Health Tip: Treating Poison Ivy

March 29, 2006 08:45:58 PM PST

(HealthDay News) -- If you've stumbled on a patch of poison ivy, here are a few tips from the Asthma and Allergy Foundation to help minimize your discomfort:

• Try to catch the rash early. If you think you might have poison ivy, wash the area well with soap and cool water.
• Over-the-counter creams and antihistamines -- such as Caladryl lotion, hydrocortisone cream, or Benadryl -- can help with symptoms.
• Try covering the rash with a mixture of baking soda and cool water.

Poison ivy is not contagious from person to person, but is spread when the oil from the plant is still on your skin and you touch other parts of your body or another person. You should be careful to look out for the plants when out in the woods or your garden, and wash your clothes in warm water when you come in from working outside.

If the rash covers a large portion of your body, or you experience fever, headache, nausea, painful rash or shortness of breath, you should contact your doctor to see if you may be having an allergic reaction to the poison ivy.

Health Tip: When to Have Wisdom Teeth Removed

March 29, 2006 08:45:58 PM PST

(HealthDay News) -- Most people have wisdom teeth -- those teeth that grow in the very back of your mouth -- as young adults. Although some people may have enough room in their mouths to accommodate their wisdom teeth, others may need to have them extracted to prevent other dental problems, including overcrowding.

According to the American Dental Association, your wisdom teeth may need to be extracted if they are growing in sideways and could impact other teeth. They should also be removed if the teeth are only partially emerged for an extended period. This allows for bacteria to form around the teeth and could cause an infection.

If you experience pain, stiffness or swelling in your jaw or other tooth pain, you should consult your dentist to see if your wisdom teeth may be causing the problems. Your dentist may refer you to an oral surgeon to see if your wisdom teeth need to be extracted.

Coming Soon: Faster, Yet Still Safe, Clinical Trials

March 29, 2006 08:45:58 PM PST
By E.J. Mundell
HealthDay Reporter

WEDNESDAY, March 29 (HealthDay News) -- In an ideal world, new, effective and safe medications would sail through clinical trials in just a couple of years.

But the drug-approval process in this country is far from ideal: In the whole of 2005, the U.S. Food and Drug Administration approved just 20 new agents, down from 36 approvals the year before.

And while everyone wants effective drugs marketed as soon as possible, the Vioxx debacle in 2004 has regulators and drug developers leery of releasing medications to market too soon.

That's why something called surrogate markers -- a kind of clinical trials "crystal ball" -- has everyone in drug development so excited.

"We're hoping that it will be the impetus to change clinical trials from five-year trials, for example, to just one-year trials," said Dr. Jerry Radich, a noted leukemia researcher in the clinical research division of the Fred Hutchinson Cancer Research Center, in Seattle.

Radich is very familiar with the issue: He's leading the first-ever federally approved, phase 3 clinical trial of a cancer agent in which a surrogate marker will be the primary criterium by which researchers will judge each drug's effectiveness.

That trial, which is still recruiting patients, will compare two doses of imatinib (Gleevec) against the experimental drug dasatinib, for patients with chronic myeloid leukemia (CML).

Surrogate markers are essentially tests or patient milestones that researchers can use as stand-ins to predict longer-term patient results, such as survival. They include patterns such as tumor shrinkage, time-to-disease-relapse, findings on a MRI or PET scan, or molecular or genetic changes in blood or tissue samples.

The important thing is that these findings can predict, with a fair amount of accuracy and years in advance, who is going to benefit from a particular therapy, and by how much.

Right now, "patient survival remains the gold standard as the endpoint for any large clinical trial," explained Dr. James Doroshow, director of the division of cancer treatment and diagnosis at the U.S. National Cancer Institute (NCI). "There's no question that if something significantly enhances a patient's survival, then that therapy -- if it has an acceptable toxicity profile -- will often, if not always, be approved by the FDA."

But there's a big problem with using survival as a study's main endpoint: Final results can take many years, even decades, to come in as researchers count up who lived and who died.

It's part of the reason why the average FDA-approved drug now takes at least a decade to make it from the laboratory to the marketplace, if not longer.

So, experts have recently focused on the development of tests that "might predict, with a very high likelihood, whether a treatment provides a survival benefit or not," Doroshow said.

In the case of Radich's trial, the test in question measures post-treatment changes in a blood-borne genetic marker that predicts the "depth" of a CML patient's response to drug therapy. Because his team won't have to wait for survival outcomes, results from this trial of 600 patients should be ready within months, not years, of initial treatment, Radich said. "It's a pretty nifty way of moving things up and getting drugs that might be potentially better out there more quickly," he said.

But won't speeding things up raise the risk that long-term side effects will go unnoticed? Not so, according to experts.

First of all, "with all the drug trials that we are talking about right now, there is enough phase 1 and 2 [safety] data, so that people are already pretty comfortable about the side effects," Radich said.

And Doroshow noted that most phase 3 trials -- which focus on efficacy -- don't end when initial results are published. "Especially for new therapies, we follow patients for a long time after that, looking for long-term effects," he said.

The NCI expert cautioned, however, that any move to surrogate markers needs to be done cautiously, first making sure that a particular marker does, in fact, predict patient survival. A joint NCI/FDA initiative to test one such theory -- that PET scan findings predict survival after lung cancer treatment -- is currently being assembled, Doroshow said. The FDA is also investigating whether time-to-disease-relapse might be a good predictor of survival for patients battling metastatic colon cancer.

If either of those efforts ends positively, the result could be much shorter -- yet still accurate -- clinical trials for drugs to fight two leading cancer killers. And experts believe surrogate markers might also serve as endpoints for trials for other forms of disease, including autoimmune disorders and infections such as HIV.

The usually conservative FDA has been unusually proactive when it comes to surrogate endpoints, said Radich, who has recently attended agency-sponsored symposiums on the topic as it relates to leukemia research.

In fact, in a statement released March 16, the agency listed "biomarkers" as one of the key planks in its "Critical Path Initiative" (CPI), which is aimed at speeding up clinical trials.

In the statement, Dr. Janet Woodcock, FDA's deputy commissioner for operations and head of the initiative, said that "most researchers agree that a new generation of predictive markers would dramatically improve the efficiency of product development, help identify safety problems before a product is on the market (and even before it is tested in humans), and facilitate the development of new types of clinical trials that will produce better data faster."

So, are surrogate endpoints the future of medical research?

"The short answer is, 'yes,' " Doroshow said. And clinical trials are just the beginning, he added.

Eventually, he said, doctors will use predictive biomarkers as "crystal balls" at the bedside to make crucial decisions as to "whether we should continue useful therapy in the appropriate patients, or discontinue therapy that may well have bad side effects in patients and in whom it can be predicted the therapy won't be useful."

More information

For more on clinical trials, head to the U.S. National Institutes of Health.

Research Brings New Insight Into Joint Health

March 29, 2006 08:45:58 PM PST

WEDNESDAY, March 29 (HealthDay News) -- Realistic models of human joints are helping researchers learn more about how the body's natural joint lubricant prevents wear and tear that can lead to osteoarthritis.

The team, from Duke University's Pratt School of Engineering in Durham, N.C., found that a component of joint fluid called lubricin does more than simply reduce friction -- it forms a thin barrier that repels joint surfaces in order to prevent them from coming into contact with one another.

Lubricin, in combination with another joint fluid component called hyaluronic acid (HA), provides an even greater protective effect for joints than either of the two components on their own, the scientists also found.

"In the healthy joint, the intact superficial surface layer of cartilage provides an extremely efficient bearing surface with an apparently very low coefficient of friction," researcher Stefan Zauscher, assistant professor of mechanical engineering and materials science, said in a prepared statement.

"Any damage to this superficial zone or absence of lubricating factors may be the cause of a cascade of mechanical failures in joints that ultimately leads to the onset of osteoarthritis," he said.

The findings were expected to be presented Wednesday at a meeting of the American Chemical Society in Atlanta.

More information

The Arthritis Foundation has more about osteoarthritis.

Guided Imagery Helps Children Facing Surgery

March 29, 2006 08:45:58 PM PST
By Serena Gordon
HealthDay Reporter

WEDNESDAY, March 29 (HealthDay News) -- Anyone who's ever "met" a child's imaginary friend knows that children are innately more creative and open to the world of make believe than adults.

That's one reason why Ohio researchers thought that children undergoing routine surgeries might be less anxious about the procedure and feel less pain afterward if they were taught to use "guided imagery."

"Guided imagery really works. It should be used in conjunction with pain medications, but it really works, and it's something that can be used at home," said the study's lead author, Myra Huth, assistant vice president of the Center for Professional Excellence Research at Cincinnati Children's Hospital Medical Center.

Guided-imagery exercises attempt to distract a person who's feeling anxious or in pain by taking them to another time or place -- at least in their imagination. These exercises are designed to get the individual to feel with all of their senses that they are in a different place.

In the guided-imagery tapes used in the new study, the researchers wanted the children, scheduled to have their tonsils and adenoids removed, to think about a park. So, the exercises tried to get the child to think about what they might see at the park, such as the green grass or children swinging on the swings. They also tried to get the children to imagine the sounds of the park, the smells, the way the playground equipment or grass might feel on the skin, and even tastes from the park, such as ice cream.

"A good imagery tape should evoke all of the senses it can and really engage the child," Huth explained.

For the first part of the study, Huth and her colleagues randomly assigned a group of 75 children into two groups. The first group was taught to use guided imagery before the surgical procedure and encouraged to use it after the procedure. The other group did not get such training and served as a control group.

In a 2004 issue of the journal Pain, the researchers reported that children using guided imagery reported significantly less pain and anxiety after the procedure than the control children did. On a pain scale of zero to 100, the average score of the control group after surgery was 42, while the group using guided imagery had an average score of 30.

For the new study, which appears in the April issue of the Journal of Pediatric Nursing, Huth and her team tried to tease out exactly how the children used guided imagery. Did they follow the tapes exactly? Or, did they come up with their own scenarios? When did the youngsters turn to the tapes, and why?

Huth said she told the children the tapes were just to get them started, that they could "go" wherever they wanted to.

But, the researchers found, many of the children did, in fact, use the tapes to "go" to a park. Not all, however, went to a traditional community park suggested in the tape. Some children let their imagination take them to an amusement park, a swimming pool, or a lake near family vacation cottages, Huth said.

Most children "traveled" to different places at different times, depending on what they were using the tape for, she said. The researchers also discovered that before the surgery, the children turned to the tapes for relaxation and to ease their anxiety. In addition to guided-imagery exercises, the tapes also began with relaxation exercises.

After surgery, the children used the tapes most when they were feeling pain. However, they still turned to the tapes for relaxation and to help them fall asleep after surgery.

"Pain is not only a physiologic phenomenon, but also an emotional one," Huth said, adding that if you can pull someone "away" from their pain, that distraction may help them feel a bit less uncomfortable.

While not a substitute for pain medications, guided imagery can significantly reduce pain and anxiety in the hospital after surgery, Huth said. She said one parent asked her, "Why aren't all hospitals doing this?"

Not everyone is sold on the benefits of guided imagery, however. Linda Downs, the tracheostomy resource nurse at Children's Memorial Hospital in Chicago, expressed doubts about using guided imagery to help control pain.

"Pain is not in your mind. Post-operative pain is for real. Listening to a tape and being able to calm a child to forget about pain? I just don't see it. It may work for anxiety, but I can't see it for pain," she said.

Downs said she was also concerned about the time needed to teach children such exercises. She said that in a small hospital it might be feasible, but in a large hospital with a busy surgical department, nurses just don't have the time.

She also noted that post-operative pain can be affected by many factors, including how much a patient had to drink and whether their doctor prescribed acetaminophen or acetaminophen with codeine.

Huth said she felt that adding guided imagery to treatment would only take a few extra minutes, and was likely something most nurses could fit in to the patient's treatment plan.

More information

To learn more about preparing your child for surgery, visit KidsHealth.org.

Brain Produces Growth Hormone

March 29, 2006 08:45:58 PM PST

WEDNESDAY, March 29 (HealthDay News) -- The brain's hippocampus produces its own store of growth hormone, researchers report.

The finding could have implications for athletes taking growth hormone and metabolic steroids to increase muscle mass and for menopausal women using estrogen replacement therapy.

"Growth hormone has been associated with growth of muscles and bones, and the production of it was believed to lie mainly in the pituitary gland," study co-author Ken S. Kosik, co-director of the Neuroscience Research Center at the University of California, Santa Barbara, said in a prepared statement.

"No one had thought too much about what growth hormone might be doing in the brain. Hormones in the brain may not be obvious compared to what they are doing in the rest of the body," Kosik said.

The study, published in this week's Proceedings of the National Academy of Sciences, also found that women produce more growth hormone than men, that adults produce more than children, and that hormone production increases in response to estrogen. Differences in the amount of growth hormone in the brain may affect reasoning and mood, the scientists said.

The study authors previously found that production of growth hormone in the hippocampus increases with learning. The new study found that stress increases production, particularly in males. The effect of stress in females depends on how much estrogen they have at the time.

"One interesting interpretation of these results is that exposure to a stressful event increases growth hormone expression in males -- but the increase in females may be dependent on their levels of estrogen at the time," study first author Christine P. Donahue, instructor in the department of neurology at Harvard Medical School, said in a prepared statement.

More information

The Endocrine Society has more about growth hormone.

Health Highlights: March 29, 2006

March 29, 2006 08:45:58 PM PST

Here are some of the latest health and medical news developments, compiled by editors of HealthDay:

Guidant Suspends Heart Stent Shipments

Quality problems have prompted Indianapolis-based Guidant Corp. to suspend shipments of a new heart stent in Europe and to halt enrollment of patients in a clinical trial in Japan to test the stent.

About one percent of the new drug-coated Xience stents did not meet quality standards, but no patients were harmed by the stents, the company said in a statement released Wednesday. It did not divulge how many of the poor quality stents were implanted in patients.

The sale of Xience stents in 25 European countries will be delayed until later this year. The stent has not yet been approved for sale in the United States, but Guidant did notify the U.S. Food and Drug Administration about the suspension of shipments, Bloomberg news reported.

The faulty stents were made at Guidant's plant in Temecula, Calif.

"We have determined the root cause of the issue, have instituted corrective measures and have resumed manufacturing," the company said in its statement.

Last year, defects forced Guidant to recall more than 100,000 implantable heart defibrillators.

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Candy Eggs Recalled

The Anthony-Thomas Candy Co. of Ohio is recalling packages of filled Easter candy eggs that may contain undeclared egg whites and the food colorings yellow # 5 and yellow #6.

People who are allergic or have a severe sensitivity to eggs could suffer a serious or life-threatening reaction if they eat the candies. The company said there have been no reports of such incidents.

The recall covers 6-ounce and 12-ounce packages of candy eggs filled with butter cream, peanut butter, fruit and nut, chocolate fudge, coconut cream, chocolate fudge pecan, and maple walnut fudge. The recalled packages carry production code numbers 6027 through 6083, the Associated Press reported.

The candy eggs were sold in a cardboard package with a clear cellophane top panel. The candies were sold in retail stores between Jan. 27 and March 27 in the following states: Alabama, Colorado, Connecticut, Illinois, Iowa, Massachusetts, Michigan, Mississippi, New York, Ohio, Tennessee, Texas, West Virginia and Wisconsin.

Consumers can return the candies to the place of purchase for a full refund. For more information, contact the Anthony-Thomas Candy Co. at (877) 226-3921.

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FDA Approves 2nd Drug for Flu Prevention

The antiviral drug Relenza has been approved for prevention of influenza A and B in adults and children five years or older, the U.S. Food and Drug Administration said Wednesday. The drug was already approved to treat influenza.

Relenza is the second drug to be given FDA approval for prevention of influenza. The other is Tamiflu, which is also approved to treat influenza.

"This approval (of Relenza) is a welcome addition to the available defenses against the flu. This new use offers the medical community another option to prevent and control influenza A and B," Dr. Steven Galson, director of the FDA's Center for Drug Evaluation and Research, said in a prepared statement.

Relenza is made and distributed by GlaxoSmithKline Inc. based in Research Triangle Park, N.C.

Two studies found that flu struck 4.1 percent of households that took Relenza, compared to 19 percent of households that took a placebo.

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Tobacco Companies Contest Payment to States: Report

Large U.S. tobacco companies are negotiating with states in a dispute involving $1.2 billion of a $6.5 billion payment the companies must give the states by mid-April under the $246 billion Master Settlement Agreement of 1998.

The companies contend that they're entitled to pay less because the states did not "diligently enforce" statutes that require smaller tobacco companies that aren't part of the agreement to create escrow accounts to cover losses in any future legal action that might include them, The New York Times reported.

Because of this, the large tobacco companies say they should not have to pay $1.2 billion of the next installment of $6.5 billion that has to be paid to the states by April 17.

"We believe the states have diligently enforced their statutes. We are negotiating with the companies to make sure they pay the full amount," Tom Miller, the Iowa attorney general and co-chairman of the National Association of Attorneys General tobacco committtee, told the Times.

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Doctors Remove 2 Dead Fetuses From Baby Girl

Doctors in Pakistan operated on a 2-month-old girl to remove two dead fetuses that grew inside her while she was in her mother's womb.

The infant was in critical condition following the two-hour operation Tuesday.

"It is extremely rare to have two fetuses being discovered inside another. Basically, it's a case of triplets, but two of the siblings grew in the other," Zaheer Abbasi, head of pediatric surgery at The Children's Hospital at Pakistan Institute of Medical Science, told the Associated Press.

Abbasi led the operation to remove the two partially grown fetuses that weighed a total of about two pounds. The two fetuses had died at about four months' gestation.

He said it was the first such case -- called fetus-in-fetu -- he was aware of in Pakistan. He did not know what caused it, the AP reported.

Fetus-in-fetu occurs in about one per 500,000 births, said a report in the June 2000 issue of the journal Pediatrics.

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No Safety Concerns About Benzene in Soft Drinks: FDA

Tests for cancer-causing benzenes in soft drinks have raised no safety concerns, the U.S. Food and Drug Administration said Tuesday. But the agency did not release details about the test results.

The FDA began testing soft drinks after a private study released in late 2005 said it found small amounts of benzene in some soft drinks, the Associated Press reported.

While a few of the drinks sampled had slightly elevated levels of benzene, the vast majority did not have any benzene or had levels that were below the U.S. federal limit for drinking water, the FDA said.

The agency will continue testing soft drinks and plans to release findings "when we have a more complete understanding of the current marketplace," Robert E. Brackett, director of the FDA's Center for Food Safety and Applied Nutrition, wrote in a letter released Tuesday.

The FDA's letter was criticized by the Environmental Working Group, which wants the agency to warn the public about soft drinks that contain two ingredients -- ascorbic acid and benzoate preservatives -- that can form benzene.

"Notably, they don't give us the data," Richard Wiles, the group's senior vice president, told the AP. "We simply asked them to disclose the results of their testing. If there's nothing to hide, why won't they show us numbers? It might be a small percentage, but there is some percentage of drinks that have very elevated levels of benzene."