• GOP sees possible upside in health care summit

    Congressional Republicans see a chance for political gain in President Barack Obama's televised health care summit next week, even though the president will be running the show.

    Obama and the Democrats are certain to highlight a crucial element of their health care plan — extending coverage to more than 30 million Americans — at the one-of-a-kind event. By comparison, a Republican plan would only help 3 million more. But during a time of ballooning deficits, the GOP figures reining in rising medical costs — not coverage — could resonate with voters in an election year.

    The Democratic health overhaul plan is estimated at some $1 trillion over 10 years, and Republicans will contrast their financial approach with that of the Democrats. So even on Obama's turf, the GOP thinks it can score a few political points.

    "I think what we have to do is keep it on the policy and really continue to describe that we have listened to the American people, and anyone listening to the American people would say scrap this bill and begin again, and let's begin again by focusing on lowering costs," Rep. Dave Camp of Michigan, who will be attending the summit as the top Republican on the House Ways and Means Committee, said Tuesday.

    Republicans know they go into the half-day event Feb. 25 with built-in disadvantages. Obama dominated when he debated House Republicans at their retreat in Baltimore last month, and the White House would like to recreate that dynamic, capitalizing on Obama's speaking skills.

    The president has already said he'll moderate the forum, and the location and staging at the Blair House guest residence are of the White House's choosing, giving Democrats home-court advantage. But Republicans say they have a different advantage: Polls show Americans side with them on the substance. All they have to do is remind viewers that's the case, and they could chalk up something like a win that could make the going even tougher for the Democrats.

    In a New York Times/CBS poll released this month, 56 percent said they preferred "a smaller government providing fewer services" to 34 percent in favor of "a bigger government providing more services." Some 27 percent named jobs as the most important issue confronting the nation while 25 percent said the economy. Thirteen percent said health care, fewer than the 16 percent who said "other."

    Republicans say all that argues in favor of their approach: taking smaller steps toward reform, not a comprehensive remake like the Democrats prefer. They'll continue to argue that Democrats should scrap their existing bills and start over.

    "Americans don't want another 2,700-page bill that raises taxes and slashes Medicare for our seniors," said Don Stewart, spokesman for Senate Minority Leader Mitch McConnell, R-Ky.

    With the summit more than a week away and lawmakers out of town for the Presidents Day recess, Republicans are in the early stages of planning their strategy for the event, which Democrats hope will jump-start legislation stalled since they lost a Massachusetts Senate seat and their ability to overcome Republican delaying tactics.

    House Minority Leader John Boehner of Ohio and McConnell, his Senate counterpart, will attend the summit along with other top Republicans. Boehner and McConnell also get to invite four lawmakers each but have not said who they will be. That decision in itself will send a message about their approach and help determine the tone of the session.

    "I think the president will lay out his ideas and I would expect that Republicans will and others will lay out their solutions," White House press secretary Robert Gibbs told reporters.

    One potential hitch for Republicans is that there is not a single GOP plan.

    In the House, one Republican plan would cover some 3 million and lower premiums by as much as 8 percent for individuals and 10 percent for small businesses — expect to hear the latter figure mentioned frequently at the summit. But a number of lawmakers have their own plans, and in the Senate no single Republican plan emerged, though individual senators put forward proposals, including some with significant similarities to the Democratic bills.

    Obama has pledged to post the Democrats' plan online before the summit; he's hoping Democrats in the House and Senate can reconcile differences between their approaches before then. Republicans have no plans to go along with Obama's request that they, too, post a comprehensive proposal online, but they don't view that as a problem.

    Keith Hennessey, who served as senior White House economic adviser to President George W. Bush, offered Republicans some advice in a posting on his blog this week. He wrote that Republicans should offer a range of significant policy changes but not feel obligated to have a single unified approach. Instead, they should "hammer home that this should have been a legislative debate and process among multiple options, rather than a take-it-or-leave-it, or option A vs. option B exercise."

    Hennessey's final words of advice: "When in doubt, shift the camera's focus to your disagreements with congressional Democrats, who will be a far easier opponent in a public snowball fight than the president."

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  • Life-Extending Cocktail Cooked Up For Mice

    Despite the hype, mega-doses of antioxidants have failed to deliver the promise of a long, healthy life. Quite to the contrary, too much vitamin E can increase the risk of stroke; too much beta-carotene can increase the risk of lung cancer in smokers; and so on down the line.

    The reason is that the antioxidant theory is way too simple, depicted as one of these battles between good and evil. Punks called free radicals roam the body looking for fights, roughing up DNA, knocking loose electrons, causing mutations and perhaps even causing aging itself. Antioxidants come swooping in, donating electrons and repairing damage.

    Some of this is true. Yet free radicals are crucial for life, embedded in the human immune system and also involved in certain important cell signaling. Meanwhile, antioxidants can turn on you, causing oxidative damage just like free radicals. There's a proper balance of free radicals and antioxidants needed for good health; and popping vitamin pills can throw off that balance.

    Yet a team of Canadian researchers has been playing with a crazy idea for more than a decade: If a lot of one antioxidant doesn't work, how about a little bit of a lot of antioxidants - you know, sort of like what you could get from a well-balanced diet?

    Turns out that their hunch might be right... in mice, anyway.

    Of mice and men

    As relayed in the current issue of Experimental Biology and Medicine, researchers at McMaster University in Hamilton, Ontario, have developed a cocktail of antioxidants and other nutrients that forestalls major aspects of the aging process in mice.

    Mice fed the cocktail dramatically warded off many of the signatures of aging, such as loss of memory, motor skills, sensory perception and energy. The reason might be the nutrients' ability to increase the activity of the mitochondria - the cellular organelles that create the enzymes needed to turn food into energy - while reducing their production of free radicals.

    The cocktail includes vitamins C, D and E, acetylsalicylic acid, beta-carotene, folic acid, garlic, ginger root, ginko biloba, ginseng, green tea extract, magnesium, melatonin, potassium, cod liver oil, flax seed oil and over a dozen more. Shaken or stirred, it doesn't matter.

    Note the word "experimental" in that journal's name, though. The work is promising, the latest in a series of papers with rather similar titles from this lab over the past decade. Yet there's no solid evidence this can work in humans.

    Less isn't more

    "Most studies only test a few things and the general results have been disappointing or unimpressive," said David Rollo, who led the study. "I find it amazing that some top cardiovascular studies have actually tested single antioxidants on study groups, because anyone in this field knows these are likely to be pro-oxidant."

    So which nutrients are doing what and how? Rollo doesn't know. He said he concocted this mix because they are associated with ameliorating key mechanisms associated with aging: free-radical production, inflammation, insulin insensitivity, cell membrane damage, and mitochondrial damage. He figures his team can always work backwards and remove nutrients to understand what their functions are.

    If you're waiting for a pill, you best start eating healthfully and exercising so that you can live that long to see it.

    The next step in his research, Rollo said, is to tweak the cocktail in short-lived crickets. Human studies are complicated because they are expensive; and slight changed in the aging rate, whatever that might mean, are hard to discern in such long-lived creatures.

    Also, the aforementioned nutrients are off-the-shelf. Big pharma isn't likely to support such a study when there is little chance of securing a patent.

    Note that this is no promise of a fountain of youth or even a major extender of life span. Rather, the right cocktail of nutrients might simply help extend youthful function and healthy life for any given individual.

    Rollo, like many in the anti-aging field, is optimistic. "Even a few extra healthy years across six billion people would be an amazing thing," he said.

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  • Most Americans Think It's Others Who Are Unhealthy

    Despite rising rates of obesity and diabetes, a new survey has found that a majority of Americans believe their health is just fine - it's everyone else who has the problem.

    More than 50 percent of respondents said that other people's health "was going in the wrong direction." In contrast, only 17 percent said their own health was going in the wrong direction.

    Commissioned by GE Healthcare, The Cleveland Clinic and Ochsner Health System, the survey looked at how Americans and their health-care professionals rate the country's health. The findings, which were released Tuesday, show a big disconnect between how Americans rate their own personal health and how they rate the health of their fellow Americans. Furthermore, Americans seem to think they are in much better shape than their doctors believe they are.

    "Either people are denying reality about themselves or they don't have the correct knowledge and believe they are doing the right things," said study author Dr. Michael Roizen, chairman of The Cleveland Clinic's Wellness Institute. "Personally, I think there is a lot of misinformation [about healthy habits]."

    On the other hand, Roizen added, many physicians may be overstating their concern about the health of the general population because they tend to see the sickest.

    According to the study, which surveyed more than 2,000 people across the United States late last year:

    * Nearly 30 percent of the respondents gave themselves an A for managing their personal health, while 92 percent of doctors gave them a C or lower.
    * Nearly a third of the study respondents gave themselves an A for eating healthy. Once again, 92 percent of doctors gave them a C or lower.
    * About a third gave themselves an A for getting regular exercise, while 91 percent of physicians gave them a C or lower.

    One disconnect is that in a land where a majority of people are overweight or obese, people tend to compare themselves favorably with their more overweight neighbors, explained Eva To, a registered dietician in White Plains, N.Y.

    "Everything is relative," she said. "In America, everything is big. But if you put them in an Asian country, they will compare themselves to someone else."

    Another problem seems to be that many respondents didn't know their basic health numbers - blood pressure, cholesterol, glucose level and other measures. Just 24 percent knew their body-mass index; 29 percent knew their blood glucose level; 33 percent knew their daily caloric intake; and only 36 percent knew their current cholesterol levels.

    And yet a majority reported that keeping those numbers in a good range was key to good health. Ninety-five percent agreed that regular checkups with their physicians were important, even though 70 percent said they had taken actions to avoid their doctors, such as hoping their health problems would go away on their own or asking a friend for medical advice instead.

    "It is important that patients communicate with their personal physicians to help manage their own health," said Dr. Scott Hayworth, president and CEO of Mount Kisco Medical Group in New York. "With this comes an obligation to be aware of how well they are following guidelines for exercise, diet and weight management."

    It's a task that may be easier said than done, according to To.

    "Americans are just not into prevention," she said. "If they are not sick, they think they are healthy. But most of the killers are silent diseases, such as diabetes, high blood pressure and hardening of the arteries. We don't feel it, but they are killers all the same."

    People also tend to rationalize their bad behavior by believing that the good things they do cancel out the negative. An extra slice of pizza, for example, may be justified as OK after a workout.

    "People may say they eat salad for lunch, but what about the salad dressing?" said To. "They look at one element and not look at the whole picture."

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  • Survey Finds Many Men Complaining of Ill-Fitting Condoms

    Poorly fitting condoms not only boost the risk of sexually transmitted diseases, they also reduce sexual pleasure during intercourse, a new study has found.

    The findings are based on a survey of 436 men, aged 18 to 67, who responded to an Internet survey after being recruited through newspaper ads and a blog on a condom sales company Web site. The survey asked the men about how a condom fit the last time they used one while having sex with a female.

    Nearly 45 percent said they'd used a condom that fit poorly the last time they had sex during the previous three months. These men were more than 2.5 times more likely to say their condom broke or slipped compared to those who said their condoms fit well. And they were five times more likely to say they experienced irritation to the penis.

    The men whose condoms fit poorly were also about twice as likely to say that the condoms made it difficult for them, their partners or both to reach orgasm. Not surprisingly, this made intercourse less pleasurable, the study authors noted.

    And the men with poor-fitting condoms were twice as likely to say they took off the condoms before they finished having sex, the survey found.

    The findings "emphasize the point that men and their female sex partners may benefit from public health efforts designed to promote the improved fit of condoms," the researchers wrote.

    The study, which surveyed men through the Web site of the Kinsey Institute for Research in Sex, Gender and Reproduction, is published online in February in the journal Sexually Transmitted Infections.

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  • Advance Toward Test for Aggressive Prostate Cancer

    Harvard researchers report what they say is a major advance toward the long-sought goal of a genetic test that can distinguish between aggressive prostate cancers that require urgent treatment and slow-growing tumors that can safely be left alone.

    Today, many men diagnosed with prostate cancer are treated with radiation or chemotherapy even though most of those cancers will grow so slowly that they are not dangerous. It is the cancers that metastasize -- spread outside the prostate gland -- that typically are life-threatening.

    "For the first time, we showed in a mouse model that when you take a gene out, you get metastasis and when you put it back in you don't get metastasis," said study author Karen Cichowski, an assistant professor of medicine in the division of genetics at Harvard's Brigham and Women's Hospital. "It looks like the entire pathway is driven by this one gene, the cascade that drives metastasis."

    Studies of human prostate cancers have shown the same effect, she said: "We have looked at the genetic pathway in a large number of human tumors, and have found it to be deregulated in more advanced prostate cancers."

    The finding could lead to better treatment of prostate cancer, because the molecule whose production is governed by the gene can be a target of drug therapy, Cichowski said.

    The molecule, designated EZH2, is an enzyme, and "enzymes are always good potential therapeutic targets," she said. "Many companies are working to develop EZH2 inhibitors."

    The Brigham and Women's program is one of a number being carried out in competitive fashion at several U.S. medical research centers. They are looking at a cluster of genes whose connection with prostate cancer was first described in 2002 by Jer-Tsong Hsieh, a professor of pathology and urology at the University of Texas Southwestern Medical Center at Dallas.

    "We complement each other; our findings are very similar," Hsieh said of the Harvard work. "I am a cell biologist and look for the protein. She uses a genetic approach."

    Hsieh's group has published several papers on the research, one as recent as last month. One current effort is to develop a chemical reagent that can detect the enzyme, he said.

    Another researcher in prostate cancer genetics is Dr. Arul Chinnaiyan, a professor of pathology and urology at the University of Michigan.

    The newly reported study "provides a nice mechanistic link as to why EZH2 leads to metastatic cancer," Chinnaiyan said. "It is exciting because there is a lot of interest in the biotechnology world in developing inhibitors of EZH2."

    His laboratory is working on such inhibitors, Chinnaiyan added.

    "Chinnaiyan showed that this gene for EZH2 is highly expressed in advanced prostate cancer," Cichowski said. "Hsieh showed that a second gene in this genetic pathway was a target of EZH2 and could be silenced by EZH2. It was one of 250 genes targeted by EZH2. We showed that in a mouse model the gene is the primary target of EZH2 in prostate cancer."

    That gene, DAB2IP, is suppressed in human prostate cancer, and the degree of suppression correlates with the aggressiveness of a cancer, the journal report said.

    "This is the first study to definitively show not only the gene but also the pathway that drives metastasis in prostate cancer," Cichowski said. "Now that we know this pathway, there are many ways to target it."

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  • Pill shows lasting benefits against hay fever

    A medication that allows hay fever sufferers to get allergy shots in the form of a pill seems to have lasting benefits, a new study finds.

    The drug, called Grazax, is a prescription medication approved in Europe for the treatment of allergies to grass pollen, one of the major triggers of springtime hay fever.

    The pill offers an alternative to allergy shots, which are typically recommended when hay fever symptoms cannot be controlled with standard medication. Allergy shots help prevent symptoms by exposing people to small amounts of the substance to which they are allergic, essentially desensitizing the immune system to the allergen.

    Allergy shots are typically given weekly at first, followed by monthly injections over several years. The treatment does not cure hay fever but is generally effective at reducing symptoms. However, the inconvenience and discomfort limits patients' willingness to try allergy shots.

    Grazax pills, which dissolve under the tongue, contain a small amount of grass-pollen extract. The drug is taken daily, starting several months before the start of the allergy season and continuing for three years thereafter.

    In the new study, researchers looked at the medication's long-term effects in patients who had stopped using it after the recommended three years. They found that, compared with patients who had been given a placebo, Grazax users had one-quarter fewer hay fever symptoms one year after stopping the medication.

    They also had less need for antihistamines and other allergy medications, according to a report in the Journal of Allergy and Clinical Immunology.

    These longer-term findings, the researchers write, support Grazax as a treatment option for people whose hay fever symptoms fail to improve with standard medication.

    Dr. Stephen R. Durham, of Imperial College London in the UK, led the study, which was funded by Denmark-based ALK-Abello, the maker of Grazax. Durham and several co-researchers on the study have received research grants and other funds from the drug company.

    The findings are based on 257 adults with grass pollen allergies, confirmed through allergy tests. They were randomly assigned to take either Grazax or inactive placebo tablets every day, beginning four to eight months before the next grass pollen season. They continued the therapy for three years.

    Over those three years and for one year after stopping the treatment, the patients rated their daily symptoms and allergy medication use.

    During the year following treatment, patients in the Grazax group reported a 26 percent reduction in symptoms like congestion and itchy, watery eyes compared with the placebo group. They also had a 29 percent reduction in medication use and gave higher ratings to their quality of life.

    Those differences were similar to those seen during the three years of active treatment, according to the researchers.

    During the last year on treatment, 15 percent of Grazax patients had side effects believed to be caused by the treatment -- the most common being itching and swelling in the mouth, ear itchiness and throat irritation.

    A clinical trial aimed at winning approval for Grazax in the U.S. is currently underway.

    SOURCE: Journal of Allergy and Clinical Immunology, January 2010.

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  • Diabetes Drugs Avandia, Actos Tied to Fractures in Women

    Women who take diabetes drugs known as thiazolidinediones, which include Avandia and Actos, are at a greater risk of bone fractures, a new study finds.

    Women who took a thiazolidinedione drug for a year were 50 percent more likely to suffer a bone fracture than patients who didn't take the drug, the researchers found. Women older than 65 were most vulnerable, with a 70 percent higher risk.

    "Older women are already at a higher risk of osteoporosis and osteoporosis-related fractures, which might explain why they appeared to be the most affected," study senior author Dr. L. Keoki Williams, of the Center for Health Services Research at Henry Ford Hospital, said in a news release.

    Thiazolidinedione drugs -- which include pioglitazone (Actos) and rosiglitazone (Avandia) -- help people with type 2 diabetes better control their blood sugar levels. The drugs work by lowering resistance to insulin and cutting the amount of glucose made by the liver.

    But doctors have worried in recent years about reports linking the drugs to bone loss and higher risk of fractures.

    The researchers studied 4,511 patients who filled at least one prescription for a thiazolidinedione between 2000 and 2007 at Henry Ford Hospital. Men were not found to be at higher risk of fracture in this study group, the study authors noted in the news release, although other recent research has suggested such a link.

    The findings are published in the February issue of the Journal of Clinical Endocrinology & Metabolism.

    The drugs "may put some patients at increased risk for other health issues, and I encourage patients to talk with their physician about other suitable options," Williams added.

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