Stomach ulcers may recur
September 29, 1998
About 20% of ulcer patients experienced a recurrence of their ulcer within
6 months of being successfully treated for infection with Helicobacter pylori, a bacteria
associated with ulcers, according to a new study.
"Results of North American studies of highest methodological quality confirm that H.
pylori eradication markedly decreases ulcer recurrence," report Dr. Loren Laine and
his colleagues. "Nevertheless, 20% of patients in these studies had ulcer recurrence
within 6 months despite successful cure of infection and no reported use of NSAIDs."
NSAIDs -- nonsteroidal anti-inflammatory drugs -- cause trauma to the lining of the
stomach and are a known risk factor for ulcers.
Helicobacter pylori (H. pylori) is a bacteria that physicians now recognize as the most
common cause of peptic ulcer disease. While other studies have shown that recurrence
decreases significantly when H. pylori-induced ulcers are successfully treated, the
current study in the September issue of the American Journal of Gastroenterology suggests
that recurrence may happen more often than these studies have shown.
The researchers, with the division of gastrointestinal and liver diseases at the
University of Southern California School of Medicine in Los Angeles and the division of
anti-infective drug products with the Food and Drug Administration (FDA) attribute their
finding to high levels of smoking and the possible unreported use of NSAIDs. According to
the report, NSAID use is common among patients with certain types of ulcers despite the
drugs' tendency to increase the risk of developing an ulcer.
For the study, the researchers reviewed 15 years of treatment data, including abstracts
from scientific meetings, published and unpublished studies, interviews with companies
that manufacture medications for H. pylori therapy in the United States, and presentations
to the FDA. Studies were double-blind, randomized North American trials of H. pylori
therapy for intestinal ulcers.
The team notes that "the odds of developing a recurrent ulcer if H. pylori infection
persists is five times greater than the odds of recurrence if H. pylori infection has been
cured." The researchers conclude that patients with ulcers due to H. pylori
"will benefit greatly from antibacterial therapy, (but) a significant minority of
patients fail to be cured of their ulcer disease despite eradication of H. pylori."
SOURCE: American Journal of Gastroenterology 1998;93:1409-1415.
Nasal spray prevents flu
September 28, 1998
A new nasal spray vaccine can protect people against influenza outbreaks
more than 90 percent of the time.
Researchers said today the new FluMist even protected people against an unexpected flu
strain that crossed the U.S. during last year's flu season.
Dr. Robert Belshe, professor of internal medicine at the St. Louis University School of
Medicine, reported that just 15 children of the more than 900 given the nasal spray
vaccine caught the flu, compared to 51 of 440 children who received a placebo spray.
At the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Diego, the
annual infectious disease meeting of the American Society of Microbiology, Belshe said
that even though the live attenuated virus used in the FluMist wasn't developed to protect
against the A/Sydney flu strain, the vaccine still offered high levels of protection.
He said, ''Live weakened virus vaccines such as FluMist are thought to mimic natural
infection better than other types of vaccines.''
For the few children who got the flu despite having been vaccinated with the nasal spray,
the length of illness was half that - about 2.1 days - compared to children who caught the
flu and were not vaccinated. They were ill 4.9 days.
FluMist, is still awaiting approval by Food and Drug Administration, and is manufactured
by Aviron, a biopharmaceutical company in Mountain View, Calif.
In other studies, researchers reported on another nasal route of attack in treating the
flu. Zanamivir, manufactured by Glaxo Wellcome, London, was found to be successful in
reducing the risk of flu by two- thirds.
Dr. Arnold Monto of the University of Michigan said, ''The drug was extremely effective in
He said Zanamivir protected patients from getting ill with flu symptoms when given to
people at risk during an influenza outbreak. Zanamivir has also been shown previous to be
effective in treating flu symptoms.
disease cases remain high
September 25, 1998
The number of cases of foodborne diseases in the US remains high,
according to a report released Thursday by the Centers for Disease Control and Prevention
(CDC) in Atlanta, Georgia.
"Each year, millions of persons become ill from foodborne diseases, though many cases
are not reported," CDC officials note.
A program called FoodNet, the Foodborne Diseases Active Surveillance Network, was
established in 1995 to track foodborne illnesses in several regions. A collaborative
effort of the CDC, the Department of Agriculture, the Food and Drug Administration, and
several state health departments, the FoodNet program currently monitors reports from a
catchment area of over 16 million people, or about 6% of the US population.
FoodNet tracks infections caused by infectious agents known to cause foodborne disease,
including bacteria such as Campylobacter, E. coli O157, Listeria, Salmonella, Shigella,
Vibrio, and Yersinia and the parasites Cryptosporidium and Cyclospora.
The CDC reports that 1997 data from FoodNet show that the number of cases showed little
change from 1996 figures.
Among the agents under surveillance, Campylobacter was again the most frequently
diagnosed, "even though outbreaks caused by this pathogen are rare," CDC
officials note. A study of the bacteria begun this year "will identify control points
and direct future prevention strategies," they add.
Data from the FoodNet program show that there were regional and seasonal differences in
reported foodborne illnesses, with most cases of bacterial infections reported in the
summer months. For example, an outbreak of Vibrio parahaemolyticus infections in the
western US during the summer of 1997 was tied to the consumption of raw oysters from
Washington State oyster beds.
And E. coli O157 infections, more common in northern states, were most often due to the
consumption of undercooked ground beef. The CDC report notes that burgers consumed at
fast-food restaurants were not associated with the E. coli cases reported in 1997,
"suggesting that recent changes in that industry may have reduced (E. coli O157)
infections from that source."
Data from the program also show that Listeria infections had the highest hospitalization
rates and caused nearly half of reported deaths due to foodborne disease. "Because of
this, FoodNet will conduct additional studies of Listeria infections to identify food
sources and control points," according to the report.
CDC officials estimate that 360 million cases of diarrheal illness occur each year,
resulting in 28 million visits to a physician. "Further studies will define the
causes and impact of these illnesses and what proportion of them may be related to
food," according to a statement issued by the agency.
Additional information about FoodNet is available at
Potassium lowers stroke
September 22, 1998
Middle-aged men -- particularly those with high blood pressure -- are less
likely than their peers to have a stroke if they consume a diet rich in potassium,
according to a report. A high intake of cereal fiber and magnesium also appear to reduce
the stroke risk, according to the report in the journal Circulation: Journal of the
American Heart Association.
"In this large prospective study, we found men with diets higher in potassium, cereal
fiber, and magnesium had a substantially reduced risk of stroke," concluded lead
author Dr. Alberto Ascherio of Harvard School of Public Health in Boston, Massachusetts,
Ascherio and colleagues looked at 43,738 men who were aged 40 to 75 in 1986. Over the next
8 years, more than 300 of those men had strokes, and those with the highest potassium
consumption (an intake of about 4.3 grams per day) were 38% less likely to have a stroke
than those with the lowest intake (about 2.4 grams per day). Potassium is found at high
concentrations in fruit, vegetables, nuts, grains, and seeds.
Men with the highest intake of magnesium (452 milligrams per day) had 30% lower stroke
risk than those who consumed the lowest level (243 milligrams per day), as did those with
the highest fiber intake (28.9 grams per day compared with 12.4 grams per day). Calcium
and sodium intake did not influence stroke risk.
Those with high blood pressure had nearly three times the risk of stroke, but men who took
potassium supplements were at lower risk.
"Potassium supplements may also be beneficial, but because of potential risks, use
should be carefully monitored and restricted to men taking potassium-losing
diuretics," the authors write.
The study could not prove that the dietary intake lowered stroke risk, because it is
possible that some other factor associated with a healthy diet lowered the risk, the
However, the findings "are consistent with the hypothesis that diets rich in
potassium, magnesium and cereal fiber reduce the risk of stroke, particularly among
hypertensive men," they conclude.
SOURCE: Circulation: Journal of the American Heart Association
Breast pain linked to
September 17, 1998
A high-fat diet and elevated cholesterol levels appear to contribute to
``cyclic mastopathy,'' a condition characterized by premenstrual breast swelling,
tenderness and pain, according to a study in the American Journal of Obstetrics and
Studies suggest that cyclic mastopathy affects roughly 40% of women in western nations,
and 5% of those in Asian countries.
Previous studies have found that women with the condition have elevated high density
lipoprotein (HDL) cholesterol levels just before their periods. In some studies, women
with cyclic mastopathy have reported fewer symptoms after cutting back on the fat in their
Comparing 34 women with severe cyclic mastopathy and 29 ''control'' subjects, the authors
of the new study found that those with the condition ate more fat throughout their
menstrual cycles. While the women with mastopathy obtained an average of 37.5% of their
calories from fat, the controls obtained 33.7% of their calories from fat. The women with
cyclic mastopathy also reported more hunger premenstrually than the controls.
Blood tests confirmed that the women with the condition had higher-than-average HDL levels
premenstrually. But the reason for this finding is unclear, write the authors, a team of
researchers headed by Dr. Pamela J. Goodwin, of Mount Sinai Hospital in Toronto, Canada.
``Extension of our observations to include an evaluation of hormonal, physiologic, and
psychologic factors that might lead to increased appetite and fat intake in women with
cyclic mastopathy... is recommended to enhance understanding'' of the disorder, Goodwin
and colleagues write.
SOURCE: American Journal of Obstetrics and Gynecology
Causes of mid-back pain
September 24, 1998
About 80 percent of Americans suffer with some form of back pain.
While it's a relatively mysterious phenomenon, we do know some of its causes. The kind of
work you do may also contribute to your problem. Sitting in front of a computer all day is
likely to give anyone back pain.
Specifically, it's the chairs we sit in that are the likely culprits. Their design and
shape promote back problems in even the healthiest people.
Prolonged sitting not only causes your shoulders to round forward, but it also forces you
to sit with your pelvis tilted too far forward as well. Sitting this way compresses the
gel -- or cushioning -- in between your vertebra, and this causes back discomfort.
Numerous studies show that strengthening abdominal and back muscles is a good first step
toward recovery. Your doctor or physical therapist can advise you on exercises that are
best for your individual problem.
Keep in mind that you should always warm up slowly, stretch, and stop doing any activity
that makes your back feel worse or causes tingling or numbness in your legs.
Clues to Flo-Jo's death
September 23, 1998
Florence Griffith Joyner, also known as 'Flo-Jo,' was the fastest woman in
the world. She was a woman whose style and flair were as dramatic as her athletic ability.
CBS News Correspondent John Roberts reports.
Though she was known to suffer from asthma and migraines, the sudden death of an athlete
in such great physical condition came as a shock to her fans, and her family.
"There were just no signs that she was ill," said her brother-in-law Bob Kersee.
While the official cause of death has not yet been determined, Flo-Jo is described to have
died from a 'heart seizure'. Unlike a heart attack, it's not caused by blocked arteries,
but electrical disturbances in the heart that cause it to beat incredibly rapidly--to the
point that it actually begins to flutter and can no longer pump blood.
"I would suspect hypertrophic cardiomyopathy as being the most likely probability
here," says Dr. Jeremy Ruskin of Mass. General Hospital.
Cardiologist Jeremy Ruskin was one of the team who advised Boston Celtic Reggie Lewis to
quit playing basketball shortly before he died from abnormal rhythms caused by
hypertrophic cardiomyopathy. He says one in 500 people have this genetically-inherited
"The muscle of the main pumping chamber becomes abnormally thickened. And it
predisposes the heart to abnormal rhythms," says Dr. Ruskin.
It's the same abnormality that took the life of college basketball star Hank Gathers in
1990 and in fact, is the No.1 cause of sudden death among young athletes.
The public wasn't aware that behind her glamorous face Flo-Jo may have had a serious heart
problem. A seizure Flo-Jo had in 1996 was explained away as exhaustion. But it now appears
as a warning sign of another life about to be cut short.
Health--The Reason to Control Your Weight
September 22, 1998
Approximately 97 million American adults are overweight. If you are one of
them, you are more likely to develop diabetes, heart disease, high blood pressure,
gallbladder disease, and certain types of cancer. However, these adverse health effects of
being overweight may be minimized, according to a new, free consumer brochure from the
National Institutes of Health (NIH).
Do You Know the Health Risks of Being Overweight? provides readers information about the
health problems linked to being overweight. The brochure also outlines how people may
prevent or reduce the negative effects of weighing more than they should by eating
healthier and getting regular exercise.
"A loss of as little as 5 to 10 percent of your body weight can make a difference in
your overall health," says Susan Yanovski, M.D., director of the Obesity and Eating
Disorders Program, National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK). "The key is a slow and steady weight loss of no more than 1 pound per week
so that you minimize muscle loss."
The brochure, provided by the federally funded Weight-control Information Network (WIN),
is free and can be obtained by calling WIN's toll-free number, 1-800-WIN-8098, or by
visiting its website. In addition to information on weight loss, WIN's toll-free number
and website provide information on topics such as childhood obesity, choosing a safe and
successful weight-loss program, weight cycling, and binge eating disorder.
In 1994, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a
part of the NIH, established WIN in response to the growing problem of overweight in the
transmitted by fish
Tue, 29 Sep 1998
A new streptococcal infection is being transmitted by a fish growing in
popularity throughout North America and being harvested in the United States, according to
Dr. Donald Low, of Mount Sinai Hospital in Toronto, Ontario, Canada.
The fish, tilapia, is becoming a staple in many Asian grocery stores.Puncture wounds from
its sharp dorsal fin that occur during handling or cleaning allow entry of Streptococcus
iniae, which resides in the gellike coating of the scales.The bacteria cause cellulitis at
the wound site, and cultures of the aspirate reveal gram-positive chains of the
"We think we have a new disease, here," Dr. Low said at the 38th Interscience
Conference on Antimicrobial Agents and Chemotherapy.So far 15 cases have been
confirmed.The infections largely have been confined to Chinese communities in Canada.In
one patient, the infection became systemic, requiring intensive care, he noted.
"The message is that this is totally preventable," Dr. Low said.Protective
gloves and careful avoidance of the sharp-edged fins prevent exposure.Treatment with
antibiotics such as cephalosporin or penicillin can successfully eradicate the agent, but
when untreated, it can become fulminant, he warned.
The incidence of Streptococcus iniae infection is undoubtedly underreported because there
is not widespread awareness of the etiology, although it has been reported in the Asian
press in Canada.Dr. James M. Hughes of the National Center for Infectious Diseases at the
CDC, in Atlanta, Georgia, said, "[t]hat kind of communication needs to be
done."One patient, for example, was treated only after making an accurate
self-diagnosis that allowed a physician to identify the species.
The American-reared tilapia is not the only carrier of the bacterium.Cultures from bass,
salmon and trout also have been positive--but tilapia usually is delivered live to markets
and is growing in demand."It is easy to rear [for harvest] because it grows quickly
and being a herbivore, is easy to feed," Dr. Low observed.