Patient gets second set of lungs
Fri, 08 Jun 2007 16:12:39 GMTBy COREY WILLIAMS, Associated Press Writer
ANN ARBOR, Mich. - A patient whose double lung transplant operation was stopped after a plane carrying donor organs crashed into Lake Michigan has received a second set of lungs, doctors announced Friday.
The 50-year-old Michigan man, whose name wasn't released at his family's request, was in critical condition at a University of Michigan Health System hospital after the more than seven-hour surgery ended early Thursday, the health system said.
"We are relieved that we were able to do this transplant and give this man another chance for life," Dr. Jeffrey Punch, director of the Division of Transplantation at University of Michigan, said in a statement. "Our friends that died in the crash would have wanted us to go on with our work."
The patient already was prepped for surgery, with his chest cut open and his lungs exposed to the air in the operating room, when the plane crashed, killing six members of a Survival Flight team.
Officials learned late Tuesday that another set of donor organs was available.
"If he had not received a transplant in a timely fashion he would have died," said Dr. Andrew C. Chang, one of two doctors who led the surgical team.
The patient has not been told of the crash. "I'll tell him more when he can handle it," Chang said.
Chang said the man's condition is "significantly improved."
The patient, a longtime smoker, needed the transplant because of a condition called chronic obstructive pulmonary disorder, the health system said. He had been on the waiting list for a double lung transplant since November.
The patient's family, in a statement released by the health system, said it was devastated and heartbroken for the families of the six team members who died in the crash.
The new organs were transported by chartered plane from an undisclosed donor hospital to Willow Run Airport near Ypsilanti, where a transplant donation specialist met the plane and carried the organs to the hospital on a Survival Flight helicopter.
"It is magnificent that this team has continued the work of our team that we lost," Dr. Robert Kelch, the health system's chief executive, said in an e-mail Friday to the health system's employees.
He noted that members of the transplant team continued to work as they dealt with the loss of their colleagues.
"This wonderful news doesn't in any way relieve the acute pain we are feeling at the loss of our dedicated Survival Flight crew," he said.
Killed in Monday's crash near Milwaukee were cardiac surgeon Dr. Martinus Spoor, transplant donation specialist Richard Chenault II, Dr. David Ashburn, a physician-in-training in pediatric cardiothoracic surgery, transplant donation specialist Richard LaPensee and pilots Dennis Hoyes and Bill Serra.
China halts production of Novartis drug
Fri, 08 Jun 2007 15:09:54 GMTBEIJING - China's drug watchdog on Friday ordered domestic companies to stop producing and selling Novartis AG's Zelnorm for irritable bowel syndrome and warned patients to stop taking it.
"The risks of Zelnorm outweigh the possible benefits for some patients based on analyses from home and abroad," China's State Food and Drug Administration said in a statement posted to agency's Web site.
The agency said China's National Center for Adverse Drug Reaction Monitoring has received 98 reports of adverse reactions concerning Zelnorm since it was introduced to the Chinese market in 2003. Most involved diarrhea and nausea, with one reported case of abnormally fast heartbeat and another of low blood pressure.
Two drug companies in southern city of Chongqing and one Beijing drug manufacturer were ordered to stop production of the drug, the agency said. A third company in Chongqing was told to halt plans to start producing it.
The official Xinhua News Agency said that hundreds of thousands of Chinese patients use the drug.
"We have announced this morning that we are complying with a request from the local authority to suspend the marketing and sales activity of in China," Novartis spokeswoman Corinne Hoff said.
"More than 85 percent of our sales were in the U.S," she said.
"I cannot give you the sales figures for China, but it's not significant," Hoff said.
Novartis agreed in March to stop selling Zelnorm in the United States, the name under which it was sold there, at the request of the Food and Drug Administration after it was linked to a higher chance of heart attack, stroke and worsening chest pain that can become a heart attack.
Study Fewer Indians with HIV seen
Fri, 08 Jun 2007 16:47:52 GMTBy SAM DOLNICK, Associated Press Writer
NEW DELHI - The number of Indians infected with HIV is far smaller than previously believed, according to new data that appears to vindicate critics who said earlier U.N. assessments of the country's epidemic were vastly overestimated.
Experts say the still-unreleased survey is likely to show that India's number of HIV cases, which last year was said to be the highest in the world at 5.7 million, is actually well below that mark.
"The actual number we've come up with in aggregate is likely to be lower, and perhaps substantially lower," said Ashok Alexander, director of the Avahan, the Indian program of the Bill & Melinda Gates Foundation, which helped fund the study.
Alexander declined to estimate what the new number would be, saying the data is still being analyzed and precise numbers would not be released for a few more weeks.
The new estimate comes from combining data collected from prenatal clinics; a survey of high-risk groups, such as sex workers; and from the government's National Family Health Survey — a method Alexander said was more reliable than the previous estimates, which relied largely on extrapolating from the prenatal clinic data.
The health survey — the third conducted since 1992-93 but the first to provide an HIV estimate — is considered the most comprehensive source and carries the most weight in determining the new figures. It covers about 200,000 people between the ages of 15 and 54, more than half of them women, and was conducted through face-to-face interviews all across India between December 2005 and August 2006.
A statement released Friday by the government's HIV control program, UNAIDS and the World Health Organization acknowledged that the new data provided "a more accurate picture of the epidemic because of availability of more information based on population surveys and improved data from high-risk groups."
But in an indication of how sensitive the new data is in India, where billions of dollars have been poured into prevention programs to stop the spread of HIV, the statement made no mention of the lower overall estimate.
Instead, it only pointed out that HIV rates remain high about groups most at risk — sex workers and their clients, especially truckers; men who have sex with men; and intravenous drug users.
Daniel Halperin, an HIV and AIDS expert at the Harvard School of Public Health, said the new data put health officials in a bind.
"On the one hand there's a real HIV epidemic in India and it needs to be addressed, but on the other, there's an understandable concern that people were worried that funding or attention could be diminished if the prevalence numbers come out lower," he said.
While health experts called the new data good news, they cautioned that HIV is still a major problem, particularly in southern Indian states where rates might be as high as 1 percent of the general population.
"This is a bit like declaring victory before even fully fighting the battle," Alexander said.
This is not the first time experts have questioned India's official HIV numbers.
Halperin and colleagues have published several studies in leading medical journals arguing that the number of AIDS victims in India and other parts of the world are actually far lower than the official numbers claim.
In 2006, Indian doctors argued in a published report that the methodology gave a flawed picture because the amount of HIV-positive people reporting to prenatal clinics, sexually transmitted infection clinics and public hospitals was not representative of their true numbers in the population.
The lead investigator behind the report, Dr. Lalit Dandona of the Administrative Staff College of India in the southern city of Hyderabad, estimated the number of infected adults at between 3.2 million and 3.5 million.
In a country with a population of more than 1.1 billion people, that's far fewer than 1 percent.
While Africa has long attracted most of the attention from international HIV experts, some Western AIDS organizations have argued in recent years that the Indian government was underestimating the scale of its HIV problem, Halperin said.
He thought the new data could serve as vindication for Indian officials.
"It turns out that some people in the government years ago were correct in rejecting the notion that the epidemic was spiraling out of control," he said.
Experts found the dramatic revision in line with an improved understanding of AIDS across the globe.
"There are corrections that happen in the data from time to time," said Paul Zeitz, executive director of the Global AIDS Alliance in Washington. "But if India still has millions of infections, there are still risks for increasing those numbers."
Clarification Vitamin DCancer story
Fri, 08 Jun 2007 20:00:15 GMTOMAHA, Neb. - In a story about a study suggesting vitamin D lowers cancer risk in older women, The Associated Press reported that an American Cancer Society doctor favors keeping current vitamin D guidelines of 200 to 600 international units daily. Dr. Michael Thun now says he misunderstood a reporter's question and holds no position on whether those amounts should be changed. He also said he thinks it's too early to recommend using vitamin D to prevent cancer.
In Britain obesity and malnutrition
Fri, 08 Jun 2007 18:10:33 GMTBy MARIA CHENG, AP Medical Writer
LONDON - It may be obvious that most Britons are overweight. What isn't so obvious is that at least 2 million of them are likely malnourished — and that includes some of the people who are too fat.
Experts say the poor state of the average British diet — often high in fat, salt and calories, but low on nutrition — means malnutrition is a problem even though food is plentiful.
"You can't always tell if a person is malnourished with your eyes," said Dr. Marinos Elia, a professor of clinical nutrition and metabolism at Southampton University. "People may be eating too much food, but they may not be eating enough fruits and vegetables."
Dr. Alastair McKinlay, a gastroenterologist and chairman of a British malnutrition action group, put it bluntly: "There's a widely held misconception that if you're fat, you can't be malnourished."
Some experts even contend that the food rationing system during World War II offered Britons more nutrition than what they're eating today. From 1939-45, Britons got books of coupons, which they traded in for limited amounts of items like flour, milk, eggs, meat and canned fruit.
"Rationing was a huge success because it ensured that if you got your allotted amounts, you got a nutritionally reasonable diet," said Dr. Colin Waine, chairman of the National Obesity Forum. "I'm not advocating a return to rationing, but it was a more balanced diet back then."
Despite the unlimited food supply today, Waine said people don't always make the right choices.
Many nutrition experts believe the number of malnourished Britons is closer to 4 million, about 6 percent of the population, than the government's estimate of 2 million.
Most malnourished people have a chronic illness like AIDS, cancer or tuberculosis. In the last five years, according to the Department of Health, the number of hospital-identified malnourished patients has risen by more than 40 percent, though experts say that is largely due to heightened surveillance rather than a dramatic jump in cases.
There are no statistics on how many obese people may be malnourished, but doctors say they are seeing patients who are both overweight and malnourished. According to government statistics, 75 percent of Britons are overweight; more than one-fifth are obese.
While malnourished fat people are hardly in danger of starvation, other health problems are possible along with obesity-related complications like diabetes and heart disease. Once they start losing weight, malnourished people may actually burn their own tissue, including muscle, rather than fat.
Usually, people with vitamin deficiencies have skin problems, a swollen thyroid or bleeding gums. In severe cases, malnourished people might also experience hair loss, muscle wasting, a swollen abdomen, anemia or rickets.
In a country like Britain, experts say, malnutrition is rarely noticed. "You've got to have pretty severe deficiencies before this is picked up," said Waine. "But I think a lot of people are on the borderline."
Part of the blame goes to the rise of processed and fast foods, most of which contain only small amounts of healthy nutrients. The national diet is in such trouble that earlier this month, the United Kingdom's Food Standards Agency recommended that folic acid be added to the nation's flour; a lack of it in the diet of pregnant women has been linked to birth defects.
Recent surveys estimate that fewer than 20 percent of adults eat the recommended five daily portions of fruits and vegetables.
Thu, 07 Jun 2007 21:55:59 GMT
By Martha Kerr
NEW YORK - A relatively new sexually transmitted infection has surpassed Neisseria gonorrhea in prevalence among young adults in the US, according to a new study.
Mycoplasma genitalium was first identified in the 1980s. It can cause inflammation of the urethra (the urinary passage from the bladder), in men, and inflammation of the cervix and the lining of the uterus in women, possibly leading to infertility. However, it seems many cases of the infection are symptom-free.
In the current study, researchers at the University of Washington, Seattle, tested 1714 women and 1218 men between the ages of 18 and 27 years participating in Wave III of the National Longitudinal Study of Adolescent Health.
Results of the study are published in the American Journal of Public Health. The investigators found Mycoplasma genitalium infection in 1.0 percent of the participants. In contrast, the prevalence of gonorrhea was 0.4 percent. The prevalence of chlamydia infection was 4.2 percent.
The prevalence of Mycoplasma genitalium infection was 11 times higher among individuals living with a sexual partner, seven times higher among blacks and four times higher among those who use condoms during sex.
None of the genitalium-positive individuals had any discharge.
&;Many M. genitalium infections are asymptomatic, like chlamydial infections,&; principal investigator Dr. Lisa Manhart told Reuters Health. &;However, unlike chlamydia, it is probably too soon to recommend widespread screening for M. genitalium.&;
There are no commercial tests to detect the organism, she explained. Furthermore, she and her colleagues note in their report that it is not clear &;whether M. genitalium-infected persons require or benefit from treatment -- and if so, what antimicrobial therapy should be recommended.&;
SOURCE: American Journal of Public Health, June 2007.
