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NPR Health News Briefs: Dec. 5 - Dec. 11

Read a roundup of health news briefs from NPR for the week of Dec. 5-Dec. 11.:

Teen Sex Declines

Dec. 10, 2004 — A new government survey of American teens finds that they're waiting longer before they start having sex. And those who are sexually active are using contraception in high numbers.

This was the first time the government had done its survey of teens since 1995. Joyce Abma said there were a lot of positive trends. She's the lead author of the report from the Centers for Disease Control and Prevention.

"About a third of both male and female teens — 15 to 17 year olds — have had sex," Abma said. "That percentage has dropped from where it was in 1995 for both males and females."

For girls, there was an 8 percent drop among those who've had intercourse. For boys, it was even more substantial — a 12 percent drop. And some of the biggest gains were among African-American teens.

For teens who are having sex, more are using contraception: 83 percent say they used condoms or other contraception the last time they had sex. — Joseph Shapiro

New Test for Treating Breast Cancer

Dec. 10, 2004 — Researchers meeting in San Antonio are reporting promising results about a new genetic test that can predict which breast cancer patients will benefit from chemotherapy.

Right now, breast cancer patients often face a difficult decision — whether to follow surgery with chemotherapy to prevent a recurrence of their disease. What makes the decision so difficult is that it's not clear which women really need the chemotherapy. In some cases the surgery alone is enough.

Several studies presented at the annual San Antonio Breast Cancer Symposium suggest a test called the Oncotype DX assay can help make that decision. The test looks at 21 genes in tissue samples taken from tumors. Based on those genes, the test can predict accurately which women are likely to have a recurrence of their cancer, and therefore are most likely to benefit from chemotherapy.

But there are issues with the test: It's ability to predict outcome isn't perfect, and it costs more than $3,000. — Joe Palca

Lawsuit Against Abortion Law

Dec. 10, 2004 — Federally funded family-planning service providers are filing suit Monday to block anti-abortion language signed into law by President Bush last week.

Buried in the $388 billion spending bill that became law last week is language added by abortion-rights opponents.

The provision bars the federal, state or local governments from enforcing laws requiring hospitals, health plans or other health care entities to provide abortion-related services.

But the National Family Planning and Reproductive Health Association says the new law conflicts with existing regulations for the federal family planning program.

That program requires that recipients of federal funds provide an abortion referral if a patient requests one. The group is filing suit in U.S. District Court in Washington on Monday to block the new language.

Backers of the new provision in the law say that it's needed to allow health care enterprises — not just individual doctors or nurses — to decline to provide abortion services or referrals. — Julie Rovner

Faster TB Drug?

Dec. 10, 2004 — Scientists are developing a new drug for tuberculosis (TB) that could work much faster than current treatments.

TB infections result in millions of deaths each year around the world. There hasn't been a new drug to treat TB in 40 years. Current medications often have to be taken every day for four to eight months.

Researchers from Johnson & Johnson report in the journal Science that they've developed a drug that could cut treatment time in half.

The drug has been successfully tested in mice. People can take the drug safely, but it's not yet clear how effective it will be in humans. That testing will take some years.

Even if the drug works well, price will be an issue. The current slow-acting medications are cheap generics. They're made available to people in poor countries for pennies a day. — Richard Harris

Painkiller Warning Issued

Dec. 10, 2004 — The Food and Drug Administration is issuing a new warning about Bextra, a painkiller similar to Vioxx.

Concerns about Bextra increased after the manufacturer of Vioxx pulled the drug because it can lead to heart attacks and stroke. So far, those problems have not been seen with Bextra.

But other side effects have been associated with the use of Bextra. These include skin blistering so severe it can be lethal — the FDA has received reports of four resulting deaths.

A recent study showed that when Bextra is used to relieve pain during coronary artery bypass surgery, it increases the risk of a heart attack, stroke and blood clots.

The FDA is now requiring Bextra manufacturer Pfizer to add a new warning to the label saying that Bextra should not be used as a painkiller in bypass surgery.

The company will also beef up a warning to discontinue the drug immediately if a skin rash occurs.

Bextra is known generically as valdecoxib; Vioxx is rofecoxib.

-- Joanne Silberner

Flu Vaccine Shortage Next Year, Too?

Dec. 9, 2004 — Federal health officials tell NPR News that they're worried about a flu vaccine shortage next year. So they're going to extraordinary lengths to test and approve a new vaccine.

Officials fear that Chiron Corporation won't be able to fix problems in its Liverpool, England, plant in time to make next fall's flu vaccine. Those problems created this year's vaccine shortage.

British regulators have extended Chiron's license suspension until early April. Dr. Anthony Fauci of the National Institutes of Health says that raises doubts about Chiron's ability to deliver flu vaccine by the fall.

"If you look at the timeframe, it makes it even more unlikely they'll be able to do that," Fauci said. "It's not impossible, but it makes it much more of a closer, tighter issue."

The NIH is launching a fast-track study of another vaccine made by GlaxoSmithKline. Fauci says the government hopes to license that vaccine by the spring. No vaccine has ever been approved that fast. — Richard Knox

Medicaid Biggest Problem for States

Dec. 9, 2004 — States rank paying for health care as their No. 1 concern, according to a survey by the National Conference of State Legislatures.

The NCSL asked state fiscal directors what they're most concerned about. Thirty directors ranked paying for Medicaid and health insurance for state employees as their top worry. That put health cost concerns over education and tax issues.

States pay a big portion of the Medicaid program for the poor. The overall rate of growth in expenditures for Medicaid was nearly 13 percent, according to an NCSL spokesperson. In 16 states, Medicaid expenditures are exceeding budget forecasts for this year.

Other than that, states are generally doing better. The NCSL survey shows that in all but three states, revenues are at or above projections. — Joanne Silberner

Reimportation Report Overdue

Dec. 9, 2004 — A government task force is late in delivering a report on whether Americans can safely buy prescription drugs from other countries.

The report was mandated by Medicare reform legislation passed in December 2003. Last March, the secretary of Health and Human Services named 13 members to the task force — all representatives of various government departments.

The task force held six listening sessions around the country. Members representing consumers, insurers, analysts and potential providers heard about the risks and benefits of importing prescription drugs.

President Bush has said that if prescription drug importation could be done safely, he'd allow it. But Capitol Hill observers believe the report will suggest conditions that would be costly to fulfill.

The report was due Wednesday. The secretary of Health and Human Services expects he'll receive the report some time next week. And he says he'll release it to the public soon after that. — Joanne Silberner

Benefit of Implantable Defibrillators Questioned

Dec. 9, 2004 — A new study in the New England Journal of Medicine shows patients with recent heart attacks do not benefit from getting implantable defibrillators.

Every year more than 150,000 Americans get defibrillators implanted in their chests. Vice President Dick Cheney has one. Experts say that number could double or quadruple under new Medicare payment rules.

Patients who survive heart attacks are at risk of sudden death from heart rhythm problems called ventricular fibrillation. Many specialists thought an implantable defibrillator could prevent these deaths.

But the new study calls into question whether people who've survived a recent heart attack really benefit. More than 700 such patients participated. After 30 months, those who got the defibrillators did not have a lower death risk.

Authors think the devices may save people from ventricular fibrillation — only to die from heart failure.

-- Richard Knox, NPR News

Flu Vaccine Snag

Dec. 8, 2004 — British regulators have extended the suspension on flu vaccine manufacturing at the Liverpool plant of Chiron Corporation. That could jeopardize next year's vaccine supply.

Chiron's British flu vaccine license was suspended on October 5 because some lots were contaminated, and the company couldn't assure all 50 million doses ordered by U.S. health care providers were safe. Now British regulators say the company needs another three months to rectify problems in its Liverpool plant.

That potentially means that Chiron won't resume vaccine production until early April. And that could be a big problem.

Generally it takes six months to make a new flu vaccine. Chiron notes that in order to deliver next fall's flu vaccine, "production must begin no later than early spring of 2005."

U.S. officials say another company may enter the flu vaccine market in the next year. But it's not clear if that company could make up the shortfall if Chiron can't meet the deadline. — Richard Knox

Breast Cancer Drug Favored

Dec. 8, 2004 — A new drug for breast cancer continues to show promise as a replacement for an old stalwart, according to research presented at the San Antonio Breast Cancer symposium.

An international group of researchers reported two years ago that an aromatase inhibitor called anastrozole (brand name, Arimidex) is better than tamoxifen in holding off breast cancer recurrences for at least three years.

Tamoxifen used to be the treatment of choice for postmenopausal women with estrogen-receptor-positive tumors. Now the researchers are reporting that anastrozole protects from recurrence better than tamoxifen for five years.

Dr. Larry Wickerham of the National Surgical Adjuvant Breast and Bowel Project says many U.S. oncologists already have switched to anastrozole or other aromatase inhibitors. The newer drugs cost five to 20 times as much as generic tamoxifen.

Women haven't taken the drug long enough to show whether anastrozole actually increases their survival rates.

The researchers who conducted the study received support from anastrozole manufacturer AstraZeneca. — Joanne Silberner

Drug Firm Publishes Studies

Dec. 8, 2004 — The controversies about antidepressants and the painkiller Vioxx have put the spotlight on a common drug industry practice: the suppression of scientific studies that are unfavorable to the industry. Drug makers can do that because they pay for most clinical research.

Responding to pressure for greater openness, drug maker Eli Lilly unveiled a public database Wednesday that summarizes many of its drug studies.

The American Medical Association, as well as an influential group of scientific journal editors, and some lawmakers and regulators, are pressing for full public disclosure of drug studies in a forum that isn't controlled by the industry.

Lilly is one of a handful of companies that's offered disclosure on a company Web site. Lillytrials.com now contains the results of some 50 trials.

It's not clear if efforts such as Lilly's will deflect pressure for a mandatory, public registry. — Snigdha Prakash

MRI Not Better Than Breast Biopsy

Dec. 7, 2004 — A new breast-cancer detection technique using magnetic resonance imaging (MRI) is not superior to a biopsy, according to a new study.

A biopsy is the usual procedure after a suspicious lump is seen on an mammogram. But mammograms aren't all that precise. And doctors have been searching for a noninvasive way to determine whether a lump is cancerous or not.

One prospect was MRI, which uses magnetic waves to detect abnormalities in tissue.

Scientists in the U.S. and Germany ran MRIs on more than 800 women who had suspicious mammograms. Then they did a biopsy.

The researchers report in the current issue of the Journal of the American Medical Association that the MRIs were very good at identifying cancer. But they also pinpointed a lot of non-cancers. That could lead to many unnecessary biopsies, or even unnecessary surgery. — Joanne Silberner

Probe: Pharmacies Overcharge Medicaid

Dec. 7, 2004 — A congressional investigation into payments for drugs under the Medicaid program for the poor has found overpayment problems similar to those found last year in Medicare, the federal health care program for the elderly and disabled.

The investigation by the House Energy and Commerce Subcommittee on Oversight and Investigations found that federal and state governments are paying hundreds of millions of dollars more than they should for drugs purchased for Medicaid patients.

Last year, the prime beneficiaries of the overpayments in the Medicare program were doctors, and the payments were reduced in last year's Medicare drug bill.

In Medicaid, the new report found that pharmacies are the ones primarily pocketing the difference between what the program pays and what the drugs actually cost.

At a hearing today, investigators revealed that in fiscal 2002, Medicaid paid the five largest pharmacy chains an average of 98 cents per pill for fluoxetine, the generic version of the antidepressant Prozac, although the pharmacies only paid an average of 36 cents per pill.

Lawmakers from both parties vowed to address the problem next year.

In a statement, Craig Fuller of the National Association of Chain Drug Stores said that overpayments on some drugs offset underpayments on others. A pharmacy "must absorb the cost of uncollectible co-payments" and cope with inadequate Medicaid dispensing fees, he said. — Julie Rovner

Obesity Weighs on Medicare

Dec. 7, 2004 — The combination of an aging population and an increasing number of overweight individuals could pose big problems for Medicare, according to a report in this week's Journal of the American Medical Association.

Researchers say that by the year 2050, nearly a quarter of all American adults will be over 65 years old. And if things don't change, many will be overweight or obese.

That could pose a nearly impossible burden on Medicare, the health program for the elderly and disabled, say researchers from Northwestern University. They looked at the body mass index of young and middle aged adults, starting in 1967, and followed them until they were 65 and eligible for Medicare.

Researchers then compared spending for individuals of different weights. They found health care costs for obese men and women were 84 percent higher than for normal-weight individuals.

In actual dollars, that added up to $5,000-$6,000 more per year in health costs. Researchers say the findings of the study show the urgent need to help Americans lose weight. — Patricia Neighmond

MS Tied to Birth Month

Dec. 7, 2004 — Researchers in Canada have found a seasonal pattern of multiple sclerosis, based on birth dates.

They found the risk of MS was highest for those born in the spring and lowest for those with November birthdays. They analyzed birth records for more than 72,000 people with MS.

The disease occurs when the lining of nerves deteriorates. Its cause is unknown.

The researchers found similar trends in Britain, Canada, Denmark and Sweden. In the study, people with MS were 13 percent more likely to have been born in May and 19 percent less likely to have November birthdays. The trend was most obvious in Scotland. The study appears in the British Medical Journal.

Scientists don't know what causes the seasonal pattern. MS is known to occur more frequently in northern climates, suggesting that environment may play a role in its development.

Previous studies have suggested that exposure to the sun or seasonal variations in mothers' vitamin D levels have an impact on brain development.

-- Richard Knox

More Flu Vaccine on the Way

Dec. 7, 2004 — Federal health officials have approved up to 4 million more doses of flu vaccine for importation from Germany. But patients getting it will have to sign a consent form.

Some 1.2 million doses of the imported vaccine will be available this month. It comes from GlaxoSmithKline, which makes the vaccine in a German plant. The company promises an additional 2.8 million doses of vaccine if it's needed.

Legally, the imported doses are considered experimental, so patients will have to sign a form saying they understand the risk of side effects.

Dr. Lester Crawford, acting commissioner of the Food and Drug Administration, says two companies want to enter the U.S. market for flu vaccines. At a press conference Tuesday, Crawford said that by 2007, "We will have a minimum of four suppliers rather than the one we were forced to deal with this year."

That should help avoid — or at least blunt — future flu vaccine shortages. — Richard Knox

False Alarm for Bird Flu

Dec. 7, 2004 — Health authorities say a suspected case of Asian bird flu in a French tourist has turned out to be a false alarm. But it made national headlines in France.

The case shows how nervous health officials are about the possibility that a human might carry bird flu from Asia to other parts of the world.

A 69-year-old French man returned home last week after a two-week vacation in Cambodia and Vietnam. On arrival he suffered from symptoms of a respiratory infection. Doctors suspected avian flu because the man had been in Vietnam, where the virus has jumped from chickens to 17 humans, killing 12 of them. But flu experts were skeptical, because a human case of bird flu hasn't been reported in Vietnam for two months.

Now the World Health Organization confirms the Frenchman did not have avian flu. If he had, it would have touched off intense efforts to see if the Asian virus is becoming more infectious to humans.

-- Richard Knox

Doctors Slow to Digitize Their Practices

Dec. 7, 2004 — Physicians are only slowly computerizing their practices, according to a new survey.

In the survey, 1,8000 doctors describe their level of computerization. Nearly 80 percent use computerized billing, because it is required by many insurance companies. But only about 25 percent keep their patients' medical records on computer, and only 3 percent communicate with their patients via e-mail.

The most computerized doctors are those are in large group practices or on salary. The surveyors suggest that the government subsidize the computerization of medicine.

Last summer, the Bush administration announced a goal of a universal electronic medical record in 10 years. The administration has so far pledged $150 million towards the effort.

The survey appears in the online journal Medscape General Medicine.

--- Joanne Silberner

Sleep Time Linked to Weight

Dec. 7, 2004 — Researchers have found evidence that the amount of sleep you get may have a lot to do with how much you weigh.

Researchers from the University of Chicago and Stanford University came up with the same findings: the less you sleep, the more likely you are to produce too much of a hormone that stimulates appetite — and too little of a hormone that makes you feel full.

In one study, subjects slept only four hours. When they awoke, they were really hungry — mostly for candy, cookies, chips, pasta and rice, all of which are high-carb foods. Researchers speculate that's because the brain translates sleep deprivation into a need for more energy from glucose.

Today, Americans sleep far less than they did a few decades ago. Researchers say the results of these studies should encourage people to get back to healthy sleeping patterns — at least eight hours a night.

-- Patricia Neighmond

U.K. Agency: SSRIs Useful in Adults

Dec. 6, 2004 — A British agency that warned against using a popular type of antidepressant in children a year ago has released a report saying the antidepressants are useful for adults.

Advisors to the British prescription drug regulatory agency reviewed antidepressants such as Prozac and Zoloft. Those drugs are called SSRIs — selective serotonin reuptake inhibitors.

The advisors looked at published studies, problems reported to the agency and records of people using the drugs. They concluded that the drugs are effective in adults. They said the drugs increase the risk of suicide in adults only a little, if at all.

Even so, they recommend that doctors carefully monitor people on antidepressants, especially early on. They singled out Effexor, which is in a similar class of drugs, saying it should only be prescribed by specialists. Effexor's manufacturer, Wyeth Laboratories, has challenged the safety concerns.

-- Joanne Silberner

AMA Opposes Unauthorized Rx Imports

Dec. 6, 2004 — The American Medical Association has passed a resolution opposing unauthorized importation of prescription drugs until the U.S. government can assure the safety of the drugs.

The AMA weighed the safety of imported drugs against the difficulty many patients have in affording American drugs.

It concluded that wholesalers and pharmacies should not import drugs unless three conditions are met:

1 - every step of the drug's shipment can be carefully monitored

2 - the drugs are approved for sale in the U.S. by the Food and Drug Administration

3 - Congress gives the FDA resources and authority to oversee the shipments and approve the foreign drug manufacturers. Many experts say that level of oversight could make imported drugs as expensive as domestically bought medicines.

The AMA also repeated its opposition to individual prescription drug importation via the Internet.

-- Joanne Silberner

Food Bioterror Rules Released

Dec. 6, 2004 — The Food and Drug Administration has released new rules requiring businesses to keep detailed records of human food and animal feeds.

"The ability to trace back will enable us to get to the source of contamination," acting FDA commissioner Lester Crawford said in a statement. "The records also enable FDA to trace forward to remove adulterated food that poses a significant health threat in the food supply."

The rules affect anyone who manufactures, processes, packs, transports, distributes, receives, holds or imports food. According to the FDA, these records must "identify the immediate previous source of all food received, as well as the immediate subsequent recipient of all food released."

The agency is holding meetings around the country beginning in January to explain this and other new bioterrorism rules that affect food. — Joe Neel

Sickle-Cell Warning

Dec. 5, 2004 — The federal government is warning doctors to continue giving blood transfusions to children with sickle-cell anemia who are at risk of strokes.

More than 70,000 Americans — mostly African Americans and Hispanics — have sickle-cell anemia. For about one in 10, the disease puts them at high risk of strokes.

Sickle-cell patients at risk of stroke must have blood transfusions every month to keep the number of abnormal blood cells at a minimum.

Four years ago, the government launched a study to see if such children could eventually do without transfusions if tests indicated a lowered stroke risk.

Now researchers say it's not safe to stop transfusions. Study results were revealed at a meeting of the American Society of Hematology in San Diego. Sickle-cell patients at risk of stroke need regular transfusions indefinitely, the researchers say, along with treatments to prevent dangerous side effects from those transfusions. — Richard Knox

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