8 cities in US line up for swine flu vaccine test|||
ST. LOUIS – Hundreds of Americans in eight cities are lining up for experimental swine flu shots in a race to get a vaccine out in case the new flu virus regains strength this fall and winter.
Sharon Frey, who is leading the government-funded testing at Saint Louis University, said scientists have been working late nights and weekends to organize the studies and recruit volunteers.
"Typically it takes a year to do this," said Frey, an infectious diseases expert. "I can tell you we're working at breakneck speed."
About 2,800 people will participate in the government-led studies. Saint Louis University will test 200 adults and 200 children. Also under way are separate studies by five flu vaccine manufacturers under contract with the government.
Health officials expect to have about 160 million doses available this fall, with the first batch sometime in September. The studies will test the safety and effectiveness of vaccines developed by drug makers and help determine dosage and whether it can be given with a seasonal flu shot.
Participants will be given different combinations of two swine flu vaccines made by drug makers Sanofi Pasteur and CSL Limited and a seasonal flu vaccine.
Frey said the data will be turned around quickly for review by the Food and Drug Administration.
It's possible the government will begin a public vaccination campaign before all of the work of the trials is complete, Dr. Anne Schuchat has said. She oversees the flu vaccination programs at the Centers for Disease Control and Prevention.
Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, the government wants to carefully monitor people who get the new vaccine for any problems.
Nicholas Sarakas, 25, of St. Peters, Mo., is among the vaccine volunteers. As a young adult, he's among the groups targeted for the swine flu vaccine; swine flu has been harder on younger people than their elders.
"I thought, 'I'll end up getting a flu shot anyway,'" he said. "Somebody has to be the first person to try it."
The other study sites are Baylor College of Medicine in Texas, Children's Hospital Medical Center in Cincinnati, Emory University, Group Health Cooperative in Seattle, University of Iowa, University of Maryland School of Medicine and Vanderbilt University.
___
On the Net:
NIH swine flu vaccine trial Q&A: http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm
Heart transplant record holder dies of cancer|||
DAYTON, Ohio – A heart transplant recipient who lived a record 31 years with a single donated organ has died at age 51 of cancer, his heart still going strong, his widow said.
Tony Huesman died Sunday night.
"He had diabetes and cancer," Carol Huesman said Monday. "His heart — believe it or not — held out. His heart never gave up until the end, when it had to give up."
Huesman got a heart transplant in 1978 at Stanford University. That was just 11 years after the world's first heart transplant was performed in South Africa.
He became the longest-living American recipient of a single transplanted heart in 2000, when a patient who had received a transplant a year before him had to undergo a second transplant.
At his death, Huesman was listed as the world's longest survivor of a single transplanted heart both by Stanford and the Richmond, Va.-based United Network for Organ Sharing.
"I'm living proof a person can go through a life-threatening illness, have the operation and return to a productive life," Huesman told the Dayton Daily News in 2006.
He worked as marketing director at a sporting-goods store.
Huesman was diagnosed with cardiomyopathy while in high school. His heart, attacked by a pneumonia virus, was almost four times its normal size from trying to pump blood with weakened muscles.
Huesman's sister, Linda Huesman Lamb, also was stricken with cardiomyopathy and received a heart transplant in 1983. The two were the nation's first brother and sister heart transplant recipients. She died in 1991 at age 29.
Huesman founded the Huesman Heart Foundation in Dayton, which seeks to reduce heart disease by educating children and offers a nursing scholarship in honor of his sister.
"He touched a lot of lives," Carol Huesman said.
8 cities in US line up for swine flu vaccine test|||
ST. LOUIS – Hundreds of Americans in eight cities are lining up for experimental swine flu shots in a race to get a vaccine out in case the new flu virus regains strength this fall and winter.
Sharon Frey, who is leading the government-funded testing at Saint Louis University, said scientists have been working late nights and weekends to organize the studies and recruit volunteers.
"Typically it takes a year to do this," said Frey, an infectious diseases expert. "I can tell you we're working at breakneck speed."
About 2,800 people will participate in the government-led studies. Saint Louis University will test 200 adults and 200 children. Also under way are separate studies by five flu vaccine manufacturers under contract with the government.
Health officials expect to have about 160 million doses available this fall, with the first batch sometime in September. The studies will test the safety and effectiveness of vaccines developed by drug makers and help determine dosage and whether it can be given with a seasonal flu shot.
Participants will be given different combinations of two swine flu vaccines made by drug makers Sanofi Pasteur and CSL Limited and a seasonal flu vaccine.
Frey said the data will be turned around quickly for review by the Food and Drug Administration.
It's possible the government will begin a public vaccination campaign before all of the work of the trials is complete, Dr. Anne Schuchat has said. She oversees the flu vaccination programs at the Centers for Disease Control and Prevention.
Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, the government wants to carefully monitor people who get the new vaccine for any problems.
Nicholas Sarakas, 25, of St. Peters, Mo., is among the vaccine volunteers. As a young adult, he's among the groups targeted for the swine flu vaccine; swine flu has been harder on younger people than their elders.
"I thought, 'I'll end up getting a flu shot anyway,'" he said. "Somebody has to be the first person to try it."
The other study sites are Baylor College of Medicine in Texas, Children's Hospital Medical Center in Cincinnati, Emory University, Group Health Cooperative in Seattle, University of Iowa, University of Maryland School of Medicine and Vanderbilt University.
___
On the Net:
NIH swine flu vaccine trial Q&A: http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm
8 cities in US line up for swine flu vaccine test|||
ST. LOUIS – Hundreds of Americans in eight cities are lining up for experimental swine flu shots in a race to get a vaccine out in case the new flu virus regains strength this fall and winter.
Sharon Frey, who is leading the government-funded testing at Saint Louis University, said scientists have been working late nights and weekends to organize the studies and recruit volunteers.
"Typically it takes a year to do this," said Frey, an infectious diseases expert. "I can tell you we're working at breakneck speed."
About 2,800 people will participate in the government-led studies. Saint Louis University will test 200 adults and 200 children. Also under way are separate studies by five flu vaccine manufacturers under contract with the government.
Health officials expect to have about 160 million doses available this fall, with the first batch sometime in September. The studies will test the safety and effectiveness of vaccines developed by drug makers and help determine dosage and whether it can be given with a seasonal flu shot.
Participants will be given different combinations of two swine flu vaccines made by drug makers Sanofi Pasteur and CSL Limited and a seasonal flu vaccine.
Frey said the data will be turned around quickly for review by the Food and Drug Administration.
It's possible the government will begin a public vaccination campaign before all of the work of the trials is complete, Dr. Anne Schuchat has said. She oversees the flu vaccination programs at the Centers for Disease Control and Prevention.
Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, the government wants to carefully monitor people who get the new vaccine for any problems.
Nicholas Sarakas, 25, of St. Peters, Mo., is among the vaccine volunteers. As a young adult, he's among the groups targeted for the swine flu vaccine; swine flu has been harder on younger people than their elders.
"I thought, 'I'll end up getting a flu shot anyway,'" he said. "Somebody has to be the first person to try it."
The other study sites are Baylor College of Medicine in Texas, Children's Hospital Medical Center in Cincinnati, Emory University, Group Health Cooperative in Seattle, University of Iowa, University of Maryland School of Medicine and Vanderbilt University.
___
On the Net:
NIH swine flu vaccine trial Q&A: http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm
Veterinarians using stem cells to treat animals|||
MIAMI – Five-year-old Lucy the Labradoodle's back limbs have been rendered unusable by rheumatoid arthritis, and she must scoot along the ground with her front paws to grab a bone. Her owners believe that a costly stem-cell treatment is the reason she's even lived as long as she has.
In fact, they say, she seems to be improving. She no longer yelps or whimpers in pain, and she needs far less medicine than before. Lucy's owners credit the stem cell treatment, despite what experts say is a lack of evidence such treatments work.
"We didn't think she'd live anywhere near this long, and I know it's because of the stem cells," says owner Carol Fischman, 57, of Vero Beach.
Thousands of dogs and horses with degenerative arthritis have had stem cell treatments, costing around $2,500 to $3,000 per procedure. There are no independent studies verifying their effectiveness, and some experts say such studies are needed to assess their potential.
University of Florida veterinarian Kristin Kirkby, who performed Lucy's procedure, said that the outcomes on five similar treatments have all been positive. But that's from owner-reported results, not scientific scrutiny.
Owners tell her their dogs have an easier time getting around the house and getting into position to urinate. Mostly, they just report their dogs appear to be more comfortable overall.
To get hard results, Kirkby says the university plans to start taking a pain inventory of each animal at the beginning of the process, followed by an evaluation and checkups afterward to measure changes.
"I think it's an exciting field. Undoubtedly the future of scientific research is going this way," Kirkby said. "It's early on, especially in the small animal side, to know what the results can be."
Vet-Stem, a Poway, Calif.-based company, is developing the stem cell therapy and began treating horses in 2003. It derives stem cells from fat samples taken from dogs and horses across the country.
The procedure has been used mainly to treat osteoarthritis, which involves loss of cartilage in the joints, but Vet-Stem is researching treatments for other diseases. Vet-Stem claims the therapy enables animals to replace cartilage and other tissue.
Since 2003, the privately held company has treated 3,500 horses and 1,500 dogs and plans to begin treating cats later this year. More than 1,500 vets are licensed to use the procedure.
Dr. Bob Harman, veterinarian and Vet-Stem founder, said it made sense to use these fat-based adult stem cells, which the body uses to create scar tissue and repair damage, to treat chronic disease in animals.
"Really, all we're doing is harnessing the existing repair machinery in the body, concentrating it, and putting it right where an injury occurs, where healing is needed, to heal naturally," he said
Adam Gassel has used stem cells to treat almost 40 dogs at his Irvine, Calif., veterinary clinic during the past two years.
"I was pretty skeptical," he said. "I was hoping that dogs would just be more comfortable."
But for about 25 percent of dogs, their owners report they are like puppies again, able to get back to normal activities, he said. Another 25 percent are able to stop taking medicines they were dependent upon. In all, Gassel said, all but 20 percent of the animals show some positive response to the therapy, according to their owners and the requests for pain medicine.
One peer-reviewed study by researchers at Cornell University, published in the American Journal of Veterinary Research and sponsored in part by Vet-Stem, found that tendinitis in horses was improved by injection of the adult stem cells.
Two other studies published in Veterinary Therapeutics found that dogs with osteoarthritis showed improvements in lameness after stem cell injections. Those studies also were sponsored by Vet-Stem and conducted by Vet-Stem researchers and other veterinarians.
Jonathan Slack, director of the University of Minnesota's Stem Cell Research Institute, said adult stem cells from fat can become cartilage in a laboratory cell culture. Conclusive results on whether the stem-cell injection process actually makes new bone cells in animals don't exist, to his knowledge.
"I guess from the dog's point of view," Slack said, "it's good if it does work."
Whatever the scientific merits of the therapies, Lucy's owners say they would do it again for her.
She's had her stem cell treatments through an IV three times, and the Fischmans want to give her a fourth one soon, despite the $3,000-per-procedure cost.
"I like the dog as much as I like my kids," said Dr. Charles Fischman, 59, who is an immunologist. "People will spend more on their dogs than they will on themselves."
Consumer protections lost in health care debate|||
WASHINGTON – It's one issue in the health care debate that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.
Yet such practical considerations are being overlooked in a debate that's become a passionate argument about the government's reach and role in medical matters.
Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.
Insurers no longer could base premiums on a person's medical history, although they still could charge more to 50-year-olds than to people in their 20s.
People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate "job lock," the fear of leaving employment that provides medical benefits.
"It would bring insurance and insurabilty standards into line with medical practice and with the way people live their lives," said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute. "When people are in the doctor's office, they're worried about that day's issue. You're not thinking, 'If I take this pill for my cholesterol, will it cause me to be denied insurance coverage in the future?'"
If President Barack Obama's effort to remake the health care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they're seriously ill.
Major insurers will accept a rollback of the industry's restrictive practices only if they're guaranteed that all Americans would be covered — a central goal of Obama's approach and a potential financial boon to the industry.
The consumer protections are part of what Republican Sen. Mike Enzi of Wyoming calls the 80 percent of health care fixes that there's consensus for. Enzi is one of six members of the Senate Finance Committee who are trying work out a bipartisan solution — with no guarantee of success.
Obama may have made a critical error by not stressing the consumer aspects of the legislation, and his advisers seem to have realized it as they belatedly retooled the White House pitch in recent days.
If a bill does pass, the biggest winners are likely to be self-employed people and small-business owners and employees, who now have the most trouble getting and keeping coverage. Those working for big companies would only benefit indirectly; they'd find it easier to keep their coverage if they get laid off or leave to launch a new career.
Insurance companies could come out ahead, too.
"They'll get a big new market with millions and millions of new customers," said Gary Claxton, a health policy expert with the Kaiser Family Foundation. "Their average profit per person may not be as high, but they still should be able to earn a profit by insuring more people."
One major catch is that the consumer protections would not be available immediately. They are timed to take effect alongside government subsidies to help people buy coverage. In the House Democratic legislation, the coverage expansion would come in 2013 — after the next presidential elections. Part of the reason for the delay is to make the costs of the bill appear more manageable.
"It's a long time to wait," said John Rother, policy and strategy chief for AARP. "This is complicated stuff, but I would have personally liked to see it done in two years."
The House legislation, the Senate health committee bill and the evolving Senate Finance Committee package differ on some important specifics, but follow the same general approach.
All would set up an insurance marketplace. This exchange would be open to individuals and small businesses, and maybe big companies later on. Government subsidies would be available for low-to-middle income households. People buying health insurance through the exchange would be part of a large pool that spreads risks, giving participants leverage similar to what government employees — including lawmakers — now have.
Health plans offered through the exchange would have to meet basic standards, so it would be easier for consumers to understand what their insurance covers. To protect against catastrophic illness, there would be annual limits on out-of-pocket costs for co-payments and deductibles. Year-to-year increases in premiums would be more predictable for small companies.
Insurers could not charge more to people in poor health or to women, as they do now. But they still could charge higher premiums due to family size, geographic location and age.
The House and the Senate health committee bills would limit age-related premiums so that a 64-year-old pays no more than twice as much an 18-year-old. But Senate Finance Committee negotiators are considering allowing as much as a 5-to-1 difference, a big savings for the young but a significantly higher cost for older people who are more likely to have health problems.
The federal consumer protections would set a basic standard for the whole country, changing a situation in which state-level safeguards vary widely.
___
On the Net:
Employee Benefit Research Institute: http://www.ebri.org/
AARP: http://www.aarp.org/
Kaiser Family Foundation: http://www.kff.org/
Senate Finance Committee: http://finance.senate.gov/
Senate Health, Education, Labor and Pensions Committee: http://help.senate.gov/
House Energy and Commerce Committee: http://energycommerce.house.gov/
House Ways and Means Committee: http://waysandmeans.house.gov/
House Education and Labor Committee: http://edlabor.house.gov/
Rate of severe childhood obesity up sharply in U.S.|||
NEW YORK – The rate of severe obesity among U.S. children and teenagers more than tripled over the past three decades, a new study finds.
Using data from a long-running government health survey, researchers found that as of 2004, nearly 4 percent of 2- to 19-year-olds in the U.S. were severely obese.
That was up more than three-fold from 1976, and more than 70 percent from 1994, the researchers report in the journal Academic Pediatrics.
"Children are not only becoming obese, but becoming severely obese, which impacts their overall health," lead researcher Dr. Joseph A. Skelton, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said in a news release from the university.
"These findings," he added, "reinforce the fact that medically-based programs to treat obesity are needed throughout the United States and insurance companies should be encouraged to cover this care."
The study also found that minority and lower-income children are at particular risk of severe obesity -- which, in children and teenagers, is defined as having a body mass index in the 99th percentile for one's age and gender.
In the most recent survey, which included 12,000 2- to 19-year-olds from across the U.S., nearly 6 percent of African-American children and teens were severely obese, as were roughly 5 percent of Mexican- Americans. That compared with 3 percent of their white peers.
In contrast, less than 1 percent of Mexican-American children and less than 2 percent of black children were severely obese in the 1970s survey.
When it came to family income, the latest survey data show that just over 4 percent of relatively lower-income children were severely obese, versus 2.5 percent of those from higher-income families.
The findings underscore a central obstacle in tackling childhood obesity, Skelton and his colleagues note: The children who are most affected also generally have the greatest difficulty getting good healthcare.
"No simple answers exist," the researchers write, pointing out that along with better access to healthcare, there also need to be broader efforts to improve the diets and lifestyle habits of U.S. children.
SOURCE: Academic Pediatrics, September 2009.
Berlusconi reprimands state TV for attacking government|||
ROME – Italian Prime Minister Silvio Berlusconi on Monday said it was "unacceptable" for state TV to criticize the government and rebuked a left-leaning newspaper which regularly publishes lurid stories about his sex life.
Berlusconi, whose family media empire owns Italy's main independent television channels, said state-owned broadcaster RAI was always against him.
"I've been able to say what a majority of Italians think, which is that it is unacceptable that public television, paid for by all, should be the only public television that is always against the government," he told RAI radio.
As well as owning powerful broadcaster Mediaset, Berlusconi has a large majority in parliament which appoints RAI's board members, a position his critics say gives him far too much power over the media.
He attacked La Repubblica, the newspaper which has kept Italians riveted with steamy narratives by escorts of his parties and a daily list of 10 uncomfortable questions for the prime minister.
"The only thing that appears off course to me is a certain type of journalism," Berlusconi said in response to a question about articles in Repubblica suggesting Italian secret service agents had gone "off course" in their investigations.
Berlusconi has boasted that selections for RAI's top executives are made at his house. He started a Friday news conference by jokingly asking RAI journalists: "What's the atmosphere at RAI like with the directors I set up?"
The chairman of RAI's board later issued a statement saying it was the duty of journalists to report all the news.
Center-left opposition leader Dario Franceschini said Berlusconi's criticism of RAI was the "latest proof of his intention to use his economic force and the power of whoever is in government to condition and intimidate every free voice."
Berlusconi retorted that the left ought to be happy as he was asking state television not to criticize anyone -- be it the government or the opposition.
So far the opposition has yet to make much hay out of Berlusconi's scandals. Surveys show his popularity has fallen over the past few months, but he still polls 49 percent despite Italy's worst economic downturn since World War Two and the media frenzy surrounding his personal life.
Obama invokes mother39s battles against cancer insurers|||
WASHINGTON – Among the heartrending tales invoked by President Barack Obama as he stumps for healthcare reform, none is more poignant than that of his own mother's losing fight against cancer.
As he presses for an overhaul of the healthcare system, Obama often recounts the crises faced by Americans who with their jobs have lost their medical coverage, or who file for bankruptcy when faced with a health calamity.
But Exhibit A among the tragic examples is that of his own mother, Ann Dunham, who lost her fight to cancer nearly a decade and a half ago as she battled insurance companies.
"It's... personal for me," Obama told a crowd at a high-profile forum on Tuesday in Portsmouth, New Hampshire.
"I will never forget my own mother as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment," he told the crowd.
He was reprising a story he told frequently on the campaign trail, and more recently on the road, while drumming up support for his health industry reform agenda.
"The insurance company was arguing that somehow she should have known that she had cancer when she took her new job, even though it hadn't been diagnosed yet," Obama told the New Hampshire audience Tuesday.
"If it could happen to her, it could happen to any one of us. And I've heard from so many Americans who have the same worries."
In the preface to his first book, "Dreams From My Father," an elegy to his absentee dad, Obama also eulogizes the mother "whom we lost, with a brutal swiftness, to cancer a few months after this book was originally published."
According to some news accounts, Ann Dunham's cancer at first had been misdiagnosed in Indonesia as indigestion.
It was later determined by experts at the Memorial Sloan-Kettering Cancer Center in New York to be a fast-moving uterine cancer that had spread to her ovaries.
In remarks that seem informed by his mother's ordeal, Obama added that his goal now with healthcare reform is to set up a system "that gives a little bit of help to people who currently are working hard every day but they don't have healthcare insurance on the job."
He also hopes to ensure that patients already insured "are not going to be dropped because of a pre-existing conditions or because you lose your job or because you change your job -- that you're actually going to get what you pay for, that you're not going to find out when you're sick that you got cheated."
"If we can set up a system that gives you some security, that's worth a lot," he said.
His mother, who held a doctorate degree in anthropology, forged a career in international economic development, working for a while with the Ford Foundation in Jakarta and later with the US Agency for International Development and the World Bank, and helping to guide micro-enterprise projects to aid poor women.
Her mother's frustrating odyssey as a cancer patient also figured into his historic presidential campaign, when he vowed to remake the medical coverage system.
"In last painful months, she was more worried about paying her medical bills than getting well," Obama said in one campaign advertisement that aired in 2008.
"I hear stories like hers everyday. For 20 years Washington has talked about healthcare reform and reformed nothing. Unless we stop the bickering and the lobbyists we will be in the same place 20 years from now," he said.
Ann Dunham returned to her home state of Hawaii where she lived out the final months of her life, and died at the age of 53 on November 7, 1995, before Obama -- who by then was living in Chicago -- could get to her bedside to say goodbye.
Obama has said that his greatest regret is not being at his mother's side when she died, and has called her the most influential person in his life.
"I think sometimes that had I known she would not survive her illness, I might have written a different book -- less a meditation on the absent parent, more a celebration of the one who was the single constant in my life," he wrote in "Dreams From My Father."
"She was the kindest, most generous spirit I have ever known," Obama wrote, "and that what is best in me I owe to her."
China closes factory after 300 children poisoned report|||
BEIJING – Authorities in northern China Wednesday announced the closure of a smelting plant blamed for the lead poisoning of at least 300 children, state media reported.
The children, all living near the Dongling Lead and Zinc Smelting Co. plant in Changqing, Shaanxi province, were found to have as much as four times the normal maximum level of lead in their blood, Xinhua news agency said.
Nearly 1,000 children had now been tested and their results would be known in three to five days, it said.
It was not immediately clear how the children were poisoned but officials have been taking samples of groundwater, soil, air and sewage to check for contamination, and there was no mention of adult sickness.
Local county deputy head He Hongnian said the closure of the plant had been ordered on August 6, two weeks after a six-year-old girl was diagnosed with lead poisoning.
Anxious parents rushed their children to hospital for blood tests, with more than 300 lead poisoning cases reported by Sunday.
The lead levels in their blood ranged from 100 milligrams to 400 milligrams per litre, compared with normal levels of between zero and 100 milligrams, Xinhua said.
Above 200 milligrams is considered hazardous, with children more vulnerable to lead poisoning which can harm the nervous system.
"We live only 200 metres from the smelting firm. Lead pollution is certain," villager Sun Yagang, whose two-year-old son was diagnosed with lead poisoning, told Xinhua.
Residents who lived within 500 metres of the plant were supposed to have been relocated but so far only 156 out of nearly 581 families had been able to move to new homes, Xinhua said, citing Changqing town chief Pu Yiming.
The county government promised to speed up the relocation.
"We will ensure that all the remaining 425 families are relocated within two years," deputy county head He was quoted as saying.
Many poverty-stricken regions in China's interior have introduced high-polluting industries without the necessary environmental evaluation, in a desperate bid to boost economic growth, state media has said.
50 million women in Asia at risk of HIV infection UNAIDS|||
BALI, Indonesia – Fifty million women in Asia are at risk of being infected with HIV because of the risky sexual behavior of their husbands or boyfriends, leading health experts said in a report on Tuesday.
More than 90 percent of the 1.7 million women now living with HIV in Asia became infected while being in monogamous, long-term relationships with men who engaged in risky sex behavior, the report launched by UNAIDS said.
These include men who had other sexual partners or who were drug users.
"We need to target men who engage in paid sex, injecting drug users, men who have sex with men, who can transmit the virus to their partners," Jean D'Cunha, regional director of the United Nations Development Fund for Women in South Asia, told a news conference held on the margins of an HIV/AIDS conference in Bali.
"We need to question the attitudes, values and behavior and transform these so that women would be less vulnerable to
HIV/AIDS."
While the issue of gender inequality is often ignored or laughed off, experts say it cannot be taken lightly in the context of HIV/AIDS, a disease that can be transmitted through sexual contact and which is incurable.
Sex workers, who have very little bargaining power to begin with, are usually forced to comply when their clients refuse to use condoms. Back home, the wives of these men too have no power to demand that condoms be used even if they know about the risky sexual behavior of their husbands.
While the fight against the AIDS epidemic has seen progress on some fronts, women continue to bear the brunt of it. Women make up 35 percent of all adult HIV infections in Asia now, up from 17 percent in 1990.
REVERSING A CULTURE
Maire Bopp-Allport, head of the Pacific Islands Aids Foundation, contracted the AIDS virus from her boyfriend around 1996. Today, she is a familiar figure in the global fight against the disease.
"At the heart of the issue is thousands of years of education to our males that it's okay to think that women are there to simply serve them and do everything they want. We need to bring a new culture where it's not okay," she told Reuters.
"They need to be able to think that the abuse of a woman is the abuse of their daughters when their daughters become women," she added.
Not enough shuteye may raise diabetes risk|||
NEW YORK – An inadequate amount of nightly sleep on a recurring basis, coupled with a sedentary lifestyle and overeating, may fuel the development of diabetes, results of a new study hint.
"Our findings suggest that combining the unhealthy aspects of the Westernized lifestyle with insufficient sleep may add to the risk of overweight and sedentary individuals to develop diabetes," Dr. Plamen Penev, of the University of Chicago, Illinois, and a senior author of the study, told Reuters Health.
Penev and colleagues subjected 11 healthy but sedentary middle-aged men and women to two 14-day periods of sedentary living with free access to food and either 5.5 hours or 8.5 hours of sleep each night.
As nightly sleep times changed from 8.5 to 5.5 hours, the participants went to bed later and got out of bed earlier and, as a result, average sleep duration was reduced by about two hours a day.
When the adults had their bedtimes decreased from a healthy 8.5 hours to 5.5 hours they showed changes in their response to two common sugar tests, which were similar to those seen in people with an increased risk of developing diabetes.
"If confirmed by future larger studies," Penev told Reuters Health, "these results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep."
SOURCE: Journal of Clinical Endocrinology and Metabolism, September 2009.
FDA concludes mercury in dental fillings not risky|||
WASHINGTON – The government declared Tuesday that silver dental fillings contain too little mercury to harm the millions who've had cavities filled with them — including young children — and that only people allergic to mercury need to avoid them.
It was something of an about-face for the Food and Drug Administration, which last year settled a lawsuit with anti-mercury activists by posting on its Web site a precaution saying questions remained about whether the small amount of mercury vapor the fillings can release were enough to harm the developing brains of fetuses or the very young.
On Tuesday, the FDA said its final scientific review ended that concern. Still, the agency did slightly strengthen how it regulates the fillings, urging dentists to provide their patients with a government-written statement detailing the mercury controversy and what science shows.
"The best available scientific evidence supports the conclusion that patients with dental amalgam fillings are not at risk for mercury-associated adverse health effects," said Dr. Susan Runner, FDA's dental products director.
Anti-mercury activists accused the agency of bowing to the dental industry and said they'd go back to court to try to force a change.
"FDA broke its contract and broke its word that it would put warnings for children and unborn children," said Charles Brown of Consumers for Dental Choice. "This contemptuous attitude toward children and the unborn will not go unanswered."
Too much mercury can harm the brain. It has made headlines in recent years as scientists have warned that some types of seafood contain enough to harm a fetus or young child.
Used since the 1800s, amalgam fillings are a mix of a different kind of mercury — a kind the body absorbs differently — with silver, copper and tin to harden it.
Tuesday, the FDA took the regulatory step of formally classifying amalgam fillings as a Class II or "moderate risk" medical device to ensure that dentists handle the mercury properly — using adequate ventilation — but to allow the allergy warning. Until now, the FDA had classified the fillings' ingredients separately.
The practical effect of that technical change? The FDA released its review of 200 scientific studies that found no risk to adults or children over 6 from the fillings.
What about pregnant women or younger children? Tuesday's ruling supersedes the precaution from last year's lawsuit settlement, Runner said.
The FDA found that while there have been only a handful of rigorous studies comparing young children given either amalgam fillings or mercury-free tooth-colored resin composite ones, those studies haven't detected any brain problems. Runner cited additional evidence concluding that babies and young children would be exposed to amounts well below safety limits.
But the statement dentists are urged to share with patients does raise the issue so that people who are concerned about the mercury can discuss an alternative.
Removing the fillings actually releases more mercury vapor, FDA said. People who think they're allergic to a filling ingredient should discuss that with a dentist.
Amalgams now account for about 30 percent of U.S. fillings, their popularity dropping in favor of tooth-colored alternatives. But they remain the cheapest filling and dentists say there are some conditions that demand amalgams, such as spots on back teeth that won't stay dry long enough for composite fillings to bond.
___
On the Net:
FDA: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/default.htm
Obese Texas man hides gun between rolls of fat|||
WASHINGTON – An obese prisoner in Harris County, Texas has been charged with illegal possession of a firearm after he was discovered to be hiding a 9mm pistol in between his rolls of fat, local media reported Saturday.
George Vera, who weighs around 500 pounds was originally arrested last week for selling counterfeit CDs, according to the Houston Chronicle newspaper.
A police spokesman told the Chronicle that Vera was searched three times over the course of his arrest and booking at the jail but managed to conceal the handgun with his rolls of fat until it was discovered in the shower.
Vera has been charged with possession of an illegal weapon in a correctional facility, which carries a penalty of two to 10 years in prison, but is currently free on bail of 10,000 dollars.
Any spread of breast cancer raises risk of return|||
Breast cancer patients with even the tiniest spread of the disease to a lymph node have a much higher risk of it recurring years later and may need more treatment than just surgery, new research suggests.
For years, doctors and patients have struggled with what to do about a microscopic tumor or stray cancer cells in a lymph node. Women with "micro tumors" usually are given estrogen-blocking drugs, chemotherapy or both; those with isolated cancer cells usually are not, because those were thought to be of low concern.
The new study challenges that view. It suggests that either type of metastasis, or spread, raises a woman's risk of having cancer show up in the breast or anywhere else in the next five years by about 50 percent.
"This took an area that was very gray and I think made it black and white," said Dr. Linda Vahdat, director of breast cancer research at Weill Cornell Medical College and an adviser for the breast cancer patient Web site of ASCO, the American Society of Clinical Oncology.
"I think it will influence treatment," she said of the study. "If we're considering treating the patient, we probably should."
Dr. Daniel Hayes, director of breast cancer treatment at the University of Michigan, agreed.
"It really does look like our biases are wrong," he said. "For the first time, it suggests that isolated tumor cells or micrometastases do have biological significance."
Vahdat and Hayes had no role in the study, which was done by researchers throughout the Netherlands. Results are in Thursday's New England Journal of Medicine.
The study is not ideal: It just observed a large number of women rather than assigning some to get treatment and comparing how they fared to others who were not treated. The study also was done at a time when treatment was less aggressive and in a country where doctors had been treating breast cancer more conservatively than in the United States.
In the U.S., many women with early stage breast cancer are given hormone blockers.
"The big issue is, should these patients also get chemotherapy?" Hayes said.
However, not all women benefit from chemotherapy even when their risk of a recurrence is high, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.
"Patients are looking for more specific treatment" tailored to their individual tumor type — not necessarily more or less treatment, he said.
The Dutch study involved more than 2,700 women with low-risk, early stage cancer — small tumors that did not seem aggressive. All had surgery to remove their breast tumors. All of their armpit lymph nodes or a few key ones called "sentinel" nodes were removed and checked for signs of cancer. Doctors do this by examining tissue slices from the nodes and using special stains to make cancer cells show up.
Larger tumors in lymph nodes already trigger further treatment. A micro tumor is a cluster of cells less than 2 millimeters — smaller than one-tenth of an inch. Most, but not all, doctors would treat these, too. Isolated tumor cells are even tinier — "you can essentially count them" in a tissue sample, Winer said — and do not typically spur further treatment under current guidelines.
The Dutch researchers compared patients based on whether they received treatment beyond surgery and whether cancer of various amounts was found in a lymph node.
In most cases, breast cancer doesn't return after surgery. Among women in the study who were given no additional treatment, 86 percent of those with no cancer in lymph nodes were free of cancer five years later. Only 76 percent of those with micro tumors and 77 percent of those with isolated cancer cells were cancer-free.
That translates to a roughly 50 percent greater risk of recurrence if any sign of cancer was present in a node.
Also, women with micro tumors or stray cells who were given additional treatment had a 43 percent lower risk of a cancer recurrence than similar women not treated beyond surgery.
The differences should lead doctors to reconsider guidelines for how tumors are classified, which guides the amount of treatment a woman receives, the authors write. Now, a micro tumor is considered "node positive" cancer, warranting further treatment, while isolated cells are called "node negative."
A new version of the guidelines is due out soon, Hayes said.
___
On the Net:
New England Journal: http://www.nejm.org
Consumer protections lost in health care debate|||
WASHINGTON – It's one issue in the health care debate that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.
Yet such practical considerations are being overlooked in a debate that's become a passionate argument about the government's reach and role in medical matters.
Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.
Insurers no longer could base premiums on a person's medical history, although they still could charge more to 50-year-olds than to people in their 20s.
People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate "job lock," the fear of leaving employment that provides medical benefits.
"It would bring insurance and insurabilty standards into line with medical practice and with the way people live their lives," said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute. "When people are in the doctor's office, they're worried about that day's issue. You're not thinking, 'If I take this pill for my cholesterol, will it cause me to be denied insurance coverage in the future?'"
If President Barack Obama's effort to remake the health care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they're seriously ill.
Major insurers will accept a rollback of the industry's restrictive practices only if they're guaranteed that all Americans would be covered — a central goal of Obama's approach and a potential financial boon to the industry.
The consumer protections are part of what Republican Sen. Mike Enzi of Wyoming calls the 80 percent of health care fixes that there's consensus for. Enzi is one of six members of the Senate Finance Committee who are trying work out a bipartisan solution — with no guarantee of success.
Obama may have made a critical error by not stressing the consumer aspects of the legislation, and his advisers seem to have realized it as they belatedly retooled the White House pitch in recent days.
If a bill does pass, the biggest winners are likely to be self-employed people and small-business owners and employees, who now have the most trouble getting and keeping coverage. Those working for big companies would only benefit indirectly; they'd find it easier to keep their coverage if they get laid off or leave to launch a new career.
Insurance companies could come out ahead, too.
"They'll get a big new market with millions and millions of new customers," said Gary Claxton, a health policy expert with the Kaiser Family Foundation. "Their average profit per person may not be as high, but they still should be able to earn a profit by insuring more people."
One major catch is that the consumer protections would not be available immediately. They are timed to take effect alongside government subsidies to help people buy coverage. In the House Democratic legislation, the coverage expansion would come in 2013 — after the next presidential elections. Part of the reason for the delay is to make the costs of the bill appear more manageable.
"It's a long time to wait," said John Rother, policy and strategy chief for AARP. "This is complicated stuff, but I would have personally liked to see it done in two years."
The House legislation, the Senate health committee bill and the evolving Senate Finance Committee package differ on some important specifics, but follow the same general approach.
All would set up an insurance marketplace. This exchange would be open to individuals and small businesses, and maybe big companies later on. Government subsidies would be available for low-to-middle income households. People buying health insurance through the exchange would be part of a large pool that spreads risks, giving participants leverage similar to what government employees — including lawmakers — now have.
Health plans offered through the exchange would have to meet basic standards, so it would be easier for consumers to understand what their insurance covers. To protect against catastrophic illness, there would be annual limits on out-of-pocket costs for co-payments and deductibles. Year-to-year increases in premiums would be more predictable for small companies.
Insurers could not charge more to people in poor health or to women, as they do now. But they still could charge higher premiums due to family size, geographic location and age.
The House and the Senate health committee bills would limit age-related premiums so that a 64-year-old pays no more than twice as much an 18-year-old. But Senate Finance Committee negotiators are considering allowing as much as a 5-to-1 difference, a big savings for the young but a significantly higher cost for older people who are more likely to have health problems.
The federal consumer protections would set a basic standard for the whole country, changing a situation in which state-level safeguards vary widely.
___
On the Net:
Employee Benefit Research Institute: http://www.ebri.org/
AARP: http://www.aarp.org/
Kaiser Family Foundation: http://www.kff.org/
Senate Finance Committee: http://finance.senate.gov/
Senate Health, Education, Labor and Pensions Committee: http://help.senate.gov/
House Energy and Commerce Committee: http://energycommerce.house.gov/
House Ways and Means Committee: http://waysandmeans.house.gov/
House Education and Labor Committee: http://edlabor.house.gov/
Rate of severe childhood obesity up sharply in U.S.|||
NEW YORK – The rate of severe obesity among U.S. children and teenagers more than tripled over the past three decades, a new study finds.
Using data from a long-running government health survey, researchers found that as of 2004, nearly 4 percent of 2- to 19-year-olds in the U.S. were severely obese.
That was up more than three-fold from 1976, and more than 70 percent from 1994, the researchers report in the journal Academic Pediatrics.
"Children are not only becoming obese, but becoming severely obese, which impacts their overall health," lead researcher Dr. Joseph A. Skelton, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said in a news release from the university.
"These findings," he added, "reinforce the fact that medically-based programs to treat obesity are needed throughout the United States and insurance companies should be encouraged to cover this care."
The study also found that minority and lower-income children are at particular risk of severe obesity -- which, in children and teenagers, is defined as having a body mass index in the 99th percentile for one's age and gender.
In the most recent survey, which included 12,000 2- to 19-year-olds from across the U.S., nearly 6 percent of African-American children and teens were severely obese, as were roughly 5 percent of Mexican- Americans. That compared with 3 percent of their white peers.
In contrast, less than 1 percent of Mexican-American children and less than 2 percent of black children were severely obese in the 1970s survey.
When it came to family income, the latest survey data show that just over 4 percent of relatively lower-income children were severely obese, versus 2.5 percent of those from higher-income families.
The findings underscore a central obstacle in tackling childhood obesity, Skelton and his colleagues note: The children who are most affected also generally have the greatest difficulty getting good healthcare.
"No simple answers exist," the researchers write, pointing out that along with better access to healthcare, there also need to be broader efforts to improve the diets and lifestyle habits of U.S. children.
SOURCE: Academic Pediatrics, September 2009.
Berlusconi reprimands state TV for attacking government|||
ROME – Italian Prime Minister Silvio Berlusconi on Monday said it was "unacceptable" for state TV to criticize the government and rebuked a left-leaning newspaper which regularly publishes lurid stories about his sex life.
Berlusconi, whose family media empire owns Italy's main independent television channels, said state-owned broadcaster RAI was always against him.
"I've been able to say what a majority of Italians think, which is that it is unacceptable that public television, paid for by all, should be the only public television that is always against the government," he told RAI radio.
As well as owning powerful broadcaster Mediaset, Berlusconi has a large majority in parliament which appoints RAI's board members, a position his critics say gives him far too much power over the media.
He attacked La Repubblica, the newspaper which has kept Italians riveted with steamy narratives by escorts of his parties and a daily list of 10 uncomfortable questions for the prime minister.
"The only thing that appears off course to me is a certain type of journalism," Berlusconi said in response to a question about articles in Repubblica suggesting Italian secret service agents had gone "off course" in their investigations.
Berlusconi has boasted that selections for RAI's top executives are made at his house. He started a Friday news conference by jokingly asking RAI journalists: "What's the atmosphere at RAI like with the directors I set up?"
The chairman of RAI's board later issued a statement saying it was the duty of journalists to report all the news.
Center-left opposition leader Dario Franceschini said Berlusconi's criticism of RAI was the "latest proof of his intention to use his economic force and the power of whoever is in government to condition and intimidate every free voice."
Berlusconi retorted that the left ought to be happy as he was asking state television not to criticize anyone -- be it the government or the opposition.
So far the opposition has yet to make much hay out of Berlusconi's scandals. Surveys show his popularity has fallen over the past few months, but he still polls 49 percent despite Italy's worst economic downturn since World War Two and the media frenzy surrounding his personal life.
Obama invokes mother39s battles against cancer insurers|||
WASHINGTON – Among the heartrending tales invoked by President Barack Obama as he stumps for healthcare reform, none is more poignant than that of his own mother's losing fight against cancer.
As he presses for an overhaul of the healthcare system, Obama often recounts the crises faced by Americans who with their jobs have lost their medical coverage, or who file for bankruptcy when faced with a health calamity.
But Exhibit A among the tragic examples is that of his own mother, Ann Dunham, who lost her fight to cancer nearly a decade and a half ago as she battled insurance companies.
"It's... personal for me," Obama told a crowd at a high-profile forum on Tuesday in Portsmouth, New Hampshire.
"I will never forget my own mother as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment," he told the crowd.
He was reprising a story he told frequently on the campaign trail, and more recently on the road, while drumming up support for his health industry reform agenda.
"The insurance company was arguing that somehow she should have known that she had cancer when she took her new job, even though it hadn't been diagnosed yet," Obama told the New Hampshire audience Tuesday.
"If it could happen to her, it could happen to any one of us. And I've heard from so many Americans who have the same worries."
In the preface to his first book, "Dreams From My Father," an elegy to his absentee dad, Obama also eulogizes the mother "whom we lost, with a brutal swiftness, to cancer a few months after this book was originally published."
According to some news accounts, Ann Dunham's cancer at first had been misdiagnosed in Indonesia as indigestion.
It was later determined by experts at the Memorial Sloan-Kettering Cancer Center in New York to be a fast-moving uterine cancer that had spread to her ovaries.
In remarks that seem informed by his mother's ordeal, Obama added that his goal now with healthcare reform is to set up a system "that gives a little bit of help to people who currently are working hard every day but they don't have healthcare insurance on the job."
He also hopes to ensure that patients already insured "are not going to be dropped because of a pre-existing conditions or because you lose your job or because you change your job -- that you're actually going to get what you pay for, that you're not going to find out when you're sick that you got cheated."
"If we can set up a system that gives you some security, that's worth a lot," he said.
His mother, who held a doctorate degree in anthropology, forged a career in international economic development, working for a while with the Ford Foundation in Jakarta and later with the US Agency for International Development and the World Bank, and helping to guide micro-enterprise projects to aid poor women.
Her mother's frustrating odyssey as a cancer patient also figured into his historic presidential campaign, when he vowed to remake the medical coverage system.
"In last painful months, she was more worried about paying her medical bills than getting well," Obama said in one campaign advertisement that aired in 2008.
"I hear stories like hers everyday. For 20 years Washington has talked about healthcare reform and reformed nothing. Unless we stop the bickering and the lobbyists we will be in the same place 20 years from now," he said.
Ann Dunham returned to her home state of Hawaii where she lived out the final months of her life, and died at the age of 53 on November 7, 1995, before Obama -- who by then was living in Chicago -- could get to her bedside to say goodbye.
Obama has said that his greatest regret is not being at his mother's side when she died, and has called her the most influential person in his life.
"I think sometimes that had I known she would not survive her illness, I might have written a different book -- less a meditation on the absent parent, more a celebration of the one who was the single constant in my life," he wrote in "Dreams From My Father."
"She was the kindest, most generous spirit I have ever known," Obama wrote, "and that what is best in me I owe to her."
China closes factory after 300 children poisoned report|||
BEIJING – Authorities in northern China Wednesday announced the closure of a smelting plant blamed for the lead poisoning of at least 300 children, state media reported.
The children, all living near the Dongling Lead and Zinc Smelting Co. plant in Changqing, Shaanxi province, were found to have as much as four times the normal maximum level of lead in their blood, Xinhua news agency said.
Nearly 1,000 children had now been tested and their results would be known in three to five days, it said.
It was not immediately clear how the children were poisoned but officials have been taking samples of groundwater, soil, air and sewage to check for contamination, and there was no mention of adult sickness.
Local county deputy head He Hongnian said the closure of the plant had been ordered on August 6, two weeks after a six-year-old girl was diagnosed with lead poisoning.
Anxious parents rushed their children to hospital for blood tests, with more than 300 lead poisoning cases reported by Sunday.
The lead levels in their blood ranged from 100 milligrams to 400 milligrams per litre, compared with normal levels of between zero and 100 milligrams, Xinhua said.
Above 200 milligrams is considered hazardous, with children more vulnerable to lead poisoning which can harm the nervous system.
"We live only 200 metres from the smelting firm. Lead pollution is certain," villager Sun Yagang, whose two-year-old son was diagnosed with lead poisoning, told Xinhua.
Residents who lived within 500 metres of the plant were supposed to have been relocated but so far only 156 out of nearly 581 families had been able to move to new homes, Xinhua said, citing Changqing town chief Pu Yiming.
The county government promised to speed up the relocation.
"We will ensure that all the remaining 425 families are relocated within two years," deputy county head He was quoted as saying.
Many poverty-stricken regions in China's interior have introduced high-polluting industries without the necessary environmental evaluation, in a desperate bid to boost economic growth, state media has said.
50 million women in Asia at risk of HIV infection UNAIDS|||
BALI, Indonesia – Fifty million women in Asia are at risk of being infected with HIV because of the risky sexual behavior of their husbands or boyfriends, leading health experts said in a report on Tuesday.
More than 90 percent of the 1.7 million women now living with HIV in Asia became infected while being in monogamous, long-term relationships with men who engaged in risky sex behavior, the report launched by UNAIDS said.
These include men who had other sexual partners or who were drug users.
"We need to target men who engage in paid sex, injecting drug users, men who have sex with men, who can transmit the virus to their partners," Jean D'Cunha, regional director of the United Nations Development Fund for Women in South Asia, told a news conference held on the margins of an HIV/AIDS conference in Bali.
"We need to question the attitudes, values and behavior and transform these so that women would be less vulnerable to
HIV/AIDS."
While the issue of gender inequality is often ignored or laughed off, experts say it cannot be taken lightly in the context of HIV/AIDS, a disease that can be transmitted through sexual contact and which is incurable.
Sex workers, who have very little bargaining power to begin with, are usually forced to comply when their clients refuse to use condoms. Back home, the wives of these men too have no power to demand that condoms be used even if they know about the risky sexual behavior of their husbands.
While the fight against the AIDS epidemic has seen progress on some fronts, women continue to bear the brunt of it. Women make up 35 percent of all adult HIV infections in Asia now, up from 17 percent in 1990.
REVERSING A CULTURE
Maire Bopp-Allport, head of the Pacific Islands Aids Foundation, contracted the AIDS virus from her boyfriend around 1996. Today, she is a familiar figure in the global fight against the disease.
"At the heart of the issue is thousands of years of education to our males that it's okay to think that women are there to simply serve them and do everything they want. We need to bring a new culture where it's not okay," she told Reuters.
"They need to be able to think that the abuse of a woman is the abuse of their daughters when their daughters become women," she added.
Not enough shuteye may raise diabetes risk|||
NEW YORK – An inadequate amount of nightly sleep on a recurring basis, coupled with a sedentary lifestyle and overeating, may fuel the development of diabetes, results of a new study hint.
"Our findings suggest that combining the unhealthy aspects of the Westernized lifestyle with insufficient sleep may add to the risk of overweight and sedentary individuals to develop diabetes," Dr. Plamen Penev, of the University of Chicago, Illinois, and a senior author of the study, told Reuters Health.
Penev and colleagues subjected 11 healthy but sedentary middle-aged men and women to two 14-day periods of sedentary living with free access to food and either 5.5 hours or 8.5 hours of sleep each night.
As nightly sleep times changed from 8.5 to 5.5 hours, the participants went to bed later and got out of bed earlier and, as a result, average sleep duration was reduced by about two hours a day.
When the adults had their bedtimes decreased from a healthy 8.5 hours to 5.5 hours they showed changes in their response to two common sugar tests, which were similar to those seen in people with an increased risk of developing diabetes.
"If confirmed by future larger studies," Penev told Reuters Health, "these results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep."
SOURCE: Journal of Clinical Endocrinology and Metabolism, September 2009.
FDA concludes mercury in dental fillings not risky|||
WASHINGTON – The government declared Tuesday that silver dental fillings contain too little mercury to harm the millions who've had cavities filled with them — including young children — and that only people allergic to mercury need to avoid them.
It was something of an about-face for the Food and Drug Administration, which last year settled a lawsuit with anti-mercury activists by posting on its Web site a precaution saying questions remained about whether the small amount of mercury vapor the fillings can release were enough to harm the developing brains of fetuses or the very young.
On Tuesday, the FDA said its final scientific review ended that concern. Still, the agency did slightly strengthen how it regulates the fillings, urging dentists to provide their patients with a government-written statement detailing the mercury controversy and what science shows.
"The best available scientific evidence supports the conclusion that patients with dental amalgam fillings are not at risk for mercury-associated adverse health effects," said Dr. Susan Runner, FDA's dental products director.
Anti-mercury activists accused the agency of bowing to the dental industry and said they'd go back to court to try to force a change.
"FDA broke its contract and broke its word that it would put warnings for children and unborn children," said Charles Brown of Consumers for Dental Choice. "This contemptuous attitude toward children and the unborn will not go unanswered."
Too much mercury can harm the brain. It has made headlines in recent years as scientists have warned that some types of seafood contain enough to harm a fetus or young child.
Used since the 1800s, amalgam fillings are a mix of a different kind of mercury — a kind the body absorbs differently — with silver, copper and tin to harden it.
Tuesday, the FDA took the regulatory step of formally classifying amalgam fillings as a Class II or "moderate risk" medical device to ensure that dentists handle the mercury properly — using adequate ventilation — but to allow the allergy warning. Until now, the FDA had classified the fillings' ingredients separately.
The practical effect of that technical change? The FDA released its review of 200 scientific studies that found no risk to adults or children over 6 from the fillings.
What about pregnant women or younger children? Tuesday's ruling supersedes the precaution from last year's lawsuit settlement, Runner said.
The FDA found that while there have been only a handful of rigorous studies comparing young children given either amalgam fillings or mercury-free tooth-colored resin composite ones, those studies haven't detected any brain problems. Runner cited additional evidence concluding that babies and young children would be exposed to amounts well below safety limits.
But the statement dentists are urged to share with patients does raise the issue so that people who are concerned about the mercury can discuss an alternative.
Removing the fillings actually releases more mercury vapor, FDA said. People who think they're allergic to a filling ingredient should discuss that with a dentist.
Amalgams now account for about 30 percent of U.S. fillings, their popularity dropping in favor of tooth-colored alternatives. But they remain the cheapest filling and dentists say there are some conditions that demand amalgams, such as spots on back teeth that won't stay dry long enough for composite fillings to bond.
___
On the Net:
FDA: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/default.htm
Obese Texas man hides gun between rolls of fat|||
WASHINGTON – An obese prisoner in Harris County, Texas has been charged with illegal possession of a firearm after he was discovered to be hiding a 9mm pistol in between his rolls of fat, local media reported Saturday.
George Vera, who weighs around 500 pounds was originally arrested last week for selling counterfeit CDs, according to the Houston Chronicle newspaper.
A police spokesman told the Chronicle that Vera was searched three times over the course of his arrest and booking at the jail but managed to conceal the handgun with his rolls of fat until it was discovered in the shower.
Vera has been charged with possession of an illegal weapon in a correctional facility, which carries a penalty of two to 10 years in prison, but is currently free on bail of 10,000 dollars.
Any spread of breast cancer raises risk of return|||
Breast cancer patients with even the tiniest spread of the disease to a lymph node have a much higher risk of it recurring years later and may need more treatment than just surgery, new research suggests.
For years, doctors and patients have struggled with what to do about a microscopic tumor or stray cancer cells in a lymph node. Women with "micro tumors" usually are given estrogen-blocking drugs, chemotherapy or both; those with isolated cancer cells usually are not, because those were thought to be of low concern.
The new study challenges that view. It suggests that either type of metastasis, or spread, raises a woman's risk of having cancer show up in the breast or anywhere else in the next five years by about 50 percent.
"This took an area that was very gray and I think made it black and white," said Dr. Linda Vahdat, director of breast cancer research at Weill Cornell Medical College and an adviser for the breast cancer patient Web site of ASCO, the American Society of Clinical Oncology.
"I think it will influence treatment," she said of the study. "If we're considering treating the patient, we probably should."
Dr. Daniel Hayes, director of breast cancer treatment at the University of Michigan, agreed.
"It really does look like our biases are wrong," he said. "For the first time, it suggests that isolated tumor cells or micrometastases do have biological significance."
Vahdat and Hayes had no role in the study, which was done by researchers throughout the Netherlands. Results are in Thursday's New England Journal of Medicine.
The study is not ideal: It just observed a large number of women rather than assigning some to get treatment and comparing how they fared to others who were not treated. The study also was done at a time when treatment was less aggressive and in a country where doctors had been treating breast cancer more conservatively than in the United States.
In the U.S., many women with early stage breast cancer are given hormone blockers.
"The big issue is, should these patients also get chemotherapy?" Hayes said.
However, not all women benefit from chemotherapy even when their risk of a recurrence is high, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.
"Patients are looking for more specific treatment" tailored to their individual tumor type — not necessarily more or less treatment, he said.
The Dutch study involved more than 2,700 women with low-risk, early stage cancer — small tumors that did not seem aggressive. All had surgery to remove their breast tumors. All of their armpit lymph nodes or a few key ones called "sentinel" nodes were removed and checked for signs of cancer. Doctors do this by examining tissue slices from the nodes and using special stains to make cancer cells show up.
Larger tumors in lymph nodes already trigger further treatment. A micro tumor is a cluster of cells less than 2 millimeters — smaller than one-tenth of an inch. Most, but not all, doctors would treat these, too. Isolated tumor cells are even tinier — "you can essentially count them" in a tissue sample, Winer said — and do not typically spur further treatment under current guidelines.
The Dutch researchers compared patients based on whether they received treatment beyond surgery and whether cancer of various amounts was found in a lymph node.
In most cases, breast cancer doesn't return after surgery. Among women in the study who were given no additional treatment, 86 percent of those with no cancer in lymph nodes were free of cancer five years later. Only 76 percent of those with micro tumors and 77 percent of those with isolated cancer cells were cancer-free.
That translates to a roughly 50 percent greater risk of recurrence if any sign of cancer was present in a node.
Also, women with micro tumors or stray cells who were given additional treatment had a 43 percent lower risk of a cancer recurrence than similar women not treated beyond surgery.
The differences should lead doctors to reconsider guidelines for how tumors are classified, which guides the amount of treatment a woman receives, the authors write. Now, a micro tumor is considered "node positive" cancer, warranting further treatment, while isolated cells are called "node negative."
A new version of the guidelines is due out soon, Hayes said.
___
On the Net:
New England Journal: http://www.nejm.org
8 cities in US line up for swine flu vaccine test|||
ST. LOUIS – Hundreds of Americans in eight cities are lining up for experimental swine flu shots in a race to get a vaccine out in case the new flu virus regains strength this fall and winter.
Sharon Frey, who is leading the government-funded testing at Saint Louis University, said scientists have been working late nights and weekends to organize the studies and recruit volunteers.
"Typically it takes a year to do this," said Frey, an infectious diseases expert. "I can tell you we're working at breakneck speed."
About 2,800 people will participate in the government-led studies. Saint Louis University will test 200 adults and 200 children. Also under way are separate studies by five flu vaccine manufacturers under contract with the government.
Health officials expect to have about 160 million doses available this fall, with the first batch sometime in September. The studies will test the safety and effectiveness of vaccines developed by drug makers and help determine dosage and whether it can be given with a seasonal flu shot.
Participants will be given different combinations of two swine flu vaccines made by drug makers Sanofi Pasteur and CSL Limited and a seasonal flu vaccine.
Frey said the data will be turned around quickly for review by the Food and Drug Administration.
It's possible the government will begin a public vaccination campaign before all of the work of the trials is complete, Dr. Anne Schuchat has said. She oversees the flu vaccination programs at the Centers for Disease Control and Prevention.
Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, the government wants to carefully monitor people who get the new vaccine for any problems.
Nicholas Sarakas, 25, of St. Peters, Mo., is among the vaccine volunteers. As a young adult, he's among the groups targeted for the swine flu vaccine; swine flu has been harder on younger people than their elders.
"I thought, 'I'll end up getting a flu shot anyway,'" he said. "Somebody has to be the first person to try it."
The other study sites are Baylor College of Medicine in Texas, Children's Hospital Medical Center in Cincinnati, Emory University, Group Health Cooperative in Seattle, University of Iowa, University of Maryland School of Medicine and Vanderbilt University.
___
On the Net:
NIH swine flu vaccine trial Q&A: http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm
Veterinarians using stem cells to treat animals|||
MIAMI – Five-year-old Lucy the Labradoodle's back limbs have been rendered unusable by rheumatoid arthritis, and she must scoot along the ground with her front paws to grab a bone. Her owners believe that a costly stem-cell treatment is the reason she's even lived as long as she has.
In fact, they say, she seems to be improving. She no longer yelps or whimpers in pain, and she needs far less medicine than before. Lucy's owners credit the stem cell treatment, despite what experts say is a lack of evidence such treatments work.
"We didn't think she'd live anywhere near this long, and I know it's because of the stem cells," says owner Carol Fischman, 57, of Vero Beach.
Thousands of dogs and horses with degenerative arthritis have had stem cell treatments, costing around $2,500 to $3,000 per procedure. There are no independent studies verifying their effectiveness, and some experts say such studies are needed to assess their potential.
University of Florida veterinarian Kristin Kirkby, who performed Lucy's procedure, said that the outcomes on five similar treatments have all been positive. But that's from owner-reported results, not scientific scrutiny.
Owners tell her their dogs have an easier time getting around the house and getting into position to urinate. Mostly, they just report their dogs appear to be more comfortable overall.
To get hard results, Kirkby says the university plans to start taking a pain inventory of each animal at the beginning of the process, followed by an evaluation and checkups afterward to measure changes.
"I think it's an exciting field. Undoubtedly the future of scientific research is going this way," Kirkby said. "It's early on, especially in the small animal side, to know what the results can be."
Vet-Stem, a Poway, Calif.-based company, is developing the stem cell therapy and began treating horses in 2003. It derives stem cells from fat samples taken from dogs and horses across the country.
The procedure has been used mainly to treat osteoarthritis, which involves loss of cartilage in the joints, but Vet-Stem is researching treatments for other diseases. Vet-Stem claims the therapy enables animals to replace cartilage and other tissue.
Since 2003, the privately held company has treated 3,500 horses and 1,500 dogs and plans to begin treating cats later this year. More than 1,500 vets are licensed to use the procedure.
Dr. Bob Harman, veterinarian and Vet-Stem founder, said it made sense to use these fat-based adult stem cells, which the body uses to create scar tissue and repair damage, to treat chronic disease in animals.
"Really, all we're doing is harnessing the existing repair machinery in the body, concentrating it, and putting it right where an injury occurs, where healing is needed, to heal naturally," he said
Adam Gassel has used stem cells to treat almost 40 dogs at his Irvine, Calif., veterinary clinic during the past two years.
"I was pretty skeptical," he said. "I was hoping that dogs would just be more comfortable."
But for about 25 percent of dogs, their owners report they are like puppies again, able to get back to normal activities, he said. Another 25 percent are able to stop taking medicines they were dependent upon. In all, Gassel said, all but 20 percent of the animals show some positive response to the therapy, according to their owners and the requests for pain medicine.
One peer-reviewed study by researchers at Cornell University, published in the American Journal of Veterinary Research and sponsored in part by Vet-Stem, found that tendinitis in horses was improved by injection of the adult stem cells.
Two other studies published in Veterinary Therapeutics found that dogs with osteoarthritis showed improvements in lameness after stem cell injections. Those studies also were sponsored by Vet-Stem and conducted by Vet-Stem researchers and other veterinarians.
Jonathan Slack, director of the University of Minnesota's Stem Cell Research Institute, said adult stem cells from fat can become cartilage in a laboratory cell culture. Conclusive results on whether the stem-cell injection process actually makes new bone cells in animals don't exist, to his knowledge.
"I guess from the dog's point of view," Slack said, "it's good if it does work."
Whatever the scientific merits of the therapies, Lucy's owners say they would do it again for her.
She's had her stem cell treatments through an IV three times, and the Fischmans want to give her a fourth one soon, despite the $3,000-per-procedure cost.
"I like the dog as much as I like my kids," said Dr. Charles Fischman, 59, who is an immunologist. "People will spend more on their dogs than they will on themselves."
Consumer protections lost in health care debate|||
WASHINGTON – It's one issue in the health care debate that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.
Yet such practical considerations are being overlooked in a debate that's become a passionate argument about the government's reach and role in medical matters.
Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.
Insurers no longer could base premiums on a person's medical history, although they still could charge more to 50-year-olds than to people in their 20s.
People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate "job lock," the fear of leaving employment that provides medical benefits.
"It would bring insurance and insurabilty standards into line with medical practice and with the way people live their lives," said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute. "When people are in the doctor's office, they're worried about that day's issue. You're not thinking, 'If I take this pill for my cholesterol, will it cause me to be denied insurance coverage in the future?'"
If President Barack Obama's effort to remake the health care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they're seriously ill.
Major insurers will accept a rollback of the industry's restrictive practices only if they're guaranteed that all Americans would be covered — a central goal of Obama's approach and a potential financial boon to the industry.
The consumer protections are part of what Republican Sen. Mike Enzi of Wyoming calls the 80 percent of health care fixes that there's consensus for. Enzi is one of six members of the Senate Finance Committee who are trying work out a bipartisan solution — with no guarantee of success.
Obama may have made a critical error by not stressing the consumer aspects of the legislation, and his advisers seem to have realized it as they belatedly retooled the White House pitch in recent days.
If a bill does pass, the biggest winners are likely to be self-employed people and small-business owners and employees, who now have the most trouble getting and keeping coverage. Those working for big companies would only benefit indirectly; they'd find it easier to keep their coverage if they get laid off or leave to launch a new career.
Insurance companies could come out ahead, too.
"They'll get a big new market with millions and millions of new customers," said Gary Claxton, a health policy expert with the Kaiser Family Foundation. "Their average profit per person may not be as high, but they still should be able to earn a profit by insuring more people."
One major catch is that the consumer protections would not be available immediately. They are timed to take effect alongside government subsidies to help people buy coverage. In the House Democratic legislation, the coverage expansion would come in 2013 — after the next presidential elections. Part of the reason for the delay is to make the costs of the bill appear more manageable.
"It's a long time to wait," said John Rother, policy and strategy chief for AARP. "This is complicated stuff, but I would have personally liked to see it done in two years."
The House legislation, the Senate health committee bill and the evolving Senate Finance Committee package differ on some important specifics, but follow the same general approach.
All would set up an insurance marketplace. This exchange would be open to individuals and small businesses, and maybe big companies later on. Government subsidies would be available for low-to-middle income households. People buying health insurance through the exchange would be part of a large pool that spreads risks, giving participants leverage similar to what government employees — including lawmakers — now have.
Health plans offered through the exchange would have to meet basic standards, so it would be easier for consumers to understand what their insurance covers. To protect against catastrophic illness, there would be annual limits on out-of-pocket costs for co-payments and deductibles. Year-to-year increases in premiums would be more predictable for small companies.
Insurers could not charge more to people in poor health or to women, as they do now. But they still could charge higher premiums due to family size, geographic location and age.
The House and the Senate health committee bills would limit age-related premiums so that a 64-year-old pays no more than twice as much an 18-year-old. But Senate Finance Committee negotiators are considering allowing as much as a 5-to-1 difference, a big savings for the young but a significantly higher cost for older people who are more likely to have health problems.
The federal consumer protections would set a basic standard for the whole country, changing a situation in which state-level safeguards vary widely.
___
On the Net:
Employee Benefit Research Institute: http://www.ebri.org/
AARP: http://www.aarp.org/
Kaiser Family Foundation: http://www.kff.org/
Senate Finance Committee: http://finance.senate.gov/
Senate Health, Education, Labor and Pensions Committee: http://help.senate.gov/
House Energy and Commerce Committee: http://energycommerce.house.gov/
House Ways and Means Committee: http://waysandmeans.house.gov/
House Education and Labor Committee: http://edlabor.house.gov/
Rate of severe childhood obesity up sharply in U.S.|||
NEW YORK – The rate of severe obesity among U.S. children and teenagers more than tripled over the past three decades, a new study finds.
Using data from a long-running government health survey, researchers found that as of 2004, nearly 4 percent of 2- to 19-year-olds in the U.S. were severely obese.
That was up more than three-fold from 1976, and more than 70 percent from 1994, the researchers report in the journal Academic Pediatrics.
"Children are not only becoming obese, but becoming severely obese, which impacts their overall health," lead researcher Dr. Joseph A. Skelton, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said in a news release from the university.
"These findings," he added, "reinforce the fact that medically-based programs to treat obesity are needed throughout the United States and insurance companies should be encouraged to cover this care."
The study also found that minority and lower-income children are at particular risk of severe obesity -- which, in children and teenagers, is defined as having a body mass index in the 99th percentile for one's age and gender.
In the most recent survey, which included 12,000 2- to 19-year-olds from across the U.S., nearly 6 percent of African-American children and teens were severely obese, as were roughly 5 percent of Mexican- Americans. That compared with 3 percent of their white peers.
In contrast, less than 1 percent of Mexican-American children and less than 2 percent of black children were severely obese in the 1970s survey.
When it came to family income, the latest survey data show that just over 4 percent of relatively lower-income children were severely obese, versus 2.5 percent of those from higher-income families.
The findings underscore a central obstacle in tackling childhood obesity, Skelton and his colleagues note: The children who are most affected also generally have the greatest difficulty getting good healthcare.
"No simple answers exist," the researchers write, pointing out that along with better access to healthcare, there also need to be broader efforts to improve the diets and lifestyle habits of U.S. children.
SOURCE: Academic Pediatrics, September 2009.
Berlusconi reprimands state TV for attacking government|||
ROME – Italian Prime Minister Silvio Berlusconi on Monday said it was "unacceptable" for state TV to criticize the government and rebuked a left-leaning newspaper which regularly publishes lurid stories about his sex life.
Berlusconi, whose family media empire owns Italy's main independent television channels, said state-owned broadcaster RAI was always against him.
"I've been able to say what a majority of Italians think, which is that it is unacceptable that public television, paid for by all, should be the only public television that is always against the government," he told RAI radio.
As well as owning powerful broadcaster Mediaset, Berlusconi has a large majority in parliament which appoints RAI's board members, a position his critics say gives him far too much power over the media.
He attacked La Repubblica, the newspaper which has kept Italians riveted with steamy narratives by escorts of his parties and a daily list of 10 uncomfortable questions for the prime minister.
"The only thing that appears off course to me is a certain type of journalism," Berlusconi said in response to a question about articles in Repubblica suggesting Italian secret service agents had gone "off course" in their investigations.
Berlusconi has boasted that selections for RAI's top executives are made at his house. He started a Friday news conference by jokingly asking RAI journalists: "What's the atmosphere at RAI like with the directors I set up?"
The chairman of RAI's board later issued a statement saying it was the duty of journalists to report all the news.
Center-left opposition leader Dario Franceschini said Berlusconi's criticism of RAI was the "latest proof of his intention to use his economic force and the power of whoever is in government to condition and intimidate every free voice."
Berlusconi retorted that the left ought to be happy as he was asking state television not to criticize anyone -- be it the government or the opposition.
So far the opposition has yet to make much hay out of Berlusconi's scandals. Surveys show his popularity has fallen over the past few months, but he still polls 49 percent despite Italy's worst economic downturn since World War Two and the media frenzy surrounding his personal life.
Obama invokes mother39s battles against cancer insurers|||
WASHINGTON – Among the heartrending tales invoked by President Barack Obama as he stumps for healthcare reform, none is more poignant than that of his own mother's losing fight against cancer.
As he presses for an overhaul of the healthcare system, Obama often recounts the crises faced by Americans who with their jobs have lost their medical coverage, or who file for bankruptcy when faced with a health calamity.
But Exhibit A among the tragic examples is that of his own mother, Ann Dunham, who lost her fight to cancer nearly a decade and a half ago as she battled insurance companies.
"It's... personal for me," Obama told a crowd at a high-profile forum on Tuesday in Portsmouth, New Hampshire.
"I will never forget my own mother as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment," he told the crowd.
He was reprising a story he told frequently on the campaign trail, and more recently on the road, while drumming up support for his health industry reform agenda.
"The insurance company was arguing that somehow she should have known that she had cancer when she took her new job, even though it hadn't been diagnosed yet," Obama told the New Hampshire audience Tuesday.
"If it could happen to her, it could happen to any one of us. And I've heard from so many Americans who have the same worries."
In the preface to his first book, "Dreams From My Father," an elegy to his absentee dad, Obama also eulogizes the mother "whom we lost, with a brutal swiftness, to cancer a few months after this book was originally published."
According to some news accounts, Ann Dunham's cancer at first had been misdiagnosed in Indonesia as indigestion.
It was later determined by experts at the Memorial Sloan-Kettering Cancer Center in New York to be a fast-moving uterine cancer that had spread to her ovaries.
In remarks that seem informed by his mother's ordeal, Obama added that his goal now with healthcare reform is to set up a system "that gives a little bit of help to people who currently are working hard every day but they don't have healthcare insurance on the job."
He also hopes to ensure that patients already insured "are not going to be dropped because of a pre-existing conditions or because you lose your job or because you change your job -- that you're actually going to get what you pay for, that you're not going to find out when you're sick that you got cheated."
"If we can set up a system that gives you some security, that's worth a lot," he said.
His mother, who held a doctorate degree in anthropology, forged a career in international economic development, working for a while with the Ford Foundation in Jakarta and later with the US Agency for International Development and the World Bank, and helping to guide micro-enterprise projects to aid poor women.
Her mother's frustrating odyssey as a cancer patient also figured into his historic presidential campaign, when he vowed to remake the medical coverage system.
"In last painful months, she was more worried about paying her medical bills than getting well," Obama said in one campaign advertisement that aired in 2008.
"I hear stories like hers everyday. For 20 years Washington has talked about healthcare reform and reformed nothing. Unless we stop the bickering and the lobbyists we will be in the same place 20 years from now," he said.
Ann Dunham returned to her home state of Hawaii where she lived out the final months of her life, and died at the age of 53 on November 7, 1995, before Obama -- who by then was living in Chicago -- could get to her bedside to say goodbye.
Obama has said that his greatest regret is not being at his mother's side when she died, and has called her the most influential person in his life.
"I think sometimes that had I known she would not survive her illness, I might have written a different book -- less a meditation on the absent parent, more a celebration of the one who was the single constant in my life," he wrote in "Dreams From My Father."
"She was the kindest, most generous spirit I have ever known," Obama wrote, "and that what is best in me I owe to her."
China closes factory after 300 children poisoned report|||
BEIJING – Authorities in northern China Wednesday announced the closure of a smelting plant blamed for the lead poisoning of at least 300 children, state media reported.
The children, all living near the Dongling Lead and Zinc Smelting Co. plant in Changqing, Shaanxi province, were found to have as much as four times the normal maximum level of lead in their blood, Xinhua news agency said.
Nearly 1,000 children had now been tested and their results would be known in three to five days, it said.
It was not immediately clear how the children were poisoned but officials have been taking samples of groundwater, soil, air and sewage to check for contamination, and there was no mention of adult sickness.
Local county deputy head He Hongnian said the closure of the plant had been ordered on August 6, two weeks after a six-year-old girl was diagnosed with lead poisoning.
Anxious parents rushed their children to hospital for blood tests, with more than 300 lead poisoning cases reported by Sunday.
The lead levels in their blood ranged from 100 milligrams to 400 milligrams per litre, compared with normal levels of between zero and 100 milligrams, Xinhua said.
Above 200 milligrams is considered hazardous, with children more vulnerable to lead poisoning which can harm the nervous system.
"We live only 200 metres from the smelting firm. Lead pollution is certain," villager Sun Yagang, whose two-year-old son was diagnosed with lead poisoning, told Xinhua.
Residents who lived within 500 metres of the plant were supposed to have been relocated but so far only 156 out of nearly 581 families had been able to move to new homes, Xinhua said, citing Changqing town chief Pu Yiming.
The county government promised to speed up the relocation.
"We will ensure that all the remaining 425 families are relocated within two years," deputy county head He was quoted as saying.
Many poverty-stricken regions in China's interior have introduced high-polluting industries without the necessary environmental evaluation, in a desperate bid to boost economic growth, state media has said.
50 million women in Asia at risk of HIV infection UNAIDS|||
BALI, Indonesia – Fifty million women in Asia are at risk of being infected with HIV because of the risky sexual behavior of their husbands or boyfriends, leading health experts said in a report on Tuesday.
More than 90 percent of the 1.7 million women now living with HIV in Asia became infected while being in monogamous, long-term relationships with men who engaged in risky sex behavior, the report launched by UNAIDS said.
These include men who had other sexual partners or who were drug users.
"We need to target men who engage in paid sex, injecting drug users, men who have sex with men, who can transmit the virus to their partners," Jean D'Cunha, regional director of the United Nations Development Fund for Women in South Asia, told a news conference held on the margins of an HIV/AIDS conference in Bali.
"We need to question the attitudes, values and behavior and transform these so that women would be less vulnerable to
HIV/AIDS."
While the issue of gender inequality is often ignored or laughed off, experts say it cannot be taken lightly in the context of HIV/AIDS, a disease that can be transmitted through sexual contact and which is incurable.
Sex workers, who have very little bargaining power to begin with, are usually forced to comply when their clients refuse to use condoms. Back home, the wives of these men too have no power to demand that condoms be used even if they know about the risky sexual behavior of their husbands.
While the fight against the AIDS epidemic has seen progress on some fronts, women continue to bear the brunt of it. Women make up 35 percent of all adult HIV infections in Asia now, up from 17 percent in 1990.
REVERSING A CULTURE
Maire Bopp-Allport, head of the Pacific Islands Aids Foundation, contracted the AIDS virus from her boyfriend around 1996. Today, she is a familiar figure in the global fight against the disease.
"At the heart of the issue is thousands of years of education to our males that it's okay to think that women are there to simply serve them and do everything they want. We need to bring a new culture where it's not okay," she told Reuters.
"They need to be able to think that the abuse of a woman is the abuse of their daughters when their daughters become women," she added.
Not enough shuteye may raise diabetes risk|||
NEW YORK – An inadequate amount of nightly sleep on a recurring basis, coupled with a sedentary lifestyle and overeating, may fuel the development of diabetes, results of a new study hint.
"Our findings suggest that combining the unhealthy aspects of the Westernized lifestyle with insufficient sleep may add to the risk of overweight and sedentary individuals to develop diabetes," Dr. Plamen Penev, of the University of Chicago, Illinois, and a senior author of the study, told Reuters Health.
Penev and colleagues subjected 11 healthy but sedentary middle-aged men and women to two 14-day periods of sedentary living with free access to food and either 5.5 hours or 8.5 hours of sleep each night.
As nightly sleep times changed from 8.5 to 5.5 hours, the participants went to bed later and got out of bed earlier and, as a result, average sleep duration was reduced by about two hours a day.
When the adults had their bedtimes decreased from a healthy 8.5 hours to 5.5 hours they showed changes in their response to two common sugar tests, which were similar to those seen in people with an increased risk of developing diabetes.
"If confirmed by future larger studies," Penev told Reuters Health, "these results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep."
SOURCE: Journal of Clinical Endocrinology and Metabolism, September 2009.
FDA concludes mercury in dental fillings not risky|||
WASHINGTON – The government declared Tuesday that silver dental fillings contain too little mercury to harm the millions who've had cavities filled with them — including young children — and that only people allergic to mercury need to avoid them.
It was something of an about-face for the Food and Drug Administration, which last year settled a lawsuit with anti-mercury activists by posting on its Web site a precaution saying questions remained about whether the small amount of mercury vapor the fillings can release were enough to harm the developing brains of fetuses or the very young.
On Tuesday, the FDA said its final scientific review ended that concern. Still, the agency did slightly strengthen how it regulates the fillings, urging dentists to provide their patients with a government-written statement detailing the mercury controversy and what science shows.
"The best available scientific evidence supports the conclusion that patients with dental amalgam fillings are not at risk for mercury-associated adverse health effects," said Dr. Susan Runner, FDA's dental products director.
Anti-mercury activists accused the agency of bowing to the dental industry and said they'd go back to court to try to force a change.
"FDA broke its contract and broke its word that it would put warnings for children and unborn children," said Charles Brown of Consumers for Dental Choice. "This contemptuous attitude toward children and the unborn will not go unanswered."
Too much mercury can harm the brain. It has made headlines in recent years as scientists have warned that some types of seafood contain enough to harm a fetus or young child.
Used since the 1800s, amalgam fillings are a mix of a different kind of mercury — a kind the body absorbs differently — with silver, copper and tin to harden it.
Tuesday, the FDA took the regulatory step of formally classifying amalgam fillings as a Class II or "moderate risk" medical device to ensure that dentists handle the mercury properly — using adequate ventilation — but to allow the allergy warning. Until now, the FDA had classified the fillings' ingredients separately.
The practical effect of that technical change? The FDA released its review of 200 scientific studies that found no risk to adults or children over 6 from the fillings.
What about pregnant women or younger children? Tuesday's ruling supersedes the precaution from last year's lawsuit settlement, Runner said.
The FDA found that while there have been only a handful of rigorous studies comparing young children given either amalgam fillings or mercury-free tooth-colored resin composite ones, those studies haven't detected any brain problems. Runner cited additional evidence concluding that babies and young children would be exposed to amounts well below safety limits.
But the statement dentists are urged to share with patients does raise the issue so that people who are concerned about the mercury can discuss an alternative.
Removing the fillings actually releases more mercury vapor, FDA said. People who think they're allergic to a filling ingredient should discuss that with a dentist.
Amalgams now account for about 30 percent of U.S. fillings, their popularity dropping in favor of tooth-colored alternatives. But they remain the cheapest filling and dentists say there are some conditions that demand amalgams, such as spots on back teeth that won't stay dry long enough for composite fillings to bond.
___
On the Net:
FDA: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/default.htm
Obese Texas man hides gun between rolls of fat|||
WASHINGTON – An obese prisoner in Harris County, Texas has been charged with illegal possession of a firearm after he was discovered to be hiding a 9mm pistol in between his rolls of fat, local media reported Saturday.
George Vera, who weighs around 500 pounds was originally arrested last week for selling counterfeit CDs, according to the Houston Chronicle newspaper.
A police spokesman told the Chronicle that Vera was searched three times over the course of his arrest and booking at the jail but managed to conceal the handgun with his rolls of fat until it was discovered in the shower.
Vera has been charged with possession of an illegal weapon in a correctional facility, which carries a penalty of two to 10 years in prison, but is currently free on bail of 10,000 dollars.
Any spread of breast cancer raises risk of return|||
Breast cancer patients with even the tiniest spread of the disease to a lymph node have a much higher risk of it recurring years later and may need more treatment than just surgery, new research suggests.
For years, doctors and patients have struggled with what to do about a microscopic tumor or stray cancer cells in a lymph node. Women with "micro tumors" usually are given estrogen-blocking drugs, chemotherapy or both; those with isolated cancer cells usually are not, because those were thought to be of low concern.
The new study challenges that view. It suggests that either type of metastasis, or spread, raises a woman's risk of having cancer show up in the breast or anywhere else in the next five years by about 50 percent.
"This took an area that was very gray and I think made it black and white," said Dr. Linda Vahdat, director of breast cancer research at Weill Cornell Medical College and an adviser for the breast cancer patient Web site of ASCO, the American Society of Clinical Oncology.
"I think it will influence treatment," she said of the study. "If we're considering treating the patient, we probably should."
Dr. Daniel Hayes, director of breast cancer treatment at the University of Michigan, agreed.
"It really does look like our biases are wrong," he said. "For the first time, it suggests that isolated tumor cells or micrometastases do have biological significance."
Vahdat and Hayes had no role in the study, which was done by researchers throughout the Netherlands. Results are in Thursday's New England Journal of Medicine.
The study is not ideal: It just observed a large number of women rather than assigning some to get treatment and comparing how they fared to others who were not treated. The study also was done at a time when treatment was less aggressive and in a country where doctors had been treating breast cancer more conservatively than in the United States.
In the U.S., many women with early stage breast cancer are given hormone blockers.
"The big issue is, should these patients also get chemotherapy?" Hayes said.
However, not all women benefit from chemotherapy even when their risk of a recurrence is high, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.
"Patients are looking for more specific treatment" tailored to their individual tumor type — not necessarily more or less treatment, he said.
The Dutch study involved more than 2,700 women with low-risk, early stage cancer — small tumors that did not seem aggressive. All had surgery to remove their breast tumors. All of their armpit lymph nodes or a few key ones called "sentinel" nodes were removed and checked for signs of cancer. Doctors do this by examining tissue slices from the nodes and using special stains to make cancer cells show up.
Larger tumors in lymph nodes already trigger further treatment. A micro tumor is a cluster of cells less than 2 millimeters — smaller than one-tenth of an inch. Most, but not all, doctors would treat these, too. Isolated tumor cells are even tinier — "you can essentially count them" in a tissue sample, Winer said — and do not typically spur further treatment under current guidelines.
The Dutch researchers compared patients based on whether they received treatment beyond surgery and whether cancer of various amounts was found in a lymph node.
In most cases, breast cancer doesn't return after surgery. Among women in the study who were given no additional treatment, 86 percent of those with no cancer in lymph nodes were free of cancer five years later. Only 76 percent of those with micro tumors and 77 percent of those with isolated cancer cells were cancer-free.
That translates to a roughly 50 percent greater risk of recurrence if any sign of cancer was present in a node.
Also, women with micro tumors or stray cells who were given additional treatment had a 43 percent lower risk of a cancer recurrence than similar women not treated beyond surgery.
The differences should lead doctors to reconsider guidelines for how tumors are classified, which guides the amount of treatment a woman receives, the authors write. Now, a micro tumor is considered "node positive" cancer, warranting further treatment, while isolated cells are called "node negative."
A new version of the guidelines is due out soon, Hayes said.
___
On the Net:
New England Journal: http://www.nejm.org
Consumer protections lost in health care debate|||
WASHINGTON – It's one issue in the health care debate that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.
Yet such practical considerations are being overlooked in a debate that's become a passionate argument about the government's reach and role in medical matters.
Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.
Insurers no longer could base premiums on a person's medical history, although they still could charge more to 50-year-olds than to people in their 20s.
People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate "job lock," the fear of leaving employment that provides medical benefits.
"It would bring insurance and insurabilty standards into line with medical practice and with the way people live their lives," said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute. "When people are in the doctor's office, they're worried about that day's issue. You're not thinking, 'If I take this pill for my cholesterol, will it cause me to be denied insurance coverage in the future?'"
If President Barack Obama's effort to remake the health care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they're seriously ill.
Major insurers will accept a rollback of the industry's restrictive practices only if they're guaranteed that all Americans would be covered — a central goal of Obama's approach and a potential financial boon to the industry.
The consumer protections are part of what Republican Sen. Mike Enzi of Wyoming calls the 80 percent of health care fixes that there's consensus for. Enzi is one of six members of the Senate Finance Committee who are trying work out a bipartisan solution — with no guarantee of success.
Obama may have made a critical error by not stressing the consumer aspects of the legislation, and his advisers seem to have realized it as they belatedly retooled the White House pitch in recent days.
If a bill does pass, the biggest winners are likely to be self-employed people and small-business owners and employees, who now have the most trouble getting and keeping coverage. Those working for big companies would only benefit indirectly; they'd find it easier to keep their coverage if they get laid off or leave to launch a new career.
Insurance companies could come out ahead, too.
"They'll get a big new market with millions and millions of new customers," said Gary Claxton, a health policy expert with the Kaiser Family Foundation. "Their average profit per person may not be as high, but they still should be able to earn a profit by insuring more people."
One major catch is that the consumer protections would not be available immediately. They are timed to take effect alongside government subsidies to help people buy coverage. In the House Democratic legislation, the coverage expansion would come in 2013 — after the next presidential elections. Part of the reason for the delay is to make the costs of the bill appear more manageable.
"It's a long time to wait," said John Rother, policy and strategy chief for AARP. "This is complicated stuff, but I would have personally liked to see it done in two years."
The House legislation, the Senate health committee bill and the evolving Senate Finance Committee package differ on some important specifics, but follow the same general approach.
All would set up an insurance marketplace. This exchange would be open to individuals and small businesses, and maybe big companies later on. Government subsidies would be available for low-to-middle income households. People buying health insurance through the exchange would be part of a large pool that spreads risks, giving participants leverage similar to what government employees — including lawmakers — now have.
Health plans offered through the exchange would have to meet basic standards, so it would be easier for consumers to understand what their insurance covers. To protect against catastrophic illness, there would be annual limits on out-of-pocket costs for co-payments and deductibles. Year-to-year increases in premiums would be more predictable for small companies.
Insurers could not charge more to people in poor health or to women, as they do now. But they still could charge higher premiums due to family size, geographic location and age.
The House and the Senate health committee bills would limit age-related premiums so that a 64-year-old pays no more than twice as much an 18-year-old. But Senate Finance Committee negotiators are considering allowing as much as a 5-to-1 difference, a big savings for the young but a significantly higher cost for older people who are more likely to have health problems.
The federal consumer protections would set a basic standard for the whole country, changing a situation in which state-level safeguards vary widely.
___
On the Net:
Employee Benefit Research Institute: http://www.ebri.org/
AARP: http://www.aarp.org/
Kaiser Family Foundation: http://www.kff.org/
Senate Finance Committee: http://finance.senate.gov/
Senate Health, Education, Labor and Pensions Committee: http://help.senate.gov/
House Energy and Commerce Committee: http://energycommerce.house.gov/
House Ways and Means Committee: http://waysandmeans.house.gov/
House Education and Labor Committee: http://edlabor.house.gov/
Rate of severe childhood obesity up sharply in U.S.|||
NEW YORK – The rate of severe obesity among U.S. children and teenagers more than tripled over the past three decades, a new study finds.
Using data from a long-running government health survey, researchers found that as of 2004, nearly 4 percent of 2- to 19-year-olds in the U.S. were severely obese.
That was up more than three-fold from 1976, and more than 70 percent from 1994, the researchers report in the journal Academic Pediatrics.
"Children are not only becoming obese, but becoming severely obese, which impacts their overall health," lead researcher Dr. Joseph A. Skelton, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said in a news release from the university.
"These findings," he added, "reinforce the fact that medically-based programs to treat obesity are needed throughout the United States and insurance companies should be encouraged to cover this care."
The study also found that minority and lower-income children are at particular risk of severe obesity -- which, in children and teenagers, is defined as having a body mass index in the 99th percentile for one's age and gender.
In the most recent survey, which included 12,000 2- to 19-year-olds from across the U.S., nearly 6 percent of African-American children and teens were severely obese, as were roughly 5 percent of Mexican- Americans. That compared with 3 percent of their white peers.
In contrast, less than 1 percent of Mexican-American children and less than 2 percent of black children were severely obese in the 1970s survey.
When it came to family income, the latest survey data show that just over 4 percent of relatively lower-income children were severely obese, versus 2.5 percent of those from higher-income families.
The findings underscore a central obstacle in tackling childhood obesity, Skelton and his colleagues note: The children who are most affected also generally have the greatest difficulty getting good healthcare.
"No simple answers exist," the researchers write, pointing out that along with better access to healthcare, there also need to be broader efforts to improve the diets and lifestyle habits of U.S. children.
SOURCE: Academic Pediatrics, September 2009.
Berlusconi reprimands state TV for attacking government|||
ROME – Italian Prime Minister Silvio Berlusconi on Monday said it was "unacceptable" for state TV to criticize the government and rebuked a left-leaning newspaper which regularly publishes lurid stories about his sex life.
Berlusconi, whose family media empire owns Italy's main independent television channels, said state-owned broadcaster RAI was always against him.
"I've been able to say what a majority of Italians think, which is that it is unacceptable that public television, paid for by all, should be the only public television that is always against the government," he told RAI radio.
As well as owning powerful broadcaster Mediaset, Berlusconi has a large majority in parliament which appoints RAI's board members, a position his critics say gives him far too much power over the media.
He attacked La Repubblica, the newspaper which has kept Italians riveted with steamy narratives by escorts of his parties and a daily list of 10 uncomfortable questions for the prime minister.
"The only thing that appears off course to me is a certain type of journalism," Berlusconi said in response to a question about articles in Repubblica suggesting Italian secret service agents had gone "off course" in their investigations.
Berlusconi has boasted that selections for RAI's top executives are made at his house. He started a Friday news conference by jokingly asking RAI journalists: "What's the atmosphere at RAI like with the directors I set up?"
The chairman of RAI's board later issued a statement saying it was the duty of journalists to report all the news.
Center-left opposition leader Dario Franceschini said Berlusconi's criticism of RAI was the "latest proof of his intention to use his economic force and the power of whoever is in government to condition and intimidate every free voice."
Berlusconi retorted that the left ought to be happy as he was asking state television not to criticize anyone -- be it the government or the opposition.
So far the opposition has yet to make much hay out of Berlusconi's scandals. Surveys show his popularity has fallen over the past few months, but he still polls 49 percent despite Italy's worst economic downturn since World War Two and the media frenzy surrounding his personal life.
Obama invokes mother39s battles against cancer insurers|||
WASHINGTON – Among the heartrending tales invoked by President Barack Obama as he stumps for healthcare reform, none is more poignant than that of his own mother's losing fight against cancer.
As he presses for an overhaul of the healthcare system, Obama often recounts the crises faced by Americans who with their jobs have lost their medical coverage, or who file for bankruptcy when faced with a health calamity.
But Exhibit A among the tragic examples is that of his own mother, Ann Dunham, who lost her fight to cancer nearly a decade and a half ago as she battled insurance companies.
"It's... personal for me," Obama told a crowd at a high-profile forum on Tuesday in Portsmouth, New Hampshire.
"I will never forget my own mother as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment," he told the crowd.
He was reprising a story he told frequently on the campaign trail, and more recently on the road, while drumming up support for his health industry reform agenda.
"The insurance company was arguing that somehow she should have known that she had cancer when she took her new job, even though it hadn't been diagnosed yet," Obama told the New Hampshire audience Tuesday.
"If it could happen to her, it could happen to any one of us. And I've heard from so many Americans who have the same worries."
In the preface to his first book, "Dreams From My Father," an elegy to his absentee dad, Obama also eulogizes the mother "whom we lost, with a brutal swiftness, to cancer a few months after this book was originally published."
According to some news accounts, Ann Dunham's cancer at first had been misdiagnosed in Indonesia as indigestion.
It was later determined by experts at the Memorial Sloan-Kettering Cancer Center in New York to be a fast-moving uterine cancer that had spread to her ovaries.
In remarks that seem informed by his mother's ordeal, Obama added that his goal now with healthcare reform is to set up a system "that gives a little bit of help to people who currently are working hard every day but they don't have healthcare insurance on the job."
He also hopes to ensure that patients already insured "are not going to be dropped because of a pre-existing conditions or because you lose your job or because you change your job -- that you're actually going to get what you pay for, that you're not going to find out when you're sick that you got cheated."
"If we can set up a system that gives you some security, that's worth a lot," he said.
His mother, who held a doctorate degree in anthropology, forged a career in international economic development, working for a while with the Ford Foundation in Jakarta and later with the US Agency for International Development and the World Bank, and helping to guide micro-enterprise projects to aid poor women.
Her mother's frustrating odyssey as a cancer patient also figured into his historic presidential campaign, when he vowed to remake the medical coverage system.
"In last painful months, she was more worried about paying her medical bills than getting well," Obama said in one campaign advertisement that aired in 2008.
"I hear stories like hers everyday. For 20 years Washington has talked about healthcare reform and reformed nothing. Unless we stop the bickering and the lobbyists we will be in the same place 20 years from now," he said.
Ann Dunham returned to her home state of Hawaii where she lived out the final months of her life, and died at the age of 53 on November 7, 1995, before Obama -- who by then was living in Chicago -- could get to her bedside to say goodbye.
Obama has said that his greatest regret is not being at his mother's side when she died, and has called her the most influential person in his life.
"I think sometimes that had I known she would not survive her illness, I might have written a different book -- less a meditation on the absent parent, more a celebration of the one who was the single constant in my life," he wrote in "Dreams From My Father."
"She was the kindest, most generous spirit I have ever known," Obama wrote, "and that what is best in me I owe to her."
China closes factory after 300 children poisoned report|||
BEIJING – Authorities in northern China Wednesday announced the closure of a smelting plant blamed for the lead poisoning of at least 300 children, state media reported.
The children, all living near the Dongling Lead and Zinc Smelting Co. plant in Changqing, Shaanxi province, were found to have as much as four times the normal maximum level of lead in their blood, Xinhua news agency said.
Nearly 1,000 children had now been tested and their results would be known in three to five days, it said.
It was not immediately clear how the children were poisoned but officials have been taking samples of groundwater, soil, air and sewage to check for contamination, and there was no mention of adult sickness.
Local county deputy head He Hongnian said the closure of the plant had been ordered on August 6, two weeks after a six-year-old girl was diagnosed with lead poisoning.
Anxious parents rushed their children to hospital for blood tests, with more than 300 lead poisoning cases reported by Sunday.
The lead levels in their blood ranged from 100 milligrams to 400 milligrams per litre, compared with normal levels of between zero and 100 milligrams, Xinhua said.
Above 200 milligrams is considered hazardous, with children more vulnerable to lead poisoning which can harm the nervous system.
"We live only 200 metres from the smelting firm. Lead pollution is certain," villager Sun Yagang, whose two-year-old son was diagnosed with lead poisoning, told Xinhua.
Residents who lived within 500 metres of the plant were supposed to have been relocated but so far only 156 out of nearly 581 families had been able to move to new homes, Xinhua said, citing Changqing town chief Pu Yiming.
The county government promised to speed up the relocation.
"We will ensure that all the remaining 425 families are relocated within two years," deputy county head He was quoted as saying.
Many poverty-stricken regions in China's interior have introduced high-polluting industries without the necessary environmental evaluation, in a desperate bid to boost economic growth, state media has said.
50 million women in Asia at risk of HIV infection UNAIDS|||
BALI, Indonesia – Fifty million women in Asia are at risk of being infected with HIV because of the risky sexual behavior of their husbands or boyfriends, leading health experts said in a report on Tuesday.
More than 90 percent of the 1.7 million women now living with HIV in Asia became infected while being in monogamous, long-term relationships with men who engaged in risky sex behavior, the report launched by UNAIDS said.
These include men who had other sexual partners or who were drug users.
"We need to target men who engage in paid sex, injecting drug users, men who have sex with men, who can transmit the virus to their partners," Jean D'Cunha, regional director of the United Nations Development Fund for Women in South Asia, told a news conference held on the margins of an HIV/AIDS conference in Bali.
"We need to question the attitudes, values and behavior and transform these so that women would be less vulnerable to
HIV/AIDS."
While the issue of gender inequality is often ignored or laughed off, experts say it cannot be taken lightly in the context of HIV/AIDS, a disease that can be transmitted through sexual contact and which is incurable.
Sex workers, who have very little bargaining power to begin with, are usually forced to comply when their clients refuse to use condoms. Back home, the wives of these men too have no power to demand that condoms be used even if they know about the risky sexual behavior of their husbands.
While the fight against the AIDS epidemic has seen progress on some fronts, women continue to bear the brunt of it. Women make up 35 percent of all adult HIV infections in Asia now, up from 17 percent in 1990.
REVERSING A CULTURE
Maire Bopp-Allport, head of the Pacific Islands Aids Foundation, contracted the AIDS virus from her boyfriend around 1996. Today, she is a familiar figure in the global fight against the disease.
"At the heart of the issue is thousands of years of education to our males that it's okay to think that women are there to simply serve them and do everything they want. We need to bring a new culture where it's not okay," she told Reuters.
"They need to be able to think that the abuse of a woman is the abuse of their daughters when their daughters become women," she added.
Not enough shuteye may raise diabetes risk|||
NEW YORK – An inadequate amount of nightly sleep on a recurring basis, coupled with a sedentary lifestyle and overeating, may fuel the development of diabetes, results of a new study hint.
"Our findings suggest that combining the unhealthy aspects of the Westernized lifestyle with insufficient sleep may add to the risk of overweight and sedentary individuals to develop diabetes," Dr. Plamen Penev, of the University of Chicago, Illinois, and a senior author of the study, told Reuters Health.
Penev and colleagues subjected 11 healthy but sedentary middle-aged men and women to two 14-day periods of sedentary living with free access to food and either 5.5 hours or 8.5 hours of sleep each night.
As nightly sleep times changed from 8.5 to 5.5 hours, the participants went to bed later and got out of bed earlier and, as a result, average sleep duration was reduced by about two hours a day.
When the adults had their bedtimes decreased from a healthy 8.5 hours to 5.5 hours they showed changes in their response to two common sugar tests, which were similar to those seen in people with an increased risk of developing diabetes.
"If confirmed by future larger studies," Penev told Reuters Health, "these results would indicate that a healthy lifestyle should include not only healthy eating habits and adequate amounts of physical activity, but also obtaining a sufficient amount of sleep."
SOURCE: Journal of Clinical Endocrinology and Metabolism, September 2009.
FDA concludes mercury in dental fillings not risky|||
WASHINGTON – The government declared Tuesday that silver dental fillings contain too little mercury to harm the millions who've had cavities filled with them — including young children — and that only people allergic to mercury need to avoid them.
It was something of an about-face for the Food and Drug Administration, which last year settled a lawsuit with anti-mercury activists by posting on its Web site a precaution saying questions remained about whether the small amount of mercury vapor the fillings can release were enough to harm the developing brains of fetuses or the very young.
On Tuesday, the FDA said its final scientific review ended that concern. Still, the agency did slightly strengthen how it regulates the fillings, urging dentists to provide their patients with a government-written statement detailing the mercury controversy and what science shows.
"The best available scientific evidence supports the conclusion that patients with dental amalgam fillings are not at risk for mercury-associated adverse health effects," said Dr. Susan Runner, FDA's dental products director.
Anti-mercury activists accused the agency of bowing to the dental industry and said they'd go back to court to try to force a change.
"FDA broke its contract and broke its word that it would put warnings for children and unborn children," said Charles Brown of Consumers for Dental Choice. "This contemptuous attitude toward children and the unborn will not go unanswered."
Too much mercury can harm the brain. It has made headlines in recent years as scientists have warned that some types of seafood contain enough to harm a fetus or young child.
Used since the 1800s, amalgam fillings are a mix of a different kind of mercury — a kind the body absorbs differently — with silver, copper and tin to harden it.
Tuesday, the FDA took the regulatory step of formally classifying amalgam fillings as a Class II or "moderate risk" medical device to ensure that dentists handle the mercury properly — using adequate ventilation — but to allow the allergy warning. Until now, the FDA had classified the fillings' ingredients separately.
The practical effect of that technical change? The FDA released its review of 200 scientific studies that found no risk to adults or children over 6 from the fillings.
What about pregnant women or younger children? Tuesday's ruling supersedes the precaution from last year's lawsuit settlement, Runner said.
The FDA found that while there have been only a handful of rigorous studies comparing young children given either amalgam fillings or mercury-free tooth-colored resin composite ones, those studies haven't detected any brain problems. Runner cited additional evidence concluding that babies and young children would be exposed to amounts well below safety limits.
But the statement dentists are urged to share with patients does raise the issue so that people who are concerned about the mercury can discuss an alternative.
Removing the fillings actually releases more mercury vapor, FDA said. People who think they're allergic to a filling ingredient should discuss that with a dentist.
Amalgams now account for about 30 percent of U.S. fillings, their popularity dropping in favor of tooth-colored alternatives. But they remain the cheapest filling and dentists say there are some conditions that demand amalgams, such as spots on back teeth that won't stay dry long enough for composite fillings to bond.
___
On the Net:
FDA: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/default.htm
Obese Texas man hides gun between rolls of fat|||
WASHINGTON – An obese prisoner in Harris County, Texas has been charged with illegal possession of a firearm after he was discovered to be hiding a 9mm pistol in between his rolls of fat, local media reported Saturday.
George Vera, who weighs around 500 pounds was originally arrested last week for selling counterfeit CDs, according to the Houston Chronicle newspaper.
A police spokesman told the Chronicle that Vera was searched three times over the course of his arrest and booking at the jail but managed to conceal the handgun with his rolls of fat until it was discovered in the shower.
Vera has been charged with possession of an illegal weapon in a correctional facility, which carries a penalty of two to 10 years in prison, but is currently free on bail of 10,000 dollars.
Any spread of breast cancer raises risk of return|||
Breast cancer patients with even the tiniest spread of the disease to a lymph node have a much higher risk of it recurring years later and may need more treatment than just surgery, new research suggests.
For years, doctors and patients have struggled with what to do about a microscopic tumor or stray cancer cells in a lymph node. Women with "micro tumors" usually are given estrogen-blocking drugs, chemotherapy or both; those with isolated cancer cells usually are not, because those were thought to be of low concern.
The new study challenges that view. It suggests that either type of metastasis, or spread, raises a woman's risk of having cancer show up in the breast or anywhere else in the next five years by about 50 percent.
"This took an area that was very gray and I think made it black and white," said Dr. Linda Vahdat, director of breast cancer research at Weill Cornell Medical College and an adviser for the breast cancer patient Web site of ASCO, the American Society of Clinical Oncology.
"I think it will influence treatment," she said of the study. "If we're considering treating the patient, we probably should."
Dr. Daniel Hayes, director of breast cancer treatment at the University of Michigan, agreed.
"It really does look like our biases are wrong," he said. "For the first time, it suggests that isolated tumor cells or micrometastases do have biological significance."
Vahdat and Hayes had no role in the study, which was done by researchers throughout the Netherlands. Results are in Thursday's New England Journal of Medicine.
The study is not ideal: It just observed a large number of women rather than assigning some to get treatment and comparing how they fared to others who were not treated. The study also was done at a time when treatment was less aggressive and in a country where doctors had been treating breast cancer more conservatively than in the United States.
In the U.S., many women with early stage breast cancer are given hormone blockers.
"The big issue is, should these patients also get chemotherapy?" Hayes said.
However, not all women benefit from chemotherapy even when their risk of a recurrence is high, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.
"Patients are looking for more specific treatment" tailored to their individual tumor type — not necessarily more or less treatment, he said.
The Dutch study involved more than 2,700 women with low-risk, early stage cancer — small tumors that did not seem aggressive. All had surgery to remove their breast tumors. All of their armpit lymph nodes or a few key ones called "sentinel" nodes were removed and checked for signs of cancer. Doctors do this by examining tissue slices from the nodes and using special stains to make cancer cells show up.
Larger tumors in lymph nodes already trigger further treatment. A micro tumor is a cluster of cells less than 2 millimeters — smaller than one-tenth of an inch. Most, but not all, doctors would treat these, too. Isolated tumor cells are even tinier — "you can essentially count them" in a tissue sample, Winer said — and do not typically spur further treatment under current guidelines.
The Dutch researchers compared patients based on whether they received treatment beyond surgery and whether cancer of various amounts was found in a lymph node.
In most cases, breast cancer doesn't return after surgery. Among women in the study who were given no additional treatment, 86 percent of those with no cancer in lymph nodes were free of cancer five years later. Only 76 percent of those with micro tumors and 77 percent of those with isolated cancer cells were cancer-free.
That translates to a roughly 50 percent greater risk of recurrence if any sign of cancer was present in a node.
Also, women with micro tumors or stray cells who were given additional treatment had a 43 percent lower risk of a cancer recurrence than similar women not treated beyond surgery.
The differences should lead doctors to reconsider guidelines for how tumors are classified, which guides the amount of treatment a woman receives, the authors write. Now, a micro tumor is considered "node positive" cancer, warranting further treatment, while isolated cells are called "node negative."
A new version of the guidelines is due out soon, Hayes said.
___
On the Net:
New England Journal: http://www.nejm.org
Abbott expanding study of its popular Xience stent|||
TRENTON, N.J. – Abbott Laboratories Inc. is expanding a study of its top-selling heart stent by more than 2,000 patients, who may also be put in a second, landmark stent study meant to find the best way to prevent potentially fatal blood clots.
The bigger study aims to determine the optimum time people should take blood-thinning medicines after they undergo a common procedure called angioplasty to clear out a blocked artery and implant a stent, a metal-mesh scaffold that props open a blood vessel. That study, begun late last year, includes more than 25,000 patients and academic researchers, federal regulators and eight major prescription drug and medical device makers.
Abbott, of North Chicago, Ill., said Thursday it is expanding a study of its already-approved Xience V stent. Those patients will be followed for five years to see how many develop a blood clot near the site of the stent and will be eligible to also enroll in the larger study.
That study was requested by the Food and Drug Administration to help doctors figure out the best treatment for their patients. It was designed and is being overseen by the Hartford Clinical Research Institute.
Because of its huge size and cost, it involves and is partly supported by the four big U.S. stent makers — Johnson & Johnson, Boston Scientific Corp., Abbott and Medtronic Inc. — plus four large drugmakers that sell anticlotting medicines — Bristol-Myers Squibb Co., Sanofi Aventis SA, Eli Lilly & Co. and Daiichi Sankyo.
Some patients will get bare-metal stents, but most will get newer ones coated with a drug to prevent re-clogging of the artery around the stent. Everyone will get at least 81 milligrams of aspirin a day and an anticlotting drug. After a year, those who haven't had complications will be split in two groups, with one continuing on the blood-thinning therapy for 18 months and the rest stopping it.
About 800,000 to 1 million American patients a year have one or more stents implanted after angioplasty. Less than 1 percent have a clot form near the stent, according to FDA officials, but that still leads to many strokes, heart attacks and deaths.
In midday trading, shares of Abbott fell 16 cents to $43.85.
Study Weightlifting helps breast cancer survivors|||
Breast cancer survivors have been getting bum advice. For decades, many doctors warned that lifting weights or even heavy groceries could cause painful arm swelling. New research shows that weight training actually helps prevent this problem.
"How many generations of women have been told to avoid lifting heavy objects?" Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston, lamented after seeing the surprising results of the new study. "Women who were doing the lifting actually had fewer arm problems because they had better muscle tone."
The study was led by Kathryn Schmitz, an exercise scientist at the University of Pennsylvania, and funded by the federal government. Results are in Thursday's New England Journal of Medicine.
More than 2.4 million Americans are breast cancer survivors, and the study could mean a big difference in their quality of life. Cancer treatment-related arm swelling now appears to be one of many ailments made better by exercise — not worse, Schmitz said.
"Fifty years ago we told people who had a heart attack not to exercise anymore," and people with sore backs to heal with bed rest, Schmitz said. "It was well-meaning advice but it was polar opposite of the truth."
Women who have had radiation to the armpit, or lymph nodes removed to check for cancer, can suffer lymphedema — a buildup of fluids that causes painful and unsightly swelling of the arms or hands.
To avoid it, doctors have advised women to avoid using the affected arm to lift toddlers, carry a heavy purse or scrub floors. Even activities like golf and tennis raised concern.
Women think, "Oh, my God, I need to baby the arm," Schmitz said.
Lifting weights — which boosts mood, muscle mass, bone strength and weight control — was thought to be a bad idea for women prone to lymphedema.
Schmitz challenged that notion with a small study several years ago, finding that weight training did not make lymphedema worse. Her new study is the first one large and long enough to give clear proof that this is so, and even suggests that weightlifting can help.
It involved 141 breast cancer survivors who had suffered lymphedema. Half were told not to change their exercise habits. The rest were given 90-minute weightlifting classes twice a week for 13 weeks at community gyms, mostly YMCAs.
They wore a custom-fitted compression garment on the affected arm and gradually worked up to more challenging weights and repetitions. For the next 39 weeks, they continued these exercises on their own.
The women's arms were measured monthly. After one year, fewer weightlifters had suffered lymphedema flare-ups — 14 percent versus 29 percent of the others. Weightlifters reported fewer symptoms and greater strength. Rates of change in arm size due to swelling were similar in both groups.
"I found it was really very effective. It not only gave me strength and mobility but it improved my balance and coordination," said one participant, Clare Faber, 66, of suburban Philadelphia. "It really does offer women hope."
Another participant, Gay McArthur, 56, of Smithfield, N.J., has continued weightlifting on her own since the study ended.
"When I first got diagnosed with lymphedema, they said I couldn't lift more than five pounds," she said. But weight training caused no problems and has made her feel better, she said.
It also should save money, though the study did not measure this, Wendy Demark-Wahnefried, of the University of Texas M.D. Anderson Cancer Center in Houston, wrote in an editorial in the medical journal. In the study, the group of weightlifters made only 77 visits to doctors or physical therapists for lymphedema flare-ups versus 195 visits for the others, she noted.
Another part of the study is evaluating whether weight training can prevent a first case of lymphedema in breast cancer survivors; results are expected soon, Schmitz said.
Breast cancer survivors should not rush into weight training — that could trigger problems. Schmitz suggests:
_Have a certified fitness professional teach you how to do the exercises properly.
_Start slow, with a program that gradually progresses.
_Wear a well-fitting compression garment during workouts.
___
On the Net:
New England Journal: http://www.nejm.org
Lymphedema advice: http://tinyurl.com/l9lgga
Glaxo starts testing its swine flu vaccine|||
LONDON – Drugmaker GlaxoSmithKline PLC said Friday it has started testing its swine flu vaccine in humans.
Glaxo said it plans to conduct 16 clinical trials of its swine flu vaccine in more than 9,000 people in Europe and North America. It expects to have early results in September from its first trial in Germany. The data will be shared with drug regulators so they can make an early decision whether to license the vaccine.
Both Europe and the United States have fast-track approval systems for the swine flu vaccine, to ensure that the vaccine is available as soon as possible — and before complete safety tests are finished. The European Medicines Agency has said swine flu vaccines could be approved within five days.
Two other major drugmakers, Novartis AG and Sanofi-Aventis SA, began testing their swine flu vaccines earlier this month. In July, Australian pharmaceutical company CSL started testing their vaccine in Australia.
Glaxo's first trial is being conducted in Germany among 128 people aged 16 to 60, according to spokeswoman Alexandra Harrison.
The company said once it has initial results, these will be submitted to European and American regulatory authorities. Glaxo said it also would provide older data on a bird flu vaccine, on which the swine flu vaccine is based.
Other Glaxo trials will test the vaccine in infants, children and the elderly. The trials are scheduled to last about a year, although Harrison said the vaccine is expected to be on the market much sooner.
"We aim to get the first doses out in September," Harrison said, with major orders fulfilled by the end of the year or early 2010.
In Europe, Glaxo is testing vaccines with an adjuvant, a chemical compound used to stretch a vaccine's active ingredient and boost the body's immune response.
In Canada and the United States, Glaxo is testing vaccines both with and without adjuvants. Neither country has ever licensed any flu medications that contain the compound.
The safety of adjuvant-boosted flu vaccines on pregnant women and children — two of the groups thought to be most at risk from swine flu — has yet to be determined conclusively.
Glaxo has orders from countries worldwide for 291 million doses of swine flu vaccine. The United States has also ordered $250 million worth of vaccine ingredients.
Glaxo says it will donate 50 million doses of swine flu vaccine to the World Health Organization for use in poorer countries. The company also plans to set aside 20 percent of its Canadian production for the same purpose.
Since swine flu emerged in April, it has killed at least 1,462 people worldwide and is estimated to have infected millions.
Scientists find rare gene behind short sleepers|||
WASHINGTON – Scientists have discovered a gene that helps a mother and daughter stay alert on about six hours sleep a night, two hours less than the rest of their family needs.
It's believed to be a very rare mutation, not an excuse for the rest of us who stay up too late. But the finding, published in Friday's edition of the journal Science, offers a new lead to study how sleep affects health.
The National Institutes of Health says adults need seven hours to nine hours of sleep for good health. Regularly getting too little increases the risk of health problems, including memory impairment and a weakened immune system. A major 2006 study estimated that as many as 30 million Americans suffer chronic insomnia, and millions more have other sleep disorders, including sleep apnea.
University of California, San Francisco, researchers have long hunted genes related to how and when people sleep. In 2001, they discovered a mutation that puts its carriers' sleep patterns out of whack: These people regularly go to bed around 7:30 p.m. and wake around 3:30 a.m.
Now the same team has found a gene involved in regulating length of sleep. In one family, the 69-year-old mother and her 44-year-old daughter typically go to bed around 10 p.m., and Mom rises around 4 and her daughter around 4:30, with no apparent ill effects. The rest of the family has typical sleep patterns.
Blood tests showed the women harbored a mutation in a gene named DEC2 that's involved in regulation of circadian rhythms, the body's clock. A check of more than 250 stored DNA samples didn't find another carrier.
Then lead researcher Ying-Hui Fu, a neurology professor, and colleagues bred mice and fruit flies that carried the mutation. Sure enough, the flies' activity and brain-wave measurements on the mice showed those with the mutation slept less — and the mice needed less time to recover from sleep deprivation.
The result: A model that "provides a unique opportunity" to study the effects of different amounts of sleep, Fu concluded.