SAN FRANCISCO - The American Academy of Ophthalmology (AAO) warns patients taking certain drugs that treat prostate enlargement to inform their eye surgeon about these medications before undergoing surgery.  These drugs can complicate cataract surgery.  A 2006 study found these patients can have successful surgery if their surgeon knows they’re taking or took these drugs and alters the surgical technique.  Flomax® is the most common drug for prostate enlargement, or benign prostatic hyperplasia (BPH).  By facilitating more complete emptying of the bladder, Flomax cuts the need to urinate in the middle of the night.  Flomax and similar systemic drugs called alpha-blockers can cause difficulty during cataract surgery, particularly if the eye surgeon hasn’t been warned.  For this reason, AAO advises patients who are taking or have taken alpha-blocker prostate drugs to inform their ophthalmologist before surgery.  Other alpha-blocker drugs include Hytrin®, Cardura®, and Uroxatral®.

BOSTON - Guilt, fear, and loneliness often afflict both the caregiver and the family in the aftermath of a medical error, feelings that can be overcome if all parties try to build bridges and develop solutions that not only can prevent error but also lead to forgiveness.  "Too Err is Human," the 1999 Institute of Medicine report, focused on the need to prevent medical error.  Still, "Little attention has been paid to the second half of the adage - ‘to forgive is divine’," write Drs. Tom Delbanco and Sigall K. Bell in a "Perspective" in the New England Journal of Medicine.  "How can we characterize and address the human dimensions of medical error so that patients, families, and clinicians may reach some degree of closure and move toward forgiveness?"  "Though it has been well recognized that clinicians feel guilty after medical mistakes, family members often have similar or even stronger feelings of guilt," the authors note.  Patients and their families may fear further harm, including retribution from healthcare providers, if they express their feelings.

WASHINGTON - HealthDay News noted The New York Times reports the new drug benefit plan for U.S. Medicare recipients has a lot of problems, including deceptive sales tactics by some private insurers, claims being denied improperly, and lack of response to consumers' questions and complaints.  Sometimes, the newspaper reports in an exclusive investigative article, the denial of appropriate medication is life-threatening, especially for patients with HIV and AIDS.  While Medicare officials have ordered corrections to be made when they learn about drug program errors, problems are a long way from being solved.  The Times says it examined 91 audit reports of the Medicare drug program begun in 2006, and found that among the 11 insurance companies fined $770,000 for "marketing violations," were three of the nation's largest: UnitedHealth, Humana, and WellPoint.

BETHESDA, MD - Here's a wake-up call: heart disease kills far more women yearly than cancer.  It's true that preventing heart problems is getting easier.  Here are some ways - backed by solid research - to care for your heart.  Get milk - a National Heart, Lung, and Blood Institute-funded study found among people who didn't eat much saturated fat, those who consumed more than three daily servings of milk, yogurt, or cheese had systolic blood pressure almost four points under those who ate only half a serving daily.  New moves - 30 minutes of tai chi, a gentle Chinese martial art that includes slow, relaxing movements, may lower blood pressure.  Go fishing - How fast your heart beats when you're at rest can indicate heart attack risk.  Higher resting heart rates have been linked to higher risk of sudden death.  The good news is eating fish can lower your heart rate.  Sip juice - Pomegranate juice seems to delay hardening of the arteries.  Laugh it up - People who watched comedy films had better blood flow versus viewers of Saving Private Ryan, found a University of Maryland School of Medicine study.

LOS ANGELES - Without U.S. and state reform on universal coverage, local coalitions can make a big difference for kids without health insurance, states University of Southern California (USC) scientists in the American Journal of Public Health.  A study of 28 California counties/regions with Healthy Kids coalitions found the efforts linked 85,000 kids with insurance.  Coalition leaders attributed success to a diverse group of stakeholders, strong leadership, and generous local and statewide contributors.  Such coalitions are "cautiously looking toward statewide legislative solutions," study authors wrote.  "Until recently, assuring all children have health insurance had escaped federal and state attention, but many counties in California were unwilling to endure this inaction and took responsibility for covering children themselves," said lead author Dr. Gregory Stevens, assistant professor of research in the Dept. of Family Medicine at USC’s Keck School of Medicine.  "Such entrepreneurship is often seen at the state level, but California counties are setting a precedent for leading the way on health issues."

ROCKVILLE, MD - MedPage Today disclosed 11 deaths and nearly 200 reports of serious cardiopulmonary events linked to microbubble contrast agents (Definity and Optison) used in echocardiography, the FDA reported.  DuPont Pharmaceuticals, maker of Definity, and GE Healthcare, maker of Optison, agreed to labeling changes emphasizing serious cardiopulmonary risk and contraindication for use in patients with unstable cardiopulmonary status, said FDA.  Most of the deaths occurred within 12 hours of use among patients with severe underlying conditions.  In four cases, patients died after cardiac arrest within 30 minutes of getting Definity.  Many of the 190 serious non-fatal reactions noted with Definity and nine reports with Optison occurred within minutes of administration and were suggestive of anaphylactic or cardiopulmonary reactions, FDA said.

SAN DIEGO - MedPage Today disclosed a highly sensitive blood test for ovarian cancer based on six biomarkers could be used to detect the disease while it is still in its curable early stages, researchers said.  The test takes advantage of six proteins tied to ovarian cancer and a multiplex assay to measure them simultaneously, said Dr. Aliza Leiser, of Yale University.  In a group of more than 500 volunteers, the test had a sensitivity of 97.5% and a specificity of 99.7%, she stated at a meeting of the Society of Gynecologic Oncologists.  That accuracy yielded a positive predictive value of 99.3% in the test population.  In the general population, where ovarian cancer hits one in 2,500, the test would have a positive predictive value of 12.6% - high enough to make it an "acceptable" screening test, Dr. Leiser said.  She noted ovarian cancer has a five-year survival rate of 90% for stage I and II; stage III and IV has a five-year survival rate of 20%.  Because of that, she said, "development of a sensitive and specific method of early detection is a priority."

MAYWOOD, IL - If your mood, energy, and motivation nosedive each November, only to return in April, you may have Seasonal Affective Disorder (SAD), claim Loyola University Health System doctors.  "Characterized by depression, exhaustion, and lack of interest in people and regular activities, this condition interferes with a person’s outlook on life and ability to function properly," said Dr. Angelos Halaris, chair of Loyola’s department of psychiatry and behavioral neurosciences.  SAD is treatable.  "The most common type of this mood disorder occurs in the winter months," said Dr. Halari, at Loyola’s Stritch School of Medicine.  "SAD is thought to be related to brain chemical imbalance, brought on by lack of light due to winter’s shorter days and usually overcast skies." He said bright light affects brain chemistry and acts as an antidepressant.  "With less light in the winter months, many people become depressed," he said.  "Those susceptible to SAD are affected even more."  Dr. Halaris noted a tendency to crave sweets is common with SAD, and social relationships are hindered.

ORLANDO - MedPage Today noted men who start the day often with a bowl of whole grain cereal are less likely to have heart failure than men who never ate whole grain cereals, scientists said.  The tie between such cereals and heart failure seems to be dose dependent, said Dr. Luc Djoussé, of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues.  They found a 26% cut in incident heart failure in men who ate such cereals at least seven times a week, but even a single bowl of such cereal once a week cut the relative risk of heart failure 14%.  Men who ate two to six bowls of whole grain cereals - cereals with 25% oat or bran - were about 22% less likely to develop heart failure than men who never consumed such cereals, they reported at the American Heart Association's Conference on Cardiovascular Disease Epidemiology and Prevention.  After correcting for age, body mass index, smoking history, alcohol consumption, vegetable consumption, physical activity, history of atrial fibrillation, and valvular heart disease, the relative risks for heart failure were 0.90 for up to one serving of whole grain cereal per week, 0.79 for two to six servings, and 0.74 for seven or more servings per week.  At baseline the average age of participants was 53.7 years.

ATLANTA - HealthDay News noted eight of 10 Americans 65 or older have heart disease, diabetes, or some other chronic illness, a U.S. Centers for Disease Control and Prevention (CDC) report shows.  The State of Aging and Health in America 2007 has up-to-date data on 15 key health indicators for older adults.  The number of Americans 65 and older is seen at 71 million by 2030, about 20% of the population; by that time, U.S. healthcare spending is figured to rise 25% due to an aging population, CDC states.  The good news is that, at the national level, we’re meeting some of the government's Healthy People 2010 targets: national goals are being met in mammograms, colorectal cancer screening, cholesterol testing, and reduction in the number of smokers.  However, no state has met the target for physical activity, eating fruits and vegetables daily, and flu and pneumonia vaccines, and only three - Colorado, Hawaii, and New Mexico - have met the target for lowering obesity.

TOKYO - MedPage Today noted obstructive sleep apnea (OSA) patients have a high rate of silent brain infarctions (SBI) that can be seen by magnetic resonance imaging, scientists found.  Patients have higher biochemical markers tied to cerebrovascular disease, said Dr. Kenji Minoguchi, of Showa University School of Medicine.  Treatment with nasal continuous positive airway pressure (nCPAP) over three months cut the level of disease markers and may lower the risk of disease, Dr. Minoguchi and colleagues wrote in the American Journal of Respiratory and Critical Care Medicine.  For unexplained reasons, the SBI had no obvious clinical consequences.  Scientists tested 50 men with newly-diagnosed OSA and 15 obese men with no sleep disorder to serve as controls.  None had other co-morbidities.  The men were given a whole-brain MRI scan, with a SBI defined as a lesion of at least 3mm.  The study found 16% of the men with OSA had evidence of silent brain infarction versus 6.7% of the controls, a significant difference.  Prevalence was higher (25%) among men with severe or moderate apnea versus those with mild disease (7.7%) or the controls.  Both differences were significant.

WASHINGTON - Monday Morning in Washington, D.C. noted the U.S. Dept. of Labor's Office of Disability Employment Policy (ODEP) awarded a two-year grant of $2,306,066 to organizations for a center to increase the employment and economic self-sufficiency of adults with disabilities.  "This grant will help them build better lives for themselves and their families," said U.S. Secretary of Labor Elaine L. Chao.  The consortium, led by the John J. Heldrich Center for Workforce Development at Rutgers University, the State University of New Jersey in New Brunswick will do research, develop and disseminate data, and provide assistance and training in five targeted, critical leadership areas identified by ODEP's research over the past six years.  Consortium members include the American Public Human Services Administration, Washington; National Leadership Consortium for Developmental Disabilities, University of Delaware/Newark; Elizabeth M. Boggs Center for Developmental Disabilities, University of Medicine and Dentistry in New Brunswick, and Community Solutions Group LLC in Arlington, Va.