Cymbalta and Chronic Pain

FDA panel recommends allowing duloxetine to treat some chronic pain conditions.
The New York Times (8/20, B3, Wilson) reports that an FDA advisory panel "on Thursday voted narrowly to recommend allowing Eli Lilly to market its blockbuster antidepressant Cymbalta [duloxetine] for some chronic pain conditions like lower back ailments that affect millions of Americans." The panel "voted 8-6 in favor of expanding approved uses" but "voted against the drug's use for osteoarthritis." FDA officials at the meeting also "assured the panel they would draft warnings against the overuse of Cymbalta for pain, if they did finally approve a label change."
The Wall Street Journal (8/20, Dooren) notes that Cymbalta is currently approved to treat depression, diabetic nerve pain, fibromyalgia and anxiety. Bob Rappaport, director of FDA's anesthesia and analgesia products division, also said the agency is considering the approval of Cymbalta to treat musculoskeletal pain, including lower-back pain, but not for all types of chronic pain.
The AP (8/20, Perrone) adds that the "panelists picked apart five clinical studies submitted by the company, which showed conflicting results for the drug's effectiveness in different pain disorders and patient groups." Many panelists also "complained that Lilly's studies were primarily composed of older, Caucasian patients, raising questions about the drug's effectiveness in different age groups and ethnicities."

Binge Drinking and Hypertension

Binge drinking may be particularly dangerous for patients with hypertension.
CNN /Health.com (8/20, Gardner) reports that binge drinking and high blood pressure may be a deadly combination for some people, according to a study published in Stroke: Journal of the American Heart Association. Investigators "followed 6,100 South Koreans age 55 and up for two decades." The researchers found that, "compared with teetotalers with normal blood pressure, men with high blood pressure...who even occasionally down more than six drinks in one sitting have nearly double the risk of dying from a stroke or heart attack."

Tai Chi and Fibromyalgia

Tai chi may be effective therapy against fibromyalgia.
The New York Times (8/19, A16, Belluck) reports, "The ancient Chinese practice of tai chi may be effective as a therapy for fibromyalgia, according to a study published on Thursday in the New England Journal of Medicine."
For the study, "doctors randomly assigned 66 fibromyalgia patients to take either a 12-week tai chi class or attend a 'wellness education' class that included stretching exercises," USA Today (8/19, Szabo) reports. "After finishing the course, 79% of tai chi participants said their symptoms had improved, compared with 39% of those in the educational class, the study shows. It was financed by the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health."
The AP (8/19, Marchione) reports that an editorial accompanying the study "called the results 'provocative' and 'striking,' but said that it's unclear how much of the benefit is due to a placebo effect. The results need to be repeated in a larger study," the editorialists concluded.
According to the Los Angeles Times (8/18, Roan) "Booster Shots" blog, "how tai chi works to reduce fibromyalgia symptoms is unknown, but it is likely a multi-factorial impact that includes improved muscle strength, psychosocial well-being, relaxation and rest that 'may raise pain thresholds and help break the 'pain cycle,' the authors wrote."
CNN /Health.com (8/19, Storrs) reports, "Previous research has shown that tai chi can help relieve the symptoms of arthritis and other pain conditions, but this study is the first controlled trial to examine its effectiveness as a treatment for fibromyalgia, which affects an estimated 10 million Americans."
The Boston Globe (8/18, Lee) "White Coat Notes" blog, WebMD (8/18, DeNoon), HealthDay (8/18, Goodwin), and MedPage Today (8/18, Neale) also covered the story.

Egg Recall

Egg recall related to salmonella outbreak expanded.
ABC World News (8/18, lead story, 2:45, Stephanopoulos) reported, "Federal health officials have put on a nationwide alert and issued one of the most sweeping food recalls in a generation. Two hundred twenty-eight million eggs from one of the country's biggest producers, after tainted eggs caused a dangerous outbreak of salmonella. It's made hundreds of people sick in at least three states and it is spreading." ABC (Wright) added, "Ironically, the FDA just issued strict new guidelines for farmers, designed to prevent salmonella outbreaks. Those guidelines took effect just last month clearly not in time to prevent this outbreak. And food safety officials stress they're still in their early stages of the investigation," and "fully expect this outbreak to grow."
NBC Nightly News (8/18, story 3, 2:35, Williams) added, "Federal investigators at these massive henhouses in Galt, Iowa believe salmonella has somehow made its way inside." The recalls are occurring "after several hundred people became sick in California, Colorado, and Minnesota. And it looks as if the hens themselves have been infected."
The New York Times (8/19, B1, Neuman) reports on the front page of its Business Day section that the "outbreak, which federal officials said was the largest of its type related to eggs in years, began in May, just weeks before new government safety rules went into effect that were intended to greatly reduce the risk of salmonella in eggs." The Times says that the "company behind the recall, Wright County Egg, of Galt, Iowa, is owned by Jack DeCoster, who has had run-ins with regulators over poor or unsafe working conditions, environmental violations, the harassment of workers, and the hiring of illegal immigrants."
USA Today (8/19, Weise) reports that the recall has "renewed questions about whether it's feasible to keep the microbe -- the most common bacterial source of food-borne illness in the nation -- out of the henhouse." Meanwhile, "CDC epidemiologist Christopher Braden said Wednesday that there may be thousands of illnesses, though no reported deaths." Braden added, "We're speculating they could have had a highly infected flock or the product could have been mishandled, but we don't really know."

Tongue Patch for Weight Loss

Tongue patch promises weight loss.
The Los Angeles Times (8/17, Mestel) "Booster Shots" blog discussed a new weight loss treatment called the Chugay Tongue Patch. "According to the PR information, the tongue is measured, then a patch is cut from surgical mesh and attached to your tongue. While affixed, it 'causes discomfort when the patient tries to eat or chew.'" Allegedly, according to the product's publicists, "the 'ideal patient' can experience 15 to 30 pounds of weight loss in a month on a liquid diet...and then the patch is removed

Steroids and Heart Function

Anabolic steroid use may be linked to poorer heart function.
The Los Angeles Times (8/17, Healy) "Booster Shots" blog reported that a study published in the journal Circulation: Heart Failure suggests that anabolic steroid use may be linked to poorer heart function. For the "study, 12 long-term users and seven non-users of anabolic steroids -- all seemingly healthy -- underwent a battery of tests of their hearts' structure and function." Researchers found that, "compared with non-users, those who had illicitly used anabolic steroids over several years had far poorer heart function than those who did not -- particularly in the left ventricle, the heart's main pumping chamber."

Teen Hearing Loss

Study: One in five teens suffers slight hearing loss.
ABC World News (8/17, story 7, 0:25, Stephanopoulos) reported, "There are some troubling findings tonight in a new study of American teenagers. Researchers found nearly one in five teens are suffering from hearing loss."
CBS Evening News (8/17, story 8, 2:25, Hill) reported that the study found "6.5 million Americans between the ages of 12 and 19 suffer from hearing loss." That's "up more than 30% from just the early 1990s."
On NBC Nightly News (8/17, story 6, 2:15, Williams), chief science correspondent Robert Bazell indicated that portable music devices may play a role in the hearing loss, saying, "At full volume, an iPod or other mp3 player gives off 105 decibels. That's equivalent to putting your ear next to a power lawn mower or attending a rock concert."
USA Today (8/18, Szabo) reports that hearing loss in American teenagers increased "31% since the mid-'90s," according to a study published Tuesday in the Journal of the American Medical Association. About "one in 20 have 'mild or worsening' hearing loss, which can make them struggle to follow conversations or teachers at school," USA Today adds.
The Los Angeles Times (8/18, Maugh) reports that the study "eliminated ear infections and exposure to loud noises in the environment as causes for the hearing loss," but "could not identify a specific cause." A recent Australian study, however, "found a 70% increased risk of hearing loss associated with the use of headphones to listen to portable music," and "many experts suspect they are the primary cause of hearing loss in teens."
Bloomberg News (8/18, Ostrow) reports the study found "hearing loss of 25 decibels or more -- enough that the children were often aware of the deficit -- increased to 5.3 percent of the sample, from 3.5 percent in the earlier group."
The Washington Post (8/17, Stein) "The Checkup" blog reported that although "the majority of hearing loss was slight," the "prevalence of mild or worse hearing loss increased 77 percent."
The AP (8/18, Johnson), the Boston Globe (8/18, Weintraub), and the San Francisco Chronicle (8/18, A1, Allday) also cover the story, as did NPR (8/17) in its "All Things Considered" program.

Dark Chocolate and Heart Failure

Dark chocolate may reduce heart failure risk in women.
The Washington Post (8/16, Stein) "The Checkup" blog reported that research published in Circulation: Heart Failure suggests that "eating a little dark chocolate in moderate amounts can be healthful."
The Time (8/16, Park) "Wellness" blog reported that investigators "found that women...who consumed one to two servings of chocolate a week enjoyed a 32% lower risk of heart failure than those who ate no chocolate at all during the nine year trial. The women who indulged a bit less, consuming one to three servings a month, reduced their odds of heart failure by 26%." HealthDay (8/16, Gardner), and MedPage Today (8/16, Phend) also covered the story.
Red meat may be linked to increased heart risks in women. CNN /Health.com (8/17, Gardner) reports that "if you eat red meat more than once a day, cutting back to one serving every other day can substantially reduce your risk of having a heart attack or dying from heart disease," according to a study published in Circulation: Journal of the American Heart Association.
WebMD (8/16, Hendrick) reported that "scientists examined data on 84,136 women between the ages of 30 and 55 over a 26-year period ending in 2006."
HealthDay (8/16, Reinberg) reported that the researchers "found that women who ate the highest amount of red meat were at the highest risk for heart disease."
According to MedPage Today (8/16, Phend), the researchers found that "a serving of chicken or turkey to replace one of beef, pork, or lamb would lower coronary heart disease risk 19%." HeartWire (8/16, Miller) also covers the story.

Bariatric Surgeryf and Type II Diabetes

Bariatric surgery may reduce medication use for obese patients with type 2 diabetes.
Bloomberg News (8/17, Gale) reports that, according to a study published Aug. 16 in the Archives of Surgery, "diabetics who undergo weight-loss surgery need fewer medications to control the condition and have lower health-care costs after the procedure." Specifically, "three-quarters of obese patients with type 2 diabetes were able to stop insulin and other blood-sugar controlling drugs within six months of undergoing bariatric surgery, researchers at the Johns Hopkins University School of Medicine said."
The Wall Street Journal (8/17, D2, Dooren) reports that for the study, which received funding from the Department of Health and Human Services, the study authors examined data on 2,235 adults who had type 2 diabetes and who underwent bariatric surgery.
The Los Angeles Times (8/16, Dennis) "Booster Shots" reported that the study authors concluded, "Health care providers should consider discussing bariatric surgery in the treatment of obese patients with Type 2 diabetes." HealthDay (8/16, Gordon) and Medscape (8/16, Hitt) also covered the story.

Routine Medical Care Problems

Routine medical care takes hit in tough economy.
The New York Times (8/17, A14, Pear) reports the "economic crisis" in the US "has reduced the use of routine medical care, and the cutbacks here are much deeper than in countries with universal health care systems," according to researchers in a new report. The study, published by the National Bureau of Economic Research, "finds that 'Americans, who face higher out-of-pocket health care costs, have reduced their routine medical care' much more" than people in Britain, Canada, France and Germany. Among Americans responding to the survey, "26.5 percent reported reducing their use of routine medical care since the start of the global economic crisis in 2007," noted the study by researchers from Dartmouth College, Princeton University and Harvard Business School. They analyzed data from "surveys designed with their help" and carried out in all five countries by TNS, a global market research concern.

Childhood Trauma and Stress

Childhood trauma may affect biochemical markers of stress.
USA Today (8/16, Jayson) reports that, according to research presented at a psychologists' meeting, "childhood trauma can cut your life short." After "using a community sample of 58 caregivers for a spouse or parent with Alzheimer's disease or dementia and a control group of 74 demographically similar people who had no caregiving responsibilities, researchers analyzed participants' depression levels and occurrence of childhood trauma to see how negative emotions and stressful experiences affect known biochemical markers of stress." They found that "childhood adversity was associated with shorter telomeres and increased levels of inflammation even after controlling for age, caregiving status, gender, body mass index, exercise and sleep."
Troubled childhoods may lead to heart disease later. USA Today (8/16, Jayson) reports that, according to a study presented at a psychologists' meeting, "troubled childhoods can lead to a host of health problems in adulthood, with heart disease as a prime possibility." In a study of 212 adolescents who "were examined over three years to see whether poverty was linked to more sensitivity to stress and early signs of heart disease," researchers found that "children from poor economic households had stiffer arteries years later and had higher blood pressure as well as more thickening of their carotid artery walls."
HealthDay (8/14, Preidt) quoted the study's lead author, who stated that adolescents may be "more vulnerable to cardiovascular risks if they are exposed to various stressors because of their hormonal changes and their sensitivity to peer rejection, acceptance and how they interpret others' attitudes towards themselves." She went on to point out that a "New Zealand study...found that children who were socially isolated -- regardless of family income -- were also at increased risk for cardiovascular disease," while "another study she conducted found that living in an impoverished family can affect a child's reactions to negative situations and, over time, increase the risk of heart disease."

Massachusetts Drug Rebates

Massachusetts bill would allow rebates for brand-name prescription drugs.
The AP (8/13, Moran) reported that in Massachusetts, consumers may soon gain the ability to "get discounts or rebates from pharmaceutical companies to help them pay for pricey brand-name prescription drugs." Legislation "to allow for such co-payment discounts, sometimes referred to as coupons, has passed both chambers and needs final approval from both before being sent to Gov. Deval Patrick (D)" for his signature. Proponents of the measure "say co-payment discounts or rebates would let more consumers purchase the brand-name prescription drugs they need."
Massachusetts hospitals say they are facing slashed payments on multiple fronts. The Boston Herald (8/16, Norton) reports that "Massachusetts hospitals say they are facing slashed payments on multiple fronts, cuts that executives predict will destabilize the healthcare delivery system." Massachusetts "plans this fiscal year to cut reimbursements by $75 million in its main contract between hospitals and MassHealth, according to the Massachusetts Hospital Association, which cited 'discussions' with the state in outlining the proposed cut to its members over the weekend.'" The Herald added, "The association said pay-for-performance programs would continue in 2011 but that instead of additional funding being paid to hospitals, MassHealth would withhold 2 percent of all hospital inpatient and outpatient payments and hospitals would then need to earn the payments back."

New Contraceptive Approval

FDA approves new five-day emergency contraceptive.
NBC Nightly News (8/13, story 8, 0:15, Curry) reported, "Today, federal health officials approved a new type of morning after contraceptive that reduces the chance of pregnancy for five days. That's two days longer than the emergency contraception known as Plan B. The new pill is called Ella and it will be available by prescription only."
The AP (8/14, Perrone) reported that the FDA on Friday approved a new type of morning-after contraceptive, Ella from HRA Pharma, a prescription-only birth control option that reduces the chance of pregnancy up to five days after sex. Ella "uses the hormone progesterone to delay ovulation, a key step in the fertilization process. Despite this, the drug has drawn criticism from anti-abortion groups who say it is closer to an abortion pill than an emergency contraception pill. Groups including the Family Research Council argue the drug is chemically similar to the abortion drug mifeprestone, which can be taken to end a pregnancy up to 50 days into the gestation period."
The Los Angeles Times (8/14, Maugh II) "Booster Shots" blog said that the drug, "known generically as ulipristal acetate, is thought to inhibit or delay ovulation by interfering with the effects of the female hormone progesterone, which stimulates ovulation. ... Women with a known or suspected pregnancy or who are breastfeeding should not use the drug."
The Washington Post (8/14, Stein) said that Ella "can cut the chances of becoming pregnant by about two-thirds for at least 120 hours after a contraceptive failure or unprotected sex, studies have shown." Supporters and opponents both said the FDA's decision "marked the clearest evidence of a shift in the influence of political ideology at the FDA. ... If the history of Plan B is any indication, Ella's approval is likely to mark the beginning of many years of political and regulatory battles over the drug."
The New York Times (8/14, A1, Harris) reported on its front page that "some advocates said Friday that the agency's relatively rapid adoption of its scientists' advice meant that its traditional separation from political considerations had returned. 'It's really important the FDA made a decision that's based on the scientific evidence and not on the political controversy,' said Diana Zuckerman, president of the National Research Center for Women and Families. But Wendy Wright, president of Concerned Women for America, which opposes abortion, said that political considerations were still at work inside the agency."
The Wall Street Journal (8/14, Mathews, Dooren) noted that the label says ulipristal likely works by inhibiting or delaying ovulation, but its efficacy also may be partly due to an effect of altering the lining of the uterus in a way that affects implantation.

Teen Botox Stats

More teens getting botulinum toxin injections.
Writing in the New York Times (8/12, E1) "Skin Deep" column on the front of the Thursday Styles section, Catherine Saint Louis observes, "According to the American Society of Plastic Surgeons, last year, botulinum toxin, which is sold here under the brand names Botox [onabotulinumtoxin A] and Dysport [abobotulinumtoxin A], was injected into Americans ages 13 to 19 nearly 12,000 times, including some teenagers who got multiple doses." Currently, "nobody knows how many teenagers who get injections of Botox or Dysport are using them for medical rather than aesthetic purposes," because the drugs "can help with physical problems -- like pain in the temporomandibular joint of the jaw -- and improving the patient's looks can be a side effect."

Prostate Cancer Prevention

Survey: Physicians slow to prescribe pill to prevent prostate cancer.
In continuing coverage, "Shots," an NPR (8/12) health blog, reports, "A generic drug called finasteride reduces the risk of prostate cancer by 25 percent, according to a 2003 study of 18,000 men." However, according to a new survey that "appears in Cancer Epidemiology, Biomarkers and Prevention," nearly "two-thirds of urologists and 80 percent of primary care doctors in the Veterans Health Administration system...say they never prescribe finasteride to prevent prostate cancer." Dr. Ian Thompson of the University of Texas Health Science Center, who "conducted the 2003" study, "thinks more doctors ought to prescribe the drug to prevent prostate cancer," an opinion shared by Dr. Linda Kinsinger "of the Veterans Health Administration, who led the new survey."

Drug Abuse Detection System

Massachusetts regulators approve expanded prescription drug abuse system.
The Boston Globe (8/12, A1, Smith) reports on its front page that Massachusetts regulators approved a new prescription drug monitoring system Wednesday to help "stop 'doctor shopping' by addicted patients." The new system "will allow physicians and pharmacists to review an online database showing previous prescriptions patients had filled for powerful painkillers such as OxyContin." Massachusetts has had a monitoring system since 1992, but it is limited and "health providers don't have direct access to its data." The new system will update data weekly "instead of monthly," and it will include data on "a much broader roster of medications that includes pain relievers such as Vicodin and Darvon, as well as steroids." The state expects to save "$2 million a year by spotting abusers" in its insurance program.

Stress and Pregnancy

Stressed women may have reduced chance of becoming pregnant.
USA Today (8/12, Rubin) reports that "a new study in the current issue of the journal Fertility and Sterility lends credence to a link between stress and time to conception, and not just in couples dealing with infertility." The new "study involved 274 British women 18 to 40 years old" who "were followed for six menstrual cycles or until they got pregnant, whichever came first."
The Time (8/11, Blue) "Wellness" blog reported that the study found "no correlation between women's levels of cortisol, another more commonly measured stress hormone, and their chance of conception," however. But, "the researchers worry that, in a cruel twist, the inability to conceive may create a vicious cycle of stress for some women. 'It has been suggested that stress may increase with the disappointment of several failed attempts at getting pregnant, setting off a cycle in which pregnancy becomes even more difficult to achieve,' said study collaborator [Germaine] Buck Louis in a statement from" the National Institutes of Health.
According to the CNN (8/11, Falco) "The Chart" blog, the study does not explain "why high levels of alpha-amylase may reduce the chance of getting pregnant, but it could be because stressful situations may reduce blood flow and delay the transport of fertilized eggs, which can contribute to the failure to conceive."
CQ HealthBeat (8/11, Reichard) noted, "Finding ways to relax could increase the odds of becoming pregnant, but researchers said turning to tobacco or alcohol to unwind wouldn't do the trick since they reduce the likelihood of pregnancy."

Osteoporosis Treatment Update

Bisphosphonates not associated with increased risk of cancer of the esophagus or stomach.
Bloomberg News (8/11, Doherty) reports, "A group of medicines widely used to prevent bone loss doesn't increase the risk of cancer of the esophagus or stomach." In fact, the "combined incidence of the two tumor types was the same for osteoporosis patients given the drugs, called bisphosphonates, as for those not treated with the medicines," according to a paper in the New England Journal of Medicine. "Duration of treatment didn't have an impact on the risk of either cancer."
The study "comes out about a year and a half after the US Food and Drug Administration (FDA) reported 23 cases of esophageal cancer between 1995 and 2008 in patients using alendronate and another 31 cases in patients using a variety of bisphosphonates in Europe and Japan," Medscape (8/10, Mulcahy) reported. So, the current study "authors took up the challenge of investigating the possible link between these cancers and oral bisphosphonates, the use of which has 'dramatically' increased in recent years in the Western world." Specifically, they analyzed analyze data on "more than 80,000" UK "patients, who were mostly women and had a mean age of 70 years."
During an "average follow-up of about 4.5 years, there were 37 cases of stomach cancer and 79 cases of esophageal cancer diagnosed in the bisphosphonate group, compared with 43 cases of stomach cancer and 72 cases of esophageal cancer after 4.4 years in the control group," HealthDay (8/10, Preidt) reported. Thus, the Belfast-based team concluded, "these drugs should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use."

Flu Pandemic is Over

WHO declares end to H1N1 pandemic.
USA Today (8/11, Sternberg) reports, "The World Health Organization on Tuesday declared the H1N1 flu pandemic over, a little more than a year after a spring flood of cases prompted a global effort to curb its wildfire transmission." WHO Director-General Margaret Chan said, "The new H1N1 virus has largely run its course." But that "doesn't mean that the so-called swine flu is gone," because countries like New Zealand are "now grappling with local outbreaks."
But, according to the Wall Street Journal (8/11, McKay), Chan also said, "It is likely that the virus will continue to cause serious disease in younger age groups." Therefore, she urged public health officials to remain vigilant in case the virus mutates and becomes deadlier. In addition, she said that "based on experience with past pandemics, we expect the H1N1 virus to take on the behavior of a seasonal influenza virus and continue to circulate for some years to come," Bloomberg News (8/11, Doherty) notes.

MRSA Update

Rate of invasive healthcare-associated MRSA infections appears to have declined.
The Los Angeles Times (8/11, Roan) reports, "Dangerous infections caused by the bacterium methicillin-resistant Staphylococcus aureus, or MRSA, appear to be declining in healthcare settings across the nation," according to data released by the Centers For Disease Control and Prevention. "Although it's unclear why healthcare-associated MRSA cases are waning, it's welcome news to hospital administrators and infection-control officials, as well as the Department of Health and Human Services, which has declared preventing such infections one of its major objectives." In fact, "stringent infection-control strategies have been implemented in many hospitals, clinics and doctors' offices in the last decade to reduce infection rates."
What's more, "in 2006, the CDC published a 74-page manual on preventing the spread of drug-resistant organisms in healthcare," and the "document reported early successes from around the world, especially from western Europe, in techniques to limit MRSA spread," the Time (8/10, Blue) "Wellness" blog reported. "It's not unlikely, then, that similar precautions were adopted by US healthcare facilities soon after." The authors of the new paper in the Journal of the American Medical Association also pointed out that "general improvements in central-venous-line infection control can contribute a great deal, since most MRSA infections in US healthcare facilities are blood-stream infections."
Before reaching those conclusions, the researchers "focused on invasive MRSA in hospital patients or those who recently got treatment in a hospital or other healthcare setting, including kidney dialysis patients," the AP (8/11, Tanner) reports. Specifically, data was collected "from centers participating in the CDC's Emerging Infections Program/Active Bacterial Core surveillance system," MedPage Today (8/10, Neale) reported. The "surveillance program collects information from nine US metropolitan areas encompassing about 15 million people."
The researchers eventually discovered that "infections with MRSA that began in hospitals and other healthcare settings have declined 28 percent in recent years," HealthDay (8/10, Behen) reported. "Rates of 'invasive' MRSA infections that had their onset in hospitals or other healthcare facilities declined an average nine percent annually from 2005 through 2008," while "invasive MRSA infections that were associated with healthcare settings but began outside, in the community...declined by about six percent annually, for a total of a 17 percent decrease over the four-year period."
Nevertheless, says lead study author Alex Kallen, "MRSA is still a 'sizable public health threat,' even given the results of" this latest study, Bloomberg News (8/11, Wechsler) reports. Thus, "new guidelines will be issued in late August or September, Kallen said." Along similar lines, Russell Olmsted, president-elect of the Association for Professionals in Infection Control and Epidemiology, "cautioned against interpreting the study's results as a reason to ease up on prevention," Modern Healthcare (8/10, McKinney) reported. "What we are seeing is that the investment in infection control and engaging providers is paying off and we want to continue to ramp up those efforts," he added. WebMD (8/10, Boyles) and the NPR (8/10, Knox) "Shots" blog also covered the study.

Night Time Noise and DNA

Some brains may be specifically wired to block out noise during the night.
USA Today (8/10, Steinberg) asks, "Why can some people sleep through car alarms and thunderstorms when others wake up at the sound of footsteps?" Harvard researchers now "believe they've found the answer tucked in sleep spindles, or bursts of brain activity that occur only during sleep."
Before reaching that conclusion, investigators conducted a "three-night study," inviting "12 volunteers who reported being deep and healthy sleepers into a sleep lab with a comfy queen-size bed outfitted with enormous speakers at the headboard," Time (8/10, Park) reports. The "researchers recorded the participants' brain waves as they slept normally the first night, and then on subsequent nights as they were bombarded with 14 different noises...which were played at progressively louder volumes." The team "paid particular attention to the patterns generated by the thalamus, a region deep in the brain that processes incoming visual and auditory stimuli."
The team had surmised that "the thalamus might generate" the "sleep spindles as a way to prevent sensory input (such as loud noise) from reaching the sleeping brain," HealthDay (8/9, Phillips) reported. According to the paper in Current Biology, "people with higher rates of spindle rhythms were consistently less likely to awake in response to these noises." But, it's still not "completely clear if sleep spindles are directly interfering with sound transmission to the brain, although that's the current hypothesis."

Waist Circumference Risks

Larger waists may be linked to greater risk of death among older adults.
The AP (8/10) reports that, according to an American Cancer Institute-funded study published in August 9/23 issue of the Archives of Internal Medicine, "belly bulge can be deadly for older adults, even those who aren't overweight or obese by other measures." In fact, the study "suggests men and women with the biggest waistlines have twice the risk of dying over a decade compared to those with the smallest tummies. Surprisingly, bigger waists carry a greater risk of death even for people whose weight is 'normal' by the body mass index, or BMI, a standard measure based on weight and height."
The study found that "men who had a waist size of 47 inches (120 centimeters) or higher and women with waists of 43 inches or larger had about twice the risk of dying over the nine-year study period than those with the smallest waist size of about 35 inches in men and 30 inches in women," Bloomberg News (8/10, Ostrow) reports. "Larger middles have been linked in previous studies to higher death rates, as well as to diabetes, heart disease and high cholesterol, the authors wrote."
The Los Angeles Times (8/9, Stein) "Booster Shots" blog reported, "Researchers from the Epidemiology Research Program of the American Cancer Society in Atlanta looked at data among 48,500 men and 56,343 women ages 50 and older who were mostly white and took part in the Cancer Prevention Study II Nutrition Cohort," following participants "until 2006, at which point 9,315 men and 5,332 women had died." The investigators "also found that men and women with the largest waist circumferences also tended to be less educated, have a high BMI, were physically inactive, used to smoke and had a history of cardiovascular or respiratory disease or cancer."
The Time (8/9, O'Callaghan) "Wellness" blog reported, "Though it's still not totally clear why fat around the gut should be more dangerous than fat distributed anywhere else on the body, it seems that some fat-cell-produced hormones can promote insulin resistance (leading to diabetes), and may throw off the body's hormonal balance in other ways, as well."

Bladder Cancer and Meat

Link between bladder cancer, processed red meat consumption appears to be weak, scientists concede.
The Los Angeles Times (8/7, Schiewe) "Booster Shots" blog reported that a newly released paper linking bladder cancer to the consumption of meat "wasn't quite as absolute as it was made to appear." Initially, investigators discovered an "apparent link" between the disease and "processed red meats that contain nitrates and nitrites," but after looking at "bladder cancer rates among those who ate the most processed meats...and those who ate the least," they "found no increased risk for bladder cancer, even though a lot of the processed meat must have been processed red meats -- the very same ones that made the red meat category look so risky. When asked about this discrepancy, lead author Amanda Cross of the NCI acknowledged that the link between bladder cancer and processed red meat consumption was weak."

Theater Therapy

Theatrical improvization program helps improve quality of life for people dealing with memory loss.
The New York Times (8/8, A21B, Reaves) reports that in a first-of-its-kind "collaboration between the Feinberg School of Medicine at Northwestern University and the Lookingglass Theater Company, the Memory Ensemble is" a program seeking "to improve the quality of life for people dealing with the early stages of memory loss" through the use of "theatrical improvisation, a method that treats all words as useful and welcomes the expression of feelings that emerge on the twisting path of memory loss -- terror, frustration, even joy." In addition, "the experience...helps participants learn to trust their instincts and make decisions based on the present, rather than the past."

Contaminated Pet Food

Study says contaminated pet foods can sicken people too.
USA Today (8/9, Szabo), citing a study in Pediatrics, reports that "contaminated pet foods can sicken people, not just animals." Children "don't have to put pet foods in their mouths to become ill," explained study author Casey Barton Behravesh, a veterinarian at the CDC. Instead, "people were at risk for salmonella simply because they fed their pets in the kitchen," Behravesh said. "People who became ill may have spread the bacteria around the kitchen because they failed to wash their hands after pouring dog chow into a bowl or handing the cat a treat." The FDA "has announced more than a dozen recalls of pet foods and treats since 2006 because of salmonella contamination," according to the study.
The AP (8/9, Tanner) reports that the pet food-related outbreak has "sickened 79 people in 21 mostly eastern states, between 2006 and 2008. Almost half of the victims were children aged two and younger." The outbreak "was blamed on salmonella bacteria found in several brands of dry dog and cat food produced at a Mars Petcare US plant in Everson, Pa., including Pedigree and Special Kitty." Symptoms "included bloody diarrhea and fever. At least 11 people were hospitalized; none died."

Back Pain Alternatives

Some physicians look to alternatives for surgical treatment to back pain.
The Minneapolis Star Tribune (8/9, Moore) reports that as the numbers of Americans suffering "from disabling back pain during their lifetimes" multiplies, "so have questions about the more aggressive forms of back treatment." In 2006, "American doctors performed approximately 343,000 spine fusion operations, up 82 percent from 1999," according to the National Center for Health Statistics, which tracks Medicare data, "omitting perhaps thousands more paid by other sources." Some feel "the rising costs, high rates of complications and second" surgeries "generate concern that the procedure may be overused." Some doctors "have embraced doubts about surgery and are exploring non-surgical options." For example, "Physicians Neck & Back Pain, a Twin Cities chain of clinics, has gained national attention for its sports medicine approach to treating back pain," the paper adds.

Drug Resistant Bacteria

Experts concerned about depleting antibiotic arsenal in fight against drug-resistant bacteria.
The Chicago Tribune (8/6, Tsouderos) reported that "bacteria are finding ways to evade, one by one, the drugs in our arsenal, and that arsenal is not being replenished with new antibiotics." Drug "companies are abandoning the antibacterial business, citing high development costs, low return on investment," and, "increasingly, a nearly decade-long stalemate" with the FDA "over how to bring new antibiotics to market." At "the core of the problem is a regulatory impasse over whether drug companies seeking FDA approval for antibiotics" should be "required to run much more stringent clinical" trials. "We don't want to approve products that don't work," Joshua Sharfstein, principal deputy commissioner of the FDA, told "physicians and scientists gathered for a workshop on antibiotics and clinical trials in late July."
Drug-resistant superbugs joining flesh-eating bacteria list. The AP (8/9, Marchione), detailing a nurse's five-year battle with "flesh-eating bacteria," reports that "in all of medicine, few infections are as feared" as necrotizing fasciitis. It "strikes out of the blue, especially obese people, diabetics, cancer patients, transplant recipients, and others with weak immune systems -- a growing group of Americans." It "kills 20 percent of its victims and horribly disfigures others." Earlier, "it used to be caused almost exclusively by one type of strep bacteria," but "now there's a scary trend: drug-resistant superbugs like the staph germ MRSA increasingly are able to make 'flesh-eating' toxins and cause nightmarish infections."

Puberty in Girls

Some US girls starting puberty as young as age seven.
The Los Angeles Times (8/9, Roan) reports that, according to a study published in the journal Pediatrics, "almost 25% of African American girls have reached a stage of breast development marking the onset of puberty by age seven, as had almost 15% of Latina girls and more than 10% of white girls." Notably, "those percentages are significantly higher than in 1997, when a landmark study first reported that girls were beginning puberty much younger than they had in the mid-20th century. In that study, the rate of girls who had begun puberty at age seven was, on average, 5% for whites, compared with 10.4% in the new study."
"Increased rates of obesity are thought to play a major role, because body fat can produce sex hormones," the New York Times (8/9, A11, Grady) reports.
Focusing on the long-term health implications of early-onset puberty, USA Today (8/9, Szabo) reports that as adults, girls who go through puberty earlier "are at greater risk for breast and endometrial cancers, possibly because they have a longer lifetime exposure to estrogen."
The Wall Street Journal (8/9, A4, Wang) explores the psychological ramifications of early puberty, reporting that some experts believe girls who mature too early may be teased by their peers or become subject to unwanted attention from other children or adults. Girls who look older than their years may also be held to age-inappropriate standards of behavior.
Delving into what may be causing girls to enter puberty earlier, Time (8/9, Park) points out that "environmental exposures to chemicals -- including pesticides and endocrine-disrupting chemicals such as bisphenol A, commonly found in plastics, and phthalates, which are contained in many personal care products -- could also play a role" in the early onset of puberty, the study's authors theorize.
According to CNN /Health.com (8/9, Gardner), the study was funded by the "National Institutes of Health...as part of a larger investigation into the environmental factors that contribute to breast cancer risk." MedPage Today (8/9, Neale) also covers the story.

Video Game Researchers?

Video game players may help unravel the challenge of protein folding.
The New York Times (8/5, Markoff) reports that "in a match that pitted video game players against the best known computer program designed for the task, the gamers outperformed the software in figuring out how 10 proteins fold into their three-dimensional configurations." Researchers at the University of Washington in 2008 made the game called Foldit "freely available via the Internet," attracting thousands of players. The success of the Foldit players, the researchers report in this week's issue of Nature, "shows that nonscientists can collaborate to develop new strategies and algorithms that are distinct from traditional software solutions to the challenge of protein folding."

Unsafe Supplements

Consumer Reports finds 12 supplements with unsafe ingredients.
ABC World News (8/3, story 8, 1:50, Sawyer) reported, "Dietary supplements are a $27 billion a year business in this country, but Consumer Reports has an alert" on "supplements the magazine says can be dangerous to your health." Consumer Reports' Nancy Metcalf said, "With the dozen supplements that we've identified, we think it's all risk and no benefit."
The CBS Evening News (8/3, story 6, 1:55, Couric) also reported, "Consumer Reports analyzed data from 1,100 supplements and identified 12 that are linked to serious health problems. These include ingredients in weight loss products...which can cause heart problems and liver damage." Certain other supplements "used for cough...are associated with liver cancer and even death." CBS noted that the "FDA cannot regulate" the supplements, which are labeled as foods, "until after a product is already on the market."
The Los Angeles Times (8/4, Stein) points out that the list of those that are unsafe include "aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe." The report also "argues that the FDA has not fully used its limited authority granted by the Dietary Supplement Health and Education Act to ban supplement ingredients that may be dangerous." In addition, the FDA was criticized "for not inspecting Chinese factories where many of the raw materials for supplements originate."
The Washington Post (8/4) adds that supplement manufacturers "routinely, and legally, sell their products without first having to demonstrate that they are safe and effective." WebMD (8/3, Doheny) also covered the story.

Autism Bill in Mass

Massachusetts governor signs bill mandating insurance coverage for autism.
The AP (8/4, LeBlanc) reports, "Massachusetts insurance companies will now be required to offer autistic people coverage for a range of treatments, under a bill (pdf) Gov. Deval Patrick (D) signed into law on Tuesday." Specifically, "the legislation...mandates" that "insurers cover the cost of diagnosis and treatment of autism spectrum disorder if it is deemed medically necessary by a doctor. Those treatments include rehabilitative, psychiatric and therapeutic care, diagnostic tests, applied behavioral analysis as well as the cost of pharmaceuticals. Insurers would not be required to pay for in-school services." The Boston Globe (8/3, Lazar) "White Coat Notes" blog also covered the story.
Scientists update lawmakers on autism research advances. CQ HealthBeat (8/4, Reichard) reports "convinced that the interplay among genes, chemicals and other environmental substances are driving increases in autism cases, federal scientists on Tuesday described a variety of taxpayer-funded studies looking at the impact of everything from plasticizers in rubber duckies to flame retardant chemicals to the chemicals in traffic pollution." Senators said "the subcommittee hearing testimony by scientists" from the NIH and the EPA "would help lawmakers make changes in federal policy to better combat the rise of autism."

Diet Trends

Low-fat, low-carbohydrate diets may produce similar weight loss.
USA Today (8/3, Hellmich) reports that low-fat and low-carbohydrate diets "produce similar weight loss and improvements in many health measures," according to a study sponsored by the National Institutes of Health and published Aug. 3 in the Annals of Internal Medicine. "To compare the two types of diet plans, researchers at three major medical centers tracked the weight loss of more than 300 obese people for two years. Half of participants followed a low-carb diet, consuming about 20 grams of carbohydrates a day for three months, then gradually increased their carb intake over time," while the other half "followed a low-calorie, low-fat diet of 1,200 to 1,800 calories a day, depending on their weight and gender, with less than 30% of calories from fat."
"Both diets improved cholesterol in a two-year study" of 307 adults, the AP (8/3, Nano) reports. However, dieters "on the low-carbohydrate diet got a bigger boost in their so-called good cholesterol, nearly twice as much as those on low-fat." Specifically, "the key difference was in HDL, or good cholesterol: a 23 percent increase from low-carb dieting compared to a 12 percent improvement from low-fat, said" the study's lead author, who likened the improvement to "the kind one might get from medicines that improve HDL."
The Los Angeles Times (8/2, Stein) "Booster Shots" blog reported that both groups of dieters "also took part in a two-year behavioral program that focused on how to manage relapses, self-monitoring, and an emphasis on moderate physical activity." Notably, "after two years, both groups had a 7% weight loss." Interestingly, the low-carb dieters also "had a substantially greater decrease in diastolic blood pressure...than did the low-fat group at three and six months," a difference that "still remained after two years."

Kids and High Cholesterol

High cholesterol in youth may increase heart risks later in life.
The Wall Street Journal (8/3 Winslow) reports that research published in the Annals of Internal Medicine suggests that even younger people should pay attention to their cholesterol levels, being that they may have an impact on health later in life.
The Los Angeles Times (8/2, Schiewe) "Booster Shots" blog reported that researchers "analyzed data from 3,258 men and women who have been tracked by the CARDIA , or Coronary Artery Risk Development in Young Adults, study for the last 20 years and were ages 18 to 30 at the start of the study." The investigators "found that participants with histories of high levels of the 'bad' LDL cholesterol were five and a half times as likely to have a buildup of calcium in their coronary arteries...than those who had optimal LDL cholesterol levels." The researchers also found that "rates of coronary calcium buildup were also higher in those who had suboptimal levels of the so-called 'good' cholesterol, high density lipoprotein, or HDL cholesterol, although this association was weaker." HeartWire (8/2, Miller) and HealthDay (8/2, Reinberg) also covered the story.
Young adults considered lax when it comes to cholesterol screening. The New York Times (8/3, D6, Rabin) reports in Vital Signs that "young adults tend to be notoriously lax about preventive health care, and cholesterol screening is no exception," according to a study published in the Annals of Family Medicine. Barely "half of all young men and women are screened for high LDL, the so-called bad cholesterol," according to the study by the CDC's Elena Kuklina and others. The research was based on "analysis of data on 2,587 young adults -- including men aged 20 to 35 and women aged 20 to 45." Kuklina said "young adults should be screened, because heart disease is a chronic condition that can begin damaging blood vessels at an early age."

Fractures in Diabetics

Fracture risk in postmenopausal women associated with use of thiazolidinedione diabetes drugs.
HealthDay (7/29, Gardner) reported that Avandia [rosiglitazone] and Actos [pioglitazone], "two widely prescribed diabetes drugs, may raise the risk of broken bones in postmenopausal women with type 2 diabetes," according to a study published online July 14 and to appear in the October issue of the Journal of Clinical Endocrinology & Metabolism. In addition, there was "a fracture risk seen among men who had been prescribed either Avandia or Actos plus a loop diuretic," but not with the drugs individually. HealthDay noted, "This isn't the first time such an association has been seen, raising doubts as to whether these drugs, which belong to the class of medications known as thiazolidinediones (TZDs), should be the first choice for treating type 2 diabetes."
"For the new study, researcher William H. Herman, MD, MPH, professor of medicine and epidemiology at the University of Michigan, Ann Arbor, evaluated a large database of managed care patients who had diabetes," WebMD (7/29, Doheny) reported. "He found that those who suffered fractures were more likely to be taking the class of drugs known as TZDs (thiazolidinediones), such as Actos and Avandia." Notably, "'diabetic women over 50 with fractures were 70% more likely to be taking a TZD drug than women without fractures,' he" stated.
MedPage Today (7/29, Bankhead) reported, "Among diabetic men with a history of fractures, concurrent use of a TZD and a loop diuretic was more than three times as common as in similar men with no history of fractures." The study authors noted that "fracture risk was associated with TZD dose, but the risk was similar for rosiglitazone and pioglitazone, suggesting a class effect." MedPage Today noted that the "study was funded by the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases."

New Websites for Procedures

Websites provide consumers with ability to shop for procedures, negotiate with providers.
USA Today (7/30, Berman) reports that "PriceDoc is one of several sites that give consumers the ability to shop for procedures ranging from a colonoscopy to teeth whitening. In some cases, the sites allow consumers to negotiate with providers." However, "Steven Findlay, health analyst for Consumers Union, says sites listing prices for procedures can be helpful, but consumers shouldn't settle for the first price offered. Unlike traditional retailers, health providers don't usually advertise sales, he says." Another site, OutOfPocket.com, "offers a price-based directory of healthcare services." A third site, NewChoiceHealth.com, "lists price ranges for procedures at various facilities to 'help educate the consumer that healthcare is retail,'" its founder explained.

Calcium and Heart Attacks

Calcium supplements may be linked to increased risk of heart attack.
The CBS Evening News (7/29, story 9, 1:40, Couric) reported, "Calcium supplements are a good way to keep your bones strong, but" research published in the online in the BMJ suggests that "they could lead to an increased risk for heart attack."
The Los Angeles Times (7/29, Maugh) "Booster Shots" blog reported that investigators "combined results from 11 randomized controlled trials of calcium supplements...involving more than 12,000 patients." The researchers "found a 31% increase in the risk of heart attack and smaller, non-significant increases in the risk of stroke and death." Although "equal numbers of women received calcium or placebo, 143 of those who received calcium suffered a heart attack, compared to 111 who received a placebo."
Bloomberg News (7/30, Craig) reports that "the researchers said they excluded from their analysis studies that compared coadministered calcium and vitamin D supplements with placebo. The findings may not be applicable to those supplements, the authors wrote."
HealthDay (7/29, Reinberg) reported that "earlier studies did not find a similar risk when people get calcium through eating foods rich in the mineral, which suggests that supplements may be an independent risk factor."
CNN /Health.com (7/30, Gardner) reports that these "findings...have some experts questioning whether calcium supplements should be used as widely as they are now, especially by elderly women, who suffer disproportionately from both heart disease and osteoporosis."

Prostate Cancer Vaccine

Prostate cancer vaccine appears to extend lives by 4.1 months.
Bloomberg News (7/28, Randall) reported, "Dendreon Corp.'s prostate cancer vaccine, Provenge, extended lives by 4.1 months," a discovery that "led to the drug's US approval in April." Even though the scientific community still doesn't "know precisely how the vaccine works or who is most likely to benefit," Harvard researchers explained that "Provenge is the first drug designed to train the body's immune system to fight cancer and is the most effective treatment for certain patients with advanced prostate tumors."
The "active cellular immunotherapy," also known as sipuleucel-T, "consists of the patient's own peripheral-blood mononuclear cells, including antigen-presenting cells, that have been activated outside the body using an engineered protein called PA2024," MedPage Today (7/28, Smith) reported. The "protein is a fusion of prostatic acid phosphatase, a prostate antigen, and granulocyte-macrophage colony-stimulating factor, which activates immune cells." Scientists tested its efficacy by randomizing 512 men to either sipuleucel-T or a placebo, which "consisted of peripheral-blood mononuclear cells that were not activated."
Investigators eventually noted that the "average survival was 25.8 months for men in the Provenge group, compared with 21.7 months for men in the placebo group, meaning that Provenge extended survival by 22 to 25 percent," HealthDay (7/28, Reinberg) reported. "If the vaccine was used by men with less severe disease survival, it might be extended for even longer," and "compared with other treatments, such as chemotherapy, radiation and hormone therapy, Provenge has been touted as having fewer and less severe side effects," according to the study published in the New England Journal of Medicine. "However, the availability and cost of Provenge are issues that need to be resolved

Vitamin D Update

Large part of US population may be deficient in vitamin D.
Writing in the New York Times (7/27, D7) "Personal Health" column, Jane E. Brody reports that "a huge part of the population" may be deficient in vitamin D. Notably, "every tissue in the body, including the brain, heart, muscles and immune system, has receptors for vitamin D, meaning that this nutrient is needed at proper levels for these tissues to function well." Current research suggests that "the effects of a vitamin D deficiency include an elevated risk of developing (and dying from) cancers of the colon, breast and prostate; high blood pressure and cardiovascular disease; osteoarthritis; and immune-system abnormalities that can result in infections and autoimmune disorders like multiple sclerosis, type 1 diabetes, and rheumatoid arthritis."

CPR Compression Only

Two new studies lend more support to compression-only CPR.
NBC Nightly News (7/28, story 9, 1:45, Williams) reported, "The rules of CPR may be about to change," as two newly published studies "question the way millions of us learn to administer" it. Indeed, "most experts all agree the most important thing to do is call 9-1-1 immediately. It's the next part that's in dispute." At present, the American Red Cross still teaches "mouth-to-mouth as part of CPR."
Now, new research "confirms" that "for bystanders with no training, chest compressions on adults are enough to restore life," ABC World News (7/28, story 7, 2:30, Sawyer) reported. "And there is no benefit to performing mouth-to-mouth resuscitation." This is noteworthy, because it's estimated that "only one third of those who go into cardiac arrest get CPR from a bystander. The hope is that by making it easier to do, more people will be willing to do it." The American Heart Association agrees with that line of thought, the CBS Evening News (7/28, story 7, 0:20, Couric) reported. It "says the simpler method will save more lives because it's easier to do."
In fact, the "American Heart Association, which trained 13 million people in CPR last year, is developing new guidelines for resuscitation that will be released in October," the Washington Post (7/29, Brown) reports. The "current guidelines encourage bystanders to at least do chest compressions, also known as hands-only CPR." The "prevailing theory is that not interrupting chest compressions with rescue breaths might ultimately deliver more oxygen than standard CPR in the crucial seven or eight minutes before paramedics arrive." Notably, "both studies, published Thursday in the New England Journal of Medicine, found a trend in that direction."
During the first and larger study, a team comprised of researchers from the University of Seattle and London "considered 1,941 people in cardiac arrest who needed bystanders to perform CPR until an ambulance arrived," Bloomberg News (7/29, Fridson) reports. "The scientists reported finding no significant difference between the 981 patients who received chest compression alone and the 960 who received both that procedure and mouth-to-mouth breathing." In fact, the "first group survived to hospital discharge at a rate of 12.5 percent and the second had an 11 percent survival rate, the scientists wrote."
The "second study was done in Sweden...included nearly 1,300 people," and reached similar conclusions, the AP (7/29, Stobbe) reports. "The studies also spotlighted the importance of having forceful dispatchers coaching bystanders," explained one expert who was not involved. "When dispatchers told callers to start CPR, about 80 percent attempted it when given hands-only instructions, more than the 70 percent who tried the standard version." The increase is being attributed to "dispatchers who immediately told callers what to do, instead of first asking them if they'd had CPR training or if they'd be willing to try it until medical help arrives."
There are, however, "exceptions to the" hands-only rule, according to the author of an editorial accompanying the studies. Dr. Myron Weisfeldt, of Johns Hopkins University, told CNN (7/29, Hellerman), "It is very important to understand that the patients in this study were adults and that for most children who suffer cardiac arrest, such as drowning victims, we must do rescue breathing." And, "patients with chronic lung disease or acute asthma, should also receive mouth-to-mouth."
What's more, even though "US emergency medicine and cardiology specialists generally seconded the authors' conclusions," the studies do "not suggest that trained rescuers -- including bystanders with training -- should not ventilate the patient," MedPage Today (7/28, Bankhead) reported. "Moreover, neither trial addressed the situation when two bystanders are present, one to perform chest compressions and the other to perform mouth-to-mouth rescue breathing," said another expert, Steve Nissen, MD, of the Cleveland Clinic.