Personal Health Care

April 10, 2009 -- The phrase "sleeping with the enemy" has a whole new meaning.

A new study shows that a sexual partner’s activities may have more to do with whether or not you gets an STD than your own behavior.

Participants in the study included 412 black and white men and women ages 15 to 24 who attended an urban STD clinic in Pittsburgh. All reported having had heterosexual sex.

Each year, roughly 19 million people in the U.S. contract a sexually transmitted disease, says the CDC. About half are between the ages of 15 and 24.

Researchers measured six characteristics to gauge the risk of a sexual partner:

• The partner had a problem with marijuana or alcohol.
• The partner was at least five years older or younger.
• The partner had been in jail.
• The partner had had sex with other people in the past year.
• The partner had had an STD in the past year.

Study participants were asked about their sexual characteristics and their partners’ characteristics. Among those whose partners’ activities were labeled as high risk, 53% were diagnosed with an STD. Among those whose own behavior was labeled as high risk, 38% were diagnosed with an STD.

The riskiest characteristics were age difference and if the partner had had an STD in the past year.

“If you are choosing high-risk partners, you are much more likely to have an STD, even when we account for your condom-use patterns,” Stephanie A.S. Staras, lead author and an assistant professor of epidemiology and health policy research in the University of Florida College of Medicine, says in a written statement.

“The theory is simple: You need to have sex with someone who has an STD to get an STD. Based on the prevalence of STDs in the United States, it seems like the public may not fully understand their risk.”

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SOURCES:

Staras, S., Sexually Transmitted Diseases, 2009; vol 36: pp 232-238.

News release, University of Florida.

CDC Fact Sheet: "Most Widely Reported, Curable STDs Remain Significant Health Threat," March 2009.

April 9, 2009 -- The CDC today reported that nine food-borne illnesses, including salmonella and E. coli, were about as common in 2008 as they've been since 2004.

Progress at cubing those illnesses has "plateaued," Robert Tauxe, MD, MPH, deputy director of the CDC's Division of Foodborne, Bacterial, and Mycotic Diseases, said at a news conference.

Tauxe says there has been "no change" in reports of lab-confirmed food-borne illnesses since 2005, and "little significant change" since 2004.

The new food-borne illness statistics appear in the CDC's Morbidity and Mortality Weekly Report.

What about last year's salmonella outbreak, which was first pegged to tomatoes and then to jalapeno peppers? Or the salmonella outbreak linked to peanut butter and other peanut products from the Peanut Corporation of America?

Those outbreaks did bump up rates of certain types of food-borne illness.

But most cases of food-borne illness aren't the result of national outbreaks; for instance, outbreaks accounted for only 7% of the salmonella cases reported to the CDC in 2008.

How Many Cases of Food-borne Illness?

The CDC's new report is based on data from 10 states: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee.

Together, those states got a grand total of 18,499 laboratory-confirmed cases of nine food-borne illnesses in 2008.

Here's how those illnesses ranked:

1. Salmonella: 7,444 cases
2. Campylobacter: 5,825 cases
3. Shigella: 3,029 cases
4. Cryptosporidium: 1,036 cases
5. E. coli 0157: 718 cases
6. Yersinia: 164 cases
7. Listeria: 135 cases
8. Vibrio: 131 cases
9. Cyclospora: 17 cases

Children younger than 4 accounted for a greater proportion of reported food-borne illnesses than other age groups.

Several food-borne illnesses -- yersinia, shigella, listeria, sampylobacter, and shiga toxin-producing E. coli 0157 -- have become less common since 1996-1998. But overall, the rate of reported food-borne illness hasn't budged much since 2004, Tauxe notes.

"Perhaps we should be grateful that it hasn't really increased," Tauxe says, noting the complexity of the modern food industry. Still, Tauxe says there is "no question that our food supply is much safer now than 50 or 100 years ago," thanks to pasteurization, cleaner water, and better control of many animal diseases.  

SOURCES:

CDC, Morbidity and Mortality Weekly Report, April 10, 2009; vol 58: pp 333-337.

Robert Tauxe, MD, MPH, deputy director, CDC Division of Foodborne, Bacterial, and Mycotic Diseases.

March 9, 2009 -- Exposure to air pollution both early and late in pregnancy may have a negative impact on fetal growth, a new study shows.

Air pollution, especially pollution from car exhaust, was linked to smaller birth weight in the newly published study even after researchers controlled for known risk factors.

The study does not prove that exposure to pollutants in the air directly affects fetal growth, and findings from previous investigations examining the question have been mixed.

But the evidence as a whole is increasingly suggestive of such a relationship, lead researcher David Q. Rich, ScD, MPH, of the University of Medicine and Dentistry of New Jersey, tells WebMD.

Air Pollution and Pregnancy

Rich and colleagues examined birth certificates and hospital discharge records for nearly 336,000 babies born full-term in New Jersey between 1999 and 2003. They then matched the birth information to air quality monitoring conducted by the Environmental Protection Agency.

Data from monitoring points within 6 miles of the mothers’ homes were used to estimate the level of exposure to specific air pollutants early in the first, second, and third pregnancy trimesters.

Babies born to mothers who were younger, less well educated, lower income, African-American, single parents, or smokers had a higher risk for having a low birth weight for their gestational age.

But even after controlling for these risk factors, increased exposure to air pollutants was associated with an increased risk for delivering a smaller baby.

Heavy exposure to the traffic exhaust pollutant nitrogen dioxide during all three trimesters was linked to an increased risk for restricted fetal growth. The researchers reported that risk of a baby being born very small for gestational age rose significantly with each 10 parts per billion increase in nitrogen dioxide exposure.

The study was published this week online and will appear in the Journal of Epidemiology and Community Health.

Larger Studies Needed

It has been suggested that exposure to air pollution during pregnancy might alter cell activity or restrict oxygen and nutrient intake by the fetus.

Maternal smoking is a well-established risk factor for poor birth outcomes, including low birth weight.

March of Dimes deputy medical director Diane Ashton, MD, MPH, tells WebMD that many of the same chemicals found in cigarette smoke are found in air pollution.

“It certainly makes sense that exposure to these chemicals in air pollution can impact pregnancy outcomes,” she says. “We definitely need larger studies to help us figure this out.”

Recruitment is under way for the largest-ever prospective study in the United States to examine the effect of environmental influences like air pollution on birth outcomes and children’s health.

The goal of the National Children’s Study is to follow 100,000 children nationwide from conception to young adulthood.

Nancy Wilson, PhD, who studies the impact of exposure to pollutants on children’s health, tells WebMD that the large size and rigorous design of the National Children’s Study should lead to more definitive answers about the role of environmental exposures in birth outcomes.

Wilson is a research leader with the Battelle Memorial Institute in Durham, N.C.

“There is a lot we still don’t know,” she says. “It is important that we understand the impact of what we introduce into the environment.”

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SOURCES:

Rich, D.Q., Journal of Epidemiology and Community Health, published online April 2009.

David Q. Rich, ScD, MPH, assistant professor, department of epidemiology, University of Medicine and Dentistry of New Jersey, Piscataway, N.J.

Diane Ashton, MD, MPH, deputy medical director, March of Dimes.

Nancy Wilson, PhD, research leader, Battelle Memorial Institute, Durham, N.C.

April 9, 2009 -- Tension, backbiting, and poor team spirit at the workplace may increase the risk for depression, a new study says.

Researchers questioned a randomly selected sample of 3,347 Finnish workers aged 30-64 in 2000 and 2001.

Each person was asked to rate team climate in the workplace on a five-point scale, assigning a number to such statements as whether the atmosphere on the job was “nice and easy,” “prejudiced and conservative,” “encouraging and supportive of new ideas,” and “quarrelsome and disagreeing.”

The workers also were queried about their social lives, living arrangements, and access to health services.

Employees who felt that team spirit was poor were 61% more likely to have a depressive disorder than workers with a good team spirit, says the study, published in the journal Occupational and Environmental Medicine. And, they were 53% more likely to have used antidepressants during the first few years after they were interviewed.

During the three years of follow-up, 9% of the participants had bought antidepressant medications.

The researchers found no correlation between the climate at work and alcohol use disorders. Findings took into account factors such as age, gender, marital status, history of mental health disorders, job demands, and tenure.

“More attention should be paid to psychological factors at work,” write the researchers, led by Marjo Sinokki of the Finnish Institute of Occupational Health.

SOURCES:

News release, BMJ Specialist Journals.

Sinokki, M. Occupational and Environmental Medicine, published online April 9, 2009.

April 9, 2009 -- Scientists are developing a new drug to slow advanced prostate cancer that resists other androgen hormone treatment.

In the advance online edition of Science, researchers report initial results from the first test if the drug, called MDV3100, in men with advanced prostatecancer.

Those men had advanced prostate cancer that had become resistant to drug therapy that targets receptors for the hormone androgen.

In the study, 30 patients took a daily pill containing either 30 or 60 milligrams of MDV3100.

Most patients, 22 out of 30, had a sustained drop in their prostate-specific antigen (PSA) level for at least 12 weeks, and 13 of those patients saw their PSA level drop by more than half. In men who have prostate cancer, PSA levels are used as a benchmark for how well their treatment is going.

MDV3100 was "well tolerated," write the researchers, who included Charles Sawyers, MD, an investigator with the Howard Hughes Medical Institute and the chairman of the human oncology and pathogenesis program at Memorial Sloan-Kettering Cancer Center in New York.

The findings are preliminary, but "we're seeing quite impressive clinical results," Sawyers tells WebMD. 

A study testing higher doses of MDV3100 in 110 additional men with advanced prostate cancer is already under way. 

Full results from those patients will probably be published within a year, and an even larger trial is set to begin this year, Sawyers says. He adds that at much higher doses than 60 milligrams, MDV3100 showed "some side effects, primarily fatigue," but that "there's pretty strong evidence that you can take a dose that's very effective that will be well tolerated." 

If all goes well with further studies, MDV3100 might be up for FDA consideration in three to four years, Sawyers says. 

"The proof that the FDA would like to see, and I think that the clinical community and patients would like to see as well, is that it prolongs survival compared to standard care," Sawyers says. "In order to answer that question, it takes several years to follow men out long enough to get results on survival."

Sawyers and several colleagues are co-inventors on patent applications covering MDV3100 and related compounds; Sawyers is also a consultant to Medivation Inc., the company that has licensed MDV3100.

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SOURCES:

Tran, C. Science, April 9, 2009; advance online "Science Express" edition.

Charles Sawyers, MD, Howard Hughes Medical Institute; chairman, Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center.

News release, Memorial Sloan-Kettering Cancer Center.