ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (06/13/89)
--- begin part 1 of 2 cut here ---
Volume 2, Number 24 June 12, 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 from the Editor .................................................. 1
2. Medical News
Medical News for week ending June 12, 1989 ............................ 2
Medical News from the United Nations .................................. 9
3. Center for Disease Control Reports
MMWR for June 1, 1989 ................................................. 15
4. Columns
CDC Calendar of Events ............................................... 24
Health InfoCom Network News Page i
Volume 2, Number 24 June 12, 1989
===============================================================================
Comments from the Editor
===============================================================================
News from the Editor
David Dodell
I am pleased to announce the resumption of news from the Centers for Disease
Control. This includes month AIDS statistics. You will notice a slight
format change this week, where the entire MMWR was placed in the newsletter as
one article.
In the old format, I received the MMWR in sections, so it was very easy for me
to break it up for this newsletter, however, this week I received it in one
complete piece. Being pressed for time, I didn't break it up this week, BUT I
plan on doing so in the future.
It will just take a little time to adjust to the new feed for the information.
Thank you for your patience.
Health InfoCom Network News Page 1
Volume 2, Number 24 June 12, 1989
===============================================================================
Medical News
===============================================================================
Medical News for week ending June 12, 1989
(c) 1989, USA TODAY/Gannett National Information Network
INSULIN MIGHT SHOW HEART RISK:
Excess insulin in the blood might be the earliest predictor of coronary
risk in men, two studies out Sunday suggest. The findings point to extra
insulin as the initial problem that often leads to high blood fat levels.
Results of the study, which tested 1,263 men and women, were released at the
American Diabetic Association's annual meeting in Detroit.
AIDS BATTLE HAS NEW WEAPONS:
Experts at the Fifth International Conference on AIDS on Montreal say there
now is much help available for people who carry the virus but don't yet have
the life-threatening infections and cancers of full-blown AIDS. HIV co-
discoverer Dr. Luc Montagnier said he expected to be able to prevent AIDS in
some HIV infected people within five years.
RESIDENT DOCTORS GET BREAK:
The clock is ticking for New York hospitals who must cut back on resident
doctors hours. A recent court ruling aimed at ending 36-hour shifts and 100-
hour workweeks for resident doctors requires New York hospitals to cut shifts
80 hours per week or 24 consecutive hours at a time. The bill, challenged in
two suits by the Hospital Association of New York State, takes effect July 1.
DEATH PROMPTED RULE CHANGE:
Rules capping the hours of resident doctors in New York state were
introduced after an 18-year-old woman died at New York hospital. The parents
of Libby Zion said exhausted interns and residents failed to treat the teen-
ager properly when she was admitted to the hospital in 1984. The change would
cut resident workweeks to 80 hours, down from 100.
U.S., SOVIETS OK DRUG TESTS:
The U.S. Olympic Committee and Soviet authorities agreed on a plan to test
Olympic athletes in both countries for drugs. The agreements, made final at a
conference in Iowa Sunday, calls for random testing of athletes from both
countries for steroids and other drugs. Penalties: Two-year suspension from
the sport for first offense; life suspension for repeat offenders.
KOOP TO STAY VOCAL ON HEALTH:
Surgeon General C. Everett Koop will retire as the nation's doctor on July
13, but plans to remain active in national health issues. Koop said recently
that he would write a book after leaving his post and plans to live in the
Washington, D.C., area and speak out often on national health issues.
Health InfoCom Network News Page 2
Volume 2, Number 24 June 12, 1989
PATIENTS COPE WELL WITH DISEASE:
Patients who discover the have incurable Huntington's Disease cope well
with the illness, a study shows. Doctors at Johns Hopkins University followed
55 patients through tests for the illness, which is always fatal. Results, in
the current issue of The Journal of the American Medical Association: None of
those who found they had the disease experienced severe depression.
DOCTORS CLOSE TO FINDING GENE:
Doctors have identified genetic sequences very close to the gene that
causes Huntington's Disease - a fatal genetic disorder of the central nervous
system. Researchers reported in the current issue of the Journal of the
American Medical Association that new tests had identified disease carriers
with 95 percent accuracy. The advances give hope of finding the gene that
triggers the disorder.
TESTS FIND CANCER EARLIER:
New tests that measure genetic changes in tumor cells might help doctors
make more accurate prognoses. Researchers at Johns Hopkins University are
using a test to determine the presence of chromosome parts that keep cells
from turning malignant. The tests, highlighted in the current issue of the
Journal of the American Medical Association, could help find and treat cancer
sooner.
NEW FERTILITY SURGERY ON WAY:
A new microsurgical technique - partial zona dissection - might benefit
couples with "extreme infertility" who have failed to achieve pregnancy with
standard in-vitro methods, said scientists at Reproductive Biology Associates
of Atlanta. It involves extracting a woman's egg and making a tiny incision to
allow sperm to get inside. It should be widely available in two to three
years.
U.S. OVERESTIMATES AIDS CASES:
U.S. health officials say they've overestimated the number of people
infected with the AIDS virus for the past three years. Studies reported
Monday at the Conference on AIDS indicate 1 million to 1.5 million people in
the United States carry the virus now. Nearly identical estimates first made
in 1986 must have been too high, officials said.
ESTIMATES SHOW EXTENT OF AIDS:
Estimates released Monday at the Conference on AIDS in Montreal indicate
that in the United States between four and six of every 1,000 people carry the
disease. The statistics are from the United States Centers for Disease
Control. Those infected are disproportionately male, black and poor, officials
said.
AIDS WAR SHOW SIGNS OF STRAIN:
In the eighth year of the AIDS epidemic, the unparalleled network of fund-
raising and volunteers assembled in San Francisco is showing signs of strain.
Health InfoCom Network News Page 3
Volume 2, Number 24 June 12, 1989
Volunteers and donations are dropping off. Many volunteers are themselves sick
or dead. The AIDS Emergency Fund might raise only $400,000 this year - to pay
for services costing $1.8 million.
HOSPITALS SHARE AIDS INFO:
Doctors at the University of Miami have linked their vast medical databases
in an effort to battle AIDS. UM and neighboring Jackson Memorial Hospital will
share information across nearly 800 research projects through a fiber optic
Integrated Systems Network from AT&T. The Miami area ranks third in the nation
- behind New York and San Francisco - in the number of reported AIDS cases.
FDA APPROVES IMAGING SYSTEM:
The Food and Drug Administration on Monday approved a new ultrasound
imaging system for intra-cardiac use. The interventional ultrasound imaging
system uses any of three catheter configurations to provide 360-degree cross-
sectional images of the interiors of blood vessels. The device will aid
doctors in the treatment of diseases like atherosclerosis.
AUTISM SEEN AS ORGANIC DISORDER:
Research on brain abnormalities is identifying autism as an organic, not an
emotional, disorder. Although the range of symptoms varies among patients,
researchers studying a group of autistic patients found the males with fragile
X syndrome shared a pattern of symptoms and behaviors. The findings were
reported in the Journal of the American Medical Association's current issue.
DRUG TREATS SICKLE CELL ANEMIA:
Sickle cell anemia patients could be helped by a new drug. Doctors at John
Hopkins University used the drug hydroxyuera on a small group of patients. The
drug appeared to turn on a gene that produces a building block of fetal
hemoglobin. The Journal of the American Medical Association's current issue
reports researchers have expanded study of the drug.
COLOR VISION GENE ISOLATED:
Researchers at Stanford University isolated the genes that produce color
vision. Doctors identified three genes that function as receptors for three
pigment proteins on the cone cells of the retina. Each receptor reacts to
light of different wavelengths to register the colors of red, green and blue,
the Journal of the American Medical Association reports in its current issue.
MEAT MIGHT WEAKEN BONES:
Eating lots of meat might weaken bones, researchers at the University of
Texas Southwestern Medical Center reported recently. High-fat diets might
leach calcium from bones, increasing the risk of osteoporosis, researchers
said. The findings were reported in a recent issue of the Journal of Clinical
Endocrinology and Medicine.
AIDS MUTATES TO RESIST MEDICINE:
AIDS researchers say they're racing against time to find drugs to
Health InfoCom Network News Page 4
Volume 2, Number 24 June 12, 1989
supplement AZT, which starts losing effectiveness within two years, new
studies show. Doctors at the Fifth International Conference on AIDS said
benefits from AZT wane after 18 months. Reasons: The virus mutates to resist
the drug and side effects make lower doses necessary.
DOCTORS PIN HOPES ON CD4:
Doctors at the Fifth International Conference on AIDS Tuesday said a new
drug was offering promise to AIDS patients. The family of soluble CD4 drugs
mimic receptors that attract the AIDS virus to certain cells, keeping it from
infecting cells and replicating. Findings presented at the conference show
CD4 might cut the amount of AIDS virus in patients.
CLINIC STUDIES AIDS IN CHILDREN:
The National Institutes of Health on Tuesday awarded a $2.9 million
research contract to study the heart and lung complications of children who
have AIDS. The Cleveland Clinic Foundation will compile information during a
six-year program studying about 1,000 AIDS patients at six clinics across the
country. The studies will begin on May 1, 1990.
STUDY SHOULD COMFORT PILL USERS:
A study in the June Journal of Obstetrics and Gynecology shows that the
birth control pill is safe for women with a history of breast cancer despite
small studies showing otherwise. The report, which involved nearly 10,000
women, won't put the controversy to rest, but findings should comfort many
women and their doctors.
RESEARCHERS STUDY BIRTH DEFECTS:
Birth defects among Mexican women exposed to toxic chemicals while working
in maquiladoras- twin industrial plants along the border - urgently need more
study, researchers said during a conference of the U.S.-Mexico Border Health
Association. A preliminary research project indicated that maquiladora workers
suffered higher-than-normal incidents of underweight babies.
VW TO HELP ADAPT VANS:
Volkswagen United States on Tuesday announced an innovative program to help
pay part of the costs associated with adapting its vans for use by handicapped
people. The firms Mobility Access Program will provide $1,500 toward adapting
its 1989 Vanagon Carat or Wolfsburg Limited Edition Vanagons to accommodate
handicapped passengers or drivers.
FIRM PLANS DRUG TESTS:
CytRx Corp. plans clinical to test the effectiveness of a new drug to treat
sickle cell anemia, the company said Tuesday. The drug, RheothRx, is designed
to soften hardened, or sickled, red blood cells that cause painful attacks in
sickle cell disease patients, and allow blood to flow in previously clogged
arteries. The drug was developed by doctors at Emory University.
CANCER VERSUS HEIGHT, WEIGHT:
Health InfoCom Network News Page 5
Volume 2, Number 24 June 12, 1989
Short men are less likely to develop certain types of cancer. The shortest
group of men in a recent study were found to be only half as likely to develop
colon cancer as the tallest group of men. National Cancer Institute studies
find the same is true for short women and breast cancer. Theory: Kids who eat
fewer calories grow up shorter, and thus are at lower risk of cancer.
MOUTH TISSUE VULNERABLE:
Cancer treatments often bring oral complications. But damage to teeth, gums
and tongue can be contained. The National Institutes of Health says using
fluorides, saliva substitutes and "meticulous" oral hygiene can help avoid
problems. Some 400,000 cancer patients suffer dental complications each year.
EXTRA VITAMINS FOR SENIORS:
People older than 60 can benefit from vitamin and mineral supplements.
Tufts University's Diet and Nutrition Letter says many older people are
deficient in Vitamin B-12, Vitamin D, folic acid, zinc, calcium and magnesium.
Tufts' Dr. Robert Russell recommends a basic multivitamin tablet for most
people. Vitamin users should not substitute vitamins for balanced nutrition.
AIDS VACCINE POSSIBLE:
Studies released at the Fifth International Conference on AIDS indicate a
vaccine can be developed, doctors said Wednesday. Researchers cautioned that
the vaccine might be many years away, but new findings countered beliefs that
the deadly virus was virtually vaccine-proof.
SUB-UNIT VACCINE MIGHT BE TRIED:
Antibodies capable of neutralizing human immunodeficiency virus are
elicited by a nine-amino acid peptide called RP335, researchers at the Fifth
Annual International Conference on AIDS said Wednesday. The finding is key to
the development of a possible subunit vaccine against AIDS. A sub-unit vaccine
uses only a non-infectious segment of a virus to trigger resistance to the
disease.
FDA APPROVES PARKINSON'S DRUG:
The Food and Drug Administration Wednesday approved a drug called
selegiline to help treat severe Parkinson's disease. The new drug inhibits an
enzyme that deactivates dopamine, the natural neurotransmitter lacking in
Parkinson's patients. The FDA said selegiline would benefit between 20,000 and
50,000 Parkinson's patients.
DRUG HELPS PREMATURE INFANTS:
A study suggests a 42-day treatment with the steroid dexamethasone
significantly improves a chronic lung disease that is a leading cause of death
and complications in premature infants. Doctors have long suspected the drug
improves lung function in premature infants. The study was released in
Thursday's New England Journal of Medicine.
LASER MIGHT TREAT HEART:
Health InfoCom Network News Page 6
Volume 2, Number 24 June 12, 1989
A laser catheter under development might someday eliminate the causes of
two crippling heart disorders. Angeion Corp. is developing a percutaneous
laser catheter that will treat arrhythmias and idiopathic hypertrophic
subaortic stenosis, a thickening of the heart muscle that reduces the amount
of blood flowing through the heart.
SMART SCOPES TO LINK DOCTORS:
Pathologists at 10 Washington, D.C.,-area hospitals will soon be using
"smart microscopes" to view microscope slide images on television screen miles
from the microscope. Bell Atlantic Corp. said Wednesday it will set up the
system, which will send video signals over fiber optic lines to high-
resolution receivers so clear they will allow doctors to make an immediate
diagnosis.
STUDY CHALLENGES YAWN THEORY:
Two researchers have challenged the idea that humans yawn to increase
oxygen in the blood and rid themselves of carbon dioxide. Researchers counted
student researchers yawns while they inhaled various mixtures of the gases and
found the rate remained constant. Results were released in the June issue of
Discover magazine. Theory: Yawning is actually a stretching function.
NEW MEDICINES ON WAY FOR CANCER:
More than 45 new genetically engineered medicines for the treatment of
cancer or cancer-related illnesses are being developed or awaiting approval by
the Food and Drug Administration, the Pharmaceutical Manufacturer's
Association said this week. The agency said cancer was now the main focus of
American biotechnology research.
SALK EXPERIMENTS SHOW PROMISE:
A chimpanzee experiment led by polio vaccine pioneer Jonas Salk provides
hope for eliminating the AIDS virus from infected people. The study also
provides clues for developing a vaccine to prevent infection, say experts who
heard Salk's report Thursday at the Fifth International Conference on AIDS.
NEW DRUG INHIBITS AIDS:
Scientists at the Fifth International Conference on AIDS Thursday released
research confirming that the drug Ampligen appears to have potential to fight
the disease in its early stages. Research conducted at Philadelphia's
Hahnemann University Hospital indicates the drug appears to have the ability
to control replication of HIV, the virus that causes AIDS.
FDA CLEARS 10-MINUTE AIDS TEST:
The Food and Drug Administration Thursday cleared a new screening test for
the AIDS virus that will produce a result in 10 minutes. Murex Clinical
Technology Corp.'s Single Use Diagnostic System will undergo clinical trials
at hospitals in nine states. The company said the test did not require
advanced training to administer.
BLOOD TEST KIT DETECTS ULCERS:
Health InfoCom Network News Page 7
Volume 2, Number 24 June 12, 1989
New blood test kits might eliminate the need for tissue biopsies to detect
an infection that causes gastric and peptic ulcers. Allergy Immuno
Technologies is marketing a line of blood test kits to detect Campylobacter
pylori, a cause of the ulcers. The company said the tests would eliminate
costly invasive medical procedures that require an endoscopy and tissue sample
from the stomach.
LASER TO DESTROY GALLSTONES:
The Food and Drug Administration on Thursday cleared a laser procedure for
eliminating gallstones and biliary stones. The MDL-1 LaserTripter from Candela
Laser Corp. could replace surgery to remove the stones, the company said. The
procedure uses a laser catheter to fire a beam to destroy the.
DIABETES MOLECULES UNCOVERED:
Researchers have uncovered two key molecules in a chain of insulin-
initiated reactions that could spark therapies for diabetes. A study published
in Friday's Journal of the American Medical Association indicates that the
molecules are helping doctors understand the chain reaction that triggers
diabetic difficulties and could help them prescribe therapy.
CELLS KEY TO HEARING RANGE:
The complexities of human hearing are slowly being unraveled at the Center
for Hearing Sciences. Researchers there recently theorized that two types of
cells in the brain's cochlear nucleus might be the key to the unexplained
range of human hearing. Each type of cell, researchers said, deals with a
specific component of encoded nerve impulses humans use to hear.
Health InfoCom Network News Page 8
Volume 2, Number 24 June 12, 1989
Medical News from the United Nations
Altered Polio Vaccine May Work for AIDS, Experiment Suggests
An altered polio virus has made rabbits generate blood proteins that
stopped AIDS virus infection in the test tube, suggesting a possible lead for
AIDS vaccines, scientists report.
Through genetic engineering, the virus had been made to display on its
exterior a portion of a protein from the AIDS virus.
The study is among several papers on acquired immune deficiency syndrome
research to appear in Thursday's issue of the British journal Nature.
Vaccines spur the body's immune system into creating proteins called
antibodies that can attack particular germs later on. Several AIDS vaccine
strategies are being tried in humans, including the use of a genetically
altered smallpox virus called vaccinia.
A vaccine using altered polio virus may lead to antibodies in such areas as
the surface of the vagina, where they might inactivate the sexually
transmitted AIDS virus before it enters the bloodstream, study co-author
Jeffrey Almond said Wednesday in a telephone interview.
Almond, of the University of Reading in Britain, and British colleagues
reported that they altered a type of polio virus that is widely used in the
oral polio vaccine, and gave it to rabbits. In the test tube, antibodies from
the rabbits' blood stopped a variety of AIDS virus strains from infecting
cells.
The result is encouraging and "raises our hopes" for finding an effective
AIDS vaccine, said an accompanying editorial by Gordon Ada of John Hopkins
University in Baltimore.
A second Nature paper dealt with simian immunodeficiency virus, called SIV,
which causes AIDS-like disease in monkeys.
Researchers said they found that SIV from a West African monkey called the
sooty mangabey is genetically very similar to HIV-2, which causes AIDS in
humans in West Africa.
HIV-2 differs from HIV-1, which causes AIDS in the United States.
Researchers suggested that SIV from a sooty mangabey or a closely related
species may have infected a human West African within the past 30 years to 40
years, and then evolved into HIV-2.
But it is also possible that the infection went the other way instead, with
HIV-2 entering the monkey, said the researchers from the National Institutes
of Health, Georgetown University and Tulane University.
They also stressed that the proposed time of the infection was only a rough
estimate.
Health InfoCom Network News Page 9
Volume 2, Number 24 June 12, 1989
WHEN ZINC STORES ARE LOW, FOLIC ACID IS A ``NO NO''
Folic acid supplements, often prescribed during pregnancy to prevent anemia,
can actually lead to low birthweights in infants born to mothers whose body
zinc stores are low, a recent study has concluded. The study found that the
effects of folic acid on zinc were apparent only in cases of increased zinc
need or low zinc intake. Supplements that contain 400 mg or more of folic acid
can reduce the body's ability to mobilize stored zinc during stress, such as
strenuous physical exercise, the researchers found, and could cause problems
for vegetarians who eat fewer zinc-rich foods and for pregnant women. A low
zinc status in mothers has been linked to low birthweights of their infants;
zinc is involved in protein synthesis and in immune function. David B. Milne,
from the US Department of Agriculture's Human Nutrition Research Center and
colleagues from Wright State University in Dayton, Ohio and Tulane University
in New Orleans found that women with the highest blood levels of folic acid
and the lowest levels of zinc had the highest number of infections after
delivery. They concluded that obstetricians, to be on the safe side, should
prescribe zinc supplements along with folic acid supplements--especially since
people need adequate body levels of zinc to absorb folic acid from foods.
RESEARCH BRIEFS (Agricultural Research Service, US Department of Agriculture).
(Compiled from Newspapers and Medical Journals for IMTS's Healthweek In
Review.)
NIH RECEIVES GO SIGNAL ON FIRST GENE-TRANSPLANT TEST
The injection of genetically engineered cells into a human patient last Monday
marked a historic first in a series of gene-transplant experiments to be
performed on 10 melanoma patients who have life expectancies of less than
three months. The National Institutes of Health (NIH) experiments are not
expected to benefit the individual subjects, but instead the inserted genes
will be used to track the movement in the body of the cancer-fighting white
blood cells in an effort to develop future treatments. Last week's procedure
came in the wake of a court agreement that rejected a suit by critics of
genetic engineering to block the NIH from carrying out the first round of
gene-transfer trials. The plaintiffs in that suit, however, enjoyed a partial
victory. Under the settlement, signed by U.S. District Judge John G. Penn, the
public will be invited to participate in the review of any plans for similar
experiments in the future, and critics will be allowed to submit suggested
amendments to the protocol, to be studied and voted on by the NIH Recombinant
DNA Advisory Committee, which is responsible for approving such plans. The
suit, filed by the Foundation on Economic Trends and its president, Jeremy
Rifkin, had alleged that the committee approved the research involving the
skin-cancer patients without conducting proper public hearings. In the
research for which the NIH has been given the go-ahead signal, patients are to
be given a genetically altered version of a type of white blood cell called
tumor-infiltrating lymphocytes. This will allow the researchers to track the
cells in the patients. Scientists in earlier work had shown some success in
fighting cancer by taking such cells from a patient's tumor, growing them in
large numbers, and then reinserting them into the patient. THE PHILADELPHIA
INQUIRER May 17,1989 p.5A; THE ATLANTA JOURNAL AND CONSTITUTION (from The
Washington Post) May 23,1989 p.A1. (Compiled from Newspapers and Medical
Journals for IMTS's Healthweek In Review.)
Health InfoCom Network News Page 10
Volume 2, Number 24 June 12, 1989
NEW TREATMENT FOR COLITIS: CYCLOSPORIN
A small pilot study suggests that the immunosuppressant cyclosporin may heal
severe ulcerative colitis, averting the need for surgical removal of the
colon, according to researchers at the Mount Sinai Medical Center in New York
City. Simon Lichtiger and Daniel H. Present reported improvement in six of 11
patients with severe colitis after two weeks of intravenous cyclosporin
treatment. "Considering the fact that all of these patients would have lost
their colons in surgery, we believe a 55% response rate is a significant
breakthrough in the treatment of ulcerative colitis," said Lichtiger. After
six months of additional treatment with oral cyclosporin and steroids (a
conventional treatment for colitis), five of the six initially responsive
patients experienced complete remission. The sixth patient also improved, but
required continued steroid therapy. Researchers suspect ulcerative colitis is
caused by the immune system's attack on a person's own colon.
Immunosuppressants are prescribed to stem such misguided attacks, but
questions remain about cyclosporin therapy because of potential adverse side
effects. Cyclosporin, commonly used to prevent organ transplant rejection, can
cause kidney damage. So far, after monitoring kidney function, Lichtiger and
Present report no evidence of damage. To better understand the drug's efficacy
and safety, the researchers plan to start a larger study in August in
conjunction with the University of Chicago and the University of California,
Los Angeles. SCIENCE NEWS May 20, 1989; 135: 310. (Compiled from Newspapers
and Medical Journals for IMTS's Healthweek In Review.)
WEEKLY HEALTH ROUNDUP
Georgia medical societies plan to meet this summer to review practices that
deny access to a popular painkiller used in childbirth to many of the state's
poor and rural women. According to the Council on Maternal and Infant Health,
which is made up of doctors who serve pregnant women and their children, some
anesthesiologists insist on prepayment for epidural injections from uninsured
patients and others refuse to give such injections unless an obstetrician is
present. Both practices are legal, but the goal of the meeting will be to find
ways to ensure that disadvantaged patients will not be refused anesthesia even
in cases where the injections are not considered ``medically necessary.'' THE
ATLANTA JOURNAL AND CONSTITUTION May 17,1989.
For the ambitious orthodontist, China may represent the new frontier. In this
nation of 1.2 billion people, crooked and oddly shaped teeth are common--the
result of poor nutrition and lack of preventive dental care. Dental services
in general are scarce, but there are only about 300 orthodontists for the
entire country, which works out to about four million mouths per orthodontist.
THE NEW YORK TIMES May 18,1989.
Athletes who complain of feeling weak and sluggish may be suffering from
``sports anemia,'' says Beth Gasho, chief clinical dietitian at Hahnemann
University Hospital. Studies have shown that 20-25% of female athletes and 10%
of males suffer from iron deficiency. THE PHILADELPHIA INQUIRER May 18,1989.
Health InfoCom Network News Page 11
Volume 2, Number 24 June 12, 1989
The World Health organization (WHO) has set aside a Palestinian application
for admission as a member state. The application had been strongly opposed by
Israel and the United States. Instead, the countries adopted a compromise
expressing the ``hope that the Palestinian people will be fully represented''
in WHO but are putting off a decision until 1990. THE NEW YORK TIMES May
13,1989.
To better meet the needs of the research community in combating the growing
public-health problem of sexually transmitted diseases (STDs) such as
chlamydial infections, gonorrhea, syphilis, and genital herpes, the National
Institute of Allergy and Infectious Diseases (NIAID) has created an STD
branch, to be headed by Dr. Judith Wasserheit. Research on AIDS, hepatitis B,
and cytomegalovirus infection is supported in other NIAID program areas. News
release, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES May 18,1989.
More than 5,000 doctors in India's government hospitals have gone on strike,
forcing hundreds of patients to seek medical care elsewhere. The doctors want
a raise of $53 a month, an increase from $16 to $40 in a government allowance
that compensates for their not being permitted to maintain private practices,
and a promotion schedule. THE ATLANTA JOURNAL AND CONSTITUTION (AP) May
17,1989.
Drug testing will be a top issue for discussion when the baseball players'
labor contract expires after this season, says James Dworkin, Purdue professor
and baseball bargaining expert. It thus joins the traditional issues of salary
arbitration and free agency as important chips on the bargaining table. THE
WALL STREET JOURNAL May 16,1989.
A voluntary labeling system for nonprescription sunglasses has been approved
by the Food and Drug Administration that will tell consumers how much
protection from ultraviolet light the glasses will provide. Under the system,
the sunglasses will be classified in three categories--cosmetic, general
purpose (for such activities as boating and driving), and special purpose (for
use in bright sunlight as on ski slopes or at beaches). THE NEW YORK TIMES
(AP) May 18,1989.
Devices used in cosmetic tanning have caused skin burns and eye injuries, and
could cause skin cancer, according to the federal Centers for Disease Control
in Atlanta. The agency based its conclusion on a survey of doctors in
Wisconsin in 1986-87, which found that 65 of their patients had required
medical attention for burns from tanning devices. The report also said that
152 people in Wisconsin had sustained eye injuries from tanning booths or
reflector lamps. THE NEW YORK TIMES (Reuters) May 21,1989.
Indoor heating with wood-burning stoves may be associated with a high rate of
chest illness in young children, particularly bronchitis, pneumonia, and upper
respiratory infections, according to findings presented at the annual meeting
Health InfoCom Network News Page 12
Volume 2, Number 24 June 12, 1989
of the American Lung Association by J. Scott Osborne 3rd, Ph.D., M.P.H., of
Michigan State University. The stoves emit a number of chemical pollutants, he
said, many of which are well established as irritants to the tissues lining
the respiratory tract. News release, AMERICAN LUNG ASSOCIATION.
Nifedipine, a heart drug used to treat a variety of ailments, is now being
used to relieve chronic hiccups. Five of seven patients who did not respond
well to traditional treatments such as tranquilizers and narcotics showed a
favorable response to nifedipine in one study described at the annual meeting
of the American Academy of Neurology in Chicago. AMERICAN MEDICAL NEWS May
19,1989.
In spite of government efforts to destroy their crop, U.S. marijuana growers
expanded their production by 38% last year, the federal National Narcotics
Intelligence Consumers Committee estimates. This puts the United States in a
virtual tie with Mexican growers as the world's second-largest producers of
the drug, behind first-place Colombia. THE WASHINGTON POST May 18,1989.
A Senate committee has approved legislation that would bar airlines from
refusing to seat blind passengers in rows that have emergency exits. The
measure counters a proposed Federal Aviation Administration regulation that
would prohibit blind and other disabled people from sitting next to emergency
doors. THE BOSTON GLOBE (AP) May 17,1989.
Radon, formaldehyde, asbestos, and other indoor air pollutants are
Massachusetts' primary public-health hazard, the state Commission on Indoor
Air Pollution reports after a two-year study. Citing the need for tough new
laws to eliminate the problem, the commission has filed bills that would offer
tax credits for radon-removal and air-exchange systems, set minimum
ventilation standards for new homes and public buildings, and require state
certification of radon-testing and radon-removal firms. THE BOSTON GLOBE May
17,1989.
The world's population, currently 5.2 billion, is likely to nearly double to
10 billion by the year 2025 and to reach 14 billion before the end of the next
century unless birth-control use increases dramatically around the world
within the next few decades, according to a report by the United Nations
Population Fund. Declining birth rates for more than 90% of the world's
population are offset by decreasing death rates and the large proportion of
people of reproductive age in many developing countries, thus accounting for
the fact the overall population is increasing by 1.7% a year despite the
success of international family-planning efforts. THE WASHINGTON POST May
17,1989.
Several states have passed laws requiring that marriage license applicants be
provided information regarding the fetal alcohol syndrome. Wisconsin was the
first, in 1985, followed by Oregon in 1987. New Hampshire and Rhode Island
enacted similar measures in 1988, and a number of other states are considering
various approaches to alerting women to the dangers of drinking during
pregnancy and the relationship between alcohol use and birth defects. STATE
HEALTH NOTES May 1989.
A Congressional effort to shift some research related to biological warfare
from the military to a civilian agency resulted in a sharp debate between
defense officials and scientists testifying before the Senate Governmental
Health InfoCom Network News Page 13
Volume 2, Number 24 June 12, 1989
Affairs Committee on a bill designed to ``diffuse suspicion'' about the
program's aims. Rep. Wayne Owens (D-Utah) told the committee that he
introduced the legislation assigning the research to the National Institutes
of Health because ``our growing enthusiasm for Army-controlled biological
research has convinced many observers--both at home and abroad--that we are
heading into an offensive biological posture.'' THE WASHINGTON POST May
16,1989.
One-fourth of adolescent boys and 42% of adolescent girls have seriously
considered committing suicide at some point in their lives, with 18% or the
girls and 11% of the boys actually trying, a nationwide survey of more than
11,400 eighth- and 10th-grade students has shown. More than three-fourths of
the eighth-graders and almost 90% of the 10th-graders have used alcohol, and
about 5% of eighth-graders and 15% of 10th-graders reported smoking marijuana.
Most knew the risk of contracting AIDS through IV drug use or sexual
intercourse with an infected partner, but about half also believed that
donating blood increased the odds of infection, and either were unsure or
believed that washing after sex reduced the risk. THE WALL STREET JOURNAL May
22,1989.
Health InfoCom Network News Page 14
--- end part 1 of 2 cut here ---andrea@ucsd.edu (Andrea K. Frankel) (06/14/89)
In article <24823@shemp.CS.UCLA.EDU> ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) writes: > > AIDS MUTATES TO RESIST MEDICINE: > > AIDS researchers say they're racing against time to find drugs to >supplement AZT, which starts losing effectiveness within two years, new >studies show. Doctors at the Fifth International Conference on AIDS said >benefits from AZT wane after 18 months. Reasons: The virus mutates to resist >the drug and side effects make lower doses necessary. Some time ago, Steve Dyer expressed dismay when I said that local AIDS support groups were advising their members not to use AZT; he claimed that it was an excellent and useful drug and that there was no evidence against its effectiveness. This posting shows that they might have been on the right track to avoid its use. The fact that the virus is mutating to resist the drug makes me shudder. It's one thing when bacteria do it - we have a number of different antibiotics, and have some ability to develop new ones. But with the AIDS virus, we have so little ability to counter it. Is 18 months of partial relief worth it, if it unleashes a more virulent mutation of the AIDS virus in the world? Andrea Frankel, Hewlett-Packard (San Diego Division) (619) 592-4664 "wake now! Discover that you are the song that the morning brings..." ______________________________________________________________________________ UUCP : {hplabs|nosc|hpfcla|ucsd}!hp-sdd!andrea Internet : andrea%hp-sdd@hp-sde.sde.hp.com (or @nosc.mil, @ucsd.edu) CSNET : andrea%hp-sdd@hplabs.csnet USnail : 16399 W. Bernardo Drive, San Diego CA 92127-1899 USA
merrill@bucasb.bu.edu (John Merrill) (06/14/89)
On 14 Jun 89 00:23:17 GMT, hp-sdd!hp-sdd.hp.com!andrea@ucsd.edu (Andrea K. Frankel) wrote <Quotes reports that HIV-I appears to be able to become resistant to AZT.> AF> The fact that the virus is mutating to resist the drug makes me shudder. AF> It's one thing when bacteria do it - we have a number of different AF> antibiotics, and have some ability to develop new ones. But with the AF> AIDS virus, we have so little ability to counter it. Is 18 months of AF> partial relief worth it, if it unleashes a more virulent mutation of the AF> AIDS virus in the world? This argument is specious in several, not terribly subtle, ways. First, it assumes that the "new" strain is more virulent than the older strain. In fact, AZT acts by inhibiting the action of viral reverse transcriptase, which the virus causes to be synthesized in order to infect its eventual host cells. The virus mutates by not using this pathway, but rather by using a less efficient method of infection---that is, by becoming *less* virulent. Second, it assumes that the "new" strain is, in fact, "new". In fact, the "new" strain of HIV is almost certainly co-existent with the "wild-type strain". It can't compete with its stronger cousin, however, except in those circumstances where its stronger cousin is selected against---that is, within the body of an immunocompromized human who is taking AZT. Finally, the argument ignores the fact that other anti-HIV drugs can be constructed which interrupt the slower pathway. AZT is not a wonder drug, except insofar as it's all there is. As the metabolic pathway by which HIV infects cells is elucidated, combinations of drugs will be found that interrupt multiple infection pathways. Since multiply-resistant strains are geometrically less common than singly-resistant strains, such synergistic treatments will surely be less prone to the selective effects of a single agent. This does mean that an asymoptomatic HIV-positive who begins a course of prophylactic AZT therapy is balancing the preservation of his or her immune system, and the resulting wide-spectrum defense of his or her health, against the eventual emergence of AZT-resistant strains of the virus within his or her body. It is possible that the weakened AZT-resistant strain might be successfully resisted by the stronger immune system of the patient who is taking prophylactic therapy, but in the absence of data, no scientific conclusions can be drawn. But the possible emergence of AZT-resistant strains of the virus is not a good reason for a person with full-blown AIDS to avoid AZT. Anyone who argues that it is is causing unnecessary suffering to an already terrible fate. -- John Merrill | ARPA: merrill@bucasb.bu.edu Center for Adaptive Systems | 111 Cummington Street | Boston, Mass. 02215 | Phone: (617) 353-5765
dyer@spdcc.com (Steve Dyer) (06/14/89)
In article <24863@shemp.CS.UCLA.EDU> andrea%hp-sdd.UUCP@ucsd.edu (Andrea K. Frankel) writes: >> AIDS MUTATES TO RESIST MEDICINE: >>benefits from AZT wane after 18 months. Reasons: The virus mutates to resist >>the drug and side effects make lower doses necessary. >Some time ago, Steve Dyer expressed dismay when I said that local AIDS >support groups were advising their members not to use AZT; he claimed >that it was an excellent and useful drug and that there was no evidence >against its effectiveness. This posting shows that they might have been >on the right track to avoid its use. Andrea, maybe you're reading in between the lines and spaces, but what I read doesn't say any such thing. If someone is diagnosed with AIDS (not simple HIV+ status), then there is overwhelming evidence that AZT will prolong life compared to people who do not take AZT (or presumably some other anti-viral--but AZT is the only approved drug right now, and the only one with long-term studies of its efficacy.) There are some medical reasons that a selected subset of people might be advised to not take AZT, but these reasons do not include "AIDS is caused by a suppressed immune system, AZT suppresses the immune system, therefore don't take AZT", which was the original sentiment to which I responded a few weeks ago. Viral resistance is not an uncommon phenomenon, and it's not surprising that we're beginning to see reports of this in people taking AZT. The challenge is to find regimens, possibly in combination with other drugs, which increase its effectiveness, decrease its toxicity and hopefully delay the development of resistance. However, this is not an argument to *not* use AZT right now in people who can benefit from it. Avoiding it all together when it could be used safely is almost a guarantee of a shorter life. The first reports of resistance are probably more important to those researchers who are looking into AZT as an early intervention in asymptomatic HIV+ individuals. Its efficacy versus toxicity versus the development of resistance versus cost are all parameters which have yet to be determined. -- Steve Dyer dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer dyer@arktouros.mit.edu