Even Elves Need a Good Night's Rest

(HealthDay News) -- This holiday season, sleep may be the most precious gift you can give yourself.

"During this frantic time of year, it is common for many people to make sleep less of a priority in order to make sure everything is accomplished in time," Michael H. Silber, president of the American Academy of Sleep Medicine (AASM), said in a prepared statement.

"However, because your body is not a machine, it can't keep going, and eventually needs to rest. To make the season more enjoyable for you, it is important to make sure you are well-rested, so that you are able to better manage the stress that often develop during this time of year," Silber said.

He noted that more people are sleep deprived during the holiday season than at any other time of the year, because people try to cram too many tasks and activities into a short period of time.
"You can't be at your best if you are fighting sleep deprivation. Saying 'no' to just one or two extra demands this time of year may make all the 'yeses' more pleasant and more enjoyable for you and your family," Silber said.

The AASM offers some tips for getting enough rest over the holidays:

• Take time to relax. Even if you have plenty to do, you should stop at a certain point in the evening in order to give your brain time to wind down before bed. This will help you sleep better.
• Keep your sleep pattern on schedule. Maintain a regular bedtime and wake-up time. Other rituals, such as a warm bath or reading before bed, also may help.
• If you become drowsy while driving to a holiday destination, pull off in a rest area and take a short nap -- about 15 to 20 minutes.
• Don't eat heavy meals before bedtime, because that causes heartburn or discomfort that can prevent you from falling asleep or disturb your sleep.
• When you go to evening parties, don't have too much alcohol or caffeine, which can also harm your sleep.

More information
The National Sleep Foundation has more about getting a good night's sleep.

Breast Cancer Rates Drop in U.S.

(HealthDay News) -- The incidence of breast cancer in the United States dropped precipitously in 2003, and new research suggests the downward trend was the result of millions of women discontinuing use of hormone replacement therapy.

The drop was most pronounced among women over 50, and was seen mostly with estrogen receptor-positive breast cancers, which are fueled by the hormone estrogen. As many as 14,000 fewer women were diagnosed with breast cancer in 2003 than in 2002, the researchers stated.

"This is big news," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System, in Baton Rouge. "This has profound public health implications for women in this country."

The decline in the number of women taking HRT came just after publication of the results of the landmark Women's Health Initiative (WHI) trial in 2002. That study, involving 16,608 participants, was halted after researchers found elevated health risks among HRT users, most notably for breast cancer and stroke.

Since then, a debate has raged about the utility and safety of HRT, with health officials advising women to take HRT only when needed and for as short a period as possible.

The authors of the current study looked at data on women in nine regions across the country from 1990 to the end of 2003.

Between 1990 and 1998, the incidence of breast cancer incidence in the United States increased at 1.7 percent per year. Between 1998 and 2003, incidence began to go down at 1 percent per year and, in 2003, there was a 7 percent drop in a single year.

According to the study authors, who presented their findings Thursday at the annual San Antonio Breast Cancer Symposium, this was the largest single drop ever in breast cancer incidence within a single year. "Something went right," study author Dr. Peter Ravdin, a research professor in biostatistics at M.D. Anderson Cancer Center in Houston, said in a statement.

Further analyses revealed that the decline was most evident in patients older than 50 and for estrogen receptor-positive tumors. The steepest decline (12 percent) was in women aged 50 to 69 who had estrogen receptor-positive tumors. Women in that age range with estrogen receptor-negative tumors saw a 4 percent decline in incidence.

Women with estrogen receptor-positive breast cancer showed an 8 percent decline vs. 4 percent for women estrogen receptor-negative breast cancer.

The incidence of breast cancer in the United States had been increasing for the two decades prior to July 2002, and experts had speculated that HRT may have played a role.

According to the researchers, about 30 percent of women over the age of 50 had been taking HRT in the first part of this decade and about half of those stopped using HRT in late 2002.

Estrogen receptor-positive tumors will stop growing if the fuel they need is cut off, which may explain the suddenness of the decline.

Still, it's not certain that HRT caused the decline, only that the association is a strong one and further studies need to be done, the researchers stated.

More information
For more on HRT, visit the U.S. National Library of Medicine.

Generic Wellbutrin XL Approved

(HealthDay News) -- The U.S. Food and Drug Administration has approved the first generic version of Wellbutrin XL (bupropion hydrochloride), an extended-release antidepressant sanctioned for major depressive disorder (MDD).

License to produce the generic version was granted to Anchen Pharmaceuticals Inc. of Irvine, Calif.

Last year, the brand-name drug, produced by GlaxoSmithKline, was the 21st highest-selling brand-name medication in the United States, with more than $1.3 billion in sales, the agency said in a statement.

Less-costly generic drugs are now used to fill more than 50 percent of all prescriptions, the FDA said. "Consumers and health professionals can be assured that an approved generic drug is bioequivalent to a brand-name drug and is its equal in dosage form, strength, and route of administration, quality, performance characteristics, and intended use," the agency statement added.

More information
To learn about Depression, visit the U.S. National Institute of Mental Health.

U.S. Panels Begin Hearings on Antibiotic's Safety

(HealthDay News) -- The manufacturer of the controversial antibiotic Ketek defended its safety while U.S. health officials defended its approval, as two days of safety hearings got underway Thursday.

In testimony before two U.S. Food and Drug Administration advisory panels, representatives of Sanofi-Aventis, which manufactures Ketek (telithromycin), claimed the drug was no more dangerous than similar antibiotics and was more effective against drug-resistant bacteria.

And at the end of the hearing, FDA officials justified the use of post-marketing data from Europe to approve the drug in April 2004.

Ketek is used to treat certain types of bronchitis, sinusitis and pneumonia. But since its approval, more than 600 cases of liver damage, loss of consciousness and other side effects have been reported, Bloomberg News reported.

"Use of post-marketing data is not unusual. It's not as if we relied solely on post-marketing data from Europe," Dr. John Jenkins, director of the FDA's Office of New Drugs, Center for Drug Evaluation and Research, explained during a news conference late Thursday.

"We had a substantial safety database on Ketek at the time of approval, far in excess of standard guidelines, and we supplemented that with post-marketing surveillance data from Europe to help us address specific questions," he added.

Before approving the drug, the FDA also took the unusual step of requesting a prospective safety trial. "That goes far beyond the internationally recognized accepted standards for the amount of data needed for approval," Jenkins said. "We wanted to assure ourselves that liver injury was not a common adverse event."

The two advisory committees are now meeting to discuss safety issues with the drug and may possibly recommend labeling changes or even its removal from the market.

Other experts not involved with the hearings questioned whether the drug should be on the market at all.

"I have never written a prescription for Ketek," said Dr. Douglas Hurley, a professor of internal medicine at Texas A&M Health Science Center. "It doesn't provide anything we don't have with a number of other drugs; so quite honestly, I don't see it as being all that important."

"It's not horribly unsafe," Hurley added. "There are some cases of liver failure, which can happen with any number of drugs. But why take the risk?"

In June, Sanofi agreed to update Ketek's labeling to reflect the possibility of severe liver damage.

Last month, a European Medicines Agency panel recommended that Ketek not be given to patients with a history of such liver conditions as hepatitis or jaundice.

But much more than a drug may be on trial here.

The U.S. Senate Finance Committee is investigating allegations of fraud involving clinical trials of Ketek and is looking into how the FDA handled Ketek-related safety issues.

According to Bloomberg, Sen. Charles Grassley, an Iowa Republican, accused the FDA of withholding relevant information at the time of the drug's approval.

The FDA "can't be in the business of misleading the public and hiding the truth," and "the integrity of the agency is at stake," Grassley said in a statement Wednesday.

Grassley asked FDA Commissioner Dr. Andrew von Eschenbach to respond by Jan. 17 to allegations that the agency had knowingly used fraudulent safety data to approve Ketek, Bloomberg reported.

Asked Thursday to respond to the allegations in the letter, Jenkins replied, "There will be an official response to the document. I don't want to get into the details of that."

More information
For more on the briefings, visit the U.S. Food and Drug Administration.

Circumcision Reduces HIV Rates, U.S. Studies Confirm

(HealthDay News) -- U.S. researchers in Africa said Wednesday that they found that circumcision is such a good defense against HIV infection that they shut down two studies early, and instead offered all participants a chance to be circumcised.

One study in the east African country of Kenya showed that circumcision cut adult males' HIV infection risk from heterosexual intercourse by 53 percent, while another study in Uganda lowered the risk by 48 percent, according to results released Wednesday.

The findings, financed by the U.S. National Institutes of Health (NIH), pointed out that the latest conclusions confirmed previous investigations into the value of circumcision as a protection against HIV, the virus that causes AIDS. This is especially important in Africa, where AIDS is an epidemic in many countries, infecting an estimated 25 million people on the continent.

Despite the good news, there is still plenty of reason for caution, AIDS experts said.

"Male circumcision is a difficult intervention to implement, and the preventive effect is relative, not absolute," said Thomas Coates, an AIDS specialist and a professor of medicine at the University of California at Los Angeles. "The magnitude of effect is 50 to 60 percent, which still leaves ample room for people to get infected with HIV."

There are other caveats as well: The study did not look at male-to-female transmission, and it was also not clear whether circumcision makes it less likely that gay men could transmit HIV to each other.

In the United States, homosexual transmission of HIV is more common than heterosexual transmission, the experts said. And most men in the United States are circumcised, making the procedure less effective as a possible prevention tool.

Still, the findings could have plenty of meaning in Africa, where HIV is commonly spread between men and women.

Studies have suggested the value of circumcision in the past, but researchers wanted to confirm the previous findings.

According to the NIH, most adult Africans are circumcised, but the rate drops below 20 percent in some areas of southern Africa where HIV and AIDS are common.

In one of the two studies, researchers enrolled 2,784 HIV-negative, uncircumcised men in Kenya beginning in 2002. The other study, in Uganda, started in 2003 and enrolled 4,996 HIV-negative, uncircumcised men.

Some of the men were assigned to immediately undergo circumcision, while others had to wait two years.

Then researchers studied whether the circumcision had any effect on their rates of getting HIV.
The results were so encouraging that an oversight board halted the studies this week, and ordered that all participants be given circumcisions instead of having to wait.

In Kenya, researchers found that only 22 of the 1,393 circumcised men in the study were infected with HIV, compared to 47 of the 1,391 men who had yet to be circumcised.
The numbers for Uganda weren't immediately available.

"Circumcision is now a proven, effective prevention strategy to reduce HIV infections in men," Robert Bailey, a study investigator and professor of epidemiology at the University of Illinois at Chicago, said in a statement.

It's not entirely clear how circumcision reduces HIV infection. But researchers have suggested that the foreskin may provide a moist, safe environment for the AIDS virus and provide more immune cells for HIV to infect.

Coates called the study results the "second greatest finding in HIV prevention," right behind research that confirmed drugs could stop mother-to-baby transmission of the AIDS virus.

Still, he added, "combination prevention" remains crucial -- combining circumcision with using condoms, reducing sexual partners, and delaying the first time people have intercourse.

The Associated Press reported that the link between male circumcision and HIV prevention was first noted in the late 1980s. The first major clinical trial, of 3,000 men in South Africa, found last year that circumcision cut the HIV risk by 60 percent.

More information
The Nemours Foundation's Web site discusses the pros and cons of circumcision.

A Year of Major Advances in Cancer Cited

(HealthDay News) -- There were important advances in the detection and treatment of cancer this year -- more people than ever are now surviving the disease -- but cuts in government cancer research dollars could slow progress in the fight.

Those are the conclusions of new research released Friday by the American Society of Clinical Oncology (ASCO).

The report, Clinical Cancer Advances 2006: Major Research Advances in Treatment, Prevention, and Screening, identified six important advances in cancer research for the year, including five new drugs that prolong life.

But, despite such progress, ASCO executives are upset at recent cuts in federal funding for cancer research. To keep pace with inflation, the group is calling for a minimum annual funding increase of at least 5 percent both from and for the U.S. National Institutes of Health (NIH).

"In the last four decades, the investment in clinical cancer research has yielded major progress in prevention, detection and treatment of a wide variety of cancers," Dr. Robert F. Ozols, chairman of ASCO's Cancer Communications Committee, said during a teleconference.

Ozols, a researcher at Fox Chase Cancer Center in Philadelphia, noted that there are now 10 million cancer survivors in the United States, up from 3.5 million in 1970.

"For the first time in 70 years, the number of deaths in the United States due to cancer declined in 2003," he said. "In addition, we are treating cancer better and with less toxicity."

The ASCO report includes only the most important developments in the way cancer is understood or impacts patient care and survival, Ozols said. The most important advances in cancer treatment in the past year, according to the report, are:

The HPV vaccine, Gardasil. As a preventive against human papillomavirus (HPV) infection, the cause of most cervical cancer, the vaccine has the potential to reduce the burden of cervical cancer, which is diagnosed in almost 500,000 women around the world each year. In addition, a 2006 study found the vaccine was also effective in preventing HPV-related vaginal and vulvar precancers.
Targeted therapies that improve survival and response rates for hard-to-treat cancers. These include:

For kidney cancer, the investigational drug temsirolimus (CCI-779), which improved survival when used as a first-line treatment for people with advanced, high-risk kidney cancer, and sunitinib (Sutent), which improved progression-free survival and response rates.

For advanced breast cancer treatment, there is now Lapatinib (Tykerb). For leukemia patients, Dasatinib (Sprycel), which is effective in those who are resistant to imatinib. And last year, cetuximab (Erbitux) arrived, the first new treatment for head-and-neck cancer in 45 years.

Significant advances in genetic tests that predict the outcomes of people with lung cancer.
"These advancers did not happen by accident," ASCO president Dr. Gabriel N. Hortobagyi, from the University of Texas M.D. Anderson Cancer Center, said at the teleconference. "These are the results of the last 30 years of work by investigators and by a major investment this country has made in cancer research."

But cancer research funding itself may well be in crisis, he added. Funding for the NIH had doubled each year up to 2003, but has not been increased since then, he said.

"If you add inflation to that, it is a net cut in funding," Hortobagyi said." We expect next year there will also be a net cut in funding, and that is unfortunate because we are even better prepared today to harvest practical results from the investment in cancer research."

In 2004, the National Cancer Institute, which is part of NIH and funds cancer research, received $4.7 billion, according to NCI. That represents only a 3.2 percent increase over the previous year.

Hortobagyi thinks that rising government deficits and spending in other areas are draining essential dollars from cancer research.

"The decreases in funding are destructive not only because they prevent further progress, but because they result in the dismantling of existing infrastructures for research," he said.

Hortobagyi believes that the National Institutes of Health needs to continue to increase funding just to keep the progress in cancer research at current levels.

"We need a minimum, but consistent, increase of 5 percent per year dedicated to biomedical cancer research," Hortobagyi said. "That will be barely above inflation. It may not ensure growth, but it will ensure maintenance of our current infrastructure and efforts."

More information

The U.S. National Cancer Institute can tell you more about cancer research.

Coated Stents Should Stay on Market, U.S. Advisers Say

(HealthDay News) -- In the face of incomplete evidence on the safety of drug-coated stents in the real world, a panel of U.S. heart experts said Friday that the devices should stay on the market, but with certain caveats.

The U.S. Food and Drug Administration panel charged with investigating the safety of such stents said that all patients receiving the devices are at heightened risk for blood clots, and that many patients receiving the devices are at risk for heart attacks and death.

But there isn't enough evidence to say if the danger of heart attacks and strokes is due to the devices or the patients' poor health, the panelists added.

The group also noted that the data on the danger of off-label use was inconclusive, and that patients receiving drug-eluting stents should receive blood thinners for at least a year after the procedure.

"We feel that there are significant uncertainties, and it is difficult to make conclusive judgments regarding this issue," panel chairman Dr. William Maisel, of Beth Israel Deaconess Medical Center in Boston, said during the hearing, according to the Associated Press.

The panelists did recommend that the labels on the devices be updated to warn doctors that off-label use won't produce the same results as seen in generally simpler cases involving healthier patients, the wire service reported.

Experts noted the lack of information on the safety of coated stents poses a serious problem.

"The first question was [whether] there's a huge safety signal that should take stents off the market, and it sounds like they're comfortable that evidence was not strong enough for anything like that," said Dr. Kevin Schulman, director of the Health Sector Management Program at Duke University, in Durham, N.C.

"This reflects an uncertainty about the level of evidence, which is unfortunate given the number of people who receive procedures each year," he added. "There's a real need to get better evidence very quickly to answer these questions."

Of particular concern are the number of people , about 60 percent of total patients, who receive the devices off-label. On-label use is limited to no more than two stents; off-label covers three or more.

"The label is fairly narrow, so most are getting it off-label," Schulman explained. "Most are getting multiple stents in one single procedure, and the original clinical trials didn't cover all of those uses."

One expert said he was concerned that the FDA was sidestepping the issue of off-label use.

"This is a most compelling and overriding public health concern that the FDA has not been willing to tackle head-on," said Dr. Robert Michler, director of the heart center at Montefiore Medical Center/Albert Einstein College of Medicine in New York City. "The stents have clearly demonstrated a reduction in restenosis rates, but the question is: at what price?"

There may actually be two prices being paid, Michler added, one being the immediate risk of blood clots and the other the fact that patients are lulled into believing that their survival rates are being improved.

"There is no evidence to support that," he said. "There has never been demonstrated a survival benefit with stents when compared to the gold standard, which is bypass surgery. If stents are being applied to patients with multi-vessel disease or single vessel disease with decreased heart function, this is being done as an off-label use because there's no evidence to support that as a lifesaving therapy."

During Friday's hearing, the second in two days, the 21 panel members, who didn't take formal votes, stated their opinions and recommendations individually or reached informal agreements on positions as a group, according to Bloomberg News. The FDA usually heeds the recommendations of its outside advisers, though it isn't required to do so.

The key issue has been whether drug-coated stents, which have become dominant tools in the field of cardiovascular surgery since their introduction three years ago, create a heightened risk of potentially fatal blood clots. An estimated 6 million people worldwide have received the devices, 3 million of them in the United States.

The drug-coated stents release medicine designed to limit the incidence of arteries reclosing after angioplasty. The problem of reclosing is more frequently seen with traditional bare metal stents. And re-closures require repeat surgery.

A number of recent studies have suggested that drug-coated stents, which can cost thousands of dollars each, have long-term dangers -- most specifically, the risk of clots that could cause heart attacks. According to some estimates, drug-coated stents may cause an extra 2,160 deaths in the United States each year.

The advisory panel's recommendations on the use of blood thinners are unlikely to change real-world practice and may even be inadequate, experts said.

"We've always recommended that patients be on aspirin and Plavix [a blood thinner] for one year, and in the subgroups that are at the highest risk for other problems continuously after that," said Dr. Scott Monrad, director of the cardiac catheterization lab at Montefiore Medical Center in New York City.

"Patients have to understand that they may have to stay on blood thinners a minimum of one year, but maybe for the rest of their lives," Schulman added.

There is also concern that stents are being used when conventional bypass surgery should really be used.

"This has made us a little more sober in recognizing that there are risks that go with the procedure, and we shouldn't be careless," said Monrad. "In some patients, bypass surgery may very well be the preferred approach."

At the same time, Monrad emphasized, stents have completely eliminated restenosis as a medical problem.

"That is a dramatic change in practice," he said. "When we fix something now, in virtually every patient it stays fixed."

And, overall, the incidence of problems is still very low, he added.

More information

Visit the American Heart Association for more on stents.

Go for Gifts That Get Kids Hopping

(HealthDay News) -- This Christmas, experts are advising that Santa skip the video games and bring kids toys that exercise more than just their thumbs.

"With obesity on the rise across the country, toys that get kids moving are some of the best gifts you can give," University of Indianapolis physical therapy professor Anne Mejia Downs said in a prepared statement. "Regular exercise can improve concentration, decrease anxiety, prevent and treat depression, and even help kids sleep better."

Downs offered a list of toys and games that encourage kids to be active. Many of the items she recommended can be played indoors.

"Kids can play them after school if they're home alone and can't leave the house, and they're also great for bad weather days," she said.

The games and toys recommended by Downs include:

Cranium Hullabaloo. It prompts children to jump, dance, and run around. It also encourages following directions, color and shape recognition, and coordination.
Twister Moves. Each player gets an individual mat that they use while they follow directions from a CD. This game emphasizes balance, coordination, flexibility, timing, reaction time and motor control.

Dance Dance Revolution. This item, based on a popular arcade game, gives children directions on how to move their feet while they listen to popular songs. It offers cardio/aerobic exercise and helps hone coordination, balance, rhythm, reaction time and motor control.
And a pedometer makes a great stocking stuffer for both kids and adults, Downs said.

"You can first use it to see how many steps you take in an average day (which is usually less than people think), and it can help you to increase the number of steps per day," she said.

Good athletic shoes or a sporting goods store gift certificate are other examples of presents that encourage physical activity.

More information

The American Heart Association has more about exercise and children.

Choose Wisely in the Organic Food Aisle

(HealthDay News) -- Not long ago, buying organic foods meant stopping at your local food co-op or a trek to the farmers' market.

You can still get organic products there, of course, but increasingly, you can also find them at mainstream markets.

"Half of organic foods sold in the U.S. are now sold by chain groceries," said Mark Kastel, co-founder and co-director of the Cornucopia Institute, in Cornucopia, Wis., a think tank and progressive farm-policy research group. "That shift has been happening the last few years."

And that trend is expected to continue. Wal-Mart Stores, for instance, recently announced it plans to double its sales of organic foods, and with its reputation for cost-cutting, the price gap between organic and conventionally grown foods may narrow, although not all experts agree with that prediction.

Costs of organic products are 25 percent to 100 percent higher than non-organic, said Ronnie Cummins, national director of the Organic Consumers Association in Finland, Minn. Typically, he said, "people are willing to pay the extra costs."

With the good news about increased availability comes a caveat: Organic foods advocates say it's getting tougher to choose the best organic offerings. They say some companies are cutting corners in the interest of boosting profits, and that consumers must educate themselves on how to read labels or do research on which companies are producing the best products.

One controversy: The fact that organic milk is produced both by family farms that allow the cows to graze outdoors in pastures, and by "factory farms" that confine cows, give them feed rather than allowing them to graze, and milk them several times a day.

"Confined [milk production] is a quicker, easier way to produce," said Will Fantle, research director of the Cornucopia Institute. But Fantle and other organic advocates frown on the process and the end product.

To help consumers, the Cornucopia Institute has posted a scorecard on its Web site, giving dairy producers a "one-to-five-cow" rating, five being best. The scorecard is the result of a one-year research project in which the research team rated 68 organic dairy producers and private-label products. The institute presented their report in April to the U.S. Department of Agriculture's National Organic Standards Board.

Knowing how to read a label can also help you pick the best organic offerings, experts say. If meat, poultry, eggs or dairy products are labeled organic, they must come from animals given no antibiotics or growth hormones, according to the USDA, which regulates organic standards. And organic produce is grown without using "most conventional pesticides; fertilizers made with synthetic ingredients or sewage sludge; bioengineering; or ionizing radiation," according to the USDA.

If a label says "certified organic," that means the product has been grown and processed according to the USDA national standards and then certified by one of the USDA-accredited certification organizations.

Consumers should also be aware that many companies are importing foods from outside the United States to cut costs, Fantle said. He believes domestically-grown product is better.

"Consumers need to look [at the label]," he said, "to see if the food is coming from foreign sources." If that information is not on the label, he said, "develop some sort of comfort level or relationship with the grocery story providing the foods. Ask, 'Where is this coming from?' "
And a final piece of advice: Don't confuse the word "natural" on a label with "organic."

" 'Natural' is not third party-certified, the way 'organic' is," he said. "It's more a marketing tool."

More information
For more on organic foods, head to the USDA.

Private Plans Boost Medicare Spending

(HealthDay News) -- Efforts to include more private insurers in Medicare may be costing the agency more money, new research shows.

On average, private Medicare Advantage (MA) plans were paid 12.4 percent more per enrollee in 2005 than what the same enrollees would have cost the traditional U.S. Medicare fee-for-service program, says a report released Thursday by the Commonwealth Fund, a private foundation that supports independent research on health and social issues.

"While encouraging enrollment in private plans was billed as a way to reduce costs for the program, Medicare Advantage, in fact, costs Medicare money because of the extra payments," report author Brian Biles, professor of health policy at George Washington University, said in a prepared statement.

The report authors estimated that extra payments to MA plans in 2005 totaled more than $5.2 billion over fee-for-service costs for about 5.6 million Medicare beneficiaries enrolled in MA plans. That works out to about $922 more per person.

Most of those extra payments were required under the Medicare Modernization Act of 2003, which was meant to expand the role of private plans in Medicare.

Eliminating extra payments to private plans could save Medicare about $30 billion over five years, the report authors estimated. These savings could be used in a number of ways, including:

filling in the coverage gap (the so-called doughnut hole) in the Part D drug benefit.

reducing the increase in the Part B premium in 2007 by about $10 per month for each beneficiary.

"If traditional Medicare and private plans are ever to compete fairly, they need to compete on a level playing field, which would require the elimination of these extra payments," Biles said.

More information
The American Academy of Family Physicians offers information about health insurance.

AIDS Deaths Rising Among Hispanic Americans

(HealthDay News) -- World AIDS Day 2006 finds U.S. Hispanics carrying much more than their share of the HIV epidemic, according to data from the National Alliance for Hispanic Health.

The Washington, D.C.-based group notes that even though Hispanics make up just 14 percent of the U.S. population, they account for 19 percent of the nearly 1 million U.S. AIDS cases diagnosed since the epidemic began more than 25 years ago.

Hispanic-Americans are also getting tested and diagnosed far too late, on average. According to U.S. Centers for Disease Control and Prevention data, more than a third (39 percent) of Hispanics were diagnosed with full-blown AIDS within a year of testing positive -- meaning they only discovered their infection late in their illness.

Overall, the number of Hispanic-Americans who died of AIDS rose by 7 percent from 2000-2004, compared to a 19 percent decline in AIDS deaths among U.S. whites.

Other key statistics:

Nearly all (89 percent) of Hispanic-American AIDS cases are clustered in Puerto Rico and nine states -- California, Connecticut, Florida, Illinois, Massachusetts, New Jersey, New York, Pennsylvania and Texas.

Hispanic women made up 21 percent of Hispanic AIDS cases diagnosed in 2004. In comparison, women represented 16 percent of AIDS cases diagnosed among whites during the same year.
About one-fourth (24 percent) of Hispanics living with HIV/AIDS have no health insurance, compared to 17 percent of non-Hispanic whites.

The situation is even more grim globally and getting worse. A study released Thursday found that, due to HIV/AIDS, 15-year-olds in South Africa now have a 56 percent chance of dying before they reach age 60, compared to a 29 percent chance for 15-year-olds in 1990, the Associated Press reported.

"The youth of today are facing a bleak future, and much still needs to be done to protect and support this vulnerable group," said Leigh Johnson, one of the authors of the report released by the Actuarial Society of South Africa and the Medical Research Council.

As of mid-2006, an estimated 5.4 million people in South Africa (population 48 million) were infected with HIV, the virus that causes AIDS. The report said that 950 people died each day in 2006 from AIDS-related causes, and 1,400 were newly-infected by HIV each day, the AP reported.

More information
Find out much more about HIV/AIDS at the U.S. Centers for Disease Control and Prevention.

Diabetes Drug Halts Weight Gain in Kids Taking Antipsychotics

(HealthDay News) -- While increasing numbers of children and teens are being treated for psychiatric illness with medications called atypical antipsychotics, many experience significant weight gain while on these drugs -- as much as a pound or more a week.

However, a new study suggests that the diabetes drug metformin may be able to put the brakes on that weight gain.

During the 16-week study period, children taking metformin along with atypical antipsychotics lost a slight amount of weight, while those given a placebo along with their psychiatric medications gained nearly 9 pounds.

"For someone with a major psychiatric diagnosis, there's a stigma attached to that to begin with, then if you add obesity on top of that, there's an additional stigma," noted the study's lead author, Dr. David Klein, an endocrinologist at Cincinnati Children's Hospital Medical Center.

"Now, if people do gain weight, there's an effective treatment to control weight gain."

Results of the study are in the December 2006 issue of the American Journal of Psychiatry.

Atypical antipsychotic medications include risperidone (brand name Risperidal), olanzapine (brand name Zyprexa) and quetiapine (brand name Seroquel). These medications are used to treat a variety of psychiatric illnesses, such as bipolar disorder and schizophrenia.

Increased appetite and accompanying weight gain are common side effects attributed to the drugs.

"We know that appetite increases, but the mechanism behind that isn't fully clear," said Dr. Glenn Hirsch, medical director of the New York University Child Study Center.

Klein said his interest was piqued when he saw a patient with type 2 diabetes who was "eating voraciously." Once he took her off the antipsychotic medications, her diabetes went away.

Unfortunately, her psychiatric symptoms quickly returned. Once back on the atypical antipsychotics, her diabetes came back.

That suggested, said Klein, "that there was some 'diabeticogenic' effect of these agents," and that insulin resistance might play some role in the excess weight gain.

So, for the current study, the researchers wanted to learn if medication that can improve the body's use of insulin might also halt the weight gain these children experienced.

For the study, the researchers randomly assigned a group 39 children between the ages of 10 and 17 to receive either 850 milligrams of metformin daily or a placebo. All of the children were taking atypical antipsychotic medications, and all had experienced at least a 10 percent gain in body weight in less than a year.

The study lasted four months. During that time, those taking the placebo gained an average of 8.8 pounds while those on metformin lost 0.2 pounds.

Additionally, there was a significant reduction in insulin resistance in the group taking metformin.

Klein said there were no serious side effects in the treatment group, and the drug was generally well-tolerated.

"For people who need these medicines and start to gain weight, this study suggests we can stop the weight gain," said Hirsch.

However, both Klein and Hirsch said that larger studies of longer duration should be conducted to confirm these findings.

In the meantime, Klein said he expects that physicians will try using metformin if they have patients who are gaining weight while taking atypical antipsychotics.

Hirsch said that if you or your child is taking these drugs, and you've done everything you can to prevent weight gain, including consulting a nutritionist and exercising, but weight gain continues, you should talk to your doctor about possibly trying metformin.

"We have a critical issue here. Certain kids need this type of medication and are helped by it, but we don't want to cause any additional problems. If you have a child who's gaining weight on this medicine, there may be a treatment that can stop the weight gain. It's certainly worth talking with your physician about it," said Hirsch.

More information
To learn more about antipsychotic medications, visit the National Institute of Mental Health.

Blood Levels of Uric Acid Predict Hypertension in Blacks

(HealthDay News) -- Higher levels of uric acid in the blood are associated with an increased risk of high blood pressure in black Americans, a new study finds.

The findings suggest that a simple blood test could help predict the risk of high blood pressure in blacks. It also suggests that medications to reduce uric acid levels may help lower hypertension-related health problems.

In the study, a team from Wake Forest University Baptist Medical Center in Winston-Salem, N.C., tracked over 9,100 people, ages 45 to 64, who did not have high blood pressure at the start of the study. The participants' blood pressure was checked every three years over four examinations.

The researchers found that, overall, people with uric acid levels in the highest 25 percent (quartile) had about a 15 percent increased risk of high blood pressure.

The link between high uric acid levels and hypertension was especially strong in black men.

Those with uric acid levels in the highest quartile had a two-fold increased risk of hypertension than black men in the lowest quartile.

The association was also strong in black women. Those in the highest quartile were 30 percent more likely to develop high blood pressure than those in the lowest quartile.

The study was published online in the journal Hypertension. More research needs to be done to determine the health effects of high uric acid, especially in blacks, the study authors said.

Uric acid levels are influenced by diet. Most uric acid is eliminated in urine. Very high levels of uric acid can cause gout.

More information
The U.S. National Library of Medicine has more about uric acid.