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DHMH Daily News Clippings
Friday, January 9, 2009

 

Not minor, not fixed (Frederick News-Post)
The ignored vitamin (Baltimore Sun)
The Doctor Is Out (Washington Post)
 

 
 
By Associated Press
Frederick News Post
Tuesday, December 9, 2008
 
BALTIMORE (AP) — A new study finds Maryland tied for last among states nationwide in readiness for a health emergency.
 
Maryland scored a five out of 10 possible points on indicators for health emergency preparedness capabilities according to the study released today by the Trust for America’s Health and the Robert Wood Johnson Foundation.
 
Tied with Maryland were Arizona, Connecticut, Florida, Montana, and Nebraska. More than half of states and the District of Columbia scored a seven or less. Louisiana, New Hampshire, North Carolina, Virginia, and Wisconsin scored the highest with 10 out of 10.
 
The study’s authors say their report has found steady progress over the past six years, but federal and state cuts are putting that progress at risk.
 
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Copyright 1997-08 Randall Family, LLC. All rights reserved.

 
 
By Kevin Spradlin
Cumberland Times-News
Tuesday, December 9, 2008
 
CUMBERLAND - No matter what bills are passed into law when the Maryland General Assembly meets next month, Sen. George Edwards warned everyone on Tuesday to pay attention to the details.
“Read the fine print,” Edwards told more than 70 area business professionals during the annual Mountain Maryland prelegislative breakfast at Holiday Inn Express in Cumberland.
 
The District 1 legislators gave a projection of subject-specific bills they feel will likely be submitted by colleagues. The bills run the gamut from addressing the budget and smart growth planning to ATV safety and repealing the death penalty.
 
“When times are good, we spend, spend, spend,” said Delegate Kevin Kelly. “When times are bad, we spend, spend, spend.”
 
Edwards said bills designed to save consumers money could end up costing money. For example, the burden of a bill aimed at utility companies cutting costs could be shifted to consumers.
 
One energy project that could be a boon to the local economy is the Marcellus shale in Garrett County and western Allegany County. The core of the natural gas runs from southwestern New York to western Pennsylvania and into Mountain Maryland. Land and mineral rights owners will make the bulk of the money, Edwards said, but they’ll spend much of it in the two-county area.
 
The project also will create an unknown number of jobs in the industry, Edwards said, as the Marcellus shale is projected to extract natural gas for 20 to 50 years.
 
While a new slots parlor at Rocky Gap Lodge & Golf Resort is a ways off in the future, the work to build the $75 million emporium - $25 million investment in the new building for every 500 machines - will create work in the near term. Edwards said much of that work should go to local laborers.
The budget and the state’s projected $2.1 billion deficit in the transportation fund over the next six years is expected to take center stage during the session, which runs from Jan. 14 through April 13. That’s on top of a $1 billion “rolling” budget shortfall, Edwards said, which also must be dealt with.
 
New revenue estimates are to be released later this month. Gov. Martin O’Malley has suggested furloughs as one of many cost-savings measures that could be taken if the figures reveal too much of a drop.
 
“If things don’t turn around real quick, we’ll have substantially less (to work with) next year,” Edwards said.
 
Delegate LeRoy Myers said one way to not spend money is to avoid paying $30 million on new optical scan voting machines when the current machines, used in last month’s election, work just fine.
 
Delegate Wendell Beitzel, a member of the House Health and Government Operations Committee, said the combination of an economic downturn and the election of Sen. Barack Obama, who favors a national health care system, to president might prevent Maryland lawmakers from addressing the issue of universal health care. The initiative was introduced in the 2007 regular session but “the price tag on that was so severe it never went anywhere,” Beitzel said.
 
Kelly, who sits on the Judiciary Committee, said he expects death penalty opponents to lobby for a repeal. He said the position of the Maryland Commission on Capital Punishment, which recently issued a report and a recommendation to repeal the law, was expected due to the members of the commission.
 
Kelly, though, believes that “the majority of people in the state are in support of the death penalty.”
 
An “emotional issue,” Kelly told a story of a person who served 12 years for a rape he didn’t commit. He was later released based on DNA evidence. Another story Kelly told was of a Maryland State Police officer who, engaged in a scuffle during what at first was a routine traffic stop, ended up “begging for his life” when the suspect got hold of the trooper’s weapon. The trooper was killed. The crime was caught on tape by the police cruiser’s dashboard camera. Kelly said the perpetrator of such a crime should be put “in the express line” to an execution.
 
Each year the forum is sponsored by the legislative committees of the Allegany and Garrett counties’ chambers of commerce. The forum was attended by Allegany County Commissioner Dale Lewis, Cumberland Mayor Lee Fiedler, Cumberland Council members Pete Elliott and Mary Beth Pirolozzi, and Frostburg Commissioner Susan Keller, among other local dignitaries and leaders in business and education.
 
Contact Kevin Spradlin at kspradlin@times-news.com
.
 
Copyright © 1999-2008 cnhi, inc.

 
 
Frederick News Post Letter to the Editor
Tuesday, December 9, 2008
 
The Nov. 24 New-Post editorial "No surprises" rightly highlights the ongoing contamination of ground water in area B at Fort Detrick. And the refusal of the Army to fix it with anything approaching deliberate speed.
 
It has been more than 16 years since the carcinogens TCE and PCE were discovered at unacceptable levels in private wells outside of Detrick. In all this time the Army has said "don't worry, it's minor, it's almost fixed." But it isn't minor and hasn't been fixed, despite repeated demands for action from the Maryland Department of the Environment, the EPA and Senators Mikulski and Cardin.
 
The Army has resisted all of this and now admits we are years away from remediation. We are even a long way from a study on how to fix it. TCE is a serious health threat, a proven carcinogen. It causes cardiovascular damage. Many TCE sites also have vapor intrusion into basements, an even more serious health risk. We don't know if that is so here because nobody has looked into it. I hope the FNP will continue to stay on top of this, and tell the community much more about the specific health impacts of TCE contamination. We need to know.
 
BETH WILLIS
Frederick
 
Copyrigh 2008 Frederick News Post.

 
Expert advice
 
By Holly Selby
Baltimore Sun
Monday, December 8, 2008
 
Ah, December. Cold, dry air, evergreen trees, boxes filled with holiday decorations - and possibly molds and dust - brought down from the attic. And you thought that this was an asthma- and allergy-free season. Among the estimated 16 million adults and 7 million children in the United States who have asthma, slightly more than half of the cases are attributable to allergies, says Dr. Alvin Sanico, medical director of the Asthma Sinus Allergy Program at Greater Baltimore Medical Center and assistant professor of medicine at the Johns Hopkins University.
 
Allergy season is typically considered to be spring to fall, when many trees and plants are pollinating. Does this mean winter is allergen-free?
 
It would depend on the specific allergens to which you are sensitive, which can easily be revealed by allergy skin testing. If you are allergic to pollen from trees, your symptoms could be worse from spring to early summer, when the tree pollen counts are typically elevated. For grass pollen it would be late spring to summer, and for weeds it would be fall. If you are sensitive to allergens from dust mites, pets such as cats and dogs, cockroaches or molds, then winter doesn't represent relief because these things can be found indoors.
 
What are the symptoms of asthma and allergies?
 
Symptoms develop as a result of inflammation and can include any combination of breathlessness, cough, wheezing, chest tightness, runny nose, postnasal drip, sneezing, nasal congestion and itchy, watery eyes. Depending on several factors, the symptoms can range from mild to severe and from intermittent to persistent.
 
Are there particular triggers to watch out for during this season?
 
Aside from the aforementioned indoor allergens, other potential triggers for asthma exacerbation to watch out for include irritants such as cold, dry air, strong scents, smoke from tobacco or [a] wood-burning fireplace, as well as respiratory infections such as the common colds that tend to be more prevalent during the winter.
 
Are there any precautions you can take?
 
If you are allergic to molds, watch out for their presence on evergreen trees, as these could account for symptoms related to live Christmas trees. Molds can also grow on certain artificial trees and other holiday ornaments that are improperly stored in damp areas. If you are allergic to dust mites, apply dust mite-proof encasements for your pillows and mattress, and wash your regular beddings using hot water at 140 degrees Fahrenheit. If you use the fireplace, make sure that the ventilation system is working well. When you spend time outdoors, wear protective clothing over your face to minimize inhalation of cold, dry air.
 
What if you are traveling for the holidays?
 
If you are allergic to cats or dogs and are visiting friends or family with these pets, make sure that you take all appropriate medications to ensure that your condition remains under good control. Be aware that cat and dog allergens can be transported through clothing, so minimize the amount of allergens that you bring home by isolating and washing exposed clothing accordingly.
 
We've heard a lot about hypoallergenic dogs recently. Are there some dogs that might cause fewer allergic reactions?
 
There are a lot of misconceptions about this subject that could lead to detrimental consequences. The fact is that there is no such thing as a hypoallergenic dog breed. All dogs and cats produce allergenic proteins that can be found in their dander, saliva and even urine, regardless of their breed or the characteristics of their hair - or lack thereof. Recent news reports of pet pundits proposing "hypoallergenic breeds" ranging from the Portuguese water dog to the Peruvian hairless dog for the future First Family can be misleading. The American Kennel Club even conducted a poll to elect the presidential pet for Malia Obama, who has asthma and allergies, and the poodle won. That is really ironic because a study by French scientists found that, compared to other breeds, poodles had the highest level of allergenic proteins in their dander. One key finding was the significant variability of levels of allergens from individual dogs within the same breed. The answer then is that some dogs may produce more - or less - allergens than others simply as part of their individual nature.
 
What advice would you give to someone who is experiencing symptoms of allergies?
 
The first step is to identify the specific allergens to which you are sensitive, if any, through a needle-free allergy skin test. This standardized test is simple and shows the results in 20 minutes. Based on these results, the three approaches to consider may include avoidance measures, use of medications that are either used daily to control your condition or used as needed to relieve breakthrough symptoms, and allergen immunotherapy that would take several months to take effect but can provide long-term benefits.
 
Holly Selby is a former editor for The Baltimore Sun.
 
Copyright © 2008, The Baltimore Sun.

 
As more is learned about the importance of the 'sunshine vitamin,' doctors are finding that most of us aren't getting enough
 
By Stephanie Desmon
Baltimore Sun
Monday, December 8, 2008
 
She didn't always order the test. For more than two decades in private practice, in fact, Dr. Patricia Czapp almost never checked the vitamin D levels of her patients.
 
Things have certainly changed.
 
"For the last two years, I've been testing virtually all of my patients," said Czapp, a family doctor at Annapolis Primary Care. "The vast majority are straight-out deficient or insufficient. It's frightening to think there's that many people walking around with that deficiency."
 
What doctors are beginning to understand is that vitamin D isn't just important for absorbing calcium and building bones. And new research seems to be coming out by the day suggesting vitamin D deficiency can lead not just to osteoporosis but possibly to heart disease, multiple sclerosis, diabetes, even cancer. Vitamin D is believed to impact the immune system and, one researcher suggests, perhaps even the functioning of the brain.
 
"When you start reading about vitamin D, how can you not offer that to your patients?" said Czapp, who was persuaded by a newly trained colleague to check for deficiencies. "What we're coming to find out is most of the cells in the body have a vitamin D receptor. Vitamin D touches hundreds of different genes in the body, regulating the immune system, fighting infection, cancer cells."
 
She isn't the only physician ordering more vitamin D tests. She is part of a growing trend among doctors turning the once-rare test into a routine part of the annual physical, making it one of the top five blood tests ordered nationwide, according to two leading lab companies.
 
Patients, reading recent headlines about vitamin D or hearing about it on the news, are also pushing the popularity of the test, asking their doctors about a vitamin they rarely thought about before. One grass-roots health organization is advocating that everyone have their vitamin D levels checked.
 
All this comes as the American Academy of Pediatrics doubled its recommendation last month of how much vitamin D children should take daily and as other groups are pushing for adults to get up to 10 times more than is currently recommended in their diets.
 
As many as half of Americans, middle-age and older, are believed to get an inadequate amount of vitamin D.
 
"That's quite sobering and it really says we've got to do better with vitamin D nutrition," said Dr. Anthony W. Norman, a biochemist at the University of California, Riverside who has studied vitamin D for decades.
 
It isn't easy to get enough vitamin D in the diet. It is found in fortified milk, juice and cereals as well as oily fish such as mackerel, sardines and wild salmon.
 
Vitamin D is commonly referred to as the sunshine vitamin, because our bodies make it when we are exposed to the sun. In northern climes, however, the sun isn't strong enough in the winter months. In the summer months, just 10 to 15 minutes a day would provide enough vitamin D, but fear of skin cancer means many people are wearing sunscreen when they go out, which blocks the beneficial rays.
 
Many people get their vitamin D from supplements.
 
Vitamin D levels are checked by taking a patient's blood and testing for the level of 25-hydroxy vitamin D circulating in it. More than 30 nanograms per milliliter is generally considered a healthy level of vitamin D, and any less than 20 is considered deficient.
 
At the North Carolina-based LabCorp, spokesman Eric Lindblom said the vitamin D test is "one of our fastest-growing tests" and that the number ordered has not only doubled this year, but each of the last four years. At New Jersey-based Quest Diagnostics, the total number of tests has grown "by approximately 80 percent compared to last year," said spokeswoman Wendy Bost.
 
In September, Mount Washington resident Shannon Wollman had a routine physical and, for the first time, her vitamin D level was checked.
 
"Everything about my blood work was perfect," she said, "except for the vitamin D deficiency."
 
Her doctor at Sinai Hospital in Baltimore put her on a serious regimen of vitamin D - one prescription pill of 50,000 international units a week for eight weeks to be followed by an over-the-counter vitamin D dose of about 1,000 IU every day.
 
Wollman, who works as a major gifts officer in Sinai's development office and as an actress and singer, said she had never thought much about vitamin D until she was given those results. Then, she said, she brought it up with one of her friends at a Rosh Hashana dinner.
 
"She said, 'The exact same thing happened to me and now I'm on a prescription,'" said Wollman, 40. "It's more common than you realize, and people hadn't been discussing it.
 
"This was never something I paid any attention to, and now I take it every day."
 
While 2,000 IU a day has long been considered the upper limit of what is safe, 200 IU a day is what has been recommended for people younger than 50, 400 IU for those 50 to 70 and 600 IU for those older than 70. Norman and a group of other University of California researchers are pushing to increase the government's recommended daily intake to 2,000 IU. And the American Medical Association has asked the Institute of Medicine to review and update its recommendation.
 
Dr. Jennifer Caudle, an internist at Sinai, has read the new research, but she cautions that people shouldn't just run out and take more vitamin D without first discussing it with their doctors. The enthusiasm and hype for vitamin D now must be tempered until more is known. She said not enough is known about what would happen if someone took too much.
 
"Is vitamin D important for people? Sure," she said. But, she said, "the information is still being gathered. I'm not sure there's a consensus on exactly how much we should be taking."
 
Norman says he takes 2,000 IU a day. He said vitamin D has receptors in more than 36 organs in the body, meaning a deficiency causes those organs not to work as well as they could. What he knows now tells him "this is the real deal."
 
"There's no reason to wait for all this evidence-based research," he said. "You don't want to go a whole decade only being one-half vitamin D supplemented or one-third vitamin D supplemented. You'll be a much healthier person."
 
At her Annapolis practice, Czapp is thinking about no longer testing all of her patients and telling them they need vitamin D supplements. The test can be expensive - $260, she said - and she sees health-care costs rising. But she worries her patients won't start upping their vitamin D intake unless they have the negative test results in their hands.
 
Meanwhile, she and her colleagues were spending so many hours explaining to patients what the deficiency was and what they should do to treat it that they came up with a form letter and a protocol to send to people when their results come in.
 
"We got tired of saying it," she said. "It was easier to hand out a letter that explained all of this."
 
Carole Baggerly started a group called Grass- rootsHealth last year in California, which focuses solely on promoting information about vitamin D. She started it after a bout with breast cancer that was followed by a diagnosis of osteoporosis. She learned she was vitamin D deficient.
 
This led to a whole list of discoveries about vitamin D. She read research that suggested raising vitamin D levels may prevent up to half of all breast cancer and two-thirds of colorectal cancer cases in the United States. She read a study showing women with the lowest levels of vitamin D had nearly double the risk of their breast cancer progressing, and a 73 percent greater risk of death compared to women with adequate vitamin D. She found out that the first study linking colorectal cancer and vitamin D was published in 1941.
 
"It's been an ignored thing," she said. "There's a tremendous disbelief that the problem exists."
 
Now she spreads the word however she can. She recently held a seminar with 160 doctors discussing the virtues of vitamin D - and the real health advances that she says could be made if everyone got their levels up. She advocates for vitamin D levels between 40 and 60 ng/ml - higher than what is currently considered adequate.
 
She traveled to many cities over the summer talking about vitamin D.
 
"The biggest question I got," Baggerly said, "was: 'How do I get my doctor to order the test? He said, 'Oh you don't need it. You're outside a lot.' The statistics say the doctors are wrong."
 
how to get enough vitamin d
Vitamin D is not found in a lot of foods, so it may be difficult to get all you need in your diet.
Vitamin D can be found in:
 
Foods: Milk, juice and cereals are fortified with vitamin D. It occurs naturally in oily fish such as mackerel, sardines and wild salmon.
 
Supplements: Many doctors are now recommending patients take over-the-counter supplements.
 
Sun: In warmer climes and in the summer, people can get enough vitamin D, also called the "sunshine vitamin," from 10 to 15 minutes in the sun in the middle of the day, but only if their skin is not covered with sunscreen. The rays needed to become vitamin D cannot get through sunscreen's barrier.
 
 
Copyright © 2008, The Baltimore Sun.

 
 
Baltimore Sun
Monday, December 8, 2008
 
Doctors-in-training are still too exhausted, says a new report that calls on hospitals to let them have a nap.
 
Regulations that capped the working hours of bleary-eyed young doctors came just five years ago, limiting them to about 80 hours a week.
 
Last week, the prestigious Institute of Medicine recommended easing the workload a bit more: Anyone working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours.
 
At issue is how to balance patient safety with the education of about 100,000 medical residents, doctors fresh out of medical school who spend the next three to seven years in on-the-job training for their specialty. The long hours are, in some ways, a badge of the profession; doctors can't simply clock out if a patient is in danger. But sleep deprivation fogs the brain, a problem that can lead to serious medical mistakes. So in 2003, the Accreditation Council for Graduate Medical Education issued the first caps. Before then, residents in some specialties could average 110 hours a week.
 
The government asked the IOM to study the current caps. Violations of current limits are common and residents seldom complain, the committee found. While quality of life has improved, there's still a lot of burnout. And despite one study that found residents made more errors while working longer shifts, patient safety depends on so many factors that it's impossible to tell if the caps helped that problem, the report said.
 
Los Angeles Times
 
Copyright © 2008, The Baltimore Sun.

 
 
By Chris L. Jenkins
Washington Post
Tuesday, December 9, 2008; HE01
 
Glenda Fried had heard the stories but never quite believed them. While she had had no problem getting her primary care physician in suburban Chicago to accept her Medicare health insurance, friends across the country were telling her about the devil of a time they were having. They talked of having to make at least 15 calls before finding a new primary care physician who participated in the taxpayer-funded medical insurance program largely for those 65 and older. Fried, 68, chalked it up to bad luck.
 
But when the retired school administrator moved to Chantilly this year to be closer to her son and his family, she realized there was some truth to the stories: Phone call after phone call was met with apologetic office mangers saying that Dr. X wasn't taking any new Medicare patients or Dr. Y wasn't taking any type of insurance at all.
 
"I must have made 12 calls before I could nail it down," she said recently. It took her a few weeks, she said, to find a physician she felt comfortable with. "One or two weren't taking new patients at all, but the vast majority were just not taking Medicare. And they were taking other forms of insurance."
 
Fried's experience is a growing concern among policymakers and health-care experts who envision a shortage of family medicine doctors and geriatricians to care for an aging population.
 
Health-care experts and advocates for the region's elderly say the problem is partly a reflection of how worried physicians are about changes in reimbursement rates from the federal government. Some physicians say they are afraid of accepting new Medicare patients and discovering later that the amount they receive for treating them will be decreased. Exacerbating those worries are concerns about the slow pace of reimbursement and the layers of paperwork it requires.
 
The nation's 44 million Medicare patients, on the other hand, tend to be satisfied with their treatment and are able to access care without delay once they have a physician, according to national surveys.
 
While statistics are not available for the D.C. region, the Medicare Payment Advisory Commission reported last week that nearly 30 percent of the 2.6 million Medicare beneficiaries seeking a new primary care physician between September 2007 and October 2008 had trouble finding one, up from 25 percent in 2005. To encourage primary care doctors to accept new Medicare patients, the commission recommended to Congress in June that it increase payments to those practitioners by redistributing payments for specialized care.
 
The group also found that Medicare patients seeking new primary care physicians were more likely to experience trouble finding one than those looking for specialists.
 
Zerline Chambers-Kersey, a primary care physician in Dumfries, said she decided last month stop taking new Medicare patients at her 9,000-patient practice. She said the delay in reimbursement and the constant worry that her rates might be cut were enough for her to also tell those currently on Medicare she would no longer see them after the end of the year. Even though she has only 150 Medicare patients now, she anticipated that this number would have grown to 600 next year because of the aging of her patients.
 
"It's just too frustrating," said Chambers-Kersey, who's been in practice by herself for 13 of her 25 years of experience.
 
"It's a business decision . . . a painful one, and in the middle my patients are the ones who feel it the most." She said she is helping her affected patients find new doctors who take Medicare as she informs them of her decision.
 
In the National Report Card on the State of Emergency Medicine released today, the American College of Emergency Physicians says that for every 100 Medicare beneficiaries, the District has 11.3 physicians who accept this coverage, a higher rate than any of the states.
 
Local advocates for the elderly say the problem of finding such physicians seems to be felt most acutely in Virginia, which has just 2.5 physicians accepting Medicare per 100 beneficiaries, according to ACEP. (The rate in Maryland is four per 100, a little better than the national average of 3.2 per 100.)
 
Those who counsel seniors in Northern Virginia said that they have received dozens of phone calls over the past several months from seniors looking for help joining a Medicare family practice.
 
"It's not the folks who already have a doctor and transition into Medicare that are having the problem," said Howard Houghton, program manager for the Fairfax chapter of the Virginia Insurance Counseling and Assistance Program, a service run by the state's local Area Agency on Aging centers. "It's those who are switching doctors or are moving to this area."
 
Much of the pressure on doctors has come from threatened reductions in fees under the formula that sets Medicare spending. Doctors were slated to receive a 10.1 percent cut in the reimbursement rate this past January and a 10.6 percent cut in July. Congress blocked the reductions both times: Doctors actually got a 1.1 percent increase. But the periodic specter of reductions is enough to leave some feeling wary.
 
Joseph Antos, a senior fellow for health-care and retirement policy at the American Enterprise Institute, said that it was largely the political debate over the Medicare rate cuts that worried doctors, but that he doubted Congress would ever follow through on such drastic measures.
 
Lobbyists for doctors and the elderly argued that cutting reimbursement rates would prompt doctors to drop out of the program: In a national survey taken this spring, the American Medical Association suggested that 60 percent of physicians would have stopped taking new Medicare patients if the July cuts had gone through.
 
But that hasn't eliminated the possibility of cuts in the future.
 
"The lack of predictability with these Medicare rates is very worrisome to many doctors," said Nancy Nielsen, president of the American Medical Association.
 
Copyright 2008 Washington Post.

 
 
By Alejandro Lazo
Washington Post
Tuesday, December 9, 2008; D04
 
Human Genome Sciences, a Washington area biotech company that in 16 years has yet to bring a commercial treatment to market, said yesterday that results were positive for the first of two late-stage clinical trials of its hepatitis C drug.
 
The Rockville company is developing the drug, Albuferon, with Swiss drugmaker Novartis. The results showed that Albuferon was as effective for hepatitis C as the current treatment on the market, a Roche drug called Pegasys, but in half as many doses. The test focused on patients who had two types of hepatitis C, both of which take 24 weeks to treat.
 
Results of Albuferon's final trial, conducted on patients with a type of hepatitis C that takes 48 weeks to treat, are expected in March. If those results are successful, the company hopes to file global marketing applications in the fall.
 
"We have a successful first trial," Jerry Parrott, a spokesman for the company, said. "We are looking to the next study, which we will have in March, and then we will have a full picture, a full understanding of the therapeutic and commercial potential of this drug."
 
Hepatitis C is a blood-borne infectious disease that can cause serious liver diseases. The results announced yesterday showed that 79.8 percent of patients receiving Albuferon showed no signs of the hepatitis C virus in their bloodstream 24 weeks after the last injection, compared with 84.8 percent of a group that received Pegasys. The trials were conducted on 933 patients in different parts of the world and most of the discrepancy between the two drugs occurred in Asia, Human Genome Sciences said. In Asia, the drug was effective in 79.8 percent of patients compared with 95.5 percent who took Pegasys.
 
"What really remains to be seen is what this number means," Parrott said. "That Asian result completely accounts for that 5 percent difference."
 
Shares closed up 14 cents yesterday, or 8.14 percent, at $1.86.
 
"This is a beaten-down stock," Han Li, an analyst with the Stanford Group, said. "We should not expect a big pop up here, as to do that we need fresh money in there and at this point there are few investors willing to take the risk."
 
Copyright 2008 Washington Post.

 
 
Associated Press
By Lindsey Tanner
Washington Post
Monday, December 8, 2008
 
CHICAGO -- Half-dose flu shots are effective in adults, especially in women and those younger than 50, and offer a viable way to stretch supplies during vaccine shortages, a government study found. The strategy also might be an option during hard economic times since lower doses likely would mean cheaper shots, said Vanderbilt University vaccine expert Dr. Kathryn Edwards, who wasn't involved in the study. And the lower dosage could open doors to vaccinating people in poor countries where flu shots are little used, she said.
 
Even so, Edwards said giving half-dose flu shots isn't ready for prime time. It's still experimental and hasn't been approved by federal authorities.
 
The study involved 1,114 adults aged 18 to 64. It's the first to test half-dose flu shots in those aged 50 and older during a single flu season, 2004-05. The results among younger adults echo previous research, said lead author Dr. Renata Engler of Walter Reed Army Medical Center.
 
The government-funded study appears in Monday's Archives of Internal Medicine.
 
"Traditionally, vaccine programs have followed a 'one-size-fits-all' approach," Engler said. That means everyone gets the same dose and during shortages, supplies are more likely to run out.
 
If the study results are confirmed through additional research, Engler said, half-doses could be given to large numbers of adults, enabling more people to get vaccinated.
 
That's important because while influenza is often underestimated, the federal Centers for Disease Control and Prevention says each year the disease is responsible for about 36,000 deaths and 200,000 hospitalizations nationwide.
 
In the study, participants were randomly chosen to get full- or half-dose flu shots in late 2004 in the Washington D.C. area. The researchers measured blood levels of antibodies to flu virus before vaccination and 21 days afterward.
 
After the shots, similar numbers of adults of all ages, including men and women, had antibody levels considered adequate to protect against the flu.
 
The 18-to-49 age group and women had the highest antibody levels. That adds to evidence that women may be more sensitive to some vaccines than men.
 
Dr. Ronald Hershow, an infectious disease specialist at the University of Illinois's Chicago campus, noted that while half-doses produced an adequate immune response, full doses produced a stronger response. And there's evidence that stronger immune responses provide better protection against disease, he said.
 
Still, the study authors argued that from a public health standpoint, it would be better to vaccinate many people with lower doses than fewer people with full doses when vaccine supplies are scarce.
 
There were few reports of flu-like illnesses among the study volunteers, but the number of people of all ages with those symptoms was similar in both the full-dose and half-dose groups.
 
Engler noted that because adults in their 60s and older are more vulnerable to flu complications, more research is needed to be sure that half-doses are adequate for them.
 
The study was done during the vaccine shortage in the winter of 2004-05 when contamination was found at a major vaccine supplier's plant in Britain.
 
Now, there are five licensed flu vaccine manufacturers, making shortages in the near future unlikely. Still, Dr. Joseph Bresee, the CDC's flu chief, said the study provides useful information just in case.
 
Flu season starts in the fall and this year is off to a pretty typical start, with low levels of disease nationwide, Bresee said.
 
"It's still a good time to get a vaccine," Bresee said,
 
 
On the Net:
Archives:http://archinternmed.org
CDC:http://www.cdc.gov
 
© 2008 The Associated Press.

 
 
Associated Press
By Stephanie Nano
Washington Post
Monday, December 8, 2008
 
NEW YORK -- A vaccine that may become the world's first to prevent malaria shows promise in protecting African children, researchers said Monday, calling the results a "major milestone."
 
In early tests, the experimental vaccine was more than 50 percent effective in preventing the deadly disease in infants and toddlers in two countries in Africa, the scientists said. A larger and longer test is expected to begin early next year, the latest effort at slowing a disease that kills nearly 1 million people annually.
 
It is the first malaria vaccine to make it this far, and if further studies are successful, marketing approval could be sought as early as 2011. The vaccine was developed by the British-based GlaxoSmithKline PLC.
 
The results "add to our confidence that we are closer than ever before" to a malaria vaccine for African children, Dr. Christian Loucq, director of the PATH Malaria Vaccine Initiative, said during a teleconference from New Orleans.
 
The nonprofit group was started with a grant from the Bill and Melinda Gates Foundation to help develop malaria vaccines and make sure they're available where needed. The group teamed up with GlaxoSmithKline, and both paid for the vaccine studies.
 
The findings were presented Monday at a New Orleans meeting of the American Society for Tropical Medicine and Hygiene and will be in Thursday's New England Journal of Medicine. Some of the researchers work for the nonprofit group or the drugmaker.
 
Malaria is a tropical disease whose victims are mostly young children in sub-Saharan Africa. It is caused by a parasite and spread through a bite from an infected mosquito. The parasite travels quickly to the liver where it matures, enters the bloodstream and causes fever, chills, flu-like symptoms and anemia. The GlaxoSmithKline vaccine is designed to attack the parasite before it can infect the liver.
 
"Given the magnitude of malaria in Africa, the results represent a major milestone," said Dr. Ally Olotu, one of the researchers from Kilifi, Kenya.
 
The World Health Organization estimates that some 247 million people worldwide get malaria each year, but the most dangerous type is mainly in Africa. Government and private programs to control it have shown some progress in recent years with the distribution of bed nets, mosquito spraying and better malaria drugs. The United Nations announced a program in September to step up efforts against the disease with the goal of eliminating it by 2015.
 
The two studies reporting findings Monday were done in rural areas of East Africa.
 
One study involved 894 children ages 5 months to 17 months in Kenya and Tanzania. During the eight months the children were followed, there were half as many cases of malaria in those who got three vaccine shots compared to those who didn't get them - an effectiveness rate of 53 percent.
 
Because malaria is so deadly, a vaccine that provides significant protection would be a public health victory.
 
"The vaccine - even a partially effective vaccine- has the potential to save hundreds of thousands of lives each year," Loucq told reporters.
 
The study was the first test of a version of the vaccine that used a new additive to boost the immune response. The older version was 35 percent effective in earlier tests.
 
The second study tested whether the malaria vaccine could be given to young infants along with routine childhood vaccines provided through a WHO program. In the study of 340 infants in Tanzania, the researchers found that the malaria vaccine could be safely added and didn't interfere with the effectiveness of the other vaccines.
 
During six months of follow-up, the vaccine was 65 percent effective against new malaria infections in the infants.
 
Dr. Salim Abdulla, lead author of the infant study, said the WHO vaccine program reaches even the remotest areas of Africa and would be an ideal way to get a malaria vaccine to the most vulnerable children.
 
William Collins, a malaria expert at the Centers for Disease Control and Prevention, said that for the vaccine to work, it must recognize and stop the malaria-carrying parasite from invading the liver within just a few seconds to a few minutes.
 
"To be that effective, and yet have only a short period of time to attack the parasite, it's remarkable that it's that effective at all," said Collins, who wrote an editorial that accompanied the studies, along with John Barnwell, also of the CDC.
 
They noted that the level of malaria infections was low in the study areas, and that the true test will come in areas with more malaria.
 
"It is, indeed, a hopeful beginning," they wrote.
 
On the Net:
Malaria Vaccine Initiative:http://www.malariavaccine.org/
New England Journal:http://www.nejm.org
 
© 2008 The Associated Press.

 
 
By Manoj Jain
Washington Post
Tuesday, December 9, 2008; HE06
 
Ten years ago, an intelligent, reserved software engineer -- a woman with the complexion of Halle Berry and the physique of a marathoner -- came to my infectious-disease clinic, accompanied by her fiance.
 
They'd been referred to me a few weeks after a rash and pneumonia prompted a clinic doctor to test the woman for HIV. The test came back positive. Her fiance, tested later, was HIV-negative.
 
Choosing my words carefully, I answered their questions about their future relationship, emphasizing condom use as well as blood and body fluid precautions. They married as scheduled, and I placed her on a regimen of four medications: eight pills daily, taken at three different times throughout the day. As time went by, her health and immune system improved.
 
A few years after her diagnosis, my patient told me that she and her husband wanted to have a child. Concerned about the risk of transmitting HIV to her husband if they stopped using condoms, I said I would refer her to an in vitro fertilization clinic. But before I could do that, my patient informed me that she was pregnant.
 
A nearby academic medical center delivered her son by Caesarean section, using all precautions to protect the baby from infection. And it worked: He was healthy and HIV-negative. My patient did not breast-feed -- again, to avoid transmission risks -- and managed well as a new mother. Soon she went back to work and even got a promotion, to software manager. Some years later, she delivered a second son, also by C-section, also HIV-negative.
 
Her husband regularly took HIV tests; all were negative. (Not every unprotected sexual encounter results in infection, but it's a kind of Russian roulette I don't recommend.)
 
Over the years, my patient tolerated the usual side effects of the HIV medication: nausea, diarrhea and a rash. Her insurance covered the cost, so for a long time the most troublesome part was the pill burden and the regimented schedule. Since only her parents and husband knew of her HIV status, carrying pills to work or to a dinner party was awkward. Then, several years ago she switched to Atripla, which combines three medications in one pill, taken once a day. Life became easier.
 
Her story is a remarkable chronicle of the advance of medicine and strong evidence of the importance of testing. Not only can my patient expect to live a relatively long and productive life, she can do it with the love and support of a healthy husband and children. None of this would have been possible without early detection and proper adherence to an HIV regimen.
 
In the early years of HIV, I recall feeling helpless as my patients' bodies succumbed to the relentless attacks by the virus. As their immune systems disintegrated, common bacteria, parasites or tuberculosis organisms would infect their lungs or a usually innocuous fungus would invade the deep tissues of their brains, and eventually they died. But in the mid-1990s, researchers developed HAART (highly active antiretroviral therapy) medicines that in various ways arrest the growth of the virus, reducing it to "undetectable levels." Over the past decade and a half, for many in the developed world, HIV has become more like diabetes or hypertension: a chronic disease instead of a death sentence.
 
But to treat infected people, doctors have to know who has the virus. That is where testing and screening come in. My patient was told to get an AIDS test when visiting a doctor for other problems; what if she hadn't? What if she had never been tested? What if she had unknowingly infected her future husband?
 
Today's screening tests are 99.5 percent sensitive in spotting the disease. (By comparison, a mammogram is only about 80 percent sensitive in detecting breast cancer.) We have not yet made the most of screening because we refuse to reshape our thinking. We are caught up by the mistaken notion that HIV, and subsequently AIDS, is a terminal illness. Also, many still incorrectly believe that the stigma of being HIV-positive outweighs the benefits of early management, treatment and containment of the disease.
 
More than a million people in America have HIV, according to the Centers for Disease Control and Prevention. One in five are unaware they have the virus; they are responsible for transmitting more than half of the 56,000 HIV infections that occur annually. In 2006, the CDC recommended that a one-time HIV test become routine for all persons between ages 13 and 64, and that those with high-risk behavior such as intravenous drug use and multiple sexual partners be tested annually. Sadly, these recommendations are not followed comprehensively, and too few people are being screened.
 
Ten years down the line, my HIV-positive patient mentioned new methods that can lower the risk of mother-to-child transmission of HIV without a Caesarean section. Maybe she could try natural childbirth. On second thought, she said with a nervous giggle, "I don't think I want to go through that." It had nothing to do with AIDS. Like any busy woman with a stressful job, a husband and two kids, she was reacting to the idea of having a third child and to experiencing the pains of childbirth. I smiled, thinking how her HIV was not a lethal specter hanging over her life, but just one of that life's details that needed to be managed.
 
Manoj Jain is an infectious-disease specialist and an adjunct assistant professor at the Rollins School of Public Health at Emory University. Comments: health @washpost.com.
 
© 2008 The Washington Post Company.

 
 
Associated Press
By Lauran Neergaard
Washington Post
Monday, December 8, 2008
 
WASHINGTON -- There's no mammogram or Pap smear for Alzheimer's disease. Yet an Alzheimer's group this week begins a push for simple memory screenings in a bid to catch possible warning signs of dementia sooner.
 
Memory screenings _ five-minute mini-tests, doable at a health fair _ are hugely controversial. But the provocative new report from the Alzheimer's Foundation of America contends they're a valuable but overlooked tool. The government has begun reviewing if there's enough science to back broader use of them.
 
How do they work? One example: Tell someone three random words _ car, pencil, banana. Then have the person draw a clock with the correct time, as a distraction. A little later, can he or she recall those three words?
 
Failing such a test doesn't mean someone has dementia. But it signals there might be a problem with short-term memory that should be checked by a doctor. Maybe it's something fixable, like depression or thyroid disease. Maybe it is an Alzheimer's warning sign. Or maybe it's a false alarm and the person just isn't a good test-taker.
 
Regardless of the uncertainty, there's clearly demand. The Alzheimer's Foundation sponsors a "memory screening day" each November and last month's drew 50,000 takers, 10,000 more than the previous year.
 
"What we're trying to accomplish is the entry-level 'let's get memory on the radar screen,'" says the foundation's Dr. Richard Powers, medical director of the Alabama Department of Mental Health. "Nobody has a strategy to deal with this."
 
Indeed, more than 5 million Americans and 26 million people worldwide have Alzheimer's. Cases are projected to skyrocket in the next two decades as the population ages. Yet few are diagnosed in the earliest stages of the relentless brain decay, when today's medications are most helpful.
 
The new report calls on Congress to set a national strategy for dementia detection, and on Medicare to make memory screening part of more new-patient checkups. Meanwhile, it backs community memory screenings, in particular targeting people who already have memory concerns but don't know how to seek help.
 
How well do they work? The guideline-setting U.S. Preventive Services Task Force in 2003 decided there wasn't enough evidence to recommend for or against routine screening. The task force is revisiting that question, and other Alzheimer's specialists have urged caution.
 
Making a check of brain function as routine as blood-pressure measurement is a laudable goal, says Dr. Zaven Khachaturian of the Lou Ruvo Brain Institute in Nevada. But correctly diagnosing people with the earliest symptoms is tremendously difficult, hindering that quest, he says.
 
Among the knowledge gaps: Nearly a million older Americans each year are estimated to develop what's called "mild cognitive impairment," or MCI. But no one knows how many will worsen to full-blown Alzheimer's, or how to predict who will. To fill such gaps, the government is midway through a giant study to see if brain scans help diagnosis; a Mayo Clinic study of MCI's evolution is tracking 3,000 people in Olmstead County, Minn.; and Khachaturian is planning a similar study to track thousands more Nevada baby boomers.
 
Plus there's a key distinction: Would memory screening target just people worried about existing problems, or those at risk of future memory loss because of older age, family history or other factors?
 
Dr. Ronald Petersen of the Mayo Clinic _ who advises the Alzheimer's Association, a different national patient-advocacy group _ calls wider screening premature.
 
No matter the cautions, people may assume they're "on the road to Alzheimer's disease," he worries. "If you're in a mall and you go into a booth and you take this little five-minute exercise ... you don't know what people are going to do with that kind of information."
 
For the truly at-risk, Khachaturian recommends regular monitoring of total cognitive function, not just short-term memory, to spot deterioration from one year to the next.
 
Screening "needs to be done carefully," he adds. "The danger with willy-nilly doing screening is it opens the door for opportunists."
 
But the Alzheimer's Foundation's Powers says screening opens the door for consumer education.
 
On last year's memory screening day, fewer than one in four who confessed to memory concerns said they'd asked a doctor about their problem. Sixteen percent scored poorly enough to have follow-up testing advised; no one knows how many did.
 
All those others who passed were warned that symptoms could arise later, and given information on steps to protect an aging brain _ by, for example, keeping in check the high blood pressure and diabetes that can spur dementia. Alabama officials even created a Web site for such information:http://www.alzbrain.org.
 
"These are the kinds of dots we need to begin to connect for people," Powers says.
 
And by the way, what were those three words again?
 
EDITOR's NOTE  Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
 
© 2008 Associated Press.

 
 
Associated Press
By Mike Stobbe
Washington Post
Monday, December 8, 2008
 
ATLANTA -- State laws meant to keep teens out of indoor tanning booths haven't made a dent, a new study has found, disappointing doctors hoping to reduce deadly skin cancers.
 
The researchers say it's not clear why the laws failed, but pointed to lax enforcement as a factor.
 
The study is the first to look at the laws' impact. Some medical experts were disturbed by the findings, saying more needs to be done about the health threat from indoor tanning parlors.
 
"Basically, these are businesses that are exposing teenagers to carcinogens," said Dr. Jeffrey Sosman, a melanoma researcher at Vanderbilt University, who was not involved in the new study. Melanoma is the deadliest form of skin cancer and has been linked to childhood sunburns.
 
An estimated 30 million Americans are customers of the nation's 25,000 indoor tanning businesses, according to the Indoor Tanning Association. The organization argues that indoor tanning, when done properly, can improve health.
 
Tanning parlors are popular with girls and young women. As many as one in three girls use indoor tanning, some studies suggest. Researchers say the rates may be even higher among female college students.
 
U.S. cases of melanoma have been increasing. It's not clear to what extent indoor tanning has played a role in that trend, but people who start indoor tanning when they're young have a higher risk of melanoma, scientists say. Melanoma can almost always be cured if caught early.
 
About 20 states now have some law aimed at curbing minors' use of indoor tanning, said Vilma Cokkinides, an American Cancer Society researcher who was one of the study's authors.
 
The research involved telephone surveys of more than 1,100 youths ages 11 to 18. The surveys were done in 1998 and 2004 in the 48 continental states. Eight states in 1998 had new or fairly new laws to restrict minors' access to indoor tanning.
 
Each of the laws allowed young people to use tanning parlors provided they had some form of parental consent, in some cases a note from a parent. Only one _ California _ had a stricter prohibition, banning children 14 and under from using tanning facilities.
 
In those eight states, about 8 percent of youths used indoor tanning in both 1998 and 2004 _ no change over the six years. Nationally, about 10 percent of youths used indoor tanning in those years, likewise holding static.
 
The study was published in Cancer, a journal of the American Cancer Society. Neutrogena Corp., a Los Angeles-based manufacturer of skin care products, paid for the study, but the company had no say in its design or analysis or the writing of the report, Cokkinides said.
 
Cokkinides said lax enforcement may be a factor behind the ineffectiveness of the laws, but her surveys did not ask kids if they had ever been turned away while trying to use an indoor tanning parlor.
 
In another study, published in October, researchers found that one-third of health officials in states with indoor tanning laws said they did not inspect tanning parlors, while another third inspected less than once a year.
 
On the Net:
Cancer Society:http://www.cancer.org/
 
© 2008 The Associated Press.

 
 
By Ashley Andyshak
Frederick News-Post
Tuesday, December 9, 2008
 
I am not a cough syrup fan. As a child, I would rather tough it out through a few days of coughing and congestion than down a dose of Robitussin (at least that's the way I remember it). Even most of the fruity-flavored kid's syrups made me sicker than I already was.
 
In recent years, more and more pediatric groups and even some at the Food and Drug Administration have recommended that parents hold off on such over-the-counter cough and cold medicines, claiming the benefits are too small and the risks too great.
 
Officials at the Food and Drug Administration recommended last year that no child under 6 take OTC meds, though the administration as a whole has not taken a formal position. Drug companies have pulled infant OTC products from store shelves and have begun using new labels for the rest, advising parents not to give the meds to children under 4.
 
Concerns about such medicines range from accidental overdose to dangerous or deadly side effects from the drugs themselves. Some parents unintentionally overmedicate their children by giving several medications for different symptoms, not realizing they all contain the same ingredients. Some drugs make children restless or irritable, and doctors say cough suppressants actually do more harm than good by preventing the body's natural mucus-removal technique.
 
Reports of deaths from cold medicines vary, depending on the source. A new report published in Pediatrics, the official journal of the American Academy of Pediatrics, shows that about 500 children die each year from these medicines. The Centers for Disease Control and Prevention reports that about 7,000 children younger than 12 are taken to an emergency room after taking OTC medications.
 
As this cold season kicks into full swing, docs recommend you don't just grab the first medicine you see for your children's coughs and colds. Check with your family doctor or pediatrician before giving your child any OTC medications, and of course make sure all drugs are kept out of your child's reach.
 
If you'd prefer to steer clear of OTC drugs altogether, try honey. Some studies have also shown honey is effective in fighting coughs with no side effects in most children older than 1 year (younger children shouldn't have honey). Placing a humidifier in the child's room can also help make breathing easier.
 
Here's to a healthy and happy holiday.
 
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