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CDC boss sees winnable battles
January-February 2011
ATLANTA - The Associated Press asked: Where would you start if you were charged with keeping the nation healthy?
Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, picked six priorities - winnable battles, he says.
They’re smoking, AIDS, auto injuries, obesity/nutrition, teen pregnancy, and healthcare infections.
Raising a few problems above dozens of others is bold for a public health official.
It's been received like a bucket of cold water - invigorating some, infuriating others.
Many advocates, legislators and others in public health devote their lives to problems that didn’t make Frieden's short list.
There’ve been hot complaints, and worry over how targeted federal public health dollars will be.
One woe is hepatitis C, long under-recognized liver-destroying virus in more than 3 million Americans.
Some experts consider the issue a ticking bomb.
Bruce Burkett, past president of the National Hepatitis C Advocacy Council, said, "I was very disappointed.
This is going to affect millions by not being on there."
Frieden responds: "In each of these areas we know what to do to make a difference and we need to do it to a much greater extent."
PHILADELPHIA - The University of Pennsylvania's Abramson Cancer Center has been rated as "exceptional" by the National Cancer Institute (NCI) during a competitive research funding review by the government agency.
WASHINGTON - MedPage Today revealed the FDA asked the maker of painkillers Darvon and Darvocet to stop selling the drugs due to the potential for serious cardiac arrhythmias. Xanodyne Pharmaceuticals agreed to remove them from the market; generic makers are expected to follow, FDA stated. Darvon has only propoxyphene as an active agent; Darvocet adds it to acetaminophen. Dr. John Jenkins, director of FDA's Office of New Drugs, said the decision was spurred by a safety study it had Xanodyne do. Patients were tested with electrocardiography and showed QT interval abnormalities occurred in users even at approved doses. Prior to the study, it seemed arrhythmias were apparent mainly at doses higher than the maximum approved.
WASHINGTON - The Wall Street Journal reported that under pressure from employers, the Obama administration loosened rules for bare-bones health insurance policies. It marks one of the administration's biggest steps to peel back regulations big business found onerous under the health care overhaul. McDonald's Corp. warned regulators it might drop its plans for 30,000 hourly workers unless it got an exemption for these policies, which have low premiums but limit payments for medical costs. As of Jan. 1, insurers must spend at least 80% of premiums on medical care and quality improvement.
ST. PETERSBURG BEACH, FL - Military medical scientists are optimistic they’ve found a blood test to detect a concussion or mild traumatic brain injury (TBI), www.CNN.com reports. "This is a breakthrough," says Col. Dallas Hack, director of the Army's Combat Casualty Care Research Program. TBI is a big concern for the military, particularly milder forms, because unlike TBI, milder injuries can’t be seen on X-rays, CT scans, or MRIs. A simple blood test would be useful not only for the military but also for civilians. If more study confirms the efficacy of this test, it could be used on those injured on the football field, in a car accident, or any other situation where the head hits something hard. "It can make a significant benefit to mankind," Hack says.
TORRANCE, CA - Patients with failing kidneys who need dialysis will do equally well if they do dialysis at home or if they go to a dialysis center. Findings show patients who require dialysis to clean their blood should pick a method based on their lifestyle and choices, Dr. Rajnish Mehrotra, of Los Angeles Biomedical Research Institute/Harbor-UCLA Medical Center, told Reuters Health. Just 7% of dialysis patients opt for the home treatment, Dr. Mehrotra and his team note in the Archives of Internal Medicine. Given the similar outcomes - and that annual per-patient costs for home dialysis are about $20,000 lower than for standard dialysis - the U.S. Center for Medicare & Medicaid Services has changed reimbursement to promote wider use of the less expensive way, they add.
WASHINGTON - Reuters reports 17,000-plus doctors and other healthcare providers took money from seven major drug firms to talk to other doctors about their products, a probe by news and non-profit groups found. More than 380 doctors, nurses, pharmacists, and other pros got more than $100,000 in 2009/2010, states the report. It said far more doctors are likely to have taken such payments, but it documented these based on data from seven drug makers. The payments aren’t illegal and usually not considered improper. The probe by journalism’s ProPublica, Consumer Reports magazine, NPR radio, and several publications showed doctors were sometimes urged to urge "off-label" Rxs - using them for ills for which they’re not OK’d. The report points to several studies showing even small gifts and payments to doctors can affect their attitudes, and many firms have stopped giving once-common gifts such as pens, cups, and objects carrying drug brand names. The groups used data from AstraZeneca, Cephalon, GlaxoSmithKline, Johnson & Johnson, Eli Lilly, Merck, and Pfizer. "Some companies were forced to disclose this information [due to] legal settlements," Consumer Reports said.
SANTA MONICA, CA - When they can avoid a health insurance deductible, people are more likely to be screened for ills like cancer and high cholesterol. The uptick is modest, and in high-deductible plans, it’s small, a study in the journal Health Services Research noted. "We found more [preventive screening] with expanded coverage, as expected, but we were surprised the increase wasn’t greater," lead author Daniella Meeker, Ph.D., information scientist at RAND Corp., told Health Behavior News Service. "When we broke it down by types of plans, we found a difference between people in low- and high-deductible plans." The study analyzed preventive screening use among 44,106 people enrolled in preferred provider organizations.
WASHINGTON - The U.S. Food and Drug Administration (FDA) approved Kapvay as the first attention-deficit hyperactivity disorder (ADHD) drug used concomitantly with a stimulant, MedPage Today disclosed. The drug - made by Shionogi - is an alpha2-adrenergic receptor agonist indicated for children and teens six to 17. It’s approved for use as a monotherapy in ADHD. The drug's formulation "minimizes peaks and troughs in blood levels," Dr. Donald C. Manning, chief medical officer at Shionogi, stated. Approval was based on two phase III trials of ix-to-17-year-olds, one of which tested the drug as a stand-alone ADHD treatment, while the other tested efficacy and safety as an add-on to therapy with a stimulant. ADHD scores showed significant gains in each group over placebo, and over psychostimulant-alone group at five weeks of treatment.
MIAMI - The Associated Press noted that for the first time in more than a decade, the U.S. Government is funding sex education programs that aren't based solely on abstinence. They're not just about handing out condoms, either. In this school year, a five-year, $375 million grant is divided among 28 programs proven to lower the pregnancy rate among participants, no matter their focus. Many programs distribute condoms, but about half aim to boost teens' academics, encourage extracurricular activities, and even improve their parents' job status. Advocates believe this "above the waist" approach gives kids tools to help them succeed in school and make better life decisions, especially about sex. The nine-month Teen Outreach Program spends under 15% of its curriculum on sex education, even though that's its chief goal. It encourages teens in 30 states to identify a community problem and spend at least 20 hours trying to fix it. "There's a growing realization we have to talk to young people about not just body parts," said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.
DELMAR, NY - Special courts that move people with serious mental illness from the criminal justice system into community treatment may cut later arrest rates and jail time, scientists told MedPage Today. In data from four such courts, participants had fewer arrests/days of incarceration 18 months after court-ordered treatment than detainees who didn't go into the system, Henry Steadman, Ph.D., of Policy Research Associates, and his team posted online at the Archives of General Psychiatry. "This first multisite study of (such) courts offers encouragement they can achieve the public safety outcomes funders and the public want," they wrote. The team checked data from four California such courts in San Francisco and Santa Clara counties, Hennepin County (MN), and Marion County (IN). Those before a mental health court had fewer arrests and incarceration days before the 18-month program; they were being treated medically at baseline; they weren’t using illegal drugs, and they had a diagnosis of bipolar disorder rather than schizophrenia or depression.
CHICAGO - ScienceDaily noted that in a comparison of results in Arizona for out-of-hospital cardiopulmonary resuscitation (CPR) for cardiac arrest done by bystanders, patients who got compression-only CPR were more likely to survive to hospital discharge than those who got conventional CPR or no CPR, states a study in JAMA (Journal of the American Medical Association). Out-of-hospital cardiac arrest is a major public health problem, affecting about 300,000 Americans annually. Although survival rates vary widely, outcomes can be aided with bystander CPR. In 2005, a program was set up in Arizona aimed at aiding survival. "These efforts included changes in the approach to the care provided by both bystanders and emergency medical services (EMS) personnel and were based on the increasing evidence in favor of minimizing interruptions in chest compressions during CPR," the authors write. A multifaceted effort was started to urge bystanders to use compression-only CPR because this way is easier to teach, learn, remember, and perform than conventional CPR with rescue breathing, the article notes.
HONG KONG - MedPage Today noted that in older people with a chronic illness, giving vaccines against pneumococcal disease and the flu can cut markedly their risk of death, plus other adversities, scientists say. In a study, outpatients 65 and older who got both vaccines saw their risk of death within the study fall 35% versus those who got neither, said Dr. Kwok-Yung Yuen, of the University of Hong Kong, and his team. They saw cuts in pneumonia, ischemic stroke, and acute cardiovascular events, they posted online at Clinical Infectious Diseases. There’s good evidence the annual trivalent flu vaccine prevents influenza and pneumonia among those 65 and older, they noted, although the evidence that the 23-valent pneumococcal vaccine reduces the risk of pneumonia and death is "less robust." The primary outcome, at week 64 after vaccination, was the rate of death due to pneumonia, chronic obstructive pulmonary disease, flu-like illness, ischemic stroke, acute myocardial infarction, and cardiac failure. Scientists found dual-vaccines had a much lower incidence of hospital admission versus the unvaccinated group: 222 admissions per 1,000 person-years versus 308.
DENVER - Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, launched www.5MinuteConsult.com, a clinical support site that gives healthcare pros answers to their questions in 30 seconds or less. Set up at the American Academy of Family Physicians' 2010 Scientific Assembly, the site helps healthcare pros obtain critical data quickly for diagnosis, treatment, and management of thousands of diseases and conditions. "Healthcare professionals need fast access to accurate, evidence-based information at the point of care with patients," said Susan Driscoll, WKH president/CEO. The site is updated constantly by healthcare pros, and data is posted in response to questions is brief and accurate for immediate patient care. Videos cover more than 200 procedures and physical therapy techniques; customizable handouts for patients cover data on their condition and lessons for treatment. Handouts are in English and Spanish and can be printed or e-mailed directly to patients.
CORVALLIS, OR - Ivanhoe Newswire notes that while 23 million Americans are diabetics, scientists say there are nearly 60 million with pre-diabetes - meaning they're likely to be diabetic within the next couple of years. Scientists believe they're on the cusp of a cure for this common woe. At Oregon State University, Donald Jump, Ph.D., department of nutrition/exercise sciences, said eliminated diet-induced diabetes - or type 2 diabetes - in lab mice, "We saw that certain enzymes were being repressed by the high-fat diet." The enzyme is fatty acid elongase-five; the more fat we eat, the less enzyme we produce. When scientists boosted output of the enzyme in mice livers, they were cured of their diabetes in five days. "The animals’ hyperglycemia disappeared, their fatty liver disappeared, their insulin resistance disappeared. We were very dazzled by this outcome," Dr. Jump added.
NEW YORK - ScienceDaily disclosed that Mount Sinai School of Medicine scientists found a gene related to the onset of type 2 diabetes is found at lower-than-normal levels in people with Alzheimer's disease. The research, led by Dr. Giulio Maria Pasinetti, Ph.D., professor of neurology, was in the journal Aging Cell. The study yields insight into a potential mechanism that might explain the relationship between type 2 diabetes and the onset and progression of Alzheimer's. Recent evidence shows healthy elderly subjects affected by type 2 diabetes are twice as likely to get Alzheimer's. "The relationship has been elusive," said Dr. Pasinetti. "This new evidence is of extreme interest, especially since approximately 60% of Alzheimer's cases have at least one serious medical condition primarily (tied to) type 2 diabetes."
CHICAGO - Early detection of any cancer is critical to survive, Ivanhoe Newswire reports. Lung cancer is known notoriously for being incredibly difficult to identify early. Scientists found that a simple swab of the cheek can detect lung cancer in earliest stages. The inner cheek is swabbed; diffuse light is shined on the cells. The swab, called partial wave spectroscopis microscopy, was able to differentiate people who had lung cancer and those who didn’t. "This study is important because it provides proof of concept that a minimally-intrusive, risk-stratification technique may allow us to tailor screening for lung cancer, the No. 1 cause of cancer deaths in Americans," said Dr. Hemant Roy, of NorthShore University Health Systems and the University of Chicago, lead author on the paper. "This represents a major step forward in translating biomedical optics breakthroughs for personalized screening for lung cancer." The paper was online at Cancer Research.
OAKLAND, CA - Heavy smoking in midlife more than doubles your odds of Alzheimer's disease, www.USATODAY.com posted from a Kaiser Permanente study, the first to examine long-term consequences of heavy smoking on Alzheimer's and vascular dementia, said principal investigator, Rachel Whitmer, a research scientist with Kaiser. From 1994 to 2008, scientists assessed records of 21,123 men and women in midlife and followed them, on average, for 23 years. Versus non-smokers, those who had smoked two packs a day hiked their risk of Alzheimer's more than 157% and had a 172% higher risk of vascular dementia - second to Alzheimer's. The study was in the Archives of Internal Medicine; while it was observational, authors have theories about what might be happening. Whitmer says: "People who smoke have higher inflammation - we know inflammation plays a role in Alzheimer's."
ADELPHI, MD - MedPage Today noted an FDA advisory panel voted 13-2 to urge approval for Benlysta to treat Lupus, despite clinical trials showing only marginal efficacy. If FDA OKs Benlysta, it would be the first new treatment for Lupus OK’d in 50 years. The drug, made by Human Genome Sciences and GlaxoSmithKline, was only slightly more effective at easing Lupus symptoms than placebo, but it cut the amount of steroids patients took, and panelists felt that it could be a promising new option for patients who are often plagued by debilitating joint pain, rashes, intense fatigue, and major weight gain.
LONDON - Getting people to eat a healthy diet, not smoke, reduce alcohol, and exercise more could avoid almost 25% of the 1.2 million cases of colon cancer diagnosed yearly, scientists told Reuters. Danish scientists found that following guidelines on exercise, waist measure, smoking, alcohol intake, and diet could cut bowel cancer risk up to 23%. "Our study reveals the useful public health message that even modest differences in lifestyle might have a substantial impact on colorectal cancer risk," said Anne Tjonneland (Institute of Cancer Epidemiology), at the Danish Cancer Society, study leader. She and her team studied data on 55,487 men/women 50-64 who hadn’t been diagnosed with cancer and followed them for 10 years. Results in the British Medical Journal showed that during follow-up, 678 people were diagnosed with bowel cancer. Scientists calculated that if all of them had followed even one extra guideline, around 13% of colon cancers were preventable.
PHILADELPHIA - If you're told your child is a bully, you must control your reaction, an expert told HealthDay News. "Take a deep breath and don't panic. Resist the temptation to respond with 'not my child.' Realize your child may be testing behaviors," Sally Kuykendall, assistant professor of health services at Saint Joseph's University, stated. "Parents must consider their child's social skills and whether or not they're mimicking violence they've been exposed to in the media, at home, or community," she added. Parents should talk to their children and maintain an ongoing dialogue, she notes. "Don't allow them to tell you they were 'just joking.' Set clear, consistent limits. Let your child know what’s socially acceptable behavior. Don't let them blame the victim, or rationalize attacks," Kuykendall said. In some cases, bullies are victims of bullying acting with counter-aggression, also called "provocative victims."
BOSTON - Even after figuring in many socio-demographic and family characteristics, children born to mothers who smoked during pregnancy were more likely to get arrested as adults, scientists told MedPage Today. The relationship was strongest when the mothers smoked at least a pack of cigarettes a day, Angela Paradis, Sc.D., of the Harvard School of Public Health, and her team posted online at the Journal of Epidemiology and Community Health. Due to the large number of potential confounders for which the analyses adjusted, findings suggest, but can’t prove, existence of a causal relationship between mom smoking and adult criminal behavior, scientists said. They acknowledged that "any causal association is likely to be weak to moderate in strength."
WEST LAFAYETTE, IN - Scientists have evidence an environmental pollutant may play a vital role in causing multiple sclerosis (MS). A hypertension drug might be used to treat MS. Acrolein was up by about 60% in spinal cord tissues of mice with a disease similar to MS, said Dr. Riyi Shi, professor of neuroscience/biomedical engineering in Purdue University's Dept. of Basic Medical Sciences. Results represent the first concrete lab evidence of a link between acrolein and MS, he said. "Only recently have scientists started to understand the details about what acrolein does to the human body," Shi said. "We are studying its effects on the central nervous system, both in trauma and degenerative diseases such as MS." Acrolein is an environmental toxin found in air pollutants - including tobacco smoke and auto exhaust. It’s also produced within the body after nerve cells are damaged.
BOSTON - The Associated Press disclosed an experimental Merck & Co. Inc. drug boosted good cholesterol safely to record highs and cut bad cholesterol to unprecedented lows in a study that stunned scientists and renewed hopes for an entirely new way of lowering heart risks. "We are the most excited we have been in decades" about a novel drug, said study leader, Dr. Christopher Cannon, of Brigham and Women's Hospital. The drug, anacetrapib, needs more testing to see if its dramatic effects on cholesterol will translate into fewer heart attacks, strokes, and deaths. Merck announced a 30,000-patient study to answer that and it will take several years.
PHILADELPHIA - The University of Pennsylvania's Abramson Cancer Center has been rated as "exceptional" by the National Cancer Institute (NCI) during a competitive research funding review by the government agency.
WASHINGTON - MedPage Today revealed the FDA asked the maker of painkillers Darvon and Darvocet to stop selling the drugs due to the potential for serious cardiac arrhythmias. Xanodyne Pharmaceuticals agreed to remove them from the market; generic makers are expected to follow, FDA stated. Darvon has only propoxyphene as an active agent; Darvocet adds it to acetaminophen. Dr. John Jenkins, director of FDA's Office of New Drugs, said the decision was spurred by a safety study it had Xanodyne do. Patients were tested with electrocardiography and showed QT interval abnormalities occurred in users even at approved doses. Prior to the study, it seemed arrhythmias were apparent mainly at doses higher than the maximum approved.
WASHINGTON - The Wall Street Journal reported that under pressure from employers, the Obama administration loosened rules for bare-bones health insurance policies. It marks one of the administration's biggest steps to peel back regulations big business found onerous under the health care overhaul. McDonald's Corp. warned regulators it might drop its plans for 30,000 hourly workers unless it got an exemption for these policies, which have low premiums but limit payments for medical costs. As of Jan. 1, insurers must spend at least 80% of premiums on medical care and quality improvement.
ST. PETERSBURG BEACH, FL - Military medical scientists are optimistic they’ve found a blood test to detect a concussion or mild traumatic brain injury (TBI), www.CNN.com reports. "This is a breakthrough," says Col. Dallas Hack, director of the Army's Combat Casualty Care Research Program. TBI is a big concern for the military, particularly milder forms, because unlike TBI, milder injuries can’t be seen on X-rays, CT scans, or MRIs. A simple blood test would be useful not only for the military but also for civilians. If more study confirms the efficacy of this test, it could be used on those injured on the football field, in a car accident, or any other situation where the head hits something hard. "It can make a significant benefit to mankind," Hack says.
TORRANCE, CA - Patients with failing kidneys who need dialysis will do equally well if they do dialysis at home or if they go to a dialysis center. Findings show patients who require dialysis to clean their blood should pick a method based on their lifestyle and choices, Dr. Rajnish Mehrotra, of Los Angeles Biomedical Research Institute/Harbor-UCLA Medical Center, told Reuters Health. Just 7% of dialysis patients opt for the home treatment, Dr. Mehrotra and his team note in the Archives of Internal Medicine. Given the similar outcomes - and that annual per-patient costs for home dialysis are about $20,000 lower than for standard dialysis - the U.S. Center for Medicare & Medicaid Services has changed reimbursement to promote wider use of the less expensive way, they add.
WASHINGTON - Reuters reports 17,000-plus doctors and other healthcare providers took money from seven major drug firms to talk to other doctors about their products, a probe by news and non-profit groups found. More than 380 doctors, nurses, pharmacists, and other pros got more than $100,000 in 2009/2010, states the report. It said far more doctors are likely to have taken such payments, but it documented these based on data from seven drug makers. The payments aren’t illegal and usually not considered improper. The probe by journalism’s ProPublica, Consumer Reports magazine, NPR radio, and several publications showed doctors were sometimes urged to urge "off-label" Rxs - using them for ills for which they’re not OK’d. The report points to several studies showing even small gifts and payments to doctors can affect their attitudes, and many firms have stopped giving once-common gifts such as pens, cups, and objects carrying drug brand names. The groups used data from AstraZeneca, Cephalon, GlaxoSmithKline, Johnson & Johnson, Eli Lilly, Merck, and Pfizer. "Some companies were forced to disclose this information [due to] legal settlements," Consumer Reports said.
SANTA MONICA, CA - When they can avoid a health insurance deductible, people are more likely to be screened for ills like cancer and high cholesterol. The uptick is modest, and in high-deductible plans, it’s small, a study in the journal Health Services Research noted. "We found more [preventive screening] with expanded coverage, as expected, but we were surprised the increase wasn’t greater," lead author Daniella Meeker, Ph.D., information scientist at RAND Corp., told Health Behavior News Service. "When we broke it down by types of plans, we found a difference between people in low- and high-deductible plans." The study analyzed preventive screening use among 44,106 people enrolled in preferred provider organizations.
WASHINGTON - The U.S. Food and Drug Administration (FDA) approved Kapvay as the first attention-deficit hyperactivity disorder (ADHD) drug used concomitantly with a stimulant, MedPage Today disclosed. The drug - made by Shionogi - is an alpha2-adrenergic receptor agonist indicated for children and teens six to 17. It’s approved for use as a monotherapy in ADHD. The drug's formulation "minimizes peaks and troughs in blood levels," Dr. Donald C. Manning, chief medical officer at Shionogi, stated. Approval was based on two phase III trials of ix-to-17-year-olds, one of which tested the drug as a stand-alone ADHD treatment, while the other tested efficacy and safety as an add-on to therapy with a stimulant. ADHD scores showed significant gains in each group over placebo, and over psychostimulant-alone group at five weeks of treatment.
MIAMI - The Associated Press noted that for the first time in more than a decade, the U.S. Government is funding sex education programs that aren't based solely on abstinence. They're not just about handing out condoms, either. In this school year, a five-year, $375 million grant is divided among 28 programs proven to lower the pregnancy rate among participants, no matter their focus. Many programs distribute condoms, but about half aim to boost teens' academics, encourage extracurricular activities, and even improve their parents' job status. Advocates believe this "above the waist" approach gives kids tools to help them succeed in school and make better life decisions, especially about sex. The nine-month Teen Outreach Program spends under 15% of its curriculum on sex education, even though that's its chief goal. It encourages teens in 30 states to identify a community problem and spend at least 20 hours trying to fix it. "There's a growing realization we have to talk to young people about not just body parts," said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.
DELMAR, NY - Special courts that move people with serious mental illness from the criminal justice system into community treatment may cut later arrest rates and jail time, scientists told MedPage Today. In data from four such courts, participants had fewer arrests/days of incarceration 18 months after court-ordered treatment than detainees who didn't go into the system, Henry Steadman, Ph.D., of Policy Research Associates, and his team posted online at the Archives of General Psychiatry. "This first multisite study of (such) courts offers encouragement they can achieve the public safety outcomes funders and the public want," they wrote. The team checked data from four California such courts in San Francisco and Santa Clara counties, Hennepin County (MN), and Marion County (IN). Those before a mental health court had fewer arrests and incarceration days before the 18-month program; they were being treated medically at baseline; they weren’t using illegal drugs, and they had a diagnosis of bipolar disorder rather than schizophrenia or depression.
CHICAGO - ScienceDaily noted that in a comparison of results in Arizona for out-of-hospital cardiopulmonary resuscitation (CPR) for cardiac arrest done by bystanders, patients who got compression-only CPR were more likely to survive to hospital discharge than those who got conventional CPR or no CPR, states a study in JAMA (Journal of the American Medical Association). Out-of-hospital cardiac arrest is a major public health problem, affecting about 300,000 Americans annually. Although survival rates vary widely, outcomes can be aided with bystander CPR. In 2005, a program was set up in Arizona aimed at aiding survival. "These efforts included changes in the approach to the care provided by both bystanders and emergency medical services (EMS) personnel and were based on the increasing evidence in favor of minimizing interruptions in chest compressions during CPR," the authors write. A multifaceted effort was started to urge bystanders to use compression-only CPR because this way is easier to teach, learn, remember, and perform than conventional CPR with rescue breathing, the article notes.
HONG KONG - MedPage Today noted that in older people with a chronic illness, giving vaccines against pneumococcal disease and the flu can cut markedly their risk of death, plus other adversities, scientists say. In a study, outpatients 65 and older who got both vaccines saw their risk of death within the study fall 35% versus those who got neither, said Dr. Kwok-Yung Yuen, of the University of Hong Kong, and his team. They saw cuts in pneumonia, ischemic stroke, and acute cardiovascular events, they posted online at Clinical Infectious Diseases. There’s good evidence the annual trivalent flu vaccine prevents influenza and pneumonia among those 65 and older, they noted, although the evidence that the 23-valent pneumococcal vaccine reduces the risk of pneumonia and death is "less robust." The primary outcome, at week 64 after vaccination, was the rate of death due to pneumonia, chronic obstructive pulmonary disease, flu-like illness, ischemic stroke, acute myocardial infarction, and cardiac failure. Scientists found dual-vaccines had a much lower incidence of hospital admission versus the unvaccinated group: 222 admissions per 1,000 person-years versus 308.
DENVER - Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, launched www.5MinuteConsult.com, a clinical support site that gives healthcare pros answers to their questions in 30 seconds or less. Set up at the American Academy of Family Physicians' 2010 Scientific Assembly, the site helps healthcare pros obtain critical data quickly for diagnosis, treatment, and management of thousands of diseases and conditions. "Healthcare professionals need fast access to accurate, evidence-based information at the point of care with patients," said Susan Driscoll, WKH president/CEO. The site is updated constantly by healthcare pros, and data is posted in response to questions is brief and accurate for immediate patient care. Videos cover more than 200 procedures and physical therapy techniques; customizable handouts for patients cover data on their condition and lessons for treatment. Handouts are in English and Spanish and can be printed or e-mailed directly to patients.
CORVALLIS, OR - Ivanhoe Newswire notes that while 23 million Americans are diabetics, scientists say there are nearly 60 million with pre-diabetes - meaning they're likely to be diabetic within the next couple of years. Scientists believe they're on the cusp of a cure for this common woe. At Oregon State University, Donald Jump, Ph.D., department of nutrition/exercise sciences, said eliminated diet-induced diabetes - or type 2 diabetes - in lab mice, "We saw that certain enzymes were being repressed by the high-fat diet." The enzyme is fatty acid elongase-five; the more fat we eat, the less enzyme we produce. When scientists boosted output of the enzyme in mice livers, they were cured of their diabetes in five days. "The animals’ hyperglycemia disappeared, their fatty liver disappeared, their insulin resistance disappeared. We were very dazzled by this outcome," Dr. Jump added.
NEW YORK - ScienceDaily disclosed that Mount Sinai School of Medicine scientists found a gene related to the onset of type 2 diabetes is found at lower-than-normal levels in people with Alzheimer's disease. The research, led by Dr. Giulio Maria Pasinetti, Ph.D., professor of neurology, was in the journal Aging Cell. The study yields insight into a potential mechanism that might explain the relationship between type 2 diabetes and the onset and progression of Alzheimer's. Recent evidence shows healthy elderly subjects affected by type 2 diabetes are twice as likely to get Alzheimer's. "The relationship has been elusive," said Dr. Pasinetti. "This new evidence is of extreme interest, especially since approximately 60% of Alzheimer's cases have at least one serious medical condition primarily (tied to) type 2 diabetes."
CHICAGO - Early detection of any cancer is critical to survive, Ivanhoe Newswire reports. Lung cancer is known notoriously for being incredibly difficult to identify early. Scientists found that a simple swab of the cheek can detect lung cancer in earliest stages. The inner cheek is swabbed; diffuse light is shined on the cells. The swab, called partial wave spectroscopis microscopy, was able to differentiate people who had lung cancer and those who didn’t. "This study is important because it provides proof of concept that a minimally-intrusive, risk-stratification technique may allow us to tailor screening for lung cancer, the No. 1 cause of cancer deaths in Americans," said Dr. Hemant Roy, of NorthShore University Health Systems and the University of Chicago, lead author on the paper. "This represents a major step forward in translating biomedical optics breakthroughs for personalized screening for lung cancer." The paper was online at Cancer Research.
OAKLAND, CA - Heavy smoking in midlife more than doubles your odds of Alzheimer's disease, www.USATODAY.com posted from a Kaiser Permanente study, the first to examine long-term consequences of heavy smoking on Alzheimer's and vascular dementia, said principal investigator, Rachel Whitmer, a research scientist with Kaiser. From 1994 to 2008, scientists assessed records of 21,123 men and women in midlife and followed them, on average, for 23 years. Versus non-smokers, those who had smoked two packs a day hiked their risk of Alzheimer's more than 157% and had a 172% higher risk of vascular dementia - second to Alzheimer's. The study was in the Archives of Internal Medicine; while it was observational, authors have theories about what might be happening. Whitmer says: "People who smoke have higher inflammation - we know inflammation plays a role in Alzheimer's."
ADELPHI, MD - MedPage Today noted an FDA advisory panel voted 13-2 to urge approval for Benlysta to treat Lupus, despite clinical trials showing only marginal efficacy. If FDA OKs Benlysta, it would be the first new treatment for Lupus OK’d in 50 years. The drug, made by Human Genome Sciences and GlaxoSmithKline, was only slightly more effective at easing Lupus symptoms than placebo, but it cut the amount of steroids patients took, and panelists felt that it could be a promising new option for patients who are often plagued by debilitating joint pain, rashes, intense fatigue, and major weight gain.
LONDON - Getting people to eat a healthy diet, not smoke, reduce alcohol, and exercise more could avoid almost 25% of the 1.2 million cases of colon cancer diagnosed yearly, scientists told Reuters. Danish scientists found that following guidelines on exercise, waist measure, smoking, alcohol intake, and diet could cut bowel cancer risk up to 23%. "Our study reveals the useful public health message that even modest differences in lifestyle might have a substantial impact on colorectal cancer risk," said Anne Tjonneland (Institute of Cancer Epidemiology), at the Danish Cancer Society, study leader. She and her team studied data on 55,487 men/women 50-64 who hadn’t been diagnosed with cancer and followed them for 10 years. Results in the British Medical Journal showed that during follow-up, 678 people were diagnosed with bowel cancer. Scientists calculated that if all of them had followed even one extra guideline, around 13% of colon cancers were preventable.
PHILADELPHIA - If you're told your child is a bully, you must control your reaction, an expert told HealthDay News. "Take a deep breath and don't panic. Resist the temptation to respond with 'not my child.' Realize your child may be testing behaviors," Sally Kuykendall, assistant professor of health services at Saint Joseph's University, stated. "Parents must consider their child's social skills and whether or not they're mimicking violence they've been exposed to in the media, at home, or community," she added. Parents should talk to their children and maintain an ongoing dialogue, she notes. "Don't allow them to tell you they were 'just joking.' Set clear, consistent limits. Let your child know what’s socially acceptable behavior. Don't let them blame the victim, or rationalize attacks," Kuykendall said. In some cases, bullies are victims of bullying acting with counter-aggression, also called "provocative victims."
BOSTON - Even after figuring in many socio-demographic and family characteristics, children born to mothers who smoked during pregnancy were more likely to get arrested as adults, scientists told MedPage Today. The relationship was strongest when the mothers smoked at least a pack of cigarettes a day, Angela Paradis, Sc.D., of the Harvard School of Public Health, and her team posted online at the Journal of Epidemiology and Community Health. Due to the large number of potential confounders for which the analyses adjusted, findings suggest, but can’t prove, existence of a causal relationship between mom smoking and adult criminal behavior, scientists said. They acknowledged that "any causal association is likely to be weak to moderate in strength."
WEST LAFAYETTE, IN - Scientists have evidence an environmental pollutant may play a vital role in causing multiple sclerosis (MS). A hypertension drug might be used to treat MS. Acrolein was up by about 60% in spinal cord tissues of mice with a disease similar to MS, said Dr. Riyi Shi, professor of neuroscience/biomedical engineering in Purdue University's Dept. of Basic Medical Sciences. Results represent the first concrete lab evidence of a link between acrolein and MS, he said. "Only recently have scientists started to understand the details about what acrolein does to the human body," Shi said. "We are studying its effects on the central nervous system, both in trauma and degenerative diseases such as MS." Acrolein is an environmental toxin found in air pollutants - including tobacco smoke and auto exhaust. It’s also produced within the body after nerve cells are damaged.
BOSTON - The Associated Press disclosed an experimental Merck & Co. Inc. drug boosted good cholesterol safely to record highs and cut bad cholesterol to unprecedented lows in a study that stunned scientists and renewed hopes for an entirely new way of lowering heart risks. "We are the most excited we have been in decades" about a novel drug, said study leader, Dr. Christopher Cannon, of Brigham and Women's Hospital. The drug, anacetrapib, needs more testing to see if its dramatic effects on cholesterol will translate into fewer heart attacks, strokes, and deaths. Merck announced a 30,000-patient study to answer that and it will take several years.