Friday, June 10, 2005

Health Headlines - June 10

Obesity's Strain Causing More Back Pain

Rising rates of obesity are increasingly tough on Americans' overloaded backs, a new patient survey finds.

"People are coming in not by dozens but in droves because of obesity and their back pain," Dr. Tom Faciszewski, an orthopedic surgeon at the Marshfield Clinic in Wisconsin, said in a prepared statement.

Earlier this year, experts at the North American Spine Society (NASS) conducted a national survey of U.S. spine care professionals and found the number of obese patients being treated for spine-related disorders has increased 67 percent over the past five years.

Eighty-seven percent of the spine care professionals in the survey agreed that obesity plays a major role in back pain, while 94 percent said they recommended weight loss as a treatment for obese patients. Fifty-five percent of the spine care professionals found that weight loss resulted in major improvements in their obese patients' symptoms.

To heighten awareness about the impact of obesity on the spine, NASS recently launched its fourth annual patient education program, "Take a Load off Your Back."

The three most common back problems in obese patients are degenerative disc disease, spondylolisthesis (slippage of the lower back disc), and disc rupture or herniation, NASS officials said.

Obese people need to change their lifestyles -- such as eating a healthier diet and getting regular exercise -- in order to reduce the burden on their spines, the experts advised.

Health Tip: Treating Ear Infections

If you develop an ear infection, don't be too quick to ask your doctor for an antibiotic.

As many as 80 percent of ear infections clear up on their own, says the Washington State Department of Health.

If you do get an ear infection you should:

* Drink more water.
* Rest in order to allow your body to fight the infection.
* Press a warm wash cloth or heating pad on low setting against your sore ear.
* Taking a decongestant may help. Don't take an antihistamine.
* Acetaminophen or ibuprofen can help relieve pain.

You should call your doctor if an earache lasts more than 12 hours or if you experience severe pain. You should also call the doctor if you suspect an infant or young child has an ear infection, if an infant or toddler rubs or pulls on an ear and seems to be in pain, and if the child also has a fever.

Health Tip: Preventing Dog Bites

Between 500,000 and 1 million people require medical attention for dog bites each year in the United States and, on average, 12 people die each year from dog bites.

Children are especially vulnerable and account for more than 60 percent of all dog-bite victims, says the American Veterinary Medical Association.

Never leave a baby or small child alone with a dog. Teach young children to be careful around pets and emphasize that they must not approach strange dogs. They should be instructed to ask for permission from a dog's owner before petting the animal.

Gene-Modified Virus Targets Tumor Cells

A genetically engineered anti-cancer virus shows promise as a treatment for people with colorectal cancer that has spread to the liver, researchers report.

"These results are very promising. The median survival time we saw among our patients was higher than you might expect among this group of patients," researcher Dr. Nancy Kemeny of Memorial Sloan-Kettering Cancer Center, New York, said in a prepared statement.

Her team tested an oncolytic herpes simplex virus (oHSV) in 12 patients with colorectal cancer that had spread to the liver and had proven resistant to first-line chemotherapy. The specific strain of the virus was NV1020, a weakened and altered form of herpes simplex virus type-1, which causes cold sores.

This specially engineered virus selectively destroys cancer cells without harming normal tissue.

In this Phase I study, the researchers gave the patients increasing doses of NV1020 delivered via a single 10-minute infusion. The virus treatment was followed by chemotherapy.

So far, the 12 patients' overall median survival time following the treatment is 23 months. One patient is still alive 30 months after the treatment.

"Our primary aim in this study was to test the safety of the virus. We were pleased to see that the virus could be administered safely in the hepatic [liver] artery without significant effects on the normal liver function," Kemeny said.

The findings were presented this week at the European Society for Medical Oncology Scientific and Educational Conference in Budapest, Hungary.

Reports Shed Light on Dangers of New MS Drug

Detailed reports shed new light on why three patients who were treated with the biologic drug Tysabri for either multiple sclerosis or Crohn's disease developed severe brain infections.

In three scientific briefs and two editorials released Thursday by the New England Journal of Medicine, the specifics of each case are laid out and analyzed by experts in the field. The journal released the package early after a possible fourth case was reported last week. Two of the first three patients have died.

"This is the first time we've had a peer-reviewed report of the information provided by the company to the public," said Dr. John R. Richert, vice president for research and clinical programs for the Multiple Sclerosis Society. "It is the first time we have been able to peruse details of the cases."

Although the news of the infections first came as a blow to those in the MS community, Richert noted that some of the details in these case reports leave open the possibility that Tysabri might one day return to the market if screening methods are found to detect which patients might be susceptible to the brain infection.

In November 2004, natalizumab (Tysabri) was approved for the treatment of multiple sclerosis (MS) and Crohn's disease, both conditions in which the body's immune system attacks it own tissue. But last February, Elan Corp. and Biogen Idec Inc., which marketed the drug, voluntarily withdrew it after reports that three patients taking it had developed progressive multifocal leukoencephalopathy (PML), a degenerative brain infection that often is fatal.

The journal reports provide "two major pieces of information we have not had before," Richert said. "One is that in one case, when they looked at blood samples that were serially obtained during the trial [of the drug], the JC virus that causes PML was detected in the blood serum before the onset of symptoms. That raises the possibility that diagnosis of this infection may be possible much earlier than we have thought in people at risk."

The second fact reported in the journal is that "one of the patients who was very, very ill from PML survived and experienced a significant recovery of neurological function," Richert said. "That person does have some significant neurological defects, but has experienced significant improvement. Until this time, we really weren't certain whether PML would be uniformly fatal or whether by stopping the drug and instituting appropriate antiviral therapy we could prevent death and effect clinical improvement."

But it will be a long time, if ever, before Tysabri is allowed back on the market, Richert acknowledged. One unresolved issue is whether the fourth patient who took the drug actually developed PML, since it is a difficult infection to diagnose accurately.

"That fourth case is up in the air," Richert said. "The question of whether that person had PML is still being evaluated."

The first reports of PML in people taking the drug "were certainly a setback," Richert said. "But the information that is newly available with these new reports is actually more encouraging news. There is still a reasonable possibility that Tysabri will eventually be approved for coming back on the market."

That possibility would be welcomed by those with either MS or Crohn's disease. FDA approval was given after carefully controlled studies showed the drug slowed progression of the conditions as no other medication had been able to do.

However, there is a strong cautionary note in the reports, said Dr. Igor J. Koralnik, an associate professor of neurology at Harvard Medical School, and co-author of one of the accompanying editorials.

Tysabri is a monoclonal antibody, engineered to attach itself to white blood cells called lymphocytes and prevent them from entering the brain, where they do the damage that causes the disabling symptoms of MS.

That same approach is being used by biomedical researchers to attack a number of other conditions, some rare but also some as widespread as asthma, Koralnik said, and so "we need to learn from this unexpected tragedy and try to get enough information to prevent it from happening again by understanding the mechanisms and monitoring for this feature."

As his editorial states, the case reports "force us to reconsider the potential risks associated with inhibition of lymphocyte trafficking. Bad things may happen when rescuers are turned back at the gates."

Infant Exposure to Controversial Compound Continues in Hospitals

Despite FDA warnings to hospitals to reduce the use of plastics that contain a compound that might affect male fertility in infants, a new study found high levels of the compound among newborns in neonatal intensive care units.

Shyness May Be in the Genes

Shy? Uncomfortable at parties? Short "junk" DNA may be to blame.

At-Home Breast Cancer Detector Effective

A hand-held imaging device designed for use at home appears effective in detecting breast cancer in its early stages, according to a University of Pennsylvania researcher who hopes the device might be available commercially to women in a year or two.

Intensive Therapy Helps Stroke Patients Regain Speech

Short-term, intense language retraining helps improve communication skills in stroke survivors, researchers report in this week's issue of Stroke.

Lifestyle Can Dictate Course of Breast Cancer

More evidence is trickling in that aspects of everyday life, including exercise, eating habits and even a common spice, can affect the incidence and course of breast cancer.

Cancer Drug Also Fights Lupus, Rheumatoid Arthritis

The cancer drug rituximab may benefit lupus patients with central nervous system (CNS) complications, according to a new U.S. study.

Available Drug Helps Prevent Breast Cancer Recurrence

Using a drug already on the market, researchers say they can block key immune system cells that actually promote breast cancer recurrence. The therapy should re-arm the body's defenses against malignancy's return, they report.

More Studies Link Painkillers to Heart Problems

Scientists on both sides of the Atlantic continue to uncover troubling news about commonly used painkillers, including ibuprofen and Celebrex.

Idaho Boy Surviving Rare Blood Disorder

In less than a month, Nicholas Ashby hopes to celebrate his fourth birthday, thanks to a bone-marrow transplant that so far is helping him survive one of the world's rarest blood disorders.

Book Offers Diet Options for the Weak

In a no-nonsense approach to weight loss, the American Heart Association's new diet book offers options for the weak. Can't give up pizza? Try eating two slices instead of your regular three. Craving ice cream? Try a sorbet.

Tips From Heart Association's Diet Book

Here are some suggestions for low-calorie snacks from the American Heart Association's new book, "No-Fad Diet: A Personal Plan for Healthy Weight Loss." All contain 50 calories or fewer.

4 animal crackers, 44 calories

1 medium apricot, 17 calories

1 Asian pear (4.3 ounces), 50 calories

Half-cup blueberries, 41 calories

10 sweet cherries, 43 calories

10 small jelly beans, 40 calories

10 pretzel sticks, 10 calories

Half-cup strawberries, 27 calories

Here are some calorie-saving food substitutions from the book:

Instead of 1 milk chocolate bar (1.55 ounces), try 10 chocolate-covered raisins for a calorie savings of 187.

Instead of 16 ounces of regular cola, try diet cola for a calorie savings of 149.

Instead of a half-cup of fried rice, try a half-cup of steamed rice for a calorie savings of 53.

Food Fact:
Now "ear" this.


It's a fact -- you don't need butter to make fresh corn taste great. For best flavor, cook corn on the cob the same day it's picked. Frozen corn has all the nutritive benefits of fresh corn because it's processed soon after it's picked -- one-half cup of corn kernels contains about 3 grams of fiber. Yellow corn contains lutein, a plant pigment that helps protect your eyes.

Fitness Tip of the day:
"Hidden" exercise.


Raking leaves, shoveling snow, cutting grass. This is exercise! All activity helps us keep fit. Take heavy yard work, for example -- treat it just as you would a more formal workout. Make sure your body is warmed up and pace yourself accordingly. Pay careful attention to they way you lift, stay hydrated and schedule breaks during the day.

FAQ of the day:
What's so bad about accelerated weight loss?


Try to lose weight too fast and your body will perceive the calorie deficit as a state of semi-starvation. To conserve energy, it will slow down the rate at which it burns calories. Crash diets may take weight off fast, but they also make it more likely the pounds will come right back when you resume your normal eating patterns.

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