N.M. lawmakers approve cancer vaccine
Tue, 13 Mar 2007 03:14:06 GMT
By MATT MYGATT, Associated Press Writer
ALBUQUERQUE, N.M. - New Mexico is on the verge of becoming the latest state to require sixth-grade girls to be vaccinated against a sexually transmitted virus that can cause cervical cancer, a spokesman for the governor said Monday.
The state House approved the bill Sunday, and Gov. Bill Richardson will sign it once he receives the legislation, spokesman Gilbert Gallegos said.
"It's a public health issue, and I believe it's an important step," Richardson said Monday. "New Mexico has always been progressive on these issues. ... We've got to find ways for young women to be protected."
The measure would take effect June 15 — 90 days after the adjournment of the Legislature.
Texas is the only state to require the vaccine so far, but other states are considering doing the same. While federal regulators have approved the vaccine, the issue of making it a requirement for girls has been surrounded by controversy.
Merck & Co., the vaccine's maker, said last month that it would suspend a behind-the-scenes lobbying campaign to get states to require it for school-age girls because of pressure from parents and medical groups.
Texas Gov. Rick Perry sidestepped his state's Legislature when he ordered the shots for girls entering the sixth grade there starting in September 2008. He has since had to defend his relationship with Merck; The Associated Press reported Perry's chief of staff met with key aides about the vaccine on the same day Merck's political action committee donated money to the governor's campaign.
It wasn't known if Merck had lobbied New Mexico officials.
Virginia lawmakers passed a similar law, which Gov. Timothy M. Kaine has said he would sign. Massachusetts Gov. Deval Patrick's budget proposal calls for providing the vaccine for free to all girls 9 to 18 who want it.
Other states have considered legislation as well. In Colorado, lawmakers are debating a bill that would make the cervical cancer vaccine mandatory for girls entering sixth grade unless their parents sign a form refusing it.
The federal government approved Gardasil, a three-dose vaccine that protects against the human papilloma virus, or HPV, in June for females ages 9 to 26. The vaccine protects against HPV strains that cause cervical, vulvar and vaginal cancers and genital warts.
More than 500 cases of mostly minor side effects have been reported in girls and women who got the vaccine. Government health officials said last month that no additional warning labels are needed.
Also Monday, two Texas lawmakers said that state health officials are not required to follow Perry's order.
Their announcement was made after meeting with Texas Attorney General Greg Abbott, who told them the order "was more like a suggestion to the head of the agency," according to state Sen. Jane Nelson.
Abbott spokesman Jerry Strickland said the attorney general's office does not discuss the content or substance of its discussions with lawmakers.
The governor's office says the order is consistent with current law, although Perry has acknowledged that the Legislature can supersede it. The Texas House is to vote Tuesday on a bill that would bar state officials from requiring the vaccine.
Office workers more prone to blood clots
Mon, 12 Mar 2007 21:54:01 GMT
By RAY LILLEY, Associated Press Writer
WELLINGTON, New Zealand - Office workers glued to computer screens are at greater risk of deadly blood clots forming in their legs than long-distance air travelers, the author of a New Zealand study on thrombosis said Monday.
The study found that 34 per cent of patients admitted to hospital with blood clots had been seated at work for long periods, its leader, Prof. Richard Beasley of New Zealand's privately funded Medical Research Institute, told The Associated Press.
Deep-vein thrombosis, or DVT, is a condition in which a blood clot forms in the deep veins of the legs. The condition can be fatal if part of the clot breaks off and blocks a blood vessel in the lungs. The condition has been linked to long-haul flights and dubbed "economy class syndrome," because passengers traveling coach often do not have the space or opportunity to stretch enough to reduce the risk of blood clotting.
"Being seated for long periods of time ... the risk is certainly there" of blood clots developing in the veins of the legs, Beasley told National Radio on Monday.
"There are considerably more people who are seated for long periods at work as part of their normal day than there are traveling," he said, adding the main groups affected are workers in the information technology industry and in call centers.
The study covered 62 patients aged under 65 who were admitted to hospital with blood clots.
Beasley said a surprise finding of the study was that "people are working for so long. We had people not uncommonly working up to 12-14 hours a day and being seated for that time."
The 34 percent finding is far higher than the 1.4 percent of blood-clot patients who recently traveled on long-haul flights, and the study showed a clear link between travel and work-related thrombosis.
"It's the same thing occurring in a similar circumstance as travelers' thrombosis," he noted.
Some reported being seated on the job for 3-4 hours at a stretch, "reflecting the very sedentary nature of our work at the moment," he said.
A second study of seated immobility at work had results "very consistent with what we've found" in the first, Beasley said without elaborating.
The study will be published next month in the New Zealand Medical Journal.
Experts seek options on painkiller abuse
Mon, 12 Mar 2007 21:31:41 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Scientists are hunting new ways to help millions of pain sufferers — from addiction-resistant narcotics to using brain scanners for biofeedback — amid a worrisome rise in abuse of today's top prescription painkillers.
The good news: Only a tiny fraction of patients who are appropriately prescribed the most powerful painkillers — drugs known as opioids, including morphine, Vicodin, fentanyl and Oxycontin — ever will become dependent on them.
And scientists told the
National Institutes of Health last week that those few who are vulnerable tend also to suffer such psychiatric disorders as depression and anxiety, giving doctors a clue about which patients need closer monitoring.
Opioids "are not dangerous if you know how to use them properly," stressed Dr. Nora Volkow, chief of NIH's National Institute on Drug Abuse. "We need to develop the knowledge that maximizes our ability to use them properly."
Amid fears that rising painkiller abuse will spark a backlash against pain sufferers, Volkow organized a two-day meeting involving several hundred scientists and primary care physicians, to bring the latest science on pain and addiction to doctors struggling to balance the drugs' clear benefits and potential harm.
Some form of chronic pain affects one of every three or four adults worldwide. The government says one in 10 Americans suffers pain that lasts a year or more. For millions, pain is severe enough to be disabling; up to 6 million patients are on long-term opioid therapy. It's not just a question of suffering: Serious pain can actually worsen recovery from various ailments.
How many need opioids but don't get them? Those numbers are hard to come by, but "pain is really under-treated in our society," opioid specialist Dr. Christopher Evans of the University of California, Los Angeles, told the NIH meeting.
By some estimates, as many as 40 percent of cancer patients and the terminally ill don't even get those medications.
At the same time, prescription drug abuse, particularly of opioid painkillers, is on the rise. One in 10 high school seniors admits to popping Vicodin for nonmedical purposes, and recent studies suggest about 2.2 million people age 12 and older first abused painkillers in the past year, outpacing new marijuana users. Some 415,000 people received treatment for painkiller abuse last year, Evans said.
So the hunt is on for pain relief that minimizes the abuse risk — not just for the 2 percent of pain patients who might become dependent, but to discourage theft or other diversion of the drugs.
"We really need to get smarter," said Dr. Pamela Palmer, director of pain research at the University of California, San Francisco, who laments that the only way now to tell how patients are using painkillers is "making people pee in a bottle to see if the drug I prescribed is in there."
Under research now:
_Pain Therapeutics Inc.'s Remoxy is in late-stage clinical trials to see if it offers an abuse-resistant version of oxycodone, the ingredient in Oxycontin. Oxycontin tablets are supposed to slowly dissolve for long-term pain relief, but abusers crush them and snort or inject the powder for a fast high. Remoxy is a thick gelatin version of oxycodone — crushing it just yields goo.
_Also being studied is a combination of naltrexone, a drug used to reduce alcohol craving, with oxycodone. The extra drug should tamp down oxycodone's brain-stimulating effect, Palmer said, but one question is whether that also will diminish pain relief.
_Another approach now in early trials pairs technology with tiny tablets of a hospital-strength opioid, sufentanil, redesigned to dissolve almost instantly under the tongue. A computerized dispenser, the size of a remote control, is programmed with the patient's dose of Nanotabs and records how much is used and how often, information the doctor would require before allowing refills or adjusting doses, says Palmer, who is working with manufacturer AcelRx Pharmaceuticals.
Better would be drugs that more selectively target the brain receptors that react to opioids, blocking multiple ones at the same time so that it's harder to develop tolerance or suffer withdrawal. While that is still years away, an initial attempt worked in rats, and NIDA will push additional research to speed human trials, Volkow said. "That would be an amazing thing."
Then there's the non-drug approach: Omneuron Inc. and Stanford University researchers are trying to teach patients to control how much pain they feel by scanning their brains and showing them the real-time MRI images as they try out different techniques.
"The brain is built to be able to modulate its pain-control processes," says Omneuron chief executive Christopher deCharms. "We're teaching people to gain conscious control."
The first study, with a few chronic pain sufferers plus healthy people given painful zaps, suggests the approach may relieve pain right after participants are trained. Now the question is whether the pain relief is real and lasts. A larger trial to test that is under way.
___
EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
VA orders review of 1400 clinics
Tue, 13 Mar 2007 09:11:00 GMT
By HOPE YEN, Associated Press Writer
WASHINGTON - The VA is ordering its 1,400 hospitals and clinics to report on the quality of their facilities to determine if squalid conditions found at Walter Reed exist elsewhere.
Veterans Affairs Secretary Jim Nicholson issued the directive in an internal memorandum sent last week to the VA's medical center directors. He said "recent events" compelled him to redouble efforts to improve the physical environment at outpatient center and medical facilities.
"I am directing you hereby to conduct and supervise a full and immediate review of your facility's environments of care," Nicholson wrote in the March 7 memorandum, which was obtained Monday. The memo asks for a full report by March 14.
"As medical center and network directors, you all are responsible," he said. "Negative responses are required."
On Monday, Nicholson paid a surprise visit to the VA medical center in Richmond, Va., as part of the department's ongoing efforts to "make sure veterans are receiving access to the best possible care and environment."
During that time, he met with center officials for two to three hours to hear their concerns about what can be done to improve care, the department said, with more visits planned to other facilities in coming months.
Nicholson's moves come in the wake of disclosures of roach-infested conditions and shoddy outpatient care at Walter Reed Medical Center, one of the nation's premier facilities for treating those wounded in
http://www.va.gov/