HIV infection rate drops in Zimbabwe
Thu, 01 Nov 2007 14:06:37 GMTHARARE, Zimbabwe - Zimbabwe has registered a 2.5 percent decline in HIV infection rates, and the number of AIDS deaths also is dropping, the government said Thursday, crediting its "tireless efforts" to fight the pandemic.
ing figures it said were verified by the United Nations, the Ministry of Health said the HIV rate dropped from 18.1 percent in people aged 15 to 49 years last year to 15.6 percent this year.
AIDS deaths also have decreased, down to 2,214 a week from around 2,500 a week, according to the new statistics.
A researcher at London's Imperial College who helped work on the figures said the trends presented were as accurate as possible given the available data, according to college spokeswoman Laura Gallagher. The UNAIDS agency was not immediately available for comment.
Poll Most OK birth control for schools
Thu, 01 Nov 2007 13:39:13 GMTBy ALAN FRAM, Associated Press Writer
WASHINGTON - People decisively favor letting their public schools provide birth control to students, but they also voice misgivings that divide them along generational, income and racial lines, a poll showed.
Sixty-seven percent support giving contraceptives to students, according to an Associated Press-Ipsos poll. About as many — 62 percent — said they believe providing birth control reduces the number of teenage pregnancies.
"Kids are kids," said Danielle Kessenger, 39, a mother of three young children from Jacksonville, Fla., who supports providing contraceptives to those who request them. "I was a teenager once and parents don't know everything, though we think we do."
Yet most who support schools distributing contraceptives prefer that they go to children whose parents have consented. People are also closely divided over whether sex education and birth control are more effective than stressing morality and abstinence, and whether giving contraceptives to teenagers encourages them to have sexual intercourse.
"It's not the school's place to be parents," said Robert Shaw, 53, a telecommunications company manager from Duncanville, Texas. "For a school to provide birth control, it's almost like the school saying, 'You should go out and have sex.'"
Those surveyed were not asked to distinguish between giving contraceptives to boys or girls.
The survey was conducted in late October after a school board in Portland, Maine, voted to let a middle school health center provide students with full contraceptive services. The school's students are sixth- through eighth-graders, when most children are 11 to 13 years old, and do not have to tell their parents about services they receive.
Portland school officials plan to consider a proposal soon that would let parents forbid their children from receiving prescription contraceptives like birth control pills.
Teenage pregnancy rates have declined to about 75 per 1,000, down from a 1990 peak of 117, according to the Guttmacher Institute, a research center. Still, nearly half of teens aged 15 to 19 report having had sex at least once, and almost 750,000 of them a year become pregnant.
The 67 percent in the AP poll who favor providing birth control to students include 37 percent who would limit it to those whose parents have consented, and 30 percent to all who ask.
Minorities, older and lower-earning people were likeliest to prefer requiring parental consent, while those favoring no restriction tended to be younger and from cities or suburbs. People who wanted schools to provide no birth control at all were likelier to be white and higher-income earners.
"Parents should be in on it," said Jennifer Johnson, 29, of Excel, Ala., a homemaker and mother of a school-age child. "Birth control is not saying you can have sex, it's protecting them if they decide to."
About 1,300 U.S. public schools with adolescent students — less than 2 percent of the total — have health centers staffed by a doctor or nurse practitioner who can write prescriptions, said spokeswoman Divya Mohan of the National Assembly of School-Based Health Care. About one in four of those provide condoms, other contraceptives, prescriptions or referrals, Mohan said.
Less than 1 percent of middle schools and nearly 5 percent of high schools make condoms available for students, said Nancy Brener, a health scientist with the federal Centers for Disease Control and Prevention.
Underlining the schisms over the issue, those saying sex education and birth control were better for reducing teen pregnancies outnumber people preferring morality and abstinence by a slim 51 percent to 46 percent.
Younger people were likelier to consider sex education and birth control the better way to limit teenage pregnancies, as were 64 percent of minorities and 47 percent of whites. Nearly seven in 10 white evangelicals opted for abstinence, along with about half of Catholics and Protestants.
In addition, 49 percent say providing teens with birth control would not encourage sexual intercourse and a virtually identical 46 percent said it would.
Though men and women have similar views about whether to provide contraceptives to students, women are likelier than men to think it will not encourage sexual intercourse, 55 percent to 43 percent.
Asked when young people should first be allowed to get birth control, ages 16 and 18 drew the most responses, while only a third chose age 15 or younger. Women's selections averaged just over age 16, slightly higher than men, while young people and Westerners preferred younger ages than others.
"I'd be pulling my kids out of that school," Ron Wrobel, 55, an engineer from Port Huron, Mich., said of the Maine middle school. He said birth control should be for teens at least 17 years old.
Mirroring the rift that has played out in countless battles in Congress, Democrats were likelier than Republicans to favor freer access to birth control and to have more faith that it reduces teenage pregnancies. Forty-five percent of Republicans — including 51 percent of GOP women — say birth control should not be provided to any students, compared to 19 percent of Democrats.
The poll involved telephone interviews with 1,004 adults from Oct. 23-25. It had a margin of sampling error of plus or minus 3.1 percentage points.
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AP Director of Surveys Trevor Tompson and AP News survey specialist Dennis Junius contributed to this report.
Firm US drug sales will fall 17 percent
Thu, 01 Nov 2007 10:18:52 GMTBy MATTHEW PERRONE, AP Business Writer
WASHINGTON - Pharmaceutical sales in the U.S. will drop to a third of global sales in 2008, from a 50 percent share two years ago, a report released Thursday says.
Prescription drugs sales in emerging economies in China, Brazil, Turkey, Mexico and elsewhere are booming but the gains will be offset by the loss of patent protection for profitable drugs worth $20 billion in annual sales in 2008, predicts health care research firm IMS Health.
Expected global sales growth of 5 percent to 6 percent, worth between $735 billion to $745 billion, in 2008 compares with 6 percent to 7 percent growth in 2006 that netted between $695 billion to $705 billion.
In the U.S., prescription drug sales growth of 4 percent to 5 percent, or $295 billion to $305 billion, is forecast by IMS Health.
U.S. patents for Johnson & Johnson's schizophrenia treatment Risperdal and Merck & Co. Inc.'s osteoporosis medicine Fosamax will likely expire, helping drive global sales growth in generic drugs of 15 percent to $70 billion.
IMS expects 29 new drugs to launch next year, but most of them will target less common diseases, not offsetting lost sales of drugs like Merck's Zocor, a widely used cholesterol-lowering drug that lost patent protection this year.
Generic manufacturers like Mylan Inc. and Barr Pharmaceuticals Inc. will continue to make inroads in emerging markets. IMS estimates prescription drug sales in China, Brazil, Mexico, Turkey and other emerging economies will account for 25 percent of the global market in 2008, although economic growth in the developing world won't benefit brand-name manufacturers as much until those countries can afford more expensive, innovative medicines.
The IMS report of slowing sales growth comes as U.S. federal regulators have stepped up scrutiny of pharmaceuticals and grown more cautious about new drug approvals, especially in the aftermath of pulling a widely sold arthritis drug because of safety concerns.
In 2007, the Food and Drug Administration has slapped new warnings on drugs from GlaxoSmithKline plc, Amgen Inc. and Eli Lilly and Co. and rejected highly anticipated products from Sanofi-Aventis and others.
While drug makers say recently passed laws giving FDA additional powers to regulate drugs may ease the agency's defensive stance, IMS foresees more warning labels and slower approvals.
"What we see is more information on drug usage becoming available and being mined to find risks and safety issues," said Murray Aitken, a senior vice president with IMS Health. "Overall this means more uncertainty for companies, as well as for their ability to get products to patients."
Brain scan abnormalities not uncommon
Thu, 01 Nov 2007 02:15:01 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - One in 60 older people may be walking around with benign brain tumors and don't know it. Even more may have bulging blood vessels in the head that could burst. These results come from a surprising new Dutch study that finds brain abnormalities are not all that uncommon.
It's not clear how alarming this is. Most of the abnormalities hadn't caused any symptoms, though some were potentially life-threatening.
But the findings may have implications for patients in the future: As more of these abnormalities are spotted with more sophisticated equipment during routine medical tests, some doctors may urge patients to have surgery or other treatment as a precaution. Or some patients may push doctors to fix the potential problem.
"It's very scary to learn there's something wrong in your head," said Dr. Aad van der Lugt, an associate professor in radiology at Erasmus MC University Medical Center in Rotterdam and a co-author of the study published in Thursday's New England Journal of Medicine
The study is based on MRI, or magnetic resonance imaging scans of 2,000 healthy adults with an average age of 63. They were participating in a study to look at the causes and consequences of age-related brain changes. The new paper's findings were incidental to the main research.
Participants who needed additional evaluation or treatment were referred to specialists. None of the brain tumors spotted by the MRIs required surgery, the researchers said.
Scans are increasingly being used, raising the chances that abnormalities will be spotted. About 20 million MRIs are done worldwide each year on the head, according to GE Healthcare, which makes scanners.
Even so, physicians do not recommend routine MRIs to look for brain problems in the way that people now get mammograms or colonoscopies.
"There's no evidence that screening MRIs of the brain are valuable," said Dr. Carolyn Meltzer, chairman of radiology at the Emory University School of Medicine.
The Dutch scientists found that 145 people — or 7.2 percent — had some dead brain tissue caused by a loss of blood flow. These are sometimes called silent strokes and usually don't result in a loss of speech or motion.
However, a patient who's had a silent stroke may be more likely to have another, more serious stroke, said Dr. Greg Joseph, a Charlotte, N.C., neuroradiologist who is part of a doctors group that reads 100 brain scans a day. Finding silent strokes allows doctors to prescribe medications or other measures that could prevent future problems, he said.
Another 32 people in the study — or 1.6 percent — had brain tumors. All but one were non-cancerous, but even benign tumors can kill if they grow and shut down vital brain functions. Doctors sometimes treat these, or do annual MRI scans to watch for signs of growth.
Another 35 people — or 1.8 percent — had bulging blood vessels, called aneurysms. Blood vessels that burst can cause serious strokes. However, all but five aneurysms found in the study were small and not considered dangerous.
The Dutch participants were mostly white, middle class and healthy; whether the same brain abnormalities would be found in other groups of people isn't known, the researchers said.
In brain scans to investigate headaches or other problems, it's not unusual to find a small percentage of unexpected abnormalities. But the new study — one of the largest of its kind which used a state-of-the-art MRI scanner — gives perhaps the best estimate of how often these occur in the general public, said Judy Illes, a University of British Columbia professor who has written extensively on the topic.
One person who is glad she had an MRI is Seattle physician Sarah Hilgenberg. Five years ago, as a 24-year-old medical student, she joined a study in which participants got an MRI brain scan in exchange for $40.
That afternoon, while peeling apples at her kitchen sink, she got a call saying a problem had been spotted. More tests revealed a spider web of blood vessels over an eye that doctors feared could burst. They placed a kind of glue in the blood vessels and then removed the tangle in surgery.
The risky treatment could have killed her, but she is fine now and did not want to live in fear of a fatal brain bleed.
"In the end, I feel very lucky that it happened," she said of the original scan.
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On The Net:
New England Journal: http://nejm.org
US bosses wrong to fire smokers obese survey
Thu, 01 Nov 2007 18:59:16 GMTWASHINGTON - Americans spoke out strongly against bosses who fire workers who are obese or smoke, a poll showed Thursday.
A scant few of the 2,267 US adults polled online by Harris Interactive early last month said employers should be allowed to fire someone who is unwilling to lose weight or stop smoking .
But around one-third of poll respondents said employers should be allowed to require staff to attend smoking cessation sessions or weight-loss programs.
&;Employers have been making headlines recently for adopting stricter wellness policies in order to control healthcare costs,&; Harris Interactive's head of healthcare research, Katherine Binns, said in a statement.
&;Companies such as Scotts and Weyco have fired employees who tested positive for nicotine,&; the statement said.
A Massachusetts man last year sued Scotts for firing him for smoking on his own time, a report in the Boston Globe said.
His suit said he was unfairly sacked for &;engaging in legal activities away from the workplace,&; the Globe report said.
Michigan-based Weyco instituted a policy in 2005 that allows employees to be laid off if they smoke, regardless of whether they engage in the habit at work or at home.
The company subsequently fired four employees who refused to be tested for nicotine, press reports said, with other reports saying Weyco staff members were fired after tests showed they had nicotine in their blood.
The poll conducted for The Wall Street Journal also showed that the number of Americans who feel the obese and smokers should pay higher healthcare premiums than their non-smoking and slim counterparts was significantly down form last year.
Thirty-seven percent said it was fair for people with unhealthy lifestyles to pay more for health insurance than their healthier counterparts, compared to 53 percent last year.
Eight out of 10 of those who said the unhealthy should carry a bigger health insurance burden also said it was unfair to ask people with healthy lifestyles to subsidize those who choose to smoke or pile on the pounds.
Three-quarters of those polled said they believed higher insurance premiums for unhealthy living could encourage people to live more healthily.
Enzyme may play role in aggressive lung cancer
Thu, 01 Nov 2007 04:29:18 GMTCHICAGO - Higher levels of an enzyme that makes estrogen may be the hallmark of a more aggressive type of lung cancer in older women, a finding that could lead to earlier diagnosis and treatment, U.S. researchers said on Thursday.
They said measuring levels of the enzyme aromatase -- which naturally converts the hormone androgen into estrogen -- could be used to predict survival in women with early stage lung cancer who are over the age of 65.
And it may also suggest treatments that inhibit aromatase, which are already approved to treat breast and ovarian cancer, might be a possible new treatment for lung cancer.
&;All indications suggest that this is a very powerful marker that lets us predict which patients have a higher likelihood of prolonged survival versus death from lung cancer,&; said Lee Goodglick, an associate professor in the Department of Pathology and Laboratory Medicine at UCLA, whose study was published in the journal Cancer Research.
The study also allows doctors to predict survival early in the disease process.
Goodglick and colleagues knew estrogen played a role in the development of lung cancer, just like it does in some breast cancers.
Studies in animals found a link between estrogen and aromatase in triggering the growth of lung cancer tumors. They studied tissue samples taken from 750 men and women.
What they found was a link between higher aromatase levels and aggressive lung cancer in women 65 and older. They did not find the higher enzyme levels in men or younger women.
The researchers are not sure why aromatase is a better predictor of lung cancer in women 65 and older, but it may have something to do with androgen, which declines steadily at that age.
They hope to study this in a larger group of people at many cancer centers across the country.
&;We need to figure out all the strategies that a lung cancer cell uses to trigger and amplify the estrogen pathway,&; Goodglick said in a statement. &;In women over 65, one trick the cancer cells appear to use is increasing aromatase.&;
Lung cancer is the second-most common cancer in women after breast cancer, according to the American Cancer Society. About 98,000 women will be diagnosed with lung cancer this year and more than 70,000 will die.
Current aromatase inhibitor medications include AstraZeneca's Arimidex or anastrozole, Pfizer's Aromasin or exemestane and Novartis' Femara or letrozole.
