Molars, incisors and canines -- oh, my!

Concerned about the strength of teeth-whitening chemicals and by the growing number of non-dental venues through which they’re being sold, the American Dental Assn. today asked the U.S. Food and Drug Administration to evaluate the compounds for safety and classify them.

Currently, teeth whiteners, which commonly use hydrogen peroxide or carbamide peroxide as the active ingredient, are neither drug nor cosmetic device nor medical device, according to the dental association.

The ADA wants the FDA to put the chemicals in a category and evaluate them for safety.

Depending on the outcome of that evaluation, the whitening compounds could be available on an unrestricted, over-the-counter basis or, if determined to be at the upper end of risky, could be restricted to prescription-only availability.

“Without appropriate regulation, the application of chemically-based tooth whitening/bleaching agents may result in harm to both hard and soft tissues in the mouth,” the ADA said in a letter to FDA Commissioner Dr. Margaret Hamburg.

Dr. Ron Zentz, senior director of the ADA’s Council on Scientific Affairs, said the FDA was supposed to have classified whiteners years ago but never finished the task.

Zentz said there was no particular tipping point for the ADA’s request, but the letter to Hamburg notes that a lot of business is being transacted outside of dentists’ offices, with potential harm to consumers – not to mention to dentists’ bottom lines. 
  
“The tremendous expansion of products available directly to consumers and application of products in venues such as shopping malls, cruise ships, and salons is troubling since consumers have little or no assurance regarding the safety of product ingredients, doses or the professional qualifications of individuals employed in these non-dental settings,” the letter states.

-- Andrew Zajac

Photo illustration credit: Los Angeles Times

Age may have its advantages in endurance sports

Endurance sports such as ultra-marathons, ultra-triathlons and cycling marathons have exploded in popularity over the years. Among them is the grandaddy of the genre, the Western States 100-Mile Endurance Run, which began in 1974 and meanders through the Western States Trail in Northern California. A new study looked at how the race has grown, and finds some interesting trends among the runners -- mostly that they've gotten older and faster.

Researchers from the Department of Veterans Affairs' Northern California Health Care System and Virginia Commonwealth University in Richmond analyzed details of the thousands of people who have competed in the race from 1974 through 2007. About 3,459 runners have finished the race since its inception, but the profiles of those men and women have changed. Many more women, for example, are competing: from 1986 to 1988, women made up 10% to 12% of the field, but since 2001 that has almost doubled to 20% to 22% of all runners.

Competitors are older too -- the average age of male and female race starters has gradually increased since 1986. In 1986, the average male runner was 41, but between 2000 and 2007 the average runner was 45 to 47. Researchers chalk those statistics up to the fact that more women age 40 and up and more men age 50 and up have been competing, and also fewer men under 50 have entered the race.

From the very first race, the average age of the top five finishes has risen from the early 30s to the late 30s. While the top five men have shown only minor changes in finish times between 1979 and 2007, not so for the women -- they've improved 37 minutes every 10 years from 1980 through 2007. That means the differences in finish times between the top five men and women have gotten smaller by 4% per decade, to about 14% in 2007. The researchers note that there was a 12% time difference between top five finish times for men and women in both the 2007 Hawaii Ironman competition and the 2007 New York City Marathon.

The study appears in the December issue of Medicine & Science in Sports & Exercise.

-- Jeannine Stein

Photo credit: Richard Hartog / Los Angeles Times

Parent training boosts medication effect for autism

Life with a child who has a pervasive developmental disorder such as autism or Asperger's syndrome is often a storm of tantrums, irritability, impulsive behavior and obstinacy — a challenge that has child psychiatrists casting about for ways to help the stressed-out families of their patients, as well as the patients themselves. 

The antipsychotic medication risperidone is approved for those with autism to reduce irritability, and many other medications are widely used to rein in the defiance and explosive behavior that often come with a PDD diagnosis. But a group of researchers, spurred by the National Institute of Mental Health, set out to see if parent training could help children already on medication to further temper their negative behaviors, and bring an added measure of peace to their families.

Compared with kids on medication alone, the behavior of children whose parents got a battery of training sessions improved more and by several measures. The success of the program prompted the authors of the study — researchers from Ohio State University, Indiana University, Yale University and the University of Pittsburgh as well as with NIMH — to declare they will make the parent-training manual, homework assignments and therapist scripts broadly available. Their study is published in the Journal of the American College of Adolescent and Child Psychiatry

"Because parents are the agents of change, parent training is less expensive than many other forms of psychosocial intervention," the researchers concluded. The growing population of kids with PDD, they added, makes the availability of "effective behavioral interventions" an urgent need.

Over 24 weeks, the parents of children with pervasive developmental disorder attended as many as 17 sessions, 60 to 90 minutes long, aimed at teaching them to help the child acquire and consolidate self-management and communication skills and to be more flexible and compliant. Parents learned to use visual schedules to ease transitions, to use positive reinforcement effectively, to teach their kids how to communicate their needs and be more flexible. A behavior therapist came to the home twice and made two telephone calls to answer questions and give support. 

— Melissa Healy

Swine flu declined slightly last week, but watch out for Thanksgiving, CDC says

Pandemic H1N1 influenza activity declined slightly last week, with only 43 states reporting widespread activity, compared with 46 states the week before, officials at the Centers for Disease Control and Prevention said this morning.

Even though levels have declined, however, they are still "higher than peak activity in many years," said Dr. Anne Schuchat, director of  the CDC's National Center for Immunization and Respiratory Diseases.

Officials fear, moreover, that flu activity will pick up as people travel around the country for Thanksgiving and Christmas. Unfortunately, she said, there are little data from seasonal flu on which to base predictions because such data are usually not prevalent so early in the year. Respiratory disease in general, however, does tend to increase early in the year after travel for the Christmas holidays. "We don't really know what is going to happen," she said.

There were an additional 21 laboratory-confirmed pediatric deaths last week, bringing the total for the year to 171 -- compared with 40 to 50 in a normal flu season. Fifteen of the deaths were confirmed to be caused by swine flu and the other six were confirmed to be caused by influenza A and are assumed to be swine flu. Overall, about two-thirds of the children who have died suffered from underlying conditions, such as asthma, cerebral palsy and muscular dystrophy.

As for the swine flu vaccine, "we are not where we want to be, but it is quickly being ordered and shipped," Schuchat said. As of this morning, 54.1 million doses have become available, 11 million more than were available last Friday, she said. About half of the doses shipped so far have been given to children, she said, and "the vast majority have gone to people who self-identified as being in a priority group." She said CDC will report data next week about potentially adverse events, "but so far we haven't seen any signals of unusual occurrences with swine flu vaccine or seasonal vaccine that would prompt us to feel urgent interventions are needed."

Schuchat also said that the agency is closely monitoring reports of an unusual strain of the swine flu virus that has been observed in some patients in Norway. The unusual strain has been seen sporadically in locations around the world, including the United States, she said, but so far there is no evidence that the mutation involved will make the virus more lethal or increase its resistance to the antiviral drug Tamiflu.

-- Thomas H. Maugh II

Have some sodium with that turkey alternative

Just in time for the pre-Thanksgiving shopping run comes a nutritional comparison of various meatless "turkeys." Fascinating stuff...

Take a look at this chart offered up by the American Dietetic Assn. The first thing that pops out is the sodium content. The word "wow" comes to mind. Field Roast Celebration? 710 milligrams per serving. The always adorable Tofurky? (It's a fun word, admit it.) 510 milligrams.

There's also a comparison to the more traditional turkey -- you know, the kind made from a turkey -- but that's more for idle curiosity. Nutrition info in such decisions tends to be beside the point.

Here's the news release if you want the chart summarized for you. And more on sodium from the American Heart Assn.

One more fact: A serving of turkey breast without skin has only 52 milligrams of sodium.

-- Tami Dennis

Photo: I dunno... Maybe sodium isn't so bad...

Credit: Los Angeles Times

Here's who should really worry about cervical cancer, doctors say

 The new cervical cancer screening recommendations might worry some women accustomed to getting screened every year. They shouldn’t, most doctors say.

 Today's story: Group recommends less frequent Pap tests 

The women who should be worried, physicians point out, are those who remain under-screened.

Half of the women who die from cervical cancer never had a Pap test, and 10% had not been screened in the five years before detection.

Overall, about 20% of U.S. women don’t get regular Pap tests, and 40% fail to get regular mammograms, said Dr. Edward Partridge, an oncologist at the University of Alabama, Birmingham. He’s the chairman of the cervical cancer screening guidelines panel for the National Comprehensive Cancer Network.

“The biggest problem is women who don’t get screened at all,” he said. “That is where your breast cancer is. That is where your cervical cancer is.”

-- Shari Roan

And from the California swine-flu front lines...

So what's the H1N1 flu situation here in California, you might well ask, having safely gotten, or given up on getting, a vaccination? Or perhaps the immunization issue was rendered moot by those days of fever and chills and pathetic moaning, and now you're just looking for empathy.

Here's what our colleagues at L.A. Now report: H1N1 deaths and hospitalizations slowed last week in state.

Health officials, of course, advise against relaxing your guard.

— Tami Dennis

The new mammogram recommendations: Task force member speaks up

Individualize, individualize, individualize. That's one message from the new U.S. Preventive Services Task Force report on mammograms that created such a ruckus this week. Though the recommendations have been painted by some as a blanket Ptth! to mammograms, the actual report was nuanced, and made plain that they didn't apply to women under 50 who were at high risk.

Go here to read about -- and watch a "Good Morning America" interview with -- a member of the task force, Dr. Timothy Wilt, who defended the panel's conclusions.

According to the report, Wilt said, among other things: "Cost is not considered at all. This is about providing high-quality healthcare for the individual [and] providing the information they need to know to make an informed decision.... The information is based on eight very large, randomized, controlled trials of mammograms in women, a series of six different databases and a variety of other studies."

It'll be interesting to see what doctors do with this information as the weeks and months unfold. Check out this article in U.S. News and World Report outlining what three physicians (a gynecologist, a family physician and an internist) say they will do when counseling patients of that age set -- recommend annual mammograms, advise against them or something in between?

Want more reaction? Read a column by Susan Perry in the MinnPost. She is taken aback by all the anger.

And here's a TV interview of a breast cancer survivor Christi Rich, who was diagnosed at age 47. She's against the new guidelines, arguing that her breast cancer would have been undetected under them.

--Rosie Mestel

What's in a name? Legislation would end use of the term 'mental retardation'

We health bloggers and reporters think about words a lot and care about using the right ones. So we were interested when we heard that a legislative proposal offered in the U.S. Senate recently would outlaw further use of the terms "mentally retarded" or "mental retardation" from federal statutes and policy papers in the area of health, education and labor.

The proposed measure would replace those terms with "intellectual disability" and "individual with an intellectual disability."

The Arc of the United States — the nation's largest and most active advocacy group for those with intellectual and related developmental disabilities — calls the terms "mental retardation" and "mentally retarded" "outdated" and "stigmatizing." The group applauds the measure, which was proposed by Sen. Barbara A. Mikulski (D-Md.), and says it's high time that federal language was updated.

" 'Retard,' 'retarded' and 'retardation,' once accepted medical terms, are now used only to insult and demean people," said Peter V. Berns, chief executive of the Arc, in a statement supporting Mikulski's proposal. He added, "Changing how we talk about people with disabilities is a critical step in promoting and protecting their basic civil rights."

The Centers for Disease Control and Prevention already use the updated term, as does the Office of the President — to which the Committee for People With Intellectual Disabilities reports. But some landmark laws — including the Individuals With Disabilities Education Act (IDEA), the Higher Education Act and the law known as No Child Left Behind — still use the terms.

The measure replicates a law recently passed by the Maryland State Assembly. As they deliberated, state lawmakers heard from 13-year-old Nick Marcellino, whose sister, Rosa, has an intellectual disability. "Some say we shouldn't worry about the words, just the way we treat people. But when you think about it, what you call people is how we treat them. If we change the words, maybe it'll be the start of a new attitude toward people with intellectual disabilities."

Mikulski has dubbed her measure Rosa's Law, in honor of Nick's sister.

There are 7 million people living with intellectual and/or developmental disabilities in the United States, and the origins of their disabilities are legion, ranging from birth injury, illness, genetic defect (a term that some may also challenge) and environmental factors. A recent post here at Booster Shots talked about a raft of medications now under study in the treatment of Down syndrome and about a survey that found that 60% of parents of offspring with the disorder would likely take a pass on such a treatment if it became available.

So, is it political correctness run amok, or is it a group's right of self-determination to stipulate (by law, no less) how they should be referred to? There are plenty of precedents to point to. But some will resist being dictated to when it comes to language.

— Melissa Healy

For pregnant women with MS or epilepsy, some good news

Researchers at Stanford University have found that women with multiple sclerosis or epilepsy have only a slightly higher risk of abnormal fetal growth and C-section delivery compared with women without the conditions. Let's repeat, only a slightly higher risk. Nor do they appear to suffer a higher rate of other complications compared with pregnant women in general.

Here's ...

The news release from Stanford University.

The abstract from the study, based on an analysis of a large national database and published Wednesday in the journal Neurology.

And more on pregnancy and MS (from the National Multiple Sclerosis Society) and on pregnancy and epilepsy (from the Epilepsy Foundation).

Both MS and epilepsy are relatively common in women of child-bearing years. And the findings should provide some reassurance to those with the conditions who are pregnant -- or contemplating becoming so.

-- Tami Dennis

Company seeks FDA permission to conduct clinical trial using human embryonic stem cells

Patients with a rare eye disease could be the first to be treated with human embryonic stem cells.

Advanced Cell Technology Inc., a Santa Monica-based biotech company with labs in Massachusetts, announced today that it has asked the U.S. Food and Drug Administration for approval to test retinal cells grown from stem cells in 12 people with Stargardt’s macular dystrophy.

The disease is a childhood version of macular degeneration and affects about one in 10,000 kids. Patients typically begin to lose their central vision between the ages of 6 and 20. As SMD progresses, things may look blurry and distorted, and patients may have trouble adjusting to low light. About half of victims are legally blind by age 50. There is no cure.

Most cases occur when children inherent a faulty version of the ABCA4 gene or the CNGB3 gene from both parents.  As a result, the photoreceptor cells in the retina don’t get enough fuel, and they atrophy.

ACT hopes to reverse this by supplying patients with new retinal pigment epithelium cells derived from human embryonic stem cells. The RPE cells have been shown to improve vision in animals, with one study restoring eye function in sick rats and mice to “near-normal” levels. Another study boosted rats’ vision to 70% that of healthy animals. No adverse side effects were found in any of the company’s pre-clinical studies, Dr. Robert Lanza, ACT’s chief scientific officer, said in an interview.

ACT proposes a Phase I/II trial designed to assess the safety and tolerability of its RPE cells. The company and its collaborators would like to recruit a dozen patients with advanced SMD at three sites: the Casey Eye Institute in Portland, Ore.; the University of Massachusetts Memorial Medical Center in Worcester; and the UMDNJ – New Jersey Medical School in Newark.

Amid much fanfare, Geron Corp. received FDA approval in January to use specialized nerve cells made out of human embryonic stem cells to treat a handful of patients paralyzed by spinal cord injuries. Those plans are on hold while the company conducts pre-clinical studies to address some safety concerns about its cells, known as GRNOPC1. Last month, Geron said it expected to initiate its clinical trial in the third quarter of 2010.

Since their creation in 1998, human embryonic stem cells have been a highly controversial area of medical research. The cells are derived from days-old human embryos, which gives them the ability to grow into any type of cell in the body. Some scientists – like those at ACT and Geron – envision using them to grow replacement tissues to treat sick patients. But many people are troubled by the fact that the stem cells are typically made by dismantling and destroying human embryos.

ACT has tried to sidestep the ethical debate by using a different method to create its stem cell lines. Instead of using an entire embryo, the company figured out a way to remove only a single blastomere cell from a three-day-old embryo and turn it into a cell line. Such single-cell biopsies are routinely performed in fertility clinics to screen embryos for devastating genetic diseases, and the procedure leaves the embryo intact. The RPE cells that would be used in the clinical trial were grown from one of the company’s single-blastomere cell lines, Lanza said.

The company is also making and testing RPE cells derived from induced pluripotent stem cells. So-called iPS cells behave like embryonic stem cells but are made by reprogramming mature cells taken from children or adults, not from embryos. However, the reprogramming process currently involves viruses and genetic manipulation techniques that make the cells unsuitable for human therapies.

Lanza said ACT decided to target Stargardt’s macular dystrophy first because it has been designated an “orphan disease” and could benefit from a faster regulatory review. The FDA has 30 days to respond to the company’s filing, made Wednesday, and the clinical trial could begin early next year.

If all goes well, the company plans to seek permission to use its RPE cells to treat age-related macular degeneration, Lanza said. That disorder is much more common, and it destroys the central vision of an estimated 1.75 million Americans.

-- Karen Kaplan

Photo: Scientists from Advanced Cell Technology remove a single cell from a days-old embryo, which was used to create a line of human embryonic stem cells. Stem cells made this way were grown into eye cells that the company hopes will treat patients with Stargardt's macular dystrophy. Credit: Associated Press photo/Advanced Cell Technology

Deaths following swine flu immunization not linked to vaccine, the WHO says

There have been about 40 deaths worldwide among people who have recently been vaccinated against pandemic H1N1 influenza, but there is no evidence the deaths are related to the vaccine, officials from the World Health Organization said today. At least 65 million people have been vaccinated, and it is inevitable that there will be some deaths among such a large group, said Dr. Marie-Paule Kieny, director for the Initiative for Vaccine Research at the WHO. Although some investigations are still ongoing, she said at a news conference in Geneva, "results of the completed investigations reported to WHO have ruled out that the pandemic vaccine is the cause of death."

She said fewer than a dozen suspected cases of Guillain-Barre Syndrome have been reported following vaccination. "Only a few of these Guillain-Barre cases may be linked to the pandemic vaccine," she said. "Illness has been transient and patients have recovered." Guillain-Barre has been a particular concern because many cases occurred during the 1976 swine flu vaccination campaign, although none were definitively linked to the vaccine. That has led to the belief in some quarters that the vaccine is worse than the illness.

Kieny said that at least 80 million doses of the vaccine have been distributed to 16 countries, and at least 65 million have been administered so far. Those figures may be conservative, however, "because immunization campaigns are underway now in 40 countries. Overall, she said, the WHO has received reports of one adverse event for every 10,000 doses of vaccine. Among those reports, five out of 100 have been for serious events, for an overall rate of five serious events for every 1 million vaccinations. Many of those events were allergic reactions among people with unsuspected allergies to eggs.

-- Thomas H. Maugh II

Spray-on anesthetic prevents premature ejaculation in U.S. trials

The first U.S. trials of a spray-on anesthetic for the penis showed that it increased the time to ejaculation nearly five-fold, providing the first good solution for premature ejaculation, researchers reported today. The findings are very similar to those obtained in a European study released in April.

Premature ejaculation is generally defined as ejaculation that occurs within a minute after insertion of the penis into the vagina, causing distress to both parties. The condition is thought to affect as many as one in three U.S. men ages 18 to 59, about twice as many as those who suffer from erectile dysfunction. Some antidepressant-like drugs, such as dapoxetine, have been approved in a few countries to treat the condition, but the Food and Drug Administration rejected it because of long-term side effects. Some physicians prescribe anesthetic creams like EMLA cream for off-label use to delay ejaculation, but such creams require 45 minutes to work and the man must use a condom to prevent the anesthetic from numbing the woman.

Plethora Solutions of London and Sciele Pharma Inc. of Atlanta have developed a spray anesthetic, called PSD502 or Tempe, that contains lidocaine and prilocaine dispensed by a metered aerosol. It is applied five minutes before intercourse, and it selectively numbs the head of the penis.

The new trial, led by Dr. Michael G. Wyllie of Plethora enrolled 256 patients at 38 centers in the U.S., Canada and Poland. Their average duration of intercourse was less than 0.6 minutes. Two-thirds of the participants used PSD502; the rest were given a placebo. Wyllie reported today at a San Diego meeting of the Sexual Medicine Society of North America that men receiving the drug increased their intercourse time to an average of 2.6 minutes, compared with an increase to only 0.8 minutes in the placebo group. The benefits persisted for the three months of the study and both men and women reported greater satisfaction with their sexual experiences. No significant adverse effects were observed.

The company expects to apply for FDA approval of the drug in the first quarter of 2010, Sciele Chief Executive Patrick Forteau said.

-- Thomas H. Maugh II

That mammogram fracas: The American College of Radiology says, Take it back!

Poor old U.S. Preventive Services Task Force.

They're asked to assess the science on mammograms, they duly do so and come out with advice that's unpopular — suggesting that regular mammograms are not advisable for most women under 50 (not a new debate) and not advisable for women over 50 every year — and now everyone's beating up on them. 

They even dared to suggest that breast self-exams are not helpful (also not a new debate).

Department of Health and Human Services Secretary Kathleen Sebelius seemed to distance herself from their conclusions and advice by telling the American people to "keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions and make the decision that is right for you."

That's not enough for the American College of Radiology.

It "is pleased to see that Secretary Sebelius has reaffirmed that mammography is a vital and lifesaving tool in the battle against breast cancer. We strongly urge women and providers to continue to adhere to the current American Cancer Society and American College of Radiology policies regarding mammographic screening," it says in a statement.

(Did anyone actually think that the task force was saying mammograms are a total waste of time and that women should never, ever get them?)

But the college also wants the task force to reverse its recommendation:

"As the task force is referenced in healthcare reform legislation as a significant factor in determining which preventative services may be offered under government 'insurance exchanges' outlined in the legislation, we ask that the secretary officially ask the task force to rescind their mammography recommendations in order to avoid confusion as healthcare reform moves forward."

—Rosie Mestel

Prematurity: California gets a C, the nation a D

 The March of Dimes has just released its 2009 Premature Birth Report -- and California continues to do badly. Its premature birth rate is 10.9%, up from 10.7% in 2008. It gets a C.

The nation as a whole, which has a pre-term birth rate of 12.7%, got a D.

Prematurity is the No. 1 cause of newborn death and is linked to complications such as learning, behavior and feeding problems, as well as a heightened risk of sudden infant death syndrome. Even late pre-term births (34 to 36 weeks instead of the full-term number of 40) raises risks. Elective cesarean sections have caused the rates of late pre-term birth to rise in recent years.

Read the report at the March of Dimes website.

--Rosie Mestel

Photo credit: Loyola University Medical Center via Getty Images

HHS Secretary Kathleen Sebelius wades into the mammogram fray

The reaction to this week's U.S. Preventive Services Task Force recommendation against regular mammograms for women under 50 was swift, emotional and highly public. Today, Health and Human Services Secretary Kathleen Sebelius weighed in, pointing out that, well, the task force is actually just an independent panel offering advice, not setting policy, so ... just do what you've been doing.

Seriously. "My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer, and they still are today. Keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions and make the decision that is right for you."

Here's her full statement.

(Enjoy the fallout, task force folks! You're on your own!)

If you want to know more about that panel, check it out here.

By the way, it's sponsored by the Agency for Healthcare Research and Quality, an agency that — we'll say it if few others will — is known for producing excellent work based on science, not emotion. That agency is within, yep, the Department of Health and Human Services.

Here's the original story: Mammogram guidelines spark heated debate

Plus a blog post on the reaction: Don't like those new mammogram recommendations? You're not alone

And here's today's story: Mammography outcry points to trouble for healthcare reform: Some Republicans say the new recommendations are an example of "rationing" that would take place under President Obama's plan to save money by basing treatment on experts' advice.

— Tami Dennis

Photo: HHS Secretary Kathleen Sebelius said she wanted to address recent confusion head on. Address it, she did. Clear it up? Perhaps not.

Credit: Mandel Ngan / AFP / Getty Images

 

Don't blame Starbucks: Cops may have poorer health due to night shifts

Midnight shift workers often find it hard to get enough quality sleep on a consistent basis. Police officers are not exempt, often working late shifts and overtime as part of their job.

A new study finds that their schedule may cause cops to develop metabolic syndrome, a cluster of symptoms including high blood pressure, insulin resistance and high trigylcerides that advance development of such conditions such as stroke, cardiovascular disease, and type 2 diabetes.

The research, published in the current issue of Archives of Environmental & Occupational Health, focused on 98 police offers who were part of the Buffalo Cardio-Metabolic Occupational Police Stress study, which began in 2003. The participants had their blood pressure checked, took a blood test and had their waist circumference measured. They also filled out a questionnaire focusing on lifestyle choices such as sleep habits, physical activity, and smoking and alcohol use.

Researchers discovered that in general, those on afternoon and midnight shifts were younger than those working during the day, and predominately male. Overall, 30% of the police officers on the night shift had metabolic syndrome. In the general population, that number was 21%, taken from the National Health and Nutritional Examination Survey. The younger officers on the night shift (average 36.5 years) also had higher rates of metabolic syndrome than age-matched men and women in the general population, who came in at 24%.

Waist circumference was larger and HDL "good" cholesterol levels were lower among night shift cops compared to the general population and to officers working day and evening shifts. Officers working nights who got less than six hours of sleep had higher averages of metabolic syndrome factors than day shift workers.

"One potential explanation for this unusual finding is that midnight shift officers were most likely to be sleep deprived because of difficulties associated with day sleeping," said John Violanti, the study's lead author, in a news release. The research associate professor at the University of Buffalo's department of social and preventive medicine added, "Sleep debt has been shown to have a harmful impact on carbohydrate metabolism and endocrine function, which could contribute to metabolic disorders."

In the study, the authors wrote, "Information gained through this study may be useful to aid further investigation of not only police officer health, but also the health of those in other first-responder occupations."

--Jeannine Stein

Photo credit: Allen J. Schaben / Los Angeles Times

KISS ex-drummer Peter Criss had breast cancer

News that former KISS drummer Peter Criss, he of the Catman persona, suffered breast cancer has provoked new interest in the subject of male breast cancer, a rare but potentially fatal tumor.

Men have only a small amount of breast tissue concentrated in the area immediately behind the nipple, probably the main reason that they account for only about 1% of all breast cancers. Nonetheless, about 1,990 men will develop the disease this year, and 480 will die from it (compared with more than 40,000 deaths in women), according to the National Cancer Institute. Male breast cancer carries about the same risk of death as the female version, but because it is generally detected at a later stage of progression, the perception is that it is more deadly. The disease is most common in men between the ages of 50 and 60. The lifetime risk of developing it is less than 1% for the average man, but for those carrying the breast cancer gene BRCA2, the risk increases to about 6%. Family history is particularly important: One in every five men with breast cancer has a relative who's also had it.

The primary risk factors for breast cancer in men are:

-- Genetic predisposition.

-- Klinefelter's syndrome, an abnormality of the sex chromosomes.

-- Exposure to radiation as a child.

-- Exposure to estrogen, such as is used in sex-change procedures.

-- Excess weight.

-- Excessive use of alcohol.

The most common signs of the disease include skin dimpling or puckering, development of a new indentation in the nipple, other changes in the nipple, and nipple discharge. If there are signs of disease, it can be detected with a mammogram -- although that is slightly more difficult with men because of the smaller size of the breasts. "It's amazing how they can get a guy's little pecs in that thing that the poor women go through," Criss said. "I have a whole new respect for women going through mammograms.

Most treatments for male breast cancer are the same as for women, with one exception: Breast-sparing surgery is typically not feasible because men have so little breast tissue. Removing the cancer means removing all of the breast.

Criss underwent two surgeries for his tumor but did not need radiation or chemotherapy. His doctor says he is cancer-free today.

For more information, go here or here.

-- Thomas H. Maugh II

Photo (top): Peter Criss in a file photo. Credit: Associated Press / Shiho Fukada

Photo (bottom): KISS. Criss is second from right. Credit: Vince Bucci / AFP Photo

Swine flu cases drop on college campuses for first time

For the first time this academic year, college campuses have reported a significant drop in cases of influenza-like illness, generally assumed to be pandemic H1N1 influenza, according to the American College Health Assn. Unfortunately, the association also recorded the first two deaths from the pandemic among college students at participating campuses.

There were 6,373 cases of illness reported on the campuses enrolling more than 3 million students in the week ending Nov. 13, a 27% drop from the week before, and 12 hospitalizations. Only 95% of the campuses reported cases, down from 98% the prior week. All but five states reported significant declines in disease activity during the week. The five states and regions with increases were New Jersey, Louisiana, Missouri, Idaho and the District of Columbia. South Dakota and Utah reported a 100% drop, with no new cases during the week.

Only limited data have been collected yet about the availability of the swine flu vaccine on campuses, but the figures show that only about 3% of students have been vaccinated to date.

In other swine flu news:

-- Canada has reported a spike in swine flu-related deaths, with more people dying of the virus during the week ending Nov. 17 than in any other week this year. Thirty-seven people died during the week, bringing the total number of laboratory-confirmed deaths in the country to 198, out of a population of 34 million. About 10% of the population has so far received the swine flu vaccine, according to health authorities.

-- The California Department of Public Health said today that 5.19 million doses of swine flu vaccine had been distributed within the state, enough for about 13.4% of the population. All counties have received at least some doses. A chart at the agency's website compares the doses filled to population.

— Thomas H. Maugh II

Is a wonder pill necessarily wonderful for people with Down syndrome?

Scientists are hard at work developing a cure for the genetic disorder Down syndrome. But even if they succeed, nearly 60% of parents whose children have Down syndrome might take a pass.

In a survey conducted by researchers from the psychiatry department at the University of British Columbia in Vancouver, 27% of parents said they would not cure their children, and another 32% said they were unsure. Many parents expressed concern that a cure would change their child’s personality, said Angela Inglis, a genetic counselor who worked on the survey.

“Yes, it is a challenge, but your life will change in so many ways for the good, [but] you can’t imagine not having him,” said one parent who would decline a cure.

That feeling was not universal. Forty-one percent of parents said they would definitely treat their children for Down syndrome. Those parents said they were motivated by a desire to make their kids more independent and to give them more opportunities in life, Inglis said. She added that parents who had the hardest time caring for their children were the most inclined to seek a cure.

“It is very difficult, especially for the family dynamics,” one parent told researchers. “It changes our life because there is so much more stress and issues with a child with special needs. We often feel like giving up on life.”

Patients with Down syndrome have three copies of chromosome 21 instead of the usual two. In addition to the mental and physical symptoms, it can cause congenital heart disease, hearing problems, celiac disease, dementia and problems with the intestines, eyes, thyroid and skeleton. People with Down syndrome often live into their 50s, according to the National Institute of Child Health and Human Development.

About one in every 800 babies is born with the disorder. Pregnant women over the age of 35 are routinely offered prenatal screening for Down syndrome. Nearly two-thirds of parents surveyed said they thought prenatal testing for the disorder – through amniocentesis or chorionic villus sampling – was a “good thing,” and 60% said such testing should be available to pregnant women of any age.

The survey was conducted in Canada and included responses from 101 parents. No similar surveys have been taken in the U.S. The results were reported this week at the National Society of Genetic Counselors’ annual education conference in Atlanta.

The question about a cure might become less theoretical in the not-too-distant future.

In patients with Down syndrome, the brain loses its ability to make an important neurotransmitter called norepinephrine. But researchers from Stanford University and UC San Diego found that in genetically engineered mice that have a rodent version of the disease, injections of a drug called xamoterol returned the animals to normal function.

Once inside the mouse brains, xamoterol converted into norepinephrine and allowed the mice to build nests and complete cognitive tests just like regular animals, according to a study being published in Thursday’s edition of Science Translational Medicine. The drug kicked in within just a few hours, but its effects wore off quickly.

The researchers suggested that people with Down syndrome could be treated with Droxidopa, another drug that converts into norepinephrine in the brain. Droxidopa is currently taken by people for orthostatic hypotension in Asia, and it's in Phase 3 clinical trials in the U.S. now. It should be taken with a second drug called carbidopa that would keep it from converting to norepinephrine until it entered the brain, the researchers said.

-- Karen Kaplan

Photo: A recent survey presented parents whose children have Down syndrome with a dilemma: To cure or not to cure? Credit: Beth A. Keiser / Associated Press