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Health Highlights: March 19 2008

Medicare Cuts Trigger Concerns About Healthcare Access: AMA Carbon Monoxide May Benefit Lung Disease Patients: Study Gene Variations Influence PTSD Risk FDA Delays Decision on New Antibiotic FDA Cautions on COPD Inhaler and Stroke Risk Stress Common Among U.S. College Students: Survey

Here are some of the latest health and medical news developments, compiled by editors of HealthDay:

Medicare Cuts Trigger Concerns About Healthcare Access: AMA

Cuts in Medicare payments to doctors have eight out of 10 Americans concerned about access to care for seniors and baby boomers, according to a survey released Wednesday by the American Medical Association.

On July 1, there will be a 10.6 percent cut in Medicare payments to doctors. Over the next decade those cuts will grow to about 40 percent, while medical practice costs increase by 20 percent, according the AMA.

In response to this year's payment cut, 60 percent of doctors say they'll be forced to limit the number of new Medicare patients they can treat. Currently, about 30 percent of Medicare patients looking for a new primary care doctor are having difficulty finding one, and the payment cuts will make access even more difficult, the group said.

"As physicians, we are terribly concerned about how these Medicare cuts will impact our senior patients," AMA board member Dr. William A. Hazel said in a prepared statement. "Seniors and boomers are concerned too; our new poll shows that 88 percent of current Medicare patients are worried about how the cuts will impact their access to health care."

The first wave of baby boomers will be eligible for Medicare in three years when they turn 65.

Nearly three-quarters of the 1,006 telephone survey respondents, aged 18 and older, said they believe Congress should stop the cuts so that doctors can continue to treat Medicare patients, the AMA said.


Carbon Monoxide May Benefit Lung Disease Patients: Study

Extremely low doses of carbon monoxide -- a dangerous gas found in car exhaust and produced by faulty heating equipment -- may help ease symptoms of asthma and chronic obstructive pulmonary disease (COPD), suggests a study by researchers at the University Medical Center at Groningen in the Netherlands.

The study included 18 people who were given a low dose of carbon monoxide for two hours on four consecutive days. When the researchers checked the level of a certain type of immune cell linked to inflammation in lung mucus, they found it had decreased by about one third, on average, in the participants, BBC News reported. In addition, the volunteers' lungs seemed to become more resistant to the effects of an irritating chemical.

The study was published in New Scientist magazine. The Dutch team plans to conduct more studies with larger numbers of people.

One expert told BBC News he has serious concerns about the safety of this kind of treatment.

"The difficulty with carbon monoxide is that there is a fine balance between levels that influence COPD, and toxic levels, and it would be very hard to gauge a safe dose for patients. This makes it potentially quite dangerous," said Dr. Paolo Paredi, of the National Heart and Lung Institute, in Great Britain.


Gene Variations Influence PTSD Risk

Gene differences may explain why some people recover from a traumatic event while others develop post-traumatic stress syndrome (PTSD), according to a study that included 900 adults who suffered abuse when they were children.

The study found that specific variations in a stress related gene may be influenced by trauma at a young age, and these variations increase the risk of PTSD in adulthood. Among adults who suffered severe child abuse, those with the gene variations scored 31 on a scale of PTSD, compared to 13 for those without the variations, the Associated Press reported.

The study, published this week in the Journal of the American Medical Association, is one of the first to show that external, non-genetic factors can affect genes in a way that increases the risk of PTSD, the researchers said.

The findings suggest there are important periods in childhood when the brain is vulnerable "to outside influences that can shape the developing stress-response system," said study co-author Dr. Kerry Ressler of Emory University, the AP reported.


FDA Delays Decision on New Antibiotic

The U.S. Food and Drug Administration wants more information about how a new antibiotic called ceftobiprole works before the agency decides whether to approve the medicine. It is designed to treat diabetic food infections and complicated skin infections, including methicillin-resistant staphylococcus aureus (MRSA).

On Tuesday, the FDA said it issued an approvable letter for ceftobiprole, which means the agency wants more time to inspect study locations and review data. It's not clear whether new studies will have to be conducted or how long the extended review will take, Bloomberg News reported.

The drug, developed by Johnson & Johnson and Basilea Pharmaceutica AG, has also been submitted for approval in Europe, Canada and Switzerland.

Ceftobiprole is among a number of new antibiotics being developed to fight MRSA, which sickens about two million Americans a year and costs about $20 billion a year to treat, Bloomberg reported. MRSA causes nearly two-thirds of all skin infections in emergency rooms. About one in 20 patients hospitalized with MRSA dies, according to the U.S. Agency for Healthcare Research and Quality.


FDA Cautions on COPD Inhaler and Stroke Risk

The U.S. Food and Drug Administration cautioned Tuesday that a respiratory inhaler used for chronic obstructive pulmonary disease may heighten the risk for stroke.

The agency said that German drug maker Boehringer Ingelheim, which manufactures Spiriva HandiHaler, reported that ongoing safety monitoring identified a possible increased risk of stroke in patients who take the medicine.

The inhaler contains tiotropium bromide and is used to treat bronchospasm associated with COPD, the FDA said in a prepared statement, adding that additional information is needed to further evaluate this preliminary information.

Boehringer Ingelheim reported that it has conducted an analysis of the safety data from 29 placebo-controlled clinical studies involving 13,500 patients with COPD, the FDA said. In 25 of the clinical studies, patients were treated with Spiriva HandiHaler, which is a once-daily, long-term maintenance medicine. In the other four, patients were treated with another formulation of tiotropium approved in Europe, Spiriva Respimat.

Based on data from these studies, the FDA statement said, the preliminary estimates of the risk of stroke were eight patients per 1,000 patients treated for one year with Spiriva, and six patients per 1,000 patients treated for one year with a placebo. That translates to an estimated excess risk of any type of stroke due to Spiriva to two patients for each 1,000 patients using Spiriva over a one-year period.

The FDA said it was working with the drug maker to evaluate the potential link, and it cautioned patients using Spiriva to not stop using the medication without talking to their doctors.


Stress Common Among U.S. College Students: Survey

Stress is a major problem for many U.S. college students, according to a survey that included 2,253 undergraduate students, ages 18-24, at 40 schools nationwide.

Four in 10 students said they were stressed often, nearly 20 percent said they felt stress all the time, one in five said they had felt too stressed to be with friends or do homework, and about the same number said things had been so bad in the past three months that they had given serious consideration to dropping out of school, the survey found.

The poll was conducted for the Associated Press and mtvU, a television network available at many colleges and universities.

Among the other findings:

  • Many students said they had symptoms such as: difficulty concentrating, sleeping and being motivated; agitation; worry; being too tired to work; eating problems; and feeling lonely and depressed.
  • About one in six said they had friends in the past year who had discussed committing suicide, and about one in 10 respondents said they had seriously considered suicide themselves.
  • Primary sources of stress included school work and grades, financial problems, relationships and dating, family problems, and extracurricular activities.
  • Women were more likely than men to feel stressed -- 45 percent vs. 34 percent.
  • White students reported more stress than black and Hispanic students.
  • About 26 percent of students said they considered talking to a counselor or getting other professional help, but only 15 percent said they actually did so.
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