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ANOREXIA

What is anorexia nervosa?

Anorexia nervosa is an illness that usually occurs in teenage girls, but it can also occur in teenage boys, and adult women and men. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia isn't just a problem with food or weight. It's an attempt to use food and weight to deal with emotional problems.

What is the difference between anorexia and bulimia?

People with anorexia starve themselves, avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating, or take laxatives or diuretics (water pills) to keep from gaining weight. People with bulimia don't usually lose as much weight as people with anorexia.

Why do people get anorexia?

The reason some people get anorexia isn't known. People with anorexia may believe they would be happier and more successful if they were thin. They want everything in their lives to be perfect. People who have this disorder are usually good students. They are involved in many school and community activities. They blame themselves if they don't get perfect grades, or if other things in life are not perfect.

What are the problems caused by anorexia?

Girls with anorexia usually stop having menstrual periods. People with anorexia have dry skin and thinning hair on the head. They may have a growth of fine hair all over their body. They may feel cold all the time, and they may get sick often. People with anorexia are often in a bad mood. They have a hard time concentrating and are always thinking about food. It is not true that anorexics are never hungry. Actually, they are always hungry. Feeling hunger gives them a feeling of control over their lives and their bodies. It makes them feel like they are good at something--they are good at losing weight. People with severe anorexia may be at risk of death from starvation.

What is the treatment for anorexia?

Treatment of anorexia is difficult, because people with anorexia believe there is nothing wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a small amount of weight loss) may be successfully treated without having to be admitted to the hospital. But for successful treatment, patients must want to change and must have family and friends to help them.
People with more serious anorexia need care in the hospital, usually in a special unit for people with anorexia and bulimia. Treatment involves more than changing the person's eating habits. Anorexic patients often need counseling for a year or more so they can work on changing the feelings that are causing their eating problems. These feelings may be about their weight, their family problems or their problems with self-esteem. Some anorexic patients are helped by taking medicine that makes them feel less depressed. These medicines are prescribed by a doctor and are used along with counseling.

How can family and friends help?

The most important thing that family and friends can do to help a person with anorexia is to love them. People with anorexia feel safe, secure and comfortable with their illness. Their biggest fear is gaining weight, and gaining weight is seen as loss of control. They may deny they have a problem. People with anorexia will beg and lie to avoid eating and gaining weight, which is like giving up the illness. Family and friends should not give in to the pleading of the anorexic patient.

Warning signs of anorexia

* Deliberate self-starvation with weight loss
* Fear of gaining weight
* Refusal to eat
* Denial of hunger
* Constant exercising
* Greater amounts of hair on the body or the face
* Sensitivity to cold temperatures
* Absent or irregular periods
* Loss of scalp hair
* A self-perception of being fat when the person is really too thin

source : American Academy of Family Physicians

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Video Game Injuries a Holiday Hazard

THURSDAY, Dec. 28 (HealthDay News) -- For those children who got new video games and systems this Christmas, parents need to make sure their youngsters don't suffer hand and thumb injuries caused by overuse of those games, the American Physical Therapy Association (APTA) says.

Constant stress on tendons, nerves and ligaments in children's hands and arms can cause long-term problems such as tendonitis, bursitis and carpal tunnel syndrome, according to Cindy Miles, owner of a pediatrics physical therapy practice in Whitehall, Pa.

Symptoms of repetitive stress injuries caused by overuse of video games include fatigue and loss of strength, minor or acute aches and pains, burning and tingling.

The APTA offers the following tips on how to prevent injuries caused by overuse of video games:

* Keep wrists straight. Don't let them bend downward when holding a game controller.
* Practice good posture while playing. Sit in a chair that provides solid back support and keep your feet comfortably on the floor.
* Stretch and move. Get up and stretch about every 20 minutes to give your head, neck and shoulder muscles a break.
* Watch for warning signs such as headaches, fatigue, muscle pain or cramping. If you notice these signs, take a break or do a different activity.

healthday.com

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Africa has high-tech tools to beat meningitis

DAKAR (Reuters) - A young girl, unconscious by the time her mother brought her to a rural clinic in southern Burkina Faso, had the classic symptoms of meningitis: fever, stiffness, vomiting.
With treatment, doctors hoped to be able to save her life although she may be permanently disabled: deafness, epilepsy or paralysis are among the effects of the disease. This latest outbreak in the remote Leraba region bordering Ivory Coast triggered alarms far away in the capital, Ouagadougou, amid fears of another epidemic wave of the disease.
In the arid Sahel region south of the Sahara, every year from December through May thousands of people, many of them children, get meningitis. Up to one in 10 who contract the disease die. Africa's "meningitis belt," stretching from Senegal to Ethiopia through some of the world's poorest and most war-scarred places including Sudan's Darfur, accounts for more than half the cases of the disease worldwide each year.
Climate conditions such as dust wind and cold nights increase the risk of the illness along with overcrowded living and the movement of large populations. Now health workers using high-tech methods to diagnose, control and even predict the disease hope to reduce its grim toll.
They say a new low-cost vaccine, lasting longer than those currently available, could be available as soon as 2009. A new test should make diagnosis quicker. And by studying the climate, they hope to be able to tell in advance where the disease will hit, and intervene before the first patient gets sick.
Experts say the new vaccine could eradicate meningitis from a community in much the same way that sustained vaccinations have all but wiped out polio worldwide."That is going to change the face of epidemic meningitis in the region," said William Perea, a
World Health Organization (WHO) meningitis expert.

NEW EPIDEMIC

Meningitis cases in the region reached a 20-year low in 2005. But then by April 2006, more than 30,000 had been reported to the WHO -- five times as many as the previous year. The pattern is typical. Since the 1970s, there have been meningitis epidemic waves every decade or so, each lasting three to four years.
Experts say last year's surge signals the start of another major epidemic in the Sahel region. In a worst-case scenario, according to WHO estimates, there could be as many as 160,000 cases in the next two years. Meningitis is an infection of the thin lining that surrounds the brain and spinal cord. It is caused by different bacteria but when diagnosed early and treated with antibiotics many patients recover fully.
It can cause complications including brain damage, deafness and learning problems. About 5-10 percent of patients die from the illness, according to the WHO. It is an infectious illness that is spread by sneezing, coughing and living in close quarters. Early symptoms include a stiff neck, headache, fever and sensitivity to light.
Health workers across the meningitis belt report cases to a central agency, in cooperation with the WHO, every week. "In a district of fewer than 30,000 people, we try to compare the figures from two weeks," said Salam Sanne, director of emergency medicine in Burkina Faso for Medecins Sans Frontieres (MSF --
Doctors Without Borders), who helped treat the girl.
"If there are two cases, and next week there are four, then we consider it an epidemic."
When the alarm is raised, medical teams spring into action to supply extra antibiotics and launch a vaccination campaign. But the WHO's Perea said the current system is not enough. For one thing, it is too slow because vaccines are targeted against specific strains of the disease. Identifying each means first sending a bacteria sample from the patient's spinal fluid to a laboratory: "The whole response may be delayed," he said.
And the current vaccine is not effective enough. "The current vaccine has a short-lived immunity. In three years there is no more immunity," said Perea. A quick and simple diagnostic test, now in final trials at Niger's Center for Medical and Health Research, should help.
"You just put a few drops of the cerebral-spinal fluid in the tube and you put your dipstick inside your tube and about 10 minutes later you will have the result," said Suzanne Chanteau, director of the research team that developed the test.

WATCHING THE DUST

Her team, known by its French acronym CERMES, is also working on improving predictions of where the next outbreak will hit. "There is a hypothesis that the low humidity in this region and also maybe the dust winds are favorable conditions for the development of infection," Chanteau said.
Researchers use satellite data to track Sahara dust storms and determine the extent of the connection between the dry, dusty air and meningitis. "We want to have atmospheric conditions categorized and be able to say if ... there are favorable conditions to have meningitis or not," says Isabelle Jeanne, head of the Geographic Information Systems-based project at CERMES. "The whole time-length will be shortened for intervention," Perea said, adding that vaccines and other new technology should help "eliminate epidemics from the belt."

Naomi Schwarz
www.reuters.com

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Brazil transfixed by 4th anorexia death

RIO DE JANEIRO, Brazil - The struggle for food has long been a drama for millions of impoverished Brazilians. But these days the nation is transfixed by another sort of starvation: anorexia among the successful and well off. The deaths of four young women in recent weeks from anorexia — a disorder characterized by an abnormal fear of becoming obese, an aversion to food and severe weight loss — have been splashed across the front pages of newspapers nationwide.

The subject has become a morbid fascination for Brazilians, and is even the theme of a popular TV soap opera. It has also touched off a debate within Brazil's fashion industry that has long presented the rail-thin model as the paragon of female beauty.

The most recent victim was Beatriz Cristina Ferraz Lopes Bastos, a 23-year-old teacher whose death Sunday at a hospital in Jau, 200 miles northeast of Sao Paulo, was reported by national television news programs.

Local media reports said she was 5 feet, 2 inches tall and weighed just 77 pounds.

"Another victim of anorexia," the newspaper Globo said on its Web site Tuesday, alongside a glamorous photo of the blonde Bastos, who was also a skilled pianist, amateur historian and author of a literature column for a hometown Web site.

The newspaper Folha de S. Paulo reported she described herself as "thin" on an Internet discussion group and friends said they had to "fight with her to eat." A former boyfriend, Leandro Murgo, told reporters Bastos was a chubby teenager and became fixated on losing weight.

Anorexia became big news in Brazil last month with the death of 21-year-old Ana Carolina Reston, a successful model who died of generalized infection caused by anorexia nervosa. She reportedly carried just 88 pounds on her 5-foot-8 frame.

"Take care for your children because their loss is irreparable," Reston's mother, Miriam, told Globo after her death. "Nothing can make the pain go away. No money in the world is worth the life of your child."

Two days later, on Nov. 16, college student Carla Sobrado Casalle, 21, died in the southeastern city of Araraquara, also with symptoms linked to anorexia. She was just under 5-foot-9 and weighed 99 pounds. A third anorexia victim died later in the month.

Eating disorders are also a daily subject for viewers of the prime-time soap opera "The Pages of Our Lives," in which a 15-year-old ballet dancer suffers from bulimia, secretly making herself vomit after eating to keep her weight down.

Death and illness from malnourishment is not uncommon in this nation of 185 million people, where 26.5 million must survive on the minimum wage of $160 a month or less. According to the IBGE Census Institute, at least 8 percent of Brazilians are underweight.

As it has in other countries, the attention on eating disorders is renewing pressures on Brazil's fashion industry, whose officials insist they do not urge models to starve themselves to attain an "ideal" body.

They noted a fashion show in Sao Paulo already had said it would bar models under age 16 as part of a national effort to raise awareness about eating disorders.

"In Paris and Milan, models under 16 years can't participate in these types of events," said Paula Marini, a spokeswoman for the Ford Models agency. "In Brazil, this is a new procedure."

Europeans also have stepped up their attention to the sometimes unhealthy aspects of fashionable looks. Organizers of Madrid's Fashion Week, for instance, announced in September that they was banning overly thin models.

Organizers of Sao Paulo Fashion Week, held every year in late January, added the minimum-age requirement to a previous rule requiring that agencies present a signed medical certificate attesting that their models are in good health.

"Beauty and fashion is about health in the first place," the creative director of Sao Paulo Fashion Week, Paulo Borges, said in a statement in July.

PETER MUELLO, Associated Press Writer
www.ap.org

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How to get healthy in 4 hours a week

A Nielsen Media Research report from fall 2006 shows that the average American spends four hours and 35 minutes watching television each day. Each week, television viewing adds up to more than 30 hours — well beyond a part-time job.

Other reports show that national and local commercials now total an average of eight minutes for every half-hour show. So the average viewer is watching 40 minutes of commercials a day, or more than four and a half hours weekly.

Television is not necessarily wasted time, as people use it to relax and learn. But lack of time is one of the most commonly reported reasons that people don’t exercise or plan and prepare healthier meals. Perhaps it is worth considering the benefits that the time you spend watching television could bring.

A gold mine of time
If lack of time keeps you from adopting some healthful habits but you aren’t ready to reduce your television-watching time, you might reconsider the way you spend your commercial-watching time. There are several different approaches you could take to make use of this gold mine of time.

First, you could use commercial times to accomplish those health-supporting tasks you never seem to get done. Many people find that one of the secrets to healthier eating is to plan meals ahead. This allows you to grocery shop more efficiently and avoid the stress that comes when you haven’t given dinner a thought until a few minutes before you hope to eat. In the course of an hour of television programming, you could plan close to a week’s worth of meals and perhaps even write the grocery list for a weekly shopping trip.

People often say that they would like to save money and eat better by bringing their lunch to work, but that they have no time to make it. Others say they find no time to prepare the fruit they’d like to have with their breakfast. Commercials offer plenty of time to do these tasks. You could also assemble foods for the next day’s breakfast.

What about fitness goals that are never met? In a single commercial break you could do several sets of crunches to tone those ab muscles, other strength-training exercises or stretches to improve your flexibility. Stashing weights or exercise bands near the television allows you to readily start an activity when the commercials start.

A second approach is to use commercials to take care of small general tasks that eat up the time you’d like to spend going for a walk or attending a fitness class. By using commercials to pay bills, do laundry and sort through mail and e-mails, the average American can accumulate more than four hours of time saved in the course of a week, enough to make a substantial boost in exercise time.

Technology offers a third option. If you have a recording technology, you can record television shows and fast-forward through the commercials. You can finish four and a half hours of television shows in fewer than four hours. The trick, however, is to use the extra time to work for you, instead of to watch yet another show.

Nutrition Notes is provided by the American Institute for Cancer Research in Washington, D.C.

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cancer

What is cancer?

The organs and tissues of the body are made up of tiny building blocks called cells. Cells in different parts of the body may look and work differently but most reproduce themselves in the same way. Cells are constantly becoming old and dying, and new cells are produced to replace them. Normally, the division and growth of cells is orderly and controlled but if this process gets out of control for some reason, the cells will continue to divide and develop into a lump which is called a tumour. Tumours can either be benign or malignant. Cancer is the name given to a malignant tumour.
In a benign tumour the cells do not spread to other parts of the body and so are not cancerous. However, if they continue to grow at the original site, they may cause a problem by pressing on the surrounding organs.
It is important to realise that cancer is not a single disease with a single type of treatment. There are more than 200 different kinds of cancer, each with its own name and treatment.

What is a cancer cell?

And just as there are hundreds of types of cell, there are hundreds of types of cancer, few of which can be treated in the same way. Every cell's life is mapped out in advance by coded instructions, called genes, held in its nucleus. These tell it how to behave, when to reproduce by dividing - and when to die.
When the instructions relating to cell multiplication and dying are wrong, the cell may start dividing uncontrollably, and not die when it should. In addition, the cancer may not follow the usual instructions that keep cells spaced out properly.
Every time the cell divides, the "bad" instruction is reproduced, so the out-of-control multiplication carries on. As these cells can be multiplying more rapidly than healthy cells, the cancer cells can form a growing lump in the body called a tumour or a lesion. As this gets larger, it can even grow its own vessels to keep it supplied with blood. A benign, or non-cancerous tumour shares this uncontrolled growth, but will not generally invade neighbouring tissues and damage them.
Tumours which do this are "malignant", or "cancerous". The type of cell in which the cancer starts will generally determine the speed at which it grows, and its resistance to treatment, although there are many variations.
Cancers harm health in a number of ways. The very size of the tumour can interfere with nearby organs, or ducts which carry important chemicals, causing pain or other symptoms.
For example, a tumour on the pancreas can grow to block the bile duct, leading to the patient developing obstructive jaundice. And a brain tumour can push on important parts of the brain, causing blackouts, fits and other problems. Even benign tumours can cause these problems if located in the wrong place.
When a cancer invade nearby tissues, they can cause bleeding from damaged blood vessels, and stop the organ which they are invading from working properly.

What happens if it spreads?

As a tumour grows, cells can break off and start growing on adjacent tissues and organs. For example, if a bowel cancer has spread through the wall of the bowel itself, it can start growing on the bladder. Cells can also enter the bloodstream and travel to distant organs, such as the lungs or brain. The technical term for this is "metastasis".
When new tumours form on distant organs, they behave like the original tumour - so a bowel cancer cell growing in the lung will not be lung cancer. Once other organs are involved, then any symptoms of the cancer can get worse. However, it may be some time before a growing cancer in certain parts of the body produces symptoms that the patient can notice. Once a cancer has started to spread beyond its original site, then the chances of a cure often begin to fall, as it becomes more difficult to treat.

How is it treated?

There are three principal ways of treating cancer:

The first is surgery, normally an operation to remove the cancerous growth, and, depending on its type, nearby tissues and organs.

A cancer patient may first undergo a minor operation called a biopsy to take a small sample of the cancer for analysis.
The surgeon will try to remove as much of the cancer as possible, but sometimes extra treatment will be needed.
This could either take the form of radiotherapy or chemotherapy, or a combination of treatments.

Types of cancer

Carcinomas
About 85% of cancers are carcinomas. They start in the epithelium, which is the covering (or lining) of organs and of the body (the skin).
Sarcomas
These form in the connective tissues of the body such as muscle, bone and fatty tissue (6% of cancers).
Leukaemias/Lymphomas
These occur in the tissues where white blood cells (which fight infection in the body) are formed, i.e. the bone marrow, and lymphatic system (5%).
Others forms of cancer
Brain tumours and other rare forms of cancer make up the other 4% of cancers.

Who gets cancer?

1 in 3 people will develop cancer during their lifetime, but cancer is not common in children or young people - it mainly occurs in the later years of life. Cancers can occur at any age, but the risk of developing cancer increases with age. Over 70% of all newly diagnosed cancers occur in people aged 60 years or more.
Some cancers are very common and others are very rare. The most recent statistics for the UK show that for men the most common cancer is lung cancer (19%), followed by prostate cancer (17%), large bowel cancer (14%) and bladder cancer (7%). For women the figures are breast cancer (29%), large bowel cancer (12%), lung cancer (11%) and cancer of the ovary (5%).
Many people with cancer can be cured. Even if a cancer cannot be cured, it can often be controlled with treatment for months or years. Cancerbackup has information on all the main types of cancer, and on some of the rarer cancers.

Why do cancers come back?

A cancerous (malignant) tumour consists of cancer cells which have the ability to spread beyond the original site. If left untreated they may invade and destroy surrounding tissues. Sometimes cells break away from the original (primary) cancer and spread to other organs in the body by travelling in the bloodstream or lymphatic system. When these cells reach a new area of the body they may go on dividing and form a new tumour, often referred to as a "secondary" or a "metastasis".

Cancer Web Link

www.cancer.org
American Cancer Society - Information and Resources for Breast ...
Dedicated to helping persons who face cancer. Supports research, patient services, early detection, treatment and education.

www.cancer.gov
Comprehensive Cancer Information - National Cancer Institute
Official site for the National Institute of Health's principal agency for cancer research.

www.cancer.ca
Canadian Cancer Society - Société canadienne du cancer
Community-based organization aimed at the eradication of cancer and enhancement of the quality of life for people living with the condition.

www.cancerresearchuk.org
Cancer Research UK: the UK's leading cancer charity
Funding world-class research and training to improve cancer treatment and prevention, and providing authoritative cancer information and advocacy.

www.kankerindo.org
Indonesian Cancer Foundation
Situs ini telah dikunjungi oleh 5249 pengunjung Published by Yayasan Kanker Indonesia Pusat.


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AIDS

What is Aids?

There is still no cure for Aids, but a combination of various drugs can reduce the virus which causes Aids to virtually undetectable levels.Some people mistakenly believe the drugs cure Aids and this has led to fears that people are becoming complacent about the disease.
Aids stands for acquired immune deficiency syndrome. People with HIV (human immunodeficiency virus) can look and feel well.
As the virus attacks the immune system, an infected person will be open to a large number of illnesses. This means there are a wide variety of symptoms.
HIV usually leads to Aids, which is diagnosed when a person has developed one of several opportunistic diseases associated with the virus as well as underlying immune problems.
The diseases include pneumonia, Kaposi's sarcoma - a form of purplish skin cancer not normally seen in young people before the advent of Aids - and dementia.

How is it transmitted?

HIV is relatively difficult to transmit as it does not live for long outside the body. It is carried in the semen, vaginal fluids, breast milk and blood. The main transmission routes are through sharing needles, sex, blood transfusions, transplants, getting infected fluid into open wounds and breast feeding.

High risk groups or behaviour

Certain groups are believed to be at higher risk of developing the virus. These include those who share needles and children who are breast fed with infected milk. As the disease began in the West in the gay community, gay men are at higher risk than heterosexuals. Sex workers and those who have multiple sexual partners are also at higher risk than average. People with other sexually transmitted diseases are also thought to be more likely to contract HIV than others.

What is the treatment?

If you want to know if you have HIV, you should contact your doctor or a sexually transmitted disease clinic about a blood test. They will usually suggest counselling before you take an HIV test to make sure you are prepared for all the implications of the result, including the impact on life insurance and mortgages. Aids organisations have reported that, in some cases, just taking the test can be enough for some companies to refuse you insurance or a mortgage.
If you test positive for the virus, there are a range of treatments you may be offered. The most popular is combination therapy, a cocktail of different anti-Aids drug, including AZT. The drugs can have powerful side effects, such as anaemia, and not everyone responds well to them.
People who take the numerous drugs have to stick to a rigid regime, but they have been shown to reduce the virus and rebuild the immune system. In some cases, the virus has been reduced to undetectable levels. However, doctors say it is too early to say yet how long they will last.

Stigma

Because of the way HIV is transmitted and the groups it has affected most - including drug users, gay men and people immigrant communities, it has attracted much media attention and prejudice. This has often made it hard for sufferers to come forward for testing. The all-parliamentary group on Aids says tackling the stigma of the disease is vital for reducing its impact.

History of the disease

The search for the origins of Aids has been dogged by political controversy.
According to the latest theory, published in Nature magazine in February and widely supported by leading experts in the field, the Aids virus first passed into people from a particular sub-species of chimp in the Central African rainforest.
Human infection occurred in the first half of the century as a result of people hunting and eating the chimps, the scientists believe. This practice continues today.
The international team, led by Dr Beatrice Hahn of the University of Alabama, say genetic tests show the main human virus, HIV-1, is closely related to a virus that infects chimps but does not make them sick.
They are now studying how common the virus is in chimps in the wild, but they face problems because the sub-species in which they found the virus - the Pan troglodytes troglodytes - is endangered.
Experts say there is evidence that HIV may have transferred to humans throughout history, but only became an epidemic in the 20th century, possibly because of increased sexual promiscuity, civil unrest and movement of people to cities.
Last year, researchers said they had found the first known case of Aids - in a Bantu man who died in 1959 in the Belgian Congo, now the Democratic Republic of Congo, and home of the sub-species of chimps.

AIDS Link

www.aids.org
Educating - Raising HIV Awareness - Building Community
Non-profit organization for the free and open exchange of information in the fight against AIDS.

www.aidsonline.com
Official journal of the International AIDS Society.

www.aidsinfo.nih.gov
Provides information about federally approved treatment guidelines for HIV and AIDS.

www.unaids.org
UNAIDS: The Joint United Nations Programme on HIV/AIDS
Joint United Nations program on AIDS/HIV. A global source of information on the AIDS epidemic, includes comprehensive information on UN policies, news, ...

www.worldaidsday.org
World AIDS Day - the international day of action on HIV and AIDS which takes place every year on 1 December.

www.thewellproject.org
Get updated on HIV/AIDS & women. Facts, resources, treatments & more

www.prb.org
HIV AIDS Reports. International Data & Analysis. Get Relevant & Objective Trend Data

www.projectinform.org
HIV / AIDS Information. Choose hope over despair. Advocacy, treatment information & more.

www.GlobalGiving.com
Improve Lives Worldwide. Support Global Healthcare

www.unicef.org
AIDS Affects Our Children, Unite for Children. Unite against AIDS - Join Now

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Good News ... And Lots of Questions

It was big news this week when researchers from the M. D. Anderson Cancer Center in Houston reported that breast-cancer rates dropped after millions of women stopped taking hormone therapy to relieve menopausal symptoms. But does that mean that these hormones (basically estrogen and sometimes a progestin) actually cause breast cancer? That’s the provocative question raised by the study. The researchers found an overall 7 percent decline in breast-cancer incidence in 2003, a year after a major study of hormonescalled the Women’s Health Initiative (WHI) was halted early because of increased breast cancer and heart disease among participants. The steepest decline, 12 percent, occurred in the number of women diagnosed with a kind of breast cancer that is especially sensitive to hormones.

Another recent study, by researchers in California, echoes these findings. Christina Clarke, an epidemiologist at the Northern California Cancer Center, and her colleagues found that breast-cancer rates in California dropped even more steeply after the WHI—12 percent fewer in 2003 and 2004. Clarke attributes the difference to the fact that California women were more likely to use hormones than women in other states. “We rarely see changes this dramatic over such a short time period,” Clarke says.

But while the connection may seem clear, researchers caution that they really won’t understand the meaning of the drop until they see national numbers for 2004, which are expected next spring, and analyze these and other statistics more carefully. Scientists need to know whether there’s a difference in breast-cancer rates between women who’ve been on hormone therapy and those who haven’t and what happens to former hormone users years after they quit. It’s possible that stopping hormone therapy merely slowed the growth of tumors that will eventually emerge—which means breast-cancer rates could rise again. Without all that data, the current numbers show only an association, not causation, says Marcia Stefanick, chair of the WHI steering committee and a professor of medicine at Stanford University.

Doctors who treat menopausal women say the new numbers shouldn’t be the only basis for a decision on whether or not to use hormones. “This isn’t a cause for alarm,” says Dr. JoAnn Manson, chief of the Division of Preventative Medicine at Brigham and Women’s Hospital in Boston. “It has been known for a while that estrogen plus progestin increases the risk of breast cancer.” But, she adds, that shouldn’t necessarily stop women with severe symptoms from using low-dose hormones for two or three years. “I think it underscores the importance of looking at your personal risk factors for breast cancer and cardiovascular disease,” says Manson, author of “Hot Flashes, Hormones & Your Health,” “and whether the benefits are likely to outweigh the risks.”

That emphasis on balancing risks and benefits is an important legacy of the WHI, says Clarke. “I think we’re really moving into an era in science where medicine is going to become personalized. It really depends on you and how bad your symptoms are and what your personal risk is for breast cancer. Do you have a history? Have you been diagnosed with a benign breast tumor before? I think you have to put all those things together with your doctor to come up with a decision.”

Since the WHI, pharmaceutical companies have begun offering many more different forms and dosages of hormone therapy—not just pills, but also lotions, patches and local therapy for symptoms like vaginal dryness. All these give women many more choices. But researchers say that if you do take hormones, it’s important to reconsider that decision regularly with your doctor—at least once a year if not more. “We don’t know how long you can go before your risk exceeds some benefits,” says Brenda K. Edwards, associate director of the surveillance research program at the National Cancer Institute. “Women and their physicians need to keep that in mind.” When it comes to hormone therapy, about the only thing that’s certain is that we need more information.

Barbara Kantrowitz
newsweek

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Behavioral therapy can help chronic back pain

NEW YORK - Pooled results from 22 clinical trials show that psychological interventions help individuals with chronic low back pain experience less actual pain, less pain-related interference with daily living, less depression and work-related disability, and greater health-related quality of life.

Dr. Robert D. Kerns, who led the analysis, told Reuters Health, “The data across randomized, controlled studies are consistent.” Psychological interventions for chronic low back pain elicit “positive results.”

Kerns, of the VA Connecticut Healthcare System in West Haven and colleagues limited their pooled analysis to studies involving adults with low back pain not related to cancer for at least three months. Most of the study subjects had suffered with low back pain for much longer — 7-1/2 years on average.

In the overall analysis, psychological treatments — namely, behavioral and cognitive-behavioral therapies; self-regulatory therapies such as hypnosis, biofeedback and relaxation; and supportive counseling — either alone or as part of a multidisciplinary approach proved superior to no treatment or “treatment as usual.”

“The largest and most consistent effect was a reduction in pain intensity,” Kerns told Reuters Health. “This is good news for persons with pain and for providers who struggle to find effective and sustained approaches for reducing unnecessary pain and suffering of the lower back.”

www.reuters.com

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Parents advised to limit kids' use of noisy toys

NEW YORK (Reuters Health) -Some toys emit noise at a high enough level to cause permanent hearing damage if they are held too close to the ear, new research from the UK shows. "With most toys, your child will only damage their hearing if they use them for too long a duration, or if they stick them in their ear," Dr. Brad Backus, a research fellow at University College London's Ear Institute who performed the study, said in a press release. "Our advice is pretty simple: don't let your child hold noisy toys too close to their ear, and don't let them play with them for more than an hour a day."

In a study commissioned by Deafness Research UK, Backus tested the noise levels of 15 popular toys for children aged 3 months to 15 years. The recommended top noise limit for toys is 85 decibels. Prolonged exposure to noise above this level can cause permanent hearing damage.

Eight of the toys emitted an average of 81 to 105 decibels when held 25 centimeters from the testing microphone, roughly arm's length for a child. Pixar Cars "Lightning McQueen" emitted 82.5 decibels, while Laser Command's noise level was 88.6 decibels.

But when held at 2.5 centimeters from the microphone, approximating the distance if the toy was held close to the ear, 14 of the toys, including Fireman Sam's Action Jupiter and Tomy's "Spin n' Sound" remote controlled car, had average noise levels between 84 and 115 decibels. The only toy with noise levels below the safety threshold was a VTECH cell phone for babies.

Toy guns were the worst offenders, emitting 120 to 140 decibels when held at arm's length and 130 to 143 decibels when held close to the ear. Noise of 140 decibels or above can cause immediate hearing damage.

"If I had children, I wouldn't give any of these gun-toys to them," noted Backus, who said his ears were ringing after testing the guns. "And I would recommend that people avoid them. They have the very real potential to cause permanent hearing loss."

SOURCE: http://www.deafnessresearch.org.uk

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Menopause study disputes herb treatment

PHILADELPHIA - A popular herbal treatment called black cohosh is practically ineffective at relieving hot flashes and night sweats in women going through menopause, a study found. The findings were disappointing news for women seeking alternatives to estrogen-progestin hormone supplements, which have been linked to breast cancer and heart problems.

The yearlong study of 351 women suffering from hot flashes and night sweats found that those given black cohosh got about the same amount of relief as those who took a placebo. And those groups saw nothing close to the improvement in women on hormones.

"It's disappointing news," said Katherine Newton, an epidemiologist who helped lead the study, funded by the National Institute on Aging and the National Center for Complementary and Alternative Medicine. "It would be nice to offer something safe and effective."

The study was conducted at Seattle-based Group Health, a health plan, and was published Monday in the Annals of Internal Medicine.

Black cohosh — an herb that is a member of the buttercup family and is commonly given to ease menopause symptoms — is available in pill or liquid form and is sold over the counter in many health food stores and over the Internet.

It is among a host of supplements including soy, wild yam, red clover and St. John's wort that have been tried for relief of hot flashes and night sweats, but studies almost universally have found they don't work.

Certain antidepressants have proved effective, and one company, Depomed Inc. of Menlo Park, Calif., plans to seek the
Food and Drug Administration's approval to sell an anti-seizure drug, gabapentin, for relief of hot flashes.

In the latest study, some participants were given black cohosh, while others received hormone supplements, a placebo or a botanical treatment that included black cohosh, alfalfa, licorice and ginseng.

Women taking the herbal treatments saw hot flashes reduced by only about half an episode per day compared with those taking the placebo, the study found. Those who got hormone therapy reduced their hot flashes by about four episodes per day when compared with the placebo.

Menopausal women can still make behavioral changes such as dressing in layers, sleeping in a cooler room and avoiding possible triggers such as very hot liquids and alcohol, Newton said. The study also shows that symptoms decreased over the course of the 12-month period and that they nearly always go away on their own.

The findings come less than a week after researchers reported a dramatic decline in U.S. breast cancer cases, a drop doctors attributed partially to fewer women using hormone therapy to treat menopause.

In 2002, a government study found a higher risk of breast cancer and heart problems occurred among women taking estrogen-progestin pills. Millions of women stopped taking the supplements. Doctors urged women with serious menopausal symptoms to use the lowest dose for as short a time as possible.

The latest study, conducted between 2001 and 2004, could hurt hopes for herbal remedies.

"We hope that this is not it," said Dr. Susan Reed, another of the study's authors. "However, there's not much that appears promising that is currently on the horizon."

The news may not all be bad. Since women who took a placebo saw some improvement, experts say there is hope that some could get relief through meditation or self-hypnosis.

"If you can relax your mind appropriately, you can also relax your body," said Barrie Cassileth, an alternative-medicine researcher at Memorial Sloan-Kettering Cancer Center in New York, who was not involved in the study. "If 30 percent of women could lose hot flashes because their mind made them do it, that's fantastic."

PATRICK WALTERS, Associated Press Writer
www.ap.org

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NKorea should spend money on food not nukes: UN rights envoy

SEOUL (AFP) - A United Nations rights envoy urged North Korea to spend its money feeding its people rather than on nuclear weapons, as talks opened in Beijing on scrapping the nuclear program.

Vitit Muntarbhorn, the UN's special rapporteur on human rights in North Korea, was speaking after a four-day fact-finding visit to
South Korea. He is barred from visiting the North.

"The military-first policy, particularly its expenditure on arms and nuclear proliferation in the DRPK (North Korea), is regrettable because the money should be spent on human development and particularly to address food security issues as well as other human needs," he told a press conference in Seoul.

Vitit said donors had also become less willing to contribute after the North's missile tests in July and its nuclear test on October 9.

He said the UN's World Food Programme had appealed for just over 100 million dollars to feed 1.9 million people over the next two years, but had received only 12-13 percent of this in donations.

"The whole humanitarian aid has been very much impacted upon by the nuclear test and missile tests, as some contributors become much more reluctant both multilaterally and bilaterally to give aid."

Vitit also noted that food shortages dated back to the mid-1990s "due to natural disasters and mismanagement." But at the end of last year the North decided to accept less monitoring of food aid and "started to pressure UN agencies and NGOs to limit their operations and even to leave the country."

Saying it "takes two to tango," he urged the North to show its commitment by allocating its own funds to ensure adequate food supplies.

Vitit visited South Korea's Hanawon refugee resettlement centre and said all those he met talked of "hardship, deprivation and repression" in the North.

He urged nations which receive North Koreans fleeing their homeland to treat them as refugees rather than economic migrants.

Vitit did not single out any nation but rights groups have strongly criticized China which routinely returns refugees to North Korea, where they face imprisonment and torture.

He said positive developments in the six-party talks, which resumed Monday, would open opportunities for humanitarian action.

"There may be in that process, some possibilities for addressing other issues, security concerns, as well as possibly human rights," Vitit said.

He urged the North to end its "discrepancies and transgressions" on human rights and implement the four international treaties to which it is a party.

In a report released in October, Vitit accused North Korea of practising "merciless discrimination against handicapped persons by setting up collective camps for them where they are designated according to their physical deformity or disability."

The report also charged that women in North Korea were being subjected to violence as well as "human trafficking and sexual exploitation."

The envoy, in the report, also focused on the root causes pushing North Koreans to flee abroad -- citing political repression and widespread hunger.

www.afp.com

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Shop for shoes, see a movie, get a shot of Botox

DALLAS - Amy Andrade had been thinking about Botox for a while. So when she spotted a spa-like “cosmedical” clinic in the upscale Dallas mall she visits about once a month, she was immediately interested.When she learned the clinic was connected with one of Texas’ leading medical institutions, she was sold.

She had Botox injected into her 32-year-old forehead and near her eyes to smooth out infinitesimal wrinkles.

“It was great. I felt like I was getting a facial,” said the furniture showroom manager.

She was hoping to look younger and knew about Botox because several of her friends have had the injections.

Medical spas like the one at Dallas’ NorthPark Center are booming. The number in the United States has jumped from 50 in 2002, when Botox injections won federal approval, to about 2,500 this year, according to the International Medical Spa Association. Malls and other retail sites are the hot spot locations as companies and medical institutions move closer to their customers.

Such spas offer minimally invasive cosmetic procedures like injections of Botox, which relaxes facial muscles to make lines fade, and fillers like Restylane, which add volume.

Not all medical spas have ties with a major medical institution like the Klinger Advanced Aesthetics Cosmedical Center, Spa and Salon at NorthPark, which has teamed up with the University of Texas Southwestern Medical Center.

Some “cosmedical” clinics don’t even require their practitioners to be plastic surgeons or dermatologists.

Those who specialize in the field say involvement by a plastic surgeon or dermatologist ensures consumer safety.

Dr. Rod Rohrich, professor and chairman of the department of plastic surgery at the University of Texas Southwestern Medical Center, is one of two plastic surgeons who help oversee cosmetics procedures at the NorthPark operation.

“When you peel back 'Botox in the mall,’ you have a top-notch medical facility in a mall setting,” he said. “What you’re doing is you’re getting the best of the best in a place where people shop and you’re doing it safely.”

www.ap.org

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Health Tip: Monitor Your Child's TV Watching

(HealthDay News) -- Too much time in front of the TV can lead to aggressive behavior and a tendency to engage in risky, unhealthy activities, the American Academy of Pediatrics says.

Parents should set rules around TV watching, including limiting time to no more than one hour or two hours each day, and never while doing homework. Carefully choose shows that your child is allowed to watch, and watch the shows with your child when you can.

Try to avoid watching shows that may convey stereotypes or inappropriate messages for children, the AAP says. Also look for educational, appropriate videos made to help children learn, grow, and develop mentally.

www.healthday.com

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Vaccine could stop transmission of malaria: study

CHICAGO (AFP) - US researchers said that they have developed an experimental vaccine that could theoretically eliminate the deadly parasite carried by mosquitoes that causes malaria.

The vaccine, which so far has only been tested in mice, would not offer people immunity like most regular shots.

Instead, the goal is to use the blood of a vaccinated person to kill the malaria parasite inside the mosquitoes after they bite their first victim.

That could effectively prevent the mosquitoes from further spreading malaria.

"It's a transmission-blocking vaccine that attempts to get rid of the parasite reservoir inside its mosquito host," explained Owen Rennert, scientific director of the National Institute of Child Health and Human Development.

Borne by mosquitoes, malaria afflicts mainly people in the tropical parts of Africa, Asia and South and Central America, and kills up to three million people a year, many of them children.

Scientists have spent decades searching for a vaccine for the disease.

But numerous experimental vaccines tried against the form of the Plasmodium falciparum parasite that resides in humans have been unsuccessful, or produced only limited immunity.

Plasmodium falciparum incites the most deadly of several forms of malaria, all caused by parasites from the Plasmodium genus.

In this study, the scientists decided to go after the early-stage form of the parasite living in the gut of the mosquito, before it matures and transfers to humans when they are bitten by the insect.

The researchers created a vaccine using a souped-up version of a protein taken from Plasmodium falciparum, and injected it into mice to create antibodies.

When serum was taken from the mice several months later and mixed in a test tube with the parasite cells, the mouse antibodies prevented the parasite cells from developing, effectively ending their life cycle.

A vaccine made in this way would not offer humans a first-line of defense against the disease, Rennert said.

The vaccinated person would still likely be infected by the mature parasite when first bitten by the mosquito.

But in feeding on their blood, the mosquito would absorb antibodies from the vaccine that would wipe out the immature Plasmodium cells inside the insects gut.

The result, they hope, could be to reduce the number of malaria cases down the line, as growth and transmission of the parasite is stifled.

But scientists at the
National Institutes of Health, which includes the Child Health and Human Development institute, are also looking at ways to combine this vaccine with one of the experimental vaccines that offer direct protection from infection.

"The two combined might give you a better response than either alone," said Rennert.

The study appears in the newest edition of the Proceedings of the
National Academy of Sciences.

www.afp.com

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Survivors recall horror of flu pandemic

CHEVY CHASE, Md. - At the height of the flu pandemic in 1918, William H. Sardo Jr. remembers the pine caskets stacked in the living room of his family's house, a funeral home in Washington, D.C.
The city had slowed to a near halt. Schools were closed. Church services were banned. The federal government limited its hours of operation. People were dying — some who took ill in the morning were dead by night.

"That's how quickly it happened," said Sardo, 94, who lives in an assisted living facility just outside the nation's capital. "They disappeared from the face of the earth."

Sardo is among the last survivors of the 1918 flu pandemic. Their stories offer a glimpse at the forgotten history of one of the world's worst plagues, when the virus killed at least 50 million people and perhaps as many as 100 million.

More than 600,000 people in the United States died of what was then called "Spanish Influenza." The flu seemed to be particularly lethal for otherwise healthy young adults, many of whom suffocated from the buildup of liquids in their lungs.

In the United States, the first reported cases surfaced at an Army camp in Kansas as World War I began winding down. The virus quickly spread among soldiers at U.S. camps and in the trenches of Europe. It paralyzed many communities as it circled the world.

In the District of Columbia, the first recorded influenza death came on Sept. 21, 1918. The victim, a 24-year-old railroad worker, had been exposed in New York four days earlier. The flu swept through the nation's capital, which had attracted thousands of soldiers and war workers. By the time the pandemic had subsided, at least 30,000 people had become ill and 3,000 had died in the city.

Among the infected was Sardo, who was 6 years old at the time.

He remembers little of his illness but recalls that his mother was terrified.

"They kept me well separated from everybody," said Sardo, who lived with his parents, two brothers and three other family members. His family quarantined him in the bedroom he had shared with his brother. Everyone in the family wore masks.

The city began shutting down. The federal government staggered its hours to limit crowding on the streets and on streetcars. Commissioners overseeing the district closed schools in early October, along with playgrounds, theaters, vaudeville houses and "all places of amusement." Dances and other social gatherings were banned.

The commissioners asked clergy to cancel church services because the pandemic was threatening the "machinery of the federal government," The Washington Star newspaper reported at the time. Pastors protested.

"There was a feeling that they couldn't turn to God, other than in prayer," Sardo said. "They liked the feeling of going to church, and they were forbidden."

The flu's spread and the ensuing restrictions "made everybody afraid to go see anybody," he said.

"It changed a lot of society," Sardo said. "We became more individualistic."

In a list of 12 rules to prevent the disease's spread, the Army's surgeon general wrote that people should "avoid needless crowding," open windows and "breathe deeply" when the air is "pure" and "wash your hands before eating."

One slogan was, "Cover up each cough and sneeze. If you don't, you'll spread the disease."

Those who were healthy wore masks when venturing outside. People who were known to be infected were threatened with a $50 fine if they were seen in public. Sardo remembers people throwing buckets of water with disinfectant on their sidewalks to wash away germs from people spitting on the street.

At the time, rumors swirled that the Germans had spread the disease — which Sardo did not believe.

A second flu survivor, 99-year-old Ruth Marshall, says she, her two sisters and a brother came down with what they thought was a cold. Then the fever struck and the illness became severe, she said.

Marshall, who lived just steps from the Capitol at the time, said the influenza deaths reported in the newspapers came as a surprise.

"We never thought we were going to die. We did pretty good — a lot of prayers," she said.

Others were not so fortunate. As the death toll started to mount, there was a shortage of coffins. Funeral homes could not keep up. Sardo's father, who owned William H. Sardo & Co., and other funeral-home directors turned to soldiers for help embalming and digging thousands of graves.

Talk of the threat of another pandemic brings back memories for Sardo, who says he has gotten a flu shot every year they are available.

"It scares the hell out of me. It does," Sardo said.

BRETT ZONGKER, Associated Press Writer
www.ap.org

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Scientists identify gene mutation in autism

PARIS (Reuters) - French scientists have identified genetic mutations in a small number of children with autism which could provide insight into the biological basis of the disorder. They sequenced a gene called SHANK3 in more than 200 people with autismspectrum disorders (ASD), which includes autism, and found mutations in the gene in members of three families.

ASD covers a range of problems that affect communication, social interaction, verbal skills and behavior.

"These mutations concern only a small number of individuals, but they shed light on one gene ... that is involved in autism spectrum disorders," Thomas Bourgeron, of the Pasteur Institute in Paris, said in a report in the journal Nature Genetics.

ASD, which affect six out of 1,000 children, range from mild to severe forms. The disorders are caused by chromosomal rearrangements in 3 to 6 percent of cases.

In people with cognitive deficits and with autistic behavior a part of their chromosome 22 is often affected. That region contains the SHANK3 gene.

In all three families identified in the study, the researchers found they had various types of mutations in the gene. Two brothers in one family had small deletions, while another child in a different family had significant deletions.

A girl with a deletion of SHANK 3 in the third family suffered from autism while her brother, who had an additional copy of the gene, had a mild form of autism called Asperger syndrome.

The cause of autism is unknown. It usually develops before the age of 30 months. A minority of autistic children, who are known as autistic savants, show remarkable artistic, musical or mathematical skills.

The protein encoded by SHANK3 interacts with other proteins called neuroligins, which have a role in giving impulses to the brain, spinal column and nerves.

www.reuters.com

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Study: No Evidence Cell Phones Cause Cancer

Summary: Using cell phones, even over a long period of time, does not appear to raise a person's risk for cancer, Danish researchers report. Their study, which appears in today's Journalof the National Cancer Institute, is the first to include people who had used cell phones for as long as 21 years.
Why it's important: Because cell phones emit a type of low-energy radiation, there is concern that using them over a long period of time could lead to cancer, especially in the brain. The growing popularity of cell phones makes it important to learn if this technology actually does have an effect on cancer.

What's already known: Of 16 previous studies looking at cell phone use and brain tumors, only 2 have found any link, says Michael Thun, MD, MS, the
American Cancer Society's vice president of epidemiology and surveillance research. However, the methods used in those 2 studies led many researchers to question the findings. One problem researchers face is that cell phones are relatively new devices, so there aren't a lot of people who have used them for more than about 10 years. It can take longer than that for some cancers to develop, so it's not clear whether using cell phones for more than 10 years might pose a problem.

How this study was done: The Danish researchers tried to address this problem by including people who had begun using cell phones as early as 1982. They looked at cell phone records for more than 420,000 adults in Denmark, and compared those to cancer cases listed in the Danish national cancer registry. They were looking to see if the number of cancer cases among cell phone users was different from what would be expected in the general population. That's a way of finding out whether cell phone users have a higher or lower cancer risk than other people. People who had had cancer before getting a cell phone were excluded from the study.

What was found: The overall number of cancers among cell phone users (14,249) was about the number expected (15,001). Cell phone users did not have a higher risk of brain or central nervous system cancers, salivary gland tumors, eye tumors, or leukemia. This was true even for people who had used cell phones for longer than 10 years. In fact, these long-term users appeared to have a lower risk of brain cancer. The researchers don't have a good explanation for that; they think it might be a chance finding and say more studies are needed.

The bottom line: Thun calls the new findings "reassuring," but not the final answer.

"Because of the widespread use of cell phones, there is an ongoing need to monitor whether risks appear over continuing follow-up," he says. "In the meantime, consumers who are concerned can minimize their exposure by using products with a remote antenna that attaches to their belt or outside the car."

www.cancer.org

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Brain can repair alcohol's damage

LONDON (Reuters) - Excessive drinking can damage brain cells but the brain can repair some of the harm, a team of international researchers said on Monday.
But they warned alcoholics should get sober as quickly as possible because the longer they continue to drink heavily, the less likely their brains will be able to regenerate.

"The core message from this study is that, for alcoholics, abstinence pays off and enables the brain to regain some substance and to perform better," said Dr Andreas Bartsch, of the University of Wuerzburg, in Germany.

Slurred speech, blurred vision and an inability to walk without swaying can occur after a few drinks but chronic alcohol abuse can cause more lasting damage and poor general health.

Research in animals has shown that alcohol can disrupt the development of new brain cells in adults. Heavy drinking during pregnancy can also affect the development of the baby's brain.

Bartsch and scientists from Germany, Britain, Switzerland and Italy uncovered the brain's regenerative ability by measuring the volume, form and function of the brains of 15 alcoholic men and women before and after they stopped drinking to see how much they changed over seven weeks.

Using sophisticated scanning techniques they showed that after 38 days without a drink the brain volume of the patients increased by an average of nearly 2 percent.

"Only the one patient with the longest history of alcohol dependence had a slightly reduced brain volume," said Bartsch, whose findings are reported online by the journal Brain.

The volunteers also performed better in concentration and attention test and had higher levels of chemicals linked to brain cell function.

All of the patients had stopped drinking without medication.

"The human brain, and particularly its white matter, seems to possess genuine capabilities for re-growth," Bartsch said.

www.reuters.com

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Air pollution killer in Asian cities

MANILA (AFP) - Air pollution is killing more than half a million people in Asian cities each year and shows no sign of improving as urban centers expand, studies by the Asian Development Bank show.
A recent ADB conference in Indonesia, was told that air pollution had reached "serious" levels in several Asian cities, with the problem worsening due to increased urbanization and motor vehicle use.

World Health Organization (WHO) expert Michal Krzyzanowski said that the estimate of premature deaths caused by urban air pollution has been revised upwards to over 750,000 globally, including more than 530,000 in Asia.

Experts cited the increase in an air pollutant known as fine particulate matter or PM10 that "enters the lungs and stays there."

PM10 is a result of burning fossil fuels and much of the PM10 in Asian cities is emitted by motor vehicles, the experts said.

"The concentration of the fine particulate matter is serious in Beijing, Dhaka, Hanoi, Ho Chi Minh City, Jakarta, Kathmandu, Kolkata, New Delhi, and Shanghai," the ADB warned in a report.

"There is a strong association between fine particulate matter and health issues in Asia as there is in Europe and the US, but in Asia the concentrations of particulates are much higher," said the report's author, Dieter Schwela.

In many cities, the concentration of PM10 exceeds 70 micrograms per cubic meter. New WHO guidelines say this should be lower than 20 micrograms per cubic meter.

Bringing the level down to the guidelines could lower the number of deaths in polluted cities by as much as 15 percent every year, the WHO said, calling for lower limits of other pollutants such as ozone and sulphur dioxide.

"Asia's growth in population, urbanization, motorization and energy consumption remain key challenges in efforts to counter air pollution. For example, lower emissions from vehicles are counter-balanced by a higher volume of vehicles," the ADB said.

Another ADB study said emerging Asia currently has rather low levels of personal motorized transport, in many cases comprising mainly motorcycles, but these levels are likely to increase drastically as incomes in these countries grow and the urban populations expands.

The Manila-based bank cited China, already the world's fourth-largest economy, where the number of cars and sport utility vehicles could rise by as much as 15 times over the next 30 years to more than 190 million vehicles.

In India, the growth could be as much as 13-fold, it said.

Correspondingly, carbon dioxide emissions could be expected to rise by 3.4 times for China and 5.8 times for India over the same period, the ADB study said.

To help address these problems, the Indonesia conference, attended by representatives of 20 Asian countries, issued a call for a review of air quality standards and air pollution indices all over the region to make them more effective and more comparable to each other.

The conference summary also called for a new "roadmap" for improved fuel quality and emission standards for new vehicles as well as more strategies to control emissions from vehicles that are already on the roads.

Other recommended measures included promoting clean, alternative, renewable energy, encouraging the use of mass public transport systems and even promoting urban housing that lowers energy consumption and emissions.

Mynardo Macaraig
www.afp.com

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