Panel Aspirin adds to colon cancer risk

Tue, 06 Mar 2007 01:26:13 GMT
By RON TODT, Associated Press Writer
PHILADELPHIA - People at average risk for colon cancer shouldn't take aspirin or painkillers like ibuprofen to try to prevent the disease, a federal task force advises, because of the risk of bleeding and other potential health problems. The recommendation for the first time by the U.S. Preventive Services Task Force includes those with a family history of colorectal cancer.
The panel said that potential risks of taking more than 300 milligrams a day of aspirin or non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen — brand names include Motrin, Advil and Aleve — include a higher risk for stroke, intestinal bleeding or kidney failure.

Those risks outweigh the potential benefits of preventing cancer, the task force said in Tuesday's issue of the Annals of Internal Medicine. The task force said that while there is good evidence that low doses of aspirin, usually less than 100 milligrams, can reduce the risk of heart disease, it does not lower the rate of colon cancer.

Colorectal cancer is the third most common type of cancer in men and women and is the second-leading cause of cancer-related deaths in the United States, killing about 56,000 people each year. About 150,000 new cases are diagnosed annually.

Most of those diagnosed are over the age of 50, and 20 percent have a parent, sibling, grandparent, aunt or uncle with the disease. Blacks have the highest rate of colorectal cancer of any group.

In 2002, the Preventive Services Task Force recommended that people age 50 and older be screened for colon cancer.

Previous studies had suggested that a daily baby aspirin could prevent precancerous polyps that sometimes become colorectal cancer. But later research showed low-dose aspirin did little good at actually preventing cancer.

Dr. Raymond DuBois, director of the Vanderbilt-Ingram Cancer Center in Tennessee, said he believes the task force's latest advice is reasonable.

"I think for the general population, the risk of either having some gastrointestinal bleeding from aspirin or cardiovascular side effect from some of these other medications ... probably outweighs their use for colon cancer," he said.

____

On the Net:

Annals of Internal Medicine: http://www.annals.org

Norovirus hits N.J. college campus

Tue, 06 Mar 2007 01:03:30 GMT

FLORHAM PARK, N.J. - Fairleigh Dickinson University's Florham Park campus was recovering Monday from a suspected norovirus outbreak that has sickened at least 124 students, school officials said.
Students began falling sick Thursday, university spokesman Art Petrosemolo said. Twenty students were treated at a hospital and released last week and over the weekend. Others visited the health center. An undetermined number of faculty and staff members also were sickened, Petrosemolo said.

A dozen new cases were reported Monday, said Florham Park health officer Dr. George Van Orden.

"We have seen a decrease over time, so hopefully the controls are working," he said.

Cleaning crews were sent into dormitory bath rooms and dining halls, and the recreation center and pool were shut down for 24 hours for cleaning. Hand sanitizer was distributed at the library, computer labs and the dining hall, and students were urged to wash their sheets in hot water, Petrosemolo said.

The 24-hour virus is spread person-to-person and causes flu-like systems including nausea, vomiting and diarrhea.

Test results later this week should confirm the cause of the outbreak, Florham Park health officials said.

The campus has about 2,200 undergraduate and 1,500 graduate students.

Experts want new definition of torture

Tue, 06 Mar 2007 01:25:02 GMT
By WILLIAM J. KOLE, Associated Press Writer
Prisoners who endure poor or degrading treatment suffer much of the same long-term psychological distress as do captives who are tortured, suggests a study published Monday.
The study was based on interviews with victims of ill treatment and torture while imprisoned in the former Yugoslavia, and experts said the findings underscored the need for a broader definition of torture.

"What is the basis for the distinction between torture and other cruel and degrading treatment? Science should inform this debate," the study's lead author, Metin Basoglu of the Institute of Psychiatry at King's College in London, told The Associated Press in a telephone interview. The study was published in the Archives of General Psychiatry.

Steve H. Miles of the University of Minnesota's Center for Bioethics, who was not involved in the study, said the findings "show that the severity of long-lasting adverse mental effects is unrelated to whether the torture or degrading treatment is physical or psychological."

"The wrongness of these inflicted harms is compounded by the fact that most abused prisoners, including those in the present war on terror, are innocent or ignorant of terrorist activities," Miles said.

The Bush administration has said the U.S. uses legal interrogation techniques — not torture — to gain information that could head off terror attacks. It insists that the U.S. complies with the U.N. Convention Against Torture.

Yet Washington's definition of torture, as interpreted by the U.S. Justice Department after reports of American abuses at Guantanamo Bay and in Iraq and Afghanistan surfaced, is fairly narrow.

It excludes mental pain and suffering created by acts that do not cause severe physical pain, such as blindfolding, hooding, forced nudity, isolation and deprivation of sleep or light, the researchers said, citing a Dec. 30, 2004, Justice Department memo. The document also contends that for an act to be considered torture, there must be proof that it inflicts "prolonged mental harm."

"The implications of such a narrow definition of torture have raised serious concerns in the human rights community," said the study. "These findings suggest that physical pain per se is not the most important determinant of traumatic stress in survivors of torture."

The study involved interviews with 279 victims who suffered ill treatment and torture while imprisoned in the 1990s in the former Yugoslavia.

The researchers said they found that aggressive interrogation techniques, humiliating treatment, verbal abuse, threats against a captive's family and being forced to watch an acquaintance being tortured produced much of the same long-term mental trauma as physical torture.

"Sham executions, witnessing torture of close ones, threats of rape, fondling of genitals and isolation were associated with at least as much if not more distress than some of the physical torture stressors," they wrote.

Such experiences were just as likely as physical torture to lead to depression or post-traumatic stress disorder, the study said.

"Ill treatment during captivity ... does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause," it concluded. "These procedures do amount to torture, thereby lending support to their prohibition by international law."

Shukrije Gashi, a pro-independence activist in Kosovo, was jailed by Yugoslav authorities in 1983 and spent nearly two years as a political prisoner. Strictly speaking, she wasn't tortured, but 2 1/2 decades later it still feels that way, she says.

Gashi was confined to a cramped, unventilated cell and fed small rations of often-rotten food. Allowed to shower just once a month, she endured frequent beatings and verbal abuse.

Today, she still trembles whenever she sees the police. Her ordeal, she says, is "a spiritual burden that stays with you forever."

Gashi copes by writing poetry and running a center for conflict management.
But 24 years later, she still can't erase the indelible memories of what she endured.
"The treatment in prison was horrific," she said. "I remain psychologically burdened. Memories of the violence follow me like a shadow."
___
Associated Press Writer Garentina Kraja in Kosovo contributed to this report.

Vaccine may treat many bird flu strains

Tue, 06 Mar 2007 01:25:31 GMT
By MARIA CHENG, AP Medical Writer
LONDON - A potential flu pandemic vaccine based on one strain of the H5N1 bird flu works against other versions of the virus as well, the vaccine's manufacturer said Monday.
GlaxoSmithKline PLC announced new study results showing that even though their pre-pandemic vaccine uses an H5N1 strain from Vietnam, it reacts against the Indonesian version of the virus. The vaccine was developed with an adjuvant exclusive to GlaxoSmithKline. Results proved the adjuvant could increase the number of vaccine doses by 10 times, which would be crucial in a pandemic situation, when demand would far outstrip supply.

One GlaxoSmithKline study measured the levels of antibodies in 400 adults, after some of them were given two shots of the vaccine. People inoculated with the vaccine tested had strong antibody levels that could potentially fight off the H5N1 Indonesian virus in addition to the Vietnamese virus.

While encouraging, this is not the first time that cross-protection has been seen. Other companies, such as Novartis SA and Sanofi Aventis have previously reported similar results. More than a dozen companies worldwide are working on potential flu pandemic vaccines.

"These results are good news, but we're still in the early days and we don't really know which of the vaccine formulations are the better ones," said Dr. Alan Hay, director of the World Health Organization's Collaborating Center laboratory in Britain. Many basic questions regarding H5N1 vaccines remain unanswered, such as the exact threshold of antibodies necessary for protection.

But the broader a vaccine's protection, the more useful stockpiles might be, since it is unknown which virus might spark the next flu pandemic. Experts believe H5N1 is the most likely candidate to mutate into a pandemic virus, but another flu subtype could ultimately be responsible. To date, H5N1 has killed at least 167 people worldwide.

If a vaccine protects against different H5N1 strains, people could theoretically be pre-vaccinated before getting a booster shot with a new formulation containing the pandemic strain, once the global outbreak strikes. A study last year found that people vaccinated with a bird flu shot using the 1997 H5N1 Hong Kong strain had an immune advantage when given another H5N1 vaccine based on the Vietnam strain, seven years later. This "prime and boost" principle could save the lives of doctors, nurses, and other first responders in a global flu outbreak.

"This anticipated protection is still hypothetical," cautioned Dr. Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research. Authorities must weigh the risks of immunizing healthy people with a vaccine that has unknown side effects.

Still, if scientists can create an H5N1 vaccine that fights other versions of the virus, resolving the continuing virus stand-off between Indonesia and WHO — Indonesia refuses to share samples unless WHO agrees to certain conditions — could be less important.

But that would hardly be ideal. "If we had a vaccine that protected against all H5 viruses, maybe we wouldn't care about what new isolates there might be," said Dr. John Treanor, a vaccines expert at the University of Rochester. "But we're not at that point yet," he said. "We don't know enough about H5N1 and we need to keep a very close eye on it."

Recurrent Chlamydia common in young women

Tue, 06 Mar 2007 00:55:31 GMT
NEW YORK - Nearly 30 percent of women in their late teens suffer recurrent infection with Chlamydia, a rate higher than previously recognized in this population, new research shows.
Recurrent bouts of Chlamydia "comprise a substantial health burden among young women," Dr. Linda M. Niccolai, from Yale University in New Haven, Connecticut, and colleagues note. Their findings, they say, suggest that enhanced efforts to prevent recurrent Chlamydia infections in young women are "urgently needed."

The findings, which appear in the Archives of Pediatrics and Adolescent Medicine for March, stem from a study of 411 young women between the ages of 14 and 19 years old who visited one of 10 community-based health centers that provided reproductive healthcare between June 1998 and September 2001.

The women were evaluated at the first visit and 6, 12, and 18 months later. A subset of 386 women was followed long term.

During an average follow-up of 4.7 years, 52.6 percent of subjects were diagnosed with Chlamydia trachomatis infection. A total of 123 women or 29.9 percent of the total sample had recurrent infections.

Roughly half of all Chlamydia infections diagnosed were recurrent and the median time to recurrent infection was 5.2 months, the authors note.

Prevention counseling, behavioral interventions, promotion of regular condom use, and innovative partner treatment strategies are some of the ways of potentially reducing recurrent Chlamydia infections among young women, the authors say.

Chlamydia is the most common sexually transmitted disease among women and often causes no symptoms. The bacterial infection can lead to a whole host of problems including pelvic inflammatory disease, ectopic pregnancy and infertility. It can also make a woman more likely to acquire or pass on the virus that causes AIDS.

SOURCE: Archives of Pediatrics and Adolescent Medicine, March 2007.

Study measures harm of stress on childrens health

Mon, 05 Mar 2007 21:16:48 GMT
By Will Dunham
WASHINGTON - Children in families facing chronic stress such as conflict between parents or violence in the home become sick more often than children under less stress, according to a study published on Monday.
Researchers led by Dr. Mary Caserta at the University of Rochester Medical Center in Rochester, New York, tracked the incidence of fevers in 169 children ages 5-10 from diverse racial and socioeconomic backgrounds.

The researchers said the reason why children from stress-filled families experienced fevers more often was unclear -- and another of their findings was a bit surprising.

While one might have expected that the immune systems of the children under chronic stress might be suppressed as they are in adults, the opposite appeared to be the case. Blood samples showed that these children had stronger functioning of certain key cells in the immune system, the study found.

The researchers were seeking a greater understanding of the effect of chronic stress on children's health.

"I think people on the street believe this unflinchingly -- stress makes you sick," Caserta said in an interview, but she wanted the study to put this to the test.

Parents of the children in the study tracked chronically stressful events in the family and their own symptoms over the course of the study, kept a diary on the health of their kids, and were given digital thermometers.

Conflict in the household, parental anxiety and depression, parental poverty and unemployment, and violence in the home or neighborhood were among these stressful conditions.

Fever was chosen as a benchmark of illness because it is easily measured and not judged subjectively. "As a infectious disease physician, I really like measurements of temperature because they're very objective," Caserta said.

The study, published in the journal Archives of Pediatric and Adolescent Medicine, found that the children under stress experienced more fevers than other children.

The researchers now hope to figure out specifically which types of stress increase the frequency of illness, and what biological processes control susceptibility to infections, which cause fevers.

"We really have to get at the mechanisms and what is going on and accounting for these increased illnesses," Caserta said.

Previous studies primarily involving older adults showed that chronic stress drives down the function of immune system cells called natural killer, or NK, cells. But this study yielded a counter-intuitive result in children.

"We found that the highest-stress kids had the highest amount of NK cell function," Caserta said.

Caserta said more research is needed to figure out what is causing this, but added that it could be because the children's immune systems are still developing.

Bad air quality speeds HK elderly to hospital study

Tue, 06 Mar 2007 10:34:51 GMT

HONG KONG - Hong Kong's air pollution is causing higher hospitalization of elderly patients with chronic bronchitis, an academic study has found, and experts on Tuesday called for urgent improvements in the city's air quality.
The study by the Chinese University in Hong Kong is the latest to link the city's worsening air quality to public health.

Frequent bad-haze days now cloak views of Hong Kong's harbor, damaging public health.

The study found a correlation between air pollution and hospital admissions for people over 70 years old suffering from chronic obstructive pulmonary disease otherwise known as chronic bronchitis.

For every 10 micrograms per cubic meter increase in polluting microscopic particulates known as PM 2.5, there was a 3.1 percent rise in the hospitalization rate for elderly patients.

Significant associations were also found between hospital admissions and other air pollutants like nitrogen dioxides, sulphur dioxide and especially ozone.

"With better air quality, perhaps we can decrease the morbidity of the elderly population, or at least the morbidity of COPD patients," said Fanny Ko, a specialist in respiratory medicine at the Chinese University, who called for urgent government action to clean up the city's choked skies.

While chronic bronchitis is caused mainly by smoking, its symptoms, including shortness of breath, can be exacerbated by poor air quality.

COPD was Hong Kong's No. 5 cause of death in 2004, afflicting some 9 percent of the elderly population who averaged 23,845 hospital visits per year for the period 2000-04.

Hong Kong's coal-fired power stations are blamed as the city's worst polluters, but increasing emissions also blow across the border from factories in southern China.

More obese adolescents turning to surgery

Tue, 06 Mar 2007 00:29:39 GMT

NEW YORK - In the current decade, there has been a dramatic increase in the number of obese adolescents having surgery to help them lose weight, although weight loss surgery remains an uncommonly performed procedure in young people.
According to a report in the Archives of Pediatrics and Adolescent Medicine this month, the number of morbidly obese 10- to 19-year-olds who had weight loss surgery varied little between 1996 and 2000 but more than tripled from 2000 to 2003.

Despite this trend, only 771 weight loss surgeries were performed in adolescents in 2003, representing less than 0.7 percent of so-called "bariatric" procedures performed nationwide, Dr. Randall S. Burd from the University of Medicine and Dentistry of New Jersey in New Brunswick and colleagues report, based on an analysis of U.S. hospital inpatient data.

Because of the small number of weight loss surgeries performed in adolescents, "there are little data that can be used to judge the risks and benefits of surgical weight loss for teenagers," the authors note.

While the health benefits of weight loss surgery in adolescents are "increasingly" being documented in single-center and multicenter studies, accurate information about "lower frequency outcomes" such as complications and death are not yet available, they add.

From the data Burd's team analyzed, it seems that early complications - those that occur while the patient is still in the hospital -- are relatively low in teens and mirror those seen in adults who have the procedure. Adolescents also tend to spend less time in the hospital following the procedure, the investigators noticed.

And while national data suggest a procedure-related death rate of 0.2 percent for adults having weight loss surgery, Burd's team says no early deaths have been recorded among adolescents who had the surgery.

As is the case with adults, most adolescents had a type of weight loss surgery called gastric bypass, which shrinks the size of their stomachs. Most were covered by private health insurance. In contrast to adults, more boys than girls had the surgery.

Burd's team warns that the low number of adolescents having weight loss surgery suggests that many may have the procedure at hospitals with limited experience with this age group.

Efforts to align weight loss surgery programs for adolescents initially with higher volume programs for adults are needed, they conclude, as are studies to get a better handle on the short- and long-term effects of this surgery on morbidly obese adolescents.

SOURCE: Archives of Pediatrics and Adolescent Medicine, March 2007.

teenhealth

Study measures harm of stress on childrens health

U.S. proposes rules to cut train ship emissions

Fri, 02 Mar 2007 20:39:40 GMT
By Timothy Gardner
NEWARK, New Jersey - The United States proposed new regulations on Friday that would slash diesel particulate emissions, linked to lung cancer, from trains and ships by 90 percent over the next several years.
The regulations, which would include stricter manufacturing standards, use of emissions technology and cleaner fuels, would begin to roll out in 2008, with final rules hitting in 2015, the Environmental Protection Agency said. Emissions from the sources of smog component nitrogen oxide would also be cut.

"By tackling the greatest remaining source of diesel emissions, we are keeping our nation's clean air progress moving full steam ahead," EPA Administrator Stephen Johnson told reporters at a bustling commercial port in New Jersey.

Tiny soot particles from sources including diesel engines can cause lung cancer, asthma, and heart problems, according to peer-reviewed studies.

The move pleased several environmental organizations.

"This puts the nation on the right side to save hundreds of lives a year and deliver savings of billions of dollars in terms of health benefits," Fred Krupp, president of green group Environmental Defense, told reporters at the port.

"It's the rare instance in which the Bush administration is actually proposing something really good for the environment," said Frank O'Donnell, president of nonprofit Clean Air Watch in a statement.

The Natural Resource Defense Council applauded the EPA, but said the country's largest locomotive maker, General Electric Co., could try to soften the rules on nitrogen oxide emissions before they are finalized.

The manufacturing conglomerate sent a letter to EPA late last year saying it would support a more relaxed standard for that pollutant. GE did not immediately return calls.

Johnson said the program would cost industry about $600 million in 2030 but result in health care savings of $12 billion by that time.

The proposals to cut emissions from diesel-powered U.S. ships and trains come on top of federal laws, passed during the Clinton presidency and which took effect in 2006, requiring diesel-engine trucks and cars to use fuel with sharply lower sulfur content. New trucks are also required to add diesel particulate filters which combined with the cleaner fuels cut particulate emissions by 90 percent.

U.S. ships and trains, which would account for the bulk of diesel soot pollution by 2030 if the rules did not go into effect, will start using the ultra-low sulfur diesel fuel by 2012.

Raymond Werner, EPA's chief of air programs in New York, said issuing the proposed rules helps oil refiners prepare to boost production of the clean fuel over coming years.

The rules would call for old locomotives to start using new emissions technology between 2008 and 2010, and newly manufactured train and ship engines to apply the standards starting in 2009.

The rules for ships apply to U.S.-flagged or U.S.-registered vessels, but not long-haul commercial liners, the EPA said.

By 2014, marine diesel engines would be required to use new highly efficient catalytic converters, with locomotive diesel engines following in 2015, the EPA said.

The EPA said the proposals were formed with input from railroad CSX Corp., GE, Caterpillar Inc. and Environmental Defense. It hopes to finalize the rules by the end of the year.

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