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BetterControlofTBSeenIfaFasterCureIsFound

TheWorldHealthOrganizationestimatesthataboutone-thirdofallpeopleareinfectedwithbacteriathatcausetuberculosis.Mosttimes,theinfectionremainsinactive.ButeachyearabouteightmillionpeopledevelopactivecasesofTB,usuallyintheirlungs.Twomillionpeopledieofit.ThediseasehasincreasedwiththespreadofAIDSanddrug-resistantformsoftuberculosis.

Currenttreatmentstakeatleastsixmonths.Patientshavetotakeacombinationofseveralantibioticdrugsdaily.Butmanypeoplestopassoonastheyfeelbetter.Doingthatcanleadtoaninfectionthatresiststreatment.Publichealthexpertsagreethatafaster-actingcurefortuberculosiswouldbemoreeffective.Nowastudyestimatesjusthoweffectiveitmightbe.AprofessorofinternationalhealthatHarvardUniversityledthestudy.JoshuaSalomonsaysashortertreatmentprogramwouldlikelymeannotjustmorepatientcured.Itwouldalsomeanfewerinfectiouspatientswhocanpassontheirinfectiontoothers.

Theresearchersdevelopedamathematicalmodeltoexaminetheeffectsofatwo-monthtreatmentplan.TheytestedthemodelwithcurrentTBconditionsinSoutheastAsia.Thescientistsfoundthatatwo-monthtreatmentcouldpreventabouttwentypercentofnewcases.Anditmightpreventabouttwenty-fivepercentofTBdeaths.Themodelshowsthatthesereductionswouldtakeplacebetweentwothousandtwelveandtwothousandthirty.Thatis,ifafastercureisdevelopedandinwideusebytwothousandtwelve.

TheWorldHealthOrganizationdevelopedtheDOTSprograminnineteenninety.DOTSisDirectlyObservedTreatment,Short-course.Healthworkerswatchtuberculosispatienttaketheirdailypillstomakesuretheycontinuetreatment.

Earlierthisyear,aninternationalpartnershipoforganizationsannouncedaplantoexpandtheDOTSprogram.Theten-yearplanalsoaimstofinanceresearchintonewTBdrugs.Thefourmostcommondrugsusednowaremorethanfortyyearsold.TheGlobalAllianceforTBDrugDevelopmentsaysitslong-termgoalisatreatmentthatcouldworkinasfewastendoses.

8NewYorkStudentsHaveSwineFlu

TheCentersforDiseaseControlandPreventionhasconfirmedcasesofswinefluineightstudentsataNewYorkpreparatoryschool,MayorMichaelBloombergsaidSunday.Thestudentshavehadonlymildsymptomsandnonehavebeenhospitalized,hesaid.Someofthestudentshavealreadyrecovered.

Morethan100studentswereabsentfromschoolduetoflu-likesymptomslastweek.NewYorkhealthofficialstestedsamplesforeightstudentsSaturdayanddeterminedthestudentswereprobablysufferingfromswineflu,andtheCDCconfirmedthediagnosisonSunday,Bloombergsaid.

TheannouncementbringsthenumberofconfirmedswineflucasesintheUnitedStatesto20.BloombergandNewYorkHealthCommissionerTomFriedensaidthereisnosignofacitywideoutbreakoftheflu,andnosignofapotentialoutbreakofswinefluatotherschools.

SomestudentsattheschoolspentspringbreakinMexico,Bloombergsaid,butauthoritieshavenotdeterminedwhetheranyofthestudentswithaconfirmedcaseofswinefluwasinMexico.SomeonewhotraveledtoMexicomaynothavehadanyflusymptomsbutpassedontheflutosomeoneelse,henoted.

Friedencalledonstudentswhoarehomesicktostayhomefor48hoursaftertheirsymptomssubside.

Ifsymptomsarenormalforaregularkindofflu,thereisnoneedtogotoahospital,saidBloomberg.Ifsymptomsbecomesevere,aswithanyillness,peopleshouldgotothehospital,hesaid.

St.Francis,whichhas2,700students,announceditwillremainclosedfortwodays.Askedwhetherthestudents’illnesseshavebeenminorbecausethey’reyoungandhealthyorbecauseitisaminorstrainofthevirus,Friedenresponded,“Wedon’tknow.”

OneGoodReasontoLetSmallpoxLive

It’snowafairbetthatwewillneverseethetotalextinctionofthesmallpoxvirus.Theideawastocapthegloriousachievementof1980,whensmallpoxwaseradicatedinthewild,bydestroyingthekillervirusinthelasttwolabsthataresupposedtohaveit–oneintheUSandoneinRussia.Ifsmallpoxhadtrulygonefromtheplanet,whatpointwasthereinkeepingthesereserves?

Inreality,ofcourse,itwasnaivetoimaginethateveryonewouldletgoofsuchapotentpotentialweapon.Undoubtedlyseveralnationsstillhaveafewvials.Andthelast“official”stocksoflivevirusbredmistrustoftheUSandRussia,fornoobviousgain.

NowAmericanresearchershavefoundananimalmodelofthehumandisease,openingthewayfortestonnewtreatmentsandvaccines.Soonceagainthere’sagoodreasontokeepthevirus—justincasethediseaseputsinareappearance.

HowdowedealwiththemistrustoftheUSandRussia?

Simple.Keepthevirusunderinternationalauspicesinawell-guardedUNlaboratorythat’sopentoallcountries.TheUSwillobject,ofcourse,justasitrejectsamultilateralapproachtojustabouteverything.Butitdoesn’tmeantheideaiswrong.Ifthevirusisuseful,thenlet’smakeittheservantofallhumanity—notjustapartofit.

Diet,AlcoholLinkedtoNearlyOneThirdofCancers

Dietissecondonlytotobaccoasaleadingcauseofcancerand,alongwithalcohol,isresponsiblefornearlyfornearlyonethirdofcasesofthediseaseindevelopedcountries,aleadingresearchersaidonTuesday.

Dr.TimKey,oftheUniversityofOxford,toldacancerconferencethatscientistsarestilldiscoveringhowcertainfoodscontributetocancer,buttheyknowthatdiet,alcoholandobesityplayamajorrole.

“Fivepercentofcancerscouldbeavoidedifnobodywasobese,”hesaid.

Whiletobaccoislinkedtoabout30percentofcancercases,dietisinvolvedinanestimated25percentandalcoholinaboutsixpercent.

Obesityraisestheriskofbreast,womb,bowelandkidneycancer,whilealcoholisknowntocausecancersofthemouth,throatandliver.It’sdangerousimpactisincreasedwhencombinedwithsmoking.

KeytoldthemeetingofthecharityCancerResearchUKthatotherelementsofdietlinkedtocancerarestillunknownbutscientistsarehopingthattheEPICstudy,whichiscomparingthedietsof500,00peoplein10countriesandtheirriskofcancer,willprovidesomeanswers.

EarlyresultsofthestudyhaverevealedthatNorway,SwedenandDenmarkhavethelowestconsumptionoffruitandvegetablesamongEuropeancountrieswhileItalyandSpainhavethehighest.Eatingatleastfiveportionsoffruitandvegetablesadayisrecommendedtoreducetheriskofcancer.

Key,principalscientistontheEPICstudy,saiditislookingatdietarylinkstosomeofthemostcommoncancersincludingcolorectal,breastandprostate.

MenTooMaySufferfromDomesticViolence

Nearlythreein10menhaveexperiencedviolenceatthehandsofanintimatepartnerduringtheirlifetimes,accordingtooneofthefewstudiestolookatdomesticviolenceandhealthamongmen.

“Manymenactuallydoexperiencedomesticviolence,althoughwedon’thearaboutitoften,”Dr.RobertJ.ReidoftheUniversityofWashingtoninSeattle,oneofstudy’sauthors,toldReutersHealth.“Theyoftendon’ttellandwedon’task.Wewanttogetthemessageouttomenwhodoexperiencedomesticviolencethantheyarenotaloneandthereareresourcesavailabletothem.”

Theresearchersaskedstudyparticipantsaboutphysicalabuseandnon-physicalabuse,suchasthreatsthatmadethemfearfortheirsafety,controllingbehavior（forexample,beingtoldwhotheycouldassociatewithandwheretheycouldgo）,andconstantname-calling.

Amongmen18to54yearsold,14.2percentsaidtheyhadexperiencedintimatepartnerviolenceinthepastfiveyears,while6.1percentreporteddomesticviolenceinthepreviousyear.

Rateswerelowerformen55andolder,with5.3percentreportingviolenceinthepastfiveyearsand2.4percenthavingexperienceditinthepast12months.

Overall,30.5percentofmenyoungerthan55and26.5percentofoldermensaidtheyhadbeenvictimsofdomesticviolenceatsomepointintheirlives.Abouthalfoftheviolencethemenexperiencewasphysical.

However,thephysicalviolencemenreportedwasn’tasharshasthatsufferedbywomeninapreviousstudy;20percentto40percentofthemenrateditassevere,comparedto61percentofwoman.

Menwhoreportedexperiencingdomesticviolencehadmoreemotionalandmentalhealthproblemsthanthosewhohadnot,especiallyoldermen,theresearchersfound.

Once—dailyPillCouldSimplifyHIVTreatment

Bristol—MyersSquibbandGileadScienceshavecombinedmanyHIVdrugsintoasinglepill.Sometimesthebestmedicineismorethanonekindofmedicine.Malaria,tuberculosisandHIV/AIDS,forexample,arealltreatedwithcombinationsofdrugs.Butthatcanmeanalotofpioustotake.Itwouldbesimplerifdrugcompaniescombinedallthemedicinesintoasinglepill,takenjustonceaday.

Now,twocompaniessaytheyhavedonethatforpeoplejuststartingtreatmentforHIV,thevirusthatcausesAIDS.ThecompaniesareBristol—MyersSquibbandGileadSciences.Theyhavedevelopedasinglepillthatcombinesthreedrugscurrentlyonthemarket.Bristol—MyersSquibbsellsoneofthemunderthenameofSustiva.Gileadcombinedtheothers,EmtrivaandViread,intoasinglepillintwothousandfour.

Combiningdrugsinvolvesmorethantechnicalissues.Italsoinvolvesissuesofcompetitionifthedrugsaremadebydifferentcompanies.Thenewonce—dailypillistheresultofwhatisdescribedasthefirstjointventureagreementofitskindinthetreatmentofHIV.

InJanuarytheNewEnglandJournalofMedicinepublishedastudyofthenewpill.Researcherscompar