Mexican boy lands in Ark. for new heart
Fri, 20 Apr 2007 02:40:34 GMTBy JON GAMBRELL, Associated Press Writer
LITTLE ROCK, Ark. - After more than 60 days in a Texas hospital's intensive care unit, an 8-year-old Mexican boy arrived Thursday in Arkansas with the hope of finding a replacement for his diseased heart.
Adrian Flores Saucedo and his mother flew by jet from San Antonio, where he been at Methodist Children's Hospital of South Texas. Residents of the Texas city raised about $500,000 for the boy, who suffers a viral infection that is eating away at his heart tissue.
"In many children, it just gives you a common cold, but in certain settings, it will cause an inflammation of the heart," said Dr. Elizabeth Frazier, head of the cardiac transplantation program at Arkansas Children's Hospital. "It permanently damages the heart muscle; it actually kills the heart muscle."
Arkansas Children's Hospital agreed to accept Adrian after several hospitals rejected him as a patient. The Little Rock hospital's 25-bed heart unit already has more patients than beds after also taking in cases from Louisiana in the wake of Hurricane Katrina. But Frazier said admitting the boy wouldn't put too much strain on their program.
Palmira Arellano, a spokeswoman for Methodist Children's Hospital, said no hospitals in San Antonio do heart transplants for children and she didn't know why other U.S. hospitals rejected Adrian. But she acknowledged that concerns for transplants extended beyond simply saving a child's life, but also whether Adrian could receive adequate care and medication on his return to Mexico.
Currently, the boy and his family are in the United States on a humanitarian visa, but they plan to return home if Adrian receives a new heart, which could take days or spill over into months.
Frazier said a doctor who cares for transplant patients in Monterrey, Mexico, more than 200 miles from the boy's home in Piedras Negras, would provide follow-up visits for the boy if he receives a heart transplant. Piedras Negras is about 140 miles from San Antonio.
"We will work with the Mexican government, which had already contacted us and will support him in whatever way is needed, be it financial, transportation, visas or whatever is required," Frazier said. But San Antonio and "the whole community had gone above and beyond for this child and his family and they were really running into blocked doors."
After arriving Thursday, Adrian quietly played with toys in a room at the hospital's pediatric intensive care unit. His mother, Christian Lizeth Saucedo-Valdez, stood by, shoulder slumped from fatigue.
Saucedo-Valdez said she still has not explained to Adrian why he remains in the hospital, fearing she might scare him more. Instead, she tells him everything will turn out fine in the end.
But the money the family has received for Adrian's care surpassed anything she thought could happen, with envelopes with small bills and checks coming from Mexico, Texas and as far as California and Virginia.
"We feel so content," his mother said. "So many people have given money to help us pay for this operation."
Mental illness strains school counselors
Fri, 20 Apr 2007 02:40:59 GMTBy DAVID CRARY, AP National Writer
NEW YORK - Across America, college counseling centers are strained by rising numbers of mentally ill students and surging demand for mental health services — a challenging trend as campus officials try to identify potential threats like the unstable Virginia Tech gunman.
And even when serious emotional problems are detected, university officials often feel constrained in how they respond due to an array of laws and policies protecting students' rights and privacy.
"The number of people coming to colleges who've had psychiatric treatment has increased tremendously," said Dr. Gerald Kay, a psychiatry professor at Wright State University and chair of the American Psychiatric Association committee on college mental health.
"Now they're able to come to college — that would not have been the case earlier," Kay said. "You've got a very large number of people who may have some vulnerabilities. It has stressed the availability of resources."
Reasons for the surge include the Americans with Disabilities Act, which gives mentally ill students the right to be at college, and increasingly sophisticated medications which enable them to function better than in the past.
Recent surveys and studies underscore the scope of the increase.
A survey last year by the American College Health Association found that 8.5 percent of students had seriously considered suicide, and 15 percent were diagnosed for depression, up from 10 percent in 2000. The Anxiety Disorders Association of America found that 13 percent of students at major universities and 25 percent at liberal arts colleges are using campus mental health services.
Dr. Chris Flynn, director of Virginia Tech's counseling center, has declined to discuss details of gunman Cho Seung-Hui's case, but said the center's staff — which includes a psychiatrist and 11 psychologists — treats about 2,000 students per school year.
In December 2005, a magistrate ordered Cho to undergo an evaluation at a private psychiatric hospital after two women complained about annoying calls from him, and an acquaintance reported he might be suicidal. An initial evaluation found probable cause that Cho was a danger to himself or others as a result of mental illness, but court papers indicate he was free to leave the hospital within days — a step allowed only if hospital officials judged him no longer a danger.
"We have to provide services to students with mental illness — it's not grounds to exclude them from our property," Flynn said. "We cannot discriminate against the mentally ill, nor do we want to."
He said the type of complaints lodged against Cho by the two women are a common and challenging phenomenon on campuses nationwide.
"It is very difficult to predict when what someone perceives as stalking is stalking, and then how it might translate into violence later," Flynn said. "Clearly, if anyone had any warning about a violent incident, people would have stepped in and acted."
Psychologist Sherry Benton, assistant director of counseling services at Kansas State University, has conducted research concluding that students' mental health problems are more complex and severe than 20 years ago.
"We're well aware that problems are getting worse, but what hasn't happened is increasing funding for mental health services," she said. "Most centers are now overwhelmed. Business has gone up and up, but budgets have remained the same or been cut, and that's a huge problem."
One factor, Benton said, is that mental health services are usually not among the categories assessed during colleges' periodic accreditation reviews. If schools needed good services to remain accredited, they might invest more, she said.
Benton views the rising demand for campus mental health services as a good news-bad news development.
"We do get a lot more students into college who have mental illness but are no problem whatsoever," she said. "They do need support and use medication; they go on to lead full, productive lives."
On the downside, she and her colleagues see stress levels among students far higher than a generation ago due to increased workloads and financial strains, often coupled with lack of healthy lifestyles.
Complicating the overall picture is a web of laws and policies that limit the options for worried staff members. Troubled students generally can't be forced to obtain treatment, and privacy laws may limit sharing information about them, even to the extent that some parents have sued schools — including the Massachusetts Institute of Technology and the Oregon Institute of Technology — for not advising them of their children's serious disorders.
Nonetheless, officials on many campuses have set up committees to pool information about students with emotional or behavioral problems so patterns can be detected in what might otherwise be seen as isolated incidents. The trick, officials say, is to find the proper balance between respecting a student's rights and protecting the university.
"That's the tightrope administrators have to walk," said Wright State's Gerald Kay.
"The issue in most instances is how do you bring these people into some sort of treatment."
Benton said any student who issues threats should be dealt with forcefully, regardless of privacy guidelines.
"Safety trumps confidentiality every time," she said. "If someone is a danger to themselves or others, then confidentiality is out the window and you notify who you need to notify to ensure the safety of them and those around them."
Peter Lake, a law professor at Stetson University, contends that officials on many campuses have been too deferential to privacy concerns, at the risk of safety at their schools.
"There's a false consciousness of privacy in higher education — as an institution, we don't like to share information," he said.
"Now, you're going to be seeing a greater emphasis on a management team or a safety czar — someone whose job it is to look at students' overall profiles," Lake said. "It's not only a good idea — it's an idea we can't live without."
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On the Net:
American College Health Association: http://www.acha.org/
CDC Teens rabies cure failed in others
Thu, 19 Apr 2007 21:54:07 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - An unusual drug combination that helped an unvaccinated teenager survive rabies has failed to save three other infected children, federal health officials reported Thursday.
It wasn't clear why the treatment succeeded with one child and failed with the others. Factors could include the strain of the virus, the dosing of the drugs and the time between infection and treatment, said Dr. Charles Rupprecht, chief of the rabies program at the U.S. Centers for Disease Control and Prevention.
"We believe speed is of the essence," said Rupprecht, a co-author of a report in this week's issue of the http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5615a1.htm
132M doses ready for upcoming flu season
Thu, 19 Apr 2007 20:39:38 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - Flu vaccine manufacturers expect to have a record 132 million doses ready for the 2007-2008 flu season, and even more could be available if a fifth company joins their ranks, officials said Thursday.
CSL Biotherapies, an Australian company, applied last month for federal approval to sell its flu vaccine in the United States this fall.
Government health officials have been expanding their flu shot recommendations to cover more age groups, and they now say that more than 200 million Americans should get vaccinated each year. But setbacks in recent years — including vaccine delays and shortages — have left doctors and patients soured and confused.
Officials say they are heartened by the increase in vaccine manufacturing.
"To protect people, we need more vaccine," said Dr. Jeanne Santoli, deputy director of the U.S. Centers for Disease Control and Prevention's immunization services division.
Influenza kills an estimated 36,000 Americans each year, and hospitalizes another 200,000, according to the http://www.cdc.gov
Glycemic load of diet has no effect on weight loss
Thu, 19 Apr 2007 15:44:09 GMTBy Amy Norton
NEW YORK - When it comes to losing weight, the number of calories you eat, rather than the type of carbohydrates, may be what matters most, according to a new study.
The findings, published in the American Journal of Clinical Nutrition, suggest that diets low in &;glycemic load&; are no better at taking the pounds off than more traditional -- and more carbohydrate-friendly -- approaches to calorie-cutting.
The concept of glycemic load is based on the fact that different carbohydrates have different effects on blood sugar. White bread and potatoes, for example, have a high glycemic index, which means they tend to cause a rapid surge in blood sugar. Other carbs, such as high-fiber cereals or beans, create a more gradual change and are considered to have a low glycemic index.
The measurement of glycemic load takes things a step further by considering not only an individual food's glycemic index, but its total number of carbohydrates. A sweet juicy piece of fruit might have a high glycemic index, but is low in calories and grams of carbohydrate. Therefore, it can fit into a diet low in glycemic load.
However, the effort of figuring out what's an allowable carb might not be worth it, if the new study is any indication.
Principal investigator Dr. Susan B. Roberts, of Tufts University, Boston, and colleagues found that a reduced-calorie diet, whether glycemic load was high or low, was effective in helping 34 overweight adults shed pounds over one year.
Study participants who followed a low-glycemic-load diet ended up losing roughly 8 percent of their initial weight, as did those who followed a high-glycemic-load diet.
&;The bottom line is that in this study we don't see one single way to eat that is better for weight loss on average,&; Roberts told Reuters Health. Of course, that doesn't mean &;anything goes&; as long as you're cutting calories.&;
A super-sized serving of French fries won't do any dieter any good, she noted.
Both diets her team used in the study were carefully controlled. For the first 6 months, participants were provided with all the food they needed, and both diets were designed to cut their calories by 30 percent while providing the recommended amount of fiber, limiting fat and encouraging healthy foods like fruits and vegetables.
The comparable outcomes suggest that, among healthy diets, no single one stands out as better, according to Roberts. So the focus should be on calories, rather than specific foods to avoid or include.
&;Focusing on calories is something we need more of, especially when portion sizes are so absurd,&; Roberts said, referring to the portions served at so many U.S. restaurants.
This doesn't mean, however, that there's no place for diets that focus on glycemic load, according to the researcher. Some studies, for example, have found that low-glycemic index foods might help control blood sugar in people with type 2 diabetes.
And in their own research, Roberts said she and her colleagues have found that low-glycemic index diets do seem more effective for overweight people who naturally secrete high levels of the hormone insulin, which regulates blood sugar.
SOURCE: American Journal of Clinical Nutrition, April 2007.
Antipsychotic drugs often affect sexual function
Thu, 19 Apr 2007 13:07:38 GMTNEW YORK - Patients taking antipsychotic drugs for schizophrenia often produce little or no hormone in the sex glands, a condition known as hypogonadism, and commonly develop subsequent problems in sexual function, according to the findings published in the Journal of Clinical Psychiatry.
Dr. Oliver D. Howes and colleagues from the Institute of Psychiatry, London, examined rates of sexual dysfunction and hypogonadism in 103 patients with schizophrenia or schizoaffective disorder who had been on stable antipsychotic medication for at least 6 months.
These patients were compared with 62 normal untreated subjects recruited from primary care practices and with 57 subjects recruited from a sexual dysfunction clinic.
The participants were assessed using the Sexual Functioning Questionnaire , in which higher scores indicate greater impairment.
Patients on antipsychotics had significantly greater average total SFQ scores -- 9.9 in women and 7.8 in men --- compared with normal subjects, who had scores of 4.1 and 4.09, respectively. The scores in the treated patients were similar to those in the patients who attended the sexual dysfunction clinic -- 7.2 in women and 9.9 in men).
Compared with normal subjects, the likelihood of patients having sexual dysfunction was increased by 15-fold in women and 9-fold in men.
Hypogonadism was common, with 79 percent of premenopausal women with low estrogen production and 92 percent with low progesterone levels. Twenty-eight percent of men had low testosterone production.&;
&;The high rates of hypogonadism suggest that patients are at increased risk of cardiovascular disease and osteoporosis,&; Howes and colleagues say. &;Clinicians are advised to inquire about sexual dysfunction and monitor...hormone levels in patients taking antipsychotics.&;
SOURCE Journal of Clinical Psychiatry, March 2007.
Aid agencies hail millions of measles vaccinations in NKorea
Fri, 20 Apr 2007 11:22:41 GMTGENEVA - More than 16 million children and adults have been vaccinated against measles in North Korea in the last two months, marking one of the fastest responses to a major outbreak of the disease, international relief agencies said on Friday.
The United Nations Children's Fund ( UNICEF), the World Health Organisation and the International Federation of Red Cross and Red Crescent Societies funded and organised the campaign after a request from the North Korean authorities in February.
&;This was a remarkable example of good cooperation between different organisations,&; said Jaap Timmer, head of the Red Cross delegation in the authoritarian and secretive communist state.
&;The local Red Cross volunteers, who have been trained in first aid and community health, reinforced the vaccination teams to enable them to finish the two phases in such a short period of time,&; he added.
Measles made its first appearance in a decade in North Korea last November, leading to four deaths and 3,600 infections.
