Study casts doubt on duct tape wart cure
Tue, 20 Mar 2007 03:34:37 GMT
By CARLA K. JOHNSON, Associated Press Writer
CHICAGO - Duct tape's success at curing warts may have been overstated, according to a new study that raises doubts about the tape's effectiveness as a cheap, painless treatment. The tape supposedly works by irritating the skin and stimulating the body's immune system to attack the virus that causes warts. It earned a place in the medicine cabinet in 2002, when a small study showed it to be effective on children and young adults.
This time, a study among older adults found duct tape helped only 21 percent of the time and was no more better than moleskin, a cotton-tape bandage used to protect the skin.
But researchers used transparent duct tape. Only later did they learn that the transparent variety does not contain rubber, unlike the better-known, gray duct tape that appeared to be effective in the 2002 study.
"Whether or not the standard type of duct tape is effective is up in the air," said co-author Dr. Rachel Wenner of the University of Minnesota, who started the new study as a medical student. "Theoretically, the rubber adhesive could somehow stimulate the immune system or irritate the skin in a different manner."
Warts are harmless, stubborn bumps on the hands or feet, caused by a type of papillomavirus. The virus camps out in the skin's upper layers without calling the attention of the body's immune system. Another type of papillomavirus causes cervical cancer, but the strains that cause warts are not cancerous.
Wenner's finding does not surprise Dr. Amy Paller, chairman of the dermatology department at Northwestern University's Feinberg School of Medicine, who was not involved in the new study.
"I have plenty of patients come in having tried duct tape. That's why they come in, because it didn't work," Paller said.
Duct tape may work better in children than in adults, Paller said. Children have strong immune systems and usually have better luck than adults getting rid of warts with any treatment, she said. The median age of subjects in the new study was 54.
Over-the-counter topical treatments containing salicylic acid sometimes work on warts. Doctors use laser therapy or liquid nitrogen against an unyielding wart, or in extreme cases a prescription cream or a virus-fighting injection. Warts usually clear up on their own in about two years, she said.
Warts can spread to other people through towels or skin-to-skin contact. They are extremely common in children, showing up in up to 20 percent in some studies. It's not known how common they are in adults.
In the new study, appearing in the March issue of Archives of Dermatology, researchers followed 80 people with warts. The patients were randomly assigned to cover their wart with either a bandage made of duct tape and moleskin, or a bandage made of moleskin alone.
Transparent duct tape was used so patients and doctors would not be able to guess which bandages contained the duct tape.
The patients were instructed to wear the bandage for a week, remove it after the seventh day and then, on the eighth day, soak the wart in water, and lightly scrape it with an emory board. They repeated the treatment for two months or until the wart disappeared. It was the same regimen as in the 2002 study.
Duct tape showed paltry success in the new study. Eight of the 39 patients who got the duct tape treatment saw their warts disappear. Nine of the 41 patients who got only moleskin saw their warts vanish. There was no significant difference between the two groups.
___
On the Net:
Archives of Dermatology: http://archderm.ama-assn.org
2for1 liver transplant saves two
Mon, 19 Mar 2007 22:47:03 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - The transplant surgeon had good news: A donated liver was on the way for critically ill Maggie Catherwood. Then he asked: Would she let doctors cut off part of her new liver to share with an equally sick baby?
"I can't imagine anyone saying no," the 21-year-old college student said last week as, teary-eyed, she met 8-month-old Allison Brown, carefully cuddling the wide-eyed baby so as not to bump each other's healing incisions.
Actually, few ever get the choice — something the nation's transplant network soon may change. There's a push to increase liver-splitting that could have many more people who are awaiting transplants being asked to share a piece of their new organ.
If the proposed changes are enacted, "I think it's safe to say we could nearly eliminate death on the pediatric liver waiting list," said Allison's surgeon, Dr. Thomas Fishbein of Georgetown University Hospital.
A liver is unlike any other organ: A piece of a healthy one can grow into a whole organ in about a month. That's why some people receive liver transplants from living donors who have just a portion of their organ cut out and given away.
Split-liver donation is different. It divides an organ donated when someone dies, to try to save two lives with one donation.
It doesn't happen very often, accounting for between 2 and 3 percent of the more than 6,000 liver transplants annually. Just 123 split-liver transplants were performed in the U.S. last year, according to the United Network for Organ Sharing, which runs the transplant system.
Particularly rare, says Fishbein, is an adult agreeing to share a liver that the waiting-list rules deem completely his or hers. Usually when a liver is split, an organ too large for a baby or small child had to be cut to fit anyway — and pediatric surgeons who don't want to waste the rest offer it to the next candidate on the waiting list.
"I didn't even know it was possible" to split a liver, said Catherwood. But she said yes, and her first question upon waking up from surgery was, "How's the baby?"
"The fact that someone else was willing to give up part of that liver they need is amazing to me," said Terri Brown, Allison's mother, in an emotional meeting with Catherwood 12 days after the transplants.
"Oh, she's adorable, oh my gosh!" exclaimed Catherwood from her wheelchair as Allison's father, Brian, handed her the baby, tiny white dog slippers peeking from beneath her blanket.
Not every transplant center has the expertise or incentive to split livers, especially those that treat only adults. It's a more technically challenging operation. It poses a slightly higher risk of post-surgery complications, such as maintaining the good blood flow necessary for the organ to survive.
Nor is every donated liver splittable. It must be a very healthy organ, not the marginal ones often transplanted; typically, the donor was a young adult who died from an accident.
But a rough estimate from the United Network for Organ Sharing is that more than 1,000 livers donated a year might qualify for splitting. Fishbein is part of a the network committee charged with spurring those transplants to try to save more youngsters. Between 10 percent and 13 percent of young children die while on the liver waiting list, including 41 babies last year.
Pending proposals would mandate that all transplant centers be notified when a potentially splittable liver is donated, and that the search for a matching recipient identify those willing to accept a partial organ.
"This is a really important topic," said Dr. George Mazariegos, transplant chief at Children's Hospital of Philadelphia, who says liver-splitting today is too dependent on individual surgeons.
"We want to take it to ... a national type of initiative where it's always thought of and always considered when there are certain criteria that are met."
Catherwood's symptoms started in the fall, when suddenly she couldn't keep food down. The day after her 21st birthday, she learned she had Wilson's disease — her liver couldn't properly dispose of the copper in food. The quiet buildup was destroying it. In early February, the Sterling, Va., woman joined the nearly 17,000 people on the waiting list for liver transplants.
Allison was 3 1/2 months old when doctors discovered her worsening jaundice meant biliary atresia — the Waldorf, Md., girl was born without all her major bile ducts. She joined the transplant list in early December, the whites of her eyes turning canary yellow as the months ticked by and her liver shut down.
Livers are distributed to the sickest patients first. Late on Feb. 27, Georgetown's Dr. Cal Matsumoto got word that the transplant network had flagged Catherwood to receive a liver from a teenager who had just died. Knowing Allison was a match, too, he broached the two-for-one transplant.
Most surgeons insist on splitting the liver themselves to be sure it's done right. Fishbein is used to middle-of-the-night trips to far-away hospitals to retrieve one piece. This time, the organ was flown on ice to Georgetown, for Fishbein and Matsumoto to divide. The left lobe — just under 20 percent — went to Allison, the rest to Catherwood in an adjoining operating room.
Surgeons carefully calculate the minimum amount of healthy liver a patient needs in the month it will take to regenerate. Indeed, the slight risk associated with split-liver transplants is usually due to not getting a big enough piece, problems with how the organ was divided, or delays in transplanting, explained Philadelphia's Mazariegos.
A liver also can be sliced into 60-40 sections for two adults, as is done with living donors. But split-liver transplants between two adults are controversial. It's harder to calculate the right volume fast enough, before the organ deteriorates.
For Catherwood and Allison, the transplant seems to be working, although they have the same risk of long-term organ rejection as any transplant recipient. Catherwood was recuperating at home, well enough even before she was discharged to indulge in chocolate. Allison remained in the hospital for observation, but her liver was clearing away the jaundice.
"It's so exciting to see what her eyes look like," her father said. "We got so lucky."
___
EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
NIH chief Stem cell ban hobbles science
Mon, 19 Mar 2007 22:30:43 GMT
By ANDREW BRIDGES, Associated Press Writer
WASHINGTON - Lifting the ban on taxpayer funding of research on new stem cells from fertilized embryos would better serve both science and the nation, the chief of the
http://www.nih.gov/
Singapore to scrap antiobesity program
Tue, 20 Mar 2007 06:19:35 GMT
SINGAPORE - Singapore plans to end its anti-obesity program in schools, the Education Ministry said, after parents complained that overweight children were being singled out and teased by classmates.
The city-state will scrap the 15-year-old "Trim and Fit" campaign next year and replace it with a holistic program that caters to all schoolchildren instead of just the overweight ones, the ministry said in a statement dated Monday that was received Tuesday.
The new holistic campaign will focus not only on raising fitness levels but also on mental and social health by promoting a healthy lifestyle, the ministry said. It did not provide details.
Under the current program, overweight children have to do special rigorous exercises during breaks and before and after school until they lose a required amount of weight, in addition to the regular physical education curriculum.
The "Trim and Fit" program reduced the proportion of overweight students from 14 percent in 1992 to 9.5 percent last year, Masagos Zulkifli, senior parliamentary secretary for education, told The Straits Times newspaper in an interview published Tuesday.
Nevertheless, the scheme has drawn criticism, especially from parents who argued a program that singles out overweight children makes them easy targets for teasing by their peers.
Zulkifli acknowledged the program stigmatizes obese students.
"If you want to focus on just overweight children, then no matter what you call it, there will be a stigma associated," he said.
Health officials and educators say school-based intervention effectively targets a generation growing up on fast food, television and computer games, and is integral to the city-state's efforts against expanding waistlines and ballooning health care costs.
Pinning hopes on herbal Viagra for biotech push
Mon, 19 Mar 2007 12:35:37 GMT
By Clarence Fernandez
KUALA LUMPUR - Malaysia's answer to Viagra is a
traditional herb the country has picked to spearhead its push
into biotechnology, but now it faces the challenge of
convincing the world the remedy is both potent and safe.
Surging interest in the herb, &;tongkat ali,&; has spawned
dozens of products, from pills to beverages, that play up its
reputed aphrodisiac properties, and could even threaten the
sway overseas of ginseng, a more-widely established remedy in
Asia.
Generations of aging Malaysian men have sworn by the
rejuvenation effects of &;tongkat ali,&; scouring the countryside
for it so eagerly that it has almost vanished from all but the
deepest rainforest, and now has the status of a protected
plant.
Scientific studies show that concoctions of &;tongkat ali&;
can help hormone production, making rats and mice more frisky,
but have yet to prove it can reliably produce the same effect
in humans, researchers say.
&;It can have different effects on different people,&; said
Abdul Razak, head of the Forest Research Institute of Malaysia,
which is driving research and commercial production of the
herb.
&;For me, it gives the energy to play a game of golf without
getting tired, but has no other effects,&; said Razak, who takes
two capsule supplements of the herb before each weekly game to
increase his stamina.
&;Tongkat ali,&; which scientists call Eurycoma longifolia,
is a slender evergreen shrub with bitter, brownish-red fruit
that is native to Malaysia and Indonesia.
All parts of the plant which grows up to 10 meters
tall can be chopped up fine and boiled in water to make the
traditional medicine.
As Malaysia looks to biotechnology for economic growth,
scientists are taking a harder look at the aphrodisiac
qualities of tongkat ali, which means the &;walking-stick of
Ali,&; in Malay, and they say it could spawn drugs to treat
cancer and malaria.
PREPARING FOR COMMERCIAL USE
Five years of research studies in collaboration with the
Massachusetts Institute of Technology in the United States have
helped to identify the key compounds in the herb, Razak said.
&;All these compounds have been found, have been tested and
have been patented, and we are now in the process of carrying
out clinical studies, and hopefully after some time we might
even commercialize this,&; he added.
A Malaysian industry and government group says the rapidly
growing global market for aphrodisiacs is worth about $4
billion and could reach nearly $7 billion by 2012, but plans
for &;tongkat ali&; to grab a share of this pie hinge on proving
it is safe.
In Taiwan this year, Taipei city officials banned six
brands of coffee from supermarkets because they contained
&;tongkat ali,&; saying the plant had not been evaluated for safe
use, although there were no confirmed reports of side-effects,
newspapers said.
The episode in January stirred indignation in Malaysia,
where some officials publicly defended the herb, saying its
safety and efficacy had been demonstrated by hundreds of years
of use.
Others said the incident showed how far Malaysia still has
to go to prove its claims for the herb.
&;We've still got a lot of homework to do as a nation,&; said
M. Rajen, chief executive of Tropical Botanics Sdn Bhd, which
counts among its products Malaysia's most popular fish-oil
brand.
Makers of ginseng, which has a global market of about $2
billion a year, according to some industry estimates, would be
ruthless in battling competition from &;tongkat ali,&; he said.
&;What we see in Taiwan and elsewhere is an example of this
ruthlessness,&; Rajen added. &;Because we have not done our
homework, we cannot fight it.&;
But Malaysia is confident it will convince the world.
Officials of Power Root Malaysia Sdn Bhd, which exports tea and
coffee drinks containing the herb to Japan and
South Korea,
have said they are looking to the United States and the Middle
East.
&;One day 'tongkat ali' will be marketed internationally,
even in Harrods of London,&; Deputy Prime Minister Najib Razak
said in January, at the launch of a $7 million biotech research
center that will study ways to clone the herb.
At the Forest Research Institute, workers in white
protective gear poured sacks of the herb into gleaming
stainless steel dryers and grinders to turn out powder for
capsules.
&;It's high time for 'tongkat ali' now,&; said researcher
Mohamad Shahidan, grinning through his face mask. &;Everybody
wants to try it.&;
Toddler improving on experimental smallpox drug
Tue, 20 Mar 2007 13:21:33 GMT
By Julie Steenhuysen
CHICAGO - An experimental pill appears to be
helping a toddler who had a near-fatal skin reaction to his
father's smallpox shot, doctors said on Monday.
The drug, an antiviral made by Siga Technologies called
ST-246, worked when more conventional treatment failed, the
doctors said.
The 2-year-old, still in critical condition at the
University of Chicago's Comer Children's Hospital, developed
the rare serious reaction called eczema vaccinatum after being
with his father, a soldier vaccinated for deployment in
Iraq.
&;He's making slow improvement every day. He's still in the
pediatric intensive care unit,&; said Dr. John Marcinak,
pediatric infectious disease specialist at the hospital.
Marcinak said the rash now consumes 80 percent of the
child's body. &;He's lost a lot of the superficial areas of his
skin called the epidermis. There is still a lot of healing that
needs to be done,&; he said.
The child, from Indiana, was admitted to the hospital on
March 3, and the U.S. Centers for Disease Control and
Prevention confirmed he was infected with the virus used in the
smallpox vaccine.
Smallpox vaccines do not use the smallpox virus, but
instead use a related virus called vaccinia that is weakened
but can still infect some people.
The child was given an intravenous form of vaccinia immune
globulin -- developed in the 1960s to treat complications of
smallpox vaccinations. He also received a treatment of the
antiviral drug cidofovir, made by Gilead Sciences Inc.
But he was still failing. His mother also had a rash but
was not ill and his father reported no adverse reaction.
By then, Marcinak and his team were having daily conference
calls with the
CDC, health departments, the
Department of
Defense and the
National Institutes of Health. During one, the
CDC suggested the hospital try the experimental drug.
The drug has helped monkeys infected with smallpox, but its
effectiveness has not been proven in humans.
Seeing the drug used in an infected patient presents a rare
opportunity for Siga. For ethical reasons, the drug can only be
tested in healthy volunteers.
&;I think we can feel reasonably confident ... that this
drug is contributing to the child's recovery,&; Siga Chief
Executive Dr. Eric Rose said in a telephone interview.
The child's case is the first report of eczema vaccinatum
since vaccination against smallpox resumed in 2002, CDC pox
virus expert Dr. Inger Damon said. She said he may already have
had eczema -- which makes patients especially vulnerable to the
serious reaction.
The smallpox virus once killed 30 percent of its victims,
and disfigured many others. A global vaccination campaign
eradicated the disease in 1979.
But some samples of smallpox remain in government freezers
and experts believe it could be used as a biological weapon.
The United States resumed vaccinating some people in 2002,
including 40,000 civilian health workers and hundreds of
thousands of military personnel.
Rose said the company hopes to have the drug approved for
sale by 2009. SIGA shares closed up nearly 14 percent on NASDAQ
on Monday, at $5.15 a share.