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Health News
for 12/09/2009

(last updated 7:30am EST 12/09/2009)

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• Experts Question Effectiveness of Tamifl... Experts Question Effectiveness of Tamiflu
12/08/2009
Study of Data on Antiviral Used for Flu Says No Clear Evidence It Prevents Complications in Otherwise Healthy Adults (3 h ago)

• 2 Infant Deaths Lead to Baby Bed Recall 2 Infant Deaths Lead to Baby Bed Recall
12/08/2009
CPSC Orders Recall of 24,000 Amby Baby Motion Beds; Hammock-like Beds Marketed to Parents of Babies with Colic or Reflux (4 h ago)

• US Spends Most on Health Care; Results L... US Spends Most on Health Care; Results Lag
12/08/2009
Health Care Spending Nearly Triple Average; Life Expectancy Ranks Behind Poland, Mexico (4 h ago)

• Sick This Holiday Season? Sick This Holiday Season?
12/08/2009
Dr. Jennifer Ashton Gives Advice on How to Handle Emergencies, Ailments Over Holidays (5 h ago)

• Meds Involved in Tiger Woods Accident? Meds Involved in Tiger Woods Accident?
12/08/2009
Report: There Are Signs They May Have Been; Another Report: At Least 7 Women Claim They Had Romantic Relationships with Him (5 h ago)

• Video: Dentistry 101 Video: Dentistry 101
12/08/2009
Do teeth whitening agents really work? Do you know how to properly floss? Dr. Jennifer Ashton talks to Dr. Patricia DeSalvo about the ins and outs of proper dental care. (7 h ago)

• Report: Millions in U.S. Drink Dirty Wat... Report: Millions in U.S. Drink Dirty Water
12/08/2009
New York Times Analysis Shows That Since 2004 More than 20% of U.S. Water Systems Have Violated Law, Few Punished (7 h ago)

• Video: New Cancer Report Promising Video: New Cancer Report Promising
12/08/2009
Katie Couric speaks with Dr. Mark Pochapin from New York-Presbyterian Hospital/Weill Cornell Med. Center about a new government study which indicates an emerging trend of decreased death rates for cancer patients. (7 h ago)

• Report: Cancer Rates, Deaths Down Overal... Report: Cancer Rates, Deaths Down Overall
12/08/2009
Joint Report from Leading Groups Focuses on Effect of Lifestlye Changes, Early Screening; Some Cancers Still on the Rise (7 h ago)

• Video: Cancer Deaths Decreasing Video: Cancer Deaths Decreasing
12/08/2009
Dr. Jennifer Ashton spoke about the reported drop in overall cancer death rates and new cases per year. (9 h ago)

• CDC: Frogs Source of Salmonella Outbreak CDC: Frogs Source of Salmonella Outbreak
12/08/2009
Strain Found in Pet Frogs Kept in Aquariums in Three Homes Where Illness Occurred (21 h ago)

• Video: EPA: Greenhouse Gases Harmful Video: EPA: Greenhouse Gases Harmful
12/08/2009
In a monumental first for the U.S. government, the Environmental Protection Agency has declared that greenhouses gases pose a significant health risk. Wyatt Andrews reports on this historic ruling. (23 h ago)

• Video: Trouble in Paradise Video: Trouble in Paradise
12/08/2009
As the debate continues over climate change and global regulations, CBS News' Mark Phillips reports from the Maldives, an island country which may be at most risk as a result of greenhouse emissions. (23 h ago)

• Cash, Clubs in Woods' SUV at Crash Scene Cash, Clubs in Woods' SUV at Crash Scene
12/07/2009
Police Report: Golfer Was at First Unresponsive When Officer Arrived at Scene of Car Accident (1 d ago)

• Video: New Homeless Veterans Shelter Video: New Homeless Veterans Shelter
12/07/2009
A new shelter has opened in Chicago's South Side to provide warmth and security for that region's homeless veterans who may seek refugee during the upcoming cold months. WBBM's Susan Carlson reports. (1 d ago)

• Video: D.C. Debates Abortion & Reform Video: D.C. Debates Abortion & Reform
12/07/2009
A congressional showdown is now underway in Washington, as lawmakers from both sides of the aisle debate whether health care reform will provide abortion coverage. CBS News' Joel Brown reports. (1 d ago)

• Video: Hepatitis C 'Breakthrough' Video: Hepatitis C 'Breakthrough'
12/07/2009
Scientists in San Antonio, Texas say that they have been able to develop a new milestone drug which can help in the combat against the liver-ravaging Hepatitis C virus. KENS' Wendy Rigby reports. (1 d ago)

• Video: Protests at Copenhagen Summit Video: Protests at Copenhagen Summit
12/07/2009
Amid worldwide protests, a 12-day international summit has been launched in the Danish capital of Copenhagen in order to address global climate change. CBS News' Charlie D'Agata reports from London. (1 d ago)

• Video: Plouffe: Sarah Palin "Our Best Fu... Video: Plouffe: Sarah Palin "Our Best Fundraiser"
12/07/2009
David Plouffe, Barack Obama's campaign manager in 2008, spoke with Bob Schieffer about his new book, "The Audacity To Win." Plus; Nancy Cordes with the latest on the Senate's health care debate. (1 d ago)

• Medicare Part D Enrollment Window Closin... Medicare Part D Enrollment Window Closing
12/07/2009
Expert from CVS Caremark Offers Advice on What to Look for in Medicare Prescription Drug Plans (1 d ago)

• Report: States cut tobacco prevention fu... Report: States cut tobacco prevention funds
12/09/2009
States cut funding for state tobacco prevention programs more than 15 percent this year, according to a report that a coalition of public health groups is releasing Wednesday. (1 h ago)

• North Korea confirms swine flu outbreak North Korea confirms swine flu outbreak
12/09/2009
North Korea acknowledged for the first time Wednesday that swine flu has hit the nation, a day after South Korea's president offered to help the impoverished neighbor fight the virus reported to have already killed dozens. (1 h ago)

• Breastfeeding may curb heart, diabetes r... Breastfeeding may curb heart, diabetes risk
12/08/2009
Mothers who breastfeed seem to have a lower long-term risk of developing a collection of risk factors for diabetes and heart disease than women who bottle-feed, a new study suggests. (2 h ago)

• Some pets sickened by swine flu as well Some pets sickened by swine flu as well
12/08/2009
A handful of pets have been sickened with swine flu in recent weeks, but here are doctors' orders: Wash your hands and don't panic. There is no evidence that humans can get the swine flu infection from pets, says the American Veterinary Medical Association. (2 h ago)

• Little evidence Tamiflu works, report sa... Little evidence Tamiflu works, report says
12/08/2009
British researchers say there is little evidence Tamiflu stops complications in healthy people who catch the flu, though public health officials contend the swine flu drug reduces flu hospitalizations and deaths. (4 h ago)

• U.S. tops world in health spending, resu... U.S. tops world in health spending, results lag
12/08/2009
The United States ranks near the bottom in life expectancy among wealthy nations despite spending more than double per person on health care than the industrialized world's average, an economic group said Tuesday. (5 h ago)

• Sweat glands are secret sensory organs Sweat glands are secret sensory organs
12/08/2009
The human body may be equipped with a separate sensory system aside from the nerves that gives us the ability to touch and feel, according to a new study. (6 h ago)

• Coroner: Self-help course led to suicide Coroner: Self-help course led to suicide
12/08/2009
An Australian coroner said Tuesday that participation in an intense self-help course led a woman to suffer a psychotic breakdown before she stripped naked and leaped to her death from an office window in front of horrified co-workers. (8 h ago)

• Newsweek: A backlash against the vaccine... Newsweek: A backlash against the vaccine haters
12/08/2009
The anti-vaccination movement has resulted in outbreaks of preventable diseases in communities that are not used to them. The unimmunized few are a threat to all, and the hypocrisy is not lost on poor countries. (10 h ago)

• Autism seen as asset, not liability, in ... Autism seen as asset, not liability, in some jobs
12/08/2009
Autism is often seen as a heartbreaking diagnosis. But in some careers, the very traits that are hallmarks of some forms of the disorder are being seen as desirable job skills. (10 h ago)

• NYT: Millions in U.S. drink dirty water NYT: Millions in U.S. drink dirty water
12/08/2009
More than 20 percent of the nation’s water treatment systems have violated key provisions of the Safe Drinking Water Act over the last five years, according to an analysis of federal data. (11 h ago)

• H1N1 may be mildest pandemic on record H1N1 may be mildest pandemic on record
12/08/2009
Leading epidemiologists are predicting that the H1N1 pandemic could end up ranking as the mildest since modern medicine began documenting influenza outbreaks. (11 h ago)

• Zhu Zhu Pets safe, safety regulators say Zhu Zhu Pets safe, safety regulators say
12/08/2009
Toy safety regulators say one of the holiday season's hottest toy crazes — Zhu Zhu Pets — do not violate federal safety standards after all. (21 h ago)

• CDC: Pet frogs source of salmonella outb... CDC: Pet frogs source of salmonella outbreak
12/08/2009
Pet frogs are being blamed for a national salmonella outbreak that sickened at least 48 people. (22 h ago)

• Colon cancer deaths could make big drop Colon cancer deaths could make big drop
12/08/2009
The colon cancer death rate in 2020 could be half of what it was in 2000, due to better screening and treatment, says a new report from the American Cancer Society. (23 h ago)

• Body mass, waist size can predict heart ... Body mass, waist size can predict heart disease
12/07/2009
Measuring body mass index or waist size in overweight people can accurately predict the risk of heart disease, Dutch scientists said on Monday. (1 d ago)

• 1 in 5 on Medicare rehospitalized in one... 1 in 5 on Medicare rehospitalized in one month
12/07/2009
One in five Medicare patients winds up back in the hospital within a month of being discharged — even worse, one in four patients with heart failure. Now a major push is on to arm patients with simple steps to keep their recovery at home on track. (1 d ago)

• Decking the halls? Watch out for danger Decking the halls? Watch out for danger
12/07/2009
Falls, fires, cuts and concussions send thousands to the nation's emergency rooms each holiday season. Reports show the newest hazards are weighted stocking hangers that topple onto kids' heads. (1 d ago)

• DNA snafu turns some kids into nonstop e... DNA snafu turns some kids into nonstop eaters
12/06/2009
Some children get severely obese because they lack particular chunks of DNA, which kicks their hunger into overdrive, researchers report. (2 d ago)

• Swine flu latest from the NHS Swine flu latest from the NHS
12/08/2009
Last updated: 16.30 BST There was a substantial drop in swine flu numbers in the week leading up to December 3, with an estimated 22,000 new cases, down from 46,000 the week before. The fall reflected a marked decrease among young adults and older children. This is the fourth consecutive week that cases have fallen. Despite this reduction, the number of people in hospital remained high, at 747. Of these, 161 were in critical condition. Sir Liam Donaldson, the chief medical officer said, “We’re not sitting here claiming victory, because there are still many things to worry about.“ A large proportion of those in hospital were children under five, a group recently prioritised to be vaccinated. Sir Liam suggested, however, that many of these children may actually have respiratory syncytial virus (RSV), a flu-like illness that commonly becomes a problem at this time of year. On Tuesday December 8, Andy Burnham, the health secretary, said that children between the ages of six months and five years will start to be vaccinated against swine flu in the run-up to Christmas. The number of deaths from swine flu has also grown, with 15 deaths in England in the week leading up to December 3. The UK death total stood at 270: 178 in England, 54 in Scotland, 25 in Wales and 13 in Northern Ireland. The vaccination programme continues successfully, with an estimated 1.6 million people in the priority groups vaccinated so far. As of last week, 275,000 doses had been administered to frontline health workers, twice the number that received the seasonal flu jab in the whole of the last flu season. Young children made a priority Children between the ages of six months and five years will soon be offered the swine flu vaccine. The move is based on evidence that they are more likely than other groups to be hospitalised. There have also been high rates of admission to critical care in this age group. Sir Liam urged everyone who is offered the vaccine to accept it: “While the risks of serious complications from flu may be small, the impact on those affected can be devastating. “Protecting those most at risk from the disease will reduce the levels of serious illness and deaths. That’s why we will shortly offer the vaccine to young children”. Parents of children who are over six months and under five years old should wait to be contacted by their local GP surgery. Vaccinations Vaccination of people in clinical risk groups is well under way, with an estimated 1.6 million doses of vaccine administered so far. NHS hospitals and GPs are now vaccinating patients facing the greatest risk of complications. Patients will be contacted by their GPs if they fall into one of the at-risk categories. Healthcare staff dealing with the public are also being vaccinated to help keep medical services running smoothly and to prevent them from passing the virus to patients. Recently, healthy children aged six months and over to under five years were added to the priority groups. Vaccination of this group will begin shortly. Parents of children of this age should wait to be contacted by their local surgery. Who is a priority for vaccination? People who are most at risk from swine flu need to be vaccinated first. These groups are, in order of priority: People aged between six months and 65 years in the seasonal flu vaccine at-risk groups. All pregnant women. The European Medicines Agency has indicated the vaccine can be given to pregnant women regardless of their stage of pregnancy. People who live with those whose immune systems are compromised, such as cancer patients or people with HIV/AIDS. People aged 65 and over in the seasonal flu vaccine at-risk groups. Healthy children aged six months and over to five years. Frontline health and social care workers will also be offered the vaccine at the same time as the first clinical at-risk groups. Health and social care workers are both at an increased risk of catching swine flu and of spreading it to other at-risk patients. What are the seasonal flu vaccine at-risk groups? These are people with: chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD), chronic heart disease, such as heart failure, chronic kidney disease, such as kidney failure, chronic liver disease, such as chronic hepatitis, chronic neurological disease, such as Parkinson's disease, diabetes requiring insulin or oral hypoglycaemic drugs, and immunosuppression (a suppressed immune system), due to disease or treatment. Planning assumptions Revised guidance for planners was issued on October 22. The new guidance is based on the latest scientific understanding of the swine flu virus, drawing on our own experience to date and the southern hemisphere’s experience of winter. This improved understanding means it is now anticipated that the impact of the virus on the UK is likely to be less severe than previously thought. The additional information now available confirms earlier guidance that children under 16 are significantly more susceptible to the virus, and up to 30% may fall ill during this second wave. The worst-case clinical attack rate is revised down from 30% to 12% between October 1 and the end of the normal flu season. The worst-case hospitalisation rate is now considered to be 35,000 with up to 5,300 requiring critical care over the same period. The worst case number of deaths is now assumed to be a further 1,000 spread across all age groups. The threat that swine flu still poses should not, however, be underestimated. Up to 1.5 million people could still become ill in the peak week. Children under 16 are particularly susceptible to the illness and unfortunately in rare cases healthy children have developed severe complications. Who is at greatest risk of serious complications from swine flu? Some people are more at risk of complications if they catch swine flu, and need to start taking antivirals as soon as it is confirmed that they have the illness. Doctors may advise some high-risk patients to take antivirals before they have symptoms, if someone close to them has swine flu. It is already known that people are particularly vulnerable if they have: chronic (long-term) lung disease, chronic heart disease, chronic kidney disease, chronic liver disease, chronic neurological disease (neurological disorders include motor neurone disease, multiple sclerosis and Parkinson's disease), immunosuppression (whether caused by disease or treatment), or diabetes mellitus. Also at risk are: patients who have had drug treatment for asthma in the past three years, pregnant women, people aged 65 and over, and children under five. National Pandemic Flu Service The National Pandemic Flu Service was launched in July. This online service assesses patients for swine flu and, if required, gives them an authorisation number that can be used to collect antiviral medication. The system, which can also be accessed by phone, will take the strain off GPs as swine flu spreads. For the moment, it is being used only in England. “The National Pandemic Flu Service is a new self-care service which will give people with pandemic swine flu symptoms fast access to information and antivirals,” said a Department of Health spokesman. “This new service will free up GPs, enabling them to deal with other illnesses that need their urgent attention.” The launch of the system brought important changes to the official advice that is given to people who think they may have swine flu. That advice – and the new system – is supported by the Royal College of General Practitioners. Advice for antivirals Several newspapers reported that the World Health Organization (WHO) had changed its advice regarding use of antivirals for swine flu. Its advice suggests that while antivirals should always be given in serious cases, they may not always be necessary for otherwise healthy people. The papers pointed out that this appeared to differ from the approach taken in the UK, where Tamiflu is being widely used. However, the Department of Health said: "We believe a safety-first approach of offering antivirals, when required, to everyone remains a sensible and responsible way forward. However, we will keep this policy under review as we learn more about the virus and its effects. "The WHO recommendations are in fact in line with UK policy on antivirals. We have consistently said that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.” (8 h ago)

• Waistline, BMI and heart risk Waistline, BMI and heart risk
12/08/2009
The Daily Mail today reports that a new study has blamed a third of heart disease deaths on being fat. It also said that “one in seven non-fatal heart disease cases could be attributed to people being overweight or obese”. This large 10-year study of about 20,000 people in the Netherlands found a link between obesity and higher waist circumference and risk of both fatal and non-fatal cardiovascular disease (CVD), such as heart attacks and strokes. The study’s strengths include its relatively large size and the fact that its BMI and waist data were collected using standard methods by trained staff. Its limitations include its reliance on national registries to identify cases of CVD. In addition, the results may not be representative of other populations, particularly the figures estimating how much CVD in a population is due to obesity and being overweight. Although the exact figures may differ for different populations, this study highlights the importance of maintaining a healthy weight in reducing CVD. Where did the story come from? The research was carried out by Dr Ineke van Dis and colleagues from the National Institute for Public Health and the Environment, Wageningen University and the Netherlands Heart Foundation in the Netherlands. The study was funded by the Ministry of Health, Welfare and Sports of the Netherlands and the National Institute of Public Health and the Environment. It was published in the peer-reviewed European Journal of Cardiovascular Prevention and Rehabilitation. This story has been reported by the Daily Mail, The Daily Telegraph and the Daily Mirror. The Daily Mail provides a reasonable report of the research, and the Mirror’s story is very brief but accurate. The Daily Telegraph initially focuses on the effects of waist circumference, saying that abdominal obesity is as bad for the heart as just being heavy, and that it increases four-fold the risk of dying from heart disease. This figure actually pertains to obesity measured by BMI and is from an analysis that took into account the participants gender and age. What kind of research was this? This was a prospective cohort study called the Monitoring Project on Chronic Disease Risk Factors (MORGEN). The researchers were particularly interested in how body mass index (BMI) and waist circumference are linked to non-fatal CVD. They say that previous studies looking at this question have largely relied on self-reported BMI and waist circumference, and that people may underestimate these measurements, which could affect results. This type of study is the best design for investigating links between people’s characteristics and their risk of disease. Setting up a study to collect data from a group of people at a future date means that the data collected is more likely to be complete and accurate than if researchers had to rely on data previously collected by other people for other purposes. Because the different groups compared may differ in factors other than the one of interest (in this case BMI), such studies should always measure factors that could also be having an effect on the outcome and take these into account in their analyses. What did the research involve? The researchers enrolled about 20,500 adults (aged 20–65 years) between 1993 and 1997 in the Netherlands. These people had their height, weight and waist circumference measured using standard methods by trained staff. They also gave blood samples, had their blood pressure measured and filled in questionnaires about their health, lifestyle and other factors such as education. Over the follow-up period to the start of 2007 (an average of 10 years), the researchers identified people who had died and their cause of death, as well as any cases of non-fatal CVD from national registers. Obesity was defined as having a body mass index of 30kg/m2 or over, and being overweight as having a body mass index of between 25 and 30kg/m2. A high waist circumference (indicating abdominal obesity) for women was defined as 88cm or higher, and a normal waist circumference was less than 80cm. A high waist circumference for men was defined as 102cm or higher, and a normal waist circumference was less than 94cm. Having measurements taken by trained staff in a standardised way increases the reliability of these measurements. The researchers then looked at what effect being overweight or obese or having a high waist circumference had on the risk of fatal or non-fatal CVD. They took into account the participants’ gender and age when looking at the proportion of people who had CVD. When comparing the risk of CVD between the different groups, they also took into account smoking, educational level, blood pressure, cholesterol level and whether the participant reported having diabetes. They also calculated what proportion of obese or overweight people’s risk of CVD was caused by their weight, and also how much of the general population’s risk of CVD was related to weight. The researchers lost 556 people to follow up, mainly because of emigration. They also excluded people who already had a history of heart attack at the start of the study, pregnant women, people with missing data and people with a BMI of less than 18.5kg/m2. This left 9,062 men and 10,572 women for analysis. What were the basic results? Overall, 42% of men and 30% of women in the study were overweight, and 10% of men and 11% of women were obese. Just over a quarter of women (26%) had a high waist circumference (abdominal obesity), and just under a fifth of men (19%). On average, the participants were followed for 10 years, during which time 728 men and 403 women were hospitalised for non-fatal CVD and 81 men and 30 women died from CVD. Over 10 years: Non-fatal CVD occurred in: 16% of obese men and 6.8% of obese women; 8.7% of overweight men and 5.1% of overweight women; 5.9% of normal weight men and 2.6% of normal weight women. Fatal CVD occurred in: 2.6% of obese men and 0.9% of obese women; 1.1% of overweight men and 0.3% of overweight women; 0.4% of normal weight men and 0.2% of normal weight women. For obese people, the risk of non-fatal CVD was about 1.3 times higher than for normal weight people, after taking into account factors that could affect the results (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1 to 1.5). Obese people were also three times more likely to die from CVD (HR 2.9, 95% CI 1.7 to 5.1). People with abdominal obesity had about 1.2 times the risk of non-fatal CVD and 2.1 times the risk of fatal CVD, compared to those with normal waist measurements. The researchers calculated that about a half of the risk of fatal CVD and a quarter of the risk of non-fatal CVD in people who were obese or overweight was caused by their weight. In the general population, about a third of deaths from CVD and one in seven cases of non-fatal CVD were caused by being overweight and obese. How did the researchers interpret the results? The researchers conclude that the link between BMI and waist circumference and risk of CVD “were equally strong”. They also say that the link between those who are overweight and obese and fatal CVD is stronger than the link with non-fatal CVD. Conclusion This study provides further support for the link between being overweight or obese and an increased risk of heart disease. The strengths of this study include its relatively large size, standardised measurement of BMI and waist circumference by trained staff, and that it adjusted for factors that could have affected the results. Some of its limitations include the following: Although a number of factors that can affect the risk of CVD were taken into account, it is possible there is some residual effect of these or other unconsidered factors on the results. Outcomes were assessed based on national records. It is possible that these records may be missing for some people, or may contain some inaccuracies. About 1,000 people from the original sample were not included in the final analyses due to missing data, previous heart attack or loss to follow up. Inclusion of these people may have affected the results. Non-fatal CVD was identified by looking at hospital records, this would miss people who had CVD but did not go to hospital. The results may not be representative of different populations. The authors point out that their population was younger (average age 43) than those used in other studies. Also, in the general population, the proportion of fatal and non-fatal CVD that is caused by people being overweight and obese will depend on how common these conditions are. So, for example, if overweight and obesity are more common in a population they may account for more of the risk, but if they are rare they may account for less of the risk. The study suggests that about a third of deaths from CVD and one in seven cases of non-fatal CVD could be prevented in the general population if people avoid becoming overweight or obese. These figures highlight the importance of maintaining a healthy weight. Links To The Headlines Third of heart disease deaths blamed on being too fat. Daily Mail, December 8 2009 Big belly 'as bad as being obese' for the heart. The Daily Telegraph, December 8 2009 Being fat is greater risk. Daily Mirror, December 8 2009 Links To Science van Dis I, Kromhout D, Geleijnse JM, et al. Body mass index and waist circumference predict both 10-year nonfatal and fatal cardiovascular disease risk: study conducted in 20 000 Dutch men and women aged 20-65 years. European Journal of Cardiovascular Prevention & Rehabilitation 2009; 16: 729-734 (12 h ago)

• Can loneliness cause cancer? Can loneliness cause cancer?
12/08/2009
“Loneliness can make cancer ‘more likely and deadly’”, according to BBC news. The news service says new research found that isolation and stress trebled the risk of breast cancer in the “naturally sociable” Norway rats. This story is based on research conducted at the University of Chicago. It took rats that were predisposed to developing breast cancer tumours and looked at the effect of rearing them in groups or in isolation. The scientists then measured the rats’ stress levels along with the number and severity of any tumours they developed. As this was an animal study it cannot be directly related to humans. Also, isolation in rats is likely to be very different to human loneliness and the complex effects it may have on the human body. This study cannot show that human loneliness increases the likelihood of cancer or that it causes cancer to be more severe. Where did the story come from? This research was conducted by Dr Gretchen Hermes and colleagues from the University of Chicago. The research was funded by a number of US institutions including the National Institute of Environmental and Health Sciences, the National Cancer Institute and the Department of Psychiatry, Yale University. It was published in the peer-reviewed medical journal Proceedings of the National Academy of Sciences . The media did report that this research was in animals, but generally exaggerated its direct relevance to humans. What kind of research was this? This was an animal study comparing the development of tumours in rats reared in groups or kept in isolation. It aimed to test the theory that social isolation is associated with abnormal hormonal and behavioural responses to stress, and that these responses may contribute to the development of tumours. This was a relatively small animal study and its direct relevance to humans is limited. What did the research involve? The researchers selected a strain of rats genetically predisposed to developing tumours. At 21 days old the rats were split into two groups: 20 rats to be reared alone in separate cages and 20 rats to be reared in four groups of five rats per cage. The researchers checked the rats twice a month for 15 months, assessing the location of any tumours, counting the number of tumours and estimating the weight of the tumours by feeling their size (tumour burden). The rats’ behaviour was assessed on two occasions: firstly when they were young (one to three months) and had not yet developed tumours, and once again when the rats were middle aged (13 months) and had already developed tumours. As part of the behavioural testing the researchers observed how the rats responded to stress by exposing them to the smell of fox urine. They then measured the amount of the stress hormone corticosterone that the rats produced in response to the predator’s scent. The rats died at 18 months on average. The researchers then performed post-mortem analyses of the types of tumours that the rats had developed. They specifically looked at the number of hormone receptors in the tumours, which is a measure of the amount of hormone present in a tumour. What were the basic results? By middle age (13 months) 74% of rats from both groups had developed a tumour, meaning the risk of developing at least one tumour did not differ between the groups. However, the socially isolated rats had an 84% greater tumour burden than the rats reared in groups. Their tumours were also more widespread. When the researchers assessed whether the tumours were carcinomas (cancerous tumours) they found that the risk of having at least one carcinoma was around three times greater in the isolated animals. Overall, isolated animals had a 50% incidence of cancerous tumours compared to 15.4% in the grouped animals. The researchers found that the isolated rats had a greater increase in corticosterone stress hormone levels than the group-reared rats when exposed to the stress-inducing fox scent. This was the case both before tumours had developed and at 13 months. The researchers found that the receptor for the corticosterone stress hormone was present in the carcinomas. The researchers also found that the isolated rats showed more typical traits of stressed behaviour than the group-reared rats. How did the researchers interpret the results? The researchers conclude that their study shows that “female rats living in social isolation from puberty through late middle age become progressively more reactive to superimposed stress”. They also say social isolation increased the size, number, distribution and malignancy of spontaneous mammary tumours, illustrating how psychological factors can change the way inherited genetic risks are expressed. Conclusion The research found an association between isolated rearing, increased stress responses and increased tumour burden in rats that were genetically predisposed to tumours. Although the animal study was well conducted it shows an association rather than a direct causal relationship between corticosterone levels and an increased likelihood of malignant tumours. Also, while rats and humans are both social animals their social dynamics clearly differ. The stress factors used in this experimental work are not relevant to modelling how human social interactions may affect risk of breast cancer, and it is not clear how relevant changes in corticosterone hormones are to the development of cancer in humans. Links To The Headlines Loneliness makes cancer 'more likely and deadly' . BBC News, December 8 2009 Loneliness 'fuels breast cancer', say scientists . Daily Mail , December 8 2009 Loneliness and stress ‘raise the chances of breast cancer’ . The Times , December 8 2009 Loneliness 'can increase risk of breast cancer' . The Daily Telegraph , December 8 2009 Links To Science Hermes GL, Delgado B, Tretiakova M et al. Social isolation dysregulates endocrine and behavioral stress while increasing malignant burden of spontaneous mammary tumors. PNAS 2009 (12 h ago)

• Gene mutation for obesity 'rare' Gene mutation for obesity 'rare'
12/08/2009
“Childhood obesity could be caused by a genetic mutation,” reported The Daily Telegraph . The newspaper said a study has shown that the condition could be genetic, rather than the result of overfeeding. This well conducted and reliable study indicates that, very rarely, some people’s DNA may affect their eating behaviour, making them more likely to become obese. This mutation was rare, with only five out of 300 very severely obese children carrying it. Most cases of childhood obesity will not be caused by this mutation. This study highlights how complex the issue of obesity is and that there is no single cause. A healthy diet and adequate physical activity remain the most important ways of maintaining a healthy weight, even for those whose genes make them more likely to become obese. Where did the story come from? This research was carried out by Elena G Bochukova and colleagues from the University of Cambridge Metabolic Research Laboratories, Addenbrooke’s Hospital in Cambridge and other institutions in the UK. The study was funded by the Wellcome Trust, the Medical Research Council (MRC) Centre for Obesity and Related Disorders and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre. It was published in the peer-reviewed science journal Nature . Some papers, including the Daily Mail and The Times highlighted the fact that genes may be playing a part but that genetics doesn’t usually tell the whole story. The Daily Mail gives more detail, saying that, among the 300 children in the study who had become very fat by the age of 10, five had the mutation and four of these had been on the at-risk register. What kind of research was this? In this case-control study , the researchers compared mutations in the DNA of 300 obese UK children with those in 7,366 apparently healthy volunteers. Nearly half of the 300 children with severe early onset obesity also had developmental delay, meaning they required special educational support, or autism. The researchers were looking for a mutation type in the children’s DNA known as a copy number variant (CNV). These occur when large chunks of DNA are either duplicated or deleted, and can result in a person having more or fewer copies of certain genes than normal. It is thought that this type of mutation plays an important role in several genetic diseases. Although the rise in obesity is mainly driven by environmental factors, genetic factors play a major role in determining why a few children are more likely to gain weight. The researchers say that genetic studies of rare causes can identify biological pathways that are also important in determining weight. What did the research involve? The 300 obese UK children were randomly selected from another study called the Genetics of Obesity Study cohort. The 7,366 apparently healthy controls were of European ancestry and from a study called the Wellcome Trust Case Control Consortium. Among the 300 UK children with severe obesity, there were 143 children with developmental delay. All 300 obese children had severe obesity defined as a body mass index (BMI) standard deviation score of more than three, meaning that they were among the top one to two per cent for their age. For example, an eight-year-old child weighed at least 11 stone (70kg) and a 10-year-old child at least 15 stone (95kg). The researchers explain that previous studies have identified small changes to the genetic code called single nucleotide polymorphisms (SNPs) associated with increased BMI. These are common and together account for only a small percentage of the inherited variation in BMI. This study looked at larger differences (the CNVs), which the researchers thought might affect obesity. Previous studies have identified rare CNVs that affect leptin and melanocortin: hormones that play a role in regulating energy intake and energy expenditure, including appetite and metabolism. This study used appropriate methods of analysis and described its methods in several appendices. What were the basic results? The researchers found an average (median) of 53 CNVs in children with severe early onset obesity and 55 in the healthy control children. They then looked at only large deletions (more than 500 kilobases, a base being one letter in the DNA code) and rare deletions (found in less than 1% of participants). These deletions were significantly more common among the 300 cases than among the 7,366 controls (P < 0.001). When the researchers investigated which specific areas of DNA were affected by deletions, they found that deletions of part of chromosome 16 (called 16p11.2) were more common in cases than controls. Out of the 300 cases, five were identified as having overlapping deletions on chromosome 16p11.2 compared to just two of 7,366 controls (P less than 5 x 10 -5 ). Children with the deletion had severe obesity from a young age. Two of the cases also had mild developmental delay, and the researchers point out that deletions in this part of the genetic code are already known to be associated with delay. How did the researchers interpret the results? The researchers conclude that "this is the first evidence that copy number variants have been linked to a metabolic condition such as obesity. They are already known to cause other disorders such as autism and learning difficulties". They go on to call for a change in attitudes and practices among those with professional responsibility for the health and wellbeing of children. They say that “severe obesity is a serious medical issue that deserves scientific investigation”. Conclusion This research forms part of a growing body of evidence on the rarer genetic causes of severe obesity. Its strengths include the relatively large number of children with this severity of obesity who were studied. The study also has some weaknesses, one of which is related to its design. Case-control studies are limited because it’s possible that other factors could be involved and causing the associations seen. For example, the genetic differences were seen in areas of the genetic code already linked with developmental delay and autism. It’s possible that the higher rate of CNVs in the cases group is partially due to the selection of children with developmental delay in this group, rather than being directly linked to obesity. However, if this were the case, it's unlikely that it would change the overall conclusion due to the size of the groups. The findings have implications for the diagnosis of severe childhood obesity. Some of the children in the study had already been formally placed on the social services at-risk register, on the assumption that the parents were deliberately overfeeding their children and causing their severe obesity. These children have reportedly now been removed from the register. The researchers suggest that, in future, children with very severe obesity should be tested for this genetic cause. The number of very severely obese children with the genetic deletions on part of chromosome 16 were rare. It should not, therefore, be assumed that all severely obese people have this genetic mutation. It is likely that the majority of obesity is related to environmental causes. A healthy diet and adequate physical activity remain the most important ways of maintaining a healthy weight. Links To The Headlines Obesity gene discovery 'may cut cases blamed on abuse'. BBC News, December 8 2009 Obese children taken off at-risk register after scientists discover they carry 'fat gene'. Daily Mail , December 8 2009 Childhood obesity linked to mutant gene. The Daily Telegraph , December 8 2009 Weight gain is guided by our DNA but doesn’t usually tell the whole story. The Times , December 8 2009 Links To Science Bochukova EG, Huang N, Keogh J, et al. Large, rare chromosomal deletions associated with severe early-onset obesity. Nature 2009; Published online December 6 (13 h ago)

• Warfarin alternative trialled Warfarin alternative trialled
12/08/2009
A new drug will slash risk of strokes according to the Daily Express . The newspaper says that the anti-clotting drug dabigatran is as safe and effective at treating deep vein thrombosis as the traditional drug warfarin. The reports are based on a trial that compared dabigatran to warfarin in people who have blood clots in the veins of the leg or lung (venous thromboembolism). The study found that dabigatran and warfarin work equally well to prevent clots, but that there is a slightly reduced risk of bleeding problems with dabigatran compared with warfarin treatment. It did not directly look at the risk of strokes. Warfarin can have a number of side effects and has to be carefully prescribed and monitored by a doctor, so there is interest in finding potential alternatives. Dabigatran is already licensed in the UK for preventing clots in people having hip or knee replacement surgery. It is not yet licensed for use in patients who already have a venous thromboembolism, and this study will be important in applying for such licensing. Where did the story come from? This research was conducted by Dr Sam Schulman and colleagues from the RE-COVER study group, and was funded by Boehringer Ingelheim, the firm that markets dabigatran. Members of Boehringer Ingelheim designed and conducted the study, which they analysed with a steering committee that vouched for the accuracy and completeness of the data and the analyses. The research was covered by the Daily Express and the Daily Mail . The Mail emphasised the problems with warfarin, saying it requires close monitoring due to difficulties in precisely controlling its dosage. The Daily Express correctly reports the main result of the study, that dabigatran and warfarin are equally effective in preventing recurrent blood clots. The Daily Express also focuses on the lower risk of bleeding with dabigatran, with a headline suggesting that dabigatran reduces the risk of strokes. While blood clots are associated with stroke and other studies have tested the drug in people at risk of stroke, this current study did not specifically look at outcomes of stroke. The Daily Mail also misreports the number of patients in the study, suggesting that 25,000 patients were involved rather than around 2,500. What kind of research was this? This study was a double-blind randomised-controlled trial (RCT) that investigated how well the newer drug dabigatran prevented the recurrence of blood clots compared to warfarin, the standard blood-thinning drug. This type of study is the best way to assess how effective a new drug is compared to the best existing drug. This particular trial was a special kind of RCT called a non-inferiority trial, which means that the researchers were assessing whether the new drug was at least as good as warfarin. Warfarin and dabigatran tablets look distinctly different to one another, so the researchers included a double dummy phase in which the two groups of participants received both an active drug and a placebo pill that looked like the other drug. This was so that the participants and the researchers would not know which active treatment they were receiving. This is the best way to ensure that patients’ or researchers’ personal beliefs about the effects of treatment do not affect the outcome or how the outcome is perceived. What did the research involve? The researchers recruited participants from 29 countries. They selected 2,539 who had either symptomatic deep vein thrombosis (DVT) of the legs or a pulmonary embolism (blood clots affecting the blood vessels of the lungs). All participants had to be considered appropriate candidates for a six-month course of anticoagulant therapy. The study also excluded people who had experienced their symptoms for more than 14 days, had recent cardiovascular disease, were at a high risk of bleeding, had abnormal liver function or had a life expectancy of less than six months. Before starting the trial patients were treated with the injected anticoagulant heparin. The participants were then randomly assigned to receive either warfarin or dabigatran for six months. There were 1,266 participants in the warfarin group and 1,273 participants in the dabigatran group. They were assessed for blood clot symptoms, bleeding, abnormal liver function and abnormal heart function once a week for the first month and then once a month for the remaining five months. The researchers also recorded details of any patient deaths. Before analysing the data, the researchers decided that dabigatran would be considered to be as effective as warfarin if it was not likely to increase the risk of symptomatic venous thromboembolism or death associated with venous thromboembolism by more than 3.6%. What were the basic results? In this study some of the participants did not complete the six-month treatment or were assessed before the end of the observation period. This was mostly due to adverse events, although the proportion of participants who did not complete the study was similar in both treatment groups (16% in the dabigatran group and 14.5% in the warfarin group). The researchers found that a similar proportion of the warfarin and dabigatran group experienced a recurrence of clots or death from recurrent clots: 2.4% in the dabigatran group and 2.1% in the warfarin group, a difference of +0.4% (95% confidence interval [CI] -0.8% to +1.5%; hazard ratio [HR] 1.10, 95% CI 0.65 to 1.84). As the difference in clot risk was less than the 3.6% margin set by the researchers, the drugs were considered to be similarly effective at preventing this outcome. The risk of having a major bleed in the dabigatran group and the warfarin group was similar, at 1.6% and 1.9% respectively (HR 0.82, 95% CI 0.45 to 1.48). However, when the analysis included both major bleeds and clinically relevant non-major bleeds those in the dabigatran group were less likely to have bleeds than those in the warfarin group (HR 0.63, 95% CI 0.47 to 0.84). Within the two treatment groups a similar proportion of participants had adverse events (dabigatran 66.3%, warfarin 67.6%). However, the proportion of participants with indigestion problems was higher in the dabigatran group (3.1%) compared to the warfarin group (0.7%; p less than 0.001). How did the researchers interpret the results? The researchers concluded that their trial “provides data to support dabigatran as a fixed-dose oral treatment for acute deep-vein thrombosis and pulmonary embolism”. They said that the decrease in non-clinical bleeds with dabigatran is an important issue since management of bleeds is time-consuming and costly and because bleeding is the major reason behind patients’ perception that warfarin treatment decreased health and quality. They also add that “dabigatran is a far more convenient drug than warfarin because it has no known interactions with foods, and minimal interactions with other drugs and therefore does not require routine blood-coagulation testing”. Conclusion The anticoagulant dabigatran is already licensed as an alternative treatment to warfarin in certain cases. This study suggests that it works equally well to prevent the recurrence of blood clots in people who have had a clot in their leg or lung. The study also suggests that both treatments have an adverse effect of causing bleeding, but there is less risk of general bleeds with dabigatran. This was a well conducted study. One potential limitation that the authors highlight is that they treated patients with the injected anticoagulant heparin for varying lengths of time before starting treatment with dabigatran or warfarin. However, the researchers say that other studies have shown that the length of time for which a patient receives heparin treatment does not affect how well subsequent anticoagulation therapies work. They also suggest that further studies should be conducted in people with different characteristics as 95% of the study’s participants were white and they had an average age of 55 years. Based on this study dabigatran may be a similarly effective alternative to warfarin for people with venous thromboembolism, and it could be more convenient than treatment with warfarin. Dabigatran is currently licensed in the UK for preventing clots in people having hip or knee replacement surgery, but it is not yet licensed for use in patients with venous thromboembolism. This study will be important in applying for such licensing. Links To The Headlines Drug option to cut risk of blood clots . Daily Mail , December 7 2009 Blood clot drug will slash risk of strokes . Daily Express , 7 2009 Links To Science Schulman S, Kearon C, Kakkar AK et al. Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism . The New England Journal of Medicine 2009; 361 (13 h ago)

• Senate Dems near health care agreement Senate Dems near health care agreement
12/09/2009
Democrats say they are getting close to pushing President Barack Obama's health care bill through the Senate. Barack Obama - Health care - President of the United States - United States Senate - United States (1 h ago)

• Deals cut on health bill may be at peril Deals cut on health bill may be at peril
12/06/2009
Senate Democratic leaders are struggling to preserve the support of interest groups for a health-care overhaul, even as lawmakers seek to change the provisions that brought the groups on board. Democratic - Health care - United States Senate - Health - United States (2 d ago)

• More women choose do-it-yourself births More women choose do-it-yourself births
12/06/2009
A small, but growing number of women are choosing to deliver their babies at home without medical help. However, doctors warn about life-threatening risks from do-it-yourself deliveries. Medicine - Women - People - Organizations - Health (2 d ago)

• Paramedics Respond to Early 911 Call at ... Paramedics Respond to Early 911 Call at Tiger Woods' Home
12/08/2009
Early this morning, at 2:36 a.m., paramedics in Orange County, Florida, responded to a 911 medical call at a house owned by Tiger Woods’ wife Elin Nordegren. Early this morning, at 2:36 a.m., paramedics in Orange County, Florida, responded to a 911 medical call at a house owned by Tiger Woods’ wife Elin Nordegren. Source: CBS News, CNN News (9 h ago)

• FDA Warns of Problems with STERIS 1 Ster... FDA Warns of Problems with STERIS 1 Sterilizor
12/06/2009
Problems with STERIS System 1 have been reported to the FDA who has notified healthcare facility administrators and infection control professionals. Healthcare facility administrators and infection control healthcare professionals have been notified by the FDA of important information regarding the regulatory status of the STERIS System 1 Processo Source: FDA (2 d ago)

• New Entrants, Improving Players Shake Up... New Entrants, Improving Players Shake Up the Market for Outsourced Transcription
12/09/2009
KLAS report evaluates the changing landscape of medical transcription vendors (1 h ago)

• How Failure to Diagnose Cases are Settle... How Failure to Diagnose Cases are Settled or Awarded
12/09/2009
Unfortunately, many patients are victimized when these trusted professionals fail to recognize symptoms and allow diseases or other medical conditions to invade their bodies. (1 h ago)

• Product Alert: “Quick Fix” Trail Mix Product Alert: “Quick Fix” Trail Mix
12/09/2009
The Rock Creek Nut Co. of Union is recalling all "Quick Fix" trail mix because it contains undeclared milk and soy in the carob chips. "Quick Fix" was distributed in Oregon and Washington at retail stores. They are packaged in 8 oz and 2 oz clear plastic bags. They do not contain a lot code. If you have an allergy or severe sensitivity to milk or soy, do not consume the product. For questions, you may call (541) 562-5482. (1 h ago)

• Seen that? - Children and stress Seen that? - Children and stress
12/09/2009
Children and stress at Daily Power Walk Young people or kids often hear from their parents that they don't know what stress is. That's wrong. Today more and more kids are stressed out and sometimes more than their parents. Causes for a ... (1 h ago)

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• Seen that? - New Tool For Detecting Brea... Seen that? - New Tool For Detecting Breast Csncer
12/08/2009
New Tool For Detecting Breast Csncer at Well Woman Blog My mother lost both breasts to breast cancer. The first breast was removed back in the forties by a doctor that didn't know what he was doing. It left horrific scars and a ... (21 h ago)

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12/09/2009
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• Seen that? - Oligonucleotide Therapeutic... Seen that? - Oligonucleotide Therapeutics Society Symposium on Oligonucleotide Therapeutics
12/09/2009
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• Seen that? - FDA approves a new class of... Seen that? - FDA approves a new class of sleeping pill
12/09/2009
FDA approves a new class of sleeping pill at Straightfromthedoc A new prescription sleep aid has won FDA approval: Rozerem, the first of a new kind of sleeping pill, today gained FDA approval. Before today, many sleeping pills had potential narcotic-like effects. True, ... (1 h ago)

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