Bird Flu Virus Can Infect Fetus

(HealthDay News) -- The deadly H5N1 bird flu virus can pass through the placenta of pregnant women and into the fetus, Chinese scientists report.

They also discovered that the virus infects organs other than lungs in adults.

The researchers, from Peking University in Beijing, analyzed tissue samples taken from two people -- a man and a pregnant women -- killed by bird flu, to determine how the virus affects different body organs.

They detected H5N1 genetic material and antigens in the lungs, certain cells in the trachea, the T-cells of the lymph node, neurons in the brain, and in cells of the placenta. They also found H5N1 genetic material in the intestinal mucosa but did not find any antigens there.

The dead woman's fetus had H5N1 genetic material and antigens in the lungs, circulating cells of the immune system, and in cells of the liver.

The findings are published in this week's issue of The Lancet medical journal.

"This study has shown the capacity for human vertical transmission of the H5N1 virus" and this "warrants careful investigation, since maternal infections with common human influenza virus are generally thought not to infect the fetus," the researchers wrote.

This and the finding that H5N1 spreads beyond the lungs in adults "are important in the clinical, pathological and epidemiological investigation of human H5N1 infection, and have implications for public health and health care providers."

More information
The World Health Organization has more about bird flu.

Take Care of Your Heart Before and After Problems

(HealthDay News) -- People need to take care of their heart both before and after heart trouble starts, two new studies suggest.

In the first study, researchers said that to avoid heart failure when you're 70 or 80, you must begin by keeping your blood pressure and weight under control when you're 50.

"We tested the hypothesis that higher levels of blood pressure and body mass index (BMI) in midlife would be powerful determinants of heart failure risk in later life, and that the risk posed by preceding measurements would remain even after accounting for these risk factors measured later in life," said lead researcher Dr. Ramachandran S. Vasan.

"This is exactly what we found," added Vasan, a senior investigator with the Framingham Heart Study and a professor of medicine at Boston University School of Medicine.

An increase of about 20 mm Hg in systolic blood pressure at age 50 was associated with a 36 percent higher risk of heart failure up to 20 years later. Every 2.2 pound increase in BMI (a ratio of weight to height) at age 50 was associated with a 6 percent increase in the risk of heart failure, Vasan said.

"The study highlights the importance of maintaining an ideal BMI and blood pressure over the life course of individuals," Vasan said.

For the study, Vasan's team collected data on 3,362 people who were part of the Framingham Heart Study who had routine examinations between 1969 and 1994. During follow-up, 518 people developed heart failure.

"The prevention of heart failure should begin early in life and should include screening for elevated blood pressure and BMI," Vasan said. "Failure to identify or treat such modifiable risk factors in early and mid-adulthood may result in the loss of opportunities to reduce the incidence of heart failure in later life."

The findings are published in the November issue of the journal Hypertension.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said he agrees that keeping both your weight and blood pressure down will help you avoid the ravages of heart failure.

"The lifetime risk for developing heart failure in both men and women is one in five," said Fonarow. "However, heart failure can be prevented, and there are a number of modifiable risk factors for heart failure, including hypertension, obesity, and diabetes.

"Maintaining a healthy blood pressure and body weight is essential to reduce the risk of heart failure," he said.

The second study found that fewer than 20 percent of patients seek cardiac rehabilitation after a heart attack or coronary bypass surgery.

"It has been shown by many trials that cardiac rehabilitation reduced the risk for new coronary events, re-hospitalization and mortality. The main advantage of cardiac rehabilitation is to reduce mortality," said study leader Dr. Jose A. Suaya, a lecturer and scientist at the Brandeis University Schneider Institutes for Health Policy, Heller School, in Waltham, Mass.

Cardiac rehabilitation also improves functional capacity, Suaya said. "Patients can walk more without pain and improve their quality of life," he said.

For the study, Suaya's group collected data on 267,427 men and women, 65 and older, who had survived a heart attack or bypass surgery. The data were drawn from 1997 Medicare claims records.

In the year after hospital discharge, only 18.7 percent of the patients had at least one session of cardiac rehabilitation. Patients who underwent bypass surgery were more likely to seek rehabilitation -- 31 percent -- compared with heart attack patients -- 13.9 percent.

More men had cardiac rehabilitation (22.1 percent) than women (14.3 percent). Age also played a role -- patients 75 to 85 were less likely to go for rehabilitation, the researchers found.

In addition, patients with other medical conditions, such as diabetes, a previous stroke, congestive heart failure or cancer, were significantly less likely to seek cardiac rehabilitation, Suaya's group found.

The study results are published in the Oct. 9 issue of the journal Circulation.

There are many reasons why patients don't seek rehabilitation, the researchers said.

"Many doctors may be reluctant to refer patients to cardiac rehabilitation," said study co-author Donald S. Shepard, a research professor at Brandeis' Heller School. "In addition, patients may not know or ask about it."

Shepard also noted that many medical institutions don't promote the service, which typically includes exercise and advice on diet. "It's not glamorous and, from the data we have, it is not very profitable," he said.

It may also be difficult for people to get to rehabilitation centers, Shepard said. "One of the findings in the study was that the closer you are, the more likely you are to use the service," he said. "Travel time and travel expense are things that reduce the use of the service."

Fonarow said "more needs to be done to ensure that eligible patients are effectively enrolled in supervised cardiac rehabilitation. The American Heart Association's 'Get With The Guidelines Program' is one example of a highly successful initiative to improve referral to cardiac rehabilitation after hospitalization for cardiovascular event or surgery."

More information
For more on heart health, visit the American Heart Association.

Support System Leads to Better Diet, Nutrition

(HealthDay News) -- Could better nutrition and diet be as close as a helpful phone call away?

A new study found that women who received telephone counseling about healthy eating habits wound up consuming more vegetables, fruits and fiber and less fat, suggesting that a support system can pay big rewards for people looking to improve their eating habits.

"With proper support, you can make a major change in your diet," said Cheryl Rock, professor of nutrition at the University of California, San Diego, and a study co-author. "A lot of people think it's an insurmountable task. But this study shows that yes, indeed, you can make a big change."
The study is published in the October issue of The Journal of Nutrition.

Rock and her colleagues randomly assigned 3,088 women, all at risk for a recurrence of breast cancer, to either a telephone counseling group or another group that didn't get the phone counseling. The phone counseling group also received newsletters talking about healthy eating and cooking classes. The women were encouraged to use recipes to help them meet their goals for more fruits, vegetables and fiber, and less fat.

The "control" -- or comparison -- group got printed materials about healthy diets and were offered cooking classes, but the themes weren't related to boosting intake of vegetables, fruit and fiber and decreasing fat.

Both groups ate fairly healthful diets at the start of the four-year study. Both ate seven vegetable and fruit servings a day, 21 grams a day of fiber and got 28.7 percent of energy from fat.

Under the 2005 Dietary Guidelines for Americans, those on a 2,000-calorie-a-day diet are advised to eat nine servings of fruits and vegetables a day, 28 grams of fiber, and to keep total fat to 20 percent to 35 percent of calories, most of the fat unsaturated.

The group that received phone counseling did better on their diet than the comparison group at the one-year and four-year mark, the researchers found. At one year, "there was a 38 percent increase in vegetable intake, a 20 percent increase in fruit, 38 percent more fiber" in the group receiving phone counseling, Rock said.

By year four of the study, the counseling group was consuming 65 percent more vegetables, 25 percent more fruit, and 30 percent more fiber. And they were getting 27 percent of their energy from fat, while the comparison group's fat intake was 31 percent.

The researchers verified the findings by taking blood samples.

The phone counseling started out frequently, then declined as people adopted the healthier habits. "The first few weeks, they talked to someone on the phone three or four times," Rock said. "Then for three or four months, they talked once a week. Then it was more like follow-up counseling. They got about 18 calls the first year, six the second year, four in the third year and three in the fourth year."

Trained counselors helped the participants with the dietary changes. "It was like coaching," Rock said. For instance, a woman might say she wanted to improve her breakfasts. A counselor might suggest eating an orange. But if the woman said, no, that wouldn't work because she ate breakfast in the car, the counselor might suggest a smoothie that includes fruits that could be sipped in a travel coffee mug.

Rock said the program has three crucial features: Demanding accountability -- the participants knew they would get another phone call; individualizing it to a person's lifestyle; and setting goals.

Another expert said the study demonstrates that phone counseling works to help people improve their diet.

"The use of phone counseling is growing, and this study shows that it can be very effective in achieving change while controlling costs," said Connie Diekman, director of nutrition at Washington University in St. Louis, and president of the American Dietetic Association.

"The frequency of the calls may make this less practical for large patient care, but it does demonstrate that contact and accountability improve outcomes," she said. "Not only is phone contact growing, but using the Internet for contact is another evolving area.

"The outcomes of the study are significant in that people maintained behavior change for four years, a change that increases the odds that the behavior will become a routine," Diekman added. "The study population, though, started out as healthier eaters, with the majority consuming five [servings of fruits and vegetables] a day, so more studies would be needed to determine if a group with poor diet habits could attain such change."

Could people enlist their family for the same support as the phone counseling, with the same effects? Maybe, Rock and Diekman said.

"Support is key to so many behavior changes. And having a partner, working as a group, or developing phone buddies are steps that many people could take to make eating changes. But the trained interviewer probably helped," Diekman said.

More information
To learn more about improving your diet, visit the American Dietetic Association.

Health Tip: Yeast Infections Can Recur

(HealthDay News) Vaginal yeast infections are common and often recur in many women. But they are easily treated with either over-the-counter or prescription medications.
These are common triggers of yeast infections, courtesy of the U.S. Department of Health and Human Services:

• Becoming stressed or not getting enough sleep.
• Maintaining a poorly balanced diet, particularly one that's high in sugar.
• Being pregnant.
• Taking certain medications, including steroids, birth control pills or antibiotics.
• Getting your period.
• Having certain health conditions, including HIV or poorly managed diabetes.

No Need for All-Day Patch to Treat 'Lazy Eye'

(HealthDay News) -- A new study could be great news for children with "lazy eye."

British researchers say youngsters may not need to wear an eye patch 12 hours a day, as is currently recommended, to treat the condition.

Instead, wearing the patch just three to four hours a day over a period of three months may do the trick to improve sight, the new study suggests.

"Lengthy durations of daily patching, which are incredibly burdensome on the child and their parents, are clinically unnecessary," said study co-author Merrick J. Moseley, a senior lecturer in the Department of Optometry and Visual Science at City University in London, England.

His team reported its findings in the Sept. 13 online edition of the British Medical Journal.

Lazy eye, or amblyopia, is caused by a disturbance to the vision pathways between the eyes and the brain, and is associated with blurred vision or crossed eyes. Studies have shown that patching can improve vision.

Although prior findings have found that patch use 12 hours a day is no better than six hours a day, many doctors have continued to prescribe more than six hours of patching daily.

To find out how well patching worked, Moseley's team studied 80 3- to 8-year-olds with amblyopia. The children were told to wear a patch for either six or 12 hours a day. The youngsters were also electronically monitored to see how long they actually wore their eye patch.

The team found that children prescribed six hours of eye patching a day did just as well as those prescribed 12 hours a day. "Moreover, monitoring showed that children wear their patches only for about half the time that they are prescribed," Moseley said.

"Children who actually patched 3 to 6 hours each day did just as well as those who patched 6 to 12 hours each day," Moseley said. However, "those who patched under 3 hours a day did significantly less well than the rest," he added.

In addition, the researchers found that children under 4 years of age require significantly less patching than those over 4 years. "The findings did not vary depending on the type of amblyopia -- anisometropic, strabismic or combined," Moseley said.

"Patching is not better beyond 3 to 4 hours a day, particularly in the case of young children," Moseley said. "The findings should signal the end of the treatment strategy wherein children are prescribed lengthy patching regimens such as 'all waking hours,' which have previously found favor among many clinicians."

"This study is an eye opener," added Dr. Daniel J. Salchow, an assistant professor of ophthalmology and visual science and director of pediatric ophthalmology at Yale University School of Medicine. "The paper really tells you what you get for a dose of patching," he said.

"We know how to treat amblyopia," Salchow said. One of the biggest problems in treating lazy eye is getting children and parents to use the patch for the prescribed time, he noted. "But those who keep the patch on longer improve faster," he said.

Salchow said that he usually prescribes six hours a day or less of patching. "Unless it's a very strong amblyopia, very seldom do I prescribe 12 hours," he said.

But it's up to parents to make sure their child wears the patch, Salchow said. "If a parent says 'it's so hard for me to have the child wear the patch,' often the results we see are disappointing," he said.

More information
For more on lazy eye, visit the National Eye Institute.

Family Dinners Shape Healthier Eating Habits

(HealthDay News) -- Teens who eat dinner with their families on a regular basis are also more likely to eat fruit and vegetables as young adults, a new study shows.

These teens also go on to drink fewer soft drinks in adulthood, the study found.

Reporting in the Journal of the American Dietetic Association, researchers at the University of Minnesota surveyed more than 1,500 students once during high school and again at age 20 about diet, social eating, meal structure and meal frequency.

The survey included questions about how often their family ate together, how much they enjoyed eating with family, if they ate on the run, and how often they ate breakfast, lunch and dinner.

Teens who reported eating family meals were more likely to report eating fruit, dark green and orange vegetables and key nutrients, and drinking fewer soft drinks. The more frequently they ate family meals as teens, the more likely they were to eat dinner as adults, placing a higher priority on structured meals and social eating.

For women, eating with their family during adolescence meant significantly higher daily consumption of calcium, magnesium, potassium, vitamin B6 and fiber as adults. Among males, eating with their family during adolescence results in eating more calcium, magnesium, potassium and fiber as adults.

More information
For more tips on planning a healthy family meal, visit Meal Planning.

International Database Seeks to Boost Treatment of Altitude Sickness

(HealthDay News) -- An international database on high altitude pulmonary edema (HAPE) -- a life-threatening buildup of fluid in the lungs that can occur at high altitudes -- has been launched at the University of Edinburgh in Scotland.

HAPE, also known as mountain sickness, can occur at altitudes as low as 2,500 meters and can affect people of all ages and fitness levels. Little is known about the condition, and there's no way to predict who is likely to be stricken by it. HAPE affects about one in 50 mountain climbers, skiers and others who venture up mountains. Some studies have suggested a genetic basis.

Treatment options are limited. Sufferers must descend from high altitude and seek immediate medical attention.

This new database, operated in conjunction with researchers from Austria, Bolivia, Britain and the United States, was created to boost research and knowledge about HAPE and possibly develop a way of identifying people susceptible to the condition.

If they can be identified, those at risk could take precautions such as climbing more slowly or taking drugs to prevent HAPE.

People who've suffered HAPE are encouraged to register with the database, which will be available to researchers worldwide. Individual details about registrants won't be given out without their consent.

More information
MedlinePlus has more about altitude sickness.

Knee Pain May Signal Lung Cancer

(HealthDay News) --Heavy smokers with knee arthritis may be experiencing an early sign of a difficult-to-treat lung cancer, research shows.

Researchers at Prato Hospital in Italy reviewed the case files of 296 patients with inflammation in one knee between 2000 and 2005.

In just under 2 percent of these patients, the mild knee arthritis was accompanied by non-small cell lung cancer. All patients were middle-aged men who had been heavy smokers for most of their lives. Once the cancer tissue was surgically removed, the knee pain cleared up as well.

About 85 percent of all lung cancers are non-small cell lung cancer, according to the American Cancer Society. Unless it is caught early, non-small cell lung cancer is difficult to treat. It spreads to the bones in one in five cases and is well advanced by the time it is diagnosed in half of all cases.

Writing in the September issue of The Annals of Rheumatic Diseases, the researchers noted that early warning signs such as knee pain could lead to earlier diagnosis and more successful treatments.

More information
To learn more about non-small cell lung cancer, visit the American Cancer Society.

HIV Drug Might Fight Cancer

(HealthDay News) -- A drug used as part of a regimen to treat HIV also appears to kill cancer cells, researchers from the U.S. National Cancer Institute report.

Based on this new finding, the HIV protease inhibitor nelfinavir is being used in a phase I clinical trial to determine what might be the safest and most effective dose for cancer patients. This strategy of finding new uses for existing drugs could have a major impact on treating cancer and other diseases, the researchers added.

"This could be a new approach to finding cancer drugs and cut the time for getting them approved," said lead researcher Dr. Phillip A. Dennis. "Repositioning drugs that are already FDA-approved could accelerate the development of new cancer therapies."

The researchers hit upon the idea of testing nelfinavir and other protease inhibitors as cancer drugs, because these drugs block Akt, a protein essential for the development of many types of cancer, including non-small cell lung cancer.

The report is published in the Sept. 1 issue of Clinical Cancer Research.

In experiments with mice, Dennis' team tested six protease inhibitors on non-small cell lung cancer and on 60 human cancer cell types from nine different kinds of malignant tissue.

At doses that are safe in HIV-infected patients, three of the drugs, nelfinavir, ritonavir and saquinavir, blocked growth of non-small cell lung cancer and every other cancer cell type tested, the researchers found.

However, nelfinavir was the most effective of all the drugs tested. It caused cancer cells to self-destruct or become stressed to the point of dying, Dennis said.

In addition, nelfinavir inhibited the growth of both drug-sensitive and drug-resistant breast cancer cells, indicating that it could be used to fight cancer cells that are resistant to common chemotherapy drugs. Nelfinavir may also be able to overcome resistance to radiation, the researchers reported.

Dennis noted that low doses of nelfinavir are used in treating HIV, and even at those low doses, the drug is effective against cancer. The current phase I trial will test higher doses to find the most effective dose with the fewest harmful side effects, he said.

In the trial, patients are already receiving higher doses with no apparent problem, Dennis said.

"If nelfinavir is proven effective in fighting cancer, it would, most likely, be used in combination with other cancer drugs," Dennis said.

One expert thinks this finding could be an important advance in cancer treatment.

"If it is proven that the toxicity levels are manageable in humans, it's going to be a great thing,"
said Charles Saxe, a scientific program director at the American Cancer Society. "Being able to get these drugs faster to patients by crossing over from one disease to another is going to be a big help."

Saxe noted that nelfinavir's ability to fight cancer in humans still needs to be proven. "But if they are right, and they can keep toxicity at reasonable levels, and they can show an effect at doses HIV patients can handle, that would be really exciting," he said.

In other cancer news, National Cancer Institute researchers report that they have found an extract of the skin of muscadine grapes (MSKE) can cause prostate cancer cells to die without affecting normal cells, according to a report in the Sept. 1 issue of Cancer Research.

The lead researcher noted this extract does not contain significant amounts of resveratrol, another grape skin component that has been linked to preventing the growth of prostate cancer.

"These results show that MSKE may have potent anti-tumor activities in the lab that differ from the effects of resveratrol. Further studies of MSKE will be necessary to determine if this extract has potential as a chemopreventive or therapeutic agent," Dr. Jeffrey E. Green, chief of the Transgenic Oncogenesis and Genomics Section at the Center for Cancer Research, said in a statement.

And in other HIV news, a study in the August issue of AIDS Patient Care and STDs, researchers found that one-fourth of HIV patients feel stigmatized by their doctors.

Most of the patients who felt that way were low-income minorities with poor access to care.

"Whether or not it is actual stigmatization is hard to measure, because it's coming from the patients that we interviewed," lead researcher Janni J. Kinsler, from the University of California, Los Angeles, said in a statement. "The point is that these people feel that way, and that's bad enough, because they're less likely to seek the care they need."

More information
For more on cancer, visit the U.S. National Cancer Institute.