ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (08/28/89)
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Volume 2, Number 31 August 28, 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
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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 August 27, 1989 .......................... 1
Medical News from the United Nations .................................. 9
2. News from the National Institute of Dental Research
Dental News from NIDR ................................................. 11
3. Food & Drug Administration News
News from the FDA ..................................................... 12
4. Meeting Announcements
MEDINFO '89 Singapore - World Congress Meeting ........................ 17
Health InfoCom Network News Page i
Volume 2, Number 31 August 28, 1989
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Medical News
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Medical News for Week Ending August 27, 1989
Copyright 1989: USA TODAY/Gannett National Information Network
Reproduced with Permission
August 21, 1989
----
GENERICS UNDER SCRUTINY:
Disagreement between doctors and the U.S. Food and Drug Administration
about safety and effectiveness of generic drugs might be due to cumbersome
procedures that discourage doctors from reporting problems. The FDA says no
firm evidence shows generics are less safe or effective than brand names. (For
more, see special Generics package below. From the USA TODAY Life section.)
TWO DRUGS BETTER THAN ONE:
Men with advanced prostate cancer live longer when two drugs inhibiting
male hormone production are combined, say researchers at the University of
Colorado Health Sciences Center in Denver. Using a newly approved drug,
flutamide, in combination with leuprolide, the group found that survival rates
rose seven months using the combination therapy, compared to leuprolide
therapy alone.
RECORD MEASLES OUTBREAK IN 1989:
Measles are blossoming in Chicago and grabbing hold in Washington, D.C.,
but overall the rash of outbreaks is slowing. Still, 1989 could be a record
year for measles. The latest numbers: 9,189 cases through Aug. 12, vs. 2,046
through the same period in 1988 - a 350 percent increase. Year-end total could
reach 10,000 to 12,000 cases.
CITIES, COLLEGES HIT BY MEASLES:
Measles cases are being reported in several parts of the country, say
health experts. Hardest hit by the outbreaks: Kent (Ohio) State University and
Texas Tech University in Lubbock had 300 to 400 cases each. Houston (1,800
cases), Los Angeles (1,000) and Chicago (800) combined have 40 percent of U.S.
cases. Houston and L.A. numbers are slowing; Chicago's aren't.
SPECIAL PACKAGE ON GENERICS:
CONCERNS ABOUT CONSISTENCY:
Generic drugs can provide substantial savings and in general doctors
support their use, say medical experts. Concerns arise about the potential for
a generic drug to vary from the brand name in the way it's broken down in the
bloodstream and for generics of the same type to vary from one another, says
Dr. Stanley van den Noort, of the American Academy of Neurology.
PROCEDURES DISCOURAGE DOCTORS:
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Volume 2, Number 31 August 28, 1989
Experts from the American Academy of Pediatrics and American Academy of
Family Physicians say federal reporting procedures make it too difficult for
doctors to document problems with generic drugs. Examples: Drugs that pack too
much of a punch and caused a toxic reaction, or packed too little and failed
to relieve symptoms.
FDA PROMISES MORE SCRUTINY:
As investigations of the generic industry and FDA approval practices
continue, the agency says it is hoping to restore confidence in both with an
overhaul of its generic division. Included: an ombudsman to better address
complaints about generics and more scientific scrutiny of how they compare to
brand-name drugs.
Aug. 22, 1989
----
MORE PEOPLE BUYING KOSHER FOOD:
Concern for good health is prompting more people than ever before to buy
kosher foods. More than 6 million U.S. residents -Jews and non-Jews alike -
regularly buy kosher food products, and the number of products is increasing.
Among the new entries: pizza wraps, ravioli and cookies. About 17,500 kosher
products are available in the United States. (From the USA TODAY Life
section.)
BRAND NAME DRUGS SCRUTINIZED:
The brand name drug industry will be in the fray that has rocked generic
drug makers and eroded confidence in some prescription drugs. The Food and
Drug Administration's Jeff Nesbit said Monday, "a very well-known brand name
company that we're wrapping up an investigation of has exactly the same kind
of problems as the generic industry." (From the USA TODAY News section.)
AIDS HOT LINES BUSY:
AIDS hot lines in cities hardest hit by the epidemic are extra hot this
week, following news that AZT can postpone the onset of AIDS, even in
symptomless infected people. But a nationwide stampede to testing centers
appears unlikely, health officials said. (From the USA TODAY Life section.)
AIDS POLICY A MUST FOR 1990S:
Companies that don't formulate policies to deal with AIDS in the workplace
are setting themselves up for enormous economic and public relations problems,
an author argues in her new book. Dr. Joan Turner, author of AIDS: Policies
and Programs for the Workplace, said the development of company policies and
creation of AIDS education programs at work was a necessity for the 1990s.
FIRST CHILD INFLUENCE SEEN:
A woman whose first child is a boy is quicker to have a second child than
one whose first child is a girl, suggests a study of the of 15,000 women
tracked by the government's National Survey of Family Growth. Reason: Husbands
are more involved with the child and marriages are more apt to last if the
first child is a boy, researchers said. (From the USA TODAY Life section.)
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Volume 2, Number 31 August 28, 1989
NEW TEST FINDS RARE MS:
A new test for a rare type of muscular dystrophy can distinguish it from
other forms and avoid potentially life-threatening diagnostic errors. The
Muscular Dystrophy Association reports the test - for Becker muscular
dystrophy -analyzes the protein dystrophin for abnormalities that are unique
to Becker MS.
THEORY - MOON SPEEDS BIRTHS:
Hospitals across the nation last week reported a surge in births during
Wednesday's rare total lunar eclipse. A nurse at a South Florida hospital said
changes in barometric pressure could be speeding pregnant women into delivery,
but some doctors expressed doubt about the long-disputed theory linking birth
and changes in tides and weather.
ROBOTS ASSIST DOCTORS:
A new generation of advanced robots is assisting doctors at Danbury (Conn.)
Hospital. The robots, trademarked "Helpmate," took two years and $2 million to
develop. One model can follow wheelchair-bound patients, carrying medication
and food, while another, more advanced model has assisted doctors performing
surgeries from hip replacements to brain surgery.
STOP SMOKING VIDEO DUE OUT:
The American Cancer Society has a new weapon to help smokers quit. The
society will soon release a video designed to help smokers through what it
calls the "critical period" - the first three weeks. The video - dubbed
"Freshstart," is hosted by comedian Robert Kline, and includes expert advice
from physicians, psychologists and ex-smokers. Price: $9.95. It will be out
Oct. 1.
DOUBLE TREATMENTS STOP CANCER:
Twice-a-day treatments of radiation therapy might be more successful at
battling cancer than traditional once-a-day treatments, new research shows.
University of Florida oncologists based their findings on success rates in 11
years of treatments. Doctors said the twice-a-day treatments increased the
success rate for stopping cancer growth by 20 percent.
OBESITY UP AMONG KIDS:
Obesity has increased 54 percent among children in the past 20 years, a new
study indicates. The study, in the August issue of the American Journal of
School Health, says obesity is an increasing cause of personal unhappiness
among adolescents. The study also noted that diet programs had average
recidivism rates of between 75 and 95 percent.
YO-YO DIETING PROMOTES OBESITY:
"Yo-yo dieting" and the body's natural tendency to slow metabolism during
dieting make weight loss difficult. A University of Florida researcher found
that obese people who "weight cycle," or repeatedly lose and gain weight,
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Volume 2, Number 31 August 28, 1989
might be predisposed to obesity. The body's natural defense against starvation
cause the body to metabolize food more slowly during dieting.
POLIO RETREATING AGAINST FIGHT:
World Health Organization officials say steps are under way that could wipe
out polio in the Western Hemisphere by the end of 1990. A recent report from
the Massachusetts Medical Society noted that great strides had been made
against the disease, mostly due to immunization programs. Only 11 countries
reported any incidence of the disease in the 1980s, down from 19 in 1974.
Aug. 23, 1989
----
KIDS WITH ASTHMA SELF-CONSCIOUS:
About half of the United States' 3 million asthmatic children might suffer
emotionally and socially because of the illness, says a report out Wednesday.
The malady embarrasses children and makes them feel self-conscious and
socially restricted, says the report based on interviews with 1,150 parents
and adult asthmatics conducted by Cornell University. (From the USA TODAY Life
section.)
ASTHMA CASES ON THE RISE:
In an asthma attack, tubes that bring air into and out of the lungs
constrict, causing breathing difficulty. Attacks can be treated with drugs. A
recent survey found 72 percent of school nurses and 46 percent of
pediatricians reported a rise in asthmatic children in the past ten years; 42
percent of physicians saw more adult patients. (From the USA TODAY Life
section.)
GENERICS HAVEN'T CAUSED DEATHS:
Investigations of the prescription drug industry involving at least a dozen
generic and one brand-name company have not uncovered any deaths or serious
injuries so far, federal officials say. Competition led some generic drug
companies to cheat on testing, use sloppy manufacturing practices and bribe
Food and Drug Administration officials. (From the USA TODAY News section.)
FDA APPROVES NICOTINE PATCH:
The Food and Drug Administration approved a new transdermal nicotine patch
for use in smoking cessation programs. Elan Corporation, maker of the Nicolan
Patch, said it licensed the patch to Warner-Lambert, and it would be marketed
through the Parke-Davis group. Clinical trials found the quit rate among
smokers using the patch was twice that of smokers using other cessation
programs.
TRANSPLANTS RISKY FOR TEENS:
The problems of adolescent rebellion makes teen-agers the riskiest
candidates for organ transplants and cause transplant death rates twice as
high as those for any other age group, doctors are warning. Reasons:
Rebellious teens often don't follow the demanding regimens for medication and
follow-up treatment, and family support is sometimes lacking.
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Volume 2, Number 31 August 28, 1989
INJURED KIDS' FAMILIES SUFFER:
The families of injured children often suffer severe emotional trauma
within a year of the child's injury, a new survey finds. Doctors at Boston's
New England Medical Center studied the families of 57 children who suffered
pediatric trauma. Sixty-six percent of the children's uninjured siblings
suffered emotional problems and 32 percent of the parents said they had
marital problems.
MED SCHOOL ANXIETY STUDIED:
The number of first year medical students experiencing depression doubled
during a recent nine-month study. The study, in the Aug. 18 Journal of the
American Medical Association, examined students' stress levels between
September and May of their first year of medical school. On the average,
anxiety increased and satisfaction with social supports decreased.
KIDNEY TRANSPLANT WAIT DOUBLES:
The waiting time to get a donor kidney doubled between 1987 and 1988, a
leading transplant hospital said this week. The University Hospital at Stony
Brook, N.Y., noted that the waiting time for a donor kidney went from 126 days
in 1987 to 233 days in 1988. About 30 percent of dialysis patients could
return to normal lives with a transplant.
LINK TO MENINGITIS SPOTTED:
Doctors at Johns Hopkins University have identified a protein deficiency in
the immune systems of some children that puts them at higher risk for
contracting meningitis. The disease is an infection of the membranes covering
the brain and spinal cord. Although some 40,000 children contract the disease
each year, many more are exposed to the bacteria that causes it.
Aug. 24, 1989
----
UNINSURED INFANTS SUFFER:
Babies born to parents without health insurance are 31 percent more likely
to die during infancy or suffer serious illness, a study released Wednesday
shows. Doctors at the University of California, San Francisco, studied records
of more than 146,000 births in the San Francisco area. (From the USA TODAY
Life section.)
GENERIC INSPECTIONS BEGIN:
The Food and Drug Administration has begun inspections of the 20 leading
manufacturers of generic drugs, the agency announced Wednesday. The effort
adds to the nationwide testing of the 30 leading generic drugs begun last
week. The new inspections include brand name companies that also make generic
drugs. (From the USA TODAY News section)
DRUG REDUCES HAIR PULLING URGE:
Doctors at the National Institute of Mental Health say a new drug shows
Health InfoCom Network News Page 5
Volume 2, Number 31 August 28, 1989
promise for treating obsessive-compulsive hair pulling. Tests of the drug
chlomipramine appeared to help reduce the urges in 13 women who suffered from
the disorder, called trichotillomania. Results were published in Wednesday's
New England Journal of Medicine. (From the USA TODAY Life section.)
8 MILLION HAVE DISORDER:
About 8 million Americans suffer from the psychological disorder
trichotillomania, the National Institute of Mental Health reported in
Wednesday's New England Journal of Medicine. The obsessive-compulsive disorder
prompts its victims - most of whom are women - to pull their own hair out. A
recently discovered therapy to fight the disease might be the first effective
known treatment for it.
SMOKING BAD FOR CAREER HEALTH:
More bad news for smokers: A survey shows that one out of four job
applicants who smoke will be turned down because of their habit. The survey,
conducted by Robert Half International Inc., quizzed 100 personnel directors
at top companies. Findings: One-quarter of them would chose the non-smoker if
two equally qualified candidates, one of whom smoked, applied for a job.
WORKING MOM'S KIDS HAPPIER:
Children of single working mothers are happier than kids of single moms who
don't work, a study shows. Loyola University researchers also found children
of working mothers were more well-adjusted. Reasons: working moms ease the
financial tension on the single-parent family, and the kids respond to the
mother's sense of accomplishment. The study is in the September Working
Mother.
TYPE A KIDS MORE COMMON:
An increasing number of children are developing the "Type A" personality
traits of their parents - impatience, anger and a "must win" attitude, a child
psychologist claims. Dr. Paul Bracke reports in the September Working Mother
that children develop these tendencies when parents link the child's worth to
performance. Type As are thought to be at high risk for heart disease later in
life.
SEVEN TYPES OF KNOWLEDGE NOTED:
A Harvard University researcher claims there are seven different types of
intelligence, while the nation's schools test children for only two of them -
mathematical and verbal. Dr. Howard Gardner adds linguistic, logical,
musical, spacial and kinesthetic to the list in an article published in the
September issue of Working Mother.
VOICE COMPUTER HELPS IMPAIRED:
A new voice-controlled computer system is helping the handicapped operate
personal computers. The system, built from a Zenith Data Systems PC and Flat
Technology monitor, includes voice recognition software that allows the
severely handicapped to operate the PC. Producer Health/Zenith Educational
Systems says the system also recognizes slang words and dialects.
Health InfoCom Network News Page 6
Volume 2, Number 31 August 28, 1989
TRANSPLANT FIRST REPORTED:
The University of Pittsburgh-Presbyterian Hospital reports 53-year-old
JoAnne Smith, who received a double lung transplant five weeks ago, received a
new liver this week and was recovering from the latest transplant. Doctors at
the hospital said Smith was the first American to undergo both surgeries.
Smith remained in a coma Tuesday, but doctors said they were hopeful she would
recover soon.
Aug. 25-27, 1989
----
CYSTIC FIBROSIS GENE FOUND:
Researchers announced they've discovered the gene that causes cystic
fibrosis, a fatal disease that strikes about 1,200 patients a year. Doctors
from the Hospital for Sick Children Research in Toronto, Howard Hughes Medical
Institute, Frederick (Md.) Cancer Research Facility, and the Universities of
Pittsburgh and Michigan cooperated in the finding. (From the USA TODAY Life
section.)
DISEASE ATTACKS LUNGS:
Cystic fibrosis is one of the most common fatal diseases striking young
people in North America. About 30,000 U.S. residents have CF. The disease
causes its victims' systems to produce abnormally thick mucus, clogging and
infecting the lungs. About half die from infections before reaching their
mid-20s. About 1,200 new cases are diagnosed each year.
NEW DRUG FIGHTS HEART ATTACKS:
A new class of drugs shows promise for reducing heart attack deaths,
according to a report from Baylor College of Medicine. Researchers found that
a group of compounds, called lazaroids, have been proven in animal tests to
inhibit lipid peroxidation, a process that destroys cells during a heart
attack. Heart attacks kill more than 500,000 U.S. residents each year.
EXERCISE KEEPS ELDERLY NIMBLE:
A consistent pattern of exercise could help keep older people more agile,
preventing debilitating accidents, says a study by doctors at Washington
University in St. Louis. The study suggests that an organized exercise program
improves the brain's central processing time, speeding reflex action that
could prevent or lessen the severity of falls and other accidents.
QUICK ANGER SHORTENS LIFE:
People who express "Type A" personality traits - anger hostility and
mistrust - are five times more likely to die before the age of 50 from heart
ailments than people who don't have the traits, a new study shows. Doctors at
the Duke University Medical Center, Durham, N.C., found that people who
angered easily, and who quickly express that anger, have a significantly
higher death rate.
SLEEP RIGHT FOR LONG LIFE:
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Volume 2, Number 31 August 28, 1989
Doctors at the University of California at San Diego have found that people
who sleep much more or much less than normal are more susceptible to heart
attacks. Their findings indicate that when sleeping patterns greatly deviate
from an average of about seven or eight hours a night, death rates are higher.
Theory: Sleep apnea, a disturbance in breathing patterns during sleep, could
be the key.
ANGIOPLASTY SUCCESSES NOTED:
Angioplasty - the procedure in which a balloon catheter is inserted into a
blocked artery and inflated - has been performed more than 150,000 times per
year since its first use. A review of those procedures by a Harvard researcher
indicates that the process has more than a 90-percent success rate, and that
fewer than one percent of angioplasty patients die when the artery is cleared.
TRAFFIC JAMS BAD FOR HEALTH:
Motorists stuck in traffic jams inhale four times the air pollution they're
exposed to when the car is in motion. Researchers at the California's South
Coast Air Quality Management District reported in the September Hippocrates
magazine that ozone monitors installed in the cars of 140 Los Angeles
commuters showed the higher ozone levels during traffic jams.
TEAM FINDS RODEO DISEASE:
A team of Seattle sports medicine specialists have discovered a disorder
peculiar to the rodeo circuit. It's called bronco-busters elbow, and the
researchers found 30 of 39 finalists in one rodeo had it. The painful ailment
is caused by bone spurs in the elbow that result from pressure on the arm used
to hold onto the animal. The bucking causes the bones to rub together.
HORMONES MIGHT HELP WOMEN SLEEP:
The same female hormones that drive reproduction might help women sleep
better, according to scientists at the University of Colorado. The researchers
compared the incidence of sleep disturbance in two groups of women while one
received extra doses of the hormones. The group that got the extra doses slept
significantly better than those who didn't take the supplement.
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Volume 2, Number 31 August 28, 1989
ORGAN DONATION FROM ANENCEPHALIC BABIES: CATCH-22
Despite the fact that organs from anencephalic infants could be transplanted
into some of the many infants and children whose tiny organs are defective or
have failed, current laws effectively prevent the removal of organs while they
are still viable, according to a recent study. Anencephalic infants are born
with little or no brain and many die within one week. Current law states that
organs cannot be removed until a person is declared brain dead. The criterion
for brain death is met when there is no brain-stem activity. The problem with
taking organs from anencephalic infants is that if the infants are kept alive
for more than one week, their organs undergo irreversible damage. Denying such
care until signs of imminent death are apparent also damages the organs. In
the recent study, 12 live-born anencephalic infants were given different
medical care to determine if their organs could be protected for later
transplantation. Six infants received intensive medical care from birth, while
the other six were given care only when signs of imminent death occurred. One
infant from each group met the criteria for death at the end of one week. When
intensive care was given from birth, organ function was maintained but the
infant did not die within the week. When care was withheld until signs of
death appeared, most organs were too damaged to be used. ``The data suggests
that it is not feasible, within the restrictions imposed by current
requirements of brain death, to procure from anencephalic infants a
substantial number of hearts and livers for transplantation,'' wrote Joyce
Peabody, M.D., department of pediatrics, Loma Linda University Medical Center,
Loma Linda, Calif. The medical and ethical implications of the study were
further debated in two related editorials. About 375 anencephalic infants
could be potential organ sources each year in the US, if the laws were
changed, estimated Robert Truog, M.D., of the Harvard Medical School. Dr.
Truog proposed that these infants, along with brain-dead people, not be judged
to be alive. Considering that rarely do anencephalic infants survive more than
one week, along with the fact that they do not feel pain as we know it, Dr.
Truog wrote that ``transplantations should be permitted without regard for the
criteria of brain death.'' However, Donald Medearis, M.D., of the
Massachusetts General Hospital, wrote that because of the increasing accuracy
of prenatal testing, and the possibility that mothers of such fetuses may
elect to abort them, fewer and fewer anencephalic infants are born in the US.
He estimated that fewer than 10 infants per year could benefit from organs
from anencephalic babies. He concluded that ``medical evidence and ethical and
practical arguments strongly favor retaining current law.'' N ENGL J MED
August 10,1989; 321:344-350,388-393. (Compiled from Newspapers and Medical
Journals for IMTS's Healthweek In Review.)
VEGETABLES MAY REDUCE RISK OF LUNG CANCER IN SMOKERS
Eating a variety of vegetables may decrease the risk of developing lung
cancer, a recent cross-cultural study in Hawaii suggests. According to Loic Le
Marchand and colleagues from the Epidemiology Program at the University of
Hawaii, the findings of a 1983-85 population-based study lend support to
previous claims about beta-carotene's protective role against lung cancer. The
investigators further concluded that all vegetables, not just those rich in
beta-carotene, showed a dose-dependent negative association with the disease.
The risk of developing lung cancer, in both males and females, was inversely
related to the amount of vegetables consumed. After adjustments for smoking,
men with the lowest total vegetable intake had nearly three times the risk of
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Volume 2, Number 31 August 28, 1989
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