Organ Transplant Recipient Contracts HIV After Donor's Unsafe Sex

Jupiterimages/Thinkstock(NEW YORK) -- Organ donors should be screened for HIV within a week of the operation, the federal Centers for Disease Control and Prevention recommended Thursday.  The call came after the first documented U.S. case of HIV spread by a living donor -- a man who tested negative 10 weeks before a sick patient got his kidney.

The recipient, a kidney failure patient on hemodialysis, contracted HIV months after receiving a kidney from a man who tested negative at his initial screening, but subsequently engaged in unprotected sex, said Claudia Hutton, director of public affairs for the New York State Department of Health in Albany.  Her department, along with New York City's Department of Health, conducted a public health investigation because the 2009 transplant took place at a New York City hospital, which she declined to identify.  However, she said the hospital had followed the necessary protocols.

All agencies involved in the investigation have declined to provide the recipient's gender because of privacy concerns.

On Monday, New York health officials issued interim recommendations calling for hospital administrators, organ transplant directors, and transplant coordinators to follow up initial blood tests for HIV, hepatitis B and hepatitis C with repeat testing.  They recommended using more sensitive testing, called nucleic acid testing, which can detect these viruses within eight to 10 days.  That is well before the immune system responds to the virus by developing antibodies, typically three weeks to eight weeks after exposure.

The state health agency said the additional tests should be performed "no longer than 14 days preceding organ donation" and recommended that potential living donors receive counseling to avoid unprotected sex and injection drug use, which could place them -- and the recipient -- at risk for HIV and hepatitis between the initial screening and the time the organs are transplanted.

Copyright 2011 ABC News Radio


New Analysis Reinforces Links Between Avandia and Heart Problems

Medioimages/Photodisc/Thinkstock(NORWICH, England) -- In 2010, the FDA announced that it would significantly restrict the use of Rosiglitazone, popularly known as Avandia, a drug used to treat type 2 diabetes after the drug was associated with a higher risk of heart attacks.

Now, a new review study from the University of East Anglia in Norwich, England adds more weight to the mounting evidence of the drug being associated with heart problems.

Researchers from the U.S. and UK analyzed the results of 16 studies that directly compare the risk of heart problems for two drugs popularly known as Actos and Avandia. Both the drugs are used to treat type 2 diabetes.

The team found that, compared with Actos, Avandia was associated with a slightly increased risk of heart problems.  However, the researchers noted that both drugs belong to the same class and are known to be associated with heart problems.

While the drug remains on the market in the United States, the use of Avandia has been suspended in Europe since September 2010.

Copyright 2011 ABC News Radio


Report: Current Laws Do Not Keep Kids from Tanning Beds

Stockbyte/Thinkstock(SAN DIEGO) -- Indoor tanning beds are known to increase the risk for skin cancer and there are several laws warning the public about this. However, a new study from San Diego University reports that current laws are not effectively working to keep adolescents from indoor tanning.

Researchers interviewed 6,125 adolescents aged 14-17 years and their parents and asked them if they had used indoor tanning beds in the past 12 months. They also analyzed state indoor tanning laws and conducted interviews with enforcement experts in the 100 most populous U.S. cities.

Their analysis found that 17.1 percent of girls and 3.2 percent of boys had used indoor tanning facilities. Moreover, teens were 70 percent more likely to use a tanning facility if a parent had used it before. Residing in a state with youth-access laws that specify age restrictions or require parental consent also did not appear to decrease the number of teens going for tanning.

The study's authors conclude that current laws are ineffective in reducing indoor tanning and bans might be needed.  The report emphasized the need for stricter laws such as a ban on tanning for people under the age of 18 years as recommended by the World Health Organization.

The study is published in the American Journal of Public Health.

Copyright 2011 ABC News Radio


Intersex Babies: Boy or Girl and Who Decides?

Jupiterimages/Thinkstock(NEW YORK) -- An estimated one in 2,000 children born each year are neither boy nor girl -- they are intersex, part of a group of about 60 conditions that fall under the diagnosis of disorders of sexual development (DSD).

Once called hermaphrodites, from the handsome Greek god who had dual sexuality, they are now known as intersex.

Standard medical treatment has been to look at the genitals, determine the gender and then correct it surgically.

But now, many are challenging the ethical basis of surgery, knowing that gender identity is complex, and doctors can sometimes get it wrong, not knowing how a child will feel about their gender assignment when they grow up.

Advocates argue that surgery is irreversible and can have tragic consequences. In some surgeries on virilized girls with ambiguous genitalia, removing sensitive tissue and vessels can ultimately rob them of sexual sensation as adults.

As little as a decade ago, the medical community thought of gender as a slate that could be erased and then redrawn. Today, gender identification is still not well understood, but experts say that when sex cannot be determined, it's better to use the best available information to assign gender, then to wait and monitor the child's psychological and physical development before undertaking surgery, if at all. Waiting until puberty also allows the child to participate in the decision.

"Our chromosomes don't tell us who we are," said Dr. Arlene Baratz, a Pittsburgh breast radiologist who has two intersex daughters. "We expect XX is pink and a girl and XY is blue and a boy, but we know from children with gender identity conditions that is not always the case, even when their bodies are perfectly typical."

Anne Tamar-Mattis, executive director of Advocates for Informed Choice, worries about the legal side of this complicated issue, especially when it involves sterilization without a child's consent.

"We don't weigh in on what medical decisions people should make," she said. "We weigh in on children's rights. If the decision involves sterilization, the child has a right to court over sight."

And when parents are making these complex decisions to remove the child's reproductive organs, they must be fully informed. Often, they are not, she said.

Katrina Karkazis, senior research scholar at Stanford's Center for Biomedical Ethics and author of Fixing Sex: Intersex, Medical Authority and Lived Experience, agrees that "the child can't speak for him or herself."

The number of children who don't accept their gender assignment is small, according to Karkazis. "What's missing is these families and kids don't get the appropriate social and psychological support."

She recommends that doctors "check in" with the child over his or her life span and "find out what they are feeling."

Copyright 2011 ABC News Radio


Fire Department App Rallies CPR-Trained Citizens in Emergencies

Stockbyte/Thinkstock(SAN RAMON, Calif.) -- A new iPhone application is making it easier than ever for CPR-trained Good Samaritans to save lives.

Launched by California's San Ramon Fire Protection District, the fire department app alerts CPR-savvy citizens to cardiac emergencies in their areas, with the hope that they'll be able to help out until emergency professionals arrive.

The app was launched in January, but got a big boost this week when San Francisco signed on as the first major city to back the technology.

"What's so important about sudden cardiac arrest is brain death occurs between four and six minutes after your heart stops. Even your best emergency services can take up to five minutes to get to the site of the patient," said Kimberly French, an information officer with the San Ramon Fire Protection District. "It's so important to bridge that gap, because what it does is it stops the clock."

Linking CPR-certified citizens to a local 911 dispatch center helps buy time until professionals can help victims of cardiac arrest, she said.

San Ramon fire officials hatched the idea after a 2009 incident in which the district's fire chief Richard Price (whom locals call "Fire Chief 2.0") was at a deli when, unbenknownst to him, a cardiac emergency was reported next door, French said.

The victim survived, she said, but the incident spurred Price and his peers to figure out how to match people with CPR training to those who need it, in real-time.

When users download the application, they're asked if they're trained in CPR. If they indicate that they are, the app quietly monitors their locations. When 911 dispatchers learn of a cardiac arrest, they can send a text-like push notification to all CPR-trained users of the application who are nearby. The message includes the location of the victim as well as the precise location of the closest public access Automated External Defibrillator (AED).

Since its launch in January, Fire Department has been downloaded more than 30,000 times, French said. But so far only the San Ramon Fire Protection District is using the site.

"The ultimate goal is to make it available for all emergency services to use," French said. "It's too good for us to keep in our little jurisdiction out here in California."

Copyright 2011 ABC News Radio


Japan Earthquake: Psychological Fallout Could Last Years

JIJI PRESS/AFP/Getty Images(TOKYO) -- The trauma doesn't seem to end for Japan: first earthquake, then Tsunami and now comes this. It's a country with more than 4,000 known dead, while nearly 10,000 more missing must cope with the threat of nuclear contamination.

Although officials are still struggling to meet the immediate, physical needs of survivors, the psychological wounds of this disaster, for those directly affected and the nation as a whole, will leave their imprint for years, even decades, to come, psychologists say.

Beyond the practical aspects of rebuilding, how does a devastated nation restore the minds and hearts of its people and stave off long-term psychological distress? Even as relief efforts fight to get food, baby formula, water, and oil to the affected region, post-trauma mental health care has already begun.

Psychiatric teams have gone into the area, says Dr. Makiko Okuyama, head of the Department of Psychosocial Medicine at the National Center for Child Health Development, who is part of the relief effort now in Japan.

After Japan's Kobe earthquake in 1995, "it was chaos," he says, but that disaster birthed Japan's first consolidated system for psychological aid following a crisis. "But this disaster is much more than we expected; too wide [of an] area and too much damage," he says.

Meeting physical needs is the first priority for psychological aid, he adds.

Back in Tokyo, the Japanese Society of Neurology and Psychiatry, the equivalent to the American Psychological Association, is meeting Friday night to discuss how it will handle the situation, says Dr. Fumitaka Noda, co-chair of the World Psychiatric Association and chair of the Japanese Society of Transcultural Psychiatry at Taisho University in Japan.

It will take a long and concerted effort on the part of mental health care workers in Japan, and most likely those abroad as well, to meet the psychological needs of the survivors in the coming weeks, months and years, says Reiko True, a clinical psychologist who worked with Kobe earthquake victims and was in Tokyo's Narita airport at the time of last week's earthquake.

"Since Kobe [Japan] has done a lot of preparation for dealing with "not only the physical and structural needs of a community, but to care for the psychological wounds of the people, but I think the needs now are overwhelming," she says. "Eventually, they will want and welcome help from the outside. What I'm hearing is that they are not prepared to accept mental health help from the outside yet, though." 

Copyright 2011 ABC News Radio


Higher Cancer Risk Continues After Chernobyl

Stockbyte/Thinkstock(BETHESDA, Md.) --  A new study from the National Institutes of Health finds the risk of thyroid cancer for those exposed to the fallout of Chernobyl has not yet to decline.

Nearly 25 years after the accident at the Chernobyl nuclear power plant in Ukraine, exposure to radioactive iodine-131(I-131, a radioactive isotope) from fallout may be responsible for thyroid cancers that are still occurring among people who lived in the Chernobyl area and were children or adolescents at the time of the accident, researchers say.

An international team of researchers led by the National Cancer Institute (NCI), part of the National Institutes of Health found a clear dose-response relationship, in which higher absorption of radiation from I-131 led to an increased risk for thyroid cancer that has not seemed to diminish over time.

The study, which represents the first prospective examination of thyroid cancer risk in relation to the I-131 doses received by Chernobyl-area children and adolescents, appeared March 17, 2011, in the journal Environmental Health Perspectives.

"This study is different from previous Chernobyl efforts in a number of important ways. First, we based radiation doses from I-131 on measurements of radioactivity in each individual's thyroid within two months of the accident," explained study author Alina Brenner, M.D., Ph.D., from NCI's Radiation Epidemiology Branch.  "Second, we identified thyroid cancers using standardized examination methods. Everyone in the cohort was screened, irrespective of dose."

The study included over 12,500 participants who were under 18 years of age at the time of the Chernobyl accident on April 26, 1986, and lived in one of three Ukrainian oblasts, or provinces, near the accident site: Chernigov, Zhytomyr, and Kiev.  Thyroid radioactivity levels were measured for each participant within two months of the accident, and were used to estimate each individual's I-131 dose.  The participants were screened for thyroid cancer up to four times over 10 years, with the first screening occurring 12 to 14 years after the accident.

Copyright 2011 ABC News Radio


Pursuit of Better Hairline Costs Some Men Their Sex Lives 

Bananastock/Getty(WASHINGTON) -- The baldness drug finasteride has left some young, otherwise healthy men with persistent impotence, diminished sex drive and depression long after they've stopped taking it, according to emerging medical studies and patient reports, as well as lawsuits filed in the United States and Canada.

Millions of men have taken five-mg finasteride tablets since the U.S. Food and Drug Administration in 1992 approved Merck and Co. Inc's Proscar for non-cancerous enlargement of the prostate gland. Millions more have taken finasteride since FDA's 1997 approval of Propecia, Merck's lower-dose (one mg) formulation for male-pattern baldness, which affects about half of all men.

In 2002, the FDA approved GlaxoSmithKline's closely related drug dutasteride (Avodart) to shrink enlarged prostates, further expanding the market for name-brand and generic 5-alpha reductase inhibitors. The drugs block an enzyme that converts the male sex hormone testosterone to dihydrotestosterone, which is toxic to hair follicles, but important for healthy sexual functioning.

Although the generally rare sexual side effects of finasteride and dutasteride have been mentioned at urology meetings, information about potentially irreversible consequences hasn't yet reached the larger community of prescribing physicians, such as dermatologists and primary care doctors -- or their patients, said researcher Abdulmaged M. Traish, a professor of biochemistry and urology at Boston University School of Medicine.

For an article published in the March issue of the Journal of Sexual Medicine, Traish and a BU colleague, along with endocrinologists from Peabody, Mass.; Germany and Norway, reviewed available scientific studies on the adverse effects of finasteride and dutasteride. Although the overall percentage of men reporting sexual side effects was small, ranging from 5 percent to 23 percent, Traish said half of them never had their side effects go away.

"We found out that we're really ignoring the important part, especially those in whom the problem becomes persistent," Traish said in an interview Wednesday. "That's the group that everybody forgot. We have to worry about the consequences for people who are going to suffer -- even after they discontinue the drug -- from continuous loss of libido and potential depression." Other observed effects included reduced ejaculation and smaller volume of semen.

Copyright 2011 ABC News Radio


Doctors Fail to Monitor Potential Opioid Abuse Appropriately

Brand X Pictures/Thinkstock(NEW YORK) -- Statistics show the abuse of prescription painkillers has been on the rise for nearly two decades, but a new study found that primary care physicians may not be diligently monitoring patients who are taking opioid painkillers such as OxyContin, even those who are at risk for becoming dependent on them. Experts say dependence on opioids accounts for much of the rampant prescription drug abuse.

"We studied a cohort of more than 1,600 primary care patients prescribed long-term opioids and looked at how frequently they received three strategies for reducing the risk of misuse," said lead researcher Dr. Joanna Starrels, assistant professor of medicine at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, N.Y. The three risk-reduction strategies are urine tests, face-to-face office visits at least every six months and within a month of changing an opioid prescription, and limiting the number of early refills.

Data showed that only eight percent of the patients in the study had any urine drug testing, less than half had regular office visits and nearly 25 percent received multiple early refills.

"This suggests that primary care physicians are not using these risk reduction strategies very frequently," said Starrels.

Whitney O'Neill knows just how powerful prescription pain medication can be, and also how easy it could be for doctors to miss the signs of addiction.

For almost eight years, she was physically dependent on them. She started taking the drugs when she was around 12, after a fall caused her to suffer from crushing migraines. She was 17 when she said the drugs became a problem.

"After years of repeated use, I developed a dependency on them," said O'Neill, now 31. "I started to get sick if I didn't take them."

While she doesn't blame her doctor for feeding her habit with a constant supply of painkillers, she doesn't think her doctor realized she had a problem. And at that time, she couldn't admit she was an addict.

"I think it was a missed opportunity to have recognized I had addictive disease," said O'Neill, who is now outreach coordinator for Faces and Voices of Recovery, an advocacy group.

Addiction specialists say a lot of burden falls on primary care physicians, usually on the front lines of pain management. Some believe primary care physicians just don't know enough about addiction, while others say factors beyond their control are contributing to the increased use of opioids.

"Most primary care physicians are not trained in addictions," said Dr. Stephen Ross, clinical director of the NYU Langone Center of Excellence on Addiction. "It's not that physicians are not well-meaning, it's just a lack of education and not knowing how to treat addictions."

"It's not a lack of awareness or caring, but they don't have the tools to help manage the risk," said Starrels. "They may not know what risk the factors are or how to monitor their patients for evidence of misuse."

As for the finding that many doctors provide more early refills to patients at higher risk for misuse, even those who have a drug use disorder, Starrels stressed it's important to figure out why. She says it may be because patients are abusing the medications or because doctors are cautious and prescribing a lower dose than patients need for pain.

"This finding is very concerning, and we need to understand the reasons." 

Copyright 2011 ABC News Radio


Lawmakers Sponsor Bill to Reduce Sports-Related Injuries

Comstock/Thinkstock(WASHINGTON) -- Kids playing sports is a good thing but what they're using to protect themselves from serious injuries may be worrisome.

With that in mind, two Democratic lawmakers introduced legislation Wednesday meant to make sure that high school-aged and younger children wear football helmets that meet stringent safety standards to lower the risk of concussions and other injuries.

The Children's Sports Athletic Equipment Safety Act, sponsored by New Mexico Sen. Tom Udall and New Jersey Congressman Bill Pascrell, would also slap stiffer penalties against equipment manufacturers who make false safety claims about their sports gear.

While today's football helmets are an upgrade from those used generations ago, most only afford maximum protection from a direct hit to the head.  They don't take into account less severe impact or accidents that spin the head and brain.

The other major problem is that helmets aren't usually replaced every year by schools.  Some athletes wear headgear that's over a decade old.

More people aged 15 to 24 suffer traumatic brain injuries from sports than from any cause other than vehicular accidents.  It's believed that there are as many as 3.8 million sports-related concussions annually.

Copyright 2011 ABC News Radio

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