Milk: Overstated Intolerance

Milk and other lactose-rich products may be getting a bum rap for food-related gastrointestinal symptoms, researchers here say.

The real culprit could well be an as-yet uncharacterized intestinal immune-mediated disorder, reported Laura Paajanen, M.D., of the Foundation for Nutrition Research here in the December issue of the American Journal of Clinical Nutrition.

In a blinded challenge of 23 individuals with food-related gastrointestinal symptoms, milk caused significant symptoms in only two, Dr. Paajanen and colleagues found.

They surveyed 827 individuals, ages 16 to 21, about food-related gastrointestinal symptoms. They then gave a clinical exam and a battery of tests, including a lactose-intolerance test and the blinded milk challenge, to 47 participants who reported such symptoms and agreed to the various tests.

The 47 participants reported food-related GI symptoms including abdominal pain, regurgitation, chronic nonspecific diarrhea, non-ulcer dyspepsia, dyschezia, and constipation. Only 14 of the 47 consumed milk or diary products without restriction. Most limited their intake of diary products to some extent, believing these to be at least partially responsible for their symptoms.

A control group of 29 symptom-free individuals also underwent the tests.

See, it's true- "milk, it does a body good!" After this study, folks will have to blame something else for a while.

From CNN.

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Diarrhea Vaccine

An experimental vaccine provided some protection against that scourge of tourism, traveler's diarrhea, when put to a rigorous test among U.S. students in Mexico and Guatemala, scientists reported Friday.

The research provides important evidence that a vaccine is possible against the hard-to-avoid germs, instead of merely urging travelers to guard against risky food and water. Now the challenge is to strengthen that protection.

"This is a very encouraging first step," said microbiologist A. Louis Bourgeois of Johns Hopkins University's Bloomberg School of Public Health, who led the study of the Swedish-developed vaccine.

Traveler's diarrhea is the leading cause of illness among visitors to developing countries, striking an estimated 20 million international travelers a year. While there are numerous causes, the chief culprit is bacteria called enterotoxigenic E. coli, or ETEC. It is spread through contaminated food and water, and while rarely life threatening to the otherwise healthy traveler, it can cause up to a week of misery.

ETEC is becoming more resistant to antibiotics, making it harder to treat the seriously ill and increasing the need for a vaccine, said Dr. David Hooper of Massachusetts General Hospital, who helped organize the American Society for Microbiology meeting where the data was unveiled.

Scientists are hunting a variety of ways to make an anti-ETEC vaccine. This one came about almost accidentally: During tests of a cholera vaccine in Bangladesh, some recipients also seemed temporarily protected from ETEC-caused diarrhea. So researchers at the University of Goteborg in Sweden and that country's SBL Vaccines created a vaccine especially for traveler's diarrhea.

They used part of that cholera vaccine, because a toxin produced by cholera is very similar to an ETEC-produced toxin. The new vaccine also contains killed E. coli cells -- designed to stimulate the immune system to attack the germs before they dock in the intestine and start making toxin.

Some 1,406 U.S. students swallowed the vaccine or a placebo before spending up to a month studying Spanish in Guatemala or Mexico. (The vaccine is considered so safe that students received it by mail, swallowing it at home as researchers supervised by telephone. )

At first, the vaccine appeared only to lessen disease severity, Bourgeois said. Then researchers used blood tests to determine if the vaccine in fact stimulated an immune response. It didn't "take" in everybody.

But among responders, it was 84 percent effective at blocking severe diarrhea, and 63 percent effective at blocking even mild cases, too. Vaccine responders who did get sick had half as many days of illness as placebo recipients.

A vaccine is always preferable to antibiotics!

From Wired.

Web Site To Notify Partners of STD's

Los Angeles County health officials have opened an internet website on which users can anonymously notify their sex partner of having been infected with a sexually transmitted disease.

The site, www.InSPOTLA.org," which opened on Wednesday, offers different types of electronic postcards to simultaneously e-mail up to six sexual partners of being infected with an STD.

"You're too hot to be out of action," reads one card, featuring the back of a handsome man covering his behind with a towel. "I got diagnosed with an STD since we played. You might want to get checked too."

The site gives information about several of the most common STDs and how to prevent them.

Another card reads: "It's not what you brought to the party, it's what you left with. I left with an STD. You might have too. Get checked soon."

The site was developed by a non-profit group called the Internet Sexuality Information Services, and co-sponsored by the Aids Healthcare Foundation, with funding from the Los Angeles County.

"Face-to-face communication is really the way to go, but some people can't do that," said Karen Mall, Aids Healthcare Foundation's director of prevention and testing.

Leave it to those crazy Californians to come up with this one. You just never know what you'll find in your email inbox now!

Just charge it...

WellChoice (New York; $3.4 million in assets) and American Express (New York) will offer American Express HealthPay Plus Card, a healthcare payment solution for participants in Empire Total Blue's consumer-directed health plan. The card, provided by American Express Bank, provides two payment options. It is tied to both a Health Savings Account (HSA) and a line of credit to help cover costs that may exceed the balance of the HSA. The HSA also allow consumers to contribute pre-tax dollars to their medical expenses.

The card provides WellChoice's 40,000 members in the Empire Total Blue consumer-directed health plan with a single payment option at a healthcare provider, physician, pharmacy or hospital.

The card allows consumers, providers and insurers a secure and easy way to manage healthcare costs and payments, asserts Jason Gorevic, senior vice president chief sales and marketing officer of WellChoice. "A lot of innovations in consumer-directed healthcare have been adding features, but this solution solves real problems and delivers real value to both consumer and healthcare providers because of the integrated claim processing," he says.

According to Gorevic, WellChoice identified the need for the HealthPay Plus Card to engage consumers further into the financial decision-making process. The health insurer also set up the card because of consumer concerns over the administrative complexity of consumer-directed health plans. "Matching up an explanation of benefits with a bill from a provider, accessing the funds and deciding where the funds are going to come from concerned the consumer," explains Gorevic. Furthermore, providers, who are used to receiving co-pays, expressed concern about collection. "We identified that a single-source solution addressed these barriers to consumer-directed healthcare," notes Gorevic.

FDA Curbs Fake Flu Remedies

The U.S. Food and Drug Administration said on Tuesday it had warned nine companies to stop marketing "bogus" flu products.

The products, including capsules that allegedly contain bacteria from dirt and other assorted immune system "boosters," all claim or claimed to help prevent or treat avian flu.

"FDA is not aware of any scientific evidence that demonstrates the safety or effectiveness of these products for treating or preventing avian flu and the agency is concerned that the use of these products could harm consumers or interfere with conventional treatments," the agency said in a statement.

"The use of unproven flu cures and treatments increases the risk of catching and spreading the flu rather than lessening it because people assume they are protected and safe and they aren't," said Dr. Andrew von Eschenbach, acting FDA commissioner.

"I consider it a public health hazard when people are lured into using bogus treatments based on deceptive or fraudulent medical claims."

All of the companies sell via Internet Web sites and the FDA complained about several claims, including "prevents avian flu," "a natural virus shield," "kills the virus," and "treats the avian flu."

Most are promoted as being "natural" or "safer" treatments that can be used in place of approved drugs.

"In the Warning Letters, FDA advises the firms that it considers their products to be drugs because they claim to treat or prevent disease," the FDA said.

This type of thing makes you wonder how far we've come from the snake oil salesman of the Wild West in the late 1800's. Perhaps not as far as we think we have. What was their phrase? "Good for whatever ails ya!" This resonates today as well.

Technology Being Developed To Aid The Elderly

In a sprawling exhibit at the conference in a Washington hotel Monday, the group displayed 50 prototypes and early-stage products -- from a robotic assistant called ``Nursebot'' to an interactive, Web-enabled medicine cabinet.

Some of the technology is expensive. It costs about $4,500 to outfit a home with wireless sensors in one Intel project: A personal computer and the Internet are used to allow doctors and relatives to check on a range of activities by a senior living alone. It tracks such things as whether medications have been taken to how many steps the person has walked since waking up, said Eric Dishman, chair of the Center for Aging Services Technology.

Prices should come down significantly in the future, he said, and those costs would be weighed against the sky-high price of medical care.

``If you look at a condition like Alzheimer's, keeping somebody in their own home for one to three days could pay for the cost of the technology,'' said Dishman, who also heads Intel's Health Research and Innovation Group.

Barrett has made health research a priority at the company, saying it fits with Intel's strategy of identifying new ways to use technology.

Barrett is a senior citizen himself, moving from chief executive officer to board chairman earlier this year because of a company policy requiring CEOs to give up their post at 65. But he said his own age has nothing to do with his recent work on technology for the aging, although he joked to the conference's opening session that he was the oldest of the six keynote speakers. Barrett said he was motivated by experience dealing with the medical needs of an older family member.

As the elderly demographic continues to increase, there will be manpower, and financial pressures to care through these patients through technology. I'm not sure if the nursebot concept will take off though.

High Fiber Diet May Not Prevent Colon Cancer

EATING lots of fibre may do little to protect against colon cancer, the latest analysis of evidence has found.

While people who eat the most fibre — in the form of cereals, vegetables and fruit — are slightly less likely to get colon cancer, the association is weak and disappears altogether when other factors are taken into account, according to an international team in the Journal of the American Medical Association. The research undermines one of the greatest of dietary shibboleths, first enunciated by the British physician Denis Burkitt in the 1960s. Working in Africa, he noticed that rates of colon cancer were low, and put it down to the fibre-rich diet of local people.

Ever since, people have been urged to eat their fibre. The latest analysis pools the results of 13 studies of about 750,000 men and women followed for between 6 and 20 years, in which more than 8,000 colon cancers were detected.

At first sight, the results suggest a link. People in the top fifth for the fibre content of their diet were 16 per cent less likely to get colon cancer than those in the lowest fifth. But on further analysis, the link disappears. If other dietary factors such as red meat, milk and alcohol are included, the link between fibre and cancer becomes insignificant.

Well, we have to eat something. Every week another study comes out and the pendulum swings some other way.

Exercise & CHF

A little exercise can go a long way for congestive heart failure patients.

A study in rats that were predisposed to heart failure found the rats that exercised moderately had a 15% extension in life span.

Researchers say humans and rat hearts are very similar, and a simple walk every day may prolong lifespan and delay heart failure symptoms in humans.

Heart failure happens when the heart progressively weakens until it can't pump very hard and fluid backs up into the lungs.

The rats were predisposed to heart failure and had hypertension. Of the rats that didn't exercise 9/10 developed terminal heart failure. 10 out of 10 exercising rats didn't die = 15% extension in life span (could have been longer had study gone longer). The study lasted 22 months.

Based on research from other labs, it appears that low intensity exercise is probably safe for people with developing heart failure, in fact it may be beneficial and may prolong life span or delay the development of heart failure.

In this study, researchers intervened at the beginning of heart failure (not when there were still no signs of the condition) and the rats showed this positive benefit.

This is encouraging news for cardiac rehab programs.

Primum Non Docere...

U.S. regulators alerted the public on Friday to a study showing a higher death rate among heart disease patients a year after taking an Abbott Laboratories Inc. antibiotic, as part of an effort to release early information about potential safety concerns.

The drug is biaxin. Why would an antibiotic cause deaths years later? This needs a lot more study.

Helping Seniors To Choose Medicare Prescription Coverage

This holiday, baby boomers can give their parents a gift they really may need: help choosing a Medicare prescription drug plan.

The new drug coverage kicks in next year, presenting those 65 and older dozens of options, each with its own premium structure, list of covered drugs and participating pharmacies. One of the best tools for cutting through the maze is Medicare's drug plan comparison program at www.medicare.gov.

That's the problem. About three-quarters of older Americans have never been on the Internet, according to a recent Kaiser Family Foundation survey. Baby boomers and younger generations can provide assistance by putting their keystroke skills to work.

Alan Dorenfeld of Pikesville recently went through the Medicare online program to select prescription drug plans for his 85-year-old father and 82-year-old mother.

"It's well done, but not well done for seniors," said Dorenfeld, 60. "You have to be comfortable with the computer -- kind of like trial and error. Put data in; take data out. Let's be honest, what percentage of 85-year-olds are computer-literate enough to be able to do that?"

The enrollment period runs from Nov. 15 through May 15. Sign up before the end of the year and coverage begins Jan. 1. Enroll after the May deadline, and you'll pay a penalty in the form of an escalating premium for each month you delay.

Personally, I'm hoping the government simplifies the plans over the next year into something everyone can understand. Do we really need so many plans except to confuse everybody?

US Life Expectancy

U.S. life expectancy has hit another all-time high — 77.6 years — and deaths from heart disease, cancer and stroke continue to drop, the government reported Thursday.

Who says we're not doing a good job?

From MSNBC.

2nd Cancer Risk In Breast Cancer Patients

Researchers led by Lene Mellemkjær of the Danish Cancer Society in Copenhagen, Denmark conducted a huge study involving 525,527 patients with breast cancer in 13 cancer registries in Europe, Canada, Australia and Singapore. Records were analyzed for second primary cancers during the period 1943 to 2000, with 133,414 women followed for more than 10 years after the initial diagnosis of breast cancer. The increased risk of a second cancer was seen in many different sites, as shown in earlier studies. "The excess of cancer after a breast cancer diagnosis is likely to be explained by treatment for breast cancer and by shared genetic or environmental risk factors although the general excess of cancer suggests that there may be additional explanations such as increased surveillance and general cancer susceptibility," the authors note.

The study found an almost 6-fold increase in the risk of cancer in connective tissue of the thorax and upper limbs, which suggests that radiation therapy, which has been used to treat breast cancer since the beginning of the 20th century, may play a role in developing a second cancer in organs close to the breast. An increased risk of myeloid leukemia was also shown, possibly as a result of chemotherapy. In addition, while previous studies had shown an increased risk of endometrial cancer with the use of tamoxifen, the current study suggests that this may not be entirely due to the drug, since the increased risk was already shown within one year of breast cancer diagnosis, it was shown before 1975 when tamoxifen was rarely used, and an increased risk of breast cancer was also seen after endometrial cancer. Colorectal, kidney and postmenopausal breast cancer appear to share obesity as a risk factor, while ovarian cancer and breast cancer seem to have a genetic predisposition in common. The study found an excess of ovarian cancer already within one year of breast cancer diagnosis, along with an increased risk of breast cancer after ovarian cancer.

From Science Daily.

Oxytocin & The Fear Hub

Scans of the hormone oxytocin's effect on human brain function reveal that it quells the brain's fear hub, the amygdala, and its brainstem relay stations in response to fearful stimuli. The work at NIMH and a collaborating site in Germany suggests new approaches to treating diseases thought to involve amygdala dysfunction and social fear, such as social phobia, autism, and possibly schizophrenia, report Andreas Meyer-Lindenberg, M.D., Ph.D., NIMH Genes Cognition and Psychosis Program, and colleagues, in the December 7, 2005 issue of the Journal of Neuroscience.

"Studies in animals, pioneered by now NIMH director Dr. Thomas Insel, have shown that oxytocin plays a key role in complex emotional and social behaviors, such as attachment, social recognition and aggression," noted NIH Director Elias Zerhouni, M.D.. "Now, for the first time, we can literally see these same mechanisms at work in the human brain."

"The observed changes in the amygdala are exciting as they suggest that a long-acting analogue of oxytocin could have therapeutic value in disorders characterized by social avoidance," added Insel.

Inspired by Swiss scientists who last summer reported [1] that oxytocin increased trust in humans, Meyer-Lindenberg and colleagues quickly mounted a brain imaging study that would explore how this works at the level of brain circuitry. British researchers had earlier linked increased amygdala activity to decreased trustworthiness. [2] Having just discovered decreased amygdala activity in response to social stimuli in people with a rare genetic brain disorder that rendered them overly trusting of others, Meyer-Lindenberg hypothesized that oxytocin boosts trust by suppressing the amygdala and its fear-processing networks

It's neat to see new information about the good ol' hormones. Who would have thought it had something to do with fear as well?
From Science Daily.

Technology To Help The Elderly & Disabled

Fernie, 56, has transformed an interest in gadgets into a lifelong professional quest to find ways for people to overcome the ravages of disease or age and let them live as independently as possible.

"For old people and people with disabilities, winter is an enormous problem," said Fernie, vice-president of research at the Toronto Rehabilitation Institute. "We know people who just don't go out in winter, because by the time they've got their coats and boots on, they're exhausted."

So some of Fernie's colleagues are designing new forms of winter coats and boots that are easier to use.

"Weather is actually a big interest of ours," Fernie said, "if only because most of the assistive devices that currently exist don't work very well except when conditions are just right.

Fernie is not just content to do research -- his goal is to create products that people can buy and use.

For instance, he designed and brought to market the SturdyGrip pole -- a movable handgrip that makes it easy for people to get out of chairs and beds. A product called Staxi -- a stackable transport chair -- enables people to get around in hospitals without having to wait for a volunteer.

This is great work to help these folks function more independently.
From CNN.