Booster Shots

Binge drinking is fun -- until the gonorrhea diagnosis

Tami Dennis — Sat, 06 Sep 2008 17:00:00 -0700

Drinking five or more alcoholic beverages at one time appears to be connected to risky sexual behaviors as well as (surprise!) higher rates of sexually transmitted diseases such as gonorrhea.

The findings, from researchers at Johns Hopkins University, would seem to be so obvious as to merit a "yeah, and ...?" Here's one of the "ands": The connection is more of a problem for women.

The researchers questioned several hundred men and women being evaluated or treated for sexually transmitted diseases, asking them about recent drug and alcohol use as well as about risky sexual practices. Those were defined as such things as having multiple partners and anal sex.

And it turns out inhibitions can be lowered too far -- meaning binge drinking gets in the way of smart decision-making. This is true for both genders obviously, but women who consume the same amount of alcohol as men can nonetheless end up with a higher concentration of alcohol in their bloodstream because of their smaller body mass, creating more impairment. As far as the actual sex, women are more likely to contract some diseases, such as HIV, through repeated condomless intercourse than are men.

Says Heidi E. Hutton, a study author and assistant professor of psychiatry and behavioral sciences, in a news release on the research: "Across genders, women binge drinkers are more likely to have anal sex than men binge drinkers. Within gender, women binge drinkers are three times as likely to have anal sex, and twice as likely to have multiple sex partners compared to women who do not drink alcohol. Compared to non-drinking women, women binge drinkers are also five times as likely to have gonorrhea."

The researchers recommend that people being treated for STDs be screened for a binge drinking problem, not just alcohol dependence.

The new research will be published in the November issue of Alcoholism: Clinical & Experimental Research.

Here's information from the Centers for Disease Control and Prevention on binge drinking (the reference list might be ultimately more useful) and a Times story about binge drinking, specifically as it relates to women: Threat behind the party girl image.

-- Tami Dennis

Photo credit: David Silverman / Getty Images

Lessons from Terri Schiavo

Susan Brink — Sat, 06 Sep 2008 06:00:00 -0700

After a lot of political and medical hoopla in the early months of 2005, Terri Schiavo, died on March 31, at the age of 41. She was institutionalized for the final 15 years of her life after suffering cardiac arrest in 1990. Her CT scans showed severe atrophy of the brain. Electroencephalograms, tests of the electrical activity of the brain, showed nothing but flat lines. An autopsy confirmed that she had been in a persistent vegetative state without awareness or any hope of improvement.

The very public death of Terri Schiavo began a rush on requests for the paperwork needed to order a good death with dignity. People lit up the phone lines of places like Aging with Dignity, asking for information on living wills.

At about that time, a team of researchers from UC San Francisco and the San Francisco VA Medical Center were interviewing 117 people about their end-of-life wishes and their feelings about advance directives, the legal documents which spell out people's desires. Turns out, they weren't so interested in the laws and specifics of advance directives, but they were eager to talk about Terri Schiavo.

"Around the time the Schiavo story peaked, we were making follow-up calls to the subjects in our advance directives study," Dr. Rebecca Sudore, geriatrics research at the VA center and lead author of the story said in a news release. "Participants had little interest in discussing our study. They just wanted to talk about Terri Schiavo and what they would want done if they were in her situation. It was clear that Terri was on everyone's minds, and that we needed to delve into the impact her story had on patient's decision making about their own end-of-life care."

In a study which appeared in the August online issue of the Journal of General Internal Medicine, with a free abstract available, the researchers found that 92% of those in the study had heard of Schiavo. Among those who had heard of the case, 61% reported clarifying their own end-of-life goals as a result; 66% reported speaking with family and friends about their wishes; and 37% reported wanting to complete and advance directive.

But only 8% actually talked to their doctor about their wishes, and only 3% filled out living will paperwork. Sudore says that physicians should grab educating moments like the Schiavo case and use it to talk directly to their patients about their wishes for the end of their lives. People should also use those moments to have a good heart to heart with family members.

A good place to start is with a document called Five Wishes, legal in 40 states including California. It covers who you want to make healthcare decisions for you if you can't; the kind of medical treatment you want or don't want, such as feeding tubes; and how comfortable you want to be, including how much pain medication you'll accept. And it urges people to consider some difficult emotional questions, such as how you want to be treated at the end of life, and what you want your loved ones to know.

But it won't work if you fill it out in isolation. Talk to your family, loved ones and physicians about your wishes. Update it as the years go by. If you toss it in a drawer, your final wishes will probably be discovered too late.

--Susan Brink

Photo credit: Chris O'Meara / Associated Press

The end of the world isn't nigh -- or is it?

Rosie Mestel — Fri, 05 Sep 2008 18:00:00 -0700

Well, another week draws to a close. As a Friday treat, we thought we'd provide you with items that may have a bearing on whether you'll be motivated to eat your oatmeal and spinach and go jogging at dawn this weekend or pour yourself more stiff cocktails than is prudent:

According to the Journal of Physics G: Nuclear and Particle Physics, Volume 35, the human species is not about to go extinct. "A new report provides comprehensive evidence to confirm that the Large Hadron Collider (LHC)'s switch-on this week poses no threat to mankind," the Institute of Physics alerts us in a news release. A scientific review of the risks concludes, among other things, that "if particle collisions at the LHC had the power to destroy the Earth, we would never have been given the chance to exist." OK, then. Try telling that to people who've been calling physicists involved in the particle-smashing project with death threats and tearful entreaties to not turn the thing on, according to an article in the Daily Telegraph. (Here's an L.A. Times article on the LHC by John Johnson from April.)

All right, so maybe the LHC isn't going to kill us all. But what about an asteroid plunging into Earth from the depths of space? For word on that risk, you will have to wait a few weeks longer. According to another report, this one from the Secure World Foundation, "For the past two years the Assn. of Space Explorers (ASE) -- the international organization of astronauts and cosmonauts from 33 countries -- has been developing a program to protect the Earth from asteroid impacts." They'll be unveiling the fruits of their efforts Sept. 25 at the Offices of the Google Foundation (yes, that's what it's called) in San Francisco.

We don't mean to alarm you. We are also not in the pay of gum manufacturers, but if the thought of atom-smashers and careening asteroids has you bent out of shape, consider the following: A study by Australian researchers (funded by Wrigley's and Cadbury's, we should disclose) found that chewing gum "was associated with higher alertness, reduced anxiety and stress, and improvement in overall performance on multi-tasking activities." Stress level was determined by assessing people with a tool called the DISS, or Defined Intensity Stressor Simulation. "Gum chewers showed a reduction in anxiety as compared to non-gum chewers by nearly 17% during mild stress and nearly 10% in moderate stress," the researchers reported. The study, reported at the 10th International Congress of Behavioural Medicine, assessed the effects of gum on 40 young adults.

So chew gum. Don't worry about the LHC. Keep your hopes high on the asteroid issue -- indeed, positive thinking is one of the tips that we offer up in a set of articles this week on the science of how to be more happy. (That's right -- after decades of researching depression, neurosis, psychosis and sundry other miseries, psychologists have of late been turning their attention to the "H" word.) Check it out by clicking on the giant "Health" word at the top of this blog.

And have a good weekend!

-- Rosie Mestel

Photo Credit: Magnet core of the world's largest superconducting solenoid magnet at the Large Hadron Collider (LHC) particle accelerator. AP Photo / Keystone, Martial Trezzini, file

The fit and famous are heading to Malibu

Jeannine Stein — Fri, 05 Sep 2008 16:00:00 -0700

Want to be in the same air space as Jennifer Lopez? See what Jon Cryer’s sweat-streaked face looks like up close and personal?

Stop by the Nautica Malibu Triathlon on Sept. 13 and 14, which has a longstanding reputation for attracting the famous and fit set. Besides J-Lo, this year’s roster for the Sunday event includes William H. Macy, Felicity Huffman, Cristian de la Fuente, Mark-Paul Gosselaar, "The Bachelor" bachelor Andy Baldwin, tennis pro Anna Kournikova, and Olympic triathlete Matt Reed. It has the distinction, says Michael Epstein, the triathlon's executive producer, of being the only triathlon that appears in the pages of People magazine.

Who knew there were so many celebs willing to don a wetsuit and brave the Pacific at 7 a.m.? The tradition of notables doing the tri dates back to 1996 when Tom Cruise signed up as part of a relay team. Epstein thought it would a great idea to encourage more celebs, and at the same time add a charity component to the race. Since then, Robin Williams, Emily Procter, Frankie Muniz, Patrick Warburton, John C. McGinley and David Duchovny have raced, although Epstein says Duchovny won’t be in the lineup this year. It has nothing to do with his, er, current situation, he adds — the actor apparently moved to New York.

We’ve noticed that J-Lo’s been quite vocal about her participation, going on morning chat shows talking about how training has helped her to lose the baby weight. Which got us wondering — with all those well known faces, is fending off paparazzi ever a problem? Are underwater camera-toting photographers angling for unflattering shots?

"We’ve been doing this so long that we’re staffed to prepare for it," he says. "There are really good photo areas where the paparazzi can get good pictures."

The entertainment industry contingent has grown so much they have their own division, competing against each other. There’s a separate corporate division as well. This year money raised goes to Childrens Hospital Los Angeles; last year the triathlon raised $780,000 for the hospital.

Epstein assures us that the celebs really do compete, even if it’s in one leg of a relay. No one, he says, has shown up, dipped a toe in the ocean and called it a day. "The thing that’s most impressive," he says, "is that the race is early — they have to get up at 3:30 or 4 a.m., and it’s pretty cool that for the day they want to be athletes and not celebrities. It’s surprising how little they ask for and how great their attitude is."

Well that's a relief. One image does stand out in Epstein’s mind: former Guns N’ Roses bass player Duff McKagan smoking a cigarette while biking. "That was kind of an interesting contrast," he says.

Unfortunately all the spaces for both events in this year’s tri are taken — the event sold out in four days — but those who want to catch a glimpse of the stars can schlep out to Malibu on Sunday. Or, you could start training for next year’s event and really have some stories to tell. Although we don’t recommend sidling up to a star during the cycling portion and handing them a script. That could end badly.

-- Jeannine Stein

Photo: Mark-Paul Gosselaar is a veteran of the Nautica Malibu Triathlon, and will be competing again this year. Credit: Nautica Malibu Triathlon

FDA posts list of drugs that may be unsafe

Shari Roan — Fri, 05 Sep 2008 13:54:08 -0700

Score one for the consumer. The U.S. Food and Drug Administration today published its first list of drugs that are on the market and being used by consumers but are under review for potential safety issues.

The list, which will be updated quarterly, was part of the FDA Amendments Act, signed into law one year ago. The law requires that the FDA inform the public each quarter of new safety information or potential signals of serious risk based on the agency's review of adverse event reports.

The FDA explains the list: "The appearance of a drug on this list does not mean that FDA has concluded that the drug has the listed risk, or that FDA has identified a causal relationship between the drug and the listed risk. It is on the list only because FDA has identified a potential safety issue."

Dr. Janet Woodcock, direct of the FDA's Center for Drug Evaluation and Research added:

"My message to patients is this: Don't stop taking your medicine. If your doctor has prescribed a drug that appears on this list, you should continue taking it unless your doctor advises you differently."

The list contains 20 drugs along with the potential safety issue of each drug. Today's report includes the antidepressant Cymbalta and links to urinary retention; the multiple sclerosis drug Tysabri and reports of melanoma skin cancer, and the drug Revlimid for multiple myeloma that is linked to a life-threatening skin condition called Stevens Johnson Syndrome.

The list comes in response to complaints by the public and physicians that they aren't being told soon enough of potential safety problems reported to the FDA. Sometimes pre-marketing clinical trials do not produce evidence of a safety problem and it is only when the drug is in wide use that a problem emerges. The list will not be a comprehensive summary of all the drugs the FDA may be working on. Each new quarterly report will contain new listings; the lists will not be cumulative. You can read about the program at the FDA's website and see the current list of potentially unsafe drugs.

-- Shari Roan

Photo credit: Nati Harnik / AP

Would you eat a clone?

Rosie Mestel — Fri, 05 Sep 2008 11:15:04 -0700

Would you eat a clone? What about the offspring of a clone? Food companies are sensing that many of us won't, and are positioning themselves accordingly. A survey conducted by the Center for Food Safety, a group that opposes cloned and genetic engineered food, reports that 20 food companies have pledged that no meat or milk from a clone will end up in their products. Among those companies: giants Kraft Foods, General Mills, Gerber/Nestle and Campbell Soup Co.

At least for meat, this is a bit of an easy promise. For economic reasons, nobody would slaughter a cloned animal for meat (except at the end of their lives) because clones are far too pricey and difficult to produce. First you have to manipulate eggs in the lab -- fish out the DNA they contain and insert the DNA from the animal you want to replicate. Then you have to nudge these cells to begin growing into embryos -- and, at a certain point, implant them in a surrogate mother. The clones have to develop and survive to birth -- and be born healthy. It takes many failed attempts to get one clone that far.

That's why it cost $60,000 for Limousin cattle rancher Larry Coleman of Charlo, Mont., to create three clones of his prize bull First Down, according to a Jan. 16 L.A. Times article by Karen Kaplan. (He did it to be able to sell the clones' semen.)

What about the offspring of clones? According to a Wall Street Journal article about the survey, Kraft's pledge did not yet extend to such offspring: "The company says it will continue to monitor consumer acceptance" of these. Other companies that have pledged to eschew clones haven't done the same for clone offspring, the article notes. Eight of the 20 companies in the survey did said they'd avoid using clone offspring if they knew, but since meat and milk from these offspring aren't tracked anyway (even clones are only tracked on a voluntary basis) you might say that was an easy promise, too!

The Food and Drug Administration, meanwhile, examined hundreds of scientific studies on clones and their offspring and concluded in January that they and their milk are as safe to consume as regular meat and milk.

In Europe, the European Food Safety Authority released a "scientific opinion" in July stating that, "There is no indication that differences exist in terms of food safety for meat and milk of clones and their progeny compared with those from conventionally bred animals. " But the report did note uncertainties because the number of studies are limited, and expressed concerns about the welfare of animals. Another EC advisory group, the European Group on Ethics in Science and New Technologies, stated that “considering the current level of suffering and health problems of surrogate dams and animal clones, the EGE has doubts as to whether cloning animals for food supply is ethically justified."

Now the European Parliament is calling for a European Union ban on animal cloning for food.

Why would clones not be safe to eat? Unlike GMOs -- where one could make a case that the physical essence of a creature has been changed in a way that might conceivably cause allergies or something -- there is no genetic material added. It's an entire genome, moved from one cell to another. There are some slight alterations in the activity of a few genes, similar to that seen with in vitro fertilization and which don't seem to persist to the clones' offspring. The animals do get their start with in vitro culture, of course, for several days. And they gestate in the wombs of surrogate mothers. But those practices are used elsewhere in modern animal husbandry, which is a far cry from "natural." (Let none of us imagine that the bird we bite into on Thanksgiving is progeny of anything other than a tryst between a turkey hen and a syringe or straw.)

As for the offspring of clones -- well, they're the products of natural reproduction -- or as natural as things in modern agriculture get (as noted above). Why should they be harmful to eat?

Even the "yuck" factor I don't quite get, personally: Would this be the same yuck factor one gets from seeing twins (devil spawn!) or from Louise Brown and the 1 million IVF babies that followed in her wake? (Not that I would eat these people, mind you.)

Would you eat a clone -- or the progeny of a clone? Why? Why not?

-- Rosie Mestel

Photo Credit: Thomas Terry / Associated Press

Hookah smoking more popular than cigarettes among students

Shari Roan — Fri, 05 Sep 2008 10:37:14 -0700

After decades of public health campaigns to convince people to stop smoking, a new threat is on the horizon. Teens and young adults, many of whom would never pick up a cigarette, are smoking tobacco from a waterpipe, or hookah.

A study published Thursday in the Annals of Behavioral Medicine is shining a light on this disturbing new trend. The study, the first random sample of U.S. college students to address waterpipe smoking, found that more than 40% of the students said they had hookah smoked and almost 10% had done so in the last 30 days. Slightly fewer students said they had smoked cigarettes.

"We were surprised that the percentage of students who reported ever engaging in waterpipe smoking was actually higher than the percentage of those who have ever smoked cigarettes," said Dr. Brian Primack, an assistant professor of medicine and pediatrics at the University of Pittsburgh and lead author of the study. "Waterpipe smoking may become even more popular in the near future since many of the new smoke-free ordinances being passed by local governments exempt waterpipe cafes. Waterpipe smoking is going to be a crucial public-health issue that will require increased surveillance and study."

In a story published last November, Los Angeles Times reporter Janet Cromley found many people believe it is less harmful than smoking cigarettes. Few studies compare the dangers of cigarette smoking to hookah smoking, but health authorities say hookah smoking is not safe. "Any of the major diseases that are associated with cigarette smoking are associated with hookah pipe smoking," Paul Knepprath, vice president of government relations for the American Lung Assn. of California, told Cromley.

A fact sheet on hookah smoking is available from the Kentucky Health Department.

-- Shari Roan

Photo: Chris Young / AFP / Getty Images

Bisphenol A: If you're alarmed, learn why

Tami Dennis — Thu, 04 Sep 2008 19:01:00 -0700

Bisphenol A. The name seems vaguely worrisome -- synthetic (not that this is necessarily a bad thing) and non-apple-pie-ish (I'd argue this is). But the headlines are downright alarming, depending on your reading material. Now the National Toxicology Program, part of the National Institutes of Health, has released its final report on the possible human effects of bisphenol A, or BPA, a chemical added to plastics to make it stronger.

In short: The folks there are concerned. Not alarmed, but concerned.

Specifically, the report states that the program has:

* some concern for effects on the brain, behavior and prostate gland in fetuses, infants and children at current human exposures to bisphenol A.

* minimal concern for effects on the mammary gland and an earlier age for puberty in fetuses, infants and children at current human exposures to bisphenol A.

* negligible concern that exposure of pregnant women to bisphenol A will result in fetal or neonatal mortality, birth defects or reduced birth weight and growth in their offspring.

* negligible concern that exposure to bisphenol A will cause reproductive effects in non-occupationally exposed adults and minimal concern for workers exposed to higher levels in occupational settings.

The final report isn't a surprise, conclusive though it seems, as it essentially backs up the draft report released in the spring. The L.A. Times reported then: Chemical in plastic may harm children.

But now Yale University researchers have announced that the chemical may damage the connections between brain cells, possibly leading to memory problems or depression. That research, published online in the Proceedings of the National Academy of Sciences, was conducted in primates and though not exactly final, certainly is provocative. It adds to the growing hysteria, uproar, fear, worry, mild concern, general curiosity, irritation at the hubbub (choose your reaction) about the chemical.

Meanwhile, California legislators are pondering the worthiness of a bill that would ban the chemical from products marketed to children under age 3. Those include baby bottles, sippy cups, formula cans and the like. Said David Lazarus, consumer reporter for the Los Angeles Times, recently: "The fact that U.S. authorities have found at least some risk that BPA could be harmful to children should be sufficient reason to act."

If you've managed to tune out the coverage and are feeling remiss -- or are simply confused about some aspect, we're here to help. Check out these Times offerings:

A Closer Look: Are plastic's safety claims shatterproof? From the story: "The chemical acts a lot like estrogen if it's introduced into the body -- and evidence now shows this happens to just about everybody every day."

Are plastics safe? This provides a look at the evidence on other chemicals too -- phthalates and more.

But the report is the main thing. Not to worry, there's an abstract (a sort of shortened, distilled version) at the beginning. At least read that.

-- Tami Dennis

Photo: Bisphenol A has been found in many plastic baby bottles.

Credit: Don Bartletti / Los Angeles Times

Orgasmic women strut their stuff

Melissa Healy — Thu, 04 Sep 2008 15:58:19 -0700

Something in the way she moves attracts you like no other lover. The sum of her stride length and vertebral rotation is quite large. The flow of energy from her legs through her pelvis and up to the spine is free, her gait is open. She saunters, she sashays, she glides.

This is a woman capable of vaginal orgasms, finds a study set to be published in the September issue of the Journal of Sexual Medicine. In fact, trained sexologists -- oh yes, Virginia, there is such a thing -- have discovered that in four out of five instances, a trained eye could distinguish between the woman with a history of reaching orgasm from penile penetration alone from the woman who, well, must content herself with the kind that results mainly from clitoral stimulation.

Did we mention? Research has shown that the ability to achieve vaginal orgasm is linked to better mental health, say the authors of the latest study. (Could Sigmund Freud have been right?) So she's not only more sensuous, more confident, more open. She's also better-adjusted!

The authors of the study believe they've found evidence that some women may be physically predisposed to having vaginal orgasms, long considered the "superior" orgasm in psychoanalytic circles. They do suggest, however, that women enjoying vaginal orgasm may just be happier and have a little extra ooomph in their stride because they're just so, well, satisfied.

Lest you think this was some undergraduate psych major's idea of prurient fun, let's set the record straight. Two psychology professors and two graduate students at the University of the West of Scotland videotaped 16 female university students in Belgium as they walked across an open space. Knowing nothing about the subjects' sexual history, they found that -- with the proper training -- they could reliably distinguish the vaginally orgasmic women from all others.

Well, of course there's an important lesson here for those who treat sexual dysfunction in women, says the editor of the Journal of Sexual Medicine. "Women with sexual dysfunction should be treated in a multidiscliplinary manner," concludes Dr. Irwin Goldstein, editor in chief of the journal. Treatment for these women might go beyond talk therapy and medication and include far-ranging therapies like moving, breathing and muscle patterns, say the authors.

--Melissa Healy

Photo credit: Vincent Thian / Associated Press

Popular diets are nutritious enough

Shari Roan — Thu, 04 Sep 2008 14:56:02 -0700

One fear people have about going on a diet for any length of time is that they may suffer from nutritional deficiencies. A study published this week is fairly reassuring, at least for people on several of the most popular diets.

The study, published by British researchers in the Nutrition Journal, found that most people on the popular diets Slim Fast, Atkins, Weight Watchers and Rosemary Conley's "Eat Yourself Slim" diet (a low-fat diet popular in the United Kingdom) typically get enough nutrients. There are some exceptions and some interesting observations, however:

Despite the fact that all of the diets except the Atkins diet advise people to eat more fruits and vegetables, only the dieters in the Weight Watchers one actually did so, and they only added one more portion a day.
People on the Atkins diet had lower intake of dietary fiber.
People on the Atkins diet had no significant changes in their absolute intake of fat per day or in the quantity of saturated fat consumed. The amount of saturated fat intake fell significantly in the other groups.
Atkins dieters had declines in folate, magnesium, calcium, iron and potassium. There was an increase in selenium.
Weight Watchers dieters had declines in riboflavin, niacin, potassium, calcium, magnesium, iron and zinc.
Slimfast dieters had declines in niacin and a rise in zinc.
Rosemary Conley dieters had declines in magnesium, potassium and zinc.

The two-month study found that all the diets resulted in a significant drop in body weight compared with non-dieters in a control group, but there was no real difference between the diets in the amount of weight lost.

-- Shari Roan

Photo credit: Ken Hively / Los Angeles Times