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	<title><![CDATA[Health ]]></title>
	<copyright>Copyright 2009 </copyright>
	<link>http://www.komonews.com/news/health</link>
	 			<description><![CDATA[ ]]></description>
		<language>en-us</language>
	<pubDate>Sat, 7 Nov 2009 09:31:22 PST</pubDate>
	<lastBuildDate>Sat, 7 Nov 2009 09:31:22 PST</lastBuildDate>
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			<title><![CDATA[Some King Co pharmacies offering swine flu vaccine]]></title>
												<link>http://www.komonews.com/news/health/69437632.html</link>
						<pubDate>Fri, 6 Nov 2009 19:35:49 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[SEATTLE -- King County Public Health is offering the H1N1 vaccine at select area pharmacies to those at high risk for the swine flu. 

Due to the national shortage of swine flu vaccine, health officials said each pharmacy will only receive a few hundred doses to be administered only to those at a higher risk for the illness. As more vaccine becomes available, however, the pharmacies will be replenished, they said. 

Those seeking immunization against swine flu will be asked to first complete a screening form at the pharmacy. Those at a higher risk of swine flu include' 

 - Pregnant women 
 - Those who live with children younger than 6 months
 - People between 6 months and 24 years old
 - People between 25 and 64 with chronic health conditions or weakened immune systems 

Pregnant women, babies and children under 2 will be given an injection, officials said, while the rest in the high-risk group will be given the nasal spray form of the vaccine. 

Officials added many of the pharmacies will not be able to vaccinate babies or children as their staff members are not licensed or trained for dealing with young patients. 

The vaccine will cost $22 or less, and the fee may be covered by some insurance companies, officials said. 

To view a complete list of the pharmacies offering the H1N1 vaccine, and to see which ones are offering the vaccine to young recipients, click here.]]></description>
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			<title><![CDATA[New gene therapy halts 2 boys' rare brain disease]]></title>
												<link>http://www.komonews.com/news/health/69320042.html</link>
						<pubDate>Thu, 5 Nov 2009 14:22:22 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - French scientists mixed gene therapy and bone marrow transplants in two boys to seemingly halt a brain disease that can kill by adolescence.

The surprise ingredient' They disabled the HIV virus so it couldn't cause AIDS, and then used it to carry in the healthy new gene.

The experiment marks the first time researchers have tried that long-contemplated step in people - and the first effective gene therapy against a severe brain disease, said lead researcher Dr. Patrick Aubourg of the University Paris-Descartes.

Although it's a small, first-step study, it has "exciting implications" for other blood and immune disorders that had been feared beyond gene therapy's reach, said Dr. Kenneth Cornetta, president of the American Society of Gene and Cell Therapy.

"This study shows the power of combining gene therapy and cell therapy," added Cornetta, whose own lab at Indiana University has long researched how to safely develop gene delivery using lentiviruses, HIV's family.

The research was published in Friday's edition of the journal Science.

In 20 years of gene therapy research, there have been few home runs and some headline-making setbacks - including a risk of leukemia caused by otherwise successful gene therapy for another rare disorder, "bubble boy disease." That's a risk that specialists hope a lentivirus-based gene therapy will eliminate.

Best known from the movie "Lorenzo's Oil", adrenoleukodystrophy, or ALD, is a rare genetic disease that, in its most devastating form, destroys the coating of nerve fibers in boys' brains. Without that coating, called myelin, the neurological system breaks down. The disease typically strikes between the ages of four and 10, leading to blindness, deafness, dementia and loss of muscle control, and killing them within a few years.

Bone marrow transplants can halt ALD by letting new myelin-forming stem cells take root. But it's difficult to find a matching marrow donor, and the transplant itself is very risky.

So what if stem cells from the boys' own bone marrow could be genetically corrected, eliminating the ALD mutation? To do that, Aubourg's team had to overcome a technical hurdle' Gene therapy works when scientists harness deliver a healthy new gene by attaching to a virus that can harmlessly infect cells. But none of today's so-called gene therapy "vectors" could penetrate enough of the stem cells needed for an ALD treatment to work.

Unlike most viruses, HIV can penetrate stem cells, and it sticks permanently. So Aubourg's team removed the genetic parts of HIV that make it dangerous, leaving basically a scaffolding to carry the new therapeutic gene.

Then they culled stem cells from two 7-year-old boys in the early stages of ALD, and mixed in the healthy gene. The boys underwent bone marrow-destroying chemotherapy and then had their genetically corrected stem cells reinserted.

Two years later, the boys have shown no sign of worsening brain damage and are functioning well with 15 percent of their blood cells producing the healthy protein, said Aubourg, who plans to test the experimental procedure in more patients. An advocacy group, the Stop ALD Foundation, is working to raise money for a similar U.S. study.]]></description>
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			<title><![CDATA[WHO: Swine flu virus is top strain worldwide ]]></title>
												<link>http://www.komonews.com/news/health/69288632.html</link>
						<pubDate>Thu, 5 Nov 2009 8:39:23 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[LONDON (AP) - The World Health Organization's flu chief said the swine flu virus has now become the predominant flu strain worldwide.

In some countries, swine flu accounts for up to 70 percent of the flu viruses being sampled, said Dr. Keiji Fukuda, WHO's top flu official.

While most people recover from the illness without needing medical treatment, officials are also continuing to see severe cases in people under 65 - people who are not usually at risk during regular flu seasons.

"We remain quite concerned about the patterns that we're seeing," Fukuda said during a press briefing Thursday.

He said the swine flu virus appeared to be fairly stable, and that samples from around the world remained very similar to when the virus was first identified in April.

Regarding the recent surge of cases in the Ukraine - which has reported more than 250,000 cases and 70 deaths of people with flu-like illness in recent weeks - Fukuda said the virus appeared no different there than anywhere else.

"We just simply have to understand that influenza can cause outbreaks in very large numbers of people," he said. "Patterns can be quite different from country to country."

Fukuda said the agency was also monitoring the impact of the virus on particularly susceptible populations.

On Wednesday, Venezuelan officials reported that swine flu had hit the Yanomami Indians, killing seven people in a population of 28,000.

Fukuda said WHO had observed that aboriginals in Australia were disproportionately hit by swine flu, but could not say whether they were more genetically vulnerable to the virus or if that was due to underlying health problems.

With swine flu vaccination programs now under way in more than 20 countries, Fukuda said no rare or dangerous side effects had been reported, and the agency was convinced the vaccine was "highly safe."

Fukuda said WHO had been surprised that the vaccine appeared to work after just one dose, but was happy about it because that mean the world's vaccine supplies could be stretched.

Even in children under 10, Fukuda said WHO recommended that one dose could be effective. Some countries, including the U.S., are recommending that children get two doses of the swine flu shot.

"It is better to provide one dose to as many children as possible rather than two doses to fewer children," Fukuda said.
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			<title><![CDATA[Old method of heart bypass better than 'off-pump' ]]></title>
												<link>http://www.komonews.com/news/health/69288572.html</link>
						<pubDate>Thu, 5 Nov 2009 8:37:50 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[NEW YORK (AP) — It seemed like a great idea — doing bypass surgery while the heart is still beating, sparing patients the complications that can come from going on a heart-lung machine. Now the first big test of this method has produced a surprise' Bypass has fewer problems and is more successful done the old way.

Most surprisingly, there were no signs of mental decline in those on the machines. Avoiding this problem was thought be one of the benefits of so-called "off-pump" surgery without a machine.

"For the vast majority, there's no advantage to doing it off-pump and there may be some disadvantages," said Dr. Frederick Grover of the University of Colorado Denver, one of the leaders of the study.

Heart bypass is believed to be the most common surgery in the world — an estimated 253,000 Americans have the operation each year. Traditionally, the surgery is done while the patient is hooked up to a heart-lung machine which takes over the job of circulating blood while the beating heart is stopped. That "on-pump" method makes it easier for surgeons to attach new arteries or veins to create detours around clogged arteries.

But the heart-lung machine carries a small risk of complications, including stroke. In the 1990s, surgeons began doing off-pump surgery — without the machine but with devices that stabilize the beating heart.

Today, about one in five bypasses are done off-pump, and it's been hotly debated which is better. Earlier, small studies have suggested outcomes were about the same, or gave a slight advantage to off-pump. The debate got attention when former President Bill Clinton had quadruple bypass with a heart-lung machine in 2004. Patients sometimes are offered a choice of methods.

The research reported in Thursday's New England Journal of Medicine is the largest to date to compare the two techniques in a rigorous manner. The study involved 2,203 patients at 18 Veterans Affairs medical centers.

About half were randomly assigned to bypass surgery with a heart-lung machine, half without.

A month after surgery, there was no difference in the number of deaths or other complications in the two groups.

But a year later, the off-pump group had worse outcomes. About 10 percent had either died, had a heart attack or needed another bypass or procedure to open a blocked artery, compared to about 7 percent of the on-pump group.

Also, the off-pump group got fewer artery detours than originally planned and fewer of their bypasses were still open after a year, about 83 percent versus 88 percent for on-pump. Because the heart is full of blood during off-pump surgery, it's harder to reach and repair the arteries at the back of the heart, Grover explained.

Some patients were given a battery of mental tests before surgery and after a year; there was no mental decline in either group.

"We always have the idea that less is more — less invasive or less anything seems to be a better answer. That isn't always the case," said Dr. Eric Peterson, a heart doctor at Duke University Medical Center.

Peterson, who wrote a journal editorial, said it was "a remarkably well-done study" but won't end the debate.

There may be some types of patients for whom off-pump bypass is beneficial, Grover and Peterson said. Previous research has suggested that women, the elderly and those with other illnesses may do better off-pump. The VA-funded study was mostly men who were younger and healthier than the typical bypass patient, Peterson noted.

Because of the results, Grover said he's become more conservative about doing off-pump bypass on his patients. But he thinks surgeons who do a lot of off-pump bypasses and are strong believers will probably stick with it.

"It is a good study for' Should America adopt this? And the answer to that is probably not," said Peterson.]]></description>
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			<title><![CDATA[FDA launches plan to curb accidental overdoses]]></title>
												<link>http://www.komonews.com/news/health/69288267.html</link>
						<pubDate>Thu, 5 Nov 2009 8:33:03 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - The Food and Drug Administration is launching a program to try and prevent millions of accidental drug overdoses that occur each year due to medication errors, misuse and other problems.

Under the plan announced Wednesday, the FDA will work with physicians to identify the types of drugs that pose the greatest risks to patients.

Proposals to improve safety include' simplifying drug labeling, standardizing dosage cups for cold medicines and requiring risk-management plans of drug manufacturers.

The agency will hold several public meetings to gather comments and plans to start its first initiatives within the next 12 months.

"All participants in the health care community have a role to play in reducing the risks and preventing injuries from medication use," said Dr. Janet Woodcock, director of the FDA's drug center.

The FDA says medication errors send 4 million Americans to the emergency room each year, resulting in 117,000 hospitalizations.

Federal regulators have made numerous attempts to curb drug overdoses in the past. Earlier this year, the FDA sent letters to the makers of two dozen powerful painkillers - including morphine, codeine and methadone - ordering them to develop plans to reduce the misuse of their drugs.

But the agency said Wednesday its so-called Safe Use initiative will take "a more coordinated, systematic manner, with interventions across all sectors of the medication distribution and use system."

One problem the agency hopes to address is liver damage caused by acetaminophen, the active ingredient in Tylenol and other over-the-counter pain relievers. Those medications cause an estimated 55,000 trips to the emergency room annually, according to federal data. Other issues include preventing operating room fires started by alcohol-based surgical solutions.

"Too many people suffer unnecessary injuries from avoidable medication misuse, errors and other problems. The FDA is launching the Safe Use Initiative to develop targeted solutions for reducing these injuries," FDA Commissioner Margaret Hamburg said in a statement.]]></description>
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			<title><![CDATA[Officials: Swine flu confirmed in Iowa cat]]></title>
												<link>http://www.komonews.com/news/health/69126827.html</link>
						<pubDate>Wed, 4 Nov 2009 10:41:43 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[DES MOINES, Iowa (AP) - The swine flu virus has been confirmed in a cat treated at the Iowa State University College of Veterinary Medicine.

Officials said Wednesday it's the first known case of the virus to be diagnosed in a cat. Veterinarians say the virus has also been confirmed in two ferrets, one in Oregon and the other in Nebraska.

The 13-year-old cat was treated in Ames, Iowa, and is recovering.

The veterinarian who treated the cat, Dr. Brett Sponseller, says two of the three people in the same house had flu-like symptoms before the cat became ill.

The case was confirmed at both Iowa State and the U.S. Department of Agriculture.

Sponseller says the flu is known to spread from humans to pets, but this is the first case of swine flu to spread to a cat.]]></description>
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			<title><![CDATA[Low cholesterol may prevent some prostate cancers]]></title>
												<link>http://www.komonews.com/news/health/68914002.html</link>
						<pubDate>Tue, 3 Nov 2009 11:51:51 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[Men may protect more than their hearts if they keep cholesterol in line' Their chances of getting aggressive prostate cancer may be lower, new research suggests.

One study found that men whose cholesterol was in a healthy range - below 200 - had less than half the risk of developing high-grade prostate tumors compared to men with high cholesterol.

A second study found that men with lots of HDL, or "good cholesterol," were a little less likely to develop any form of prostate cancer than men with very low HDL.

Both studies were published Tuesday in Cancer Epidemiology Biomarkers & Prevention, a journal of the American Association for Cancer Research.

The two studies are not definitive and have some weaknesses. Yet they fit with plenty of other science suggesting that limiting fats in the bloodstream can lessen cancer risk.

"There might be this added benefit to keeping cholesterol low," said Elizabeth Platz of Johns Hopkins University.

She led the first study, which looked at 5,586 men aged 55 and older who were in the placebo group of a big federal cancer prevention study done in the 1990s.

Cholesterol levels made no difference in the odds of getting prostate cancer except for the 60 men who developed high-grade tumors, the type that grow and spread fast. The chance of developing one of these aggressive tumors was 59 percent lower among men with cholesterol under 200.

That's "a striking reduction in risk," Eric Jacobs and Susan Gapstur, epidemiologists with the American Cancer Society, write in an accompanying editorial.

Now for the caveats' Researchers do not know how many men in the study were taking statin drugs such as Lipitor, Zocor or Crestor. That means some of the reduced cancer risk could have come from these cholesterol-lowering medicines instead of from low cholesterol by itself.

Previous reports also suggest that statins can lower cancer risk, but it's premature to take them for this reason until better studies are done, doctors advise. Statins have long been known to prevent heart disease, and nothing about the new research changes that.

The second study involved more than 29,000 Finnish men more than a decade ago. The men, all smokers, were testing whether various vitamins and nutrients could lower their cancer risk.

Those with highest levels of HDL were 11 percent less likely to develop prostate cancer than those with lowest levels, said study leader Dr. Demetrius Albanes of the National Cancer Institute.

Prostate cancer is the most common cancer in American men. More than 192,000 new cases are expected to occur in the United States this year, leading to an estimated 27,360 deaths.]]></description>
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			<title><![CDATA[New vaccine offers hope in Africa's malaria battle]]></title>
												<link>http://www.komonews.com/news/health/68866607.html</link>
						<pubDate>Tue, 3 Nov 2009 8:41:34 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[SIAYA, Kenya (AP) — A mother watched with dread as a nurse inserted a tube in her baby's head. Blood streamed into the anemic 4-month-old who already has malaria, the mosquito-borne disease that kills a million African children every year.

"Malaria is one of the deadliest sicknesses for children," the nurse said — words that sent the young mother into a crumpled heap on the bed beside her wide-eyed baby boy, wrapped in a blue-and-yellow floral blanket.

There is new hope, however, in this verdant area where President Barack Obama's relatives live. A vaccine that appears to be able to prevent the disease in about 50 percent of children, is now undergoing the final stage of testing.

If regulators determine the vaccine is safe, it could be on the market in three to five years — the first vaccine against a human parasite.

Tens of millions of Africans are plagued by malaria every year, and more than a third of the hospital beds in this rural Kenyan region next to Lake Victoria are dedicated to its victims. More than 1 million children die of the disease in Africa annually, a crippling economic drain that prolongs a cycle of disease and poverty throughout the continent.

Malaria is also prevalent in parts of Asia, the Middle East and Central and South America.

This vaccine was developed specifically for Africa, however, and will only prevent the African strain of the disease. Experts say it would be a historic advancement.

"Some may say, '50 percent, that's not great.' And that's true. If you get a measles vaccine, you're not going to get measles again," said Dr. Dave Jones, a U.S. Army colonel and director of a clinic in nearby Kombewa operated by the Walter Reed Army Institute of Research and the Kenya Medical Research Institute.

"But at the same time, when you consider we lose 1 million kids a year, if you could cut that in half it would be a great step forward."

Experts from around the globe are meeting in the Kenyan capital, Nairobi, this week as part of the fifth pan-African malaria conference, and a news conference on the vaccine trial is scheduled for Tuesday.

More than $500 million has been spent on the combined efforts by drug maker GlaxoSmithKline and the PATH Malaria Vaccine Initiative, which is funded by the Bill & Melinda Gates Foundation. The Phase III testing is being done at 11 sites in seven African countries on 16,000 children under the age of 18 months.

The goal is to immunize children against malaria during their youngest high-risk years, and then for them to develop their own natural immunities as they age.

At the spartan, open-air clinic in Kombewa last week, Patrician Mrunde, a 34-year-old mother of six, sat in the hallway with her youngest, 6-month-old Linda, who was waiting to receive a shot as part of the trial.

Mrunde has seen her eldest child stricken with fever and lapse into convulsions from malaria, and a young relative die from it.

"I decided to join the study to get help for the disease," she said.

Dr. Allen Otieno, a 38-year-old pediatrician, said "everybody is afraid" of malaria in the region. He called the new vaccine promising. "As scientists we have great hope that it will reduce the burden of malaria," he said.

Joe Cohen, a top researcher for GlaxoSmithKline, said all the data collected during testing have been encouraging.

The 66-year-old Cohen, who has been working on a malaria vaccine for two decades, said the trial results will be submitted to regulators in 2012, and that a vaccine could be on the market shortly afterward.

No prices have been set for the vaccine, Cohen said, though families in Africa may not have to pay anything for it because the Gates Foundation, UNICEF, WHO and the GAVI Alliance would provide funds.

GlaxoSmithKline "is committed to making sure pricing will never be a barrier to access for this vaccine," Cohen said.

The vaccine has been in development for more than 20 years through the combined efforts of GlaxoSmithKline, the Malaria Vaccine Initiative, the Walter Reed Army Institute of Research and others.

"No single person could have ever achieved this," Cohen said. "That's the lesson that should be taken out of the collaboration."

Malaria is caused by a parasite and spreads through a bite from an infected mosquito. The parasite travels quickly to the liver where it matures, enters the bloodstream and causes fever, chills, flu-like symptoms and anemia. The vaccine is designed to attack the parasite before it can infect the liver.

Until now, the main line of defense in preventing the disease has been distribution of bed nets and mosquito spraying.

Jonathan Odro Anyumba, chairman of the board of the Kombewa district hospital, said malaria is a huge burden in this verdant area of Kenya, where many live in mud huts and collect water in plastic jugs from flowing streams.

Families must sleep under nets to protect against the disease, though many don't have any. Even half the beds at his hospital don't have nets, Anyumba said.

"When you visit these areas you'll find that each and every child has malaria. Thirty to 50 percent of the deaths in this community are from malaria," he said. "I think this vaccine is going to be very, very useful."]]></description>
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			<title><![CDATA[Poor countries see troubling rise in breast cancer]]></title>
												<link>http://www.komonews.com/news/health/68867817.html</link>
						<pubDate>Tue, 3 Nov 2009 8:45:56 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - Nurses were training women in rural Mexico to examine their breasts for cancer when one raised her hand to object. If she lost her breast, Harvard public health specialist Felicia Knaul recalls the woman saying, "My man would leave me" - and with him, the family's income.

International cancer specialists meet this week to plan an assault on a troubling increase of breast cancer in developing countries, where nearly two-thirds of women aren't diagnosed until it has spread through their bodies.

Adding to the problem, some worrisome data suggests that breast cancer seems to strike women, on average, about 10 years younger in poor countries than it does in the U.S. No one knows why.

"Today in most developing countries you see a huge bulge of young, premenopausal women with breast cancer," says Knaul, who heads Harvard's Global Equity Initiative and was herself diagnosed at age 41 while living in Mexico.

"We should help them to know what they have and to fight for their treatment."

But from Mexico to Malawi, stigma like Knaul witnessed a few weeks ago may prove as big a barrier as poverty.

"One of the trainers said, 'If he'd leave you for that, he's not worth having,'" Knaul says. But she acknowledged that will be a hard message for some women's economic realities.

"It's not a trivial consideration," agrees Dr. Lawrence Shulman of the Dana Farber Cancer Institute, who is part of a team working to begin cancer care in parts of Africa where "the women are often seen as really either vessels for producing children or as sex slaves."

But some success in treating HIV and tuberculosis in those areas has him "hopeful we can make a difference. I don't think it's a pipe dream."

Knaul and Shulman on Tuesday were bringing together an international task force of health specialists and prominent charities to begin planning a two-pronged approach.

First, train midwives and other rural health providers to perform regular breast exams, using the power of touch in places where mammography machines simply are too expensive. That won't catch the very smallest tumors, but specialists agree it could improve diagnosis dramatically in some areas.

Second, the task force will start negotiating lower prices for generic chemotherapy for poor countries, following the same model that has helped transform AIDS care in parts of Africa.

You don't need in-country cancer specialists to administer that chemo, says Shulman - just a network of oncologists who can provide help or instruction to local health officials by e-mail or phone, as he has advised colleagues in Malawi.

Breast cancer long has been considered a cancer mostly of wealthier countries. Indeed, about 192,000 new cases are expected in the U.S. this year, where long-term survival is high thanks in part to good screening.

The true prevalence in most developing countries is unknown, because of poor diagnosis and bad record-keeping. But new Harvard research estimates they'll be home to 55 percent of the world's 450,000 expected breast cancer deaths this year.

The report predicts the poorest countries will experience a 36 percent jump in breast cancer by 2020.

One problem' In wealthy countries, earlier diagnosis can lead to breast-saving surgery instead of breast removal. Even countries like Rwanda and Malawi have clinics that perform mastectomies if patients can travel to the capitals, Shulman says. But few have radiation equipment, making breast-conserving surgery there not an option yet. (He is hunting a radiation unit for Rwanda but says that's in the very earliest stages of planning.)

Mexico is a mixed situation, with radiation, other treatments and diagnostic mammography available in some places. That's how Knaul - whose husband is a former health minister of Mexico - was diagnosed, early enough that mastectomy and chemotherapy give her good odds.

But she fumes that while Mexico's poor and rural women often get Pap smears to check for cervical cancer, "no one even suggests they check your breasts" at the same visit. She founded an advocacy group - Cancer de Mama - to help, noting that Mexico's insurance program for the poor covers breast cancer care but they must get diagnosed first.]]></description>
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			<title><![CDATA[Premature births worsen US infant death rate]]></title>
												<link>http://www.komonews.com/news/health/68864972.html</link>
						<pubDate>Tue, 3 Nov 2009 8:38:05 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[ATLANTA (AP) — Premature births, often due to poor care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries, a government report said Tuesday.

About 1 in 8 U.S. births are premature. Early births are much less common most of Europe; for example, only 1 in 18 babies are premature in Ireland and Finland.

Poor access to prenatal care, maternal obesity and smoking, too-early cesarean sections and induced labor and fertility treatments are among the reasons for preterm births, experts said.

Premature babies born before 37 weeks tend to be more fragile and have under-developed lungs, said the lead author of the new report, Marian MacDorman of the U.S. Centers for Disease Control and Prevention.

Premature births are the chief reason the U.S. ranks 30th in the world in infant mortality, with a rate more than twice as high as infant mortality rates in Sweden, Japan, Finland, Norway and the Czech Republic. For several years, the U.S. has ranked poorly among industrialized nations. MacDorman's report scrutinizes the reasons for that.

If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant births could be avoided and the U.S. infant mortality rate would be about one-third lower than it is, according to a calculation by MacDorman and others at the CDC's National Center for Health Statistics.

Why so many more premature infants here? Experts offered several possible explanations'

—Fertility treatments and other forms of assisted reproduction probably play a role because they often lead to twins, triplets or other multiple births. Those children tend to be delivered early.

—The U.S. health care system doesn't guarantees prenatal care to pregnant women, particularly the uninsured, said Dr. Alan R. Fleischman, medical director for the March of Dimes.

—Maternal obesity and smoking have been linked to premature births and may also be a factor.

—Health officials are also concerned that doctors increasingly are inducing labor or performing C-sections before the 37th week. However, Fleischman said most infant deaths do not occur in babies just shy of 37 weeks gestation, but rather in those much younger,

Labor was induced in nearly 16 percent of premature births in 2006, up from about 8 percent in 1991. Cesarean sections were done in 36 percent of preterm births, up from 25 percent in 1991, MacDorman said.

The report used 2005 statistics to make comparisons to 14 European countries. There is more recent data' International infant mortality statistics for 2006 and 2007 indicate that since 2000, the U.S. rate has stood at about 7 infant deaths for every 1,000 live births.

The report also found that while the United States more commonly saw premature births, survival rates for infants at that gestational age were as good or better than most European countries.

"So, once the baby is born too early, we do a good job of saving it. What we have trouble with is preventing the preterm birth in the first place," MacDorman said.]]></description>
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