Medical News

HIV infection rate among U.S. blacks doubles

2005-04-15T18:31:00.000-07:00

BOSTON - The HIV infection rate has doubled among blacks in the United States over a decade while holding steady among whites — stark evidence of a widening racial gap in the epidemic, government scientists said Friday.
advertisement
document.write('
[AD]Other troubling statistics indicate that almost half of all infected people in the United States who should be receiving HIV drugs are not getting them.
The findings were released in Boston at the 12th Annual Retrovirus Conference, the world’s chief scientific gathering on the disease.
'A burgeoning epidemic'“It’s incredibly disappointing,” said Terje Anderson, director of the National Association of People With AIDS. “We just have a burgeoning epidemic in the African American community that is not being dealt with effectively.”
Researchers and AIDS prevention advocates attributed the high rate among blacks to such factors as drug addiction, poverty and poor access to health care.
getCSS("3088874");
Test yourself

• How much do you know about AIDS?
The HIV rates were derived from the widely used National Health and Nutrition Examinations Surveys, which analyze a representative sample of U.S. households and contain the most complete HIV data in the country. Researchers at the Centers for Disease Control and Prevention compared 1988-1994 data with figures from 1999-2002.
The surveys look only at young and middle-aged adults who live in households, excluding such groups as soldiers, prisoners and homeless. Thus, health officials believe the numbers probably underestimate true HIV rates in this country.
Still, they show a striking rise in the prevalence of the AIDS virus from 1 percent to 2 percent of blacks. White rates held steady at 0.2 percent. Largely because of the increase among blacks, the overall U.S. rate rose slightly from 0.3 percent to 0.4 percent.
Smaller studies had shown rising infection rates among blacks in recent years, but this study takes a longer and more complete look at changes in the general population.
“I think it’s very concerning,” said Dr. Susan Buchbinder, who leads HIV research for the city of San Francisco. “I think what we need to look at is how we can reduce those rates and get more people into treatment.”
More focus on drug addiction neededShe recommended a stronger focus on treating drug addiction.
The lead CDC researcher, Geraldine McQuillan, said she was encouraged to see the HIV rate among younger blacks holding steady at just under 1.5 percent.
“It tells me we’re making some headway,” she said.
Other national data and published reports studied by the CDC showed that 480,000 HIV-infected people ages 15 to 49 should have been getting antiviral drugs in 2003, yet only 268,000, or 56 percent, were given such medication.
Researcher Eyasu Teshale of the CDC said the gap represents “a substantial unmet health care need.”
Treatment is widely viewed as a central component in prevention. Powerful AIDS drugs that came into wide use in the mid-1990s can knock down levels of the virus in the body, reducing the chances that the patient will infect others.
Nearly 1 million people in the United States have contracted the AIDS virus since the outbreak began in the early 1980s. About 40,000 people test positive each year, and more than 18,000 die. However, U.S. infections have remained fairly level in recent years with the use of powerful HIV drugs.

Vietnamese woman infected with bird flu, HIV

2005-04-15T18:29:00.000-07:00

HANOI - A 21-year-old woman has been infected by both the deadly HIV/AIDS virus and bird flu, the first such case in Vietnam, health officials said on Thursday.
advertisement[AD]The Health Ministry said two other patients have been diagnosed with the H5N1 virus in the northern provinces of Ha Tay and Hung Yen between April 2 and 8 but no deaths were reported.
The latest findings brought to 41 the total number of patients with bird flu in Vietnam since December 2004, 16 of whom have died, the ministry said in a statement.
Nguyen Van Thich, head of the Center for Preventive Medicine in the northern province of Quang Ninh, said the woman, the first to be diagnosed with both bird flu and HIV in Vietnam, used to work at a hairdresser's shop. She was hospitalized in late March with fever and coughing.
“She is still very weak,” he told Reuters, adding that the woman has been treated at a provincial hospital.
Quang Ninh province bordering China has one of the highest number of HIV carriers in Vietnam, most of them drug addicts and prostitutes.
Vietnam has reported 68 human infections of the H5N1 virus since the disease first hit Asia in late 2003, killing 36 Vietnamese.
Click for related content
Deadly bird flu could spread beyond Asia
What's the difference between bird flu and common flu?
Less virulent, spreading fasterTwelve Thais and three Cambodians have also died of the virus that the World Health Organization says has the potential to mutate into a form that could pass easily between humans and cause a pandemic in which millions could die.
Doctor Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology, was quoted on Thursday by state media as saying Vietnam has taken nearly 1,000 blood samples from the patients, birds and water fowl infected by bird flu to help identify the map of the virus allocation.
Hien said the H5N1 virus tested this year showed it has changed slightly from the type that struck in 2004, its virulence was less but the speed of its spread was higher, reported the state-run Nguoi Lao Dong newspaper.
Some samples had been sent for further testing in the United States and the final results to confirm the difference would be available later this month, Hien said.
The Agriculture Ministry said poultry outbreaks have now been reported only in the southern province of Tra Vinh in the Mekong Delta where the virus broke anew last December and spread to 35 of Vietnam’s 64 provinces.
Doctor Hoang Thuy Long, former head of the institute, told a government meeting on Wednesday that most of the infected people in Vietnam, including several family clusters, had contact with sick birds.
“Even though so far the transmission mechanism of the disease remains unclear, the avian influenza H5N1 type in Vietnam shows no sign of being spread directly between human and human,” Long was quoted by state-run Quan Doi Nhan Dan daily as saying.
Copyright 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters

Clinton pledges $10 million for pediatric AIDS

2005-04-15T18:24:00.000-07:00

Former President Bill Clinton listens to the speakers during a news conference, Monday, April, 11, 2005 in New York. Clinton announced Monday that his foundation's HIV/AIDS Initiative will deliver treatment to 10,000 children in about 10 countries by the end of the year. (AP Photo/Mary Altaffer)
getCSS("3088867");
FREE VIDEO

• Clinton interviewApril 12: Former President Bill Clinton and Dr. Paul Farmer talk about their mission to fight HIV/AIDS in rural areas around the world.
Today show
The Associated Press
Updated: 10:14 a.m. ET April 12, 2005
NEW YORK - Former President Bill Clinton announced Monday that his foundation’s HIV/AIDS Initiative is pledging $10 million to deliver treatment to 10,000 children in at least 10 countries by the end of the year, part of an effort to reach more than 60,000 youngsters by the end of next year.
advertisement
document.write('
[AD]“The world cannot continue to turn its back on these children,” Clinton said. “Together we can save millions of lives.”
Under the initiative, the medicine will reach China, the Dominican Republic, Lesotho, Rwanda, Mozambique and Tanzania this spring. Clinton also said his foundation will expand its HIV/AIDS program in Rwanda.
About 15,000 to 25,000 children are currently receiving treatment against the virus that causes AIDS, nearly half of them in Brazil and Thailand, Clinton said at a news conference in his Harlem office.
The William J. Clinton Foundation is working with UNICEF and other organizations to expand the program to reach more than 60,000 children by the end of 2006.
The Clinton Foundation partners with more than a dozen countries in Africa, the Caribbean and Asia. Working with individual governments, the foundation provides technical assistance and mobilizes human and financial resources. It also provides access to HIV/AIDS drugs and diagnostics that are 50 to 90 percent lower than market rates. Approximately 40 countries are purchasing medicines and tests under the Clinton Foundation’s agreements.
© 2005 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

All Professional News: Friday April 15, 2005

2005-04-15T18:21:00.000-07:00

Clinical
High-dose Rebif reduces events in early-stage MS
"Distress Thermometer" may be useful in cancer patients
Radiation therapy improves outcomes after atherectomy
Steroids plus low beta2-agonist use cuts asthma hospitalizations
Helminth therapy appears safe and effective for ulcerative colitis
Low molecular weight heparins prolong survival in cancer patients
Pessimism, anxiety tied to development of Parkinson's disease
Exercise-induced dyspnea often wrongly blamed on asthma
Weight loss reduces risk for gout
Avastin effective against breast cancer
Drug & Device Development
Genetic test predicts colon cancer treatment response
UK tests ozone machine to destroy prions on surgical instruments
IVIg shows promise for Alzheimer's disease
Economic
Cost-effectiveness of painkillers depends on risk factors
Epidemiology
Constipation common among infants and toddlers
Depression increases mortality risk in diabetics
Hypogonadism does not impact quality of life in older men with COPD
Genotype associated environmentally induced breast cancer
Legislative
Medicaid controversy continues
Policy
Report calls for US national cord blood board
Public Health
UK shortage of MMR vaccine sparks mumps fear
WHO: Marburg spreads but Angola isolation ward empty
Regulatory
U.S. court says FDA ephedra ban too broad
Ads for Remodulin misleading, US FDA says
Barr to lobby states if FDA rejects contraceptive
Ads for Remodulin misleading, US FDA says
Science
Autoantibodies to amphiphysin linked to stiff-person syndrome
Ergosterol inhibitor active against murine Chagas' disease
Enzyme links hypertension with cardiac hypertrophy

Depression increases mortality risk in diabetics

2005-04-15T18:19:00.001-07:00

By Megan Rauscher
NEW YORK (Reuters Health) - The results of a new study confirm that individuals with diabetes are prone to depression and show that over a 10-year period depressive symptoms significantly increase the risk of death among persons with diabetes but not among persons without diabetes.
"Our analysis indicates that the relationship between depression and mortality is different in people with and without diabetes mellitus," Dr. Xuanping Zhang from the US Centers for Disease Control and Prevention in Atlanta, told Reuters Health.
"Depression should be considered a target for diabetes management interventions," the researcher added.
Dr. Zhang and colleagues examined the relation between depressive symptoms and mortality among 558 diabetic and 7063 nondiabetic participants in the NHANES I Epidemiologic Follow-up Study (1982-1992). A total of 276 diabetics and 1499 nondiabetics died during the study.
The prevalence of Centers for Epidemiologic Studies Depression (CES-D) scores greater than or equal to 16, an indicator of depression, was higher in the diabetic than in the nondiabetic cohort (26.3% vs 15.8%).
In analyses controlling for sociodemographic, lifestyle, and health-status variables, diabetics with CES-D scores of 16 or higher had a 54% greater mortality than those with CES-D scores under 16, the team reports in the April 1st issue of the American Journal of Epidemiology.
There was no significant association between depression and mortality in the nondiabetic population.
This study, Dr. Zhang said, "helps to clarify the contradictory findings on the association between depression and mortality among general populations by demonstrating the importance of observing subgroups, rather than aggregated populations, when examining the effect of depression on mortality."

IVIg shows promise for Alzheimer's disease

2005-04-15T18:19:00.000-07:00

By Larry Schuster
MIAMI BEACH (Reuters Health) - Intravenous immunoglobulin (IVIg) shows promise for arresting -- and perhaps even reversing -- the cognitive decline of Alzheimer's disease, a preliminary study suggests.
"Our very small study suggests that this already approved antibody product may be useful for treating Alzheimer's disease," Dr. Norman R. Relkin, at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York. Cognitive functioning improved in six of seven Alzheimer's disease patients given IVIg for 6 months, he reported at the annual meeting of the American Academy of Neurology.
IVIg contains a relatively high level of anti-amyloid beta antibodies, Dr. Relkin told Reuters Health.
In a phase I trial, the researchers administered IVIg to seven women and one man diagnosed with mild-to-moderate Alzheimer's disease. The patients, whose mean age was 74 years, had a mean Mini-Mental Status Examination (MMSE) score of 23.5.
The patients were randomized to receive one of four dosing regimens: 0.4 g/kg every 2 weeks, 0.4 g/kg every week, 1.0 g/kg every 2 weeks, or 2.0 g/kg every month. Anti-amyloid antibody levels increased significantly in plasma after each IVIg infusion in a dose-dependent fashion. Also, anti-amyloid antibody levels rose incrementally with successive treatments, the study showed.
Of the seven patients who completed 6 months of treatment, none had decreased cognitive function and six had improved cognitive function, Dr. Relkin said. "In 6 months, one would expect a 1.5-point decline in MMSE scores. Our patients showed a 3-point increase."
The participants experienced only minor and infrequent side effects, such as chills following the infusion.
The study was funded by a grant from Baxter BioScience, which manufactures IVIg as Gammagard. A separate study in Germany, in which five patients were given IVIg, showed similar results, he said.
Together, the two small studies "give us strong encouragement," Dr. Relkin said. But, he stressed, it is too soon to start treating Alzheimer's disease patients with IVIg.
If IVIg shows good results in phase II and III studies, Dr. Relkin said he hopes to purify the anti-amyloid antibody from the blood product and make a synthetic formulation to treat patients.
"Because IVIg is derived from pooled blood, it's in limited supply. The synthesized antibody product would be cheaper and in more ample supply," he said.

Low molecular weight heparins prolong survival in cancer patients

2005-04-15T18:16:00.000-07:00

Last Updated: 2005-04-15 15:09:19 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Low molecular weight heparins (LMWH) appear to have direct anti-cancer activity, especially in patients with nonmetastatic tumors and patients with a predicted survival that exceeds 6 months, according to two reports in the April 1st issue of the Journal of Clinical Oncology.
Previous research has suggested a survival advantage when LMWHs are administered to cancer patients, but the data were inconclusive, Dr. Clara P. W. Klerk of the University of Amsterdam and her team note.
To further investigate, they conducted a randomized, double-blind, placebo-controlled study of 302 patients with metastasized or locally advanced solid tumors and no venous thromboembolism.
Active treatment consisted of subcutaneous injections of nadroparin, twice daily for 14 days then once a day for the next 4 weeks. Metastatic disease was present in approximately 90% of patients.
During mean follow-up of 12 months, median survival was 6.6 months in the placebo group and 8.0 months in the nadroparin group, for a hazard ratio (HR) of 0.75 (p = 0.021).
The advantage was even more pronounced among patients with a life expectancy of 6 months or longer (median survival 9.4 months versus 15.4 months, HR 0.64, p = 0.010).
Risk of major bleeding was not significantly increased.
Dr. Klerk's group suggests that LMWH "can interfere with angiogenesis, adhesion of cancer cells to vascular endothelium, and invasion."
In the second study, Dr. Mark N. Levine at Henderson Hospital in Hamilton, Ontario, and colleagues conducted a post hoc analysis of data from the CLOT trial (Comparison of Low Molecular Weight Heparin Versus Oral Anticoagulant Therapy for Long Term Anticoagulation in Cancer Patients with Venous Thromboembolism).
Patients with cancer and acute venous thromboembolism (n=602) were randomized to 6 months treatment with dalteparin alone 200 U/kg for 1 month followed by 150 U/kg for 5 months, or dalteparin for 1 week followed by an oral coumarin derivative for 6 months.
Among the patients without metastases (75 in each group), the probability of death at 12 months was 36% in the coumarin group and 20% in the dalteparin group (HR 0.50, p = 0.03).
Among the 221 patients with metastatic disease assigned to dalteparin and 231 allocated to oral anticoagulant, there was no significant difference according to treatment group (HR 1.1, p = 0.46).
Dr. Levine's group theorizes that "in patients with disseminated cancer, tumor-related vasculature is sufficiently developed so that an antiangiogenic agent would have minimal impact, whereas impairing the establishment of such vasculature by an antiangiogenic agent could exert an inhibitory effect on tumor growth even beyond the time of drug exposure."
In a related editorial, Dr. Nicholas R. Lemoine at Queen Mary University of London comments that "much work needs to be done to identify the mechanisms involved, but there are already indications that the interface between the coagulation system and the cancer cell will be a rewarding area for cell biology and cancer therapeutics."
J Clin Oncol 2005;23:2119-2120,2123-2135.

Don't give up!

2005-04-15T18:15:00.000-07:00

Staying motivated starts with the planning. If you plunge into a weight-loss programme without setting clear and realistic goals or strategies for dealing with slimming saboteurs, your motivation will wane at the first hurdle.
1. Think positive
Your thoughts influence your every action, from what you eat to how active you are. If you always feel deprived while losing weight, then it will be hard to stick to your plan. Think positive and your motivation to succeed will stay high.
2. Plan ahead
Be clear and positive about your motivations for losing weight and plan goals that will enable you to make lifestyle changes you can achieve and keep up. Why not get a friend to help you?
3. Skill up
A wide range of skills is essential for successful weight control. These could include how to be more active, plan realistic goals, choose and prepare the right foods, cope with cravings, or develop the 'skill' of self-control. Having the right skills will make you feel confident that you can lose weight - and confidence helps you to stay motivated.
4. The diet-binge cycle
Beware the diet-binge cycle. There's nothing like a series of failed diets to squash confidence in your ability to lose weight. Quick-fix diets offer a short-term solution to a long-term issue. So avoid them. Stay motivated with a healthy and sustainable approach to weight control.
5. Keep it interesting
Motivation can wane if you feel hungry or bored. So don't skip meals or follow overly restrictive plans. Fill up with plenty of vegetables and fruit and make appetite-regulating protein-rich foods - such as lean meat, fish, pulses, eggs or low fat dairy foods - part of balanced meals. Keep the meals varied. Don't deny yourself certain foods - rigid rules can make you crave certain food even more. Eat small amounts and take time to taste and enjoy them.
6. Set realistic goals
Write down:
your chosen goal, for example, walking for 30 minutes daily for the next month
how the goal will help you and what you need to do to achieve it
possible barriers to achieving your goal
ways to overcome those barriers
how you'll reward your success (for example, buy a new CD or item of clothing)
7. Coping with cravings
Cravings might seem like something you've no control over. However, they aren't a physical addiction but a normal and learned response to some sort of trigger. How we think affects how we respond or act. How we act can be influenced by the potential consequences. For example, on your 'bad day', you may crave a large Danish pastry with your lunch. But you still have time to decide whether you'll eat it or not. Try this exercise: think beyond what the Danish will taste like, and about the consequences of either eating it or giving/throwing it away. If you eat it how will you feel? If you don't eat it how will you feel? Now, think about how you'd prefer to feel. Making conscious choices like this helps you to feel in control of what you eat and overcome cravings.
Tips to cope with cravings
Never say never about a food - you'll crave it more.
Try not to leave craved or trigger foods in sight or easy reach (or in the house!). Avoid shopping when hungry - and without a shopping list.
Outlast cravings - it can be done and most subside after 20 minutes or so. A list of distracting activities can help, for example, go out for a walk, log online, call a friend, tidy the bedroom, have a bath, paint your nails.

8. Coping with social situations
Plan what you're going to eat before you go out.
If you eat out regularly, it's unlikely to always be a treat. So opt for healthier choices and save the treats for true special occasions.
If you find it hard to say "no thanks" to food in case you offend, practise it at home.
Eat something light before going to parties - then stand away from the nuts and sausage rolls.
If you feel that you 'have to eat what's put in front of you' or 'can't live without a pudding', redefine yourself as someone who can 'do without' as you've chosen to change your habits, lose weight - and feel great!
9. More motivational tips
Make a list of the benefits of losing weight and refer to it regularly.
Don't expect to change too much, too quickly. Take things one step at a time.
Visualise yourself at your (realistic) goal weight.
Focus on what you've achieved rather than what you still have to do.
Enlist some ongoing support - from a friend, partner, chat room, health professional or responsible health club or slimming group.

Healthy teens

2005-04-15T18:09:00.000-07:00

Nutritional considerations
In July 2000, the long-awaited Government report into the eating and physical activity habits of children was published. The National Diet and Nutritional Survey: Young People Aged 4-18 Years provided detailed information on the nutritional intakes and physical activity levels of young people in the UK.
Alarmingly, during the seven-day recording period, more than half the young people in the survey had not eaten any citrus fruits, leafy green vegetables, such as cabbage, greens or broccoli, eggs or raw tomatoes.
Iron deficiency
Iron deficiency is one of the most common nutritional deficiencies in the UK and adolescents are at special risk - up to 13 per cent of teenage boys and girls were found to have low iron stores. Rapid growth, coupled with a fast lifestyle and poor dietary choices, can result in iron-deficiency or anaemia. Teenage girls need to pay particular attention to iron as their iron stores are depleted each month following menstruation.
The main dietary source of iron is red meat, but there are lots of non-meat sources too, including fortified breakfast cereals, dried fruit, bread and green leafy vegetables. The body doesn't absorb iron quite as easily from non-meat sources, but you can enhance absorption by combining them with a food rich in vitamin C (found in citrus fruits, blackcurrants, green leafy vegetables). In contrast, tannins found in tea reduce the absorption of iron. Therefore, it's better to have a glass of orange juice with your breakfast cereal than a cup of tea.
Calcium deficiency
The report also highlighted that 25 per cent of teens had calcium intakes below recommended levels. This has serious implications for the future, with respect to bone health.
Osteoporosis is a bone disease that causes bones to become brittle and break very easily. Bones continue to grow and get stronger until the age of 30 - with the teenage years being the most important for development. Vitamin D, calcium and phosphorous are vital for this process. Calcium requirements for the teenage years range from 800 to 1000 mg per day.
Calcium-rich foods should be consumed on a daily basis. The richest source of calcium in most people's diet is milk and dairy products. Consuming a pint of milk a day or eating other dairy products will ensure a sufficient intake of calcium. Alternatively, try fortified soya milk.
Approximate calcium content of some common foods:
Food
Calcium Content
1/3 pint (0.2 litre) whole milk
220mg
1/3 pint (0.2 litre) semi-skimmed milk
230mg
1/3 pint (0.2 litre) Fortified soya milk
246mg
Tofu (60g or 2oz)
304mg
1oz (28g) hard cheese
190mg
1 carton low-fat yogurt
285mg
2oz sardines (60g) (including bones)
310mg
3 large slices brown or white bread
100mg
3 large slices wholemeal bread
55mg
4oz (115g) cottage cheese
80mg
4oz (115g) baked beans
60mg
4oz (115g) boiled cabbage
40mg
Foods to choose
Adolescence is a time for rapid growth, and the primary dietary need is for energy - often reflected in a voracious appetite! Ideally, foods contributing to dietary energy should comply with healthy eating principles.
In practice, this often isn't the case; average consumption of fat and sugars is high, while that of starchy carbohydrates and fibre is low. While undesirable, in the short term this won't do much harm. This only becomes a potential problem when this type of diet persists into adulthood.
Teenagers should be encouraged to choose a variety of foods from the other basic food groups:
Plenty of starchy carbohydrates - bread, rice, pasta, breakfast cereals, chapattis, couscous and potatoes.
Plenty of fruit and vegetables - at least five portions every day.
Lots of dairy products, such as milk, yoghurt, fromage frais and pasteurised cheeses.
Enough protein, such as meat, fish, eggs, beans and pulses.
Not too many fatty and sugar-rich foods.
Other important dietary habits to follow during adolescence include:
Drink at least eight glasses of fluid a day.
Eat breakfast -it can provide essential nutrients and improve concentration in the mornings. Choose a fortified breakfast cereal with semi-skimmed milk and a glass of fruit juice.
Take regular exercise, which is important for overall fitness and cardiovascular health, and also helps in bone development.
Be sensible with alcohol - experimenting with alcohol is often part of growing up and asserting independence. If you do drink try not to binge and keep intakes within sensible limits.

varol.blogspot.com

2005-04-03T12:18:00.000-07:00

adres burasıdır arkadaşlar
www.varol.blogspot.com