.:: Health Care Article and News ::.

Friday, March 30, 2007

Health Tip: Toilet Training Your Child

Toilet training should begin only when the child is able to recognize and communicate when a diaper is soiled.

According to the American Academy of Family Physicians, this most often occurs between 18 and 24 months of age. But some children may remain in diapers as late as 2 1/2 to 3 years old, the academy says.

Before training begins, introduce your child to her potty chair by keeping it in her play area, the physician's group advises. Let her sit in the chair any time she wants to -- fully clothed -- but never force her to sit in it.

Finally, encourage her to sit on her potty chair without a diaper on. Show her how you place waste from her diaper into the potty chair, then transfer to the toilet. Allow her to flush the toilet and watch the waste disappear.

Parkinson's drug pulled from U.S. market

U.S. health officials withdrew the Parkinson's disease drug pergolide from the market on Thursday, citing a history of safety concerns that include potentially fatal heart valve damage.

The Food and Drug Administration (FDA) decided to pull the drug, first developed by Eli Lilly and Co. under the name Permax, after reports showed it can cause similar problems to the kind that triggered the withdrawal of the diet drug combination "fen-phen."

The risks, when added to the fact that it was no better than other available medications, showed "it really didn't have a place in therapy any more," said Dr. Robert Temple, head of the FDA's office of drug evaluation.

Pergolide is not widely used and sees between 12,000 and 25,000 prescriptions a year, Temple said. Parkinson's patients taking the drug should not immediately stop taking it, but should be switched to alternative medicines, he added.

Lilly spokesman Charlie McAtee said the company transferred U.S. ownership to Valeant Pharmaceuticals International in 2005. He added Lilly still sells the product under multiple names in other countries.

Valeant representatives could not be immediately reached for comment.

Both Par Pharmaceuticals and Teva Pharmaceutical Industries Ltd. also make generic forms of the drug. All manufacturers of the drug agreed "the time had come" to halt sales, Temple said.

Representatives of Par and Teva did not return calls seeking comment.

Pergolide, approved in late 1988, is a dopamine agonist usually used in combination with other medicines to help manage symptoms of Parkinson's -- a movement disorder with no cure that causes uncontrollable tremors throughout the body.

The FDA decided to pull the drug, which already carried a black box warning, after two reports published in January showed it could cause valve regurgitation. In such cases, the valves do not close tightly and the backflow of blood can lead to breathing problems, fatigue and heart palpitations.

While there were no reported deaths, Temple said, the damage can require valve replacement surgery. If not fixed, the condition can cause heart failure and sudden death.

Pfizer Inc. also makes a dopamine agonist called Dostinex, or cabergoline, that was cited for heart damage in the studies published by the
New England Journal of Medicine.

While Dostinex is cleared for Parkinson's in Europe, it is only allowed on the U.S. market for the hormone and blood disorder known as hyperprolactinemia.

Higher doses needed to treat Parkinson's that would trigger the valve problems are not FDA-approved, Temple said.

Other similar drugs can cause problems, but none as severe as heart damage, he said.

"We now have very good data that the other drugs with similar properties, other dopamine agonists, don't do this," Temple said. "We didn't really have that before."

Other dopamine agonists include GlaxoSmithKline's Requip, or ropinirole, and Boehringer Ingelheim Pharmaceuticals, Inc.'s Mirapex, or pramipexole.

Shares of Valeant closed up 2 cents at $17.13 on the New York Stock Exchange on Thursday. Shares of Par closed up 63 cents at $25.24, also on the NYSE, while Teva shares closed up 16 cents at $36.85 on the Nasdaq. Shares in Lilly closed up 40 cents at $53.41 on the New York Stock Exchange.

Parkinson's Drug Pergolide Withdrawn Over Heart Concerns

The Parkinson's disease drug pergolide has been removed from the market because it has been linked to heart valve damage in patients.

The drug, which goes by the brand name Permax, has had a troubled history. It was voluntarily withdrawn Thursday by its maker, Valeant Pharmaceuticals, at the request of the U.S.Food and Drug Administration.

Two generic versions are manufactured by Par Pharmaceuticals and Teva Pharmaceutical Industries.

"The reason for the withdrawal is because of the high rate of damage to the heart valves in users of pergolide," Dr. Robert Temple, director of the Office of Medical Policy at the FDA's Center for Drug Evaluation and Research, said during a teleconference Thursday afternoon. "The damage causes the valve to become leaky. The drug is called a dopamine agonist and is used as starting therapy for Parkinson's patients."

The drug has been available since 1988, and the first reports of heart valve damage surfaced in 2002, Temple said. In 2003, the drug's label was changed to reflect these problems. In 2006, further studies prompted the FDA to mandate a "black box warning" on the drug's label.

The last straw was the publication of two studies in January in the
New England Journal of Medicine that showed a fivefold increased risk of valve damage from taking the drug. One of the studies also revealed that about 23 percent of people on the drug developed heart valve problems, Temple said. "That what led to our new action," he said.

In addition, reports showed that other dopamine agonists did not cause heart valve problems, Temple noted. "Pergolide has no advantage over any of the other therapies for Parkinson's," he said. "Almost all patients can be converted to another drug. We concluded that this drug really didn't have a place in therapy anymore."

Currently, about 12,000 to 25,000 patients are taking pergolide in the United States, and its use has been declining, Temple said.

Temple said there are some patients who only do well on pergolide. "We hope to make some arrangement for those people so they can get the drug, providing they understand the risk," he said.

"We are telling these patients not to stop the drug abruptly," he added. "If the patients, with their physicians, conclude they need a dopamine agonist, there are ways to switch."

The voluntary withdrawal will not take place immediately. This will allow time for health-care providers and patients to make appropriate treatment decisions, Temple said.

According to the U.S.National Institutes of Health, Parkinson's is a disease of the nervous system. The four main symptoms are tremors, stiffness of the limbs and trunk, slowness of movement, and impaired balance. These symptoms usually begin gradually and worsen with time. As they become more pronounced, patients may have difficulty walking, talking or completing other simple tasks.

Mexicans march to support abortion law

Several thousand women marched through the Mexican capital in support of a bill to legalize abortion in the first three months of pregnancy, a proposal that has drawn harsh criticism from the Roman Catholic Church.

About 3,000 protesters led by city legislators from various political parties on Thursday shouted "Freedom to choose!" and criticized President Felipe Calderon, a social conservative who has spoken out against the reform.

"A woman can decide to have an abortion or not have it, but it's her decision," said former presidential candidate Patricia Mercado, a leftist and feminist. "A secular state has the obligation to give the right to women to take this decision in the best conditions."

The bill was proposed by the leftist Democratic Revolution Party, or PRD, which holds a majority in the assembly in Mexico City — a federal district with its own legislature — and party legislators are confident it will pass in April.

PRD lawmakers also sent a bill to the federal Congress to legalize abortion nationwide, but the bill is expected to face a tougher test there, where Calderon's conservative National Action Party is the biggest force.

On Sunday, thousands of anti-abortion activists marched through the capital led by Cardinal Norberto Rivera, Mexico's most prominent cleric.

The march followed an international anti-abortion conference featuring the
Vatican's top anti-abortion campaigner, Cardinal Alfonso Lopez Trujillo. The Vatican does not want to lose its fight against abortion in Mexico, which has the second-largest Catholic population in the world.

Mexico's constitution bans religious groups from political activity and the PRD has called on the authorities to stop clerical involvement in the marches.

Most Latin American countries, including Mexico, allow abortion if the woman's life is in danger or in cases of rape or incest. In November, Nicaragua passed a law banning abortion in all cases. Cuba permits abortions within the first 12 weeks of pregnancy, as does the United States.

Parental Drinking Boosts Alcoholism Risk for ADHD Kids

hildren with attention-deficit hyperactivity disorder (ADHD) are at increased risk for alcohol problems, and parental alcoholism and stressful family experiences are important factors in that risk, two new studies suggest.

"Children with ADHD are believed to be at risk for alcoholism because of their impulsivity and distractibility, as well as other problems that often accompany ADHD, such as school failure and behavior problems," Brooke Molina, an associate professor of psychiatry and psychology at the University of Pittsburgh, said in a prepared statement.

Molina is corresponding author for both studies, which are published in the April issue of Alcoholism: Clinical & Experimental Research.

The first study used interviews and questionnaires to assess the drinking habits of 364 young people with ADHD and a similar number of young people without ADHD.

"We found that the children with ADHD were more likely than the comparison group to drink heavily and to have enough problems related to their drinking that they were diagnosed with alcohol abuse or dependence," Molina said. "This means that their drinking caused problems such as fights with their parents or friends, a drop in their grades at school, or difficulty with controlling the amount of alcohol they drank."

The study found that drinking problems among young people with ADHD began around age 15.

"The 15- to-17-year-olds with childhood ADHD reported being drunk an average of 14 times in the previous year, versus only 1.8 times for 15- to-17-year-olds in the study who did not have childhood ADHD. Whereas 14 percent of the 15- to-17-year-olds were diagnosed with alcohol abuse or dependence, none of the 15- to-17-year-olds without childhood ADHD were," Molina said.

In the second study, researchers interviewed 142 adolescents who'd been diagnosed with childhood ADHD and 100 adolescents without ADHD about their drinking behavior and negative life events. In addition, the teens' parents were asked about their drinking histories.

"One of the reasons that children with ADHD might be at risk for alcohol problems is that alcoholism and ADHD tend to run together in families," Molina said.

"We found that parental alcoholism predicted heavy problem drinking among the teenagers, that the association was partly explained by higher rates of stress in these families, and these connections were stronger when the adolescent had ADHD in childhood. So, the bottom line is that when the child has ADHD and the parent has suffered from alcoholism, either currently or in the past, the child will have an increased risk for alcohol problems himself or herself," Molina said.

"Weekender" Cialis promises China marital bliss

Eli Lilly & Co., maker of impotence drug Cialis, hopes that Chinese couples who might resort to traditional aphrodisiacs or divorce court to resolve sexual problems will seek marital bliss with its own remedy.

The U.S. drugmaker launched a marketing campaign for Cialis in the world's most populous country on Thursday with the release of a survey showing that 45 percent of middle-aged Chinese couples had experienced erectile dysfunction problems.

Since only one-third of those couples had thought about seeking treatment, Lilly believes that efforts to boost awareness of the problem would increase sales of Cialis, whose long-lasting effects have given it the nickname "the weekender."

"This drug is effective, because men are like light bulbs. They can be turned on and off easily. Women are like irons, they need a long time to heat up, but also a long time to cool down," said psychologist Qiu Xiaolan, brought in as part of Lilly's media campaign to educate the public.

Cialis, which has been distributed to 5,000 Chinese pharmacies this month, is effective for up to 36 hours, longer than rival drugs on the market, Lilly says.

"It's a longer window of opportunity," Eli Lilly China President Jorg Ostertag told a news briefing.

About 35 million Chinese men suffer from some form of erectile dysfunction, Lilly said. Nearly 10 percent of these will eventually look for some sort of treatment, mainly in pharmacies.

FAMILY HARMONY

Erectile dysfunction is common among men with diabetes, high blood pressure and high cholesterol levels, and has historically been treated in China with traditional medicines containing herbs or animal parts such as tiger penis and rhinoceros horns.

"Erectile dysfunction has become a serious issue. It not only threatens men's health, but also challenges family relationships and harmony," Ostertag said.

A local court in south China granted a divorce to a woman who remained a virgin after four years of marriage due to her husband's apparent sexual dysfunction, Xinhua news agency reported in October.

More than 10 percent of divorce cases center on sexual dysfunction, Xinhua quoted a judge with the court in south China's Guangxi Zhuang Autonomous Region as saying.

The Supreme People's Court has ruled that sexual dysfunction that cannot be cured is proper grounds for divorce, Xinhua said.

Industry estimates for China's market for impotence drugs range from 500 million yuan to as much as 2 billion yuan a year ($65 million to $260 million).

Cialis, although growing faster globally than Viagra, still lags its rival, which was launched in China by Pfizer, the world's largest drugmaker, in 2000.

Levitra, an impotence drug developed jointly by Bayer AG, GlaxoSmithKline Plc and Schering-Plough Corp., is also available in China.

Pfizer does not disclose sales figures for Viagra in China but global revenues from of the drug rose 1 percent to $1.7 billion last year.

Worldwide sales of Lilly's Cialis jumped 30 percent to $971 million.

WHO support male circumcision to fight spread of AIDS

UN health agencies on Wednesday gave the stamp of approval for including male circumcision in the panoply of arms to fight the spread of
AIDS, stressing though that its success also depended on safe-sex awareness, sensitivity and resources.

The World Health Organisation (WHO) and the specialised agency
UNAIDS declared that millions of lives could be saved if circumcision were widely and safely practised.

They issued guidelines at a press conference in Paris following a debate among experts, health officials and grassroots groups in Geneva on March 6-8.

"The recommendations represent a significant step forward in
HIV prevention," said Kevin de Cock, director of the WHO's HIV/AIDS Department.

"Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men," said de Cock.

"Scaling up male circumcision in such countries will result in immediate benefit to individuals," he said, adding, however: "It will be a number of years before we can expect to see an impact on the epidemic from such investment."

The spur for the recommendation has been two trials conducted in Uganda and a third in South Africa.

These studies found that men who had been circumcised reduced the risk of HIV infection by between 51 and 60 percent at least, as compared with uncircumcised counterparts.

"The efficacy of male circumcision in reducing female-to-male transmission of HIV has been proven beyond reasonable doubt. This is an important landmark in the history of HIV prevention," said the WHO and UNAIDS.

According to figures published in Public Library of Science (PLoS) Medicine that were cited in the UN document, 5.7 million new cases of HIV infection and three million deaths could be prevented over 20 years if male circumcision were universally practised in sub-Saharan Africa.

The two agencies made these points:

-- Circumcision reduces, but does not eliminate, the risk of infection for the man in the context of heterosexual intercourse.

There is no evidence yet as to whether circumcision has any impact on the risk of infection for the woman, on the risk among men who have sex with other men, or on the risk for heterosexual anal intercourse.

-- Circumcision should be a part of a prevention package that also includes safe-sex counselling and access to condoms for both partners.

"Communities, and particularly men opting for the procedure and their partners, require careful and balanced information and education materials that underline male circumcision is not a 'magic bullet' for HIV prevention but is complementary to other ways of reducing risk of HIV infection," the guidelines warn.

-- Circumcision has to carried out with confidentiality and the informed consent of the male and without coercion or discrimination. Countries should also emphasise that male circumcision has no connection with female genital mutilation, a practice with many adverse physical and psychological impacts and with no demonstrated medical benefits.

-- Circumcision should be promoted "with full adherence to medical ethics" but in a "culturally appropriate manner." For instance, traditional practitioners who carry out circumcision in a ritual to symbolise a child's transition to adulthood should be consulted to help ensure support for a circumcision campaign.

-- Countries should carefully assess their needs in funding, trained personnel and medical equipment before promoting a circumcision campaign, to avoid botched operations.

More than 25 million people have died of AIDS since the disease was first detected in 1981. At the end of 2006, an estimated 39.5 million people had AIDS or HIV, and 4.3 million became newly infected with the virus that year.

The clinical reason for circumcision's preventive effect is still being investigated.

One theory is that the foreskin has a very thin lining and suffers minor abrasions during intercourse, making it easier for the human immunodeficiency virus (HIV) to enter the man's bloodstream. Another is that the foreskin is rich in Langerhans cells, whose surface is configured in such a way that the AIDS virus readily latches on to them.

Obesity boosts prostate cancer mortality

Obese men diagnosed with prostate cancer are more than twice as likely to die of the disease than their leaner peers, a new study shows.

They also have more than triple the risk that the cancer will spread beyond their prostate gland, Dr. Alan R. Kristal of Fred Hutchinson Cancer Research Center in Seattle and colleagues found.

"These results provide yet one more important reason for men to adopt healthful patterns of diet and physical activity to achieve and maintain a normal weight," Kristal and his team conclude in the medical journal Cancer.

A number of studies have linked excess weight with more advanced prostate cancer, Kristal and his team note, but evidence for the effect of obesity on actual outcome from the disease has been unclear. To investigate, they looked at 752 men who had been diagnosed with prostate cancer between 1993 and 1996 and followed for an average of 9.5 years.

Men who were obese in the year before they were diagnosed with prostate cancer, meaning their body mass index (BMI) was 30 or higher, were 2.6 times more likely to have died of the disease, the researchers found. They were also at 3.6 times greater risk of disease metastasis.

The data also suggested that the effect of obesity on mortality risk was stronger among men with more aggressive disease.

A clinical trial would be needed to determine if weight loss could actually help treat prostate cancer, Kristal and colleagues add.

Wednesday, March 28, 2007

Health Tip: Never Leave a Child Alone in the Tub

Young children -- not just infants -- still need strict supervision during bath time to prevent burns, drowning and other accidents.

Here are some suggestions for bath time safety, courtesy of the American Academy of Family Physicians:

* Never leave a child unattended in the bathtub, even for a few seconds. Don't entrust an older child to watch a toddler, either.
* If you have to answer the door or the telephone, take the child with you.
* Always test the water in the bathtub yourself before immersing your child. A child's sensitive skin can burn easily from water that's too warm or hot.
* Keep all electrical appliances -- radios, hair dryers, curling irons, etc. -- far away from the tub.

Diabetes-Parkinson's Link Grows Stronger

As people with obesity-linked type 2 diabetes age, their risk of getting Parkinson's disease also climbs, a new study warns.

In fact, excess weight may explain why diabetics are at increased risk of getting the neurological disorder, a Finnish study suggests.

"These findings are important from a clinical and public health point of view," said study author Dr. Gang Hu, senior researcher at the National Public Health Institute in Helsinki. "Type 2 diabetes is increasing rapidly in all populations, and its impact on various health outcomes are not fully known or even explored."

His team's study -- the first large effort to follow people over time and evaluate the diabetes-Parkinson's link -- is published in the April issue of Diabetes Care.

Parkinson's disease affects about 1.5 million Americans, according to the National Parkinson Foundation. It occurs when certain brain cells or neurons die or become impaired. These cells normally produce a substance called dopamine, which helps regulate coordinated movement. Symptoms of Parkinson's include tremor, slow movement and difficulties keeping one's balance.

In type 2 diabetes, the body doesn't properly use insulin or doesn't make enough insulin, which is crucial for the body's uptake of glucose for energy. Excess weight is the major risk factor for type 2 diabetes.

A few other studies have looked at how prevalent type 2 diabetes is among patients with Parkinson's, but, according to Hu, "the results are inconsistent."

His team's study included more than 51,000 Finnish men and women with no prior history of Parkinson's, between the ages of 25 and 74, at the beginning of the trial.

During the 18 years of follow-up, 324 men and 309 women developed Parkinson's disease.

When Hu and his team evaluated the subjects' medical histories, they found that people with type 2 diabetes were 83 percent more likely to get Parkinson's.

The increased risk was still present even after the researchers took into account body mass index (BMI), alcohol intake, coffee/tea intake, smoking and physical activity.

So, what's behind the association? "It could be hypothesized that diabetes might increase the risk of Parkinson's disease partly through excess body weight," Hu said. "The positive association between body weight and the risk of Parkinson's disease has been found in our previous studies."

Another expert called the study "very preliminary," however.

Cathy Nonas, director of diabetes and obesity programs at North General Hospital and an assistant clinical professor at Mount Sinai School of Medicine, New York City, said the association does makes sense. "I could theorize -- just theorize -- that because it takes a lot of energy for brain cells to use glucose, that insulin resistance in type 2 diabetes might affect carbohydrate metabolism in dopaminergic neurons, causing some sort of dysfunction and rendering them unable to defend against cell damage," she said.

In fact, Nonas is studying the effects of very low-protein, very low-carbohydrate diets on Parkinson's patients. The theory is that when you deplete the body of carbs, it makes more "ketones" -- substances produced when the body breaks down fat for energy. According to Nonas, ketones may be an easier fuel than glucose for the brain to use, perhaps improving some Parkinson's symptoms.

But that research is in its infancy. For now, Nonas said, the best advice is for anyone with type 2 diabetes to keep it under control and see their doctor regularly. If they develop new symptoms, such as difficulty walking or tremors, they should make their doctor aware of them, she added.

Type 2 diabetes may raise Parkinson's risk

Patients with type 2 diabetes are more likely to develop Parkinson's disease, although the reasons are unclear, Finnish researchers reported on Wednesday.

They found that people with type 2 diabetes were 83 percent more likely to be diagnosed with Parkinson's later in life than people in the general population. This risk was the same for men and women and was independent of other risk factors.

"Diabetes might increase the risk of Parkinson's disease partly through excess body weight," the researchers wrote in the April issue of Diabetes Care.

Being overweight and not exercising enough are linked with type 2 diabetes, which is becoming more common around the world. Diabetes can lead to blindness, limb loss, heart disease and early death.

Parkinson's is a movement disorder caused by the destruction of certain brain cells. People often develop tremors first, but the incurable disease can progress to paralysis and death.

There are no known major risk factors for Parkinson's, but some studies suggest exposure to chemicals such as pesticides may cause some cases. It affects about 1 million people in the United States alone.

Dr. Gang Hu and colleagues at the National Public Health Institute in Helsinki, Finland, followed 51,552 Finnish men and women aged 25 to 74 for 18 years. None had Parkinson's disease at the beginning of the study.

About 600 developed Parkinson's by the end of it, and those who did were nearly twice as likely to have diabetes as well, the researchers found.

They said they would investigate the link further.

Circumcision recommended to fight HIV

U.N. health agencies recommended Wednesday that heterosexual men undergo circumcision because of "compelling" evidence that it can reduce their chances of contracting
HIV by up to 60 percent.

But World Health Organization and UNAIDS experts said men need to be aware that circumcision is only partial protection against the virus and must be used with other measures.

"We must be clear," said Catherine Hankins of UNAIDS. "Male circumcision does not provide complete protection against HIV."

Studies suggest 5.7 million new cases of HIV infection and 3 million deaths over 20 years could be prevented by male circumcision in sub-Saharan Africa, the agencies said.

Still, men and women who consider male circumcision as an HIV preventive method need to continue using other forms of protection such as male and female condoms, abstinence, delaying the start of sexual activity and reducing the number of sexual partners, she said.

Otherwise, they could develop a false sense of security and engage in high-risk behaviors that could undermine the partial protection provided by male circumcision, the agencies said.

Men also should be warned that they are at a higher risk of being infected with HIV if they resume sex before their wound has healed. Likewise an HIV-positive man can more easily pass on the disease to his partner if the wound is still unhealed.

The recommendations were based on a meeting earlier this month in Montreux, Switzerland, where experts discussed three trials — in Kenya, Uganda and South Africa — that produced "strong evidence" of the risk reduction resulting from heterosexual male circumcision.

"Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men," a joint statement said.

The agencies said much depends on the situation in a given country, and little general benefit will result in countries where the HIV epidemic is concentrated among sex workers, injecting drug users or men who have sex with men.

The public health impact is likely to be most rapid where there is a high rate of HIV infection among men having sex with women.

"It was therefore recommended that countries with high prevalence, generalized heterosexual HIV epidemics that currently have low rates of male circumcision consider urgently scaling up access to male circumcision services," the agencies said.

More study is needed to determine whether male circumcision will cut the transmission of HIV to women. More study also is required to find out whether male circumcision will reduce HIV infection in homosexual intercourse, it said, but it said promoting circumcision of HIV-positive men was not recommended.

"The recommendations represent a significant step forward in HIV prevention," said Dr. Kevin De Cock, director of WHO's HIV/
AIDS department. "Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men."

Increasing male circumcision in areas where it the procedure is rare will result in immediate benefit to the men circumcised, but it will take years before there will be an impact on the epidemic.

Although the rate of circumcision varies considerably from country to country, globally an estimated 665 million men, or 30 percent of men in the world, are circumcised, the statement said.

The agencies said the risks involved in male circumcision are generally low, but can be serious if the operation is performed in unhygienic settings by poorly trained, ill-equipped health workers.

Priority should be given to providing circumcision to age groups at highest risk of acquiring HIV because it will have the most immediate impact on the disease. But, it said, circumcising younger males also will have a public health impact over the longer term.

It gave no estimate how much providing the service would cost, but said more money would be needed, but that donors should regard it as "an important, evidence-based intervention."

WHO support male circumcision to fight spread of AIDS

UN health agencies on Wednesday gave the stamp of approval for including male circumcision in the panoply of arms to fight the spread of AIDS, stressing though that its success also depended on safe-sex awareness, sensitivity and resources.

The World Health Organisation (WHO) and the specialised agency
UNAIDS declared that millions of lives could be saved if circumcision were widely and safely practised.

They issued guidelines at a press conference in Paris following a debate among experts, health officials and grassroots groups in Geneva on March 6-8.

"The recommendations represent a significant step forward in
HIV prevention," said Kevin de Cock, director of the WHO's HIV/AIDS Department.

"Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men," said de Cock.

"Scaling up male circumcision in such countries will result in immediate benefit to individuals," he said, adding, however: "It will be a number of years before we can expect to see an impact on the epidemic from such investment."

The spur for the recommendation has been two trials conducted in Uganda and a third in South Africa.

These studies found that men who had been circumcised reduced the risk of HIV infection by between 51 and 60 percent at least, as compared with uncircumcised counterparts.

"The efficacy of male circumcision in reducing female-to-male transmission of HIV has been proven beyond reasonable doubt. This is an important landmark in the history of HIV prevention," said the WHO and UNAIDS.

According to figures published in Public Library of Science (PLoS) Medicine that were cited in the UN document, 5.7 million new cases of HIV infection and three million deaths could be prevented over 20 years if male circumcision were universally practised in sub-Saharan Africa.

The two agencies made these points:

-- Circumcision reduces, but does not eliminate, the risk of infection for the man in the context of heterosexual intercourse.

There is no evidence yet as to whether circumcision has any impact on the risk of infection for the woman, on the risk among men who have sex with other men, or on the risk for heterosexual anal intercourse.

-- Circumcision should be a part of a prevention package that also includes safe-sex counselling and access to condoms for both partners.

"Communities, and particularly men opting for the procedure and their partners, require careful and balanced information and education materials that underline male circumcision is not a 'magic bullet' for HIV prevention but is complementary to other ways of reducing risk of HIV infection," the guidelines warn.

-- Circumcision has to carried out with confidentiality and the informed consent of the male and without coercion or discrimination. Countries should also emphasise that male circumcision has no connection with female genital mutilation, a practice with many adverse physical and psychological impacts and with no demonstrated medical benefits.

-- Circumcision should be promoted "with full adherence to medical ethics" but in a "culturally appropriate manner." For instance, traditional practitioners who carry out circumcision in a ritual to symbolise a child's transition to adulthood should be consulted to help ensure support for a circumcision campaign.

-- Countries should carefully assess their needs in funding, trained personnel and medical equipment before promoting a circumcision campaign, to avoid botched operations.

More than 25 million people have died of AIDS since the disease was first detected in 1981. At the end of 2006, an estimated 39.5 million people had AIDS or HIV, and 4.3 million became newly infected with the virus that year.

The clinical reason for circumcision's preventive effect is still being investigated.

One theory is that the foreskin has a very thin lining and suffers minor abrasions during intercourse, making it easier for the human immunodeficiency virus (HIV) to enter the man's bloodstream. Another is that the foreskin is rich in Langerhans cells, whose surface is configured in such a way that the AIDS virus readily latches on to them.

Italy to offer cervical cancer vaccine

A vaccine against the sexually transmitted virus that can cause cervical cancer went on sale Wednesday in Italy, the first European Union nation to offer the vaccine free for 12-year-old girls, the Italian Health Ministry said.

The ministry said a campaign will be launched soon to encourage the free vaccination of 12-year-olds but that the vaccine for the human papillomavirus, of HPV, will not be mandatory. Older girls and women who want the vaccination will have to pay for it.

Proponents of the vaccine say it will be most effective when given before girls become sexually active. Ministry officials said the vaccine is being supplied by Sanofi-Pasteur, the vaccine division of Sanofi-Aventis.

Efforts to make the vaccine mandatory have triggered controversy in parts of the United States. Last month, in Texas, the governor ordered that schoolgirls going into sixth grade in 2008 be vaccinated against HPV. Conservatives contended that requiring the vaccine would encourage premarital teenage sex and erode parental rights.

HPV infection can lead to cervical cancer in women. It rarely causes cancer in men.

Type 2 diabetes may raise Parkinson's risk

Patients with type 2 diabetes are more likely to develop Parkinson's disease, although the reasons are unclear, Finnish researchers reported on Wednesday.

They found that people with type 2 diabetes were 83 percent more likely to be diagnosed with Parkinson's later in life than people in the general population. This risk was the same for men and women and was independent of other risk factors.

"Diabetes might increase the risk of Parkinson's disease partly through excess body weight," the researchers wrote in the April issue of Diabetes Care.

Being overweight and not exercising enough are linked with type 2 diabetes, which is becoming more common around the world. Diabetes can lead to blindness, limb loss, heart disease and early death.

Parkinson's is a movement disorder caused by the destruction of certain brain cells. People often develop tremors first, but the incurable disease can progress to paralysis and death.

There are no known major risk factors for Parkinson's, but some studies suggest exposure to chemicals such as pesticides may cause some cases. It affects about 1 million people in the United States alone.

Dr. Gang Hu and colleagues at the National Public Health Institute in Helsinki, Finland, followed 51,552 Finnish men and women aged 25 to 74 for 18 years. None had Parkinson's disease at the beginning of the study.

About 600 developed Parkinson's by the end of it, and those who did were nearly twice as likely to have diabetes as well, the researchers found.

They said they would investigate the link further.

Suicide top killer of young Chinese

Suicide is the top killer of young Chinese, accounting for more than a quarter of deaths in the 15 to 34-year-old age group last year, the official China Daily said on Tuesday.

The stress of living in a highly competitive and fast changing society is taking a rising toll on the country's young, many of them only children both pampered and pressured by parents and grandparents.

Statistics from the Chinese Association of Mental Health showed suicide was the leading killer of young people in 2006, causing 26 percent of deaths. The association did not give a total number of deaths.

In 2003, the last year for which figures are available, over a quarter of a million people committed suicide in China and another two million attempted suicide, the paper said.

In comparison the United States had 31,500 suicides in the same year -- a far lower rate, even taking into account the country's smaller population, the paper added.

Many of the deaths in China are among teenagers, with a survey of more than 140,000 high school students finding that around 20 percent said they had considered suicide and 6.5 percent said they had made concrete plans to kill themselves.

Since 2002 the proportion of teenagers considering each of the three steps toward suicide -- considering it, making a plan and taking action -- had all risen, the report by the Child and Teenage Health Research Institute at Peking University found.

Around half the children said they had felt lonely in the previous year and 40 percent had recurrent sleeping problems.

The problems were due in part to a cultural unwillingness to discuss feelings, relationship difficulties and the lack of channels for exploring self-identity, researchers found.

Asked to picture their ideal world, they drew themselves without uniforms or regulated hairstyles, free from parents' and teachers' controls, the paper added.

Health Tip: Grill Safely

Gas and charcoal grills cause thousands of outdoor and structure fires each year. To prevent your grill from becoming a safety hazard, follow these suggestions from the Home Safety Council:

* Keep the area surrounding the grill free of children and pets until the grill has completely cooled.
* When the grill is in use, be sure it is at least three feet away from any structure or object -- including trees, shrubs or the house.
* When using a charcoal grill, only use lighter fluid designed for such grills.
* When using a gas grill, check the connections between the tank and the grill carefully before each use.
* Never check for gas leaks using a match.

Health Tip: Foods to Avoid During Pregnancy

Safe, well-balanced meals are especially important during pregnancy. The American Pregnancy Foundation says certain foods should be avoided entirely, including:

* Raw meat, shellfish and eggs.
* Many deli meats that could be undercooked and harbor bacteria. During pregnancy, it's a good idea to reheat deli meats until they're steaming.
* Fish that contain mercury or have been exposed to pollutants.
* Smoked seafood.
* Unpasteurized milk, soft cheeses and pate.
* Unwashed, raw vegetables.

Two children bring Egypt bird flu cases to 29

Two Egyptian children have been infected with avian flu, the health ministry announced on Tuesday, bringing to 29 the number of infections reported since the virus appeared in the country a year ago.

Rihab Mahmud Helmi, a six-year-old girl, and Mahmud Gomaa Mohammed, a five-year-old boy, have been brought to Cairo for treatment, ministry spokesman Abdel Rahman Shaheen told AFP.

The children -- from separate southern Egyptian cities -- are in stable condition and being treated with the Tamiflu drug. Their families are under observation.

The announcement comes only two days after another child, three-year-old Hagar Mohammed Awadallah from the southern city of Aswan, was diagnosed with the highly pathogenic H5N1 strain of the virus.

Shaheen added that Awadallah's condition is improving.

Egypt's position on major bird migration routes and the widespread practice of keeping domestic fowl close to living quarters have helped the Arab world's most populous nation to the highest human death toll from avian flu outside Asia.

So far 13 people have died from the virus since it first appeared in Egypt in February 2006.

Women and young children, often charged with caring for the birds, have borne the brunt of the disease.

Va. gov. proposes cancer vaccine change

The governor on Monday proposed a measure to make it easier for parents to exempt their daughters from receiving a vaccine for the sexually transmitted virus that can cause cervical cancer.

Last month, the Legislature passed bills to require all girls entering the sixth grade to get the vaccine for the human papillomavirus, or HPV.

Gov. Timothy M. Kaine's amendment would eliminate the need for parents or guardians to submit written requests for their children to opt out of the vaccine, called Gardasil.

"While I believe that this vaccine shows great promise for preventing cancer, I believe that the decision to administer this vaccine should be made by parents," Kaine said in a statement.

The Legislature will reconvene for a one-day session April 4 to consider Kaine's proposal.

Virginia's legislature was the first to pass a bill requiring the vaccine for girls. Texas Gov. Rick Perry sidestepped the Legislature and ordered the shots for girls there, but lawmakers are considering overriding that order.

Bills were introduced in about 20 states to require the vaccine, but some have backed off because of concerns over the vaccine's safety and protests from conservatives who say requiring it promotes promiscuity and erodes parents' rights.

Chile rediscovers native Mapuche remedies

Chileans are rediscovering the ancient herbal remedies of the Mapuche indigenous tribe, including a sexual energizer touted as a natural Viagra and other inexpensive alternative medicines.

Chile's largest native ethnic group, the Mapuche, who live mainly in the Temuco area of southern Chile, have long used a wide variety of herbal remedies for everything from arthritis and acne to a lack of libido.

One of the most popular remedies, palwen, known as "Mapuche Viagra," was snatched up earlier this year by enthusiastic tourists attending a local song festival, who exhausted supplies of the aphrodisiac in the port town of Valparaiso.

The Mapuche, whose name means people of the earth, are famous for their fierce resistance to the Spanish conquest. Their modern-day population is relatively small, and indigenous culture is not as influential in Chile as in other Latin American countries.

The herbal medicine trend has made many Chileans reclaim a part of their Indian heritage.

"A year ago I discovered Mapuche medicine and it's worked. I'm now being treated for arthritis. I use it to complement the medications my doctor prescribes," Aurora Navarrete, a 59-year-old housewife, told Reuters.

The natural remedies got a boost four years ago when the Mapuche community took over the administration of the Maquehue Hospital in Temuco and set up a pharmacy project using regular doctors and Mapuche healers called machis.

The machis set up traditional Mapuche wooden huts called rucas on the hospital grounds so that patients could opt for Mapuche remedies as well as modern medical treatments, with many taking advantage of both.

The herbalist pharmacy venture, called Makelawen and owned by Herbolaria de Chile (Herbalists of Chile) and a Mapuche trade organization, has spread across the country, growing from one pharmacy with 50 clients to seven pharmacies, including four in the capital, Santiago.

MAPUCHE WISDOM

Oclida Millallanca, a 28-year-old Mapuche woman in traditional dress wearing the signature crown of silver coins draped across her forehead, tends the Makelawen pharmacy in downtown Santiago.

"I'm like a psychologist. People tell me about their problems, their physical and spiritual complaints. People trust Mapuche wisdom," said Millallanca as Mapuche music played in the background.

The Makelawen pharmacy does not look like an immediate threat to Chile's retail pharmacies, which are dominated by three major chains, but it is gaining followers.

"My children and I use this type of alternative because it's more natural," said housewife Liliana Dorival, 56. "I have different varieties of these medications, they're good."

Makelawen now offers nearly 50 products, which are sold as liquid tinctures based on plant extracts. At $3.80 a bottle, they are cheaper than most conventional medicines.

Prostate biopsy may be misleading in obese men

In overweight or obese men, prostate biopsy may underestimate the aggressiveness of prostate cancer, research suggests.

"Even if a well-done biopsy shows low-grade cancer in an obese patient, there is still a reasonable likelihood that the patient may have high-grade disease," Dr. Stephen J. Freedland of Duke University Medical Center, Durham, North Carolina commented in a university statement.

A misleading prostate biopsy could lead to inadequate or inappropriate treatment of the cancer, he and colleagues warn in their report, published today in the journal Urology.

The prostate specific antigen, or PSA, is a blood test used to look for early signs of prostate cancer. Men who have a suspicious PSA result often undergo a prostate biopsy, which involves inserting a needle into the prostate to extract tissue for analysis. The results of the biopsy play a critical role in treatment decisions.

Freedland and colleagues analyzed data from 1,113 men who underwent surgical removal of their prostates. The investigators compared the aggressiveness of each patient's cancer, determined by the biopsy tissue, with the actual aggressiveness of disease found by a more extensive microscopic examination of the removed prostate.

Based on inspection of the prostate, the disease of 299 men (27 percent) was upgraded to a worse status and downgraded to a more favorable status in 123 men (11 percent). Disease status was on the mark in 691 men (62 percent).

In analyses that took into consideration the influence of potentially confounding factors, obesity was significantly associated with upgrading of the prostate biopsy results.

Obese men were 89 percent and overweight men 44 percent more likely than normal-weight men to have a more aggressive form of prostate cancer than was suggested by the biopsy.

"We already know it's more difficult to diagnose prostate cancer in obese men because they have lower levels of PSA...and because their larger-sized prostates make it more likely for a biopsy to miss the cancer," Freedland said. "These findings further suggest that we could be missing even more high-grade disease among obese men."

Doctors may need to perform more biopsy samples on obese men, according to Freedland, in order to determine the "true aggressiveness of the prostate cancer and allow treatment to be better tailored to the patients' needs."

SOURCE: Urology, March 2007.

Monday, March 26, 2007

Depression Ups Heart Failure Death Risk

Depression significantly increases the risk of major health problems and even death in elderly people with chronic heart failure, an Italian study finds.

"This trial demonstrates the critical importance of mental health monitoring for successful management of heart failure in this population," study co-author Dr. Aldo Maggioni, of the ANMCO Research Center in Florence, said in a prepared statement.

His team studied almost 19,000 patients over the age of 60 with heart failure. Of these, more than 2,400 were receiving drug treatment for depression before their diagnosis of heart failure. The patients being treated for depression tended to be older, female, and more likely to have a history of peripheral vascular disease and stroke than those without depression.

The heart failure patients with depression were much more likely to die or suffer problems such as stroke, transient ischemic attack (TIA), or mild stroke), heart attack, and to require re-hospitalization, the researchers reported.

"Effective methods to monitor and treat depression in nursing homes should be implemented to improve the quality of life for patients with heart failure," Maggioni said.

The study was expected to be presented Sunday at the American College of Cardiology's annual meeting, in New Orleans.

Chile rediscovers native Mapuche remedies

Chileans are rediscovering the ancient herbal remedies of the Mapuche indigenous tribe, including a sexual energizer touted as a natural Viagra and other inexpensive alternative medicines.

Chile's largest native ethnic group, the Mapuche, who live mainly in the Temuco area of southern Chile, have long used a wide variety of herbal remedies for everything from arthritis and acne to a lack of libido.

One of the most popular remedies, palwen, known as "Mapuche Viagra," was snatched up earlier this year by enthusiastic tourists attending a local song festival, who exhausted supplies of the aphrodisiac in the port town of Valparaiso.

The Mapuche, whose name means people of the earth, are famous for their fierce resistance to the Spanish conquest. Their modern-day population is relatively small, and indigenous culture is not as influential in Chile as in other Latin American countries.

The herbal medicine trend has made many Chileans reclaim a part of their Indian heritage.

"A year ago I discovered Mapuche medicine and it's worked. I'm now being treated for arthritis. I use it to complement the medications my doctor prescribes," Aurora Navarrete, a 59-year-old housewife, told Reuters.

The natural remedies got a boost four years ago when the Mapuche community took over the administration of the Maquehue Hospital in Temuco and set up a pharmacy project using regular doctors and Mapuche healers called machis.

The machis set up traditional Mapuche wooden huts called rucas on the hospital grounds so that patients could opt for Mapuche remedies as well as modern medical treatments, with many taking advantage of both.

The herbalist pharmacy venture, called Makelawen and owned by Herbolaria de Chile (Herbalists of Chile) and a Mapuche trade organization, has spread across the country, growing from one pharmacy with 50 clients to seven pharmacies, including four in the capital, Santiago.

MAPUCHE WISDOM

Oclida Millallanca, a 28-year-old Mapuche woman in traditional dress wearing the signature crown of silver coins draped across her forehead, tends the Makelawen pharmacy in downtown Santiago.

"I'm like a psychologist. People tell me about their problems, their physical and spiritual complaints. People trust Mapuche wisdom," said Millallanca as Mapuche music played in the background.

The Makelawen pharmacy does not look like an immediate threat to Chile's retail pharmacies, which are dominated by three major chains, but it is gaining followers.

"My children and I use this type of alternative because it's more natural," said housewife Liliana Dorival, 56. "I have different varieties of these medications, they're good."

Makelawen now offers nearly 50 products, which are sold as liquid tinctures based on plant extracts. At $3.80 a bottle, they are cheaper than most conventional medicines.

Study links child care to poor behavior

Children who got quality child care before entering kindergarten had better vocabulary scores in the fifth grade than did youngsters who received lower quality care.

Also, the more time that children spent in child care, the more likely their sixth grade teachers were to report problem behavior.

The findings come from the largest study of child care and development conducted in the United States. The 1,364 children in the analysis had been tracked since birth as part of a study by the National Institutes of Health.

In the study's latest installment, being released Monday, researchers evaluated whether characteristics observed between kindergarten and third grade were still present in fifth grade or sixth grade. The researchers found that the vocabulary and behavior patterns did continue, though many other characteristics did dissipate.

The researchers said the increase in vocabulary and problem behaviors was small, and that parenting quality was a much more important predictor of child development.

In the study, child care was defined as care by anyone other than the child's mother who was regularly scheduled for at least 10 hours per week.

The researchers said the enduring effect of child care quality is consistent with other evidence showing that children's early experiences matter to their language development.

The long-term effect on behavior also may have a logical explanation, the researchers said.

"One possible reason why relations between center care and problem behavior may endure is that primary school teachers lack the training as well as the time to address behavior problems, given their primary focus on academics," the researchers said.

The study appears in the current issue of Child Development. The authors emphasized that the children's behavior was within a normal range and that it would be impossible to go into a classroom, and with no additional information, pick out those who had been in child care.

Mexican Catholics protest abortion bills

Reciting the rosary and chanting prayers, several thousand abortion opponents summoned by Mexico's Roman Catholic Church marched through the capital to oppose a proposal to legalize the procedure in the first three months of pregnancy.

The abortion bill, proposed by the leftist Democratic Revolution Party, is sure to launch a protracted fight between liberal lawmakers and conservative forces in a nation where about 90 percent of people are at least nominally Catholic. Mexican law allows abortion only if the woman's life is in danger or in cases of rape or incest.

Mexico City Cardinal Norberto Rivera on Sunday led a march of about 25 blocks to the Basilica of the Virgin of Guadalupe, Mexico's patron saint, where he celebrated an afternoon Mass on a balcony overlooking the basilica's packed main plaza.

"We are united here so that they hear our voice, the voice of life," Rivera, who regularly comments on politics despite a constitutional ban on such activity by clerics, told an applauding crowd.

Attending Sunday's so-called "pilgrimage for life" were extended families, Catholic youth groups and habit-wearing nuns who waved banners and balloons emblazoned with the image of the Virgin of Guadalupe. Some wore white to symbolize purity, and recited the rosary as they walked alongside slow-moving pickup trucks equipped with loudspeakers that blasted hymns and prayers. Others carried signs reading "Let's defend life."

Colombian Cardinal Alfonso Lopez Trujillo, the
Vatican's top anti-abortion campaigner who was in the capital for the Third International Pro-Life Congress, appeared to be keeping a low profile Sunday, and was not visibly present at Rivera's Mass.

The Mexican constitution bars foreigners — including Lopez Trujillo and members of U.S. anti-abortion groups attending the conference — from political activism. In 2000, authorities barred U.S. and Canadian anti-abortion activists from returning to Mexico for five years after they joined protests in Mexico City's main square. Such groups were not noticeable at the march either.

Mexican law also prohibits political involvement by domestic religious leaders such as Rivera, although that provision has been weakly enforced — especially under the church-friendly PAN. In his sermon Sunday, Rivera said the church's fight against abortion is not about politics, but about the moral teachings of God.

Bills proposed by the opposition Democratic Revolution Party, or PRD, in Mexico City's assembly and the federal Congress would legalize abortion during the first three months of pregnancy.

The PRD argues that current Mexican law forces poor women to seek back-street operations, while the wealthy can travel to the United States for the procedure.

"We need to stop thousands of women from dying in unsafe operations," said Sen. Carlos Navarrete, who heads the PRD in the Senate.

The measure is expected to pass easily in Mexico City, a federal district with a PRD-dominated legislature that recently approved same-sex civil unions in the capital.

But it will face a tougher road at the federal level, where President Felipe Calderon's conservative National Action Party holds a plurality.

"The people are in favor of life," said Jorge Alberto Serna, 28, an activist for the poor who attended the anti-abortion march. Abortion-legalization proponents "are not listening to the society," he said.

ndonesia confronts WHO over vaccines

The World Health Organization might guarantee that poor nations get access to bird flu vaccines in the event of a pandemic, the top WHO flu official said Monday, hoping to end a dispute triggered by Indonesia's decision to stop sharing virus samples.

Indonesia — the nation hardest hit by bird flu, with 66 human deaths — is refusing to send samples of the H5N1 bird flu virus to WHO until it stops sharing them with commercial vaccine makers.

The cash-strapped country says the current system is unfair because it cannot afford vaccines produced using its strains.

"The system places developing countries at potential disadvantages in terms of price, access and supply of vaccine," Health Minister Siti Fadilah Supari said at a meeting of global health officials in Jakarta aimed at finding a solution to the standoff. "The rules of the system must be changed."

The country has said in the past that it wants a legally binding agreement that the samples will not be used for commercial purposes, but Supari made no mention of that demand in her opening speech.

Indonesia's decision has received support from some other developing nations, but has alarmed international scientists desperate to check whether the virus is mutating into a more dangerous form.

Dr. David Heymann, WHO's top flu official, said one short-term solution might be "stockpiles of pandemic vaccine in which industry would set aside a percentage of pandemic vaccine for developing country needs, with a guarantee of purchase from WHO."

Later, the body might help Indonesia and other developing countries develop vaccine production facilities themselves, he said.

He said Indonesia's demand that the world body not make virus strains available to commercial vaccine makers was not a solution and would hinder global cooperation in the fight against the virus.

In comments to reporters, Supari did not respond to the possible solution proposed by Heymann, but insisted that the country would not send the samples outside the country if it meant that vaccine makers could access them.

"A collaborating center and vaccine factory could be developed here so there will be no need for the virus to be sent outside the country," she said. "Why not? We have the most virus and patients."

The meeting, attended by health officials from 18 countries, is to end Wednesday.

Indonesia's decision to stop cooperating with WHO has highlighted inequalities in global access to vaccines and drugs.

"Wealthy countries are always in a better position to be able to produce vaccines, to buy them and to distribute them," said Dr. James Campbell, a leading bird flu vaccine researcher at the University of Maryland.

Bird flu has killed at least 169 people since it began ravaging Asian poultry stocks in 2003, according to WHO. It remains hard for people to catch, and most human cases have been linked to contact with sick birds. But experts fear it could mutate into a form that spreads easily among people, potentially sparking a pandemic that could kill millions.

Currently, only up to about 500 million doses of flu vaccine can be produced annually — far short of what would be needed in a pandemic.

To ensure it has access to a bird flu vaccine, Indonesia has reached a tentative agreement with U.S. drug manufacturer Baxter Healthcare Corp. Under the deal, Indonesia would provide the virus in exchange for Baxter's expertise in vaccine production.

Friday, March 23, 2007

More Seniors Suffering Spinal Cord Injury

The number of spinal cord injures among people aged 70 and older has risen more than fivefold in the past three decades, U.S. researchers report.

This jump in cases "is likely the result of an aging population and propensity for these patients to have SCI (spinal cord injury) with minor trauma," researcher Dr. James Harrop, an assistant professor of neurological and orthopedic surgery at Jefferson Medical College in Philadelphia, said in a prepared statement.

His team reviewed the cases of almost 3,500 spinal cord injury patients treated at Jefferson Regional Spinal Cord Injury Center from 1978 to 2006. Overall, yearly admissions increased nearly 60 percent since the early 1980s, but admission for patients aged 70 and older increased more than 580 percent.

In 1980, elderly people accounted for 4.2 percent of patients admitted to the spinal cord injury center. By 2006, that had increased to 15.4 percent.

"Falls continue to be the predominant mechanism for geriatric spinal cord injuries with 74 percent of geriatric injuries resulting from a fall in this series," Harrop said.

The study also found that elderly spinal cord patients were about eight times more likely than younger patients to die in hospital or within a year of their injury. The rate of death during hospitalization was 3.2 percent for patients younger than age 70, compared with 27.7 percent for patients aged 70 and older.

Death rates in the year after a spinal cord injury were 5.4 percent for patients younger than age 70 and 44.4 percent for those aged 70 and older.

The findings were presented at a recent meeting of the American Association of Neurological Surgeons.

Health Tip: My Child's Sick

Your child has diarrhea and is vomiting. At what point should you take him to the doctor?

The American Academy of Family Physicians recommends that you contact the pediatrician immediately if, in addition to his other symptoms, he's also:

* Less than 6 months of age.
* Greater than 6 months of age and has a fever higher than 101.4 degrees Fahrenheit.
* Got symptoms of dehydration, or hasn't urinated in eight hours or more.
* Had a severe stomach ache for more than two hours, or vomiting has lasted for more than eight hours or has been extremely forceful.
* Had bloody or slimy stools.
* Had blood in the vomit.
* Possibly swallowed a poisonous substance.
* Had a stiff neck.
* Been unusually tired.

Health Tip: If Your Child Has a Seizure

If your child is having a seizure, it's important to prevent injury and keep her safe from harm.

The Children's Hospital Boston recommends that you:

* Stay calm, and don't leave the child unattended during the seizure.
* Gently lie the child on the floor, on her side, with a soft object under her head. Try to keep her head from falling backward.
* Do not allow the child to lie on her back, as she could choke if she vomits.
* Loosen any tight or restrictive clothing.
* Move any hard objects, such as tables and chairs, out of the way.

Once the seizure ends, contact your child's doctor, who may want to know:

* Where did the seizure begin (commonly, the hands, arms, legs, or eyes)?
* Did the seizure stay in one area of the body or did it travel to other parts?
* How long did the seizure last?
* Were there any factors that seemed to cause or trigger the seizure?

Fitted Sports Gear Key to Eye Protection

Each year in the United States, about 40,000 people -- a third of them children -- suffer sports-related eye injuries that could be prevented by wearing appropriate, sport-specific protective eyewear that's been properly fitted by an eye-care specialist, according to the American Academy of Ophthalmology (AAO).

"Athletes need to choose to use protective eyewear, because eye injuries can be devastating," Dr. Monica L. Monica, clinical correspondent for the AAO, said in a prepared statement. The group has designated April as "Sports Eye Safety Month."

"Eye injuries are one of the leading causes of visual impairment in children. The injuries range from abrasions of the cornea and bruises of the lids to internal eye injuries, such as retinal detachments and internal bleeding. Unfortunately, some of these young athletes end up with permanent vision loss and blindness," Monica said.

Many children's sports leagues don't require athletes to use protective eyewear, so parents must insist that their children wear eye protection.

"Parents also can set a good example by wearing eye protection when playing sports and work to help pass local ordinances requiring children to wear protective eyewear when engaging in sports," Monica said.

Adult and child athletes can choose from a variety of lightweight and sturdy protective eyewear that doesn't hinder performance, said Dr. M. Bowes Hamill, associate professor of ophthalmology at Baylor College of Medicine in Houston and clinical correspondent for the AAO.

Lenses in protective eyewear should be made of polycarbonate, which can withstand impact from a ball or other projectile traveling at up to 90 miles an hour.

"Contact lenses offer no protection, and street glasses are inadequate to protect against any type of eye injury," Hamill said.

If you do suffer an eye injury, seek immediate medical attention, he added.

Berlin Zoo polar bear makes public debut

With a sniff and a stumble, Berlin Zoo's irresistibly cuddly baby polar bear made his public debut Friday, delighting hundreds of excited children who packed around the pen's railings. "We want Knut! We want Knut!" chanted a group of third graders who came to see the zoo's star, dubbed "cute Knut" by the German media.

Ambling cautiously over the uneven, grassy ground, Knut clambered over a log and sniffed curiously at the legs of his handler, Thomas Doerflein.

"I'm so happy to be able to see him today," said Leila Klamann, 9, whose class was visiting the zoo. "And he's so cute!"

Some children climbed nearby playground towers for a better view.

Born at the zoo on Dec. 5, the cub has already famous through his video podcast and TV series. Star photographer Annie Leibovitz also came to take his portrait for an environmental campaign.

Poking his nose into a stream, the 15-week-old cub appeared interested in exploring the pen Friday, but returned frequently to Doerflein, who has raised him by hand since his mother rejected him and his brother shortly after their birth. The other cub later died.

"He looks even better and sweeter than he does on TV," said Julian Fuerster, 10. "And more cuddly."

The fate of the nearly 19-pound bear stirred a media flap when an animal activist insisted the cub would have been better off dead than raised by humans. The zoo flatly rejected the idea.

"If you see the little bear, you'll see it's stupid to say something like that," said Ragnar Kuehne, a zoo curator.

The general public will be able to see Knut beginning Saturday, when he is scheduled to make similar, brief appearances with his handler.

Bacteria-killing viruses fight ear infections too

An enzyme viruses use to punch holes in bacteria works to prevent ear infections in mice and might offer a safe way to prevent them in children, too, U.S. researchers said on Friday.

They said their surprisingly easy experiment might also be the first step toward preventing some deadly complications of influenza and other viral infections.

"This was an idea we had and it worked out right away. It was like magic," said Dr. Jonathan McCullers of St. Jude Children's Research Hospital in Memphis, Tennessee.

Years of testing must be done to make sure the treatment is safe, but it was 100 percent effective in mice, McCullers and colleagues report in Friday's issue of the Public Library of Science journal PLoS Pathogens.

As many as 80 percent of children in the United States have at least one ear infection in early childhood -- a condition known as acute otitis media.

It causes pain and temporary hearing loss and frantic parents often demand antibiotics from doctors. But antibiotics rarely work and studies suggest giving them to children for ear infections is helping drive the evolution of drug-resistant bacteria known as "superbugs."

Streptococcus pneumoniae is a common cause of these infections although viruses are also important, the researchers said. Often children are colonized with strep, meaning they carry the bacteria without symptoms, and then become ill after a viral infection like a cold or influenza.

"We had just discovered this particular strain (of S. pneumoniae) that causes otitis media really effectively. When we put it into mice it went right to their ears and caused ear infections right away," McCullers said in a telephone interview.

KILLER VIRUSES

Vincent Fischetti and colleagues at Rockefeller University in New York had been working with bacteriophages, a kind of virus that infects bacteria. He had one that killed Streptococcus pneumoniae very well and purified the enzyme that it uses to lyse, or punch a hole in, bacteria.

"Vince had this enzyme and he said, 'Will you test it?' and I did and it worked beautifully," McCullers said.

The enzyme, dripped into the noses of the mice, completely prevented ear infections in the mice.

Many researchers are finding that these bacteria-killing bacteriophages, or phages for short, can be manipulated to help medicine.

"These infectious viruses, when they want to leave the bacteria to go infect a lot of other bacteria and spread, they have developed these enzymes that punch a hole into the cell wall," McCullers said.

This kills the bacterium. The phages can be engineered in the lab to attack only specific kinds of bacteria, and are harmless to human cells.

"One of the applications we could imagine using is if you have kids in the wintertime that are prone to getting viruses and such, you could have nasal spray that you spray in the kid's nose once a week to just clear the bacteria out," McCullers said.

Or perhaps a spray could be used after a bout of influenza to prevent the secondary infections. This might be useful for elderly people, as seasonal flu kills 36,000 mostly elderly people every year in the United States.

"Most people don't die from the influenza, they die because of a bacterial infection after the flu," McCullers said.

But years of safety trials will have to be done before such a treatment could even be tested in children, he cautioned.

Clinical Trial to Examine Creatine as Parkinson's Treatment

A large-scale clinical trial to determine whether the nutritional supplement creatine can slow the progression of Parkinson's disease is expected to be launched Thursday by the U.S. National Institute of Neurological Disorders and Stroke, part of the
National Institutes of Health (NIH).

The double-blind, placebo-controlled study will be conducted at 51 medical centers in the United States and in Canada, and will include 1,720 people with early-stage Parkinson's disease.

The study will enroll people who've been diagnosed with Parkinson's disease within the past five years and who have been treated for two years or less with drugs that increase levels of dopamine in the brain. Many symptoms of Parkinson's disease are due to a loss of dopamine, a neurotransmitter that helps control movement.

Creatine is not approved for treatment of Parkinson's disease or any other condition, but it's widely believed that it improves exercise performance. Studies have suggested that creatine can improve the function of mitochondria, which produce energy inside cells. There's also some indication that creatine may act as an antioxidant that prevents damage from compounds that are harmful to brain cells.

"This study is an important step toward developing a therapy that could change the course of this devastating disease," NIH Director Dr. Elias A. Zerhouni said in a prepared statement. "The goal is to improve the quality of life for people with Parkinson's for a longer period of time than is possible with existing therapies."

Parkinson's disease, which affects at least 1 million people in the United States, is a degenerative brain disorder that causes symptoms such as tremors, stiff muscles and slow movement. While certain drugs can reduce symptoms of Parkinson's disease, there are no proven treatments that slow the progression of the disease.

Seniors prefer to exercise alone

Older people would rather exercise alone than be surrounded by a bunch of youthful hard bodies in Spandex, suggests a study that examined how group fitness appeals to people of different ages.

The results are a cautionary note about providing the right exercise setting for senior citizens, said University of British Columbia researcher Mark Beauchamp.

"A growing body of evidence suggests that a far greater proportion of people actually prefer to exercise alone with some instruction," rather than in a class, his study found.

Beauchamp, who works in UBC's School of Human Kinetics, said researchers found that people of all ages generally prefer to exercise with people their own age — or they may opt to go it alone. He noted that older people may be intimidated by "the Spandex-clad ideal" seen in some exercise environments.

Researchers studied the behaviors of 947 people, ranging in age from 30 to 92, in the northern English city of Leeds.

When people in their 30s and 40s were asked how they'd feel about exercising with twentysomethings, they responded positively. Not so for those 50 and up, the study found.

When people in their 60s and 70s were asked about exercising with those their same age, they reacted positively, while those in the other age groups were more negative about that prospect.

"All this study highlights is older adults can exercise in environments that are socially supportive," when given the right setting, Beauchamp said.

The study is to be published in the April issue of the Annals of Behavioral Medicine.

Dr. Barbara Resnick, an expert in geriatric exercise and motivation at the University of Maryland School of Nursing, said the study makes clear the importance of environment in getting older adults to exercise.

"There are many individuals who enjoy exercising with others, and surveys have confirmed that they enjoy exercising in formats which are Spandex-free and among others their own age and ability level," Resnick said. "Conversely, there are some older individuals who choose to exercise alone" with a variety of options, such as outdoors, she said.

Resnick said it's important for governments to promote physical activity both through community centers and through walking trails and other outdoor options.

Man gets probation for dead deer sex

A 20-year-old man received probation after he was convicted of having sexual contact with a dead deer. The sentence also requires Bryan James Hathaway to be evaluated as a sex offender and treated at the Institute for Psychological and Sexual Health in Duluth, Minn.

"The state believes that particular place is the best to provide treatment for the individual," Assistant District Attorney Jim Boughner said.

Hathaway's probation will be served at the same time as a nine-month jail sentence he received in February for violating his extended supervision.

He was found guilty in April 2005 of felony mistreatment of an animal after he killed a horse with the intention of having sex with it. He was sentenced to 18 months in jail and two years of extended supervision on that charge as well as six years of probation for taking and driving a vehicle without the owner's consent.

Hathaway pleaded no contest earlier this month to misdemeanor mistreatment of an animal for the incident involving the deer. He was sentenced Tuesday in Douglas County Circuit Court.

"The type of behavior is disturbing," Judge Michael Lucci said. "It's disturbing to the public. It's disturbing to the court."

Brain Defect Tied to Diabetes-Related Erectile Dysfunction

Diabetes-related erectile dysfunction is caused by a defect in the nitric oxide (NO) mechanism in a part of the brain called the paraventricular nucleus (PVN), a U.S. study finds.

The PVN, located in the hypothalamus, plays a role in many functions, including penis erection and sexual behavior.

Sexual dysfunction is a common problem in men with diabetes. This study offers new information about the association between diabetes and erectile dysfunction and may help improve treatments, said researchers at the University of Nebraska Medical Center in Omaha.

After a series of experiments with rats, the researchers concluded that erectile dysfunction in diabetes is due to a defect in the NO mechanisms within the PVN. This defect is the loss in the synthetic enzyme for the production of NO within the neurons of the PVN. Restoring production of this synthetic enzyme may benefit diabetic patients with erectile dysfunction.

The findings are published in the March issue of the American Journal of Physiology - Regulatory, Integrative and Comparative Physiology.

Child hunger at 'emergency' level in Central America

Malnutrition among Central American children is "a massive emergency" killing thousands every day and compromising the region's economic future, a
United Nations World Food Program official told AFP.

Pedro Medrano, the Food Program's regional director for Latin America and the Caribbean, said that countries in the region need only "political will" to deal with the chronic problem, which he said is costing their economies some six billion dollars per year.

"Child malnutrition is a massive emergency, because it is jeopardizing the future of Central American countries and of the Dominican Republic," said Medrano, speaking on the sidelines of the Inter-American Development Bank's annual meeting here.

"We believe that when a country has a 50 percent level of chronic malnutrition, we are talking about a national emergency, one that does not appear in the news media, but which means that ever day thousands of children are dying of malnutrition.

At the meeting, senior finance ministry officials for Central American nations and the Dominican Republic signed a document on Monday committing to eradicating chronic child malnutrition in their respective countries.

According to the IADB, it is the first time the nations commit to prioritize fighting chronic child malnutrition, and the first time the region's finance ministry officials agree on joint measures for nutrition.

"We are talking about a million and a half children in Central America. This region has the resources. It is only a matter of political will to prevent hunger among children," Medrano said.

Medrano cited a recent study by the WPF and the Economic Commission for Latin America and the Caribbean (ECLAC) showing the grave impact how grave the situation is for Central American economies.

"Our estimates are that the economic cost of malnutrition is between two percent and 12 percent of gross domestic product," depending on which country, or an average of six percent for the Central American region, he said.

"This is approximately an average of six billion dollars lost annually by Central American countries due to malnutrition."

Proper care and nutrition of children at their earliest ages "are fundamental to overcome poverty and assure economic growth and the stability of the countries," he said.

Medrano drew a direct link between malnutrition and the violence that bests much of the region, saying those who aren't cared for early make their way eventually into gangs.

Violence "is the final stage of a process of social breakdown," Medrano said.

"There is no reason for any child to go hungry. It does not cost so much, only 20 cents a day per child," he said.

Heart Association Backs Statin Use for At-Risk Kids

The use of cholesterol-lowering statin drugs in youngsters should be part of updated guidelines for treating children and adolescents with high-risk lipid abnormalities, particularly high cholesterol.

That's the recommendation contained in an
American Heart Association scientific statement published in the March 21 issue of the journal Circulation.

New data and increased knowledge about the beginnings of heart disease make it necessary to update the guidelines, the statement authors said.

"Guidelines drawn up by the National Cholesterol Education Program (NCEP) more than 10 years ago didn't really address the use of statins, a class of drugs that can lower cholesterol. Since that time, several drug trials in kids with familial hypercholesterolemia, a genetic predisposition to high cholesterol, have shown the use of statins had similar safety and effectiveness as in adults," Dr. Brian McCrindle, head of the statement writing group, said in a prepared statement.

"In addition to highlighting new evidence, this new statement addresses a greater need for recognizing young patients with multiple risk factors and how those factors could influence the decision to treat with medications or not," said McCrindle, a professor of pediatrics at the University of Toronto and staff cardiologist at the Hospital for Sick Children in Toronto, Canada.

The statement focuses on children with high-risk lipid abnormalities, such as familial hypercholesterolemia, diabetes, or a family history of cardiovascular disease or early heart attacks and stroke.

While other children who are overweight or obese may have elevated cholesterol levels, most of them would not meet the criteria for being prescribed cholesterol-lowering drugs. For these children, lifestyle changes would be the most appropriate treatment, McCrindle said.

Among the recommendations in the statement:

* In addition to checking family history in overweight and obese children, doctors should do screening with a fasting lipid profile.
* Overweight and obese children with lipid abnormalities should be screened for other aspects of metabolic syndrome, a condition characterized by a group of specific risk factors, such as excess weight, high blood pressure, elevated triglycerides, low levels of HDL "good" cholesterol and high fasting glucose levels.
* Lifestyle changes should be recommended for most children. But, if needed, a statin (started at the lowest dose) is recommended as the first line of treatment for children who meet criteria for starting lipid-lowering drug therapy, if there are no contraindications.
* For children with high-risk lipid abnormalities, the presence of additional risk factors or high-risk conditions may also lower the recommended levels of LDL "bad" cholesterol at which drug therapy should be started and lower the desired maintained target levels of LDL cholesterol. These high risks may include: male gender; strong family history of premature cardiovascular disease or events; presence of associated low HDL; high triglycerides; small dense LDL; presence of overweight or obesity and aspects of the metabolic syndrome; and the presence of other medical conditions associated with increased risk of atherosclerosis.

The statement also offers advice on monitoring children with lipid abnormalities as they grow, including keeping track of height, weight, body mass index, onset of puberty, and checking fasting lipoprotein profile every six to 12 months.

Tuesday, March 20, 2007

Over 5M living with Alzheimer's

More than 5 million Americans are living with
Alzheimer's disease, a 10 percent increase since the last Alzheimer's Association estimate five years ago — and a count that supports the long-forecast dementia epidemic as the population grays.

Age is the biggest risk factor, and the report to be released Tuesday shows the nation is on track for skyrocketing Alzheimer's once the baby boomers start turning 65 in 2011. Already, one in eight people 65 and older have the mind-destroying illness, and nearly one in two people over 85.

Unless scientists discover a way to delay Alzheimer's brain attack, some 7.7 million people are expected to have the disease by 2030, the report says. By 2050, that toll could reach 16 million.

Why? Ironically, in fighting heart disease, cancer and other diseases, "we're keeping people alive so they can live long enough to get Alzheimer's disease," explains association vice president Steve McConnell.

Indeed, government figures released last year that show small drops in deaths from most of the nation's leading killers between 2000 and 2004 — even as deaths attributed to Alzheimer's disease increased 33 percent.

Yet the report also contains a startling finding: Between 200,000 and half a million people under age 65 have either early-onset Alzheimer's or another form of dementia. Researchers have been hard-pressed to estimate of the number of young sufferers.

"I think this has been drastically underreported," said Dr. Bill Thies, the Alzheimer's Association's medical director.

He cites as an example a 55-year-old having problems at work, such as behavior changes or missing deadlines, that may be early signs of brain impairment but that go unrecognized until they progress to full-scale memory problems.

The new report — based on federal population counts, not new disease research — is the first update of the Alzheimer's toll since 2002, when it was estimated to afflict 4.5 million people. It comes as Congress is considering funding for research into Alzheimer's and other diseases.

No one knows what causes Alzheimer's creeping brain degeneration. It gradually robs sufferers of their memories and ability to care for themselves, eventually killing them. There is no known cure, and today's drugs only temporarily alleviate symptoms.

Because it complicates treatment for every other illness, the new report shows Medicare spends nearly three times as much for dementia patients' care as for the average beneficiary — $13,207 a year vs. $4,454. Medicare's spending on dementia-related care is projected to double to more than $189 million by 2015.

That doesn't include the value of the unpaid round-the-clock care that families and friends provide the vast majority of Alzheimer's patients who live at home — a tab the new report calculates at almost $83 billion_ or nursing home costs.

There are nine drugs in late-stage clinical trials, including a few that aim to slow Alzheimer's worsening. If such drugs pan out, delaying Alzheimer's symptoms by even a few years could cut by millions the coming decades' predicted toll, the report notes.

Drug Shields Parkinson's Patients Against Fracture

Risedronate, a drug used to strengthen bone, helps lower the risk of hip fractures in people with Parkinson's disease, Japanese researchers report.

"Prior to the study, these men had been experiencing a rapid rate of bone loss due to inactivity. Our findings show risedronate, along with vitamin D2, effectively controls the progression of osteoporosis, and reduces the risk of hip fractures," study author Dr. Yoshihiro Sato, of Mitate Hospital in Tokyo, said in a prepared statement.

The two-year study included 242 elderly men with Parkinson's disease. Half of them were given risedronate and vitamin D2, while the other half received a placebo and vitamin D2.

The men taking risedronate were three times less likely to suffer a hip fracture than those taking the placebo, the researchers report in the March 20 issue of the journal Neurology.

Bone mineral density among the men taking the drug increased by 2.2 percent, while it decreased by nearly three percent among men taking the placebo. Researchers also found that a biomarker for bone loss decreased by nearly 47 percent among men taking risedronate and by 33 percent among men taking the placebo.

Side effects caused by the drug included abdominal pain and inflammation of the esophagus.

The study was supported by Takeda Pharmaceuticals, which helped develop risedronate.

Bone drug may benefit immobile Parkinson's patients

Immobilization and lack of sunlight exposure cause accelerated bone loss in people with Parkinson's disease, increasing their risk of hip fracture. But taking the bone-building drug Actonel with vitamin D seems to curb the risk of fractures in elderly men with Parkinson's disease, even though they continue to have frequent falls.

That's according to a Japanese study involving 242 men aged 65 to 85 with Parkinson's disease who were not totally disabled and who were otherwise healthy. All of the men took vitamin D and 121 also took Actonel (2.5 mg daily).

After 2 years, the rate of falls per subject did not differ between the groups; however fewer men taking Actonel plus vitamin D suffered a hip fracture.

There were three hip fractures in the Actonel group and nine in the vitamin D only group -- a relative risk reduction of 67 percent.

Dr. Yoshihiro Sato, from Mitate Hospital in Tagawa and associates note that the rate of hip fractures, even in the Actonel group, was still much higher than that seen in the general population.

Sato's team also observed that bone mineral density increased on average by 2.2 percent in the Actonel group and decreased by 2.9 percent in the vitamin D only group.

So, even though the subjects suffered from vitamin D insufficiency and disuse, Actonel was of benefit. The authors suggest that treatment with vitamin D along with Actonel may provide even greater benefits for people with Parkinson's disease.

SOURCE: Neurology March 20, 2007.

Cellular 'Fingerprint' IDs Infectious Disease

American researchers have found a way to use disease "fingerprints" to identify viruses and bacteria that cause common infections in children.

In some cases, tracking viruses or bacteria that cause illness can be difficult because they may not be present in the blood or other easily accessible areas of the body. To get around this problem, researchers at the University of Texas Southwestern Medical Center, Children's Medical Center Dallas and Baylor Institute for Immunology Research devised a new approach.

It involves analyzing telltale "fingerprints" that a disease leaves behind on cells involved in the body's immune response. Those clues can be used to create a composite sketch of the offending virus or bacteria.

The researchers tested this approach in 29 children with four common infections -- flu, staph, strep, and
E. coli -- and were able to distinguish between the flu, strep and E. coli in 95 percent of cases. They were also able to distinguish between staph and E. coli with 85 percent accuracy.

The study appears in the March issue of the journal Blood.

"We are genetically programmed to respond differently to different infections. We have developed the tools to understand that," study lead author Dr. Octavio Ramilo, professor of pediatrics at the University of Texas Southwestern Medical Center, said in a prepared statement.

"Infectious diseases are the No. 1 cause of death in the world. So we hope this eventually can be used not only to diagnose, but also to understand the prognosis and how the body is responding to therapy," Ramilo said.

Study casts doubt on duct tape wart cure

Duct tape's success at curing warts may have been overstated, according to a new study that raises doubts about the tape's effectiveness as a cheap, painless treatment. The tape supposedly works by irritating the skin and stimulating the body's immune system to attack the virus that causes warts. It earned a place in the medicine cabinet in 2002, when a small study showed it to be effective on children and young adults.

This time, a study among older adults found duct tape helped only 21 percent of the time and was no more better than moleskin, a cotton-tape bandage used to protect the skin.

But researchers used transparent duct tape. Only later did they learn that the transparent variety does not contain rubber, unlike the better-known, gray duct tape that appeared to be effective in the 2002 study.

"Whether or not the standard type of duct tape is effective is up in the air," said co-author Dr. Rachel Wenner of the University of Minnesota, who started the new study as a medical student. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner."

Warts are harmless, stubborn bumps on the hands or feet, caused by a type of papillomavirus. The virus camps out in the skin's upper layers without calling the attention of the body's immune system. Another type of papillomavirus causes cervical cancer, but the strains that cause warts are not cancerous.

Wenner's finding does not surprise Dr. Amy Paller, chairman of the dermatology department at Northwestern University's Feinberg School of Medicine, who was not involved in the new study.

"I have plenty of patients come in having tried duct tape. That's why they come in, because it didn't work," Paller said.

Duct tape may work better in children than in adults, Paller said. Children have strong immune systems and usually have better luck than adults getting rid of warts with any treatment, she said. The median age of subjects in the new study was 54.

Over-the-counter topical treatments containing salicylic acid sometimes work on warts. Doctors use laser therapy or liquid nitrogen against an unyielding wart, or in extreme cases a prescription cream or a virus-fighting injection. Warts usually clear up on their own in about two years, she said.

Warts can spread to other people through towels or skin-to-skin contact. They are extremely common in children, showing up in up to 20 percent in some studies. It's not known how common they are in adults.

In the new study, appearing in the March issue of Archives of Dermatology, researchers followed 80 people with warts. The patients were randomly assigned to cover their wart with either a bandage made of duct tape and moleskin, or a bandage made of moleskin alone.

Transparent duct tape was used so patients and doctors would not be able to guess which bandages contained the duct tape.

The patients were instructed to wear the bandage for a week, remove it after the seventh day and then, on the eighth day, soak the wart in water, and lightly scrape it with an emory board. They repeated the treatment for two months or until the wart disappeared. It was the same regimen as in the 2002 study.

Duct tape showed paltry success in the new study. Eight of the 39 patients (21 percent) who got the duct tape treatment saw their warts disappear. Nine of the 41 patients (22 percent) who got only moleskin saw their warts vanish. There was no significant difference between the two groups.

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