Top : 2007 : 2007_06_18

• Skipping insulin for weight risky

• Stroke drug may also help with frostbite

• U.S. circumcision rate drops

• GlaxoSmithKline plans 5 new cancer drugs

• Checkups key to success of obesity surgery

Skipping insulin for weight risky

Mon, 18 Jun 2007 20:12:55 GMT
By JIM ELLIS, Associated Press Writer
Like many teenage girls, Lee Ann Thill was obsessed with her appearance. A diabetic, she was already suffering from bulimia — forcing herself to throw up to lose weight. But it wasn't enough, and she'd recently put on 20 pounds.
Then one day at a camp for diabetic teens, she heard counselors chew out two girls for practicing "diabulimia" — not taking their insulin so they could lose weight, one of the consequences of uncontrolled diabetes.

Don't you realize you could die if you skip your insulin? the counselor scolded. Don't you know you could fall into a coma or damage your kidneys or your eyes?

But that's not what registered with Thill, who has Type 1, or juvenile diabetes. Instead, she focused on this: Skipping insulin equals weight loss. For the next 17 years, diabulimia was her compulsion.

"I took just enough insulin to function," said Thill, now 34, of Magnolia, N.J.

Today, she worries about the long-term damage that may have come from her weight obsession. At 25, a blood vessel hemorrhage in her eye required surgery. At 28, doctors told her she had damaged kidneys.

"I'm fearful for the future," Thill said. "I feel very strongly that had I taken care of myself, I could have lived as long as anyone without diabetes. I don't think that's going to happen now."

Diabulimia is usually practiced by teenage girls and young women, and it may be growing more common as the secret is exchanged on Internet bulletin boards for diabetics and those with eating disorders. One expert who has studied the phenomenon estimates that 450,000 Type 1 diabetic women in the United States — one-third of the total — have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death.

"People who do this behavior wind up with severe diabetic complications much earlier," said Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston.

The American Diabetes Association has long known about insulin omission as a tactic to lose weight. But "diabulimia" is a term that has only cropped up in recent years and is not a recognized medical condition, said Barbara Anderson, a pediatrics professor at Baylor College of Medicine in Houston.

Type 1 diabetes is a disorder in which the body's own immune system attacks insulin-producing cells in the pancreas. People with this disease produce little or no insulin, so they take shots of the hormone daily.

It differs from Type 2, the form associated with obesity and which accounts for about 90 to 95 percent of all diabetes.

Insulin is vital for delivering glucose from the bloodstream to the body's cells. Without insulin, cells starve even while the bloodstream becomes burdened with too much glucose.

When Type 1 diabetics skip or reduce their insulin, they risk falling into a coma or even dying. Blindness, amputations and kidney failure are some of the long-term complications that can develop.

Warning signs for diabulimia include a change in eating habits — typically someone who eats more but still loses weight — low energy and high blood-sugar levels, Goebel-Fabbri said. Frequent urination is another signal. When sugars are high, the kidneys work overtime to filter the excess glucose from the blood.

This purging of sugar from the body through the kidneys is similar to someone with bulimia, who binges and then purges, or vomits, Anderson said.

Studies show that women with Type 1 diabetes are twice as likely to develop an eating disorder. Ironically, good diabetes management, which requires a preoccupation with food, counting carbohydrates and following a diet, may lead some to form an unhealthy association with food, Goebel-Fabbri said.

Jacq Allan, 26, of London, is a diabulimic. When recently interviewed, she said she had not taken her insulin shots for two weeks and rarely takes them regularly. She weighs 42 pounds less than she did a year ago.
Allan is stuck between two fears: taking insulin, which may lead to weight gain, and the damage her destructive compulsion is doing to her body.
"I'm terrified of insulin," Allan said. "Every morning I wake up and think maybe I should go to the hospital."
Diagnosed with Type 1 diabetes nearly three years ago, Allan said she can feel the constant, sky-high sugar in her blood. Her list of ailments — chest pain, heart palpitations, muscle cramps, bacterial infections and lower back pain — are not the usual health problems of a twenty-something.
"I'm constantly worried that my eyes are going to go, but they seem relatively OK for the moment," she said. "I always wonder if this will be the day that some major organ fails. I kind of want something to happen because then maybe I'll stop."
Gwen Malnassy, 21, of Santa Monica, Calif., detailed her struggle with diabulimia for three years in a diary she posted on the Internet.
"If you don't think it will happen to you, don't fool yourself," writes Malnassy, diagnosed with diabetes at 9, in her final entry 11 months ago. "I believed the same."
Doctors diagnosed Malnassy with both anorexia and bulimia at 13, she said.
"I would look at magazines and think that if I looked like the models, I would have more friends and be more popular," Malnassy said in a recent interview.
She began withholding insulin at 17 after learning of the practice during a doctor's visit and continued withholding insulin off and on until last year.
Malnassy continues in her online diary: "I will say it again. Reach out; get help. Do not fall; do not let the disorder consume you. It's a miserable way to exist."
___
On the Net:
http://care.diabetesjournals.org/cgi/content/abstract/22/12/1956

Skipping insulin for weight risky

Mon, 18 Jun 2007 20:12:55 GMT
By JIM ELLIS, Associated Press Writer
Like many teenage girls, Lee Ann Thill was obsessed with her appearance. A diabetic, she was already suffering from bulimia — forcing herself to throw up to lose weight. But it wasn't enough, and she'd recently put on 20 pounds.
Then one day at a camp for diabetic teens, she heard counselors chew out two girls for practicing "diabulimia" — not taking their insulin so they could lose weight, one of the consequences of uncontrolled diabetes.

Don't you realize you could die if you skip your insulin? the counselor scolded. Don't you know you could fall into a coma or damage your kidneys or your eyes?

But that's not what registered with Thill, who has Type 1, or juvenile diabetes. Instead, she focused on this: Skipping insulin equals weight loss. For the next 17 years, diabulimia was her compulsion.

"I took just enough insulin to function," said Thill, now 34, of Magnolia, N.J.

Today, she worries about the long-term damage that may have come from her weight obsession. At 25, a blood vessel hemorrhage in her eye required surgery. At 28, doctors told her she had damaged kidneys.

"I'm fearful for the future," Thill said. "I feel very strongly that had I taken care of myself, I could have lived as long as anyone without diabetes. I don't think that's going to happen now."

Diabulimia is usually practiced by teenage girls and young women, and it may be growing more common as the secret is exchanged on Internet bulletin boards for diabetics and those with eating disorders. One expert who has studied the phenomenon estimates that 450,000 Type 1 diabetic women in the United States — one-third of the total — have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death.

"People who do this behavior wind up with severe diabetic complications much earlier," said Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston.

The American Diabetes Association has long known about insulin omission as a tactic to lose weight. But "diabulimia" is a term that has only cropped up in recent years and is not a recognized medical condition, said Barbara Anderson, a pediatrics professor at Baylor College of Medicine in Houston.

Type 1 diabetes is a disorder in which the body's own immune system attacks insulin-producing cells in the pancreas. People with this disease produce little or no insulin, so they take shots of the hormone daily.

It differs from Type 2, the form associated with obesity and which accounts for about 90 to 95 percent of all diabetes.

Insulin is vital for delivering glucose from the bloodstream to the body's cells. Without insulin, cells starve even while the bloodstream becomes burdened with too much glucose.

When Type 1 diabetics skip or reduce their insulin, they risk falling into a coma or even dying. Blindness, amputations and kidney failure are some of the long-term complications that can develop.

Warning signs for diabulimia include a change in eating habits — typically someone who eats more but still loses weight — low energy and high blood-sugar levels, Goebel-Fabbri said. Frequent urination is another signal. When sugars are high, the kidneys work overtime to filter the excess glucose from the blood.

This purging of sugar from the body through the kidneys is similar to someone with bulimia, who binges and then purges, or vomits, Anderson said.

Studies show that women with Type 1 diabetes are twice as likely to develop an eating disorder. Ironically, good diabetes management, which requires a preoccupation with food, counting carbohydrates and following a diet, may lead some to form an unhealthy association with food, Goebel-Fabbri said.

Jacq Allan, 26, of London, is a diabulimic. When recently interviewed, she said she had not taken her insulin shots for two weeks and rarely takes them regularly. She weighs 42 pounds less than she did a year ago.
Allan is stuck between two fears: taking insulin, which may lead to weight gain, and the damage her destructive compulsion is doing to her body.
"I'm terrified of insulin," Allan said. "Every morning I wake up and think maybe I should go to the hospital."
Diagnosed with Type 1 diabetes nearly three years ago, Allan said she can feel the constant, sky-high sugar in her blood. Her list of ailments — chest pain, heart palpitations, muscle cramps, bacterial infections and lower back pain — are not the usual health problems of a twenty-something.
"I'm constantly worried that my eyes are going to go, but they seem relatively OK for the moment," she said. "I always wonder if this will be the day that some major organ fails. I kind of want something to happen because then maybe I'll stop."
Gwen Malnassy, 21, of Santa Monica, Calif., detailed her struggle with diabulimia for three years in a diary she posted on the Internet.
"If you don't think it will happen to you, don't fool yourself," writes Malnassy, diagnosed with diabetes at 9, in her final entry 11 months ago. "I believed the same."
Doctors diagnosed Malnassy with both anorexia and bulimia at 13, she said.
"I would look at magazines and think that if I looked like the models, I would have more friends and be more popular," Malnassy said in a recent interview.
She began withholding insulin at 17 after learning of the practice during a doctor's visit and continued withholding insulin off and on until last year.
Malnassy continues in her online diary: "I will say it again. Reach out; get help. Do not fall; do not let the disorder consume you. It's a miserable way to exist."
___
On the Net:
http://care.diabetesjournals.org/cgi/content/abstract/22/12/1956

Stroke drug may also help with frostbite

Mon, 18 Jun 2007 20:00:54 GMT
By DOUG ALDEN, Associated Press Writer
SALT LAKE CITY - An anti-clotting drug used to treat strokes and heart attacks can also restore blood flow to frostbitten fingers and limbs, greatly reducing the need for amputation, according to a new study.
Doctors at the University of Utah who conducted the research on a small sample of patients hope it marks the start of a move beyond the traditional — and limited — treatment for frostbite.

"What it does is help to rescue that tissue that is damaged but not yet dead," said Dr. Stephen Morris, one of the authors of the study, which was released Monday in the Archives of Surgery medical journal.

Patients who received the thrombolytic therapy at the university's burn center were more likely to keep their frostbitten fingers and toes than patients who went without the drug.

All patients had similar degrees of frostbite.

Thrombolytic therapy is not new, but has been difficult to study because not every frostbite victim is a candidate. For instance, people already on blood thinners or someone who has suffered a head injury would be at risk for serious complications from the anti-clotting drug.

Dr. John Twomey, burn director at the Hennepin County Medical Center in Minneapolis, first tried the therapy on a patient about 20 years ago and has treated 18 other patients with it since.

Twomey, whose early findings are mentioned in the Utah study, said the treatment for frostbite has been limited to warming the affected tissue and waiting to see how much would survive.

"We saw all these frostbitten patients come in, and there was absolutely nothing we could do to alter their disease," Twomey said. "That was pretty discouraging and disheartening to see that happening, and it happened repeatedly."

In the Utah study, six patients who were treated with a drug called tissue plasminogen activator, or tPA, within 24 hours of injury were compared with 25 other patients who did not receive the drug, and one patient who got the anti-clotting drug later than the 24-hour window.

Among the patients who received tPA within 24 hours, only six of 59 frostbitten fingers or toes were removed, or about 10 percent. In the other group, 97 of 234 affected digits were amputated, or about 41 percent.

The sample used for the study was small and taken only from one geographic area. The study was also based only on the one anti-clotting drug. Those are just a few of the variables that leave questions to be answered by future research.

But for some, the findings may offer a chance at avoiding amputation.

"For the injured tissue, there's still hope," said Dr. Amalia Cochran, another of the University of Utah authors.

___

On the Net:

The Archives of Surgery: http://www.archsurg.com

University of Utah burn center: http://uuhsc.utah.edu/burncenter/

Stroke drug may also help with frostbite

Mon, 18 Jun 2007 20:00:54 GMT
By DOUG ALDEN, Associated Press Writer
SALT LAKE CITY - An anti-clotting drug used to treat strokes and heart attacks can also restore blood flow to frostbitten fingers and limbs, greatly reducing the need for amputation, according to a new study.
Doctors at the University of Utah who conducted the research on a small sample of patients hope it marks the start of a move beyond the traditional — and limited — treatment for frostbite.

"What it does is help to rescue that tissue that is damaged but not yet dead," said Dr. Stephen Morris, one of the authors of the study, which was released Monday in the Archives of Surgery medical journal.

Patients who received the thrombolytic therapy at the university's burn center were more likely to keep their frostbitten fingers and toes than patients who went without the drug.

All patients had similar degrees of frostbite.

Thrombolytic therapy is not new, but has been difficult to study because not every frostbite victim is a candidate. For instance, people already on blood thinners or someone who has suffered a head injury would be at risk for serious complications from the anti-clotting drug.

Dr. John Twomey, burn director at the Hennepin County Medical Center in Minneapolis, first tried the therapy on a patient about 20 years ago and has treated 18 other patients with it since.

Twomey, whose early findings are mentioned in the Utah study, said the treatment for frostbite has been limited to warming the affected tissue and waiting to see how much would survive.

"We saw all these frostbitten patients come in, and there was absolutely nothing we could do to alter their disease," Twomey said. "That was pretty discouraging and disheartening to see that happening, and it happened repeatedly."

In the Utah study, six patients who were treated with a drug called tissue plasminogen activator, or tPA, within 24 hours of injury were compared with 25 other patients who did not receive the drug, and one patient who got the anti-clotting drug later than the 24-hour window.

Among the patients who received tPA within 24 hours, only six of 59 frostbitten fingers or toes were removed, or about 10 percent. In the other group, 97 of 234 affected digits were amputated, or about 41 percent.

The sample used for the study was small and taken only from one geographic area. The study was also based only on the one anti-clotting drug. Those are just a few of the variables that leave questions to be answered by future research.

But for some, the findings may offer a chance at avoiding amputation.

"For the injured tissue, there's still hope," said Dr. Amalia Cochran, another of the University of Utah authors.

___

On the Net:

The Archives of Surgery: http://www.archsurg.com

University of Utah burn center: http://uuhsc.utah.edu/burncenter/

U.S. circumcision rate drops

Mon, 18 Jun 2007 18:43:35 GMT
By RACHEL KONRAD, Associated Press Writer
SAN FRANCISCO - On the eighth day of her son's life, Julia Query welcomed friends and family to celebrate his birth and honor their Jewish heritage.
But there was no crying, no scalpel, no blood, no "mohel" — the person who traditionally performs ritual circumcisions in the Jewish faith. In fact, Elijah Rose's "bris" differed markedly from the ceremony long used to initiate Jewish boys into a covenant with God: There was no circumcision.

"I knew before I was even pregnant that I would not circumcise," said Query, 39, a San Francisco filmmaker whose son was born in 2002. "It's not like you're just cutting a piece of paper off a pad — there's no `cut here' line. It's not made to be cut off, and I would never, ever do that to my baby."

Query is among a growing number of American parents refusing circumcision, in which the foreskin is removed from the penis.

According to a study by the National Health and Social Life Survey, the U.S. circumcision rate peaked at nearly 90 percent in the early 1960s but began dropping in the '70s. By 2004, the most recent year for which government figures are available, about 57 percent of all male newborns delivered in hospitals were circumcised. In some states, the rate is well below 50 percent.

Experts say immigration patterns play the biggest role in the decline, which is steepest in Western states with big populations from Asian and Latin American countries where circumcision is uncommon. The trend has also accompanied a change in Americans' attitudes toward medicine and their bodies.

"The rates of drug-free labor and breast-feeding all rose during the 1980s, while the initial declines in male circumcision rates began during the 1980s as well," said Katharine Barrett, an anthropology lecturer at Stanford University. "It may have been part and parcel of the wider effort to reclaim bodies — adult female and infant male — from unnecessary and potentially harmful medical interventions."

Circumcision remains the nation's most common surgery, and the United States is still one of the few developed countries where a majority of baby boys are circumcised. But circumcision is a heated issue and the subject of vehemently pro and anti Web sites.

"We were all circumcised when I was born," said R. Louis Schultz, a 79-year-old New Yorker and author of "Out in the Open: The Complete Male Pelvis." "People thought it could ward off masturbation or disease, and those funny attitudes have really changed. Now people are saying, `Why do it?'"

Many doctors still recommend circumcision because of some evidence that it reduces the risk of penile cancer, urinary tract infections, HIV and perhaps other sexual transmitted diseases. Many major insurance companies still cover it, and many hospitals offer it free for newborns.

But circumcision opponents say the medical benefits are dubious. Penile cancer, for example, is extremely rare. Since 1999, the American Academy of Pediatrics has not endorsed routine circumcision.

The debate escalated in February, when studies found that heterosexual men in Africa who were circumcised had HIV infection rates up to 60 percent lower than uncircumcised men. Because of those studies, the American Academy of Pediatrics is taking another look at its policy.

About one in three males worldwide is circumcised. In the United States, the rates vary widely by region.

It is most prevalent in the upper Midwest. In 2004, according to data compiled by the federal Agency for Healthcare Research and Quality, more than 79 percent of newborn boys in the Midwest were circumcised before leaving the hospital. Michigan and Kentucky had the highest rates, at 85 percent.

In the fast-growing West, the rate declined dramatically — from 64 percent in 1979 to just under 32 percent in 2004.

In California, the rate of hospital circumcisions among newborns was 21 percent. California — which has more immigrants than any other state — had the lowest circumcision rate in the study, which had comprehensive data on only 27 states.

The decline coincides with rising immigration from Asia and Latin America.

"If you have a solid Victorian, American background, routine circumcision is not unusual," said Carol A. Miller, clinical professor of pediatrics at University of California at San Francisco.
Circumcision was uncommon in 35-year-old Usha Toland's family, which has roots in India, Sri Lanka and Malaysia. When her son, Reynick, was born in 2005 in San Francisco, her husband, Chris, a white man from Southern California, assumed his son would be circumcised. But after the couple read Web sites and medical literature, they decided against the surgery.
"Usha probably would have understood if I really wanted to have Reynick circumcised," said Chris, a 42-year-old advertising executive. "But ultimately I didn't want to bring pain to the child unnecessarily. We wanted to do things the way God or the universe meant them to be."
Many parents fear their boys would feel awkward in the locker room if they were not circumcised.
"I like the idea of him looking like his dad — that's the most important thing for me," said Denise Milito Stockwell, 40, an artist in Chicago who had her 15-month-old son, Harlan, circumcised. "It wasn't traumatic for him in any way. He came back from the event sleeping."
Circumcision is still common in many Jewish and Muslim communities.
Ruth Katz, 38, of San Francisco had both her sons circumcised at brises. She and her husband, Michael Rapaport, were astonished when the teacher in their birthing class described circumcision as "immoral" and "not consensual."
"The edict to have your son circumcised was the first covenant with God — the first challenge to being Jewish," said Katz, pursuing a master's degree in business administration. "I am a progressive person and think a lot about human rights issues, but I have never questioned this."

U.S. circumcision rate drops

Mon, 18 Jun 2007 18:43:35 GMT
By RACHEL KONRAD, Associated Press Writer
SAN FRANCISCO - On the eighth day of her son's life, Julia Query welcomed friends and family to celebrate his birth and honor their Jewish heritage.
But there was no crying, no scalpel, no blood, no "mohel" — the person who traditionally performs ritual circumcisions in the Jewish faith. In fact, Elijah Rose's "bris" differed markedly from the ceremony long used to initiate Jewish boys into a covenant with God: There was no circumcision.

"I knew before I was even pregnant that I would not circumcise," said Query, 39, a San Francisco filmmaker whose son was born in 2002. "It's not like you're just cutting a piece of paper off a pad — there's no `cut here' line. It's not made to be cut off, and I would never, ever do that to my baby."

Query is among a growing number of American parents refusing circumcision, in which the foreskin is removed from the penis.

According to a study by the National Health and Social Life Survey, the U.S. circumcision rate peaked at nearly 90 percent in the early 1960s but began dropping in the '70s. By 2004, the most recent year for which government figures are available, about 57 percent of all male newborns delivered in hospitals were circumcised. In some states, the rate is well below 50 percent.

Experts say immigration patterns play the biggest role in the decline, which is steepest in Western states with big populations from Asian and Latin American countries where circumcision is uncommon. The trend has also accompanied a change in Americans' attitudes toward medicine and their bodies.

"The rates of drug-free labor and breast-feeding all rose during the 1980s, while the initial declines in male circumcision rates began during the 1980s as well," said Katharine Barrett, an anthropology lecturer at Stanford University. "It may have been part and parcel of the wider effort to reclaim bodies — adult female and infant male — from unnecessary and potentially harmful medical interventions."

Circumcision remains the nation's most common surgery, and the United States is still one of the few developed countries where a majority of baby boys are circumcised. But circumcision is a heated issue and the subject of vehemently pro and anti Web sites.

"We were all circumcised when I was born," said R. Louis Schultz, a 79-year-old New Yorker and author of "Out in the Open: The Complete Male Pelvis." "People thought it could ward off masturbation or disease, and those funny attitudes have really changed. Now people are saying, `Why do it?'"

Many doctors still recommend circumcision because of some evidence that it reduces the risk of penile cancer, urinary tract infections, HIV and perhaps other sexual transmitted diseases. Many major insurance companies still cover it, and many hospitals offer it free for newborns.

But circumcision opponents say the medical benefits are dubious. Penile cancer, for example, is extremely rare. Since 1999, the American Academy of Pediatrics has not endorsed routine circumcision.

The debate escalated in February, when studies found that heterosexual men in Africa who were circumcised had HIV infection rates up to 60 percent lower than uncircumcised men. Because of those studies, the American Academy of Pediatrics is taking another look at its policy.

About one in three males worldwide is circumcised. In the United States, the rates vary widely by region.

It is most prevalent in the upper Midwest. In 2004, according to data compiled by the federal Agency for Healthcare Research and Quality, more than 79 percent of newborn boys in the Midwest were circumcised before leaving the hospital. Michigan and Kentucky had the highest rates, at 85 percent.

In the fast-growing West, the rate declined dramatically — from 64 percent in 1979 to just under 32 percent in 2004.

In California, the rate of hospital circumcisions among newborns was 21 percent. California — which has more immigrants than any other state — had the lowest circumcision rate in the study, which had comprehensive data on only 27 states.

The decline coincides with rising immigration from Asia and Latin America.

"If you have a solid Victorian, American background, routine circumcision is not unusual," said Carol A. Miller, clinical professor of pediatrics at University of California at San Francisco.
Circumcision was uncommon in 35-year-old Usha Toland's family, which has roots in India, Sri Lanka and Malaysia. When her son, Reynick, was born in 2005 in San Francisco, her husband, Chris, a white man from Southern California, assumed his son would be circumcised. But after the couple read Web sites and medical literature, they decided against the surgery.
"Usha probably would have understood if I really wanted to have Reynick circumcised," said Chris, a 42-year-old advertising executive. "But ultimately I didn't want to bring pain to the child unnecessarily. We wanted to do things the way God or the universe meant them to be."
Many parents fear their boys would feel awkward in the locker room if they were not circumcised.
"I like the idea of him looking like his dad — that's the most important thing for me," said Denise Milito Stockwell, 40, an artist in Chicago who had her 15-month-old son, Harlan, circumcised. "It wasn't traumatic for him in any way. He came back from the event sleeping."
Circumcision is still common in many Jewish and Muslim communities.
Ruth Katz, 38, of San Francisco had both her sons circumcised at brises. She and her husband, Michael Rapaport, were astonished when the teacher in their birthing class described circumcision as "immoral" and "not consensual."
"The edict to have your son circumcised was the first covenant with God — the first challenge to being Jewish," said Katz, pursuing a master's degree in business administration. "I am a progressive person and think a lot about human rights issues, but I have never questioned this."

GlaxoSmithKline plans 5 new cancer drugs

Mon, 18 Jun 2007 15:14:19 GMT

LONDON - GlaxoSmithKline PLC, the world's second-largest pharmaceutical company, said Monday that it expects to introduce five new cancer treatments through 2010.
The drugs will treat a range of different cancers, including cancer of the cervix, the company said in a statement. The new treatments are cervarix, pazopanib, promacta, rezonic and ofatumumab.

Most recently Glaxo introduced Tykerb, its oral treatment for breast cancer, in March. The market for cancer treatments is worth about 20 billion pounds and is growing at a rate of about 20 percent a year, the company estimates.

"Over the next three years, GSK will make a difference to millions of patients facing cancer," said Glaxo's head of research and development, Moncef Slaoui.

Glaxo has seen its shares drop recently after the New England Journal of Medicine published an article saying its diabetes drug Avandia raised the risk of heart attack by 43 percent.

The U.S. Food and Drug Administration said it will require a heart failure warning on Avandia. The drug already carries a warning about heart conditions.

Glaxo shares dipped 0.4 percent to 1,321 pence on the London Stock Exchange.

Checkups key to success of obesity surgery

Mon, 18 Jun 2007 18:21:37 GMT
By Megan Rauscher
NEW YORK - Seriously overweight people who undergo gastric bypass surgery to shed pounds should try to make as many scheduled post-op doctors appointments as possible, according to a new study. It shows that follow-up care is a key component of the long-term success of the weight-loss surgery.
With gastric bypass surgery -- the most common method of &;bariatric&; surgery -- surgeons reduce the size of the stomach, which substantially limits the amount of food a person can eat.

&;Weight loss following gastric bypass varies from patient to patient,&; note Dr. Jon C. Gould and colleagues of the University of Wisconsin in Madison in a report to the annual meeting of the American Society for Bariatric Surgery. Continued and long-term follow-up care at a dedicated bariatric surgery clinic may impact the amount of weight that is lost, they add.

The investigators took a look back at 85 adults who had gastric bypass surgery at their center and found that the results were best in those who attended follow-up appointments for at least 3 years after they had the surgery.

Patients who attended every scheduled post-surgery follow-up appointment for 3 to 4 years lost 74 percent of their excess weight, whereas patients who kept every appointment for only 1 year lost 60 percent of their excess weight. Patients who missed appointments in the first year lost 56 percent of their excess weight.

&;Our follow-up routine calls for visits at 2 weeks post-op, 6 weeks post-op, 6 months, and then annually after surgery indefinitely,&; Gould noted in a telephone interview with Reuters Health. &;If we identify problems, we bring people in more often.&; The follow-up visits include meeting with a dietitian and medical health professional and often a health psychologist.

The most common reason given for missing scheduled appointments after gastric bypass surgery was lack of coverage by the patients' insurance company.

&;This study shows that the more you put into bariatric surgery, the more you get out of it,&; Gould said in a written statement. &;Patients must continue to attend their bariatric medical appointments and insurers should provide coverage for these visits.&;

In 2006 an estimated 177,600 severely obese people in the United States had bariatric surgery, according the American Society for Bariatric Surgery estimates. About 15 million or 1 in 50 adults in the US have morbid obesity, which is associated with a number of other diseases and conditions including type 2 diabetes, heart disease, sleep disturbances, asthma, cancer, and joint problems.