Health Tip: Toilet Training Your Child

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

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

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

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

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Parkinson's drug pulled from U.S. market

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

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

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

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

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

Valeant representatives could not be immediately reached for comment.

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

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

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

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

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

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

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

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

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

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

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

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

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Parkinson's Drug Pergolide Withdrawn Over Heart Concerns

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

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

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

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

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

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

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

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

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

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

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

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

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Mexicans march to support abortion law

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

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

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

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

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

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

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

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

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

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Parental Drinking Boosts Alcoholism Risk for ADHD Kids

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

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

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

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

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

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

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

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

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

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

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"Weekender" Cialis promises China marital bliss

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

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

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

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

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

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

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

FAMILY HARMONY

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

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

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

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

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

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

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

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

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

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

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WHO support male circumcision to fight spread of AIDS

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

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

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

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

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

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

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

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

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

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

The two agencies made these points:

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

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

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

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

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

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

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

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

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

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

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Obesity boosts prostate cancer mortality

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

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

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

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

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

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

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

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Health Tip: Never Leave a Child Alone in the Tub

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

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

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

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Diabetes-Parkinson's Link Grows Stronger

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Type 2 diabetes may raise Parkinson's risk

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

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

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

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

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

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

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

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

They said they would investigate the link further.

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Circumcision recommended to fight HIV

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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WHO support male circumcision to fight spread of AIDS

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

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

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

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

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

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

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

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

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

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

The two agencies made these points:

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

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

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

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

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

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

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

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

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

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

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Italy to offer cervical cancer vaccine

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

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

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

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

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

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Type 2 diabetes may raise Parkinson's risk

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

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

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

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

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

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

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

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

They said they would investigate the link further.

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Suicide top killer of young Chinese

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

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

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

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

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

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

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

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

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

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

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Health Tip: Grill Safely

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

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

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Health Tip: Foods to Avoid During Pregnancy

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

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

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Two children bring Egypt bird flu cases to 29

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

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

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

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

Shaheen added that Awadallah's condition is improving.

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

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

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

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Va. gov. proposes cancer vaccine change

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

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

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

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

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

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

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

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Chile rediscovers native Mapuche remedies

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

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

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

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

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

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

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

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

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

MAPUCHE WISDOM

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

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

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

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

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

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Prostate biopsy may be misleading in obese men

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

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

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

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

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

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

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

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

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

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

SOURCE: Urology, March 2007.

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Depression Ups Heart Failure Death Risk

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

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

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

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

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

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

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Chile rediscovers native Mapuche remedies

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

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

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

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

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

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

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

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

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

MAPUCHE WISDOM

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

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

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

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

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

Read More..

Study links child care to poor behavior

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

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

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

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

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

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

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

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

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

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

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Mexican Catholics protest abortion bills

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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ndonesia confronts WHO over vaccines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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More Seniors Suffering Spinal Cord Injury

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

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

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

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

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

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

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

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

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Health Tip: My Child's Sick

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

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

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

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Health Tip: If Your Child Has a Seizure

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

The Children's Hospital Boston recommends that you:

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

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

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

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Fitted Sports Gear Key to Eye Protection

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

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


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

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

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

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

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

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

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

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Berlin Zoo polar bear makes public debut

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

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

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

Some children climbed nearby playground towers for a better view.

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

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

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

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

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

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

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Bacteria-killing viruses fight ear infections too

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

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

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

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

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

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

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

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

KILLER VIRUSES

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

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

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

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

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

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

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

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

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

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

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Clinical Trial to Examine Creatine as Parkinson's Treatment

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

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

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

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

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

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

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Seniors prefer to exercise alone

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

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

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

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

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

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

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

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

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

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

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

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

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Man gets probation for dead deer sex

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

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

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

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

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

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

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Brain Defect Tied to Diabetes-Related Erectile Dysfunction

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

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

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

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

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

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Child hunger at 'emergency' level in Central America

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Heart Association Backs Statin Use for At-Risk Kids

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

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

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

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

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

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

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

Among the recommendations in the statement:

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

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

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Over 5M living with Alzheimer's

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

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

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

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

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

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

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

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

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

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

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

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

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

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Drug Shields Parkinson's Patients Against Fracture

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

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

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

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

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

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

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

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Bone drug may benefit immobile Parkinson's patients

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

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

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

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

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

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

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

SOURCE: Neurology March 20, 2007.

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Cellular 'Fingerprint' IDs Infectious Disease

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

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

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

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

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

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

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

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Study casts doubt on duct tape wart cure

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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World's smallest horse has tall order

At just a hair over 17 inches tall, the miniature horse is more inclined to walk under fences than jump them. And her owners have sheltered the mare from ever gaining "circus-sideshow" or "one-trick-pony" status. As the world's smallest horse, 5-year-old Thumbelina, weighing in at 57 pounds, has a bigger mission: to raise $1 million for children's charities this year.

Handler Michael Goessling, son of miniature horse farmers Kay and Paul Goessling, says Thumbelina is the ideal child advocate. Her name comes from the Hans Christian Andersen fairytale of a woman the size of a thumb.

"When kids meet her in person, they want to talk to her and know what she likes and dislikes," Goessling said. "It's amazing because she is so loving with people. She craves attention."

In the months after being named "World's Smallest Living Horse" by Guinness World Records last summer, Thumbelina has certainly not been short on attention.

She's been showered with praise on the television talk-show circuit. The flow of schoolchildren who visit her is constant, and many leave with coloring books dedicated to the Goessling family pet.

"I'll have her out for hours. She's so mild mannered, everything just seems to brush off her shoulders. There have been 100 kids around petting her and she'll take a nap," Goessling said.

When Thumbelina travels the country this year, she'll do so in style — in a recreational vehicle that's her converted stable on wheels. Goessling calls it the Thumby Mobile.

An upcoming "Thumbelina Children's Tour" is expected to include stops in the 48 contiguous states at children's hospitals, schools, summer camps, fairs, horse shows and charitable fundraisers.

At Goose Creek Farms, the Goesslings breed miniatures for sale and for horse show competitions, a hobby that's brought them numerous ribbons for more than a decade.

But Thumbelina's special. "We don't want to make a penny off of her," Michael Goessling said. "We never have. There will never be another Thumbelina."

Most of her days are spent playing with like-size farm dogs. She even sleeps in a dog house.

The family calls her a "miniature-miniature" and genetically she's a dwarf. Rules of nature say it's a bad idea for her to reproduce, Goessling said.

Thumbelina often avoids the company of her taller, but still unusually small counterparts. Of the 40 or so miniature horses stabled on the ranch, most are more than a foot taller than Thumbelina.

The tiny horse and her charitable foundation have helped raise about $10,000 for children's charities since she gained World record status as the smallest horse ever recorded, at 17 1/2 inches at the withers.

When a Guinness official came from London to certify the record, a photograph was taken of Thumbelina and the world's largest living horse, Radar, a Belgium Draft horse from Texas standing at 6-foot-7 — about 40 times larger than Thumbelina.

She wasn't intimidated.

"I got the impression that Thumbelina wasn't so keen on sharing the limelight with the tallest horse at all," said Michael Whitty, who's in charge of Guinness' Picture Media.

The picture will appear in the 2008 World Record book to be released this fall.

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Obese Men With Prostate Cancer Face Higher Death Risk

Men who are obese when they're diagnosed with prostate cancer are 2.6 times more likely to die of the disease than normal-weight men, new findings suggest.

The study, by researchers at the Fred Hutchinson Cancer Research Center in Seattle, included 752 recently diagnosed prostate cancer patients who were followed for about 10 years. Of the men in the study, 50 died of prostate cancer, and 64 died of other causes.

"I was very surprised by the findings. We found the prostate-cancer-specific mortality risk associated with obesity was similar regardless of treatment, disease grade or disease stage at the time of diagnosis," senior author Alan Kristal, associate head of the Cancer Prevention Program in Hutchinson's Public Health Sciences Division, said in a prepared statement.

"If a man is obese at the time of diagnosis, he faces a 2.6-fold greater risk of dying as compared to a normal-weight man with the same diagnostic profile, regardless of whether he has radical prostatectomy or radiation therapy, whether or not he gets androgen-deprivation therapy, whether he has low- or high-grade disease, and whether he has localized, regional or distant disease," Kristal said.

The study also found that obese men with local or regional prostate cancer -- disease that's confined to the prostate or has spread to surrounding tissue -- are 3.6 times more likely than normal-weight men to have their cancer spread to distant organs (metastatis).

It's believed that both inflammation and steroid hormones are factors in the link between obesity and increased risk of prostate cancer metastasis and death, the researchers said.

"We are now beginning to appreciate that obesity is a massive inflammatory condition, and obesity also increases levels of serum estrogens and growth factors that can promote cancer growth," Kristal said.

The study is published in the March 15 issue of Cancer.

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Secret to slim kids? Just a little running around

Just 15 minutes a day of kicking around a ball or swimming might be enough to keep children from becoming obese, British and U.S. researchers said on Monday.

A study of 5,500 children who agreed to wear a motion sensor device showed that those who exercised more were less likely to be obese -- and that short bursts of intense activity seemed to be the most helpful.

Children who did 15 minutes a day of moderate exercise -- equivalent to a brisk walk -- were 50 percent less likely than inactive children to be obese, the researchers reported in the Public Library of Science journal PLoS Medicine.

"Our data suggest that higher intensity physical activity may be more important than total activity," Andy Ness of the University of Bristol and colleagues wrote.

"This study provides some of the first robust evidence on the link between physical activity and obesity in children," Chris Riddoch of Britain's Bath University, who worked on the study, said in a statement.

"We know that diet is important, but what this research tells us is that we mustn't forget about activity. It's been really surprising to us how even small amounts of exercise appear to have dramatic results."

Obesity is on the rise in many countries, including the United States, where 60 percent of the population is overweight or obese, Britain and elsewhere in Europe.

It is clearly a matter of people eating more calories than they burn off, but experts cannot agree whether diet or exercise is more important -- and which kind of exercise might be best.

Ness' team studied 5,500 children, with an average age of 12, who with their mothers have been taking part in a larger, long-term study of health.

The children agreed to wear a device called an accelerometer, which measures total activity, and they had X-ray scans for body fat. The researchers rated the children with the top 10 percent levels of fat mass as obese.

The less the children exercised, the more likely they were to be obese, the study found.

"These associations suggest even a modest increase of 15 minutes moderate and vigorous physical activity might result in an important reduction in the prevalence of overweight and obesity," the researchers wrote.

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Some scientists eye odd climate fixes

When climate scientist Andrew Weaver considers the idea of tinkering with Earth's air, water or sunlight to fight global warming, he remembers the lessons of a favorite children's book.

In the book, a cheese-loving king's castle is infested with mice. So the king brings in cats to get rid of the mice. Then the castle's overrun with cats, so he brings in dogs to get rid of them, then lions to get rid of the dogs, elephants to get rid of the lions, and finally, mice to get rid of the elephants.

That scenario in "The King, the Mice and the Cheese," by Nancy and Eric Gurney, should give scientists pause before taking extreme measures to mess with Mother Nature, says Weaver of the University of Victoria.

However, in recent months, several scientists are considering doing just that.

They are exploring global warming solutions that sound wholly far-fetched, including giant artificial "trees" that would filter carbon dioxide out of the air, a bizarre "solar shade" created by a trillion flying saucers that lower Earth's temperature, and a scheme that mimics a volcano by spewing light-reflecting sulfates high in the sky.

These are costly projects of last resort — in case Earth's citizens don't cut back fast enough on greenhouse gas emissions and the worst of the climate predictions appear not too far away. Unfortunately, the solutions could cause problems of their own — beyond their exorbitant costs — including making the arid Middle East even drier and polluting the air enough to increase respiratory illnesses.

Kevin Trenberth, climate analysis chief at the National Center for Atmospheric Research, said mankind already has harmed Earth's climate inadvertently, so it's foolish to think that people can now fix it with a few drastic measures.

But at Trenberth's same Boulder, Colo., research center, climate scientist Tom Wigley is exploring that mock volcano idea.

"It's the lesser of two evils here (the other being doing nothing)," Wigley said. "Whatever we do, there are bad consequences, but you have to judge the relative badness of all the consequences."

Studying the concept of how volcanic pollutants could lessen global warming — the Earth was slightly cooler after the eruption of a Philippine volcano 16 years ago — was brought to the forefront of scientific debate last summer by Nobel Laureate Paul Crutzen.

"It was meant to startle the policymakers," said Crutzen, of Germany's Max Planck Institute for Chemistry. "If they don't take action much more strongly than they have in the past, then in the end, we have to do experiments like this."

In the past, scientists and others have avoided talking publicly about these ideas, known as "geoengineering," even though the concept was first raised in 1965. They worried that the hope of a quick technological fix to global warming would prevent politicians and the public from making the real energy sacrifices that they say are necessary to slow climate change.

David Keith, a University of Calgary engineering professor and one of the world's experts in geoengineering, says that just because tinkering with the air, water and sunlight are possible, they should not be substitutes for cutting emissions just because "we've been politically weak-kneed."

Instead, he said, such options should be researched as an "insurance policy" in case global warming is even worse than forecast. And that prospect has caused climate scientists to talk about the issue more openly in recent months.

There is also a chance that discussion of such radical ideas as a volcano or sun shade could shock the world into acting to reduce fossil fuel emissions, Keith said.

However, White House science adviser Jack Marburger, said spending money on geoengineering doesn't make sense. The federal government, which spends about $2 billion on climate change science, invests nearly all of its research on energy sources that produce fewer or no greenhouse gas emissions.

"I don't think it's scientifically feasible at this time to consider a plan like that (geoengineering)," Marburger told The Associated Press. "The real urgency is to reduce carbon dioxide."

In 2001, the Intergovernmental Panel on Climate Change looked at geoengineering as part of its report on how to lessen global warming. It found some promise, worried about unexpected side effects, legal and ethical implications, and concluded that "unlike other strategies, geoengineering addresses the symptoms rather than the causes of climate change."

Even proponents of geoengineering research are wary.

"We are playing with fire here," Keith said. "Those of us suggesting we do something are suggesting it with real nervousness."

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Malaysia pins hopes on herbal Viagra for biotech push

Malaysia's answer to Viagra is a traditional herb the country has picked to spearhead its push into biotechnology, but now it faces the challenge of convincing the world the remedy is both potent and safe.

Surging interest in the herb, "tongkat ali," has spawned dozens of products, from pills to beverages, that play up its reputed aphrodisiac properties, and could even threaten the sway overseas of ginseng, a more-widely established remedy in Asia.

Generations of aging Malaysian men have sworn by the rejuvenation effects of "tongkat ali," scouring the countryside for it so eagerly that it has almost vanished from all but the deepest rainforest, and now has the status of a protected plant.

Scientific studies show that concoctions of "tongkat ali" can help hormone production, making rats and mice more frisky, but have yet to prove it can reliably produce the same effect in humans, researchers say.

"It can have different effects on different people," said Abdul Razak, head of the Forest Research Institute of Malaysia, which is driving research and commercial production of the herb.

"For me, it gives the energy to play a game of golf without getting tired, but has no other effects," said Razak, who takes two capsule supplements of the herb before each weekly game to increase his stamina.

"Tongkat ali," which scientists call Eurycoma longifolia, is a slender evergreen shrub with bitter, brownish-red fruit that is native to Malaysia and Indonesia.

All parts of the plant which grows up to 10 meters (33 ft) tall can be chopped up fine and boiled in water to make the traditional medicine.

As Malaysia looks to biotechnology for economic growth, scientists are taking a harder look at the aphrodisiac qualities of tongkat ali, which means the "walking-stick of Ali," in Malay, and they say it could spawn drugs to treat cancer and malaria.

PREPARING FOR COMMERCIAL USE

Five years of research studies in collaboration with the Massachusetts Institute of Technology in the United States have helped to identify the key compounds in the herb, Razak said.

"All these compounds have been found, have been tested and have been patented, and we are now in the process of carrying out clinical studies, and hopefully after some time we might even commercialize this," he added.

A Malaysian industry and government group says the rapidly growing global market for aphrodisiacs is worth about $4 billion and could reach nearly $7 billion by 2012, but plans for "tongkat ali" to grab a share of this pie hinge on proving it is safe.

In Taiwan this year, Taipei city officials banned six brands of coffee from supermarkets because they contained "tongkat ali," saying the plant had not been evaluated for safe use, although there were no confirmed reports of side-effects, newspapers said.

The episode in January stirred indignation in Malaysia, where some officials publicly defended the herb, saying its safety and efficacy had been demonstrated by hundreds of years of use.

Others said the incident showed how far Malaysia still has to go to prove its claims for the herb.

"We've still got a lot of homework to do as a nation," said M. Rajen, chief executive of Tropical Botanics Sdn Bhd, which counts among its products Malaysia's most popular fish-oil brand.

Makers of ginseng, which has a global market of about $2 billion a year, according to some industry estimates, would be ruthless in battling competition from "tongkat ali," he said.

"What we see in Taiwan and elsewhere is an example of this ruthlessness," Rajen added. "Because we have not done our homework, we cannot fight it."

But Malaysia is confident it will convince the world. Officials of Power Root Malaysia Sdn Bhd, which exports tea and coffee drinks containing the herb to Japan and
South Korea, have said they are looking to the United States and the Middle East.

"One day 'tongkat ali' will be marketed internationally, even in Harrods of London," Deputy Prime Minister Najib Razak said in January, at the launch of a $7 million biotech research center that will study ways to clone the herb.

At the Forest Research Institute, workers in white protective gear poured sacks of the herb into gleaming stainless steel dryers and grinders to turn out powder for capsules.

"It's high time for 'tongkat ali' now," said researcher Mohamad Shahidan, grinning through his face mask. "Everybody wants to try it."

($1=3.509 Malaysian Ringgit)

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Resistance to Hormone Leptin Called Key to Obesity

Researchers may have uncovered the biochemical defect that underlies food-induced obesity in mice.

Assuming it can be duplicated in humans, the finding suggests several potential anti-obesity drug targets, experts said.

Michael Cowley, of the Oregon National Primate Research Center at Oregon Health and Science University, led the study, which examined the cause of leptin resistance in diet-induced obese mice.

Leptin is a hormone, secreted by fat cells, which indicates how much fat is in the body and regulates food intake by binding to neurons in the hypothalamus region of the brain. In lean people, leptin serves to regulate weight by controlling appetite and the use of stored energy. Obese individuals, however, appear to be resistant to leptin, much as diabetics are resistant to insulin.

The question was, what is the mechanism driving leptin resistance.

In the study, genetically identical mice were fed a high-fat diet for 20 weeks, at which point about 65 percent were obese. (That's a finding that Cowley said highlights the importance of epigenetics -- genetic differences not coded in DNA itself -- in obesity).

By comparing the obese animals to their lean littermates, as well as to control mice fed a normal diet, the researchers found that leptin normally governs neuropeptide release from cells called neurons in the hypothalamus, suppressing food intake and controlling energy utilization. In animals made obese by diet, however, leptin failed to trigger any response in these cells.

"We knew these cells were leptin-sensitive already," Cowley said. "The interesting finding was that they become non-responsive. We've identified the site of leptin resistance."

The study is published in the March 2007 issue of Cell Metabolism.

Dr. Julio Licinio, chairman of the department of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, who was not involved in the research, praised the study, calling it "very rigorous and sophisticated."

Licinio cited two interesting implications of the research. The first is that, in mice at least, leptin resistance is what he calls "functional," not permanent, and can be corrected by diet-induced weight loss.

Said Cowley: "If we put the obese animals on a low-fat diet, they recover from leptin resistance and drop weight. And when they recover, all the circuitry responses return to normal. We don't know if humans would respond in the same way, but we know that weight loss in humans is beneficial, even if you don't hit the ideal target weight."

Licinio also said the study suggests potential targets for drug development to fight excess weight. But, he added, "What the paper does not show is how resistance occurs and how you can overcome it."

One interesting facet of the findings, Cowley said, is the recognition that obesity, like diabetes, is truly a physical disease. "Obesity is not just a failure of will," he said. "This is a fundamental biological difference between obese and lean groups."

Licino said: "I think the take-home message is that (this study) gives hope. You need the caveat that it's not the same between mice and humans, but it does give hope that loss of a person's (ability) to regulate what they eat can be restored to maintain a normal weight."

Read More..

Health Tip: Taking Your Child's Temperature

If your child appears sick and might be running a fever, it's important to take his temperature properly.

There are different kinds of thermometers, but certain types may be better suited to your child's age range, the American Academy of Family Physicians says. Here are the group's recommendations:

* For children younger than 3 months, a digital thermometer should be used rectally. Electronic ear thermometers are not recommended, as ear canals are typically too small at this age to get an accurate reading.
* For children between 3 and 4 months, a digital thermometer used rectally or an electronic ear thermometer both should provide accurate readings.
* For children aged 4 and older, digital thermometers used orally will suffice. If the child has a cough, stuffy nose or has difficulty with an oral thermometer, an electronic ear thermometer or digital thermometer placed under the arm should work.

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Child in hospital after father has smallpox jab

he 2-year-old son of a soldier deployed to Iraq is in critical condition after developing a reaction to his father's smallpox vaccination, the U.S. Centers for Disease Control and Prevention said on Saturday.

The child, being treated in a Chicago hospital, has a rare but very serious reaction to the vaccination site called Eczema vaccinatum, the
CDC said. It is the first such case since vaccination against smallpox resumed in 2002, said CDC pox virus expert Dr. Inger Damon.

The toddler's father is a soldier vaccinated while on deployment to Iraq. The father was unexpectedly furloughed and evidently his wife and son touched the vaccine site and became infected, the CDC said.

"They can get a particularly noxious and sometimes fatal rash," Damon said in a telephone interview.

The smallpox vaccine is made using a closely related virus called vaccinia. It is scratched into the surface of the skin, where it causes a mild infection that makes people much less susceptible to smallpox.

But because it uses a live virus, the vaccine can cause severe and sometimes deadly side effects. Eczema vaccinatum is one of them, although this is the first case to be reported since smallpox vaccinations resumed in the United States in 2002.

"The child is a dependent of a U.S. Army Service member deploying to Iraq," the CDC said in a statement.

"We don't know what the soldier's reaction was like at his vaccination but he is doing well now and hasn't described any illness that we are aware of," Damon said.

The child has been treated with immune globulin, an antiviral drug called cidofovir, and an experimental antiviral made by Siga Technologies called SIGA-246, Damon said.

"We are cautiously optimistic that the child is improving," Damon said.

ONCE-FATAL RASH

Between 1959 and 1968, when smallpox vaccination was common, 12 cases of Eczema vaccinatum were reported in the United States, with an 18 percent fatality rate.

The smallpox virus once killed 30 percent of its victims, leaving many others disfigured. A global vaccination campaign eradicated the disease in 1979.

But some samples of the virus remained in government freezers and experts believe it could be used as a biological weapon. The United States resumed vaccinating some people in 2002, including 40,000 civilian health workers and hundreds of thousands of military personnel.

Many civilians resisted getting inoculated because of the vaccine's notorious side effects. But the CDC has reported only two very severe cases, both involving heart conditions that potentially could have been caused by the vaccine.

Damon said a stringent screening program had made vaccination safer than in years past. Anyone predisposed to side effects, such as people known to have eczema, are not supposed to get the shot.

"So I think this is one of those unfortunate events where a family member who was at risk from vaccinia ends up coming in contact with a vaccinated individual," she said.

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Booster Seat Laws Keep Kids Safe

State booster seat laws may be saving the lives of young children, a new study finds.

Researchers at the University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia found that kids aged 4 to 7 are more likely to be properly restrained in car crashes in states that have the booster seat laws in place.

Reporting in the March issue of the Archives of Pediatrics & Adolescent Medicine, they analyzed data on 6,102 children in 5,198 vehicles involved in crashes from December 1998 through December 2004.

The data came from the District of Columbia and 16 states in the four regions (East, Midwest, South and West) of the United States. Seven of the states and the District of Columbia have booster seat laws that went into effect during the study. The other nine states had no such laws.

"Between the first six months of 1999 and the last six months of 2004, appropriate restraint use increased from 21.5 percent to 74.8 percent for children aged 4 to 5 years and from 3 percent to 22.9 percent for children aged 6 to 7 years," the study authors wrote.

Children in states with booster seat laws were 39 percent more likely to be appropriately restrained in crashes than youngsters in states with no booster seat laws.

The study authors noted that 350 children aged 4 to 7 were killed in motor vehicle crashes in the United States in 2004 and that booster seats are an inexpensive, easy-to-use and effective way of protecting children.

"Our data suggests that booster seat provisions for children aged 4 through 7 years will have some effect on all children in this age range," the researchers concluded. "Given the current greater use of appropriate restraints for 4- to 5-year-olds compared with older children, future upgrades to child restraint laws should target all children through at least age 7 years to achieve the greatest effect on overall child restraint use."

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Zinc Supplements Save Poor Children's Lives

In the developing world, daily zinc supplements can reduce the risk of death in children aged 1 to 4, but they do not provide any significant benefit for babies under 1, U.S. researchers report.

Zinc, which is one of the most plentiful trace elements in the body, is believed to play an important role in healthy immune system function.

The study, by a team from the Johns Hopkins Bloomberg School of Public Health in Baltimore, included more than 42,500 children in the East African nation of Zanzibar. Half the children received daily zinc supplements (5 milligrams for infants, 10 milligrams for children 12 months and older), while the other half received a placebo pill.

Overall, children who took the zinc supplements were 7 percent less likely to die than those who took the placebo. In children aged 12 to 48 months, those taking zinc supplements were 18 percent less likely to die.

"This large trial demonstrates that the benefits of zinc supplementation include mortality reduction in addition to the reduction in cases of pneumonia, diarrhea and malaria that we found in previous trials," study senior author Dr. Robert Black, professor and chairman of the Bloomberg School's department of international health, said in a prepared statement.

The study appears in the March 17 issue of The Lancet.

"While further work is needed to evaluate higher dose effects, recommendations for use of zinc as a preventive strategy needs to consider the collective evidence of the effect on growth, morbidity and mortality, which would suggest benefit in children age 6 months and up," lead author Sunil Sazawal, an associate professor in the department of international health, said in a prepared statement.

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Resistance to Hormone Leptin Called Key to Obesity

Researchers may have uncovered the biochemical defect that underlies food-induced obesity in mice.

Assuming it can be duplicated in humans, the finding suggests several potential anti-obesity drug targets, experts said.

Michael Cowley, of the Oregon National Primate Research Center at Oregon Health and Science University, led the study, which examined the cause of leptin resistance in diet-induced obese mice.

Leptin is a hormone, secreted by fat cells, which indicates how much fat is in the body and regulates food intake by binding to neurons in the hypothalamus region of the brain. In lean people, leptin serves to regulate weight by controlling appetite and the use of stored energy. Obese individuals, however, appear to be resistant to leptin, much as diabetics are resistant to insulin.

The question was, what is the mechanism driving leptin resistance.

In the study, genetically identical mice were fed a high-fat diet for 20 weeks, at which point about 65 percent were obese. (That's a finding that Cowley said highlights the importance of epigenetics -- genetic differences not coded in DNA itself -- in obesity).

By comparing the obese animals to their lean littermates, as well as to control mice fed a normal diet, the researchers found that leptin normally governs neuropeptide release from cells called neurons in the hypothalamus, suppressing food intake and controlling energy utilization. In animals made obese by diet, however, leptin failed to trigger any response in these cells.

"We knew these cells were leptin-sensitive already," Cowley said. "The interesting finding was that they become non-responsive. We've identified the site of leptin resistance."

The study is published in the March 2007 issue of Cell Metabolism.

Dr. Julio Licinio, chairman of the department of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, who was not involved in the research, praised the study, calling it "very rigorous and sophisticated."

Licinio cited two interesting implications of the research. The first is that, in mice at least, leptin resistance is what he calls "functional," not permanent, and can be corrected by diet-induced weight loss.

Said Cowley: "If we put the obese animals on a low-fat diet, they recover from leptin resistance and drop weight. And when they recover, all the circuitry responses return to normal. We don't know if humans would respond in the same way, but we know that weight loss in humans is beneficial, even if you don't hit the ideal target weight."

Licinio also said the study suggests potential targets for drug development to fight excess weight. But, he added, "What the paper does not show is how resistance occurs and how you can overcome it."

One interesting facet of the findings, Cowley said, is the recognition that obesity, like diabetes, is truly a physical disease. "Obesity is not just a failure of will," he said. "This is a fundamental biological difference between obese and lean groups."

Licino said: "I think the take-home message is that (this study) gives hope. You need the caveat that it's not the same between mice and humans, but it does give hope that loss of a person's (ability) to regulate what they eat can be restored to maintain a normal weight."

Read More..

French firm develops possible test for Alzheimer's

ExonHit Therapeutics, a French company that diagnoses diseases and develops drugs to treat them, said on Thursday it had found a possible blood test for the brain wasting disease Alzheimer's.

"This is an important development as there is currently no diagnostic test that can accurately identify patients with Alzheimer's disease," ExonHit said in a statement.

ExonHit said it had identified a panel of genes that allowed to diagnose from blood the possible presence of Alzheimer's. It said this represented a major step forward from other methods aimed at detecting Alzheimer's from spinal fluids.

From a group of 85 people, 51 of whom had Alzheimer's and 34 did not, the panel of blood genes correctly identified 78 percent of those suffering from the disease and 82 percent of those who did not.

"A prospective clinical study will further define the specificity and selectivity of the (blood) markers identified," ExonHit said.

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Child Sexual Abuse More Likely in Single-Parent Homes

Adult men who grew up in single-parent households are twice as likely as other men to have been sexually abused during childhood, a U.S. study found.

That's because parental absences in single-parent homes provide more opportunities for sexual predators to abuse children, the researchers said.

"Children being raised by one parent are at a greater risk for many things as they grow up, including health risks such as poorly controlled diabetes and asthma. We now must add childhood sexual abuse to part of this risk picture," study author Dr. William C. Holmes, an assistant professor of medicine and epidemiology at the University of Pennsylvania School of Medicine, said in a prepared statement.

His team published the findings in the March 13 issue of the Journal of Epidemiology and Community Health.

Even after adjusting for socioeconomic factors, the study found that children in single-parent families had a higher overall risk of being sexually abused than children with two parents. The risk was higher in one-parent homes with lower incomes than in one-parent homes with higher incomes.

Holmes noted that parental absence is common in single-parent homes because the single mother or father has to work to provide for the family. As a result, children may seek an adult with whom to share experiences and bond.

"Predators are pretty good at finding and grooming these sorts of kids. They set children up over time, earn their trust, act as parent-substitutes by giving them attention and sometimes gifts," Holmes said.

The findings from this and other studies show that single parents need more support, such as improving their access to quality child care.

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Spending on kids to be smaller share

U.S. children may lose out over the next decade even as the federal government spends more on domestic programs, because a smaller share will go to education, health care and other benefits, researchers said on Thursday.

A day after two Democrats introduced a bill to boost health coverage for children, a new report by the Urban Institute showed that children's programs would represent 13 percent of domestic spending by 2017, down from about 15 percent in 2006.

This adds up to billions of dollars.

"If you keep the budget on its current path, children are going to get squeezed," said Eugene Steuerle, a senior fellow at the institute. "To extent you think investment in children is an important policy agenda, you're squeezing and putting enormous pressure on that part of the agenda."

Programs focused on children totaled $333 billion last year and would increase $36 billion by 2017 under current law, the study said. Other domestic spending would rise to $2.4 trillion from $1.8 trillion.

However, Steuerle said that if the low-income health care program known as Medicaid was not included in the total, spending on children would actually decrease by 2017.

Part of the problem is that children's programs often lack automatic funding increases or annual renewal, unlike some major domestic spending, the study said.

"I think the key findings are that investment in children has never been a high federal priority, but it would be one that's going to clearly decline as we move toward the future unless we really get our budget house in order," Steuerle said.

The Bush administration and Congress are working to find ways to provide health care services to 9 million children who have no insurance coverage and resolve complaints from states who fear a shortfall of billions of dollars in aid.

State governors have said the $5 billion in additional funding the Bush administration has pledged for each of the next five years for the State Children's Health Insurance Program (SCHIP) is insufficient.

New York Sen. Hillary Rodham Clinton, who is seeking the 2008 Democratic presidential nomination, unveiled legislation on Wednesday with a colleague in the House of Representatives aimed at covering uninsured children through existing programs.

The measure, coauthored by Democrat Rep. John Dingell (news, bio, voting record) of Michigan, would give states incentives to expand their existing programs for children's health insurance and would help states identify the estimated 6 million children eligible for public programs but not currently enrolled.

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Spending on children to shrink

U.S. federal spending on nutrition, education and health care programs for children is on course to shrink as a share of the total budget over the next decade, researchers said on Thursday.

A day after two Democrats introduced a bill to boost health coverage for children, a new report by the Urban Institute showed that children's programs would represent 13 percent of domestic spending by 2017, down from about 15 percent in 2006.

That translates into billions of dollars.

"If you keep the budget on its current path, children are going to get squeezed," said Eugene Steuerle, a senior fellow at the institute. "To the extent you think investment in children is an important policy agenda, you're squeezing and putting enormous pressure on that part of the agenda."

Programs focused on children totaled $333 billion last year and would increase $36 billion by 2017 under current law, the study said. Other domestic spending would rise to $2.4 trillion from $1.8 trillion.

However, Steuerle said that if the Medicaid low-income health care program was not included in the total, spending on children would actually decrease by 2017.

Part of the problem is that children's programs often lack automatic funding increases or annual renewal, unlike some major domestic spending, the study said.

"I think the key findings are that investment in children has never been a high federal priority, but it would be one that's going to clearly decline as we move toward the future unless we really get our budget house in order," Steuerle said.

The study also found that spending on children had shifted to in-kind benefits such as food stamps and subsidized housing rather than tax credits, exemptions and welfare cash payments.

The Bush administration and Congress are working to find ways to provide health care services to 9 million children who have no insurance coverage and resolve complaints from states who fear a shortfall of billions of dollars in aid.

State governors have said the $5 billion in additional funding the Bush administration has pledged for each of the next five years for the State Children's Health Insurance Program or SCHIP is insufficient.

New York Sen.
Hillary Rodham Clinton, who is seeking the 2008 Democratic presidential nomination, unveiled legislation on Wednesday with a colleague in the House of Representatives aimed at covering uninsured children through existing programs.

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Health agency says hepatitis cases down sharply

New cases of the liver disease hepatitis fell sharply in the United States from 1995 to 2005, federal health officials said on Thursday, and credited vaccination, particularly among children.

More than 100,000 Americans became infected with hepatitis viruses in 2005, compared to about 500,000 in 1995, the U.S. Centers for Disease Control and Prevention reported.


The incidence of hepatitis A and B dropped to the lowest levels recorded since the government first started keeping records on them more than four decades ago, the
CDC said. It also reported a retreat in cases of hepatitis C.

These are the three most commonly occurring forms of acute viral hepatitis in the United States. Hepatitis B and C can lead to liver cancer and death.

From 1995 to 2005, new cases of reported acute hepatitis A plummeted by 88 percent to an incidence rate of 1.5 per 100,000 people, the CDC said. During the same period, reported cases of acute hepatitis B plunged 79 percent to a rate of 1.8 per 100,000 people.

CDC epidemiologist Annemarie Wasley said prevention efforts by health authorities have paid off, particularly with the widespread use of hepatitis A and B vaccines.

"Rates are declining for all ages, but much of the decline is driven by declining rates in children, which is the age group that has been covered by routine vaccination for both hepatitis A and B," Wasley said in a telephone interview.

More progress is needed to drive down rates among intravenous drug users, homosexuals and heterosexuals with multiple sex partners, Wasley said.

Dr. Kevin Fenton, who heads the CDC's National Center for
HIV/
AIDS, Viral Hepatitis, STD and TB Prevention, hailed the progress against hepatitis A and B in particular as "one of the big public health success stories of the last 10 years."

Under CDC recommendations, all children ages 12 months to 23 months should be vaccinated against hepatitis A, as should people in high-risk groups such as international travelers, gay men and drug users.

The CDC recommends three doses of hepatitis B vaccine beginning at infancy. It is also recommended for people with multiple sex partners and intravenous drug users.

The CDC said cases of hepatitis C also fell, but the trend should be viewed warily because surveillance is limited, as many people do not develop symptoms immediately and may be unaware they are infected with the virus.

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16,000 child malnutrition cases in Niger since January

Almost 16,000 child malnutrition cases, including 18 deaths, have been registered in the west African state of Niger since the start of the year, the UN World Health Organisation said Thursday.

The total number of malnutrition cases for children under five was 15,791, the WHO said in a report. Nearly 14,000 of those cases were classified as moderate, while the others were called severe.

The hardest-hit regions include Maradi in the southeast and Tahoua and Tillabery in the west, where thousands of children were affected by Niger's 2005 famine.

Drought and locust attacks caused that shortage, which left three million people dependent on emergency food aid in the Sahel nation, much of which is arid and has borders with Mali and north African Saharan nations.

In January, the government and the
United Nations said child malnutrition had decreased. It reached a 10.3 percent level in 2006 compared to 15.3 percent the year before, they said.

However, the report said acutely severe cases of child malnutrition remained high, reaching 1.4 percent in 2006 compared to 1.8 percent in 2005.

Despite a 336,000-ton grain surplus in 2006, several agricultural villages claimed large shortages, the agriculture ministry said.

In some regions, malnutrition has persisted in part because of traditional practices rather than a lack of supply, Niger authorities say.

Those practices include preventing pregnant women and infants from eating items such as eggs or fish because of a belief that it could harm their health, the Niger health ministry says.

Niger, one of the world's poorest countries, has also seen strong population growth of about 3.3 percent per year.

Women have on average seven children, but there is also a high level of maternal and neo-natal deaths for an average of seven out of 1,000 women and 278 per 1,000 children, according to official statistics.

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Sexually transmitted HPV remains mystery

Nearly every working day, Dr. Elizabeth Poynor encounters anxious young women who come to her New York City office with an HPV diagnosis. The human papillomavirus is the most prevalent sexually transmitted diseases — so common that researchers estimate most people will have some form of it in their lifetime. Young adults are especially at risk because they tend to be the most sexually active group.

And yet Poynor finds that most of her young patients — even if they've heard of a new vaccine aimed at preventing the worst kinds of HPV — know little about the virus and the harm it can do.

Many women find themselves scrambling to understand HPV after a routine Pap smear determines they have it. And that, Poynor and others say, creates angst that could be avoided with more education.

"This is a very common problem, period," Poynor, a gynecological oncologist in private practice, says of HPV. "That's the first thing I try to tell my patients, to put their minds at ease and to potentially take away some of the stigma that a sexually transmitted disease might carry."

The reasons that HPV is so little known are many. Poynor thinks it's been overshadowed by higher-profile STDs, such as
HIV and herpes. Others note that, when marketing its vaccine, pharmaceutical company Merck & Co. has chosen to focus on the potential for cervical cancer rather than the virus itself, which also can cause genital warts.

And then there's the gender divide. Both men and women can have high-risk HPV and low-risk types. But, doctors say, high-risk strains pose more problems for women, potentially leading not only to cervical cancer but also to infertility.

Frequently, men are seen as the silent carriers who can unknowingly spread HPV to their sexual partners. And even when people know they have HPV, they often think condoms offer 100 percent protection, when research has shown that they don't.

That was the case for one 24-year-old woman in San Francisco, who recently learned she has one of the high-risk types of HPV. She was one of a few young women with HPV interviewed for this story, all of whom spoke on the condition of anonymity because of the stigma of having an STD.

"I was scared, sad, disappointed and definitely ashamed. It seemed unfair that I should have it when I've had relatively few partners," says the young woman, who's been sexually active for eight years and had four monogamous sexual partners, including her current boyfriend of two years.

She knew little about HPV at the time. But when her doctor uttered the words "pre-cancer," in reference to the abnormal cells found in her cervix, she frantically searched the Internet to educate herself.

"It definitely made me question a lot about my past choices," says the young woman, who plans to soon attend graduate school to study culinary arts.

Certainly, doctors say, having more sexual partners increases a person's chance of contracting HPV. But, they say, HPV also can be contracted from just one partner and even one sexual encounter.

Having a partner get tested for STDs also isn't a guarantee, as one 22-year-old woman discovered.

"I always made getting tested a requirement. Then I would know I wasn't getting anything," says the recent college graduate who lives in Washington Township, Mich., near Detroit.

She has since been diagnosed with HPV and will soon undergo a procedure known as laser ablation to remove precancerous cells in her cervix. Other procedures often include a colposcopy, which is a close examination of abnormal cells in the cervix, and, if need be, a biopsy in which doctors remove a cone-shaped portion of the cervix to test it.

"I've been in to see the doctor five times in the last month — it's just overwhelming," says the young woman, who ended up sharing her diagnosis with her boyfriend and parents.

Having more information and the support of loved ones has helped.

"When you just say STD, people are like 'Ohhh,'" she says. "But when you ask those questions and understand more about it, it's not necessarily as scary."

While some women who have HPV think it's too late for them to be vaccinated against HPV, some doctors say it would still be worth it, since it shields against the worst four types of HPV.

"Even if a young woman has one type of high-risk HPV, there's nothing to say that she cannot be infected with the other three," says Dr. Tina Tan, an infectious disease specialist at Children's Memorial Hospital in Chicago.

Federal officials recently recommended that girls as young as age 9 receive the HPV vaccine. Some parents remain reluctant, though — worried that the vaccine could be considered a license to have sex.

Dr. Gary Rose, head of the Medical Institute for Sexual Health in Austin, Texas, says parents should reconsider, even if they're certain their daughters will wait until marriage for sex.

"There are a couple of things you can't be sure of," he tells those parents. "One is the sexual history of the person your daughter marries." The other, he says, is the risk of abuse or rape.

Because the vaccine does not protect against all types of HPV, Poynor and Tan say regular Pap smears and early treatment remain keys to fighting the virus. And they agree that some protection from condoms is better than none.

One young woman from San Antonio, Texas, who was diagnosed with HPV two years ago, also calls educating men about their role in spreading HPV "crucial."

"I had to tell my boyfriend about it," says the 26-year-old professional, "and he still doesn't get what it is."

Read More..

A brief explanation of HPV

WHAT IS HPV? The human papillomavirus, which includes common warts, exists in more than 100 forms, about 30 of which can be sexually transmitted. The virus is ancient and incredibly common. Most people who have genital HPV show no symptoms and clear the virus on their own, though some strains can cause persistent genital warts and cancer.


WHO'S AT RISK? Anyone who's sexually active can contract genital HPV, though young adults have been shown to be particularly susceptible because they're more sexually active. Separate studies have found that 45 percent of young women, ages 20 to 24, and half of men, ages 18 to 40, have HPV. While men can develop genital warts — and sometimes HPV-related genital or anal cancers — doctors say cervical cancer in women, caused by high-risk strains of HPV, is much more prevalent. HPV also may affect fertility, and doctors say some treatments for advanced HPV can make it difficult to get or stay pregnant.

WHAT CAN BE DONE? The new HPV vaccine protects against four high-risk types of the virus that can cause cervical cancer and genital warts. Beyond that, doctors recommend that women get regular Pap smears to check for abnormal cells caused by HPV and have male partners use condoms, though they do not offer 100 percent protection from HPV.

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Are Common Chemicals Feeding Obesity Epidemic?

Exposure to a class of chemicals commonly found in soap and plastics could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men, a new study suggests.

The chemicals, known as phthalates, have already been implicated in male reproductive problems including low sperm counts and low testosterone levels. However, it's too soon to know whether they are actually causing these health problems, cautioned the researchers and others.

"It's premature for folks to be alarmed," said study author Dr. Richard Stahlhut, a resident in preventive medicine at the University of Rochester School of Medicine & Dentistry in New York.. "What is more alarming is the reason we are doing studies like this. Another study showed that testosterone levels had dropped about 22 percent in men, and that sperm counts had dropped to levels that are considered subfertile or infertile."

"It's an important observation that chemical exposures could be contributing to obesity and diabetes in the general population," added Dr. Ted Schettler, science director for the Science and Environmental Health Network. "This is one more example of a family of chemicals that may be contributing to this problem, but this study has obvious limits that the authors acknowledge in great detail."

The study was published in the March 14 online edition of Environmental Health Perspectives.

Phthalates have been widely used for more than half a century in everything from paint to time-released medicines, but only recently have they become a topic of concern. Animal studies show that phthalates decrease testosterone levels while human studies have found that phthalates are associated with poor sperm quality in men.

This study follows up on other studies that correlated abnormal sperm counts and low testosterone levels with phthalates. Men with low testosterone levels develop abdominal obesity and insulin resistance, so these authors speculated that phthalates might be behind the depressed testosterone levels.

"That's the missing link, testosterone as a [possible] link between phthalates and obesity," Stahlhut said.

Stahlhut and his team analyzed urine, blood samples and other data collected for the National Health and Nutritional Examination Survey (NHANES), a large government survey, from 1999 to 2002.

Of the adult men available, 1,451 had data on phthalate exposures, obesity and waist circumference. Of these, 651 also had data on fasting glucose and insulin levels needed to calculate insulin resistance.

According to the analysis, more than 75 percent of the U.S. population has measurable levels of several phthalates detectable in their urine.

Men with the highest levels of phthalates in their urine had more belly fat and insulin resistance, even after adjusting for other factors.

One drawback of the data, and therefore of the study, is that no information on hormone levels was available, nor was there any long-term data.

In any event, phthalates are unlikely to be the whole story. The chemicals have been shown, in animal studies, to have an effect on thyroid hormone, which could also be a pathway to increased obesity.

"This is just part of the search for answers," Stahlhut said. "The thing we're certain of is not that phthalates are doing this, but that phthalates require very careful scrutiny. I'm certain that the declines in testosterone and sperm production require urgent investigation, and I'm certain that phthalates are on the list of chemicals that could be part of the issue."

"It's a complex, multi-factorial problem," Schettler added. "What the authors are suggesting is that a chemical exposure may be one among many factors. The study is certainly hypothesis-generating. It clearly makes a case that this potential link ought to be studied in more detail in more systematic ways."

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Health Tip: Prevent Obesity in Your Child

(HealthDay News) -- The incidence of childhood obesity has more than doubled in the past two decades, according to the U.S. Centers for Disease Control and Prevention.

Noting that healthy eating habits begin at home, the American Academy of Family Physicians offers these suggestions to prevent the problem:

* Don't force him to eat when he isn't hungry -- he shouldn't have to clean his plate if he's already full.
* Don't use food as a reward, or as a comfort when he's upset.
* Feed your child a healthy, balanced diet -- one that includes fast food no more than once a week.
* Limit your child's TV watching and encourage physical activity, like playing outside. Offer to play outside with your child.
* Encourage your child to get regular exercise, so that he continues to exercise into adulthood.

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Many Blacks, Hispanics Misinformed About Alzheimer's

WEDNESDAY, March 14 (HealthDay News) -- Black and Hispanic communities harbor many misconceptions about Alzheimer's disease, a new survey shows.

Conducted by Harris Interactive for the Alzheimer's Foundation of America, the survey results showed, among other things, that black and Hispanic caregivers were more likely (37 percent and 33 percent) than caregivers of other races (23 percent) to believe that Alzheimer's is a normal part of aging.

"Many of African-Americans and Hispanics thought it was almost normal that people would get Alzheimer's disease as they age," said foundation CEO Eric J. Hall. "This says a lot about the need for education in these communities."

The problem is especially acute in black and Hispanic communities, said Dr. Warachal E. Faison, clinical director of Alzheimer's Research and Clinical Programs at the Medical University of South Carolina. "In minority communities, there is this misconception that Alzheimer's disease is a normal part of aging," she said. "Those subtle symptoms that occur in Alzheimer's disease are often missed in these communities."

According to the survey, 70 percent of black and 67 percent of Hispanic caregivers were more likely to dismiss the symptoms of Alzheimer's as old age, compared with 53 percent of caregivers of other races.

Moreover, 67 percent of black and 63 percent of Hispanic caregivers were more likely to say that they did not know enough about Alzheimer's to recognize the symptoms, compared with 49 percent of caregivers of other races.

However, 33 percent of blacks and 26 percent of Hispanic caregivers were more likely than caregivers of other races (12 percent) to think that they were at a higher risk for Alzheimer's.

The survey also found that it took an average of 31 months after symptoms started before Alzheimer's was diagnosed. In addition, some 33 percent reported that the patient's concern about being stigmatized delayed diagnosis, and 21 percent of the caregivers reported concern about the stigma of dementia that delayed them in seeking a diagnosis.

Among those surveyed, blacks and Hispanics (36 percent and 22 percent, respectively), were more concerned about being stigmatized than other races (18 percent).

"We see, again, stigma around this disease," Hall said. "Stigma promotes a denial of the disease and a delay in diagnosis."

The survey also found that those blacks and Hispanics who are religious (73 percent of responders) were more likely to listen to religious leaders and allow their religion to influence health-care decisions than those weren't as religious (31 percent).

While assisted-living facilities and nursing homes are commonly used by Alzheimer's patients, many blacks and Hispanics don't consider them an option. However, these same groups tend to rely on support groups, the survey found.

Faison thinks the medical community is not diagnosing Alzheimer's early enough in minority communities.

"These findings alert us that patients with Alzheimer's are not being assessed and diagnosed early enough, and they are not aware of the treatment options available to them," Faison said. "One of the reasons for the delay in diagnosis is that these patients were unlikely to be offered a memory screening."

Another expert agreed that more needs to be done to reach minority communities to educate them about Alzheimer's disease.

"Alzheimer's is not a normal part of aging," said Laura Kochevar, associate director of Hispanic/Latino Outreach at the Alzheimer's Association. "The need to educate people in minority communities about Alzheimer's is essential."

The Alzheimer's Association currently has outreach programs that target both the black and the Hispanic communities. "These programs are using television, radio and print to educate minority communities about the disease," Kochevar said.

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Chickenpox Vaccine Booster Shot a Good Idea

WEDNESDAY, March 14 (HealthDay News) -- Protection against chickenpox slowly fades in children immunized against the disease, suggests a study that adds support to a recommendation for a booster shot of the vaccine.

The study found the incidence of chicken pox increased over time among vaccinated children -- from 1.6 cases per person-year one year after immunization to 9 cases per person-year five years later and more than 58 cases per person-year nine years later, according to the report.

"This is the kind of monitoring we do to check a vaccination program," said senior researcher Dr. Jane F. Seward, acting deputy director of the U.S. Centers for Disease Control and Prevention's division of viral diseases. "This is the first time monitoring shows an increase in the number of cases over time."

Seward's team published the findings in the March 15 issue of the
New England Journal of Medicine.

A vaccine against varicella, the medical name for chickenpox, was introduced in 1995 with a recommendation that it be given during the first year of life. Last year, a recommendation for a second shot at 4 to 6 years of age was added by the American Academy of Pediatrics and other medical bodies.

"No vaccine we have is 100 percent perfect," explained Dr. Robert Frenck, a professor of pediatrics in infectious diseases at Cincinnati Children's Hospital and a member of the American Academy of Pediatrics committee for infectious diseases. "You have people who don't respond or lose immunity over time."

Chickenpox is rarely fatal, but it can cause an outbreak of hundreds of temporarily disfiguring open sores. The cases found in the study -- which focused on immunized children in Antelope Valley, Calif., northeast of Los Angeles -- tended to be relatively mild, Seward said.

"In general, the cases were very modified from natural varicella," she said. "So, the vaccine does appear to stand up."

However, the study also shows that "there is a greater chance of the disease not being mild over time," Seward said. "We need to keep following this group to see if it translates into more disease over time."

"The important thing is that the [first-shot] protection is about 90 percent effective," Frenck said. "There was an 85 percent reduction in cases of varicella over 10 years."

A new multiple vaccine, approved last year, should make it easier for children to get both the first and recommended second shot, Frenck said. Protection against chicken pox has been added to the MMR vaccine, aimed at measles, mumps and rubella (German measles).

A second shot offers advantages in addition to protection against a childhood outbreak, Seward said, since chickenpox can occur in adults. "There is definitely improved immune response after the second dose. There is better immunity in the long term," she said.

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UN rejects Indian Muslims' reported fear of polio vaccinations

NEW DELHI (AFP) - Muslims in northern India are immunising their children against polio, a UN study says, rejecting reports they were opposing a vaccination drive for fear it would render their children sterile.

A majority of the 674 polio cases in India in 2006 were in Muslim-dominated western Uttar Pradesh state and health campaigners had said Muslims were obstructing the immunisation drive this week because of sterility fears.

But a study by the United Nations Children's Education Fund (
UNICEF) posted on its website on Tuesday said the region regarded as the epicentre of the 2006 outbreak had made "important progress" in suppressing the disease.

The fact that just one of the 15 cases of polio recorded nationwide since January was from western Uttar Pradesh was proof that Muslims were immunising their children, the report said.

The finding "contradicts recent arguments that the recurrent cases of polio in the region were mainly due to the failure of many Muslims to have their children vaccinated," it said.

Some 74 percent of mosques monitored in a district of western Uttar Pradesh informed locals about dates when volunteers would administer the oral vaccine, the study added.

India, which is in the midst of its third polio vaccination drive since January, plans to immunise 95 million children by the time the campaign ends on Saturday.

Last year, India's Health Minister Anbumani Ramadoss set 2007 as the deadline for eradicating the crippling disease in the country. India has been accused by the World Health Organisation of exporting the virus elsewhere in Asia as well as to Africa.

India is one of the four remaining polio-endemic countries in the world along with
Afghanistan, Pakistan and Nigeria

Nigeria has been struggling to curb polio since some northern Islamic states imposed a year-long vaccine ban in mid-2003 over rumours that the vaccine caused sterility and it was part of a western plot against Muslims.

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Two top Democrats unveil child-health proposal

WASHINGTON (Reuters) - Two leading congressional Democrats on Wednesday unveiled legislation intended to ensure that the 9 million U.S. children who currently have no health insurance can get it through existing government programs.

Sen.Hillary Rodham Clinton, a Democratic presidential hopeful, and Rep. John Dingell (news, bio, voting record), chairman of the House of Representatives Energy and Commerce Committee, sponsored the bill, introduced in both chambers of Congress.

It is the most recent of a number of proposals to bring health insurance to at least some of the 47 million people lacking it in a country of 300 million that is the richest in the world. About one child out of eight is uninsured.

The proposal's cost was being analyzed by the
Congressional Budget Office, Dingell said at a news conference with Clinton. He did not say how the bill would be paid for.

During the first term of her husband
Bill Clinton's presidency, Sen. Clinton led a failed universal health-coverage initiative. This bill is more modest, but she said it would address an acute need -- getting all children insured.

It would give the 50 U.S. states incentives to expand their existing programs for children's health insurance and would help states identify the estimated 6 million children eligible for public programs but not currently enrolled.

"It is clear to me that this is the kind of congressional action that is a step toward universal coverage for everyone," Clinton said in a Senate hearing room as dozens of children from local schools watched.

"Taking care of our children first is not only the right thing and the smart thing to do, but is really a moral obligation for all of us," Clinton added.

The bill would give states federal funds to broaden health coverage, for children whose families earn incomes up to four higher than the defined poverty level, through the State Children's Health Insurance Program, also known as SCHIP.

States would have to speed enrollment of qualified children by getting rid of waiting lists and enrollment caps.

Clinton said she did not want the bill to encourage employers currently offering health insurance to employees' children to drop this coverage. It has new incentives to bolster employer-provided coverage for children, she said.

SCHIP is due for reauthorization this year. Enacted in 1997, it gives states money to provide insurance for underprivileged children. States set eligibility rules, benefit packages and payment levels.

A study released separately by the Robert Wood Johnson Foundation found that fewer lower-income parents were being offered health insurance by employers. About 47 percent of parents in families earning less than $40,000 annually are offered insurance at work, down 9 percent since 1997, it showed.

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Obesity surgery complication studied

RALEIGH, N.C. - Doctors warn that a few obesity surgery patients have developed a serious neurological condition, with symptoms of confusion and poor coordination, linked to a lack of vitamin B1.

Wernicke encephalopathy, which is caused by a thiamine deficiency, is normally associated with severe alcoholism or chronic malnutrition. However, researchers say it can also occur within a few months of obesity surgery if patients stop taking prescribed vitamin supplements or if they vomit frequently, preventing vitamins from being absorbed.

Patients who show symptoms "need to seek help immediately and get injections of thiamine as early as possible," said study author Sonal Singh, an instructor in internal medicine at Wake Forest University School of Medicine. "For doctors, the message is that they should keep this in their minds when they see these patients."

Singh said cases of Wernicke encephalopathy may increase as the number of bariatric surgeries performed in the United States continues to grow. About 170,000 obesity surgeries were done in 2005, up from 120,000 the year before and 16,000 in 1992.

Philip Schauer, the president of the American Society for Bariatric Surgery, said that while Wernicke encephalopathy isn't unique to obesity surgery or a common outcome after such procedures, he agrees it's something doctors should watch for.

"A mild degree of nausea after surgery and rare, episodic vomiting is really common in the first several days and weeks after surgery. If it's an isolated thing, one or two episodes and that's it, it's not a problem," said Schauer, who is also director of bariatric surgery at the Cleveland Clinic in Ohio.

More severe symptoms should be addressed immediately, he said.

"The surgeon and the health care team ... must be aware of somebody having very severe nausea and vomiting," Schauer said. "That person, if they're calling from home, should be brought in to see the doctor or to the emergency room."

Singh and co-author Abhay Kumar of the University of Iowa searched obesity surgery case histories, dating back to the 1980s, locating 32 cases of Wernicke encephalopathy. They looked at symptoms and risk factors.

Their findings are published in the this week's issue of the journal Neurology. The researchers called for more study to determine how often the condition affects bariatric patients and to determine the best treatment for it.

The study found that cases occurred from four to 12 weeks after the surgery, though one occurred 18 months later. Twenty-seven victims were female, but that may be because 75 percent of the surgeries involved women.

The patients suffered from confusion, a lack of coordination and rapid rhythmic eye movement, classic symptoms of Wernicke encephalopathy. Several also had problems with weakness, seizures, deafness and limb numbness.

Most recovered completely after getting thiamine intravenously, though a few continued to have problems with memory, coordination and vision.

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Obesity, illness speed testosterone decline

NEW YORK (Reuters Health) - Gaining too much weight can accelerate the decline in testosterone levels that accompanies aging, a new study shows.

"Although hormone declines appear to be an integral aspect of the aging process, rapid declines need not be dismissed as inevitable," the researchers conclude.

Men's testosterone levels fall as they get older, which may contribute to health problems such as diabetes, loss of bone and muscle mass, and sexual dysfunction, Dr. Thomas G. Travison of New England Research Institutes in Watertown, Massachusetts and colleagues note in a report in The Journal of Clinical Endocrinology and Metabolism.

To better understand how much of the decline in testosterone over time is due to aging and how much might be related to health and lifestyle changes, the researchers looked at data for 1,667 men 40 to 70 years old followed from 1987-1989 to 2002-2004. They were able to gather data for the entire time period on 35 percent, or 584, of the men.

Sharper declines in testosterone occurred among men who developed a chronic illness during the course of the study, those who lost a spouse, those who began taking six or more medications, and those who quit smoking, the researchers found.

And adding 4 to 5 points to one's body mass index (BMI) -- a tool used to determine how fat or thin a person is -- resulted in a drop in testosterone levels similar to that seen over 10 years of aging.

On average, the men experienced a 14.5 percent drop in total testosterone levels for every decade of life and a 27 percent reduction in free testosterone, but when the researchers looked at a subset of men who were completely healthy throughout the course of the study, declines in total and free testosterone were 10.5 percent and 22.8 percent, respectively. This suggests, the researchers say, that a "substantial proportion" of testosterone decline is due to changes in health.

"These results suggest the possibility that age-related hormone decline may be decelerated through the management of health and lifestyle factors," they conclude.

SOURCE: The Journal of Clinical Endocrinology and Metabolism, February 2007.

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Health Tip: Building Your Child's Self-Esteem

Proper self-esteem can help your children make healthier decisions and avoid negative pressures. Children with good self-esteem also have an easier time dealing with problems and conflicts, the Nemours Foundation says.

Here are the foundation's suggestions for building self-esteem in your child:

* Praise your child for the effort she's made, rather than the outcome.
* Redirect your child's irrational perceptions of herself.
* Be very affectionate with your child -- give her lots of spontaneous hugs and encouraging notes.
* Be truthful in your feedback, but try to highlight the positive.
* Encourage her to participate in activities that encourage cooperation, rather than competition.

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Undocumented Immigrants' Childbirth Is Top Emergency Medicaid Expense

TUESDAY, March 13 (HealthDay News) -- The lion's share of Emergency Medicaid expenditures in North Carolina covers undocumented immigrants' pregnancy and labor complications, a trend that's probably occurring in other states, a new study found.

The findings are one of the first close-up looks at the health care needs of the growing numbers of immigrants in the United States, and they appear to question the monetary costs of excluding undocumented immigrants from routine health care, especially prenatal care.

Other experts agreed.

"Providing a dollar's worth of prenatal care can save $3 of postnatal care," said Mara Youdelman, director of the National Language Access Advocacy Project at the National Health Law Program in Washington, D.C. "It's much more costly to use Emergency Medicaid to pay for prematurity and low birth-weight babies and postnatal complications."

The research is published in the March 14 issue of the
Journal of the American Medical Association, which has a series of articles on health care.

Undocumented immigrants are estimated to account for 29 percent of the total foreign-born population in the United States. Many "new growth" states that previously did not have large immigrant populations, such as North Carolina, are getting many of the newcomers. These "new growth" states may be less prepared to meet the health-care needs of the new arrivals, the study authors suggested.

In North Carolina, the total foreign-born population grew by 274 percent during the 1990s, and included about 300,000 undocumented immigrants by 2004. These immigrants face a host of barriers to accessing health care, not the least of which is federal law.

Undocumented immigrants and legal immigrants who have been in the United States less than five years are generally excluded from Medicaid benefits. But they can receive emergency medical care (known as Emergency Medicaid) if they are children, pregnant women, families with dependent children, or elderly or disabled.

For pregnant women, Emergency Medicaid funds cover labor but not routine prenatal care.

In their study, researchers at the University of North Carolina analyzed administrative claims data for Emergency Medicaid, which showed that 48,391 people in the state received emergency care between 2001 and 2004.

Within that group, 99 percent of patients were undocumented immigrants, 93 percent were Hispanic, 95 percent were female and 89 percent were between the ages of 18 and 40.

In addition, the data showed, about 82 percent of Emergency Medicaid spending in 2004 was for childbirth and pregnancy complications, which accounted for 91 percent of hospitalizations.

About one-third of the remaining funds were spent on "sudden-onset" problems, such as injuries and poisonings. (Hispanic immigrants account for a disproportionate number of workplace injuries and fatalities in the United States, and motor vehicle injuries are the leading cause of death among Hispanics in North Carolina). Large chunks also went to complications of chronic disease, such as kidney failure.

The study found that the largest spending increases occurred among undocumented immigrants who were elderly and disabled.

Spending on pregnant women increased by 22 percent during the study period, by 70 percent for families with dependent children, by 82 percent for disabled patients and by 98 percent for elderly patients.

Still, only a small proportion of the undocumented population seems to be using Emergency Medicaid. The 16,106 patients utilizing Emergency Medicaid in 2004 represented only 5 percent of the total estimated undocumented immigrant population of North Carolina. Emergency Medicaid was less than 1 percent of the total state Medicaid budget, the study authors said.

The study authors wrote: "The availability of affordable culturally and linguistically appropriate primary care, however, will be a critical determinant of both the effectiveness and cost efficacy of health care for immigrants in new-growth areas."

But without Emergency Medicaid, many medical institutions and poor people would be lost.

"We're very happy that Emergency Medicaid covers women, especially the ones who have childbirth, or we wouldn't have funding. We would be destitute," said Dr. Leo B. Twiggs, chairman of obstetrics and gynecology at the University of Miami Miller School of Medicine, and clinical service chief at Jackson Memorial Hospital. Jackson is the safety-net hospital for Florida's Miami/Dade county and serves many undocumented immigrants who give birth.

"It's the right thing to do," Twiggs said.

By Amanda Gardner
HealthDay Reporter

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Imaging Compound IDs Telltale Signs of Alzheimer's

TUESDAY, March 13 (HealthDay News) -- Scientists have confirmed that an imaging agent known as Pittsburgh Compound B binds to abnormal protein growth in the brain that are a signature of Alzheimer's disease.

The results hold a two-fold promise, both for being able to better diagnose the disease and for being able to judge the effectiveness of drugs that target the amyloid beta protein.

"This study confirms the accuracy of the new PiB [Pittsburgh Compound B] molecular imaging for amyloid," said Dr. John Growdon, senior author of the paper and director of the Memory Disorders Unit at Massachusetts General Hospital in Boston. "It indicates that PiB uptake does not necessarily indicate Alzheimer's disease. It does, however, indicate that this would be a good biological marker or surrogate outcome measure in drug trials directed toward clearing or reducing the amount of amyloid in the brain."

Maria Carrillo, director of medical and scientific relations at the Alzheimer's Association, added: "We are pretty excited about seeing this research come out. PiB does indeed show great promise and it shows promise in two different arenas, diagnosis and monitoring anti-amyloid therapies, which are potentially just around the corner."

If one application doesn't work, the other one still could, Carrillo added.

According to the Alzheimer's Association, about 4.5 million Americans have the disease, a number that has more than doubled since 1980. Many more suffer from cognitive impairment, which could be a harbinger of the disease. And scientists project that some 13.2 million older Americans will have Alzheimer's disease by 2050, unless new ways are found to prevent or treat the disease.

Diagnosis of Alzheimer's is a notoriously tricky affair, and is never 100 percent definite until an autopsy is performed.

Many experts believe that Alzheimer's is caused by a build-up of amyloid plaque proteins in the brain. But, again, the protein can only be detected through an autopsy.

Previous studies have shown that PiB, a compound invented by researchers at the University of Pittsburgh Medical Center, binds to amyloid-beta in the brains of mice and also shows up on PET scans of human patients who are thought to have Alzheimer's.

PiB crosses the blood-brain barrier, giving a strong PET signal in the cortex of brains of people with suspected Alzheimer's. But there had been no confirmation that PiB was actually lighting up amyloid-beta deposits.

The new study, carried out by researchers at Massachusetts General Hospital and published in the March issue of Archives of Neurology, involved the case of a 76-year-old man with memory loss. He was eventually diagnosed with dementia with Lewy bodies, which does not also preclude the presence of Alzheimer's.

While he was still alive, the man enrolled in a study involving PiB imaging and, as part of that study, underwent a standard positron emission tomographic (PET) bran scan that suggested Alzheimer's. The scan showed that PiB had been taken up throughout the cerebral cortex, the outer layer of the brain.

Three months later, the man died following a head injury and an autopsy was performed.

The man did indeed have dementia with Lewy bodies as well as several features characteristic of Alzheimer's. Most of the amyloid beta was found in the walls of blood vessels, a condition known as cerebral amyloid angiopathy.

The distribution of the plaques matched the distribution seen in the PiB study, the authors stated. The man had features of Alzheimer's, but not at a level that indicated a true diagnosis of the disease.

While the absorption of PiB does indicate the presence of amyloid in the brain, a positive PiB PET scan does still not mean a definite diagnosis of Alzheimer's. About 15 percent of people in previous PiB studies with no cognitive impairment had some level of PiB uptake, the authors stated.

"PiB is going to be pivotal for this decade," Carrillo said. "But we need more studies like this. It's not enough on its own."

The Alzheimer's Association last year awarded its largest research grant to the Alzheimer's Disease Neuroimaging Initiative (ADNI) to expand the study to include PET scans using PiB. This and another grant to the ADNI marked the association's single largest investment ever in a research project.

"We decided that because this had so much potential, it was important that it be studied on the clinical trial level," Carrillo explained. "Hopefully after three years of following the same people we will have a much more definitive idea of what types of diagnosis could be made with PiB and how we can actually help in monitoring anti-amyloid therapies that could be out this year if we're lucky. This is just the tip of the iceberg."

By Amanda Gardner
HealthDay Reporter

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Child of parents who live long has lower rate of heart ills

WASHINGTON (AFP) - The children of parents who live to a ripe old age may face a reduced risk of cardiovascular disease when they themselves reach middle age, according to a study published Monday.

Individuals with at least one parent who survived to age 85 or beyond would be at less risk of heart attack or stroke, said researchers at the Boston University School of Medicine.

The study, published in the latest issue of Archives of Internal Medicine, looked at 1,697 men and women, with an average age of 40, whose parents lived to 85 years and beyond, or died before January 1, 2005, and compared both.

Their parents had also participated in a 1948 study involving residents of Framingham, a small town northeast of Massachusetts that has been the subject of significant studies cardiovascular disease and cancer.

The researchers took into account their levels of education, body mass, smoking habits, blood pressure and blood cholesterol levels.

They found that individuals whose parents both died before age 85 scored the worse in cardiovascular disease risk assessments. Those whose parents both lived to age 85 or beyond scored better.

"Our findings suggest that individuals with long-lived parents have more advantageous cardiovascular risk profiles in middle age compared with those whose parents died younger and that the risk factor advantage persists over time," they said.

Previous research found that children of centenarians on average lived longer, and were less likely to suffer from heart disease, hypertension and diabetes until much later in life.

But this study is the first to make a specific link between parents' age and risk of heart disease, the researchers said.

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Pregnancy tops emergency spending for immigrants

NEW YORK (Reuters Health) - Childbirth and pregnancy complications account for most of the Emergency Medicaid spending for undocumented immigrants, new research indicates.

Undocumented immigrants who have been in the U.S. for less than 5 years are not eligible for Medicaid, with the exception of limited emergency coverage provided by the Emergency Medicaid program.

To see how the Emergency Medicaid program is being used by this population, Dr. C. Annette DuBard, from the University of North Carolina at Chapel Hill, and Dr. Mark W. Massing, from The Carolinas Center for Medical Excellence in Cary, North Carolina, analyzed data for 48,391 individuals who received services that were reimbursed between 2001 and 2004.

The overwhelming majority of subjects were Hispanic, female, and between the ages of 18 and 40, according to the report in the
Journal of the American Medical Association.

During the 4-year study period, total spending rose by 28 percent, the authors note. Eighty-two percent of the spending and 91 percent of hospitalizations in 2004 were related to childbirth and complications of pregnancy.

Other common conditions for which Emergency Medicaid was used included injury, kidney failure, stomach and intestinal disease, and heart conditions.

"Medicaid spending for emergency care of recent and undocumented immigrants, although a small proportion of the total Medicaid budget, is increasing rapidly in this new immigrant growth state," the authors conclude.

While spending on childbirth and pregnancy complications dominate, the researchers also observed rapid increases in the use of Emergency Medicaid services by the elderly and disabled.

SOURCE: Journal of the American Medical Association, March 14, 2007.

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Obese More Likely to Be Kept in the Hospital After Stroke

TUESDAY, March 13 (HealthDay News) -- Obese people are much less likely than lean patients to be discharged directly home from a hospital after being treated for ischemic stroke (reduced or blocked blood flow to the brain), a U.S. study finds.

Instead, obese patients were more likely to first be transferred to inpatient rehabilitation care, general medicine service, or skilled nursing facility.

"This study suggests that hospitalized obese individuals may have poorer discharge clinical outcomes than their leaner counterparts," says a team from the University of California, Los Angeles, Medical Center.

The study included 451 ischemic stroke patients, average age 65, treated between 2003 and 2006. The patients were divided into four categories based on their body mass index (BMI): BMI of 35 or greater -- class II obesity; BMI of 30 to 34 -- class I obesity; BMI of 25 to 29 -- overweight; BMI of less than 25 -- lean.

Class II obesity patients were much less likely to be discharged directly home than lean patients (26 percent vs. 45 percent). The study also found that class II and class I obesity patients showed a statistically nonsignificant trend toward extended length of hospital stay than lean patients (6.3 days vs. 5.2 days).

The study found no differences in in-hospital death rates (18 of the 451 patients died) or in functional activity outcome among the different BMI categories.

Further research needs to be done to confirm the results and to identify the reasons for this difference between obese and lean patients, the researchers wrote in the March issue of the Archives of Neurology.

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Obesity reduces odds of going home after stroke

NEW YORK (Reuters Health) - Obese individuals who suffer a stroke are significantly less likely to be discharged home and tend to stay in the hospital longer than lean individuals who suffer a stroke, researchers from the University of California at Los Angeles have observed.

Obesity has been shown to be an independent risk factor for stroke, but its effect on the outcome after a stroke has not been well studied. Against this backdrop, Tannaz Razinia and colleagues examined the association between body weight and discharge destination for patients hospitalized for a stroke.

Data from 451 patients admitted to a university hospital stroke service were included in the analysis. Twenty-eight percent of study subjects were men and the average age of the patients was 65 years.

Razinia and colleagues found that obese stroke sufferers were significantly less likely to be discharged home than their lean counterparts (26 percent vs. 45 percent).

In addition, a trend toward longer hospital stays was seen in obese relative to lean subjects. Obese subjects required about 6.3 days in the hospital compared with 5.2 days for lean subjects.

"Our study provides further impetus for identifying and appropriately treating obese individuals at risk for first and recurrent stroke," the authors conclude.

Future studies, they add, are required to confirm these results and to identify reasons for the differences noted.

SOURCE: Archives of Neurology, March 2007.

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Doctor, 81, keeps Arkansas hospital open

MURFREESBORO, Ark. - An elderly doctor has come out of retirement to keep the sole hospital in Pike County open after it lost a three-member medical staff. Dr. Hiram Ward, 81, who began his practice in the rural Arkansas county five years before Pike County Memorial Hospital was built in 1958, became the hospital's only medical staff member in January.

Ward provided doctor's care to patients at the 32-bed hospital by himself until last week when Dr. Tommy Gray, who lives 148 miles away at Conway, heard about the hospital's plight and began helping out temporarily, says hospital administrator Rosemary Fritts.

"I volunteered to come out of retirement," Ward says. "Nobody asked me to. I came back so that our hospital would stay open."

The hospital employs 55 people and is the second-largest employer in Murfreesboro behind the school district. With the hospital struggling financially, county voters in December approved a three-eighths-cent sales tax to boost its revenues.

But the following month, Drs. Phillip White and Mark Floyd announced they could no longer continue seeing patients at Pike County Memorial because their malpractice insurer had discontinued coverage for their hospital work. A third doctor had retired previously.

Although the hospital's patient referral list has declined with patients referred to larger hospitals in Hot Springs, Nashville and Texarkana, Ward says there is no substitute for the kind of care people get at the hospital in Murfreesboro.

"We have a coronary care unit and we do stabilize people who have heart attacks and send them off to get bypasses and stents put in," Ward says. "Quite a few of them would lose their life if the hospital wasn't here."

He says some physicians in the new generation don't know patients.

"They don't know how to correlate the problem with the patient's environment and their family setting," Ward says. "The family setting means a lot: what kind of job you're doing and the situation you are in. Whether you are getting along with your wife or not.

"We've known these people forever. It's like taking care of them at home," he says. "It's important to people and you feel much more secure. A big part of getting better is the faith you have in the doctor."

Ward was the only doctor in the county at one time. Briefly after he started his practice in 1953, another doctor in the county died. Ward remembers once he saw 132 people in a 24-hour period. He was paid $2 for an office call and $3 if he made a house call.

Ward plans to retire — again — as soon as the hospital signs contracts with two physicians to work there. Hospital officials say Pike County Memorial will continue to have physician coverage 24 hours a day, seven days a week as they actively recruit physicians to the area.

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Vision correction may raise fall risk in elderly

NEW YORK (Reuters Health) - Helping frail older people to see more clearly may put them at increased risk of falls, according to a new study from Australia.

This could be because getting used to a new eyeglass prescription may throw people off balance, Dr. Robert G. Cumming, at Concord Hospital in New South Wales, and colleagues suggest. Whatever the explanation, they say the findings indicate that programs aimed at preventing falls among the elderly by improving their vision should be put on hold for now.

One previous study found that removing cataracts -- which allows people to see contrasts more clearly -- reduced falls among elderly people, but another found no effect, Cumming and his team note in the Journal of the American Geriatrics Society.

To better understand how improving elderly people's vision might affect fall risk, the researchers randomly assigned 616 men and women aged 70 and older to receive vision and eye exams, along with appropriate treatment, or to receive their usual care.

In the treatment group, 92 people got new eyeglasses, 24 had a home visit with an occupational therapist, 17 received glaucoma treatment, and 15 had cataract surgery.

However, during the following year, 65 percent of people in the treatment group fell at least once, compared to 50 percent of those in the control group. Thirty-one fractures occurred in the treatment group, while there were 18 among the untreated participants.

Overall, the men and women given vision treatment were 57 percent more likely to fall and 74 percent more likely to sustain fractures than those in the control group.

One explanation for the findings is that study participants needed a long time to adjust to new eyeglasses, Cumming and his team said. It's also possible, they add, that people in the treatment group who were given a clean bill of visual health became more active and took "unaccustomed risks."

While the findings must be confirmed by other researchers, Cumming and his team add, "it may be premature to implement the wide range of vision-related interventions to prevent falls proposed by others."

They also advise that eye care providers working with elderly people should be aware that their patients may be more prone to fall after receiving a new set of glasses. "They should prescribe conservatively and give appropriate advice about the need for caution during adaptation to new eyeglasses," the team concludes.

SOURCE: Journal of the American Geriatrics Society, February 2007.

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Heart Disease Lower in Children of Parents Who Live to 85

MONDAY, March 12 (HealthDay News) -- If you're the child of parents who lived to 85 or more, your risk for heart disease in middle age is significantly lower than children of parents who died earlier, researchers report.

According to the findings, published in the March 12 issue of the Archives of Internal Medicine, children of long-lived parents tended to have lower blood pressure and lower cholesterol. They also had lower Framingham Risk Scores, which is a 10-year estimate of coronary heart disease risk based on age; total cholesterol and levels of high-density lipoprotein (the so-called good cholesterol); blood pressure; diabetes; and cigarette smoking.

The findings appear to point to the benefit of "good genes." But genetics are only part of the equation, said Dr. Clyde B. Schechter, of Albert Einstein College of Medicine in New York City, and author of an accompanying editorial in the journal.

"Genetics shouldn't overshadow a healthy lifestyle," Schechter said.

For the study, Dr. Dellara F. Terry, of Boston University School of Medicine, and colleagues collected data on 1,697 people who participated in the Framingham Heart Study, a large, population-based study started in 1948. All the people in the new study had parents who also participated in the Framingham study.

Those included in the new study were examined between 1971 and 1975 -- average age 40 -- to assess their risk factors for heart disease. Between 1983 and 1987, 1,319 of the study participants were examined again.

Among the 1,697 people who began the study, 11 percent had two parents who lived to 85 or older, 47 percent had one parent who lived that long, and 42 percent had both parents die before age 85.

People whose parents lived to 85 or more had optimal or normal blood pressure, and an optimal to normal total/high-density lipoprotein cholesterol ratio. Moreover, a higher percentage of people whose parents lived to 85 or beyond had lower Framingham Risk Scores than people whose parents died younger.

The Framingham Risk Scores were worst among those whose parents both died before 85 and best among those whose parents both lived to 85 or more, the researchers found.

"Our findings suggest that individuals with long-lived parents have more advantageous cardiovascular risk profiles in middle age compared with those whose parents died younger and that the risk factor advantage persists over time," the authors noted.

"There are well-established genetic contributions to each of the risk factors that we have examined that may partially explain the reduced risk factors for those with long-lived parents. Better understanding of genetic variation in cardiovascular risk factors and longevity eventually may be helpful for disease prevention and treatment strategies in the community," they concluded.

Schechter said that how you manage the cardiac risk factors is more important than genes in determining how long you will live.

"For the bulk of the population, what's important is: 'Am I going to die in my 70s or make it into my 80s?' " Schechter said. "For that, things like whether you smoke, how you eat, whether you get exercise are tremendously important and probably overshadow the genetics, because your genes aren't particularly important in determining whether you die at 70 or 80."

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Heart Disease Lower in Children of Parents Who Live to 85

MONDAY, March 12 (HealthDay News) -- If you're the child of parents who lived to 85 or more, your risk for heart disease in middle age is significantly lower than children of parents who died earlier, researchers report.

According to the findings, published in the March 12 issue of the Archives of Internal Medicine, children of long-lived parents tended to have lower blood pressure and lower cholesterol. They also had lower Framingham Risk Scores, which is a 10-year estimate of coronary heart disease risk based on age; total cholesterol and levels of high-density lipoprotein (the so-called good cholesterol); blood pressure; diabetes; and cigarette smoking.

The findings appear to point to the benefit of "good genes." But genetics are only part of the equation, said Dr. Clyde B. Schechter, of Albert Einstein College of Medicine in New York City, and author of an accompanying editorial in the journal.

"Genetics shouldn't overshadow a healthy lifestyle," Schechter said.

For the study, Dr. Dellara F. Terry, of Boston University School of Medicine, and colleagues collected data on 1,697 people who participated in the Framingham Heart Study, a large, population-based study started in 1948. All the people in the new study had parents who also participated in the Framingham study.

Those included in the new study were examined between 1971 and 1975 -- average age 40 -- to assess their risk factors for heart disease. Between 1983 and 1987, 1,319 of the study participants were examined again.

Among the 1,697 people who began the study, 11 percent had two parents who lived to 85 or older, 47 percent had one parent who lived that long, and 42 percent had both parents die before age 85.

People whose parents lived to 85 or more had optimal or normal blood pressure, and an optimal to normal total/high-density lipoprotein cholesterol ratio. Moreover, a higher percentage of people whose parents lived to 85 or beyond had lower Framingham Risk Scores than people whose parents died younger.

The Framingham Risk Scores were worst among those whose parents both died before 85 and best among those whose parents both lived to 85 or more, the researchers found.

"Our findings suggest that individuals with long-lived parents have more advantageous cardiovascular risk profiles in middle age compared with those whose parents died younger and that the risk factor advantage persists over time," the authors noted.

"There are well-established genetic contributions to each of the risk factors that we have examined that may partially explain the reduced risk factors for those with long-lived parents. Better understanding of genetic variation in cardiovascular risk factors and longevity eventually may be helpful for disease prevention and treatment strategies in the community," they concluded.

Schechter said that how you manage the cardiac risk factors is more important than genes in determining how long you will live.

"For the bulk of the population, what's important is: 'Am I going to die in my 70s or make it into my 80s?' " Schechter said. "For that, things like whether you smoke, how you eat, whether you get exercise are tremendously important and probably overshadow the genetics, because your genes aren't particularly important in determining whether you die at 70 or 80."

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FDA OKs Glucose-Monitoring Device for Children

MONDAY, March 12 (HealthDay News) -- The U.S.Food and Drug Administration approved on Monday a real-time glucose-monitoring device for children ages 7 to 17 with type 1 diabetes.

The device, previously approved only for adults with type 1 diabetes, is called a REAL-Time continuous glucose monitoring (CGM) system, which warns about dangerously high or low glucose levels, manufacturer Medtronic Inc. of Minneapolis said. It is a specially designed pediatric model of the MiniMed Paradigm REAL-Time System and Guardian REAL-Time System, the company said in a prepared statement.

Clinical studies showed that REAL-Time continuous glucose monitoring devices help reduce the duration of hypoglycemic events and lower HbA1c levels by as much as 2 percentage points. For every 1 percentage point drop in HbA1c, there is a 35 percent reduction in diabetes-related complications such as blindness, amputation and organ failure, the company said.

"Diabetes management is especially difficult for pediatric patients, and Medtronic REAL-Time CGM therapy could benefit thousands of children and their families who struggle to maintain control of their disease," Dr. Bruce Buckingham, director of pediatric endocrinology at Lucille Packard Children's Hospital at Stanford University, said in a prepared statement.

More than a million people in the United States have type 1 diabetes, including more than 175,000 younger than age 20.

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Child of parents who live long has lower rate of heart ills

WASHINGTON (AFP) - The children of parents who live to a ripe old age may face a reduced risk of cardiovascular disease when they themselves reach middle age, according to a study published Monday.

Individuals with at least one parent who survived to age 85 or beyond would be at less risk of heart attack or stroke, said researchers at the Boston University School of Medicine.

The study, published in the latest issue of Archives of Internal Medicine, looked at 1,697 men and women, with an average age of 40, whose parents lived to 85 years and beyond, or died before January 1, 2005, and compared both.

Their parents had also participated in a 1948 study involving residents of Framingham, a small town northeast of Massachusetts that has been the subject of significant studies cardiovascular disease and cancer.

The researchers took into account their levels of education, body mass, smoking habits, blood pressure and blood cholesterol levels.

They found that individuals whose parents both died before age 85 scored the worse in cardiovascular disease risk assessments. Those whose parents both lived to age 85 or beyond scored better.

"Our findings suggest that individuals with long-lived parents have more advantageous cardiovascular risk profiles in middle age compared with those whose parents died younger and that the risk factor advantage persists over time," they said.

Previous research found that children of centenarians on average lived longer, and were less likely to suffer from heart disease, hypertension and diabetes until much later in life.

But this study is the first to make a specific link between parents' age and risk of heart disease, the researchers said.

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Heart-healthy folks apt to have long-lived parents

NEW YORK (Reuters Health) - Children whose parents enjoyed a long life, living well into their 80s, seem to have healthier hearts in middle age compared with children whose parents did not live this long. Moreover, the heart advantage persists over time, which should help them follow in their parents' footsteps.

U.S. researchers found that the presence, and progression over 12 years, of several heart disease risk factors, such as high blood pressure, was lower among middle-aged offspring with "long-lived" parents compared with people whose parents did not live into very old age.

The findings come from the Framingham Heart Study, a multigenerational study of risk factors for heart disease and other chronic diseases that began in 1948 among residents of Framingham, Massachusetts.

Among 1697 children of Framingham study participants, 188 had both parents live to age 85 or older; 804 had one parent survive to age 85 or older; and 704 had neither parent live this long, Dr. Dellara F. Terry from Boston University and colleagues report in the Archives of Internal Medicine.

The worst Framingham Risk Scores -- a measure of heart disease risk that uses age, smoking, cholesterol and blood pressure to estimate a person's odds of suffering a heart attack -- were found in children whose parents had both died before age 85. The best risk scores were found among children whose parents had both lived to age 85 or older.

Among a subset of 1,319 offspring followed long-term, those with long-lived parents maintained their "advantageous cardiovascular risk profiles."

"There are well established genetic contributions to each of the risk factors that we have examined that may partially explain the reduced risk factors for those with long-lived parents," the authors note.

"A greater understanding of the genetics of cardiovascular risk factors and longevity may lead to advances in the prevention and treatment of cardiovascular diseases in the future," Dr. Terry commented to Reuters Health.

Dr. Clyde B. Schechter adds in an editorial: "We are only beginning to learn about the determinants of exceptional longevity. Several fruitful areas are already the subject of active research, but much more remains to be done."

"Progress in this area is not just of intrinsic interest," Schechter from Albert Einstein College of Medicine, Bronx, New York writes, "it also has the potential to promote discoveries that will improve the prevention and treatment of cardiovascular disease and other age-related diseases."

SOURCE: Archives of Internal Medicine, March 12, 2007.

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Early infection tied to leukemia risk in childhood

NEW YORK (Reuters Health) - The chances of children being diagnosed with leukemia seem to be related to the number of infections they had in their first year of life, research from the UK suggests.

Dr. Eve Roman from the University of York and colleagues identified 455 children with leukemia diagnosed between 2 and 5 years of age, and found that 425 of them had a type called acute lymphoblastic leukemia or ALL.

According to the researchers' report in the American Journal of Epidemiology, children diagnosed with ALL had significantly more infectious episodes in infancy than did a comparison group of matched "controls" without leukemia.

The average number of episodes was 3.6 for children with ALL, versus 3.1 for controls. Overall, 24 percent of ALL children and 18 percent of controls were diagnosed with at least one infection during the first month of life, and by the end of their first year of life this figure had risen to 88 percent of ALL patients and 85 percent among controls.

Children with ALL "who had more than one neonatal infectious episode tended to be diagnosed with ALL at a comparatively young age," the investigators found. The average age when ALL was diagnosed was 38 months for children with two or more episodes of infection in the newborn period, compared to 45 months for kids with only one episode or none.

Roman and her colleagues conclude that "early infection is positively associated with early-onset ALL."

They say the findings support the theory that "a dysregulated immune response to infection in the first few months of life" promotes the development of ALL later in childhood.

SOURCE: American Journal of Epidemiology, March 2007.

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N.M. lawmakers approve cancer vaccine

ALBUQUERQUE, N.M. - New Mexico is on the verge of becoming the latest state to require sixth-grade girls to be vaccinated against a sexually transmitted virus that can cause cervical cancer, a spokesman for the governor said Monday.

The state House approved the bill Sunday, and Gov. Bill Richardson will sign it once he receives the legislation, spokesman Gilbert Gallegos said.

"It's a public health issue, and I believe it's an important step," Richardson said Monday. "New Mexico has always been progressive on these issues. ... We've got to find ways for young women to be protected."

The measure would take effect June 15 — 90 days after the adjournment of the Legislature.

Texas is the only state to require the vaccine so far, but other states are considering doing the same. While federal regulators have approved the vaccine, the issue of making it a requirement for girls has been surrounded by controversy.

Merck & Co., the vaccine's maker, said last month that it would suspend a behind-the-scenes lobbying campaign to get states to require it for school-age girls because of pressure from parents and medical groups.

Texas Gov. Rick Perry sidestepped his state's Legislature when he ordered the shots for girls entering the sixth grade there starting in September 2008. He has since had to defend his relationship with Merck; The Associated Press reported Perry's chief of staff met with key aides about the vaccine on the same day Merck's political action committee donated money to the governor's campaign.

It wasn't known if Merck had lobbied New Mexico officials.

Virginia lawmakers passed a similar law, which Gov. Timothy M. Kaine has said he would sign. Massachusetts Gov. Deval Patrick's budget proposal calls for providing the vaccine for free to all girls 9 to 18 who want it.

Other states have considered legislation as well. In Colorado, lawmakers are debating a bill that would make the cervical cancer vaccine mandatory for girls entering sixth grade unless their parents sign a form refusing it.

The federal government approved Gardasil, a three-dose vaccine that protects against the human papilloma virus, or HPV, in June for females ages 9 to 26. The vaccine protects against HPV strains that cause cervical, vulvar and vaginal cancers and genital warts.

More than 500 cases of mostly minor side effects have been reported in girls and women who got the vaccine. Government health officials said last month that no additional warning labels are needed.

Also Monday, two Texas lawmakers said that state health officials are not required to follow Perry's order.

Their announcement was made after meeting with Texas Attorney General Greg Abbott, who told them the order "was more like a suggestion to the head of the agency," according to state Sen. Jane Nelson.

Abbott spokesman Jerry Strickland said the attorney general's office does not discuss the content or substance of its discussions with lawmakers.

The governor's office says the order is consistent with current law, although Perry has acknowledged that the Legislature can supersede it. The Texas House is to vote Tuesday on a bill that would bar state officials from requiring the vaccine.

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Weight-Loss Surgery Caution: Take Your Vitamins

HealthDay News -- Obese patients who undergo weight-loss surgeries such as gastric bypass can develop a rare but serious brain condition linked to vitamin deficiency, a new study warns.

Taking the recommended dose of supplements after surgery can prevent the brain illness, called Wernicke encephalopathy, which is caused by a deficiency of thiamine, a B vitamin.

The syndrome is "a problem everyone needs to be aware of," said Dr. Neil Hutcher, immediate past president of the American Society for Bariatric Surgery and director of the bariatric surgical service at Bon Secours St. Mary's Hospital in Richmond, Va.

Hutcher was not involved in the study, which is published in the March 13 issue of Neurology.

Wernicke encephalopathy can include vomiting, confusion, lack of coordination and visual changes such as nystagmus, an involuntary eye movement that can limit vision.

Doctors who perform weight-loss surgeries have known for years about this post-op complication, said study author Dr. Sonal Singh, an instructor in internal medicine at Wake Forest University School of Medicine, in Winston-Salem, N.C.

Singh is an internist and does not perform the gastric bypass surgeries. But he got interested in studying Wernicke encephalopathy after he treated a case a few years ago and then began noticing other patients with the problem.

"Absorption of vitamins is decreased after most gastric bypass surgery, so supplements are prescribed to make sure they get enough," Singh said. Still, some patients may fail to take the supplements as prescribed, boosting risks for low thiamine and Wernicke encephalopathy.

Taking a closer look at the issue, Singh and co-researcher Dr. Abhay Kumar of the University of Iowa combed the medical literature and uncovered 32 cases of Wernicke encephalopathy after obesity surgery.

The 32 patients had various types of obesity surgery, but the most common type was Roux-en-Y gastric bypass, in which some of the stomach and small intestine is bypassed.

Singh found that most instances of Wernicke encephalopathy occurred from 4 to 12 weeks after the surgery, and that one case came on 18 months later. Most of the patients, 27, were women.

When the researchers evaluated the cases, they found some patterns. The complication "usually occurs in younger women, under age 55," Singh said. "It usually occurs between one to three months after surgery."

"Vomiting is a risk factor,'' he said. "If you [frequently] vomit, you are more likely to get it."

Of the 32 patients, 13 made full recoveries after treatment with vitamin B1, but others continued to have problems. One patient died while hospitalized from septic shock, Singh wrote.

"Some got the problem despite taking the supplement," he said. But, in many of the cases, the patients were not taking the supplements as prescribed.

One thing is clear: Wernicke encephalopathy affects only a very small proportion of the 170,000 people who undergo obesity surgery in the United States each year, Singh said.

Still, because the condition can be permanent and is preventable and treatable, it's important for physicians and patients to be aware of it, Singh said.

Hutcher agreed that the risk to any one patient is small. Wernicke encephalopathy is "not at epidemic proportions," he said, noting that 32 patients with the syndrome were identified "out of hundreds of thousands of bariatric surgeries." Hutcher estimated that, overall, there must be "close to a half million bariatric surgery patients in the U.S."

For patients who have undergone the surgery or plan to, Singh has this advice: "After the surgery, make sure you take your vitamin supplements, including the thiamine, and if you have vomiting or other symptoms [such as confusion, lack of coordination, visual changes], seek help immediately."

While potentially serious when it does occur, Wernicke encephalopathy is "totally preventable and either completely or partially reversible," Hutcher said.

Reputable physicians who do bariatric surgery will emphasize that supplements are crucial after surgery, he added.

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Neurological condition linked to obesity surgery

WASHINGTON (Reuters) - Some obese people who have weight-loss surgery, particularly younger women, develop a neurological condition most often seen in severe alcoholics and linked to a vitamin deficiency, researchers said on Monday.

A study in the journal Neurology described the cases of 27 women and five men who developed the condition, Wernicke encephalopathy, after bariatric surgery.

Nearly all had experienced frequent vomiting in the weeks after surgery. Two patients died.

Wernicke encephalopathy can develop when the body does not get enough vitamin B1, also known as thiamine. It affects the brain and nervous system, with symptoms including double vision, eye movement abnormalities, unsteady walking, memory loss and hallucinations.

Lead researcher Dr. Sonal Singh of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said it was unclear how common the condition was in people who have had surgery for obesity.

The researchers said they think it appears in people who have the surgery if they stop taking vitamin supplements or when they vomit so often that it prevents vitamin absorption.

Singh said, when recognized quickly, the condition can be treated easily with injections of thiamine.

People who have the surgery and their doctors should watch for signs of the condition in the first few weeks after the operation, Singh said.

Obesity is a growing problem in the United States and other rich countries, and the popularity of weight-loss surgery has been increasing steadily.

About 170,000 people had the procedure in the United States in 2005, a tenfold rise from the early 1990s. A study last week found that use of the surgery tripled among U.S. adolescents from 2000 to 2003.

"THIS IS A RISK"

"We're not saying to people 'Don't get the surgery.' But I think this is a risk that has to be considered now in the equation when people are deciding," Singh said.

Wernicke encephalopathy is usually associated with severe alcoholism or chronic malnutrition.

Singh and co-author Dr. Abhay Kumar of the University of Iowa combed through scientific literature for reported cases of the condition in people after bariatric surgery to figure out its timing, risk factors and symptoms.

They said it appeared most frequently one to three months after surgery, especially in young women, but developed as late as 18 months after surgery in one person.

The study found the condition can appear after all types of weight-loss surgery, including gastric bypass in which surgeons section off a small portion of the stomach into a pouch that bypasses the first part of the small intestine and connects directly to the lower portions.

Other types include surgery to "band" the stomach and gastric partitioning that divides the stomach into two parts.

Thirteen of the 32 people recovered fully. Some of the 32 experienced symptoms not typical of the condition, including seizures, hearing loss, psychosis, muscle weakness and pain or numbness in the extremities, the study found.

"It's really too early to say how common or how rare it is. I think it is more common than people expect," Singh said.

While most of the cases involved women, Singh said it was too soon to say whether women were more susceptible or only appeared to be because about three quarters of weight-loss surgery patients are women.

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Prescription drug sales rise 8.3 percent

U.S. prescription drug sales rose 8.3 percent to $274 billion last year, fueled by the Medicare drug benefit, increased use of generic medicines and new treatments for diseases such as cancer and diabetes, according to a new report. This year, the pace of sales growth is expected to slow but remain in a compounded annual rate of between 6 percent and 9 percent through 2010 as the Medicare drug benefit is annualized and more generic products enter the market, according to the report released late Thursday by IMS Health. IMS Health provides data to the pharmaceutical and health care industries.

U.S. drug sales rose 5.8 percent to $253.7 billion in 2005.

But in 2006 the Medicare drug benefit offered prescription coverage to some individuals who were previously uninsured or underinsured. Prescriptions dispensed through the Medicare drug benefit accounted for 17 percent of retail prescriptions by the end of the year, the report said.

Sales of unbranded generics rose 22 percent to $27.4 billion, driven by prescriptions for medicines such as the copycat versions of cholesterol agent Zocor and antidepressant Zoloft.

IMS also noted some new drugs performed well last year, such as cancer agent Sutent from Pfizer Inc. and diabetes treatments such as Eli Lilly and Co.'s Byetta and Merck & Co.'s Januvia.

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Career-driven Indians bank sperm for midlife families

Pressure to perform in India's expanding job market has led to a surge of young male executives making deposits at sperm banks so they can have children later in life, reports said Sunday.

Many men who want to advance in India's fast-growing economy have decided that long hours at the office make it impossible to follow traditional social norms such as early marriage, according to a separate international survey.

The Times of India said more than half the long-term frozen semen samples now being received at Delhi's solitary commercial sperm bank, Cryogenie, were from healthy young men unwilling to procreate until they are professionally well-established.

"Over the last three years, the trend of healthy young men coming in to get their semen stored has really gone up," Cryogenie chief Iqbal Mehdi told the daily.

"Right now, between 50 and 60 percent of our long-term frozen samples are from healthy individuals," said Mehdi.

Cryogenie, which stores sperm in liquid nitrogen at temperatures of minus 192 degrees Celsius (-313.6 degrees Fahrenheit), said it charges 3,000 rupees (66.5 dollars) to preserve samples indefinitely.

Health experts confirmed the trend of "career-oriented" men putting family plans on hold in favour of career goals.

"Four or five years ago, no healthy individual would go in for freezing sperm but now with career concerns being very important, the option is being taken up," said Ashok Khurana, a New Delhi-based fertility consultant.

Other experts said the trend among Indian women to freeze eggs, or embryos, was less visible, despite expanding opportunities for both men and women in India.

Many of the hundreds of thousands of new jobs have come from India's leap into the global arena as a hub for software and services such as outsourced call centres, accounting and medical consulting.

Even with a large, educated English-speaking population, demand for talent has caused a boom in salaries.

But many of the new jobs require overnight shifts to serve customers in the United States and Europe, and this means drastic lifestyle changes.

As a result job-related tension has changed social mores in which parents had pushed their children to get married by age 28, especially for males.

A survey conducted by global market research agency ACNielsen last month said that in the past decade 79 percent of Indians chose the 30s as the right age for a wedding.

"The new generation is more career-oriented and is reluctant to assume other responsibilities before their career objectives are fulfilled," said Sarang Panchal, executive director of ACNielson's South Asian chapter.

Marriage is less important for career-oriented young Indians, and only 53 percent of respondents consider marriage a "life goal," one of the lowest in the Asia Pacific region, Panchal said.

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Childbirth kills one woman every seven minutes in India

A woman dies every seven minutes in India because of complications during pregnancy or childbirth, the government said in a report Saturday.

The number of women dying each year from pregnancy and childbirth is 77,000, the Registrar General of India said in a report, three times higher than a government target.

Some 301 women in 100,000 births die each year due to "pregnancy-related complications" despite the government's goal of bringing the mortality rate below 100, said the registrar general.

"In other words, one woman is dying every seven minutes due to complications related to pregnancy and childbirth," said the body which records births and deaths.

Rundown maternity services and near-absent mother-and-childcare centres and rural health facilities contributed to the huge death rate of mothers, the body said.

The report came after India's ruling Congress party chief Sonia Gandhi said on International Women's Day on Thursday that problems faced by women could not "be seen in isolation and their development is linked to the national economy."

The report added: "Despite all the maternal health programmes and improvement in primary healthcare system, very few states are close to this desired figure (of keeping the mortality rate below 100 per 100,000 births)."

Federal ministry officials blamed the states for not doing enough to improve maternal health care.

"The national target is to keep the mortality rate to below 100 per live births but laxities by states in upgrading their (health) facilities is making it difficult," said an unnamed government official quoted by the Press Trust of India.

The report said that Uttar Pradesh, India's most populous state with 170 million people, had the highest maternal mortality rate with 517 deaths per 100,000 live births.

The southern state of Kerala, the only Indian state to boast 100 percent literacy, came nearest to the national target with a figure of 110 deaths per 100,000 live births, the report said.

The mortality rate has actually climbed in many states during the past five years, the report added.

In 1999, there were 220 deaths per 100,000 live births in Uttar Pradesh -- less than half the current rate.

Rises were also seen in the southern state of Tamil Nadu which has a mortality rate of 134, up from 79, and the western state of Gujarat with 172, up from 28.

India last month hiked its federal annual outlay for health by 22 percent to 11.36 billion rupees (2.5 billion dollars) with special emphasis on the welfare of children and women as well as on efforts to contain the spread of HIV/AIDS.

"But the cascading effect will be visible only if state governments too hike their respective health budgets," said health expert Shimoni Sinha.

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Not enough asthmatic kids get flu shot

Only 29 percent of U.S. children with asthma get the flu vaccine even though it is recommended to protect against serious influenza complications common with asthma, federal health officials said on Thursday.

The first national estimate of how many asthmatic children get the vaccine shows far too few do, even though they risk getting dangerous complications from flu that can land them in the hospital.

"That number is a bummer -- it's an embarrassment," said Dr. William Schaffner, chairman of the Department of Preventive Medicine at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Asthma, an inflammatory condition of the airways, can trigger attacks of wheezing, shortness of breath, chest tightness and coughing.

The inflammation makes it more difficult for air to move in and out of the lungs. Breathing sometimes becomes so labored that asthma attacks can turn life-threatening.

The study by the U.S. Centers for Disease Control and Prevention showed that 29 percent of children aged 2 to 17 with asthma got flu shots during the 2004-2005 flu season, compared to 10 percent of children who do not have asthma. The
CDC recommends that all children older than 6 months who have asthma get the flu vaccine each year.

"The most surprising thing was just how low the coverage rate was, at 29 percent. We really actually would hope for 100 percent," said CDC epidemiologist Susan Brim, who led the study.

"I think a lot of parents and maybe even some physicians just aren't aware of the recommendation," Brim added, who suggested that parents make an appointment well in advance for a doctor to give their child the vaccine in the autumn.

Children with asthma face increased risk for complications from flu. Influenza viral infections can provoke asthma attacks that could require hospitalization and may predispose these children to developing pneumonia.

"Every parent of an asthmatic knows who they are, and they really do have to bring the children in to be vaccinated," added Schaffner, also the vice president of the National Foundation for Infectious Diseases.

The findings were based on a 2005 national survey with data on about 5,000 children, about a 10th of whom had asthma. Vaccination levels remained largely consistent for asthmatic children of all ages. For children without asthma, the most likely to have gotten the vaccine were those ages 2 to 4.

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UK-Odd Summary

Luxembourg on Thursday dismissed a report suggesting a dire shortage of toilets in one of the world's wealthiest countries. "It's astonishing," Antoine Haag of Luxembourg's statistics office told Reuters when asked to explain why the country came top of a latrine-shortage list published in the report by the Organisation for Economic Co-operation and Development.

Aristocrat offers dog as best man at gay weddings

LONDON (Reuters) - An eccentric aristocrat is offering his rich and famous dog Jasper -- who "is a bit gay" -- to act as "best man" at same-sex weddings at his country estate. "He is the perfect best man," Sir Benjamin Slade said of his cross-bred canine. "He will not be making any embarrassing speeches, he hoovers up all the leftover food and he is castrated."

Hole in pyjamas reveals Internet plagiarism

LONDON (Reuters) - Candidates for British universities have been caught red-handed copying their applications from the Internet after hundreds mentioned "burning a hole in pyjamas at age eight" on their online entrance forms. The phrase, taken from a Web site which provides examples of personal statements used by successful candidates, describes an early encounter with a chemistry set.

Google Earth urged to remove "Mount Hitler" name

BERLIN (Reuters) - The mayor of a small town in Germany on Thursday called on Google Earth to delete a reference to a nearby "Mount Hitler" from its geographic image service, saying it was misleading. Andreas Wiedemann, mayor of Bad Toelz, south of Munich, said the peak near the Bavarian town had been known as Mount Hitler for a short time during the Third Reich but had been given back its original name of Heigelkopf after World War Two.

Man bashes wife's Women's Day gift in red tape rage

BELGRADE (Reuters) - A Serb man was so enraged at the bureaucracy blocking the import of a car he wanted to give his wife as a Women's Day present, he went to the customs depot and smashed it up with a metal bar. Sasa Djunisijevic bought the Aixam 500, a microcar that may be driven with a motorcycle licence, last year. He wanted to give it to his wife on Thursday, but officials were still debating whether it was a car or a bike and had blocked the import.

Fans pay to chat with Jackson in Japan

TOKYO (Reuters) - Excited fans got the chance to meet Michael Jackson in Tokyo on Thursday -- but only those who could afford to pay 400,000 yen (1,770 pounds) for the privilege. Fans of the "King of Pop" screamed as he arrived by van at the venue in the Japanese capital for the event, at which he had promised to chat and take pictures with up to 300 guests, but not to sing or dance.

Legless panda needs a hand to improve sex life

BEIJING (Reuters) - An animal research centre in northern China has appealed to the world for help to fashion an artificial leg for a panda that lost a limb -- along with its sex life -- in a fight, local media reported on Thursday. In December, a resident of Dajiangou village in Shaanxi province stumbled upon a group of pandas fighting, the Beijing News said.

Missing words on new $1 coins mystify U.S. Mint

WASHINGTON (Reuters) - In God We Trust. In machines? Not so much. An unknown number of new U.S. $1 coins bearing the image of George Washington are missing the words "In God We Trust" and other lettering along the edges, the U.S. Mint said on Wednesday.

Obese Mexican outside for first time in five years

MONTERREY, Mexico (Reuters) - A Mexican man who once weighed half a tonne left his house for the first time in five years on Wednesday after losing 440 pounds (200 kg) through diet and exercise. A crane lifted Manuel Uribe, 40, off the sidewalk and onto a lorry after friends and family heaved him from the house still sitting on his bed.

Name card promises dazzling impression

TOKYO (Reuters) - If you want to shine in a first meeting, a Japanese firm may have the answer -- a name card made of gold. Mitsubishi Materials is selling gold business cards of 99.99 percent purity. Each card costs 10,000 yen (45 pounds).

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Legless panda needs a hand to improve sex life

An animal research center in northern China has appealed to the world for help to fashion an artificial leg for a panda that lost a limb -- along with its sex life -- in a fight, local media reported on Thursday.

In December, a resident of Dajiangou village in Shaanxi province stumbled upon a group of pandas fighting, the Beijing News said.

One seriously injured panda, a two- or three-year-old female that rescuers named "Niu Niu" (girl), was taken to an animal rescue center and saved, but lost two-thirds of its front left leg.

"Niu Niu's spirits have lifted, the wound has healed and her appetite has basically recovered. But without her left paw, her loss of balance has directly affected her love life," the paper said.

"The rescue centre's staff suddenly had a bold idea. If they could give Niu Niu an artificial limb, not only would that solve her walking and foraging for food, it would also enable her to mate."

Staff were appealing to the world's experts for suggestions and hoped to receive a plan for a "meticulously scientific" fake limb as soon as possible, the paper said.

China goes to great lengths to protect the giant panda, which is regarded a national treasure and found only in nature reserves in the country's Sichuan, Gansu and Shaanxi provinces.

Last July, Chinese vets and dentists were planning an operation to implant three false teeth in a panda injured after a fall in the wild in the same province, local media reported.

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Congress steers spending to aliens, obese GIs

Taxpayers are funding a telescope to search for space aliens and research devoted to improving the shelf-life of vegetables, part of $13.2 billion in special-interest projects the U.S. Congress approved last year, a private watchdog group said on Wednesday.

The billions of dollars, attached to spending bills for the Department of Defense and Department of Homeland Security, were detailed in the annual "Pig Book" report compiled by Citizens Against Government Waste.

As two potbellied pigs named Winnie and Dudley munched on rice cakes, group President Tom Schatz chastised congressional lawmakers for what he called wasteful spending of tax dollars.

Citizens Against Government Waste brands as "pork projects" funds inserted into bills without congressional oversight, money not awarded competitively, serving only a local or special interest or requested by only one chamber of Congress.

Referring to the $1 million for a telescope searching for extra-terrestrial intelligence, Schatz said, "It's not clear how the Department of Defense was going to protect us against an invasion" by space aliens.

In this Chinese year of the pig, the $13.2 billion attached to fiscal 2007 spending bills paled when compared to the $29 billion in pork the group said it identified a year ago.

Last year's Republican-controlled Congress only passed two of the 11 spending bills funding government activities, greatly reducing the opportunities for inserting special-interest money. When Democrats took over Congress in January, they passed the remaining funding, but with a moratorium on the "earmarks."

But the real test of Congress' appetite for pork will come soon, as lawmakers begin writing next year's spending bills.

Of the $1.35 million to be spent by the military to study obesity among soldiers, Schatz quipped, "We thought that was supposed to be taken care of in basic training."

The group took Sen. Patty Murray (news, bio, voting record), a Washington Democrat, to task for winning $1.65 million to research ways to increase vegetables' shelf-life. Schatz's group said the money is being directed to California-based Arcadia Biosciences, which has a facility in Seattle.

Murray argued that the
Pentagon supports the project and it was a "vital research program that has the potential to greatly benefit our brave men and women stationed far abroad who have difficulty purchasing fresh fruits and vegetables."

The watchdog group also criticized $5.5 million for the University of California's Ernest Gallo Clinic and Research Center to study the effects of alcohol and drug abuse on the brain. Winemaking king Gallo, 97, died on Tuesday.

Sens. Ted Stevens (news, bio, voting record), an Alaska Republican, and Daniel Inouye (news, bio, voting record), a Hawaii Democrat, "served more than their fair share of bacon" to their states, the group said. The two are the senior members of the Senate Appropriations panel that oversees military spending.

Alaska received $209.9 million in pork, a 127 percent increase over the $92.4 million last year, according to the report.

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Obesity doubles in Sweden in 25 years

The number of obese people in Sweden has doubled in the past 25 years, with one in 10 Swedes now considered largely overweight, a Statistics Sweden study showed.

Obesity is now as common among women as men, according to the report, which was published on Tuesday and studied Swedes' weight from 1980 until 2005.

The problem has increased most among young women, non-labour workers and rural residents, though Swedes across all social groups registered weight gains during the period.

Obesity, blamed on changes in diet and lifedtyles, has long been a problem in the United States and is on the rise in many European countries. In France, nine percent of people are considered obese, compared to 12 percent in Germany and 23 percent in Britain.

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UNICEF says health of Thai women, children improving

Thailand has made substantial progress on the health of women and children, but needs to provide more education on preventing HIV and close the health gap between rich and poor, a UNICEF study found Friday.

Thailand has significantly increased immunisations and access to safe drinking water and sanitation since 1990, when its economy began expanding rapidly, the survey by the Thai government and United Nations Children's Fund said.


The National Statistical Office canvassed 43,000 households for the survey, the biggest ever to be conducted on the health and education of women and children in Thailand.

Among its main findings were that 98 percent of primary school-age children were attending classes, while 83 percent of one-year-olds had been vaccinated against six childhood diseases.

Some 94 percent of households had access to safe drinking water, and 99 percent had safe sanitation, it said.

"These are very impressive achievements that Thailand can be proud of," said Tomoo Hozumi, UNICEF's country representative.

"At the same time, the results show that there are some remaining challenges," he added.

Only 5.4 percent of Thai babies were being exclusively breastfed in the first six months of life, which is the best way to ensure infants receive proper nutrition, the survey found.

Thailand also trails other countries in the use of iodised salt, which is the best way of ensuring that children receive enough of the nutrient that is crucial to preventing mental problems.

While Thailand has been praised internationally for its efforts to treat HIV/
AIDS, the survey found that more needed to be done to teach women how to prevent the disease.

Fewer than half of the women questioned completely understood how the disease was transmitted and how it can be prevented.

In many key measures, people who were rich and well-educated were healthier than poor Thais.

Poor children are four times as likely to be underweight as rich ones, and twice as likely to suffer stunted growth, it said.

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Too few kids with asthma get flu shots

ATLANTA - Children with asthma should get flu shots to protect them, but only 3 in 10 do, U.S. health officials said Thursday.

"We were surprised at how low the number was," said Susan Brim of the U.S. Centers for Disease Control and Prevention, lead author of a study that looked at flu shot data from 2005.

The study represents the first national estimates on flu vaccination rates for asthmatic children.

Children with asthma, a chronic lung problem marked by wheezing, coughing and labored breathing, can die from flu complications, such as pneumonia and acute respiratory disease. And they are at higher risk for those problems. Inactivated flu vaccine is recommended for asthmatic children older than six months.

The study's findings came from an analysis of a 2005 national survey of the parents of children ages 2 to 17. About 5,100 kids were represented in the data, and 557 of them had asthma.

Only 29 percent of the asthmatic children had gotten flu shots during the 2004-05 flu season. The lowest vaccination rates were among children ages 5 to 12 who had not had an asthma attack or episode in the previous year.

The survey came after a flu vaccine shortage that caused long waiting lines for shots. Brim said it's not clear what impact that had on the study results: Asthmatic children were prioritized for the scarce shots, so the shortage may not have hurt — and possibly might even have boosted — vaccination rates that year, she said.

The low rates may have to do with family's misperceptions about flu shots, said Dr. Gerald Teague, a pediatric pulmonary specialist at Emory University.

Many patients seem to mistakenly believe flu shots can trigger asthma attacks or flu symptoms, and it's important that doctors talk to families and address such concerns, Teague said.

"Influenza in a child or adult with asthma can be fatal," he said.

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Child's sleep disorder affects parents too

NEW YORK (Reuters Health) - When children have sleep problems, their parents -- especially mothers -- often have sleep-deprived nights too, research shows.

In a study of families with children seen at a sleep clinic, researchers found that when children had multiple sleep problems, their parents were more likely to have daytime drowsiness.

Mothers were generally more affected than fathers, possibly because they were the ones who typically responded to their children's problems in the middle of the night, the researchers speculate.

"A child's sleep problem affects the whole family," said lead study author Dr. Julie Boergers, of Bradley Hasbro Children's Research Center and Brown Medical School in Providence, Rhode Island.

This is important, she told Reuters Health, because research shows that sleep disruptions and daytime sleepiness have negative effects on people's mood, behavior and health. For parents, sleep deprivation may cause them to have less patience with their child or spouse, and be less productive at work and at home, Boergers explained.

The study, published in the Journal of Family Psychology, is based on 107 families of children ages 2 to 12 who were evaluated at a sleep disorders clinic. The children's sleep problems ranged from the breathing disorder sleep apnea to night terrors and sleepwalking to behavioral issues like refusing to go to bed.

When parents were surveyed about their own sleep habits and daytime alertness, it turned out that those whose children had more than one sleep problem tended to suffer more daytime sleepiness than other parents.

This was particularly true of mothers, even though they reported sleeping roughly the same number of hours that fathers did.

It's possible that mothers did have more sleep interruptions than fathers, even though they logged roughly the same number of hours in bed, according to Boergers and her colleagues. While fathers in general may be taking on more child-rearing responsibilities, they note, moms are probably still the ones who more often get out of bed to check on their child.

According to Boergers, some signs of a childhood sleep disorder include excessive daytime sleepiness, difficulty falling asleep, frequent nighttime waking or snoring.

"It's also important to recognize that some children who demonstrate daytime behavior problems or mood disturbances may suffer from an underlying sleep disorder," she said.

Parents who suspect their child may have a sleep disorder "shouldn't hesitate" to seek help for it, Boergers said, as there are effective behavioral therapies and medications available.

SOURCE: Journal of Family Psychology, March 2007.

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Pain complicates depression treatment in elderly

NEW YORK (Reuters Health) - By interfering with normal activities, chronic pain can impede recovery from depression in older adults, according to findings reported in the Journal of the American Geriatrics Society.

Dr. Shahrzad Mavandadi, of the University of Pennsylvania, Philadelphia, and colleagues examined the effects of pain on the response to depression treatment in 524 men, 60 years of age or older, who were seen at a VA medical center.

The men were randomly assigned to an integrated care group, in which patients saw a mental health professional at a primary care clinic, or to a specialty care group, in which the patient was referred to a mental health professional at another facility.

The researchers assessed the patients' pain severity, the degree to which pain interfered with work inside and outside the home, and depression symptoms at the beginning of the study and at 3, 6, and 12 months.

The results showed that depression symptoms decreased over time in both treatment groups. However, pain modified the reductions in symptoms.

Patients who reported higher levels of pain severity and more interference with work activity had less improvement in their depression symptoms. Pain that interfered with activities had a greater effect on depression symptoms, than did pain severity, the team reports.

These findings, and the fact that pain and depression often occur together in the elderly, suggest that older patients who are being treated for depression might benefit from routine assessment of pain as well as any other medical conditions that may complicate their treatment, Mavandadi said in an interview with Reuters Health.

"Better assessment and treatment of these conditions may improve depression...outcomes," she said. Also, when patients with pain are being assessed to confirm a depression diagnosis and determine the course of treatment, it may help to incorporation tests that address various aspects of the pain condition, rather than just pain severity.

Mavandadi also noted that these findings may be attributed to a number of factors. For example, she suggested that the mere experience of pain may contribute to greater distress and depressive symptoms both directly and indirectly through its impact on physical and psychosocial functioning.

Pain can also interfere with "the patients' and providers' ability to manage depression," Mavandadi said. "Dealing with severe pain may be distracting and hinder, both physically and psychologically, the patient's ability to concentrate on a treatment regimen or successfully engage in treatment visits," she explained. Furthermore, pain and depression each require time and attention.

SOURCE: Journal of the American Geriatrics Society, February 2007.

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Exercise slows decline in Alzheimer's patients

Nursing home residents with
Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown.

Dr. Yves Rolland, of Hospital La Grave-Casselardit in Toulouse, France, and colleagues examined the effects of a program of exercise for one hour twice weekly on activities of daily living, physical performance, nutritional status, behavioral disturbance and depression among 134 Alzheimer's disease patients in nursing homes.

The patients were 83 years old on average. They were assigned to the exercise program, which focused on walking, strength, balance and flexibility training, or to routine medical care for 12 months.

As reported in the Journal of the American Geriatrics Society, 110 participants completed the study. Among the 56 subjects in the exercise group who completed the study, the rate of adherence to the program was about 33 percent on average.

At the end of the 12 months, the average activities-of-daily-living score was significantly more improved in the exercise group than in the routine medical care group, Rolland's team reports.

In addition, average walking speed improved significantly more in the exercise group than in the routine medical care group at 6 months and 12 months.

However, the exercise program had no apparent effect on behavioral disturbance, depression or nutritional assessment scores.

SOURCE: Journal of the American Geriatrics Society, February 2007.

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Health Tip: Taking Your Child's Temperature

(HealthDay News) -- If your child appears sick and might be running a fever, it's important to take his temperature properly.

There are different kinds of thermometers, but certain types may be better suited to your child's age range, the American Academy of Family Physicians says. Here are the group's recommendations:

• For children younger than 3 months, a digital thermometer should be used rectally. Electronic ear thermometers are not recommended, as ear canals are typically too small at this age to get an accurate reading.


• For children between 3 and 4 months, a digital thermometer used rectally or an electronic ear thermometer both should provide accurate readings.


• For children aged 4 and older, digital thermometers used orally will suffice. If the child has a cough, stuffy nose or has difficulty with an oral thermometer, an electronic ear thermometer or digital thermometer placed under the arm should work.

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Exercise slows decline in Alzheimer's patients

NEW YORK (Reuters Health) - Nursing home residents with
Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown.

Dr. Yves Rolland, of Hospital La Grave-Casselardit in Toulouse, France, and colleagues examined the effects of a program of exercise for one hour twice weekly on activities of daily living, physical performance, nutritional status, behavioral disturbance and depression among 134 Alzheimer's disease patients in nursing homes.

The patients were 83 years old on average. They were assigned to the exercise program, which focused on walking, strength, balance and flexibility training, or to routine medical care for 12 months.

As reported in the Journal of the American Geriatrics Society, 110 participants completed the study. Among the 56 subjects in the exercise group who completed the study, the rate of adherence to the program was about 33 percent on average.

At the end of the 12 months, the average activities-of-daily-living score was significantly more improved in the exercise group than in the routine medical care group, Rolland's team reports.

In addition, average walking speed improved significantly more in the exercise group than in the routine medical care group at 6 months and 12 months.

However, the exercise program had no apparent effect on behavioral disturbance, depression or nutritional assessment scores.

SOURCE: Journal of the American Geriatrics Society, February 2007.

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Circumcision may lift HIV risk for women

LONDON - Circumcision may reduce men's chances of contracting
HIV by up to 60 percent — but early results suggest the procedure may put women at increased risk of infection, according to preliminary data presented Tuesday.

Early results announced at a U.N. consultation in Switzerland on the potential impact of male circumcision on
AIDS in Africa suggested that if HIV-positive men do not abstain from sex while healing from circumcision surgery, their female partners might have a higher chance of catching HIV from them.

However, experts said the results were not conclusive — and highly susceptible to other factors, such as condom use — demonstrating the difficulties of utilizing circumcision in HIV prevention in sub-Saharan Africa, where more than 60 percent of those with AIDS are women.

Previous studies have confirmed the dramatic impact circumcision has in cutting men's HIV infection rates, but a big question has been the resulting effect on women.

The first evidence — though very preliminary — suggests there is a period immediately following surgery when men may more easily transmit the virus to their female partners.

"Women are already so vulnerable in this epidemic," said Jennifer Kates, an AIDS expert at the Kaiser Family Foundation who is not connected to the study. "We need to be particularly careful about anything that could put them at even greater risk."

Researchers at the Rakai Health Sciences Program and Makerere University in Uganda and the John Hopkins Bloomberg School of Public Health in the U.S. tracked 997 HIV-positive men in Uganda and their female partners.

Among 70 men with HIV who underwent circumcision, 11 of their female partners became infected with the virus in the month after the surgery. In contrast, only four partners of 54 uncircumcised men with HIV in the control group caught the virus — nearly half the rate, early results showed.

Researchers said the results suggest increased HIV transmission from men who have sex before they had properly healed.

However, they said the numbers so far were too small to be statistically significant, and left open the possibility that the higher rates were due to chance; both groups of men and women were given repeated HIV prevention education and free condoms.

Experts said the study showed the importance of finding ways to protect women in the search for ways to fight AIDS.

"We need to err on the side of caution to protect women in any future male circumcision program," said Dr. Maria Wawer, the study's lead investigator, a researcher at Johns Hopkins Bloomberg School of Public Health.

More than 60 percent of AIDS patients in sub-Saharan Africa are women. The social and economic inequalities between men and women are thought to be responsible for the elevated rates of infection in women, with many women trapped in relationships with unfaithful men.

The preliminary results do not call into question the utility of circumcision as a way to prevent AIDS in Africa.

But "while male circumcision has extraordinary potential to prevent HIV infection, these new findings remind us that we must proceed with thought and care in developing strategies to expand male circumcision in Africa," said Dr. Kevin De Cock, director of WHO's AIDS department. "Circumcision is an additional prevention strategy rather than a replacement for anything else."

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Transplant failures linked to drug costs

NEW YORK (Reuters Health) - After children and adolescents receive an organ transplant, more than 90 percent do well at the one-year mark. Thereafter, unfortunately, the rate of loss of the grafted organ increases, investigators report.

Dr. Mark A. Schnitzler, from the St. Louis University School of Medicine, and his associates believe that the transplant failure rate is often related to the inability to pay for immune suppressing drugs, which are required for the remainder of the patient's life to prevent rejection of the transplant.

These drugs "are incredibly expensive, sometimes more than $13,000 a year," Schnitzler comments in a university press release.

He and his associates have reviewed the financial aspects of continuing graft survival, and report their findings in the medical journal Pediatric Transplantation.

Medicare pays for most organ transplants in the U.S. However, coverage of immunosuppressant drugs ends 36 to 44 months after surgery or when the patient reaches adulthood. Many patients, especially young adults, cannot afford to pay for these drugs. Moreover, only about 30 percent of young adults have health insurance.

"Even for families with insurance, the co-payments can be a huge financial burden," Schnitzler adds.

For individuals who have employer-sponsored and private health insurance, coverage ends once a patient reaches a lifetime maximum amount stipulated by their policies.

As a result of these circumstances, many transplanted organs are rejected and patients' lives are shortened.

One study of 1000 people who received a donor kidney found that graft loss more than doubled when Medicare coverage ended. Once the transplanted kidney no longer works, the risk of death increases 9-fold.

The cost to society of failed organ transplants is also high. One study of kidney grafts found that "functioning transplants are 10 times less expensive than allowing them to fail during the year following failure."

Schnitzler and his colleagues conclude that new public policies requiring lifetime health care coverage for organ transplant recipients would be cost-effective, and would prolong patients' lives.

SOURCE: Pediatric Transplantation, March 2007.

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Study raises questions about circumcision in AIDS

Circumcision helps protect men from getting the
AIDS virus but may make an already-infected man more likely to infect a woman if he does not let his penis heal completely, researchers said on Tuesday.

Researchers working in Uganda released early findings from a study of 997
HIV-infected men. It indicated that women who had sex with a man who did not wait to heal fully after circumcision seemed to have a higher risk of infection than through sex with an uncircumcised infected man.

Intercourse might cause tiny tears in the surgical wound, which in turn could put HIV-infected blood into the woman's vagina, the researchers speculated.

They found no apparent increased risk for female sex partners of infected men who waited until a doctor certified that the wound had completely healed.

"We thoroughly agree that this should not be used to discredit the incredible value of male circumcision for the prevention of HIV acquisition in men," Dr. Maria Wawer of Johns Hopkins University in Baltimore, who leads the study, told reporters.

Women make up the majority of HIV-infected people in Africa, where HIV largely is spread through heterosexual sex.

The wounds from circumcision take about four weeks to heal. The findings emphasized the importance for men to abstain from sex until fully healed, said Dr. Ron Gray of Johns Hopkins.

The study will be completed in two years. The preliminary findings were issued in Switzerland as U.N. health officials consider circumcision policy recommendations.

Public health leaders think circumcision may be a powerful way to reduce HIV infection in Africa, the continent hardest hit by AIDS. Three previous African studies showed circumcised men are 50 to 60 percent less likely to become infected with the human immunodeficiency virus.

Experts say the lower risk may be because cells on the inside of the foreskin, the part of the penis cut off in circumcision, are particularly susceptible to HIV infection. HIV also may survive better in the warm, damp environment beneath foreskin.

'PARADOXICAL SITUATION'

"The data shows a paradoxical situation," Dr. Kevin De Cock, director of the
World Health Organization's Department of HIV/AIDS, said in a conference call with reporters.

De Cock said the new findings were preliminary, incomplete and statistically insignificant because of how few people were involved. He said when the study is completed, it might even show circumcision can protect a man's female sex partner.

The team at Johns Hopkins, the Rakai Health Sciences Program and Makerere University in Uganda said they viewed circumcision as important in AIDS prevention efforts.

The researchers tracked infection rates of 113 previously uninfected female partners of infected men. Of 12 women who had sex with infected men before the circumcision wound was fully healed, three became infected within six months.

Of 55 female partners of infected circumcised men who waited to resume sex until the wound healed, six became infected. That was similar to the infection rate of female partners of uncircumcised infected men -- four of 46.

Of the 39.5 million people worldwide infected with HIV, 24.7 million are in sub-Saharan Africa. About 25 million people have died from AIDS since it was first identified a quarter century ago.

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Family therapy helps kids with type 1 diabetes

Specially tailored family therapy can help teens with type 1 diabetes keep their blood sugar levels under control.

However, the 12-session program is expensive and complex, making widespread use impractical, Dr. Tim Wysocki of the Nemours Children's Clinic in Jacksonville, Florida and colleagues note. "Adapting (the program) to make the intervention less labor intensive, and, thus, less expensive, might be valuable," they add.

Good family communication and problem-solving skills are important for helping young people with type 1 diabetes to manage the condition, Wysocki and his team note in the medical journal Diabetes Care.

They developed a family-based behavioral therapy program specifically tailored to address diabetes-related family issues. The program consisted of 12 sessions offered over six months, and included training in "behavioral contracting" techniques for family members and "a 1-week parental simulation of living with type 1 diabetes."

For their study, the researchers randomly assigned 104 families of teens with poorly controlled type 1 diabetes to the behavioral family therapy program, standard care, or a multifamily support group that included educational elements.

While levels of A1C, a measurement of long-term blood glucose control, fell in all three groups over the first six months, A1C levels climbed again in the standard-care and support-group kids, but remained low for the behavioral family therapy group up to 18 months after the program began.

The results support the efficacy of a family-based behavioral therapy approach in improving diabetes control, the researchers conclude, "but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of this intervention."

SOURCE: Diabetes Care, March 2007.

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Lula tells Brazil to respect women

RIO DE JANEIRO (Reuters) - Brazilians must show women more respect by using condoms during sex, President Luiz Inacio Lula da Silva said on Wednesday at an event to help women avoid sexually transmitted diseases.

AIDS is growing among heterosexual women. We are going to fight hypocrisy. We need to give out condoms and teach people how to use them. People need to be taught how to have sex, that's the only way we will have an AIDS-free country," Lula said.

Lula's words marked the start of a new Health Ministry program to lower AIDS infection rates among women, up 44 percent from 1995 to 2005.

The program, started one day before International Women's Day on Thursday, aims to give out 14 million free female condoms and to double
HIV-testing for women.

"Sex is something everybody likes, it's a biological necessity for humans, so what we must do is teach," Lula said.

"We have to improve the gray matter in people's brains so they understand that women should be respected."

Brazil has been applauded by global health organizations for slowing overall AIDS infection rates by giving away free condoms. But studies show men sometimes ask women not to use condoms and women are more likely to be infected with HIV by men than vice versa.

One option for women is the female condom, a latex product women can insert before sex.

Women have the same legal rights as men in Brazil, but the culture is male-dominated, abortion is illegal and laws against domestic abuse and other crimes are weakly enforced.

Brazil is also the world's largest Roman Catholic nation, and the church frowns on condoms and premarital sex.

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"Stealth" gonorrhea strains on the rise

NEW YORK (Reuters Health) - There is global dissemination of a type of gonorrhea that lacks an enzyme used by many commercial kits to confirm a diagnosis of infection, investigators report.

The enzyme -- called prolyliminopeptidase -- was previously thought to be common to all gonorrheal strains and its absence can result in incorrect, doubtful, or delayed diagnosis, they point out.

Dr. Magnus Unemo from Orebro University Hospital in Sweden and colleagues investigated the possibility of widespread transmission of prolyliminopeptidase-negative strains of gonorrhea in several countries.

They found that most of these strains -- identified in Australia, New Zealand, and Scotland -- were indistinguishable or highly related to a strain previously reported in an English and Danish outbreak.

The majority of the specimens also remained fully susceptible to several antibiotics used to treat gonorrhea, the researchers note.

The findings indicate "a widespread dissemination among several countries" of prolyliminopeptidase-negative gonorrhea that evolved from a single original strain, the investigators conclude in the medical journal Sexually Transmitted Infections.

Increased awareness of these gonorrhea strains worldwide is "crucial," and changes in the way the diagnosis is made may be needed in several geographic areas, Unemo and colleagues say. "For example, the use of at least two different assays ... which are based on different principles, is fundamental."

SOURCE: Sexually Transmitted Infections, February 2007.

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Half ton man continues weight loss

SAN NICOLAS DE LOS GARZA, Mexico - A man who once weighed well over a half ton left his house for the first time in five years Wednesday — wheeled outside on his bed to greet neighbors and see a mariachi band. "The sky is beautiful and blue and what I want is to enjoy the sun," said Manuel Uribe, who had once been certified by doctors as weighing 1,235 pounds. Though still unable to leave his bed, Uribe has lost 395 pounds since he began a high-protein diet a year ago. He now weights about 840 pounds.

To celebrate the milestone, six people pushed Uribe's wheel-equipped iron bed out to the street as a mariachi band played and a crowd gathered. Then, a forklift lifted him onto a truck and the 41-year-old rode through the streets of San Nicolas de los Garza, a Monterrey suburb.

With dozens of reporters and photographers in tow, Uribe traveled along, passing the town's plaza and church and waving at clusters of people eager to get a glimpse of him.

"It fills me with joy to see he's getting better and getting a little sun," Uribe's neighbor Guadalupe Guerra said. "I would go crazy if I had to be inside my house for so many years."

Uribe was a chubby kid and weighed more than 250 pounds as an adolescent. In 1992, he said his weight began ballooning further.

Since the summer of 2002, Uribe has been bedridden, relying on his mother and friends to feed and clean him.

He drew worldwide attention when he pleaded for help on national television in January 2006. Afterward, an Italian and a Spanish doctor both visited and offered gastric bypass surgery.

But Uribe chose to accept help from Mexican nutritionists working with the Zone diet. He says he will stick to that diet until he reaches his goal of 265 pounds.

"My goal is to leave the house on my own but I know that will be a long process," he said. Doctors say it may take between three and four years for Uribe to reach his goal.

Uribe said he plans to start a foundation to help overweight people get medical assistance and teach them about healthy eating habits.

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Congress steers spending to aliens, obese GIs

WASHINGTON (Reuters) - Taxpayers are funding a telescope to search for space aliens and research devoted to improving the shelf-life of vegetables, part of $13.2 billion in special-interest projects the U.S. Congress approved last year, a private watchdog group said on Wednesday.

The billions of dollars, attached to spending bills for the
Department of Defense and Department of
Homeland Security, were detailed in the annual "Pig Book" report compiled by Citizens Against Government Waste.

As two potbellied pigs named Winnie and Dudley munched on rice cakes, group President Tom Schatz chastised congressional lawmakers for what he called wasteful spending of tax dollars.

Citizens Against Government Waste brands as "pork projects" funds inserted into bills without congressional oversight, money not awarded competitively, serving only a local or special interest or requested by only one chamber of Congress.

Referring to the $1 million for a telescope searching for extra-terrestrial intelligence, Schatz said, "It's not clear how the Department of Defense was going to protect us against an invasion" by space aliens.

In this Chinese year of the pig, the $13.2 billion attached to fiscal 2007 spending bills paled when compared to the $29 billion in pork the group said it identified a year ago.

Last year's Republican-controlled Congress only passed two of the 11 spending bills funding government activities, greatly reducing the opportunities for inserting special-interest money. When Democrats took over Congress in January, they passed the remaining funding, but with a moratorium on the "earmarks."

But the real test of Congress' appetite for pork will come soon, as lawmakers begin writing next year's spending bills.

Of the $1.35 million to be spent by the military to study obesity among soldiers, Schatz quipped, "We thought that was supposed to be taken care of in basic training."

The group took Sen. Patty Murray (news, bio, voting record), a Washington Democrat, to task for winning $1.65 million to research ways to increase vegetables' shelf-life. Schatz's group said the money is being directed to California-based Arcadia Biosciences, which has a facility in Seattle.

Murray argued that the
Pentagon supports the project and it was a "vital research program that has the potential to greatly benefit our brave men and women stationed far abroad who have difficulty purchasing fresh fruits and vegetables."

The watchdog group also criticized $5.5 million for the University of California's Ernest Gallo Clinic and Research Center to study the effects of alcohol and drug abuse on the brain. Winemaking king Gallo, 97, died on Tuesday.

Sens. Ted Stevens (news, bio, voting record), an Alaska Republican, and Daniel Inouye (news, bio, voting record), a Hawaii Democrat, "served more than their fair share of bacon" to their states, the group said. The two are the senior members of the Senate Appropriations panel that oversees military spending.

Alaska received $209.9 million in pork, a 127 percent increase over the $92.4 million last year, according to the report.

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Obesity doubles in Sweden in 25 years

STOCKHOLM (AFP) - The number of obese people in Sweden has doubled in the past 25 years, with one in 10 Swedes now considered largely overweight, a Statistics Sweden study showed.

Obesity is now as common among women as men, according to the report, which was published on Tuesday and studied Swedes' weight from 1980 until 2005.

The problem has increased most among young women, non-labour workers and rural residents, though Swedes across all social groups registered weight gains during the period.

Obesity, blamed on changes in diet and lifedtyles, has long been a problem in the United States and is on the rise in many European countries. In France, nine percent of people are considered obese, compared to 12 percent in Germany and 23 percent in Britain.

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Diet study tips scale in favor of Atkins

CHICAGO (Reuters) - A study of four popular diets found that women put on the one with the least carbohydrates -- the Atkins plan -- lost at least twice as much weight as those on the others, researchers said on Tuesday.

"Many health professionals, including us, have either dismissed the value of very-low-carbohydrate diets for weight loss or been very skeptical of them," said Christopher Gardner, assistant professor of medicine at the Stanford Prevention Research Center in California, lead author of the study.

"But it seems to be a viable alternative for dieters," he added, for whom the basic message is cutting down as much as possible