*** Can your cholesterol be too low?
NASHVILLE, Tenn. (AP) - While off-the-chart cholesterol levels can
trigger strokes, a new study raises the possibility that unusually
low amounts may sometimes cause them as well. High cholesterol is
always portrayed in public health messages as an undivided evil. A
study presented Saturday at the American Heart Association's annual
stroke conference suggests that, in truth, the facts about
cholesterol are a little more complicated, even though on balance low
cholesterol is still far better than high cholesterol. For many
years, experts have been convinced that too much cholesterol,
particularly the variety called low-density lipoprotein, or LDL,
increases the risk of heart disease. The link between cholesterol and
strokes is less clear-cut. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558352915-7c1
* A recent study concludes that dental amalgam (silver dental fillings)
and its mercury component do not appear to play roles in the
development of Alzheimer's disease.
- note: previous research has found imbalances of
some metal elements, including mercury, in patients
with Alzheimer's disease.
- researchers at the University of Kentucky at Lexington
studied 68 Alzheimer's patients and 33 control subjects to
collect data; the dental histories of all patients were
examined, as was information on their non-dental
exposure to mercury.
- found no evidence of a link between dental amalgam and
increased risk of Alzheimer's.
- authors say the study is the thorough clinical pathological
correlative study of humans to show that dental amalgam is
not a neurotoxic factor in the development of Alzheimer's.
- the study is in The Journal of The American Dental Association
(February, 1999).
*** Study confirms Agent Orange reports
WASHINGTON (AP) - A review of what has been done to determine how
Agent Orange and other herbicides affected Vietnam veterans confirms
earlier studies linking them with several diseases but leaves
unanswered painful medical questions. Thursday's report by the
Institute of Medicine offers no new evidence affecting benefits for
Vietnam War veterans or their offspring, but the Department of
Veterans Affairs said the study will be valuable for further
research. Despite continuing investigation into links to birth
defects, diabetes and a list of other illnesses, no scientific
studies over the last two years has provided enough information to
draw significant new conclusions about whether herbicides are linked
to any condition. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558418793-563
*** Agent Orange again linked to cancer
WASHINGTON (AP) - Benefits for Vietnam War veterans are not likely to
be affected by an independent review that confirms ties of Agent
Orange to several diseases without resolving lingering questions
about birth defects or diabetes. The study retains three forms of
cancer as well as chemical acne as definitely linked to use of
herbicides to defoliate the Vietnam countryside. It also confirms a
list of six other diseases, including a spinal birth defect that has
appeared in some children of veterans, as possibly linked. All 10
diseases remain on the list of those for which all veterans who
served in Vietnam may receive benefits from the Veterans Affairs
Department. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558428070-acb
* A new report suggests that elective foot and ankle surgery may
increase the risk of bone and joint degeneration in diabetics.
- note: diabetes-related nerve damage can lead to recurrent
ulcerations, foot and ankle instability and deformities
- note: diabetes-related nerve damage can lead to recurrent
ulcerations, foot and ankle instability and deformities
that are sometimes treated with surgery.
- researchers at the Miller Orthopaedic Clinic in Charlotte,
North Carolina, studied 25 diabetic patients who developed
the bone and joint degeneration condition called Charcot
neuropathic arthropathy following elective surgery performed
by orthopaedic surgeons.
- found that 21 of 25 patients had documented pre-existing
peripheral neuropathy and that none of the patients had
shown evidence of Charcot deformity prior to the surgery.
- authors note that the average time to Charcot development
following surgery was 11 weeks and that the findings
suggest that while surgery may be successful in treating
the original foot problems, it may make patients susceptible
to Charcot disease.
- the report was presented by the Miller Orthopaedic Clinic's
Robert Anderson, M.D., at the American Orthopaedic Foot and
Ankle Society annual meeting in Anaheim, California
(February 8, 1999).
* A new report concludes that pulsed, low-intensity ultrasound may
be useful in helping fractured bones to mend.
- researchers at the University of Pennsylvania School of
Medicine say studies have found that a significant
percentage of fractured bones that had failed to fuse
after conventional treatment benefited from the
ultrasound therapy.
- the report further notes that ultrasound speeded the
healing of fractures that would have mended without
the therapy.
- authors say ultrasound aids in the mending of fractures by
stimulating the conversion of cartilage into bone.
- the report was presented by the University of Pennsylvania's
Dr. R. Bruce Heppenstall at the annual meeting of the American
Academy of Orthopaedic Surgeons in Anaheim, California
(February 8, 1999).
"AIDS Falls Off State's List of Top 10 Causes of Death"
Dallas Morning News Online (02/10/99); Beil,
Laura
According to the Bureau of Vital Statistics, AIDS is no longer
one of the top 10 causes of deaths in Texas. Anti-HIV medication
has been credited for the decrease in the AIDS-mortality rate.
HIV-associated deaths declined for the second straight year; AIDS
had been on the list of top 10 killers in the state since 1990.
"The Price of Success"
New Scientist (01/30/99) Vol. 161, No.
2171, P. 12; Knight, Jonathan
Researchers from the University of California at San Francisco
have developed a mathematical model showing that drug resistance
in some HIV-infected individuals to highly active antiretroviral
therapy (HAART) could lead to large increases in HIV incidence in
the future. Sally Blower and others found that if the incidence
in San Francisco of drug resistance in HIV among homosexual men
is equal to levels seen in clinical trials, then the HIV
incidence in the city will decrease by 20 percent in the next 10
years. Additionally, if risky sexual activity among homosexual
men in the city falls by half, then the HIV incidence will
decrease by 50 percent. However, if 90 percent of homosexual men
in San Francisco take HAART and adherence is worse than seen in
clinical trials, the HIV rate will increase 15 percent over the
next 10 years, according to Blower's model. Blower notes that
one way to avoid this scenario is to expand the strict policy of
monitoring patients used in clinical trials to all HIV-positive
patients. Drug companies are also trying to increase adherence
by simplifying regimens.
"Soluble Markers of Immune System Activation"
IVD Technology (01/99-02/99) Vol. 5,
No. 1, P. 51; George, David A.
CD4 cell count and HIV-1 viral load have been used as predictors
for HIV-associated disease progression. Other markers for
prediction are being investigated, including
beta-2-microglobulin, neopterin, and tumor necrosis factor
receptor type II (TNFR-II). The three markers have all shown to
have approximately equal clinical value. Clinical immunoassays
are currently available for beta-2-microglobulin. While rising
levels of the molecule is associated with disease progression,
there are conflicting results pertaining to the predictive value
of beta-2-microglobulin. Some studies have shown that TNFR-II is
a significant predictor of AIDS progression among rapid
progressors. Future research needs to determine the best manner
that these markers can be used in monitoring disease progression.
"Origin of HIV-1 in the Chimpanzee Pan Troglodytes Troglodytes"
Nature (02/04/99) Vol. 397, No. 6718, P. 436;
Gao, Feng; Bailes, Elizabeth; Robertson, David L.; et al.
Scientists have traced the origin of HIV-1 to SIVcpz found in Pan
troglodytes troglodytes. The researchers sequenced a strain of
SIVcpz found in a chimpanzee with a natural infection and found
that all HIV-1 strains known to infect man are closely related to
this SIVcpz lineage. The scientists further discovered that
HIV-1 group N is a mosaic of SIVcpzUS and HIV-1 related
sequences, indicating an ancestral recombination event in a host
chimpanzee. The authors state that "these results, together with
the observation that P. t. troglodytes coincides uniquely with
areas of HIV-1 group M, N, and O endemicity, indicates that P. t.
troglodytes is the primary reservoir for HIV-1 and has been the
source of at least three independent introductions of SIVcpz into
the human population." The authors note the possibility that
other chimpanzee subspecies are infected with the SIV strain and
that they may have transmitted the viruses to humans. In
conclusion, the researchers recommend the screening of free-range
living chimpanzees and human populations from corresponding
geographic locales in order to fully understand the extent of
natural SIVcpz infection.
"From Pan to Pandemic"
Nature (02/04/99) Vol. 397, No. 6718, P. 385;
Weiss, Robin A.; Wrangham, Richard W.
Recent data has shown that HIV-1 originates from the SIVcpz strain
found in the chimpanzee Pan troglodytes troglodytes. Other
research has discovered that several HIV-2 strains came from
SIVsm found in sooty mangabey monkeys, while human T-lymphotropic
virus type 1 appears to have developed from related simian
viruses. The cross-species transmission of these viruses raises
some important issues, including concerns that
xenotransplantation of tissue may not be safe. Additionally,
many monkeys are hunted for their meat, and people may be getting
infected as a result. Many of the monkeys are being hunted into
endangerment or extinction, and conservationists are unsure if a
campaign publicizing the disease-transmitting danger involved in
the hunting of these animals will be beneficial or harmful.
There are fears that such a campaign, designed to reduce hunting
of the apes, could backfire. Furthermore, there are issues
concerning the use of chimpanzees in animal research. The new
findings may lead to an increase of interest in using the animals
for study models. There may be a more acceptable method of
research with the monkeys, however; the scientists who traced the
origin of HIV-1 used data acquired through fieldwork with
free-living apes. In addition to monitoring live apes, field
workers may also use fresh corpses that they occasionally find
and DNA analysis of feces in order to further conduct studies
while minimizing their impact on the chimpanzee population.
"U.S. Can't Ignore Implications of TB Plaguing Russia"
USA Today (02/08/99) P. 16A; Lee, Christopher
Christopher Lee, project manager of the Princeton Project 55
Tuberculosis Initiative, asserts in a letter to the USA Today
that the United States cannot ignore the spread of tuberculosis
in Russia when assessing the economy of the region and broader
public health concerns. He states that the prison system is the
source of the current outbreak, with 10 percent of the 1 million
prisoners in Russia infected with TB. Up to 30 percent of all
prisoners are released each year, resulting in 1 million latent
infections spreading throughout the community every three years.
Currently, there are 150,000 active TB cases in Russia in the
civilian population, and experts believe the levels will compound
50 times by 2000. Mortality will increase seventyfold, with
death among children increasing ninetyfold. In addition,
multidrug-resistant TB (MDR-TB) is at the highest level ever
reported. Lee insists that "the U.S. government must take
immediate action to address the MDR-TB epidemic and consider it a
major foreign policy issue, not only to aid the Russian family
but also to protect American families."
*** Poll: Less control of health care
WASHINGTON (AP) - Almost as many Americans say their insurance
companies play the biggest role in their medical care as those who
say their doctors call the shots, a new poll shows. Women are more
critical than men, with 40% saying the health care system is in worse
shape than it was five years ago, says the poll conducted for The
Associated Press. The biggest complaint was the inability of people
to choose their own doctors. As these concerns grow, Congress is
again considering how to give people more control over their own
health care without substantially increasing costs. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558347764-8b5
*** Medicare makes strides vs. waste
WASHINGTON (AP) - Medicare is losing significantly less money to
waste, fraud and mistakes, government auditors say. "It appears we
have turned a corner and are headed in the right direction," said
Nancy-Ann DeParle, administrator of the health insurance program for
the elderly and disabled. An audit released Tuesday by the Health and
Human Services Department's inspector general estimates that Medicare
paid out $12.6 billion it shouldn't have in the government's fiscal
year 1998, which ended Sept. 30. That's about 7 cents out of every
dollar that was spent by Medicare in direct payments to health care
providers, including doctors and hospitals. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558398048-447
*** France to try HIV-tainted blood case
PARIS (AP) - The debate over who is responsible for the use of
HIV-tainted blood in transfusions in France has endured for years and
has implicated former high-ranking government officials. Three former
government ministers, including a former prime minister, will go on
trial Tuesday for their alleged roles in France's worst health
scandal. All are charged with employing a "strategy of favoritism"
that delayed systematic testing for AIDS with an American-made test
while a French test was being readied. Nearly 4,000 people in France
contracted AIDS from blood transfusions from the early 1980s until
1986, and an experts' report in 1991 found 300 were "avoidable." See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558378684-23d
*** N.E. medical mag supports JAMA editor
(AP) - The editor in chief of a top U.S. medical journal says the
firing of another publication's editor was "an irrational decision
and an ominous precedent." Dr. George Lundberg was fired from the
Journal of the American Medical Association on Jan. 15 for publishing
a 1991 survey of college students on whether oral sex constitutes
sex. AMA executive vice president E. Ratcliffe Anderson Jr. accused
Lundberg of inappropriately injecting the AMA into a political debate
by deliberately running the study during President Clinton's
impeachment trial. In an editorial in Wednesday's New England Journal
of Medicine, editor in chief Dr. Jerome Kassirer said a medical
journal should be a "lively forum" for the discussion of important
issues, even if they involve medicine only indirectly. See
http://www.infobeat.com/stories/cgi/story.cgi?id=2558410074-a0f
SOURCES:
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