ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (06/21/89)
--- begin part 1 of 7 cut here ---
Volume 2, Number 25 June 20, 1989
+------------------------------------------------+
! !
! Health Info-Com Network !
! Newsletter !
+------------------------------------------------+
Editor: David Dodell, D.M.D.
St. Joseph's Hospital and Medical Center
10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA
Telephone (602) 860-1121
(c) 1989 - Distribution on Commercial/Pay Systems Prohibited without
Prior Authorization
International Distribution Coordinator: Robert Klotz
Nova Research Institute
217 South Flood Street, Norman, Oklahoma 73069-5462 USA
Telephone (405) 366-3898
The Health Info-Com Network Newsletter is distributed weekly. Articles on a
medical nature are welcomed. If you have an article, please contact the
editor for information on how to submit it. If you are intrested in joining
the distribution system please contact the distribution coordinator.
E-Mail Address:
Editor:
FidoNet = 1:114/15
Bitnet = ATW1H @ ASUACAD
Internet = ddodell@stjhmc.fidonet.org
LISTSERV = MEDNEWS @ ASUACAD
Distribution:
North America Australia/Far East Europe
FidoNet = 1:19/9 David More Henk Wevers
Usenet = krobt@mom.uucp FidoNet = 3:711/413 Fidonet
Internet = krobt%mom@uokmax.ecn.uoknor.edu 2:500/1
Sponsors
========
Dr. Edward Delgrosso Black Bag BBS (FidoNet 1:150/101) Tel 1-302-731-1998
===============================================================================
T A B L E O F C O N T E N T S
1. Comments from the Editor
News Concerning USA Today ............................................. 1
2. Medical News
Medical News for Week Ending June 18, 1989 ............................ 2
Medical News from the United Nations .................................. 7
3. Center for Disease Control Reports
[MMWR 6-15-89] Outbreak of Giardiasis ................................ 15
Problems Created by Heat-Inactivation of Serum before HIV Testing ..... 18
Work Injuries in Automotive Parts Manufacturing Company ............... 20
Guidelines Prophylaxis Pneumocystis Pneumonia for HIV Infected ........ 23
4. Food & Drug Administration News
News from the Food and Drug Administration ............................ 32
5. Columns
HIV/AIDS Surveillance Report for June 1989 ............................ 39
Health InfoCom Network News Page i
Volume 2, Number 25 June 20, 1989
===============================================================================
Comments from the Editor
===============================================================================
A Message from the Editor
Concerning
USA Today
I have received several messages from various readers of our newsletter
concerning our feed from USA Today. The main problem they cite is the lack of
information to followup on the news items.
I think I have found a solution to this problem, as long as it isn't abused.
For now on, you will notice that each set of articles will start with a date.
This date is very important. If the article ends with the following (From the
USA Today xyz Section), then you can find the full length article in that days
issue of USA Today.
However, most of the news items do not have that tag. If you have a real need
for furthur information, please contact me direct. I have spoken to the news
editor at USA Today who puts together this section, and he has agreed to
supply me reference information from any article, as long as he knows the
title and the date it was published.
Please remember that I am a volunteer, and have limited time to track down
these requests, and I don't want to abuse the good nature of the editor at USA
Today. So please only use this request ability only when you really need more
information.
I hope this will solve some of the problems. As always, feedback is welcomed
at any of the electronic mail addresses above.
David
Health InfoCom Network News Page 1
Volume 2, Number 25 June 20, 1989
===============================================================================
Medical News
===============================================================================
Medical News for Week Ending June 18, 1989
(c) 1989 USA TODAY/Gannett National Information Network
Reproduced with Permission
June 13, 1989
AIDS FEAR CHANGES DATING:
Sixty percent of college students think dating practices have changed due
to concerns about AIDS. A survey by New York research firm Decisions Center
Inc. questioned 2,100 full- and part-time students on 350 campuses nationwide.
Results: 62 percent of the men and 59 percent of the women say AIDS has
changed dating practices and 8 percent of the students know someone with AIDS.
PLASTIC SURGERY ON THE RISE:
The number of selected plastic surgery procedures jumped 81 percent between
1982 and 1988, the American Society of Plastic and Reconstructive Surgeons
said recently. The group based its estimate on the numbers of 16 common
procedures performed by society members. The data showed that 77 percent of
plastic surgery patients in 1988 were women, with most between 35 and 50 years
old.
PLASTIC SURGERY VIEWS SHIFT:
More people approve of cosmetic surgery than just six years ago, according
to a survey from the American Society of Plastic and Reconstructive Surgeons.
The group's 1988 random sample of consumers showed 48 percent of those asked
approve of the surgery, up from 32 percent in 1982. Only 3 percent
disapproved, while 9 percent disapproved in 1982. Results were released
recently.
STAR SURGERY CHANGES VIEW:
Greater public acceptance of plastic surgery is due to wider use of the
procedures by trend-setters such as film stars, the American Society of
Plastic and Reconstructive Surgeons said. A recent survey showed a 50 percent
increase in acceptance of plastic surgery from 1982 to 1988. Other factors
noted in the attitude shift: greater emphasis on physical fitness and healthy
appearance.
EVEN TOTS CAN DECEIVE ADULTS:
Children as young as 3 showed deceptive behavior in a recent study.
Researchers at the University of Medicine and Dentistry of New Jersey studied
groups of 3-year-olds and found half the children lied about peeking at a toy.
Results were published in the current issue of Developmental Psychology. The
study said kids who lied smiled more and made other attempts to mask the
deception.
Health InfoCom Network News Page 2
Volume 2, Number 25 June 20, 1989
FLUID MIGHT CAUSE SPINA BIFIDA:
New research is focusing on exposure to amniotic fluid as the cause of
spina bifida. Scientists at Johns Hopkins University theorize that exposure to
the fluid, which surrounds the fetus but does not harm skin, can be
destructive to the spinal cord. The research is outlined in the current issue
of Science News. Spina bifida is a neural-tube defect that causes spinal
damage.
700,000 TO CLAIM BLACK LUNG:
The U.S. Labor Department's black lung program will handle about 700,000
claims for disability benefits due to the disease this year, the department
said. It estimated that 20 percent of retired miners suffer from black lung,
while 10 percent of active coal miners have it. Black lung is a form of
pneumoconiosis caused by the inhalation of coal dust.
June 14, 1989
ONLY CHILDREN RUN HEALTH RISK:
Adults who were only children are much more likely to have higher blood
pressure than grownups raised with siblings, a study by New York cardiologists
shows. The study of nearly 1,500 people found average systolic pressure - the
pressure when the heart beats - was about nine points higher. Theory: Only
children face more stress from parents who have high expectations.
SAYING NO TO AIDS PRESSURE:
Scientists must not bow to all pressure to speed up research into new AIDS
treatments or drugs, Anthony Fauchi, who directs AIDS research at the National
Institutes of Health, said Tuesday. He said some AIDS protesters' tactics
were destructive and could lead to studying drugs unscientifically.
STUDY - FAT CAUSES FAT:
New findings make it official: The reason many people are fat is that they
eat too much fat. Researchers at Laval University in Quebec studied 244 men
who consumed whatever they liked. Their findings, published in the American
Journal of Clinical Nutrition, indicate subjects with high-fat diets were
fatter. The data also indicates that exercise does not increase the ability to
burn fat.
DOCTORS HELP MORE QUIT SMOKING:
People are more likely to quit smoking if a doctor tells them to, a new
study shows. Doctors at the University of Indiana and Indianapolis Veterans
Hospital succeeded in getting patients to quit smoking 15 percent of the time,
compared to an average "quit rate" of 5 percent. Meanwhile, only half the
smokers in the study said their doctor has advised them to quit.
STUDY - THREE DISORDERS LINKED:
A Texas study reveals a puzzling link between high blood pressure, sexual
Health InfoCom Network News Page 3
Volume 2, Number 25 June 20, 1989
difficulties and a sleep disorder called apnea. The journal Sleep reports in
its current issue that Baylor College of Medicine found half the male patients
with hypertension and erectile problems also suffered from the sleep disorder.
Just how the three conditions are linked remains a mystery.
ULCER TO PNEUMONIA LINK STUDIED:
Researchers are looking for ways to break the chain that causes stress
ulcers and then pneumonia in seriously ill patients. Doctors at the
University of Iowa are searching for treatments to battle stress ulcers.
Trauma can trigger the ulcers and treatment that lowers stomach acid levels
allows bacteria to flourish and invade the lungs, causing potentially fatal
pneumonia.
MICROWAVE DOESN'T HURT FOOD:
Cooking food in a microwave oven doesn't reduce nutritional value, recent
nutritional studies indicate. In fact, food cooked in a microwave might be
healthier. Ascorbic acid and folate content - both heat-sensitive nutrients in
vegetables - are retained better in microwaves than in conventional cooking.
Levels of thiamin, a nutrient in meats, remain the same in both methods.
IMPOTENCE CAUSES TRACED:
Impotence in elderly men is not usually psychological, according to a study
in June's Archives of Internal Medicine. The study, at the Medical College of
Virginia at Richmond, looked at 121 men with an average age was 68. More than
45 percent had neurovascular problems that could be treated effectively, and
in 15 percent the problems were totally reversible.
SCHIZOPHRENIA GENE DOUBTED:
New studies are dashing hopes of finding a single gene responsible for
schizophrenia. Doctors recently felt they were closing in on such a gene, but
reports from Scotland and the University of Utah indicate the disorder is too
complex to be triggered by one gene, Science News reports in its current
issue. The disorder affects about one in 100 people worldwide.
June 15, 1989
POLYMER KEY TO ONE-TIME NEEDLE:
A polymer disc is the key to a new hypodermic syringe that cannot be
reused. Scientists at Johns Hopkins Applied Physics Laboratory developed the
syringe to fight the spread of diseases by drug users. A tiny hydrogel polymer
disc behind the needle allows liquid to flow through its center only once,
then seals within 20 minutes to prevent using again.
GAS PERMEABLE CONTACTS BETTER:
The Consumer Union on Wednesday gave high praise to new gas permeable
contact lenses. The agency said the new lenses, which permit more oxygen to
reach the surface of the eye, are more comfortable, easier to clean and
maintain and last longer than conventional soft contact lenses. The agency
reports on the lenses in the current of Consumer Reports magazine.
Health InfoCom Network News Page 4
Volume 2, Number 25 June 20, 1989
ENZYMES MIGHT FIGHT CHOLESTEROL:
Enzymes that act as anti-cholesterol agents might help reduce the nation's
blood cholesterol level from 50 percent to 80 percent. Research by Frost and
Sullivan released this week indicates that 10 enzymes are currently under test
for use as cholesterol-reducing food additives. The consulting firm predicted
their use would rise through the 1990s.
REPORT EYES KIDS' DISORDERS:
Marked advances have been made in treating a variety of childhood mental
disorders in the past two decades, a report by the Institute of Medicine
indicates. The report notes that 12 percent of all children younger than 18
suffer from some form of diagnosable mental disorder.
STUDY - ALCOHOL USE A PRIORITY:
The Surgeon General's Workshop on Health Promotion and Aging released a
report this week calling alcohol abuse among the elderly an urgent health
priority. The report linked alcohol abuse to increased incidence of
cardiovascular disease, coronary artery disease and hypertension. The report
listed specific recommended measures to reduce the rate of alcohol abuse among
the elderly.
LASERS TO ZAP CAVITIES:
Dentists might soon be replacing the drill with a laser that vaporizes
cavities painlessly and without anesthesia. A California laser technology
company unveiled the dLase 300 in New York Wednesday. Sunrise Technologies
Inc. said the laser would "change the face of dentistry." Tests of the new
laser by the Food and Drug Administration are under way, officials said.
June 16-18, 1989
AIDS SPENDING ESCALATING:
The federal government spent $5.5 billion on AIDS research and treatment
from 1982 to 1988. Spending is expected to be $2.1 billion in 1989 alone. The
New England Journal of Medicine reports in its current issue that federal
spending on AIDS will increase annually and exceed $4.3 billion in 1992 alone.
About 60 percent of funds will come from the U.S. Public Health Service.
AIDS-FUSION MOLECULE FOUND:
Researchers at Johns Hopkins University report identifying a molecule on
the surface of white blood cells that helps AIDS-infected cells fuse with and
pass their infection to uninfected cells. The findings, reported in the
current issue of Science News, might help physicians find new ways of battling
the progression of the disease in infected patients.
FDA TO OPEN AIDS DRUG HOTLINE:
The Food and Drug Administration will initiate a computerized information
service on AIDS therapies and clinical trials. The service will include
Health InfoCom Network News Page 5
Volume 2, Number 25 June 20, 1989
results of clinical trials and will include results of earlier tests with the
sponsors' permission. The agency is expected to set up and promote a toll-free
number within weeks.
MOST SUPPORT ANIMAL TESTS:
More than three-fourths of Americans say they think it is necessary to use
animals in medical research, a recent Gallup Poll indicates. The poll,
commissioned by the American Medical Association and reported in a recent
newsletter, reported that 77 percent of 1,500 adults thought animal testing
was necessary to advance medicine. Seventeen percent disagreed.
WIDER HEART DONOR POOL SOUGHT:
A Canadian cardiac specialist called for transplant programs to include
damaged hearts in donor programs. Dr. Arthur Dodek of St. Paul's Hospital in
Vancouver, British Columbia, argued that many people recover from minor heart
attacks. Dodek argued in this week's New England Journal of Medicine that
programs that demand flawless donor hearts are unrealistic.
FIRM TO TEST NEW VENTILATOR:
Infrasonics Inc. on Thursday announced that the Food and Drug
Administration had recommended testing the company's new high-frequency
ventilator, the HFV Infant Star. An FDA panel will examine the device, which
allows physicians to ventilate infants unresponsive to other methods. The
company said Thursday that it expected approval after the review.
OLD DRUG MIGHT HOLD NEW HOPE:
A drug long used to combat African sleeping sickness might be a powerful
anti-cancer agent. Researchers at the National Cancer Institute report
suranim, developed in the 1920s, shrank patients' tumors by more than 50
percent in a recent trial. The drug is available from the Centers for Disease
Control as an "orphan drug," one rarely used.
DOCTORS USE NEW DIABETES TEST:
Scientists have developed a genetic test that might help predict a
patient's chances of developing the most serious form of diabetes. Science
News reports in its current issue that doctors at the University of Pittsburgh
School of Medicine said the test analyzed DNA taken from white blood cells.
While the test doesn't diagnose diabetes, it can be an indicator.
Health InfoCom Network News Page 6
Volume 2, Number 25 June 20, 1989
Medical News from the United Nations
MARKETING PSYCHIATRIC CARE FOR KIDS: A BOOMING BUSINESS
The ads make it clear. ``Mental illness has come out of the closet, and even
your child may be a victim. Watch for the signs, and call us for help.''
Fearful, guilt-ridden parents, worried about teen drug abuse, depression, and
suicide, increasingly are being spurred on by the advertising to go to the
experts. The result is an expanding phenomenon of adolescents entering
psychiatric hospitals for treatment. By even the most conservative estimates,
150,000 teenagers are expected to be hospitalized for psychiatric care this
year. The trend has become big business. According to stock analysts, the
revenues of companies that sell these services could grow by as much as 20% a
year over the next few years. But critics, including mental health
professionals and child-advocacy groups, point to studies that have found that
many, if not most, of these admissions are inappropriate, and actually may be
harmful. The ads, they say, tempt parents to hospitalize their children for
what is normal, if difficult, adolescent behavior. Said Kirk Johnson, general
counsel for the American Medical Association (which fought a battle against
advertising by medical professionals all the way to the Supreme Court in 1972,
but lost): ``When a doctor or hospital implies a result, that they will fix
something that is wrong, consumers are willing to believe that authority.''
But in the other corner sits Carol Szpak, spokesperson for the American
Psychiatric Association. ``You can always find disagreeable and tasteless
ads,'' she said, ``but our members are telling people there is treatment out
there, and the ads serve in a way to destigmatize the whole treatment
process.'' The bottom line? Psychiatric hospital beds in for-profit hospitals
increased by 150% from 1969 to 1982, beds that had to be filled. The hospitals
evidently found a successful solution by targeting a new audience--families
with children, particularly adolescents--with advertising and other marketing
ploys, ranging from seminars for guidance counselors to a contest awarding a
cruise to a hospital employee generating the most admissions. Successful or
not, however, the approach is controversial even among the professionals.
``Because of these ads, everyone is painted with the same brush,'' said Irene
Nelson, intake coordinator for Chicago's Associates in Adolescent Psychiatry.
Parents want a child admitted who balks at homework or cuts school for a day,
she said. ``We wouldn't hospitalize, but others probably would. It's gotten
out of hand.'' Said Orville McElfresh, marketing VP for Parkside Medical
Services, also of Chicago: ``Advertising has become dramatic, hard hitting,
more direct. Being subtle just doesn't work.'' CHICAGO TRIBUNE May 30,1989
p.1. (Compiled from Newspapers and Medical Journals for IMTS's Healthweek In
Review.)
AIDS BLOOD TEST MAY TAKE ALMOST 3 YRS. TO TURN POSITIVE
People may harbor silent infections with the AIDS virus yet have negative
screening tests for nearly three years after becoming infected, according to a
California study. Not only is this latency period far longer than the time
lag previously documented but the study also found that such a ``prolonged
period of latency...may be more common that previously recognized'' and that
``the degree of infectiousness during such periods is unknown.'' The study
used blood samples drawn every six months from homosexual men who continued to
engage in high risk sexual practices. The 133 men who formed the study group
and whose screening AIDS tests were negative initially were drawn in 1986 from
Health InfoCom Network News Page 7
Volume 2, Number 25 June 20, 1989
a much larger group of 1,637 homosexual men enrolled in the Los Angeles branch
of the Multicenter AIDS Cohort Study. The researchers, led by David T.
Imagawa, PhD, of the University of California at Los Angeles, found that 31 of
these men who had negative screening antibody tests--23%--had the human
immunodeficiency virus (HIV-1) in their blood when viral cultures were done.
Four of the 31 men in the study converted to positive screening blood tests;
27 remained negative 28 to 36 months after the virus was first isolated. Using
the sensitive polymerase chain reaction which can detect tiny amounts of
genetic information, the investigators demonstrated that two of the four men
had the virus in their systems 35 months before seroconversion and that one
was infected 30 months before his screening test became positive. An
accompanying editorial by William A. Haseltine, PhD, of the Dana-Farber Cancer
Institute in Boston, explains that this study offers both good and bad news.
The good news is that the long latency period suggests that the body's immune
system can fend off symptoms for long periods, suggesting that ``it may be
possible to suppress the expression of the virus with combinations of
antiviral drugs.'' But the findings also raise ``the sobering possibility that
HIV-1 infections may be transmitted by blood and organ donors who are silently
infected.'' The California team warns, however, that this extremely long
latency may not occur in other groups, such as those who acquire AIDS because
of contaminated blood ``Additional studies are needed to determine the
proportion of infections that currently available serologic tests for HIV-1
antibody may not detect,'' they wrote. NEW ENGL J MED June 1,1989; 320:1458-
1462, 1487-1489. (Compiled from Newspapers and Medical Journals for IMTS's
Healthweek In Review.)
MEDICAL NOTEBOOK; More doubt raised about standard AIDS test
More evidence emerged here yesterday that people who test negative on
standard antibody tests of exposure to AIDS may actually harbor the virus on
the basis of another test called PCR.
Half of the female sexual partners of AIDS-infected hemophiliac men appear
to have traces of the AIDS viral genetic material in their systems on the
basis of PCR, or polymerase chain reaction tests, even though they
consistently tested negative over a period of three years on standard antibody
tests, said Indira K. Hewlett, a scientist at the Center for Biologics,
Evaluation and Research in Bethesda, Md.
Furthermore, said Hewlett, it was the wives in couples who did not
consistently use condoms who were most likely to test PCR-positive.
Hewlett's report to scientists attending the Fifth International Conference
on AIDS is "one of the most important studies at this conference and the first
clean study with PCR that I have seen. I believe these results," said Dr.
James Goedert, an expert in AIDS transmission among hemophiliacs at the
National Institutes of Health.
Hewlett's study, done for the US Food and Drug Administration, which is
interested in PCR as a potential measure to monitor the safety of the blood
supply, appears to add support to the conclusions of a controversial study
published last week in the New England Journal of Medicine that found that the
AIDS virus can be isolated in the blood of one-quarter of high-risk gay men
Health InfoCom Network News Page 8
Volume 2, Number 25 June 20, 1989
who test negative on antibody tests. That study has provoked intense
discussion and worry as well as skepticism among scientists here.
Unlike the Journal study, however, Hewlett's team did not isolate the virus
from the hemophiliacs' wives. At a press conference last night, US government
scientists called the Hewlett study provocative but noted that at least two
similar studies were unable to find evidence of AIDS infection in such a high
percentage of hemophiliacs' wives.
In other presentations yesterday, AIDS experts said they still believe 1.5
mnillion Americans are infected with the AIDS virus. Though this official US
government estimate has not changed in several years, scientists said they
were increasingly confident of this figure.
They presented strongly supportive data from studies on US Army recruits,
active soldiers, 27 "sentinel" hospitals, outpatient blood screening from
private physicians' offices, job corps applicants and childbearing women, all
of which support the 1.5 million figure, noted Dr. Timothy Dondero, an AIDS
specialist at the federal Centers for Disease Control in Atlanta.
Most of the epidemiological studies also supported the basic shift of the
AIDS epidemic toward minorities.
And the US Army data also supported the picture scientists have long
believed about how the AIDS virus is transmitted. Among soldiers who were
infected with the AIDS virus but who denied they had engaged in known risk
behaviors such as intravenous drug abuse or anal sex with another man, 77
percent turned out, after confidential interviews, to have actually engaged in
such risk behaviors. Furthermore, among these men at least, bisexuality was
far more common than only male-male sex. In a sobering study of Nairobi
prostitutes, researchers led by Joan Kreiss of the University of Washington in
Seattle found that the spermicidal compound Nonoxynol-9 not only failed to
protect the women against the AIDS virus, but was associated with a higher
rate of genital ulcers. Genital ulcers are a known risk factor that enhances
the ease of transmission of the AIDS virus. More evidence emerged yesterday
that breast milk from infected mothers can transmit the AIDS virus to nursing
infants, according to a study by Subhash Hira in Lusaka, Zambia. Although
growing numbers of children in Africa may be getting infected through this
route, said Hira, breast feeding is nevertheless a relatively "inefficient"
mode of virus transmission. And because there are no good alternatives to
breast feeding in the developing world, he said, public health officials
should not discourage women from nursing. Like many other doctors at the
conference - at which 11,600 delegates are officially registered - Dr.
Margaret Fischl of the University of Miami School of Medicine stressed a
growing sense of optimism about treatment for AIDS infection.
AIDS therapy will soon resemble cancer treatment in the growing
availability of combination drug regimens. Such combination therapies should
help offset toxicities between drugs and also take advantage of synergistic
activity between drugs. Most promising so far, said Fischl, is a combination
of AZT, the only antiviral drug so far FDA-approved, plus GM-CSF, an immune
system booster, plus alpha-interferon, which can act as both an immune booster
and antiviral.
On this regimen, she said, AIDS patients were able to keep their blood cell
--- end part 1 of 7 cut here ---