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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>Sun, 22 Nov 2009 09:25:49 PST</pubDate>
	<lastBuildDate>Sun, 22 Nov 2009 09:25:49 PST</lastBuildDate>
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			<title><![CDATA[Tamiflu-resistant swine flu cluster reported in NC]]></title>
												<link>http://www.komonews.com/news/health/70641302.html</link>
						<pubDate>Fri, 20 Nov 2009 11:54:03 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[ATLANTA (AP) - Health officials say four people in North Carolina have tested positive for a type of swine flu that's resistant to the drug Tamiflu.

It's the first cluster of that many cases seen in the U.S.

Health officials said Friday the four cases were reported at Duke University Hospital in Durham over the past six weeks.

Tamiflu is one of two medicines that help against swine flu. Health officials have been closely watching for signs that the virus is mutating, making the drugs ineffective.

About 52 resistant cases have been reported in the world since April, including 15 in the U.S. so far. Officials with the U.S. Centers for Disease Control and Prevention say almost all the U.S. cases have been isolated.



(Copyright 2009 by The Associated Press.  All Rights Reserved.)

 AP-NY-11-20-09 1432EST]]></description>
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			<title><![CDATA[Report: 20-somethings can go 2 years between Paps]]></title>
												<link>http://www.komonews.com/news/health/70631652.html</link>
						<pubDate>Fri, 20 Nov 2009 9:59:14 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - First mammograms. Now - in an apparent coincidence - Pap smears.

New guidelines by the American College of Obstetricians and Gynecologists say most women in their 20s can have a Pap smear every two years instead of annually to catch slow-growing cervical cancer.

The change comes amid a separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology.

The guidelines also say'

&bull; Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.

&bull; Women 30 and older should wait three years between Paps once they've had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.

&bull; Women with HIV, other immune-weakening conditions or previous cervical abnormalities may need more frequent screening.

Paps can spot pre-cancerous changes in the cervix in time to prevent invasive cancer, and widespread use has halved cervical cancer rates in the U.S. in recent decades. About 11,270 new cases will be diagnosed this year, and about 4,070 women will die from it, according to American Cancer Society estimates. Half of women diagnosed with cervical cancer have never had a Pap, and another 10 percent haven't had one in five years.

Cervical cancer is caused by certain strains of the extremely common sexually transmitted virus called HPV, for human papillomavirus. There is a new HPV vaccine that should cut cervical cancer in the future; ACOG's guidelines say for now vaccinated women should follow the same Pap guidelines as the unvaccinated.

But the updated guidelines reflect better understanding of HPV. Infection is high among sexually active teens and young adults. Women's bodies very often fight off an HPV infection on their own without lasting harm, although it can take a year or two. The younger the woman, the more likely that HPV is going to be transient.

Moreover, ACOG cited studies showing no increased risk of cancer developing in women in their 20s if they extended Pap screening from every year to every two years.

As for adolescents, ACOG said cervical cancer in teens is rare - one or two cases per million 15- to 19-year-olds - while HPV-caused cervical abnormalities usually go away on their own, and unnecessary treatment increases the girls' risk of premature labor years later.

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			<title><![CDATA[Comparison of Democratic health care bills ]]></title>
												<link>http://www.komonews.com/news/health/70701187.html</link>
						<pubDate>Sat, 21 Nov 2009 11:06:47 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[A comparison of the health care bills before Congress'

The Senate Democratic bill (Patient Protection and Affordable Care Act)'

WHO'S COVERED' About 94 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Illegal immigrants would not receive assistance.

COST' Coverage provisions cost $848 billion over 10 years.

HOW IT'S PAID FOR' Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 1.95 percent on income over $200,000 a year for individuals; $250,000 for couples. New 5 percent tax on elective cosmetic surgery. Cuts to Medicare and Medicaid. Excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees on employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.

REQUIREMENTS FOR INDIVIDUALS' Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.

REQUIREMENTS FOR EMPLOYERS' Not required to offer coverage, but medium and large companies would pay a fee if the government ends up subsidizing employees' coverage.

SUBSIDIES' Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.

BENEFITS PACKAGE' All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage' The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent.

INSURANCE INDUSTRY RESTRICTIONS' Starting in 2014' no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation' children up to age 26 can stay on parents insurance; no lifetime limits on coverage.

GOVERNMENT-RUN PLAN' A new federal insurance plan would be offered to compete against private carriers. The government would negotiate — not dictate — payment rates for medical providers. Unlike the House bill, states could opt out of the plan. It's not clear the proposal commands enough votes to survive, and it could be replaced by a standby system pushed by moderates that would not go into effect until it was clear individual states were experiencing a lack of competition among private companies.

HOW YOU CHOOSE YOUR HEALTH INSURANCE' Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Employees would be generally encouraged to keep their work-provided coverage.

DRUGS' Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.

CHANGES TO MEDICAID' Income eligibility levels likely to be standardized to 133 percent of poverty, which is $29,327 a year for a family of four, for all parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.

LONG-TERM CARE' New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST' Amendment expected to be offered on the Senate floor to strip the health insurance industry of its antitrust exemption.

The House bill (Affordable Health Care for America Act)'

WHO'S COVERED' About 96 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.

COST' The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.

HOW IT'S PAID FOR' $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers' concerns that the taxes would hit too many people and small businesses.

There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.

REQUIREMENTS FOR INDIVIDUALS' Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.

REQUIREMENTS FOR EMPLOYERS' Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt — a change from the original $250,000 level to accommodate concerns of moderate Democrats — and the penalty is phased in for companies with payrolls between $500,000 and $750,000.

Small businesses — those with 10 or fewer workers — get tax credits to help them provide coverage.

SUBSIDIES' Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE' Beginning in 2013 through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFITS PACKAGE' A committee would recommend a so-called essential benefits package including preventive services. Out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange.

INSURANCE INDUSTRY RESTRICTIONS' Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age.

GOVERNMENT-RUN PLAN' A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version — preferred by moderate lawmakers — would let the HHS secretary negotiate rates with providers.

CHANGES TO MEDICAID' The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.

DRUGS' Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.

LONG-TERM CARE' New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST' Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative.



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			<title><![CDATA[Military experiment seeks to predict PTSD]]></title>
												<link>http://www.komonews.com/news/health/70631337.html</link>
						<pubDate>Fri, 20 Nov 2009 9:52:59 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[TWENTYNINE PALMS, Calif. (AP) - Two days before shipping off to war, Marine Pfc. Jesse Sheets sat inside a trailer in the Mojave Desert, his gaze fixed on a computer that flashed a rhythmic pulse of contrasting images.

Smiling kids embracing a soldier. A dog sniffing blood oozing from a corpse. Movie star Cameron Diaz posing sideways in a midriff top. Troops cowering for safety during an ambush.

A doctor tracked his stress levels and counted the number of times he blinked. Electrode wires dangled from his left eye and right pinky finger.

Sheets is part of a military experiment to try to predict who's most at risk for post-traumatic stress disorder. Understanding underlying triggers might help reduce the burden of those who return psychologically wounded - if they can get early help.

PTSD is a crippling condition that can emerge after a terrifying event - car accident, sexual assault, terrorist attack or combat. It's thought to affect as many as one in five veterans returning from Afghanistan and Iraq.

Military doctors have been mystified as to why certain warfighters exposed to bombings and bloodshed develop paralyzing stress symptoms while others who witness the same trauma shake it off.

Studies on veterans and civilians point to some clues. Childhood abuse, history of mental illness and severity of trauma seem to raise a person's risk. Having a social net and a coping strategy appear to offer some protection.

However, none of the factors explored so far are reliable predictors.

"Right now, we can't determine with certainty who will and who won't develop PTSD," said Paula Schnurr, deputy executive director of the Department of Veterans Affairs' National Center for Posttraumatic Stress Disorder. "Perhaps with better measures, we can get closer."

Earlier this year, a quarterly publication from the national PTSD center found that studies to date have looked at only "a narrow band of the potential risk and resilience predictors" and that more work beyond surveys was needed.

New PTSD studies are using technology to try to get at the answer. Select Marine and Army units are undergoing a battery of physical and mental tests before deployment including genetic testing, brain imaging and stress exams. They are followed in war zones and upon return.

There's an urgency to detect early signs. Since the 2001 terrorist attacks, more than 1.8 million U.S. troops have fought in Afghanistan or Iraq. The Obama administration is weighing whether to increase forces in Afghanistan where violence has escalated in recent months.

Previously called shell shock, combat fatigue and post-Vietnam syndrome, PTSD was officially recognized as a mental disorder in 1980. Sufferers experience flashbacks, nightmares, sudden outbursts and social withdrawal and are sometimes haunted years after the trauma.

The ongoing wars have given scientists fresh opportunities to follow service members.

One autumn morning, a throng of Marines squeezed into a trailer at the Marine Corps Air Ground Combat Center in Southern California before deploying to Afghanistan. They belonged to the 3rd Battalion, 4th Marine Regiment - nicknamed the "Thundering Third."

"We're doing this not to make you better prepared to go do what you have to do in Afghanistan. We're not doing this to make your health any better," said Dr. William Nash, a retired Navy psychiatrist and study co-investigator. "We're doing this so that we can learn more about how to protect Marines from stress injuries like PSTD."

Nash asked how many have heard of PTSD. A half dozen raised their hands.

Who wants PTSD? "Right, nobody," he answered rhetorically.

The trailer soon buzzed like a factory, with Marines rotating from one test station to another in an assembly line. They donated blood, urine and saliva samples so researchers can search for genetic biomarkers that might play a role.

Groundbreaking research published last year on adult survivors of child abuse suggests that specific variations of a gene increased their chances of developing PTSD. Scientists believe there may be many other gene variants that contribute to PTSD risk.

Marines also underwent a blink test to gauge their startle response and neuropsychological screening. They filled out questionnaires and were interviewed by psychiatrists with a checklist to diagnose PTSD.

The work is funded by the Marine Corps, Veterans Affairs and Navy Medicine. Last year, about 1,000 Marines were recruited before leaving for Iraq.

This latest batch of 673 Marines who were tested during a two-week period in the fall headed to Afghanistan where they're sure to see more intense fighting. They will be followed up in the field by Navy corpsmen with special "stress first-aid" training to read early signals.

Researchers recently did six-month follow-up testing on some Marines who returned from Iraq. It will take time to analyze the results, said the study's lead investigator, Dr. Dewleen Baker of the VA San Diego Healthcare System.

Cmdr. Bryan Schumacher, the 1st Marine Division's top doctor, said the purpose of studying PTSD triggers is not to bar someone from service. If it turns out that something can be done to prevent it, those vulnerable could get special training to reduce their risk, he said.

Similar research is ongoing 1,300 miles away at the University of Texas at Austin where scientists have collected detailed health data from 178 soldiers from nearby Fort Hood who recently came back from Iraq. The base was the scene of a massacre on Nov. 5 when an Army psychiatrist opened fire, killing 13 people and wounding dozens more.

The shooting has not affected the research, which enrolled first-time deployed soldiers. Unlike the Marines, the soldiers filled out monthly questionnaires online while in combat that tracked their experiences such as whether they saw a roadside bomb go off or knew of a wounded buddy.

Before deployment, soldiers submitted a DNA sample, had an MRI scan of their brain and inhaled carbon dioxide as part of a stress reaction test.

Early results suggest soldiers who reacted more strongly to the CO2 test and who were exposed to more stress in the field showed greater PTSD symptoms, said chief researcher Michael Telch, of UT Austin's Laboratory for the Study of Anxiety Disorders.

The decision to volunteer in the Marine experiment was personal for Lance Cpl. Jaecob Kyllo. His grandfather fought in Korea and Vietnam and two uncles served in Operation Desert Storm. They spoke less afterward and would get irritated easily.

Kyllo said his uncles were diagnosed with PTSD and suspects his grandfather had it too.

"I've seen it before and it's not the most pleasant thing," said the 20-year-old from Seattle, who previously served in Iraq.

Melvin Carter, a 27-year-old Marine sergeant who had done three tours in Iraq, noticed buddies who were once laid-back turn angry after coming home. The Oakland, Calif., native copes with stress by laughing and cracking jokes.

Navy corpsman Benjamin Reinhardt was recently trained to look for signs of PTSD in 20 Marines attached to a mortar platoon. He likened his job to a school nurse. Marines confide in him about their innermost struggles. He thinks he can spot when someone is not himself.

"I tend to be reasonably observant with people's personalities. I can see changes," said the 21-year-old from upstate New York.

He added' "I hope none of us become PTSD casualties."

Sheets, a 22-year-old private first class from Newark, Del., has never seen combat before. Before joining the Marines, Sheets dabbled with college and was working a dead-end job hauling trash.

He enlisted after being inspired by a sermon from his pastor. While in infantry school, he met a sergeant who suffered from PTSD. He's not exactly sure what it is, but has heard horror stories.

"A guy comes home from war and he's freaking out. He's beating his wife. He's drinking. He's doing everything he can. He'll go off and he'll hate the Marine Corps," Sheets said. "And it's just like, OK, is that going to be me when I come home?"

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			<title><![CDATA[FDA panel backs safety, benefits of Spiriva]]></title>
												<link>http://www.komonews.com/news/health/70630837.html</link>
						<pubDate>Fri, 20 Nov 2009 9:45:49 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - Federal health experts on Thursday brushed off lingering safety questions about a popular inhaler drug and suggested it carry bolder benefit claims.

The Food and Drug Administration's panel of lung specialists voted 11-1 in favor of new labeling about the benefits of Boehringer Ingelheim's Spiriva Handihaler, which is approved to treat lung disease.

The FDA is not required to follow the group's advice though it usually does.

The German company submitted studies to the FDA showing Spiriva reduces specific side effects of chronic obstructive pulmonary disease, such as coughing, wheezing and shortness of breath.

"I thought both trials showed unequivocal evidence of benefit," said panelist Daren Knoell, a pharmacy professor at Ohio State University.

Boehringer said in a statement it was pleased with the panel's vote and would continue working with the FDA as it completes its review. A company spokeswoman declined to disclose the expected date for an FDA decision.

Spiriva is co-marketed in the U.S. by Pfizer Inc., the world's largest drugmaker.

While Thursday's meeting was prompted by Boehringer's request for bolstered labeling claims, FDA regulators also asked the panel to examine conflicting evidence about whether Spiriva increases the risk of heart attack, stroke and death.

An analysis of multiple studies published in the Journal of the American Medical Association last year suggested increased risks with the inhaler. But panelists said a more definitive, 6,000-patient trial by the company did not show increased death, and suggested it can actually reduce that risk.

Panelists voted 11-1 that the company's data "adequately address" concerns about increased stroke. They voted 11-0, with one abstention, that the same study addresses the issue of increased risk of heart attack.

Panel chair Dr. Mark Brantly said the company might eventually be able to win approval for a claim about the drug's lifesaving powers.

"We encourage this be pursued as an indication in the future as an important outcome," said Brantly, a professor of lung care at the University of Florida.
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			<title><![CDATA[Experts say radical measures won't stop swine flu ]]></title>
												<link>http://www.komonews.com/news/health/70524537.html</link>
						<pubDate>Thu, 19 Nov 2009 10:20:40 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[LONDON (AP) - Health experts say extraordinary measures against swine flu - most notably quarantines imposed by China, where entire planeloads of passengers were isolated if one traveler had symptoms - have failed to contain the disease.

Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show.

China's official count of nearly 70,000 reported illnesses with 53 deaths is dwarfed by estimates of millions of cases with nearly 4,000 deaths in the United States, a nation with about a third of China's population.

Dr. Michael O'Leary, WHO's top representative in China, says there has been a dramatic spike in Chinese swine flu cases recently and those reported by the government are only "minimum numbers."

"We have new cases occurring all the time," he told The Associated Press last week. "There's always more deaths than we could possibly know about."

He said there is little data to prove interventions like mass quarantines and school closures slow down disease transmission. "To draw a causal link ... is not always possible," O'Leary said, adding that WHO expected a disease as contagious as swine flu to spread regardless of what measures countries impose.

China's Health Minister Chen Zhu defended his country's aggressive quarantine policy, telling the AP on Wednesday that the measures helped slow the spread of the virus long enough for China to develop a vaccine, which authorities are now scrambling to administer.

"With initial efforts of containment, actually we not only reduced the impact of the first wave to China, but we also won time for us to prepare the vaccine," Chen said in an interview on the sidelines of a meeting of the Global Forum for Health Research in Havana.

He said China was vaccinating 1.5 million people a day against swine flu as part of a massive effort to try to reach as many as 90 million people - about 7 percent of the country's population - by the end of the year.

"We know this is not enough for a population of 1.3 billion, but at least for the vulnerable people, for the students, people with underlying basic diseases and ... for pregnant women, we have vaccines," Chen said.

On Thursday, Dr. Zhong Nanshan, director of Guangzhou's Institute of Respiratory Diseases, said in a local newspaper he believed government officials were covering up swine flu deaths to appear as though their handling of the epidemic had been successful.

"I totally don't believe the current number of swine flu deaths that have been reported in the country," Zhong said in Guangzhou Daily. He was one of the doctors who openly challenged China's 2003 cover-up of its outbreak of Severe Acute Respiratory Syndrome.

China has acknowledged swine flu is now widespread despite its aggressive attempts at containment.

Earlier this month, Feng Zijian, head of China's Center for Disease Control and Prevention, said the country's reported figures are only "a very small portion" of the total number of cases.

He said China is now focusing on confirming severe cases and no longer tests every person with a fever for swine flu. He said the official figures were based on cases confirmed in outbreaks or at monitoring sites like hospitals.

Other nations that have carried out draconian swine flu policies indicate they have little effect in containing the disease.

Ukraine, which reported more than 250,000 suspected cases last week, closed all schools and universities, and advised people not to travel and to stay away from public places. In Mongolia, all bus travel has been suspended and gatherings of more than 40 people have been banned. Still, both countries are now facing major swine flu outbreaks.

Argentina, Singapore, Malaysia and Egypt have also enacted radical swine flu prevention measures - and all have been gripped by widespread outbreaks.

When WHO declared swine flu to be a pandemic in June, it described the virus as "unstoppable." It advised countries not to close their borders or impose mass quarantines, warning such measures would be useless since people often spread flu viruses before developing any symptoms.

China is no exception, scientists say.

"China did not keep the virus out. They failed," said Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

He said he believes the actual number of swine flu cases is "far in excess of what China is reporting," based on the center's own network of official and unofficial sources in the country.

Some experts say the relatively small size of China's reported outbreak is suspicious given that neighboring regions are battling huge epidemics. Last week, WHO said Mongolia, which borders China, was reporting its health system was being crushed by swine flu cases.

In Hong Kong, a city of 7 million on China's southern coastline, authorities have reported 40 swine flu deaths, compared to the 53 reported in China.

"The issue in China has to do with surveillance," said Sandra Mounier-Jack, a flu expert at the London School of Hygiene and Tropical Medicine. Because swine flu symptoms are so vague, many cases are being missed in China, as they are everywhere, she said.

WHO and the U.S. Centers for Disease Control and Prevention gave up counting swine flu cases months ago when the virus became widespread.

Past disease outbreaks also give experts reason to question China's numbers. In 2003, China covered up an epidemic of Severe Acute Respiratory Syndrome, which ultimately killed about 800 people when it spread worldwide.

---

Associated Press writers Will Weissert in Havana; Cara Anna, Christopher Bodeen and Gillian Wong in Beijing, and Medical Writer Margie Mason in Hanoi contributed to this report.


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			<title><![CDATA[Study: CT scans rule out heart attacks faster]]></title>
												<link>http://www.komonews.com/news/health/70523897.html</link>
						<pubDate>Thu, 19 Nov 2009 10:12:43 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[ORLANDO, Fla. (AP) - A CT scan - a kind of super X-ray - provides a faster, cheaper way to diagnose a heart attack when someone goes to the emergency room with chest pains, a new study suggests.

About 6 million people each year go to hospitals with chest pain, but only a small fraction are truly having a heart attack. CT scans are increasingly used to diagnose problems because they give a deep, detailed view inside the body. But they put out a lot of radiation, which may raise a person's chances of developing cancer.

Whether these scans are worth that risk is unknown. The new study suggests that for ruling out heart attacks in the emergency room, they just might be.

The research involved 749 chest pain sufferers at 16 big medical centers around the country. These were people who did not have clear signs of a heart attack from blood tests or EKGs, but doctors are afraid to send them home without more tests.

Between 4 percent and 13 percent of such patients will have a missed diagnosis of a heart attack, and up to one quarter of that group will die, said the new study's leader, Dr. Kavitha Chinnaiyan, a cardiologist at William Beaumont Hospital in suburban Detroit.

"One of the most common reasons for an emergency room physician to be sued is that they send a patient out and then they come back with a heart attack," said Dr. Sidney Smith, a former American Heart Association president from the University of North Carolina at Chapel Hill. "It is a big problem."

In the study, half of the patients were given CT scans and the rest, standard imaging tests with a radioactive dye. Of the CT patients, 82 percent were found to have clear arteries and were discharged immediately. In the other group, 89 percent were determined to have normal arteries and sent home.

The portion of patients who needed a definitive but invasive test - angiography - to see whether they should have an artery-opening balloon angioplasty procedure or bypass operation was the same - 6 to 7 percent of each group.

The big difference was in cost and time.

CT scan patients were diagnosed in about three hours versus more than six for the others. Their testing also cost less - $2,137 on average versus $3,458 for standard screening.

"It's equally safe, it's faster and it's cheaper," said Chinnaiyan, who has no financial ties to imaging companies. She reported results Wednesday at a heart association conference in Florida.

The study had partial support from Bayer Pharmaceuticals, which makes products used in heart imaging. A few doctors involved in the study have had research grants from Bayer or a firm that makes imaging equipment.

"These are promising results" for CT scanning, said Smith, who had no role in the work. "They were able to identify a certain group that did not need to be admitted."

Radiation remains a concern, though. A CT scan of the chest involves 10 to 15 millisieverts (a measure of dose) versus 0.01 to 0.15 for a regular chest X-ray, 3 for a mammogram and a mere 0.005 for a dental X-ray.

On the other hand, people with chest pain often are admitted to a hospital and then given repeated tests over a number of days that can add up to a high cumulative radiation dose.

"If you had a CT scan and it showed you were fine, you would not get any of that radiation," said Dr. Mariell Jessup of the University of Pennsylvania, who led the conference's scientific panel.

A more definitive picture of risks and benefits will come from a big study just getting under way, headed by Duke University's Dr. Pamela Douglas.

The $32.5 million federally funded study is the largest ever for heart imaging and the only one to look at how various imaging tests ultimately affect the rates of death, heart attack, stroke, hospitalization and other factors. It will enroll 10,000 people in the United States and Canada.

A big question, Douglas said, is' "As people get more and more radiation medically, are we adding up some new cases of cancer?"
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			<title><![CDATA[Task force doctor stands by mammogram advice]]></title>
												<link>http://www.komonews.com/news/health/70523722.html</link>
						<pubDate>Thu, 19 Nov 2009 10:09:58 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[WASHINGTON (AP) - A member of the independent panel whose new mammogram recommendations have led to confusion defended the task force's report, saying Thursday that it was based on the most up-to-date, accurate information available.

Dr. Timothy Wilt, a member of the U.S. Preventive Services Task Force, stuck by its recommendation that most women don't need mammograms in their 40s and should get one every two years starting at 50. The American Cancer Society's long-standing position has been that women should get annual cancer-screening mammograms starting at age 40.

The panel's recommendations "were based on the most rigorous peer review of up-to-date, accurate information about the evidence about the harms and benefits of treatment," Wilt said on ABC's "Good Morning America."

On Wednesday, Health and Human Services Secretary Kathleen Sebelius tried to ease the furor that has erupted since the panel issued its recommendations Monday. She said the task force does "not set federal policy and they don't determine what services are covered by the federal government." She advised women to "keep doing what you've been doing for years - talk to your doctor about your individual history, ask questions, and make the decision that is right for you."

Wilt did not take issue with Sebelius' statement. "Our recommendations support an individualized decision-making process," he said, and each woman still needs to talk with her doctor to make the most informed decision.

The recommendations from the task force have left women confused about whose advice to follow. And opponents of changing health care policy have criticized the new recommendations as an example of what could be expected from government-managed care.

Wilt denied accusations that the recommendations were made to help the government spend less on mammograms.

"Costs are not considered at all," he said.

The panel of doctors and scientists concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies, without substantially improving odds of survival for women under 50.]]></description>
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			<title><![CDATA[FDA panel backs Pfizer's enhanced vaccine for kids]]></title>
												<link>http://www.komonews.com/news/health/70522962.html</link>
						<pubDate>Thu, 19 Nov 2009 10:02:36 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[BETHESDA, Md. (AP) - Federal health experts said Wednesday an updated version of Pfizer's best-selling anti-infection vaccine is safe and effective for infants and toddlers, despite company studies that failed to meet certain goals.

The Food and Drug Administration's panel of vaccine experts voted 10-1 in favor of Pfizer's Prevnar 13 to protect against pneumococcal disease.

While the FDA is not required to follow the group's advice, its recommendation moves the company closer to expanding the use of a treatment that racked up more than $2.7 billion in sales last year as the world's top-selling vaccine.

"We're very gratified to have achieved a positive recommendation from the committee," said Dr. Emilio Emini, Pfizer's chief of vaccine research.

The FDA is expected to make its approval decision by Dec. 30.

The new vaccine reduces risk of infection from 13 varieties of the disease, which causes thousands of cases of ear infection, meningitis and pneumonia each year. The new version adds protection against six additional strains to the seven covered by the current vaccine.

The FDA says the new strains account for more than 60 percent of pneumococcal cases in children younger than 5 in the U.S.

Pfizer has estimated that use of Prevnar 13 could prevent 9,800 deaths and 160,000 hospitalizations due to pneumonia over 10 years.

Pfizer is competing against rivals GlaxoSmithKline and Merck to cement its place in the global vaccine marketplace. GlaxoSmithKline markets the vaccine Synflorix, which is approved in Europe for use in children. Merck markets Pneumovax 23, which also defends against pneumococcal disease but is targeted for use in adults.

Vaccines are seen as a critical path to growth for drugmakers, as slowing prescription medicine sales and intensifying generic competition put pressure on company bottom lines.

FDA reviewers noted that company studies failed to meet preselected goals for three types of pneumococcal disease.

But Pfizer scientists argued that the missed statistical targets were a result of comparisons between the new vaccine and the original Prevnar. Since Prevnar is recommended for all children in the U.S., the company could not compare patients taking Prevnar 13 against an untreated group - the standard method for studying drugs and vaccines.

The FDA panel recommended long-term safety tracking for the new vaccine, and Pfizer has agreed to a 43,000-patient follow-up study.

"The data I've heard suggest it's safe, but these were fairly small studies and we're inferring safety with Prevnar 13 from our experience with Prevnar," said panel member Patricia Ferrieri, a professor at the University of Minnesota Medical Center.

New York-based Pfizer acquired Prevnar from Wyeth, as part of a $68 billion buyout that closed last month.

Prevnar has been on the market for more than nine years and is on sale in 95 countries. More than 235 million doses have been distributed, according to the company.

The vaccine requires a series of four injections, generally given at 2, 4 and 6 months old and then between 12 and 15 months old.

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			<title><![CDATA[Don't blame fast food: Mummies had heart disease]]></title>
												<link>http://www.komonews.com/news/health/70375867.html</link>
						<pubDate>Wed, 18 Nov 2009 9:16:08 PST</pubDate>
							<category><![CDATA[News]]></category>
																<description><![CDATA[ORLANDO, Fla. (AP) — You can't blame this one on McDonald's' Researchers have found signs of heart disease in 3,500-year-old mummies.

"We think of it as being caused by modern risk factors," such as fast food, smoking and a lack of exercise, but the findings show that these aren't the only reasons arteries clog, said Dr. Randall Thompson, a cardiologist at the Mid America Heart Institute in Kansas City.

He and several other researchers used CT scans, a type of X-ray, on 22 mummies kept in the Egyptian National Museum of Antiquities in Cairo. The subjects were from 1981 B.C. to 334 A.D. Half were thought to be over 45 when they died, and average lifespan was under 50 back then.

Sixteen mummies had heart and blood vessel tissue to analyze. Definite or probable hardening of the arteries was seen in nine.

"We were struck by the similar appearance of vascular calcification in the mummies and our present-day patients," said another researcher, Dr. Michael Miyamoto of the University of California at San Diego. "Perhaps the development of atherosclerosis is a part of being human."

One mummy had evidence of a possible heart attack but scientists don't know if it was fatal. Nor can they tell how much these people weighed — mummification dehydrates the body.

Of those whose identities could be determined, all were of high social status, and many served in the court of the Pharaoh or as priests or priestesses.

"Rich people ate meat, and they did salt meat, so maybe they had hypertension (high blood pressure), but that's speculation," Thompson said.

With modern diets, "we all sort of live in the Pharaoh's court," said another of the researchers, Dr. Samuel Wann of the Wisconsin Heart Hospital in Milwaukee.

The oldest mummy with heart disease signs was Lady Rai, a nursemaid to Queen Ahmose Nefertari who died around 1530 B.C. — 200 years before King Tutankhamun.

German imaging company Siemens AG, the National Bank of Egypt and the Mid-America Heart Institute paid for the work. Results are in this week's Journal of the American Medical Association and were reported Tuesday at an American Heart Association conference.]]></description>
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