Health Tip: Who's at Greater Risk for Heat-Related Illness

Health Tip

Heat-related illness occurs when the body can't cool itself during extremely hot and humid conditions. According to the U.S. Centers for Disease Control and Prevention, certain people are at greater risk, including:

• Infants and young children up to 4 years of age.
• People aged 65 and older.
• People who are significantly overweight or obese.
• People who overexert themselves or don't drink enough fluids.
• People with high blood pressure, heart disease, and those who take certain medications for depression, insomnia or poor circulation.

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Last Flu Season Was Mild, But Child Deaths Worrying

Although the 2006-07 flu season was comparatively mild in the United States, it still claimed the lives of 68 children, and experts say more must be done to reduce the death toll. They're especially concerned about the steady rise in a potentially lethal combination of infection with flu and drug-resistant staphylococcus, or "staph."

"While waiting to see what this year will bring, we should all plan to roll our sleeves up and get vaccinated and in no way let our guard down," said Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center. In a report released Thursday by the U.S. Centers for Disease Control and Prevention, experts said the 2006-07 flu season peaked in mid-February. And there were actually fewer pediatric deaths and fewer children hospitalized with influenza than in the past three flu seasons, according to the CDC.

But, among the 68 children whose deaths were associated with flu from Oct. 1, 2006, to May 19, 2007, 21 had influenza plus Stapholococcus aureus ("staph") that was resistant to a leading antibiotic, methicillin, according to the report in the Aug. 10 issue of the CDC's Morbidity and Mortality Weekly Report.

In comparison, only one child died from flu coupled with S. aureus infection in 2004 through 2005, and three died during the 2005-06 season, the CDC said.

"We are looking into the number of deaths of children combined with staff bacterial infection," said Dr. Joe Bresee, CDC's chief of the Epidemiology and Prevention Branch in the Influenza Division. "From our perspective, it looks like it has increased."

Bresee said the CDC isn't sure if the number of deaths is actually rising, or the increase is due to better reporting. "The actual risk to kids from this is not known, but it is concerning," he said.

Bresee thinks that increasing the number of young children who get flu shots is key to reducing the problem. "They would be less likely to get influenza and, therefore, less likely to get co-infections with S. aureus," he said.

Despite the troubling news that such dual infections may be on the rise, the past season's flu statistics were relatively positive, Katz said.

"Data from the last flu season provide mostly good news," he said. "The number of cases was never unusually high. The strains were mostly of the expected varieties, and vaccine composition was just right. The death toll from complications of influenza was a bit lower than average."

The reasons for the milder flu season aren't clear, said Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine. "It could be increased surveillance and improved care and more awareness of what influenza can do," he said. "It may also be a less virulent strain of the virus."

Katz noted that, even in a good year, the average number of deaths from flu in the United States totals about 30,000, mostly among the elderly.

During the 2006-07 flu season, the influenza A (H1) virus was most common in the United States, but the A (H3) virus was found to be more common late in the season, according to the CDC.

For the 2007-08 vaccine, the U.S. Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee has recommended that the trivalent flu vaccine contain A/Solomon Islands/3/2006-like (H1N1), A/Wisconsin/67/2005-like (H3N2), and B/Malaysia/2506/2004-like viruses, the CDC reported.

The influenza A (H3N2) and influenza B components remain the same for the new vaccine. These recommendations were based on antigenic analyses of recently isolated influenza viruses, epidemiologic data, vaccination studies in humans, and the availability of vaccine strains and reagents, the CDC said.

Last season, around the world, influenza A (H1), A (H3), and B viruses were most common. In Africa, small amounts of influenza A and B were seen. In Europe and Asia, influenza A (H3) virus was most common, but low levels of A (H1) were seen. Influenza B viruses were seen at lower levels in Asia and Europe but were most common in some countries, according to the CDC.

The best way to protect yourself from flu is to get vaccinated, experts said. "We had a good flu year. But that was last year," Katz noted.

In terms of the H5N1 bird flu virus, from December 2003 to mid-July 2007, 319 cases of bird flu in humans were reported to the World Health Organization. Among these cases, 60 percent (192) were fatal. To date, no human cases of bird flu have been reported in the United States.

All human cases were reported from Asia (Azerbaijan, Cambodia, China, Indonesia, Iraq, Laos, Thailand, Turkey, and Vietnam) and Africa (Djibouti, Egypt, and Nigeria).

But, "the threat of an avian flu pandemic still looms," Katz said. "To date, deaths from avian flu have been few, and limited to Asia. But no one knows for sure when that might change."

Siegel, author of Bird Flu: Everything You Need to Know About the Next Pandemic, noted that although H5N1 has a high mortality rate, "we see year after year that it is confined to birds. There is no indication that it is about to become a massive human problem. There is no indication that it is on the verge of transforming."

source : news.yahoo.com

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China targets toy and drug manufacturers

China has banned two factories from exporting toys after a high-profile recall of Mattel products including Big Bird and Elmo because of fears about lead in paint. It has also put on trial five drug company managers accused of killing patients with a tainted medicine, exposing corruption and lax safety that have alarmed consumers worldwide.

China has been struggling to convince the world its products are safe after a series of scandals over tainted pet food, drugs, tires, toys and toothpaste. China stripped export licenses from Hansheng Wooden Products Factory and Lida Toy Company, both based in the booming southern province of Guangdong, the General Administration of Quality Supervision, Inspection and Quarantine watchdog said on its Web site on Thursday.

Lead is toxic and can pose serious health risk to young children who often put objects in their mouths.

Hansheng, based in Dongguan, was the producer of 1.5 million wooden vehicles, buildings and other train-set toys sold in the United States from January 2005 through June 2007, and then voluntarily recalled by U.S. toymaker RC2 Corp., an Illinois-based company that imports the popular "Thomas & Friends" toys.

About 1.5 million preschool toys made by Lida Toy, a Foshan-based contract manufacturer for Mattel Inc.'s Fisher-Price unit, were recalled across the globe by the U.S. company last week.

Mattel said the toys, which include popular characters such as Elmo, Cookie Monster and Dora, could have contained excessive amounts of lead in their surface paint.

The Chinese watchdog said the problem was with Lida's paint supplier, which had provided "fake lead-free" paint for use in production.

It ordered the companies to "correct" their problems, and said police were investigating.

But it defended the made-in-China brand and said the overwhelming majority of toys met American standards. Of about 300,000 batches for export, the U.S. Consumer Product Safety Commission had only made about 29 recalls, it said.

It added that importers and "brand" companies also had a "very big responsibility" and that it hoped that "foreign toy brands further improve product design and supervision and control to prevent loopholes in toy quality and safety."

The general manager of the Qiqihar No. 2 Pharmaceutical Company, Yin Jiade, and four other employees are accused of killing patients by using a cheap, fatal substitute ingredient in a drug to treat gall bladder, liver and gastric disorders, the China News Service reported on Thursday.

The tainted medicine killed 13 patients in the southern city of Guangzhou, where the trial began on Wednesday. The same Chinese-made chemical has been linked to dozens of deaths in Panama, where it was used in a cough syrup.

Testimony from the defendants has highlighted abuses that have alarmed domestic and foreign consumers and prompted China to execute the former head of its food and drug watchdog, Zheng Xiaoyu, for taking bribes and dereliction of duty in July.

Most of the staff of the company laboratory had no knowledge of chemistry or any training, lab director Chen Guifen was quoted as saying.

The victims died last year after receiving injections of tainted Armillarisni A, made by the Qiqihar No. 2 which is based in the country's northeast.

More than 5 million doses of drugs made by the company had been recalled nationwide since the scam was exposed in May 2006, state newspapers said.

source : news.yahoo.com

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Health Care "Fat" hormone sheds new light on obesity

The hormone that tells us we are full also regulates our desire for certain foods, researchers said on Thursday, in a finding that sheds light on why people gain weight and could lead to new treatments for obesity. The study showed that patients with a rare genetic disorder who lacked the hormone called leptin ate less after receiving injections of the hormone, said I.S. Farooqi, a researcher at Cambridge University who led the study.

Previous research has shown the hormone does not help people with normal leptin levels lose weight, but scientists still do not completely understand how it works, Farooqi said. "By studying patients who have no leptin and then treating them with leptin, we can tell what it is doing," Farooqi said in a telephone interview. "It gives a clear look at how leptin operates in the brain."

In the study, published in the journal Science, researchers searched for "circuits" in the brain that signal when a person is hungry or full and found that they were linked to areas involved in determining the enjoyment of food. To see how the hormone worked, the researchers showed the patients pictures of different types of food, ranging from tasty fare like chocolate cake and pizza to blander choices such as cauliflower and broccoli.

The patients with the genetic disorder -- of which there are about a dozen known cases in the world -- liked all types of food, ate excessively and were obese, the researchers said.

Using magnetic resonance imaging technology, the researchers tracked the patients' brain activity as they responded to the pictures and pinpointed several key areas that play an important role when it comes to a desire for food.

After the patients received leptin injections, the areas that had previously shown activity all the time at the sight of food were only active if the people had not eaten the night before, which was a normal response, Farooqi said.

It showed desire for food is driven by biology -- not greed -- which causes overeating and obesity, Farooqi said.

Knowing how leptin, which is produced by fat cells, triggers different parts of the brain could lead to new drugs that target obesity and help dangerously overweight people take pounds off.

"If you find those molecules that leptin triggers then you can manipulate or target them with drugs to treat obesity," Farooqi said. "The first step is to work out what leptin does and how it does it."

source : news.yahoo.com

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Health Tip: Risk Factors for Prostate Cancer

Prostate cancer is one of the most common cancers that affect men. While most cases aren't fatal, it is important to understand the risk factors for the disease to help recognize symptoms and begin treatment early.

The U.S. National Cancer Institute lists these potential risk factors for prostate cancer:

• Aging.
• High levels of testosterone.
• A high-fat diet, which may increase the risk. (A low-fat diet rich in fruits and vegetables may help the risk.)
• Blacks are at much greater risk of prostate cancer, whites are at intermediate risk, and Japanese have the lowest average risk.

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Panel worried about baby bottle chemical

A chemical used in plastic baby bottles and other products may affect unborn babies and young children and more study on its safety is needed, a U.S. panel of experts said on Wednesday. The National Toxicology Program Center for the Evaluation of Risks to Human Reproduction convened an expert panel on the effects of bisphenol A, used in clear plastic polycarbonate bottles. Its report will be available later this year, the NTP said.

It said the panel of experts "expressed negligible concern that exposure to Bisphenol A in utero produces birth defects and malformations." But for pregnant women and fetuses, the committee expressed some concern that exposure to Bisphenol A in utero causes neural and behavioral effects.The NTP, part of the National Institute of Environmental Health Sciences, said people can be exposed to the chemical by direct contact or via food or drink that has been in contact with a material containing bisphenol A.

Environmental groups have for years been complaining about the safety of plastic toys, baby bottles and other products containing bisphenol A and pother chemicals known as phthalates.

"(The Center) selected this chemical for evaluation because of (1) high production volume, (2) widespread human exposure, (3) evidence of reproductive toxicity in laboratory animal studies, and (4) public concern," the NTP said in a statement.

Polycarbonate plastics are used in food and drink packaging and resins are used to coat metal products such as food cans, bottle tops, and water supply pipes.

The Juvenile Products Manufacturers Association, which represents the leading manufacturers of baby bottles in the United States, said the panel's brief statement suggested the bottles are safe.

"The Panel's conclusions today reaffirm the safety of plastic baby bottles," said JPMA President Robert Waller.

"These findings validate the Food and Drug Administration's conclusions and the conclusions of governments and independent scientists worldwide that polycarbonate plastic baby bottles are safe."

source : news.yahoo.com

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Calcium supplements ward of pregnancy complication

Pregnant women who take calcium supplements reduce their risk of developing preeclampsia, sometimes called toxemia of pregnancy, according to a new study. However, calcium supplementation has no effect on the risk of preterm birth or stillbirth. Dr. G. J. Hofmeyr, of the University of the Witwatersrand/University of Fort Hare, East London, South Africa, and colleagues conducted a systematic review of 12 clinical trials, involving over 15,500 women, that compared at least 1 gram of calcium daily during pregnancy with an inactive "placebo" supplement.

Most of the women were at low risk for pregnancy complications, but they had low levels of calcium in their diet. Compared with placebo, calcium supplementation was associated with less high blood pressure and less preeclampsia, the investigators report in the British Journal of Obstetrics and Gynecology.No overall effect was seen on the risk of preterm birth or stillbirth or infant death before hospital discharge.

"Calcium supplementation during pregnancy for women with deficient dietary calcium intake offers modest benefit for individual women," Hofmeyr's team concludes.

"However, a public health policy of calcium supplementation during pregnancy is unlikely to have a major impact on the incidence of pre-eclampsia," they continue, because in those communities where dietary calcium is inadequate, high-risk women "often attend antenatal clinics late in pregnancy or not at all and so would not benefit from strategies directed at those attending for antenatal care."

The researchers therefore suggest "that future research be directed towards evaluation of improving calcium intake at a population level, for example by food fortification, rather than at an individual level."

source : news.yahoo.com

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Some children shut out from vaccines

For children whose health insurance doesn't cover newly recommended shots, it's better to have no insurance at all, a new study suggests. Free vaccines are available to children who are uninsured or qualify for public insurance. But many states can't afford to help children with inadequate private insurance that doesn't cover new, expensive shots and even some older shots, the study found. That puts more than a million children at risk, researchers said.

Illinois, for example, doesn't provide vaccines against chickenpox, pneumonia, hepatitis A, human papillomavirus and rotavirus to children with insufficient private insurance. Parents would have to pay $400 out of pocket for those vaccines. "Health insurance plans are not necessarily keeping up with the new vaccines, posing significant ethical dilemmas to public health clinics," said the study's lead author Dr. Grace Lee of Harvard Medical School.

The study of the nation's patchwork system of paying for immunizations appears in Wednesday's Journal of the American Medical Association.

Childhood shots have become a $1 billion-a-year endeavor for government since the discovery of polio vaccine 55 years ago. The per-child cost grew more than sevenfold from $155 in 1995 to $900 for boys and $1,200 for girls this year. Costs in the private sector are higher.

Lee and her colleagues surveyed states to find out which shots they provide and to whom. Program managers from 48 states responded. Lee wouldn't say which states participated because researchers promised anonymity.

Sixteen of the states require health insurers to cover all recommended vaccines.

About 55 million employees and their dependents get coverage through self-insured companies that are exempt from state mandates. Those people are the most likely to be underinsured for vaccines, said vaccine policy expert Dr. Matthew Davis of the University of Michigan.

According to the research, 17 states reported they were unable to give a vaccine for meningitis to children with inadequate private insurance, even if they were seen in public health clinics. And eight states don't give pneumococcal shots to underinsured infants and toddlers.

A handful of states don't provide shots for chickenpox and hepatitis A to the underinsured. Two states don't provide Tdap, the combined booster shot for tetanus, diphtheria and pertussis (whooping cough) for 11- to 12-year-olds.

More than 1 million insured children are unable to get the meningococcal vaccine leaving them vulnerable to potentially deadly infection, the researchers estimated.

The survey did not ask about two vaccines recommended last year: an oral vaccine for infants against rotavirus, a common cause of childhood diarrhea and vomiting, and a vaccine for girls against human papillomavirus, which can cause cervical cancer.

Workers covered by plans marketed by Aetna and other insurance companies generally are covered for childhood vaccines, although they may have to pay co-payments or satisfy deductibles, said Mohit Ghose, a spokesman for America's Health Insurance Plans.

As costs rise, it may be necessary to decide at a national level which vaccines are most important, Davis said. He was not involved in the new study, but wrote an accompanying editorial in the journal.

Officials at the U.S. Centers for Disease Control and Prevention oppose prioritizing vaccines and instead favor better coverage by insurers and more government funding as a safety net, said CDC immunizations director Dr. Lance Rodewald.

source : news.yahoo.com

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Energy drinks' caffeine in line with coffee

Despite such speedy-sounding names as "Full Throttle," "Amp" and "Rush," energy drinks pack a punch that is generally no stronger than coffee, according to a report released on Monday. A comparison of 12 popular energy drinks, published in the September issue of Consumer Reports, found that the caffeine in 8 ounces of various brands ranged from 50-145 milligrams (mg), though most were in the 75- to 80-mg range.

Results were rounded to the nearest 5 mg. By comparison, the caffeine in an 8-oz cup of brewed coffee can range from 65-120 mg, with an average of 85 mg, according to the National Coffee Association. The least-caffeinated energy drink Consumer Reports tested was the fruit punch-flavored offering by Target Corp.'s private label Archer Farms, with 50 mg. At the high end was the lemon-lime flavored Celsius with 145 mg.

Market-leading Red Bull had 80 mg of caffeine. Sobe No Fear, owned by PepsiCo Inc., had 85 mg of caffeine. Amp had 75 mg of caffeine, while Rush and Coca-Cola Co.'s Full Throttle both had 80 mg.

Jamie Kopf Hirsh, associate editor at Consumer Reports and the report's author, said it was "good news" that energy drinks were not much more caffeinated than coffee, but said consumers should still be cautious.

Even though 8 ounces is the standard serving size for measuring, most containers have more than that, and most consumers drink more than that.

"You don't have to be alarmed by this, you just have to account for it in your daily caffeine intake," Hirsh said, adding that energy drinks, with their graphic video-game-like logos that appeal to young men, could be "coffee for the new generation."

source : news.yahoo.com

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Coffee may slow memory declines in women

Drinking more than three cups of coffee a day helped protect older women against some age-related memory decline, French researchers said on Monday, giving women more reason to love the world's most popular stimulant. Men did not enjoy the same benefit, they said. "The more coffee one drank, the better the effects seemed to be on (women's) memory functioning in particular," said Karen Ritchie at the French National Institute of Medical Research, whose work appears in the journal Neurology.

The researchers followed more than 7,000 men and women in three French cities, checking their health and mental function and asking them about their current and past eating and drinking habits, their friends, and their daily activities. They used this information to sort out the specific role caffeine played in these women's lives.

They found that women who drank more than three cups of coffee per day, or its caffeine equivalent in tea, retained more of their verbal and -- to a lesser extent -- visual memories over four years.

These women had a 33 percent lower odds of having verbal memory declines and 18 percent lower odds of having visual and spatial memory declines, compared to women who drank one cup or fewer per day.

The effect also depended on age, with women over 80 reaping more benefits from these beverages than those who were 10 to 15 years younger, Ritchie's team wrote. It was unclear whether current or former coffee consumption made the difference.

Some studies in mice have suggested that caffeine might block the buildup of proteins that lead to mental decline.

Ritchie is not sure why only women benefited in her study.

"Our best guess is that women don't metabolize coffee in the same way (as men)," she said in a telephone interview.

Ritchie plans to follow the women longer to see if caffeine delays the onset of dementia -- the mental confusion that signals Alzheimer's disease and other brain disorders.

She said people should weigh any brain gains derived from caffeine against other effects of the stimulant, including raised blood pressure.

The average American drinks one to two cups of coffee a day, according to the National Coffee Association.

source : news.yahoo.com

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Two-Drug Combo Tough on Kidney Cancer

Kidney cancer might have met its match in a new combination of cancer drugs, a new study shows. Used together, interferon alpha, a drug that boosts the body's ability to fight off tumors and infections, and sorafenib, a drug that cuts off a tumor's blood supply, led to significant tumor shrinkage in 33 percent of patients in a U.S. pilot study.

"We found that by combining a drug that enlists the immune system's help in combating cancer with one that cuts off a tumor's blood supply, we could substantially increase patients' response rates to treatment," lead investigator Dr. Jared Gollob, of the Duke Comprehensive Cancer Center in Durham, N.C., said in a prepared statement. Used alone, each drug is only successful in fighting 5 percent to 10 percent of tumors. But the new study finds that the combination works much better. Sorafenib is sold under the brand name Nexavar. The drugs had an additional benefit, the researchers said, in that the combo therapy doubled the time before tumors began to grow again. According to Gollob, most tumors begin growing again after about five or six months when treated by either drug alone.

Reporting in the Aug. 1 issue of the Journal of Clinical Oncology, Gollob and his research team gave 40 study patients sorafenib in pill form twice daily and interferon alpha injections three time a week for eight weeks. If the patient's tumor had not grown or had shrunk after eight weeks, they repeated the cycle after a two-week break until the tumors disappeared or the cancer got worse. The researchers monitored the tumors using computerized-tomography (CT) scans.

The approach completely destroyed tumors in two of the 40 patients.

Researchers plan to begin a multi-site clinical trial that will analyze the impact of giving patients increasing doses of sorafenib alone after their tumors have shrunk as much as possible on the combination treatment.

According to the U.S. National Cancer Institute, about 51,000 people suffer from kidney cancer every year, and almost 13,000 will die from the disease. The majority of patients are men over the age of 45. The cancer is especially deadly, because it very rarely causes symptoms until it has reached an advanced stage. By the time kidney cancer rates stage IV status, it has spread to other organs such as lungs, liver and bones. People are given six months to two years to live once they reach stage IV, and only about 10 percent are alive five years after diagnosis.

The Duke team noted that one of the biggest challenges facing doctors and patients with kidney cancer is the cancer's resistance to chemotherapy, radiation and other common cancer-fighting tools.

source : news.yahoo.com

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Gene therapy treatment offers Parkinson's relief

Two studies published on Thursday offer new hope for Parkinson's disease -- one using gene therapy to treat the symptoms and another investigating a drug that might stop the incurable disease in its tracks.

While both are in early experimental stages, each takes a new approach to treating the devastating brain condition, which affects millions of people globally.

In the gene therapy trial, Dr. Michael Kaplitt of New York-Presbyterian Hospital/Weill Cornell Medical Center and colleagues used a harmless virus called an adeno-associated virus to carry a new gene into the brains of 11 volunteers with advanced Parkinson's disease.

They found it had no ill effects and appeared to reduce their symptoms, and the benefits lasted for four years in some.

"These exciting results need to be validated in a larger trial, but we believe this is a milestone -- not only for the treatment of Parkinson's disease, but for the use of gene-based therapies against neurological conditions generally," Kaplitt said in a statement.

The idea behind gene therapy is to replace faulty genes or augment the activity of beneficial genes. In the past the approach has had mixed success. In one trial in 1999 one patient died, while in another two people developed leukemia as a result of such treatment.

In the latest attempt, the gene that was delivered to the Parkinson's patients controls production of an enzyme called GAD or glutamic acid decarboxylase. GAD controls a neurotransmitter or message-carrying chemical called GABA.

GABA calms overactive neurons, and its production is lost in Parkinson's. This helps cause some of the jittery and shaky movements that mark the disease.

Writing in the Lancet medical journal, the researchers said their volunteers had about a 27 percent improvement in symptoms.

"Because this was the first such study of its kind, we targeted just one side of the brain initially out of concerns for the patients' safety," Dr. Matthew During of Ohio State University, who worked on the study, said in a statement.

Brain scans showed a change in brain cell activity on the treated side of the brain, he said.

The researchers have formed a company called Neurologix, based in New Jersey, to develop the treatment.

In another study, published in the journal Science, a team at Massachusetts General Hospital and Harvard Medical School said they had designed a drug that can protect the neurons damaged in Parkinson's disease.

The drug blocks the action of an enzyme called SIRT2, a member of a group of enzymes called sirtuins, which are involved in the aging process.

"By inhibiting SIRT2 we protect neurons from cell death," Aleksey Kazantsev, who led the study, said in a telephone interview.

They have tested their drug in lab dishes and in fruit flies, which can be engineered to develop a condition highly similar to Parkinson's in humans.

The researchers are also testing their approach in other brain diseases, including Huntington's and Alzheimer's.

Current drug treatments for Parkinson's all eventually stop working. Electronic stimulation is still experimental, although it may help, and researchers are also testing ways to transplant new brain cells into patients.

source : news.yahoo.com

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Eritrean custom stronger than law on cutting girls

For 3-year-old Amira, a law banning female genital mutilation in Eritrea came too late.

Wrapped in an orange traditional dress, Amira's mother, who gives her name only as Gerejet, says she circumcised the child to please her future husband.

"It was the culture that we have taken from our grandmothers, but we also do it for the pleasure of the men," the 30-year-old told Reuters in a small village west of the Eritrean capital.

Like Gerejet and Amira, some 100 million women worldwide have been circumcised, a procedure that at its most extreme involves cutting off the clitoris and external genitalia then stitching the vagina to reduce a woman's sexual desire.

Eritrea banned female genital mutilation (FGM) in April. The government has warned anyone taking part in or promoting the practice faces a fine of several hundred dollars or up to 10 years in jail.

Government officials are optimistic the law will force a change in attitudes but others worry the practice is too ingrained for legal threats to have much impact. About 90 percent of Eritrean woman have undergone the ordeal.

"FGM is a deep-rooted culture and it needs a persistent continuous effort (to halt it)," Luul Ghebreab, president of the National Union of Eritrean Women, told Reuters.

The U.N. Children's Fund,
UNICEF, says Eritrea ranks amongst the worst in the world for FGM and a survey by Eritrea's government in 2002 found less than one percent of circumcisions were performed by trained health professionals.

Pirkko Heinonen, the UNICEF representative in Eritrea, says the practice spans Christian and Muslim communities as well as all nine of Eritrea's ethnic groups.

"But we have come to a turning point. It was the exception not to be cut but I think in the younger age group, it is the exception to be cut," she says.

Sitting inside her thatched-roof house, Gerejet believes Eritrean women will welcome the new law. She had circumcised her daughter because no man would marry a girl unless she was cut.

"But nothing will happen to another daughter if she is not cut," Gerejet says in Hagaz, 100 km (62 miles) from Asmara. "We thank God the law was issued. At least the pain will stop."

THE CIRCUMCISER

Government officials say the law banning the practice is only part of a long process of public education dating since Eritrea's 30-year independence struggle from Ethiopia.

"Eritrea is easily manageable, there is a chain system, a village level, the sub-zone, the zonal level. We can control it," said Tesfay Misgna, a health ministry campaigner.

Tesfay said communities have taken a lead in banning the practice: "The legal issues are very vital, because some people need them. But even some villages made their own laws before the government made it."

"By the year 1999, it was 95 percent and then 2003, it was 89 percent. Nowadays we hope it will be less that this."

Meriam Mohamed Omar, a former circumciser, pulls the fabric of her purple dress to mimic external genitalia and sticks a small needle through it.

"I used to use a thin stick from a palm tree. You hold the genitalia in two then cut it," she says.

Meriam says she stopped the practice four years ago after learning of the consequences for a girl. Some 3 million girls are afflicted globally each year, according to the
United Nations.

"Most of the time she suffers the pain when she is giving birth, but also during sex," Meriam says.

The United Nations says circumcised women are up to 70 percent more vulnerable to potentially fatal bleeding after delivery. Up to 20 out of every 1,000 babies born in Africa die because their mothers were circumcised.

Aid workers say cultural traditions will be the biggest barrier to eradicating female circumcision. Across the riverbed from Hagaz in the village of Glass, residents say the practice still goes on.

"The people just say they accept (the law), but they really don't," one resident says. Heinonen says the new law is a milestone in the process and agrees there is still much to do.

"It is a very difficult thing to do to your family when you are one of the first ones to stop it," she says.

"It is based on a real fear that if I do not let my daughter to be cut, is she going to be seen as a prostitute?"

source : news.yahoo.com

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FDA Seeks Strictest Warning for Diabetes Drugs

The U.S.Food and Drug Administration has asked that two controversial type 2 diabetes drugs carry a "black box" warning on the potentially heightened risk of congestive heart failure in some patients.

In prepared testimony before a Congressional committee that was convened Wednesday following a published report on the cardiac dangers of Avandia, FDA Commissioner Dr. Andrew von Eschenbach said the agency had asked that Avandia, made by GlaxoSmithKline, and Actos, made by Takeda Pharmaceuticals, carry the more prominent warning because "despite existing warnings, these drugs were being prescribed to patients with significant heart failure."

According to von Eschenbach's testimony, the request for the warning -- the strictest one possible -- was issued to both companies May 23, two days after publication of a study in the New England Journal of Medicine that found Avandia (rosiglitazone) increased the risk of heart attack by as much as 43 percent.

But the decision to request the heightened warning wasn't made public until von Eschenbach's appearance before the House Committee on Oversight and Government Reform, which is reviewing the FDA's role in the Avandia controversy.

The May 21 Avandia study was led by Dr. Steven Nissen, a Cleveland Clinic cardiologist who was among the first to warn about the heart risks posed by the now-banned arthritis drug Vioxx.

Following the release of the NEJM study on Avandia, the FDA issued a safety alert, but stopped short of asking for a stronger warning label, saying more analysis was needed.

"The Food and Drug Administration is aware of a potential safety issue related to rosiglitazone," Dr. Robert J. Meyer, director of FDA's Office of Drug Evaluation II, said during a May 21 teleconference. But, he added, "At this point, we have not reached a definitive conclusion on the data. We don't feel there is consistent enough data to make a decision from a regulatory standpoint. We are not ready to make an action."

On Tuesday, results of a British study, funded by GlaxoSmithKline, were released and showed no significant increased risk for heart attack or death from heart disease associated with Avandia.

The study, which was released early by the New England Journal of Medicine to coincide with the House hearing, also found no increased risk for cardiac events among diabetics taking Avandia and those not taking it.

"Overall, there was no significant difference between those on rosiglitazone and those not on rosiglitazone," study co-author Stuart J. Pocock, of the London School of Hygiene & Tropical Medicine, said Tuesday. "The concern about cardiovascular death, I think, we have clearly deflated. The concern on heart attack -- our data are modifying that concern, but it's still inconclusive."

But one expert pointed out Tuesday that the original goal of the new study was to show a benefit of rosiglitazone in preventing heart disease.

"When you get a finding that is against the hypothesis, it makes me sit up and take note," said Dr. David M. Nathan, of Massachusetts General Hospital, and author of an accompanying editorial in the journal. "None of the data is reassuring. You don't give the drug the benefit of the doubt -- you give safety the benefit of the doubt."

And another expert, Dr. Bruce M. Psaty, who wrote a second editorial in the journal, said Wednesday of the Avandia findings, "I combined the results from this study with the study by Nissen, and there was still a 33 percent increase in risk of a heart attack."

Psaty, of the University of Washington in Seattle, also testified at Wednesday's House hearing.

Afterwards, he said that the FDA needs to have a "black box" warning about heart attack risk, not just heart failure risk, which he said has been known for a long time.

"It sounds like the FDA has had this data on heart attack risk since 2005," he said. "In Europe, the label was revised back in September."

Psaty added that the FDA needs to mandate post-marketing studies to uncover safety problems.

"You need a drug safety system that is complementary to the rapid approval system that we have in place," Psaty said. "What we are seeing with Avandia and Vioxx is the fallout of the system where you sped up approval and did not do anything to test safety."

Meanwhile, the FDA announced Wednesday that an advisory panel will meet on July 30 to weigh the cardiovascular risks of the class of diabetes drugs that includes Avandia.

In response to that announcement, the Cleveland Clinic's Nissen said in a prepared statement: "We published our meta-analysis on the cardiovascular safety of Avandia because we felt it was our obligation to alert the medical and patient community to a potentially serious drug safety problem and urged comprehensive evaluations to clarify the risks."

He added, "We encourage a lively scientific debate about these issues and look forward to the results of the FDA advisory board hearings in July. During today's congressional hearings, we learned that meta-analyses conducted by the FDA and GlaxoSmithKline showed similar results to our findings. We would like to see those analyses published in peer-reviewed journals so that the totality of information on the cardiovascular safety of Avandia is available to doctors and patients."

Also Wednesday, Takeda Pharmaceuticals announced that it would add the boxed warning requested by the FDA to prescription labels for Actos (pioglitazone).

Dr. Robert Spanheimer, the company's senior medical director for diabetes and metabolism, said in a prepared statement, "Takeda remains confident in the safety and efficacy of Actos when used according to its label, and with this revision, we can heighten patient and physician awareness of an already known, but serious side effect."

On Tuesday, GlaxoSmithKline had issued a prepared statement saying that the British study should reassure type 2 diabetes patients that Avandia was safe.

"They [the findings] add to the weight of evidence, from both previously published long-term clinical trials and other studies, that the overall ischemic cardiovascular safety profile of Avandia is comparable to the traditional anti-diabetes treatments. Patients and physicians should find these data reassuring," said Moncef Slaoui, the company's chairman for research and development.

In response to the growing controversy over Avandia's safety profile, the American Diabetes Association on Wednesday issued an advisory statement.

"As a result of all of this information, the American Diabetes Association strongly encourages patients taking this medication to consult with their physician as to its benefits and risks," the statement read. "The Association also reminds patients, however, that they should not stop taking any prescribed medications without first discussing the issue with their health-care provider."

source : news.yahoo.com

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