Wanted: A Test With Less Recoil; Every Attempt to Create Sensitive but Less Unpleasant Colon Cancer Screen, Including the Latest, Falls Short
_____Another imperfect new test for colon cancer has entered the market -- the second screening method to draw wide attention in six months -- and the impetus is no mystery. Dissatisfaction with the gold standard test, colonoscopy, is driving the hunt for more patient-friendly alternatives, but so far all fall short of the ideal.
_____The latest test, called Pregen-Plus and developed by Exact Sciences in Marlborough, Mass., looks for DNA patterns in a patient's stool sample. But while the test is noninvasive -- an advantage for the colonoscopy-adverse -- and needn't be administered by a gastroenterologist, it's also far less sensitive in its detection capability and it's expensive.
Washington Post, March 9, 2004

Out for Blood: Can Leeches End Your Knee Pain?
_____Could voracious bloodsucking creatures, looking for a new post-Halloween role, find it in medicine? In a paper published today, a group of researchers suggests that letting four to six leeches suck away for an hour or so can dull the pain of osteoarthritis of the knee for weeks.
_____The work, done by a group of German doctors and published in the Annals of Internal Medicine, compared 24 patients who received one round of leech therapy -- just over an hour of sucking by four to six of the worms -- to 27 patients who received a single dose of a painkilling gel. A week after the treatments, the bloodletting group reported feeling significantly better than their undrained peers. Three months later, this difference was not statistically significant, though patients in both groups reported feeling better than before they started.
_____"Currently, no pharmacologic agent has similar lasting effects after a single, local administration," wrote the authors, from the academic teaching hospital of the University of Duisburg-Essen. While acknowledging that the mechanism by which leech feeding might relieve pain was unknown, they speculated that leech saliva may contain pain-fighting chemicals.
Washington Post, Nov. 4, 2003

Bed Medicine?: It's Not a Drug. But Ads for a 'Viagra-Like' Product for Women Might Fool You
_____For those for whom the sexual revolution has deteriorated into some sort of battle-of-the-sexes arms race, a company called Warner Health Care says it can offer women something to keep competitive with their Viagra-enhanced mates in the quest for sexual satisfaction.
_____Warner's product, Avlimil, is a widely advertised, slickly packaged set of pills designed to be taken daily. Readers of magazines as varied as Parenting and Forbes have seen the ads, with their soft-focus photos suggesting a solution to a problem called female sexual dysfunction. "They have Viagra," goes the two-page pitch. "Now we have Avlimil." The fine print (and what worth-its-salt medical ad would be without fine print?) suggests the pill "is an effective formula for improving female sexual response."
_____The fine print also mentions one distinction between the little blue pill and Avlimil: "Avlimil is not a prescription drug. It is a non-synthetic, once-daily, non-hormonal supplement." Skip the fine print and you might never know.
Washington Post, July 29, 2003

Answering SARS: Hiding Fevers, Sprays That Kill and Other Reader Questions
See the complete collection of "Answering SARS" columns here.
_____This week we launch a regular effort to address reader questions about severe acute respiratory syndrome (SARS), the deadly and still little understood disease that is spreading from Asia to the rest of the world.
Washington Post, May 20, 2003

DEET: It Can't Be Beat
_____For all the counting of dead birds, the treating of ponds thick with mosquito larvae and the possibility of widespread spraying, the final line of defense against West Nile remains the human skin. Keep the insects away from that fragile barrier and the risk plunges to zilch.
_____The scientific consensus on the best way to do that remains clear: In the United States, nothing comes close to DEET. Since the government developed the chemical 50 years ago, it's become the gold standard for keeping all manner of creepy-crawlies at bay. Especially mosquitoes.
Washington Post, May 6, 2003

Tips for Self-Protection
_____Last week was the second annual Patient Safety Week, an effort to raise awareness of medical errors. But advocates such as Public Citizen's Sidney Wolfe worry that efforts to address the problem are short on real change. Meaning patients still need to ensure their own safety.
Washington Post, March 18, 2003

Charting a Course The Journey to Adulthood Can Cover Rough Terrain: One Group Has Set Landmarks Along the Way
_____Earlier this winter, three groups of teens tromped through the woods of Great Falls on a rain-soaked orienteering course. Each team's objective was simple: Use a map to find the way from one "control" point to the next, finally emerging from the forest and crossing the finish line.
_____But for the adults who had brought the high school freshmen to Great Falls, the objective was more complex: They wanted the youths to emerge unscarred not just from the sodden woods but from the thicket of adolescence. The trip marked a midpoint in a year-long coming-of-age program designed by the Washington Ethical Society to help youths develop a new sense of responsibility, a better understanding of themselves and a respect for their community.
Washington Post, March 4, 2003

A Reason to Exercise Buried Deep in Your Gut
_____Chalk up one more powerful reason to exercise: A new study in the Journal of the American Medical Association suggests that regular aerobic activity not only helps control weight for those middle-aged and older, but also reduces a hard-to-see kind of fat that's linked to heart disease, diabetes and cancer. This intra-abdominal or visceral fat is clumps of cells that surround internal organs and lead to dangerous levels of cholesterol and insulin in the blood.
_____Although the study followed only post-menopausal, overweight women, the results mirror findings in smaller studies that found benefit for other groups in reducing intra-abdominal fat.
Washington Post, January 20, 2003

A Self-Test for Diabetics
_____Monitoring hemoglobin A1c is the gold standard method for tracking blood sugar levels in diabetics. Many patients don't get the test nearly as often as experts advise, perhaps because it has required a trip to the lab and another medical bill.
_____But a new device, available without prescription and approved last month by the Food and Drug Administration (FDA), can provide fast A1c readings at home. Still, some experts questioned the need for and value of a home test for A1c.
_____The wisdom of tracking A1c levels has been acknowledged since a landmark clinical trial, completed in 1993, showed that small reductions in blood levels of this protein -- whose presence can serve as a measure of blood sugar over a three- to four-month period -- can lead to significant reductions in the risk of serious complications such as blindness and kidney disease.
January 13, 2003

At the Pharmacy Counter, Generics Flex Their Muscle
_____ For pharmacists and patients across the country, 2002 was the year of the Cheap White Pill. Generic drug usage hit an all-time high, according to Express Scripts, a pharmacy benefit manager, fueled by generic versions of blockbuster products and by health plans determined to swap high-priced brand-name drugs for their cheaper equivalents.
_____Last year, 45.2 percent of prescriptions filled were for generic drugs -- up 5 percent from 2001, according to Express Scripts. The biggest reason for the big jump? Cheap versions of the antidepressant Prozac (fluoxetine HCL), the diabetes drug Glucophage (metformin HCL) and the heart pill Zestril (lisinopril). Patients have flocked to generic fluoxetine more quickly than any other new generic drug, according to executives at Eli Lilly, maker of Prozac.
_____"Obviously, this is good news for purchasers," said Brad Cameron, a spokesman for Business for Affordable Medicine, a coalition of companies, labor groups and state governors looking for ways to reduce health care costs. It's been an industry rule of thumb that prices drop 30 percent in the first six to 12 months after a generic's debut -- during which time only a single manufacturer may have the sole right to sell a generic -- and as much as 70 percent thereafter. Lately, however, generic prices have not been falling as quickly. "You really need generic competition to bring down prices significantly," said Cameron.
January 7, 2003

Your Body: 2003 -- The Brain
_____ The Latest Like muscles, the brain needs regular workouts to retain agility, especially in old age. A team from Rush-Presbyterian-St. Luke's Medical Center in Chicago that followed more than 800 Catholic nuns for seven years reported in the Journal of the American Medical Association that those with the most "cognitive activity" -- like working crossword puzzles or reading newspapers -- were significantly less likely develop Alzheimer's disease. Similar findings emerged from a general population study published in the journal Neurology.
_____A paper published in Nature Neuroscience found champion memorizers associated an object to be remembered with a specific image, suggesting that the key to memory may not be how smart or old you are, but how much you're willing to work at it.
January 7, 2003

Stay-at-Home Dads, Popping Off
_____ There's not a big difference between spending a day with a group of toddlers and hanging out for a day with a few dozen stay-at-home dads. Neither group pays close attention to schedules, no one sits still for long, and everyone has fun.
_____I've stayed home with my 15-month-old daughter since March, so I feel like I have a pretty good grip on the toddler psyche. And now, after attending the national At-Home Dad Convention last month, I'm beginning to understand what makes my fellow at-home dads tick, too.
_____The gathering, hosted by a community college in suburban Chicago, attracted a diverse and hard-to-caricature crowd of around 100. Some guys, like me, are in their twenties and still searching for the best diaper brand. Others, having guided their children to adolescence, are beginning to face their own mortality. Everyone there was united in a few basic ways -- we were all crazy about our kids, excited to bond with a peer group, and bound and determined to enjoy ourselves.
December 9, 2002

Beauty Coverup?: A Cosmetic Ingredient Is Linked to Animal Defects. Its Human Risks Are Less Clear
_____ Phthalates, chemical substances that make plastic more flexible without reducing its strength, are an all-but-inescapable part of life in the 21st century. They're used in toys, garden hoses, shower curtains and medical devices. They're also common ingredients in beauty products, making nail polish chip-resistant and making hair spray keep a bouffant in line.
_____"But a small coalition of consumer groups, led by Environmental Working Group and Health Care Without Harm, has cried foul, claiming the chemicals' risk to millions of cosmetic-wearing women has been underestimated. Over the past months, citing animals studies that have linked the additives (pronounced THAY-lates) to birth defects, including liver and kidney damage and malformation of the testes, the anti-phthalates groups have run ads in The Washington Post and the New York Times warning of toxic chemicals lurking in perfumes and hair mousse.
_____Last week the Cosmetic Ingredient Review (CIR), a scientific panel that monitors the safety of substances in U.S. cosmetics, weighed in on the matter and came away unswayed by the activists. The CIR, which claims to operate independently of the Cosmetic, Toiletry and Fragrance Association that funds it, said there's no new evidence to suggest that phthalates in cosmetics pose any health risk to women or their offspring.
November 26, 2002

Joint Dilemma: New Data Suggest One-Third of U.S. Adults Have Arthritis. Unfortunately, Treatments Aren't Keeping Pace
_____ With last week's announcement that almost 70 million American adults -- one out of three -- are affected by arthritis, it's a good time to face the unpleasant realities about the chronic joint inflammation disease. For most people, there's no preventing it, no curing it and no treating it effectively except by managing pain. Seeking pain relief carries risks of its own, and the best strategy for keeping the disease contained -- a healthy diet and regular exercise -- is not generally heeded by the afflicted.
_____"We are dealing with conditions that are very common, and that will be more common and more of a burden as the years go on," said Eric Matteson, a professor of rheumatology and internal medicine at the Mayo Clinic in Rochester, Minn. "We baby boomers are getting old."
_____The U.S. Centers for Disease Control and Prevention (CDC) reported late last month that 69.9 million adults have arthritis or chronic joint pain symptoms. That figure is more than 60 percent higher than past estimates, and experts said the number will grow as Americans get older and heavier, two of the most powerful risk factors for the disease.
November 5, 2002
SEE ALSO (sidebar): Everyday Painkillers May Pose Problems of Their Own

A Mouth Guard for the Brain?
_____ Concussions have become as much a part of football as end-zone theatrics, with thousands of high school, college and professional players each year suffering blows to the head severe enough to disturb brain function. A small company says it has the solution: a $19.99, industrial-strength mouth guard supposed to protect the skull by locking the top and bottom teeth together.
_____The unorthodox-looking device, dubbed the Brain Pad, is said to work by keeping the jaw from sliding back and slamming into the brain after a blow to the face. Most traditional mouthguards merely cover the top teeth to protect against dental injuries.
October 29, 2002

Out for Blood, but Prudently: Red Cross Wants No Repeat of 2001 Fiasco
_____ Even as blood supply experts debate the lessons of the aftermath of last year's terrorist attacks, when thousands lined up to donate blood that would later expire, unused, on hospital shelves, the Red Cross is again urging Americans to roll up their sleeves to forestall a blood shortage.
_____But while the Red Cross calls the current blood supply level "critical" -- less than a two-day supply is available nationally -- the General Accounting Office (GAO) describes the nation's stockpiles as "generally adequate" and growing.
_____Which view is right may depend on the unknowable -- what, if any, emergencies the near future holds. But the government and blood banks do agree that the nation's blood supply needs to be better managed and that massive post-crisis donation drives like last year's help little in disaster management.
September 17, 2002

Dying to Stay Home?: Study Says Full-Time Dads Die Early. One Man Begs to Differ
_____ As a guy who writes a lot about cardiology, I'm mindful of the need to keep my heart healthy. I put soy milk on my whole-grain cereal in the mornings, and I exercise three or four times a week to drive my heart rate up and my heart disease risk down. Those efforts, however, might be futile.
_____As it turns out, I'm taking a walk on the wild side, health-wise. My sin? I stay at home nearly full time with my 1-year-old, walking to the park, reading Dr. Seuss and parroting my child's incomprehensible babbling back to her.
_____I blame the folks at the Framingham Heart Study for bursting my bubble. This project has tracked thousands of Massachusetts residents for decades to determine risks for heart diseases. The study has quite a distinguished history: Framingham is responsible for linking smoking, cholesterol and high blood pressure to heart disease. Now these researchers have tagged stay-at-home dads with a scarlet "A" (for "attack"; as in "heart").
_____Apparently, the risk of death for stay-at-home dads is nearly twice that for their rat-racing, cubicle-dwelling peers, even when you take into account all the traditional risk factors for heart disease. The finding is somewhat puzzling -- the best that researchers have done is to suggest that perhaps the stress of flouting society's assumed breadwinner role for the male of the species is enough to do us in.
September 10, 2002

Limbering Up to Prevent Injury? Now That's a Stretch
_____ Your grade school gym teacher was wrong. So was your high school track coach, the head of your beer league softball team and, probably, your mom: Failing to stretch before taking the field or hitting the track won't hurt you, according to a report in the British Medical Journal. What little research has been done on stretching, write the authors, two Australian researchers, suggests that it doesn't noticeably reduce either muscle soreness or injury.
_____The BMJ review focused on five studies that followed thousands of patients, including two large studies of Australian army recruits published in the last five years. No study lasted longer than 12 weeks.
_____Any reduction in muscle soreness that was due to stretching was "too small to make stretching to prevent soreness worthwhile" for most athletes, the researchers found. The report estimated that a typical individual would have to spend 23 years stretching every other day to prevent a single injury.
September 10, 2002

Quit Paxil, And Then: Zap!: Complaints Surface About Stopping Drug
_____ Paxil, the world's best-selling antidepressant, has become the target of growing complaints that stopping the drug causes severe side effects ranging from flu-like symptoms to electric-shock-like sensations in the brain that patients have labeled the "zaps." This marks the first time that one of the new generation of antidepressant medications, often described as non-habit-forming, has been accused of being addictive.
_____The patient complaints, which previously circulated chiefly on electronic bulletin boards and specialized Web sites, became more public last week when a federal judge in California ordered the drug's maker, GlaxoSmithKline, to pull TV ads that boast the drug is "not habit-forming." The judge later put that ruling, which said the ads may have underplayed the drug's possible role in causing withdrawal symptoms, on hold.
_____Both Glaxo and the Food and Drug Administration (FDA) have challenged the decision, part of a California court case brought on behalf of Paxil users.
_____At stake, potentially, is the treatment of thousands of U.S. patients on Paxil, which brought Glaxo almost $3 billion in revenue last year and was prescribed more than 70 million times in the last decade. That growth has been driven in part by an expanding list of uses. Paxil is approved for the treatment of depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder and generalized anxiety disorder.
SEE ALSO (sidebar): The Trick to Putting Paxil Behind: Proceed Slowly, Under a Doctor's Care
August 27, 2002