6 die from braineating amoeba in lakes
Fri, 28 Sep 2007 19:04:28 GMT
By CHRIS KAHN, Associated Press Writer
PHOENIX - It sounds like science fiction but it's true: A killer amoeba living in lakes enters the body through the nose and attacks the brain where it feeds until you die.
Even though encounters with the microscopic bug are extraordinarily rare, it's killed six boys and young men this year. The spike in cases has health officials concerned, and they are predicting more cases in the future.
"This is definitely something we need to track," said Michael Beach, a specialist in recreational waterborne illnesses for the Centers for Disease Control and Prevention.
"This is a heat-loving amoeba. As water temperatures go up, it does better," Beach said. "In future decades, as temperatures rise, we'd expect to see more cases."
According to the CDC, the amoeba called Naegleria fowleri killed 23 people in the United States, from 1995 to 2004. This year health officials noticed a spike with six cases — three in Florida, two in Texas and one in Arizona. The CDC knows of only several hundred cases worldwide since its discovery in Australia in the 1960s.
In Arizona, David Evans said nobody knew his son, Aaron, was infected with the amoeba until after the 14-year-old died on Sept. 17. At first, the teen seemed to be suffering from nothing more than a headache.
"We didn't know," Evans said. "And here I am: I come home and I'm burying him."
After doing more tests, doctors said Aaron probably picked up the amoeba a week before while swimming in the balmy shallows of Lake Havasu, a popular man-made lake on the Colorado River between Arizona and California.
Though infections tend to be found in southern states, Naegleria lives almost everywhere in lakes, hot springs, even dirty swimming pools, grazing off algae and bacteria in the sediment.
Beach said people become infected when they wade through shallow water and stir up the bottom. If someone allows water to shoot up the nose — say, by doing a somersault in chest-deep water — the amoeba can latch onto the olfactory nerve.
The amoeba destroys tissue as it makes its way up into the brain, where it continues the damage, "basically feeding on the brain cells," Beach said.
People who are infected tend to complain of a stiff neck, headaches and fevers. In the later stages, they'll show signs of brain damage such as hallucinations and behavioral changes, he said.
Once infected, most people have little chance of survival. Some drugs have stopped the amoeba in lab experiments, but people who have been attacked rarely survive, Beach said.
"Usually, from initial exposure it's fatal within two weeks," he said.
Researchers still have much to learn about Naegleria. They don't know why, for example, children are more likely to be infected, and boys are more often victims than girls.
"Boys tend to have more boisterous activities , but we're not clear," Beach said.
In central Florida, authorities started an amoeba phone hot line advising people to avoid warm, standing water and areas with algae blooms. Texas health officials also have issued warnings.
People "seem to think that everything can be made safe, including any river, any creek, but that's just not the case," said Doug McBride, a spokesman for the Texas Department of State Health Services.
Officials in the town of Lake Havasu City are discussing whether to take action. "Some folks think we should be putting up signs. Some people think we should close the lake," city spokesman Charlie Cassens said.
Beach cautioned that people shouldn't panic about the dangers of the brain-eating bug. Cases are still extremely rare considering the number of people swimming in lakes. The easiest way to prevent infection, Beach said, is to use nose clips when swimming or diving in fresh water.
"You'd have to have water going way up in your nose to begin with" to be infected, he said.
David Evans has tried to learn as much as possible about the amoeba over the past month. But it still doesn't make much sense to him. His family had gone to Lake Havasu countless times. Have people always been in danger? Did city officials know about the amoeba? Can they do anything to kill them off?
Evans lives within eyesight of the lake. Temperatures hover in the triple digits all summer, and like almost everyone else in this desert region, the Evanses look to the lake to cool off.
It was on David Evans' birthday Sept. 8 that he brought Aaron, his other two children, and his parents to Lake Havasu. They ate sandwiches and spent a few hours splashing around.
"For a week, everything was fine," Evans said.
Then Aaron got the headache that wouldn't go away. At the hospital, doctors first suspected meningitis. Aaron was rushed to another hospital in Las Vegas.
"He asked me at one time, 'Can I die from this?'" David Evans said. "We said, 'No, no.'"
On Sept. 17, Aaron stopped breathing as his father held him in his arms.
"He was brain dead," Evans said. Only later did doctors and the CDC determine that the boy had been infected with Naegleria.
"My kids won't ever swim on Lake Havasu again," he said.
___
On the Net:
More on the N. fowleri amoeba:
http://www.cdc.gov/ncidod/dpd/parasites/naegleria/factsht_naegleria.htm#what
Drug trials go unwatched study says
Fri, 28 Sep 2007 17:40:51 GMT
WASHINGTON - Clinical trials that enroll millions of patients in tests of experimental drugs and medical devices get scant government oversight, according to a report released Friday.
Over a six-year period, the Food and Drug Administration inspected just one of every 100 trial sites, raising questions about the agency's ability to ensure the safety of study participants, according to the report by Health and Human Services Department inspector general Daniel Levinson.
Hampered by the lack of a comprehensive catalog of clinical trials, the FDA is unable to even identify all trials, the estimated 350,000 study sites and the institutional review boards that oversee each study to ensure they meet scientific, ethical and legal obligations, the report says.
Those limitations hinder the FDA's ability to ensure participants are protected from unreasonable risks, Levinson said.
The FDA relies on just 200 inspectors to police human studies of drugs and devices. The inspections they perform focus more on ensuring the accuracy of trial data than on verifying the measures put in place to protect the study participants, the investigation found.
Even when inspectors do turn up serious problems, their findings are frequently downgraded by senior officials and almost never followed by inspections to see whether the issues have been resolved, according to the report. In the case of the FDA's drug office, 68 percent of inspector recommendations that the agency take regulatory action, typically in the form of a warning letter, were downgraded.
The FDA found serious problems at test sites 348 times between 2000 and 2005. But only 26 investigators were disqualified from conducting further clinical trials, and data were disqualified just twice, according to the report.
"The report makes clear without a tough cop on the beat to enforce the rules, unscrupulous researchers can take advantage of trial participants and potentially expose them to harm," said Rep. Edward Markey, D-Mass., co-author of a provision in an FDA bill signed into law this week that creates a mandatory clinical trial registry.
The FDA told the inspector general that inspections make up only one part of its efforts to ensure human subject are protected. The agency sees its review of study protocols before they get under way as the most important step in protecting participants.
The FDA oversees the safety of companies' drug or medical device trials, while the Office for Human Research Protections does the same for federally financed tests. There is no federal monitoring of privately financed, noncommercial trials.
The study was first reported in The New York Times' Friday editions.
Study ties certain cancers divorce rate
Fri, 28 Sep 2007 03:09:24 GMT
By MARIA CHENG, AP Medical Writer
BARCELONA, Spain - People who develop cervical or testicular cancer may face another harsh reality: they are more likely to get divorced than those without the disease, a new study says.
In research presented Thursday at a meeting of the European Cancer Organization, Norwegian experts found cancer patients were no more likely to get divorced than people without cancer, except for those with cervical and testicular cancer. The divorce rate actually dropped slightly in the years following diagnosis for most cancers, they said.
But the study showed women with cervical cancer had a 40 percent higher chance of getting divorced than other women. Men with testicular cancer were 20 percent more likely to get divorced than similar men without cancer. Both types of cancer are curable and are diagnosed at younger ages than other cancers.
The researchers didn't have any information on why the couples divorced. Experts thought that the breakups could be due both to the cancers, and to the youth of the couples involved. Older couples might be more committed to each other and less likely to get divorced even when faced with a serious illness.
The researchers said the risk of divorce among those with cervical or testicular cancer dropped with age.
"It seems to be worse for your marriage to get cancer early," said Astri Syse, an epidemiologist at the Norwegian Cancer Registry who led the study.
The researchers looked at 2.8 million people, comparing the divorce rates of 215,000 cancer survivors and couples with no cancer. They did not ask about the reasons for the divorces, but only looked at marriage and divorce registration data between 1974 and 2001.
The researchers said since Norway's divorce rate is the same as other developed countries the results may apply elsewhere.
Lesley Fallowfield, a professor of psycho-oncology at Sussex University who was not connected to the study, said that because sex is a particularly important way for young couples to cement their relationship, a cancer diagnosis that affects a couple's sex life might be very damaging.
"No patient develops cancer in a social vacuum," she said. "The diagnosis will always have an impact on a loved one, and in some cases, they may decide to leave."
Syse said that her study was good news for some cancer patients.
"There's a myth that if you get breast cancer, your husband will leave you," she said. In fact, she and her colleagues found that survivors of breast cancer were less likely to get divorced than similar women without the disease.
Another study presented Wednesday at the Barcelona meeting found that children of cancer patients were so affected by the news of their parent's diagnosis that they had post-traumatic stress symptoms years later.
"We clearly need to be looking closer at how cancer affects a patient's loved ones," Fallowfield said. "There is more to treating cancer than just medical care."
___
On the Net:
European Cancer Organization: http://www.ecco-org.eu/
Study Law prompts drop in heart attacks
Fri, 28 Sep 2007 01:13:19 GMT
By VALERIE BAUMAN, Associated Press Writer
ALBANY, N.Y. - A study released Thursday credits New York's 2003 Clean Indoor Air Act with an 8 percent drop in heart attacks statewide because of reduced exposure to second-hand smoke.
The report, issued by the state Health Department, found that hospitals admitted 3,813 fewer patients for heart attacks in 2004 than would be expected in New York without the indoor smoking ban. Studies elsewhere have reached similar conclusions. In one case, the rate of admissions for heart attacks returned to normal after the ban was lifted.
Admissions for strokes associated with the smoking ban remained unchanged in New York, according to the report, which was published in The American Journal of Public Health.
"The scale of our study is much larger than any study done before," said Harlan Juster, who led the study and works for the state Health Department. "Where they looked at a few hospitals, we looked at all hospitals in New York state that are required to report."
The study examined results from every hospital in the state except those that are federally run. It also tracked other variables that contributed to reducing heart attacks and isolated results related to secondhand smoke. The total decrease in heart attacks was greater than 8 percent. Researchers said that number unavailable Thursday.
Previous studies reported more dramatic results, including a 2003 study in Helena, Mont., that found heart attacks fell by about 40 percent after voters passed an indoor smoking ban. The rates returned to normal then the ban was lifted.
Another study found heart attack rates in Pueblo, Colo., dropped by 27 percent in the 18 months after a smoking ban was imposed in bars, restaurants and other public places.
Michael Seigel, a professor at Boston University's Social And Behavioral Sciences Department who reviews tobacco policies for the school, including smoking bans, questioned the conclusions of the New York study based on its limited scope.
"You can't conclude that that decline was due to the smoking ban," said Siegel, who has testified in New York City, Connecticut and Massachusetts about the value of indoor smoking bans. "Because it's possible that decline was happening everywhere, and without assessing data from every state, there's no way to know."
The New York study examined information from a 10-year span starting before the statewide smoking ban took effect. Researchers found that regulations by local governments that preceded the statewide ban also contributed to a downward trend for heart attacks.
"The moderate laws that were done in many counties did have an impact on reducing emissions and did protect people from secondhand smoke," Juster said. "This reports speaks to the importance of having a comprehensive statewide ban on indoor smoking."
"Science is not supposed to root for a particular outcome," said Audrey Silk, of New York City Citizens Lobbying Against Smoker Harassment. "It's to study and dispassionately report the results. These are advocates first and scientists second."
Juster said the study was unbiased.
"Clearly I'm a researcher, but I'm also probably a tobacco control advocate," Juster said. "But I'm a researcher first. If the law was not effective I would be reporting that, but the law is effective."
The U.S. Surgeon General reported last year that nonsmokers exposed to secondhand smoke increase their risk of developing heart disease and lung cancer by up to 30 percent.
At least 22 states and the District of Columbia have enacted measures requiring all workplaces, including restaurants and bars, to be smoke-free, according to the National Conference of State Legislatures.
The American Journal of Public Health performs blind peer review of published articles.
___
For more information: http://www.ajph.org/
Highcarb diet may help you think faster
Fri, 28 Sep 2007 20:49:03 GMT
By Joene Hendry
NEW YORK -
A low-carbohydrate/high-fat
diet and a high-carbohydrate/low-fat diet both improve weight
loss, enhance mood, and speed thinking, a study shows, but the
low-carb diet may offer less benefit in terms of the rate of
cognitive processing.
&;In overweight and obese patients, following an
energy-restricted dietary plan for weight loss is associated
with improvements in mood, regardless of macronutrient
composition,&; Dr. Grant D. Brinkworth told Reuters Health.
Moreover, while both a high- and low-carbohydrate diets
seem to boost the speed of cognitive processing, &;the
interesting result was that compared to the high-carbohydrate
diet, subjects consuming the low-carbohydrate diet had a
smaller improvement,&; Brinkworth noted.
Brinkworth, of the Commonwealth Scientific and Industrial
Research Organization-Human Nutrition, in Adelaide, Australia
and colleagues compared mood and cognitive function in
overweight or obese, but otherwise healthy, men and women who
were between 24 to 64 years old.
Over 8 weeks, participants followed one of two diets of
similar caloric and macronutrient content, the researchers
report in the American Journal of Clinical Nutrition.
The low-carbohydrate diet contained 35 percent total
protein, 61 percent total fat and 4
percent total carbohydrate. The high-carbohydrate diet
consisted of 24 percent total protein, 30 percent total fat
, and 46 percent total
carbohydrate.
The researchers found no changes in mood among the 93
participants consuming either the low- or high-carbohydrate
diet for the study duration. They did find, however, a small
between-group difference, favoring the high-carb dieters, in
the speed in which participants performed intelligence and
reasoning tests.
The findings suggest, Brinkworth noted, that &;very low
carbohydrate diets may offer less benefit than a high
carbohydrate diet for improving cognitive function.&;
The investigators say further research is needed to
determine whether similar outcomes occur with similar diets of
longer duration.
SOURCE: The American Journal of Clinical Nutrition,
September 2007.
Stem cell therapy takes a toll on sex lives
Fri, 28 Sep 2007 18:31:36 GMT
NEW YORK - A long-term study shows that
sexual dysfunction is a major problem that does not fully
subside after a type of stem cell therapy called hematopoietic
cell transplantation, or HCT. This is true in both men and
women.
High-dose chemotherapy and HCT is often used for people who
have life-threatening blood diseases, such as leukemia and
lymphoma.
&;The prevalence and extent of sexual problems
mandates that survivors be made aware of potential changes and
given resources to address these needs,&; write researchers in
the journal Blood.
&;Survival without a sex life should not be what cancer
survivors settle for or what health care professionals consider
a successful outcome of cancer treatment,&; said Dr. Karen
Syrjala, co-director of the Survivorship Program at the Fred
Hutchinson Cancer Research Center, Seattle, Washington.
&;Sexual dysfunction in survivors of cancer needs to become
a priority for research funding and a routine topic of
discussion between doctors and their patients after cancer
treatment,&; she added.
Syrjala and colleagues had 161 patients complete an
assessment of their sexual health before HCT and at several
time points up to 5 years after HCT. All of them completed one
or more surveys during the 5-year period.
At the 5-year mark, these assessments were compared against
a matched control group made up of siblings, friends, and
volunteers from the community.
The results showed that both men and women were having less
sex 6 months after HCT than before, but, by 1 year, sexual
activity for most of the men had recovered to
pre-HCT levels. For women, recovery of sexual activity took
longer, with just over half returning to sexual
activity after 2 years.
For those who were sexually active 5 years after HCT,
however, 46 percent of men and 80 percent of women said they
had problems that disrupted sexual function. Moreover, 5 years
after HCT, the rates of sexual activity and level of sexual
function were below those of the control group, suggesting that
HCT recipients did not fully recover from the effects of the
cancer itself or cancer treatments.
&;One very positive aspect of this research,&; Syrjala told
Reuters Health, &;is that both men and women are more willing to
discuss their difficulties than they were a decade
ago. This makes it possible for us to learn what men and women
need and to find out what works to improve their sex lives.&;
SOURCE: Blood, online September 18, 2007.
Gene mutation tied to earlyonset Parkinson disease
Fri, 28 Sep 2007 19:36:06 GMT
By Will Boggs, MD
NEW YORK - People with a certain gene
mutation are more likely to get Parkinson's disease early --
before the age of 50 -- compared to those without the gene
abnormality, according to a new study.
Dr. Lorraine N. Clark, from Columbia University, New York,
and colleagues analyzed the genes of 278 people with
Parkinson's disease and 179 people without the disease.
They report that 14 percent of the people with Parkinson's
disease carried mutations in the glucocerebrosidase gene
compared to only five percent of people without the disease.
The gene abnormality was found in 22 percent of people who
were diagnosed with Parkinson's disease before age 50 compared
to 10 percent of the people with disease onset after age 50.
&;Our results confirm that GBA mutations are risk factors
for Parkinson's disease and may lead to getting the disease at
a younger age,&; Clark said in a statement. &;We found those
people with GBA mutations developed Parkinson's disease nearly
two years earlier than people without the gene abnormality.&;
The researchers also looked at how Jewish ancestry affected
the likelihood of getting Parkinson's disease at an earlier age
since some studies have found people with Jewish ancestry are
more likely to have GBA mutations.
Of those with Parkinson's disease, Clark's team found the
gene abnormality in 17 percent of subjects with Jewish ancestry
compared to only eight percent of those without Jewish
ancestry, suggesting that it may be an important risk factor in
people with Jewish ancestry.
SOURCE: Neurology September 18, 2007.
Men okay with prostate cancer surveillance study
Fri, 28 Sep 2007 19:34:23 GMT
NEW YORK -
In men with early or
&;localized&; prostate cancer, the strategy of active
surveillance of their cancer does not appear to increase levels
of psychological stress any more than undergoing immediate
treatment does, according to UK researchers.
With active surveillance, or &;watchful waiting,&; patients
with early prostate tumors are monitored regularly and only
treated if their cancer progresses.
&;Our study found that men on active surveillance were no
more likely to have anxiety and depression than those who were
receiving, or had received, immediate treatment,&; study chief
Dr. Katriina L. Whitaker told Reuters Health. This supports the
acceptability of active surveillance as an approach for
managing localized prostate cancer.
The paper was published in the September issue of BJU
International. Dr. Whitaker's last name at the time was Burnet.
Although studies suggest that many men with localized
prostate cancer may not require radical treatment, like
surgery, a consequence of active surveillance may be increased
psychological stress, Whitaker of University College London and
colleagues note.
To determine if this is the case, they followed 329 men
with localized disease. One hundred were on active
surveillance, 81 were currently receiving radical treatment and
148 had previously received radical radiation therapy.
Overall, 16 percent met criteria for anxiety and 6 percent
met criteria for depression. Analysis showed that higher
anxiety scores were significantly associated with being younger
and with a longer interval since diagnosis. Depression was also
significantly associated with a longer interval since
diagnosis.
However, anxiety and depression were not significantly
associated with management by active surveillance.
The researchers point out that other measures of coping and
quality of life might also be important. However, they conclude
that close monitoring &;was not associated with greater
psychological distress than more immediate treatment for
prostate cancer.&;
SOURCE: BJU International, September 2007.
