Health & Fitness (140)
NEW YORK (AP) — Doctors may one day be able to control a patient's HIV infection in a new way: injecting swarms of germ-fighting antibodies, two new studies suggest.
In monkeys, that strategy sharply reduced blood levels of a cousin of HIV. The results also gave tantalizing hints that someday the tactic might help destroy the AIDS virus in its hiding places in the body, something current drugs cannot do.
The study results "could revolutionize efforts to cure HIV" if the approach is found to work in people, said a commentary published Wednesday by the journal Nature along with the monkey studies.
Antibodies are proteins in the blood that grab onto specific germs and mark them for elimination. People infected with HIV naturally make antibodies to fight the AIDS virus, but they are generally ineffective. The two new studies used lab-made versions of rare antibodies with unusual potency against HIV.
One study of rhesus monkeys showed a profound effect from a single injection of antibodies, said lead author Dr. Dan Barouch of Harvard and the Beth Israel Deaconess Medical Center in Boston.
The 18 animals had been infected with SHIV, a monkey version of HIV. In 13 animals, blood levels of SHIV became undetectable by standard tests within a week of the treatment. After the antibodies petered out, the virus came back. That happened one to three months after treatment.
In three monkeys with the lowest levels of SHIV before treatment, the virus didn't return during an observation period of up to eight months. Barouch said the animals were not cured, but the treatment had apparently improved their immune systems enough to keep the virus in check.
The two other monkeys started with the highest blood levels of SHIV. Treatment lowered those levels but not to the point where they were undetectable.
The second study in Nature, from the National Institutes of Health, showed encouraging results in a smaller group of monkeys.
In people, standard drugs routinely tamp down HIV to undetectable levels in the blood. But the antibody approach may someday help doctors attack virus that's hiding in infected cells, beyond the reach of today's drugs, said the Nature commentary by Dr. Steven Deeks of the University of California, San Francisco, and Dr. Louis Picker of the Oregon Health & Science University in Beaverton.
In theory, antibodies might activate the body's immune system to kill those infected cells, they wrote. Barouch's results hinted at such an effect, they noted. Virus levels dropped faster in the monkeys than they do when people get standard HIV drugs, and when the monkey virus returned, it generally didn't reach its pre-treatment levels. Barouch also found virus levels reduced in cells and tissues after treatment.
The findings of the two studies are "provocative" about prospects for attacking HIV's hiding places, Deeks said in a telephone interview.
"These studies raised more questions than they answered," he said. "But that's how science advances."
Online: Nature: http://www.nature.com/nature
CHICAGO (AP) -- Doctors 2 parents: Limit kids' tweeting, texting & keep smartphones, laptops out of bedrooms. (hash)goodluckwiththat.
The recommendations are bound to prompt eye-rolling and LOLs from many teens but an influential pediatricians group says parents need to know that unrestricted media use can have serious consequences.
It's been linked with violence, cyberbullying, school woes, obesity, lack of sleep and a host of other problems. It's not a major cause of these troubles, but "many parents are clueless" about the profound impact media exposure can have on their children, said Dr. Victor Strasburger, lead author of the new American Academy of Pediatrics policy
"This is the 21st century and they need to get with it," said Strasburger, a University of New Mexico adolescent medicine specialist.
The policy is aimed at all kids, including those who use smartphones, computers and other Internet-connected devices. It expands the academy's longstanding recommendations on banning televisions from children's and teens' bedrooms and limiting entertainment screen time to no more than two hours daily.
Under the new policy, those two hours include using the Internet for entertainment, including Facebook, Twitter, TV and movies; online homework is an exception.
The policy statement cites a 2010 report that found U.S. children aged 8 to 18 spend an average of more than seven hours daily using some kind of entertainment media. Many kids now watch TV online and many send text messages from their bedrooms after "lights out," including sexually explicit images by cellphone or Internet, yet few parents set rules about media use, the policy says.
"I guarantee you that if you have a 14-year-old boy and he has an Internet connection in his bedroom, he is looking at pornography," Strasburger said.
The policy notes that three-quarters of kids aged 12 to 17 own cellphones; nearly all teens send text messages, and many younger kids have phones giving them online access.
"Young people now spend more time with media than they do in school - it is the leading activity for children and teenagers other than sleeping" the policy says.
Mark Risinger, 16, of Glenview, Ill., is allowed to use his smartphone and laptop in his room, and says he spends about four hours daily on the Internet doing homework, using Facebook and YouTube and watching movies.
He said a two-hour Internet time limit "would be catastrophic" and that kids won't follow the advice, "they'll just find a way to get around it."
Strasburger said he realizes many kids will scoff at advice from pediatricians - or any adults.
"After all, they're the experts! We're media-Neanderthals to them," he said. But he said he hopes it will lead to more limits from parents and schools, and more government research on the effects of media.
The policy was published online Monday in the journal Pediatrics. It comes two weeks after police arrested two Florida girls accused of bullying a classmate who committed suicide. Police say one of the girls recently boasted online about the bullying and the local sheriff questioned why the suspects' parents hadn't restricted their Internet use.
Mark's mom, Amy Risinger, said she agrees with restricting kids' time on social media but that deciding on other media limits should be up to parents.
"I think some children have a greater maturity level and you don't need to be quite as strict with them," said Risinger, who runs a communications consulting firm.
Her 12-year-old has sneaked a laptop into bed a few times and ended up groggy in the morning, "so that's why the rules are now in place, that that device needs to be in mom and dad's room before he goes to bed."
Sara Gorr, a San Francisco sales director and mother of girls, ages 13 and 15, said she welcomes the academy's recommendations.
Her girls weren't allowed to watch the family's lone TV until a few years ago. The younger one has a tablet, and the older one has a computer and smartphone, and they're told not to use them after 9 p.m.
"There needs to be more awareness," Gorr said. "Kids are getting way too much computer time. It's bad for their socialization, it's overstimulating, it's numbing them."
Follow AP Medical Writer Lindsey Tanner atHTTP://WWW.TWITTER.COM.LINDSEYTANNER
WASHINGTON (AP) -- The Food and Drug Administration is recommending new restrictions on prescription medicines containing hydrocodone, the highly addictive painkiller that has grown into the most widely prescribed drug in the U.S.
In a major policy shift, the agency said in an online notice Thursday that hydrocodone-containing drugs should be subject to the same restrictions as other narcotic drugs like oxycodone and morphine.
The move comes more than a decade after the Drug Enforcement Administration first asked the FDA to reclassify hydrocodone so that it would be subject to the same restrictions as other addictive painkilling drugs. The FDA did not issue a formal announcement about its decision, which has long been sought by many patient advocates, doctors and state and federal lawmakers.
For decades, hydrocodone has been easier to prescribe, in part because it is only sold in combination pills and formulas with other non-addictive ingredients like aspirin and acetaminophen.
That ease of access has made it many health care professionals' top choice for treating chronic pain, everything from back pain to arthritis to toothaches.
In 2011, U.S. doctors wrote more than 131 million prescriptions for hydrocodone, making it the most prescribed drug in the country, according to government figures. The ingredient is found in blockbusters drugs like Vicodin as well as dozens of other generic formulations.
It also consistently ranks as the first or second most-abused medicine in the U.S. each year, according to the DEA, alongside oxycodone. Both belong to a family of drugs known as opioids, which also includes heroin, codeine and methadone.
Earlier this year the Centers for Disease Control and Prevention reported that prescription painkiller overdose deaths among women increased about fivefold between 1999 and 2010. Among men, such deaths rose about 3.5-fold. The rise in both death rates is closely tied to a boom in the overall use of prescribed painkillers.
The FDA has long supported the more lax prescribing classification for hydrocodone, which is also backed by professional societies like the American Medical Association.
But the agency's top drug regulator, Dr. Janet Woodcock, said in a statement Thursday: "The FDA has become increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States."
The FDA says it will formally request in early December that hydrocodone be rescheduled as a Schedule II drug, limiting which kinds of medical professionals can write a prescription and how many times it can be refilled.
The Controlled Substances Act, passed in 1970, put hydrocodone drugs in the Schedule III class, which is subject to fewer controls. Under that classification, a prescription for Vicodin can be refilled five times before the patient has to see a physician again. If the drug is reclassified to Schedule II, patients will only be able to receive one 90-day prescription, similar to drugs like OxyContin. The drug could also not be prescribed by nurses and physician assistants.
The FDA's request for reclassification must be approved by officials in other agencies within the Department of Health and Human Services.
News of the FDA decision was applauded by lawmakers from states that have been plagued by prescription drug abuse, many who have been prodding the agency to take action for months.
"Today was a tremendous step forward in fighting the prescription drug abuse epidemic that has ravaged West Virginia and our country," said Democratic Sen. Joe Manchin, in a statement. "Rescheduling hydrocodone from a Schedule III to a Schedule II drug will help prevent these highly addictive drugs from getting into the wrong hands and devastating families and communities
Sen. Charles Schumer of New York noted that the FDA's own expert panel recommended the reclassification more than nine months ago.
"Each day that passes means rising abuse, and even death, at the hands of hydrocodone-based drugs," Schumer said in a statement.
Still, Thursday's action immediately sparked criticism from some professional groups that said that the tighter restrictions could have unintended consequences, such as burdening health care workers and patients.
"The FDA's reported decision will likely pose significant hardships for many patients and delay relief for vulnerable patients with legitimate chronic pain, especially those in nursing home and long-term care," said Kevin Schweers, a spokesman for the National Community Pharmacists Association.
CHICAGO (AP) - Doctors are sending a warning to new mothers who feed their babies with breast milk purchased online.
A new study says testing shows the breast milk can contain potentially dangerous bacteria including salmonella.
Researchers bought and tested more than 100 breast milk samples sold by women on one popular site, and 75 percent of those samples contained high amounts of bacteria that could sicken babies. Researchers did not identify the website.
The research also cites several cases in which babies did get sick from a stranger's breast milk.
Breast milk also is provided through milk banks, whose clients include hospitals. But they screen donors and pasteurize donated milk to kill any germs.
Both online breast milk sites and milk banks charge fees.
BOSTON (AP) — New research suggests that high levels of BPA, a chemical in many plastics and canned food linings, might raise the risk of miscarriage in women prone to that problem or having trouble getting pregnant.
The work is not nearly enough to prove a link, but it adds to "the biological plausibility" that BPA might affect fertility and other aspects of health, said Dr. Linda Giudice, a California biochemist who is president of the American Society for Reproductive Medicine. The study was to be presented Monday at the group's annual conference in Boston. Last month, ASRM and an obstetricians group urged more attention to environmental chemicals and their potential hazards for pregnant women.
BPA, short for bisphenol-A, and certain other environmental chemicals can have very weak, hormone-like effects. Tests show BPA in nearly everyone's urine, though the chemical has been removed from baby bottles and many reusable drink containers in recent years. The federal Food and Drug Administration says BPA is safe as used now in other food containers.
Most miscarriages are due to egg or chromosome problems, and a study in mice suggested BPA might influence that risk, said Dr. Ruth Lathi, a Stanford University reproductive endocrinologist.
With a federal grant, she and other researchers studied 115 newly pregnant women with a history of infertility or miscarriage; 68 wound up having miscarriages and 47 had live births.
Researchers analyzed blood samples from when the women were discovered to be pregnant and divided them into four groups based on BPA levels. Women in the top quarter had an 80 percent greater risk of miscarriage compared to those in the bottom group even though they were similar in age and other factors. However, because the study is relatively small, there was a big range of possible risk — from only slightly elevated to as much as 10 times higher.
"It may be that women with higher BPA levels do have other risk factors" for miscarriage that might be amplified by BPA, Lathi said.
The study is not cause for alarm, but "it's far from reassuring that BPA is safe" for such women, she said.
To minimize BPA exposure, avoid cooking or warming food in plastic because heat helps the chemical leak out, she said. Don't leave water bottles in the sun, limit use of canned foods and avoid handling cash register receipts, which often are coated with resins that contain BPA.
"It's impossible to avoid it completely," Lathi said.
BPA info: http://1.usa.gov/QHrkfN
Infertility info: http://www.sart.org and
WASHINGTON (AP) -- Little Amelia Sloan became a pioneer shortly after her birth.
The healthy baby is part of a large research project outside the nation's capital that is decoding the DNA of hundreds of infants. New parents in a few other cities soon can start signing up for smaller studies to explore what's called genome sequencing - fully mapping someone's genes to look for health risks - should become a part of newborn care.
It's full of ethical challenges.
Should parents be told only about childhood threats? Or would they also want to learn if their babies carried a key gene for, say, breast cancer after they're grown? Could knowing about future risks alter how a family treats an otherwise healthy youngster? And how accurate is this technology - could it raise too many false alarms?
This is the newest frontier in the genetic revolution: how early to peek into someone's DNA, and how to make use of this health forecast without causing needless worry.
"This was something that was looming over the horizon," said Dr. Alan Guttmacher, a pediatrician and geneticist who heads the National Institutes of Health's child health division. Last month, NIH announced a $25 million, five-year pilot project in four cities - Boston, San Francisco, Chapel Hill, N.C., and Kansas City, Mo. - to start answering some of the questions before the technology is widely offered for babies.
Today, the 4 million U.S. babies born annually have a heel pricked in the hospital, providing a spot of blood to be tested for signs of at least 30 rare diseases. This newborn screening catches several thousand affected babies each year in time for early treatment to prevent death, brain damage or other disabilities. It's considered one of the nation's most successful public health programs.
A complete genetic blueprint would go well beyond what that newborn blood spot currently tells doctors and parents - allowing a search for potentially hundreds of other conditions, some that arise in childhood and some later, some preventable and some not.
"If I truly believed that knowing one's genome was going to be transformative to medicine over the next decade or more, then wouldn't I want to start generating that information around the time of birth?" asked Dr. John Niederhuber, former director of the National Cancer Institute who now oversees one of the largest baby-sequencing research projects to date.
At Niederhuber's Inova Translational Medicine Institute in Falls Church, Va., researchers are mapping the genomes of newborns, along with their parents and other relatives for comparison. The long-term goal of the privately funded study is to uncover genetic patterns that predict complex health problems, from prematurity to developmental disorders.
But the experimental tests will turn up some gene mutations already well-known to cause serious ailments, and participating parents must choose upfront whether to be told. They don't get a full report card of their baby's genes. Only ones that cause treatable or preventable conditions - so-called medically actionable findings - are revealed, to the family's doctor. That means in addition to pediatric diseases, parents also could learn whether a baby carries a particular breast-cancer-causing gene, information useful once she reaches young adulthood.
Nurse Holly Sloan was eager to enroll daughter Amelia, although she thought hard about how she'd handle any bad news.
"If it was something that we could hopefully prevent through diet or exercise or some kind of lifestyle change, we could start with that as early as possible," said Sloan, of Warrenton, Va. "I guess I'm just the type of person, I would rather know and address it." Five months after Amelia's birth, she hasn't gotten any worrisome results.
Until now, genome sequencing has been used mostly in research involving curious adults or to help diagnose children or families plagued by mysterious illnesses.
But many specialists say it's almost inevitable that DNA mapping eventually will be used for healthy young children, too, maybe as an addition to traditional newborn screening for at least some tots. It takes a few drops of blood or a cheek swab. And while it's still too costly for routine use, the price is dropping rapidly. Whole genome sequencing is expected to soon come down to $1,000, what it now costs for a more targeted "exome" sequencing that maps only certain genes and may be enough.
The NIH decided this was a window of opportunity to explore different ways this technology might be used. One of the four teams - at Children's Mercy Hospital in Kansas City - will test rapid gene-mapping to speed diagnosis of sick babies in intensive care.
Another will look for narrow sets of genes important in childhood, such as those involved with immune disorders not detected by today's newborn screening or that alter how a child processes medication. "It's not going to be some sort of fishing expedition throughout the genome," said Dr. Robert Nussbaum of the University of California, San Francisco.
The two other projects - at Brigham and Women's Hospital in Boston and the University of North Carolina, Chapel Hill - will go a step further by enrolling healthy infants as they explore what kind of information parents want about their babies' future.
"We aren't even sure that genome-scale sequencing in newborns is really a good idea," cautioned UNC lead researcher Dr. Jonathan Berg in a recent Facebook chat to alert the community about the study. Rather than a one-time mapping, it's possible that "we will use targeted sequencing at certain times in a person's life, when that specific information will actually be medically useful."
For those pioneering babies whose DNA is being mapped already, researchers are "trying to figure out what is legal, versus ethical, versus good medicine" in revealing results, said geneticist Joe Vockley, Inova Translational Medicine Institute's chief science officer.
Mom and Dad may be told something their child, once grown, wishes hadn't been revealed. Other findings may be withheld now that would be good to know years later, as new treatments are developed.
"This is a living, breathing problem," Vockley said, "not a static decision that's made, and it lasts for all time."
CHICAGO (AP) - A television pitchman accused of pushing false information during his late-night infomercials could avoid jail because of the government shutdown.
The Federal Trade Commission sued Kevin Trudeau, alleging he made misleading statements about his weight-loss books. Trudeau says he's unable to pay a $37 million judgment, and the FTC wants him jailed until he proves his financial assets.
But because of the government shutdown, FTC lawyers aren't getting paid. They were expected to ask a judge during a Friday hearing in Chicago to jail Trudeau, but they requested that the hearing be indefinitely delayed.
The judge briefly jailed Trudeau last month and warned he could do it again.
Trudeau's attorney didn't return a message Thursday. A voicemail for FTC lawyers said they couldn't respond until "the government ... resumes operation."