Biking and Walking Best for Weight Loss

Women interested in preventing age-related weight gain should take up biking or walking.
USA Today (6/29, Hellmich) reports, "Women who want to prevent weight gain as they age should hop on a bike or take a brisk walk," discoveries that add "to mounting evidence of the importance of moderate to vigorous exercise for weight control." Those who participated in the Harvard study "gained an average of 20½ pounds over 16 years," but "those who regularly biked or walked briskly were less likely to gain as much."
The "findings are based on the second Harvard Nurses' Health Study, which is tracking 116,608 female nurses who periodically fill out questionnaires about their health, weight, diet and behavior," the New York Times (6/29, D6, Rabin) Vital Signs reports. The "new analysis, published in the June 28 issue of Archives of Internal Medicine, looked at weight change and behavior from 1989 (when the nurses were 25 to 42 years old) to 2005; to isolate the effects of exercise, the researchers controlled for other obesity risk factors."

Depression in Adolescents

Certain signs may indicate adolescents may be suffering from depression.
On the front of its Personal Journal section, the Wall Street Journal (6/29, D1, Bernstein) discusses signs parents should look for in teenagers who may be suffering from depression. While experts caution that parents should not diagnose depression in their children themselves, they should consult with a mental health professional should their child demonstrate four of more signs of certain behaviors over the course of two weeks or longer. Parents should look for signs of sleep impairment or disturbance, diminished interest in pleasurable activities, feelings of worthlessness, diminished energy and concentration, marked changes in appetite, obvious psychomotor disturbances, and suicidality.

Avandia and Heart Disease

Two studies suggest diabetes drug Avandia increases risk of heart problems.
ABC World News (6/28, story 7, 2:20, Sawyer) reported, "Two major studies have found the medicine called Avandia [rosiglitazone] could create a significant new risk of heart attack and other serious problems."
The CBS Evening News (6/28, story 10, 0:30, Smith) reported, "FDA experts meet in two weeks to decide whether or not to pull Avandia off the market."
NBC Nightly News (6/28, story 8, 0:20, Williams) reported, however, that the drug's maker, GlaxoSmithKline, "said today the drug is effective and safe."
The Washington Post (6/29, Stein) reports that one study, "involving more than 35,500 people, found that Avandia significantly raises the chances of a heart attack." A separate study "of more than 227,500 Medicare patients -- the largest such study to date -- found that the drug boosts the risk for strokes, heart failure, and death."
The Los Angeles Times (6/29, Roan) reports that the first study "found Avandia raised the risk of heart attacks by 28% to 39% as compared with other diabetes medications. The study was published online in the Archives of Internal Medicine."
Bloomberg News (6/29, Cortez) quotes Steven Nissen, MD, lead author of the study, as saying, "I think we've got more than enough evidence to say this drug should not be used."
USA Today (6/29, Marcus) reports that in the second study, published in the Journal of the American Medical Association, "scientists from the Center for Drug Evaluation and Research at the Food and Drug Administration evaluated data from 227,571 Medicare beneficiaries taking either Avandia or Actos [pioglitazone hydrochloride]." The investigators found "no differences in the risk for heart attack between the two drugs, but the study found that compared with Actos, Avandia was associated with a 25% increased risk of heart failure, a 27% increased risk of stroke and a 14% increased risk of death."
The Boston Globe (6/29, Rowland) quotes the study's coauthor Dr. David Graham, the FDA's associate director for science and medicine, as saying, "Look at our study, and then ask yourself, 'Why would you want to take Avandia?'"

Menopause Blood Test

Simple blood test may predict when women will reach menopause.
The Los Angeles Times (6/27, Stein) "Booster Shots" blog reported, "Predicting when women will reach menopause has never been an accurate science, but a new study suggests it could become considerably more precise." In fact, scientists in Iran have "found that concentrations of a specific hormone can be assessed in a blood test, providing a fairly precise forecast."
Although the "test does not predict when women will lose their fertility -- which typically occurs about a decade before menopause," the researchers said that "if doctors know when women will go into menopause, they can calculate roughly when they will run out of eggs," the AP (6/28, Cheng) reports. "Scientists say the test could be especially helpful in identifying women who might go into menopause early -- in their late 40s or earlier instead of their mid-50s."
The work centers on the anti-Mullerian hormone, levels of which were measured in 266 women, Reuters (6/27, Kelland) reported. The women underwent testing three times during a nine-year period, and investigators also recorded data regarding their reproductive and socioeconomic history. Lead investigator Ramezani Tehrani further explained, "We developed a statistical model for estimating the age at menopause from a single measurement of AMH concentration." By "using this model, we estimated mean average ages at menopause for women at different time points in their reproductive life span."
Thus far, "only 63 of the 266 women in the study reached menopause during the 12-year follow-up period," CNN (6/27, Gardner) reported. "Still, for these women, the test results accurately predicted menopause, give or take an average of about four months, with a maximum margin of error of three to four years (the greatest amount the test was 'off')." Notably, "on average, the women in the study experienced menopause at age 52."

Potential New Fibromyalgia Drug

FDA panel to review Jazz's potential fibromyalgia drug.
The AP (6/25) reports that "Jazz Pharmaceuticals, Inc. said Thursday that a Food and Drug Administration panel of experts will review the company's potential fibromyalgia drug," JZP-6, "at a meeting on Aug. 20."

Medical Residents Work Hours

New limits on medical residents' work hours proposed.
The Wall Street Journal (6/24, Wang) reports that the Accreditation Council for Graduate Medical Education has proposed new guidelines, published in the New England Journal of Medicine, to limit the number of hours medical residents work and to increase supervision for those with less experience.
The AP (6/24, Tanner) reports that "the draft regulations aim to promote patient safety and reduce medical errors by enhancing work conditions for sometimes sleep-deprived junior physicians." Under the guidelines, "new doctors in their first year of residency training programs" would "be more closely supervised by experienced doctors and the maximum length of their work shifts would be cut from 24 hours to 16 hours."
Meanwhile, "the procedures would trim the length of time interns can be on call to 16 hours from 30 previously," Bloomberg News (6/23, Fridson) reports. The council "restricted intern working hours to no more than 80 a week" in 2003, "and 30 at one stretch after a 1999 Institute of Medicine report found medical errors claimed 44,000 to 98,000 lives annually." But, "a 2008 report...said that a lack of adherence" was "common and underreported."
The guidelines would allow residents "to work a maximum of 28 hours" after "their first year," the Columbus Dispatch (6/24, Crane) reports. "Patient advocacy groups and others criticized the recommendations as not going far enough to reduce doctor fatigue and prevent medical mistakes." Modern Healthcare (6/24, Robeznieks) also covers the story.

Sunscreen Update

American sunscreens less effective because of outdated FDA regulations, scientists say.
On the front of the Thursday Styles section, Catherine Saint Louis writes in the New York Times (6/24, E1, Saint Louis) "Skin Deep" column that "the Food and Drug Administration is considering a set of guidelines for sunscreen that would set up a four-star system for effectiveness against UVA rays. The rules would also ban the use of misleading terms like 'sunblock' and 'all-day protection' from labels." However, "these rules were proposed three years ago, and the agency has yet to take action." Meanwhile, "consumers are left with sunscreen regulations that date back to...1978 when the science of sun protection was far more primitive. The status quo leaves Americans with less-effective sunscreens than Europeans, doctors and scientists say."

Coffee May Help Oral Health

Coffee may reduce risk of oral cavity, pharynx cancers.
The Salt Lake Tribune (6/23) reports that "coffee may protect drinkers from cancers of the oral cavity and pharynx," according to a study published online by the journal Cancer Epidemiology, Biomarkers and Prevention.
The CNN (6/22, Henry) "Paging Dr. Gupta" blog reported that investigators "looked at nine existing studies and analyzed how much coffee was consumed by more than 5,000 cancer patients and about 9,000 healthy people." The investigators "found that regular coffee drinkers -- those who drank more than four cups of coffee a day -- had a 39 percent decreased risk of two types of head and neck cancer: oral cavity and pharynx cancers." However, "coffee did not decrease the risk of a third type of oral cancer -- laryngeal cancer."

Heart Attack Rates and Supplements

Folic acid, vitamin B12 may not help reduce heart risks.
Time (6/23, Park) reports that a study published in the Journal of the American Medical Association has found that "lowering patients' blood levels of homocysteine did not in turn reduce their risk of heart trouble." During "the seven-year study of 12,064 heart-attack survivors, participants took daily supplements of folic acid and vitamin B12, which are known to break down homocysteine in the body." While "the supplementation lowered the amount of the amino acid in patients' blood 28%, it had no effect on rates of heart events or stroke compared with people taking placebo pills."
Reuters (6/23, Joelving) reports, however, that Dr. Jane Armitage, who led the research, said that the findings "are reassuring in the sense that there were no safety concerns."
HealthDay (6/22, Behen) reported that "some previous studies have raised concerns that large doses of folic acid might increase the risk of certain cancers, but" this "study found no increased risk of any form of cancer." HeartWire (6/22, Hughes) also covered the story.

Cell Phone Towers and Childhood Cancer

Researchers find no link between cell phone towers and children's cancer risk.
The AP (6/23, Cheng) reports that "children whose mothers lived close to a mobile phone tower while pregnant did not appear to be at any higher risk of cancer than children whose mothers lived farther away," according to a study published in the British Medical Journal. Investigators "analyzed 1,397 cancer cases in children up to age four from 1999 to 2001 in the United Kingdom. Using a national birth registry, they identified 5,588 similar children without cancer."
The Los Angeles Times (6/22, Kaplan) "Booster Shots" blog reported that "the team also gathered detailed data about all 81,781 cellphone towers that were operational in the country during that time, including each tower's location, height, output power, and how many antennas it had." The researchers found that, "in virtually every permutation of their calculations, there was no correlation between the cellphone towers and the cancer cases."
Bloomberg News (6/23, Hallam) reports that "the study is the largest of its kind, and the findings should put any reports of cancer clusters around mobile-phone towers into context, the researchers wrote."
The Washington Post (6/22, Stein) "The Checkup" blog reported that, "in an editorial accompanying the study, John Bithell of the University of Oxford said that while the study had some shortcoming, the findings should be reassuring to people living near cell phone towers."

New MS Drug from Chinese Fungus

Research on ancient Chinese fungus leads to MS drug.
The Wall Street Journal (6/22, Landers) reports that for many years, Chinese medicine has noted the healing properties in a certain type of fungus known to destroy bugs. Now, fingolimod, a medication drawing on those observations, may soon be approved as a treatment for multiple sclerosis. Earlier this month, an FDA panel recommended that the agency approve the drug.

Male Anxiety and Heart Disease

Men diagnosed with anxiety in late teens, early 20s may be more likely to have heart disease later in life.
CNN /Health.com (6/22, Gardner) reports that "men diagnosed with anxiety in their late teens or early 20s are more than twice as likely to have heart disease or a heart attack later in life than their more laid-back peers, according to a" study published in the Journal of the American College of Cardiology. Researchers looked at data on nearly "50,000 Swedish men born between 1949 and 1951 who were undergoing medical examinations for military service." During a 37-year follow-up, researchers found that "people with anxiety had more than double the risk of heart disease and two-and-a-half times the risk of suffering a heart attack."

Probiotic Update

Probiotics, prebiotics may not always live up to their health claims.
The Los Angeles Times (6/21, Dance) reported that "probiotics and prebiotics -- from bacteria-infused beverages to microbe-filled chocolates -- are gaining in popularity, even as some scientific studies find they don't always live up to their claims." Being that "the Food and Drug Administration does not regulate probiotics, proof of efficacy is often sketchy." The Times added that "last year, Dannon settled a lawsuit with yogurt buyers who asserted its ad campaign made false promises."

Men Stressed by Work and Family

Men stressed by attempt to balance work, parenting responsibilities.
The New York Times (6/20, WK1, Parker-Pope) reported on the front page of its Week in Review section that "several studies show that fathers are now struggling just as much -- and sometimes even more -- than mothers in trying to fulfill their responsibilities at home and in the office." In addition, fathers "seem more unhappy than mothers with the juggling act: In dual-earner couples, 59 percent of fathers report some level of 'work-life conflict,' compared with about 45 percent of women, according to a 2008 report from the Families and Work Institute in New York." One expert noted, "Men are facing the same clash of social ideals that women have faced since the 1970s -- how do you be a good parent and a good worker?"

Obesity and Gut Bacteria

Research suggests gut bacteria may influence weight.
The Los Angeles Times (6/21, Dance) reports, "Between 10 trillion and 100 trillion microbes, mainly bacteria, dwell in a person's colon and small intestine." Recently, "researchers have discovered significant links between gut bacteria and weight and metabolism in mice -- and are starting to find similar associations in people." Yet, the "story in humans is far from certain, though, and scientists say it's too soon to concoct microbe-filled 'stay-slim' beverages -- a fact that has not prevented some companies from promoting their bacteria-laden products as helpful for weight loss."

Cell Phone Radiation

San Francisco measure would require retailers to post data on cell phone radiation.
The Los Angeles Times (6/17, Olivarez-Giles) reports, "San Francisco is close to enacting a law that would require retailers to post signs stating how much radiation is emitted from cell phones. The city's Board of Supervisors voted 10 to 1 on Tuesday to approve the ordinance, which would require stores to provide each phone's 'specific absorption rate' -- a measurement of radiation absorbed by a phone user's body tissue that each manufacturer is required to register with the Federal Communications Commission." This "law, the first of its kind in the United States, would apply only to stores in San Francisco."

Older Americans and Drug Abuse

Report says more older Americans are abusing drugs.
Dow Jones Newswire (6/16, Jackson) reports that, according to a newly released report sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), more older Americans are abusing drugs, such as marijuana, cocaine, and heroin. According to Peter Delaney, director of SAMHSA's office of applied studies, "I think we think about prevention only for young kids. We also need to begin to think about prevention options for older adults." The report indicates, however, that the number one cause of substance abuse treatment admissions remains alcohol abuse.

Infants and Vitamin D

FDA warns against giving infants more than 400 international units of vitamin D.
The Los Angeles Times (6/15, Maugh) "Booster Shots" blog reported, "The Food and Drug Administration on Tuesday warned parents about the dangers of giving infants more than 400 international units (IU) of vitamin D." Indeed, "supplementation is recommended for some infants, especially those being breastfed, because a deficiency can lead to bone problems, such as thinning, soft and misshapen bones." But, "overdoses...can cause nausea and vomiting, loss of appetite, excessive thirst, frequent urination, constipation, abdominal pain, muscle weakness, muscle and joint aches, confusion and fatigue, as well as more serious consequences such as kidney disease."
Notably, "many of the vitamin D supplements in stores use droppers that could allow anyone to accidentally give harmful amounts of the vitamin to a baby," according to the CNN (6/15, Willingham) "Paging Dr. Gupta" blog. Therefore, those caring for infants should "make sure the vitamin D dropper is...clearly marked with units of measurement." The FDA also recommends "keeping in touch with your pediatrician should help avoid any problems with vitamin D overdosing."

Vaccine Safety Website

FDA launches website with safety data on new drugs, vaccines.
USA Today (6/16, Rubin) reports, "The Food and Drug Administration launched a website Tuesday where patients and healthcare professionals can find safety information about recently approved drugs and vaccines." On its Postmarketing Drug Safety Evaluations site, the FDA plans to include "what it has learned about the safety of a new drug or biologic, such as a vaccine, 18 months after approval, or after 10,000 patients have used it, whichever comes later." Robert Boucher, an official in the FDA's Office of Surveillance and Epidemiology in the Center for Drug Evaluation and Research, said the agency will make a "broad sweep" of adverse-event reports, medical studies and drug utilization databases.
The AP (6/16, Perrone) notes that the "agency plans to publish the summaries on a quarterly basis," and each "new drug, including drugs approved back to September 2007, will receive a safety summary within roughly two years of approval, according to the FDA."
Bloomberg News (6/16, Peterson) points out that the first reports will include "medications for infections, hypertension and depression, the FDA said."

Nutritional Guidelines

HHS, USDA unveil preliminary dietary guidelines.
ABC World News (6/15, story 5, 1:40, Sawyer) reported that on Tuesday, "a government panel issued a brand new plea for all of us to change how we eat." ABC (Davis) added, "Nutritionists say obesity is the biggest threat to public health. In the last 30 years, obesity rates for kids have tripled."
The Los Angeles Times (6/16, Zajac) reports, "The Department of Agriculture issued new guidelines Tuesday for improving the nation's diet, but the main recommendations are steps Americans have so far largely avoided -- cutting back on salt, sugar and saturated fats, and consuming more fruits and vegetables." While "the preliminary version of the latest Dietary Guidelines for Americans is not much different from recommendations issued 30 years ago," the "growing mountain of evidence linking an overweight, sedentary lifestyle to disease and high medical costs may give the new guide added urgency."
USA Today (6/16, Hellmich) notes, "The report is based on the latest scientific evidence and was prepared by a 13-member panel of national nutrition and health experts. The public now has 30 days to comment at www.dietaryguidelines.gov." Meanwhile, the final version of the "guidelines will be released later this year by the US Department of Agriculture" and HHS.
The AP (6/16, Jalonick) explains that the "panel, appointed by the Agriculture and Health and Human Services Departments, makes dietary recommendations every five years that serve as the basis for the government's popular food pyramid and for a range of federal nutrition programs, including school lunches." The new guidelines follow "the prestigious Institute of Medicine, which said earlier this year that people need just 1,500 mg [of salt] daily for good health, less if they're over 50. Average consumption is more than 3,400 mg."
The Wall Street Journal (6/16, Gray) reports that the guidelines recommend that all Americans consume no more than 1,500 milligrams of salt per day. Currently, the recommendation is 2,300 milligrams for most people, and 1,500 for those with health conditions such as hypertension. In addition, the guidelines state that children's intake of fats and sugary drinks should be limited, while their level of exercise should be increased.

Sunscreen Advised for Everyone

AMA advises people of all skin colors to wear sunscreen, avoid excessive sun exposure.
The Washington Post (6/17, Huget) "The Checkup" blog reported that the American Medical Association is advising "people of all skin colors, including blacks and Hispanics," to "wear sunscreen and avoid excessive sun exposure to reduce their skin-cancer risk." AMA's "stance...reflects the facts that skin-cancer incidence is on the rise among blacks and Hispanics, that skin cancer is more likely deadly for blacks than it is for whites, and that many people with dark skin apparently aren't aware of their risk for skin cancer." Now, under its "new policy, the AMA pledges to 'support and encourage efforts to increase awareness of skin cancer risks, skin cancer screening, and sun-protective behaviors in communities of color.'"

New Morning After Pill

FDA panel says new morning-after pill is safe, effective.
ABC World News (6/17, story 7, 0:25, Sawyer) reported, "A new type of morning-after pill is a big step closer to going on sale in the US. Today, an FDA advisory panel voted unanimously that the pill called ellaOne [ulipristal acetate] is safe and effective."
The CBS Evening News (6/17, story 8, 0:25, Couric) reported, "Studies show it can prevent pregnancy up to five days after intercourse. That's two days more than the over-the-counter Plan-B [levonorgestrel] pill."
NBC Nightly News (6/17, story 5, 1:35, Holt) chief medical editor Nancy Snyderman, MD, explained that the new pill "is a close chemical cousin to the morning-after pill RU-486 [mifepristone]."
The New York Times (6/18, A14, Harris) reports, "Ella blocks the effects of progesterone, a female hormone that spurs ovulation," but "some mystery remains over exactly how it works. That mystery spurred a fierce debate outside the committee over whether it should be considered an abortion drug." The dispute focuses on "whether the drug works by delaying ovulation (as the pill's manufacturer claims) or by preventing a fertilized egg from implanting itself in the uterus (as anti-abortion advocates say)."
"The positive recommendation moves the pill, which is already approved in Europe, one step closer to the US market," the AP (6/18, Perrone) reports. In studies conducted "by the drug's manufacturer, HRA Pharma...ellaOne prevented pregnancies longer and more consistently than Plan B." In a head-to-head comparison of the two drugs in nearly 1,700 women, researchers found that women "who took ellaOne had a 1.8 percent chance of becoming pregnant, while women who took Plan B had a 2.6 percent chance."
WebMD (6/17, DeNoon) pointed out that the drug, if approved, would be known in the US as Ella, even though it is sold in Europe under the name EllaOne. WebMD also noted that "one possibly serious drawback to Ella is that it may be less effective in obese women." However, "in a 6-5 vote, the panel said no specific labeling should be required to address this issue."
MedPage Today (6/17, Walker) reported that side effects reported in trials "were headache, nausea, dysmenorrhea, abdominal pain, fatigue, and dizziness, which were reported by at least 5% of all women in the studies. The safety profile is similar to that of levonorgestrel."

Overweight Married Couples

Research shows married people have higher BMIs than singles.
Abby Ellin wrote in the New York Times (6/13, ST17) that "gaining weight during marriage is about as common as holding your breath under water." In fact, "a 2008 study in the Journal of Economics and Human Biology examined data from 12,000 men and women ages 18 to mid-40s. Compared with when they were single, the body mass index (or BMI, a height-to-weight ratio) of married men increased by 1.5 percent above and beyond what they would normally gain as they aged, and that of women shot up 2 percent."

Second Hand Smoke and Mental Illness

Exposure to secondhand smoke may increase symptoms of psychological distress.
The New York Times (6/11, Rabin) reports in Vital Signs that "even people exposed to secondhand smoke are at significantly increased risk -- and more likely to be hospitalized for -- mental illness," according to a study published online June 7 in the Archives of General Psychiatry. In a study of "about 5,560 nonsmoking adults and 2,595 smokers" whose "mental-health was assessed by a 12-item questionnaire," researchers discovered that "nonsmokers exposed to secondhand smoke were 1.5 times as likely to suffer from symptoms of psychological distress as unexposed nonsmokers...and the risk increases the greater their exposure to passive smoking."

Back Pain Needs Time

Time often best antidote for back pain.
The AP (6/11) reports, "By one recent estimate, Americans are spending a staggering $86 billion a year in care for aching backs," even though "that research found little evidence that the population got better as the bill soared over the past decade." The AP adds, "The reality is that time often is the best antidote. Most people will experience back pain at some point, but up to 90% will heal on their own within weeks." Because of that, "doctors aren't even supposed to do an X-ray or MRI unless the pain lingers for a month to six weeks." The article explains that a formal exercise program designed to strengthen muscles of the core and back is helpful for many back-pain patients in restoring functionality and lessening pain.

Ecstasy Deaths

CDC report details deaths, ED visits among partygoers taking "Ecstasy."
The Los Angeles Times (6/12, Lin) reports, "A 24-year-old man died and 18 others were transported to emergency" departments "after taking Ecstasy at an all night New Year's Eve rave at the Los Angeles Sports Arena, according to a report released Thursday." These incidences occurred shortly after the deaths "of two men who had attended a Cow Palace rave over the Memorial Day weekend south of San Francisco." The authors of the article, which appears in the CDC's Morbidity and Mortality Weekly Report, said such cases raise "questions about whether publicly owned venues like the Sports Arena should host such events."
This is an issue that will only grow larger, considering that "use of the drug is increasing, and many overdoses go underreported," Bloomberg News (6/11, Randall) reports. In fact, the "number of patients at treatment programs in Los Angeles County citing ecstasy as their drug of choice increased almost sevenfold from 2005 to 2009."

Shingles Vaccine Problems

Fewer than 10 percent of eligible patients have been vaccinated against shingles due to modern obstacles.
In the New York Times (6/10) Doctor and Patient column, Pauline Chen, MD, pointed out that although the shingles vaccine was seen as "contemporary medicine's elegant response to a once intractable, age-old problem," in the two years following its introduction, "fewer than 10 percent of all eligible patients have received it" largely due to "modern...obstacles." For instance, CDC researchers "found that fewer than half" of surveyed primary care physicians "strongly recommended the shingles vaccine," because most "were concerned about patient cost." The "vaccination costs $160 to $195 per dose, 10 times more than other commonly prescribed adult vaccines; and insurance carriers vary in the amount they will cover."

Physicians on Facebook?

Op-ed: Physicians should not "friend" patients on Facebook.
Katherine Chretien writes in a USA Today (6/10) opinion piece, "As social media have redefined (read: near-obliterated) the distinction between personal and professional identities, physicians have been grappling with how to define our professionalism in the digital age. There are currently no national guidelines for social media use by physicians (although the American College of Physicians is reportedly in the process of devising some), and few medical schools have social media policies in place." But, "for many of us physicians on Facebook, the thought of opening up our personal pages filled with family photos, off-the-cuff remarks and potentially, relationship status and political and/or religious views to our patients gives us the heebie-jeebies." Chretien says that "at best, this could result in awkwardness," and at worst, it could destroy the "patient-physician bond."

Texting While Driving

Physicians urged to counsel patients on dangers of distracted driving.
The Los Angeles Times (6/9, Stein) "Booster Shots" blog reported that "Dr. Amy Ship, author of a perspective paper in the Thursday issue of the New England Journal of Medicine" argues that "doctors should counsel patients about the potentially devastating effects of texting or talking on the phone while driving."
The CNN (6/9, Wade) "Paging Dr. Gupta" blog reported that Ship "writes that doctors should have the conversation with patients during annual exams."
The Boston Globe (6/9, Cooney) "White Coat Notes" blog reported that Ship writes, "Primary care doctors are uniquely positioned to teach and influence patients; we should not squander that power." She makes the case for preventive care, noting that asking patients "about driving and distraction is as central...as the other questions we ask." Reuters (6/10) also covers the story.

Back Surgery Update

Americans spending more on back surgery, but few find relief.
The AP (6/9, Neergaard) reports, "Even though only a fraction of people with back pain are good candidates for surgery, complicated spine operations are on the rise. So is the hunt for any relief." According to "one recent estimate, Americans are spending a staggering $86 billion a year in care for aching backs -- from MRIs to pain pills to nerve blocks to acupuncture. That research found little evidence that the population got better as the bill soared over the past decade." The AP notes, "The reality is that time often is the best antidote. Most people will experience back pain at some point, but up to 90 percent will heal on their own within weeks," and "for run-of-the-mill cases, doctors aren't even supposed to do an X-ray or MRI unless the pain lingers for a month to six weeks."

Post Traumatic Stress in Iraq Vets

One in 10 Iraq veterans may develop a severe case of PTSD.
The Los Angeles Times (6/7, Kaplan) "Booster Shots" blog reported that a study published June 8 in the Archives of General Psychiatry examines "how many soldiers develop" post-traumatic stress disorder (PTSD) "and other mental health disorders after deployment." Researchers "from the US Army Medical Research and Materiel Command examined 13,226 anonymous surveys completed by veterans of Operation Iraqi Freedom." The investigators found that "roughly one in 10 survey-takers had PTSD that was severe enough to cause 'serious functional impairment.'"
"Between nine percent and 14 percent of the soldiers were diagnosed with PTSD or depression resulting in serious impairment, while 23 percent to 31 percent were deemed to have some impairment," CNN /Health.com (6/7 Gardner) reported. Notably, "the risk of mental health problems may be more persistent among National Guard soldiers, the study suggests. A greater proportion of men and women in the National Guard than in the Army were diagnosed with PTSD and depression one year after their return, although the two groups had similar rates at the three-month mark."

Brain Tumor 'Helmet'

Battery-powered helmet may benefit patients with brain tumors.
Bloomberg News (6/5, Randall) reported that a "helmet, powered by a six-pound battery pack," may benefit patients with brain tumors, according to a study presented at the annual meeting of the American Society of Clinical Oncology. Researchers found that the helmet "helped patients with recurrent tumors live 7.8 months, compared with a median 6.1 months for patients given the best available chemotherapies or Roche AG's Avastin." Bloomberg added that "the electric fields resonate at a frequency designed to do no harm to healthy brain tissue."

Eat After Execise!

Exercising without eating beforehand may help burn more fat.
The AP (6/4, Cheng) reports, "Though many athletes eat before training, some scientists say that if you really want to get rid of more fat, you should skip the pre-workout snack." In a study published in April in the journal by Medicine & Science in Sports & Exercise, researchers found that fasting bicyclists "burned a higher proportion of fat to carbohydrates than the group that ate." The investigators theorized that "exercising without eating produces muscles that are better at absorbing glucose," a finding that may help patients with diabetes "control their insulin levels."

High School Students and Drug Abuse

One in five high school students may abuse prescription medications.
The AP (6/4) reports that a survey (pdf) from the Centers for Disease Control and Prevention "shows one in five high school students have taken a prescription" medication not obtained by a prescription from a physician, including pain medicines and medications for attention-deficit/hyperactivity disorder "used as study aids."
The 2009 National Youth Risk Behavior Survey also found that "twelfth-graders had the highest likelihood of prescription" medication "abuse, at 26 percent, and ninth-graders had the lowest, at 15 percent," the CNN (6/3, Landau) "Paging Dr. Gupta" blog reported.
HealthDay (6/3, Reinberg) reported that the survey of some "16,460 high school students" also revealed that "the abuse of prescription" medications "was widest among whites at 23 percent, followed by Hispanics at 17 percent, and black students at 12 percent."

Teens and the Rhythm Method

Fewer teens worried about pregnancy; more use rhythm method.
The CBS Evening News (6/2, story 10, 0:25 Couric) reported, "More of America's teenagers are turning to one of the oldest methods of birth" control: the "rhythm method." The newly released report from the CDC's National Center for Health Statistics also reveals that "64% of teenaged boys believe its okay for an unmarried female to have a child. That's up from half."
In fact, "among teens in the USA, the percentage who have had sexual intercourse or say they'd be pleased if they or their partner were to get pregnant hasn't changed much since early in the decade, and there appears to be a growing acceptance of having babies outside marriage," USA Today (6/3, Rubin) reports. One expert, who was not involved in the study, pointed out that "given the publicity about unmarried celebrities having babies and the growing number of single mothers overall...it's not surprising that teens are more accepting of the notion."
But, it hasn't always been that way, considering the "teen birth rate declined steadily from 1991 through 2005," AP (6/3, Stobbe) reports. In 2007, however, the rate rose. Then "it dropped again in 2008, by two percent, to about 10 percent of all births." The new report from the CDC may help explain why the "decline in childbearing stalled out."
The researchers began their investigation by looking at data "collected through in-person interviews with 2,767 teenagers ages 15 to 19," Bloomberg News (6/3, Gibson) reports. Investigators eventually found that "among never-married females, 42 percent reported having sex at least once," while 43 percent of men said they had engaged in sexual relationships. Interestingly, the "number of boys who chose 'don't want to get female pregnant' as the reason for avoiding sex fell by half to 12 percent from the last survey."

Cigarette Toxin Update

US cigarette brands expose smokers to higher levels of cancer-causing agents.
CBS News (6/1) reported on its website that "'cigarettes from around the world vary in their ingredients and the way they are produced,' Dr. Jim Pirkle, deputy director for science at the CDC's National Center for Environmental Health, Division of Laboratory Sciences, said in a statement." But a newly-published paper appearing in Cancer Epidemiology Biomarkers and Prevention shows, "for the first time, the major carcinogens and cancer-causing agents in tobacco products, which researchers call tobacco-specific nitrosamines [TSNAs], were found in higher levels in US cigarettes than in cigarettes from" three other countries.
Before reaching that conclusion, the "CDC team enlisted 126 regular smokers in Australia, Canada, Britain and, in the US, in New York and Minnesota," the Los Angeles Times (6/1, Maugh) "Booster Shots" blog reported. "All smoked one brand routinely, typically the most popular brands in their country." Minnesotans "smoked Marlboro, Newport, Marlboro Light and Camel Light, while those in New York smoked Marlboro, Newport, Newport Light, Camel Light and Marlboro Menthol." The researchers "focused on the most lethal carcinogen in the tobacco smoke, 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanone (NNK), and its primary metabolite in urine, known informally as NNAL."

Childhood Vaccine Opinion

Parents who refuse vaccines put other people's "children in harm's way," clinician says.
In an op-ed in the Los Angeles Times (6/1), Pamela Nguyen, of UCLA's Mattel Children's Hospital, pointed out that, according to CDC data, "there were 197,000 measles deaths worldwide" in 2007. The following year, "a seven-year-old unvaccinated child who was exposed to the virus while abroad" ignited an outbreak in San Diego. Still, "many parents continue not to vaccinate their children." Some believe certain "vaccine-preventable diseases" are "no longer a threat," while "parents in the San Diego outbreak...were afraid of autism." This is "creating large reservoirs of susceptibility, primarily in private and charter schools that are generally free from state restrictions." In other words, "by choosing not to vaccinate, parents put not only their own children, but also other peoples' 'children in harm's way.'"

Prolia and Fracture Risk Reduction

FDA approves denosumab for postmenopausal women at increased risk of fractures.
The Wall Street Journal (6/2, Gryta) reports that the Food and Drug Administration has approved Amgen's Prolia (denosumab) for postmenopausal women who face an increased risk of fractures.
The Los Angeles Times (6/2, Olivarez-Giles) reports that the drug, "which has been in development for about 15 years, will be available to the public within the next week, Amgen said in a statement."
The AP (6/2, Perrone) reports that "pill-based osteoporosis drugs, such as Fosamax [alendronate] and Zometa [zoledronic acid], have been available for more than a decade." However, "Amgen Executive Vice President Dr. Roger Perlmutter said many women can't tolerate those drugs or have trouble remembering to take a daily medication." The drugmaker "said in a statement that Prolia is the first drug to target a cellular pathway that breaks down bones."
Bloomberg News (6/2, Waters) reports that "Amgen will follow more than 4,500 women who started taking denosumab in clinical trials for up to 10 years and will create a monitoring program to solicit reports and compile records about any adverse events in women taking the drug, the company said in a statement." The drugmaker "asked the FDA in a separate application to approve denosumab for reducing fractures in cancer patients whose tumors have spread to their bones." Amgen is also "conducting studies to see if the drug can stop cancer from spreading to bone."
The Ventura County Star (6/2, Hoops) notes that "the FDA's approval is ahead of schedule -- the target date was July 25 -- but comes on the heels of the European Union's granting of marketing authorization, which came Friday." Reuters (6/2, Berkrot) also covers the story.

Viagra Alternative

Experimental spray may prolong time to ejaculation in men.
The Wall Street Journal (6/1, Mathews) reports on an experimental spray of anesthetics lidocaine and prilocaine that was shown to improve sex for some men who experience premature ejaculation, according to two studies that will be presented at the Tuesday at the American Urological Association's annual meeting. In the studies of 539 men, those who were randomly assigned to the spray or a placebo version, reached orgasm a mean of three minutes 18 seconds after beginning sex, compared with about 56 seconds for those who got the placebo. Japan's Shionogi & Co. Ltd., which owns the drug, said it hopes to apply for FDA approval and announced it is already in discussions with the agency.

Blood Sugar Testing and Video Games

Blood-sugar meter that connects with gaming systems may help children with diabetes.
The Washington Post (6/1, Kritz) reports that the FDA "recently approved Bayer HealthCare's Didget, a blood-sugar meter that can connect with the Nintendo DS and DS Lite gaming systems." Children "who test their blood sugar as prescribed by their doctor get access to higher levels in certain games, as well as entry into a 'diabetes world' where they can communicate with other gamers who have the condition." Although "points are awarded for staying within ranges, not for reaching specific numbers...no additional points are given after a child has tested four times in a 24-hour period, a common goal set by physicians."

Prostate Surgery Update

Only surgery produces improvement in symptoms among patients with enlarged prostate glands.
The Los Angeles Times (5/29, Maugh) reported, "Medications, laser treatment, and surgery can all arrest the growth of an enlarged prostate gland, but only surgery can produce an improvement in symptoms, particularly a reduction in incontinence," Mayo Clinic researchers asserted. In fact, "'only the surgical intervention group reported a decrease in incontinence,' from 64.5% to 41.9%." Indeed, "transurethral resection of the prostate, or TURP, is generally reserved for those who have failed to respond to drug treatment or who cannot tolerate the medications." But findings presented during the American Urological Association's annual meeting also indicate that "it might be useful to introduce it earlier in the course of the disease."

Vitamin D Update

IOM to release updated recommendations for vitamin D.
The Boston Globe (5/31, Lazar) reported that "a growing body of evidence suggests that substantially boosting a person's intake of vitamin D...may offer protection against heart attacks, high blood pressure, various cancers, falls and fractures in elders, and even depression." However, a study published May 12 in the Journal of the American Medical Association "found that a large, single annual dose of vitamin D, given in roughly 1 1/2 times the amount an adult would typically take during an entire year, actually increased the number of falls and fractures among older women, especially in the first three months after the dosing." Later this year, the Institute of Medicine "is expected to release updated recommendations" for minimal daily requirements of vitamin D.

HPV Vaccine in Men

CDC says HPV vaccine is safe, effective in men.
Time (5/28, Park) reports in its Wellness blog that the CDC has "confirmed its provisional recommendation from 2009 that the HPV vaccine (Gardasil) against human papillomavirus infection is both safe and effective in males in preventing genital warts." Notably, the "HPV vaccine was approved by the Food and Drug Administration in 2006 for use in females from age nine to 26 to prevent cervical cancer and genital warts. Soon after, the CDC's Advisory Committee on Immunization Practices (ACIP), which helps to set the US's vaccination policies, recommended that Gardasil become part of routine vaccination for all girls 11 to 12 years old." Then, in 2009, "the ACIP added males to the population who can benefit from Gardasil vaccination, but stopped short of advising routine immunization."

Exercise and Molecular Fitness

Researchers identify 21 molecules in bloodstream that respond to exercise.
The Boston Globe (5/28, Johnson) reports that, according to research published in the May 26 issue of the journal Science Translational Medicine, cardiologist Dr. Gregory Lewis, of the Massachusetts General Hospital, and colleagues from MIT and Harvard, have "begun to unravel the secrets of exercise, in part by analyzing blood samples taken minutes after runners crossed the Boston Marathon finish line. The findings, they say, could begin to reveal how exercise achieves its potent effects and could lead to ways of improving athletic performance or treating disease." So far, they found that "exercise affects fit people differently than those who are less fit, and they identified 21 molecules in the bloodstream, called metabolites, that respond to exercise."
HealthDay (5/27, Goodwin) reported, "A better understanding of" metabolites, which burn fat, "may not only boost athletic performance, but help prevent or treat chronic illnesses such as type 2 diabetes and heart disease by correcting metabolite deficiencies."

Johnson & Johnson Charges

Johnson & Johnson faces possible criminal charges for pattern of violations.
ABC World News (5/27, story 6, 2:45, Stephanopoulos) reported, "Government officials said today they are considering criminal charges against Johnson & Johnson, stemming from last month's huge recall of Tylenol and other popular over the counter children's medicines."
NBC Nightly News (5/27, story 5, 2:25, Williams) reported, "Johnson & Johnson insists it has taken dramatic steps to clean up the plants where the recalled products are made. Meanwhile, the FDA says it has referred the matter to its criminal division for consideration."
On the front of its Business Day section, the New York Times (5/28, B1, Singer) reports, "The Johnson & Johnson unit that recalled millions of bottles of liquid children's Tylenol and other pediatric medicines last month may face criminal penalties, product seizures, or other sanctions, an official from the Food and Drug Administration said Thursday." Notably, the "agency is considering further actions against McNeil Consumer Healthcare...after a pattern of violations in manufacturing and quality control practices led to a number of recent recalls," Sharfstein "said at a Congressional hearing on Thursday."
The Washington Post (5/28, A03, Layton) notes, "When faced last year with Motrin IB caplets that were not dissolving properly, McNeil Consumer Healthcare, a division of Johnson and Johnson, hired contractors to buy the products under orders not to mention the term 'recall,' according to documents released by the House Committee on Oversight and Government Reform." Then, "after the Food and Drug Administration discovered the effort -- because one of the contractors accidentally dropped an instruction sheet on the floor of a store -- McNeil announced a recall of roughly 88,000 packages of the product." And, in the last year, there have been "four recalls of McNeil products...including the April 30 recall of 136 million bottles of infant and children's Tylenol, Motrin, Benadryl and Zyrtec, which have shaken consumers' confidence and threaten to stain Johnson and Johnson's brand name."

Orlistat Warning

FDA now requiring liver-injury warning label on "popular" diet drug.
ABC World News (5/26, story 8, 0:20, Sawyer) reported, "There is a new warning about...popular weight loss drugs," medicines that have been taken by nearly "40 million people." After receiving "reports of liver damage by some users," the FDA has decided to put "a new warning on" Xenical (orlistat), developed by Roche's Genentech, "and its over-the-counter version, Alli," which is manufactured by GlaxoSmithKline (GSK), NBC Nightly News (5/26, story 9, 0:20, Williams) reported.
To date, the agency has identified "13 cases of severe liver damage associated with the drugs, one in the United States and 12 abroad," according to the Los Angeles Times (5/26, Maugh) "Booster Shots" blog. "Two of the patients died from liver failure and three others required liver transplants."
Last August, "the FDA initiated a review of the drug after receiving 32 reports of serious liver injury with hepatocellular necrosis or acute hepatic failure, 30 of them outside the US," MedPage Today (5/26, Neale) reported. The "current announcement of a labeling change comes at the end of the agency's review process."
Now, the revised label for orlistat (Xenical) will "include new safety information about rare cases of severe liver injury," Medscape (5/26, Lowes) reported. "In addition, the Drug Facts label for an over-the-counter, 60-mg formulation of orlistat (Alli) will now feature a warning about severe liver injury." The agency stated, however, that "it has not yet established a causal relationship between orlistat use and severe liver injury" for a few reasons. For instance, some of the patients in question were taking other drugs while using the diet medications, Dow Jones Newswire (5/27, Dooren) reports. Others may have had conditions that exacerbated their liver issues.
Still, HealthDay (5/26, Gardner) reported, the agency is "'telling consumers and healthcare providers to be vigilant should [patients] develop symptoms suggestive of liver impairment,' said FDA spokeswoman Elaine Gansz Bobo." She added, "We are not advising routine monitoring of liver enzymes as that will not help predict who may develop hepatic impairment on the drug."

Unhealthy Restaurant Dishes

Group unveils list of most unhealthy restaurant dishes.
NBC Nightly News (5/25, story 8, 2:30, Williams) reported, "There are certain things we like to eat, we eat them knowing they are not great for us. And then about once a year a group comes along to warn us all and tell us exactly what's in what we're eating. Well, it's that time of year. This year with about 1/3 of the American population classified as obese, the so-called extreme eating awards take on a new urgency."
ABC World News (5/25, story 7, 1:40, Sawyer) reported that "in America, where two of three adults are already considered overweight or obese, a new wakeup call tonight" about a "list of restaurant dishes that simply top the charts." ABC (De Nies) added, "They're big sellers at top food chains across the country, loaded with hidden fat, salt and sugar."
The Los Angeles Times (5/26, Stein) reports that "the Center for Science in the Public Interest has come out with its Xtreme Eating awards, giving dubious honors to restaurant fare that maxes out on fat and calories." The Times adds, "Among the winners (or should that be losers?) is the pasta carbonara at Cheesecake Factory; when served with chicken this dish comes in at 2,500 calories and 85 grams of saturated fat. Also on the list is the New Zealand rack of lamb at Outback Steakhouse. The lamb alone (no sides) is 1,300 calories and 60 grams of saturated fat, plus 1,340 milligrams of sodium (recommended daily allowance of sodium is from 2,400 milligrams for a healthy adult, although some health experts think it should be far lower)."

Herbal Supplement Contaminants

GAO study reveals contaminants in herbal supplements.
The New York Times (5/26, A15, Harris) reports, "Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found." Although the "levels of heavy metals -- including mercury, cadmium and arsenic -- did not exceed thresholds considered dangerous," almost half of them "contained pesticide residues that appeared to exceed legal limits." Notably, "Dr. Joshua M. Sharfstein, principal deputy commissioner of the Food and Drug Administration, said in an interview that he was not concerned about the safety of the supplements tested by the GAO investigators." Still, Sharfstein added that "the FDA had increased enforcement actions against supplements spiked with prescription drugs."

Sleep Apnea and Throat Exercises

Throat exercises may help patients with sleep apnea reduce their condition's severity.
According to the New York Times (5/24, O'Connor) Really? column, some sleep apnea sufferers "complain that the mask and headgear" used during CPAP "cause uncomfortable side effects, like congestion." There is new data, however, that may support a "free and fairly simple alternative" for such patients. "In a study published last year in the American Journal of Respiratory and Critical Care Medicine, scientists recruited a group of people with obstructive sleep apnea and split them into two groups." Three months into the trial, investigators found that "subjects who did the throat exercises snored less, slept better, and reduced the severity of their condition by 39 percent. They also showed reductions in neck circumference."

Blood Pressure and Soda

Drinking fewer sugary drinks may lower blood pressure.
The Los Angeles Times (5/24, Stein) "Booster Shots" blog reported that "there may be a link between drinking fewer sugar-sweetened beverages and lowering blood pressure," according to a study published in the journal Circulation: Journal of the American Heart Association. Researchers followed "810 men and women age 25 to 70 who were part of a lifestyle intervention study and had prehypertension or stage I hypertension." The researchers found that "drinking one less serving, or 12 ounces, of sugar-sweetened beverages per day was associated with 1.8 drop in systolic blood pressure, and a 1.1 drop in diastolic blood pressure over 18 months."
Reuters (5/25, Steenhuysen) quotes one of the study authors as saying, "If you reduce your consumption by two servings, you would probably lower your blood pressure even more."
The NPR (5/24, Knox) "Shots" blog pointed out that "Americans drink two 12-ounce servings of these sugary drinks a day, on average."

Delayed Vaccine Update

Delaying childhood vaccinations may offer no benefit.
The Los Angeles Times (5/24, Maugh) "Booster Shots" blog reported, "Now that the thimerosal-autism link has been thoroughly discredited, some autism advocates argue that neurodevelopmental problems are caused by overloading children's immune systems with too many vaccines too early in life." Consequently, a "growing number of parents are asking pediatricians to use alternative vaccination schedules that spread out the shots, even though there is no evidence to suggest that the practice may be helpful." That evidence, however, may be hard to come by, as scientists "cannot ethically conduct a clinical trial of delayed vaccinations because of the potential risks to the children involved."
To get around that issue, researchers at the University of Louisville School of Medicine decided to turn to data compiled through a project spearheaded by the CDC, the Wall Street Journal (5/25, Dooren) reports. Launched in 1990 with the help of eight managed care organizations, the Vaccine Safety Datalink project aimed to monitor safety and outcomes. The current study authors zeroed in on 1,047 children who received shots between 1993 and 1997. Between 2003 and 2004, all of the children were subjected to 42 tests which, among other things, assessed their IQs, verbal abilities, and coordination, Reuters (5/24, Joelving) reported. The cohort was then grouped according to whether they received all of their inoculations within the first year of life or somehow failed to follow the schedule.
Specifically, "children were classified as up-to-date if they had received at least two hepatitis B, three diphtheria-tetanus-pertussis (DTP), three Haemophilus influenzae type B (Hib) and two polio vaccines on time during the first seven months of life," HealthDay (5/24, Behen) reported. "A vaccine was considered on time if it was given within 30 days of the recommended age." After conducting "two separate analyses," the researchers "found no evidence to suggest that multiple vaccines in the first year of life negatively impact a child's cognitive abilities later. In fact, the first analysis revealed that children who received all their vaccines on time performed slightly better on two of the 42 tests," whereas those "who missed or were late on one or more doses of vaccine didn't do better on any test."
Notably, "children getting vaccines later than doctors' schedules were more likely to be from families with lower household incomes and had a lower percentage of mothers with college degrees," WebMD (5/24, Hendrick) reported. In comparison, "those with on-time vaccinations were slightly younger at the time of neuropsychological assessment (mean 9.2 versus 9.4 years)," MedPage Today (5/24, Gever) reported. Nevertheless, "'there was no evidence of neurodevelopmental delays or deficits associated with on-time vaccination," Michael J. Smith, MD, MSCE, and Charles R. Woods, MD, MS, wrote in a study published online May 24 in Pediatrics.