Bird Flu In Iraq

Amina Qader gazed sadly as her 70 ducks and chickens, once her main source of income, were hauled away Tuesday in plastic bags to be buried alive in a nearby muddy grave. The widow's birds are among more than 500,000 killed in the past two days across northern Iraq as this war-ravaged country battles to control a deadly bird flu outbreak.

The bird slaughter followed Monday's announcement that a 15-year-old girl who died Jan. 17 had the deadly H5N1 strain.

"I am so scared of bird flu, so I gave all my birds away to be killed, even though none were ill," she says. "We've relied on them for years for our livelihood. What are we to do now?"

Iraqi authorities have promised to compensate people for the loss of their chickens, ducks and other domesticated birds, but have given no amount.

Bingird is a village of about 2,500 people on the western side of Dukan reservoir, a stop for migratory birds flying south from Turkey, where at least 21 people have been diagnosed with the H5N1 strain.

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New Drug For Chronic Constipation

The U.S. Food and Drug Administration has approved a new prescription drug called Amitiza to treat adults with chronic constipation, one of the most common disorders among Americans, the agency said on Tuesday.

The drug, made by privately held Sucampo Pharmaceuticals Inc., is the first of a new kind of treatment that works by increasing the amount of fluid in the intestines, officials said.

Japan's Takeda Pharmaceutical Co. Ltd. (4502.T: Quote, Profile, Research) will help promote and sell the drug, a type of chloride channel activator.

Amitiza is intended for patients who experience constipation over time with no known cause, and should be taken twice daily with food, the FDA said in a statement.

The capsules aim to relieve constipation, abdominal bloating and discomfort. Side effects can include headache, nausea, diarrhea and abdominal pain, among others.

Sucampo spokesman Brad Fackler would not comment on the Bethesda, Maryland-based company's sales projections or terms of the deal with Takeda. He added that about 30 million Americans suffer from constipation each year.

Dozens of over-the-counter laxatives are available on the U.S. market, including fiber-filled products, stool softeners and stimulants. Some types are also abused by users looking to lose or maintain weight.

Unlike most laxatives, which often increase fluid in the stool itself, Fackler said Amitiza helps the stool move through the intestines

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Medicaid Strain

President Bush used a dose of Clinton-inspired humor in his State of the Union speech Tuesday night, but New York Democrats weren't laughing at his latest call to rein in spiraling health care costs for seniors and the poor.

In the prime-time address, Bush called on both parties to act now to head off the growing strain of Medicaid, Medicare and Social Security _ government entitlement programs whose costs are expected to balloon in coming decades.

Perhaps seeking to defuse any lingering partisan anger over his failed effort to revamp Social Security last year, he used a family joke to bring up the contentious issue of rising health care costs.

"This year, the first of about 78 million Baby Boomers turn 60, including two of my dad's favorite people _ me and President Clinton. This milestone is more than a personal crisis _ it is a national challenge," Bush said.

The elder Bush and Bill Clinton became a much-discussed political odd couple last year after the pair did charity work together for hurricane and tsunami victims.

Seeking to regain momentum with Congress, Bush said health care was one of several issues _ along with energy independence, education and immigration _ critical to keeping America competitive in a global marketplace.

"Keeping America competitive requires affordable health care," the president said.

At $44.5 billion a year and growing, New York's Medicaid program is the nation's largest, straining both state and county budgets. Any significant changes to Medicare or Medicaid likely would have a bigger impact on the Empire State than any other.

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Health Care Savings Accounts To Be Pushed In State Of The Union Address

From USA Today:

President Bush's expected call for expansion of health savings accounts in Tuesday's State of the Union address will likely stoke the debate over the accounts.

Under the law, the accounts must be coupled with health insurance policies that carry at least a $1,050 annual deductible for individuals or $2,100 for families. They allow people to set aside money, tax free, to cover medical costs. This year, the maximum allowable deposit is $2,700 for individuals and $5,450 for families. Bush wants to increase those contribution levels.

The accounts are seen by proponents as part of a larger effort to create an "ownership society" in which financial responsibility for retirement and health care costs shifts more to individuals and away from government and employers.

Proponents, who include some of Bush's economic advisers, say the system of spending accounts paired with high-deductible policies will make people more judicious users of medical care because they will have to pay a greater portion of the costs themselves.

Critics say many Americans are already struggling to pay for health care, so promoting higher-deductible polices will leave the poor and the chronically ill in worse shape. Critics, who include the Commonwealth Fund and Consumers Union, also fear the accounts will attract mostly healthy people, leaving sicker and more expensive patients in traditional insurance, whose costs will then rise. Overall, they say, the accounts won't save the nation money on health care.

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Inhaled Insulin

From Det News:

The Food and Drug Administration on Friday approved an inhaled form of insulin, the first new way to get that hormone into the body since it was discovered in 1921 -- and a new treatment option for many of the 21 million Americans with diabetes.

The approval fulfills an arduous scientific quest that spanned most of the 20th century and spilled over to the 21st. And it marks the biggest change in diabetes treatment in decades, one that doctors hope will lure a fair slice of the American population into their offices to talk about controlling blood sugar. The product poses long-term safety questions, though, and it's not clear yet whether it will be more expensive than standard insulin.

Millions of Americans need treatment with insulin but don't get it because it involves frequent, painful needle sticks and injections. About 5 million take the hormone, but a high proportion inject themselves too few times during the day because it's so inconvenient. Doctors hope inhaled insulin will overcome some of that resistance, helping diabetics ward off a slew of medical problems that afflict those who don't control their disease.

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Obesity Virus ???

New study results bolster the controversial hypothesis that certain cases of obesity are contagious. Over the last 20 years, some research has suggested that certain strains of human and avian adenoviruses--responsible for ailments ranging from the chest colds to pink eye--actually make individuals build up more fat cells. Having antibodies to one strain in particular, so-called Ad-36, proved to correlate with the heaviest obese people, and in one study, pairs of twins differed in heft depending on exposure to that virus. Now researchers have identified another strain of adenovirus that makes chickens plump

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Red Dye

From Seattle Pi:

Food and cosmetic labels may soon be required to list the presence of widely used red colorings made from insects, but will not have to disclose the dyes' origins, according to a proposed rule made public Friday.

The Food and Drug Administration has proposed requiring that manufacturers flag the presence of cochineal extract and carmine in their products. The red colorings are extracted from the ground bodies of an insect exploited since the time of the Aztecs.

The proposed rule comes in response to reports of severe allergic reactions to the colorings, the regulatory agency said. A 1998 petition by the Center for Science in the Public Interest asked that the FDA take action.

Carmine is used in ice cream, strawberry milk, fake crab and lobster, fruit cocktail cherries, port wine cheese, lumpfish eggs and liqueurs like Campari, according to the FDA. Carmine's also used in lipstick, makeup base, eye shadow, eyeliners, nail polishes and baby products, the agency said.

Cochineal extract is used in fruit drinks, candy, yogurt and some processed foods.

Cochineal extract has long been made from the dried and ground female bodies of an insect called Dactylopius coccus costa. Indians living in pre-Columbian Mexico were the first to recognize the cactus-sucking insect could be used as a source of dye.

Read more here.

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Did Lincoln Have Marfan's Syndrome?

The Chicago Historical Society is negotiating with DNA researchers to allow sampling of some of its Abraham Lincoln artifacts -- including the blood-stained sheets from his deathbed -- in an effort to investigate whether he had Marfan syndrome.

Historians have long puzzled over whether Lincoln might have had Marfan, a genetic disorder. But new research has Lincoln ancestors wondering if his clumsy gait might actually have been caused by something else.

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Gastric Balloon For Weight Loss

Inserted down the patient's throat, a round silicon balloon is filled with a saline solution and remains in the stomach for about six months, when it is deflated and taken out before the material degrades.

"We introduce a balloon of half a liter volume (about a pint) in the stomach and inflate it so it takes up space and helps slow down the eating," said Dr. Nicola Basso, the obesity surgeon who performed the procedure on Campati in early January. "This causes a sense of fullness, and the patient is helped to lose weight."

The balloon, which also contains methylene blue to signal any leak, does not alter the shape of the abdomen and is too big to slip down into the digestive tract.

Basso, who has performed the procedure on about 700 patients in six years, said the technique allows an average drop of 33-44 pounds over six months, although the weight loss is often temporary.

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New Thinking For Cell Phones In Hospitals

From TechNudge:

The prohibition against mobile phones in hospitals may do more harm than good, a new report reveals. Medical facilities prohibit cell phone use, but some doctors already use them. And it turns out they reduce medical errors because communication is more timely, a new study finds. Mobile phones rarely cause electronic magnetic interference, Yale School of Medicine researchers reported today.

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Unraveling Avian Flu

From VOA News:

Scientists in the United States say they believe they have discovered what makes bird flu viruses so deadly to humans.

Researchers at St. Jude Children's Research Hospital in Memphis, Tennessee, say the culprit may be a protein found in the genes of many avian flu viruses. The scientists say this protein can attach to proteins in human cells.

They found the protein only in the avian flu viruses they sampled, and not in any of what are known as the human strains of the disease.

The researchers say this striking difference between the two viruses may explain why avian influenza is more lethal to people than human influenza.

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TGIF: You might work in the ER if...

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Vaccine Prototype

From TechNudge:

University of Pittsburgh researchers announced they have genetically engineered an avian flu vaccine from the critical components of the deadly H5N1 virus that completely protected mice and chickens from infection. Avian flu has devastated bird populations in Southeast Asia and Europe and so far has killed more than 80 people.

Because this vaccine contains a live virus, it may be more immune-activating than avian flu vaccines prepared by traditional methods, say the researchers. Furthermore, because it is grown in cells, it can be produced much more quickly than traditional vaccines, making it an extremely attractive candidate for preventing the spread of the virus in domestic livestock populations and, potentially, in humans, according to the study, published in the Feb 15 issue of the Journal of Virology and made available early online.

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"Eat Your Vegetables!"

When Mom or Dad told you to eat up all your fruits and vegetables “because they're good for you,” they were right — although they may not have known all the reasons why. Now researchers conclude that a daily smorgasbord of fruits and vegetables can dramatically cut the risk of suffering a stroke.

An analysis of international studies involving 257,000 people found that those who ate more than five servings of fruit and vegetables a day had a 26 per cent reduced incidence of stroke, compared with those who ate fewer than three servings daily.

Individuals who consumed three to five servings cut their stroke risk by 11 per cent, said principal investigator Dr. Feng He, a cardiovascular research fellow at the St. George's University School of Medicine in London.

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Aprotonin: Risks Outweigh Benefits

A drug approved by the FDA, and sold worldwide for the last 13 years, has now been proven to double a patient's risk of kidney failure, and increase the risk of heart attack, heart failure, and stroke.

The drug Aprotinin has been given to an estimated one million surgery patients to limit bleeding.

These results are based on an independent, observational study conducted by the Ischemia Research and Education Foundation (IREF), in association with the McSPI Research Group, both nonprofit biomedical research organizations, dedicated to saving and extending lives.

IREF and McSPI founder and principal scientist, Dennis T. Mangano, Ph.D., M.D.says the study, which comes hot on the heels of the Vioxx experience,indicates that the problem of drug safety is not only common, but is also much more elusive than previously thought.

He says the study provides compelling evidence of Aprotinin's serious risks, and strongly suggests discontinuation of use and replacement with either of the two alternative generic and far less costly medications proven safe in this study to be safer.

Mangano says their findings raise even more troubling concerns, as Aprotinin has been on the market for three times as long as Vioxx, and yet few comprehensive safety studies have been conducted since approval; the life-threatening complications found with Aprotinin occurred far more frequently than those with Vioxx, and far less expensive generic alternatives to Aprotinin which are equally effective in limiting bleeding have been available, but have been underused.

According to the study replacing Aprotinin with one of two safe generic drugs would annually prevent as many as 11,050 dialysis complications, save at least $1 billion in healthcare (dialysis) costs, and reduce drug costs by at least $250 million.

Figures show that each year approximately one million patients worldwide undergo surgical treatment following a heart attack, with the majority of these patients receiving one of three antifibrinolytic agents to limit blood loss during surgery, Aprotinin produced by Bayer Healthcare, or one of the generic drugs aminocaproic acid and tranexamic acid.

I can recall more than one cardiac surgeon that swore by Aprotonin to prevent massive bleeding for their high risk patients. Some believed that the drug needed to be used on all redo CABG's. I think they're going to have to rethink those ideas. I keep wondering how dangerous drugs like this can get past the finicky FDA.

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Best place for a cardiac arrest...

From Oldster:

An elderly man collapsed from cardiac arrest in a ballroom packed with cardiologists and other doctors attending an American Heart Association fundraiser.

'If you have to go down, that was the place, I guess,' said Dr. Richard Westerman, a cardiologist who helped save the man.

The unidentified patient suddenly slumped over during Saturday night's seventh annual 'Heart Ball,' witnesses said. He had no pulse or blood pressure.

'It looked like he was a goner,' said Santa Barbara City Councilman Brian Barnwell, who was among the 300 people attending the $250-a-plate event. Several doctors sprang into action and revived the man by performing cardiopulmonary resuscitation. Paramedics took him to a hospital.

The patient recovered, Westerman said Monday.

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Ban On Primatene Mist To Protect The Atmosphere

From Seattle PI:

Asthma sufferers may not be able to buy nonprescription inhalers much longer because the devices contain propellants that harm the ozone layer.

An advisory panel voted 11-7 Tuesday to recommend that the Food and Drug Administration remove the "essential use" status that Primatene Mist and other similar nonprescription inhalers require to be sold, spokeswoman Laura Alvey said. Final revocation of that status would mean a de facto ban on their sale.

The FDA usually follows the advice of its outside panels of experts, though a decision can take months. If the agency opts to follow the recommendation, it would begin a rulemaking process that would include public comment, Alvey said.

Wyeth Consumer Healthcare estimates that 3 million Americans use Primatene Mist for mild or intermittent cases of asthma, spokesman Fran Sullivan said. About two-thirds also use a prescription inhaler but rely on Primatene as a backup. Another 700,000 use the inhalers because they don't have a prescription or lack health insurance, he said.

The company is the biggest maker of epinephrine inhalers, with $43 million in sales last year. The drug opens air passages to the lungs to relieve temporarily wheezing, shortness of breath and troubled breathing, according to the FDA.

The over-the-counter inhalers proposed to be banned contain the drug epinephrine along with chlorofluorocarbons, or CFCs, which propel the medicine into the lungs of asthmatics.

Why do I think that atmospheric conditions did not motivate this decision. While I agree that Primatene is suboptimal therapy for asthmatics, it is better than nothing. Asthma is common in inner city areas; perrhaps this is all they can afford. I hope we don't see a spike in asthma ER visits due to no Primatene.

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Good For the Heart, But Doesn't Prevent Cancer

From FoxNews:

Eating fish is good for you, but it won't prevent cancer, according to a new study.

It's no reason to stop eating fish rich in the important nutrients called omega-3 fatty acids. Omega-3 fatty acids cut your risk of heart disease and stroke and aid children's early mental development. They seem to do many other good things, too.

They just do not just fight cancer, find RAND researcher Catherine H. MacLean, MD, PhD, and colleagues. As part of a huge, government-funded study, MacLean's team looked for every scrap of evidence on omega-3 fatty acids and cancer risk. They analyzed 38 large studies that evaluated the risk of 11 different cancers in people who consumed different amounts of omega-3 fatty acids.

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First OTC Weight Loss Drug Approved

Two committees that advise the Food and Drug Administration yesterday voted to support GlaxoSmithKline's effort to bring the first nonprescription weight-loss drug to the market.

Committee members voted 11-3 to support taking a lower-dose version of the prescription drug Xenical over the counter, saying the potential benefits of having an alternative to unproven dietary supplements outweigh the risks.

The ultimate decision now rests with Food and Drug Administration officials. But George Quesnelle, president of Glaxo's North American Consumer Products division in Moon, said the company expects to be selling its product later this year.

Glaxo anticipates that 5 million to 6 million people per year will purchase the drug, which will be sold under the name Alli.

"We look forward to working with the FDA to gain final approval," Mr. Quesnelle said. "We're excited by the potential to provide consumers with an FDA-approved over-the-counter option that provides gradual but meaningful weight loss."

With the side effect of diarrhea, and over 5 million interested in the drug, that's a lot of trips to the bathroom!

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Hearing Damage From the iPod

The popular iPod may be doing more harm than good, especially to the hearing of the user, doctors say. According to Christine Albertus, an audiologist with the Marshfield Clinic in Marshfield, Wisconsin, iPod users should limit their use of the device to two hours or less per day.

The problem lies in the in-ear headphones Apple offers for the device. Before, music blasted from the speakers of their home audio systems. With the advent of the Walkman, the sound moved closer to the ear through muff-style headphones.


Now, with the iPod and other MP3 players, sound is now pumped directly into the ear, which is a potential health issue. "We're moving sound closer and closer. It's really increasing pressure on the ear," Albertus said.

Hearing damage can also accumulate, says Albertus. Even at reasonable levels, damage can occur after continuous listening. This problem is becoming prevalent in today's youth. "Fast forward, and they may be hearing aid candidates by the time they're in their early 40s," she said.

This is an impending health crisis. As more and more of the younger generation listen to the wildly popular iPod, many of them will end up with hearing loss at the rate we're going here. Maybe Apple will have to come out with the iHearing Aid.

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Limiting Flavors Limits Weight

From CNN:

Forget counting carbs and calories. Obesity researcher Dr. David Katz says the way to lose weight is to limit flavors. Katz says people stop eating when the brain's appetite center registers "full." But eating lots of flavors promotes overeating because different sensors must register full for appetite to subside, Katz says.

We can call this "The Bland Diet." What a boring weigh to lose weight, and salsa doesn't even really have calories!
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Working To Death

From MedPage Today:

There's a plausible explanation for how humdrum employees can be worked to death.

Researchers here have found that employees with chronic work stress have more than twice the risk of having metabolic syndrome as their more laid back co-workers.

"A dose-response association exists between exposure to work stress and the metabolic syndrome," reported Tarani Chandola, D.Phil., and colleagues at University College London, today in the online version of the BMJ, formerly the British Medical Journal.

"The study provides evidence for the biological plausibility of psychosocial stress mechanisms linking stressors from every day life with heart disease," the investigators wrote.

They looked at data on more than 10,000 Britons who took part in the landmark Whitehall II study, which follows the health of men and women on Her Majesty's civil service.

A previous study using the same dataset by co-authors Michael Marmot, M.D., and Eric Brunner, M.D., found that workers who feel that they are treated justly on the job have a significantly lower risk for coronary artery disease than their fellow employees who feel they can't get a break.

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One man's trash...

From CNN:

After the holiday is over, some Christmas trees end up in landfills, others get a second gig as garden mulch.

But soon thousands may end up as part of a lifesaving drug.

The needles of pine, spruce and fir trees contain a fairly high concentration of shikimic acid, the main ingredient in Tamiflu. Countries all over the world are stockpiling the drug in anticipation of a bird flu pandemic.

Most shikimic acid is obtained from star anise, a cooking spice from a tree grown in China. Prices of the spice skyrocketed when anxiety over a the possibility of a human outbreak of avian flu escalated.

A small Canadian company, Biolyse Pharma Corp., is now processing thousands of discarded trees to retrieve the acid.

"It's an urgent matter, and we should be starting production -- not once the pandemic hits, but before that," said chemist Brigitte Kiecken, Biolyse's CEO.

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Robot Takes X-Rays

From TechNudge:

A US scientist has developed a robot, which can take X-ray pictures of sufferers of orthopedic injuries as they move around. Complaints of orthopedic injuries are among the most common reasons people visit the doctor. Surgeons use static X-rays, MRI and CT scans to diagnose patients. They also use X-ray video. But current technologies provide only a tight view of a very limited range of motions in a controlled laboratory setting.

The best part is the robot doesn't have to worry about radiation exposure!

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Nursing Shortage

Hospitals are under pressure to keep control of their bottom lines, and nurses account for a large part of their budgets. But a recent study published in the Health Affairs medical journal found hiring more nurses could actually save a hospital money in the long run. The study found 6,700 patient deaths and four million days of hospital care could be avoided each year by increasing staff of registered nurses.

However, training new nurses is the problem. Last year, nursing schools had to turn away 125,000 applicants because they didn't have enough faculty to teach them. Many nursing professors are retiring just when they're needed most.

"Today, we have a cruel and unfortunate development, said Buerhaus, who co-authored the Health Affairs study. "Our current workforce will get older and older and retire in large numbers in the next decade just as we see the aging of baby boomers, all 80 million of them, beginning to turn 65 and consuming more health care."

To make matters worse, patients in hospitals today are sicker than 20 years ago. In the past, a nurse could take care of more patients because some of them were recovering from minor operations. But now, with so many outpatient procedures, an overnight hospital stay is a rarity.

"We have a much higher acuity level patient who requires a lot more nursing care and we have less nurses to provide that care," said Dr. Timothy Babineau, the chief medical officer at the University of Maryland's Medical Center.

We all know that our nurses are in short supply. It's nice to see some media attention on the issue.

See the list of Magnet nurses, by hospital here.

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TGIF: Frozen In

From Oldster:

When a 58-year-old motorist nipped into a German highway rest stop public toilet to answer the call of nature Friday morning, he had no idea how nippy it really was, and found himself trapped in the toilet stall after the lock froze while he was inside.

Unable to pry the door open, the man finally was able to explain his predicament when someone occupied the stall next to him and get them to call police on a cell phone.

After about an hour in the chilly cell, police were able to get the door open and free the man, whom they described about 'thoroughly frozen through, but in good general health.'

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Suspended Animation Revisited

From The Sydney Morning Herald:

Researchers are testing potentially life-saving techniques for keeping humans in a state of suspended animation while surgeons repair their wounds.

US doctors have developed a method of inducing hypothermia to shut down the body's functions for up to three hours.

In tests, they reduced the body temperature of injured pigs from 37C to 10C before operating on them and then reviving them.

Now they are applying for permission to test the procedure on casualty patients without a pulse who have lost large amounts of blood, New Scientist magazine reported.

It is thought this method and others could one day be used on car crash and gunshot victims, as well as in the battlefield to treat wounded soldiers.

A surgeon at Massachusetts General Hospital in Boston, Hasan Alam, has tested the technique about 200 times on pigs, with a 90 per cent success rate.

First he anaesthetises the animal, then cuts a major vein and artery in its abdomen to simulate multiple gunshots to a person's chest and abdomen.
As the pig rapidly loses about half its blood and enters a state of shock, Dr Alam drains its blood and stores it before pumping chilled organ preservation fluid into its system.

The animal's body temperature falls to about 10C until it is in a state of "profound hypothermia" and has no pulse and no electrical activity in its brain.

But after the blood stored earlier is warmed and pumped back into the pig's body its heart starts beating again and it comes back to life.

"It is still pretty awe-inspiring," Dr Alam said. "Once the heart starts beating and the blood starts pumping, voila, you've got another animal that's come back from the other side.

"Technically, I think we can do it in humans."

I will admit, on first read this sounded like something out of a horror movie. On the other hand, medical advances have been based on less. It's not like we have a great standard therapy for patients that have lost half their circulating blood volume that arrive at the hospital without a pulse.

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Happy 100th Birthday

The mind-altering drug LSD is an unlikely subject for a 100th birthday party.

Yet Swiss chemist Albert Hofmann, father of the "problem child" and first human guinea pig of LSD, is celebrating his centenary Wednesday in good health and planning to attend an international scientific meeting on the hallucinogenic, which inspired a generation of flower children as it worried their parents.

"I sat down at home on the divan and started to dream," Hofmann told Swiss television network SF DRS about his first experience with LSD. "I had wonderful visions. What I was thinking appeared in colors and in pictures. It lasted for a couple of hours and then it disappeared."

Hofmann, who also has had bad experiences with the drug, continues to insist that the controversial substance should be used as a medical treatment, particularly for psychiatric research. But LSD's reputation has been as turbulent as some acid trips.

I don't think the insurance companies are going to foot the bill for this "therapy."

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Biobank To Open For Deposits

From TechNudge:

You might donate blood to help save someone's life. But would you donate your blood, your DNA, and your most intimate medical secrets on a promise that it may help save a life years from now?

Half a million people will be expected to do just that in the coming months, with another half a million people to follow, as two huge medical research projects get under way in the UK and US. The British project, called Biobank, is due to start within weeks, after five years of preparation. The American project, announced in 2004 by the National Human Genome Research Institute in Bethesda, Maryland, is still at the planning stage.

This brings up all kinds of privacy issues, with the hope of some serious genetic research. My hope is that they set this up so that everyone's privacy is safeguarded. What if they discover a "heart attack gene?" This poor soul, or souls, would then have difficulty finding a full time job, spouse, and health insurance. Information solves some problems, but creates just as many more.

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Some more info here.

The Latest On Mobile Phones & Cancer

Using a mobile phone does not increase the risk of developing the most common type of brain tumor, according to a study on Friday.

After a four-year survey, scientists at the Institute of Cancer Research in London and three British universities found no link between regular, long-term use of cell phones and glioma.

"Overall, we found no raised risk of glioma associated with regular mobile phone use and no association with time since first use, lifetime years of use, cumulative hours of use, or number of calls," said Professor Patricia McKinney, of the University of Leeds, in a report in the British Medical Journal.

She added that the results were consistent with the findings of most studies done in the United States and Europe.

Anthony Swerdlow, a co-author of the report, from the Institute of Cancer Research, said the survey is larger than any of the other published studies and part of a collaboration involving 13 countries.

During the past two decades, the use of mobile phones has risen rapidly worldwide but there has been no hard evidence to substantiate fears that the technology causes health problems ranging from headaches to brain tumors.

With the amount of time we all spend on our cell phones, this is quite a relief! Now we can keep on talkin' with reckless abandon until our five hour battery runs out.

Additional info here.
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New Package Inserts For Prescription Medications

U.S. health officials announced Wednesday a major overhaul of the package inserts that accompany prescription drugs.

It's hoped that the changes, designed to be easier to read and understand, will benefit not only doctors and other health-care workers, but consumers as well, officials said at a news conference.

"We see this as a platform whereby we can build much better consumer information," said Dr. Janet Woodcock, deputy commissioner for operations at the U.S. Food and Drug Administration. "This is just one step in getting better prescribing information to the people who need it."

The revisions, the first since 1975, will require that package inserts include a "prominently displayed summary of key information including indications, usage, dosage and administration," said FDA acting commissioner Dr. Andrew von Eschenbach. This summary, or "Highlights" section, will be about half a page in length, he said.

Health-care professionals can also expect to see a table of contents, patient-consulting information to ease communication between doctor and patient, as well as a toll-free number and Internet reporting information for suspected side effects. Drug manufacturers will also be required to provide a list of all substantive changes made to the product during the past year.

I hope they also make the print larger. It's just too tiny now.

More info here.

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Top Ten In Medgadget Awards

I just wanted to thank one and all, for each of you that gave us your vote in the recent MedGadget competition for the best new medical blog. Despite being barely two months old, and despite the fact that the "best new medical blog" category had the most voting, we managed to come in at eigth place.

Along this line of thought, it was interesting to note the uneven voter turnout between categories. Best New Medical Blog category received a combined 2115 votes--far more than any other division, and fivefold more than the smallest category (the Best Literary Medical Blog, which was also the one with the fewest nominees).

We'll think of it as being on Car & Driver's "Ten Best" list. Acura never seems to complain about it. Congratulations to Nee Naw that won the category.
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New Bird Flu Test

From TechNudge:

Chip maker STMicroelectronics said Wednesday it has teamed with Singapore-based medical firm Veredus Laboratories to develop a disposable laboratory-on-a-chip that can detect strains of bird flu and other influenza viruses within an hour.

Based on ST’s In-Check platform, the application under development aims to identify whether a patient is infected with the avian flu (H5N1) or a subtype of Influenza A or B in a single test, rather than conducting a series of tests, as required now.

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Yogurt Joins The Fight Against HIV

Yogurt bacteria may be useful in blocking HIV transmission, providing a cheap and effective way of fighting the virus, Nature magazine said, citing a study by researchers in the U.S. and the U.K.

Lactococcus lactis, a bacterium used to produce cheese and yogurt, was altered genetically by scientists at Brown Medical School in Rhode Island and the U.K.'s Food Research institute to generate cyanovirin, a drug that has been used to stop HIV infection in the cells of monkeys and humans, Nature said on its Web site.

The bacterium is also found in the human body, including the stomach and vagina where it halts the growth of other harmful bacteria. The same principle could be applied with the genetically modified version, Nature said. The bacteria may have advantages over vaccines because it could be applied directly to peripheral areas of the body including the mucosal surfaces of the vagina, the report said.

``You need less of the therapeutic chemical if you deliver it locally,'' Lothar Steidler, a molecular biologist at Cork University in Ireland who has worked on modifying bacteria to deliver drugs, was quoted saying by Nature.com.

The bacteria can live in the vagina for as long as a week, and the scientists are working to prolong the life, the magazine said. Bharat Ramratnam, an HIV specialist at Brown in Providence, Rhode Island, and colleagues led the research, which is published in the Journal of Acquired Immune Deficiency Syndrome, Nature said. The researchers will test the bacteria in monkeys.

Should the bacterium prove useful it would be a cheaper way of providing protection, an important issue for countries in Asia and Africa where AIDS and HIV are rife, the report said.

This would be an inexpensive way to slow down the spread of HIV. If this works, they should put it in all of our yogurt, like fluoride in the water.

Medicine Tag
Health Tag

Coffee & The Heart

A new research has found that two cups of coffee can reduce the body's ability to boost blood flow to the heart muscle in response to exercise.

"Whenever we do a physical exercise, myocardial blood flow has to increase in order to match the increased need of oxygen.

“We found that caffeine may adversely affect this mechanism. It partly blunts the needed increase in flow," said Philipp A. Kaufmann, M.D., F.A.C.C., from the University Hospital Zurich and Center for Integrative Human Physiology CIHP in Zurich.

The researchers, including lead author Mehdi Namdar, M.D., F.A.C.C., studied 18 young, healthy people who were regular coffee drinkers. The participants did not drink any coffee for 36 hours prior to the study testing.

In one part of the study, PET scans that showed blood flow in the hearts of 10 participants were performed before and immediately after they rode a stationary exercise bicycle.

In the second part of the study, the same type of myocardial blood-flow measurements were done in 8 participants who were in a chamber simulating the thin air at about 15,000 feet (4,500 meters) altitude.

The high-altitude test was designed to mimic the way coronary artery disease deprives the heart muscle of sufficient oxygen.

In both groups, the testing procedure was repeated 50 minutes after each participant swallowed a tablet containing 200 milligrams of caffeine, the equivalent of two cups of coffee.

The caffeine dose did not affect blood flow within the heart muscle while the participants were at rest.

However, the blood flow measurements taken immediately after exercise were significantly lower after the participants had taken caffeine tablets. The effect was pronounced in the group in the high-altitude chamber.

Blood flow normally increases in response to exercise, and the results indicate that caffeine reduces the body's ability to boost blood flow to the muscle of the heart on demand.

Dr. Kaufmann said that caffeine may block certain receptors in the walls of blood vessels, interfering with the normal process by which adenosine signals blood vessels to dilate in response to the demands of physical activity.

Medicine Tag
Health Tag

On Aspirin Therapy

When it comes to the role of aspirin in preventing cardiovascular events, men are from heart attacks, and women are from strokes.


For both men and women, aspirin therapy provides significant protection against cardiovascular events, but it works in different ways depending upon gender. Aspirin protects women against ischemic strokes, but not myocardial infarction or death, while it affords men protection against MI, but not strokes or cardiovascular mortality.


Those conclusions are drawn from results of a meta-analysis conducted by David L. Brown, M.D., of the State University of New York here and colleagues at other centers, and published in the Jan. 18 issue of Journal of the American Medical Association.


"This is good news because many of the past studies of the effect of aspirin in preventing cardiovascular events looked only at men, so physicians were reluctant to prescribe aspirin for women because there was little data," said co-author Jeffrey Berger, M.D, of Duke University in Durham, N.C. "But now, the combined data of recent trials involving women demonstrates that women can benefit just as much from aspirin therapy as men."

So therefore, both males and females benefit, but in different ways. Intriguing, no?

Medicine Tag
Health Tag

Plastic Surgery Is Booming

From The Independent:

Bigger breasts were top of the shopping list for women seeking cosmetic surgery last year, which saw overall demand soar by one-third.

The growing acceptability of nip and tuck as a means to cosmetic enhancement has fuelled a booming industry and turned plastic surgeons into millionaires.

Breast augmentations, costing £4,000, were up by more than 50 per cent to 5,655 operations - the commonest procedure in the cosmetic surgery pantheon. Breast reductions were less than half as popular with 2,700 procedures, up less than 10 per cent on 2004.

Anti-ageing procedures - facelifts, eyelid surgery and brow lifts - also boomed with increases of between a third and a half.

Men are also going under the knife in search of aesthetic perfection with the number of cosmetic operations up 80 per cent from 1,348 to 2,440. But they still account for just 11 per cent of the total. The most popular operation on men is rhinoplasty - the nose job.

The figures are published today by the 170-member British Association of Aesthetic Plastic Surgeons (BAAPS), which represents the top surgeons in the business. They carried out 22,041 operations last year, up from 16,367 in 2004.

More than 100,000 cosmetic procedures are carried out in Britain each year, including treatments such as Botox for wrinkles and laser peels to rejuvenate skin, performed by doctors, who have had no specialist training in cosmetic surgery.

Somehow, even in a country with socialized medicine, they still have plenty of money for this sort of thing. It's always interesting to see what a society thinks is important. Hip replacement for an octogenarian or botox? Ultimately, our patients are voting with their dollars.

Medicine Tag
Health Tag

Eat Healthy....Live Longer

Cutting back on calories will not only help you lose weight, it may also reverse the ageing process, according to new research.

Scientists found that a group of healthy eating fanatics had hearts 15 years younger than those of other people their own age.

Ultrasound scans showed their heart muscle was unusually elastic. In addition an important heart function, the way the heart relaxes between beats, looked astonishingly young.

Genetics was not thought to be a factor, since most of the US volunteers had parents, grandparents, or siblings who had suffered heart attacks or strokes.

The key influence appeared to be what they ate.

Members of the Caloric Restriction Society, to which the group belong, stay clear of processed foods, soft drinks, sugary desserts, and white bread.

The patients ate what is essentially known as "The Mediterranen Diet." While this is encouraging, I think this would require a lot of work to get our patients to comply with this type of therapy.

Medicine Tag
Health Tag

Drinking On The Job

Based on a nationwide telephone survey of 2,805 employed adults, a researcher at the University of Buffalo in New York reports that an estimated 15% of the workforce has had at least one incident in the last year of drinking before or during work, being under the influence of alcohol while at work or being hung over while at work.

Michael Frone, an associate professor of psychology, estimates that in the last year, 1.8% of the workforce has consumed alcohol at least once before coming to work, 7.1% of workers drank alcohol at least once during the workday and 9.2% of the workforce has soldiered on with a hangover.

The study, published in this month's Journal of Studies on Alcohol, found that alcohol use was more common among men, younger workers and single people. The good news is that such use is infrequent. For example, of employees who drank before work, 71% did it less than monthly.

Some more info here.

I see why "Have you ever had an 'eye-opener'?" is one of the CAGE questions.

Medicine Tag
Health Tag

Dell Plans To Profit From Bird Flu

Dell Inc.'s direct-to-customer sales could allow it to turn a bird-flu outbreak into a revenue booster by letting buyers avoid shopping in public, the company's chief executive said Thursday.

"We deliver to homes," said Dell CEO Kevin Rollins. "People don't have to come to stores."

During the SARS epidemic, "our business in China boomed," he said, because people were either quarantined or sequestered themselves at home in order to avoid coming in contact with the deadly virus.

The same thing could happen again if there's a bird-flu epidemic, Rollins said.

Personally, I can't believe that the chairman of Dell would stand up at a luncheon and tell the guests how he expected his company to profit from an epidemic. I've never liked Dell computers, and now I have one more reason not to purchase anything from them.

Medicine Tag
Health Tag

Pill Cam

Last year, Shivshanker added a new, noninvasive weapon to his gastroenterological arsenal. Instead of the traditional endoscopy, with some patients he uses the PillCam, a plastic capsule about the size of a large vitamin pill that is fitted with video cameras at each end.

The patient is not sedated, as in an endoscopy, but simply swallows the pill with water. It progresses down the esophagus and takes about 2,600 color pictures at a rate of 14 per second. After 20 minutes, the doctor evaluates the video images and makes a diagnosis. The disposable capsule is passed naturally, usually within 24 hours.

The wave of the future! The original pill cameras took an image every other second, this is much faster. This allows it to evaluate the esophagus and GE junction.
Health

ER's On Verge Of Crisis

States are lagging in maintaining hospital emergency departments and the public safety that could make them less necessary, according to a report released by a physicians` group Tuesday.

The report -- issued by the American College of Emergency Physicians -- gave states an overall `C-minus` for not doing enough to maintain staffing and funding for emergency rooms. The report also charges that many states have not reined in malpractice lawsuits, a politically touchy issue that has divided the political parties in Congress and in the states.

'The results of this report make it clear that the national emergency health care system needs urgent attention,' concludes the report. 'Their beds are full, their hallways are full, their resources are being stretched to the limit,' said Frederick Blum, the group`s president.

California earned the highest marks, although the group still gave the state only a `B` score. Massachusetts, Connecticut and the District of Columbia also earned `B`s`. Arkansas scored at the bottom with a `D` for what doctors said was weak public funding, a shortage of trauma centers, and a high traffic fatality rate.

ACEP is asking Congress to provide direct funding to help bolster emergency departments. The report graded states on doctor and nursing staff levels, hospital spending, whether or not they have residency training programs in emergency medicine, and other items. The group also took into account public health and safety factors like seat belt and motorcycle helmet laws.

We, and our patients, have suffered the consequences of our overburdened emergency departments. Some of our patients get fed up with the wait and leave before being seen, and getting their symptom diagnosed. Our ER's are already operating at capacity, or above. If there were a disaster (heaven forbid), there is nothing left of reserve capacity to be able to handle it. After all, the hospital cafeteria can only help out so much under even the most adverse circumstances.

Man's Best Friend Joins The Fight Against Cancer

Dogs can detect whether someone has cancer by sniffing the person's breath, a new study shows.

Dogs trained to sniff out cancer With only a few weeks of basic "puppy training", the ordinary household dogs are able to detect both early and late-stage lung and breast cancers by merely sniffing the breath samples of patients.

The study was conducted by the Pine Street Foundation, a cancer research organization in San Anselmo, California, and published in the March issue of the journal Integrative Cancer Therapies.

According to Michael McCulloch, who led the research, their study provides “compelling evidence that cancers hidden beneath the skin can be detected simply by (dogs) examining a person's breath.”

Lung- and breast-cancer patients are known to exhale patterns of biochemical markers in their breath.

"Cancer cells emit different metabolic waste products than normal cells," said Nicholas Broffman, the executive director of the Pine Street Foundation. "The differences between these metabolic products are so great that they can be detected by a dog's keen sense of smell, even in the early stages of disease."

Dogs, known as the man’s best friend, are expected to become an important tool in early screening and detecting cancers, which can greatly improve a patient's survival chances.

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Noncompliant Patients

A lot of people with heart disease aren't taking the medications their doctors prescribe for them as often as they should, cardiologists report.

Almost half of the 31,750 people treated at Duke University for major heart problems in a seven-year study acknowledged that they were not taking beta blocker drugs, aspirin and cholesterol-lowering drugs exactly as their doctors had ordered, according to a report in the Jan. 10 issue of Circulation.

In fact, the study showed, the patients who would benefit most from drug therapy -- the elderly, those with heart failure, those with other diseases -- were the least likely to be using them as directed.

The study participants had all undergone at least one heart procedure, such as bypass surgery, or had at least 50 percent blockage of one coronary artery. Yet, while a majority did take the drugs now and then, many did not take them regularly.

For aspirin, presumably the easiest drug to take, 29 percent said they did not consistently use it as ordered. The compliance rate was much lower for other medications: 46 percent said they took beta blockers as ordered, and only 44 percent followed instructions for using lipid-lowering drugs such as statins.

The usage of ACE inhibitor drugs by people with heart failure, the progressive loss of ability to pump blood, were even lower: only 20 percent said they took the medication consistently.

This is rather discouraging. I wonder if the patients really understand how important these medications are to their health, and even survival. Less than 50% compliance is a health crisis in its own right.

What's the solution here? Patient education? Paper checklists? Visiting nurses? Phone call reminders? I think we should all brainstorm here and try to do better; our patients deserve no less from us.

Bodies: The Controversy

Premier Exhibitions, which produced "Bodies," obtained the bodies and body parts from the Dalian Medical University of Plastination Laboratories in China.

The Chinese laboratories prepare the skinned bodies and body parts via polymer preservation, also called plastination or plasticization. In this process body water and fats are replaced with liquid silicone rubber. The laboratory supplies the bodies to human-anatomy exhibits around the world.

The corpses and body parts used in "Bodies: The Exhibition" were "legally obtained" from various medical schools and universities in China, Glover said. In addition to being a spokesperson for "Bodies," Glover is a professor emeritus of anatomy and cell biology at the University of Michigan in Ann Arbor.

"It is standard legal practice in both the United States and China that unclaimed or unidentified remains are made available for medical education, which is one of the key goals of our exhibition," he said.

But Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, is uncomfortable with the practice. Regardless of the law, the use of unclaimed bodies in human-anatomy exhibits is questionable, Caplan says.

"There's a fine line between education and exploitation in these kinds of exhibits. And you only want people to be displayed if you have their consent, not the consent of a third party," he said.

Gastric Ballooning For Weight Loss

A popular procedure in Europe called gastric ballooning seems like a great alternative to gastric-bypass surgery. All it takes is inserting a balloon into the stomach through the throat and then filling the balloon with liquid.

Unlike gastric-bypass surgery, gastric ballooning is a quick, relatively painless and affordable way to help obese people lose weight. But the Food and Drug Administration has not approved the gastric-ballooning procedure, and it is almost nonexistent in the United States.

Why? This international difference of opinion stems in part from a nagging sense of doubt among American bariatric surgeons and other obesity experts about the balloon's safety and effectiveness. Not a lot of clinical trials have been done, and some experts theorize that the balloon technique isn't drastic enough to reduce ghrelin, a hormone produced in the stomach that increases hunger and that gastric-bypass surgery suppresses.

It doesn't help that the history of the gastric balloon has been marred with controversy. Older intragastric balloon models tended to break down from stomach-acid corrosion, and some even passed into the intestines, where they caused life-threatening bowel obstructions, said Dr. Nicholas Bertha, a bariatric surgeon at St. Clares Health System Center for Weight Loss Surgery in New Jersey.

But Inamed Health, a manufacturer of a newer version called the BioEnterics Intragastric Balloon, states on its Web site that its balloon is made of "durable, elastic, high-quality silicone." And the balloons are left in place for only six months to prevent any corrosion.

Safety concerns aside, Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York, said that the stomach eventually "learns" to compensate for the balloon's presence and the weight-loss benefit is lost.

"Long-term [clinical] trials are unlikely to show lasting weight loss for a period of time to make the investment worthwhile," Roslin said.

I don't think this controversy is going to be settled any time soon.

On Magnet Therapy...

The use of magnetic devices to cure a variety of ills has soared in recent years but there is no evidence they work, according to an editorial in the British Medical Journal.

The market for magnetic bracelets, knee pads and the like may now be worth about one billion dollars a year, but two American scientists argue in the journal on Friday that many people are being fooled as to their therapeutic benefits.

"Money spent on expensive and unproved magnet therapy might be better spent on evidence-based medicine," professors Leonard Finegold and Bruce Flamm wrote.

They said the many studies that purport to show magnets do work are suspect because a magnet's main characteristic -- to be attracted or repelled by metals -- would betray it compared with placebos.

But they said magnet wearers may feel better even if there is no supporting evidence.

"Perhaps subjects with magnetic bracelets subconsciously detected a tiny drag when the bracelets were near ferromagnetic surfaces (which are ubiquitous in modern life), and this distracted or otherwise influenced the perceived pain."

The pair warned the sophisticated marketing of magnetic devices could result in underlying medical conditions being left untreated.

"Magnets are touted by successful athletes, allowed to be widely advertised, and sold without restrictions, so it is not surprising that lay people think that claims of therapeutic efficacy are reasonable," they said.

Bird Flu In Turkey- 3rd Child Died

A third child died from suspected bird flu in eastern Turkey today, and up to 30 other people have been treated in hospital after showing signs of the disease.
Hulya Kocyigit, 11, died in a hospital in Van a day after her 15-year-old sister, Fatma, had succumbed to the virus, hospital officials said. The girls' brother, 14-year-old Mehmet Ali, died on Sunday.

The condition of a fourth ill child from the same family had improved and he was no longer attached to a respirator, Huseyin Avni Sahin, the head physician at the hospital, said. However, three people remained in a serious condition.