Child's weight course is family affair

Life for the Washington family has changed. Instead of fast food for dinner, they have grilled chicken and vegetables. Sugary drinks have been replaced with diet soda. Frisbee games in their yard have encroached on television time.

It's been more than two months since the Washingtons — Bill, Sue and their 9-year-old daughter Alana — completed a family program for children struggling with their weight and now they're trying to stick to their nutrition and fitness goals.

"It's been gradual," said Bill Washington on a summer afternoon as Alana snacked on grapes, low-fat crackers and low-fat cheese. "I've noticed her willingness to participate and be active in healthy decisions."

Alana misses doughnuts, but concedes that she enjoys much of the healthier fare her family has been eating. She prefers baked Cheetos to the regular ones, loves diet Mountain Dew and has even developed a love for snow peas.

The three-month program — called Dean Foods LEAN (Lifestyle, Exercise and Nutrition) Families Program — offered at Children's Medical Center Dallas focuses on making fitness and nutrition changes for the whole family.

"We're really trying to teach them skills they can use for the rest of their lives," said Dr. LeAnn Kridelbaugh, the program's medical director.

The Dallas program is one of many across the United States trying to tackle the issue of childhood obesity — more than one-third of American children are overweight. At least 95 children's hospitals have similar programs, according to a survey by the National Association of Children's Hospitals and Related Institutions and Columbus Children's Hospital in Ohio.

A recent study in the Journal of the American Medical Association showed some encouraging results for intensive family programs. It compared weight management counseling for youths with a comprehensive family based program in which participants met much more frequently.

Children in the family programs kept up their healthier routine the entire year. As they grew taller, their body mass index fell even though their weight stayed the same. Those who only got counseling had an increase in body mass index and weight.

The Dallas program has enrolled about 90 children since it began last year, and about 80 percent stayed with it to the end. It's geared for children ages 6 to 11 with a body mass index in the obesity range. About half of the participants either maintain or decrease their body mass index.

The program costs about $1,300 per family with discounts for those who don't have insurance that covers it.

For small children, Kridelbaugh said the focus is on developing better eating and fitness habits rather than weight loss. With proper nutrition and exercise, height and weight should balance out as they grow.

"The philosophy is not 'Let's get you to lose weight in 12 weeks,'" Kridelbaugh said. "What we're trying to teach them is eating habits and activity habits that you do for a lifetime."

Dallas pediatrician Marjorie Milici has referred about 15 families to the Children's program.

"We're seeing so many patients, I don't have the time to do the education they're doing," Milici said.

Each weekly 2-hour session begins with a healthy snack and a review of the previous week's goals. Parents and children break into separate groups for their lesson, then regroup to set the next week's targets.

Three weeks into the program, Jessica Duckworth's 5-year-old daughter EmmaLee was already getting the idea. She told her grandfather, who often showered her with candy, that she couldn't eat sweets all the time. On his next visit, he brought fruit.

"It's been easier for her than it has been for us," Jessica Duckworth said.

EmmaLee's mom and grandmother said a trip to the Dallas Zoo revealed her progress. Usually they bring a wagon for when Jessica tired but this time they left it home. It turned out that EmmaLee, full of energy and pep, didn't need it anyway.

For Alana Washington, it's been a summer of swimming and camp. She's grown almost an inch while her weight has remained constant.

"Prior to this, it was constantly gaining no matter what," Sue Washington said of her daughter. "Now the brakes are on."

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Health Tip: Packing Your Prescriptions

If you're planning to hit the road this summer and you need to take your medications along, here are suggestions from AARP:

• In case of an emergency, pack a complete list of all medications you take, including those sold over-the-counter.
• If you're flying, pack medications in their original packages in a carry-on bag, instead of checking them.
• Take more medication than you expect to need, in case travel plans change or you run into problems getting home.
• Pack any medications that need to be refrigerated in insulated, cooled packaging.
• If you're going to another country, make sure you comply with that nation's laws on bringing in medications.

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Female Cancer Survivors Lack Frank Sex Talk From Docs

Three out of four women treated for genital tract cancer feel their doctors should initiate more conversations about the cancer's impact on their sexual health, new research finds. "We found that these women valued sexuality and participated in sexual relationships and activities at a rate similar to women who had not been through cancer treatment, but they were not adequately prepared for the sexual issues that their cancer or its treatment introduced," study author Dr. Stacy Lindau said in a prepared statement. The sexual problems included pain and limited lubrication.

Two out of three women whose reproductive and sexual organs were severely compromised by the treatment also reported that their doctors never brought up sex, according to the study. Writing in the August issue of Gynecologic Oncology, University of Chicago Medical Center researchers expressed concern that if doctors are not discussing the impact of medical treatment on sexuality under these circumstances, sexual health was even less likely to be discussed in other situations, particularly with older women. Previous studies have shown that patients are themselves reluctant to bring up sexual issues.

The research team surveyed 219 women aged 40 to 50 years old who had been treated for a rare form of vaginal or cervical cancer. The women were all members of a registry for people who might have been exposed to synthetic hormones while in their mother's womb. Most of the women had been treated with surgery or radiation therapy when they were in their late teens or 20s and had survived more than two decades after their diagnosis. The researchers then compared the responses from these women with race- and age-matched controls selected from a 1992 national study on sexual norms.

The cancer survivors reported more sexual problems and four times more health problems that interfered with sex all or most of the time, but they were just as likely to be married as the comparison group. Fifty percent of the survivors reported three or more sexual problems, compared to 15 percent of their peers. They were also seven times more likely to feel pain during intercourse and three times more likely to have difficulty lubricating. More than one out of three survivors complained about the scars from their treatment as well as frequent bladder infections and incontinence.

Those of the survivors who reported a conversation with their physician about the sexual impact of treatment were the women who were more likely to have three or more sexual problems at the same time.

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Ad for safe sex: massive floating condom

Concertgoers at a festival in the Dutch city of Lichtenvoorde were treated to an unusual sight Friday: A pink hot air balloon 127 feet high, shaped exactly like a condom, drifting lazily across the sky. The balloon, with the words "Vrij Veilig" — Dutch for "Safe Sex" — was launched by the public health service in the eastern district of Gelre-Ijssel, near the German border.

The director of the health service, known by its Dutch acronym GGD, said the festival was an ideal opportunity to reach young people. More than 80,000 are expected to attend the three-day Zwarte Cross event — a combination motor-cross race and hard rock concert, with Dutch gothic metal band "Within Temptation" headlining. "This is a playful way of asking for attention to the problem of sexually transmitted diseases, HIV and AIDS," said Laurent de Vries. Nurses on the concert grounds also handed out educational material and free condoms as part of the campaign, he said.

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Child specific HIV drugs needed to combat virus

A leading HIV expert urged Wednesday drugs giants to focus on developing anti-retroviral medicines for children, after research showed early treatment of babies can reduce death rates by 75 percent. As the International AIDS Society conference wrapped up in Sydney, US researcher Annette Sohn said some 780,000 HIV positive children globally needed anti-retroviral medicines but only 15 percent of them were receiving treatment.

Sohn, an assistant professor at the University of California San Francisco's paediatric infectious diseases division, said there was also a lack of specialised medicine developed for HIV positive children. She said that children's medical treatment often consisted of health professionals simply breaking up adult pills into what they hoped was child-sized doses.

"Better generic paediatric anti-retrovirals that are both potent enough to achieve sustained clinical and virological improvement and have limited long-term metabolic side effects are urgently needed," she said.

Sohn, who is conducting research in Vietnam, said better diagnostic tools for medical practitioners working on paediatric HIV were also needed and some treatment may have to be started before a full diagnosis can be made.

"We are not identifying more HIV positive women during pregnancy and we lack the ability to diagnose their infants, so we don't know they're infected until they're already very sick," she said.

"By that time, it's often too late to prevent opportunistic infections and maximise the treatment benefits of anti-retroviral therapy."

Sohn said the need for action was underlined by studies showing that early anti-retroviral treatment in babies could dramatically improve survival rates.

"Research presented at this and other conferences have increasingly proven that we are waiting too long to treat HIV positive-children in resource-limited settings (poor countries)," she said.

One South African study presented to the conference found that the death rates among babies who were given anti-retrovirals at aged three months was 75 percent lower than those who were not treated.

Avy Violari, from the University of Witwatersrand in Johannesburg, said the study had the potential to revolutionise HIV treatment among babies, which normally only begins after 12 months.

"These findings have implications for guidelines on timing of anti-retroviral therapy in early infancy and support the need for enhanced early diagnosis of infants and early effective transition into care," she said.

The study, titled Children With HIV Early Antiretroviral Therapy, involved 377 babies in Cape Town and Soweto.

Conference co-chair David Cooper, the head of Australia's National Centre in HIV Epidemiology and Clinical Research, said its results could force a rethink about treatment of HIV positive babies.

"Normally babies born to HIV positive mothers aren't treated for 12 months because when they're born they have antibodies from their mothers and it takes that long to know whether the baby itself is infected with the virus," he said.

"This research means we'll have to look very hard at earlier intervention."

The 4th IAS conference ended Wednesday after four days, when more than 1,000 abstracts on HIV research were presented to 5,000 experts.

"It's been an amazing conference, notable for a number of scientific developments, including new treatments that are offering people living with HIV/AIDS and their clinicians greater options in the future," said IAS executive director Craig McClure.

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New Study Reaffirms HRT Link to Breast Cancer Rate Declin

Scientists have once again linked a drop in breast cancer rates from 2003 to 2004 to a parallel decrease in women's use of hormone therapy beginning in 2002. The decline in breast cancer rates persisted even though mammography screening rates remained stable, said researchers at Kaiser Permanente, reporting in the August issue of the Journal of the National Cancer Institute.

"The message is pretty straightforward," said study lead author Dr. Andrew Glass, senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "If you need to take hormone therapy to block menopausal symptoms, do it for the shortest duration and the lowest dose." "We now have a second observation that when we discontinue or decrease hormone therapy, we have a very significant drop in breast cancer incidence," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "This is another piece of information that I think women should use in determining whether or not they want to take hormone therapy. To me, it shows that combination therapy [estrogen plus progestin] does increase the incidence of breast cancer. Women need to take this into consideration."

Last December, a different set of researchers reported a precipitous drop in the incidence of breast cancer in 2003 and suggested that the downward trend was the result of millions of women discontinuing use of hormone replacement therapy.

The decline in the number of U.S. women taking hormone replacement therapy came after publication of the results of the landmark Women's Health Initiative (WHI) trial in 2002. That study, involving 16,608 participants, was halted after researchers found elevated health risks among HRT users, most notably for breast cancer and stroke.

Since then, a debate has continued over the utility and safety of hormone therapy, with health officials advising women to take HRT only when needed and for as short a period as possible.

The authors of the new study reviewed the medical histories of 7,386 women diagnosed with invasive breast cancer and treated at Kaiser Permanente Northwest between 1980 and 2006. The records were available through Kaiser Permanente's computerized database, which includes a tumor registry and clinical, pathology, radiology and pharmacy data systems.

From the early 1980s to the early 1990s, breast cancer rates rose 26 percent, then an additional 15 percent through 2001. From 2003 to 2006, rates dropped by 18 percent.

The 26 percent increase paralleled increases in the rates of mammograms as well as increases in the use of hormone therapy, especially combination therapy, the researchers said.

The 15 percent increase -- from 1992 to 2002 -- echoed a continued rise in the use of hormone therapy, although mammogram rates remained stable from 1991 rates.

The drop in breast cancer rates starting in 2003 coincided with a 75 percent drop in hormone therapy rates, although mammography rates remained the same.

"When HRT went down, breast cancer rates went down and mammography rates remained the same," Glass said. "This was an important finding, because others had suggested maybe the drop in breast cancer rates was because mammograms had gone down, but it didn't happen in the Kaiser numbers. The only thing we can figure out is, it's probably related to HRT, that fluctuations in HRT are the most likely explanation for fluctuations in breast cancer rates."

The increase in breast cancer rates occurred primarily in women over the age of 45 who had estrogen receptor-positive breast cancer.

According to Glass, this study is the first to document all these different factors -- mammography, hormone therapy, breast cancer and estrogen-receptor status -- in one study.

But one expert found the study's conclusions lacking.

"This is an interesting look at the picture but really is not evidence-based medicine," said Dr. Lila Nachtigall, director of the women's wellness program at New York University Medical Center and professor of obstetrics and gynecology at New York University School of Medicine. The study did not correlate individual cases of breast cancer with hormone use, therefore issues of causality cannot be decided, she added.

"To try to prove causality is confusing to doctors and patients," she said. "I think it's a combination of things."

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Myths About Cancer Risk Abound

Misconceptions about cancer are rampant among Americans, a new study finds, including the mistaken notions that cancer deaths are on the rise and that air pollution is a greater cancer risk than smoking. "A substantial proportion of people have some inaccurate beliefs about cancer risk," said lead researcher Kevin Stein, the director of the Behavioral Research Center at the American Cancer Society.

These misconceptions "can affect their health-related behaviors," he added. For example, he said, people might smoke more if they believe smoking is less harmful than city air. "We want to be sure that people understand what risk factors are real and what are not real," Stein said.

The report appears in the September 1 issue of Cancer. In the study, Stein's team asked 957 adults whether or not they agreed with 12 common cancer myths.

About two-thirds (67.7 percent) said the risk of dying from cancer was increasing -- even though statistics show that the five-year cancer survival rate has been steadily improving for the last 30 years.

Almost 39 percent agreed with the myth that living in a polluted city puts a person at a higher risk of developing lung cancer than smoking a pack of cigarettes a day would.

"If people believe that the risk of cancer is higher from pollution than from smoking they may be more likely to engage in risky behavior," Stein said.

Many people also believed that low-tar cigarettes are less likely to cause lung cancer than regular cigarettes, Stein noted.

"Really, there is no evidence for that," he said.

In addition, almost 30 percent of the respondents thought electronic devices, such a cell phones, can cause cancer (studies have shown there is no effect).

Among other myths explored: Close to 15 percent thought products such as shampoo, deodorant and antiperspirants can cause cancer. And 6.2 percent believed underwire bras could trigger breast cancer.

Stein's team found that education and money was directly related to the belief in such myths.

"Related to these misconceptions were people who were underserved in terms of socioeconomic status and education," he said. "People who don't have the opportunities to hear public health messages are more likely to hold these beliefs," he added.

"We need to do a better job of providing reliable accurate health information to these groups," Stein said. He also believes that misconceptions about other medical conditions are likely to be seen among the same groups.

Some people may hold these misconceptions to justify their own behavior, Stein said, noting also that studies show people who engage in risky behaviors like smoking tend to underestimate the risks.

One expert said that better education can help dispel the myths.

"The public understanding of cancer risk suffers from important gaps and misconceptions," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

"In some cases, cancer risk is exaggerated; American women believe breast cancer is the leading cause of death among them, but heart disease kills fully 10 times as many women," Katz said.

He added, "Some potential risk factors, such as pesticide residues on foods, are exaggerated, while others, such as cigarette smoking or excessive sun exposure, don't get the full respect they deserve."

This study confirms that the misconceptions are greatest in socioeconomically challenged populations, Katz said. "The population at greatest risk of cancer seems to know the least about the disease, and how to prevent it," he said.

"Among the important disparities in our country is access to reliable, understandable health information," Katz added. "To empower people to protect themselves from cancer, we must arm them with accurate information."

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Health Tip: Don't Aggravate an Upset Stomach

Got an upset stomach? Here are suggestions on how to tame it, courtesy of the U.S. National Library of Medicine:

• Drink plenty of clear liquids, like water, ginger ale, or certain fruit juices. Drink slowly and consume only small amounts at a time to avoid aggravating the stomach.
• Avoid dark and heavy fluids, like cola or coffee.
• If you're vomiting, don't eat any solid food until you haven't been sick in at least six hours. Then, slowly introduce light foods, like dry toast or crackers.
• Over-the-counter medications like Pepto Bismol may help ease nausea in adults. These medicines, however, contain aspirin-like ingredients and should never be given to children or teens who have had recent bouts with chickenpox or flu.
• If nausea and vomiting do not subside, consult your doctor without delay.

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China seizes 18,000 fake Viagra pills in raids

Chinese police have seized more than a ton of fake drugs for impotence, bird flu and malaria, including at least 18,000 fake Viagra tablets, state media reported on Wednesday. The Ministry of Public Security, which launched the national crackdown on counterfeit goods in 2005, announced 10 of its top cases ranging from fake drugs to fake toothpaste on Tuesday, the Xinhua news agency said on its Web site.

More than 30 people were detained on suspicion of either making or selling the drugs.

Police in the eastern province of Zhejiang raided a gang making counterfeit Viagra and selling the tablets to 12 countries, including the United States and Holland, it said, adding that a total of 18,000 pills were seized. In Guangdong, police had arrested 12 people and seized 1 ton of fake drugs and two production lines and large quantities of raw materials for making "sildenafil citrate," the scientific name of Viagra.

Police detained 19 suspects and shut down six factories in May last year for making fake Tamiflu, a bird flu drug, and selling it to the United States via the Internet, the agency said.

In April last year, police cracked a ring making and selling pirated toothpaste across the country and arrested five suspects, it said.

Chinese media report on scandals involving substandard or fake drug and food almost every day, and the issue burst into the international spotlight when tainted additives exported from China contaminated pet food in North America.

Public fears about food safety grew in China in 2004 when at least 13 babies died of malnutrition after they were fed fake milk power with no nutritional value.

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New Study Reaffirms HRT-Breast Cancer Link

Scientists have once again linked a drop in breast cancer rates from 2003 to 2004 to a parallel decrease in women's use of hormone therapy beginning in 2002. The decline in breast cancer rates persisted even though mammography screening rates remained stable, said researchers at Kaiser Permanente, reporting in the August issue of the Journal of the National Cancer Institute. "The message is pretty straightforward," said study lead author Dr. Andrew Glass, senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "If you need to take hormone therapy to block menopausal symptoms, do it for the shortest duration and the lowest dose."

"We now have a second observation that when we discontinue or decrease hormone therapy, we have a very significant drop in breast cancer incidence," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "This is another piece of information that I think women should use in determining whether or not they want to take hormone therapy. To me, it shows that combination therapy [estrogen plus progestin] does increase the incidence of breast cancer. Women need to take this into consideration."

Last December, a different set of researchers reported a precipitous drop in the incidence of breast cancer in 2003 and suggested that the downward trend was the result of millions of women discontinuing use of hormone replacement therapy.

The decline in the number of U.S. women taking hormone replacement therapy came after publication of the results of the landmark Women's Health Initiative (WHI) trial in 2002. That study, involving 16,608 participants, was halted after researchers found elevated health risks among HRT users, most notably for breast cancer and stroke.

Since then, a debate has continued over the utility and safety of hormone therapy, with health officials advising women to take HRT only when needed and for as short a period as possible.

The authors of the new study reviewed the medical histories of 7,386 women diagnosed with invasive breast cancer and treated at Kaiser Permanente Northwest between 1980 and 2006. The records were available through Kaiser Permanente's computerized database, which includes a tumor registry and clinical, pathology, radiology and pharmacy data systems.

From the early 1980s to the early 1990s, breast cancer rates rose 26 percent, then an additional 15 percent through 2001. From 2003 to 2006, rates dropped by 18 percent.

The 26 percent increase paralleled increases in the rates of mammograms as well as increases in the use of hormone therapy, especially combination therapy, the researchers said.

The 15 percent increase -- from 1992 to 2002 -- echoed a continued rise in the use of hormone therapy, although mammogram rates remained stable from 1991 rates.

The drop in breast cancer rates starting in 2003 coincided with a 75 percent drop in hormone therapy rates, although mammography rates remained the same.

"When HRT went down, breast cancer rates went down and mammography rates remained the same," Glass said. "This was an important finding, because others had suggested maybe the drop in breast cancer rates was because mammograms had gone down, but it didn't happen in the Kaiser numbers. The only thing we can figure out is, it's probably related to HRT, that fluctuations in HRT are the most likely explanation for fluctuations in breast cancer rates."

The increase in breast cancer rates occurred primarily in women over the age of 45 who had estrogen receptor-positive breast cancer.

According to Glass, this study is the first to document all these different factors -- mammography, hormone therapy, breast cancer and estrogen-receptor status -- in one study.

But one expert found the study's conclusions lacking.

"This is an interesting look at the picture but really is not evidence-based medicine," said Dr. Lila Nachtigall, director of the women's wellness program at New York University Medical Center and professor of obstetrics and gynecology at New York University School of Medicine. The study did not correlate individual cases of breast cancer with hormone use, therefore issues of causality cannot be decided, she added.

"To try to prove causality is confusing to doctors and patients," she said. "I think it's a combination of things."

source : news.yahoo.com

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Natural Protein Protects Against Cancer

Researchers have identified a protein that plays a key role in preventing skin cancer cells from dividing and multiplying. Writing in the July 20 issue of Molecular Cell, a team at the University of Texas M.D. Anderson Cancer Center, reported that the protein IKKa prevented a vital "checkpoint" gene from shutting down and allowing cancer cells to spread.

The protein often is absent or only found at lower levels in a type of skin cancer cell. IKKa is found at lower than normal levels in aggressive squamous cell carcinomas in both mice and humans. When operating normally, it allows the checkpoint gene 14-3-3o to respond to DNA damage in the cell. The gene usually creates a protein that blocks defective cells from dividing, allowing genetic errors to be repaired rather than copied.

Without IKKa proteins, the gene does not function optimally, and cells that multiply with damaged or abnormal genes are the root of cancer.

The interaction is part of the process of DNA methylation -- a process by which the work of a gene is chemically altered, but the gene itself is not damaged. Researchers look for ways to chemically turn the gene back on and restore its function.

The team inserted IKKa into deficient cells, which allowed the checkpoint gene to work again.

"What we've identified is a mechanism that promotes genetic instability in keratinocytes, a critical type of skin cell that makes up 90 percent of epidermal cells, during the development of human skin cancers," Yinling Hu, senior author of the paper and assistant professor in M.D. Anderson's department of carcinogenesis at the Science Park-Research Division in Smithville, Texas, said in a prepared statement. "Our finding opens a new avenue for identifying new therapeutic targets for battling cancer," Hu said.

The findings may have implications for a broad array of cancers, as the researchers noted that the checkpoint gene 14-3-3o is also shut dow n in cancerous epithelial cells. Epithelial cells are found in the outer layer of skin and in the linings of other body organs such as lungs, and the gastrointestinal, reproductive and urinary tracts.

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China seizes Viagra in crackdown on fake drugs

Police in China seized one ton of fake Viagra pills during a series of raids on gangs that were making counterfeit drugs to sell domestically and overseas, state press reported Wednesday. Aside from the the popular anti-impotency drug, fake versions of Tamiflu, which is being stockpiled around the world for a potential bird flu pandemic, and anti-malarial medications were uncovered, Xinhua news agency said.

Four gangs were busted making the drugs during a two-year crackdown that involved Chinese and US authorities, as well as Interpol, Xinhua said, citing the Ministry of Public Security. The announcement of the busts come after the former head of China's food and drug watchdog Zheng Xiaoyu was executed this month for taking bribes to approve medicines, some of which were unsafe.

The one ton of Viagra was uncovered in China's southern Guangdong province that borders Hong Kong following a raid late last year made in co-operation with US law authorities, Xinhua said.

The Tamiflu raids in May also took place after acting on intelligence from US authorities, resulting in the arrests of 19 suspects. Xinhua said the gang had been trying to sell the Tamiflu into the United States via the Internet.

Few other details of the busts, or the expected trials of the suspects, were revealed.

No reason was given as to why the information on the raids was released so long after the events.

But following the execution of the former head of the drug watchdog, China has ramped up a public relations campaign to reassure the world it is doing all it can to combat the problem of substandard and fake medicines.

The nation also consistently vows to better work with its global partners to end the rampant pirating in China of all kinds of goods, from software and movies to clothing and auto parts.

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Notre Dame coach loses medical lawsuit

A jury found against Notre Dame football coach Charlie Weis on Tuesday in his malpractice lawsuit against two doctors he claimed botched his care after he had gastric bypass surgery five years ago. The jury deliberated for less than half a day before finding Massachusetts General Hospital surgeons Charles Ferguson and Richard Hodin were not negligent.

Weis, 51, who won three Super Bowls as the offensive coordinator for the New England Patriots, accused the surgeons of negligence, saying they allowed him to bleed internally for 30 hours before performing a second surgery to correct the complication. Weis nearly died after the 2002 surgery. He testified that he still has numbness and pain in his feet and sometimes has to use a motorized cart.

Weis was stoic as the verdict was read and left the courtroom without comment. His lawyer, Michael Mone, did not immediately return a call seeking comment.

The doctors declined to comment as they left the courtroom, referring questions to their attorney, William Dailey Jr.

"They and all of the staff down at the Mass. General wished Coach Weis well," Dailey said.

Ferguson, director of Massachusetts General's surgical residency program, and Hodin, a surgeon and professor at Harvard Medical School, said internal bleeding was a well-known complication of the stomach stapling surgery. They said they believed the bleeding would stop on its own and were concerned about performing a second surgery because of the risk of a pulmonary embolism.

Ferguson testified that Weis ignored his advice and pushed to have the operation done quickly rather than going through a recommended six-week preoperative program.

Lawyers for the doctors told the jury that Weis, who weighed about 350 pounds before the surgery, lost about 100 pounds over the next year and landed one of the premier coaching jobs in the country at Notre Dame, his alma mater.

The first trial ended in a mistrial in February after Ferguson and Hodin rushed to the aid of a juror who collapsed in the courtroom.

Weis decided to have the surgery after seeing a slimmed-down Al Roker on television. With a family history of heart disease, he said he was motivated by a desire not to leave his wife a widow.

Weis testified that he told only two people, his wife and Patriots quarterback Tom Brady, about his decision. He told New England coach Bill Belichick he was going to have a "stomach procedure."

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HIV medics freed after Libya-EU deal

Six foreign medics convicted of infecting hundreds of Libyan children with HIV were freed on Tuesday after a "full partnership" deal between Tripoli and the European Union ended their eight-year ordeal. Their return to Bulgaria ends what Libya's critics called a human rights scandal and could allow the long-isolated north African state to complete a process of normalizing ties with the West.

Bulgarian President Georgi Parvanov pardoned the five nurses and a Palestinian doctor who recently took Bulgarian citizenship after their arrival in Sofia on a French jet. The medics said they were innocent and had been tortured to confess. "I know I am free, I know I am on Bulgarian soil, but I still cannot believe it," 48-year-old nurse Christiana Valcheva said as the medics and their families wept and hugged each other at the airport.

The Bulgarian nurses were flown to Sofia after the EU, which Bulgaria joined in January, agreed a last-minute breakthrough deal with Libya on medical aid and political ties.

"We hope to go on further normalizing our relations with Libya. Our relations with Libya were in a large extent blocked by the non-settlement of this medics issue," EU Commission President Jose Manuel Barroso said.

Libyan Foreign Minister Mohammed Abdel-Rahman Shalgam said the deal had opened the way to "full cooperation and partnership between Libya and the European Union."

Bulgaria and its allies in Brussels and Washington had suggested that not freeing the nurses would hurt Libya's efforts to emerge from decades of diplomatic isolation imposed for what the West called its support of terrorism.

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Study links low cholesterol levels and cancer

The heart benefits of taking so-called statin drugs to reduce cholesterol might be offset by a slightly increased risk of cancer, although the evidence is by no means clear, U.S. scientists said on Tuesday. A new pooled, or meta, analysis of past studies involving 41,000 patients on statins found one additional incident of cancer per 1,000 patients with low levels of LDL, or "bad" cholesterol, compared to those with higher LDL.

The results will be published in the July 31 issue of the Journal of the American College of Cardiology. Dr Richard Karas, professor of medicine at Tufts University School of Medicine in Boston, who led the research, stressed the association did not prove statins caused the increase in cancer risk.

"The demonstrated benefits of statins in lowering the risk of heart disease remain clear; however, certain aspects of lowering LDL with statins remain controversial and merit further research," he said in a statement.

The analysis looked at clinical trials published before November 2005 and involved patients treated with popular statins, including Pfizer Inc.'s Lipitor and Merck & Co. Inc.'s Zocor, which is now off patent.

It did not include data from recently launched statins such as AstraZeneca Plc's Crestor and Merck/Schering-Plough Corp.'s Vytorin.

Dr John C. La Rosa of the State University of New York Downstate Medical Center in Brooklyn, who wrote an accompanying editorial in the journal, said the new research needed to be seen in perspective.

"These current findings provide insufficient evidence that there is any problem with LDL lowering that outweighs its significant benefits on vascular disease," he said.

One possibility is that the higher cancer risk in patients with low LDL reflects the fact they live longer and are therefore more likely to develop cancer.

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Stem cell movement faces setbacks in Mo.

Eight months ago, Missouri seemed well on its way to becoming a national leader in stem cell research. Voters amended the state's constitution to protect stem cell research — even the controversial form using cells from human embryos. Actor Michael J. Fox appeared in TV ads, visibly shaking from Parkinson's disease as he sought votes for stem cell supporter Claire McCaskill in her bid for the U.S. Senate.

Now the spotlight is all but gone after a research institute and lawmakers withdrew financial support. "Things are obviously not moving forward," said state Sen. Chuck Graham, a Democrat who backed the amendment in November. "Right now, you can't tell the amendment passed. People are running in the opposite direction. It's incredibly frustrating." Some researchers even fear the techniques known as therapeutic cloning could still be outlawed in Missouri.

Scientist Kevin Eggan had once considered packing up his lab at the Harvard Stem Cell Institute and moving to Missouri. Now he's reluctant.

"I couldn't possibly come to a place where I thought the potentially lifesaving research I want to do could become illegal," said Eggan, who works on degenerative nerve disorders like Lou Gehrig's disease.

The setbacks began when conservative Missouri lawmakers stripped funding for some prominent life sciences projects, including a $150 million research center at the University of Missouri in Columbia.

Then in June, a medical institute in Kansas City announced it would halt its $300 million expansion project because of controversy over the research. The founders of the Stowers Institute of Medical Research had financed most of the $30 million campaign to pass the amendment.

Critics of embryonic stem cell research are opposed to the process because it requires embryos to be destroyed to harvest their cells.

"I think stem cell research is extraordinarily promising and exciting and that we ought to move forward on it. But Missouri does not need to clone human embryos in order to become a leader in life sciences," said state Sen. Matt Bartle, a Republican who wants to repeal November's vote.

Opponents were also encouraged when three teams of scientists announced last month that they had produced the equivalent of embryonic stem cells in mice without destroying embryos.

Two weeks later, President Bush vetoed a bill that would have permitted human embryonic research — a clear signal to like-minded Missourians who saw November's vote, 51 percent to 49 percent, as anything but a clear mandate.

Some amendment supporters insist the stem cell movement is still moving forward.

"There's no question that Missouri is better off today than it was prior to the November election," said Connie Farrow, spokeswoman for the Missouri Coalition for Lifesaving Cures, which supports the measure.

Proof of the progress, Farrow said, can be found in embryonic stem cell projects at Washington University in St. Louis, the Stowers Institute and the University of Missouri.

Stowers researchers, for example, are coaxing stem cells to develop into the types of cells that make up the human spine to possibly learn more about the causes of scoliosis.

Stowers spokeswoman Laurie Roberts said the institute has been conducting human embryonic stem cell research since the start of the year. Finding more stem cell researchers has been a struggle, she said, but the effort continues.

The institute "absolutely wants to expand and to do it right here in the state of Missouri," Roberts said, referring to the more than 100 acres that the institute bought in Kansas City.

Other states are closely watching developments in Missouri.

Since the amendment's passage, Farrow said, stem cell supporters from Nebraska, Oklahoma, Florida, Georgia, Kentucky and Virginia have contacted the Coalition for Lifesaving Cures. They want pointers on how to promote stem cell initiatives in their states, she said.

"Our stem cell amendment is a model for other states," Farrow said. "We're not going to stand idly by and let a few minority interest groups take our state backward."

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Health Tip: Your Teething Baby

A baby's first set of teeth usually starts to emerge at about 6 months of age. While discomfort and irritability are common in teething babies, other symptoms may be warning signs of another problem. Here are some basics that parents should know about teething, courtesy of the American Dental Association:

• Irritability, fussiness, drooling, and loss of appetite are common symptoms of teething.
• Diarrhea, rash, and fever are not caused by teething, and should be evaluated by a doctor.
• Small cysts near erupting teeth are common and harmless.
• Tender gums may be soothed with a teething ring, pacifier, or a cream that helps numb the gums.
• Gums can also be massaged with a clean finger or damp piece of gauze.

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Circumcision urged in curbing AIDS spread

Australia - A U.S. health expert urged governments worldwide Tuesday to endorse circumcision to slow the spread of HIV, saying men without the procedure have a greater risk of contracting the virus from infected female partners. Experts at an AIDS conference in Sydney also warned that HIV infection rates were rising among men who have sex with men in developing countries because of discrimination and lack of access to health services.

The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by around 60 percent. But only 30 percent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons. Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2 1/2 times more likely to contract HIV from infected female partners, though many health officials were still unclear about its benefits.

"If we had a vaccine that was 60 percent protective, we would be very happy and we would be rolling it out as fast as we can," Bailey told reporters at an International AIDS Society Conference in Sydney, Australia.

"The next step is to get the leaders of countries to actually come up with policy statements endorsing the practice," said Bailey, who has conducted circumcision-related studies in Africa and the United States.

Without local support, international agencies would be unlikely to encourage the procedure to avoid being seen as imposing foreign cultures or values, he said.

Circumcision, the removal of the foreskin from the penis, has long been suspected of reducing men's susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.

In March, the WHO urged heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of getting the disease. However, it cautioned that male circumcision is not a complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity and reducing the number of sexual partners.

"Circumcision could drive the epidemic to a declining state toward extinction," Bailey said. "We must make safe, affordable, voluntary circumcision available now."

Bailey also called on international agencies to ramp up funding for circumcision in countries hardest-hit by the epidemic.

Michel Kazatchkine, the executive director of the Global fund, a leading international health agency, also called for increased funding.

"I believe that the evidence is overwhelming for the efficacy of circumcision," Kazatchkine told The Associated Press on the sidelines of the meeting. "And if countries come to us ... I see no reason at all why we wouldn't fund that."

Kazatchkine said his organization had not yet received any requests for funding for circumcision, and noted that the WHO advice on the topic was only released in March.

Also at the conference, a leading American AIDS research group said HIV infection rates among men who have sex with men were rising in Africa, Asia and Latin America, citing figures from UNAIDS.

Studies also show that less than 5 percent of that group have access to HIV-related health care, the American Foundation for AIDS Research, or amfAR, said.

"This is a massive failure of the HIV/AIDS response globally and I think one that needs to be addressed," said Kevin Frost, amFAR's chief executive officer.

In Kenya, around 40 percent of men who have sex with men are estimated to be HIV positive, compared to a 6 percent rate in the country's overall population, amFAR said. In Senegal, nearly 22 percent are believed to be infected, compared to less than 1 percent of the general population.

In Uruguay and Mexico, 21 percent and 15 percent are estimated to have the disease.

Under an initiative launched at the AIDS Society Conference, amFAR will seek to raise $3 million in the next three years to provide grants for AIDS education and research among men who have homosexual sex in developing countries.

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Circumcision could save millions from HIV infection, conference told

Male circumcision could prevent millions of HIV infections every year and play a major role in controlling the virus' spread in developing nations, a major AIDS conference was told Tuesday. US researcher Richard Bailey called on health authorities to actively promote circumcision, saying the scientific evidence left no doubt that it could reduce HIV infection rates by up to 60 percent.

Bailey, from the University of Illinois, said three studies in Africa had all confirmed a long-standing belief about the effectiveness of circumcision in reducing the risk of HIV infection. "The last two were actually stopped early because they showed such a high level of efficacy that it wouldn't be ethical to continue the trial and withhold circumcision from the control group," Bailey told reporters at the International AIDS Society conference in Sydney.

He said universal circumcision could avert two million new infections and 300,000 deaths in sub-Saharan Africa over 10 years.

Bailey said while health authorities would rush to implement a vaccine that was 60 percent effective, there was an element of squeamishness in some cultures about promoting male circumcision.

"It's been a really long haul because it's the penis after all, so it's not that easy to accept that kind of intervention," he said.

"Circumcision is not just simply a medical procedure, it's tied up in a complex web of cultural and religious practices and beliefs, so it's not easy for politicians and ministries of health to very quickly come out in favour of circumcision in countries where it's not traditionally practiced."

Bailey said leaders in developing nations needed to endorse circumcision because international health authorities would not impose it because they feared being seen as culturally insensitive.

"But the time to act is right now," he said. "Delaying the roll-out of circumcision could be causing more harm, not just because more people are getting infected with HIV than necessary but also people are going to unqualified practitioners."

The conference also heard that the practice, common in Africa, of women rinsing themselves with lemon juice after sex did not reduce the risk of HIV infection.

Nigerian researcher Atiene Sagay said a study of more than 300 Nigerian prostitutes found that women douched to avoid infection but it was totally ineffective.

"People suggested it could be a microbicide (but) we know much better than that now," Sagay said.

He said the practice was not an effective contraceptive measure either, as alkaline semen easily neutralised citric acid.

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Modern technology and ancient surgery battle AIDS

The emergence of new and improved drugs, genetic engineering and the ancient surgical practice of circumcision are the latest weapons in the fight against AIDS, the International AIDS Society conference was told on Tuesday.

A new batch of drugs that slow the progress of HIV in patients and genetically modified cells that prevent further infections are about to become available or trialed, doctors told the world's largest AIDS conference.

"It's an extremely exciting time in terms of drug development. We have better drugs in existing classes, as well as whole new classes of drugs," said Professor David Cooper, co-chairman of the 2007 IAS conference in Sydney.

"Patients and their clinicians now have a much wider choice of drug combinations than ever before," said Cooper, director of Australia's National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales.

But the biggest breakthrough for the world's poorest nations, which will not initially be able to afford these new drugs and which carry the heaviest AIDS burden, lies in a procedure dating back to at least 2,300 B.C. in Egypt -- circumcision.

African studies have shown that male circumcision can reduce HIV transmission from women to men by about 60 percent, said Professor Robert Bailey at the School of Public Health at the University of Illinois at Chicago.

Universal circumcision could avert two million new infections and 300,000 deaths in sub-Saharan Africa over 10 years, he said.

Africa is the epicenter of the AIDS epidemic. South Africa has an estimated 5.5 million people with HIV and is struggling to stem the spread of the disease in the general population.

Bailey said that while the World Health Organisation (WHO) had now endorsed circumcision as a preventative measure, encouraging the widespread use of circumcision would not be easy.

"Circumcision is not just simply a surgical procedure. It's tied up in a complex web of cultural and religious practices and beliefs," he said.

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Circumcision could save millions from AIDS

Millions of new HIV infections in Africa could be avoided if more men were circumcised, an International AIDS Society conference was told on Tuesday. Studies in Africa have found that male circumcision, the world's oldest surgical procedure dating back to 2300 BC, reduces HIV transmission from females to males by 60 percent.

Universal circumcision could avert 2 million new infections and 300,000 deaths in sub-Saharan Africa over 10 years, said Professor Robert Bailey from the School of Public Health at the University of Illinois in Chicago. "If we had a vaccine that was 60 percent protective we would be very happy and rolling it out as fast as possible," Bailey told the IAS conference in Sydney.

"But no one stands to profit from male circumcision -- no one but the 4,000 in Africa who will be infected tomorrow." Africa is the epicenter of the AIDS epidemic. South Africa has an estimated 5.5 million people with HIV and is struggling to stem the spread of the disease in the general population.

But African nations such as Cameroon and Nigeria, where circumcision is common, have a much lower rate of HIV infection than Zimbabwe and Swaziland where there is little circumcision.

The idea of using circumcision as a weapon against AIDS emerged after studies in Uganda, Kenya, Malawi, Zambia and the United States found the potential to significantly reduce infections, said Bailey, adding the World Health Organisation has now endorsed circumcision as a disease prevention method.

"The challenge ahead for us is how to roll out circumcision safely ... and to persuade leaders in countries that it is going to help their populations," Bailey told a news conference.

"Circumcision is not just simply a surgical procedure. Its tied up in a complex web of cultural and religious practices and beliefs," he added.

"It's not easy for politicians and ministers of health to quickly come out in favor of circumcision in countries where circumcision is not traditionally practiced."

Bailey said aid organizations would not offer the service until local governments endorsed it, for fear of being seen as culturally insensitive.

WOMEN BACK CIRCUMCISION

Women in African nations are expected to be the drivers behind using circumcision to stop HIV infection as they are traditionally associated with ensuring hygiene in communities.

"Women, more than men, equate circumcision with improved hygiene," said Bailey.

"It's often up to women to provide the water, the soap and the materials for men to bathe and cleanse themselves. Many of the women complain the men are not as clean as they could be."

Circumcision should not be seen by men as their only preventative measure against HIV and must still be combined with safe sex practices. Condom use should still be encouraged.

"It's very important not to view this as a standalone surgical procedure," said Bailey.

Many Africans were already seeking circumcision to try and stop the spread of HIV, but many were suffering medical complications because of poor procedures.

There also was some evidence that circumcision may help prevent infection between homosexual men, with one study in Uganda showing a 30 percent reduction in infection

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Doctors treating older anorexics

Kelli Smith was nervous as she walked into the Philadelphia treatment center, seeking help at last for her anorexia. Looking around at the other patients, she was struck by how young they seemed.

"I just kind of looked around and I thought, 'Oh, where is someone my age?'" recalls Smith. At age 31, she found herself face-to-face with teenagers and 20-somethings.

Eating disorders such as anorexia and bulimia have long been considered diseases of the young, but experts say in recent years more women have been seeking help in their 30s, 40s, 50s, and older. Some treatment centers are creating special programs for these more mature patients.

Most of the women in this age group who seek treatment have had the problem for years, said Dr. Donald McAlpine, director of an eating disorders clinic at Mayo Clinic in Rochester, Minn. "The epidemiology is pretty clear that anorexia and bulimia both peak in the late teens, early 20s," yet "a lot of (patients) continue to be symptomatic right on through to middle life."

People who study eating disorders suggest several reasons there might be more women over 30 seeking treatment for what is typically a young woman's problem: growing public awareness, social pressure to be thin and an aging group of baby boomers.

National statistics on eating disorders are hard to come by, but data from some treatment centers suggest a steady increase.

In the Minneapolis suburb of St. Louis Park, Park Nicollet Health Services' Eating Disorders Institute saw 43 patients ages 38 and older in 2003 — about 9 percent of its total patients. For the first six months of this year, the institute has treated nearly 500 patients 38 and older, about 35 percent of its total.

The Renfrew Center, a network of treatment centers in the eastern U.S., said it saw a steady increase in the percentage of patients 30 and older who sought treatment at its Philadelphia center for eating disorders, peaking at 20 percent of 522 patients in 2005 before declining in 2006.

"Whatever this is — if it's an increased awareness, if it's a response to being in midlife — those numbers are staggering," said Carol Tappen, director of operations for the Eating Disorders Institute.

Women over 30 who seek treatment tend to fall into three categories, said Holly Grishkat, who directs outpatient programs at Renfrew.

Some have had an eating disorder for years. Others had a disorder in remission that resurfaced because of new stress in life, such as a divorce or loss of a parent. A third group, the smallest of the three, includes women who develop an eating disorder late in life.

Of Renfrew's patients over age 30 in 2005, about 60 percent first suffered from an eating disorder at 18 or younger. Nearly 20 percent said they were 30 or older when they first encountered the problem.

While body image is an issue for any age group, women over 30 are dealing with problems that teens don't have, such as work, divorce, stepchildren and aging parents.

"It's not about wanting to be the cheerleader or being the homecoming queen," said Tappen. "It's much bigger than that."

They also are dealing with an aging process, or childbirth, that changes the way they look.

"One day, (a woman) wakes up and the kids are gone and she has a sense that nobody really needs her. She looks in the mirror and she says, 'My body is shot,'" said Tappen. "This woman says, 'You know, that's it. I'm going on a diet.'"

Tappen said the aging of the huge baby boomer population may be one reason the Eating Disorders Institute has seen more older patients. Not only are there now more people in this group, but this population has traditionally been image-conscious, she said.

"Baby boomers have always cared about how they looked, what they wear," she said. "I think a lot of eating disorders years ago went undiagnosed because it was the thing to do."

The Eating Disorders Institute is building a new facility, set to open in 2009, that will offer a treatment track for mature patients.

Grishkat, of The Renfrew Center, encourages older women to seek age-specific treatment programs. Some may be embarrassed to get help alongside very young women. Also, some older women may take on maternal roles for younger girls when they should be focusing on themselves, she said.

"It's not a lost cause at 30, 40, 50 years old," she said. "You can still get better. In some sense, the older women do better in recovery than younger women. They tend to be more motivated."

For Smith, motherhood was a motivator. When she entered treatment, she was told she might have internal damage that could affect her ability to have children. Now 39 and out of treatment, she and her husband are parents to a 2-year-old boy and live in New Jersey. She says she's in recovery, and her primary goal these days is to be healthy.

"There's no question I put on weight because I wanted to have a baby," she said. "And I stay healthy right now for my baby."

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Newer Breast Cancer Drugs Appear to Boost Life Spans

A newer generation of breast cancer medications added months to the lives of patients with the most advanced form of the disease, according to the first study of its kind.

Still, the prognosis for the patients remains grim, with the exception of those who have a particular type of cancer that responds well to a new drug. And, one expert noted, the study did not include the newer cancer drug Herceptin, which has proven to prolong women's lives.

Even so, "this provides encouragement to patients with metastatic breast cancer" who were the focus of the study, said lead author Dr. Stephen Chia, a medical oncologist at the British Columbia Cancer Agency. "We can tell them that we have more drugs available, and it appears they do allow them to live longer."

Breast cancer is the most commonly diagnosed type of cancer, and only lung cancer kills more women.

Researchers have had a difficult time figuring out whether newer drugs, including the class called aromatase inhibitors, are effective for the most serious forms of breast cancer. It's considered unethical to assign one group of terminal cancer patients to a drug and give others a placebo or simply keep them comfortable.

"We're making a leap of faith as to what we're doing, how we're spending our resources, that we're actually allowing them to live longer," Chia said.

The new study looked at patients in the Canadian province of British Columbia between 1991 and 2001. All the 2,150 women had metastatic breast cancer, meaning tumors had spread beyond the breast.

The researchers found that the average survival time in the 1991-1992 and 1994-1995 periods was fairly stable, at 438 and 450 days, respectively. But when new drugs became available in the middle of the decade, survival grew to 564 days (1997-1998) and 667 days (1999-2001).

The newer medications included chemotherapy drugs and drugs known as aromatase inhibitors that tinker with estrogen levels. The study doesn't prove conclusively that the drugs lead to higher life spans, but the authors wrote that it seems likely.

An increase in life span of about eight months may not seem like much. But Chia pointed out that it's an average, and some women live longer.

In addition, he said, the newer drugs appear to be easier on patients, so they have better quality of life during their final days.

The results are in the Sept. 1 issue of the journal Cancer.

Dr. Eric Winer, director of the Breast Oncology Center at the Dana-Farber Cancer Institute in Boston, said the newer drugs are, indeed, easier for patients to tolerate.

"They're not only more effective, but they're kinder and gentler than they used to be. On a daily basis, our waiting room is filled with women, many of whom have advanced breast cancer but don't look different from those with early stages of breast cancer," he said.

But Winer noted that the study, which was first reported four years ago, is a bit outdated, because it was done before Herceptin (trastuzumab) was approved in 1998.

Herceptin allows about a quarter of women with breast cancer to survive for years, he said. The drug works best in those with HER2-positive cancer.

But, he added, "There are many women who are only living a year or two or three with this illness. We want it to be much better than that."

Meanwhile, another study published in the journal followed up on a previous study assessing the value of group therapy in breast cancer patients.

The case-control trial found that patients in weekly group therapy had only similar survival rates to those given literature-based patient education.

But the study also found that group therapy improved the quality of life for women with estrogen-receptor-negative tumors.

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Group therapy doesn't extend life in breast cancer

Women with breast cancer who take part in group therapy sessions with other patients live no longer than those who do not, but experience a better quality of life and less pain, researchers said on Monday.

The study led by Dr. David Spiegel of Stanford University School of Medicine in California ran counter to findings published in 1989 by a group also led by Spiegel that women in psychotherapy groups outlived other breast cancer patients.

That original study helped popularize such group therapy, but subsequent research produced mixed results.

Spiegel said he was surprised and disappointed that the new study, which tracked 125 women with breast cancer that had spread to other parts of the body, did not find that group therapy prolonged their lives.

But Spiegel said the study confirmed that these weekly sessions served to improve the quality of life for the women, with these patients reporting less pain, distress and anxiety.

"The main finding was that overall, we did not replicate our earlier finding that group therapy for metastatic breast cancer leads to longer survival," Spiegel said in a telephone interview.

"The take-home message for women is that support groups help you live better, whether or not they help you live longer," added Spiegel, whose findings are published in Cancer, a journal of the American Cancer Society.

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By Dennis Thompson

Melanoma remains a stubborn foe, with doctors reporting limited success in preventing the sometimes fatal skin cancer and even less success developing a cure.

"We'd like to reduce that death rate, but that's not happening," said Dr. Martin A. Weinstock, chairman of the American Cancer Society's Skin Cancer Advisory Committee. "We're not being effective in preventing melanoma. We've been making progress in early detection but not as much as we would like. And therapy for melanomas not detected early is basically poor."

But several advances announced in the last year -- from testing "sentinel" lymph nodes as a way to jump-start aggressive treatment, to new gene therapies that may one day beat back the cancer -- have given doctors a cautious sense of optimism.

Still, the experts add that these treatments need more testing, and prevention remains the best way to avoid the disease. So, the message remains the same -- protect yourself from the sun, and keep an eye on unusual skin growths.

"There are a lot of therapies that are promising," said Weinstock, professor of dermatology and community health at Brown University and chief of dermatology at the VA Medical Center in Providence, R.I. "But they're all possibilities. We just don't know if they're going to pan out yet."

Skin cancers in general are extremely survivable. The U.S. National Cancer Institute estimates that more than 1 million new cases of non-melanoma skin cancer will be diagnosed in 2007, claiming fewer than 2,000 lives.

Melanoma is another matter. It's rarer than basal cell or squamous cell skin cancer, with about 59,900 new cases expected to strike Americans this year. But it will kill an estimated 8,110 people, according to the cancer institute.

Melanoma remains frustratingly hard to prevent and cure, Weinstock said.

It begins in skin cells called melanocytes that produce melanin, the pigment that gives skin its natural color. Skin exposed to the sun causes melanocytes to produce more pigment, creating a sun tan. Sometimes, clusters of melanocytes and surrounding tissues form moles on the skin.

Melanoma occurs when those pigment cells become malignant. The first sign of trouble often is a change in the size, shape, color or feel of an existing mole, with most melanomas displaying a black or blue-black area. Melanoma also can appear as a new mole that is black or looks abnormal or ugly, according to the cancer institute.

If undetected or left untreated, melanoma can spread to other parts of the body, such as the liver, lungs or brain. The first sign that melanoma has spread, or metastasized, usually is the appearance of cancer cells in the body's lymph nodes. Part of the body's defense system, the nodes produce lymph, which travels throughout the body and filters out impurities.

In the past, doctors fighting melanoma would remove many or all of the body's lymph nodes to help prevent the spread of the cancer. But the experimental sentinel node biopsy technique allows doctors to remove only a few lymph nodes directly affected by the melanoma.

In the procedure, a radioactive substance is injected near the melanoma and its progress through the body is tracked. The first lymph nodes to take up the substance are called the sentinel lymph nodes.

Since the cancer is most likely to head to those lymph nodes first, only those nodes are surgically removed for testing. If positive, the rest of the lymph nodes are tested and removed. But if negative, the patient avoids what can be a painful procedure.

Sentinel node biopsy has been around for about two decades, but new studies have shown that its use can give patients a better fighting chance against metastasized melanoma.

A 2006 study headed by Dr. Donald L. Morton, who helped create the technique, found that patients whose lymph nodes tested positive and then had the rest of their nodes removed enjoyed a much higher five-year survival rate, compared with people who tested positive but delayed removal of their lymph nodes.

"The risk of dying from melanoma was almost one-half reduced if you had the lymph nodes removed versus waiting for them to grow to a detectable size," said Morton, medical director and chief of the melanoma program at John Wayne Cancer Institute at Saint John's Health Center, in Santa Monica, Calif.

Other scientists have found that boosting the immune system's ability to recognize and destroy cancer cells shows promise in treating melanoma.

In a recent study, National Cancer Institute researchers treated 17 patients with advanced, metastatic melanoma with white blood cells called T-lymphocytes that had been genetically engineered to better recognize the skin cancer. The result: Two of the patients went into a sustained remission.

Doctors believe this shows that such gene therapy can work, but much more work and many refinements remain ahead.

Until these tactics are improved upon, Weinstock recommends that people use the American Cancer Society's recommended "Slip, Slop, Slap" strategy for fighting skin cancer.

"The one major avoidable cause of melanoma is exposure to ultraviolet radiation from the sun," Weinstock said. "Slip on a shirt, slop on the sunscreen and slap on a hat."

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New HIV infections outpace treatment

Access to life-extending HIV/AIDS drugs in developing countries has improved during the past three years, but new infections still dramatically outpace efforts to bring treatment to patients, health officials said Monday.

Three years ago, fewer than 300,000 people in the developing world were receiving the anti-retroviral drugs that help treat the virus. Last year, 2.2 million people in developing countries received the drugs, according to Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.

"However, for every one person that you put in therapy, six new people get infected. So we're losing that game, the numbers game," Fauci told Australian Broadcasting Corp. radio.

In many parts of the developing world where the HIV/AIDS epidemic is still growing exponentially, effective prevention strategies — such as condom distribution, needle exchanges and basic education about the disease — reach less than 15 percent of the population.

"The proven prevention modalities are not accessible to any substantial proportion of the people who need them," said Fauci, one of the keynote speakers at the Fourth International AIDS Society Conference on HIV Pathogenesis and Treatment in Sydney, Australia, which runs through Wednesday.

"Although we are making major improvements in the access to drugs, clearly prevention must be addressed in a very forceful way," he added.

According to recent World Health Organization statistics, only 28 percent of the world's HIV/AIDS patients are receiving anti-retroviral drugs.

Dr. Brian Gazzard, chairman of the British HIV Association, said that while great advances have been made in extending access to anti-retrovirals, the disease is still running rampant in parts of Asia and Africa.

"The HIV epidemic is essentially uncontrolled, uncontrolled in Africa, uncontrolled completely in Asia right now," he told reporters at the conference, which has drawn 5,000 delegates from 133 countries. "The epidemic still is in an exponential growth phase ... and I think that is likely to continue."

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Medicare to reduce U.S. payments for anemia drugs

The U.S. Medicare health insurance program said on Friday it would reduce payments for anemia drugs when used to treat elderly and disabled patients who are undergoing kidney dialysis.

Anemia drugs known as erythropoiesis-stimulating agents, or ESAs, are sold by Amgen Inc. as Epogen and Aranesp and by Johnson & Johnson as Procrit.

"In response to safety concerns, we are modifying the ESA monitoring policy to provide greater restrictions on the dosage amounts of ESAs for which payment is made" for patients with hemoglobin levels above 13 grams per deciliter, the Centers for Medicare & Medicaid Services (CMS) said in a statement.

The new limits will take effect January 1, 2008. CMS said it would take public comments to decide if it should further revise the policy.

An Amgen spokeswoman could not immediately be reached for comment.

Johnson & Johnson spokeswoman Stephanie Fagan said the policy would not affect Procrit because the company does not market the drug for use in dialysis patients.

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Steps Prior to Pregnancy Can Protect Baby

Planning ahead before pregnancy helps new moms give their babies the best possible start in life, experts say.

And to help in that planning, here's an eight-step pre-pregnancy checklist from Barbara Coulter-Smith, a Texas obstetrician/gynecologist at Baylor Regional Medical Center at Grapevine:

• Take folic acid supplements. Folic acid is a B vitamin that reduces the risk of neural tube defects such as spina bifida. Few women get enough folic acid in their diet, so it's important to take supplements. Talk with your doctor.
• Make sure all your vaccinations are up to date, including immunization against chickenpox and rubella. You should also be up to date on your tetanus shot (every 10 years).
• Don't smoke while trying to get pregnant or during pregnancy. Smoking can increase the risk of miscarriage and of low-birth-weight babies. Do not drink alcohol when you're pregnant.
• Maintain a healthy weight. Being overweight can increase the risk of gestational diabetes and other pregnancy-related complications.
• Exercise helps you maintain or lose weight and helps you manage stress. If you do get pregnant, talk to your doctor about the kinds of exercise that are safe to do during pregnancy.
• If you have a chronic medical condition, talk to your doctor about the health risks of pregnancy and about which prescription medications you can still take during pregnancy. It's also important to tell your doctor about any family history of hereditary disorders before you start planning a pregnancy.
• After stopping the use of contraception, wait for one spontaneous menstrual cycle before trying to conceive. A normal menstrual cycle signals that the lining of the uterus is healthy enough to support a new life.
• Men also need to do some pre-pregnancy planning. Avoid hot tubs, saunas, smoking and alcohol, all of which can affect sperm count.

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Health Tip: Bicycle Safety for Children

Before your child uses that new bicycle, the most important things to equip him or her with is a properly-fitted helmet and a basic knowledge of bicycle safety.

Here are suggestions, courtesy of the International Bicycle Fund:

• Always wear a bicycle helmet.
• Never bike in the road or on a busy street. Stay on the sidewalk.
• Stop and look for cars at any intersection before crossing.
• Although biking on the sidewalk, always ride in the same direction as traffic, and follow all road signs.
• Try to keep both hands on the bike handles at all times.
• Don't ride at night, and wear bright clothing -- even during daylight.

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Chinese don't believe cardboard buns scare a hoax

Ordinary Chinese are refusing to believe government claims that a recent media report on cardboard-filled buns was a hoax aimed at hyping the nation's food safety woes, state press said Saturday.

The government's assertion that the televised report was bogus is being viewed as an attempt by authorities to stem the bad publicity over a series of recent food safety scandals that have caused anger in China and abroad, the official Xinhua news agency said.

"I guess government departments must be hoping to reduce the negative impact on the public by declaring the TV news report a hoax," Xinhua quoted Chen Huiqin, a retired Shanghai middle school teacher, as saying.

A cab driver, surnamed Liu, said he could not believe the investigative news report aired by Beijing TV on July 8 was a fabrication.

"It's not just me, most of my customers didn't believe it was a hoax either," the report quoted Liu as saying.

The report generated wide national and international attention as the latest in a string of scares involving China-produced foods, including toxic seafood, virus-plagued pigs and chemical-laden toothpaste.

The "expose" purportedly showed a seller of the buns, known as "baozi," softening shredded cardboard with an industrial chemical and fortifying the bogus meat with a bit of fatty pork.

But following government inspections, the authorities concluded that the report was a hoax perpetrated by a temporary Beijing television station employee. Police have subsequently detained six people in connection with the case.

Earlier this month, China executed the former head of its food and drug safety watchdog for corruption, in what was widely seen as an attempt by the government to show it is serious about the problem.

source : news.yahoo.com

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Health Tip: Risk Factors for Preeclampsia

Preeclampsia is a condition in pregnancy, characterized by a sudden, significant rise in blood pressure and swelling of the hands and feet. It can be dangerous for both the fetus and the mother. Here is a list of common risk factors, courtesy of the Preeclampsia Foundation:

• A first pregnancy.
• Family or personal history of preeclampsia, chronic high blood pressure, diabetes or kidney disease.
• Obesity.
• Multiple birth pregnancies.
• Age younger than 18 or greater than 40.
• Other conditions including polycystic ovarian syndrome, lupus, rheumatoid arthritis, sarcoidosis or multiple sclerosis.

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Steps Prior to Pregnancy Can Protect Baby

Planning ahead before pregnancy helps new moms give their babies the best possible start in life, experts say.

And to help in that planning, here's an eight-step pre-pregnancy checklist from Barbara Coulter-Smith, a Texas obstetrician/gynecologist at Baylor Regional Medical Center at Grapevine:

• Take folic acid supplements. Folic acid is a B vitamin that reduces the risk of neural tube defects such as spina bifida. Few women get enough folic acid in their diet, so it's important to take supplements. Talk with your doctor.
• Make sure all your vaccinations are up to date, including immunization against chickenpox and rubella. You should also be up to date on your tetanus shot (every 10 years).
• Don't smoke while trying to get pregnant or during pregnancy. Smoking can increase the risk of miscarriage and of low-birth-weight babies. Do not drink alcohol when you're pregnant.
• Maintain a healthy weight. Being overweight can increase the risk of gestational diabetes and other pregnancy-related complications.
• Exercise helps you maintain or lose weight and helps you manage stress. If you do get pregnant, talk to your doctor about the kinds of exercise that are safe to do during pregnancy.
• If you have a chronic medical condition, talk to your doctor about the health risks of pregnancy and about which prescription medications you can still take during pregnancy. It's also important to tell your doctor about any family history of hereditary disorders before you start planning a pregnancy.
• After stopping the use of contraception, wait for one spontaneous menstrual cycle before trying to conceive. A normal menstrual cycle signals that the lining of the uterus is healthy enough to support a new life.
• Men also need to do some pre-pregnancy planning. Avoid hot tubs, saunas, smoking and alcohol, all of which can affect sperm count.

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Health Tip: Hernias in Children

A hernia is a bulge caused by tissue that protrudes through a weak spot in a muscle wall, where it doesn't belong. While hernias are more common in adults, they can also occur in children.

Here are signs that your child may have a hernia, courtesy of the Nemours Foundation:

• A bulge that appears when your child is straining, coughing, crying or standing, and disappears when sleeping or resting.
• A bulge that is always visible.
• Swelling or discoloration of the groin or abdomen.
• A bulge in the groin that is swollen, red, inflamed and causing your child extreme pain.
• A combination of symptoms including irritability, pain, constipation, fever or vomiting

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Youngest Infants at Risk of Death While Seated

Cases are very rare, but babies younger than one month old may be vulnerable to sudden unexplained death while seated, say researchers from the Montreal Children's Hospital.

A new study published July 19 in the online edition of Archives of Disease in Childhood analyzed all sudden unexpected deaths occurring among babies up to 12 months of age in Quebec, Canada, between 1991 and 2000.

During this time period, 534 babies died, but the cause of death was fully investigated in only 508 of the cases.

In 99 of the deaths, the cause of death was eventually determined, but for 409 babies, the cause of death remained unexplained.

Seventeen (3.3 percent) of the babies who died were seated, predominantly -- but not exclusively -- in car seats. Ten of these deaths were unexplained.

While premature babies were not at increased risk, babies younger than one month old were almost four times as likely to die suddenly while seated, compared to the older babies. And babies under one month old whose deaths were unexplained were more than seven times as likely to die while seated, compared to older babies with unexplained deaths.

The authors cautioned that the rate of deaths among seated babies is still small, and there's no question about the safety of using car seats for baby. Instead, it is important to take extra care when dealing with very young babies in any type of seat, the researchers said.

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Studies Track Treatment Outcomes for Kids With ADHD

Children with attention deficit hyperactivity disorder (ADHD) showed sustained improvement but were still at increased risk of behavioral problems in the years after treatment, say researchers.

Four studies appearing in the August 2007 issue of the Journal of the American Academy of Child and Adolescent Psychiatry evaluated the outcomes of children who participated in the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA), the first major randomized trial comparing different treatments of ADHD. The initial results of MTA were published in 1999.

During the 14-month controlled treatment period, children with ADHD were assigned to receive usual community care or one of three treatments: medication alone, medication plus behavioral therapy, or behavioral therapy only.

Ratings from both family members and teachers favored the combination treatment, and careful medication management was more successful than medication provided through usual community care sources.

After 14 months of controlled treatments, families were free to choose the kind of treatment their children received, if any.

In one of the follow-up studies, researchers evaluated the children three years after the controlled treatment ended -- when they were 10 to 13 years old. They found that while 45 percent to 71 percent of the children were taking medication, continuing medication treatment was no longer associated with better outcomes.

"Our results suggest that medication can make a long-term difference for some children if it's continued with optimal intensity and not started or added too late in a child's clinical course," Peter Jensen, a researcher at Columbia University, said in a prepared statement.

A second study in the same issue of the journal found that children differed in their response to medication. A team at the University of California, Irvine, reported that about a third of the children showed a gradual, moderate improvement; about half showed a large initial improvement that was sustained through the third year of follow-up; and about 14 percent responded well initially but then symptoms returned during the second and third years.

The study's authors suggested that withdrawing the medication on a trial basis may help physicians determine if some children still need to take medications.

Another study by the same group suggested that taking medication for ADHD was associated with slowed growth. A group of 65 children who had never taken medication grew larger -- about three-quarters of an inch taller and six pounds heavier -- than a comparison group of 88 children who stayed on medication over the three years of follow-up.

A final article from the University of Pittsburgh reported that, despite treatment, children with ADHD showed higher-than-normal rates of delinquency than kids without ADHD (27.1 percent vs. 7.4 percent) and higher rates of substance abuse (17.4 percent vs. 7.8 percent) after three years.

Researchers will continue to follow the children to determine their outcomes in adolescence and adulthood.

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Low-Carb Diets Combat Metabolic Syndrome

A low-carbohydrate diet helps people with a condition called metabolic syndrome, a collection of serious risk factors found in some obese individuals.

Now, a new study confirms the diet is effective against the syndrome, and the researchers think they've discovered how it works.

Eating a low-carb diet improves the hormonal signaling involved in obesity and improves the sense of fullness, allowing weight loss, according to study leader Matthew R. Hayes, a postdoctoral fellow at the University of Pennsylvania.

"There is this strong interest in the field in carb-restricted diets in the treatment of obesity," said Hayes, who conducted the research while a doctoral student at Pennsylvania State University. "That [interest] comes from a number of controlled clinical trials that demonstrate overweight or obese people, maintained on low-carb diets, are successful if they adhere to the diet."

"It's definitely a hot debate in the field," Hayes added, whether the diets work. "We wanted to look at not only if it worked but how."

People with metabolic syndrome struggle with excessive abdominal fat; low levels of HDL -- good -- cholesterol; and insulin resistance or glucose intolerance, in which the body doesn't properly use insulin or blood sugar. Metabolic syndrome raises the risk of heart disease, type 2 diabetes and other serious health problems, according to the American Heart Association.

Hayes and his colleagues studied 20 men and women with metabolic syndrome, instructing them to follow a low-carb diet similar to the popular South Beach Diet. For phase one, which lasted two weeks, the study participants were told to get 10 percent of their calories from carbohydrates. For phase 2, which lasted the remaining 10 weeks of the study, they were told to eat up to 27 percent carbs.

"The subjects did lose weight, and they lost total body fat. Their weight was a little over 200 pounds when the study started. By the end of the study, the subjects weighed about 193, 194. They lost close to 10 pounds during the three-month study."

And, Hayes said, "By the end of the study, about 50 percent no longer had metabolic syndrome."

The study participants didn't follow the diets strictly, he found. "Phase one intake was 25 percent [carbohydrates], on average," he said, rather than the 10 percent recommended. "Phase two carb intake was 35 percent," he said, although 27 percent was recommended. But it was a reduction from the participants' pre-study diet, which included 47 percent of calories from carbohydrates, he said.

To find out why the weight declined, Hayes' team did hormone assays, measuring fasting and post-meal blood levels of hormones associated with appetite and food intake, such as insulin, leptin and cholecystokinin (CCK).

"We found some changes in hormone levels," he said. "We saw a decrease in insulin, a decrease in leptin levels by the end of phase one. It was fast."

"By the end of phase 2, the insulin levels had crept up toward baseline; the leptin levels also rose, but it did not come back to the levels at baseline," Hayes said.

"These alternations in hormone levels acting together help reduce the amount of food consumed," he said. "There's a synergy. Based on the literature already out there, we are speculating that this synergy of hormones may be the mechanism explaining why people are satisfied with less food and [the low-carb diet] results in weight loss."

However, Hayes emphasized that the study, published in the August issue of The Journal of Nutrition, was small and preliminary, and more research is needed.

Connie Diekman, director of university nutrition at Washington University in St. Louis and president of the American Dietetic Association, also urged caution when interpreting the study findings. "The study is small in size, and the population is not extremely diverse," she said, although she thinks the study design was good.

"The study was focused on metabolic syndrome, so the outcomes may not be transferable to people who are overweight but do not have the syndrome, since the cause of the syndrome is still not clear," Diekman said.

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Genetic Analysis Offers Insights Into AIDS Resistance

Variations in three genes play a critical role in how different people infected with HIV respond during the early stages of their infection.

This finding, detailed in the July 20 issue of Science, could help scientists find vaccines as well as new treatment targets for people infected with the AIDS-causing virus.

"There are new mechanisms of control of HIV1 that are implicated by these findings," said study senior author David Goldstein, a professor of molecular genetics and microbiology at Duke University and director of the school's Center for Population Genomics and Pharmacogenetics. "We don't yet know how to capitalize on those new mechanisms to develop new treatments, but it establishes directions for exploring new treatment options."

The study results are the first to emerge from the Center for HIV/AIDS Vaccine Immunology (CHAVI), a seven-year project funded by the U.S. National Institute of Allergy and Infectious Diseases (NIAID) with a goal of understanding the genetic influences on early responses to HIV infection. Many more studies are planned.

"We're really only just getting started," Goldstein said.

"It is a very important study," said NIAID Director Dr. Anthony Fauci. "It's significant for a couple of reasons. First of all, it used a technique that is going to be increasingly used in the genetics of medicine and that is to do a genome-wide association study to try and identify genes or modifications of genes which we call polymorphisms that are associated with certain expression of disease."

People infected with HIV have widely varying responses to their infection, with some falling sick quickly and others successfully fighting off full-blown AIDS for years or even decades.

One measurable difference is the level of circulating virus in the blood during the "stable" period after a person is infected but before he or she develops symptoms. This "viral load" is generally an indication of how well the person's immune system is fighting off the infection.

The new study searched for genetic differences that might explain variations in viral loads.

"One of the big questions in HIV is what are the determinants of the great variability in individuals being able to handle the virus. That's a big, big open question," Fauci said. "One of the ways to address that is to say look, there are some people whose viral set point, the level at which the body holds the virus in the absence of therapy, that varies enormously from person to person. We have no idea why that's the case. This study came up with three gene polymorphisms which appear to be associated very strongly with the ability to set the viral load. The combination of those explains about 15 percent of the variation in viral load among patients."

"The approach that we've taken is to use these natural differences among individuals in how well they can control the virus after infection as a pointer to new ways to act against the virus," Goldstein said. "That variation is huge. Some can push viral levels so low they will never progress to AIDS, whereas others can hardly contain it."

It took the international team of geneticists 18 months to identify the three crucial genes. In the end, they identified 486 appropriate patients from a possible universe of 30,000 people worldwide, and did genome-wide scanning on these patients. The study participants could not be undergoing treatment (as this would affect viral load levels), they had to know when they became infected, and there had to be high-quality laboratory estimates of their viral load.

This was the first time a genome-wide approach has been used for an infectious disease, the researchers said.

Two of the gene variants -- or polymorphisms -- were found in genes controlling the human leukocyte antigen (HLA) system, which helps identify foreign invaders and tags them for destruction. These genes, HLA-A and HLA-B, are switched off by HIV when it enters the body so the immune system is no longer able to recognize the virus as foreign.

Research published in the May 13 issue of Nature Genetics also implicated the HLA-B gene. That study found that HLA-B, in combination with another gene, KIR3DL1, might confer some protection against AIDS progression.

But HIV doesn't seem to be able to shut off HLA-C, the third gene variant identified by the researchers behind the new study. "This had not been a focus of attention in the past because it was not known that it is important in the control of HIV," Goldstein said. "We've now implicated this part of the immune response as being important so it now becomes a focus."

"It might be that this gene represents a vulnerable point for HIV," he added. "As far as we know, HIV can't act against it."

The three gene variants identified in the study explain 15 percent of the variability in how well people contain their viral load. "In genetic terms, that's a lot," Goldstein said. "These are very important genetic effects."

The next CHAVI study will look at what factors might protect people from becoming infected with HIV in the first place.

source : news.yahoo.com

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