Just 1 in 4 know heart attack signs
Fri, 22 Feb 2008 02:02:36 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - Only about 1 in 4 Americans know the warning signs of a heart attack and what to do first, according to a new government report. That's a decline in knowledge since the last survey in 2001, which showed nearly 1 in 3 to be well informed.
The study's lead author, Dr. Jing Fang, called public awareness in the new survey "alarmingly low." Fang is with the Centers for Disease Control and Prevention, which surveyed residents of 13 states and the District of Columbia.
Heart attack warning signs can include one or more of the following five symptoms: shortness of breath; pain or discomfort in the chest; discomfort in the arms or shoulder; a feeling of weakness or lightheadedness; and discomfort in the jaw, neck or back.
Chest pain is the most common symptom. Women are more likely than men to experience some of the other symptoms, particularly shortness of breath and back or jaw pain, according to the American Heart Association.
Anyone experiencing these symptoms should call 911, the heart association advises.
The groups best informed of heart attack warning signs and what to do about them tended to be white, highly educated, and women. Also scoring well were residents of West Virginia, which has some of the nation's highest heart attack death rates.
Each year more than 900,000 Americans suffer a heart attack, and about 157,000 of them are fatal. About half the deaths occur within an hour of symptoms occurring, experts say.
Because different people experience different symptoms, it's important to be aware of all of them, doctors say.
"It's not always massive chest pain," said Wayne Rosamond, a University of North Carolina epidemiology professor and expert on heart disease statistics.
Of course, knowing is not the same as doing: Although most of those who got the heart attack symptoms right said they would call 911, other studies show that only about half of heart attack victims go to a hospital by ambulance, Rosamond noted.
Patients' concerns about lack of health insurance status or other matters may explain why so few go to a hospital, said Rosamond, who was not involved in the new study.
The CDC's findings were based on a random-digit-dial telephone survey of about 72,000 people in 2005.
In West Virginia, more than 35 percent of respondents from that state knew all five warning signs and that they should call 911, compared with 27 percent in the overall study population.
Iowa and Minnesota also were at the top of the list. The gap between West Virginia and the two other states was not statistically significant.
West Virginia consistently ranks among the states with the highest heart attack deaths rates, and also is a leader in smoking, obesity, high cholesterol and other heart disease risk factors. But it's not clear whether personal experience was the reason the state's residents were so well informed. Public health education campaigns or other factors may also explain the result, experts said.
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On the Net:
The CDC publication: http://www.cdc.gov/mmwr
The American Heart Association: http://www.americanheart.org
Feds prescribe new recipe for flu shot
Fri, 22 Feb 2008 00:43:24 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Next year's flu vaccine is getting a complete overhaul to provide protection against three new and different influenza strains — hopefully better protection than this year's version.
Advisers to the Food and Drug Administration unanimously backed the new recipe on Thursday, echoing an earlier decision by the World Health Organization. It's a highly unusual move: Seldom are more than one or two strains swapped out from one year to the next.
Now the question is whether vaccine manufacturers can make such a big change in time to produce more than 100 million doses by the fall.
"It's going to be a really busy spring and summer, and of course we're always looking for fallback positions just in case things don't work out well," said Dr. Nancy Cox, flu director at the Centers for Disease Control and Prevention. "There's a lot of work that will be going on ... to try and make sure that everything comes together in such a way that there will be plenty of vaccine."
One concern: A strain called Brisbane/10 that's responsible for much of this winter's misery doesn't grow very quickly in the laboratory, potentially complicating already laborious vaccine production.
The flu vaccine must be reformulated every year to keep up with the fast-evolving influenza virus, and this year the government made a rare wrong bet on which strains would cause the most disease. The flu season got off to a slow start, but it rocketed in mid-January as some new strains arrived — and the CDC found the vaccine is a good match for only about 40 percent of the virus now spreading in the U.S.
That Brisbane/10 strain is the big culprit, one first spotted in Australia late last winter, too late for scientists to include in this year's vaccine recipe even if they had predicted it would gain steam.
Flu viruses come in different strains that constantly mutate, until one that few people have immunity against emerges and is able to spread widely. Each year's vaccine contains protection against two varieties of the harsher Type A flu — subtypes known as H1N1 and H3N2 — and one from the more benign Type B family.
CDC and international authorities expect Brisbane/10, a version of the H3N2 flu, to still be around next year. They predict a second new Type A strain, known as H1N1/Brisbane/59, also will hit, along with a newer Type B/Florida strain, prompting Thursday's decision to put all three in next year's vaccine.
It's a gamble based on tracking illness around the globe, and the CDC does have a pretty good record: 16 of the last 19 flu seasons had well-matched vaccines.
Still, "as we always say, influenza is quite unpredictable," Cox cautioned Thursday.
The recipe must be set about eight months before manufacturers start shipping doses because flu vaccine production is so complex. Health authorities come up with seed stocks of the virus strains that manufacturers then must grow in chicken eggs.
Makers of vaccine for the Southern Hemisphere already have added the troublesome Brisbane/10 strain to their own shots, and found it doesn't grow easily. Scientists now are working on a solution to that technical problem, such as using a very similar virus — it's even called "Brisbane/10-like" — found in Uruguay that would provide the same protection, Cox said.
"It's certainly a challenge for all the manufacturers," said Nancy Kavanaugh of Medimmune Inc., which makes a nasal spray flu vaccine, the only non-shot version. "We're working with three new strains. ... There's some unknowns related to those and how they're going to grow."
As for the rest of this winter, the CDC says the current vaccine should provide some protection, perhaps resulting in a milder case of flu than if someone hadn't been inoculated. It's too early to tell if this winter's flu will be more deadly than usual. Every year, the flu infects up to 20 percent of the population, hospitalizes 200,000 people and kills 36,000.
Indonesia sends bird flu samples to WHO
Fri, 22 Feb 2008 04:51:30 GMTBy ZAKKI HAKIM, Associated Press Writer
JAKARTA, Indonesia - Indonesia sent 12 bird flu samples to a World Health Organization laboratory this week after receiving assurances its rights to any vaccines produced from them would be recognized, the health minister said.
Indonesia had been refusing to send samples to WHO since January 2007, saying poor nations needed guarantees that any pandemic vaccines developed from the virus would be affordable and available to them.
It was unclear whether Indonesia would now routinely share samples, a move that would effectively end a standoff that experts have said could jeopardize global efforts to battle bird flu.
Health Minister Siti Fadilah Supari told The Associated Press late Thursday that 12 samples from recent bird flu patients were sent on Tuesday to the WHO-affiliated Centers for Disease Control and Prevention in Atlanta, the United States.
"This is just for risk assessment," Supari said. "If they want to develop them into a seed virus they must notify us. If they make them into a vaccine our rights over will be recognized." She did not elaborate.
WHO officials in Jakarta declined immediate comment on her statement.
Supari has been calling for WHO to change its 50-year-old influenza virus sharing system so that developing countries that hand over samples retain the rights to any vaccines produced from them.
Currently, poor countries are obliged to send samples to WHO, which then makes them available to pharmaceutical companies to use in vaccine production. Wealthy nations have stockpiled tons of bird flu vaccines, while Indonesia has limited supplies.
WHO and Indonesia have engaged in numerous rounds of talks trying to find a solution that would ensure developing countries have equal access to a pandemic vaccine at an affordable price.
Indonesia has recorded 105 deaths from bird, almost half the global tally, according to WHO.
Bird flu remains hard for people to catch, but health experts worry the virus could mutate into a form that passes easily among humans, sparking a pandemic. So far, most human cases have been linked to contact with infected birds.
Scientists have warned that Indonesia, which has millions of backyard chickens and poor medical facilities, is a potential hot spot for a global bird flu pandemic.
UK doctors urge higher taxes on alcohol
Thu, 21 Feb 2008 22:36:03 GMTBy RAPHAEL G. SATTER, Associated Press Writer
LONDON - The British Medical Association lobbied Thursday for higher taxes on alcohol, an end to happy hours, and a steep reduction in the permitted blood alcohol-limit for drivers.
A report by the group said new laws were needed to combat an epidemic of alcohol misuse that is costing health and law enforcement services billions of dollars a year.
It comes at a crucial juncture in the national debate about how to tackle Britain's booze culture — one which has lawmakers re-examining everything from super-size glasses at fancy wine bars to super-cheap ciders at discount supermarkets.
British supermarket giant Tesco PLC said Thursday it wanted to work with the government on new laws to ensure what it called the "responsible pricing" of alcohol, something campaigners say shows a consensus is building on how to handle the nation's drinking problem.
"As doctors we see first hand how alcohol misuse destroys lives. It causes family breakdowns, is a major factor in domestic violence, ruins job prospects, is often related to crime and disorderly behavior and it kills," said Dr. Vivienne Nathanson, the British Medical Association's head of science and ethics.
The association's report makes grim reading. Britain is among of the hardest drinking countries in Europe, and the country's alcohol-related death rate almost doubled between 1991 and 2005 — from 6.9 to 12.9 per 100,000 people.
Britain's hospitals are groaning under the strain. The association cited a 2004 government study putting alcohol's cost to the country's health, law enforcement and criminal justice services at billions of dollars a year.
Another study estimated that 70 percent of all peak-time emergency room admissions were linked to alcohol. London's ambulance service has devoted one of its vehicles, known colloquially as the "booze bus," exclusively to peeling intoxicated revelers off the streets.
The debate over the escalation in alcohol abuse is consuming an increasing amount of media attention. On New Year's Day, British papers carried front page pictures of half-naked teenage girls staggering around town centers and comatose youngsters passed out on sidewalks.
Earlier this month, Home Secretary Jacqui Smith said she was worried by data that showed a majority of the country's 13-year-olds had consumed alcohol, while the president of Britain's Association of Chief Police Officers said last week that the country needed to "wake up" to its pathological relationship with alcohol.
"We have got a real problem with the way alcohol is marketed, the way it is consumed," Ken Jones told the British Broadcasting Corp. on Feb. 13.
Some have blamed the legalization of round-the-clock alcohol sales for the problem, saying it encourages all-night drinking. Others invoke British drinking culture and its emphasis on trading rounds of beer on an empty stomach. Some lawmakers even point to the size of wine glasses, accusing bars of trying to get patrons to consume more.
The British Medical Association said price, promotion and availability were key, and its report carried a graph showing alcohol consumption rising in line with increasing affordability.
The association urged the government to raise taxes, introduce minimum price levels on drink sales, cut back on opening hours and reduce the legal limit for blood alcohol content while driving.
It also urged the government to prohibit "happy hour" promotions and what it said was the "excessively cheap" alcohol being offered at convenience stores and supermarkets.
While the recommendations were not new, they come at the right time, said Frank Soodeen, a spokesman for Alcohol Concern, a charity devoted to fighting alcohol abuse.
Soodeen said that, paired with Tesco's offer, the medical association's report gave the government political cover to take more aggressive action on regulation and taxation.
The government, meanwhile, is conducting its own study of the impact of alcohol pricing on harmful drinking. The review, commissioned by the Department of Health, is due to be published over the summer.
Len Pentlin, 38, nursing a pint in a central London pub, said authorities could always look to the United States.
"You could increase the age limit," Pentlin said. "When I went to America in 1989, I went to some states and they asked for an ID."
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Associated Press Writer Regan McTarsney contributed to this report.
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On the Net:
British Medical Association: http://www.bma.org.uk
Fast Food Ads Fueling Obesity Among Hispanic Kids
Fri, 22 Feb 2008 04:47:21 GMTTHURSDAY, Feb. 21 -- The large number of fast food commercials on Spanish-language television in the United States may be contributing to the obesity epidemic among Hispanic youths, new research suggests.
Among American children, Hispanics have the highest rates of overweight and obesity.
Researchers from the Johns Hopkins Children's Center reviewed 60 hours of programming airing between 3 p.m. and 9 p.m. (heavy viewing hours for school-age children) on Univision and Telemundo, the two largest Spanish-language channels in the United States. The stations reach 99 percent and 93 percent of U.S. Hispanics, respectively.
The stations averaged two to three food commercials an hour, with one-third of them specifically targeted to children. Almost half of all food commercials promoted fast food, and more than half of all drink commercials featured soda and drinks with high sugar content. The study was published in the Feb. 18 online issue of the Journal of Pediatrics.
"While we cannot blame overweight and obesity solely on TV commercials, there is solid evidence that children exposed to such messages tend to have unhealthy diets and to be overweight," lead investigator Dr. Darcy Thompson, a pediatrician at Hopkins, said in a prepared statement.
To reduce the impact of food commercials, young children should be restricted to two hours or less per day of TV, and parent should talk to their children about healthy diet and food choices, the researchers said. Children younger than 2 shouldn't be allowed to watch any TV.
The Hopkins team also recommended that pediatricians caring for Hispanic children should be aware of their patients' heavy exposure to food commercials and the possible effects of that exposure. In addition, public health officials should lobby policy makers to limit food advertising that targets children.
More information
The Nemours Foundation has more about overweight and obesity in children.
