Lung cancer screens may not save livesWed, 07 Mar 2007 01:00:50 GMTBy CARLA K. JOHNSON, Associated Press Writer CHICAGO - A new study suggests that screening smokers and former smokers for lung cancer doesn't save lives or prevent advanced disease and may lead to unneeded and harmful treatment. But it's not the final word on CT scans. Some experts have hoped that the scans, which are a special kind of X-ray that can detect tiny lung abnormalities, will prevent lung cancer deaths by getting people into treatment earlier. But there hasn't been convincing evidence of that. A large and authoritative scientific study won't be completed for a few years. Without that evidence, the http://jama.ama-assn.org Circumcision may lift HIV risk for womenWed, 07 Mar 2007 01:02:20 GMTBy MARIA CHENG, AP Medical Writer LONDON - Circumcision may reduce men's chances of contracting HIV by up to 60 percent — but early results suggest the procedure may put women at increased risk of infection, according to preliminary data presented Tuesday. Early results announced at a U.N. consultation in Switzerland on the potential impact of male circumcision on AIDS in Africa suggested that if HIV-positive men do not abstain from sex while healing from circumcision surgery, their female partners might have a higher chance of catching HIV from them. However, experts said the results were not conclusive — and highly susceptible to other factors, such as condom use — demonstrating the difficulties of utilizing circumcision in HIV prevention in sub-Saharan Africa, where more than 60 percent of those with AIDS are women. Previous studies have confirmed the dramatic impact circumcision has in cutting men's HIV infection rates, but a big question has been the resulting effect on women. The first evidence — though very preliminary — suggests there is a period immediately following surgery when men may more easily transmit the virus to their female partners. "Women are already so vulnerable in this epidemic," said Jennifer Kates, an AIDS expert at the Kaiser Family Foundation who is not connected to the study. "We need to be particularly careful about anything that could put them at even greater risk." Researchers at the Rakai Health Sciences Program and Makerere University in Uganda and the John Hopkins Bloomberg School of Public Health in the U.S. tracked 997 HIV-positive men in Uganda and their female partners. Among 70 men with HIV who underwent circumcision, 11 of their female partners became infected with the virus in the month after the surgery. In contrast, only four partners of 54 uncircumcised men with HIV in the control group caught the virus — nearly half the rate, early results showed. Researchers said the results suggest increased HIV transmission from men who have sex before they had properly healed. However, they said the numbers so far were too small to be statistically significant, and left open the possibility that the higher rates were due to chance; both groups of men and women were given repeated HIV prevention education and free condoms. Experts said the study showed the importance of finding ways to protect women in the search for ways to fight AIDS. "We need to err on the side of caution to protect women in any future male circumcision program," said Dr. Maria Wawer, the study's lead investigator, a researcher at Johns Hopkins Bloomberg School of Public Health. More than 60 percent of AIDS patients in sub-Saharan Africa are women. The social and economic inequalities between men and women are thought to be responsible for the elevated rates of infection in women, with many women trapped in relationships with unfaithful men. The preliminary results do not call into question the utility of circumcision as a way to prevent AIDS in Africa. But "while male circumcision has extraordinary potential to prevent HIV infection, these new findings remind us that we must proceed with thought and care in developing strategies to expand male circumcision in Africa," said Dr. Kevin De Cock, director of WHO's AIDS department. "Circumcision is an additional prevention strategy rather than a replacement for anything else." Surgeon general Teen drinking a problemWed, 07 Mar 2007 01:52:04 GMTWASHINGTON - Americans need a wake-up call about the widespread use of alcohol by millions of underage drinkers, acting Surgeon General Kenneth Moritsugu said Tuesday. Moritsugu issued a report that he said was designed to get all sectors of society involved in solving a major health problem. He described alcohol as the drug of choice for teens. The 2005 National Survey on Drug Use and Health estimates there are 11 million underage drinkers in the United States. Nearly 7.2 million are considered binge drinkers, typically meaning they drank more than five drinks on occasion. "Alcohol remains the most heavily abused substance by America's youth," Moritsugu said. He said the report calls for a "change in the culture and attitudes toward drinking in America. We can no longer ignore what alcohol is doing to our children." Moritsugu urged more research on adolescent alcohol use and its relationship to physical and mental development. He said there is new research that indicates alcohol may harm the development of the brain in adolescents. Although there has been a significant decline in tobacco and illicit drug use among teens, underage drinking has remained at consistently high levels, he said. In part, that high use stems from tolerance by adults. "Too many Americans consider underage drinking a rite of passage to adulthood," said Moritsugu. "Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life." ____ On the Net: Surgeon General's report: http://www.surgeongeneral.gov Panel nixes aspirin as cancer preventiveWed, 07 Mar 2007 01:10:10 GMTBy RON TODT, Associated Press Writer PHILADELPHIA - People at average risk for colon cancer shouldn't take aspirin or painkillers like ibuprofen to try to prevent the disease, a federal task force advises, because of the risk of bleeding and other potential health problems. The recommendation for the first time by the U.S. Preventive Services Task Force includes those with a family history of colorectal cancer. The panel said that potential risks of taking more than 300 milligrams a day of aspirin or non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen — brand names include Motrin, Advil and Aleve — include a higher risk for stroke, intestinal bleeding or kidney failure. Those risks outweigh the potential benefits of preventing cancer, the task force said in Tuesday's issue of the Annals of Internal Medicine. The task force said that while there is good evidence that low doses of aspirin, usually less than 100 milligrams, can reduce the risk of heart disease, it does not lower the rate of colon cancer. Colorectal cancer is the third most common type of cancer in men and women and is the second-leading cause of cancer-related deaths in the United States, killing about 56,000 people each year. About 150,000 new cases are diagnosed annually. Most of those diagnosed are over the age of 50, and 20 percent have a parent, sibling, grandparent, aunt or uncle with the disease. Blacks have the highest rate of colorectal cancer of any group. In 2002, the Preventive Services Task Force recommended that people age 50 and older be screened for colon cancer. Previous studies had suggested that a daily baby aspirin could prevent precancerous polyps that sometimes become colorectal cancer. But later research showed low-dose aspirin did little good at actually preventing cancer. Dr. Raymond DuBois, director of the Vanderbilt-Ingram Cancer Center in Tennessee, said he believes the task force's latest advice is reasonable. "I think for the general population, the risk of either having some gastrointestinal bleeding from aspirin or cardiovascular side effect from some of these other medications ... probably outweighs their use for colon cancer," he said. ____ On the Net: Annals of Internal Medicine: http://www.annals.org Diet study tips scale in favor of AtkinsWed, 07 Mar 2007 13:47:15 GMTBy Michael Conlon CHICAGO - A study of four popular diets found that women put on the one with the least carbohydrates -- the Atkins plan -- lost at least twice as much weight as those on the others, researchers said on Tuesday. "Many health professionals, including us, have either dismissed the value of very-low-carbohydrate diets for weight loss or been very skeptical of them," said Christopher Gardner, assistant professor of medicine at the Stanford Prevention Research Center in California, lead author of the study. "But it seems to be a viable alternative for dieters," he added, for whom the basic message is cutting down as much as possible on refined carbohydrates such as white bread and carbonated drinks. The research was described as the largest and longest comparison yet done on the four diets. They were Atkins, the lowest in carbohydrates for the four; the Zone diet, also low in carbohydrates and based on a 40:30:30 ratio of carbohydrates to protein to fat; the Lifestyle, Exercise, Attitudes, Relationships and Nutrition diet which follows U.S. government guidelines for low fat but higher carbohydrates; and the Ornish diet, which is very high in carbohydrates but very low in fat. The study randomly assigned a group of 311 overweight, post-menopausal, non-diabetic women one of the four diets. All attended weekly diet classes for eight weeks and were given books to follow. Their weight and metabolism were then checked for the following 10 months. CHOLESTEROL AND BLOOD PRESSURE Women assigned to the Atkins group lost an average of 10.4 pounds compared to 5.7 pounds for LEARN, 4.8 pounds for Ornish and 3.5 pounds for Zone, the study said. The women on the Atkins diet also had the most improvements in terms of cholesterol and blood pressure, added the study published in this week's Journal of the American Medical Association. The authors said some have worried that diets low in carbohydrates but high in total and saturated fat would cause cholesterol problems and increase the risk of heart disease. "These concerns have not been substantiated in recent weight-loss diet trials," including the new research, the authors said. Barry Sears, who developed the Zone diet, criticized the study as "bad science," saying details show the participants did not really follow the diet rules. "The execution basically was fairly pathetic at best so the conclusions are jaded," he said in an interview. The way people followed the Atkins diet in the study, he said, is actually closer to the Zone's principles. Study author Gardner, however, said one of the strengths of the $2 million project was that it mimicked real-world conditions, with participants preparing or buying all their own meals and not everyone following the diets exactly. Gardner said the Atkins diet has "a very simple message. Get rid of all refined carbohydrates to lose weight," thus targeting the increasing consumption of refined sugars, such as high-fructose corn syrup. He also said the Atkins diet is best at encouraging people to drink more water, and when people replace sweetened drinks with water, they do not generally eat more food. |
