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NPR Health News Briefs: Jan. 2 - Jan. 8

Read a roundup of health news briefs from NPR for the week of Jan. 2 - Jan. 8, 2005:

Reproductive Success Rates

Jan. 7, 2005 — A report from the Centers for Disease Control and Prevention finds a woman's age is a major factor in determining the success of artificial reproduction.

In vitro fertilization offers many women the chance to conceive. The CDC report shows that 45,000 babies were born in the U.S. with the help of technology in 2002, the latest year of data available.

But the report also finds that younger women have the most success. Some 37 percent of IVF procedures started in 2002, in women aged 35 or younger, resulted in live births. The rate fell to 11 percent in women who were 41 or 42 when the procedure was started.

The CDC says this report is a reminder that age remains a primary factor with respect to pregnancy success, even when technology is used.

The report also found that 35 percent of IVF pregnancies resulted in multiple births of twins or more. — Allison Aubrey

CRP as Important as Cholesterol?

Jan. 6, 2005 — Researchers say heart attack survivors should watch their levels of a blood protein called CRP, just as much as they monitor their cholesterol levels.

CRP stands for C-reactive protein. High levels signal inflammation within the body. Some researchers are convinced inflammation contributes to heart disease.

Now two studies in Thursday's New England Journal of Medicine indicate that lowering CRP levels reduces patients' risk of a second heart attack. CRP can be lowered by the same drugs, called statins, that are used to reduce cholesterol.

One study finds that the patients whose cholesterol and CRP are reduced by statins have half the rate of second heart attacks, compared to patients whose cholesterol and CRP remain high. The other study shows that aggressive treatment to lower CRP levels reduces the buildup of deposits in coronary arteries — whatever patients' cholesterol levels.

Dr. Paul Ridker of Brigham and Women's Hospital in Boston led one of the studies. He's convinced that lowering CRP is important.

But convincing doctors and patients may take time, he says. "Our challenge now is going to be to educate physicians and patients about the importance of measuring and reducing CRP."

Some heart specialists say there's not evidence to prove cause and effect yet. One of those is Dr. Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital.

"I think there's still a lot of skepticism among the thought leaders," she said in a telephone interview. "And it may just be because the landscape has changed so much and we've been in this situation before and we've been burned."

In the past, she says, doctors and patients have embraced positive findings about hormone replacement therapy and heart health, as well as vitamin supplementation and lowered heart attack risks. Both ideas have since been disproved.

The study led by Dr. Ridker in Boston was partially funded by Bristol-Myers Squibb Company, which makes a cholesterol-lowering statin drug. The other study published Thursday was funded entirely by Pfizer, Inc., which also manufacturers a statin drug. — Richard Knox

Malaria in the Caribbean

Jan. 6, 2005 — Malaria has shown up in two tourist areas in the Dominican Republic that had previously been considered malaria-free, the Centers for Disease Control and Prevention says.

The areas are Punta Cana in La Altagracia Province on the far eastern tip of the island and Duarte Province in the north.

Seventeen cases have been reported in recent weeks among tourists visiting these areas. Fourteen European tourists have been affected, along with three Americans.

Other popular tourist areas, including the capital, Santo Domingo, are not considered malarious. Malaria is endemic in the mountainous interior regions of the country, according to the CDC.

The CDC recommends that travelers to the resort and tourist areas consider taking chloroquine to prevent disease.

To prevent mosquito bites, the CDC advises travelers to use insect repellent containing up to 50 percent DEET and wear long-sleeved clothing; if not staying in screened or air-conditioned housing, they should sleep under a net, preferably one treated with insecticide.

In many areas around the world, the malaria parasite has become resistant to chlorquine, but not so in the Dominican Republic, the CDC says.

The CDC says that the Dominican government has taken steps to eradicate the mosquito responsible for carrying the malaria parasite in these areas. The report appears in Thursday's issue of Morbidity and Mortaility Weekly Report. — Joe Neel

Risky Rodents

Jan. 6, 2005 — Pet rodents can provide comfort, but they also can be dangerous.

The Centers for Disease Control and Prevention says it's received one report of a woman who died from "rat-bite fever" in Washington state. And a 3-year-old Denver boy got an infection known as tularemia from a pet hamster.

In the case of rat-bite fever, the CDC said a previously healthy 19-year-old woman was pronounced dead on arrival at an emergency room. An acquaintance said the woman had had a fever for three days, along with fever, headache, muscle aches and nausea. She was anxious and confused prior to arriving in the emergency room and was having trouble breathing.

She was an animal groomer and had nine pet rats at home. Rat-bite fever is known to cause rapid death in children, but no cases have been reported in adults.

In the Denver case, the boy's parents had bought the child six pet hamsters around Christmastime last year.

The child became ill after one of the six hamsters his parents purchased bit the child on his left ring finger. He had fevers and aches for at least seven weeks. He got better after several courses of different antibiotics.

The hamsters all died of "wet-tail disease," a.k.a. diarrhea, within one week of purchase. Colorado health department investigators found that the pet store that sold the hamsters had had an unusually high number of hamster deaths during the period in question. Look-back studies failed to find the original source of the bacteria.

Tularemia is caused by the bacterium Francisella tularensis. Cases of hamster-to-human transmission have not been previously reported in the United States, but the CDC says that tularemia has been reported among hamster hunters in Russia. — Joe Neel

Abortion Arguments

Jan. 6, 2005 — A federal district court in Washington, D.C., heard arguments Wednesday in a suit to block a federal abortion law signed in December.

The abortion language was included in the huge appropriations bill signed by President George W. Bush last month. The language would protect the ability of hospitals, health plans and other groups of providers to refuse to provide abortions or abortion-related services.

But a group representing federally funded family planning groups sued to block enforcement. The National Family Planning and Reproductive Health Association says the new law conflicts with regulations that require family planning clinics to offer abortion referrals to pregnant women who request them.

Lawyers for the Department of Justice argued that the law and the regulations don't conflict — and if they do, it should be the regulations, not the law, that should be blocked.

A decision in the case is expected later this month. — Julie Rovner

Canadian Drug Savings Shrink

Jan. 5, 2005 — Americans who buy drugs from Canada are seeing discounts deteriorate, according to a new study.

At the beginning of 2003, average savings on 30 popular brand-name drugs bought from Canada were 38 percent off U.S. prices, according to the nonprofit group pharmacychecker.com. By the end of 2004, average savings fell to 29 percent.

The group says changes are due in part to the declining value of the U.S. dollar, and in part to restrictions imposed by drug makers on Canadian drug sellers in an attempt to thwart the cross-border trade. In fact, the group found that about 7 percent of the brand-name drugs it tracks can now be purchased at lower prices from online pharmacies in the United States than from Canada.

Even existing discounts may disappear in the near future. The Canadian government is reportedly considering changes that would effectively bar Canadian pharmacies from selling drugs to Americans who don't come to Canada in person. — Julie Rovner

Medical Malpractice Reform Campaign Begins

Jan. 5, 2005 — President George W. Bush is in Illinois to renew his call for medical malpractice reform. Opponents of the plan are gearing up as well.

The president's visit highlights Madison County, Ill., which lawsuit opponents have singled out as a "judicial hellhole," where judges routinely grant large awards. Mr. Bush wants Congress to pass a bill limiting damage awards in medical malpractice lawsuits. The House has repeatedly passed the bill, but the Senate has so far refused to go along.

The political stalemate will continue if trial lawyer and consumer groups have their way. They say the damage limits would make it impossible for families of women and children who are injured or killed by negligent doctors to even find a lawyer to take their case. And they point out that damage caps do more to boost the profits of insurance companies than to decrease malpractice insurance premiums for doctors. — Julie Rovner

Pill Availability Has Little Impact

Jan. 5, 2005 — Making so-called "morning-after" pills more readily available doesn't increase risky sexual behavior, according to a new study. Nor does it increase the pills' use, either.

The study, which appears in this week's Journal of the American Medical Association, split 2,100 women between the ages of 15 and 24 into three groups. One group was given doses of the emergency contraceptive pills to keep at home. The pills only work when taken up to 72 hours after unprotected intercourse.

Another group was given access to the pills without prescription at a nearby pharmacy. The third group was required to go to a health clinic to get the pills.

None of the groups showed a decrease in use of other contraceptives or an increase in unprotected sex. But women in the group given easy access at a drug store were no more likely to use the pills than those who had to go to the health clinic. Only those who had the pills at home were more likely to use them.

The Food and Drug Administration last year rejected efforts to sell the pills over the counter. The agency may reconsider its decision this year. — Julie Rovner

Test for Pregnancy Risk

Jan. 5, 2005 — Medical researchers have discovered a new way to detect a potentially life-threatening condition that develops in 5 percent of all pregnancies.

The condition is called "preeclampsia." The telltale signs are high blood pressure and swelling. Currently, the only way to identify the condition is by monitoring pregnant women's blood pressure weekly and by urine tests during the last trimester of pregnancy.

But now researchers have discovered there's a way to detect the condition up to 13 weeks earlier. Scientists at Beth Israel Deaconess Medical Center in Boston have found that a protein, detectable in urine halfway through a pregnancy, is a good indicator that the condition has started. The finding could pave the way for the development of a simple, inexpensive screening test.

This would be a useful goal given that, worldwide, preeclampsia is one of the leading causes of maternal and infant mortality. — Allison Aubrey

Congress Takes Up Health

Jan. 4, 2005 — The 109th Congress convenes Tuesday with a full plate of health items to consider.

President George W. Bush is planning a speech Wednesday to tout his top health issue — capping damage awards in medical malpractice lawsuits. The House has long supported the president's goal. But the new Senate still appears to lack the supermajority needed to overcome objections not just from Democrats, but from some Republicans as well.

On Medicaid, the nation's governors have weighed in on the fate of the program for the poor, which the states finance jointly with the federal government. Governors don't want Congress to try to balance the federal budget by loading more of Medicaid's costs onto the states.

The Food and Drug Administration will also come under scrutiny, as both the House and Senate are expected to examine the way the FDA assures the safety of drugs. New questions have been raised since last year's withdrawal from the market of the popular painkiller Vioxx, and data suggesting that other painkillers may raise the risk of heart disease.

-- Julie Rovner

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