U.S. Declares Public Health Emergency in Response to Swine Flu

(HealthDay News) -- U.S. health officials declared a public health emergency Sunday in response to the swine flu outbreak, as the number of confirmed cases nationwide rose to 20. Read more

Experts Highlight Inroads to Preventing Cancer

(HealthDay News) -- Scientists looking at everyday factors that influence cancer risk are finding important new clues that could affect cancer prevention strategies.

"Many of us believe that prevention is better than trying to identify drugs for people after they get cancer," said Dr. Peter Shields, deputy director of the Lombardi Comprehensive Cancer Center and interim chairman of the Department of Medicine at Georgetown University Medical Center in Washington, D.C. "As we understand risk factors better, it may be possible to personalize cancer prevention."

Shields moderated a Monday teleconference highlighting cancer prevention-related findings that are being presented at the annual meeting of the American Association for Cancer Research, in Denver.

One study found that two common gene variants do not protect individuals from the ill effects of smoking.

In the study, smoking boosted the odds for the two most common types of colorectal polyps: adenomas and hyperplastic polyps, although the association was stronger in the latter.

People who had smoked a pack of cigarettes a day for a year had a 68 percent increased risk for adenomas but a 238 percent increased risk for hyperplastic polyps. Those still smoking had the same risk for adenomas as former smokers but a more than threefold increased risk for the second type of polyp.

Polyps can be precursors to colon cancer, but if they're detected early, the disease can often be prevented.

There was also a slight though not statistically significant risk from "charred" (well done) meat.

"Susceptibility to smoking did not vary by this gene, and everyone needs to be concerned [about the risk of smoking]," said Andrea N. Burnett-Hartman, a doctoral student at the Fred Hutchinson Cancer Research Center in Seattle.

"This gene is not going to protect you from the carcinogenic effects of smoking, at least in colorectal tissue," she said. In terms of meat consumption, she added that "everything in moderation" remains a good rule.

Another study found that specific genetic variations in the cox-1 and cox-2 genes indicate different risks for colorectal cancer. This might help determine who would benefit from the cancer-prevention benefits of nonsteroidal anti-inflammatory drugs (NSAIDs).

Although NSAIDs, including aspirin and cox-2 inhibitors, have been shown to reduce the risk of colorectal cancer, that benefit may be nullified by an increased risk of heart disease seen in some cox-2 inhibitors such as Vioxx, which was removed from the market.

Other findings being presented at the society's meeting include:

• A tool that looks simultaneously at several genetic variants and family history might more accurately predict who is at risk for prostate cancer and who could benefit from more aggressive prevention efforts. Men who had at least 15 of the gene variants included in the tool were found to have a 34 percent increased risk of developing prostate cancer in a 20-year span, or 45 percent increased risk if they had a family history of the disease. But without the combination of genetic information, their risk would have been estimated at only 13 percent.
• Rats born to mothers who had been given folic acid supplementation during and after pregnancy were found to have experienced changes in DNA methylation in both the liver and the colon. DNA methylation is a process whereby genes can be turned off or on. Folic acid is recommended before and during pregnancy to prevent neural tube defects in babies. Folic acid intake in North America has soared since these recommendations were implemented in 1998.
• Abnormal collections of cells were found in the blood of 38 percent of people with chronic lymphocytic leukemia (CLL) as early as 10 years before their diagnosis -- something that could be a clue in the so-far fruitless search for causes of the disease. "Apparently, these cells are cranking out proteins years before people get CLL," said Dr. Neil Caporaso, a section chief at the U.S. National Cancer Institute. "We can try to understand what causes people to get these abnormalities and, more importantly, what causes somebody to progress from having relatively benign protein abnormalities to developing leukemia. We can search for environmental agents and genes that could cause this next step."

More information
The American Cancer Society has more on preventing cancer.

Impotence Drugs Don't Harm Vision: Study

(HealthDay News) -- The erectile dysfunction drugs Cialis (tadalafil) and Viagra (sildenafil) didn't appear to damage vision in men who took the medications daily for six months, according to a drug company study.

These drugs, called selective phodiesterase type 5 (PDE5) inhibitors, treat erectile dysfunction by interfering with the action of the compound PDE5 in the blood vessels of the penis. But there are concerns that PDE5 inhibitors may also act on similar compounds in the retina, the part of the eye that receives and transmits images to the brain, according to background information in the study.

Men taking PDE5 inhibitors have reported mild and temporary blurred vision, altered light perception, and blue-tinged vision.

This Eli Lilly study included 244 men, ages 30 to 65, who were randomly selected to take either 5 milligrams of tadalafil, 50 mg. of sildenafil, or a placebo daily for six months. The men underwent thorough eye tests before, during and after treatment.

By the end of the study, the researchers found no significant differences in vision between the men who took the drugs and those who took the placebo. The findings were published in the April issue of the journal Archives of Ophthalmology.

"There are several reasons ophthalmologists need to be acquainted with the pharmacologic profiles of PDE5 inhibitors and their potential side effects," the authors wrote "The frequency of erectile dysfunction, which is a form of peripheral vascular disease that impairs men's abilities to achieve and maintain an erection, increases dramatically with age and in the presence of cardiovascular risk factors. Therefore, many men who take PDE5 inhibitors to treat their erectile dysfunction will also be followed up by ophthalmologists for ocular disorders such as diabetic retinopathy, macular degeneration and ocular vascular disease."




"Furthermore, PDE5 inhibitors can exert direct effects on the retina, and such effects probably account for many of the visual side effects such as blue-tinged vision and light sensitivity that have been reported," they concluded.

But they said their "results indicate that there is no cumulative damage or effect of clinical significance for either 5 milligrams of tadalafil or 50 milligrams of sildenafil taken daily for six months."

More information
The American Urological Association has more about erectile dysfunction.

A Creamy Treat for "Lungevity"

Step one for preventing lung cancer: say no to tobacco. Step two: have a tablespoon of . . . Read more.

Nicotine Replacement May Help Smokers Quit Gradually

(HealthDay News) -- For smokers who want to cut down on the number of cigarettes they smoke, using nicotine replacement therapy not only helps them smoke less but makes it twice as likely that they will quit altogether, British researchers report.

Although using nicotine replacement therapy -- such as gum, inhalers, patches and lozenges -- as a way to reduce smoking is approved in Britain and other countries, it remains unapproved and controversial in the United States. Some think it sends the wrong message -- that cutting down on smoking is OK. Others think that because tobacco companies make other nicotine delivery devices, this approach is merely a boon to the tobacco industry.

"We looked at papers that took people who said, 'I don't want to stop smoking, but I am prepared to reduce my smoking,' " said lead researcher Dr. Paul Aveyard, from the School of Health and Population Sciences at the University of Birmingham. They were given either a nicotine replacement product or a placebo, "and twice as many in the active treatment groups quit smoking compared with the placebo side," he said.

The results are similar to studies on the use of nicotine replacement therapy among people who said they wanted to quit.

In addition, Aveyard said, there were no serious adverse effects from the use of nicotine replacement while people continued to smoke.

The findings were published online April 3 in BMJ.

For the study, Aveyard's team reviewed seven studies that compared the use of nicotine gum or inhalators with placebos to see which was more effective in gradually getting smokers to quit. The studies included a total of 2,767 people.

Over six to 18 months, 6.75 percent of those using nicotine replacement stopped smoking for six months -- double the proportion of those using placebos. The researchers said it meant that 3 percent of smokers quit who otherwise would not have.

Participants in the studies who used nicotine replacement also received regular behavioral support and monitoring, and the researchers said that this support may have been as important as the nicotine replacement itself.

Aveyard said that use of nicotine replacement would allow treatment of many more smokers than the small number who say they want to quit. "It potentially opens the door to treat almost all smokers with treatments that were formally reserved for people who are wanting to quit right now," he said.

Because most nicotine replacement drugs are available over-the-counter but are not approved in the United States for smoking reduction, Aveyard suggests that people who want to try this approach should first consult with their doctor.

Dr. Norman H. Edelman, chief medical officer of the American Lung Association, predicted that the topic is going to be widely discussed in the United States.

"In Britain, they are a little bit ahead of us," Edelman said. "Right now, the FDA approval for nicotine replacement therapy is as an aid to cessation. The next issue is whether we should use nicotine therapy to reduce smoking without worrying about whether people quit or not."

The American Lung Association says that it should be used to help people quit smoking, but the group has "not adopted the idea of using nicotine replacement therapy for risk reduction," Edelman said.

And whether the Food and Drug Administration will approve its use to cut down on smoking is unclear, he said.

"It's a hot potato topic," Edelman said. "Cigarette companies are manufacturing nicotine delivery devices of all kinds, and there is a tendency to be negative about that. Nobody feels kindly disposed to letting tobacco companies make nicotine delivery devices."

And using nicotine replacement to reduce smoking sends the message that you can benefit by just smoking less, and "the American Lung Association is very opposed to that," Edelman said. "We do not support risk reduction by just smoking fewer cigarettes."

In a related article in the Journal of Thoracic Oncology, researchers reported that programs to help people quit smoking are cost-effective even for people with lung cancer.

A research team led by Dr. Christopher Slatore, from the University of Washington in Seattle, found that a smoking cessation program started before lung resection surgery was cost-effective both one and five years after surgery. They based their analysis on length of survival and improvement in the person's quality of life.

Although the results of the study apply only to people eligible for resection, all lung cancer patients should take part in smoking cessation programs, the researchers concluded.

More information
The American Lung Association has more on quitting smoking.

FDA Investigating Salmonella-Tainted Pistachios

(HealthDay News) -- U.S. Food and Drug Administration officials said Monday night that the agency is investigating a salmonella contamination that could involve 1 million pounds of pistachios that were sold in at least 31 states.

The current contamination is not connected to the recent salmonella scare involving peanuts, the officials said.

"We are not dealing with an outbreak here," Dr. David Acheson, associate commissioner for foods at the FDA, said during a teleconference Monday evening. "This is a proactive move by the firm to recall contaminated product, and it is very distinctly not linked to an outbreak. This recall is being undertaken by sampling by part of the food industry."

The California Department of Public Health is also involved in the investigation.

The company in question, Setton Farms, is recalling certain pistachio nuts based on these findings, Acheson said. Investigators are honing in on pistachios packaged in a plant in Terra Bella, Calif.

"These findings came to light because of testing that another company was doing as part of routine analysis in which they found a variety of different types of salmonella. Based on this, they contacted the FDA," he said.

On March 24, Kraft Foods alerted the FDA and started a recall of its Back to Nature Nantucket Blend trail mix, Acheson said.

Setton Farms supplies pistachios in large quantities to 36 wholesalers who repackage them or resell them, Acheson said.

"The number of products that are going to be recalled over the coming days will grow simply because these pistachios have been repackaged to consumer level containers," Acheson said.

Setton Farms also supplied pistachios to grocer Kroger Co., which has already issued a recall, Acheson said. Those nuts were sold in 31 states, the Associated Press reported.

There have been some consumer complaints about these products, Acheson said. "That does mean definitively that they caused illness. Some consumers developed gastrointestinal illness, and called [the] FDA," he said.

The agency is recommending that people avoid eating any pistachio products. However, they should hold on to these products until it's clear which ones are affected, Acheson added.

This is not the first time this year that nut products have been found to be tainted with salmonella.

In January, U.S. officials launched a criminal investigation into a salmonella outbreak tied to tainted peanut products that sickened almost 700 people and may have contributed to at least nine deaths. The probe will focus on possible criminal violations at the Georgia processing plant owned by Peanut Corp. of America (PCA), which knowingly shipped peanut butter and peanut paste products that had tested positive for salmonella, officials said at the time.

And just last month, FDA officials issued a warning that consumers shouldn't eat any peanuts or peanut products sold by Westco Fruit and Nuts Inc. because they may be contaminated with salmonella. Peanuts used in the Westco products may have come from PCA, officials said.

More information
For more on salmonella, visit the U.S. Centers for Disease Control and Prevention.