ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (06/28/89)
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Volume 2, Number 26 June 26, 1989
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Editor: David Dodell, D.M.D.
St. Joseph's Hospital and Medical Center
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Telephone (602) 860-1121
(c) 1989 - Distribution on Commercial/Pay Systems Prohibited without
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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 June 25, 1989 ............................ 1
Medical News from the United Nations .................................. 8
2. Center for Disease Control Reports
[MMWR 6-22-89] Outbreaks of Staphylococcal Food Poisoning ............ 13
Dengue Epidemic -- Ecuador, 1988 ...................................... 15
Disease Promotion of Overweight Behavior .............................. 17
Heterosexual Transmission of AIDS/HIV Infection ....................... 19
Health InfoCom Network News Page i
Volume 2, Number 26 June 26, 1989
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Medical News
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Medical News for Week Ending June 25, 1989
(c) 1989, USA TODAY/Gannett National Information Network
June 19, 1989
-----
AIDS EXPOSURES AVOIDABLE:
More than one-third of all accidental exposures of health care
professionals to AIDS could have been prevented, a study from the Centers for
Disease Control reports. The study, reported in the June 16 New England
Journal of Medicine, found 37 percent of the 1201 exposures since 1983 were
avoidable. Eighty percent were from accidental needle sticks.
PATIENTS RARELY TRANSMIT AIDS:
Health professionals are at low risk for contracting AIDS by treating
patients, a recent study reports. The study, by the Centers for Disease
Control and reported in the June 16 issue of the New England Journal of
Medicine, found that 1,201 health care workers were exposed to blood from AIDS
patients from 1983 to 1988. Four have since tested positive for HIV antibody.
LACK OF SLEEP CAN DAMAGE HEART:
Doctors at the University of Kentucky found that lack of sleep - or deep
sleep - can hurt one's heart. The Journal of the American Medical Association
reports in its June 16 issue that doctors found patients with a "sleep
efficiency" of 70 percent or less performed poorly on the coronary tests.
FIRM DONATES SYNTHETIC SKIN:
An American pharmaceutical company has donated an advanced synthetic skin
substitute to treat burn victims of a June 4 gas explosion in the Soviet
Union. A team of physicians will carry the supply of BioBrane biosynthetic
skin, manufactured by Winthrop Pharmaceuticals. The synthetic skin helps
prevent infection and reduces the need for painful dressing changes during
healing.
COMPUTER ANALYZES VIRUS:
Researchers at Perdue University are using computers to create high-
resolution portraits of human and animal viruses. After isolating a virus in a
crystalization processes, the scientists analyze X-rays of the virus. Using a
supercomputer, they achieve near-atomic resolution, allowing them to examine
the structure and behavior of the disease.
SOME CHOLESTEROL MIGHT BE OK:
Whether the ratio of two types of cholesterol might be a strong determinant
of heart disease will be addressed by a group of cardiac specialists in
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Volume 2, Number 26 June 26, 1989
Washington, D.C., Monday. Studies show that the ratio of high-density
lippoprotiens, called "good cholesterol," to the total cholesterol level might
be an indicator of heart disease and other disorders.
STUDY - MEDICINE NOT TAKEN:
Many patients don't take their medications when prescribed, a survey
indicates. Doctors at the Veterans Administration Hospital in West Haven,
Conn., tracked 24 epilepsy patients and found that only 87 percent took
medicine once a day when required. The rate dropped for multiple medications
per day: 81 percent for two medications, 77 percent for three and 39 percent
for four.
HOSPITALS COPE WITH VIOLENCE:
A pioneering study depicts America's emergency rooms as places where
threats and violence are common and staff are often unprotected. The
University of Louisville found that one-third of the hospitals in a recent
survey reported at least one threat of violence per day against staff members.
Of the 127 hospitals responding, 23 reported one threat per month involving a
weapon.
FEW TRAINED FOR VIOLENCE:
Less than half of the hospitals in a recent survey provide training to
recognize and control aggression in patients, and slightly more than half have
24-hour security. A study by the University of Louisville on violence in the
emergency room found that only 51 of the 127 hospitals surveyed trained staff
members to recognize and control aggression.
June 20, 1989
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SEPARATING SMOKERS DOESN'T HELP:
An internal Environmental Protection Agency report suggests separating
smokers and non-smokers doesn't help unless they're put in separate rooms with
separate ventilation systems. The report said passive smoke - smoke inhaled
from another person's cigarette -is the leading source of indoor air pollution
and exposure to carcinogens. (From the USA TODAY Life section.)
OFFICIALS SAY NEW LAW IS WASTED:
A controversial new law in New Jersey that tracks medical waste could push
health care costs up and do little to combat waste washing up on the state's
beaches, health officials said. The law, which takes effect Thursday, imposes
strict requirements on 30,500 doctors, dentists and funeral directors in the
Garden State.
WELLNESS PROGRAMS SAVE MONEY:
Programs that urge employees to quit smoking and treat hypertension can
save companies thousands of dollars in hospital costs in the long run, a
survey said. Equitable Life Assurance Co. reported Monday that it saved $5.52
in health care costs for every dollar spent on stress reduction programs.
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Volume 2, Number 26 June 26, 1989
SYSTEM HELPS PATIENTS GET GOING:
Doctors at the University of Florida have developed a diagnostic system
they say might help many people who suffer from inadequate bladder control.
The team uses a computerized diagnostic system to evaluate bladder function.
Dr. Lisa Landy, director of the program, said in most of the cases, the
problem that triggers inadequate control is completely corrected.
PAIN KILLER COMES FROM PAIN:
The same protein that triggers pain in burn victims is being used to create
powerful pain-killing lotions and sprays. Doctors at the University of
Colorado are performing clinical trials on a bradykinin antagonist - a drug
made from the protein bradykinin, the same protein that causes pain. The
antagonist blocks pain impulses to the brain at the injury site.
STUDIES EXPLORE MEMORY:
Researchers are slowly piecing together how humans store and recall
memories. Scientific American reports in its July issue that neurobiologists
at the National Institute of Neurological and Communicative Disorders and
Stroke are advancing theories on the biochemistry of associative memory.
Researchers also note their theories could help construct computer-based
memory systems.
ALCOHOL HAS EFFECT ON STROKES:
Light to moderate drinking might help prevent a common type of stroke, but
heavy drinking might contribute to a more deadly type, a new study from the
American Heart Association found. The study, which examined more than 100,000
people, found that light drinkers had a lower risk than non-drinkers for
strokes caused by blood clots. Heavy drinkers showed higher risk for
hemorrhagic strokes.
THERAPY BATTLES HEART DISORDER:
New treatments are being developed to combat myocarditis, a mysterious
inflammation of the heart muscle. The American Heart Association said Monday
that doctors at Children's Hospital of Los Angeles had developed a treatment
that decreases hyperactivity of white blood cells in myocarditis victims. The
hyperactive cells are believed to damage the heart muscle.
KIDS USING SMOKELESS TOBACCO:
Smokeless tobacco use is increasing among teen-agers, and a new report
calls for programs to fight health risks associated with its use. The Journal
of School Health reports in its July issue that 21 percent of boys between 12
and 17 have tried smokeless tobacco and 7 percent use it regularly. Eleven
percent of young adults - 18 to 25 years old - use smokeless tobacco.
June 22, 1989
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Volume 2, Number 26 June 26, 1989
EPA ATTACKS PASSIVE SMOKE:
This week's report on the dangers of passive tobacco smoke is only the
start of a major offensive by the Environmental Protection Agency against
smoking in the workplace, experts said. The report, issued earlier this week,
called passive smoke a leading source of indoor air pollution. (See special
Passive Smoke package below. From the USA TODAY Life section.)
OFFICIAL DECRIES FUNDING TREND:
An American Cancer Society official said Wednesday that federal funds once
earmarked for heart disease and cancer research were now being diverted to
find a cure for AIDS. Dr. John Laslo, the cancer society's senior vice
president for research, decried the trend, noting that cancer still kills many
more Americans than Acquired Immune Deficiency Syndrome. (From the USA TODAY
Life section.)
POSSIBLE AIDS VACCINE IN WORKS:
A potential AIDS vaccine is being called a "strong contender" in the battle
against the deadly disease. HGP-30, which began Phase 1 clinical testing in
Britain last month, attacks a protein called P17, believed to help the AIDS
virus fuse to other healthy cells in the body. Doctors believe the protein is
common to all strains of the virus.
HEART RECIPIENT STILL CRITICAL:
George Hancock remained in critical condition Wednesday at Tucson's
University Medical Center after receiving a long-awaited heart transplant
early Tuesday. Hancock's life has been sustained by an artificial heart since
February - the second longest such use of an artificial heart, doctors said. A
hospital spokesman said his condition was improving.
HERPES DEATH PROMPTS WATCH:
Michigan state health officials are monitoring 21 lab technicians after a
23-year-old technician contracted a rare form of herpes virus from working
with an infected monkey. The technician, who apparently did not report being
bitten or scratched by the monkey, died Tuesday. His name was not released.
WOMEN IN 30S HAVE MORE BABIES:
One third of all children born in 1988 were born to mothers in their 30s,
the U.S. Census Bureau said this week. In 1976, only 19 percent of newborns
were born to women in their 30s, the bureau said. The number of childless
wives in their 30s planning to have children is also increasing dramatically,
from 34 percent in 1975 to 54 percent in 1988. (From the USA TODAY Life
section.)
SURVEY - FEWER PEOPLE DIETING:
Fewer Americans are dieting, according to a recent survey. The survey, by
Booth Research Services Inc. for the Calorie Control Council, found 48 million
people - one in four adults - claimed to be dieting. A similar survey in 1986
found 65 million were on diets. Also noted: One-third of all adult women say
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Volume 2, Number 26 June 26, 1989
they're on a diet, compared to one-fifth of adult men.
HEALTH TREND - MILK IN BAGS:
Midwesterners worried about dioxin from milk containers migrating into milk
can now purchase milk in bags at some stores. Officials at Wisconsin's Kwik-
Trip market dairy operations say 50 percent of the milk the chain sells is in
the gallon-and-a-half bags, up 30 percent in the past year. The bags are
tough, and milk in bags is 40 cents cheaper per gallon, the chain said.
SPECIAL PACKAGE - PASSIVE SMOKE:
NEW TESTS MORE ACCURATE:
Scientists are using a new and effective method to measure the exposure of
non-smokers to passive smoke - smoke inhaled from another person's cigarette.
The technique measures levels of a chemicals left by nicotine in the urine of
non-smokers. The tests are helping silence critics of data on the widespread
hazards of passive smoke.
EPA - PASSIVE SMOKE KILLS:
Passive smoking results in 5,000 lung cancer deaths each year, and
contributes to as many as 32,000 heart disease deaths each year, a recent
Environmental Protection Agency report states. Surgeon General C. Everett
Koop said recently that passive smoke was responsible for a "significant
number" of the 20,000 annual cancer deaths in the United States.
REPORTS TO TRIGGER LITIGATION:
The federal government will issue its first comprehensive assessment of
health risks to non-smokers in December, and legal experts expect an explosion
of litigation to ensure smoke-free working conditions. Statistics on passive
smoke remain controversial, but the legal outlook for those injured by the
smoke is expected to improve as tests become more accurate.
June 23-25, 1989
-----
DOCTORS CLAIM AIDS CURE:
Doctors at Johns Hopkins Oncology Center report they might have completely
eliminated the AIDS virus from a patient suffering from AIDS and cancer. The
41-year-old man, who underwent intensive, experimental treatments involving
chemotherapy, bone marrow transplants and the AIDS-killing drug AZT, later
died from cancer, but tests showed no AIDS in his body. More research is under
way.
MONKEYS MIGHT HAVE AIDS:
Scientists in Atlanta report AIDS-infected monkeys might be developing AIDS
four to six years after contracting the virus. If so, chimpanzees at the
Yerkes Regional Primate Research Center would be the first naturally
occurring, non-human species to get HIV-induced AIDS. The development could
Health InfoCom Network News Page 5
Volume 2, Number 26 June 26, 1989
help researchers test myriad drugs to fight the disease.
CHECKS SHOULD START EARLY:
Children should have their cholesterol tested after age 2 to help fight
heart disease in later years, The American Health Foundation said Thursday.
The foundation also said the total fat in children's diets should be no more
than 30 percent of their daily calorie intake, and called for more nutritional
information on packaged foods. (From the USA TODAY Life section.)
STUDY SHOWS WHERE THE FAT IS:
Wisconsin and Indiana have the highest proportion of overweight people,
according to a recent survey by the federal Centers for Disease Control. New
Mexico has the least. The survey, of adults in 32 states and the District of
Columbia, also noted that on a regional basis, the West has the fewest fat
people. The Northeast is second, followed by the South and the Midwest.
FAT LINKED TO IMMUNE SYSTEM:
Research at Harvard Medical School has revealed a link between the immune
system and some forms of obesity. Adipsin, a protein secreted by fat cells, is
similar to a key immune system protein. Theory: Obesity could involve defects
in this part of the immune system. The findings are reported in Friday's issue
of the journal Science.
IT'S LYME DISEASE SEASON:
Summer is prime time for Lyme disease, and as the July 4th weekend
approaches, concerns about the disease rise. Health officials are concerned
that celebrants will head into wood and fields without taking proper
precautions against disease-carrying deer ticks. So far this year, cases of
the disease have been reported in 43 states.
LASER `ACTIVATES' DRUG:
A Canadian company filed a request Thursday to begin testing a new cancer
drug that would be "activated" by a laser. Quadra Logic Technologies requested
approval from Canadian authorities to test a procedure involving the drug
Photofrin, which is harmless when injected, but kills cancer cells when
"switched on" by a low-power laser channeled through a fiber optic probe.
COLORED CONTACTS CUT VISION:
Some popular new soft contact lenses could do more than just change eye
color. They decrease vision, a study reports. Scientists at Louisiana State
University report testing the visual fields of patients wearing Dura-Soft 3
colored soft contact lenses found that the lenses cut users visual fields
between 21 and 47 percent. Their findings were published in July's Archives of
Opthalmology.
VITAMIN MIGHT FIGHT PARKINSON'S:
Vitamin E found in some foods might fight Parkinson's Disease. Doctors at
the University of Medicine and Dentistry of New Jersey report in the July
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Volume 2, Number 26 June 26, 1989
Archives of Neurology that a survey attempting to link specific foods with the
disease found those who ate lots of nuts, salad oils and dressings and plums
were least likely to get it. Theory: Vitamin E in the foods fights the
disease.
NEW TREATMENT BATTLES COCAINE:
Doctors at Yale University School of Medicine report high success rates in
battling cocaine addiction using a new drug treatment. As part of a six-week
study, cocaine addicts were given the drug desipramine hydrochloride. More
than half remained cocaine-free for three to four consecutive weeks. Doctors
hope the drug can be used as a first step to treating severely addicted users.
DIABETES, BRAIN PROBLEMS LINKED:
Children who get Type I diabetes might also suffer from impaired
intellectual functioning. A study by the Hospital for Sick Children in
Toronto, Canada, indicates that children who contract the disease before their
5th birthday showed diminished spacial skills, while those who got the disease
after their 5th birthday showed some verbal skill deficiencies.
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Volume 2, Number 26 June 26, 1989
Medical News from the United Nations
1st REPORTED CASE: GENITAL HERPES FROM ARTIFICIAL INSEMINATION
Physicians from Washington state have just reported what they believe is the
first documented case of transmission of genital herpes by donor insemination.
``To our knowledge, this is the first documented case of HSV [herpes simplex
virus] transmission among thousands of semen recipients in the United
States,'' said Donald E. Moore, MD, of the University of Washington School of
Medicine in Seattle, and colleagues. There are two strains of HSV. Type 1
generally causes `cold sores'; type 2 causes genital lesions and is usually
transmitted sexually. Not only are persons with genital herpes infections
subject to recurrent, painful genital sores, but infants who are infected at
birth (through the mother's genital tract) may be severely damaged. According
to the researchers' report, the semen donor had contracted an asymptomatic HSV
type 2 infection from his long-time sexual partner. In 1986, his semen was
used to inseminate two HSV-seronegative recipients; an HSV-2 infection
developed in one of the women who, as of July 1987, the researchers said,
``continued to have genital herpetic recurrences every other month
with....mildly painful lesions.'' Through laboratory tests of samples taken
from the donor's semen and from the cervix of the woman in whom primary
genital herpes developed, the researchers confirmed donor-to-recipient HSV-2
transmission. Several other women injected with the donor's sperm for
artificial insemination did not develop HSV-2 infections. Nevertheless, the
researchers concluded that the resulting case of genital herpes in one of the
semen recipients warrants that therapeutic donor insemination programs screen
donors more carefully in the future, since the present case ``illustrates that
during asymptomatic, primary HSV-2 infection, virus can be found in the semen
for a prolonged period, and semen can be infectious during this time.'' They
added that the case ``is of particular concern because the prevalence of
genital herpes is increasing in the United States,'' and because recent
studies indicate that whereas about one-fourth of the US population is
seropositive for HSV-2, over 70% of those testing positive have no history of
genital lesions [and so may be unaware of their infection prior to testing].
Approximately one-third of genital herpes infections, the researchers said,
are acquired from asymptomatic persons. ``Because of the possibility of
asymptomatic acquisition and transmission of HSV-2, semen donors and their
sexual partners should undergo serologic screening for genital herpes using
new, type-specific HSV serologic techniques....Serologic prescreening for HSV-
2 should also be considered for insemination recipients in light of the high
incidence of asymptomatic HSV-2 disease and its impact on neonatal herpes
acquisition.'' The researchers pointed out that the American Fertility Society
recommends the exclusion of all HSV-2 positive donors from therapeutic donor
insemination programs. JAMA June 16,1989; 261:3441-3443. (Compiled from
Newspapers and Medical Journals for IMTS's Healthweek In Review.)
MDs CREATE DATABASE TO TRACK AIDS INSURANCE PAYMENTS
A national organization of physicians is developing a computer database to
track insurance companies' payment--or nonpayment--of AIDS claims. The one-
year-old group based in Chicago, the Physicians Association for AIDS Care
(PAAC), includes 430 physicians and 28 pharmaceutical companies nationwide.
Data will be collected from patients of PAAC physicians who have been denied
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Volume 2, Number 26 June 26, 1989
payment for AIDS-related claims. The physicians will be able to use this data
when negotiating claim denials with insurance companies, according to PAAC's
executive director Gordon Nary. In addition, patients of PAAC physicians will
be assisted in their disputes by the AIDS Medical Resource Center, the Chicago
group that provided start-up money for PAAC. Mr. Nary said he thought the new
database would benefit both physicians and insurers. ``If we can show
[insurance companies] that it's in their best interest to pay for certain
treatments and improve the quality of people's lives, then it's a win-win
situation.'' Commenting on the wide variation in insurance coverage of AIDS
treatments, Dr. Bernard Branson, a Baltimore private practitioner, said that
``For people in private practice who aren't sponsored by university research,
it can be very risky to start administering a new treatment, then find out the
insurance company won't cover it and the patient can't afford it.'' AMERICAN
MEDICAL NEWS June 2,1989 p.17. (Compiled from Newspapers and Medical Journals
for IMTS's Healthweek In Review.)
NONOXYNOL 9, VINEGAR DOUCHE MAY PREVENT AIDS IN RAPE VICTIMS
Physicians responsible for the initial treatment of female rape victims should
consider administering nonoxynol 9 or a 1:10 vinegar solution to protect
against possible rapist-to-victim transmission of the AIDS virus, according to
two medical professionals from Maryland. Nonoxynol 9 is a spermicidal agent
used in many birth control substances. A number of recent studies have shown
that it can inactivate several types of sexually-transmitted-disease
pathogens, including the human immunodeficiency virus (HIV) that causes AIDS.
Also, according to Ilene M. Foster of the Baltimore County Health Department
in Towson, Md., and John Bartlett, MD, of The Johns Hopkins University School
of Medicine in Baltimore, ``unpublished data suggest nonoxynol 9 will not
affect evidential material needed to pursue legal action.'' For example, they
said, recent studies show that genetic material (DNA) necessary for confirming
the identity of the rapist can be isolated from sperm cells as many as five
days after exposure to nonoxynol 9. The need for rape victims to be treated
with some type of anti-HIV agent is crucial, but appears to be ``a neglected
area,'' the authors wrote in a letter to the Journal of the American Medical
Association. Their survey of 37 designated rape treatment centers in Maryland
revealed that, among 19 responders, ``only one center had a policy for female
victims of rape that included consideration of possible HIV transmission.'' In
conclusion, the authors urged ``the routine use of a topical anti-HIV agent
such as nonoxynol 9 as soon as possible after the assault, perhaps by the
victim herself, or as soon as possible after arrival at the hospital.'' The
authors suggested that even if rape victims do not seek medical care, they
should use nonoxynol 9 or a diluted vinegar douche at home. JAMA June
16,1989; 261:3407. (Compiled from Newspapers and Medical Journals for IMTS's
Healthweek In Review.)
TEST REVEALS EARLY AIDS INFECTIONS IN NEWBORNS
A new test can identify babies who are born infected with the AIDS virus so
they can be quickly treated in an effort to delay or stop fatal illnesses,
researchers say.
When mothers are infected with AIDS, they have about a one in three chance
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Volume 2, Number 26 June 26, 1989
of passing it on to their babies during pregnancy. But doctors have had to
wait more than a year before knowing which newborns are infected.
The still-experimental test can frequently - though not always - sort this
out soon after birth.
"It's something of a breakthrough. We have been very hindered by the fact
that we don't have diagnostic tests in infants," said Dr. Martha F. Rogers of
the U.S. Centers for Disease Control in Atlanta.
"We need that critically because people would like to start treatment with
AZT very early on," she added. "But you are stuck with treating every child
born to a (virus) positive mother with a fairly toxic drug, and you'll be
treating some kids who don't have the infection and don't need it."
AZT, the only approved AIDS drug, can temporarily reverse some of the most
severe symptoms of AIDS when given to babies with the disease. Some believe
that the drug might delay the appearance of AIDS in infected babies if they
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