Marion County Medical Center

Health Shorts

November 2007

HPV Test Outperforms Pap Smear
A test for human papillomavirus (HPV) was found to be nearly twice as effective as a Pap smear in detecting early cell changes that often develop into cervical cancer, according to a study of more than 10,000 Canadian women published in the New England Journal of Medicine [October, 2007]. HPV, usually manifested as genital warts, is a virus found in 99 percent of cervical cancers.

The HPV test found 95 percent of subjects who had precancerous changes in the cervix while the Pap smear detected only 55 percent. Another study published in the same issue of the New England Journal of Medicine concluded that the detection rate could be increased by 51 percent through combining the two types of tests. A vaccine against some strains of HPV was introduced in June of 2007, but vaccination does not reduce the need for screening.
[SOURCE: Gene Emery, “Virus test found to be better than Pap smear for women,” Reuters Health, October 17, 2007; NEJM, October, 2007]

Access to HPV Vaccine Is Crucial
Gardasil, the new vaccine to prevent cervical cancer, is recommended for all 11- and 12-year-old females. The immune response is greater at this young age, and the vaccine should be administered before sexual activity has started.

The three-shot regimen costs about $360, and the Centers for Disease Control advisory committee recommended that it be included in the federal Vaccines for Children program, which provides free shots to about 40 percent of American children. At present, low socioeconomic status is a risk factor for cervical cancer.
[SOURCE: Donya C. Arias, “New vaccine for cervical cancer virus raises access questions: vaccine approved,” Nations Health 2006;36(6)]

Mothers Want Daughters Immunized
A strong majority of mothers in Great Britain want to have their young daughters given a new vaccine to prevent cervical cancer. Health officials are asking that females age 10 to 14 be immunized, and only 12 percent of mothers were worried that vaccination would encourage their daughters to become sexually active. Another 13 percent were concerned about possible side effects, but 75 percent approved of early immunization.
[SOURCE: “UK mothers back cervical cancer vaccine for kids,” Reuters Health, January 24, 2007; survey conducted by Cancer Research UK]

First HPV, Then Cervical Cancer
At least 99 percent of women who develop cervical cancer have been infected with one of several types of the human papillomavirus (HPV). But the timing may lead a woman to misjudge her risk.

A woman is most susceptible to HPV infection between the ages of 24 and 30, and, since there may be no symptoms, she is unlikely to know she has been infected. Cervical cancer nearly always appears much later in life; in fact, about 20 percent of cases occur after age 60, when a new HPV infection is unlikely.
Only a few types of HPV are associated with cervical cancer, and not all women infected with these types will develop cancer.
[SOURCE: American Cancer Society, “Detailed guide: cervical cancer,” August 4, 2006]

Test Your Knowledge of Angina
If you have stable angina, it’s important to know as much as possible about your condition. To test your knowledge, take this TRUE/FALSE quiz:

1. Angina is a type of mini- heart attack. TRUE or FALSE?
2. Each time you experience angina, your heart suffers permanent damage. TRUE or FALSE?
3. It’s very important to avoid activities that bring on angina. TRUE or FALSE?

The correct answer is FALSE to each of the above questions. Yet a survey of 197 angina patients found that 82 percent of subjects believed incorrectly that they should avoid activities that bring on angina, while 53 percent were wrong on question 2 and 30 percent wrong on question 1.

The same study concluded that “educating patients and demystifying angina” was effective in keeping patients out of the hospital and improving their quality of life.
[SOURCE: “Educating angina patients about their disease reduces hospital admissions,” Reuters Health, April 11, 2007; Journal of Pain Management, 2007;33:310–318]

Exercise Is Best for Keeping Muscles
Levels of hormones such as dehydroepiandrosterone, DHEA, decline with aging at about the same time that abdominal fat tends to become more obvious in both men and women. A two-year study published in the New England Journal of Medicine [October 19, 2006] found that DHEA had no effect on body composition in men and women age 60 and over. Previous studies established that it’s possible to maintain and increase muscle mass at any age through regular exercise that includes strength training.
[SOURCE: “Abdominal fat and what to do about it,” Harvard Women’s Health Watch,. December, 2006]

Exercise Key to Kids’ Abdominal Fat
Abdominal obesity is considered an important health problem that is becoming increasingly prevalent among American children. Visceral abdominal fat is associated with an increased risk of heart disease and type 2 diabetes.

A study of 42 eight-year-old children at risk of obesity found a strong link between increased physical activity and reductions in visceral fat. The authors recommended “structured physical training...to prevent further visceral fat accumulation.”
[SOURCE: Brian E. Saelens, Randy J. Seeley, Kelly van Schaick, Lane F. Donnelly and Kendall J. O’Brien, “Visceral abdominal fat is correlated with whole-body fat and physical activity among 8-y-old children at risk of obesity,” American Journal of Clinical Nutrition, January, 2007]

Stop Fat Storage in Its Tracks
You’ve just had a good 45-minute workout, and the machine tells you that you’ve burned 475 calories. Don’t start feeling too smug: your body is going to start storing fat again before you know it.

In a laboratory study using adolescent rats and exercise wheels, University of Missouri researchers found that abdominal fat cells of physically fit rats started storing fat just five hours after the end of exercise. After two days with no exercise, the fat cells increased in size by 19 percent.
[SOURCE: Daniel J. DeNoon, “Skipping exercise makes fat a bigger problem,” WebMD Weight Loss Clinic–Medical News, April 19, 2005; Journal of Physiology, April, 2005]

Losing Weight? Measure Waist
If you’re trying to slim down, measuring your waist circumference may tell you more about your body composition and your overall health than either weight or body mass index (BMI). Even more than total body fat or weight, abdominal fat is considered an important risk factor for type 2 diabetes, high blood pressure, high cholesterol and heart disease.

A waist measurement greater than 40 inches for a man or 35 inches for a woman is considered high risk. Starting at the top of the hip bone, bring the tape measure all the way around, level with your navel. Don’t hold your breath and don’t pull the tape too tight.
[SOURCE: “Calculating your waist circumference,” WebMD Medical Reference, March 29, 2007]

Kidney Disease Rises among Seniors
The prevalence of chronic kidney disease has increased by about four percent over the past decade, and those most affected are older adults and those who are overweight or have diabetes, heart disease or high blood pressure.

About 40 percent of Americans over age 60 and all adults with type 2 diabetes had kidney disease, according to a report based on national health studies from 1999 to 2004. The disorder was found in 15 percent of overweight and 20 percent of obese subjects; 28 percent of those with heart disease; and 24 percent of those with hypertension.
[SOURCE: Centers for Disease Control, Morbidity and Mortality Weekly Report, March 1, 2007]

New Kidney Treatment Being Tested
Chronic kidney disease, common among diabetics and persons with uncontrolled blood pressure, is a progressive condition that at present cannot be reversed. A new antiinflammatory agent is currently undergoing trials to determine its safety and effectiveness in blocking the inflammation involved in diabetic kidney disease.

At present, diabetic kidney disease is managed through smoking cessation, weight reduction, dietary modifications and control of blood pressure and blood sugar.
[SOURCE: Caroline Cassels, “Researchers investigating inflammation as promising treatment target in diabetic kidney disease,” Medscape Medical News, January 12, 2006]

New Angina Treatment Helps ED
Erectile dysfunction frequently accompanies heart disease, but many men with angina are not allowed to take oral ED medications because of possible interactions with nitrate medications used to treat their recurrent chest pain. A new non-invasive treatment for angina has been found effective in reducing both angina and erectile dysfunction.

Enhanced external counterpulsation (EECP) uses three sets of cuffs wrapped around the patient’s calves and lower and upper thighs that are inflated sequentially to improve blood flow throughout the body. In one study, 89 percent of patients undergoing EECP had improvements in angina status and 84 percent reported improvement in their ED. In fact, 40 percent had complete resolution of their erectile dysfunction.
[SOURCE: W.E. Lawson, et al, “Effect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunction,” International Journal of clinical Practice, 2007;61(5):757-762]

Don’t Waste Time Wondering
About 5 million Americans go to the emergency department each year with chest pain. While slightly less than half of these cases involve heart-related pain, nearly all require a doctor’s opinion. Those who waste time wondering if they should go to the ER could literally die of indecision.
[SOURCE: W. Steven Pray, “The Patient with Chest Pain,” U.S. Pharmacist, 2007; 32(2), 2007]

Health Shorts

November 2007

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