ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (07/05/89)
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Volume 2, Number 27 July 3, 1989
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Editor: David Dodell, D.M.D.
St. Joseph's Hospital and Medical Center
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T A B L E O F C O N T E N T S
1. Medical News
Medical News for Week Ending July 2, 1989 ............................. 1
2. Center for Disease Control Reports
[MMWR 6-29-89] Heat-Related Deaths .................................... 9
Aedes albopictus Infestation -- United States, Mexico ................ 12
MMWR Rx on HIV and Hepatitis B Virus in Health/Public Safety Workers .. 14
3. Food & Drug Administration News
FDA News Releases ..................................................... 15
4. Columns
Neurological Surgeon Group Increase Awareness of Organ Donation ....... 19
Study Participating Request ........................................... 20
5. Articles
Herpes Simplex Virus .................................................. 21
Health InfoCom Network News Page i
Volume 2, Number 27 July 3, 1989
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Medical News
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Medical News for Week Ending July 2, 1989
(copyright 1989) USA TODAY/Gannett National Information Network
Reproduced with Permission
June 26, 1989
AGENCY SAYS AIDS UNDERESTIMATED:
The number of people who will have AIDS by 1991 appears to have been
underestimated by a third, shows a federal report out Monday. The new General
Accounting Office projections of 300,000 to 480,000 cases contradicts widely
held Centers for Disease Control estimates of 185,000 to 320,000 cases. The
GOA says CDC used faulty data for their estimates. (From the USA TODAY Life
section.)
GROUP SAYS PATIENTS SACRIFICED:
AIDS activists are charging that doctors are sacrificing AIDS patients in
order to compare new drugs' effectiveness against dummy treatments. The AIDS
information group Project Inform recently called for programs to monitor the
progression of disease in AIDS patients subjected to placebo treatments,
allowing them to switch to more effective treatments if their condition
merits.
SKIN CANCER RATE RISING:
Recent increases in skin cancer have forced doctors to boost their estimate
of the chances of getting skin cancer. New estimates from the Skin Cancer
Foundation indicate that one person in 128 born in 1989 will get skin cancer.
If the increase in cancer continues, by the year 2000, one in 90 Americans
will get the disease during their lifetime.
DA VINCI MENTIONED PARKINSON'S:
Leonardo da Vinci might have accurately described the symptoms of
Parkinson's Disease long before it was discovered by the medical community.
Hippocrates magazine reports in its July issue that researchers at the
University of British Columbia in Canada found a description of the disease in
one of da Vinci's notebooks. Da Vinci died in 1519. Physician James Parkinson
named the syndrome in 1817.
ARTHRITIS LINKED TO BRAIN:
Researchers have linked arthritis to a defect in the brain's response to
stress. Doctors at the National Institute of Arthritis and Musculoskeletal and
Skin Diseases said new tests showed defects in the hypothalamus might inhibit
the production of a hormone that regulates the body's response to stress and
inflammation in the joints.
BLOOD FLOW MIGHT INHIBIT CPR:
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Volume 2, Number 27 July 3, 1989
Abnormalities in blood flow to the brain could cause fatal brain damage in
patients resuscitated after cardiac arrest. A study at Georgetown University
School of Medicine indicates that patients who regained consciousness after
being revived from cardiac arrest had normal blood flow to the brain.
Abnormally high blood flow was blamed for causing brain damage that killed
patients in the study.
SUNLIGHT MIGHT SPARK GOOD MOOD:
Researchers are linking basic biochemistry to why people simply "feel
better" in the summer. Doctors at Tufts University have found that sunlight
triggers a change in brain chemical production in the pineal gland - believed
to be linked to mood control. Researchers say they think sunlight could
trigger a biochemical chain reaction that leads to a better mood.
DOCTORS SEARCH FOR SALT KEY:
Doctors at the University of Pennsylvania are searching for a way to "turn
off" human craving for salt. The Penn researchers recently discovered that two
hormones - angiotensin and aldosterone - arouse a craving for salt in
laboratory animals. They hope the research will lead to a medication to
eliminate the cravings in humans. Excess sodium has been linked to high blood
pressure.
June 27, 1989
FDA CLEARS AIDS DRUGS:
The Food and Drug Administration on Monday cleared a new drug to fight
blindness caused by AIDS. Ganciclovir, which slows vision damage from the
disease, will be marketed by Syntex Corp. of Palo Alto, Calif. The FDA also
cleared the hormone R-eryrthropoietin to fight anemia caused by AIDS. (From
the USA TODAY Life section.)
ORTHO OFFERS FREE AIDS DRUG:
Ortho Pharmaceutical Corp. said Monday that it would provide an
experimental drug treatment for anemia to AIDS patients free of charge. The
drug, EPREX, recombinant human erythroprotien, will be provided to doctors for
their anemic AIDS patients. AIDS drugs such as AZT, while battling the
disease, cause side effects that attack bone marrow and cause anemia to
worsen.
NURSES IN SHORT SUPPLY:
Almost 60 percent of the nation's hospitals face a severe nursing shortage,
threatening the quality of health care, says a major study to be released this
week. The eight month study by the HayGroup polled 857 hospitals and found 59
percent had nursing vacancy rates of 10 percent; 19 percent of the hospitals
had vacacancy rates over 20 percent. (From the USA TODAY Life section.)
LASER SURGERY CLEARS ARTERIES:
A new laser technique will replace the scalpel in a procedure that will
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Volume 2, Number 27 July 3, 1989
clear arteries of dangerous deposits. Called endarterectomy, the process was
developed as an alternative to surgery. During endarterectomy, a low-powered
argon laser cuts fatty deposits from the arterial wall in a single piece,
preventing possible strokes from stray pieces often left in surgery.
INTERFERON FIGHTS WARTS:
A study shows that intramuscular interferon was effective in treating
patients with sexually transmitted genital warts. The study, by doctors at the
American Academy of Dermatology, found that 56 percent of men treated with
alpha interferon had at least 50 percent clearing of the lesions, while 11
percent had total clearing. Interferon is a protein that induces antiviral
activity.
COMPUTERS REPLACE LAB ANIMALS:
Researchers at Purdue University are using computers, video and holography
to replace animals in medical and veterinary labs. Purdue's school of
veterinary medicine is reducing the number of animals used in hands-on
experience by using technology that allows students to "practice" surgical
technique on a computer screen or see an animal's reaction to a drug in
computer simulations.
NEW TECHNIQUE TESTS SUNSCREENS:
Doctors are using a new technique to test the protection of sunscreens
before they reach the beach. Doctors at the University of Toronto apply a
chemical to the ears of lab mice, making them sensitive to ultraviolet rays to
help determine their sensitivity to the rays. The sunscreen is then graded on
its ability to suppress ear swelling in later tests.
COMPUTER MONITORS PRESSURE:
A computer-aided, portable monitoring system is helping doctors battle
hypertension. BioAnalogics Inc. of Los Angeles recently unveiled its
Diagnostic Hypertension Treatment System, a computerized, portable unit that
monitors a patient's blood pressure around the clock and produces data on
hypertension and obesity.
MOST DON'T TREAT HYPERTENSION:
Most people with hypertension are not seeking - or getting -needed medical
treatment, the American Heart Association said this week. According to the
association estimates, 60 million Americans have hypertension. Only 11 percent
of those are receiving treatment for the disease, and 46 percent of high blood
pressure sufferers are unaware they have it.
June 28, 1989
GROUPS RECOMMEND MAMMOGRAMS:
Agreeing that the benefits of early detection of breast cancer outweigh the
risks of mammograms, 11 medical groups said Tuesday that tests should be
extended to women in their 40s. The groups said women ages 40 to 49 should
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Volume 2, Number 27 July 3, 1989
have a mammogram every two years and women 50 and older should have annual
mammograms. (See special Mammogram package below. From the USA TODAY News
section.)
WORKING WOMEN HEALTHIER:
Working women have higher levels of a "good cholesterol" that could help
them avoid heart disease. A team of West German scientists found that women
who work outside the home averaged 64 milligrams per deciliter of high-density
lipoprotien. That's 2.5 to 3.6 mg/dl higher than the homemakers' average.
Study results were published in the June 24 Science News.
EYE EXAM COSTS VARY:
Two studies released Tuesday say opthalmologists charge considerably more
than optometrists for identical, routine eye exams. Opthalmologists specialize
in the treatment of eye disease, while optometrists are primary care eye
physicians. Both studies were conducted separately by the State University of
New York. Charges for eye exam: optometrists - $41; opthalmologists - $61.
LASER DRUG TESTS EXPANDED:
Doctors are expanding tests of a treatment that uses light-activated drugs
to attack cancer. Phase III studies have begun on Photodynamic Therapy,
Quadralogic Technologies said Tuesday. The therapy uses the drug Photofrin.
After injection, the drug's cancer-fighting characteristics are "activated" by
light piped into the cancer sight by fiber optic laser light.
MICE HELP HUMAN TRANSPLANTS:
A new species of transgenic mouse is helping immunologists learn how the
body's immune system identifies foreign tissue. Researchers at Washington
University in St. Louis, are studying responses of mice whose immune systems
have been altered to attack their own tissue. Doctors hope the research will
help them understand why human systems reject donor organs.
COMPUTER EXAMINES AIDS DRUGS:
Scientists are using three-dimensional computer imaging and magnification
to study the characteristics of compounds used to fight AIDS. By revealing the
chemical characteristics of drugs such as AZT, researchers hope to learn more
about how they affect the deadly disease. New computer imaging technology
allows them to view molecular structure from various points of view.
NEW SHEATH STOPS INFECTION:
A new sheath that uses infection-fighting materials is helping to avoid
catherter-related infections and the complications they cause. The sheath,
called VitaCuff by its manufacturer, is impregnated with silver ions and fits
into the skin at the catherter site. Studies show VitaCuff significantly
reduces the incidence of infection caused by germs that invade the site.
SPECIAL PACKAGE ON MAMMOGRAMS:
BREAST CANCER TO KILL 40,000:
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Volume 2, Number 27 July 3, 1989
Breast cancer is the number one cancer among women, a group of medical
experts said Tuesday. The disease will strike more than 142,000 American women
this year and 40,000 women will die from it during 1989. About one-third of
all cancers strike women between the ages of 40 and 50, the groups said. (From
the USA TODAY News section.)
MAMMOGRAM ISSUE CONTROVERSIAL:
Controversy surrounding mammograms has centered on whether screening would
benefit women younger than 50. The issue is complex because mammograms expose
women to X-rays, cost up to $200 and mass screening involves millions of
women. While many groups have not recommended mammograms for women younger
than 50, the tests are the most sensitive way to detect early breast cancer.
ODDS OF GETTING CANCER UP:
The odds of getting breast cancer have risen in the past four years, making
early detection of the disease vital, a group of 11 health organizations said
Tuesday. The odds of getting the disease were one in 13 in 1985. The groups
now agree that the odds are about one in 10.
June 29, 1989
HEART ATTACK DRUG IMPROVED:
A clot-busting drug that interrupts heart attacks has been redesigned to
work longer, which might reduce the risk of a second heart attack. In test
tube experiments, an altered version of the drug tissue plasminogen activator
remained potent when exposed to substances that de-activate its current form,
the journal Nature reports in its June 29 edition. (From the USA TODAY Life
section.)
SECRET AIDS TESTS REVEALED:
A group of doctors and AIDS advocates are testing an unapproved AIDS drug
in secret, the New York Times reported Wednesday. The group, contending Food
and Drug Administration approval is too slow, is testing the smuggled Chinese
drug GLQ223 - known as Compound Q - on 30 patients in New York, San Francisco,
Los Angeles and Miami. The FDA said the tests might be illegal.
FBI SETS DNA STANDARDS:
The FBI said Wednesday that it had completed a scientific conference aimed
at standardizing the use of DNA analysis in the criminal justice system. The
technology, which scientists claim can identify criminals through mapping of
their DNA, has been challenged by many state and federal courts. The FBI
symposium included more than 350 scientists from 21 nations.
NIH WARNS AGAINST UV-A RAYS:
The National Institutes of Health recently recommended using sunscreens
that block ultraviolet A rays, which dermatologists say can permanently damage
the skin. NIH said most sunscreens blocked ultraviolet B rays, but did little
or nothing to screen from UV-A. Food and Drug Administration tests show that
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Volume 2, Number 27 July 3, 1989
UV-A rays damage tissue beneath the skin surface and affect the immune system.
PAIN MIGHT BE SIMPLE HEARTBURN:
Chest pain during vigorous exercise might be a sign of heartburn, not heart
disease. A study reported in the June 22 Journal of the American Medical
Association said heartburn caused by gastroesophageal reflux - the leakage of
acid from the stomach up through the esophagus - is sometimes mistaken for
angina, the chest pains that are sometimes a sign of heart disease.
INJURY TYPES FOUND IN GAME:
New research on women basketball players indicates that women suffer
injuries for different reasons than their male counterparts. A study of 134
basketball players at eight Division I colleges found that women who were more
tentative about the game and were easily bored were most likely to be hurt.
Among men, those who have a previous injury are most likely to be hurt.
HEAT KILLED 95 LAST YEAR:
Last year, 95 people died from heat stroke, the National Oceanic and
Atmospheric Association said Tuesday. The agency, charged with recording and
predicting the nation's weather, said heat complications probably contributed
to countless other deaths, and warned against overexposure to high
temperatures and sunlight.
FIRM UNVEILS ULCER SENSOR:
Applied Biosciences said Wednesday that it would license its new
gastrointestinal sensor to Synectics Medical AB of Stockholm, Sweeden. The
sensor detects and measures ulcers and hyperacidity in the stomach and
gastrointestinal reflux of stomach acid into the esophagus. Gastrointestinal
reflux is being examined as a possible contributor to sudden infant death
syndrome.
NEW DEVICE EXPLORES BRAIN:
Scientists at the Max Planck Institute for Psychiatry are using an
innovative new computer-assisted scanning system to monitor brain activity.
The Brain Electric Source Analysis - or BESA -software package helps doctors
measure the voltage and find the source of voltage changes in individual brain
structures.
June 30-July 2, 1989
PROTEIN FIGHTS BREAST CANCER:
Doctors at the University of Michigan might have found a protein that
inhibits the growth of breast cancer. The researchers isolated a pure form of
the protein mammastatin, which apparently inhibits breast cancer growth. The
protein is produced naturally in the body. Doctors hope to clone the gene that
produces mammastatin and use it to fight the disease. (From the USA TODAY Life
section.)
MULTIPLE SCLEROSIS GENE FOUND:
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Volume 2, Number 27 July 3, 1989
A study in the journal Cell Friday shows evidence linking a gene to an
increased susceptibility to the disease multiple sclerosis. Research at
Massachusetts General Hospital in Boston, comparing immune cells of siblings
with and without M.S., found that siblings with the disease were more likely
to be born with a specific pattern on chromosome 7. (From the USA TODAY Life
section.)
SEAT BELT USE UP SINCE 1983:
Safety belt use is up 400 percent since 1983, the National Safety Council
said Thursday. The council said 47 percent of Americans now buckle up
regularly, and 37 states and the District of Columbia have mandatory seat belt
laws. Belt use among motorists in states without belt laws is also up, the
group said, to 37 percent.
LIVING LONGER WITH CANCER:
Support groups might help prolong the lives of cancer patients. Research
at Stanford University studied 86 women with cancer during a 10-year period.
Those who chose to attend weekly support group therapy lived an average of
36.6 months after starting the survey, while women who chose medical treatment
alone survived 18.9 months.
SMOKING RULES HELP KIDS QUIT:
Rules against smoking at school encourages more students to quit, a study
shows. The study, published in the July issue of the American Journal of
Public Health, said students at schools with strong anti-smoking policies were
less likely to smoke - on or out of school. Meanwhile, the study also noted
that punishments for violating the policies had little effect on smokers.
CAFFEINE HIGHER AFTER QUITTING:
Concentrations of caffeine increase for at least six months in people who
have stopped smoking but continue drinking coffee at the same rate.
Researchers at the University of California at San Francisco found that
caffeine moves out of the system of non-smokers faster than smokers. When
smokers stop smoking, their bodies loose caffeine slower, increasing caffeine
levels.
LOW STRESS IS KEY TO HEALTH:
Reducing stress could help keep chronically ill children's diseases under
control. Researchers at the Washington University at St. Louis studied 53
insulin-dependent diabetic children and found that family stress was the most
important factor influencing the child's metabolic stability. The less stress,
researchers said, the better the child managed the diabetes.
REPORT - KIDS UNPROTECTED:
Most accidental poisonings with prescription drugs happen because drugs are
out of their containers, a report says. The report, in the July American
Journal of Public Health, said 61 percent of all accidentally ingested drugs
were either out in the open or in a bottle that wasn't child-proof.
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Volume 2, Number 27 July 3, 1989
Recommendation: a better child-proof bottle that's easy for adults to use.
GENETICS CONFERENCE TO OPEN:
Doctors from five continents will gather in Boston for the 21st Annual
March of Dimes Clinical Genetics Conference. The conference is scheduled for
July 9 to 12 at the Lafayette Hotel. Topics include genetic disorders such as
muscular distrophy, cystic fibrosis, Huntington's disease and sickle cell
anemia. For information, call the March of Dimes at (914) 997-4640.
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Volume 2, Number 27 July 3, 1989
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Center for Disease Control Reports
===============================================================================
Morbidity and Mortality Weekly Report
Thursday June 29, 1989
Current Trends
Heat-Related Deaths -- Missouri, 1979-1988
From 1979 through 1988, 491 deaths were attributed to excessive heat
exposure* in Missouri. More than half of these occurred during a 1980 heat
wave (Figure 1). Although heat-related mortality is also influenced by factors
such as humidity and regional acclimatization (1), trends for heat-related
deaths in Missouri during 1979-1988 paralleled the state's average summer
temperatures** (Figure 1).
Persons greater than or equal to 65 years of age were the most severely
affected, accounting for 330 (67.2%) of the deaths (Table 1). The mortality
rate for this population was 48.7 per 100,000 persons, compared with 3.8 per
100,000 for persons less than 65 years of age. The rate for nonwhites was
substantially greater than that for whites, even after controlling for age
(Table 1). For persons less than 65 years of age, the rate for males was twice
that for females; in contrast, gender-specific rates for persons greater than
or equal to 65 years of age were similar (Table 1).
Reported by: SE Stewart, B Gibson, G Land, Div of Health Resources,
Missouri Bur of Health Data Analysis, D Rackers, HD Donnell Jr, MD, State
Epidemiologist, Missouri Dept of Health. A Graumann, User Svcs Br, National
Climatic Data Center, National Oceanic and Atmospheric Administration. Health
Svcs Br, Div of Environmental Hazards and Health Effects, Center for
Environmental Health and Injury Control, CDC. Editorial Note: Growing
scientific and public concern about the potential for global warming due to
the "greenhouse effect" has focused attention on the health effects of heat
during the summer (2). Heat-related mortality during July 1980 demonstrated
the effect that high temperatures can have on health (3). Missouri, which
reported greater than 17% of the nation's 1716 heat-related deaths in 1980,
maintains active surveillance of such deaths as part of a system for early
detection and prevention of heat-related morbidity and mortality.
Most heat-related deaths result from heatstroke, a severe illness in which
thermoregulatory failure results in core body temperatures exceeding 105 F
(40.6 C). Heatstroke is a medical emergency that can develop in a few minutes
or hours. Symptoms are primarily those of altered mental status and can
progress from lethargy and confusion to stupor and coma as the body
temperature rises; anhidrosis may occur, but many heatstroke patients perspire
profusely. Treatment includes the rapid lowering of body temperature followed
by intensive supportive care. Heatstroke is often fatal ( greater than 40%),
even when treatment is optimal (4,5).
The elderly are at greatest risk for heat-related illness, especially
those who have chronic illness and/or take medications that might predispose
to heatstroke. Also at increased risk are infants and children less than 4
years old, particularly those with congenital abnormalities of the central
nervous system or with diarrheal illness; alcoholics; persons taking
neuroleptic medications (antipsychotics or major tranquilizers) or
anticholinergic drugs (e.g., tricyclic antidepressants, antihistamines, some
antiparkinsonian agents, and over-the-counter sleeping pills); and persons who
are physically or mentally impaired (5).
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Volume 2, Number 27 July 3, 1989
Additional risk factors include a prior history of heatstroke; certain
uncommon conditions such as congenital absence of sweat glands, systemic
sclerosis, and hyperthyroidism; and exercising in the heat without proper
training and acclimatization. Obesity increases the risk for exercise-induced
heatstroke (5). Although racial differences in heat-related deaths have been
reported, attempts to assess the separate contributions of race and
socioeconomic status to heatstroke risk have been largely unsuccessful (3);
there is no evidence of a biologic predisposition for heatrelated death
associated with race.
Preventive measures include reducing physical activity, drinking extra
liquids, and increasing time spent in air-conditioned places (6). Adequate
salt intake is important; however, salt tablets are not recommended for
preventing heatstroke in the general population and may be harmful to persons
with certain preexisting illnesses such as hypertension and heart failure
(3,7). At very high temperatures (high 90s and above), fans are ineffective
for cooling and may increase heat stress and the risk of heatstroke (8,9).
Therefore, persons without home air-conditioners should seek shelter in an
air-conditioned environment rather than rely on the use of electric fans (6).
References
1. Kalkstein LS, Davis RE. Weather and human mortality: an evaluation of
demographic and interregional responses in the United States. Ann Assoc Am
Geographers 1989;79:44-64.
2. Schneider SH. The greenhouse effect: science and policy. Science
1989;243:771-81.
3. Jones TS, Liang AP, Kilbourne EM, et al. Morbidity and mortality associated
with the July 1980 heat wave in St. Louis and Kansas City, Missouri. JAMA
1982;247:3327-31.
4. Hart GR, Anderson RJ, Crumpler CP, Shulkin A, Reed G, Knochel JP. Epidemic
classical heat stroke: clinical characteristics and course of 28 patients.
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