Health Highlights: Jan. 24, 2005

U.S. Infant Mortality Rate Rises for 1st Time in 44 Years Health Care Group Rates Top Hospitals Surgeon General Urges Mothers-to-Be to Take Folic Acid Public Citizen Asks FDA to Remove Arthritis Drugs Supreme Court Rules Against Florida in Right-to-Die Case

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

U.S. Infant Mortality Rate Rises for 1st Time in 44 Years

For the first time since 1958, the infant mortality rate has increased in the United States, and the largest contributing factor was a rise in the birth of very small infants, according to a U.S. Centers for Disease Control and Prevention report released Monday.

The report, which covered births in 2002, revealed an increase in infant mortality from 6.8 deaths per 1,000 live births in 2001 to 7.0 per 1,000 in 2002. The CDC originally reported the findings last year.

Overall, there were 27,970 infant deaths in 2002 compared to 27,568 deaths in 2001. Preliminary data for 2003 suggest the increase seen in 2002 may not be continuing, the CDC said.

The number of extremely small babies -- weighing less than 1 lb., 10.5 oz. at birth -- increased by almost 500 births from 2001 to 2002. The increase was primarily found among mothers in the peak childbearing ages of 20 to 34 years, and they occurred across most racial and ethnic groups. Infant mortality rates had been declining for these extremely small babies, but the majority of infants born at this weight still die within the first year of life, the report said.

Multiple births may also have contributed to the rise in low birth-weight infants. About 3 percent of births in the United States were multiple births in 2002, yet they accounted for about 25 percent of the overall increase in infant mortality. Yet, most of the rise was due to an increase for babies born in single deliveries, the report found.

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Health Care Group Rates Top Hospitals

A study released Monday names hospitals in the top 5 percent in the nation in clinical quality. The top hospitals -- 229 out of nearly 5,000 -- were ranked based on the death and complication rates of Medicare patients in 28 common procedures and diagnoses, from hip replacement to bypass surgery, for the years 2001, 2002 and 2003.

The study found that Medicare patients going to these hospitals had a 12 percent to 20 percent better chance of surviving common procedures and diagnoses when compared with an average hospital. The report, titled the third annual HealthGrades Hospital Quality and Clinical Excellence Study, was done by HealthGrades, an independent health-care quality organization.

Among the other findings: If all patients went to a so-called "Distinguished Hospital for Clinical Excellence" for four of the highest-volume procedures and diagnoses -- coronary bypass, angioplasty, stroke and community-acquired pneumonia -- 52,949 lives could have been saved from 2001 to 2003. And a Medicare patient who underwent heart bypass surgery at a Distinguished Hospital for Clinical Excellence had, on average, a 15.3 percent better chance of surviving than a patient who received treatment at an average hospital.

To view the full report, visit www.healthgrades.com.

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Surgeon General Urges Mothers-to-Be to Take Folic Acid

As part of the "Year of the Healthy Child" campaign, U.S. Surgeon General Richard H. Carmona has designated this "Folic Acid Awareness Week," urging all women of childbearing age to consume the recommended amounts of folic acid each day.

Folic acid is a B vitamin needed for proper cell growth to help prevent such birth defects as neural tube defects, serious birth defects of the brain (anencephaly) and spine (spina bifida). Research has shown that, if taken before and during early pregnancy, folic acid can prevent 70 percent of these birth defects. Every woman of childbearing age, even if she is not planning on becoming pregnant, should supplement her diet with 400 micrograms of folic acid each day, Carmona said.

However, women whose family history shows a high risk of neural tube defects should take 10 times that amount -- 4 milligrams. But this increased dosage must come from folic acid supplements, not by increasing the number of multivitamins a woman takes due to a risk of vitamin A poisoning, Carmona said.

Carmona urged all women of childbearing age to talk with their doctor about steps they can take to keep themselves healthy.

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Public Citizen Asks FDA to Remove Arthritis Drugs

The consumer safety group Public Citizen says it has petitioned the U.S. Food and Drug Administration to remove from the market the two Pfizer arthritis drugs Celebrex and Bextra.

Celebrex (celecoxib) and Bextra (valdecoxib) are among a class of painkillers called cox-2 inhibitors, which also included the now-defunct drug Vioxx. The latter was removed from the market last fall after maker Merck & Co. said new studies linked the drug to an increased risk of heart attack and stroke.

Since then, the FDA has been investigating the two Pfizer drugs to see if they posed similar risks. Since the Vioxx withdrawal and the recent release of studies showing possible cardiovascular risks among Celebrex and Bextra users, Pfizer has kept Celebrex on the market but agreed to suspend advertising for the drug. It also placed a warning on Bextra noting an increased risk among people who have had recent heart bypass surgery.

In 2004, nearly 24 million U.S. prescriptions were filed for Celebrex, and some 13 million for Bextra, Public Citizen said in a statement.

Cox-2 drugs have been touted as more stomach-friendly than older painkillers, a notion disputed by Public Citizen medical chief Dr. Sidney Wolf. "These drugs are not only more expensive and more dangerous than older, safer pain relievers, they are no better at protecting the gastrointestinal tract," Wolf said in the group's statement.

The FDA offered no immediate comment.

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Supreme Court Rules Against Florida in Right-to-Die Case

The U.S. Supreme Court refused Monday to reinstate a Florida law that has kept a severely brain-damaged woman alive against the wishes of her husband.

The nation's highest court refused to overturn the decision of the Florida Supreme Court, which last fall declared unconstitutional the so-called "Terri's law" that is keeping 41-year-old Terri Schiavo on a feeding tube. Monday's ruling should clear the way for the tube to be removed, the Associated Press reported.

Her husband, Michael Schiavo, has long contended that his wife never wanted to be kept alive by artificial means, despite her leaving no written instructions. Her parents have fought efforts to have her feeding tube removed.

Michael Schiavo won the right to have the tube disconnected in 2003, but the Florida legislature quickly passed a law giving Gov. Jeb Bush the right to have the tube reinserted after it had been removed for six days. Terri Schiavo, whom doctors have declared in a permanent vegetative state since a heart attack in 1990, has been kept alive in a nursing home.

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