Bizarre effects on teens

KUALA LUMPUR: Is hormonal imbalance creating more male teenagers with breasts, while female teenagers are getting more hairy?

Cosmetic and aesthetic physician Dr Alice Prethima said she is seeing many cases of gynecomastia (enlargement of breasts in males) in her clinic.

But, she is also seeing teenage girls coming in because they have too much hair all over their body.

“Compared to the past, there are many girls with terrible hair problems. They are losing the hair on their heads and growing hair on other areas of their body where there shouldn’t be. And, the hair is so long and thick,” she said.

Dr Prethima attributed the abnormalities in male and female teenagers to the food chain and diet.


Physical changes: Bodies of teenage boys are converting testosterone to another form due to bad oestrogenic substance in the environment resulting in abdominal fat and abnormally sized breasts.
“Children are eating too much animal-based food, and those animals are fed with a lot of growth hormones.

“Our society has become more affluent. We may eat meat for breakfast, lunch and dinner,” she added.

She said bad oestrogens was also entering the body from plastic materials such as fizzy bottled drinks which “bleed” bad oestrogen.

“Those plastic containers that we use to warm our food, the polystyrene boxes in which we pack our food, the plastic bags that we pour the curry into, the roti canai we wrap in plastic – all of those bleed bad oestrogen substances. There is also a lot of pesticides, insecticides and bad oestrogenic substances in the environment, and this will manifest in different ways for those of different ages,” she added.

Dr Prethima said due to “xeno ostrogen”, instead of producing testosterone, the bodies of teenage boys are converting it to (harmful) 16 hydroxyoestrone, which results in the loss of hair and the development of acne, abdominal fat and abnormally-sized breasts.

Plastic and reconstructive surgeon Dr V. Surendranathan said gynecomastia was now becoming very common among teenage boys, mainly due to the children’s eating habits and sedentary lifestyle.

“They are eating too much chicken and getting very little exercise. They are stuck in front of the television and computers all day.

“It’s very embarrassing for the boys to have breasts. They can’t even take off their T-shirt in school.”

Dr Surendranathan said he has even had to perform breast-reducing procedures on 13 and 14 years old boys. The former president of the Malaysian Association of Plastic, Aesthetic & Craniomaxillofacial Surgeons (Mapacs) said there has been a noticeable increase in such cases over the last few years.

Consultant plastic and cosmetic surgeon Dr Heng Kien Seng said he too has been seeing a lot of cases of teenage boys with gynecomastia, and he has had to perform breast reduction procedures on these boys so that they can regain the physical look of normal male chests.

Among the treatments available include liposuction, gland excision, and reduction mammoplasty.

Salmonella infection

Salmonella infection (salmonellosis) is a common bacterial infection of the intestinal tract. Salmonella typically live in the intestines of animals and humans and are shed through feces, where the bacteria remain highly contagious. Humans become infected most frequently through contaminated food sources, such as poultry, meat and eggs.

Typically, people with salmonella infection develop diarrhea, fever and abdominal cramps within 12 to 72 hours. Signs and symptoms of salmonella infection generally last four to seven days. Most healthy people recover without specific treatment.

In some cases, diarrhea can be extremely dehydrating and require prompt medical attention. Life-threatening complications may also develop should the infection spread beyond your intestines.

Your risk of salmonella infection is higher if you travel to countries with poor sanitation. Preventive measures include proper cooking, good hygiene such as hand washing, and avoiding raw or undercooked eggs and meat.

Salmonellosis Outbreak in Certain Types of Tomatoes

FDA has issued a warning to consumers nationwide that an outbreak of Salmonella serotype Saintpaul, an uncommon type of Salmonella, has been linked to consumption of raw red plum, red Roma, round red tomatoes, and products containing these raw tomatoes.

Consumers who are unsure of where the tomatoes are from that they have in their home are encouraged to contact the store or place of purchase for that information. If consumers are unable to determine the source of the tomatoes, they should not be eaten.

Consumers should also be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in other dishes.

Types of tomatoes not linked to any illnesses are cherry tomatoes, grape tomatoes, and tomatoes with the vine still attached.

Since mid April, there have been 383 reported cases of salmonellosis nationwide caused by Salmonella Saintpaul, an uncommon form of Salmonella. At least 48 hospitalizations have been reported.

Red Plum/Red Roma tomatoes implicated in outbreak

Round red tomato implicated in outbreak

More salmonella cases tied to tomatoes

The number of cases of sickness caused by tomatoes has risen in recent days; 383 people have been infected with a rare form of salmonella since April in 30 states and the District of Columbia, federal health officials said Wednesday.

At least 48 of the victims, who range in age from younger than 1 to 88, have been hospitalized, an official with the Centers for Disease Control and Prevention said.

No deaths have officially been blamed on the outbreak, but the infection may have contributed to the death in Texas of a man in his 60s who also had cancer, the CDC said.

The increase reported Wednesday resulted not from a large number of new cases but from improved surveillance by state health departments in response to the outbreak and from the fact that laboratories completed analyzing samples, said Dr. David Acheson, associate commissioner for foods at the Food and Drug Administration.

Still, the outbreak is considered ongoing, with onset of illness in the latest case June 5.

"We do not think the outbreak is over," said Dr. Robert Tauxe, deputy director of the Division of Foodborne, Bacterial and Mycotic Diseases at the CDC.

All of the victims have been infected with a strain of Salmonella Saintpaul.

Acheson said that although there is a "high likelihood" that the contaminated fruit came from Florida or Mexico, authorities have not been able to pinpoint the source and may never be able to do so.

"We may not ultimately know the farm where these came from," he said. "Personally, I am still optimistic, but I'm trying to be realistic."

Acheson said Mexican health authorities have reported "some cases" of Salmonella Saintpaul, but he did not know whether they share the genetic fingerprint that marks the U.S. cases.

The FDA is testing tomatoes both domestically and as they cross the southern border, he said.

He said FDA plans to hire more inspectors to tighten scrutiny of food processing plants.

Tauxe said it is not possible to say whether the outbreak has peaked: "We really cannot predict what the final number is going to be or even what the shape of the curve is going to look like."

Cherry tomatoes, grape tomatoes and tomatoes with the vine still attached have been deemed safe, as have tomatoes from northern Florida, Acheson said. Roma plum and red round tomatoes are safe to eat if they are from areas that have been excluded, he said.

A list of such areas is posted on the FDA's Web site. Reported by CNN

108 students suffer food poisoning in Jasin, Malaysia

JASIN: Students from SK Bukit Tembakau suffered from food poisoning after consuming free nasi lemak given to them in conjunction with Maulidur Rasul celebrations.

In the 10am incident on Friday, 108 students suffered from symptoms including nausea, vomiting, diarrhoea and feeling light-headed after eating the meal during their recess break.

It is believed the food had been ordered by the school from an external caterer.

Following the incident, teachers had to take the students to the Umbai Community Polyclinic in their cars with several ambulances sent to the school to help with the transportation of other students to the government clinic.

It is believed that the school took 170 students to the clinic worrying many more had been affected after eating the nasi lemak.

However, doctors confirmed only 108 children had suffered effects of food poisoning.

Only 10 required drips to treat their condition with one of them subsequently sent to the Malacca Hospital for further treatment and observation.

By 1.30pm all 107 students except one were discharged after receiving outpatient treatment.

State Women's Affairs and Health Exco member Norpipah Abdul, who rushed to the clinic upon receiving the news, reminded schools to not freely accept food from external caterers.

“The health department has taken food samples for testing and if it is confirmed to have been spoilt, we will immediately close down the premises (caterer) awaiting further inspection from health officers,” she said.

Food poisoning cases increase by 100% in Malaysia 2007

KOTA BARU: Food poisoning in Malaysia has increased 100% from last year for the period of January till Sept 15, with 67% of such cases confined to primary and secondary school students.

Despite a perceived higher awareness about food hygiene, the country continues to be plagued with food poisoning cases. There were 11,226 cases from January till Sept 15 this year, a 100% increase compared to the same period last year.

Health Ministry's Health Education Division director Abdul Jabar Ahmad said Selangor had the highest number of food poisoning cases, followed by Perak, Terengganu and Kelantan.

"The alarming concern is that 67% out of 11,226 victims of food poisoning were schoolchildren," he said, after launching the national food safety campaign for schools at the teachers resource centre here.

To address the issue, the ministry would hold roadshows, exhibitions, pop quizes and enrol artistes to help generate awareness about proper food preparation and the importance of nutrition when cooking food.

Besides that, school canteen operators would be monitored closely while consumers must also be alert of hygiene when it comes to food.

Abdul Jabar said a questionnaire would be distributed to all schoolchildren in the country soon to gauge their level of awareness about food safety and preparation.

Kelantan education department's student affairs unit head Ahmad Yani Mohamad said the education authorities had terminated the services of six canteen operators this year.

This underlines the department's commitment to food safety, he said. Ahmad Yani also urged the local authorities to check the status of hawkers trading outside the school compound to ensure they do not sell sub-par standard food and drinks to students.

Food from China on alert list

Honey, oyster sauce and dried mushrooms are among food products from China which have been placed on the food alert list for contravening regulations in Malaysia.

Data from the Health Ministry Food Quality and Safety Division indicated, in samples taken on specific dates, that pesticide residue was detected in the dried mushrooms on four occasions from April to July this year.

Drug residue was found in the honey sample taken in June while the cancer-causing agent 3-MCPD was found in oyster sauce tested in May.

There were 32 Chinese products placed under the ministry's Food Safety Information System (FoSIM) level five alert, where products are held, tested and then released, from January to October this year.

There are six levels of alerts – the first is auto clearance and the sixth is auto rejection.

Other products included frozen eel, seaweed, frozen royal red prawns, shitake mushrooms and salted turnip. All other China-imported food items were put on level four alert which requires examination.

Food found to have contravened the Food Act 1983 and Food Regulations 1985 was either destroyed or returned to the country of origin.

Malaysia imports US$680mil (RM2.3bil) worth of food items from China yearly.

Thailand had 17 food products on the list while nine food products from India contravened regulations including groundnut kernels in which aflatoxin, a cancer-causing agent, was found on six occasions from sampling done from March to September.

Six products from Indonesia including natural honey, kicap manis, prawn crackers and chilli sauce were also put on the watch list.

Roasted seaweed from Singapore was found to contain metal contaminants on four occasions from July to September.

In all, 103,480 imported food consignments were tested until September. A total of 49 consignments were rejected or destroyed.

Minister Datuk Seri Dr Chua Soi Lek told reporters yesterday that the quality of imported food was safe because of constant monitoring at 36 entry points with the cooperation of the Customs Department and other agencies.

Dr Chua said the monitoring and inspection of food and premises was also carried out.

“Some operators do not practise cleanliness. That is why food poisoning happens from time to time, including at school canteens. They think that if the food is cooked, it is safe to be eaten,” he said, adding that factors like how the food was kept and the equipment used also contributed to food poisoning.

From January to June this year, a total of RM416,260 in fines was collected from 2,290 cases. The ministry also shut down 2,957 unsanitary food outlets.

Prevention methods for foodborne illness

There are a number of ways to prevent foodborne illness, which include methods for food purchasing, storage and preparation. There are also specific ways to prevent foodborne illness while traveling.

>> Create a healthy living environment >> View VIDEO

Tips for buying food include:

• Never buy packages with tears or leaks.
  
  
• Do not buy foods past their expiration date.
  
  
• Do not buy produce that appears bruised or otherwise damaged.
  
  
• Do not buy fresh-cut produce that has not been refrigerated or stored in ice.
  
  
• Keep raw beef, pork and poultry separate from other foods.
  
  
• Put refrigerated or frozen items in the shopping cart last, right before checking out.
  
  
• If possible, store refrigerated or frozen items in insulated bags until they can be refrigerated.
  
  
• Bring cold foods home immediately.

Tips for storing food include:

• Always refrigerate perishable foods quickly.
  
  
• Store eggs in their original carton in the coldest part of the refrigerator (not the refrigerator door).
  
  
• Cool large volumes of food in several small containers.
  
  
• Do not store milk in the refrigerator door.
  
  
• Do not let perishable food stand at room temperature for more than two hours.
  
  
• Store meat on the bottom shelf of the refrigerator or in the back or in the freezer.
  
  
• Make sure the refrigerator is set to 40 degrees Fahrenheit (4.4 degrees Celsius) or lower. The freezer should be set to 0 degrees Fahrenheit (- 17.8 degrees Celsius).

Tips for food preparation include:

• Wash hands for at least 20 seconds with soap and warm water before and after cooking.
  
  
• Wash countertops and tables before and after cooking.
  
  
• Wash fruits and vegetables with cold running water before cutting or eating, and remove any damaged areas before eating.
  
  
• When preparing both meat and vegetables, use separate cutting boards for each.
  
  
• Defrost meats in the refrigerator or microwave and then cook immediately.
  
  
• When using a marinade for meat, it must be cooked before being placed on cooked meat.
  
  
• Cook foods to appropriate temperature. Casseroles, beef, veal, pork and lamb should be cooked to 160 degrees Fahrenheit (71.1 degrees Celsius). Poultry should be cooked to minimum internal temperatures of 165 degrees Fahrenheit (73.9 degrees Celsius), according to a recent advisory from the Food Safety and Inspection Service (FSIS). Use a meat thermometer to test temperature. Eggs should be cooked until the yolk is hard.
  
  
• Marinades used on raw meat or poultry should never be reapplied to cooked foods.
  
  
• Never place cooked meats on dishes that previously held raw meats.
  
  
• Use a clean produce brush to scrub fruit and vegetables, such as cucumbers.
  
  
• Commercial produce washed are not generally recommended.
  
  
• Dry produce with a paper towel or clean cloth to reduce and additional bacteria.

Tips for food safety while eating away from home (on picnics, car trips or sporting events) include:

• When transporting food, make sure the cooler is clean and dry before adding food.
  
  
• Keep foods well wrapped in plastic wrap or plastic containers.
  
  
• Keep foods cold with a cooler, ice, ice packs or insulated bags.
  
  
• Place meats at the bottom of the cooler to prevent drips onto other foods.
  
  
• Pack two coolers, one for food and another for beverages.
  
  
• Store the cooler in the coolest part of the car and out of the sunlight.
  
  
• Bring disposable hand wipes for cleaning if soap and water are not available.
  
  
• Do not consume foods that have been left out in hot temperatures for more than a few hours.

Tips for food safety while traveling to other countries (particularly Latin America, Asia, Africa and the Middle East) include:

• Do not drink or brush teeth with unfiltered water. Use bottled, boiled or sterilized water instead.
  
  
• Make sure the seal is intact when buying bottled water.
  
  
• Only use ice made from bottled, boiled or sterilized water.
  
  
• Eat only cooked meats, fish and vegetables.
  
  
• Eat only pasteurized dairy products and avoid soft cheese, such as Brie and cottage cheese.
  
  
• Peel and wash raw fruits with clean bottled water before eating. Wash hands before peeling and eating fruit.
  
  
• Do not buy food from street vendors.

Types and differences of foodborne illness

More than 250 foodborne illnesses have been identified. Most of them are infections, caused by pathogens (organisms that cause disease) such as bacteria, viruses and parasites found in food. Others are poisonings caused by toxins or chemicals that have contaminated food, such as food served in lead-glazed pottery, or naturally poisonous foods, such as poisonous mushrooms. The most common types of foodborne illnesses include: More >> Ten Most Harmful Foodborne Pathogens Campylobacteriosis. Caused by the Campylobacter bacteria, which is the most commonly identified bacteria that causes diarrhea. The bacteria live in the intestines of birds. Undercooked chicken or other foods are frequent sources of this type of infection. Clostridium perfringens infection. Results in diarrhea, abdominal pain, nausea and vomiting and usually develops after eating improperly stored or cooked meat. Salmonellosis. Caused by the Salmonella bacteria, which is widespread in the intestines of birds, reptiles and mammals. Any type of food can become contaminated with the salmonella bacteria. The foods that most frequently transmit salmonella are poultry, meat, eggs and dairy products. People may also be exposed to salmonella through contact with household pets - especially lizards, turtles, and snakes - and through contact with contaminated surfaces, such as computer keyboards and cooking utensils. Fever, diarrhea and abdominal cramps are common symptoms. In people with poor health or weakened immune systems, bacteria can enter the bloodstream and cause life-threatening infections. Some infected people do not develop symptoms, but instead become carriers and spread the infection to others. Escherichia coli (E. coli) infection. E. coli is a bacterial pathogen found in cattle and other related animals. Illness often occurs when people consume food (especially beef) or water that has been contaminated with microscopic amounts of cow feces. E. coli can also be spread through contact with contaminated surfaces and by touching infected animals (e.g., petting zoos). The illness causes severe diarrhea that may be bloody and painful abdominal cramps. In a small number of cases, a serious condition called hemolytic uremic syndrome (HUS) can occur. This can result in anemia, profuse bleeding and kidney failure. Calicivirus. An extremely common cause of viral foodborne illness. However, this type is rarely diagnosed because the laboratory test is not widely available. The virus (a type of norovirus) can spread from one person to another or through food. For instance, a kitchen worker may spread the virus during food preparation. Shigellosis. Caused by the Shigella bacteria. It can be transmitted by eating food or drinking beverages contaminated by food handlers with Shigella, eating vegetables grown in fields containing sewage, eating food contaminated by flies bred in infected feces and drinking or swimming in contaminated water. The bacteria cause fever, bloody diarrhea and abdominal pain. Bacillus cereus food poisoning. Caused by the Bacillus cereus bacteria. It usually presents with extreme nausea and vomiting and has the fastest onset of symptoms (three hours) of foodborne illnesses. Bacillus cereus food poisoning is commonly seen in people after consuming Chinese fried rice. Staphylococcal food poisoning. Caused by the Staphylococcus aureus bacteria. Unlike other types of foodborne illness, this form is not caused by contamination. The bacteria can grow in some foods (e.g. dairy products, fish and processed meats) and produce a toxin that results in intense vomiting. Ascariasis (roundworm). A parasitic worm infection caused by contact with contaminated food or soil. Vibrio. There are many different types of this bacteria, one of which causes cholera. Other Vibrio species are commonly found in raw or undercooked shellfish. An infection often causes chills and fever. Giardiasis. Caused by the parasite Giardia that is passed to humans in drinking water or from infected animal products. Giardia is a common traveler’s illness which causes abdominal cramps and diarrhea. Chemical food poisoning. Some types of foods, such as certain species of mushrooms, contain toxins that result in illness. Most cases result in mild symptoms. However, some are more serious and require immediate medical treatment. Botulism. A rare, but serious illness caused by the Clostridium botulinum bacteria. If untreated, it can cause paralysis and respiratory failure. Cases of botulism are usually contracted from insufficiently heated home-canned foods, such as asparagus, green beans, beets and corn.

About foodborne illness

Foodborne illnesses (commonly known as food poisoning) are gastrointestinal infections that occur when foods contaminated with harmful organisms are ingested.

Food can be contaminated by a number of pathogens (organisms that cause disease) including bacteria, viruses and parasites. The pathogen enters the body by the mouth and then travels into the stomach and intestines. After infection, an incubation period occurs, which may last from hours to days before symptoms appear.

Although rarer, foodborne illness can also be caused by toxins and chemicals. For instance, pesticides can remain on foods, which can cause illness. A naturally toxic substance, such as poisonous mushrooms, may be consumed, also causing sickness. Symptoms vary according to the source and may include nausea, vomiting, abdominal cramps and diarrhea.

The risk of acquiring foodborne illnesses is typically greater during the summer months because the warm weather speeds up bacterial growth on raw meats and poultry.

To preven such food contamination ozone food sterilizer is an effecttive method to use. It is recomended to sterilizer the food before consume or store into freezer.

In most cases, foodborne illnesses are not serious and do not cause serious complications. However, certain types of illnesses such as botulism (severe food poisoning caused by a bacterial toxin) can result in serious health consequences (such as spontaneous abortion in pregnant women) or death.

In some people (especially children) a condition called hemolytic uremic syndrome (HUS) can result from infection by a particular strain of the E. coli bacteria. HUS is a rare disorder that usually affects children between ages 1 to 10. Although most children recover completely, it may cause acute renal (kidney) failure, seizures, heart failure, pancreatitis or, in rarer cases, diabetes.

The types of common foodborne illnesses can change over time. Typhoid fever, tuberculosis and cholera were once common foodborne diseases before food safety measures (such as pasteurization and safe food canning) became commonplace. In recent years, new foodborne illnesses have been discovered. In 1996, the parasite Cyclospora was identified as a cause of diarrhea that occurred after Guatemalan raspberries were consumed. In 1998, a new strain of the bacteria Vibrio parahaemolyticus contaminated oyster beds in Galveston Bay, Texas, and caused people that consumed the oysters to become ill.

Although local and state health departments are required to report cases of foodborne illness to the U.S. Centers for Disease Control and Prevention (CDC), establishing precise figures is difficult. Most cases are not diagnosed because people do not seek treatment for the illness or physicians do not diagnose it. Therefore, the case is never reported to the CDC.

According to estimates by the CDC, there are approximately 76 million cases of foodborne illness each year in the United States. These cases result in an estimated 325,000 hospitalizations and 5,000 deaths annually.

In addition to tracking individual cases of foodborne illness, health departments keep track of outbreaks of foodborne illness. This occurs when a group of people eat the same contaminated food and two or more of them become sick. According to the CDC, about 400 to 500 outbreaks investigated by local and state health departments are reported each year.

Despite recent outbreaks, researchers report that the foods that Americans consume are now safer than in previous years.

Foodborne Illness

Foodborne illness is a gastrointestinal infection caused by eating foods that contain harmful bacteria, viruses, parasites or toxins.

According to estimates by the U.S. Centers for Disease Control and Prevention (CDC), approximately 76 million cases of foodborne illness occur each year in the United States. These cases result in an estimated 325,000 hospitalizations and 5,000 deaths a year.

More than 250 foodborne diseases have been identified. Some of the most common types of foodborne illnesses include Campylobacteriosis (caused by Campylobacter bacteria), Salmonellosis (caused by Salmonella bacteria) and Calicivirus (Norwalk-like virus).

Food can become contaminated in a variety of ways during production and preparation. For example, beef and poultry can become contaminated during slaughter.

To preven such food contamination ozone food sterilizer is an effecttive method to use. It is recomended to sterilizer the food before consume or store into refrigerator.

The most common signs and symptoms of foodborne illness include nausea, vomiting, diarrhea and abdominal cramps.

Foodborne illnesses can be difficult to diagnose. Diagnosis typically begins with a physical examination which includes a medical history and a list of recent foods consumed. Some types of foodborne illnesses are diagnosed by analyzing stool under a microscrope to detect the presence of bacteria.

Most cases of foodborne illness are mild and can be treated at home by replacing lost fluids and electrolytes, which are necessary to maintain the body’s chemical balance. More serious cases may be treated in a hospital where patients are given fluids intravenously (through a vein).

Foodborne illness can be prevented in a variety of ways. For example, foods that may become contaminated, such as meats and milk, should be stored in the freezer or the coldest parts of the refrigerator. Washing hands before and after food preparation, establishing separate cutting boards for meat and vegetables and thoroughly cooking beef and chicken are other ways to prevent foodborne illness.

Gastroenteritis

Gastroenteritis is any irritation or inflammation of stomach or intestinal linings. Symptoms include nausea, vomiting, diarrhea, stomach cramps and abdominal pain. It is often caused by infection or foodborne illness. Foodborne illness, or food poisoning, can be caused by bacteria, viruses, parasites or toxins. Dysentery is a type of gastroenteritis of the colon.

>> Ten Most Harmful Foodborne Pathogens

Towards zero food poisoning

THE Selangor state government is extremely concerned with the high number of food-poisoning cases in the state and has ordered its health department to take concrete steps to eliminate the problem.

According to state health committee chairman Datuk Dr Lim Thuang Seng, the state health department is increasing its efforts to monitor canteens in schools, factories and hostels in the state.
“Currently, we have many cases involving school canteens. The health department is going all out to achieve zero case at the school canteens,” he said.

Lim said the measures taken included educating the canteen operators to adhere to the rules and regulations in food handling, making sure that their workers handling food abided by the rules.
Lim, who was asked to comment on a recent case of food poisoning, said that up to last month, the state had recorded 24 cases of food poisoning involving almost 2,000 people, with 14 of the cases involving school canteens.
He said that usually premises identified as serving contaminated food causing food poisoning would be ordered to shut down for 14 days.

However, in the case of school canteens, it was rather difficult to be strict on the ruling.
“The school canteens cannot stay closed for too long, so we just order them to carry out cleaning and remedial work. If the premises is found to be clean, then it can open again,” he said.
“Sometimes the canteens would only be closed for a few days instead of two weeks,” Lim said.
He said that most school canteens had more than one operator, which would help the students even if one of them was ordered to stop operation temporarily.

Breast Cancer

A new drug prevents breast cancer in older, high-risk women just as well as today's standby tamoxifen -- but with fewer side effects, the National Cancer Institute announced on 17th April.

Called raloxifene, the newer drug already is sold to treat bone-thinning osteoporosis.
But the striking new results, from a government study of nearly 20,000 women, suggest that raloxifene may supplant its older cousin as the first choice for breast cancer prevention in postmenopausal women at high risk of developing the disease.

"Now women have a choice," Dr. Leslie Ford, NCI's cancer prevention chief, said in an interview Monday. "It's good news, because we're giving you a choice with fewer side effects."
Manufacturer Eli Lilly & Co., which sells raloxifene under the brand name Evista, plans to seek Food and Drug Administration approval for the new use.

Until now, tamoxifen has been the only drug approved to reduce the chances of breast cancer striking high-risk women.

Both drugs are "selective estrogen response modulators" -- they act like the estrogen hormone in some tissues but like an anti-estrogen in others.

Estrogen can fuel certain breast cancers, making tamoxifen a longtime top choice both to prevent the disease's return in women with estrogen-sensitive tumors and to reduce the odds of it striking high-risk women in the first place.

However, tamoxifen causes some rare but serious side effects: It acts like an estrogen in the uterus and bloodstream, thus increasing users' risk of getting uterine cancer or a life-threatening blood clot.

Raloxifene is a close chemical relative, and earlier research suggested that it might help breast cancer, too. So the NCI launched the $88 million study to compare the two.

Taking either tamoxifen or raloxifene daily for up to five years cut in half women's chances of developing invasive breast cancer, NCI announced Monday.

Raloxifene caused the same side effects, but not as many. Raloxifene users had 36 percent fewer uterine cancers and 29 percent fewer blood clots, according to initial results of the "Study of Tamoxifen and Raloxifene," or STAR project. Raloxifene users also suffered fewer vision-blocking cataracts.

Some 2 million U.S. women every year are thought to be candidates for tamoxifen risk-reduction therapy, but many have avoided it for fear of those side effects, said STAR researcher Dr. Kathy Albain of Loyola University.

While the reduction in those side effects was significant, the study also showed how uncommon the effects are. Thirty-six tamoxifen users developed uterine cancers, compared with 23 raloxifene users. The risk of blood clots was similarly low: 54 tamoxifen users had one in the lung, compared with 35 raloxifene users.

Still, "here we have something that's a little less scary," Albain said of the raloxifene findings. "It might tip the scales for a lot of women."

The new study means no change for premenopausal women -- there's no data showing whether raloxifene is safe for them, Albain stressed.

Nor does it mean that tamoxifen users should necessarily switch, she said. Women currently are prescribed tamoxifen for five years, and its breast cancer prevention benefit continues even after they stop taking the drug -- as raloxifene's seems to. So a woman already in, say, year four of her tamoxifen course with no sign of side effects probably has little to gain by switching, she explained.

But that's a question researchers were girding for as they spent Monday notifying study participants of the results.

One puzzle: While raloxifene was equally effective in blocking invasive breast cancer, it didn't protect quite as well as tamoxifen against noninvasive types of breast cancer such as ductal carcinoma in situ, noted Dr. Len Lichtenfeld of the American Cancer Society.

That type of tumor isn't life-threatening and shouldn't water down the overall message of raloxifene's benefit, said Dr. Victor Vogel of the University of Pittsburgh, who oversaw the study's design.

Among postmenopausal women, who's at high risk? Most of the study participants had a 4 percent chance of getting breast cancer within five years -- because of advanced age, a close relative with the disease, never having a child or having one late in life, or other well-known risk factors that women can calculate on a government Web site: http://cancer.gov/bcrisktool.

In simpler terms, for every 1,000 of those women, doctors expected 40 to develop breast cancer within five years if they did nothing, but taking one of the drugs cut that number to 20, Ford explained.

Understanding the Germs and Viruses that cause infection

Bacteria, viruses and other infectious organisms live everywhere. You can find them in the air; on food, plants and animals; in the soil and in the water; and on just about every other surface — including your own body. They range in size from microscopic single-cell organisms to parasitic worms that can grow to several feet in length.

Most of these organisms (microbes) won't harm you. But others can cause infection. Your immune system protects you against an abundance of these infectious agents, and at times, it's a tough task. Viruses and bacteria are cunning adversaries, constantly seeking new ways to breach your immune system's defenses.

But you can give your immune system a fighting chance by understanding a little bit about the various kinds of microbes, what you can do to avoid infection and under what circumstances you should seek medical care.

Infectious agents: A multitude of microscopic invaders

Bacteria

Bacteria are one-celled organisms visible only with a microscope. They're so small that if you lined up a thousand of them end to end, they could fit across the end of a pencil eraser. They're shaped like short rods, spheres or spirals. They're usually self-sufficient and multiply by subdivision.

Among the earliest forms of life on earth, bacteria have evolved to thrive in a variety of environments. Some can withstand searing heat or frigid cold, and others can survive radiation levels that would be lethal to a human being. Many bacteria, however, prefer the mild environment of a healthy body.

Not all bacteria are harmful. In fact, less than 1 percent cause disease, and some bacteria that live in your body are actually good for you. For instance, Lactobacillus acidophilus — a harmless bacterium that resides in your intestines — helps you digest food, destroys some disease-causing organisms and provides nutrients to your body.

But when infectious bacteria enter your body, they can cause illness. They rapidly reproduce, and many produce toxins — powerful chemicals that damage specific cells in the tissue they've invaded. That's what makes you ill. The organism that causes gonorrhea (gonococcus) is an example of a bacterial invader. Others include some strains of the bacterium Escherichia coli — better known as E. coli — which cause severe gastrointestinal illness and are most often contracted via contaminated food. Other conditions caused by bacteria include strep throat and staph infection.

E. coli O157:H7 is a bacterium responsible for food-borne infections linked to eating undercooked ground beef.

Viruses

In its simplest form, a virus is a capsule that contains genetic material — DNA or RNA. Viruses are even tinier than bacteria. To see them, scientists must use an electron microscope, a high-powered instrument that produces enlarged images of minute objects. To put their size into perspective, consider that, according to the American Society for Microbiology, if you were to enlarge an average virus to the size of a baseball, the average bacterium would be about the size of the pitcher's mound. And just one of your body's millions of cells would be the size of the entire ballpark.

The main mission of a virus is to reproduce. However, unlike bacteria, viruses aren't self-sufficient — they need a suitable host to reproduce. When a virus invades your body, it enters some of your cells and takes over, instructing these host cells to manufacture what it needs for reproduction. Host cells are eventually destroyed during this process. Polio, AIDS and the common cold are all viral illnesses.

The influenza virus takes over healthy cells, spreads through your body and causes illness. Signs and symptoms include fever, chills, muscle aches and malaise.

Fungi

Molds, yeasts and mushrooms are types of fungi. For the most part, these single-celled organisms are slightly larger than bacteria, although some mushrooms are multicelled and plainly visible to the eye — for instance, the mushrooms you may see growing in a wooded area or even in your backyard. Mushrooms aren't infectious, but certain yeasts and molds can be.

Fungi live in the air, water, soil and on plants. They can live in your body, usually without causing illness. Some fungi have beneficial uses. For example, penicillin — an antibiotic that kills harmful bacteria in your body — is derived from fungi. Fungi are also essential in making certain foods, such as bread, cheese and yogurt.

Other fungi aren't as beneficial and can cause illness. One example is candida — a yeast that can cause infection. Candida can cause thrush — an infection of the mouth and throat — in infants, in people taking antibiotics and in people with impaired immune systems. It's responsible for most types of infection-induced diaper rash.

Infection with candida fungus can lead to problems such as diaper rash, vaginal yeast infections and oral thrush.

Protozoa

Protozoa are single-celled organisms that behave like tiny animals — hunting and gathering other microbes for food. Protozoa can live within your body as a parasite. Many protozoa inhabit your intestinal tract and are harmless. Others cause disease, such as the 1993 Cryptosporidium parvum invasion of the Milwaukee water supply, sickening more than 400,000 people. Often, these organisms spend part of their life cycle outside of humans or other hosts, living in food, soil, water or insects.

Most protozoa are microscopic, but there are some exceptions. One type of ocean-dwelling protozoa (foraminifer) can grow to more than 2 inches in diameter.

Some protozoa invade your body through the food you eat or the water you drink. Others can be transmitted through sexual contact. Still others are vector-borne, meaning they rely on another organism to transmit them from person to person. Malaria is an example of a disease caused by a vector-borne protozoan parasite. Mosquitoes are the vector transmitting the deadly parasite plasmodium, which causes the disease.

Cryptosporidium is a protozoan protected by a strong outer shell that allows it to survive outside the body for long periods of time.

Helminths

Helminths are among the larger parasites. The word "helminth" comes from the Greek for "worm." If this parasite or its eggs enter your body, they take up residence in your intestinal tract, lungs, liver, skin or brain, where they live off the nutrients in your body. The most common helminths are tapeworms and roundworms.

The largest of the roundworms range in length from 6 to 14 inches. But imagine the largest of the tapeworms — they can grow to be 25 feet or longer. Tapeworms are made up of hundreds of segments, each of which is capable of breaking off and developing into a new tapeworm.

Infection by one type of roundworm, known as a hookworm, can cause problems in your small intestine or lungs. The average hookworm is about half an inch long.

Understanding infection vs. disease

There's a distinct difference between infection and disease. Infection, often the first step, occurs when bacteria, viruses or other microbes enter your body and begin to multiply. Disease occurs when the cells in your body are damaged — as a result of the infection — and signs and symptoms of an illness appear.

In response to infection, your immune system springs into action. An army of white blood cells, antibodies and other mechanisms goes to work to rid your body of whatever's causing the infection. For instance, in fighting off the common cold, your body might react with fever, coughing and sneezing.

When to seek medical care
If you think you've contracted an infectious disease, contact your doctor. Although some infectious diseases, such as the common cold, might not require a visit to the doctor, others might call for the expertise of a trained professional.

Seek medical care if you suspect that you have an infection and you have experienced any of the following:

An animal bite
Difficulty breathing
A cough lasting longer than a week
A fever of 100.4 F (38.0 C) or more
Periods of rapid heartbeat
A rash, especially if it's accompanied by a fever
Swelling
Blurred vision or other difficulty seeing
Vomiting
An unusual or severe headache

Your doctor can perform diagnostic tests to find out if you're infected, the seriousness of the infection, and how best to treat that infection.

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Bacteria and Foodborne Illness

Foodborne illness results from eating food contaminated with bacteria (or their toxins) or other pathogens such as parasites or viruses. The illnesses range from upset stomach to more serious symptoms, including diarrhea, fever, vomiting, abdominal cramps, and dehydration. Although most foodborne infections are undiagnosed and unreported, the Centers for Disease Control and Prevention estimates that every year about 76 million people in the United States become ill from pathogens in food. Of these, about 5,000 die.


Causes
Harmful bacteria are the most common causes of foodborne illnesses. Some bacteria may be present on foods when you purchase them. Raw foods are not sterile. Raw meat and poultry may become contaminated during slaughter.

Seafood may become contaminated during harvest or through processing. One in 20,000 eggs may be contaminated with Salmonella inside the egg shell. Produce such as lettuce, tomatoes, sprouts, and melons can become contaminated with Salmonella, Shigella, or Escherichia coli (E. coli) O157:H7.

Contamination can occur during growing, harvesting, processing, storing, shipping, or final preparation. Sources of contamination are varied; however, these items are grown in the soil and therefore may become contaminated during growth or through processing and distribution. Contamination may also occur during food preparation in the restaurant or in the person's kitchen.

When food is cooked and left out for more than 2 hours at room temperature, bacteria can multiply quickly. Most bacteria grow undetected because they do not produce an "off" odor or change the color or texture of the food. Freezing food slows or stops bacteria's growth but does not destroy the bacteria. The microbes can become reactivated when the food is thawed. Refrigeration may slow the growth of some bacteria, but thorough cooking is needed to destroy the bacteria.

Symptoms
In most cases of foodborne illness, symptoms resemble intestinal flu and may last a few hours or even several days. Symptoms can range from mild to serious and include:

abdominal cramps
nausea
vomiting
diarrhea
fever
dehydration

Risk Factors
Some people are at greater risk for bacterial infections because of their age or immune status. Young children, pregnant women and their fetuses, the elderly, and people with lowered immunity are at greatest risk


Complications
Some micro-organisms, such as Listeria monocytogenes and Clostridium botulinum, cause far more serious illness than vomiting or diarrhea. They can cause spontaneous abortion or death.

In some people, especially children, hemolytic uremic syndrome (HUS) can result from infection by a particular strain of bacteria, E. coli O157:H7, and can lead to kidney failure and death.

HUS is a rare disorder that affects primarily young children between the ages of 1 and 10 years and is the leading cause of acute renal failure in previously healthy children. The child may become infected after consuming a contaminated food, such as meat (especially undercooked ground beef), unpasteurized apple cider or apple juice, or raw sprouts.

The most common symptoms of infection are vomiting, abdominal pain, and diarrhea, which may be bloody. In 5 to 10 percent of cases, HUS develops about 2 to 6 days after the onset of illness. This disease may last from 1 to 15 days and is fatal in 3 to 5 percent of cases.

Symptoms of HUS include fever, lethargy, irritability, and pallor. In about half the cases, the disease progresses until the kidneys are unable to remove waste products from the blood and excrete them into the urine (acute renal failure). A decrease in circulating red blood cells and blood platelets and reduced blood flow to organs may lead to multiple organ failure. Seizures, heart failure, inflammation of the pancreas, and diabetes can also result. However, most children recover completely. You need to see a doctor right away if you have any of the following symptoms, with or without gastrointestinal symptoms:

Signs of shock, such as weak or rapid pulse; shallow breathing; cold, clammy, pale skin; shaking or chills; or chest pain.
Signs of severe dehydration, such as dry mouth, sticky saliva, decreased urine output, dizziness, fatigue, sunken eyes, low blood pressure, or increased heart rate and breathing.
Confusion or difficulty reasoning.


Treatment
Most cases of foodborne illness are mild and can be treated by increasing fluid intake, either orally or intravenously, to replace lost fluids and electrolytes. In cases with gastrointestinal or neurologic symptoms, people should seek medical attention.

In the most severe situations, such as HUS, the patient may need hospitalization in order to receive supportive nutritional and medical therapy. Maintaining adequate fluid and electrolyte balance and controlling blood pressure are important. Doctors will try to minimize the impact of reduced kidney function. Early dialysis is crucial until the kidneys can function normally again, and blood transfusions may be needed.

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Mercury content in fish: A concern for pregnant women

I've heard that pregnant women should avoid eating fish. Is this true?

The Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) recommend that pregnant women limit the amount of commercial and sport fish they eat to no more than 12 ounces (cooked) a week. This is because some fish contain high levels of mercury, which can harm the nervous system of the developing fetus. If you're pregnant, the FDA advises that you eat a variety of fish and avoid fish that contain higher levels of mercury.

Fish most likely to contain mercury	Fish known to be low in mercury
Shark	Salmon
Swordfish	Pollock
King mackerel	Farm-raised catfish
Tilefish	Canned light tuna*

*Note: Tuna steaks and canned albacore tuna have higher levels of mercury than canned light tuna.

Mercury occurs naturally in trace amounts in the environment. But it can also accumulate in streams, lakes and oceans as a result of industrial pollution. Nearly all fish contain trace amounts of a form of mercury called methylmercury. Large fish tend to have higher levels of mercury than small fish.

Check local advisories about the safety of fish caught in your local rivers and streams. If no advice is available, limit the amount of fish you eat from local waters to 6 ounces (cooked) a week.