Marion County Medical Center

Health Shorts

July 2007

Leukemia, Flu Link Explored
Cases of acute lymphocytic leukemia (ALL), the most common form of childhood leukemia, increased after the two most recent outbreaks of severe flu in the United Kingdom, according to an Oxford University study.

Researchers stressed that the results provide no proof of a cause-effect relationship but rather a correlation that might be explored in future studies. Data revealed sharp upswings in ALL in 1976 and again in 1990–each time just a few months after flu epidemics.
[SOURCE: Daniel J. DeNoon, “Flu May Trigger Childhood Leukemia,” WebMD Medical News, March 14, 2006]

One Cell Becomes a Trillion
Leukemia, in its acute forms, begins with one cancerous cell that goes on to form a trillion or more leukemia cells. These are white blood cells, but they do not function like other white cells in fighting infection. They also crowd out normal red blood cells, charged with delivering oxygen to cells, and platelets, which are needed for the clotting of blood.
[SOURCE: Leukemia and Lymphoma Society, “Leukemia,” last updated May 10, 2007]

Radiation, Leukemia Link Is Clear
The link between nuclear radiation and the risk of leukemia is well established. After the atomic bomb attacks on Nagasaki and Hiroshima in World War II, the leukemia rate for survivors living within a thousand miles of the blasts was 20 times higher than that of the general population.

An increased risk of childhood leukemia in offspring of these survivors, however, has not been demonstrated. One study found an increased risk for children exposed to radiation in utero, but other studies failed to confirm this result.
[SOURCE: Martin Belson, Beverly Kingsley and Adrianne Holmes, “Risk Factors for Acute Leukemia in Children: A Review,” Environmental Health Perspectives, 2007;115(1):138-145]

Pre-Diabetes in Mothers a Risk
It’s long been known that diabetes during pregnancy is a risk for both mother and child. A recent large study found that high blood sugar in the mother during pregnancy is associated with an increased risk of large babies and first-time Caesarean section births. The babies were more likely to have low blood sugar and high insulin levels with an increased risk of obesity, diabetes and high blood pressure in later life.

“We have established without any question that levels of blood sugar less elevated than typical diabetes carry risks,” wrote the lead author of the study which was presented at the annual scientific meeting of the American Diabetes Association.
[SOURCE: Carla K. Johnson, “Study Links Blood Sugar to Newborn Rirks,” AP Health, June 23, 2007; Study by Boyd Metzger of Northwestern University]

Blood Sugar Control Is Improving
Of the 20.8 million Americans with diabetes, more than half are keeping their blood sugar at the level recommended by their doctors, compared to only a third who had their blood sugar under control in 2001.

Tight control of blood sugar is crucial to preventing diabetic complications that affect the heart, large and small blood vessels, nerves, kidneys, eyes and other organs.
[SOURCE: Julie Steenhuysen, “Americans Making Progress Managing Diabetes,” Reuters Health, June 23, 2007]

Eat Your Watermelon and Papaya
Watermelon, papaya, apricots, asparagus, carrots, squash, red bell peppers, spinach and other greens–they’re all foods high in carotenoids and, as such, should help you head off type 2 diabetes. A study published in the American Journal of Epidemiology [May 19, 2006] found that among teens and young adults followed for 15 years, non-smokers with the highest blood levels of carotenoids at the start of the study were the least likely to develop type 2 diabetes.
[SOURCE: Alan Greene, FAAP, M.D., “Organic Watermelon, Papaya, and Diabetes,” WebMD Medical Commentary from DrGreene.com, reviewed on May 31, 2006]

Coffee Linked to Lower Diabetes Risk
Women who drank six or more cups of coffee a day–decaf or regular–had a 22 percent lower risk of type 2 diabetes than non-coffee-drinkers, according to a study published in the Archives of Internal Medicine [June 26, 2006]. The researchers were surprised to find that the lowest risk was for women who drank decaf coffee; those drinking regular coffee had only slightly lower risk than those not drinking coffee at all.

The authors pointed out that the study did not prove that decaf coffee prevents diabetes but only that a higher coffee intake and a lower diabetes risk occurred in the same women. [SOURCE: Karen Kassel, MS, RD, MEd, “Coffee Drinkers have a Lower Risk of Type 2 Diabetes,” EBSCO Publishing, June, 2006; M.A. Pereira et al, “Coffee Consumption and Risk of Type 2 Diabetes Mellitus,” Archives of Internal Medicine, June 26, 2006]

MRSA: Who’s at Risk?
MRSA (methicillin resistant staphylococcus aureus), a strain of staph that’s immune to the effects of most commonly used antibiotics, was until recently found mostly in hospitals and nursing homes. Over the past decade, cases of MRSA acquired in the community have become increasingly common.

Community-acquired MRSA is often found among persons who live and work in close proximity. Clusters of cases have been found among high school, university and professional athletes; military recruits; children in day care centers; Pacific Islanders; Alaskan Natives; Native Americans; men who have sex with men, and prisoners.

Risk factors include close skin-to-skin contact, cuts or abrasions in the skin, contaminated items or surfaces, crowded living conditions and poor hygiene.
[SOURCE: Centers for Disease Control, “Community-Associated MRSA Information for the Public,” last modified February 3, 2005]

MRSA More Prevalent Than Thought
Methicillin-resistant staphylococcus aureus (MRSA) is 8 to 11 times more prevalent than previously believed and may be infecting 30,000 hospital patients in the United States, according to a survey conducted by infection control professionals in October and November of 2006. About 34 per 1,000 patients were infected and an additional 12 per 1,000 were colonized by this bacterial strain that is immune to most commonly used antibiotics.

[SOURCE: Mike Stobbe, “Staph Superbug May Be Infecting Patients,” AP Health, June 25, 2007, paper presented at annual meeting of Association for Professionals in Infection Control and Epidemiology, June, 2007]

The Five C’s of Germ Transmission
To prevent transmission of bacterial infections such as methicillin-resistant staphylococcus aureus (MRSA), infection control specialists recommend thinking of the five Cs:

crowding
cleanliness (or lack thereof)
contaminated surfaces (such as in saunas and training tables)
contact (particularly skin to skin) and
compromised skin.

Frequent use of antibiotics is another risk factor for MRSA, a strain of staph that is resistant to most antibiotics.
[SOURCE: William T. Basco, Jr., M.D., “Community Acquired MRSA: Evolving Pathogens,” Highlights of the Pediatric Academic Societies Annual Meeting, May 14-17, 2005, Washington, D.C.]

MRSA Increasing Rapidly–Why?
A study conducted at a large public hospital in Chicago found a seven-fold increase in cases of community-acquired MRSA (methicillin-resistant staphylococcus aureur) from 2000 to 2005. During that same period, there was no increase in the rate of community-acquired staph infections that were not drug resistant.

The researchers do not know why the incidence of MRSA has increased so dramatically. The hospital in which the study was conducted, however, serves a population that includes persons living in public housing and those who have recently spent time in jail.
[SOURCE: Miranda Hitti, “MRSA Rising: Who’s at Risk?” WebMD Medical News, May 28, 2007; B. Hota, Archives of Internal Meldicine, May 28, 2007]

Drug Eases Chemo Brain Symptoms
Early studies of Provigil, a drug previously used to treat narcolepsy, found that it enhanced memory and attention among breast cancer survivors suffering side effects of chemotherapy known as chemo brain. Chemo brain is mild to moderate cognitive impairment involving memory, learning, attention and concentration.

In a study of 68 breast cancer patients suffering chemo brain symptoms, subjects using the drug for eight weeks had improvements in attention. The authors stressed that more studies are needed.
[SOURCE: Charlene Laino, “‘Genius Pill’ Relieves Chemo brain,” WebMD Medical News, June 5, 2007; Sadhna Kohli, Ph.D., MPH, 43rd Annual Meeting of the American Society of Clinical Oncology, June 1-5, 2007, Chicago, Illinois]

Brain Changes Noted after Chemo
Brain scans of breast cancer survivors who had undergone chemotherapy showed specific areas of reduced metabolism as long as 5 to 10 years after the last dose of chemotherapy, according to a study conducted at UCLA and published in Breast Cancer Research and Treatment [October, 2006].

In tests of memory, women who had chemotherapy and those given tamoxifen both scored lower than women not receiving those treatments. Many of the women in all groups, however, had normal test scores, and the researchers described the deficits as “really relatively subtle changes.”
[SOURCE: Miranda Hitti, “Subtle Memory Problems after Chemo?” WebMD Medical News, October 5, 2006; Daniel Silverman, “Breast Cancer Research and Treatment, October, 2006]

Why Chemo Brain?
Nearly all cancer patients undergoing toxic treatments such as chemotherapy have some subtle, short-term deficits in memory and concentration. About 15 percent, however, including many breast cancer survivors, have more striking symptoms known as chemo brain that linger for 10 years or longer. Oncologists believe the reasons may include very high doses, such as those used to prepare for bone marrow transplantation, and combining chemotherapy with hormonal treatments such as tamoxifen or aromatase inhibitors.
[SOURCE: Jane Gross, “Chemotherapy Fog Is No Longer Ignored as Illusion,” New York Times Health, April 29, 2007]