Health News for Late July 2008

Cancer

Fighting Lymphoma with Tobacco

While tobacco has a justifiably bad reputation for causing cancer, a new technique may allow it to help some people fight cancer. A phase 1 clinical trial has been conducted in which tobacco plants have been used to create a vaccine against follicular B cell lymphoma. Researchers altered a virus that only attacks tobacco plants by adding a gene from participating patients' cancer cells, and then infected tobacco plants with the altered viruses. In a week, they extracted the protein the plants produced in response to the infection, and then injected the patients with the individualized plant-derived vaccine. No patients experienced side effects, and more than 70% have had cellular or humoral immune responses, and 47% developed antigen-specific responses. The process has already worked to cure cancer in mice, but in humans, the study was only assessing the safety and immune-stimulating ability of the plant-produced vaccines. Future studies will be needed to show if the vaccine works as a treatment in humans. The research was published online on July 21 in Proceedings of the National Academy of Sciences.

Testing a Pill for Fighting Prostate Cancer

A report from a phase 1 trial of a drug to fight castration-resistant prostate cancer is showing promising results, with significant tumor shrinkage and dramatic falls in PSA levels in men who have not responded to other treatments. The drug, abiraterone, which targets an enzyme called CYP17, delayed worsening of the disease by a median of 400 days among a group of 21 men. The results were published online on July 21 in the Journal of Clinical Oncology. Also see the July 22 news release from The Institute of Cancer Research.

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Cell Phones

Cell Phone & Cancer Warning

On July 23, in a move that is certain to cause enormous amounts of controversy, Dr. Ronald Herberman, Director of the University of Pittsburgh Cancer Institute (UPCI), issued an advisory on cell phone use, stating, "Recently I have become aware of the growing body of literature linking long-term cell phone use to possible adverse health effects including cancer. Although the evidence is still controversial, I am convinced that there are sufficient data to warrant issuing an advisory to share some precautionary advice on cell phone use." Of the 10 points of advice, the first is: "Do not allow children to use a cell phone, except for emergencies. The developing organs of a fetus or child are the most likely to be sensitive to any possible effects of exposure to electromagnetic fields." In a TV interview with Pittsburgh's KDKA news, Herberman's colleague, Dr. Devra Davis, head of the Center for Environmental Oncology at the UPCI said in response to the interviewer's comment about lack of evidence and "crying wolf," "It depends on what you mean by evidence. If you want to have enough sick and dead people before you take action and prevent harm – that's what we did with tobacco, isn't it?" For more information, read Heberman's article The Case for Precaution in the Use of Cell Phones Advice from the University of Pittsburgh Cancer Institute Based on Advice from an International Expert Panel.

Prenatal Cell Phone Exposure & Behavior

A paper published in the July issue of Epidemiology looked at a group of 13,159 children whose mothers participated in the Danish National Birth Cohort early in pregnancy. When the children were seven years old, the mothers completed a questionnaire about their children's behavior and health, as well as their own cell phone use in pregnancy and the child's use of cell phones. Researchers found that prenatal exposure to cell phones (and to a lesser extent, postnatal exposure to cell phones) was associated with behavioral difficulties such as emotional and hyperactivity problems around the age of school entry. They stated, "These associations may be noncausal and may be due to unmeasured confounding. If real, they would be of public health concern given the widespread use of this technology." Another possible suggestion for the observation? "…(T)he lack of attention given to a child by mothers who are frequent users of cell phones."

Cell Phone Texting Advisory

Not that many texting addicts will pay attention, but on July 30, the American College of Emergency Physicians issued an advisory concerning texting, as emergency physicians report they are seeing a dangerous trend: A rise in injuries and deaths related to sending text messages at inappropriate times, such as while walking, driving, biking, or rollerblading. Here are just two of their five recommended safety measures:

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Diabetes

Distress & Diabetes Risk

A study published in the July issue of Diabetic Medicine looked at 2,127 middle-aged men and 3,100 middle-aged women in Sweden with baseline normal glucose tolerance. Researchers found that men with high psychological distress levels, including symptoms of anxiety, apathy, depression, fatigue, and insomnia, are at increased risk of pre-diabetes and type 2 diabetes. Men with the highest levels of psychological distress were 2.2 times more likely to develop the diabetes than those with the lowest levels. No link was found in women.

Soda, Juice, & Diabetes Risk

An article published in the July 28 issue of Archives of Internal Medicine, which looked at 43,960 African American women who were followed up between 1995 and 2005, has found that those who reported drinking two or more non-diet soft drinks daily had a 24% increased risk for type 2 diabetes than those who drank fewer than one per month, and that women who drank two or more sweetened fruit drinks per day had a 31% increased risk than those who drank fewer than one per month. The good news is that diet soft drinks, grapefruit juice, and orange juice were not linked to a higher diabetes risk.

Diabetes & Birth Defects

Findings published online on August 1 in the American Journal of Obstetrics & Gynecology indicate that diabetic women who become pregnant are three to four times more likely to have a child with one or multiple birth defects than a mother who is not diabetic. According to a press release from the CDC, defects include heart defects, defects of the brain and spine, oral clefts, defects of the kidneys and gastrointestinal tract, and limb deficiencies. Study lead author Dr. Adolfo Correa, who is an epidemiologist at CDC's National Center on Birth Defects and Developmental Disabilities, said, "Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children."

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Errors

Fatal Medication Errors

An investigation published in the July 28 issue of Archives of Internal Medicine examined all US death certificates from January 1, 1983, to December 31, 2004, for a total of 49,586,156 certificates. During the period, the overall fatal medication error (FME) death rate increased by 360.5%, and far exceeds the increase in death rates from adverse effects of medications (33.2%) or from alcohol and/or street drugs (40.9%). Specifically, researchers examined four types of FMEs, and found variations in increases in death rates as follows: Type 1 (domestic FMEs combined with alcohol and/or street drugs), up 3196%; type 2 (domestic FMEs not involving alcohol and/or street drugs), up 564%; type 3 (nondomestic FMEs combined with alcohol and/or street drugs), up 555%; type 4 (nondomestic FMEs not involving alcohol and/or street drugs), up 5%.

The Cost of Medical Errors

A July 28 press release from the Agency for Healthcare Research and Quality reports that potentially preventable medical errors that occur during or after surgery may cost employers nearly $1.5 billion a year.

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Miscellaneous

Livers from Older Donors

A paper on liver transplants for HCV, which was published in the July issue of Archives of Surgery, has found that those who received a liver from a donor aged 60 to 78 years had no difference in survival rates when compared to those who received a liver from a younger donor. At one, three, and five years, overall patient survival was 88.1%, 78.3%, and 69.2%, respectively.

Parasites & Susceptibility to HIV

An article published on July 23 in PLoS Neglected Tropical Diseases suggests that parasitic infection can increase susceptibility to HIV. Researchers tested two groups of monkeys, one parasite-free and one infected with the parasitic worm that causes schistosomiasis, and found that lower amounts of the AIDS virus (17 times lower) were needed to cause HIV infection in monkeys who had the worms than in the parasite-free monkeys. They wrote, "These results suggest that worm infections may increase the risk of becoming infected with HIV-1 among individuals with viral exposures. Furthermore, they support the idea that control programs for schistosomiasis and perhaps other parasitic worm infections may also be useful in helping to reduce the spread of HIV/AIDS in developing countries where helminths are endemic."

Sleep Apnea & Night Heart Attacks

Research published in the July 29 issue of the Journal of the American College of Cardiology has found that in patients with obstructive sleep apnea (OSA), the frequency of a heart attack was higher from midnight to 0600h, whereas for those without OSA, the frequency was higher from 0600h to noon. In the overnight hours, MI occurred in 32% of OSA patients and only 7% of non-OSA patients studied. Of all patients who had an MI between midnight and 0600h, 91% had OSA.

Music Volume & Alcohol Consumption

An observational study of 40 male beer drinkers in a bar has found that louder music makes people drink more and drink faster. They found that with the louder music, the average number of drinks ordered rose from 2.6 to 3.4 drinks, and the time taken to consume the drink fell to an average 11.45 minutes from 14.51 minutes. The study was published online on July 21 in Alcoholism: Clinical and Experimental Research.

How Much Exercise to Maintain Weight Loss?

Findings published in the July 28 issue of Archives of Internal Medicine looked at the effect of exercise on 24-month weight loss maintenance in 201 overweight and obese women. They show that 275 minutes (4.6 hours) per week of physical activity, in combination with a reduction in energy intake, is important in allowing overweight women to sustain a weight loss of more than 10%.

Preeclampsia and a Mother's Immune System

A letter published online on July 27 in Nature Medicine has found more evidence linking preeclampsia to immunity. Researchers took immune molecules called autoantibodies from women with preeclampsia and injected them into mice, which then started to develop a condition very similar to preeclampsia. However, mice given an injection of losartan to block the action of the autoantibodies did not develop the condition.

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