Armadillos and Leprosy

Genetic sequencing confirms armadillos can transmit some leprosy strains to humans.
The AP (4/28, Chang) reports, "With some genetic sleuthing, scientists have fingered a likely culprit in the spread of leprosy in the southern US: the nine-banded armadillo." According to a study in the New England Journal of Medicine, DNA tests "show a match in the leprosy strain between some patients and these prehistoric-looking critters."
Bloomberg News (4/28, Ostrow) reports that the researchers identified the "same strain of leprosy in 28 of 33 wild armadillos and 25 of 39 patients who lived in states where the animals are common." Exposure to "fresh armadillo blood or tissue raises the risk of leprosy infection," the study authors said.
The New York Times (4/28, A7, Harris, Subscription Publication) reports that the cases are concentrated in "Louisiana and Texas, where some people hunt, skin and eat armadillos." Leprosy now joins a "host of other infectious diseases -- including flu, HIV/AIDS and SARS -- that are known to have jumped from animals to humans."
The Los Angeles Times (4/28, Brown) notes that annually, about "100 to 150 people" in the US are "diagnosed with the malady, which is also known as Hansen's disease. ... 'It doesn't mean people need to run away from armadillos the way they do a rattlesnake, but people need to be careful,'" said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, which "helped fund the research."

Autism Screening Test

New early screening test detects autism in children as young as one year.
USA Today (4/28, Szabo) reports an "early screening test for autism, designed to detect signs of the condition in babies as young as 1 year old, could revolutionize the care of autistic children, experts say, by getting them diagnosed and treated years earlier than usual." The 24-item "checklist takes just five minutes to complete and can be filled out in a pediatrician's waiting room, when parents bring children for their routine 12-month checkup, says a study of more than 10,000 infants," published in the Journal of Pediatrics. The study was funded "by the National Institutes of Health and others."
The San Diego Union-Tribune (4/28, Lavelle) reports researchers at UCSD "say a promising tool in diagnosing autism early and getting treatment for the syndrome could start with asking parents to fill out a simple questionnaire at their baby's one-year checkup." Dr. Karen Pierce, "assistant director of the UC San Diego Autism Center of Excellence, recruited 137 San Diego pediatricians for a study that has screened nearly 10,500 1-year-olds for a possible autism spectrum disorder or developmental delay, using a 24-item questionnaire." The questionnaire "has the potential for identifying children with autism early enough to get treatment while their brains are developing internal connections," Pierce said.
The AP (4/28, Neergaard) reports the research "is a first step in the quest for earlier autism screening." Experts "say early therapy can lessen autism's severity, even if they don't know exactly what types will prove best." Dr. Lisa Gilotty of the National Institute of Mental Health says, "The earlier you start, the better."
The Washington Post (4/28, Stein) reports by "allowing scientists to study children with autism when they are younger, it could also provide crucial new insights into the disease's causes, further dispelling discredited theories about vaccines and other supposed risk factors, as well as leading to better ways to diagnose and treat the disorder." Thomas R. Insel of the National Institute of Mental Health said, "Beyond this exciting proof of concept, such a screening program would answer parents' concerns . . . with more confidence than has ever been done before." The Wall Street Journal (4/28, Wang, Subscription Publication) also reports the study.

Eating Out with Allergies

Restaurants may be unsafe for people with food allergies.
HealthDay (4/26, Gordon) reported that according to the Food Allergy and Anaphylaxis Network (FAAN), as many as "12 million Americans" have food allergies; and the primary culprits are "milk, eggs, peanuts, tree nuts, shellfish, soy and wheat." Although it is "easy to control your environment," restaurant food may not be safe. A study the journal Clinical and Experimental Allergy, which included "managers, waiters and chefs at 90 restaurants," found that although only 33 percent "said they'd had specific" food allergy training, "81 percent said they still felt confident they could provide a safe meal to a customer with food allergies." Moreover, 38 percent erroneously "believed that people with food allergies could drink water to dilute the allergen and lessen" the allergic reaction severity; and another 23 percent mistakenly thought eating only a "small amount of a food allergen" was safe.

Housebound Elderly and Dementia

Analysis suggests "housebound" elderly may be more likely to develop Alzheimer's disease.
HealthDay (4/26, Dotinga) reported that seniors who are "'housebound' seem to have nearly double the risk of developing Alzheimer's disease," according to a study in the American Journal of Geriatric Psychiatry. Researchers followed "1,294 seniors from two separate studies of older adults whose health was being tracked over time." Although no seniors "showed signs of dementia" at the beginning of this study, over an average "4.4 years, 180 developed Alzheimer's disease."

Pain Pill Combination

FDA approves pain-relief treatment that reduces arthritis, ulcer risk.
The Chicago Tribune (4/25, Japsen) reported, "The US Food and Drug Administration has approved a Skokie drug maker's pain-relief pill that reduces the risk of stomach ulcers by combining the pain-relief drug ibuprofen with a high dose of famotidine, the active ingredient in the antacid Pepcid." Horizon Pharma said the agency's "approval of Duexis (ibuprofen/ famotidine), a combination of 800 milligrams of ibuprofen and 26.6 milligrams of famotidine should be available in the second half of this year."

Wine and Sea Salt

Many Americans may not be well informed about sea salt, red wine.
HealthDay (4/25, Preidt) reported that "most Americans have heard that red wine has health benefits, but many don't understand the need to limit consumption, finds an American Heart Association survey." Most respondents also "mistakenly believe that sea salt is a low-sodium alternative to table salt," the survey found. Among the "1,000 adults polled, 76 percent agreed with the statement that wine can be good for your heart, but only 30 percent knew the AHA's recommended limits for daily wine consumption."

Obese Teen Risk

Obese teenagers as likely to participate in risky behavior as thinner peers.
The Time (4/25, Melnick) "Healthland" blog reported, "Obese teens tend to be socially outcast, and so researchers had long assumed they were less likely to engage in the kinds of risky social behaviors that mark traditional adolescence: drinking, smoking and hooking up." However, according to a survey published in the May issue of Pediatrics, "obese teens are just as likely to participate in these rites of teenhood as their thinner peers. In some ways, obese teens' behavior is even riskier."
The Los Angeles Times "Booster Shots" blog reported, "Psychologists at the Cincinnati Children's Hospital Medical Center in Ohio compared the 'risky' behavior of 410 teens who were extremely obese (body-mass index in the 99th percentile) with 8,669 normal-weight teens (body-mass index within the 5th and 84th percentiles) using the 2007 Youth Risk Behavior Survey, a national survey of high school students conducted by the Centers for Disease Control and Prevention. The survey asked how often the teenagers used drugs, tobacco or alcohol, had sexual encounters, and experienced suicidal thoughts or attempts."
WebMD (4/25, Goodman) reported researchers found that "extremely obese girls were about twice as likely as slimmer students as to have ever tried cigarettes or to be current smokers. Extremely obese boys were about 50% more likely than their normal-weight counterparts to have ever tried cigarettes or to have started smoking before age 13." The researchers also found that "although heavy girls were about half as likely as their slimmer peers to have ever had sex, when they did have intercourse, they were nearly five times more likely to do so under the influence of alcohol or drugs." CNN (4/25, Caruso) "The Chart" blog and MedPage Today (4/25, Walsh) also covered the story.

NSAID's and SSRI's

NSAIDs may impair effectiveness of SSRIs.
The Wall Street Journal (4/26, Wang) reports that, according to a mouse and human study published in the journal Proceedings of the National Academy of Sciences, nonsteroidal anti-inflammatory drugs, such as Aleve (naproxen) and Advil (ibuprofen), appear to impair the effectiveness of selective serotonin reuptake inhibitors, such as Prozac (fluoxetine) and Celexa (citalopram).

"E" Cigarette

FDA seeks to regulate e-cigarettes as tobacco products.
In its "Booster Shots" blog, the Los Angeles Times (4/26, Healy) reports the Food and Drug Administration "announced Monday that it will act to ensure the government's right to impose marketing, manufacturing and safety restrictions on 'electronic cigarettes,' a nicotine delivery device widely billed as an alternative to cigarettes for those trying to quit and for smokers who can't light up." In a letter "posted to the FDA's website Monday, Dr. Lawrence R. Deyton, director of the FDA's Center for Tobacco Products, said the agency will act to regulate e-cigarettes as tobacco products. To shore up its authority to do so, the agency will propose new regulatory language that would specifically define e-cigarettes as a tobacco product."
The AP (4/26, Felberbaum) reports the FDA said it "won't try to regulate" smokeless electronic cigarettes under "stricter rules for drug-delivery devices." The news is "considered a victory for makers and distributors of the devices, which continue to gain popularity worldwide."

Physician Trends

Young physicians eschew private practice.
On its front page, the New York Times (4/23, A1, Harris, Subscription Publication) reported on the difficulty that 62-year-old Dr. Ronald Sroka has had trying to sell his family medical practice in Crofton, Maryland. Younger physicians "are refusing to take over these small practices. They want better lifestyles, shorter work days, and weekends free of the beepers, cellphones and patient emergencies that have long defined doctors' lives. Weighed down with debt, they want regular paychecks instead of shopkeeper risks." Furthermore, "even if they wanted such practices, banks - attuned to the growing uncertainties - are far less likely to lend the money needed."

Peppermint News Flash

Scientists explain how peppermint soothes gastric pain associated with IBS.
HealthDay (4/22, Dotinga) reported that new research "offers insight into how peppermint helps relieve the symptoms" of irritable bowel syndrome (IBS). In the journal Pain, researchers report that peppermint "contributes to relief of pain from inflammation in the gastrointestinal tract. 'Our research shows that peppermint acts through a specific anti-pain channel called TRPM8 to reduce pain-sensing fibers, particularly those activated by mustard and chili,'" said study author Dr. Stuart Brierley from the University of Adelaide in Australia. He noted that there appears to be a "definite link between IBS and a former bout of gastroenteritis, which leaves nerve pain fibers in a heightened state, altering mechanisms in the gut wall and resulting in ongoing pain."

HIV Survival Stats

Most children born with HIV infection now survive into adulthood.
HealthDay (4/24, Dotinga) reported, "Most children born with HIV infection now survive into adulthood, a markedly different prognosis from the near-certain death that awaited HIV-infected babies years ago," according to a study published in the Journal of Acquired Immune Deficiency Syndromes. "'About two thirds of these kids, at this point, don't have virus detectable in the blood,' Tulane University infectious diseases expert Dr. Russell Van Dyke said in a university news release. 'While they are still infected and they are not cured, it's surprising how well they're doing, considering what they've been through.'" But, "with longer survival, new issues arise. 'We're not seeing the deaths we used to see due to infections, but we're starting to worry about longer-term complications,'" Dr. Van Dyke added.

Antibiotic Resistance

Routine antibiotic use at animal farms may be causing resistance in humans.
The Los Angeles Times (4/25, Adams) reports that, according to a study published in the journal Clinical Infectious Diseases, Staphylococcus aureus bacteria was found "on 47% of 136 samples of beef, chicken, pork and turkey from 26 grocery stores in five US cities" and that of "those bacteria, 96% were resistant to at least one type of antibiotic and more than half were resistant to at least three." The researchers concluded that the resistant staph was "probably coming from the animals -- and not, say, a worker's unclean hands. This seems to point the finger at antibiotic use in agriculture." Although calls for restrictions on antibiotics "used to combat human infectious disease, have come from a slew of organizations," including the Centers for Disease Control and Prevention and the American Medical Association, "the practice remains."

Healthy Label?

Dieters more likely to be deceived by fattening food labeled "healthy."
The Los Angeles Times (4/22, Cevallos) "Booster Shots" blog reports, "Dieters may be more easily fooled by 'healthy' food labels or descriptions than those who don't worry as much about nutrition facts," according to an article in the Journal of Consumer Research. In one of several similar experiments by researchers from the University of South Carolina, "76 people were randomly approached and offered $5" to rate how "healthful and how nutritious" a menu item appeared to be "(a color photo was included)." Dieters were "more likely" to give the dish, which contained cheese and salami, a "slightly higher healthy grade" if it was labeled as a "salad than if it was called pasta," whereas non-dieters "gave both about the same grade."

Family Violence

Family violence may increase risk of bullying.
In a front-page story, the Boston Globe (4/22, A1, Lazar) reports that "one-fourth of Massachusetts middle-schoolers and 16 percent of high school students report enduring bullying at school," according to a report released by the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention that puts the "state at the center of the national discussion over the issue." The study found that students who "said they had been involved in bullying, as both a perpetrator and a victim, were five times more likely to report they had been hurt physically by a family member, compared to those who said they were neither a victim nor a bully. And they were substantially more likely to have witnessed violence against other family members."
Bloomberg News (4/22, Vannucci) reports that the study found that "bullies and victims were about three times more likely to witness family violence." Around "44 percent of middle school students and 31 percent of high schoolers are involved in harassment incidents," according to the researchers. "Almost 27 percent of middle school students were bully victims versus 16 percent of high school students"; and about "7.5 percent of the middle school students were bullies, compared with 8.4 percent for the high school students."

Birth Control Pill Warning

Birth-control pills with drospirenone linked to higher risk of blood clots.
Bloomberg News (4/22, Hallam) reports, "Women who use birth-control pills made with the hormone drospirenone, such as Bayer AG (BAYN)'s Yasmin, are three times more likely to develop blood clots than those who take an older oral contraceptive," according to two studies published in the British Medical Journal.
MedPage Today (4/21, Walsh) reported that, for the first study, researchers "analyzed data from the longitudinal US PharMetrics database, identifying 186 cases of thromboembolism among women using these agents between 2002 and 2008. They compared these cases with 681 controls that were matched for year of birth and index date."
HealthDay (4/21, Gardner) reported, "Those taking the newer pill had a 2.3 times greater risk for a blood clot. The absolute risk, however, was still small -- 30.8 per 100,000 among those taking drospirenone, compared to 12.5 per 100,000 in women taking levonorgestrel." The second study looked at "similarly aged women in the United Kingdom and found a three-fold elevated risk for blood clots among women taking the newer version of the pill. That translated to 23 per 100,000 women in the drospirenone group and 9.1 per 100,000 women in the levonorgestrel group."

New Cervical Cancer Test

FDA approves cervical cancer viral test.
Bloomberg News (4/20, Doherty) reported the Food and Drug Administration has approved Roche's "test to identify women at high risk of developing cervical cancer." The test can be used to "detect two types of the human papillomavirus, or HPV, that account for more than 70 percent of cervical cancer cases," the company said in a statement. The Roche product also "identifies 12 other types that pose an increased risk of causing the disease." WebMD (4/20, DeNoon) reported that the new Roche test "detects precancerous lesions over 90% of the time. But it also gives false-positive results about 30% of the time." Dow Jones Newswire (4/20, Mijuk, Subscription Publication) also covered the story.

Hand Sanitizer Warning

FDA issues false claims warnings for hand sanitizer to four companies.
The AP (4/21) reports the Food and Drug Administration "issued warnings to four manufacturers of hand sanitizing products for making unsupported claims about the bacteria-fighting benefits of their products." The FDA says the companies "claim their lotions and gels can prevent a variety of infections, including E. coli and bird flu." FDA compliance director Deborah Autor, said in a statement, "The FDA cannot allow companies to mislead consumers by making unproven prevention claims."
Time (4/20) "Healthland" blog reported that the companies claim their products "prevent infection from methicillin-resistant Staphylococcus aureus."

TV and Heart Disease

Too much television may increase future cardiovascular risk for children.
HealthDay (4/20, Doheny) reported, "Young children who spend too much time watching TV or playing computer games have narrower eye arteries than kids who are more physically active," according to a study published online in Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association. "Narrower arteries are a marker of future cardiovascular risk, and the narrower the vessels, the higher the risk," according to the researchers.
WebMD (4/20, Boyles) reported that "the study included close to 1,500 6- and 7-year-olds living in Sydney, Australia. The children's parents completed questionnaires designed to assess how much time the kids spent watching TV or using other electronic equipment and how much time they spent engaging in physical pursuits." In addition, "digital photographs were taken in the back of each child's eyes to determine the width of the retinal blood vessels."

Sleep and Work

Managers urged to address workers' sleep issues.
In a USA Today (4/21, Mednick) forum article, Sara Mednick, assistant professor in the Department of Psychiatry at the University of California, San Diego, notes the suspension of the seventh US air traffic controller this year, and Transportation Secretary Ray LaHood's description of the incidents as "absolutely unacceptable." Mednick says, "But truth be told, working 24/7 is what got us into this mess in the first place." America has "been taking sleep for granted far too long," and "although sleep researchers, such as myself, and the news media have been alerting us to the importance of sleep for awhile, it appears the people in charge have been slow make the necessary changes to the way we work during the hours when we are most vulnerable to sleepiness."
In an editorial, the Los Angeles Times (4/21) says in response to the reports of air traffic controllers sleeping on the job, "the FAA has adjusted controllers' schedules and mandated that additional controllers be assigned during sleepy midnight shifts." Of course, "they're not the only workers who get so fatigued that they fall asleep on the job." A sleep study "cited in the New York Times on Sunday says the overwhelming majority of people need eight hours of sleep," and "most of those who get less and think they're operating fine on it turn out to be too sleep-deprived to realize how sleep-deprived they are."

Gut Bacteria Types

People may be distinguished by one of three gut "enterotypes."
The New York Times (4/21, A17, Zimmer, Subscription Publication) reports that in the "early 1900s, scientists discovered that each person belonged to one of four blood types." Now according to a study in the journal Nature, scientists say there are "just three distinct ecosystems in the guts of people," and each of the types "makes a unique balance of enzymes."
According to the Los Angeles Times (4/21, Brown) "Booster Shots" blog, "Bioinformatics expert Peer Bork of the European Molecular Biology Laboratory in Heidelberg, Germany," the senior author of the paper, said that finding the three enterotypes "was 'a big surprise...we expected more variation.'" When the researchers took "stool samples from 22 European individuals, extracted the DNA, and then attempted to determine the composition of the DNA," they discovered that the three "distinct microbe combinations appeared throughout the samples."
Bloomberg News (4/21, Vannucci) reports that the three enterotypes "were classified into groups named for the predominant bacteria in the cluster: Bacteroides, Prevotella and Ruminococcus." The researchers "noted some differences in vitamin production among the groups." People in the Bacteroides group had "microbes that produced more vitamin C, B2, B5 and H," whereas the Prevotella group had "more B1 and folic-acid producing bacteria."

Birth Control Pills and Gallstones

Some oral contraceptives may be linked to gallbladder disease risk.
MedPage Today (4/20, Baron-Faust) reported that "some of the newest and most popular oral contraceptives -- including the drospirenone/ethinyl estradiol combo marketed as Yaz -- have been linked to a small, but significant risk of gallbladder disease, according to a large retrospective cohortstudy " published in the CMAJ. The researchers, who looked at data on "nearly three million women taking ethinyl estradiol combined with one of seven progestins between 1997 and 2009, found a small, but statistically significant risk of having gallstones for drospirenone (adjusted RR 1.20, 95% CI 1.16 to 1.26)." The investigators "also found a similar risk of gallbladder disease...for desogestrel (adjusted RR 1.05, 95% CI 1.01 to 1.09) and for norethindrone (adjusted RR 1.10, 95% CI 1.06 to 1.14) compared with the older progestin levonorgestrel RR 1.00 (ref)."

Low IQ and Pesticide Exposure

Researchers link pesticide exposure in womb to lower IQs.
USA Today (4/21, Szabo) reports that "children exposed to high pesticide levels in the womb have lower average IQs than other kids, according to three independent studies" published "in Environmental Health Perspectives." The research "involved more than 400 children, followed from before birth through ages 6 to 9, from both urban and rural areas." One "study found that the most heavily exposed children scored an average of 7 points lower on IQ tests compared with children with the lowest pesticide exposures."
CNN (4/21, Gardner) reports that in one of the other studies, investigators "measured levels of the organophosphate chlorpyrifos in" 265 Dominican and black "women's umbilical cord blood." The investigators "found that when the children were 7, the IQs of those with the highest exposure in the womb was roughly three points lower, on average, than those with the lowest prenatal exposure." Meanwhile, "in the third study...researchers found that the association between organophosphate exposure and developmental delays was more pronounced in children whose mothers had a certain genetic variant that influences an enzyme that breaks down organophosphates." MedPage Today (4/21, Neale) also cover the story.

Ex Smokers Live Longer

Regardless of past smoking habits, healthy living may reduce cancer-, cardiovascular death rates.
HealthDay (4/19, Preidt) reported that a "healthy lifestyle nearly halves nonsmokers' risk of death from cancer, cardiovascular disease and other causes," according to a study in the journal Cancer Biomarkers, Epidemiology, and Prevention. The researchers reviewed "diet and lifestyle questionnaires filled out in 1992 and 1993 by almost 112,000 non-smoking women and men in the Cancer Prevention Study." After 14 years of follow-up, for participants with higher compliance scores, the "risk of cardiovascular-related death was 58 percent lower for women and 48 percent lower for men, and the risk of cancer death was 24 percent lower in women and 30 percent lower in men." Notably, the findings were "similar for both never and former" smokers.

New Alzheimers Guidelines

NIH releases new guidelines for Alzheimer's diagnosis.
In continuing coverage, the Los Angeles Times (4/20, Cevallos) reports in its "Booster Shots" blog that new guidelines for diagnosing Alzheimer's "recognize the disease as a continuum, not a single stage, according to a release Tuesday by the National Institutes of Health's National Institute on Aging and the Alzheimer's Assn." The new guidelines "reflect the more modern understanding of the disease: Alzheimer's can start progressing up to 10 years before signs of dementia. And autopsies can reveal a brain riddled with plaques in someone who showed no signs of dementia."
NPR (4/19, Shute) reports the expansion of the definition of Alzheimer's disease "won't change how the vast majority of people are diagnosed" and "doesn't change the very limited treatment choices." The new criteria, "which were developed by the National Institute on Aging and the Alzheimer's Association, are almost guaranteed to prompt confusion, even in people who are thinking quite clearly." The "biomarker tests and PET scans aren't yet accurate enough to reliably diagnose Alzheimer's, and haven't been approved by the Food and Drug Administration."

Drug Supply Shortage

Drug Supply Shortage: ASHP: 150 "medically necessary" drugs now in short supply. Scripps (4/20, Bowman) reports that according to the American Society of Health System Pharmacists, there are 150 'medically necessary' drugs in short supply, double the number typically reported five years ago. 'It is as bad as it's ever been, definitely a crisis,'" said Bona Benjamin, who directs ASHP's "medication supply monitoring efforts."

Prescription Drug Abuse Monitoring

FDA unveils plan to curb opioid prescription drug abuse.
The Wall Street Journal (4/20, Gleason, Subscription Publication) reports the Food and Drug Administration said Tuesday that it will require pharmaceutical companies to produce new educational tools about their opioid painkillers in an effort to reduce prescription drug abuse. Department of Health and Human Services Assistant Secretary Howard Koh said at a briefing, "This growing public-health crisis is suffocating our society."
USA Today (4/20, Ledger) reports, "American Medical Association President Cecil Wilson said his organization supports the intent of the drug abuse prevention plan but is concerned 'that a key element of this strategy that relies on industry to develop educational materials and initiatives to train prescribers could in the future become a mandatory part of the DEA registration process for prescribing controlled substances.'"
Bloomberg News (4/19, Larkin) reported, "Pfizer Inc. (PFE), Johnson & Johnson (JNJ) and Endo Pharmaceuticals Holdings Inc. (ENDP) will have to train doctors before they can give patients extended-release painkillers under a US plan aimed at reducing prescription drug abuse." The FDA said on Tuesday that "16 companies that make 25 pain patches and pills must create a program to teach medical professionals when these drugs should be used to combat pain and how to recognize signs that the treatments are being misused."
HealthDay (4/19, Gardner) noted that the "new Risk Evaluation and Mitigation Strategy (REMS) is part of a larger multi-agency initiative announced Tuesday by the White House to reduce overall prescription drug abuse" in the US. "'This new REMS will provide tools to doctors and other prescribers for appropriate pain management to reduce risks and at the same time preserve access for patients and appropriate management of pain for those suffering from moderate to severe pain,' said Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research" at the FDA. "For now, the initiative will be limited to extended-release and long-acting products, which, Woodcock said, 'have a much greater risk than immediate-release because they contain more medicine.'"
Modern Healthcare (4/20, Daly, Subscription Publication) reports, "President Barack Obama's administration also will push for enactment of as-yet-unintroduced legislation to require physician participation in opioid prescribing training. But, if Congress does not enact a law "requiring mandatory physician participation in such training, the FDA could aim to tighten control on opioid prescribing through restricted formularies."
Meanwhile, The Hill (4/19, Pecquet) "Healthwatch" blog reported that as a "first step, the FDA sent letters to opioid manufacturers on Tuesday requiring that they provide a plan for training prescribers and educating patients about the safe use, storage and disposal of opioids. They have 120 days to respond, setting in place a regulatory process that officials hope to have in place within 12 months." The FDA missive was sent to the producers of Dolophine (methadone); MS Contin, Kadian, Avinza, Embeda, Oramorph (morphines); OxyContin (oxycodone); Exalgo (hydromorphone); Duragesic (transdermal fentanyl); Butrans (buprenorphine); and Opana ER (oxymorphone).
Also covering the story are the AP (4/20), USA Today (4/20, Ledger), NPR (4/19, Hensley) "Shots" blog, PBS NewsHour (4/19, Bowser) "The Rundown" blog, WebMD (4/19, DeNoon), and, on its website, CNN (4/20, Young).

Breast Device Recall

Axxent FlexiShield Mini recall elevated to class I.
The New York Times (4/15, A17, Subscription Publication) reports that "the recall of a medical device" known as the Axxent FlexiShield Mini, "that left particles of tungsten in women's breasts has been classified as the most serious type of recall, one involving 'situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death,' the Food and Drug Administration said on Wednesday." The device, used during a particular type of radiation treatment, "left the breast tissue and chest muscles riddled with hundreds of tungsten particles." The Times adds, "That the tungsten shows up on mammograms is what made the recall Class I, the most serious type, said Karen Riley, a spokeswoman for the Food and Drug Administration."
Medscape (4/14, Hitt) reported that "internal investigations by the manufacturer showed no evidence that the particles are toxic; therefore, permanent damage to body structures or functions is not expected. The product recall was based on the fact that it was difficult to distinguish tungsten particles from suspicious calcifications in breast tissue on follow up X-rays or scans."

MS and Breastfeeding

Breastfeeding may reduce MS relapses in new mothers.
MedPage Today (4/14, Smith) reported that, "for new mothers with multiple sclerosis (MS), exclusive breastfeeding for several months after delivery appears to protect against relapses," according to a study presented at the annual meeting of the American Academy of Neurology. Researchers found, "in a prospective cohort study of 72 women" with MS, that "less than one in 10 who breast fed exclusively had a relapse in the first six months after delivery." Conversely, more than "a third of those who did not breast feed exclusively suffered a relapse."

Home Safety Devices

Installing home safety devices could reduce children's risk for injury up to 70%.
HealthDay (4/14, Preidt) reported that home safety devices "greatly reduce the number of injuries sustained by small children," according to a study in the Archives of Pediatrics and Adolescent Medicine. Researchers looked at "two groups of families with newborns. One set of families had properly installed and maintained safety devices in their homes." After two years of follow-up, children in the homes "with the safety devices had 70-percent fewer home-related injuries that required medical attention than did the children in the other group." Notably, about "2,800 children die from preventable injuries in the home, and millions more are treated in hospital emergency rooms," each year in the US, according to the researchers.

Anxiety Therapy

CBT combined with psychotropic medication effective for treating anxiety in primary care.
Medscape (4/14, Brauser) reported, "Cognitive behavior therapy (CBT) in combination with psychotropic medication is highly effective for treating most anxiety disorders in primary care," according to a study published in the April issue of the Archives of General Psychiatry. In a study of "more than 1000 patients, those who underwent the Coordinated Anxiety Learning and Management (CALM) collaborative care program had significantly decreased symptoms of principal generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD), and comorbid SAD than did those randomized to receive usual treatment from their primary care physician."

ADD Medication Shortage

AD/HD, ADD medication shortages have parents scrambling.
On its website, MSNBC (4/14, Aleccia) reported, "Nationwide shortages of popular drugs used to treat ADD and AD/HD are sending parents scrambling." In the past "two weeks, federal Food and Drug Administration officials added the drugs methylphenidate hydrochloride and amphetamine mixed salts, the generic names for Ritalin and Adderall, to an expanding list of national drug shortages." However, the American Society of Health-System Pharmacists, which "tracks drug supply issues, has listed the products in short supply for nearly a month, and there have been regional reports of spotty shortages even before that." The New York Times (4/14, Belkin) "Motherlode" blog also covered the story.

Do It Yourself DNA

FDA considering whether to regulate do-it-yourself DNA tests. The Los Angeles Times (4/18, Ogilvie) reports that at-home, "do-it-yourself" genetics tests have stirred controversy among "geneticists, bioethicists," physicians and other healthcare professionals, as well as consumer advocates. Some believe that in "bypassing health professionals, the tests are irresponsible at best and potentially dangerous at worst," whereas others feel that "individuals who want their personal health-risk information should be able to get it." Presently, the Food and Drug Administration is "weighing both sides as it mulls whether to regulate this fast-growing industry."

Alcohol and Energy Drinks

People who drink alcohol-energy combos may be more likely to take risks. HealthDay (4/15, Salamon) reported that combining the caffeine of energy drinks with "alcohol is riskier than drinking alcohol alone," according to a study published online in advance of the July 2011 print issue of Alcoholism: Clinical & Experimental Research. The scientists randomly divided "56 college students between the ages of 21 and 33 into four groups" to receive either an "alcoholic beverage, an energy drink, a mixed drink with both ingredients, or a placebo." Although all of the students who drank alcohol "showed impaired impulse control," those who drank the alcoholic energy drink "perceived themselves to be less impaired" -- a perception, which the study authors said, could "make them more likely to take risks such as driving while intoxicated." The study was also covered by MedPage Today (4/15, Bankhead) and WebMD (4/15, Doheny).

Alcohol Report

Report: Most US adults with alcohol problems do not recognize their need for treatment. Medscape (4/15, Cassels) reported, "According to a spotlight report (pdf) released by the Substance Abuse and Mental Health Services Administration (SAMHSA), the vast majority of US adults with alcohol problems don't recognize their need for treatment." Based on data on some 67,500 Americans over the age of 12, researchers found that "of 7.4 million adults who met criteria for alcohol abuse, only 87,000 (1.2%) perceived a need for treatment." Likewise, "among 5.6 million who met criteria for alcohol dependence, only 7.8% perceived a need for treatment."

Pacifiers Examined

Article discusses pros, cons of pacifier use. WebMD (4/16, Fries) reported that it "went to pediatricians, parents, therapists, and dentists to get the pros and cons of baby pacifiers." Some of the reasons to use a pacifier include "protection against SIDS, helping babies pacify themselves," and "easier weaning." Some of the reasons against using a pacifier include mistakenly assuming a child needs to be pacified when it "really needs nutrition-based sucking, such as a breast or bottle," and an increased risk for ear infections. The article also included ten tips for pacifier use and pacifier weaning.

BMI and Health Risks

Some experts say BMI is imprecise tool for measuring health risks. The Los Angeles Times (4/17, Healy) reported that "sometime later this year, the Centers for Disease Control and Prevention will release its latest accounting of the nation's weight problem, as measured by the body mass index, or BMI." However, "a number of experts caution that the BMI is a fairly imprecise tool -- and often wrong -- for helping individual patients appraise their health prospects." A growing "number of researchers cite a major gap in the BMI: its inability to reflect the health effects of an individual's exercise habits."

STD Rate Update

US seniors' STD rates rose 43% in five years. The Los Angeles Times /Orlando Sentinel (4/16, Jameson) reported, "Across the nation, and especially in the Sunshine State, the free-love generation is continuing to enjoy an active -- if not always healthy -- sex life." But at a "stage in life when many would expect sexually transmitted diseases to be waning, seniors are noticeably ahead of the national curve." Overall in the US, from 2005 to 2009, the number of reported cases of "syphilis and chlamydia among those 55 and older increased 43 percent," according to the Centers for Disease Control. The rise was "even more dramatic" in Central Florida, where syphilis and chlamydia cases "increased 71 percent in that same five-year period."

Sugar May Be a Toxin

Expert makes case that sugar is a toxin. In a lengthy article, Gary Taubes, a Robert Woods Johnson Foundation independent investigator, discusses in the New York Times (4/17, MM47, Taubes, Subscription Publication) claims made by pediatric hormone disorder specialist and childhood obesity expert Robert Lustig, MD, of the University of California-San Francisco School of Medicine, who makes a "persuasive case...that sugar is a 'toxin' or a 'poison,'" including high-fructose corn syrup. Should Lustig prove to be right, then Americans' "excessive consumption of sugar is the primary reason that the numbers of obese and diabetic Americans have skyrocketed in the past 30 years," and the sweet substance "is also the likely dietary cause of several other chronic ailments widely considered to be diseases of Western lifestyles -- heart disease, hypertension, and many common cancers among them."

Fatty Liver Update

Vigorous exercise may reduce risk for fatty liver progression. The Los Angeles Times (4/13, Stein) "Booster Shots" blog reports that walking on a treadmill "may put the brakes on the development of fatty liver disease" (NAFLD) in pre-diabetic, obese people, according to findings presented at the American Physiological Society's Experimental Biology meeting. The researchers followed "15 obese people" with NAFLD as they "walked on a treadmill at a fairly high intensity (85% of their maximum heart rate) for one hour a day for a week." After seven days, the study participants had "increased their polysaturated lipid index by an average 84%, bumped up their adiponectin levels and had better insulin sensitivity. ... 'The participants were burning more fat,' which may in turn reduce damage from fatty liver disease," said lead author Jacob Haus from the Cleveland Clinic. HealthDay (4/13, Preidt) also covered the study.

Apples Fight Fat!

Eating apples may help reduce LDL cholesterol in postmenopausal women. The Los Angeles Times (4/12, Kaplan) "Booster Shots" blog reported that "an apple a day really can help keep the doctor away, at least for postmenopausal women," according to research presented at Experimental Biology 2011. Researchers found, "in study of 160 women who ate either dried apples or prunes daily for one year," that "the women who ate apples saw their low-density lipoprotein cholesterol...drop by 23% after six months. At the same time, their" HDL cholesterol "rose about 4% over the course of the study." WebMD (4/12, Goodman) reported that "the women in the apple group" also "lost weight -- an average of about 3 pounds over the course of a year." HealthDay (4/12, Gordon) reported that "daily apple consumption also significantly lowered levels of C-reactive protein and lipid hydroperoxide, two substances that may indicate an increased risk of heart disease. What effects, if any, the prunes had on cholesterol levels were not mentioned in the study abstract."

Herpes Update

Asymptomatic HSV-2 carriers can transmit genital herpes, study finds. The NPR "Shots" blog (4/12) reported, "Researchers at the University of Washington have found just how easily people infected with herpes simplex type 2 virus, which causes genital herpes, can unknowingly pass it on to other people." According to a study published Tuesday in the Journal of the American Medical Association, participants who tested positive for herpes simplex virus type 2 used a swab to collect 'genital secretions' each for 30 consecutive days and kept symptom diaries. The researchers found that "410 people with symptomatic genital herpes and 88 participants who tested positive for infection," showed no symptoms. The Time (4/12, Melnick) "Healthland" blog noted that on average, the researchers found those "who had had past herpes outbreaks were infectious 20.1% of the time, while the asymptomatic group was found to be able to transmit the virus 10.2% of time." According to the Los Angeles Times (4/12, Roan) "Booster Shots" blog, the analysis, "one of the largest studies to date" of people tested positive for herpes simplex virus type 2, also found that virus presence was detected "at least once in 83.4% of the people with symptomatic infection and in 68.2% of people with asymptomatic herpes." The authors say the study shows that even people with asymptomatic herpes type 2 "can transmit it to a sexual partner."

New Spinal Implants

FDA clears three new spinal implant devices for market. The AP (4/12) reports, "Integra LifeSciences Holdings Corp. said Monday it has received clearance from the Food and Drug Administration to market three new spinal implant devices." The implant devices are "small hollow spinal implants that are inserted between vertebrae to restore the space between discs, relieving nerve pressure and back pain by maintaining the natural disc space height." The devices have a "graft window to allow natural bone growth to occur through them and form a strong connection that incorporates the implant." Dow Jones Newswire (4/11, Stynes, Subscription Publication) also covered the story.

Macular Degeneration and Vitamin D

Vitamin D may help protect women against age-related macular degeneration. ABC World News (4/11, story 8, 1:55, Stephanopoulos) reported that vitamin D may help protect women against age-related macular degeneration (AMD), according to a new study. MedPage Today (4/11, Neale) reported that "looked at data from the Carotenoids in Age-Related Eye Disease Study (CAREDS), which was conducted under the umbrella of the Women's Health Initiative Observational Study. In CAREDS, age-related macular degeneration status was assessed an average of six years after serum samples were analyzed for 25(OH)D status." The new analysis, published in the Archives of Ophthalmology, "included 1,313 women ages 50 to 79." WebMD (4/11, Hendrick) reported that "in the study, researchers say women under 75 who got the most vitamin D had a 59% decreased risk of developing age-related macular degeneration, compared to women with the lowest vitamin D intake." The "researchers also found that the women who had a blood vitamin D level higher than 38 nmol/L had a 48% decreased risk of early" AMD. "A blood level of 50 nmol/L is considered sufficient, according to the Institute of Medicine."

End of Life Study

Dartmouth researchers release report on end-of-life care. The New York Times (4/12, A22, Hartocollis, Subscription Publication) reports, "At the end of life, people with chronic diseases like cancer get more aggressive medical care in the New York area than anyplace else in the country, continuing a trend going back decades, according to a report released on Monday by researchers at Dartmouth College." The researchers, who "looked at federal data from 2007, the most recent year available, found that 46 percent of chronically ill patients in the Manhattan hospital region, which also covers most of Brooklyn and Staten Island, were being treated at hospitals when they died, as opposed to dying at home or in hospices or nursing homes. That rate was the highest in the country." Modern Healthcare (4/12, Barr, Subscription Publication) reports that "in the study, the average patient spent 10.9 days in the hospital during the last six months of life in 2007, compared with 11.3 in 2003." The researchers also found that "in 2003, 32.2% of patients in the last six months of their life died in a hospital; by 2007, the rate had dropped to 28.1%." Meanwhile, "the average number of hospice days per patient in the last six months of life increased to 18.3 days from 12.4 days." The St. Paul Pioneer-Press (4/12, Snowbeck) reports that the researchers found that "Medicare beneficiaries in Minnesota are less likely than those in other states to die in a hospital, because doctors and hospitals elsewhere pile on costly -- and perhaps unwanted -- care at the end of life," which is "part of the reason average Medicare spending per beneficiary in Minnesota is significantly below the national average." The Salt Lake Tribune (4/12, Henetz) reports that "Utah residents at the end of their lives spent the fewest number of days in hospitals in the nation -- 6.4 days, compared to a national average of 11.2 days." Just "12 percent of those who died spent time in an ICU, the nation's lowest rate." The researchers also found that "Utahns who died received more days of hospital-related hospice services than any other state except Oklahoma, and close to twice the national average."

Ovarian Cancer Risk

Talc-based powder use may increase ovarian cancer risk by 30%. MedPage Today (4/7, Bankhead) reported that the "use of talc-based powder significantly increases the risk of invasive ovarian," according to findings presented at the American Association for Cancer Research. The researchers analyzed data from a "case-control study involving more than 2,000 women with ovarian cancer and a similar number of women without the cancer." Talc applications were estimated from "patient-reported frequency and duration of use." After adjusting for "age, parity, oral contraceptive use, tubal ligation," BMI, smoking or alcohol use, and ethnic/racial or familial breast or ovarian cancer history, the study team performed analyses for cases of nonmuscinous-invasive, nonserous-invasive, and serous-invasive cancer. They found that for all analyses, talc use was associated with "an increased prevalence of ovarian cancer; the magnitude of the difference between users and nonusers ranged between 20% and 40%, most often about 30%."

Ecstasy and Brain Damage

MRI scans show long-term ecstasy users may be at risk for brain damage. HealthDay (4/7, Preidt) reported, "Long-term users of the illegal drug ecstasy" (3,4-methylenedioxymethamphetamine) are at risk for "brain damage," according to a study in the Journal of Neurology Neurosurgery and Psychiatry. The researchers used MRI scans to measure the "volume of the hippocampus" in 10 men who were long-term ecstasy users and seven men "who had never used the drug." On average, the users had taken an "average of 281 ecstasy tablets" over the previous six years. The scans revealed that compared to non-users, ecstasy users had an average 10.5-percent "less hippocampal volume" and an average "4.6-percent lower overall proportion of grey matter in the brain, which suggests that the effects of ecstasy may not be limited to the hippocampus." According to WebMD (4/7, Hendrick), the study authors said their findings "mirror previous research that has indicated acute swelling and later atrophy of hippocampal tissue in long-term ecstasy users." Notably, the scientists pointed out that hippocampus atrophy "is a hallmark" for progressive cognitive-impairment diseases, such as Alzheimer's. Medscape (4/7, Lowry) noted that the ecstasy users had also "used more amphetamine and cocaine," but there were "no significant differences between the two groups in recreational drug exposure, other than ecstasy. Both groups also drank alcohol regularly." Meanwhile, Jean M. Bidlack, PhD, professor at the University of Rochester School of Medicine and Dentistry in New York, who was not involved in the study, said the preliminary trial "needs to be followed up with a larger study that enrolls a greater number of former ecstasy users."

Meditation vs. Morphine

Meditation may be more effective than morphine. The Chicago Tribune (4/8, Cevallos) reports, "Meditation appears to be a powerful way to take away pain -- just a short session is more potent than even morphine, if we're to believe the headlines." According to "a new study published in the Journal of Neuroscience, meditation rookies reported feeling less pain after meditation training than they had felt before the training." Notably, the "study, from Wake Forest Baptist Medical Center, echoes other research that suggests clearing your mind can reduce pain, but it's far too early to recommend that chronic pain sufferers toss out their pain-killers." The participants in the study attended 20-minute classes four times, which focused on breathing and relaxation.