Monday, February 9, 2009

Multivitamins Not Found to Reduce Risk of Cancer or Cardiovascular Disease

Many postmenopausal women take multivitamins in the belief that they help prevent cardiovascular disease or cancer, but a large study has found that they do neither.

Previous studies have had mixed results, some suggesting that multivitamin supplements are associated with a reduced risk for some cancers, others finding little or no effect.

For the new findings, published in the February issue of The Archives of Internal Medicine, researchers analyzed data from 68,132 women who were enrolled in a clinical trial and 93,676 in an observational study. They followed the women for an average of about eight years to track the health effects of multivitamins.

After controlling for age, physical activity, family history of cancer and many other factors, the researchers found that the supplements had no effect on the risk for breast cancer, colorectal cancer, endometrial cancer, lung cancer, ovarian cancer, heart attack, stroke, blood clots or mortality.

The scientists acknowledge that women who take vitamins also engage in other healthy behaviors, and that there may be unknown variables affecting their results.

“Consumers spend money on dietary supplements with the thought that they are going to improve their health, but there’s no evidence for this,” said Marian L. Neuhouser, the lead author and a nutritional epidemiologist with the Fred Hutchinson Cancer Research Center in Seattle. “Buying more fruits and vegetables might be a better choice.”

source: nytimes.com

Pregnancy May Delay Treatment Of Breast Cancer

By Karla Gale
NEW YORK (Reuters Health) - When breast cancer develops during pregnancy, its diagnosis and treatment of are often delayed. As a result, the woman's long-term survival may be jeopardized, doctors at the University of Texas M. D. Anderson Cancer Center report.

"Pregnancy-associated breast cancer is the most frequent cancer associated with pregnancy," Dr. George H. Perkins told Reuters Health, but it is low on the list of possible diagnoses that most doctors consider.

Furthermore, pregnancy can mask symptoms of breast cancer, making it more difficult to recognize, he noted.

The team identified all the cases of breast cancer associated with pregnancy that were treated at their institution between 1973 and 2006; 51 developed during pregnancy while 53 occurred within a year after pregnancy.

Women with pregnancy-associated breast cancer had more advanced tumors than similar young women who were not pregnant, indicating delayed diagnosis. Nevertheless, outcomes were similar in the two groups, the researchers report in the medical journal Cancer.

That's probably because most women were given a course of chemotherapy before undergoing surgery, Perkins said.

Among the 51 women who developed breast cancer during pregnancy, 25 received no treatment until after delivery. There was a trend toward worse 10-year survival rates with deferred treatment compared with treatment during pregnancy.

In addition to timely treatment, the research team also urges thorough diagnostic evaluation of breast symptoms that occur during pregnancy, using ultrasound or, with proper shielding of the fetus, mammography.

Thursday, February 5, 2009

6 Things You Need to Know About Pancreatic Cancer

Supreme Court Justice Ruth Bader Ginsburg is being treated for pancreatic cancer, but doctors reportedly caught the small tumor early, which may improve her odds of surviving the usually deadly disease. Pancreatic cancer is relatively rare, but in the past few years, it has gotten more attention because it has afflicted actor Patrick Swayze and Apple CEO Steven Jobs. Here are some facts you need to know:

1. Pancreatic cancer is not a particularly common form of cancer.
Despite the high-profile cases, fewer than 38,000 people were diagnosed with the disease last year, compared with more than 215,000 cases of lung cancer and almost 185,000 of breast cancer, according to the National Cancer Institute.

2. It is, however, extremely deadly.
For all stages of the disease combined, about 20 percent of patients will be alive a year after being diagnosed, and fewer than 4 percent of patients will be alive after five years, according to the American Cancer Society. But as with most cancers, early detection improves survival; those diagnosed with the earliest form of the disease have a five-year survival rate (excluding deaths from other causes) of more than 35 percent.

3. Early detection is tough because symptoms are so vague.
There may be no symptoms at all in the earliest stages, says the NCI. But the following symptoms may indicate a problem: pain in the upper abdomen or back, loss of appetite and/or weight loss, nausea and vomiting, jaundice, and weakness; those symptoms can also indicate a host of common medical problems, so don't panic. (Ginsburg, a colon cancer survivor, underwent CT scanning during an annual checkup, which turned up the pancreatic tumor.) The difficulty of early detection is one reason the disease in its most common form is so deadly, says Gauri Varadhachary, a medical oncologist specializing in pancreatic cancer at the M.D. Anderson Cancer Center in Houston. Other factors: It tends to metastasize elsewhere in the body very early on, and it's resistant to chemotherapy and radiation.

4. Like other cancers, it's not one disease.
There are different forms of pancreatic cancer. Jobs, for example, had what's called a neuroendocrine, or islet cell, tumor. These are very rare but also slower-growing, with a better prognosis. The most common kind is called an adenocarcinoma. We don't yet know what type Ginsburg has.

5. Some people are more at risk than others.
According to the NCI, there are seven known risk factors for pancreatic cancer: being older (as with most cancers, age puts people at risk), smoking or past smoking, having diabetes, being male, being African-American, having a family history of the cancer, and having chronic pancreatitis. Obesity and diet may also be risk factors, as might exposure to certain chemicals. But many cases arise in people with none of those factors, says Varadhachary. While there's no current screening test, trials are underway to see if endoscopy and ultrasound might make a difference in high-risk people.

6. Certain hereditary genetic mutations put people at risk.
Those with a mutation in the BRCA1 and BRCA2 genes, known for their role in breast and ovarian cancer (including breast cancer in men), are also at higher risk of pancreatic cancer. Researchers are also looking at other genes that may influence pancreatic cancer, as well as other, nonhereditary mutations.

source: usnews.com

Health Advocates React To Hospice Medicaid Cuts

S.C. Lawmakers Cut Medicaid Hospice Benefits From Budget

GREENVILLE, S.C. -- The hospice mission is to serve all, regardless of ability to pay -- but that may become a bigger challenge to fulfill for hospice groups statewide.

In efforts to save money, South Carolina state lawmakers decided to cut Medicaid hospice benefits -- a move that will force dying patients to fend for themselves.

Home care is just one of the many daily services hospice provides. But after February 28, Flora Ann Brown and others who are terminally ill will no longer have hospice benefits through Medicaid.

"What will happen to them if Medicaid is taken out?" said Brown's guardian, Elaine Burdette. "Will some lose their lives, have shorter lives, because they are not getting the care they need?"

The Department of Health and Human Services was forced to cut $137 million last year. By cutting Medicaid hospice benefits, it's expected to save nearly $16 million.

"These are people if we were not involved with them they would probably end up in emergency rooms or ICUs, because they wouldn't have the care needed in their home," said Pam Melbourne, president of the Hospice of the Upstate.

Melbourne said Medicaid pays an average of $130 a day per patient for hospice care. If those same patients went to the hospital for care, Medicaid would pay $1,300 a day.

"You're not eliminating the cost, just transferring it somewhere else," Melbourne said.

"It's hard knowing there are people out there who need our service, want our service, but have to make a decision whether or not to take our services," said registered nurse Christie Dove, of the Hospice of the Upstate.

There is a resolution calling on the state to stop the Medicaid cuts. The measure passed unanimously in the House, and is now in a senate committee.

Copyright 2009 by WYFF4.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed

Fertility Drugs and Ovarian Cancer Not Linked, Study Says

One of the largest studies to explore whether fertility drugs increase a woman’s risk of ovarian cancer found “no convincing association” with the cancer, though researchers said they would continue to follow tens of thousands of Danish women to see if their risk increased with age.

The generally reassuring results were consistent with several other recent studies, which have tempered an initial panic set off in the 1990s when reports suggested that the widely used fertility drugs might lead to a surge in a cancer that is relatively uncommon but often fatal.

The new study, published online Thursday in the British Medical Journal, did not rule out a cancer link altogether. It suggested that the risk of one form of ovarian cancer may be elevated after use of the popular drug clomiphene (brand name Clomid), though researchers said the finding could have been a statistical aberration.

“The message to give clinicians and patients is that over all these data provide further evidence that fertility drugs do not increase the risk of ovarian cancer to any great extent,” said Allan Jensen, an assistant professor of cancer epidemiology at the Danish Cancer Society and the first author of the paper. The senior author was Susanne Krüger Kjaer.

Dr. Jensen added, “You should always balance a possible small increase in ovarian cancer risk with the physical and psychological benefits of pregnancy made possible only by use of these drugs.”

As part of the study, the researchers followed 54,362 women who had been referred to Denmark’s fertility clinics between 1963 and 1998. They gathered information about the women from Denmark’s birth, cancer and hospital discharge registries, seeking more detailed information on medications from individual medical records of a subgroup of 1,241 of the women.

Among the 54,362 infertile patients followed for an average of 15 years, there were 156 cases of ovarian cancer. The average age of the women by the end of the study was 47.

Medical records were used to analyze the relative incidence of ovarian cancer in women who had taken either gonadotropins, clomifene citrate, human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone, compared with ovarian cancer rates of women who had not taken each of the individual drugs (but may have been treated with one of the other medications).

After adjusting for risk factors, the researchers concluded there was no increase in ovarian cancer risk associated with the drugs, nor was there an increased risk for women who underwent 10 or more cycles of treatment or for women who never became pregnant despite treatment.

The only statistically significant increase was seen in an analysis looking at different types of ovarian cancer tumors; in that analysis, women who had taken clomiphene citrate had a 67 percent increase in serous ovarian cancer tumors.

A separate analysis comparing women who had used a fertility drug with women who had not used any of the drugs also found no significant differences, Dr. Jensen said, but those figures were not included in the paper. There was also no difference in risk for women who had used a combination of fertility drugs.

The research in this area is complicated by the fact that infertile women appear to be at higher risk for ovarian cancer to begin with, which is why this study compared infertile women with one another rather than with other women in the population. In addition, because ovarian cancer is quite rare, large populations must be studied to obtain meaningful results.

The scientists cautioned that the women in the study would have to be followed for many more years to see if their risk increased over time. The mean age for diagnosis of ovarian cancer in women is 63.

“This is the largest study to look at ovarian cancer and they’re right, it’s a major strength of the study,” said Louise Brinton, the chief of the National Cancer Institute’s hormonal and reproductive epidemiology branch, adding that she was surprised the authors played down the finding of an association between Clomid and serous ovarian cancer, which may be more influenced by hormonal factors than some other tumors. Clomid is one of the older drugs in use.

Dr. Roberta Ness, dean of the University of Texas School of Public Health and the author of an earlier analysis that found no association between the drugs and cancer, said that finding might have been an aberration. “When you’re doing multiple analyses and splitting this way, that way and the other, the likelihood this is just a spurious finding is greater than the likelihood it’s real.”

source: nytimes.com

Tuesday, February 3, 2009

Why Soy Is NOT a Health Food



Review of the health problems with soy and why it is not the health food you were led to believe it is.

Coffee Drinkers Show Lower Dementia Risk

By Amy Norton
NEW YORK (Reuters Health) - In more good news for coffee lovers, a new study suggests that middle-aged adults who regularly drink a cup of java may have a lower risk of developing dementia later in life.

Whether coffee itself deserves the credit is not yet clear, but researchers say the findings at least suggest that coffee drinkers can enjoy that morning cup "in good conscience."

The study found that among 1,400 Finnish adults followed for 20 years, those who drank three to five cups of coffee per day in middle-age were two-thirds less likely than non-drinkers to develop dementia, including Alzheimer's disease.

The findings, reported in the Journal of Alzheimer's Disease, add to a string of studies finding that coffee drinkers have lower risks of several diseases, including Parkinson's disease, certain cancers and diabetes.

No one is recommending that people start drinking coffee to ward off any disease, however. Researchers do not know if it's components of coffee itself -- like caffeine or certain antioxidants -- or something else about coffee drinkers that explains the recent study observations.

The current study was an epidemiological one, explained lead researcher Marjo H. Eskelinen, which means it can point to an association between coffee and dementia risk, but does not prove cause-and-effect.

Still, "the results open a possibility that dietary interventions could modify the risk of dementia," Eskelinen, a doctoral candidate at the University of Kuopio in Finland, told Reuters Health.

There are a few potential reasons why coffee could help stave off dementia, researchers point out. One reason is related to the fact that coffee drinkers may have a lower risk of type 2 diabetes, and diabetes, in turn, is linked to a higher risk of dementia.

Coffee also contains plant chemicals, such as chlorogenic acid, that act as antioxidants and may help protect body cells from damage over time. For its part, caffeine may have a protective effect on brain cells because it blocks receptors for a chemical called adenosine, which has depressant effects in the central nervous system.

More research is needed to determine whether coffee is truly protective, but for now, Eskelinen said, "those people who have been drinking coffee can still do so in good conscience."

SOURCE: Journal of Alzheimer's Disease, January 2009.

Heart Test Can Pack Radioactive Wallop

Having a CT scan of the heart to check for heart disease? You may want to ask how your hospital plans to conduct the test. A new study suggests that people who get the common heart test can get a dramatic range of radiation exposures.

In the study of 1,965 patients undergoing the CT scans (also known as cardiac CT angiography), the median exposure was roughly equivalent to 600 chest X-rays, or about 12 milliSievert (mSv) of radiation, according to the report in this week's issue of the Journal of the American Medical Association.

Traditional angiography -- a technique in which a catheter is snaked though a blood vessel and dye is injected near the heart -- exposes patients to roughly half the dose of CT angiography, or about 5--8 mSv, says study author Jorg Hausleiter, M.D., of the University of Munich in Germany. It's also about the same amount of radiation as other standard cardiac screenings, such as the nuclear stress test.

There was a wide range of exposures in the study depending on the medical center and the way the tests were performed. The median radiation dose ranged from 4.6 to 30 mSv. About 80 percent of the centers studied used techniques to reduce radiation, such as adjusting the CT scan to the patient's size (meaning smaller patients get less radiation) or precisely timing the radiation dose to a particular point in the heart rhythm (which shortens the duration of exposure).

Overall, the danger posed by radiation is very small, according to Hausleiter. Being exposed to 10 mSv increases an individual's cancer risk by 0.02 percent, he says. However, the greater the exposure to radiation, the greater the risk.

Nearly all of the 50 sites in the international study, which included sites in the U.S., Canada, Europe, Asia, the Middle East, and Latin America, were making at least some effort to limit excess radiation. Other medical centers may be doing even less to cut down on radiation during the test, says Andrew J. Einstein, M.D., Ph.D., of Columbia University Medical Center, who wrote an editorial accompanying the study.

"Probably the group of centers which were studied in this paper are more sophisticated and more aware of radiation-reduction methods than your typical center that is performing cardiac CT angiography," he says. According to Einstein, many other sites may not be using radiation-reduction techniques at all.

When cardiac CT angiography is being used appropriately -- meaning, for example, in people with chest pain suggesting blocked heart arteries, rather than as a screening test for people with no symptoms of heart disease -- the benefits far outweigh the risk of the radiation, according to Einstein and Hausleiter.

However, cardiac CT scans are often marketed directly to patients interested in finding out how much plaque they have in their arteries, even though there's no evidence to show that this is an appropriate way to use the test, Hausleiter says. Health.com: 28 days, 28 ways to slash your risk of heart disease

Critics of cardiac CT angiography question whether its benefits warrant its current widespread use and the amount of radiation exposure. In fact, on Monday the American Heart Association issued an advisory warning that imaging tests, including CT scans, be used cautiously to minimize exposure to radiation.

In the new study, Hausleiter and his colleagues looked at patients who underwent cardiac CT angiography at 21 university hospitals and 29 community hospitals between February and December 2007. They found some regional differences in radiation exposure; for example, the median dose was three times higher in South America and Latin America than in Canada and the United States.

More than 70 percent of the centers in the study were using electrocardiographically controlled tube current modulation (ECTCM), which is currently the best-known strategy for reducing radiation dose. It involves timing the radiation beam to the diastole, when the heart is resting between beats. This is when the heart is the quietest, so it's easiest to get a good image of the organ.

Another strategy involves using less energy (100 kV instead of the standard 120 kV), which is effective but useful only for patients who are not obese. Finally, sequential scans take a series of pictures of the heart at the same exact point in the cardiac cycle, which also reduces radiation dose. This approach, as well as ECTCM, can be used only in people with slow, steady heartbeats. Another problem, Einstein noted, is that doctors often don't know what a patient's heart rate will be until he or she is on the table being readied for the scan.

But the fact that centers were able to use at least one radiation-reduction technique in most patients "should serve as a wake-up call to cardiac CT laboratories that do not routinely use these methods," Einstein writes in his editorial.

Patients who undergo cardiac CT angiography are within their rights to ask about what strategies, if any, are being used to reduce radiation dosage, he said.

"I would not recommend anyone to have this test done without discussing it with their doctor first. It's not something patients should be initiating on their own," he adds.

Caution is warranted not only due to the radiation exposure, according to Einstein, but also because the dye that must be injected into the veins to perform the test can cause kidney damage in some people. While a person's doctor would be able to judge if he or she would be harmed by the dye and thus shouldn't have the test, he said, "there are some sites that would be willing to perform this test on anyone."

David J. Brenner, Ph.D., D.Sc., of Columbia University's Center for Radiological Research was not involved in the current study, but he coauthored a 2007 report warning that overuse of CT scans could contribute to excess cancer risks. He said that such CT scans are still controversial.

New technology can decrease the radiation dose from cardiac CT scans, but as this study shows, "It's very variable from institution to institution -- in part because there is no regulatory body making sure that there is some degree of quality control," says Brenner

source: edition.cnn.com

Study Spotlights Helicopter Dangers

WASHINGTON -- Emergency medical helicopter pilots had the most dangerous jobs in the U.S., racking up fatalities at a faster clip than loggers and other historically risky professions, according to a new study presented to federal air-crash investigators.

In addition to sobering statistics about the hazards of such medical chopper flights for patients as well as pilots, testimony at a National Transportation Safety Board hearing Tuesday illustrated the drawbacks of relying on voluntary industry efforts to improve safety.

Comparing 13 medical helicopter crashes that claimed 29 lives in 2008 with federal fatality rates for many other accident-prone professions, Dr. Ira Blumen, of the University of Chicago Hospitals, concluded that statistically the pilots "far exceed any of the high-risk occupations."

At least 180 people have been killed or seriously injured in U.S. medical helicopter crashes over past decade, with 2008 ending up as the most deadly year ever. Against this backdrop, the safety board is prodding regulators to require helicopter operators to install devices that can warn pilots of impending collisions with the ground, as well as digital flight-data recorders that are better able to record what occurred in the event of a crash.

During the first of four days of hearings this week, the safety board also began examining how powerful economic forces -- ranging from consolidation to how much the government will reimburse operators -- affect safety margins.

Almost half of the world's roughly 26,000 choppers fly in the U.S. One industry representative testified that it's time for operators to become more aggressive in pursuing safety goals and embracing federal mandates.

"We have to, in essence, change the way we do business," said Matthew Zuccaro, president of Helicopter Association International. He said helicopter operators must pay more attention to flight planning, adverse weather hazards and ways to retrofit the existing fleet with advanced safety equipment.

At the same time, the Federal Aviation Administration released updated figures about the results of its years-long campaign to promote voluntary industry compliance.

An FAA spokesman told reporters that so far roughly 40% of U.S. helicopters have been voluntary outfitted with collision-avoidance systems, and only about 11% have recorders. Testimony by a Canadian helicopter official offered a stark contrast to the U.S. experience.

Sylvain Seguin, vice president of Canadian Helicopters, the largest medical chopper organization in Canada, described extensive safety programs that have allowed Canada to avoid a single fatality in this segment since the 1970s. Mr. Seguin emphasized that Canadian medical choppers have two-pilot crews as opposed to many single-pilot flights in the U.S. Funded and regulated strictly by government, the craft are equipped with the latest safety devices. They are required to adhere to strict instrument-flight rules and safeguards in all cases.

Write to Andy Pasztor at andy.pasztor@wsj.com

Putting A Face On The Stem Cell Argument

By MARY SWIFT
SOMETIME SOON, perhaps even this week, President Barack Obama is expected to lift federal regulations on the use of embryonic stem cells in medical research.

With recently awarded FDA approval, a California biotech firm sits poised to begin the world's first human trial that will involve injecting embryonic stem cells into the spinal cords of people who are paralyzed.

The subject spurs heated debate. Advocates believe it will throw open the door to medicine's future. Opponents say it destroys life.

At the heart of the debate, but on the sidelines of the fight, Jacob Coffron, soon to turn 18, sits in a wheelchair and breathes with the help of a ventilator.

His is the human face of the argument for embryonic stem cell research.

At 15, he fell while climbing over a fence outside his mother's Des Moines apartment.

He hasn't breathed on his own since. A month at Harborview was followed by four months at Seattle Children's, then he came home.

His mom, Amy Garnett, cares for him during the day. An aide comes in at night. Twice a week, he goes to Redmond's Pushing Boundaries, an organization that offers exercise therapy for victims of spinal cord injury.

Time has transformed him from a young teen into a near-man. He is husky and has the beginnings of a beard.

Dressed in dark sweat pants, and a black and gray T-shirt decorated with the image of a wizard and a dragon, he sat in a wheelchair in his bedroom one recent morning with a black watch cap pulled down close to his eyes. For a time he sat covered by a comforter he has to ask to have removed.

"I get so cold sometimes that I can't get warm," said Coffron, who by nature is quiet, understated -- and given to a dry sense of humor that surfaces in one-liners.

He wears metal studs in his lips and metal wires in his ears.

A poster from "Lord of the Rings" and one of the Three Stooges decorate the walls. A collection of miniature dragons sits on one shelf. Across the room, wire baskets holding an assortment of medical supplies hang on the wall next to his bed where his 12-year-old brother Cole sprawls companionably.

A silver-colored basketball -- a gift from a friend -- serves as a bittersweet reminder of a former passion."What I miss most is basketball, just playing for fun," Coffron said.

He's planning on a tattoo when he turns 18 next month, dreams about someday living in his own apartment and smiles wryly when he's asked about his "good" days.

"A good day is when they're not yelling," he said, mounting a lighthearted jab at his mother and grandmother, Jane Coffron of Kent. They laughed.

He drew more laughter when asked what he liked to eat.

"A lot," he deadpanned, flashing a fleeting smile.

After his accident, Coffron went back to Mount Rainier High briefly but eventually dropped out. At his mother's urging, he's now talking about getting a tutor and working on his GED.

His father, Terry Hornbeck, lives nearby and has a knack for treating his son like a buddy, a gift not lost on his son, who calls him "more like a friend than a dad."

Struggling to understand why an act as innocent as climbing over a fence ended so badly, he said, "I still haven't found the answer."

Behind him, Jane Coffron dabbed at her eyes. That question -- and its unfathomable answer -- is still emotional for her.

But she is steadfast in her belief that embryonic stem cell research is the key to her grandson's future.

"With it, there's hope," she said. "This is the first time that someone with his type of injury can look forward and have real hope."

As discussion swirled around him, he listened without speaking, his expression set.

Coffron's not about to kiss off hope. But right now he's busy coping with the present -- not politics.

"I don't know," he said softly when he spoke again. "I just take one day at a time."

P-I columnist Mary Swift can be reached at 206-909-9612 or swiftyk@netscape.com.
source: seattlepi.nwsource.com

Monday, February 2, 2009

Have A Heart For Women's Health

Many women who need to hear this message the most aren't getting it: Heart disease is the No. 1 killer of women.

Nationally, only 28 percent of African-American women and 24 percent of Hispanic women understand this reality, said Elizabeth Cisco, a member of the board of the American Heart Association's Midwest Affiliate. The comparable figure for all women is 57 percent, according to association data.

Cisco hopes the association's annual Go Red for Women campaign (www.goredforwomen.org) during February will increase awareness.

"I lose sleep thinking about the fact that the audience we need to be communicating to has a higher rate of heart disease. We have a lot of work to do to educate all women," said Cisco, system marketing executive at St. Vincent Health.

On National Wear Red Day on Friday, everyone is encouraged to wear red -- symbolizing the fight against heart disease. During the Love Your Heart Casting Call from 11 a.m. to 2 p.m. at the Indianapolis Artsgarden, above the intersection of Washington and Illinois streets, women who have improved their health can apply to star in local, possibly national, promotions to inspire other women.

Another event is the annual Go Red for Women Luncheon Feb. 20 at the Downtown Marriott, presented by St. Vincent Heart Center of Indiana. For information, call (317) 873-3640.

While one in 30 women will die of breast cancer, one in three will die of heart disease, said Cisco. "Women are taught to think a lot about the outside of our chest, with respect to breast cancer, but we also need to be thinking about the inside of our chests."

U.S. Study: Insulin Possible New Treatment For Alzheimer's Disease

WASHINGTON, Feb. 2 (Xinhua) -- A Northwestern University-led research team reports that insulin, by shielding memory-forming synapses from harm, may slow or prevent the damage and memory loss caused by toxic proteins in Alzheimer's disease.

The findings, which provide additional new evidence that Alzheimer's could be due to a novel third form of diabetes, was published Monday in the online edition of the Proceedings of the National Academy of Sciences.

In a study of neurons taken from the hippocampus, one of the brain's crucial memory centers, the scientists treated cells with insulin and the insulin-sensitizing drug rosiglitazone, which has been used to treat type 2 diabetes. (Isolated hippocampal cells are used by scientists to study memory chemistry; the cells are susceptible to damage caused by ADDLs, toxic proteins that build up in persons with Alzheimer's disease.)

The researchers discovered that damage to neurons exposed to ADDLs was blocked by insulin, which kept ADDLs from attaching to the cells. They also found that protection by low levels of insulin was enhanced by rosiglitazone.

ADDLs, short for "amyloid beta-derived diffusible ligands," are known to attack memory-forming synapses. After ADDL binding, synapses lose their capacity to respond to incoming information, resulting in memory loss.

The protective mechanism of insulin works through a series of steps by ultimately reducing the actual number of ADDL binding sites, which in turn results in a marked reduction of ADDL attachment to synapses, the researchers report.

"Therapeutics designed to increase insulin sensitivity in the brain could provide new avenues for treating Alzheimer's disease," said senior author William L. Klein, a researcher in North western's Cognitive Neurology and Alzheimer's Disease Center." Sensitivity to insulin can decline with aging, which presents a novel risk factor for Alzheimer's disease. Our results demonstrate that bolstering insulin signaling can protect neurons from harm."

Kids Most In Need Least Likely To Take Vitamins

By Megan Rauscher
NEW YORK (Reuters Health) - Children and teenagers who face the greatest risk of nutritional deficiencies tend to use vitamin and mineral supplements the least, researchers reported Monday.

Among 10,828 US children ages 2 to 17 years old who participated in the 1999 to 2004 United States National Health and Nutrition Examination Survey, roughly 34 percent had used vitamin and mineral supplements in the past month.

"We hypothesized," Dr. Ulfat Shaikh told Reuters Health, "that children who had poor diets (low vegetable intake, low milk intake, high fat intake, low fiber intake), faced food insecurity, had less physical activity and poor access to health care, would use such supplements more."

"What we found was for the most part the opposite of what we expected," said Shaikh from University of California Davis School of Medicine, Sacramento.

"Other than children who were underweight (we did expect these children to use more vitamin and mineral supplements and found this to be true from the data), children who used vitamin and mineral supplements were for the most part healthier, had more nutritious diets, greater physical activity, lower sedentary activity, lower obesity, lower food insecurity and better health care access," Shaikh noted.

"Their parents additionally reported them to be in better health than children who did not use such supplements."

The American Academy of Pediatrics does not recommend vitamin and mineral supplements for healthy children older than 1 year who consume a varied diet, Shaikh and colleagues note in a report in the Archives of Pediatrics and Adolescent Medicine.

"Our data," Shaikh warned, "indicate that families with children who may benefit from these supplements appear to have limited resources and competing financial demands that prevent them from using them."

SOURCE: Archives of Pediatrics and Adolescent Medicine, February 2009.

PostPartum Depression Often Revealed in Blood Test

Many a new mother suffers the ravages of postpartum depression just when her new baby demands the most attention. Until recently, there’s been little physical evidence to determine which mothers are most at risk of developing this debilitating condition but doctors at the University of California, Irvine, have just reported their finding that a simple blood test, taken during pregnancy, does indeed provide clinical evidence of impending depression and it does so in time to begin intervention strategies before symptoms begin.

Assistant psychology professor Ilona S. Yim led a research team through a study of placental corticotropin-releasing hormone (pCRH) and any potential link with postpartum pregnancy. Their success rate in identifying new mothers who would later develop postpartum depression was 75%.

Yim’s team worked with 100 women at various stages of pregnancy. They tested the study participants’ blood for pCRH and each woman was assessed for symptoms of depression. The psychological evaluations were conducted during pregnancy and again about eight weeks after delivery, a time when postpartum depression typically begins.

Sixteen of the study participants did develop postpartum depression and each one had high levels of pCRH in her bloodstream at the 25th week of pregnancy. Using blood testing for pCRH alone revealed a 75% accuracy rate but adding the psychological evaluations to the blood testing proved even more accurate.

About 13% of all new mothers develop postpartum depression. The condition makes it difficult for the woman to cope with everyday issues but her new baby and all other family members suffer as well. Children can develop problems with cognition, behavior, and social issues when a parent is depressed.

A lingering complication of postpartum depression is that the disorder is likely to return in the future. When mothers are at particular risk, intervention can begin before symptoms start appearing and, in many cases, they can ward off the condition before it develops.

Yim suggests stress reduction measures, such as yoga, for mothers at risk. She says women who already have a history of depression are at greater risk of postpartum depression, as are women who’ve experienced stressful events in life, have a weak social support system, and who suffer from low self-esteem. When a woman experiences anxiety, depression, or stress during pregnancy, her risk of postpartum depression increases.

The February issue of the journal, ‘Archives of General Psychiatry,’ carries Yim’s full report.

Peanut Product Recall Took Company Approval

WASHINGTON — Even though federal health officials have begun a criminal investigation into whether the Peanut Corporation of America deliberately sold contaminated products, the government still needed the company’s permission last week before announcing a huge recall of its products.

The wording of the recall statement had to be approved by the company before the Food and Drug Administration could publish it under current rules. The agency relies on cooperation from food makers to ensure the safety of the food supply even when those makers are suspected of crimes.

Some Democrats in Congress have vowed to change this by giving the F.D.A. more authority, and the agency’s critics say it is too timid with the power it has.

On Monday, President Obama promised a “complete review of F.D.A. operations.”

“I think that the F.D.A. has not been able to catch some of these things as quickly as I expect them to catch,” Mr. Obama said in an interview on the “Today” show.

The president said Americans should be able to count on the government to keep children, including his daughter, Sasha, 7, safe when they eat peanut butter.

“That’s what Sasha eats for lunch probably three times a week,” Mr. Obama said. “And, you know, I don’t want to have to worry about whether she’s going to get sick as a consequence to having her lunch.”

The White House press secretary, Robert Gibbs, said Friday that Mr. Obama would soon announce a new F.D.A. commissioner and other officials. Mr. Gibbs said they would put in place a “stricter regulatory structure” to prevent breakdowns in food-safety inspections.

Part of the review is sure to examine whether the requirement for the peanut company’s approval caused delays in warnings about its products once public health officials became aware of significant problems at its plant in Blakely, Ga. The warning also covered products from the company’s customers that manufacture food, including Kellogg.

A representative for the peanut company would not comment. Kris Charles, a Kellogg spokeswoman, said “Kellogg acted quickly and recalled potentially impacted products within hours” of the peanut company’s second recall announcement.

Judy Leon, an F.D.A. spokeswoman, refused to comment.

More than 500 people have been sick in the outbreak of salmonella poisoning, and 8 have died. More than 430 product brands have been recalled.

The delays meant Sarah Kirchner of Belle Plaine, Minn., whose two young children became ill from the outbreak, for weeks had no idea how to prevent a recurrence. Her 3-year-old son, Michael, was hospitalized for four days with intense pain in his head, neck and shoulders, she said.

“He had a spinal tap, bone scan, M.R.I. and a CT scan,” Ms. Kirchner said. “I’m still so worried about him.”

Representative Rosa DeLauro, Democrat of Connecticut, said she had been asking top food and drug officials for years if they needed authority for ordering mandatory recalls.

But the officials said companies cooperated when recalls were needed.

“They can’t even get a press release out on this stuff without industry approval. It’s just unbelievable,” said Ms. DeLauro, who promised to offer legislation on Wednesday that would split the agency’s food oversight into a separate entity with mandatory recall authority and other powers.

Public health officials pinpointed the Blakely plant as the source of the salmonella outbreak on Jan. 9. The peanut company announced a limited recall on Jan. 13 and expanded it on Jan. 16. The company waited until Jan. 28 before recalling all products made at the plant in 2007 and 2008, even though it had known since 2007 that tests of products showed contamination with salmonella.

Food buyers and some top public health officials say they knew before any public announcement that the company’s products and those of its customers were the likeliest source of the outbreak.

Craig Wilson, an assistant vice president at Costco, said he pulled Kellogg’s Keebler and Austin peanut butter crackers off shelves a day before Kellogg’s first announcement and nearly a week before the Peanut company and Kellogg issued a nationwide recall that covered those cookies.

Mr. Wilson said he could not wait for the F.D.A. to make announcements about food problems that are widely known among food safety officials.

“I don’t want to say that you can’t rely on the F.D.A.,” Mr. Wilson said, “but we certainly can move quicker than they do.”

The F.D.A. can seize a product that it suspects is contaminated, and it can ask a federal judge for authority to recall products if a maker refuses to do so. The agency can also announce that it suspects problems with a product before the company agrees to a recall. But it rarely does any of these.

Bill Marler, a food safety lawyer in Seattle, said the agency had neither the authority nor the courage it needed to keep the food supply safe.

Michael R. Taylor, a former top official at the food agency, said change was needed.

“F.D.A. negotiates communications about recalls with companies,” Mr. Taylor said, “and that sometimes leads to delays. Changing that dynamic when people are getting seriously ill and dying is something that ought to happen.”

Friday, January 30, 2009

Cigarettes As Gifts Undermines China's Anti-Smoking

BEIJING, Jan. 30 (Xinhua) -- Despite knowing all the harms of smoking, Li Pingping, who lives in Shanghai, still decided to buy two cartons of cigarettes as presents for her father back in southwest China's Chongqing.

"When you pick up gifts for the elders during festivals or anniversaries, cigarettes are a nice choice," she said.

Li will take the cigarettes with her on the three-hour-flight to her hometown Chongqing Municipality.

It's Chinese tradition to give cigarettes when meeting new friends or visiting relatives, either to show friendliness or respect.

But the tradition has long stood in the way of the government's and anti-smoking organization's efforts to discourage smoking.

Xu Guihua, deputy director of Chinese Association on Tobacco Control (CATC), said "the lack of understanding and support" has made their job difficult.

The truth is, in China, not only are the smokers exchanging cigarettes as gifts, nonsmokers are also fanning the flame by buying cigarettes for their friends and family and are unwittingly exposing themselves to second-hand smoke.

Li Pingping said her father is the only smoker in the family off our, but no one minds him smoking when they spend time together, nor do they mind when he meets with chain-smoking guests in their apartment.

"I always buy cigarettes for elders, they could send those cigarettes to their friends even when they quit smoking. It is a practical gift and, most often, they like it," she said.

But it is not easy to break the habit of smoking.

Yang Xu, doctor at the Cardiovascular Institute of Fuwai Hospital, said, "A small percentage of heavy smokers face the potential danger of sudden death as abrupt smoking cessation can cause many health disorders."

The Chinese anti-smoking authorities are aware of this problem.

Yang Gonghuan, director of the National Tobacco Control Office, has called for more effective publicity to help people understand the hazards of smoking.

And just days ahead of the Spring Festival, the Ministry of Health(MOH), the World Health Organization, and the Chinese Center for Disease Control and Prevention jointly launched a program to distribute 200,000 anti-smoking posters across the country.

"You have sent your friends both blessings and respiratory problems such as lung caner; you have sent your colleagues both respect and cardio vascular diseases such as heart disorders and stroke; you have sent your family love, care and death," a poster reads.

Non-governmental organizations and individuals are also joining the fight against smoking advertising campaigns.

Wu Yiqun, deputy director of the Think tank Research Center for Health Development, a Beijing-based non-governmental organization, often asks anti-smoking experts to write complaint letters to health authorities.

His proposals included banning tobacco companies' sponsorship in Shanghai's Formula One, smoking scenes in the popular TV series the Shanghai Grand, accentuating warning signs on cigarette packs and dissuading tobacco companies from attending quake relief charity awards.

In spite of all the endeavors made, the result is far from satisfactory.

According to the annual smoking control report by MOH, the number of young smokers are on the rise.

MOH statistics show that about 350 million people smoke in China, or almost 36 percent of the population aged above 15, and about one million die of smoking-related ailments annually.

The number of young smokers aged from 13 to 18 has hit 130 million in China.

The tobacco control difficulty is that "a nonsmoking, no cigarette-distributing and no cigarettes as gifts has not emerged in the society," said Yang Gonghuan.

"It's part of the Chinese custom to send cigarettes as gifts. Sending cigarettes is, in fact, planting dangers," he said.

Chen Wei, 36, a primary school teacher who has smoked for 20 years, is fully aware of the hazards of smoking and has heard all the discouragement from health organizations.

But he still expects his friends to send him cigarettes.

"I would still buy cigarettes anyway. And if someone gave me cigarettes as a gift, I would save some money on that."

"A lot of guys smoke around me, and it's impolite if I don't get a pack ready to give them or not to receive my friends' or relatives' cigarettes when they want to show some closeness," he said.

source: chinaview.cn

A Future for Stem Cells

As President Obama continues his welcome sprint past former President George W. Bush's policies - goodbye gag rules, torture, inattention to climate change - we'd like to pause at one destination that has a particular interest for California. Last week, the Food and Drug Administration approved a request from Geron, a biotechnology company based in Menlo Park, to begin a human clinical trial testing embryonic stem cells.

The new decision's an excellent sign for stem cell researchers and those who have been desperately waiting for treatments. Though Obama has yet to lift all of Bush's restrictions on stem cell research, and the FDA's act doesn't mean that the federal government will be immediately investing much money in it, it does mean that the United States is finally ready to move forward. But it presents California's Institute for Regenerative Medicine (CIRM) - the San Francisco-based stem-cell institution formed to disperse $3 billion worth of bond money that California voters approved in 2004 - with a challenge. Now that the federal government is ready to take up the issue of stem cells, what will CIRM do with all that money?

One thing it won't be doing is giving that money back, despite the state's dire economic situation. Since the voters approved the money, there isn't much of a mechanism to stop CIRM from spending it.

That said, CIRM's main function may turn out to be positioning California as a job center and research hub for stem-cell research. (Economic research has shown that wherever the first seeds of a new industry germinate is where the hub of the entire industry tends to grow.) And provided that they realign their mission and funding goals, there's no reason why CIRM can't be as crucial to the future of stem-cell research as the federal government will be.

Fortunately, CIRM has already started to think about the future. "We have discussed doing things differently," said Don Gibbons, CIRM's chief communications officer. "For example, the National Institutes of Health tends to fund basic research, not transitional research, and the latter is what you need in order to get your product to market. So this month and next month we'll be talking about whether or not we should reallocate some of our funding to that research, so that we can help move stem cells to therapies and patients more quickly."

Gibbons added that the institute may also consider funding more "non cell-therapy uses of stem cells" that have shown great promise, such as drug development. "Vioxx wouldn't have gotten onto the market, for instance, if companies had been able to use stem cells to test for toxicity," he said.

We're heartened to see that CIRM is prepared to change with the times, and we encourage it to leverage the generosity of the California voter to form more partnerships with private companies and, one day soon, the federal government. California needs to stay a leader in the field of biotechnology.

source: sfgate.com

Democratic Stealth Care

With the nation preoccupied by the financial crisis, Democrats have been quietly working to nationalize health care.

Tom Daschle is still waiting to be confirmed as secretary of health and human services, not that he's in any rush. Democrats are already enacting his and Barack Obama's agenda of government-run health care -- entirely on the QT.

This was the real accomplishment of this week's House vote for the $819 billion "stimulus," and is the overriding theme of Congress's first month. With the nation occupied with the financial crisis, and with that crisis providing cover, Democrats have been passing provision after provision to nationalize health care.

If Democrats learned anything from the HillaryCare defeat, it was the danger of admitting to their wish to federalize the health market. Since returning to power, they've pursued a new strategy: to stealthily and incrementally expand government control. "What no one is paying attention to in the [stimulus]," says Wisconsin Rep. Paul Ryan, "is that Democrats are making a big grab at the health-care sector."

It began one week after the swearing-in, when Nancy Pelosi whipped through a big expansion of the State Children's Health Insurance Program. The Schip bill was Democrats' first stab at stealth expansion, unveiled in 2007, though vetoed by George W. Bush.

Initially designed for children of working-poor families, this new Super-Schip will be double in size, and even kids whose parents make $65,000 a year will be eligible. The program will also now cover pregnant women and automatically enroll their new arrivals. The Congressional Budget Office estimates 2.4 million individuals will drop their private coverage for the public program.

Still, it's the "stimulus" that has proven the real gift horse -- a behemoth that has allowed Democrats to speed up the takeover of health care under cover of an economic crisis. They initially claimed, for instance, the "stimulus" would provide Medicaid money to states struggling to pay existing bills. What in fact it does is dramatically expand the number of Americans who qualify for Medicaid.

Under "stimulus," Medicaid is now on offer not to just poor Americans, but Americans who have lost their jobs. And not just Americans who have lost their jobs, but their spouses and their children. And not Americans who recently lost their jobs, but those who lost jobs, say, early last year. And not just Americans who already lost their jobs, but those who will lose their jobs up to 2011. The federal government is graciously footing the whole bill. The legislation also forbids states to apply income tests in most cases.

House Democrat Henry Waxman was so thrilled by this blowout, it was left to Republicans to remind him that the very banking millionaires he dragged to the Hill last year for a grilling would now qualify for government aid. His response? A GOP proposal to limit subsidies to Americans with incomes under $1 million was accepted during markup, but had disappeared by final passage. In this new health-care nirvana, even the rich are welcome. CBO estimates? An additional 1.2 million on the federal Medicaid dime in 2009.

The "stimulus" also hijacks Cobra, a program that lets the unemployed retain access to their former company health benefits -- usually for about 18 months. The new stimulus permits any former employee over the age of 55 to keep using Cobra right up until they qualify for Medicare at age 65. And here's the kicker: Whereas employees were previously responsible for paying their health premiums while on Cobra, now the feds will pay 65%. CBO estimates? Seven million Americans will have the feds mostly pay their insurance bills in 2009.

The bill even takes a whack at the private market. Under the guise of money for "health technology," the legislation makes the government the national coordinator for electronic health records, able to certify what platforms are acceptable. This is an attempt to squelch a growing private market that is competing to improve transparency and let consumers compare providers and costs. In liberal-world, only government should be publishing (and setting) health-care prices.

Add it up, and Democrats may move 10 million more Americans under the federal health umbrella -- in just four weeks! Good luck ever cutting off that money. Meanwhile, the Democratic majority is gearing up for a Medicare fight, where it may broach plans to lower the eligibility age to 55. Whatever costs accrue, they'll pay for by slashing the private Medicare Advantage option.

Mr. Obama will, of course, offer his health-care reform at some point. But he's clearly happy to get what he can, when he can. Despite talk of entitlement reform, he's voiced no disapproval of this vast new health-care grab. And don't forget he chose Mr. Daschle, who appreciates stealth himself. In his 2008 book outlining his health-care reform, he offers his party two pieces of political advice: Move fast, before there can be a public debate, and write as vague a bill as possible.

Guiding all of this is the left's hope that by the time America wakes up to what's happening, it'll be too late. Democrats might be on to something.

Write to kim@wsj.com
source: online.wsj.com

Octuplets' Mother Already Has Twins, Four oother Children

By Jessica Garrison, Andrew Blankstein and Jeff Gottlieb
When she learned that she was expecting multiple babies, doctors gave her the option of selectively reducing the number of embryos, but she declined.

The woman who gave birth to octuplets this week already has six young children and never expected that the fertility treatment she received would result in eight more babies, her mother said Thursday.

Dr. Harold Henry, right, a member of the octuplets' delivery team at Kaiser Permanente Medical Center in Bellflower, leaves a news conference with neonatalogist Mandhir Gupta, left, and Karen Maples, chief of service for obstretics and gynecology. The doctors were peppered with questions about how the hospital handled the pregnancy. Hospital officials said the mother came to Kaiser already in her 12th week of pregnancy. They did not say where she received her fertility treatment.

The woman, who has not been publicly identified, had embryos implanted last year, and "they all happened to take," Angela Suleman said, leading to the eight births Monday. "I looked at those babies. They are so tiny and so beautiful."

She acknowledged that raising 14 children is a daunting prospect.

"It's going to be difficult," Suleman added, noting that her daughter's father is going back to Iraq, where neighbors said he worked as a contractor, to help support the expanded family.

The mother of the octuplets lives on a well-kept cul-de-sac in Whittier, where more than a dozen reporters and camera crews descended Thursday.

Neighbors said she and her six children -- ages 7, 6, 5, 3 and 2-year-old twins -- live there with her mother. Her marital status is unknown. Family members did not answer the door, but when a reporter called the home asking for Suleman, she spoke briefly.

According to her account, when her daughter discovered that she was expecting multiple babies, doctors gave her the option of selectively reducing the number of embryos, but she declined.

"What do you suggest she should have done? She refused to have them killed," Suleman said as the sound of children could be heard in the background. "That is a very painful thing."

The information about the family came amid growing questions about the medical ethics of the case and how the woman came to carry eight babies to term.

Although the successful births at Kaiser Permanente Medical Center in Bellflower have received worldwide attention, they also have prompted disapproval from some medical ethicists and fertility specialists, who argue that high-number multiple births endanger the mother and also frequently lead to long-term health and developmental problems for the children.

Under the guidelines of the American Society for Reproductive Medicine, U.S. doctors normally would not implant more than two embryos at a time in a woman under the age of 35. After that age it is more difficult to become pregnant. The mother of the octuplets is believed to be 33, based on available public records.

The doctors who delivered the babies held a news conference Thursday in which they were peppered with questions about how the hospital handled the woman's pregnancy.

Hospital officials said the woman came to Kaiser already in her 12th week of pregnancy. They did not say where she received the fertility treatment.

Dr. Harold Henry, a member of the delivery team, said doctors counseled her regarding the options and risks -- among them aborting some of the fetuses.

"Our goal is to provide the best possible care, no matter what the situation or circumstances are," Henry said. "What I do is just explain the facts. I always talk about the risks. The mother weighs those options, and she chooses the option based on spiritual or personal makeup."

Henry said the eight children would "require quite a bit of resources. You need many diapers, bottles, car seats, food -- quite a bit."

Doctors, nurses and other medical personnel had planned for the births for months. They were expecting to deliver seven babies but discovered the eighth during delivery. It took only five minutes to deliver all eight by Caesarean section.

The births marked only the second time that octuplets had been successfully delivered in the United States.

At the news conference, Dr. Karen Maples read a statement from the mother in which she thanked the Kaiser staff for its help and support.

"We understand that you are all curious about the arrival of the octuplets, and we appreciate your respect for our family's privacy. Please know in our own time, we will share additional details about this miraculous experience," the statement said.

"The babies continue to grow strong every day and make good progress. My family and I are ecstatic about their arrival. Needless to say, the eighth was a surprise to us all, but a blessing as well."

"We thank all of you for the positive thoughts, prayers and generosity."

Already, Kaiser officials said, the mother is receiving gift baskets, sealed envelopes and flowers.

source: latimes.com

Zoloft, Lexapro the Best of Newer Antidepressants

THURSDAY, Jan. 29 (HealthDay News) -- Sertraline (Zoloft) and escitalopram (Lexapro) are the best of 12 new-generation antidepressants, while reboxetine is the least effective, a new analysis shows.

The Italian researchers reviewed 117 studies that included more than 25,000 patients with major depression to come to this conclusion.

The drugs tested in the trials were bupropion (Wellbutrin/Zyban), citalopram (Celexa), duloxetine (Cymbalta), escitalopram, fluoxetine (Prozac), fluvoxamine (Luvox), milnacipran (Savella), mirtazapine (Remeron), paroxetine (Paxil), reboxetine (Edronax/Vestra), sertraline, and venlafaxine (Effexor).

Based on their analysis, the review authors concluded sertraline and escitalopram were the best antidepressants overall in terms of efficacy and patient acceptability. Sertraline was found to be more effective than duloxetine by 30 percent, fluvoxamine (27 percent), fluoxetine (25 percent), paroxetine (25 percent), and reboxetine (85 percent). Escitalopram was more effective than duloxetine by 33 percent, fluoxetine (32 percent), fluvoxamine (35 percent), paroxetine (30 percent), and reboxetine (95 percent).

Mirtzapine and venlafaxine were as effective as sertraline and escitalopram. But the latter two drugs had the best patient acceptability, which meant significantly fewer patients stopped treatment.

The review was published online Jan. 29 and was expected to be published in an upcoming print issue of The Lancet.

"The most important clinical implication of the results is that escitalopram and sertraline might be the best choice when starting a treatment for moderate to severe major depression, because they have the best possible balance between efficacy and acceptability," Dr. Andrea Cipriani, of the University of Verona in Italy, and colleagues said in a news release from the journal.

"Sertraline seems to be better than escitalopram because of its lower cost in most countries. However, in the absence of a full economic model, this recommendation cannot be made unequivocally, because several other costs are associated with the use of antidepressants," they added.

More information
The U.S. Agency for Healthcare Research and Quality has more about antidepressants.

New Look at Food Safety After Peanut Tainting

By GARDINER HARRIS and PAM BELLUCK
Christopher Meunier, 7, had not been sick since he was a toddler, but in late November, he suddenly had a high fever and bloody diarrhea and started vomiting.

Christopher Meunier had salmonella poisoning last year. “He was just screaming in pain,” his mother, Gabrielle Meunier, said.

“He was just in screaming pain,” said his mother, Gabrielle Meunier of South Burlington, Vt. “He said, ‘It hurts so bad, I want to die’ — something you don’t expect to hear out of a 7-year-old’s mouth.”

Hospitalized for six days, Christopher had salmonella poisoning, making him one of more than 500 people sickened across the country after eating peanut butter or peanut products made at a Peanut Corporation of America plant in Blakely, Ga.

The Food and Drug Administration has charged that the company knowingly shipped contaminated products to some of the largest food makers in the country from a plant that was never designed to make peanut butter safely, causing one of the most extensive food recalls in history. The company responded that it disagreed with some of the agency’s findings and that it had “taken extraordinary measures to identify and recall all products that have been identified as presenting a potential risk.”

Food scares have become as common as Midwestern tornadoes. Cantaloupes, jalapen~os, lettuce, spinach and tomatoes have all been subject to major recalls in recent years. And a growing list of manufacturers and trade associations joined consumer advocates in begging for stricter regulations — calls that the Bush administration largely rejected.

A clutch of legislative proposals this year would offer fixes to the system, and people offering those measures expect President Obama to support them because, as a candidate, he repeatedly promised reforms.

“Far too often, tainted food is not recalled until too late,” Mr. Obama said last year. “When I am president, it will not be business as usual when it comes to food safety. I will provide additional resources to hire more federal food inspectors.”

Nearly all of the proposed legislation under consideration would require companies like the Peanut Corporation of America to lay out specific plans for manufacturing safely and testing routinely. The bills would require that test results and other records be made available to government inspectors upon demand, and would provide additional money for more intense inspections of domestic and foreign food factories. Some would also fix the patchwork system by which outbreaks are detected.

Senator Richard J. Durbin, Democrat of Illinois, and Representative Rosa DeLauro, Democrat of Connecticut, also propose creating a food agency independent of the F.D.A. so that food would receive single-minded attention. At present, at least 12 federal agencies regulate food safety. The battle between those who would strengthen the F.D.A. and those who would break it up will be an important fight this year.

“I think I can prevail on the president to take a fresh look at this,” Mr. Durbin said. “We can no longer forgive or explain what’s happening with food safety in this country.”

Neither the White House nor the Health and Human Services Department would comment on Thursday. But the peanut case, critics say, demonstrates just how badly the system needs fixing, starting with the patchwork surveillance system that is the first indicator that something has gone wrong.

Cases like Christopher’s are reported to local health departments, which in turn are to report them to the Centers for Disease Control and Prevention. By mid-November, the disease centers had seen enough cases of a similar strain of salmonella to be concerned.

“The numbers were not necessarily significant initially — one here, one there,” said Lola Russell, a disease centers spokeswoman. “Over time, those numbers began to grow.”

By mid-December, the Minnesota Department of Health, known as among the best in the nation, had received reports of nine people with salmonella poisoning. As a result, the department’s Team Diarrhea, a group of graduate students who work nights, started calling patients and their caregivers to ask about their food choices .

“We had a lot of peanut-butter eaters,” said Carlota Medus, a state epidemiologist. “But none of the brand names were matching up well.”

Other states were reporting similar cases, but as in Minnesota, no one could figure out the shared food. The process is fraught with uncertainty. State health officials ask people what they remember eating in the days before they became ill. Poor memories and bad records hamper these efforts, and officials are often sent on fruitless pursuits.

Delay is part of the problem. More than two weeks generally pass between the time someone is diagnosed with an illness and the result of a stool sample test is passed on to federal officials.

Last year, the F.D.A. announced a recall of tomatoes, only to discover near the end of the outbreak that the problem had actually been with jalapen~os. Tomato growers, who saw much of their crop destroyed and endured millions in losses, were outraged.

With the illnesses involving peanut butter, an initial suspect was chicken.

“The chicken was actually a red herring,” said Ms. Russell of the C.D.C., a diversion that resulted from an outbreak of illness among people who had eaten chicken at an Ohio restaurant as well as peanut butter at a school cafeteria.

Then on Dec. 22, a nursing home in northern Minnesota reported a cluster of cases. Investigating outbreaks in nursing homes is both more challenging and easier than elsewhere — easier because the facilities have set menus, harder because patients are often unable to say what menu choices they ate.

Then another nursing home reported illnesses. On Dec. 28, a Minnesota elementary school reported two children who had become ill. The holidays prevented state workers from talking to school cafeteria workers, but the health department was able to track down the school’s food supplier. Everyone seemed to be eating peanut butter.

Finally, a state health worker asked the nursing homes if they still had jars of the suspect peanut butter. One did, and on Jan. 9, that peanut butter tested positive for salmonella. The state announced that King Nut peanut butter, sold only to institutions, was the culprit. King Nut’s product was made by the Peanut Corporation of America.

The F.D.A. then descended on the Georgia plant with a team of inspectors. It used authority granted under a 2002 bioterrorism law to demand records that inspectors from the Georgia Agriculture Department, which had inspected it twice before without finding serious violations, had not been given access to.

The records showed that on 12 occasions from 2007 to 2008, tests of peanut products made at the plant were contaminated by salmonella. Each time, retests came up clean. But F.D.A. officials said the initial tests should have led plant officials to quarantine their product and clean their facility — neither of which occurred.

Sheryl Gay Stolberg contributed reporting.
source: nytimes.com

Thursday, January 29, 2009

Kidney Donors Live Just As Long As Others

People who donate a kidney live just as long and are just as healthy as those with two kidneys, according to a new study by University of Minnesota researchers that is the largest ever done on the long-term health consequences of donation.

The study provides a reassurance that experts hope will encourage more organ donations at a time when the need for such life-saving transplants is on the rise. Today there are 78,000 people on the kidney transplant list, and most will not survive the five- to seven-year wait for a kidney from a deceased donor.

Researchers tracked down nearly all of the 3,700 people who had donated kidneys at the university’s transplant center between 1963 and 2007.

The findings will be published today in the New England Journal of Medicine with an editorial that described the results as surprising and quite reassuring.

Snowy owls start to move south

Biologists say an increase in snowy owl sightings in the South suggests that the arctic species did so well in its northern breeding grounds last year that competition is driving the young ones to warmer climates.

The showy white owls of “Harry Potter” fame are rarely seen south of northern Ohio. This year, they’ve also been spotted farther south, in states where they’re rarely seen.

In Tennessee, birders armed with spotting scopes and telephoto lenses scrambled from as far away as Georgia and Alabama to see the first snowy owl reported in that state in 22 years.

Snowy owls nest on the ground in the Arctic tundra and many of them stay there year-round, while some winter in Canada and the northern United States. Biologists said that this year’s owl population grew so large, many of the young males moved farther south to stake out feeding territory.

Planet heats up, cools down rapidly

Astronomers have found a planet with a galactic case of hot flashes.

In just six hours, this planet four times the size of Jupiter heats up by more than 1,200 degrees, according to a study published in today’s issue of the journal Nature.

“It’s the first observation of changing weather” on a planet outside our solar system, said study author Gregory Laughlin, an astronomy professor at the University of California at Santa Cruz. He used NASA’s Spitzer Space Telescope to study the planet.

Normally, the planet HD80606b is a toasty 980 degrees or so. But in the few hours it whips around its sun, the planet gets zapped with mega-heat, pushing the thermometer closer to 2,240 degrees.

When it comes closest to its sun, it becomes one giant “brewing storm” complete with shock waves, Laughlin said. The radiation bombarding the planet is 800 times stronger than when it is farthest away.

Then just as quickly, the planet slingshots away and radiates the heat to the cool vacuum of space. It glows cherry red and the temperature plummets, Laughlin said.

Cold aids manatee count

Aided by a string of cold snaps, state scientists counted a record number of manatees in Florida waters this year. The annual aerial count, conducted two weeks ago, recorded 3,807 manatees, topping the previous high in 2001 by more than 500 animals, according to a report released Wednesday by the Florida Fish and Wildlife Conservation Commission’s Fish and Wildlife Research Institute. Wildlife managers cautioned that the aerial counts don’t mean the population has suddenly boomed or the endangered mammal is no longer at risk. They amount to a snapshot, a minimum number that can vary wildly according to weather.

Study: ‘Bubble boy disease’ eased by gene therapy

Gene therapy seems to have cured eight of 10 children who had potentially fatal “bubble boy disease,” according to a study that followed their progress for about four years after treatment.

The eight patients were no longer on medication for the rare disease, which cripples the body’s defenses against infection. The successful treatment is reported in today’s issue of the New England Journal of Medicine.

Bubble boy disease is formally called severe combined immunodeficiency, or SCID. The genetic disorder is diagnosed in about 40 to 100 babies each year in the United States. The nickname comes from the experience of a Houston boy, David Vetter, who became famous for living behind plastic barriers to protect him from germs. David, who died in 1984 at age 12, had the most common form of SCID. The new study involved a different form of SCID —- and one that holds a key position in medical history. In 1990 it became the first illness to be treated by gene therapy, according to the U.S. government.

Popularity in the genes?

Researchers say popularity seems to have an inherited component.

Nicholas Christakis of Harvard, along with Christopher Dawes and James Fowler of the University of California, San Diego, studied 1,110 twins in a population of more than 90,000 adolescents. They measured indications of popularity such as the number of times an individual was named as a friend and whether an individual tended to be at the center or the edge of a social group.

There was more similarity between the social positions of identical twins than of fraternal twins, an indication that the measures of popularity had an inherited component, the researchers report in Tuesday’s edition of Proceedings of the National Academy of Sciences.

While identical and fraternal twins both have the same parents, identical twins come from the same egg while fraternal twins are fertilized separately.

source: ajc.com

Senate Likely to Pass Bill on Kids' Health Insurance

SCHIP Could Cover 11 Million Children

The Senate is expected to approve a bill today that provides health insurance to about 11 million low-income children, paving the way for President Obama to claim an early legislative victory and collect a quick down payment on his campaign pledge to guarantee care to every American child.

Senate Democrats, after easily defeating Republican attempts to narrow the bill yesterday, predicted they had the votes to renew and expand the popular State Children's Health Insurance Program.

Presently, the $25 billion program covers 7 million children living near the poverty level who do not qualify for Medicaid. Under the Senate bill and similar legislation passed by the House, an additional 4 million youngsters would be eligible for discounted care at an added cost of $32 billion over 4 1/2 years. That would leave Obama about 5 million children short of his promise to ensure that every youngster in the country has health insurance.

Proponents say the need for a health-care safety net has become all the more urgent, given the dire state of the economy. Opponents argue that the Democratic legislation goes beyond the original intent of the program by including children of legal immigrants and some families with incomes as high as $60,000 a year.

Both the House and Senate versions include millions of dollars for recruiting and enrolling youngsters. The expanded coverage would be paid for by increasing the cigarette tax by 61 cents a pack.

"This bill will make a real difference in the lives of children and families across America and is a great way to start the new year," said Sen. Debbie Stabenow (D-Mich.). "I am very pleased to be a part of this and to know that we have a president who will enthusiastically and quickly sign this bill as one of his first actions."

After the final vote in the Senate, House and Senate negotiators must resolve minor differences between the two versions before it can be sent to the White House for Obama's signature.

In 2007, many prominent Republicans joined with Democrats in efforts to expand the program. Twice, President Bush ignored the entreaties of those in his party and vetoed the legislation, calling the effort a dangerous shift toward "government-run health care."

Yesterday, those same Republicans reacted bitterly to changes made by the Democrats now that they control Congress and the White House.

In particular, Republicans objected to a provision in both the House and Senate versions that would, for the first time, lift a five-year waiting period for children of legal immigrants to enroll in the program.

"This is not the bill we intended," bellowed the normally mild-mannered Sen. Pat Roberts (R-Kan.). The Democrats' decision to "simply ram it down our throats . . . is very, very bad precedent," he said.

Sen. Orrin G. Hatch (R-Utah), who had helped craft the 2007 bipartisan bills, offered an amendment that would have required states to enroll 95 percent of eligible, native-born children before opening it to immigrants.

"Our U.S. citizen children should be covered first," he said.

"Those kids come from low-income families with parents that work hard and pay taxes just like citizens," countered Senate Finance Committee Chairman Max Baucus (D-Mont.). "And, those kids need checkups and prescriptions just like all other CHIP kids."

Republicans and some conservative analysts also noted that as many as 2 million children with access to private health insurance might switch to the cheaper government-subsidized program, a trend known as "crowd out."

Baucus said the bill aims to minimize that by giving states a new option to subsidize employer-sponsored coverage for low-income children. Those subsidies would help keep private insurance affordable.

An eclectic mix of business interests, consumer groups and medical providers lobbied aggressively for expansion of the program, including the National Governors Association, labor unions, the retiree group AARP, the Blue Cross/Blue Shield Association and the Pharmaceutical Research and Manufacturers of America.

When Congress enacted the $700 billion financial bailout last fall, "we were told you've got to take care of Wall Street if you want to take care of Main Street," said Sister Carol Keehan, president of the Catholic Health Association of the United States. "Well, Main Street can never be safe if their children don't have health care."

Staff writer Perry Bacon Jr. contributed to this report.

source: washingtonpost.com