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Health Highlights: May 9, 2005

Scientists Seek Ways to Alter Colon Cancer Drug's Severe Side Effects States Propose Billions in Medicaid Cuts More Than Half of Americans Have Frequent Pain: Poll Knee Problems Linked to Obesity FDA Warns Pfizer On Zoloft Magazine Ad Implantable Defibrillator Use Recommended for Certain Recently Diagnosed Heart Patients

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

Scientists Seek Ways to Alter Colon Cancer Drug's Severe Side Effects

An effective colon cancer drug's side effects are sometimes so severe it can't be used, and scientists are hopeful their new findings will help alter the drug's formula to make it tolerable to more people.

A team of scientists at the Weizmann Institute of Science, working in collaboration with scientists at St. Jude Children's Research Hospital in Memphis, Tenn. investigated the side effects of the drug CPT-11, an FDA-approved colon cancer medication. The researchers noticed that the side effects, which include nausea, vomiting and diarrhea, seemed similar to those experienced by some users of Alzheimer's drugs, and this led them to suspect an enzyme similar to the one in Alzheimer's might also be evident in reacting with CPT-11.

The drug is known as a prodrug, according to Weizmann Institute scientists Joel Sussman, Dr. Michal Harel and Israel Silman. This means that in order for it to become effective, it actually undergoes a molecular change after being injected in the body. The enzyme that initiates the change is known as acetylcholinesterase (AChE), and this may be what brings about the severe side effects.

"The enzymes are like locks made by the same locksmith, but varied slightly to open with different keys," Sussman said in a statement. "The cancer drug fits AChE like a key that slides in part way, but won't turn," he concludes.

The next step is to alter the delivery molecule to develop a better fit, the researchers say.

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States Propose Billions in Medicaid Cuts

Governors and state legislators have devised a plan to limit Medicaid services, make some beneficiaries pay more for care, and save the burgeoning insurance program billions of dollars, The New York Times reported Monday.

The governors and lawmakers, in offering their blueprint to the U.S. Congress, say their plan would save about $10 billion over the next five years, the newspaper said. The Times reported the proposal has a "substantial" chance of passing, since states heavily contribute to the program. Some of the suggestions resemble those offered by President Bush in his 2006 budget, while other suggested cuts go even further, according to the newspaper.

A coalition of organizations representing beneficiaries, including AARP, pediatricians, hospitals, and nursing homes, is gearing up to fight the proposed cuts, the Times said.

State officials told the newspaper that their goal is not just to save money, but also to avoid having to drop thousands of beneficiaries from the Medicaid program, as is being done in states like Tennessee and Missouri.

Medicaid is the nation's largest insurance program and covers 50 million low-income people. Though originally intended for the poor, it now covers many people with incomes well above the poverty line, the Times said.

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More Than Half of Americans Have Frequent Pain: Poll

More than half of Americans surveyed said they live with chronic or recurring pain, and just under half have had significant pain in the last two weeks, according to a new poll.

Chronic pain, which 19 percent said they had, was defined as pain that lasted three months or more. An additional 34 percent said they had recurrent pain, the survey by ABC News, USA Today, and Stanford University Medical Center found.

Six-in-10 participants rated their last bout with pain as moderate or severe. Back and knee pain were the most common afflictions, according to an ABC News account of the poll.

Four-in-10 Americans said pain interfered with their mood, daily activities, sleep, and ability to enjoy life. Therapies ranged from heating pads and ice packs to less mainstream methods including message therapy, homeopathic, and herbal remedies.

While six-in-10 participants said they took prescription drugs for pain, 51 percent of these respondents said the medications worked very well, the ABC report said.

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Knee Problems Linked to Obesity

Add knee problems to the list of ailments faced by people who are considered obese, University of Utah researchers say.

More than half of the 850,000 knee surgeries performed in the United States each year are related to being extremely overweight, the scientists wrote in the May issue of the American Journal of Preventive Medicine.

According to the Associated Press, the researchers studied 544 patients who had cartilage tears repaired during the years 1996 to 2000. The male and female patients ranged in age from 50 to 79.

In addition to the obvious strain being overweight places on the knees, the researchers speculated that circulation problems in obese people reduce the blood supply to knee cartilage, the AP reported.

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FDA Warns Pfizer About Zoloft Magazine Ad

A magazine advertisement for the antidepressant Zoloft omitted important information about the possibility of suicide, the U.S. Food and Drug Administration said in a May 6 letter to the drug's manufacturer, Pfizer Inc.

The letter, along with a warning to health care professionals about possible suicide risks with Zoloft, was posted on the FDA's Web site Friday. The Wall Street Journal reports that the ad the government agency mentioned was one that ran in the New York Times Sunday Magazine Oct. 24, 2004. The FDA letter reminded Pfizer it had alerted the pharmaceutical company in May 2004 that the information had to be included the labeling material on all print advertising.

"This ad is concerning from a public health perspective because it fails to include a serious risk associated with the drug," the FDA Consumer Promotion Analyst Kay A. Chitale wrote. "Specifically, the main page of the ad fails to communicate any information pertaining to the risk of clinical worsening and suicidality in patients who are on Zoloft therapy," Chitale concluded.

The Wall Street Journal said that Pfizer had agreed to change the Zoloft label last July.

Whether deliberately or by coincidence, the FDA issued the alert about Zoloft and the risk of pediatric suicide to the public and health officials on May 5.

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Implantable Defibrillator Use Recommended for Certain Recently Diagnosed Heart Patients

A patient who has just been diagnosed with cardiomyopathy, a disease that affects the heart muscle's ability to pump, would benefit from an implantable defibrillator, a study has concluded.

The research was presented over the weekend to members of the Heart Rhythm Society's Annual Scientific Sessions in New Orleans and was based on previous studies showing that implantable cardiac defibrillators (ICDs) were effective in controlling cardiac myopathy.

But the U.S. government's Center for Medicare and Medicaid Services had established payment guidelines based on cardiac myopathy diagnoses of about nine months, the lead researcher said in a news release.

Dr. Alan Kadish, associate chief of Cardiology and associate director of the Bluhm Cardiovascular Institute at Northwestern Memorial Hospital, said the study was designed to see if those diagnosed with cardiac myopathy would benefit from an earlier ICD implant.

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