Parents shouldn’t shrug off homesickness as a more-or-less benign right-of-passage for their children, according to a report from the American Academy of Pediatrics. Research has shown that one in five children attending summer camp are so debilitated by homesickness that it interferes with their ability to participate in group activities and benefit from the experience. As many as half of children who are unexpectedly separated from their parents for an indefinite period of time—such as in a stay at the hospital—suffer severe homesickness that may hamper their ability to heal.

Many of the AAP’s prevention tips sound like common sense. But a recent study showed that coaching parents and children about homesickness ahead of time decreased the severity of first-time campers by an average of 50%. Among the guidelines: build up to the time away by giving children chances to practice their independence throughout the year, help them develop a sense of control by involving them in the decision to go to camp, tell them that homesickness is normal and that it’s okay to share their feeling with trusted camp counselors or other adults.

Clinical psychologist Christopher Thurber, one of the AAP study’s authors, has made more tips available at his website campspirit.com.

What it Means: Parents and doctors need to plan ahead if they want to keep homesickness to a minimum at either summer camp or the hospital.

From the Archive:
Feb. 5, 2006 Happiness Isn’t Normal
Nov. 1, 1999: Freshman Blues

Long-term treatment with medications like Nexium, Prilosec and Zantac increases the risk of suffering a hip fracture in men and women who are 50 or older. The risk of hip fracture increases the higher the dose of such so-called proton pump inhibitors (used to treat severe and chronic heartburn) and the longer the treatment, according to a study in the Journal of the American Medical Association.   

Many common calcium supplements need to be in an acidic environment to dissolve. The JAMA study authors speculate that decreasing the acidic environment of the stomach with proton-pump inhibitors also decreases the body’s ability absorb calcium.

This is not the most rigorous type of scientific study possible but it is certainly one that’s worth paying attention to. Investigators used computers to comb through the health records of 1.8 million patients in the U.K. to compare the medical history of those who had suffered hip fractures with those who hadn't. There were more hip fractures among those who took proton pump inhibitors than among those who hadn't.

It’s also possible that whatever caused the severe heartburn in the first place—like infection with the ulcer-causing bacterium Helicobacter pylori—may actually be the real reason behind the difficulty in absorbing calcium. 

What it means: Proton-pump inhibitors have helped a lot of people with severe heartburn. 
If you need to take them, it makes sense to increase your intake of calcium-rich products like broccoli, collard greens, bok choy, canned salmond and sardines, and almonds because calcium is more easily absorb through food.

If you’re taking insoluble calcium supplements, be sure and take them with a meal, particularly somewhat acidic foods like lentils, apples, blueberries and bananas.

It also makes sense to find out if an H. pylori infection is causing your chronic heartburn. That typically means having an endoscopy to look at your stomach lining and then taking antibiotics that are strong enough to kill a germ that’s tough enough to live in the acidic environment of the stomach.

From the Archive:
Oct. 9, 2005 The Ulcer Bug
Jan. 3, 2005 What Risks Lurk in Your Medicine Cabinet?

You can stop worrying about getting brain cancer from your cell phone. A massive study of just about every private cell phone user in Denmark shows no link between gabbing on your mobile and the development of brain tumors.

The 420,000 participants averaged about 8.5 years of cell phone use, although some of them had been using cell phones for as long as 21 years. But there was not even a hint of an increase in brain cancer incidence the longer they used the phone.

A closer examination of different types of brain cancer—from gliomas to acoutsic neuromas—showed no increase in brain cancer subtypes either, according to investigators, led by Joachim Schuz of the Institute of Cancer Epidemiology of the Danish Cancer Society in Copenhagen.

Bizarrely, the cell-phone study, which was published in the Journal of the National Cancer Institute, showed some unexpected benefits. Male cell phone users were less likely to develop lung cancer. But that’s probably a result of the fact that the first people to use cell phones in Denmark were quite well-off, and rich men are less likely to smoke cigarettes than poorer men. Rich women are just as likely to smoke as poor women in Denmark and so female cell-phone users were just as likely to develop lung cancer as their non-cell-phone-user counterparts.

More difficult to explain is the finding that women who had used cell phones for a long time were more likely to develop cervical cancer and kidney cancer. Since cervical cancer is typically caused by a sexually transmitted virus, it’s possible, the study authors say, that early adopters were also more likely to have sex with several partners. But researchers have no explanation for why there was an uptick in kidney cancer.

The study was funded by the Danish Strategic Research Council and the Danish Cancer Society.

What it Means:
The largest study to date has found no link between brain cancer and cell phone use. So if a link does indeed exist, it is likely to be very small.

The results do not necessarily apply to children since anyone under the age of 18 was excluded from the study.

From the Archive:
Oct. 24, 2006 Cell Phones and Sperm
June 29, 2006 Don’t Talk and Drive!

Propping open a clogged artery with angioplasty and a stent in the first few hours after a heart attack can mean the difference between life and death or between full recovery and severe disability. But about a third of patients who could benefit from such interventions don’t make it to the hospital within the first 12 hours of their heart attack, which is the optimal time for these procedures. Should doctors go ahead and do them anyway?

Until recently, most cardiologists thought the answer was yes. But a study of 2,166 men and women, published in the New England Journal of Medicine, has just concluded that placing stents more than three days after a heart attack began is not worthwhile and may actually do more harm than good.

This group of study subjects got to the hospital 24 hours or more after their heart attack began. They were then randomly assigned to either receive a stent,  along with standard medications, or just the drugs alone. After four years of follow-up, investigators determined that the late placement of stents did not improve the patients’ chances of survival, nor did they have any fewer heart attacks than those who were on medical treatment alone. In fact,  late stenting seemed to increase slightly the risk of having another heart attack in the future.

What it Means: Minutes matter when you’re suffering a heart attack. The faster you get to a good hospital that knows when to stent—and just as importantly when not to—the better off you’ll be.

From the Archive:
Sept. 6, 2006 How Safe Are Drug-Coated Stents?
Sept. 5, 2005 How New Heart-Scanning Technology Could Save Your Life

Knees feeling a little creaky? Maybe you should treat yourself to an Indian curry dinner with plenty of turmeric. Researchers from the University of Arizona discovered that a collection of compounds in the Indian spice blocks a protein that is known to play a key role in inflammatory disorders, such as rheumatoid arthritis, multiple sclerosis and asthma.

The investigators created several standardized extracts of the turmeric and fed them to laboratory animals that had been bred for the study of rheumatoid arthritis, a highly debilitating form of arthritis that leads to severely deformed joints.

The research, which is being published in an online issue of the research journal Arthritis and Rheumatism, showed that three of turmeric’s major components, called curcurminoids, interfered with the action of a type of protein called Nuclear Factor kappa-B, or NF-KB for short. Once NF-KB is activated in a joint, it attaches itself to the genes of a cell and triggers the production of lots of inflammatory chemicals. As a result, a number of pharmaceutical companies have been studying NF-KB as a possible target for new arthritis drugs.

What it means: Turmeric is not the cure for rheumatoid arthritis. But studying the spice’s properties more closely could help investigators find new treatments for the disease. In the meantime, adding turmeric to your cooking is a great way to improve the flavor. And if there are any health benefits, well, all the better.

From the Archive:

Jul. 31, 2006: Natural Healing
Dec. 1, 2002: Rheumatoid Arthritis: The other crippling joint disease

CDC officials announced on Wednesday that they expect 75 million doses of flu vaccine to be sent to doctors, hospitals and other groups by the end of this October—up from 60 million doses at the same time last year. Because of the cumbersome way the vaccine is manufactured and distributed, however, not everyone is getting all the inoculations they want right away.

In fact, there have been scattered reports of delays in several states, including New Jersey and Virginia. And on Monday, the American Academy of Pediatrics reported that FluZone, the only vaccine approved for children from six months to three years of age, would probably not be in most doctors’ offices until November.

What it means: There tends to be a lot of anxiety in October about whether or not there will be enough flu shots. So far, it looks like there will be plenty to go around. CDC estimates that between 110 million and 115 million doses will be manufactured by the time the season is over.

But the logistics of getting millions of doses to all the different doctors’ offices, clinics,  companies and retail outlets that offer flu shots means that not everyone can be vaccinated at once—not even within a few weeks. Faster, more efficient methods of production would help but since flu vaccine is not a big money-maker, companies tend not to invest a lot in vaccine research. 

Most people don’t realize that the flu season generally peaks pretty late—in February. So getting a shot in November or December, when vaccine supplies generally start to build, still gives you plenty of protection.

From the Archive:

Oct. 5, 2006: A Fresh Dose of Flu Vaccine
Jan. 1, 2006: How to Make a Better Vaccine

PUNIT PARANJPE / REUTERS
A child affected by cancer sits in a hospital in Mumbai, India

The largest study ever conducted of adult survivors of childhood cancer shows that they are as much as eight times as likely to suffer from severe or even life-threatening health conditions as their healthy siblings. The study, which is being published in the New England Journal of Medicine, evaluated the health of more than 10,000 adults—average age 26—who had been cancer patients as children.

The numbers are stark. About one in four survivors developed severe or life-threatening conditions in the years after their treatment, compared with just 5% of their siblings who had never had cancer. By contrast, only one in three survivors had no apparent problems with their health at the time of the study, compared with 63% of their siblings.

Children who had survived Hodgkin’s disease were more likely to suffer secondary cancers and heart disease as adults. Youngsters with tumors of the brain or spine were more likely to have memory and other cognitive problems.

What it means: As devastating—and thankfully uncommon—as it is to learn that a child has cancer, the bad news is  softened somewhat by the fact that two-thirds of children with cancer can be cured of their disease, according to the National Cancer Institute. Indeed, medical advances over the past several decades have shown that aggressive treatment with radiation, chemotherapy and surgery seems to work better at fighting cancers in children than they do in many adults. Children are also better able to recover after therapy than most adults.

But there is a dark side to being cured of cancer at such a young age.  The treatments, while necessary for survival, can themselves lead to life-long health problems, such as secondary cancers, heart disease and kidney problems. In some cases, these conditions can be fatal as well. 

Anyone who has had cancer as a child should be monitored by specialists even after they become adults. “Many cancer survivors and many clinicians are not aware of the risk,” Dr. Kevin Oeffinger, a physician at Memorial Sloan Kettering Cancer Center in New York and one of the study’s authors, said in a phone interview. “But there are health problems that we can prevent or can detect early and more easily manage.” 

Oeffinger recommends regular visits every one to two years with a specialist who follows adult survivors of pediatric cancer or a clinician who is willing to work with such a specialist. These doctors will pay particular attention to radiation dosage and location. Some chemotherapeutic agents also have more long-lasting effects than others—such as the anthracylines (e.g. adriamycin),  the cyclophosphamides (cytoxan) and bleomycin.

From the Archive:

Aug. 21, 2006 Surviving Childhood Cancer
June 7, 2006 How Drug Cocktails Are Changing the Way We Treat Cancer

The Centers for Disease Control (CDC) has been trying for a while now to make it easier for patients to get an HIV test. By doing so, health officials hope to decrease dramatically the number of Americans who become infected with HIV, which has been stuck at about 40,000 new cases per year for more than a decade.

So now it's official. The CDC has published its final recommendation that doctors and other medical care workers offer an HIV test to everyone aged 13 to 64 as a routine part of medical care, regardless of whether or not they appear to be in a high-risk group. The new guidelines, which were published Thursday, allow patients to give verbal consent to the test unlike previous guidelines, which required written consent as well as pre-test counseling.

Patients can still refuse to be tested if they want, but the idea is to prompt more people to learn their HIV status.

What it Means: Don’t be surprised if your doctor asks you if you’d like to get an HIV test in the next few weeks or months. Public health officials believe that if more people learn their HIV status, the number of new cases will fall because people who know they are HIV-positive tend to take precautions to keep from transmitting the infection to others. Unfortunately, men and women who are not aware that they are HIV-positive account for about half of the estimated 40,000 cases of new infections that occur each year.

From the Archive:

May 9, 2006: Why Routine HIV Testing Makes Sense
May 25, 2006: The Origins of HIV

A study of 2,772 teenagers with an unusual heart condition called Long QT Syndrome found that fainting one or more times in the previous two years increased their risk of premature death, according to a study in this week’s Journal of the American Medical Association. Boys with the condition were at greater risk before puberty while the risk in girls increased after they reached adolescence.

People with Long QT syndrome have a variation in the way their heart’s natural pacemaker conducts electrical charges across the cardiac muscle. Most people with the condition live normal lives but, for reasons that aren’t entirely clear, teenagers and young adults with the condition are more vulnerable to developing a sudden, potentially fatal irregular heartbeat that is often brought on by strenuous physical activity—say while on the playing field or during an intense emotional upset. 

What it means: Long QT syndrome is often diagnosed with the help of an electrocardiogram (EKG)—although the condition is not always easy to detect. More recently, genetic tests have become available for some mutations that cause the condition. But the JAMA study found was unable to determine if any one genetic defect was more risky than another.

The JAMA study also showed that the risk of sudden death in participants who had fainted in the previous two years was reduced 64% when they took drugs called beta-blockers. Beta-blockers did not seem to make much of a difference in long QT patients with no history of fainting.

From the Archive:

Sept. 10,2006: To An Athlete, Aching Young
Dec. 4, 2005: A Better CPR

There’s no question that there are fads in medicine. And there’s no question that aggressive marketing can fuel those fads. The latest example may well be the drug-coated stents that have become so popular in recent years for propping open clogged arteries.

Researchers at an international meeting of cardiologists in Barcelona this week presented evidence that some drug-coated stents may slightly increase the risk of developing a potentially fatal clot as time goes on in comparison to older bare-metal stents. By some estimates, as many as 90% of stents in highly developed countries, including the U.S., are now drug-coated (or drug-eluting) stents.

“Drug-eluting stents are an important breakthrough in cardiology that probably should have been selectively used from the outset,” says Dr. Spencer King, a pioneer in the use of stents and a former president of the American College of Cardiology. “The marketing was unbelievable.”

To understand why drug-coated stents might pose a problem, you have to know a little bit about why they were developed in the first place.

Stents are tiny wire meshes that force open a partially clogged artery. After the stent is placed during a procedure called angioplasty, the body normally grows some tissue around the metal. If there’s too much tissue growth or scarring, the artery can close up again, sometimes requiring a second procedure.

Drug-coating stents interfere with that scarring process. And studies have shown that they do in fact decrease the risk of having to undergo a second procedure, but there’s been little evidence that they actually decrease the risk of heart attack or death.   

Here’s one possible source of trouble: by inhibiting the growth of scars, drug-coated stents may also stop the growth of normal tissue. Eventually the body may overreact to the foreign metal by forming a clot, which could lead to a heart attack or death.

The data presented in Barcelona suggested that there was more of a problem with the sirolimus-containing stent (made by Johnson and Johnson). There was no significant difference between the bare-metal stents and the paclitaxel-containing stent (made by Boston Scientific).

What it means: First of all, don’t panic if you already have a drug-coated stent. The risk, while serious, is still small and many doctors are dealing with the issue by keeping their patients on anti-clotting medication for longer periods of time. Unfortunately, Dr. King says, that may present its own problems—particularly in older patients—and there’s no way to monitor who may be at greatest risk.

There also seems to be a growing movement in the U.S. to be more particular about who gets a drug-eluting stent. “If you have large arteries and fairly short lesions, the advantage of drug-eluting stent is small,” King says. They may work better for people with diabetes or smaller coronary arteries. Also, some of the newer drug-coated stents may have other advantages.

From the Archive:

TIME Collections: Heart Disease

A study from the Mayo Clinic provides new evidence that Parkinson’s disease, a neurodegenerative disorder that interferes with how the brain communicates to various muscles, may be triggered by a kind of allergic reaction. Although the findings, which appear in the journal Neurology, provide no practical benefits to folks who have Parkinson’s now or are worried about developing it in the future, the research suggests new avenues for further investigation.

By looking at the health records of nearly 200 people who are being treated for Parkinson’s and comparing them to another group of folks who were of the same age and sex but did not have Parkinson’s, Mayo Clinic doctors found that those with the movement disorder were 40% more likely to have also suffered from seasonal allergies (allergic rhinitis). Because allergies are a sign of an overactive immune system that targets pollen, grass and other normally harmless compounds, the researchers hypothesize that perhaps an overactive immune system that targets brain tissue might be at the heart of Parkinson’s disease as well.

What it Means: So if you have hay fever are you doomed to develop Parkinson’s disease when you grow older? No. The Mayo study is what’s called an associational study of fewer than 200 people. Think of it as a message to other researchers that says, “Hey, look at this. What do you make of this?”

It could be that the biological fact that links the two pieces of evidence—Parkinson’s and allergies—is indeed a hyperactive immune system. Or it could in fact be that allergy sufferers simply go to the doctor more often to get relief from their symptoms and so their other medical symptoms are more likely to get spotted and diagnosed.

Even if Parkinson’s begins with an overactive immune reaction of some kind, that still doesn’t explain what triggered the reaction—pesticides, drug use, family history? Also since allergies are so common and Parkinson’s disease relatively uncommon, there must be something more to the story.

From the Archive:
Jul. 24, 2006: Yes, It Really is Brain Surgery
Jun. 26, 2006: Parkinson’s and Bug Killers

Close analysis of 15 different studies shows that there is a modest link between daily consumption of processed meats—like bacon, sausage, hot dogs, ham or salami—and an increased risk of developing stomach cancer. However, it’s not clear whether the risk is directly attributable to the meat itself or to some other unknown factor common to processed-meat eaters.

There’s been a lot of debate in scientific circles over whether eating processed meats causes stomach cancer. No single study has been large enough or detailed enough to answer the question definitively, so researchers from the Karolinska Institute in Stockholm pooled the data from the best available studies in order to get a better sense of the evidence.

Writing in the Journal of the National Cancer Institute, the Swedish investigators concluded that eating 30 g (just over an ounce) of processed meat each day increased the risk of developing stomach cancer anywhere from 15% to 38%. The results were most consistent for bacon consumption.

Other studies have suggested that the high-salt content in processed meat irritates the lining of the stomach and that a lifetime of exposure could increase the likelihood that some of the affected tissue could turn cancerous. Many processed meats also contain nitrates, compounds that are known to have cancer-promoting qualities.

However, none of the studies reviewed by the Swedish investigators took into account that infection with H. pylori, a very hardy bacteria that can live in the stomach and is a major cause of ulcers, might explain some of the increased risk of stomach cancer. For comparison's sake, H. pylori infection has been shown to increase the risk of stomach cancer by 300% to 600%.

What it Means: Stomach cancer rates have declined around the world over the past 50 years—probably as a result of the increased use of refrigeration (as opposed to salting or smoking) to store food, as well as the greater availability of fresh fruits and vegetables. Still, about 700,000 people around the world die of stomach cancer each year so it makes sense to limit your consumption of processed meats. A little bacon or some cured ham every now and again won’t kill you (as long as you don’t have heart disease) but you could be taking a chance with your health if you eat them every day.

From the Archive:

Oct. 28, 1991: Cancer From Germs
Feb. 5, 2001: Repairing the Damage (How to Live Healthier)

After an initial burst of enthusiasm for the benefits of strength training, Americans seem to have dropped their bar bells and resigned themselves to flabby muscles. A survey of 30,000 men and women, reported in the Morbidity and Mortality Weekly Report, found that the number of folks who engaged in muscle-building activities at least twice a week rose from 17.7% in 1998 to 20.2% in 2001 and then dipped slightly to 19.6% in 2004.

That’s too bad, because building muscles—either with weights or by doing, yoga, calisthenics or other forms of resistance training—helps to fight osteoporosis, boosts the levels of good cholesterol in the blood and ramps up your metabolism, making it harder to gain weight. By improving your balance, among other things, strength training also increases the chances that you will be able to live independently as you get older.

And not to worry, you don't have to bulk up like Incredible Hulk to reap the benefits. Getting just a little more definition in your muscles can go a long way towards improving your overall health. Since muscles are more compact than fat, your clothes will fit better, too.

What it Means: Health experts have set a national goal of having 30% of the U.S. population actively involved in strength training by 2010. It looks increasingly likely that we will miss the goal. The study authors speculated that part of the problem may be that too often you have to do something special or go somewhere special to partake in a strength-training program. If building muscles were more a part of everyday routines—at schools, community centers and during leisure time activities—there’s a pretty good chance more people would benefit.

From the Archive:
Jun. 6, 2005: Exercise Tips for the Frail
Jul. 22, 2002: Muscle Power

The more active you are, the more likely you’ll live longer than your inactive peers, according to a report in the Journal of the American Medical Association.

Researchers from the National Institute on Aging in Bethesda, Md. studied a group of 300 men and women between the ages of 70 and 82. Since people often overestimate the amount of exercise they do, the investigators decided to measure activity level more directly by calculating how much carbon dioxide the participants created during the course of their daily routines. (Carbon dioxide is a byproduct of any energy-producing activity in the body.)

To make those measurements, the researchers gave the participants a special kind of water that i s made up of unusual forms of hydrogen and oxygen. By measuring the amount of hydrogen and oxygen in the participants’ urine, the scientists were able to calculate how much carbon dioxide had to have been expended.

When they divided the group into thirds, based on activity level, the NIA researchers found that the most active group had a 12% risk of dying over the course of the six-year study. The middle group had a 17.6% risk of dying during the study and the least active group had a 24.&% risk of dying during the study.

What it Means: This study provides more evidence that physical activity is one of the keys to good health. In this study, the total level of activity included more than what we think of as exercise--going to the gym or taking long walks. Climbing stairs, gardening, doing housework and other activities also seemed to help prolong life.

From the Archive:
01/21/2002 Walk, Don't Run
10/17/2005 Aging Naturally

Merck’s vaccine against cervical cancer—dubbed Gardasil—jumped through another important regulatory hoop today when the federal Advisory Committee on Immunization Practices voted to recommend that it be routinely given to girls who are 11 to 12 years old. The decision, which is expected to be approved by both CDC and the Health and Human Services, should pave the way for private insurers to cover payment of the pricey shot, which at $120 for each of three doses, is one of the most expensive available.

And what about children whose families have no health insurance? The Committee also recommended that Gardasil be included in the Vaccines for Children program, which covers youngsters who are native American or Alaskan or are eligible for Medicaid or have no insurance. In fact, about 40% of the US child population is included in the Vaccines for Children Program.

The ACIP recommendation also allows vaccination of children as young as age nine (at the discretion of doctors or families) and up to age 26.

Studies are underway to see if the HPV vaccine is safe and effective for boys and older women.

What it Means: Gardasil is the first vaccine against human papilloma virus, a sexually transmitted infection that is responsible for triggering most cases of cervical cancer. There are two main reasons for giving the vaccine to girls 11-to-12 years old: 1) the inoculation is most effective when given before sexual intercourse occurs and 2) younger teens mount a more vigorous antibody response to the vaccine than older teens do.

There had been some concern that social conservatives might oppose the vaccine for fear that it might encourage sexual intercourse at an early age but no such opposition was apparent at the public meetings of the ACIP.

From our Archive:
May 18, 2006: Cervical Cancer Vaccine
June 21, 2006 Defusing the War over the “Promiscuity" Vaccine

Journalists need to do a better job of writing about medical research that is presented at scientific meetings, according to a study published in the Medical Journal of Australia. Three physicians from research institutions in New Hampshire and Vermont reviewed 187 articles in the popular press about the proceedings at five scientific meetings and found that most of the press reports omitted such key facts as study size or even the main finding.

Research presented at scientific meetings is often so preliminary that it doesn’t even get published in medical journals. That’s an important point to remember because publication in a good journal usually includes some kind of peer review by other researchers. If you can’t convince them your data is worth considering, you don’t get to move on to the next step, which is having other people validate it.

Basically, results presented at medical meetings are the scientific equivalent of gossip. Journalists who don’t let you know that or report other key facts do their readers a real disservice and wind up contributing to the popular perception that scientists prove one thing one week only to refute it the next week. 

What it Means:
Because so many people rely on the popular press for their medical information, there is a growing demand for better medical reporting in the U.S. Two websites that recently began ranking medical coverage in the media are The Health News Review, which actually gives stars to different stories, and the Knight Science Journalism Tracker, which aims to create a kind of “peer review within science journalism.”

From the Archive:
3/20/2006 Daily Rx: Reader Be Wary

Get ready for another round of “I told you so”in the condom wars. Researchers from the National Institute of Public Health in Mexico report in the British Medical Journal that adding condoms and emergency contraception to a 15-week, sex-education program in a group of public high schools in central Mexico had no effect on the youngster’s sex lives.

A year after the program was over, the students were just as likely to engage in sex as they were before the program began, according to surveys of the nearly 11,000 participants. Overall, there was no difference in the condom-using habits of those who were sexually active. Nor were they more, or less, likely to have sex.

What makes the study particularly compelling is that it was a prospective study, meaning that the students were divided into different groups before the study began to see which intervention would be most effective.

Intriguingly, young men in the condom groups who were sexually active were more likely to use the prophylactics with casual partners or if they paid money to have sex. The number of sexually active young women who reported having a partner who was five or more years older also increased from 23% in the control group to 31% in the condoms-plus-contraception group.    

What it Means:
It looks like teaching kids about HIV, condoms and contraception increases their knowledge about AIDS but doesn’t necessarily get them to change their sexual habits. Then again, neither does access to condoms make them any more likely to have sex than they were before.

From the Archive:
03/20/2006 Sex, Money and Power in India
05/10/2006 What Zuma Case Says About ABC

Teenagers who pledge to abstain from sex often don’t tell the truth.

More than half of all teenagers surveyed who pledged not to engage in sexual intercourse until marriage denied having made the promise when a second, follow-up survey was conducted a year later. Those who had initiated sex during that year were three times more likely to deny taking an abstinence pledge than those who hadn’t had sex.

Similarly, almost a third of teenagers who said they were sexually active in the first survey and then subsequently took a virginity pledge denied their earlier sexual history when asked about it in a second survey.

The findings are part of a study on teen sexual behavior, which is being published online in advance of the June issue of the American Journal of Public Health.

What it Means: You can’t always depend on what adolescents say they are doing when evaluating the effectiveness of an abstinence-based program. Measuring something more concrete, like rates of sexually transmitted diseases, may provide a more objective assessment.

From the Archive:
09/26/2005 A Teen Twist on Sex
09/18/2005 Prevention is Still Better than Cure

Some studies have results that are fairly straightforward to understand and act upon. Others need a little more time to digest. Monday’s news about the ability of raloxifene to prevent breast cancer falls into the latter category.

The Study of Tamoxifen and Raloxifene (STAR) compared the gold standard for the prevention of breast cancer (tamoxifen) to a drug that has already been approved to treat and prevent osteoporosis (raloxifene). The study lasted four years and looked at more than 19,000 post-menopausal women who were also at high risk of developing breast cancer. Both drugs work by targeting estrogen receptors throughout the body

Initial results from the head-to-head comparison determined that raloxifene is just as effective as tamoxifen at preventing breast cancer. However, raloxifene offered some clear advantages: women who took the drug were somewhat less likely to develop uterine cancer, blood clots and cataracts.

What it Means: These results are going to require closer analysis. Already it's clear there are several important caveats to keep in mind. Previous studies have shown that tamoxifen reduces a woman’s risk of developing both ductal carcinoma in situ (DCIS), which can develop into invasive breast cancer, and lobular carcinoma in situ (LCIS), which recent research suggests may not be as harmless as was once thought. The results from the STAR study showed that raloxifene offered no such benefit.

Also, we’re talking about small improvements in absolute risk. For example, giving either raloxifene or tamoxifen to 1,000 women for five years would prevent about 20 breast cancers. Researchers have to make sure they understand the risks and benefits more thoroughly before making any broad recommendations.

The results are also preliminary and have not yet been published in a peer-reviewed medical journal. More information will be presented in June at the annual meeting of the American Society for Clinical Oncology. There is still much work that needs to be done to sort out what the results of the STAR trial might mean for individual patients.

From the Archive:
02/18/2002: Estrogen: A Villain and Possible Savior
10/20/2003: Cancer Fighter

Banning the use of certain antibiotics to treat livestock helps prevent the development of drug-resistant germs in people. Australia’s decision to forego the use of a class of antibiotics called fluoroquinolones—which includes the anti-anthrax drug Ciprofloxacin—in poultry and other animals is the main reason why Australians have very few cases of a certain type of antibiotic-resistant food-poisoning, according to a study in the May 15 issue of the journal Clinical Infectious Diseases.

Researchers studied laboratory reports from all over Australia of 585 patients who had been infected with Campylobacter jejuni, a common source of food poisoning. The investigators found that about 2% of locally acquired infections were resistant to Ciprofloxacin. (The figures ranged from 0% in Tasmania to nearly 8% in the state of Victoria.)

By contrast, 64% of the Campylobacter infections that participants developed while traveling overseas were resistant to Ciprofloxacin. The study authors report that rates of Cipro-resistant infection in Australia parallel those found in Sweden, which banned the use of fluoroquinolones in livestock in 1986.

What it Means: The widespread use of antibiotics in animals has a direct effect on the ability of those same drugs to treat infections in people. The U.S. Food and Drug Administration prohibited the use of fluoroquinolones for the treatment of poultry in September 2005, after a five-year fight with a drug maker.

From the Archive:
03/17/2006 Will We Run out of Antibiotics?
01/21/2002 Playing Chicken With Our Antibiotics

The brains of folks who have a near-death experience during a life-threatening crisis may be wired somewhat differently from those who do not. Researchers from the University of Kentucky report preliminary evidence that suggests that the difference lies in the brain’s ability to discriminate between wakefulness and sleep. Their study appears in the April 11 issue of the research journal Neurology.

Near-death experiences have been the object of much lore and speculation—not to mention a few television episodes—ever since 1975 when Raymond Moody published a book filled with survivors’ stories. But neurologists still don’t quite understand what triggers the episodes or why more people don’t experience them. After all, if it was just a simple matter of the brain not getting enough oxygen, you would expect just about everyone who was ever resuscitated after cardiac arrest to report seeing a bright light or long-dead relatives after the ordeal.

Kevin Nelson and colleagues at the University of Kentucky decided to focus on two features of many near-death experiences—the bright lights and a sense of the body’s paralysis. They realized that these features are also hallmarks of a situation in which one of sleep’s more mysterious stages—characterized by rapid eye movement—intrudes on normal wakefulness. The investigators decided to explore a possible link.

REM intrusion can occur normally, as when you’re just beginning to fall asleep or wake up or in people with sleep disorders like narcolepsy. It often results in seeing or hearing something that isn’t there. Nelson and his team interviewed 55 people who had had a near-death experience and compared them to 55 other people of similar age and background who had not. The Kentucky team determined that 60% of those who had a near-death experience had previously experienced REM intrusion compared to 25% in the control group.

What it Means: This is a so-called associational study, so it doesn’t prove a link between REM sleep and near-death experiences. As such, it doesn’t help patients make sense of their near-death experiences either. But it does suggest that neurologists might want to pay more attention to a part of the brain stem called the locus ceruleus, which is involved in the regulation of REM sleep.

From the Archive:
12/20/2004 Why We Sleep
09/18/200 A Kinder, Gentler Death

The Journal: Psychology and Aging

The Study: A study of a 229 people aged 50 to 68 found that those who were lonely tended to have higher blood pressure readings—by as much as 30 points—compared to those who had lots of friends and felt engaged in their communities. The difference was smallest in those who were closest to age 50 but greatest in those who were closest to 68, according to researchers from the University of Chicago.

What it Means: The difference in blood pressure readings was much greater than the researchers expected. While this is still an associational study—and therefore doesn't prove cause and effect—it does fit with previous data suggesting that greater social involvement plays at least some role in promoting good heath as we age. Since loneliness is not entirely in our control, it also pays to remember that exercise and weight loss are also beneficial in keeping blood pressure down.

From our Archive:
03/20/2006 New Ways To Think About Old Diseases
12/05/2005  Blood Pressure and Cognition

The Journal Archives of Surgery

The Study All things being equal, older patients (60 and up) are at greater risk of suffering severe complications from bariatric surgery for the treatment of obesity.

Doctors at the Oregon Health Sciences University in Portland looked at the health records of 425 men and women who undergone either gastric bypass surgery or another operation called biliopancreatic diversion with duodenal switch. The average length of follow up was about a year after the operation.

In general, the patients lost a little over half of their excess weight. Older patients and those who had undergone biliopancreatic diversion with duodenal switch were more likely to suffer from complications such as a clot in the lungs, obstruction of the bowel and internal bleeding. About one in ten patients suffered a severe complication with the most common problem being leakage at the surgical site. The death rate was just under 0.9%.

What it Means: Previous studies have already shown that patients over age 60 are more likely to die from complications after bariatric surgery.  This study suggests that their rate of complication is greater as well and should be carefully considered before an obese person 60 and older undergoes bariatric surgery.

From our Archive:
03/19/2006 The Politics of Fat
06/07/2004 How We Grew So Big

The Journal: Archives of Internal Medicine

The Study: Telephone counseling lines are more effective at helping people to kick the smoking habit than self-help materials alone. Researchers in Minnesota assigned 837 smokers who wanted to quit into two groups. The first group received self-help material and had access to other standard smoking cessation services. The second group were counseled over the phone seven times during the first two months and then nearly eight times for the following year.

After three months, a poll of the subjects in the telephone group showed that more than a third had not smoked for at least the prior week compared to 10% in the standard care group. After a year, 13% of the telephone group was still not smoking compared to 4% in the control group. Participants in the telephone group were more likely to

What it Means: Several recent studies have shown that telephone counseling lines are among the most effective tools available for helping folks to stop smoking. You can increase your odds of successfully quitting if you make a telephone counseling service  part of the attempt. 

From the Archive:
11/28/2005 Smoke Free
08/30/2005 China's Smoking Curb is Bad News for Big Tobacco

The Journal: Annals of Internal Medicine

The Study: Nearly 75% of serious skin infections treated at several Atlanta clinics turned out to be resistant to the antibiotics normally used to treat such conditions. Based on this and other studies, it seems clear that infections with methicillin-resistant staphylococcus aureas (MRSA) bacteria are now widespread across the US and pose an ever-increasing danger to otherwise healthy folks.

Researchers have been stunned at how quickly MRSA bacteria have spread through American cities, suburbs and rural areas. Genetic studies have shown that this particular superbug is not related to strains of antibiotic-resistant staph that have shown up from time to time in hospitals. Perhaps most alarming, otherwise healthy children and young adults appear to be particularly susceptible to the community-based strain of MRSA. This may be in part because they are more active and tend to get cut more often or have skin abrasions that allow staph infections to develop.

Just last week, the Infectious Diseases Society of America renewed its call for Congress to do whatever it takes to help the pharmaceutical industry focus on the problem and develop stronger and more powerful antibiotics to treat MRSA and other antibiotic-resistant bacteria.

What it Means: Doctors need to change how they treat skin infections. Instead of assuming that MRSA occurs only in hospitals, they have to realize the infection has become widespread throughout the community. They need to use much stronger antibiotics to treat MRSA skin infections, which often look, at least at first, like a bad spider bite with patches of blackened dead tissue.

As a general rule, MRSA bacteria found in the community are resistant to cephalosporin- and penicillin-based drugs. Most of them can still, however, be treated with doxycycline, minocycline, trimethoprim-sulfamethoxazole or vancomycin.

From the Magazine:
07/25/2006 Too Much of a Good Thing
01/15/2001 Antibiotics Crisis
09/01/1997 Germ Warfare

The Journal: Archives of Internal Medicine

The Study: Taking estrogen pills for seven years or more does not reduce the risk of heart disease in healthy women, aged 50 to 79, who have had a hysterectomy. There was a trend in the data, however, that suggests estrogen supplementation might benefit women aged 50 to 59—but the difference was not statistically significant.

This study of estrogen therapy in nearly 11,000 post-menopausal women was part of the much larger Women’s Health Initiative, which had already concluded, amongst great fanfare, that long-term hormone replacement (whether with estrogen and progestin or estrogen alone) does not protect women against heart disease.

So why look at the data again? A number of researchers are starting to suspect that there is a “window of opportunity” around the menopause, during which a woman’s body may be more amenable to the benefits of hormone therapy without triggering some of its risks. After a certain point, however, the body no longer apparently responds so positively and the risks outweigh the benefits. Or at least that's the concept. This study doesn’t prove that idea but it gives investigators new leads to follow.

What it Means: Women who have undergone a hysterectomy (removal of the uterus) are often given the choice of estrogen therapy to deal with any symptoms. A woman with an intact uterus should not take estrogen alone since it increases her risk of uterine cancer. In addition, women with a personal or family history of breast cancer should also think very carefully about undergoing hormone replacement therapy, since estrogen may increase boost their risk of breast cancer.

Having said all that, there may be certain situations in which estrogen could be beneficial. For one thing, estrogen (with or without progestin) is very effective at alleviating the severe menopausal symptoms that occur in some women. This study suggests that researchers should look more closely at possible cardiac benefits in younger women as well.

However, that could be a pretty tall order, scientifically speaking, since women in the decade just before and after menopause are pretty darn healthy. It would take a very large study population—the investigators of this study figure at least 17,000 women—to have a shot at detecting a statistically significant result.

From the Magazine:
10/17/2005 Aging Naturally
10/10/2005 Menopause: Beyond Hot Flashes

The Journal: Journal of the American Medical Association

The Studies: Three studies that looked at nearly 50,000 healthy, post-menopausal women over the course of eight years found no significant effect of a low-fat diet on reducing the risk of heart disease, stroke, breast cancer or colorectal cancer. If you dig beyond the headlines, however, you’ll realize that these findings are not as contradictory as they seem.

When the studies, which were sponsored by the National Heart, Lung and Blood Institute as part of the Women’s Health Initiative, were first designed back in the 1980s, it made sense to focus on the total amount of fat in the diet. At that time, reducing total fat seemed like the best, most likely way to reduce heart disease and certain forms of cancer. And so investigators split the participants into two groups: one that attempted to bring its total fat consumption down to 20% of calories and one that stayed up around 35% of calories from fat.

Since then, however, other research has shown that the amount of saturated fats and trans fats in the diet may be even more important, within reason, than the total amount of fat, you eat. That’s just a fancy way of saying that vegetables sautéed in olive oil are healthier for your heart than a thick juicy hamburger. More recently, epidemiologists are starting to wonder if the combination of total fat plus large amounts of heme—a natural protein that contains iron and that’s particularly abundant in red meat—serves as an important environmental trigger for colorectal cancer. And of course, there’s the issue of physical activity and exercise, which turn out to promote good health in all sorts of ways.

So even though the studies showed that lowering total fat, by itself, doesn’t work miracles in heart disease or cancer, there are signs that eating fewer of your calories from fat is still a good idea. The number of women on the low-fat regimen who went on to develop breast cancer dropped by 9%. Although that wasn’t statistically significant, it may simply be that the study didn’t last long enough or the decrease in fat consumption was too gradual for investigators to pick up an effect. (Most of the women didn’t actually get down to 20% but averaged around 29%).

In addition, the women in the low-fat group had fewer polyps and other lesions that are thought to be precancerous. So once again, perhaps their incidence of colorectal cancer wasn’t any lower because the study hadn’t lasted long enough for enough of the women to get cancer.

What it Means: The same health advice that you've been hearing all along still applies. Get more fruits and vegetables in your diet—five daily servings the size of your fist is what’s recommended but many nutrition experts believe “nine is divine.” Exercise regularly, at least 30 minutes a day most days of the week. And, if you’re old enough, be sure to get a regular mammogram, colonoscopy and heart checkup. Oh, and one other thing, the women who decreased their total fat intake didn't gain weight as they got older. In fact, some of them lost a pound or two.

—Christine Gorman

From our archive:

02/06/2006: No Miracle Diets for Heart Disease or Cancer
TIME collection: Heart Disease
TIME collection: Cancer

The Journal: Lancet Neurology

The Study: Researchers have long hoped to develop a biological screening test for Alzheimer's disease that doesn't require direct examination of brain tissue—something that's usually possible only at autopsy. This study suggests that looking for three key proteins in a spinal tap may be the way to go.

Investigators from Sweden examined 180 patients with mild cognitive impairment, a condition that sometimes, but not always, leads to Alzheimer's disease or other forms of dementia. The researchers were able to perform spinal taps on 137 of these patients and measured the amounts of three different brain proteins—beta amyloid 42, total tau and phosphorylated tau—in the spinal fluid. (You would expect to find some brain proteins in the spinal fluid because the spinal fluid bathes the brain as well.) Each of these proteins has previously been linked in various ways to the neurological plaques and tangles that damage the brains of Alzheimer's patients.

After an average of a little over five years, 57 of the 137 study participants developed Alzheimer's disease, 21 developed another form of dementia and 56 saw no changes in their cognitive abilities. When the researchers went back to their initial spinal tap measurements, they found that those patients with the high levels of total tau together with low levels of beta amyloid 42 were 17 times more likely to develop Alzheimer's disease. (The low levels of beta amyloid 42 presumably occur because more and more of the protein is being bound up in the amyloid plaques that are damaging the brain.) In this group of patients the spinal test for these two proteins was 95% sensitive and 83% specific—meaning that 95% of the patients who eventually developed Alzheimer's disease had a positive spinal test and 83% of the patients who remained healthy did not. (Put another way, the test would have indicated that 17% of patients were going to develop Alzheimer's when in fact they didn't.)

What it Means: This study provides important research findings but there is still no easy way to screen patients for Alzheimer's disease. Neurologists are also investigating whether different types of brain scans might also help screen patients for Alzheimer's disease.

From our archive:
11/14/2005 Music and the Mind
07/17/2000: The New Science of Alzheimer's

The Journal: Archives of Internal Medicine

The Study: More good reasons for men, at least, to get their blood pressure checked and not smoke or gain weight. A new analysis of data from the 2001-2002 National Health and Nutrition Examinational Study (NHANES) found a pretty strong link between erectile dysfunction and obesity, diabetes, hypertension and smoking.

The analysis, which was conducted by investigators from the University of California, Los Angeles, and the Urologic Diseases in America Project, found that nearly one in five men aged 20 and older experienced erectile dysfunction, defined as sometimes or never being able to maintain an erection adequate for sexual intercourse. Just over 6% of the men aged 20 to 29 in the study experienced ED compared to 77% of men aged 75 and older.

It seems that past studies tended to underestimate the prevalence of erectile dysfunction. The number of men who went to the doctor’s office to be treated for the condition jumped 50% in 1998, when the Food and Drug Administration first approved Viagra.

What it means: Erectile dysfunction doesn’t affect just a man’s sex life. It may also be a sign of an underlying health problem.

From our archive:
01/19/2004 Still Sexy After 60

09/01/2003 Move Over, Viagra

The Journal: Annals of Internal Medicine

The Study: Exercising three or more times a week seems to decrease the risk of developing various types of dementia, including Alzheimer's disease, in men and women over the age of 65, according to researchers from the Group Health Cooperative, a non-profit health maintenance organization in Seattle, Washington.

The investigators studied 1740 apparently healthy people age 65 and older and followed them for at least six years. They excluded anyone who was already showing signs of cognitive impairment at the beginning of the study, then they asked participants how active they were and what sorts of physical activity they did on a regular basis. Test subjects who exercised at least three times a week were 38% less likely to have dementia at the end of the study than those who were less active.

What It Means: Although the study does not prove that exercise prevents or even delays dementia, it is highly suggestive. This is the fourth big study to show such a beneficial link. Considering how good exercise is for the rest of your body, particularly your heart, it makes sense to keep moving. Your brain may thank you later.

From our archive:
01/16/2006 Can You Prevent Alzheimer's Disease?
11/14/2005 Music and the Mind

The Journal: New England Journal of Medicine

The studies: Two new vaccines against rotavirus, a gastrointestinal infection that kills about half a million children each year in the developing world, appear to be both safe and effective. Each of the vaccines--one of which was developed by Merck and the other by GlaxoSmithKline--was tested on more than 60,000 infants. Doctors were particularly excited that the vaccines reduced the need for hospitalization more dramatically than they had anticipated.

What it means: Although rotavirus is a bigger killer in developing countries, it causes plenty of trouble in the U.S. as well. Most adults who are sickened by the virus suffer a temporarily debilitating case of "stomach flu" but about 55,000 infected children are hospitalized in the U.S. each year with severe diarrhea. Their smaller size makes them more vulnerable to the loss of fluids from their bodies. A previous vaccine had to be withdrawn from the market when it was linked to an uncommon but potentially life-threatening side effect called intussusception, in which one section of the bowel telescopes into another. 

From our archive:
11/07/2005: This Generation's Moon Shot
12/28/98: Healthy Germs

The Journal: The American Journal of Gastroenterology

The Study: Milk thistle, a popular alternative-medicine remedy for the liver, shows no evidence of helping people with hepatitis B or C or alcoholism, according to a review of the data from 13 randomized clinical trials involving a total of 915 patients. Researchers from Copenhagen University Hospital found that participants who had taken milk thistle for at least six months did not live any longer, or have any fewer complications, than those who took placebos or followed no treatment at all. Some studies suggested an overall benefit to lifespan, but these were the least rigorous trials.

What it Means: The scientific evidence for or against milk thistle in the treatment of liver disease has been all over the map. The best thing you can say about the Copenhagen review is that, at least, it didn’t turn up any suggestion that milk thistle makes liver disease worse.

From Our Archive:

11/23/1998 Is it Good Medicine?

10/15/2001 Post-Traumatic Infection

Journal: The Journal of the American Medical Association

The study: Two studies found that the side effects from a recent smallpox vaccination campaign were not as great as feared. Researchers recorded 822 adverse effects in a group of nearly 40,000 volunteers who had been inoculated at least once in 2003. One hundred people suffered serious side effects, 85 of them requiring hospitalization. Two people were permanently disabled, ten suffered life-threatening illnesses and three died.

What it means: Doctors have long known that the smallpox vaccine was not the safest vaccine around. But before smallpox was eradicated in 1980, it made sense to get vaccinated since the disease itself was so much worse. Now, there are fears that terrorists might somehow get their hands on stocks of virus that still exist in some laboratories and figure out how to release it on an unprotected world. That's why, in 2003, the U.S. government vaccinated nearly 40,000 physicians, nurses and other volunteers.

The number of side effects were kept down because participants were carefully chosen. (No one, for example, whose immune system has been compromised by HIV can safely take the smallpox vaccine.) They were also quick to seek medical attention if they developed any reactions to the vaccine. Such care might not be possible in the unlikely event of a smallpox attack. Although the government says it has enough smallpox vaccine for everyone, research is ongoing to try to develop a safer alternative.

From our archive:
10/18/2001  The New Worry: Smallpox
05/20/1960  Two Faces of Smallpox

Journal: Journal of the American Medical Association

Study: Mothers in the long, ongoing Nurses' Health Study who are of normal weight and who breast-fed their children for at least a year[EM]the amount of nursing recommended by the American Academy of Pediatrics[EM]had a 15% lesser risk of developing diabetes than mothers who bottle-fed their children. The decreased risk lasted for 15 years after the children were born.

What it means: Doctors have long known that, other things being equal, breast-feeding is best for the overall health of babies. The latest results suggest that breast-feeding has health benefits for Mom, too.

From the archive:

10/24/2005  Suckers for Safety 
07/26/1999  Your Family

Journal: Lancet online

Study:  An experimental  vaccine developed by GlaxoSmithKline continues to provide partial protection against malaria in children aged one to four years for at least 18 months. The study  (free registration required) showed that the total number of cases of malaria fell 35% in a group of 1,44