Double dipping Seinfeld was right
Sat, 02 Feb 2008 03:30:03 GMTBy SUSANNE M. SCHAFER, Associated Press Writer
COLUMBIA, S.C. - Keep an eye on the salsa this Super Bowl Sunday: A researcher inspired by a famous "Seinfeld" episode has concluded that double dipping is just plain gross.
"That's like putting your whole mouth right in the dip!" George Costanza was admonished on the show after he dipped a chip twice at a wake. That's not too far off, said Clemson University professor Paul L. Dawson.
Last year the food microbiologist's undergraduate students examined the effects of double dipping using volunteers, wheat crackers and several sample dips. They found that three to six double dips transferred about 10,000 bacteria from an eater's mouth to the remaining dip sample.
"I was very surprised by the results," Dawson said in a telephone interview Thursday. "I thought there would be very minimal transfer. I didn't think we would be able to detect it."
The professor said the students' research didn't get into the risk behind such a bacteria transfer, but they got the idea.
"I like to say it's like kissing everybody at the party — if you're double dipping, you're putting some of your bacteria in that dip," Dawson said.
The results of the research are scheduled to be published in the journal Food Safety within the next six months, he said.
HPV causing more oral cancer in men
Sat, 02 Feb 2008 00:02:17 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - The sexually transmitted virus that causes cervical cancer in women is poised to become one of the leading causes of oral cancer in men, according to a new study.
The HPV virus now causes as many cancers of the upper throat as tobacco and alcohol, probably due both to an increase in oral sex and the decline in smoking, researchers say.
The only available vaccine against HPV, made by Merck & Co. Inc., is currently given only to girls and young women. But Merck plans this year to ask government permission to offer the shot to boys.
Experts say a primary reason for male vaccinations would be to prevent men from spreading the virus and help reduce the nearly 12,000 cases of cervical cancer diagnosed in U.S. women each year. But the new study should add to the argument that there may be a direct benefit for men, too.
"We need to start having a discussion about those cancers other than cervical cancer that may be affected in a positive way by the vaccine," said study co-author Dr. Maura Gillison of Johns Hopkins University.
The study was published Friday in the Journal of Clinical Oncology.
Human papillomavirus, or HPV, is the leading cause of cervical cancer in women. It also can cause genital warts, penile and anal cancer — risks for males that generally don't get the same attention as cervical cancer.
Previous research by Gillison and others established HPV as a primary cause of the estimated 5,600 cancers that occur each year in the tonsils, lower tongue and upper throat. It's also been known that the virus' role in such cancers has been rising.
The new study looked at more than 30 years of National Cancer Institute data on oral cancers. Researchers categorized about 46,000 cases, using a formula to divide them into those caused by HPV and those not connected to the virus.
They concluded the incidence rates for HPV-related oral cancers rose steadily in men from 1973 to 2004, becoming about as common as those from tobacco and alcohol.
The good news is that survival rates for the cancer are also increasing. That's because tumors caused by HPV respond better to chemotherapy and radiation, Gillison said.
"If current trends continue, within the next 10 years there may be more oral cancers in the United States caused by HPV than tobacco or alcohol," Gillison said.
Studies suggest oral sex is associated with HPV-related oral cancers, but a cause-effect relationship has not been proved. Other researchers have suggested that even unwashed hands can spread it to the mouth as well.
Gillison pointed toward sex as an explanation for the increase in male upper throat cancers. However, HPV-related upper throat cancers declined significantly in women from 1973 to 2004.
Merck's vaccine, approved for girls in 2006, is a three-dose series priced at about $360. It is designed to protect against four types of HPV, including one associated with oral cancer.
Merck has been testing the vaccine in an international study, but it is focused on anal and penile cancer and genital warts, not oral cancers, said Kelley Dougherty, a Merck spokeswoman.
"We are continuing to consider additional areas of study that focus on both female and male HPV diseases and cancers," Dougherty said.
Merck officials praised Gillison's research, saying it will elevate the importance of HPV-related oral cancers.
Government officials and the American Cancer Society say they don't know yet whether Merck's vaccine will be successful at preventing disease in men. No data from the company's study are available yet.
Indeed, it's not clear yet that the vaccine even prevents the HPV infection in males, let alone cancer or any other illness, said Debbie Saslow of the American Cancer Society.
Merck plans to seek U.S. Food and Drug Administration approval for the vaccine in men later this year, meaning a government decision would be likely in 2009.
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On the Net:
Journal of Clinical Oncology: http://jco.ascopubs.org
Puerto Rico home of deadly syndrome
Sat, 02 Feb 2008 00:02:15 GMTBy DANICA COTO, Associated Press Writer
AGUADILLA, Puerto Rico - Mayra Nieves is used to being ostracized and called names as an albino in this Caribbean community. What she fears is not being able to breathe. Nieves is among hundreds of Puerto Ricans who have a rare type of albinism that leads to a deadly lung disease.
Sufferers such as Nieves, 30, a mother of three, have roughly five years to live once they've been diagnosed with the lung condition, known as pulmonary fibrosis.
The island has the world's highest incidence of this often fatal type of albinism, which was likely brought by a colonizer centuries ago and proliferated as the isolated population intermarried.
Today it is the focus of an experimental drug study at the National Institutes of Health. Researchers aim to minimize lung scarring from the disease that smothers air sacs and prevents oxygen from entering the bloodstream.
Nieves still remembers the day several years ago — before her diagnosis — when she suddenly passed out, gasping for air.
"I almost died," she said. "It was scary. I couldn't talk, but I remember thinking, 'Dear God, let me stay. My daughters need me.' "
Various genetic disorders can lead to albinism, defined by a lack of pigmentation in eyes, skin and hair. But Type 1 of the so-called Hermansky-Pudlak Syndrome is particularly deadly, said Dr. Thomas Markello, who works at the medical genetics branch of the National Institutes of Health. The syndrome, which is rare worldwide, is the leading cause of albinism in Puerto Rico, he said.
An estimated 300 to 500 albinos with the fatal strain live in Puerto Rico's northwest region, the island's largest concentration. NIH estimates that one in every 400 to 2,000 people worldwide carries the gene for the syndrome, compared with one in every 20 Puerto Ricans living in the northwest.
"All patients will need a lung transplant to stay alive unless we succeed in fixing the problem," Markello said.
Nieves flew to an NIH clinic in Bethesda, Md., several times last year for the drug study, which is aimed at people in the earliest stages of the disease. She still has a couple of visits left.
Her mother and father are albinos, and her father suffers from Hermansky-Pudlak. Two of his cousins died from it. Nieves' husband is not albino, nor are her daughters, though all three carry the gene — and the potential for continuing the syndrome.
The albinos scattered across the mountain villages here are often ridiculed. Nieves almost dropped out of school for being called "milk" and other nicknames. People warned their children to stay away from her, fearing they could "catch" her genetic condition. Albinism has even broken up marriages. People who don't know they carry the gene sometimes accuse spouses of cheating when an albino child is born.
If both parents are carriers of the syndrome, children have a 25 percent chance of developing it, said Enid Rivera, the director of epidemiology in Puerto Rico's Health Department.
Most sufferers develop lung problems in their 30s and 40s, but patients as young as 25 and old as 65 have died from the disease, Markello said.
Like Nieves, several dozen Puerto Ricans are taking the experimental drug, pirfenidone, which already has been the subject of 12 U.S. trials involving other ailments, including the scarring of kidneys spurred by diabetes.
Lung function among albino sufferers improved slightly in a previous pirfenidone study. Researchers say they need at least 40 patients for the current one, and they have enrolled about 26 so far.
There's no cost to participating in the drug study, and the known side effects seem to be as mild as heartburn. But scores of afflicted Puerto Ricans have refused. Some believe prayer alone will help, while others mistrust the idea of government research.
"I've had people on the phone praying, saying their faith will get them through," said Donna Appell, who founded the New York-based, Hermansky-Pudlak Syndrome Network and helped establish a Puerto Rican chapter.
German Acevedo, 30, is among the sufferers trying to enlist others.
"OK, they use you, but they might be saving your life," he tells the skeptics.
Lung transplants aren't an alternative for Puerto Rican sufferers, Markello said, mostly because the procedure costs around $300,000 and is not available on the island. Many sufferers do not have insurance. For those 65 and younger, Medicaid is not an option, because it does not cover off-island treatment.
No one keeps records of how many Puerto Ricans have died from the syndrome. NIH researchers suspect many deaths have been wrongly blamed on pneumonia, asthma and lung cancer.
CDC Flu outbreaks reported in 11 states
Sat, 02 Feb 2008 01:29:31 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Flu season is in full swing, with wide outbreaks in 11 states — and a new strain is starting to emerge that this year's vaccine doesn't specifically target, the government's public health chief said Friday.
People still should get their flu shot, and there's plenty available, Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, told The Associated Press.
So far, the majority of flu cases are being caused by strains that are a good match to the vaccine — and it should provide some cross-protection against the new bug, too, Gerberding stressed.
"We're still very optimistic" about the protection, Gerberding said. "If people haven't gotten their flu shot, it really is still not too late."
Every year, the flu infects up to 20 percent of the population, causes the hospitalization of 200,000 people and kills 36,000.
Flu is a virus, but it can make its victims vulnerable to bacterial infections, in the lungs or the bloodstream, at the same time.
Children are at particular risk, and the CDC this week sent an alert to doctors to watch for young flu victims who might also have such bacterial infections as the notorious drug-resistant staph known as MRSA.
Last year, the CDC learned of 73 children who died from flu, and 44 percent of them had a bacterial co-infection — mostly staph. Compared to earlier years, that's a five-fold increase in staph piggybacking on kids' flu.
While the CDC's newest flu report lists one child death so far this year, Gerberding wanted to be sure that doctors test for staph in any child with a suspicious illness "because these bacteria need special treatment, and we want to make sure they get the right therapy."
Each year's vaccine contains protection against three influenza strains — two members of the nasty Type A family, an H1N1 and an H3N2 version, plus a milder Type B — that experts predict will cause the most illness.
So far this year, H1N1 is causing the vast majority of disease, Gerberding said.
But a new H3N2 strain emerged near the end of Australia's flu season, too late to be included in the U.S. vaccine. Called H3N2/Brisbane-like, it is now sickening Americans, although it still is making for a small proportion of cases, Gerberding cautioned.
Some 132 million doses of vaccine were produced this year, more than ever before. It's too early to know how many people got vaccinated, but Gerberding said a record number of doses were distributed to doctors and other vaccine providers — and that there is still some available.
CDC has found flu affecting most of the country but widespread outbreaks in Alaska, Colorado, Hawaii, Kansas, Massachusetts, Mississippi, New Mexico, New York, Pennsylvania, Texas and Virginia.
Obese patients wait longer for kidney transplants
Fri, 01 Feb 2008 20:29:29 GMTNEW YORK - Extremely obese adults in need of a kidney transplant appear to wait longer for a donor organ than their thinner counterparts do, a study has found.
The findings, according to researchers, suggest there may be a bias in the way donor kidneys are allocated.
Analyzing a decade's worth of national transplant data, researchers at Johns Hopkins University in Baltimore found that morbidly obese patients - those who are 100 or more pounds overweight -- on the kidney transplant waiting list were 44 percent less likely to receive a donor organ as normal-weight patients.
There was no similar disparity seen among overweight or mildly obese patients, the researchers report in the Journal of the American Society of Nephrology.
"The results identify a potential bias in organ allocation that is not consistent with the goals of our allocation system," Dr. Dorry L. Segev, the lead researcher on the study, said in a statement.
In the U.S., the United Network for Organ Sharing oversees the allocation of donor organs. Segev and his colleagues based their findings on UNOS data for 132,353 patients on the waiting list for a kidney transplant between 1995 and 2006.
They found that even when they considered medical factors that affect a person's eligibility for a donor kidney -- such as age or diabetes -- the odds of receiving a transplant decline with the severity of a patient's obesity.
Waiting-list patients who were morbidly obese were the least likely to get a transplant. Similarly, those considered severely obese were 28 percent less likely to receive a donor kidney than normal-weight patients were.
In addition, when a donor organ did become available, the most obese patients were more likely than other patients to be "bypassed" -- meaning their doctors were more likely to decline the offer of a kidney.
"It is possible that providers are bypassing obese patients and instead transplanting non-obese patients because they feel that kidneys are a scarce resource and they want the kidneys to go to the patients who will benefit most from them," Segev said.
"However," he added, "there is strong evidence that even obese patients will benefit significantly from a kidney transplant."
Moreover, Segev noted, the organ allocation system was not set up to operate on such medical judgments, and all patients placed on the transplant waiting list are supposed to have a fair chance of getting an organ.
He pointed to two possible "disincentives" for transplant surgeons to operate on severely obese patients. One is that the surgery for these patients is more difficult and they tend to have more complications and longer hospital stays, Medicare pays a set amount for the operation.
A second disincentive, according to Segev, may be the fact that surgeons' and hospitals' transplant success rates are publicly reported. This may make them reluctant to take on a large number of high-risk patients.
If bias against severely obese transplant candidates does exist, it's not immediately clear how to remedy the problem, Segev and his colleagues point out.
Another study at Johns Hopkins is currently looking at whether obese transplant candidates should first be referred for weight-loss surgery to reduce their risk of post-transplant complications.
SOURCE: Journal of the American Society of Nephrology, February 2008.
Safe sex the message as Rio launches into Carnival
Fri, 01 Feb 2008 22:22:35 GMTBy Angus MacSwan
RIO DE JANEIRO - Wearing nuns' veils, condom-shaped hats and all kinds of silly headgear, Brazilians partied in the beer-slicked streets of Rio de Janeiro on Friday as its Carnival started in earnest.
Crowds gathered in the historic hilltop district of Santa Teresa for one of the most popular binges, the Bloco das Carmelitas. Elsewhere, bars and cafes overflowed onto the streets as the beat of samba drums rose above the throng.
Many of the revelers in Santa Teresa wore hats shaped liked condoms -- distributed as part of a campaign to promote safe sex and prevent the spread of sexually transmitted disease.
The government has handed out 19.5 million free condoms across Brazil, drawing criticism from Roman Catholic clerics in the world's largest Catholic nation.
"The condom means safe sex -- that's a good Carnival message," said Thais, a long-legged blonde chugging beer with her girlfriends.
Others wore black nuns' veils.
"The story is that a long time ago, a nun jumped over the wall of the Carmelita convent, down there, so she could dance in Carnival," said a hat seller named Rita.
The Bloco das Carmelitas social club named itself after the convent but the revelers showed no signs of being restrained by religious considerations.
An estimated 700,000 Brazilian and foreign tourists are expected to join in the five-day fiesta, famed the world over for its extravagant samba parades and dancers dressed in little more than plumed head-dresses and high-heeled shoes.
REMINDER OF VIOLENCE
The day got off to a solemn start, however, as police demanding more pay placed nearly 600 crosses on Copacabana Beach in memory of slain officers -- a reminder of the violence that grips the crime-plagued city.
The protest was part of a campaign for better working conditions that has thrown the police force into disarray in the build-up to the festivities.
About 50 officers offered to resign this week and 11 have been sacked, including the force commander, but Rio Gov. Sergio Cabral has pledged that security for Carnival would not be compromised.
Brazilians have good reason to celebrate this year as the country enjoys an economic boom that has given more people jobs and put more money in their pockets.
"Yes, it's been a good year," said Thais, a 26-year-old law student, offering her condom hat to a reporter.
Asked about the violence that afflicts Rio, she said: "That happens in certain parts of the city but not everywhere, not here. Nothing's happened to me for a long time."
Rio is one of the world's most violent cities, with heavily-armed drug gangs controlling many of its slums, or favelas, and police responding with military-style raids.
"We want to pay homage to our heroes, we want to show the community the cost of the life of a policeman," Police Officers Association head Dilson Ferreira de Anaide said as he and other policemen placed 586 crosses in the sand on Copacabana Beach -- one for each of their colleagues killed in action since 2004.
"We earn 30 reais a day, less than a maid earns."
The crisis in the force erupted after Col. Ubiratan Angelo was sacked by state security chief Jose Beltrame for allowing a mass police protest to go ahead last weekend.
The new commander, Col. Gilson Pitta, promised that the public would be safe.
"We are going to have the most peaceful Carnival of all time, for Rio residents and for tourists," he said.
More than 9,500 police will patrol the streets for Carnival, which peaks when the city's top samba groups march in the Sambadrome parade strip on Sunday and Monday nights.
Pregnant Women With Asthma Should Stay on Low Dose of Meds
Sat, 02 Feb 2008 04:46:55 GMTFRIDAY, Feb. 1 -- During pregnancy, asthmatic women should continue to use their asthma medication in the lowest dose possible to manage symptoms.
So recommends a new Practice Bulletin just released by the American College of Obstetricians and Gynecologists .
The bulletin says women with moderate or severe asthma should also be monitored throughout pregnancy for fetal growth restriction and signs of possible preterm birth.
During pregnancy, asthma attacks may deprive the fetus of oxygen and may be associated with premature birth, growth restriction and other fetal complications, as well as illness and death in women, the ACOG said.
The new recommendations are based on a review of existing studies and support the position of the U.S. National Asthma Education Prevention Program that "it is safer for pregnant women with asthma to be treated with asthma medications than it is for them to have asthma symptoms and exacerbations."
"Previously, there was limited guidance regarding the management of asthma during pregnancy," Dr. Andrew J. Satin, chairman of the ACOG's Committee on Practice Bulletins-Obstetrics, said in a prepared statement. "With the growing number of asthmatics in the U.S., it became a priority to formalize recommendations for ob-gyns, who will likely see an increasing number of asthmatic patients."
"Research consistently shows that women with well-controlled asthma can have healthy pregnancies with excellent maternal and perinatal outcomes," Dr. Mitchell P. Dombrowski, an ACOG Fellow who contributed to the new Practice Bulletin, said in a prepared statement. "The ultimate goal of controlling asthma during pregnancy is to ensure that the fetus continues to get adequate oxygen by preventing asthma attacks."
The bulletin is published in the February issue of Obstetrics & Gynecology.
More information
The American Academy of Allergy, Asthma and Immunology has more about asthma and pregnancy.
Sarkozy unveils plan to fight Alzheimer39s disease
Fri, 01 Feb 2008 19:43:36 GMTSOPHIA ANTIPOLIS, France - President Nicolas Sarkozy on Friday unveiled a five-year plan to fight Alzheimer's disease that afflicts 860,000 elderly people in France.
The 1.6-billion-euro plan provides for the creation of a new research foundation to pool efforts at scientific advances and sets up a network of nursing homes to help families cope.
"This is a lasting commitment on behalf of the state in the fight against this disease," Sarkozy said during a visit to Sophia Antipolis, near the French Riviera city of Nice.
"This is a personal commitment," added Sarkozy, who had singled out Alzheimer's disease as a priority of his health policy during his campaign for the presidency last year.
Most of the funds for the plan will come from a new user fee on health services that came into effect on January 1.
The France-Alzheimer association representing families of Alzheimer's patients welcomed the plan, with president Arlette Meyrieux saying it could yield "significant progress" .
But she added "we want to see the details and how it's going to be implemented and with what means."
An estimated 1.3 million people are expected to suffer from Alzheimer's in France by 2020 and the number could hit 2.1 million by 2040.
The degenerative brain disorder is the leading cause of loss of autonomy for the elderly.
Sarkozy wants to organize a Europe-wide conference on Alzheimer's disease during the six-month French presidency of the European Union starting in July.
Experimental Vaccine Halts Prostate Cancer in Mice
Sat, 02 Feb 2008 04:47:06 GMTBy Ed Edelson
HealthDay Reporter
FRIDAY, Feb. 1 -- An experimental prostate cancer vaccine has stopped the progress of the disease in 90 percent of the mice who got it, California researchers report.
"The vaccine turned the cancer into a chronic, manageable disease," said W. Martin Kast, lead author of a report published in the Feb. 1 issue of Cancer Research.
Twenty mice, genetically bred to develop prostate cancer, were given the vaccine in a two-step process, said Kast, a professor of molecular microbiology and immunology at the University of Southern California, Los Angeles.
When the mice were 8 weeks old, they got one injection consisting of a fragment of DNA that coded for prostate stem cell antigen , a protein that is overproduced as prostate cancers grow. That injection alerted the immune system, Kast said.
A second shot, given two weeks later, used a modified horse virus to deliver the gene for PSCA, throwing the immune system into full action against the tumor.
Only two of the 20 vaccinated mice developed full-blown prostate cancer at the end of one year. Twenty other similarly bred mice who did not get the vaccine died of their cancers.
A vaccine for prostate cancer already exists, but it is only designed to extend survival for men in advanced stages of the disease and it has not been approved for use in the United States.
The new vaccine is designed to be used much earlier, Kast said. "Our vaccine approach would be to give it before you actually develop the disease," he said. Candidates for vaccination would be men who have high levels of prostate-specific antigen , a protein associated with the cancer.
Physicians now perform biopsies in most such cases, looking for evidence of cancer, which is usually inconclusive. The vaccine could be given instead of the "watchful waiting" now common for these men, Kast said.
The series of animal tests needed to prepare for a first human trial will take perhaps two years, Kast said. As for marketing the vaccine, he added, "I have already started to talk to some companies about this."
A precedent for such use already exists in the form of the vaccine against cervical cancer that is in medical use in the United States, Kast noted.
A new urine test that could help narrow the number of men diagnosed with possible prostate cancer was also described in the same issue of the journal.
"It is an extension of a current test," said Dr. Arul Chinnaiyan, director of the University of Michigan Center for Translational Pathology and lead author of the report.
The current test, developed at Michigan and marketed by the biotechnology company Gen-Probe, screens for one molecular marker of prostate cancer. The new test screens for four more key markers.
"It is for early screening to supplement PSA testing," Chinnaiyan said. "The benefit of this is that it could spare some people from some unnecessary biopsies. Eighty percent of men with high PSA levels don't have cancer. This could pick up 80 percent of them."
Both reports brought guarded reaction from Dr. Durado Brooks, director of prostate and colorectal cancers for the American Cancer Society.
The California work, Brook said, "is an interesting direction in terms of a way to develop a vaccine, but it is a long way from clinical use."
As for the new test, he added, while it could possibly reduce the number of biopsies, it does not fulfill the big hope for prostate cancer tests: distinguishing between slow-growing cancers that are best left alone and fast-growing malignancies that require quick and aggressive treatment.
"We really need a better handle on which prostate cancers will be more aggressive," he said.
Meanwhile, researchers at the U.S. National Cancer Institute report in the same journal that they have discovered genetic factors that drive the development of prostate cancer in black men, who are more likely to die of the disease than whites.
An analysis shows numerous differences in genes governing the immune response to cancer, they reported.
More information
Learn about prostate cancer from the U.S. National Cancer Institute.
