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Heavy Metal Under Fire - When forests burn, airborne mercury is part of the fallout, say researchers - Monday, January 28, 2002 by newsmanager

By Jackie Rothenberg HealthScoutNews Reporter (HealthScoutNews) -- Wildfires belch as much mercury into the air as power plants do, says new research. Scientists think they know how much of this heavy metal is in the atmosphere, but this latest study shows a source not previously known: smoke plumes from wildfires. "The amount of mercury coming out of power plants was well known, and now it turns out to be that the amount of mercury coming out of wildfires is along the same magnitude," says Hans Friedli, a senior research associate with the National Center for Atmospheric Research in Boulder, Colo. His findings appear in this month's issue of Geophysical Research Letters. During wildfires, mercury stored in the foliage and ground litter is released into the atmosphere. Friedli and a colleague discovered this by setting controlled fires in Montana and by flying over naturally occurring wildfires last year in Canada and again recently in the Pacific Northwest. They measured the mercury levels coming off of each. The mercury emitted in the fires is primarily gaseous elemental mercury, which poses no health risk to firefighters. But, Friedli says, the emission of mercury does present a threat when you look at the big picture. When elemental mercury goes into the air, it oxidizes and converts to ionic mercury, a form that deposits much faster into bodies of water. Once there, it turns into the toxic methylmercury, which enters the food chain through contaminated fish and presents a health risk. "The issue is that the stuff gets redistributed into areas where it can be converted into methylmercury, where it can become a problem," Friedli says. How much is burnt off trees and goes into the air? When a tree burns, up to 99 percent of the mercury it stores vaporizes, the researchers found. This means burning forests puts about 800 tons of mercury per year into the air worldwide, they say. About 6,500 tons of gaseous elemental mercury are in the air at any one time. Michael Murray, staff scientist at the National Wildlife Federation, agrees, saying, "It's important to have a handle on all the sources of mercury -- and this is filling in the picture. Anything that helps us understand the mercury cycle is useful to scientists as well as helpful to policymakers." Another related experiment that Friedli and his team will do in Saskatchewan, Canada, later this month will examine the role of soil in wildfires. The researchers think heated soil is also a factor in the high emission of mercury during the fires. What To Do Mercury comes from both natural and manmade sources. There isn't much that can be done about the natural sources, but much is already in the works to stem emissions from human sources. The Environmental Protection Agency has determined that mercury from power plants -- the largest source of mercury in the United States -- is a marked risk to public health and is working to lower emissions from coal-fired power plants. The EPA is set to propose regulations by the year 2003 and issue final rules by 2004. "We're urging the Bush administration to make the deepest cuts possible -- to cut mercury from power plants by at least 90 percent," says Andy Buchsbaum, a senior mercury policy specialist at the National Wildlife Federation. "Wildfires are part of the mercury cycle," he says. "And the only way to reduce mercury from wildfires is to reduce the mercury in the cycle, so you have to reduce it from human sources -- like power plants." If you're wondering what health risks mercury poses, here is an excellent fact sheet from the Centers for Disease Control and Prevention.

Good Habits Reduce Blood Clots - Monday, January 28, 2002 by garyfarr

January 21, 2000 BELFAST, IRELAND—The benefits of a healthy lifestyle continue to stack up. The latest news is that good lifestyle habits can lower blood-clotting components that may trigger heart disease and stroke. Researchers found that the men who smoked, drank alcohol, didn't exercise, and were obese had higher levels of blood components related to clotting. Those high levels may lead to heart attack or stroke. Not only can individuals improve their cholesterol and blood pressure levels by exercising, keeping their weight at healthy limits and not smoking, they can also reduce the tendency for formation of blood clots and improve circulation, noted the study's Author John W.G. Yarnell, M.D. The study analyzed six clotting-related components in the men's blood samples and found that two of them— fibrin D-dimer and von Willebrand factor—were lowered by exercise. But obese men in the study had 30 to 50 percent higher levels of two other clotting components: tissue plasminogen antigen and plasminogen activator. The smokers and heavy drinkers in the group also had higher levels of some clotting factors, but the levels fell if the men quit smoking.

Sleep Problems Are Risk Factor for High Blood Pressure - Monday, January 28, 2002 by garyfarr

February 21, 2000 NEW YORK, NY—A new study published by the American Lung Association confirms that sleep-related breathing problems are an independent risk factor for high blood pressure. The study of 1,190 patients seen at a sleep disorders center in Marburg, Germany, found that the more severe a person's sleep-related breathing disorder, the higher the risk of high blood pressure, or hypertension. The risk of hypertension was greatest in people with sleep-related breathing problems who were age 50 and younger. According to lead researcher Ludger Grote of Sahlgrenska University Hospital in Gothenburg, Sweden, the study results point to the need for patients with sleep-related breathing problems to have their blood pressure checked, and for hypertension patients to be evaluated for clinical signs of sleep-related breathing problems. Sleep-related breathing disorder is a condition in which the throat narrows repetitively throughout sleep. These people tend to snore during the night and be sleepy during the daytime. In addition to being at increased risk for high blood pressure, they are also at increased risk for heart disease.

Study Links Infections and Cardiovascular Death - Monday, January 28, 2002 by garyfarr

SALT LAKE CITY, UT Researchers at LDS Hospital, Johns Hopkins University, and the Washington (DC) Hospital Center have new evidence that a number of infectious bugs -- including hepatitis A and herpes simplex virus types 1 and 2 – are strongly associated with heart attacks and cardiovascular death. In a major new prospective study of nearly 900 heart disease patients, researchers at the three centers found a significant association between infectious viruses and bacteria and risk of heart attack or cardiovascular death. Specifically, researchers found that the more infectious agents patients tested positive for, the more likely they were to die of a heart attack. "The results of this study add further evidence that infection plays an important role in cardiovascular disease and cardiovascular death," says one of the study's authors, Joseph B. Muhlestein, MD, director of LDS Hospital's Cardiac Research Laboratory.

AMA's Anti-Gift Campaign Funded by Gift-Givers - Monday, January 28, 2002 by newsmanager

The American Medical Association (AMA) is under fire from the consumer watchdog group Public Citizen over an educational campaign advising doctors not to accept drug company gifts. The problem, Public Citizen says, is the campaign is funded largely by drug companies. The AMA will spend about $1 million on the campaign, says an Associated Press article. It includes informational brochures, a new Web site on gift guidelines and an ethics book for doctors and industry representatives, it says. The group itself will contribute just over $400,000. The rest, the article points out, comes from gifts of $50,000 to $100,000 each from nine drugmakers listed in a letter to members announcing the campaign. Public Citizen's Dr. Sidney Wolfe, who heads the organization's Health Research Group, characterized the AMA execs who came up with the idea as "brain-dead," the article says. He calls the campaign itself "prostitution," it adds. The AMA, the article continues, was not available for comment. The AMA adopted guidelines a decade ago on doctors accepting cash and gifts "of substantial value" from drug companies, the article notes. Free trips and hotel accommodations for conference attendance are included, it adds, while work-related pens and notepads are not. But because "evidence suggests that many members may be unaware of the guidelines," the article quotes the AMA letter as saying, the new campaign was developed. Wolfe is quoted as likening the campaign to the doctor group's 1997 deal with Sunbeam to endorse that company's products. The AMA abandoned that project, the article reports, losing about $10 million and "hundreds of members" in the process.

Aetna in 'Landmark' HMO Settlement Over Treatment - Monday, January 28, 2002 by garyfarr

In a settlement with the state of Texas, health insurance giant Aetna Inc. agreed on Tuesday to stop offering financial bonuses to doctors who limit health care, a practice criticized because patients were denied treatment to save money. Texas Attorney General John Cornyn said the "landmark'' agreement with the nation's No. 1 health insurer could become a model for other health maintenance organizations. "This agreement takes the surprises out of managed health care," he said at a news conference. "Instead of finding a way to pay, too many HMOs have hidden behind paperwork and legal definitions, while consumers and their doctors hunt for solutions based on a short-term timeline," Cornyn said. He said the settlement would ensure that "any financial incentives to doctors do not affect the quality of care received by patients.'' The 1998 lawsuit against the firm's Aetna U.S. Healthcare unit and several other health insurers charged that they meted out financial penalties to physicians who exceeded medical budgets and rewarded those who did not, Reuters reported. Many HMO patients have complained that they were denied care without proper explanation or for apparent financial reasons. Aetna, based in Hartford, Conn., did not admit wrongdoing and will pay no fines or penalties. The lawsuit, filed by then-Texas Attorney General Dan Morales, originally sought to fine the company $10,000 per violation. "We agreed this is a win-win for everybody. It restores the confidence of the consumer in the health plan and restores the confidence in their physicians,'' said Arthur Leibowitz, chief medical officer of Aetna U.S. Healthcare. The settlement also requires Aetna to disclose the reasons for denying medical coverage and limits how often the company can change the list of covered prescription drugs. Aetna also agreed to create a consumer ombudsman office for its 960,000 Texas HMO members. Nationally, Aetna provides health benefits to 29 million members. Cornyn said he hoped the other defendants in the state suit would follow Aetna's lead and adopt the same policies. They include Humana Inc. Health Plans of Texas, PacifiCare Health Systems Inc. of Texas, NYLCare Health Plan of the Southwest and NYLCare Health Plans of the Gulf Coast. He said the state would pursue legal action against Aetna if the firm did not live up to the agreement. "My office will not hesitate to go to court if the provisions of the agreement are not fulfilled. We expect others to live up to this agreement or suffer the consequences," Cornyn said.

Older Americans Don’t Seek Treatment for Daily Pain - Monday, January 28, 2002 by garyfarr

More than half (55 percent) of Americans 65 years of age or older experience daily pain, and 69 percent of this group attribute their pain to arthritis, according to a survey released last week by the Arthritis Foundation, Atlanta, and reported by Reuters Health. In many cases, the pain is chronic, with the average duration of pain reported to be 110 weeks. According to the survey respondents, however, only about half of these patients seek treatments to alleviate their pain. The Gallup Organization survey of 2,002 Americans showed that while 23 percent of Americans ages 18 years and older experience joint pain every few days or daily, only 51 percent of those surveyed reported visiting their doctor in the past three years for treatment. In response to these findings, the Arthritis Foundation and participating organizations announced a public education program. There is "a perception that getting older means increased pain and that there is no treatment for pain," said Dr. Jack Klippel, medical director of the Arthritis Foundation, adding that Americans in pain need to be educated that "pain is not part of growing older and arthritis can be treated. People in pain should talk to their doctors."

Paraplegic to Attempt Second Yosemite Climb - Monday, January 28, 2002 by newsmanager

Mark Wellman, who gained international acclaim by successfully completing the first paraplegic ascent of Half Dome in Yosemite National Park, will celebrate the 10th anniversary of his climb by ascending the monolith once again. Wellman and his long-time climbing partner Mike Corbett will tackle their second ascent of dome on Sept. 4, exactly 10 years to the day after their first successful climb. A 1982 climbing accident left Wellman paralyzed from the waist down. Following treatment at the regional Kaiser Foundation Rehabilitation Center,Wellman has gained international attention by becoming the first paraplegic to conquer the 3,000-foot El Capitan in Yosemite National Park and the treacherous 2,200-foot vertical tis-sa-ack route on Half Dome. He's also the first paraplegic to sit-ski 50-miles across the Sierra Nevada Mountain Range using only his arms. Wellman will demonstrate his climbing techniques at a send-off celebration at the Kaiser Foundation Rehabilitation Center in Vallejo, Calif. on Thursday, August 30 at 10 a.m. Wellman will scale a 25-foot climbing wall, using only his arms and specially designed adaptive equipment that replicates what will be used as he climbs Half Dome. Wellman also will provide a demonstration of his training regiment and will be available to answer questions and provide insight into his career following his accident. Although members of the media are invited to attend, the event is not open to the public.

Congressman urges investigation of possible link between autism and multiple measles-mumps-rubella vaccinations - Monday, January 28, 2002 by garyfarr

Backed by families convinced that vaccines caused their children to develop autism, Indiana Republican Rep. Dan Burton promised he would use his power to investigate the issue. Activists say the rate of autism, a vaguely defined neurological condition whose symptoms can range from violence to withdrawn behavior, has skyrocketed in the past 10 years. “Ten years ago, autism affected 1 in 10,000 children. Today, conservative estimates are that it affects one in 500 children,” a group known as “Unlocking Autism” said in a statement. The U.S. Centers for Disease Control and Prevention (CDC) estimated in 1997 that autism affected 1 in 500 people. Burton, chairman of the House Government Reform Committee, said he was persuaded by charts that suggested the upswing came with the advent of multiple vaccines. “We are going to pursue this. We are going to get answers,” Burton, whose grandson, Christian, has autism, told a news conference ahead of a hearing on the subject called by his committee. “I intend to subpoena people from pharmaceutical companies before my committee,” Burton said. He said he would investigate disagreements on the side-effects of vaccines and would make sure that staffers and advisers to the Food and Drug Administration (FDA), which regulates drugs and vaccines, did not have any financial interest in commercial vaccines. ABCNews, April 7, 2000

FDA says it has no authority over the content labels of bottled drinking water - Monday, January 28, 2002 by garyfarr

The FDA has released a draft study stating that it had no authority to require makers of bottled water to provide on their labels information about the water's exact contents. "A number of consumers, particularly people with weakened immune systems, have requested that the date of bottling, the water's mineral profile, the overall acid level, and the type of treatment it underwent be spelled out on the labels", stated, Rebecca Buckner, author of the FDA report. The FDA report was mandated by a 1996 amendment to the Safe Drinking Water Act (SDWA), which required agency officials to study the feasibility of informing consumers about the contents of bottled water. But these amendments did not expressly address the FDA's authority to implement these changes. In fact, the amendments primarily were passed to provide consumers with a "confidence report" regarding the level of contaminates found in their public drinking water. Currently, FDA regulations simply require that these products be tested for about 75 different potential contaminates. The industry also does some self-regulation, such as submitting to spontaneous inspections by an independent safety monitoring organization. 2000 Healtheon, February 22, 2000

Insecticides Cause Mad Cow Disease - Monday, January 28, 2002 by garyfarr

Pharmaceutical interests in the UK are ignoring new scientific research that shows the insecticide used in the UK government's own warble-fly campaigns triggered the UK surge of "Mad Cow" disease. Latest experiments by Cambridge University prion specialist, David R. Brown, have shown that manganese bonds with prions. Other researchers work shows that prions in the bovine spine --along which insecticides are applied-- can be damaged by ICI's Phosmet organophosphate(OP) insecticide -causing the disease. British scientists have led the current theory that an infectious prion in bonemeal fed to cattle causes bovine spongiform disease (BSE). Infectious prions are also claimed to cause new variant Creutzfeld-Jakob Disease (CJD) in humans -from ingesting beef. But the infectious prion theory serves to obscure a tragic chemical poisoning scandal behind the majority of BSE cases. The new work proves that the prions can bond with manganese in animal feeds or mineral licks. These manganese prions cause the neurological degeneration seen in BSE. By a similar process, prions in human brains are damaged by lice lotions containing organophosphate. This can result in neurological diseases like CJD and Alzheimer's -later in life. Many might be surprised to hear that organophosphates were developed by Nazi chemists during the course World War Two, as a chemical weapon nerve agent. The marginalized research has devastating financial implications for ICI. It would provide a firm basis for litigants -who could include CJD sufferers, farmers across the world and families of the many British farmers who committed suicide during this BSE debacle. Scientist and organic farmer, Mark Purdey gave evidence to the UK BSE inquiry, that warble fly insecticide was the cause of the disease. The scientist wheeled out to rubbish Purdy's evidence -Dr. David Ray, later turned out to have been receiving funding from the insecticide manufacturer ICI. Purdey has been consistently denied even exploratory funding to extend his privately supported research. Yet the Purdey/Brown chemical poisoning model matches with the epidemiological spread of CJD clusters in humans. It also predicts the incidence of BSE-type diseases in animals. The accepted infectious model fits neither. The pharmaceutical industry is all the more determined to hide the chemical source of BSE and CJD, because a spotlight on chemicals would expose the role the insecticides in Alzheimer's --another neurodegenerative disease--that might lead to claims which would dwarf those from BSE and CJD litigants. In fact, two leading brain researchers into CJD and Alzheimer's have died in suspicious circumstances in recent years. In the United States, the Environmental Protection Agency is already reviewing Phosmet's safety. The Centers for Disease Control in the US has recently conducted experiments on mice that confirm the organophosphate risk. Not only is the EC beef slaughter campaign futile -because BSE disease is mostly noninfectious, but unless the underlying chemical cause is addressed, BSE will simply reappear from chemical causes. A new warble fly campaign is already underway in France using the organophosphate insecticide. Of greater concern is that some lotions for scabies and head lice are now priming children and adults, for CJD and Alzheimer's in later life. Bonding the Prion Cambridge University prion biochemist, David R. Brown is dismissive of the science behind the infectious model of BSE. He terms it "a very limited amount of science by a few assumed- reputable scientists." He insists there is "no evidence an infectious agent is present in either meat or milk." "Simple tests on udder walls of cows --which could easily detect an infectious prion-- have not been done, why I don't understand." A number of researchers have found that organophosphate(OP) in systemic warble fly insecticide can deform the prion molecule, rendering it ineffective at buffering free radical effects in the body. Worse still, the prion is then partial to bond with manganese and become a 'rogue' prion. A chain reaction whereby rogue prions turn others to rogues also, can explain the bovine spongiform disease mechanism. Brown showed how prion protein bonds benignly with copper, but lethally with manganese. Even natural variations in relative environmental availability of manganese versus copper can trigger prion degradation. The CJD and BSE symptoms mirror 'manganese madness', an irreversible fatal neuro-psychiatric degenerative syndrome that plagued manganese miners in the first half of the last century Shining A Light On Spongiform Organic dairy farmer and peer-review-published independent scientist, Mark Purdey, says the accepted theory of transmission from BSE-infected cattle to human CJD -by bonemeal or meat, is dependent on a mutant prion that has never been isolated under the scientific protocol called Koch's postulates. Purdey's insistence on sticking to the letter of this scientific law earned him the condemnation of UK officialdom when he first mooted his theory. But Purdey pointed to CJD clusters downwind of a British Phosmet production plant to back his case. He gave evidence to the UK Government BSE inquiry and was supported by Conservative MP, Thessa Gorman. His views were discounted, but his subsequent research and the new Cambridge prion work have confirmed the alternative theory. Despite this, and the backing of a British peer, he is denied even exploratory funding. Why does CJD degeneration in humans begin in the retina, and why are CJD disease clusters found in high altitude locations? The prion molecule has a known natural role as a shock absorber of damaging energy from ultraviolet rays and other oxidizing agents. Once this prion defense system is rendered ineffective by organophosphates - for example in human head lice lotions, these oxidizing effects have an unmediated impact on tissues. Eventually, UV radiation damages the retina and oxidative stress destroys the brain tissues of CJD patients. This theory would expect to find higher CJD incidence in mountain regions -where UV radiation levels are elevated. That prediction holds true. A similar but accelerated mechanism could be driving BSE. ICI's Phosmet organophosphate warble fly insecticide -applied on the backs of animals along the spinal column, similarly degrades prions. "Systemic versions of the insecticide are designed to make the entire cow carcass toxic to warble fly," explains Purdey. "Unfortunately it's toxic to prions too -especially those prions located just millimeters from the point of application." The damaged prions are then ready to react with manganese in animal feed, or manganese sprayed on land or in mineral licks -to become the driving force of BSE neurodegeneration. Purdey says manganese-tipped prions set off lethal chain reactions that neurologically burn through the animal. Chickens notoriously excrete most of the supplements fed to them -including manganese. And their manganese-rich excreta have been blended into cattle feed in the UK. Natural variations in the relative environmental availability of copper and manganese can also spur prion degeneration says Purdey. From this research, any prudent person would conclude there is a significant risk attaching to the use of organophosphate in humans. Preparations for head lice and scabies are known to be overused in practice and might be priming users for CJ disease. The Money Trail Critical scientists like Purdey are unlikely to prevail. The pharma industry holds most research purse strings, and would hardly energetically explore an avenue of research that could expose them to litigation for causing BSE. The official theory is lavishly funded, alternative theories rarely, if at all. There are more explosive implications to his -and other's latest research. Purdey says similar organophosphate-induced protein deformation could also underlie Alzheimer's disease. If that were true, the litigation fallout would destroy some pharmaceutical giants, and a lot of very influential noses would be out of joint. Disturbingly, Purdey and other brain researchers seem to have had an undue share of unfortunate accidents. Purdey's house was burned down and his lawyer who was working with him on Mad Cow Disease was driven off the road by another vehicle and subsequently died. The veterinarian on the case also died in a car crash -locally reported as: 'Mystery Vet Death Riddle.' Dr. C. Bruton, a CJD specialist --who had just produced a paper on a new strain of CJD-- was killed in a car crash before his work was announced to the public. Purdey speculates that Bruton might have known more than what was revealed in his last scientific paper. In 1996, leading Alzheimer's researcher Tsunao Saitoh, 46 and his 13 -year-old daughter were killed in La Jolla, California, in what a Reuters report described as a "very professionally done" shooting.

Boston Hospitals Launch Second Opinions Online - Monday, January 28, 2002 by newsmanager

For $600, patients can submit detailed health information to a new Web site that then forwards that information to a specialist -- who offers the patient's primary care physician (PCP) a second opinion. The service – sponsored by three high-profile hospitals – is designed to reduce problems with crowded doctors' offices and with rural patients' access to specialists. And the sponsors say it's perfectly ethical as well. The A-list sponsors are Massachusetts General Hospital, the Dana Farber Cancer Institute and Brigham and Women's Hospital, all in Boston, notes an article by Alexa Pozniak at ABCNews.com. The facilities offer links on their own Web sites to what's being called the Partners Online Specialty Consultation site. The telemedicine project is run by Partners HealthCare, the management company that also operates Mass General and Brigham and Women's, the ABCNews.com article says. The $600 price tag is generally not covered by insurers. To start the process, the article continues, patients contact their PCPs, who actually initiate the service. Patients then complete detailed online registration forms and submit them with payment. The PCPs then forward any needed back-up documentation to the designated specialists. The specialists respond with three business days, and the PCPs discuss results with the patients. That approach skirts one of the problems with telemedicine – doctors have to be licensed to practice in the state the patient resides in. This way, the patient's own PCP is the one actually doing the requesting and analyzing of results. A spokesperson for the operation told ABCNews.com that some 4,000 specialists are available through the service. While some ethicists say doctors shouldn't render opinions without actually seeing the patient, the article notes, supporters point out that it's the next best thing for rural patients and patients who couldn't otherwise afford consultation by such top-notch doctors. The Cleveland Clinic, the ABCNews.com article adds, says it plans to offer a similar service soon. Source - ABCNews.com

East Meets West as Physicians Explore Spirituality-Based Healing - Monday, January 28, 2002 by newsmanager

By Rogena Silverman While still in the minority, a new breed of physician is embracing spiritually-based healing practices and alternative medicine. These physicians are referring their patients to chiropractors and acupuncturists, as well as recommending massage therapy, yoga, and meditation as tools to cope with illness and physical rehabilitation. All of these practices are used to help patients find energy and strength from within to deal with conditions that affect the mind and body. Even medical schools are now beginning to offer course that combine spirituality and medicine. As recently as 10 years ago, few medical school curriculums offered courses on spirituality and healing. However, according to Health magazine, such courses are now offered at 72 out of 125 medical schools in the United States-including George Washington University, Harvard School of Medicine, and Duke University School of Medicine. ************************************************************************** "A merry heart doeth good like a medicine; but a broken spirit drieth the bones." (Proverbs 17:22) ************************************************************************** For centuries, medical practitioners from Eastern-based cultures have long-recognized the connection of health and spirit. For example, Indian-born endocrinologist-turned-spiritual-leader Deepak Chopra, MD, has been a recent pioneer in bridging Eastern and Western medicine and spirituality. Chopra, who believes in the concept of "longevity personality," claims that the five senses are the gateway to the inner pharmacy. In his book, Quantum Healing:Toward Perfect Health, Chopra states, "The force responsible for healing is within the patient." For instance, he believes that individuals can be taught to use sounds in their environment to reestablish balance between their mind and body during meditation. Chopra also writes in Ageless Body, Timeless Mind that the connection between body and mind is so strong that emotional conditions, such as severe depression, can weaken the body-damaging the immune system and even causing such illnesses as cancer and heart disease. On the contrary, the emotions of joy, fulfillment, and love can actually extend the life span. "Life is awareness, awareness is life," he writes. As Western physicians begin to embrace these practices and philosophies, medical institutions are offering courses related to spirituality and medicine. In May, a cross-disciplinary curriculum was established at George Washington University when the George Washington University Institute for Spirituality and Health (GWISH) was opened. Courtesy of a 2-year grant of $2.4 million from the John Templeton Foundation, the Washington, DC-based institute is devoted to creating specialized programs and courses to help medical students understand spiritual and religious concerns of their patients. In a recent article in Health magazine (August 7, 2001, page HE01), GWISH director Christina Puchalski, MD, states that the center is dedicated to the concept that "spirituality is a key dimension" for achieving optimal health and coping with illness. Her ultimate goal is to heighten the awareness of this concept. Puchalski, an internist and long-time advocate of uniting spirituality and medical care, encourages her patients to reach out to their spiritual anchors, or do a "spiritual inventory" to help them through their illness. A firm believer in the strength of an extended community of caregivers, Puchalski believes that this responsibility reaches beyond health care givers to extended families, friends, priests, and spiritual counselors. GWISH's primary patients are those with chronic and terminal conditions. Facility representatives encourage institutions of worship to participate in a patient's clinical care. It is because of the reality that more people are living alone, with no family, friends, or other support systems nearby, that Puchalski believes there must be public policy to ensure patients' access to public care. "We need to create new communities of caring," she says. GWISH is not alone in its efforts to combine spirituality and medicine. As recently as 10 years ago, few medical school curriculums offered courses on spirituality and healing. However, according to Health magazine, such courses are now offered at 72 out of 125 medical schools in the United States-including Harvard School of Medicine and Duke University School of Medicine. It is possible that within the next decade, because of physicians like Puchalski and Chopra-and institutions like GWISH-this trend toward body/mind/spirit consciousness may become a more common medical practice among physicians. All it takes is a little faith. Rogena Silverman is Editor of Orthopedic Technology Review

The Internet Is Still Good Medicine for Health Care - Monday, January 28, 2002 by newsmanager

Last week's folding of the Industry Standard and Wednesday's announcement by America Online that it is laying of 1,200 workers is just the newest examples of the woes facing the Internet economy. However, in spite of the continuing tailspin in the dot.com world, for the medical community, the Web is still a growing concern. "With all the Internet companies failing and struggling to survive we felt that it was the perfect environment right now to start up an Internet site," says Christopher Herz, business development manager for the recently launched telemedicine site Ecureme.com. "Afforable health care will always be needed, and everybody is looking for a technological vehicle to move that. There's a void in services with everyone going down. With all the confusion and the stability with health care there was a greater need, more than ever to produce a site that not only could educate but provide cost effective, affordable, high tech services that are deliverable to the masses. We've seen where people have failed, we've seen why big companies have failed." For other companies, such as Aventis Pharmaceuticals, the Internet is a way to complement its brick and mortar business. "We think that e-business has the opportunity to help us build our core business," says Kirk Schueler, senior vice president of e-business for Aventis and CEO of the company's recently launched its telemedicine site, Mydoconline.com. "It's difficult but not impossible for a company to be successful on the Web alone," he says. "Many companies have tried that and have not been successful." He says that a better business model is to have a traditional "brick and mortar" operation and to use the Internet to "expand and leverage your current assets." Schueler estimates that about 100 million Americans check the Internet for medical advice Ecureme.com promises to give patients greater access to doctors via their computer screen-through face-to-face videoconferencing to personalize it for the patient-reintroducing the traditional house call with 21st century technology. "Right now the view in health care is that the patient is a liability-we're going to reverse that," says Ardeshir Talieh, MD, Ecureme.com's chief of telemedicine and vice president. "We can really deliver quality care [at a] very low cost." The site also features games and general medical information like more traditional-and floundering-sites, like drkoop.com. Eventually Talieh hopes to offer preventative programs such as yoga and tai chi classes online and give doctors the ability to do more thorough examinations with advanced sensor technology. And at $4.99 per minute for a consultation, also makes good business sense for doctors and good medical sense for patients. "I saw my physician friends frustrated getting reimbursed almost nothing--$6 for a visit say-and they were also losing the art of medicine; I always considered myself an artist not a scientist," says Talieh. He says that telemedicine offers a solution that allows doctors to practice their "art" and to make money. Talieh sees Ecureme.com-and companies like it-as more than just a business venture that will benefit a few doctors and patients. "Right now I see telemedicine as the last hope for health care in America," he says. Like Ecureme.com, Mydoconline is designed to give patients greater access to their doctors. The difference is that patients can only use the service if their doctor subscribes to it. Enabling the launch of Ecureme.com was an arrangement the new company made with Verizon Wireless to provide broadband support. A company spokesman says that its support of the new site reflects its corporate philosophy. "What we've been excited about is the opportunity to make some of the miracles of telemedicine and health care accessible to people in remote places with our broadband technology and network," says Julia Wilson. "Part of our vision for the next wave of the Internet revolution is making access to health care as seamless as possible." The support also makes sense from a business perspective, Verizon expects to meet or exceed its goal of 1.3 million new DSL subscribers this year-all potential users of the Ecureme.com service. "Ecureme is offering a very valuable service and very valuable information to our customers, and customer service is important to us," says Wilson. "Certainly we're cautiously optimistic about the future." With the new HIPAA privacy regulations, there might be an expectation that medical e-business and online information exchanges between doctors and patients will dry up. Not so, says Schueler. "I think [HIPAA] will actually fuel some of the growth in the use of the Internet for maintaining medical records and communicating between physicians and patients," he says. Talieh notes that patient records are actually more accessible now sitting in doctors' offices than they are on an Internet server. Talieh says that Ecureme's HIPAA software has opened a potential new revenue stream for the company, which it hopes to sell to providers. Although there have been numerous failures in the world of Internet medicine, there are also successes. The physicians at Cedars-Sinai Medical Center in Los Angeles have been using Palm Pilots, wireless modems, and customized software to have access to their patients 24 hours a day since 1998. The successful system, which allows physicians and caregivers to access information over a secure Internet server, eliminates the need to wait for paper reports. As for the future of medical e-commerce, Schueler says that it is bright. "There's a tremendous amount of opportunity for expansion of what's being done on the Internet today relative to health," he says. "But some [sites] will go away. I think some of the content sites that don't have an adequate business model will go away. I think the sites that somehow link with a real entity will be much more robust." Source: HealthBizNews.com C.A. Wolski, Feature Editor

Day care leads to stronger bacteria - Monday, January 28, 2002 by garyfarr

In a two-year study involving 240 toddlers and 46 of their siblings in Beer-Sheva, Israel, researchers at Ben-Gurion University in Beer-Sheva found the high use of antibiotic treatment among children attending day-care centers was contributing to the rise in bacterial resistance to medications. This was particularly true, researchers found, for bacteria that attacked the nose and throat, such as Streptococcus pneumonaie. "Day-care centers act as microenvironments that facilitate and promote ... spread and transmission of antibiotic-resistant respiratory tract organisms in the community and should be seen as major targets for intervention," says lead researcher Dr. Ron Dagan. Researchers found the same resistant S. pneumonaie strains in the siblings of the kids attending the day-care centers studied, suggesting that spread of such superbugs may not be confined to the child-care facility. The findings suggest day-care centers work as incubators for bacteria, researchers reported Saturday at the 40th Interscience Conference on Antimicrobial Agents and Chemotherapy meeting in Toronto. High rates of respiratory infections among kids often leads to high use of antibiotics, which is making the bacteria come back even tougher than before. Also, they point out, day-care centers host babies and toddlers whose hygiene standards may vary greatly, which can also increase the rate of infection.

Toxins poisoning US's children - Monday, January 28, 2002 by garyfarr

Every year, U.S. industry releases about 24 billion pounds of toxic substances that are believed to cause developmental and neurological problems in children. This alarming finding is one of many in Polluting Our Future: Chemical Emissions in the U.S. that Affect Child Development and Learning, a joint report released Thursday by the National Environmental Trust, Physicians for Social Responsibility and the Learning Disabilities Association. Polluting Our Future looks closely, for the first time ever, at the scope and sources of neurological and developmental air pollutants. Nearly one in every six, or about 12 million, children in the United States suffers from at least one developmental, learning or behavioral disability such as mental retardation, birth defects, autism or attention deficit hyperactivity disorder. Polluting Our Future determines that about one in every 200 American children, or more than 360,000, live with developmental or neurological disabilities caused by exposure to toxic substances including developmental and neurological toxins.

Not all personal trainers up to par - Monday, January 28, 2002 by garyfarr

The fitness industry is so unregulated, the person spotting your sit-ups could be anything from a rehab specialist to a dressed-up jock. "It's too easy to become a trainer," said Greg Werner, director of strength and conditioning at James Madison University in Harrisonburg. You've got people coming out of the woodwork who say they want to do this." The danger, Werner said, is that gyms will boast about a staff that might not be as experienced as advertised. "There's a ton of certifications out there," said Richard Cotton, chief exercise physiologist for the California-based First Fitness Inc. "(A certification) is a badge that someone can wear for good reasons and not-so-good reasons." Certifications make exercise trainers seem more professional, Cotton said, but they vary widely in quality. For example, an American College of Sports Medicine certification -- considered the gold standard of fitness certifications -- requires six months of study, workshops and tests. But most others require less, said Cathy Stewart, director of certification for ACSM. There are about 250 organizations that grant some sort of professional certification to fitness specialists, said Jennifer Evans, a spokesman for the American Council on Exercise. ACE, one of the larger organizations, has certified 88,000 fitness specialists since 1990. In 1999 alone, ACE passed 7,535 trainers -- six times more than it did in 1990.

Parents may be graduating their children from booster seats to soon - Monday, January 28, 2002 by garyfarr

Parents have greatly improved in making sure their children are protected while riding in motor vehicles, according to researchers. Yet, results of a Partners for Child Passenger Safety study suggest that many children are still at risk of injury as parents prematurely graduate them from child car seats to booster seats and adult seat belts. "There is a large exposure of children to crashes," said study co-author Dr. Flaura Koplin Winston, principal investigator of Partners for Child Passenger Safety. "A large percentage are inappropriately restrained for their age," she stated. To investigate the cause of injury and death among children in crashes, the Children's Hospital of Philadelphia, collaborated with State Farm Insurance and the University of Pennsylvania to conduct an ongoing study. This interim report released in the fourth year of the study analyzes data from 30,000 crashes involving State Farm-insured children under age 16. Study findings show that "less than 5% of children who should be in booster seats are," said Winston in an interview with Reuters Health. Ironically, she stressed, the peak use of booster seats occurs "at age 3, when kids should be in (child) car seats." Current guidelines state that "children should continue to ride in a forward-facing car seat until they reach 40 pounds, usually around age 4," the authors write. When that weight requirement is reached, children should first be graduated to booster seats until they are at least 4 feet, 9 inches and 80 pounds, and then to adult seat belts. However, 83% of 4 to 8 year olds and 16% of 3 year olds are "inappropriately restrained in adult seat belts," the investigators report. "The main problem," Winston explained, is that "the child's thigh is too short." The child has to "scoot" forward to sit comfortably, which pushes the lab belt above the abdomen, she explained. He or she is thus placed at risk for injuries to the liver, spleen and spinal cord in a crash. The most significant injuries sustained by children in car accidents include concussions, severe lacerations, and internal organ damage. The majority of these injuries (64%) occur to the head. "Children do not heal as easily from brain injuries as they do from injuries to other parts of their bodies," the researchers note. The use of age-appropriate restraints is crucial to avoid such injury, the report suggests. Reuters, May 29, 2000

Preventing Death And Injury From Medical Errors Requires Dramatic, System-Wide Changes - Monday, January 28, 2002 by garyfarr

WASHINGTON - Reducing one of the nation's leading causes of death and injury - medical errors - will require rigorous changes throughout the health care system, including mandatory reporting requirements, says a new report from the Institute of Medicine (IOM) of the National Academies. The report lays out a comprehensive strategy for government, industry, consumers, and health providers to reduce medical errors, and it calls on Congress to create a national patient safety center to develop new tools and systems needed to address persistent problems. The human cost of medical errors is high. Based on the findings of one major study, medical errors kill some 44,000 people in U.S. hospitals each year. Another study puts the number much higher, at 98,000. Even using the lower estimate, more people die from medical mistakes each year than from highway accidents, breast cancer, or AIDS. Moreover, while errors may be more easily detected in hospitals, they afflict every health care setting: day-surgery and outpatient clinics, retail pharmacies, nursing homes, as well as home care. Deaths from medication errors that take place both in and out of hospitals - more than 7,000 annually - exceed those from workplace injuries. "These stunningly high rates of medical errors - resulting in deaths, permanent disability, and unnecessary suffering - are simply unacceptable in a medical system that promises first to 'do no harm,'" says William Richardson, chair of the committee that wrote the report and president and chief executive officer of the W.K. Kellogg Foundation, Battle Creek, Mich. "Our recommendations are intended to encourage the health care system to take the actions necessary to improve safety. We must have a health care system that makes it easy to do things right and hard to do them wrong." The know-how exists to prevent many of these mistakes, and so the committee sets as a minimum goal a 50 percent reduction in errors over the next five years. "We believe that with adequate leadership, attention, and resources, improvements can be made," says Richardson. "As we say in the report, 'It may be part of human nature to err, but it is also part of human nature to create solutions, find better alternatives, and meet the challenges ahead.'" The majority of medical errors do not result from individual recklessness, the report says, but from basic flaws in the way the health system is organized. Stocking patient-care units in hospitals, for example, with certain full-strength drugs - even though they are toxic unless diluted - has resulted in deadly mistakes. And illegible writing in medical records has resulted in administration of a drug for which the patient has a known allergy. Medical knowledge and technology grow so rapidly that it is difficult for practitioners to keep up. And the health care system itself is evolving so quickly that it often lacks coordination. For example, when a patient is treated by several practitioners, they often do not have complete information about the medicines prescribed or the patient's illnesses. To achieve a better safety record, the committee recommends a four-part plan designed to create both financial and regulatory incentives that will lead to a safer health care system. Taken together, these recommendations and findings represent a systematic way to design safety into the process of care. They should be evaluated after five years to assess progress in making the health system safer. A National Center for Patient Safety Health care is a decade or more behind other high-risk industries in its attention to ensuring basic safety. The chance of dying in a domestic airline flight or at the workplace has declined dramatically in recent decades, in part because of the creation of federal agencies that focus on safety. Using that model, Congress should create a center for patient safety within the U.S. Department of Health and Human Services (HHS), the committee said. This center would set national safety goals, track progress in meeting them, and invest in research to learn more about preventing mistakes. The center also would act as a clearinghouse, an objective source of the latest information on patient safety for the nation. For example, if a health care organization improves safety, its practices should be shared with a broad audience, and the center, working with others, would help provide the needed channel. Administratively, the home for the center should be in the HHS Agency for Health Care Policy and Research; Congress would need to spend $30 million to $35 million to set it up, the committee says. This estimate is based on the kind of work the center would perform and on investments in issues of similar magnitude, as well as safety research by the public and private sectors. Funding would need to grow to at least $100 million, a little more than 1 percent of the $8.8 billion spent each year as a result of medical errors that cause serious harm. Mandatory and Voluntary Reporting Systems The committee defines "error" as the failure to complete a planned action as intended or the use of a wrong plan to achieve an aim, and notes that not all errors result in harm. To learn about medical treatments that lead to serious injury or death and to prevent future occurrences, the committee recommends establishing a nationwide, mandatory public reporting system. Hospitals first, and eventually other places where patients get care, would be responsible for reporting such events to state governments. Currently, about a third of the states have their own mandatory reporting requirements. While the committee believes that the public has a right to know about errors resulting in serious harm, it nevertheless recommends federal legislation to protect the confidentiality of certain information. Specifically, data should be protected on medical mistakes that have no serious consequences, where the information is collected and analyzed solely for the purpose of improving safety and quality. This would encourage the growth of voluntary, confidential reporting systems so that practitioners and health care organizations can correct problems before serious harm occurs. Without such legislation, fears that reported information might ultimately be subpoenaed and used in lawsuits could discourage participation by health care organizations and providers. Role of Consumers, Professionals, and Accreditation Groups A top-down system won't be enough to bring about the kind of fundamental changes needed to improve patient safety, the report says. Pressure from all directions will be necessary. Public and private purchasers of health care insurance - such as businesses buying coverage for their workers - must make safety a prime concern in their contracting decisions. Doing so will create financial incentives for health care organizations and providers to make needed changes. One reason consumers do not push harder for patient safety is that they assume accrediting and certifying organizations, as well as local and state regulators, do it for them. But regulators and accreditors should make patient safety a key component of their evaluations, the committee says. For most health care professionals, there is no assessment of clinical performance once they get their licenses to practice, for example. Licensing and certifying bodies should implement periodic re-examinations of doctors, nurses, and other key providers, based on both competence and knowledge of safety practices. The U.S. Food and Drug Administration, which regulates prescription and over-the-counter drugs and medical devices, should increase its attention to public safety. Efforts should be made to eliminate similar-sounding drug names as well as confusing labels and packaging that foster mistakes. Numerous studies have documented errors in prescribing medications and dispensing by pharmacists and unintentional mistakes on the part of the patient. Building a Culture of Safety Health care organizations must create an environment in which safety will become a top priority. This culture of safety means designing systems geared to preventing, detecting, and minimizing hazards and the likelihood of error - not attaching blame to individuals. The report stresses the need for leadership by executives and clinicians, and for accountability for patient safety by boards of trustees. That means creating and adequately funding systems to monitor safety. Well-understood safety principles should be adopted, such as designing jobs and working conditions for safety; standardizing and simplifying equipment, supplies, and processes; and avoiding reliance on memory. All hospitals and health care organizations should implement proven medication safety practices, the committee says, such as using automated drug-ordering systems. Medication errors occur frequently in hospitals, yet many are not making use of known methods for improving safety. Patients themselves could provide a major safety check in most hospitals, clinics, and practices. They need to know which medications they are taking, the appearance, and the side effects. They also should be responsible for notifying their doctors of medication discrepancies and the occurrence of side effects. There are no "magic bullets," the report emphasizes; no one part of this plan will be sufficient to bring about the degree of change needed. And responsibility for taking action should not be borne by any single group of providers, but must be addressed by all parts of the health care enterprise. This report is the first in a series expected to be released through an IOM initiative to develop a strategy for improving the quality of health care in America. The study was funded by the National Research Council and the Commonwealth Fund. The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional charter granted to the National Academy of Sciences.

Hot tub bubbles said to cause respiratory problems - Monday, January 28, 2002 by garyfarr

The bubbles in the hot tubs contain bacteria which are dispersed around the room when they burst, causing respiratory problems, they report. The jets in the baths create aerosols which carry the bacteria, spreading them around people's homes, according to the National Jewish Medical and Research Center in the US. Doctors at the centre have recently given care to four children with a lung disease caused by nontuberculosis mycobacteria (NTM), which were found in hot tub water or the homes of the people diagnosed. Unlike its bacterial cousin tuberculosis, which is transmitted by infected humans, NTM is not contagious. In nature, the bacteria live in brown ocean water, such as tide pools. But indoor hot tubs, which can produce a mist, may be causing this lung disease to become more prevalent, the researchers suggest. The organisms enter the air when a mist, called aerosolisation, is produced and the bacteria are suspended in water droplets. Night sweats People with NTM often suffer from fever, tiredness, night sweats, coughs and weight loss. Dr Cecile Rose reported the research findings at the American Thoracic Society's international conference. She said: "The jets from hot tubs aerosolize the bacteria, which is how this becomes a problem. "Bubbles rich with the bacteria rise up, burst and disperse the bacteria throughout a room." She added: "For people with mild cases of NTM, removing the hot tub from the home is the primary treatment." Dr Rose stated that the respiratory problem is often misdiagnosed as sarcidosis, which is characterised by inflamed, microscopic growths called granulomas most often found in the lungs. "This disease mimics other granulomatous lung diseases, but few people understand the link between hot tub exposure and the symptoms of disease." British Boardcasting Company, May 10, 2000

The Best Health Care Goes Only So Far - Monday, January 28, 2002 by newsmanager

Newsweek, August 27, 2001 from the pen of George Lundberg, M.D. Lundberg is the editor in chief of Medscape and a co-author of Severed Trust: Why American Medicine Hasn’t Been Fixed. A few quotes and a bit of data from Lundberg are very illustrative, for example: In 1950, the United States spent $12.7 billion or 4.4% of its gross national product (GNP) on health care, but in 2002, we will spend a whopping $1.5 trillion ofr14% of the GNP on health care. "…as medical consumers we treat death as a problem to be solved." "Physicians--frustrated by their inability to cure the disease and fearing loss of hope of the patient--too often offer aggressive treatment far beyond what is scientifically justified." "…people in Japan and Sweden, countries that spend far less on health care, have achieved longer and healthier lives than we have." "As a nation, we may be overfunding the quest for unlikely cures."

Shock Doc's Own Study Invalidates Electroshock As A Therapy - Monday, January 28, 2002 by garyfarr

100% OF THE DEPRESSED PARTICIPANTS EXPERIENCE THE RETURN OF THEIR SYMPTOMS WITHIN 6 MONTHS Note: Over 100,000 Americans still receive electric shock treatments each year. According to a recently released study by Dr. Harold A. Sackeim, one of the most vocal supporters of the psychiatric procedure Electroshock or ECT (Electro-Convulsive Therapy), the "treatment" has a 100% relapse rate! The study published in the March 14, 2001 issue of the Journal of the American Medical Association (JAMA 2001;285:1299-1307) started with 340 depressed patients who agreed to participate. The patients were majorly women whose ages averaged in the late 50's. Of these, 290 completed the initial ECT procedures which consisted of 5 electroshock sessions. The authors then excluded from the study 195 patients because they did not respond at all to the ECT or because they wanted to try alternative treatments (did not want to continue) or had medical side effects. To put this more clearly, those patients that did not experience even brief relief of their symptoms of depression from the treatment were not counted in the statistics. Of the remaining 121 patients, 100% had a relapse (return of depression) within 6 months of stopping the ECT. "The authors of this study actually invalidate their own results by excluding those 195 patients that did not respond to the ECT," stated Dr. Moira Dolan, medical advisor for the Citizens Commission on Human Rights (CCHR) www.cchr.org, a psychiatric watchdog group. She further stated, "The authors did not intend to show that there was a 100% relapse rate, but that is what the figures show. Only 84 patients could participate in the last part of the study where they used psychiatric drugs and placebos after the ECT, but those results were meaningless because there was a 50% response rate with the placebo! "Their own study validates what the critics have been saying for years - that ECT is a barbaric needless torture of patients that has no therapeutic value!" For further information on the abuses of the psychiatric profession go to this page.

More Urinary Infections Resist Treatment - Monday, January 28, 2002 by garyfarr

Many Bugs Have Developed Antibiotic Resistance — A growing list of antibiotics commonly prescribed to treat painful urinary tract infections in women have become ineffective as the pathogens become drug-resistant, according to a study released today. Already, pathogens such as E-coli that cause bladder infections have become resistant to such antibiotics as ampicillin and cephalothin, Kal Gupta, a researcher at the University of Washington in Seattle, wrote in a study published in the Journal of the American Medical Association. “Of considerably greater concern is the increasing prevalence of resistance to trimethoprim and trimethoprim-sulphamethoxazole that we observed,” he wrote, referring to two commonly prescribed drugs used to treat acute bladder infections, the most common urinary tract infection. Increasing Concern Intensive use of antibiotics, particularly by children, has created increasing concern that bacterial infections will become immune to treatment with existing antibiotics, and that more and more powerful drugs will need to be developed. In a four-year study of 4,000 women diagnosed with bladder infections, the researchers found that the proportion resistant to trimethoprim and trimethoprim-sulphamethoxazole rose from 8 percent in 1992 to 16 percent in 1996. The infections were generally treated successfully with three other drugs: nitrofurantoin, gentamicin and ciprofloxacin hydrochloride. Levels of drug resistance varies by community, the researchers said, and physicians should consider changing antibiotics when local resistance rates exceed 15–20 percent.

Millions of strokes go undetected - Monday, January 28, 2002 by garyfarr

FORT LAUDERDALE, Fla., Feb. 16 — A surprising 11 million Americans each year have strokes that are never detected because they cause no obvious symptoms, although over time they may lead to memory loss and other ills, a study concludes. DOCTORS HAVE long known that people can have insidious “silent strokes” — tiny spots of dead cells inside the brain that do not cause classic stroke symptoms. But the new study suggests they are extremely common, occurring in about 4 percent of the U.S. population each year. Besides the 11 million Americans who have silent strokes annually, about 750,000 more have ones that cause classic stroke symptoms, such as slurred speech, dizziness and numbness on one side. “Silent strokes are epidemic in this country,” said Dr. Megan C. Leary. While they occur in parts of the brain where they don’t cause symptoms right away, “the word ‘silent’ should be put in quotes, because their effects accumulate over the years.” While a single silent stroke may have no impact, repeated ones lead to memory lapses, mood problems and difficulty walking. They are also a sign that people are especially prone to full-blown strokes. Leary and colleagues from UCLA Medical Center released the results Friday at a meeting of the American Stroke Association in Fort Lauderdale. “It’s an alarming estimate,” said Dr. Robert J. Adams of the Medical College of Georgia. “It’s surprisingly high but very possibly accurate.” The researchers say silent strokes are rare before age 30. But after that, their prevalence doubles every 10 years. By the time people reach their 70s, one in three has a silent stroke every year. The researchers also found that some people have more than one silent stroke in a year. When these repeat ones are added together, Americans have almost 22 million silent strokes annually. This means that only 3 percent of the total number of strokes in 1998, when the data were compiled, were actually diagnosed. Leary based her estimate on two surveys involving brain scans on about 5,500 Americans. “What’s sad is that silent strokes and symptomatic strokes are among the most preventable diseases in this country,” Leary said. Doctors can see the scars left by silent strokes when they perform routine brain scans. But ordinarily they do not search for them. However, the new data raise the possibility that perhaps they should, since people who have one silent stroke are likely to have many more. Strokes can be prevented by keeping blood pressure under control, lowering cholesterol, treating diabetes and stopping smoking. Leary said if people actually know they have had a silent stroke, they might be more willing to stick to blood pressure medicines and cholesterol-lowering drugs that cut their risk. The new data suggest that diagnosed strokes “may be just the tip of the iceberg,” said Dr. Ralph Sacco of Columbia University. But while they raise the possibility that doctors should look for silent strokes and treat victims more aggressively, “we don’t have the data to show that yet.” In a separate study, Dutch doctors did brain scans on a cross-section of 1,077 elderly people. They found that one-quarter of them had signs of stroke, and 80 percent of these were silent strokes. “Up until now, we have not told people about silent strokes because we didn’t know what they mean,” said Dr. Sarah E. Vermeer of Erasmus Medical Center in Rotterdam. “Now we have evidence that silent strokes do count.”

Fluoridated Water: Some Say It Is Unnecessary - Monday, January 28, 2002 by garyfarr

Friday February 16 By Charnicia E. Huggins NEW YORK (Reuters Health) - Countless studies have shown that water fluoridation may prevent tooth decay. However, members of the New York State Coalition Opposed to Fluoridation believe that the practice may be unnecessary or even harmful. Water fluoridation is a threat to health, a threat to democracy--in the sense of medication without informed consent--and ``a huge threat to the role of honest science, not corporate science, in public policy,'' said Dr. Paul Connett of St. Lawrence University in Canton, New York. Connett is one of the founding members of the NYS Coalition Opposed to Fluoridation. Fluoride, a naturally occurring element, is used to prevent tooth decay. The compound can be ingested through a fluoridated water supply and help strengthen teeth during development, and can be applied directly to teeth via mouth rinses, toothpaste or other products, according to the American Dental Association (ADA). Studies conducted as early as the 1930s and the 1940s show that children who drink fluoridated water will have lower tooth decay rates than those who drink nonfluoridated water. Recent studies, including those conducted in countries outside the US, continue to show similar results, according to the ADA. The ADA states that ``dental decay can be expected to increase if water fluoridation in a community is discontinued for one year or more, even if topical products such as fluoride toothpaste and fluoride rinses are widely used.'' However, study results from a team of Canadian and American researchers suggest otherwise, according to the antifluoridation coalition. A Study Runs Counter To Most In a study of nearly 6,000 Canadian schoolchildren, Dr. Gerardo Maupome from the University of British Columbia, and his colleagues found that the prevalence of cavities decreased in communities that stopped fluoridating their water. No difference was noted in communities that continued the fluoridation practice, the authors report in the February issue of the journal Community Dentistry and Oral Epidemiology. ``When you have thousands upon thousands of studies, it shouldn't be a surprise that occasionally there will be a study that comes out with an unanticipated result,'' John Stamm, dean of the School of Dentistry at the University of North Carolina-Chapel Hill told Reuters Health. However, ``the vast majority of studies strongly support the efficacy of properly used water fluoridation.'' As a proponent of the fluoridation practice, Maupome insists that his results do not prove that the practice is unnecessary. ``Overall, the experience of disease was different in the two communities--the fluoridated and the nonfluoridated,'' Maupome told Reuters Health. Children in towns that discontinued their water fluoridation did have a higher rate of dental decay, but as a result of good access to dental care, ''(it) had become fillings by the time the children were reexamined,'' he explained. ``Water fluoridation still makes sense even for a population with good access to care and low experience of decay,'' Maupome maintains. Due to the ubiquitous presence of fluoride, however--in mouth rinses, toothpaste, etc,--the impact of fluoridation ``is not as clear cut as you would have found a half a century ago,'' he told Reuters Health. Group Says Fluoridation Unnecessary If, as Maupome said, the effects of the cessation of water fluoridation are not readily detectable due to other existing sources of the element--or better treatment--the continued practice of fluoridation is therefore unnecessary, Connett contends. ``You can't have it both ways,'' he said in an interview with Reuters Health. ``Either the fluoridation is absolutely critical to prevent tooth decay'' or it is not. In most European countries, tooth decay levels are similar to, if not less than, those in the United States, Connett said, ''and very few of them fluoridate their drinking water.'' Also, studies conducted in Cuba, Finland and former Eastern Germany have revealed a decrease in dental decay in communities where fluoridation was stopped, according to Connett. ``So I think they (water fluoridation advocates) have some real explaining to do.'' Many of the authors cited by Connett, however, used short study periods, Stamm said. Maupome's study, for example, took place over a period of 3 to 4 years. ``The effects of fluoride are cumulative,'' Stamm explained. ''When you cease fluoridation (for a short period) you cannot expect to see a window where there's all of a sudden a spike in the dental caries rate that comes back down after the water fluoridation is reintroduced.'' Connett's main worries, however, are the potential dangers of water fluoridation, such as fluoride accumulation in the bones, ``which no one is studying,'' Connett said. He speculates that the high rate of osteoarthritis as well as some osteosarcomas--cancer of the bone--may be linked to water fluoridation. A lesser concern is dental fluorosis--or tooth discoloration cau