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Health Highlights: Oct. 10, 2003

Massachusetts Ranked as Smartest State New Treatment for Hot Flashes Approved Breast Cancer Drug Cuts Risk of Relapse San Diego E. coli Outbreak Traced to Lettuce Former SARS Patients Stricken With Bone Disease FDA: Food Manufacturers Have to Register

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

Massachusetts Declared the Smartest State

Home to renowned schools of higher learning including Harvard and MIT, Massachusetts has been ranked as the smartest state in the United States by the editors of Morgan Quitno Press in their annual reference book, Education State Rankings.

At the other end of the scale, New Mexico came in last for the second-straight year.

The list is based on 21 factors, including per pupil spending; public high school graduation rates; average class size; student reading, writing and math proficiency; and pupil/teacher ratios.

Rounding out the top five states are: Vermont, Connecticut (last year's winner), Montana and New Jersey. For the complete list, visit http://www.morganquitno.com/edrank03.htm.

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New Treatment for Hot Flashes Approved

The U.S. Food and Drug Administration has approved new estrogen-based skin lotion to treat hot flashes and night sweats associated with menopause.

Estrasorb, manufactured by Novavax, should only be applied to the legs, thighs or calves, the agency says. The product is absorbed through the skin into the blood stream, and therefore should not be used with sunscreens, which may limit the medicine's effects.

The FDA says the product will contain the same warning labels as other forms of menopausal Hormone Replacement Therapy (HRT). Earlier this year, the government began warning women and their doctors that such therapies containing estrogen and progestin may be associated with increased risks of heart disease, stroke, and breast cancer.

The agency recommends that Estrasorb and similar products "be used in the lowest dose and for the least duration required to provide relief." Users are strongly urged to discuss the benefits and risks of these medications with their doctors.

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Breast Cancer Drug Cuts Risk of Relapse

Breast cancer patients taking a new type of drug called letrozole had about half the rate of relapses as women taking a non-medicinal placebo, HealthDay reports.

Because the results were so promising, investigators report in the Nov. 6 issue of the New England Journal of Medicine, they halted a major international trial of the new drug early.

Up to now, an older drug called Tamoxifen has been a great boon to women who have estrogen-receptor-positive breast cancer, meaning cancer that is fueled by the hormone estrogen. The drug reduces the risk of recurrence by 47 percent and the risk of death by 26 percent for five years after surgery. Unfortunately, tamoxifen stops working after that time and may even reverse its action, promoting the growth of cancer cells.

The new Novartis medication is one of a novel class of drugs called aromatase inhibitors. While tamoxifen works by occupying the estrogen receptor and preventing the hormone from binding, letrozole goes further and actually blocks production of estrogen.

The letrozole trial began in 1998 and ended up with 5,187 women in Canada, the United States and Europe who were postmenopausal, had hormone-receptor-positive tumors and had been on tamoxifen for about five years. It was coordinated by the National Cancer Institute of Canada.

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San Diego E. coli Outbreak Traced to Lettuce

California health officials say a commercial salad mix appears responsible for an outbreak of E. coli food poisoning among at least 27 people in San Diego and Orange counties, the San Diego Union-Tribune reports.

Most of those infected are children. The product was shipped to at least two San Diego County school districts -- Alpine Union and San Marcos Unified -- and a state health official says other districts may also have received supplies of the mix. He wouldn't name those other districts or where they are located, the newspaper reports.

The suspect mix was also distributed to a number of restaurants among the Pat & Oscar's chain. Twenty-two probable infections from the potentially lethal bacteria have been reported in San Diego County and five in Orange County. Symptoms include bloody diarrhea, vomiting, abdominal cramps, and nausea.

Federal and state health officials are analyzing samples of the salad mix, produced by Gold Coast Produce Co. of Oxnard. Experts tell the newspaper the outbreak is somewhat unusual, since the strain of bacteria normally is linked to underecooked beef, not lettuce.

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Former SARS Patients Stricken With Bone Disease

Hong Kong health officials say some former SARS patients have been stricken with a rare bone disease that may be linked to steroid treatments used to fight the virus, the Agence France-Presse news service reports.

The condition, avascular necrosis, strikes as many as 20,000 people annually, according to the U.S. National Institutes of Health. It's caused by diminished flow of blood to the bones, which causes bone tissue to die and may even lead to bone collapse.

The condition most often affects people ages 30 to 50, and commonly strikes long bones like the femur -- the one that extends from the knee to the hip.

A spokeswoman from the Hong Kong Hospital Authority acknowledges the known link between steroidal medications and bone weakness, adding that officials are attempting to track down and test all who received the treatment for SARS.

The spokeswoman wouldn't provide the news service with an estimate of how many former patients may be affected.

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FDA: Food Manufacturers Have to Register

By the end of the year, the U.S. government hopes to know the names and addresses of every company that makes or processes food in America.

Health and Human Services Secretary Tommy Thompson has announced two new regulations he says are designed to protect the health and safety of American consumers.

According to the U.S. Food and Drug Administration, the first regulation requires food importers to provide the FDA with advance notice of human and animal food shipments imported or offered for import on or after Dec. 12, 2003. This advance information will allow the FDA, working with U.S. Customs and Border Protection (CBP), to more effectively target inspections and ensure the safety of imported foods. The FDA expects to receive about 25,000 notifications about incoming shipments each day.

The second regulation requires domestic and foreign food facilities that manufacture, process, pack or hold food for human or animal consumption in the United States to register with the agency by Dec. 12, 2003. As a result, FDA will have for the first time a complete roster of foreign and domestic food facilities. The agency expects about 420,000 facilities to register under this requirement.

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