discussions with women considering combined hormone therapy, especially those with a high risk of lung cancer ... such as current smokers or long-term past smokers." Dr. Apar Kishor Ganti questioned whether hormone therapy should be used at all. "These results, along with the findings showing no protection against coronary heart disease, seriously question whether hormone-replacement therapy has any role in medicine today," he wrote..... Hormone Therapy May Make Lung Cancer More Likely: Expert says finding supports doubts about value of treatment   　 SATURDAY, Sept. 19 (HealthDay News) -- Taking a combination form of hormone replacement therapy, which includes both estrogen and progestin, increases a woman's risk for dying from lung cancer, a new study has found. The finding stems from an analysis of data from the Women's Health Initiative trial on 16,608 postmenopausal women, aged 50 to 79, in the United States who had been randomly assigned to take either a once-daily tablet of 0.625 milligrams conjugated equine estrogen plus 2.5 mg medroxyprogesterone acetate or a placebo. After eight years, 73 women taking the hormone therapy and 40 women in the placebo group had died of lung cancer. That meant, according to the researchers, that women who took the drug were 71 percent more likely to die from the disease. The study also found that women taking the hormone therapy were 28 percent more likely to be diagnosed with lung cancer, although the study noted that the finding was not statistically significant. "Treatment with estrogen plus progestin in postmenopausal women ... increased the number of deaths from lung cancer, in particular deaths from non-small-cell lung cancer," concluded Rowan Chlebowski, of the Los Angeles Biomedical Research Institute at Harbour-UCLA Medical Center, and his colleagues. The researchers urged that the findings "be incorporated into risk-benefit discussions with women considering combined hormone therapy, especially those with a high risk of lung cancer ... such as current smokers or long-term past smokers." Dr. Apar Kishor Ganti, from the University of Nebraska Medical Center in Omaha, wrote in an accompanying editorial that "because the optimum safe duration of hormone-replacement therapy in terms of lung cancer survival is unclear, such therapy should probably be avoided in women at a high risk of developing lung cancer, especially those with a history of smoking." In fact, Ganti questioned whether hormone therapy should be used at all. "These results, along with the findings showing no protection against coronary heart disease, seriously question whether hormone-replacement therapy has any role in medicine today," he wrote. "It is difficult to presume that the benefits of routine use of such therapy for menopausal symptoms outweigh the increased risks of mortality, especially in the absence of improvement in the quality of life." The study, which appears online and in an upcoming print issue of The Lancet, was released Sept. 19 to coincide with the European Cancer Organization meeting.More information The U.S. National Institute on Aging has more on hormones and menopause. --Robert Preidt SOURCE: The Lancet, news release, Sept. 19, 2009 Hormone Therapy for Prostate Cancer Raises Heart Risks: Treatment methods should take into account side effects, researchers say "We found that prostate cancer patients treated with hormone therapy had an elevated risk of developing all of the individual types of heart problems and that they were more likely than normal to die from those causes," said Mieke Van Hemelrijck. "In a more detailed analysis by type of hormone therapy, the lowest increase in risk for ischemic heart disease, heart attack and heart failure was seen in the group taking anti-androgen therapy, and we saw no increase in risk of death from heart disease in this group. Patients on gonadotropin-releasing hormone agonist therapy had the highest risk of these problems," Van Hemelrijck said. The findings suggest that physicians should consider heart-related side effects when prescribing hormone therapy for prostate cancer patients and may want to refer patients to a cardiologist before the start of hormone therapy.... Hormone Therapy for Prostate Cancer Raises Heart Risks: Treatment methods should take into account side effects, researchers say 　 TUESDAY, Sept. 22 (HealthDay News) -- Hormone therapy to treat advanced prostate cancer can increase the risk of heart disease, but some types of hormone therapy appear to be safer than others, new research has found. The study included 30,642 Swedish men with either locally advanced prostate cancer or prostate cancer that had spread (metastatic cancer), who had received hormone therapy as primary treatment for their cancer. The study findings were scheduled to be presented Tuesday at the European Cancer Organization meeting in Berlin. In a news release from the European Cancer Organization, the researchers described the types of hormone therapy used: removal of the testicles to eliminate the main source of testosterone production; injections of gonadotropin-releasing hormone agonists to reduce testosterone production by the testicles; and anti-androgen pills that block testosterone from attaching to prostate cells. Most of the patients received one treatment, but 38 percent were given two types of drugs, the study authors noted. The men were followed for an average of three years and monitored for ischemic heart disease, heart attacks, arrhythmia, and heart failure. "We found that prostate cancer patients treated with hormone therapy had an elevated risk of developing all of the individual types of heart problems and that they were more likely than normal to die from those causes," study lead author Mieke Van Hemelrijck, a cancer epidemiologist at King's College in London, England, said in the news release. Specifically, hormone therapy was associated with a 24 percent increased risk of heart attack, a 19 percent increased risk of arrhythmia, a 31 percent increased risk of ischemic heart disease, and a 26 percent increased risk of heart failure, the researchers found. The increased risk of heart disease began a few months after the men began hormone therapy. The study also found that hormone therapy was associated with a 28 percent increased risk of fatal heart attack, a 21 percent increased risk of dying from heart disease, a 26 percent increased risk of death from heart failure, and a 5 percent increased risk of fatal arrhythmia. "In a more detailed analysis by type of hormone therapy, the lowest increase in risk for ischemic heart disease, heart attack and heart failure was seen in the group taking anti-androgen therapy, and we saw no increase in risk of death from heart disease in this group. Patients on gonadotropin-releasing hormone agonist therapy had the highest risk of these problems," Van Hemelrijck said. The findings suggest that physicians should consider heart-related side effects when prescribing hormone therapy for prostate cancer patients and may want to refer patients to a cardiologist before the start of hormone therapy, the researchers stated.More information The American Urological Association Foundation has more about hormone therapy for prostate cancer. -- Robert Preidt SOURCE: European Cancer Organization, news release, Sept. 22, 2009 Could Swine Flu Panic Be Worse Than Outbreak Itself?: With infections typically causing only mild illness, experts point to exaggerated fears as the real threat "We have limited resources in the U.S. -- if this [swine flu] captures our negative imagination, it's going to hurt our health-care system," said Dr. Marc Siegel. "Our emergency rooms will be flooded with worried people, doctors' phones will be hanging off the hook, everyone will be afraid of every sniffle and wanting to get tested for the flu." Some examples of moves that many believe are stoking Americans' flu fears this season: Numbers out of context: nearly 600 Americans have died from H1N1 swine flu. That sounds like a scary number, until you realize that the "regular" seasonal flu kills about 36,000 Americans each year; Dramatic moves by public health officials: The widespread U.S. school closings ordered when H1N1 flu first surfaced in the spring can incite societal fear. Could Swine Flu Panic Be Worse Than Outbreak Itself?: With infections typically causing only mild illness, experts point to exaggerated fears as the real threat By Amanda Gardner: HealthDay Reporter TUESDAY, Sept. 22 (HealthDay News) -- With all the warnings and preparations, dire predictions and hastily ordered vaccines, could the growing worry about H1N1 swine flu prove more disruptive than the actual outbreak? That notion is weighing on the minds of more than a few infectious-disease experts as the fall and winter flu season looms. Not only does societal panic not help during a public health situation, such as the current H1N1 flu pandemic, it can actually backfire, creating its own set of problems, the experts said. "We have limited resources in the U.S. -- if this [swine flu] captures our negative imagination, it's going to hurt our health-care system," said Dr. Marc Siegel, associate professor of medicine at New York University School of Medicine in New York City. "Our emergency rooms will be flooded with worried people, doctors' phones will be hanging off the hook, everyone will be afraid of every sniffle and wanting to get tested for the flu." Some examples of moves that many believe are stoking Americans' flu fears this season: � Numbers out of context. The U.S. Centers for Disease Control and Prevention reports that nearly 600 Americans have died from H1N1 swine flu, which now comprises 97 percent of new U.S. influenza infections. That sounds like a scary number, until you realize that the "regular" seasonal flu kills about 36,000 Americans each year.� Dramatic moves by public health officials. The widespread U.S. school closings ordered when H1N1 flu first surfaced in the spring can incite societal fear. While well-intentioned, this type of public health initiative tends to focus on a worst-case scenario and can be "alarmist" and "overly restrictive," according to a study on H1N1 panic appearing Sept. 3 in the British Medical Journal (BMJ). Simplistic, emotional media headlines can also stoke outsized fears, creating "irrational behavior," said Joshua Klapow, associate professor at the University of Alabama at Birmingham School of Public Health and a member of the CDC-funded South Central Center for Public Health Preparedness. Americans have been here before, the experts noted. There were the post-9/11 anthrax attacks, fueling the public's fear that terrorists would unleash deadly smallpox germs on the population. "People were stockpiling antibiotics. It didn't really result in a shortage, but it could have," said Dr. Dean Blumberg, associate professor of pediatric infectious diseases at the University of California, Davis Children's Hospital. A rush for flu drugs has its own dangers, Blumberg said, because "people stockpiling Tamiflu or taking it inappropriately for the current swine flu might create [viral] resistance so the drug might not work well when we really need it." Doomsday scenarios typically do not materialize, fortunately. Hysteria over the possible Y2K computer meltdown fizzled after the machines came through Jan. 1, 2000, relatively unscathed. And headlines over West Nile virus, SARS, Ebola virus and the bird flu have all faded, at least for now. Often in a period of perceived crisis, people focus only on the benefit of certain precautionary measures, not the possible risks, Blumberg noted. The dangers of that approach were revealed in 1976 during the last H1N1 outbreak, when a federal government decision to vaccinate 43 million people against a different swine flu strain backfired. Not only did the dreaded outbreak never materialize (illness never spread beyond 240 soldiers stationed at Fort Dix, N.J.) but some 500 Americans who did get vaccinated came down with a rare neurodegenerative condition called Guillain-Barre syndrome, which many experts believe was linked to the shot. Twenty-five of those 500 people died. The current H1N1 outbreak remains far from a "worst-case scenario" with most illnesses still mild, even though they're widespread. However, according to the BMJ article, medical laboratories are already straining under the sheer number of specimens they're being asked to test -- many from patients who ordinarily wouldn't have even considered a flu test before. "Parents are calling pediatricians and demanding vaccine," added Dr. Geoffrey Weinberg, professor of pediatrics at the University of Rochester Medical Center in New York. "It's a burden on the offices because they're fielding so many phone calls." The reality: "The [H1N1] infection to date has appeared to be mostly modest and has not caused a huge number of hospitalizations," Dr. Geoffrey Weinberg said.More information Get the facts on H1N1 flu at the U.S. Centers for Disease Control and Prevention.Tips to Keep H1N1 Panic at Bay Joshua Klapow, a disaster mental health specialist at the University of Alabama at Birmingham, said a few simple steps can help you keep your head in the time of swine flu: � Get a reality check. "Remind yourself to gain perspective," Klapow said. "The headlines of death, the headlines of serious, serious illness are only the headlines and they are not balanced by the fact that the vast majority are not dying and are not getting severely ill." Visit the CDC Web site, as well as that of your local health department for more complete information. "This will give you a much more accurate picture of swine flu as it affects you," Klapow said� Act sensibly to cut your risk. That's as simple as washing your hands frequently, keeping your hands out of your nose, ears and mouth, and staying away from people who are sick. "This is incredibly powerful preventive medicine," Klapow said. "The best way to be safe is with this sort of basic public health practice."� Remember that fear is unhealthy. "All that anxiety does is weaken your immune system, which puts you at greater risk for catching this virus or any other virus," Klapow said. "Getting a grip is critical -- not just so you feel better emotionally but it will increase the chance that you ward this off." SOURCES: Dean Blumberg, M.D., associate professor, pediatric infectious diseases, UC Davis, Children's Hospital; Geoffrey Weinberg, M.D., professor, pediatrics, University of Rochester Medical Center; Marc Siegel, M.D., associate professor of medicine, New York University School of Medicine, New York City and author, Swine Flu: The New Pandemic; Joshua Klapow, Ph.D., certified disaster mental health specialist, associate professor, University of Alabama at Birmingham School of Public Health and faculty member, South Central Center for Public Health Preparedness; Sept. 3, 2009, British Medical Journal With Alcohol, Starting Young May Lead to Dependency: Study suggests teens who drink could trigger genetic predisposition Teens who start drinking before age 15 could jump-start any genetic conditions they might have that predispose them to developing alcohol dependency, according to an Australian study. From a biological perspective, taking that first drink at a young age "may induce changes in the highly sensitive adolescent brain, which may also modify an individual's subsequent genetic vulnerability to [alcohol dependence]," said Arpana Agrawa. The younger people were when they had their first drink, especially if that occurred before age 15, the more symptoms of alcohol dependency they developed, the study found. Early drinkers also tended to have an increased genetic vulnerability for alcohol. Agrawal said the findings should be used to discourage young people from experimenting with drinking early because such behavior might trigger an onset of alcohol abuse. With Alcohol, Starting Young May Lead to Dependency: Study suggests teens who drink could trigger genetic predisposition   　 FRIDAY, Sept. 18 (HealthDay News) -- Teens who start drinking before age 15 could jump-start any genetic conditions they might have that predispose them to developing alcohol dependency, according to an Australian study. From a biological perspective, taking that first drink at a young age "may induce changes in the highly sensitive adolescent brain, which may also modify an individual's subsequent genetic vulnerability to [alcohol dependence]," Arpana Agrawal, an assistant professor of psychiatry at Washington University School of Medicine and an author of the study, said in a university news release. The findings, published online Sept. 18 and in the December print issue of Alcoholism: Clinical & Experimental Research, are based on a study of 6,257 adult twins. The younger people were when they had their first drink, especially if that occurred before age 15, the more symptoms of alcohol dependency they developed, the study found. Early drinkers also tended to have an increased genetic vulnerability for alcohol. Those who had their first drink later in life showed far fewer signs of alcohol dependency, despite the genetic predisposition, Agrawal noted. This suggests that alcohol dependency among those who started drinking later, "while less common, are attributable to unique experiences of those individuals -- for example, a traumatic life event," she said. Carol A. Prescott, a professor of psychology at the University of Southern California, said the findings had two possible conclusions. "Early drinking changes the course an individual is on, and is thus a direct cause of increased [alcohol dependency] risk, and early drinking is correlated with [alcohol dependency] risk and is thus an indirect indicator of ... risk," she said in the news release. Agrawal said the findings should be used to discourage young people from experimenting with drinking early because such behavior might trigger an onset of alcohol abuse. The researchers plan to do a similar study that looks at older and younger groups in Australia and the United States to try to duplicate their findings.More information The U.S. National Institute on Alcohol Abuse and Alcoholism has suggestions on talking to kids about alcohol. -- Kevin McKeever SOURCE: Alcoholism: Clinical & Experimental Research, news release, Sept. 18, 2009 Lower Drinking Age Linked to Later-Life Problems: Study finds more alcohol, drug abuse among those who could drink before 21 People who grew up in a place and time when they could legally buy alcohol before age 21 are more likely than others