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GENERAL HEALTH 

• Soda Targeted in Fight Against Obesity

• The Forgotten Population: Health Disparities and Minority Men. 

• Patients’ rights and responsibilities.

NEW YORK (Reuters Health) - 4/7/2005  In a new study, US researchers describe seven patients who developed nonarteritic ischemic optic neuropathy (NAION), an eye problem that can result in permanent vision loss, after taking Viagra (sildenafil) for erection difficulties. Combined with past reports, this study brings the total number of sildenafil-related NAION cases to 14.

With the exception of one patient whose symptoms began 24 to 36 hours after using Viagra, the patients developed symptoms within 24 hours of use. In all patients, the initial symptoms were blurred vision and some degree of vision loss. In one patient, both eyes were affected, whereas in the remainder, just one was involved.

All of the patients had one or more heart disease risk factors. High blood pressure was invariably present and most men also had high cholesterol levels. Three patients had preexisting eye problems that may have increased their risk of NAION.

The final vision in the patients' affected eye(s) ranged from perfect vision to only light perception, the investigators note in the Journal of Neuro-Ophthalmology

A representative from Pfizer, the maker of Viagra, was not immediately available for comment.

SOURCE: Journal of Neuro-Ophthalmology, March 2005.

By Jean F. Gibbs

According to a 1998 report by the American Cancer Society, NCI, and the Centers for Disease Control and Prevention, U.S. cancer incidence and death rates, for all cancers combined and for most of the leading cancer sites, declined by 0.7% and 0.5% respectively between 1990 and 1995, reversing a nearly 20-year trend of increasing incidence and death rates.

Yet, cancer continues to disproportionately affect blacks. Why do African Americans get cancer more often, and why are they more likely to die from it?  (...NEXT)

People may get too much vitamin A and iron from supplements, the government says. It set the minimum limit for vitamin A at 900 micrograms a day for men and 700 for women, with an upper limit of 3,000 micrograms a day -- less than is found in many popular vitamin supplements. Men and post-menopausal women need only 8 milligrams a day of iron, the new report said, while pre-menopausal women should get 18 milligrams a day and pregnant women 27. No one should take in more than 45 milligrams a day, the report said.

• NEW YORK (Reuters Health) March 8, 2006 - Three out of four Americans aged 50 to 70 aren't getting regular colon cancer screening, according to a survey sponsored by the maker of a new screening test for the disease. 

  Colon cancer is currently the second leading cancer killer in the United States, with 60,000 Americans expected to die from the disease this year.

  The American Cancer Society recommends that everyone get a colonoscopy to test for colon cancer at age 50. But 26 percent of the 1,200 people surveyed said their doctor had never discussed colon cancer screening with them, and 24 percent said they didn't get screened because they had no symptoms of the disease. Twenty-eight percent said they didn't want to have a colonoscopy.  

  The survey, conducted by Harris Interactive, was sponsored by EXACT Sciences Corp., a Marlborough, Massachusetts-based company that makes a new non-invasive test that screens for colon cancer by looking for cancer-related DNA in the stool.

  Stool DNA tests, which can be done at home, have a roughly 60 percent rate of detection, and rarely yield false-positive results.

  PHYSICIAN GENDER AND COMMUNICATION
  
  Female primary care physicians spend more time with their patients and engage in more active partnership communication than their male counterparts, according to a review article in "The Patient-Physician Relationship" section of the August 14 issue of JAMA.    
  
  Debra L. Roter, Dr.P.H., of Johns Hopkins University and colleagues, conducted online database searches of articles for the years 1967 to 2001 looking for studies about the effect of physician gender on communication during medical visits.  The researchers found 23 observational studies and 3 large physician-report studies in 29 publications to review.    
  
  "Female physicians engage in communication that more broadly relates to the larger life context of patients' conditions by addressing psychosocial issues through related questioning and counseling, greater use of
  emotional talk, more positive talk, and more active enlistment of patient input," the researchers found.    "There were no gender differences evident in the amount, quality, or manner of biomedical information giving or social conversation.  Medical visits with female physicians are, on average, 2 minutes (10 percent) longer than those with male physicians." 
  The authors note that gender-related practice patterns in some specialties may differ from those evident in primary care.
  (JAMA. 2002; 288:756-764.  Available post-embargo at jama.com.)
  For More Information: Contact the JAMA/Archives Media Relations
  Department at 312/464-JAMA (5262).
   

• An expert task force formed by the National Kidney Foundation (NKF), in a report published recently in the American Journal of Kidney Diseases (2002;39: supplement) concludes that ten of millions of Americans are at high risk of kidney failure but are not given routine tests that could slow or even stop the progression of the disease. 

  The panel believes that as many as 20 millions people with common diseases such as diabetes, high blood pressure, with a family history of kidney disease are at risk of developing kidney disease themselves.  About 20 million more already have some kidney damage that may go unnoticed, as it often causes no visible or obvious  symptoms.                                              

The panel is now recommending that high-risk individuals --including the elderly, those with diabetes, high blood pressure or a family history of kidney disease--get three key tests when visiting their doctor: a test to measure creatinine levels in the blood, a screen to check for protein in the urine, and a simple blood pressure measurement.  

Studies performed in recent years have linked elevated levels in each test to an increased risk of kidney disease and possible failure.  "The message is 'Know your numbers,"' said Dr. William F. Keane, the president of the American Kidney Foundation [the same as millions now know their cholesterol]. 

The panel's recommendations give doctors 'action plan' designed to guide intervention depending on test results and the stage of kidney disease.  The plan calls for the use of medication and lifestyle changes for those estimated 6 million Americans whose lab test may reveal early but symptom-free kidney damage. (Sources: Reuters Health & American Journal of Kidney Diseases 2002;39:supplement)

• Acetaminophen (the active ingredient of Tylenol) has been in clinical use for more than 100 years and is one of the most widely used analgesics in the world.  Though it is well known for its safety, it is also one of the most frequent pharmaceutical agents responsible for poisoning.

• A clinical study, directed by I. Jon Russell, M.D., PhD, of the University of Texas Health Science Center, found that underquilts made from pure, resilient wool help patients with fibromyalgia symptoms.  The findings were presented at Myopain '01 Physicians Conference held in September 2001.  "Patients reported greater sleep efficiency and quality during the wool underquilt intervention, versus their normal sleep routine." 

• 
  Do men go through some kind of "menopause" like women? The answer is yes. Studies done in the past ten years have shown that men can experience low testosterone levels (a male hormone) that cause them to have a series of symptoms or problems.
  They may have hot flashes, night sweats, fatigue, lowered energy, increased body fat (pot belly), diminished sex drive and ability, increased incidence of heart attacks. Some men can even become impotent. Testosterone replacement prescribed by your doctor may alleviate or correct those problems.

Related topic: Do You Have Low Testosterone?

• 
  Just a reminder! Birth control pills taken with some antibiotics may become less effective. A back-up method of contraception is advisable. More info can be found about that on the insert that comes with your pills.