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Health Headlines - June 19

Posted Oct 23 2008 2:23pm

Prostate Cancer Report Grades States

Five states -- Arkansas, Kentucky, Mississippi, New Mexico, and Wisconsin -- received failing grades on the second annual Prostate Cancer Report Card, issued Monday by the National Prostate Cancer Coalition (NPCC).

Three of those states -- Arkansas, Mississippi, and Wisconsin -- flunked for the second-straight year on the report card, which assigns grades based on measures including prostate death and screening rates, support for prostate cancer-related legislation, and patient accessibility to urologists and clinical trial sites.

The five states with the best grades were: Connecticut (A), New Jersey (A-), Rhode Island (A-), California (B+) and Iowa (B+).

"More than 230,000 men will be diagnosed with [prostate cancer] this year, but with greater access to yearly screenings, early detection can save lives," NPCC CEO Dr. Richard N. Atkins said in a statement.


World's Oldest Man is 111

A 111-year old resident of southern Japan is the world's oldest man, says the Guinness Book of World Records. Tomoji Tanabe took the title in January after the death of 115-year-old Emiliano Mercado del Toro of Puerto Rico.

Tanabe, born Sept. 18, 1895, was officially certified as the world's oldest man earlier this month and received a certificate from the Guinness Book of World Records at a ceremony Monday, the Associated Press reported.

Tanabe, a former city land surveyor, does not drink alcohol or smoke. He lives in the city of Miyakonojo.

The world's oldest woman -- also the world's oldest person -- lives in Japan, too. Yone Minagawa, 114, was born Jan. 4, 1893, the AP reported.


Infants at Risk for Elevator Injuries

Among children, infants up to two years old are most likely to suffer elevator-related injuries, says a study by researchers at the Indiana University School of Medicine and Ohio State University.

They analyzed 29,030 elevator-related injuries suffered by children in the United States between 1990 and 2004 that were severe enough to require a visit to a hospital emergency room.

Of those injuries, 28.6 percent involved children up to two years of age, according to the study, which appears in an advance online issue of the journal Clinical Pediatrics.

"What really surprised us was the number of infants with head injuries in our study. As the elevator doors close mothers may not realize the vulnerability of babies in strollers or in their arms," lead author Dr. Joseph O'Neil, assistant professor of clinical pediatrics at the Indiana University School of Medicine, said in a prepared statement.

Overall, 98 percent of children with elevator-related injuries were treated and released from the emergency department. Of the two percent admitted to hospital for additional treatment, most had head, hand, or finger injuries.


Women with Twin Brother Less Likely to Have Children

Women with a twin brother may be 25 percent less likely to have children than women with a twin sister, says a U.K. study that examined centuries-old Finnish medical records, BBC News reported.

Exposure in the womb to the male hormone testosterone may be an important factor, said Sheffield University researchers. Their study appears in the journal Proceedings of the National Academy of Sciences.

The study also found that females with a twin brother were 15 percent less likely to marry than women with a twin sister, BBC News reported.

The researchers said they analyzed data on twins in the 1700s and 1800s because advanced healthcare and modern fertility/conception treatments would skew modern data.

"There is some evidence to support this observation. Exposure to testosterone in the womb in sheep recreates a similar syndrome to a condition called PCOS, which is a known cause of infertility in humans," Dr. Laurence Shaw, a fertility expert at the London Bridge Fertility Centre and a spokesman for the British Fertility Society, told BBC News.


Scientists Identify Hearing Loss Gene

Belgian scientists have identified a gene variant that causes otosclerosis, the single most common cause of hearing loss among white adults. The finding may lead to new treatments for the condition, which affects about one in 250 people.

Otosclerosis is caused by abnormal bone growth in the middle ear, which blocks sound waves from reaching the inner ear. University of Antwerp scientists found that many people with otosclerosis had a specific variant in a gene called TGBF1, BBC News reported.

The finding was presented at a European Society of Human Genetics conference, where the researchers also said that a more active variant of TGBF1 actually helped protect against otosclerosis.

This is a significant finding, Vivienne Michael, chief executive of Deafness Research UK, told BBC News.

"At the moment the most common treatment is surgery, but this findings opens the door to alternative therapies which would prevent or slow the abnormal bone growth that causes the condition," Michael said.


Asthmatics With Gene Defect May Need More Medicine

Defects in a gene that produces the protein filaggrin affect how often people with asthma need to take medicines, say British researchers, who added that their finding could lead to reductions in medication requirements for asthmatics.

Last year, the University of Dundee team identified the gene that produces filaggrin. The protein is normally found in large quantities in the skin's outermost layers and acts as a barrier to keep moisture in and foreign organisms out, BBC News reported.

Research in children with asthma revealed that defects in the gene can make asthma patients three-to-six times more likely to need to use their inhaler every day and more likely to require extra asthma medicines in addition to inhaled steroids, the scientists said.

The study appears in the Journal of Allergy and Clinical Immunology.

'Pill Splitting' Cuts Drug Costs for Patients, Health Plans

A practice patients often use to cut down on drug costs, called "pill splitting," can also save money for insurance companies and employers, a study of the University of Michigan's own health benefit plan shows.

In pill splitting, patients cut larger-dose tablets in half to double the amount of smaller-dose pills they receive in a single prescription -- for example, dividing 40-milligram tablets to create twice as many 20-milligram doses for the same price. And since drug companies and pharmacies don't usually double the price of medications as the dose doubles, that can mean lower overall per-pill drug costs and fewer drug store co-pays for consumers.

"Splitting is not really new," added study lead researcher Hae Mi Choe, who is an assistant clinical professor of pharmacy at the university. "What was different about this study was that we found out what it would be like if you return some of those savings to the patient."

Her team's study involved more than 100 university health plan members who take cholesterol-reducing drugs such as statins. Statins tend to be good candidates for splitting, the researchers noted, because they linger in the body for a long time, and any impact splitting might have on their action wouldn't greatly alter their effects.

The authors cautioned, however, that not all pills can be safely split. For example, those that pass through the body rather quickly, or have special time-release coatings, are not good candidates for splitting.

After the six-month randomized trial, 89 percent said they'd be willing to continue splitting their cholesterol medications in exchange for a 50 percent reduction in their prescription co-pays, the study found.

A survey returned by 109 health plan members found that 59 percent would be willing to split medications for as little as $5 to $10 in savings per prescription. However, for 12 percent of the survey respondents, no amount of monetary reward would encourage them to split pills.

In 2006, the university's health benefit plan (which covers 80,000 employees) offered the pill-splitting program for three statin drugs that reduce cholesterol. The program saved 500 employees who chose that option a total of $25,000 in co-pay reductions. In turn, the university saved $195,000 in drug costs, Choe added.

The study, published in the American Journal of Managed Care's June issue, also showed that pill splitting did not negatively affect participants' adherence to either their medication regimens or health status. Other types of medications are expected to be added to the program, Choe said.

In the corporate world, "early adapters" are looking at adding an incentive for pill-splitting in their 2009 health plans, said Eric Michael of Mercer Human Resource Consulting, in Minneapolis, a pharmacist and expert on corporate health plans. The University of Michigan's "study will go a long way toward promoting financial incentives, because it's from a credible, independent source," Michael said.

Splitting co-pays might not be quite enough of a financial incentive to get large numbers of patients to take the extra trouble to split pills, according to Greg Scandlen, president of the nonprofit Consumers for Health Care Choices, based in Maryland. If insurance carriers or employers "shared savings 50-50 with the patient, that would be a real incentive," he added.

And with an increased use of health savings accounts -- from which consumers pay 100 percent of drug costs -- "you'd have a substantial incentive," added Scandlen, whose group supports private health insurance.

Already, some managed care plans require pill splitting without financial incentive for appropriate medications, Michael explained.

Many other prescription drugs already are scored at their surface and are ready to be split apart by hand, Michael added. For example, he noted that Buspar, an anti-anxiety medication, is scored to break in either half or in thirds. Newer medications, he said, are less likely to come pre-scored, he said. According to Choe, participants in the University of Michigan study used pill-splitter devices to avoid problems with pills crumbling or being too hard to cut

Michael said he favors having pharmacists, not patients, split the pills, and some states -- but not all -- already authorize pharmacists to do this for customers. For one thing, certain patient groups, such as the elderly, might not be appropriate for pill splitting because of problems with dexterity, he said.

In addition, "A patient might forget to split and [therefore] might take twice the dose," Michael reasoned. "That might not be life-threatening, depending upon the medication, but it could be if they took it for a sustained amount of time."

Choe agreed that those kinds of concerns should be considered when deciding what pills to include in a splitting program. "If doubling the dose will lead to detrimental consequences, I wouldn't recommend splitting," she said.

Colgate says fake toothpaste a low health risk

Colgate-Palmolive Co. said on Friday counterfeit toothpaste that may contain a toxic chemical posed a low health risk, and it was picking up suspected fakes labeled "Colgate" brand from discount stores in four U.S. states.

'"It's a low health risk but the bottom line is, it doesn't belong in toothpaste," said Doug Arbesfeld, a spokesman for the U.S. Food and Drug Administration.

After analyzing some counterfeit samples, Colgate said it agreed with Arbesfeld's statement.

Two residents of the New York City borough of Staten Island who said they had used the counterfeit toothpaste were hospitalized, the Staten Island Advance newspaper reported.

The FDA traced the counterfeit toothpaste to New Jersey distributor MS USA Trading Inc., Arbesfeld said.

On Thursday, Colgate reported finding phony "Colgate" toothpaste in discount stores in New York, New Jersey, Pennsylvania and Maryland.

The company said the discount stores with the counterfeit toothpaste were independently owned.

The counterfeit toothpaste may contain the toxic chemical diethylene glycol, or DEG, and is labeled as being manufactured in South Africa. It comes in a 5-ounce (100 ml) tube, a size Colgate does not make or sell in the United States, the company said.

The chemical is sometimes illegally used as an inexpensive sweetener and thickening agent. It is also found in solvents and antifreeze.

DEG-contaminated toothpaste has been seized in Costa Rica, the Dominican Republic, Panama and Nicaragua. The sweet substance, sometimes used as a substitute for glycerin, was found in cough syrup in Panama that led to the deaths of at least 100 people last year.

According to the newspaper article, Doris Harrell said she developed nausea, stomach pain, dizziness and irregular bowel movements after using the toothpaste last week.

Her cousin Ricky Simmons was cited in the article as saying he had stomach pains after using the toothpaste two weeks ago, the article said.

Harrell said she bought the toothpaste at Neighborhood Discount Inc. on Staten Island last month, according to the newspaper.

The store's manager, Ashraf Elbaz, told Reuters he pulled tubes of toothpaste off shelves early Friday morning as soon as he heard about the incident.

Colgate said it had contacted all of its accounts and that none reported having any of the fake toothpaste. The company said it would take it off shelves if it heard of any stores with it in stock.

Colgate said it was trying to reach the people on Staten Island who reported becoming ill to be helpful and to obtain information about the counterfeit product.

MS USA is recalling all lots of 5-ounce Colgate toothpaste tubes it distributed to discount retail stores in the four states, according to a statement. MS USA could not be reached for additional comment.

Consumers can identify the counterfeit product by the size as well as the label tracing it to South Africa, Colgate said. In addition, there are misspellings on the package including "SOUTH AFRLCA" and "isclinically," Colgate said.

Two weeks ago the FDA warned consumers to avoid any toothpaste made in China after its inspectors found DEG in tubes sold at two stores. It also issued an import alert to prevent all toothpaste from three Chinese companies that make brands found to contain DEG from entering the United States.

It was unclear where the fake Colgate toothpaste originated.

Colgate said on Thursday it was working with the FDA to identify those responsible for the counterfeit products. The company said it does not use DEG in its toothpaste.

Colgate shares closed down 22 cents at $66.63 on the New York Stock Exchange.

More information about the toothpaste products in question can be found on the FDA's web site
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