Folic acid is getting renewed focus as a baby protecting vitamin. Also known as Vitamin B9,  it is essential to many bodily functions, not only guarding against spina bifida and other related birth defects, but now also linked to the prevention of premature births and heart defects.

According to the AP, doctors specializing in pregnancy are now questioning whether or not it is time for the government to increase the levels of folic acid added to some foods to help ensure expectant mothers get the necessary amounts.  However, there are drawbacks to this proposal, as too much folic acid poses a cancer risk for older adults.

“Folate is assuming the role of a chameleon, if you will,” says Dr. Joel Mason of Tufts University’s nutrition research center, who is researching that possible risk. 

Folic acid is a synthetic version of the B vitamin, folate. Folate occurs naturally in green, leafy vegetables, citrus and dried beans, and is essential to healthy growth at a cellular level. Therefore, all humans need it, but our bodies do not store enough of it. 

Pregnant women need high levels of it, even before conception, to prevent neural tube defects, which are abnormalities of the spine and brain. These types of birth defects have decreased by 33% since the U.S. mandated the fortification of certain breads, cereals and pastas with folic acid in 1998.

Two new studies indicate folic acid may be more beneficial than previously believed. 

In the first study, researchers in Texas evaluated nearly 35,000 pregnancies and concluded that women who reported taking folic acid supplements for at least one year prior to conceiving reduced their risk of having a premature baby by 50%.

In the second study, Canadian researchers evaluated 1.3 million births in Quebec since 1990 looking for heart defects. They discovered that the number of defects decreased by 6% each year since 1998, the year Canada began fortifying its food.

Health authorities have advised women who could become pregnant to take a daily supplement containing 400 micrograms of folic acid, for years.  This is recommended because obtaining enough folate through a normal diet is very difficult. 

Last month, the U.S. Preventive Services Task Force further encouraged women to take a daily vitamin that contained 400-800 micrograms of folic acid.

“We’ve seen in the U.S. and Canada dramatic changes in neural tube defects just with fortification. The question now is would a little more fortification, or even twice as much fortification, impact that bottom line, as well as those other potential benefits,” says Dr. Alan Fleischman, medical director of the March of Dimes.

Fleischman’s organization will summon pregnancy and folate specialists this summer to discuss this issue. 

Currently, the European Union and Britain are debating whether or not to begin food fortification in their countries as well. 

The issue is further complicated by the potential cancer risk to older adults, both male and female, who consume too much folic acid.

The dilemma lies in that some studies indicate that people who do not eat enough folate are at an increased risk for colon cancer and certain other cancers, while other research in animals shows that too much of the vitamin can stimulate the growth of some cancers. 

There is little human evidence to support the results of the animal tests. However, when researchers followed the cases of patients predisposed to precancerous colon polyps, the ones taking a high-dosage folic acid, 1,000 micrograms daily for three years, had more new polyps than those given a dummy pill.

In March, scientists analyzed 640 men from the earlier study and discovered that after 10 years, the ones who took folic acid were more likely to have been diagnosed with prostate cancer.

Tufts’ Mason explained this phenomenon indicating that while folate is normally a protective agent, if a person’s body already has some precancerous or cancerous cells, too much folate can exacerbate their growth. 

Because older adults are more likely to harbor cancerous cells in their colons or prostates, those taking a folic acid supplement will be more prone to these types of cancer.

Fortified foods alone wouldn’t be enough to cause any damage, stresses Fleischman: “I don’t think it’s going to end up being a generational argument.”

Everyone should eat plenty of leafy greens and citrus fruits, both good source of folate.  Deriving your daily folate from natural food sources is important at all ages. However, until the issue is settled, Mason warns that older adults “really ought to think twice about whether you should take a vitamin supplement that contains folic acid.”

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On the Net:

• Tufts University
• U.S. Preventive Services Task Force
• March of Dimes

U.K. researchers say that drinking a moderate amount of alcohol protects against the development of gallstones.

Analysis of data from 25,000 men and women showed that consuming two units a day cuts the chance of developing gallstones by a third.

Even though gallstones are very common, symptoms and complications are only seen in three out of 10 cases.

At a U.S. conference, delegates heard that alcohol reduces cholesterol in the bile from which gallstones form.

Data from a large study was used by researchers to look at the link between diet and cancer in men and women at an age range of 45-74.

Alcohol consumption was compared with the risk of developing symptomatic gallstones over a 10-year period.

Those that developed the condition were at an average age of 62 and more than two-thirds were women.

The ones in the highest alcohol group had a 32% lower risk than those who drank no or little alcohol.

The risk of gallstones fell 3% for each unit of alcohol drunk extra per week.

The researchers said that its been suggested that alcohol could reduce gallstones through its effects on cholesterol, but the magnitude of the effect had not been calculated.

Gallstones are formed in the gallbladder from bile and are made of hardened cholesterol.

It is believed that one in three women and one in six men get gallstones at some point in their life, but they are more common in adults that are older.

Other factors are obesity, rapid weight loss, medications and pregnancy.

A clinical lecturer at the University of East Anglia and a specialist registrar in gastroenterology, Dr. Paul Banim, said alcohol was known to increase levels of “good” HDL cholesterol which was also known to be protective against cardiovascular disease and can alter the composition of cholesterol in the bile.  Banim was the study leader for the research.

He said that excessive alcohol intake can create health problems, but quantifying the amount alcohol reduces the risk of gallstone development allow doctors to offer specific guidance.

Dr. Andrew Hart, Banim’s colleague and a senior lecturer in gastroenterology, said the findings boosted their understanding of how gallstones are formed.

“Once we examine all the factors related to their development in our study in the UK, including diet, exercise, body weight and alcohol intake, we can develop a precise understanding of what causes gallstones and how to prevent them.”

President of the British Society of Gastroenterology, professor Chris Hawkey, said the study was interesting but should be interpreted with caution due to it only measuring an association.

“Nevertheless, previous research has found similar findings and it seems likely to be a real effect.”

“The University of East Anglia are producing interesting data on consumption of particular foods and alcohol – for example a recent study from that unit suggests that oily fish may protect against ulcerative colitis.”

“Moderate alcohol below recommended limits is associated with good health. But alcohol is addictive and drinkers must be careful not to escalate their intake.”

The findings were presented at an annual meeting in Chicago at the Digestive Disease Week.

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On the Net:

• University of East Anglia
• Digestive Disease Week

When contact lens maker Bausch & Lomb Inc. went private in 2007, it was not without good cause.

Company leaders have explained that the company wanted to handle a disastrous recall of its popular lens cleaner “without a lot of outside distraction.”

In the past year, the optical products company has managed to quietly settle almost 600 lawsuits involving claims of fungal-infections, while dozens of individual claims are still waiting to be heard. In all, Bausch & Lomb Inc. has doled out a whopping $250 million “” and the number is still growing.

Upwards of 700 wearers of contact lenses in the U.S. and Asia claimed that they were exposed to a potentially blinding fungal infection known as Fusarium keratitis while using ReNu with MoistureLoc, a multipurpose cleaning solution for storing and moistening contact lenses.

In several cases, the damage was permanent. Seven people in Tennessee, Florida, Maryland, New York, Oregon and West Virginia had to have an eye removed, while at least 60 more have had to undergo corneal transplant surgery.

Between June 2005 and September 2006, officials from the U.S. Centers for Disease Control and Prevention confirmed 180 cases of infection in 35 states before the federal organization stopped its surveillance, explained Dr. Benjamin Park, an epidemiologist with the CDC. The organization continued to hear rumors of unconfirmed cases popping up in the months following the product MoistureLoc’s removal from the market.

“Surveillance usually captures the tip of the iceberg and sometimes it captures a larger tip than other times,” added Park in an interview.

One of the dozens of out-of-court settlements made in May was a case brought by Broadway actress and comedienne, Andrea Martin, whose cornea was scarred by a fungal infection. In another case in Colorado, a professional race-car driver’s career came to an abrupt and early end after he had to undergo a corneal transplant.

The fungus responsible for the infections is so rare that the majority of American opthamoligists have never even encountered a case.  Bausch & Lomb says they still don’t know how the microbe managed to sneak in through their tight screening procedures.

The outbreak first popped up in Hong Kong in spring 2005 and later climaxed in the U.S. just days after the product was removed from shelves in April 2006.

Most victims complained of eye irritation that was later followed by intense, searing pain. A number of patients were improperly diagnosed and thus suffered from delayed or incorrect treatment. One woman in New York was first affected some three months after Bausch & Lomb announced a worldwide recall of the product.

“She didn’t know about the recall, and the infection was so aggressive; she lost her eye within two months,” explained her attorney.

Government health experts have concluded that MoistureLoc was the only contact lens solution that contributed to the outbreak, though the details remain largely a mystery.

A number of scientists have hypothesized that alexidine, the novel disinfectant used in MoistureLoc, was absorbed too quickly by the contact lenses and that the moisturizing ingredients in the solution formed a biofilm that promoted the growth of the fungus to levels capable of causing infection.

With several lawsuits still being contested, the possibility that Bausch & Lomb’s health care disaster might be publicly aired in court is still very real “” a contingency that some lawyers and doctors would be pleased to see.

“The truth has been very carefully buried, and it appears to have been buried going back to the beginnings of the outbreak,” said chairman of the American Optometric Association, Dr. Arthur Epstein.

“All settlements were predicated on silence about the clinical findings and blame and so forth. My hope was that what actually happened would become part of public record in a courtroom. That way, we’d be able to learn from it and move on and make sure it never happened again.”

In the wake of the infections, the Food and Drug Administration has said that it intends to lay out more rigorous testing standards for lens solutions.

“We did take the two epidemics as very much of a wake-up call, because contact lens safety is an essential public health issue,” said Dr. Malvina Eydelman, director of the federal agency’s ophthalmic division.

Financial analysts predict that the MoistureLoc imbroglio could end up costing the company over $500 million in settlement and attorney payouts. Yet even more damaging for Bausch & Lomb has been the loss of hegemony in the highly profitable lens care market.

When the private equity firm Warburg Pincus purchased Bausch & Lomb for $3.67 billion in October 2007, Chief Executive Ronald Zarrella said that the buyout would let the company “pursue the growth path we were on […] without a lot of outside distraction.”

The 156-year-old Rochester-based company has over 13,000 employees and reported some $2.5 billion in sales for the 2007 fiscal year. Company leaders say they hope to return the firm to public ownership at some point in the next six years.

In an attempt to spruce up their rapidly retreating lens care sales, Bausch & Lomb has been forced to fall back on an older product, ReNu MultiPlus. But sales of the product have dropped by $72 million, from $522 million in 2005 to about $450 million in 2008.  During the same period, one of the company’s competitors, Alcon, has seen a rise in sales from $297 million to $469 million, according to analyst Peter Bye of Jefferies & Co. in New York.

Alcon’s multipurpose solution still has a clean image, and “that’s why they’re cleaning up” in the market right now, explained Bye.

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On the Net:

• Bausch & Lomb Inc.

New research shows that breast cancer survivors risk having their disease come back if they use certain antidepressants while also taking the cancer prevention drug tamoxifen.

Close to 500,000 women in the United States take tamoxifen, which cuts the chances of getting breast cancer again in half.  Quite a few of them also take antidepressants for hot flashes, because hormone pills are not considered safe after breast cancer.

Doctors have known for a while that antidepressants and other medicine lowers the amount of tamoxifen’s active form in the bloodstream.  But the affect on cancer risk is unknown.

However a new study that was reported on Saturday at a cancer conference in Florida is the largest to look at the issue.  The results showed that using these interfering drugs, including Prozac, Paxil or Zoloft, can virtually wipe out the benefit tamoxifen provides.

Doctors question the magnitude of harm from combining the medicines, and a smaller study suggests it may not be that big of an impact.

It is evident that not all antidepressants pose this problem, so women should talk to their doctors about which ones are best.

“There are other alternatives we can consider” that are safer, said Dr. Eric Winer, breast cancer chief at the Dana-Farber Cancer Center in Boston.

Winer had no role in the study, which was done by Medco Health Solutions Inc., a large insurance benefits manager.  The research team used members’ medical records to identify 353 women taking tamoxifen, plus other drugs that might interfere with it, and 945 women taking tamoxifen alone.  The women taking a drug combination did so for about a year on average.

Researchers then checked to see how many were treated for a second cancer occurrence.  There were other occurrences in 7 percent of the women taking tamoxifen alone, and then 14 percent of the women taking other drugs that might interfere.

Dr. Robert Epstein, Medco’s chief medical officer, said that if women want to take an antidepressant, “you probably want to stay away from those three.”

Epstein said that no greater beast cancer risk was seen in women taking the antidepressants Celexa, Lexapro or Luvox with tamoxifen, and there are reasons to think that other antidepressants may be safe as well.

Another study, led by Dr. Vincent Dezentje of Leiden University Medical Center in the Netherlands, found little risk from combining tamoxifen and popular antidepressants.  But only 150 women that took part in the study took the pill cocktail for over two months, and they were compared to women taking combinations for a shorter times.

The federal Food and Drug Administration is considering changing tamoxifen’s warning label to warn about the antidepressant drugs and a gene variation some women have that might make the drug less effective.

“This is a very controversial area,” said Dr. Claudine Isaacs, a breast specialist at Georgetown University’s Lombardi Comprehensive Cancer Center. “Until these data are absolutely clear, I would avoid drugs that impact on tamoxifen metabolism.”

Breast cancer is the most common cancer in American women, with over 182,000 new cases diagnoses last year that caused nearly 41,000 deaths.

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On the Net:

• Medco Health Solutions Inc.
• Leiden University Medical Center
• American Society of Clinical Oncology

National data shows a “dramatic” rise in the number U.S. teenagers choosing to abstain from sex between 1992 and 2002, while the use of contraceptives among those who are sexually active has similarly shot up, according to a new report.

The most recent reports from the period after 2002, however, show that teen pregnancy rates are once again starting to climb.  According to the report’s lead author Dr. Jennifer Manlove from Child Trends in Washington, D.C., this indicates that more work needs to be done.

“We need to continue to focus on this issue into the future to help reduce high rates of teen childbirth in the U.S., especially since things are trending in the opposite direction right now,” Dr. Manlove told reporters.

In the report published in the Journal of Adolescent Health, she and her colleagues examined statistics provided by the National Survey of Family Growth, looking specifically at the years 1992, 1997 and 2002 in an attempt to evaluate the role that factors like family environment, individual personality characteristics and relationship types had on teen sexual behavior.

Among the positive trends observed by the research group was a general decline in sexual activity in both boys and girls between the ages of 15 and 19.  The number of female teens having sex fell from 56 percent in 1992 to 47 percent in 2002, while the percentage of teen males having sex fell from 61 percent to 46 percent during the same period.

After a close analysis of the data, Manlove and her colleagues say they believe these downward trends to be a direct result of better educated parents and a reduced number of teens who themselves had been born to teenage mothers.

The study also showed that use of contraceptives between 1992 and 2002 rose from 62 percent to 72 percent for girls and from 65 percent to 78 percent for boys.

Additionally, the group found that teens were generally waiting longer before having sex for the first time, a fact which likely helps to explain some of the other trends.

The frequent of media reports in recent years claiming that teenagers are “hooking up” more than ever were not corroborated by the report.  “Based on these data we did not see any increase in casual sex,” stated the researchers.

Manlove says they are unsure about what’s behind the recent resurgence in teen pregnancy, though she suspects that incessant media coverage of teen moms like Bristol Palin and Jamie Lynn Spears has perhaps given teen pregnancy a shade of normalcy. 

“There has been a lot of media attention given to pregnant teens.  You can’t underestimate the power of the media,” she said.

Manlove stressed that while having the “sex talk” with children is important, a parent’s best weapon against teen pregnancy is to simply focus on maintaining overall good communication with their adolescent kids.  Simple family activities like eating dinner together seem to have an impact on reducing the likelihood of teen pregnancy, she explained.

She also said that when talking to their children, parents should try to help their teens become future-oriented by encouraging them to develop plans and goals for their future.  Studies support this advice, showing that adolescents who have college plans and begin thinking early about their careers are far less likely to become teen parents.

“I think there’s a lot parents can do,” said Dr. Manlove.

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On the Net:

• Child Trends
• Journal of Adolescent Health

A new study by researchers in Brazil finds that “night owls” have a gloomier disposition than “early birds.” 

The scientists chose to study people’s sleeping schedules because depression has been shown to have a deleterious effect on sleep, said Dr. Maria Paz Loayza Hidalgo of the Universidade Federal do Rio Grade do Sul, the study’s lead author.

Indeed, research has shown that some depressed people can be aided by light therapy, in which patients sit in front of a bright light for two hours first thing in the morning in an attempt to reset sleep schedules that have been altered by depression.

In the current study, researchers randomly selected 200 healthy people with no history of mental illness and queried them about their depression symptoms and sleeping habits.  

The scientists found that night owls were nearly three times as likely as early birds to have symptoms of severe depression.  More remarkable yet was the fact that when compared with those who went to bed at an intermediate time, night owls were five times more likely to have severe symptoms of depression.

On average, the differences between bedtimes were small, with night owls turning in around midnight and early birds around 11 p.m.  The same held true with waking time, with night owls rising on average 40 minutes later than early birds.   In both groups, the total sleep duration was about the same.

“The study shows that even relatively subtle shifts in patterns of sleep seem to make a big difference in how people rate their mood,” said Dr. Ian A. Cook, an associate psychiatry professor at UCLA and director of the university’s Depression Research & Clinic program.

“That’s very intriguing stuff. Like any good study, it raises many more questions than it answers,” he told MSNBC news.

However, what is not yet known is whether the sleep schedule is causing the depression symptoms or whether those symptoms are keeping people up late, he added.

Nevertheless, the study suggests that it might be possible to enhance one’s mood with schedule changes, he said.

For those who wish to test this theory, Cook suggests using a second alarm clock set for a targeted bed time as a reminder to turn in on time.

Dr. Alan Manevitz, a psychiatrist at New York-Presbyterian Hospital/Weill Cornell Medical Center, advises steering clear of any stimulating activities close to your new bedtime.  In particular, Manevitz suggests foregoing late night email checks to avoid any anxiety that might come from reading distressing messages.  Also, the light from a computer screen tends to wake some people up a bit.

However, other experts believe that sleep schedules and the tendency towards depression might not be so easy to change.

Scientists have identified genes that cause some people to have a tendency to rise early and others to sleep late, said Dr. Eric Nofzinger, director of the sleep neuroimaging research program at the University of Pittsburgh School of Medicine.

There may be some natural differences in brain wiring that keep night owls more awake during the evening hours and that make them more depression prone, Nofzinger told MSNBC.

Nofzinger used a PET scanner to examine the brains of depressed patients, and found they functioned differently during sleep than those of others.  In particular, depressed patients showed much more activity in parts of the brain involved in processing and experiencing emotions, he explained.  As a result, they never get a full, restorative night’s sleep.

Although some people may simply have genes that make it more difficult for them to go to sleep earlier, others may simply be responding to the demands and options of modern life, said Cook.

“This study raises the question of what happens in a world of 24-hour news cycles that tempt people to stay up late,” Cook said.

“That could create a tendency to drift into the night owl pattern which could create a risk for developing mood problems.”

The study was published in the journal Psychiatry and Clinical Neurosciences.

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On the Net:

• Psychiatry and Clinical Neurosciences

Surprisingly few pharmacies in the U.S. are able to translate prescription medication instructions into Spanish, making it difficult for patients who speak only Spanish to understand how to take their medications properly, according to a new study from the Northwestern University Feinberg School of Medicine.

The first multi-state study investigating the ability of pharmacies to translate prescription labels found more than half of the pharmacies were unable to translate any labels or could do only a limited number of translations. The study looked at pharmacies in states with a large existing Latino population (Texas and Colorado) and in states with a rapid growth in Latino population (Georgia and North Carolina). These states — because of their large Latino populations — are likely to have the greatest demand and capability for translation. Other states may be further behind, researchers said.

“The lack of translation for prescription medication instructions is a major problem,” said lead author Stacy Cooper Bailey, clinical research associate and director of the Health Literacy and Learning Program at Northwestern’s Feinberg School. “If you don’t know how to take your medications correctly, it is going to be difficult for you to manage your medical condition. Taking medications incorrectly could cause serious problems or even death.”

The study will appear in the June issue of the journal Medical Care.

Bailey said the study results indicate the overall problem is far more prevalent than what had been suggested in prior single-site studies conducted in New York and Milwaukee.

Bailey and colleagues surveyed 764 pharmacies, including national chains, in four states. The study found 34.9 percent (267) could not offer any translation services; 21.7 percent (166) offered only limited translation services and 43.3 percent (331) said they could provide translated instructions. Of the total, 28 percent were independent pharmacies and 72 percent were part of national, regional or state chains.

The data also showed that 44 percent of pharmacies located in counties where the Latino population exceeds a quarter of the population were unable to provide comprehensive Spanish medication instructions.

“The numbers are much worse than I anticipated,” Bailey said.

“A lot of effort has gone into improving language services in hospitals, but pharmacies have been overlooked,” Bailey said. “That is unfortunate because a lot of people take medications. It’s one of the most common health tasks that you have to perform. Knowing how to take your medications correctly is essential.”

Bailey said some pharmacists report being afraid to use translations because they don’t know what the Spanish translations mean. “They worry they are giving an incorrect instruction and they will be liable for it,” Bailey said. “Pharmacies also may not be aware of software programs that offer translations,” she added.

Availability of translations is likely to be even worse for people who speak a language other than Spanish, Bailey said. “We have to be able to provide medication instructions in multiple languages, even beyond Spanish. More laws need to be passed to guide and enforce language services in pharmacies. We also need to come up with innovative ways of helping pharmacies provide these services. There are ways to overcome this obstacle.”

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On the Net:

• Northwestern University
• Medical Care

A new study published Wednesday finds that surgical stockings designed to prevent blood clots in stroke patients perform no better than routine care. 

Doctors typically advise patients to wear the thigh-length stockings to help minimize the risk of clots forming and traveling to the heart or lungs, where they can sometimes be fatal.

Millions of the graduated stockings are provided to stroke victims each year in hopes the garments will reduce the risk of deep vein thrombosis (DVT), a potentially lethal blood clot that forms in the leg.

The condition is often referred to as “economy-class syndrome”, since airline passengers sitting for long flights in cramped airline seating sometimes develop the clot because of poor blood circulation in their legs.

However, DVT can occur in any position where an individual is sedentary for long periods of time, and hospitalized stroke patients particularly at risk.

Doctors in Britain conducted a study of 2,500 bedridden patients who had been admitted to hospitals in Italy, Australia and Britain within one week of having a stroke.

Half received standard hospitalized care for strokes, while the rest received normal care plus the compression stockings.  The patients were checked twice for clots by an ultrasound scanner.

The results of the study found that 10.0 percent of the stockings group had suffered a DVT, while 10.5 percent of the routine-care group had ““ a difference that was statistically insignificant.

Furthermore, five times as many patients who wore the stockings had suffered blisters, skin breaks and skin ulcers.

“Abandoning this ineffective and sometimes uncomfortable treatment will free up significant health resources — both funding and nurse time — which might be better used to help stroke patients,” wrote lead researcher Martin Dennis of the University of Edinburgh.

The study was published on Wednesday in The Lancet medical journal.  A summary can be viewed here.

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On the Net:

• The Lancet

The last of the nation’s first stair-climbing wheelchair was quietly sold this spring, with its high-price tag having resulted in disappointing sales. 

The poor sales of Johnson & Johnson’s iBOT, which failed to sell more than a few hundred units, raises the question of how much society is willing to pay for such high-tech assistance for the disabled. 

A veteran who lost both legs in Iraq received the last known available iBOT last month, which was donated after its original owner had died.

Current iBOT users who now fear their chairs would wear out are joining high-profile Segway-inventor Dean Kamen in lobbying Congress for changes in Medicare reimbursements. Medicare currently reimburses just $6,000 for the iBOTs, despite their price tag of $22,000.
 
“If I ever had to get out of this chair, I really don’t know if I’d want to live anymore, to be honest with you,” said Alan T. Brown, who is mostly paralyzed from the chest down and on his second iBOT, during an interview with the Associated Press.

“Guys in these chairs … we might be disabled now, but then we’d really become disabled,” said Brown, 42, of Hollywood, Florida.

However, price wasn’t the iBOT’s only downfall.  Because the high-tech chair requires use of at least one arm and some upper-body control, only a fraction of the paralyzed were candidates to use the chair.

Nevertheless, disability specialists say what has happened with the iBOT carries implications beyond the chair itself, and raises the question of how the country will handle such specialized medical equipment.

Dr. Michael Boninger, director of the University of Pittsburgh Medical Center’s rehabilitation institute, gave an example.  Medicare, he said, routinely pays tens of thousands of dollars for hip replacements to keep patients walking pain-free.  However, a 70-year-old who can’t undergo that procedure must become too impaired to easily care for at home before Medicare will approve even just a basic electric wheelchair.

Medicare says that’s how Congress established its rules.

“The wheelchair is maybe the most enabling technology in medicine, period,” Boninger told the AP.

“What it is, is discriminatory policy.”

The iBOT saga also sounds a cautionary signal about expensive innovation. Henry Claypool, the new director of the federal Office on Disability, says new technology must come with scientific evidence that it changes users’ lives in ways current alternatives cannot.

“Innovative technology should be treated as something we need to embrace when we really find it has a chance to advance a group’s function and integration into the community,” Claypool, himself a wheelchair user, told the Associated Press.

Opinions differ on whether or not the iBOT accomplished that task.

The iBOT’s wheels rotate up and over one another to move up and down stairs.  The device uses gyroscopes that sense and adjust to a user’s center of gravity.

The Department of Veterans Affairs had purchased the iBOTs for a limited number of disabled soldiers.

However, by the end of 2006, Medicare concluded that the iBOT’s stair-climbing function and some other features, such as lifting users to standing height and moving over uneven terrain, were not medically necessary for at-home care.  As a result, they decided to pay only the basic electric wheelchair price.

When doctors deem them required, Medicare does provide far more expensive wheelchairs equipped for some pressure-easing motions or to handle breathing equipment.

Johnson & Johnson said reimbursement was partly to blame for lack of a “sustainable market,” but also committed to provide iBOT users repair service through 2013.

“Giving people independence and access and freedom and technology ought to be something we do,” said Kamen, adding that an iBOT might also save money on home modifications.

However, today’s priority is to expand health care access rather than provide pricier enhancements, warns University of Michigan business professor Erik Gordon, who tracks Johnson & Johnson.

Gordon said that venture capitalists that fund device research have warned the industry that new designs must demonstrate a better value than existing alternatives.

“To a certain extent, there are breakthroughs we just can’t afford,” he told the AP.

Army pilot Gary Linfoot of Clarksville, TN, demonstrates the pros and cons of such advancements.  He was paralyzed last year in a helicopter crash in Iraq, and received an iBOT through the nonprofit Huey 091 Foundation.  However, he alternates between it and his VA-provided manual wheelchair, which lets him drive a car, not a van, to Fort Campbell, where he now runs an aquatic training facility. 

He had an elevator installed in his home, but uses the iBOT to reach high shelves or to work under the hood of his car. 

He also uses his iBOT when visiting friends whose houses have a step or two that “may as well be Mount Everest.”

“You don’t understand all the accessibility issues until you find yourself in one and you’re trying to navigate the world yourself,” he told the AP.

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On the Net:

• iBOT
• Medicare

An experimental vaccine applied the surface of the skin appears to protect against certain types of ear infections. Scientists from the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, report their findings today at the 109th General Meeting of the American Society for Microbiology in Philadelphia.

“Our data are the first to show that transcutaneous immunization is an effective way to prevent experimental ear infections and lays the foundation for an effective, yet simple, inexpensive ““ and potentially transformative ““ way to deliver vaccines,” says Laura Novotny, one of the study researchers.

Nontypeable Haemophilus influenzae (NTHi) is one of the three main bacterial causes of otitis media (OM), an infection or inflammation of the middle ear. OM is one of the most significant health problems for children in the United States, costing approximately $5 billion annually. It is estimated that 83% of all children will experience at least one ear infection prior to 3 years of age.

Currently infections are managed with antibiotics; however, the emergence of antibiotic-resistant microorganisms is of concern. Surgery to insert tubes through the tympanic membrane relieves painful symptoms, but the procedure is invasive and requires the child to be under general anesthesia. Thus, it is necessary to develop different ways to treat or preferably prevent this disease.

“We have designed several vaccine candidates which target proteins on the outer surface of this bacterium. Previous work in our lab showed that after immunization by injection, each of the three vaccine candidates prevented experimental ear infections caused by NTHi. In this study, we now wanted to test an alternative but potentially equally effective method to deliver a vaccine,” says Novotny.

The method, known as transcutaneous immunization, involved placing a droplet of each vaccine onto the ear and rubbing it into the skin.

In this study, four groups of chinchillas were immunized with one of the three vaccine candidates. A fourth group received a placebo. Each vaccine was placed on the ears of chinchillas once a week for three weeks. All animals were then inoculated with NTHi through the nose and directly into the middle ears. Animals that received the vaccines were able to very rapidly reduce, or completely eliminate NTHi from the nose and ears, but animals that received a placebo did not.

This study was performed by Laura A. Novotny of Dr. Lauren O. Bakaletz’s laboratory in the Center for Microbial Pathogenesis at The Research Institute at Nationwide Children’s Hospital in Columbus, OH and in collaboration with Dr. John D. Clements, Department of Microbiology and Immunology, Tulane University, New Orleans, LA. Research was made possible by funding from the NIDCD/NIH R01 03915 & 007464. Data were presented at the 109th General Meeting of the American Society for Microbiology in Philadelphia, PA on May 21, 2009.

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On the Net:

• American Society for Microbiology
• Research Institute at Nationwide Children’s Hospital

Researchers said on Wednesday that the same part of the brain that makes us crave food and sex might also help determine whether somebody is a warm and sentimental “people” person, Reuters reported.

The study, reported in the European Journal of Neuroscience Scientists, found a greater concentration of brain tissue in certain areas of the brain may drive some people to gush fuzzy feelings more than others.

Graham Murray of Cambridge University in Britain, who led the study, said they could now pin down the relationship between a specific aspect of someone’s personality and a specific region of their brain.

“Those are the regions that we know are important for basic biological drives like for food and sex,” he said.

The study collected data from questionnaires used to help measure the relationship between personality and brain structure in 41 men.

The researchers, who collaborated with a team at Oulu University in Finland, asked the volunteers how well they thought they connected to people, how they showed their emotions and whether they liked to please people.

Brain scans were employed to analyze the concentration of grey matter””tissue rich in brain cells known as neurons””in different regions.

The study found that those subjects who scored “warm and fuzzy” on the questionnaires had more brain tissue in the orbitofrontal cortex””the outer strip of the brain just above the eyes””and in a deep structure in the center of the brain called the ventrial striatum.

Research studies in the past had shown that the two areas were important for how the brain processed certain pleasures such as sweet tastes or sexual stimuli.

Murray explained that sociability and emotional warmth are complex features of the personality and the new research provides a better understanding at a biological level of why people differ in the degrees to which those traits are expressed.

However, he said cultural differences could also play a role, given that Americans tended to score higher on personality tests than Scandinavians, for instance.

The new findings could offer clues into how the human brain evolved and may even provide further insights into psychiatric disorders like autism, schizophrenia and other conditions marked by social interaction difficulties.

Murray said the brain structure that supports social interaction evolved out of the brain structures that supported basic survival drives.

“It opens a line of enquiry to investigate some of these problems that psychiatric patients may have,” he said.

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On the Net:

• University of Cambridge
• European Journal of Neuroscience

New research warns that a popular surgery used to perform face lifts is associated with too many risks and poor results to be worthwhile for patients.

The procedure is called a “thread lift,” and it involves placing barbed threads under the skin and then tightening them to pull up drooping facial tissues.

In 2005, the Food and Drug Administration approved the Contour Thread Lift system, but it was later rescinded after numerous problems were reported. 

However, Dr. Rima F. Abraham of Albany Medical College, New York and her colleagues note similar products are still available, and the procedure is widely advertised.

Abraham’s team studied 33 patients who underwent the procedure; twenty-three had other procedures as well, while the rest had thread lifts only. Ten additional patients who had other types of plastic surgery served as a comparison “control” group.

Four plastic surgeons that were not told which procedure the patients had received, rated the “aesthetic improvement” for each patient on a scale from 0 (no improvement) to 3 (considerable improvement).

One month after the procedure, the surgeons saw improvements in all the patients. However, at follow-up sessions, which averaged 21 months later, the thread-lift-only group scored lowest, with average improvement scores ranging from 0.2 to 0.5.

The research found that patients who had thread lifts plus other procedures, scores ranged from 0.5 to 1.4. However, scores ranged from 1.5 to 2.3 for the group that only had traditional procedures.

Thread lifts don’t produce lasting results, Abraham and her colleagues say, because they don’t change the shift in facial volumes that happens with aging.

They noted that excess skin left over after facial “tightening” is left in place, and the results seen a month after thread lifting were probably from swelling and inflammation.

The study found complications with thread- lifts such as visible knots and dimpling of the skin.

Three patients involved in the study had to have a thread removed.

Abraham and researchers say that thread-lifts carry a high risk of complications, while extensive scarring may make it difficult to remove the threads. They note that other studies have found up to 20% of patients need a repeat surgery.

“Given these findings, as well as the measurable risk of adverse events and patient discomfort, we cannot justify further use of this procedure for facial rejuvenation,” said the study.

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On the Net:

• FDA
• Albany Medical College

The US Justice Department announced on Monday that it would work alongside 16 states in two whistleblower lawsuits against Madison, N.J.-based drugmaker Wyeth.

Filed in federal court in Massachusetts, the lawsuits claim that Wyeth charged too much for Protonix, a stomach acid-suppressing drug, which resulted in millions of dollars being siphoned from state Medicaid programs.

The Justice Department is seeking payment from Wyeth, which allegedly failed to pay hundreds of millions of dollars in rebates to state Medicaid programs.

Manufacturers of brand-name drugs are required by law to allow for the same rebates to Medicaid programs as they provide to customers.

“Our complaint charges that Wyeth created the Protonix bundle so they could increase their market share at the expense of the Medicaid program — a program to provide the least advantaged Americans with necessary medical care and services,” Assistant Attorney General Tony West said in a statement.

“By offering massive discounts to hospitals, but then hiding that information from the Medicaid program, we believe Wyeth caused Medicaid programs throughout the country to pay much more for these drugs than they should have,” he added.

Wyeth announced it intends to defend itself in order to show no wrongdoing on its part.

“The company believes that its pricing calculations were correct and intends to defend itself vigorously in these actions,” said Doug Petkus, a Wyeth spokesman.

Other states involved in the lawsuit include California, Delaware, Florida, Illinois, Indiana, Louisiana, Massachusetts, New York, Michigan, Nevada, New Hampshire, Tennessee, Texas, Virginia and Wisconsin.

“The best price reporting requirement is designed to assure that the nation’s healthcare programs for the poor – the Medicaid programs – are treated equally with drug companies’ best commercial customers,” Michael Loucks, acting U.S. attorney for the District of Massachusetts, said in a statement.

According to the Associated Press, Wyeth is currently in talks with Pfizer Inc to acquire the drug company for more than $60 billion later this year.

—

On the Net:

• US Justice Department
• Wyeth

As crews spend nine months of the year cut off from the rest of civilization, Australia’s Antarctic research stations are taking lessons learned from space to try to improve the diagnosis and treatment of staff in remote locations, Reuters reported.

Similar to working on a space mission, Australia’s Antarctic Division operates some of the world’s most remote outposts and assignments.

However, doctors dealing with a medical emergency or diagnosing a patient have difficult challenges to overcome, as evacuation is impossible during the long winter months of isolation.

But now the Royal Perth Hospital in Western Australia is working with the division to develop a set of guidelines that would increase medical care by allowing staff with minimal medical training to use newly developed 3D diagnostic ultrasound.

Project member Marilyn Zelesco, a sonographer at Royal Perth Hospital, told Reuters it is the first study that involves 3D or ultrasonic volume imaging in extreme medicine””medical practices conducted in very remote areas.

The idea would help outpost doctors by sending patient images to be stored and then forwarded to specialists for analysis.

Jeff Ayton, the division’s chief medical officer, said it isn’t possible to train a generalist doctor in all facets of medical care for such remote and isolated areas.

“You would normally have a whole team of specialists who would conduct expert investigations,” he added.

Ayton, who was attending an international space medicine gathering in Houston, Texas, experienced the new 3D technology firsthand when a doctor at Australia’s Mawson research station in Antarctica demonstrated the equipment for the first time in a live transmission diagnosis.

Trained sonographers are traditionally required to operate and interpret ultrasound images, however it is not possible to employ such experts at the division’s research stations or on missions in space.

Ayton noted the challenges of isolation and minimally trained medical and non-medical personnel in space.

He said having the ability to quickly fetch good diagnostic-quality images and send them off to someone else for assessment in an emergency situation is a great advantage.

“It frees up the generalist doctor in treating the patient,” he said.

Diagnostic ultrasound is already a staple of NASA’s space program.

Zelesco and Rob Hart of the Royal Perth Hospital, two of the researchers on the division’s project, have even developed protocols for astronauts to use 2D ultrasound on the International Space Station.

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Image Credit: mysibel.blogcu.com/

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On The Net:

NASA

UK Researchers are now reporting that the Bird flu may not have been as threatening to humans as was originally believed because our noses are too cold for the virus to thrive.

A re-creation of the environment of the nose done by Imperial College London shows that at 89.6 degrees Fahrenheit the avian flu viruses lose the ability to function and spread.

It is quite possible that the viruses have adapted to withstand the warmer 104 degree environment in the bowels of birds.
They say that a mutation is necessary to make the bird flu a danger to humans.

The study, published in the journal PLoS Pathogens, also found that human viruses are affected by the colder temperatures found in the nose but not to the same extent.

The researchers said that human viruses are still able to replicate and spread under those circumstances. 

Both of the viruses were able to successfully grow at normal human body temperatures of 98.6 degrees, which is the same as the environment in the lungs.

They were also able to create a mutated human flu virus by adding a certain protein from the surface of an avian influenza virus.

This virus serves as an example of how a new strain could potentially develop and cause a pandemic, but was also unsuccessful at 89.6 degrees.

Study leader Professor Wendy Barclay says this information suggests that if a new human influenza strain evolved by mixing with an avian influenza virus, it would still have to further mutate in order for it to successfully infect humans. 

“Our study gives vital clues about what kinds of changes would be needed in order for them to mutate and infect humans, potentially helping us to identify which viruses could lead to a pandemic.”

She added that further research might point to warning signs in viruses that are beginning to make the genetic changes necessary for them to cross over to humans.

“Animal viruses that spread well at low temperatures in these cultures could be more likely to cause the next pandemic than those which are restricted.”

She said swine flu that was spreading from person to person through what seemed to be upper respiratory tract infection was likely an example of a virus adapting to cope with the cooler temperatures of the nose.

“This work confirms the fact that temperature differences in the avian and human sites of influenza infection are key to virus establishment,” said Professor Ian Jones, an expert in virology at the University of Reading.

“It is certainly part of the explanation of why avian viruses, such as H5N1, fail to transmit readily to humans.”

He added that the research also revealed that the proteins on the outside of the virus were essential to its function at different temperatures.

“This helps the monitoring of avian flu as it indicates which changes to look out for.”

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On The Net:

PLoS Pathogens

Imperial College London

A new report shows that while the birth rate among unmarried women in the US is on the rise, it is still far behind in comparison to trends witnessed in Northern European countries.

The number of infants born out of wedlock in the US hit an historic high of 1,714,643 in 2007.

Countries including France, Denmark, the United Kingdom and Iceland each have a higher rate of births to unwed mothers than in the US.

Iceland has the most, with 6 in 10 births among unmarried women. In Sweden and Norway, about half of all births are to unwed mothers.

In the US, the percentage of babies born to unwed women is about 40 percent, according to the new CDC report issued on Wednesday.

Countries with lower percentages than the US include Ireland, Germany, Canada, Spain, Italy and Japan.

The new CDC report draws its conclusions based on data collected from previous studies in comparison to up-to-date information.

Stephanie Ventura of the CDC’s National Center for Health Statistics told the Associated Press that unmarried births have undergone significant percentage increases in the US and at least 13 other industrialized nations since 1980.

“Basically we’re seeing the same patterns,” Ventura said.

“The values surrounding family formation are changing and women are more independent than they used to be,” Carl Haub, a demographer at the Population Reference Bureau in Washington, D.C., told the AP. “And young people don’t feel they have to live under the same social rules that their parents once did.”

Unmarried women in the US are typically paid less and are uneducated, said analysts.

Most births to teenagers ““ 86 percent in 2007 ““ are nonmarital. Also, 60 percent of births to women between the age of 20 and 24 and nearly one-third of births to women 25-29 were nonmerital in 2007.

“Teenagers accounted for just 23 percent of nonmarital births in 2007, down steeply from 50 percent in 1970,” said the report.

However, in Northern Europe, men and women tend to live together in long-term relationships without getting married, Haub said.

He added that the overall number of births would decline globally due to the troubled economy. However, the he expects the rate of children born to unwed mothers to continue to rise.

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On the Net:

• CDC – National Center for Health Statistics Homepage

As the global outbreak of swine flu appears to be tapering off, there are now 33 countries reporting an estimated total of 6,080 confirmed cases, including 3,009 in 45 U.S. states, 2,446 in Mexico and 358 in Canada, The Associated Press reported.

However, the death total is relatively low at 65 confirmed, of which 60 were in Mexico, three in the U.S., one in Canada and one in Costa Rica.

Mexico has tested about 9,000 sick people and found that the country’s dead represents 2.5 percent of confirmed cases, suggesting the virus is not as deadly as initially feared, according to Health Secretary Jose Angel Cordova.

Cordova said pneumonia might be much more deadly, killing 9,500 people in Mexico last year. He reported that the last death from swine flu was on May 7.

He also addressed Mexico’s hard-hit tourism industry, saying there are “very few” cases in tourist destinations – including 7 in Cancun.

“There is no risk for tourists – they can return to these relaxing vacation spots,” he said.

But experts at the U.S. Centers for Disease Control and Prevention warn that there is a danger the virus will mutate into something more dangerous, perhaps by combining with the more deadly but less easily spread bird flu virus circulating in Asia and Africa.

Many fear it could also combine with the northern winter’s seasonal H1N1 virus, which was resistant to Tamiflu, and health officials worry it could make the new swine flu resistant to Tamiflu as well.

The World Health Organization is warning countries to limit the use of antiviral drugs to ensure adequate supplies as swine flu is still spreading around the globe.

In an attempt to contain the virus before it spreads more widely, antiviral drugs such as Tamiflu and Relenza have been administered much more aggressively in European countries than in the U.S. and Mexico.

EU and Latin American officials, including Mexican officials, were meeting in Prague on Wednesday to discuss the threat.

The U.N. agency thinks antivirals should be targeted mainly at people already suffering from other diseases or complications””such as pregnancy””that can lower a body’s defenses against flu, according to WHO medical expert Dr. Nikki Shindo.

Officials from the CDC are suggesting pregnant women take the drugs if diagnosed with swine flu, even though the effects on the fetus are not completely known.

Flu infections have raised the risk of premature birth in past flu epidemics and pregnant women are more likely to suffer pneumonia when they catch flu.

Dr. Anne Schuchat of the CDC said risks from the virus are greater than the unknown risks to the fetus from Tamiflu and Relenza.

“We really want to get the word out about the likely benefits of prompt antiviral treatment for pregnant women,” she said.

Cordova said Mexico now gives Tamiflu to anyone who has had direct contact with a person infected with swine flu and since schools are now back in session, authorities plan to give it to any children who may be showing symptoms of contraction.

The state education department reported Tuesday that 5,689 children in Mexico’s Baja California state, on the U.S. border, were turned away from schools when classes resumed because they had symptoms like runny noses, headaches or sore throats.

The WHO is receiving a donation from Swiss pharmaceuticals company Roche Holding AG that will provide enough Tamiflu for 5.65 million people.

A new stockpile for children will include another 650,000 packets containing smaller doses of the drug.

At the start of the outbreak, Mexican authorities had enough Tamiflu for only 1 million people, but have since built up reserves of 1.5 million courses.

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On the Net:

• CDC
• WHO
• Image Courtesy Flickr

It turns out that there is a very good reason why we are taught from such a young age to cover our mouths when sneezing or coughing.

Up to 20,000 viruses are released in the average cough, which is enough to infect many people, especially those who are not vaccinated.

Julian Tang, a consultant at Singapore’s National University Hospital’s Division of Microbiology, says that the normal cough produces as many as 3,000 tiny droplets.

Going by existing research on influenza viral levels in nasal secretions, and assuming that each droplet from a cough measures between 1 and 5 micrometers (one thousandth of a millimeter) in diameter, the viruses in a single cough quickly become hard to count.

Tang says, “Based on this research and assuming about 3,000 droplets are produced per cough, this range of influenza viruses produced per cough is about 195 to 19,500.”

“This (3,000) is also the number of droplets estimated to remain suspended in air for long periods — so-called droplet nuclei. Larger droplets carrying influenza viruses may also be produced during a cough, but these will fall to the ground relatively quickly and will no longer be considered to be significant in the airborne transmission of influenza,” he said.

The new H1N1 influenza virus spreading around the world has inspired governments around the world to re-educate and encourage people to observe good personal hygiene practice.

A TV advertisement in Indonesia shows a young woman scolding an admiring man at a village sing-a-long, telling him to go to a health clinic because “that’s not a normal cough.”

Directed toward the uneducated populations, the advertisements are set to a dangdut (traditional pop music) theme and have an easy-to-remember slogan and theme song.

Experts are unsure how to qualify an infective dose when it comes to a flu virus.

As a guideline, previous research has found that it only takes 1 to 10 organisms to cause viral hemorrhagic fevers, and 10 to 100 organisms to cause viral encephalitis.

Tang says an infective dose of flu virus depends on various factors such as the constitution and health of people breathing in these droplets and whether they had been previously vaccinated.

“It is difficult to give an exact number for the infectious dose — and this may even differ for the same individual throughout the year. But probably for immune people, the infectious dose will be higher than for non-immune people — hence, the benefits of vaccination,” Tang says.

“Those previously vaccinated or naturally infected to the same or similar virus can develop a rapid antibody response and clear the virus in the respiratory tract before the virus can take hold and cause disease”¦(but) even immune hosts may develop symptoms if the viral load exposure is sufficiently high,” he added.

Doctors say most airborne flu transmissions occur within a one-yard proximity, or by direct physical contact with contaminated objects.

“Wearing masks may well help to reduce the transmission of these infections, as well as covering the mouth with your hand or a tissue when coughing or sneezing — simply by using a barrier to prevent dissemination of the virus,” Tang says.

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On the Net:

National University Hospital, Singapore

Researchers on Monday reported the findings of an unprecedented extensive study of genetic diversity of the Mexican population that could reveal why certain people are affected by different diseases such as the H1N1 Influenza A virus.

The study was commissioned by Mexico’s National Institute of Genomic Medicine (INMENGEN) and is published in the Proceedings of the National Academy of Sciences (PNAS).

“We assessed the benefit of a Mexican haplotype map to improve identification of genes related to common diseases in the Mexican population,” said lead author Dr. Gerardo Jimenez-Sanchez and his team of 116 Mexican researchers.

The team analyzed genetic information of 300 Mestizos from six different geographic locations in Mexico. They also analyzed genetic composition of 30 members of the indigenous Zapotecas group in America.

Researchers found that the genetic composition of the Mexican Mestizo and Indigenous populations were different from the three other known human genetic subgroups – Yoruba from Africa, Caucasians of European descent, and the Chinese and Japanese of Asia.

“This study makes clear that Latin Americans with mixed ancestry are different enough from other people worldwide that a full-scale genomic mapping project would be wise both scientifically and economically,” said Dr. Julio Frenk of the Harvard School of Public Health.

“It would allow doctors to analyze fewer genetic markers when diagnosing the risk that a patient will develop a disease that depends on complex factors.”

Researchers said they found 89 common gene variations that were not listed in the International HapMap Project from 2002 to 2006.

“This effort will contribute to the design of better strategies aimed at characterizing the genetic factors underlying common complex diseases in Mexicans,” said Jimenez-Sanchez.

“In addition, this information will increase our knowledge of genomic variability in Latino populations.”

The study’s findings have implications for others outside of Mexico as well, said researchers.

“More than 560 million people live in Latin American countries, and according to U.S. Census Bureau estimates the Latino population reached 45.5 million in 2007, representing the largest and fastest-growing minority group in the United States,” they wrote.

Although the new findings are too young to draw clear lines between the outbreak of H1N1 Influenza A in Mexico, they may help experts identify why cases of the international virus has resulted in death primarily in Mexico.

“It is not possible today to say genetic variation is responsible for the unique H1N1 influenza A mortality rate in Mexico,” Jimenez-Sanchez said.

“However, knowledge of genomic variability in the Mexican population can allow the identification of genetic variations that confer susceptibility to common diseases, including infections such as the flu.”

“It will also help develop pharmacogenomics to help produce medicines tailored to people of a specific genetic group, to the creation of drugs that are both safer and more effective.”

President of Mexico, Felipe Calderon Hinojosa, said: “The genomic map of the Mexican population is an essential contribution of Mexico to science and public health. This study represents an important landmark to develop genomic medicine in Mexico to improve healthcare of its population. I commend our National Institute of Genomic Medicine, INMEGEN, for such a significant milestone.”

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On the Net:

• National Institute of Genomic Medicine, Mexico
• Proceedings of the National Academy of Sciences

Three British war veterans recently joined a dozen wounded U.S. troops for the twice-yearly Warrior Dive in Key Largo in May that promotes scuba diving as a rehabilitative therapy, according to Reuters.

After half an hour of working to get quadriplegic British Royal Marine Dominic Lovett into a neoprene wetsuit, six scuba instructors helped him into the waters of the Florida keys to let him experience a temporary freedom from his disabilities.

Lovett was able to swim around the shallow lagoon with a motorized propeller hooked to his air tank, allowing his first ocean dive since he was paralyzed from the neck down during a military training accident 15 months before.

“Absolutely fantastic,” Lovett said. “Brilliant, absolutely brilliant…I’m so happy.”

It first began with a group of wounded soldiers from the 101st Airborne at the U.S. Army’s Fort Campbell in Kentucky, and has now expanded to include outpatients from the National Naval Medical Center in Bethesda, Maryland, and Walter Reed Army Medical Center in Washington, D.C.

Vice president and training director for the International Association for Handicapped Divers, Fraser Bathgate, was brought to Fort Campbell in 2007 to train the wounded soldiers that formed the Eagle Divers club.

Key Largo merchants and veterans generously donated hotel rooms and boat rides, hosted barbecues and provided a bus with a wheelchair lift to show their gratitude for the troops’ service.

Kenny Wheeler of the Ocean Divers dive shop said, “We want to make this a true gift from the Upper Keys community.”

Bathgate, a Scotsman paralyzed from the waist down from a climbing accident in 1986, is also a co-founder of the newly created Deptherapy Foundation that provides scuba rehab to disabled British veterans and brought three Royal Marines to Key Largo.

A friend encouraged Bathgate to try diving and he loved it so much that after learning to rotate his hips enough to propel himself underwater he went on to become a certified instructor.

“I felt a freedom I hadn’t felt since I was in the chair,” the Edinburgh resident told Reuters.

“I was the first instructor to have qualified from a wheelchair,” said Bathgate, who has worked the last 15 years to train other instructors on how to work with disabled divers.

Being weightless under water, the injured are able to exercise atrophied muscles and gain cardiovascular strength without stressing joints, Deptherapy co-founder Martin Hannan said.

“I know this therapy works. I can see it in people’s eyes,” Hannan said.

The outings also give wounded soldiers the opportunity to meet with others who are dealing with the same issues and understand exactly what they’re going through.

Iraq and Afghanistan war veterans joke about how insurance companies refuse to pay for the prosthetic “swim legs” because they are considered merely recreational.

Two of the men chime, “Write your congressman!”, as an idea for how to acquire the dive-fins.

Most disabled divers are able to use regular diving gear by making minor adaptations, Bathgate said. Some amputees use special prosthetics or rig old ones to be used underwater.

Dive instructor Maria Greenfield of Norman, Oklahoma, discovered the hard way that she could not stay underwater without removing the cosmetic coverings from her prosthetic legs down to the metal skeleton.

“Boy are they buoyant! I was floating upside down,” joked Greenfield, whose lower legs had been crushed by a car.

Jeremy Stengel, a U.S. Marine corporal and “water fanatic” lost his left leg below the knee after being hit by an improvised explosive in Iraq. He now uses a prosthetic with a jointed ankle that can be locked with the toes pointed downward in order to allow him swim with dive fins.

“I kind of sit at the bottom and take it all in, watching everything go by. It’s relaxing,” Stengel said. “Trying to even out the weights is the only issue.”

Divers have to wear lead weights to keep them from floating to the surface. Stengel’s prosthetic leg weighs less than his natural right one, so in order to keep from rolling in the water, he has to add weight to his left side.

Lovett’s more debilitating injuries require more special gear. During cold-weather training in Norway, he jumped into a snow bank that turned out to be an ice bank crushing his spine.

The 21-year-old has very limited movement in his arms but absolutely none in his legs or torso. He swims with the help of a Pegasus Thruster, an underwater propeller powered by a battery the size of a coffee thermos. He had the control button attached to a glove which he can operate by pushing it against his chin.

Equipment maker Oceanic provided a dive mask with a data screen to allow him to see depth and air levels, which divers are usually able to view on handheld gauges.

Dive instructors swim in front of and on each side of him to keep him stable. The seas are too turbulent to risk taking him out by boat to the colorful coral reefs, so he is limited to practicing in a pool and the lagoon, where only a few transparent gray fish live.

Lovett’s spinal chord injuries make it difficult to regulate body temperatures, so Lovett is limited to 20 dives to prevent hypothermia..

“It’s an awful lot of work for 20 minutes, but it’s worth it,” said Bathgate. “The freedom he’s getting is immense compared to being dragged through the water by others. He’s in charge.”

Lovett declared it incredible “just to move under the water and go where I wanted to go.”

According to a new study released on Friday, junk food commercials constitute an average of two-thirds of television food advertisements shown during hours children are most likely to be watching.

At the top of the list were Germany and the United States, whose junk food commercials made up some 90 percent of their televised food ads.  At the bottom were Britain and Australia with roughly 50 percent.

Researchers say they are urging government action to curb the amount of television marketing of this sort in an effort to combat youth obesity.

“Internationally, children are exposed to high volumes of unhealthy food and beverage advertising on television,” the research group told the European Congress on Obesity in Amsterdam.

“Limiting this food marketing is an important preventative strategy for childhood obesity.”

Worldwide, the International Obesity Task Force estimates that some 177 million children and teens under the age of 18 are overweight or obese.  Of these, they say, roughly 22 million are overweight children under the age of five.

Among the many risks associated with diabetes, one of the most frequent amongst children is the rapidly growing rate of type 2 diabetes, or non-inherited diabetes.  The expensive treatments associated with diabetes have many governments concerned that their already tightly-budgeted national health systems could be stretched beyond their limits.

The increase in sedentary lifestyles, including hours a day sitting in front of computers or television, has also been identified as a joint factor contributing to skyrocketing obesity rates throughout the western world.

“There is a lot of attention on unhealthy food marketing as an influence on childhood obesity and a lot of governments are reluctant to regulate,” said Bridget Kelly a nutrition researcher for the Cancer Council NSW in Australia and co-author of the study.  “So most countries in the study don’t have regulations on food advertising.”

The study examined television programming trends in Australia, Asia, Eastern and Western Europe and North and South America.  They observed that the number of advertisements for fast food, sweets and high-fat snacks significantly increased during the times when youths were most likely to be tuned in.

“Children see around 4,000 to 6,000 food advertisements on television a year and between 2,000 and 4,000 are for unhealthy foods,” explained Kelley in an interview.  “So even if you are in countries that are advertising less to children, that is still a lot.”

Researchers concede, however, that it is difficult to establish a direct causal connection between junk food advertisements and obesity.  Still, they argue that television marketing is a significant factor in shaping what kind of foods children prefer.

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On the Net:

• International Obesity Task Force
• Cancer Council NSW
• European Congress on Obesity