ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (08/20/89)
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Volume 2, Number 30 August 19, 1989
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! Health Info-Com Network !
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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
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T A B L E O F C O N T E N T S
1. Comments & News from the Editor
We're Back In Service! ................................................ 1
2. Medical News
Medical News for Week Ending August 20, 1989 .......................... 2
Medical News from the United Nations .................................. 7
3. Center for Disease Control Reports
[MMWR 8-10-89] Non-A, Non-B Hepatitis ................................. 12
Progress Toward Eradicating Poliomyelitis from the Americas ........... 15
Urogenital Anomalies in Offspring of Women Using Cocaine .............. 18
Deaths from Diabetes .................................................. 21
End-Stage Renal Disease Associated with Diabetes ...................... 22
4. General Announcments
Ethical Issues in Biomedical and Behavioral Research .................. 24
News from Division of Research Grants NIH ............................. 26
Health InfoCom Network News Page i
Volume 2, Number 30 August 19, 1989
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Comments & News from the Editor
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We're Back In Service!
Well after several weeks of frustration, I've been able to get back on
schedule putting together the newsletter. As many of you know, my home was
struck by lighting several weeks ago, totally destroying the computer that I
not only compose the newsletter on, but other electronic appliances in our
home.
Luckily, with the insurance claim, and a matching grant from St. Joseph's
Hospital, we were able to get a updated machine with multi-tasking cabilities
that will allow me to put together much easier.
I also want to thank everyone who sent me electronic mail expressing concern
for me and my families well-being. The messages of appreciation and concern
really helps me get through the hours of putting the newsletter together.
Again, thank you.
And now to our regularly scheduled newsletter.
David
Health InfoCom Network News Page 1
Volume 2, Number 30 August 19, 1989
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Medical News
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Medical News for Week Ending August 20, 1989
Source: USA TODAY/Gannett National Information Network
Copyright 1989, Reproduced with Permission
IRRATIONAL AIDS FEAR PERSISTS:
One out of five Americans still believes - incorrectly - that the deadly
AIDS virus can be contracted by donating blood, a new study finds. The
American Association of Blood Banks said Tuesday that fear of the disease from
blood donation or transfusion was decreasing from previous years. (From the
USA TODAY Life section.)
MOST WANT THEIR OWN BLOOD:
An overwhelming percentage of U.S. residents would prefer to use their own
previously donated blood for surgery because of fear of contracting AIDS from
donated blood, says a survey by the American Association of Blood Banks. The
agency said the chances of getting AIDS from a blood transfusion were between
one in 100,000 and one in 200,000 nationwide. (From the USA TODAY Life
section.)
FEDS RAID GENERIC MAKERS:
Investigators raided drug manufacturers nationwide Tuesday in a search for
fraudulent generic drugs. Food and Drug Administration officials said seizures
could continue for weeks. Officials have found evidence that manufacturers
used bribes and false tests to win drug approval. (For more, see the special
Generic section below. From the USA TODAY News section.)
HUMAN TASTE BUDS HIGHLIGHTED:
Humans taste bitterness as a defense against accidental poisoning, new
research shows. The research, by doctors at Yale University, was delivered to
the American Psychological Association's meeting in New Orleans this week. The
findings also show that the humans can be divided into two groups, one with a
distinctly sharper sense of taste than others.
SKIN CANCER, WINE LINK FOUND:
Researchers at Yale University have found a link between skin cancer and
wine consumption. The study, conducted with 117 patients with precancerous
moles, was trying to establish a link between sun exposure and the condition
of the moles. They found instead that although the sun could make moles
appear, the moles were more likely to turn cancerous if the patients drank
wine.
ONLY CHILD PRONE TO HIGH BP:
An adult who is an only child is more likely to have high blood pressure
than associates with siblings, a new study shows. Doctors at the University of
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Volume 2, Number 30 August 19, 1989
Buffalo found a "significantly higher" systolic and diastolic blood pressure
among lone children than in a control group. Theory: The only children's
hypertension could be due to increased stress because of parents' high
expectations.
NEW BONE TECHNIQUE AT WORK:
Doctors at the Children's Hospital of Buffalo are using a new technique to
stretch the crushed shoulder bone of an Armenian earthquake victim so it will
accept an artificial limb. A surgeon at the hospital is working to quadruple
the length of the bone left after Armenian doctors amputated the 14-year-old's
arm.
ONE FIBER FIGHTS CANCER BETTER:
Fiber from fruits and vegetables appears to have more power to fight a
specific type of cancer than fiber from grains, a new study shows. Doctors at
the University of Buffalo found that fiber from grains was more effective at
fighting rectal cancer than other types of fiber, probably because of
differences in the fermentation process that breaks the fiber down during
digestion.
SPECIAL PACKAGE ON GENERICS:
GENERICS CUT HIGH HEALTH COSTS:
Generic drugs are increasingly prescribed by doctors under pressure from
consumers and insurance companies seeking ways to hold down health care costs.
Generic drugs are supposed to be as effective as brand name drugs. More than
430 million prescriptions for the drugs were written last year, the FDA said.
GENERICS SUBJECT OF PROBE:
The nation's generic drug approval process has been under investigation by
health officials for more than a year. Food and Drug Administration officials
found production records were falsified to meet federal standards, and
different versions of drugs than those approved were sold to consumers. So
far, four FDA officials have pleaded guilty to various charges, the FDA said.
SOME IN INDUSTRY WANTED RAIDS:
Hemant Shah, a drug analyst with HKS and Co., a Wall Street brokerage firm,
said some companies had suggested the unannounced inspections because generic
drug manufacturers wanted to clear the air. "Eighty percent of generics are
manufactured by companies not under investigation," he said.
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Aug. 17, 1989
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ALCOHOL HURTS BREAST-FED KIDS:
Mothers who drink alcohol while breast-feeding their baby could be slowing
the child's development, a new study shows. Doctors at the University of
Michigan found that mothers who breast-fed their children and drank one drink
a day scored significantly lower on a test to measure motor skills at one
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Volume 2, Number 30 August 19, 1989
year. (From the USA TODAY Life section.)
IQ, HOME LINK SPOTTED:
A study finds that adopted children, regardless of the backgrounds of their
natural parents, have IQs an average 12 points higher when raised in affluent
homes. Thursday's Nature reports researchers found that children with well-to-
do natural parents adopted by poorer families scored 15 points higher than
those born to less wealthy folks. (From the USA TODAY Life section.)
CHECKING UP ON DOCTOR IS TOUGH:
A Connecticut study by two doctors seeking to verify the expertise of
doctors found that verification was nearly impossible, and the release of
information on a physician's skills was often at the whim of organizations or
the physicians themselves. The study, in Thursday's New England Journal of
Medicine, was conducted by doctors Julia M. Reade and Richard M. Ratzan.
JUNK FOOD AT THE FAIR:
Experts said this week that eating in moderation before and after a summer
county fair can help the body compensate for the high-calorie treats Americans
often enjoy at the celebrations. A low-calorie diet for two days before and
three days after a fair can discount the impact of high-calorie snacks
consumed and reduce the shock to the system.
NEW ALZHEIMER'S STRIDE MADE:
Scientists have taken an important step toward understanding Alzheimer's
disease by showing how a protein damages brain cells in victims. The 12-member
team has mass-produced the protein in a test tube, creating the first model of
how senile placques form on brain cells of Alzheimer's victims. Until now,
that formation could only be studied in cadavers, scientists said.
ALZHEIMER'S STRIKES 2.5 MILLION:
More than 2.5 million people in the United States suffer from Alzheimer's,
an incurable degenerative disease that attacks the brain, impairing memory,
thinking and physical functions. The disease most often afflicts the elderly,
but patients can be as young as 40.
TINY WASP FIGHTS LYME DISEASE:
Researchers at the University of Massachusetts are hoping the microscopic
larvae of the tiny chalcid wasp will help them battle Lyme disease. The larvae
are parasites that kill dear ticks, which carry the disease. When the insects
were introduced on a Naushon Island near Martha's Vineyard in 1926, the tick
population there dropped 30 percent, researchers said.
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Aug. 18-20, 1989
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AZT HELPS EARLY AIDS SUFFERERS:
Up to 425,000 seemingly-healthy people with immune systems damaged by the
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Volume 2, Number 30 August 19, 1989
AIDS virus could stay well longer by taking the drugs AZT, officials said
Thursday. The findings were based on a two-year study of 3,200 patients who
had aids, but no symptoms. Two weeks ago, scientists announced AZT might help
up to 200,000 people with early pre-AIDS symptoms. (From the USA TODAY Life
section.)
AIDS DRUGS TO BECOME AVAILABLE:
A Food and Drug Administration committee, responding to demands from AIDS
activists, endorsed a plan to make experimental AIDS drugs more widely
available Thursday. At issue: allowing people who don't qualify for or can't
get into regular drug trials to get experimental drugs through a so-called
parallel track system. Many details remain to be settled. (From the USA TODAY
Life section.)
DEPRESSION TOPS LIST OF ILLS:
A new study of depression finds that it's more disabling than arthritis,
ulcers, diabetes or high blood pressure in terms of limiting people or causing
them to stay in bed. The study, coordinated by the RAND Corp. looked at 11,242
adult outpatients in a variety of settings. Depression afflicts nearly 10
million Americans. (From the USA TODAY Life section.)
GENERIC INDUSTRY SUPPORTS RAID:
The generic drug industry supports the Food and Drug Administration's
sweeping investigation of the top 30 generic drugs - an investigation begun
amidst revelations of drug switching and other fraud, industry experts said
Thursday. Officials raided drug warehouses earlier this week and confiscated
generic drugs to test their safety. (From the USA TODAY Life section.)
GENETIC RESEARCH KEY TO DISEASE:
Genetic research is speeding the diagnosis of muscular distrophy and could
lead to therapies for the disease. Genica Pharmaceuticals Corp. recently
introduced a conclusive test to detect the presence of the disease in infants.
Previous testing could offer a probable answer, but weren't conclusive. The
testing also led to a protein doctors believe is linked to the degenerative
disease.
FIRES CLAIM 6,277 IN 1988:
The National Fire Protection Association said this week that 6,215
civilians died in fires during 1988, a 7 percent jump from 1987's total of
5,810. The figures do not include 62 firefighters killed battling blazes.
Officials said the increase indicated that more attention needed to be paid to
strict fire code enforcement.
VITAMINS DON'T STOP DEFECTS:
Taking vitamins before pregnancy doesn't reduce the risk of birth defects,
a new study finds. Doctors at the National Institute of Child Health and Human
Development found that the use of multiple vitamins by mothers prior to
pregnancy was not linked to a reduction in birth defects, Thursday's New
England Journal of Medicine reports.
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Volume 2, Number 30 August 19, 1989
DIETERS NEED EXERCISE, TOO:
Those "no exercise" weight loss programs might help people lose weight, but
much of what they lose will be lean tissue, not fat. The August American
Journal of School Health says researchers studied obese women on an 800-
calorie per day liquid diet. Those who exercised found that 74 percent of the
weight they lost was composed of fat. Sedentary dieters' losses were 54
percent fat.
NCI HAS NEW PAP SMEAR SYSTEM:
The National Cancer Institute announced a new system for reporting the
results of cervical/vaginal Papanicolaou, or "Pap" smears. The new "Bethesda
System," developed at an NCI workshop in Bethesda, Md., should clarify the
scientific interpretation of test results, NCI officials said. A Pap smear
tests cell scrapings for the presence of cancer.
APNEA LINKED TO DEPRESSION:
A new study of kidney dialysis patients has found that 85 percent of them
have symptoms of sleep apnea, a periodic cessation of breathing during sleep.
Doctors at George Washington University Hospital said the research might be
the source of depression that often appears in the late stages of renal
disease. Sleep apnea causes patterns of sleep disturbance and can trigger
depression.
PELLETS FIGHT LUNG CANCER:
Doctors at Johns Hopkins University are using a new treatment designed to
deliver radioactive pellets into the lungs of patients with inoperable cancer.
Researchers admit the treatment is designed to "buy quality time" for the
patients by forcing their cancer to retreat temporarily. The radioactive
pellets are delivered via a fiber optic scope placed into the lung, then
retrieved later.
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Volume 2, Number 30 August 19, 1989
Medical News from the United Nations
UNICEF: DISNEY, UNICEF PLAN JOINT HEALTH PROJECT
Mickey Mouse has made children laugh for 60 years, but later this year he's
moving into a more serious business: saving them.
Walt Disney Co., Mickey's creator, and UNICEF, the United Nations
Children's Fund, announced Tuesday that they will begin a pilot project in
Guatemala by the end of the year using Disney characters to educate parents
and children about disease and sanitation.
Details of the agreement have not been decided, and Disney representatives
could not specify how much aid would be provided, but UNICEF officials said
the group plans to use Disney artists and marketing knowledge.
"This is more important than money," said UNICEF Executive Director James
P. Grant. "When Mickey or Donald Duck speak, children and their parents
listen."
Most Useful Alliance
Officials hope to expand the project worldwide, eventually producing
videos, comic books and audiotapes with Disney characters trumpeting UNICEF
health advice. Because UNICEF spends as much as 70% of its budget on
distributing information, Disney's participation could be its most useful
alliance, officials said.
Grant and Roy Disney, Walt Disney Co. vice chairman, re-dedicated
Disneyland's 25-year-old "It's a Small World" attraction in honor of the
partnership on Tuesday. Disney noted that the ride was created by the Disney
Co. for the UNICEF Pavilion at the 1964 New York World's Fair.
Officials chose Guatemala for the first Disney-UNICEF project because it
has a relatively small population but one of the world's highest infant
mortality rates.
Book to Be Interpreted
"We also picked Guatemala because it's tough," said Grant. "Much of the
population is illiterate and there are still political murders in the country,
so if we can save lives there, we can save them anywhere."
Disney said one of the new partnership's first projects probably will be to
interpret a book UNICEF published in July for the International Assn. of
Pediatricians. It details several dozen simple steps to prevent infant deaths,
such as immunization and longer breast feeding.
"Starvation isn't funny no matter how you look at it," Disney said. "But
we'll try to get our message across in a fun way."
UNICEF: AFRICA: WORLD HEALTH ORGANIZATION
Despite recent measures to control the spread of the Acquired Immune
Deficiency Syndrome (AIDS) in Africa, cases of the killer disease continue to
increase, according to a World Health Organization (WHO) report issued here
today.
The report counts Africa as having a total of 30,082 cases. Of that number,
Uganda heads the list with 6,772 cases, Kenya is second with 5,949 and
Tanzania follows with 4,158.
"More cases are being reported to the World Health Organization and there
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Volume 2, Number 30 August 19, 1989
is definitely a remarkable increase in the number of people who have AIDS in
Africa," says Dr. Benjamin Nkowane, an epidemiologist with the WHO in Geneva.
But delegates to the Africa regional conference of the International
Epidemiological Association (IEA) here point out that these figures do not
reflect the extent to which the deadly disease has spread throughout the
continent.
"The problem we have is that our governments always want to underestimate
the figures when reporting them to the WHO," says Dr. William Phiri of
Zambia. He added, however, that "these snags are now being overcome and some
governments are now being open."
Zambia has been especially hard-hit by the disease, and latest figures
indicate that cases are increasing in this Southern African nation.
Nkowane says reporting of AIDS cases in other African countries (mostly
sub-Saharan Africa, where AIDS is transmitted heterosexually) is incomplete,
and, based on serological data, the actual cumulative total AIDS cases in
these countries was over 200,000 by Jan. 1, 1989.
Dr. Erica Williams, secretary general of the Society for Women and AIDS in
Africa, says certain measures have been taken in Nigeria, for example, to
discourage "prostitutes" from meeting anyone known to have the AIDS virus.
"We tell the prostitutes if we know that some men have AIDS not to accept
them. This may sound like an unorthodox way of doing things but it is working
out," she told the four-day conference here.
Williams says her organization has adopted these measures to prevent the
disease from spreading, and also because men do not cooperate with the
counselling teams to use condoms. According to Williams, Nigeria --Africa's
most populous nation with over 100 million people -- officially has only a
small number of AIDS cases.
IMTS WEEKLY HEALTH ROUND-UP
Symptoms of ear infections in drug abusers may be attributable to the practice
of hiding banned substances within the ear, say British doctors from the Royal
Liverpool Hospital and from St. Mary's Hospital in London, who cited their own
experience. Thus, both the medical profession and police officers should take
heed of drug abusers with recent onset of external ear infections or deafness
and should examine the ears carefully, they said. BMJ (British Medical
Journal) July 15,1989.
Leading the list in doling out honoraria to Congress last year, the Tobacco
Institute spent $123,400 in lobbying Congressional leaders and key committee
members on behalf of tobacco interests. Second and third on the list were the
broadcasting and banking industries, according to the study by the government
watchdog group Common Cause. THE BOSTON GLOBE (AP) July 11,1989. Chronically
underfed animals live longer than their heavily fed counterparts, perhaps
because they suffer fewer illnesses, including autoimmune diseases. In seeking
the answer to why diet restriction works, scientists at the University of
South Florida in St. Petersburg found that mice prone to autoimmune disease
naturally produce two to seven times the normal amount of Ly-1+ B-cells, a
type of white blood cell involved in the production of autoantibodies, which
attack the body's own substances. The research reported in the June
Proceedings of the National Academy of Sciences also showed that chronically
restricting the diets of these mice to 60% of normal reduced the number of the
potentially destructive B-cells to a normal level. SCIENCE NEWS July 15,1989.
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Volume 2, Number 30 August 19, 1989
Recent outbreaks of the viral infection fifth disease--so-called because it
was the fifth infectious disease to be identified--are causing concern among
pregnant women, in whom it has been linked to a slightly increased risk of
miscarriage during the first 12 weeks of pregnancy. The usually mild illness,
which is caused by parvovirus B19, is also known as erythema infectiosum
because of the red facial rash it produces. THE WASHINGTON POST July 11,1989.
New Yorkers will soon have sexual equality of restrooms under a bill recently
signed into law by Gov. Mario Cuomo. The law requires any public building
erected after June 1, 1990, to provide women's restrooms with a number of
toilets equal to the number of urinals and toilet stalls in the men's rooms.
THE NEW YORK TIMES (AP) July 12,1989.
The Lyme Borreliosis Foundation, an organization set up to assist people
afflicted with Lyme disease, recently opened a new national headquarters in
Tolland, Conn. The foundation was established in March 1988 by Karen
Forschner, who is herself a victim of the tick-spread ailment that can cause
arthritis and nerve and brain damage. LOS ANGELES TIMES (UPI) July 24,1989.
Although there have been no documented cases of Lyme disease being spread
through blood transfusions, several experts have criticized health officials
for taking an ostrichlike attitude toward the possible risk. Of particular
concern are reports from French and US researchers regarding the durability of
the Lyme spirochete, Borrelia burgdorferi. At the New York Medical College in
Valhalla, blood containing B. burgdorferi was placed in a refrigerator under
conditions mimicking blood storage. Six weeks later, the researchers were able
to culture the microbe from the blood samples. Workers at the Pasteur
Institute in Paris have reported similar results. THE NEW YORK TIMES July
18,1989.
Respiratory syncytial virus (RSV), an influenza-like virus that is the most
important cause of lower respiratory tract infection in young children, kills
about 2,000 infants in the United States each year and causes an additional
55,000 to be hospitalized. However, hope is on the horizon, with researchers
at the recent annual meeting of the American Society of Virology in London,
Ont., reporting progress in the development of an RSV vaccine. They estimate
that it will be available commercially in three to five years. SCIENCE NEWS
July 15,1989.
PUBLIC HEALTH CHIEF BLAMES CONGRESS FOR AIDS FUNDING SHORTAGE
The head of the U.S. Public Health Service acknowledged Tuesday that little
federal money is available for early treatment of people infected with the
AIDS virus, but blamed Congress for failing to allocate the money.
Dr. James O. Mason, assistant secretary for health at the Department of
Health and Human Services, said Congress often fails to provide additional
money to pay for new programs it authorizes.
"I think that's interesting," he said.
"It would be helpful if you folks would provide leadership," shot back Rep.
Ted Weiss, D-N.Y., chairman of the House oversight subcommittee grilling Mason
and other administration officials about a broad range of AIDS programs.
Although the exchanges never got more testy than that, there was a
consistent undercurrent of disagreement over who bears prime responsibility
for what Weiss and Rep. Nancy Pelosi, D-Calif., maintained was inadequate
financing for AIDS treatment.
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Volume 2, Number 30 August 19, 1989
The two House members represent the two cities with the largest AIDS
populations, New York and San Francisco.
Mason noted that Congress authorized $$15 million last fall to help pay for
AZT administered to patients who could not afford to pay for it themselves
during the current fiscal year. AZT, which costs several thousand dollars a
year per patient, is the only approved drug treatment for AIDS.
However, the AZT authorization did not carry with it a new appropriation to
replace the one that had been used up. That left HHS officials with the choice
of ignoring Congress' direction to continue paying for the drug or dipping
into other AIDS budget accounts to come up with the $$15 million.
Mason, who headed the Centers for Disease Control in Atlanta before being
appointed to the No. 2 HHS job by President Bush, said he faces a similar
dilemma in the emerging fiscal 1990 budget because the AZT program is
authorized at $$30 million but not included in the appropriations bill
scheduled for debate later this week.
"The only place I can find that (money) is to take it out of prevention or
biomedical research," said Mason. "Someone has to make a priority decision."
From a broader perspective, Mason pointed out that he also bears
responsiblity for preparing the entire Public Health Service budget, which
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