Study links lung disease to WTC work
Wed, 09 May 2007 01:40:15 GMTBy AMY WESTFELDT, Associated Press Writer
NEW YORK - Rescue workers and firefighters contracted a serious lung-scarring disease called sarcoidosis at a much higher rate after the Sept. 11 attacks than before, said a study that is the first to link the disease to exposure to toxic dust at ground zero.
The study, published by nine doctors including the medical officer monitoring city firefighters, Dr. David Prezant, found that firefighters and rescue workers contracted sarcoidosis in the year after Sept. 11, 2001, at a rate more than five times higher than the years before the attacks.
Unlike previous studies that have linked exposure to the toxic dust cloud that enveloped lower Manhattan after the World Trade Center's collapse to many different respiratory illnesses, this study zeros in on one disease.
Sarcoidosis, which can be life-threatening, causes an inflammation in the lungs that deposits tiny cells in the organs, leaving scar tissues that damage them. Several rescue workers and others exposed to trade center dust have claimed they contracted the disease from their work at ground zero.
The study compared the rates of contracting sarcoidosis among fire department employees for 15 years before Sept. 11 and for five years after it. It said firefighters who showed symptoms of the disease on chest X-rays underwent more intensive exams.
After the trade center attack, 26 firefighters were diagnosed with sarcoidosis, the study found. Thirteen were diagnosed in the first year after the attacks, which represents a rate of 86 per 100,000. In the 15 years before the attack, the rate of sarcoidosis was 15 per 100,0000, the study found.
None of the 26 rescue workers, who are in their 30s and 40s, has died of the disease, and about 10 have improved or recovered since their diagnoses, the study found. Two of the firefighters were former smokers, the study found.
The study was published this week in the May issue of CHEST Physician, a journal published by the American College of Chest Physicians.
Farmed fish fed contaminated material
Wed, 09 May 2007 01:40:43 GMTBy ANDREW BRIDGES, Associated Press Writer
WASHINGTON - Farmed fish have been fed meal spiked with the same chemical that has been linked to the pet food recall, but the contamination was probably too low to harm anyone who ate the fish, federal officials said Tuesday.
The Canadian-made meal included what was purported to be wheat gluten, a protein source, imported from China. The material was actually wheat flour spiked by the chemical melamine and related, nitrogen-rich compounds to make it appear more protein rich than it was, officials said.
After pigs and chickens, the farmed fish mark the third food animal given contaminated feed. The level of contamination is expected to be too low to pose any danger to human health, said Dr. David Acheson, the FDA's assistant commissioner for food protection.
It wasn't immediately clear if any of the farmed fish entered the food supply. However, Acheson said at least one firm's fish were still too young and small to be sold. Investigators were visiting other U.S. aquaculture farms that used the contaminated feed. Farmed fish typically are sold for direct consumption or for stocking lakes and streams.
The head of a St. Louis company said it brokered a deal to import nearly 353,000 pounds of the Chinese wheat gluten that went directly to a Canadian aquaculture feed ingredient company called Westaqua. Listings for Canadian fish meal producers include a company called Westaqua Commodity Group Ltd.
When reached by telephone, the president of Westaqua Commodity Group Ltd. , based in Vancouver, British Columbia, declined to talk about the matter.
"I can't talk to you about that today," Kelly Mills said, adding: "We're not talking to the press about this issue."
Melamine, a chemical found in plastics and pesticides and not approved for use in pet or human food in the U.S., contaminated pet food that either sickened or killed an unknown number of dogs and cats. Since March 16, more than 100 brands of pet food have been recalled because they were contaminated with melamine.
Acheson said that fish samples would be screened for signs of melamine. "Depending upon what we find in that testing, that is going to drive the next steps," Acheson said.
Canadian officials are aware of the finding, Acheson said.
"We used it to make pet food. They used it to make fish meal," he told reporters.
Federal health and food officials have said some 20 million chickens and thousands of hogs also were fed feed contaminated by melamine. As with the fish, they said the risk to human health is very low.
U.S. investigators also have learned that the purported Chinese wheat gluten and a second ingredient, rice protein concentrate, were actually simple wheat flour. The flour was spiked with melamine and related, nitrogen-rich compounds to make it appear more protein rich than it was. In tests, nitrogen levels are measured to gauge the overall protein content of food ingredients.
"What we discovered is these are not wheat gluten and rice protein concentrate but in fact are wheat flour contaminated by melamine," Acheson said.
The FDA is considering enforcement options, he added. The ingredients came from two Chinese firms: Xuzhou Anying Biologic Technology Development Co. and Futian Biology Technology Co. Ltd.
The supposed wheat gluten was exported directly from China to Canada in a deal brokered by a U.S. company, ChemNutra Inc., Acheson said. ChemNutra also supplied the ingredient to a Canadian dog and cat food company, Menu Foods, that's since recalled dozens of brands.
Steve Stern, a ChemNutra spokesman, said the Las Vegas company actually only cobrokered the deal to supply wheat gluten to the fish meal producer: "We never owned it, we never sold it."
Edmund Collins, president of Diversified Ingredients Inc., later said it was his St. Louis company that handled the deal, with Westaqua receiving the wheat gluten directly from China last July and August. Collins said his company has provided the FDA with information, but added no one in return has indicated the ingredient tested positive for melamine. Acheson said only that the chemical was found in fish meal.
"We have not been alerted and we have been very upfront on this," Collins said.
When asked why ChemNutra didn't disclose previously that it played a part in that deal, Stern said the company did notify the FDA in mid April. However, the company chose not to include the co-brokered shipment in an April 2 recall of the wheat gluten it had imported for use in pet food _again because it hadn't sold the ingredient, Stern said.
Menu Foods has said it faces more than 50 lawsuits. It in turn has sued ChemNutra. And the FDA has searched facilities belonging to both companies.
Group Kids dental health not improving
Wed, 09 May 2007 00:04:58 GMTBEND, Ore. - Dental health may not be getting any worse for Oregon children, but dentists say they see few signs that it is improving.
"I've seen a lot of it for a long time," said Dr. Cate Quas, a pediatric dentist in Bend who treats many Oregon Health Plan patients. "I see horrendous stuff in preschoolers."
Quas said she recently pulled 10 of a little boy's 20 teeth because the decay was so extensive. She said the boy told her he looked like an old man so she made him a retainer with prosthetic teeth.
"What happens is that families, they let the problem get too bad because they don't know where to go and they can't afford it. Of course it just snowballs and they end up with a toothache or an infection," said Vickie Matthews, coordinator of the Kemple Children's Clinic, which coordinates dental care for low-income children in Central Oregon.
"We have had some kids here with life-threatening infections," Matthews said.
According to a report released in November by the Oregon Department of Human Services, 56 percent of children ages 6 to 8 in Oregon have had dental caries, which is tooth decay that can lead to cavities.
Nationwide, 50 percent of children in the same age group have experienced dental caries, although the overall prevalence of tooth decay in older children is decreasing.
"Oregon has an oral disease burden. It's a silent epidemic," said Brett Hamilton, managing director of public and professional education for the Oregon Dental Association. "A lot of times people don't associate their mouth with their whole body or realize that their mouth is part of their overall health."
Quas blames too much milk or sugary drinks for much of the problem.
"The stuff you see in preschoolers is generally created when they are toddlers," she said. "It's not like between the ages of 2 and 5 the tooth decay becomes rampant."
Some parents give their children juice in sippy cups and let them carry the sugary drink around all day, or put them to bed with milk in their bottles, Quas said. Sugars in the fluids coat the teeth, giving bacteria a chance to take hold.
"The food pools on top of the teeth and the bacteria have a heyday," Quas said. "They have little parties all night long and eat into the teeth."
Instead, Quas and other dentists recommend giving children water in sippy cups or bottles instead of drinks that are high in sugar.
Often parents also don't realize that recommendations on dental care have changed, said Dr. Mike Shirtcliff, president and CEO of Northwest Dental Services in Redmond. The group of almost 300 Oregon dentists works to improve access to basic dental care in rural areas of the state.
"The mythology in dentistry is you don't treat pregnant women unless it is an emergency and you don't treat kids until they are 30 months old," Shirtcliff said.
But now the professional standard is to treat pregnant women, and babies should be seen before their first birthday. "We've been working hard to change the standard of care. It's going from old knowledge to new knowledge."
Shirtcliff's organization works to educate and encourage dentists to treat more patients with Oregon Health Plan coverage. Because the Oregon Health Plan does not reimburse at as high a rate as other types of insurance, he said, sometimes dentists are reluctant to participate.
In Central Oregon there are plenty of pediatric dentists, Shirtcliff said. But places like Douglas County, the Southern Oregon coast and areas of Eastern Oregon have a limited number of pediatric dentists to serve the population.
Dentists also recommend fluoridation of drinking water to prevent decay.
The Oregon Dental Association has been pushing the state Legislature for years to mandate that Oregon's drinking water be fluoridated, Hamilton said.
"There seems to be more and more decay," said Dr. Dean Nyquist, a Bend dentist who sees many young children with serious dental problems. "Especially in our area where we do not have fluoride in the water. It makes a big difference."
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Information from: The Bulletin, http://www.bendbulletin.com
Bill Clinton announces AIDS drug deals
Tue, 08 May 2007 11:48:24 GMTBy KAREN MATTHEWS, Associated Press Writer
NEW YORK - Former President http://www.clintonfoundation.org/
Parent interviews may prevent obesity in child
Wed, 09 May 2007 18:20:24 GMTBy Anne Harding
NEW YORK - Researchers are developing a potential new weapon in the battle against obesity: training pediatricians and dietitians in a special interviewing technique designed to motivate parents of overweight kids to make healthy changes in their family lifestyles.
The technique, motivational interviewing, involves asking open-ended questions (for example, &;could you tell me how you feel about your weight&;), listening and repeating the interviewee's answers, and encouraging them to recognize what is holding them back from making changes, Dr. Robert P. Schwartz of Wake Forest University School of Medicine in Winston-Salem, North Carolina, the study's lead author, told Reuters Health.
&;What you want to do is get the patient to take responsibility for their behaviors,&; Schwartz said in an interview. &;What motivational interviewing does is help people get unstuck from their ambivalence.&;
Motivational interviewing has been used successfully to help people with substance abuse problems, but employing the approach to address physical activity and nutrition is something new, he added.
Schwartz and his team conducted a pilot study of the approach with 91 children aged 3 to 7 and their parents. The children were either overweight or normal weight but had an obese parent. They were randomized to a control group, given safety handouts lee; a minimal intervention group, which had one motivational interviewing session with the pediatrician; or an intensive group, made up of two sessions with either a pediatrician or nutritionist.
Six months later, the researchers found, there were drops in body mass index percentile for children in each group, but these reductions weren't statistically significant. One third of patients dropped out of the program overall, and dropout rates were particularly high in the intensive group, half of whom left the program.
Parents of children in the minimal intervention group said their children cut down on eating snacks after the interview session, while those in the intensive group reported eating out less often. There were no significant differences among the groups or before and after the intervention in terms of time spent watching TV, amount of fruit and vegetables consumed, or consumption of sweetened drinks. However, 94 percent of parents said the interview sessions &;helped them think about changing their eating habits.&;
Schwartz and his team are now planning a larger, longer-term study of the intervention, after making a number of changes to the program, such as cutting down on paperwork for clinicians, adding a training DVD, and building in more phone interviews. They plan to enroll 600 overweight children 2 to 8 years old, and to follow them for five ears.
&;This was a feasibility study to try to work out the bugs in doing this, and we certainly found many,&; Schwartz said.
SOURCE: Archives of Pediatrics and Adolescent Medicine, May 2007.
Kan. spikes conservative sex ed policies
Wed, 09 May 2007 02:52:26 GMTBy CARL MANNING, Associated Press Writer
TOPEKA, Kan. - The Kansas Board of Education on Tuesday repealed sex education policies enacted last year, the latest move by the moderate majority to undo efforts by conservatives when they dominated the board.
One rescinded policy recommended that schools stress abstinence until marriage, while the other urged school districts to get parental permission before students could attend human sexuality classes.
On a 6-3 vote, the board replaced the policies with one that recommends "abstinence plus" sex education programs and leaves it up to the state's 296 school districts to decide whether to get parental permission.
The "abstinence plus" program stresses abstinence before marriage, while also urging schools to give students information about birth control and prevention of sexually transmitted diseases.
"It's a matter of emphasis," said chairman Bill Wagnon.
Wagnon said the goal was "to describe the curriculum standards in terms of 'it's more than just simply an encouragement of abstinence,' but we want a balance and comprehensive educational program about sex."
But conservative member Kathy Martin said most parents want the standards enacted last year.
"Abstinence until marriage is the best message we can give our children," Martin said.
She said the old standards "emphasized self-control over birth control," and the new standards "fail to give a true picture."
It was the second major change for the 6-4 moderate bloc since taking control in January. Wagnon said the final major change could come Wednesday if the board hires a new education commissioner to replace Bob Corkins, hired by conservatives in 2005. His hiring touched off criticism because he had no experience as a school administrator, and he resigned in November after the new board was elected.
In February, the board repealed science standards backed by social conservatives and switched to ones that treat evolution as well-supported by research. The standards, which take effect next school year, are used to develop tests to measure how well students learn science.
The old standards, endorsed by supporters of "intelligent design," questioned the theory of evolution.
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On the Net:
State Board of Education: http://www.ksde.org
Pure fruit juice not likely to put weight on kids
Wed, 09 May 2007 19:24:59 GMTBy Megan Brooks
NEW YORK - Contrary to popular belief, drinking pure 100 percent fruit juice does not make young children overweight or at risk for becoming overweight, new research shows. Pure fruit juice provides essential nutrients and, in moderation, may actually help children maintain a healthy weight.
Inconsistent research findings have led to continued debate over the potential associations between drinking 100 percent fruit juice, nutrient intake, and overweight in children.
In the their study, researchers analyzed the juice consumption of 3,618 children ages 2 to 11 using data from the National Health and Nutrition Examination Survey.
&;The bottom line is that 100 percent juice consumption is a valuable contributor of nutrients in children's diet and it does not have an association with being overweight,&; study chief Dr. Theresa Nicklas, a child nutrition specialist at Baylor College of Medicine in Houston, told Reuters Health. She presented the new data at the Pediatric Academic Societies' annual convention in Toronto this week.
&;If you look at the weight of the evidence there are at least 7 studies plus the one I presented that show no association between 100 percent juice and overweight among children,&; Nicklas added. Even among the children who consumed the most juice, there was no association with the children being overweight or at risk for overweight, she said.
The results also indicate that juice consumption &;is not excessive among 2- to 11-year-olds,&; Nicklas said. In fact, 57 percent of the children did not consume 100 percent juice at all, &;which is much higher than I expected,&; she said.
The average daily consumption of pure fruit juice in the study population was 4.1 ounces -- an amount in line with recommendations from the American Academy of Pediatrics.
And while there were a few children who consumed larger amounts of juice , their increased intake was not associated with overweight or at risk for being overweight. In fact, children in the 2 to 3-year-old category who drank the most juice were nearly three times less likely to be overweight or at risk for overweight than children who drank no juice at all.
Nicklas and her colleagues also found that children who drank any amount of 100 percent juice ate less total fat, saturated fat, sodium, added sugars and added fats. Pure juice drinkers also had higher intakes of a number of key nutrients including vitamin C, potassium, magnesium, folate, vitamin B6 and iron. They also ate more whole fruits, like apples.
Nicklas encourages parents who are concerned about their child being overweight to look beyond their juice consumption. &;My advice would be to look at the total number of calories that child is taking in and look at where the bulk of those calories are coming from and equally important look at the activity level of the child.&;
UK court to hear Alzheimer39s drugs case in June
Wed, 09 May 2007 17:21:25 GMTLONDON - Drug manufacturers challenging a decision by Britain's cost-effectiveness watchdog to restrict access to Alzheimer's drugs on the state health service will get their day in court next month.
Eisai Co Ltd and Pfizer Inc, which jointly market the top-selling such medicine Aricept, said on Wednesday the High Court had granted a request to fast track the date for a judicial review and the hearing would commence on June 25.
The companies are challenging the process by which the National Institute for Health and Clinical Excellence reached its decision to ban anti-dementia medicines for National Health Service patients with newly diagnosed mild Alzheimer's disease.
It is the first time that the agency in charge of deciding which medicines are offered in the state health system in England and Wales has faced such legal action.
NICE believes drugs like Aricept do not make enough of a difference to be used at all stages of Alzheimer's disease. In future, it wants them to be prescribed only for a minority of patients with disease of moderate severity.
Anti-cholinesterase drugs such as Aricept can help but not cure some Alzheimer's patients. They are widely used in other countries, but NICE experts calculate that their cost -- around 1,000 pounds per patient a year -- means they are not cost-effective for most patients.
Men less likely to survive early breast cancer
Wed, 09 May 2007 18:21:35 GMTNEW YORK - While breast cancer is far more common in women than in men, men may be more likely to die from early-stage breast tumors, a new study suggests.
Male breast cancer is rare, accounting for less than 1 percent of all breast cancers. But unlike the case with breast cancer in women, there have been no improvements in survival the past 30 years in men with this disease.
The rarity of breast cancer in men has prevented clinical trials, and treatment is based on what's known about female breast cancer.
But the new findings, published in the journal Cancer, suggest that there may be biological differences in male and female breast cancers that affect survival. Specifically, men with relatively small tumors or tumors that had not yet spread to the lymph nodes had a shorter survival time than their female counterparts.
Among men whose breast cancer had not spread to the lymph nodes, the typical survival time was 6 years, compared with nearly 15 years among women.
The difference suggests a need for better understanding of male breast cancer, and improved treatments, according to Dr. Zeina A. Nahleh and her colleagues at the University of Cincinnati.
The researchers based their findings on a large cancer registry maintained by Veterans' Affairs. They reviewed the records of 612 men treated for breast cancer and compared them with 2,413 women treated for the disease.
While Nahleh's team found no difference in survival times of men and women with more-advanced breast cancer, they did find one among patients with earlier-stage tumors.
When it came to treatment, men had lower rates of both chemotherapy and radiation than women did, but they were as likely as women to receive hormone therapy.
Hormonal therapies for breast cancer, such as the drug tamoxifen, block the ability of estrogen to fuel tumor growth. As in women, men's breast tumor cells often have receptors for estrogen, which means hormone therapy can be helpful.
However, Nahleh and her colleagues write, it's possible that men's breast tumors do not respond well to standard therapy with tamoxifen.
&;A better understanding of this disease is needed,&; they conclude, &;so that new opportunities for therapeutic intervention may be developed.&;
SOURCE: Cancer, April 15, 2007.
