Health Highlights: Dec. 8, 2003

Bush Signs Sweeping Medicare Changes Schizophrenia Drug Approved for Manic Depression Not Enough Women Checked for Osteoporosis: Study Stress May Boost Risk of Alzheimer's Study Finds Most Online Growth Hormone Drugs Bogus NIH Officials Often Consult for Drug Companies: Report

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

Bush Signs Sweeping Medicare Changes

President Bush Monday signed the most sweeping changes to Medicare since the program's inception 38 years ago.

The $400 billion program, spanning 10 years, adds prescription drug coverage to the federal health insurance program for the elderly and disabled, beginning in 2006. Before then, participants can buy a discount card for $30 or less to help offset prescription costs, the Associated Press reports.

In a bid to hold down spiraling health-care costs, the bill includes a plan for private insurers to offer direct competition to the traditional government-run program. That pilot six-year effort is slated to begin in 2010, the AP says.

Among a number of less-publicized components is a two-year, $500 million program that covers 50,000 participants who use a limited number of self-administered drugs for conditions like oral cancer, the AP says. Another three-year provision allows Medicare to contract with private firms to identify insurance fraud and overpayments.

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Schizophrenia Drug Approved for Manic Depression

Johnson & Johnson says its schizophrenia drug Risperdal has been approved by the U.S. Food and Drug Administration for the treatment of bipolar disorder, often called manic depression.

The drug was approved to be used alone or with standard treatments like lithium or valproate for bipolar I disorder, its more severe form. Affecting 2 million people in the United States, the disorder is characterized by dramatic high and low mood swings.

The manic episodes, with symptoms including excessive excitement and hyperactivity, can lead to delusional thinking and dangerous risk-taking behavior. And the condition's depressive state can lead to suicide. Nearly 40 percent of people with untreated bipolar disorder abuse alcohol and drugs, the company says.

In three clinical trials in which the drug was used alone or in combination with standard therapies, patients saw significantly greater symptom improvement than those who took a non-medicinal placebo.

The drug's label includes a warning that it could cause abnormal heart rhythm, especially among patients with existing heart conditions. Common side effects include muscle tremors and stiffness, sleepiness, nausea, and increased saliva.

Risperdal has been available in the United States since 1994 for the treatment of schizophrenia.

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Not Enough Women Checked for Osteoporosis: Study

Nearly 54 percent of older women who suffered a fracture -- a strong indicator of osteoporosis -- were not evaluated or treated for the bone-thinning disease, according to a new study by Kaiser Permanente researchers in Oregon.

And more than 95 percent of the 3,812 women in the study did not receive a bone mineral density measurement after their fractures, says the study, which appears in the December issue of the Journal of Bone and Joint Surgery.

"We need to do a better job of recognizing and managing osteoporosis," says Dr. Adrianne Feldstein, lead author of the study. "The bottom line is that clinicians and female patients over 50 should view a fracture as a possible symptom of osteoporosis until proven otherwise. Any low-impact fracture should trigger evaluation and treatment."

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Stress May Boost Risk of Alzheimer's

People who are easily stressed are more likely to suffer the memory loss caused by Alzheimer's disease than their more relaxed peers, a new study finds.

There was "an extraordinary decline in memory" among the older people who tested highest on a standardized scale of susceptibility to stress, study leader Robert S. Wilson, a professor of neurophysiology at Rush University Medical Center in Chicago, tells HealthDayNews.

"This suggests to us the likelihood that over a lifetime, a chronic experience of stress somehow down-regulates the brain region that governs stress response," says Wilson. "Unfortunately, that part of the brain also regulates memory."

The finding raises the possibility that treating stress-prone people, perhaps with antidepressants, can help prevent memory loss, Wilson says, but that is a relatively distant prospect.

The study appears in the Dec. 9 issue of Neurology.

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Study Finds Most Online Growth Hormone Drugs Bogus

Most of the human growth hormone (HGH) products sold over the Internet are bogus, according to a study by the dietary-supplement testing company ConsumerLab.com.

Any nonprescription products that contain significant amounts of the hormone would be illegal, and so most of those tested had only trace amounts, according to a report from the White Plains, N.Y., company cited by The New York Times.

The naturally occurring hormone prompts bone and muscle growth among children, and scientists are conducting long-term studies of its purported rejuvenating effects on adults. Web sites often tout the products with advertising lines like "Look and Feel 20 Years Younger."

One supplement cited by ConsumerLab, a nasal spray called Retropin 2000, sells on some Web sites for as much as $70. But it contains only 2,000 nanograms of the hormone per dose, or one-thousandth of what a doctor might normally prescribe, according to the Times report. There's also no evidence to show that the normally injected hormone would work in spray form, the newspaper adds.

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NIH Officials Often Consult for Drug Companies: Report

Some top officials at the National Institutes of Health -- an agency once known as an advocate of scientific inquiry on behalf of the American public -- have received hundreds of thousands of dollars each in consulting fees from drug companies whose products they were responsible for monitoring, the Los Angeles Times reports.

In some cases, those officials were acting as consultants to companies whose drugs were connected to deaths of patients involved in NIH trials, the newspaper says.

Dr. Ruth L. Kirschstein, who as deputy director and acting director of the agency since 1993 approved many of the consulting arrangements, told the newspaper she did not believe the officials' actions had compromised the public's interest.

"I think NIH scientists, NIH directors and all the staff are highly ethical people with enormous integrity," she said. "And I think we do our business in the most remarkable way."

She said she would "think about" whether administrators should learn more about a company's ties to the NIH before approving the consulting arrangements, the newspaper reports.

Medical ethicists such as Dr. Arnold S. Relman, former editor of The New England Journal of Medicine, said that private consulting by government scientists posed "legitimate cause for concern."

"If I am a scientist working in an NIH lab and I get a lot of money in consulting fees, then I'm going to want to make sure that the company does very well," Relman told the newspaper.

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