Health Highlights: Jan. 10, 2008

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

Women Need to Consume Folic Acid to Reduce Risk of Birth Defects

U.S. health officials are emphasizing the need for all women of childbearing age, especially those ages 18 to 24, to consume 400 micrograms of folic acid a day in order to prevent serious birth defects.

Consumption of folic acid, a B vitamin, results in a 50 percent to 70 percent reduced risk of neural tube defects, which affect the spine and brain and occur in about 3,000 pregnancies each year in the United States.

WHAT TO KNOW
    • Women Need to Consume Folic Acid to Reduce Risk of Birth Defects
    • Bird Flu Virus Called 'Stable'
    • Circulatory Problems Seen in Women Using Evra Birth Control Patch
    • Low Dose of Aspirin Effective in Treating Heart Attack: Study
    • Millions of Young People Use Cough Medicines to Get High
    • Most Doctors Say Error-Reporting Systems Are Inadequate

The recommendation is published in the Jan. 11 issue of the Morbidity and Mortality Weekly Report, from the U.S. Centers for Disease Control and Prevention.

A 2007 March of Dimes survey found that only 40 percent of women ages 18 to 45 reported daily consumption of folic acid. Women ages 18 to 24 had the lowest reported daily consumption (30 percent), and lower awareness (61 percent) and knowledge (6 percent) about folic acid than older women.

Efforts to promote folic acid intake need to focus on younger women because they account for about a third of all births to women ages 18 to 44 and have the highest rate of unintended pregnancies, the report said.

Another article in this week's MMWR noted that folic acid knowledge and consumption rates are declining among women of childbearing age in Puerto Rico. It also said that rates of neural tube defects in Puerto Rico are increasing, after an overall decline from 1996 through 2003.

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Bird Flu Virus Called 'Stable'

Programs to contain outbreaks of the H5N1 bird flu virus have proven highly effective and the virus itself has remained remarkably stable, says Bernard Vallat, director general of the World Organization for Animal Health.

Since H5N1 first appeared in 2003, many experts have worried the virus could mutate into a form easily transmitted between people and spark a global pandemic that could kill millions of people.

But Vallat said there's been no evidence of such a mutation in H5N1, Agence France-Presse reported.

"We have never seen a virus which has been so stable for so long. Compared to other viruses, it is extremely stable, which minimizes the risk of mutation" into a pandemic strain, he said.

Vallat also noted that a system to improve veterinary surveillance, especially in developing nations, has helped to quickly identify and eradicate H5N1 outbreaks in poultry flocks.

Since 2003, the H5N1 virus has killed 216 people, mostly in Asia, AFP reported.

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Circulatory Problems Seen in Women Using Evra Birth Control Patch

There have been 16 reported cases of blood clots and one heart attack, resulting in two deaths, among women using the Evra birth control patch since it was introduced in Canada in early 2004, says a report in a Health Canada newsletter.

"Health Canada is currently reviewing updated information for Evra and will notify health-care professionals and consumers as required," agency spokesman Alastair Sinclair said in an e-mail, the Canadian Press reported.

In November 2006, safety information about Evra was released by drug maker Janssen-Ortho and Health Canada. This information noted that one study had found that women using the patch were more likely to develop blood clots in the legs and lungs than women who used oral contraceptives. But another study found no difference in blood clot risk between the two types of contraceptives.

The reported cases of blood clots and heart attack are not a cause for concern, said gynecologist Dr. Melissa Mirosh, former fellow of the contraception advice, research and education fellowship program at Queen's University in Kingston, Ont.

"When you look at any estrogen-containing product available on the marker, whether it's the pill or the Evra patch or NuvaRing, the vaginal ring, all of them slightly increase the risk of blood clot," she told the CP.

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Low Dose of Aspirin Effective in Treating Heart Attack: Study

Many doctors may be using unnecessarily high doses of aspirin to treat heart attack patients, suggest the authors of a study in the Jan. 15 issue of the journal Circulation.

Researchers looked at data on nearly 50,000 patients in two international trials and found that a low dose of aspirin (162 milligrams or less) appeared to be just as effective as a higher dose in initial treatment of ST-elevation myocardial infarction (STEMI), one of the most common types of heart attack.

The lower dose is safer, because it's associated with less bleeding, the researchers noted.

"We have known for almost 20 years that a low dose of aspirin given in the early stages of a heart attack can save lives," lead author Dr. Jeffrey Berger, a cardiologist at Duke University Medical Center, said in a prepared statement. "Yet the majority of the doctors in this country are still prescribing 325 milligrams despite the lack of evidence showing that more is better."

He said the findings of this study suggest that doctors need to reassess their use of aspirin in heart attack patients.

"If a lower dose of aspirin is just as good -- and more may be harmful -- why risk it?" he said.

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Millions of Young People Use Cough Medicines to Get High

About 3.1 million Americans ages 12-25 (5 percent) used cough and cold medicines to get high last year, according to a federal Substance Abuse and Mental Health Services Administration report released Wednesday.

That's about the same number of young people who used LSD and many more than the number who used methamphetamine, said the agency's 2006 report on drug abuse and health.

More than 140 over-the-counter cough and cold medicines contain the cough suppressant DXM that, when taken in large amounts, can cause disorientation, slurred speech, blurred vision and vomiting, the Associated Press reported.

The rate of misuse of cough and cold medicines in the 12-25 age group was 2.1 percent among whites, 1.4 percent among Hispanics, and 0.6 percent among blacks.

"While increasing attention has been paid to the public health risk of prescription drug abuse, we also need to be aware of the growing dangers of misuse of the over-the-counter cough and cold medications, especially among young people," said SAMHSA Administrator Terry Cline, the AP reported.

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Most Doctors Say Error-Reporting Systems Are Inadequate

Many American doctors believe current medical error-reporting systems are inadequate and instead rely on informal discussions with colleagues. This means that important information about medical errors and how to prevent them often isn't shared with hospitals or health-care organizations, says a study in the January/February issue of the journal Health Affairs.

The study, funded by the U.S. Agency for Healthcare Research and Quality (AHRQ), surveyed more than 1,000 doctors in rural and urban areas of Missouri and Washington state between July 2003 and March 2004.

"These findings shed light on an important question -- how to create error-reporting programs that will encourage clinician participation," AHRQ Director Dr. Carolyn M. Clancy said in a prepared statement. "Physicians say they want to learn from errors that take place in their institution to improve patient safety. We need to build on that willingness with error-reporting programs that encourage their participation.

Among the survey findings:

  • Only 30 percent of respondents felt that current error-reporting systems were adequate.
  • 56 percent reported a prior involvement with a serious error, 74 percent with a minor error, and 66 percent with a near miss.
  • More than half (54 percent) agreed with the statement that "medical errors are usually caused by failures of care delivery systems, not failures of individuals."
  • The majority agreed that they should report errors to their hospital or health-care organization to improve patient safety, and agreed that they needed to know about errors in their organizations and discuss errors with colleagues to improve patient safety.